bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physiological Redundancy in Older Adults in Relation to the Change with Age in the Slope of a Frailty Index
Authors: Rockwood Kenneth , Rockwood Michael R. H. , Mitnitski Arnold 
Published: January 2010

OBJECTIVES: To test the proposition, using routinely available clinical data, that deficit accumulation results in loss of redundancy. In keeping with the reliability theory of aging, this would be quantitated by attenuation in the slope of a Frailty Index (FI) with age. The more deficits, the less steep the slope and the less redundancy.DESIGN: Cross‐sectional analysis of a prospective cohort study, with 5‐year mortality data.SETTING: The clinical sample of the second wave of the Canadian Study of Health and Aging.PARTICIPANTS: Two thousand three hundred five people aged 70 and older at baseline.MEASUREMENTS: A FI based on data used for a Comprehensive Geriatric Assessment (CGA), the slope of the relationship between age and the FI‐CGA, the limit value of the FI‐CGA, mortality.RESULTS: An age‐invariant limit to deficit accumulation was demonstrated; the observed 99% limit was 0.66. At the 25th percentile of deficit accumulation (FI‐CGA ∼0.18), the slope of the FI‐CGA in relation to age was 0.044 (range 0.038–0.049). When deficits had increased to 75% of the maximum value (FI‐CGA ∼0.52), the slope fell to 0.021 (range 0.016–0.027). By the 85th percentile (FI‐CGA ∼0.6), the slope had become statistically indistinguishable from 0.CONCLUSION: As predicted by the reliability theory of aging, the rate of deficit accumulation slows with increasing frailty. A FI derived from data routinely collected as part of a CGA can in this way quantify loss of redundancy in older adults. Quantifying loss of redundancy can aid clinical decision‐making; its application to individual prognostication in clinical samples warrants further evaluation.
How Insurance Brokers Create Value—A Functional Approach
Authors: Maas Peter 
Published: January 2010

AbstractFundamental changes in the market make it necessary for insurance intermediaries to continuously redefine their roles. This study concentrates on a customer perspective of the future role of insurance brokers, using the theoretical foundations of the customer value approach. Findings from 20 in‐depth interviews with leading managers of various types of multinational companies are supplemented with the results from interviews conducted with representatives of intermediaries and insurers. From this study it can be concluded that, depending on the customer's individual situation, brokers will assume one of four functions, the choice of which will be highly dependent on the degree of innovation and individualization desired. The investigation shows that although traditional transaction‐oriented services will continue to be important, there will be a shift toward tailor‐made solutions with an emphasis on consulting services, a situation that will require brokers to acquire new skills so as to be able to meet customer needs.
Personal and global economies: Male carpet manufacturers as entrepreneurs in the weaving neighborhoods of Konya, Turkey
Authors: ISIK DAMLA 
Published: January 2010

ABSTRACTSituating the Turkish carpet‐weaving industry within the historical and political context of small and medium‐sized enterprises (SMEs), this study concentrates on male carpet manufacturers in Konya, Turkey. It explores how their divergent and at times awkward articulations of successful entrepreneurship affect and are affected by local labor conditions and relationships. The efforts of carpet manufacturers to achieve entrepreneurial flexibility have both liberating and constraining effects, demonstrating that the meanings and practices some researchers ascribe to the market economy and flexibility cannot be understood if disengaged from the particulars of culture.
The cachet dilemma: Ritual and agency in new Dutch nationalism
Authors: VERKAAIK OSKAR 
Published: January 2010

ABSTRACTIn 2006, the Dutch government introduced a naturalization ceremony for foreigners wishing to become Dutch citizens. Local bureaucrats who organize the ceremony initially disapproved of the measure as symbolic of the neonationalist approach to migration. I analyze how their criticism is undermined in the process of designing the ritual, the form of which continues to express a culturalist message of citizenship, despite organizers’ explicit criticism or ridicule. Using the concept of “cultural intimacy,” I show how nationalism builds on a shared embarrassment among local bureaucrats, from which the new citizens are excluded by way of the ceremony.
The commodification of fetishes: Telling the difference between natural and synthetic sapphires
Authors: WALSH ANDREW 
Published: January 2010

