bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of life of persons with transfemoral amputation: Comparison of socket prostheses and osseointegrated prostheses
Authors: Pospiech Philip Thomas , Wendlandt Robert , Aschoff Horst-Heinrich , Ziegert Sibylle , Schulz Arndt Peter 
Published: August 2020

Background:
Until recently, no study had compared the quality of life of persons with transfemoral amputation treated with osseointegration to socket prosthesis users.

Objectives:
Comparison of quality of life in two types of prostheses users: a cohort of patients with osseointegration and patients equipped with a socket prosthesis who were group-matched for age, body mass index and mobility grade.

Study design:
A cross-sectional study that compared

Methods:
The quality of life of 39 participants (22 in the osseointegration group and 17 in the socket prosthesis group) was measured using the Questionnaire for Persons with Transfemoral Amputation (Q-TFA) and European Questionnaire 5-dimension 3-level (EQ-5D-3L) surveys.

Results:
Compared with the socket prosthesis group, the osseointegration group had a significantly higher ‘Global’ score (p = 0.022) and a significantly lower ‘Problem’ score (p < 0.001) of the Q-TFA. The ‘Mobility’ (p = 0.051) and ‘Use’ scores (p = 0.146) of the Q-TFA, the EQ-5D-3L index (p = 0.723), and EQ-5D visual analog scale (p = 0.497) showed no significant differences between groups.

Conclusions:
Patients with osseointegration experienced less prosthesis-associated problems than socket prosthesis users and had a higher prosthesis-associated quality of life when assessed with the Q-TFA. General quality of life, as assessed with the EQ-5D-3L, was not different between groups.
Where Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home?
Authors: Venkatesh Arjun K. , Gettel Cameron J. , Mei Hao , Chou Shih-Chuan , Rothenberg Craig , Liu Shu-Ling , D’Onofrio Gail , Lin ZhenQiu , Krumholz Harlan M. 
Published: August 2020

Objectives: This study aimed to characterize the distribution of acute care visits among Medicare beneficiaries receiving skilled nursing facility (SNF) services. Methods: We conducted a cross-sectional analysis of a 20% sample of continuously enrolled Medicare beneficiaries in the 2012 Chronic Condition Warehouse data set. Beneficiaries were grouped by the number of days of SNF services, and acute care visits were categorized as “before SNF,” “during SNF,” or “after SNF.” Results: Among the 10,717,786 Medicare beneficiaries analyzed, 384,312 (3.6%) had at least one SNF stay. Discussion: Beneficiaries who received SNF services had a higher proportion of acute care visits made to emergency departments (EDs) than beneficiaries who did not receive SNF services. Also, a higher proportion of acute care visits were made to EDs by beneficiaries after a SNF stay in comparison to residents actively residing in a SNF. The acute care capabilities of SNFs and post-SNF transitions of care to the community setting are discussed.
Association Between Physical Exercise and Cognitive Function Among Community-Dwelling Older Adults
Authors: Endeshaw Yohannes , Goldstein Felicia 
Published: August 2020

Objectives: To examine the association between self-reported physical exercise and cognitive function. Design: Secondary data analysis of a prospective cohort study. Participants: Community-dwelling older adults with normal cognitive function at baseline. Measurements: Data on self-reported physical exercise, immediate and delayed recall, clock drawing test, and orientation to time and current events were collected at baseline and annual follow-up visits. Generalized estimation equation method was used to determine the association between physical exercise and decline in cognitive function. Results: A total of 4,227 participants were included in the analysis, 58% women, 78% White, mean (SD) age 75.7 (7.1) years. The risk of cognitive decline was lower among those who reported moderate-to-high intensity exercise (odds ratio [OR] confidence interval [CI] = 0.45 [0.20, 0.69]; p < .001) and low-intensity exercise (OR [CI] = 0.62 [0.44, 0.83]). Conclusion: These results reaffirm the positive impact of physical exercise in maintaining cognitive function among older adults.
Breast-cancer mortality in screened versus unscreened women: Long-term results from a population-based study in Queensland, Australia
Authors: Dunn Nathan , Youl Philippa , Moore Julie , Harden Hazel , Walpole Euan , Evans Elizabeth , Taylor Kate , Philpot Shoni , Furnival Colin 
Published: August 2020

