bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management and quality indicators of diabetes mellitus in people with intellectual disabilities
Authors: Taggart L. , Coates V. , Truesdale‐Kennedy M. 
Published: October 2012

AbstractBackgroundPeople with intellectual disabilities (ID) are at a higher risk of developing diabetes compared with the non‐intellectually disabled population, as a consequence of genetic syndromes and because this cohort are more exposed to many of the identified risk factors. However, little is known about the management of diabetes in this population. The aim of this study was to examine the demographics, health and the diabetes quality of care indicators used with people with ID in one region of the UK.MethodologyThis was a quantitative study using a postal survey design. An anonymised questionnaire was posted to all community ID teams and supported living/residential facilities requesting information on the demographics, health and quality of care indicators for people with ID who have diabetes on their caseloads.ResultsIn total 186 questionnaires were returned. Results showed that 125 people with ID had Type 2 diabetes (67%) and 61 people had Type 1 (33%). Significantly more people with Down syndrome and Autistic Spectrum Disorder had Type 1 diabetes. This study found that 6% had glycossylated glucose levels (HbA1c) greater than 9.5% and for 52% the levels were between 6.5% and 9.4%. Individuals reported to have poor glycaemic control were statistically more likely to have Type 1 diabetes and be younger, live with parents or independently and be obese. Results also illustrate that the national standards for good diabetes management were only partially met.DiscussionBecause of their enhanced predisposition for the development of diabetes this population merits particular attention with regards to screening for the onset of diabetes. The extent to which the quality of diabetes care indicators were achieved was variable but results suggest that for many people the indices were not met, that glycaemic control was poor, that only a quarter were of normal weight, that many were hypertensive and that almost a quarter had no record of their lipid levels. These findings provoke two important questions: first, who should be responsible for promoting diabetes management in this client group and second, how can service provision be tailored to better meet their needs? Greater collaborative working and education is required between ID services, primary healthcare and diabetes clinicians in order to promote the health and meet the quality indicators of diabetes care among this population.
Perceived burden and neuropsychiatric morbidities in adults with 22q11.2 deletion syndrome
Authors: Karas D. J. , Costain G. , Chow E. W. C. , Bassett A. S. 
Published: October 2012

AbstractBackground22q11.2 deletion syndrome (22q11.2DS) is a common genetic subtype of intellectual disability (ID) remarkable for its constellation of congenital, developmental and later‐onset features. Survival to adulthood is now the norm, and serious psychiatric illness is common in adults. However, little is known about the experiences and perceived needs of individuals with 22q11.2DS and their caregivers at time of transition from paediatric to adult models of care and beyond.MethodWe administered a mail survey to 84 caregivers of adults with 22q11.2DS and 34 adult patients themselves, inquiring about medical and social services, perceived burden and major challenges in adulthood in 22q11.2DS. Standard quantitative and qualitative methods were used to analyse the responses.ResultsFifty‐three (63.1%) caregivers and 20 (58.8%) adults with 22q11.2DS completed the survey. Perceived burden was high, with psychiatric illness and/or behavioural issues considered the most challenging aspects of adulthood in 22q11.2DS by the majority of caregivers (70.0%) and many patients themselves (42.9%). Irrespective of the extent of ID and the presence or absence of other major features, caregivers expressed dissatisfaction with medical and social services for adults, including at time of transition from paediatric care.ConclusionsTo our knowledge, this is the first study to examine the subjective experiences of adults with 22q11.2DS and their caregivers and to identify their perceived needs for services. Better awareness of 22q11.2DS and its later‐onset manifestations, early diagnosis and treatment of psychiatric illness, additional support at time of transition and dedicated clinics for adults with 22q11.2DS may help to improve patient outcomes and reduce caregiver burden.
Human rights and intellectual disabilities in an era of ‘choice’
Authors: Fyson R. , Cromby J. 
Published: October 2012

AbstractBackgroundEfforts to uphold and promote the human rights of people with intellectual disabilities (ID) are being affected by the increasing emphasis on ‘choice’ in the delivery of social care services. While rights presume subjects or selves to whom they apply, there is a disconnect between the subjects presumed within human rights frameworks and the variable capacities of a heterogeneous ID population. This disconnect is amplified by choice discourses which characterise current service provision based upon neoliberal ideologies.MethodConceptual assumptions and theoretical positions associated with human rights in relation to people with ID are critically examined.ResultsThe analysis results in an argument that current conceptualisations of personhood in relation to human rights exclude people with ID. The adverse effects of this exclusion are exacerbated within services which emphasise the permissive rights associated with a neoliberal agenda of ‘choice’ over protective rights.ConclusionsIn order to ensure that the human rights of people with ID are upheld, neoliberal emphases on choice need to be tempered and a more nuanced and inclusive notion of personhood in relation to universal human rights needs to be adopted.
Psychological therapies for people with intellectual disabilities: comments on a Matrix of evidence for interventions in challenging behaviour
Authors: Campbell M. , Robertson A. , Jahoda A. 
Published: October 2012

