Miracle-dz/UniFAR-FTUs huggingface dataset:
A critical review of the effectiveness of environmental assessment and modification in the prevention of falls amongst community dwelling older people

Introduction The potential of environmental assessment and modification to reduce falls has recently received attention within the gerontology literature. Research investigating the clinical effectiveness of this intervention in falls prevention reports conflicting results. Discrepancies are due to variation in the risk profile of study participants and the health care background of the person providing the environmental intervention or the intensity of the intervention provided. Method The purpose of this paper is to compare and contrast two systematic reviews, which include meta-analyses, of environmental interventions for falls prevention in community dwelling older people, using the critical appraisal skills programme tool for systematic reviews. Findings Both reviews found that: environmental assessment and modification was effective in falls prevention; intervention was effective with high but not low risk participants; and that high intensity environmental assessment was effective, whereas low intensity intervention was not. Environmental interventions which were delivered by occupational therapists were deemed high intensity, probably because their underpinning theoretical frameworks focus on the impact of the environment on function. Conclusion We discuss possible reasons why occupational therapist led environmental assessment and modification is clinically effective in falls prevention, for people at high risk of falls, whereas non occupational therapist led intervention is not.
Facial Growth in Adulthood after Primary Periosteoplasty or Primary Bone Grafting in UCLP

Objective: The primary research aim of this study was to compare long-term differences in craniofacial morphology at adulthood between two groups of unilateral cleft lip and palate (UCLP) patients: one operated by primary periosteoplasty and the other by primary bone grafting. Design: The two groups were followed longitudinally at 5-year intervals; this study examined the 15to 20-year age range. Setting: University hospital/center located in Prague, Bohemia, Czech Republic. Patients: 17 men with primary bone grafting, 29 men with primary periosteoplasty. Interventions: Primary bone grafting or periosteoplasty. Methods: Serial cephalometric radiographs. Main outcome measures: Conventional cephalometric and finite element measures. Results: The mandibular symphysis was larger in the bone-grafted group. The periosteoplasty group displayed a more horizontal growth of the mandible with less rotation than the bone-grafted group. There were no other significant differences. Conclusions: We conclude that the original outcomes differences observed in childhood and adolescence were masked by skeletal and dental compensations in adulthood. These observations can be attributed to both natural growth and clinical intervention.
Medical Genetics on the Cleft Palate–Craniofacial Team: Understanding Parental Preference

Objective This study examined health care professionals' perceptions of parental preferences and preferences of parents of affected children (cleft lip, cleft palate, both, or other craniofacial anomaly) for prenatal testing with respect to oral-facial clefts and craniofacial anomalies. Design This was a descriptive study assessing and comparing questionnaire responses of two independent groups. Participants Healthcare professional participants comprised 570 U.S. members of the American Cleft Palate–Craniofacial Association. Parent participants comprised 97 parents of children seen at the University of Pittsburgh Cleft Palate–Craniofacial Center. Main outcome Measures A practitioner survey was developed to examine practitioner perception of parental desire for involvement, desire for knowledge, and reaction to learning of a birth defect. A parent survey was developed to correspond with the practitioner survey. Results Health professionals' perceptions of parental preferences often paralleled parental preference data. However, parental responses were found to be significantly different from practitioner perception of parental preferences on one question reflecting desire for involvement (x2 = 33.35, df=1, p = .001) and on one question reflecting desire for knowledge (x2 = 4.82, df =1, p = .03). For both questions, higher percentages of parents responded that they would want this involvement or information. Conclusions Findings are consistent with those reported In other studies of prenatal testing preferences and susceptibility. Results suggest that parents of affected children have a strong desire for information and involvement in prenatal testing and counseling decisions. Parents appear to value preparation in spite of acknowledging anxiety associated with prenatal information.
The Relationship between Arch Dimensions and the 5-Year Index in the Primary Dentition of Patients with Complete UCLP

Objective: To compare dental arch dimensions of children in the primary dentition with repaired unilateral clefts of the lip and palate (UCLP) to a noncleft group of a similar age and determine how the dimensions of the cleft arches relate to an index of treatment outcome. Method: Dental study casts of 44 5to 6-year-olds with complete UCLP (22 boys and 22 girls) from a single center, whose primary surgery had been carried out by one surgeon, were matched for age, sex, and ethnicity with dental study casts from a longitudinal growth study. Analysis of variance was used to ascertain differences in arch dimensions between the two groups. The cleft group casts were then assessed with an established index of surgical outcome, the 5-year-old index. Spearman’s rank correlation coefficient was used to see how the arch dimensions of the cleft group related to the categories of the index. Results and Conclusions: Maxillary arch dimensions were significantly smaller in the cleft group than in the noncleft group, irrespective of sex (p , .05). In the mandibular arch, there was no difference between the cleft and noncleft groups (p . .05). Maxillary arch dimensions of the cleft group correlated significantly with the 5-year-old index for arch length and intercanine width (p , .05) but not intermolar width (p 5 .842). This would suggest that the 5-year-old index is a suitable tool for assessing the outcome of treatment in the primary dentition for anteroposterior and anterior transverse arch dimensions.
The profile and outcomes of stroke patients discharged from a hospital In the Eastern Cape

