bluuebunny/crossref_metadata_2025_split huggingface dataset:
Malaysian occupational therapists’ practices with children and adolescents with autism spectrum disorder
Authors: Kadar Masne , McDonald Rachael , Lentin Primrose 
Published: January 2015

Introduction Occupational therapy is one of the health care professions that provides assessments and interventions for children and adolescents with autism spectrum disorder. However, to date, there is no information available regarding occupational therapy practices in Malaysia for this population. The purpose of this study is to describe the occupational therapy services for children and adolescents with autism spectrum disorder in Malaysia, including the perceived training needs of practitioners. Method We surveyed the registered members of the Malaysian Occupational Therapy Association using a mailed questionnaire. Results A response rate of 15.5% was obtained. The majority of the responses were from those working in hospital settings who had less than 5 years’ experience working as occupational therapists with children and adolescents with autism spectrum disorder. The theories, assessments, interventions, and training that related to respondents’ practices mainly revolved around sensory-based approaches. Encouragingly, more than 70% of the respondents claimed that they performed assessments of daily living activities in their service. Client-centred practice was a further feature of occupational therapist respondents involved in this study. Conclusion Future study is needed, especially to engage more respondents and thereby produce more generalizable results and an in-depth exploration of the continuing education needs of occupational therapists in Malaysia.
Sustaining professional identity in practice following role-emerging placements: Opportunities and challenges for occupational therapists
Authors: Clarke Channine , Martin Marion , de Visser Richard , Sadlo Gaynor 
Published: January 2015

Introduction Role-emerging placements are increasingly being used to help prepare occupational therapy graduates for practice in a changing health and social care climate. However, while the literature on such placements is increasing, few longitudinal studies have explored their impact on graduates’ professional practice and identity. Method Interpretative phenomenological analysis was used to gain an understanding of the ways in which five occupational therapy graduates felt their role-emerging placement influenced their professional identity and practice once qualified. In-depth interviews were carried out with the graduates once they had been working as occupational therapists for a minimum of 6 months. Results In the absence of other occupational therapists, students on placements created professional identities of their own making and generated visions of the type of therapist they wanted to become. Once qualified, however, there were mixed experiences concerning the extent to which this identity could be sustained in practice. Particular difficulty was encountered by those working in National Health Service settings, where graduates questioned whether their practice was congruent with the professional understandings and ways of being they had developed on placement. Conclusion Role-emerging placements acted as a catalyst for participants’ personal and professional development. Further research on the long-term influence of role-emerging placements is required.
Quantitative MRI T2 Relaxation Time Evaluation of Knee Cartilage
Authors: Li Hong , Chen Shuang , Tao Hongyue , Chen Shiyi 
Published: January 2015

Background: Associated meniscal injury is well recognized at anterior cruciate ligament (ACL) reconstruction, and it is a known risk factor for osteoarthritis. Purpose: To evaluate and characterize the postoperative appearance of articular cartilage after different meniscal treatment in ACL-reconstructed knees using T2 relaxation time evaluation on MRI. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 62 consecutive patients who under ACL reconstruction were recruited in this study, including 23 patients undergoing partial meniscectomy (MS group), 21 patients undergoing meniscal repair (MR group), and 18 patients with intact menisci (MI group) at time of surgery. Clinical evaluation, including subjective functional scores and physical examination, was performed on the same day as the MRI examination and at follow-up times ranging from 2 to 4.2 years. The MRI multiecho sagittal images were segmented to determine the T2 relaxation time value of each meniscus and articular cartilage plate. Differences in each measurement were compared among groups. Results: No patient had joint-line tenderness or reported pain or clicking on McMurray test or instability. There were also no statistically significant differences in functional scores or medial or lateral meniscus T2 values among the 3 groups ( P > .05 for both). There was a significantly higher articular cartilage T2 value in the medial femorotibial articular cartilage for the MS group ( P < .01) and the MR group ( P < .05) compared with that of the MI group, while there was no significant difference in articular cartilage T2 value between the MS and MR groups ( P > .05) in each articular cartilage plate. The medial tibial articular cartilage T2 value had a significant positive correlation with medial meniscus T2 value ( r = 0.287; P = .024) Conclusion: This study demonstrates that knees with meniscectomy or meniscal repair had articular cartilage degeneration at 2 to 4 years postoperatively, with higher articular cartilage T2 relaxation time values compared with the knees with an intact meniscus.
“Frustrated,” “Depressed,” and “Devastated” Pediatric Trainees
Authors: Dixit Avika , Feldman-Winter Lori , Szucs Kinga A. 
Published: January 2015