AbstractBackgroundPsychological therapies with a proven efficacy in the general population are being adapted for use with people who have intellectual disabilities in community settings.MethodsA systematic review of peer‐reviewed literature published between 1980 and 2010 was carried out, to identify the evidence base for effective psychological interventions in challenging behaviour. Relevant databases were searched using applied key terms. Evidence was graded, according to the quality of the research. A best‐evidence Matrix was produced to improve guidance for service providers and practitioners in the range, volume and quality of psychological interventions.ResultsThere is a limited amount of efficacy research that meets the most stringent standards of empirical evidence.ConclusionsIt is important to broaden the evidence base and consider the context of psychological interventions, alongside the values underpinning care and treatment.
Current status of robot‐assisted laparoscopic radical prostatectomy: How does it compare with other surgical approaches?
Authors: Lim Sey Kiat , Kim Kwang Hyun , Shin Tae‐Young , Rha Koon Ho 
Published: October 2012

AbstractThe aim was to review the current status and evaluate the outcomes of robot‐assisted laparoscopic radical prostatectomy in comparison with open radical prostatectomy and laparoscopic radical prostatectomy. Between January 2008 and June 2012, published English language comparative studies comparing robot‐assisted laparoscopic radical prostatectomy with either open radical postatectomy and/or laparoscopic radical prostatectomy were reviewed. End‐points for this review include oncological, functional and perioperative outcomes, and complications. Compared with laparoscopic radical prostatectomy and/or open radical prostatectomy, robot‐assisted laparoscopic radical prostatectomy offered at least equivalent oncological control. Current evidence seems to suggest a superiority of robot‐assisted laparoscopic radical prostatectomy over open radical prostatectomy and laparoscopic radical prostatectomy in terms of functional outcomes, such as urinary continence and potency. Risks of perioperative complications were also low after robot‐assisted laparoscopic radical prostatectomy. Robot‐assisted laparoscopic radical prostatectomy offers at least equivalent oncological and functional outcomes with low risks of complications when compared with open radical prostatectomy and laparoscopic radical prostatectomy. However, there is a paucity of high‐level evidence available in current literature.
Preoperative prediction of malignant involvement of resected ureters in patients undergoing radical cystectomy for bladder cancer
Authors: Gondo Tatsuo , Nakashima Jun , Ohno Yoshio , Hashimoto Takeshi , Takizawa Issei , Sakamoto Noboru , Horiguchi Yutaka , Aoyagi Teiichiro , Ohori Makoto , Tachibana Masaaki 
Published: October 2012

ObjectiveTo investigate preoperative predictors of ureteral involvement of bladder malignancy and to develop a novel preoperative model for the prediction of ureteral involvement in bladder cancer patients undergoing radical cystectomy.MethodsThis study included 197 consecutive bladder cancer patients treated with radical cystectomy. The correlations of preoperative factors with ureteral involvement were analyzed by univariate analysis with Pearson's χ2‐test and multivariate logistic regression analysis with a stepwise selection procedure.ResultsPositive ureteral involvement was observed in 38 (19.3%) patients. Tumor location (involvement of the vesical trigone), clinical T stage (≥ cT3) and the number of tumors (≥3), but not sex, tumor grade and histological features determined by transurethral resection of bladder tumor, tumor size, shape of tumor, concomitant presence of carcinoma in situ, preoperative intravesical therapy, number of transurethral resection of bladder tumor procedures or the presence of hydronephrosis were significantly associated with ureteral involvement in the univariate analysis. Multivariate logistic regression analysis confirmed that the aforementioned three significant factors identified in the univariate analysis were significant independent predictors of ureteral involvement. The probability of ureteral involvement estimated by a combination of these three parameters was well correlated with the real incidence (R = 0.904, P = 0.0021).ConclusionsTumor location (involvement of vesical trigone), clinical T stage (≥cT3) and the number of tumors (≥3) are significant independent preoperative predictors of ureteral involvement of malignancy in bladder cancer patients undergoing radical cystectomy. Our predictive model might be useful for preoperative prediction of ureteral tumor involvement.
Incidence and risk of treatment for benign prostatic hyperplasia in Japanese men: A 15‐year longitudinal community‐based study
Authors: Fukuta Fumimasa , Masumori Naoya , Mori Mitsuru , Tsukamoto Taiji 
Published: October 2012

