bluuebunny/crossref_metadata_2025_split huggingface dataset:
Job Satisfaction, Work-Related Stress and Intentions to Quit of Scottish GPS
Authors: Simoens S. , Scott A. , Sibbald B. 
Published: January 2017

Job satisfaction and work-related stress influence physician retention, turnover, and patient satisfaction. This study purports to elicit the views of Scottish GPs on job satisfaction, stress, intentions to quit, and to examine any patterns by demographic, job, and practice characteristics. A descriptive, cross-sectional study was undertaken by postal questionnaire on a random sample of 1,000 GP principals, 359 GP non-principals, and 62 PMS GPs. The response rate was 56%. GPs were most satisfied with their colleagues, variety in the job, and amount of responsibility given. The most frequently mentioned sources of job stress were increasing workloads, paperwork, insufficient time to do justice to the job, increased and inappropriate demands from patients. White, female, young (under 40 years) and old (55 years and over) GP non-principals and PMS GPs who work less than 50 hours per week as a GP were more likely to be satisfied with their job and reported lower levels of stress. Conclusions: GP participation in the workforce could be promoted by introducing more flexible working patterns (e.g. part-time work), by expanding the scope of contractual arrangements, and by making patient expectations more realistic by clearly communicating what the role of a GP actually encompasses.
Cryoprecipitate Therapy in Haemophilia
Authors: Forbes C. D. , Hunter J. , Barr R. D. , Davidson J. F. , Short D. W. , McDonald G. A. , McNicol G. P. , Wallace J. , Douglas A. S. 
Published: January 2017

This paper describes experience over an 18-month period of a new preparation of factor VIII, cryoprecipitate, prepared by the Regional Blood Transfusion Service from human plasma. This relatively simple and inexpensive method selectively extracts the factor VIII leaving behind the other blood products for use in other ways. Replacement therapy in the treatment of haemophilia has been generally regarded as inadequate due to the difficulty in obtaining potent antihaemophilic globulin in sufficient amounts, and cryoprecipitate represents a useful advance. Bleeding episodes in 25 patients with factor VIII deficiency have been treated with cryoprecipitate on 41 occasions and an assessment of the haemostatic effect of this material has been made in treating haemarthrosis, muscle haematomata and the management of major and minor surgical operations. Routine follow-up over a 6 month period was undertaken to determine the incidence of side effects. Two cases of hepatitis were found, possibly resulting from cryoprecipitate therapy. However, both patients had also received blood or fresh frozen plasma and the source of the hepatitis virus must remain in doubt. No factor VIII inhibitors were found despite repeated courses of therapy in several patients. The advantages and disadvantages of cryoprecipitate are set out and its encouraging place in the management of haemophilic bleeding assessed.
Coliform Bacteraemia in Infants
Authors: Conn Nancy K. 
Published: January 2017

The incidence of patients with positive blood cultures from which a single species of coliform bacillus was isolated is given for the years 1962 to 67. There has been an increase during these years particularly in neonatal infants: 91 cases were recorded in babies under 6 months of age, and the bacteriological and clinical findings have been related in 85. Children born either prematurely or as a multiple birth and those with congenital malformations showed a predisposition to this form of infection. Many of the remaining cases had an associated localised infection. Some aspects of the cause of the increase in coliform bacteraemia in babies are discussed and the severity and possible implications of the infection are emphasised.
Ischaemic Carotid Strokes Angiographic Investigation of 523 Patients
Authors: Angel F. , Cross J. N. , Tedeschi G. M. , Jennett W. B. , Steven J. L. , Grossart K. W. 
Published: January 2017

Carotid angiography showed a lesion in more than two-thirds of this series of ischaemic carotid strokes; two-thirds of the lesions shown were in the neck vessels. Carotid narrowing (incomplete occlusion) in the neck was much commoner after the age of 50 years and was frequently associated wth a temporary stroke. Complete carotid occlusion in the neck did not become commoner with increasing age as did carotid narrowing; nor was it associated with previous temporary strokes (as was carotid narrowing). It is therefore doubtful whether complete occlusion is usually the end-result of narrowing. Persisting strokes were frequently preceded by one or more temporary strokes; these ‘warning strokes’ were more frequent in patients with carotid narrowing. Middle cerebral artery lesions accounted for two-thirds of all intracranial lesions; they were particularly common in association with pregnancy and rarely caused temporary strokes.
The Natural History of Bacterial Colonization of the Newborn in a Maternity Hospital (Part I)
Authors: McAllister T. A. , Givan J. , Black A. , Turner M. J. , Kerr M. M. , Hutchison J. H. 
Published: January 2017

