bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adolescents’ perceptions of music therapy following spinal fusion surgery
Authors: Kleiber Charmaine , Adamek Mary S 
Published: September 2012

Aims and objectives.  To explore adolescents’ memories about music therapy after spinal fusion surgery and their recommendations for future patients.Background.  Spinal fusion for adolescent idiopathic scoliosis is one of the most painful surgeries performed. Music therapy is shown to decrease postoperative pain in children after minor surgery. In preparation for developing a preoperative information program, we interviewed adolescents who had spinal fusion and postoperative music therapy to find out what they remembered and what they recommended for future patients.Methods.  Eight adolescents who had spinal fusion for adolescent idiopathic scoliosis were interviewed about their experiences. For this qualitative study, the investigators independently used thematic analysis techniques to formulate interpretive themes. Together they discussed their ideas and assigned overall meanings to the information.Results.  The eight participants were 13–17 years of age and had surgery between 2–24 months previously. The overarching themes identified from the interviews were relaxation and pain perception, choice and control, therapist interaction and preoperative information. Participants stated that music therapy helped with mental relaxation and distraction from pain. It was important to be able to choose the type of music for the therapy and to use self‐control to focus on the positive. Their recommendation was that future patients should be provided with information preoperatively about music therapy and pain management. Participants recommended a combination of auditory and visual information, especially the experiences of previous patients who had spinal fusion and music therapy.Conclusion.  Music provided live at the bedside by a music therapist was remembered vividly and positively by most of the participants.Relevance to clinical practice.  The presence of a music therapist providing patient‐selected music at the bedside is important. Methods to introduce adolescents to music therapy and how to use music for relaxation should be developed and tested.
Caregivers’ lived experience of assisted feeding
Authors: Martinsen Bente , Norlyk Annelise 
Published: September 2012

Aims and objectivesThe aim of this study was to explore caregivers’ experience of assisted feeding.BackgroundAssisted feeding presupposes a technical and creative coordination of the behaviour of the caregiver and the person who needs assistance. To achieve this, the two parties must be able to perceive and interpret each other's verbal and non‐verbal behaviour and respond.DesignA qualitative approach using in‐depth semi‐structured interviews conducted with caregivers was used.MethodsTwelve caregivers with different educational background (nurses and care assistants) were interviewed during 2010. Transcriptions of interviews were analysed using the phenomenological guidelines by Dahlberg and colleagues.ResultsThe essence of assisted feeding among caregivers was identified to be a healing activity creating a basis for recovery. The constituents of the essence were as follows: with simulated calmness, with the nutritional aspect in mind, with relatives as source and resource, with work experiences and personal preferences as reference points and with inconsistent reactions to patient behaviours.ConclusionWhen performing assisted feeding, caregivers adjust their care to the individual patient drawing on their personal knowledge and empathy. They mainly focus on the nutritional aspect of assisted feeding but also take their own beliefs and societal norms around eating into consideration. There seems to be a tension between the importance caregivers assign to the nutritional aspect of assisted feeding and the low status this task holds, not only in the hierarchy of hospital activities but also among caregivers.Relevance to clinical practiceAn overriding guideline for assisted feeding should be formulated, so that the activity will be less dependent on the individual caregiver's personal beliefs, time pressure and the character of the surroundings.
Individual support planning: perceptions and expectations of people with intellectual disabilities in the Netherlands
Authors: Herps M. A. , Buntinx W. H. E. , Curfs L. M. G. 
Published: September 2012

