bluuebunny/crossref_metadata_2025_split huggingface dataset:
SUPPORTING GENERAL PRACTITIONERS TO PROVIDE OUT-OF-HOURS PALLIATIVE CARE
Authors: Magee C , Koffman J 
Published: February 2014

IntroductionOffering choice about place of care to patients is fundamentally influenced by out-of-hours service provision. Concerns have been raised about continuity, availability of information and access to support services. General practitioners (GPs) provide most care out-of-hours, but see few palliative patients. Keeping knowledge up-to-date is challenging.Aim(s) and method(s)To explore the views, confidence and educational preferences of out-of-hours GPs in order to inform recommendations for future education. Structured postal survey sent to 1005 GPs across England employed by an independent provider of out-of-hours services.Results203 GPs completed the questionnaire (response rate 20.3%). Organisational factors were felt to have significantly greater impact on care delivery than clinical factors (p<0.0005): lack of familiarity, time pressures and lack of information from in-hours services were ranked highest. Confidence in assessing palliative care emergencies (42.8%, n=87: ‘not so confident’ or ‘not at all confident’), managing symptoms in non-cancer patients (39.4%, n=80) and prescribing a new syringe driver (39.0%, n=79) was lowest. Low confidence was associated with infrequent exposure (p<0.05) and lack of training (p<0.05). Educational preferences were strongly associated with confidence (p<0.0005); the above topics were most requested. E-learning was the preferred method (67.5%, n=137). 82.1% (n=165) felt training focused on out-of-hours work would be beneficial.Conclusion(s)Organisational factors continue to hinder care delivery, but confidence in key palliative care competences is lacking. Educational strategies must be targeted at GPs needs, both in terms of content and delivery. Specialist palliative care services should engage with out-of-hours providers to support education.
DEVELOPING TRAINING FOR SUPPORTERS OF LAY-CARERS INVOLVED WITH HOME BASED END OF LIFE CARE: A PARTICIPATORY APPROACH
Authors: Hardy B , Caswell G , Ewing G , Grande G , Kennedy S , Tabreham J , Seymour J 
Published: February 2014

IntroductionCurrent policy aims to enable more people to die in the place of their choice, and increase the number of people who die at home. Essential to this aspiration is the involvement of lay-carers, usually family or friends of the ill person. The importance of this role is acknowledged at a national level, however carers continue to report many unmet emotional and practical support needs. Innovative approaches are required if we are to improve the experiences of lay-carers in end of life situations. In this poster, we report on the progress of an innovative participatory research project, which is developing training for people who support carers. We hope to engage delegates in discussion about the utility of the training for their own organisations and communities.Aim(s) and method(s)The project aims to develop and pilot an introductory training programme for supporters of carers in end of life situations, such as support workers and volunteer mentors. Participatory action research methods have been used to engage with stakeholders including carers and carer support organisations. The programme is being piloted from January 2014.ResultsCurrent evaluation activities show the developing programme to be acceptable to a range of stakeholders. Ongoing piloting and evaluation will further test the utility of the programme.Conclusion(s)The training programme will be publically available at the end of the project, and free to use. Participatory research methods are a useful way to engage with a range of stakeholders and to raise awareness of end of life care issues.
SATISFACTION OF CARERS OF PEOPLE WITH ADVANCED DEMENTIA: THEIR EXPERIENCES AT THE OF END OF LIFE
Authors: Vickerstaff V , Sampson EL , Scott S , Davis S , Lord K , Harrington J , Elliott M , Kupeli N , Jones L 
Published: February 2014

