bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health Beliefs of Haitian Elders Related to Influenza Prevention
Authors: Tamara Adonis‐Rizzo M. , Jett Kathleen F. 
Published: January 2007

ABSTRACT
Objective: Each year, about 20% of the persons living in the United States gets influenza, and the majority of those who die as a consequence are over 65. Many of these deaths may be preventable. In this study, the health beliefs, attitudes, and cultural practices related to the prevention of influenza by Haitian elders are studied.Design and sample: Using a focused ethnographic approach, 10 adults above the age of 55 and born in Haiti were interviewed.Methods: Data were collected using interviews and participant observation. Interviews were conducted in Creole by the primary author. Participant observation occurred for the length of a “flu season” in a neighborhood nurse‐managed clinic during the provision of routine health care.Results: Themes of competing paradigms, fear of sickness, taking care of oneself, and cautious willingness emerged.Conclusions: The participants described what is known in western medicine as influenza, as “a cold,” or “a big cold.” While they were uncertain of influenza immunizations, there was an overwhelming willingness to accept one if recommended by respected others and trusted health providers. The results of the study can serve as a springboard for future attempts to better understand this unique and at‐risk population.
The Measles Initiative to Control Measles in Kenya
Authors: Bradsher Charlotte A. , Stotts R. Craig , Carter Michael A. , Grabowsky Mark 
Published: January 2007

ABSTRACT
Purpose: To describe the epidemiology of measles in Kenya and evaluate the Measles Initiative's (MI's) mass immunization campaign and its impact on measles control in Kenya.Methods: This descriptive study focused on evaluating the MI's simultaneous mass campaigns in the provinces of Kenya, the implementation process of the campaign strategy, post‐campaign impact data, and precampaign measles trends. Secondary data were obtained from the Kenya Ministry of Health and MI documentation involving vaccine coverage, and morbidity and mortality rates. Analysis focused on program achievement with a comparison of immunization coverage results and program goals.Outcomes: Campaign goals of vaccination coverage were successfully achieved, and subsequent surveillance data indicate significant decreases in measles morbidity and mortality. Barriers to participation, sociocultural factors, and environmental demographics were identified and addressed.Implications: The success of the MI immunization program was the result of the commitment of expert international public health agencies in partnership with the Kenyan government. The strategies used for this successful public health activity can be applied to improve vaccination programs in other countries.
A Targeted Testing Program for Tuberculosis Control and Prevention Among Baltimore City's Homeless Population
Authors: Lashley Mary 
Published: January 2007

ABSTRACT
Objective: To identify cases of latent tuberculosis infection (LTBI) and improve access to TB treatment among the inner‐city homeless.Design: This is an intervention study describing the impact of a public health program on TB prevention and control.Sample: The target population for the project was residents and recent graduates of a residential addictions recovery program in a faith‐based, inner‐city mission.Intervention: Faculty and student nurses administered purified protein derivative (PPD) tuberculin skin tests and TB symptom assessments on site to homeless Mission residents. Residents testing positive for TB infection were referred to the local city health department for follow‐up. Residents placed on prophylactic therapy received intensive tracking and coaching interventions to encourage adherence to the 9‐month regimen.Results: Ninety‐eight percent of the target population was screened for LTBI. Ninety percent of residents requiring treatment for LTBI successfully accessed treatment services. Thirty‐three percent of residents completed at least 6 months of treatment.Conclusion: The program demonstrated a modest improvement in treatment completion among the inner‐city homeless when compared with local City Health Department treatment completion rates. This program demonstrates how a faith‐based organization, an academic institution, and local government can successfully partner together to meet community needs.
Paracetamol: New Vistas of an Old Drug
Authors: Bertolini Alfio , Ferrari Anna , Ottani Alessandra , Guerzoni Simona , Tacchi Raffaella , Leone Sheila 
Published: January 2007

