bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self‐Care Practices Used by Older Men and Women to Manage Urinary Incontinence: Results from the National Follow‐up Survey on Self‐Care and Aging
Authors: II T. M. Johnson , Kincade J. E. , Bernard S. L. , Busby‐Whitehead J. , DeFriese G. H. 
Published: April 2015

OBJECTIVES: To estimate the extent to which self‐care practices are employed by older adults with urinary incontinence (UI); to determine how demographic and functional status measures are associated with self‐care practice use; and to explore the relationship between contacting a doctor and disposable pad use.DESIGN: A cross‐sectional analysis of a national probability sample using multiple logistic regression.SETTING: Responses of subjects with UI (n = 787) from the 1993–1994 National Follow‐up Survey on Self‐Care and Aging, a follow‐up survey of older Medicare beneficiaries living in the community within the contiguous United States drawn in 1990–1991MEASURES: Subject responses about UI, fecal incontinence, dressing, eating, bathing, Instrumental Activities of Daily Living (IADL), Mobility Activities of Daily Living (MADL), age, gender, place of residence, race, education, proxy response to the survey, and self‐reported medical conditions.RESULTS: Self‐care practices used by more than 25% of respondents with UI included using disposable pads, limiting trips, and limiting fluids. Among older adults with incontinence, more women used disposable pads (44.5%; 95% CI, 36.9–52.1) and performed exercises (14.2%; 95% CI, 9.7–18.9) than did men (15.1%; 95% CI, 8.1–22.1; and 4.3%; 95% CI, 1.0–7.7, respectively). Bi‐variate analysis showed respondents with severe UI or fecal incontinence reported greater use of self‐care practices. In multivariate models of the three most commonly used self‐care practices, measures of UI severity were not always associated independently with self‐care practice use, whereas ADL measures of functional status were. Disposable pad use was positively independently associated (OR 3.36; 95% CI, 2.01–5.63) in multivariate models with contacting a doctor about incontinence, even after controlling for age, gender, demographics, and self‐reported medical conditions.CONCLUSIONS: Use by older adults of self‐care practices to manage urinary incontinence is predicted independently in multivariate models by measures of functional status such as dressing, eating, bathing, IADLs or MADLs, but not by all UI measures. Disposable pad users had increased odds of contacting a doctor, suggesting that self‐care practices and formal medical care are not always inversely related. J Am Geriatr Soc 48:894–902, 2000.
Using Structured Implicit Review to Assess Quality of Care in the Program of All‐inclusive Care for the Elderly (PACE)
Authors: Pacala James T. , Kane Robert L. , Atherly Adam J. , Smith Maureen A. 
Published: April 2015

OBJECTIVE: To develop a quality assessment tool for care rendered to enrollees in the Program for All‐inclusive Care of the Elderly (PACE) that can discriminate care quality ratings across PACE sites.DESIGN: Structured implicit review (SIR) of medical records by trained geriatricians and geriatric nurse practitioners.SETTING: Eight PACE sites.PARTICIPANTS: Older adults enrolled in a PACE program for at least 6 months (n = 313).MEASUREMENTS: Process and outcome measures for both overall care and 14 specific conditions (tracers) managed up to 1 year.RESULTS: Overall care quality was judged to be above a community standard in 56% and below standard in 8% of cases. Process of care was rated as very good or good in 70% of the cases. Outcomes depended on how questions were phrased: only 19% of cases improved, whereas 28% were judged to have fared better than expected given their condition at baseline. The SIR method produced ratings demonstrating considerable variability across the sites; three of the sites consistently showed poorer quality ratings than the other five.CONCLUSIONS: PACE care was generally assessed to be of good quality, but with room for improvement. Despite significant limitations of poor interrater reliability for process of care measures, excessive time involved for the reviews, and lack of a control group, the SIR method was able to consistently discriminate quality ratings among PACE sites. A modified version of the assessment instrument could prove useful in a quality improvement program for PACE care. J Am Geriatr Soc 48:903–910, 2000.
The Impact of Legislation on Psychotropic Drug Use in Nursing Homes: A Cross‐National Perspective
Authors: Hughes Carmel M. , Lapane Kate L. , Mor Vincent , MD Naoki Ikegami , Jónsson Pálmi V. , Ljunggren Gunnar , Sgadari Antonio 
Published: April 2015

