bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of transnasal oesophagoscopy in the management of globus pharyngeus and non-progressive dysphagia
Authors: Sanyaolu LN , Jemah A , Stew B , Ingrams DR 
Published: December 2015

Introduction Transnasal oesophagoscopy is a relatively new method of examining the upper aerodigestive tract via the nasal passage as an outpatient procedure without the need for sedation. It has been shown to be a well tolerated, safe and accurate technique, that can therefore be used in the investigation of patients thought to have globus pharyngeus and other non sinister causes of dysphagia. Methods A total of 150 consecutive patients undergoing transnasal oesophagoscopy were analysed retrospectively. Results The main indications for this procedure were non-progressive dysphagia (n=68, 45%) and globus pharyngeus (n=60, 40%). Transnasal oesophagoscopy was normal in 65% of patients and 42% of patients were discharged from clinic at the same appointment with no further investigation. The most common positive findings were laryngeal erythema (13%) and oesophagitis (10%). Conclusions Transnasal oesophagoscopy is a useful adjunct to the management of patients with the symptoms of globus pharyngeus and non-progressive dysphagia.
The management of vacuum neck drains in head and neck surgery and the comparison of two different practice protocols for drain removal
Authors: Kasbekar AV , Davies F , Upile N , Ho MW , Roland NJ 
Published: December 2015

Introduction The management of vacuum neck drains in head and neck surgery is varied. We aimed to improve early drain removal and therefore patient discharge in a safe and effective manner. Methods The postoperative management of head and neck surgical patients with vacuum neck drains was reviewed retrospectively. A new policy was then implemented to measure drainage three times daily (midnight, 6am, midday). The decision for drain removal was based on the most recent drainage period (at <3ml per hour). A further patient cohort was subsequently assessed prospectively. The length of hospital stay was compared between the cohorts. Results The retrospective audit included 51 patients while the prospective audit included 47. The latter saw 16 patients (33%) discharged at least one day earlier than they would have been under the previous policy. No adverse effects were noted from earlier drain removal. Conclusions Measuring drainage volumes three times daily allows for more accurate assessment of wound drainage, and this can lead to earlier removal of neck drains and safe discharge.
Socioeconomic deprivation and age are barriers to the online collection of patient reported outcome measures in orthopaedic patients
Authors: Jenkins PJ , Sng S , Brooksbank K , Brooksbank AJ 
Published: December 2015

Introduction Questionnaires are used commonly to assess functional outcome and satisfaction in surgical patients. Although these have in the past been administered through written forms, there is increasing interest in the use of new technology to improve the efficiency of collection. The aim of this study was to assess the availability of internet access for a group of orthopaedic patients and the acceptability of online survey completion. Methods A total of 497 patients attending orthopaedic outpatient clinics were surveyed to assess access to the internet and their preferred means for completing follow-up questionnaires. Results Overall, 358 patients (72%) reported having internet access. Lack of access was associated with socioeconomic deprivation and older age. Multivariable regression confirmed increased age and greater deprivation to be independently associated with lack of internet access. Out of the total group, 198 (40%) indicated a preference for assessment of outcomes via email and the internet. Conclusions Internet access was not universal among the patients in our orthopaedic clinic. Reliance on internet collection of PROMs may introduce bias by not including results from patients in older age groups and those from the more deprived socioeconomic groups.
Short and long-term cosmesis of cervical thyroidectomy scars
Authors: Dordea M , Aspinall SR 
Published: December 2015

Introduction Multiple surgical approaches to the thyroid gland have been described via cervical or extracervical routes. Improved cosmesis, patient satisfaction, reduced pain (procedure dependent) and early discharge have all been reported for minimally invasive approaches with similar safety profiles and long-term outcomes to conventional surgery. This review summarises the current evidence base for improved cosmesis with minimally invasive cervical approaches to the thyroid gland compared with conventional surgery. Methods A systematic review was undertaken. The MEDLINE®, Embase™ and Cochrane databases were searched for relevant articles. Results A total of 57 papers thyroid papers were identified. Of those, 20 reported some form of cosmetic outcome assessment. There were 6 randomised controlled trials with 412 patients (evidence level 2B), 7 cohort studies with 3,073 patients (level 3B) and 7 non-comparative case series with 1,575 patients (level 4). There was significant heterogeneity between studies in terms of wound closure technique, timing of scar assessment and scar assessment scales (validated and non-validated). Most studies performed early scar assessments, some using non-validated scar assessment tools. Conclusions Assessment of cosmesis is complex and requires rigorous methodology. Evidence from healing/remodelling studies suggests scar maturation is a long-term process. This calls into question the value of early scar assessment. Current evidence does not support minimally invasive surgical approaches to the thyroid gland if improved long-term cosmesis is the goal.
Medical therapy for polycystic liver disease
Authors: Khan S , Dennison A , Garcea G 
Published: December 2015