Bacteriological examinations were performed on 1103 infants to determine the ages at which the newborn are colonized at different sites by bacteria, and with which organisms. On the day of birth, specimens for culture included aspirated gastric contents, and swabs from nose, throat, groin and rectum; on Day 3 the umbilical cord clamp with a section of the cord, swabs from nose, throat, groin and rectum; on days 5 and 1, and weekly thereafter, swabs from the same 4 sites. These examinations included identification of the individual bacterial species. The mass of information so obtained was analysed by computer. The high level of bacterial colonization by day 3 was striking and, indeed, large numbers of potential pathogens were grown from infants within one hour of birth. Staphylococcus aureus was found only in very small numbers of infants, e.g. only 2.6 per cent of infants' umbilical cords on day 3, and 4 per cent of infants' noses on day 7. If the levels of colonization reflect the risks of infection, Pseudomonas aeruginosa ranks close to Staph. aureus in the newborn nursery of the modern maternity hospital. Forty two different species of bacteria were isolated from these infants of which 24 were potential pathogens and of the latter, gram-negative organisms greatly outnumbered the gram-positive. This high incidence of gram-negative colonization in a large series of hospitalized neonates may be a normal phenomenon but it suggests that the risk of infection is today greater with gram-negative than with gram-positive bacteria. The figures for carriage of pathogenic staphylococci in the present investigation contrast markedly with the figures reported by many workers between 1950 and 1960.
Clinical Examination as a Screening Method for Breast Cancer
Authors: McLatchie Greg , McArdle Colin , Menzies Thomas 
Published: January 2017

A five-year experience of a breast cancer screening clinic in a Scottish urban area is reported. During this period 28 per cent of the female population aged 25 to 70 years was screened by clinical examination alone. The pick-up rate for cancers was 7.8 per 1,000 ‘well’ women examined, and 21 per cent of all patients with cancer were under 40 years old. Clinical examination is an effective and economical method of screening for breast cancer. The establishment of similar clinics to detect breast disease in women of all age groups is recommended.
Home Parenteral Nutrition in Tayside 1980–1992
Authors: Johnston D.A. , Pennington C.R. 
Published: January 2017

The experience of Home Parenteral Nutrition (HPN) in Tayside over the last 13 years has been reviewed with particular reference to the indications for, complications of, and quality of life whilst receiving HPN. The observed complication rate has been compared with that of the UK experience, and the observed complication rate for the first seven years of HPN experience has been compared with the subsequent six years. The Tayside experience equates broadly with that of the UK, although there was a different pattern of complications. Increasing experience with HPN has resulted in a fall in HPN related complications to 1 per 3.4 treatment years in Tayside, a rate as low as that of the most experienced HPN centre in the UK.
Protein C and S Deficiency Causing Childhood Stroke
Authors: Brown D.C. , Livingston J.H. , Minns R.A. , Eden O.B. 
Published: January 2017

The annual incidence of cerebrovascular disease in children is 2.5/100,000 and cerebral infarction is being increasingly recognised in neonates.1 Deficiency of proteins C and S and their roles in thrombosis have only recently been recognised.2 Immunologic and functional assays of these proteins now make it possible to determine whether deficiency of them is associated in any particular case of childhood cerebrovascular accident (CVA).3 We describe two patients, both presenting with stroke in childhood, who were found to be deficient, one in protein C and one in protein S.
An Audit of Sickle Cell Screening in a Paediatric Hospital Population
Authors: Baraka A. , Haddock G , Roussis X. , Leventis J. , Fyfe A.H.B. 
Published: January 2017

