bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Profile of Regulated Nurses Employed in Canadian Long-Term Care Facilities
Authors: Squires Janet E. , Baumbusch Jennifer , Demery Varin Melissa , MacDonald Ibo , Chamberlain Stephanie , Boström Anne-Marie , Thompson Genevieve , Cummings Greta , Estabrooks Carole A. 
Published: March 2019

RÉSUMÉLe personnel infirmier autorisé (PIA) et les infirmiers auxiliaires (Iaux) fournissent le volet spécialisé des soins infirmiers dans les centres de soins de longue durée au Canada. Cependant, peu d’études se sont penchées sur cette main-d’œuvre importante. Une enquête a été réalisée chez 309 PIS et 448 Iaux provenant de 91 centres pour personnes âgées situés dans l’Ouest canadien afin de décrire leur profil démographique et certaines variables associées à leur travail et à leur santé. Les Iaux étaient significativement plus jeunes que les PIA, travaillaient un plus grand nombre d’heures et avaient moins d’expérience en soins infirmiers. Ils étaient aussi davantage confrontés à des comportements réactifs d’aînés atteints de démence, comparativement aux PIA. Les PIA et les Iaux plus jeunes rapportaient un épuisement professionnel (burnout, épuisement émotionnel) plus sévère et davantage de problèmes de santé mentale que les groupes plus âgés. Des différences significatives ont également été observées entre les provinces, les régions et les propriétaires exploitants en ce qui concerne les variables démographiques, ainsi que les variables liées au travail et à la santé des PIA et des Iaux. Ces résultats permettront d’informer les décisions politiques importantes à venir et la planification de la main d’œuvre afin d’améliorer la qualité de vie au travail pour le personnel infirmier œuvrant en centres de soins de longue durée.
Epidemiology of two decades of invasive meningococcal disease in the Republic of Ireland: an analysis of national surveillance data on laboratory-confirmed cases from 1996 to 2016
Authors: Bennett D. , O'Lorcain P. , Morgan S. , Cotter S. , Cafferkey M. , Cunney R. 
Published: March 2019

AbstractWe examined the epidemiology of invasive meningococcal disease (IMD) in the Republic of Ireland (ROI) between epidemiological year (EY) 1996/1997 and EY2015/2016. Over the 20 EYs, 3707 cases were reported with annual incidence rates per 100 000 peaking at 11.6 in EY1999/2000, decreasing significantly to 1.5 in EY2015/2016. The highest disease burden was in infants and children <5, whereas adults aged ⩾65 years experienced the highest case fatality ratio (CFR) of 15.7% but over the study period the median annual CFR remained low (4.4%). Meningococcal serogroup B (menB) dominated (78%), followed by menC (17%), menW (1%) and menY (1%). The incidence of menC IMD declined significantly in all age groups after menC vaccine introduction in 2000. MenB incidence also declined over the 20 EYs with decreasing trends in all age groups under 65, including an almost 50% decrease in infants over the final four EYs. IMD incidence in the ROI has declined, partly attributable to menC vaccination success, coupled with a spontaneous decline in menB. However, recent gradual increases in non-menB IMD and the introduction of vaccines targeting menB demand continued detailed surveillance to accurately monitor trends and to assess vaccine impact.
23 “To die, to sleep – to sleep, perchance to dream..." Inhibition of Nightmares with Pramipexole: A Possible Treatment for PTSD
Authors: Escobar-Montealegre Freddy , Brar Preet , Hirsch Alan Richard 
Published: March 2019

