bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interventions for sleep difficulties in adults with an intellectual disability: a systematic review
Authors: Shanahan P. J. , Palod S. , Smith K. J. , Fife‐Schaw C. , Mirza N. 
Published: January 2019

AbstractBackgroundCurrent literature highlights higher prevalence rates of sleep difficulties amongst adults with an intellectual disability. However, no synthesis has been conducted to assess the effectiveness of existing interventions in this population. Thus, the aim of this review was to assess the effectiveness of sleep interventions in adults with an intellectual disability (ID).MethodEight databases were searched to identify interventions for sleep difficulties amongst adults with an ID. The study quality was assessed with the Risk Of Bias In Non‐randomised Studies – of Interventions. Nine studies (n = 97) were eligible for inclusion in the review.ResultsThere was a notable study on heterogeneity in terms of the population, study design, intervention studied, sleep assessment and outcome assessments used. Eight of the nine studies reported improvement in sleep following intervention. However, these findings need additional support as only 97 participants involving a variety of interventions and measurement systems were used across all studies. Furthermore, eight of the nine studies had serious to critical risk of bias. The only study identified as having low risk of bias was a placebo‐controlled randomised controlled trial for the use of melatonin.ConclusionsThis review highlights the need for objective measures such as actigraphy and studies with greater experimental control investigating sleep interventions in adults with ID.
Adults with Down syndrome: a comprehensive approach to manage complexity
Authors: Carfì A. , Vetrano D. L. , Mascia D. , Meloni E. , Villani E. R. , Acampora N. , Brandi V. , Fries B. E. , Martin L. , Bernabei R. , Onder G. 
Published: January 2019

AbstractBackgroundDown syndrome (DS) is characterised by premature ageing that affects selected organ systems, and persons with this condition can present patterns of co‐morbidities and deficits often observed in the older population without DS. However, information on the characteristics of adult persons with DS is limited.The objective of the study is to describe characteristics of adults with DS collected with a standardised, comprehensive assessment instrument.MethodsCross‐sectional study.Four hundred thirty adults with DS (age range 18/75 years) from three countries (Italy, n = 95; USA, n = 175; and Canada, n = 160).A standardised assessment instrument (interRAI intellectual disability) was used to assess sample characteristics.ResultsMean age ranged from 35.2 (standard deviation 12.0) years in the US sample to 48.8 (standard deviation 9.0) years in the Canadian sample. Most participants in the Italian and US sample were living in private homes, while more than half of those in the Canadian sample were institutionalised. Prevalences of geriatric conditions, including cognitive deficits, disability in the common activities of daily living, symptoms of withdrawal or anhedonia, aggressive behaviour, communication problems, falls and hearing problems were high in the study sample. Gastrointestinal symptoms, skin and dental problems and obesity were also frequently observed.ConclusionsAdults with DS present with a high level of complexity, which may suggest the need for an approach based on a comprehensive assessment and management that can provide adequate care. Further research is needed to understand better the effectiveness of such an approach in the DS population.
Motivations, Beliefs, and Expectations of Spanish Nurses Planning Migration for Economic Reasons: A Cross‐Sectional, Web‐Based Survey
Authors: Gea‐Caballero Vicente , Castro‐Sánchez Enrique , Díaz‐Herrera Miguel Ángel , Sarabia‐Cobo Carmen , Juárez‐Vela Raúl , Zabaleta‐Del Olmo Edurne 
Published: January 2019

AbstractPurposeMigration of nurses is not a new or recent event. During the past few decades, nursing migration flows have been a constant trend worldwide. The main objective of this study was to explore the motivations, beliefs, and expectations that Spanish nurses had when considering migration to another country in the near future.DesignCross‐sectional, Internet survey of Spanish nurses planning migration for professional reasons.MethodsAd hoc, web‐based questionnaire following the Nurses Early Exit Study guidelines.FindingsOne hundred seventy‐two nurses responded. Fifty percent of the participants intended to emigrate in the following 6 months and had chosen the United Kingdom as their destination. The most important drivers of migration were unemployment or precarious employment, and professional development. Fifty‐eight percent of the participants were very afraid of experiencing discrimination or rejection.ConclusionsThis first study conducted in Spain directly exploring determinants of nurse migration highlighted globalization‐driven factors and specific acculturation fears.Clinical RelevanceEmployment uncertainty and professional development remain key push drivers for migration of Spanish nurses. Discrimination and rejection due to migrancy were concerns for 60% of the participants.
Effect of Fabrication Technique on the Marginal Discrepancy and Resistance of Lithium Disilicate Crowns: An In Vitro Study
Authors: Sadid‐Zadeh Ramtin , Li Rui , Miller Lorin M. , Simon Michael 
Published: January 2019

