bluuebunny/crossref_metadata_2025_split huggingface dataset:
Numbers and Policy in Care for People with Intellectual Disability in the United Kingdom
Authors: Glover Gyles 
Published: November 2014

BackgroundStatements or commitments making use of numbers have an important place in government policy. They appear at all stages of the policy process: campaigning, formulation, monitoring and evaluation. Many types of source are involved including research studies, national survey information, routine operational data collections and special systems devised to monitor particular initiatives.MethodThe paper presents examples of policy uses of numerical evidence, and some sources of data that have been used to support them in the field of care for people with intellectual developmental disability in England.ConclusionsDifferent levels of precision or coverage are required at different stages of the process. Different types of numerical data are appropriate at the various stages of the policy process.
Building bridges in dietary counselling: an exploratory study examining the usefulness of wellness and wellbeing concepts
Authors: McMahon A.‐T. , Tay P. C. , Tapsell L. , Williams P. 
Published: November 2014

AbstractBackgroundOver the last decade, professional discourse around health ownership has been evolving to recognise an individually‐driven wellness/wellbeing approach. Concurrently, dietetic competencies have changed to include client‐centred counselling incorporating individual client's perspectives within dietary prescriptions. The present exploratory research aimed to explore how client‐centred counselling practice was being represented in the dietetic literature and to examine dietitians' perspectives about working with clients in the current environment.MethodsTo explore the professional position, a literature search was conducted using keywords encompassing client‐centred care and competency within professional dietetic journals (2001–2010). To develop a contextual case study, 10 in‐depth interviews with dietitians delivering weight‐loss prescriptions within a clinical trial were conducted. Recordings of their perspectives on roles, opportunities/barriers and counselling strategies were transcribed verbatim and examined using inductive thematic and content analysis.ResultsEleven articles were incorporated into a narrative review describing practice issues related to traditional forms of consultation and the effectiveness of client‐centred approaches. The over‐riding theme from the interviews (Professional Identity Dilemma) highlighted tension felt by dietitians in their dual role as nutrition expert and counsellor, trained to deliver biomedical imperatives (clinical targets), and their challenge to accept client‐defined health perspectives. Supporting themes (Adherence factors and Constructs of health) exposed details on barriers to dietary change and the impact of contextual factors on this change that were linked to wellness and wellbeing concepts.ConclusionsAppreciating wellness and wellbeing concepts may add a useful adjunct to client‐centred approaches to dietary counselling through building bridges between clinical targets and client health perspectives.
Elevated spinal monoamine neurotransmitters after antenatal hypoxia–ischemia in rabbit cerebral palsy model
Authors: Drobyshevsky Alexander , Takada Silvia Honda , Luo Kehuan , Derrick Matthew , Yu Lei , Quinlan Katharina A. , Vasquez‐Vivar Jeannette , Nogueira Maria Inês , Tan Sidhartha 
Published: November 2014

AbstractWe hypothesized that a deficiency in the descending serotonergic input to spinal cord may underlie postnatal muscle hypertonia after global antenatal hypoxic‐ischemic injury in a rabbit model of cerebral palsy. Neurotransmitter content was determined by HPLC in the spinal cord of newborns with and without muscle hypertonia after fetal global hypoxic‐ischemic brain injury and naïve controls. Contrary to our hypothesis, serotonin levels in both cervical and lumbar expansions and norepinephrine in cervical expansion were increased in hypertonic kits relative to non‐hypertonic kits and controls, with unchanged number of serotonergic cells in caudal raphe by stereological count. Serotonergic fiber length per unit of volume was also increased in hypertonic kits’ cervical and lumbar spinal cord, both in dorsal and ventral horns. Gene expression of serotonin transporter was increased and 5‐HTR2 receptors were decreased in hypertonic kits relative to controls in cervical and lumbar cord. Intrathecal administration of non‐selective serotonin receptor inhibitor methysergide decreased muscle tone in hypertonic kits only. Conversely, intrathecal administration of serotonin solution increased muscle tone only in non‐hypertonic kits. We speculate that maturation of serotonergic system in spinal cord may be directly affected by decreased corticospinal connectivity after antenatal hypoxic‐ischemic brain injury.
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Following prenatal hypoxia–ischemia, newborn rabbits exhibit elevated levels of serotonin in the spinal cord that were linked to muscle hypertonia. Serotonergic terminal density was also increased in hypertonic newborns’ spinal cord. Intrathecal administration of the non‐selective serotonin receptor inhibitor methysergide decreased muscle tone in hypertonic newborns only. Elevated spinal serotonin thus suggests a novel pathophysiological mechanism of hypertonia in cerebral palsy.
Different effects of bisphenol‐A on memory behavior and synaptic modification in intact and estrogen‐deprived female mice
Authors: Xu Xiaohong , Gu Ting , Shen Qiaoqiao 
Published: November 2014

