bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measurement of Community Participation and Use of Leisure by Service Users with Intellectual Disabilities: the Guernsey Community Participation and Leisure Assessment (GCPLA)
Authors: Baker Peter A. 
Published: March 2003

AbstractCommunity integration is now an important principle guiding service provision for people with intellectual disabilities. However, it has been argued that research has contributed little in the way of guidance and that this is mainly because of the lack of appropriate measures. The Guernsey Community Participation and Leisure Assessment (GCPLA) is described in the present paper. The GCPLA is a comprehensive assessment of community participation and the use of leisure that produces both quantitative and qualitative data. Data are presented which suggest that the instrument is potentially both valid and reliable. A study comparing use of their community by service users and a staff control group showed that the service users had a smaller range of activities, were less busy (i.e. took part in fewer frequent activities), and were more likely to access their communities in the presence of staff or carers, rather than alone or with friends. Suggestions for the use of the GCPLA are discussed including individual planning, service evaluation and training.
Outcome Evaluation of Bereavement Groups for Adults with Intellectual Disabilities
Authors: Stoddart Kevin P. , Burke Lillian , Temple Valerie 
Published: March 2003

Background  Individuals with intellectual disabilities respond to loss in similar ways to other individuals. Bereavement interventions, whether provided individually or in a group, need to be planned according to the person's understanding, presenting symptoms, psychological functioning and support system. Measuring the effectiveness of such interventions is critical in order to increase our knowledge of useful interventions for this population. The present authors discuss individual and group bereavement therapy, and outline the goals and approaches used in their bereavement groups for adults with intellectual disabilities.Methods  Individuals referred for bereavement group therapy were interviewed and assessed prior to their participation in the group. Measures of depression, anxiety, and knowledge of death and bereavement issues were administered before and after group participation.Results  Scores for depression were significantly lower following group participation. However, scores for anxiety were mild and not significantly reduced. The participants' understanding and knowledge of the bereavement process did not improve significantly. When those with single and dual diagnosis were considered separately, those with a dual diagnosis experienced a significant decrease in depression, while those with a single diagnosis did not. Furthermore, depression scores for those with a dual diagnosis were generally higher.Conclusions  The present preliminary investigation of therapeutic outcomes for bereavement group intervention suggests little change in anxiety and knowledge of death/bereavement issues, but significant improvement in symptoms of depression for participants, particularly those with a dual diagnosis. The weaknesses of the present study are discussed along with possible improvements for future studies.
Integration of Recent Reviews on Offenders with Intellectual Disabilities
Authors: Lindsay William R. 
Published: March 2003

Background  Over the last 20 years, the interest in and amount of research relating to offenders with intellectual disability has increased.Methods  Using a series of databases and less formal library searches, 11 articles that review across aspects of offenders and offending were considered. Reviews that considered only single aspects of offending or single offender groups were not included in this paper.Results  The reviews highlight the following issues: epidemiology of offending and offenders; vulnerability; remedial and preventative intervention; and assessment of the offence. Issues of the importance of families and carers, female offenders, recidivism/outcome and research were also mentioned.
Staff Activity in Supported Housing Services
Authors: Felce David , Lowe Kathy , Jones Edwin 
Published: March 2003

Background  Variation in staff performance between small community housing services indicates the need for research on the factors which predict high‐quality care.Methods  The associations between service sector, staffing levels, staff characteristics, internal organization or working practices, non‐institutional milieu, and staff activity and the nature and extent of staff attention to residents were explored in a study of 10 statutory, 10 voluntary and nine private sector community housing schemes.Results  There were few significant differences between sectors after differences in resident abilities were taken into account. Higher staff to resident ratios predicted greater resident receipt of attention and assistance but also a lower proportion of time during which each member of staff was directly concerned with residents. A greater range in resident ability predicted lower resident receipt of attention and assistance. A higher proportion of qualified staff was not shown to be a positive attribute but greater prior experience was associated with staff spending more time directly concerned with residents, less time doing ‘other’ activity and residents receiving more assistance. Measures of the internal organization and non‐institutional milieu of the settings were not strongly related to staff activity.Conclusions  The findings are consistent with previous research that there are diminishing marginal returns associated with increasing staff. Size of residence was unimportant. Links between service organization and staff performance require further research but retaining experienced staff appears to be important. As resident receipt of attention and assistance was unrelated to their adaptive behaviour level, there is a need to find ways to ensure that staff support matches the needs of residents better.
Interpretation of pulsatility index in feeder arteries to low‐impedance vascular beds
Authors: Gosling R. G. , Lo P. T. S. , Taylor M. G. 
Published: March 2003

