bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Results of a New Method of Treatment for Idiopathic Congenital Vertical Talus
Authors: Dobbs Matthew B. , Purcell Derek B. , Nunley Ryan , Morcuende Jose A. 
Published: March 2007

BACKGROUND:
The treatment of idiopathic congenital vertical talus has traditionally consisted of manipulation and application of casts followed by extensive soft-tissue releases. However, this treatment is often followed by severe stiffness of the foot and other complications. The purpose of this study was to evaluate a new method of manipulation and cast immobilization, based on principles used by Ponseti for the treatment of clubfoot deformity, followed by pinning of the talonavicular joint and percutaneous tenotomy of the Achilles tendon in patients with idiopathic congenital vertical talus.
METHODS:
The cases of eleven consecutive patients who had a total of nineteen feet with an idiopathic congenital vertical talus deformity were retrospectively reviewed at a minimum of two years following treatment with serial manipulations and casts followed by limited surgery consisting of percutaneous Achilles tenotomy (all nineteen feet), fractional lengthening of the anterior tibial tendon (two) or the peroneal brevis tendon (one), and percutaneous pin fixation of the talonavicular joint (twelve). The principles of manipulation and application of the plaster casts were similar to those used by Ponseti to correct a clubfoot deformity, but the forces were applied in the opposite direction. Patients were evaluated clinically and radiographically at the time of presentation, immediately postoperatively, and at the time of the latest follow-up. Radiographic measurements obtained at these times were compared. In addition, the radiographic data at the final evaluation were compared with normal values for an individual of the same age as the patient.
RESULTS:
Initial correction was obtained both clinically and radiographically in all nineteen feet. A mean of five casts was required for correction. No patient underwent extensive surgical releases. At the final evaluation, the mean ankle dorsiflexion was 25° and the mean plantar flexion was 33°. Dorsal subluxation of the navicular recurred in three patients, none of whom had had pin fixation of the talonavicular joint. At the time of the latest follow-up, there was a significant improvement (p < 0.0001) in all of the measured radiographic parameters compared with the pretreatment values, and all of the measured angles were within normal values for the patient's age.
CONCLUSIONS:
Serial manipulation and cast immobilization followed by talonavicular pin fixation and percutaneous tenotomy of the Achilles tendon provides excellent results, in terms of the clinical appearance of the foot, foot function, and deformity correction as measured radiographically at a minimum two years, in patients with idiopathic congenital vertical talus.
Mechanical Distraction for the Treatment of Posttraumatic Stiffness of the Elbow in Children and Adolescents
Authors: Mader Konrad , Koslowsky Thomas Christian , Gausepohl Thomas , Pennig Dietmar 
Published: March 2007

BACKGROUND:
Elbow contracture is a recognized sequela of elbow injuries in children and adolescents, but previous studies of operative treatment with formal capsular release have demonstrated unpredictable outcomes and unfavorable results.
METHODS:
Over a period of five years, fourteen children and adolescents with a mean age of fourteen years who had posttraumatic stiffness of the elbow were managed according to a prospective protocol. Eleven patients had undergone a mean of three previous operative procedures before the index operation. After intraoperative distraction with an external fixator, there was a relaxation phase for six days followed by mobilization of the elbow joint under distraction in the fixator for a mean of seven weeks. Intraoperative range of motion under distraction reached a mean of 100°. Open arthrolysis was not performed, but in four children impinging heterotopic bone was removed through a limited approach. Decompression of the ulnar nerve was performed in seven patients.
RESULTS:
The mean preoperative arc of total elbow motion was 37°. The mean pronation was 46°, and the mean supination was 56°. After a mean duration of follow-up of thirty-four months, all patients but two had achieved an arc of motion of 100°. The mean arc of flexion-extension was 108° (range, 75° to 130°). The mean range of pronation was 73° (range, 20° to 90°), and the mean range of supination was 75° (range, 10° to 90°). There were no pin-track infections or deep infections, and all elbows were stable. At the time of follow-up, three patients had radiographic evidence of humeroulnar degeneration.
CONCLUSIONS:
Closed distraction of the elbow joint with use of a monolateral external fixation frame with motion capacity yields more favorable results than other previously reported options for the treatment of posttraumatic elbow contractures in children and adolescents.
Solid Phosphorus Phase in Aluminum‐ and Iron‐Treated Biosolids
Authors: Huang Xiao‐Lan , Chen Yona , Shenker Moshe 
Published: March 2007

