bluuebunny/crossref_metadata_2025 huggingface dataset:
Past Decline Versus Current eGFR and Subsequent ESRD Risk
Authors: Kovesdy Csaba P. , Coresh Josef , Ballew Shoshana H. , Woodward Mark , Levin Adeera , Naimark David M.J. , Nally Joseph , Rothenbacher Dietrich , Stengel Benedicte , Iseki Kunitoshi , Matsushita Kunihiro , Levey Andrew S. ,   the CKD Prognosis Consortium
Published: December 2015

eGFR is a robust predictor of ESRD risk. However, the prognostic information gained from the past trajectory (slope) beyond that of the current eGFR is unclear. We examined 22 cohorts to determine the association of past slopes and current eGFR level with subsequent ESRD. We modeled hazard ratios as a spline function of slopes, adjusting for demographic variables, eGFR, and comorbidities. We used random effects meta–analyses to combine results across studies stratified by cohort type. We calculated the absolute risk of ESRD at 5 years after the last eGFR using the weighted average baseline risk. Overall, 1,080,223 participants experienced 5163 ESRD events during a mean follow-up of 2.0 years. In CKD cohorts, a slope of −6 versus 0 ml/min per 1.73 m2 per year over the previous 3 years (a decline of 18 ml/min per 1.73 m2 versus no decline) associated with an adjusted hazard ratio of ESRD of 2.28 (95% confidence interval, 1.88 to 2.76). In contrast, a current eGFR of 30 versus 50 ml/min per 1.73 m2 (a difference of 20 ml/min per 1.73 m2) associated with an adjusted hazard ratio of 19.9 (95% confidence interval, 13.6 to 29.1). Past decline contributed more to the absolute risk of ESRD at lower than higher levels of current eGFR. In conclusion, during a follow-up of 2 years, current eGFR associates more strongly with future ESRD risk than the magnitude of past eGFR decline, but both contribute substantially to the risk of ESRD, especially at eGFR<30 ml/min per 1.73 m2.
Past Decline Versus Current eGFR and Subsequent Mortality Risk
Authors: Naimark David M.J. , Grams Morgan E. , Matsushita Kunihiro , Black Corri , Drion Iefke , Fox Caroline S. , Inker Lesley A. , Ishani Areef , Jee Sun Ha , Kitamura Akihiko , Lea Janice P. , Nally Joseph , Peralta Carmen Alicia , Rothenbacher Dietrich , Ryu Seungho , Tonelli Marcello , Yatsuya Hiroshi , Coresh Josef , Gansevoort Ron T. , Warnock David G. , Woodward Mark , de Jong Paul E. ,   the CKD Prognosis Consortium
Published: December 2015

A single determination of eGFR associates with subsequent mortality risk. Prior decline in eGFR indicates loss of kidney function, but the relationship to mortality risk is uncertain. We conducted an individual–level meta-analysis of the risk of mortality associated with antecedent eGFR slope, adjusting for established risk factors, including last eGFR, among 1.2 million subjects from 12 CKD and 22 other cohorts within the CKD Prognosis Consortium. Over a 3-year antecedent period, 12% of participants in the CKD cohorts and 11% in the other cohorts had an eGFR slope <−5 ml/min per 1.73 m2 per year, whereas 7% and 4% had a slope >5 ml/min per 1.73 m2 per year, respectively. Compared with a slope of 0 ml/min per 1.73 m2 per year, a slope of −6 ml/min per 1.73 m2 per year associated with adjusted hazard ratios for all-cause mortality of 1.25 (95% confidence interval [95% CI], 1.09 to 1.44) among CKD cohorts and 1.15 (95% CI, 1.01 to 1.31) among other cohorts during a follow-up of 3.2 years. A slope of +6 ml/min per 1.73 m2 per year also associated with higher all–cause mortality risk, with adjusted hazard ratios of 1.58 (95% CI, 1.29 to 1.95) among CKD cohorts and 1.43 (95% CI, 1.11 to 1.84) among other cohorts. Results were similar for cardiovascular and noncardiovascular causes of death and stronger for longer antecedent periods (3 versus <3 years). We conclude that prior decline or rise in eGFR associates with an increased risk of mortality, independent of current eGFR.
The correlation between aldehyde dehydrogenase-1A1 level and tumor shrinkage after preoperative chemoradiation in locally advanced rectal cancer
Authors: Rafli Rhandyka , Gondhowiardjo Soehartati A , Kantaatmadja Adang Bachtiar , Matondang Sahat , Krisnuhoni Ening
Published: December 2015

This study was performed to determine the correlation between aldehyde dehydrogenase-1A1 (ALDH1A1) level and tumor shrinkage after chemoradiation in locally advanced rectal cancer. This is a retrospective study of 14 locally advanced rectal cancer patients with long course neoadjuvant chemoradiation. ALDH1A1 level was measured using ELISA from paraffin embedded tissue. Tumor shrinkage was measured from computed tomography (CT) scan or magnetic resonance imaging (MRI) based on Response Evaluation Criteria in Solid Tumor v1.1 (RECIST v1.1). The mean of ALDH1A1 level was 9.014 ± 3.3 pg/mL and the mean of tumor shrinkage was 7.89 ± 35.7%. Partial response proportion was 28.6%, stable disease proportion was 50% and progressive disease proportion was 21.4%. There was a significant strong negative correlation (r = –0.890, p < 0.001) between ALDH1A1 and tumor shrinkage. In conclusion, tumor shrinkage in locally advanced rectal cancer after preoperative chemoradiation was influenced by ALDH1A1 level. Higher level of ALDH1A1 suggests decreased tumor shrinkage after preoperative chemoradiation.
Threshold-based parametric analysis of diffusion-weighted magnetic resonance imaging at 3.0 Tesla to identify men with prostate cancer
Authors: Moran Diarmaid C , Marignol Laure , Fagan Andrew J , Dunne Ruth , Perry Antoinette S , O'Driscoll Dearbhail , Gaffney Eoin , Lynch Thomas H , Meaney James F M , Hollywood Donal H
Published: December 2015