AbstractA simple electrical circuit is proposed as a model for peripheral vascular beds of low impedance. The model consists of a flow and pressure source, i.e. the ‘feeder’ artery, with the vascular bed represented by a Zener diode Z giving rise to a ‘back pressure’ Pz and a pure resistance R. By applying Ohm's law to the definition of pulsatility index PIflow of flow in the feeder artery, it is shown that PIflow is dependent only on the mean blood pressure (input), the pulse pressure and Pz, and is independent of R.For those vascular beds where the impedance is largely resistive, e.g. the brain, the kidney and the uterine‐placental complex, it is suggested that Pz may be a more useful characterizing parameter than the value of PIflow as at present used by some workers. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
The value of ultrasonic examination to detect and diagnose breast carcinomas. Analysis of the results obtained in 125 tumors using radiographic and ultrasound mammography
Authors: Rotten D. , Levaillant J. M. 
Published: March 2003

AbstractA series of 125 breast carcinomas studied by both radiological and ultrasound mammography, and which were observed in 102 patients, is presented. Of the lesions, 76.5% were less than 20 mm in diameter, and 16.8% had a diameter 10 mm or less. Sixteen lesions were in situ or microinvasive. Analysis of the results shows a 40.8% rate of false‐negative results with radiological mammography, when only ‘highly suspicious’ and ‘suspicious’ images are considered. This figure is reduced to 28% when ‘benign‐appearing’ masses are included in the computation. Using similar diagnostic categories, the false‐negative rates obtained with ultrasound mammography were 14.4% and 12.8%, respectively. Combining radiological and ultrasound mammography resulted in a dramatic decrease in the false‐negative rate to 4% The number of false‐negative results observed with either radiological or ultrasound mammography was in the higher range of reported values when compared to selected studies. However, they may, in fact, closely reflect the real performance of these investigations, as they are available to patients in everyday clinical practice.Analysis of the data shows that radiological mammography is less efficient in younger patients. The mean age of the patients in the radiological mammography positive group was 54.3 ± 1.2 years, as opposed to 47.5 ± 2.1 (p = 0.004) in the radiological mammography negative group. In contrast, the efficiency of ultrasound mammography is independent of the patient's age, and con sequently of breast density. In this series, no obvious size effect was apparent on tumor visibility using either imaging modality.The present study shows that the false‐negative rate of radiological as well as ultrasound mammography is higher than usually perceived. Given the complementarity of radiological and ultrasound mammography, their combination proves highly sensitive and highly specific. However, this conclusion will only apply when both breasts are examined completely, but not when ultrasound examination of the breasts is restricted to the imaging of an anomaly detected with radiological mammography. The time needed to perform a complete breast examination reduces its potential use in a screening program. On the other hand, its use appears of major relevance in patients with breasts where the performance of radiological mammography is questionable, such as younger women, or women with dense breasts. Copyright © 1992 International Society of Ultrasound in Obstetrics and Gynecology
Fetal echocardiography and color Doppler flow imaging: the Rotterdam experience
Authors: Stewart P. A. , Wladimiroff J. W. 
Published: March 2003

AbstractThe adjunctive role of Doppler color flow mapping in the evaluation of cardiac structures and function was studied in 440 normal fetuses between 17 and 22 weeks of gestation (median, 20 weeks) and in 73 fetuses with suspected congenital heart disease between 16 and 38 weeks of gestation (median, 28 weeks). Flow through atrioventricular and arterial valves was generally easy to identify and identification was successful in approximately 90% of the normal fetuses. Flow in the pulmonary veins and through the foramen ovale was visualized in approximately 60% of normal cases. In the group with suspected congenital heart disease, Doppler color flow imaging provided additional information on both cardiac structure and function in 34 fetuses, on function alone in 13 fetuses and on structure alone in 20 fetuses. No additional information was collected in six fetuses. Copyright © 1993 International Society of Ultrasound in Obstetrics and Gynecology
Blood flow velocity in the uterine and ovarian arteries during the normal menstrual cycle
Authors: Sladkevicius P. , Valentin L. , Maršál K. 
Published: March 2003

AbstractTwelve healthy women with regular menstrual cycles were examined with a combination of two‐dimensional real‐time ultrasound and color and spectral Doppler techniques on cycle days 4 and 8 and daily from cycle day 12 until follicular rupture, then days + 1, +2, +5, +7 and +12 after follicular rupture. The uterine and subendometrial arteries, arteries in the ovarian stroma and hilum, in the wall of the largest follicle of each ovary, and in the wall of the corpus luteum were examined. The pulsatility index and the time‐averaged maximum velocity were calculated. In the uterine arteries the pulsatility index was highest on day + 2, after which it decreased successively to its lowest value, whereas the time‐averaged maximum velocity reached its highest value on day + 12. Similar changes were observed in the subendometrial arteries. In the non‐dominant ovary, neither the pulsatility index nor the time‐averaged maximum velocity manifested any consistent changes during the cycle. In the dominant ovary, the time‐averaged maximum velocity increased and the pulsatility index decreased after follicular rupture, being significantly higher and lower, respectively, in the luteal than in the follicular phase. These changes were seen in the ovarian hilum, stroma and follicular wall, but were most obvious in the wall of the dominant follicle and of the corpus luteum. We conclude that the blood circulation in the uterus and in the dominant ovary changes considerably during the menstrual cycle, whereas that in the non‐dominant ovary shows no unequivocal changes. Copyright © 1993 International Society of Ultrasound in Obstetrics and Gynecology
Biometric measurements in fetuses of different race and gender
Authors: Bromley B. , Frigoletto F. D. , Harlow B. L. , Evans J. K. , Benacerraf B. R. 
Published: March 2003

