bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive, psychosocial, somatic and treatment factors predicting return to work after breast cancer treatment
Authors: Hedayati Elham , Johnsson Aina , Alinaghizadeh Hassan , Schedin Anna , Nyman Håkan , Albertsson Maria 
Published: August 2012

Scand J Caring Sci; 2013; 27; 380–387

Cognitive, psychosocial, somatic and treatment factors predicting return to work after breast cancer treatment
Background:  Breast cancer (BC) may affect the ability to work. In this study, we want to identify any associations between cognitive, psychosocial, somatic and treatment factors with time to return to work (RTW) among women treated for BC.Methods and participants:  At eight (baseline) and 11(follow‐up) months after BC diagnosis, women who had received adjuvant treatment for early BC at Stockholm South General Hospital completed the Headminder neuropsychological tests to obtain the Cognitive Stability Index (CSI), the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire and its Breast Cancer Module. At both time points, we compared the scores from women who had returned to work with those who had not. We also reviewed the medical certificates of women still on sick leave at 8, 11 and 18 months after diagnosis to determine why they had not returned to work.Results:  At baseline, 29 of 45 enroled women were working and 15 were not (one dropped out after baseline testing). The 14 women still not working 11 months after BC diagnosis had more advanced BC (OR = 3.64, 95% CI 2.01–7.31), lymph‐node involvement (OR = 18.80, 95% CI 5.32–90.69) and Her 2‐positive tumours (OR = 10.42,95% CI 2.19–65.32) than did working women. None of the scores for the four cognitive domains changed significantly at follow‐up in either group. Comments on the medical certificates generally supported these findings. Independently of any adjuvant cancer therapy, overall quality of life improved and most women did RTW 18 months after BC diagnosis.Conclusions:  Chemotherapy is associated with longer periods of sick leave. Cognitive functions do not predict RTW. Independently of any adjuvant therapy, most women eventually RTW in a few months. The ability to predict RTW after BC treatment should help prepare higher‐risk patients for delayed RTW and allow earlier interventions to restore their social relations and quality of life.
Differential short‐ and long‐term effects of an invertebrate predator on zooplankton communities in invaded and native lakes
Authors: Kelly Noreen E. , Yan Norman D. , Walseng Bjørn , Hessen Dag O. 
Published: August 2012

AbstractAimForecasting the effects of invasive species remains difficult, because short‐term effects may be transitory and theories of long‐term effects are poorly developed and rarely tested. Here, we compare zooplankton communities from freshwater lakes in Norway and Canada that differ in their duration of exposure to the invertebrate predator Bythotrephes longimanus, to aid in predicting its potential long‐term impacts on Canadian zooplankton communities.LocationFreshwater lakes in Canada and Norway.MethodsWe compared differences in zooplankton community structure, richness and occurrence between lakes with and without Bythotrephes in Canada and Norway using univariate and multivariate analyses of the incidence of crustacean zooplankton species.ResultsCorrespondence analysis confirmed that zooplankton community composition differed dramatically in lakes with and without Bythotrephes in Canada but not in Norway. The short‐term exposure of Canadian lakes to Bythotrephes led to lower zooplankton diversity, particularly for cladoceran species, whereas in Norway, a greater diversity of zooplankton, particularly for copepod species, occurred in lakes where Bythotrephes has been present for long periods. Significantly more species in Norway demonstrated an increase in their frequency of occurrence, while significantly more species in Canada demonstrated a decrease, in lakes containing Bythotrephes.Main conclusionsBythotrephes can modify zooplankton community structure, diversity, and spatial occurrence across a watershed in a short period (i.e. a few decades) after invasion; however, some species appear to adapt to the presence of Bythotrephes over time. We hypothesize the long‐term effects of higher diversity in Norwegian lakes is attributed to altered interspecific community interactions, coupled with behavioural adaptations to avoid Bythotrephes predation, enabling the remaining species to increase their populations in space and time. If Canadian communities adapt similarly, the long‐term effects of Bythotrephes invasion in Canada may thus be less severe than those observed in the first few decades of the invasion.
Teaching Hospital Financial Status and Patient Outcomes Following ACGME Duty Hour Reform
Authors: Navathe Amol S. , Silber Jeffrey H. , Small Dylan S. , Rosen Amy K. , Romano Patrick S. , Even‐Shoshan Orit , Wang Yanli , Zhu Jingsan , Halenar Michael J. , Volpp Kevin G. 
Published: August 2012