ABSTRACTOn the basis of multisited research concerning the international sapphire trade, I discuss what stories told about natural sapphires can reveal about why and how people value these stones. Because the stuff of sapphires (corundum) can be cheaply synthesized in a laboratory, what is perhaps most distinctive and valuable about natural sapphires is their geological origins, a fact that people in the trade recognize and emphasize in their marketing of the gemstones. Demand for natural sapphires is attributable to more than just effective marketing, however. What the stories I cite in this article may reveal best of all are the irreproducible value‐adding qualities that are understood by many to be inherent to natural sapphires.
Who Comes Back? Characteristics and Predictors of Return to Emergency Department Services for Pediatric Mental Health Care
Authors: Newton Amanda S. , Ali Samina , Johnson David W. , Haines Christina , Rosychuk Rhonda J. , Keaschuk Rachel A. , Jacobs Philip , Cappelli Mario , Klassen Terry P. 
Published: January 2010

AbstractObjectives:  The objective of this study was to investigate predictors of emergency department (ED) return visits for pediatric mental health care. The authors hypothesized that through the identification of clinical and health system variables that predict return ED visits, which children and adolescents would benefit from targeted interventions for persistent mental health needs could be determined.Methods:  Data on 16,154 presentations by 12,589 pediatric patients (≤17 years old) were examined from 2002 to 2006, using the Ambulatory Care Classification System (ACCS), a provincewide database for Alberta, Canada. Multivariable logistic regressions identified predictors, while survival analyses estimated time to ED return.Results:  In the multivariable analysis, there were four patient factors significantly associated with ED return. Male sex (odds ratio [OR] = 0.78; 99% confidence interval [CI] = 0.69 to 0.89) was associated with a lower rate of return, as was child age. The likelihood of ED return increased with age. Children ≤5 years (OR = 0.26; 99% CI = 0.14 to 0.46) and between ages 6 and 12 (OR = 0.64; 99% CI = 0.51 to 0.79) were less likely to return, compared to 13‐ to 17‐year‐olds. Patients with families receiving full assistance for covering government health care premiums were more likely to return compared to those with no assistance (OR = 1.59; 99% CI = 1.33 to 1.91). Patients were more likely to return if their initial presentation was for a mood disorder (OR = 1.72; 99% CI = 1.46 to 2.01) or psychotic‐related illness (OR = 2.53; 99% CI = 1.80 to 3.56). There were two modest health care system predictors in the model. The likelihood of return decreased for patients triaged as nonurgent (OR = 0.62; 99% CI = 0.45 to 0.87) versus those triaged as urgent (level 3 acuity) and increased for patients with visits to general (vs. pediatric) EDs (OR = 1.25; 99% CI = 1.03 to 1.52). ED region (urban vs. rural) did not predict return. Within 72 hours of discharge, 6.1 and 8.7% of patients diagnosed with a mood disorder and psychotic‐related illness, respectively, returned to the ED. Throughout the study period, 28.5 and 36.6% of these diagnostic populations, respectively, returned to the ED.Conclusions:  Among children and adolescents who accessed the ED for mental health concerns, being female, older in age, in receipt of social assistance, and having an initial visit for a mood disorder or psychotic‐related illness were associated with return for further care. How patient presentations were triaged and whether visits were made to a pediatric or general ED also affected the likelihood of return.ACADEMIC EMERGENCY MEDICINE 2010; 17:177–186 © 2010 by the Society for Academic Emergency Medicine
Evaluation of the genetic basis of phenotypic heterogeneity in north Indian patients with Thalassemia major
Authors: Sharma Nidhi , Das Reena , Kaur Jasbir , Ahluwalia Jasmina , Trehan Amita , Bansal Deepak , Panigrahi Inusha , Marwaha Ram Kumar 
Published: January 2010

Abstract Objectives: To assess the molecular basis of phenotypic heterogeneity in north Indian patients with thalassemia major (TM). Methods: To determine the clinical severity, 130 patients of TM were studied for the age of first presentation and frequency of blood transfusion. The type of beta mutations, Xmn–1Gγ polymorphism and G6PD Mediterranean mutation was characterized. Analysis of the phenotypic presentation and the genotype was performed. Results: Majority (83.8%) presented before 1 year of age (mean 8.8 months). The caste distribution showed 41.6% were Aroras and 32.3% were migrants from Pakistan. IVS1‐5(G→C) was commonest (32.7%) and the common five Indian mutations comprised of 88.4% of alleles. The mean age of presentation with IVS1‐5(G→C), Fr 8/9, (+G) 619‐bp del and IVS1‐1(G→T) homozygosity was 4.3, 6, 3.4 and 9.1 months respectively. Xmn–1Gγ status showed −/− in 66.9%, +/− in 26.1% and +/+ in 6.9% patients. Xmn–1Gγ−/− presented before 1 year of age. The mean age of presentation with +/+ was 18.3 months. Six hemizygous boys and one heterozygous girl with G6PD Mediterranean were found (prevalence 5.3%). Eight patients could be reclassified as thalassemia intermedia on follow up. Conclusions: This study showed that majority of TM in north India present before 1 year of age and homozygous 619‐bp deletion presents the earliest. The presence of Xmn‐1Gγ polymorphism delays the presentation, is associated with the IVS 1‐1 (G→T) and shows variable improvement with hydroxyurea therapy. Based on the results of genotyping, reevaluation of patients can improve the outcome in a few patients.
Heart rate variability (HRV) in adolescent females with anxiety disorders and major depressive disorder
Authors: Henje Blom E , Olsson EM , Serlachius E , Ericson M , Ingvar M 
Published: January 2010

AbstractAim:  The aim of this study was to investigate heart rate variability (HRV) in a clinical sample of female adolescents with anxiety disorders (AD) and/or major depressive disorder (MDD) compared with healthy controls and to assess the effect of selective serotonin reuptake inhibitors (SSRI) on HRV.Methods:  Heart rate variability was measured in adolescent female psychiatric patients with AD and/or MDD (n = 69), mean age 16.8 years (range: 14.5–18.4), from 13 out‐patient clinics and in healthy controls (n = 65), mean age 16.5 years (range: 15.9–17.7). HRV was registered in the sitting position during 4 min with no interventions.Results:  Logarithmically transformed high frequency HRV (HF), low frequency HRV (LF) and standard deviation of inter beat intervals (SDNN) were lower in the clinical sample compared with the controls (Cohen’s d for HF = 0.57, LF = 0.55, SDNN = 0.60). This was not explained by body mass index, blood pressure or physical activity. Medication with SSRI explained 15.5% of the total variance of HF, 3.0% of LF and 6.5% of SDNN.Conclusions:  Adolescent female psychiatric patients with AD and/or MDD show reduced HRV compared with healthy controls. Medication with SSRI explained a part of this difference.
In‐label and off‐label use of respiratory drugs in the Italian paediatric population
Authors: Baiardi P , Ceci A , Felisi M , Cantarutti L , Girotto S , Sturkenboom M , Baraldi E 
Published: January 2010

AbstractAim:  To evaluate the prescription rate of respiratory drugs (ATC code R03) in an Italian community setting and to estimate the extent of off‐label use by both age and indication.Methods:  A cohort study aimed at evaluating prescriptions of drugs with ATC code R03 was conducted for the period 2002–2006. Data source was the PEDIANET Database.Results:  Ninety percent of R03 prescriptions are covered by 11 active substances or combinations, corresponding to 67 medicinal products. Inhaled corticosteroids are the most prescribed anti‐asthmatic agents, followed by short‐acting β2 mimetics. The mean off‐label rate is 19 and 56%, by age and indication respectively. The majority of off‐label uses is among children under the age of 2. Five active substances are used at dosages not supported by adequate dose‐finding studies.Conclusion:  In Italy, many respiratory drugs are approved for the treatment of paediatric respiratory diseases, but a remarkable percentage of their prescriptions is off‐label. This pharmaco‐utilization study demonstrates that there is a need to perform clinical studies aimed at increasing the current knowledge on marketed paediatric drugs, and to revise and re‐label the existing regulatory documents to reduce their off‐label uses.
Considerations for an Evidence-Based Definition of Premature Ejaculation in the DSM-V
Authors: Segraves Robert Taylor 
Published: January 2010

ABSTRACT

Introduction
The Diagnostic and Statistical Manual of Mental Disorders, 4th Ed., text revision (DSM-IV-TR) criteria for premature ejaculation (PE) have been criticized on multiple grounds including that the criteria lack precision, that the requirement of marked distress is inappropriate, and that the specification of etiological subtypes should be deleted. Since these criteria were originally adopted, there has been a tremendous gain in knowledge concerning PE.

Aim
The goal of this manuscript is to review evidence relevant to diagnostic criteria for PE published since 1990.

Method
Medline searches from 1990 forward were conducted using the terms PE, rapid ejaculation, ejaculatory disorder, and intravaginal ejaculatory latency. Early drafts of proposed alterations in diagnostic criteria were submitted to advisors.

Main Outcome Measure
Expert opinion was based on review of evidence-based medical literature.

Results
The literature search indicated possible alterations in diagnostic criteria for PE.

Conclusions
It is recommended that the Diagnostic and Statistical Manual committee adopt criteria similar to those adopted by the International Society of Sexual Medicine. It is proposed that lifelong PE in heterosexual men be defined as ejaculation occurring within approximately 1 minute of vaginal penetration on 75% of occasions for at least 6 months. Field trials will be necessary to determine if these criteria can be applied to acquired PE and whether analogous criteria can be applied to ejaculatory latencies in other sexual activities. Serious consideration should be given to changing the name from PE to rapid ejaculation. The subtypes indicating etiology should be eliminated.
REPORTS: Considerations for Diagnostic Criteria for Erectile Dysfunction in DSM V
Authors: Segraves Robert Taylor 
Published: January 2010

ABSTRACTIntroductionThe Diagnostic and Statistical Manual of Mental Disorders, 4th Ed., text revision (DSM-IV-TR) criteria for erectile disorder have been criticized as multiple grounds including that the criteria lack precision, that the requirement of marked distress is inappropriate, and that the specification of etiological subtypes should be deleted.AimThe goal of this manuscript is to review evidence relevant to diagnostic criteria for erectile disorder published since 1990.MethodMedline searches from 1990 forward were conducted using the terms erectile disorder and impotence. Early drafts of proposed alterations in diagnostic criteria were submitted to advisors.Main Outcome MeasureEvidence regarding modification of criteria for DSM V diagnostic criteria for erectile dysfunction was judged by whether existing data justified the adoption of precise criteria which would lead to homogenous groups for research. Another outcome measure was whether data exist to reliably differentiate fluctuations in normal function from pathological states.ResultsThe literature review revealed a large literature concerning erectile disorder but minimal evidence concerning an operational definition for this disorder.ConclusionsIt is recommended that erectile disorder be precisely defined in order to clearly differentiate alterations in normal function from a condition requiring medial intervention and to facilitate clinical research. It is specifically proposed that erectile dysfunction be defined as failure to obtain and maintain an erection sufficient for sexual activity or decreased erectile turgidity on 75% of sexual occasions and lasting for at least 6 months. It is also recommended that erectile disorder be defined independently of distress.
Coronary heart disease knowledge tool for women
Authors: Thanavaro Joanne L. , Thanavaro Samer , Delicath Timothy 
Published: January 2010

Purpose: To develop a tool that measures coronary heart disease (CHD) knowledge specifically for women. Data sources: The new CHD knowledge tool, based on previous surveys of women's CHD knowledge, has 25 multiple‐choice questions. An expert panel evaluated content and face validity. The tool was pilot tested in women without CHD, who were admitted to a Chest Pain Center. The tool was subsequently administered to laywomen and female cardiovascular nurses to evaluate its validity and reliability. The sample included 49 women as the control group (Group 1), 23 cardiovascular nurses as a known group (Group 2), and 22 women with an educational program as the treatment group (Group 3). Knowledge of women in Group 1 was compared with Groups 2 and 3 in known group and predictive validity tests. Conclusion: The new tool demonstrates good validity and reliability to measure CHD knowledge in women. Implications for practice: Women continue to have low CHD knowledge, and nurse practitioners should provide education to improve women's CHD knowledge as a strategy to promote healthy lifestyle practices and CHD risk prevention. The new tool can be utilized in future research to measure women's CHD knowledge.
The human papillomavirus in women over 40: Implications for practice and recommendations for screening
Authors: Montgomery Kymberlee , Bloch Joan Rosen 
Published: January 2010

