bluuebunny/crossref_metadata_2025_split huggingface dataset:
GERIATRICS IN MANAGED CARE
Authors: Brummel‐Smith Kenneth , Newcomer Robert , Harrington Charlene , Kane Robert 
Published: April 2015

BACKGROUND: In 1996 the Health Care Financing Administration implemented a second generation of the Social HMO demonstration. This model retained the chronic care benefits of the original Social HMOs while attempting to develop a geriatric service model integrated into primary care and a screening and assessment process focused directly on healthcare risk factors. Other refinements included risk‐adjusted capitation payment, broadened eligibility for expanded care benefits, low co‐payments for these benefits, and no caps on the expanded care benefits expenditures.OBJECTIVES: The geriatric approach is designed to facilitate integration among providers and levels of care. This includes timely application of primary care monitoring and treatment to reduce illness and disability as well as a geriatric education and consultation program to provide specialty support for complex cases. Care management is designed for those requiring home‐based care, those discharged from hospitals or nursing homes, and those having difficulty with treatment regimens.DESIGN: A case study of the Social HMO implementation through the Fall of 1999.SETTING: Health Plan of Nevada (HPN), with locations in Las Vegas, Reno, and surrounding areas.PARTICIPANTS: More than 25,000 Medicare beneficiaries participated during the study period.MEASUREMENTS: Administrative reports, charts, and interviews with administrators and clinicians.RESULTS: Within 12 months of operation under this authority, HPN succeeded in putting in place most of the components of the planned geriatric approach: a screening program to identify patients “at risk” for high service costs and disability and timely application of primary care treatment to reduce illness and disability. Geriatric education and a consultation program for complex cases were available, but full implementation was delayed until the plan was able to hire a full time geriatrician.CONCLUSIONS: Health Plan of Nevada's Social HMO program reflects current perspectives on how to integrate chronic care into an HMO. The accomplishments affirm that the provision of risk‐adjusted reimbursement, along with the 5% supplement to the normal Medicare capitation payment, are sufficient incentives for a health plan to restructure itself so that it places a priority on retaining and serving populations at risk for high expenditures. J Am Geriatr Soc 48:829–834, 2000.
Aerobic Exercise Training‐Induced Reductions in Abdominal Fat and Glucose‐Stimulated Insulin Responses in Middle‐Aged and Older Men
Authors: Pratley Richard E. , Hagberg James M. , Dengel Donald R. , Rogus Ellen M. , Muller Denis C. , Goldberg Andrew P. 
Published: April 2015

OBJECTIVE: To test the effects of aerobic exercise training on glucose‐stimulated insulin responses in middle‐aged and older individuals.DESIGN: A 9‐month moderate‐intensity aerobic exercise training trial in 17 men.SETTING: An academic medical center.INTERVENTION: Subjects walked, jogged, or cycled at 50 to 60% heart rate reserve (HRR) three times per week for 30 to 45 minutes and progressed over 6 to 9 months until subjects were training at 80 to 85% of HRR for 45 to 60 minutes three to four times per week. Training intensity was stabilized for 2 weeks before retesting. Diets were stabilized on American Heart Association Step I diets before training, and calories increased to prevent weight loss.MEASUREMENTS: At baseline and after training, subjects underwent measurement of body fat (hydrodensitometry), regional fat distribution (waist‐to‐hip ratio (WHR)), VO2 max (maximal treadmill testing), diet intake (7‐day food records), and glucose and insulin responses during 75 g, 2‐hour oral glucose tolerance tests (OGTT) and 2‐hour hyperglycemic (+ 7.9 mmol/L) glucose clamps.RESULTS: Aerobic exercise training increased VO2 max by 15% and decreased body fat from 22.8 ± 1.6 to 20.8 ± 1.5% (P < .0001), waist circumference by 2% (P = .038), and WHR by 1% (P = .035). Fasting glucose and insulin levels, and glucose responses during the OGTT did not change, but insulin responses during the OGTT decreased 16% (P = .027) after training. Training reduced early (0–10 minutes) and late (20–120 minutes) phase insulin responses by 14% (P = .017 and .042, respectively), but did not significantly change glucose disposal (+ 8%, P = .398). Multiple regression analyses showed that changes in waist circumference (r2 = 0.68, P < .0001) and percent body fat (r2 = 0.08, P = .049) were independent predictors of the reductions in the late phase insulin responses with exercise training, however, changes in VO2 max were not (P = .199).CONCLUSIONS: The decrease in glucose‐stimulated insulin secretion with aerobic exercise training in middle‐aged and older men appears to be mediated, at least in part, by reductions in the amount of abdominal fat. Regular physical exercise may prevent or ameliorate conditions associated with hyperinsulinemia including dyslipidemia, hypertension, and atherosclerosis in this group.
Sedative, Hypnotic, and Antianxiety Medication Use in an Aging Cohort over Ten Years: A Racial Comparison
Authors: Blazer Dan , Hybels Celia , Simonsick Eleanor , Hanlon Joseph T. 
Published: April 2015

