bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emotional Adaptation of Children Undergoing Bone Marrow Transplantation
Authors: Günter Michael , Karle Michael , Werning Andreas , Klingebiel Thomas 
Published: January 2017

Objective: To examine stress reactions and psychic adaptation of children aged 8–12 years in single-room treatment under isolation conditions after bone marrow transplantation (BMT). Methods: The prospective longitudinal study included free diagnostic interviews and a large test battery. We used a mixture of projective tests questionnaires and an intelligence test (the German version of the revised Wechsler Intelligence Scale for Children) to evaluate different adaptation processes. Results: The questionnaires clearly showed children's strong tendencies to adapt to the situation and to normalize their behaviour under isolation conditions. In contrast, the psychoanalytic interview and the projective tests demonstrated a very differentiated emotional adjustment: Before transplantation, coming to terms with the life-threatening situation was deferred. After transplantation, very intensive emotional examination of the situation and superficial adaptation (protective denial) were observed. Conclusions: It is very important to intensify the child's and the family's psychosocial support before admitting the child for hospital treatment. Family conflicts and neurotic developments should be regarded as risk factors for marked and potentially dangerous stress reactions.
A reformative shear precipitation procedure for the fabrication of vancomycin-loaded poly(lactide-co-glycolide) microspheres
Authors: Wang Lei , Yang Qinmeng , Chen Yirong , Chai Yu , Li Jiao Jiao , Du Lin , Tan Ruizhe , Yang Shenyu , Tu Mei , Yu Bin 
Published: January 2017

This study reports the encapsulation of vancomycin, as a model hydrophilic drug, into poly(lactide-co-glycolide) microspheres using a novel reformative shear precipitation procedure. In contrast to the external aqueous phase used in the conventional microencapsulation technique based on emulsion solvent evaporation/extraction, the reformative shear precipitation procedure explored in this study uses a shear medium composed of glycerol as the viscous medium and ethanol as polymer antisolvent, which is relatively immiscible with the hydrophilic drug. This limits drug diffusion and leads to rapid microsphere solidification, which allows a large proportion of the hydrophilic drug to be encapsulated within the microspheres. The influence of various processing parameters, including polymer concentration, volume ratio of ethanol to glycerol in the shear medium, volume of aqueous drug solution, initial drug loading, and injecting rate of the drug–polymer emulsion, on the encapsulation efficiency and characteristics of resulting microspheres were investigated. The morphology and release characteristics, as well as mechanical, in vitro and in vivo behaviour of vancomycin-loaded poly(lactide-co-glycolide) microspheres prepared using the novel procedure were also investigated. The results demonstrated that the reformative shear precipitation procedure could achieve the loading of hydrophilic drugs into poly(lactide-co-glycolide) microspheres with high encapsulation efficiency, and the success of the procedure was largely influenced by the volume ratio of ethanol to glycerol in the shear medium. Vancomycin-loaded poly(lactide-co-glycolide) microspheres prepared using this procedure demonstrated favourable mechanical characteristics, antibacterial activity, and in vivo degradation behaviour which suggested their suitability for use as a sustained delivery system.
Therapeutic Touch —The Caring Environment
Authors: Patricia Rose Heidt 
Published: January 2017

Abstract: A case study of one nurse's experience of Therapeutic Touch is presented. The major themes of the interview data are discussed by the researcher. The study provides a deeper insight into the caring relationship of the nurse during the time the nurse treats her patient with Therapeutic Touch. Summary: In this case study one nurse presents her experiences while administering treatment by TT. An analysis of the themes of the interview indicates the nurse's primary experience is one of participating in opening the flow of the universal life energy in the patient and herself. The process involves (1) OPENING INTENT — allowing herself to focus on getting the universal life energy moving again, (2) OPENING SENSITIVITY — assessing the quality of its flow, and (3) OPENING COMMUNICATION — participating in a healing relationship that unblocks, engages and enlivens its movement. For the nurse in this study, administering treatment by TT is a special way of caring for a patient. By acknowledging her patient as “openness”, i.e., a person who is always changing, growing, living, willing and healing, she chooses a treatment modality which supports this fundamental nature in her patient. Her caring stands as a challenge to traditional conceptual models about the nature of healing and person-environment relationships. In our present health care system, riddled with fragmentation, and relying heavily on technological innovation, the treatment she gives her patient may indeed be nursing's great boon. The nurse's willingness and ability to share her inner experiences about administering treatment by TT is a very important step in building a knowledge base about this treatment modality. Up to this time, there has been a concentration on experimental research which indicates general effects of TT treatment. Now, as more qualitiative data is collected about nurses' and patients' personal accounts of TT, professional nurses may benefit by using them as models for their own development of TT practice.
Recruiting for Success – the Potential for Using Occupational Personality Questionnaires for the Assessment of Doctors
Authors: Chambers Ruth , Wright Derek , Taylor Heather 
Published: January 2017

