bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishing new nursing roles: a case study of the English community matron initiative
Authors: Drennan Vari , Goodman Claire , Manthorpe Jill , Davies Sue , Scott Cherill , Gage Heather , Iliffe Steve 
Published: April 2011

Aim and objective.  To examine the factors affecting the extent to which English policy on the introduction of community matrons for people with chronic conditions was implemented.Background.  Improving health services for people with chronic diseases (long‐term conditions) is an international priority. In England, the new post of community matron, a case management role, was introduced. A target was set for 3000 community matrons to be in post by 2008, but this was not achieved.Design.  A realist, pragmatic evaluation of the introduction of community matron posts.Method.  The study used mixed methods at multiple levels: an analysis of national and local strategy and planning documents, a national survey and a stakeholder analysis using semi‐structured interviews in three primary care organisation case study sites.Results.  National policy established targets for the introduction of community matron posts, but there was local variation in implementation. Pragmatic decisions reflected the history of local service configurations, available finance, opportunities or challenges created by other service redesigns and scepticism about the value of the community matron role. There was resistance to ‘bolt on’ nursing roles in primary care.Conclusions.  The implementation of the community matron role is an example of how a policy imperative that valued the clinical skills and expertise of nurses was reinterpreted to fit with local patterns of service delivery. Before new nursing roles are introduced through national policies, a more nuanced understanding is required of the local factors that resist or support such changes.Relevance to clinical practice.  There is a need for consultation and understanding of local conditions before the implementation of workforce initiatives. For clinicians, it is important to understand how the context of care shapes priorities and definitions of new nursing roles and how their expertise is recognised and used.
Enhancing health literacy and behavioural change within a tele‐care education and support intervention for people with type 2 diabetes
Authors: Long Andrew F. , Gambling Tina 
Published: April 2011

AbstractBackground  Behavioural change interventions for persons with chronic illness draw on a variety of theoretical approaches including motivational interviewing and shared decision making. Health literacy provides an additional, potentially powerful explanatory framework to guide research and practice.Objective  To examine the changes in the depth and detail of diabetes‐related knowledge and confidence for persons with type 2 diabetes.Design  Two‐year, prospective, observational study, using questionnaire data at two time points (baseline and 2 years later) and in‐depth interviews with a theoretically selected subsample.Setting and participants  A total of 319 patients initially recruited from a deprived urban area in north‐west EnglandIntervention  Dedicated tele‐carer education and support, tailored to the individual circumstances of the patient.Main outcome measures  Perceptions of confidence, levels of empowerment, learning for self‐care and most helpful aspects of the intervention.Results  Over 90% expressed confidence in keeping their blood sugar controlled, and high levels of perceived empowerment (mean = 4.25; 95% CI, 4.17–4.33) were found. Changes in the depth and detail of diabetes‐related knowledge and confidence, from the specific to the more general, were observed and enhanced competence in translating knowledge into practice.Discussion and conclusions  The intervention, built within a developed working partnership between tele‐carer and patient, operated at two levels: health literacy, enhancing knowledge, developing personal skills and enabling self‐control; and socio‐psychological behavioural change, tailored to individuals within their socio‐economic environments, enabling increased motivation and supportive problem‐solving. Both approaches find reflection in the findings and provide powerful explanatory lenses to interrogate the data.
Outcome of renal transplantation in children: A multi‐center national report from Iran
Authors: Otukesh Hasan , Hoseini Rozita , Rahimzadeh Nahid , Fereshtehnejad Seyed‐Mohammad , Simfroosh Naser , Basiri Abbas , Sharifian Mostafa , Hashemi Ghamar Hoseini , Falahzadeh Hosein , Derakhshan Ali , Fazel Mojtaba , Reiesee Darioush , Sayedzadeh Abdolhasan , Vazirian Shams , Nikibakhsh Ahmad Ali , Moghadam Ali Ghafari , Mohamadzadeh Hashem , Naderi Ali , Isfahani Taher , Larijani Faezeh , Shorkhi Hadi , Pasha Abazar Akbarzadeh , Shahbazian Heshmatollah , Valavi Ehsan , Mortazavi Fakhrolsadat , Gheisari Allaleh 
Published: April 2011