OBJECTIVES: Prescriptions of sedatives, hypnotics, and antianxiety medications have decreased over the past 15 years. However, racial differences have not been well investigated in controlled analyses.DESIGN: A prospective cohort study.SETTINGS AND PARTICIPANTS: The authors analyzed data from a community‐based, biracial cohort of older adults (n = 4000 at baseline) followed for 10 years to determine sociodemographic and health characteristics associated with the use of these medications between 1986 and 1996.MAIN OUTCOME MEASURES: Information about sedative, hypnotic, and antianxiety medication use and demographic and health characteristics was obtained from a race‐stratified, probability‐based sample of black and white community‐dwelling older adults in the Piedmont region of North Carolina during four in‐person interviews spanning 10 years. Descriptive statistics were calculated. Logistic regression was used for the final models.RESULTS: A total of 13.3% of the subjects were taking these medications in 1986, with the frequency of use declining only to 11.8% in 1996 despite the cohort aging 10 years. Correlates of use at baseline were female gender, white race, depressive symptoms, poor self‐rated health, impaired physical function, and health services use. These correlates persisted for each of the three follow‐up waves of the survey. In 1996, the odds for being white and using these medications was 4.70 in controlled analyses.CONCLUSIONS: Despite the overall decline in the use of sedative, hypnotics, and antianxiety agents in the general population in recent years, over the 10 years of this survey, an aging cohort continued to use these medications at a frequency greater than the general population and did not demonstrate a significant decline in use. Factors unrelated to health status, specifically being white, were among the strongest correlates of use throughout the years of follow‐up.
Depressive Symptoms and Risk of Alzheimer's Disease in More Highly Educated Older People
Authors: Geerlings Mirjam I. , Schmand Ben , Braam Arjan W. , Jonker Cees , Bouter Lex M. , van Tilburg Willem 
Published: April 2015

BACKGROUND AND OBJECTIVE: In an earlier study we observed that a depressive syndrome was highly predictive of developing Alzheimer's disease (AD) in older persons with normal baseline cognition and higher levels of education. We interpreted these findings as the depression being an early noncognitive manifestation of AD in persons with more cognitive reserve. The present study examines whether specific symptoms of depression can be identified that predict AD among older subjects with higher levels of education.DESIGN AND PARTICIPANTS: In the community‐based Amsterdam Study of the Elderly (AMSTEL), a sample of 3147 nondemented persons with normal cognition, 65 to 84 years old, was selected and divided into subjects with >8 years and ≤8 years of education. At baseline, the presence or absence of 12 specific symptoms of depression was assessed. At follow‐up, patients with incident AD were diagnosed according to DSM‐IV criteria in a two‐step diagnostic procedure.RESULTS: After an average follow‐up of 3.2 years, 1911 persons were reevaluated, of whom 22 with >8 years and 31 with ≤8 years of education had developed AD. Multivariate logistic regression analyses showed that among persons with >8 years of education depressed mood and subjective bradyphrenia were strongly associated with incident AD. No association between depressive symptoms and AD was observed among subjects with ≤8 years of education.CONCLUSIONS: Both depressed mood and subjective bradyphrenia seem to indicate subclinical AD in older people with higher levels of education. Clinicians should be alert that in these persons, AD may become apparent within a relatively short period of time.
The Prevalence of Functional Limitations and Disability in Older Persons in the US: Data from the National Health and Nutrition Examination Survey III
Authors: Ostchega Yechiam , Harris Tamara B. , Hirsch Rosemarie , Parsons Van L. , Kington Raynard 
Published: April 2015

