bluuebunny/crossref_metadata_2025_split huggingface dataset:
Care priorities‐ Registered Nurses’ clinical daily work in municipal elderly care settings
Authors: Norell Margaretha , Ziegert Kristina , Kihlgren Annica 
Published: September 2012

Scand J Caring Sci; 2013; 27; 388–395

Care priorities‐ Registered Nurses’ clinical daily work in municipal care settings
Common in Swedish elderly home care is that Registered Nurses work independently, and lead the care team without being a part of it. People involved in the care of the patient can be social services, physician, Registered Nurse (RN), nurses in inpatient care and family. In according to current model for nursing documentation RNs interventions is described as participation, information/education, support, environment, general care, training, observation/surveillance, special care drug administration and coordination. Time pressure is perceived as high, but the nurses have the opportunity to influence their daily work situation and make priorities. The purpose of this study was to investigate how RNs prioritise interventions in municipal elderly care settings. A quantitative descriptive method was used for the study. Data were collected during the months of April and October 2004 – 2008, using a web‐based form. The nurses filled in patient’s type of housing, performed interventions, and if the interventions were delegated. Interventions were described as keywords and were attributed a certain amount of time, calculated in previous time studies. The inclusion criteria were: all patients 80 years of age and older, in a municipality in south‐western Sweden, who received some form of health care from a RN, or performed by non‐certified staff by delegation. Results indicate that differences in priority could be observed, depending on the patient’s gender, or whether the patient was living in independent or sheltered housing. Drug administration was prioritised for female patients, while coordination became a priority for patients living in ordinary housing. Support received the highest priority, regardless if the patient lived in ordinary or sheltered housing. However, it is not entirely clear what support signifies in municipal health care settings, and this issue would therefore require further investigation.
Health‐related quality of life of patients with severe heart failure. A cross‐sectional multicentre study
Authors: Fotos Nikolaos V. , Giakoumidakis Konstantinos , Kollia Zoi , Galanis Petros , Copanitsanou Panagiota , Pananoudaki Evangelia , Brokalaki Hero 
Published: September 2012

BackgroundHeart failure is a serious chronic syndrome that is accompanied by significant physical and psychological burdens, resulting in poor quality of life.AimTo assess the quality of life of patients with severe heart failure and its correlation with patient demographic, socio‐economic and clinical characteristics.MethodWe studied 199 patients with heart failure who were hospitalized in the Cardiology Department of three general hospitals of Greece during a 1‐year period. Demographic and socio‐economic data were obtained using a short questionnaire, while clinical data were obtained from medical record review. The assessment of the patients' quality of life was performed using Minnesota Life with Heart Failure Questionnaire (MLWHFQ).FindingsThe mean MLWHFQ score was 62.7 (±20.3). Significantly lower quality of life was found in patients with diabetes mellitus (Coefficient beta (β) = 11.4; 95% Confidence Interval (CI), 5.2–17.5), hypertension (β = 10.3; CI, 1.4–19.1), chronic renal failure (β = 13.9; CI, 5.9–21.9), chronic respiratory failure (β = 11.2; CI, 4.7–17.7), cancer (β = 12.3; CI, 2.3–22.4), psychiatric disease (β = 10.5; CI, 0.6–20.4) and those patients who were classified in New York Heart Association class IV (β = 10.6, CI = 4.1–17.0).ConclusionsThe average score of the MLWHFQ was high, and this reflects the poor quality of life of patients. Higher scores in specific patient groups show the negative influence of these factors in quality of life. The holistic care of patients with heart failure by a multidisciplinary team of healthcare professionals could improve their quality of life.
Comparison of Health Care Utilization: United States versus Canada
Authors: Pylypchuk Yuriy , Sarpong Eric M. 
Published: September 2012

ObjectiveTo compare health care utilization between Canadian and U.S. residents.Data SourcesNationally representative 2007 surveys from the Medical Expenditure Panel Survey for the United States and the Canadian Community Health Survey for Canada.Study DesignWe use descriptive and multivariate methods to examine differences in health care utilization rates for visits to medical providers, nurses, chiropractors, specialists, dentists, and overnight hospital stays, usual source of care, Pap smear tests, and mammograms.Principal FindingsThe poor and less educated were more likely to utilize health care in Canada than in the United States. The differences were especially pronounced for having a usual source of care and for visits to providers, specialists, and dentists. Health care use for residents with high incomes and higher levels of education were not markedly different between the two countries and often higher for U.S residents. Foreign‐born residents were more likely to use health care in Canada than in the United States. The descriptive results were confirmed in multivariate regressions.ConclusionsGiven the magnitude of our results, the health insurance structure in Canada might have played an important role in improving access to care for subpopulations examined in this study.
Which States Enroll Their Medicaid‐ Eligible, Citizen Children with Immigrant Parents?
Authors: Seiber Eric E. 
Published: September 2012

