bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐Term Care Financing: Lessons From France
Authors: DOTY PAMELA , NADASH PAMELA , RACCO NATHALIE 
Published: June 2015

Policy Points:
France's model of third‐party coverage for long‐term services and supports (LTSS) combines a steeply income‐adjusted universal public program for people 60 or older with voluntary supplemental private insurance.
French and US policies differ: the former pay cash; premiums are lower; and take‐up rates are higher, in part because employer sponsorship, with and without subsidization, is more common—but also because coverage targets higher levels of need and pays a smaller proportion of costs.
Such inexpensive, bare‐bones private coverage, especially if marketed as a supplement to a limited public benefit, would be more affordable to those Americans currently most at risk of “spending down” to Medicaid.
ContextAn aging population leads to a growing demand for long‐term services and supports (LTSS). In 2002, France introduced universal, income‐adjusted, public long‐term care coverage for adults 60 and older, whereas the United States funds means‐tested benefits only. Both countries have private long‐term care insurance (LTCI) markets: American policies create alternatives to out‐of‐pocket spending and protect purchasers from relying on Medicaid. Sales, however, have stagnated, and the market's viability is uncertain. In France, private LTCI supplements public coverage, and sales are growing, although its potential to alleviate the long‐term care financing problem is unclear. We explore whether France's very different approach to structuring public and private financing for long‐term care could inform the United States’ long‐term care financing reform efforts.MethodsWe consulted insurance experts and conducted a detailed review of public reports, academic studies, and other documents to understand the public and private LTCI systems in France, their advantages and disadvantages, and the factors affecting their development.FindingsFrance provides universal public coverage for paid assistance with functional dependency for people 60 and older. Benefits are steeply income adjusted and amounts are low. Nevertheless, expenditures have exceeded projections, burdening local governments. Private supplemental insurance covers 11% of French, mostly middle‐income adults (versus 3% of Americans 18 and older). Whether policyholders will maintain employer‐sponsored coverage after retirement is not known. The government's interest in pursuing an explicit public/private partnership has waned under President François Hollande, a centrist socialist, in contrast to the previous center‐right leader, President Nicolas Sarkozy, thereby reducing the prospects of a coordinated public/private strategy.ConclusionsAmerican private insurers are showing increasing interest in long‐term care financing approaches that combine public and private elements. The French example shows how a simple, cheap, cash‐based product can gain traction among middle‐income individuals when offered by employers and combined with a steeply income‐adjusted universal public program. The adequacy of such coverage, however, is a concern.
Magnesium sulfate, chorioamnionitis, and neurodevelopment after preterm birth
Authors: Kamyar M , Manuck TA , Stoddard GJ , Varner MW , Clark EAS 
Published: June 2015

ObjectiveTo assess the neuroprotective effect of magnesium sulfate (MgSO4) in preterm children exposed to chorioamnionitis.DesignA secondary analysis of a multicentre randomised controlled trial of antenatal MgSO4 administered to women at risk of preterm birth for the prevention of cerebral palsy (CP). Singleton, non‐anomalous pregnancies with clinical chorioamnionitis, delivering at ≥24 weeks of gestation, were selected. Cases were exposed to antepartum MgSO4; controls received placebo.SettingMulticentre randomised controlled trial.PopulationSingleton, non‐anomalous pregnancies with clinical chorioamnionitis, delivering at ≥24 weeks of gestation.MethodsAll data were analysed by intention to treat. Univariate and multivariate analyses were performed.Main outcome measuresPrimary outcome was a composite of stillbirth, death by the age of 1 year, or moderate or severe CP by the age of 2 years. Secondary outcomes included a composite neonatal outcome as well as neurodevelopmental delay, defined as Bayley II mental and psychomotor developmental indices <70 at the age of 2 years. Subgroup analysis assessed these outcomes in children born at <28 weeks of gestation.ResultsA total of 396 children were included, with 192 (48.5%) randomised to MgSO4. Maternal and delivery characteristics were similar between the groups. The primary outcome occurred in 14.1% of children exposed to MgSO4 and 12.7% of children exposed to placebo (relative risk, RR 1.29; 95% CI 0.70–2.38). Rates of stillbirth, death, moderate–severe CP, and neurodevelopmental delay did not differ between groups. In the subgroup analysis of children born at <28 weeks of gestation, there was no difference in the rates of the primary outcome, nor in the secondary outcomes assessed. [Correction added on 02 March 2016 after online publication: There were errors in statistical data analysis and these have been corrected throughout the article.]ConclusionsAmong children at risk for early preterm delivery exposed to chorioamnionitis, antenatal administration of MgSO4 was not associated with improved neurodevelopmental outcome. We do not recommend any change in the guidelines on the administration of MgSO4 for neuroprotection based on this study.Tweetable abstractMgSO4 was not associated with improved neurodevelopmental outcome in setting of chorioamnionitis.
Current and Recent Advanced Strategies for Combating Biofilms
Authors: Sadekuzzaman M. , Yang S. , Mizan M.F.R. , Ha S.D. 
Published: June 2015