AbstractBackground  According to Dutch jurisdiction, individual support plans (ISP) should register the mutual agreements between a person with intellectual disabilities (ID) and a professional service organisation with respect to the support that will be provided. In planning for support, active involvement of both parties is necessary. The current study focuses on the perceptions and experiences of Dutch persons with ID with respect to their involvement in their ISP.Method  Data were gathered through semi‐structured interviews with 61 people with mild to moderate ID. Participants were recruited in 23 Dutch service provider organisations. A systematic qualitative analysis was performed on the interview transcripts.Results  Although persons with ID are present at their ISP meeting, active client involvement in developing, executing and evaluating the ISP is not common practice. Issues of accessibility and lack of control over the process and content of ISP hamper effective involvement of people with ID.Conclusions  The study raises questions concerning ISP practices in the Netherlands. The question needs to be addressed as to how to facilitate active involvement of people with ID in planning for support. The results further suggest that support organisations perceive an ISP rather as a formal document to comply with bureaucratic rules than as an instrument of empowerment to enhance control of persons with ID over their own lives.
Responsivity to criminogenic need in forensic intellectual disability services
Authors: Lindsay W. R. , Holland A. J. , Carson D. , Taylor J. L. , O'Brien G. , Steptoe L. , Wheeler J. 
Published: September 2012

AbstractBackground  Research has shown for some time that addressing criminogenic need is one of the crucial aspects of reducing reoffending in all types of offenders. Criminogenic need such as anger or inappropriate sexual interest is considered to be crucial in the commission of the offence. The aim of the present study is to investigate the extent to which forensic services address the needs of those accepted into services.Method  This study reviews the treatment for 197 offenders with intellectual disability accepted into a range of services. Participants' case files were examined to ascertain the extent to which need was addressed through recognised therapies. A standard pro forma was used on which we had established good reliability across four research assistants.Results  The most frequently referred problems were violence and sexual offending. Specialist forensic intellectual disability community services were significantly more likely to provide treatment specifically designed to address index behaviours when compared to generic community services and secure services.Conclusions  Various possible explanations of these findings are explored including staffing levels, diagnosed mental illness, expertise of staff and clarity of purpose in services.
Patient and provider views on the use of medical services by women with intellectual disabilities
Authors: Wilkinson J. , Dreyfus D. , Bowen D. , Bokhour B. 
Published: September 2012

AbstractBackground  People with intellectual disabilities (ID) receive primary care in community‐based practices and are encouraged to participate in the physician–patient relationship. However, the nature of this participation is not known.Methods  Qualitative data were analysed to obtain perspectives from patients and providers regarding clinic visits. Patient participants were recruited from community organisations, while physician participants were recruited from emails and phone calls to local and regional practices and a national and regional list serve. Analysis methods derived from grounded theory were used.Results  Twenty‐seven women with ID and 22 family physicians were interviewed. Themes important to both groups included time, how the support worker should be used in the encounter and the nature of the physician–patient relationship. Patients expressed frustration at how little time they spent with their physician, and wished that physicians would speak directly to them instead of to their support worker. Physicians felt that patients with ID took too much time, and said that they preferred communicating with the support worker. The interviews also revealed unconscious biases about people with ID.Conclusions  Patient participation is encouraged for people with ID, but is limited because of both physician and patient factors. Greater awareness of these factors may improve care for patients with ID.
Dissecting molecular stress networks: identifying nodes of divergence between life‐history phenotypes
Authors: Schwartz Tonia S. , Bronikowski Anne M. 
Published: September 2012

AbstractThe complex molecular network that underlies physiological stress response is comprised of nodes (proteins, metabolites, mRNAs, etc.) whose connections span cells, tissues and organs. Variable nodes are points in the network upon which natural selection may act. Thus, identifying variable nodes will reveal how this molecular stress network may evolve among populations in different habitats and how it might impact life‐history evolution. Here, we use physiological and genetic assays to test whether laboratory‐born juveniles from natural populations of garter snakes (Thamnophis elegans), which have diverged in their life‐history phenotypes, vary concomitantly at candidate nodes of the stress response network, (i) under unstressed conditions and (ii) in response to an induced stress. We found that two common measures of stress (plasma corticosterone and liver gene expression of heat shock proteins) increased under stress in both life‐history phenotypes. In contrast, the phenotypes diverged at four nodes both under unstressed conditions and in response to stress: circulating levels of reactive oxygen species (superoxide, H2O2); liver gene expression of GPX1 and erythrocyte DNA damage. Additionally, allele frequencies for SOD2 diverge from neutral markers, suggesting diversifying selection on SOD2 alleles. This study supports the hypothesis that these life‐history phenotypes have diverged at the molecular level in how they respond to stress, particularly in nodes regulating oxidative stress. Furthermore, the differences between the life‐history phenotypes were more pronounced in females. We discuss the responses to stress in the context of the associated life‐history phenotype and the evolutionary pressures thought to be responsible for divergence between the phenotypes.
Use of scintigraphy to evaluate gastric accommodation and emptying: Comparison with barostat
Authors: Tomita Toshihiko , Okugawa Takuya , Yamasaki Takahisa , Kondo Takashi , Toyoshima Fumihiko , Sakurai Jun , Oshima Tadayuki , Fukui Hirokazu , Daimon Takashi , Watari Jiro , Kashiwagi Toru , Matsumoto Takayuki , Miwa Hiroto 
Published: September 2012

