bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of stigma on Chinese women's attitudes towards seeking treatment for urinary incontinence
Authors: Wang Cuili , Li Jingjing , Wan Xiaojuan , Wang Xiaojuan , Kane Robert L. , Wang Kefang 
Published: November 2014

Aims and objectivesTo examine whether and how stigma influences attitudes towards seeking treatment for urinary incontinence, and whether its effect varies by symptom severity.BackgroundUrinary incontinence is prevalent among women, but few seek treatment. Negative attitudes towards urinary incontinence treatment inhibit from seeking care. Urinary incontinence is a stigmatised attribute. However, the relationship between stigma and attitudes towards seeking treatment for urinary incontinence has not been well understood.DesignThis was a cross‐sectional community‐based study.MethodsWe enrolled a sample of 305 women aged 40–65 years with stress urinary incontinence from three communities in a Chinese city between May–October in 2011. Data were collected on socio‐demographic characteristics, urinary incontinence symptoms, stigma and attitudes towards seeking treatment for urinary incontinence using a self‐reported questionnaire. Effects of stigma were analysed using path analysis.ResultsAttitudes towards seeking treatment for urinary incontinence were generally negative. For the total sample, all the stigma domains of social rejection, social isolation and internalised shame had direct negative effects on treatment‐seeking attitudes. The public stigma domain of social rejection also indirectly affected treatment‐seeking attitudes through increasing social isolation, as well as through increasing social isolation and then internalised shame. The final model accounted for 28% of the variance of treatment‐seeking attitudes. Symptom severity influenced the strength of paths: the effect of internalised shame was higher in women with more severe urinary incontinence.ConclusionsStigma enhances the formation of negative attitudes towards seeking treatment for urinary incontinence; public stigma affects treatment‐seeking attitudes through internalisation of social messages.Relevance to clinical practiceStigma reduction may help incontinent women to form positive treatment‐seeking attitudes and engage them in treatment. Interventions should specifically target the self‐stigma domains of social isolation and internalised shame in women with urinary incontinence to most efficiently increase their use of health care.
The experience of self‐management following venous leg ulcer healing
Authors: Kapp Suzanne , Miller Charne 
Published: November 2014

Aims and objectivesThe aim of the study was to explore the experiences of older people as they self‐managed following venous leg ulcer healing. The objectives were to describe the beliefs, attitudes, actions, enablers and barriers to self‐management and to consider the impact of an e‐learning client education package on how people approach recurrence prevention.BackgroundVenous leg ulcers affect 1% of people worldwide and more than 3% of older people. Up to 70% of ulcers reoccur. Appreciation of the experience of self‐management following healing can equip health services to more effectively prepare people for self‐management in the longer term.DesignA descriptive exploratory design was used.MethodsOlder people who had received an e‐learning education programme while their venous ulcer was active were interviewed after healing from July–September 2010. Interviews were recorded, transcribed and thematically analysed.ResultsParticipants believed in the efficacy of compression therapy, skin care, activity and exercise and healthy eating to prevent recurrence, and engage in activities that reflect recommendations of the education. As beliefs and conduct of self‐management activities can change over time, regular professional monitoring and support would assist people to refine health goals, plan self‐management activities and prevent recurrence.ConclusionsParticipation in a standardised education programme completed prior to healing informed successful self‐management strategies among people who seek to prevent venous leg ulcer recurrence. Further research should consider the benefits of regular, ongoing professional monitoring and support among this group.Relevance to clinical practiceClinicians have a role in supporting their clients to know about, perform and believe in the importance of self‐management strategies for healing and recurrence prevention. Clinicians require the capacity to support clients which standardised client education tools can facilitate.
Patients and nursing staff views of using the education needs assessment tool in rheumatology clinics: a qualitative study
Authors: Hardware Bernadette , Johnson Dawn , Hale Claire , Ndosi Mwidimi , Adebajo Adewale 
Published: November 2014

