bluuebunny/crossref_metadata_2025_split huggingface dataset:
Periodontal considerations in older individuals
Authors: Darby I 
Published: March 2015

AbstractIn the next few years there will be a great increase in the percentage of the population aged over 65. Not only will they have more teeth than previous generations, but also a large number of implants. The increase in age is accompanied by an increase in the prevalence and incidence of periodontal diseases. In addition, there is a decrease in manual dexterity and an increase in co‐morbidity and medications affecting the oral cavity. Dental care in aged care facilities can be poor and access to dental professionals difficult. This article discusses these issues.
Oral medicine and the ageing population
Authors: Yap T , McCullough M 
Published: March 2015

AbstractThe oral cavity is subject to age related processes such as cellular ageing and immunosenescence. The ageing population bears an increased burden of intraoral pathology. In oral medicine, the majority of presenting patients are in their fifth to seventh decade of life. In this review, we discuss the ageing population's susceptibility to mucosal disorders and the increased prevalence of potentially malignant disorders and oral squamous cell carcinoma, as well as dermatoses including oral lichen planus and immunobullous conditions. We also address the ageing population's susceptibility to oral discomfort and explore salivary secretion, ulceration and the symptoms of oral burning. Finally, we will describe orofacial pain conditions which are more likely encountered in an older population. This update highlights clinical presentations which are more likely to be encountered in the ageing population in a general practice setting and the importance of screening both new and long‐term patients.
Relaxation and guided imagery do not reduce stress, pain and unpleasantness for 11‐ to 12‐year‐old girls during vaccinations
Authors: Nilsson Stefan , Forsner Maria , Finnström Berit , Mörelius Evalotte 
Published: March 2015

AbstractAimRelaxation and guided imagery is a distraction technique known to reduce discomfort during paediatric medical procedures. We examined whether its use decreased the stress experienced by 11‐ to 12‐year‐old girls receiving the human papilloma virus vaccination, as well as the intensity and unpleasantness of any pain.MethodsA randomised crossover trial was conducted with 37 girls. During the first vaccination, each girl was randomised to receive either relaxation and guided imagery or standard care. They then received the other form of care during the second vaccination. Salivary cortisol was measured before each vaccination, and 30 minutes after it was administered. The girls reported pain intensity and pain unpleasantness before and directly after each vaccination and stress after each vaccination.ResultsOn a group level, relaxation and guided imagery did not decrease cortisol levels, self‐reported stress, pain intensity and pain unpleasantness. Salivary cortisol levels decreased significantly in both groups during the second vaccination.ConclusionRelaxation and guided imagery did not prove beneficial during the vaccination of 11‐ to 12‐year‐old girls and is not recommended as a regular nursing intervention. However, further research is needed into effective techniques to help children who experience pain unpleasantness in connection with needle procedures.
Estimating tissue iron burden: current status and future prospects
Authors: Wood John C. 
Published: March 2015

SummaryIron overload is becoming an increasing problem as haemoglobinopathy patients gain greater access to good medical care and as therapies for myelodysplastic syndromes improve. Therapeutic options for iron chelation therapy have increased and many patients now receive combination therapies. However, optimal utilization of iron chelation therapy requires knowledge not only of the total body iron burden but the relative iron distribution among the different organs. The physiological basis for extrahepatic iron deposition is presented in order to help identify patients at highest risk for cardiac and endocrine complications. This manuscript reviews the current state of the art for monitoring global iron overload status as well as its compartmentalization. Plasma markers, computerized tomography, liver biopsy, magnetic susceptibility devices and magnetic resonance imaging (MRI) techniques are all discussed but MRI has come to dominate clinical practice. The potential impact of recent pancreatic and pituitary MRI studies on clinical practice are discussed as well as other works‐in‐progress. Clinical protocols are derived from experience in haemoglobinopathies but may provide useful guiding principles for other iron overload disorders, such as myelodysplastic syndromes.
Knowledge use and learning in everyday social work practice: a study in child investigation work
Authors: Avby Gunilla , Nilsen Per , Ellström Per‐Erik 
Published: March 2015