AbstractBackground and AimScintigraphy is a useful noninvasive technique for assessment of gastric motility, especially emptying, but there is little knowledge of use of the technique to assess gastric accommodation. Therefore, to clarify the usefulness of scintigraphy as a technique for assessing gastric accommodation, we compared scintigraphy with barostat, the gold standard modality.MethodsTwenty healthy volunteers (14 men, six women; mean age, 28.5 ± 5.4 years) were enrolled in the study. The volunteers ingested a radiolabeled (99mTc) test meal and scintigraphic images were recorded. Radioactivity in the upper third and whole stomach was calculated to evaluate accommodation. In the barostat procedure, gastric accommodation was evaluated by measuring the maximum volume of the distended balloon. Thereafter, correlation between scintigraphic and barostat accommodation was investigated. Intra‐and inter‐observer variation of the scintigraphic test results were also assessed. Finally, the diagnostic performance of scintigraphy was evaluated by using sumatriptan as a positive control.ResultsMeasurements of accommodation by scintigraphy and barostat correlated (r = 0.524, P < 0.05). Sumatriptan significantly increased scintigraphically measured gastric accommodation (with sumatriptan, 51.5 ± 16.4%; without sumatriptan, 38.4 ± 13.8%) (P < 0.01), and had significantly (P < 0.05) delayed 50% half emptying time at 60, 90, 120, and 150 min after the start of the experiment. The data from repeated scintigraphic tests were highly reproducible (r = 0.804) with significant differences not observed among the investigators (inter‐observer variation = 0.932, intra‐observer variation = 0.898).ConclusionGastric scintigraphy is a useful technique for assessing gastric accommodation and emptying.
Celiac disease arthropathy and autoimmunity study
Authors: Iqbal Tariq , Zaidi Mukarram A , Wells George A , Karsh Jacob 
Published: September 2012

AbstractBackground and AimTo evaluate presence of sero‐negative spondyloarthritis (SpA) in celiac disease (CD) patients, and whether compliance with a gluten free diet (GFD) improved arthritis manifestations in these patients.MethodsWe undertook a prospective, questionnaire based, cross‐sectional cohort study to evaluate the presence or absence of SpA simultaneously in both CD and non‐CD cohorts.Results356/590 (60.3%) patients with CD participated in this study. 99% had diagnosis confirmed by a diagnostic test (79% small bowel biopsy, 19.8% blood test, 3.9% stool test). Approximately 131 (37%) cases of arthritis were reported in CD patients. Of the 6/356 CD patients with seronegative spondyloarthritides, four had sacroiliitis, two ankylosing spondylitis, and one psoriatic arthritis, compared to one ankylosing spondylitis and five psoriatic arthritis in non‐CD. Osteoarthritis (89 vs 59, P = 0.93) was the most common diagnosis reported by respondents. More CD patients with diarrhea (94%) and anemia (81%) improved on GFD, compared to arthritis symptoms (30%). Autoimmune thyroiditis (10.6% vs 0.4%), insulin dependent diabetes mellitus (IDDM) (2.2% vs 1.7%), systemic Lupus erythematosus (SLE) (1.1% vs 0), and psoriasis (12.9% vs 5.5%) occurred more frequently in CD patients. The prevalence of Crohn's disease, ulcerative colitis, Sjogren's syndrome, primary biliary cirrhosis, and primary sclerosing cholangitis was around 1% each. Univariate Logistic regression analysis showed ≤ high school education (odds ratio [OR] 2.01, P < 0.003), age ≥ 60 years (OR 4.13, P < 0.001), and osteoporosis (OR 2.78, P < 0.001) to be significantly associated with report of arthritis in CD patients.ConclusionWe did not find a high rate of SpA in CD patients. In contrast, increased rates of autoimmune thyroiditis, SLE, IDDM, and psoriasis were seen in CD.
Treatment monitoring and mortality risk adjustment in anaemic Jehovah's Witnesses
Authors: Beliaev Andrei M. , Marshall Roger J. , Smith Warren , Windsor John A. 
Published: September 2012

