bluuebunny/crossref_metadata_2025_split huggingface dataset:
143 Audio-Visual Training of Perception in Ageing
Authors: O'Brien Jessica , Jason Chan , Setti Annalisa 
Published: September 2019

Abstract

Background
Multisensory perception is the ability to merge information from different sensory modalities. There is a growing interest in identifying ways to improve multisensory perception abilities in older adults, as inefficient multisensory processing has been linked to cognitive and functional impairments. Previous research has shown multisensory perception can be improved in young adults through training their simultaneity judgement. In the present study, we tested whether two different versions of this successful training protocol could train audio-visual abilities in older adults.

Methods
Fifty-eight (32 female) community dwelling and cognitively healthy older adults participated in this study. The age range was 60 – 85 (M=72.47, SD = 6.46). Recruitment was completed through active retired and community-based HSE Falls groups. Participants were randomly assigned to one of two experimental conditions; synchronous or asynchronous training. Each group performed a similar computer-based training protocol, the difference between groups being the instruction given during training. Participants’ multisensory processing was assessed using the Sound-induced Flash Illusion (SiFI) which measures processing efficiency based on susceptibility to an audio-visual illusion.

Results
After 3 days of training, the Analysis of Variance on multisensory thresholds revealed no significant main effect of Training Group [F(1, 42) = .22, p = .64, partial eta squared = .005], Time [F(1, 42) = .007, p = .93, partial eta squared <.001] or SOA [F(5, 210) = 1.19, p = .31, partial eta squared = .028]. Further analyses showed no performance improvement, nor change in susceptibility to the SiFI.

Conclusion
These results provide useful information for future studies exploring ways to train multisensory processing in older adults. We argue the cognitive demands of the computer-based task may account for the lack of an effect in older adults. Our findings highlight the role of task demands and cognitive load as factors to consider in future training studies with older adults.
147 Assessing Assessment: An Audit of Continence Assessment and Documentation in a City Centre Teaching Hospital
Authors: Randles Mary , Hayes Mary , Cotter Susanne , Saramago Ines , McGrath Kieth , O'Caoimh Rónán , O'Connor Kieran , O'Hea Anne , Hannon Evelyn 
Published: September 2019

Abstract

Background
Urinary incontinence (UI) is defined by the International Continence Society as “any involuntary leakage of urine.” UI can negatively impact patients' physical and mental wellbeing and quality of life. Since older adults constitute a growing hospital population, evaluation and improvement of this patient group's quality of care is recognized as a priority in the study hospital. A continence assessment helps to determine what the problem is and what management is required.
This audit aims to determine whether appropriate assessments of continence in older adults presenting to the hospital setting were completed and documented.

Methods
An audit tool was adapted from the Royal College of Physicians National Continence Audit tool and the hospital's own elimination documentation pathway. On a chosen day a general medical ward and a specialist geriatric medicine ward were assessed. Medical charts, nursing notes, emergency department proforma, frailty intervention team proforma and skin integrity proforma were reviewed. Documentation of continence status, symptoms, type, investigations, continence wear, catheterisation and management were assessed. Continence care plans and evidence of communication/discussion with patients were also assessed.

Results
Thirty-one sets of documentation were reviewed. Twenty-four patients were aged over 65. Of these patients 12 were male and 12 were female. Four patients had no continence status documented. Forty-two percent of those reviewed over 65 had documented incontinence and of these only 40% had the elimination section of their nursing proforma fully completed. Six of the patients with documented incontinence had their symptoms/type of incontinence documented. Two Patients had urinary catheters, the indications for these catheters were documented

Conclusion
This audit found that overall the assessment and documentation of continence in older adults was sub-optimal. Based on this audit an assessment tool and education program will be introduced to the specialist geriatric medicine ward with the goal of improving assessment of continence and optimal management.
159 Geographic Accessibility and Capacity of Day Care Services for People with Dementia
Authors: Pierse Tom , Cullinan John , Keogh Fiona , O'Shea Eamon 
Published: September 2019

Abstract

Background
Day care is an important service for some people with dementia and their carers. In Ireland, day care services for people with dementia are delivered by a mix of dementia specific day-care centres and generic centres that cater for people with dementia to various degrees. In this paper we map the geographic variation in the supply of day care services for people with dementia relative to potential need.

Methods
Using a national HSE survey of day care centres, we estimate the current supply of day care services for people with dementia in both generic and dementia specific centres by combining a number of qualitative and quantitative measures. To identify the variation in supply, we map day care provision at local and regional levels to the number of people with dementia in the area. To consider geographic accessibility, we map and analyse the population living outside the catchment area of the day care centres.