AbstractBiofilms are matrix‐enclosed microbial aggregates that adhere to a biological or nonbiological surface. Biofilm formation is a significant problem in the medical, food, and marine industries and can lead to substantial economic and health problems. The complex microbial community of a biofilm is highly resistant to antibiotics and sanitizers and confers persistent survival that is a challenge to overcome. There are several conventional approaches to combating biofilms, physical and/or mechanical removal, chemical removal, and the use of antimicrobials, sanitizers, or disinfectants to kill biofilm organisms. However, biofilms are highly resistant to these approaches as opposed to planktonic cells. Thus, novel approaches other than the conventional methods are urgently needed. In this review, we discuss current and new advanced antibiofilm strategies that are superior to the conventional method in terms of addressing the biofilm problem for the improvement of healthcare, food safety, and in industrial processes.
Inactivation of Listeria monocytogenes using Water Bath Heat Treatment in Vacuum Packed Ricotta Salata Cheese Wedges
Authors: Spanu Carlo , Scarano Christian , Spanu Vincenzo , Pala Carlo , Salvo Riccardo Di , Piga Carlo , Ullu Antonio , Casti Daniele , Lamon Sonia , Cossu Francesca , Ibba Michela , De Santis Enrico Pietro Luigi 
Published: June 2015

AbstractRicotta salata cheese is frequently contaminated on the surface with Listeria monocytogenes. Water bath heat treatment in vacuum packed whole ricotta salata cheese wheels demonstrated to be effective in inactivating L. monocytogenes. However, the risk of cross‐contamination in ricotta salata wedges is increased during cheese cutting. Therefore, the effectiveness of heat treatment in ricotta salata wedges has to be demonstrated conducting a new validation study. In this study, 9 different time temperature combinations, 75, 85, and 90 °C applied for 10, 20, and 30 min each, were tested on artificially contaminated ricotta salata cheese wedges. The extent of the lethal effect on L. monocytogenes was assessed 1 and 30 d after the application of the hot water bath treatment. Five of 9 combinations, 75 °C for 30 min, 85 °C for 20, and 30 min, and 90°C for 20 and 30 min, demonstrated to meet the process criteria of at least 5 log reduction. Sensory analyses were also conducted in order to account for the potential impact on sensory features of ricotta salata wedges, which showed no significant differences between treatments.
Parental determinants of metabolic syndrome among adolescent Asian Indians: A cross‐sectional analysis of parent–offspring trios
Authors: Baxi Rahul , Vasan Senthil K. , Hansdak Samuel , Samuel Prasanna , Jeyaseelan Visali , Geethanjali Finney S. , Murray Ruth R. , Venkatesan Padmanaban , Thomas Nihal 
Published: June 2015