AbstractIntroductionThe association of sleep disorders and post-traumatic stress disorder (PTSD) is almost universal. Nightmares are not only one of the most commonly associated but also featured as a diagnostic criterion for PTSD. PTSD-related nightmares are particularly distressing, may impair functioning and increase risk of suicide. No specific pharmacologic agent has been demonstrated to impair dreaming. Inhibition of PTSD-related nightmares with pramipexole has not heretofore been described. Such a case is presented.MethodsCase study - This 60 year-old male with PTSD and trauma-related nightmares upon introduction of pramipexole 0.5mg PO qHS for Restless Leg Syndrome (RLS) had total elimination of dreams, which recurred upon discontinuation of this agent as a result of insomnia and increased anxiety. A lower dose of 0.375mg qHS provided optimal RLS-symptom control and overall improved tolerance despite nightmare recurrence.ResultsAbnormalities on Neurological examination: Recent recall: 2 of 4 objects without improvement with reinforcement. Able to spell the word “world” forwards but not backwards. Abstract thought impaired. Chemosensory testing: Anosmia and normogeusia. Motor: Drift: mild right pronator drift with right cerebellar spooning and right abductor digiti minimi sign. Reflexes: 3+ brachioradialis and biceps bilaterally, absent ankle jerks. Other: CT scan with and without contrast: normal.DiscussionNightmares related to PTSD may occur during Rapid Eye Movement (REM) sleep and non-REM sleep. Underlying sympathetic activation may lead to disruptive motor behavior similar to that seen in REM sleep behavior disorder. The exact mechanism of action by which inhibition of dreams occurred with use of pramipexole is unclear. Such a response is consistent with prior documented evidence of REM sleep suppression with low-dose pramipexole such as it‘s efficacy in reducing the intensity and frequency of nightmares and dream enactment related to REM sleep behavior disorder. Further research on therapeutic interventions that target nightmares directly may be beneficial for the management of patients with PTSD.
33 An Intervention to Decrease Benzodiazepine Prescribing by Providers in an Urban Clinic
Authors: Platt Lois , Savage Teresa A. , Rajagopal Nimmi 
Published: March 2019

AbstractSTUDY OBJECTIVESOutpatient benzodiazepine use can cause side effects including dependence (20–30%) and death from respiratory depression when used with alcohol or opioids. Benzodiazepine use is on the rise in the U.S., increasing 67% from 1996–2013. In this quality improvement project, two educational interventions were combined with the intent of decreasing benzodiazepine prescribing by providers (MDs, APRNs) in an urban university clinic.STUDY QUESTIONWhen prescribers working in a low-income clinic receive an intervention to increase awareness of benzodiazepine dangers and promote harm reduction strategies compared to treatment as usual, do they write fewer benzodiazepine prescriptions in the month following the intervention?METHODA hybrid intervention combining academic detailing (educational outreach visits) and pharmaceutical industry detailing (merchandising, relationship building) was provided in two sessions to family practice providers (salaried and residents) working in a university outpatient clinic in Chicago. The subject matter included benzodiazepine risks, alternative treatments for anxiety & insomnia, and methods to deal with patient demand. All clinic providers (n=40) were invited to participate. Participants were self-selected to attend each session (although resident physicians were obligated to attend). A total of 20–24 providers attended each session.Benzodiazepine prescription information was extracted by clinic information systems for two periods: 12months pre-intervention, and 30days post-intervention. For ease of comparison, each prescription was converted to a common denominator: the diazepam-equivalent dose. The pre-intervention monthly average (for one year) was compared to 30-day post-intervention data. The outcome measure was the numeric difference in the prescribed diazepam-equivalents pre- and post-intervention. This number was used as a measure of the effectiveness of the intervention. A decrease in prescribing post- compared to pre-intervention would indicate a successful intervention.RESULTSThere was an 80% decrease in benzodiazepine prescribing in the 30-day post-intervention period compared to the 12-month pre-intervention monthly average. This result cannot be explained by personnel changes at the clinic. Although these did occur in 2017, the pattern of prescribing was stable throughout the year prior to this intervention.CONCLUSIONSThe combination of academic and pharmaceutical industry detailing influenced family practice providers in an urban clinic setting to decrease benzodiazepine prescribing by 80%. Decreased benzodiazepine prescribing should decrease patient morbidity and mortality.
40 Pseudo Cranial Nerve I Dysfunction: Subjective Hyposmia and Subjective Hypogeusia but Normosmia and Normogeusia - 3 cases
Authors: Benskin Kristal , Hirsch Alan R. 
Published: March 2019