Aims and objectivesTo evaluate the usability of the educational needs assessment tool in clinical practice, from a practitioner and patient perspective and to establish whether patients perceive that they are getting an equally good or equally inadequate education service for their needs.BackgroundThe educational needs assessment tool was developed to enable patients with Rheumatoid Arthritis to assess their education needs prior to a consultation with a health professional. The educational needs assessment tool has been translated into nine languages and measurement properties have been established, however, its usability in clinical practice has not been studied.DesignA qualitative study embedded into a multicentre RCT in which patients had been randomised into either educational needs assessment tool‐focused education (Experimental Group) or usual care (control group).MethodsBoth groups were seen by a clinical nurse specialist. Sixteen patients and four clinical nurse specialists were recruited from the Rheumatology Outpatient Departments of three Acute Hospitals within the U K. Data were collected by interviews with patients and clinical nurse specialist. Analysis followed the Framework approach.ResultsPatients and clinical nurse specialist found completion of the educational needs assessment tool straightforward, comprehensive and easy to use. Completing the educational needs assessment tool helped patients to focus on what they needed to know from the clinical nurse specialist. Patients in both the control group and the experimental group felt supported and reassured by their clinical nurse specialist and perceived that they received a good and adequate education provision.ConclusionThis study provides useful insights into the ability of the educational needs assessment tool to assess the educational needs of patients with rheumatoid arthritis in routine clinical practice.Relevance to clinical practiceThe educational needs assessment tool would be useful as a structured guide for nurses when assessing and meeting individual patient educational needs. This has the potential to improve patient‐centred care, involve patients more actively in their care and enhance the long‐term effects of patient education provision.
Interobserver reliability of attending physicians and bedside nurses when using an inpatient paediatric respiratory score
Authors: Biondi Eric A. , Gottfried Julie Albright , Dutko Fioravanti Irene , Schriefer Jan A. , Aligne Claude Andrew , Leonard Michael S. 
Published: November 2014

Aims and objectivesThis study aimed to determine the interobserver reliability between bedside nurses and attending physicians for a paediatric respiratory score as part of an asthma Integrated Care Pathway implementation.BackgroundAn Integrated Care Pathway is one approach to improving quality of care for children hospitalised with asthma. Prior to implementation of the integrated care pathway, it was necessary to train nursing staff on the use of a respiratory assessment tool and to evaluate the interobserver reliability use of this tool.DesignProspective study using a convenience sample of children hospitalised for a respiratory illness in an academic medical centre.MethodsThe respiratory assessment used was the Paediatric Asthma Score. Bedside nurse‐attending physician (27 different RNs and three attending paediatric hospitalists) pairs performed 71 simultaneous patient assessments on 20 patients. Intraclass correlation coefficient and kappa statistics were used to assess interobserver reliability.ResultsThe overall intraclass correlation coefficient was nearly perfect where κ = 0·95, 95% CI (0·92, 0·97) and overall kappa for reliability based on clinically relevant score breakpoints was also high with κ = 0·82, 95% CI (0·75, 0·90). The majority of subgroup analyses revealed substantial to almost perfect agreement across a variety of diagnoses, age ranges, and individual score components.ConclusionsBedside nurses, with support and training from attending physicians, can perform respiratory assessments that agree almost perfectly with those of attending physicians.Relevance to clinical practiceThe use of an Integrated Care Pathway allows for optimal interprofessional collaboration between bedside nurses and attending physicians.
Acute fatty liver of pregnancy associated with fetal mitochondrial trifunctional protein deficiency
Authors: Kobayashi Tomoko , Minami Sawako , Mitani Ayuki , Tanizaki Yuko , Booka Mina , Okutani Takahiro , Yamaguchi Seiji , Ino Kazuhiko 
Published: November 2014

AbstractAcute fatty liver of pregnancy (AFLP) is a devastating disorder of the maternal liver in the third trimester. Recent studies have demonstrated an association between AFLP and fetal fatty acid oxidation disorders. Here, we report a case of AFLP caused by fetal mitochondrial trifunctional protein (TFP) deficiency. A 21‐year‐old parous woman presented with nausea, genital bleeding and abdominal pain at 33 weeks of gestation. Laboratory data revealed hepatic failure and disseminated intravascular coagulopathy. The patient underwent emergency cesarean section and was diagnosed with AFLP from the clinical characteristics. She was successfully treated with frequent plasma exchange. The newborn presented severe heart failure and died on the 39th day after birth. Tandem mass spectrometry indicated long‐chain fatty acid oxidation disorder. Gene analysis demonstrated homozygous mutation in exon 13 of HADHB, the gene responsible for mitochondrial TFP deficiency. The parents carried a heterozygous mutation at the same location in HADHB.
Gestrinone combined with ultrasound‐guided aspiration and ethanol injection for treatment of chocolate cyst of ovary
Authors: Wu Xiaoyun , Xu Yun 
Published: November 2014

