bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Nursing Home Placement in a Population‐Based Dementia Cohort
Authors: Smith G. E. , Kokmen E. , O'Brien P. C. 
Published: April 2015

OBJECTIVE:To examine risk factors for nursing home placement in a population‐based dementia cohort.METHODS:The Mayo Clinic Medical Records linkage system was used to identify all patients with onset of dementia between 1980 and 1984. The patient group included 314 cases who met DSM‐III‐R criteria for dementia, including 220 cases who were community dwelling at onset. All dementia patients were followed until death. A control group included 323 patients who did not, at any point, meet DSM‐III‐R criterion for dementia. The groups were initially matched on age, gender, and year of initial registration. Demographic, medical, social, and functional predictors were examined as static and time‐dependent risk factors for nursing home placement in the initial community‐dwelling subgroups, using stepwise Cox regression modeling.RESULTS:Of the 314 dementia patients, 282 took residence in licensed skilled nursing homes for at least 6 weeks, suggestive of custodial care, at some point during the course of their illness. In the control group, 162 of the 323 people required nursing home placement. Within controls, the predictor variables of time to nursing home placement included initial age, being divorced, living in a townhome, apartment or assisted living apartment, change in Charlson comorbidity score, and change in amount of daily assistance required. Within the dementia sample, seven predictors were eventually determined to be associated with time to nursing home placement. These included total number of years of education, age at onset of dementia, being single, living in a retirement or supervised apartment at onset, change in Charlson comorbidity score, and a change in the amount of daily assistance required.CONCLUSIONS:Cumulative incidence of placement was 90% in the dementia cohort and 50% in the controls. Certain variables seem to impact time to nursing home placement in all older persons, whether they have dementia or not. Among these are age, living in assisted living settings, increasing comorbidity scores, and increasing need for functional assistance. Certain additional factors may have a specific impact in dementia. Among these is education, which seems to provide a protective effect. These predictors may be important covariates in clinical dementia studies that include time to nursing home placement as an outcome variable.J Am Geriatr Soc 48: 519–525, 2000.
Advance Directive Preferences Among Subpopulations of Asian Nursing Home Residents in the Pacific Northwest
Authors: Vaughn Gina , Kiyasu Elizabeth , McCormick Wayne C. 
Published: April 2015

OBJECTIVE: To study advance directives (code status) among subgroups of Asian nursing home residents.DESIGN: Cross‐sectional design.PARTICIPANTS AND SETTING: A total of 423 residents of Asian descent (aged >55) from two ethnic nursing homes in Seattle, Washington.METHODS: Chart review was conducted on 423 residents (199 discharged between 1995 and 1998 and 244 current residents) to ascertain code status, age, gender, ethnicity, comorbidity (using the Charlson Index), and religion.RESULTS: Seventy percent of the residents were women, median age was 83 ± 9, 43% were Chinese, 40% Japanese, and 17% other Asian (Korean, Filipino, Southeast Asian). The majority of the patients in any subgroup (72% overall) were ‘no code’. In bivariate analysis, ethnicity, increased age, and comorbidity were correlated with no code status. In multivariable logistic regression, Japanese residents were more likely to be no code (OR 4.1 (95% CI, 3.1‐ 5.4)) controlling for age, comorbidity, gender, and religion. Chinese were more likely to be full code (OR 3.3 (95% CI, 2.6–4.2)).CONCLUSIONS: Code status differs significantly among Asian subgroups in these ethnic nursing homes. Whereas the majority of residents are no code, Japanese residents are more likely than Chinese or others to be no code. Higher age and comorbidity are also correlated with no code status. J Am Geriatr Soc 48: 554–557, 2000.
Interrater Reliability of the Clinical Dementia Rating in a Multicenter Trial
Authors: Rockwood Kenneth , Strang David , MacKnight Chris , Downer Robert , Morris John C. 
Published: April 2015

