bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reported medication errors after introducing an electronic medication management system
Authors: Redley Bernice , Botti Mari 
Published: September 2012

Aims and objectivesTo explore the effects of introducing an electronic medication management system on reported medication errors.BackgroundComputerised medication management systems have been found to improve medication safety; however, introducing medication management system into healthcare environments can create unanticipated or new problems and opportunities for medication error.DesignDescriptive analysis of medication error reports.MethodsThis was a retrospective analysis of 359 incident reports drawn from the period of 1 May 2005–30 April 2006 across two hospital sites of a single not‐for‐profit private health service located in metropolitan Melbourne. Site A used a conventional pen and paper system for medication management, and Site B had introduced a computerised medication management system.ResultsMost medication errors occurred at the nurse administration (71·5%) and prescribing (16·4%) stages of delivery. The most common medication error type reported at Site A was omission (33%), and at Site B was wrong documentation (24·2%). A higher proportion of errors at the prescribing phase, and less nurse administration errors, were detected at Site B where the medication management system was in use. The incidence of other, less frequent errors was similar across the two hospital sites.ConclusionsThis examination of medication error reports suggests there are differences in the types of medication errors that are reported in association with the introduction of electronic medication management system compared to pen and paper system systems. The findings provide a new insight into the effects of introducing an electronic medication management system on the types of medication errors reported.Relevance to clinical practiceThe findings provide a new insight into the types of medication errors that are reported during implementation of an electronic medication management system. Extra support for physicians prescribing practices should be considered.
Effect of congenital heart defects on language development in toddlers with Down syndrome
Authors: Visootsak J. , Hess B. , Bakeman R. , Adamson L. B. 
Published: September 2012

AbstractBackgroundDown syndrome (DS, OMIM #190685) is the most commonly identified genetic form of intellectual disability with congenital heart defect (CHD) occurring in 50% of cases. With advances in surgical techniques and an increasing lifespan, this has necessitated a greater understanding of the neurodevelopmental consequences of CHDs. Herein, we explore the impact of CHD on language development in children with DS.MethodsTwenty‐nine children with DS were observed systematically in parent–child interactions using the Communication Play Protocol to evaluate their language use; they also completed the Mullen Scales of Early Learning and MacArthur Communication Development Inventory. Mean ages were 31.2 months for children with DS and CHD (DS + CHD, n = 12) and 32.1 months for children with DS and a structurally normal heart (DS − CHD, n = 17).ResultsCompared with the DS − CHD controls, the DS + CHD group revealed lower scores in multiple areas, including fine motor skills and expressive and receptive vocabulary. Whereas most differences were not statistically significant, the Communication Development Inventory word count and symbol‐infused joint engagement differed significantly (P < 0.01) and marginally (P = 0.09) between groups.ConclusionsFinding that CHDs may account for part of the variation in language delay allows us to consider the specific mechanisms underlying the impact of CHDs on language acquisition in children with DS. Conclusions from this first study on early language outcomes of children with DS + CHD may be useful for clinicians in providing developmental surveillance and early intervention programmes with specific emphasis on language therapy as part of long‐term follow‐up for children with DS + CHD.
Caregiving of children with intellectual disabilities in China – an examination of affiliate stigma and the cultural thesis
Authors: Chiu M. Y. L. , Yang X. , Wong F. H. T. , Li J. H. , Li J. 
Published: September 2012

AbstractBackgroundWhile caregivers of children with intellectual disabilities are burdened in every part of the world, it is suspected that particular contexts may make the situation worse. There is little literature on caregivers in China, where familial and clan responsibility rather than individual effort is emphasised, and where communal support, while treasured, is often lacking.MethodA total of 211 caregivers in two cities, one with and the other without randomised design, participated in a survey study that assessed affiliated stigma, loss of face, anxiety, mental health and empowerment.ResultsA proportion of 60.6% of participants were found to be conspicuous cases with mental disturbance of a level which required further professional attention. Participants with better resource appeared to have coped better, enjoying lower psychological distress, lower anxiety and a higher level of personal empowerment. Multiple regression analysis revealed that mental health is related to the affective dimension of affiliated stigma, loss of face and anxiety level. This was found to account for more than half the variance (55%).DiscussionThe subjective burden of care occurs not in isolation but in a cultural field. Chinese caregiving is characterised by a lack of formal support, and such cultural concerns as loss of face and strong affiliated stigma. This socio‐political context makes caregiving all the more challenging. The situation has to be addressed by both practitioners and policy makers if family caregiving is to be valued and made sustainable.
Quantitative 3D evaluation of step ascent and descent in individuals with Down syndrome – analysis of a daily challenging task
Authors: Galli M. , Cimolin V. , Ferrario D. , Patti P. , Heaney G. , Freedland R. , Albertini G. , Brown W. T. 
Published: September 2012

