bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transforming care in Cornwall: A review of the quality of the lives of people with learning disabilities a decade post‐discharge from hospital
Authors: Niven Abigail , Gamman Lee , Webb Alison , Goodey Rebecca , Shankar Rohit 
Published: January 2020

Accessible summary

The government wants people with learning disabilities and/or autism to move out of hospitals back to their homes.

Cornwall did this in 2007, and we asked the people who moved and their carers how they are now.

They have generally done well, and nearly all have stayed in their homes with lots of support.

Various factors such as accommodation, social network, skill acquisition and impact of their past were explored.

AbstractBackgroundIn the light of the current national guidance to reduce the number of inpatient learning disability beds, a review was completed of the quality of lives of the people who had been former inpatients in Cornwall at the time of closure of the learning disability inpatient facilities almost 10 years before transforming care.Materials and MethodsAll former inpatients who were discharged from the learning disability inpatient setting in Cornwall were invited to participate either directly or through their carers or family members. Measures of current activity levels and semi‐structured interviews on quality of life were conducted.ResultsThe majority interviewed had person‐centred plans, health action plans and positive behaviour support plans. Guernsey Community Participation & Leisure Assessment showed overall the study group did not meet comparative standards laid out by the scale in any of the subdomains (p < .05). Peoples' lives were varied, with a lack of informal relationships, meaningful occupation, homeownership and advocacy being relatively poor for all. Alongside this, to enable people to have safer lives, restrictive practices were commonplace particularly continuous supervision and use of psychotropic medication to manage behavioural risk.ConclusionsThis study highlights that people with complex concerns with a history of placement breakdowns and past institutionalisation can be settled successfully and safely in local communities. However, it is difficult for many of them to achieve a satisfactory quality of life long term. The obligation for this lies with service providers to provide adequate support to overcome that difficulty.
Assessing resiliency in paediatric rehabilitation: A critical review of assessment tools and applications
Authors: Seko Yukari , Lamptey De‐Lawrence , Nalder Emily , King Gillian 
Published: January 2020

AbstractBackgroundsResiliency has attracted a growing interest in paediatric rehabilitation as a key capacity for disabled children and their families to thrive. This study aimed to identify measures used to assess resiliency of disabled children/youth and their families and critically appraise the current use of resiliency measures to inform future research and practice.MethodsA two‐stage search strategy was employed. First, systematic reviews of resiliency measures published since 2000 were searched. Second, full names of measures identified in at least two systematic reviews were searched across four electronic databases. Included studies assessed resiliency among children/youth (0–18 years old) with chronic health conditions and/or disabilities and their families. Identified articles were then analysed to discern the study's definition of resiliency, authors' rationales for measurement selection, and types of perceived adversities facing the study participants.ResultsFrom an initial yield of 25 measures identified in five systematic reviews, 11 were analysed in two or more reviews. The second stage yielded 41 empirical studies published between 2012 and 2018, which used 8 of the 11 resiliency measures searched by name. Of 41, 17 studies measured resiliency of disabled children/youth, 23 assessed resiliency within family members, and 1 studied both children/youth and their families. Our critical appraisal identified inconsistencies between the studies' definition of resiliency and chosen measures' operationalization, implicit assumption of disabilities as a developmental risk that automatically results in life adversities, and the tendency among family studies to reduce resiliency down to stress coping skills. Research that encompasses contextual factors and developmental influences is lacking.ConclusionsThere is a need for a situated measurement approach that captures multiple interacting factors shaping resiliency over one's life course. Resiliency measures would benefit from a greater focus on a person–environment transaction and an alternative definition of resiliency that accounts for multiple capacities to navigate through disabling environments.
Effect of conversion to implant‐assisted removable partial denture in patients with mandibular Kennedy classification Ⅰ: A systematic review and meta‐analysis
Authors: Park Jin‐Hong , Lee Jeong‐Yol , Shin Sang‐Wan , Kim Hyun‐Jung 
Published: January 2020

