bluuebunny/crossref_metadata_2025_split huggingface dataset:
The development of specialized palliative care in the community: A qualitative study of the evolution of 15 teams
Authors: Seow Hsien , Bainbridge Daryl 
Published: May 2018

Background: Interprofessional specialized palliative care teams at home improve patient outcomes, reduce healthcare costs, and support many patients to die at home. However, practical details about how to develop home-based teams in different regions and health systems are scarce. Aim: To examine how a variety of home-based specialized palliative care teams created and grew their team over time and to identify critical steps in their evolution. Design: A qualitative study was designed based on a grounded theory approach, using semi-structured interviews and other documentation. Setting/Participants: In all, 15 specialized palliative care teams from Ontario, Canada, representing rural and urban areas. Data were collected from core members of the teams, including nurses, physicians, personal support workers, spiritual counselors, and administrators. Results: In all, 122 individuals where interviewed, ranging from 4 to 10 per team. The analysis revealed four stages in team evolution: Inception, Start-up (n = 4 teams), Growth (n = 5), and Mature (n = 6). In the Inception stage, a champion provider was required to leverage existing resources to form the team. Start-up teams were testing and adjusting care processes to solidify their presence in the community. Growth teams had core expertise, relationships with fellow providers, and 24/7 support. Mature teams were fully integrated in the community, but still engaged in continuous quality improvement. Conclusion: Understanding the developmental stages of teams can help to inform the progress of other community-based teams. Appropriate outcome measures at each stage are also critical for team motivation and steady progress.
Anterior Cruciate Ligament Tibial Footprint Size as Measured on Magnetic Resonance Imaging: Does It Reliably Predict Actual Size?
Authors: Kim Seong Hwan , Lee Han-Jun , Park Yong-Beom , Jeong Han-Sol , Ha Chul-Won 
Published: May 2018

Background: Measuring the size of the anterior cruciate ligament (ACL) tibial footprint on magnetic resonance image (MRI) is common for preoperative planning of ACL reconstruction. However, the accuracy of such measurement has not been well documented. Purpose: To investigate whether the actual size of the ACL tibial footprint could be predicted by its measurement on MRI and to develop equations to improve the accuracy of predicting the actual size based on MRI measurement. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A total of 164 patients with normal visualized ACL in gross evaluation and MRI were included (mean ± SD age, 67.3 ± 8.3 years). Cases with ACL tear, severe mucoid degeneration, osteophyte around the ACL tibial insertion, or intervals >12 months between MRI and actual measurement were excluded. The ACL tibial footprint was carefully dissected and measured during total knee arthroplasty. The length of the ACL tibial footprint on MRI was measured on a sagittal image, while the width was measured on an oblique coronal image. For the ACL tibial footprint, the association between measurement on MRI and actual measurement of length and width was analyzed via univariable and multivariable regression analyses. Reliability of measurements on MRI was also evaluated. Results: The length and width of the ACL tibial footprint as measured on MRI showed strong correlation with the actual length and width (coefficients: ρ = 0.904 and ρ = 0.808, respectively). There were differences between ACL size on MRI and its actual size: length, 12.4 mm (range, 9.7-15.3 mm) vs 13.8 (10.6-17.8) ( P < .001); width, 8.8 mm (range, 7.0-12.1 mm) vs 7.2 (5.8-10.4) ( P < .001). Based on sex, there were also differences between the size per MRI and the actual size ( P < .001 for all): length in men, 12.6 mm (range, 10.9-15.3 mm) vs 14.2 (12.3-17.8); length in women, 12.4 mm (range, 9.7-14.5 mm) vs 13.7 (10.6-15.8); width in men, 9.3 mm (range, 8.0-12.1 mm) vs 7.6 (5.8-10.4); width in women, 8.7 mm (range, 7.0-10.4 mm) vs 7.2 (5.8-9.7). The actual length of the ACL tibial footprint could be predicted by its length on MRI and sex ( R2 = 0.83, P < .001). Similarly, actual width could be predicted by the width on MRI and sex ( R2 = 0.75, P < .001). All intraclass correlation coefficients were >0.8, indicating good reliability. Conclusion: Measurements of the size of the ACL tibial footprint on MRI showed strong correlation with its actual size. Prediction equations showed good concordance correlation coefficients.
Money can’t buy love but can it buy peace? Evidence from the EU Programme for Peace and Reconciliation (PEACE II)
Authors: Brück Tilman , Ferguson Neil T. N. 
Published: May 2018

