bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delirium in older adults attending adult day care and family caregiver distress
Authors: Bull Margaret J. 
Published: December 2010

bull m.j. (2010) Delirium in older adults attending adult day care and family caregiver distress. International Journal of Older People Nursing6, 85–92 doi: 10.1111/j.1748‐3743.2010.00260.xBackground.  Delirium is a critical, costly, frequently reversible problem in older adults. Findings of previous studies indicate that delirium occurs in up to 65% of hospitalised older adults and up to 80% of terminally ill patients. Few studies address the frequency of delirium in community dwelling older adults and the extent to which delirium symptoms create distress for their family caregivers.Aims.  To determine the frequency of delirium in older people attending two adult day centers (ADC) in the United States and identify the extent to which delirium symptoms were associated with family caregivers’ mental health symptoms, and ways of coping with the older adults’ care.Method.  A descriptive, cross‐sectional design was used. Thirty older adults and their family caregivers were randomly selected from the rosters of the ADC.Results.  Only 6.7% of the older adults had a positive screen for delirium. The majority of family caregivers (96.6%) stated that they had no knowledge of delirium prior to participating in this study.Implications for practice.  Both older adults and their family caregivers need education about delirium symptoms and risks.
Use of moderate sedation for a patient with Down syndrome, intellectual disability, and Eisenmenger syndrome: a case report
Authors: Kunimatsu Teruhito , Greenan Setsue , Yamashita Anzu , Yamamoto Toshiharu , Ikeda Masakazu 
Published: December 2010

ABSTRACTFor patients who have Eisenmenger syndrome (ES), perioperative risks are high even for noncardiac surgery, such as dental extractions.We report on the case history of a 38‐year‐old male patient with Down syndrome (DS), intellectual disability (ID), and ES. The patient was scheduled for extraction of the right maxillary second molar tooth. His physical health was poor. Following oxygenation, midazolam was administered intravenously very slowly until the optimum sedative level was obtained, with a total dosage of 3.5 mg. There were no marked changes in vital signs during the perioperative period, and the patient was discharged the same day.This case suggests that moderate or conscious sedation using midazolam for dental treatment of a patient with DS, ID, and ES was well tolerated. Several critical points are presented in this review.
Salivary factors and dental plaque levels in relation to the general health of elderly residents in a long‐term care facility: a pilot study
Authors: Brukienė Vilma , Aleksejūnienė Jolanta , Gairionytė Agnė 
Published: December 2010

ABSTRACTThe goal of this study was to examine salivary factors and formation of dental plaque in elderly subjects who were institutionalized and to relate these factors to general health and medication use.This cross‐sectional study consisted of 50 elderly individuals who were institutionalized and 25 healthy young volunteers who served as a reference group. For each subject, salivary flow rates, salivary pH, and buffering capacity were assessed. Baseline Plaque Index and Plaque Formation Rate Index were used as a measure of oral hygiene. Information on each patient's general health and medication use was acquired from the institution.An evaluation of the results of this study suggests that salivary protective qualities and dental plaque levels in the elderly subjects who were institutionalized were worse than in healthy young individuals. An association between the general health of the elderly and salivary flow rate was found.
Treating patients with Autism Spectrum Disorder—SCDA members’ attitudes and behavior
Authors: Weil Taryn N. , Bagramian Robert A. , Inglehart Marita Rohr 
Published: December 2010

ABSTRACTThe goal of this study was to explore (a) the attitudes and behavior of members of the Special Care Dentistry Association (SCDA) who self‐identified as treating patients with Autism Spectrum Disorders (ASD) and (b) the relationship between their professional attitudes and behaviors concerning these patients.Data were collected from 75 SCDA members who responded to an anonymous web‐based survey on the SCDA website. The majority of respondents liked to treat children and adults with ASD (57%/56.9%). They treated approximately nine patients with ASD in an average week. The more they liked to treat children with ASD, the more patients with ASD they treated (r = .313; p = .018), and the more accommodations to overcome problems with communication, social interactions and aversion to change they made (r = .404; p < .001).Providers’ attitudes concerning patients with ASD were quite positive and correlated with professional behavior concerning these patients. Future research should explore whether improving attitudes towards providing care for special needs patients could increase professional behavior and thus contribute to reducing the access to care problems these patients face.
Dental utilization by adult Medicaid enrollees who have indicators of intellectual and developmental disabilities (IDD)
Authors: Chalmers Jane M. , Kuthy Raymond A. , Momany Elizabeth T. , Chi Donald L. , Bacon Robert A. , Lindgren Scott D. , Askelson Natoshia M. , Damiano Peter C. 
Published: December 2010

