bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study protocol: a systematic review of pediatric shared decision making
Authors: Wyatt Kirk D , Prutsky Lopez Gabriela , Domecq Garces Juan Pablo , Erwin Patricia , Brinkman William B , Montori Victor M , LeBlanc Annie 
Published: July 2013

AbstractBackgroundShared decision making in pediatrics is unique because it often involves active participation of both the child or adolescent patient and his or her caregiver(s) in the decision making process with the clinician or care team, and the extent to which the patient is involved is commensurate with their developmental level. However, little is known about the nature of pediatric-specific shared decision making interventions and their impact.Methods/DesignWe will perform a systematic review with the objective of summarizing the nature of shared decision making practices, tools, techniques and technologies in the pediatric setting as well as their effects. A literature search will include Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Library, Web of Science, Scopus and Ovid PsycInfo databases in addition to consultation of a group of shared decision making experts to identify unpublished or in-progress works. We will include original research studies involving patients <18 years, their caregivers, or both, and summarize methods and approaches designed to engage participants in the health care decision making process with clinicians. Perinatal and research participation decisions will be excluded. Descriptions of participants involved, interventions used and the measured outcomes will be reported. Quality assessment will be performed according to the design of each study, where possible.DiscussionWe anticipate that the paucity of published quantitative data and the heterogeneous nature of the reported results will preclude quantitative analysis. In this event, a meta-narrative approach will be undertaken.Systematic review registrationPROSPERO registration number:CRD42013004761
Extended pancreas donor program – the EXPAND study rationale and study protocol
Authors: Proneth Andrea , Schnitzbauer Andreas A , Zeman Florian , Foerster Johanna R , Holub Ines , Arbogast Helmut , Bechstein Wolf O , Becker Thomas , Dietz Carsten , Guba Markus , Heise Michael , Jonas Sven , Kersting Stephan , Klempnauer Jürgen , Manekeller Steffen , Müller Volker , Nadalin Silvio , Nashan Björn , Pascher Andreas , Rauchfuss Falk , Ströhlein Michael A , Schemmer Peter , Schenker Peter , Thorban Stefan , Vogel Thomas , Rahmel Axel O , Viebahn Richard , Banas Bernhard , Geissler Edward K , Schlitt Hans J , Farkas Stefan A 
Published: July 2013

Abstract

Background

Simultaneous pancreas kidney transplantation (SPK), pancreas transplantation alone (PTA) or pancreas transplantation after kidney (PAK) are the only curative treatment options for patients with type 1 (juvenile) diabetes mellitus with or without impaired renal function. Unfortunately, transplant waiting lists for this indication are increasing because the current organ acceptability criteria are restrictive; morbidity and mortality significantly increase with time on the waitlist. Currently, only pancreas organs from donors younger than 50 years of age and with a body mass index (BMI) less than 30 are allocated for transplantation in the Eurotransplant (ET) area. To address this issue we designed a study to increase the available donor pool for these patients.

Methods/Design

This study is a prospective, multicenter (20 German centers), single blinded, non-randomized, two armed trial comparing outcome after SPK, PTA or PAK between organs with the currently allowed donor criteria versus selected organs from donors with extended criteria. Extended donor criteria are defined as organs procured from donors with a BMI of 30 to 34 or a donor age between 50 and 60 years. Immunosuppression is generally standardized using induction therapy with Myfortic, tacrolimus and low dose steroids. In principle, all patients on the waitlist for primary SPK, PTA or PAK are eligible for the clinical trial when they consent to possibly receiving an extended donor criteria organ. Patients receiving an organ meeting the current standard criteria for pancreas allocation (control arm) are compared to those receiving extended criteria organ (study arm); patients are blinded for a follow-up period of one year. The combined primary endpoint is survival of the pancreas allograft and pancreas allograft function after three months, as an early relevant outcome parameter for pancreas transplantation.

Discussion

The EXPAND Study has been initiated to investigate the hypothesis that locally allocated extended criteria organs can be transplanted with similar results compared to the currently allowed standard ET organ allocation. If our study shows a favorable comparison to standard organ allocation criteria, the morbidity and mortality for patients waiting for transplantation could be reduced in the future.

