bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is multidisciplinary teamwork the key? A qualitative study of the development of respiratory services in the UK
Authors: Pinnock Hilary , Huby Guro , Tierney Alison , Hamilton Sonya , Powell Alison , Kielmann Tara , Sheikh Aziz 
Published: September 2009

Summary Objectives Using frameworks, such as the long-term conditions pyramid of healthcare, primary care organizations (PCOs) in England and Wales are exploring ways of developing services for people with long-term respiratory disease. We aimed to explore the current and planned respiratory services and the roles of people responsible for change. Setting A purposive sample of 30 PCOs in England and Wales. Design Semi-structured telephone interviews with the person responsible for driving the reconfiguration of respiratory services. Recorded interviews were transcribed and coded, and themes identified. The association of the composition of the team driving change with the breadth of services provided was explored using a matrix. Results All but two of the PCOs described clinical services developed to address the needs of people with respiratory conditions, usually with a focus on preventing admissions for chronic obstructive pulmonary disease (COPD). Although the majority identified the need to develop a strategic approach to service development and to meet educational needs of primary care professionals, relatively few described clearly developed plans for addressing these issues. Involvement of clinicians from both primary and secondary care was associated with a broad multifaceted approach to service development. Teamwork was often challenging, but could prove rewarding for participants and could result in a fruitful alignment of objectives. The imminent merger of PCOs and overriding financial constraints resulted in a ‘fluid’ context which challenged successful implementation of plans. Conclusions While the majority of PCOs are developing clinical services for people with complex needs (principally in order to reduce admissions), relatively few are addressing the broader strategic issues and providing for local educational needs. The presence of multidisciplinary teams, which integrated primary and secondary care clinicians with PCO management, was associated with more comprehensive service provision addressing the needs of all respiratory patients. Future research needs to provide insight into the structures, processes and inter-professional relationships that facilitate development of clinical, educational and policy initiatives which aim to enhance local delivery of respiratory care.
Vapor Permeability Measurements: Impact of Cup Sealing, Edge Correction, Flow Direction, and Mean Relative Humidity
Authors: Hens Hugo S. L. C. 
Published: September 2009

Abstract
Water vapor permeability is a basic hygrothermal characteristic of a porous material. At first sight, the cup test used for measuring the property looks simple. Conditions to be fulfilled, however, are that the vapor flow crosses the sample only, is one-dimensional, and that flow direction has no impact on the result. Flow through the sample only demands a perfectly vapor-tight edge-high seal between sample and cup. That condition was tested using different sealing solutions. The results learned that more precautions than expected were needed. If the flow is not one-dimensional, for example, because such perfect seal is only realizable for a sample larger than the cup mouth, an edge correction must be applied to the value measured. As far as direction is concerned, measurements on a couple of hygroscopic materials gave different vapor permeability results for inward and outward flows. Long-lasting sorption after a fast initial hygroscopic moisture uptake appeared to be the reason for that. Dry, wet, and very wet cup testing shows that vapor permeability of hygroscopic materials increases with relative humidity. Some attribute that effect to surface flow from higher to lower relative humidity in the adsorbed water layers once beyond 50 % relative humidity. If that hypothesis was correct, apparent vapor permeability of hygroscopic layers, in situations where partial water vapor pressure and relative humidity gradients oppose, should be much lower than that measured with a wet cup. During the cold season opposing gradients are present in assemblies with a hygroscopic layer at the outside, covered by a vapor retarding finish. Yet, hot box testing on that kind of assemblies did not reveal vapor permeabilities lower than the wet cup value, although interstitial condensation between the hygroscopic and vapor retarding layer was a fact.
CaPO4 Blasted Implants Inserted Into Iliac Crest Homologue Frozen Grafts
Authors: Franco Maurizio , Rigo Leone , Viscione Alessandro , De Santis Bruno , Tropina Emanuela , Brunelli Giorgio , Guidi Riccardo , Avantaggiato Anna , Carinci Francesco 
Published: September 2009