ABSTRACTThe purpose of this study was to determine dental utilization and type of dental services for Medicaid‐enrolled adults who had been identified as having intellectual and developmental disabilities (IDD). Using Iowa claims data, the authors identified adults who met any of five IDD criteria for inclusion during calendar year 2005. Service utilization rates, including use of preventive dental, routine restorative, and complex restorative services, were determined.Approximately 60% of adults with IDD had at least one dental visit in 2005. Among adults with at least one dental visit, 83% received a preventive service, 31% a routine restorative service, and 16% a complex dental service. Those age 65 and older had fewer preventive dental services than other age groups. In Iowa, dental utilization for adults 22–64 years of age with IDD was reasonably high (64%) in 2005, but individuals over age 65 had lower utilization (45%).
Bone subtraction CT angiography for the detection of intracranial aneurysms
Authors: Ramasundara S , Mitchell PJ , Dowling RJ 
Published: December 2010

AbstractIntroduction: The aim of the study was to retrospectively analyse the accuracy of CT angiography (CTA) of the Circle of Willis and a prototype bone subtraction CT angiogram (BSCTA) compared with digital subtraction angiography (DSA) in the detection of intracranial aneurysms.Methods: A total of 36 patients with suspected subarachnoid haemorrhage who had CTA scans that had matching DSA studies between November 2005 and December 2006 were retrospectively reviewed by two experienced neurointerventionalist. Three‐dimensional volume‐rendered (3D VR) CTA and BSCTA were reviewed, followed by review of the source data in multi‐planar reformats (MPRs). The results were then assessed for sensitivity and specificity compared with the gold standard DSA. Time taken to review the studies, visibility of the ophthalmic, posterior communicating arteries, superior cerebella artery, posterior cerebral artery on the 3D VR BSCTA and CTA were analysed. BSCTA was assessed for residual bone and artificial stenosis. Further, the aneurysms were analysed for suitability of endovascular treatment versus surgical treatment based on CTA and BSCTA with MPR and 3D VR.Results: CTA 3D VR sensitivity and specificity was 94 and 80%, respectively. CTA MPR sensitivity and specificity was 100% and 90%, respectively. When both CTA 3D VR and MPR images were combined the sensitivity and specificity was 100 and 90%, respectively. BSCTA 3D VR sensitivity and specificity was 91 and 90%, respectively, and the MPR sensitivity and specificity was 97 and 90%, respectively. When both BSCTA 3D VR and MPR images were combined the sensitivity was 97% with a specificity of 90% Overall, an 84% correlation was found between both CTA and BSCTA when compared with DSA for assessing for suitability of endovascular treatment versus surgical treatment. A statistically significant difference was shown between the time taken to review the CTA and BSCTA (P < 0.001 confidence interval 3.1–3.9 min).Conclusion: In this study there was no significant difference between the diagnostic ability of BSCTA compared with CTA. Importantly, both CTA and BSCTA had high sensitivities and specificities compared to DSA.
Clinical outcomes following endovascular treatment of the malfunctioning autologous dialysis fistula
Authors: Tapping CR , Mallinson PI , Scott PM , Robinson GJ , Lakshminarayan R , Ettles DF 
Published: December 2010

