bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occupation, well-being, and culture: Theory and cultural humility / Occupation, bien-être et culture : la théorie et l’humilité culturelle
Authors: Hammell Karen R. Whalley 
Published: August 2013

Background. The Canadian Model of Occupational Performance and Engagement depicts individuals embedded within cultural environments that afford occupational possibilities. Culture pertains not solely to ethnicity or race but to any dimension of diversity, including class, gender, sexual orientation, and ability. Purpose. This paper highlights specific dimensions of cultural diversity and their relationships to occupational engagement and well-being. Key issues. Cultural variations constitute the basis for a socially constructed hierarchy of traits that significantly determine occupational opportunities and impact mental health and well-being. Cultural humility is an approach to redressing power imbalances in client-therapist relationships by incorporating critical self-evaluation and recognizing that cultural differences lie not within clients but within client-therapist relationships. Implications. It is proposed that theoretical relevance would be enhanced if culturally diverse perspectives were incorporated into theories of occupation. Cultural humility is advocated as an approach to theoretical development and in efforts to counter professional Eurocentrism, ethnocentrism, and intellectual colonialism.
The relationship between NHS performance indicators and suicide rates
Authors: Zhinchin Galina , Shah Ajit 
Published: August 2013

Aims and method As mental health services have an important role in prevention of suicides, the relationship between Care Quality Commission performance ratings of mental health trusts and the local suicide rates were examined with the null hypothesis that there will be no relationship between them. Data on suicide rates for men and women aged 16–65 for each district covered by a mental health trust were ascertained from the Office of National Statistics for the year 2009. Data on performance ratings of mental health trusts for the same year were obtained from the Care Quality Commission Report. Results There was no significant relationship between suicide rates in the districts covered by 60 mental health trusts in England and Wales and their performance ratings. Clinical implications The negative findings suggest that the performance rating of mental health trusts do not influence local suicide rates.
Prospective, Randomized, Blinded, Comparative Study of Injectable Micronized Dehydrated Amniotic/Chorionic Membrane Allograft for Plantar Fasciitis—A Feasibility Study
Authors: Zelen Charles M. , Poka Attila , Andrews James 
Published: August 2013

Background: Specialized treatment of plantar fasciitis that can reduce inflammation and promote healing may be a possible alternative prior to surgical intervention. We report the results of a randomized clinical trial examining the efficacy of micronized dehydrated human amniotic/chorionic membrane (mDHACM) injection as a treatment for chronic refractory plantar fasciitis. Methods: An institutional review board–approved, prospective, randomized, single-center clinical trial was performed. Forty-five patients were randomized to receive injection of 2 cc 0.5% Marcaine plain, then either 1.25 cc saline (controls), 0.5 cc mDHACM, or 1.25 cc mDHACM. Follow-up visits occurred over 8 weeks to measure function, pain, and functional health and well-being. Results: Significant improvement in plantar fasciitis symptoms was observed in patients receiving 0.5 cc or 1.25 cc mDHACM versus controls within 1 week of treatment and throughout the study period. At 1 week, American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot scores increased by a mean of 2.2 ± 17.4 points for controls versus 38.7 ± 11.4 points for those receiving 0.5 cc mDHACM ( P < .001) and 33.7 ± 14.0 points for those receiving 1.25 cc mDHACM ( P < .001). By week 8 AOFAS Hindfoot scores increased by a mean of 12.9 ± 16.9 points for controls versus 51.6 ± 10.1 and 53.3 ± 9.4 for those receiving 0.5 cc and 1.25 cc mDHACM, respectively (both P < .001). No significant difference in treatment response was observed in patients receiving 0.5 cc versus 1.25 cc mDHACM. Conclusion: In patients with refractory plantar fasciitis, mDHACM is a viable treatment option. Larger studies are needed to confirm our findings. Level of Evidence: Level I, prospective randomized study.
Teleconsultations reduce greenhouse gas emissions
Authors: Oliveira Tiago Cravo , Barlow James , Gonçalves Luís , Bayer Steffen 
Published: August 2013

