bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Computerized Adaptive Test for Patients With Shoulder Impairments Produced Responsive Measures of Function
Authors: Hart Dennis L. , Wang Ying-Chih , Cook Karon F. , Mioduski Jerome E. 
Published: April 2010

BackgroundComputerized adaptive tests (CATs) promise efficient outcomes data collection with little loss of measurement precision. The shoulder CAT has not been assessed for administrative efficiency, nor have prospective studies been completed to evaluate the sensitivity to change or the responsiveness of CAT-based functional status (CAT-FS) measures.ObjectiveThe purpose of this study was to evaluate the efficiency and responsiveness of the shoulder CAT.DesignThis was a secondary analysis of prospectively collected data.MethodsData were analyzed from patients with shoulder impairments who received outpatient rehabilitation in 518 clinics in 30 US states. Over the testing time, 30,987 patients completed the shoulder CAT at intake, and of these, 13,805 completed the CAT at discharge (45% completion rate). The efficiency of routine CAT administration was evaluated, and the sensitivity to change and responsiveness of CAT-FS measures were assessed.ResultsOn average, patients took about 1.5 minutes (SD &lt;2 minutes) to answer 6 CAT items (SD=2), which produced precise estimates of CAT-FS measures that adequately covered the content range and had negligible floor and minimal ceiling effects. Ninety-four percent of the patients had CAT-FS scores between 20 and 80, where upper-level 95% confidence interval (CI) standard errors were between 3.2 and 4.6 (out of 100). Of patients with both intake and discharge data, 79% had CAT-FS change scores greater than minimal detectable change, and 76% had changes greater than minimal clinically important improvement.LimitationsBecause this study was a secondary analysis, the results may have been affected by patient selection bias. Future studies would benefit from more complete data.ConclusionsThe results indicate the shoulder CAT was efficient and support the precision, sensitivity, and responsiveness of CAT-FS measures.
Detectable Changes in Physical Performance Measures in Elderly African Americans
Authors: Mangione Kathleen Kline , Craik Rebecca L. , McCormick Alyson A. , Blevins Heather L. , White Meaghan B. , Sullivan-Marx Eileen M. , Tomlinson James D. 
Published: April 2010

Background
African American older adults have higher rates of self-reported disability and lower physical performance scores compared with white older adults. Measures of physical performance are used to predict future morbidity and to determine the effect of exercise. Characteristics of performance measures are not known for African American older adults.

Objective
The purpose of this study was to estimate the standard error of measurement (SEM) and minimal detectable change (MDC) for the Short Physical Performance Battery (SPPB), Timed “Up & Go” Test (TUG) time, free gait speed, fast gait speed, and Six-Minute Walk Test (6MWT) distance in frail African American adults.

Design
This observational measurement study used a test-retest design.

Methods
Individuals were tested 2 times over a 1-week period. Demographic data collected included height, weight, number of medications, assistive device use, and Mini-Mental Status Examination (MMSE) scores. Participants then completed the 5 physical performance tests.

Results
Fifty-two participants (mean age=78 years) completed the study. The average MMSE score was 25 points, and the average body mass index was 29.4 kg/m2. On average, participants took 7 medications, and the majority used assistive devices. Intraclass correlation coefficients (ICC [2,1]) were greater than .90, except for the SPPB score (ICC=.81). The SEMs were 1.2 points for the SPPB, 1.7 seconds for the TUG, 0.08 m/s for free gait speed, 0.09 m/s for fast gait speed, and 28 m for 6MWT distance. The MDC values were 2.9 points for the SPPB, 4 seconds for the TUG, 0.19 m/s for free gait speed, 0.21 m/s for fast gait speed, and 65 m for 6MWT distance.

Limitations
The entire sample was from an urban area.

