bluuebunny/crossref_metadata_2025_split huggingface dataset:
Young Women’s Perceived Health and Lifetime Sexual Experience: Results from the National Survey of Family Growth
Authors: Hall Kelli S. , Moreau Caroline , Trussell James 
Published: March 2012

ABSTRACT

Introduction
Sexuality is a component of health and well-being for all women, including adolescents. Yet relationships between young women’s health perceptions and sexual behavior are unclear.

Aim
We examined associations between perceived health and lifetime sexual experiences among young U.S. women.

Methods
We used data from 4,413 young women ages 15–24 years in the National Survey of Family Growth, 2002–2008. Descriptive, bivariate, and multivariate statistics estimated relationships between categories of perceived health and types of lifetime sexual experience.

Main Outcome Measures
A self-rated health Likert item and sexual history questions were administered with a computer-assisted survey instrument.

Results
Young women reported excellent (30%), very good (41%), good (23%), and fair-poor (6%) health. Sexual experiences included vaginal (64%), oral (64%), and anal (20%) sex. Negative experiences included involuntary sex (11%) and sexually transmitted infection (STI) history (8%). In multivariate logistic regression models, lower perceived health (“good” rather than “excellent”) was positively associated with vaginal (odds ratio [OR] 1.5, confidence interval [CI] 1.1–2.1, P = 0.02), oral (OR 1.5, CI 1.1–2.1, P = 0.005), and anal (OR 1.4, CI 1.0–2.0, P = 0.03) sex. In models stratified by age, point estimates for vaginal (OR 1.8, CI 1.2–2.6, P = 0.002) and oral (OR 1.9, CI 1.4–2.6, P &lt; 0.001) sex were higher among adolescents ages 15–19 years, but associations were insignificant among young adults ages 20–24 years. When controlling for negative sexual experiences, point estimates were stable in models including STI history but statistically insignificant when including involuntary sexual experience. Other characteristics associated with sexual experiences varied by type of experience and included age, race/ethnicity, employment situation, poverty level, insurance status, childhood family situation, religious service participation, cohabitation/marital experience, and body mass index.

Conclusions
Further investigation is warranted to disentangle potentially negative relationships between perceived health (as well as response bias and more objective health outcomes), sociodemographic factors, and diverse sexual experiences among young women in the United States.
Extremely low risk for acquisition of a respiratory viral infection in the emergency room of a large pediatric hospital during the winter season
Authors: Maltezou Helena C. , Mougkou Katerina , Asimaki Hara , Koniaraki Katerina , Katerelos Panos , Giannaki Maria , Theodoridou Maria 
Published: March 2012

Please cite this paper as: Maltezou et al. (2012). Extremely low risk for acquisition of a respiratory viral infection in the emergency room of a large pediatric hospital during the winter season. Influenza and Other Respiratory Viruses DOI: 10.1111/j.1750‐2659.2012.00355.x.The aim of this study was to investigate the rate of transmission of respiratory viral infections to children visiting the emergency room of a large pediatric hospital during winter. A total of 615 children were prospectively studied. Twenty‐two (3·6%) children developed at least one symptom compatible with a respiratory viral infection within 1–7 days after the visit, including cough (12 children), fever (8), rhinorrhea (7), and/or respiratory distress (1). Three children (0·49%) developed an influenza‐like illness. These findings indicate that transmission of respiratory viral infections to children visiting an emergency room during the winter season is extremely low.
Comparative Efficacy of Aliskiren/Valsartan vs Valsartan in Nocturnal Dipper and Nondipper Hypertensive Patients: A Pooled Analysis
Authors: Giles Thomas D. , Alessi Thomas , Purkayastha Das , Zappe Dion 
Published: March 2012