AbstractPurposeTo evaluate the impact of fabrication technique on the marginal fit and resistance of lithium disilicate crowns.Materials and MethodsTwelve ivorine molars were prepared to receive lithium disilicate crowns. The preparations were digitally recorded using an intraoral scanner, and the crowns were designed following the anatomy of an unprepared tooth using a design software. The designed crowns were fabricated using 3 techniques: (1) milling from lithium disilicate blocks using a 3‐axis milling machine (3XM), (2) milling from lithium disilicate blocks using a 5‐axis milling machine (5XM), and (3) milling from resin‐wax billet using a 5‐axis milling machine, followed by heat‐pressing the pattern into lithium disilicate (5XWP). For the control group, the wax patterns were fabricated by one lab technician, and the crowns were fabricated by heat‐pressing the pattern into lithium disilicate (CWP). After sintering, the crowns were secured on their associated preparations using an elastomeric material. The marginal gap of each crown was then measured at 14 defined locations through analyses of 20× images captured with a stereomicroscope. The marginal integrity and resistance to rotation of each crown were assessed by 2 calibrated practitioners. Differences in outcomes by fabrication technique were assessed using Wilcoxon, Kruskal Wallis, and Fisher's exact tests, as appropriate (α = 0.05).ResultsCrowns fabricated using digital workflows (3XM, 5XM, 5XWP) had significantly smaller mean marginal gaps compared to the CWP group (p = 0.0001, p = 0.0002, p = 0.0001, respectively); however, 3XM group was the only group to exhibit significantly better marginal integrity than the CWP group (p = 0.0004). No significant difference (p = 0.6004) in the resistance to rotation of crowns was observed between groups.ConclusionsChoice of fabrication technique and instrument may impact the marginal discrepancy of lithium disilicate crowns; however, all fabrication techniques analyzed produced crowns with acceptable marginal discrepancies.
Obtaining information from family caregivers to inform hospital care for people with dementia: A pilot study
Authors: Toye Christine , Slatyer Susan , Quested Eleanor , Bronson Mary , Hill Andrew , Fountaine Janet , Uren Hannah V. , Troeung Lakkhina , Maher Sean 
Published: January 2019

AbstractAimWe aimed to implement a systematic nurse–caregiver conversation, examining fidelity, dose and reach of implementation; how implementation strategies worked; and feasibility and mechanisms of the practice change.BackgroundAppropriate hospital care for people living with dementia may draw upon: information from the patient and family caregiver about the patient's perspective, preferences and usual support needs; nursing expertise; and opportunities the nurse has to share information with the care team. Within this context, planned nurse–caregiver communication merits further investigation.MethodsIn Phase I, we established the ward staff's knowledge of dementia and Alzheimer's disease, prepared seven nurse change leaders, finalised the planned practice change and developed implementation plans. In Phase II, we prepared the ward staff during education sessions and leaders supported implementation. In Phase III, evaluations were informed by interviews with change leaders, follow‐up measures of staff knowledge and a nurse focus group. Qualitative data were thematically analysed. Statistical analyses compared nurses' knowledge over time.ResultsPlanned practice change included nurses providing information packs to caregivers, then engaging in, and documenting, a systematic conversation. From 32 caregivers, 15 received information packs, five conversations were initiated, and one was completed. Knowledge of dementia and Alzheimer's disease improved significantly in change leaders (n = 7) and other nurses (n = 17). Three change leaders were interviewed, and six other nurses contributed focus group data. These leaders reported feeling motivated and suitably prepared. Both nurses and leaders recognised potential benefits from the planned conversation but viewed it as too time‐consuming to be feasible.ConclusionsThe communication initiative and implementation strategies require further tailoring to the clinical setting. A caregiver communication tool may be a helpful adjunct to the conversation. Implementation may be enhanced by more robust stakeholder engagement, change leader inclusion in the reference group and an overarching supportive framework within which change leaders can operate more effectively.Implications for PracticeNurse‐caregiver communication in this context requires inititatives tailored to the clinical setting with input from all stakeholders.
Mendelian randomisation and the goal of inferring causation from observational studies in the vision sciences
Authors: Plotnikov Denis , Guggenheim Jeremy A 
Published: January 2019

