bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome in women with no endocervical component on cervical cytology after treatment for high‐grade cervical dysplasia
Authors: HUANG Alice , QUINN Michael , TAN Jeffrey 
Published: June 2009

Background:  Cervical cancer and its precursors still remain an important cause of morbidity and mortality despite adequate screening programs. It is now established practice in Australia that a Pap smear without an endocervical component, which is otherwise negative, does not warrant an earlier repeat smear. This study aims to determine if the lack of an endocervical component in women with previously treated high‐grade abnormalities of the cervix increases the risk of subsequent cytological abnormalities.Method:  Data were retrieved from an electronic database in the Oncology and Dysplasia Unit at The Royal Women's Hospital in Melbourne, Australia. Women who underwent treatment for high‐grade cervical abnormalities from 2000–2004 were included in the study. Women with negative cytology immediately after their operations were first identified, and the incidence of subsequent cytological abnormalities was calculated and then separated according to their endocervical status.Results:  Of the 1260 women in the study population, seven developed high‐grade abnormalities (six with an endocervical component and one without) and 107 developed low‐grade abnormalities (98 with an endocervical component and nine without).Conclusion:  The lack of an endocervical component was not statistically significantly associated with a higher incidence of either high‐grade or low‐grade abnormalities. Therefore, women who have had previous treatments for high‐grade abnormalities do not need to have earlier repeat smears or intervention if the cytology lacks an endocervical component.
Long‐Term Outcome in 44 Horses with Stifle Lameness After Arthroscopic Exploration and Debridement
Authors: COHEN JENNIFER M. , RICHARDSON DEAN W. , MCKNIGHT ALEXIA L. , ROSS MICHAEL W. , BOSTON RAYMOND C. 
Published: June 2009

Objective—To (1) examine the outcome in horses with osteoarthritis or intra‐articular soft tissue injuries of the stifle after arthroscopic exploration and debridement and (2) to determine any imaging or surgical findings that may influence prognosis.Design—Case series.Animals—Horses (n=44) with lameness referable to the stifle, diagnosed with osteoarthritis, meniscal tears, or other intra‐articular soft tissue injuries based on arthroscopic examination.Methods—Medical records of horses with stifle lameness that had arthroscopic exploration were reviewed. Horses with osteochondrosis lesions, intra‐articular fractures, or osseous cyst‐like lesions were excluded. Pertinent case information was analyzed and short‐ and long‐term outcome was assessed.Results—There was no association between radiographic score and surgery score. Diagnostic ultrasound had a sensitivity of 79% and a specificity of 56% for identifying meniscal injuries. Follow‐up information was available for 35 horses; 23 horses (60%) improved after surgery, 16 (46%) became sound, and 13 (37%) returned to their previous level of function. A negative association was observed between age and degree of preoperative lameness and outcome. More severe changes observed on preoperative radiographs were also negatively associated with prognosis. No horses with grade 3 meniscal tears improved postoperatively and increasing meniscal pathology was negatively associated with return to previous function. A weak association between surgery grade and outcome was also observed. Degree of chondral damage, location of primary pathology, and microfracture techniques had no effect on outcome.Conclusions—Advanced horse age, severe lameness and preoperative radiographic changes, and presence of large meniscal tears are associated with a negative postoperative outcome for horses with stifle lameness. Appearance of the articular surface at surgery appears to be an inconsistent prognostic indicator.Clinical Relevance—Some horses with extensive cartilage damage may return to athletic function after arthroscopic debridement and lavage. A more pessimistic prognosis may be given to older horses, those with more severe preoperative lameness, and those with severe radiographic changes or large meniscal tears.
Effect of Prosthesis Number and Position on Rima Glottidis Area in Equine Laryngeal Specimens
Authors: DART ANDREW , TEE ELIZABETH , BRENNAN MOSES , DART CHRISTINA , PERKINS NIGEL , CHAPMAN STELLA , DEBNEY SALLY 
Published: June 2009