Background: Exclusive breastfeeding (EBF) is recommended until about 6 months of age. Pediatricians are at the forefront of encouraging mothers to achieve this goal, yet pediatricians who parent during their training may face substantial barriers in achieving their own breastfeeding goals. Objectives: This study aimed to assess breastfeeding support available to US pediatricians in training and the effect of trainees’ personal experiences on their attitude toward breastfeeding. Methods: An online survey was emailed to American Academy of Pediatrics Section on Medical Students, Residents, and Fellowship Trainees members. Results: There were 927 respondents, of which 421 had children and 346 breastfed their children. Almost 80% agreed that 6 months is the ideal duration for EBF. One in 4 did not have access to or were not aware of a private room to express milk or breastfeed. Forty percent needed to extend the duration of their training for a longer maternity leave, with breastfeeding a factor for longer leave among 44%. One in 4 did not meet their breastfeeding duration goal, and 1 in 3 did not meet their goal for EBF. Negative emotions were common among those not meeting goals. Ninety-two percent felt that their or their partner’s experience with breastfeeding affected their clinical interaction with patients’ mothers. Conclusion: A majority of respondents cited problems with breastfeeding support during training, and many failed to meet their intended goals. Not meeting personal breastfeeding goals was associated with negative emotions and influenced how they counsel about breastfeeding as a result of personal and often negative attitudes.
Measuring Video Game Engagement Through Gameplay Reviews
Authors: Kirschner David , Williams J. Patrick 
Published: January 2015

Aim. In this article, we develop a method, that we call the gameplay review method, for measuring players’ engagement with digital games through players’ interactions with video recordings of their own gameplay. Method. The gameplay review method arose from a microsociological study of the gameplay of eight young adults who each played approximately 20 hours of WORLD OF WARCRAFT over a 3-month period in 2012. Using data from in-depth interviews and audiovisual recordings of one of the eight participants, this article focuses on how the method leveraged participants’ knowledge of their experiences and ties that knowledge to measures of engagement. We outline the method’s four-step process (producing Level I data, analyzing Level I data, producing Level II data, analyzing Level II data) to guide the generation and analysis of rich video data. The method involves focused discussions on selected recorded segments of participants’ gameplay and is a means of connecting game design with both empirical and interpretive data. Results. We show how, as participants progress, they learn about game design features and deepen their understanding of games. We found that participants’ developing perceptions of, and relationships to, design features affect their engagement with digital games. Conclusion. The gameplay review method is significant in its ability to measure engagement by dealing explicitly with empirical and interpretive data.
Dignified Palliative Long-Term Care
Authors: Ho Andy Hau Yan , Luk James K. H. , Chan Felix H. W. , Chun Ng Wing , Kwok Catherine K. K. , Yuen Joseph H. L. , Tam Michelle Y. J. , Kan Wing W. S. , Chan Cecilia L. W. 
Published: January 2015