IntroductionCarers of people with advanced dementia (AdvD) have high burden and poor mental and physical health. The CoMPASs:IOn programme has developed and is piloting a complex intervention to improve end-of-life care for people with AdvD including support for families.Aim(s) and method(s)Pilot longitudinal cohort study of carers (target N=40) of people with AdvD (Functional Assessment Staging Scale 7a and above), assessed at study entry then monthly for 9 months or until patient death using the HADS, SF-12 and Satisfaction with Care at the End of Life in Dementia Scale (SWCEOLD).Results25 carers currently recruited (mean age 62, range 43–91; 68% female; 76% child of the person with dementia, 48% in paid employment). 92% of those they care for reside in care homes. Initial SWC-EOLD scores were 29.7 (range 13–40), consistent even in 7 carers whose relative died (mean score 30.3 (range 13–40) a month before death, 32.1 (range 13–40) after bereavement). On HADS (cut off ≥8), at initial assessment 40% had anxiety, 28% depression. Anxiety decreased over time; 20% have recorded anxiety 9 months later (7 carers). Two months post-bereavement, 14% of carers had anxiety or depression. At first assessment, SF-12 physical scores were 50 (range 33–58) remaining constant, mental health 48 (range 19–64) declining to 44 post death.Conclusion(s)It is feasible to recruit carers of people with AdvD and retain them into bereavement. Carers were satisfied with on-going care and around the time of death for the person with AdvD. Accrual continues for a further 4 months.
A fresh approach to ditch cutting analysis as an aid to exploration in areas affected by large igneous province (LIP) volcanism
Authors: Millett J. M. , Hole M. J. , Jolley D. W. 
Published: February 2014

Abstract
Where hydrocarbon exploration targets occur within basins affected by large igneous province (LIP) sequences, an understanding of the volcanic stratigraphy is essential in compiling accurate basin models at all scales. Ditch cutting samples are one of the most commonly available sources of data yielding information in the context of LIP stratigraphy such as phenocryst load, degree of secondary precipitation and lava composition, largely unattainable by remote sensing. Where core data is limited or absent, cuttings provide the only means of accessing such data along with valuable inference of volcanic facies development and down-hole conditions. Interpretations based on cuttings data are widely used in industry and, as such, a repeatable and well-defined methodology for the analysis and designation of volcanic facies from cuttings is an important requirement for regional and individual play modelling. Such an approach has not been common practice to date. We propose a system of basic percentage-based cuttings analysis and ternary classification specifically tailored to LIP sequences, and argue for the benefits of a coherent and transparent basin-wide approach. The classification system is further developed into a log-style output for easy integration and comparison with other down-hole geophysical and biostratigraphic data.
First-In-Human Phase I Study of Lurbinectedin (PM01183) in Patients with Advanced Solid Tumors
Authors: Elez María Elena , Tabernero Josep , Geary David , Macarulla Teresa , Kang S. Peter , Kahatt Carmen , Pita Arturo Soto-Matos , Teruel Carlos Fernandez , Siguero Mariano , Cullell-Young Martin , Szyldergemajn Sergio , Ratain Mark J. 
Published: February 2014

AbstractPurpose: Lurbinectedin (PM01183) binds covalently to DNA and has broad activity against tumor cell lines. This first-in-human phase I study evaluated dose-limiting toxicities (DLT) and defined a phase II recommended dose for PM01183 as a 1-hour intravenous infusion every three weeks (q3wk).Experimental Design: Thirty-one patients with advanced solid tumors received escalating doses of PM01183 following an accelerated titration design.Results: PM01183 was safely escalated over 200-fold, from 0.02 to 5.0 mg/m2. Dose doubling was utilized, requiring 15 patients and nine dose levels to identify DLT. The recommended dose was 4.0 mg/m2, with one of 15 patients having DLT (grade 4 thrombocytopenia). Clearance was independent of body surface area; thus, a flat dose of 7.0 mg was used during expansion. Myelosuppression, mostly grade 4 neutropenia, occurred in 40% of patients but was transient and manageable, and none was febrile. All other toxicity was mild and fatigue, nausea and vomiting were the most common at the recommended dose. Pharmacokinetic parameters showed high interindividual variation, though linearity was observed. At or above the recommended dose, the myelosuppressive effect was significantly associated with the area under the concentration-time curve from time zero to infinity (white blood cells, P = 0.0007; absolute neutrophil count, P = 0.016). A partial response was observed in one patient with pancreatic adenocarcinoma at the recommended dose.Conclusion: A flat dose of 7.0 mg is the recommended dose for PM01183 as a 1-hour infusion q3wk. This dose is tolerated and active. Severe neutropenia occurred at this dose, although it was transient and with no clinical consequences in this study. Clin Cancer Res; 20(8); 2205–14. ©2014 AACR.
Intensive Cardiovascular Risk Reduction Induces Sustainable Changes in Expression of Genes and Pathways Important to Vascular Function
Authors: Ellsworth Darrell L. , Croft Daniel T. , Weyandt Jamie , Sturtz Lori A. , Blackburn Heather L. , Burke Amy , Haberkorn Mary Jane , McDyer Fionnuala A. , Jellema Gera L. , van Laar Ryan , Mamula Kimberly A. , Chen Yaqin , Vernalis Marina N. 
Published: February 2014

