bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of ingested foreign bodies according to age, type and location: a retrospective observational study
Authors: Kim S.Y. , Park B. , Kong I.G. , Choi H.G.
Published: October 2015

Objective

This study aimed to analyse the types and locations of ingested foreign bodies according to different age groups, from infants to the elderly.

Design

A retrospective chart review.

Setting

Tertiary referral centre.

Participants

A total of 4682 patients who ingested foreign bodies from January 2006 through February 2014.

Methods

The frequencies of foreign bodies were investigated in each age group. The types of foreign bodies were categorised into fish bones, chicken bones, seafood, tablets, food, metal, batteries, glass, teeth, plastics and others. The anatomic locations of the objects were classified as the oral cavity, tongue base, tonsils, oropharynx, hypopharynx, oesophagus, stomach and colon. The types, locations and origins of the foreign bodies were analysed according to the age groups.

Results

The frequency of foreign body ingestion was high in patients up to 14 years of age, after which the risk of foreign body ingestion markedly decreased. Fish bones were the most commonly suspected foreign bodies in all of the age groups. However, non‐food‐type foreign bodies were more common in both the young and elderly groups. The tonsils were the most common anatomic site of foreign body impaction except in the group of patients older than 65 years. The stomach and oesophagus were also common locations of foreign bodies in the groups of patients younger than 10 years (10.5%) and older than 65 years (39.4%).

Conclusion

The frequency of foreign body ingestion was highest in young children. However, we observed specific age‐based characteristics that indicate specific precautions to take to avoid foreign body ingestion.
Active versus passive humidification for self‐ventilating tracheostomy and laryngectomy patients: a systematic review of the literature
Authors: Wong C.Y.Y. , Shakir A.A. , Farboud A. , Whittet H.B.
Published: October 2015

Objective

To determine whether active or passive humidification methods are more effective in preventing pulmonary complications in self‐ventilating neck breather patients.

Design

Systematic Review adhering to PRISMA guidance (checklist sourced from www.equator-network.org/).

Setting

Review of current published relevant literature at a tertiary department of Otolaryngology and Head & Neck Surgery.

Participants

We included all separate studies and comparison studies of active and passive humidification techniques in adult and paediatric neck breather patients.

Main Outcome Measures

The primary outcome is the reduction in pulmonary complications. Secondary outcomes include patient compliance; carer and user satisfaction.

Results and Conclusions

Seven studies were included in this review: two RCTs (133 patients), one randomised controlled cross‐over trial (29 patients), three randomised prospective studies (171 patients), and one retrospective study (73 patients). Only one study was conducted on paediatric neck breathers. The overall quality of the studies was low. Five studies were at a high risk of bias. Of the remaining two studies, one study had a low risk of bias and the other had an unclear risk. Despite limited subject evidence, results show that passive methods of humidification (mainly HME) is the preferred choice of humidification in the spontaneously breathing neck breather patients group mainly due to the reduction in pulmonary complaints, and better patient compliance.
Eradication of esophageal varices by sclerotherapy combined with argon plasma coagulation: Effect of portal hemodynamics and longitudinal clinical course
Authors: Kondo Takayuki , Maruyama Hitoshi , Kiyono Soichiro , Sekimoto Tadashi , Shimada Taro , Takahashi Masanori , Okugawa Hidehiro , Yokosuka Osamu , Kawahira Hiroshi , Yamaguchi Tadashi
Published: October 2015

Background and Aim

To demonstrate the effect of endoscopic injection sclerotherapy (EIS) with argon plasma coagulation (APC) as a primary/secondary prophylaxis for esophageal varies (EV) on portal hemodynamics and long‐term outcomes in cirrhosis.

Methods

This prospective study included 48 cirrhotic patients (64.5 ± 11.4 years; 26 bleeders, 22 non‐bleeders). Post‐treatment outcomes (EIS and APC; median observation period, 12.8 months for recurrence and 21.1 months for prognosis) were evaluated with respect to the findings of hepatic venous catheterization, Doppler ultrasound, and endoscopic ultrasonography (EUS).

Results

All patients showed EV eradication after endoscopic treatment, and a decreased frequency of a patent left gastric vein (pre: 83.3%, post: 27.1%, P < 0.001). However, hepatic venous pressure gradient (HVPG, mmHg) remained unchanged after the treatment, pre: 16.1 ± 3.6, post: 15.6 ± 3.8 (P = 0.269). Cumulative variceal recurrence/rebleeding rates were 25.5%/5.6% and 62.4%/23.1% at 1 and 3 years, respectively. Post‐treatment EUS finding, area of submucosal vessels in the cardia ≥12 mm2 was the only significant factor for variceal recurrence (hazard ratio 9.769, 95% confidence interval 3.046–31.337; P < 0.001). Cumulative recurrence rate was significantly higher in patients with area of submucosal vessels in the cardia ≥12 mm2 (58.3% at 1 year and 100% at 3 years) than in those without (11.4% at 1 year and 40.9% at 3 years, P < 0.001). Cumulative overall survival rates were 95.2% and 71.9% at 1 and 3 years, respectively, showing no significant relationship with HVPG.