Objective In the context of a mature mammographic screening programme, the aim of this population-based study was to estimate rates of breast-cancer mortality among participants versus non-participants in Queensland, Australia. Methods The Queensland Electoral Roll was used to identify women aged 50–65  in the year 2000 (n = 269,198). Women with a prior history of invasive or in situ breast cancer were excluded (n = 6,848). The study population was then linked to mammography records from BreastScreen Queensland together with the Wesley Breast Screening Clinic (the largest provider of private screening in Queensland) to establish a screened cohort (n = 187,558) and an unscreened cohort (n = 74,792). Cohort members were matched and linked to cancer notifications and deaths through the state-based Queensland Oncology Repository. Differences in breast-cancer mortality between the two cohorts were measured using Cox proportional hazards regression. Results After 16 years of follow-up, women in the screened cohort showed a 39% reduction in breast-cancer mortality compared to the unscreened cohort (HR = 0.61, 95%CI = 0.55–0.68). Cumulative mortality over the same period was 0.47% and 0.77% in the screened and unscreened cohorts, respectively. Conclusions This study found a significant reduction in breast-cancer mortality for women who participated in mammographic screening compared to unscreened women. Our findings of a breast-cancer mortality benefit for women who have mammographic screening are in line with other observational studies.
Provision and Utilization of Team- and Community-Based Operative Care for Patients With Cleft Lip/Palate in North Carolina
Authors: Le Elliot , Shrader Peter , Bosworth Hayden , Hurst Jillian , Goldstein Benjamin , Drake Amelia , Wood Jeyhan , David Lisa R. , Runyan Christopher M. , Vissoci Joao Ricardo Nickenig , Harker Matthew , Allori Alexander C. 
Published: August 2020

Objective: To characterize operative care for cleft lip and/or palate (CL/P) based on location (ie, from American Cleft Palate Craniofacial Association [ACPA]–approved multidisciplinary teams or from community providers). Design: Cross-sectional analysis of Healthcare Cost and Utilization Project State Inpatient Database and State Ambulatory Surgery & Services Database databases for North Carolina from 2012 to 2015. Setting/Patients and Main Outcome Measures: Clinical encounters for children with CL/P undergoing operative procedures were identified, classified by location as “Team” versus “Community,” and characterized by demographic, geographic, clinical, and procedural factors. A secondary evaluation reviewed concordance of team and community practices with an ACPA guideline related to coordination of care. Results: Three teams and 39 community providers performed a total of 3010 cleft-related procedures across 2070 encounters. Teams performed 69.7% of total volume and performed the majority of cleft procedures, including cleft lip repair, palate repair, alveolar bone grafting, and correction of velopharyngeal insufficiency. Community locations principally offered myringotomy and rhinoplasty. Team care was associated with higher guideline concordance. Conclusions: American Cleft Palate Craniofacial Association –approved team-based care accounts for the majority of cleft-related care in North Carolina; however, a substantial volume of cleft-related procedures was provided by community providers, with 3 providers accounting for the vast majority of community cases.
A Single-Center Retrospective Evaluation of the Use of Oral Factor Xa Inhibitors in Patients With Cerebral Venous Thrombosis
Authors: Powell Marissa , Tremolet de Villers Kathryn , Schwarz Kerry , Case David , Trujillo Toby 
Published: August 2020

