bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Validation of Instruments for Measuring Temperament and Attachment in a Mother-Child Dyad
Authors: Owsley Vicki B. 
Published: January 2017

A mother and child are active partners in the development of a reciprocal system of reactions to form an attachment relationship. Facilitation of a healthy maternal–child relationship is a goal toward which pediatric nurses direct their interventions. Tb accurately assess the temperaments of both mothers and young children, and their attachment behaviors, reliable and valid measuring instruments are necessary. The findings of this study support the need for further research on the construct validity of the NYLS Temperament and Attachment Q–set instruments. Factor analyses demonstrated the NYLS Young Adult Questionnaire to have seven subscales rather than thenine stipulated in the literature. Evidence of robust factors was not presented. Watersand Deane (1985) stipulated four criterion sorts for the Attachment Q–set. Four factors were interpreted with three of them congruent with the literature. There was evidence of the factors being robust. To further insure creditable construct validity studies, multiple samples from different populations need to be employed in future studies.
Managing New Technology: Economics Research and Practical Decisions
Authors: Buxton M. J. 
Published: January 2017

Rapidly advancing health technology poses problems for managers. Although clear conceptual frameworks exist for economic evaluation, in practice severe problems remain in carrying out timely research that is locally appropriate to the needs of managers. This paper explores some of these problems in the context of the policy analysis interface between economic research and the management of technology. In the light of experience gained from recent evaluation research it indicates how researchers and managers can each contribute to the provision of a stronger empirical basis for policy making and policy management. An earlier version of this paper was presented at the joint meeting of the Health Economists Study Group and Institute of Health Service Management, University of York, 6–8 July 1987. The author would like to thank Christopher Spry and Mike Drummond for helpful comments.
Business Planning in Hong Kong Hospitals: The Emergence of a Seamless Health Care Management Process
Authors: Thompson D. 
Published: January 2017

This paper examines the progress made by public hospitals in Hong Kong in implementing a business planning approach. A review of available literature suggests two main exploratory themes. The first establishes the key features of business planning in the private sector. The second theme discusses the problems of adapting this approach to the distinctive requirements of the public sector. The literature also suggests three dimensions for evaluating planning: incremental-developmental; reactive-proactive; ends-means. Qualitative data were collected by scrutinizing relevant organizational documentation and by discussions with focus groups formed by participants in the planning process. The data were analyzed against eight key elements of a business plan identified from the literature and from panels of business experts. These elements were found to be present in the Hospital Authority's plans but were less evident in hospital level plans. Because of the unitary nature of hospital organization in Hong Kong, it has been difficult for hospitals to break out of a reactive, incremental and ends-based pattern to a more imaginative identification of the distinctive business and market that they may be in. This is, however, changing rapidly and it is clear that there is in place a robust and ‘seamless’ health care management process.
Managing Health Services: How Administrative Data and Population-Based Analyses Can Focus the Agenda
Authors: Roos N. P. , Black C. , Roos L. L. , Frohlich N. , DeCoster C. , Mustard C. , Brownell M. , Shanahan M. , Fergusson P. , Toll F. , Carriere K. C. , Burchill C. , Fransoo R. , MacWilliam L. , Bogdanovic B. , Friesen D. 
Published: January 2017

University-based researchers in Manitoba, Canada, have used administrative data routinely collected as part of the national health insurance plan to design an integrated database and population-based health information system. This information system is proving useful to policymakers for providing answers to such questions as: which populations need more physician services? Which need fewer? Are high-risk populations poorly served or do they have poor health outcomes despite being well served? Does high utilization represent overuse or utilization related to high need? More specifically, this system provides decision-makers with the capability to make critical comparisons across regions and subregions of residents' health status, socioeconomic risk characteristics, and use of hospitals, nursing homes, and physicians. The system permits analyses of demographic changes, expenditure patterns, and hospital performance in relation to the population served. The integrated database has also facilitated outcomes research across hospitals and counties, utilization review within a single hospital, and longitudinal research on health reform. A particularly interesting application to planning physician supply and distribution is discussed. The discussion highlights the strengths of integrated population-based information in analyzing the health care system and raising important questions about the relationship between health care and health.
Emergency Contraception: Who are the Users?
Authors: Fox J , Weerasinghe D , Marks C , Mindel A 
Published: January 2017