Stroke is the third leading cause of death and disability worldwide. The Uitenhage Provincial Hospital admits many stroke patients. To date, no in-depth study has been conducted on stroke patients admitted to the Hospital. This study identified the profile of stroke patients admitted to the Uitenhage Provincial Hospital and explored the challenges that these patients experienced post stroke. A concurrent mixed model design was used to collect the data. Firstly retrospective data was obtained by means of a quantitative data gathering instrument designed by the researcher. The information obtained, included data relating to demographic characteristics, reported risk factors relating to stroke, stroke onset-admission interval and length of hospital stay, as well as information relating to the process of physiotherapy. Secondly quantitative prospective information was collected by means of the Barthel Index, the Modified Rankin Scale and the Facilitators And Barriers Survey. The sample for the quantitative phase was drawn from medical records of 168 stroke patients admitted to the Uitenhage Provincial Hospital from the 1 of January 2008 up to and including the 31 of December 2009. For the second prospective quantitative part of the study, participants were selected conveniently from the admitted patients. In the qualitative phase, nine participants taken of the sampled participants were selected. The Microsoft Excel 2007 Package and the SPSS 18 for social sciences were used to analyse the quantitative data. Means, standard deviations, frequencies and percentages were calculated for descriptive purposes and the Chi-square test was used to test for associations between variables. Qualitative analysis began with the transcription of voice recordings and the translation of relevant Afrikaans transcription into English. Emerging categories were identified within the pre-
Learning Disability, School Achievement, and Grade Retention among Children with Cleft: A Two-Center Study

Objective: This study examined the prevalence of learning disability (LD), level of school achievement; and prevalence of grade retention by type of cleft and gender at two craniofacial centers. Setting: The setting included two university-based craniofacial centers. Design/Patients: Participants included 84 consecutively evaluated patients from one center who were matched by cleft type, age, and gender with 84 patients evaluated at the second center. Outcomes: The outcomes included learning disability, school achievement, and grade retention. Results: The results revealed that 46% of subjects with cleft had LD, 47% had deficient educational progress, and 27% had repeated a grade (excluding kindergarten) in school. Males with cleft palate only (CPO) had a significantly higher rate of LD than any other subject group. Males with CPO and females with cleft lip and palate (CLP) were more likely to repeat a grade in school than were females with CPO and males with CLP. Conclusions: Children with cleft are at risk for learning disability, low school achievement, and grade retention.
Incidence of Secondary Lip Surgeries as a Function of Cleft Type and Severity: One Center's Experience

Objective: This study was conducted to ascertain the frequency of surgeries typically required to adequately repair a cleft lip. Material: All operations performed on patients with clefts of the lip (alveolus and palate) from 1968 to 1990 in the Rostock Cleft Center were evaluated. Methods: Procedures were classified as primary labioplasties versus secondary revisions. Patients were also classified according to cleft type, the anatomical segment revised, and the reason for lip revision. Two indices were calculated. The revision index related the number of revisions to the number of primary labioplasties. The index of indication related the number of patients with revisions to the number of primary labioplasties. Results: During the period of study, 712 primary labioplasties and 771 secondary revisions were performed. The overall revision index was 1.10. The index of indication varied from 0.28 for unilateral complete clefts of the lip to 0.67 for bilateral complete clefts of the lip. Revision of the lip was the most common secondary procedure, followed by nostril and columella revision, and revision of the oral vestibule. Conclusions: The incidence of secondary surgery of the repaired cleft lip (index of indication) of about 35% is similar to previously reported data. However, the incidence varies with cleft type and is required more often with bilateral complete clefts of the lip.
Quantitative Description of the Morphology of the Human Palate by a Mathematical Equation

Objective: To derive a three-dimensional mathematical description of normal human hard tissue palatal size and shape. Methods: The maxillary dental casts of 30 adolescents free from respiratory problems, who had a complete (28 teeth) permanent sound dentition with normal occlusion, were studied. The x, y, z coordinates of several standardized palatal and dental landmarks were obtained with a computerized three-dimensional digitizer. Palatal landmarks were used to derive a mathematical equation of palatal shape in the frontal and sagittal planes. Palatal width, length, frontal and sagittal heights, and sagittal slope, as well as dental arch transverse and anteroposterior dimensions, were computed. Results: Neither the size nor the shape of the palate was significantly influenced by gender. Only the intercanine distance was larger (p , .025) in males than in females. Conclusions: Data collected in the present investigation could represent a first database for the quantitative description of normal human palatal morphology in subjects with a complete permanent dentition.
Cranial Base Growth and Morphology in Second-Trimester Normal Human Fetuses and Fetuses with Cleft Lip