Background: Clinical practice guidelines recommend that cerebral venous thrombosis (CVT) be managed with long-term anticoagulant therapy using warfarin or low-molecular-weight heparin (LMWH) for 3 to 12 months. However, oral factor Xa inhibitors may offer preferable alternative treatment options for these patients. Objective: The primary objective was to determine the effectiveness and safety of rivaroxaban or apixaban compared with warfarin or enoxaparin as long-term anticoagulation therapy for patients with a new diagnosis of CVT. Methods: This was a single-center retrospective review of patients with newly diagnosed CVT who received acute and maintenance anticoagulation treatment. Study groups compared patients who received warfarin, enoxaparin, or an oral factor Xa inhibitor as their maintenance anticoagulant. The primary outcome was recurrent thrombotic events while on anticoagulation. Secondary outcomes included modified Rankin Scale, improved cerebral venous sinus opacification, duration of anticoagulant therapy, bleeding events during anticoagulant therapy, and adverse effects. Results: A total of 119 patients were included in the analysis: warfarin (89), enoxaparin (11), and oral factor Xa inhibitor (19). The risk of recurrent thrombotic events were 11.2%, 0%, and 10.5% in the warfarin, enoxaparin, and oral factor Xa inhibitor treatment groups, respectively ( P = 0.7635). There were no significant between-group differences observed regarding any of the secondary outcomes. Conclusions: Although the sample size is limited, these findings indicate that oral factor Xa inhibitors are a reasonable treatment option for patients with CVT. There was a trend toward more persistent symptoms in patients on warfarin, suggesting a potential improvement in recovery among patients that received an oral factor Xa inhibitor.
Clinical pharmacy services in an ambulatory oncology clinic: Patient perception and satisfaction
Authors: Munro Lauren , Myers Glenn , Gould Odette , LeBlanc Michael 
Published: August 2020

Introduction Studies have shown that patients rate pharmacists more favourably when the pharmacist expresses interest in the patient and attends to patients’ perspectives. There is limited available evidence evaluating both patient perception and satisfaction regarding clinical pharmacy services provided in an ambulatory oncology clinic. Methods This was a prospective mixed methods study involving surveys and patient interviews. Consenting participants completed a survey at their first visit evaluating their perceptions of the importance of the clinical pharmacy services offered in the ambulatory oncology clinic. They completed a second survey 6-8 weeks later to re-evaluate their perceptions and to measure satisfaction ratings. The final component of this study involved semi-structured one-on-one telephone interviews to gather qualitative data regarding the study objectives. Results A total of 35 participants completed the survey, of which eleven completed one-on-one patient telephone interviews. Patients perceived the clinical pharmacy services assessed as important to their care before receiving treatment. The ratings of the importance of the pharmacist in managing patients’ nausea/vomiting significantly decreased when remeasured, whereas the importance of meeting the pharmacist in the clinic significantly increased. The importance of the role of the pharmacist was highlighted in patient interviews as well: patients particularly valued the pharmacist’s initiative to meet them in the clinic, the education provided by pharmacist, and the pharmacist’s accessibility throughout treatment. Conclusions Overall, patients in the ambulatory oncology clinic perceived the services offered as important to their care and they were highly satisfied.
Associations Between 24-Hour Time Use and Academic Achievement in Australian Primary School–Aged Children
Authors: Watson Amanda , Dumuid Dorothea , Olds Tim 
Published: August 2020