AbstractSonographic fetal biometric measurements on 6082 low‐risk patients were compared in the second and third trimesters of pregnancy with respect to fetal race and gender. Ultrasonic measurements were obtained from fetuses of women participating in the Routine Antenatal Diagnostic Imaging with Ultrasound Study (RADIUS), who underwent both an early sonographic evaluation between 15 and 22 weeks' gestation and a later scan between 31 and 35 weeks' gestation. In the 16–21‐week scans, male fetuses had significantly larger biparietal diameter measurements compared to female fetuses (estimated difference 0.852 mm, 95% CI 0.737–0.967). There was only minimal difference in biparietal diameter between Black and White fetuses. Femur length was similar in both female and male fetuses, but longer in Black compared to White fetuses (estimated difference 0.808 mm, 95% CI 0.539–1.078).During the 31–35‐week scans, male fetuses continued to have larger biparietal diameter measurements compared to female fetuses (estimated difference 1.22 mm, 95% CI 1.04–1.40), and femur lengths were persistently longer in Black compared to White fetuses (estimated difference 0.563 mm, 95% CI 0.234–0.893).Further investigation is necessary to evaluate the effect of these slight differences in morphometric fetal measurements between races and genders, so that we can determine how best to use them for optimizing prenatal care. Copyright © 1993 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis and fetal outcome of cystic adenomatoid malformation of the lung: case report and historical survey
Authors: Roelofsen J. , Oostendorp R. , Volovics A. , Hoogland H. 
Published: March 2003

AbstractDiagnostic ultrasound allows prenatal diagnosis of cystic adenomatoid malformation of the lung from the second trimester onwards throughout pregnancy. If the diagnosis is made before the 24th week of pregnancy, counselling often results in termination of pregnancy. Whether or not this attitude is in agreement with good medical practice is discussed on the basis of our own experience and a review of the literature. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
Expectant management of interstitial pregnancy
Authors: Zalel Y. , Caspi B. , Insler V. 
Published: March 2003

AbstractA case of interstitial pregnancy is described. Transvaginal ultrasound examination, performed at 8 weeks' gestation, revealed an empty endometrial cavity with an eccentric gestational sac in the left uterine corner, with a clear separation between the uterine cavity (endometrium) and the gestational sac. Expectant management, consisting of repeated sonographic examinations and assessment of serum β‐human chorionic gonadotropin, resulted in a favorable outcome. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
Blood flow velocity in the uterine and ovarian arteries during menstruation
Authors: Sladkevicius P. , Valentin L. , Maršál K. 
Published: March 2003

AbstractEleven healthy women with regular menstrual cycles were examined with a combination of two‐dimensional real‐time ultrasound and color and spectral Doppler techniques on the 7th day after follicular rupture, and on the 1st, 2nd, 3rd and 4th days of menstrual bleeding. Both uterine arteries, arteries in the stroma and hila of both ovaries, in the wall of the largest follicle of the non‐dominant ovary and in the wall of the corpus luteum were examined with the Doppler technique. The pulsatility index (PI) and the time‐averaged maximum velocity were calculated. In the uterine arteries, the PI was highest on the first day of menstrual bleeding (median PI 3.2 for the dominant and 3.0 for the non‐dominant uterine artery), after which it decreased to its lowest values on the second day (median PI 2.1 and 1.8, respectively) and third day (median PI 2.2 and 2.1, respectively). The time‐averaged maximum velocity reached its highest value on the second and third days of menstruation. The corpus luteum was still visible on the first day of menstrual bleeding in all women, and on the second day in five. It was indistinguishable on the third and fourth days of menstruation in all women. In the dominant ovary, the time‐averaged maximum velocity of flow in the arteries in the ovarian hilum decreased during menstrual bleeding and was lower during menstruation than in the preceding luteal phase. In the non‐dominant ovary, neither the PI nor the time‐averaged maximum velocity manifested any consistent changes during the period studied. We conclude that substantial changes in PI and time‐averaged maximum velocity occur in the uterine arteries and in the arteries of the dominant ovary during menstruation. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
Differential diagnosis of breast lesions by color Doppler
Authors: Madjar H. , Prömpeler H. J. , Sauerbrei W. , Mundinger A. , Pfleiderer A. 
Published: March 2003

