bluuebunny/crossref_metadata_2025_split huggingface dataset:
Process Quality Indicators Targeting Cognitive Impairment to Support Quality of Care for Older People with Cognitive Impairment in Emergency Departments
Authors: Schnitker Linda M. , Martin‐Khan Melinda , Burkett Ellen , Beattie Elizabeth R. A. , Jones Richard N. , Gray Len C. ,   The Research Collaboration for Quality Care of Older Persons: Emergency Care Panel
Published: March 2015

AbstractObjectivesThe objective of this study was to develop process quality indicators (PQIs) to support the improvement of care services for older people with cognitive impairment in emergency departments (ED).MethodsA structured research approach was taken for the development of PQIs for the care of older people with cognitive impairment in EDs, including combining available evidence with expert opinion (phase 1), a field study (phase 2), and formal voting (phase 3). A systematic review of the literature identified ED processes targeting the specific care needs of older people with cognitive impairment. Existing relevant PQIs were also included. By integrating the scientific evidence and clinical expertise, new PQIs were drafted and, along with the existing PQIs, extensively discussed by an advisory panel. These indicators were field tested in eight hospitals using a cohort of older persons aged 70 years and older. After analysis of the field study data (indicator prevalence, variability across sites), in a second meeting, the advisory panel further defined the PQIs. The advisory panel formally voted for selection of those PQIs that were most appropriate for care evaluation.ResultsIn addition to seven previously published PQIs relevant to the care of older persons, 15 new indicators were created. These 22 PQIs were then field tested. PQIs designed specifically for the older ED population with cognitive impairment were only scored for patients with identified cognitive impairment. Following formal voting, a total of 11 PQIs were included in the set. These PQIs targeted cognitive screening, delirium screening, delirium risk assessment, evaluation of acute change in mental status, delirium etiology, proxy notification, collateral history, involvement of a nominated support person, pain assessment, postdischarge follow‐up, and ED length of stay.ConclusionsThis article presents a set of PQIs for the evaluation of the care for older people with cognitive impairment in EDs. The variation in indicator triggering across different ED sites suggests that there are opportunities for quality improvement in care for this vulnerable group. Applied PQIs will identify an emergency services’ implementation of care strategies for cognitively impaired older ED patients. Awareness of the PQI triggers at an ED level enables implementation of targeted interventions to improve any suboptimal processes of care. Further validation and utility of the indicators in a wider population is now indicated.
How can we promote smoking cessation in people with schizophrenia in practice? A clinical overview
Authors: Stubbs B. , Vancampfort D. , Bobes J. , De Hert M. , Mitchell A. J. 
Published: March 2015

ObjectiveHigh rates of smoking and nicotine dependence are associated with increased physical comorbidity and premature death in people with schizophrenia. We conducted a clinical overview to establish how smoking cessation should be promoted in practice.MethodSystematic clinical review of major electronic databases from inception till November 2014.ResultsA growing body of evidence supports pharmacological interventions to assist smoking cessation. The most promising evidence is for bupropion with several meta‐analyses demonstrating its effectiveness. Currently, there is limited evidence demonstrating the effectiveness of nicotine replacement therapy (NRT) and varenicline, although this is likely to be due to the paucity of research. There are no consistent data to suggest that pharmacological interventions increase adverse events. Behavioural and psychosocial interventions also demonstrate promise, particularly when combined with pharmacotherapy. Careful monitoring of antipsychotic levels (in particular clozapine) is essential, and the promotion of physical activity may be useful to negate potential weight gain and diabetes risk following smoking cessation.ConclusionEvidence from systematic reviews and meta‐analyses suggests that smoking cessation interventions are effective in people with schizophrenia, although more long‐term research is required. Promoting smoking cessation should be given utmost priority in clinical practice, and we offer practical strategies to facilitate this.
Perianal lichen dermatoses: A review of 60 cases
Authors: Day Tania , Bohl Tanja Gizela , Scurry James 
Published: March 2015