AbstractThe aim of this study was to explore knowledge use and learning among social workers in everyday child investigation work. Research was undertaken in two Swedish children's services departments. The study applied an ethnographic approach. Methods for data collection included interviews, participant observations, reflective dialogues and a documentary analysis of case files. The social workers' knowledge sources were classified into research‐based, practice‐based and ordinary knowledge. The findings show that the social workers preferred practice‐based knowledge, which was primarily conveyed from colleagues and previous experience, and rarely consulted knowledge from sources found outside the practice setting. Furthermore, the findings suggest that the integration of knowledge was made possible through the social workers' engagement in both a verbal and a more cognitive (tacit) reasoning activity, processes that fostered learning at work. The social workers' learning was predominantly adaptive as they learned to handle tasks in a fairly routinized way on the basis of rules or procedures. The findings lend support to the notion that the use of different knowledge forms could potentially trigger learning in everyday social work.
Deep‐colour vat dyeing of cotton knit fabric on a modified jet dyeing machine
Authors: Wakoh Hiroshi , Furuie Mina , Inaba Daisuke , Azuma Nobuto , Nakane Koji , Ogata Nobuo , Shimizu Toru , Ishimaru Osamu 
Published: March 2015

To improve the vat dyeing of cotton knit fabric with Indanthren Black RB Coll. (CI Vat Black 9), the basic parameters of dyeing, including the concentrations of chemicals, the dyeing temperature and duration, and the apparent diffusion coefficient of the dye, were obtained by test dyeing with a stoppered Erlenmeyer flask and the cellophane film roll method. A stable vat dyeing process has been developed on a modified jet dyeing machine for the first time without using nitrogen to purge oxygen. Modifications were made to improve the airtightness of the machine and the equipment in the liquor circulating system, with a water inlet and outlet for the gentle oxidation of dyed fabric, and with monitoring by means of a sensor inserted in the liquor circulating system for in situ measurements of the redox potential and the pH of the dyeing liquors. These measurements made it possible to follow to their completion the process of dyeing and the process of gentle oxidation by overflow washing with water and final oxidation. Optimal conditions with regard to the amount of reducing agent, the dyeing temperature (80 °C), and oxidising processes were established with this machine. It was found that, by using the modified machine and process conditions, dyeing proceeded stably and reproducibly (at 80 °C) to yield grade A dyed fabric. Visual inspection confirmed that faultless deep‐colour dyeing of the fabric was attained. Production has been proceeding successfully for the past 2 years. Owing to its insolubility, complete removal of the dye from the wastewater has been possible.
Myeloid sarcoma: an unusual presentation for acute tracheal stenosis
Authors: Podgaetz Eitan , Kriegsmann Mark , Dincer Erhan H. , Allan James S. 
Published: March 2015

AbstractBackground and AimsExtramedullary involvement of acute myelogenous leukemia (AML) is rare and has been reported under the terms myeloid sarcoma (MS), granulocytic sarcoma, chloroma, extramedullary acute myeloid leukemia, myeloblastoma and myelosarcoma. The most common extramedullary involvement includes soft tissues and lymph nodes, but it may arise in different sites of the body. There are only very few reports about MS in the pulmonary system, and involvement of the trachea is extremely rare.MethodsThis is the first report of initial presentation of MS by severe acute tracheal stenosis.ResultsAfter failed tracheal dilatation, a tracheostomy was performed where tracheal tissue was submitted for pathology. Histology of the tracheal biopsy and bone marrow revealed AML. The patient was subsequently referred to our oncology service for further management.ConclusionMyeloid sarcoma should be part of the differential for acute tracheal stenosis.
Prognostic factors affecting survival in non‐small cell lung carcinoma patients with malignant pleural effusions
Authors: Kasapoglu Umut Sabri , Arınç Sibel , Gungor Sinem , Irmak Ilim , Guney Pinar , Aksoy Ferda , Bandak Dilek , Hazar Armagan 
Published: March 2015