AbstractBackground: There is limited long‐term prospective data on the use of endovascular techniques and the use of thrombolysis in malfunctioning autologous haemodialysis fistulas.Purpose: Prospective assessment of clinical outcomes following angioplasty with or without low‐dose thrombolysis was undertaken in patients who presented with malfunctioning autologous haemodialysis fistulas.Methods: Consecutive patients referred to our department over a 6‐month period were included. Twenty‐five patients underwent percutaneous intervention by angioplasty alone (n = 14), angioplasty and stent (n = 2), thrombolysis alone (n = 2), angioplasty, thrombolysis and stent (n = 2) and angioplasty and thrombolysis (n = 5). Patients underwent clinical follow‐up and were reviewed at 6, 12, 18 and 24 months to determine fistula status. Thirty‐day mortality in the group was two patients. Statistical analysis was performed with Mann–Whitney, chi‐squared and Kruskal–Wallis tests. Kaplan–Meier curves were constructed to compare primary and secondary patency rates.Results: Technical success and initial clinical success rates were 88% and 76%, respectively. Primary and secondary clinical success rates at 6 months were 68% and 72%, at 12 months were 68% and 72%, at 18 months were 60% and 68% and at 24 months were 52% and 68%, respectively. There were no major complications following interventional procedures. There were four minor complications. After an initially successful procedure, five patients required subsequent intervention during the follow‐up period. The overall fistula event rate was very low (five per 600 patient months or 0.0996 per access year) with a fistula loss rate of 0.14 per access year.Conclusions: Our results confirm that excellent clinical results can be achieved by percutaneous endovascular treatment in malfunctioning autologous fistulas, justifying their continued use as first‐line management.
Clinician's guide to prostate IMRT plan assessment and optimisation
Authors: Martin JM , Frantzis J , Eade T , Chung P 
Published: December 2010

SummaryIntensity‐modulated radiotherapy (IMRT) offers dosimetric benefit for irregularly shaped treatment volumes compared to three‐dimensional conformal approaches. Some groups advocate IMRT as the standard of care for prostate radiotherapy. For clinicians, assessment of an IMRT plan can introduce new opportunities and challenges. Although a standard IMRT plan may be deemed acceptable by meeting pre‐set dose constraints, further optimisation may yield a superior treatment plan by further reducing dose to critical structures or improving target volume homogeneity. The aim of this article is to present aspects of IMRT planning relevant to clinicians to aid in plan critiquing.
Experimental Surgical Therapies for Huntington's Disease
Authors: Demeestere Jelle , Vandenberghe Wim 
Published: December 2010

SUMMARYHuntington's disease (HD) is an autosomal dominant neurodegenerative disorder characterized by abnormal movement, cognitive decline, and psychiatric disturbance. HD is caused by a trinucleotide repeat expansion in theHTTgene and a corresponding neurotoxic polyglutamine expansion in the huntingtin protein. There is currently no therapy to modify the progressive course of the disease, and symptomatic treatment options are limited. In this review we describe a diverse set of emerging experimental therapeutic strategies for HD: deep brain stimulation; delivery of neurotrophic factors; cell transplantation;HTTgene silencing using RNA interference or antisense oligonucleotides; and delivery of intrabodies. The common feature of these experimental therapies is that they all require a neurosurgical intervention, either for implantation of an electrode or for brain delivery of molecules, viruses or cells that do not cross the blood–brain barrier upon oral or intravenous administration. We summarize available data on the rationale, safety, efficacy, and intrinsic limitations of each of these approaches, focusing mainly on studies in HD patients and genetic animal models of HD. Although each of these strategies holds significant promise, their efficacy remains to be proven in HD patients.
The Upside of APP at Synapses
Authors: Hoe Hyang‐Sook , Lee Hey‐Kyoung , Pak Daniel T. S. 
Published: December 2010

