bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying undiagnosed dementia in residential care veterans: comparing telemedicine to in‐person clinical examination
Authors: Shores Molly M. , Ryan‐Dykes Peggy , Williams Rhonda M. , Mamerto Bless , Sadak Tatiana , Pascualy Marcella , Felker Bradford L. , Zweigle Mercedes , Nichol Paul , Peskind Elaine R. 
Published: January 2004

AbstractBackgroundDementia is a common but frequently undiagnosed problem in aging. Barriers to early diagnosis include a lack of routine screening for dementia and a lack of access to specialty consultative services. We conducted a pilot study to see if telemedicine could provide reliable, accurate geriatric consultative services to evaluate patients for dementia who were residing at remote sites.MethodsThis was a prospective cohort study that compared the diagnostic reliability of telemedicine to an in‐person examination for dementia. Eligible subjects were residents of a Washington State Veterans' Home, age 60 years or older, with no prior diagnosis of dementia. Eligible subjects were screened for dementia using the 7‐Minute Screen. Veterans who screened positive and consented to participate in the study received an in‐person neuropsychiatric evaluation at baseline, and then both telemedicine and in‐person examinations for dementia conducted by experienced geriatric psychiatrists. The accuracy of the telemedicine diagnosis was estimated by comparing it to the diagnosis from the clinical examination. Three geriatric psychiatrists who were blinded to the results of the clinical examination conducted the telemedicine and in‐person examinations. We also assessed attitudes of the subjects and geriatric psychiatrists towards the telemedicine sessions.ResultsEighteen of 85 subjects screened were ‘positive’ for dementia on the 7 Minute Screen. Of these, 16 consented to participate in the telemedicine study. Twelve of the 16 subjects were subsequently diagnosed with dementia by the telemedicine examination. The telemedicine diagnoses were in 100% agreement with the diagnoses from the in‐person clinical examinations. Moreover, the subjects reported a high degree of satisfaction with the telemedicine experience and that they would like to have further care through telemedicine in the future. The geriatric psychiatrists reported technical difficulties with the audio‐visual quality of telemedicine in the initial phases of the project that resolved as familiarity with the telemedicine equipment increased. None of these problems had an adverse impact on the diagnostic accuracy of telemedicine.ConclusionsWe found that telemedicine was as accurate as an in‐person clinical examination in establishing the diagnosis of dementia. In addition, subjects reported a high degree of satisfaction with telemedicine and a willingness to participate in telemedicine clinical care in the future. Given the large increase in the aging population and the shortage of geriatric psychiatrists nationally, it appears that telemedicine may be a promising means to expand the availability of geriatric psychiatric consultation to remote areas. Published 2004 John Wiley & Sons, Ltd.
Reasons of informal caregivers for institutionalising dementia patients previously living at home: the Pixel study
Authors: Thomas Philippe , Ingrand Pierre , Lalloue Fabrice , Hazif‐Thomas Cyril , Billon Rémy , Viéban François , Clément Jean‐Pierre 
Published: January 2004

AbstractContextStudy of the problems and requirements of the main caregiver providing home care for dementia patients that have resulted in the patient being institutionalised.ObjectivesTo determine the reasons for placing the dementia patient in an institution.ResourcesSelf‐administered questionnaire of 48 questions on the patient and caregiver, including a list of complaints, given to the main caregiver. Medical questionnaire on the patient filled in by the geriatrician.ResultsData were collected from 109 questionnaires concerning 75 females with dementia (84.7 ± 6.7 years) and 34 demented males (80.8 ± 7.4 years). In two‐thirds of cases the main caregiver was a female, aged 61.1 ± 12.1 years. Cognitive disorders were not the main reasons for institutionalising patients. The most frequent caregiver complaint at the time of institutionalisation was incontinence, followed by withdrawal. The caregiver's main problem resulting in institutionalisation was dependence, with behavioural disorders in second place. A treatment with anticholinesterase for dementia was associated with a live‐in carer being provided for 20 months longer than in the case of patients not receiving this treatment. Statistical analysis revealed 6 groups of separate caregiver‐patient situations. On the one hand there were those patients who appeared to be easy for the caregiver to cope with: those with no problems, docile patients and passive patients not opposing care. In these cases the caregiver was most often young and male, or not directly related to the patient. On the other hand there were 3 other groups: patients with inappropriate motor behaviours, violent/agitated patients and unmotivated patients who opposed care. These patients lived with an elderly caregiver who had been looking after the patient for several years.DiscussionCaregivers' requirements are for help with coping with and preventing dependence. The caregiver suffers terribly from a lack of relief, particularly when young.ConclusionIt is necessary to change the focus of home care for dementia patients towards preventing loss of autonomy and its consequences and to allow for periods of relief for home caregivers. Copyright © 2004 John Wiley & Sons, Ltd.
Patient predictors of response to treatment of depression in Alzheimer's disease: the DIADS study
Authors: Steinberg Martin , Munro Cynthia A. , Samus Quincy , V.Rabins Peter , Brandt Jason , Lyketsos Constantine G. 
Published: January 2004