AbstractBackground and AimsLung cancer is the most common cause of malignant pleural effusions (MPEs). For patients with lung cancer and MPE, median survival is only 3–4 months. The aim of this study was to evaluate lung cancer patients with MPE by clinical and laboratory findings on admission, and determine 2‐year survival rate and prognostic factors.MethodsBetween 2008 and 2011, we examined 199 cases of non‐small cell lung carcinoma with MPE. Demographic factors of patients, tumor characteristics, treatment delivered and laboratory parameters affecting prognosis were evaluated. Survival rates were estimated by Kaplan–Meier method. Significance of each prognostic factors selected by univariate analysis were confirmed using Cox regression model.ResultsThe study included 139 (69.8%) male and 60 (30.2%) female patients with a median age of 64 (30–85) years. Median overall survival was 4.4 months. Adenocarcinoma was the leading cause of MPE with 80.4%. A univariate analysis showed that factors affecting mortality included gender (P < 0.001), MPE with distant metastasis (P = 0.025), lower serum albumin (P < 0.0001), lower pleural protein (P < 0.0001), increased serum lactate dehydrogenase (P = 0.003), increased serum C‐reactive protein (CRP) (P < 0.0001), increased white blood cells (P < 0.0001), histopathological type (P = 0.004) and treatment decision (P < 0.0001). A multivariate analysis revealed that patients who had high level of serum CRP (P = 0.017), lower serum albumin (P = 0.009) and lower pleural protein (P = 0.003), MPE with distant metastasis (P = 0.003) and those who were chemotherapy naive (P < 0.0001) had shorter survival.ConclusionHigh level of serum CRP, lower serum albumin and lower pleural protein, MPE with distant metastasis were most important prognostic factors for non‐small cell lung carcinoma in patients with MPEs.
Provision of structured diabetes information encourages activation amongst people with diabetes as measured by diabetes care process attainment: the WICKED Project
Authors: Gillani S. M. R. , Nevill A. , Singh B. M. 
Published: March 2015

AbstractBackgroundPeople with diabetes have better outcomes if they actively participate in their care. Patient‐focused interventions can be effective in activating patients. Yet there is no known trial to evaluate the impact of the provision of individualized diabetes‐specific information on patient activation and diabetes care outcomes.MethodsIn a randomized controlled trial, all people (n = 14 559) with diabetes within the local health economy were recruited and cluster randomized into two groups with the active group mailed a structured personalized report containing information on all nine of their diabetes care processes, whereas the control group received standard care. Differences in their Failed Process Score (FPS) were compared at three months.ResultsAt three months, the FPS score (1.25 ± 1.87 vs. 1.35 ± 1.97, P < 0.01) and the change in FPS score (0.48 ± 1.55 vs. 0.42 ± 1.49, P < 0.02) were significantly better in those mailed a structured personalized report. A dichotomized FPS score [good attainment (GA) vs. poorer attainment], was significantly better in those mailed (χ2 = 10.0, P < 0.05) and using a binary logistic regression analysis adjusting for all demographic factors and the baseline FPS, the relative effect of mailing compared with non‐mailing on three‐month GA category was OR 1.14 (95% CI 1.04–1.25, P < 0.01).ConclusionsProvision of structured and individualized information to people with diabetes can positively influence the level of patient activation, promote better engagement and open the potential to improve other crucial diabetes outcomes.
Data‐driven directions for effective footwear provision for the high‐risk diabetic foot
Authors: Arts M. L. J. , de Haart M. , Waaijman R. , Dahmen R. , Berendsen H. , Nollet F. , Bus S. A. 
Published: March 2015

