bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Patient‐Centred Medical Home in the USA
Authors: Epperly Ted 
Published: January 2011

AbstractRationale  The Patient‐Centred Medical Home (PCMH) is a new model of health care delivery in the USA at the primary care level that emphasizes integrated and coordinated care around the patients' needs and desires. The PCMH emphasizes a practice‐wide team approach to provide high quality, accessible and cost‐effective health care for acute, chronic and prevention‐oriented problems.Method  This article is a descriptive overview of the PCMH in the USA.Results  The data on the PCMH have shown decreased mortality, morbidity and increased patient and physician satisfaction with care. Additionally, quality of care and patient access have improved. There has been decreased emergency room utilization, decreased hospitalization and decreased cost per patient.Conclusion  The PCMH in the USA has been an outstanding transformative model change to re‐centre health care back to cost‐effective, quality, accessible primary care.
The Individual Practice Development Theory: an individually focused practice development theory that helps target practice development resources
Authors: Melton Jane , Forsyth Kirsty , Freeth Della 
Published: January 2011

AbstractBackground  Research indicates that multifaceted practice development (PD) interventions are more effective than single strategies. However, models of education in health care need to consider cost‐effectiveness.Objectives  This paper presents a research‐based, PD theory called the Individual Practice Development Theory. It argues that programmes that use the Individual Practice Development Theory to tailor PD support to the learning needs of practitioners will result in more engagement in PD and will target PD resources efficiently.Methods  The in‐depth qualitative, multi‐method realistic evaluation was of a multifaceted, organization‐wide PD programme in one National Health Service Mental Health and Learning Disabilities Trust. Semi‐structured interviews, practice observation and documentation audit were used to gather data from occupational therapists.Findings  Results indicated that environmental contexts, particularly the support of the immediate team, and the participant's personal circumstances affected PD behaviour change. Six mechanisms acted as catalysts. These were: Building Confidence, Finding Flow, Accumulating Reward, Conferring with Others, Constructing Knowledge Know‐how and Channelling Time. Four stages of PD characterized as: ‘In the Hangar’, ‘On the Runway’, ‘Take‐off’ and ‘In the Air’ were identified. The research also illustrated the interconnectivity between outcome levels, contextual circumstances and activating mechanisms.Discussion  The findings suggested that PD interventions need to be more individually tailored to achieve optimum learning outcomes. The identification of four discernable stages permits rapid understanding of PD support needs in order to focus PD support.Conclusion  With a systematic and individualized approach to PD in health care, more target PD supports can be put in place.
Evaluation of effectiveness and satisfaction outcomes of a mental health screening and referral clinical pathway for community nursing care
Authors: ALLEN J. , ANNELLS M. , NUNN R. , PETRIE E. , CLARK E. , LANG L. , ROBINS A. 
Published: January 2011

Accessible summary

The study aimed to develop, trial and evaluate a feasible, best‐practice mental health screening and referral clinical pathway for generalist community nursing care of war veterans and war widow(er)s in Australia.
This paper reports the evaluation pertaining to clients on whom the pathway was trialled and their informal carers, most of whom were highly satisfied or satisfied with care provided through application of the pathway.
Understanding is gained of how community nurses might productively screen for mental health difficulties among not only war veteran and war widow(er) clients, but possibly clients in general.
The trialled pathway, which was modified and refined following the study, is now available on the Internet as an evidence‐based resource for community nurses in Australia to guide holistic community nursing care for war veterans and war widow(er)s where that care is funded by Department of Veterans' Affairs.