Conclusions
The SEMs were similar to previously reported values and can be used when working with African American and white older adults. Estimates of MDC were calculated to assist in clinical interpretation.
Postpartum sexual function of women and the effects of early pelvic floor muscle exercises
Authors: CITAK NEVIN , CAM CETIN , ARSLAN HEDIYE , KARATEKE ATES , TUG NIYAZI , AYAZ REYHAN , CELIK CEM 
Published: April 2010

AbstractObjective. To evaluate the effects of early pelvic floor muscle training after vaginal delivery on sexual function. Design. Prospective randomized study. Settings. Urogynecology clinic of a tertiary medical center in Istanbul, Turkey. Population. Total of 75 primiparous women. Methods. Pelvic floor‐muscle strength was assessed during rest and straining in primiparous women in their 4th postpartum month, after which the women were randomized into training (n = 37) and control (n = 38) groups. Patients were re‐evaluated in the 7th postpartum month. Main outcome measures. Female sexual function and pelvic muscle strength scores. Results. Desire, pain and total female sexual index scores were significantly higher in the 7th month compared to 4th month in both groups (p < 0.05). However, sexual arousal, lubrication, orgasm, and satisfaction scores were improved in the 7th month in the training group (paired t‐test, p < 0.001), but not significantly in the control group (p > 0.05). All domains except satisfaction were significantly higher in the training group compared with the controls. Pelvic floor‐muscle strength was found to be increased in the 7th month in the training group (Wilcoxon rank test, Z = 4.123, p < 0.001), whereas there was no significant difference between the 4th and 7th month measurements in the controls (p > 0.05). Conclusion. Pelvic floor‐muscle training improves pelvic floor‐muscle function, and starting after the puerperal period, exercise appears to have positive effects on female sexual function.
Does allocation of low risk parturient women to a separate maternity unit decrease the risk of emergency cesarean section?
Authors: NESHEIM BRITT‐INGJERD , ESKILD ANNE , GJESSING LEIF 
Published: April 2010

AbstractObjective. To study whether the selection of low risk parturient women into a separate maternity unit leads to a lower risk of emergency cesarean section, compared to giving birth in a unit with mixed cases. Design. Hospital based registry study. Setting. Maternity units in two university hospitals in Oslo, Norway. Population. All low risk parturient women with attempted vaginal deliveries in the years 2001–2003, a total number of 11,686 deliveries. Methods. Data were obtained from standardized patient records and risks of cesarean section were estimated as odds ratios. Main outcome measures. Emergency cesarean section risk. Results. Compared with women giving birth in a unit with mixed cases, women giving birth in a maternity unit with low risk cases only had a higher risk of emergency cesarean section (OR 1.4; 95% CI 1.2–1.6). Conclusions. Giving birth in a low risk maternity unit is associated with a higher risk of cesarean section for low risk parturient women compared with giving birth in a maternity unit with mixed cases.
Obstetric fistula in 14,928 Ethiopian women
Authors: MULETA MULU , RASMUSSEN SVEIN , KISERUD TORVID 
Published: April 2010

AbstractObjectives. Obstetric fistulas are severe sequelae of prolonged obstructed labor, a widespread but incompletely documented problem of low‐income countries. Here, we characterize women with obstetric fistula, test the hypothesis that primi‐ and multipara represent different profiles and that fetal size is an important factor in developing fistula. Design. Hospital registry statistics and questionnaire. Population. A total of 14,928 Ethiopian women with obstetric fistula in 1974–2006 and 434 admitted in 2007–8. Methods. Self‐reported age, marital status, education, distance from home to health facility, parity, duration of labor, neonatal outcome and sex, lag time to treatment; measurement of weight, stature, extent of lesion and clinical assessment of continence before hospital discharge. Outcome measures. Duration of labor, extent of pelvic injury and neonatal survival, cure rate. Results. Primi‐ were more common than multiparous cases (56.8 vs. 43.2%). They were of similar age at marriage (17 years) and stature at hospital admission, but shorter than the population average (152.7 vs. 156.5 cm). Primipara had longer labor than multipara (50.5% > 3 days vs. 27%), larger uro‐vaginal fistula, more stillbirths (95 vs. 88%), recto‐vaginal fistula, vaginal scarring, persistent incontinence after repair and were more commonly divorced. Male fetuses were involved in 76.7% of obstructed deliveries but in only 44.6% of a previous uneventful delivery in multipara. Educational attainment positively influenced outcomes. Conclusions. Obstetric fistula is more commonly associated with primiparous than subsequent pregnancies. Primipara have a longer and more damaging labor. A causative role for cephalo‐pelvic disproportion is supported by the observation that male fetuses are more commonly involved in obstructed labor.
Pelvic artery embolization in the management of obstetric hemorrhage
Authors: SIDHU HARPREET KAUR , PRASAD GRV , JAIN VANITA , KALRA JASWINDER , GUPTA VIVEK , KHANDELWAL NIRANJAN 
Published: April 2010