Current UK guidelines for the detection of sickle cell disease (SSD) recommend pre-operative screening of patients of African or Afro-Caribbean descent and of patients from the Middle East, South Italy, Greece and India. These recommendations have considerable cost implications for the NHS. We have undertaken a retrospective audit of the use of SSD screening in our own institution. Between January 1987 and August 1992,1305 patients under 15 years of age (mean 3.8 years) underwent screening for SSD. Surgical patients accounted for 1120 tests (85.8%). The majority of patients tested were of Asian descent (n=955; 73%); only 350 (27%) were of African or Afro-Caribbean descent. Only four patients (0.3%) tested positive (all sickle cell trait); three of Afro-Caribbean descent and one from Bahrain. We conclude that, in our population, the incidence of HbS is low. Patients of African or Afro-Caribbean descent should continue to be tested but a selective policy may be indicated in other ethnic groups.
Wool Setting: The Effect of Esterification
Authors: Holt L. A. , Leach S. J. , Milligan B. 
Published: January 2017

Esterification of wool fabrics with methanol, ethanol, n-propanol or n-butanol (containing 0.1 M HCl as catalyst) has been found to modify both amide and carboxyl side chains. Modification of amide groups is especially marked with the higher alcohols. The esterified fabrics set more readily than untreated fabric when steam-pressed in the presence of 0.05 M buffer (pH 7), but not when M potassium chloride is added to the buffer. The effect of esterification in enhancing the settability of wool can be explained in terms of the Donnan effect. In solutions of low ionic strength, the internal pH of a wool fiber differs from that of the external solution and this effect is accentuated on esterification. As a result, the internal pH of esterified wool is much higher than that of untreated wool. Since wool sets more readily in alkaline than in neutral solution, esterification enhances settability. At high ionic strengths, however, the Donnan effect is suppressed. The internal and external pH values are the same for both untreated and esterified fabrics, which therefore set at the same rate.
The Mechanics of Looped-Pile Carpets
Authors: El-Shiekh Aly , Hersh S. P. 
Published: January 2017

The idealized geometry of a looped-pile carpet is analyzed. Mechanisms of deformation are outlined, and the limiting conditions for each mechanism are discussed. Expressions are derived for both the initial and final geometries of the loop. Strain levels in the fibers in a deformed carpet are predicted, and the results are presented in dimensionless parameters which can be easily converted into usual textile terms. Attention is given to the practical implications of this mathematical approach to carpet design.
An Examination of the Cause of the Humidity Sensitivity of the Lightfastness of Dyed Materials
Authors: Giles Charles H. , Haslam Ronald , Duff David G. 
Published: January 2017

Light fading of some typical sulfonated acid wool and direct cotton dyes has been assessed, visually against the blue standards, on cotton, wool, silk, and anodized aluminum, and spectrophotometrically in films of regenerated cellulose and gelatin, at various respective relative humidities of the surrounding atmosphere. Some tests were also made in which the films were exposed to light when sealed against entrance of air. The known, lower susceptibility of fading rate to relative humidity of dyes on wool compared with cotton is confirmed and shown to apply also to silk and gelatin. Fading of dyes on anodized aluminum, after sealing, is unaffected by any change in the humidity of the surrounding atmosphere. It is suggested that on cotton, increase in RH causes more rapid fading because of increased fiber swelling, which accelerates transport of oxygen to the excited dye molecule. The anodic film on aluminum does not swell and so is unaffected by change in RH. Though the swelling effect operates with proteins, it is less noticeable because fading thereon is only partly caused by oxidation; mainly it is due to reduction, hydrogen being abstracted from the substrate itself, and therefore fading is less dependent on oxygen transport into the fiber. This suggestion is consistent with the observation made in this work—that fading on cellulose is considerably retarded by completely sealing the dyed substrate against air, whereas fading on a typical protein (gelatin) is hardly affected at all.
Successful Treatment of Scabies with Oral Ivermectin in Nigeria
Authors: Nnoruka E N , Agu C E 
Published: January 2017