Background—
Healthy lifestyle changes are thought to mediate cardiovascular disease risk through pathways affecting endothelial function and progression of atherosclerosis; however, the extent, persistence, and clinical significance of molecular change during lifestyle modification are not well known. We examined the effect of a rigorous cardiovascular disease risk reduction program on peripheral blood gene expression profiles in 63 participants and 63 matched controls to characterize molecular responses and identify regulatory pathways important to cardiovascular health.

Methods and Results—

Dramatic changes in dietary fat intake (−61%;
P
<0.001 versus controls) and physical fitness (+34%;
P
<0.001) led to significant improvements in cardiovascular disease risk factors. Analysis of variance with false discovery rate correction for multiple testing (
P
<0.05) identified 26 genes after 12 weeks and 143 genes after 52 weeks that were differentially expressed from baseline in participants. Controls showed little change in cardiovascular disease risk factors or gene expression. Quantitative reverse transcription polymerase chain reaction validated differential expression for selected transcripts. Lifestyle modification effectively reduced expression of proinflammatory genes associated with neutrophil activation and molecular pathways important to vascular function, including cytokine production, carbohydrate metabolism, and steroid hormones. Prescription medications did not significantly affect changes in gene expression.

Conclusions—
Successful and sustained modulation of gene expression through lifestyle changes may have beneficial effects on the vascular system not apparent from traditional risk factors. Healthy lifestyles may restore homeostasis to the leukocyte transcriptome by downregulating lactoferrin and other genes important in the pathogenesis of atherosclerosis.

Clinical Trial Registration—

URL:
www.clinicaltrials.gov
. Unique identifier: NCT01805492
Opposing Effects of Appetitive and Aversive Cues on Go/No-go Behavior and Motor Excitability
Authors: Chiu Yu-Chin , Cools Roshan , Aron Adam R. 
Published: February 2014

Abstract
Everyday life, as well as psychiatric illness, is replete with examples where appetitive and aversive stimuli hijack the will, leading to maladaptive behavior. Yet the mechanisms underlying this phenomenon are not well understood. Here we investigate how motivational cues influence action tendencies in healthy individuals with a novel paradigm. Behaviorally, we observed that an appetitive cue biased go behavior (making a response), whereas an aversive cue biased no-go behavior (withholding a response). We hypothesized that the origin of this behavioral go/no-go bias occurs at the motor system level. To test this, we used single-pulse TMS as a motor system probe (rather than a disruptive tool) to index motivational biasing. We found that the appetitive cue biased the participants to go more by relatively increasing motor system excitability, and that the aversive cue biased participants to no-go more by relatively decreasing motor system excitability. These results show, first, that maladaptive behaviors arise from motivational cues quickly spilling over into the motor system and biasing behavior even before action selection and, second, that this occurs in opposing directions for appetitive and aversive cues.
The Role of Right Prefrontal and Medial Cortex in Response Inhibition: Interfering with Action Restraint and Action Cancellation Using Transcranial Magnetic Brain Stimulation
Authors: Dambacher Franziska , Sack Alexander T. , Lobbestael Jill , Arntz Arnoud , Brugman Suzanne , Schuhmann Teresa 
Published: February 2014

