bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gambling and Problem Gambling among Canadian Urban Aboriginals
Authors: Williams Robert J. , Belanger Yale D. , Prusak S. Yvonne 
Published: July 2016

Objective: To assess the prevalence of gambling and problem gambling in urban Aboriginals in the Canadian Prairie provinces and to determine the predictors of problem gambling. Method: In total, 1114 Aboriginals living in 15 cities in Alberta, Saskatchewan, and Manitoba were recruited via posters and direct solicitation at Native Friendship Centres, shopping malls, and other locations where Aboriginals congregated. They each completed a self-administered 5- to 10-minute survey. Results: Urban Aboriginals in the present sample were found to have a much higher level of gambling participation than the general Canadian public, especially for electronic gambling machines, instant lotteries, and bingo. Their intensity of participation in terms of number of formats, frequency of play, and gambling expenditure was also very high. This, in turn, is an important contributing factor to their very high rate of problem gambling, which was found to be 27.2%. Problem gambling was higher in males, unemployed people, and cities having the highest proportion of their population consisting of urban Aboriginals. Conclusions: Urban Aboriginal people appear to have some of the highest known rates of problem gambling of any group in Canada. This is attributable to having many more risk factors for problem gambling, such as a greater level of participation in gambling, greater participation in continuous forms of gambling (e.g., electronic gambling machines), younger average age, higher rates of substance abuse and mental health problems, and a range of disadvantageous social conditions (e.g., poverty, unemployment, poor education, cultural stress) that are conducive to the development of addictive behaviour.
The impact of the TelEmergency program on rural emergency care: An implementation study
Authors: Sterling Sarah A , Seals Samantha R , Jones Alan E , King Melissa H , Galli Robert L , Isom Kristen C , Summers Richard L , Henderson Kristi A 
Published: July 2016

Introduction Timely, appropriate intervention is key to improving outcomes in many emergent conditions. In rural areas, it is particularly challenging to assure quality, timely emergency care. The TelEmergency (TE) program, which utilizes a dual nurse practitioner and emergency medicine-trained, board-certified physician model, has the potential to improve access to quality emergency care in rural areas. The objective of this study was to examine how the implementation of the TE program impacts rural hospital Emergency Department (ED) operations. Methods Methods included a before and after study of the effect of the TE program on participating rural hospitals between January 2007 and December 2008. Data on ED and hospital operations were collected one year prior to and one year following the implementation of TE. Data from participating hospitals were combined and compared for the two time periods. Results Nine hospitals met criteria for inclusion and participated in the study. Total ED volumes did not significantly change with TE implementation, but ED admissions to the same rural hospital significantly increased following TE implementation (6.7% to 8.1%, p-value = 0.02). Likewise, discharge rates from the ED declined post-initiation (87.1% to 80.0%, p-value = 0.003). ED deaths and transfer rates showed no significant change, while the rate of patient discharge against medical advice significantly increased with TE use. Discussion In this analysis, we found a significant increase in the rate of ED admissions to rural hospitals with TE use. These findings may have important implications for the quality of emergency care in rural areas and the sustainability of rural hospitals’ EDs.
Personal Reflections
Authors: McLean Gary N. 
Published: July 2016

The Problem In this issue, we have collectively attempted to capture a history of the Academy of Human Resource Development (AHRD or the Academy, used interchangeably). But is historical research important? Why have a history of AHRD now? What are the difficulties in doing historical research? And what does an historical history tell us about the changes to AHRD? The Solution In this article, I provide my reflections on the process that was used in putting this history together in light of commonly accepted criteria for a quality historical article. I chose reflection for this task consistent with Schön’s advice to use reflection to improve as a practitioner. I explored the difficulty in doing historical research, examined why it is so difficult to get historical research published, looked beyond the facts or events of AHRD’s history, and suggested areas that are still missing from this historical record. The Stakeholders Probably, those with the greatest interest in this article (and this issue) are those who are or have been members of the Academy. Others who might be interested are those who are involved in their own professional organization, other than AHRD. Those who are exploring the possibility of joining the Academy and those interested in the history of the broad scope of human resource development (HRD) are also likely to be interested.
Association between parent and child weight status among private school children in Delhi, India
Authors: Greene-Cramer Blanche , Harrell Melissa B. , Hoelscher Deanna M. , Sharma Shreela , Ranjit Nalini , Gupta Vinay , Nazar Gaurang , Arora Monika 
Published: July 2016