Conclusion

EIS with APC for EV is unlikely to have a significant influence on portal pressure.
Diagnosis of vertebral artery dissection in childhood posterior circulation arterial ischaemic stroke
Authors: McCrea Nadine , Saunders Dawn , Bagkeris Emmanouil , Chitre Manali , Ganesan Vijeya
Published: October 2015

Aim

Review a series of children with posterior circulation arterial ischaemic stroke (PCAIS) to identify diagnostic modality and associations in cases of vertebral artery dissection (VAD).

Method

Retrospective analysis of 30 cases of childhood PCAIS identified from two tertiary centres over 11 years. Clinical and demographic details were recorded. Brain and cerebrovascular imaging were reviewed. Aetiology was classified using the Childhood Arterial Ischaemic Stroke Standardized Classification and Diagnostic Evaluation criteria. Outcome was evaluated using standardized paediatric stroke outcome scores. Logistic regression was used to explore variables associated with diagnosis.

Results

Twenty‐three patients were male (77%) and 7 were female (23%). VAD was the most commonly identified aetiology, in 15 cases (50%). Aetiology was undetermined in 12 (40%), probable cardioembolism in two, and reversible cerebral vasoconstriction syndrome in one. In those with VAD, diagnosis was made on initial magnetic resonance angiography (MRA) in six (40%). Further cases of VAD were diagnosed with catheter angiography (n=6), computed tomographic angiography (n=1), or follow‐up MRA (n=2). Presence of multiple infarcts was associated with a diagnosis of VAD.

Interpretation

Endoluminal cerebrovascular imaging increases the rate of diagnosis of VAD in childhood PCAIS and should especially be considered if there are multiple infarcts.
Maternal medical conditions during pregnancy and gross motor development up to age 24 months in the Upstate KIDS study
Authors: Ghassabian Akhgar , Sundaram Rajeshwari , Wylie Amanda , Bell Erin , Bello Scott C , Yeung Edwina
Published: October 2015

Aim

We examined whether children of mothers with a medical condition diagnosed before or during pregnancy took longer to achieve gross motor milestones up to age 24 months.

Method

We obtained information on medical conditions using self‐reports, birth certificates, and hospital records in 4909 mothers participating in Upstate KIDS, a population‐based birth cohort. Mothers reported on their children's motor milestone achievement at 4, 8, 12, 18, and 24 months of age.

Results

After adjustment for covariates (including pre‐pregnancy body mass index), children of mothers with gestational diabetes took longer to achieve sitting without support (hazard ratio [HR]=0.84, 95% confidence interval [CI] 0.75–0.93), walking with assistance (HR=0.88, 95% CI 0.77–0.98), and walking alone (HR=0.88, 95% CI 0.77–0.99) than children of females with no gestational diabetes. Similar findings emerged for maternal diabetes. Gestational hypertension was associated with a longer time to achieve walking with assistance. These associations did not change after adjustment for gestational age or birthweight. Severe hypertensive disorders of pregnancy were related to a longer time to achieve milestones, but not after adjustment for perinatal factors.

Interpretation

Children exposed to maternal diabetes, gestational or pre‐gestational, may take longer to achieve motor milestones than non‐exposed children, independent of maternal obesity.
Intergroup Dialogue as a Just Dialogue: Challenging and Preventing Normalization in Campus Dialogues
Authors: Yazbak‐Abu Ahmad Manal , Dessel Adrienne B. , Mishkin Alice , Ali Noor , Omar Hind
Published: October 2015

The tensions from the Israeli occupation of Palestine reach around the globe and heated debates over the struggles of these two peoples are evident on U.S. college campuses. The power imbalance represented in the relationship between Palestinians and Israelis is replicated on college campuses. BDS (Boycott, Divestment, and Sanctions) is a response to this inequality, is a movement to end the occupation, and has raised the issue of normalization. Teaching about this conflict presents particular challenges for faculty who negotiate this highly contested issue in classrooms or campus communities, and intergroup dialogue is an important pedagogy that can be used. It is critical to address normalization in intergroup dialogue. We discuss examples and themes of normalization in intergroup dialogue, and present pedagogical and other strategies to prevent and address normalization in intergroup dialogue and in other similar intergroup contact approaches with Arab or Palestinian and Jewish or Israeli participants.
Constitutional Reforms in Jordan: A Critical Analysis
Authors: Bani Salameh Mohammed Torki , Ali Ananzah Azzam
Published: October 2015

This study aims to shed light on the experience of the Jordanian constitutional reforms during the era of King Abdullah II and the Arab Spring. Moreover, this study provides a comprehensive and integrated view of these vital reforms and the democratic process in Jordan. With due consideration to the fact that the constitution represents the backbone of any political regime, constitutional developments in Jordan have been reviewed since the first Jordanian Constitution was drafted in 1928. By analyzing the most recent constitutional amendments, we identify the main features of these amendments as well as their strengths and weaknesses, potential for success or risk of failure, and the positive and negative reactions thereto. This study provides a summary and recommendation, notably, the need for further constitutional amendments to consolidate the process of reform and democracy in Jordan.
Covering the Building of a Kingdom: The Saudi Arabian Authority in The London Times and The New York Times, 1901–1932
Authors: Alrebh Abdullah F.
Published: October 2015

