bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perspectives on evidence‐based practice from consumers in the US public mental health system
Authors: Tanenbaum Sandra J. 
Published: September 2010

Abstract
Rationale, aims and objectives  Evidence‐based practice (EBP) is a matter of mental health policy in USA. Supporters find it useful in two forms, as generating a list of approved practices and as providing information to practitioners and consumers engaged in shared decision making. Almost nothing has been written about consumer perspectives on EBP. Given that they play an important role in the second form of EBP, this study explores the range and logic of these perspectives and of related views about the role of information in decision making.
Methods  Four focus groups (n = 38) were held in two settings in a Midwestern state in 2005. Thirty‐nine face‐to‐face semi‐structured interviews were conducted at three settings in 2006. Focus group members and interviewees were seriously mentally ill consumers in the public mental health system. Focus group sessions and interviews were audiotaped and transcribed. Thematic categories and subcategories were analysed.
Results  Focus group members and interviewees varied among themselves and between groups in their responses, but three major thematic categories emerged in both groups – consumers have positive and negative attitudes towards evidence; consumers seek and receive information from multiple sources; and consumers have competing and complementary principles for decision making. Interviews revealed that although real shared decision making is rare, consumers want to and may be involved in decisions about their care.
Conclusions  EBP per se has mostly by‐passed consumers in the public mental health system, but at least some want to be better informed about and more involved in their care. Their misgivings about evidence are reasonable and resonate with the principles of the recovery movement.
Can ‘Cascades’ make guidelines global?
Authors: Fried Michael , Krabshuis Justus 
Published: September 2010

AbstractWhy are guidelines in medicine so important today? What role do they have? Why and how did the World Gastroenterology Organization (WGO) choose a global focus? What does this mean for guidelines? These are the underlying questions addressed by our article. We argue that the addition of ‘Cascades’ to guidelines will increase their impact in large parts of the world. By so doing, we hope to add a new dimension to the ‘knowledge into action’ debate. A number of illustrations shows how raised expectations and resource restrictions pose – or should pose – an enormous challenge for guideline makers. Furthermore, the emphasis on evidence also creates problems for guideline making. If resources are limited it is unlikely gold‐standard technologies are available. We believe Cascades can help.A Cascade is a selection of two or more hierarchical diagnostic or therapeutic options, based on proven medical procedures, methods, tools or products for the same disease, condition or diagnosis, aiming to achieve the same outcome and ranked by available resources.The construction of such a cascade is a hazardous intellectual journey that goes, to some extent, against established practice. But lives can be saved by matching options for diagnosis and treatment to available resources. While the optimal strategy, defined through an evidence‐based approach, should always be the goal, one must be aware of the resource limitations that confront our colleagues in certain parts of the world and we should endeavour to work with them in the guideline development process to develop strategies that are clinically sound yet economically feasible and dacceptable to their populace.
Optimizing clinical practice with case‐based reasoning approach
Authors: Dussart Claude , Pommier Pascal , Siranyan Valérie , Grelaud Gilles , Dussart Sophie 
Published: September 2010

Summary
Rationale and aims  Learning through experience is an important approach that humans employ to comprehend new problems. The knowledge of physicians does not only consist of rules, but of a mixture of textbook knowledge and experience. Medical treatment is facing a challenge of knowledge discovery from the growing volume of information.
Method  Case‐based reasoning (CBR) matches the natural reasoning model of human. This approach is similar to that used by physicians when they are thinking: ‘I have seen a patient like this’, and provides instant recollection of past cases that may be relevant to the present case. In fact, CBR is an approach for solving problems based on solutions of similar past cases. Unlike other forms of reasoning such as rule‐based reasoning, CBR does not draw conclusions by chaining together generalized rules.
Conclusion  The application of CBR to medical databases can be powerful techniques to aid physicians in making decisions about the management of their patients, in various types of medical units. CBR is an effective reasoning strategy for optimizing clinical practice.
Reason, reality and objectivity – shared dogmas and distortions in the way both ‘scientistic’ and ‘postmodern’ commentators frame the EBM debate
Authors: Loughlin Michael 
Published: September 2010