The aim of this study is to determine the accuracy of three apparent diffusion coefficient (ADC) threshold values in detecting prostate cancer (PCa) prior to prostate biopsy. 60 men with clinical suspicion of PCa underwent endorectal diffusion-weighted magnetic resonance imaging (DW-MRI) at 3.0 Tesla (T). Three ADC threshold values (tADC: 1.0, 1.2 and 1.4 × 10-3 mm2/s) were sequentially applied to ADC maps for the detection of malignant lesions in the prostatic peripheral zone (PZ). Segment-based and patient-specific PCa detection performance of these tADC values was correlated with the histopathological results from the subsequent 12-core transrectal ultrasound (TRUS)-guided biopsy. Mean of ADC and area size of the identified malignant region of interests (ROIs) were recorded. Accuracy for PCa detection was assessed by receiver operating characteristic curves. 1.0 × 10-3 mm2/s of tADC provided 79% sensitivity, 97% specificity and 93% positive predictive value for PCa. Area size of the malignant ROI was a good independent factor for PCa detection (AUC = 0.85). ROI area size 0.2 cm2 was identified as the best performing cut-off values for the detection of PCa. Refined detection criteria combining area size ≤0.2 cm2 and ADC <1.0 × 10-3 mm2/s increased the detection performance. In conclusion, threshold-based parametric evaluation of DW-MRI at 3.0 T can detect PZ PCa accurately prior to biopsy.
Análisis general de las técnicas de intervención del Estado en la economía
Authors: Saura Fructuoso Carlos
Published: December 2015

El siguiente estudio tiene como fin un análisis general de las diferentes técnicas que dispone el Estado y el Sector Público para intervenir en la economía, tanto desde una vertiente restrictiva como aperturista de la iniciativa privada. A menudo, mecanismos como la nacionalización, liberalización, privatización y desregulación tienden a confundirse entre ellos, por lo que una adecuada delimitación resulta fundamental para proceder a un análisis jurídico de los diferentes efectos que se derivan de su utilización.
Los servicios públicos locales: reforma de la Administración local en tiempos de crisis económica
Authors: Chinchilla Juan Antonio , Domínguez Mónica
Published: December 2015

Este trabajo se centra en el intento de la Ley 27/2013, de Racionalización y Sostenibilidad de la Administración Local, de limitar, al socaire del principio de equilibrio presupuestario, los servicios públicos que hasta el momento venían prestando las entidades locales. El punto de partida es el análisis de las medidas adoptadas como consecuencia de la crisis económica, así como de las medidas normativas de reforma de la Administración local. De este marco se derivan un nuevo régimen de las competencias locales, la reforma de los modos de gestión de los servicios públicos, así como novedades relativas al papel y la intervención local en la iniciativa económica y en la reserva de recursos y servicios esenciales al ámbito local.
Códigos de comportamiento para la administración pública
Authors: Boehm Frédéric
Published: December 2015

Los códigos se pueden entender como un conjunto de estándares y principios para guiar, ordenar y así facilitar la convivencia en una colectividad dada. Esta contribución revisa la historia de estos códigos en la administración pública, resaltando el vínculo con la necesidad de recuperar la confianza de los ciudadanos, entre otras cosas a través de un comportamiento ético de los servidores públicos. Sobre la base de la literatura y la experiencia internacional, se retoman factores clave para el diseño y la implementación exitosa de un código que logre incidir en el comportamiento en la administración pública.
A European convergence towards a stare decisis model?
Authors: Civitarese Stefano
Published: December 2015

The article revolves around the doctrine of precedent within the so-called European legal space, wondering whether and to what extent we can speak of a convergence towards a stare decisis model boosted by the harmonizing role of the Court of Justice of the European Union. The article argues that although there are still some differences between civil law and common law legal systems they regard more the style of reasoning and the deep understanding of the relationship between the present decision of a court and past judicial decisions than the very existence of the constraints of the latter upon the former. The article concludes that a sort of mechanism of stare decisis has in fact been created, even though, on the one hand, uncertainty remains as to the way in which the binding force of a precedent concretely operates in the system, and on the other hand, this mechanism relates exclusively to the relationships between past and future decisions of higher courts (horizontal effect). This change, far from being a shift towards a truly judge-made law system or a consequence of the final abandonment of the dictates of the rule of law, enhances legal certainty contributing to the fundamental requirement of stability of law as a feature of the ideal of the rule of law.
La desnaturalización del contrato de empleo público
Authors: Luján-Acosta Fernando
Published: December 2015