AbstractColor Doppler allows flow detection in small tumor vessels. Due to the vascularity associated with the growth of malignancies, this method can be used to differentiate between benign and malignant breast lesions. In order to study the typical flow characteristics, we investigated multiple Doppler flow parameters. A UM9 HDI (ATL) was used with a linear transducer L 10‐5. The number of tumor vessels and the mean, maximum and total flow velocity were measured in 325 benign and 133 malignant lesions and showed highly significant differences (p < 0.0001). Flow profiles (resistance index and systolic/diastolic frequency ratio) showed a large overlap and did not allow accurate tumor differentiation when mean and minimum values were analyzed. Surprisingly, the maximum resistance index and systolic/diastolic frequency ratio were significantly higher in carcinomas than in benign lesions, but the overlap of the values was wider than the flow velocity measurements. Using the vessel number and the total tumor vascularity, 90% of all lesions could be differentiated. A difficulty that we encountered was that a few cancers have very low flow values and some of the proliferative benign lesions can have increased flow. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
The prenatal sonographic appearance of enteric duplication cysts
Authors: Richards D. S. , Langham M. R. , Anderson C. D. 
Published: March 2003

AbstractEnteric duplication cysts are rare lesions, and relatively few cases have been diagnosed prenatally. We report two cases with a distinctive presentation. One, a duplication of the antrum of the stomach, was adjacent to an extralobar pulmonary sequestration. The other, a duodenal duplication, appeared as a thick‐walled right lower quadrant cyst. We observed distinct peristalsis in this cyst, a finding that helped us make a firm diagnosis of enteric duplication. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Spontaneous resolution of non‐immune hydrops fetalis secondary to transplacental parvovirus B19 infection
Authors: Bhal P. S. , Davies N. J. , Westmoreland D. , Jones A. 
Published: March 2003

AbstractWe report a case of hydrops fetalis secondary to transplacental parvovirus B19 infection, in which spontaneous resolution of the hydrops occurred 4 weeks after the initial presentation. This case emphasizes the role of conservative management based one ultrasound evidence of continued resolution of the hydrops and intrauterine growth retardation. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal sonography of the endometrium in a representative sample of postmenopausal women
Authors: Gull B. , Karlsson B. , Milsom I. , Wikland M. , Granberg S. 
Published: March 2003

AbstractThe aim of this study was to assess endometrial thickness using transvaginal sonography in a representative sample of postmenopausal women and to evaluate whether the technique can be used for screening of endometrial cancer. A random sample (n = 1000) of the total population of women aged 45–80 years resident in the city of Göteborg in 1993 was invited to attend for transvaginal sonography. The only exclusion criterion was hysterectomy. Transvaginal sonography was performed in 827 women. An endometrium of ≤ 4 mm was not investigated further. Women with an endometrium of 5–7 mm and non‐measurable cases were re‐assessed 1 year later, and women with an endometrial thickness of ≥ 8 mm were investigated directly with hysteroscopy and/or dilatation and curettage. A total of 559 women were postmenopausal and 183 were taking some form of hormonal substitution (33%). One case of endometrial cancer (endometrial thickness 19 mm), 23 cases of polyps without atypia (endometrial thickness 8–18 mm) and no cases of endometrial hyperplasia were diagnosed. Endometrial thicknesses were as follows (mean ± SEM; respectively grouped as ≤ 4 mm, 5–7 mm and ≥ 8 mm): total population of postmenopausal women (3.4 ± 0.1 mm, 82%, 13% and 6%); postmenopausal women without estrogens (3.0 ± 0.1 mm, 90%, 7% and 3%); postmenopausal women on medium‐potency estrogens + gestagen (5.1 ± 0.3 mm, 49%, 40% and 11%) and women with low‐potency estrogens only (3.6 ± 0.3 mm, 85%, 6% and 9%). The prevalence of endometrial cancer was 0.2% and for benign polyps 3.2% in this representative sample of postmenopausal women. Our results do not support generalized endometrial screening with transvaginal sonography. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Multiple intracardiac tumors: spontaneous prenatal recovery of fetal bradyarrhythmia
Authors: Cha'ban F. K. , Cohen‐Overbeek T. E. , Frohn‐Mulder I. M. , Wladimiroff J. W. 
Published: March 2003

AbstractAlthough prenatally detected intracardiac tumors are reported to have a poor prognosis, tumor regression and even tumor disappearance have been observed during childhood. A case of prenatal cessation of fetal cardiac tumor growth and return of cardiac arrhythmia to normal sinus rhythm is presented. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology