bluuebunny/crossref_metadata_2025_split huggingface dataset:
On‐Line Electrochemistry/Electrospray Ionization Mass Spectrometry (EC/ESI‐MS) for the Generation and Identification of Nucleotide Oxidation Products
Authors: Baumann Anne , Lohmann Wiebke , Jahn Sandra , Karst Uwe 
Published: November 2009

AbstractThe oxidation behavior of DNA and RNA nucleotides is studied by an on‐line set‐up consisting of an electrochemical thin‐layer cell (EC) directly coupled to electrospray ionization mass spectrometry (ESI‐MS). This set‐up allows the generation of nucleotide oxidation products in the electrochemical cell at increasing potentials. Moreover, the products are determined directly, without isolation or derivatization steps, by electrospray ionization time of flight mass spectrometry (ESI‐ToF/MS). The dependence of the mass spectra on the applied potential is displayed as ‘mass voltammograms’. An advanced set‐up, consisting of the electrochemical cell coupled to electrospray ionization tandem mass spectrometry (EC/ESI‐MS/MS) allows further structure elucidation based on fragmentation experiments. The electrochemical conversion is performed using a boron doped diamond (BDD) working electrode, which is known to generate hydroxyl radicals at high potentials. The capability of the EC‐MS system to generate highly relevant oxidation products which also occur upon oxidative damage in vivo is demonstrated in this study by the formation of well known biomarkers for DNA damage, including 2′‐deoxy‐8‐oxo‐guanosine 5′‐monophosphate.
Predictors of adherence to atypical antipsychotics (risperidone or olanzapine) in older patients with schizophrenia: an open study of 3½ years duration
Authors: Ritchie C. W. , Harrigan S. , Mastwyk M. , Macfarlane S. , Cheesman N. , Ames D. 
Published: November 2009

AbstractObjectiveAlthough the evidence base for the use of antipsychotics in older people with schizophrenia is generally of low quality, it tends to support the use of atypical antipsychotics. Only limited information regarding longer term adherence to these apparently more effective drugs is available. The aim of this study was to determine predictors of adherence to risperidone or olanzapine in patients over 60.MethodsPatients receiving care from old age psychiatrists for their schizophrenia were randomised to treatment with olanzapine or risperidone and were followed for up to 3½ years. Kaplan–Meier curves were generated to assess the univariate effect of randomisation drug on long‐term adherence and Cox regression adjusted for baseline variables which may have affected adherence.ResultsIn total, 60.6% of the 66 patients in the study were still taking their randomised drug by the end of the interval in which they remained under observation (64.7% olanzapine and 56.3% risperidone). This difference was non‐significant. No baseline variable was associated with an increased risk of non‐adherence, though the delivery form of pre‐randomisation drug (oral or depot) was weakly (p = 0.054) associated with patients originally on depot being less likely to be adherent to an atypical drug.ConclusionsOverall adherence with atypical medication was good with almost two‐thirds of the patients remaining on their randomisation drug for the interval in which they were under observation. Patients taken off depot were less likely to be adherent but there was no significant difference in adherence between olanzapine and risperidone. Scrutiny of the survival curves suggested that non‐adherence is an early event in treatment and patients adherent at 6 months were likely to remain adherent over a longer time period. Copyright © 2009 John Wiley & Sons, Ltd.
Three sides of the same coin: measuring global cognitive impairment with the MMSE, ADAS‐cog and CAMCOG
Authors: Wouters Hans , van Gool Willem A. , Schmand Ben , Zwinderman Aeilko H. , Lindeboom Robert 
Published: November 2009