AbstractAimsCustom‐made footwear is used to offload the diabetic foot to prevent plantar foot ulcers. This prospective study evaluates the offloading effects of modifying custom‐made footwear and aims to provide data‐driven directions for the provision of effectively offloading footwear in clinical practice.MethodsEighty‐five people with diabetic neuropathy and a recently healed plantar foot ulcer, who participated in a clinical trial on footwear effectiveness, had their custom‐made footwear evaluated with in‐shoe plantar pressure measurements at three‐monthly intervals. Footwear was modified when peak pressure was ≥ 200 kPa. The effect of single and combined footwear modifications on in‐shoe peak pressure at these high‐pressure target locations was assessed.ResultsAll footwear modifications significantly reduced peak pressure at the target locations compared with pre‐modification levels (range –6.7% to –24.0%, P < 0.001). The metatarsal heads were most frequently targeted. Repositioning an existing (trans‐)metatarsal pad in the shoe insole (–15.9% peak pressure relief), applying local cushioning to the insole (–15.0%) and replacing the insole top cover with Plastazote (–14.2%) were the most effective single modifications. Combining a new Plastazote top cover with a trans‐metatarsal bar (–24.0% peak pressure relief) or with local cushioning (–22.0%) were the most effective combined modifications.ConclusionsIn people with diabetic neuropathy and a recently healed plantar foot ulcer, significant offloading can be achieved at high‐risk foot regions by modifying custom‐made footwear. These results provide data‐driven directions for the design and evaluation of custom‐made footwear for high‐risk people with diabetes, and essentially mean that each shoe prescribed should incorporate those design features that effectively offload the foot.
A genetic diagnosis of maturity‐onset diabetes of the young (MODY): experiences of patients and family members
Authors: Bosma A. R. , Rigter T. , Weinreich S. S. , Cornel M. C. , Henneman L. 
Published: March 2015

AbstractAimsGenetic testing for maturity‐onset diabetes of the young (MODY) facilitates a correct diagnosis, enabling treatment optimization and allowing monitoring of asymptomatic family members. To date, the majority of people with MODY remain undiagnosed. To identify patients' needs and areas for improving care, this study explores the experiences of patients and family members who have been genetically tested for MODY.MethodsFourteen semi‐structured interviews with patients and the parents of patients, and symptomatic and asymptomatic family members were conducted. Atlas.ti was used for thematic analysis.ResultsMost people with MODY were initially misdiagnosed with Type 1 or Type 2 diabetes; they had been seeking for the correct diagnosis for a long time. Reasons for having a genetic test included reassurance, removing the uncertainty of developing diabetes (in asymptomatic family members) and informing relatives. Reasons against testing were the fear of genetic discrimination and not having symptoms. Often a positive genetic test result did not come as a surprise. Both patients and family members were satisfied with the decision to get tested because it enabled them to adjust their lifestyle and treatment accordingly. All participants experienced a lack of knowledge of MODY among healthcare professionals, in their social environment and in patient organizations. Additionally, problems with the reimbursement of medical expenses were reported.ConclusionsPatients and family members are generally positive about genetic testing for MODY. More education of healthcare professionals and attention on the part of diabetes organizations is needed to increase awareness and optimize care and support for people with MODY.
Successful self‐management among non‐insulin‐treated adults with Type 2 diabetes: a self‐regulation perspective
Authors: Tanenbaum M. L. , Leventhal H. , Breland J. Y. , Yu J. , Walker E. A. , Gonzalez J. S. 
Published: March 2015