ABSTRACTStabilization of phosphorus (P) in sewage sludge (biosolids) to reduce water‐soluble P concentrations is essential for minimizing P loss from amended soils and maximizing the capacity of the soil to safely serve as an outlet for this waste material. The chemical form at which P is retained in biosolids stabilized by Al2(SO4)3·18H2O (alum) or FeSO4·7H2O (FeSul) was investigated by scanning electron microscopy (SEM) equipped with energy‐dispersive X‐ray elemental spectrometry (EDXS) and by X‐ray diffraction (XRD). Both treatments resulted in the formation of a Ca‐P phase, probably brushite. Phosphorus was further retained in the alum‐treated biosolids by precipitation of an Al‐P phase with an Al/P molar ratio of about 1:1, while in the FeSul‐treated biosolids, P was retained by both precipitation with Fe/P molar ratios of 1:1 or 1.5:1, and by adsorption onto newly formed Fe hydroxides exhibiting an Fe/P molar ratio of up to 11:1. All of these mechanisms efficiently reduced P solubility and are crucial in biosolids environmentally safe agronomic beneficial use for this waste product; however, each P phase formed may react differently in the amended soil, depending on soil properties. Thus, the proper P stabilization method would depend on the target soil.
Sources of Sediment and Phosphorus in Stream Flow of a Highly Productive Dairy Farmed Catchment
Authors: McDowell R. W. , Wilcock R. J. 
Published: March 2007

ABSTRACTBoth sediment and phosphorus (P) are important contaminants for surface water quality. Knowing the main sources of sediment and P loss within agricultural catchments enables mitigation practices to be better targeted. With this in mind seasonal loads of suspended sediment (SS), dissolved reactive P (DRP), total P (TP), and bioavailable P (BAP) were measured in a low gradient stream draining an intensively farmed New Zealand dairying catchment. Integrating in situ samplers were deployed to collect samples and the results merged with continuous flow data to calculate seasonal loads during 2005 through 2006. Flow rate, SS, and TP concentrations peaked in winter‐spring and were lowest in summer‐autumn. Concentrations of BAP in trapped sediment were greatest in autumn, contrasting with winter and spring when greater amounts of sediment were trapped, but with lower P enrichment. Analysis of 137Cs and mixing model output showed that a major source of sediment and associated P in winter and spring was stream banks. Possible causes for this include trampling and destabilization by stock, channel straightening and sediment removal, and removal of riparian trees that stabilize banks. Modelling indicated that overland flow probably from topsoil (but could include sediment from lanes) contributed most sediment during summer and autumn. Remediation aimed at decreasing particulate P inputs to streams should focus on riparian protection measures, such as permanent stock exclusion and planting with shrubs and trees, ensuring runoff from lanes is minimized, and decreasing Olsen P to nearer optimum agronomic levels.
Traditional Chinese Medicine in the Treatment of Diabetes
Authors: Covington Maggie B. 
Published: March 2007

In Brief
Traditional Chinese medicine (TCM) is a system of healing that is thousands of years old. It has long been utilized in the Chinese culture to treat the complex of symptoms that Western medicine terms diabetes mellitus. This article will outline the key concepts and therapies of TCM that play a role in the evaluation and treatment of diabetic patients.
Case Study: Infections in Diabetes Mellitus
Authors: Schaberg Dennis S. , Norwood John M. 
Published: March 2007

In Brief
Acute care for patients with diabetes varies greatly depending on the nature of the patients’ primary illness and physical condition during hospitalization. The following two case studies review common considerations when treating 1) diabetic patients who develop infections; and 2) hyperglycemic inpatients who have had an acute myocardial infarction or cerebrovascular accident.
Management of Diabetes Mellitus in Surgical Patients
Authors: Dagogo-Jack Samuel , Alberti K. George M.M. 
Published: March 2007

