bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methods of synthesizing qualitative research studies for health technology assessment
Authors: Ring Nicola , Jepson Ruth , Ritchie Karen 
Published: October 2011

Objectives: Synthesizing qualitative research is an important means of ensuring the needs, preferences, and experiences of patients are taken into account by service providers and policy makers, but the range of methods available can appear confusing. This study presents the methods for synthesizing qualitative research most used in health research to-date and, specifically those with a potential role in health technology assessment.Methods: To identify reviews conducted using the eight main methods for synthesizing qualitative studies, nine electronic databases were searched using key terms including meta-ethnography and synthesis. A summary table groups the identified reviews by their use of the eight methods, highlighting the methods used most generally and specifically in relation to health technology assessment topics.Results: Although there is debate about how best to identify and quality appraise qualitative research for synthesis, 107 reviews were identified using one of the eight main methods. Four methods (meta-ethnography, meta-study, meta-summary, and thematic synthesis) have been most widely used and have a role within health technology assessment. Meta-ethnography is the leading method for synthesizing qualitative health research. Thematic synthesis is also useful for integrating qualitative and quantitative findings. Four other methods (critical interpretive synthesis, grounded theory synthesis, meta-interpretation, and cross-case analysis) have been under-used in health research and their potential in health technology assessments is currently under-developed.Conclusions: Synthesizing individual qualitative studies has becoming increasingly common in recent years. Although this is still an emerging research discipline such an approach is one means of promoting the patient-centeredness of health technology assessments.
Psychological First-Aid Training for Paraprofessionals: A Systems-Based Model for Enhancing Capacity of Rural Emergency Responses
Authors: McCabe O. Lee , Perry Charlene , Azur Melissa , Taylor Henry G. , Bailey Mark , Links Jonathan M. 
Published: October 2011

AbstractIntroduction: Ensuring the capacity of the public health, emergency preparedness system to respond to disaster-related need for mental health services is a challenge, particularly in rural areas in which the supply of responders with relevant expertise rarely matches the surge of demand for services.Problem: This investigation established and evaluated a systems-based partnership model for recruiting, training, and promoting official recognition of community residents as paraprofessional members of the Maryland Medical Professional Volunteer Corps. The partners were leaders of local health departments (LHDs), faith-based organizations (FBOs), and an academic health center (AHC).Methods: A one-group, quasi-experimental research design, using both post-test only and pre-/post-test assessments, was used to determine the feasibility, effectiveness, and impact of the overall program and of a one-day workshop in Psychological First Aid (PFA) for Paraprofessionals. The training was applied to and evaluated for 178 citizens drawn from 120 Christian parishes in four local health jurisdictions in rural Maryland.Results: Feasibility—The model was demonstrated to be practicable, as measured by specific criteria to quantify partner readiness, willingness, and ability to collaborate and accomplish project aims. Effectiveness—The majority (93–99%) of individual participants “agreed” or “strongly agreed” that, as a result of the intervention, they understood the conceptual content of PFA and were confident about (“perceived self-efficacy”) using PFA techniques with prospective disaster survivors. Impact—Following PFA training, 56 of the 178 (31.5%) participants submitted same-day applications to be paraprofessional responders in the Volunteer Corps. The formal acceptance of citizens who typically do not possess licensure in a health profession reflects a project-engendered policy change by the Maryland Department of Health and Mental Hygiene.Conclusions: These findings are consistent with the conclusion that it is feasible to consider LHDs, FBOs, and AHCs as partners to work effectively within the span of a six-month period to design, promote, conduct, and evaluate a model of capacity/capability building for public mental health emergency response based on a professional “extender” rationale. Moreover, consistently high levels of perceived self-efficacy as PFA responders can be achieved with lay members of the community who receive a specially-designed, one-day training program in crisis intervention and referral strategies for disaster survivors.
Pre‐operative and intraoperative determinants for prolonged ventilation following adult cardiac surgery
Authors: WIDYASTUTI Y. , STENSETH R. , PLEYM H. , WAHBA A. , VIDEM V. 
Published: October 2011