Purpose: To critically examine the system dynamics necessary for successfully implementing a novel end-of-life integrated care pathway (EoL-ICP) program in promoting dignity and quality of life among terminally-ill Chinese nursing home residents. Methods: Thirty stakeholders were recruited to participate in 4 interpretive-systemic focus groups. Results: Framework analysis revealed 10 themes, organized into 3 categories, namely, (1) Regulatory Empowerment (interdisciplinary teamwork, resource allocation, culture building, collaborative policy making), (2) Family-Centered Care (continuity of care, family care conference, partnership in care), and (3) Collective Compassion (devotion in care, empathic understanding, compassionate actions). Conclusions: These findings highlight the importance of organizational structure, social discourse, and shared meaning in the provision of EoL-ICP in Chinese societies, underscoring the significant triangulation between political, cultural, and spiritual contexts embodied in the experience of dignity.
Correlation of Postoperative Midfoot Position With Outcome Following Reconstruction of the Stage II Adult Acquired Flatfoot Deformity
Authors: Conti Matthew S. , Chan Jeremy Y. , Do Huong T. , Ellis Scott J. , Deland Jonathan T. 
Published: January 2015

Background: No studies investigating the effect of the midfoot (talonavicular joint) position on clinical outcomes following flatfoot reconstruction have been performed. The purpose of our study was to determine whether a postoperative abducted or adducted forefoot alignment, as determined from anteroposterior (AP) radiographs, was associated with a difference in outcomes using the Foot and Ankle Outcome Score (FAOS). Methods: Midfoot abduction was defined on postoperative AP radiographs, evaluated at a mean of 1.9 years in 55 patients from the authors’ institution who underwent flatfoot reconstruction for a stage II adult acquired flatfoot deformity (AAFD), as a lateral incongruency angle greater than 5 degrees, a talonavicular uncoverage angle greater than 8 degrees, and a talo–first metatarsal angle greater than 8 degrees based on previously reported measurements. Patients with 2 or more measurements in the abduction category were classified as the abduction group (n = 30); those with 1 or fewer measurements in the abduction category were placed in the adduction group (n = 25). The preoperative and postoperative FAOS values with a mean follow-up of 3.1 years were compared using Wilcoxon rank-sum tests. Results: Patients corrected to a position of adduction showed significantly lower improvement in the FAOS daily activities ( P = .012) and quality of life subscales ( P = .046). The mean improvement in subscale scores for the adducted group was lower for pain ( P = .052) and sports activities ( P = .085) but did not reach statistical significance. No significant difference in the FAOS symptoms subscale ( P = .372) between groups was found. Conclusion: Correction of the talonavicular joint to a position of adduction following a stage II AAFD was associated with decreased patient outcomes in daily activities and quality of life compared with an abducted position. These results suggest that overcorrection to a position of midfoot adduction leads to a lesser amount of individual patient improvement in reconstruction of a stage II AAFD. Level of Evidence: Level III, comparative series.
More Equal than We Thought? Using Vote Validation to Better Understand Participation Inequality in the States
Authors: Franko William W. 
Published: January 2015

AbstractInequality in political participation is a well-known and often studied feature of American politics. An important study examining misreporting of voter turnout in opinion surveys, however, calls into question the true extent of participation inequality. Ansolabehere and Hersh's first-ever 50-state vote validation project shows that those with more political resources are more likely to misreport turnout. That is, those with higher incomes are more likely than others to report that they had voted when in fact they did not. These findings suggest that income disparities in participation are not as large as opinion surveys have led us to believe. Moreover, studies using differences between voters and nonvoters as a key political indicator may also be biased. This article presents the first assessment of whether vote misreporting creates systematic bias in measures of state participation inequality. An index of economic inequality in participation for the 50 states is developed using the Ansolabehere and Hersh validated vote data and compares the measure of political inequality with a similar measure using traditional (i.e., nonvalidated) survey data. These state indices are used to determine the extent of bias produced by misreporting and whether this bias has implications for studies using these measures of participation inequality. The latter is assessed by examining the influence of the self-reported and validated inequality measures on state welfare programs and minimum wage policy.
Arterial vessels behind the right internal jugular vein with relevance to central venous catheterisation
Authors: Chandra Manik , Start Sarah , Roberts David , Bodenham Andrew 
Published: January 2015