AbstractINTRODUCTIONHyposmia refers to reduced ability to smell and hypogeusia is a partial loss of the ability to taste (Hummel, Basile, & Huttenbrink, 2016). Complaints of hyposmia and hypogeusia in the presence of normosmia and normogeusia has not heretofore been described. Three such cases are presented.OBJECTIVETo explore the complaints of reduced smell and taste with normal objective olfaction and gustation.METHODAll patients were given screening tests for smell and taste and obtained scores consistent with normosmia and normogeusia. The 12-item version of the Brief Smell Identification Test (B-SIT), using the odorants banana, chocolate, cinnamon, gasoline, lemon, onion, paint thinner, pineapple, rose, soap, smoke and turpentine was used. The Retronasal Olfactory Test was used to determine their perception of flavour and the Proplythiouracil Disc Taste Test used for gustation. Each patient also underwent a complete physical and neurological examination with any abnormalities mentioned.RESULTSCase 1: This 53 year old female, 8months prior to presentation, developed the flu followed by the inability to taste any foods and differentiate between smells, with everything smelling bitter.Results: Chemosensory testing: Olfaction: Brief Smell Identification Test (B-SIT): 10 (normosmia). Retronasal Olfactory Test: Retronasal Smell Index: 9 (normal). Gustation: Propylthiouracil Disc Taste Test: 7 (normal).Case 2: This 86 year old female, 6months prior to presentation, developed reduced taste, of gradual onset, to the point upon presentation was only 10% normal. She was able to taste lemons but very little else.Results: B-SIT: 9 (normosmia). Retronasal Smell Index: 10 (normal). Propylthiouracil Disc Taste Test: 10 (normogeusia).Case 3: This 63 year old female was nasute until 3months prior to presentation, when she developed an upper respiratory infection, followed by loss of smell and taste to 20% of normal.Results: B-SIT: 10 (normosmia). Retronasal Smell Index: 7 (normal). Propylthiouracil Disc Taste Test: 10 (normogeusia).CONCLUSIONDiscordance between subjective and objective findings may be due to the wide distribution of normal in the general population in olfactory ability. The associated reduction in retronasal smell may then be interpreted by the patient as reduced ability to taste. Alternatively, complaints of hyposmia and hypogeusiamay be due to a non-organic need such as malingering or psychosomatic illness, or could represent a primary defect in the cortical integration of smell and taste, interpreted as reduction in perceived flavor, yet the primary sensory neurons and threshold as tested would appear to be normal. This disparity possibly indicates that the testing modalities are too insensitive to demonstrate more subtle sensory perception findings, and suggests the need for more refined testing methods for smell and taste.
44 Real World Effectiveness: A 6-month Naturalistic Follow-up Study of Schizophrenia Patients After Switching to Aripiprazole Monohydrate (AOM) Treatment
Authors: Gómez-Revuelta Marcos , Pelayo-Terán José María , Juncal-Ruiz María , Fernández-Rodríguez María , Vázquez-Bourgon Javier , Suárez-Pinilla Paula , Porta-Olivares Oriol 
Published: March 2019