OBJECTIVE: To test the interrater reliability of the Clinical Dementia Rating (CDR) in a multicenter clinical trial.DESIGN: Observational study.SETTING: Training session for a multicenter trial of milameline, a direct muscarinic agonist, in the treatment of Alzheimer's disease.PARTICIPANTS: Twenty‐four raters (physicians and nurses) familiar with drug trials and expert in the care of patients with Alzheimer's disease.METHODS: Independent scoring of the CDR using four videotaped CDR interviews.OUTCOME MEASURE: Interrater reliability, as tested by the Kappa statisticRESULTS: The overall interrater reliability was 0.62. Within the CDR domains, the global kappas ranged from 0.33 ± 0.06 to 0.88 ± 0.06.CONCLUSIONS: The data support moderate to high overall interrater reliability but show important difficulties in the reliable assessment of early dementia. J Am Geriatr Soc 48: 558–559, 2000.
MODELS OF GERIATRICS PRACTICE
Authors: Reuben David B. , Hughes Terry Lynn , Medina‐Walpole Annette M. 
Published: April 2015

OBJECTIVE: To describe the establishment and utilization of an interdisciplinary Behavior Management Program in a Transitional Care Unit as a new model of Geriatrics Practice.DESIGN: Descriptive Study.SETTING: A 50‐bed Transitional Care Unit in a Veterans Affairs Medical Center in Syracuse, New York.PARTICIPANTS: All residents admitted to the Transitional Care Unit were observed for a 6‐month period under the Behavior Management Program.PROGRAM STRUCTURE: The Behavior Management Program involved an interdisciplinary team approach to the management of behavioral disturbances. This included development of a Behavior Team and a comprehensive Behavior Observation Record, which readily assisted caregivers in determining and monitoring target behaviors that required modification. Both nonpharmacological and pharmacological interventions were employed to assist in the modification of behavioral disturbances.RESULTS: The Behavior Management Program enhanced the overall care of Transitional Care Unit residents with behavioral disturbances. The more appropriate use of medications for specific target behaviors led to a reduction in behavioral disturbance episodes and increased the earlier diagnosis and treatment of depression. The interdisciplinary nature of the Behavior Management Program promoted educational efforts and camaraderie among staff and created a stronger liaison between the Transitional Care Unit and the Psychiatry Service. In addition, several management improvements were identified as a result of the implementation of the Behavior Management Program.CONCLUSIONS: An interdisciplinary Behavior Management Program can prove to be a valuable asset in the management of behaviors for people with dementia, psychiatric illness, and other medical illnesses. More effective use of nonpharmacological and psychopharmacological interventions enhances the quality of life in a frail older population. This approach has strong potential for successful use in a variety of clinical settings by providers and caregivers alike. J Am Geriatr Soc 48: 581–587, 2000.
Families' Perception of the Added Value of Hospice in the Nursing Home
Authors: Baer Wendy M. , Hanson Laura C. 
Published: April 2015

OBJECTIVE: To determine if family members perceive that hospice improves the care of dying nursing home residents during the last 3 months of life.DESIGN: Mailed survey.PARTICIPANTS: Family members for all nursing home hospice enrollees in North Carolina during a 6‐month period.MEASUREMENTS: After residents' deaths, family members answered questions about the quality of care for symptoms before and after hospice, the added value of hospice, the effect of hospice on hospitalization, and special services provided by nursing home staff or by hospice staff.RESULTS: A total of 292 (73%) of 398 eligible family members completed surveys. The average age of the nursing home residents who had received hospice was 79.5 years; 50% had cancer and 76% were dependent for self‐care. In their last 3 months, 70% of decedents had severe or moderate pain, 56% had severe or moderate dyspnea, and 61% had other symptoms. Quality of care for physical symptoms was rated good or excellent by 64% of family before hospice and 93% after hospice (P < .001). Dying residents' emotional needs included care for moderate or severe depression (47%), anxiety (50%), and loneliness (35%). Quality of care for emotional needs was rated good or excellent by 64% of family before hospice and 90% after hospice (P < .001). Fifty‐three percent of respondents believed hospice prevented hospitalizations. Family estimated the median added value of hospice to be $75 per day and described distinct special services provided by hospice and by nursing home staff.CONCLUSIONS: Family members believe that nursing home hospice improves quality of care for symptoms, reduces hospitalizations, and adds value and services for dying nursing home residents. J Am Geriatr Soc 48:879‐882, 2000.
Physical Activity, Falls, and Fractures Among Older Adults: A Review of the Epidemiologic Evidence
Authors: Gregg Edward W. , Pereira Mark A. , Caspersen Carl J. 
Published: April 2015