Objective—To assess the effect of 1 or 2 laryngeal prosthetic sutures on rima glottidis areas in equine laryngeal specimens.Study Design—Experimental, randomized design.Animals—Cadaveric equine larynges (n=16).Methods—Larynges were collected from 10 horses; 2 sutures each were preplaced in the right and left sides of each larynx. A dorsal suture (DS) was placed through the caudal rim of the dorsal midline of the cricoid cartilage, under the cricopharyngeus muscle and through the proximal and rostral aspect of the muscular process. A lateral suture (LS) was placed 1.5 cm lateral to the DS and through the muscular process more distal and caudal to the 1st suture. Larynges were positioned in a customized stand and the rima glottidis photographed after each suture (LS or DS) or suture combination (CS) was tied in random sequence. An additional 6 larynxes were used to determine whether the tension applied to the sutures was repeatable. Sutures were preplaced in both the right and left side of each larynx as described above and each suture and CS was tied and released 3 times in each larynx. Photographs were taken of the rima glottidis after each suture or CS was tied generating 3 replicates for each suture configuration on each side of the 6 larynges.Results—Mean rima glottidis area was not different between DS and LS when tied alone (P=.85); however, mean area after CS (DS+LS) was greater than DS (P<.001) and LS (P<.001) alone. The coefficient of variation for the 6 suture patterns were low (1–7%) and the intraclass correlation coefficient estimates were very high (0.997–0.998) demonstrating excellent repeatability between replicates for each of the 3 suture configurations.Conclusion—Our results suggest that laryngoplasty using 2 prostheses; 1 placed dorsally in the cricoid and through the rostral and proximal muscular process and 1 placed 1.5 cm lateral to the 1st and more caudal and distal in the muscular process results in a greater cross sectional area of the rima glottidis than either suture used alone.Clinical Relevance—Seemingly prosthetic sutures contribute independently to each other in determining the contour of the rima glottidis. Use of 2 prosthetic sutures improves crosssectional area of the rima glottidis compared with each suture alone and may improve surgical outcome in laryngoplasty.
Age, Tibial Plateau Angle, Sex, and Weight as Risk Factors for Contralateral Rupture of the Cranial Cruciate Ligament in Labradors
Authors: BUOTE NICOLE , FUSCO JASON , RADASCH ROBERT 
Published: June 2009

Objective—To compare rates of contralateral cranial cruciate ligament rupture (CCLR) in Labradors based on age and weight at initial rupture, sex, and tibial plateau angle (TPA) and to determine whether Labradors that rupture their initial cranial cruciate ligament (CCL) at an earlier age (<4 years) are more likely to rupture their contralateral side within a certain period of time.Study Design—Case series.Animals—Labradors (n=94) that had tibial plateau leveling osteotomy (TPLO).Methods—Two groups: no contralateral rupture (NR) and contralateral rupture (CR) were compared for significant (P<.05) differences in percentage of subsequent cruciate tears using a Wilcoxon's rank‐sum tests for continuous variables and Fisher's exact test for sex. Adjusted odds ratios for likelihood of subsequent cruciate tears (yes/no) were estimated using logistic regression. Associations of these characteristics with time to subsequent rupture were assessed using Kaplan–Meier survival analysis estimation. Predictors of presentation with bilateral ruptures (BR) versus single rupture were also evaluated using Wilcoxon's rank‐sum tests and a generalized Fisher's exact test.Results—Subsequent CCLR occurred in 45 dogs (48%), and BR on admission were identified in 10 dogs (10.6%). Comparing NR and CR dogs, there were no significant differences between age or weight at initial rupture, sex or TPA; however there were associations toward longer time to CR for dogs older than the median age and female dogs (intact and spayed). There were no significant differences in age, sex, weight, or TPA of dogs with bilateral CCL ruptures compared with initial unilateral ruptures; however, there was a trend toward dogs presenting at an older age and with lower TPA's in the BR group. Among the 84 NR/CR dogs, the median time to rupture of the contralateral CCL was 5.5 months (95% CI 5.2–5.7).Conclusions—Age and weight at initial rupture, sex, and TPA does not affect likelihood or rate of contralateral CCL rupture or presentation with bilateral CCL ruptures.Clinical Relevance—Approximately 50% of Labradors will rupture the contralateral CCL within 5.5 months of the initial rupture but age, weight, sex, and TPA cannot be used as predictive features.
Exploring Factors Associated With the Incidence of Sexual Harassment of Hospital Nurses by Patients
Authors: Hibino Yuri , Hitomi Yoshiaki , Kambayashi Yasuhiro , Nakamura Hiroyuki 
Published: June 2009