AbstractBackgroundManagement of anaemic Jehovah's Witness (JW) patients, who refuse blood transfusion on religious grounds, is challenging. In the published literature, there are few cohort studies that consider causes of mortality in isolation and are lacking in their predictive power. This does not allow clinicians to monitor treatment progress of severely anaemic JW patients and adjust their risk of mortality. The study aims to develop an anaemia‐related mortality risk prediction instrument.MethodsThis retrospective cohort study evaluated anaemia‐related mortality risk factors of JW patients. JW patients were identified from the records of four major public hospitals in the Auckland and Midlands regions of New Zealand (North Shore, Auckland City, Middlemore and Waikato hospitals) for the period 1998 to 2007 inclusive. The inclusion criteria were age ≥15 years and severe anaemia (haemoglobin concentration ≤80 g/L). Palliative care cancer patients were excluded.ResultsAnaemia‐related risk factors of mortality for JW patients were identified, weighted and used to construct a mortality risk predictive score (the Hamilton Anaemia Mortality Risk Score (Hamilton AMRS)). This permitted stratification of JW patients into mortality risk groups according to their Hamilton AMRS. It is shown that patients with Hamilton AMRS of 0 to 2 had 4% mortality, patients with Hamilton AMRS of 3 to 4 had 29% mortality, patients with Hamilton AMRS of 5 had 40% mortality and patients with Hamilton AMRS of ≥6 had 67% mortality.ConclusionThe Hamilton AMRS allows treatment monitoring of anaemic JW patients and adjustment of their risk of mortality.
Thyroid cancer in Graves’ disease: is surgery the best treatment for Graves’ disease?
Authors: Tamatea Jade A. U. , Tu'akoi Kelson , Conaglen John V. , Elston Marianne S. , Meyer‐Rochow Goswin Y. 
Published: September 2012

AbstractBackgroundGraves’ disease is a common cause of thyrotoxicosis. Treatment options include anti‐thyroid medications or definitive therapy: thyroidectomy or radioactive iodine (I131). Traditionally, I131 has been the preferred definitive treatment for Graves’ disease in New Zealand. Reports of concomitant thyroid cancer occurring in up to 17% of Graves’ patients suggest surgery, if performed with low morbidity, may be the preferred option. The aim of this study was to determine the rate of thyroid cancer and surgical outcomes in a New Zealand cohort of patients undergoing thyroidectomy for Graves’ disease.MethodThis study is a retrospective review of Waikato region patients undergoing thyroid surgery for Graves’ disease during the 10‐year period prior to 1 December 2011.ResultsA total of 833 patients underwent thyroid surgery. Of these, 117 were for Graves’ disease. Total thyroidectomy was performed in 82, near‐total in 33 and subtotal in 2 patients. Recurrent thyrotoxicosis developed in one subtotal patient requiring I131 therapy. There were two cases of permanent hypoparathyroidism and one of permanent recurrent laryngeal nerve palsy. Eight patients (6.8%) had thyroid cancer detected, none of whom had overt nodal disease. Five were papillary microcarcinomas (one of which was multifocal), two were papillary carcinomas (11 mm and 15 mm) and one was a minimally invasive follicular carcinoma.ConclusionThyroid cancer was identified in approximately 7% of patients undergoing surgery for Graves’ disease. A low complication rate (<2%) of permanent hypoparathyroidism and nerve injury (<1%) supports surgery being a safe alternative to I131 especially for patients with young children, ophthalmopathy or compressive symptoms.
Technical competence in surgeons
Authors: Faurie Clare , Khadra Mohammed 
Published: September 2012