AbstractPurposeRandomised controlled trials (RCTs) allow reliable causal inferences to be drawn regarding the effectiveness of specific interventions. However, they are expensive to carry out, and not all exposure‐outcome relationships can be tested in an RCT framework: for example, it would be unethical to deliberately expose participants to a putative risk factor, or the time‐scale involved may be prohibitive. Mendelian randomisation (MR) has been proposed as an alternative approach for drawing causal inferences, with the major advantage that the method can often be applied to existing, cross‐sectional study datasets. Therefore, results from an MR study can be obtained much more quickly and cheaply than through an RCT.Recent findingsThe validity of causal inferences from an MR study are dependent on two key assumptions, neither of which can be tested fully. Nevertheless, several approaches have been proposed in the last 3 years that either highlight questionable results, or provide valid causal inference if the necessary assumptions are met only in part. Compared to certain other areas of clinical practice, the ophthalmic research community has been slow to adopt MR.SummaryAn MR study cannot match an RCT in its strength of evidence for a claim of causality. However, MR still has much to offer. In some circumstances, an MR study can provide causal insight into research questions that cannot be addressed by an RCT, while more generally, an MR study can be used to evaluate the supporting evidence before deciding to embark on a lengthy and costly RCT.
From suppression to stereoacuity: a composite binocular function score for clinical research
Authors: Webber Ann L , Wood Joanne M , Thompson Benjamin , Birch Eileen E 
Published: January 2019

AbstractPurposeThis study aimed to validate a binocular function score that is based on common clinical measures of visual function, providing a more complete analysis of binocular outcomes, against laboratory‐based dichoptic tests of threshold stereoacuity and depth of suppression.MethodsScores on a composite binocular function (BF) score derived from clinical stereoacuity measures (Randot Preschool Stereoacuity Test and Randot Butterfly) and the Worth 4 Dot test were determined in adults (n = 20; age 24.8 ± 7.2 years) and children (N = 77; age 8.3 ± 1.7 years) with abnormal binocular vision from strabismus or amblyopia. Adults had threshold stereoacuity measured with a novel, computerised dichoptic psychophysical test of stereopsis. Depth of suppression (dichoptic eye chart inter‐ocular contrast balance test) was determined in both adults and children.ResultsClinical Randot stereoacuity was measurable in 50% of adult and 61% of child participants. Threshold stereoacuity was measurable in 65% of the adult participants. The presence of suppression or simultaneous perception (flat fusion or diplopia) was measurable in all participants, enabling assignment of a BF score to all participants in both groups. In adults, the BF score was highly correlated with the psychophysical threshold stereoacuity measure (ρ = 0.71; p < 0.001). In both adults and children, there was also a high correlation between the BF score and inter‐ocular contrast balance (adult ρ = 0.90; child ρ = 0.86; p < 0.001).ConclusionsThe composite BF score is a convenient and valid scale of binocularity that can be used to extend the stereoacuity measure in cohorts where nil stereoacuity is common and thus could be considered as an outcome measure in clinical trials.
Corneal and conjunctival injury seen in urgent care centres in Israel
Authors: Zimmerman Deena R , Shneor Einat , Millodot Michel , Gordon‐Shaag Ariela 
Published: January 2019

