bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of Bipolar Electrocautery and Chemical Cautery for Control of Pediatric Recurrent Anterior Epistaxis
Authors: Johnson Nathan , Faria John , Behar Philomena 
Published: July 2015

ObjectiveTo compare the outcome of children with anterior epistaxis treated intraoperatively with either bipolar electrocautery or silver nitrate chemical cautery.Study DesignCase series with chart review.SettingTertiary‐care pediatric otolaryngology practice.SubjectsChildren aged 2 to 18 years treated with either intraoperative bipolar electrocautery or silver nitrate chemical cautery of the anterior nasal septum for recurrent anterior epistaxis.MethodsAny reported bleeding event after surgery was recorded. The mean time from surgery to recurrent epistaxis was compared between groups.ResultsFifty patients underwent bipolar electrocautery, while 60 patients underwent silver nitrate chemical cautery. Within 2 years, 1 (2%) patient in the bipolar electrocautery group and 13 (22%) patients in the silver nitrate chemical cautery group had recurrent epistaxis (P =. 003). Two years after treatment, there was no difference between treatment groups. Overall, 4 patients (8%) had recurrent epistaxis postoperatively in the bipolar electrocautery group at a mean of 4.34 years after treatment, while 17 (28.3%) patients recurred after a mean of 1.53 years of treatment in the silver nitrate chemical cautery group (P =. 01).ConclusionCompared to those treated with chemical cautery, those treated with bipolar electrocautery had a longer nosebleed‐free period and a lower incidence of recurrent epistaxis within 2 years of treatment. Beyond 2 years, the treatment methods are equivocal. Bipolar electrocautery may be a superior treatment in children who will not tolerate in‐office chemical cautery, in those with a risk of severe bleeding, or when it can be combined with other operative procedures.
The Changing Landscape of Vestibular Schwannoma Management in the United States—A Shift Toward Conservatism
Authors: Carlson Matthew L. , Habermann Elizabeth B. , Wagie Amy E. , Driscoll Colin L. , Van Gompel Jamie J. , Jacob Jeffrey T. , Link Michael J. 
Published: July 2015

ObjectiveTo characterize the evolving management of vestibular schwannoma (VS) in the United States.Study DesignRetrospective analysis of the Surveillance, Epidemiology, and End Results (SEER) database.SettingSEER database.Subjects and MethodsAll patients with a diagnosis of VS were analyzed. Data were described and compared using trend analyses and univariate and multivariable logistic regression.ResultsA total of 8330 patients (average age 54.7 years, 51.9% female) were analyzed. The mean incidence was approximately 1.1 per 100,000 per year and did not vary significantly across time; however, from 2004 to 2011, there was a statistically significant decrease in tumor size category at time of diagnosis (P <. 01). Overall, 3982 patients (48%) received primary microsurgery, 1978 (24%) radiation therapy alone, and 2370 (29%) observation. Within the microsurgical cohort, 732 (18%) underwent subtotal resection, and of those, 98 (13.4%) received postoperative radiation therapy. Multivariable regression revealed that surgical treatment was more common in younger patients and larger tumor size categories (P <. 05). Management trend analysis revealed that microsurgery was used less frequently over time (P <. 0001), observation was used more frequently (P <. 0001), and the pattern of radiation therapy remained unchanged. Linear regression was used to create an equation that was applied to predict future management practices. These data predict that by 2026, half of all cases of VS will be managed initially with observation.ConclusionWhile the incidence of VS has remained steady, tumor size at time of diagnosis has decreased over time. Within the United States there has been a clear, recent evolution in management toward observation.
Occult Temporal Bone Facial Nerve Involvement by Parotid Malignancies with Perineural Spread
Authors: Carlson Matthew L. , Patel Neil S. , Modest Mara C. , Moore Eric J. , Janus Jeffrey R. , Olsen Kerry D. 
Published: July 2015