SUMMARYThe memory dysfunctions that characterize Alzheimer's disease (AD) are strongly correlated with synapse loss. The amyloid precursor protein (APP) and its cleavage product Aβ play central roles in synapse and memory loss, and thus are strongly implicated in the pathogenesis of AD. Numerous in vitro and transgenic AD mouse model studies have shown that overexpression of APP leads to Aβ accumulation, which causes decreased synaptic activity and dendritic spine density. However, the normal synaptic function of APP itself is not fully understood. Several recent studies have found that full‐length APP promotes synaptic activity, synapse formation, and dendritic spine formation. These findings cast APP as a potential key player in learning and memory. It is of interest that the synaptic functions of full‐length APP are opposite to the effects associated with pathological Aβ accumulation. In this review, we will summarize the normal functions of APP at synapses and spines along with other known functions of APP, including its role in cell motility, neuronal migration, and neurite outgrowth. These studies shed light on the physiological actions of APP, independent of Aβ effects, and thus lead to a better understanding of the synaptic dysfunctions associated with AD.
Description of Study Population and Analysis of Factors Influencing Adherence in the Observational Italian Study “Evaluation of Pharmacotherapy Adherence in Bipolar Disorder” (EPHAR)
Authors: Barraco Alessandra , Rossi Andrea , Nicolò Giuseppe ,   for the EPHAR Study Group
Published: December 2010

SUMMARYBackground: In patients with bipolar disorder, medication is effective in preventing relapses. Unfortunately, adherence to treatment in bipolar disorder, as in other chronic or recurrent conditions, is not optimal. Estimates of nonadherence to prescribed treatment range from 30% to 60% in epidemiological studies, and are at around 30% in clinical trials. Adherence to treatment is a potent predictor of effectiveness, both in clinical trials and cohort studies, therefore is a very relevant area of investigation. This study will try to show a picture of the real life care where adherence is influenced by a wide range of variables. Methods: Prospective, observational, multicenter study in 650 adult patients with bipolar disorder, who had to initiate or change their treatment regimen, observed for 1 year. Adherence was measured by the Simplified Medication Adherence Questionnaire (SMAQ). Additional variables: Symptom severity, Montgomery‐Åsberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Clinical Global Impression–Bipolar Disorder (CGI‐BD), the Drug Attitude Inventory score (DAI‐30), and quality of life (EuroQoL 5 Dimensions). The variables were recorded every 3 months for the next year. Results: Most subjects were out‐patients (77.1%), female (58.8%), aged 31–50 years (50.1%) and overweight (41.8%) or obese (28.7%); 67.4% had type I bipolar disorder and 66.8% had depressive or mixed symptoms. Adherence was 39.9% at baseline (and increased up to 67.0% at completion. The main predictors of nonadherence were alcohol consumption, severe bipolar symptoms, young age at time of first treatment, negative attitude towards treatment. Conclusions: The patient population of this observational trial was representative of the patients changing their therapy for bipolar disorder seen in clinical practice in Italy. Lack of adherence to pharmacotherapy for bipolar disorder is a serious issue, which is more likely to arise in alcohol users and patients with severe symptoms, negative attitude towards medication and/or initiation of treatment early in life. The findings could lead to a more adequate approach of adherence in patients with bipolar disorders.
Comparison of Countercurrent Flow Limitation Experiments Performed in Two Different Models of the Hot Leg of a Pressurized Water Reactor With Rectangular Cross Section
Authors: Vallée Christophe , Seidel Tobias , Lucas Dirk , Tomiyama Akio , Murase Michio 
Published: December 2010