Introduction Somatostatin analogues and rapamycin inhibitors are two classes of drugs available for the management of polycystic liver disease but their overall impact is not clearly established. This article systematically reviews the literature on the medical management of polycystic liver disease. The outcomes assessed include reduction in liver volume and the impact on quality of life. Methods The English language literature published between 1966 and August 2014 was reviewed from a MEDLINE®, PubMed, Embase™ and Cochrane Library search. Search terms included ‘polycystic’, ‘liver’, ‘sirolimus’, ‘everolimus’, ‘PCLD’, ‘somatostatin’, ‘octreotide’, ‘lanreotide’ and ‘rapamycin’. Both randomised trials and controlled studies were included. References of the articles retrieved were also searched to identify any further eligible publications. The studies included were appraised using the Jadad score. Results Seven studies were included in the final review. Five studies, of which three were randomised trials, investigated the role of somatostatin analogues and the results showed a mean reduction in liver volume ranging from 2.9% at six months to 4.95 ±6.77% at one year. Only one randomised study examined the influence of rapamycin inhibitors. This trial compared dual therapy with everolimus and octreotide versus octreotide monotherapy. Liver volume reduced by 3.5% and 3.8% in the control and intervention groups respectively but no statistical difference was found between the two groups (p=0.73). Two randomised trials investigating somatostatin analogues assessed quality of life using SF-36®. Only one subdomain score improved in one of the trials while two subdomain scores improved in the other with somatostatin analogue therapy. Conclusions Somatostatin analogues significantly reduce liver volumes after six months of therapy but have only a modest improvement on quality of life. Rapamycin inhibitors do not confer any additional advantage.
Length of stay and cost analysis of neonates undergoing surgery at a tertiary neonatal unit in England
Authors: Shetty S , Kennea N , Desai P , Giuliani S , Richards J 
Published: December 2015

Introduction There is a lack of knowledge on the average length of stay (LOS) in neonatal units after surgical repair of common congenital anomalies. There are few if any publications reporting the activity performed by units undertaking neonatal surgery. Such activity is important for contracting arrangements, commissioning specialist services and counselling parents. The aim of this study was to describe postnatal LOS for infants admitted to a single tertiary referral neonatal unit with congenital malformations requiring surgery. Methods Data on nine conditions were collected prospectively for babies on the neonatal unit over a five-year period (2006–2011). For those transferred back to their local unit following surgery, the local unit was contacted to determine the total LOS. Only those babies who had surgery during their first admission to our unit and who survived to discharge were included in the study. Cost estimates were based on the tariffs agreed for neonatal care between our trust and the London specialised commissioning group in 2011–2012. Results The median LOS for the conditions studied was: gastroschisis 35 days (range: 19–154 days), oesophageal atresia 33 days (range: 9–133 days), congenital diaphragmatic hernia 28 days (range: 7–99 days), intestinal atresia 24 days (range: 6–168 days), Hirschsprung’s disease 21 days (range: 15–36 days), sacrococcygeal teratoma 17 days (range: 12–55 days), myelomeningocoele 15.5 days (range: 8–24 days), anorectal malformation 15 days (range: 6–90 days) and exomphalos 12 days (range: 3–228 days). The total neonatal bed day costs for the median LOS ranged from £8,701 (myelomeningocoele) to £23,874 (gastroschisis). The cost of surgery was not included. Conclusions There is wide variation in LOS for the same conditions in a single neonatal unit. This can be explained by different types and severity within the same congenital anomalies, different surgeons and other clinical confounders (eg sepsis, surgical complications, associated anomalies). These data will enable us to give more detailed information to families following prenatal or postnatal diagnosis. They also allow more detailed planning of resource allocation for neonatal admissions.
Reactivity of Callovo-Oxfordian Claystone and its Clay Fraction With Metallic Iron: Role of Non-Clay Minerals in the Interaction Mechanism
Authors: Rivard Camille , Pelletier Manuel , Michau Nicolas , Razafitianamaharavo Angelina , Abdelmoula Mustapha , Ghanbaja Jaafar , Villiéras Frédéric 
Published: December 2015