OBJECTIVES: Assess the relationship between physical activity and risk for falls and osteoporotic fractures among older adults.DESIGN: Review and synthesis of published literature.MEASUREMENTS: We searched the literature using MEDLINE, Current Contents, and the bibliographies of articles identified. We included randomized controlled trials (RCT) of the effects of physical activity on the incidence of falls and case‐control and prospective cohort studies of the association of physical activity with osteoporotic fracture risk. We also summarized mechanisms whereby physical activity may influence risk for falls and fractures.RESULTS: Observational epidemiologic studies and randomized clinical trials evaluating the effectiveness of physical activity programs to prevent falls have been inconclusive. However, many studies have lacked adequate statistical power, and recent trials suggest that exercise, particularly involving balance and lower extremity strength training, may reduce risk of falling. There is consistent evidence from prospective and case‐control studies that physical activity is associated with a 20–40% reduced risk of hip fracture relative to sedentary individuals. The few studies that have examined the association between physical activity and risk of other common osteoporotic fractures, such as vertebral and wrist fractures, have not found physical activity to be protective.CONCLUSIONS: Epidemiologic studies suggest that higher levels of leisure time physical activity prevent hip fractures and RCTs suggest certain exercise programs may reduce risk of falls. Future research needs to evaluate the types and quantity of physical activity needed for optimal protection from falls and identify which populations will benefit most from exercise. J Am Geriatr Soc 48:883–893, 2000.
Driving Cessation in Older Men with Incident Dementia
Authors: Foley Daniel J. , Masaki Kamal H. , Ross G. Webster , MD Lon R. White 
Published: April 2015

OBJECTIVE: To determine the prevalence and cessation of driving among older men with incident dementia in the Honolulu‐Asia Aging Study.DESIGN: Retrospective cohort data from a community‐based study of incident dementia.SETTING: The Honolulu Heart Program and the Honolulu‐Asia Aging Study.PARTICIPANTS: A total of 643 men who were evaluated for the incidence of Alzheimer's disease or other dementia between the fourth and the fifth examination of the Honolulu Heart Program.MEASUREMENTS: Driving history, diagnosis of dementia, grip strength, walking speed, standing balance test, interviewer's rating of vision status, and the neurologist's notes on mentions of driving behavior from informal interviews with a caregiver or family informant.RESULTS: The prevalence of driving declined dramatically with level of cognitive functioning. Among 162 men evaluated and found to have normal cognitive functioning, 78% still drove, compared with 62% of 287 men with poor cognitive functioning but no clinical dementia, 46% of 96 men with a new diagnosis of very mild dementia (Clinical Dementia Rating = 0.5), and 22% of 98 men with a new diagnosis of mild dementia (CDR = 1). Only one of 23 men diagnosed with moderate or more severe staged incident dementia (CDR > 1) was driving. About 10% of the 59 demented persons still driving relied on co‐pilots, and only one driver was reported as involved in a crash according to a review of the neurologists' notes.CONCLUSIONS: Incident dementia is a major cause of driving cessation. Based on these data, we estimate that approximately 4% of male drivers aged 75 years and older nationwide (about 175,000 men) have dementia. This number will increase with the projected growth of drivers aged 75 years and older. J Am Geriatr Soc 48:928–930, 2000.
Prevalence, Effectiveness, and Predictors of Planning the Place of Death Among Older Persons Followed in Community‐Based Long Term Care
Authors: Leff Bruce , Kaffenbarger Kimberly P. , Remsburg Robin 
Published: April 2015