J Clin Hypertens (Greenwich). 2012; 14:299–306. ©2012 Wiley Periodicals, Inc.This pooled analysis of ambulatory blood pressure (BP) monitoring data from two 8‐week randomized controlled trials compared the antihypertensive efficacy and safety of combination aliskiren/valsartan vs valsartan alone in hypertensive patients (nocturnal dippers or nondippers). At study end, patients were taking aliskiren/valsartan 300/320 mg or valsartan 320 mg. In dippers (n=138) and nondippers (n=132), aliskiren/valsartan provided significantly (P<.05) greater reductions from baseline to week 8 than valsartan in 24‐hour, daytime, and last‐4‐hour mean ambulatory systolic BP (maSBP). Treatment differences were more pronounced in nondippers. Nighttime maSBP reductions with aliskiren/valsartan were significantly greater vs valsartan in nondippers (−17.0 mm Hg vs −8.9 mm Hg; P<.05) but not dippers (−7.6 mm Hg vs −4.5 mm Hg; P=.16). In all time periods, combination therapy was generally associated with BP reductions that were greater in nondippers than dippers. Conversion from nondipper to dipper status was 32% vs 22% for aliskiren/valsartan vs valsartan (P=.48). Both treatments were similarly well tolerated. Although the addition of aliskiren to valsartan did not significantly alter dipper status, our data suggest an increased contribution of the renin‐angiotensin‐aldosterone system to the nondipper status of hypertensive patients.
Early loading of Astra Tech implants in the lower jaw. I. A comparison between immediate placement of implants in fresh extraction sockets and conventional implant surgery
Authors: Kahnberg K‐E. , Vannas‐Löfqvist L. , Hakeberg M. 
Published: March 2012

AbstractAim:  The aim of the present study was to evaluate early (1–2 weeks) loading of Astra Tech implants in the anterior part of the mandible, between the mental foramina, in a 3‐year clinical and radiological study.Material and methods:  Early loading of Astra Tech Tioblast implants was performed in the lower jaw in 20 patients. Prosthetic loading of the implants was done between 1 and 2 weeks following surgery. The patients were divided in two groups with 10 patients in each group. One group had conventional implant surgery in edentolous mandibles, while in the second group extraction of remaining teeth and immediate placement of implants and early loading was carried out.Results:  Clinical success rate was very high in all cases. However radiological examination showed a slightly inferior outcome after immediate placement in fresh extraction sockets and early loading of the implants with regard to the marginal bone level. There was however no significant difference between the groups.
RapidArc patient specific mechanical delivery accuracy under extreme mechanical limits using linac log files
Authors: Wijesooriya Krishni , Aliotta Eric , Benedict Stanley , Read Paul , Rich Tyvin , Larner James 
Published: March 2012

