bluuebunny/crossref_metadata_2025_split huggingface dataset:
The place of standardisation in home care practice: an ethnographic study
Authors: Björnsdóttir Kristín 
Published: November 2013

Aims and objectivesTo explore the benefits and shortcomings of using standardised work methods in home care nursing.BackgroundHealth care is increasingly shaped by the use of standardised work methods. This trend is reflected in the use of management tools aimed at monitoring service quality and efficiency, as well as in the evidence‐based movement that has led to a shift in focus from the practitioner to the knowledge found in guidelines and clinical protocols. This study addressed the impact of this development on home care services.DesignThis is an ethnographic study involving fieldwork in home care nursing in Iceland.MethodsThe study took place in one neighbourhood in an urban area in Iceland in 2010. Members of five of six home care nursing teams agreed to participate. Team leaders were observed during visits to older person's homes and at team and interdisciplinary meetings. Semi‐structured interviews were conducted with the team leaders and 15 older persons.ResultsThe results were presented as three themes: For it all to hang together, which referred to attempts on behalf of the team leaders to coordinate complex services and assistance for the benefit of each patient; Working with more advanced cases, which reflected the uptake of standardised methods to address health matters locally; and Being heard, which reflects the politics of using standardised methods.ConclusionsStandardised work methods can be helpful and are welcomed by home care nurses as long as they can also use their own discretion and draw on other forms of knowledge when needed.Relevance to clinical practiceThis study brought out the importance of flexibility in home care practice. Standardised work methods are welcomed and seen as helpful as long as they can be used based on the discretion of the practitioner.
Obesity and physical activity patterns in children and adolescents
Authors: Laguna María , Ruiz Jonatan R , Gallardo Cristian , García‐Pastor Teresa , Lara María‐Teresa , Aznar Susana 
Published: November 2013

AimThe aim of this study is to measure objectively and accurately the physical activity (PA) patterns in Spanish children and adolescents according to their obesity status, gender and age groups.MethodsA sample of 487 children and 274 adolescents from the European Youth Heart Study participated in the study. The variables measured were anthropometric characteristics (height, weight and body mass index), and PA was measured during 6 consecutive days using the GT1M accelerometer.ResultsThree‐way analysis of variance (age × gender × obesity status) showed significant differences in the interaction effect in age, gender and obesity status (normal‐weight and overweight/obesity) for mean of moderate‐to‐vigorous PA (MVPA) (P = 0.02) and vigorous PA (VPA) (P = 0.014) within the sample. Nine‐year‐old normal‐weight children achieved significantly (P < 0.05) more MVPA on weekdays than 9‐year‐old overweight/obesity children. During weekend days, all sample achieved significant more MVPA (P < 0.01) and significant more VPA (P < 0.05) than during weekdays. Few children (37.5% of 9‐year‐old normal‐weight and 34.0% of 9‐year‐old overweight/obese) and adolescents (16.4% and 27.3% normal‐weight and overweight/obese, respectively) met the current health‐related recommendations of 60 min of MVPA daily.ConclusionsIt is clear that activity levels are insufficient for all children, in particular overweight/obese children and adolescents, although the precise nature of the relationship appears to differ between boys and girls.
Anticonvulsant activity of Aloe vera leaf extract in acute and chronic models of epilepsy in mice
Authors: Rathor Naveen , Arora Tarun , Manocha Sachin , Patil Amol N , Mediratta Pramod K , Sharma Krishna K 
Published: November 2013

Abstract

Objectives
The effect of Aloe vera in epilepsy has not yet been explored. This study was done to explore the effect of aqueous extract of Aloe vera leaf powder on three acute and one chronic model of epilepsy.

Methods
In acute study, aqueous extract of Aloe vera leaf (extract) powder was administered in doses 100, 200 and 400 mg/kg p.o. Dose of 400 mg/kg of Aloe vera leaf extract was chosen for chronic administration. Oxidative stress parameters viz. malondialdehyde (MDA) and reduced glutathione (GSH) were also estimated in brain of kindled animals.

