bluuebunny/crossref_metadata_2025_split huggingface dataset:
ICSH recommendations for the measurement of Haemoglobin F
Authors: STEPHENS A. D. , ANGASTINIOTIS M. , BAYSAL E. , CHAN V. , DAVIS B. , FUCHAROEN S. , GIORDANO P. C. , HOYER J. D. , MOSCA A. , WILD B. ,   ON BEHALF OF THE INTERNATIONAL COUNCIL FOR THE STANDARDISATION OF HAEMATOLOGY (ICSH)
Published: September 2011

SummaryMeasurement of the Haemoglobin F in red cell haemolysates is important in the diagnosis of δβ thalassaemia, hereditary persistence of fetal haemoglobin (HPFH) and in the diagnosis and management of sickle cell disease. The distribution of Hb F in red cells is useful in the diagnosis of HPFH and in the assessment of feto‐maternal haemorrhage. The methods of quantifying Hb F are described together with pitfalls in undertaking these laboratory tests with particular emphasis on automated high‐performance liquid chromatography and capillary electrophoresis.
Magnetic Resonance Arthrogram and Arthroscopy of the Shoulder: A Comparative Retrospective Study with Emphasis on Posterior Labral Lesions and Radiologist Locality
Authors: Kalson Nicholas S. , Geoghegan John M. , Funk Lennard 
Published: September 2011

Background Magnetic resonance arthrography(MRA) is a routine diagnostic investigation for glenohumeral lesions; however, diagnostic arthroscopy remains the gold standard. The present study aimed tto investigate the diagnostic accuracy of glenohumeral MRA compared to arthroscopy, with particular interest in previously unreported aspects, such as posterior labral lesions and the locality of the reporting radiologists. Methods Ninety-five consecutive patients with pre-operative MRA and subsequent arthroscopy were included. Patients were grouped into MRA reported by specialist radiologists within the specialist shoulder unit ( n = 58) or reported by nonlocal musculoskeletal radiologists ( n = 37). Results In the local radiologist group, the sensitivity/specificity for Hill – Sachs lesions was 0.71/0.85, anterior labral tears 0.75/0.73, posterior labral tears 0.50/0.92, superior labral tear from anterior to posterior (SLAP) lesions 0.71/0/91 and rotator cuff tears (RCTs) 0.40/0.81. In the nonlocal radiologist group, the sensitivity/specificity for Hill – Sachs lesions was 0.64/0.88, anterior labral tears 0.70/0.79, posterior labral tears 0.40/0.81, SLAP lesions 0.66/0/82 and RCT 0.40/0.81. A nonsignificant trend of lower sensitivity/specificity for lesions reviewed by the nonlocal radiologists was found. Discussion MRA is not 100% sensitive or specific and does not negate arthroscopy. There is a lower diagnostic accuracy of posterior compared to anterior labral lesions and improved accuracy of glenohumeral MRA diagnosis may be achieved with the increased experience of radiologists within specialist units and regular surgical feedback of cases.
Survival and bronchial carcinoid tumors: Development of surgical techniques in a 30‐year experience of 82 patients in China
Authors: Wei Sen , Hao Chunfang , Gong Lei , Hu Chengguang , Lian Jianhong , Zhou Qinghua 
Published: September 2011

AbstractBackground:  We aimed to identify the factors determining long‐term survival after surgical management for bronchial typical carcinoid (TC) and atypical carcinoids (AC) and to compare the clinical outcome of the different surgical strategies used in the two periods of 1980–1994 and 1995–2005.Methods:  Records of 82 patients with an initial pathological diagnosis of bronchial carcinoid tumor who underwent surgical management from January 1980 to December 2009 were reviewed. Tumors were classified as TC or AC using the 2004 World Health Organization criteria.Results:  There were 60 TC and 22 AC. Surgical procedures included lobectomies, sleeve or bronchoplastic resections, pneumonectomies, wedge resections, and segmental resections. Significantly fewer pneumonectomies and more sleeve and bronchoplastic resections were performed after 1994. The prognosis was more favorable for TC than AC. Comparing lymph node status N0 with N1 + N2, 5‐ and 10‐year survival was 92% and 85% vs. 61% and 41%. No patient with lymph node involvement survived more than 15 years.Conclusions:  Tumor subtype and lymph node status have the greatest impact on long‐term survival following surgery. AC and/or regional lymph node metastases have the worst prognosis. Formal anatomic and tissue‐saving lung resection plus systematic radical mediastinal lymphadenectomy for TC and AC should be standard.
Desmitis of the medial tarsal collateral ligament in 7 horses
Authors: Sherlock C. E. , Eggleston R. B. , Peroni J. F. , Parks A. H. 
Published: September 2011