ObjectivesTo determine the incidence of and the risk factors for treatment in Japanese men with benign prostatic hyperplasia/lower urinary tract symptoms enrolled into a longitudinal community‐based study.MethodsA total of 267 of 319 men aged 40–79 years were eligible for this study, with nearly 15 years of follow up. Their medical records were checked to look for any medical treatment for benign prostatic hyperplasia/lower urinary tract symptoms. The risk of treatment for benign prostatic hyperplasia/lower urinary tract symptoms was determined by calculating the hazard ratio using the Cox proportional hazards model. Five baseline parameters were considered: the International Prostate Symptom Score, the peak urinary flow rate, the prostate volume, the serum prostate‐specific antigen and the internal prostatic architecture on transrectal ultrasonography.ResultsData were successfully collected for 171 men (64%; 121 survivors and 50 deceased). During approximately 1900 person‐years of follow up, the overall incidence of treatment for benign prostatic hyperplasia/lower urinary tract symptoms was 15.4/1000 person‐years. All five parameters were statistically significant predictors of future treatment for benign prostatic hyperplasia/lower urinary tract symptoms: International Prostate Symptom Score greater than 7 (hazard ratio 6.2, P < 0.001), prostate volume greater than 30 mL (hazard ratio 4.3, P = 0.002), peak urinary flow rate less than 12 mL/s (hazard ratio 4.4, P < 0.001), prostate‐specific antigen greater than 1.4 ng/mL (hazard ratio 4.0, P < 0.001) and internal prostatic architecture group 3 (hazard ratio 3.2, P = 0.002).ConclusionsSeverity of lower urinary tract symptoms, decreased peak urinary flow rate, enlarged prostate volume, high prostate‐specific antigen value and internal prostatic architecture at baseline are independent risk factors for treatment in Japanese men presenting with benign prostatic hyperplasia/lower urinary tract symptoms.
Non‐suture technique for rabbit oviduct anastomosis with 2‐octyl cyanoacrylate: A histopathologic and biomechanical analysis
Authors: Zhu Hua , Yang Xiao‐Jun , Li Xiao‐Lin , Zhang Hu‐Xiang , Zheng Fei‐Yun 
Published: October 2012

AbstractAim:  The aim of this study was to investigate histological and biomechanical properties of oviduct anastomosis with 2‐octyl cyanoacrylate (OCA) in the rabbit.Material and Methods:  Sixty female rabbits were randomly divided equally into three groups: A (control), B (traditional catgut suture), and C (non‐suture technique using OCA). After suture or OCA anastomosis, gross examination (adhesion formation) and histopathology (hematoxylin–eosin), ultrastructure (transmission electron microscopy), and biomechanics (bursting pressure) on para‐anastomotic site were investigated on oviduct taken at 1 (A1, B1, C1) and 4 (A2, B2, C2) weeks, respectively.Results:  Adhesion score in group B was more severe than that in groups A and C at 1 and 4 weeks. Histopathology showed that acute endosalpingitis in group B was the most intense at 1 week, followed by significantly more tissue stimulation induced by catgut and foreign‐body giant cells in group B than in group C at 4 weeks. Ultrastructural damage of ciliated cells was reversed partly (B2) and completely (C2) at 4 weeks. Bursting pressure in C1 was weaker than that in B1, followed by no significant difference at 4 weeks.Conclusion:  Non‐suture using OCA for oviduct anastomosis can be accepted as a new‐perspective technique.
Modified pheromone traps help reduce bycatch of bark‐beetle natural enemies
Authors: Martín Ana , Etxebeste Iñaki , Pérez Gema , Álvarez Gonzalo , Sánchez Estela , Pajares Juan 
Published: October 2012

Thanasimus formicariusandTemnochila caerulea,two of the main predators ofIps sexdentatus, a well‐known forest pest in Southern Europe, are captured in high numbers when trappingI. sexdentatusas a result of the kairomonal effect of the lures used.A preliminary field trial showed that predators could survive for at least 1 week within trapping containers, although predator mutilation and high predator death rates were observed.Different modifications of conventional multiple funnel and slot traps with the objective of reducing natural enemy entrance into trap containers were bioassayed in field experiments conducted over four seasons. Based on the larger sizes of predators, different designs using welded wire‐mesh screens improved performance to different extents. Providing escape windows just above the screen on multiple funnel traps gave the most promising results, including when effect sizes among all tested designs were compared.Thus, a simple modification of the lowest funnel of the multiple funnel traps would reduce the bycatch ofT. formicariusandT. caerulea, hence improving the efficiency of trapping programmes by lowering the likely impact on natural populations of these predators.
The impact of body mass index on surgical outcomes of robotic partial nephrectomy
Authors: Isac Wahib E. , Autorino Riccardo , Hillyer Shahab P. , Hernandez Adrian V. , Stein Robert J. , Kaouk Jihad H. 
Published: October 2012