OBJECTIVES: To quantify the impact of legislation on nursing home residents, psychotropic drug use, and the occurrence of falls in the US compared with five countries with no such regulation.DESIGN: A retrospective cross‐sectional studySETTING: Nursing homes in five US states and selected nursing homes in Denmark, Iceland, Italy, Japan, and SwedenPARTICIPANTS: Residents in nursing homes in five US states and the aforementioned countries during 1993–1996MAIN OUTCOME MEASURES: Using data collected using the Minimum Data Set, logistic regression provided estimates of the legislative effects on the use of antipsychotics and antianxiety/hypnotics while simultaneously adjusting for potential confounders. The occurrence of falls was evaluated similarly.RESULTS: Prevalence of antipsychotic and/or antianxiety/hypnotic use varied substantially across countries. After adjustment for differences in age, gender, presence of psychiatric/neurologic conditions, and physical and cognitive functioning, residents in Denmark, Italy, and Sweden were at least twice as likely to receive these drugs (Denmark Odds Ratio (OR)=2.32; 95% Confidence Intervals (CI), 2.15–2.51; Italy OR = 2.05; 95% CI, 1.78–2.34; Sweden OR=2.50; 95% CI, 2.16–2.90); in Iceland, the risk was increased to greater than 6 times (OR=6.54; 95% CI, 5.75–7.44) that of the US. Residents were less likely to fall in Italy, Iceland, and Japan compared with the US, despite more extensive use of psychotropic medication, whereas residents in Sweden and Denmark were more likely to fall.CONCLUSIONS: Policy has had an impact on the prescribing of psychotropic medication in US nursing homes compared with other countries, but it is unclear if this is translated into better outcomes for residents.J Am Geriatr Soc 48:931–937, 2000.
Predictors of Nursing Home Placement in Parkinson's Disease: A Population‐Based, Prospective Study
Authors: Aarsland Dag , Larsen Jan Petter , Tandberg Elise , Laake Knut 
Published: April 2015

OBJECTIVES: To examine the rate and predictors of nursing home placement in patients with Parkinson's disease.DESIGN: Four‐year prospective study.SETTING: A population‐based study in western NorwayPARTICIPANTS: 178 community‐dwelling subjects with Parkinson's disease.MEASUREMENTS: Main outcome measure was the time from baseline to nursing home admission. Baseline evaluation of motor symptoms (Unified Parkinson's Disease Rating Scale, UPDRS), cognition (clinical dementia interview, Gottfries, Bråne & Steen dementia scale, and Mini‐Mental State Examination), depression (clinical interview and the Montgomery & Åsberg Depression Rating Scale), and psychotic symptoms (UPDRS Thought Disorder item) were performed.RESULTS: Forty‐seven patients (26.4%) were admitted to a nursing home during the 4‐year study period. Institutionalized patients were older, had more advanced Parkinson's disease with more severe motor symptoms and impairment of activities of daily living, were cognitively more impaired, were more often living alone, and had more hallucinations than those who continued to live at home. Duration of disease, levodopa dose, and gender distribution did not differ between the two groups. A Cox proportional hazards linear regression analysis showed that old age, functional impairment, dementia, and hallucinations were independent predictors of nursing home admission.CONCLUSIONS: Both motor and neuropsychiatric symptoms contributed to institutionalization, but the presence of hallucinations was the strongest predictor. This finding indicates it is possible that effective treatment of hallucinations may reduce the need for institutionalization in patients with Parkinson's disease. J Am Geriatr Soc 48:938–942, 2000.
Immunologic Response to a Single Dose of Tetanus Toxoid in Older People
Authors: Shohat Tamy , Marva Esther , Sivan Yoram , Lerman Ilana , Mates Avraham , Cohen Avital 
Published: April 2015

