bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fruit and vegetable intake among college students in nitra - comparative study
Authors: Jurí­ková Tünde , Viczayová Ildikó , Mlček Jiří­ , Sochor Jiří­ , Balla Štefan , Baroň Mojmí­r 
Published: October 2016

The aim of the study was to collect and analyse the frequency of fruit (fresh, dried, canned and nuts) and vegetable (fresh, tinned, legumes, soya) consumption in the group of 242 respondents aged 19 - 22 years-students of Constantine the Philosopher University in Nitra; to evaluate differences according to field of study and language in which they study (Hungarian or Slovak) by questionnaire method. On the base of collected data it can be concluded that in general the consumption of fresh fruits and vegetables can be considered as very low (only once a day) together with canned and dried fruit (nuts) and tinned vegetable (rarely). Furthermore, the majority of respondents took legumes only 1 - 3 times a week or rarely and soya had never been consumed. The statistically significant differences between college students of PEEH and the rest of assayed group of students had not been confirmed so the higher level of knowledge in health has not been connected with the higher consumption of fruits and vegetables. On the other hand, statistically significant differences have been proved between the following assayed groups of university students: RTH ↔ RTS (χ 7.90, p <0.05), J ↔ RTH (χ 9.99, p <0.05), J ↔ RTS (χ 10.00, p <0.05), J ↔ PEES - SK (χ 9.91, p <0.05). Statistically significant differences were assayed also in consumption of dried fruits or nuts among the following field of study: J ↔RTS (χ 9.48, p <0.01), RTH ↔ RTS (χ 12.57, p <0.05), RTS↔PEES (χ 8.19, p <0.01). Consumption of fresh vegetables was statistically different between the students J↔RTS (χ 9.95, p <0.05) and RTS ↔PEES (χ 8.19, p <0.01).
The uptake of active surveillance for the management of prostate cancer: A population-based analysis
Authors: Richard Patrick O. , Alibhai Shabbir M.H. , Panzarella Tony , Klotz Laurence , Komisarenko Maria , Fleshner Neil E. , Urbach David , Finelli Antonio 
Published: October 2016

Introduction: Active surveillance (AS) is a strategy for the management of low-risk prostate cancer (PCa). However, few studies have assessed the uptake of AS at a population level and none of thesewere based on a Canadian population. Therefore, our objectives were to estimate the proportion of men being managed by AS in Ontario and to assess the factors associated with its uptake.Methods: This was a retrospective, population-based study using administrative databases from the province of Ontario to identify men ≤75 years diagnosed with localized PCa between 2002 and 2010. Descriptive statistics were used to estimate the proportion of men managed by AS, whereas mixed models were used to assess the factors associated with the uptake of AS.Results: 45 691 men met our inclusion criteria. Of these, 18% were managed by AS. Over time, the rates of AS increased significantly from 11% to 21% (p<0.001). Older age, residing in an urban centre,being diagnosed in the later years of the study period, having a neighborhood income in the highest quintile, and being managed by urologists were all associated with greater odds of receiving AS.Conclusions: There has been a steady increase in the uptake of AS between 2002 and 2010. However, only 18% of men diagnosed with localized PCa were managed by AS during the study period. The decisions to adopt AS were influenced by several individual and physician characteristics. The data suggest that there is significant opportunity for more widespread adoption of AS.
Comparison of prostate MRI-3D transrectal ultrasound fusion biopsy for first-time and repeat biopsy patients with previous atypical small acinar proliferation
Authors: Cool Derek W. , Romagnoli Cesare , Izawa Jonathan I. , Chin Joseph , Gardi Lori , Tessier David , Mercado Ashley , Mandel Jonathan , Ward Aaron D. , Fenster Aaron 
Published: October 2016