AbstractAimThe aim of this study was to determine clinical performance of gestrinone combined with ultrasound‐guided aspiration and ethanol injection in treating chocolate cyst of ovary.MethodsSixty‐eight patients enrolled in this study were randomly divided into two groups: control group and combination treatment group. In the control group, 34 patients were treated with ultrasound‐guided aspiration and ethanol injection. In the combination treatment group, 34 patients received gestrinone p.o. following ultrasound‐guided aspiration and ethanol injection.ResultsThe recurrence rate of chocolate cyst was 10‐fold lower in the combination treatment group (2.94%, 1/34) than in the control group (29.4%, 10/34) at 12 months. The effective rate for reduction of chocolate cyst was significantly higher in the combination treatment group (94.12%, 32/34) than in the control group (64.71%, 22/34) (P = 0.009).ConclusionGestrinone combined with ultrasound‐guided aspiration and ethanol injection therapy is an effective treatment for ovarian chocolate cyst with low recurrence rate.
In women with thyroid autoimmunity, does low‐dose prednisolone administration, compared with no adjuvant therapy, improve in vitro fertilization clinical results?
Authors: Litwicka Katarzyna , Arrivi Cristiana , Varricchio Maria Teresa , Mencacci Cecilia , Greco Ermanno 
Published: November 2014

AbstractAimThe objective of the study was to verify if prednisolone treatment may influence the in vitro fertilization (IVF) outcome in euthyroid women affected by thyroid autoimmunity.MethodsOne hundred and ninety‐four patients including 60 positive for antithyroid antibodies (ATA) underwent the ovarian stimulation in the standard long protocol for IVF and 30 women received the low‐dose prednisolone from the day of oocyte retrieval.ResultsThe overall, clinical pregnancy and live birth rate in ATA‐positive patients receiving prednisolone supplementation was significantly higher when confronted with ATA‐positive untreated subjects (60.0% vs 30.0%, P = 0.02; 46.6% vs 16.6%, P = 0.03; and 46.6% vs 20.0%, P = 0.05, respectively). The same parameters in ATA‐positive untreated women were significantly lower than in the controls (30.0% vs 50.7%, P = 0.0001; 16.6% vs 38.1%, P = 0.04; and 20.0% vs 40.3%, P = 0.04, respectively).ConclusionThere is a strong association between the presence of thyroid autoantibodies and poor IVF outcome. The prednisolone co‐treatment may improve the clinical pregnancy rate and reduce the miscarriage rate after IVF in women affected by thyroid autoimmunity.
Positive peritoneal cytology at interval surgery is a poor prognostic factor in patients with stage T3c advanced ovarian carcinoma: A retrospective study
Authors: Nagasaka Kazunori , Kawana Kei , Tomio Kensuke , Tsuruga Tetsushi , Mori‐Uchino Mayuyo , Miura Shiho , Tanikawa Michihiro , Miyamoto Yuichiro , Ikeda Yuji , Sone Kenbun , Adachi Katsuyuki , Matsumoto Yoko , Arimoto Takahide , Oda Katsutoshi , Osuga Yutaka , Fujii Tomoyuki 
Published: November 2014