During right internal jugular vein cannulation, complications can arise due to transfixion of the posterior wall and damage to other vessels. The risks to the subclavian artery and its branches are less well appreciated than the carotid artery. Example images are lacking in the literature. Using ultrasound and cadaveric studies, we aim to provide clinically relevant images of at-risk vessels posterior to the right internal jugular vein to emphasise their close proximity, and provide strategies to avoid potential complications. Using ultrasound in 24 patients, we found the presence of numerous arterial vessels (excluding the carotid) within 8.0 mm of the posterior wall of the right internal jugular vein at the levels of the mastoid, cricoid and supraclavicular region. Cadaveric dissections further highlighted the close proximity of numerous branches of the subclavian artery. Vulnerable branches of the subclavian artery include the thyrocervical trunk, inferior thyroid and vertebral arteries. More inferior approaches to right internal jugular vein cannulation are likely to put more arterial branches at risk. Higher resolution ultrasound enables visualisation of these arteries prior to cannulation. If identified, measures should be taken to avoid vein transfixion and arterial damage.
Arm versus forearm tourniquet for carpal tunnel decompression – Which is better? A randomized controlled trial
Authors: Cousins G. R. , Gill S. L. , Tinning C. G. , Johnson S. M. , Rickhuss P. K. 
Published: January 2015

Tourniquet pain is a common source of complaint for patients undergoing carpal tunnel decompression and practice varies as to the tourniquet position used. There is little evidence to suggest benefit of one position over another. Our aim was to compare patient and surgeon experience of forearm and arm tourniquets. Following a power calculation, 100 patients undergoing open carpal tunnel decompression under local anaesthetic were randomized to either an arm or a forearm tourniquet. Measurements of blood pressure, heart rate and pain were taken at 2.5 min intervals. The operating surgeon also provided a visual analogue scale rating for the extent of bloodless field achieved and for any obstruction caused by the tourniquet. There was no statistically significant inter-group difference in patient pain or physiological response, tourniquet time, bloodless field or length of procedure. The degree of obstruction caused by the tourniquet was significantly higher in the forearm group. Level of Evidence: I. Prospective Randomized Controlled Trial
Surgical adhesive BioGlue™ does not benefit tendon repair strength: an ex vivo study
Authors: Jordan M. C. , Schmitt V. , Dannigkeit S. , Schmidt K. , Meffert R. H. , Hoelscher-Doht S. 
Published: January 2015

Surgical adhesives are useful supplements in surgery, but their benefit in tendon repair is uncertain. The purpose of this study was to evaluate the effect of BioGlue™ on strength of flexor tendon repair. A total of 60 porcine flexor tendons were divided into three groups. In group one, a conventional core and peripheral suture repair was used. In group two, a core suture and BioGlue™ were used. In group three, a conventional core and peripheral suture repair and BioGlue™ were used. We performed static and cyclic axial load testing and measured diameter of the repair site. We found that BioGlue™ did not improve the tensile strength when added to a core and peripheral suture and that there was an increase in bulk at the repair site. We conclude that BioGlue™ application cannot replace a peripheral suture as tensile strength significantly decreases without a peripheral suture, and it does not benefit a tendon already repaired with a core and peripheral suture. Level of evidence: n/a
Qigong program on insomnia and stress in cancer patients: A case series report
Authors: Kim Seungmo , Lee Sangnam , Kwon Osung , Park Seonghoon , Seo Jungchul , Kim Kyungsoon 
Published: January 2015