AbstractBoth defenders and certain critics of evidence‐based medicine (EBM) share philosophical commitments – assumptions about the meaning of and relationship between such fundamental concepts as ‘objectivity’, ‘subjectivity’ and ‘rationality’– that frame the debate between them. Critics need to be particularly careful in analysing their own philosophical commitments. Ironically, failure to do so has led some to ground their rejection of EBM in philosophical theses that are less clear and/or more contentious than the reasonable conclusions they wish to defend. There is no need to label ‘objectivity’ a ‘myth’ or ‘scientific method’ an ‘illusion’ in order to identify what is wrong in EBM. Such strategies play into the hands of EBM dogmatists, allowing them to continue to position themselves as the defenders of ‘science’ and ‘reason’.
Systematic review: indicators to evaluate effectiveness of clinical pathways for gastrointestinal surgery
Authors: Lemmens Lidwien , Van Zelm Ruben , Vanhaecht Kris , Kerkkamp Hans 
Published: September 2010

Abstract
Background  A systematic review on clinical pathways for gastrointestinal surgery was performed. The aim was to study indicators that are used to evaluate these clinical pathways and to study which effects of clinical pathways are reported.
Methods  A search was performed for the period from January 2000 to November 2006 in MEDLINE, EMBASE and CINAHL. The Leuven Clinical Pathway Compass was used to categorize the indicators reported in literature.
Results  Twenty‐three studies were selected, of which 16 were controlled studies. The studies assessed most frequently complication rates, re‐admissions, mortality and length of stay. More specific indicators like time to start defecation and time to return to enteral feeding were reported as well. None of the studies reported adverse effects in any of the domains of the Clinical Pathway Compass.
Conclusion  Clinical pathways for gastrointestinal surgery can enhance efficiency of care without adverse effects on outcome. Specific indicators to evaluate these clinical pathways are time to return to enteral feeding and time to defecate. Furthermore, additional to complication rates, number of re‐admissions, mortality and length of stay, indicators such as the number of re‐operations, pain scores and intensive care unit admission can be assessed to monitor effectiveness and patient safety of the clinical pathways.
The radio properties of optically obscured Spitzer sources
Authors: Magliocchetti M. , Andreani P. , Zwaan M. A. 
Published: September 2010

Abstract
This paper analyses the radio properties of a subsample of optically obscured (R≥ 25.5) galaxies observed at 24 μm by the Spitzer Space Telescope within the First Look Survey. Ninety-six F24 μm≥ 0.35 mJy objects out of 510 are found to have a radio counterpart at 1.4 GHz, 610 MHz or at both frequencies, respectively, down to ∼40 and ∼200 μJy. IRAC photometry sets the majority of them in the redshift interval z≃[1–3] and allows for a broad distinction between active galactic nucleus (AGN) dominated galaxies (∼47 per cent of the radio-identified sample) and systems powered by intense star formation (∼13 per cent), the remaining objects being impossible to classify. The percentage of radio identifications is a strong function of 24-μm flux: almost all sources brighter than F24 μm∼ 2 mJy are endowed with a radio flux at both 1.4 GHz and 610 MHz, while this fraction drastically decreases by lowering the 24-μm flux level. The radio number counts at both radio frequencies suggest that the physical process(es) responsible for radio activity in these objects have a common origin regardless of whether the source shows mid-infrared emission compatible with being an obscured AGN or a star-forming galaxy. We also find that both candidate AGN and star-forming systems follow (although with a large scatter) the relationship between 1.4-GHz and 24-μm fluxes reported by Appleton et al. which identifies sources undergoing intense star formation activity. However, a more scattered relation is observed between 24-μm and 610-MHz fluxes. On the other hand, the inferred radio spectral indices α indicate that a large fraction of objects in our sample (∼60 per cent of all galaxies with estimated α) may belong to the population of ultrasteep spectrum sources, typically ‘frustrated’ radio-loud AGN. We interpret our findings as a strong indication for concurrent AGN and star-forming activity, whereby the 1.4-GHz flux is of thermal origin, while that at 610 GHz mainly stems from the nuclear source.
Short‐term paracetamol therapy during pregnancy and a lower rate of preterm birth
Authors: Czeizel Andrew E. , Dudás Istvan , Puhó Erzsébet 
Published: September 2010