Trial registration

Trial registered at:
NCT01384006
Outbreak of multidrug-resistant Klebsiella pneumoniae carrying qnrB1 and bla
CTX-M15
in a French intensive care unit
Authors: Filippa Nathalie , Carricajo Anne , Grattard Florence , Fascia Pascal , El Sayed Faten , Defilippis Jean Pierre , Berthelot Philippe , Aubert Gerald 
Published: July 2013

Abstract

Background
The prevalence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae is increasing globally and is a major clinical concern. Between June 2008 and September 2009, 4% of patients in an intensive care unit (ICU) were found to be colonized or infected by strains of Klebsiella pneumoniae multiresistant to ceftazidime, ciprofloxacin, and tobramycin; an investigation was initiated and isolates were characterized by molecular typing and resistance patterns.

Methods
Antibiotic susceptibilities were determined by Vitek2®, Etest®, and agar dilution. Gene encoding beta-lactamases and plasmid-mediated quinolone resistance PMQR determinants (qnr, aac(6′)-Ib) were characterized by PCR, sequencing, and transfer assays. DiversiLab® fingerprints were used to study the relatedness of isolates.

Results
Fourteen isolates co-expressing bla

CTX-M15, qnrB1, and aac(6′)-Ib-cr were identified. Genotypic analysis of these isolates identified 12 clonally related strains recovered from 10 patients. The increased prevalence of bla

CTX-M15-qnrB1-aac(6′)-Ib-cr-producing K. pneumoniae coincided with the presence in the ICU of a patient originally from Nigeria. This patient was infected by a strain not clonally related to the others but harbouring qnrB1 and aac(6′)-Ib-cr genes, a finding not hitherto observed in France. We suspected transmission of resistance plasmids followed by rapid dissemination of the multiresistant K. pneumoniae clone by cross-transmission.

Conclusion
This study highlights the importance of microbiological screening for multidrug-resistant strains in ICUs, particularly among patients from regions in which multidrug-resistant bacteria are known to exist.
How caregivers view patient comfort and what they do to improve it: a French survey
Authors: Lombardo Véronique , Vinatier Isabelle , Baillot Marie-Lou , Franja Vicenta , Bourgeon-Ghittori Irma , Dray Sandrine , Jeune Sylvie , Mossadegh Chirine , Reignier Jean , Souweine Bertrand , Roch Antoine ,   Société de Réanimation de Langue Française (SRLF)
Published: July 2013

Abstract

Background
Intensive care unit (ICU) patients are exposed to many sources of discomfort. Most of these are related to the patient’s condition, but ICU design or how care is organized also can contribute. The present survey was designed to describe the opinions of ICU caregivers on sources of patient discomfort and to determine how they were dealt with in practice. The architectural and organizational characteristics of ICUs also were analyzed in relation to patient comfort.

Methods
An online, closed-ended questionnaire was developed. ICU caregivers registered at the French society of intensive care were invited to complete this questionnaire.

Results
A total of 915 staff members (55% nurses) from 264 adult and 28 pediatric ICUs completed the questionnaire. Analysis of the answers reveals that: 68% of ICUs had only single-occupancy rooms, and 66% had natural light in each room; ICU patients had access to television in 59% of ICUs; a clock was present in each room in 68% of ICUs. Visiting times were <4 h in 49% of adult ICUs, whereas 64% of respondents considered a 24-h policy to be very useful or essential to patients’ well-being. A nurse-driven analgesia protocol was available in 42% of units. For caregivers, the main sources of patient discomfort were anxiety, feelings of restraint, noise, and sleep disturbances. Paramedics generally considered discomfort related to thirst, lack of privacy, and the lack of space and time references, whereas almost 50% of doctors ignored these sources of discomfort. Half of caregivers indicated they assessed sleep quality. A minority of caregivers declared regular use of noise-reduction strategies. Twenty percent of respondents admitted to having non-work-related conversations during patient care, and only 40% indicated that care often was or always was provided without closing doors. Family participation in care was planned in very few adult ICUs.

