bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hearing and vision care provided to older people residing in care homes: a cross-sectional survey of care home staff
Authors: Andrusjak Wendy , Barbosa Ana , Mountain Gail 
Published: August 2020

Abstract
Background:Hearing and vision loss in older people has been proven to affect physical and mental health and increase the speed of cognitive decline. Studies have demonstrated that certain practices and improved staff knowledge increase the effective care of residents’ ears and eyes, yet it is not known which practices are being implemented in care homes. This study aimed to identify the gaps in staff knowledge regarding hearing and vision difficulties in older residents, and which practices known to improve ear and eye care in older care home residents are not commonly implemented in care homes in England.Methods:This study used a cross-sectional survey design. Survey questions were informed by the existing literature and were focused on practices, staff knowledge, and other aspects that have shown to affect residents’ hearing and vision care. The survey was sent to care homes across England between November 2018 and February 2019 via email and in paper format for care home staff to complete. Descriptive statistics and Chi-Square analysis were applied to identify the factors influencing the care being provided to care home residents. Results:A total of 400 care home staff responded from 74 care homes. The results revealed that screening tools are rarely used by staff to identify hearing and vision impairments; that care homes have limited access to other assistive devices for hearing and vision loss, and that audiology services do not regularly assess care home residents. A majority of staff who responded were not confident in ear and eye care. Responses were found to be influenced by the respondents’ job role, length of time working in care homes and also the care home type and care home size. Findings confirmed a lack of standardised practice and the importance of shared communication for promulgation of best practice.Conclusion:This study has identified that some practices known to facilitate ear and eye care are not commonly applied in a sample of English care homes. It has also shown that care home staff knowledge of ear and eye care is inconsistent. The information derived from this survey can be used to inform guidelines for best practice and inform needs for future research.
Analysis of the Effect of Serious Illness Medical Insurance on Relieving the Economic Burden of Rural Residents in China: A Case Study in Jinzhai County
Authors: Li Yang , Duan Guangfeng , Xiong Linping 
Published: August 2020

Abstract
Background: In 2003, China established a New Rural Cooperative Medical System (NRCMS) for rural residents to alleviate the burden of medical expenses among rural residents. However, its reimbursement for high medical costs was insufficient. Therefore, China gradually established the Serious Illness Insurance System (SIMIS) based on NRCMS. After receiving payment through NRCMS, patients in rural areas who met the requirements of SIMIS policy would receive a second payment for their high medical expenses. This study aimed to analyze the effect of the implementation of SIMIS on alleviating the economic burden of rural residents in Jinzhai County.Methods: The study used the inpatient reimbursement data of NRCMS in Jinzhai County, Anhui Province, from 2013 to 2016. We adopted descriptive and regression discontinuity (RD) methods to analyze the payment effect of SIMIS. The RD analysis targeted patients (n = 7,353) whose annual serious illness expenses were between CNY 10,000 (1,414 USD) and CNY 30,000 (4,242 USD), whereas the descriptive analysis was used for data of the patients compensated by SIMIS (n = 2720).Results: The results of RD showed that the actual medical insurance payment proportion increased by about 2.5% (lwald = 0.025, P <0.01), inside medical insurance self-payment proportion increased by about 2% (lwald = 0.020, P <0.10), and outside medical insurance self-payment proportion decreased by about 1.6% (lwald = -0.016, P <0.05). The descriptive results showed that patients with serious illnesses mostly chose to go to a hospital outside the county. The annual average number of hospitalizations was 3.64. The reimbursement mainly came from the NRCMS. The payment amount of SIMIS was relatively small, and the out-of-pocket medical expenses were still high.Conclusion: The medical technology level of Jinzhai County could not meet the needs of patients with seriously illnesses, the number of beneficiaries of SIMIS was small, and the ability to relieve the burden of medical expenses of the rural residents was insufficient. The high out-of-pocket expenses increased the possibility that only people with good economic conditions could benefit from the reimbursement of SIMIS, resulting in inequity.
Assessment of the Efficacy of the Far Cortical Locking Technique for Proximal Humeral Fractures: A Comparison with the Conventional Bicortical Locking Technique
Authors: S. J.B. , Y. J.S. , K. Y.J. , K. K.B. 
Published: August 2020