Otukesh H, Hoseini R, Rahimzadeh N, Fereshtehnejad S‐M, Simfroosh N, Basiri A, Sharifian M, Hashemi GH, Falahzadeh H, Derakhshan A, Fazel M, Reiesee D, Sayedzadeh A, Vazirian S, Nikibakhsh AA, Moghadam AG, Mohamadzadeh H, Naderi A, Isfahani T, Larijani F, Shorkhi H, Pasha AA, Shahbazian H, Valavi E, Mortazavi F, Gheisari A. Outcome of renal transplantation in children: A multi‐center national report from Iran.  Pediatr Transplantation 2011: 15: 533–538. © 2011 John Wiley & Sons A/S.Abstract:  The outcome of pediatric renal transplantation was previously reported by a single‐center study at the year 2006. Therefore, we aimed to evaluate and report the characteristics and outcome of renal pediatric renal transplantation in a multi‐center nationwide study. In this nationwide report, medical records of 907 children (≤18 yr) with renal transplantation in eight major pediatric transplant centers of Iran were recorded. These 907 patients received a total of 922 transplants. All children who failed to follow‐up were excluded. Rather than baseline characteristics, graft and patient outcomes were considered for survival analysis. For further analysis, they were divided into two groups: patients who had graft survival time more than 10 yr (n = 91) and the ones with graft survival time of equal or less than 10 yr (n = 831). Of 922 recipients, 515 (55.8%) were boys and 407 (44.2%) were girls with the mean age of 13.10 (s.d. = 3.54) yr. DGF and AR were occurred in 10% and 39.5% of the transplanted children, respectively. Transplantation year, dialyzing status before transplantation, DGF, and AR were significant enough to predict graft survival in cox regression model (overall model: p < 0.001). Nowadays, there is a successful live donor pediatric renal transplantation in Iran. Graft survival has improved in our recipients and now the graft survival rates are near to international standards.
Corneal invasion by hemangiosarcoma in a horse
Authors: Pinn Toby L. , Cushing Tim , Valentino Lorie Moore , Koch Seth A. 
Published: April 2011

AbstractA 15‐year‐old gray Arabian gelding presented for evaluation of a lateral limbal mass extending across approximately 30% of the cornea. Grossly, the raised mass appeared nonpigmented, smooth, and irregular in shape, with an area of central necrosis and serosanguinous discharge. The mass was removed via lamellar keratectomy and histopathologic evaluation revealed features characteristic of hemangiosarcoma (HSA), including irregular vascular channels lined by a plump spindle cell population. Immunohistochemistry results showed that the neoplastic cells lining the vascular channels present diffuse and strong cytoplasmic reaction with von Willebrand Factor and the perivascular spindle cells exhibit moderate cytoplasmic reaction for smooth muscle actin. A lack of cytokeratin staining definitively excluded a diagnosis of atypical squamous cell carcinoma. Smooth muscle actin staining of the perivascular cells adjacent to the neoplastic endothelial cells is not a feature commonly described in HSA and has not been reported in previous cases of equine HSA. The horse remained in good health 21 months postkeratectomy and has exceeded the survival time of previously documented equine ocular HSA cases where more extreme surgical excision was performed.
Superficial corneal squamous cell carcinoma occurring in dogs with chronic keratitis
Authors: Dreyfus Jennifer , Schobert Charles S. , Dubielzig Richard R. 
Published: April 2011