AbstractIn this paper, we review the literature to date on technical competence in surgeons; how it can be defined, taught to trainees and assessed. We also examine how we can predict which candidates for surgical training will most likely develop technical competence. While technical competency is just one aspect of what makes a good surgeon, we have recognized a need to review the literature in this area and to combine this with broader definitions of competency. Our review found that several methods are available to objectively measure, assess and predict technical competence and should be used in surgical training.
Arterial supply of the tendinous rotator cuff insertions: an anatomical study
Authors: Papakonstantinou Maritsa K. , Pan Wei‐Ren , le Roux Cara Michelle , Richardson Martin D. 
Published: September 2012

AbstractBackgroundConfirming the presence of arteries crossing the osteotendinous junctions (OTJs) of the rotator cuff may explain why rates of avascular necrosis (AVN) of the humeral head vary between three‐ and four‐part proximal humeral fractures. It is hypothesized that the humeral head remains better vascularized in three‐part fractures because one tuberosity with its inserting rotator cuff tendons is still attached to the articular fragment and supplying it with blood.MethodsEighty rotator cuff tendons from 20 shoulder girdles of cadavers aged 68–94 years were studied. In six shoulder girdles, the anterior circumflex humeral artery and posterior circumflex humeral artery (PCHA) were injected with ink, and the extra‐ and intraosseous courses of the vasculature were dissected until the OTJs of the rotator cuff.ResultsThe rotator cuff insertions received an arterial supply across their OTJs in 50% of cases (75% in supraspinatus, 67% in subscapularis, 33% in infraspinatus and 20% in teres minor). Supraspinatus and subscapularis insertions were vascularized by the arcuate artery, while the insertions of infraspinatus and teres minor were supplied by an unnamed terminal branch of the PCHA. This was named ‘posterolateral artery’.ConclusionThe presence of arteries crossing the OTJs of the rotator cuff, as well as the differences in the frequency arteries crossed the OTJs of individual rotator cuff tendons, may help explain why there is a lower rate of AVN of the humeral head in thee‐part, compared with four‐part proximal humeral fractures.
Long‐range temporal correlations in the subthalamic nucleus of patients with Parkinson’s disease
Authors: Hohlefeld F. U. , Huebl J. , Huchzermeyer C. , Schneider G.‐H. , Schönecker T. , Kühn A. A. , Curio G. , Nikulin V. V. 
Published: September 2012

AbstractNeuronal activity in the subthalamic nucleus (STN) of patients with Parkinson’s disease (PD) is characterised by excessive neuronal synchronization, particularly in the beta frequency range. However, less is known about the temporal dynamics of neuronal oscillations in PD. In this respect long‐range temporal correlations (LRTC) are of special interest as they quantify the neuronal dynamics on different timescales and have been shown to be relevant for optimal information processing in the brain. While the presence of LRTC has been demonstrated in cortical data, their existence in deep brain structures remains an open question. We investigated (i) whether LRTC are present in local field potentials (LFP) recorded bilaterally from the STN at wakeful rest in ten patients with PD after overnight withdrawal of levodopa (OFF) and (ii) whether LRTC can be modulated by levodopa treatment (ON). Detrended fluctuation analysis was utilised in order to quantify the temporal dynamics in the amplitude fluctuations of LFP oscillations. We demonstrated for the first time the presence of LRTC (extending up to 50 s) in the STN. Importantly, the ON state was characterised by significantly stronger LRTC than the OFF state, both in beta (13–35 Hz) and high‐frequency (> 200 Hz) oscillations. The existence of LRTC in subcortical structures such as STN provides further evidence for their ubiquitous nature in the brain. The weaker LRTC in the OFF state might indicate limited information processing in the dopamine‐depleted basal ganglia. The present results implicate LRTC as a potential biomarker of pathological neuronal processes in PD.