AbstractBackgroundThe aim of the present study was to investigate the relationship between parental metabolic syndrome (MS) and the risk of MS and associated abnormalities in adolescent offspring.MethodsThis cross‐sectional study was performed on 304 adolescents (12–16 years; 236 children with at least one parent and 124 father–mother–child trios) recruited from four schools representing different socioeconomic strata from Vellore, India. Anthropometric data was collected and blood pressure, blood glucose, and lipids were measured.ResultsThe prevalence of MS in adolescent offspring, fathers, and mothers was 3.3%, 52.5%, and 48.7% respectively. The most commonly observed metabolic abnormality among adolescents was lower high‐density lipoprotein. Maternal waist circumference (WC) was strongly correlated with adolescent body mass index (P = 0.007), WC (P < 0.001), serum triglycerides (P = 0.02), and systolic (P = 0.005) and diastolic (P = 0.01) blood pressure. Maternal MS status was significantly associated with a greater risk of central obesity (WC odds ratio [OR] 2.02; 95% confidence interval [CI] 1.21–3.17) in offspring. Both parents having MS conferred a significant effect on the child's WC (OR 1.21; 95% CI 1.72–2.07) and increased risk of MS (OR 6.19; 95% CI 1.64–23.26).ConclusionsThis study highlights the possible heritable parental components that may contribute to the MS phenotype in offspring: MS in adolescent offspring is related to parental MS status, and maternal traits reflect offspring adiposity and metabolic traits more strongly than paternal factors. Therefore, adolescent children of parents with MS should be targets for primordial prevention of cardiometabolic disease.
Breath‐holding times in various phases of respiration and effect of respiratory training in lung cancer patients
Authors: Tibdewal Anil , Munshi Anusheel , Pathak Rima , Misra Shagun , Daptardar Anuradha , Singh Vincent , Agarwal Jai Prakash 
Published: June 2015

AbstractIntroductionBreath‐holding (BH) technique is used for reducing the intrafraction‐tumour motion in mobile lung tumours treated with radiotherapy (RT). There is paucity of literature evaluating differences in BH times in various phases of respiration in patients with lung cancer.MethodsOne hundred consecutive patients with lung cancer planned for radical RT/chemoradiation were accrued in the study. Eighty‐seven patients were eligible for analysis at RT conclusion. Baseline pulmonary function test (PFT) were performed in all patients, and respiratory training was given from the day of RT planning. Deep inspiration breath hold (DIBH), deep expiration breath hold (DEBH) and mid‐ventilation breath hold (MVBH) were recorded manually with a stopwatch for each patient at four time points (RT planning/baseline, RT starting, during RT and RT conclusion).ResultsMedian DIBH times at RT planning, RT starting, during RT and RT conclusion were 21.2, 20.6, 20.1 and 21.1 s, respectively. The corresponding median DEBH and MVBH times were 16.3, 18.2, 18.3, 18.5 s and 19.9, 20.5, 21.3, 22.1 s, respectively. Respiratory training increased MVBH time at RT conclusion compared to baseline, which was statistically significant (19.9–22.1 s, P = 0.002). DIBH or DEBH times were stable at various time points with neither a significant improvement nor decline. Among various patient and tumour factors Forced Vital Capacity pre‐bronchodilation (FVCpre) was the only factor that consistently predicted DIBH, DEBH and MVBH at all four time points with P value <0.05.ConclusionsBH was well tolerated by most lung cancer patients with minimum median BH time of at least 16 s in any of the three phases of respiration. Respiratory training improved MVBH time while consistently maintaining DIBH and DEBH times throughout the course of radiotherapy.
Acute alcohol intoxication and bispectral index monitoring
Authors: Gerstman M. D. , Merry A. F. , McIlroy D. R. , Hannam J. A. , Mitchell S. J. , Myles P. S. 
Published: June 2015