AbstractObjective Canine corneal squamous cell carcinoma (SCC) is a rare tumor, with only eight cases previously published in the veterinary literature. The Comparative Ocular Pathology Lab of Wisconsin (COPLOW) has diagnosed 26 spontaneously occurring cases, 23 in the past 4 years. This retrospective study describes age and breed prevalence, concurrent therapy, biologic behavior, tumor size and character, and 6‐month survival rates after diagnosis.Results A search of the COPLOW database identified 26 corneal SCC cases diagnosed from 1978 to 2008. There is a strong breed predilection (77%) in brachycephalic breeds, particularly those prone to keratoconjunctivitis sicca. The mean age was 9.6 years (range 6–14.5 years). Follow‐up information >6 months was available for 15 of 26 cases. Recurrence occurred in the same eye in nine cases, seven of which were incompletely excised at the time of first keratectomy. No cases were known to have tumor growth in the contralateral eye and no cases of distant metastases are known. Where drug history is known, 16 of 21 dogs had a history of treatment with topical immunosuppressive therapy (cyclosporine or tacrolimus) at the time of diagnosis.Conclusion Chronic inflammatory conditions of the cornea and topical immunosuppressive therapy may be risk factors for developing primary corneal SCC in dogs. SCC should be considered in any differential diagnosis of corneal proliferative lesions. Superficial keratectomy with complete excision is recommended, and the metastatic potential appears to be low.
Changing diet and physical activity to reduce gestational weight gain: a meta‐analysis
Authors: Gardner B. , Wardle J. , Poston L. , Croker H. 
Published: April 2011

SummaryExcessive pregnancy weight gain is associated with adverse maternal and child health outcomes. Intervention developers have assumed that adopting a healthier diet and increasing physical activity in pregnancy can limit weight gain, but evaluations of such interventions have yielded mixed results. Recent reviews of this literature have not identified defining characteristics of effective interventions. We systematically reviewed 10 published controlled trials of interventions that aimed to reduce gestational weight gain through changes in diet or physical activity. Characteristics of the sample, intervention content and delivery, and methodology were categorized. Meta‐analysis showed that, overall, diet and physical activity change was effective in reducing gestational weight gain, but there was considerable heterogeneity in outcomes. Our analysis points to sample characteristics and aspects of intervention design, content, delivery and evaluation which differ between studies and may explain variation in effectiveness. Failure to evaluate changes in behaviour or its psychological determinants, and under‐reporting of intervention content, may obscure identification of the processes by which weight change is effected. This limits our ability to discern active intervention ingredients. We suggest that behaviour‐based gestational weight gain reduction interventions be more systematically designed, evaluated and reported to build on insights from behavioural science.
The association between 5‐min Apgar score and mortality disappears after 24 h at the borderline of viability
Authors: Lagatta Joanne , Yan Ke , Hoffmann Raymond 
Published: April 2011

AbstractAim:  To quantify the relationship between 5‐min Apgar scores and infant mortality for infants at the borderline of viability.Methods:  Cohort study of 7008 infants 23–25 weeks’ gestation using 2002 US National Center for Health Statistics data. Using Cox proportional‐hazards models, we quantified the relationship between Apgar score and infant mortality for all infants, and then infants surviving their first 24 h. Models were adjusted for gestational age, birth weight, gender, delivery method, plurality, maternal race, marital status and education.Results:  Within one year, 46% of infants died. Of the non‐survivors, deaths within 24 h were more common among infants with Apgar scores 0–3 (83%) than among infants with Apgar scores 7–10 (13%). When including all infants and adjusting for potential confounders, each 1‐point increase in Apgar score decreased the hazard of mortality by 0.82. However, after excluding infants who died within 24 h, the hazard ratio increased to 0.95; although statistically significant, the practical impact was negated.Conclusions: For 23–25 week gestation infants surviving the first 24 h, the Apgar score loses clinical significance. Clinicians should be aware of the limitations of clinical assessments in the delivery room.
Treatment of Herpes Labialis: Comparison of Two OTC Drugs and Untreated Controls
Authors: MCCARTHY JAMES P. , BROWNING WILLIAM D. , TEERLINK CRAIG , VEIT GEORGE 
Published: April 2011