El presente artículo trata el contrato de empleo público desde dos perspectivas: teórica doctrinaria y jurídica normativa. La problemática que aborda refiere a las modificaciones del contrato de empleo público, esencialmente en la década del 90 del pasado siglo a partir de la transformación, reforma y crisis del Estado argentino. La progresiva y sistemática aplicación de normas y mecanismos laborales a partir de los procesos citados ha impactado en el tipo de contrato objeto de estudio desnaturalizándolo, debido a que sigue estando bajo la égida del Estado. La hipótesis de la desnaturalización, propuesta en este artículo, permite una mirada holística en relación a la problemática del empleo público.
El dominio público y los bienes públicos: Europa y América Latina. ¿El hijo sigue mirando al padre?
Authors: Chemás Sergio
Published: December 2015

El estudio del derecho de los bienes públicos en América Latina y en Colombia es algo todavía poco desarrollado. Se sigue mirando hacia el derecho comparado para obtener respuestas, tal como un hijo mira a su padre, porque fue allá donde surgieron los grandes desarrollos del tema. El dominio público en Europa y América Latina es producto de un encuentro entre varias autoridades en el tema de los bienes públicos tanto de Europa como de América Latina. Esta reseña se divide en tres partes: i) un breve análisis de derecho comparado frente al concepto de dominio público; ii) la identificación de los contenidos más interesantes e innovadores de los regímenes de bienes públicos, y iii) un ejercicio académico para que el lector lo desarrolle al leer el libro.
Apuntes sobre la Comisión Nacional de los Mercados y la Competencia de España
Authors: Ortiz Sandra
Published: December 2015

La creación de la Comisión Nacional de los Mercados y la Competencia mediante la Ley 3/2013, cuyo objeto es el de garantizar la libre competencia y regular todos los mercados y sectores productivos de la economía española para proteger a los consumidores, requiere de un análisis detallado desde el surgimiento de las Autoridades Independientes y el concepto de regulación y la incorporación de dichas autoridades en el ordenamiento español, haciendo especial énfasis en las Comisiones Reguladoras de los Servicios de Red. Se analiza además la revisión del modelo comparado y la tendencia de unificar organismos de igual naturaleza regulatoria o de competencia, así como los fallos proferidos por parte del Tribunal de Justicia de la Unión Europea sobre el carácter complementario y el papel que cumple el derecho de la competencia como red de seguridad.
Violent Death Rates and Risk for Released Prisoners in North Carolina
Authors: Lize Steven Edward , Scheyett Anna M. , Morgan Candice R. , Proescholdbell Scott K. , Norwood Tammy , Edwards David
Published: December 2015

Released prisoners face high risk of early mortality. The risk of violent death, specifically homicide and suicide, are addressed in this study. Data on inmates released from the North Carolina Division of Adult Corrections (N= 476) matched to the Violent Death Reporting System are analyzed to estimate rates and demographic and criminal justice–related predictors. Violent death rates for persons released from prison were more than 7 times higher than for the general adult population. Results from multinomial logistic regression indicate decreased homicide risk for every year of age, whereas male gender and minority race increased risk. For suicide, minority race, release without supervision, and substance abuse treatment in prison decreased fatality risk. By contrast, a history of mental illness increased suicide risk. Implications for practice and research are discussed.
Home Invasion Homicide Offenders: An Analysis of Subsequent Prison Rule Violations
Authors: Sorensen Jonathan , Bonner Heidi , Visconte Shelley , Vigen Mark , Woods S. O.
Published: December 2015

This study adds to the small body of research on home invasion by describing the circumstances surrounding home invasions that resulted in the death of a resident. The 2 most common types of home invasion homicides (HIHs) involved “drug ripoffs” and robberies of older adults for money and property. The study also examined subsequent rule-violating behavior of 132 HIH inmates while incarcerated. The rate of rule violations among HIH inmates was similar to a broader cohort of incarcerated homicide offenders. A logistic regression model identified variation in assaultive prison behavior based on some routine predictors (age, education, race, and prior imprisonment) and 2 associated with the crime (method of killing and age by gender of victims).
Sexual Assault Experienced by Deaf Female Undergraduates: Prevalence and Characteristics
Authors: Elliott Smith Rebecca A. , Pick Lawrence H.
Published: December 2015

Approximately 25% of hearing women in the United States experience rape in their lifetime, whereas deaf women have been found to experience increased rates of assault consistent with other marginalized populations. This study explored sexual assault prevalence and characteristics of assault in deaf female undergraduate students. Results revealed that more than two-thirds of the participants (69%) endorsed experiencing at least one assault and more than half (56%) experienced multiple types of assault. Most assaults were committed by a man known to the survivor. Characteristics (e.g., hearing status, primary language, and ethnicity) of the survivors and the assailants are explored. The implications of this data are discussed as well as the development of culturally and linguistically sensitive outreach and educational programs.
Effects of Physical and Emotional Child Abuse and Its Chronicity on Crime Into Adulthood
Authors: Jung Hyunzee , Herrenkohl Todd I. , Lee Jungeun Olivia , Klika J. Bart , Skinner Martie L.
Published: December 2015

Analyses tested hypotheses that pertain to direct and indirect effects of parent-reported physical and emotional abuse on later self-reported criminal behavior in a sample of 356 adults of a longitudinal study of more than 30 years. Childhood antisocial behavior was included in analyses as a potential mediator. Physical abuse only predicted adult crime indirectly through childhood antisocial behavior, whereas emotional abuse predicted adult outcome both directly and indirectly. Chronicity of physical abuse was indirectly related to later crime in a subsample test for those who had been physically abused (n = 318), whereas chronicity of emotional abuse was neither directly nor indirectly related to adult crime in a test of those who had been emotionally abused (n = 225). Implications for future research and practice are discussed.
Confirmation of the Validity of the Relational Coordination Survey as a Measure of the Work Environment in a National Sample of Infection Preventionists
Authors: Gilmartin Heather M. , Pogorzelska-Maziarz Monika , Thompson Sarah , Sousa Karen H.
Published: December 2015

