bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender Differences in Response to Emotional Stress: An Assessment Across Subjective, Behavioral, and Physiological Domains and Relations to Alcohol Craving
Authors: Chaplin Tara M. , Hong Kwangik , Bergquist Keri , Sinha Rajita 
Published: May 2008

Background:  Women and men are at risk for different types of stress‐related disorders, with women at greater risk for depression and anxiety and men at greater risk for alcohol‐use disorders. The present study examines gender differences in emotional and alcohol craving responses to stress that may relate to this gender divergence in disorders.Method:  Healthy adult social drinkers (27 men, 27 women) were exposed to individually developed and calibrated stressful, alcohol‐related, and neutral‐relaxing imagery, 1 imagery per session, on separate days and in random order. Subjective emotions, behavioral/bodily responses, cardiovascular arousal [heart rate (HR), blood pressure (BP)], and self‐reported alcohol craving were assessed.Results:  Women reported and displayed greater sadness and anxiety following stress than men and men had greater diastolic BP response than women. No gender differences in alcohol craving, systolic BP or HR were observed. Subjective, behavioral, and cardiovascular measures were correlated in both genders. However, for men, but not women, alcohol craving was associated with greater subjective emotion and behavioral arousal following stress and alcohol cues.Conclusions:  These data suggest that men and women respond to stress differently, with women experiencing greater sadness and anxiety, while men show a greater integration of reward motivation (craving) and emotional stress systems. These findings have implications for the gender‐related divergence in vulnerability for stress‐related disorders, with women at greater risk for anxiety and depression than men, and men at greater risk for alcohol‐use disorders than women.
Decisional Capacity for Research Participation in Individuals with Mild Cognitive Impairment
Authors: Jefferson Angela L. , Lambe Susan , Moser David J. , Byerly Laura K. , Ozonoff Al , Karlawish Jason H. 
Published: May 2008

OBJECTIVES:To assess decisional capacity performance and the neuropsychological correlates of such performance to better understand higher‐level instrumental activities of daily living in individuals with mild cognitive impairment (MCI).DESIGN:Cross‐sectional.SETTING:Research center, medical center, or patient's home.PARTICIPANTS:Forty participants with MCI and 40 cognitively normal older controls (NCs) aged 60 to 90 (mean age±standard deviation 73.3±6.6; 54% female).MEASUREMENTS:Capacity to provide informed consent for a hypothetical, but ecologically valid, clinical trial was assessed using the MacArthur Competence Assessment Tool for Clinical Research. Neuropsychological functioning was assessed using a comprehensive protocol.RESULTS:Adjusted between‐group comparisons yielded significant differences for most decisional capacity indices examined, including Understanding (P=.001; NC>MCI) and Reasoning (P=.002; NC>MCI). Post hoc analyses revealed that participants with MCI who were categorized as capable of providing informed consent according to expert raters had higher levels of education than those who were categorized as incapable.CONCLUSION:The findings suggest that many individuals with MCI perform differently on a measure of decisional capacity than their NC peers and that participants with MCI who are incapable of providing informed consent on a hypothetical and complex clinical trial are less educated. These findings are consistent with prior studies documenting functional and financial skill difficulties in individuals with MCI.
Types, Prevalence, and Potential Clinical Significance of Medication Administration Errors in Assisted Living
Authors: Young Heather M. , Gray Shelly L. , McCormick Wayne C. , Sikma Suzanne K. , Reinhard Susan , Johnson Trippett Linda , Christlieb Carol , Allen Tiffany 
Published: May 2008