The objective was to describe the demographic and sexual characteristics of clients attending a Sexual Health Clinic for emergency contraception (EC). Information about women attending the Parramatta Sexual Health Clinic (PSHC) who received EC between January 1999 and July 2002 was derived from the clinic database. Age-matched controls were randomly selected. Univariate and logistic regression analysis was performed to establish which factors were associated with use of EC. Two hundred and sixty-seven women requesting EC, and an equal number of controls, were studied. Factors that were independently associated with EC use were being a student, (OR=1.7 [95% CI 1.02–2.69]) and having a regular sexual partner (OR=2.3 [95% CI 1.14–4.73]). Women requiring EC were significantly less likely to have had a sexually transmitted infection (STI) (OR=0.3 [95% CI 0.16–0.60]) or a previous pregnancy (OR=0.2 [95% CI 0.09–0.67]) than controls. We concluded that users of EC are at low-risk for STIs, but need counselling about safer sex.
Clinical and Laboratory Study of First Episode Genital Herpes in Singapore
Authors: Cheong W K , Thirumoorthy T , Doraisingham S , Ling A E 
Published: January 2017

A prospective study of the epidemiology, clinical aspects and laboratory features of first episode genital herpes was carried out in Middle Road Hospital, Singapore between June 1986 and December 1987. A total of 68 patients were studied. There were more women than men in the study population with a female to male ratio of 7.5 to 1. The peak incidence of first episode genital herpes was between 20 and 29 years of age. Specimens from 63 patients yielded positive culture for herpes simplex virus (HSV). HSV-1 was isolated from 21 patients (30.9%), HSV-2 from 41 patients (60.3%) and untyped HSV from one patient (1.5%). True primary genital herpes was diagnosed in 43 patients (68.3%) using a test for complement fixing antibodies to HSV. HSV-1 was found to be the causative agent in 18 (41.9%) of the true primary infections, HSV-2 in 24 (55.8%) and untyped HSV in one (2.3%). In comparison, HSV-1 was isolated in only 2 (10%) of the 20 patients with non-primary first episode genital herpes; HSV-2 was found in 13 patients (65%) and the culture was negative in 5 (25%).
Risk Factors for Chlamydia Trachomatis Infection in 6810 Young Women Attending Family Planning Clinics
Authors: Ramstedt Kristina , Forssman Lars , Giesecke Johan , Granath Fredrik 
Published: January 2017

Screening programmes are important for the control of Chlamydia trachomatis (Ct) infection, a disease spread mainly by asymptomatic carriers. Risk factors for Ct infection were assessed in 6810 consecutive asymptomatic young women seeking contraceptive advice. All women filled in a questionnaire and were offered Ct testing. Of the 5785 who consented to testing, 425 (7.3%) were Ct culture positive. Four variables were significantly related to increased risk of being infected: age 18–23 years, duration of present relationship < 1 year, non-use of condoms, and a history of not having had a previous genital infection. It is not possible to devise screening criteria that would effectively identify women at high risk. Therefore a screening programme should be targeted at all sexually active young people. However, if after some years the programme succeeds in lowering general Ct prevalence, these factors may be important when selecting patients for Ct testing.
Prevalence of HIV-2 Infection in a Family Planning Clinic in Lisbon
Authors: Victorino Rui M M , Guerreiro D , Lourenço M Helena , Ferreira M O Santos , Teles L Cunha 
Published: January 2017

A significant proportion (10%) of notified AIDS cases in Portugal are due to HIV-2 infection as a result of the close connections of Portugal with Western African Countries (ex-Portuguese colonies) where there is a high HIV-2 seroprevalence. We conducted a seroepidemiological study of HIV-1 and HIV-2 infection in 1400 women attending family planning and antenatal clinics in a health centre in Lisbon with the objective of analysing whether there was evidence of HIV-2 spread in this population. The seroprevalence for HIV, as determined by ELISA and confirmed by Western Blot, was 0.42% (6 cases) and 50% of these were of HIV-2 infection. Analysis of the epidemiological inquiries reveals that out of the 6 seropositive cases, only one was a drug addict (HIV-1) and another a western African black woman (HIV-2). The other 4 cases (2 HIV-2 and 2 HIV-1) were white Portuguese women with no history of travelling to Africa or previous blood transfusions, and the only risk factor was a history of multiple sexual partners (in 3 out of 4).
High Cumulative Incidence of Genital Herpes Amongst HIV-1 Seropositive Heterosexuals in South London
Authors: O'Farrell Nigel , Tovey Stuart J 
Published: January 2017