AbstractPurposeCorneal and conjunctival injuries (CCI) comprise a large portion of the cases presenting to hospital‐based emergency departments (ED) with ocular involvement. Urgent Care Centres (UCC) offer community based emergency care at lower cost than hospital‐based emergency departments (ED) and with greater temporal convenience than primary care office settings. While CCI prevalence and treatment at hospital‐based EDs has been well studied, this is the first report, to our knowledge, on CCI demographics and aetiology presenting to UCCs.MethodsThis retrospective study was approved by the institutional ethics committee. The setting is a UCC system in Israel, modelled on USA urgent care facilities, consisting of 17 branches at the time of the study. Electronic medical record data (between November 1, 2015 and October 31, 2016) of patients diagnosed with corneal disorder, foreign body or eye disorder were retrieved and reviewed for inclusion/exclusion criteria. Data collected included gender, age, chief complaint, diagnosis, treatment and discharge status (sent home or referred to ED). International Classification of Diseases, Ninth Revision (ICD‐9) codes were assigned to each record based on a review of all fields. UCC results were compared to all ED patients in Israel using data from a public report. Data were analysed by descriptive statistics and logistic regression analysis.ResultsOf the 602 074 charts screened, 4797 patients presented with CCI (0.8%). The average age was 32.6 ± 18.2 years and 71.3% were male. Among these, 26.4% were referred to the ED compared to 6.8% from the entire UCC cohort. ICD‐9 code Foreign body (FB) of the eye was the most common cause of CCI (56.5%) followed by the following ICD‐9 codes: trauma (18.1%), chemical in the eye (11.1%) and corneal disorder due to a contact lens (5.1%). Logistic regression analyses showed the following risk factors for ED referral: age (22–64), male gender, ICD‐9 code FB, work‐related injury and the presence of a clinical abrasion in the eye.ConclusionsThe aetiology of ocular injury at UCC is similar to previous studies of ED. Most CCI can be treated at UCC saving ED resources and underscores the importance of this mode of health care delivery in the overall health system.
A curious case of cervicofacial actinomycosis following third molar surgery
Authors: Conville R. M. , Atkins S. 
Published: January 2019

AbstractActinomycosis is caused by branched, filamentous anaerobic Gram‐positive bacteria called Actinomyces. It is a chronic granulomatous and suppurative infectious disease of which there are three variations; cervicofacial, abdominal and pulmonary. This infection is a rare complication of dental surgery and can have devastating consequences if left untreated. A 35–year‐old male presented with a 2 month history of a swelling to his left cheek following the surgical removal of a lower third molar. A provisional diagnosis of an infected sebaceous cyst was made at a local clinic, and a course of Flucloxacillin was prescribed. To further investigate the lesion an ultrasound scan was performed and an aspirate taken for histopathological analysis. The results were found to be consistent with the clinical suspicion of actinomycosis. A multidisciplinary approach was adopted to manage the patient's case which included liaising with the medical microbiology team to deliver appropriate antimicrobial therapy. The aim of this case report is to highlight the importance of having a clinical suspicion of cervicofacial actinomycosis. This infectious disease can spread into adjacent soft tissues causing serious damage to local structures if not identified. Early diagnosis and management is essential for good outcomes.
Handgrip strength: An effective screening instrument for anemia in the elderly women
Authors: Santos Patrícia Honório Silva , Carmo Érica Assunção , Carneiro José Ailton Oliveira , Nery Adriana Alves , Casotti Cezar Augusto 
Published: January 2019

AbstractObjectiveThe objectives of this study were to discover associations between anemia and functional performance indicators, and to identify the best functional performance test to screen for anemia in the elderly.MethodsA cross‐sectional study analyzed data from 109 elderly residents in the community. For statistical analysis, the Logistic Regression and the Receiver Operating Characteristic (ROC) curve was used.ResultsThe prevalence of anemia in the elderly was 13.9%. There was an inverse association between handgrip strength (HGS) and anemia in women; the HGS test was an effective screening tool for anemia in the elderly.ConclusionThe HGS test can be used to screen for anemia in the elderly women.
Picolinic acid spray stimulates the antioxidative metabolism and minimizes impairments on photosynthesis on wheat leaves infected by Pyricularia oryzae
Authors: Aucique‐Pérez Carlos Eduardo , Resende Renata Sousa , Neto Lara Beatriz Cruz , Dornelas Fernanda , DaMatta Fábio Murilo , Rodrigues Fabrício Ávila 
Published: January 2019