Key findings
In acute study, Aloe vera leaf (extract) powder in a dose-dependent manner significantly decreased duration of tonic hind limb extension in maximal electroshock seizure model, increased seizure threshold current in increasing current electroshock seizure model, and increased latency to onset and decreased duration of clonic convulsion in pentylenetetrazole (PTZ) model as compared with control group. In chronic study, Aloe vera leaf (extract) powder prevented progression of kindling in PTZ-kindled mice. Aloe vera leaf (extract) powder 400 mg/kg p.o. also reduced brain levels of MDA and increased GSH levels as compared to the PTZ-kindled non-treated group.

Conclusions
The results of study showed that Aloe vera leaf (extract) powder possessed significant anticonvulsant and anti-oxidant activity.
A Systematic Review of the Psychosocial Outcomes Associated with Erectile Dysfunction: Does the Impact of Erectile Dysfunction Extend Beyond a Man's Inability to Have Sex?
Authors: McCabe Marita P. , Althof Stanley E. 
Published: November 2013

Abstract

Aim
The aim of this study was to report and analyze the published data from randomized controlled trials (RCTs) for (i) the psychosocial outcomes associated with erectile dysfunction (ED) before treatment with a phosphodiesterase type 5 (PDE5) inhibitor; and (ii) the change in psychosocial outcomes after the use of a PDE5 inhibitor in men with ED.

Methods
The method used was a prospectively designed systematic literature review of publications reported in MEDLINE via PubMed, EMBASE, the Cochrane Library, Science Citation Index Expanded, and PsychINFO from January 1, 1995 to May 14, 2012.

Main Outcome Measures
The main outcome measures were scores on psychosocial measures in men who were treated for ED with a PDE5 inhibitor before and after treatment.

Results
A total of 1,714 publications were retrieved; 1,674 publications were excluded because they did not meet the design requirements of the review, and 40 publications (32 RCTs) were retained. Before treatment, men who participated in clinical trials reported relatively good quality of life and overall relationships, but poor sexual relationships and sexual satisfaction, diminished confidence, low self-esteem, and symptoms of depression. After treatment, there were significant improvements from baseline in most of these measures, except for overall life satisfaction and overall relationship satisfaction.

Conclusions
ED and the treatment of ED are associated with substantially broader aspects of a man's life than just erectile functioning. This review demonstrates the importance of evaluating the psychosocial factors associated with ED and its treatment, and the importance of using standardized scales to conduct this evaluation. Further research is needed to better understand the mechanisms underlying the reciprocal relationships among physical and psychological functioning in men with ED.
Intracavernous Delivery of Clonal Mesenchymal Stem Cells Restores Erectile Function in a Mouse Model of Cavernous Nerve Injury
Authors: Ryu Ji-Kan , Kim Da-Ham , Song Kang Moon , Yi TacGhee , Suh Jun-Kyu , Song Sun U. 
Published: November 2013

Abstract

Introduction
Recently, much attention has focused on stem cell therapy; bone marrow-derived stem cells (BMSCs) are one of the most studied mesenchymal stem cells used in the field of erectile dysfunction (ED). However, a major limitation for the clinical application of stem cell therapy is the heterogeneous nature of the isolated cells, which may cause different treatment outcomes.

Aim
We investigated the effectiveness of mouse clonal BMSCs obtained from a single colony by using subfractionation culturing method (SCM) for erectile function in a mouse model of cavernous nerve injury (CNI).

Methods
Twelve-week-old C57BL/6J mice were divided into four groups: sham operation group, bilateral CNI group receiving a single intracavernous (IC) injection of phosphate-buffered saline (20 μL) or clonal BMSCs (3 × 105 cells/20 μL), and receiving a single intraperitoneal (IP) injection of clonal BMSCs (3 × 105 cells/20 μL).

Main Outcome Measures
The clonal BMSC line was analyzed for cell-surface epitopes by using fluorescence-activated cell sorting and for differentiation potential. Two weeks after CNI and treatment, erectile function was measured by electrically stimulating the cavernous nerve. The penis was harvested for histologic examinations and Western blot analysis.

Results
Clonal BMSCs expressed cell surface markers for mesenchymal stem cells and were capable of differentiating into several lineages, including adipogenic, osteogenic, and chondrogenic cells. Both IC and IP injections of clonal BMSCs significantly restored cavernous endothelial and smooth muscle content, and penile nNOS and neurofilament content in CNI mice. IC injection of clonal BMSCs induced significant recovery of erectile function, which reached 90–100% of the sham control values, whereas IP injection of clonal BMSCs partially restored erectile function.