The cumulative incidence of sexually transmitted diseases (STD) in a cohort of 51 (35 female, 16 male) HIV-1 seropositive STD clinic attenders who had acquired HIV-1 infection via heterosexual transmission was investigated through a retrospective review of the case notes. The women were followed up for a mean 11.6 months and the men for 18 months. Thirty-one (88%) of the women and 13 (81%) of the men were of sub-Saharan African origin. Approximately half of the subjects were first diagnosed as HIV-1 positive with CD4 counts <200×106/1 and a quarter with CD4 counts <50×106/1. STDs detected in women were: genital herpes 15 (43%), Candida 12 (34%), bacterial vaginosis 9 (25%), and in men: genital herpes 6 (38%), non-gonococcal urethritis 4 (25%). No cases of gonorrhoea were detected. At the time of first diagnosis of genital herpes at the clinic, the mean CD4 count in women was 275×106/1 and in men 285×106/1. Genital herpes was the AIDS defining diagnosis in 3 of the women. The recognized risk of HIV transmission via genital lesions should be stressed in HIV-1 positive subjects with genital herpes. The incidence of other STD was low—both knowledge of HIV status and safer sex counselling may limit unsafe sexual behaviour and should be evaluated further as a strategy for limiting the spread of HIV-1 infection.
Screening for Tuberculosis in an East London HIV Clinic
Authors: Theodore C M , Forster G E , Goh B T , Barnes N , Hughes D 
Published: January 2017

A prospective study was carried out to assess the value of routine skin tuberculin testing and chest radiography in HIV seropositive patients, attending the Genitourinary Medicine (GUM) clinic between July 1991–May 1992. 144 consecutive HIV seropositive patients had tuberculin Tine tests and chest radiographs performed. Ten patients were treated for active tuberculosis (TB) on the basis of abnormal radiography with or without strongly positive (Grade 3/4) skin tuberculin tests. A further 10 patients received prophylaxis on the basis of abnormal chest radiography consistent with previous tuberculous infection or strongly positive tuberculin tests. Active or previous tuberculous infection was found in the UK born Caucasian homosexual population as well as in injecting drug users and patients who were born in areas of high TB prevalence. Screening for TB in HIV seropositive patients is important both for detecting asymptomatic tuberculous infection and for recognizing patients at risk for reactivation of latent TB. We showed a high pick-up rate with 20 out of 144 patients having treatment as a result of screening.
Accuracy of Ultrasound in a Screening Programme for Abdominal Aortic Aneurysms
Authors: Thomas P R S , Shaw J C , Ashton H A , Kay D N , Scott R A P 
Published: January 2017

To assess the accuracy of ultrasound in the measurement of aortic diameter. A general practice based screening programme for abdominal aortic aneurysm. (a) comparison of ultrasound with computed tomography (CT) measurement; (b) two period crossover study to assess interobserver error; (c) comparison of ultrasound measurements by technicians and radiologists. In 36 patients where CT showed clear maxima in anteroposterior diameter, the measurement by ultrasound was consistently less than by CT scan (mean ultrasound — CT difference — 4·4 mm, range —12·3 to 2·4 mm). There was no difference in the measurements made by different ultrasonographers, but their method of measurement produced a reading for aortic diameter less than that obtained by a vascular radiologist. These' results show that ultrasound measurement is less accurate for smaller aneurysms, consistently gives a smaller reading for aortic diameter when compared with CT measurement, but was reproducible between ultrasonographers. Monitoring and audit of aneurysm screening programmes to assess accuracy and reproducibility of ultrasound measurement is recommended.
Evaluation of the Effect on Breast Cancer Mortality of Population Based Mammography Screening Programmes
Authors: Törnberg Sven , Carstensen John , Hakulinen Timo , Lenner Per , Hatschek Thomas , Lundgren Bengt , Tornberg S 
Published: January 2017

