bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health and social work practitioners’ experiences of working with risk and older people
Authors: Beech Christian , Verity Fiona 
Published: January 2020

Purpose
The purpose of this paper is to explore interprofessional and multidisciplinary working between health and social care practitioners providing services to older people through the prism of how risk is assessed and managed. It proposes that whilst interprofessional and multidisciplinary working is a broad and commonly researched topic, there is a relative paucity of evidence specifically regarding how health and social care practitioners work together across structural, cultural and ideological divides. The study aims to expand the domain of integrated health and social care by including perceptions, understanding and use of the concept of risk by professionals from different disciplines.

Design/methodology/approach
This paper is based upon an exploratory study using an interpretivist phenomenological perspective, including 23 semi-structured individual interviews with health and social care practitioners and 2 non-participant observations of multidisciplinary team meetings.

Findings
The paper provides empirical insights around the complex dynamics of interprofessional and multidisciplinary working between health and social care practitioners, in particular the saliency of the interconnectedness of individual practitioner Personalities with the Process of interprofessional and multidisciplinary working under the auspices of relevant Policy drivers.

Research limitations/implications
The research was conducted in Wales and, due to the increasingly divergent policy context within the UK, the research results may lack generalisability from a wider UK or international perspective. Therefore, researchers are encouraged to test the propositions of this research further.

Practical implications
The paper includes implications for both interprofessional and multidisciplinary policy and practice with older people. With new models of integrated care being sought, the findings of this study may offer a timely and valuable contribution, particularly from the inclusion of a social care perspective and in better understanding the interconnectedness of practitioner personalities with process and policy.

Originality/value
This paper fulfils an identified need to study the complex dynamics and interconnectedness between health and social care practitioners who work together to provide services to older people.
Creating a successful health pathway to support the integration of patient care
Authors: Chow Josephine S.F. , Gonzalez-Arce Veronica Eugenia , Tam Chun Wah Michael , Warner Kerry , Maurya Nutan , Mcdougall Alan 
Published: January 2020

Purpose
HealthPathways (HPW) is an online health information portal which provides general practitioners (GPs), guidance on the assessment, management and referral of a range of conditions linked to local resources. However, there is a lack of understanding of the acceptance of pathways within primary health. The paper aims to discuss this issue.

Design/methodology/approach
This qualitative study identified baseline factors that promote the successful implementation of HPW in a major local health district (LHD) in Australia. The development, implementation and acceptance of Diabetes HPW were evaluated. A total of 16 semi-structured interviews were conducted with 12 stakeholders and 4 GPs. Interviews were digitally recorded, transcribed and analyzed qualitatively using a thematic analysis approach.

Findings
Four major themes were identified that promote the integration of care in the region through utilizing HPW: engagement, sustainability, transparency and accountability. Several factors identified as “enablers” or “barriers” are described at micro and macro levels of the healthcare system.

Originality/value
By combining the perspectives of both stakeholders and end-users, this qualitative evaluation of the localized HPW has identified relational and structural factors that promote the successful implementation of HPW to facilitate the integration of care in this LHD. Furthermore, this study provides other implementers with a comprehensive evaluation of the HPW development.
The numerical translation of verbal probability expressions by patients and clinicians in the context of peri‐operative risk communication
Authors: Wiles M. D. , Duffy A. , Neill K. 
Published: January 2020