AbstractBisphenol‐A (BPA) has the capability of interfering with the effects of estrogens on modulating brain function. The purpose of this study was to investigate the effects of BPA on memory and synaptic modification in the hippocampus of female mice under different levels of cycling estrogen. BPA exposure (40, 400 μg/kg/day) for 8 weeks did not affect spatial memory and passive avoidance task of gonadally intact mice but improved ovariectomy (Ovx)‐induced memory impairment, whereas co‐exposure of BPA with estradiol benzoate (EB) diminished the rescue effect of EB on memory behavior of Ovx mice. The results of morphometric measurement showed that BPA positively modified the synaptic interface structure and increased the synaptic density of CA1 pyramidal cell in the hippocampus of Ovx females, but inhibited the enhancement of EB on synaptic modification and synaptogenesis of Ovx mice. Furthermore, BPA up‐regulated synaptic proteins synapsin I and PSD‐95 and NMDA receptor NR2B but inhibited EB‐induced increase in PSD‐95 and NR2B in the hippocampus of Ovx mice. These results suggest that BPA interfered with normal hormonal regulation in synaptic plasticity and memory of female mice as a potent estrogen mimetic and as a disruptor of estrogen under various concentrations of cycling estrogen.
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We showed that bisphenol‐A (BPA) improved ovariectomy (Ovx)‐induced memory impairment but diminished the rescue effect of estradial on memory of Ovx mice. BPA increased the synaptic density of the Ovx hippocampus, but inhibited the enhancement of estradial on synaptogenesis of Ovx mice. Our findings provided evidence hat BPA interfered with hormonal regulation in synaptic plasticity and memory of female mice as a potent estrogen mimetic and as a disruptor of estrogen under various concentration of cycling estrogen.
Identification of the role of bone morphogenetic protein (BMP) and transforming growth factor‐β (TGF‐β) signaling in the trajectory of serotonergic differentiation in a rapid assay in mouse embryonic stem cells in vitro
Authors: Yamasaki Atsushi , Kasai Atsushi , Toi Akihiro , Kurita Maki , Kimoto Saki , Hayata‐Takano Atsuko , Nakazawa Takanobu , Nagayasu Kazuki , Shintani Norihito , Hashimoto Ryota , Ito Akira , Meltzer Herbert Y. , Ago Yukio , Waschek James A. , Onaka Yusuke , Matsuda Toshio , Baba Akemichi , Hashimoto Hitoshi 
Published: November 2014

AbstractThe mechanism by which extracellular molecules control serotonergic cell fate remains elusive. Recently, we showed that noggin, which inactivates bone morphogenetic proteins (BMPs), induces serotonergic differentiation of mouse embryonic (ES) and induced pluripotent stem cells with coordinated gene expression along the serotonergic lineage. Here, we created a rapid assay for serotonergic induction by generating knock‐in ES cells expressing a naturally secreted Gaussia luciferase driven by the enhancer of Pet‐1/Fev, a landmark of serotonergic differentiation. Using these cells, we performed candidate‐based screening and identified BMP type I receptor kinase inhibitors LDN‐193189 and DMH1 as activators of luciferase. LDN‐193189 induced ES cells to express the genes encoding Pet‐1, tryptophan hydroxylase 2, and the serotonin transporter, and increased serotonin release without altering dopamine release. In contrast, TGF‐β receptor inhibitor SB‐431542 selectively inhibited serotonergic differentiation, without changing overall neuronal differentiation. LDN‐193189 inhibited expression of the BMP signaling target gene Id, and induced the TGF‐β target gene Lefty, whereas the opposite effect was observed with SB‐431542. This study thus provides a new tool to investigate serotonergic differentiation and suggests that inhibition of BMP type I receptors and concomitant activation of TGF‐β receptor signaling are implicated in serotonergic differentiation.
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Candidate‐based screening for serotonergic induction using a rapid assay in mouse embryonic stem cells revealed that the bone morphogenetic protein (BMP) type I receptor kinase inhibitors selectively induce serotonergic differentiation, whereas the TGF‐β receptor inhibitor SB‐431542 inhibits the differentiation. These results suggest that inhibition of BMP type I receptors and concomitant activation of transforming growth factor‐β (TGF‐β) receptor signaling are involved in the early trajectory of serotonergic differentiation.
To what extent is the work environment of staff related to person‐centred care? A cross‐sectional study of residential aged care
Authors: Sjögren Karin , Lindkvist Marie , Sandman Per‐Olof , Zingmark Karin , Edvardsson David 
Published: November 2014