Introduction: This study evaluates the clinical benefit of magnetic resonance-transrectal ultrasound (MR-TRUS) fusion biopsy over systematic biopsy between first-time and repeat prostate biopsypatients with prior atypical small acinar proliferation (ASAP).Methods: 100 patients were enrolled in a single-centre prospective cohort study: 50 for first biopsy, 50 for repeat biopsy with prior ASAP. Multiparameteric magnetic resonance imaging (MP-MRI) and standard 12-core ultrasound biopsy (Std-Bx) were performed on all patients. Targeted biopsy using MRI-TRUS fusion (Fn-Bx) was performed f suspicious lesions were identified on the prebiopsyMP-MRI. Classification of clinically significant disease was assessed independently for the Std-Bx vs. Fn-Bx cores to compare the two approaches.Results: Adenocarcinoma was detected in 49/100 patients (26 first biopsy, 23 ASAP biopsy), with 25 having significant disease (17 first, 8 ASAP). Fn-Bx demonstrated significantly higher per-core cancer detection rates, cancer involvement, and Gleason scores for first-time and ASAP patients. However, Fn-Bx was significantly more likely to detect significant cancer missed on Std-Bx for ASAP patients than first-time biopsy patients. The addition of Fn-Bx to Std-Bx for ASAP patients had a 166.7% relative risk reduction for missing Gleason ≥ 3 + 4 disease (number needed to image with MP-MRI=10 patients) compared to 6.3% for first biopsy (number to image=50 patients). Negative predictive value of MP-MRI for negative biopsy was 79% for first-time and 100% for ASAP patients, with median followup of 32.1 ± 15.5 months.Conclusions: MR-TRUS Fn-Bx has a greater clinical impact for repeat biopsy patients with prior ASAP than biopsy-naïve patients by detecting more significant cancers that are missed on Std-Bx.
Communication about life-sustaining therapy: insights from the Adaptive Leadership Framework
Authors: Neglia Elizabeth , Anderson Ruth , Brandon Debra , Docherty Sharron 
Published: October 2016

Objective: Effective provider and caregiver communication is central to quality care during treatment for life-threatening illnesses. The study aim was to analyze communication patterns between providers and a parent of an infant with a life-threatening disease using the Adaptive Leadership Framework, which is an activity that involves mobilizing others to adapt to a difficult situation.Method: A secondary analysis was conducted using 23 interviews of providers and mother with an infant diagnosed with Hurler’s syndrome. The interviews focused on decision-making challenges in regard to the infant’s treatment and were conducted over a 1-year period (pre-transplant, study entry, monthly, after a life-threatening event or substantial change in treatment and at 1-year post enrollment). Content analysis was used to identify and categorize communication patterns using concepts from the Adaptive Leadership Framework.Results: Infant illness events and parent-provider caregiving were chronicled across a 1-year trajectory. Despite the life-threatening nature of Hurler’s disease, the parent and providers did not discuss palliative care or end-of-life. The parent sought direction and answers from the providers. The Adaptive Leadership Framework suggested how communication approaches were often mismatched with the apparent needs of the parent. Discussion: The results of the study accentuate the need to improve communication between provider and parents about end-of-life for their child. Adaptive Leadership illuminates how providers can influence a parent’s behavior when facing a challenging situation. This study suggests that Adaptive Leadership is a useful framework to guide research about healthcare communication in dealing with challenging issues.
Shared decision-making: merging evidence into patient- centered care
Authors: Elwyn Glyn 
Published: October 2016

Miles and Mezzich argue for the coalescence of evidence-based medicine (EBM) and patient-centered care, citing many of the key protagonists that have argued for the central place of 'the patient' in the clinical process of care for almost a hundred years. Peabody, Engel, Levenstein and many more have put cogent cases forward, but very little seems to change. They see clinical practice as being too technical, too mechanistic, driven by impersonal protocols and guidelines. The person and his/her family become lost and confused among fragmented systems of care that fail to develop any semblance of relationship or continuity and where personal preferences get short shrift. The trend shows no sign of abating, as technological advances increase levels of specialisation.
Response to Miles and Mezzich
Authors: Turner Andrew , Blakey John , Kerry Roger 
Published: October 2016