ABSTRACTParacetamol (acetaminophen) is one of the most popular and widely used drugs for the treatment of pain and fever. It occupies a unique position among analgesic drugs. Unlike NSAIDs it is almost unanimously considered to have no antiinflammatory activity and does not produce gastrointestinal damage or untoward cardiorenal effects. Unlike opiates it is almost ineffective in intense pain and has no depressant effect on respiration. Although paracetamol has been used clinically for more than a century, its mode of action has been a mystery until about one year ago, when two independent groups (Zygmunt and colleagues and Bertolini and colleagues) produced experimental data unequivocally demonstrating that the analgesic effect of paracetamol is due to the indirect activation of cannabinoid CB1receptors. In brain and spinal cord, paracetamol, following deacetylation to its primary amine (p‐aminophenol), is conjugated with arachidonic acid to form N‐arachidonoylphenolamine, a compound already known (AM404) as an endogenous cannabinoid. The involved enzyme is fatty acid amide hydrolase. N‐arachidonoylphenolamine is an agonist at TRPV1 receptors and an inhibitor of cellular anandamide uptake, which leads to increased levels of endogenous cannabinoids; moreover, it inhibits cyclooxygenases in the brain, albeit at concentrations that are probably not attainable with analgesic doses of paracetamol. CB1receptor antagonist, at a dose level that completely prevents the analgesic activity of a selective CB1receptor agonist, completely prevents the analgesic activity of paracetamol. Thus, paracetamol acts as a pro‐drug, the active one being a cannabinoid. These findings finally explain the mechanism of action of paracetamol and the peculiarity of its effects, including the behavioral ones. Curiously, just when the first CB1agonists are being introduced for pain treatment, it comes out that an indirect cannabino‐mimetic had been extensively used (and sometimes overused) for more than a century.
Exercise Program for Nursing Home Residents with Alzheimer's Disease: A 1‐Year Randomized, Controlled Trial
Authors: Rolland Yves , Pillard Fabien , Klapouszczak Adrian , Reynish Emma , Thomas David , Andrieu Sandrine , Rivière Daniel , Vellas Bruno 
Published: January 2007

OBJECTIVES: To investigate the effectiveness of an exercise program in improving ability to perform activities of daily living (ADLs), physical performance, and nutritional status and decreasing behavioral disturbance and depression in patients with Alzheimer's disease (AD).DESIGN: Randomized, controlled trial.SETTING: Five nursing homes.PARTICIPANTS: One hundred thirty‐four ambulatory patients with mild to severe AD.INTERVENTION: Collective exercise program (1 hour, twice weekly of walk, strength, balance, and flexibility training) or routine medical care for 12 months.MEASUREMENTS: ADLs were assessed using the Katz Index of ADLs. Physical performance was evaluated using 6‐meter walking speed, the get‐up‐and‐go test, and the one‐leg‐balance test. Behavioral disturbance, depression, and nutritional status were evaluated using the Neuropsychiatric Inventory, the Montgomery and Asberg Depression Rating Scale, and the Mini‐Nutritional Assessment. For each outcome measure, the mean change from baseline to 12 months was calculated using intention‐to‐treat analysis.RESULTS: ADL mean change from baseline score for exercise program patients showed a slower decline than in patients receiving routine medical care (12‐month mean treatment differences: ADL=0.39, P=.02). A significant difference between the groups in favor of the exercise program was observed for 6‐meter walking speed at 12 months. No effect was observed for behavioral disturbance, depression, or nutritional assessment scores. In the intervention group, adherence to the program sessions in exploratory analysis predicted change in ability to perform ADLs. No adverse effects of exercise occurred.CONCLUSION: A simple exercise program, 1 hour twice a week, led to significantly slower decline in ADL score in patients with AD living in a nursing home than routine medical care.
Effect of Institutional Respite Care on the Sleep of People with Dementia and Their Primary Caregivers
Authors: Lee David , Morgan Kevin , Lindesay James 
Published: January 2007