Conclusions
Results of this survey showed that ICUs are poorly equipped to ensure patient privacy and rest. Access by loved ones and their participation in care also is limited. The data also highlighted that some sources of discomfort are less often taken into account by caregivers, despite being considered to contribute significantly.
Estimating long-run equilibrium real exchange rates: short-lived shocks with long-lived impacts on Pakistan
Authors: Zardad Asma , Mohsin Asma , Zaman Khalid 
Published: July 2013

Abstract
The purpose of this study is to investigate the factors that affect real exchange rate volatility for Pakistan through the co-integration and error correction model over a 30-year time period, i.e. between 1980 and 2010. The study employed the autoregressive conditional heteroskedasticity (ARCH), generalized autoregressive conditional heteroskedasticity (GARCH) and Vector Error Correction model (VECM) to estimate the changes in the volatility of real exchange rate series, while an error correction model was used to determine the short-run dynamics of the system. The study is limited to a few variables i.e., productivity differential (i.e., real GDP per capita relative to main trading partner); terms of trade; trade openness and government expenditures in order to manage robust data. The result indicates that real effective exchange rate (REER) has been volatile around its equilibrium level; while, the speed of adjustment is relatively slow. VECM results confirm long run convergence of real exchange rate towards its equilibrium level. Results from ARCH and GARCH estimation shows that real shocks volatility persists, so that shocks die out rather slowly, and lasting misalignment seems to have occurred.
Time spent on health related activity by older Australians with diabetes
Authors: Yen Laurann E , McRae Ian S , Jowsey Tanisha , Bagheri Nasser 
Published: July 2013

Abstract
Aims
There is little information available about what people do to look after their health, or how long people spend on health activities. This study identifies key health related activities and time taken as part of self management by people with diabetes. Management planning often lacks information that this study provides that would help clinicians and patients to create manageable and do-able plans that patients can follow.

Methods
Data were collected in 2010 using a national survey of people aged 50 years the National Diabetes Services Scheme. Respondents provided recall data on time used for personal health care, non-clinical health activity; and health service interactions. Data were analysed using Stata 12 and SPSS 19.

Results
While most people with diabetes spend on average less than 30 minutes a day on health-related activities (excluding exercise), the highest decile of respondents averaged over 100 minutes. Time spent increased with the number of co-existent conditions. Taking medication and sitting in waiting rooms were the most frequently reported activities. The greatest amount of time was spent on daily personal health care activities.

Conclusion
The time demands of diabetes for older people can be substantial. Better patient engagement in self management might result from a better match in care planning between the illness demands and the patient time availability, with potential to reduce admissions for hospital care.
Transcriptome analysis of human tissues and cell lines reveals one dominant transcript per gene
Authors: Gonzàlez-Porta Mar , Frankish Adam , Rung Johan , Harrow Jennifer , Brazma Alvis 
Published: July 2013

Abstract
Background
RNA sequencing has opened new avenues for the study of transcriptome composition. Significant evidence has accumulated showing that the human transcriptome contains in excess of a hundred thousand different transcripts. However, it is still not clear to what extent this diversity prevails when considering the relative abundances of different transcripts from the same gene.

Results
Here we show that, in a given condition, most protein coding genes have one major transcript expressed at significantly higher level than others, that in human tissues the major transcripts contribute almost 85 percent to the total mRNA from protein coding loci, and that often the same major transcript is expressed in many tissues. We detect a high degree of overlap between the set of major transcripts and a recently published set of alternatively spliced transcripts that are predicted to be translated utilizing proteomic data. Thus, we hypothesize that although some minor transcripts may play a functional role, the major ones are likely to be the main contributors to the proteome. However, we still detect a non-negligible fraction of protein coding genes for which the major transcript does not code a protein.