SummaryShared decision‐making is central to the pre‐operative consent process and accurate communication of risk is dependent on a clear understanding of numerical information by both the patient and clinician. The risk of an adverse event or complication is often described using verbal probability expressions but how these are interpreted by clinicians and patients in the pre‐operative setting has not been studied. We asked patients and clinicians to assign a numerical translation (as a percentage) for seven verbal probability expressions in relation to the probability of a major peri‐operative complication occurring. In total, data from 290 patients and 57 clinicians were analysed. There was a wide range in percentages assigned by patients to all verbal probability expressions. Patients assigned a wider range of percentage values to each of the verbal probability expressions and these were all significantly higher than those assigned by clinicians: median (IQR [range]) negligible risk 5% (1–15 [0–100]) vs. 0% (0–0 [0–5]); minimal risk 5% (2–10) [0–100]) vs. 1% (0–1 [0–10]); low risk 10% (3–10 [0–100]) vs. 1% (0–2) [0–10]); standard risk 20% (10–40) [0–100]) vs. 1% (1–5) [0–30]); moderate risk 33% (20–50) [0–100]) vs. 5% (3–10) [0–80]); high risk 70% (30–90 [0–100]) vs. 15% (10–40) [1–75]); and very high risk 90% (50–95 [0–100]) vs. 40% (20–50 [5–100]), respectively (p < 0.005 for all comparisons). There is considerable variation in the numerical translation of verbal probability expressions by both patients and clinicians. This suggests that verbal probability expressions should not be used in isolation as part of doctor–patient discussions regarding peri‐operative risk.
Effect of mean HbA1c on the association of HbA1c variability and all‐cause mortality in patients with type 2 diabetes
Authors: Tseng Juei‐Yu , Chen Hsin‐Hung , Huang Kuo‐Chin , Hsu Sheng‐Pang , Chen Ching‐Chu 
Published: January 2020

AbstractAimTo evaluate the effect of mean HbA1c on the correlation between HbA1c variability and all‐cause mortality, and the risks associated with different levels of HbA1c and glycaemic control status in patients with type 2 diabetes.Materials and MethodsPatients with type 2 diabetes and at least three HbA1c measurements within 12–24 months were included. HbA1c variability score, coefficient of variation (CV) and standard deviation (SD) were used to evaluate variability. A variability score of 50 was set as a cutoff to define low and high variability.ResultsA total of 4216 patients were included, of whom 1196 died during the observation period (11.1 ± 3.2 years). All‐cause mortality increased with HbA1c variability score and the quartiles of HbA1c CV and SD. The strength of this association was attenuated after adjustment for mean HbA1c, and the risks associated with HbA1c variability and glycaemic control status were similar. The highest associated risk was observed with an HbA1c variability score of >50 and mean HbA1c of ≥7.5%. Mortality risk was significantly higher with a mean HbA1c of ≤6.0% and >8.5% and of ≤6.0% and >8.0% for low and high HbA1c variability, respectively.ConclusionsMean HbA1c contributed to the correlation between HbA1c variability and all‐cause mortality. The risks associated with HbA1c variability and glycaemic control status were similar. The relationship between mean HbA1c and mortality presented a J‐shaped distribution for both low and high HbA1c variability.
A greater proportion of participants with type 2 diabetes achieve treatment targets with insulin degludec/liraglutide versus insulin glargine 100 units/mL at 26 weeks: DUAL VIII, a randomized trial designed to resemble clinical practice
Authors: Sesti Giorgio , Bardtrum Lars , Dagdelen Selcuk , Halladin Natalie , Haluzík Martin , Őrsy Petra , Rodríguez Martin , Aroda Vanita R. 
Published: January 2020

AbstractThis report presents the efficacy and safety of insulin degludec/liraglutide (IDegLira) versus insulin glargine 100 units/mL (IGlar U100) as initial injectable therapy at 26 weeks in the 104‐week DUAL VIII durability trial (NCT02501161). Participants (N = 1012) with type 2 diabetes (T2D) uncontrolled on oral antidiabetic drugs (OADs) were randomized 1:1 to open‐label IDegLira or IGlar U100. Visits were scheduled at weeks 1, 2, 4 and 12, and every 3 months thereafter. After 26 weeks, glycated haemoglobin (HbA1c) reductions were greater with IDegLira versus IGlar U100 (−21.5 vs. –16.4 mmol/mol [−2.0 vs. –1.5%]), as was the percentage of participants achieving HbA1c <53 mmol/mol (78.7% vs. 55.7%) and HbA1c targets without weight gain and/or hypoglycaemia. Estimated treatment differences for insulin dose (−13.01 U) and body weight change (−1.57 kg) significantly favoured IDegLira. The hypoglycaemia rate was 44% lower with IDegLira versus IGlar U100. Safety results were similar. In a trial resembling clinical practice, more participants receiving IDegLira than IGlar U100 met treatment targets, supporting use of IDegLira as an initial injectable therapy for people with T2D uncontrolled on OADs and eligible for insulin initiation.
A proposal to introduce dental trauma into medical education: An insight
Authors: Yeng Thai , O'Sullivan Anthony J. , Shulruf Boaz 
Published: January 2020