AbstractObjectiveThis review evaluated the change in treatment outcomes after conversion from conventional removable partial denture (RPD) to implant‐assisted removable partial denture (IARPD). The patient‐reported outcome measures (PROMs), objective parameters for evaluation of functional performance, and biological and mechanical complication were evaluated.Materials and MethodsThis systematic review was based on the Cochrane review methodology and followed the criteria of the preferred reporting items for systematic reviews and meta‐analyses (PRISMA). We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus up to April 3, 2019. After the initial search, additional electronic and hand searches were performed to identify further studies, ongoing studies, and gray literature, without restrictions on language, year of publication, or publication type.ResultsIn total, 6,544 non‐duplicate articles were identified, and 31 were eligible for full‐text search. Finally, 19 publications based on 13 independent studies were selected. In the meta‐analysis, general patient satisfaction was significantly increased (p < .05), and the improved mastication was remarkable oral function. In oral health‐related quality of life, the oral health impact profile score was significantly improved, and improvements of physical pain and psychological disability were prominent (p < .05). Masticatory performance was improved in terms of maximum bite force, active occlusal contact area, and mandibular jaw movement (p < .05). The weighted mean survival rate of implants was 96.60%.ConclusionsAfter conversion from conventional RPD to IARPD, the PROMs and masticatory performance significantly improved in partially edentulous patients under mandibular Kennedy classification I.
Audience research as a cornerstone of demand management interventions for illegal wildlife products: Demarketing sea turtle meat and eggs
Authors: Veríssimo Diogo , Vieira Sara , Monteiro Domingas , Hancock Joana , Nuno Ana 
Published: January 2020

AbstractThe unsustainable wildmeat trade has been long recognized as a threat to wildlife. Yet, its impact on marine species has been underresearched. Sea turtles have been historically threatened by unsustainable trade, but there are few studies of consumer profile, motivations, and preferences. We conducted a survey in São Tomé Island, Gulf of Guinea, West Africa, including eight rural communities (n = 1,160) and the capital city of São Tomé (n = 628). We estimated prevalence of consumption, preference and availability of sea turtle meat and eggs. About 25% of rural and 32% of urban respondents had consumed meat in the past year. Around 25% of rural respondents were egg consumers, whereas little consumption was found in urban areas. Social norms were a predictor of consumption of sea turtle meat and eggs in rural communities but not in São Tomé city. Regarding influencers, teachers and religious leaders were the most trusted sources in rural communities, while teachers and NGOs were most trusted in São Tomé city. Radio and television were the most trusted channels in rural communities, while urban dwellers trusted radio the most. This research showcases how a structured approach to audience research can obtain behavioral insights that can guide behavior change efforts.
Durability of glycaemic control in patients with type 2 diabetes after metformin failure: Prognostic model derivation and validation using the DISCOVER study
Authors: Ling Suping , Sun Ping , Zaccardi Francesco , Khosla Sajan , Cooper Andrew , Fenici Peter , Khunti Kamlesh 
Published: January 2020

AbstractAimTo develop and internally validate prognostic models on the long‐term durability of glycaemic control in patients with type 2 diabetes after metformin failure.Materials and MethodsDISCOVER is a 3‐year, prospective observational study across six continents investigating second‐line glucose‐lowering therapies. In this analysis from 35 countries, we included patients on metformin initiating second‐line glucose‐lowering medication(s) because of physician‐defined lack of efficacy. The outcome was durability of glycaemic control, defined as three consecutive levels of HbA1c at 6‐, 12‐ and 24‐month follow‐up at target (HbA1c equal to or lower than the level when the physician initiated the second‐line therapy in patients with baseline HbA1c ≤7% [53 mmol/mol]; and equal to or lower than 7% in those with baseline HbA1c >7%). We developed and internally validated two prognostic models: a base model, which included age, sex, ethnicity, country income group, baseline HbA1c and second‐line therapy, and an advanced model, established through statistical variable selections from a model including base variables and 13 additional predictors selected from a literature review. We used logistic regression to develop and 500 bootstrapping samples to internally validate the models; discrimination and calibration were used to assess model performance.ResultsOverall, 896 out of 2995 participants (29.9%) had sustained glycaemic control. The base model performed well: Nagelkerke R2 was 0.13, C‐index 0.70 (95% CI: 0.68, 0.71) and bias‐corrected C‐index 0.69 after internal validation. Diabetes duration, insurance type, estimated glomerular filtration rate and glucose self‐monitoring were additionally selected in the advanced model, which had only a slightly better performance compared with the base model: Nagelkerke R2 0.20, C‐index 0.71 (95% CI: 0.69, 0.73) and bias‐corrected C‐index 0.70. Calibration plots showed good calibrations of both validated models.ConclusionThese prognostic models, which include simple demographic and routinely collected clinical information, enabled the estimation of the probability of 2‐year sustained glycaemic control in patients after metformin failure. The models have been implemented into a web‐based tool to support healthcare professionals in their decisions.
Higher versus standard starting dose of insulin glargine 100 U/mL in overweight or obese Chinese patients with type 2 diabetes: Results of a multicentre, open‐label, randomized controlled trial (BEYOND VII)
Authors: Ji Linong , Wan Hailong , Wen Binhong , Wang Xueying , Wang Junfen , Bian Rongwen , Pang Wuyan , Tian Jian , Wang Yan , Bian Fang , Gao Zhengnan , Condoleon Alex , Feng Wei , Zhang Xia , Cui Nan 
Published: January 2020