Background Previous research has examined associations between individual activity behaviors and academic achievement. Yet activity behaviors should be analyzed together because they are codependent parts of the 24-hour day. Aims This study aims to explore the associations between all daily activity behaviors (sleep, sedentary time, light physical activity [LPA], and moderate-to-vigorous physical activity [MVPA]) and academic achievement using compositional data analysis. Method Participants for this study were drawn from two cohorts: the Australian arm of the cross-sectional International Study of Childhood Obesity, Lifestyle and the Environment ( n = 452; mean age 10.7 years ( SD = 0.4); 54% female) and CheckPoint ( n = 1278; mean age 12 years [ SD = 0.4]; 50% female), a cross-sectional study nested between Waves 6 and 7 of the Longitudinal Study of Australian Children. Objective daily activity behavior data (sleep, sedentary time, LPA, and MVPA) were collected using 8-day, 24-hour accelerometry. Academic achievement was assessed using a nationally administered standardized test in literacy (spelling, grammar and punctuation, writing and reading) and numeracy. Compositional models (adjusted for age, sex, socioeconomic position, and pubertal development) regressed academic scores against isometric log ratios of activity behaviors. We used the models to estimate academic achievement for observed daily activity mixes. Estimated outcomes were plotted against time spent in each individual activity domain, and loess curves were fitted. Discussion and conclusion In two different cohorts using two different accelerometers, lower LPA was related to better numeracy and literacy and higher sedentary time to better literacy (relative to time spent in other domains). Discussion and conclusion. LPA likely “drains time” from other movement behaviors, which are beneficial for academic achievement.
Feline leukaemia virus infection: A practical approach to diagnosis
Authors: Hofmann-Lehmann Regina , Hartmann Katrin 
Published: August 2020

Practical relevance: Feline leukaemia virus (FeLV) is a retrovirus of domestic cats worldwide. Cats lacking strong FeLV-specific immunity and undergoing progressive infection commonly develop fatal FeLV-associated disease. Many aspects of FeLV infection pathogenesis have been elucidated, some during more recent years using molecular techniques. It is recommended that the FeLV status of every cat is known, since FeLV infection can influence the prognosis and clinical management of every sick cat. Moreover, knowledge of a cat’s FeLV status is of epidemiological importance to prevent further spread of the infection. Clinical challenges: Diagnosing FeLV infection remains challenging due to different outcomes of infection, which can vary over time depending on the balance between the virus and the host’s immune system. Furthermore, testing for FeLV infection has become more refined over the years and now includes diagnostic assays for different viral and immunological parameters. Knowledge of FeLV infection pathogenesis, as well as the particulars of FeLV detection methods, is an important prerequisite for correct interpretation of any test results and accurate determination of a cat’s FeLV status. Aims: The current review presents recent knowledge on FeLV pathogenesis, key features to be determined in FeLV infection, and frequently used FeLV detection methods, and their characteristics and interpretation. An algorithm for the diagnosis of FeLV infection in a single cat, developed by the European Advisory Board on Cat Diseases, is included, and FeLV testing in specific situations is addressed. As well as increasing awareness of this deadly infection in domestic cats, the aim is to contribute diagnostic expertise to allow veterinarians in practice to improve their recognition, and further reduce the prevalence, of FeLV infection.
Feline abdominal ultrasonography: What’s normal? What’s abnormal? Renal pelvis, ureters and urinary bladder
Authors: Griffin Sally 
Published: August 2020

Practical relevance: Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Ultrasound examination of the urinary tract provides important information useful in the investigation of several conditions including ureteral obstruction and cystitis. Clinical challenges: Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even for the experienced ultrasonographer, differentiating between incidental findings, such as lipid droplets in the bladder, and pathological changes can be challenging. Aim: This review, part of an occasional series on feline abdominal ultrasonography, discusses the ultrasonographic examination of the normal and diseased renal pelvis, ureters and urinary bladder. Aimed at general practitioners who wish to improve their knowledge of and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. Ultrasound examination of the kidneys and perinephric space was discussed in an article published in May 2020. Equipment: Ultrasound facilities are readily available to most practitioners, although the use of ultrasonography as a diagnostic tool is highly dependent on operator experience. Evidence base: Information provided in this article is drawn from the published literature and the author’s own clinical experience.
The predictors, barriers and facilitators to effective management of acute pain in children by emergency medical services: A systematic mixed studies review
Authors: Whitley Gregory A , Hemingway Pippa , Law Graham R , Jones Arwel W , Curtis Ffion , Siriwardena Aloysius N 
Published: August 2020