Objectives: to evaluate the Saville and Holdsworth Occupational Personality Questionnaire (OPQ) to assess its potential and validity as a tool in the recruitment of doctors. To determine the range of personality characteristics in a group of general practitioners. Design: an administered commercially available questionnaire. Setting: general practitioners in North and Mid. Stafffordshire. Subjects: 133 general practitioners or trainees. Results: 44% of general practitioners agreed to participate. The majority found it useful and recognised its potential to increase self-awareness, highlight weaknesses that might be improved and for future recruitment of others to their teams. Doctors' personality traits were similar to those of managerial/professional norms. The validity of the OPQ was supported by (a) significant associations with subjects' previously reported mental health problems and (b) 83% of respondents confirming that their reports correctly described their personalities at work. Conclusions: OPQs have a place in the recruitment of doctors by identifying appropriate people to strengthen the team.
Management of Intrameatal Warts in Men
Authors: McKenna J G , McMillan A 
Published: January 2017

The case notes of 1080 men with genital warts were analysed retrospectively over a 30-month period. One hundred and forty patients were identified with intrameatal warts and an audit of their treatment is discussed. When electrocautery and cryotherapy were compared the former produced a more rapid resolution of the lesions. Cystourethroscopy was performed on 16 patients with intrameatal warts. No patient had involvement beyond the distal 3 cm of the urethra. Data on concurrent sexually transmitted diseases, population characteristics and pattern of referral are presented and compared to previously reported studies.
Effect of Parity on Human Chorionic Gonadotropin Levels and Down's Syndrome Screening
Authors: Haddow James E , Palomaki Glenn E , Knight George J 
Published: January 2017

Objective To investigate further the association between parity and human chorionic gonadotrophs (hCG) levels during the second trimester and determine whether prenatal screening for Down's syndrome might be made more efficient by adjusting for this variable. Methods Measurements of hCG were analysed in relation to parity from a cohort of 16 675 singleton pregnancies with viable outcomes, and from 108 singleton pregnancies affected by Down's syndrome. Cigarette smoking during pregnancy and maternal age were also analysed in relation to hCG levels. Results For both unaffected pregnancies and pregnancies with Down's syndrome the median hCG levels were 7% lower in parous than in nulliparous women. A doseresponse relation was also documented for the unaffected pregnancies. When para 0, para 1, and para 2 women were studied separately, hCG levels rose steadily as age advanced. Adjusting hCG levels for parity led to a 0£1% reduction in variance of the distribution of hCG measurements in unaffected pregnancies and to a negligible increase in Down's syndrome screening efficiency. Conclusion The effect of parity is not sufficiently great to warrant routine adjustment of hCG levels as part of prenatal screening for Down's syndrome.
Construction of a Community Height Surveillance Programme: The Hackney Growth Initiative
Authors: Hearn S , Cotterill A M , Majrowski W , Rohan C , Jenkins S , Savage M O 
Published: January 2017

Objectives To determine why, in the London Borough of Hackney before 1990, fewer children than expected were identified with remedial causes of short stature. To construct a practical model for height surveillance of 5 and 11 year old school entrants to improve the quality of child growth surveillance. Setting City and Hackney Borough, London, United Kingdom. Methods School nurses were trained by a clinical auxologist to measure children's height at school entry accurately and reproducibly. New procedures for measurement technique, plotting of data, referral, and audit were established. A reference manual was provided and a continuing training programme was started. Results During the first year the percentage of the target group measured was low. Changes in work practice led to improvements from 77% measured in the first year to 91% in the second year and 87% in the third year for 5 year olds. Improvements for 11 year olds were from 36% to 86% to 87% over the three years. Only 1£2% of 5 year olds and 2 6% of 11 year olds measured had height less than the third centile (compared with Tanner's height standards). Conclusions School nurses measured height reliably. New audit procedures led to rapid changes in working practice and improvements in the percentage of children measured. The low numbers of short children previously identified with unrecognised abnormality may indicate an upward trend in height in this inner city population.
Effect of Retesting with Dietary Restriction in Haemoccult Screening for Colorectal Cancer
Authors: Robinsno M H E , Moss S M , Hardcastle J D , Whynes D K , Chamberlain J O , Mangham C M 
Published: January 2017

