bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new standardization model for physician staffing at hospitals
Authors: Ben‐Gal Irad , Wangenheim Michael , Shtub Avraham 
Published: November 2010

PurposeThe purpose of this paper is to develop a model for physician staffing requirements that could be generally applied to any hospital department, taking into account factors such as occupancy level, professional absences, allowances, physician work duties and patient service levels.Design/methodology/approachThe ability to generalize the model was tested via its implementation in five hospital departments considered to represent a cross‐section of all hospital requirements: internal medicine, surgery, orthopedics children's (pediatrics), and gynecology. The work is based on a combination of a survey, work sampling and direct time study, conducted by professional observers with a high degree of frequency and over a relatively long period of time.FindingsThe model is based on the concept of “required work capacity” of physicians. The model makes it possible to account for such factors as yearly capacity, level of desired service, increments for work conditions, roster duties and necessary absences.Practical implicationsThe findings indicate that the departments studied required a significant increase in their physician staffing. In these departments the present manpower situation stands at 80–90 percent of the necessary staffing based on the average annual occupancy. The new staffing requirements model can be implemented in various departments.Originality/valueThis paper is an original effort to develop a model for physician staffing requirements at hospitals based on a survey, work‐study and direct time study. This contributes to past research that focused on the development of staffing requirements models, e.g. for nurse or family physicians. The paper presents an original model for physician staffing requirements at hospitals.
The roles of law, client race and program visibility in shaping police interference with the operation of US syringe exchange programs
Authors: Beletsky Leo , Grau Lauretta E. , White Edward , Bowman Sarah , Heimer Robert 
Published: November 2010

ABSTRACTAims To determine the comparative levels of and associations between policing interference and characteristics of US syringe exchange programs (SEPs).Design Cross‐sectional.Setting A national survey of US SEPs.Participants A total of 111 program managers (representing 59% of all US SEPs).Measurements Program manager self‐report.Findings With overall interference profiles ranging from systematic to totally interference‐free, 43% of respondents reported at least monthly client harassment, 31% at least monthly unauthorized confiscation of clients' syringes, 12% at least monthly client arrest en route to or from SEP and 26% uninvited police appearances at program sites at least every 6 months. In multivariate modeling, legal status of SEP, jurisdiction's syringe regulation environment and affiliation with health department were not associated with frequency of police interference. Programs serving predominantly injection drug users (IDUs) of color were 3.56 times more likely to report frequent client arrest en route to or from SEP and 3.92 times more likely to report unauthorized syringe confiscation. Those serving more than three sites were 3.96 times more likely to report client harassment, while stationary operation was protective against uninvited police appearances. The majority (56%) reported not documenting adverse police events; those who did were 2.92 times more likely to report unauthorized syringe confiscation from clients.Conclusions Findings highlight limitations of the impact of legal reforms on aligning police activities with SEP operations. Systematic adverse event surveillance and evidence‐based structural interventions are needed to maximize the benefits of public health prevention targeting IDUs and other criminalized populations. SEPs that report no adverse events may represent programs already working in harmony with law enforcement agencies, a priority highlighted in US Centers for Disease Control's new SEP guidelines. The significance of mechanisms translating criminal justice disparities into health disparities is discussed.
Cigarette tax and public health: what are the implications of financially stressed smokers for the effects of price increases on smoking prevalence?
Authors: Martire Kristy A. , Mattick Richard P. , Doran Christopher M. , Hall Wayne D. 
Published: November 2010

ABSTRACTAims  This paper models the predicted impact of tobacco price increases proposed in the United States and Australia during 2009 on smoking prevalence in 2010 while taking account of the effects of financial stress among smokers on cessation rates.Methods  Two models of smoking prevalence were developed for each country. In model 1, prevalence rates were determined by price elasticity estimates. In model 2 price elasticity was moderated by financial stress. Each model was used to estimate smoking prevalence in 2010 in Australia and the United States.Results  Proposed price increases resulted in a 1.89% and 7.84% decrease in smoking participation among low socio‐economic status (SES) groups in the United States and Australia, respectively. Model 1 overestimated the number of individuals expected to quit in both the United States (0.13% of smokers) and Australia (0.36% of smokers) by failing to take account of the differential effects of the tax on financially stressed smokers. The proportion of low‐income smokers under financial stress increased in both countries in 2010 (by 1.06% in the United States and 3.75% in Australia).Conclusions  The inclusion of financial stress when modelling the impact of price on smoking prevalence suggests that the population health returns of increased cigarette price will diminish over time. As it is likely that the proportion of low‐income smokers under financial stress will also increase in 2010, future population‐based approaches to reducing smoking will need to address this factor.
Quantitative trait loci affecting eggshell traits in an F2 population
Authors: Tuiskula‐Haavisto M. , Honkatukia M. , Preisinger R. , Schmutz M. , de Koning D. J. , Wei W. H. , Vilkki J. 
Published: November 2010