Miles and Mezzich offer a welcome and comprehensive account of historical recent developments in healthcare and the role of its practice models. They identify a ‘crisis’ in medicine, which seems to have occurred in part because the science of medicine has been over-emphasised and the importance of compassion and care de-emphasised. As they point out, this crisis has been perceived to have evolved over the past one hundred years. Evidence Based Medicine (EBM) is suggested to be inadequate to solve the crisis and it may be the case that EBM, in fact, has precipitated it because it ignores patients qua persons. It is also suggested that Patient Centred Care (PCC) seeks to address the imbalance, but that this is inadequate, too. Between these existing views it is claimed that Person Centred Medicine (PCM) solves the crisis by giving persons and evidence their proper roles and relative importances
Use of Complementary and Alternative Medicine Among Pediatric Ophthalmology Patients in San Diego, California
Authors: Hilkert Sarah M , Askari Naz , Hirsch Jan D , Robbins Shira L 
Published: October 2016

Objectives: Complementary and Alternative Medicine (CAM) has become increasingly common in pediatrics. While previous studies have evaluated pediatric CAM use across various subspecialties, estimates regarding pediatric CAM use in ophthalmology are lacking. This study explores CAM use among pediatric ophthalmology patients in a pediatric ophthalmology practice.Methods: 609 self-report questionnaires were distributed to parents whose children were seen at the University of California, San Diego / Ratner Children’s Eye Center between July 2009 and January 2010. The survey included questions regarding demographic information of the parent, eye condition of the child, and CAM use by the child. The two main outcomes were CAM use in the past and preference for CAM use in the future. Results: 126 surveys were included in the final analysis. Overall, 11% of parents reported previous CAM use for their child’s eye condition, and 44% of parents indicated a preference for CAM use for their child’s eye condition, depending on the side effects. Logistic regression revealed that past CAM use was not associated with the parent’s race, gender, or level of education. However, CAM preference was negatively associated with the parent’s level of education (p = 0.045). Discussion: As with other pediatric subspecialties, treatment of children with CAM is common in pediatric ophthalmology. Given the significant number of parents who reported using CAM and/or a preference for CAM, our results emphasize the need for all pharmacists, ophthalmologists, and pediatricians to discuss CAM use with patients and their families.
Involving stroke patients and carers in the planning and conduct of a research study exploring the use of art therapy in stroke rehabilitation
Authors: Ali Khalid , Parekh Nikesh , Roffe Christine , Waller Diane 
Published: October 2016

Background Demonstrating meaningful Patient and public involvement (PPI) in research is a core requirement by research funders and ethics committees. However PPI amongst older people is relatively neglected. This paper describes the involvement of older people in planning and conducting a research study exploring Art Therapy (AT) in stroke rehabilitation. Methods The research team discussed the proposed study in a semi-structured focus group meeting with four stroke survivors (and 2 carers) recently discharged from hospital, and separately with another two stroke survivors. Following input from PPI in the planning stage; the actual AT study was conducted involving six male stroke patients over six weeks. Weekly on-going input from the study participants themselves informed conduct of subsequent AT sessions. After completing the AT study, another meeting was held with the study participants to inform a future larger study. Results The stroke survivors and carers confirmed the relevance and need of a creative research intervention such as AT in stroke rehabilitation. PPI informed the methodology as group interactive AT rather than one-to-one sessions, recommended including a qualitative narrative of the study, and informed practical aspects of the study such as timing, location, facilitation, assessment and evaluation. Post study feedback with the research participants helped identify positive and negative aspects of the conducted study, and shaped a current grant application. Conclusions We have demonstrated the value of engaging older people in planning research. It is feasible, enhances the quality of the research and ensures that the study design meets the participant needs.
PSYCHOGENIC VOICE DISORDER: A VIEW THROUGH THE LENS OF SELF
Authors: Jacobs Margaret , Van Biene Leo 
Published: October 2016