AbstractThe study aimed to explore the effectiveness of a mental health screening and referral clinical pathway for generalist community nursing care of war veterans and war widow(er)s in Australia on outcomes of client self‐reported mental health, quality of life, and client and carer satisfaction. The pathway was developed by literature review and consultation, then trialled and evaluated. Validated screening tools were embedded within the pathway to support generalist nurses' mental health decision making. Pre‐ and post‐measures were applied. Clients on whom the pathway was trialled were invited to complete an evaluation survey questionnaire, as were their informal carers. Most clients and carers who responded to these questionnaires were highly satisfied or satisfied with care provided through application of the pathway. This study adds understanding about one way that community nurses might identify people with mental health difficulties. The trialled pathway, which was modified and refined following the study, is now available on the Internet as an evidence‐based resource for community nurses in Australia to guide practice and maximize holistic care for war veterans and war widow(er)s where that care is funded by Department of Veterans' Affairs.
Host suitability of Vitis rootstocks to root‐knot nematodes (Meloidogyne spp.) and the dagger nematode Xiphinema index, and plant damage caused by infections
Authors: Gutiérrez‐Gutiérrez C. , Palomares‐Rius J. E. , Jiménez‐Díaz R. M. , Castillo P. 
Published: January 2011

The host suitability of commercial Vitis rootstocks commonly used in Spain (161‐49C, 41B, 1103P, 110R, 140Ru and SO4) to root‐knot nematodes (Meloidogyne arenaria, M. incognita, M. javanica) and Xiphinema index, and damage caused by nematode infection were determined under controlled conditions. The three root‐knot nematodes reproduced with a rate higher than one in all rootstocks, indicating that they are suitable hosts for these nematodes. Growth of rootstocks infected with the root‐knot nematodes was less vigorous than that of nematode‐uninfected controls in the majority of the rootstocks studied. Root infection resulted in moderate to severe root galling in all rootstocks. The shoot and main stem diameters appeared to be the most sensitive variables of damage caused by infection by Meloidogyne spp., with reduction rates from 36% and 53% in 161‐49C to 57% and 66% in 140Ru, respectively. The shoot height was not significantly affected by the root‐knot nematodes and the root fresh weight generally increased as a consequence of intensive galling. The nematode X. index caused significant root damage with a reproduction factor higher than one in all rootstocks. However, reproduction factor was significantly influenced by the rootstock and significantly decreased by about 12‐fold (5·7 to 18·1‐fold) with the increase in inoculum density from 100 to 1000 nematodes per plant. The root dry weight was reduced by X. index infections, and was the plant growth variable most affected by the nematode infection in all rootstocks at both inoculum densities. Meloidogyne arenaria, M. incognita, M. javanica and X. index, prevalent in many world vineyards, are all shown to have a damaging effect on the six tested rootstocks.
Soluble Urokinase Plasminogen Activator Receptor During Allogeneic Stem Cell Transplantation
Authors: Haastrup E. , Andersen J. , Ostrowski S. R. , Høyer‐Hansen G. , Jacobsen N. , Heilmann C. , Ullum H. , Müller K. 
Published: January 2011

AbstractPrevious studies have found that soluble urokinase plasminogen activation receptor (suPAR) increases during inflammatory and malignant illness and elevated suPAR levels may be associated with poor clinical outcome. The purpose of this study was to investigate plasma levels of suPAR during the course of allogeneic stem cell transplantation (SCT). Twenty SCT patients were included in the study. suPAR was measured by ELISA in daily taken plasma samples during the pretransplant conditioning with chemotherapy and weekly for 1 month after infusion of the graft. suPAR levels before the start of the conditioning were significantly elevated when compared to those of healthy controls. During the conditioning in particular treatment with antithymocyte globulin was associated with significantly increased suPAR levels (P = 0.012). At day +7 after infusion of the graft, suPAR levels had decreased to pretreatment levels. High suPAR levels at day 0 were associated with increased mortality (P = 0.011). The present study found increased suPAR levels during the conditioning in SCT patients. Further, the data indicated that increased suPAR levels may be associated with increased mortality, suggesting suPAR as a candidate for further studies as an outcome predictor in SCT.
The interface between health systems and vertical programmes in Francophone Africa: the managers’ perceptions
Authors: Keugoung Basile , Macq Jean , Buvé Anne , Meli Jean , Criel Bart 
Published: January 2011