Currently, several topical scabicides are available but there is yet no oral or parenteral drug which has been established for the treatment of scabies in Nigeria. Ivermectin which is a modified avermectin, known to be an ectoparasiticidal agent in animals, has been used in adults for systemic parasitosis. In Nigeria, 25% benzyl benzoate is being extensively used for the treatment of scabies in adults. It is effective and readily available. The present study was carried out to evaluate the efficacy and safety of ivermectin in the treatment of patients with scabies at the skin clinic of the University of Nigeria Teaching Hospital, Enugu. Fifty-eight patients with scabies were recruited for the study; 13 (22.4%) were children aged between 5–14 years. Oral ivermectin was given in a single dose of 200 μg/kg body weight to 29 patients. The remaining 29 patients had to apply 25% benzyl benzoate emulsion. All patients received a full physical and dermatological examination prior to onset of treatment and weekly for 4 weeks. Skin scrapings were taken to confirm the diagnosis of scabies. There was a 93% resolution of pruritus with ivermectin and 48% with benzyl benzoate. No side effects were observed with ivermectin. Our results show that oral ivermectin is a promising, effective and safe alternative in both children and adults of Nigeria when compared to 25% benzyl benzoate topical application.
Measles Vaccine Coverage and Immune Response in Children of Caiabi and Metuktire Indian Tribes Living in Malarial Endemic Area: Parque Indígena Do Xingu, Central Brazil
Authors: Spindel R , Baruzzi R G , Souza V A U F , Ferreira A W , Avila S L M 
Published: January 2017

Measles vaccination efficiency was evaluated in children from two Indian tribes — Caiabi and Metuktire — living in the Amazon region, in the Parque Indígena do Xingu (PIX). The population sample, selected at random, made up 37 Caiabi and 28 Metuktire children, aged from 20–75 months (40%). For operational and epidemiological reasons, measles vaccine is given from 6 months of age. The average age of children when they received the vaccine was 11.5 months for the first dose and 20 months for the second. The search for IgG antibodies against measles virus and Plasmodium falciparum was made through immunofluorescence assay (IFA). Measles vaccine coverage has reached 60% at 12 months of age and 92% at 18 months, whereas post-vaccine serum conversion was 95% in Caiabi children (geometric mean of titres (GMT) 126) and 89% in Metuktire (GMT 109). The difference in GMT is not statistically significant. Seventy-three per cent of Caiabi children (GMT 101) and 100% of Metuktire children (GMT 135) were plasmodium antibody positive, showing they had been exposed to malarial infection. Despite the differences detected, the immune response to measles vaccine was satisfactory in both groups, with a positive percentage consistent with that achieved in non-malarial areas in Americas. The results show the efficiency of a vaccination programme in an indigenous area despite the difficulties in reaching the villages and maintaining the cold chain, and also despite the malaria endemicity.
Pyomyositis in Adults: A 12 Year Review
Authors: Yusufu L M D , Sabo S Y , Nmadu P T 
Published: January 2017

From January 1988 to December 1999, 43 adults with pyomyositis were managed at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Staphylococcus aureus was the most commonly cultured organism (92.5%). All the 41 patients responded well to incision and adequate drainage, antibiotics and partial thickness skin grafting in 10 patients (23.2%). Two patients (4.65%) died from septicaemia, while being resuscitated.
Echocardiographic Features of Peripartum Cardiac Failure: The Zaria Syndrome
Authors: Danbauchi S S 
Published: January 2017

Zaria has the highest incidence of peripartum cardiac failure, a syndrome of unsettled aetiology. Over the years it has been noted that there has been a decrease in the period of treatment by traditional methods from an average of 90 days to 30 days and with a complete avoidance of hot bed treatment. Twenty-one subjects with the syndrome were studied: they exhibited the same clinical findings as evinced in previous reports from our centre. Echocardiography findings of dilated heart with depressed left ventricular function were noted. There was a statistically significant relationship between the duration of practice and ejection fraction (EF), r=0.36 and P<0.05, duration of practice and left ventricular internal diameter in diastole (LVIDd), r=0.28, P<0.05. Were these subjects suffering from a quiescent heart muscle disease from a previous viral myocarditis and did they require an expanded volume as a trigger? Or are they intolerant of salt requiring only a small increase from the traditional method of treatment to precipitate cardiac failure? Further investigation in the field of molecular biology is required.
Brucellosis: A Retrospective Evaluation
Authors: Taşbakan Meltem Işikgöz , Yamazhan Tansu , Gökengin Deniz , Arda Bilgin , Sertpolat Mahmut , Ulusoy Sercan , Ertem Ekin , Serter Demir 
Published: January 2017