Conclusion
We established a homogeneous population of mouse clonal BMSCs using SCM; clonal BMSCs successfully restored erectile function in CNI mice. The homogeneous nature of clonal mesenchymal stem cells may allow their clinical applications.
The Implications of Temporary Jobs on the Distribution of Wages in Italy: An Unconditional IVQTE Approach
Authors: Bosio Giulio 
Published: November 2013

AbstractUsing Italian data, this paper investigates the wage implications of temporary jobs across the whole pay profile using unconditional quantile regression (UQR) models. Results clearly indicate that the wage penalty associated to temporary jobs is significantly larger at the bottom of wage profile and is almost absent for high‐wage jobs. This is in line with the sticky floors hypothesis, supporting the idea that the wage gap for temporary employees depends on their position in the wage distribution for low‐paid jobs. To recover a causal interpretation, I employ an instrumental variable (IV) strategy. I adopt the unconditional instrumental variable quantile treatment effects (IVQTE) estimator proposed by Frolich and Melly, which corrects for endogenous selection in temporary contracts. The IVQTE estimates yield similar results to standard UQR, even if the wage penalty is larger in size at the bottom of the wage distribution and disappears at the top quantiles. This evidence highlights that policies aimed at increasing flexibility may reinforce the two‐tier nature of the Italian labour market and the relative wage inequality.
Peripheral blood leucocyte subclasses as potential biomarkers of adipose tissue inflammation and obesity subphenotypes in humans
Authors: Pecht T. , Gutman‐Tirosh A. , Bashan N. , Rudich A. 
Published: November 2013

SummaryWhile obesity is clearly accepted as a major risk factor for cardio‐metabolic morbidity, it is also apparent that some obese patients largely escape this association, forming a unique obese subphenotype(s). Current approaches to define such subphenotypes include clinical biomarkers that largely reflect already manifested comorbidities, such as markers of dyslipidaemia, hyperglycaemia and impaired regulation of vascular tone, and anthropometric or imaging‐based assessment of adipose tissue distribution. Low‐grade inflammation, evident both systemically and within adipose tissue (particularly intra‐abdominal fat depots), seems to characterize the more cardio‐metabolically morbid forms of obesity. Indeed, several systemic inflammatory markers (C‐reactive protein), adipokines (retinol‐binding protein 4, adiponectin) and cytokines have been shown to correlate in humans with adipose tissue inflammation and with obesity‐associated health risks. Circulating leucocytes constitute a diverse group of cells that form a major arm of the immune system. They are both major sources of cytokines and likely also of infiltrating adipose tissue immune cells in obesity. In the present review, we summarize currently available literature on ‘classical’ blood white cell classes and on more specific leucocyte subclasses present in the circulation in human obesity. We critically raise the possibility that leucocytes may constitute clinically available markers for the more morbidity‐associated obesity subphenotype(s), and when available, for intra‐abdominal adipose tissue inflammation.
Surgical Management of the Multiple‐Ligament Injured Knee: a Case Series from Chongqing, China and Review of Published Reports
Authors: Zhang Yuan , Zhang Xia , Hao Yong , Zhang Yu‐Mei , Wang Min , Zhou Yue 
Published: November 2013

ObjectiveThe correct management of multiple‐ligament injured knees (MLIKs) remains controversial. This study aimed to summarize the epidemiological features and short‐term results of patients treated in our department.MethodsSixty‐six patients diagnosed with MLIKs from 2009 to 2011 were enrolled. Relevant patient characteristics and clinical variables were analyzed to characterize the epidemiology. A surgical algorithm based on a knee dislocation classification system and postoperative rating scales, including Lysholm and Tegner rating, as well as joint mobility, stability and radiography were collected for functional evaluation at 2.5‐year follow‐up.ResultsThe epidemiological profile demonstrated that 30‐ to 50‐year‐old men were at the highest risk. The primary causes were vehicle accidents and falls and most common injury type cruciate combined collateral ligament injuries. Final follow‐up analysis comparing operative versus conservative management and surgically treated mild versus severe MLIKs showed significant differences in Lysholm and Tegner scale scores, as well as knee mobility and stability.ConclusionThe therapeutic outcome of MLIKs depends on various clinical variables and a surgical algorithm. Satisfactory restoration of function was acquired in the majority of our surgically treated MLIK cases; however, most patients had not achieved their pre‐injury activity levels by the follow‐up endpoint.
Written Pain Neuroscience Education in Fibromyalgia: A Multicenter Randomized Controlled Trial
Authors: van Ittersum Miriam W. , van Wilgen C. Paul , van der Schans Cees P. , Lambrecht Luc , Groothoff Johan W. , Nijs Jo 
Published: November 2013