SummaryObjective  To explores the interface between vertical programmes (VPs) and general health services (GHS) in sub‐Saharan Africa.Methods  Using semi‐structured interviews, we analysed the perceptions of a selection of experienced mid‐level managers of health systems and of VP originating in francophone Africa on the nature and quality of this interface.Results  The respondents acknowledged that VPs lead to both positive and negative effects on the functioning of GHS. The overall result, however, cannot be viewed as a simple summation of the positive effects possibly compensating for the negative ones. Indeed, some of the negative effects have a profound impact on the management and operation of the health care delivery system and may undermine the long‐term institutional capacity of the general health systems. The quality and the nature of the interface between VP and GHS strongly vary in time, between settings and programmes.Conclusion  We argue for more systematic monitoring of the interface between VP and GHS, so as to identify and address, in a timely manner, significant disruptive effects and deficiencies in a perspective of systemic capacity building of health systems.
The patient‐reported Clinicians’ Cultural Sensitivity Survey: a field test among older Latino primary care patients
Authors: Nápoles Anna M. , Santoyo‐Olsson Jasmine , Farren Georgianna , Olmstead Jill , Cabral Ruben , Ross Barry , Gregorich Steven E. , Stewart Anita L. 
Published: January 2011

AbstractBackground  Patient‐reported measures of clinicians’ cultural sensitivity are important to assess comprehensively quality of care among ethnically diverse patients and may help address persistent health inequities.Objective  Create a patient‐reported, multidimensional survey of clinicians’ cultural sensitivity to cultural factors affecting quality of care.Design  Using a comprehensive conceptual framework, items were written and field‐tested in a cross‐sectional telephone survey. Multitrait scaling and factor analyses were used to develop measures.Setting and participants  Latino patients age ≥50 from primary care practices in California.Main variables studied  Thirty‐five items hypothesized to assess clinicians’ sensitivity.Main outcomes measures  Validity and reliability of cultural sensitivity measures.Results  Twenty‐nine of 35 items measuring 14 constructs were retained. Eleven measures assessed sensitivity issues relevant to all participants: complementary and alternative medicine, mind–body connections, causal attributions, preventive care, family involvement, modesty, prescription medications, spirituality, physician discrimination due to education, physician discrimination due to race/ethnicity and staff discrimination due to race/ethnicity. Three measures were group specific: two to limited English proficient patients (sensitivity to language needs and discrimination due to language) and one to immigrants (sensitivity to immigrant status). Twelve multi‐item scales demonstrated adequate reliability (alpha ≥0.68 except for Spanish discrimination due to education) and evidence of construct validity (item‐scale correlations for all scales >0.40 except for sensitivity to immigrant status). Two single‐item measures demonstrated sufficient construct validity to retain for further development.Discussion and conclusions  The Clinicians’ Cultural Sensitivity Survey can be used to assess the quality of care of older Latino patients.
Photoselective vaporization for prostatic obstruction with the 120‐W lithium triborate laser: 1‐year clinical outcomes
Authors: Woo Henry Hyunshik , Hossack Tania Anne 
Published: January 2011

AbstractThere are few reports of the clinical outcomes of photoselective vaporization of the prostate (PVP) for benign prostatic hyperplasia (BPH) using the 120‐W lithium triborate (LBO) laser. The present study evaluates clinical outcomes of 76 men treated with the 120‐W LBO laser by an experienced PVP surgeon with 12 months follow up. The International Prostate Symptom Score (IPSS), peak flow rate (Qmax) and post‐void residual (PVR) were examined at baseline and at 3 and 12 months. These parameters at baseline and 12 months were 20 ± 7.0, 7.6 ± 3.5 mL/s, 155 ± 155 mL and 8.1 ± 6.1, 22.5 ± 10.3 mL/s, 59 ± 87 mL, respectively. Clinically, meaningful improvements in IPSS, Qmax and PVR were observed at 3 months and sustained at 12 months. There were few adverse events, with only 5.3% of patients requiring recatheterization. Clinical outcome at 12 months was similar to that at 3 months and to other published series.
Umbilical laparoendoscopic single site surgery versus inguinal varicocelectomy for bilateral varicocele: A comparative study
Authors: Park Sung‐Woo , Kim Tae‐Nam , Lee Wan , Park Hyun Jun , Lee Sang‐Don , Park Nam Cheol 
Published: January 2011