OBJECTIVES: Several studies have demonstrated that a large percentage of older people are inadequately immunized against tetanus. The aim of this study was to assess the immunity against tetanus in a group of individuals aged 69 and older and to examine the immune response to a single dose of tetanus toxoid.DESIGN: A convenience sample of 115 residents of a large retirement home, aged 69 and older, was studied. After a blood sample for anti‐tetanus antibody titer, a single dose of tetanus toxoid vaccine was administered. Repeat titers were obtained 6 weeks after the vaccination and analyzed by ELISA assay. Antibody levels equal to or greater than 0.1IU/mL were considered protective.RESULTS: Sixty‐seven of 115 (58.3%) individuals had adequate antibody titers. Those individuals who reported having been vaccinated with tetanus toxoid in the past were more likely to be immunized adequately compared with those who reported having never been vaccinated (66.7% vs 39.3%, P = .02). After vaccination, 34 of 46 (73.9%) individuals with inadequate antibody titers became seropositive. Those who remained seronegative had mean prevaccination antibody titers significantly lower than those who seroconverted. Sixteen of 17 (94.1%) persons who reported having been vaccinated in the past and were found to be seronegative developed adequate antibody titers following vaccination, compared with only nine of 16 (56.2%) who reported never having been vaccinated (P = .04). There was no association between seroconversion rate and age, sex, underlying diseases, and army service.CONCLUSIONS: Most individuals will develop an adequate anti‐tetanus antibody titer following administration of a single dose of tetanus vaccine. A history of past immunization is a good predictor of becoming adequately immunized. It is important that physicians follow the current recommendations for adult immunization and initiate campaigns to ensure that the older population is protected against tetanus. J Am Geriatr Soc 48:949–951, 2000.
Breast Cancer Screening for Older Women in a Primary Care Practice
Authors: Tishler Julie , McCarthy Ellen P. , Rind David M. , Hamel Mary Beth 
Published: April 2015

OBJECTIVE: To determine rates of breast cancer screening for older women cared for in a primary care practice and to identify associations between patient and physician characteristics and breast cancer screening.STUDY DESIGN: A retrospective cohort study of older women.SETTING: An urban hospital‐based academic general medicine practice. This practice uses a computerized medical record and office procedures that facilitate tracking and ordering of mammograms.PARTICIPANTS: A random sample of 130 women aged 65 to 80 who receive primary care at a hospital‐based general medicine practice.MEASUREMENTS: Data were collected from the hospital's computerized medical record. We recorded all clinical breast exams and mammograms performed or recommended during the 2‐year study period.RESULTS: The median age of the 130 women studied was 71, and 21% of the women were black. Most patients had no serious comorbid illness (69%) and were independent in their activities of daily living (92%). During the 2‐year study period, mammography was recommended for 95% of women and completed for 84%, and clinical breast exam was performed on 75%. Patients of male physicians had higher rates of mammography than patients of female physicians (89% vs 75%, P = .045). Patients of faculty physicians had higher rates of clinical breast exam than patients of house officers or fellows (83% vs 56%, P = .001).CONCLUSIONS: We report a very high rate of mammography for women cared for at a hospital‐based primary care practice. The systems in place to facilitate ordering and tracking of mammograms probably contributed to the unusually high rate of mammography observed. J Am Geriatr Soc 48:961–966, 2000.
Molten Salt Synthesis, Polymorphism, and Microwave Dielectric Properties of Ba8NiTa6O24 Perovskite
Authors: Gong Meilu , Lu Fengqi , Kuang Xiaojun , Yu Xiaodi , Wang Quanchao , Li Xiaohui , Fang Liang 
Published: April 2015

Molten salt synthesis (MSS) of the eight‐layer hexagonal perovskite Ba8NiTa6O24 was performed using mixed KCl–NaCl salts in comparison with solid‐state synthesis (SSS). In the SSS, the hexagonal Ba8NiTa6O24 formed at 1300°C via a reaction between cubic Ba3NiTa2O9 and hexagonal Ba5Ta4O15. While the MSS did not lower the synthesis temperature of the hexagonal Ba8NiTa6O24 but stabilized an unusual A‐ and B‐site‐deficient cubic perovskite polymorph of Ba8NiTa6O24 below 1350°C as an intermediate phase prior to transforming into the hexagonal phase. This cubic polymorph contains ~3% A‐site and ~9.5% B‐site vacancies plus ~3% Ba cations in the B sites and demonstrated remarkable stability below 1350°C when without presence of the molten salt. The cubic polymorph displayed larger ε ~ 36 and τf ~ 110 ppm/°C than the hexagonal polymorph from the MSS (ε ~ 29 and τf ~ 67 ppm/°C). The hexagonal SSS‐processed ceramics showed advantageous dielectric properties (Qf ~ 52 000 GHz, τf ~ 30 ppm/°C) over both cubic and hexagonal MSS‐processed ones (Qf ~ 18 600–20 000 GHz), while displaying anisotropic grain growth. The anisotropic grain growth was suppressed significantly by the MSS processing.
Comparison of three methods for measuring psoriasis severity in clinical studies (Part 2 of 2): use of quality of life to assess construct validity of the Lattice System Physician's Global Assessment, Psoriasis Area and Severity Index and Static Physician's Global Assessment
Authors: Simpson M.J. , Chow C. , Morgenstern H. , Luger T.A. , Ellis C.N. 
Published: April 2015