Efforts to evaluate third-party peacebuilding interventions are welcome but many studies rely on experimental approaches that might be at odds with the theories that underpin the discipline. Rigorously evaluating interventions ill-suited to experimental analyses is just as important, however, especially when programmes adopt novel approaches. In this article, we employ an instrumental variables approach to evaluate one such intervention – the EU Programme for Peace and Reconciliation (PEACE II). Following contemporary peacebuilding theories, PEACE II disseminated funds to grassroots organizations via unique intermediate funding bodies and an innovative open competition. Splitting Northern Ireland into 582 wards, we merge panel data on individuals’ perceptions of neighbourhood quality with PEACE II’s accounts. One-stage analyses show that individuals in treatment regions report significantly elevated perceptions. Two-stage approaches, accounting for biases arising from the rollout method, show no significant relationship. Post-estimation analyses imply that funding did not reach areas with the poorest observable indicators. We thus remain agnostic on the effectiveness of the funded projects but conclude that, despite solid theoretical foundations, weaknesses in the application of these theories hampered potential positive impacts. Future interventions can learn from this and should ensure stronger ties between the theoretical base and how these theories are applied to funding disbursement. JEL Codes: O18; F35
Individualized Care Scale-patient: A Spanish validation study
Authors: Rodríguez-Martín Beatriz , Martin-Martin Raúl , Suhonen Riitta 
Published: May 2018

Background: I suggest this individualized care is a fundamental principle closely linked to nursing ethics and has important benefits for the patients, however, nurses do not always take into consideration the principles of individualized care. Moreover, there is no validated instrument to assess patients’ views of individualized care in Spanish-speaking countries. Objectives: To assess the validity and reliability of the Spanish version of the Individualized Care Scale-patient. Design: A cross-sectional study design was conducted. A questionnaire survey, including the Individualized Care Scale-patient, was used for data collection. Psychometric properties of reliability and validity were assessed. Fit indices of the overall model were computed. Participants and research context: Survey data were collected from a sample of 118 inpatients at a public hospital in Spain. Ethical considerations: Informed consent from participants and ethical approval was obtained from a regional Clinical Research Ethics Committee. Findings: Ordinal Cronbach’s alphas were 0.966 for Individualized Care Scale-patient subscale A and 0.969 for Individualized Care Scale-patient subscale B. The polychoric correlation between each item and the subscale ranged between 0.653–0.874 and 0.604–0.916, respectively. The exploratory factor analysis revealed a three-factor solution. Personal life situation explained relatively large amounts of the variance. Goodness of fit index showed a good fit for the model. Discussion: This study confirms three factors underlining the individualized care concept, but some differences were found in the load of the factors, such as the relevance of “personal life situation” subscale, that need further research. Conclusion: The Spanish version of the Individualized Care Scale-patient is reliable, valid, user-friendly, and suitable to be used in Spanish-speaking countries showing satisfactory properties. This instrument may help managers better understand and develop areas in which patients perceive lower individualized care received and the factors influencing it. Such key information will help ensure the right of the patient to be respected as an individual.
Patients’ perception of dignity in Iranian general hospital settings
Authors: Hosseini Fahimeh Alsadat , Momennasab Marzieh , Yektatalab Shahrzad , Zareiyan Armin 
Published: May 2018

