bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depressive symptoms of house-poor persons: Korean panel data evidence
Authors: Lee Tae-Hoon , Park Eun-Cheol , Kim Woorim , Kim Juyeong , Shin Jaeyong , Kim Tae Hyun 
Published: July 2016

Background: There are no studies researching the relationship between house-poor persons and mental health. Therefore, this study aimed to investigate the relationship between house-poor status and depressive symptoms. Aim: To examine the relationship between the house-poor and depressive symptoms according to household income. Methods: Data from the Korean Welfare Panel Study were used. House-poor were defined as people having possession with over 10% house-related interest in disposable income. About 7,565 participants over the age of 19 years were followed up from 2011 to 2013. The generalized estimating equations were used for analysis. Results: Individuals with more house-related debt showed increasingly higher depression scores (possession with under 5% related debt to disposable income β = 0.2024, p = .1544; under 10% β = 0.7030, p = .0008; over 10% β = 1.3207, p < .0001). Individuals possessing houses with over 10% ratio of house-related debts to disposable income had higher depression scores than individuals without house ownership (no possession β = 0.8927, p < .0001). Conclusion: Individuals without houses and individuals owning houses with higher percentages of house-related interests showed higher levels of depressive symptoms. Therefore, this study affirmed that the importance of considering the most vulnerable groups in addressing the mental health of individual.
To do more, better, faster and more cheaply: using big data in public administration
Authors: Maciejewski Mariusz 
Published: July 2016

Big data have become a game-changer for modern public administration in those areas in which they are used. Although their application is still limited in the public sector, their use develops dynamically in areas where they bring tangible results in terms of efficiency and efficacy. This article presents the concept of big data, outlines the possibilities for using big data in the public sector and methods of their utilization, highlights cases where these have been implemented, along with the results. This article discusses applications of big data methods in public policy design and implementation and in public authority internal management. It includes a summary of the benefits, disadvantages and challenges related to utilization of big data. The article also briefly addresses historical, current and predictive approaches. Research was carried out using internet-based case analysis and is limited by the confidentiality of details relating to big data methods. Although the research has had to be limited to publicly available descriptions, the findings make it possible to understand the big data phenomenon in public administration and to draw general lessons from their use. Points for practitioners Big data is a contemporary phenomenon. Properly utilized it brings astonishingly positive outcomes for public administration in terms of its efficacy, efficiency, and overall client satisfaction. These benefits are a result of significant increase in the accuracy of decision-making, a significant acceleration of performance of internal the ‘information task’ and a significant reduction in operating costs related to the decision-making process. This is possible thanks to the digitization of human life and IT developments applied in a specific way for public administration – the way of big data methods where huge amounts of data are processed in a form of reasoning by powerful IT technology to present information that helps public administration to better perform its task.
Multi‐institutional Study of Voice Disorders and Voice Therapy Referral
Authors: Misono Stephanie , Marmor Schelomo , Roy Nelson , Mau Ted , Cohen Seth M. 
Published: July 2016

ObjectivesTo assess perspectives of patients with voice problems and identify factors associated with the likelihood of referral to voice therapy via the CHEER (Creating Healthcare Excellence through Education and Research) practice‐based research network infrastructure.Study DesignProspectively enrolled cross‐sectional study of CHEER patients seen for a voice problem (dysphonia).SettingThe CHEER network of community and academic sites.MethodsPatient‐reported demographic information, nature and severity of voice problems, clinical diagnoses, and proposed treatment plans were collected. The relationship between patient factors and voice therapy referral was investigated.ResultsPatients (N = 249) were identified over 12 months from 10 sites comprising 30 otolaryngology physicians. The majority were women (68%) and white (82%). Most patients reported a recurrent voice problem (72%) and symptom duration >4 weeks (89%). The most commonly reported voice‐related diagnoses were vocal strain, reflux, and benign vocal fold lesions. Sixty‐seven percent of enrolled patients reported receiving a recommendation for voice therapy. After adjusting for sociodemographic and other factors, diagnoses including vocal strain/excessive tension and vocal fold paralysis and academic practice type were associated with increased likelihood of reporting a referral for voice therapy.ConclusionsThe CHEER network successfully enrolled a representative sample of patients with dysphonia. Common diagnoses were vocal strain, reflux, and benign vocal fold lesions; commonly reported treatment recommendations included speech/voice therapy and antireflux medication. Recommendation for speech/voice therapy was associated with academic practice type.
Variation in the Use of Vestibular Diagnostic Testing for Patients Presenting to Otolaryngology Clinics with Dizziness
Authors: Piker Erin G. , Schulz Kris , Parham Kourosh , Vambutas Andrea , Witsell David , Tucci Debara , Shin Jennifer J. , Pynnonen Melissa A. , Nguyen‐Huynh Anh , Crowson Matthew , Ryan Sheila E. , Langman Alan , Roberts Rhonda , Wolfley Anne , Lee Walter T. 
Published: July 2016