AbstractRationaleLong-acting injectable antipsychotic therapies may offer benefits over oral antipsychotics in patients with schizophrenia. However, there is still a lack of real-world studies assessing the effectiveness of these therapies.ObjectiveThis study aimed to explore the safety, tolerability, and treatment response of aripiprazole monohydrate (AOM) once monthly in non-acute but symptomatic adult patients switched from previous therapy with frequently used oral or injectable atypical antipsychotics.MethodsThis was a post hoc analysis of a prospective, interventional, single-arm, open-label, 6-month study.ResultsThe patients (N=54) were switched to aripiprazole monohydrate once-monthly (AOM) from daily oral treatment or monthly injectable treatment with either aripiprazole (n=25), olanzapine (n=7), paliperidone extended-release (PP1M) (n=10), quetiapine (n=4), or risperidone (n=8). In all groups, mean Positive and Negative Syndrome Scale total (p=0.0001) and Clinical Global Impression-Severity scores improved significantly (p=0.0001). A reduction of ≥50% reduction of BPRS total-score and a CGI severity-score ≤4 in the Positive and Negative Syndrome Scale total score were observed in 16.7% (aripiprazole), 21.2% (olanzapine), 35.1% (PP1M), 27.3% (quetiapine), and 37.2% (risperidone) of patients. The patients showed significant improvements involving safety features as they experienced significant overall weight loss (p=0.0001) and prolactine decrease (risperidone p=0.0001, paliperidone extended-release p=0.0001). AOM once-monthly was well tolerated, presenting no new safety signals. Patient also reported an overall significant improvement on their quality of life measured with the Quality of Life Rating Scale (QLS) (p=0.0004) as well as in sexual functioning PRSexDQ-SALSEX (p=0.0001). In addition, the all cause treatment discontinuation rate after6-month follow-up was small (n=3; 5,55%)ConclusionsThese data illustrate that stable, non-acute but symptomatic patients either on oral antipsychotic therapy or under monthly antipsychotic treatment may show clinically meaningful improvement of psychotic symptoms, tolerability involving relevant side effects and quality of life perception. The findings are limited by the naturalistic study design; thus, further studies are required to confirm the current findings.Keywords: Long-acting injectable antipsychotic therapy. Oral antipsychotic. Effectiveness- Tolerability-Quality oflife.
45 Long-term Treatment with Deutetrabenazine Is Associated with Continued Improvement in Tardive Dyskinesia: Results from an Open-label Extension Study
Authors: Hauser Robert A. , Fernandez Hubert H. , Stamler David , Davis Mat D. , Factor Stewart A. , Jimenez-Shahed Joohi , Ondo William G. , Jarskog L. Fredrik , Woods Scott W. , LeDoux Mark S. , Shprecher David R. , Anderson Karen E. 
Published: March 2019

AbstractStudy ObjectiveTo evaluate long-term efficacy of deutetrabenazine in patients with tardive dyskinesia (TD) by examining response rates from baseline in Abnormal Involuntary Movement Scale (AIMS) scores. Preliminary results of the responder analysis are reported in this analysis.BackgroundIn the 12-week ARM-TD and AIM-TD studies, the odds of response to deutetrabenazine treatment were higher than the odds of response to placebo at all response levels, and there were low rates of overall adverse events and discontinuations associated with deutetrabenazine.MethodPatients with TD who completed ARM-TD or AIM-TD were included in this open-label, single-arm extension study, in which all patients restarted/started deutetrabenazine 12mg/day, titrating up to a maximum total daily dose of 48mg/day based on dyskinesia control and tolerability. The study comprised a 6-week titration and a long-term maintenance phase. The cumulative proportion of AIMS responders from baseline was assessed. Response was defined as a percent improvement from baseline for each patient from 10% to 90% in 10% increments. AlMS score was assessed by local site ratings for this analysis.Results343 patients enrolled in the extension study (111 patients received placebo in the parent study and 232 patients received deutetrabenazine). At Week 54 (n=145; total daily dose [mean±standard error]: 38.1±0.9mg), 63% of patients receiving deutetrabenazine achieved ≥30% response, 48% of patients achieved ≥50% response, and 26% achieved ≥70% response. At Week 80 (n=66; total daily dose: 38.6±1.1mg), 76% of patients achieved ≥30% response, 59% of patients achieved ≥50% response, and 36% achieved ≥70% response. Treatment was generally well tolerated.ConclusionsPatients who received long-term treatment with deutetrabenazine achieved response rates higher than those observed in positive short-term studies, indicating clinically meaningful long-term treatment benefit.Presented at: American Academy of Neurology Annual Meeting; April 21–27, 2018, Los Angeles, California, USA.Funding Acknowledgements: This study was supported by Teva Pharmaceuticals, Petach Tikva, Israel.
53 Computer Vision, Facial Expressivity and Schizophrenia: A Review
Authors: Boazak Mina , Cotes Robert 
Published: March 2019