Background: Health care-associated infections (HAIs) are leading causes of morbidity and mortality. Prevention of HAIs requires multifaceted approaches that consider the work environment in which interventions are implemented. Purpose: This study assessed the construct validity of the Relational Coordination Survey (RCS) as a measure of the work environment in infection prevention departments. Methods: Data were obtained from 614 infection preventionists (IPs). Factor analysis and structural equation modeling tested the hypothesized model. Results: Cronbach’s alpha for the 28-item RCS was .91. Factor analyses confirmed a four-factor solution that explained 58.17% of the variance. The fit indices for the model indicated an adequate fit, χ2(346) = 699.38, p < .00; comparative fit index = .94; root mean square error of approximation = .06. Conclusions: The RCS may be a useful tool for measuring aspects of the work environment for IPs.
Psychometric Validation and Comparison of the Self-Reporting Questionnaire-20 and Self-Reporting Questionnaire-Suicidal Ideation and Behavior Among Congolese Refugee Women
Authors: Bell Sue Anne , Lori Jody , Redman Richard , Seng Julia
Published: December 2015

Background: The Self-Reporting Questionnaire (SRQ) has long been used among refugee populations to detect common mental health disorders. Purpose: Our purpose was to compare findings from psychometric validation of the 20-item SRQ with a modified version, the SRQ-SIB (suicidal ideation and behavior). Methods: Factor analysis of both scales was performed in a sample of Congolese refugee women as well as predictive validity, contrast validity, and internal consistency. Results: Both scales exhibited a reliability of .911. The SRQ-SIB exhibited a three-factor solution; somatic, psychological, and SIB. The SIB was highly predictive for having experienced sexual violence. Analyses validate the use of both, but the SIB is useful for differentiating more severe cases of common mental disorder (CMD). Conclusions: The SRQ-SIB may be an important tool for the nursing assessment of suicide among refugee women.
Psychometric Evaluation of the Wang Pregnancy Stress Scale: Revised for Taiwanese Women
Authors: Wang Janet F. , Billings Anthony A.
Published: December 2015

Background and Purpose: Develop and assess psychometric properties of the Wang Pregnancy Stress Scale for measuring stress among pregnant women in Taiwan. Methods: Data were collected in 3 obstetric and gynecological clinics in Taiwan; 485 pregnant women participated in this study. We used exploratory factor analysis and internal consistency reliability was measured using Cronbach’s alpha. Results: A 4-factor structure emerged for the Wang Pregnancy Stress Scale. The internal reliability of the scale as measured by Cronbach’s alpha was .898, with standardized alpha .905. Conclusions: The Wang Pregnancy Stress Scale has high reliability and validity in measuring pregnancy stress that would allow nurses or health care workers to measure women’s stress levels during pregnancy. Nurses can use the assessed pregnancy stress to alter intervention of care for their pregnant clients.
Validation of the Urdu Version of Wagnild and Young’s Long and Short Resilience Scales Among 20- to 40-Year-Old Married Women Living in Urban Squatter Settlements of Karachi, Pakistan
Authors: Bhamani Shireen Shehzad , Pasha Omrana , Karmaliani Rozina , Asad Nargis , Azam Iqbal
Published: December 2015

Background: There were no instrument exists in South Asia to assess resilience. Thus, this study assessed the validity and reliability of the Urdu version of Wagnild and Young’s long and short Resilience Scales. Methods: Study was carried out in two urban squatter settlements of Karachi, Pakistan. Resilience Scales were validated against the depression, anxiety, and life satisfaction scales among 20- to 40-year-old married women. Sample size for validity and reliability were 636 and 319. Results: Moderate negative correlation with the depression and anxiety and moderate positive significant correlation with life satisfaction were found with both scales. The test–retest correlation were .54 and .49, respectively. Internal consistency were found acceptable. Concurrent validity were .729 and .813. Conclusions: Study found a valid and reliable resilience scale in Urdu language.
Psychometric Testing of the French Language Quality of Prenatal Care Questionnaire
Authors: Sword Wendy , Heaman Maureen , Peterson Wendy E. , Salvador Ann , Akhtar-Danesh Noori , Bradford-Janke Amanda
Published: December 2015

Background and Purpose: To assess the psychometrics of the French language Quality of Prenatal Care Questionnaire (QPCQ). Methods: Data from 302 women were used in a confirmatory factor analysis and in assessment of construct validity through hypothesis testing and internal consistency reliability using Cronbach’s alpha. Results: The 6 factors (subscales) were verified and confirmed. Hypothesis testing further supported construct validity. The overall QPCQ had acceptable internal consistency reliability (Cronbach’s alpha = .97) as did 5 subscales (Cronbach’s alpha = .70–.92); the Sufficient Time subscale had poorer reliability (Cronbach’s alpha = .61). Conclusions: The French language QPCQ is a valid and reliable self-report measure of prenatal care quality. It can be used in research and in quality improvement work to strengthen prenatal care services.
Psychometric Testing of the Health Care Evidence-Based Practice Assessment Tool
Authors: Sleutel Martha R. , Barbosa-Leiker Celestina , Wilson Marian
Published: December 2015