Results
There is significant variation across the country in the existing capacity of day care centres to cater for people with dementia. The number of places per 100 persons with dementia varies from 9 to 16 across the Community Health Organisation areas. We show that 20 per cent of people with dementia are not living within a 15km radius of a day care centre that caters for people with dementia.

Conclusion
Day care has a place in the menu of service for people with dementia living in the community. As the number of people with dementia grows, investment in day care centres needs to be targeted to areas of greatest need. In many parts of the country, the current day care centres have limited capacity to provide a service for people with dementia that live in their catchment area. There is considerable geographical inequity in day care provision for people with dementia across the country.
Caring for and assessing pediatric patients: Aspects to consider as a pharmacy practitioner
Authors: Eiland Lea S , Meyers Rachel S 
Published: September 2019

AbstractPurposePharmacists care for patients of all ages. Pediatric patients are not smaller versions of adults; thus, they provide a unique challenge to pharmacists. Basic components of patient assessment and considerations for medication dosing and administration for pediatric patients are reviewed here.SummaryEach pediatric patient is different, and physiological changes occur as a patient ages. Growth, vital signs, and laboratory tests are common assessments for all patients. However, there are unique factors to consider within the pediatric population, and a pharmacist must understand how to assess and interpret these data for pediatric patients of all ages. Additionally, individualized medication dosing is based on patient factors such as age, weight, or body surface area in this population. Key information about the administration of medications and understanding of dosage formulations for this patient population is an area where pharmacists can make recommendations to prescribers and counsel patients and caregivers in order to improve patient outcomes and increase adherence.ConclusionPatient assessment by the pharmacist is a key step in developing a patient treatment plan. Assessment factors in the pediatric population can differ from those in the adult population. A working knowledge of differences within the pediatric population and understanding how to assess them is essential for providing optimal patient care to this population.
Pediatric-to-adult healthcare transitions: Current challenges and recommended practices
Authors: Hobart Catherine B , Phan Hanna 
Published: September 2019

Abstract

Purpose
An overview of the pediatric-to-adult healthcare transition (HCT) process, including stakeholders, challenges, and fundamental components that present opportunities for pharmacists and pharmacy technicians, is provided.

Summary
Pediatric-to-adult HCT programs should be longitudinal in nature, be patient focused, and be coproduced by patients, caregivers, and care team members. Educational components of HCT programs should include knowledge and skills in disease state management and self-care; safe and effective use of medications, as well as other treatment modalities; and healthcare system navigation, including insurance issues. Interprofessional involvement in HCT is encouraged; however, roles for each discipline involved are not clearly delineated in current guidelines or literature. Possible influencing elements in achieving successful pediatric-to-adult HCT outcomes include those that are related to patient and/or caregiver factors, clinician awareness, availability of resources, and ability to achieve financial sustainability.

Conclusion
The use of structured pediatric-to-adult HCT programs is currently recommended to optimize patient and health-system outcomes. Given the importance of medication-related knowledge and healthcare system navigation skills to successful care transitions, there are opportunities for pharmacists and pharmacy technicians to contribute to HCT programs.
Does Implant Surface Texture Affect the Risk of Capsular Contracture in Subglandular Breast Augmentation and Breast Augmentation-Mastopexy?
Authors: Lista Frank , Austin Ryan E , Saheb-Al-Zamani Maryam , Ahmad Jamil 
Published: September 2019

Abstract

Background
Previous studies have reported decreased rates of capsular contracture associated with the use of textured surface breast implants placed in the subglandular plane during breast augmentation. However, since the publication of these studies, our understanding of the pathophysiology of capsular contracture, as well as the surgical techniques utilized to minimize bacterial contamination of the implant, have advanced considerably.

Objectives
The purpose of this study was to re-evaluate the relation between implant surface texturization and capsular contracture rates for breast implants placed in the subglandular plane during primary breast augmentation.

Methods
Retrospective chart review was performed of all primary subglandular breast augmentation procedures involving the use of either smooth or textured round silicone gel implants, with or without simultaneous mastopexy. The primary outcome measures included clinically significant capsular contracture (Baker grade III/IV) and revision surgery for capsular contracture.

Results
Between 2010 and 2017, 526 patients underwent primary subglandular breast augmentation with either smooth (n = 212) or textured (n = 314) round silicone gel implants; 248 patients underwent breast augmentation, whereas 278 underwent breast augmentation-mastopexy. Average follow-up was 756 days in the textured group and 461 days in the smooth group. Five cases of capsular contracture were observed in the textured group, and 7 cases of capsular contracture were observed in the smooth group (P = 0.20).