OBJECTIVES: To describe the types and potential clinical significance of medication administration errors in assisted living (AL).DESIGN: Cross‐sectional observational study.SETTING: This study was conducted in 12 AL settings in three states (Oregon, Washington, and New Jersey).PARTICIPANTS: Participants included 29 unlicensed assistive personnel and 510 AL residents.MEASUREMENTS: Medication administration observations, chart review, and determination of rates, types, and potential clinical significance of errors using standardized methodology.RESULTS: Of 4,866 observations, 1,373 errors were observed (28.2% error rate). Of these, 70.8% were wrong time, 12.9% wrong dose, 11.1% omitted dose, 3.5% extra dose, 1.5% unauthorized drug, and 0.2% wrong drug. Excluding wrong time, the overall error rate dropped to 8.2%. Of the 1,373 errors, three were rated as having potential clinical significance.CONCLUSION: A high number of daily medications are given in AL. Wrong time accounted for the majority of the errors. The bulk of the medications are low risk and routine; to promote optimal care delivery, clinicians need to focus on high‐risk medications and residents with complex health problems.
Identification of Older Patients with Heart Failure Who May Be Candidates for Hospice Care: Development of a Simple Four‐Item Risk Score
Authors: Huynh Bao C. , Rovner Aleksandr , Rich Michael W. 
Published: May 2008

OBJECTIVES: To identify predictors of 6‐month mortality in older patients with heart failure (HF) and to develop a risk score for identifying potential candidates for hospice care.DESIGN: Secondary data analysis of a previously conducted randomized, clinical trial.SETTING: Barnes‐Jewish Hospital, St. Louis, Missouri.PARTICIPANTS: Two hundred eighty‐two patients with HF aged 70 and older.INTERVENTION: Participants were randomized to conventional care or a multidisciplinary intervention designed to reduce rehospitalization.MEASUREMENTS: All‐cause 6‐month mortality.RESULTS: Patients were followed for up to 14 years; 43 (15.2%) died within 6 months of hospital discharge. Multivariate logistic regression analysis identified four independent predictors of 6‐month mortality: serum urea nitrogen of 30 mg/dL or greater (odds ratio (OR)=5.78, 95% confidence interval (CI)=2.65–12.66), systolic blood pressure less than 120 mmHg (OR=4.81, 95% CI=1.94–11.91), peripheral arterial disease (OR=3.09, 95% CI=1.26–7.58), and serum sodium less than 135 mEq/L (OR=2.27, 95% CI=0.98–5.27). Patients were stratified into four risk groups based on the presence or absence of these four risk factors. Six‐month mortality rates for patients with zero, one, two, or three or more risk factors were 3.7%, 16.3%, 41.0%, and 66.7%, respectively (P<.05). The presence of three or more risk factors was associated with a positive predictive value of 66.7% and a negative predictive value of 86.4%.CONCLUSION: Although additional studies are needed, these findings suggest that a simple four‐item risk score can identify older patients with HF at high risk of dying within 6 months. This may enable clinicians to better advise patients about prognosis, adjust management accordingly, and if appropriate, facilitate referral for hospice care. Conversely, patients with a more‐favorable prognosis may be suitable candidates for more‐aggressive interventions.
Gait Dysfunction in Mild Cognitive Impairment Syndromes
Authors: Verghese Joe , Robbins Matthew , Holtzer Roee , Zimmerman Molly , Wang Cuiling , Xue Xiaonan , Lipton Richard B. 
Published: May 2008

OBJECTIVES: To conduct a systematic clinical and quantitative assessment of gait in older adults with mild cognitive impairment (MCI) syndromes.DESIGN: Cross‐sectional.SETTING: Einstein Aging Study, a community‐based longitudinal aging study.PARTICIPANTS: Fifty‐four individuals with amnestic MCI (a‐MCI), 62 with nonamnestic‐MCI (na‐MCI), and 295 healthy controls identified from the Einstein Aging Study participants.MEASUREMENTS: Comparison of clinical and quantitative gait performance in subjects with MCI subtypes with that of cognitively normal older adults.RESULTS: Neurological gaits were more common in a‐MCI (31.5%, P=.008) but not in na‐MCI (19.4%, P=.55), than in controls (16.3%). Quantitative gait in multiple parameters was worse in both MCI subtypes than in controls. Factor analysis revealed three independent factors representing pace, rhythm, and variability. Subjects with a‐MCI had worse rhythm and variability scores than those with na‐MCI and controls. Subjects with na‐MCI had worse performance on the pace domain than the other two groups. Subjects with MCI and gait abnormalities had higher disability scores than subjects with MCI without gait abnormalities.CONCLUSION: Gait dysfunction is common in older individuals with amnestic and nonamnestic subtypes of MCI.
Stage 2 Pressure Ulcer Healing in Nursing Homes
Authors: Bergstrom Nancy , Smout Randall , Horn Susan , Spector William , Hartz Arthur , Limcangco M. Rhona 
Published: May 2008

