bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paid employment amongst adults with learning disabilities receiving social care in England: trends over time and geographical variation
Authors: Hatton Chris 
Published: February 2018

PurposeThe purpose of this paper is to examine trends over time and geographical variation in rates of paid employment amongst working age adults with learning disabilities receiving long-term social care in England.Design/methodology/approachData were drawn from NHS Digital adult social care statistics examining paid/self-employment for working age (18-64 years) adults with learning disabilities known to social care (2008/2009 to 2013/2014) or receiving long-term social care (2014/2015 to 2016/2017).FindingsIn 2016/2017, councils reported that 5.7 per cent of working age adults (7,422 people) with learning disabilities receiving long-term social care were in paid/self-employment, with higher employment rates for men than women and most people working less than 16 hours per week. Paid employment rates seem to be slightly declining over time, and there is wide variation across councils in reported paid/self-employment rates.Social implicationsDespite good evidence for the cost effectiveness of supported employment support, employment rates for adults with learning disabilities receiving long-term social care remain extremely low.Originality/valueThis paper presents in one place statistics concerning the paid employment of working age adults with learning disabilities in England.
Evaluating service users’ experiences using Talking Mats®
Authors: Stewart Kitty , Bradshaw Jill , Beadle-Brown Julie 
Published: February 2018

PurposeThe purpose of this paper is to establish the effectiveness of Talking Mats® (TM) in evaluating service users’ experiences, and explore their views of the implementation of person-centred active support (PCAS).Design/methodology/approachThis is a mixed-methods study, employing qualitative interviewing and observational measures.FindingsBoth qualitative and quantitative measures indicated inconsistent implementation of PCAS. It was possible to effectively gain participants’ views on positive and negative aspects of quality of support and quality of life, using TM, across three themes, My life, My support and Self-determination.Research limitations/implicationsGeneralisability of the research may be limited due to the sample, and the potential for researcher and interviewer bias is acknowledged.Practical implicationsTM provides a mechanism that may facilitate the inclusion of the views and experiences of people with intellectual and developmental disability (PWIDD) who have limited verbal skills. Their views need to be reflected in adaptions made to PCAS.Originality/valueThis study included a population who are often left out of qualitative research because of the methodologies adopted. It also included older PWIDD, where there has been less research about the effectiveness of TM.
Toward data-based clinical decision making for adults with challenging behavior using the Behavior Problems Inventory-Short Form (BPI-S)
Authors: Bowring Darren L. , Totsika Vasiliki , Hastings Richard P. , Toogood Sandy 
Published: February 2018

Purpose
The Behavior Problems Inventory-Short Form (BPI-S) is a shorter version of the Behavior Problems Inventory-01. In this paper, BPI-S population norms are reported from a total administrative population of adults with intellectual disability (ID). To facilitate the use of the BPI-S in clinical services to assess behavior change, the purpose of this paper is to describe how to use BPI-S clinically significant and reliable change (RC) scores.

Design/methodology/approach
Data were gathered on 265 adults with ID known to services. Proxy informants completed the BPI-S on challenging behaviors over the previous six months. Clinically significant cut-off values and RC scores were calculated using the Jacobson and Truax’s (1991) method.

Findings
BPI-S clinical reference data are presented to provide benchmarks for individual and group comparisons regarding challenging behavior. Examples demonstrate how to use clinical norms to determine change.

Practical implications
Behavior change is a major goal of researchers and practitioners. Data from the present study can make the BPI-S a valuable tool for determining change in challenging behavior following service input or intervention.

Originality/value
Whilst well used in research, the BPI-S may be less extensively used in practice. This present study provides data to enable researchers and practitioners to use the BPI-S more widely in assessing clinical outcomes, such as intervention research and service evaluation.
Impact of dietary patterns and the main food groups on mortality and recurrence in cancer survivors: a systematic review of current epidemiological literature
Authors: Jochems Sylvia H J , Van Osch Frits H M , Bryan Richard T , Wesselius Anke , van Schooten Frederik J , Cheng Kar Keung , Zeegers Maurice P 
Published: February 2018