To evaluate, by analysis of breast cancer mortality data from all the 26 Swedish counties for the years 1971 to 1990, whether the effect of the introduction of mammography screening in Sweden can be assessed by observation from existing mortality data. A Poisson regression model was used to study whether a decrease in breast cancer mortality among women aged 50–74 years was associated with the extent of mammography screening in different counties and periods. In regions where mammography screening had been introduced, breast cancer mortality tended to be decreased, on average, compared with regions with-'out screening. If a 10 year time lag between the start of screening and its full effect on mortality is assumed then the estimated reduction in breast cancer mortality associated with introduction of screening was 19% with a 95% confidence interval ranging from 3% to 37%. The results suggest that the effect of mammography screening may be studied using existing routine mortality data and appropriate statistical modelling. This way of assessing the outcome of the screening is valuable when continuously monitoring a screening programme that has become a public health routine.
Assessment of Lesions Detected at Mammographic Screening: Performance at First or Repeat Screening in the Florence Programme
Authors: Ciatto Stefano , Del Turco Marco Rosselli , Giorgi Daniela , Morrone Doralba , Catarzi Sandra , Ambrogetti Daniela , Paci Eugenio , Zappa Marco 
Published: January 2017

To evaluate the assessment criteria and the results achieved in the detection of breast lesions at mammographic screening. Review of cases assessed in the last screening round of Florence city (FC.- first screening round: 29 522 subjects) and Florence district (FD — repeat screening round: 13 268 subjects) programmes. Methods – Referral and biopsy rates, predictive values, and prevalence of cancers detected by screening were determined, as well as the frequency of the diagnostic procedures used at assessment, and their contribution to the final diagnosis according to the mammographic appearance of the suspected lesion. Assessment costs were estimated. Referral rate (FC 4.2%; FD 1.8%), referral positive predictive value (FC 18.7%; FD 28.3%), surgical biopsy rate (FC 0.96%; FD 0.6%), benign/malignant biopsy ratio (FC 0.20; FD 0.13), and prevalence of cancers detected by screening (FC 0.78%; FD 0.5%) were all within the European Community (EC) recommended standards for screening performance. The benign biopsy rate was considerably lower than that of recommended standards. The cost for each subject assessed was 179 000 Italian lire at the first and 116 000 lire at repeat screening. The cost for each subject screened that was attributable to assessment was 7600 lire at the first or 2100 lire at repeat screening. Limited referral rates and costs were achieved and the proportion of cancers detected by screening was high. The number of referrals was further reduced at repeat screening, and assessment had a limited impact on total screening costs. Detail or magnification mammography, palpation, sonography, and fine needle aspiration cytology all contributed to the final diagnosis and should be immediately available at the assessment clinic. The observed benign biopsy rate was particularly low and suggests that EC recommended standards should be modified.
Survival of Patients with Breast Cancer Diagnosed in the United Kingdom Trial of Early Detection of Breast Cancer
Authors: Moss S M , Ellman R , Coleman D , Chamberlain J ,   For the United Kingdom Trial of Early Detection of Breast Cancer Group
Published: January 2017

To examine the survival of patients with breast cancer diagnosed in different centres and by different methods in the United Kingdom trial of early detection of breast cancer, in order to investigate the contribution of different factors to the previously observed reductions in breast cancer mortality. A non-randomised trial of the early detection of breast cancer, in which women aged 45–64 in two districts were offered annual screening for seven years, women in a further two districts were offered education about breast self examination (BSE), and those in four districts formed a comparison group. Patients with breast cancer are classified according to the type of centre, method of detection, and attendance for BSE education. Univariate and multivariate survival analyses are carried out, including tumour size, dissemination status, and use of adjuvant treatment as additional variables. In the univariate analysis, patients with breast cancer who are nonattenders for screening have a significantly worse prognosis than those in the comparison centres. Patients whose cancer is detected by mammography have the best survival rate. The inclusion of size and dissemination status in the multivariate analysis explains only about one third of the improved prognosis in these cases. There is a significant difference between prognosis in the two BSE centres. The use of prognostic factors as recorded in this trial to predict breast cancer mortality may be inadequate.
Feasibility Study of a Randomised Trial of Ovarian Cancer Screening
Authors: Tabor Ann , Jensen Flemming R , Bock Johannes E , Høgdall Claus K 
Published: January 2017