Purpose:To assess the accuracy of RapidArc (RA) delivery for treatment machine operation near allowable mechanical limits in dynamic multileaf collimator (DMLC) leaf velocities, gantry speeds, and dose rates.Methods:Thirty RA patient plans were created for treatment of lung, gastrointestinal, and head and neck cancers on a Trilogy unit. For each patient, three RA plans were generated; one with medium MLC velocities, highest gantry speeds, and dose rates (case A); one with maximal allowable MLC leaf velocities (case B); and one with lowest gantry speeds (case C). Combinations of dose rates (140–600 MU/min), gantry speeds (2–5.4°/s), and DMLC leaf velocities (1.3–2.4 cm/s) were utilized to test the RapidArc delivery accuracy. Linac delivery log files were acquired after delivery of each plan. In‐house developed software was used to read in the original RapidArc DICOM plan and update the plan to reflect the delivered plan by using the leaf position (L), gantry position (G), and MU dose values (D) extracted from the linac log files. This modified DICOM RT plan was imported back to ECLIPSE and the delivered 3D dose map recomputed. Finally, the planned and delivered 3D isodose maps were compared under three criteria to evaluate the dosimetric differences: maximum percentage dose difference, 3D gamma analysis criteria for 3%/3mm DTA, number of dose voxels having a dose difference that is greater than 1%, 2%, or 3% of the maximum dose, and their respective percentages.Results:For the three cases indicated above, MLC leaf position discrepancies between planned and delivered values are 0.8 ± 0.2, 1.2 ± 0.2, and 0.8 ± 0.2 mm; the maximum gantry position discrepancies are 0.9° ± 0.2°, 0.9° ± 0.2°, and 0.6° ± 0.1°, and the maximum differences in delivered MU per control point are 0.2 ± 0.1, 0.2 ± 0.1, and 0.04 ± 0.01, respectively. Maximum percentage dose difference observed is 6.7%, for a case where 1 cm MLC leaves were used with high MLC leaf velocity. Maximum number (percentage) of dose voxels having a dose difference that is greater than 1%, 2%, and 3% of the maximum dose were 4761 (0.35%), 897 (0.07%), and 188 (0.01%). This also corresponds to the plan utilizing the most number of 1 cm MLC leaves. The 3D Gamma factor acceptance rates are better than 99%.Conclusions:This work shows that the accuracy of RapidArc delivery holds across the full range of gantry speeds, leaf velocities, and dose rates with small dosimetric uncertainties for 0.5 cm MLC leaves. However, caution should be exercised when using large MLC leaves in RapidArc. A novel technique to obtain the delivered 3D dose distributions using machine log files is also presented.
Preferred and actual place of death for patients referred to a specialist palliative care service
Authors: Arnold Liz , Finucane Anne , Mullin Jenny , Oxenham David 
Published: March 2012

IntroductionThe Department of Health's End of Life Strategy promotes high quality care for people approaching the end of life, including supporting patients to die in the place of their choice. Surveys suggest that the majority of the general population would choose to die at home. The authors present data on preferred place of death (PPD) for 1127 patients in contact with specialist palliative care services over a two year period. The authors examine whether preferences of hospice patients differ from those of the general population and whether documenting PPD relates to actual PPD. Methods: PPD data were collected prospectively as part of standard care for all patients referred to Marie Curie Hospice, Edinburgh. Case notes were reviewed retrospectively.Results77% of patients expressed a PPD. 60% chose hospice and 37% chose home; only 3% chose hospital or care home. 85% of patients died in their PPD. The proportion of patients who died in their PPD was higher for those wishing to die at the hospice (93%) compared to those wishing to die at home (72%). 17% of patients who did not express a preference died in hospital, compared to 6% of those with a documented place of death.
Questionnaire surveys of end of life experiences in three Dutch hospices
Authors: Koedam-Visser Ineke , Fenwick Peter 
Published: March 2012

BackgroundA study of End of Life Experiences (ELEs) was carried out in Rotterdam Holland. These experiences seem to comfort the dying and prepare them for death.MethodThirty carers in three hospices who participated in the study were given a 5-year retrospective 42 item questionnaire. 1 year later the then prospective questionnaire was again give to any carers who remained at the hospices. The questionnaires were followed by a 1 h indepth recorded interview, a year apart.ResultsThe results show that ELEs are not uncommonly reported. Deathbed visions were reported by over 70% of carers, deathbed coincidences by 50%, moving to a new reality before death by 55% and radiant light surrounding the body at the time of death by 55%. Interestingly terminal lucidity or ‘lighting up before death’ was only reported by 20% of carers.DiscussionThis paper will report the results of the Dutch study and compare them to those found in two hospices and a nursing home in England using the same questionnaire. In the interviews carers stressed the importance of ELEs in bringing comfort to the dying and particularly in being comforting to the relatives in their grieving. There are marked differences in the teaching of Dutch and English carers, 78% of Dutch carers had been trained in the nature of ELEs compared to only 6% in the English study. Both groups wanted more training in this area and asked for special courses and the production of pamphlets. Staff members in England found more difficulty in discussing ELEs between themselves than those in Holland.
A systematic review exploring factors supporting partnership working between generalist and specialist palliative care services: implications for older people
Authors: Gardiner Clare , Ingleton Christine , Gott Merryn 
Published: March 2012

