bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementing Treatment Frequency and Duration Guidelines in a Hospital-Based Pediatric Outpatient Setting: Administrative Case Report
Authors: Hanson Heather , Harrington Ann Tokay , Nixon-Cave Kim 
Published: January 2015

Background and PurposeDetermining treatment frequency and duration of physical therapist services is an important component of outpatient pediatric physical therapist practice, yet there is little research available to inform these decisions. Treatment frequency guidelines (TFG) can assist decision making in guiding pediatric physical therapy. The purpose of this project was to examine the feasibility and application of implementing TFG in hospital-based pediatric outpatient physical therapy.Project DescriptionPreviously developed TFG were modified for use in our pediatric outpatient physical therapy department to include duration and were referred to as treatment frequency and duration guidelines (TFDG). In order to successfully implement the TFDG, there were 2 phases to the project. In phase 1, the staff were provided the guidelines and procedures in a staff meeting and via email using a PowerPoint presentation. Phase 2 was initiated due to the poor response of the staff in implementing the guidelines in their practice after phase 1. The format was changed to include formal re-education via small-group and one-on-one education sessions (phase 2). Chart reviews were completed to assess therapists' adherence to using TFDG.OutcomesTherapists' adherence to use of TFDG increased following re-education: phase 1 (n=225 charts, 31% adherence) and phase 2 (n=197 charts, 90% adherence).DiscussionTreatment frequency and duration guidelines may assist in guiding frequency and duration decisions in pediatric physical therapy. Education via in-person meetings may improve adherence among staff.
Evidence-Based Practice Implementation: Case Report of the Evolution of a Quality Improvement Program in a Multicenter Physical Therapy Organization
Authors: Stevans Joel M. , Bise Christopher G. , McGee John C. , Miller Debora L. , Rockar Paul , Delitto Anthony 
Published: January 2015

Background and Purpose
Our nation's suboptimal health care quality and unsustainable costs can be linked to the failure to implement evidence-based interventions. Implementation is the bridge between the decision to adopt a strategy and its sustained use in practice. The purpose of this case report is threefold: (1) to outline the historical implementation of an evidence-based quality improvement project, (2) to describe the program's future direction using a systems perspective to identify implementation barriers, and (3) to provide implications for the profession as it works toward closing the evidence-to-practice gap.

Case Description
The University of Pittsburgh Medical Center (UPMC) Centers for Rehab Services is a large, multicenter physical therapy organization. In 2005, they implemented a Low Back Initiative utilizing evidence-based protocols to guide clinical decision making.

Outcomes
The initial implementation strategy used a multifaceted approach. Formative evaluations were used repeatedly to identify barriers to implementation. Barriers may exist outside the organization, they can be created internally, they may result from personnel, or they may be a direct function of the research evidence. Since the program launch, 3 distinct improvement cycles have been utilized to address identified implementation barriers.

Discussion
Implementation is an iterative process requiring evaluation, measurement, and refinement. During this period, behavior change is actualized as clinicians become increasingly proficient and committed to their use of new evidence. Successfully incorporating evidence into routine practice requires a systems perspective to account for the complexity of the clinical setting. The value the profession provides can be enhanced by improving the implementation of evidence-based strategies. Achieving this outcome will require a concerted effort in all areas of the profession. New skills will be needed by leaders, researchers, managers, and clinicians.
How Strongly Is Aerobic Capacity Correlated With Walking Speed and Distance After Stroke? Systematic Review and Meta-Analysis
Authors: Outermans Jacqueline , van de Port Ingrid , Wittink Harriet , de Groot Janke , Kwakkel Gert 
Published: January 2015