AbstractThe problemThis proposal aims to tackle the common poor management of traumatic dental injury (TDI) by medical doctors and subsequent poor healthcare outcomes for patients. The literature reports that most medical doctors, in either private practice or hospital emergency departments, lack the knowledge, skills, and confidence needed to adequately assess and manage victims of TDI. This is due to little or no clinical dentistry and dental trauma education being included in their medical studies.The gap in the literatureFrom a review of the literature, there is a clear lack of learning provision for medical students on the topic of dental anatomy and trauma. In addition, there appears to be no formal university theoretical and clinical training during medical school.The practical implicationsThe introduction of dental trauma into the medical curriculum will provide students with a better understanding of the importance of early management for better patient outcomes. Medical doctors competent in managing emergency dental trauma procedures will be able to provide a higher standard of care that could prevent potentially lifelong negative repercussions for the patient.
Dravet syndrome: Treatment options and management of prolonged seizures
Authors: Cross J. Helen , Caraballo Roberto H. , Nabbout Rima , Vigevano Federico , Guerrini Renzo , Lagae Lieven 
Published: January 2020

AbstractOver time, with careful delineation of Dravet syndrome, we have gained experience in treatments most likely to lead to improvement in seizures, as well as those that should be avoided. Sodium valproate, clobazam, stiripentol, and topiramate are all medications that may lead to benefit, as well as the ketogenic diet. Bromides may be utilized in resistant cases. However, equally important are outlining prompt rescue treatment for prolonged seizures and avoidance of precipitants. Newer agents including cannabidiol and fenfluramine have been demonstrated to be of benefit in clinical trials. We propose an algorithm for management, but appreciate that the positioning of newer agents is yet to be established.
SCN1A‐related phenotypes: Epilepsy and beyond
Authors: Scheffer Ingrid E. , Nabbout Rima 
Published: January 2020

AbstractSCN1A, encoding the alpha 1 subunit of the sodium channel, is associated with several epilepsy syndromes and a range of other diseases. SCN1A represents the archetypal channelopathy associated with a wide phenotypic spectrum of epilepsies ranging from genetic epilepsy with febrile seizures plus (GEFS+), to developmental and epileptic encephalopathies (DEEs). SCN1A disorders also result in other diseases such as hemiplegic migraine and autism spectrum disorder (ASD). Dravet syndrome (DS) is the prototypic DEE with an early onset of febrile status epilepticus, hemiclonic or generalized tonic‐clonic seizures, and later onset of additional seizure types. Electroencephalography (EEG) and magnetic resonance imaging (MRI) are normal at onset. Development is normal in the first year of life but plateaus rapidly, with most patients ultimately having intellectual disability. Epilepsy is drug‐resistant and necessitates polytherapy. Most pathogenic variants occur de novo in the affected child, but they are inherited from mosaic affected or unaffected parents in rare cases. The molecular finding of haploinsufficiency is consistent with a loss‐of‐function defect in cells and animal models. Although seizures are the most commonly reported symptom in DS, many additional issues critically affect patients’ cognitive and behavioral functioning. Hemiplegic migraine (HM) is a rare form of migraine with aura, characterized by the emergence of hemiparesis as part of the aura phase. All SCN1A mutations reported in sporadic/familial HM3 are missense mutations. Most of the experimental results show that they cause a gain of function of NaV1.1 as opposed to the loss of function of the epileptogenic NaV1.1 mutations. SCN1A and SCN2A pathogenic variants have been identified in genetic studies of cohorts of patients with ASD. In addition, ASD features are often reported in patients with Dravet syndrome and other DEEs.
Effect of ageing time on quality characteristics of different bovine muscles
Authors: Sadowska Anna , Świderski Franciszek , Kostyra Eliza , Rachtan‐Janicka Joanna , Najman Katarzyna 
Published: January 2020