Study Type – Therapy (case series)Level of Evidence 4“What's known on the subject?” and “What does the study add?”Obesity is associated with higher incidence of renal cell carcinoma. Laparoscopic and robotic partial nephrectomy (RPN) was shown to be technically feasible in the obese population. In the present study we evaluated the impact of obesity on outcome of RPN, in a large cohort of patients.In the present study, obese patients had a higher American Society of Anesthesiologists score and larger tumour size. We evaluated obesity as a categorical and a continuous variable, and we adjusted for confounding factors. We categorized obesity based according to the WHO classification of obesity. We described our technical modifications to overcome difficulties that can be encountered during the surgery. Obese patients had a higher estimated blood loss, but no difference in blood transfusion rate, operation duration or warm ischaemia time.OBJECTIVE
To assess the impact of body mass index (BMI) on the surgical outcomes of robotic partial nephrectomy (RPN).
PATIENTS AND METHODS
Medical charts of 250 consecutive patients who underwent RPN at our institution between 2006 and 2010 were reviewed.
Patients were categorized based on their BMI into four groups per international classification of obesity into: normal (BMI < 25 kg/m2), overweight (25–29.9), obese (30–39.9) and morbidly obese (≥40).
Preoperative characteristics as well as perioperative and postoperative outcomes were analysed and compared between the groups.
RESULTS
Of the 250 patients, 43 (17.2% of the entire cohort) were non‐obese, 104 (41.6%) were overweight, 75 (30%) were obese, and 28 (11.2%) were morbidly obese.
Groups were similar in terms of age, gender, history of previous surgery and nephrometry score (P= 0.5).
Patients with higher BMI had a higher American Society of Anesthesiologists (ASA) score (median 3 for obese and morbidly obese groups vs 2 for non‐obese groups; P= 0.002) and tumour size (median 3.6, 2.9, 2.5 and 2.3 cm in those who were morbidly obese, obese, overweight and with normal BMI, respectively; P= 0.005).
Patients within the morbidly obese group had a higher estimated blood loss (median 250 mL) than other groups (median: 200, 200, 150 mL, respectively) (P= 0.03).
No significant difference was detected between the groups in terms of operation duration, warm ischaemia time, transfusion rate and postoperative complications.
CONCLUSION
Robotic partial nephrectomy represents an effective treatment modality for renal tumours providing equivalent surgical outcomes even for patients with BMI up to 60 kg/m2.
Diagnostic tests in urology: percentage of free prostate‐specific antigen (PSA)
Authors: Yi Yooni , Breau Rodney H. , Witiuk Kelsey , Neuberger Molly M. , Dahm Philipp 
Published: October 2012

What's known on the subject? and What does the study add?
Free to total PSA ratios are commonly used as an adjunct to total PSA levels to better define an individual's risk for prostate cancer; however, its strengths and weaknesses are not well understood.
This article illustrates the use of likelihood ratios that can be generated from the reported sensitivities and specificities from given free to total PSA thresholds in either increasing or decreasing an individual patient's probability of prostate cancer. Understanding the strengths and limitations of free to total PSA testing will help clinicians anticipate whether its use is indicated or not.
A systematic review of stereotactic radiotherapy ablation for primary renal cell carcinoma
Authors: Siva Shankar , Pham Daniel , Gill Suki , Corcoran Niall M. , Foroudi Farshad 
Published: October 2012

Study Type – Therapy (systematic review)Level of Evidence 1aWhat's known on the subject? and What does the study add?At present, little is known about the role of stereotactic ablative body radiotherapy in the treatment of primary renal cell carcinoma. The published evidence to date totals 126 patients worldwide. The majority of evidence is retrospective in nature.The present study adds context to the current literature by providing an overall summary of the evidence.OBJECTIVE
To critically assess the use of stereotactic ablative body radiotherapy (SABR) for the treatment of primary renal cell carcinoma with particular focus on local control and toxicity outcomes.
METHODS
A systematic search on PubMed was performed in January 2012 independently by two radiation oncologists using structured search terms.
Secondary manual searches were performed on citations in relevant publications and abstracts in major radiotherapy journals.
Outcomes, techniques, biological doses and scientific rigour of the studies were analysed.
RESULTS
In total 10 publications (seven retrospective and three prospective) were identified. A wide range of techniques, doses and dose fractionation schedules were found.
A total of 126 patients were treated with between one and six fractions of SABR. Median or mean follow‐up ranged from 9 to 57.5 months. A weighted local control was reported of 93.91% (range 84%–100%).
The weighted rate of severe grade 3 or higher adverse events was 3.8% (range 0%–19%). The weighted rate of grade 1–2 minor adverse events was 21.4% (range 0%–93%). The most commonly employed fractionation schedule was 40 Gy delivered over five fractions.
CONCLUSIONS
Current literature suggests that SABR for primary renal cell carcinoma can be delivered with promising rates of local control and acceptable toxicity.
However, there was insufficient evidence to recommend a consensus view for dose fractionation or technique.
This indicates the need for further prospective studies assessing the role of this technique in medically inoperable patients.