AbstractBackgroundStep ascent and descent can perturb stability increasing the incidence of falls, especially in older individuals with functional limitations and intellectual disabilities, such as those with Down syndrome (DS). The aim of this study was to investigate the biomechanics and motor coordination of step ascent and descent in adults with DS and compare them with a group of healthy individuals, considering movement kinematics and kinetics.MethodFourteen adults with DS and 12 similarly aged adults without DS who were free of known motor problems were quantitatively assessed during ascending and descending a step using an optoelectronic system (BTS SMART‐D), force platforms and video recording. Kinematic and kinetic parameters were identified and calculated for each study participant and comparisons were made between the DS and a control group (CG).ResultsDespite similar age ranges, subjects in the DS group performed the step ascent and descent movements slower, with longer duration and with a more accentuated range of motion of the trunk and of the ankle joint than those in the CG. Additionally, the double stance phase on the step was substantially longer in the DS group when represented as a percentage of the entire stepping sequence (ascent, double stance on the step and descent). In terms of kinetics, ground force platform data revealed that the DS subjects showed higher instability in the medio‐lateral direction during double support phase than similarly aged CG subjects and cannot be attributed to age‐associated changes in stability.ConclusionsThese findings help to elucidate the complex biomechanical strategy of people with DS during a step ascent and descent movement task and may have a major role in the multidimensional evaluation and tailored management for them.
Recommendations for utilizing and reporting population genetic analyses: the reproducibility of genetic clustering using the program structure
Authors: Gilbert Kimberly J. , Andrew Rose L. , Bock Dan G. , Franklin Michelle T. , Kane Nolan C. , Moore Jean‐Sébastien , Moyers Brook T. , Renaut Sébastien , Rennison Diana J. , Veen Thor , Vines Timothy H. 
Published: September 2012

AbstractReproducibility is the benchmark for results and conclusions drawn from scientific studies, but systematic studies on the reproducibility of scientific results are surprisingly rare. Moreover, many modern statistical methods make use of ‘random walk’ model fitting procedures, and these are inherently stochastic in their output. Does the combination of these statistical procedures and current standards of data archiving and method reporting permit the reproduction of the authors' results? To test this, we reanalysed data sets gathered from papers using the software package structure to identify genetically similar clusters of individuals. We find that reproducing structure results can be difficult despite the straightforward requirements of the program. Our results indicate that 30% of analyses were unable to reproduce the same number of population clusters. To improve this, we make recommendations for future use of the software and for reporting structure analyses and results in published works.
Detecting genes for variation in parasite burden and immunological traits in a wild population: testing the candidate gene approach
Authors: Brown E. A. , Pilkington J. G. , Nussey D. H. , Watt K. A. , Hayward A. D. , Tucker R. , Graham A. L. , Paterson S. , Beraldi D. , Pemberton J. M. , Slate J. 
Published: September 2012