AbstractObjectiveTo investigate patient predictors of response to treatment of Major Depressive Episode (MDE) in Alzheimer's disease (AD).MethodsForty‐four outpatients with AD and MDE were randomized to receive either sertraline or placebo in a 12‐week placebo‐controlled, flexible‐dose clinical trial after a one week single‐blind placebo phase. All participants were evaluated for depression at entry using the 21‐item Hamilton Depression Rating Scale (HDRS) and the Cornell Scale for Depression in Dementia (CSDD). All subjects completed baseline neuropsychological testing. Caregiver burden and depression were also measured. The forty‐two subjects who completed at least one post‐enrollment follow‐up visit were included in the analysis.ResultsNo baseline demographic, mood, neuropsychiatric, neuropsychological, or caregiver variable was a statistically significant predictor of response to treatment. There were trends for African‐American patients (p=0.07) and those with milder baseline agitation/aggression (p=0.08) to respond better.ConclusionNo baseline characteristic assessed clearly predicts response to treatment of MDE in AD. A diverse population of depressed AD patients may thus respond similarly to the same treatment. Copyright © 2004 John Wiley & Sons, Ltd.
Disclosing a diagnosis of dementia: a systematic review
Authors: Bamford Claire , Lamont Sharon , Eccles Martin , Robinson Louise , May Carl , Bond John 
Published: January 2004

AbstractBackgroundThe issue of diagnostic disclosure in dementia has been debated extensively in professional journals, but empirical data concerning disclosure in dementia has not previously been systematically reviewed.ObjectiveTo review empirical data regarding diagnostic disclosure in dementia.MethodsFive electronic databases were searched up to September 2003 (Medline, Embase, Cinahl, Sociological Abstracts, Web of Science). Additional references were identified through hand searches of selected journals and bibliographies of relevant articles and books. The title and abstract of each identified paper were reviewed independently by two reviewers against pre‐determined inclusion criteria: original data about disclosure were presented and the paper was in English. Any disagreements were resolved by discussion until consensus was reached. Data were extracted independently by two reviewers using a structured abstraction form. Data quality were not formally assessed although each study was critically reviewed in terms of methodology, sampling criteria, response rates and appropriateness of analysis.ResultsFifty‐nine papers met the inclusion criteria for detailed review. Many of the studies had methodological shortcomings. The studies reported wide variability in all areas of beliefs and attitudes to diagnostic disclosure and reported practice. Studies of the impact of disclosure indicate both negative and positive consequences of diagnostic disclosure for people with dementia and their carers.ConclusionsExisting evidence regarding diagnostic disclosure in dementia is both inconsistent and limited with the perspectives of people with dementia being largely neglected. This state of knowledge seems at variance with current guidance about disclosure. Copyright © 2004 John Wiley & Sons, Ltd.
Alzheimer Disease International's 10/66 Dementia Research Group—One model for action research in developing countries
Authors: Prince Martin , Graham Nori , Brodaty Henry , Rimmer Elizabeth , Varghese Mathew , Chiu Helen , Acosta Daisy , Scazufca Marcia 
Published: January 2004