BackgroundProlonged ventilation is a serious complication after cardiac surgery, but few risk prediction models exist. Our objectives were to develop a specific risk prediction model based on pre‐operative variables, to identify whether selected intraoperative variables could improve prediction, and to compare our model with the EuroSCORE.MethodsData from 5027 patients undergoing open‐heart surgery in 2000–2007 were used for logistic regression model development. Internal validation was performed by bootstrapping. Discrimination and calibration were assessed with areas under the receiver operating characteristic curve (AUC) and the Hosmer–Lemeshow test. Our pre‐operative model was compared with predictions based on the additive and logistic EuroSCORE.ResultsAge, previous cardiac surgery, peripheral arterial disease, left ventricular hypertrophy, chronic pulmonary disease, renal insufficiency, pre‐operative hemoglobin concentration, urgent or emergency operation, and operation other than isolated coronary artery bypass grafting were identified as pre‐operative predictors for prolonged ventilation (model I). Discrimination and accuracy were excellent (AUC: 0.848 and shrinkage factor: 94%). Calibration was good (Hosmer–Lemeshow test: P
= 0.43). Inclusion of a few intraoperative variables somewhat improved the model, increasing shrinkage factors (96%) and discrimination ability (AUC model II = 0.870 and model III = 0.875 for two alternative such models). Our pre‐operative model showed better performance than the logistic or additive EuroSCORE.ConclusionsThe pre‐operative risk prediction model for prolonged ventilation with easily obtainable variables in routine clinical work performed well and was only slightly improved by inclusion of intraoperative variables. Performance was better than with the EuroSCORE.
Developing the skill of endotracheal intubation: implication for emergency medicine
Authors: BERNHARD M. , MOHR S. , WEIGAND M. A. , MARTIN E. , WALTHER A. 
Published: October 2011

BackgroundSecuring the airway by means of endotracheal intubation (ETI) represents a fundamental skill for anaesthesiologists in emergency situations. This study aimed to evaluate the time needed by first‐year anaesthesiology residents to perform 200 ETIs and assessed the associated success rates and number of attempts until successful ETI.MethodsThis prospective single centre study evaluated the number of working days, the success rate, the attempts needed until successful ETI in consecutive blocks of 25 ETI procedures and the related difficulties and complications.ResultsFrom 2007 to 2010, 21 residents were evaluated consecutively. These residents needed a mean (mean ± standard deviation) of 15.6 ± 3.0 days for 25 ETIs. Out of all residents 52% reached the target value of 200 ETIs after 50.2 ± 14.8 weeks of total working time. The ETI success rate after the first 25 ETIs increased steadily to the results after 200 ETIs (ETI success rate within one ETI attempt: 67% vs. 83%, P = 0.0001; ETI success rate within all ETI attempts: 82% vs. 92%, P = 0.0001). The number of attempts required until successful ETI decreased from 1.6 ± 0.8 after the first 25 ETIs to 1.3 ± 0.6 after 200 ETIs (P = 0.0001).ConclusionThe increasing rate of relative ETI success and the decreasing rate of necessary attempts for successful airway management suggest a steadily increasing gain in ETI experience. The complications that developed during the first 200 ETI procedures justify supervision by a specialist in the field or a senior physician. Moreover, these results may influence the minimum requirement for qualification in anaesthesiology and emergency medicine.
Oral drug challenges in non‐steroidal anti‐inflammatory drug‐induced urticaria, angioedema and anaphylaxis
Authors: Chaudhry T. , Hissaria P. , Wiese M. , Heddle R. , Kette F. , Smith W. B. 
Published: October 2011

AbstractBackground:  Urticaria, angioedema and anaphylaxis are common adverse reactions to non‐steroidal anti‐inflammatory drugs (NSAIDs).Aim:  To investigate the clinical characteristics of NSAID‐induced acute hypersensitivity reactions with structured oral drug challenges.Methods:  Patients with NSAID‐induced urticaria, angioedema or anaphylaxis were challenged with either the homologous NSAID to confirm diagnosis or a heterologous NSAID to investigate cross‐reactivity. Data were analysed retrospectively and supplemented by a telephone questionnaire.Results:  Sixty‐eight patients (mean age 48.3, 53 females) reported a total of 75 instances of NSAID‐induced reactions of which 64% were purely cutaneous and 36% were systemic anaphylaxis. Ibuprofen was the most frequent cause of reactions (35%), however, diclofenac was the most frequent cause of anaphylaxis (48%). Seventeen out of 40 (43%) homologous NSAID challenges were positive; presentation with anaphylaxis or reaction to diclofenac predicted a positive challenge. Only 7 of 28 (25%) of heterologous NSAID challenges were positive. Structured challenges enabled us to identify 23 (34%) patients with selective reactivity to a single NSAID, 19 (28%) patients with cross‐reactivity to multiple NSAIDs and 23 (34%) patients in whom NSAID hypersensitivity was not reproduced. Selective reactors presented most often with anaphylaxis and some had a background of beta‐lactam antibiotic allergy. Cross‐reactive patients often had a background of chronic urticaria and presented with milder reactions.Conclusion:  In the absence of a reliable in vitro test, structured drug challenges allow identification of selective and cross‐reactive NSAID hypersensitivity syndromes. NSAID‐induced anaphylaxis is often associated with selective hypersensitivity and patients may not need to avoid other NSAIDs.
Positive spillover effects of prescribing requirements: increased cardiac testing in patients treated with trastuzumab for HER2+ metastatic breast cancer
Authors: Lu C. Y. , Srasuebkul P. , Drew A. K. , Ward R. L. , Pearson S.‐A. 
Published: October 2011