ObjectiveTo examine whether hospital financial health was associated with differential changes in outcomes after implementation of 2003 ACGME duty hour regulations.Data Sources/Study SettingObservational study of 3,614,174 Medicare patients admitted to 869 teaching hospitals from July 1, 2000 to June 30, 2005.Study DesignInterrupted time series analysis using logistic regression to adjust for patient comorbidities, secular trends, and hospital site. Outcomes included 30‐day mortality, AHRQ Patient Safety Indicators (PSIs), failure‐to‐rescue (FTR) rates, and prolonged length of stay (PLOS).Principal FindingsAll eight analyses measuring the impact of duty hour reform on mortality by hospital financial health quartile, in postreform year 1 (“Post 1”) or year 2 (“Post 2”) versus the prereform period, were insignificant: Post 1 OR range 1.00–1.02 and Post 2 OR range 0.99–1.02. For PSIs, all six tests showed clinically insignificant effect sizes. The FTR rate analysis demonstrated nonsignificance in both postreform years (OR 1.00 for both). The PLOS outcomes varied significantly only for the combined surgical sample in Post 2, but this effect was very small, OR 1.03 (95% CI 1.02, 1.04).ConclusionsThe impact of 2003 ACGME duty hour reform on patient outcomes did not differ by hospital financial health. This finding is somewhat reassuring, given additional financial pressure on teaching hospitals from 2011 duty hour regulations.
Effects of kinin B1 and B2 receptor antagonists on overactive urinary bladder syndrome induced by spinal cord injury in rats
Authors: Forner Stefânia , Andrade Edinéia L , Martini Alessandra C , Bento Allisson F , Medeiros Rodrigo , Koepp Janice , Calixto João B 
Published: August 2012

Background and PurposeKinin B1 and B2 receptors have been implicated in physiological and pathological conditions of the urinary bladder. However, their role in overactive urinary bladder (OAB) syndrome following spinal cord injury (SCI) remains elusive.Experimental ApproachWe investigated the role of kinin B1 and B2 receptors in OAB after SCI in rats.Key ResultsSCI was associated with a marked inflammatory response and functional changes in the urinary bladder. SCI resulted in an up‐regulation of B1 receptor mRNA in the urinary bladder, dorsal root ganglion and spinal cord, as well as in B1 protein in the urinary bladder and B1 and B2 receptor protein in spinal cord. Interestingly, both B1 and B2 protein expression were similarly distributed in detrusor muscle and urothelium of animals with SCI. In vitro stimulation of urinary bladder with the selective B1 or B2 agonist elicited a higher concentration‐response curve in the SCI urinary bladder than in naive or sham urinary bladders. Cystometry revealed that treatment of SCI animals with the B2 selective antagonist icatibant reduced the amplitude and number of non‐voiding contractions (NVCs). The B1 antagonist des‐Arg9‐[Leu8]‐bradykinin reduced the number of NVCs while the non‐peptide B1 antagonist SSR240612 reduced the number of NVCs, the urinary bladder capacity and increased the voiding efficiency and voided volume.Conclusions and ImplicationsTaken together, these data show the important roles of B1 and B2 receptors in OAB following SCI in rats and suggest that blockade of these receptors could be a potential therapeutic target for controlling OAB.
Risk of Mortality and Nursing Home Institutionalization After Injury
Authors: Porell Frank W. , Carter Mary W. 
Published: August 2012