ObjectiveTo characterize disease presentation and outcomes following surgical treatment of parotid malignancies with occult temporal bone facial nerve (FN) involvement.Study DesignCase series with chart review.SettingTertiary academic referral center.Subjects and MethodsThirty consecutive patients (mean age 58 years; 77% men) who underwent surgery for parotid malignancies with occult perineural involvement of the intratemporal FN were included. Primary outcome measures included margin status and recurrence.ResultsThe mean duration of clinical follow‐up was 49 months, and the most common presenting symptom was FN paresis (n = 23; 77%) followed by pain (n = 15; 50%). To obtain a proximal FN margin, 27 patients (90%) underwent mastoidectomy, and 3 patients (10%) had lateral temporal bone resection. The intratemporal FN margin was cleared in 26 patients (87%), most commonly in the mastoid segment (60%). Adjuvant therapy was given in 25 patients (83%). Ten patients (33%) experienced locoregional (4; 13%) and/or distant (8; 27%) recurrence at a median of 19 months (mean 26, 2–54 months) following surgery. Locoregional failure was significantly more common in cases with a positive intratemporal FN margin (66% vs 8%; P =. 045). Overall 1‐, 3‐, and 5‐year disease‐specific survival rates were 83%, 79%, and 72%, respectively.ConclusionsPerineural invasion of the intratemporal FN by parotid malignancy is uncommon. Normal preoperative FN function does not preclude histopathologic involvement. Temporal bone FN exploration should be considered when a positive margin is encountered at the stylomastoid foramen, as failure to do so is associated with an increased rate of locoregional recurrence.
Extracorporeal membrane oxygenation for the treatment of adult sickle cell acute chest syndrome
Authors: Parhar Ken , Parizkova Barbora , Jones Nicola , Valchanov Kamen , Fowles Jo-Anne , Besser Martin , Telfer Paul , Kaya Banu , Vuylsteke Alain , Rubino Antonio 
Published: July 2015

Sickle cell disease (SCD) is a hereditary haemoglobinopathy that results in polymerization of haemoglobin molecules and subsequent vaso-occlusion. A common cause of death in adults is acute chest syndrome (AChS) with resulting hypoxemic respiratory failure. Veno-venous extracorporeal membrane oxygenation (VV-ECMO) has been used successfully in acutely reversible respiratory failure when conventional mechanical ventilation has been unable to adequately oxygenate and ventilate in a lung-protective fashion. We present an adult SCD patient with severe respiratory failure due to AChS, successfully treated with VV-ECMO. We also discuss some of the technical challenges and considerations when using ECMO in the SCD patient.
A critical analysis of the internal logic in the Life-Space Assessment (LSA) composite score and suggested solutions
Authors: Siordia Carlos 
Published: July 2015

Background: An individual’s ability to live independently is commonly measured in health research interested in identifying risk factors associated with disablement processes. In order to inform clinical practice, population research has attempted to identify the contraction of “lived-space” by using various survey instruments. Problem: Studies assessing habitual movements over the environment with the Life-Space Assessment (LSA) survey instrument should carefully consider how the LSA Composite Score (LSA-CS) is computed. Until now, no publication has carefully delineated the assumptions guiding the internal logic used in the computation of the LSA-CS. Core argument: Because the internal logic of the LSA may need further justification, a non-data-editing scoring algorithm should be considered. Solution: Compute LSA-CS by only using non-edited data. Specific aim: Paper first delineates the logic guiding the algorithm used in the formation of the LSA-CS and explains how the scoring creates and changes participant responses when they conflict with its internal logic. An easy-to-use SAS® 9.3 program for estimating a Non-Data-Edited LSA-CS (NDE-LSA-CS) is also presented. Conclusion: Researchers interested in assessing lived-space should carefully consider if the internal logic of the LSA-CS is warranted. Clinicians should know it is important to understand the strengths and weaknesses of outcome measures used when deciding on whether to apply the results of research to direct clinical practice.
Hydrotherapy vs. conventional land-based exercise for improving walking and balance after stroke: a randomized controlled trial
Authors: Zhu Zhizhong , Cui Liling , Yin Miaomiao , Yu Yang , Zhou Xiaona , Wang Hongtu , Yan Hua 
Published: July 2015