The orientalist literature subjected the Middle East in an exotic way — mostly as an “Arabian Nights” society ruled by traditional sultans and/or tribal chiefs — rather than modern governance structure's “bureaucracy.” The presumption within postcolonial scholarship has been that this perception influenced the policy landscape in the United States and Europe, especially the media depictions of the oriental leaders and leadership. The paper empirically tests this hypothesis through content analysis using Weber's categorization of leadership of two newspapers of record — The New York Times in the United States and The London Times in the United Kingdom — during the period of state building in Saudi Arabia (1901–1932). I find that rather than depicting the Saudi leadership as “backward,” these newspapers in particular, tend to overstate the development of the Saudi state during this period. As Weber is best known for his three types of authority, it benefits the discipline to see how the interpretive communities of Western journalists operationalized “authority” in terms of politics and religion of Saudi Arabia as this monarchy emerged.
Islamists’ Conceptualization of Belonging and Otherness: The Case of Atawhid w'Al‐Islah in Morocco
Authors: Mahmi Najah , Jebbar Abdelhak
Published: October 2015

As one of the various Islamic groups in Morocco, each of which defends its case and concretizes Islamic activism in its way and according to its own philosophies, beliefs, goals and political agendas, the movement of Atawhid w'Al‐Islah presents itself through its discursive formations as the most open, flexible, and tolerant group in the Moroccan religious scene, and affirms values of dialogue, cooperation, tolerance, moderation, and embracement of otherness to be its founding beliefs and ideologies, while, in empirical reality, it fails to keep the same positive image and prove a real belief in the claimed principles and values. The two concepts of “group” and “belonging” stand as the shaping motives of the movement's actions and reactions, suggesting the notion of “distance” which controls interaction within and outside the group according to calculations of proximity, formed and framed by the belonging factor itself which dictates taxonomies and polarizations, defining people in terms of “X” and “Y.” This invigorates an intricate othering system that vacillates between the two extremes of simulation and stigmatization, and binary oppositions forged within a sphere of dissociativeness and inequality formulations. In this respect, this article aims to study the movement of Atawhid w'Al‐Islah's introversion and extroversion legacies, portraying the main features of its members and activities and scrutinizing its perception of “belonging” and “otherness” as two main concepts around which revolve its in‐group/out‐group taxonomies.
Economies of Desire: Sexuality and the Sex Industry in the 21st Century
Authors: Hakim Catherine
Published: October 2015

New data from sex surveys confirm that demand for commercial sex is based on permanent disparities between male and female desire, and is therefore ineradicable. Demand and supply are growing, facilitated by economic growth, the Internet, globalisation and changing sexual attitudes. A key objection to the sex industry is that pornography, lap dancing and prostitution promote rape and other kinds of violence against women. However, the evidence contradicts this contention. The commercial sex industry is impervious to prohibitions and cannot be eliminated. Laws which constrain sellers of sexual services or criminalise purchasers are not evidence‐based, and are bound to fail, wasting public resources.
Deirdre Mccloskey, Kirznerian Growth and The Role of Social Networks
Authors: Geloso Vincent
Published: October 2015

This article expands on the view of Deirdre McCloskey that the economic growth of the Western world since the end of the eighteenth century can be explained by the process of entrepreneurial change as expounded by Israel Kirzner. This article argues that while Kirzner's approach to economic development is indeed fruitful, it should be augmented through the study of social networks, which McCloskey has largely ignored. When social networks are seen in the light of the Kirznerian process of entrepreneurship, they represent an important institution that relays information about the proper identification and perception of opportunities.
Economic Freedom and Women's Emancipation in the MENA Region
Authors: Adnane Souad
Published: October 2015

The position of women in the Middle East and North Africa (MENA) region is a complex topic, difficult to comprehend without allowing for socio‐cultural norms, legal frameworks and the global gender context. In thinking about a practical framework for action, the free market perspective is relevant and necessary. However, this alone does not seem to provide a complete answer to the problem of promoting women's economic status. This article makes the case for the importance of market‐friendly, but also gender‐sensitive, policies to promote women's economic freedom and hence women's emancipation in the MENA region.
One health – an ecological and evolutionary framework for tackling Neglected Zoonotic Diseases
Authors: Webster Joanne P. , Gower Charlotte M. , Knowles Sarah C. L. , Molyneux David H. , Fenton Andy
Published: October 2015