Objectives To determine the detection rate, false positive and false negative rates associated with a policy of retesting with dietary restriction after an initial positive Haemoccult screening test for colorectal cancer, in order to compare the cost effectiveness of such a policy with the alternative, in which all subjects with a positive test would proceed directly to diagnostic colonoscopy. Methods Over four years in a large randomised control trial in Nottingham 35 260 subjects had a mean of 1£5 screening rounds each at two-yearly intervals, and were followed up for a minimum of 27 months. During this period subjects with positive screening tests were asked to repeat the test with dietary restrictions. Estimates of costs of the initial screening and of diagnostic colonoscopy were used to estimate the cost for each cancer detected by the different policies. Results 1209 subjects had a positive initial screening test and 1033 (85£4%) completed the retests. Four hundred and ninety nine subjects were investigated and 89 cancers detected. In the 710 subjects with negative retests six interval cancers were diagnosed in the two years after screening. If these had been detected by screening under a policy of immediate colonoscopy, test sensitivity would have been improved from 53£6% to 57£2% (P = 0–02), but the cost for each cancer detected would have increased from £773 to £1509. Conclusion Retesting with dietary restrictions reduces costs and maximises the benefit of limited colonoscopy resources, but results in a small but significant reduction in test sensitivity compared with a policy for immediate colonoscopy.
Role of Screening in Reducing Invasive Cervical Cancer Registrations in England
Authors: Fouquet Roger , Gage Heather 
Published: January 2017

Objective –To estimate the effect of screening on invasive cervical cancer registrations in England. Setting –The Health of the Nation target for cervical cancer seeks to reduce the incidence of invasive cases (ICD 180) by at least 20% between 1986 and 2000. Method - The available area-level statistics on invasive cervical cancer registrations, screening activity, and socioeconomic and behavioural characteristics for 145 district health authorities in England over the period 1985–91 were collected. A multiple regression analysis sought to explain variations in incidence rates by relating screening and socioeconomic and behavioural variables to registration rates. Results —Districts with higher unemployment levels and higher numbers of pregnancies in young women had higher registration rates for invasive cervical cancer. The cervical smear rate for women aged 35–64 in a district was positively related to registrations, whereas the relation was negative for the 20–34 age group. Conclusions –The higher registration rates for invasive cervical cancer in districts with higher cervical smear rates for women aged 35–64 may reflect historically lower screening cover. The negative relation between the cervical smear rate and invasive cervical cancer registrations in women aged 20–34 is accompanied by high registration rates for preinvasive (ON III) cervical cancer (ICD 233.1). For the advantages of the Pap test to be fully realised, and for invasive cervical cancer registrations to fall in line with the Health of the Nation targets, a comprehensive screening programme, with a high take up rate is required. The various changes to the screening programme introduced since 1988 should help to achieve this. Public health policy should focus on educating the population about the risk factors for cervical cancer and the significance of screening.
Population Screening for Haemochromatosis: A Unifying Analysis of Published Intervention Trials
Authors: Bradley Linda A , Haddow James E , Palomaki Glenn E 
Published: January 2017

Objectives— To examine the efficacy of population screening for haemochromatosis by analysing the screening performance of seven intervention trials, and to compare this with the expected performance derived from family studies. Setting— Seven population intervention trials carried out between 1983 and 1995 in Australia, Scandinavia, Iceland, and the United States. Methods— Seven of 23 English language trials identified were suitable for the meta-analysis. Transferrin saturation and serum ferritin measurements derived from family studies were used to predict detection and false positive rates for each trial. Results— The seven trials used various screening and diagnostic criteria. A total of 18 396 men and 12 254 women were screened. Because some cases were not detected by screening, and some screen positive individuals did not complete diagnostic testing, the prevalence of homozygous individuals was underestimated in all the trials. The reported and predicted percentages of screen positive individuals nearly always agreed. The homozygote prevalence was estimated to be 34 men and 40 women per 10 000 (prevalence predicted from family studies is 53 per 10 000). Clinical manifestations were present in 50% of male and 44% of female homozygotes. Conclusions— False positive rates, homozygote prevalences, and frequency of clinical manifestations were in general agreement with predictions from family studies. However, incomplete understanding about a number of issues requires that further pilot trials be carried out before screening can be considered part of routine medical practice.
Molecular Screening of Families Affected by Familial Adenomatous Polyposis (FAP)
Authors: Gazzoli I , De Andreis C , Sirchia S M , Sala P , Rossetti C , Bertario L , Colucci G 
Published: January 2017