Abstract
Background Locking plate fixation is one of the treatment strategies for the management of proximal humeral fractures. However, stiffness after locking plate fixation is a clinical concern. The mechanical stiffness of the standard locking plate system may suppress the interfragmentary motion necessary to promote secondary bone healing by callus formation. The far cortical locking (FCL) technique was developed to address this limitation in 2005. FCL increases construct flexibility and promotes callus formation. Our study aimed to evaluate the clinical and radiological outcomes of the FCL technique when implemented in proximal humeral fracture management. Furthermore, we compared the surgical outcomes of FCL with those of the conventional bicortical locking (BCL) screw fixation technique.Methods Forty-five consecutive patients who had undergone locking fixation for proximal humeral fractures were included in this study. A proximal humeral locking plate (PHILOS) system with BCL screw fixation was used in the first 27 cases, and the periarticular proximal humeral locking plate with FCL screw fixation was used in the final 18 consecutive cases. Functional capacity was assessed using the constant score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion. Radiographic outcomes were evaluated using the Paavolainen method of measuring the neck-shaft angle (NSA).Results No significant differences in clinical outcomes (ASES score, constant score, and range of motion)were found between the two groups. The union rate at 12 weeks was significantly higher in the FCL group (94.4%) than in the BCL group (66.7%, p=0.006). No significant differences in NSA were found between the two treatment strategies. The complication rate was not significantly different between the two groups.Conclusions When implemented in proximal humeral fractures, the FCL technique showed satisfactory clinical and radiological outcomes as compared with the conventional BCL technique. The bone union rate at 12 weeks after surgery was significantly higher in the FCL group than in the BCL group. However, no significant difference in the final bone union rate was found between the two groups.Level of evidence: Level III-2, Retrospective study
An Audit Tool for Longitudinal Assessment of the Health-Related Characteristics of Urban Neighborhoods: Implementation Methods and Reliability Results
Authors: Dastidar Bonnie Ghosh , Hunter Gerald , Sloan Jennifer C , Collins Rebecca L , Richardson Andrea S , Troxel Wendy , Colabianchi Natalie , Dubowitz Tamara 
Published: August 2020

Abstract
Background: Improving the neighborhood environment may help address chronic disease and mortality. To identify neighborhood features that are predictors of health, objective assessments of the environment are used. Multiple studies have reported on cross-sectional assessments of health-related neighborhood features using direct observation. As study designs expand to better understand causation and predictors of change, there is a need to test whether direct observation methods are adequate for longitudinal assessment. To our knowledge, this is the first study to report on the reliability of repeated measurements of the neighborhood environment, and their stability, over time.Methods: The Pittsburgh Hill/Homewood Research on Neighborhood Change and Health (PHRESH) study conducted longitudinal assessments in two low-income, African American neighborhoods at three waves (years 2012, 2015, 2017). The PHRESH audit tool is a modification of earlier validated tools, with an emphasis on environment features relevant for physical activity, sleep, and obesogenic behaviors. Trained data-collector pairs conducted direct observations of a 25% sample of street segments in each neighborhood. At each wave, we audited a sub-sample of street segments twice and assessed reliability using percentage inter-observer agreement and krippendorf’s alpha statistics. Stability of these items was assessed as exhibiting moderate or high agreement at every time point. Results: Across waves, a majority (81%) of the items consistently demonstrated moderate to high agreement except for items such as public/communal space, amount of shade, sidewalk features, number of traffic lanes, garden/flower bed/planter, art/statue/monument, amount of trash, and physical disorder. The list of items with poor agreement includes features that are easy to miss (e.g. flower bed/planter), hard to assess from outside (e.g. public/communal space), or may change quickly (e.g. amount of trash). Conclusion: In this paper, we have described implementation methods, reliability results and lessons learned to inform future studies of change. We found the use of consistent methods allowed us to conduct reliable, replicable longitudinal assessments of the environment. Items that did not exhibit stability are less useful for detecting real change over time. Overall, the SSA direct observation tool is an effective and practical instrument to detect change in the neighborhood environment.
Influence of Bacterial Organic Selenium on Blood Parameters, Immune Response, Selenium Retention and Intestinal Morphology of Broiler Chickens
Authors: Dalia A. M. , Loh T. C. , Sazili A. Q. , Samsudin Anjas Asmara 
Published: August 2020

Abstract
Background: Several studies indicated that dietary organic selenium (Se) usually absorbed better than an inorganic source, with high retention and bioavailability. Dietary Se as an antioxidant element affects the immune system and hematological status in animals. Therefore, the aim of this study was to evaluate the effect of dietary supplementation of bacterial selenium as an organic source on hematology, immunity response, selenium retention, and gut morphology in broiler chickens. Results: The present results revealed that supplementation of inorganic Se was associated with the lowest level of RBC, HB, and PCV with significant difference than ADS18-Se. In the starter stage, both T2 and T5 were associated with the significantly highest IgG level compared to the basal diet, while all supplemented groups showed higher IgM levels compared to the control group. In the finisher phase, all Se supplemented groups showed significant (P ˂ 0.05) increases in IgG, IgA, and IgM levels compared to T1. Birds fed bacterial-Se showed high intestinal villus height and better Se retention more than sodium selenite. The organic selenium of ADS18 had a superior action in improving Se retention compared to ADS1 and ADS2 bacterial Se. Conclusion: Bacterial organic Se had a beneficial effect on the villus height of small intestine led to high Se absorption and retention. Thus, it caused a better effect of Se on hematological parameters and immunity response.
Peripheral Anterior Chamber Depth and Screening Techniques for Primary Angle Closure Disease in Community Elderly Chinese
Authors: Luo Qin , Xue Wenwen , Yuan Yin , Fu Chaowei , He Jiangnan , Zou Haidong , Tong Xiaowei , Lee Richard K. , Ge Ling 
Published: August 2020