Abstract Purpose: To identify factors affecting nurse‐perceived sexual harassment and specific types of patient sexual behavior experienced by Japanese nurses. Design: Cross‐sectional questionnaire study of Japanese hospital nurses. Methods: Self‐administered questionnaires (N=600) were distributed to Japanese hospital nurses, and 464 were returned (response rate of 77.3%). Two instruments were used: one was for determining sexual harassment by patients, and the other was for determining specific types of patient behavior that had sexual connotations. Findings: Registered nurses were at a much higher risk of sexual harassment than were nurse assistants. In addition, registered nurses had a much more positive attitude toward gender equality compared with assistant nurses. Conclusions: A positive attitude toward gender equality mediated by a relatively high education level might be associated with increasing reports of sexual harassment. An increasing incidence of sexual harassment claims among nurses should prompt hospital organizations to take proper action against it. Education on gender equality was thus considered a long‐term solution for reducing the sexual harassment of Japanese hospital nurses. Clinical Relevance: Establishing a safer working environment could enable nurses to provide better care for patients and thereby promote the development of good relationships between nurses and patients.
Predictors of the Intensity of Symptoms in a Cluster in Patients With Breast Cancer
Authors: Kim Hee‐Ju , Barsevick Andrea M. , Tulman Lorraine 
Published: June 2009

Abstract Purpose: To examine the influence of selected demographic and clinical variables on the intensity of symptoms in two previously identified symptom clusters (psychoneurological and upper gastrointestinal) across the treatment trajectory for breast cancer. Design: A secondary analysis was conducted with a sample of 282 female breast‐cancer patients who were receiving chemotherapy or radiation therapy in two American cancer centers. Data were collected three times across the treatment trajectory: baseline (before chemotherapy or radiation treatment) and two follow‐up times after treatment initiation. Method: Multiple regression analyses were done at each time point to examine the influence of selected demographic and clinical variables on the intensity of symptoms in each cluster. Findings: Baseline physical performance status was a consistent predictor of symptom intensity in the psychoneurological cluster across time whereas age and treatment modality were consistent predictors of symptom intensity in the upper gastrointestinal cluster. Poor physical performance at baseline predicted more intense psychoneurological symptoms. Younger women and women undergoing chemotherapy experienced more intense gastrointestinal symptoms. In addition, at the second follow‐up treatment modality also influenced intensity of symptoms in the psychoneurological cluster and race and baseline physical performance status also influenced the intensity of symptoms in the upper gastrointestinal cluster. Conclusions: Clinicians can anticipate that younger patients, patients with poor baseline physical performance status, and patients who receive chemotherapy will have more intense treatment‐related gastrointestinal and psychoneurological symptoms during adjuvant breast cancer therapy. Further research is needed to determine whether collective management for symptoms in a cluster may be beneficial. Clinical Relevance: Clinicians can use findings from the present study to identify patients who need greater attention to symptom assessment and management, including anticipatory counseling of patients and families.
Predictive Validity of the International Hospital Outcomes Study Questionnaire: An RN4CAST Pilot Study
Authors: Bruyneel Luk , Heede Koen Van den , Diya Luwis , Aiken Linda , Sermeus Walter 
Published: June 2009