Understanding the complex population biology and transmission ecology of multihost parasites has been declared as one of the major challenges of biomedical sciences for the 21st century and the Neglected Zoonotic Diseases (NZDs) are perhaps the most neglected of all the Neglected Tropical Diseases (NTDs). Here we consider how multihost parasite transmission and evolutionary dynamics may affect the success of human and animal disease control programmes, particularly neglected diseases of the developing world. We review the different types of zoonotic interactions that occur, both ecological and evolutionary, their potential relevance for current human control activities, and make suggestions for the development of an empirical evidence base and theoretical framework to better understand and predict the outcome of such interactions. In particular, we consider whether preventive chemotherapy, the current mainstay ofNTDcontrol, can be successful without a One Health approach. Transmission within and between animal reservoirs and humans can have important ecological and evolutionary consequences, driving the evolution and establishment of drug resistance, as well as providing selective pressures for spill‐over, host switching, hybridizations and introgressions between animal and human parasites. Our aim here is to highlight the importance of both elucidating disease ecology, including identifying key hosts and tailoring control effort accordingly, and understanding parasite evolution, such as precisely how infectious agents may respond and adapt to anthropogenic change. Both elements are essential if we are to alleviate disease risks fromNZDs in humans, domestic animals and wildlife.
Influenza hospitalization epidemiology from a severe acute respiratory infection surveillance system in Jordan, January 2008–February 2014
Authors: Al‐Abdallat Mohammad , Dawson Patrick , Haddadin Aktham Jeries , El‐Shoubary Waleed , Dueger Erica , Al‐Sanouri Tarek , Said Mayar M. , Talaat Maha
Published: October 2015

Background

Acute respiratory infections (ARIs) are a major cause of morbidity and mortality worldwide. Influenza typically contributes substantially to the burden of ARI, but only limited data are available on influenza activity and seasonality in Jordan.

Methods

Syndromic case definitions were used to identify individuals with severe acute respiratory infections (SARI) admitted to four sentinel hospitals in Jordan. Demographic and clinical data were collected. Nasopharyngeal and oropharyngeal swabs were tested for influenza using real‐time reverse transcription polymerase chain reaction and typed as influenza A or B, with influenza A further subtyped.

Results

From January 2008–February 2014, 2891 SARI cases were tested for influenza, and 257 (9%) were positive. While 73% of all SARI cases were under 5 years of age, only 57% of influenza‐positive cases were under 5 years of age. Eight (3%) influenza‐positive cases died. An annual seasonal pattern of influenza activity was observed. The proportion of influenza‐positive cases peaked during November–January (14–42%) in the non‐pandemic years.

Conclusions

Influenza is associated with substantial morbidity and mortality in Jordan. The seasonal pattern of influenza aligns with known Northern Hemisphere seasonality. Further characterization of the clinical and financial burden of influenza in Jordan will be critical in supporting decisions regarding disease control activities.
Telling tales in school: extended contact interventions in the classroom
Authors: Aronson Krista Maywalt , Stefanile Cristina , Matera Camilla , Nerini Amanda , Grisolaghi Jacopo , Romani Gianmarco , Massai Federica , Antonelli Paolo , Ferraresi Laura , Brown Rupert
Published: October 2015

Extended contact has demonstrated its effectiveness in promoting more positive intergroup attitudes among children in previous experimental research. The current project evaluates the use of extended contact interventions involving story‐telling in two novel school settings: the United States (N = 213) and Italy (N = 222) among children aged 5–12 years. Findings indicate support for the effectiveness of the interventions in these two locations among younger minority and majority children but call into question the durability of positive outcomes. Applications and implications are discussed.
The Consequences of Being an Object of Suspicion: Potential Pitfalls of Proactive Police Contact
Authors: Tyler Tom R. , Jackson Jonathan , Mentovich Avital
Published: October 2015

During the latter half of the 20th century U.S. policing became more professional (Skogan & Frydl 2004) and the rate of violent crime declined dramatically (Blumstein & Wallman). Yet public trust and confidence in the police increased at best marginally and there has been a large and continuing racial gap in police legitimacy. This article reviews changes in police policy and practice to explore the reasons for this seeming paradox. It is argued that a new model of proactive police stops has increased both the frequency and the range of police contact with people in the community. Such police contact does not inherently undermine public trust in the police, but the style of such contact, which involves the police communicating suspicion of ongoing or future criminal conduct and seeking to prevent it via the threat or use of coercion, has not increased trust. This article examines how such policies developed and why they are problematic. The result of a survey of Americans shows that perceived suspicion damages the social bonds between the police and the community and undermines trust in the police. The article concludes by arguing that police contact need not be inherently negative and contact during which the police use fair procedures can addresses issues of crime and disorder while building trust and confidence.
Leases and Executory Contracts in Chapter 11
Authors: Ayotte Kenneth
Published: October 2015

This article offers the first empirical analysis of the timing and disposition decisions large Chapter 11 debtors make with respect to their leases and other bilateral (“executory”) contracts in bankruptcy, with an emphasis on commercial real estate leases. Section 365, which governs these contracts, allows debtors to choose whether to keep (“assume”), abandon (“reject”), or transfer (“assign”) their contracts, with time limits provided by the Bankruptcy Code. The main goal of the article is to analyze a controversial change to the Code in 2005 (BAPCPA) that shortens the time to expiration of a debtor's option to reject, requiring tenant‐debtors to make decisions on their real estate leases within seven months unless a landlord grants an extension. I find that the seven‐month limit strongly accelerated real estate lease disposition decisions, suggesting that bankruptcy bargaining is far from a frictionless, Coasean world. Further, I find that BAPCPA is associated with a significantly lower probability of reorganization for the most lease‐intensive firms. I also test a simple theory of real options, and I find that debtors do not behave as the simple theory suggests. In particular, many executory contracts are assumed before expiration. I present suggestive evidence of implicit contracting motives: debtors often assume early in order to secure performance from their counterparties that cannot be guaranteed by the contract alone.
Does Juvenile Delinquency Reduce Educational Attainment?
Authors: Ward Shannon , Williams Jenny
Published: October 2015