AbstractIn the last decade, some investigations have reported that the resorbable blast media surface (also named CaPO4 blasted implants [CaPO4-BIs]) has achieved excellent results. However, no report regarding CaPO4-BIs inserted into fresh frozen bone (FFB) is available. Thus, we planned a retrospective study on a series of CaPO4-BIs inserted into FFB to evaluate their clinical outcome. In the period between December 2003 and December 2006, 16 patients (10 females and 6 males, median age of 55 years) were operated on, and 76 CaPO4-BIs were inserted. The mean implant follow-up was 23 months. Implant diameter and length ranged from 3.25 to 4.5 mm and from 11.5 to 15 mm, respectively. Implants were inserted to replace 7 incisors, 11 cuspids, 31 premolars, and 27 molars. Only 1 out of 76 implants was lost (ie, survival rate [SVR] = 98.7%), and no differences were detected among the studied variables. When peri-implant crestal bone resorption was used as an indicator of clinical success (ie, success rate), it was possible to identify some variables that correlated with a better clinical outcome. Specifically, Cox regression showed that removable prosthetic restoration and longer implant length correlated with a statistically significant lower delta implant abutment junction (IAJ; ie, reduced crestal bone loss) and thus a better clinical outcome. In this study, CaPO4-BIs had high survival and success rates, similar to those reported in previous reports of 2-stage procedures in nongrafted bone. CaPO4-BIs inserted into FFB are reliable devices, although greater marginal bone loss occurs when fixed prosthetic restorations and short implants are used.
Depression and Diabetes among Low-Income Hispanics: Design Elements of a Socio-Culturally Adapted Collaborative Care Model Randomized Controlled Trial
Authors: Ell Kathleen , Katon Wayne , Cabassa Leopoldo J. , Xie Bin , Lee Pey-Jiuan , Kapetanovic Suad , Guterman Jeffry 
Published: September 2009

Objective: This article describes design elements of the Multifaceted Depression and Diabetes Program (MDDP) randomized clinical trial. The MDDP trial hypothesizes that a socioculturally adapted collaborative care depression management intervention will reduce depressive symptoms and improve patient adherence to diabetes self-care regimens, glycemic control, and quality-of-life. In addition, baseline data of 387 low-income, 96% Hispanic, enrolled patients with major depression and diabetes are examined to identify study population characteristics consistent with trial design adaptations. Methods: The PHQ-9 depression scale was used to identify patients meeting criteria for major depressive disorder (1 cardinal depression symptom + a PHQ-9 score of > 10) from two community safety net clinics. Design elements included sociocultural adaptations in recruitment and efforts to reduce attrition and collaborative depression care management. Results: Of 1,803 diabetes patients screened, 30.2% met criteria for major depressive disorder. Of 387 patients enrolled in the clinical trial, 98% had Type 2 diabetes, and 83% had glycated hemoglobin (HbA1c) levels ≥ 7%. Study recruitment rates and baseline data analyses identified socioeconomic and clinical factors that support trial design and intervention adaptations. Depression severity was significantly associated with diabetes complications, medical comorbidity, greater anxiety, dysthymia, financial worries, social stress, and poorer quality-of-life. Conclusion: Low-income Hispanic patients with diabetes experience high prevalence of depressive disorder and depression severity is associated with socioeconomic stressors and clinical severity. Improving depression care management among Hispanic patients in public sector clinics should include intervention components that address self-care of diabetes and socioeconomic stressors.
The Abuse of Prescription Medications: Borderline Personality Patients in Psychiatric versus Non-Psychiatric Settings
Authors: Sansone Randy A. , Wiederman Michael W. 
Published: September 2009

