bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recovering from a stroke: a longitudinal, qualitative study of older Norwegian women
Authors: Eilertsen Grethe , Kirkevold Marit , Bjørk Ida Torunn 
Published: June 2010

Aim.  To illuminate older women’s experiences and the characteristics of the recovery process following a stroke.Background.  Patients with stroke face serious challenges related to bodily changes, existential aspects and daily life after stroke. Few qualitative longitudinal studies have examined the recovery process from the perspective of the patient. Knowledge about older women’s experiences in coping with life after a stroke is limited.Design.  Prospective, longitudinal, case‐study design.Methods.  Six women aged 68–83 suffering from first‐time stroke were recruited from two stroke units. Each participant was interviewed in‐depth 12–14 times during the first two years post stroke. The interviews addressed how they experienced their body, their self‐understanding, daily life and how this had changed over time. Most interviews took place in the participants’ homes. Gadamer’s philosophical hermeneutics informed the analyses.Results.  Post stroke recovery was slow and complex and evolved through four distinct phases. In the first phase (0–2 months post stroke), the participants’ main concerns were their bodily changes; in the second phase (2–6 months), activities of daily life; in the third phase (6–12 months), self‐understanding and in the fourth phase (12–24 months), going on with life. The transition between phases was gradual.Conclusion.  Recovery from stroke evolves over time through four distinct phases, which differ depending on significant experiences and associated meanings. Psychological and social resources are equally critical in the women’s process of recovery.Relevance to clinical practice.  The four phases of rehabilitation suggest at what points various concerns require increased therapeutic attention. Psychological and social resources must be vitalised at an early phase similar to bodily resources. This knowledge may assist professionals in offering adequate help throughout the recovery process even beyond the established rehabilitation period.
An exploratory study of anxiety in carers of stroke survivors
Authors: Greenwood Nan , Mackenzie Ann 
Published: June 2010

Aims and objectives.  To investigate anxiety in informal carers of stroke survivors in the first three months after discharge.Background.  Informal carers, also called caregivers, play a vital role in supporting stroke survivors. However, caring for stroke survivors can have adverse consequences amongst carers such as burden, stress and reduced quality of life. Emotional distress is also commonly reported but anxiety has received less attention than depression.Design.  Prospective, longitudinal, descriptive study.Method.  Forty‐five carers completed the Hospital Anxiety and Depression Scale on two occasions – within one month and at three months after discharge from stroke and rehabilitation units.Results.  Carers were more likely to have scores indicating anxiety than depression. In the first month, half the carers (51·1%) scored in the cut‐off for anxiety and a third were in the cut‐off for depression (31·1%). At three months, the picture was very similar with nearly identical proportions in the anxious and depressed categories (48·9% and 28·9%, respectively). Changes in numbers of cases of anxiety and depression and in mean anxiety scores were non‐significant but there was a significant decrease in depression scores (p = 0·048). Fourteen carers (31·1%) at one month and eleven (24·4%) at three months fell into both anxious and depressed categories.Conclusions.  Anxiety is a relatively neglected emotional outcome in stroke carers. Our study suggests anxiety is an important issue very early in caring whilst other research suggests it remains prevalent for many months. Given the significant role carers play in rehabilitation of stroke survivors, greater recognition of their emotional state is required. Further, longitudinal research with larger sample sizes from a range of geographical areas and improved understanding of factors associated with anxiety is needed.Relevance to clinical practice.  Nurses working in the community are ideally placed to identify and support carers suffering from anxiety.
Risk factors for deep sternal wound infections after cardiac surgery in Jordan
Authors: Al‐Zaru Ibtisam M , Ammouri Ali A , Al‐Hassan Mousa A , Amr Anas A 
Published: June 2010

Aim.  The purpose of this study was to assess rates of and risk factors for deep sternal wound infection after coronary artery bypass grafting surgery.Background.  Deep sternal wound infection is one of the most devastating complications of cardiac surgery, resulting in multiple operative and non‐operative procedures and increased hospital costs.Design.  A retrospective design using an existing coronary artery surgery database of adults (n = 206) who had undergone coronary artery bypass grafting surgeries between January 2004–January 2006 at a university affiliated hospital, northern Jordan was used.Method.  Multiple logistic regression analyses were used to asses rates of and risk factors for deep sternal wound infection.Results.  Deep sternal wound infection incidence rate was 22% of the total sample. Risk factors of deep sternal wound infection include: (1) diabetes (OR = 0·317, p = 0·048), (2) Obesity (OR = 0·275, p = 0·011), (3) duration of surgery (OR = 4·22, p = 0·032) and (4) use of intraaortic balloon pump (OR = 0·033, p = 0·001).Conclusion.  The proposed model provides a preliminary indication of risk factors placing coronary artery bypass grafting patients at risk of DSWI. Further investigations and testing of the model are needed.Relevance to clinical practice.  Determining patients who are at risk of developing deep sternal wound infection after cardiac surgeries is the first step towards its prevention.
An experimental test for effects of the maternal environment on delayed germination
Authors: Tielbörger Katja , Petrů Martina 
Published: June 2010