Abstract
The ability of inhibiting impulsive urges is paramount for human behavior. Such successful response inhibition has consistently been associated with activity in pFC. The current study aims to unravel the differential involvement of different areas within right pFC for successful action restraint versus action cancellation. These two conceptually different aspects of action inhibition were measured with a go/no-go task (action restraint) and a stop signal task (action cancellation). Localization of relevant prefrontal activation was based on fMRI data. Significant task-related activation during successful action restraint was localized for each participant individually in right anterior insula (rAI), right superior frontal gyrus, and pre-SMA. Activation during successful action cancellation was localized in rAI, right middle frontal gyrus, and pre-SMA. Subsequently, fMRI-guided continuous thetaburst stimulation was applied to these regions. Results showed that the disruption of neural activity in rAI reduced both the ability to restrain (go/no-go) and cancel (stop signal) responses. In contrast, continuous thetaburst stimulation-induced disruption of the right superior frontal gyrus specifically impaired the ability to restrain from responding (go/no-go), while leaving the ability for action cancellation largely intact. Stimulation applied to right middle frontal gyrus and pre-SMA did not affect inhibitory processing in neither of the two tasks. These findings provide a more comprehensive perspective on the role of pFC in inhibition and cognitive control. The results emphasize the role of inferior frontal regions for global inhibition, whereas superior frontal regions seem to be specifically relevant for successful action restraint.
Ventral Striatum and the Evaluation of Memory Retrieval Strategies
Authors: Badre David , Lebrecht Sophie , Pagliaccio David , Long Nicole M. , Scimeca Jason M. 
Published: February 2014

AbstractAdaptive memory retrieval requires mechanisms of cognitive control that facilitate the recovery of goal-relevant information. Frontoparietal systems are known to support control of memory retrieval. However, the mechanisms by which the brain acquires, evaluates, and adapts retrieval strategies remain unknown. Here, we provide evidence that ventral striatal activation tracks the success of a retrieval strategy and correlates with subsequent reliance on that strategy. Human participants were scanned with fMRI while performing a lexical decision task. A rule was provided that indicated the likely semantic category of a target word given the category of a preceding prime. Reliance on the rule improved decision-making, as estimated within a drift diffusion framework. Ventral striatal activation tracked the benefit that relying on the rule had on decision-making. Moreover, activation in ventral striatum correlated with a participant's subsequent reliance on the rule. Taken together, these results support a role for ventral striatum in learning and evaluating declarative retrieval strategies.
Is There a Relationship between Potential and Actual Skill?
Authors: Kumar Arun , Peng Peitao , Chen Mingyue 
Published: February 2014

Abstract
In this paper, possible connections between actual and potential skill are discussed. Actual skill refers to when the prediction time series is validated against the observations as the verification while perfect skill refers to when the observed verification time series is replaced by one of the members from the ensemble of predictions. It is argued that (i) there need not be a relationship between potential and actual skill; (ii) potential skill is not constrained to be always greater than actual skill, and examples to the contrary can be found; and (iii) there are methods whereby statistical characteristics of predicted anomalies can be compared with the corresponding in the observations, and inferences about the validity of the (positive) gap between potential and actual skill as “room for improvement” can be better substantiated.
The Prevalence and Correlates of Mental and Emotional Health Among American Indian Adults With Type 2 Diabetes
Authors: Walls Melissa L. , Aronson Benjamin D. , Soper Garrett V. , Johnson-Jennings Michelle D. 
Published: February 2014

Aims The purpose of this study was to examine the prevalence and correlates of mental and emotional health factors among a sample of American Indian (Indigenous) adults diagnosed with type 2 diabetes. Methods Data are from a community-based participatory research project involving 2 Indigenous reservation communities. Data were collected from 218 Indigenous adults diagnosed with type 2 diabetes via in-person paper-and-pencil survey interviews. Results Reports of greater numbers of mental/emotional health problems were associated with increases in self-reported hyperglycemia, comorbid health problems, and health-impaired physical activities. Conclusions This study addresses a gap in the literature by demonstrating the associations between various mental/emotional health factors and diabetes-related health problems for Indigenous Americans. Findings underscore the importance of holistic, integrated primary care models for more effective diabetes care.
The Influence of Electrolarynx Use on Postlaryngectomy Voice‐Related Quality of Life
Authors: Cox Steven R. , Doyle Philip C. 
Published: February 2014