Over the past three decades there has been a surge in the prevalence of overweight and obesity worldwide in both adults and children. To date few studies have examined obesity in India and most have only looked at prevalence estimates. While studies in Western countries have identified parent weight status as a predictor of child weight status, there have been no studies examining this association in India. This study examined the relationship between parent weight status and child weight status using an internationally representative growth reference for children and Asian-specific action points for adults. Overall, this study found 29.6% of children and 77.7% of parents in a sample of private schools in Delhi, India were overweight/obese. Parent weight status was found to be associated with child weight status after controlling for child grade and sex. However, while maternal weight status was associated with child weight status (odds ratio=1.51, 95% confidence interval: 1.04–2.20), paternal weight status was not (odds ratio=1.10, 95% confidence interval: 0.81–1.48). The association was greatest between mothers and sons (odds ratio=2.13, 95% confidence interval: 1.39–3.27). These results provide initial evidence that parent weight status is associated with child weight status in Delhi, India. Future research should continue to explore the relationship between parent, particularly maternal, and child weight status to better understand the nature of the relationship and the differences between male and female children. Interventions to address child overweight and obesity in India should include parents as direct targets.
Bolus Calculator Settings in Well-Controlled Prepubertal Children Using Insulin Pumps Are Characterized by Low Insulin to Carbohydrate Ratios and Short Duration of Insulin Action Time
Authors: Hanas Ragnar , Adolfsson Peter 
Published: July 2016

Background: The “500 rule” has been used extensively to find the insulin to carbohydrate ratio (ICR) for carbohydrate counting (CC). Duration of insulin action (DIA) is often recommended to be set to 4 hours. Data are lacking on validating these routines in young children. Methods: ICR was calculated by dividing carbohydrate grams by insulin units. Insulin sensitivity factor (ISF) was defined by the 100 rule (100 divided by total daily insulin dose [TDD]). DIA was set to 3 hours. ICR, ISF, and DIA were adjusted continuously. Data for this retrospective analysis were taken from pump downloads at a routine visit. ICR and ISF were recalculated to rules (ICR/ISF multiplied by TDD). Results: A total of 21 prepubertal children aged 7.0 ± 2.3 (mean ± SD), range 2-10 years, with diabetes duration 3.0 ± 1.9, range 0.5-7.7 years, used the pump bolus calculator for CC. HbA1c IFCC (NGSP) was 53 ± 6 mmol/mol (7.0 ± 0.5%). None had experienced severe hypoglycemia (unconsciousness/seizures) since diabetes diagnosis. TDD was 0.7 ± 0.1 U/kg/24 h (range 0.5-1.0), and the percentage basal insulin 38 ± 11%. Median breakfast rule was 211 (Q, quartiles 162;310), and for other meals 434 (Q 301;496). Median ISF rule was 113 (Q 100;128) in the morning, and 120 (Q 104;134) during the rest of the day. DIA was 2.6 ± 0.5 h (range 2-3) and target BG 5.3 ± 0.4 mmol/l (range 5.0-6.0). Conclusions: Prepubertal children seem to need more bolus insulin for meals than calculated from the 500 rule, especially at breakfast, but less insulin for corrections than calculated from the 100 rule. Two to 3 hours seems to be the appropriate range for DIA in this age group.
Treatment Outcomes and Tolerability Following Initiation of GLP-1 Receptor Agonists Among Type 2 Diabetes Patients in Primary Care Practices in Germany
Authors: Qiao Qing , Johnsson Kristina , Grandy Susan , Kostev Karel 
Published: July 2016