AbstractIdentifying the genes underlying phenotypic variation in natural populations can provide novel insight into the evolutionary process. The candidate gene approach has been applied to studies of a number of traits in various species, in an attempt to elucidate their genetic basis. Here, we test the application of the candidate gene approach to identify the loci involved in variation in gastrointestinal parasite burden, a complex trait likely to be controlled by many loci, in a wild population of Soay sheep. A comprehensive literature review, Gene Ontology databases, and comparative genomics resources between cattle and sheep were used to generate a list of candidate genes. In a pilot study, these candidates, along with 50 random genes, were then sequenced in two pools of Soay sheep; one with low gastrointestinal nematode burden and the other high, using a NimbleGen sequence capture experiment. Further candidates were identified from single nucleotide polymorphisms (SNPs) that were highly differentiated between high‐ and low‐resistance sheep breeds. A panel of 192 candidate and control SNPs were then typed in 960 individual Soay sheep to examine whether they individually explained variation in parasite burden, as measured as faecal egg count, as well as two immune measures (Teladorsagia circumcincta‐specific antibodies and antinuclear antibodies). The cumulative effect of the candidate and control SNPs were estimated by fitting genetic relationship matrices (GRMs) as random effects in animal models of the three traits. No more significant SNPs were identified in the pilot sequencing experiment and association study than expected by chance. Furthermore, no significant difference was found between the proportions of candidate or control SNPs that were found to be significantly associated with parasite burden/immune measures. No significant effect of the candidate or control gene GRMs was found. There is thus little support for the candidate gene approach to the identification of loci explaining variation in parasitological and immunological traits in this population. However, a number of SNPs explained significant variation in multiple traits and significant correlations were found between the proportions of variance explained by individual SNPs across multiple traits. The significant SNPs identified in this study may still, therefore, merit further investigation.
The impact of increasing the upper age limit of donation on the eligible blood donor population in Canada
Authors: Fan W. , Yi Q.‐L. , Xi G. , Goldman M. , Germain M. , O'Brien S.F. 
Published: September 2012

SUMMARYObjectivesUsing population prevalence data for deferrable diseases/conditions we estimated the Canadian population eligible to donate according to three upper‐age limit scenarios.BackgroundThe donor selection criteria limit the number of potential blood donors but relaxing the upper age criteria could mitigate this.Methods and MaterialsForty deferral criteria were identified and their corresponding prevalence data obtained to estimate the number of people excluded by the criteria. The eligible blood donor population was estimated from national census data taking the age limits, deferral criteria and deferral time‐period into account. As more than one disease/condition may co‐exist, the estimate was adjusted to avoid over‐representation.ResultsOf about 33 million Canadians aged 17 (18 in Québec) to 65, 15·1 million (45·8%) are eligible to donate blood. This number increases to 15·7 million when including people up to 71 years and to 17·1 million in the absence of an upper age limit.ConclusionAs about 1·2 million units are collected from 600 000 donors annually, there are more than enough eligible people to meet the need. However, recruitment of donors is challenging and the absence of an upper age limit allows an additional 2 million people to donate. Other countries may wish to consider modification of the upper age criterion to address the effect of an aging population on the blood supply.
Self‐pollination and parthenocarpic ability in developing ovaries of self‐incompatible Clementine mandarins (Citrus clementina)
Authors: Mesejo Carlos , Yuste Roberto , Martínez‐Fuentes Amparo , Reig Carmina , Iglesias Domingo J. , Primo‐Millo Eduardo , Agustí Manuel 
Published: September 2012

This study aimed to determine if self‐pollination is needed to trigger facultative parthenocarpy in self‐incompatible Clementine mandarins (Citrus clementina Hort. ex Tan.). ‘Marisol’ and ‘Clemenules’ mandarins were selected, and self‐pollinated and un‐pollinated flowers from both cultivars were used for comparison. These mandarins are always seedless after self‐pollination and show high and low ability to develop substantial parthenocarpic fruits, respectively. The time‐course for pollen grain germination, tube growth and ovule abortion was analyzed as well as that for carbohydrates, active gibberellins (GA1 and GA4), auxin (IAA) and abscisic acid (ABA) content in the ovary. ‘Clemenules’ showed higher pollen grain germination, but pollen tube development was arrested in the upper style 9 days after pollination in both cultivars. Self‐pollination did not stimulate parthenocarpy, whereas both un‐pollinated and self‐pollinated ovaries set fruit regardless of the cultivar. On the other hand, ‘Marisol’ un‐pollinated flowers showed greater parthenocarpic ovary growth than ‘Clemenules’ un‐pollinated flowers, i.e. higher ovule abortion rate (+21%), higher fruit set (+44%) and higher fruit weight (+50%). Further, the greater parthenocarpic ability of ‘Marisol’ paralleled higher levels of GA1 in the ovary (+34% at anthesis). ‘Marisol’ ovary also showed higher hexoses and starch mobilization, but lower ABA levels (−64% at anthesis). Self‐pollination did not modify carbohydrates or GA content in the ovary compared to un‐pollination. Results indicate that parthenocarpy in the Clementine mandarin is pollination‐independent with its ability to set depending on the ovary hormone levels. These findings suggest that parthenocarpy in fertile self‐incompatible mandarins is constitutively regulated.
A smaller endotracheal tube combined with intravenous lidocaine decreases post‐operative sore throat – a randomized controlled trial
Authors: XU Y. J. , WANG S. L. , REN Y. , ZHU Y. , TAN Z. M. 
Published: September 2012