Objective: The present radiographic study describes the size and shape of the cranial base from the sagittal aspect for a sample of 77 second-trimester ‘‘normal’’ control fetuses (n 5 61) and fetuses (n 5 16) exhibiting isolated, unilateral clefts of the lip (CL), ranging in fertilization age from 10 to 22 weeks. Methods: Fetuses were placed in a cephalostat, and standardized, lateral head radiographs were taken. The radiographs were traced, and 15 cephalometric landmarks were identified and digitized for analysis. Growth curves for cranial base lengths, angles, and areas were compared between control and CL groups. Also, cranial base triangles were constructed and shape comparisons were made using tensor biometric analysis. Results: No significant differences (p . .05) in regression line slopes were noted for any comparisons between the control and CL samples. Tensor biometric analysis also revealed no significant differences in the shapes of various cranial base triangles between the control and CL samples. Conclusion: This report presents second-trimester baseline growth curves for various cranial base components in CL human fetal specimens, and these data suggest that CL fetuses may also be used as an appropriate control sample for prenatal growth comparison studies of cleft lip and palate and cleft palate.
Purkinje Cells

Purkinje cells [5], also called Purkinje neurons, are neurons in vertebrate animals located in the cerebellar cortex of the brain. Purkinje cell bodies are shaped like a flask and have many threadlike extensions called dendrites, which receive impulses from other neurons called granule cells [6]. Each cell also has a single projection called an axon, which transmits impulses to the part of the brain that controls movement, the cerebellum [7]. Purkinje cells [5] are inhibitory neurons: they secrete neurotransmitters that bind to receptors that inhibit or reduce the firing of other neurons. Purkinje cells [5] were the first neuronal cells identified. Researchers study the embryonic development of Purkinje cells [5] to elucidate how they function in various mechanisms in the body.
Parental Perspectives of Children Born with Cleft Lip and/or Palate: A Qualitative Assessment of Suggestions for Healthcare Improvements and Interventions

Objective To assess parental perspectives on effective interventions and to summarize parents’ suggestions for health care professionals to improve the care provided to their children born with cleft lip and/or palate. Design Qualitative interviews. Setting Comprehensive craniofacial center at a Midwest pediatric hospital. Participants Seventeen parents of children under the age of 1 who were born with CL/P. Results Interventions that parents identified as effective included repetition of information, showing pictures of other children (before and after surgery), and anticipatory guidance about surgeries and their child's development. Despite the high level of satisfaction, parents expressed a desire for health care professionals to use more written and visual information, to have more contact with other parents of children born with clefts, and for health care professionals outside the Craniofacial Center to be more knowledgeable about CL/P. Conclusions Although parents of children with CL/P were for the most part satisfied with their children's care, the parents who were interviewed for this study suggested attainable changes that may result in more constructive and positive involvement of parents as integral members of the craniofacial team.
Longitudinal Study on the Changes of Maxillary Arch Dimensions in Japanese Children with Cleft Lip and/or Palate: Infancy to 4 Years of Age

The focus of this study was an analysis of maxillary arch growth changes prior to the time of cheiloplasty up to 4 years of age. Serial dental casts were obtained and measured in 95 children with cleft lip and palate, or both: 7 unilateral cleft lip and alveolus (CLA), 52 unilateral cleft lip and palate (UCLP), 24 bilateral cleft lip and palate (BCLP), and 12 isolated cleft palate (CP). The children were treated at the Kyushu University Dental Hospital. The results are as follows: (1) Prior to cheiloplasty, the maxillary buccal segments in the subjects with cleft lip and palate showed lateral displacement. The premaxilla in BCLP subjects was protruded. (2) Cheiloplasty influenced maxillary anterior arch width, but not posterior width. The operation caused posterior displacement of the premaxilla in BCLP subjects. (3) Palatoplasty affected the growth of the maxillary arch in the transverse and anteroposterior dimensions. (4) A variety of growth patterns observed in the patients (e.g., increasing or decreasing of the maxillary arch dimensions) suggests that maxillary arch dimensions were affected not only by surgery, but also by other individual factors such as genetic facial pattern and severity of the cleft.
Type 2 diabetic patients compliance with drug therapy and glycaemic control