SummaryThe relationships between short‐term oral paracetamol treatment during pregnancy and mean gestational age and birthweight, in addition to the prevalence of preterm birth and low birthweight were estimated using newborn infants in the population‐based large dataset of the Hungarian Case‐Control Surveillance of Congenital Abnormalities between 1980 and 1996. Gestational age and birthweight were medically recorded.Of 38 151 newborn infants, 173 were born to mothers who had paracetamol treatment during pregnancy. A 0.4‐week increase in the mean gestational age was found among exposed relative to unexposed, and with the use of paracetamol during pregnancy there was a significant reduction in the proportion of preterm birth (3.5% vs. 9.2%) (adjusted P = 0.01). The possible preterm birth protective effect of paracetamol may be associated with paracetamol‐induced reduction of prostacyclin production in pregnant women. The clinical relevance of these findings needs further studies.
Ethnic differences in congenital malformations in the Netherlands: analyses of a 5‐year birth cohort
Authors: Anthony S. , Kateman H. , Brand R. , Den Ouden A. L. , Dorrepaal C. A. , Van Der Pal‐de Bruin K. M. , Buitendijk S. E. 
Published: September 2010

SummaryCongenital malformations are among the major causes of perinatal mortality and morbidity at present. Research into the ethnic diversity of congenital malformations can form a basis both for aetiological studies and for health care advice and planning. This study compared the overall prevalence of congenital malformations, the prevalence in different organ systems and of several specific malformations between different maternal ethnic groups in the Netherlands using a 5‐year national birth cohort (1996–2000) containing 881 800 births. Maternal ethnic groups considered were Dutch; Mediterranean (Moroccan/Turkish); other European; Black; Hindu and Asian. Mediterranean women had a 20% higher risk of having a child with a congenital malformation than Dutch women (age‐adjusted OR = 1.21 [95% CI 1.16, 1.27]). They showed an increased risk of malformations in several organ systems such as the central nervous system and sensory organs, the urogenital system and skin and abdominal wall. Further, they had an increased risk of the group of chromosomal malformations/multiple malformations/syndromes. For the specific group of multiple malformations the maternal age adjusted OR was 1.80 [95% CI 1.47, 2.20]. The Black group showed a significantly increased risk of skeletal and muscular malformations (age adjusted OR = 1.76 [95% CI 1.53, 2.02]) with a sixfold increased risk of polydactyly compared with the Dutch group. For Mediterranean women, the largest and fastest growing group of immigrants in the Netherlands, this study demonstrated an increased risk of congenital malformations.
Smoking during pregnancy and preterm birth according to obstetric history: French national perinatal surveys
Authors: Nabet Cathy , Ancel Pierre‐Yves , Burguet Antoine , Kaminski Monique 
Published: September 2010

SummaryThe relation between smoking and preterm delivery is not totally known. Our aim was to determine whether smoking during pregnancy was associated with preterm birth among women at different risk according to their obstetric history. The study was based on data from the 1998 French national perinatal survey. Of the 13073 singleton live births, 4.7% were preterm; 15% of the pregnant women were moderate (one to nine cigarettes per day) and 10% heavy smokers (at least 10 cigarettes per day). Smoking heavily was related to preterm birth (crude odds ratio [OR] = 1.35, 95% confidence interval [95% CI]: [1.04, 1.74]). Multivariable logistic regression showed a relation between smoking and preterm birth among multiparae without previous adverse pregnancy outcomes; the associated adjusted ORs (AORs) were 1.25 [95% CI 0.83, 1.87] among moderate smokers and 1.46 [95% CI 0.98, 2.20] among heavy smokers. The corresponding AORs were 0.69 [95% CI 0.46, 1.05]) and 0.96 [95% CI 0.59, 1.56] for primiparae and 1.11 [95% CI 0.63, 1.93] and 0.50 [95% CI 0.25, 0.98] for multiparae with previous adverse pregnancy outcomes. Our study showed a relation between heavy smoking during pregnancy and preterm birth mostly for women with low obstetric risk.
Assessing levels of contaminants in breast milk: methodological issues and a framework for future research
Authors: Renfrew Mary J. , Hay Alaistair M. W. , Shelton Nicola , Law Graham , Wallis Susan , Madden Shelley , Shires Susan , Sutcliffe Anne , Woolridge Michael W. 
Published: September 2010