Summary 1. Recent models on bet‐hedging germination in annual plants assume a negative relationship between the proportion of offspring that germinate and the quality of the maternal environment. An increase in the proportion of seeds remaining dormant in the next year, when produced in seasons with high reproduction may result from selection that avoids overcrowding in the following year. 2. We present the first empirical test of this prediction by utilizing a field experiment in Israel which manipulated the entire maternal environment. We subjected semi‐arid and Mediterranean annual plant communities to different rainfall treatments: control, reduced and increased rainfall. We then related maternal environment quality to offspring germination fractions for three focal species in two consecutive seasons. 3. There was a negative relationship between the quality of the maternal environment and offspring germination fraction in four out of twelve cases. The negative relationship was stronger for the least competitive species and in the environment with high competition intensity, supporting the role of competition for the observed pattern. 4. Our results suggest that competition with all neighbours is more likely to explain the pattern than sib competition. 5. Synthesis. Our findings provide the first experimental evidence of a highly reliable cue (productivity of maternal environment) that allows for plants to respond to their future biotic environment. There is an urgent need for testing predictions of theoretical models in natural populations and for incorporating the role of density dependence in studies of bet‐hedging germination.
Psychometric evaluation of the post‐discharge surgical recovery scale
Authors: Berg Katarina , Idvall Ewa , Nilsson Ulrica , Årestedt Kristofer Franzén , Unosson Mitra 
Published: June 2010

AbstractRationale, aim and objectives  Day surgery patients are discharged after a short period of postoperative surveillance, and reliable and valid instruments for assessment at home are needed. The aim of this study was to evaluate the psychometric properties of a Swedish version of the post‐discharge surgical recovery (PSR) scale, an instrument to monitor the patient's recovery after day surgery, in terms of data quality, internal consistency, dimensionality and responsiveness.Methods  Data were collected on postoperative days 1 and 14 and included 525 patients. Data quality and internal consistency were evaluated using descriptive statistics, correlation analyses and Cronbach's α. The dimensionality of the scale was determined through an exploratory factor analysis. Responsiveness was evaluated using the standardized response mean and the area under the receiver operating characteristics curve (AUC). The correlation between change score in PSR and change score in self‐rated health was assessed using Pearson's correlation coefficient. Patients' ability to work and their self‐rated health on postoperative day 14 were used as external indicators of change.Results  Six items showed floor or ceiling effects. Cronbach's coefficient α was 0.90 and the average inter‐item correlation coefficient was 0.44 after the deletion of two items. The items were closely related to each other, and a one‐factor solution was decided on. A robust ability to detect changes in recovery (standardized response mean = 1.14) was shown. The AUC for the entire scale was 0.60. When initial PSR scores were categorized into three intervals, the ability to detect improved and non‐improved patients varied (AUC 0.58–0.81). There was a strong correlation between change scores in PSR and health (0.63).Conclusions  The Swedish version of the PSR scale demonstrates acceptable psychometric properties of data quality, internal consistency, dimensionality and responsiveness. In addition to previous findings, these results strengthen the PSR scale as a potential instrument of recovery at home.
Statistical process control as a tool for controlling operating room performance: retrospective analysis and benchmarking
Authors: Chen Tsung‐Tai , Chang Yun‐Jau , Ku Shei‐Ling , Chung Kuo‐Piao 
Published: June 2010

AbstractBackground  There is much research using statistical process control (SPC) to monitor surgical performance, including comparisons among groups to detect small process shifts, but few of these studies have included a stabilization process. This study aimed to analyse the performance of surgeons in operating room (OR) and set a benchmark by SPC after stabilized process.Methods  The OR profile of 499 patients who underwent laparoscopic cholecystectomy performed by 16 surgeons at a tertiary hospital in Taiwan during 2005 and 2006 were recorded. SPC was applied to analyse operative and non‐operative times using the following five steps: first, the times were divided into two segments; second, they were normalized; third, they were evaluated as individual processes; fourth, the ARL0 was calculated;, and fifth, the different groups (surgeons) were compared. Outliers were excluded to ensure stability for each group and to facilitate inter‐group comparison.Results  The results showed that in the stabilized process, only one surgeon exhibited a significantly shorter total process time (including operative time and non‐operative time).Conclusion  In this study, we use five steps to demonstrate how to control surgical and non‐surgical time in phase I. There are some measures that can be taken to prevent skew and instability in the process. Also, using SPC, one surgeon can be shown to be a real benchmark.
A pediatric asthma management program in a low‐income setting resulting in reduced use of health service for acute asthma
Authors: Andrade W. C. C. , Camargos P. , Lasmar L. , Bousquet J. 
Published: June 2010