To assess the feasibility of a randomised trial of ovarian cancer screening by vaginal ultrasonography. A population based study, recruiting a random sample of the female population aged 46 to 65 years living in Copenhagen, Denmark. Randomised controlled trial allocating 50% to the study group having vaginal ultrasonography, and 50% to the control group having no examination, (a) Acceptability of the study was evaluated by the proportion of eligible women willing to participate in the study, (b) The false positive rate was evaluated as the proportion of women without ovarian cancer referred for an operation because of abnormal ovaries detected by ultrasonography. 950 (64–3%) of the 1477 eligible women participated in the study. At the first scan abnormal ovaries were detected in 54 of 435 women (12%), significantly more frequently among younger women. Nine women were referred for an operation because of abnormal findings in the ovaries, giving a false positive rate of 2%Ovarian size and morphology found at operation corresponded with those at ultrasonography; none of them was malignant. A randomised controlled trial of ovarian cancer screening using vaginal ultrasonography seems acceptable in the general population. The rate of abnormal ovaries at ultrasonography with the cut offs used in this study was quite high. Such a study is, therefore, feasible, but it is proposed that it is carried out in an older age group (50–64 years) and that the cut offs used for ovarian size and morphology are re-evaluated. Second line tests, such as colour Doppler flow, should be considered in order to reduce the false positive rate.
Opportunistic Screening for Abdominal Aortic Aneurysm
Authors: Derbyshire Neil D J , Lindsell David R M , Collin Jack , Creasy Terence S 
Published: January 2017

To contribute to the current debate on screening for abdominal aortic aneurysm (AAA). Radiology department of the John Radcliffe Hospital, Oxford. The prevalence of AAA in 317 clinically referred male patients aged 65–74 undergoing abdominal ultrasonography with no clinical suspicion of an AAA was investigated over a period of one year. Over the year 15/317 (5%) patients were found to have an aneurysm (defined as aortic diameter (≥30mm), with eight (3%) patients having an aortic diameter of ≥40 mm. Six months later appropriate management for the AAA had been started for only four patients. A knowledge assessment questionnaire sent to 245 hospital clinicians and general practitioners showed that 17 (12%) of the 139 respondents would initiate no review of patients found to have an aneurysm of 30–39 mm and two would take no action with aneurysms of 40–49 mm. Thirty two (23%) respondents would seek advice on management for all categories of aneurysm, 14% from the radiologist. Opportunistic screening for AAA in men undergoing clinically indicated abdominal ultrasonography is easy, productive, without discernible cost, and discloses a prevalence of AAA comparable with that of population screening programmes. Routine opportunistic measurement of aortic diameter during abdominal ultrasonography in the at risk group would allow 12–15% of men aged 65–74 to be screened for AAA within five years without the need for any additional resources.
Monitoring Trends in Prenatal Diagnosis of Down's Syndrome in England and Wales, 1989–92
Authors: Morris Joan K , Mutton David E , Ide Roy , Alberman Eva , Bobrow Martin 
Published: January 2017

The national register of chromosomal anomalies that lead to Down's syndrome has enabled the monitoring of change in prenatal diagnosis for this condition, and the factors which affect the change. The proportion of cases of cytogenetically diagnosed Down's syndrome in England and Wales detected prenatally rose to 46% in 1991–2 from 31% in 1988–9, a 1·5-fold increase (95% confidence interval 1·3 to 1·7). The increase was confined to mothers under 40 years and was due to the introduction of screening by maternal serum analysis and ultrasound. Over a quarter of affected pregnancies in women aged 25–29 were detected prenatally in 1991–2 compared with less than 10% in 1988–9. Analysis of the data showed regional differences in prenatal diagnosis rates, and in the length of time elapsing between the diagnostic test and termination of an affected pregnancy. An inexplicable finding was that this period varied with the sex of the fetus, being on average a day longer for females than for males.