OBJECTIVES: To evaluate the sleep–wake patterns of community‐dwelling patients with dementia and their primary caregivers before, during, and after 2‐week periods of institutional respite care.DESIGN: Prospective case series.SETTING: Four community hospital units in East Midlands, United Kingdom.PARTICIPANTS: Thirty‐nine patients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for dementia and caregivers completed baseline assessments; 33 of these dyads completed the full protocol.INTERVENTION: A 2‐week period of institutional respite care during which patients were admitted to community hospitals (and received routine care) while caregivers remained at home.MEASUREMENTS: For patients and caregivers, primary sleep outcomes were derived from 6 weeks of continuous wrist actigraphy (2 weeks baseline; 2 weeks respite; 2 weeks follow‐up) using the Actiwatch system. For caregivers, actigraphic measures were augmented with assessments of quality of life (using the Medical Outcomes Study 36‐item Short Form survey) and quality of sleep (using the Pittsburgh Sleep Quality Index) at baseline and by daily sleep diaries and weekly Epworth Sleepiness Scale ratings throughout the study.RESULTS: At baseline, caregivers and patients showed profiles of clinically significant sleep disturbance. For caregivers, respite periods were associated with significant (P<.05) increases in total sleep time per night, total time in bed per night, and improvements in subjective sleep quality. The benefits of respite were most evident for caregivers who did not share a bedroom with the patient. For patients, respite was associated with significant (P<.05) increases in sleep onset latency, reductions in total sleep time per night, and weakening of the circadian activity rhythm. All measures shifted in the direction of baseline levels at follow‐up.CONCLUSION: Dementia caregivers show a profile of sleep disturbance consistent with adjustment insomnia, with sleep disturbances partially reversed during periods of institutional respite care. Nevertheless, for patients, respite care worsens already disturbed sleep patterns. To optimize benefits for caregivers and patients, respite care should target sleep management.
Physical Activity Is Associated with Incident Disability in Community‐Based Older Persons
Authors: Boyle Patricia A. , Buchman Aron S. , Wilson Robert S. , Bienias Julia L. , Bennett David A. 
Published: January 2007

OBJECTIVES:To examine the association between physical activity and the risk of incident disability, including impairment in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), in community‐based older persons free of dementia.DESIGN:Prospective, observational cohort study.SETTING:Approximately 40 retirement communities across the Chicago metropolitan area.PARTICIPANTS:More than 1,000 older persons from the Rush Memory and Aging Project, an ongoing longitudinal clinical‐pathological study of common chronic conditions of old age.MEASUREMENTS:All participants underwent detailed annual clinical evaluations that included assessments of physical activity, ADLs, IADLs, and gait performance. The associations between physical activity, mortality, and incident disability were examined using a series of Cox proportional hazards models controlled for age, sex, education, and baseline gait.RESULTS:At baseline, participants spent a mean±standard deviation of 3.0±3.5 hours per week engaging in physical activity (range 0–35). In a proportional hazards model, the risk of death decreased 11% (hazard ratio (HR)=0.89, 95% confidence interval (CI)=0.83–0.95) for each additional hour of physical activity per week. For those who were not disabled at baseline, the risk of developing disability in ADLs decreased 7% (HR=0.93, 95% CI=0.88–0.98) for each additional hour of physical activity per week. Similarly, the risk of disability in IADLs decreased 7% (HR=0.93, 95% CI=0.89–0.99) for each additional hour of physical activity.CONCLUSION:For community‐based older persons without dementia, physical activity is associated with maintenance of functional status, including a reduced risk of developing impairment in ADLs and IADLs.
Women Who Maintain Optimal Cognitive Function into Old Age
Authors: Barnes Deborah E. , Cauley Jane A. , Lui Li‐Yung , Fink Howard A. , McCulloch Charles , Stone Katie L. , Yaffe Kristine 
Published: January 2007

OBJECTIVES: To determine whether older women who maintain optimal cognitive function into old age differ from those who experience minor cognitive decline typically associated with normal aging.DESIGN: Prospective cohort study.SETTING: The Study of Osteoporotic Fractures.PARTICIPANTS: Nine thousand seven hundred four older women.MEASUREMENTS: A modified Mini‐Mental State Examination (mMMSE) was performed at baseline and Years 6, 8, 10, and 15. Random‐effects regression was used to classify subjects as cognitive maintainers (slope≥0), minor decliners (slope < 0 but > lowest tertile), or major decliners (slope ≤ lowest tertile). Stepwise logistic regression was used to identify factors most predictive of being a cognitive maintainer versus a minor decliner (excluding major decliners).RESULTS: Women had a mean age of 72 at baseline and 85 at follow‐up. Nine percent maintained optimal cognitive function, 58% experienced minor decline, and 33% experienced major decline. Most factors differed progressively over the three cognitive groups. After adjustment for key confounders, odds ratios for factors most predictive of being a cognitive maintainer as opposed to minor decliner were 1.9 (95% confidence interval (CI)=1.2–2.9) for lack of diabetes mellitus, 1.2 (95% CI=1.0–1.4) for lack of hypertension, 1.7 (95% CI=1.3–2.3) for lack of smoking, 1.2 (95% CI=1.1–1.5) for moderate alcohol consumption, 1.4 (95% CI=1.1–1.7) for lack of difficulty with instrumental activities of daily living, and 1.2 (95% CI=1.0–1.4) for lack of low social network.CONCLUSION: Almost 10% of older women maintained optimal cognitive function into old age. Cognitive maintainers were less likely to have comorbid medical conditions, less likely to have difficulty with daily activities or poor social networks, and more likely to engage in healthy behaviors than minor cognitive decliners.
A Randomized Trial of a Screening, Case Finding, and Referral System for Older Veterans in Primary Care
Authors: Rubenstein Laurence Z. , Alessi Cathy A. , Josephson Karen R. , Trinidad Hoyl M. , Harker Judith O. , Pietruszka Fern M. 
Published: January 2007