Aims and objectivesTo explore the relationship between staff characteristics, perceived work environment and person‐centred care in residential aged care units.BackgroundPerson‐centred care is often described as the model of choice in residential aged care and in the care of persons with dementia. Few empirical studies have reported on the relationship between how staff experience different aspects of their work and person‐centred care.DesignThe study had a cross‐sectional quantitative design.MethodsStaff in 151 residential aged care units in Sweden (n = 1169) completed surveys which included questions about staff characteristics, valid and reliable measures of person‐centred care, satisfaction with work and care, job strain, stress of conscience and psychosocial unit climate. Statistical analyses of correlations, group differences and multiple linear regression analysis estimated with generalised estimating equation were conducted.ResultsHigher levels of staff satisfaction, lower levels of job strain, lower levels of stress of conscience, higher levels of a supportive psychosocial unit climate and a higher proportion of staff with continuing education in dementia care were associated with higher levels of person‐centred care. Job strain and a supportive psychosocial climate, explained most of the variation in person‐centred care.ConclusionsThis study shows that the work environment as perceived by staff is associated with the extent to which staff perceive the care as being person‐centred in residential aged care. These empirical findings support the theoretical postulation that the work environment is an important aspect of person‐centred care.Relevance to clinical practicePromoting a positive and supportive psychosocial climate and a work environment where staff experience balance between demands and control in their work, to enable person‐centred care practice, seems to be important implications for managers and leaders in residential aged care.
Interventions combining motivational interviewing and cognitive behaviour to promote medication adherence: a literature review
Authors: Spoelstra Sandra L. , Schueller Monica , Hilton Melissa , Ridenour Kimberly 
Published: November 2014

Aims and objectivesThis article presents an integrative review of the evidence for combined motivational interviewing and cognitive behavioural interventions that promote medication adherence. We undertook this review to establish a scientific foundation for development of interventions to promote medication adherence and to guide clinical practice.BackgroundThe World Health Organization has designated medication adherence as a global problem. Motivational interviewing and cognitive behaviour interventions have been found to individually promote medication adherence. However, there is a gap in the literature on the effect of combined motivational interviewing and cognitive behavioural approaches to promote medication adherence.DesignIntegrative review.MethodsCOCHRANE, PubMed and CINAHL were searched to access relevant studies between 2004–2014. Inclusion criteria were interventions combining motivational interviewing and cognitive behavioural therapy with medication adherence as the outcome. Articles were assessed for measures of adherence and methodological rigour. Analysis was performed using an integrative review process.ResultsSix articles met the inclusion criteria. A randomised controlled trial reported pretreatment missed doses of 5·58 and post‐treatment of 0·92 and trended towards significance. Four cohort studies had effect sizes of 0·19–0·35 (p < 0·05). A case study had a pretreatment adherence rate of 25% and post‐treatment 77% (p < 0·01).ConclusionsAlthough there were a limited number of studies on combined motivational interviewing and cognitive behavioural interventions, five out of six were effective at improving medication adherence. Future studies with large rigorous randomised trials are needed.Relevance to clinical practiceThis review provides clinicians with the state of the science in relation to combined motivational interviewing and cognitive behavioural therapy interventions that promote medication adherence. A summary of intervention components and talking points are provided to aid nurses in informing decision‐making and translating evidence into practice.
Risk score comprising maternal and obstetric factors to identify late preterm infants at risk for neonatal intensive care unit admission
Authors: Phaloprakarn Chadakarn , Manusirivithaya Sumonmal , Boonyarittipong Payon 
Published: November 2014