ObjectiveWe used a national otolaryngology practice–based research network database to characterize the utilization of vestibular function testing in patients diagnosed with dizziness and/or a vestibular disorder.Study DesignDatabase review.SettingThe Creating Healthcare Excellence through Education and Research (CHEER) practice‐based research network of academic and community providersSubjects and MethodsDizzy patients in the CHEER retrospective database were identified through ICD‐9 codes; vestibular testing procedures were identified with CPT codes. Demographics and procedures per patient were tabulated. Analysis included number and type of vestibular tests ordered, stratified by individual clinic and by practice type (community vs academic). Chi‐square tests were performed to assess if the percentage of patients receiving testing was statistically significant across clinics. A logistic regression model was used to examine the association between receipt of testing and being tested on initial visit.ResultsA total of 12,468 patients diagnosed with dizziness and/or a vestibular disorder were identified from 7 community and 5 academic CHEER network clinics across the country. One‐fifth of these patients had at least 1 vestibular function test. The percentage of patients tested varied widely by site, from 3% to 72%; academic clinics were twice as likely to test. Initial visit vestibular testing also varied, from 0% to 96% of dizzy patients, and was 15 times more likely in academic clinics.ConclusionThere is significant variation in use and timing of vestibular diagnostic testing across otolaryngology clinics. The CHEER network research database does not contain outcome data. These results illustrate the critical need for research that examines outcomes as related to vestibular testing.
Evaluation of Compliance for Treatment of Sudden Hearing Loss
Authors: Witsell David L. , Khoury Tawfiq , Schulz Kristine A. , Stachler Robert , Tucci Debara L. , Wojdyla Daniel 
Published: July 2016

ObjectiveThe objective of this study is to describe the presentation and management of sudden sensorineural hearing loss for patients seen in academic and community‐based practices within the context of the American Academy of Otolaryngology—Head and Neck Surgery Foundation’s “Clinical Practice Guideline: Sudden Hearing Loss.” The intention is to use these findings to guide implementation strategies and quality improvement initiatives and as pilot data for the development of clinical research initiatives.Study DesignA cross‐sectional study of patients with sudden hearing loss.SettingPatients were recruited from practices within the Creating Healthcare Excellence through Education and Research (CHEER) network. The CHEER network is an National Institutes of Health–funded network of 30 otolaryngology sites across the country, half of which are community based and half of which are academic practices.Subjects and MethodsA total of 173 patients were recruited. Data were gathered via custom questionnaires collected by study site coordinators and entered into a secure online platform. Descriptive analyses and correlation statistics were run with SAS 9.3.1.ResultsOf the 13 guideline statements in the American Academy of Otolaryngology—Head and Neck Surgery Foundation’s clinical practice guideline on sudden hearing loss, 11 statements were evaluable through this study. Compliance for otolaryngologists was >95% for key action statements (KASs) 1, 3, and 6; 90% to 95% for KASs 5 and 10; and <90% for KASs 7 and 13. Compliance was <45% for nonotolaryngologists for KASs 3 and 5‐7.ConclusionsThere is opportunity for nonotolaryngologists to improve for statements 3 and 5‐7. Otolaryngologists are compliant with many of the KASs overall, but there is significant room for improvement.
Smoking status and 30-day mortality in patients undergoing pulmonary resections
Authors: Mediratta Neeraj , Poullis Michael 
Published: July 2016