Objectives Health services contribute significantly to greenhouse gas emissions. New models of delivering care closer to patients have the potential to reduce travelling and associated emissions. We aimed to compare the emissions of patients attending a teleconsultation – an outpatient appointment using video-conferencing equipment – with those of patients attending a face-to-face appointment. Methods We estimated the total distances travelled and the direct and indirect greenhouse gas emissions for 20,824 teleconsultations performed between 2004 and 2011 in Alentejo, a Portuguese region. These were compared to the distances and emissions that would have resulted if teleconsultations were not available and patients had to attend face-to-face outpatient appointments. Estimates were calculated using survey data on mode of transport, and national aggregate data for car engine size and fuel. A sensitivity analysis using the lower and upper quartiles for survey distances was performed. Results Teleconsultations led to reductions in distances and emissions of 95%. 2,313,819 km of travelling and 455 tonnes of greenhouse gas emissions were avoided (22 kg of carbon dioxide equivalent per patient). The incorporation of modes of transport and car engine size and fuel in the analysis led to emission estimates which were 12% smaller than those assuming all patients used an average car. Conclusions The availability of remote care services can significantly reduce road travel and associated emissions. At a time when many countries are committed to reducing their carbon footprint, it is desirable to explore how these reductions could be incorporated into technology assessments and economic evaluations.
Impact of deprivation on occurrence, outcomes and health care costs of people with multiple morbidity
Authors: Charlton Judith , Rudisill Caroline , Bhattarai Nawaraj , Gulliford Martin 
Published: August 2013

Objective This study aimed to estimate the impact of deprivation on the occurrence, health outcomes and health care costs of people with multiple morbidity in England. Methods Cohort study in the UK Clinical Practice Research Datalink, using deprivation quintile (IMD2010) at individual postcode level. Incidence and mortality from diabetes mellitus, coronary heart disease, stroke and colorectal cancer, and prevalence of depression, were used to define multidisease states. Costs of health care use were estimated for each state from a two-part model. Results Data were analysed for 141,535 men and 141,352 women aged ≥30 years, with 33,862 disease incidence events, and 13,933 deaths. Among incidences of single conditions, 22% were in the most deprived quintile and 19% in the least deprived; dual conditions, most deprived 26%, least deprived 16% and triple conditions, most deprived 29%, least deprived 14%. Deaths in participants without disease were distributed most deprived 22%, least deprived 19%; in participants with single conditions, most deprived 24%, least deprived 18%; dual conditions, most deprived 27%, least deprived 15%, and triple conditions, most deprived 33%, least deprived 17%. The relative rate of depression in most deprived participants with triple conditions, compared with least deprived and no disease, was 2.48 (1.74 to 3.54). Costs of health care use were associated with increasing deprivation and level of morbidity. Conclusions The higher incidence of disease, associated with deprivation, channels deprived populations into categories of multiple morbidity with a greater prevalence of depression, higher mortality and higher costs. This has implications for the way that resources are allocated in England’s National Health Service.
Presentational approaches used in the UK for reporting evidence synthesis using indirect and mixed treatment comparisons
Authors: Tan Sze Huey , Bujkiewicz Sylwia , Sutton Alexander , Dequen Pascale , Cooper Nicola 
Published: August 2013