Abstract
Background

To investigate the distribution of peripheral anterior chamber depth (ACD) and the relationship between peripheral ACD and gonioscopy compared to other ocular parameters for primary angle closure disease (PACD) screening.

Methods

Cross-sectional study. Adults 50 and older were enrolled from a population-based study using cluster random sampling in Pudong New District, Shanghai. Remote ocular screening was performed with digital anterior eye structure photography. Van Herrick measurements were used to evaluate the peripheral ACD, the depth of the peripheral anterior chamber, and corneal thickness (CT), and the ACD to CT ratio was calculated. Subjects with peripheral ACD less than 0.5 CT were made follow-up appointments for clinical examination with gonioscopy. Receiver operating characteristic curves (ROC) were generated to show the performance of different tests in screening for primary angle closure disease (PACD).

Results

2528 adults participated in the study with 91 patients diagnosed with PACD. 2463 subjects had valid data in the right eye available for analysis. The mean peripheral ACD values for men and women were significantly different: 1.04±0.46 (range 0.11-2.93) CT and 0.87±0.41 (range 0.12-2.96) CT respectively (t=-4.18; P<0.0001). Multivariate logistic regression analysis reveals that peripheral ACD declined by 0.31 CT (P<0.0001) per diopter of SE and was 0.19 CT (P<0.0001) shallower in women than in men (r2=0.1304, P<0.0001). Peripheral ACD performed best in screening for PACD.

Conclusions

Peripheral ACD measurement is recommended for PACD screening in community elderly Chinese.
The Epidemiology of Moebius Syndrome
Authors: carta arturo , Favilla Stefania , Calzetti Giacomo , Casalini Maria Cristina , Ferrari Pier Francesco , Bianchi Berrnardo , Simonelli Maria Beatrice , Farci Roberta , gandolfi Stefano , Mora Paolo 
Published: August 2020

Abstract
Background: The epidemiology of Moebius Syndrome (MBS) is actually difficult to assess. In the present study we investigated the epidemiology of MBS in a well-defined population over a precise geographical area. Materials and Methods: Our University Hospital is the only national referral Centre for the diagnosis and treatment of MBS. Participants to this cross sectional study are patients affected by MBS who have been periodically followed by our medical staff since 1998. Most of the patients were referred to our hospital by the Italian Association of Moebius Syndrome (AISMO). Demographic data necessary for our purposes were made available by AISMO database updated to April 2018. Subjects were assigned to the geographical macro- areas which are the ones conventionally used for surveys and epidemiological investigations by the Italian National Institute of Statistics. Rates and prevalence of the MBS cases were calculated referring to the last survey of the Italian population available. Every study parameter was then calculated by reference to the whole country and to macro-area partition. Gender rate and the corresponding prevalence were calculated with respect to the weighted whole population and to the respective gender population. Chi-square analysis was adopted to investigate possible differences among geographical regions and/or gender. A p value <0.05 was considered statistically significant. Results: One-hundred and sixty-four out of 212 MBS patients fulfilled our inclusion criteria. All cases were Caucasian and sporadic. The median age at diagnosis was 3.6 years, ranging from 0-55; this range was significantly reduced to 0-5 years (median age at diagnosis: 2.2 years) for patients included after 2007. The birth prevalence calculated was 0.06 cases per 10000 live births with an overall prevalence of 0.27/100000 without any gender or geographical predisposition. Conclusions: The rate of MBS prevalence herein observed, rounded for possible underestimation, is 0.3/100000 people without any regional difference in the distribution of the cases. Our data confirm on a national basis the rarity of the disease.
Secondary signs on preoperative CT as predictive factors for febrile urinary tract infection after ureteroscopic lithotripsy
Authors: Kim Jin Woo , Lee You Jin , Ha Yun-Sok , Lee Jun Nyung , Kim Hyun Tae , Chun So Young , Kim Bum Soo 
Published: August 2020