This article investigates the effect of delinquency in youth on subsequent educational attainment. To do so, we focus on delinquent acts committed by age 16 and examine their impact on two measures of educational attainment: high school graduation and college graduation. Using information on males from the extremely rich National Longitudinal Survey of Youth 1997, we find plausible evidence that delinquency by age 16 reduces the likelihood of graduating from high school and college. This effect is driven by early initiators, those who offend intensely, and by those whose delinquent activities involve income‐generating acts. Importantly, the impact of delinquency on education is not confined to those who have interaction with the criminal justice system, or gang members. Further analysis suggests that a channel through which delinquency impacts education is expected returns to crime, as reflected by subjective beliefs about the probability of arrest for a property crime.
Can a Single Country Increase the Taxes of Multinational Corporations? Evidence from the Impact of the 1993 Corporate Tax Rate Increase on Fortune 500 Companies
Authors: Jensen Nathan M. , Rosenzweig Adam H.
Published: October 2015

There is a debate in the literature about the ability of multinational corporations to use legal mechanisms, such as transfer pricing and intercompany debt, to prevent any one country from meaningfully increasing effective tax rates (ETRs) on corporations. Evidence suggests that tremendous shifting of profits across borders is occurring, leading to calls for significant policy responses. At the same time, multinational companies are also observed relocating their headquarters or reincorporating in foreign jurisdictions, at least in part for tax reasons. This has led many to claim that international tax in a globalized world has devolved into a race to the bottom. In response, multinational organizations such as the OECD and G‐20 have called for increased multilateralism and cooperation as the last, best hope for the international tax regime. Yet, to date little has been written on the extent to which any one, single country can meaningfully increase taxes on multinational companies unilaterally through changes in rate. We contribute to this literature by designing an empirical study of whether and to what extent a largely unanticipated tax rate increase in a single country affects the ultimate tax liability of multinational corporations. We do so by examining how an actual increase in corporate tax rates in the United States impacted worldwide cash taxes for Fortune 500 companies. Using the 1 percent corporate tax rate increase enacted in 1993, which was enacted for one year without any accompanying base changes, we find that this rate increase led to an increase in worldwide cash taxes reported by multinational companies across the board. We include a number of case studies to further explore the implications of this tax increase. These case studies support the contention that little tax avoidance occurred immediately in response to the increase in the tax rate.
Treatment of Substance Use Disorders in Older Adults: Implications for Care Delivery
Authors: Sahker Ethan , Schultz Susan K. , Arndt Stephan
Published: October 2015

Objectives

To compare substance use treatment differences of individuals aged 65 and older with that of those younger than 65 by analyzing smaller age groupings.

Design

A retrospective analysis using Kruskal–Wallis chi‐square and chi‐square tests of association. Covariates were entered into an adjusted logistic regression to predict successful treatment completion.

Setting

Iowa substance use disorder treatment centers.

Participants

Individuals aged 30 to 96 admitted to substance use treatment in Iowa between 2010 and 2013 (N = 57,591).

Measurements

Successful treatment completion, program length of stay, primary problem substance, referral source, and client demographic characteristics were analyzed to explore differences between age groupings in those aged 65 and older and between those aged 65 and older and those younger than 65.

Results

Findings demonstrated that individuals aged 65 to 69 were more likely to complete treatment successfully than those aged 75 and older (2 log likelihood χ2 = 102.06, degrees of freedom = 6, P < .001), and treatment referrals were increasingly more likely to occur from a primary care setting with increasing age. The eldest group reported significantly more hospitalizations because of their substance use (Wald z = 3.05, P < .002). Finally, referrals for driving under the influence were more likely in those aged 70 and older.

Conclusion

Excluding the oldest group (7,596), older age was associated with greater successful treatment completion. Overall, greater screening and earlier detection may be a critically important means of enhancing safety for older persons with substance use disorders.
Cost‐Effectiveness of Nutrition Intervention in Long‐Term Care
Authors: Simmons Sandra F. , Keeler Emmett , An Ruopeng , Liu Xulei , Shotwell Matthew S. , Kuertz Brittany , Silver Heidi J. , Schnelle John F.
Published: October 2015

Objectives

To determine the cost‐effectiveness of two nutrition interventions on food, beverage, and supplement intake and body weight.

Design

Randomized, controlled trial.

Setting

Five skilled nursing home facilities.

Participants

Long‐stay residents with orders for nutrition supplementation (N = 154).