Conclusions
Smooth surface implants placed in the subglandular plane were not at a significantly increased risk of capsular contracture compared with textured surface implants. We suggest that adherence to a surgical technique focused on minimizing bacterial contamination of the implant is of greater clinical significance than implant surface characteristics when discussing capsular contracture.

Level of Evidence: 4
Left Interhemispheric Craniotomy for Resection of Cavernous Malformation: 2-Dimensional Operative Video
Authors: Hendricks Benjamin K , Spetzler Robert F 
Published: September 2019

Abstract
Thalamic cavernous malformations pose variable surgical challenges given that the location and size of the lesion often determine the approach surgical trajectory. The patient in this case has a large thalamic cavernous malformation that results in a mass effect on the third ventricle and directly abuts the lateral ventricle. A small interhemispheric craniotomy is performed to allow for an anterior interhemispheric transcallosal approach to the lesion. The lateral ventricle is accessed, and the septum is removed to enhance visualization of the surgical field. A small rim of normal parenchyma on the lateral margin of the thalamus is transgressed, and the cavernous malformation is entered. The lesion is removed in a piecemeal manner. Use of counter traction assists with the piecemeal removal. The lighted suction is critical during inspection and manipulation of the lesion within the resection cavity given the limited lighting deep within the cavity. The lesion was removed completely, and postoperative imaging confirms gross total resection. The patient gave informed consent for surgery and video recording. The institutional review board approval was deemed unnecessary. Used with permission from the Barrow Neurological Institute.
Randomized crossover study investigating resident retention of menopause-related knowledge after completion of learning modules
Authors: Shinnick Julia K. , Raker Christina , Hampton B. Star , Eger Renee 
Published: September 2019

Abstract

Objective:
The aim of this study was to evaluate residents’ retention of menopause-based knowledge immediately after, and 3 months after completion of, self-administered modules that varied by menopause-related topic and delivery format.

Methods:
Prospective crossover study of Obstetrics and Gynecology and Family Medicine residents at one institution over the 2017 to 2018 academic year. Residents were randomized to a series of three PowerPoints (Microsoft, Redwood, WA), each <30 slides, administered during regularly scheduled didactics. Each series contained three subjects (Menopause Basics [MB], Hormone Therapy [HT], and Genitourinary Syndrome of Menopause [GSM]) delivered through three different presentation styles (typical presentation [typical], pictures and a narration [pictures], and interactive to reveal information [interactive]). Knowledge and comfort were assessed through baseline, immediate postexposure, and 3-month follow-up surveys containing 24 knowledge questions (multiple choice) and 10 comfort and satisfaction questions (5-point Likert scale and multiple choice). Statistical tests were applied with P<0.05 considered significant.

Results:
Thirty-three residents completed the 3-month follow-up. Immediately postexposure, knowledge and comfort increased from baseline for all topics (P < 0.05). When formats were grouped together to investigate retention by topic, the HT topic demonstrated a sustained increase in knowledge on 3-month follow-up (P = 0.047). The typical format of the GSM topic had significantly better retention than the picture format (P = 0.027). All formats were associated with a significant increase in comfort (all P < 0.01).

Conclusions:
Participation in this specialized menopause curriculum led to short-term increases in objectively assessed menopause-related knowledge. Tailoring self-administered learning modules to learning styles did not, however, effectively enhance overall knowledge retention on 3-month follow-up, though comfort in managing menopause remained increased.

Video Summary:

http://links.lww.com/MENO/A474.
Retrospective analysis of phytoSERM for management of menopause-associated vasomotor symptoms and cognitive decline: a pilot study on pharmacogenomic effects of mitochondrial haplogroup and APOE genotype on therapeutic efficacy
Authors: Wang Yiwei , Hernandez Gerson , Mack Wendy J. , Schneider Lon S. , Yin Fei , Brinton Roberta D. 
Published: September 2019

Abstract

Objective:
PhytoSERM is a selective estrogen receptor beta (ERβ) modulator comprised of three phytoestrogens: genistein, daidzein, and S-equol. The PhytoSERM formulation promotes estrogenic action in the brain while largely inactive or inhibitory in reproductive tissue. A phase Ib/IIa clinical trial (ClinicalTrial.gov ID: NCT01723917) of PhytoSERM demonstrated safety and pharmacokinetics profile of PhytoSERM. While this study was not powered for efficacy analysis, we conducted a pilot, retrospective analysis to identify potential responders to PhytoSERM treatment, and to determine the optimal populations to pursue in a phase II clinical trial of efficacy of the PhytoSERM formulation.