SummaryTo assess the scale of the possible exposure by the breast‐fed infant to potentially harmful substances in breast milk, methodologically robust studies are essential. Many studies in this field, however, do not report details of crucial issues such as recruitment and milk sampling. The aims of the study reported here were to develop robust methods for the study of contaminants in breast milk, and to develop a framework for future research and population monitoring. Three cohorts of women and babies were recruited by midwives from five sites in northern England. Cohort 1 (cross‐sectional, n = 322) were asked to provide two milk samples, one at one week following birth and one at a subsequent time point. Cohort 2 (longitudinal, n = 54) were asked to provide five samples at specified time points over the first 12–16 weeks after birth. Cohort 3 (convenience, n = 18), mothers of babies in the Special Care Unit, were asked to donate surplus breast milk. A novel method of analysing fat concentration in small volumes was developed and tested. A randomly selected set of samples from different donors and stages of lactation was screened for organochlorine pesticide residues, polychlorinated biphenyls, dioxins/furans, phthalates and heavy metals.A total of 453 samples were donated. Cohort 3 was the least successful route of recruitment. Cohorts 1 and 2 combined were most representative of the population. Sample collection, transport and storage procedures, and the collection of data on life style and diet, were robust and acceptable to women. Midwifery involvement in recruitment was an essential component. This study offers a framework both for the conduct of future research studies, and for the establishment of regional and national monitoring mechanisms for contaminants in breast milk. Similar work on contaminants in formula as fed to babies is needed to inform risk assessment methods.
Practice‐based research network solutions to methodological challenges encountered in a national, prospective cohort study of mothers and newborns
Authors: Finch Stacia A. , Lalama Christina , Spino Cathie , Schwartz Heidi C. , Wasserman Richard C. , McCormick Marie C. , Bernstein Henry H. 
Published: September 2010

SummaryThe emergence of practice‐based research networks (PBRN) has facilitated the execution of multifaceted community‐based studies. As study complexity increases, so does the number of methodological barriers encountered. This paper's goal was to delineate methodological barriers and to evaluate the effectiveness of selected strategies and approaches developed and implemented in allowing a prospective, national PBRN cohort study to succeed in enrolling geographically dispersed mother/healthy term infant dyads (n = 4300) on the day of post‐partum discharge. Specific methodological barriers included: (1) obtaining multiple Institutional Review Board (IRB) approvals; (2) gathering longitudinal data from multiple individuals; (3) soliciting multiple perspectives on discharge decision making; and (4) bolstering minority enrolment. The most effective strategies and approaches we employed to address these methodological challenges were: (1) preparing and distributing the ‘IRB Packet’; (2) recruiting multiple practices covered by the same IRB; and (3) obtaining supplemental funding for increasing minority enrolment. We expect that other PBRN investigators can benefit from our experience and solutions in the successful conduct of this multifaceted community‐based study.
Diet during early pregnancy and development of gestational diabetes
Authors: Radesky Jenny S. , Oken Emily , Rifas‐Shiman Sheryl L. , Kleinman Ken P. , Rich‐Edwards Janet W. , Gillman Matthew W. 
Published: September 2010

SummaryDiet composition may be a modifiable predictor of risk for abnormal glucose tolerance during pregnancy. Prior studies suggest that diets high in total fat, saturated fat, red and processed meats, and with high glycaemic load increase the risk of developing gestational diabetes mellitus (GDM), while polyunsaturated fats, carbohydrates and fibre are protective. The aim of this study was to investigate associations of these and other nutrients and foods, including n‐3 fatty acids, trans fats, whole grains and dietary patterns, with risk of GDM. We studied 1733 women with singleton pregnancies enrolled in Project Viva, a prospective pregnancy and birth cohort study in eastern MA. Using multinomial logistic regression, we examined associations of first trimester diet, assessed by validated food frequency questionnaire, with results of glucose tolerance testing at 26–28 weeks of gestation.A total of 91 women developed GDM and 206 women had impaired glucose tolerance (IGT). Pre‐pregnancy body mass index (BMI) was a strong predictor for GDM risk (OR 3.44 [95% CI 1.88, 6.31] for pre‐pregnancy BMI ≥30 vs. <25 kg/m2). After adjustment for confounders, the OR [95% CI] for risk of GDM for total dietary fat was 1.00 [0.96, 1.05], for saturated fat 0.98 [0.88, 1.08], for polyunsaturated fat 1.09 [0.94, 1.26], for trans fat 0.87 [0.51, 1.49], and for carbohydrates 1.00 [0.96, 1.03] per each 1% of total energy. The adjusted OR [95% CI] for risk of GDM for a one standard deviation increase in energy‐adjusted glycaemic load (32 units, about two soft drinks) was 0.96 [0.76, 1.22] and for each daily serving of whole grains was 0.90 [0.73, 1.13]. Dietary patterns and intake of red and processed meats were not predictive of glucose tolerance outcome. Estimates for IGT were similar to those for GDM. Intake of n‐3 fatty acids was associated with increased GDM risk (OR 1.11 [95% CI 1.02, 1.22] per each 300 mg/day), but not with IGT risk. Except for this finding, perhaps due to chance, these data do not show that nutrient or food intake in early pregnancy is linked to risk of GDM. Nutritional status entering pregnancy, as reflected by pre‐pregnancy BMI, is probably more important than pregnancy diet in development of GDM.
A comparative survey of the neurosecretory cells occurring in the adult brain of several species of Lepidoptera
Authors: HINKS C.F. 
Published: September 2010