ObjectiveTo investigate voice‐related quality of life in an effort to index self‐assessed voice disability in speakers who use the electrolarynx and to determine the perceived level of influence of the electrolarynx on vocal communication.Study DesignProspective study.SettingThis study was conducted at a tertiary care facility.Subjects and MethodsForty laryngectomized adults (25 men, 15 women) who used the electrolarynx as a primary method of communication served as participants. The Voice‐Related Quality of Life measure was administered and scored in standard fashion and descriptive data generated for physical, social‐emotional, and total scores.ResultsData indicate substantial variability in self‐perceived quality of life specific to voice use; a wide range of physical, social‐emotional, and total scores were observed. Only one‐quarter of these participants rated themselves as having “poor/fair” voice‐related quality of life.ConclusionOur findings suggest that use of the electrolarynx as a postlaryngectomy method of verbal communication has a wide‐ranging influence on self‐perceived voice‐related quality of life and that mean scores from prior studies may not accurately reflect the potential value of the electrolarynx. Communication disability related to electrolarynx use does in fact vary; however, it is not uniformly poor, and some may be highly proficient users. Consequently, the Voice‐Related Quality of Life measure may also serve as a useful tool for clinical documentation of rehabilitation outcomes in those who use the electrolarynx as a postlaryngectomy method of speech.
Costs of illness and quality of life in patients with systemic lupus erythematosus in South Korea
Authors: Cho JH , Chang SH , Shin NH , Choi BY , Oh HJ , Yoon MJ , Lee EY , Lee EB , Lee TJ , Song YW 
Published: February 2014

Objective To assess the costs of illness, health-related quality of life (HRQOL) and their associated factors in patients with systemic lupus erythematosus (SLE) in South Korea. Method Two hundred and one patients with SLE were enrolled at the Rheumatology clinic of Seoul National University Hospital. Direct, indirect and total costs and HRQOL were measured using hospital electronic data and face-to-face interview. Socio-demographic and clinical factors associated with cost of illness and HRQOL were analyzed using multiple regression and multivariate logistic regression. Results The average total cost of illness was estimated to be KRW 9.82 million (US $ 8993) per year, of which 41.6% was accounted for by direct costs and 58.4% by indirect costs. In multivariate regression, patients with renal involvement and those with depression incurred an average increment in annual total costs of 37.6% ( p = 0.050) and 49.1% ( p = 0.024), respectively, and an average increment in annual direct costs of 26.4% ( p = 0.050) and 43.3% ( p = 0.002), respectively, compared with patients without renal involvement and depression, respectively. In addition, disease damage was positively associated with an average increment in annual total and direct costs (55.3%, p = 0.006; 33.3%, p = 0.013, respectively), and the occurrence of indirect costs (OR 2.21, 1.09–4.88). There was no significant difference in HRQOL between patients with and without renal involvement (0.655 vs. 0.693, p = 0.203) Conclusion Renal involvement, depression, and disease damage were major factors associated with higher total and medical costs for patients with SLE in South Korea. Effective treatment of renal disorders and depression may reduce the high economic burden of SLE.
The dignity of the nursing profession
Authors: Sabatino Laura , Stievano Alessandro , Rocco Gennaro , Kallio Hanna , Pietila Anna-Maija , Kangasniemi Mari K 
Published: February 2014

Background: Nursing continues to gain legitimation epistemologically and ontologically as a scientific discipline throughout the world. If a profession gains respect as a true autonomous scientific profession, then this recognition has to be put in practice in all environments and geographical areas. Nursing professional dignity, as a self-regarding concept, does not have a clear definition in the literature, and it has only begun to be analyzed in the last 10 years. Objectives: The purpose of this meta-synthesis was to determine the various factors that constitute the notion of nursing professional dignity. The target was to create a tentative model of the concept. Research design: The research design was a meta-synthesis (N = 15 original articles) of nursing professional dignity described in the literature, based on the guidelines by Noblit and Hare. Method and findings: Original studies were sought out from electronic databases and manual searches. The selection of literature was conducted on stages based on titles (n = 2595), abstracts (n = 70), and full-texts (n = 15) according to the inclusion and exclusion criteria. From this analysis, a clear definition of nursing professional dignity emerged that underscored two main macro-dimensions constituting this intertwined, multidimensional, and complex notion: characteristics of the human beings and workplace elements. Conclusion: The recognition of nursing professional dignity could have a positive impact on patients because the results clearly showed that nurses are more prone to foster patients’ dignity, patients’ safety, and a better quality of care if their own dignity is respected. If nurses are uncomfortable, humiliated, or not seen in their professional role, it is difficult to give to others good care, good support, or good relationships.