ObjectiveTo determine whether there is an association between dietary patterns/indices and foods from the main food groups (highest vs lowest intakes) prior to or after cancer diagnosis and mortality and cancer recurrence in cancer survivors.ParticipantsSurvivors of common cancers with a 10-year survival rate of ≥50%: bladder, bowel, breast, cervical, kidney, laryngeal, prostate, testicular, uterine cancer, malignant melanoma and (non-)Hodgkin’s lymphoma.Outcome measuresMortality (overall, cancer-specific, from other causes) and cancer recurrence.Information sourcesPubMed, Embase and the Cochrane Library were searched from inception to April 2017. Additional studies were identified by searching reference lists. Two authors independently screened titles and abstracts, assessed study quality and extracted the data.ResultsA total of 38 studies were included. The risk of bias was rated low for the included randomised controlled trials (RCTs) and moderate for the cohort studies. The quality of evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and was rated moderate (RCTs), and (very)low (cohort studies). Reducing the amount of fat after diagnosis appears to decrease the risk of breast cancer recurrence. Adherence to a high-quality diet and prudent diet after diagnosis appears to decrease the risk of death from other causes (and overall mortality for high-quality diet) in breast cancer survivors. Adherence to a Western diet, before and after diagnosis, appears to increase the risk of overall mortality and death from other causes among breast cancer survivors. Evidence from studies among other cancer survivors was too limited or could not be identified.ConclusionFor many cancer survivors, there is little evidence to date to indicate that particular dietary behaviours influence outcomes with regard to recurrence and mortality. Notwithstanding, limited evidence suggests that a low-fat diet, a high-quality diet and a prudent diet are beneficial for breast cancer survivors, while a Western diet is detrimental for breast cancer survivors.
Domestic violence: a cross-sectional study among pregnant women in different regions of Sri Lanka
Authors: Muzrif Munas M , Perera Dinusha , Wijewardena Kumudu , Schei Berit , Swahnberg Katarina 
Published: February 2018

ObjectivesThe aims of this study were to assess the regional differences in domestic violence among pregnant women in the capital district and in the tea plantation sector of Sri Lanka, to explore potential contributory factors and to assess whether healthcare workers addressed domestic violence and disclosure among survivors.DesignA cross-sectional study was carried out using interviewer-administered Abuse Assessment Screen.SettingFifty-seven antenatal clinic centres in the capital district and 30 in the tea plantation sector.ParticipantsPregnant women between 6 and 40 weeks of gestational age. In the capital district, 1375 women were recruited from antenatal clinic centres in the urban (n=25) and in the rural areas (n=32), and 800 women from 30 centres in the tea plantation sector. The response rate in the capital district was 95.6% and 96.7% in the tea plantation sector.ResultsAmong the total sample of pregnant women (n=2088), the prevalence of ‘ever abused’ was 38.6%, and the prevalence of ‘currently abused’ was 15.9%. ‘Ever abused’ (31.5% vs 50.8%) and ‘currently abused’ (10% vs 25.8%) were significantly higher (P<0.001) among the women living in the tea plantation sector. ‘Ever abused’ was associated with living in the tea plantation sector, being employed, living far from gender-based violence care centre and of Muslim ethnicity, after adjusting for age, education and family income. Only 38.8% of all participants had been asked by healthcare workers about abuse. Living in the tea plantation sector and lower level of education were associated with not being asked. Among those who reported ‘ever abused’, only 8.7% had disclosed the experience to a healthcare worker.ConclusionDomestic violence was prevalent and highest among women in the tea plantation sector compared with the capital district. The capacity of healthcare workers in addressing domestic violence should be increased.
Randomised clinical trial of an early palliative care intervention (SUPPORT) for patients with idiopathic pulmonary fibrosis (IPF) and their caregivers: protocol and key design considerations
Authors: Lindell Kathleen Oare , Nouraie Mehdi , Klesen Melinda J , Klein Sara , Gibson Kevin F , Kass Daniel J , Rosenzweig Margaret Quinn 
Published: February 2018

IntroductionIdiopathic pulmonary fibrosis (IPF), a progressive life-limiting lung disease affects approximately 128 000 newly diagnosed individuals in the USA annually. IPF, a disease of ageing associated with intense medical and financial burden, is expected to grow in incidence globally. Median survival from diagnosis is 3.8 years, and many of these patients succumb to a rapid death within 6 months. Despite the fatal prognosis, we have found that patients and caregivers often fail to understand the poor prognosis as the disease relentlessly progresses. Based on feedback from patients and families living with IPF, we developed the S-Symptom Management, U-Understanding the Disease, P-Pulmonary Rehabilitation, P-Palliative Care, O-Oxygen Therapy, R-Research Considerations and T-Transplantation (‘SUPPORT') intervention to increase knowledge of the disease, teach self-management strategies and facilitate preparedness with end of life (EOL) planning.MethodsThis study is a randomised trial to test the efficacy of SUPPORT intervention compared with routine care in patients with IPF and their caregivers delivered after three clinical visits. We are recruiting a cohort of 64 new IPF patient/caregiver dyads (32 for each dyad).ResultsThe trial will evaluate whether the SUPPORT intervention decreases stress, improves symptom burden, quality of life, preparedness and advance care planning for patients and caregivers, quality of dying and death for caregivers if the patient dies during the course of the study, as well as assess the impact of primary palliative care on healthcare resource use near the EOL.ConclusionBy increasing knowledge of the disease, teaching self-management strategies and facilitating preparedness with EOL planning, we will address a critical gap in the care of patients with IPF.Trial registration numberNCT02929017; Pre-results.
An injured man with acute altered mental status
Authors: Chuang Hung-Yu , Kung Lu-Chih , Huang Ming-Yuan 
Published: February 2018

Clinical introductionA 58-year-old man sustained injuries due to accidental fall from a height of 5 m onto a solid floor while operating a crane. He was fully conscious without external evidence of head injury when presented to the ED. The patient had multiple fractures involving the fourth, fifth and seventh of the left ribs, left iliac wing and superior ramus of the pelvis, comminuted fracture of the left femur shaft, and an open fracture of the mandible. Two hours after ED presentation, the patient developed acute confusion and lethargy, which rapidly progressed to coma and respiratory distress, and was subsequently intubated with mechanical ventilation support. Emergent CT scan of the head is shown (figure 1).Figure 1CT scan of the head without contrast.QuestionWhat is the most likely diagnosis?A. Cerebral haemorrhageB. Brain metastasisC. Cerebral fat embolismD. Diffuse axonal injury
A diagnostic red herring
Authors: Martin-Bates Alexander J , Martin-Bates Charles , Withnall Richard 
Published: February 2018

Clinical introductionA 29-year-old keen parachutist presented to the emergency services in Cyprus complaining of sudden-onset facial flushing, dizziness and a widespread rash. The episode began on a hot day, 1 hour after she had eaten a breakfast of tinned tuna, and while she was ascending in an aircraft to parachute from 10 000 ft. She completed her jump uneventfully. She had no significant medical history (figure 1).Figure 1Patient’s legs on presentation; this rash was generalised.QuestionBased on the history and rash, which ONE of the following is the most likely diagnosis?Fish allergyHeat-related eruptionScombrotoxin poisoningStress-induced urticaria
Evidence for reduced susceptibility to cardiac bradycardias in South Asians compared with Caucasians
Authors: Yuyun Matthew F , Squire Iain B , Ng G André , Samani Nilesh J 
Published: February 2018

ObjectivesTo investigate ethnic differences in susceptibility to bradycardias in South Asian and white European patients in the UK by determining rates of permanent pacemaker (PPM) implantation for sinus node dysfunction (SND) and atrioventricular block (AVB) in each ethnic group.MethodsWe carried out a retrospective cohort study into new PPM implantation during the period from 1 May 2006 to 31 March 2014, in patients of South Asian and Caucasian ethnicity resident in Leicestershire, UK. Numbers of individuals at risk in each ethnic group were derived from UK National Census data of 2011. Crude, and age-standardised incidence rates and risk ratios per 1000 population of PPM implantation were calculated for Caucasians and South Asians.ResultsDuring the study period, 4883 individuals from the Leicestershire population of 980 328 underwent PPM implantation, a cumulative implantation rate of 4.98/1000 population. The population cumulative PPM implantation rate for SND was 1.74/1000, AVB 2.83/1000 and other indications 0.38/1000 population. The crude incidence in Caucasians (6.15/1000 population) was higher than in South Asians (1.07/1000 population) and remained higher after age standardisation (5.60/1000 vs 2.03/1000, P<0.001). The age-standardised cumulative PPM implantation rates were lower in South Asians for both SND (0.53/1000 in South Asians; 1.97/1000 in Caucasians, P<0.001) and AVB (1.30/1000 in South Asians; 3.17/1000 in Caucasians, P<0.001). Standardised risk ratios (95% CI) for PPM implantation in South Asians compared with Caucasians for all pacing indications, SND and AVB were 0.36 (95% CI 0.36 to 0.37), 0.27 (95% CI 0.27 to 0.28) and 0.41 (95% CI 0.41 to 0.42), respectively.ConclusionsRates of PPM implantation are lower in South Asians residing in the UK, compared with Caucasians. This observation raises the possibility of lower inherent susceptibility to bradycardias in South Asians compared with Caucasians. Studies aimed at identifying underlying mechanisms, including possible genetic differences, are warranted.
The subduction initiation stage of the Wilson cycle
Authors: Hall Robert 
Published: February 2018