AbstractIntroductionFacial expressivity in schizophrenia has been a topic of clinical interest for the past century. Besides the schizophrenia sufferers difficulty decoding the facial expressions of others, they often have difficulty encoding facial expressions. Traditionally, evaluations of facial expressions have been conducted by trained human observers using the facial action coding system. The process was slow and subject to intra and inter-observer variability. In the past decade the traditional facial action coding system developed by Ekman has been adapted for use in affective computing. Here we assess the applications of this adaptation for schizophrenia, the findings of current groups, and the future role of this technology.Materials and MethodsWe review the applications of computer vision technology in schizophrenia using pubmed and google scholar search criteria of “computer vision” AND “Schizophrenia” from January of 2010 to June of 2018.ResultsFive articles were selected for inclusion representing 1 case series and 4 case-control analysis. Authors assessed variations in facial action unit presence, intensity, various measures of length of activation, action unit clustering, congruence, and appropriateness. Findings point to variations in each of these areas, except action unit appropriateness, between control and schizophrenia patients. Computer vision techniques were also demonstrated to have high accuracy in classifying schizophrenia from control patients, reaching an AUC just under 0.9 in one study, and to predict psychometric scores, reaching pearson’s correlation values of under 0.7.DiscussionOur review of the literature demonstrates agreement in findings of traditional and contemporary assessment techniques of facial expressivity in schizophrenia. Our findings also demonstrate that current computer vision techniques have achieved capacity to differentiate schizophrenia from control populations and to predict psychometric scores. Nevertheless, the predictive accuracy of these technologies leaves room for growth. On analysis our group found two modifiable areas that may contribute to improving algorithm accuracy: assessment protocol and feature inclusion. Based on our review we recommend assessment of facial expressivity during a period of silence in addition to an assessment during a clinically structured interview utilizing emotionally evocative questions. Furthermore, where underfit is a problem we recommend progressive inclusion of features including action unit activation, intensity, action unit rate of onset and offset, clustering (including richness, distribution, and typicality), and congruence. Inclusion of each of these features may improve algorithm predictive accuracy.ConclusionWe review current applications of computer vision in the assessment of facial expressions in schizophrenia. We present the results of current innovative works in the field and discuss areas for continued development.
69 Mnemonics versus Cramming. Learning Can Be Effective, Efficient and Fun. A Systematic Review Studying Memorization Techniques in Education
Authors: van de Lint Rosemarijn , Bosman Michiel 
Published: March 2019

AbstractThe ProblemWhile learning is at the core of any education (e.g., primary or high school, college, or continuing medical education, to name a few), evidence-based methods of effective memorization are lacking from most forms of education. If attempts are made to teach memorization techniques, they are often without a sound scientific backing. The classical form of memorization (popularly known as “cramming”, or “rote learning”) is tedious, time consuming, and - we know from personal experience - can be so boring that students avoid memorizing at all. A “new” technique of memorization, which is usually referred to as “mnemonics” or “memory techniques” (first reported as being used by the Greeks and the Romans to learn speeches by heart) has received rave reviews from enthusiastic users. A quick search of the scientific databases shows the technique has been studied quite extensively in a number of areas, including education, the medical world, and in the field of learning disabilities, but as far as we know no systematic reviews have assessed the effectivity of using the mnemonics technique versus classical memorization in education.Study ObjectiveWe hypothesize that memorization using mnemonics is a more effective strategy than classical memorization(cramming). To study this hypothesis we have performed a systematic review as described below. In this poster we will describe our study and show preliminary findings.MethodDesign: We have performed a systematic review using the Rapid Evidence Assessment procedure described by the Center for Evidence Based Management.Setting and participants: Studies included limited to those that tested the use of mnemonics in education (primary school, high school, university).Interventions and main outcome measure of the primary studies: We included studies that compared memorization using mnemonics with “regular” memorization (cramming).ResultsUsing 4 databases (Academic Search Premier, PubMed, ERIC and PsycInfo) we found 803 articles. After one round of filtering 589 articles were excluded from the study. The major reasons for exclusion were: learning disabilities, non-educational setting, and no study. In this poster we present the results of the first 10 papers that were included after the second, more stringent, round of filtering. In all 10 papers the mnemonics group performed significantly better on at least a number of the memorization tasks, but in no instance worse than the control group. In some cases where the control groups performed worse, the results were not significant.ConclusionsThis poster describes the analysis of the first 10 papers of our full set of mnemonics studies. They all show a significant advantage of using mnemonics in memorization. If these results are confirmed in our full systematic review, we expect this to have a significant impact on the way “learning how to learn” is taught.