Background: The aim was to investigate real-world treatment outcomes and tolerability of GLP-1 receptor agonist (GLP-1RA) therapy in patients with type 2 diabetes in Germany. Methods: Patients from 323 primary care practices who started any GLP-1RA therapy (89 Byetta, 108 Bydureon, 347 Victoza patients) between January 1, 2011, and December 31, 2013 (index date) were analyzed retrospectively (Disease Analyzer database, Germany). Changes from baseline in HbA1c, weight, and hypoglycemia were evaluated in 3 follow-up periods of 0-6, 7-12, and 13-18 months. Results: A total of 544 diabetes patients (mean age: 57.9 years; men: 54%) were eligible for the study. Mean (SD) HbA1c (%) decreased from 8.3 (1.4) at baseline to 7.4 (1.2) in 6 months, 7.6 (1.3) in 7-12 months and 7.6 (1.4) in 13-18 months, respectively ( P < .001 for all), while the proportion of patients with HbA1c <7% increased from 15% at baseline to 38%, 36% and 35% in the corresponding periods ( P < .0001 for all). Multivariate-adjusted beta coefficients corresponding to changes in HbA1c (%) from baseline were –.52, –.44, and –.44, respectively, in the follow-up periods for baseline HbA1c (%) ( P < .0001 for all). The prevalence of hypoglycemia at baseline was 0.7%; this did not change significantly after treatment. Conclusions: In clinical practice, GLP-1RA treatment was associated with improved glycemic control without increased hypoglycemia for up to 18 months. The higher the baseline HbA1c, the greater the HbA1c reduction recorded.
A corny cause of cerebrospinal fluid ascites: A case report and review of literature
Authors: Jamal Hira , Abrams Gary 
Published: July 2016

Objective: To report a rare cause of cerebrospinal fluid ascites. Methods: A 37-year-old female with history of intracranial hypertension and a ventriculo-peritoneal shunt was referred to liver clinic for evaluation of newly developed ascites. Results: Initially, the cause of ascites was thought to be secondary to a liver etiology. However, this was excluded after a comprehensive evaluation including portal pressure measurements. We determined the ascites to be infected cerebrospinal fluid secondary to a rare commensal organism, Corynebacterium non-Jeikeium, which resolved after removing ventriculo-peritoneal shunt, appropriate antibiotics and conversion to a ventriculo-atrial shunt. Conclusion: Cerebrospinal fluid ascites is a rare complication of VP shunts and since 1976 only 8 cases of Corynebacterium non jk VP shunt infections have been reported in the literature but none associated with ascites. Also this report highlights the beneficial role of transjugular portal pressure measurements in the evaluation of ascites.
Development of the COMIC Model for the comprehensive evaluation of integrated care interventions
Authors: Busetto Loraine , Luijkx Katrien , Vrijhoef Hubertus Johannes Maria 
Published: July 2016

Objective To develop a model for the comprehensive evaluation of integrated care interventions that provides insights into when, why and how successful outcomes can be achieved. Methods A preliminary model was developed based on the Context + Mechanism + Outcome Model and further developed based on its application to a literature review, two case studies and an expert questionnaire. The COMIC Model for studying the Context, Outcomes and Mechanisms of Integrated Care interventions interventions assumes that an intervention is introduced using certain mechanisms (categorised according to the Chronic Care Model), which are met with particular context factors (described by barriers and facilitators and categorised according to the Implementation Model), which combined, contribute to specific outcomes (categorised by the WHO dimensions of quality of care). Results Application of the COMIC model to the literature review and expert questionnaires did not allow for statements to be made about the relationships between mechanisms, context and outcomes. Application to the two case studies made it possible to (1) comprehensively analyse the mechanisms, context and outcomes of the specific case, (2) to make the relationships between the mechanisms, context and outcomes within each case visible, and (3) to compare the two cases to each other in a systematic way that added value to the analysis. Discussion Using the COMIC Model makes it possible to comprehensively study the interplay of the mechanisms, context and outcomes of integrated care interventions and thereby provides insights into when, why and how integrated care contributes to improved outcomes.
A Surgical Model of Posttraumatic Osteoarthritis With Histological and Gait Validation
Authors: Zahoor Talal , Mitchell Reed , Bhasin Priya , Schon Lew , Zhang Zijun 
Published: July 2016