Fungal pathogens produce toxins that are important for their pathogenesis and/or aggressiveness towards their hosts. Picolinic acid (PA), a non‐host selective toxin, causes lesions on rice leaves resembling those originated from Pyricularia oryzae infection. Considering that non‐host selective toxins can be useful for plant diseases control, this study investigated whether the foliar spray with PA on wheat (Triticum aestivum L.) plants, in a non‐phytotoxic concentration, could increase their resistance to blast, stimulate the anti‐oxidative metabolism, and minimize alterations in photosynthesis. The PA spray at concentrations greater than 0.1 mg ml−1 caused foliar lesions, compromised the photosynthesis and was linked with greater accumulation of hydrogen peroxide (H2O2) and superoxide anion radical (O2•−). Fungal mycelial growth, conidia production and germination decreased by PA at 0.3 mg ml−1. Blast severity was significantly reduced by 59 and 23%, respectively, at 72 and 96 h after inoculation for plants sprayed with PA (0.1 mg ml−1) at 24 h before fungal inoculation compared to non‐sprayed plants. Reduction on blast symptoms was linked with increases on ascorbate peroxidase (EC 1.11.1.11), catalase (EC 1.11.1.6), glutathione peroxidase (EC 1.11.1.9), glutathione reductase (EC 1.8.1.7), glutathione‐S‐transferase (EC 2.5.1.18), peroxidase (EC 1.11.1.7), and superoxide dismutase (EC 1.15.1.1) activities, lower H2O2 and O2•− accumulation, reduced malondialdehyde production as well as less impairments to the photosynthetic apparatus. A more efficient antioxidative metabolism that rapidly scavenges the reactive oxygen species generated during P. oryzae infection, without dramatically decreasing the photosynthetic performance, was a remarkable effect obtained with PA spray.
Cold‐ and menthol‐evoked membrane potential changes in the moss Physcomitrella patens: influence of ion channel inhibitors and phytohormones
Authors: Koselski Mateusz , Wasko Piotr , Kupisz Kamila , Trebacz Kazimierz 
Published: January 2019

Microelectrode measurements carried out on leaf cells from Physcomitrella patens revealed that a sudden temperature drop and application of menthol evoked two types of different‐shaped membrane potential changes. Cold stimulation evoked spike‐type responses. Menthol depolarized the cell membrane with different rates. When it reached above 1 mV s−1, the full response was recorded. Characteristic for the full responses was also a few‐minute plateau of the membrane potential recorded after depolarization. The influence of inhibitors of calcium channels (5 mM Gd3+), potassium channels (5 mM Ba2+), chloride channels (200 μM Zn2+, 50 μM niflumic acid) and proton pumps (10 μM DES), an activator of calcium release from intracellular stores (Sr2+), calcium chelation (by 400 μM EGTA) and phytohormones (50 μM auxin, 50 μM abscisic acid (ABA), 500 μM salicylic acid) on cold‐ and menthol‐evoked responses was tested. Both responses are different in respect to the ion mechanism: cold‐evoked depolarizations were influenced by Ba2+ and DES; in turn, menthol‐evoked potential changes were most effectively blocked by Zn2+. Moreover, the effectiveness of menthol in generation of full responses was reduced after administration of auxin or ABA, i.e. phytohormones known for their participation in responses to cold and regulation of proton pumps. The effects of DES indicated that one of the main conditions for generation of menthol‐evoked responses is inhibition of the proton pump activity. Our results indicate that perception of cold and menthol by plants proceeds in different ways due to the differences in ionic mechanism and hormone dependence of cold‐ and menthol‐evoked responses.
Intimate Partner Violence in Small Towns, Dispersed Rural Areas, and Other Locations: Estimates Using a Reconception of Settlement Type
Authors: DuBois Kathryn O. , Rennison Callie Marie , DeKeseredy Walter S. 
Published: January 2019

AbstractCurrent understanding of victimization of those in rural settlements compared to other types of settlements is limited by inadequate classifications of settlement types. The typical approach—one based on the incorrect use of the U.S. Office of Management and Budget’s classification of metropolitan areas—may mask important variations in the incidence of violent victimization, and in part explain mixed results related to this issue. To investigate this, we detail problems with following the typical approach, and then describe an alternative measure of settlement type. We next use this alternative settlement type measure to estimate the incidence of intimate partner violence (IPV) against women from 1992–2015 National Crime Victimization Survey data. Over the period examined, the incidence of IPV was highest for women living in small towns (11.4 per 1,000). In contrast, women living in dispersed rural settlements (7.9 per 1,000) shared rates with those in suburbs (7.9 per 1,000) and exurbs (7.1 per 1,000) while reporting rates lower than those of women residing in the urban core (9.7 per 1,000). These results provide clarity to earlier research on the incidence of IPV across settlement types and they call into question the salience of geographic isolation as a determinant of IPV in nonmetropolitan locales.