Methods:
In this retrospective analysis involving 46 participants (n = 16, placebo; n = 18, 50 mg/d PhytoSERM; and n = 12, 100 mg/d PhytoSERM), the therapeutic effect of PhytoSERM was stratified by 2 genetic risk modulators for Alzheimer's disease: mitochondrial haplogroup and APOE genotype.

Results:
Our retrospective responder analysis indicated that participants on 50 mg of daily PhytoSERM (PS50) for 12 weeks significantly reduced hot flash frequency compared with their baseline (mean [95% CI])−1.61, [−2.79, −0.42], P = 0.007). Participants on 50 mg of PhytoSERM also had significantly greater reduction in hot flash frequency at 12 weeks compared with the placebo group (−1.38, −0.17 [median PS50, median placebo], P = 0.04). Fifty milligrams of daily PhytoSERM also preserved cognitive function in certain aspects of verbal learning and executive function. Our analysis further suggests that mitochondrial haplogroup and APOE genotype can modify PhytoSERM response.

Conclusion:
Our data support a precision medicine approach for further development of PhytoSERM as a safe and effective alternative to hormone therapy for menopause-associated hot flash and cognitive decline. While definitive determination of PhytoSERM efficacy is limited by the small sample size, these data provide a reasonable rationale to extend analyses to a larger study set powered to address statistical significance.
Predicting Development of Bilateral Menière's Disease Based on cVEMP Threshold and Tuning
Authors: Noij Kimberley S. , Herrmann Barbara S. , Guinan John J. , Rauch Steven D. 
Published: September 2019

Objective:To investigate if the cervical vestibular evoked myogenic potential (cVEMP) is predictive for developing bilateralMenière'sdisease (MD).Study Design:Retrospective cohort study.Setting:Tertiary care center.Patients:Records of 71 patients previously diagnosed with unilateral MDat our institution who underwent cVEMP testing between 2002 and 2011 were screened.Intervention:Patients were contacted to answer a questionnaire to identify which patients had developed bilateral disease. Based on questionnaires and medical charts, 49 patients with a follow-up time of at least 5 years were included. The 49 originally asymptomatic ears are referred to as “study ears.” Previously reported cVEMP criteria (original criteria) applied to study-ear cVEMPs separated them intoMenière-like and normal-like groups.Main Outcome Measure:The main purpose was to determine if previously obtained cVEMP thresholds and tuning ratios of unilateral MD patients could predict who develops bilateral disease.Results:From the 49 included patients, 12 developed bilateral disease (24.5%). The study ears characterized by original cVEMP criteria asMenière-like were significantly more likely to develop bilateral disease compared with the normal-like study ears. The original criteria predicted development of bilateral disease with a positive predictive value (PPV) and negative predictive value (NPV) of 58.3% and 86.5% respectively. ROC curves were used to revise cVEMP criteria for predicting the progression to bilateral disease. A revised criterion combining three cVEMP metrics, reached a PPV and NPV of 85.7% and 93.7%.Conclusion:cVEMP threshold and tuning in unilateral MD patients are predictive of which patients will develop bilateral disease.
Improving the safety of chemotherapy process by a risks management tool
Authors: Ouasrhir Abdelali , Bourhaleb Zouhour , Rahhali Rabie , Boukhatem Noureddine 
Published: September 2019

Abstract

Objectives:
Chemotherapy compounding is a main step of chemotherapy cancer process. This step is formed by many parts. A multidisciplinary team is assembled to define critical points and failures linked to this process and proposed different actions to secure them and improve chemotherapy cancer process.

Methodology:
By a prospective analysis risks tool: the failure modes, effects, and criticality analysis (FMECA), anticancer drug process compounding was sequenced in many parts. During the brainstorming, different ideas expressed and were classified into an Ishikawa cause–effect diagram. The criticality indexes (CI) are calculated from occurrence, severity, and the detection probability.

Results:
The sum of CIs of 18 identified failure modes was CI = 3607 for the decentralized system and CI = 726 after the new organization of compounding process. The chemotherapy production step represents 37.17% (CI = 1341) of all failures in the old process. The greatest risk reductions between the old and the new process concerned the risk of ‘Double check missing before delivery to the ward’ by a factor reduction of 28.0). Among the CIs remaining superior to 100, there was one failure: ‘Typing error during prescription’ (CI = 144).

Conclusion:
Modification of the chemotherapy-compounding process by centralization, training program, and implementation of procedures resulted in an important risk reduction as shown by risk analysis. Our study illustrates the usefulness of risk analysis methods in the healthcare system. A systematic use of risk analysis is needed to improve the safety of high-risk activities in healthcare processes.