ObjectiveTo identify which states achieve comparable enrollment rates for Medicaid‐eligible, citizen children with immigrant and nonimmigrant parents.Data SourceA total of 810,345 Medicaid‐eligible, citizen children drawn from the 2008–2010 American Community Survey.Study DesignThis study estimates a state fixed‐effects probit model of uninsured status for Medicaid‐eligible, citizen children. State and immigrant family interaction variables test whether citizen children in immigrant families have a higher probability of remaining uninsured compared to children in nonimmigrant families. Simulations predict the uninsured rates for Medicaid eligible children in immigrant and nonimmigrant families and rank states by the differences between the two groups.Principal FindingsWhile some states have insignificant and near zero differences in predicted uninsured rates, many states have enrollment disparities reaching 20 percent points between citizen children with immigrant and nonimmigrant parents.ConclusionsMany states have large differences in enrollment rates between their Medicaid‐eligible, citizen children with immigrant and nonimmigrant parents. Addressing these enrollment disparities could improve the health status of citizen children in immigrant families and earn Children's Health Insurance Program Reauthorization Act bonus payments for many states.
Protective effect of nectandrin B, a potent AMPK activator on neointima formation: inhibition of Pin1 expression through AMPK activation
Authors: Ki Sung Hwan , Lee Jung‐Woon , Lim Sung Chul , Hien Tran Thi , Im Ji Hye , Oh Won Keun , Lee Moo Yeol , Ji Young Hyun , Kim Yoon Gyoon , Kang Keon Wook 
Published: September 2012

Background and PurposeNeointima is considered a critical event in the development of vascular occlusive disease. Nectandrin B from nutmeg functions as a potent AMP‐activated protein kinase (AMPK) activators. The present study addressed whether nectandrin B inhibits intimal hyperplasia in guide wire‐injured arteries and examined its molecular mechanism.Experimental ApproachNeointima was induced by guide wire injury in mouse femoral arteries. Cell proliferation and mechanism studies were performed in rat vascular smooth muscle cells (VSMC) culture model.Key ResultsNectandrin B increased AMPK activity in VSMC. Nectandrin B inhibited the cell proliferation induced by PDGF and DNA synthesis. Moreover, treatment of nectandrin B suppressed neointima formation in femoral artery after guide wire injury. We have recently shown that Pin1 plays a critical role in VSMC proliferation and neointima formation. Nectandrin B potently blocked PDGF‐induced Pin1 and cyclin D1 expression and nectandrin B‘s anti‐proliferation effect was diminished in Pin1 overexpressed VSMC. PDGF‐induced phosphorylation of ERK and Akt was marginally affected by nectandrin B. However, nectandrin B increased the levels of p53 and its downstream target p21 and, also reversibly decreased the expression of E2F1 and phosphorylated Rb in PDGF‐treated VSMC. AMPK inhibition by dominant mutant form of adenovirus rescued nectandrin B‐mediated down‐regulation of Pin1 and E2F1.Conclusions and ImplicationsNectandrin B inhibited VSMC proliferation and neointima formation via inhibition of E2F1‐dependent Pin1 gene transcription, which is mediated through the activation of an AMPK/p53‐triggered pathway.
Azaindole derivatives are inhibitors of microtubule dynamics, with anti‐cancer and anti‐angiogenic activities
Authors: Prudent Renaud , Vassal‐Stermann Émilie , Nguyen Chi‐Hung , Mollaret Marjorie , Viallet Jean , Desroches‐Castan Agnès , Martinez Anne , Barette Caroline , Pillet Catherine , Valdameri Glaucio , Soleilhac Emmanuelle , Di Pietro Attilio , Feige Jean‐Jacques , Billaud Marc , Florent Jean‐Claude , Lafanechère Laurence 
Published: September 2012