AbstractIn order to better understand the possible interactions between steel canisters and a claystone host rock, in this case the Callovo-Oxfordian rock (COx), the present study investigated in detail, under conditions relevant to high-level radioactive waste repositories (anoxic conditions, temperature of 90°C), the reactions between metallic iron and: (1) COx; (2) the clay fraction extracted from COx (CF); and (3) mixtures of CF with quartz, calcite, or pyrite. Batch experiments were then carried out in the presence of NaCl-CaCl2 background electrolyte, for durations of 1, 3, and 9 months. Solid and liquid end-products were characterized by a combination of techniques including liquid analyses, transmission and scanning electron microscopies, X-ray diffraction, N2 adsorption at 77 K, and Mössbauer spectroscopy. The interaction between CF and metallic iron appeared to proceed by means of pathways similar to those illustrated in previous studies on interactions between metallic iron and purified clays. In spite of the many similarities with previous studies, significant differences were observed between the behavior of COx and CF, particularly in terms of pH and Eh evolution, iron consumption, chemical composition of the neoformed particles, and textural evolution. Such differences demonstrate the important role played by non-clay minerals in reaction pathways. The addition of carbonates or pyrite to CF did not lead to significant change in reactivity. In contrast, under the conditions used in the present study, i.e. for relatively low iron:clay ratios, the presence of quartz strongly influenced reaction pathways. In the presence of quartz, magnetite was observed only in trace abundances whereas the amounts of magnetite were significant in experiments without quartz. Furthermore, filamentous serpentine particles with a small Al:Si ratio appeared which could develop from an FeSiAl gel that only forms in the presence of quartz. Considering that most clay rocks currently being considered for radioactive waste disposal contain significant amounts of quartz, the results obtained in the present study may be of significant interest for predicting the long-term behavior of clay barriers in such sites.
Moving Us Toward a Theory of Individual Quality of Life
Authors: Schalock Robert L. , Verdugo Miguel A. , Gomez Laura E. , Reinders Hans S. 
Published: December 2015

Abstract
This article discusses three steps involved in moving us toward a theory of individual quality of life: developing a conceptual model, integrating theory components, and applying and evaluating the theory. Each of the proposed steps is guided by established standards regarding theory development and use. The article concludes with a discussion of criteria that can be used to evaluate the theory and the contribution that a theory of individual quality of life would make to the field of disability.
Representaciones sociales y orientación educativa del profesorado
Authors: San Román Sonsoles , Vecina Carlos , Usategui Elisa , Del Valle Ana Irene , Venegas Mar 
Published: December 2015

En este artículo pretendemos informar del planteamiento teórico y metodológico de un proyecto de investigación, que hemos iniciado recientemente, sobre las representaciones sociales y culturales que condicionan al profesorado en la función docente y práctica orientadora[1], así como de los estudios previos en cuyos resultados nos hemos apoyado para avanzar en nuestras hipótesis. Nuestro planteamiento parte de la consideración de las transformaciones sociales y su influencia en la institución escolar, favoreciendo un contexto de incertidumbre para el profesorado, consideramos claves las representaciones sociales como guía de su actuación en la relación con los alumnos, pudiendo determinar la orientación escolar y profesional que sobre éstos ejercen. Como punto final, se pretende analizar desde una mirada sociológica, la identificación de criterios y posibles modelos de orientación desplegados y practicados por los docentes, como un fenómeno que se construye socialmente.Para acabar se presentan brevemente los resultados de estudios previos realizados por el equipo de investigación, referentes a las representaciones sociales de los alumnos en el profesorado, cuestiones que hacen plantear el camino que toma la orientación de dichos estudiantes. Estudios que nos han aportado conclusiones para la configuración del trabajo de investigación actual.[1] Se trata de un proyecto de I+D+i, Contexto Socioeconómico y Orientación Educativa y Profesional del Profesorado de Secundaria, aprobado por el Ministerio de Economía y Competitividad (España), para su realización durante el período 2014-2016, con referencia CSO2013-47168-R, bajo la dirección de la investigadora principal Sonsoles San Román Gago (Universidad Autónoma de Madrid).
Povezave med razjedo zaradi pritiska in ohranjanjem integritete kože pacienta v intenzivni zdravstveni obravnavi: pregled literature
Authors: Emeđi Dragica , Skela-Savič Brigita 
Published: December 2015