BackgroundRestoration of walking capacity, as reflected by walking speed and walking distance, is a primary goal after stroke. Peak aerobic capacity (peak oxygen consumption [V̇o2peak]) is suggested to be correlated with walking capacity after stroke. Although the strength of this correlation is unclear, physical therapy programs often target walking capacity by means of aerobic training.PurposeThe purpose of this systematic review was to summarize the available evidence on the correlation between V̇o2peak and walking capacity.Data SourcesThe databases MEDLINE, CINAHL, EMBASE, Cochrane Library, and SPORTDiscus were searched up to May 2014.Study SelectionCross-sectional studies reporting correlation coefficients between V̇o2peak and walking capacity in stroke were included, along with longitudinal studies reporting these correlation coefficients at baseline.Data ExtractionThe methodological quality of the studies was assessed using a checklist of 27 items for observational research. Information on study design, stroke severity and recovery, and assessments and outcome of V̇o2peak and walking capacity, as well as the reported correlation coefficients, were extracted.Data SynthesisThirteen studies involving 454 participants were included. Meta-analyses showed combined correlation coefficients (rɱ) for V̇o2peak and walking speed and for V̇o2peak and walking distance of .42 (95% credibility interval=.31, .54) and .52 (95% credibility interval=.42, .62), respectively.LimitationsThe studies included in the present review had small sample sizes and low methodological quality. Clinical and methodological diversity challenged the comparability of the included studies, despite statistical homogeneity. Relevant data of 3 studies could not be retrieved.ConclusionsThe strength of the correlation of V̇o2peak with walking speed was low and moderate for V̇o2peak and walking distance, respectively, indicating that other factors, besides V̇o2peak, determine walking capacity after stroke.
Design and Kinematic Evaluation of a Novel Joint-Specific Play Controller: Application for Wrist and Forearm Therapy
Authors: Crisco Joseph J. , Schwartz Joel B. , Wilcox Bethany , Costa Laura , Kerman Karen 
Published: January 2015

BackgroundThe wrist extensors and flexors are profoundly affected in most children with hemiparetic cerebral palsy (CP) and are the major target of physical therapists' and occupational therapists' efforts to restore useful hand functions. A limitation of any therapeutic or exercise program can be the level of the child's engagement or adherence. The proposed approach capitalizes on the primary learning avenue for children: toy play.ObjectiveThis study aimed to develop and evaluate the measurement accuracy of innovative, motion-specific play controllers that are engaging rehabilitative devices for enhancing therapy and promoting neural plasticity and functional recovery in children with CP.DesignDesign objectives of the play controller included a cost-effective, home-based supplement to physical therapy, the ability to calibrate the controller so that play can be accomplished with any active range of motion, and the capability of logging play activity and wrist motion over week-long periods.MethodsAccuracy of the play controller in measuring wrist flexion-extension was evaluated in 6 children who were developing in a typical manner, using optical motion capture of the wrist and forearm as the gold standard.ResultsThe error of the play controller was estimated at approximately 5 degrees in both maximum wrist flexion and extension.LimitationsMeasurements were taken during a laboratory session, with children without CP, and no toy or computer game was interfaced with the play controller. Therefore, the potential engagement of the proposed approach for therapy remains to be evaluated.ConclusionsThis study presented the concept, development, and wrist tracking accuracy of an inexpensive approach to extremity therapy that may have a health benefit for children with hemiparesis, and potentially for patients of any age with a wide range of extremity neuromotor impairments.
A noninvasive estimation of cerebral perfusion pressure using critical closing pressure
Authors: Varsos Georgios V. , Kolias Angelos G. , Smielewski Peter , Brady Ken M. , Varsos Vassilis G. , Hutchinson Peter J. , Pickard John D. , Czosnyka Marek 
Published: January 2015

OBJECT
Cerebral blood flow is associated with cerebral perfusion pressure (CPP), which is clinically monitored through arterial blood pressure (ABP) and invasive measurements of intracranial pressure (ICP). Based on critical closing pressure (CrCP), the authors introduce a novel method for a noninvasive estimator of CPP (eCPP).

METHODS
Data from 280 head-injured patients with ABP, ICP, and transcranial Doppler ultrasonography measurements were retrospectively examined. CrCP was calculated with a noninvasive version of the cerebrovascular impedance method. The eCPP was refined with a predictive regression model of CrCP-based estimation of ICP from known ICP using data from 232 patients, and validated with data from the remaining 48 patients.