AbstractBackgroundSystems for determining psoriasis severity in clinical trials have not been sufficiently validated against patients’ perceived quality of life.ObjectiveTo validate three systems of physician‐determined psoriasis severity (the Lattice System Physician's Global Assessment [LS‐PGA], Psoriasis Area and Severity Index [PASI] and static Physician's Global Assessment [sPGA]).MethodsData were from a 24‐week randomized, double‐blind, placebo‐controlled, multicenter trial of therapy with oral calcineurin inhibitors in 445 patients. Construct validity was measured by correlations of the three severity scores with patients’ self‐reported quality of life (QoL) from the Dermatology Life Quality Index (DLQI) and a DLQI item about psoriasis symptoms.ResultsAll severity systems were moderately and positively correlated with QoL, indicating construct validity. QoL was most consistently related to physicians’ assessments of body surface area involved with psoriasis (iBSA) followed by, in the order of consistency, plaque elevation, erythema and scale.ConclusionsThe LS‐PGA weights iBSA and aspects of plaque morphology in concert with their relative effects on QoL. The LS‐PGA, sPGA and PASI are validated by their relationship to QoL in a clinical trial.
Comparison of three methods for measuring psoriasis severity in clinical studies (Part 1 of 2): change during therapy in Psoriasis Area and Severity Index, Static Physician's Global Assessment and Lattice System Physician's Global Assessment
Authors: Chow C. , Simpson M.J. , Luger T.A. , Chubb H. , Ellis C.N. 
Published: April 2015

AbstractBackgroundAccurate and reliable assessment of changes in psoriasis severity is critical in clinical trials of therapies.ObjectiveTo compare Psoriasis Area and Severity Index (PASI), static Physician's Global Assessment (sPGA), and the Lattice System Physician's Global Assessment (LS‐PGA) in a trial of systemic treatments for plaque psoriasis vulgaris and to assess whether they measure change in psoriasis induced by therapy.MethodsPatients were randomized to voclosporin or cyclosporine for 24 weeks (the ‘24‐week‐treatment’ group, n = 366), or placebo for 12 weeks followed by voclosporin for 12 weeks (the ‘initial‐placebo’ group, n = 89).ResultsAll scoring systems changed in concert and were sensitive enough to detect reductions in severity during placebo therapy as well as with active therapy (P < 0.01 for each measurement). At study onset, there were poorer correlations of sPGA with PASI (r = 0.45) and LS‐PGA (r = 0.39) than between PASI and LS‐PGA (r = 0.68). After therapy, all correlations were stronger, but sPGA continued to be less well correlated (with PASI, r = 0.85; with LS‐PGA, r = 0.79) than LS‐PGA with PASI (r = 0.90). Two‐ or three‐step improvements in LS‐PGA showed very good to excellent accuracy in corresponding to PASI‐50 and PASI‐75, respectively, and were more accurate than comparable changes in sPGA.ConclusionPASI, sPGA and LS‐PGA are responsive to the varying degrees of improvement in psoriasis induced by either placebo or active therapy. While the three systems capture similar information, each has different reasons for use in a clinical trial.
Is an online skin cancer toolkit an effective way to educate primary care physicians about skin cancer diagnosis and referral?
Authors: Gulati A. , Harwood C.A. , Rolph J. , Pottinger E. , Mcgregor J.M. , Goad N. , Proby C.M. 
Published: April 2015