OBJECTIVES: To test whether a system of screening, assessment, referral, and follow‐up provided within primary care for high‐risk older outpatients improves recognition of geriatric conditions and healthcare outcomes.DESIGN: Controlled clinical trial with 3‐year follow‐up; intervention versus control group allocation based on practice group assignment.SETTING: Department of Veterans Affairs (VA) ambulatory care center.PARTICIPANTS: Seven hundred ninety‐two community‐dwelling patients aged 65 and older identified by postal screening survey.INTERVENTION: The intervention combined a structured telephone geriatric assessment by a physician assistant, individualized referrals and recommendations, selected referral to outpatient geriatric assessment, and ongoing telephone case management.MEASUREMENTS: Main outcomes were VA medical record evidence of recognition and evaluation of target geriatric conditions (depression, cognitive impairment, urinary incontinence, falls, functional impairment), functional status (Functional Status Questionnaire, FSQ), and hospitalization (VA databases and self‐reported non‐VA usage).RESULTS: Intervention participants were more likely to have target conditions recognized, evaluated, and referred to specialized services within 12 months of enrollment, although there were no significant differences in FSQ scores or acute hospitalization between intervention and control groups at 1, 2, or 3 years follow‐up. Subgroup analyses suggested improvements in depression symptoms and functional impairment at 1‐year follow‐up in intervention participants with these problems at baseline, but these findings were not evident at later follow‐up.CONCLUSION: The intervention increased recognition and evaluation of target geriatric conditions but did not improve functional status or decrease hospitalization. Innovative screening methods can identify older people in need of geriatric services, but achieving measurable improvement in functional status or hospitalization rates will likely require a more‐intensive intervention than a program involving primarily unsolicited referrals and short‐term consultations.
Association Between Advance Directives and Quality of End‐of‐Life Care: A National Study
Authors: Teno Joan M. , Gruneir Andrea , Schwartz Zachary , Nanda Aman , Wetle Terrie 
Published: January 2007

OBJECTIVES: To examine the role of advance directives (ADs) 10 years after the Patient Self‐Determination Act.DESIGN: Mortality follow‐back survey.SETTING: People who died in a nursing home, hospital, or at home.PARTICIPANTS: Bereaved family member or other knowledgeable informant.MEASUREMENTS: Telephone interviewers that asked about the use of written ADs, use of life‐sustaining treatment, and quality of care by asking whether staff provided desired symptom relief, treated the dying with respect, supported shared decision‐making, coordinated care, and provided family with the needed information and emotional support.RESULTS: Of the 1,587 people who died, 70.8% had an AD. Persons who died at home with hospice or in a nursing home were more likely to have an AD. In addition, those with an AD were less likely to have a feeding tube (17% vs 27%) or use a respirator in the last month of life (11.8% vs 22.0%). Bereaved family members who reported that the decedent did not have an AD were more likely to report concerns with physician communication (adjusted odds ratio (AOR)=1.4, 95% confidence interval (CI)=1.1–1.6) and with being informed about what to expect (AOR=1.2, 95% CI=1.0–1.3). No statistically significant differences were observed in other outcomes. Even in those with an AD, important quality concerns remained; one in four reported an unmet need in pain, one in two reported inadequate emotional support for the patient, and one in three stated inadequate family emotional support.CONCLUSION: Bereaved family member report of completion of an AD was associated with greater use of hospice and fewer reported concerns with communication, yet important opportunities remain to improve the quality of end‐of‐life care.
Shear Bond Strength Evaluation of Different Veneering Systems on Ni‐Cr Alloys
Authors: Çiftçi Yalçın , Canay Şenay , Hersek Nur 
Published: January 2007