AbstractBackgroundThe 10/66 Dementia Research Group (10/66) founded in 1998, is a network of over 100 researchers from mainly developing countries. 10/66 is committed to encourage more good quality research in those regions, where an estimated two‐thirds of all those with dementia live. It represents a collaboration of academics, clinicians, and an international non‐governmental organization, Alzheimer's Disease International (ADI).Method10/66 pilot studies in 26 centres in Latin America, India, Africa and China and SE Asia suggest that education and culture‐fair diagnosis is an attainable aim. Despite extended family care networks, these studies also identified high levels of practical, psychological and economic strain upon caregivers. Population‐based studies in six centres will now estimate prevalence, describe impact and seek to identify genetic and environmental risk factors in novel settings. At a practical level, 10/66 has studied ways to circumvent the lack of help‐seeking in developing countries, and has developed a low‐level intervention to educate and train caregivers.ConclusionThe links with ADI and its international networks, and the volunteerism of ADIs members have fostered the rapid growth of 10/66. The partnership facilitates both the raising of awareness and influence upon policy, as 10/66 research evidence can be used by ADI and national Alzheimer's Associations to direct and support advocacy. Copyright © 2004 John Wiley & Sons, Ltd.
A case of radiation recall mucositis associated with docetaxel
Authors: Culp Laura R. , Pou Anna M. , Jones Dennie V. , Bayouth John , Sanguineti Giuseppe 
Published: January 2004

AbstractBackground.Radiation recall reactions, in particular dermatitis, are well documented in the literature. However, radiation recall mucositis is a rare clinical phenomenon.Methods.We report a case of a 45‐year‐old man diagnosed with squamous cell carcinoma of the base of tongue. He was treated with surgery followed by chemotherapy and radiation therapy. Several months after completing treatment, he had a recurrence develop outside of the previously irradiated field. He was offered radiation therapy concurrent with docetaxel as salvage therapy.Results.During salvage therapy, acute recall mucositis developed corresponding to his previously irradiated fields. His chemotherapy with docetaxel was withheld, and his symptoms rapidly improved.Conclusions.This case describes radiation recall mucositis associated with docetaxel, a rare but potentially serious clinical situation. Given the potential severity of the reaction and increasing use of docetaxel as second‐line treatment of recurrent head and neck cancers, it is important to be aware of this phenomenon. © 2004 Wiley Periodicals, Inc. Head Neck 26: 197–200, 2004
Prostatic adenocarcinoma metastatic to the head and neck and the workup of an unknown epithelioid neoplasm
Authors: Hunt Jennifer L. , Tomaszewski John E. , Montone Kathleen T. 
Published: January 2004

AbstractBackground.Epithelioid tumors in the head and neck are common and include both primary and metastatic lesions. For metastatic lesions, clinical factors, tumor location, and ancillary immunohistochemical studies must be taken into consideration to help the clinician and the pathologist determine the site of origin. One unusual, but important, primary tumor that can metastasize to the head and neck is carcinoma of the prostate (CAP).Methods.The files of the University of Pennsylvania Department of Pathology were searched for cases of metastatic CAP. All slides were examined, and clinical information was obtained from the referring physician's patient charts.Results.We describe 14 cases of metastatic CAP to the head and neck. Six patients had no history of CAP at the time of biopsy of the head and neck metastasis, and only eight patients had other widespread metastatic disease. Histologically, most of the tumors had epithelioid cells with prominent nucleoli and cribriform, solid, or infiltrating single cell growth patterns. PSA and PSAP immunohistochemical stains were positive in all cases. Seven of 12 patients with known follow‐up are alive after radiation or hormonal therapy.Conclusions.These results demonstrate a fair prognosis with possible prolonged survival with metastatic CAP to the head and neck after appropriate diagnosis and subsequent hormone and radiation therapy. Given this survival advantage with treatment, it is critical to consider the diagnosis of metastatic CAP when evaluating a metastatic malignant ephitelioid tumor in the head and neck of an elderly man. © 2003 Wiley Periodicals, Inc. Head Neck 26: 171‐178, 2004.
A concurrent chemoirradiation with cisplatin followed by adjuvant chemotherapy with ifosfamide, 5‐fluorouracil, and leucovorin for stage IV nasopharyngeal carcinoma
Authors: Chua Daniel T.T. , Sham Jonathan S. T. , Au Gordon K. H. 
Published: January 2004