OBJECTIVES: To identify resident and wound characteristics associated with Stage 2 pressure ulcer (PrU) healing time in nursing home residents.DESIGN: Retrospective cohort study with convenience sampling.SETTING: One hundred two nursing homes participating in the National Pressure Ulcer Long‐Term Care Study (NPULS) in the United States.PARTICIPANTS: Seven hundred seventy‐four residents aged 21 and older with length of stay of 14 days or longer who had at least one initial Stage 2 (hereafter Stage 2) PrU.MEASUREMENTS: Data collected for each resident over a 12‐week period included resident characteristics and PrU characteristics, including area when first reached Stage 2. Data were obtained from medical records and logbooks.RESULTS: There were 1,241 initial Stage 2 PrUs on 774 residents; 563 (45.4%) healed. Median time to heal was 46 days. Initial area was significantly associated with days to heal. Using Kaplan‐Meier survival analyses, median days to heal was 33 for small (≤1 cm2), 53 days for medium (>1 to ≤4 cm2), and 73 days for large (>4 cm2) ulcers. Using Cox proportional hazard regression models to examine effects of multiple variables simultaneously, small and medium ulcers and ulcers on residents with agitation and those who had oral eating problem healed more quickly, whereas ulcers on residents who required extensive assistance with seven to eight activities of daily living (ADLs), who temporarily left the facility for the emergency department (ED) or hospital, or whose PrU was on an extremity healed more slowly.CONCLUSION: PrUs on residents with agitation or with oral eating problems were associated with faster healing time. PrUs located on extremities, on residents who went temporarily to the ED or hospital, and on residents with high ADL disabilities were associated with slower healing time. Interaction between PrU size and place of onset was also associated with healing time. For PrU onset before or after admission to the facility, smaller size was associated with faster healing time.
The effect of gamma irradiation on the quality of apheresis platelets during storage for 7 days
Authors: Tynngård Nahreen , Studer Monika , Lindahl Tomas L. , Trinks Marie , Berlin Gösta 
Published: May 2008

BACKGROUND: This study compares the quality of gamma‐irradiated versus nonirradiated platelet (PLT) concentrates (PCs) during storage for 7 days as assessed by various in vitro methods. A new technique, free oscillation rheometry (FOR), which measures clotting time and coagulum elasticity, was also used to evaluate the PLT function.STUDY DESIGN AND METHODS: Single‐donor PLTs were collected by apheresis technique (n = 20). The PLTs from each donor were divided into two PCs, one gamma‐irradiated with 25 Gy and the other used as a nonirradiated control. Blood gases, metabolic variables, and swirling were analyzed from Day 0. Samples taken on Days 1, 5, and 7 were also analyzed for hypotonic shock response (HSR), P‐selectin, and glycoprotein (GP)Ib expression by flow cytometry and coagulation by FOR.RESULTS: Swirling, HSR, and the percentage of GPIb‐expressing cells were well maintained for 7 days of storage. pH was always within accepted range (6.4‐7.4). Glucose decreased and lactate increased during the storage period (p < 0.05). P‐selectin expression increased during storage (p < 0.05). The FOR clotting time remained constant, whereas the build‐up of elasticity was slower after storage (p < 0.05). No difference was found between irradiated and nonirradiated PCs.CONCLUSION: The results indicate a well‐preserved quality of gamma‐irradiated apheresis PLTs during storage for 7 days as assessed by in vitro methods, with no difference compared to nonirradiated PLTs.
Oviposition site selection by herbivorous beetles: a comparison of two thistle feeders, Cassida rubiginosa and Henosepilachna niponica
Authors: Fujiyama Naoyuki , Torii Chiharu , Akabane Michiko , Katakura Haruo 
Published: May 2008

