bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of atomoxetine in childhood Attention-Deficit/Hyperactivity Disorder with comorbid Oppositional Defiant Disorder
Authors: Kaplan S. , Heiligenstein J. , West S. , Busner J. , Harder D. , Dittmann R. , Casat C. , Wernicke J. F. 
Published: June 2007

Objective: To compare the safety and efficacy of atomoxetine, a selective inhibitor of the norepinephrine transporter, versus placebo in Attention-Deficit/Hyperactivity Disorder (ADHD) patients with comorbid Oppositional Defiant Disorder (ODD). Methods: A subset analysis of 98 children from two identical, multi-site, double-blind, randomized, placebo-controlled trials involving 9 weeks of treatment with atomoxetine or placebo was conducted. Patients met DSM-IV ADHD criteria. ODD was diagnosed with the Diagnostic Interview for Children and Adolescents-IV (DICA-IV; Reich, Welner, & Herjanic, 1997). ADHD severity was assessed with the ADHD Rating Scale-IV-Parent Version: Investigator Administered and Scored (ADHD-RS-IV-Parent:Inv; DuPaul, Power, Anastopoulos, & Reid, 1998); the short version of the Conners’ Parent Rating Scales-Revised (CPRS-R:S; Conners, 2000); and the Clinical Global Impressions of ADHD Severity (CGI-ADHD-S; Guy, 1976). Clinical response was defined as a ≥ 25% reduction in ADHD-RS-IV-Parent:Inv total score. Results: ADHD-RS-IV-Parent:Inv, CGI-ADHD-S, and three CPRS-R:S subscale scores improved markedly with atomoxetine treatment. However, a decrease in the CPRS-R:S Oppositional subscore for atomoxetine-treated patients was not significantly greater than scores for placebo-treated patients. Clinical response rates were 65.4% in the atomoxetine group, and 36.4% in the placebo group ( p = .007). Conclusion: Atomoxetine was effective for the treatment of ADHD in patients with comorbid ODD. It did not significantly reduce the severity of ODD symptoms, and was well tolerated by the patients.
Neuropsychological Testing: Methodology, Interpretation and Outcomes
Authors: Stump David A. 
Published: June 2007

The outcome most dreaded by patient and surgeon alike is a brain dysfunction. Numerous surveys indicate most patients would prefer death to significant neurological impairment. Cardiac surgery currently enjoys a remarkable safety record in regard to a low death rate and major cerebral infarctions. However, neurobehavioral dysfunction, i.e. memory, coordination, and attention deficits, continues to be an area that is identified in the literature as a major negative outcome associated with cardiac surgery. If the cardiac surgical community is going to eliminate brain injury associated with interoperative methods and apparatus, then a sensitive, reproducible and quick assessment of brain function that can be reliably correlated with surgical interventions is a basic requirement. This paper discusses the experimental design, environmental and statistical concerns relative to selecting a battery of neurobehavioral assessment tools appropriate for cardiac surgery patients so, as a team, we can make a safe operation safer.
The Humidity Variation in Crawl Spaces of Japanese Houses
Authors: Iwamae Atsushi , Matsumoto Mamoru 
Published: June 2007

We found that many houses experience summer condensation in the crawl spaces. These houses are constructed in compliance with the Japanese Building Code requirements for crawl space ventilation and contain ground covers. The humidity in the crawl space affects durability of the house. We have monitored the temperature and humidity variations of 36 houses in Japan over two years and confirmed the annual variations of hygro-thermal conditions in the crawl spaces by the numerical analysis. Numerical calculations using a one-dimensional heat transfer model agreed well with the measured results. These results show that during the summer, houses in this region of Japan have extremely high humidity in crawl spaces. The daily average of crawl space vapor pressure is nearly equal to that of the outdoors. The effects of floor thermal resistance and ground moisture are also estimated in this paper.
Inverclyde ferry services: A passenger segmentation analysis
Authors: Graham Margaret , Russell Victoria 
Published: June 2007