AbstractWe studied the role of pelvic artery embolization in management of obstetric hemorrhage by retrospective analysis of 50 cases of obstetric hemorrhage in a tertiary care referral hospital where this procedure was used. Uterine and or internal iliac artery embolization was performed for the management of postpartum hemorrhage (39 cases; 78%), post abortal bleeding (6 cases; 12%) and gestational trophoblastic disease (4 cases; 8%). In one case of postpartum hemorrhage procedure could not be performed due to arterial spasm (2%). Prophylactic embolization was carried out in one case of placenta accreta. The mean age of the women was 27 years and 54% were primiparas. In six women embolization was done after hysterectomy failed to control pelvic hemorrhage. One fourth of women had coagulopathy at the time of presentation. There were five cases of pelvic hematoma and three cases of arteriovenous malformations. The success rate of the procedure was 94% and the procedure was unsuccessful for controlling bleeding in three women. There were no major procedure related complications. Thus, pelvic artery embolization is an effective alternative to surgery in controlling obstetric hemorrhage and as a fertility and life‐saving procedure.
Suicide by Occupation: Does Access to Means Increase the Risk?
Authors: Skegg Keren , Firth Hilda , Gray Andrew , Cox Brian 
Published: April 2010

Objective: To examine suicide by identified occupational groups in New Zealand over a period of 30 years, focusing on groups predicted to have high suicide rates because of access to and familiarity with particular methods of suicide. Method: Suicide data (including open verdicts) for the period 1973–2004 were examined, excluding 1996 and 1997 for which occupational data were not available. Occupational groups of interest were dentists, doctors, farmers (including farm workers), hunters and cullers, military personnel, nurses, pharmacists, police and veterinarians. Crude mortality rates were calculated based on numbers in each occupational group at each quinquennial census, 1976–2001. Standardized mortality ratios were calculated using suicide rates in all employed groups (the standard population). Results: Few of the occupations investigated had high risks of suicide as assessed by standardized mortality ratios, and some were at lower risk than the total employed population. Standardized mortality ratios were elevated for male nurses (1.7; 95% CI: 1.2–2.5), female nurses (1.3; 95% CI: 1.0–1.6), male hunters and cullers (3.0; 95% CI: 1.7–4.8), and female pharmacists (2.5; 95% CI: 0.8–5. 9). Doctors, farmers and veterinarians were not at high risk, and men in the police and armed forces were at low risk. Access to means appeared to have influenced the method chosen. Nurses, doctors and pharmacists were more likely to use poisoning than were other employed people (3, 4 and 5 times respectively, compared with all others employed). Farmers and hunters and cullers were more than twice as likely as all others employed to use firearms. Conclusions: Access to means may be less important in some circumstances than in others, perhaps because of the presence of other factors that confer protection. Nevertheless, among the groups we studied with access to lethal means were three groups whose risk of suicide has so far received little attention in New Zealand: nurses, female pharmacists, and hunters and cullers.
Prediction of Aggression and Restraint in Child Inpatient Units
Authors: Crocker Jandi H. , Stargatt Robyn , Denton Christine 
Published: April 2010

Objective: The aim of the present exploratory study was to determine the predictors of aggression and restraint in children admitted to a child psychiatric inpatient unit in Melbourne, Australia. Method: A retrospective review of incident report forms over a 12 month period at the State Wide Child Inpatient Unit (SWCIU) was conducted. These report forms were based upon 41 children aged 5–12 years, who had various psychiatric diagnoses including conduct disorder, attention-deficit–hyperactivity disorder and anxiety disorders. Results: A total of 70 children were admitted to the SWCIU during the audit period. Forty-one children aged 5–12 engaged in 235 violent incidents. A high-risk assessment and disruptive behaviour disorder were associated with aggressive behaviour and restraint. Disruptive behaviour disorder also predicted more serious episodes of aggression. Conclusions: There are readily identifiable patient factors that predict aggression and the need for restraint in child inpatient units.
Gender Differences in Sociodemographic and Clinical Characteristic and the Quality of Life of Chinese Schizophrenia Patients
Authors: Xiang Yu-Tao , Weng Yong-Zhen , Leung Chi-Ming , Tang Wai-Kwong , Chan Sandra S. M. , Wang Chuan-Yue , Han Bai , Ungvari Gabor S. 
Published: April 2010