ObjectivesTo evaluate the effects of unintentional injuries on the risks of nursing home institutionalization and mortality in older adults.DesignA retrospective analysis of data from the Medicare Current Beneficiary Survey, a nationally representative survey of Medicare beneficiaries.SettingNoninstitutionalized community residents.ParticipantsOlder adult panel members (N = 12,031) with continuous Medicare eligibility not enrolled in managed care in a cohort starting between 1998 and 2001.MeasurementsCox regression and competing risk survival models were estimated using time‐varying injury‐status dummy variables and control variables for outcomes measured as time until death and institutionalization, respectively.ResultsAlmost 4% of persons were institutionalized, 15% died, 14% had a sentinel injury, and 3% had two or more minor nonsentinel injuries within 1‐year period. Persons hospitalized for sentinel injury had elevated institutionalization and mortality risks during an injury episode and after the episode ended. Persons receiving outpatient treatment for sentinel injuries had elevated institutionalization risk during injury episodes (subhazard ratio [SHR] = 6.78, 95% confidence interval [CI] = 3.72–12.37) and elevated mortality risk after episodes (hazard ratio [HR] = 1.60, 95% CI = 1.28–2.00). Persons with multiple minor nonsentinel injuries within a year also had elevated mortality (HR = 1.56, 95% CI = 1.15–2.11) and institutionalization (SHR = 3.55, 95% CI = 2.25–5.67) risks.ConclusionMortality and institutionalization risks extend well beyond the acute episode of treatment for sentinel and repeated minor injuries. More research is needed on longer‐term health outcomes of injury survivors to inform development of evidence‐based quality‐of‐care indicators.
The Elder‐Friendly Emergency Department Assessment Tool: Development of a Quality Assessment Tool for Emergency Department–Based Geriatric Care
Authors: McCusker Jane , Verdon Josée , Vadeboncoeur Alain , Lévesque Jean‐Frédéric , Sinha Samir K. , Kim Katherine Y. , Belzile Eric 
Published: August 2012

ObjectivesTo develop and conduct a preliminary validation of selected subscales of an elder‐friendly emergency department (ED) assessment tool.DesignContent validation of tool by an international panel. Construct validation using care ratings of ED lead physicians and nurses.SettingQuebec, Canada.ParticipantsThe international panel comprised 34 clinicians, administrators, and researchers. The construct validation was based on a 2006 survey of ED lead physicians and nurses at all 103 EDs in the province, of whom 68 (66%) supplied complete data.MeasurementsThe initial tool included five subscales: ED staffing, screening and assessment, discharge planning, community services, and care philosophy. Differences in subscale scores were examined according to ED size, and of these scores were correlated with care ratings made by lead physicians and nurses.ResultsThe average scores for three subscales (ED staffing, discharge planning, and community services) varied according to ED size. After adjustment for ED size, three subscales (screening and assessment, discharge planning, and community services) were correlated with ED nurse or physician care ratings. A preliminary tool, taking into account all factors, is proposed.ConclusionThis study provides preliminary evidence of the validity of three subscales of the proposed elder‐friendly ED assessment tool. Results suggest that ED size should be considered in interpreting these subscales. Further evaluation and validation of the proposed tool will be needed to further its utility in helping to focus the quality improvement efforts of clinicians, managers, and administrators related to the care they provide older adults.
Risk of Fatal Injury in Older Adult Drivers, Passengers, and Pedestrians
Authors: Rolison Jonathan J. , Hewson Paul J. , Hellier Elizabeth , Husband Poppy 
Published: August 2012

ObjectivesTo compare risk of fatal injury in elderly road users (drivers, passengers, pedestrians) with that of younger age groups and to assess the contribution of elderly road users to the number of reported fatalities in the population.DesignFatality age was categorized as 21 to 29, 30 to 39, 40 to 49, 50 to 59, 60 to 69, or 70 and older, and road user was categorized as driver, passenger, or pedestrian. Estimated number of trips made by each age group was used to adjust for exposure and to measure individual risk.SettingFatalities recorded in Britain between 1989 and 2009.ParticipantsPopulation‐wide fatal injury counts in Britain.MeasurementsAge of fatally injured drivers, passengers, and pedestrians. Estimated number of trips made per year by drivers, passengers, and pedestrians.ResultsRisk of fatal injury, but not fatality numbers in the population, were higher for older adult (≥70) drivers than for younger age groups. Risk of fatal injury was also high for older adult passengers and pedestrians, who represented the majority of older adult fatalities.ConclusionPrevious emphasis on driver impairment in older age has unduly focussed attention on elderly drivers, who represent a minority of all driver fatalities. Older adults represent a much larger proportion of passenger and pedestrian fatalities. Additional policy schemes and initiatives should be targeted at safeguarding older adult passengers and making the road environment safer for elderly pedestrians.
The Development of Academic Geriatric Medicine in the United States 2005 to 2010: An Essential Resource for Improving the Medical Care of Older Adults
Authors: Bragg Elizabeth J. , Warshaw Gregg A. , Meganathan Karthikeyan , Brewer David E. 
Published: August 2012