This research project was funded jointly by Scottish Enterprise Renfrewshire and the Moffat Centre at Glasgow Caledonian University. The rationale was to identify the existing passenger mix on two Scottish ferry routes and to what extent the ferry service relied on leisure visitors and tourists. The study was undertaken in three seasonal phases that served to segment passengers into specific purpose of travel groups, identify accommodation and leisure activity choices and monitor spending behaviour. The main aim of this paper is to provide ferry passenger profiles that reflect passenger types using two Scottish ferry routes exiting from Gourock and Wemyss Bay ports during regular and holiday periods. Existing passenger use and quality ratings of goods and services are assessed. The objective is to provide marketing recommendations that will stimulate economic benefit for the ferry company and local businesses and services. In 1999 ferry passenger intercept surveys were conducted during three seasonal phases. Phase 1, undertaken in an off-peak period during winter, identified that almost half of all traffic was related to business commuting. Over 60 per cent of surveyed passengers were residents of Argyll who began their journey from home, which tended to be less than 20 miles from the ferry terminal. During Phase 2, carried out over the Easter break, traffic was more diverse with only 28 per cent of Argyll residents travelling on both routes. However, over 40 per cent began their journey from Argyll and a high leisure market segment was identified, originating predominantly from central Scotland. Visiting friends and relatives (VFR) and day trips were the most popular reason for travel from both destinations. During Phase 3, conducted in the summer, nearly half of all passengers originated from Argyll, including a large proportion of day trippers. Visitors from England and overseas were more pronounced during this phase. English visitors were more likely to stay in hotels while overseas visitors chose guesthouse or bed-and-breakfast accommodation.
Bright light therapy for demented nursing home patients with behavioral disturbance
Authors: Thorpe Lilian , Middleton Joan , Russell Gwen , Stewart Norma 
Published: June 2007

The objective of this study was to examine the effects of morning bright light on behavioral disturbances in dementia using a repeated measures ABA design. We hypothesized that morning bright light in demented patients reduces the agitation rating and directly observed disruptive behavior, but increases observed positive behavior. The study was done in a special care unit of a long term care facility, with 16 demented residents ages 60 to 89, 13 female and three male. Morning bright light (Day-Light Box 10000, produced by DayLight Technologies, Inc, providing 10,000 lux) was administered Monday to Friday during the treatment week. The Global Deterioration Scale rating at baseline, followed by baseline, treatment and post-treatment ratings in the Cohen-Mansfield Agitation Inventory (CMAI) and Environment-Behavior Interaction Code (EBIC) were used as measurements Compared to baseline, the mean total Cohen-Mansfield score decreased more during the phototherapy week than during the post-treatment week (p < 0.05 on one-tailed paired t-test). Regardless of phototherapy, Cohen-Mansfield scores decreased significantly in summer versus fall-spring (p < .005). Although the direct behavioral measures [EBIC] showed no statistically significant change compared to baseline, there was a pattern of greater mean increase in positive behaviors (p = .08) during phototherapy than in the post-treatment week, and a mean decrease of total disruptive behaviors most pronounced in the post-treatment week (p = .05). Bright light therapy has modest efficacy in reducing agitation, with possible concurrent improvement in positive behaviors. Disruptive behaviors may also become less frequent during phototherapy with evidence of even greater delayed optimal effect. Further research should focus on subgroups of patients demonstrating a particularly robust response, enhance power through a larger sample, provide for longer light exposure, and control for seasonal variables.
Apolopoprotein-E gene polymorphism and lipid profiles in Alzheimer's disease
Authors: Isbir Turgay , Agaçhan Bedia , Yilmaz Hülya , Aydin Makbule , Kara Ihsan , Eker Engin , Eker Deniz 
Published: June 2007