Background and PurposeDrugs targeting microtubules are commonly used for cancer treatment. However, the potency of microtubule inhibitors used clinically is limited by the emergence of resistance. We thus designed a strategy to find new cell‐permeable microtubule‐targeting agents.Experimental ApproachUsing a cell‐based assay designed to probe for microtubule polymerization status, we screened a chemical library and identified two azaindole derivatives, CM01 and CM02, as cell‐permeable microtubule‐depolymerizing agents. The mechanism of the anti‐tumour effects of these two compounds was further investigated both in vivo and in vitro.Key ResultsCM01 and CM02 induced G2/M cell cycle arrest and exerted potent cytostatic effects on several cancer cell lines including multidrug‐resistant (MDR) cell lines. In vitro experiments revealed that the azaindole derivatives inhibited tubulin polymerization and competed with colchicines for this effect, strongly indicating that tubulin is the cellular target of these azaindole derivatives. In vivo experiments, using a chicken chorioallantoic xenograft tumour assay, established that these compounds exert a potent anti‐tumour effect. Furthermore, an assay probing the growth of vessels out of endothelial cell spheroids showed that CM01 and CM02 exert anti‐angiogenic activities.Conclusions and ImplicationsCM01 and CM02 are reversible microtubule‐depolymerizing agents that exert potent cytostatic effects on human cancer cells of diverse origins, including MDR cells. They were also shown to inhibit angiogenesis and tumour growth in chorioallantoic breast cancer xenografts. Hence, these azaindole derivatives are attractive candidates for further preclinical investigations.
Vitamin D levels and other factors related to bone mineral density during pregnancy
Authors: Shao Hongfang , Tao Minfang , Fan Yajing , Jing Jianling , Lu Jianping 
Published: September 2012

BackgroundMultiple factors appear to affect bone mineral density (BMD) during pregnancy.AimsThe aim of this study was to determine the relationships between BMD of the os calcaneus as measured by quantitative ultrasound (QUS) and levels of vitamin D3, parathyroid hormone (PTH), albumin (Alb), calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) in a group of Chinese women.MethodsMultiple parameters, including density of the os calcaneus, were recorded for a group of 130 women in early (mean gestation, 16.09 ± 2.65 weeks) and late (mean gestation, 32.01 ± 3.45 weeks) stages of pregnancy; 139 nonpregnant women served as controls.ResultsBone mineral density was lower in pregnant women than in controls at both early and late stages of pregnancy. Levels of Ca, P and ALP were significantly negatively correlated with BMD over the course of pregnancy. Levels of D3, PTH and Alb showed a falling trend from early to late pregnancy as with QUS BMD of the os calcaneus, but the correlations were not statistically significant.ConclusionsMany factors are correlated with BMD. We suggest that levels of Ca and ALP should be included in the routine examination of pregnant women.
Dinoprostone vaginal pessary for induction of labour: Safety of use for up to 24 h
Authors: Tathem Kellie , Harris Lisa J. , O'Rourke Peter , Kimble Rebecca M. 
Published: September 2012

BackgroundCervidil® (dinoprostone) intravaginal pessaries are used for induction of labour and maintain serum prostaglandin levels for up to 24 h. The Therapeutic Goods Administration approves Cervidil® for 12‐h use. However, twenty‐four‐hour use of Cervidil® is supported in Europe, New Zealand, America and some Australian hospitals.AimTo assess the safety of Cervidil® use for up to 24 h for induction of labour in nulliparous women.MethodsA retrospective cohort study of 269 consecutive women receiving Cervidil® at the Royal Brisbane and Women's Hospital (RBWH) between July 2007 and December 2008 was performed. The primary outcome measures were frequency of, and time to, uterine tachysystole with or without fetal heart rate (FHR) changes. Secondary outcome measures included frequency of maternal (intrapartum temperature, postpartum haemorrhage) and neonatal (low Apgars, resuscitation, nursery admission) morbidity. Morbidity outcomes of those who received Cervidil® for less than or equal to 12 h were compared with those who received Cervidil® for more than 12 h.ResultsUterine tachysystole occurred in 9.3% of patients receiving Cervidil®, with a mean time to tachysystole of 10 h. The majority of cases (68%) occurred within 12 h of use. There was no increase in maternal or neonatal morbidity for those who received Cervidil® for longer than 12 h.ConclusionTwenty‐four‐hour use of Cervidil® is likely as safe as 12‐h use for induction of labour in nulliparous women.
Unexplored Diversity and Conservation Potential of Neotropical Hot Caves
Authors: Ladle Richard J. , Firmino João V. L. , Malhado Ana C. M. , Rodríguez‐Durán Armando 
Published: September 2012