In Brief
Diabetes is associated with increased requirement for surgical procedures and increased postoperative morbidity and mortality. The stress response to surgery and the resultant hyperglycemia, osmotic diuresis, and hypoinsulinemia can lead to perioperative ketoacidosis or hyperosmolar syndrome. Hyperglycemia impairs leukocyte function and wound healing. The management goal is to optimize metabolic control through close monitoring, adequate fluid and caloric repletion, and judicious use of insulin.
Cognitive Functioning and Self-Management in Older People With Diabetes
Authors: Asimakopoulou Koula , Hampson Sarah E. 
Published: March 2007

The extent to which diabetes is responsible for cognitive dysfunction in older people continues to be investigated. Research is also being conducted to better understand why people with diabetes find self-management of their illness a challenge and to develop behavioral interventions to help older people improve their diabetes self-management. There is little research combining these two issues, that is, whether the level and type of cognitive impairment associated with diabetes affects people’s self-management. In this article, we review the evidence for deficits in cognitive functioning in older people with diabetes (predominantly type 2) and consider the implications for diabetes self-management.Case-control and epidemiological studies comparing cognitive functioning of older people with and without diabetes have yielded inconsistent findings. However, one may draw the broad conclusion that there is some evidence of decline in more complex aspects of cognitive function, such as verbal memory, learning, and psychomotor efficiency. Cognitive functioning is probably also adversely affected by age, illness duration, glycemic control, and the presence of other co-morbid conditions. People with diabetes are at increased risk for dementia. This research is limited by lack of consensus on cognitive measures across studies and small sample sizes limiting power to detect differences. We summarize the findings from our study relating cognitive functioning to self-management behaviors for older people with type 2 diabetes, in which we found only a few associations.On the basis of the available evidence, we conclude that the cognitive impairment associated with relatively uncomplicated type 2 diabetes in older adults is unlikely to adversely affect self-management of the illness.
Evidence-Based Trends for Achieving Weight Loss and Increased Physical Activity: Applications for Diabetes Prevention and Treatment
Authors: Delahanty Linda M. 
Published: March 2007

In Brief
The prevalence of overweight and obesity is increasing dramatically and so is the incidence of type 2 diabetes. Evidence-based treatment recommendations for overweight and obesity have been published, and recent research has demonstrated that lifestyle interventions, primarily weight loss and increased activity, are very effective in preventing diabetes. It is time to critically evaluate evidence-based treatment trends in these areas and reassess our clinical practice guidelines. Emerging evidence on the effectiveness of meal replacements for weight loss, for example, is impressive and warrants attention. Evidence-based research trends suggest that we should include the use of meal replacements in our repertoire of weight-loss strategies to help people prevent and treat type 2 diabetes.
Interactions Between Complementary Therapies or Nutrition Supplements and Conventional Medications
Authors: Shane-McWhorter Laura , Geil Patti 
Published: March 2007

In Brief
Although there are many effective diabetes medications, patients with diabetes may decide to use complementary therapies or nutrition supplements in addition to their conventional medications. The two case studies presented in this article review drug interactions and other issues that must be considered when patients decide to combine traditional medications with other therapies.
Familial Clustering of Diabetic Nephropathy: Perceptions and Risk Recognition Among Mexican-American Patients With a Family History of Diabetes
Authors: Arar Nedal H. , Hazuda Helen P. , Plaetke Rosemarie , Sartorio Valeria , Arar Mazen Y. , Abboud Hanna E. 
Published: March 2007