Objectives To establish current guidance and practice in UK on presentation of indirect comparison and mixed treatment comparison analyses; to provide recommendations to improve indirect comparison/mixed treatment comparison reporting and to identify research priorities for improved presentation. Methods Existing institutional guidance for conducting indirect comparison/mixed treatment comparison alongside current practice in health technology assessment was reviewed. Reports published in UK by the Health Technology Assessment programme since 1997, which utilized indirect comparison/mixed treatment comparison methods, were reviewed with respect to the presentation of study data, statistical models and results. Recommendations for presentation were developed. Results Guidance exists that provide the details necessary to conduct a successful indirect comparison/mixed treatment comparison analysis but recommendations on presentation are limited. Of 205 health technology assessment reports that contained evidence synthesis for effectiveness, 19 used indirect comparison/mixed treatment comparison methods. These reports utilized numerous presentational formats from which the following key components were identified: network table/diagram for presenting data; model description to allow reproducibility; and tables, forest plots, matrix tables and summary forest plots for presenting a range of results. Recommendations were developed to ensure that reporting is explicit, transparent and reproducible. Approaches most understandable by non-technical decision makers, and areas where future research is required, are outlined. Conclusions There is no standard presentational style used in UK for reporting indirect comparison/mixed treatment comparison, and the use of graphical tools is limited. Standardization of reporting and innovation in graphical representation of indirect comparison/mixed treatment comparison results is required.
The effect of the proximity of patients’ nearest alternative hospital on their intention to search for information on hospital quality
Authors: Victoor Aafke , Rademakers Jany , Rooijen Margreet Reitsma-van , Jong Judith de , Delnoij Diana , Friele Roland 
Published: August 2013

Objective In several countries, patients are encouraged to choose health care providers. Simultaneously, there is a tendency towards the concentration of health care, which might lessen the choice. Our aim was to assess the impact of patients’ distances from their providers on their information-seeking, which is one element of choice. Methods Two thousand members of the Dutch Health Care Consumer Panel were sent a questionnaire that included a question on whether they would search for information about hospitals to inform their choice. Distances from providers were obtained from a database that includes the distances between all postcodes in the Netherlands. To assess the influence of distance on information-seeking, logistic regression analyses were conducted. Results There was a good response (75%). Older, less educated respondents were less inclined to seek information when their nearest alternative was located further away (OR 0.85; 95% CI: 0.79–0.92), and younger, more educated respondents were more inclined to search in this situation (OR 1.11; 95% CI: 1.01–1.22). Conclusions As fewer older, less educated patients would search for information to guide their choice, they might not opt for the best hospital. Additionally, the need for providers to compete for the patronage of these patients might be lessened.
Are Asian hands more flexible than their Caucasian counterparts?
Authors: Shahid Mohammad , Mahroof Sabreena , Wu Feiran , Bourne Kathryn , Jose Rajive , Titley Garth 
Published: August 2013

Introduction Though there is a general perception that Asian hands have an increased range of movements in all their joints, there is very little written in the literature on this topic. Our unit caters to a multiethnic population and it has been our experience that the outcomes after hand surgery are generally better in Asian hands. This study was aimed at comparing the range of movements between two cohorts of volunteers: Asians and Caucasians. Methods Data were collected on their ethnicity, gender, age, handedness and any medical conditions. The Beighton score was measured for all subjects and range of movements was measured using a standard goniometer. Totally, 114 subjects were enrolled into the study, which included 53 men (46%). Results There were 59 Caucasians and 55 Asians. The range of movements of wrist and hand was greater in Asians and the difference was statistically significant ( p < 0.05). Men in general had greater range of movement of the fingers whereas women had greater range of movement of the thumb. There was no difference between Asian men and women with regard to wrist movements. However, Caucasian women had greater wrists movements than Caucasian males. The average Beighton score was the highest in Asian women (7), followed by Asian men (6). Caucasian men and women had an average Beighton Score of 2. Discussion Normative data for different ethnic groups are important for hand therapy as they can guide rehabilitation protocols. Our study demonstrates that a difference in hand flexibility between British Asians and their Caucasian counterparts exists.
Cartilage Intermediate Layer Protein and Asporin Polymorphisms Are Independent Risk Factors of Lumbar Disc Degeneration in Male Collegiate Athletes
Authors: Min Seok-Ki , Nakazato Koichi , Ishigami Hideaki , Hiranuma Kenji 
Published: August 2013