Background: Dignified care is one of the main objectives of holistic care. Furthermore, paying attention to dignity as one of the fundamental rights of patients is extremely important. However, in many cases, the dignity of hospitalized patients is not considered. Dignity is an abstract concept, and comprehensive studies of the dignity of Iranian patients hospitalized in general hospital settings are limited. Objective: The aim of this study was to explore the concept of dignity from the perspective of patients hospitalized in general hospital settings in Iran. Research design: This study takes a qualitative approach. Data were gathered using individual, semi-structured interviews. Qualitative content analysis was the method used to analyse and interpret the data. The criteria suggested by Guba and Lincoln were used ensure the trustworthiness of the study. Participants and research context: A total of 14 hospitalized patients in general hospital settings in Shiraz participated in this study. Ethical considerations: The Research Ethics Committee of the Shiraz University of Medical Sciences approved the protocol of the study and the ethical principles were followed throughout. Findings: The findings of this study revealed four main themes – ‘respectful atmosphere’, ‘patient privacy’, ‘preservation of authority’ and ‘receiving attention’ – and 10 categories. Discussion: Patients need to be hospitalized in a respectable environment in which their privacy is preserved and paid attention, providing them with sufficient authority in terms of medical decisions and their life-related issues. The dignity of hospitalized patients will be preserved under these conditions. Conclusion: Patients hospitalized in general hospital settings need to retain their dignity. This can contribute to the optimal therapeutic outcomes for them. Therefore, it is suggested that a cultural, professional and institutional background, in which all components of the patient’s dignity are protected and emphasized, should be provided.
A 3-year retrospective analysis of elderly patients with heat illness
Authors: Mo Weichun , Chen Junfeng , Zhang Feng , Shen Jie 
Published: May 2018

Background: Heat illness in elderly patients has frequently occurred. Because of the difficulties in diagnosis and treatment, it is necessary for us to understand the clinical characteristics of elderly patients with heat illness. Objective: This study presents the demographic, clinical, and laboratory data for elderly patients who presented to our emergency department with heat illness and compares elderly group and non-elderly group to find out characteristics of elderly patient. Methods: We retrospectively analyzed the data of the elderly heat illness patients who had been presented to the emergency department of Jinshan Hospital, Fudan University, between 1 July 2014 and 1 October 2016. Results: There were 64 patients in the study in total and 25 elderly patients (39.1%). The mean age of the elderly patients was 72.8 ± 6.7 years; 18 cases (72%) were male and 7 cases (28%) were female. There were 5 mild cases (20%) and 20 severe cases (80%) in the elderly, which included 1 with heat cramps (5%), 4 with heat exhaustion (20%), and 15 with heat stroke (75%). Lactate dehydrogenase and creatine kinase were significantly higher in the elderly than in the non-elderly (p < 0.0001; t-value = −3.915 and −5.134, respectively). The Acute Physiologic Assessment and Chronic Health Evaluation II score and Modified Early Warning System score were significantly higher in the elderly than in the non-elderly (p < 0.0001; t-value = −6.411 and −4.705, respectively). Age was positively correlated with the Acute Physiologic Assessment and Chronic Health Evaluation II score and Modified Early Warning System score (r2 = 0.4939 and 0.3317, respectively; p value all <0.0001). The Acute Physiologic Assessment and Chronic Health Evaluation II score was positively correlated with lactate dehydrogenase and creatine kinase (r2 = 0.4103 and 0.4520, respectively; p value all <0.0001). The Modified Early Warning System score was positively correlated with lactate dehydrogenase and creatine kinase (r2 = 0.4759 and 0.5850, respectively; p value all <0.0001). There were 19 patients (76%) who improved and 6 patients (24%) who died in the elderly group. Conclusion: Chronic diseases and complications have increased rates in the elderly, who are also more likely to acquire severe heat illness, especially heat stroke. Lactate dehydrogenase and creatine kinase are positively correlated with Acute Physiologic Assessment and Chronic Health Evaluation II scores and Modified Early Warning System scores, which indicates that lactate dehydrogenase and creatine kinase could be good predictors of the severity of heat illness.
Obstructive sleep apnoea is more prevalent in men with schizophrenia compared to general population controls: results of a matched cohort study
Authors: Myles Hannah , Vincent Andrew , Myles Nicholas , Adams Robert , Chandratilleke Madhu , Liu Dennis , Mercer Jeremy , Vakulin Andrew , Wittert Gary , Galletly Cherrie 
Published: May 2018