Objective: To investigate the effects of hydrotherapy on walking ability and balance in patients with chronic stroke. Design: Single-blind, randomized controlled pilot trial. Setting: Outpatient rehabilitation clinic at a tertiary neurological hospital in China. Subjects: A total of 28 participants with impairments in walking and controlling balance more than six months post-stroke. Intervention: After baseline evaluations, participants were randomly assigned to a land-based therapy (control group, n = 14) or hydrotherapy (study group, n = 14). Participants underwent individual sessions for four weeks, five days a week, for 45 minutes per session. Main measures: After four weeks of rehabilitation, all participants were evaluated by a blinded assessor. Functional assessments included the Functional Reach Test, Berg Balance Scale, 2-minute walk test, and Timed Up and Go Test. Results: After four weeks of treatment, the Berg Balance Scale, functional reach test, 2-minute walk test, and the Timed Up and Go Test scores had improved significantly in each group ( P < 0.05). The mean improvement of the functional reach test and 2-minute walk test were significantly higher in the aquatic group than in the control group ( P < 0.01). The differences in the mean values of the improvements in the Berg Balance Scale and the Timed Up and Go Test were not statistically significant. Conclusion: The results of this study suggest that a relatively short programme (four weeks) of hydrotherapy exercise resulted in a large improvement in a small group ( n = 14) of individuals with relatively high balance and walking function following a stroke.
Psychometric evaluation of the Posture and Postural Ability Scale for children with cerebral palsy
Authors: Rodby-Bousquet Elisabet , Persson-Bunke Måns , Czuba Tomasz 
Published: July 2015

Objective: To evaluate construct validity, internal consistency and inter-rater reliability of the Posture and Postural Ability Scale for children with cerebral palsy. Design: Evaluation of psychometric properties. Setting: Five child rehabilitation centres in the south of Sweden, in November 2013 to March 2014. Subjects: A total of 29 children with cerebral palsy (15 boys, 14 girls), 6–16 years old, classified at Gross Motor Function Classification System (GMFCS) levels II ( n = 10), III ( n = 7), IV ( n = 6) and V ( n = 6). Main measures: Three independent raters (two physiotherapists and one orthopaedic surgeon) assessed posture and postural ability of all children in supine, prone, sitting and standing positions, according to the Posture and Postural Ability Scale. Construct validity was evaluated based on averaged values for the raters relative to known-groups in terms of GMFCS levels. Internal consistency was analysed with Cronbach’s alpha and corrected Item–Total correlation. Inter-rater reliability was calculated using weighted kappa scores. Results: The Posture and Postural Ability Scale showed construct validity and median values differed between GMFCS levels ( p < 0.01). There was a good internal consistency (alpha = 0.95–0.96; item–total correlation = 0.55–0.91), and an excellent inter-rater reliability (kappa score = 0.77–0.99). Conclusion: The Posture and Postural Ability Scale shows high psychometric properties for children with cerebral palsy, as previously seen when evaluated for adults. It enables detection of postural deficits and asymmetries indicating potential need for support and where it needs to be applied.
Epidemiology and Microbiology of Sepsis Syndromes in a University-Affiliated Urban Teaching Hospital and Level-1 Trauma and Burn Center
Authors: Tulloch Luis G. , Chan Jeannie D. , Carlbom David J. , Kelly Mary Jo , Dellit Timothy H. , Lynch John B. 
Published: July 2015

Purpose: To use the 2010 to 2011 data collected by structured chart review to provide a detailed up-to-date description of the epidemiology and microbiology of the sepsis syndromes. Methods: Prospective observational study conducted at a university-affiliated urban teaching hospital and level-1 trauma and burn center. All adult patients who triggered a Code Sepsis in the emergency department (ED) between January 2010 and December 2011 were included. Results: One hundred eighty four patients presented with a verified sepsis syndrome and triggered a Code Sepsis in the ED during the studied time period. The mean hospital and intensive care unit length of stays (LOSs) were 15.4 (interquartile range [IQR] = 14) and 6.7 (IQR = 5) days, respectively. The total inpatient mortality was 19% (n = 35). Patients with an unspecified source of infection and those without an isolated pathogen had the highest inpatient mortality, 42.1% (n = 8) and 23.3% (n = 10), respectively. Conclusion: Hospital mortality and hospital LOS of sepsis are similar to those reported in other observational studies. Our study confirms a decline in the mortality of sepsis predicted by earlier longitudinal studies and should prompt a resurgence of epidemiological research of the sepsis syndromes in the United States.
No duty owed to the relatives of a victim of a person with mental illness
Authors: Scott Russ 
Published: July 2015