BackgroundThe care that most people receive at the end of their lives is provided not by specialist palliative care professionals but by generalists such as GPs, hospital staff and others who have not undertaken specialist training in palliative care. Older people in particular are more likely to receive palliative care from generalists. A key focus of recent UK policy is improving partnership working across the spectrum of palliative care provision. However there is little evidence to identify factors which support collaborative working between specialists and generalists, and the implications of collaborative working for older people.AimTo explore factors that support partnership working between specialist and generalist palliative care providers, and the implications for older people and their families.MethodA systematic review of studies relating to partnership working between specialist and generalist palliative care providers was undertaken. Six electronic databases were searched for papers published up until Jan 2011.ResultsOf the 159 articles initially identified, 24 papers met the criteria for inclusion. Factors supporting good partnership working included: good communication between different providers; clear definition of roles and responsibilities; opportunities for shared learning and education; appropriate and timely access to specialist palliative care services; co-ordinated care across a spectrum of care provision.ConclusionMultiple examples of good partnership working between specialist and generalist providers exist, however there is little consistency regarding how models of collaborative working are developed, and which models are most appropriate and effective. Little is known about the direct impact of collaborative working on older patients, and how collaborative working can enhance care for this group. Further empirical work is required to gain the direct perspectives of health professionals and older patients regarding collaborative working in palliative care.
Patient and carer reports of care in metastatic presentation of cancer of unknown primary origin
Authors: Hughes Philippa , Farrington Clare , Brooks David , Bath Peter , Noble Bill 
Published: March 2012

BackgroundPatient and caregiver experiences of cancer of unknown primary (CUP) have been under-researched. Common challenges include diagnostic uncertainty, poor prognosis and difficulty in identifying this population.Aims and methodsAs part of a study to evaluate the development of a CUP team and pathway, we sought patient and carer viewpoints. Patients presenting with metastases of unknown primary origin were invited to complete questionnaires on symptoms, quality of life and care and to participate in semi-structured interviews, during two 6-month periods. A retrospective survey of all bereaved caregivers was conducted, using the VOICES (Views of Informal Caregivers-Evaluation of Services) questionnaire.ResultsDuring two 6-month periods, 88 patients presented with CUP. Median time from presentation to death was 40 days. VOICES was sent to 71 bereaved carers, and 26 (36.6%) responded. Both good and bad care were reported, with primary care settings and hospital settings demonstrating variable practice in communication, control of pain and breathlessness and quality of care. Reports of hospice care were uniformly good. Where carers reported positive experiences of death at home they also reported effective home- care support. Of those patients well enough to be approached, 10 completed questionnaires and four were interviewed. Questionnaire data indicated a considerable symptom burden for some, particularly weakness/tiredness and pain. Interview themes included appreciation of the quality of care received, frustration at waiting for investigations and results, confusion as to who was leading care, distress at communication of bad news and difficulty in accepting the diagnosis of cancer.ConclusionsThis small study highlights the distress experienced, but also demonstrates that good care is achievable. Palliative care has a particular contribution to make not only in optimising symptom control, but in addressing key issues associated with this cancer presentation: co-ordinating investigations and care, and providing skilled communication where diagnosis is uncertain.
What do patients with advanced incurable cancer want from the management of their pain?
Authors: Gibbins Jane , Bhatia Rebecca , Forbes Karen , Reid Colette 
Published: March 2012