SummarySevere lameness, tarsocrural joint effusion and medially focused peritarsal swelling combined with focal pain on palpation are clinical signs suggestive of acute injury to the medial tarsal collateral ligament. Diagnosis can be made on physical examination and ultrasonographic findings; however, magnetic resonance imaging may provide more information especially with subtle injury. Acute exacerbation of the injury during the prolonged convalescence is common. The prognosis for medial tarsal collateral ligament desmitis appears good for survival but fair for return to previous levels of performance and requires prolonged periods of rest and a controlled exercise programme.
Pharmacists' awareness of Australia's health care reforms and their beliefs and attitudes about their current and future roles
Authors: Mak Vivienne S L , Clark Alice , Poulsen Joo H , Udengaard Kimmie U , Gilbert Andrew L 
Published: September 2011

Abstract

Objective
To explore pharmacists' awareness of Australia's health care reforms and their beliefs and attitudes about their current and future roles.

Methods
Four focus groups were conducted with 32 South Australian pharmacists: two groups included community pharmacists and pharmacy owners; one included hospital pharmacists and another, consultant pharmacists.

Key findings
Four themes emerged: (1) poor awareness of health care reform agenda; (2) strong adherence to the supply model; (3) lack of appreciation of alternative models; and (4) communication barriers.

Conclusions
Participants' low awareness of Australia's health care reforms and their expressed beliefs and attitudes to their current role in the health system suggest that they are not well prepared for the potential future roles expected of health professionals in the health care reform agenda.
Grip strength and lower limb extension power in 19–72-year-old Danish men and women: the Health2006 study
Authors: Aadahl Mette , Beyer Nina , Linneberg Allan , Thuesen Betina Heinsbæk , Jørgensen Torben 
Published: September 2011

AimTo assess muscular fitness by hand grip strength (HGS) and lower limb extension power (LEP) and to explore associations with age, leisure time physical activity (LTPA) and body composition.Study populationA population-based sample of 19–72-year-old men and women were invited to participate in the health survey 'Health2006'. The response rate was 43.8% (N=3471), 55% were women, and the mean age was 49±13 years.MethodsHeight, weight, waist circumference, HGS and LEP were measured and participants answered a self-administered questionnaire. LEP was measured in a subsample of subjects (n=438). Gender-stratified multiple linear regression analyses were carried out. Data were adjusted for age, height and waist circumference.ResultsA large inter-individual variation was found in HGS and LEP. Both measures declined with age and were highly correlated (r=0.75, p<0.0001). LTPA was positively associated with HGS in men (p=0.0002) and women (p<0.0001) in the total sample, but in the subsample was significant in men only (p=0.004); the association between LTPA and LEP was significant in women only (p=0.02).ConclusionIn this large population-based study sample, muscular fitness declined with age and LTPA was associated with HGS in both genders. The findings emphasise the importance of maintaining a physically active lifestyle at any age.
Can oral history improve healthcare professionals understanding of patients in palliative care?
Authors: Winslow Michelle , Smith Sam , Noble Bill 
Published: September 2011

This presentation will consider the potential benefit of oral history in the context of medical and nurse education to aid a deeper understanding between patient and physician. We contend that oral history is a valid source of information for use in educating healthcare professionals through the reproduction of the authentic voice of the interviewee.An oral history is a deeply personal account that expresses identity and explores meaning. When heard together with a clinical history there is potential for health professionals to gain knowledge of the variety of patients' experiences, deepening and broadening awareness of the process and consequences of disease. This understanding can enhance awareness of psychosocial matters and prepare them for clinical encounters in the future.In palliative care, health professionals hear the concerns and distress of individual patients and carers by a process of active listening and structured questioning; their knowledge is synthesised from findings arising from population case studies and studies using both quantitative and qualitative methodologies. While oral history makes no claim to be generalisable in a scientific sense, like other practices in the humanities, it does seek to describe the human condition. Oral histories are uncluttered by imposed theoretical frameworks or extrinsic interpretations and in this sense the patient has greater agency and the health professional can gain more rounded understandings.The value of oral history to the health professional is that it allows communication with patients and carers that is unfiltered by a medical agenda. Accounts of patients' experience are put into context in a way that retains their individual voice and agency.
Corneal donation in palliative care: a doctor's perspective
Authors: Al-Qurainy Rasha , Prentice Wendy 
Published: September 2011