OBJECTIVE: To provide estimates by sex and age and by sex and race/ethnicity of the proportion of older Americans who have difficulty with functional limitations and daily activities.SETTING: The Third National Health and Nutrition Examination Survey (NHANES III) 1988–1994.DESIGN: A cross‐sectional nationally representative survey.PARTICIPANTS: All persons aged 60 and older who completed a household interview (N = 6866) during NHANES III (conducted 1988–1994).MEASUREMENTS: The self‐reported physical and functional disability questions from NHANES III included: lower‐extremity function, instrumental activities of daily living, basic activities of daily living, needing help with personal and routine daily activities, and use of assistive devices for walking.RESULTS: Non‐Hispanic black and Mexican‐American men and women generally reported significantly (P < .01) more disability than did non‐Hispanic white men and women. Disability was greater for minority women than for men. For both men and women, the prevalence in disability increased significantly (P < .01) with age for each measure.CONCLUSIONS: These sex‐age and sex‐race/ethnicity national estimates of disability indicate that minority women may represent a vulnerable subpopulation.
Reliability and Prevalence of Physical Performance Examination Assessing Mobility and Balance in Older Persons in the US: Data from the Third National Health and Nutrition Examination Survey
Authors: Ostchega Yechiam , Harris Tamara B. , Hirsch Rosemarie , Parsons Van L. , Kington Raynard , Katzoff Myron 
Published: April 2015

OBJECTIVE: This report provides reliability and prevalence estimates by sex, age, and race/ethnicity of an observed physical performance examination (PPE) assessing mobility and balance.SETTING: The Third National Health and Nutrition Examination Survey (NHANES III) 1988–1994.DESIGN: A cross‐sectional nationally representative survey.PARTICIPANTS: All persons aged 60 and older (n = 5403) who performed the PPE either in the mobile examination center (MEC) or in the home during NHANES III (conducted 1988–1994).MEASUREMENTS: The PPE included timed chair stand, full tandem stand, and timed 8‐foot walk.RESULTS: Timed chair stand and 8‐foot timed walk were reliable measurements (Intraclass Correlations > 0.5). Women were significantly slower (P < .001) than men for both timed chair stands and timed walk. Non‐Hispanic white men and women did the maneuvers in significantly less time than non‐Hispanic black men and women and Mexican Americans women (P < .001).CONCLUSIONS: Lower extremity functions measured by timed chair stand and walk are reliable. Women at every age group were more physically limited than men.
Distinction Between Preclinical Alzheimer's Disease and Depression
Authors: Visser Pieter Jelle , Verhey Frans R. J. , Ponds Rudolf W. H. M. , Kester Arnold , Jolles Jellemer 
Published: April 2015

OBJECTIVE: To assess the prevalence of depression in subjects with preclinical Alzheimer's disease (AD) and to investigate the possibility of differentiating subjects with preclinical AD and depression from subjects with depression‐related cognitive impairment.DESIGN: A prospective, observational cohort study.SETTING: An outpatient memory clinic of a university‐affiliated hospital.PARTICIPANTS: Nondemented subjects with cognitive impairment older than 55 years (n = 111) without neurological or somatic causes for the cognitive impairment.MEASUREMENTS: At baseline, data were collected on patient characteristics, the severity of depression, and cognitive functioning. The course of the cognitive impairment and the presence of dementia were assessed after 2 and 5 years.RESULTS: Twenty‐five subjects had preclinical dementia with Alzheimer's type dementia at follow‐up. Sixty percent of these subjects (n = 15) were depressed at baseline. Subjects with depression and preclinical AD had at baseline a poorer performance on the cognitive tasks and were older than the subjects with depression‐related cognitive impairment. Logistic regression with backward step selection selected age and memory performance as the best predictors for Alzheimer's type dementia in the depressed subjects. The specificity of these predictors for the diagnosis of future Alzheimer's type dementia in depressed subjects was 94%, sensitivity was 90%, positive predictive value was 90%, and negative predictive value was 94%.CONCLUSIONS: Depression is common in preclinical AD. Depressed subjects with preclinical AD can be accurately differentiated from subjects with depression‐related cognitive impairment by age and the severity of the memory impairment. Research that aims to investigate preclinical AD should not exclude a priori subjects with depression inasmuch as preclinical AD is often accompanied by depression. J Am Geriatr Soc 48: 479–484, 2000.
Mobility Difficulties and Physical Activity as Predictors of Mortality and Loss of Independence in the Community‐Living Older Population
Authors: Hirvensalo Mirja , Rantanen Taina , Heikkinen Eino 
Published: April 2015