AbstractIn insects that feed on plants in both adult and larval stages, it is often difficult to distinguish oviposition preference from adult feeding preference, because oviposition can occur at or in proximity to feeding sites. In the present study, characteristics of oviposition site selection of two beetle species, Cassida rubiginosa Müller (Coleoptera: Chrysomelidae) and Henosepilachna niponica (Lewis) (Coleoptera: Coccinellidae), were investigated in the field and laboratory, with particular attention to relationships with adult feeding sites. In the field, distances between adult feeding scars and egg masses differed for C. rubiginosa and H. niponica, with the former being very small and the latter averaging 24.6 cm. The same tendencies for the distances between adult feeding scars and egg masses of the two beetle species were confirmed in cages in which only female beetles were released. Cassida rubiginosa restricted egg laying to host plants in the field and to leaves in laboratory assays. On the other hand, H. niponica placed 8% of egg masses on plants adjacent to host plants in the field and often placed eggs on artificial substrates rather than leaf discs in laboratory assays. These results suggest that oviposition and female feeding sites are virtually inseparable in the case of C. rubiginosa, while H. niponica females do not necessarily keep to host plant leaves as oviposition substrates and they tend to oviposit at some distance from their feeding sites. Results are discussed in relation to proximate and ultimate causes of host selection behavior.
Evaluation of early stimulation programs for enhancing brain development
Authors: Bonnier Christine 
Published: May 2008

AbstractThe term ‘early intervention’ designates educational and neuroprotection strategies aimed at enhancing brain development. Early educational strategies seek to take advantage of cerebral plasticity. Neuroprotection, a term initially used to characterize substances capable of preventing cell death, now encompasses all interventions that promote normal development and prevent disabilities, including organisational, therapeutic and environment‐modifying measures, such as early stimulation programs. Early stimulation programs were first devised in the United States for vulnerable children in low‐income families; positive effects were recorded regarding school failure rates and social problems. Programs have also been implemented in several countries for premature infants and low‐birth‐weight infants, who are at high risk for neurodevelopmental abnormalities. The programs target the child, the parents or both. The best evaluated programs are the NIDCAP (Newborn Individualized Developmental Care and Assessment Program) in Sweden for babies <1500 g in neonatal intensive care units and the longitudinal multisite program IHDP (Infant Health and Development Program) created in the United States for infants <37 weeks or <2500 g.Conclusion: Although the NIDCAP and the IHDP targeted different populations, they produced similar effects in several regards: efficacy was greatest with programs involving both the parents and the child; long‐term stimulation improved cognitive outcomes and child–parent interactions; cognition showed greater improvements than motor skills and larger benefits were obtained in families that combined several risk factors including low education attainment by the mothers.
Quality of life in chronic illness: children, parents and paediatricians have different, but stable perceptions
Authors: Janse A J , Sinnema G , Uiterwaal C S P M , Kimpen J L L , Gemke R J B J 
Published: May 2008

AbstractAim: Quality of life assessments can be helpful to estimate the well‐being of chronically ill children. The aim of this study was to investigate the differences in perception of health‐related quality of life (HRQoL) among children, parents and paediatricians at the time of diagnosis and after initial treatment in four chronic diseases.Methods: HRQoL was assessed with the Health Utilities Index mark 3 (HUI3). The HUI3 consists of eight attributes (vision, hearing, speech, ambulation, dexterity, emotion, cognition and pain).Results: Nineteen paediatricians and 60 patients (aged 10–17 years) and their parents with newly diagnosed acute lymphoblastic leukaemia, juvenile idiopathic arthritis, asthma or with cystic fibrosis admitted for pneumonia participated in the study.Health and well‐being perceptions were clearly different among paediatricians, parents and patients, both at diagnosis and after initial treatment. Perception differences were more prominent in the subjective attributes, emotion and pain. The agreement for these attributes was 23% and 5%, respectively. Paediatricians assessed the patients to have less pain than the patients and parents did. The reverse was true for the attribute emotion. At follow‐up, the agreement was higher for the attributes ambulation and pain.Conclusion: At the onset of a chronic disease and after initial treatment, paediatricians, parents and children have different perceptions of the child's quality of life, particularly as to the subjective attributes pain and emotion. In view of these differences in perception among patients, their caregivers and paediatricians, this study suggests that whenever possible, multi‐respondent assessment of HRQoL should be considered.
Factors related to fatigue among older patients with heart failure in primary health care
Authors: Hägglund Lena , Boman Kurt , Stenlund Hans , Lundman Berit , Brulin Christine 
Published: May 2008