Objective: Lumbar disc degeneration (LDDG), recently reported to have strong genetic determinants, is a major cause of discopathy and lower back pain. However, most studies have only evaluated the effects of a single susceptibility polymorphism. Our purpose was to examine the effect of two susceptibility polymorphism for LDDG in Japanese collegiate athletes. Design: We investigated two susceptibility genes for LDDG—cartilage intermediate layer protein (CILP) and asporin (ASPN)—in 516 collegiate athletes and genotyped the risk allele of CILP (1184T/C) and ASPN (D14). LDDG was evaluated using T2-weighted magnetic resonance imaging. Results: By using logistic regression analysis, we found that the ASPN D14 allele and CILP genotype were associated with an increased risk of LDDG in male but not female athletes (CILP CT: odds ratios [OR] = 1.77, 95% confidence interval [CI] = 1.07-2.93; CILP CC: OR = 4.38, 95% CI = 1.42-13.54; ASPN D14: OR = 2.17, 95% CI = 1.10-4.28]. We also found that CILP C and ASPN D14 were independent variables. The ORs with more than two risk alleles were largely increased. Conclusions: The CILP and ASPN polymorphisms are independent genetic risk factors for LDDG in male but not female Japanese collegiate athletes.
Faecal calprotectin and lactoferrin as markers for monitoring disease activity and predicting clinical recurrence in patients with Crohn’s disease after ileocolonic resection: A prospective pilot study
Authors: Yamamoto Takayuki , Shiraki Manabu , Bamba Takuya , Umegae Satoru , Matsumoto Koichi 
Published: August 2013

Background:Several studies have reported that faecal calprotectin and lactoferrin showed a close correlation with endoscopic inflammation in patients with inflammatory bowel disease. However, the clinical significance of faecal calprotectin or lactoferrin in postoperative Crohn’s disease (CD) is not fully evaluated. This prospective study was to investigate the relationship between endoscopic activity, and faecal calprotectin and lactoferrin, and assess the predictive value of these markers for future recurrence.Methods:Twenty patients who remained in remission during 6–12 months after ileocolonic resection for CD were included. All patients underwent ileocolonoscopy for assessing endoscopic activity (Rutgeerts score) in the neo‐terminal ileum. A stool sample was collected for measurement of calprotectin and lactoferrin. All patients were then followed up for 12 months, and clinical recurrence was defined as a CDAI >150 with an increase of ≥70 points.Results:The mean time between surgery and the endoscopic examination at entry was 7.2 months. The endoscopic scores were i0 or i1 in 10 patients, i2 in six patients, i3 in three patients, and i4 in one patient. Both calprotectin and lactoferrin positively correlated with the endoscopic scores (p  = 0.0001 and p  = 0.038, respectively). Six patients developed clinical recurrence during the 12‐month follow‐up. Both calprotectin and lactoferrin levels were significantly higher in patients with clinical recurrence than those in remission (p  = 0.0007 and p  = 0.025, respectively). A cutoff value of 170 µg/g for calprotectin had a sensitivity of 83% and a specificity of 93% to predict a risk of clinical recurrence, while a cutoff value of 140 µg/g for lactoferrin had a sensitivity of 67% and a specificity of 71%.Conclusions:Both calprotectin and lactoferrin levels correlate well with endoscopic activity after ileocolonic resection for CD. Calprotectin and lactoferrin could be clinically relevant biomarkers for predicting postoperative recurrence. Further well‐designed large trials should strengthen the findings of the present investigation.
Nasally administered Lactobacillus rhamnosus strains differentially modulate respiratory antiviral immune responses and induce protection against respiratory syncytial virus infection
Authors: Tomosada Yohsuke , Chiba Eriko , Zelaya Hortensia , Takahashi Takuya , Tsukida Kohichiro , Kitazawa Haruki , Alvarez Susana , Villena Julio 
Published: August 2013

Abstract

Background
Some studies have shown that nasally administered immunobiotics had the potential to improve the outcome of influenza virus infection. However, the capacity of immunobiotics to improve protection against respiratory syncytial virus (RSV) infection was not investigated before.