Objective: In this study, the prevalence of prescription substance abuse among those with borderline personality symptomatology was examined in a large cohort of respondents who participated in one of 13 prior research projects. Method: The entire cohort ( N = 1039) was divided into 3 sub-samples: a psychiatric sample ( n = 440), a predominantly primary care sample ( n = 599), and an internal medicine sample ( n = 332; i.e., a well-defined subset of the predominantly primary care sample that consisted of only internal medicine outpatients seen at one location). The borderline personality scale of the Personality Diagnostic Questionnaire (PDQ), either the revised (PDQ-R) or fourth (PDQ-4) version, was used to diagnose all participants either with or without borderline personality. One item from the Self-Harm Inventory, “Have you ever intentionally, or on purpose, abused prescription medication?,” was then used in the subsequent analyses. Results: Among the psychiatric, predominantly primary care, and internal medicine subsamples, the prevalence rates of prescription medication abuse in those diagnosed with borderline personality according to the PDQ were 46.9%, 46.2%, and 11.5%, respectively. In all subsamples, those with borderline personality were statistically significantly more likely to abuse prescription medication than those without the disorder. For example, borderline patients in the psychiatric sample were twice as likely to abuse prescription medications, in the predominantly primary care sample 4 times as likely, and in the internal medicine only sample nearly 6 times as likely. Conclusions: Regardless of setting, patients with BPD are at great risk for the abuse of prescription medications.
Separating Equilibria in Public Auctions
Authors: Gavious Arieh 
Published: September 2009

Abstract
We consider two private-value auctions where the prize in one is higher than the prize in the other. We show that a separating equilibrium exists in which bidders with a high valuation attend the auction with the higher prize while bidders with a low valuation attend the auction with the lower prize. In addition, we prove that a weak separating equilibrium exists where the strong bidders attend the high prize auction while the weak bidders randomize and may attend either auction, although with a higher probability of attending the low prize auction. In the set of auctions with separating equilibrium, we find the optimal minimum bids that maximize a seller's expected revenue.
Evaluating Voluntary Measures with Treatment Spillovers: The Case of Coal Combustion Products Partnership
Authors: Lange Ian 
Published: September 2009

Abstract
Voluntary measures have traditionally been evaluated using a similar framework regardless of their structure. The framework assumes that the measure provides partners with a treatment (information, research support, etc.) that will not be transferred to non-partners. In this framework, a voluntary measure is said to be worthwhile if differences are significant between the behavior of partners and non-partners, correcting for the potential endogeneity of becoming a partner. However, voluntary measures take many different forms, some which are expected to have transfers to non-partners (spillovers). The Coal Combustion Products Partnership (C2P2) is a U.S. voluntary program with a structure that is likely to provide treatment spillovers to non-partners. This paper evaluates C2P2 and tests whether treatment spillovers are affecting non-partners' behavior. Results are consistent with a program that would traditionally be considered unsuccessful, but the consideration of treatment spillovers makes it consistent with a successful program.
Effect of Pharmacological Treatment of Depression on A1C and Quality of Life in Low-Income Hispanics and African Americans With Diabetes
Authors: Echeverry Diana , Duran Petra , Bonds Curley , Lee Martin , Davidson Mayer B. 
Published: September 2009

OBJECTIVETo determine whether pharmacological treatment of depression in low-income minorities with diabetes improves A1C and quality of life (QOL).RESEARCH DESIGN AND METHODSThis was a 6-month, randomized, double-blind, placebo-controlled trial. Patients were screened for depression using Whooley's two-question tool at a county diabetes clinic. Depression was confirmed (or not) with the Computerized Diagnostic Interview Survey (CDIS) software program, and the severity of depression was assessed monthly by the Hamilton Depression Scale (HAM-D). Depressed subjects with A1C levels ≥8.0% were randomly assigned to receive either sertraline or placebo. Diabetes care was provided by nurses following detailed treatment algorithms who were unaware of therapy for depression.RESULTSA total of 150 subjects answered positively to at least one question on Whooley's questionnaire. The positive predictive value for depression diagnosed by CDIS was 69, 67, and 84% for positive answers to question 1 only, question 2 only, or both, respectively. Of the 89 subjects who entered the study, 75 completed. An intention-to-treat analysis revealed significant differences between baseline and 6 months in HAM-D and pain scores, QOL, and A1C and systolic blood pressure levels in both groups, with no differences between groups for the first three but a significantly greater decrease with sertraline in A1C and systolic blood pressure levels. Changes in HAM-D scores and A1C levels were significantly correlated in all subjects (P = 0.45 [P &lt; 10−6]).CONCLUSIONSIn this low-income minority population, pharmacological treatment of depression significantly improved A1C and systolic blood pressure levels compared with placebo.
Impact of Metabolic Syndrome Compared With Impaired Fasting Glucose on the Development of Type 2 Diabetes in a General Japanese Population
Authors: Mukai Naoko , Doi Yasufumi , Ninomiya Toshiharu , Hata Jun , Yonemoto Koji , Iwase Masanori , Iida Mitsuo , Kiyohara Yutaka 
Published: September 2009