One hundred and sixty-six presumed brucellosis patients were included in the study. These patients were classified as primary (91), relapse (18) and suspected (57) cases according to their clinical presentations, and serologic and microbiologic test results. Primary and relapse cases were evaluated retrospectively according to age, sex, residence, routes of transmission, clinical and laboratory findings, treatment regimens, duration of treatment, and relapse rates. Of the 109 primary and relapse patients, 57 were male and 52 female. The ages of the patients ranged between 16–75 (mean age 40.2). The percentages of the urban and rural residence of the patients were 41.3% and 58.7%, respectively. The most common mode of transmission was consumption of unpasteurized milk and milk products (67.9%). Malaise, fever and sweating were the most frequently observed symptoms (96.3%, 95.4%, 91.7%, respectively). The most common signs were fever (97.2%), splenomegaly (59.6%), and hepatomegaly (37.6%). The liver was the most frequently involved organ (21.1%). Almost all (99.1%) patients were serologically positive. However, the positivity rate of culture was low (15.6%). The most frequently preferred antimicrobial regimen was rifampin and doxycycline combination. The relapse rate was 8.3%. Brucellosis is still prevalent in Turkey as in many other countries in the Mediterranean basin. The clinical presentation of the disease may show regional variations. Patients with a history of occupational or nutritional contact with the bacterium and with a compatible clinical picture should be examined using appropriate diagnostic techniques before any attempt to prescribe an antimicrobial.
Vernal Keratoconjunctivitis in Nigerians: 109 Consecutive Cases
Authors: Ukponmwan Catherine U 
Published: January 2017

Vernal keratoconjunctivitis was the most common conjunctival disease seen over a 2 year period (January 1997–December 1998) at the University of Benin Teaching Hospital, Benin City, Nigeria. One hundred and nine consecutive patients were seen with vernal keratoconjunctivitis. There was a male to female ratio of 1:1.3. The age range of the patients was 5 months to 38 years with a mean age of 15.5 ± 8.3 years (SD). Of the patients 54.1% were children. Itching was the most common symptom, followed by redness, tearing, aching eye and photophobia. Ninety patients (82.6%) had predominantly tarsal papillae, while the others had mixed and limbal papillae. A history of atopic diseases such as asthma and rhinitis was present in only five patients (4.5%). There was no patient with corneal ulcer or scarring. Although the complications were few, health education of the patients about the dangers of self medication with steroids should be emphasized.
Paramedicals' Clinical Accuracy
Authors: Pust Ronald E , Burrell J Michael 
Published: January 2017

A random sample of 102 cases referred in 1983 by paramedicals to the Southern Highlands Provincial Hospital, Papua New Guinea, was analysed for agreement with the final hospital diagnosis and with standardized primary care therapies. Health centre diagnosis was judged accurate in 45% of cases; inaccuracies in a further 17% had no projected health consequences. However, resulting serious sequelae could be projected in half of the incorrect diagnoses. Diagnosis of surgical cases was more often accurate (P<0.05) than in medical cases. Treatment which was adequate or standard for the diagnosis made at the health centre had been given there in 80% of cases. However, there were serious diagnostic inaccuracies in 38% of all referral cases; this study suggests a need for problem-based paramedical education in diagnosis, especially in non-surgical problems. Visits by doctors to health centres could reinforce this diagnostic teaching and better evaluate paramedicals' clinical accuracy in the health centre.
Influence of Health Education on Local Beliefs
Authors: Stefanini Angelo 
Published: January 2017

Health education can sometimes lead to unexpected results when people adapt their beliefs to new ideas being taught. Recent experience of the department of health education at St Mary's Hospital Lacor is presented to illustrate this phenomenon. The Acholi practice of removing children's unerupted deciduous canine teeth is reviewed, and the results of a retrospective study of hospital admissions of children with complications following the operation are analysed. The increased number of such admissions following a health education campaign is discussed, and it is concluded that a more radical approach is needed to counteract the harmful belief. Partial success and indirect positive results should not satisfy health workers whose main goal must be to make people fully understand what is dangerous to their wellbeing.