RESULTS
Cohort analysis showed eCPP to be correlated with measured CPP (R = 0.851, p < 0.001), with a mean ± SD difference of 4.02 ± 6.01 mm Hg, and 83.3% of the cases with an estimation error below 10 mm Hg. eCPP accurately predicted low CPP (< 70 mm Hg) with an area under the curve of 0.913 (95% CI 0.883–0.944). When each recording session of a patient was assessed individually, eCPP could predict CPP with a 95% CI of the SD for estimating CPP between multiple recording sessions of 1.89–5.01 mm Hg.

CONCLUSIONS
Overall, CrCP-based eCPP was strongly correlated with invasive CPP, with sensitivity and specificity for detection of low CPP that show promise for clinical use.
Seasonal variability in the incidence of carcinomatous meningitis
Authors: Koutras Angelos , Sakellakis Minas , Makatsoris Thomas , Psachoulia Charalabia , Kardari Maria , Nikolakopoulos Achilleas , Gogos Charalabos , Kalofonos Haralabos P. 
Published: January 2015

OBJECT
The aim of the study was to investigate whether there are seasonal differences in the occurrence of carcinomatous meningitis (CM), with a greater prevalence of the disease in months with higher temperatures.

METHODS
The authors searched the records of all patients with a diagnosis of CM from 1998 until 2013 at the University Hospital of Patras, Greece. The date of hospitalization was extracted for each patient. The cases were divided into 2 categories depending on the time of CM diagnosis. Based on the official data regarding the annual temperature distribution in this region, the authors divided the patients into 2 groups. The first group consisted of cases diagnosed with CM from October 15 to April 15 (cold climate and shorter daytime duration), whereas the second group comprised patients diagnosed between April 15 and October 15 (warm climate and longer daytime duration).

RESULTS
Overall, 44 confirmed cases of CM were found. The most common type of malignancy associated with the development of CM was breast cancer (27 patients), while the second most common tumor was lung carcinoma (11 patients). The median interval between the time of initial cancer diagnosis and CM was 4.5 years. Thirty-one patients were diagnosed with CM during the period between April 15 and October 15, while the remaining 13 patients developed CM between October 15 and April 15, a significant difference (p = 0.01).

CONCLUSIONS
Significantly more patients developed CM during the warm season of the year. To the authors' knowledge, this is the first study to provide evidence for the potential seasonal variability in CM incidence. However, these results should be validated prospectively in larger cohorts.
Pattern and Risk Assessment of Bedsore in Hospitalized Patients
Authors: Ruhul Amin Md , Monoarul Haque Md , Saha Pradip Kumar , Eusuf Zai Sumaiya Zabin , Mahmud Hossain Sarder , Akter Sanjida 
Published: January 2015

Objective: This descriptive type of cross sectional study was conducted to assess pattern and risk factors of bedsore in hospital admitted patients in Dhaka city with a sample size of 114.Methods: A pretested, modified, questionnaire was used to collect the data. All the data were entered and analyzed by using Statistical Package of Social Science 16.0 versions. Results: Study found that 17.5%, 41.2%, 27.2% and 14% of the respondents belonged to age group of 1-20 years, 21-40 years, 41-60 years and 61-80 years respectively with mean age 37.97 +16.909 years. Responsible diseases for bedsore were spinal cord injury (41.2%), fracture (30%), stroke (24%), unconsciousness (7.2%) and GBS (2.8%) respectively. Study revealed that common area of bedsore were back of the sacrum (57%), back of the scapula (34.2%), medial aspect of knee joint (22.8%), malleoli (21.1%), greater trochanter of femur (15.8%), external occipital protuberance (14%), olecranon process of ulna (9.6%), above the coccyx (9.6%), iliac crest (7%), spine of the scapula (3.5%), posterior superior iliac joint (2.6%) and sacro-iliac joint (1.8%) respectively. Study also found that superficial and deep type of bedsore were 58.8% and 41.2% consecutively. Besides study revealed that 26.3% of the respondents were diabetic, 31.6% obese, 28.1% suffering from malnutrition, 61.4% did not use pneumatic bed and 7.2% patients did not maintain proper positioning 2 hourly and these were the risk factors of this study. Significant association was found between type of bed sore and use of pneumatic bed (P=0.000<0.05) as well as nutritional status (P=0.004<0.05).Conclusions: Changing position and use of pneumatic bed was best methods of prevention of bedsore.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21049
Prognostic Significance of B Type Natriuretic Peptide in Acute Coronary Syndrome
Authors: Chowdhury Nasreen , Khan Md. Aminul Haque , Hoque Md Mozammel 
Published: January 2015