BackgroundPost‐operative sore throat (POST) has increasingly been a common clinical complication particularly in thyroid surgery. We conducted a trial to evaluate the effect of non‐pharmacological [smaller‐sized endotracheal tube (ETT)] combined with pharmacological intervention [lidocaine intravenous (i.v.)] on POST in women undergoing thyroid surgery.MethodsTwo hundred and forty patients scheduled for thyroid surgery were randomly divided into four groups: Group A, ETT size 7.0 with saline; Group B, ETT size 6.0 with saline; Group C, ETT size 7.0 with lidocaine; Group D, ETT size 6.0 with lidocaine. Patients in Groups C and D received i.v. 1.5 mg/kg lidocaine that was filled in syringe up to 10 ml 5 min before induction of anaesthesia; whereas patients in Groups A and B received an equal volume of saline. The incidence and severity of POST were evaluated at 1, 6 and 24 h after tracheal extubation.ResultsThe highest incidence of POST occurred at 6 h after extubation in all groups. The incidence of POST was significantly lower in Group D compared with Groups A (23% vs. 62%, P < 0.01), B (23% vs. 42%, P = 0.03) and C (23% vs. 43%, P = 0.02) at 6 h after extubation. Group D had significantly decreased severity of POST compared with Groups A, B and C 6 and 24 h after extubation (P < 0.05).ConclusionUse of smaller‐sized ETT combined with i.v. lidocaine decreases the incidence and severity of POST in women undergoing thyroid surgery.
Balance outcomes from two small rural hospitals
Authors: Downs Stephen , Marquez Jodie , Chiarelli Pauline 
Published: September 2012

AbstractObjectives:  To describe predicted and measured balance changes in patients receiving physiotherapy in two rural hospitals, and to explore the relationship among balance at discharge, carer availability and patients' discharge destination.Design:  Prospective measurement study.Setting:  Two rural Australian hospitals.Participants:  Eighty‐nine inpatients with a median age of 84.Main outcome measures:  Berg Balance Scale (BBS) on admission and the treating physiotherapist's estimate at admission of individual patient's discharge BBS. Follow‐up measures included discharge BBS, carer availability after discharge and patient discharge destination.Results:  Although change in measured balance of study participants had wide variability, balance measured by the BBS displayed a statistically and clinically significant improvement. A strong relationship was found between balance scores and discharge destination. However, no relationship was found between carer availability and discharge destination. Physiotherapists' estimates of discharge BBS displayed an average error of 7/56.Conclusions:  The strong relationship between measured balance and discharge destination in these elderly study participants suggests that maximising their balance might minimise admissions to nursing home. The high variability of measured balance change suggests outcomes are difficult to predict. The study results suggest that premature assessment of patient's suitability for nursing home placement should be avoided. The accuracy of physiotherapist's estimates of discharge BBS suggests that greater weight might be placed on their input to facilitate the discharge planning process.
Culture and rural health
Authors: Farmer Jane , Bourke Lisa , Taylor Judy , Marley Julia V. , Reid John , Bracksley Stacey , Johnson Nicole 
Published: September 2012