Abstract
In the Wilson cycle, there is a change from an opening to a closing ocean when subduction begins. Subduction initiation is commonly identified as a major problem in plate tectonics and is said to be nowhere observable, yet there are many young subduction zones at the west Pacific margins and in eastern Indonesia. Few studies have considered these examples. Banda subduction developed by the eastwards propagation of the Java trench into an oceanic embayment by tearing along a former ocean–continent boundary. The earlier subducted slab provided the driving force to drag down unsubducted oceanic lithosphere. Although this process may be common, it does not account for young subduction zones near Sulawesi at different stages of development. Subduction began there at the edges of ocean basins, not at former spreading centres or transforms. It initiated at a point where there were major differences in elevation between the ocean floor and the adjacent hot, weak and thickened arc/continental crust. The age of the ocean crust appears to be unimportant. A close relationship with extension is marked by the dramatic elevation of land, the exhumation of deep crust and the spectacular subsidence of basins, raising questions about the time required to move from no subduction to active subduction, and how initiation can be identified in the geological record.
Genetic Variability in eIF2α Gene Is Associated with Islet β-Cell Function in the Development of Diabetes in a Chinese Han Population
Authors: Gu Nan , Ma Xiaowei , Zhang Jianwei , Jin Mengmeng , Feng Nan , Deng Ruifen , Bai Ge , Zhang Hong , Guo Xiaohui 
Published: February 2018

Aims. Protein kinase-like endoplasmic reticulum kinase (PERK)/eukaryotic translation initiation factor 2 alpha (eIF2α) pathway mutations lead to failure of β-cell function. The aim of this article was to assess the association between eIF2α and the risk of glucose metabolism abnormalities. Methods. Two eIF2α SNPs (rs9840992 T>C and rs13072593 A>G) were selected based on CHB data from HapMap, and 1466 unrelated nondiabetes individuals were genotyped. All subjects were examined by the 75 g oral glucose tolerance test, and 733 participated in a subsequent insulin release test. Various indicators of insulin resistance and islet β-cell function were examined. Results. There were no significant differences in genotype distribution and allele frequency between the prediabetes and controls. CC genotype carriers at rs9840992 showed higher insulin levels at 120 min after a 75 g glucose load than noncarriers. Also, CC homozygotes had higher ΔI30/ΔG30 and ΔI120/ΔG120 than noncarriers, even after adjusting for insulin resistance. CC homozygotes had greater AUCi values than noncarriers. Subjects aged ≥ 65 yrs, those with a BMI ≥ 24 kg/m2 and those carrying the rs9840992 risk allele, had a 2.5-fold higher risk of glucose abnormalities than subjects who had none of these risk factors. Conclusion. The eIF2α polymorphism is associated with islet β-cell function in a Chinese population.
Concurrent Inhibition of Neurosphere and Monolayer Cells of Pediatric Glioblastoma by Aurora A Inhibitor MLN8237 Predicted Survival Extension in PDOX Models
Authors: Kogiso Mari , Qi Lin , Braun Frank K. , Injac Sarah G. , Zhang Linna , Du Yuchen , Zhang Huiyuan , Lin Frank Y. , Zhao Sibo , Lindsay Holly , Su Jack M. , Baxter Patricia A. , Adesina Adekunle M. , Liao Debra , Qian Mark G. , Berg Stacey , Muscal Jodi A. , Li Xiao-Nan 
Published: February 2018