BackgroundBispectral index (BIS) monitoring is commonly used to decrease the risk of awareness during anaesthesia. We aimed to determine the relationship between blood alcohol concentration and brain function (as measured by BIS) in healthy adults.MethodsIn this prospective observational study, 21 anaesthetic registrars self‐regulated alcohol consumption over a 3‐h period. Expired alcohol concentration (breathalyser) and BIS measurements were performed hourly for 4 h. A venous blood alcohol sample was taken at the conclusion of the study period.ResultsThe main outcome measures were the correlation between blood alcohol and brain function as measured by BIS and the change in BIS from baseline (∆BIS) at 4 h. The median number of standard drinks consumed was 9.1 (IQR 7.7–12.3), range 5.4–17. At 4 h, there was a moderate inverse correlation between BIS and blood alcohol (r = −0.49, P = 0.029) and between ∆BIS and blood alcohol (r = −0.46, P =0.043).ConclusionIn healthy young adults, we found a moderate correlation between venous blood alcohol concentration and BIS. This suggests that acute alcohol consumption can decrease BIS. This information may be relevant when providing anaesthesia to intoxicated patients who require urgent or time‐critical surgery, although certain limitations of this study should be kept in mind.
Does previous chemotherapy‐induced nausea and vomiting predict postoperative nausea and vomiting?
Authors: da Silva H. B. G. , Sousa A. M. , Guimarães G. M. N. , Slullitel A. , Ashmawi H. A. 
Published: June 2015

BackgroundPostoperative nausea and vomiting (PONV) remains a problem in the postoperative period. Previous PONV in oncology patients has recently been associated with chemotherapy‐induced nausea and vomiting (CINV). We assessed if CINV could improve Apfel's heuristic for predicting PONV.MethodsWe conducted a retrospective study of 1500 consecutive patients undergoing intermediate or major cancer surgery between April and July 2011. PONV was assessed in the first postoperative day during post‐anaesthesia care. The assigned anaesthetist completed an electronic medical record with all of the studied variables. Multiple logistic regression analyses were performed to assess whether any of the variables could add predictive ability to Apfel's tallying heuristic, and receiver operating characteristic (ROC) curves were modelled. The areas under the curve (AUC) were used to compare the model's discriminating ability for predicting patients who vomited from those who did not vomit.ResultsThe overall incidence of PONV was 26%. Multiple logistic regressions identified two independent predictors for PONV (odds ratio; 95% CI), Apfel's score (1.78; 1.23–2.63) and previous chemotherapy‐induced vomiting (3.15; 1.71–5.9), Hosmer–Lemeshow's P < 0.0001. Previous CINV was the most significant predictor to be added to Apfel's heuristic in this population.ConclusionsA history of chemotherapy‐induced nausea vomiting was a strong predictor for PONV and should be investigated as an added risk factor for PONV in the preoperative period of oncology surgery in prospective studies.
Childhood neglect predicts disorganization in schizophrenia through grey matter decrease in dorsolateral prefrontal cortex
Authors: Cancel A. , Comte M. , Truillet R. , Boukezzi S. , Rousseau P.‐F. , Zendjidjian X. Y. , Sage T. , Lazerges P.‐E. , Guedj E. , Khalfa S. , Azorin J.‐M. , Blin O. , Fakra E. 
Published: June 2015

ObjectivePsychosocial trauma during childhood is associated with schizophrenia vulnerability. The pattern of grey matter decrease is similar to brain alterations seen in schizophrenia. Our objective was to explore the links between childhood trauma, brain morphology and schizophrenia symptoms.MethodTwenty‐one patients with schizophrenia stabilized with atypical antipsychotic monotherapy and 30 healthy control subjects completed the study. AnatomicalMRIimages were analysed using optimized voxel‐based morphometry (VBM). Childhood trauma was assessed with the Childhood Trauma Questionnaire, and symptoms were rated on the Scale for the Assessment of Negative Symptoms (SANS) and Scale for the Assessment of Positive Symptoms (SAPS) (disorganization, positive and negative symptoms). In the schizophrenia group, we used structural equation modelling in a path analysis.ResultsTotal grey matter volume was negatively associated with emotional neglect (EN) in patients with schizophrenia. Whole‐brainVBManalyses of grey matter in the schizophrenia group revealed a specific inversed association between EN and the right dorsolateral prefrontal cortex (DLPFC). Path analyses identified a well‐fitted model in which EN predicted grey matter density in DLPFC, which in turn predicted the disorganization score.ConclusionOur findings suggest that EN during childhood could have an impact on psychopathology in schizophrenia, which would be mediated by developmental effects on brain regions such as theDLPFC.
Ahead of its time: 40 years after the advice versus treatment family study
Authors: Orford Jim 
Published: June 2015