AbstractThis paper considers the role of culture in rural health, suggesting that the concept and its impacts are insufficiently understood and studied. It reviews some of the ways that culture has been considered in (rural) health, and states that culture is either used ambiguously and broadly – for example, suggesting that there is a rural culture, or narrowly – indeed perhaps interchangeably with ethnicity, for example Aboriginal culture as a unity. The paper notes that, although culture is a dynamic social concept, it has been adopted into a biomedical research paradigm as though it is fixed. Culture is often treated as though it is something that can be addressed simplistically, for example, through cultural sensitivity education. Authors suggest that culture is an unaddressed ‘elephant in the room’ in rural health, and that exploring cultural differences and beliefs and facing up to cultural differences are vital in understanding and addressing rural health and health system challenges.
Inter‐rater reliability of three adult handwriting legibility instruments
Authors: Au Eunice H. , McCluskey Annie , Lannin Natasha A. 
Published: September 2012

Background/aimLegibility is important for functional, handwritten communication. Deficits in legibility can impair occupational performance following stroke or trauma. Few instruments are available to assess adult handwriting legibility during rehabilitation. The aim of this study was to compare inter‐rater reliability of a new four‐point legibility rating instrument with two existing instruments, and describe scale structure and item difficulty of each instrument.MethodsThree trained raters scored 60 handwriting samples using: (i) a Four‐Point Scale (FPS); (ii) the modified Evaluation Tool of Children's Handwriting (mETCH); and (iii) the new modified FPS. Rater concordance and exact agreement were investigated using the intra‐class correlation coefficient (ICC3,1), multi‐rater kappa (κ) and Krippendorff's alpha (α). Cronbach's alpha was calculated to examine internal consistency reliability, and Rasch modelling was used to examine scale structure and item difficulty.ResultsRater concordance for the FPS was fair (ICC3,1 = 0.37); exact agreement was poor (κ = 0.19; α = 0.19). Rater concordance for the two mETCH subtests was fair to moderate (ICC3,1 = 0.39–0.50), but with no exact agreement (κ < 0.00). Rater concordance for three subtests of the modified FPS was slight to moderate (ICC3,1 = 0.16–0.51); exact agreement ranged from nil to fair (κ = −0.06–0.30; α = −0.05–0.30). Rasch modelling confirmed internal consistency of instruments, but was low between‐rater consistency (rater severity variability).ConclusionsA reliable instrument for measuring change over time remains elusive. In the meantime, these instruments can be used by individual clinicians to diagnose and rate legibility.
Body image and depressive symptoms in 13‐year‐old adolescents
Authors: Almeida Sandra , Severo Milton , Araújo Joana , Lopes Carla , Ramos Elisabete 
Published: September 2012

Aims:  To evaluate the prevalence of body dissatisfaction and the association with depressive symptoms in 13‐year‐old adolescents, according to gender, and also to analyse the possible modifying effect of body mass index on this association.Methods:  We evaluated 1868 adolescents as part of a population‐based study in an urban community in Porto, Portugal. Using the Figure Rating Scale, participants choose their perceived and their desired figures; body dissatisfaction was measured by the difference between these values. The Beck Disorder Inventory II was used to measure depressive symptoms. Weight and height were measured by trained interviewers. To quantify the association between depressive symptoms and body dissatisfaction, regression parameters and 95% confidence intervals (CIs) were obtained by linear regression and bootstrapping.Results:  Among females, 15.8% desired a bigger figure and 41.4% desired a thinner figure. Among males, this occurred for 34.1% and 33.5%, respectively. After adjustment, we found that body dissatisfaction was associated with increased depressive symptoms, in both genders, especially in those participants who wish to be thinner and in those presenting higher discrepancy between figures (B = 6.5, 95% CI 4.1;9.3 for females, B = 3.3, 95% CI 1.3;6.8 for males). The association between body dissatisfaction and depressive symptoms was stronger among non‐overweight (for participants who wish to be thinner: B = 5.18 95% CI 3.56; 6.95 vs. B = 3.49, 95% CI 1.70; 5.29 among females and B = 2.47, 95% CI 0.73; 4.76 vs. B = 1.60, 95% CI 0.34; 2.88 among males).Conclusions:  The direct association between the wish to be thinner and depressive symptoms was stronger among the non‐overweight youth.