Objective
The aims of this study were: a) to evaluate whether the nasal administration of Lactobacillus rhamnosus CRL1505 (Lr05) and L. rhamnosus CRL1506 (Lr06) are able to improve respiratory antiviral defenses and beneficially modulate the immune response triggered by TLR3/RIG-I activation; b) to investigate whether viability of Lr05 or Lr06 is indispensable to modulate respiratory immunity and; c) to evaluate the capacity of Lr05 and Lr06 to improve the resistance of infant mice against RSV infection.

Results
Nasally administered Lr05 and Lr06 differentially modulated the TLR3/RIG-I-triggered antiviral respiratory immune response. Lr06 administration significantly modulated the production of IFN-α, IFN-β and IL-6 in the response to poly(I:C) challenge, while nasal priming with Lr05 was more effective to improve levels of IFN-γ and IL-10. Both viable Lr05 and Lr06 strains increased the resistance of infant mice to RSV infection while only heat-killed Lr05 showed a protective effect similar to those observed with viable strains.

Conclusions
The present work demonstrated that nasal administration of immunobiotics is able to beneficially modulate the immune response triggered by TLR3/RIG-I activation in the respiratory tract and to increase the resistance of mice to the challenge with RSV. Comparative studies using two Lactobacillus rhamnosus strains of the same origin and with similar technological properties showed that each strain has an specific immunoregulatory effect in the respiratory tract and that they differentially modulate the immune response after poly(I:C) or RSV challenges, conferring different degree of protection and using distinct immune mechanisms. We also demonstrated in this work that it is possible to beneficially modulate the respiratory defenses against RSV by using heat-killed immunobiotics.
Accuracy of endoscopic diagnosis of Helicobacter pyloriinfection according to level of endoscopic experience and the effect of training
Authors: Watanabe Kazuhiro , Nagata Naoyoshi , Shimbo Takuro , Nakashima Ryo , Furuhata Etsuko , Sakurai Toshiyuki , Akazawa Naoki , Yokoi Chizu , Kobayakawa Masao , Akiyama Junichi , Mizokami Masashi , Uemura Naomi 
Published: August 2013

Abstract

Background
Accurate prediction of Helicobacter pylori infection status on endoscopic images can contribute to early detection of gastric cancer, especially in Asia. We identified the diagnostic yield of endoscopy for H. pylori infection at various endoscopist career levels and the effect of two years of training on diagnostic yield.

Methods
A total of 77 consecutive patients who underwent endoscopy were analyzed. H. pylori infection status was determined by histology, serology, and the urea breast test and categorized as H. pylori-uninfected, -infected, or -eradicated. Distinctive endoscopic findings were judged by six physicians at different career levels: beginner (<500 endoscopies), intermediate (1500–5000), and advanced (>5000). Diagnostic yield and inter- and intra-observer agreement on H. pylori infection status were evaluated. Values were compared between the two beginners after two years of training. The kappa (K) statistic was used to calculate agreement.

Results
For all physicians, the diagnostic yield was 88.9% for H. pylori-uninfected, 62.1% for H. pylori-infected, and 55.8% for H. pylori-eradicated. Intra-observer agreement for H. pylori infection status was good (K > 0.6) for all physicians, while inter-observer agreement was lower (K = 0.46) for beginners than for intermediate and advanced (K > 0.6). For all physicians, good inter-observer agreement in endoscopic findings was seen for atrophic change (K = 0.69), regular arrangement of collecting venules (K = 0.63), and hemorrhage (K = 0.62). For beginners, the diagnostic yield of H. pylori-infected/eradicated status and inter-observer agreement of endoscopic findings were improved after two years of training.

Conclusions
The diagnostic yield of endoscopic diagnosis was high for H. pylori-uninfected cases, but was low for H. pylori-eradicated cases. In beginners, daily training on endoscopic findings improved the low diagnostic yield.