SYNOPSISThe types of neurosecretory cell occurring in the adult brain of 23 species of Lepidoptera are described, and their numbers and distribution recorded. A system of classification based on existing descriptions of neurosecretory cells from Lepidoptera and insects from other orders is proposed.
The glandular source and social functions of trail pheromones in two species of ants (Leptogenys)
Authors: FLETCHER D.J.C. 
Published: September 2010

SYNOPSISThe existence of trail pheromones in Leptogenys attenuata and L.nitida is demonstrated, and the glandular source identified. The role of these pheromones in colony emigration and foraging is elucidated.
Simulium berneri Freeman (Diptera: Simuliidae) and its mayfly host (Ephemeroptera: Oligoneuridae)
Authors: DISNEY R.H.L. 
Published: September 2010

SYNOPSISAn analysis is given of collections of Elassoneuria nymphs bearing immature Simulium berneri from the forest zone of West Cameroon near Kumba. The size and sex of the mayfly nymphs, the size and attachment sites of S. berneri and the infestation rates are recorded. The method of dispersion is discussed.
Two phoretic black‐flies (Diptera: Simuliidae) and their associated mayfly host (Ephemeroptera: Heptageniidae) in Cameroon
Authors: DISNEY R.H.L. 
Published: September 2010

SYNOPSISSimulium afronuri and S.lumbwanum are recorded living in association with nymphs of Afronurus in the forest zone of West Cameroon. Observations on infestation rates, attachment sites, larval size distribution and dispersion are recorded. Evidence of niche separation between the two simuliid species is discussed.
Roosting and related activities in some Australian Zygoptera
Authors: O'FARRELL A.F. 
Published: September 2010

SYNOPSISPerching, roosting and early morning activities in Austrolestes annulosus and A.leda (Sympecmatidae) and Ischnura heterosticta (Coenagrionidae) are described and discussed in relation to the general biology of these insects, especially their capacity for physiological colour change.
Feeding behaviour and trypanosomatid infections of some Tabanids and Culicidae in Colombia
Authors: PAGE W. A. 
Published: September 2010

SYNOPSISAn account is given of the feeding activity and biting behaviour of seven species of Tabanidae taken on a bait cow in the field. Trypanosomatid parasites found in these species, and in Mansonia spp. captured on the same bait, are described.
Some factors affecting the site and pattern of leaf‐cutting activity in the ant Atta cephalotes L.
Authors: BARRER P. M. , CHERRETT J. M. 
Published: September 2010

SYNOPSISAn account is given of some aspects of the leaf‐cutting behaviour of the ant Atta cephalotes L. Chemical and physical factors that determine the site of cutting are described, and the significance of these in the pattern of plant attack is discussed.
Studies on the coexistence of three species of Eupteryx (Hemiptera: Cicadellidae) on nettle
Authors: QUESNE W. J. LE 
Published: September 2010

SYNOPSISAn account is given of the relative numbers of adults of three species of Eupteryx, coexisting on nettle, collected regularly over a period of seven years, and possible causes of fluctuations are suggested.
Changes in oxygen uptake and respiratory quotient during post‐embryonic development of the leaf‐insect Phyllium crurifolium Serville (Phasmida: Phylliidae)
Authors: MODDER W. W. D. , SIVARAJAH K. 
Published: September 2010

SYNOPSISRespiratory changes in laboratory stocks of Phyllium crurifolium, from hatching to instar VI, are described. The significance of these changes is discussed.