AbstractAimThe aim of this study was to develop and validate an antepartum risk score based on maternal and obstetric characteristics to predict the requirement for neonatal intensive care unit (NICU) admission among late preterm infants.Material and MethodsA chart review was performed of 455 singleton late preterm deliveries at our institution between July 2010 and December 2011. Logistic regression analysis was used to develop a risk score, which was derived from β coefficients of the significant variables. A receiver–operator curve was plotted to determine the optimal cut‐off score for predicting NICU admission. Validation of the score was tested in another cohort of 450 women who delivered a singleton late preterm infant between January 2012 and June 2013.ResultsA total of 98 infants (21.5%) in the development cohort were admitted to the NICU. The significant factors for NICU admission included: premature rupture of membranes, antepartum hemorrhage, medical disorders during pregnancy, prenatal estimation of fetal weight, gestational age at delivery, and mode of delivery. These six variables were integrated into a risk‐scoring model, which ranged from −2 to 9 points. A cut‐off score of ≥1 produced the maximum area under the receiver–operator curve of 0.764. At this cut‐off point, the sensitivity was 79.6% and specificity was 73.1%. When the risk score was tested in the validation cohort, similar results were demonstrated.ConclusionAn antepartum risk score was developed to predict the requirement for NICU admission among late preterm infants and was validated in an independent cohort.
Lipid‐soluble fraction of Shakuyaku‐kanzo‐to inhibits myometrial contraction in pregnant women
Authors: Sumi Genichiro , Yasuda Katsuhiko , Tsuji Shoko , Kanamori Chiharu , Tsuzuki Tomoko , Cho Hisayuu , Nishigaki Akemi , Okada Hidetaka , Kanzaki Hideharu 
Published: November 2014

AbstractAimShakuyaku‐kanzo‐to, a Kampo medicine composed equally of shakuyaku and kanzo, is an antispasmodic drug that can inhibit contraction of uterine smooth muscles in pregnant women and rats. We aimed to test the inhibitory effects of water‐ and lipid‐soluble extracts of shakuyaku‐kanzo‐to, shakuyaku, and kanzo in order to identify the fraction responsible for inhibiting uterine smooth muscle contraction in pregnancy.Material and MethodsMyometrial tissues were obtained from pregnant women and rats. The water‐ and lipid‐soluble fractions of shakuyaku‐kanzo‐to, shakuyaku, and kanzo were obtained using the method of Bligh and Dyer. Lipid‐soluble fractions were also partially purified using thin‐layer chromatography (TLC) with a chloroform : methanol : water (65:25:4 by volume) solvent system to yield four TLC fractions. The effect of each fraction on oxytocin‐induced myometrial contraction was examined in vitro.ResultsLipid‐soluble fractions obtained from shakuyaku‐kanzo‐to and kanzo inhibited myometrial contraction; water‐soluble fractions had no effect. Of the four TLC fractions, the inhibitory effect was greatest with TLC fraction 1 (0.75 < Rf value ≤ 1.0). Neither the water‐soluble nor the lipid‐soluble fraction from shakuyaku inhibited myometrial contraction.ConclusionsThese results suggest that lipid‐soluble substances with low polarity derived from kanzo are responsible for the inhibitory effect of shakuyaku‐kanzo‐to on myometrial contraction.
Statins and Male Sexual Health: A Retrospective Cohort Analysis
Authors: Davis Richard , Reveles Kelly R. , Ali Sayed K. , Mortensen Eric M. , Frei Christopher R. , Mansi Ishak 
Published: November 2014

ABSTRACT

Introduction
Conflicting reports exist regarding the role of statins in male gonadal and sexual function. Some studies report a beneficial effect, particularly for erectile dysfunction (ED), through statins’ anti-inflammatory and cardiovascular protective properties. Others suggest that statins might be associated with sexual dysfunction through negative effects on hormone levels.

Aim
This study aims to compare the risk of gonadal or sexual dysfunction in statin users vs. nonusers in a single-payer healthcare system.

Methods
This was a retrospective cohort study of all male patients (30–85 years) enrolled in the Tricare San Antonio market. Using 79 baseline characteristics, we created a propensity score-matched cohort of statin users and nonusers. The study duration was divided into a baseline period (October 1, 2003 to September 30, 2005) to describe patient baseline characteristics, and a follow-up period (October 1, 2005 to March 1, 2012) to determine patient outcomes. Statin users were defined as those prescribed a statin for ≥3 months between October 1, 2004 and September 30, 2005.