AbstractThe term hot cave is used to describe some subterranean chambers in the Neotropics that are characterized by constantly high ambient temperatures generated by the body heat of high densities of certain bat species. Many of these species have limited geographic ranges, and some occur only in the hot‐cave environment. In addition to the bats, the stable microclimate and abundant bat guano provides refuge and food for a high diversity of invertebrates. Hot caves have so far been described in the Caribbean and in a few isolated locations from Mexico to Brazil, although there is some evidence that similar caves may be present throughout the tropics. The existing literature suggests these poorly known ecosystems, with their unique combination of geomorphology and bat‐generated microclimate, are particularly sensitive to disturbance and face multiple threats from urbanization, agricultural development, mining, and tourism.Diversidad No Explorada y Potencial de Conservación de Cuevas Neotropicales Calientes
The Habutengsu metapelites and metagreywackes in western Tianshan, China: metamorphic evolution and tectonic implications
Authors: LÜ Z. , BUCHER K. , ZHANG L. , DU J. 
Published: September 2012

AbstractThe HP‐UHP metamorphic belt of western Tianshan in northwestern China is a rarely preserved oceanic UHP terrane which consists predominantly of meta‐siliciclastic rocks, occasionally accompanied by lens‐shaped metabasites. The metapelites and metagreywackes from the Habutengsu Valley and adjacent area within this belt contain quartz, albite, garnet, white mica, chlorite and rutile/titanite, with or without minor amounts of barroisite, glaucophane, clinozoisite, allanite, graphite, carbonate and tourmaline. Included in coarse‐grained garnet, pseudomorphs of clinozoisite + paragonite after lawsonite are common, seldom also together with inclusions of chloritoid, jadeite and glaucophane. In the northern Habutengsu area, garnet is compositionally characterized by similar cores with consistently low‐Ca content. Similar garnet armouring coesite has been reported in UHP schists from the same area. Deduced P–T conditions during formation of these Ca‐poor garnet cores are 25–31 kbar and 430–510 °C, which are consistent with the computed stability of the observed assemblage Grt + Gln + Lws ± Jd ± Cld in the coesite stability field. Thus, the occurrences of the UHP metapelites and metagreywackes define an internally coherent UHP unit in the north of the Habutengsu area, the spatial extension of which is much larger than previously known. Compared with the northern ones, the southern metapelites and metagreywackes in the Habutengsu area consist of similar minerals and have similar bulk rock compositions but significantly different garnet chemistry, indicating an abrupt variation in P–T conditions during garnet growth. The derived conditions initiating the garnet growth for the southern rocks in a similar range (18–21 kbar and 450–500 °C) and thus constrain a coherent HP unit in the south of the Habutengsu area. The juxtaposition of two exhumed slices of contrasting metamorphic grades probably indicates the change of subduction dynamics of the palaeo‐Tianshan oceanic crust, the subduction polarity (from south to north) of which accounts for the spatial relationship between these two units.
Effect of Forced Transitions on the Most Functionally Impaired Nursing Home Residents
Authors: Thomas Kali S. , Dosa David , Hyer Kathryn , Brown Lisa M. , Swaminathan Shailender , Feng Zhanlian , Mor Vincent 
Published: September 2012

ObjectivesTo examine the hospitalization rate and mortality associated with forced mass transfer of nursing home (NH) residents with the highest levels of functional impairment.DesignRetrospective cohort study.SettingOne hundred nineteen Texas and Louisiana NHs identified as being at risk for evacuation for Hurricane Gustav.ParticipantsSix thousand four hundred sixty‐four long‐stay residents residing in at‐risk NHs for at least three consecutive months before landfall of Hurricane Gustav.MeasurementsUsing Medicare claims and instrumental variable analysis, the mortality (death at 30 and 90 days) and hospitalization rates (at 30 and 90 days) of the most functionally impaired long‐stay residents who were evacuated for Hurricane Gustav were compared with those of the most functionally impaired residents who did not evacuate.ResultsThe effect of evacuation was associated with 8% more hospitalizations by 30 and 90 days for the most functionally impaired residents. Evacuation was not significantly related to mortality.ConclusionThe most functionally impaired NH residents experience more hospitalizations but not mortality as a consequence of forced mass transfer. With the inevitability of NH evacuations for many different reasons, harm mitigation strategies focused on the most impaired residents are needed.
Does Feeding Tube Insertion and Its Timing Improve Survival?
Authors: Teno Joan M. , Gozalo Pedro L. , Mitchell Susan L. , Kuo Sylvia , Rhodes Ramona L. , Bynum Julie P. W. , Mor Vincent 
Published: September 2012