ABSTRACTStatement of the Problem:  Rapid resolution of active herpes labialis lesions is of great benefit to the patient not only in terms of controlling pain and disfigurement, but in disruption of needed dental treatment.Purpose of the Study:  Using three groups, this retrospective study investigated the time required to complete healing and the loss of discomfort.Methods and Materials:  Based on 180 completed surveys, responses were divided into three groups: One group used Abreva (GlaxoSmithKline, Parsippany, NJ, USA). The second used Viroxyn (Quadex Pharmaceuticals, West Jordan, UT, USA). The third group, the Control group, consisted of untreated lesions. All three groups were asked about past experiences with lesions treated using Abreva and/or Viroxyn, and lesions which were left untreated. In addition, 58 participants who had used Viroxyn only responded. Participants were provided standardized responses from which to choose.Results:  For both the time to healing and time to loss of discomfort, participants in both the Abreva and Viroxyn groups experienced significant improvements. Relative to the Abreva, Viroxyn provided significant improvement in both outcomes (all t‐tests; all p < 0.001). Relative to the Control group, Viroxyn and Abreva offered an 8.0 and 4.0 day reduction in time to healing, respectively. Loss of discomfort occurred within 3.0 days and 1 hour for Abreva and Viroxyn, respectively.Conclusion:  Relative to the untreated controls, both Abreva and Viroxyn offered a significant reduction in both the time to healing and time to loss of discomfort. Furthermore, Viroxyn offered a significant reduction relative to Abreva.CLINICAL SIGNIFICANCEProviding care to patients with active lesions greatly increases the risk of spread of infection from one site to another and to members of the dental team. Precautions include the use of special personal protective equipment and limiting treatment during active outbreaks to urgent care only. Accordingly, any treatment that shortens healing time for active lesions would contribute significantly to the health and well‐being of the patient and the dental team.(J Esthet Restor Dent 24:103–111, 2012)
Ionizing radiation absorption of surgeons and endoscopy nurses during endoscopic retrograde cholangiopancreatography
Authors: Lo Irene , Lau Stephanie H.Y. , Kwok Kam‐Hung , Kao Sau‐San , Cheung Moon‐Tong 
Published: April 2011

Objective:  Exposure of surgeons and nurses to radiation during endoscopic retrograde cholangiopancreatography (ERCP) has not been studied in our locality. Recently, data suggest that cataracts can occur at doses far lower than the permissible occupational limits. The present study is to determine the amount of radiation absorbed by surgeons and nurses while carrying out ERCP.Methods:  We prospectively recorded the radiation absorption of three surgeons and two nurses during all ERCP procedures for 6 months. Radiation absorption was measured by wearing thermoluminescent dosimeters specifically for measuring eye lens, finger and whole‐body dose. Results were compared with standards set by the International Commission on Radiation Protection. The difference in absorbed radiation to different parts of the body among each individual was evaluated. The number of ERCP procedures a surgeon can tolerate before reaching the occupational limit was determined. Ways to minimise radiation exposure are discussed.Results:  Three surgeons carried out a total of 134 ERCP, while two nurses assisted in 255 ERCP over a period of 6 months. The mean yearly whole‐body, eyes and fingers‐absorbed dose for surgeons were 0.19 mSv, 0.25 mSv and 0.62 mSv, respectively; whereas those for nurses were 0.1 mSv, 0.84 mSv and 1.07 mSv, respectively. They were all well below the international occupational limit. Among the whole‐body dose, eye lens dose and fingers dose, eye lens dose was the first factor that reached the occupational limit.Conclusion:  The current radiation safety practice in our endoscopy suite is satisfactory. Human eyes are more vulnerable to radiation damage when compared with the rest of the body. Wearing lead‐eyeglasses during ERCP is mandatory.
INVERSE DYNAMICS OF THE LOWER EXTREMITIES: NOVEL APPROACH CONSIDERING TALOCRURAL AND SUBTALAR JOINT AXIS
Authors: RUPP TILLE KAROLINE , SCHMITT SYN 
Published: April 2011

