bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Randomized, Double‐Blind, Placebo‐Controlled Clinical Trial of the Chinese Herbal Medicine “Ba Wei Di Huang Wan” in the Treatment of Dementia
Authors: Iwasaki Koh , Kobayashi Seiichi , Chimura Yuri , Taguchi Mayumi , Inoue Kazumi , Cho Shigehumi , Akiba Tetsuo , Arai Hiroyuki , Cyong Jong‐Chol , Sasaki Hidetada 
Published: August 2004

Objectives: To evaluate whether a traditional Chinese herbal medicine, ba wei di huang wan (BDW), improves cognitive and physical functioning in dementia patients.Design: An 8‐week randomized, double‐blind, placebo‐controlled trial.Setting: Long‐term‐care facility in Japan.Participants: Thirty‐three patients with mild to severe dementia (7 men and 26 women; mean age±standard deviation=84.4±7.8) were recruited and enrolled from May 2002 through September 2002.Intervention: Participants were randomly assigned to the active drug (BDW) group (n=16) or the placebo group (n=17) and treated for 8 weeks.Measurement: Cognitive function and activities of daily living (ADLs); palsatility index.Results: After the trial, cognitive function as assessed using the Mini‐Mental State Examination (MMSE) significantly improved from 13.5±8.5 to 16.3±7.7 (P<.01, 95% confidence interval (CI)=−4.1 to −1.4) in the BDW group. The ADL score in the Barthel Index also significantly changed, from 61.8±34.6 to 78.9±21.1 (P<.01, 95% CI=−26.2 to −7.9). In contrast, MMSE and Barthel Index scores of the placebo group showed no significant change. Eight weeks after the end of the administration, MMSE and Barthel Index scores of the BDW group declined to the baseline level. The pulsatility index in the internal carotid artery as measured using Doppler sonography significantly decreased in the BDW group (2.5±1.7 to 1.9±0.5, P<.05) but not in the placebo group.Conclusion: These results argue the benefits of BDW in the treatment of dementia.
Fall‐Risk Assessment and Management in Clinical Practice: Views from Healthcare Providers
Authors: Fortinsky Richard H. , Iannuzzi‐Sucich Michele , Baker Dorothy I. , Gottschalk Margaret , King Mary B. , Brown Cynthia J. , Tinetti Mary E. 
Published: August 2004

Objectives: To determine the extent to which healthcare providers reportedly address evidence‐based fall risk factors in older patients after exposure to an educational intervention and to determine barriers reportedly encountered when these healthcare providers intervene with or refer older patients with identified fall‐risk factors.Design: Cross‐sectional study using a structured interview.Setting: Geographic area of Connecticut where the Connecticut Collaboration for Fall Prevention (CCFP) has been implemented.Participants: Emergency department (ED) physicians, hospital‐based discharge planners or care coordinators (nurses or social workers), home health agency nurses, and office‐based primary care physicians (total n=33) after exposure to the CCFP implementation team.Measurements: Self‐reported practices (direct intervention or referral) and barriers when addressing seven evidence‐based risk factors for falls: gait and transfer impairments, balance disturbances, multiple medications, postural hypotension, sensory and perceptive deficits, foot and footwear problems, and environmental hazards.Results: Respondents were most likely to report directly intervening with or referring older patients for gait and transfer impairments (85%) and balance disturbances (82%) and least likely to do so when encountering foot or footwear problems (58%) and sensory or perceptive deficits (61%). ED physicians reported lowest rates of direct intervention or referral for foot or footwear problems (20%), home health agency nurses for sensory or perceptive deficits (50%), and office‐based primary care physicians for foot or footwear problems (50%). Patient compliance was the most commonly reported barrier to successful direct intervention across several risk factors, whereas inadequate availability of other healthcare providers and lack of Medicare reimbursement were the most commonly reported barriers to successful patient referrals.Conclusion: After exposure to the CCFP implementation team, the majority of healthcare providers reported directly intervening or referring patients when addressing all risk factors, but results pinpointed specific healthcare provider groups with room for improvement in assessment and management of specific risk factors. Patient education appears to be a necessary adjunct to healthcare provider training, because patient compliance was a reported barrier to optimal intervention by healthcare providers.
A Comparison of Gait Characteristics Between Older Women with and Without Peripheral Neuropathy in Standard and Challenging Environments
Authors: Richardson James K. , Thies Sibylle B. , DeMott Trina K. , Ashton‐Miller James A. 
Published: August 2004