Objective: The aim of the present study was to determine the sociodemographic and clinical correlates of the gender of Chinese schizophrenia outpatients and their impact on patients quality of life (QOL). Methods: Two hundred and fifty-five clinically stable schizophrenia outpatients were randomly selected in Hong Kong. Counterparts matched according to gender, age, age at onset, and length of illness were recruited in Beijing, China. All of the subjects at both sites were interviewed by the same investigator using standardized assessment instruments. Results: The combined Beijing–Hong Kong sample contained 251 male and 254 female patients. On univariate analysis more male patients were employed, they had a significantly higher monthly income, and took higher doses of antipsychotic drugs. No difference was found, however, in any of the QOL domains between the genders. On multivariate analysis being employed, taking a higher dose of antipsychotic drugs, having more severe extrapyramidal side-effects, and a higher score on the physical domain of QOL were independently associated with male gender. Conclusion: Female gender is independently associated with lower scores on the physical aspects of QOL, but there is no difference between the genders in the psychological, social and environmental aspects.
Cigarette Smoking in Patients with Schizophrenia in China: Prospective, Multicentre Study
Authors: Wang Chuan-Yue , Xiang Yu-Tao , Weng Yong-Zhen , Bo Qi-Jing , Chiu Helen F. K. , Chan Sandra S. M. , Lee Edwin H. M. , Ungvari Gabor S. 
Published: April 2010

Objective: The aim of the present study was to explore the rate of cigarette smoking and its sociodemographic and clinical characteristics in Chinese schizophrenia patients. Methods: In a multicentre, randomized, controlled, longitudinal study, 374 clinically stable patients with schizophrenia were interviewed at entry using standardized assessment instruments, and followed up for 1–2 years. Results: The rate of cigarette smoking was 13.9% in the whole sample, and 26.2% in men and 3.5% in women. On univariate analysis, male sex, unemployment, alcohol consumption, older age, older age at onset, longer duration of illness, more frequent admissions, more severe hostility–excitement at entry and less deterioration in hostility–excitement over the study period were significantly associated with cigarette smoking. On multivariate analysis, male sex, unemployment, alcohol consumption, more frequent admissions, less severe positive and negative symptoms at entry, smaller decline in negative symptoms and more deterioration in disorganized thoughts over the study period were independently associated with cigarette smoking. Conclusion: The rate of cigarette smoking in Chinese schizophrenia patients is considerably lower than most figures reported in the Western literature.
Anticholinesterase Duration in the Australian Veteran Population
Authors: Gadzhanova Svetla , Roughead Libby , Mackson Judith 
Published: April 2010

Objective: The aim of the present study was to determine the duration of initial anticholinesterase treatment in veteran patients in Australia. Three anti-dementia medications were investigated (donepezil, rivastigmine and galantamine) and two different setting were compared (community and residential aged care facilities). Method: A retrospective cohort study was performed using the Department of Veterans’ Affairs pharmacy claims data. Patients were included in the cohort if they had been dispensed at least one anticholinesterase prescription (index) between 2003 and 2006, were aged 65 years or over at the time of that index dispensing, and had not been dispensed any anticholinesterase medicine in the previous 12 months. Patients were followed until discontinuation (ceased or switched), death or 1 year of follow up. Time to treatment discontinuation was analysed utilizing the Kaplan-Meier method. Cox proportional hazards models were used to compare the risk of treatment discontinuation among the three treatment groups adjusting for the effect of patients’ characteristics. Results: Of the new users of anticholinesterases (n = 10088), 47% of those on donepezil, 46% of those on galantamine, and 47% of rivastigmine patients discontinued their initial therapy within 6 months. A total of 32% of patients who ceased therapy reinitiated it during the study period; 28% returned to the same index medication and 4% restarted therapy with a different anticholinesterase. The median treatment duration was: 199 days (95% CI, 182–208) for donepezil patients (n = 6705), 233 days (95% CI, 212–259) for galantamine patients (n = 2898), and 219 days (95% CI, 176–260) for rivastigmine patients (n = 394). Patients in community settings were more likely to discontinue their initial anticholinesterases earlier compared to those living at residential aged care facilities (relative risk, RR=1.21; 95% CI, 1.12, 1.31). Conclusions: Almost half of the Australian veteran patients who initiated anticholinesterases treatment discontinued (ceased or switched) therapy within 6 months. However, one-third of those who ceased therapy reinitiated it during the study period.
Neonatal Growth Outcomes at Birth and one Month Postpartum Following In Utero Exposure to Antidepressant Medication
Authors: Lewis Andrew J. , Galbally Megan , Opie Gillian , Buist Anne 
Published: April 2010