AbstractBackground.To evaluate the toxicity and efficacy of concurrent chemoirradiation with cisplatin followed by adjuvant ifosfamide, 5‐fluorouracil and leucovorin in patients with stage IVb nasopharyngeal carcinoma (NPC)Patients and Methods.Between October 1998 and August 2001, 35 Chinese patients with stage IVb NPC (N3a:12, N3b:23) were treated with by concurrent chemoirradiation using cisplatin 100 mg/m2 on days 1, 22, and 43 of radiotherapy, followed by adjuvant chemotherapy with 1.4 g/m2, ifosfamide, 450 mg/m2 5‐fluorouracil, and 20 mg/m2 leucovorin daily for 5 days and repeated every 3 weeks for three cycles. Radiotherapy was given using standard fractionation at 2 Gy/day to a total of 68 Gy to the nasopharynx and 66 Gy to the neck.Results.All patients completed the prescribed radiotherapy. Twenty‐three patients (66%) completed all scheduled cycles of chemotherapy. The compliance rate for concurrent and adjuvant chemotherapy was 71% and 80%, respectively. Grade 3 mucositis occurred in 37%, and grade 3 dermatitis occurred in 11.5% during radiotherapy. Grade 3 neutropenia occurred in 17% during concurrent chemotherapy, and grade 3–4 neutropenia occurred in 48.5% during adjuvant chemotherapy. There were no treatment‐related deaths. With a median follow‐up of 31 months, the 3‐year relapse‐free rate was 60%, and the 3‐year overall survival rate was 74%. Locoregional control was excellent, with a 3‐year local and nodal relapse‐free rate of 91% and 83%, respectively. Eleven patients (31%) had developed distant metastases, and the 3‐year distant metastasis‐free rate was 66%.Conclusions.The chemotherapy regimen tested is practical with an acceptable compliance rate. Despite having a more advanced stage disease, the observed outcome of our patients seems to be comparable with other series using platinum‐based adjuvant chemotherapy. Further investigation to confirm the benefit of using the study regimen in advanced stage NPC is warranted. © 2004 Wiley Periodicals, Inc. Head Neck 26: 118–126, 2004
Prioritizing treatment outcomes: Head and neck cancer patients versus nonpatients
Authors: List Marcy A. , Rutherford Judith Lee , Stracks John , Pauloski Barbara Roa , Logemann Jerilyn A. , Lundy Donna , Sullivan Paula , Goodwin William , Kies Merrill , Vokes Everett E. 
Published: January 2004

AbstractBackground.Treatment decisions in head and neck cancer (HNC) might involve consideration of uncertain tradeoffs of one late effect against another or increasing toxicity or residual impairment for increased chance of survival. Understanding how patients prioritize potential outcomes, as well as whether these preferences are similar to those of nonpatients, is important to informed decision making and treatment planning.Methods.Two hundred forty‐seven newly diagnosed HNC patients from nine institutions and 131 nonpatients rank ordered a set of 12 potential treatment outcomes (eg, cure; being able to swallow; normal voice) from highest (1) to lowest (12).Results.Patients and nonpatients were similar with respect to the three items most frequently ranked in the top three, that is, “being cured of cancer,” “living as long as possible,” and “having no pain” in that order. In contrast, patients more frequently ranked “cure” (90% vs 80%) and less frequently ranked “no pain” (34% vs 52%) in the top three.Conclusions.Survival seems to be of paramount importance to both patient and nonpatient groups, overshadowing associated toxicities and potential dysfunction. At the same time, patients might be more willing than nonpatients to undergo aggressive treatments and endure acute distress in the interest of potential long‐term gains (ie, cure or longer survival). © 2004 Wiley Periodicals, Inc. Head Neck 26: 163–170, 2004
Modelling actual, reference and equilibrium evaporation from a temperate wet grassland
Authors: Gavin H. , Agnew C. A. 
Published: January 2004