AbstractAimsTo clarify the role of self‐monitoring of blood glucose (SMBG) in the self‐management of Type 2 diabetes from the patient's perspective, using in‐depth interviews with non‐insulin‐treated adults to investigate how they learned to manage their diabetes effectively and whether SMBG played a significant role in this process.MethodsIndividual interviews were conducted with 14 non‐insulin‐treated adults with Type 2 diabetes who had significantly improved their glycaemic control [64% women; 50% black; 21% Hispanic; mean age 60 years; mean HbA1c concentration 43 mmol/mol (6.1%)]. Interviews were transcribed and analysed by a coding team, applying the concept of illness coherence from the Common Sense Model of Self‐Regulation.ResultsThe majority of participants relied on SMBG to evaluate their self‐management efforts. Key themes included: adopting an experimental approach; experiencing ‘a‐ha’ moments; provider‐assisted problem‐solving; using SMBG and other feedback to evaluate when their efforts were working; and normalizing diabetes‐specific behaviour changes as being healthy for everyone.ConclusionsOur qualitative data are consistent with the argument that SMBG, if implemented appropriately with enough education and provider access, can be a powerful tool for non‐insulin‐treated adults with Type 2 diabetes to monitor their self‐management. Establishing sufficient conditions for illness coherence to develop while individuals are learning to use SMBG could increase their sense of personal control in managing a complex and demanding illness.
Changes in physical activity among adults with diabetes: a longitudinal cohort study of inactive patients with Type 2 diabetes who become physically active
Authors: Palakodeti S. , Uratsu C. S. , Schmittdiel J. A. , Grant R. W. 
Published: March 2015

AbstractAimsTo identify the predictors and clinical effects among inactive patients with diabetes who become physically active, in the setting of a large integrated health system.MethodsWe studied adults with Type 2 diabetes with at least two clinic visits between December 2011 and November 2012 who reported being inactive at their first visit. The mean (±sd) interval between their first and last visit was 6.2 (±2.3) months. We analysed self‐reported moderate‐to‐vigorous physical activity data collected using a structured intake form during routine clinical care.ResultsThe study cohort (N = 6853) had a mean age of 60.2 years; 51.4% were women and 53.6% were non‐white. Nearly two‐thirds (62.5%, n = 4280) reported remaining physically inactive, while 16.0% reported achieving the recommended moderate‐to‐vigorous physical activity levels (≥ 150 min/week) by the last visit of the study period. Female gender (odds ratio 0.77, 95% CI 0.67, 0.88), obesity (BMI 30–34.9 kg/m2: odds ratio 0.76, 95% CI 0.60, 0.97; BMI ≥ 35 kg/m2: odds ratio 0.55, 95% CI 0.42, 0.70), chronic kidney disease (odds ratio 0.78, 95% CI 0.65, 0.94) and depression (odds ratio 0.77, 95% CI 0.62, 0.96) were each independently associated with not achieving the recommended moderate‐to‐vigorous physical activity level, while physician referral to lifestyle education was a positive predictor (odds ratio 1.40, 95% CI 1.09, 1.85). Controlling for baseline differences, patients achieving the recommended moderate‐to‐vigorous physical activity target lost 1.0 kg more weight compared with patients remaining inactive (P < 0.001).ConclusionsPatients with diabetes in a real‐world clinical setting lost weight after becoming physically active; however, nearly two‐thirds of patients remained inactive. Novel interventions to address physical inactivity in primary care should address barriers faced by older patients with medically complex disease.
Diagnosis and assessment of peripheral arterial disease in the diabetic foot
Authors: Brownrigg J. R. W. , Schaper N. C. , Hinchliffe R. J. 
Published: March 2015

AbstractApproximately half of all patients with a diabetic foot ulcer have co‐existing peripheral arterial disease. Identifying peripheral arterial disease among patients with foot ulceration is important, given its association with failure to heal, amputation, cardiovascular events and increased risk of premature mortality. Infection, oedema and neuropathy, often present with ulceration, may adversely affect the performance of diagnostic tests that are reliable in patients without diabetes. Early recognition and expert assessment of peripheral arterial disease allows measures to be taken to reduce the risk of amputation and cardiovascular events, while determining the need for revascularization to promote ulcer healing. When peripheral arterial disease is diagnosed, the extent of perfusion deficit should be measured. Patients with a severe perfusion deficit, likely to affect ulcer healing, will require further imaging to define the anatomy of disease and indicate whether a revascularization procedure is appropriate.