BACKGROUND: Little is known about whether patients plan for the site of their death and whether such planning is effective.OBJECTIVE: To determine the prevalence, effectiveness, and predictors of planning the place of death among older home‐bound persons followed in a community‐based, physician‐led house call program.DESIGN: Retrospective chart review.SETTING: A geographically defined catchment area in southeast Baltimore, Maryland.PATIENTS: One hundred twenty‐five patients who died between July 1995 and November 1998 who were followed in a physician‐led house call program.MAIN OUTCOME MEASURES: Presence of a plan to die in a specific place and concordance between planned and actual place of death.RESULTS: Eighty patients (64%) made a plan to die in a specific place, and these plans were executed successfully in 73 cases (91%). The median time between formulating a plan to die in a specific place and death was 36 days. In logistic regression analysis, making a plan to die in a specific place was positively associated with an advance directive of Do Not Resuscitate (DNR) (odds ratio (OR) 11.7, confidence interval (CI) 3.7, 32.5) and negatively associated with the lack of an identifiable main medical problem other than being homebound (OR 0.17; CI, 0.02–0.88).CONCLUSIONS: Among a group of frail older persons living in the community, planning to die in a particular place was common and implemented successfully most of the time. Providing physician care at home may facilitate improved end‐of‐life care for older persons. J Am Geriatr Soc 48:943–948, 2000.
Fabrication of Transparent Dysprosium Aluminum Garnet (Dy3Al5O12) Ceramics via a Solid‐State Reaction Method
Authors: Hu Song , Qin Xianpeng , Lu Chunhua , Zhou Guohong , Xu Zhongzi , Wang Shiwei 
Published: April 2015

Polycrystalline, transparent Dy3Al5O12 ceramics were firstly fabricated by a solid‐state reaction method using high‐purity Dy2O3 and Al2O3 powders. The fully dense Dy3Al5O12 ceramic with an average grain size of less than 10 μm was obtained by vacuum sintering at 1820°C for 6 h. The in‐line transmittance of the optimized sample reaches 80% in the visible region. Scanning electron microscopy reveals that no secondary phases and almost no pores are observed at grain boundaries or triple junctions, and the fracture mode of the ceramic is mainly transgranular. The Dy3Al5O12 ceramic is promising for magneto‐optical applications. Verdet constant of the Dy3Al5O12 transparent ceramic is as high as −0.41 min·(Oe·cm)−1.
Effects of Sintering Aids on the Transparency and Conversion Efficiency of Cr4+ Ions in Cr: YAG Transparent Ceramics
Authors: Zhou Tianyuan , Zhang Le , Yang Hao , Qiao Xuebin , Liu Peng , Tang Dingyuan , Zhang Jian 
Published: April 2015

Tetravalent chromium‐doped Y3Al5O12 ceramics were fabricated by solid‐state reactive sintering method using high‐purity Y2O3, α‐ Al2O3, and Cr2O3 powders as the starting materials. CaO and MgO were co‐doped as the sintering aids. The effects of TEOS and divalent dopants (CaO and MgO) on the optical qualities, the conversion efficiency of Cr4+ ions, and the microstructure evolutions of 0.1 at.% Cr4+: YAG ceramics were investigated. Fully dense, dark brown colored Cr4+: YAG ceramics with an average grain size of 3.1 μm were achieved. The in‐line transmittance of the as‐prepared ceramic at 2000 nm was 85.3% (4 mm thick), and the absorption coefficient at 1030 nm (the characteristic absorption peak of Cr4+ ions) was as high as 3.7 cm−1, which was higher than that of corresponding single crystals fabricated by Czochralski method.
Cost‐Effectiveness of Therapeutic Drug Monitoring in Diagnosing Primary Aldosteronism in Patients With Resistant Hypertension
Authors: Velasco Alejandro , Chung Oliver , Raza Fayez , Pandey Ambarish , Brinker Stephanie , Arbique Debbie , Price Angela , Lotan Yair , Das Sandeep R. , Vongpatanasin Wanpen 
Published: April 2015

Primary aldosteronism (PA) is present in up to 20% of patients with treatment‐resistant hypertension (TRH). Investigation for PA in patients with TRH is recommended by current guidelines after medication nonadherence is excluded. Studies using therapeutic drug monitoring (TDM) have shown that >50% of patients with TRH are nonadherent to their prescribed antihypertensive medications. However, the relationship between the prevalence of PA and medication adherence as confirmed by TDM has not been previously assessed. A retrospective analysis from a hypertension referral clinic showed that prevalence of PA in adherent patients with TRH by TDM was significantly higher than in nonadherent patients (28% vs 8%, P<.05). Furthermore, cost analysis showed that TDM‐guided PA screening was $590.69 less expensive per patient, with minimal impact on the diagnostic accuracy. These data support a TDM‐guided PA screening approach as a cost‐saving strategy compared with routine PA screening for TRH.
Single versus double flap approach in periodontal regenerative treatment
Authors: Schincaglia Gian Pietro , Hebert Eric , Farina Roberto , Simonelli Anna , Trombelli Leonardo 
Published: April 2015