IntroductionCorneal donation is a possibility for many palliative care patients after death but anecdotal evidence suggests it is seldom done. Previous research in other settings (especially acute medical settings) suggest lack of knowledge and a negative attitude from staff contributing to low donation rates, rather than public refusal.AimTo explore palliative care doctors' knowledge and attitudes about corneal donation and to find if any associations with corneal procurement exist.Methods and resultsA postal survey was conducted that tested knowledge of corneal donation and asked about attitude and behaviour (past experiences). A 14 item questionnaire was sent to 427 practising palliative care consultants and associate specialists in the UK. A response rate of 50% was achieved and the findings were analysed using SPSS software and thematic content analysis. The study showed that over half (57%) of doctors had an inadequate level of knowledge about corneal donation but did have a positive personal and professional attitude towards it. There was a statistically significant association between their personal and professional attitude (ie, either both would be positive or both negative) with a significant association between a positive attitude and a higher mean knowledge score. The most common perceived drawback of discussing donation was fear of causing distress (36% of doctors gave this response). In practice, causing distress was reported by 4.8% of the doctors.ConclusionThe study found an association between palliative care doctors' knowledge and attitude with procurement behaviour. Those that viewed donation positively had a greater amount of knowledge. Doctors tended to have the same professional view as their personal view. This could suggest that doctors bring their personal opinions into the work place and exhibit gate-keeping behaviour which could have implications for practice. The study also highlighted the differences between doctors' perceptions and actual experiences.
Gaining ‘real-time’ feedback to influence patient and family care
Authors: Horne Gillian , Biggs Jane 
Published: September 2011

IntroductionGaining meaningful feedback about service user experience when patients are at the end of life can be difficult. The hospice through its relationship with the local primary care trust won a competition hosted by Picker Institute Europe and Fr3dom Health Solutions. The award enabled the development of patient, relative and public experience surveys.AimsTo design specific user experience surveys which are easy to administer, would provide meaningful feedback to enhance quality of care and inform future service developments.MethodsFive surveys were designed by clinical teams with the help of Picker Institute Europe. Surveys were designed to be relevant to each clinical area. Hospice volunteers were trained in administering the electronic surveys. A survey about the inpatient discharge process was administered through SMS text messaging. The community survey was administered in written format with an option to complete on-line.ResultsResults are providing useful feedback on inpatient and family experience of involvement in decisions about care, dignity, choice in food and help in eating, cleanliness and noise of the environment. Community survey results are providing us with feedback on patient experience on the effectiveness of symptom management and public surveys have provided peoples views on access to and knowledge of the hospice. The informal verbal comments given to volunteers are helpful in seeking to meet needs not picked up by the survey.DiscussionResults are providing useful information about different aspects of our service, which may not have been possible using standard written surveys. Staff and patients have commented on the ‘professionalism’ of the volunteers in administering the surveys and volunteers have enjoyed being involved in this project.ConclusionThe use of bespoke surveys using electronic devices, administered by trained volunteers, is an effective way of gaining feedback from a variety of service users.
£30 m investment in children and young people's palliative care – taking up the challenge
Authors: McNamara Katrina 
Published: September 2011

In 2007, Professor Sir Alan Craft led an independent review that identified variation in the availability of children's palliative care services and issues around their sustainability. In June 2010, Department of Health (DH) announced the availability of up to £30 million is being made available to help children's hospices, networks and other providers develop local children's palliative care projects and help to address the key issues set out in the Craft report.This presentation aims to set out the developments achieved by ACT, the UK children's palliative care organisation following the successful application to the DH in England for funding.Over 400 projects were successful in their bids for funding. ACT's successful bids included:▶Extubation care pathway and parents' critical care leaflet▶Symptom control manual and formulary▶Children's palliative care handbook for GPs▶Family Companion update and film.ACT has also worked in partnership with BLISS to further work on neonatal activity and with Children's Hospice UK to roll-out a programme of Square Table events to facilitate local debates about key issues in children's palliative care.
'A foot in the door' – an introductory programme for patients with early stage motor neuron disease
Authors: Stananought Nicola , Greene Marie , Sutherland Jane , Midgley Corinna , Asiam Evelyn 
Published: September 2011

IntroductionPatients with MND are usually referred to palliative care services late in their disease progression. Reasons for this appear to centre on patients being so distressed at the prospect of palliative care services involvement, that they delay referral for as long as possible. Having identified this as a problem, the hospice embarked on a joint venture with the Motor Neurone Disease Association. The premise of such joint working was to develop an outreach project for local patients with early stage MND. A grant was successfully secured from the DH (project 64 grant).AimsThe aims of the project were to introduce this cohort of patients/carers to palliative care services at a much earlier stage in their illness and to decrease levels of distress/anxiety associated with a referral. It was also to give the opportunity for patients/carers to meet others in a similar situation and to provide them with information about common problems.MethodsTwo programmes were devised, each of 10 sessions, with a different theme per session. Each programme was devised to support 10 new patients/carers, with sessions taking place in the day hospice (hence the title ‘a foot in the door’).ResultsDuring the first and final sessions of each programme, patients/carers were asked to anonymously score a series of statements concerning their confidence in (and experience in accessing) care, their concerns for the future and feelings about hospice services. Results show that a positive change in all domains occurred.ConclusionThis outreach project had a positive impact on MND patients/carers. The project format can be replicated by other palliative care providers.A DVD further detailing the project is being made in order to help other palliative care providers develop similar work.
Improving end of life care on the front line
Authors: Scates Caroline 
Published: September 2011