In this study, the relationship between lipid profiles of sera and apolipoprotein E (apo E) gene polymorphism was investigated in 35 patients with Alzheimer's disease (AD) and 29 healthy people. Apo E genotypes and allele frequencies of the AD patient group were: apo E2/3, 2 (5.7 percent); apo E2/4, 1 (2.9 percent); apo E3/3, 26 (74.3 percent); apo E3/4, 5 (14.3 percent); apo E4/4, 1 (2.9 percent); 2, 3(4.2 percent); 3, 59 (84.2 percent); 4, 8 (11.4 percent). The healthy group's apo E genotypes and allele frequencies were: apo E2/3, 1 (3.4 percent); apo E3/3, 27 (93.1 percent); apo E3/4, 1 (3.4 percent); 2, 1 (1.7 percent); 3, 56 (96.5 percent); 4, 1 (1.7 percent). In Alzheimer's cases, 4 allele frequencies increased significantly as compared to the healthy group (p < 0.05). When the effects of the apo E isoforms on lipid profiles were evaluated, a relationship between apo E 4 allele and high total levels of serum cholesterol was found, whereas of apo E 2 allele was associated with the low total cholesterol of serum, although the difference was not statistically significant (p > 0.05). This study confirms the association of apo E 4 allele with lipid profiles in AD patients.
Depression among Alzheimer's caregivers: Identifying risk factors
Authors: Shua-Haim Joshua R. , Haim Todd , Shi Yong , Kuo Yen-Hong , Smith Juanita M. 
Published: June 2007

Purpose: The purpose of this study was to reveal risk factors contributing to the development of depression among caregivers of Alzheimer's disease patients. Methods: In a cross-sectional study, all caregivers of consecutive Alzheimer's disease patients were asked to participate in the study. Patient and caregiver depression was evaluated by using the Yesavage Geriatric Depression Scale (GDS). Information regarding patients' functional status, driving status, and type of behavioral abnormalities was obtained from caregivers. Patients' functional status was evaluated by using the Katz Activity of Daily Living (ADL) scale. The Folstein Mini-Mental Status Examination (MMSE) was used to evaluate cognition. Risk factors for Alzheimer's caregiver depression were assessed by means of logistic regression analysis. Results: A total of 92 patients and caregivers were evaluated. Fifteen were excluded due to incomplete data. A total of 77 pairs were included in this analysis. The age of caregivers ranged from 28 to 88 years. Mean (standard deviation [SD]) age was 63.1 (SD = 16.3) years old. Husbands and wives (caregivers) accounted for 49.4 percent; daughters or sons (or daughters-or sons-in-law) accounted for 42.9 percent. There were 29 caregivers (38 percent) found to be depressed. By using multivariate analysis, the following factors have been identified as risk factors for depression in Alzheimer's caregivers: depression in the dementia patient; ADL functional scores of 12 or greater; and the presence of hallucinations. Conclusion: Three risk factors were found to have a strong association with Alzheimer's caregiver depression. Early recognition of such risk factors may help to identify Alzheimer's caregivers with depression.
Alzheimer's disease: A study of assessment and stages
Authors: Joiner Judy , LeDuc Janet , Neubauer Judi , Stehman Jean Mason , Strachan Geraldine , Glenner Joy 
Published: June 2007

This investigation was performed for the purpose of determining whether the majority of Alzheimer's disease (AD) patients have well defined symptoms during the course of the disease that make it possible to characterize thefunctional level of the patient. There are numerous classifications of the stages of AD. The simplest of these classifications divide the disease into three stages (see Table 1). 1. Onset (Light) 2. Middle (Moderate) 3. Terminal (Severe) From a predictive standpoint it is important to know definable steps in the progression of the disease and when a patient passes from one stage into the next stage. This assessment has importance both in terms of caregiving procedures as well as medicinal therapy, e.g., medication, and long term care provisions. The Alzheimer's Family Center, Inc. (AFC) has researched data on 12 AD patients who were reviewed in a two-year retrospective study (see Table 2).
Alzheimer's disease: designing the physical environment
Authors: Brawley Elizabeth 
Published: June 2007

As we become more deeply concerned with the care of people with Alzheimer's disease and related disorders, it becomes increasingly clear that design is not just an incidental concern, but is integral to a well balanced program for this population. It is gratifying that over the last few years attention has begun to focus on the basic issues of quality of care. We have only begun to examine the potential of the physical surroundings in preventing and dealing with the loss of function-vision, hearing, mobility, social behavior and mental competence. It is, at the same time, equally disheartening that many involved in institutional care still seek only to meet minimum code requirements without responding to care, care management and the residence itself. The facilities themselves look dismal and depressing and perhaps more importantly, do not function much better. The average facility may have a ”decorated“ lobby, but design that is both functional and attractive is the exception. Often buildings are renovated or ”designed“ without architectural or professional design input. These ”design efforts“ are characterized by the inclusion of super graphics, the cosmetic approach of bright colors and the inclusion of grab bars and handrails. It is my view that incorporating environmental design into the quality of care and care management programs can greatly enhance these programs to the benefit of both the cognitively impaired and the staff.
Impact of spouse caregiving on health behaviors and physical and mental health status
Authors: Connell Cathleen M 
Published: June 2007