We aimed to identify predictors, barriers and facilitators to effective pre-hospital pain management in children. A segregated systematic mixed studies review was performed. We searched from inception to 30-June-2020: MEDLINE, CINAHL Complete, PsycINFO, EMBASE, Web of Science Core Collection and Scopus. Empirical quantitative, qualitative and multi-method studies of children under 18 years, their relatives or emergency medical service staff were eligible. Two authors independently performed screening and selection, quality assessment, data extraction and quantitative synthesis. Three authors performed thematic synthesis. Grading of Recommendations Assessment, Development and Evaluation and Confidence in the Evidence from Reviews of Qualitative Research were used to determine the confidence in cumulative evidence. From 4030 articles screened, 78 were selected for full text review, with eight quantitative and five qualitative studies included. Substantial heterogeneity precluded meta-analysis. Predictors of effective pain management included: ‘child sex (male)’, ‘child age (younger)’, ‘type of pain (traumatic)’ and ‘analgesic administration’. Barriers and facilitators included internal (fear, clinical experience, education and training) and external (relatives and colleagues) influences on the clinician along with child factors (child’s experience of event, pain assessment and management). Confidence in the cumulative evidence was deemed low. Efforts to facilitate analgesic administration should take priority, perhaps utilising the intranasal route. Further research is recommended to explore the experience of the child. Registration: PROSPERO CRD42017058960
Building knowledge for policy and practice based on service user and carer experiences: A case study of Scottish adult safeguarding research
Authors: Sherwood-Johnson Fiona , Mackay Kathryn 
Published: August 2020

Summary This article presents Scottish adult safeguarding as a case study to illuminate some challenges of building knowledge for policy and practice based on service user and carer voices. It draws on five of our own research projects that have evaluated implementation of Scottish adult safeguarding legislation and/or asked more exploratory questions about risk, safety and support. Findings We show how practical and ethical issues limited our more evaluative lines of inquiry. We then show how increasingly participative approaches led to studies that were more accessible and that connected more deeply with service users’ and carers' lives, but that also faced greater challenges in the translation of their findings back into the policy and/or practice environment. Applications We conclude with an argument for ongoing dialogue between policy-makers, professionals, service users and carers, researchers, educators and students about knowledge, its different forms and sources, its generation and its use.
The need for palliative and support care services for heart failure patients in the community
Authors: Ganz Freda DeKeyser , Roeh Keshet , Eid Muhammad , Hasin Tal , Harush Chen , Gotsman Israel 
Published: August 2020

AbstractBackgroundPalliative care is a care option considered appropriate for those with heart failure, but is uncommon partially due to a lack of timely identification of those needing palliative care. A standard mechanism that triggers which heart failure patients should receive palliative care is not available. The Gold Standards Framework (GSF) identifies those needing palliative care but has not been investigated with heart failure patients.ObjectivesTo describe palliative care provided in the community and determine whether the GSF can identify heart failure patients in need of palliative care.MethodsDescriptive study. A total of 252 heart failure patients in the community completed a demographic characteristics questionnaire, the Edmonton symptom assessment scale-revised and the Minnesota living with heart failure questionnaire. Clinical data were collected from the medical chart and the primary physician completed the GSF prognostic indicator guidance.ResultsParticipants had a mean age of 76.9 years (standard deviation 10.9), most at New York Heart Association level III (n = 152, 60%). Fewer than half received pain medications (n = 76, 30%), anxiolytics (n = 35, 14%), antidepressants (n = 64, 25%) or sleep medications (n = 65, 26%). Eight patients spoke with a psychologist or psychologist (3%). One had an advanced directive and 16 (6%) had a record of discussions with their family caregivers. Three (1%) had end-of-life discussions with their healthcare providers. Most healthcare providers responded ‘no’ to the ‘surprise question’ (n = 160, 63%). Sensitivity and specificity of the gold standards framework was poor.ConclusionsFew community dwelling heart failure patients received most aspects of palliative care. The gold standards framework was not a good indicator of those who should receive palliative care.