AbstractGriffith Edwards’ proposal for the alcohol ‘treatment versus advice’ study—also known as ‘the family study’—illustrates how ahead of his time he was. The sample consisted of 100 married men who attended with their wives for a comprehensive assessment. Those randomized to ‘advice’ were told that the responsibility for attaining the goal of abstinence lay in the patient's hands, supported by his wife, that no further intervention was indicated, but that the research social worker would ‘keep a watching brief’ by visiting the home every 4 weeks for 12 months. Across multiple outcome measures there was no evidence that ‘treatment’—considerable in amount by modern standards—was better than advice. Conversely, marital variables such as wives’ alcohol‐related hardship were significantly predictive of the outcome of the drinking problem. The study was arguably one of the principal sources of the whole ‘brief treatments’/‘brief interventions’ movement which gathered momentum from then on and which, arguably, has itself become the conventional wisdom. The findings questioned the very nature of the addiction change process, suggesting that non‐specific factors might be the more important, an issue that still remains unresolved. It is less clear that the study has left such a mark in terms of the development of a family and social model of addiction treatment and change. For example, it continues to be a struggle to help treatment organizations to become more family‐inclusive.
Empowerment through education and science: three intersecting strands in the career of Griffith Edwards
Authors: Crome Ilana 
Published: June 2015

AbstractThis paper describes three important strands in the career of Griffith Edwards that define him as a leader and an innovator. Believing that education and science were critical for the development of addiction as a profession and as a field of inquiry, his approach was multi‐faceted: educating all doctors to appreciate the fundamental issues in addiction; training psychiatrists in the complexity of ‘dual diagnosis’ and specific specialist intervention; and teaching that addiction could be a chronic condition which required care management over the life course. These three inter‐related areas are directly related to the need for a range of practitioners to have an understanding of addiction so that patients can be properly managed. The greater our understanding of the nature of addiction behaviour, the more likely the potential to optimize treatment and train practitioners from different professional disciplines.
Indication for cataract surgery. Do we have evidence of who will benefit from surgery? A systematic review and meta‐analysis
Authors: Kessel Line , Andresen Jens , Erngaard Ditte , Flesner Per , Tendal Britta , Hjortdal Jesper 
Published: June 2015

AbstractThe need for cataract surgery is expected to rise dramatically in the future due to the increasing proportion of elderly citizens and increasing demands for optimum visual function. The aim of this study was to provide an evidence‐based recommendation for the indication of cataract surgery based on which group of patients are most likely to benefit from surgery. A systematic literature search was performed in the MEDLINE, CINAHL, EMBASE and COCHRANE LIBRARY databases. Studies evaluating the outcome after cataract surgery according to preoperative visual acuity and visual complaints were included in a meta‐analysis. We identified eight observational studies comparing outcome after cataract surgery in patients with poor (<20/40) and fair (>20/40) preoperative visual acuity. We could not find any studies that compared outcome after cataract surgery in patients with few or many preoperative visual complaints. A meta‐analysis showed that the outcome of cataract surgery, evaluated as objective and subjective visual improvement, was independent on preoperative visual acuity. There is a lack of scientific evidence to guide the clinician in deciding which patients are most likely to benefit from surgery. To overcome this shortage of evidence, many systems have been developed internationally to prioritize patients on waiting lists for cataract surgery, but the Swedish NIKE (Nationell Indikationsmodell för Katarakt Ekstraktion) is the only system where an association to the preoperative scoring of a patient has been related to outcome of cataract surgery. We advise that clinicians are inspired by the NIKE system when they decide which patients to operate to ensure that surgery is only offered to patients who are expected to benefit from cataract surgery.