Abstract
Background: Febrile urinary tract infection (UTI) is one of the most common complications after ureteroscopic lithotripsy (URS). We evaluated the effect of secondary signs on preoperative computed tomography (CT) for febrile UTI after URS.Methods: In total, 182 patients who underwent URS for ureteral stones from January 2013 to December 2015 were retrospectively included in this study. These patients were divided into two groups according to the presence of postoperative febrile UTI after URS. We compared the clinical factors, stone factors, and secondary signs between the groups. Predictive factors for febrile UTI after URS were analyzed using a multivariate logistic regression model. Results: Febrile UTI occurred in 26 of the 182 patients. In univariate analysis, presence of comorbid chronic kidney disease (CKD) and stone size were significantly different between UTI and non-UTI groups. Among secondary signs, presence of hydroureter, perinephric fat stranding, periureteral fat stranding, and tissue rim sign were significantly different between the groups. In multivariate logistic regression analysis, comorbid CKD, stone size, perinephric fat stranding, and tissue rim sign were independent predictive factors for febrile UTI after URS. Conclusion: This study demonstrated that secondary signs including perinephric fat stranding and tissue rim sign on preoperative CT, CKD, and stone size are independent predictive factors for febrile UTI after URS.
Delphi consensus on strategies in the management of opioid-induced constipation in cancer patients
Authors: Sarrió Regina Gironés , Calsina-Berna Agnès , García Adoración Gozalvo , Esparza-Miñana José Miguel , Ferrer Esther Falcó , Porta-Sales Josep 
Published: August 2020

Abstract
Background: Opioid-induced constipation (OIC) is a frequent and bothersome adverse event related with opioid therapy in cancer patients. Despite the high prevalence, medical management of OIC is often uncertain. The current project aimed to investigate expert opinion on OIC management and provide practical recommendations to improve the clinical approach of OIC in cancer patient.Methods: A modified Delphi method was conducted involving 46 different physicians experts in OIC. Using a structured questionnaire of 67 items this project intended to seek consensus on aspects related to diagnosis, treatment, and quality of life of cancer patients suffering with OIC.Results: After two rounds, a consensus was reached in 91% of the items proposed, all in agreement. Agreement was obtained on OIC definition (95.7%). Objective and patient-reported outcomes included in that definition should be assessed routinely in clinical practice. Responsive to symptom changes and easy-to-use assessment tools were recommended (87.2%). Successful diagnosis of OIC requires increase clinicians awareness of OIC and proactivity to discuss symptoms with their patients (100%). Successful management of OIC requires individualization of the treatment (100%), regular revaluation once is established, and keeping it for the duration of opioid treatment (91.5%). Oral Peripherally Acting µ-Opioid Receptor Agonists (PAMORAs), were considered good alternatives for the treatment of OIC in cancer patients (97.9%). This drugs and laxatives can be co-prescribed if OIC coexist with functional constipation.Conclusions: The panelists, based on their expert clinical practice, presented a set of recommendations for the management of OIC in cancer patients.
Midwives’ experiences of implementing respectful maternity care knowledge in daily maternity care practices after participating in a four-day RMC training
Authors: Dzomeku Veronica Millicent , Bemah Boamah Mensah Adwoa , Emmanuel Nakua Kweku , Pascal Agbadi , Jody Lori R. , Peter Donkor 
Published: August 2020

Abstract
Background: In Ghana, studies documenting the effectiveness of evidence-based specialized training programs to promote respectful maternity care (RMC) practices in healthcare facilities are few. Thus, we designed a four-day RMC training workshop and piloted it with selected midwives of a tertiary healthcare facility in Kumasi, Ghana. The present paper evaluated the impact of the training by exploring midwives’ experiences of implementing RMC knowledge in their daily maternity care practices four months after the training workshop.Methods: Through a descriptive qualitative research design, we followed-up and conducted 14 in-depth interviews with participants of the RMC training, exploring their experiences of applying the acquired RMC knowledge in their daily maternity care practices. Data were managed and analysed using NVivo 12. Codes were collapsed into subthemes and assigned to three major predetermined themes.Results: The findings have been broadly categorized into three themes: experiences of practising RMC in daily maternity care, health facility barriers to practising RMC, and recommendations for improving RMC practices. The midwives mentioned that applying the newly acquired RMC knowledge has positively improved their relationship with childbearing women, assisted them to effectively communicate with the women, and position them to recognize the autonomy of childbearing women. Despite the positive influence of the training on clinical practice, the midwives said the policy and the built environment in the hospital does not support the exploration of alternative birthing positions. Also, the hospital lacked the required logistics to ensure privacy for multiple childbearing women in the open labour ward. The midwives recommended that logistics for alternative birthing positions and for privacy in the ward should be provided. Also, all midwives and staff of the hospital should be taken through the RMC training program to encourage good practice.Conclusion: Despite the report of some RMC implementation challenges, the midwives noted that the 4-day RMC training has had a positive impact on their maternity caregiving practice in the hospital. Policies and programs aimed at addressing the issue of disrespect and abusive practices during maternity care should advocate and include the building of facilities that support alternative birthing positions and privacy of childbearing women during childbirth.