Objectives: To compare gait patterns in older women with and without peripheral neuropathy (PN) in standard (smooth surface, normal lighting) and challenging environments (CE) (irregular surface, low lighting).Design: Observational, controlled study of 24 subjects.Setting: Biomechanical research laboratory.Participants: Twenty‐four older women, 12 with PN and 12 without PN (mean age±standard deviation =67.1±7.9 and 70.2±4.3, respectively).Measurements: Gait parameters and, in the 12 PN subjects, neuropathy severity.Results: The CE was associated with increases in step width, step‐width variability, step‐width range, step width–to–step length ratio, step time and step‐time variability, and decreases in step length and speed. The PN subjects demonstrated a greater step width–to–step length ratio and step time and shorter step length and slower speed than the control subjects. In adapting to the CE, the PN subjects demonstrated greater increases in step width–to–step length ratio and step‐time variability and a greater decrease in step length than did the control subjects. In the standard environment, only one gait parameter correlated with PN severity, whereas in the CE, four gait parameters did so.Conclusion: The subjects demonstrated a gait that was slower, less efficient, and more variable temporally and in the frontal plane in the CE. Control and PN subjects demonstrated similar variability in medial‐lateral step placement in the CE but at the cost of speed and efficiency for the PN subjects. Because the CE magnified gait differences between the two groups of subjects and caused gait changes in the PN subjects that correlated with PN severity, the CE may offer improved resolution for detecting gait abnormalities.
Blood Pressure Components and Cardiovascular Events in Older Adults: The Rotterdam Study
Authors: Mattace‐Raso Francesco U. S. , Van Der Cammen Tischa J. M. , Van Popele Nicole M. , Van Der Kuip Deirdre A. M. , Schalekamp Maarten A. D. H. , Hofman Albert , Breteler Monique M. B. , Witteman Jacqueline C. M. 
Published: August 2004

Objectives: To compare the strength of the relative risks of systolic (SBP) diastolic blood pressure (DBP) and pulse pressure (PP) as predictors of myocardial infarction and stroke in older adults.Design: Prospective cohort study.Setting: The Rotterdam Study, a Dutch population‐based study.Participants: A total of 4,234 subjects aged 55 and older with no previous myocardial infarction (MI) or stroke at baseline.Measurements: Blood pressure levels at baseline, first MI and stroke, all‐cause mortality during follow‐up.Results: During follow‐up, 205 subjects had an MI (average follow‐up period 7 years), 137 subjects had a stroke (average follow‐up period 6.1 years), and 748 subjects died. A 1–standard deviation difference in SBP, DBP, and PP was associated with relative risks of MI of 1.24 (95% confidence interval (CI)=1.06–1.46), 1.07 (0.92–1.25), and 1.25 (1.07–1.48), respectively. Corresponding relative risks for stroke were 1.59 (1.37–1.86), 1.27 (1.10–1.48), and 1.48 (1.27–1.72). For all‐cause mortality the corresponding relative risks and 95% CI were 1.21 (1.11–1.31), 1.06 (0.99–1.14), and 1.20 (1.10–1.31).Conclusion: The results of this study suggest that, in a population of apparently healthy older adults, PP is not a better predictor of cardiovascular events and all‐cause mortality than SBP.
Comparison of Fracture, Cardiovascular Event, and Breast Cancer Rates at 3 Years in Postmenopausal Women with Osteoporosis
Authors: Silverman Stuart L. , Delmas Pierre D. , Kulkarni Pandurang M. , Stock John L. , Wong Mayme , Plouffe Leo 
Published: August 2004