Main Outcome Measures
Outcomes were identified as the occurrence of benign prostatic hypertrophy (BPH), ED, infertility, testicular dysfunction, or psychosexual dysfunction during the follow-up period as identified by inpatient or outpatient International Classification of Diseases, 9th Revision, Clinical Modification codes. Logistic regression was used to determine the association of statin use with patient outcomes.

Results
Of 20,731 patients who met study criteria, we propensity score-matched 3,302 statin users with 3,302 nonusers. Statin use in men was not significantly associated with an increased or decreased risk of BPH (odds ratio [OR] 1.08; 95% confidence interval [CI] 0.97–1.19), ED (OR 1.01; 95% CI 0.90–1.13), infertility (OR 1.22; 95% CI 0.66–2.29), testicular dysfunction (OR 0.91; 95% CI 0.73–1.14), or psychosexual dysfunction (OR 1.03; 95% CI 0.94–1.14).

Conclusions
Statin use was not associated with increased risk of being diagnosed with gonadal or sexual dysfunction in men. Further studies using a larger sample may be needed.
Changes in Physical Properties of Enzyme‐Treated Beef Before and After Mastication
Authors: Takei Ryo , Hayashi Masahiro , Umene Shingo , Narita Kazuyoshi , Kobayashi Yasunori , Masunaga Hiroaki 
Published: November 2014

AbstractThis study was conducted to determine whether enzymatically softened beef is more easily ingested by individuals with decreased masticatory function while retaining the original appearance and palatability using a homogeneous enzyme permeation (HEP) method. The number of mastication cycles required to induce the first swallow of normally cooked beef (NB) and HEP‐treated beef (HEPB) was investigated. Pre‐ and post‐mastication samples were also tested for firmness, viscoelastic properties, compression stress and disintegrability. Compared with NB, HEPB was shown to require less than one‐third the number of mastication cycles while retaining approximately 1/15 the firmness. HEP treatment reduced the coefficient of viscosity to less than 1/20 of NB. Stress increased abruptly with compression of post‐mastication NB samples, while a lower increase was observed for HEPB. Disintegration tests revealed fewer residues for HEPB.HEPB demonstrated sufficient softness, good deformability and quick water dispersibility while retaining the same shape as NB.Practical ApplicationWith these features, beef made using the homogeneous enzyme permeation method is expected to expand the applicability of oral nutrition and help establish a new approach to nutritional management for people with difficulty masticating. This technology has already been used for food products named “iEat” (EN Otsuka Pharmaceutical Co., Ltd., Japan), which are produced for patients with masticatory difficulties.
Community assembly in a tropical cloud forest related to specific leaf area and maximum species height
Authors: Long Wenxing , Schamp Brandon S. , Zang Runguo , Ding Yi , Huang Yunfeng , Xiang Yangzhou 
Published: November 2014

AbstractQuestionWe tested whether co‐existing tree species in tropical dwarf forests were deterministically assembled along gradients of air temperature, relative humidity and light availability, according to two important functional traits, specific leaf area (SLA) and maximum species height (Hmax).LocationTropical montane cloud forest, Bawangling Nature Reserve, Hainan Island, south China.MethodsNull model analyses were used in conjunction with trait and species composition data collected to test our hypotheses at four plot sizes (25 m2, 100 m2, 400 m2 and 900 m2), addressing whether the consistent importance of variation in SLA and Hmax extends to these unique forests, as well as theoretical predictions concerning how patterns change with plot size.ResultsLow SLA species were significantly over‐represented within forest communities for the two largest plot sizes, and taller‐growing tree species were over‐represented across all four plot sizes. Plot‐level analyses indicated that low SLA species were associated with lower temperatures.ConclusionsOur results show that tropical dwarf forests are deterministically assembled with respect to these two traits, and are consistent with other studies indicating that SLA responds to abiotic filters. Co‐existing tree species were not significantly divergent for these two traits, indicating that variation in these two traits among trees does not contribute to niche differences (i.e. limiting similarity) and therefore co‐existence within forest plots. Finally, our study demonstrates that patterns of community assembly change with plot size; however, trait convergence did not increase with plot size as previously predicted.