AbstractPurpose:To study the predictive validity of the instrument used in the International Hospital Outcomes Study (IHOS) for an upcoming EU‐funded project (RN4CAST), which will indicate the effect of the nursing work environment and nursing staff deployment on nurse recruitment, retention, and productivity; and on patient outcomes in 11 European countries.Methods:Cross‐sectional analysis of data from 179 nurses (75% response rate) who completed an IHOS‐like nurse survey questionnaire, which included the Revised Nursing Work Index and the Maslach Burnout Inventory. The nurses worked in four Belgian acute‐care hospitals. Logistic regression modeling was performed to explore associations between nurse‐perceived outcomes and nursing work environment factors that were checked with confirmatory factor analysis.Findings:We confirmed associations between nurse‐perceived outcomes and the following nursing work environment factors: nurse‐physician relationship; staffing, and resource adequacy; and nurse manager ability, leadership, and support of nurses. A 1‐point increase in the rating of the factor nurse‐physician relationship was significantly associated with a 2.5‐fold (OR, 2.53; 95%CI, 1.29–4.93;p<0.01) increase in the odds of reporting high job satisfaction and with a fourfold (OR, 4.02; 95%CI, 1.85–8.70;p<0.001) increase in the odds of reporting excellent nurse‐perceived quality of care. A 1‐point increase in the rating of the factor staffing and resource adequacy was significantly associated with an approximate threefold (OR, 2.81; 95%CI, 1.38–5.72;p<0.01) increase in the odds of reporting high job satisfaction and with a fourfold (OR, 0.23; 95%CI, 0.12–0.47;p<0.001) decrease in the odds of reporting burnout.Conclusions:The predictive validity of the IHOS instrument was supported by the confirmation of key factors, which were previously identified by previous international research, and by the finding of similar associations between these factors and nurse‐perceived outcomes. The IHOS questionnaire that will be used in the RN4CAST project is robust and psychometrically sound.Clinical Relevance:The RN4CAST consortium, consisting of members from 15 countries, will use a similar instrument to that used in the International Hospital Outcomes study to measure the nursing work environment. This information will be linked with patients’ experiences and data extracted from routinely collected hospital discharge data. RN4CAST will show the important role of nursing staff in providing high quality care and allow refinement of current forecasting models for personnel planning in nursing.
Providing Transcultural to Children and Parents: An Exploratory Study From Italy
Authors: Festini Filippo , Focardi Stella , Bisogni Sofia , Mannini Claudia , Neri Stella 
Published: June 2009

Abstract Purpose: Immigration and multiculturalism are relatively recent in Italian society, and social adaptation to this new reality is still ongoing. Immigrants to Italy mainly come from China, Albania, Northern Africa, and Eastern Europe. Because no study about this topic was found, our goal was to investigate attitudes and problems encountered by Italian nurses in a paediatric setting with regard to nursing care of children and their families from other countries. Design and Methods: Exploratory study. An anonymous 11‐item “ad hoc” questionnaire was distributed to 201 ward nurses of the Meyer Paediatric Hospital, Florence, Italy in May 2007. Findings: In all, 129 nurses (64.1%) answered the questionnaire; 78.3% reported having experienced some difficulties in providing care to foreign children and their families. The language barrier was reported as the most important, although more than two‐thirds of nurses speak a language in addition to Italian. About half of the nurses encountered problems in care because of different nutrition and personal hygiene customs of patients and their families. Religious and spiritual practices were perceived as a problem by only a minority of nurses. Almost half of the nurses reported having been involved in care situations wherein they felt embarrassed or disapproval concerning the behaviour of parents of foreign children. This included discomfort about different views concerning the social role of women. Nurses also perceived in foreign parents opinions different from their own about the role of nurses (10%) and attitudes of children toward pain associated with medical procedures (45%). Conclusions: This is the first study we know about regarding attitudes of Italian nurses toward multicultural care. Effective communication is the main aspect of delivering culturally competent care. Language as a means of communication is paramount for an effective nurse‐patient relationship without which nursing care is unsatisfactory. Our study indicates the importance of teaching transcultural nursing, cultural diversity, and culturally competent nursing care in university and continuing professional education programs for Italian nurses and nursing students. Clinical Relevance: This study indicates the strengths and weaknesses of Italian nurses in managing the care of non‐Italian children and their families; and the need for a background of transcultural nursing and theory.
Activating killer immunoglobulin‐like receptor incompatibilities enhance graft‐versus‐host disease and affect survival after allogeneic hematopoietic stem cell transplantation
Authors: Giebel Sebastian , Nowak Izabela , Dziaczkowska Joanna , Czerw Tomasz , Wojnar Jerzy , Krawczyk‐Kulis Malgorzata , Holowiecki Jerzy , Holowiecka‐Goral Aleksandra , Markiewicz Miroslaw , Kopera Malgorzata , Karolczyk Agnieszka , Kyrcz‐Krzemien Slawomira , Kusnierczyk Piotr 
Published: June 2009