AbstractWe aimed to determine the efficacy of umbilical laparoendoscopic single site surgery (LESS) bilateral varicocelectomy on the basis of a comparative study versus open inguinal bilateral varicocelectomy. We enrolled 39 patients who underwent bilateral varicocelectomy with predetermined surgical indications at two hospitals with either the LESS (n = 19) or the open inguinal approach (n = 20). Operative time, operation‐related pain (10‐point visual analog pain scale), catch‐up growth of the testes, semen parameters, and complications after surgery between the LESS group and the open group at 3 months after surgery were compared. Operative times were 46.8 and 72.8 min (P < 0.001) in the LESS and open surgery groups, respectively. Patients in the LESS group reported lower surgery‐related pain than those in the open surgery group at 3 months (2.5 vs 1.2, P = 0.029). A significant improvement in terms of semen concentration, motility, catch‐up growth of the bilateral testes was observed in both groups, although no significant differences were detected between the groups. Postoperative complications were also similar between the two groups. LESS varicocelectomy required a shorter operative time than inguinal varicocelectomy for bilateral cases. In addition, the LESS procedure showed less postoperative pain and cosmetic benefits with similar seminal outcomes. Thus, LESS for patients undergoing bilateral varicocelectomy represents a promising surgical approach.
Monitoring biodegradative enzymes with nanobodies raised inCamelus dromedariuswith mixtures of catabolic proteins
Authors: Zafra Olga , Fraile Sofía , Gutiérrez Carlos , Haro Amparo , Páez‐Espino A. David , Jiménez Jose I. , de Lorenzo Víctor 
Published: January 2011

SummaryFunctional studies of biodegradative activities in environmental microorganisms require molecular tools for monitoring catabolic enzymes in the members of the native microbiota. To this end, we have generated repertories of single‐domain VHHfragments of camel immunoglobulins (nanobodies) able to interact with multiple proteins that are descriptors of environmentally relevant processes. For this, we immunizedCamelus dromedariuswith a cocktail of up to 12 purified enzymes that are representative of major types of detoxifying activities found in aerobic and anaerobic microorganisms. Following the capture of the antigen‐binding modules from the mRNA of the camel lymphocytes and the selection of sub‐libraries for each of the enzymes in a phage display system we found a large number of VHHmodules that interacted with each of the antigens. Those associated to the enzyme 2,3 dihydroxybiphenyl dioxygenase ofBurkholderia xenovoransLB400 (BphC) and the arsenate reductase ofStaphylococcus aureus(ArsC) were examined in detail and found to hold different qualities that were optimal for distinct protein recognition procedures. The repertory of anti‐BphC VHHs included variants with a strong affinity and specificity for linear epitopes of the enzyme. When the anti‐BphC VHHlibrary was recloned in a prokaryotic intracellular expression system, some nanobodies were found to inhibit the dioxygenase activityin vivo. Furthermore, anti‐ArsC VHHs were able to discriminate between proteins stemming from different enzyme families. The easiness of generating large collections of binders with different properties widens considerably the molecular toolbox for analysis of biodegradative bacteria and opens fresh possibilities of monitoring protein markers and activities in the environment.
Mini‐laparotomy approach to radical cystectomy
Authors: Jensen Jørgen B. , Pedersen Knud V. , Olsen Kasper Ø. , Bisgaard Ulla F. , Jensen Klaus M. 
Published: January 2011