Academic geriatric medicine programs are critical for training the physician workforce to care effectively for aging Americans. This article updates the progress made by U.S. medical schools from 2005 to 2010 in developing these programs. Academic leaders in geriatrics in accredited allopathic and osteopathic medical schools were surveyed in the winter of 2010 (60% response rate), and results were compared with findings from a similar 2005 survey (68% response rate). Physician faculty in geriatrics increased from 9.6 (mean) full‐time equivalents (FTEs) in 2005 to 11.2 by 2010. In 2010, faculty and staff effort was mostly devoted to clinical practice (mean = 37%) and education (mean = 33%), with only seven responding schools devoting more than 40% of faculty effort to research. Schools that have been designated as Centers of Excellence had a median 20 FTE physician faculty, compared with seven at the other schools (P < .001). In 2010, 27% of medical schools required a geriatrics clerkship, and 87% (n = 83) had an elective geriatric clerkship. In summary, more fellows and faculty were recruited and trained in 2010 than in 2005, and some academic programs have emerged with strong education, research, and clinical initiatives. Medical student exposure to geriatrics curriculum has increased, but few academic geriatricians are pursuing research careers, and the number of practicing geriatricians is declining. New approaches to training the entire physician workforce to care for older adults will be required to ensure adequate medical care for aging Americans.
A Clinical Action Measure to Assess Glycemic Management in the 65–74 Year Old Veteran Population
Authors: Soroka Orysya , Tseng Chin‐Ling , Rajan Mangala , Maney Miriam , Pogach Leonard 
Published: August 2012

ObjectivesTo evaluate the effect of including of clinical actions within 6 months of a glycosylated hemoglobin (HbA1c) level greater than 8% upon measure adherence (pass rates) and to assess the association between patient factors and the likelihood of not passing.SettingVeterans Health Administration.DesignRetrospective cohort study for FY2002 to FY2004.ParticipantsOne hundred fifty‐three thousand one hundred thirty‐two veterans aged 65–74 with diabetes mellitus not taking insulin; 99% were male and 86% white.MeasurementsThe clinical action measure included three categories: (a) initial pass (index HbA1c < 8%); (b) modified pass (index HbA1c ≥ 8%), and the hierarchical occurrence of one of the following events within 6 months after date of index HbA1c: subsequent HbA1c < 8%, being started on insulin (100% weight), new oral medication (50% weight), care in a diabetes mellitus–related clinic (25% weight); and (c) failure (no category met or HbA1c > 9%). Multinomial logistic regression models were used to evaluate associations between participant factors and the likelihood of not passing initially.ResultsMost (82.6%) or the participants had an index HbA1c of less than 8%, and 10.6% were in the modified pass group. The failure rate (17.4%) fell to 6.8% when actions were weighted equally and to 9.4% using different weights. Veterans who are African American (odds ratios (ORs) = 1.43 and 1.44), unmarried (ORs = 1.19 and 1.24), poor (ORs = 1.36 and 1.17), or taking two or more oral antihyperglycemic agents (ORs = 2.61 and 3.72) were significantly more likely to be in the modified pass and failure groups, respectively.ConclusionMost veterans with an initial HbA1c of 8% or greater had clinical actions within 6 months. A measure that incorporates multiple treatment options, including education and nutrition, could be of benefit by encouraging dialogue of such options between patients and clinicians.
A Pilot Randomized Controlled Trial of a Decision Support Tool to Improve the Quality of Communication and Decision‐Making in Individuals with Atrial Fibrillation
Authors: Fraenkel Liana , Street Richard L. , Towle Virginia , O'Leary John R. , Iannone Lynne , Van Ness Peter H. , Fried Terri R. 
Published: August 2012