AbstractObjectivesTo determine the diagnostic range of lichen dermatoses of the perianus, their extent, and response to treatment.MethodsWe reviewed perianal biopsies submitted to a tertiary referral pathology service between January 2010 and July 2014, interpreted as ‘lichen’ or ‘lichenoid’. We collected data on patients' characteristics, referring specialty, extent of lesion and response to treatment.ResultsDuring the study period, 60 perianal biopsies met our inclusion criteria. The distribution of diagnoses was lichen sclerosus (LS) in 25/60 (42%), lichen simplex chronicus (LSC) in 23/60 (38%), lichen planus (LP) in 10/60 (17%), and a non‐specific lichenoid reaction in 2/60 (3%). Eleven of 25 cases of LS (44%) showed superimposed LSC. Of 10 LP cases, nine (90%) were hypertrophic and three of these showed pseudoepitheliomatous hyperplasia; none were erosive LP. Compared with patients in the LS and LSC groups, those with LP were more likely to have a localised lesion. Topical steroids were prescribed in 91% cases with treatment data available, and 98% of treated patients who returned for follow up had improved or their disease was resolved.ConclusionsWe encountered a spectrum of perianal lichen dermatoses, with LS, LP and LSC all represented. LS biopsied at the perianus is often lichenified. Hypertrophic LP is a common form of LP at the perianus.
Adverse effects of topical corticosteroids in paediatric eczema: Australasian consensus statement
Authors: Mooney Emma , Rademaker Marius , Dailey Rebecca , Daniel Ben S , Drummond Catherine , Fischer Gayle , Foster Rachael , Grills Claire , Halbert Anne , Hill Sarah , King Emma , Leins Elizabeth , Morgan Vanessa , Phillips Roderic J , Relic John , Rodrigues Michelle , Scardamaglia Laura , Smith Saxon , Su John , Wargon Orli , Orchard David 
Published: March 2015

AbstractAtopic eczema is a chronic inflammatory disease affecting about 30% of Australian and New Zealand children. Severe eczema costs over AUD 6000/year per child in direct medical, hospital and treatment costs as well as time off work for caregivers and untold distress for the family unit. In addition, it has a negative impact on a child's sleep, education, development and self‐esteem. The treatment of atopic eczema is complex and multifaceted but a core component of therapy is to manage the inflammation with topical corticosteroids (TCS). Despite this, TCS are often underutilised by many parents due to corticosteroid phobia and unfounded concerns about their adverse effects. This has led to extended and unnecessary exacerbations of eczema for children. Contrary to popular perceptions, (TCS) use in paediatric eczema does not cause atrophy, hypopigmentation, hypertrichosis, osteoporosis, purpura or telangiectasia when used appropriately as per guidelines. In rare cases, prolonged and excessive use of potent TCS has contributed to striae, short‐term hypothalamic‐pituitary‐adrenal axis alteration and ophthalmological disease. TCS use can also exacerbate periorificial rosacea. TCS are very effective treatments for eczema. When they are used to treat active eczema and stopped once the active inflammation has resolved, adverse effects are minimal. TCS should be the cornerstone treatment of atopic eczema in children.
Ocular Motor Score (OMS): a clinical tool to evaluating ocular motor functions in children. Intrarater and inter‐rater agreement
Authors: Olsson Monica , Teär Fahnehjelm Kristina , Rydberg Agneta , Ygge Jan 
Published: March 2015

AbstractPurposeOcular motor score (OMS) is a new clinical test protocol for evaluating ocular motor functions in children and young adults. OMS is a set of 15 important and relevant non‐invasive ocular motor function parameters derived from clinical practice. The aim of the study was to evaluate OMS according to intrarater and inter‐rater agreement.MethodsForty children aged 4–10 years, 23 girls median age 6.5 (range 4.3–9.3) and 17 boys median age 5.8 (range 4.1–9.8) were included. The ocular motor functions were assessed and scored according to the OMS protocol. The examinations were videotaped. To obtain the intrarater agreement, the first author examined and scored the children twice, first in the clinic and 2 weeks later by watching the videotape. To obtain the inter‐rater agreement, three other raters independently scored the ocular motor function of the children by watching the videotapes.ResultsThe overall observed intrarater agreement was 88%, and the observed inter‐rater agreement between the three raters was 80%. For none of the subtests was there an observed intrarater agreement lower than 65%. Three of the subtests had an observed inter‐rater agreement of 65% or below.ConclusionOverall there was high observed intra‐ and inter‐rater agreement for the OMS test protocol. Subtests such as saccades and smooth pursuit were more difficult for raters to score similarly according the clinical OMS test protocol.
Impact of CYP2C19 polymorphism on the pharmacokinetics of nelfinavir in patients with pancreatic cancer
Authors: Kattel Krishna , Evande Ruby , Tan Chalet , Mondal Goutam , Grem Jean L. , Mahato Ram I. 
Published: March 2015