AimsPain is one of the most frequent symptoms among patients with metastatic cancer. Measuring the efficacy of the management of pain is challenging. There is currently little in the literature to inform us how patients with advanced incurable cancer determine whether their pain is controlled or not. This study aimed to explore how these patients describe the control of pain.MethodsA qualitative study using face-to-face interviews with patients who had advanced incurable cancer and experienced pain. Data was analysed using the principles of the grounded theory approach.ResultsTwelve patients were interviewed until data saturation was reached; four themes emerged; ‘maintaining role, self and independence’, ‘compromising/modifying expectations’, ‘role of healthcare professionals’ and ‘meaning of pain in context of illness’.ConclusionPatients determined if their pain was ‘controlled’ by whether or not they were able to perform activities or tasks, and maintain relationships with family or friends, which determined themselves as individuals. Participants did not find the use of numerical rating scales useful or meaningful in determining whether they were able to perform these activities or maintain a sense of control and independence. Goal setting for patients with advanced cancer pain may be useful to allow patients to determine what they want from the ‘management’ of their pain. These patient derived outcomes could be useful in clinical practice and research.
Symptom management and its barriers among patients with terminal advanced cancer in Thailand
Authors: Nilmanat Kittikorn , Promnoi Chantra , Phungrassami Temsak , Chailungka Pachariya , Tulathamkit Kandawasri , Noo-urai Prachuap 
Published: March 2012

AimsEffective symptom management is important part of end of life care. It is aimed at improving the quality of dying. The findings presented in this conference are taken from a larger project, the aim of which was to explore the experience of patients living with terminal cancer in southern, Thailand. This presentation reports on one of the main themes under this study's investigation; symptom management and its barriers.MethodA longitudinal qualitative study was conducted. Fifteen patients who had been diagnosed with terminal cancer and 20 caregivers were recruited. Series interviews and observations were employed. Content analysis was applied.FindingsThe common symptoms perceived by patients as most burdensome and distressful were lack of energy, anorexia, pain and dry mouth. Family played a key role in managing symptoms for the dying patients. Symptom management strategies used by family caregivers focused not only on searching for cure by using complementary therapy, but also on managing everyday symptoms based on their beliefs and experiences. The barriers to manage symptoms consisted of attitude and concern about medication and its side effects, lack of knowledge about symptoms and symptom management, patients' wills to live, limited access due to the services system, and communication gaps among persons involved in care (doctor-care giver, care giver-care giver, patient-care giver).ConclusionThe finding from this research will provide a picture of experiences of patients with terminal advanced cancer. Awareness of effects of perceived barriers to symptom management will guide healthcare providers to develop effective interventions to improve quality of life among these patients.
Investigation of the family approach to weight and eating for families affected by cancer cachexia
Authors: Hopkinson Jane 
Published: March 2012

BackgroundWeight loss and anorexia are symptoms of cancer cachexia syndrome. They are experienced by up to 80% of patients with advanced cancer and can be distressing for both patients and their family members. A Post Doctoral Fellowship funded by Macmillan Cancer Support (2008–11) has enabled the development of the first psycho-educational family intervention for cachexia-related problems: the Family Approach to Weight loss and Eating (FAWE).AimTo report a Phase I proof of concept study of FAWE, with scope as defined by the Medical Research Council's guidelines for developing a complex intervention.MethodsThe study was a mixed-methods investigation of the acceptability and feasibility of FAWE, including observation of its benefits and potential harms. The study protocol was completed by 16/20 purposively selected patient-family carer community-dwelling dyads in the South of England in 2010/11. Research interviews, which included the FAWE intervention, were of 30–135 min duration (median 72 min) and conducted in the dyads' homes. A User Involvement Group (consumers, dietitians, clinical psychologists, nurses specialists, family therapists and academics) were engaged across the course of the study, so that expert opinion informed data analysis and refinement of the FAWE intervention.ResultsThe patient-family carer dyads comprised seven female and nine male patients (age range 41–84 years) and their carers. The techniques used in the three step FAWE intervention were observed to facilitate the intended talk, without apparent adverse consequences. Patient-family carer dyads were found accepting of and to express satisfaction with a nurse delivered intervention that provides both information about eating well with cancer cachexia and that aids perspective taking, talk about food and feelings and talk about how family members help each other with cachexia-related problems.ConclusionFAWE should now be tested in a pilot trial for effect on emotional health outcomes in patients and their family carers.