ObjectivesTo design a tool for nonvalvular atrial fibrillation (NVAF) to inform individuals of their individual stroke and bleeding risks, assist in clarifying priorities, and promote communication.DesignClustered randomized controlled trial.SettingPrimary care clinics.ParticipantsIndividuals with NVAF (N = 135).InterventionCompletion of tool before regularly scheduled visit.MeasurementsPrimary outcomes included the 100‐point informed and values clarity subscales of the decisional conflict scale (lower scores indicate individual is more informed and has greater clarity). Secondary outcomes included knowledge, patient–clinician communication, and change in treatment.ResultsSixty‐nine individuals were enrolled in the intervention group and 66 in the control group. After their visit, intervention participants had lower scores on the informed (mean difference = −11.9, 95% confidence interval (CI) = −21.1 to −2.7) and values clarity subscales (mean difference = −14.6, 95% CI = −22.6 to −6.6). Greater proportions of intervention participants knew medications for reducing stroke risk (61% vs 31%, P < .001) and side effects (49% vs 37%, P = .07). Stroke (71% vs 12%) and bleeding risk (69% vs 20%) were discussed more frequently in the intervention than control group (P < .001). Five intervention participants expressed a preference for medication that was not concordant with their current treatment plan. There was no change in treatment plan in either group.ConclusionThe tool was effective in improving perceived and actual knowledge and values clarity and in increasing physician–patient communication but did not change treatment.
Development of Vascular Risk Factors over 15 Years in Relation to Cognition: The Hoorn Study
Authors: Reijmer Yael D. , van den Berg Esther , Dekker Jacqueline M. , Nijpels Giel , Stehouwer Coen D. A. , Kappelle L. Jaap , Biessels Geert Jan 
Published: August 2012

ObjectivesTo investigate the development of vascular risk factor levels at four points over 15 years in relation to late‐life cognitive functioning.DesignLongitudinal population‐based study.SettingThe Hoorn Study, a community‐based cohort study of glucose metabolism and cardiovascular risk.ParticipantsThree hundred eighty individuals without dementia (mean baseline age 57.7 ± 5.5).MeasurementsFour extensive medical examinations were conducted over 15 years. Cognition was assessed in detail at the fourth examination. The time course of vascular risk factors across the examinations was compared between individuals in the highest tertile (good performance) and those in the lowest tertile (poor performance) of cognitive functioning on three cognitive domains (memory, information processing speed, and attention and executive functioning (A&EF)).ResultsIndividuals with poor information processing speed had higher levels of systolic blood pressure at baseline (mean difference (standard error) 11.6 (2.6) mmHg, P < .001) than those with good information processing speed. Individuals with poor A&EF had a higher waist:hip ratio (3.03 (1.15), P = .009), glycosylated hemoglobin (0.29% (0.10%), P = .005) and total cholesterol:high‐density lipoprotein cholesterol ratio (0.38 (0.19), P = .04) at baseline than individuals with good A&EF, although the differences in vascular risk factor levels between the poor and good cognition group diminished with increasing age.ConclusionHigh blood pressure, adiposity, hypercholesterolemia, and hyperglycemia at midlife are associated with late‐life cognitive dysfunction, but for most risk factors, this relationship gradually attenuates with increasing age. These results suggest that timing of vascular treatment strategies to prevent cognitive impairment is critical.
Transcutaneous Application of Pulsed Radiofrequency Treatment for Shoulder Pain
Authors: Taverner Murray G. , Loughnan Terence E. , Soon Chien‐Wuen I. 
Published: August 2012

AbstractWe report a retrospective audit of transcutaneous pulsed radiofrequency treatment therapy (TCPRFT) for shoulder pain over a 4‐year period.Methods:  Electronic and manual case review revealed that TCPRFT had been performed on 13 patients, with 15 painful shoulders, using a single treatment session between 2006 and 2010 in an outpatient setting.Results:  Of the 15 shoulders treated, 10 (two‐thirds) had pain relief for over 3 months with an average pain score reduction of 6.1 of 10 and an average duration of pain relief of 395 days. Two experienced pain relief of < 3 months with an average reduction in pain score of 4.3 of 10 and an average duration of effect of 11 days. Three cases experienced no pain relief from the treatment.Summary:  These results suggest TCPRFT may provide clinically useful pain relief and be another treatment modality for shoulder pain. Our findings justifies further research, and we are proceeding with a double‐blind placebo randomized controlled studies to determine the efficacy of TCPRFT in chronic shoulder pain.