Intervention

Participants were randomized into a usual care control group, an oral liquid nutrition supplement (ONS) intervention group, or a snack intervention group. Research staff provided ONS, according to orders or a variety of snack foods and beverages twice per day between meals, 5 days per week for 24 weeks and assistance to promote consumption.

Measurements

Research staff independently weighed residents at baseline and monthly during the 24‐week intervention. Resident food, beverage and supplement intake and the amount of staff time spent providing assistance were assessed for 2 days at baseline and 2 days per month during the intervention using standardized observation and weighed intake procedures.

Results

The ONS intervention group took in an average of 265 calories more per day and the snack intervention group an average of 303 calories more per day than the control group. Staff time required to provide each intervention averaged 11 and 14 minutes per person per offer for ONS and snacks, respectively, and 3 minutes for usual care. Both interventions were cost‐effective in increasing caloric intake, but neither intervention had a significant effect on body weight, despite positive trends.

Conclusion

Oral liquid nutrition supplements and snack offers were efficacious in promoting caloric intake when coupled with assistance to promote consumption and a variety of options, but neither intervention resulted in significant weight gain.
Clinical Utility of the Trail‐Making Test as a Predictor of Driving Performance in Older Adults
Authors: Papandonatos George D. , Ott Brian R. , Davis Jennifer D. , Barco Peggy P. , Carr David B.
Published: October 2015

Objectives

To assess the clinical utility of the Trail‐Making Tests (TMTs) as screens for impaired road‐test performance.

Design

Secondary analyses of three data sets from previously published studies of impaired driving in older adults using comparable road test designs and outcome measures.

Setting

Two academic driving specialty clinics.

Participants

Older drivers (N = 392; 303 with cognitive impairment, 89 controls) from Rhode Island and Missouri.

Measurements

Standard operating characteristics were evaluated for the TMT Part A (TMT‐A) and Part B (TMT‐B), as well as optimal upper and lower test cut‐points that could be useful in defining groups of drivers with indeterminate likelihood of impaired driving who would most benefit from further screening or on‐road testing.

Results

Discrimination remained high (>70%) when cut‐points for the TMTs derived from Rhode Island data were applied to Missouri data, but calibration was poor (all P < .01). TMT‐A provided the best utility for determining a range of scores (68–90 seconds) for which additional road testing would be indicated in general practice settings. A high frequency of cognitively impaired participants unable to perform the TMT‐B test within the allotted time limited the utility of the test (>25%). Mere inability to complete the test in a reasonable time frame (e.g., TMT‐A > 48 seconds or TMT‐B > 108 seconds) may still be a useful tool in separating unsafe from safe or marginal drivers in such samples.

Conclusion

The TMTs (particularly TMT‐A) may be useful as screens for driving impairment in older drivers in general practice settings, where most people are still safe drivers, but more‐precise screening measures need to be analyzed critically in a variety of clinical settings for testing cognitively impaired older drivers.
Self‐Reported Hearing Loss Predicts 5‐Year Decline in Higher‐Level Functional Capacity in High‐Functioning Elderly Adults: The Fujiwara‐Kyo Study
Authors: Tomioka Kimiko , Okamoto Nozomi , Morikawa Masayuki , Kurumatani Norio
Published: October 2015

Objectives

To clarify the relationship between self‐reported hearing loss (HL) and 5‐year decline in higher‐level functional capacity in high‐functioning elderly adults.

Design

Population‐based, prospective cohort study.

Setting

The Fujiwara‐Kyo Study, Nara, Japan.

Participants

Community‐dwelling individuals aged 65 and older with a perfect baseline and valid follow‐up instrumental activity of daily living (IADL) (n = 3,267), intellectual activity (IA) (n = 2,925), and social role (SR) (n = 2,698) scores.

Measurements

Self‐reported HL was evaluated using a single question: “Do you feel you have hearing loss?” IADLs, IA, and SR were measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG‐IC) subscales. Geriatric syndromes (depressive symptoms, cognitive impairment, sleep disturbance, falls, urinary incontinence, visual impairment) were self‐reported at baseline. Blood tests were performed to measure cardiovascular risk factors.

Results

During 5‐year follow‐up, new declines developed for 213 participants in IADLs, 272 in IA, and 327 in SR. After adjustment for all covariates, including geriatric syndromes, using multiple logistic regression analysis, self‐reported HL at baseline was associated with a decline in IA (odds ratio (OR) = 1.39, 95% confidence interval (CI) = 1.04–1.86) and SR (OR = 1.34, 95% CI = 1.02–1.76) but not IADLs (OR = 1.07, 95% CI = 0.76–1.48).

Conclusion

Self‐reported HL was found to be a significant predictor of decline in IA and SR. Preventive intervention against age‐related HL may contribute to maintaining high‐level functional capacity in independent elderly adults.
Lower Protein Intake Mediates Association Between Lower Occlusal Force and Slower Walking Speed: From the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians Study
Authors: Okada Tadashi , Ikebe Kazunori , Kagawa Ryosuke , Inomata Chisato , Takeshita Hajime , Gondo Yasuyuki , Ishioka Yoshiko , Okubo Hitomi , Kamide Kei , Masui Yukie , Takahashi Ryutaro , Arai Yasumichi , Thomson William Murray , Maeda Yoshinobu
Published: October 2015

Objectives

To investigate the association between lower extremity motor function and occlusion in older adults and to examine the possibility of dietary intake of protein mediating the association.