Background and Purpose: Evidence-based practice (EBP) is essential to optimal health care outcomes. Interventions to improve use of evidence depend on accurate assessments from reliable, valid, and user-friendly tools. This study reports psychometric analyses from a modified version of a widely used EBP questionnaire, the information literacy for nursing practice (ILNP). Methods: After content validity assessments by nurse researchers, a convenience sam
ple of 2,439 nurses completed the revised 23-item questionnaire. We examined internal consistency and used factor analyses to assess the factor structure. Results: A modified 4-factor model demonstrated adequate fit to the data. Cronbach’s alpha was .80–.92 for the subscales. Conclusions: The shortened ILNP (renamed Healthcare EBP Assessment Tool or HEAT) demonstrated adequate content validity, construct validity, and reliability.
A Pilot Test of the Everyday Stressors Index–Spanish Version in a Sample of Hispanic Women Attending Prenatal Care
Authors: Gómez María L. , Ashford Kristin , Linares Ana M. , Hall Lynne A.
Published: December 2015

Background and Purpose: Prenatal and postpartum psychosocial stress are associated with adverse pregnancy outcomes. Hispanic women experience higher levels of stress during pregnancy. This pilot study assessed the psychometric characteristics of the Everyday Stressors Index-Spanish (ESI-S) version. Methods: Secondary analysis in a convenience sample, n = 51 women. Results: The ESI-S showed adequate internal consistency (Cronbach’s alpha = .86). Two factors accounted for 40% of the item variance. The greatest sources of stress were “having too many responsibilities” and “not enough money for basics”. Higher levels of stressors were associated with older age, living without a partner, and working part or full time. The ESI-S was positively correlated with measures of perinatal depression. Conclusions: Findings support the reliability and validity of the newly translated ESI-S.
Electronic Medical Record Validation: Exploring the Reliability of Intracranial Pressure Data Abstracted From the Electronic Medical Record–Pilot
Authors: Olson DaiWai M. , Rogers Michael S. , Stutzman Sonja E.
Published: December 2015

Background and Purpose: Intracranial pressure (ICP) monitoring is crucial to decision making for neurologically injured patients, yet measurement of ICP varies greatly among practitioners. Methods: Unblinded, nonrandomized, observational pilot study comparing ICP values collected using pen and paper (P&P), electronic medical record (EMR), and video data with continuous data acquisition (CDA) technology. Results: ICP values did not significantly differ between EMR and P&P records, despite an average of 16 minutes difference in reporting times. ICP values varied significantly when comparing CDA data to EMR or paper. Conclusion: The results of this pilot study put in to question the validity of ICP values that are recorded in the medical record, which has implications for patient care and research.
A Scoping Literature Review: The State of Knowledge on Home Care Equipment and Supplies
Authors: Fraser Kimberly D. , Lai Jonathan , Nissen Catherine , Choo Queenie , Davenport Jamie , Gutscher Abram
Published: December 2015

We explored the state of knowledge on home care supplies and equipment because not much is known about this topic. We used a scoping review for the literature review because it was the most appropriate approach considering the state of the literature. We searched for articles published in both the gray and peer-reviewed literature. We established five overarching themes based on the findings. These were supply management, durable medical equipment, wound care, best practices, and costs.

This review demonstrates that although knowledge about home care supplies and equipment is growing, it is still an understudied area.
Social Role Theory and Social Role Valorization for Care Management Practice
Authors: Blakely Thomas J. , Dziadosz Gregory M.
Published: December 2015

This article proposes that social role theory (SRT) and social role valorization (SRV) be established as organizing theories for care managers. SRT is a recognized sociological theory that has a distinctive place in care management practice. SRV is an adjunct for SRT that focuses on people who are devalued by being in a negative social position and supports behavior change and movement to a valued social position.
The Home-Delivered Meals Program: A Promising Intervention for Suburban Older Adults Living Alone
Authors: Lee Kyongweon , Raiz Lisa
Published: December 2015

This study examined differences in perceived benefits of home-delivered meals between older adults living alone and those living with others. Recommendations were also discussed to enhance services by examining differences between these two subgroups.

This study used secondary data analysis focusing on two open-ended questions that were collected in a client satisfaction survey conducted by AgeOptions, the Area Agency on Aging (AAA) in suburban Cook County, Illinois. Out of 199 older adults or their caregivers who participated in the survey, 126 (63.3%) older adults were living alone. All of the survey participants shared their perception of home-delivered meals benefits, and 91 respondents (45.7%) offered recommendations on the program.

The results suggest that there is a greater need for transportation options, financial security, regular safety checks, and basic support for older adults who live alone compared to those living with others. The most frequent recommendation from all older adults was increasing the variety of meal options. Older adults living alone complained less about taste and the way meals were cooked than older adults living with others, but they requested availability of meals customized for those with unique needs. Additionally, older adults living alone offered a wider range of recommendations for the program as well as identify more diverse benefits from the program than those living with others.
An Ankle-Foot Orthosis With a Lateral Extension Reduces Forefoot Abduction in Subjects With Stage II Posterior Tibial Tendon Dysfunction
Authors: Neville Christopher , Bucklin Mary , Ordway Nathaniel , Lemley Frederick
Published: December 2015

Study Design

Controlled laboratory, repeated measures.