AbstractObjectiveThe total scores of the ADAS‐cog, MMSE and CAMCOG, comprising various cognitive tasks, are widely used to measure a dimension of global cognitive impairment. It is unknown, however, whether this dimension is common to these instruments. This hampers comparisons when either of these instruments is used. The extent to which these instruments share a common dimension of global cognitive impairment and how their scores relate was examined.MethodsRasch analysis of CAMCOG and MMSE data of participants from a population based study and two memory clinics pooled with ADAS‐cog and MMSE data of participants from three RCTs (overall N = 1566) to estimate a common dimension of global cognitive impairment and to examine the goodness of fit of the individual items to this dimension.ResultsUsing the estimated common dimension of global cognitive impairment, the total scores of the instruments could be related, e.g. a mean level of global cognitive impairment corresponded to a predicted score of 11.4 (ADAS‐cog), 72.6 (CAMCOG) and 22.2 (MMSE). When revised according to The Rasch validity analyses, every individual item could be fitted to the dimension.ConclusionsThe MMSE, ADAS‐cog and CAMCOG reflect a valid common dimension of global cognitive impairment, which enables comparisons of RCTs that use the ADAS‐cog and observational studies that use the CAMCOG and MMSE. Copyright © 2009 John Wiley & Sons, Ltd.
Primary care and dementia: 2. long‐term care at home: psychosocial interventions, information provision, carer support and case management
Authors: Robinson Louise , Iliffe Steve , Brayne Carol , Goodman Claire , Rait Greta , Manthorpe Jill , Ashley Peter , Moniz‐Cook Esme ,   the DeNDRoN Primary Care Clinical Studies Group
Published: November 2009

AbstractObjectiveTo write a narrative review of the role of primary care physicians in the long‐term care of people with dementia living at home, with a focus on psychosocial interventions, the provision of information and carer support, behavioural and psychological symptoms and case management.MethodsThe systematic review carried out for the NICE/SCIE Guidelines was updated from January 2006, Cochrane Reviews were identified and other publications found by consultations with experts.ResultsIn primary care, the long‐term care of people with dementia living at home can be structured around several key themes: reframing dementia with a focus on a social model of disability; active use of information sources; supporting carers (caregivers); the management of behavioural and psychological symptoms and a structured case management approach.ConclusionsCaring for people with dementia in primary care demands the same systematic approach as the management of other long‐term conditions. The systematic follow‐up of both people with dementia and their carers should be integrated into primary care. Reframing dementia, with an emphasis on abilities retained may allow people with dementia and their families to develop more effective coping strategies; an increase in skill mix within primary care is required to deliver this and may also improve the management of behavioural problems. The potential benefits of person‐centred interventions, like advance care planning, and alternative models of service delivery, such as a structured, collaborative care approach which promotes integrated case management within primary care, require further evaluation. Copyright © 2009 John Wiley & Sons, Ltd.
Who will be eligible? An investigation of the dementia population eligible for cholinesterase treatment following the change in NICE guidance
Authors: Matthews Fiona E , Muniz‐Terrera Graciela , McKeith Ian , Brayne Carol ,   MRC CFAS
Published: November 2009

AbstractObjectivesInvestigate the impact of the changes in eligibility within England and Wales (E&W) for prescription within the UK National Health Service for treatment of Alzheimer's disease (AD).MethodsA population‐based study in England and Wales with 13 004 individuals measured with MMSE at baseline was used to examine the distributions of individuals within eligibility criteria. Information obtained from informants enabled classification of the study defined dementia cases to ICD10 diagnosis of subtype (AD, dementia with vascular risk, both or other).ResultsFifty six per cent of dementia patients (representing 323 000 individuals in E&W) fall into the new MMSE criteria band. A further 120 000, 20% of dementia patients, are estimated to have disease that is considered too mild for treatment. Further examination of type of dementia showed that those with mixed AD and vascular dementia had similar proportions of dementia cases within the treatable MMSE group as the subgroup with AD alone, though with mixed disease individuals more often score below the lower threshold. There is substantial instability in the eligibility groupings over a short time period.ConclusionsThe population impact of new NICE criteria of excluding high MMSE scores is to exclude one in five individuals with AD and a further one in ten of those with a mixed disease. Changing the guidance has almost balanced the loss of treatment for the high MMSE group (13%) with the introduction of treatment for those scoring 10/11 (11%). Copyright © 2009 John Wiley & Sons, Ltd.
Neuropsychiatric correlates of white matter hyperintensities in Alzheimer's disease
Authors: Berlow Yosef A. , Wells William M. , Ellison James M. , Sung Young Hoon , Renshaw Perry F. , Harper David G. 
Published: November 2009