OBJECTIVE
We examined whether metabolic syndrome predicts incident type 2 diabetes more effectively than impaired fasting glucose (IFG) in a general Japanese population.

RESEARCH DESIGN AND METHODS
A total of 1,935 nondiabetic subjects aged 40–79 years were followed-up prospectively for a mean of 11.8 years.

RESULTS
During the follow-up, 286 subjects developed type 2 diabetes. Compared with those without metabolic syndrome, the multivariate-adjusted hazard ratio (HR) for incident type 2 diabetes was significantly higher in subjects of both sexes with metabolic syndrome, even after adjustment for confounding factors, age, family history of diabetes, total cholesterol, alcohol intake, smoking habits, and regular exercise (men: HR 2.58 [95% CI 1.85–3.59]; women: 3.69 [2.58–5.27]). The multivariate-adjusted HR of metabolic syndrome for type 2 diabetes was slightly lower in men and similar in women compared with that of IFG. The multivariate-adjusted HR for type 2 diabetes rose progressively as the number of metabolic syndrome components increased in both subjects with and without IFG. In stratified analysis, the multivariate-adjusted risk of type 2 diabetes was significantly higher in subjects with metabolic syndrome alone (2.37 [1.45–3.88]) or IFG alone (3.49 [2.57–4.74]) and markedly increased in subjects with both metabolic syndrome and IFG (6.76 [4.75–9.61]) than in subjects with neither metabolic syndrome nor IFG. Furthermore, the multivariate-adjusted risk for type 2 diabetes was also significantly higher in subjects with both metabolic syndrome and IFG than in those with either one alone (both P &lt; 0.001).

CONCLUSIONS
Our findings suggest that metabolic syndrome significantly increases the risk of incident type 2 diabetes, independent of IFG, and is therefore a valuable tool to identify individuals at high risk of type 2 diabetes.
Maternal Glycemia and Risk of Large-for-Gestational-Age Babies in a Population-Based Screening
Authors: Kerényi Zsuzsa , Tamás Gyula , Kivimäki Mika , Péterfalvi Andrea , Madarász Eszter , Bosnyák Zsolt , Tabák Adam G. 
Published: September 2009

OBJECTIVE
Gestational diabetes is a risk factor for large-for-gestational-age (LGA) newborns, but many LGA babies are born to mothers with normal glucose tolerance. We aimed to clarify the association of maternal glycemia across the whole distribution with birth weight and risk of LGA births in mothers with normal glucose tolerance.

RESEARCH DESIGN AND METHODS
We undertook a population-based gestational diabetes screening in an urban area of Hungary in 2002–2005. All singleton pregnancies of mothers ≥18 years of age, without known diabetes or gestational diabetes (World Health Organization criteria) and data on a 75-g oral glucose tolerance test at 22–30 weeks of gestation, were included (n = 3,787, 78.9% of the target population). LGA was determined as birth weight greater than the 90th percentile using national sex- and gestational age–specific charts.

RESULTS
Mean ± SD maternal age was 30 ± 4 years, BMI was 22.6 ± 4.0 kg/m2, fasting blood glucose was 4.5 ± 0.5 mmol/l, and postload glucose was 5.5 ± 1.0 mmol/l. The mean birth weight was 3,450 ± 476 g at 39.2 ± 1.2 weeks of gestation. There was a U-shaped association of maternal fasting glucose with birth weight (Pcurve = 0.004) and risk of having an LGA baby (lowest values between 4 and 4.5 mmol/l, Pcurve = 0.0004) with little change after adjustments for clinical characteristics. The association of postload glucose with birth weight (P = 0.03) and the risk of an LGA baby (P = 0.09) was weaker and linear.