Background

Posterior tibial tendon dysfunction is a common musculoskeletal problem that includes tendon degeneration and collapse of the medial arch of the foot (flatfoot deformity). Ankle-foot orthoses (AFOs) typically are used to correct flatfoot deformity. Correction of flatfoot deformity involves increasing forefoot adduction, forefoot plantar flexion, and hindfoot inversion.

Objectives

To test whether a foot orthosis with a lateral extension reduces forefoot abduction in patients with stage II posterior tibial tendon dysfunction while walking.

Methods

The gait of 15 participants with stage II posterior tibial tendon dysfunction was evaluated under 3 conditions: a standard AFO, an AFO with a lateral extension, and a shoe-only control condition. Kinematic variables of interest were evaluated at designated time points in the gait cycle and included hindfoot inversion/eversion, forefoot plantar flexion/dorsiflexion, and forefoot abduction/adduction. A 3-by-4, repeated-measures analysis of variance (brace condition by gait phase) was used to compare variables across conditions.

Results

The AFO with a lateral extension resulted in a significantly greater change in forefoot adduction compared to the standard AFO (2.6°, P = .02) and shoe-only conditions (4.1°, P<.01) across all phases of stance. Forefoot plantar flexion was significantly increased when comparing the standard AFO and AFO with a lateral extension to the shoe-only condition. The AFO with the lateral extension also demonstrated significantly increased hindfoot inversion during the loading response and terminal stance phases.

Conclusion

Off-the-shelf and standard AFOs have been shown to improve forefoot plantar flexion and hindfoot eversion, but not forefoot adduction. A lateral extension added to a standard AFO along the forefoot significantly improved forefoot adduction in participants with posterior tibial tendon dysfunction while walking. J Orthop Sports Phys Ther 2016;46(1):26–33. Epub 11 Dec 2015. doi:10.2519/jospt.2016.5618
Assessment of outcome of Quadricepsplasty in Knee contractures of patients with arthrogryposis
Authors: Hallaj Moghadam Mohammad , BirjandiNejad Ali , Ghoreishi Seyed Alireza
Published: December 2015

Arthrogryposis multiplex congenita (AMC) refers to a group of conditions, unrelated to one another, which are similarly characterized by the contracture of multiple joints in the body. One of the common therapies in patients with AMC and knee extension contracture is quadricepsplasty. However, no comprehensive studies have been conducted on the results of the application of this method.This prospective study included 14 patients (9 females and 5 males) with 23 hyperextension contractures of the knee. Before surgery, all patients had underwent non-surgical treatment (manipulation and serial casting) for at least 6 months, but none had responded to the treatment. Then patients underwent a Quadricepsplasty. Range of motion (ROM) of the knee and patients ambulation based on modified form of Functional Mobility Scale (FMS) before and after surgery were evaluated in a follow up 3 years.The mean passive knee ROM before surgery was 7.17° (0° to 15°), which increased to 65.65° (35° to 105°) after the operation. According to t-test results, this increase was statistically significant (P<0.005).The mean ambulation score (modified FMS) of the patients before surgery was 1.57, which increased to 3.71. According to t-test results, this increase was statistically significant (P<0.005).Quadricepsplasty is the method of choice for the surgical treatment of knee extension contracture in AMC patients, who do not respond to non-surgical treatments. This method leads to a significant improvement in knee ROM. On the other hand, it preserves quadriceps strength at 4/5 level, and finally, along with other therapeutic interventions for other lower limb deformities, leads to ambulation improvement in these patients.Bangladesh Journal of Medical Science Vol.14(4) 2015 p. 331-335
Clinical, Etiological and Antibiotic Susceptibility Profiles of Community-Acquired Urinary Tract Infection in a Western Hemisphere of Baghdad
Authors: Hussein Naser S
Published: December 2015

Background: In majority of community-acquired urinary tract infection (CA-UTI) cases, physicians can prescribe empirical therapy without a pretreatment urine culture especially in resource poor settings, where the cost of urine culture is more than cost of treatment itself. Objective: With growing problem of drug resistance globally as well as data on CA-UTI in Iraq are scare. We conduct this study to analyze clinical presentation, etiology and antibiotic sensitivity of bacteria causing community acquired urinary tract infection (CA-UTI). Material and Methods: Outpatients urine cultures and clinical presentations were collected from April 2012 to October 2012. A positive urine culture was defined as growth of a single bacteria with colony count of more than 100,000 CFU/ml and disk diffusion technique was performed to determine antibiotics susceptibility of isolated bacteria species. Clinical symptoms, causative uropathogens and their antibiotic sensitivity were recorded. Results: Of 299 urine cultures processed, a positive urine culture was detected in 100 subjects. Dysuria and bladder irritability (frequency and urgency) were the most common clinical presentation. 39% of isolated bacteria was Escherichia coli and Staphylococcus strains (30%). The isolated uropathogens showed a substantial sensitivity reduction to most of test antibiotics. Conclusion: Clinical presentation had a minor role in diagnosis of CA-UTI and this study revealed that E. coli and Staphylococcus strains were most prevalent isolated uropathogens. Susceptibility test showed there was a high sensitivity to nitrofurantoin, amikacin and imipenem.Bangladesh Journal of Medical Science Vol.14(4) 2015 p.352-358
Pulmonary actinomycosis affecting chest wall: a case report
Authors: Hassan Md. Zakiul , Uddin Md. Nazim , Ahsan H. M. Nazmul
Published: December 2015