Objectives— To assess the risk of developing familial adenomatous polyposis (FAP) in presymptomatic individuals using APC gene flanking and intragenic polymorphic markers. Setting— Twenty families enrolled in the Italian Registry of Polyposis comprising a total of 217 individuals, including 53 (24%) presymptomatic subjects with a 50% a priori risk of FAP, were analysed. Direct analysis techniques had previously failed to identify the FAP mutation in these families. Methods— DNA isolated from peripheral mononuclear blood cells and tissue sections was analysed by the polymerase chain reaction and a panel of seven highly polymorphic markers—YN5.64, CB83, CB26, LNS, APC1458.5, MBC, 37AB. Amplification products were separated by a modified denaturing gel electrophoresis method. Results— The haplotype associated with the disease was identified in 18 families (90%). The segregation of the FAP haplotype in these kindreds showed that 10 presymptomatic individuals had inherited the FAP mutation and carried a high risk of developing the disease. The remaining two families were not informative because of the lack of a sufficient number of probands or biological specimens. Conclusions— These data indicate that indirect analysis with linked DNA markers has a high rate of success in defining the risk of FAP of presymptomatic subjects, provided that a sufficient number of probands or samples is available. Uninformative families accounted for 10% of the total, indicating that linkage analysis may still have higher sensitivity than direct mutation analysis techniques. The combined use of both approaches should be implemented, however, to enhance further the application of molecular genetics to the screening of families with FAP.
Family perspectives on organ and tissue donation for transplantation: A principlist analysis
Authors: dos Santos Marcelo José , Feito Lydia 
Published: January 2017

Background: The family interview context is permeated by numerous ethical issues which may generate conflicts and impact on organ donation process. Objective: This study aims to analyze the family interview process with a focus on principlist bioethics. Method: This exploratory, descriptive study uses a qualitative approach. The speeches were collected using the following prompt: “Talk about the family interview for the donation of organs and tissues for transplantation, from the preparation for the interview to the decision of the family to donate or not.” For the treatment of qualitative data, we chose the method of content analysis and categorical thematic analysis. Participants: The study involved 18 nurses who worked in three municipal organ procurement organizations in São Paulo, Brazil, and who conducted family interviews for organ donation. Ethical considerations: The data were collected after approval of the study by the Research Ethics Committee of the School of Nursing of the University of São Paulo. Results: The results were classified into four categories and three subcategories. The categories are the principles adopted by principlist bioethics. Discussion: The principles of autonomy, beneficence, non-maleficence, and justice permeate the family interview and reveal their importance in the organs and tissues donation process for transplantation. Conclusion: The analysis of family interviews for the donation of organs and tissues for transplantation with a focus on principlist bioethics indicates that the process involves many ethical considerations. The elucidation of these aspects contributes to the discussion, training, and improvement of professionals, whether nurses or not, who work in organ procurement organizations and can improve the curriculum of existing training programs for transplant coordinators who pursue ethics in donation and transplantation as their foundation.
Effect of the Addition of Ciprofloxacin on Theophylline Pharmacokinetics in Subjects Inhibited by Cimetidine
Authors: Davis Robin L. , Quenzer Ronald W. , Kelly H. William , Powell J. Robert 
Published: January 2017

OBJECTIVE: Although the effect of individual enzyme inhibitors on hepatic microsomal enzyme activity has been studied extensively, little data exist on the effects of combinations of inhibiting agents. The purpose of this study was to investigate the effect of the addition of a second hepatic oxidative enzyme inhibitor on the inhibition of metabolism in subjects already maximally inhibited by cimetidine. Ciprofloxacin was used as the second inhibitor. DESIGN: In a randomized crossover sequence, subjects received theophylline 5 mg/kg on day 6 of therapy with cimetidine 2400 mg/d, ciprofloxacin 1 g/d, both drugs, or while drug-free. SETTING: National Institutes of Health-funded General Clinical Research Center. PARTICIPANTS: Eight normal volunteers (6 men, 2 women; mean age 25.2 y). OUTCOME MEASURES: Theophylline pharmacokinetic parameters after each treatment were determined by model independent pharmacokinetic analysis. Statistical analysis of the data for differences between treatments was assessed by ANOVA for repeated measures. RESEARCH: When administered alone, ciprofloxacin and cimetidine caused a significant increase in theophylline elimination half-life and a decrease in clearance. Theophylline elimination half-life was significantly longer during combined therapy compared with either drug alone. Theophylline clearance was lower during combined treatment, although this relationship did not reach statistical significance. CONCLUSIONS: The addition of a second enzyme inhibitor in subjects receiving maximally inhibiting doses of cimetidine can produce a further decrease in the hepatic metabolism of drugs that are metabolized by the cytochrome P-450 microsomal enzyme system. As cimetidine and ciprofloxacin are frequently used together for a variety of common clinical indications, clinicians should be aware of this drug interaction and should consider that a similar effect may occur when other enzyme inhibitors are used concomitantly.