AimThis study evaluated the influence of CYP2C19 polymorphisms on the pharmacokinetics of nelfinavir and its metabolite M8 in patients with pancreatic cancer.MethodsNelfinavir was administered orally to patients for over 10 days. The plasma concentrations of nelfinavir and M8 were measured by HPLC. The genotypes of CYP2C19*1, CYP2C19*2 and CYP2C19*3 were determined by the polymerase chain reaction‐restriction fragment length polymorphism method.ResultsPharmacokinetic profiles of nelfinavir and M8 were characterized by wide interindividual variability. The meanCmaxof nelfinavir in CYP2C19*1/*1 patients was 3.89 ± 0.40 (n = 3) and 5.12 ± 0.41 (n = 30) µg ml–1, while that of CYP2C19*1/*2 patients was 3.60 (n = 1) and 6.14 ± 0.31 (n = 5) µg ml–1at the doses of 625 and 1250 mg nelfinavir twice daily, respectively. For the M8 metabolite, the meanCmaxof CYP2C19*1/*1 patients was 1.06 ± 0.06 (n = 3) and 1.58 ± 0.27 (n = 30) µg ml–1, while those of CYP2C19*1/*2 patients were 1.01 (n = 1) and 1.23 ± 0.15 (n = 5) µg ml–1at the doses of 625 and 1250 mg nelfinavir twice daily, respectively. The area under the plasma concentration–time curve (AUC(0,12 h)) values of nelfinavir for CYP2C19*1/*1 patients were 28.90 ± 1.27 and 38.90 ± 4.99 µg ml–1·h and for CYP2C19*1/*2 patients, AUC(0,12 h) was 28.20 (n = 1) and 40.22 ± 3.17 (n = 5) µg ml–1·h at the doses of 625 and 1250 mg nelfinavir twice daily, respectively. TheCmaxof nelfinavir was significantly higher (P<0.05) in CYP2C19*1/*2 patients but there was no statistical difference in AUC(0,12 h).ConclusionCYP2C19*1/*2 genotype modestly affected the pharmacokinetic profiles of nelfinavir and M8 in patients with locally advanced pancreatic cancer.
Emerging drug targets for Aβ and tau in Alzheimer's disease: a systematic review
Authors: West Sophie , Bhugra Praveen 
Published: March 2015

AbstractAimsCurrently, treatment for Alzheimer's disease (AD) focuses on the cholinergic hypothesis and provides limited symptomatic effects. Research currently focuses on other factors that are thought to contribute to AD development such as tau proteins and Aβ deposits, and how modification of the associated pathology affects outcomes in patients. This systematic review summarizes and appraises the evidence for the emerging drugs affecting Aβ and tau pathology in AD.MethodsA comprehensive, systematic online database search was conducted using the databases ScienceDirect and PubMed to include original research articles. A systematic review was conducted following a minimum set of standards, as outlined by The PRISMA Group . Specific inclusion and exclusion criteria were followed and studies fitting the criteria were selected. No human trials were included in this review. In vitro and in vivo AD models were used to assess efficacy to ensure studied agents were emerging targets without large bodies of evidence.ResultsThe majority of studies showed statistically significant improvement (P < 0.05) of Aβ and/or tau pathology, or cognitive effects. Many studies conducted in AD animal models have shown a reduction in Aβ peptide burden and a reduction in tau phosphorylation post‐intervention. This has the potential to reduce plaque formation and neuronal degeneration.ConclusionsThere are many emerging targets showing promising results in the effort to modify the pathological effects associated with AD. Many of the trials also provided evidence of the clinical effects of such drugs reducing pathological outcomes, which was often demonstrated as an improvement of cognition.
The effects of activating prior topic and metacognitive knowledge on text comprehension scores
Authors: Kostons Danny , van der Werf Greetje 
Published: March 2015