Abstract
Objective. Diabetic nephropathy (DN) clusters in families with type 2 diabetes, suggesting a genetic susceptibility for its development and progression. We investigated DN probands’ and relatives’: 1) perceptions of the causes and clustering of DN and 2) recognition of their genetic susceptibility and of other selected risk factors.
Research methods. Structured interviews were conducted with 246 Mexican-American participants in the Family Investigation of Nephropathy and Diabetes (FIND) study using the Contextual Assessment Approach Questionnaire (CAA-Q). A total of 105 (43%) DN probands and 141 (57%) first-degree relatives were enrolled. Subjects averaged 56 years of age (range: 33–76; SD: 9.04); 62% were females. Data analysis included both qualitative and quantitative methods using Atlas.ti and SPSS 9.0 software packages.
Results. Eighty-three percent of subjects recognized that type 2 diabetes clusters in their family, while 63% asserted that DN did not. Fifty-three percent of diabetic relatives presented with a high urinary albumin/creatinine ratio (≥0.03) and were unaware of having DN (P ≤0.05). All subjects viewed DN as a component of type 2 diabetes and not a separate disease entity. More than 80% of the subjects considered ethnicity but not age of onset or sex as risk factors for developing type 2 diabetes or DN.
Conclusion. Participants viewed type 2 diabetes and DN in the context of health behaviors related to their everyday activities. They considered DN to be part of diabetes with no direct genetic predisposition and not a separate entity. Diabetic relatives under-estimated their risks for developing DN and were not engaged in preventive measures to reduce these risks. We recommend that health professionals consider these findings when interacting with high-risk diabetic patients. DN is a serious complication of diabetes that requires special care, education, prevention, and management.
Psychological Functioning of Obese Individuals
Authors: Fabricatore Anthony N. , Wadden Thomas A. 
Published: March 2007

In BriefThis review found that obese individuals in the general population have essentially normal psychological functioning. Obese women, however, are at greater risk than obese men of depression and related complications. Binge eating and extreme obesity further increase the likelihood of patients reporting emotional complications. Pharmacotherapy and psychotherapy may be of benefit in this subset of individuals.
Development and Validation of the Diabetes Quality of Life Brief Clinical Inventory
Authors: Burroughs Thomas E. , Desikan Radhika , Waterman Brian M. , Gilin Debra , McGill Janet 
Published: March 2007

Objective. To design and test the reliability and validity of a brief, treatment-focused version of the Diabetes Quality of Life (DQOL) questionnaire for use with both type 1 and type 2 diabetes.

Research design and methods. Questionnaire packets including the DQOL, measures of current diabetes self-care behaviors, and demographic and health characteristics were mailed to 1,080 adults with type 1 or type 2 diabetes. A total of 498 patients returned completed packets. A three-stage statistical process was used to understand the underlying structure of the DQOL and to identify items most predictive of self-care behaviors and satisfaction with diabetes control.

Results. Principal components analysis, conducted on 26 items predictive of the main criteria, identified five key underlying factors. For each component, best subset regression analysis was conducted to identify nonredundant questions that best explained self-care behaviors and satisfaction with diabetes control.
A combined set of 15 questions was reliable (alpha = 0.85) and valid, though several questions were more relevant to type 1 or type 2 diabetes. For patients with type 1 diabetes, the 15-item brief inventory was equally or more effective at predicting self-care behaviors (shortened scale R2 = 0.360; full scale R2 = 0.254) and satisfaction with diabetes control (shortened scale R2 = 0.562; full scale R2 = 0.580) than the original 60-item DQOL. For type 2 diabetic patients, only satisfaction with diabetes control was well-predicted, but the 15-item inventory accounted for as much variance as the original 60-item DQOL (shortened scale R2 = 0.513; full scale R2 = 0.492).

Conclusions. The 15-item DQOL Brief Clinical Inventory provides a total health–related quality of life score that predicts self-reported diabetes care behaviors and satisfaction with diabetes control as effectively as the full version of the instrument. In addition, it provides a vehicle for quickly screening patients for readiness and specific treatment-related concerns. It takes about 10 minutes to administer and can be used to identify quality of life issues that might not arise during the typical patient-provider encounter.
Identifying and Prioritizing Diabetes Care Issues Among Mental Health Professionals of a Multi-Ethnic, State Psychiatric Hospital
Authors: Kaholokula Joseph Keawe’aimoku , Schirmer Todd N. , Elting Dirk 
Published: March 2007