Aim.  Our aim was to explore the relationship between fatigue and physical, mental, social and demographic factors among older patients with heart failure, with special reference to gender.Background.  If interventions aimed at preventing or alleviating fatigue are to be successful, more knowledge about factors associated with fatigue is needed.Design.  A cross‐sectional design was used.Methods.  Forty‐nine patients aged 77.7 ± 8.7 years (21 men and 28 women) with verified heart failure from one primary healthcare centre answered a questionnaire including Multi‐dimensional Fatigue Inventory, 36‐item Short‐Form Health Survey, Geriatric Depression Scale, Self‐Transcendence Scale, Resilience Scale, Social Provision Scale and demographic variables. Descriptive statistics and multiple linear regression analyses were conducted.Results.  Levels of general fatigue were high (mean 14.6 ± 3.9). Female gender (β = 0.280, P = 0.033) and role function for physical reasons (β = −0.458, P = 0.001) explained 36% of the variance in general fatigue.Conclusions.  Fatigue was more closely related to limitations in role functioning for physical reasons than to reduced physical function per se or to mental and social factors. Women reported more fatigue than men.Relevance to clinical practice.  Caregivers should examine the impact of fatigue in everyday life for each individual.
Transitions in men’s caring identities: experiences from home‐based care to nursing home placement
Authors: Eriksson Henrik , Sandberg Jonas 
Published: May 2008

Objectives.  The aim of this study is to describe, from a gender identity perspective, the experiences of older men involved in the process of caring for a partner at home and the placement into a nursing home.Background.  Few studies have paid attention to the importance of gender when considering the social experiences of older men providing care for an ill spouse and finally placing a partner in a nursing home. Further understanding is much needed of how older men experience the process of caring for a spouse from a gender identity perspective.Design.  A qualitative constructivist approach was adopted for this study.Participants.  Data consists of interviews with seven men that have been informal carers and experienced the placement of their wife in a nursing home.Methods.  Interviews were analysed with a constructivist approach.Results.  The results indicate that men go through two transitions in their gender identity during the caregiving process and placement. From the mutual loving relationship of being a loving husband, the social responsibility of daily care of their wives changes the situation into that of being a caring husband, and finally with the move to a nursing home there is a transition from intimate care to a relationship based on friendship.Conclusions.  The results show that older caregiving men undergo a process involving a reconstruction of gender identity. To formally recognize men’s caring activities and to make them sustainable, we believe that men in an informal caring relationship need support.Relevance to clinical practice.  Nurses need to recognize the identity struggles resulting in sadness and suffering that are related to changes in men’s lives during the caregiving process. Understanding the dynamics and changes that occur when men take on a caring task is important for the development of their role as carers.
Transnational Family Dynamics, Second Generation and the Ties that Flex: Palestinian Migrants between the United States and the West Bank
Authors: Isotalo Riina 
Published: May 2008

AbstractThis article aims at supplementing the discussions on transnational family life and second generation. More specifically, it aims to look at the consequences of spatially fractured parent-child and kin relations and the years spent in the United States in the encounters between young women and different collectives in Palestine; how background shaped their experiences 'at home'. It also intends to distinguish between different family members and power relations and agency created and sustained through transnational family ties. Second- and third-generation transnational ties and practises are often approached from the perspective of the migration destination country. The present article, however, sheds light to the perspective of country of origin and 'reverse migrants' as Levitt (2002) put it. I refer to these individuals as transmigrants (Basch et al. 1994), return migrants and in some cases returnees. The paper argues that young western-born return migrant women associate with transnational family in shifting and sometimes-ambivalent ways that reflect their responses to gendered and generational forms of incorporation and rejection that female transnationals face in specific societal contexts. The argument implicates that the meanings of transnational family ties and the motives behind transnational practices can change even during a rather short time-span. Yet the forms of transnational practices, such as marriage patterns, may remain seemingly traditional. The paper concludes that transnational family ties are a resource for Palestinian migrants of second and third generation; they remain meaningful even when young transmigrants have a conscious oppositional stand in relation to gender roles and family ideology that these ties imply.