Patients with psychogenic voice disorder (PVD), a disorder of voice in the absence of identifiable pathology, present a particular challenge to clinicians. Although the voice can usually be restored by the use of speech therapy, recurrences can only be prevented by psychotherapeutic intervention. Psychological factors have been long recognized as playing a role in these disorders, but the nature of this contribution has been unclear. Various conceptual frameworks have been used to understand this disorder. While for much of the last century, “conversion” has been seen as the primary process that underpins this disorder, little attention has been paid to the role of dissociation in this regard. This paper explores the utility of viewing PVD through a lens of Self. In so doing, PVD can be considered as a symptomatic expression of a compromised sense of Self which has its genesis in relational trauma and maladaptative defensive maneuvers. These are underpinned by complex dissociative processes which operate largely outside of conscious awareness. A clinical vignette demonstrates the utility of treating this disorder with both speech therapy techniques and a specific mode of psychotherapy, the Conversational Model, which is focused on the fostering of a sense of Self. It will be shown that this perspective not only provides a clear view of the genesis of thisdisorder, but also describes a pathway for effective treatment.
Visit Entropy: comparing a novel method to existing continuity of care measures
Authors: Garrison Gregory M , Bania Buck 
Published: October 2016

Introduction: Continuity of care is a key characteristic of primary care yet there is little agreement on an accepted measure of continuity. Density (Usual Provider Continuity, Primary Provider Continuity), dispersion (Continuity of Care Index), and sequence (Sequence of Care Index) are often used measures, but they each have specific drawbacks when applied to patients with multi-comorbidity who are cared for within a patient-centered medical home practice.Methods: A new measure of continuity called Visit Entropy was developed using mathematical constructs from information theory and physics. This was compared to four existing measures of continuity in a dataset of 811 hospitalized primary care patients.Results: Visit Entropy is inversely related to other measures of continuity of care. It has a less skewed distribution and it helps differentiate the substantial number of patients at the extremes of other measures of continuity of care. Visit Entropy also eliminates the problem of undefined values caused by division by zero seen in other continuity measures.Conclusions: Visit Entropy solves many of the shortcomings of existing continuity measures when applied to a dataset of primary care patients cared for within a medical home practice. Further study is indicated to determine if Visit Entropy is associated with the benefits commonly ascribed to continuity of care and if it matches patient and physician perceptions of continuity of care.
A participatory learning model and person-centered healthcare: moving away from “one hand clapping”
Authors: Stephens John 
Published: October 2016

The level of complexity within healthcare practice makes close collaboration with ‘service users’ a necessity in the education of pre-registration healthcare professionals to promote the development of optimal clinical decision making skills in the delivery of safe, effective, and efficient person-centred care. This article reports on the development of a series of facilitated workshops within two pre-registration physiotherapy programmes framed by an adapted participatory learning model, underpinned by the concepts of complexity science, in an attempt gain some understanding of the facilitation of learning that is person-centred and collaborative in nature.The participatory learning model offers a structure to organise a learning process in a manner that is not only conceptually appealing but also of practical use. The model would seem to have the potential for transfer to broader areas of professional education. In embracing participation and complexity ‘don’t be afraid to start’, and ‘learn from doing’ are key messages of encouragement. However, it is important to think about any training needs across organisations and individuals, to find and nurture relationships, and to be creative and also have clarity of purpose.
Consultant Pharmacist Case Management of Older People in Intermediate Care: a New Innovative Model
Authors: Miller Ruth , Darcy Carmel M , Friel Anne , Scott Michael G , Toner Stephen B 
Published: October 2016