OBJECTIVE: In older people, mobility impairments and physical inactivity are risk factors for further disability and death. We studied the interaction of physical activity and mobility impairment as a predictor of dependence and mortality.DESIGN: A population‐based, prospective study. The data were collected in structured interviews in the year 1988 and 8 years later in the year 1996 as part of the Evergreen Project.PARTICIPANTS: Subjects were 1109 independently living, at baseline 65‐ to 84‐year‐old people in the city of Jyväskylä, in central Finland.METHODS: Participants were ranked into four groups: (1) Intact mobility and physically active (Mobile‐Active), (2) Intact mobility and sedentary (Mobile‐Sedentary), (3) Impaired mobility and physically active (Impaired‐Active), and (4) Impaired mobility and sedentary (Impaired‐Sedentary). The confounders adjusted for in the models included age, marital status, education, chronic conditions, smoking, and physical exercise earlier in life.RESULTS: In men and women, the relative risk of death was two times greater in Impaired‐Active and three times greater in Impaired‐Sedentary groups than the risk of death in Mobile‐Active groups. However, the risk of death did not differ between Mobile‐Active and Mobile‐Sedentary groups. The odds ratio for dependency (95% confidence interval) in Impaired‐Sedentary men was 5.21 (1.44–18.70) and in Impaired‐Sedentary women was 2.92 (1.52–5.60) compared to Mobile‐Active groups. The risk of dependence did not differ significantly between Mobile‐Active, Mobile‐Sedentary, and Impaired‐Active groups.CONCLUSIONS: Mobility impairments predicted mortality and dependence. However, among people with impaired mobility, physical activity was associated with lower risks, whereas the risk did not differ according to activity level among those with intact mobility. Despite of their overall greater risk, mobility‐impaired people may be able to prevent further disability and mortality by physical exercise. J Am Geriatr Soc 48: 493–498, 2000.
The Effectiveness of a Weight Maintenance Intervention for Adults with Intellectual Disabilities and Obesity: A Single Stranded Study
Authors: Spanos Dimitrios , Hankey Catherine R. , Melville Craig A. 
Published: April 2015

BackgroundThe evidence base for weight management programmes incorporating a weight loss and a weight maintenance phase for adults with intellectual disabilities (ID) is limited. This study describes the weight maintenance phase of a multicomponent weight management programme for adults with intellectual disability and obesity (TAKE 5).Materials and MethodsThirty‐one participants who had completed the 16 week TAKE five weight loss intervention (Phase I) were invited to participate in a 12 month weight maintenance intervention (Phase II). Content included recommendations of the National Weight Control Registry.ResultsTwenty‐eight participants completed Phase II with 50.4% maintaining their weight (mean weight change −0.5 kg, SD 2.2), 28.7% gaining weight (mean weight gain 5.4 kg, SD 2.2) and 21.6% losing weight (mean weight loss −8.0 kg, SD 3.0) at 12 months.ConclusionFurther research is justified to investigate the efficacy of weight loss maintenance interventions in adults with intellectual disability and obesity, using controlled study designs.
The Relationship between Voluntary Disclosure, External Financing and Financial Status
Authors: Jankensgård Håkan 
Published: April 2015

AbstractUsing unique Swedish disclosure data from 2007 to 2012, this paper reports three important sets of findings with regard to the relationship between firms’ voluntary disclosure, external financing and financial status. First, financially strong firms disclose more than weaker ones. Second, firms that obtain new financing (equity or debt) disclose more than firms that do not. Third, the association between voluntary disclosure and financing events is stronger in financially weak firms. This last finding is new in the literature. Perhaps financially weak firms that obtain external funding have higher disclosure to counteract contracting and valuation problems in the financial markets.
Internet cognitive failure and fatigue relevant to learners' self‐regulation and learning progress inEnglish vocabulary with a calibration scheme
Authors: Hong J.‐C. , Hwang M.‐Y. , Chang H.‐W. , Tai K.‐H. , Kuo Y.‐C. , Tsai Y.‐H. 
Published: April 2015