Background Smoking status has not been shown to have a significant effect on 30-day mortality after potentially curative resectional surgery for non-small-cell lung cancer, and this is reflected in the guidelines of the National Institute for Health and Care Excellence in the United Kingdom. Methods A validated prospective thoracic surgery database of consecutive patients undergoing potentially curative resection at a single institution was analyzed. Univariate and propensity analyses of 30-day mortality were performed. Results Univariate analysis identified 30-day mortality as significantly lower in current smokers ( n = 852, 2.6%) than ex-smokers ( n = 1587, 4.9%; p < 0.001). Propensity 1:1 matching of male patients resulted in 727 current smokers being matched to 727 ex-smokers. The overall balance test (χ2 = 6.1, degrees of freedom = 8, p = 0.6), indicated a good match. After propensity matching, the mortality rate was significantly higher in current smokers ( p = 0.01). Conclusions Current smokers and ex-smokers are statistically different with regard to risk factors for death. This results in a skewed population of current and ex-smokers undergoing resection for non-small-cell lung cancer. Development of a risk model for 30-day mortality revealed that current smokers have a lower predicted 30-day mortality than ex-smokers, a finding that is counterintuitive. Propensity matching balanced the current and ex-smoker groups to correct for group differences. Analysis after propensity matching identified current smoking as a significant factor determining 30-day mortality.
Outcomes of Anatomic Anterior Cruciate Ligament Reconstruction
Authors: Lee Joon Kyu , Lee Sahnghoon , Lee Myung Chul 
Published: July 2016

Background: The choice of graft type is an important factor to the outcome of anterior cruciate ligament (ACL) reconstruction. Purpose: To compare knee joint stability and functional outcomes of anatomic ACL reconstruction with double-bundle hamstring tendon (DBHT) and bone–quadriceps tendon (BQT) autografts. Study Design: Cohort study; Level of evidence, 3. Methods: Ninety-six patients underwent ACL reconstruction with either DBHT (hamstring group) or BQT autograft (quadriceps group). Each group included 48 patients who were retrospectively matched on the basis of age, sex, and body mass index; there were no statistically significant differences between the 2 groups (all P > .05). All patients had a minimum follow-up of 2 years. Outcome evaluations included the manual laxity test, International Knee Documentation Committee subjective evaluation, Tegner activity score, modified Lysholm score, anterior knee pain questionnaire, KT-2000 arthrometer side-to-side difference, Cybex II isokinetic testing, and tunnel position evaluation by quadrant method. Results: Manual laxity test results were significantly improved in both groups after surgery (all P < .05). The maximum KT-2000 arthrometer side-to-side difference improved from 4.0 to 1.9 mm in the hamstring group and 3.9 to 2.1 mm in the quadriceps group ( P = .65). Modified Lysholm scores in the hamstring and quadriceps groups improved from 69.4 and 70.2 to 88.4 and 92.1 ( P = .30), and International Knee Documentation Committee subjective evaluation scores improved from 56.0 and 60.3 to 77.9 and 80.2 ( P = .37), respectively. Tegner activity scores for the hamstring and quadriceps groups were 4.7 and 4.6 preoperatively and 4.6 and 4.7 ( P = .80) at final follow-up, respectively. There were no between-group differences on postoperative anterior knee pain ( P > .05 for all questionnaire categories), nor were there differences in recovered extensor muscle strength during isokinetic testing (82.9% vs 81.0% at 60 deg/s, P = .71; 85.1% vs 83.8% at 180 deg/s, P = .81). However, flexor muscle strength recovery was better in the quadriceps group (86.6% vs 92.2% at 60 deg/s, P = .22; 87.1% vs 99.6% at 180 deg/s, P = .01). There were no significant differences in tunnel positioning between the 2 groups (all P > .05). Conclusion: Anatomic ACL reconstruction with the BQT autograft showed similar knee stability and functional outcome scores when compared with the DBHT autograft. Additionally, better flexor muscle strength recovery was found in the quadriceps group, indicating a potential advantage of the BQT autograft in ACL reconstruction.
Treatment pathways in an inception lupus cohort over the first three years
Authors: Hanly J G , Sayani A , Doucette S , Iczkovitz S , Terres J A Ross 
Published: July 2016