Uvod: Namen raziskave je prikazati večdimenzionalne potrebe in možne dejavnike tveganja za razjedo zaradi pritiska pri odraslih pacientih v intenzivni zdravstveni obravnavi.
Metode: Uporabili smo analizo in sintezo pregleda dokazov iz zbirke podatkov EMERALD, CINAHL, PubMed in ProQuest. Ključne iskalne besedne zveze so bile: »quality of care«, »pressure ulcer«, »prevention and treatment of pressure ulcers«, »skin integrity critical care patients«. Omejitveni kriteriji iskanja so bili: obdobje 2010 do 2013, celotno besedilo člankov v angleščini. Začetna merila je izpolnjevalo 280 zadetkov in 40 izbranih ustreznih prispevkov. Potek raziskave je prikazan v skladu z načeli Cochranove zbirke, ocena kakovosti dokazov pa v hierarhiji dokazov.
Rezultati: Identificiranih je 191 kod, ki so združene v 11 vsebinskih kategorij: okolje intenzivne terapije – značilnosti nekaterih dejavnikov tveganja, čas bivanja v enoti, vazoaktivne učinkovine, spol, starost, administrativno diagnostična kategorija, postelja, ležišče, lestvica Waterlow, razjeda zaradi pritiska in pomen prve stopnje razjede.
Diskusija in zaključek: Raziskava pokaže pomen uvedbe proaktivnih ukrepov za ohranjanje integritete kože pacienta. Osredotoča se na vitalnost tkiva in promocijo kakovostne zdravstvene oskrbe z vidika teorije. Potrebne so raziskave, ki bi za boljše razumevanje pojasnjevale številna druga tveganja in učinkovite programe za vitalnost kože.
Nurses' impact on quality of care: lessons from RN4CAST
Authors: Sermeus Walter 
Published: December 2015

Introduction: The RN4CAST - study (acronym for Nurse Forecasting in Europe) was launched in 2009 and ended in 2011 under the European Union's Seventh Framework Programme. The aim of the RN4CAST-study was to study how features of work environments and qualifications of the nurse workforce impact nurse retention, burnout among nurses and patient outcomes.
Methods: The study was conducted in twelve European countries and was conducting a cross-sectional survey in 500 hospitals in which more than 33,000 nurses and more than 11,000 patients were involved. These data were linked to patient outcome data from administrative databases.
Results: The study showed that patient outcomes such as patient mortality and patient satisfaction is highly related to nurse staffing characteristics such as patient-to-nurse ratios, nurse qualification and nursing work environment. Also nurse outcomes such as burnout, intention-to-leave, job satisfaction are related to staffing adequacy and nursing work environment.
Discussion and conclusion: The RN4CAST study generated a large evidence base of nurse workforce issues across European health systems which is quite unique in terms of the number and qualification of nursing staff, the quality of working environments, burnout rates, job satisfaction rates, intention-to-leave rates that can be used for policy making.
Smernice za izobraževanje v zdravstveni negi na študijskem programu prve stopnje Zdravstvena nega (VS)
Authors: Skela-Savič Brigita 
Published: December 2015