AbstractAimto compare the outcomes of a regenerative strategy based on recombinant human platelet‐derived growth factor–BB (rhPDGF‐BB, 0.3 mg/ml) and β‐tricalcium phosphate (β‐TCP) in the treatment of intraosseous defects accessed with the Single Flap Approach (SFA) versus Double Flap Approach based on papilla preservation techniques (DFA).Materials and MethodsFifteen and 13 defects, randomly assigned to SFA or DFA, respectively, were grafted with rhPDGF‐BB + β‐TCP. Probing parameters were assessed before and 6 months after surgery. Pain (VASpain) was self‐reported using a visual analogue scale.ResultsTwelve SFA sites and DFA 6 sites showed complete flap closure at 2 weeks post‐surgery. No significant differences in 6‐month changes in probing parameters and radiographic defect fill were found between groups. Significantly lower VASpain was observed in SFA group compared to DFA group at day +1, +2 and +6. A significantly greater number of analgesics were consumed in the DFA group compared to the SFA group at day +1.ConclusionsWhen combined with rhPDGF‐BB and β‐TCP, the SFA may result in similar clinical outcomes, better quality of early wound healing, and lower pain and consumption of analgesics during the first postoperative days compared to the DFA.
Practitioner Review: Self‐injurious behaviour in children with developmental delay
Authors: Oliver Chris , Richards Caroline 
Published: April 2015

BackgroundSelf‐injurious behaviour is shown by a significant minority of children with developmental delay and has a substantial impact on child and carer wellbeing. Characteristics such as a greater degree of intellectual disability, autism spectrum disorder, some genetic syndromes and repetitive and impulsive behaviours are positively associated with self‐injury. Prevalence generally increases with age into midadulthood and the behaviour is notably persistent.ScopeIn this review, we discuss the dominant causal theory of self‐injury which draws on the principles of operant learning. We evaluate the utility of this theory to account for all empirical observations of self‐injury.FindingsA model of self‐injury is presented that extends a previous model described by Guess and Carr. The new model integrates child characteristics and operant learning principles in a phenotype × environment paradigm to explain the variance in developmental trajectory of the severity of self‐injury.ConclusionsBehaviour dysregulation, as evidenced by the associations between self‐injury, self‐restraint, repetitive and impulsive behaviours, is identified as potentially influencing the severity and persistence of self‐injury. Risk markers for self‐injury are identified and the extended model indicates points of intervention and highlights the possibility of risk‐related, targeted early intervention. The need for increased training of practitioners in the delivery of demonstrably effective interventions for self‐injury is identified.
Evaluation of soil‐applied insecticides with Bt maize for managing corn rootworm larval injury
Authors: Estes R. E. , Tinsley N. A. , Gray M. E. 
Published: April 2015

AbstractThe western corn rootworm, Diabrotica virgifera virgifera LeConte, is considered one of the most significant insect pests of maize in North America. Larvae of other secondary subterranean pests such as grape colaspis, Colaspis brunnea (F.), and Japanese beetle, Popillia japonica Newman, can also injure maize seedlings and cause yield loss. In the past decade, maize hybrids containing Bt proteins have been used to manage the western corn rootworm; additionally, seeds are commonly treated with a neonicotinoid and fungicide combination to control secondary pests. Recently, soil‐applied insecticides have been used in conjunction with rootworm Bt hybrids (and seed‐applied insecticides) in areas with perceived risk for increased rootworm larval or secondary pest damage. We conducted a series of trials from 2009 to 2011 that examined multiple rootworm Bt hybrids and their near‐isolines, along with two soil‐applied insecticides, to determine whether the Bt plus insecticide combination resulted in an increased level of efficacy or yield. We also sampled for Japanese beetle and grape colaspis larvae to determine their potential for reducing yield. Densities of secondary pests in our trials were low and likely had no effect on maize yield. The addition of a soil‐applied insecticide to rootworm Bt hybrids improved efficacy only once across 17 location‐years, when overall corn rootworm injury was highest; an improvement in yield was never observed. Our results suggest that the use of a soil‐applied insecticide with a rootworm Bt hybrid should only be considered in scenarios with potentially significant rootworm larval populations. However, potential negative consequences related to trait durability when soil insecticides are used with rootworm Bt maize should be considered.