Objective. The purpose of this study was to identify and prioritize diabetes care issues in a multi-ethnic, state psychiatric hospital.
Research design and methods. The nominal group technique (NGT) was used to gather qualitative and quantitative data. Three NGT groups were conducted with various mental health professionals from the hospital.
Results and conclusions. The overall results indicated that the primary concerns relating to diabetes care among hospital staff included 1) lack of knowledge of diabetes care by both patients and staff; 2) lack of proper training in diabetes care among staff; 3) poor communication between hospital units and mental health disciplines; and 4) need for a multi-modal and cross-cultural approach to diabetes care.
A Gym-Based Wellness Challenge for People With Type 2 Diabetes: Effect on Weight Loss, Body Composition, and Glycemic Control
Authors: Tucker Richard M. , May Casey , Bennett Richard , Hymer Jenny , McHaney Blair 
Published: March 2007

Context. Modification of diet and exercise is known to be effective in treating diabetes and obesity, but options for practical, effective interventions are few.Objective. To assess the effectiveness of a gym-based fitness competition with financial incentives in weight loss and diabetes control in adults with type 2 diabetes.Design. Retrospective analysis of outcomes of a quality improvement initiative in diabetes care. Analysis was made from comparisons of measurements made of participants before enrollment to those of the subset of enrolling participants who finished the challenge.Setting. Outpatient multispecialty group practice clinic and private gym in rural eastern Washington State.Participants. Sixty-nine adults with type 2 diabetes who were followed by the participating clinic. Participants were recruited from diabetes disease management registries and from newspaper and posted advertisements.Interventions. Participants competed in a 5.5-month, gym-based structured exercise and diet program with close clinical monitoring. Substantial financial awards were made at the end of the program based on a point system that included credits for diet tracking, gym attendance, body composition improvement, participation in patient education sessions, and adherence to the diabetes care regimen.Main outcome measures. The primary outcomes were weight loss and body composition improvement. Secondary outcomes included quality of life assessment and improvements in hemoglobin A1c (A1C) and lipid levels.Results. Thirty participants (45%) finished the program and could be evaluated. Significant (P &lt; 0.05) improvements were seen for A1C results; weight loss; decrease in body fat; inches lost from abdomen, thigh,and hips; and physical component score from a quality-of-life scale (the Short-Form 8 [SF-8] health survey). Weight loss was seen in 28 of the 30 patients who completed the program (mean loss = 15.9 lb; median = 14.5 lb;range = 4.5–49.7 lb). A1C reductions were seen in 86% of these participants (mean = –1.52%; median = –1.6%; range = +0.8 to–5.0%). Physician-directed reduction of one or more diabetes,lipid-lowering, or anti-hypertensive medications occurred in 28%, and discontinuation of one more medications occurred in 28%.Conclusion. Structured financial incentives are highly effective in achieving weight loss and improved clinical outcomes in some adults with type 2 diabetes.
Point-of-Care Testing in Diabetes Management: What Role Does It Play?
Authors: Brown Judith Belle , Harris Stewart B. , Webster-Bogaert Susan , Porter Sheila 
Published: March 2007

Diabetes is a multisystem disease requiring complex management provided by a variety health care professionals (HCPs). Comprehensive care of patients with diabetes requires frequent testing of hemoglobin A1c (A1C),and research indicates that use of point-of-care testing (POCT) can affect patients' A1C results in the shortterm. The purpose of this qualitative study was to explore the ideas, opinions, and expectations of HCPs and patients with diabetes about the potential role of POCT, including its impact on patient-provider interactions, patient care, and issues of implementation.In-depth interviews, which were audiotaped and transcribed verbatim, were conducted with key stakeholders. The analysis used immersion and crystalization strategies. Thirty-seven interviews were conducted: seven with endocrinologists and internists, seven with family physicians, eight with diabetes educators, seven with family practice nurses, and eight with patients with diabetes.Two major themes emerged from the data analysis: 1) the impact of POCT on the clinical encounter and the care of patients, and 2) the POCT machine, including accuracy and the cost of incorporating the machine into clinical practice. The analysis revealed strong similarities across all groups of HCPs, and patients also expressed similar concerns.This study illuminates perceptions of HCPs and patients regarding the impact of POCT on diabetes management. POCT was viewed as having many benefits in the clinical care of patients with diabetes, including face-to-face encounters that offer immediate feedback, proactive patient education,increased collaboration between patients and providers, and improved patient adherence. However, logistical issues, such as the machine's accuracy and cost factors, could be significant barriers to implementation