Objective The treatment algorithm for new onset systemic lupus erythematosus (SLE) is less well defined than for other rheumatic diseases. We examined the treatment patterns in an inception cohort of SLE patients over the first three years of disease between 2000 and 2010. Methods Patients fulfilled the American College of Rheumatology classification criteria for SLE within 12 months of enrollment and completed three subsequent annual visits. Data collection included patient demographics, SLE manifestations, medications, SLE disease activity index-2K (SLEDAI-2K) and Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index. Analysis included descriptive statistics and repeated measures mixed models. Results Seventy-nine patients, 83.5% female and 91.1% Caucasian were studied. At baseline the mean (SD) age was 40.6 (16.4) years, disease duration was 0.36 (0.28) years and SLEDAI-2K was 5.7 (4.6). Over three years, cumulative use of corticosteroids, antimalarials and immunosuppressants was 53.2%, 77.2% and 40.5% respectively. Corticosteroids were usually used in combination with antimalarials and/or immunosuppressants. Between baseline and final assessments the use of corticosteroids fell (44.3% vs 15.2%) in contrast to antimalarials (55.7% vs 70.9%) and immunosuppressants (26.6% vs 34.2%). Of 44/79 (55.7%) patients not receiving corticosteroids at baseline 84.1% remained off corticosteroids for the study duration. Thirty-seven of 79 (46.8%) patients never received corticosteroids and only 5/79 (6.3%) at all four assessments. Patients taking corticosteroids at baseline had higher mean (SD) daily dose and cumulative dose over three years compared with patients not on corticosteroids at baseline (9.0 (0.8) vs 0.3 (1.3) mg; 10.8 (8.5) vs 0.3 (1.2) g). As a group, SLE patients who used corticosteroids either at baseline, at any time in the three year study or in high cumulative doses had the highest average disease activity scores over the same time frame and had a significant fall in SLEDAI-2K scores ( p < 0.05) compared with patients not exposed to corticosteroids. Conclusion Use of corticosteroids occurred in approximately half of new onset SLE, usually in combination with antimalarials and/or immunosuppressants. It was associated with both higher disease activity at baseline and improvement over time. Patients who did not receive corticosteroids at presentation were unlikely to do so over the next three years.
Threats to nurses’ dignity and intent to leave the profession
Authors: Valizadeh Leila , Zamanzadeh Vahid , Habibzadeh Hosein , Alilu Leyla , Gillespie Mark , Shakibi Ali 
Published: July 2016

Background: It is essential to pay attention to and respect the dignity of nurses to maintain them in their profession while they deliver skilled nursing care. Little is known, however, about how a sense of dignity influences the practitioner. Objectives: The purpose of this study is to describe nurses’ experiences of threats to their dignity occurring within clinical settings, which generates an intention to leave clinical practice. Research design and method: The study was performed using qualitative content analysis. The participants were 21 clinical nurses with work experience who were employed across a range of clinical posts. Data obtained from the semi-structured interviews were analyzed and interpreted using a content analysis approach. Ethical considerations: The study was approved by the Ethics Committee of Tabriz University of Medical Sciences and was guided by the ethical principles of voluntary enrolment, anonymity, privacy, and confidentiality. Findings: Within data analysis, three main themes and nine categories were extracted as follows: (1) lack of professional pride (physician’s dominance, intangible nature of nursing, and negative attitude toward clinical nurses); (2) oppressive work environment (high workload, disrespect, discrimination, and lack of support); and (3) suppression of progressivism (lack of appreciation and attention to meritocracy). Discussion: Almost all of the participants have experienced some degree of disrespect and violation of dignity. In general, attempts made by the participants to show their objection to the threats and to support and protect their dignity have not been effective and in fact made them more inclined to leave the clinical work. Conclusion: According to the views of nurses themselves, identification of the factors threatening nurses’ dignity can be one of the appropriate solutions for the broader and deeper investigation of this phenomenon and can help promote and support nurses’ dignity and their retention within the profession.
Validating the Effectiveness Scale of Children’s Familial Influencing Behavior Within Three-Generational Relationships
Authors: Sun Qian , Lou Vivian Weiqun , Law Ben M. F. 
Published: July 2016