A recent survey of epidemiological studies lists ankle injuries as one common sport injury. However, the details of the injury mechanisms of ankle sprains — the majority of ankle injuries — remain not well understood. The purpose of the presented study is twofold. The first aim is to introduce a new, widely applicable method to calculate ankle joint torques during movement using inverse dynamics. The subtalar and talocrural joint are modeled as anatomically based revolute joints. The kinematics of the lower extremities and ground reaction force are used as input data. Second, a comparison of two calculation approaches (dynamic versus static) is reported, aimed at verifying and simplifying the introduced method to have a more convenient tool at hand for applications in the field. For one first movement measurement (hopping), the calculated joint torques show a good match for the two calculation approaches. After further application, the evaluation of the resulting joint torques will provide further insights into the joint mechanics and can contribute to a better understanding of the respective injury mechanisms. Hence, this approach is interesting for researchers to be used in order to understand ankle injuries and to determine the influence of landing grounds and shoes on ankle joint torques.
Normal faulting on Sifnos and the South Cycladic Detachment System, Aegean Sea, Greece
Authors: Ring Uwe , Glodny Johannes , Will Thomas M. , Thomson Stuart 
Published: April 2011

Abstract:

We constrain the timing and kinematics of normal faulting on Sifnos, Cyclades, Greece. Penetrative top-to-the-NE kinematic indicators associated with a shallow dipping foliation occur in the deepest tectonic unit (Greenschist Unit). Combined
P
–
T
analysis and Rb–Sr dating indicates that this deformation was under way by 29.4 ± 3.4 Ma at
P
–
T
conditions of
c
. 16 kbar and
c
. 550 °C, and continued to operate at least until 22.8 ± 0.2 Ma at
P
–
T
conditions of
c
. 8 kbar and
c
. 400 °C. The later top-to-the-south directed Sifnos Detachment developed at the top of the Greenschist Unit and cuts the top-to-the-NE structures. Zircon fission-track ages suggest that deformation on the Sifnos Detachment was largely terminated by about 13–10 Ma. Subsequent extension was accommodated by high-angle normal faults. Regionally the top-to-the-south detachment phase on Sifnos correlates with top-to-the-south extensional faulting on nearby Serifos, which started there at
c
. 15–13 Ma. Top-to-the-south extensional shearing on Ios to the SE commenced earlier at
c
. 19–18 Ma, suggesting that top-to-the-south extension propagated westward from Ios to Sifnos and Serifos, or that extension was partitioned into different top-to-the-south detachment systems that operated at different times. Collectively these top-to-the-south detachments are named here the South Cycladic Detachment System, which played a key role in the opening of the Cretan Sea forearc basin.
STAT3 Inhibition Is a Therapeutic Strategy for ABC-like Diffuse Large B-Cell Lymphoma
Authors: Scuto Anna , Kujawski Maciej , Kowolik Claudia , Krymskaya Ludmila , Wang Lin , Weiss Lawrence M. , DiGiusto David , Yu Hua , Forman Stephen , Jove Richard 
Published: April 2011

Abstract
Persistent STAT3 signaling contributes to malignant progression in many diverse types of human cancer. STAT3 is constitutively active in activated B-cell (ABC)–like diffuse large B-cell lymphomas (DLBCL), a class of nongerminal center derived DLBCL cells for which existing therapy is weakly effective. In this report, we provide a preclinical proof of concept that STAT3 is an effective molecular target for ABC-like DLBCL therapy. Direct inhibition of STAT3 with short hairpin RNA suppressed the growth of human ABC-like DLBCL in mouse models in a manner associated with apoptosis, repression of STAT3 target genes, and inhibition of a tumor-promoting microenvironment. Together, these results suggest that STAT3 is essential to maintain the pathophysiology of ABC-like DLBCL and therefore that STAT3 inhibition may offer a promising approach in its therapy. Cancer Res; 71(9); 3182–8. ©2011 AACR.