Design

Cross‐sectional, population‐based study.

Setting

Urban and rural area in Japan.

Participants

Community‐dwelling septuagenarians (N = 655) and octogenarians (N = 629).

Measurements

Information was collected on occlusal force, protein intake, grip strength, walking speed, sociodemographic characteristics, and medical history. Multivariable logistic regression analysis was used to investigate the association between walking speed, occlusal force, and protein intake, and structural equation modeling analysis and mediation analysis were performed to investigate the validity of the hypothesized model and identify the indirect effect of protein intake in occlusal force and walking speed.

Results

The proportion of participants whose walking speed was 0.8 m/s or slower (slow walking speed) was 27.7%. Logistic regression analyses showed that slower walking speed was associated with occlusal force (odds ratio = 1.57, P = .001) after adjusting for medical history, body mass index, grip strength, and protein intake. The fit of the hypothesized model that walking speed was associated with occlusal force through protein intake was good, and the indirect effect was significant.

Conclusion

Slower walking speed was associated with lower occlusal force. Lower protein intake mediated the association between walking speed and occlusal force. Maintaining occlusal force might prevent insufficient nutrition intake and further deterioration of motor function in older people.
Drug–Alcohol Interactions in Older U.S. Adults
Authors: Qato Dima Mazen , Manzoor Beenish S. , Lee Todd A.
Published: October 2015

Objectives

To characterize the extent and nature of drug–alcohol interactions in older U.S. adults.

Design

Cross‐sectional.

Setting

Community.

Participants

Nationally representative population‐based sample of community‐dwelling older adults (N = 2,975).

Measurements

Regular drinkers were defined as respondents who consumed alcohol at least weekly. Medication use was defined as the use of a prescription or nonprescription medication or dietary supplement at least daily or weekly. Micromedex was used to determine drug interactions with alcohol and their corresponding severity.

Results

One thousand one hundred six (41%) of the participants consumed alcohol regularly, and 567 (20%) were at‐risk for a drug–alcohol interaction because they were regular drinkers and concurrently using alcohol‐interacting medications. More than 90% of these interactions were of moderate or major severity. Antidepressants and analgesics were the most commonly used alcohol‐interacting medications in regular drinkers. Older adult men with multiple chronic conditions had the highest prevalence of potential drug–alcohol interactions.

Conclusion

The potential for drug–alcohol interactions in the older U.S. adult population may have important clinical implications. Efforts to better understand and prevent the use of alcohol‐interacting medications by regular drinkers, particularly heavy drinkers, are warranted in this population.
Midlife and Late‐Life Smoking and Risk of Dementia in the Community: The Hisayama Study
Authors: Ohara Tomoyuki , Ninomiya Toshiharu , Hata Jun , Ozawa Mio , Yoshida Daigo , Mukai Naoko , Nagata Masaharu , Iwaki Toru , Kitazono Takanari , Kanba Shigenobu , Kiyohara Yutaka
Published: October 2015

Objectives

To clarify the association between midlife and late‐life smoking and risk of dementia.

Design

Prospective cohort study.

Setting

The Hisayama Study, Japan.

Participants

Japanese community‐dwellers without dementia aged 65 to 84 (mean age 72) followed for 17 years (1988–2005) (N = 754), 619 of whom had participated in a health examination conducted in 1973–74 (mean age, 57) and were included in the midlife analysis.

Measurements

The risk estimates of smoking status on the development of dementia were computed using a Cox proportional hazards model.

Results

During follow‐up, 252 subjects developed all‐cause dementia; 143 had Alzheimer's disease (AD), and 76 had vascular dementia (VaD). In late life, the multivariable‐adjusted risk of all‐cause dementia was significantly greater in current smokers than in never smokers; similar associations were seen for all‐cause dementia, AD, and VaD in midlife current smokers. Meanwhile, no significant association was observed between past smoking and risk of any type of dementia in late or midlife. Multivariable analysis showed that smokers in midlife and late life had significantly greater risks than lifelong nonsmokers of all‐cause dementia (adjusted hazard ratio (aHR) = 2.28, 95% confidence interval (CI) = 1.49–3.49), AD (aHR = 1.98, 95% CI = 1.09–3.61), and VaD (aHR = 2.88, 95% CI = 1.34–6.20). Such associations were not observed for midlife smokers who quit smoking in late life.