Background: Posttraumatic osteoarthritis (PTOA) is secondary to an array of joint injuries. Animal models are useful tools for addressing the uniqueness of PTOA progression in each type of joint injury and developing strategies for PTOA prevention and treatment. Hypothesis: Intra-articular fracture induces PTOA pathology. Study Design: Descriptive laboratory study. Methods: Through a parapatellar incision, the medial tibial plateau was exposed in the left knees of 8 Sprague-Dawley rats. Osteotomy at the midpoint between the tibial crest and the outermost portion of the medial tibial plateau, including the covering articular cartilage, was performed using a surgical blade. The fractured medial tibial plateau was fixed with 2 needles transversely. The fractured knees were not immobilized. Before and after surgery, rat gait was recorded. Rats were sacrificed at week 8, and their knees were harvested for histology. Results: After intra-articular fracture, the affected limbs altered gait from baseline (week 0). In the first 2 weeks, the gait of the operated limbs featured a reduced paw print intensity and stride length but increased maximal contact and stance time. Reduction of maximal and mean print area and duty cycle (the percentage of stance phase in a step) was present from week 1 to week 5. Only print length was reduced in weeks 7 and 8. At week 8, histology of the operated knees demonstrated osteoarthritic pathology. The severity of the PTOA pathology did not correlate with the changes of print length at week 8. Conclusion: Intra-articular fracture of the medial tibial plateau effectively induced PTOA in rat knees. During PTOA development, the injured limbs demonstrated characteristic gait. Clinical Relevance: Intra-articular fracture represents severe joint injury and associates with a high rate of PTOA. This animal model, with histologic and gait validations, can be useful for future studies of PTOA prevention and early diagnosis.
Anterior Cruciate Ligament Reconstruction Using a Combination of Autograft and Allograft Tendon
Authors: Darnley James E. , Léger-St-Jean Benjamin , Pedroza Angela D. , Flanigan David C. , Kaeding Christopher C. , Magnussen Robert A. 
Published: July 2016

Background: Anterior cruciate ligament (ACL) reconstruction with hamstring autografts less than 8.5 mm in diameter is associated with worse patient-reported outcome scores and increased risk of revision surgery compared with reconstructions performed with larger grafts. One proposed solution to small autograft harvest is to create a hybrid graft by augmenting autografts with allograft tissue to increase graft diameter. Purpose: To compare hybrid autograft/allograft ACL reconstruction to autograft ACL reconstruction, specifically analyzing the patient-reported outcome scores and the risk of revision surgery at 2 years postoperative. Study Design: Cohort study; Level of evidence, 3. Methods: From the years 2002 to 2009, a total of 34 patients were identified from a prospectively collected database as having undergone hybrid ACL reconstruction. Twenty-seven of 34 (79.4%) patients had a 2-year follow-up. These 27 patients were matched by age (within 1 year) and sex to 27 patients who underwent hamstring autograft ACL reconstruction during the same period. At the 2-year mark, revision surgery risk and patient-reported outcome scores were compared between the 2 groups. Results: The mean age for the hybrid and matched groups (±SD) was 20.9 ± 7.0 years. Both the hybrid and control groups had 17 males and 10 females. There was no significant difference in preoperative patient-reported outcome scores, meniscus tears, or cartilage lesions between the 2 groups. Graft size was larger in the hybrid group (9.5 ± 0.6 mm) than in the autograft group (8.4 ± 0.9 mm) ( P < .001). At 2 years postoperative, patient-reported outcome scores were similar between the hybrid and autograft groups. Revision surgery was required in 5 (18.5%) patients who underwent hybrid reconstruction compared with 2 (7.4%) of those who underwent autograft reconstruction ( P = .26). Conclusion: Patients who undergo ACL reconstruction with hybrid hamstring grafts and hamstring autografts report similar patient-reported outcome scores at 2 years postoperative but may be at increased risk for revision ACL reconstruction.
High attenuation areas on chest computed tomography in community-dwelling adults: the MESA study
Authors: Podolanczuk Anna J. , Oelsner Elizabeth C. , Barr R. Graham , Hoffman Eric A. , Armstrong Hilary F. , Austin John H.M. , Basner Robert C. , Bartels Matthew N. , Christie Jason D. , Enright Paul L. , Gochuico Bernadette R. , Hinckley Stukovsky Karen , Kaufman Joel D. , Hrudaya Nath P. , Newell John D. , Palmer Scott M. , Rabinowitz Dan , Raghu Ganesh , Sell Jessica L. , Sieren Jered , Sonavane Sushil K. , Tracy Russell P. , Watts Jubal R. , Williams Kayleen , Kawut Steven M. , Lederer David J. 
Published: July 2016