AbstractMounting evidence supports the use of face‐to‐face pain neuroscience education for the treatment of chronic pain patients. This study aimed at examining whether written education about pain neuroscience improves illness perceptions, catastrophizing, and health status in patients with fibromyalgia.A double‐blind, multicenter randomized controlled clinical trial with 6‐month follow‐up was conducted. Patients with FM (n = 114) that consented to participate were randomly allocated to receive either written pain neuroscience education or written relaxation training. Written pain neuroscience education comprised of a booklet with pain neuroscience education plus a telephone call to clarify any difficulties; the relaxation group received a booklet with relaxation education and a telephone call. The revised illness perception questionnaire, Pain Catastrophizing Scale, and fibromyalgia impact questionnaire were used as outcome measures. Both patients and assessors were blinded. Repeated‐measures analyses with last observation carried forward principle were performed. Cohen's d effect sizes (ES) were calculated for all within‐group changes and between‐group differences.The results reveal that written pain neuroscience education does not change the impact of FM on daily life, catastrophizing, or perceived symptoms of patients with FM. Compared with written relaxation training, written pain neuroscience education improved beliefs in a chronic timeline of FM (P = 0.03; ES = 0.50), but it does not impact upon other domains of illness perceptions.Compared with written relaxation training, written pain neuroscience education slightly improved illness perceptions of patients with FM, but it did not impart clinically meaningful effects on pain, catastrophizing, or the impact of FM on daily life. Face‐to‐face sessions of pain neuroscience education are required to change inappropriate cognitions and perceived health in patients with FM.
White Racism, Social Class, and the Backlash Against Affirmative Action
Authors: Pierce Jennifer L. 
Published: November 2013

AbstractAmong scholars in sociology and history, the backlash against affirmative action has been blamed on White working‐class Americans. What has received far less attention is the individual and collective institutional role(s) played by the White middle and upper middle‐class in backlash politics. Given that individuals in these social classes have far greater institutional power than White working‐class Americans, their beliefs and practices deserve sustained critical attention, and, as the few existing research studies demonstrate, White middle‐class and upper middle‐class Americans have played an influential role in backlash politics. Part of the reason for this gap in the literature is that these groups are more difficult to access as research subjects. Gaining access to this population may require working through many levels of a bureaucratic organization designed to protect their time and privacy. Moreover, when interviewed, these Americans are more likely than their working‐class counterparts to mask racist sentiments through the polite language of “color blindness.” Research methods that complement surveys and in‐depth interviews are recommended as strategies for probing White middle and upper middle‐class Americans' deeply hidden beliefs.
Diagnostic accuracy of clinical tests for ankle syndesmosis injury
Authors: Sman Amy D , Hiller Claire E , Rae Katherine , Linklater James , Black Deborah A , Nicholson Leslie L , Burns Joshua , Refshauge Kathryn M 
Published: November 2013