AbstractAimThe purpose of our study is to investigate clinically significant prognostic factors at the time of interval surgery (IS), comprising interval look surgery and interval debulking surgery, for T3c (International Federation of Gynecology and Obstetrics stage IIIc to IV) advanced ovarian cancer (AOC) patients during primary treatment.MethodsWe reviewed records of patients with T3c AOC who underwent IS following neoadjuvant chemotherapy or up‐front primary debulking surgery with adjuvant chemotherapy at our institution between January 1996 and December 2010. For analysis of prognostic factors, cytology of peritoneal exfoliative cells at IS was added to clinicopathological variables.ResultsA retrospective analysis was performed on 50 cases. The median age was 61.1 years (range, 38–78), with median follow‐up of 45.9 months (range, 12–122). Macroscopic tumors were completely resected in 32 cases (64%) at IS. Univariate analyses of clinicopathological factors for IS identified preoperative serum cancer antigen‐125 levels (≥20 IU/mL; P = 0.0539), number of residual lesions at IS (≥20; P = 0.0554), incomplete surgery at IS (P = 0.0171) and positive peritoneal cytology at IS (P = 0.0015) as significant factors for prognosis regarding progression‐free survival (PFS). Multivariate analysis identified positive peritoneal cytology (P = 0.0303) as a unique independent predictor of poor prognosis in PFS.ConclusionPositive peritoneal cytology at IS appears to be a significant factor for poor prognosis in PFS, which may provide useful information for post‐IS chemotherapy planning. IS in the treatment of AOC may be useful for not only complete resection, but also for identification of patients with poor prognosis.
Percutaneous Implantation of a Second Device in Patients with Residual Right‐to‐Left Shunt after Patent Foramen Ovale Closure
Authors: ROVERA CHIARA , BIASCO LUIGI , ORZAN FULVIO , BELLI RICCARDO , OMEDÈ PIERLUIGI , GAITA FIORENZO 
Published: November 2014

IntroductionThe management of patients with residual right‐to‐left shunt (rRLS) after percutaneous patent foramen ovale (PFO) closure is debated. The aim of this study was to define the incidence of moderate‐to‐large rRLS and to report the feasibility, safety and long‐term clinical outcome of transcatheter closure of rRLS.Methods and ResultsFrom June 2000 to March 2013, 322 subjects underwent percutaneous PFO closure. In 39 patients (12.1%) with moderate‐to‐large rRLS on transcranial Doppler (TCD) and/or transesophageal echocardiogram a second cardiac catheterization was performed with the aim of completing the closure. A second closure device was implanted in 21 patients (53.8%). In the remaining 18 (46.2%), a second device was not delivered for the following reasons: in 13 (72.2%) no residual passage could be crossed, in 5 (27.8%) the residual shunt was deemed to be negligible. No complications occurred. After the second procedure, complete closure was proved by TCD in 16/21 (76.2%) subjects. One patient received a third device. During follow‐up (41 ± 19 months), no cerebrovascular ischemic accidents occurred.ConclusionA second percutaneous PFO occlusion device can be safely implanted in patients with significant rRLS. However, a moderate‐to‐large rRLS on TCD and/or TEE may not necessarily represent a significant risk of further paradoxical embolization.
A reverse Warburg metabolism in oral squamous cell carcinoma is not dependent upon myofibroblasts
Authors: Jensen David H. , Therkildsen Marianne H. , Dabelsteen Erik 
Published: November 2014

BackgroundThe reverse Warburg effect describes the phenomenon that epithelial cancer cells take advantage of the metabolic machinery from nearby cancer‐associated fibroblast, inducing them to produce lactate and ketones to fuel the high metabolic demands of the epithelial tumour tissues. This is in breast cancer observed as a lack of stromal caveolin‐1 (CAV‐1) and an increased expression of monocarboxylate transporter 4 (MCT‐4) in the tumour stroma, with a concomitant increase in the expression of monocarboxylate transporter 1 (MCT‐1) in the epithelial, tumour compartment. The lack of CAV‐1 and increased expression of MCT‐4 have been shown to have prognostic importance, primarily in patients with breast cancer. However, this phenomenon has only scarcely been described in oral squamous cell carcinoma (OSCC). Given the prognostic importance of myofibroblasts in OSCC, we also examined a potential relationship between the expression of MCT‐4 and the presence of myofibroblasts.MethodsParaffin‐embedded tissues from 30 patients with OSCC were immunostained with antibodies towards MCT‐1, MCT‐4, Cav‐1, GLUT‐1, α‐SMA, TOMM20 and KI‐67, and evaluated for their specific epithelial and stromal expression.Results and conclusionsIn patients with OSCC, we find an increased expression of MCT‐1 and MCT‐4 in both the epithelial and stromal compartment, with almost no overlap in their spatial expression. We found a large spatial overlap between α‐SMA and MCT‐1 in the stroma compartment, but no relationship between MCT‐4 and myofibroblasts. Interestingly, we did not observe any relationship between the absence of CAV‐1 and the presence of MCT‐4 as has been shown in breast carcinomas.
Clitoral Reconstruction After Female Genital Mutilation/Cutting: Case Studies
Authors: Abdulcadir Jasmine , Rodriguez Maria I. , Petignat Patrick , Say Lale 
Published: November 2014