AbstractBackgroundCardiotoxicity is a concern in patients on trastuzumab therapy, and cardiac function assessment is a recommended practice. In 2006, trastuzumab was publically subsidised for human epidermal growth factor receptor‐2 early stage breast cancer with a requirement for cardiac testing prior to and during treatment.AimTo investigate the spillover effects of this requirement on testing rates in metastatic patients treated with trastuzumab where no monitoring requirements are applied.MethodsWe examined cardiac testing (echocardiography or multiple‐gated acquisition scan) in 3779 women with metastatic breast cancer receiving trastuzumab between December 2001 and February 2010 and used interrupted time‐series analyses to estimate changes in testing rates. The main outcome measures were the proportion of eligible patients, by quarter, receiving a cardiac function test pretreatment and during trastuzumab therapy.ResultsOnly 21% of women had a cardiac function test pretreatment, and 47% were tested at some point during the first year of trastuzumab therapy. The introduction of mandatory cardiac testing for early breast cancer was associated with an immediate 8% increase (95% confidence interval, 2–14%) in pretreatment cardiac testing and an immediate 7% increase (95% confidence interval, 4–10%) in testing during therapy in metastatic patients. Testing rates during therapy increased steadily from early 2005, coinciding with the release of interim results from several trastuzumab trials reporting cardiac‐safety outcomes.ConclusionThe introduction of mandatory cardiac testing for early stage disease spilled over to the metastatic setting. While deviation from guidelines may be warranted in some cases, this study suggests underutilisation of cardiac testing among patients treated with trastuzumab in the metastatic setting.
U‐100, pH‐Neutral formulation of VIAject®: faster onset of action than insulin lispro in patients with type 1 diabetes
Authors: Heinemann L. , Nosek L. , Flacke F. , Albus K. , Krasner A. , Pichotta P. , Heise T. , Steiner S. 
Published: October 2011

Aims: VIAject® is a formulation of human insulin with a very fast onset of action. Previous studies used VIAject in a concentration of 25 U/ml and a pH of 4 [VIAject 25 (VJ25)]. Objective of this double blind, three‐way crossover study was to compare the pharmacodynamic/pharmacokinetic properties of a novel formulation of VIAject with a concentration of 100 U/ml and a neutral pH [VIAject 7 (VJ7)] with VJ25 and insulin lispro (LIS).Methods: Forty‐three patients with type 1 diabetes [aged 43 (21–65) years, BMI 24.1 (20–28) kg/m2 and HbA1c 7.5 (5.7–9.5) %] participated in this study. They received subcutaneous injections of 12 U of each insulin formulation under euglycaemic glucose clamp conditions.Results: VJ7 was bioequivalent to VJ25 [90% confidence interval (CI) of the ratios for total insulin AUCs and maximum insulin concentration (CINS max) was within 0.80–1.25]. VJ7 showed a faster absorption compared to LIS [time to CINS max 23 vs. 60 min; difference (CI) −30 (−35 to −23)] and faster onset of action [time to early half‐maximal glucose infusion rate (GIR) 25 vs. 44 min; −18 (−26 to −10)], and a higher AUC of glucose infusion rate (AUCGIR) in the first 60 min after injection [176 vs. 107 mg/kg; ratio 1.65 (1.27 to 2.14)], contributing to a slightly higher value for AUCGIR 0–480[1263 vs. 1095 mg/kg; 1.15 (1.06 to 1.26)]. Maximum GIR was similar between VJ7 and LIS [6.1 vs.6.6 mg/kg/min; ratio 0.93 (0.86 to 1.01)], whereas the duration of action (tGIR50%–late) was longer with VJ7 [274 vs. 228 min; 50 (25 to 73)].Conclusions: This formulation of VIAject is bioequivalent to the previously used formulation and has a faster absorption/onset of action than LIS.
The International Effects of China’s Growth, Trade and Education Booms
Authors: Harris Richard G. , Robertson Peter E. , Xu Jessica Y. 
Published: October 2011