Objective: To review the case of an acutely psychotic person who was discharged into the care of a friend whom he killed later the same day, and to consider the reasoning of the High Court in the subsequent negligence action of the victim’s relatives. Conclusions: By a narrow interpretation, the High Court found that the exercise of the powers and duties in relation to the involuntary detention of a mentally ill person as prescribed by the Mental Health Act were inconsistent with a common law duty of care to another person or the relatives of another person.
Are psychiatrists trained to be leaders in mental health? A survey of early career psychiatrists
Authors: van Zeist-Jongman Annette 
Published: July 2015

Objective: The aim of this study was to investigate how early career psychiatrists in 2014 valued the leadership skill education in their training to become psychiatrists. Method: All psychiatrists who gained Fellowship since 2009 after training in New Zealand or Australia were invited to take part in a survey. Results: Respondents considered themselves not adequately prepared for the leadership, management and administrative tasks and roles they have as psychiatrists, with preparedness for management tasks scoring the lowest. They valued as most useful to have opportunity to practice with a leadership role, to be able to observe ‘leaders at work’, to have a supervisor with special interests and skills in leadership and management and to have a formal teaching program on leadership and management. They advised teaching to be given throughout the entire 5 years of the training program by experienced leaders. Conclusions: Leadership skills training in the education of psychiatrists should contain both practical experience with leadership and management roles and formal teaching sessions on leadership and management skills development. Suggestions for improvement of the leadership and management skills education in the training of psychiatrists have been formulated.
Emil Kraepelin’s ideas on transcultural psychiatry
Authors: Steinberg Holger 
Published: July 2015

Objective: Prevailing degeneration theory and an increasing number of people in inpatient mental treatment aroused the famous German psychiatrist Emil Kraepelin’s (1856–1926) interest to investigate whether the mental illnesses typical for Europe were also characteristic for ‘primitive peoples’. He thus dedicated a period spent in the Dutch East Indies (Java) in 1904 to transcultural psychiatric research. This paper endeavours to compile Kraepelin’s key findings, aiming to make readers aware of what kind of transcultural research Kraepelin did and what conclusions he came up with. At the same time it provides some background for the question of whether Kraepelin can really be referred to as the founder of transcultural psychiatry. Conclusion: Kraepelin assumed that illnesses with exterior causes depended on the type of stimulants widely used in a given culture. Since he found little evidence for progressive paralysis, he concluded that European brains were particularly prone to sequelae of syphilis. For endogenous psychoses he postulated differences in both symptoms and courses, depressions being rarer and milder, and ceasing sooner. By contrast, he found dementia praecox (mainly covered by the concept of schizophrenias later) to be the most prevalent mental illness in Java, explicitly different in form from that in Europe.
Can understanding the neurobiology of body dysmorphic disorder (BDD) inform treatment?
Authors: Rossell Susan L , Harrison Ben J , Castle David 
Published: July 2015

Objectives: We aim to provide a clinically focused review of the neurobiological literature in body dysmorphic disorder (BDD), with a focus on structural and functional neuroimaging. Conclusions: There has been a recent influx of studies examining the underlying neurobiology of BDD using structural and functional neuroimaging methods. Despite obvious symptom similarities with obsessive–compulsive disorder (OCD), no study to date has directly compared the two groups using neuroimaging techniques. Studies have established that there are limbic and visual cortex abnormalities in BDD, in contrast to fronto-striatal differences in OCD. Such data suggests affect or visual training maybe useful in BDD.
Social anxiety disorders in clinical practice: differentiating social phobia from avoidant personality disorder
Authors: Lampe Lisa 
Published: July 2015

Objective: To outline the problems around overlap between social phobia (SAD) and avoidant personality disorder (AVPD) and provide guidelines that may assist clinicians to differentiate these conditions. Conclusions: A constellation of symptoms can be identified that may distinguish AVPD from SAD, with key features being a strong and pervasively negative self-concept, a view of rejection as equating to a global evaluation of the individual as being of little worth and a sense of not fitting in socially that dates from early childhood. It is important to identify the presence of AVPD in order to anticipate potential problems with engagement and retention in therapy, to target treatment interventions and optimise outcome.
Implementing music therapy on an adolescent inpatient unit: a mixed-methods evaluation of acceptability, experience of participation and perceived impact
Authors: Patterson Sue , Duhig Michael , Darbyshire Chris , Counsel Robin , Higgins Niall , Williams Ian 
Published: July 2015