Objectives: To compare event rates for osteoporotic fractures, cardiovascular events, and breast cancer in postmenopausal women with osteoporosis.Design: A prospective, observational study of the placebo group in the double‐blind, randomized Multiple Outcomes of Raloxifene Evaluation trial.Setting: One hundred eighty clinical research centers in 25 countries.Participants: Postmenopausal women (n=2,565, mean age=67) with osteoporosis were given calcium (500 mg/d) and vitamin D (400–600 IU/d) supplements.Measurements: The occurrence of at least one new fracture, cardiovascular event, or breast cancer diagnosis at 3 years was identified and adjudicated.Results: The occurrence of any fracture was the most common event in these women. In women without prevalent vertebral fractures (n=1,627), the event rates per 1,000 patient‐years were 45.4 for any fracture, 15.2 for vertebral fracture, 4.7 for clinical vertebral fracture, 0.9 for hip fracture, 8.3 for any cardiovascular event, and 5.2 for all breast cancer. In women with prevalent vertebral fractures (n=938), the event rates per 1,000 patient‐years were 117.4 for any new fracture, 77.1 for new vertebral fracture, 25.7 for clinical vertebral fracture, 5.8 for hip fracture, 15.1 for any cardiovascular event, and 2.6 for all breast cancer. The effect of prevalent fracture status on event rates was not dependent on whether women were older or younger than 65, but women aged 65 and older had a 3.6 times greater occurrence of cardiovascular events than younger women, irrespective of prevalent fracture status.Conclusion: These data on the relative incidence of clinically significant skeletal and extra‐skeletal outcomes may be useful in choosing an agent for health maintenance for postmenopausal women with osteoporosis.
Validation of the Late‐Life Function and Disability Instrument
Authors: Sayers Stephen P. , Jette Alan M. , Haley Stephen M. , Heeren Tim C. , Guralnik Jack M. , Fielding Roger A. 
Published: August 2004

Objectives: To assess the concurrent and predictive validity of the Late‐Life Function and Disability Instrument (LLFDI).Design: Cross‐sectional.Setting: University‐based human physiology laboratory.Participants: One hundred one men and women aged 80.8±0.4.Measurements: A short physical performance battery (SPPB) and a self‐paced 400‐m walk (400‐m W) were used as performance tests of lower extremity function. The LLFDI was used to assess self‐reported function and physical disability. Partial correlations adjusted for age and body mass index were used to determine the concurrent and predictive validity of the LLFDI. Statistical significance was accepted at P<.004 using a testwise correction.Results: LLFDI Overall Function scores were moderately associated with the SPPB (r=0.65, P<.001), 400‐m W gait speed (r=0.69, P<.001), and measures of lower extremity function. Correlations of the two lower extremity subscores of the LLFDI (correlation coefficient (r)=0.63–0.73, P<.001) were greater than for the LLFDI upper extremity subscores (r=0.19–0.26, P>.004). Performance measures of function predicted disability limitations in the range of r=0.37–0.44 (P<.001) and disability frequency in the range of r=0.16–0.20 (P>.004).Conclusion: These findings support the concurrent and predictive validity of the LLFDI. Results support the use of the LLFDI scales as a substitute for physical performance tests when self‐report is a preferred data‐collection format.
Clinical Global Impression of Change in Physical Frailty: Development of a Measure Based on Clinical Judgment
Authors: Studenski Stephanie , Hayes Risa P. , Leibowitz Ruth Q. , Bode Rita , Lavery Laurie , Walston Jeremy , Duncan Pamela , Perera Subashan 
Published: August 2004

Objectives: To expand the ability to assess physical frailty by developing a Clinical Global Impression of Change in Physical Frailty (CGIC‐PF) instrument.Design: Qualitative and quantitative instrument development.Setting: Academic centers.Participants: Six expert panel members, 46 clinicians, 24 patients, and 12 caregivers.Measurements: Literature review and structured group processes with experts, clinicians, and consumers were used to generate an initial list of domains and indicators. Structured interviews with clinical experts in the area of frailty were used to establish relevance and feasibility of measurement of domains. Interrater reliability was assessed through a Web‐based study. Geriatricians pilot tested the feasibility of the baseline CGIC‐PF with 10 patients.Results: The CGIC‐PF includes six intrinsic domains (mobility, balance, strength, endurance, nutrition, and neuromotor performance) and seven consequences domains (medical complexity, healthcare utilization, appearance, self‐perceived health, activities of daily living, emotional status, and social status). Each domain has two to four clinical indicators. Change is scored on a 7‐point scale from markedly worse to markedly improved. Average interrater reliability of the CGIC‐PF for the Web‐based cases was 0.97. Geriatricians completed a baseline CGIC‐PF on their own patients in 10 minutes or less.Conclusion: The CGIC‐PF is a structured assessment of change in physical frailty with defined content and process. It has strong face validity, reliability, and feasibility for use in clinical research. It may be useful as one criterion of change and as an anchor for change in other measures.
Therapist Experience and “Style” as Factors in Co‐therapy
Authors: RICE DAVID G. , FEY WILLIAM F. , KEPECS JOSEPH G. 
Published: August 2004