The impact of caring for a spouse with a progressive dementia on caregiver's health behaviors and health status was examined. Data collected from 44 spouse caregivers indicates that: • Providing full-time care interferes with preventive health behaviors (eating nutritiously, exercising) and contributes to high risk behaviors (overeating, alcohol and substance use); • Health behaviors are frequently used as coping strategies; • Caregivers rated their own health as poorer than their spouse's health; and • Disabling (arthritis, cardiac and back problems) and stress-related health problems (migraines, colitis) are a consequence of and interfere with care provision.
Differences in service attitudes and experiences among families using three types of support services
Authors: Bass David M. , Mccarthy Catherine , Eckert Sharen , Bichler Joyce 
Published: June 2007

One goal of support services for family members of Alzheimer's patients is to facilitate the use of other formal services. Few existing studies empirically test the relationship between support service use and the use of other community or residential services. This research describes the relationship between support and other service use by comparing families who used three types of support services: • Information and referral • Educational programs; and • Support groups. Data from in-person interviews with 127 family caregivers showed that families who used one of the three support services differed in the use of other services, service attitudes, past service experiences, and reasons for support service use. Results profile the characteristics of families who turn to different types of support services and illustrate the importance of past service characteristics for explaining current and future utilization. Information and referral (I & R), educational programs, and support groups are commonly provided support services for family members of Alzheimer's disease victims. These three support services share the common goal of facilitating and encouraging the use of other formal services for Alzheimer patients and their family members. Despite this goal, research on support services has seldom considered whether their use is related to the use of other services.
Hip fracture in patients with Alzheimer's disease
Authors: Shua-Haim J. R. , Parikh A. , Gross J. S. 
Published: June 2007

The purpose of this study was to evaluate the outcome of hip fracture repair and rehabilitation in patients with Alzheimer's disease. A retrospective study of patients with Alzheimer's disease, who sustained hip fracture repair during the years 1992 and 1993 was done. All patients were living in the community and were followed in the Memory Disorder Institute (MDI) in a large community hospital. A total of nineteen patients with dementia had sustained a hipfracture and 14 patients met the criteria of probable Alzheimer's disease. Five patients were excluded due to non Alzheimer's type of dementia. Surgical hip repair was performed in 13 patients. One patient refused surgery. All patients had 10 days of rehabilitation for ambulation. Patients who needed longer rehabilitation were transferred to a rehabilitation center. Post operative findings include the fact that all 14 patients were able to ambulate 25 feet with assistance in the rehabilitation department (including a patient who refused surgical repair). One month follow-up after hospital discharge reveals that patients with pre-hip fracture Mini-Mental Status (MMSE) equal or below 15 (total of 9 patients), were unable to ambulate with any assistance. There were four patients with MMSE > 15. Three were able to ambulate after hip surgical repair (with or without assistance), although one patient was non ambulatory. Interestingly, even the patient who refused surgical repair (MMSE = 10), was able to ambulate 50 feet with a walker while in the hospital After discharge to her home, she was unable to ambulate. Our findings suggest that none of the patients with Alzheimer's disease and MMSE ≤ 15, who sustained hip fracture repair were able to ambulate one month after hospital discharge.
A simulated driving evaluation for patients with Alzheimer's disease
Authors: Shua-Haim Joshua R. , Gross Joel S. 
Published: June 2007

A prospective study concerning the driving ability of 41 patients with the diagnosis of Alzheimer's disease (AD) was performed. Using a simulated driving test we evaluated the predictive value of the MMSE,'4 ADL,5-7 and IADL&9 to determine the ability of a person with Alzheimer's disease to drive. All patients were driving at the time of the evaluation. There was no correlation between driving performance and functional status evaluated by ADL and IADL. When comparing driving performance with cognitive evaluation by MMSE, a significant number of patients with MMSE c 22failed the test, compared to patients with MMSE > 22 (P = 0.01, Fisher's exact test). No patient with a MMSE < 20 passed the driving test. The authors recommend that health care professionals who are caring for people with Alzheimer's disease with a MMSE of22 or less should request a driving evaluation.
Ensuring the adequacy of long term care of AD patients: Special challenges and advocacy mechanisms
Authors: Kosberg Jordan I. , Garcia Juanita L. , Dulka Iryna M. 
Published: June 2007