Acute Coronary syndrome (ACS) is the most common cause of admission to the coronary care unit with highest risk of death and adverse outcomes. ACS accounts for 6070% of all admissions in the hospital. Patients with ACS encompass a heterogeneous group that varies widely regarding severity of the underlying coronary artery disease, prognosis and response to treatment. Patients with the highest risk of subsequent events usually have the largest benefit of an intensified pharmacological treatment and early mechanical intervention. The prognosis for low-risk patients, on the other hand, is often difficult to improve further and these patients usually benefit more from a conservative management with a lower risk of side effects. Therefore, risk stratification is essential and should be initiated early and updated continuously throughout the hospital stay. Early risk stratification is usually performed by the use of clinical background factors, clinical presentation, electrocardiography and biochemical markers of myocardial damage. Levels of natriuretic peptides have been shown to reflect cardiac performance. The aim of this study was to review elaborately on B type Natriuretic Peptide (BNP) and its prognostic value in patient with ACS. This review focuses on the emerging role of these peptides in the early risk stratification of ACS patients. Elevation of BNP levels in acute MI and UA is predictive of a greater risk of death, post infarction heart failure, or reinfarction. Post infarction studies demonstrate that elevated plasma BNP levels are associated with larger infarct size, increased probability of ventricular remodeling, lower ejection fraction, higher risk of heart failure, and increased mortality. This cardiac marker is a potent predictor of mortality in patients with all forms ACS. BNP measurements serve as an index of severity of the ischemic injury, as well as the degree of impairment in left ventricular function.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21079
A Cluster of Cases of Acute Poststreptococcal Glomerulonephritis in a Family
Authors: Ferdousi Asma , Ahsan Nazmul , Datta Mitra 
Published: January 2015

Acute post streptococcal glomerulonephritis (APSGN) remains a common cause of acute nephritis in children. Acute poststreptococcal glomerulonephritis usually occurs as sporadic cases, occasionally an unusually high incidence of acute nephritis has been recorded. In our country we need to recognize, document and analyze epidemic attacks of acute post streptococcal glomerulonephritis. Then we can plan for its prevention. We have reported here a cluster of cases of APSGN prevailed in a family of a rural setting of southeast part of Bangladesh which was admitted in a subdistrict level hospital and also noticed that total admitted cases of APSGN in that hospital was more during the month of notification in comparison to other months but were not able to identify all the cases of APSGN prevailing in that area. Prophylactic antibiotic treatment is advisable in epidemic conditions and to household contacts of index cases in communities where the prevalence of the disease is high. It is expected that there are some cluster of cases of APSGN in different regions of our country during different period that is to be notified. Public awareness regarding prevention and early treatment of scabis is required.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21034
Report of a Rare Case of Sarcomatoid Renal Cell Carcinoma
Authors: Hossain Mohammad Ismail , Ahmed Imtiaz , Bhattacharjee Pradip , Ahamad M Sahab Uddin , Rahman Zillur 
Published: January 2015

A 50 years old non-smoker female with the history of right flank pain and hematuria surgically treated with right sided radical nephrectomy. Macroscopically it showed a large growth located at the lower pole of the right kidney. Histologically the tumor was composed of exuberant sarcomatous elements predominantly malignant fibrous histiocytoma like pattern and diagnosed as sarcomatoid renal cell carcinoma. There was no scope for immunohistological analysis of that tumor in our setup. It is important to recognize the sarcomatoid component in the renal tumors because of its aggressive behavior and adverse prognosis. We report herein a case of sarcomatoid renal cell carcinoma histomorphogically.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21039
Tuberous Sclerosis Complex : A Case Report
Authors: Haque Shahara , Morshed Tarannum , Begum Hasina , Islam Shahidul , Fatema Kaniz , Begum Afroza , Shoyab Muhammad 
Published: January 2015