NOTE: SEVERAL PASSAGES HAVE BEEN TRANSPOSED IN THIS ARTICLE. IT HAS BEEN REPRINTED CORRECTLY IN VOL. 11, JUNE, 1972 AT PAGE 227Self‐descriptions of general in‐therapy behavior, attitudes toward co‐therapy, and ratings of co‐therapy effectiveness were collected from 25 experienced (E) and 25 inexperienced (IE) therapists who treated a total of 48 married couples in co‐therapy. Major findings were: (a) six different therapeutic “styles” emerged via factor analysis of the therapists' self‐descriptions of in‐therapy behavior, (b) E and IE therapists as a group had different personal therapeutic styles and preferences as to the style desired in a co‐therapist, (c) subjectively rated effectiveness of co‐therapy correlated with the degree of comfort felt by the therapist in the relationship and the acceptance by the co‐therapist, and (d) there was evidence of a “point of diminishing returns” in satisfaction for therapists in general, which came with increasing experience in doing co‐therapy.
A Family Art Evaluation
Authors: RUBIN JUDITH A. , MAGNUSSEN MAX G. 
Published: August 2004

A two‐hour family art evaluation session has been designed by an art therapist and a clinical child psychologist. It has been used in a child guidance center for the past four years by the authors and other staff.All family members are asked to engage in three tasks: (a) individually developing a scribble into a picture; (b) individually creating a family portrait, and (c) jointly deciding upon and executing a mural. Each task is followed by individual and group discussion of products, associations, and feelings aroused. Occasional “free” art products are collected during the session.The procedure is discussed and illustrated in terms of the rationale for selection of tasks; the sources of data available on individuals, family characteristics, and family interaction patterns; the relationship of the projective and behavioral data to diagnostic conclusions and treatment recommendations; and the implementation and modifications of the technique within the clinic.
A study of logger fatalities from 1992–2000
Authors: Scott D F 
Published: August 2004

Objectives:To determine if certain loggers are at increased risk of death during logging operations.Methods:Statistical analysis of 780 logger fatalities for a nine year period (1992–2000).Results:The major findings are: (1) treefallers suffer nearly 63% of all fatalities, (2) the region where the fatality occurred and the size of the employer were not significant factors that contributed to a high percentage of treefaller fatalities, and (3) the Northeast and Midwest regions showed a higher percentage of fatalities compared with the South and West regions.Conclusions:Overall, the logger fatality rate for 1992–2000, compared with 1980–88 has decreased slightly; however, treefallers continue to be the group of loggers who suffer the highest fatality rate.
Use of mechanical patient lifts decreased musculoskeletal symptoms and injuries among health care workers
Authors: Li J , Wolf L , Evanoff B 
Published: August 2004