Study Type – Therapy (case series)Level of Evidence 4What’s known on the subject? and What does the study add?In the recent decade minimally invasive endoscopically approaches have been suggested as a way to reduce morbidity following radical cystectomy.The present study suggests that the same advantages found, when comparing endoscopical cystectomy to classical open cystectomy, can be achieved by reducing the wound length of the open approach.OBJECTIVE
To investigate the feasibility of performing radical cystectomy (RC) through a mini‐laparotomy and to evaluate the effect of a smaller incision on wound problems, immediate postoperative pain, bowel function and length of hospital stay (LOS).
PATIENTS AND METHODS
Two consecutive cohorts of patients, one with 75 patients undergoing open RC (ORC) with lymph node dissection up to the aortic bifurcation through a conventional long midline incision and one with 75 patients undergoing RC through a mini‐laparotomy (MinilapRC) of intentionally <8–10 cm.
Patient characteristics, operative duration, estimated blood loss (EBL), incidence and severity of wound problems, return of bowel function, amount of analgesics needed and LOS were analysed according to the intention‐to‐treat principle.
RESULTS
The demographic characteristics of the two groups were similar.
An incision of ≤10 cm was made in 65% of the patients in the MinilapRC group with a median (range) length of incision of 9 (6.5–19) cm. In the final third of patients operated on in the MinilapRC group, 76% had an incision of ≤8 cm.
The operative duration and EBL were not significantly different between the groups.
Wound problems were significantly fewer, bowel function was restored more quickly and the need of postoperative analgesics was less in the MinilapRC group.
In the MinilapRC group LOS was reduced by a median of 3 days.
CONCLUSION
MinilapRC is feasible in most patients without increasing operative duration. The reduced incision length reduces postoperative morbidity.
Focal therapy in the management of localized prostate cancer
Authors: Nguyen Carvell T. , Jones J. Stephen 
Published: January 2011

What’s known on the subject? and What does the study add? Focal therapy, which includes cryotherapy and high‐intensity focused ultrasound, is a nascent and somewhat controversial field in the management of prostate cancer. The current review presents the rationale, indications and potential role for focal therapy in patients with localized prostate cancer.OBJECTIVES• To assess the rationale, efficacy, and morbidity of various methods of achieving focal prostatic ablation.• To determine the current role of focal therapy in the management of localized prostate cancer.METHODS• We performed a literature review of focal therapy in prostate cancer, with an emphasis on more established methods such as cryoablation and high‐intensity focused ultrasound.RESULTS AND CONCLUSIONS• Focal ablative methods allow targeted destruction of prostatic tissue while limiting the morbidity associated with whole‐gland therapy.• Local cancer control after focal therapy appears promising but does not approach that of established whole‐gland therapies.• Until we have the ability to identify patients reliably with truly focal disease and predict their natural history, focal therapy cannot be considered to be the definitive therapy for localized prostate cancer.
Context of sexual risk behaviour among abused ethnic minority adolescent women
Authors: Champion J.D. 
Published: January 2011

CHAMPION J.D. (2011) Context of sexual risk behaviour among abused ethnic minority adolescent women. International Nursing Review58, 61–67Background:  Evidence suggests that multiple influences on sexual behaviour of adolescents exist, ranging from relationships with significant others including sexual or physical abuse and childhood molestation to substances used prior to sex and environmental circumstances such as sex work.Purpose:  This study aims to describe associations between childhood molestation and sexual risk behaviour.Method:  African American and Mexican American adolescent women aged 14–18 years (n = 562) with sexually transmitted infection (STI) or abuse histories and enrolled in a randomized controlled trial of behavioural interventions were interviewed via self‐report concerning sexual risk behaviour, abuse and childhood molestation at study entry.Results:  Sexual (59%), physical (77%) and psychological (82%) abuse and childhood molestation (25%) were self‐reported without differences by ethnicity. Adolescents reporting childhood molestation experienced more forms of sexual, physical and psychological abuse than others and higher incidences of STI. Fewer attended school; however, more had arrests, convictions, incarcerations and probations. Stressors including depression, running away, thoughts of death and suicide were highest for those reporting childhood molestation. Those reporting childhood molestation engaged in higher sexual risk behaviours than adolescents experiencing other forms of sexual or physical abuse (lifetime partners, bisexual relationships, anal and group sex, sex with friends with benefits, sex for money, concurrent partners, drug use including multiple substances, alcohol use and alcohol problems). These adolescents reported ‘getting high’ and having sex when out of control as reasons for sex with multiple partners.Conclusion:  Interventions for abused adolescent women necessitate a focus on associations between childhood molestation and a multiplicity of sexual risk behaviours for prevention of abuse, substance use and sex work, STI/human immunodeficiency virus (HIV) and sequelae.