AbstractChina’s international trade flows have increased by 500 per cent since 1992, far outstripping GDP growth. Likewise tertiary education enrolments have increased by 300 per cent. We simulate these changes using a multi‐sector growth model of the Chinese and USA economies. A decade of trade biased growth in China is found to raise USA GDP by approximately 3–4.5 percentage points and has a large impact on the demand for tertiary education in China. Despite these positive effects of growth, the results suggest that the expansion of China’s education sectorper sehas practically no long‐run impact on the USA economy.
Can perceptual learning be used to treat amblyopia beyond the critical period of visual development?
Authors: Astle Andrew T , Webb Ben S , McGraw Paul V 
Published: October 2011

Citation information: Astle AT, Webb BS & McGraw PV. Can perceptual learning be used to treat amblyopia beyond the critical period of visual development? Ophthalmic Physiol Opt 2011, 31, 564–573. doi: 10.1111/j.1475‐1313.2011.00873.xAbstractBackground:  Amblyopia presents early in childhood and affects approximately 3% of western populations. The monocular visual acuity loss is conventionally treated during the ‘critical periods’ of visual development by occluding or penalising the fellow eye to encourage use of the amblyopic eye. Despite the measurable success of this approach in many children, substantial numbers of people still suffer with amblyopia later in life because either they were never diagnosed in childhood, did not respond to the original treatment, the amblyopia was only partially remediated, or their acuity loss returned after cessation of treatment.Purpose:  In this review, we consider whether the visual deficits of this largely overlooked amblyopic group are amenable to conventional and innovative therapeutic interventions later in life, well beyond the age at which treatment is thought to be effective.Recent findings:  There is a considerable body of evidence that residual plasticity is present in the adult visual brain and this can be harnessed to improve function in adults with amblyopia. Perceptual training protocols have been developed to optimise visual gains in this clinical population. Results thus far are extremely encouraging; marked visual improvements have been demonstrated, the perceptual benefits transfer to new visual tasks and appear to be relatively enduring. The essential ingredients of perceptual training protocols are being incorporated into video game formats, facilitating home‐based interventions.Summary:  Many studies support perceptual training as a tool for improving vision in amblyopes beyond the critical period. Should this novel form of treatment stand up to the scrutiny of a randomised controlled trial, clinicians may need to re‐evaluate their therapeutic approach to adults with amblyopia.
Risk factors for microbial contamination of peripheral blood stem cell products
Authors: Donmez Ayhan , Aydemir Sohret , Arik Bahar , Tunger Alper , Cilli Feriha , Orman Mehmet , Tombuloglu Murat 
Published: October 2011

BACKGROUND: Despite the well‐known contamination rates and presence of microbial agents in stem cell products, the risk factors affecting microbial contamination have not been well described.STUDY DESIGN AND METHODS: In a 12‐year period, we retrospectively reviewed culture results of peripheral blood stem cell products with the intent of identifying risk factors for microbial contamination.RESULTS: Microbial contamination was detected in 28 (5.7%) products of the postprocessing period and in 18 (3.66%) products of the postthawing period. Large‐volume leukapheresis (LVL; odds ratio [OR], 5.85; 95% confidence interval [CI], 1.52‐22.49; p = 0.01) and high numbers of stem cell culture sampling (OR, 1.4; 95% CI, 1.03‐1.91; p = 0.03) were found to be risk factors for postprocessing bacterial contamination. The presence of postprocessing bacterial contamination was a risk factor for postthawing (OR, 28.89; 95% CI, 6.67‐125.15; p < 0.001) and posttransplant (OR, 3.25; 95% CI, 1.24‐8.50; p = 0.01) microbial growth. In transplants that were performed using contaminated products, the same pathogen was detected in 20% of patients and different pathogens were found in 35% of patients.CONCLUSION: Cultures should be carefully monitored in LVL products and in samples with high numbers of cultures performed. Growth of different bacterial pathogens must be considered in transplants that are performed with contaminated products.
Lipoic acid and moderate swimming improves the estrous cycle and oxidative stress in Wistar rats
Authors: Martins Rand Randall , de Oliveira Macedo Ulisvaldo Brunno , Leite Lúcia Dantas , Rezende Adriana Augusto , Brandão-Neto José , Almeida Maria das Graças 
Published: October 2011