ObjectiveOur aim was to investigate the diagnostic accuracy of the clinical presentation of ankle syndesmosis injury and four common clinical diagnostic tests.DesignCross-sectional diagnostic accuracy study.Setting9 clinics in two Australian cities.Participants87 participants (78% male) with an ankle sprain injury presenting to participating clinics within 2 weeks of injury were enrolled.MethodsClinical presentation, dorsiflexion-external rotation stress test, dorsiflexion lunge with compression test, squeeze test and ankle syndesmosis ligament palpation were compared with MRI results (read by a blinded radiologist) as a reference standard. Tests were evaluated using diagnostic accuracy, sensitivity, specificity and likelihood ratios (LRs). A backwards stepwise Cox regression model determined the combined value of the clinical tests.ResultsThe clinical presentation of an inability to perform a single leg hop had the highest sensitivity (89%) with a negative LR of 0.37 (95% CI 0.13 to 1.03). Specificity was highest for pain out of proportion to the apparent injury (79%) with a positive LR of 3.05(95% CI 1.68 to 5.55). Of the clinical tests, the squeeze test had the highest specificity (88%) with a positive LR of 2.15 (95% CI 0.86 to 5.39). Syndesmosis ligament tenderness (92%) and the dorsiflexion-external rotation stress test (71%) had the highest sensitivity values and negative LR of 0.28 (95% CI 0.09 to 0.89) and 0.46 (95% CI 0.27 to 0.79), respectively. Syndesmosis injury was four times more likely to be present with positive syndesmosis ligament tenderness (OR 4.04, p=0.048) or a positive dorsiflexion/external rotation stress test (OR 3.9, p=0.004).ConclusionsAlthough no single test is sufficiently accurate for diagnosis, we recommend a combination of sensitive and specific signs, symptoms and tests to confirm ankle syndesmosis involvement. An inability to hop, syndesmosis ligament tenderness and the dorsiflexion-external rotation stress test (sensitive) may be combined with pain out of proportion to injury and the squeeze test (specific).
Readiness for cancer rehabilitation in Denmark: protocol for a cross-sectional mixed methods study
Authors: Kristiansen Maria , Adamsen Lis , Hendriksen Carsten 
Published: November 2013

IntroductionRehabilitation is a key element in most cancer care policies in recognition of the often unmet physical, psychological and social needs among the rising numbers of patients with cancer. A systematic assessment of patients’ needs and available rehabilitation services constitute the foundation for timely, comprehensive and coordinated cancer rehabilitation. This study aims to provide insight into the current organisation and practice of cancer rehabilitation in Denmark with special emphasis placed on the assessment of patients’ needs and availability of services across the cancer treatment trajectory.Methods and analysisA cross-sectional design using a mixed methods approach will be used in order to analyse the readiness for cancer rehabilitation in different sectors and from differing perspectives. Substudy 1 consists of an electronic survey among the 98 Danish municipalities and focuses on the availability and use of cancer rehabilitation services for patients with all types of cancers. In substudy 2, a survey among the 19 surgical and 12 oncological departments involved in colorectal cancer treatment in Denmark is conducted in order to describe the current clinical practice regarding the assessment of rehabilitation needs and referral to services. Substudy 3 involves a retrospective clinical audit and semistructured interviews at four randomly selected surgical and oncological departments treating colorectal patients with cancer in order to elucidate current needs assessment practices.Ethics and disseminationThe study was approved by the Danish Data Protection Agency and will be conducted in accordance with the principles of the Helsinki Declaration Representatives from municipalities and clinical practice are engaged in the design and execution of the study in order to ensure the usefulness of survey instruments, reflexive interpretation of data and transfer of implications into practice.ResultsPublished in international peer-reviewed scientific journals and presented at conferences, seminars and as short reports.
‘Not yet’ and ‘Just ask’: barriers and facilitators to advance care planning—a qualitative descriptive study of the perspectives of seriously ill, older patients and their families
Authors: Simon Jessica , Porterfield Pat , Bouchal Shelley Raffin , Heyland Daren 
Published: November 2013

ObjectivesTo explore seriously ill, older hospitalised patients’ and their family members’ perspectives on the barriers and facilitators of advance care planning (ACP).MethodsWe used qualitative descriptive study methodology to analyse data from an interviewer administered, questionnaire-based, Canadian multicentre, prospective study of this population.ResultsThree main categories described these barriers and facilitators: (1) person (beliefs, attitudes, experiences, health status), (2) access (to doctors and healthcare providers, information, tools and infrastructure to communicate ACP preferences) and (3) the interaction with the doctor (who and how initiated, location, timing, quality of communication, relationship with doctor).ConclusionsBased on the findings, we suggest strategies for both healthcare systems and individual healthcare providers to improve the quality and quantity of ACP with this population. These include assessing readiness for participation in ACP and personalising relevance of ACP to each individual, routinely offering scheduled family meetings for exploring a person's own goals and sharing information, ensuring systems and policies are in place to access previous ACP documentation and ensuring doctors’ education includes ACP communication skills.