SummaryThis study assessed the impact of the ageing period on the sensory qualities and physical properties of muscles derived from animals obtained by crossing dairy cattle with Limousin meat breed animals. The materials consisted of five muscles – the musculus semitendinosus, musculus semimembranosus, musculus longissimus thoracis, musculus longissimus lumborum and musculus gluteus medius – which underwent the ageing process in a vacuum at 2 °C ± 1 °C. In the case of the raw muscles, the colour, pH and the extent of drip loss was determined. In the case of the grilled muscles, a sensory evaluation was conducted and the texture was instrumentally evaluated. The results showed that the musculus semitendinosus achieved the greatest improvement in positive sensory characteristics due to 14 or 21 days of ageing, which may extend its culinary utility. Among the tested muscles, the musculus longissimus thoracis and lumborum and musculus gluteus medius showed the highest culinary utility after 14 and 21 days of ageing.
Palatability and hygiene characteristics of dry‐aged pork and optimisation of dry ageing period
Authors: Nam Oh Seong , Park Inmyoung 
Published: January 2020

SummaryTo improve upon understanding of the quality characteristics of dry‐aged pork, pork belly and arm shoulder were dry‐aged for 0, 7, 14, 21 and 28 days. Their physicochemical, free amino acid (FAA) content and microbiological analysis were performed to evaluate palatability and hygiene. After 28 days of ageing, total FAA content increased by 56.1% and 71.4% for pork belly and arm shoulder, respectively. The amount of individual FAAs increased, except for glutamine. At 28 days, total bacteria and coliform continuously increased to 4.40 and 4.43 log (CFU g−1) for pork belly sample, respectively, and 5.92 and 4.26 log (CFU g−1) for arm shoulder sample, respectively; moreover, E. coli was first detected and Salmonella spp. and Listeria spp., which are considered indicators of meat food poisoning, were not detected. Altogether, extended dry ageing period can impose a potential hygiene concern, though palatability is increased, requiring optimisation in the dry ageing process.
Using two phases of the CD4 T cell response to blood‐stage murine malaria to understand regulation of systemic immunity and placental pathology in Plasmodium falciparum infection
Authors: Gbedande Komi , Carpio Victor H. , Stephens Robin 
Published: January 2020

AbstractPlasmodium falciparum infection and malaria remain a risk for millions of children and pregnant women. Here, we seek to integrate knowledge of mouse and human T helper cell (Th) responses to blood‐stage Plasmodium infection to understand their contribution to protection and pathology. Although there is no complete Th subset differentiation, the adaptive response occurs in two phases in non‐lethal rodent Plasmodium infection, coordinated by Th cells. In short, cellular immune responses limit the peak of parasitemia during the first phase; in the second phase, humoral immunity from T cell–dependent germinal centers is critical for complete clearance of rapidly changing parasite. A strong IFN‐γ response kills parasite, but an excess of TNF compared with regulatory cytokines (IL‐10, TGF‐β) can cause immunopathology. This common pathway for pathology is associated with anemia, cerebral malaria, and placental malaria. These two phases can be used to both understand how the host responds to rapidly growing parasite and how it attempts to control immunopathology and variation. This dual nature of T cell immunity to Plasmodium is discussed, with particular reference to the protective nature of the continuous generation of effector T cells, and the unique contribution of effector memory T cells.
Testing the effectiveness of a weight bias educational intervention among clinical psychology trainees
Authors: Brochu Paula M. 
Published: January 2020

AbstractWeight bias is a neglected issue in the health professions, including mental health training programs. Even though mental health professionals exhibit many of the same weight biases that are seen at the societal level and among other health professionals, mental health programs rarely provide training on weight bias, weight diversity, or critical weight science. No study to date has tested the effectiveness of a weight bias reduction intervention in a mental health setting. The purpose of this study was to examine the efficacy of a weight bias seminar informed by the attribution‐value model of prejudice. Using a pretest‐posttest design, 45 clinical psychology trainees completed measures of weight controllability beliefs, anti‐fat attitudes, and attitudes toward fat clients 1 week before and 1 week after the weight bias seminar. After the weight bias seminar, participants reported weaker weight controllability beliefs, anti‐fat attitudes, and negative client attitudes. Furthermore, weight controllability beliefs mediated the effect of the weight bias seminar on participants’ general anti‐fat attitudes and client‐specific attitudes. Thus, this study identifies weight controllability beliefs as a potential mechanism underlying the efficacy of educational weight bias interventions in mental health training programs. Future weight bias educational interventions may benefit from application of the attribution‐value model of prejudice.
Computed tomography analysis of the cranium of Champsosaurus lindoei and implications for the choristoderan neomorphic ossification
Authors: Dudgeon Thomas W. , Maddin Hillary C. , Evans David C. , Mallon Jordan C. 
Published: January 2020