Purpose: The aim of this study was to evaluate the shear bond strength of four esthetic veneering materials on nickel‐chromium (Ni‐Cr) alloy.
Materials and Methods: Forty square patterns (10 × 10 × 1.5 mm) were cast with Ni‐Cr, divided equally into four groups, and received four treatments for veneering: conventional porcelain‐fused‐to‐metal (PFM), Artglass, Targis/Vectris, and Biodent light‐cured prosthodontic composite resins. After sandblasting of the cast metal surfaces with 50 μm alumina, the composites were applied to the surfaces according to manufacturers' recommendations. Shear bond strength was determined at a crosshead speed of 0.5 mm/min. Results were analyzed statistically with Kruskal‐Wallis analysis of variance and multiple comparison tests.
Results: Mean shear bond strength values were 34.96 MPa for PFM, 14.17 MPa for Targis/Vectris, 13.64 MPa for Artglass, and 10.56 MPa for Biodent. The PFM group exhibited significantly higher bond strength values compared with the other three groups (p < 0.001).
Conclusion: PFM showed considerably higher shear bond strength values than the three metal‐resin bonding techniques.
Transfusion‐related acute lung injury surveillance (2003‐2005) and the potential impact of the selective use of plasma from male donors in the American Red Cross
Authors: Eder Anne F. , Herron Ross , Strupp Annie , Dy Beth , Notari Edward P. , Chambers Linda A. , Dodd Roger Y. , Benjamin Richard J. 
Published: January 2007

BACKGROUND:American Red Cross surveillance data on transfusion‐related acute lung injury (TRALI) fatalities were analyzed to evaluate the association with components from donors with white blood cell (WBC) antibodies and to examine the potential impact of the selective transfusion of plasma from male donors.STUDY DESIGN AND METHODS:Suspected TRALI reports in 2003 through 2005 were identified and all fatalities were reviewed and classified by three physicians as “probable TRALI” or of “unrelated etiology,” with independent review of the associated serologic investigation. Hospital investigational and reporting biases could not be fully controlled in this retrospective study.RESULTS:A total of 550 reports of suspected TRALI, including 72 fatalities, were investigated. The number of reports increased each year and the rate varied by geographic region. Retrospective review of fatalities revealed 38 cases of probable TRALI, the majority (24 of 38 [63%]) after plasma transfusion. A female, WBC antibody–positive donor was involved in 71 percent (27 of 38) of cases and in 75 percent (18 of 24) of cases involving plasma transfusion. Female antibody‐positive donors were more likely to be associated with probable TRALI than with unrelated cases (p = 0.0001; odds ratio [OR], 9.5; 95% confidence interval [CI], 2.9‐31.1]. The rate of probable TRALI among recipient fatalities was higher for plasma components (1:202,673; OR, 12.5; 95% CI, 5.4‐28.9) and apheresis platelets (PLTs; 1:320,572; OR, 7.9; 95% CI, 2.5‐24.8) compared to red cells (1:2,527,437). Male donors contributed 64.5 and 52.0 percent of distributed apheresis PLTs and plasma components, respectively, in 2005.CONCLUSION:Plasma components linked to female donors with WBC antibodies were responsible for the majority of probable TRALI fatalities. Prudent measures to limit transfusion of WBC antibody–containing plasma components may prevent as many as six fatalities per year in the Red Cross system.
Optimal Security Design and Dynamic Capital Structure in a Continuous‐Time Agency Model
Authors: DeMARZO PETER M. , SANNIKOV YULIY 
Published: January 2007

ABSTRACTWe derive the optimal dynamic contract in a continuous‐time principal‐agent setting, and implement it with a capital structure (credit line, long‐term debt, and equity) over which the agent controls the payout policy. While the project's volatility and liquidation cost have little impact on the firm's total debt capacity, they increase the use of credit versus debt. Leverage is nonstationary, and declines with past profitability. The firm may hold a compensating cash balance while borrowing (at a higher rate) through the credit line. Surprisingly, the usual conflicts between debt and equity (asset substitution, strategic default) need not arise.