CONCLUSIONS
Both low and high fasting glucose values at 22–30 weeks of gestation are associated with increased risk of an LGA newborn. We suggest that the excess risk related to low glucose reflects the increased use of nutrients by LGA fetuses that also affects the mothers' fasting glucose.
Health Care and Productivity Costs Associated With Diabetic Patients With Macrovascular Comorbid Conditions
Authors: Fu Alex Z. , Qiu Ying , Radican Larry , Wells Brian J. 
Published: September 2009

OBJECTIVETo examine and quantify from the societal perspective the impact of macrovascular comorbid conditions (MVCCs) on health care and productivity costs in diabetic patients in the U.S.RESEARCH DESIGN AND METHODSWith use of the pooled Medical Expenditure Panel Survey (MEPS) 2004 and 2006 data, a nationally representative adult sample (aged ≥18 years) was included in the study. Health care cost was measured by the annual health care expenditure. Productivity cost was calculated from the lost productivity from missed work days and additional bed days due to illness/injury based on the 2006 average national hourly wage. Both 2004 and 2006 cost data were adjusted to 2006 dollars. Given the heavily right-skewed distribution of the cost data, the generalized linear model with log-link function and γ variance was used to identify the relationship between MVCCs and costs after controlling for age, sex, race, ethnicity, education, income, employment status, smoking status, health insurance, diabetes severity, and comorbidities. Negative binomial models were applied to analyze the outcomes of missed work days and bed days. All statistics were adjusted using the proper sampling weight from MEPS.RESULTSCompared with diabetic patients without MVCCs (n = 3,320), those with MVCCs (n = 913) had statistically significant higher annual health care costs (5,120 USD, P &lt; 0.001), more missed work days (13.03 days, P &lt; 0.001), and more bed days (7.60 days, P = 0.025) per patient after controlling for differences in sociodemographics, smoking, diabetes severity, and comorbidities. The marginal lost productivity cost was 2,388 USD annually per patient.CONCLUSIONSFrom the U.S. societal perspective, MVCCs in diabetic patients are associated with increased health care and lost productivity costs.
Bound for Success: A Systematic Review of Constraint-Induced Movement Therapy in Children With Cerebral Palsy Supports Improved Arm and Hand Use
Authors: Huang Hsiang-han , Fetters Linda , Hale Jennifer , McBride Ashley 
Published: September 2009

BackgroundConstraint-induced movement therapy (CIMT) is a potentially effective intervention for children with hemiplegic cerebral palsy (CP).PurposeThe objectives of this systematic review are: (1) to investigate whether CIMT is supported with valid research of its effectiveness and (2) to identify key characteristics of the child and intervention protocol associated with the effects of CIMT.Data Sources and Study SelectionA search of MEDLINE (1966 through March 2009), Entrez PubMed (1966 through March 2009), EMBASE (1980 through March 2009), CINAHL (1982 through March 2009), PsychINFO (1887 through March 2009), and Web of Science (1900 through March 2009) produced 23 relevant studies.Data Extraction and SynthesisThe 2 objectives of the review were addressed by: (1) scoring the validity and level of evidence for each study and calculating evidence-based statistics, if possible, and (2) recording and summarizing the inclusion and exclusion criteria, type and duration of constraint, intervention and study durations, and outcomes based on the International Classification of Functioning, Disability and Health (ICF).LimitationsOnly studies published in journals and in English were included in the systematic review.ConclusionsStudies varied widely in type and rigor of design; subject, constraint, and intervention characteristics; and ICF level for outcome measures. One outcome measure at the body functions and structure level and 4 outcome measures at the activity level had large and significant treatment effects (d≥.80), and these findings were from the most rigorous studies. Evidence from more-rigorous studies demonstrated an increased frequency of use of the upper extremity following CIMT for children with hemiplegic CP. The critical threshold for intensity that constitutes an adequate dose cannot be determined from the available research. Further research should include a priori power calculations, more-rigorous designs and comparisons of different components of CIMT in relation to specific children, and measures of potential impacts on the developing brain.