Objective: There is evidence of increasing prescription of antidepressant medication in pregnant women. This has arisen from the recognition of the importance of treating maternal depression. This must be balanced, however, with information on outcomes for infants and children exposed to antidepressants in pregnancy. The aim of the present study was to examine whether neonatal outcomes including gestational age at birth, neonatal growth outcomes at birth and then at 1 month postpartum were altered by in utero exposure to antidepressant medication using a prospective and controlled design. Method: A prospective case–control study recruited 27 pregnant women taking antidepressant medication and 27 matched controls who were not taking antidepressant medication in pregnancy at an obstetric hospital in Melbourne, Australia. Of the 27 women taking medication, 25 remained on medication in the third trimester. A purpose-designed self-report questionnaire and the Beck Depression Inventory-II were completed in pregnancy, after birth and at one month postpartum. In addition information was collected on exposed and non-exposed infants including Apgar scores, birthweight/length/head circumference and gestational age at birth. Weight/length/head circumference was again collected at 1 month of age. Results: Infants exposed to antidepressants in utero were eightfold more likely to be born at a premature gestational age, had significantly lower birthweight and were smaller in length and head circumference than non-exposed infants. There was no association between birth outcomes and maternal depression. At 1 month, the difference in weight in the exposed group became significantly greater than the control group. Conclusion: Antidepressant exposure in utero may affect gestational age at birth and neonatal outcomes independently of antenatal maternal depression. Further studies are needed to examine whether these findings vary according to the type of antidepressant prescribed and follow up growth and development in exposed infants beyond 1 month.
Associations Between Diet Quality and Depressed Mood in Adolescents: Results from the Australian Healthy Neighbourhoods Study
Authors: Jacka Felice N. , Kremer Peter J. , Leslie Eva R. , Berk Michael , Patton George C. , Toumbourou John W. , Williams Joanne W. 
Published: April 2010

Objective: Adolescence frequently coincides with the onset of psychiatric illness and depression is commonly observed in adolescents. Recent data suggest a role for diet quality in adult depression. Given the importance of adequate nutrition for brain development, it is of interest to examine whether diet quality is also related to depression in adolescents. Methods: The study examined 7114 adolescents, aged 10–14 years, who participated in the Australian Healthy Neighbourhoods Study. Healthy and unhealthy diet quality scores were derived from a dietary questionnaire. The Short Mood and Feelings Questionnaire for adolescents measured depression. Adjustments were made for age, gender, socioeconomic status, parental education, parental work status, family conflict, poor family management, dieting behaviours, body mass index, physical activity, and smoking. Results: Compared to the lowest category of the healthy diet score, the adjusted odds ratios (95% confidence interval) for symptomatic depression across categories (C) was: C2 = 0.61 (0.45–0.84); C3 = 0.58 (0.43–0.79); C4 = 0.47 (0.35–0.64); and C5 = 0.55 (0.40–0.77). Compared to the lowest quintile, the adjusted odds ratios (95% confidence interval) for symptomatic depression across increasing quintiles of the unhealthy diet score were: Q2 = 1.03 (0.87–1.22); Q3 = 1.22 (1.03–1.44); Q4 = 1.29 (1.12–1.50); and Q5 = 1.79 (1.52–2.11). Conclusions: Our results demonstrate an association between diet quality and adolescent depression that exists over and above the influence of socioeconomic, family, and other potential confounding factors.