AbstractPurpose: Pediatric glioblastoma multiforme (pGBM) is a highly aggressive tumor in need of novel therapies. Our objective was to demonstrate the therapeutic efficacy of MLN8237 (alisertib), an orally available selective inhibitor of Aurora A kinase (AURKA), and to evaluate which in vitro model system (monolayer or neurosphere) can predict therapeutic efficacy in vivo.Experimental Design: AURKA mRNA expressions were screened with qRT-PCR. In vitro antitumor effects were examined in three matching pairs of monolayer and neurosphere lines established from patient-derived orthotopic xenograft (PDOX) models of the untreated (IC-4687GBM), recurrent (IC-3752GBM), and terminal (IC-R0315GBM) tumors, and in vivo therapeutic efficacy through log rank analysis of survival times in two models (IC-4687GBM and IC-R0315GBM) following MLN8237 treatment (30 mg/kg/day, orally, 12 days). Drug concentrations in vivo and mechanism of action and resistance were also investigated.Results: AURKA mRNA overexpression was detected in 14 pGBM tumors, 10 PDOX models, and 6 cultured pGBM lines as compared with 11 low-grade gliomas and normal brains. MLN8237 penetrated into pGBM xenografts in mouse brains. Significant extension of survival times were achieved in IC-4687GBM of which both neurosphere and monolayer were inhibited in vitro, but not in IC-R0315GBM of which only neurosphere cells responded (similar to IC-3752GBM). Apoptosis-mediated MLN8237 induced cell death, and the presence of AURKA-negative and CD133+ cells appears to have contributed to in vivo therapy resistance.Conclusions: MLN8237 successfully targeted AURKA in a subset of pGBMs. Our data suggest that combination therapy should aim at AURKA-negative and/or CD133+ pGBM cells to prevent tumor recurrence. Clin Cancer Res; 24(9); 2159–70. ©2018 AACR.
Capecitabine Efficacy Is Correlated with TYMP and RB1 Expression in PDX Established from Triple-Negative Breast Cancers
Authors: Marangoni Elisabetta , Laurent Cécile , Coussy Florence , El-Botty Rania , Château-Joubert Sophie , Servely Jean-Luc , de Plater Ludmilla , Assayag Franck , Dahmani Ahmed , Montaudon Elodie , Nemati Fariba , Fleury Justine , Vacher Sophie , Gentien David , Rapinat Audrey , Foidart Pierre , Sounni Nor Eddine , Noel Agnès , Vincent-Salomon Anne , Lae Marick , Decaudin Didier , Roman-Roman Sergio , Bièche Ivan , Piccart Martine , Reyal Fabien 
Published: February 2018

Abstract
Purpose: Triple-negative breast cancer (TNBC) patients with residual disease after neoadjuvant chemotherapy have a poor outcome. We developed patient-derived xenografts (PDX) from residual tumors to identify efficient chemotherapies and predictive biomarkers in a context of resistance to anthracyclines- and taxanes-based treatments.
Experimental Design: PDX were established from residual tumors of primary breast cancer patients treated in neoadjuvant setting. TNBC PDX were treated by anthracyclines, taxanes, platins, and capecitabine. Predictive biomarkers were identified by transcriptomic and immunohistologic analysis. Downregulation of RB1 was performed by siRNA in a cell line established from a PDX.
Results: Residual TNBC PDX were characterized by a high tumor take, a short latency, and a poor prognosis of the corresponding patients. With the exception of BRCA1/2-mutated models, residual PDX were resistant to anthracyclines, taxanes, and platins. Capecitabine, the oral prodrug of 5-FU, was highly efficient in 60% of PDX, with two models showing complete responses. Prior treatment of a responder PDX with 5-FU increased expression of thymidylate synthase and decreased efficacy of capecitabine. Transcriptomic and IHC analyses of 32 TNBC PDX, including both residual tumors and treatment-naïve derived tumors, identified RB1 and TYMP proteins as predictive biomarkers for capecitabine response. Finally, RB1 knockdown in a cell line established from a capecitabine-responder PDX decreased sensitivity to 5-FU treatment.
Conclusions: We identified capecitabine as efficient chemotherapy in TNBC PDX models established from residual disease and resistant to anthracyclines, taxanes, and platins. RB1 positivity and high expression of TYMP were significantly associated with capecitabine response. Clin Cancer Res; 24(11); 2605–15. ©2018 AACR.