The world is aging. The United Nations' has estimated an increase in those 65 years of age and older in the world from 6 percent of the total population in 1985 to 9.7 percent of the population by the year 2025. The growth in the elderly population is most significant among the oldest of the old. While the incidence of Alzheimer's disease (AD) is related to advanced age (as are other forms of dementia), it can be concluded that the aging of the world will result in an increase in the worldwide number of AD patients. For example, in the United States presently there are in excess of 2.5 million persons with AD and 100,000 AD patients are dying on a yearly basis-it is the fourth leading cause of death in the United States for the elderly, following heart disease, cancer, and stroke.2 Holmes et al project that the number of AD victims in the United States will increase to over 14 million persons by the year 2050.3 It has been estimated that one-third of all American families have at least one parent who has AD.4
Stages of caregiving
Authors: Pfeiffer Eric 
Published: June 2007

Scales delineating the stages of Alzheimer's disease (AD) have been published by a number of authors. These scales have been found to be extremely useful in clinical practice as well as in research on Alzheimer patients. But the care of an Alzheimer patient generally involves not only the identified patient but also a primary caregiver. Based on my work with Alzheimer patients and their families, I have recognized and described the stages of caregiving as experienced by caregivers. They are as follows: Stage 1: Coping with the initial impact of being told the diagnosis. Stage 2: To be or not to be...a caregiver? Stage 3: At-home caregiving—the long journey. Stage 4: Considering institutional placement. Stage 5: Caregiving during residential or institutional placement. Stage 6: Death of the patient—grief and relief. Stage 7: Resuming life—healing and renewal.
Long-Term Results of Local Thrombolysis Followed by First Rib Resection: An Encouraging Clinical Experience in Treatment of Subclavian Vein Thrombosis
Authors: Yilmaz E. N. , Vahl A. C. , van Heek N. T. , Vermeulen E. G. J. , Rauwerda J. A. 
Published: June 2007

The purpose of this study was to present the long-term results of our experience, which includes thrombolysis, surgical decompression, and long-term anticoagulation. The medical records of 24 patients who were admitted to Academic Hospital Vrije Universiteit, Amsterdam, the Netherlands, between January 1983 and October 1997, with effort thrombosis of the subclavian vein were reviewed. There were 21 men and 3 women, with a mean age of 30.5 years and an average duration of the symptoms of 2.9 days. Clinical diagnosis was confirmed by phlebography and duplex in all patients. A loading dose of 10,000 units streptokinase was given followed by an infusion at a rate of 10,000 units per hour. Phlebography was repeated daily in order to evaluate the effect of the treatment. Thrombolysis was achieved in 2 to 8 days (mean 5 days). After achievement of complete thrombolysis, anticoagulation with heparin and coumarin derivatives was started; the latter were continued for 3 months. Six to 12 weeks after the thrombolysis, patients with costoclavicular compression syndrome underwent surgery. A transaxillary first rib resection, partial scalenotomy, and transection of the tendon of subclavian muscle were performed. Thrombolysis was achieved in all patients but one, with a successful lysis percentage of 95.8%. In one patient, the local streptokinase therapy had to be discontinued because of pulmonary embolism. Resection of the first rib was performed on 19 patients. Two patients refused to be operated on. The other three were lost to follow-up, right after the thrombolytic therapy. In long-term evaluation, all the patients who underwent first rib resection were symptom free, whereas the two patients who refused to be operated on had pain and discoloration of the affected arm, although venous patency was achieved. The subclavian vein thrombosis occurs as a result of repetitive trauma due to anatomic constriction of the vein by the clavicle and the first rib complex. Therefore, we advise addressing the therapy not only to the superimposed thrombus but also to the correction of the underlying anatomic abnormality.