BackgroundResearch on prior knowledge activation has consistently shown that activating learners' prior knowledge has beneficial effects on learning. If learners activate their prior knowledge, this activated knowledge serves as a framework for establishing relationships between the knowledge they already possess and new information provided to them. Thus far, prior knowledge activation has dealt primarily with topic knowledge in specific domains. Students, however, likely also possess at least some metacognitive knowledge useful in those domains, which, when activated, should aid in the deployment of helpful strategies during reading.AimsIn this study, we investigated the effects of both prior topic knowledge activation (PTKA) and prior metacognitive knowledge activation (PMKA) on text comprehension scores.Samples & MethodsEighty‐eight students in primary education were randomly distributed amongst the conditions of the 2 × 2 (PTKA yes/no × PMKA yes/no) designed experiment.ResultsResults show that activating prior metacognitive knowledge had a beneficial effect on text comprehension, whereas activating prior topic knowledge, after correcting for the amount of prior knowledge, did not.ConclusionsMost studies deal with explicit instruction of metacognitive knowledge, but our results show that this may not be necessary, specifically in the case of students who already have some metacognitive knowledge. However, existing metacognitive knowledge needs to be activated in order for students to make better use of this knowledge.
Partial vs radical nephrectomy for T1 renal tumours: an analysis from the British Association of Urological Surgeons Nephrectomy Audit
Authors: Hadjipavlou Marios , Khan Fahd , Fowler Sarah , Joyce Adrian , Keeley Francis X. , Sriprasad Seshadri ,   BAUS Sections of Endourology and Oncology
Published: March 2015

ObjectivesTo analyse and compare data from the British Association of Urological Surgeons Nephrectomy Audit for perioperative outcomes of partial (PN) and radical nephrectomy (RN) for T1 renal tumours.Patients and MethodsUK consultants were invited to submit data on all patients undergoing nephrectomy between 1 January and 31 December 2012 to a nationally established database using a standard pro forma. Analysis was made on patient demographics, operative technique, and perioperative data/outcome between PN and RN for T1 tumours.ResultsOverall, data from 6 042 nephrectomies were reported of which 1 768 were performed for T1 renal tumours. Of these, 1 082 (61.2%) were RNs and 686 (38.8%) were PNs. The mean age of patients undergoing PN was lower (PN 59 years vs RN 64 years; P < 0.001) and so was the WHO performance score (PN 0.4 vs RN 0.7; P < 0.001). PN for the treatment of T1a tumours (≤4 cm) accounted for 55.6% of procedures, of which 43.9% were performed using a minimally invasive technique. For T1b tumours (4–7 cm), 18.9% of patients underwent PN, in 33.3% of which a minimally invasive technique was adopted. The vast majority of RNs for T1 tumours were performed using a minimally invasive technique (90.3%). Of the laparoscopic PNs, 30.5% were robot‐assisted. There was no significant difference in overall intraoperative complications between the RN and PN groups (4% vs 4.3%; P = 0.79). However, PN accounted for a higher overall postoperative complications rate (RN 11.3% vs PN 17.6%; P < 0.001). RN was associated with a markedly reduced risk of severe surgical complications (Clavien Dindo classification grade ≥3) compared with PN even after adjusting for technique (odds ratio 0.30; P = 0.002). Operation time between RN and PN was comparable (141 vs 145 min; P = 0.25). Blood loss was less in the RN group (mean for RN 165 vs PN 323 mL; P < 0.001); however, transfusion rates were similar (3.2% vs 2.6%; P = 0.47). RN was associated with a shorter length of stay (median 4 vs 5 days; P < 0.001). A direct comparison between robot‐assisted and laparoscopic PN showed no significant differences in operation time, blood loss, warm ischaemia time, and intraoperative and postoperative complications.ConclusionsPN was the method of choice for treatment of T1a tumours whereas RN was preferred for T1b tumours. Minimally invasive techniques have been widely adopted for RN but not for PN. Despite the advances in surgical technique, a substantial risk of postoperative complications remains with PN.
Exploring the determinants of secular decreases in dental caries among Korean children
Authors: Lee Hye‐Ju , Han Dong‐Hun 
Published: March 2015