AbstractChoristoderes are extinct neodiapsid reptiles that are well known for their unusual cranial anatomy, possessing an elongated snout and expanded temporal arches. Although choristodere skulls are well described externally, their internal anatomy remains unknown. An internal description was needed to shed light on peculiarities of the choristodere skull, such as paired gaps on the ventral surface of the skull that may pertain to the fenestra ovalis, and a putative neomorphic ossification in the lateral wall of the braincase. Our goals were: (i) to describe the cranial elements of Champsosaurus lindoei in three dimensions; (ii) to describe paired gaps on the ventral surface of the skull to determine if these are indeed the fenestrae ovales; (iii) to illustrate the morphology of the putative neomorphic bone; and (iv) to consider the possible developmental and functional origins of the neomorph. We examined the cranial anatomy of the choristodere Champsosaurus lindoei (CMN 8920) using high‐resolution micro‐computed tomography scanning. We found that the paired gaps on the ventral surface of the skull do pertain to the fenestrae ovales, an unusual arrangement that may be convergent with some plesiosaurs, some aistopods, and some urodeles. The implications of this morphology in Champsosaurus are unknown and will be the subject of future work. We found that the neomorphic bone is a distinct ossification, but is not part of the wall of the brain cavity or the auditory capsule. Variation in the developmental pathways of cranial bones in living amniotes was surveyed to determine how the neomorphic bone may have developed. We found that the chondrocranium and splanchnocranium show little to no variation across amniotes, and the neomorphic bone is therefore most likely to have developed from the dermatocranium; however, the stapes is a pre‐existing cranial element that is undescribed in choristoderes and may be homologous with the neomorphic bone. If the neomorphic bone is not homologous with the stapes, the neomorph likely developed from the dermatocranium through incomplete fusion of ossification centres from a pre‐existing bone, most likely the parietal. Based on the apparent morphology of the neomorph in Coeruleodraco, the neomorph was probably too small to play a significant structural role in the skull of early choristoderes and it may have arisen through non‐adaptive means. In neochoristoderes, such as Champsosaurus, the neomorph was likely recruited to support the expanded temporal arches.
The anti‐sebum property of chitosan particles
Authors: Tangkijngamvong Natsinee , Phaiyarin Punnawich , Wanichwecharungruang Supason , Kumtornrut Chanat 
Published: January 2020

AbstractBackgroundSeborrhea is linked to several medical and mental conditions. Although it is common, effective agents and the standardized sebum level for seborrhea are not elucidated.AimsTo determine the efficacy of chitosan particles (CP) formulation on controlling sebum secretion, its extended effects on skin redness and texture after combining with proretinal nanoparticles (CP‐PRN), and a correlation of the clinical grading with sebum levels that affect mental health.Patients/MethodsA four‐week clinical trial with forty subjects was conducted. Subjects applied either CP formulation or CP‐PRN during nighttime. Objective measurements including sebum levels, transepidermal water loss (TEWL), skin corneometry, skin redness, and texture were analyzed. Subjects completed a self‐assessment clinical grading of skin oiliness at every visit.ResultsBoth CP and CP‐PRN significantly decreased sebum levels (P ≤ .01) at week 4 compared to baseline. CP also resulted in significant decreases in TEWL (P ≤ .05) and skin corneometry (P ≤ .05) throughout the study. A significant improvement in skin redness was observed with CP‐PRN (P ≤ .01). A moderate correlation between the clinical grading and sebum levels was detected (coefficient of 0.5, P ≤ .001), with a sebum level of 106 μg cm‐2 indicating emotional discomfort. One subject experienced local irritation with the CP‐PRN. Mild pruritic symptoms were reported in both groups.ConclusionsChitosan particles exhibited an interesting anti‐sebum effect. It could be combined with PRN to extend benefits without losing the sebum controlling effect. The clinical grading may be useful in practice due to a modest correlation with sebum levels.