AbstractAimTo determine the safety of a higher starting dose of basal insulin in overweight/obese patients with type 2 diabetes (T2D).Materials and methodsThis 16‐week, randomized, multicentre, open‐label trial enrolled adults with T2D (body mass index 25–40 kg/m2) and suboptimal glycaemic control (glycated haemoglobin [HbA1c] 7.5–11.0% [58–97 mmol/mol] and fasting plasma glucose [FPG] >9.0 mmol/L) with two to three oral anti‐hyperglycaemic drugs at 51 centres in China. Patients were randomized (1:1) to a higher (0.3 U/kg) or standard (0.2 U/kg) starting dose of insulin glargine 100 U/mL, which was then titrated to achieve a self‐monitored fasting blood glucose (FBG) of 4.4 to 5.6 mmol/L. The primary endpoint was the percentage of patients with ≥1 episode of overall confirmed hypoglycaemia (≤3.9 mmol/L or severe).ResultsAt the end of study (n = 866), 11.0% patients treated with the 0.3 U/kg starting insulin dose experienced overall confirmed hypoglycaemia versus 8.6% of patients treated with 0.2 U/kg (estimated difference 2.1%, 95% confidence interval − 1.68, 5.89). The proportions of patients with symptomatic (9.8% vs 7.0%; P = 0.128) and nocturnal hypoglycaemia (2.7% vs 1.2%; P = 0.102) were similar in the two groups. There were no events of severe hypoglycaemia or FBG <3.0 mmol/L during the 16‐week treatment, and achievement of HbA1c <7.0% (53 mmol/mol) (37.1% vs 37.1%) or FPG <5.6 mmol/L (15.9% vs 16.3%), <6.1 mmol/L (27.6% vs 26.1%), or < 7.0 mmol/L (48.8% vs 48.3%) without hypoglycaemia were comparable in the two groups. Moreover, the mean time was shorter (4.53, 3.95 and 2.74 weeks vs 5.51, 5.21 and 3.64 weeks) and number of titrations was lower (3.5, 3.0 and 2.0 vs 4.3, 4.0 and 2.8) to achieve self‐monitored FBG targets of <5.6, <6.1 and <7.0 mmol/L in the higher versus the standard insulin dose group (all P < 0.01).ConclusionsAmong overweight/obese patients with T2D, a higher insulin starting dose was as safe as the standard starting dose, and self‐monitored FBG targets were achieved earlier with the higher versus the standard dose.
Geographic variation in performance of a widespread generalist insect herbivore
Authors: Vidal Mayra C. , Lill John T. , Marquis Robert J. , Murphy Shannon M. 
Published: January 2020

1. Generalist herbivores are often widespread and occur in a variety of environments. Due to their broad distribution, it is likely that some populations of generalists will encounter host plants with geographic variation in traits that could affect the herbivore's growth and survival (i.e. performance). However, the geographic pattern of performance has rarely been studied for generalists, especially across large geographic ranges.2. This study used one of the most generalist herbivore species known, the fall webworm (Hyphantria cunea Drury 1773, Erebidae, Lepidoptera), to experimentally test how the performance of a local population of fall webworms varies with increasing geographic distance of the host plant population from the local herbivore population. Specifically, a transplant experiment was used to compare the performance of one fall webworm population feeding on its local host plants with its performance on host populations from two other locations, 1300 and 2600 km away.3. It was found that fall webworms performed better on their local host plant populations than on populations from other regions, with performance at its lowest when reared on hosts of the same species from the farthest region. It was also found that local fall webworms do not perform well on hosts commonly used by fall webworms at the other two, more distant sites.4. This study helps to elucidate how the performance of generalist herbivores varies along their geographic range and suggests possible local adaptation to different sets of hosts across sites.
Rapid degeneration of neurons in the penumbra region following a small, focal ischemic stroke
Authors: Fifield Kathleen E. , Vanderluit Jacqueline L. 
Published: January 2020