To cite this article: Andrade WCC, Camargos P, Lasmar L, Bousquet J. A pediatric asthma management program in a low‐income setting resulting in reduced use of health service for acute asthma. Allergy 2010; 65: 1472–1477.AbstractBackground:  The effectiveness of pediatric asthma management programs in reducing health services utilization during exacerbations in developing countries is not widely studied. This study was carried out to assess the effectiveness of an asthma management program to reduce the overall health services utilization by acute asthma in children and adolescents.Methods:  In this historical population‐based real‐life cohort study, we selected 582 patients with asthma aged 4–15 living in deprived areas in the town of Itabira, Brazil, of which 470 cases were assisted by the asthma management program and 112 were controls. The end point was the first physician‐diagnosed asthma exacerbation occurring after study enrollment and within 12 months after admission. All 470 cases received a written plan about exacerbation self‐management, including the use of inhaled albuterol at home. Three hundred and seventeen out of 470 cases (67.4%) were also treated with beclomethasone diproprionate (BDP).Results:  Both groups were comparable regarding gender, age group, and place of residence. At the end of the study, only 5% of cases vs 34% of controls did seek health services because of acute asthma (P < 0.01). Statistical difference also remained when comparing the 112 controls with the 153 cases not treated with com BDP (Hazard Ratio = 0.04, 95% CI, 0.01–0.14, P < 0.01).Conclusions:  Results have demonstrated the effectiveness of the pediatric asthma management program in reducing dependence on the health services for acute asthma. Effectiveness was also observed in subjects with no use of BDP.
Effect of asthma treatment on fitness, daily activity and body composition in children with asthma
Authors: Vahlkvist S. , Inman M. D. , Pedersen S. 
Published: June 2010

To cite this article: Vahlkvist S, Inman MD, Pedersen S. Effect of asthma treatment on fitness, daily activity and body composition in children with asthma. Allergy 2010; 65: 1464–1471.AbstractBackground:  Although several cross‐sectional studies have assessed the daily physical activity in children with asthma, the impact of the level of asthma control remains unknown.Aim:  To assess the influence of asthma treatment–induced changes in asthma control on daily physical activity, cardiovascular fitness and body composition in children with asthma.Methods:  Daily accelerometer‐measured physical activity, cardiovascular fitness, body composition (percent fat, percent lean tissue and bone mineral density) and a variety of asthma outcomes (to assess the level of asthma control) were measured over 4 weeks in 55 children with newly diagnosed untreated asthma and 154 healthy, sex and age‐matched controls. Treatment with inhaled corticosteroids was initiated after the baseline period. All outcome measurements were repeated after 1 year and some also during the year of treatment.Results:  Asthma control improved markedly during the year of treatment. The improvement in control was associated with a significant increase in total daily activity of 2.8 h/week compared with the healthy controls (P < 0.001). In addition, significant increases were seen in moderate‐vigorous activity (33 min/week; P = 0.01) and in cardiovascular fitness (1.2 ml O2/min*kg) compared with the healthy controls. The improvement in activity was mainly seen during the last 6 month of the study. No difference was seen between the two groups in changes in percent body fat.Conclusion:  Poorly controlled asthma is associated with reduced physical activity and cardiovascular fitness. Improvement in asthma control is associated with a clinically relevant increase in daily physical activity and cardiovascular fitness.
Can Honey Bees Learn the Removal of a Stimulus as a Conditioning Cue?
Authors: Abramson Charles I. , Nolf Sondra L. , Mixson T. Andrew , Wells Harrington 
Published: June 2010

AbstractExperiments investigated a Pavlovian conditioning situation where the presence and absence of the stimulus are reversed temporally with respect to the presentation of a reward. Instead of a conditioned stimulus (e.g. odor) signaling the presence of a reward, the stimulus (e.g. odor) is present in the environment except just prior to the presence of the reward. Thus, the absence of the stimulus, or offset of the stimulus (e.g. absence of odor), serves as a conditioned stimulus and is the reward cue. Honey bees (Apis mellifera) were used as a model invertebrate system, and the proboscis‐conditioning paradigm was used as the test procedure. Using both simple Pavlovian conditioning and discrimination‐learning protocols, animals learned to associate the onset of an odor as conditioned stimuli when paired with a sucrose reward. They could also learn to associate the onset of a puff of air with a sucrose reward. However, bees could not associate the offset of an order stimulus with the presentation of a sucrose reward in either a simple conditioning or a discrimination‐learning situation. These results support the model that a very different cognitive architecture is used by invertebrates to deal with certain environmental situations, including signaled avoidance.
Plumage Colouration, Age, Testosterone and Dominance in Male Red Bishops (Euplectes orix): A Laboratory Experiment
Authors: Edler Alice U. , Friedl Thomas W. P. 
Published: June 2010