Background: In recent years, the interest in Qigong as an alternative therapy has grown following reports of its ability to regulate psychological factors in cancer patients. This is a case series to evaluate the outcome measures of Qigong when used as an adjunct to standard medical care to treat insomnia and stress in cancer patients. Patients and methods: The Qigong program was applied to four cancer patients with insomnia, stress, and anxiety. The program consisted of 30-min sessions involving exercise, patting of the 12 meridians, and spontaneous breathing exercises three times a week for a period of 4 weeks. The Pittsburgh Sleep Quality Index was measured as the primary outcome, while the Stress Scale, the State–Trait Anxiety Inventory, and the Functional Assessment Cancer Therapy–General determined the secondary outcomes. Insomnia, stress, and anxiety levels were examined weekly, while quality of life was examined on the first visit and the last visit. Results: The Pittsburgh Sleep Quality Index and Stress Scale scores were reduced after conduct of the Qigong program. Conclusion: This study could provide a better understanding of Qigong’s influence on insomnia and stress in cancer patients. However, a larger controlled trial should be conducted to confirm these findings.
Use of probe‐based confocal laser endomicroscopy (pCLE) in gastrointestinal applications. A consensus report based on clinical evidence
Authors: Wang Kenneth K , Carr-Locke David L , Singh Satish K , Neumann Helmut , Bertani Helga , Galmiche Jean-Paul , Arsenescu Razvan I , Caillol Fabrice , Chang Kenneth J , Chaussade Stanislas , Coron Emmanuel , Costamagna Guido , Dlugosz Aldona , Ian Gan S , Giovannini Marc , Gress Frank G , Haluszka Oleh , Ho Khek Y , Kahaleh Michel , Konda Vani J , Prat Frederic , Shah Raj J , Sharma Prateek , Slivka Adam , Wolfsen Herbert C , Zfass Alvin 
Published: January 2015

BackgroundProbe‐based confocal laser endomicroscopy (pCLE) provides microscopic imaging during an endoscopic procedure. Its introduction as a standard modality in gastroenterology has brought significant progress in management strategies, affecting many aspects of clinical care and requiring standardisation of practice and training.ObjectiveThis study aimed to provide guidance on the standardisation of its practice and training in Barrett's oesophagus, biliary strictures, colorectal lesions and inflammatory bowel diseases.MethodsInitial statements were developed by five group leaders, based on the available clinical evidence. These statements were then voted and edited by the 26 participants, using a modified Delphi approach. After two rounds of votes, statements were validated if the threshold of agreement was higher than 75%.ResultsTwenty‐six experts participated and, among a total of 77 statements, 61 were adopted (79%) and 16 were rejected (21%). The adoption of each statement was justified by the grade of evidence.ConclusionpCLE should be used to enhance the diagnostic arsenal in the evaluation of these indications, by providing microscopic information which improves the diagnostic performance of the physician. In order actually to implement this technology in the clinical routine, and to ensure good practice, standardised initial and continuing institutional training programmes should be established.
The human gastric microbiota: Is it time to rethink the pathogenesis of stomach diseases?
Authors: Nardone Gerardo , Compare Debora 
Published: January 2015

IntroductionAlthough long thought to be a sterile organ, due to its acid production, the human stomach holds a core microbiome.AimTo provide an update of findings related to gastric microbiota and its link with gastric diseases.MethodsWe conducted a systematic review of the literature.ResultsThe development of culture‐independent methods facilitated the identification of many bacteria. Five major phyla have been detected in the stomach: Firmicutes, Bacteroidites, Actinobacteria, Fusobacteria and Proteobacteria. At the genera level, the healthy human stomach is dominated by Prevotella, Streptococcus, Veillonella, Rothia and Haemophilus; however, the composition of the gastric microbiota is dynamic and affected by such factors as diet, drugs and diseases. The interaction between the pre‐existing gastric microbiota and Helicobacter pylori infection might influence an individual's risk of gastric disease, including gastric cancer.ConclusionsThe maintenance of bacterial homeostasis could be essential for the stomach's health and highlights the chance for therapeutic interventions targeting the gastric microbiota, even if gastric pH, peristalsis and the mucus layer may prevent bacteria colonization; and the definition of gastric microbiota of the healthy stomach is still an ongoing challenging task.