Abstract
In order to investigate the two-phase flow behavior during countercurrent flow limitation in the hot leg of a pressurized water reactor, two test models were built: one at the Kobe University and the other at the TOPFLOW test facility of Forschungszentrum Dresden-Rossendorf (FZD). Both test facilities are devoted to optical measurement techniques; therefore, a flat hot leg test section design was chosen. Countercurrent flow limitation (CCFL) experiments were performed, simulating the reflux condenser cooling mode appearing in some accident scenarios. The fluids used were air and water, both at room temperature. The pressure conditions were varied from atmospheric at Kobe to 3.0 bars absolute at TOPFLOW. According to the presented review of literature, very few data are available on flooding in channels with a rectangular cross section, and no experiments were performed in the past in such flat models of a hot leg. Commonly, the macroscopic effects of CCFL are represented in a flooding diagram, where the gas flow rate is plotted versus the discharge water flow rate, using the nondimensional superficial velocity (also known as Wallis parameter) as coordinates. However, the classical definition of the Wallis parameter contains the pipe diameter as characteristic length. In order to be able to perform comparisons with pipe experiments and to extrapolate to the power plant scale, the appropriate characteristic length should be determined. A detailed comparison of the test facilities operated at the Kobe University and at FZD is presented. With respect to the CCFL behavior, it is shown that the essential parts of the two hot leg test sections are very similar. This geometrical analogy allows us to perform meaningful comparisons. However, clear differences in the dimensions of the cross section (H×W=150×10 mm2 in Kobe, 250×50 mm2 at FZD) make it possible to point out the right characteristic length for hot leg models with rectangular cross sections. The hydraulic diameter, the channel height, and the Laplace critical wavelength (leading to the Kutateladze number) were tested. A comparison of our own results with similar experimental data and empirical correlations for pipes available in literature shows that the channel height is the characteristic length to be used in the Wallis parameter for channels with rectangular cross sections. However, some limitations were noticed for narrow channels, where CCFL is reached at lower gas fluxes, as already observed in small scale hot legs with pipe cross sections.
Investigations and Countermeasures for Deactivation of Hydrogen Recombination Catalyst at Hamaoka Units 4 and 5
Authors: Kawasaki Toru , Aizawa Motohiro , Iizuka Hidehiro , Yamada Koji , Kujimoto Mitsuo 
Published: December 2010

Abstract
The hydrogen concentration in the outlets of off-gas recombiners increased at Hamaoka Units 4 and 5, and their reactors could not continue the startup operations. Therefore, we investigated why the recombination reactions were deactivated and we selected appropriate countermeasures for both plants. Two types of deactivation mechanisms were found from our investigations. The first cause was the decrease in the active surface area of alumina as support material due to dehydrative condensation. The other cause was the catalyst being poisoned by organic silicon compounds. Organic silicon was introduced from the organosilicon sealant used at the junctions of low-pressure turbines. We also found that a boehmite rich catalyst was deactivated more easily by organic silicon than gamma alumina because boehmite had numerous hydroxyl groups. Finally, we estimated that the deactivation of hydrogen recombination catalysts was caused by two combined factors; these were the characteristics of boehmite as the ingredient of catalysts support and the organic silicon poisoning the catalyst surface. As countermeasures, the boehmite was changed into more stable gamma alumina by adding heat treatment in a hydrogen atmosphere at 500°C for 1 h, and the source of organic silicon, organosilicon sealant, was removed. The improved catalysts were applied at Hamaoka Units 4 and 5. Moreover, the linseed oil that used to be used at the plants was applied again as sealant in the low-pressure turbine casing instead of organosilicon sealant. As a result of the application of these countermeasures, the reactors could be started without increasing the hydrogen concentration at these plants.
The Hidden Role of Women in Monitoring Nineteenth-Century African Weather: Instrumental Observations in Equatorial Guinea
Authors: Gallego M. Cruz , Domínguez-Castro Fernando , Vaquero José M. , García-Herrera Ricardo 
Published: December 2010

Abstract
Some of the first systematic meteorological observations in Africa were made by two women in Equatorial Guinea in 1875. Sisters Isabel and Juliana Urquiola, together with Manuel Iradier, Isabel's husband, built a meteorological observatory on Little Elobey Island (0°59′46″N, 9°32′14″E), off the tiny nation's western coast. From 1 June to 31 December 1875, the sisters took subdaily readings (6, 12, 15, and 18 h past midnight local time) of humidity, temperature, precipitation, and wind direction and speed. To evaluate the quality of these historical observations, the authors have compared them with equivalent modern meteorological data from Cocobeach (the modern meteorological station nearest to Little Elobey). The monthly-mean distributions of maximum and minimum temperature are similar to those of Cocobeach, but minimum temperatures are 2.4°C higher than Cocobeach values. Despite this difference, the observations of the Urquiola sisters were found to be far better and more consistent than other observations of the time. Sadly, the duo never enjoyed an appropriate acknowledgment of their detailed weather measurements, some taken eight times per day, which were some of the first measurements in Equatorial Guinea. Their unappreciated task unfortunately also had a high cost on their health for the rest of their lives, made all the worse for Isabel Urquiola with the loss of a baby.