Objectives: Obstructive sleep apnoea (OSA) may be more common in people with schizophrenia compared to the general population, but the relative prevalence is unknown. Here, we determine the relative prevalence of severe OSA in a cohort of men with schizophrenia compared to representative general population controls, and investigate the contribution of age and body mass index (BMI) to differences in prevalence. Methods: Rates of severe OSA (apnoea–hypopnoea index > 30) were compared between male patients with schizophrenia and controls from a representative general population study of OSA. Results: The prevalence of severe OSA was 25% in the schizophrenia group and 12.3% in the general population group. In subgroups matched by age, the relative risk of severe OSA was 2.9 ( p = 0.05) in the schizophrenia subjects, but when adjusted for age and BMI, the relative risk dropped to 1.7 and became non-significant ( p = 0.17). Conclusions: OSA is prevalent in men with schizophrenia. Obesity may be an important contributing factor to the increased rate of OSA.
Have large femoral heads reduced prosthetic impingement in total hip arthroplasty?
Authors: Waddell Bradford S , Koch Chelsea , Trivellas Myra , Burket Jayme C , Wright Timothy , Padgett Douglas 
Published: May 2018

Background: Prosthetic impingement is implicated in dislocation after total hip arthroplasty (THA). While use of larger diameter femoral heads reduces the incidence of dislocation, the effect of larger heads upon impingement rate is unknown. We assessed retrieved THA components for evidence of impingement to determine if large femoral heads reduced the rate of impingement in primary THA and what factors might influence impingement. Methods: Liners from 97 primary THAs retrieved at revision arthroplasty were scored for evidence of impingement, defined as wear or deformation on the rim of the component. Component inclination and version were measured from anteroposterior and cross-table lateral radiographs. Results: Independent of revision diagnosis, 77% of liners demonstrated evidence of impingement. Impingement was less prevalent and less severe as head size increased. Severe impingement was observed in 50% of the liners with 28-mm heads, 15% of liners with 32-mm heads, and 21% of liners with 36-mm heads. Regardless of head size, 76% of liners revised for instability demonstrated impingement. Decreased head-neck ratio, use of an elevated liner, increased length of implantation, and increased version were associated with increased severity of impingement. Discussion: We showed that larger head sizes are associated with decreased incidence of impingement on retrieved acetabular liners when compared to smaller head sizes. Larger heads have reduced but not eliminated impingement, which remains a potential source of instability.
The effect of patient, fracture and surgery on outcomes of high energy neck of femur fractures in patients aged 15–50
Authors: Hoskins Wayne , Rayner Johnny , Sheehy Rohan , Claireaux Harry , Bingham Roger , Santos Roselyn , Bucknill Andrew , Griffin Xavier L 
Published: May 2018

Introduction: High-energy femoral neck fractures in young patients can be devastating, with the risk of osteonecrosis, nonunion, malunion and lifelong morbidity. The aim of this study is to define the effects of patient, fracture and surgical factors on the outcome of high-energy femoral neck fractures in patients aged from 15 to 50 years. Methods: A retrospective review was conducted of high-energy femoral neck fractures in patients aged 15–50 managed surgically at a Level 1 Trauma Centre, using a prospectively recorded trauma database. Low energy trauma (including falls from <1 m), medical conditions adversely affecting bone density, and pathological fractures were excluded. A clinical and radiological review was performed. The primary outcome measures were the development of osteonecrosis or nonunion leading to total hip arthroplasty (THA). Secondary outcome measures included osteotomy or other surgical procedures, quality of reduction and malunion. Results: 32 patients meeting the inclusion criteria were identified between January 2008 and July 2015. The mean follow-up was 58.5 months (range 980–3,048 days). 3 patients (9.4%) required THA. No other surgical procedures were performed. None of the 29 other patients developed radiologically apparent osteonecrosis. Fracture type, displacement, anatomical reduction and fixation type were not statistically significant risk factors affecting these outcomes. For all patients, an average of 8% loss of femoral neck height and 10% femoral neck offset were seen. Conclusions: At a mean 4.9-year follow-up, the incidence of high-energy femoral neck fractures leading to THA was 9.4%, as a consequence of osteonecrosis or nonunion. Malunion was common.
Gait asymmetries in unilateral symptomatic hip osteoarthritis and their association with radiographic severity and pain
Authors: Farkas Gary J , Schlink Bryan R , Fogg Louis F , Foucher Kharma C , Wimmer Markus A , Shakoor Najia 
Published: May 2018