Conclusion

Persistent smoking from mid‐ to late life is a significant risk factor for dementia and its subtypes in the general Japanese population.
Impact of shortened dental arches on oral health‐related quality of life
Authors: Antunes J. L. F. , Tan H. , Peres K. G. , Peres M. A.
Published: October 2015

This study described the prevalence of adults with shortened dental arches (SDA) in Brazil, specifically assessing the differences of oral health‐related quality of life [the prevalence and severity of oral impacts on daily performance (OIDP)] by dentition status. We analysed data from the 2010 National Survey of Oral Health in Brazil, including home interviews and oral examinations. The assessment of SDA used two alternative definitions: having 3–5 natural occlusal units (OUs) in posterior teeth or having 4 OUs in posterior teeth. Both definitions included having intact anterior region and no dental prosthesis. The analysis was weighted, and a complex sampling design was used. Negative binomial regression models assessed associations as adjusted for socio‐demographic conditions and dental outcomes. A total of 9779 adults (35–44 years old) participated in the study. A non‐negligible proportion had SDA: 9·9% and 3·8% for the first and second definition, respectively. Individuals with SDA (first definition) ranked higher in OIDP prevalence [count ratio (CR) 1·22; 1·09–1·36, 95% confidence interval (CI)] and severity (CR = 1·43; 1·19–1·72, 95% CI) than those with more natural teeth. This difference was not statistically significant when adjusted for socio‐demographic and dental covariates: OIDP prevalence (CR = 1·04; 0·92–1·17, 95% CI) and severity (CR = 1·09; 0·91–1·30, 95% CI). Analogous results were obtained when the second definition of SDA was adopted. These findings suggest that a considerable contingent of adults may function well without dental prostheses, despite having several missing teeth. This conclusion challenges the traditional approach of replacing any missing tooth and instructs the allocation of more dental resources to preventive, diagnostic and restorative services.
Sexual Risk‐Taking Among Recently Emancipated Female Foster Youth: Sexual Trauma and Failed Family Reunification Experiences
Authors: Gonzalez‐Blanks Ana , Yates Tuppett M.
Published: October 2015

Foster youth evidence shows elevated rates of risk behaviors, including sexual risk‐taking (e.g., unprotected sex). Some studies have identified child maltreatment, particularly sexual abuse, as a risk for later sexual risk‐taking, but none have examined how child welfare placement experiences relate to youth's sexual risk‐taking. This study investigated relations among child maltreatment, child welfare placements, and sexual risk‐taking among 114 recently emancipated female foster youth. Sexual abuse and failed reunifications with parents were associated with greater sexual risk‐taking. Moreover, dissociative symptoms exacerbated the relation between sexual abuse and sexual risk‐taking. These findings highlight the need for greater consideration of risks associated with emancipated youth's sexual risk‐taking and for more research to understand how youth experience unsuccessful family reunifications.
An observational study of the effectiveness of alternative care providers in the management of obstructive sleep apnea
Authors: Pendharkar Sachin R. , Dechant Anthony , Bischak Diane P. , Tsai Willis H. , Stevenson Ann‐Marie , Hanly Patrick J.
Published: October 2015

Alternative care providers have been proposed as a substitute for physician‐based management of obstructive sleep apnea. The purpose of this study was to describe the clinical course of patients with a new diagnosis of obstructive sleep apnea who were treated with continuous positive airway pressure and followed by alternative care providers at a tertiary care sleep clinic. It was hypothesized that care by alternative care providers would result in improvement of daytime sleepiness and satisfactory treatment adherence, and that a specific number of follow‐up visits could be identified after which clinical outcomes no longer improved. The Epworth Sleepiness Scale score was measured for each patient at baseline and at each alternative care provider visit. Patients were discharged when they demonstrated a significant improvement in sleepiness and were adherent to therapy. The Epworth Sleepiness Scale score decreased by 3.9 points from baseline to discharge. Patients with three or more visits required more follow‐up time to achieve the same clinical improvement as those with only two visits. Continuous positive airway pressure adherence was comparable to previous studies of physician‐led care and improved with ongoing alternative care provider follow‐up. The current results suggest that clinical care by alternative care providers leads to continued improvements in sleepiness in patients with obstructive sleep apnea who are treated with continuous positive airway pressure, and that a minority of patients require longer follow‐up to achieve a satisfactory clinical response to therapy.
Nonnative Speakers Do Not Take Competing Alternative Expressions Into Account the Way Native Speakers Do
Authors: Robenalt Clarice , Goldberg Adele E.
Published: October 2015

When native speakers judge the acceptability of novel sentences, they appear to implicitly take competing formulations into account, judging novel sentences with a readily available alternative formulation to be less acceptable than novel sentences with no competing alternative. Moreover, novel sentences with a competing alternative are more strongly dispreferred when they contain high‐ compared to low‐frequency verbs. We replicate these findings with a group of native speakers and extend the paradigm to second language (L2) users. Previous work has found that compared to native speakers, L2 users are less able to generate online expectations during language processing, implying a reduced ability to differentiate between novel sentences with and without a competing alternative. We test this prediction and confirm that, while L2 speakers learn from positive exemplars, they show no evidence of taking competing grammatical alternatives into account, except at the highest quartile of speaking proficiency, where L2 judgments align with native speaker judgments.

Open Practices

This article has been awarded Open Materials and Open Data badges. All materials and data are publicly accessible via the Open Science Framework at https://osf.io/f3dh6. Learn more about the Open Practices badges from the Center for Open Science: https://osf.io/tvyxz/wiki.