AbstractObjectiveTo investigate the association of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD) and magnetic resonance imaging (MRI) measures of brain atrophy and white matter hyperintensities (WMH).MethodsThirty‐seven patients with probable AD received the Neuropsychiatric Inventory (NPI), the Mini Mental Status Exam (MMSE), and an MRI scan as part of their initial evaluation at the Outpatient Memory Diagnostic Clinic at McLean Hospital. MRI‐based volumetric measurements of whole brain atrophy, hippocampal volumes, and WMH were obtained. Analysis of covariance models, using age as a covariate and the presence of specific BPSD as independent variables, were used to test for differences in whole brain volumes, hippocampal volumes and WMH volumes.ResultsIncreased WMH were associated with symptoms of anxiety, aberrant motor behavior, and night time disturbance, while symptoms of disinhibition were linked to lower WMH volume. No associations were found for whole brain or hippocampal volumes and BPSD.ConclusionsThese findings suggest that white matter changes are associated with the presence of BPSD in AD. Copyright © 2009 John Wiley & Sons, Ltd.
Self‐neglect and cognitive function among community‐dwelling older persons
Authors: Dong XinQi , Wilson Robert S. , Mendes de Leon Carlos F. , Evans Denis A. 
Published: November 2009

AbstractObjectiveElder self‐neglect is a common public health issue, but it is unclear to what degree it is associated with cognitive function. This study aimed to examine the cross‐sectional association between self‐neglect and cognitive function.MethodsChicago Health and Aging Project (CHAP) is a population‐based epidemiological study conducted in a geographically defined community in Chicago (N = 8698): we identified 1094 CHAP participants who had self‐neglect reported to social services agency, which assessed the self‐neglect severity. Cognitive function was assessed using the Mini‐Mental State Examination (MMSE), the Symbol Digit Modalities Test (Perceptual Speed), and both immediate and delayed recall of the East Boston Memory Test (Episodic Memory). An index of global cognitive function scores was derived by averaging z‐scores of all tests. Linear regression models were used to assess the association of self‐neglect severity and cognitive function.ResultsSelf‐neglect was associated with poorer cognitive function. After adjusting for confounders, self‐neglect was associated with lower global cognitive function (parameter estimate[PE] = −0.367, standard error[SE] = 0.026, p < 0.001), lower MMSE (PE = −2.592, SE = 0.182, p < 0.001), episodic memory (PE = −0.288, SE = 0.032, p < 0.001), and perceptual speed (PE = −5.428, SE = 0.444, p < 0.001). In addition, higher self‐neglect severity scores were associated with lower global cognitive function (PE = −0.008, SE = 0.003, p = 0.014). Greater self‐neglect severity was not correlated with worse performance on MMSE, but was correlated with worse performance on episodic memory (PE = −0.008,=SE = 0.003, p = 0.010), and perceptual speed (PE = −0.131, SE = 0.042, p = 0.002).ConclusionSelf‐neglect is associated with lower global cognitive function, episodic memory and perceptual speed. Future studies are needed to examine the temporality of these associations. Copyright © 2009 John Wiley & Sons, Ltd.
Suicidal ideation and its correlates among elderly in residential care homes
Authors: Malfent Daniela , Wondrak Tanja , Kapusta Nestor D. , Sonneck Gernot 
Published: November 2009

AbstractObjectiveThe highest suicide rates are found among the elderly, therefore suicidal ideation is prevalent in long‐term care facilities. Despite these facts and multiplying losses, most residents show no signs of suicidal ideation. There is a lack of information on which factors protect against suicidal thoughts among the elderly. The aim of this pilot study was to assess the prevalence and correlates of suicidal ideation with risk and protective factors among older residential care home residents in Vienna.MethodsThis cross‐sectional study was conducted in 15 Viennese residential care homes. Participants completed a self‐report questionnaire containing sociodemographic factors, physical health, mental health, and protective factors like optimistic attributional style, self‐efficacy, and internal locus of control as well as satisfaction with life and were finally asked about active and passive suicidal thoughts and behaviors.ResultsWith the voluntary participation of 129 residents aged 60 years or more, active suicidal ideation during the last month was identified in 7% of the elderly, 11% reported active suicidal ideation during the past year. Primarily, we found that protective factors like internal locus of control, self‐efficacy, and satisfaction with life were important single predictors of active suicidal ideation during the past month. Depressive symptoms and current psychotherapeutic treatment were additionally important predictors.ConclusionsSuicidal ideation is prevalent in Viennese residential care homes; consequently it is necessary to recognize and treat suicidal ideation in an adequate way. Our findings suggest that research and prevention strategies could not merely target risk, but also include protective factors. Copyright © 2009 John Wiley & Sons, Ltd.
Evaluation of a brief educational program for dementia carers: The AENEAS Study
Authors: Kurz Alexander , Wagenpfeil Stefan , Hallauer Johannes , Schneider‐Schelte Helga , Jansen Sabine ,   for the AENEAS Study Group
Published: November 2009