AbstractObjectiveThe aim of this study was to determine the contributions of sealant and water fluoridation to the time trends in dental caries from 2003 to 2010.Materials and methodsData were from three waves of the Korean National Oral Health Surveys between 2003 and 2010, including a total of 23 059 children (11 889 boys and 11 170 girls) aged 8, 10, and 12 years. The impacts of sealant and water fluoridation on dental caries were obtained by logistic regression for each age group of children. The contributions of sealant and water fluoridation to the time trends in the prevalence of dental caries were examined by a series of logistic regression models, and changes in the adjusted odds ratios for each survey year were also calculated.ResultsOver the past 7 years, the prevalence of dental caries decreased dramatically. Although sealant had a significant impact on dental caries in each survey year, remarkable decreases in dental caries from 2003 to 2010 were not explained by the secular changes in the dental sealant or water fluoridation factor.ConclusionWe observed important population declines in dental caries in Korea in children aged 8–12 years; however, the likely causes for these secular trends remain to be determined.
‘I think other parents might. …’: Using a projective technique to explore parental supply of alcohol
Authors: Jones Sandra C. , Magee Christopher , Andrews Kelly 
Published: March 2015

AbstractIntroduction and AimsA growing body of research indicates parental supply of alcohol to children and adolescents is common. The present study aimed to examine parents' reasons for supplying alcohol to adolescents that they may find hard to articulate or not be consciously aware of.Design and MethodsA projective methodology was used, whereby respondents were asked to explain the thoughts and motivations of a gender‐matched parent in a scenario in which the parent did or did not provide alcohol to their teenage child. Respondents were 97 mothers and 83 fathers of teenagers who completed an anonymous online survey. Open‐ended responses were coded thematically; t‐tests were used to compare quantitative responses between the scenarios.ResultsThe quantitative analysis found the parent who provided alcohol was less likely to be seen as making sure their child was safe and educating them about boundaries, but more likely to be seen as being a friend as well as a parent and (for females only) making sure their child fits in with others. The open‐ended responses showed explanations for not providing alcohol most commonly focused on ensuring the child's safety, obeying the law, and setting rules and boundaries, and for providing alcohol focused on ensuring the child fit in with peers and beliefs about harm minimisation.Discussion and ConclusionsThe findings suggest that these respondents (parents) harboured a number of misperceptions about underage drinking and experienced conflicts in weighing up the perceived benefits of providing alcohol to their children against the risks of adolescent drinking. [Jones SC, Magee C, Andrews K. ‘I think other parents might. …’: Using a projective technique to explore parental supply of alcohol. Drug Alcohol Rev 2015;34:531–9]
Relations between infants’ emerging reach‐grasp competence and event‐related desynchronization in EEG
Authors: Cannon Erin N. , Simpson Elizabeth A. , Fox Nathan A. , Vanderwert Ross E. , Woodward Amanda L. , Ferrari Pier F. 
Published: March 2015

AbstractRecent reports of similar patterns of brain electrical activity (electroencephalogram: EEG) during action execution and observation, recorded from scalp locations over motor‐related regions in infants and adults, have raised the possibility that two foundational abilities – controlling one's own intentional actions and perceiving others’ actions – may be integrally related during ontogeny. However, to our knowledge, there are no published reports of the relations between developments in motor skill (i.e. recording actual motor skill performance) and EEG during both action execution and action observation. In the present study we collected EEG from 21 9‐month‐olds who were given opportunities to reach for toys and who also observed an experimenter reach for toys. Event‐related desynchronization (ERD) was computed from the EEG during the reaching events. We assessed infants’ reaching‐grasping competence, including reach latency, errors, preshaping of the hand, and bimanual reaches, and found that desynchronization recorded in scalp electrodes over motor‐related regions during action observation was associated with action competence during execution. Infants who were more competent reachers, compared to less competent reachers, exhibited greater ERD while observing reaching‐grasping. These results provide initial evidence for an early emerging neural system integrating one's own actions with the perception of others’ actions.