Introduction. It has been shown that despite effective methods of treatment 50% of diabetic patients fail to achieve satisfactory glycaemic control, which leads to accelerated development of complications and increased mortality. Clinical experience indicates that no improvement of metabolic control is possible without patient compliance. The aim of our study was to evaluate the effects of age, sex, educational background, duration of diabetes, dosage regimens of oral antidiabetics, insulin therapy, level of patient independence, family support, co-morbidities, treatment at outpatient diabetes clinics and patient knowledge of diabetes and its complications on compliance with drug therapy and the maintenance of glycaemic control by patients with type 2 diabetes mellitus. Material and methods. The study enrolled 200 patients (124 women and 76 men) managed at three general wards and four outpatient facilities in the £od¼ region. The evaluationwas based on a 50-item questionnaire developed specifically for the purposes of the study. Results. In the study population, the most important factors affecting patient compliance with drug therapy included: patient knowledge about the treatment of diabetes (P = 0.005; OR, 13.89), insulin therapy (P = 0.027; OR, 0.26) and other people’s support (P = 0.010; OR, 0.14), while the most important factors affecting patient compliance with the recommendations concerning glycaemic control were: age below 65 years (P = 0.027l; OR, 0.35), insulin therapy (P = 0.001; OR, 0.26) and treatment at outpatient diabetes clinics (P = 0.003; OR, 0.25). Conclusions. Our study has demonstrated unsatisfactory compliance with drug therapy and glycaemic self-control in the study population. An improvement with this respect may be achieved though continuing patient education about diabetes.
Factors Related to Relapse after Le Fort I Maxillary Advancement Osteotomy in Patients with Cleft Lip and Palate

Objective: To identify factors associated with relapse after maxillary advancement in cleft lip and palate patient. Subjects: Seventy-one cleft lip and palate patients underwent Le Fort I maxillary advancement osteotomy between 1988 and 1998, and 58 patients (42 unilateral cleft and 16 bilateral cleft) with complete data were investigated for relapse by clinical and cephalometric analysis. The clinical follow-up period ranged from 1.5 to 8.5 years (mean 2.5 years). Results: Horizontal advancement averaged 6.9 mm. There was a significant correlation between surgical movement and postoperative relapse in both the horizontal and vertical planes. In vertical repositioning, 15 patients had maxillary intrusion and 31 had inferior repositioning. There was a significant difference between the intrusion group and the inferior repositioning group. There was a significant correlation between surgical and postoperative rotation regardless of the direction. Other factors were evaluated by the horizontal relapse rate. Type of cleft and the rate of relapse were statistically associated. A relapse was more likely to occur in patients with bilateral cleft. There were no significant associations with the rate of relapse in type of operations or previous alveolar bone grafting. There was no significant correlation between the rate of relapse and the number of missing anterior teeth, postoperative overbite and overjet, and age at operation. Four of 71 patients experienced major relapse, and 3 of them underwent jaw surgery again. Conclusions: Based on clinical and cephalometric analysis, two-jaw surgery should be performed in cases of severe maxillary hypoplasia, and overcorrection may be useful in inferior repositioning or surgical rotation. Special attention should be paid to the patient with bilateral cleft, multiple missing teeth, or shallow postoperative overbite.
Clinico-etiological profile and outcome of hyponatremia in hospitalised adult patients

Background: Hyponatremia is a common electrolyte abnormality in hospitalised patients. Incidence varies from 1% to 40%. It is common in the elderly, mainly owing to impaired water and electrolyte balance in response to diet, drugs and environmental changes. This study is to evaluate clinical features, aetiologies and outcome in patients with hyponatremia (Sr. Na <120 mmol/L at the time of admission). Methods: An observational study was conducted in 76 patients admitted in Kamalnayan Bajaj Hospital, Aurangabad from August 2013 to August 2014. All patients having their serum sodium concentration less than 120 mmol/L were included in the study. History, examination and relevant details were taken. Outcome was noted. Student’s t-test, chi square test and Fisher’s exact test were applied for statistical analysis. Results: In the present study, mean age of the patients was 59.4% years. 43% patients were euvolemic, 38% hypervolemic and 19% hypovolemic. Nausea (54%) was most common gastrointestinal while drowsiness (42%) was the most common neurological symptom. Etiology of hyponatremia was multifactorial in 76% cases. Use of diuretics (53%) was the most common etiological factor. SIADH was suspected in nine patients. Mortality was 21%. Most common comorbid conditions were hypertension (51%) and diabetes mellitus (42%). Conclusions: Hyponatremia is a common electrolyte abnormality in hospitalised patients. There is an increasing tendency for it to occur with increasing age, hypertension, diabetes mellitus and use of drugs (diuretics). Nausea, vomiting and drowsiness are the commonest symptoms. Mortality is high, though not directly related to serum sodium levels. Hyponatremia acts as a poor prognostic marker of primary disease.
The Black Dog Institute

Objectives: To describe the structural and functional components of a new State-based initiative addressing depressive disorders, the Black Dog Institute. Method: Institute components and objectives, together with background information on the ‘Black Dog’ concept, are described. Conclusions: It is hoped that this briefing will inform readers about current objectives.