The generation of reactive oxygen species resulting from physical activity may trigger adaptive processes at the reproductive level and in the antioxidant defense system itself. The objective of this study was to investigate the effects of moderate daily swimming and lipoic acid (LA) supplementation on estrous cycle duration and pro-oxident and antioxidant markers in young Wistar rats. Animals were submitted to daily swimming (for 1 h) for 30 days, between 1300 h and 1400 h. The following study groups were formed: group 1, sedentary; group 2, submitted to swimming; group 3, sedentary supplemented with 100 mg·kg–1·day–1 of LA; and group 4, submitted to swimming and supplementation with 100 mg·kg–1·day–1 of LA. The estrous cycle of the animals was evaluated daily, and the following oxidative stress markers were measured: plasma thiobarbituric acid reactive substances (TBARS) and glutathione (GSH), erythrocyte superoxide dismutase (SOD), GSH peroxidase (GPx) and catalase (CAT) activity. The exercise protocol increased estrous cycle duration in group 2, especially in the diestrous phase. There was also a decrease in lipoperoxidation, with enhanced antioxidant activity of SOD and GPx. Group 4 showed no alteration in estrous cycle duration and maintained the beneficial effects on the antioxidant system observed in group 2. The increase in estrous cycle duration and improved oxidative stress markers may be an adaptive response to moderate exercise. LA impeded any exercise-induced alteration in the cycle but preserved improvements in the antioxidant system.
Inhibitory effect of a tyrosine-fructose Maillard reaction product, 2,4-bis(p-hydroxyphenyl)-2-butenal on amyloid-β generation and inflammatory reactions via inhibition of NF-κB and STAT3 activation in cultured astrocytes and microglial BV-2 cells
Authors: Lee Young-Jung , Choi Dong-Young , Choi Im Seup , Han Jin-Yi , Jeong Heon-Sang , Han Sang Bae , Oh Ki-Wan , Hong Jin Tae 
Published: October 2011

Abstract

Background
Amyloidogenesis is linked to neuroinflammation. The tyrosine-fructose Maillard reaction product, 2,4-bis(p-hydroxyphenyl)-2-butenal, possesses anti-inflammatory properties in cultured macrophages, and in an arthritis animal model. Because astrocytes and microglia are responsible for amyloidogenesis and inflammatory reactions in the brain, we investigated the anti-inflammatory and anti-amyloidogenic effects of 2,4-bis(p-hydroxyphenyl)-2-butenal in lipopolysaccharide (LPS)-stimulated astrocytes and microglial BV-2 cells.

Methods
Cultured astrocytes and microglial BV-2 cells were treated with LPS (1 μg/ml) for 24 h, in the presence (1, 2, 5 μM) or absence of 2,4-bis(p-hydroxyphenyl)-2-butenal, and harvested. We performed molecular biological analyses to determine the levels of inflammatory and amyloid-related proteins and molecules, cytokines, Aβ, and secretases activity. Nuclear factor-kappa B (NF-κB) DNA binding activity was determined using gel mobility shift assays.

Results
We found that 2,4-bis(p-hydroxyphenyl)-2-butenal (1, 2, 5 μM) suppresses the expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) as well as the production of nitric oxide (NO), reactive oxygen species (ROS), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) in LPS (1 μg/ml)-stimulated astrocytes and microglial BV-2 cells. Further, 2,4-bis(p-hydroxyphenyl)-2-butenal inhibited the transcriptional and DNA binding activity of NF-κB--a transcription factor that regulates genes involved in neuroinflammation and amyloidogenesis via inhibition of IκB degradation as well as nuclear translocation of p50 and p65. Consistent with the inhibitory effect on inflammatory reactions, 2,4-bis(p-hydroxyphenyl)-2-butenal inhibited LPS-elevated Aβ42 levels through attenuation of β- and γ-secretase activities. Moreover, studies using signal transducer and activator of transcription 3 (STAT3) siRNA and a pharmacological inhibitor showed that 2,4-bis(p-hydroxyphenyl)-2-butenal inhibits LPS-induced activation of STAT3.

Conclusions
These results indicate that 2,4-bis(p-hydroxyphenyl)-2-butenal inhibits neuroinflammatory reactions and amyloidogenesis through inhibition of NF-κB and STAT3 activation, and suggest that 2,4-bis(p-hydroxyphenyl)-2-butenal may be useful for the treatment of neuroinflammatory diseases like Alzheimer's disease.