Uvod: Področje izobraževanja v zdravstveni negi na ravni Evropske unije ureja Direktiva 2013/55/EU. Nacionalnih smernic za področje izobraževanja v zdravstveni negi, ki bi bile nadgradnja direktivi na tem področju, v Sloveniji ni, prav tako v zadnjih desetih letih ni opredeljenih potreb po izobraževanju v zdravstveni negi.
Metode: Uporabljena je bila komplementarna kombinacija kvalitativnih metod konsenza (panelna skupina ekspertov, tehnika skupinskega konsenza), kvantitativna neeksperimantalna opisna metoda Delfi in metoda pregleda literature. Vključeni so bili predstavniki visokošolskih in zdravstvenih zavodov, nacionalno združenje v zdravstveni negi in študenti zdravstvene nege.
Rezultati: Obdobje razvoja smernic je trajalo od leta 2013 do 2015 in je vključevalo šest iteracij različnih metod konsenza. Po metodi »snežne kepe« in institucijske pripadnosti je sodelovalo več kot 150 strokovnjakov na področju zdravstvene nege (visoko šolstvo, zdravstveni zavodi), od tega 18 študentov zdravstvene nege. Prepoznanih je bilo osem vsebinskih področij smernic.
Zaključek in implementacija: Smernice so dobro izhodišče za poenotenje visokošolskega izobraževanja na področju zdravstvene nege v Republiki Sloveniji. Dajejo osnove za presojo kakovosti izobraževanja v zdravstveni negi in so podlaga tudi za politiko, ki mora prevzeti odgovornost na ravni količine in kakovosti visokošolskega izobraževanja v zdravstveni negi.
The Use of Virtual Media Laboratory to Increase Students’ Motivation on Direct Current Circuits Materials at Class X of MAN I Pekanbaru
Authors: Emhadelima Emhadelima 
Published: December 2015

The purpose of the study is to determine whether there is a significance effect on the use of Practicum methods by using Crocodile Program combined with lectures, question and answer activities give significant effect on students’ activities in learning electricity simple lesson and to identify whether the use of the simulation lab provides better results than the traditional lab on learning outcomes. 36 natural science students was involved in the study. The data was analyzed by using t-test. The finding showed that the use of Practicum methods by using Crocodile Program combined with lectures; question and answer activities give significant effect on students’ activities in learning electricity simple lesson. The finding also showed that the use of the simulation lab can provide better results than the traditional lab on learning outcomes. It occurred when there is an adequate software capability and students can operate the software properly. Without taking into account about the cost of procurement of computers and software programs Crocodile, lab simulations are very low cost because it does not need to purchase laboratory equipment, supplies and other consumables. It is expected that Crocodile Program not only as a practical method to implement but also as a medium to explain the concepts of electronic circuits. Key words: Virtual Media, Circuits Materials.Copyright © 2015 by Al-Ta'lim All right reserved
A gastric stump cancer with unusual appearance
Authors: Sapmaz Ferdane , Basyigit Sebahat , Uzman Metin , Simsek Gulcin Guler , Akkan Tolga , Nazligul Yasar 
Published: December 2015

A 60 year old man was referred to our hospital with the chief complaints of abdominal pain and vomiting. He underwent a distal gastrectomy with a Billroth II gastrojejunostomy for a peptic ulcer 13 years ago. Esophagogastroduodenoscopy (EGD) did not reveal any gross lesion in the stomach but depigmented areas were seen in the anastomosis line. The histopathology of the anastomotic area revealed poorly differentiated adenocarcinoma. Gastric stump cancers can be polypoid, fungating, ulcerated and diffusely infiltrating tumors respectively. In our case, the appearance of adenocarcinoma was quite different from that described in the classification system.
Appropriateness of knee MRI prescriptions in a hospital of Birjand, 2014
Authors: Vejdani Marjan , Molavi Taleghani Yasamin , Kachoei Amir Reza , Hosseini Roghayeh , Salehi Sirvan , Foji Samira , Goudarzian Maryam , Fattahzadeh-Ardalani Ghasem 
Published: December 2015

<p class="abstract"><strong>Background:</strong> Knee pain is one of the most common complains which cause patients to visit a doctor and Magnetic Resonance Imaging (MRI) is one of the common diagnostic methods which are common to find the cause of Knee pain. This study aim to determine knee MRI appropriateness, in Valiasr hospital of Birjand in 2014.</p><p class="abstract"><strong>Methods:</strong> In this study descriptive – analytical study, 150 patients referred to MRI unit were selected using convenient sampling method. Data were gatherers using a Questionnaire and then analyzed by SPSS16 using descriptive statistics and Pearson, chi-square and Fisher's exact tests. </p><p class="abstract"><strong>Results:</strong> Of 150 cases, 70 (46.7%) were considered inappropriate, 7 (4.7%) were uncertain, and 73 (48.7%) were deemed to be appropriate. The economic burden of inappropriate prescriptions was 46200000 Rails. A statistical significant relation was observed between appropriateness of prescription with sex, jobs, education, physician specialist and referring institution.</p><strong>Conclusions:</strong> Considering the high rate of inappropriate prescriptions, it is necessary to find the causes. Developing, customization, and perform clinical guidelines in all of our country may help reducing this rate.