Emergency Care Practitioners (ECPs) are often asked to respond to 999 calls from patients that are dying at home. If relatives caring for loved ones at the end of life suddenly become afraid or anxious, or if new symptoms develop, then the ECPs are often called and have to make quick assessments and judgements about the situation. This project is about enhancing the skills and knowledge of the ECPs to enable them in decision making, and recognising some of the complications and complexities at the end of life. The ultimate aim is to keep patients in their preferred place of care.AimTo provide 5 days of training to ECPs from the East of England on end of life care, including what palliative care emergencies are, what the end of life care tools are and an introduction to the drugs available in emergency boxes.MethodsBetween November 2010 and March 2011 we welcomed over 30 ECPs on five study days on end of life care. Each delegate attended the same programme and had the opportunity to discuss the most difficult aspects of attending palliative care patients.ResultsOur initial feedback from the evaluation forms was encouraging. For many delegates, this was the first training that they had received on end of life care.DiscussionThe initial feedback received and the links that we have now built with the ambulance service, are certainly encouraging. We have been given some anecdotal evidence from the local end of life care facilitator who has already seen positive results in practice.ConclusionBy September, we will have further feedback from the ECPs as we plan to wait until they have had an opportunity to put what they have learned into practice before assessing how this training has influenced practice and what needs to develop further.
Supporting the setting up of a tertiary palliative care service. Positive reflections on reaching out
Authors: Midgley Corinna , Hafeez Haroon 
Published: September 2011

In 2008 a new Consultant in Internal Medicine was appointed to a busy cancer centre in Pakistan. He found himself providing predominantly palliative care, alongside a skilled but small palliative nurse team. This was recognised. He was made Consultant Lead for Palliative Care, and supported to enrol on a UK Diploma course and to do a 6 week locum registrar spell in a UK hospice for professional development.The relationships forged led him to request continued connecting with the hospice Consultant, through SKYPE, for 1 h per month once back in Pakistan. This to allow reflection on complex cases, as he had no Consultant to do this with.We started connecting 2 years ago, achieving 10 × 1 h sessions annually, discussing 1–2 cases each time. The palliative care team in Pakistan contributed, and an educationalist/Nurse joined the Consultant in the UK hospice.For Pakistan it has been so useful to discuss difficult symptom control and emotional challenges with an experienced physician, with, over time, real gains in patient, family and staff support. Sharing of working policies has been invaluable. Our connection has helped powerful lobbying to politicians regarding controlled drugs access, and armoury for Consultant and team to pursue initiatives like the Liverpool Care Pathway.For the UK we have seen our Pakistan colleagues overcoming huge practical challenges, particularly in support of people at home, often involving intense family support in care delivery. We have been impressed by the willingness of the wider hospital team to work together, quickly, towards best comfort care. These things have enhanced our UK care: we are more including of families, and understand more those we care for with international connections. We recommend this as an affordable, manageable and rewarding way to support international palliative care development and build educational and supportive links across services.
Co-ordinating care: a clinicians tale
Authors: Johnson Bronia , Smith Wendy 
Published: September 2011

IntroductionThe Palliative Care Co-ordination Centre (PCCC) was first devised as part of the Marie Curie Cancer Care ‘Delivering Choice Programme’ acting as an administrative centre to book packages of care on a first come, first served basis of care for palliative care patients. In August 2010 clinical leads were introduced into the centre.AimsTo provide a central point of communication for clinicians, working with the referring clinicians to ensure that care is prioritised and co-ordinated. To ensure patients receive the most appropriate level of care. To support patient choice at the end of life by facilitating discharge from hospital and reducing inappropriate admissions.MethodIntroduction of clinical staff with palliative care and community nursing experience. Extended working; opening at weekends.Access to SystmOne patient records, the palliative care template and introduction of a county-wide prioritisation tool.Results▶Clear discussion regarding patient needs and priority between referring clinician and PCCC team – care based on need not first come, first served.▶Patients' care packages are routinely prioritised resulting in complex patients receiving the majority of their care from dedicated palliative care providers.▶Reallocation of care to support unmet need / reprioritisation of patient care supporting patient and their family and carers at home.DiscussionThe introduction of clinical staff has enabled patient need and priority to be matched to the appropriate care and has released resources and reduced unmet need.This has supported both speedier discharge from and prevented unnecessary admission to hospital.It has also highlighted issues with the current systems and barrier to the effective use of Continuing Healthcare.ConclusionThe introduction of clincians has been a positive investment; the issues highlighted need to be addressed to further improve outcomes for patients and their families.