AbstractObjectives: Killer immunoglobulin‐like receptors (KIRs) regulate function of natural killer (NK) cells and a subset of T cells. In this study, we prospectively evaluated the impact of donor and recipient activating KIR genes on outcome of allogeneic hematopoietic stem cell transplantation (alloHSCT) for patients with hematological malignancies.Methods: One‐hundred consecutive recipients of myeloablative transplantation and their donors were tested for KIR genotype as well as for immune reconstitution, including activating KIR expression on NK cells and T cells.Results: In a multivariate analysis, mismatches of particular activating KIRs such that the patient was negative and the donor was positive (P−D+) resulted in increased risk of acute (KIR2DS1) and chronic (KIR2DS3) graft‐versus‐host disease (GVHD) as well as relapse (KIR2DS5). KIR2DS1 incompatibility in the same direction in the presence of HLA‐C‐group 2 ligand in recipient was associated with reduced overall (risk ratio, RR = 3.01;P = 0.01) and disease‐free survival (RR = 2.92,P = 0.03). Activating mismatches in P−D+direction resulted in decreased CD4+ : CD8+T‐cell ratio up to 1 yr after alloHSCT, as a consequence of decreased CD3+CD4+number within the first 100 d and increased CD3+CD8+number in later time‐points. Among six evaluated patients, expression of activating KIRs on NK cells and T cells was particularly prominent for those developing intestinal GVHD.Conclusion: Our findings indicate that the presence of particular activating KIRs in donor with their absence in recipient enhances GVHD, which is not accompanied by graft‐versus‐leukemia effect. Evaluation of activating KIR genotype may allow optimization of both donor selection and transplantation procedure in order to avoid GVHD.
Internet-Based Brief Sex Therapy for Heterosexual Men with Sexual Dysfunctions: A Randomized Controlled Pilot Trial
Authors: Van Lankveld Jacques J.D.M. , Leusink Peter , Van Diest Selma , Gijs Luk , Slob A. Koos 
Published: June 2009

ABSTRACTIntroductionInternet-based sex therapy for men with erectile dysfunction has been advocated as an easily accessible and cost-effective treatment.AimTo test whether Internet-based sex therapy is superior to waiting list.MethodsInternet-based therapy was administered to heterosexual men with erectile dysfunction or premature ejaculation, without face-to-face contact, in a waiting-list controlled design, with pre-, post-, and follow-up measurements at 3 and 6 months posttreatment. Treatment was based on the sensate-focus model of Masters and Johnson, and supplemented with cognitive restructuring techniques.Main Outcome MeasuresSelf-reported improvement of sexual functioning, erectile functioning (men with ED), premature ejaculation (men with PE), sexual desire, overall sexual satisfaction, and sexual self-confidence.ResultsNinety-eight men participated (58 ED, 40 PE). Sexual functioning was much or somewhat improved in 40 participants (48%). In participants with ED, a near significant effect of treatment was found (P = 0.065), with higher levels of sexual desire (P &lt; 0.05) and sexual self-confidence (P = 0.05) in treated men, in addition to improved erectile functioning (P = 0.01) and overall sexual satisfaction (P &lt; 0.001) in both groups. In participants with PE, treatment was not superior to waiting list. In participants with ED, erectile functioning (P &lt; 0.05) and overall sexual satisfaction (P = 0.002) improved significantly. In participants with PE, latency to ejaculation (P &lt; 0.001), sexual desire (P &lt; 0.05), and overall sexual satisfaction (P &lt; 0.05) improved significantly from baseline to posttreatment, with no further changes at both follow-ups. Sexual self-confidence in men with PE remained unchanged during treatment until follow-up at 3 months posttreatment, and then was found to be improved at 6-months follow-up (P &lt; 0.05).ConclusionInternet-based sex therapy for male erectile dysfunction was efficacious for male erectile disorder. For men with premature ejaculation, however, treatment was not superior to waiting list.