Rationale, Aims and Objectives: In 2011, ‘Transforming Your Care’ outlined the remodelling of Health and Social Care in Northern Ireland (HSCNI) UK, specifically recommending better integration of hospital and community services for older people. This work aimed to evaluate consultant pharmacist case management for older patients admitted from acute to intermediate care continuing back into the community setting, given the importance of such a transition to person-centered healthcare. Method: On transfer to intermediate care, the consultant pharmacist determined the Medication Appropriateness Index (MAI) for each drug prescribed. Individualised pharmaceutical care plans were implemented with clinical interventions recorded and graded using Eadon criteria. Cost savings resulting from interventions which prevent medication errors/Adverse Drug Events (ADEs) have been estimated using the model as described by the University of Sheffield School of Health and Related Research (ScHARR); these were applied. Drugs stopped/started were costed using the NHS dictionary of medicines and devices (dm+d). Case management continued via communication with GPs and/or community pharmacists and post-discharge patient telephone calls/home visits. Results: Three hundred and fifty-five patients had 3674 drugs assessed for medication appropriateness; both individual and total drug MAI scores on admission to and discharge from intermediate care, were significantly reduced (Wilcoxon signed rank test, p<0.001, n=355). An average of 2.5 clinical interventions per patient were made, with 84% being self-graded as Eadon ≥ Grade 4 (significant interventions resulting in improved care standards). Clinical interventions yielded potential savings of £63-144k pa whilst annual drug cost savings were £68k. Conclusion: This project demonstrated consultant pharmacist case management results in both cost savings and more appropriate prescribing with safer, seamless and more person-centered care.
From reactive to proactive basic palliative hospital care. Evaluation of one-nurse-based telephone follow-up and bedside consultation to advanced gastrointestinal cancer patients and informal caregivers: A quasi-experimental study
Authors: Soelver Lisbeth , Krogsgaard Marianne 
Published: October 2016

Rationale and aim: Organizational and staff-related barriers need to be overcome in order to integrated early palliative care and develop its supporting infrastructure. We aimed to evaluate the use of a one-nurse-staffed telephone line and bedside consultations on a surgical ward.Method: Advanced gastrointestinal cancer patients and their relatives are offered at diagnosis telephone contact with a nurse with a specialism experience and expertise in the field of palliative care – the contact is lifelong. A proactive holistic approach is taken, including individual needs assessment, guidance, regulation of medication and a tight follow-up. The nurse also acts as a sparring advice partner for colleagues and facilitates complex situations and process. Contacts are described qualitatively in a logbook and the effect on the incidence of hospital admissions and hospital deaths was investigated using a quasi-experimental design with a historical control group. Data were processed using descriptive statistics and Chi-squared (x 2) test.Results: Over 9 month 131 patients and 427 consultations were registred. Outgoing telephone calls to patients, caregivers and professionals (40%). Incoming phone calls (31%) and in-person meeting with patients and families during hospitalization or outpatient visits (29%). Over 15 month intervention and control period the test showed a significant reduction in the short-term admissions of < 2 days, and a significant reduction in the number of patients who died during hospitalization.Conclusion: The telephone follow-up and bedside consultations by one qualified nurse, is an interface that supports continuity and cooperation and could underpine more effective basic palliative care.
Second‐order finite volume with hydrostatic reconstruction for tsunami simulation
Authors: Clain S. , Reis C. , Costa R. , Figueiredo J. , Baptista M. A. , Miranda J. M. 
Published: October 2016

AbstractTsunami modeling commonly accepts the shallow water system as governing equations where the major difficulty is the correct treatment of the nonconservative term due to bathymetry variations. The finite volume method for solving the shallow water equations with such source terms has received great attention in the two last decades. The built‐in conservation property, the capacity to correctly treat discontinuities, and the ability to handle complex bathymetry configurations preserving some steady state configurations (well‐balanced scheme) make the method very efficient. Nevertheless, it is still a challenge to build an efficient numerical scheme, with very few numerical artifacts (e.g., small numerical diffusion, correct propagation of the discontinuities, accuracy, and robustness), to be used in an operational environment, and that is able to better capture the dynamics of the wet‐dry interface and the physical phenomena that occur in the inundation area. In the first part of this paper, we present a new second‐order finite volume code. The code is developed for the shallow water equations with a nonconservative term based on the hydrostatic reconstruction technology to achieve a well‐balanced scheme and an adequate dry/wet interface treatment. A detailed presentation of the numerical method is given. In the second part of the paper, we highlight the advantages of the new numerical technique. We benchmark the numerical code against analytical, experimental, and field results to assess the robustness and the accuracy of the numerical code. Finally, we use the 28 February 1969 North East Atlantic tsunami to check the performance of the code with real data.