Evidence suggests that lung injury, inflammation and extracellular matrix remodelling precede lung fibrosis in interstitial lung disease (ILD). We examined whether a quantitative measure of increased lung attenuation on computed tomography (CT) detects lung injury, inflammation and extracellular matrix remodelling in community-dwelling adults sampled without regard to respiratory symptoms or smoking.We measured high attenuation areas (HAA; percentage of lung voxels between −600 and −250 Hounsfield Units) on cardiac CT scans of adults enrolled in the Multi-Ethnic Study of Atherosclerosis.HAA was associated with higher serum matrix metalloproteinase-7 (mean adjusted difference 6.3% per HAA doubling, 95% CI 1.3–11.5), higher interleukin-6 (mean adjusted difference 8.8%, 95% CI 4.8–13.0), lower forced vital capacity (FVC) (mean adjusted difference −82 mL, 95% CI −119–−44), lower 6-min walk distance (mean adjusted difference −40 m, 95% CI −1–−80), higher odds of interstitial lung abnormalities at 9.5 years (adjusted OR 1.95, 95% CI 1.43–2.65), and higher all cause-mortality rate over 12.2 years (HR 1.58, 95% CI 1.39–1.79).High attenuation areas are associated with biomarkers of inflammation and extracellular matrix remodelling, reduced lung function, interstitial lung abnormalities, and a higher risk of death among community-dwelling adults.
Pathogen- and antibiotic-specific effects of prednisone in community-acquired pneumonia
Authors: Wirz Sebastian A. , Blum Claudine A. , Schuetz Philipp , Albrich Werner C. , Noppen Christoph , Mueller Beat , Christ-Crain Mirjam , Tarr Philip E. 
Published: July 2016

In a double-blind, randomised, placebo-controlled trial of hospitalised patients with community-acquired pneumonia (CAP), we demonstrated shorter time to clinical stability (TTCS) with adjunct corticosteroid therapy compared with placebo.We did a pre-planned, exploratory analysis of any association between microbiological diagnosis, antibiotic treatment and procalcitonin level and effect of prednisone on TTCS, mortality, and CAP complications (n=726 participants, enrolled between December 2009 and May 2014). Multiplex viral real time PCR was systematically performed in nasopharyngeal swabs beginning November 2011 (n=489). Other investigations and treatments were at the discretion of the physician. Effect modification was tested with inclusion of interaction terms in the statistical models.Reduced TTCS with prednisone was seen in all microbiological, antibiotic, procalcitonin and afebrile patient subgroups. We found evidence for a different prednisone response in patients with pneumococcal pneumonia in whom intravenous antibiotic duration was not shorter (interaction p=0.01) with prednisone, as was observed in the remaining study population. In patients without macrolide treatment, rehospitalisations were not lower with prednisone (interaction p=0.04). After adjustment for multiple testing, these subgroup effects were no longer significant.Prednisone was associated with shorter TTCS independent of CAP aetiology. In pneumococcal pneumonia, prednisone effects on secondary endpoints may be less favourable.
Efficacy of pirfenidone in patients with idiopathic pulmonary fibrosis with more preserved lung function
Authors: Albera Carlo , Costabel Ulrich , Fagan Elizabeth A. , Glassberg Marilyn K. , Gorina Eduard , Lancaster Lisa , Lederer David J. , Nathan Steven D. , Spirig Dominique , Swigris Jeff J. 
Published: July 2016

Thispost hocanalysis examined the differences in idiopathic pulmonary fibrosis disease progression and the effects of pirfenidone in patients stratified by more preservedversusless preserved baseline lung function status using forced vital capacity (FVC) or GAP (gender, age and physiology) index stage.Efficacy outcomes,i.e.FVC, 6-min walking distance (6MWD) and dyspnoea (University of California San Diego Shortness of Breath Questionnaire (UCSD SOBQ)), were analysed at 12 months in patients randomised to pirfenidone 2403 mg·day−1or placebo in the pooled phase 3 CAPACITY/ASCEND population (n=1247), with subgroups stratified by baseline FVC ≥80%versus<80% or GAP stage IversusII–III. Treatment-by-subgroup interaction was tested based on a rank ANCOVA model; factors in the model included study, region, treatment, subgroup and treatment-by-subgroup interaction term.Patients with both more preserved (FVC ≥80% or GAP stage I) and less preserved (FVC <80% or GAP stage II–III) lung function at baseline demonstrated clinically significant disease progression at 12 months in terms of categorical decline in FVC, 6MWD and UCSD SOBQ. The magnitude of pirfenidone treatment effect was comparable between subgroups, regardless of whether lung function was classified using FVC or GAP index stage.These findings support the initiation of treatment with pirfenidone, irrespective of stage of baseline lung function in this patient population.