AbstractBackgroundSkin disorders account for over 20% of GP consultations. Half of dermatology referrals to secondary care are for skin lesions, but only 12% of urgent skin cancer referrals are deemed appropriate. Suitably designed online learning resources may positively impact GP confidence in the recognition of skin cancer and improve patient outcomes.ObjectiveThis study evaluated the impact of a national, online, skin cancer recognition toolkit on GP confidence and knowledge in diagnosing skin cancers and referral behaviour to secondary care.MethodsThe toolkit, consisting of a referral decision aid, lesion recognition resource, clinical cases and a quiz, was launched in March 2012. Website usage statistics and online focus groups were used to assess the usability of the website and perceived changes in behaviour. The impact of the toolkit was assessed using national skin cancer referral data, cross‐sectional questionnaires and urgent skin cancer referral data to two NHS trusts.ResultsThe toolkit was accessed by 20% of GPs in England from 20th March to 31st October 2012; spending a mean of over 5 minutes each, with over 33% return users. A survey revealed that the toolkit improved perceptions of skin cancer training and self‐reported knowledge about skin cancer referral pathways. Analysis of referral patterns did not identify an impact of the toolkit on number or appropriateness of urgent skin cancer referrals in the eight months following the launch of the website. Online focus groups confirmed the usefulness of the resource and suggested a positive influence on knowledge and referral behaviour.ConclusionThe skin cancer toolkit is an accessible online learning resource for improving confidence with skin cancer referral amongst GPs. Although we were unable to identify any immediate changes in skin cancer diagnoses or appropriate referral behaviours, research is required to evaluate its longer term effects on outcomes.
Identification and field and laboratory tests of the sex pheromone of Cerconota anonella Sepp. (Lepidoptera: Oecophoridae)
Authors: Pires E. V. , Mendonça A. de L. , Vaníčková L. , Serra N. S. J. , da Silva R. de C. C. , dos Santos D. C. , Campos R. da S. , Sant'Ana A. E. G. , do Nascimento R. R. 
Published: April 2015

AbstractThe Annona fruit borer, Cerconota anonella Sepp., is a serious agricultural pest in many tropical areas of the world. The identification of an attractant for male C. anonella could offer new methods for pest detection and control. A mixture of compounds extracted from female C. anonella elicited antennal depolarization in the male borer. These compounds were identified as octadecanal, 1‐octadecanol, octadecyl acetate, (Z)‐octadec‐9‐enal (Z9‐18:Ald), (Z)‐octadec‐9‐en‐1‐ol (Z9‐18:OH) and [(Z)‐octadec‐9‐enyl] acetate (Z9‐18:Ac) by one‐ and two‐dimensional gas chromatography–mass spectrometry. In laboratory bioassays, synthetic individual compounds as well as synthetic mixtures were found to be attractive to males. In addition, field tests using Delta traps with 1 mg of the ternary mixture composed of Z9‐18:Ac, Z9‐18:Ald and Z9‐18:OH in the ratio of 1 : 3 : 5 caught as many males as traps containing virgin females. The ternary mixture of Z9‐18:Ac, Z9‐18:Ald and Z9‐18:OH was identified as attractant to C. anonella males and can be used to detect and control populations of this insect in Annonaceae plantations.
Extraction of Kiwifruit Seed (Actinidia Deliciosa) Oil Using Compressed Propane
Authors: Coelho Renata , Kanda Luis R.S. , Hamerski Fabiane , Masson Maria Lucia , Corazza Marcos L. 
Published: April 2015

AbstractThis study reports the extraction of kiwifruit seed oil using compressed propane as solvent and its modeling based on the Brunauer–ETmmett–Teller theory of adsorption. Temperature and pressure were the variables investigated on the kinetics of extraction. The overall extraction yields were compared with the Soxhlet extraction with n‐hexane. Most of extraction conditions using compressed propane have presented high extraction rates and overall extraction yield of 31.7 ± 1.4%. The kinetic model used showed to be able and very reliable to correlate the different conditions of extraction with compressed propane. Furthermore, the alternative extraction technique investigated in this work was found to be suitable for the oil extraction from kiwifruit seeds after short times of extraction.Practical ApplicationsCompressed propane extraction is an environment‐friendly technology that can be efficiently used in oilseed extractions. A product that is free of residual solvent and without degradation of thermolabile compounds highlights the use of compressed propane as solvent for applications in food, cosmetic and pharmaceutical industries. The kiwifruit seed oil, which is predominately constituted by α‐linolenic acid (ALA), was efficiently extracted using compressed propane with a maximum extraction yield in a short time of extraction. The mathematical model applied to represent the kinetics of extraction is based on three parameters with physical meaning and it may be easily and reliably used in modeling, design, simulation and optimization, as well as in the scale‐up of this extraction process.