AbstractActual and reference evaporation from a wet grassland in Southeast England was studied over the spring and summer of 1999 (March to September) through changes in surface wetness. The Penman–Monteith (using resistance values for reference grass surface), equilibrium evaporation and Priestley–Taylor models were compared with output from the Bowen ratio energy balance (BREB) method. On field visits, inundation of the grazing marsh was mapped and surface soil moisture monitored in a regular grid using a capacitance probe. During the study period, the extent of flooding fell from approximately 10% to 0% and the surface soil moisture declined from over 38% to 15%. Daily averaged Bowen ratios displayed large variation but were below unity, indicating that latent energy flux was the dominant energy sink. The Penman–Monteith and equilibrium evaporation models underestimated during periods of surface inundation and overestimated when no surface water was present. Computed values of the Priestley–Taylor parameter α showed daily variability, but α was predictable with surface wetness such an average value of α = 1·25 characterized periods of inundation, and an average values of α = 0·80 represented periods of no surface water. The performance of the models in computing actual evaporation was compared with the BREB using the root‐mean‐square error and index of agreement. The optimal model was the Priestley–Taylor model. Copyright © 2004 John Wiley & Sons, Ltd.
Estimating evapotranspiration from a reed bed using the Bowen ratio energy balance method
Authors: Peacock C. E. , Hess T. M. 
Published: January 2004

AbstractAn increase in demand for water for agricultural and domestic use, combined with new legislation regarding the water needs of natural habitats, has led to an increased requirement for accurate calculations of hydrological fluxes through wetlands. Evapotranspiration is one of the most important but least well understood fluxes in wetland hydrology. Research has been carried out on Stodmarsh National Nature Reserve in Kent, UK, a Ramsar site containing the largest reed beds in southern England. The objective was to quantify water loss through evapotranspiration on the site to allow more effective management of water levels and maintenance of maximum conservation potential for bird life. The Bowen ratio energy balance approach was employed, which is one of the most accurate ways of measuring evapotranspiration but has been rarely used on reed beds. These measurements were used with Penman–Monteith reference evapotranspiration in order to create crop coefficients. It was found that crop coefficients were inconsistent from day to day but were generally less than unity. The inconsistency was thought to be caused by variations in meteorological conditions: e.g. significant differences in crop coefficients were found between days with high radiation and a dry canopy, compared with days with low radiation and a wet canopy. Canopy interception of precipitation was particularly important, with crop coefficients being significantly higher on wet days, possibly due to the higher rates of evaporation of intercepted water due to the lack of stomatal resistance. Copyright © 2004 John Wiley & Sons, Ltd.
The impacts of sodicity on soil strength
Authors: Kyei‐Baffour N. , Rycroft D. W. , Tanton T. W. 
Published: January 2004

AbstractThe paper describes an investigation into the relationship between the level of sodium induced at the soil surface by the evaporation of saline water and the shear strength, both immediately after salinisation and then again after leaching. The results indicate that the strength of the surface increases during salinisation in response to increasing sodicity. The increase in shear strength on leaching became apparent once the levels of sodicity had begun to exceed values currently used to identify when swelling and dispersion are likely to exert an influence on the soil structure. It was also discovered that these effects were not merely confined to the surface but existed throughout the depth of the soil. Copyright © 2004 John Wiley & Sons, Ltd.
Linear and non‐linear optimization models for allocation of a limited water supply
Authors: Ghahraman Bijan , Sepaskhah Ali‐Reza 
Published: January 2004

AbstractOne partial solution to the problem of ever‐increasing demands on our water resources is optimal allocation of available water. A non‐linear programming (NLP) optimization model with an integrated soil water balance was developed. This model is the advanced form of a previously developed one in which soil water balance was not included. The model also has the advantage of low computer run‐time, as compared to commonly used dynamic programming (DP) models that suffer from dimensionality. The model can perform over different crop growth stages while taking into account an irrigation time interval in each stage. Therefore, the results are directly applicable to real‐world conditions. However, the time trend of actual evapotranspiration (AET) for individual time intervals fluctuates more than that for growth‐stage AETs. The proposed model was run for the Ardak area (45 km NW of the city of Mashhad, Iran) under a single cropping cultivation (corn) as well as a multiple cropping pattern (wheat, barley, corn, and sugar beet). The water balance equation was manipulated with net applied irrigation water to overcome the difficulty encountered with incorrect deep percolation. The outputs of the model, under the imposed seasonal irrigation water shortages, were compared with the results obtained from a simple NLP model. The differences between these two models (simple and integrated) became more significant as irrigation water shortage increased. Oversimplified assumptions in the previous simple model were the main causes of these differences. Copyright © 2004 John Wiley & Sons, Ltd.