AbstractTo determine the factors of learning effectiveness inEnglish vocabulary learning when using a calibration scheme, this study developed a freshman English mobile device application (for iPhone 4) for students with low levels ofEnglish proficiency to practise vocabulary in the beginning of theirFreshmanEnglish course. Data were collected and validated from 243 subjects for confirmatory factor analysis and structural equation modeling. The findings revealed thatInternet cognitive failure (i.e., trait cognitive disability) was positively correlated to Internet cognitive fatigue (i.e., state cognitive disability). Both types of Internet cognitive disability were negatively correlated to self‐regulation in English vocabulary learning (SREVL).SREVLwas positively correlated to the degree of learning improvement. The findings implied that the use of a calibration design for mobile English vocabulary learning could benefit students with low levels of Internet cognitive disability but high levels ofSREVL.
Influence of inter‐dental tissues and root surface condition on complete root coverage following treatment of gingival recessions: a 1‐year retrospective study
Authors: Pini‐Prato Giovanpaolo , Magnani Cristina , Zaheer Faizan , Rotundo Roberto , Buti Jacopo 
Published: April 2015

AbstractAimTo explore the influence of inter‐dental tissues and root surface condition on complete root coverage following surgical treatment of gingival recessions.MethodsThree hundred and eighty‐six single recessions treated over 28 years were assessed. Patient‐level and periodontal variables, presence/loss of inter‐dental tissues, and presence/absence of non‐carious cervical lesions (NCCLs) were recorded. Root coverage was assessed 1‐year post‐surgery. Multilevel analysis was performed to identify predictors of CRC.ResultsBased on type of root coverage procedure four patient groups were created: free gingival graft (FGG) (n = 116), coronally advanced flap (CAF) (n = 107), CAF+connective tissue graft (CTG) (n = 131), and guided tissue regeneration (GTR) (n = 32). Percentages of complete root coverage (CRC) were 18.1% for FGG, 35.5% for CAF, 35.1% for CAF+CTG, and 18.8% for GTR. There was an OR = 0.26 (p < 0.0001) of achieving CRC in cases with loss of inter‐dental tissue compared with cases with no inter‐dental tissue loss. Similarly, cases with presence of NCCL showed an OR = 0.28 (p < 0.0001) of achieving CRC compared with cases without a NCCL. FGG achieved less CRC then CAF+CTG (p = 0.0012; OR = 0.32).ConclusionsNCCLs, just like inter‐dental tissue loss, are significant negative prognostic factors in achieving CRC following root coverage procedures.
A root canal filling per se does not have a significant negative effect on the marginal periodontium
Authors: Bertl Kristina , Suljkanovic Nedim , Suljkanovic Lejla , Lettner Stefan , Esfandeyari Azadeh , Moritz Andreas , Stavropoulos Andreas , Bruckmann Corinna 
Published: April 2015

AbstractAimTo evaluate the periodontal status of single‐rooted endodontically treated teeth (ET), correcting for patient‐ and tooth‐related factors.MethodsClinical parameters (BoP,PD,CAL) of 240 ET and 240 contralateral vital teeth (VT), before and after non‐surgical periodontal treatment, were extracted retrospectively from the journals of 175 patients. Possible patient‐related (age, gender, smoking status) and tooth‐related (interproximal restoration, root canal filling's extent, post, tooth type) confounders were tested.ResultsAt baseline, frequency of BoP at an interproximal site at ET versus VT was 70.4% versus 65.0%, respectively. The frequency of teeth with interproximal PD ≥5 mm and CAL ≥5 mm was 47.9% versus 42.9% and 54.6% versus 49.6% at ET and VT, respectively. Interproximal PD and CAL at ET versus VT were 3.86 versus 3.61 mm and 4.11 versus 3.95 mm. After correcting for tooth‐related factors, no significant differences were observed between ET and VT. An improper restoration had a significant (p < 0.001) negative effect on BoP [OR 3.49 (95%CI: 1.95–6.27)], PD [36.81% (95%CI: 18.52–57.92)] and CAL [27.01% (95%CI: 12.67–43.18)]. No significant differences between ET and VT were observed regarding clinical outcome of non‐surgical periodontal therapy.ConclusionsPresence of a root canal filling per se does not have a significant negative influence on the marginal periodontium, when correcting for the quality of the interproximal restoration.