Conclusions
Overall, our findings suggest that the transcriptome from protein coding loci is dominated by one transcript per gene and that not all the transcripts that contribute to transcriptome diversity are equally likely to contribute to protein diversity. This observation can help to prioritize candidate targets in proteomics research and to predict the functional impact of the detected changes in variation studies.
What civilian psychiatrists should know about military psychiatry
Authors: Deahl Martin , Siddiquee Rehan 
Published: July 2013

SummaryFew of us have first-hand experience of military psychiatry. However, as a result of recent conflict and the imminent downsizing of the armed forces we will almost certainly be seeing increasing numbers of ex-servicemen in our clinics. This paper explains what civilian mental health professionals should know when dealing with service and ex-service men and women.
Suicide prevention: are we doing enough?
Authors: Cole-King Alys , Parker Victoria , Williams Helen , Platt Stephen 
Published: July 2013

SummaryHealthcare professionals require an understanding of how the behaviour and characteristics of both patients and assessors can affect suicide risk identification and response. This article reviews the literature on how we currently assess suicide risk and considers the need for a paradigm shift in how healthcare professionals engage with and assess suicidal patients. It also reviews some of the evidence base for interventions to mitigate the risk of suicide and promotes pragmatic and compassionate interventions.
New diagnostic concepts in Alzheimer's disease
Authors: Watkin Anna , Sikdar Sudip , Majumdar Biswadeep , Richman Anna V. 
Published: July 2013

SummaryThis article gives an overview of the profile of Alzheimer's disease, its pathophysiology and recent developments in technology that enable better understanding of the mechanism of disease. The diagnostic criteria and role of biomarkers proposed are explained. The new subgroups described are outlined in table form for easy reference. Subtypes of mild cognitive impairment (MCI) are reviewed and the conversion of amnestic MCI to Alzheimer's disease is considered. The implications and change to current clinical practice form the basis of the conclusion of the article.
Review of treatment for late-life depression
Authors: Allan Charlotte L. , Ebmeier Klaus P. 
Published: July 2013

SummaryDepressive disorder in those over the age of 60 has many clinical similarities to depression in younger adults, but biological changes related to ageing may necessitate a different approach to treatment. We present an evidence-based review of treatment for late-life depression, focusing on pharmacological approaches, including monotherapy, combination and augmentation strategies. Selective serotonin reuptake inhibitors such as sertraline and citalopram are well tolerated, have the advantage of a favourable side-effect profile, and are good options for first-line treatment. Second-line treatment options include combination therapy with a second antidepressant, or treatment augmentation with an antipsychotic or lithium. We also consider evidence for nonpharmacological treatment strategies, including psychological therapy and neurostimulation. Finally, we summarise evidence for treatment of depression in patients in dementia.
Socioeconomic status as a risk factor for dementia death: individual participant meta-analysis of 86 508 men and women from the UK
Authors: Russ Tom C. , Stamatakis Emmanuel , Hamer Mark , Starr John M. , Kivimäki Mika , Batty G. David 
Published: July 2013

BackgroundLife-course socioeconomic factors may have a role in dementia aetiology but there is a current paucity of studies. Meta-analyses of individual participant data would considerably strengthen this evidence base.AimsTo examine the association between socioeconomic status in early life and adulthood with later dementia death.MethodIndividual participant meta-analysis of 11 prospective cohort studies (1994–2004,n= 86508).ResultsLeaving full-time education at an earlier age was associated with an increased risk of dementia death in women (fully adjusted hazard ratio (HR) for age ⩽14v.age ⩾16: HR = 1.76, 95% Cl 1.23–2.53) but not men. Occupational social class was not statistically significantly associated with dementia death in men or women.ConclusionsLower educational attainment in women was associated with an increased risk of dementia-related death independently of common risk behaviours and comorbidities.
Tardive dyskinesia in schizophrenia
Authors: Liddle Peter F. 
Published: July 2013

SummarySarró et al report grey matter deficits associated with tardive dyskinesia in schizophrenia. Much evidence suggests that the intrinsic pathophysiology of schizophrenia contributes to predisposition to tardive dyskinesia. The possibility that antipsychotics might play a causal role in the grey matter deficits cannot be excluded, but the evidence is tenuous.
Crisis teams: systematic review of their effectiveness in practice
Authors: Carpenter Rebecca A. , Falkenburg Jara , White Thomas P. , Tracy Derek K. 
Published: July 2013