Objective: We aimed to assess the feasibility of delivering a music therapy program on adolescent psychiatric wards. Method: We undertook a mixed-methods evaluation of a pilot program. Various active and receptive techniques were employed in group music therapy sessions delivered as part of a structured clinical program. Data collected in interviews with participants and staff and feedback questionnaires were thematically and descriptively analysed and triangulated. Results: Data from 62 questionnaires returned by 43 patients who took part in 16 music therapy sessions, and seven staff, evidenced strong support for music therapy. Patients typically reported experiencing sessions as relaxing, comforting, uplifting, and empowering; >90% would participate by choice and use music therapeutically in the future. Staff endorsed music therapy as valuable therapeutically, reporting that patients engaged enthusiastically and identified sessions as improving their own moods and ward milieu. Conclusions: Integration of music therapy in inpatient treatment of adolescents is feasible and acceptable, and is valued by staff and patients as a complement to ‘talking therapies’. Participation is enjoyed and associated with outcomes including improvement in mood, expression of feelings and social engagement consistent with recovery.
Mental health in the Solomon Islands: developing reforms and partnerships
Authors: Ryan Brigid , Orotaloa Paul , Araitewa Stephen , Gaoifa Daniel , Moreen John , Kiloe Edwin , Same William , Goding Margaret , Ng Chee 
Published: July 2015

Objectives: The Solomon Islands face significant shortages and geographical imbalances in the distribution of skilled health workers and resources, which severely impact the delivery of mental health services. The government's Integrated Mental Health Service has emphasised the importance of greater community ownership and involvement in community-based mental health care, and of moving from centralised services to increased local and accessible care. Methods: From 2012 to 2014, the Solomon Islands Integrated Mental Health service worked with Asia-Australia Mental Health to build workforce capacity and deliver sustainable community mental health programs. Results: Supported by the Australian Aid Program’s Public Sector Linkages Program, this project shared resources and fostered links between public sector agencies in Australia, Fiji and the Solomon Islands. Conclusions: Key learning points from the collaboration included the critical need to establish partnerships with community stakeholders, the importance of sustaining a well-functioning mental health team, and optimising the strengths of the local resources in the Solomon Islands. Through this project, national policies, promotion and service delivery were strengthened, through the exchange of experiences and mobilisation of north-south (Australia-Solomon Islands) and south-south (Solomon Islands-other Pacific nations) technical expertise. This project demonstrates the potential for international partnerships to contribute to the development of culturally-appropriate and integrated mental health services.
Educating for diversity: an evaluation of a sexuality diversity workshop to address secondary school bullying
Authors: Lucassen Mathijs FG , Burford James 
Published: July 2015

Objective: To evaluate the potential of a 60-minute sexuality diversity workshop to address bullying in secondary schools. Methods: Students completed pre- and post-workshop questionnaires. Descriptive statistics were used to summarise results with pre- to immediate post-workshop changes compared using t-tests. Thematic analysis was used to analyse open-ended questionnaire responses. Results: We had 229 students (mean age 13.7 years) attending 10 workshops participate in the study. Three-quarters of students thought the workshop would reduce bullying in schools, and over 95% of the participants thought that other secondary schools should offer the workshop. There was a significant increase in valuing ( p < 0.001) and understanding ( p < 0.001) sexuality-diverse individuals (e.g. lesbian, gay and bisexual people), between the pre- and post-workshop results. School climates were largely perceived to be ‘hard’ and included ‘bullying/mocking’ of sexuality-diverse students; however, many individual students reported a desire to be supportive of their sexuality-diverse peers. Conclusions: Sexuality-based bullying is commonplace in secondary schools. This form of bullying is associated with depression and suicide attempts. Reducing sexuality-based bullying is very likely to have a positive impact on the mental health of young people. Brief workshops, as a part of a wider suite of interventions, have some potential to create safer school environments.