Purpose: This study examined the development and validation of the Effectiveness Scale of Child Familial Influencing Behavior. This measurement is constructed to evaluate the effectiveness of child familial influencing behaviors within three-generational relationships. Methods: The effectiveness of child familial influencing behaviors was rated by two informants (parent and grandparent) on 601 children from Grade 1 to Grade 3 in China. Results: The Effectiveness Scale of Child Familial Influencing Behavior consisted of three factors with 12 indicators related to highly influential tactics, moderately influential tactics, and low influential tactics and showed satisfactory reliability, a good model fit, and strong construct validity. Discussion: The findings provided good evidence of the Effectiveness Scale of Child Familial Influencing Behavior as a reliable tool with which to evaluate child familial influencing behaviors in a multigenerational context. Implications for further social work practice and research are discussed.
Aging in cats
Authors: Bellows Jan , Center Sharon , Daristotle Leighann , Estrada Amara H , Flickinger Elizabeth A , Horwitz Debra F , Lascelles B Duncan X , Lepine Allan , Perea Sally , Scherk Margie , Shoveller Anna K 
Published: July 2016

Practical relevance: Aged pets comprise a significant proportion of the small animal veterinarian’s patient population; in the USA, for example, it was estimated that over 20% of pet cats were 11 years of age or older in 2011. Certain changes associated with aging are neither positive nor negative, but others are less desirable, associated with illness, changes in mobility or the development of unwanted behaviors. These changes can greatly affect the health and wellbeing of the cat and have a tremendous impact on the owner. Clinical challenges: Regular veterinary examinations are essential for evaluating the health of older patients and for providing owners with guidance regarding optimal care. With the exception of overt disease, however, it is difficult to definitively determine if a cat is displaying changes that are appropriate for age or if they reflect an abnormal process or condition. Goals: This is the first of two review articles in a Special Issue devoted to feline healthy aging. The goals of the project culminating in these publications included developing a working definition for healthy aging in feline patients and identifying clinical methods that can be used to accurately classify healthy aged cats. This first review provides a thorough, systems-based overview of common health-related changes observed in cats as they age. Evidence base: There is a paucity of research in feline aging. The authors have drawn on expert opinion and available data in both the cat and other species.
The scalpel model of third language acquisition
Authors: Slabakova Roumyana 
Published: July 2016

Aims and Objectives: This article proposes the “scalpel model,” a new model of third and additional language (L3/Ln) acquisition. The model aims to identify and examine what happens beyond the initial state of acquisition and what factors may influence change from one state of knowledge to another. Methodology: The article briefly examines the currently proposed hypotheses and models and evaluates the existing evidence for their predictions. It highlights several cognitive and experiential factors affecting crosslinguistic influence that are not taken into account by the current models. These factors include: structural linguistic complexity; misleading input or lack of clear unambiguous evidence for some properties or constructions; construction frequency in the target L3; and prevalent language activation or use. Data and analysis: Findings of recently published research are discussed in support of the scalpel model. In particular, findings of differential learnability of properties within the same groups of learners suggest that L1 or L2 transfer happens property by property and is influenced by diverse factors. Findings: The scalpel model explicitly argues that wholesale transfer of one of the previously acquired languages does not happen at the initial stages of acquisition because it is not necessary. It also argues that transfer can be from the L1 or the L2 or both, but it is not only facilitative. Originality: The new model increases the explanatory coverage of the current experimental findings on how the L3/Ln linguistic representations develop. Implications: The model emphasizes the importance of the cognitive, experiential, and linguistic influences on the L3/Ln beyond transfer from the L1 or L2. Thus, it aligns L3/Ln acquisition with current debates within L2 acquisition theory.