AbstractObjectiveTo evaluate the efficacy of a practical, easily implemented, educational intervention in group format for informal carers of persons with dementia.MethodsMulti‐centre, randomised, controlled, single‐blind trial involving 292 family caregivers of patients with moderate dementia in Alzheimer's disease.ResultsParticipants valued program components which had a practical impact on their caring role. The intervention achieved minor effects on the participants' psychological quality of life and did not reduce carer depression. It was also not associated with a lower rate of patient nursing home admissions. A subgroup analysis suggested that the intervention actually promoted the decision for nursing home placement in caregivers who were over‐burdened and not coping well when they entered the study.ConclusionTo improve dementia carer support, educational components might be intergrated into more comprehensive and individualised interventions which include problem solving and behavioural management strategies, ensure the transfer of newly acquired skills into the everyday context, and adequately deal with the emotional consequences of the caring role. Copyright © 2009 John Wiley & Sons, Ltd.
Neuroimaging predictors for depressive symptoms in cerebral small vessel disease
Authors: Fu Jian Hui , Wong Kelvin , Mok Vincent , Hu Xintao , Xiong Yunyun , Chen Yangkun , Tang Wai Kwong , Chen Xiangyan , Wong Adrian , Chu Winnie , Wong Ka Sing , Wong Stephen 
Published: November 2009

AbstractObjectiveAlthough cerebral small vessel disease (SVD) is closely associated with late life depression, patients with even severe SVD may have no depressive symptoms. We postulate that concurrent brain atrophy may also involve in the pathogenesis of depressive symptoms in SVD. We aimed to investigate the relevance of brain atrophy in predicting depressive symptoms among patients with severe SVD.MethodsWe recruited 45 lacunar stroke patients who had diffuse white matter lesion (WML) and varying severity levels of depressive symptoms. We used a quantitative hybrid warping method to determine the volume of 99 brain regions for each patient. We assessed severity of depressive symptoms using the depression score of the hospital anxiety and depression scale (HADS‐D). We first performed correlation analysis of each brain variable with the depression score. Significant variables were then entered separately into linear regression analysis to explore predictors of HADS‐D, with adjustment of relevant clinical variables.ResultsThe mean age (SD) of the 45 participants was 74.6 (8.3) years. The mean HADS‐D score was 3.5, with score ranging from 0 to15. Variables that had a significant correlation coefficient with HADS‐D were gender, hypertension, Oxford handicap scale, left inferior frontal gyrus, right subthalamic nucleus, left posterior limb of internal capsule, and right cerebellum. Regression analyses showed that only left inferior frontal gyrus atrophy (β = −0.354, p = 0.017) predicted HADS‐D score after adjusted for other relevant clinical variables.ConclusionConcurrent atrophy of left inferior frontal gyrus is associated with depressive symptoms in elderly patients with severe SVD. Copyright © 2009 John Wiley & Sons, Ltd.
Shared decision‐making in the primary care treatment of late‐life major depression: a needed new intervention?
Authors: Raue Patrick J. , Schulberg Herbert C. , Lewis‐Fernandez Roberto , Boutin‐Foster Carla , Hoffman Amy S. , Bruce Martha L. 
Published: November 2009