Introduction: Little is known about the loading patterns in unilateral hip osteoarthritis (OA) and their relationship to radiographic severity and pain. We aimed to examine the loading patterns at the hips of those with unilateral symptomatic hip OA and identify associations between radiographic severity and pain with loading alterations. Methods: 61 subjects with symptomatic unilateral hip OA underwent gait analyses and evaluation for radiographic severity (Kellgren-Lawrence [KL]-grade) and pain (visual analogue scale) at bilateral hips. Results: Hip OA subjects had greater range of motion and higher hip flexion, adduction, internal and external rotation moments at the contralateral, asymptomatic hip compared to the ipsilateral hip ( p < 0.05). Correlations were noted between increasing KL-grade and increasing asymmetry of contralateral to ipsilateral hip loading ( p < 0.05). There were no relationships with pain and loading asymmetry. Discussion: Unilateral symptomatic hip OA subjects demonstrate asymmetry in loading between the hips, with relatively greater loads at the contralateral hip. These loading asymmetries were directly related to the radiographic severity of symptomatic hip OA and not with pain. Conclusion: Additional research is needed to determine the role of gait asymmetries in disease progression.
Epidemiology of Figure Skating Injuries: A Review of the Literature
Authors: Han Julie S. , Geminiani Ellen T. , Micheli Lyle J. 
Published: May 2018

Context: As the popularity and technical demands of figure skating increase, so will the number of athletes presenting with sport-related problems. Evidence Acquisition: Searches were performed across PubMed from 1980 to 2017. The keywords searched were skating, skaters, incidence, and injuries. The search was limited to English-language articles and human participants. Relevant articles were cross-referenced. Study Design: Clinical review. Level of Evidence: Level 5. Results: Previous studies suggest an increase in incidence of figure skating injuries from 1982 to 2003. When combining all disciplines of figure skating, there is a similar proportion of acute and overuse injuries. Within disciplines, overuse injuries appear to be more common in singles skating, while acute injuries are more common in pairs skating, ice dancing, and synchronized skating. Lower extremity injuries are more common than upper extremity injuries in all disciplines, and pairs skating accounts for the majority of upper extremity injuries. Ankle sprains are the most common skating injury, and patellar tendinitis is the most common overuse injury across all disciplines. Stress fractures are the most common overuse injury in female singles skaters. Conclusion: The predominance of overuse injuries in singles disciplines reflects their increasing technical difficulty, with more difficult jumps and longer training hours. Partner disciplines are more likely to involve acute injuries and upper extremity injuries due to high-risk throws and lifts. Emphasis should be placed on properly fitting skating boots, intrinsic foot and ankle strengthening, and lower extremity flexibility, which may prevent many of the common lower extremity and back injuries in figure skating.
Meditation-induced neuroplastic changes of the prefrontal network are associated with reduced valence perception in older people
Authors: Chau Bolton K. H. , Keuper Kati , Lo Mandy , So Kwok-Fai , Chan Chetwyn C. H. , Lee Tatia M. C. 
Published: May 2018

Background: Neuroplastic underpinnings of meditation-induced changes in affective processing are largely unclear. Methods: We included healthy older participants in an active-controlled experiment. They were involved a meditation training or a control relaxation training of eight weeks. Associations between behavioral and neural morphometric changes induced by the training were examined. Results: The meditation group demonstrated a change in valence perception indexed by more neutral valence ratings of positive and negative affective images. These behavioral changes were associated with synchronous structural enlargements in a prefrontal network involving the ventromedial prefrontal cortex and the inferior frontal sulcus. In addition, these neuroplastic effects were modulated by the enlargement in the inferior frontal junction. In contrast, these prefrontal enlargements were absent in the active control group, which completed a relaxation training. Supported by a path analysis, we propose a model that describes how meditation may induce a series of prefrontal neuroplastic changes related to valence perception. These brain areas showing meditation-induced structural enlargements are reduced in older people with affective dysregulations. Conclusion: We demonstrated that a prefrontal network was enlarged after eight weeks of meditation training. Our findings yield translational insights in the endeavor to promote healthy aging by means of meditation.