Aims and methodCrisis resolution and home treatment teams (variously abbreviated to CRTs, CRHTTs, HTTs) were introduced to reduce the number and duration of in-patient admissions and better manage individuals in crisis. Despite their ubiquity, their evidence base is challengeable. This systematic review explored whether CRTs: (a) affected voluntary and compulsory admissions; (b) treat particular patient groups; (c) are cost-effective; and (d) provide care patients value.ResultsCrisis resolution teams appear effective in reducing admissions, although data are mixed and other factors have also influenced this. Compulsory admissions may have increased, but evidence that CRTs are causally related is inconclusive. There are few clinical differences between ‘gate-kept’ patients admitted and those not. Crisis resolution teams are cheaper than in-patient care and, overall, patients are satisfied with CRT care.Clinical implicationsHigh-quality evidence for CRTs is scarce, although they appear to contribute to reducing admissions. Patient-relevant psychosocial and longitudinal outcomes are under-explored.
Evaluation of three assertive outreach teams
Authors: Macpherson Rob , Thyarappa Praveen , Riley Genevieve , Steer Hannah , Blackburn Mike , Foy Chris 
Published: July 2013

Aims and methodTo evaluate outcomes for service users during their first year of treatment in three English assertive outreach teams. Changes in health and social functioning, engagement with services, service use and need (rated by staff and service users) were evaluated.ResultsIn 49 service users we found a significant increase in mean staff-rated met needs up to 6 months of treatment. There were no significant changes in ratings of engagement or Health of the Nation Outcome Scales (HoNOS) scores at 6 and 12 months. Unmet needs rated by service users and staff showed a non-significant trend for improvement across a range of individual health and social domains. Duration of hospital admission reduced significantly between the 12 months before the evaluation and the 12 months of the evaluation. Formal and informal admission and levels of contact with crisis teams reduced over the study period.Clinical implicationsAlthough these results offer some support to the assertive outreach approach, further research in larger samples is needed to identify which changes in health and social functioning are associated with transfer to assertive outreach teams.
Public mental health: the local tangibles
Authors: Campion Jonathan 
Published: July 2013

SummaryPublic mental health involves a number of important elements relevant to psychiatrists. This includes estimation of the level and impact of unmet need for treatment of mental disorder, prevention of mental disorder and promotion of mental well-being particularly in higher-risk groups. In the UK, the majority of people with mental disorder receive no intervention. This is despite the large impact and costs of mental disorder and existence of cost-effective interventions which result in economic savings even in the short term. Furthermore, spend is virtually absent for interventions to prevent mental disorder and promote mental well-being despite prominence within government policy and a good evidence base. At a time of budget cuts, local information about level, impact and costs of such unmet need as well as effective interventions are important to accurately inform the required investment for treatment of mental disorder, its prevention and promotion of mental well-being. Information about impact of interventions including economic savings across a broad range of sectors can also be estimated. This article summarises recent public mental health commissioning guidance which provides such information.
Dr Nathaniel Minton MA, DPM, FRCPsych
Authors: Clein Lewis 
Published: July 2013

Formerly consultant psychiatrist, St Peter's Hospital, Chertsey, The Priory, and Capio Nightingale Hospital, LondonDr Nathaniel Minton, who was born on 28 May 1935, had a unique training in psychiatry for a British graduate, because he spent 3 years (1965–1968) training in psychoanalysis and depth psychotherapy at the C.G.Jung Institute in Zurich, trained individually by Jolande Jacobi, Jung's senior deputy. When later, in 1979, he became a consultant psychiatrist at St Peter's Hospital, Chertsey, he was also recognised as being a psychotherapist at the Royal Holloway University of London.
Determination of AMBER Force Field Parameters for Thioester by Quantum Chemical Calculations
Authors: Oda Akifumi , Fukuyoshi Shuichi , Nakagaki Ryoichi , Takahashi Ohgi 
Published: July 2013

Abstract
The AMBER force field parameters around the sulfur atom of the thioester moiety were determined by high-accuracy quantum chemical calculations. The atomic charges of acetylcysteine were also calculated. The quantum chemical and molecular mechanical calculations of short peptides including acetylcysteine were carried out, and the results were compared to evaluate the new parameters.