The aim of this report is to present various clinical and radiological features of a young female patient with tuberous sclerosis who exhibited multiple hamartomas of various organ system. Tuberous sclerosis is a rare neurocuteneous syndrome exhibiting multiple hamartomatous proliferations that may involve multiple organ system such as brain, kidney, heart, lungs, eyes and skin. An 18 year old female patient presented with abdominal pain and swelling. Clinical examination of the patient revealed presence of facial angiofibromas and huge left flank mass. She also gave history of twin pregnancy with IUD. USG of abdomen showed bilateral gross angiomyolipoma with necrosis and haemorrhage in left kidney. CT and MRI of brain showed presence of multiple cortical tubers and calcified subependymal nodules. This case report is a good example of complex nature of tuberous sclerosis. The diagnosis and management of these patients depend on the presentation of the disease.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21044
Liens mère-enfant et violences conjugales
Authors: Marchal Helen , Derivois Daniel 
Published: January 2015

Cet article écrit par deux psychologues cliniciens met en évidence ce qui des difficultés apparentes entre mère et fils est le fruit du passé de violences conjugales et ce qui est de l’ordre des difficultés primaires du lien. À partir de l’étude d’une dyade mère-fils rencontrée en MECS au travers d’un dispositif praticien, trois types d’entretiens ont été mis en place : individuels, mère-enfant et fraternels. Les divers éléments de la clinique tendent à montrer que les difficultés actuelles s’originent dans la relation primaire mère-fils où la problématique de la dette tient elle aussi une part importante.
La collusion des signifiants dans le holding onirique du néogroupe famille-thérapeute
Authors: Joubert Christiane 
Published: January 2015

À partir des travaux sur le holding onirique familial (Ruffiot, 1982), l’article propose le rêve comme voie royale d’accès aux signifiants inconscients, en collusion, dans le lien, au sein du néogroupe thérapeutique famille-thérapeute. Les signifiants fonctionneraient comme des attracteurs dans le lien. Les signifiants inconscients sont véhiculés par le transgénérationnel et « s’accrochent » au corps du sujet. Ils se révèlent donc via le rêve, en image d’abord et par la perlaboration groupale. Ils peuvent se « désagripper du corps », de la sensation, et redeviennent mobiles, circulent plus librement et se complexifient, dans le cadre de la cure familiale, grâce à la dynamique transféro-contretransférentielle. C’est ce que l’article montre via deux vignettes cliniques.
A Modified Kernel Method for Solving Cauchy Problem of Two-Dimensional Heat Conduction Equation
Authors: Zhao Jingjun , Liu Songshu , Liu Tao 
Published: January 2015

AbstractIn this paper, a Cauchy problem of two-dimensional heat conduction equation is investigated. This is a severely ill-posed problem. Based on the solution of Cauchy problem of two-dimensional heat conduction equation, we propose to solve this problem by modifying the kernel, which generates a well-posed problem. Error estimates between the exact solution and the regularized solution are given. We provide a numerical experiment to illustrate the main results.
Thermodynamical Bending of FGM Sandwich Plates Resting on Pasternak’s Elastic Foundations
Authors: Sobhy Mohammed , Zenkour Ashraf M. 
Published: January 2015

AbstractThe analysis of thermoelastic deformations of a simply supported functionally graded material (FGM) sandwich plates subjected to a time harmonic sinusoidal temperature field on the top surface and varying through-the-thickness is illustrated in this paper. The FGM sandwich plates are assumed to be made of three layers and resting on Pasternak’s elastic foundations. The volume fractions of the constituents of the upper and lower layers and, hence, the effective material properties of them are assumed to vary in the thickness direction only whereas the core layer is still homogeneous. When in-plane sinusoidal variations of the displacements and the temperature that identically satisfy the boundary conditions at the edges, the governing equations of motion are solved analytically by using various shear deformation theories as well as the classical one. The influences of the time parameter, power law index, temperature exponent, top-to-bottom surface temperature ratio, side-to-thickness ratio and the foundation parameters on the dynamic bending are investigated.