AbstractIschemic stroke causes immediate cell death within the infarct core, whereas cells in the surrounding penumbra region are damaged but can be salvaged. Rapid restoration of blood flow can rescue these cells in the first few hours post‐stroke. It remains unclear how long cells within the penumbra region can survive. To address this, we compared the acute cellular response within the ischemic core versus the penumbra region following an Endothelin‐1‐induced focal ischemic stroke in mice. We used vascular labelling to distinguish the three regions of blood perfusion: the non‐perfused core; the hypo‐perfused penumbra; and the perfused region. Within 4 hr post‐stroke ~80% of neurons died in the non‐perfused core, while 40% of neurons died in the hypo‐perfused region. From 4 to 24 hr post‐stroke, surviving neurons within the hypo‐perfused region underwent extensive dendritic and axonal degeneration. Breakdown of the blood brain barrier, microglia activation, monocyte/neutrophil infiltration and astrogliosis, however, was not observed until 24 hr post‐stroke. The cellular response within the hypo‐perfused region was distinct from the non‐perfused core. The core was comprised primarily of infiltrating peripheral monocytes and leukocytes, whereas the hypo‐perfused region contained activated microglia and astrocytes. This study shows that small, localized ischemic strokes exhibit altered breakdown of the BBB in comparison with larger strokes. Furthermore, the massive degeneration of neuronal processes within the penumbra region suggests that the timeline to salvage surviving neurons is limited. In summary, the findings from this study reinforce the urgent need for therapeutic strategies targeting the acute hours post‐stroke.
A stable home‐base promotes allocentric memory representations of episodic‐like everyday spatial memory
Authors: Broadbent Nicola , Lumeij Lucas Berend , Corcoles Marta , Ayres Alice I. , Bin Ibrahim Mohammad Zaki , Masatsugu Brittany , Moreno Andrea , Carames Jose‐Maria , Begg Elizabeth , Strickland Lauren , Mazidzoglou Theofilos , Padanyi Anna , Munoz-Lopez Monica , Takeuchi Tomonori , Peters Marco , Morris Richard G. M. , Tse Dorothy 
Published: January 2020

AbstractA key issue in neurobiological studies of episodic‐like memory is the geometric frame of reference in which memory traces of experience are stored. Assumptions are sometimes made that specific protocols favour either allocentric (map‐like) or egocentric (body‐centred) representations. There are, however, grounds for suspecting substantial ambiguity about coding strategy, including the necessity to use both frames of reference occasionally, but tests of memory representation are not routinely conducted. Using rats trained to find and dig up food in sandwells at a particular place in an event arena (episodic‐like 'action‐where' encoding), we show that a protocol previously thought to foster allocentric encoding is ambiguous but more predisposed towards egocentric encoding. Two changes in training protocol were examined with a view to promoting preferential allocentric encoding—one in which multiple start locations were used within a session as well as between sessions; and another that deployed a stable home‐base to which the animals had to carry food reward. Only the stable home‐base protocol led to excellent choice performance which rigorous analyses revealed to be blocked by occluding extra‐arena cues when this was done after encoding but before recall. The implications of these findings for studies of episodic‐like memory are that the representational framework of memory at the start of a recall trial will likely include a path direction in the egocentric case but path destination in the allocentric protocol. This difference should be observable in single‐unit recording or calcium‐imaging studies of spatially‐tuned cells.
Relationships between population densities and niche‐centroid distances in North American birds
Authors: Osorio‐Olvera Luis , Yañez‐Arenas Carlos , Martínez‐Meyer Enrique , Peterson A. Townsend 
Published: January 2020

AbstractCorrelational ecological niche models have seen intensive use and exploration as a means of estimating the limits of actual and potential geographic distributions of species, yet their application to explaining geographic abundance patterns has been debated. We developed a detailed test of this latter possibility based on the North American Breeding Bird Survey. Correlations between abundances and niche‐centroid distances were mostly negative, as per expectations of niche theory and the abundant niche‐centre relationship. The negative relationships were not distributed randomly among species: terrestrial, non‐migratory, small‐bodied, small‐niche‐breadth and restricted‐range species had the strongest negative associations. Distances to niche centroids as estimated from correlational analyses of presence‐only data thus offer a unique means by which to infer geographic abundance patterns, which otherwise are enormously difficult to characterise.
The imaginary of the city versus messy realities
Authors: Stafford Anne , Stapleton Pamela , Wei Hua , Williams Karel 
Published: January 2020

AbstractAccounting research on transport has been narrowly focused on cost recovery and the consequences of privatization and restructuring. Accounting researchers have not engaged with the now dominant orthodoxy about cities as agglomeration argued by urbanists like Glaeser or championed earlier critical understandings of the limits of urban planning argued by Jane Jacobs. Working within that critical tradition, this paper innovates by presenting an exploratory and interdisciplinary case study of public transport in the city of Greater Manchester, which draws on accounting and other evidence. Policy makers have represented the construction of Manchester's new tram system as a major success but we argue that the system represents an ill‐judged investment priority, which had unintended consequences for the whole public transport system. Part of the problem is classic top down failure to engage local specifics because the tram network has added a radial system to a city with untidy orbital movement patterns and diverse mobility requirements. This awkward gap between the imaginary of the policy makers and messy realities has financial consequences because the capital costs of tram increasingly squeeze the ability of the public transport authority to subsidize the bus services, which carry 10 times as many passengers as tram. The political question is whether and how this kind of argument and evidence can inform popular politics and shift what is taken for granted by experts and the political classes in Manchester.