Purpose: Cervical cancer is the second leading cause of cancer deaths among women worldwide. Human papillomavirus (HPV) has been shown to be the precursor of cervical cancer in over 99% of these cases. Although preventative measures have greatly reduced the burden of HPV‐induced cervical cancer, these measures cannot be utilized by women who are unaware of the existence of HPV and its relationship to their health. Women over the age of 40 are being newly diagnosed with HPV, profoundly impacting their lives and their sense of well‐being. This article highlights the necessity for clinicians to assess knowledge, health beliefs, and preventative measures regarding HPV and cervical cancer in women over the age of 40. Data sources: Review of scientific literature of knowledge, health beliefs, and preventative measures in women regarding HPV and cervical cancer and clinical practice guidelines. Conclusions: Although women aged 40 and above are not specifically considered high risk for HPV infection, many women are testing positive in this age group and are facing the impact of an HPV diagnosis that implicates a sexually transmitted disease and is known to be a precursor to cervical cancer. Implications for practice: Suggested questions to use for all patients are presented as it is crucial for healthcare providers to understand the healthcare needs of this age group in order to appropriately direct resources and to save the lives of women from this preventable disease.
If pelvic inflammatory disease is suspected empiric treatment should be initiated
Authors: Abatangelo Lisa , Okereke Lilian , Parham‐Foster Cheryle , Parrish Colleen , Scaglione Leanne , Zotte Deborah , Taub Leslie‐Faith Morritt 
Published: January 2010

Purpose: To assist the nurse practitioner (NP) to make a rapid diagnosis and develop a treatment plan for pelvic inflammatory disease (PID) in order to assist women to promote their health and reduce their risk of the unnecessary sequelae of infertility, tubal damage, and the possibility of a subsequent ectopic pregnancy. Data sources: Centers for Disease Control guidelines and recent clinical practice literature were searched to provide guidance on how to diagnose, treat, and educate the patient with PID. Conclusions: The incidence of PID is approximately 1 million women annually. PID is diagnosed in 1%–2% of sexually active women under the age of 25, with a higher incidence in African American women. Women with PID produce over 2 million emergency room and office visits and incur health care costs of over 4 billion dollars annually. Implications for practice: PID is associated with chronic pelvic pain, infertility, and ectopic pregnancy. Symptoms can range from subtle and indolent to acute and fulminant. Having a high index of suspicion for the diagnosis will assist the NP in treating patients with this disease. Empiric antibiotic therapy should be initiated in all women at risk who have uterine, adnexal, or cervical motion tenderness on a bimanual exam with no other explanation for these symptoms. Without response to treatment, if the diagnosis is unclear, or if a surgical emergency is being considered, prompt referral to a specialist is warranted. Secondary preventive measures are discussed.
A concept analysis of home and its meaning in the lives of three older adults
Authors: Gillsjö Catharina , Schwartz‐Barcott Donna 
Published: January 2010

gillsjö c. & schwartz‐barcott d. (2010) A concept analysis of home and its meaning in the lives of three older adults. International Journal of Older People Nursing 6, 4–12 doi: 10.1111/j.1748‐3743.2010.00207.xAim.  To identify and define the concept of home and its meaning in the lives of three older women.Background.  For many older adults home is the centre of daily life and increasingly important as a place where health care is delivered. Yet, as a concept, home remains theoretically and empirically underdeveloped.Methods.  The Hybrid Model of Concept Development was used to interface theoretical analysis and empirical observation with a focus on definition. A comprehensive, interdisciplinary literature review, semi‐structured interviews with three older women and case and cross‐case analysis were completed.Results.  Interviewees spoke of childhood, community, residential, church and heavenly homes. Feelings of comfort and security were associated with residential homes, peace and quiet with church homes, safety and pleasure with heavenly homes. The experience of home as being taken for granted, unselfconscious and unrecognized, became obvious when one woman tried to consciously establish a sense of being at home in her new residence.Conclusion.  No single comprehensive and measurable definition was found. However, three major components were identified (place, relationship and experience) and used to define home as a place to which one is attached, feels comfortable and secure and has the experience of dwelling.Relevance to clinical practice.  Every day assumptions about the meaning of home and home as just another place where health care is provided are called into question. Increased awareness and dialogue is needed among health‐care providers working with older adults in their homes. Future research needs to explore the impact of home care on the older adult’s meaning of home and its potential impact on recovery.