Thoracic actinomycosis is an uncommon, chronic suppurative bacterial infection caused by Actinomyces species. Thoracic actinomycosis represents about one-fourth of all cases of actinomycosis. We report a case of left sided pleural effusion with hydropneumothorax with collapse and consolidation of left lung with discharging sinus in the left anterior chest wall. Actinomycosis was suspected and confirmed by microscopic identification of sulfur granules in the discharge of the sinus tract and also identification of gram-positive filamentous bacteria in the specimen of discharging sinus.Bangladesh Journal of Medical Science Vol.14(4) 2015 p.417-41
Multiple Lung Hydatid Cysts and Cardiac Hydatid Cyst: A Rare Presentation
Authors: Garg Shyam , Umesh Umesh , Singh Varinder Pal , Gupta Nitin , Aggarwal Jayant , Kumar Ravi
Published: December 2015

Hydatid cysts are commonly present in liver. Cardiac hydatid cysts are very rare and represent less than 2% of all cases of hydatidosis. They can occur as widespread infection or as an isolated event. We present here a case with multiple lung hydatid cysts and a single cardiac hydatid cyst involving the apical antero-interventricular septum. A brief overview of disease and the investigations to establish the diagnosis is discussed here with introduction.Bangladesh Journal of Medical Science Vol.14(4) 2015 p.393-395
Analysis of socio-demographic and microbiological profile of vaginal discharge in patients attending Kathmandu University Hospital, Nepal
Authors: Shrestha Abha , Tuladhar Nuche Ratna , Chawla Chander Dev
Published: December 2015

Background: Vaginal discharge and associated vaginal symptoms is very common amongst women of South East Asia, hence it is necessary to make accurate diagnosis and also for appropriate treatment by identifying the causative microorganisms. Objectives: To analyze the socio-demographic and microbiological profile of vaginal discharge. Methodology: This is a prospective, non-randomized study performed in one hundred and ninety three patients attending in Department of Obstetrics and Gynecology in Kathmandu University Hospital, Dhulikhel, Nepal. The patients with vaginal discharge and age of ?16 years included. Vaginal discharge was taken from the posterior and lateral fornices. The swab was cultured on blood, chocolate and Mac Conkeys agar and incubated at 37°C for 24-48 hours. Fungus when isolated was subcultured onto Sabouraud dextrose agar. The data were analyzed using the SPSS 11.5 software. Result: The frequency of vaginal discharge was 1.67%. Most of the patients fell within 16-25 years. 50.3% patients were illiterate whereas only 3.1% was having master degree. 50.3% patients were having class V socioeconomic status where as only 2.6% had class I status. Housewife accounted for 67.9% whereas other occupation (petty business) accounted for only 5.2%. Most of the patients with vaginal discharge were from Newar and Tamang ethnic group. Bacterial vaginosis was isolated in 36.3% and normal flora accounted for 20.7%. Conclusion: There is still lack of awareness about the vaginal discharge be it abnormal discharge or physiological leucorrhea and related problems. So, it is worthwhile to create public awareness and also to find out the socio-demographic factors affecting the pattern of microbiological flora variation in vaginal discharge, as it gives us the clue regarding the use of appropriate antimicrobial therapy and the changes that can be made to the quality of life of the women.Bangladesh Journal of Medical Science Vol.14(4) 2015 p.323-326
Role of CMV & Interferon-? in Myocardial Infarction, Angina and Hypertension
Authors: Haider Mehvash , Rizvi Meher , Malik Abida , Azam Md , Rabbani M U
Published: December 2015

Aims: There is limited epidemiologic evidence relating CMV specifically to primary coronary atherosclerosis. Its association with atherosclerosis and restenosis appears to have merit and needs to be studied further. Cardiovascular disease being an inflammatory process leads to detectable rise in inflammatory markers like Interferon-?. The aim of this study was to evaluate the role of CMV and Interferon-? in cardiovascular disease. Methods: Study was conducted on 63 randomly selected cardiovascular disease patients and 29 healthy controls. ELISA for detection of IgG antibodies against CMV were detected (Calbiotech Diagnostics, USA). Interferon-? levels were determined by ELISA (Diaclone, USA). Relevant investigations, clinical history & examination were recorded. Results: Of 63 cases 41 (65.08%) were positive for IgG antibodies against CMV and 8 (27.58%) of 29 controls were IgG positive (p<0.001). Among CMV seropositives 19 (46.34%) were MI patients, 13 (31.70%) were hypertensives and 9 (21.95%) were angina patients. The mean value of Interferon-? for cases was 32.13pg/ml, the mean of controls was 11.32pg/ml (p<0.0001). Among CMV IgG seropositives the mean value of Interferon-? in hypertensives was 12.76pg/ml, in angina patients was 32.48pg/ml and in MI patients was 67.10pg/ml. Conclusion: In our study CMV seropositivity was significantly associated with CVD cases. CMV seropositivity increased with severity of disease. Mean value of Interferon-? was higher among cases reflecting role of inflammatory aetiology in CVD. Mean value of Interferon-? increased with severity of disease infection clearly indicating the role of inflammatory markers along with CMV in cardiovascular disease.Bangladesh Journal of Medical Science Vol.14(4) 2015 p.339-345
Primary Xanthoma of Femur: A Case Report
Authors: Hossain Mohammad Ismail , Khan AKM Shahabuddin
Published: December 2015