Objective:To evaluate the effectiveness of mechanical patient lifts in reducing musculoskeletal symptoms, injuries, lost workday injuries, and workers’ compensation costs in workers at a community hospital.Design:Pre-post intervention study.Setting:Three nursing units of a small community hospital.Patients or subjects:Nursing personnel.Interventions:Mechanical patient lifts were made available and nursing staff trained in their use between August 2000 and January 2001.Main outcome measures:Workers completed symptom surveys at baseline and six months after lift training. Pre-intervention and post-intervention rates of injuries and lost workday injuries using Occupational Safety and Health Administration logs of the three study units, from the period July 1999 through March 2003 were analyzed. Injuries potentially related to lifting patients were included in the analyses. Using workers’ compensation data from the same time period, the compensation paid ($ per full time equivalent [FTE]) due to injuries during the pre-intervention and post-intervention period was calculated.Results:Sixty one staff members were surveyed pre-intervention; 36 (59%) completed follow up surveys. Statistically significant improvements in musculoskeletal comfort (p<0.05) were reported for all body parts, including shoulders, lower back, and knees. Injury rates decreased post-intervention, with a relative risk (RR) of 0.37 (95% confidence interval (CI) 0.16 to 0.88); decreased injury rates persisted after adjustment for temporal trends in injury rates on non-intervention units of the study hospital (RR = 0.50, 95% CI 0.20 to 1.26). Adjusted lost day injury rates also decreased (RR = 0.35, 95% CI 0.10 to 1.16). Annual workers’ compensation costs averaged $484 per FTE pre-intervention and $151 per FTE post-intervention.Conclusion:Reductions were observed in injury rates, lost workday injury rates, workers’ compensation costs, and musculoskeletal symptoms after deployment of mechanical patient lifts. Strengths of this study include the community hospital setting and the inclusion of a variety of different outcomes. Limitations include the pre-post study design and the small sample size.
Work related injuries in small scale commercial fishing
Authors: Marshall S W , Kucera K , Loomis D , McDonald M A , Lipscomb H J 
Published: August 2004

Objective:To describe the epidemiology of work related injury in a group of small scale, independent commercial fishers.Design:Cross sectional survey (baseline instrument of a prospective cohort study).Setting and subjects:Commercial fishers in eastern North Carolina.Results:A cohort of 219 commercial fishers was established and 215 subjects completed an injury questionnaire. The main types of fishing conducted by the cohort were finfishing (159/215) and crabbing (154/215). Of the 215 fishers, 83 reported that they had suffered an injury event in the previous 12 months, a retrospective recall incidence proportion of 38.6 per 100 workers (95% confidence interval 32.1 to 45.1). The 83 injury events resulted in 94 injuries; 47% were penetrating wounds and 24% were strains/sprains. Half of injuries were to the hand/wrist/digits and 13% were to the back. Of the penetrating wounds, 87% were to the hand/wrist/digits, 32% became infected, and 80% were caused by contact with finfish, shellfish, or other marine animal. Of the strains/sprains, 48% were to the back and 26% were to the shoulder. Seventy percent of strains/sprains were caused by moving heavy objects, mainly either while hauling in nets, pots, or lines or loading/unloading the boat.Conclusion:In this group of small scale, independent fishers, the most common reported injuries were penetrating wounds to the hand/wrist/digits from marine animals and strains/sprains to the back while moving heavy objects.
Occupational injuries identified by an emergency department based injury surveillance system in Nicaragua
Authors: Noe R , Rocha J , Clavel-Arcas C , Aleman C , Gonzales M E , Mock C 
Published: August 2004

Objectives:To identify and describe the work related injuries in both the formal and informal work sectors captured in an emergency department based injury surveillance system in Managua, Nicaragua.Setting:Urban emergency department in Managua, Nicaragua serving 200–300 patients per day.Methods:Secondary analysis from the surveillance system data. All cases indicating an injury while working and seen for treatment at the emergency department between 1 August 2001 and 31 July 2002 were included. There was no exclusion based on place of occurrence (home, work, school), age, or gender.Results:There were 3801 work related injuries identified which accounted for 18.6% of the total 20 425 injures captured by the surveillance system. Twenty seven work related fatalities were recorded, compared with the 1998 International Labor Organization statistic of 25 occupational fatalities for all of Nicaragua. Injuries occurring outside of a formal work location accounted for more than 60% of the work related injuries. Almost half of these occurred at home, while 19% occurred on the street. The leading mechanisms for work related injuries were falls (30%), blunt objects (28%), and stabs/cuts (23%). Falls were by far the most severe mechanism in the study, causing 37% of the work related deaths and more than half of the fractures.Conclusions:Occupational injuries are grossly underreported in Nicaragua. This study demonstrated that an emergency department can be a data source for work related injuries in developing countries because it captures both the formal and informal workforce injuries. Fall prevention initiatives could significantly reduce the magnitude and severity of occupational injuries in Managua, Nicaragua.