AbstractObjectiveWe suggest that clinicians consider models of shared decision‐making (SDM) for their potential ability to improve the treatment of major depression in the primary care setting and overcome limitations of collaborative care and other interventions.MethodsWe explore the characteristics and techniques of patient–clinician SDM, with particular emphasis on this model's relevance to the unique treatment concerns of depressed older adults.ResultsWe describe a SDM intervention to engage older adults in depression treatment in the primary care sector.ConclusionsIt is timely to examine SDM models for elderly depressed primary care patients given their potential ability to improve treatment adherence and clinical outcomes. Copyright © 2009 John Wiley & Sons, Ltd.
Hypothetical versus real preferences: results from an opportunistic field experiment
Authors: Bryan Stirling , Jowett Sue 
Published: November 2009

AbstractOver recent years there has been renewed interest in cost‐benefit analysis (CBA) in health care but the ‘hypothetical bias’ concern (i.e. the belief that WTP values overstate real preferences) is a remaining anxiety. This paper reports new empirical data comparing hypothetical and real preferences in a health care context, using the clinical setting of patient self‐management (PSM) of anticoagulation (warfarin) therapy. The data offer considerable support for the use of WTP and CBAs in a self‐management health care context; the hypothetical bias hypothesis is not supported by our data. The generalisability of these results to other health care settings needs to be explored. Copyright © 2009 John Wiley & Sons, Ltd.
The impact of health needs assessment and prioritisation on District Health Board planning in New Zealand
Authors: Coster Gregor , Mays Nicholas , Scott Claudia , Cumming Jacqueline 
Published: November 2009

AbstractObjectives District Health Boards (DHBs) in New Zealand are mandated to assess and prioritise the health needs of their resident populations. This paper evaluates the impact of those health needs assessments (HNAs) and prioritisation practices on health service planning and purchasing in the first 3 years of the DHBs (2001–2003).Methods DHB HNAs, 5‐yearly strategic plans, and annual plans were evaluated using document analysis to determine the impact of needs assessments on prioritisation and planning by boards. Key informant interviews with DHB senior managers were used to identify differences between boards.Results HNAs had relatively little influence on the direction of planning and purchasing. HNAs conducted in DHBs that focussed on planning at the service level and in relation to population subgroups using a ‘mixed‐scanning’ approach and ‘service planning groups’ had a greater impact on planning and purchasing than more comprehensive approaches. DHBs found prioritisation difficult due to the level of control exercised by central government over their actions.Conclusions HNAs in New Zealand need to be less ambitious, more focussed and more closely institutionally linked to prioritisation, service planning and purchasing processes if they are to have an impact on the allocation of resources. Copyright © 2009 John Wiley & Sons, Ltd.
Improvement in social competence in patients with schizophrenia: a pilot study using a performance‐based measure using virtual reality
Authors: Park Kyung‐Min , Ku Jeonghun , Park Il‐Ho , Park Ji‐Yeon , Kim Sun I. , Kim Jae‐Jin 
Published: November 2009

AbstractObjectiveThe objective of this study was to explore the possibility of the use of Virtual Reality Functional Skills Assessment (VRFSA) in a future regular clinical trial, as well as to report a preliminary result about effectiveness of atypical antipsychotics to social competence in schizophrenia.MethodsWe developed the VRFSA that measured subjects' performances automatically and used analogue scale rather than Likert scale. Twenty‐four female patients with paranoid schizophrenia and 15 healthy females were recruited. This was a 6‐week, randomized, open‐label, and flexible dose study, and 2 treatments (baseline versus post‐treatment) × 2 skills phases (receptive versus expressive) × 2 patient groups (aripiprazole versus risperidone) analysis of variance was used in the final analysis.ResultsThere was a significant difference in the VRFAS between the patients and the healthy subjects (p < 0.05). Eighteen patients were included in the final analysis. We found larger treatment effect than those found in previous studies, and significant treatment × skills phase × group interaction effect on the VRFAS.ConclusionsOur results suggest that the VRFAS is strongly sensitive to changes in social competence and thus especially beneficial in short‐term clinical trials. In addition, atypical antipsychotics can improve social competence and differentially improve receptive skills and expressive skills in schizophrenia. Copyright © 2009 John Wiley & Sons, Ltd.