Xanthoma of bone is a very rare benign bone disorder with features mimicking primary bone tumours or metastatic lesions and their definitive diagnosis is very difficult. This condition can occur in patients with both normal and abnormal lipid profiles. Xanthoma of femur in a normolipidemic patient is very rare. Histopathological study gives a definitive diagnosis. We report a case of a 17 year old patient who was hospitalized in orthopedic department for fracture of the right femur with a lytic lesion at the fracture site. The patient was normolipidemic and hypothyroid. The diagnosis of xanthoma was selected histomorphologically. The fracture was treated surgically by nailing and bone graft.Bangladesh Journal of Medical Science Vol.14(4) 2015 p.396-398
Cavernous hemangioma presented with gigantic tongue
Authors: Abdullah Mokhti , Ghazali Norzi , Mohamad Irfan , Mohamad Hazama
Published: December 2015

Lingual hemangioma is a benign congenital vascular tumour that may cause macroglossia. It can present with airway obstruction, speech disturbance, swallowing difficulties and mandible dental deformities. It usually occurred during childhood. Females are more affected. It usually poses difficulties in diagnosis and management. This case illustrated a rare case of lingual hemangioma in a 5 year old boy presented with tongue enlargement associated with swallowing difficulties and significant tongue bleeding which required blood transfusion. Surgical intervention in the form of tongue reduction surgery was successfully done to him. Histopathological examination revealed a cavernous hemangioma.Bangladesh Journal of Medical Science Vol.14(4) 2015 p.405-408
A New Theory on the Evaluation of Traditional Chinese Acupuncture Mechanisms from the Latest Medical Scientific Point of View
Authors: Inanç Betül Battaloğlu
Published: December 2015

Acupuncture is a key component of traditional Chinese medicine involving the insertion of needles through the skin at specific points on the body to achieve therapeutic effects and is an ancient Chinese art of healing. Using ancient scientific principles, acupuncture treats illnesses
by bringing a person's body into harmony and regulating the balance of Yin and Yang. Balancing Yin and Yang is one basic principle of Chinese medicine, and balancing methods for combination of meridians and acupoints have been described throughout the history of Chinese medicine. Clinical
observations and principal research on acupuncture focus on the adjustment of the Zang-Fu organ and have shown that the adjustment by acupuncture relied largely on the effective components in different organs. What does this effectiveness mean? In fact, is acupuncture a treatment that shows
its effects with signals to the autocrine, paracrine and endocrine pathways? What role does embryology play in this area? Furthermore, molecular biology has opened avenues to newer methods for the study of embryology and to enhance our understanding of growth and development. Can evaluation
of acupuncture with these branches of science be more scientific? We discuss this interesting topic in this original article. After all this time, it is reasonable that different therapeutic techniques and approaches are developed for acupuncture.
Beneficial Acupuncture Treatment For Systemic Sclerosis which was Non-Responsive To Medications
Authors: Karatay Saliha , Uzkeser Hulya
Published: December 2015

Although various drugs have been used in the treatment of systemic sclerosis, a disease-modifying drug that can be a gold standard is yet to be defined. The effects of acupuncture treatment used in inflammatory diseases on systemic sclerosis patients are not clearly known. This report
presents the successful outcome of acupuncture treatment applied to two female systemic sclerosis patients who had suffered from the disease for seven years (aged 54 years) and 30 years (aged 65 years), despite the use of various drugs.
In Vitro Assessment of Human Islet Vulnerability to Instant Blood-Mediated Inflammatory Reaction (IBMIR) and Its Use to Demonstrate a Beneficial Effect of Tissue Culture
Authors: Ramnath Raina D. , Maillard Elisa , Jones Katherine , Bateman Paul A. , Hughes Stephen S. J. , Gralla Jane , Johnson Paul R. , Gray Derek W. R.
Published: December 2015

Culture of human pancreatic islets is now routinely carried out prior to clinical islet allotransplantation, using conditions that have been developed empirically. One of the major causes of early islet destruction after transplantation is the process termed instant blood-mediated inflammatory reaction (IBMIR). The aim of this study was to develop in vitro methods to investigate IBMIR and apply them to the culture conditions used routinely in our human islet isolation laboratory. Freshly isolated or precultured (24 h, 48 h) human islets were incubated in either ABO-compatible allogeneic human blood or Hank's buffered salt solution (HBSS) for 1 h at 37°C. Tissue factor (TF) expression and leukocyte migration were assessed by light microscopy. TF was also quantified by ELISA. To assess β-cell function, glucose-stimulated insulin secretion (GSIS) assay was carried out. The extent of islet β-cell damage was quantified using a proinsulin assay. Islets cultured for 24 h had higher GSIS when compared to freshly isolated or 48-h precultured islets. Freshly isolated islets had significantly higher TF content than 24-h and 48-h precultured islets. Incubation of freshly isolated human islets in allogeneic human blood released 6.5-fold higher level of proinsulin in comparison to freshly isolated human islets in HBSS. The high level of proinsulin released was significantly attenuated when precultured islets (24 h or 48 h) were exposed to fresh blood. Histological examination of fresh islets in blood clot showed that some islets were fragmented, showing signs of extraislet insulin leakage and extensive neutrophil infiltration and necrosis. These features were markedly reduced when the islets were cultured for 24 h. These results suggest that our standard 24-h islet culture is markedly beneficial in attenuating IBMIR, as evidenced by increased GSIS, lower content of TF, decrease islet fragmentation, and proinsulin release.