ABSTRACT

Introduction
Clitoral reconstruction following female genital mutilation/cutting (FGM/C) is a new surgical technique reported to be a feasible and effective strategy to reduce clitoral pain, improve sexual pleasure, and restore a vulvar appearance similar to uncircumcised women. However, data on safety, care offered, and evaluation of sexual and pain outcomes are still limited.

Aims
This study aims to present the care offered and clinical outcomes of two women who received multidisciplinary care, including psychosexual treatment, with clitoral reconstruction. We report their long-term outcomes, and the histology of the removed periclitoral fibrosis.

Methods
We report the cases of two women with FGM/C types II and III who requested clitoral reconstruction for different reasons. One woman hoped to improve her chronic vulvar pain, as well as improve her sexual response. The other woman requested surgery due to a desire to reverse a procedure that was performed without her consent, and a wish to have a genital appearance similar to non infibulated women. They both underwent psychosexual evaluation and therapy and surgery. The histology of the periclitoral fibrosis removed during surgery was analyzed.

Results
At 1-year postoperatively, the first woman reported complete disappearance of vulvar pain and improved sexual pleasure, including orgasm. Our second patient also described improved sexuality at 1-year follow-up (increased sexual desire, lubrication, vulvar pleasure, and sensitiveness), which she attributed to a better self body image and confidence. Both women reported feeling satisfied, happy, and more beautiful.

Conclusion
We show a positive outcome in pain reduction and improved sexual function, self body image, and gender after psychosexual therapy and clitoral reconstruction. More evidence is needed about clitoral reconstruction to develop guidelines on best practices. Until research is conducted that rigorously evaluates clitoral reconstruction for its impact on pain and sexuality, we advise always offering a multidisciplinary care, including sexual therapy before and after the surgery.
Treating Immune‐tolerant Hepatitis B
Authors: Tseng T.‐C. , Kao J.‐H. 
Published: November 2014

SummaryHepatitis B virus (HBV) infection is a major cause of cirrhosis and hepatocellular carcinoma worldwide. On the basis of virus–host interactions, the natural history of HBV carriers can be divided into four chronological phases. In the first immune tolerance phase, HBV carriers are positive for hepatitis B e antigen (HBeAg) and have high HBV replication activity, normal ALT levels as well as minimal liver disease. Ample evidence has shown that patients in the immune tolerance phase have very low viral evolution and minimal risk of fibrosis progression. However, recent immunological studies argued that HBV‐specific immune responses already exist in a proportion of immune‐tolerant patients and the immune activities are comparable to those in the immune clearance phase. Regarding antiviral therapy, whether these immune‐tolerant patients are indicated for treatment remains debated. Previous studies showed that HBeAg‐positive patients with normal or near‐normal ALT levels, who are assumed to be in the immune tolerance phase, have a lower HBeAg seroconversion rate receiving either pegylated interferon or nucleos(t)ide analogue treatment. The latest clinical trial focusing on‐treatment response of immune‐tolerant patients with tenofovir disoproxil fumarate‐based therapy also confirmed the results. The HBeAg seroconversion rates are <5% at 4 years of treatment. Considering the minimal risk of disease progression and low treatment response rates in immune‐tolerant patients, current antiviral therapy should not be recommended unless the patients have advanced liver fibrosis. In addition, novel agents targeting the HBV template known as covalently closed circular DNA and aiming to reduce or eliminate it are urgently required.