ObjectivesTo examine survival with and without a percutaneous endoscopic gastrostomy (PEG) feeding tube using rigorous methods to account for selection bias and to examine whether the timing of feeding tube insertion affected survival.DesignProspective cohort study.SettingAll U.S. nursing homes (NHs).ParticipantsThirty‐six thousand four hundred ninety‐two NH residents with advanced cognitive impairment from dementia and new problems eating studied between 1999 and 2007.MeasurementsSurvival after development of the need for eating assistance and feeding tube insertion.ResultsOf the 36,492 NH residents (88.4% white, mean age 84.9, 87.4% with one feeding tube risk factor), 1,957 (5.4%) had a feeding tube inserted within 1 year of developing eating problems. After multivariate analysis correcting for selection bias with propensity score weights, no difference was found in survival between the two groups (adjusted hazard ratio (AHR) = 1.03, 95% confidence interval (CI) = 0.94–1.13). In residents who were tube‐fed, the timing of PEG tube insertion relative to the onset of eating problems was not associated with survival after feeding tube insertion (AHR = 1.01, 95% CI = 0.86–1.20, persons with a PEG tube inserted within 1 month of developing an eating problem versus later (4 months) insertion).ConclusionNeither insertion of PEG tubes nor timing of insertion affect survival.
Antibody levels correlate with detection of Trypanosoma cruzi DNA by sensitive polymerase chain reaction assays in seropositive blood donors and possible resolution of infection over time
Authors: Sabino Ester C. , Lee Tzong‐Hae , Montalvo Lani , Nguyen Megan L. , Leiby David A. , Carrick Danielle M. , Otani Marcia M. , Vinelli Elizabeth , Wright David , Stramer Susan L. , Busch Michael ,   NHLBI Retrovirus Epidemiology Donor Study‐II (REDS‐II) International Program
Published: September 2012

BACKGROUND: The clinical significance of anti‐Trypanosoma cruzi low‐level reactive samples is incompletely understood. Polymerase chain reaction (PCR)‐positive rates and antibody levels among seropositive blood donors in three countries are described.STUDY DESIGN AND METHODS: Follow‐up samples were collected from T. cruzi–seropositive donors from 2008 through 2010 in the United States (n = 195) and Honduras (n = 58). Also 143 samples from Brazil in 1996 to 2002, originally positive by three serologic assays, were available and paired with contemporary follow‐up samples from these donors. All samples were retested with Ortho enzyme‐linked immunosorbent assay (ELISA). PCR assays were performed on coded sample panels by two laboratories (Blood Systems Research Institute [BSRI] and American Red Cross Holland Laboratory [ARC]) that amplified kinetoplast minicircle DNA sequences of T. cruzi.RESULTS: PCR testing at BSRI yielded slightly higher overall sensitivity and specificity (33 and 98%) compared with those at the ARC (28 and 94%). Among seropositive donors, PCR‐positive rates varied by country (p < 0.0001) for the BSRI laboratory: Brazil (57%), Honduras (32%), and the United States (14%). ELISA signal‐to‐cutoff ratios (S/CO) were significantly higher for PCR‐positive compared to PCR‐negative donors (p < 0.05 for all comparisons). Additionally, PCR‐negative Brazilian donors exhibited greater frequencies of antibody decline over time versus PCR‐positive donors (p = 0.003).CONCLUSION: For all three countries, persistent DNA positivity correlated with higher ELISA S/CO values, suggesting that high‐level seroreactivity reflects chronic parasitemia. Significant S/CO declines in 10% of the PCR‐negative Brazilian donors may indicate seroreversion after parasite clearance in the absence of treatment.