AbstractVisual signals such as plumage characteristics in birds often play a key role in the establishment of dominance in contests by acting as a badge of status that can be used to assess individual fighting ability. We studied the role of plumage colouration in males of the red bishop (Euplectes orix), a sexually dimorphic and polygynous weaverbird species occurring in sub‐Saharan Africa and breeding in dense colonies around water. Males are highly territorial and often engage in competition over limited resources such as breeding sites and potential mates. By experimentally staging male–male contests over a limited food source, we wanted to determine whether the orange–red breeding plumage in this species serves as a dominance signal between individuals, with males with redder plumage being dominant over those with duller plumage. In the first set of experiments, we staged contests between unfamiliar and unmanipulated males. The setup of the second set of experiments was identical to the first, with the exception that those males with the lowest chroma and hue values had their plumage experimentally reddened within the range of the natural variation. In addition to plumage colouration, we incorporated testosterone levels, body condition and age into the analysis of factors contributing to contest outcome. Our results show a consistent and strong age effect in both sets of experiments, which seems to be independent of plumage colouration, testosterone and body condition. This suggests that in the red bishop, the outcome of male–male competitions over limited resources is determined by age‐related acquired experience rather than by status signalling through plumage colouration.
Risks Associated with Predator Immobility, Movement Direction, and Turn Direction Similarly Affect Pursuit‐Deterrent Signaling and Escape by Zebra‐Tailed Lizards (Callisaurus draconoides)
Authors: Cooper, Jr William E. 
Published: June 2010

AbstractSome prey may signal to deter pursuit by predators. Because deterrence is not needed when risk is low or useful when capture is imminent, most signaling should occur at intermediate risk. Probability of fleeing increases with risk for various risk factors. At low–intermediate risk, more frequent signaling should occur as assessed risk associated with risk factors increases. I examined the effects of three risk factors related to immobility and movement by a predator: standing distance (distance from prey to immobile predator), directions of walking, and turning by the predator. Risk is greater when the predator stands nearer, walks toward prey vs. retreating, and turns toward prey vs. away. In the lizard Callisaurus draconoides, which signals by elevating and waving its tail, signaling was more frequent before fleeing when I stood immobile at the shorter of two distances. All the lizards fled when I walked toward them, regardless of standing distance. Fewer fled when I moved away and only at the shorter standing distance. At the shorter standing distance, signal probability was high and did not differ between movement directions. At the longer standing distance, fewer lizards signaled and only when I moved toward them. Patterns of response of signaling and escape to combinations of standing distance and turn direction were qualitatively identical. When I turned away from lizards, none displayed or fled at the longer standing distance. At the shorter standing distance, probabilities of displaying and fleeing were higher when I turned toward than away from lizards. Standing distance affected signaling interactively with directions of movement and turning in manners readily interpretable from risk. Signaling was affected by risk associated with all factors, being absent or infrequent at both high‐ and low‐risk levels but frequent at intermediate risk, strengthening evidence for pursuit‐deterrent signaling.
Hospital costs and outcomes among intravenous antifungal therapies for patients with invasive aspergillosis in the United States
Authors: Kim Aryun , Nicolau David P. , Kuti Joseph L. 
Published: June 2010

SummaryThis study determined the economic burden of aspergillosis‐related hospitalisations in the United States during years when new antifungal treatments were introduced. A retrospective observational cohort study from the hospital perspective was conducted using national administrative data from the Premier Perspective™ Database. Patients (n = 1603) coded for infection caused by Aspergillus species during 1835 admissions who received at least 3 days of intravenous antifungal therapy between 2000 and 2006 were included. All costs were inflated to $US 2006. Length of stay, hospital costs and mortality were compared after stratification by initial antifungal therapy. Median hospital costs were $52 803 (25 929–100 730) and did not differ by year over the study period. Intravenous antifungals accounted for 7.2% (range: 0.78–15.9%) of the cost of aspergillosis‐related hospitalisation. Crude mortality was 36.7% and was the lowest in the last 2 years of the study (2005, 2006). Although antifungal utilisation changed over the course of the study, initial antifungal choice was not independently associated with crude mortality. In contrast, initial therapy with intravenous voriconazole was associated with reduced total hospitalisation costs and length of hospital stay. Treatment with amphotericin B lipid complex or caspofungin was also independently associated with a reduced length of hospital stay. In this large US study, mortality and costs for aspergillosis‐related hospitalisations were considerable, but antifungals accounted for a small percentage of total costs associated with treatment and did not independently affect in‐hospital crude mortality. Only initial treatment with intravenous voriconazole was associated with reduced total hospitalisation costs.