SummaryGood eggshell quality is important for both table egg quality and chicken reproductive performance. Weak eggshells cause economic losses in all production steps. Poor eggshell quality also poses increased risk for Salmonella infections. Eggshell quality has been a difficult trait to improve by traditional breeding, as it can be measured only for females and it is difficult and expensive to measure. Breeding for improved shell quality may therefore benefit from the use of marker‐assisted selection. In an effort to find markers linked to eggshell quality, we have used an F2 population of 668 females to map quantitative trait loci (QTL) affecting eggshell traits (eggshell deformation, breaking force, weight). By using 160 microsatellite markers on 27 chromosomes, we found 11 genome‐wide and 15 suggestive QTL for shell traits measured at different times during production. Loci affecting the deformation were found on chromosomes 1, 2, 6, 10, 14 and Z. Loci affecting the breaking force were detected on chromosomes 2, 3, 10, 12 and Z. Loci affecting the shell weight were detected on chromosomes 6, 12, 24 and Z. Each QTL explains between 1.5% and 4.6% of the phenotypic variance, adding up to 10‐15% of total phenotypic variance explained for the different traits. No epistatic effects were observed between loci affecting eggshell traits. Because the effects for quality are mainly additive, these results provide a basis for further characterization of the loci to identify closely linked markers to be used in marker‐assisted selection.
Successful strategies to improve RN retention and patient outcomes in a large medical centre in Hawaii
Authors: Kooker Barbara Molina , Kamikawa Cynthia 
Published: November 2010

Aims and objectives.  The purpose of this paper is to describe an assessment of a major retention initiative implemented at The Queen’s Medical Center in Honolulu, Hawaii, in response to the nursing workforce shortage in the state.Background.  After tracking the situation for several years, nursing leadership at the medical centre critically analysed their registered nurse retention data. The retention rate among new nurses in their first year of employment was only 55·97%.Design.  A training programme was initiated to improve registered nurse retention and patient care outcomes with external funding from the US Health Resources and Services Administration.Method.  New nurses were supported via additional training and clinical coaches beyond the basic orientation period. Leadership skills of nurse managers were expanded to strengthen their role in retention of new nurses. Four inpatient nursing units became Magnet Pilot Units to demonstrate progress towards achievement of Magnet standards and improvement of patient outcomes.Results.  From 2005–2009, first‐year‐registered nurse retention improved from 55·97–68·20%; registered nurse vacancy rate decreased from 11·26–2·19%; patient satisfaction increased from 84·6–87·8%; registered nurse satisfaction‐autonomy improved from 43·55–49·29; registered nurse satisfaction‐decision‐making went from 41·13–47·97%; and nosocomial decubitus ulcer rate decreased from 15·3–6·7% in the intensive care units.Conclusions.  Dedicated resources and targeted activities can make a difference in outcomes for both nurses and patients. Keys to success included engaging staff, having high expectations coupled with high support, providing data to unit‐level staff to measure improvements emphasising renewed accountability and maintaining the focus on quality patient care.Relevance to clinical practice.  When the goal is to provide the highest level of quality patient care, professional development of staff and managers is important to meet performance expectations and achieve target clinical goals. Improving registered nurse retention and vacancy rates while also improving patient outcomes had significant human resource and financial benefits for the organisation and contributed to achieving Magnet Recognition.
The joys and terrors of fast adaptation: new findings elucidate antibiotic resistance and natural selection
Authors: Roth John R. 
Published: November 2010

SummaryExperiments of Pränting and Andersson demonstrate how bacteria adapt to the growth limitation caused by antibiotic resistance mutations. The process of adaptation relies on gene copy number changes that arise at high rates, including duplications (10−4 per cell per generation), amplifications (10−2 per cell per generation) and mutant copy loss (10−2 per cell per division). Reversible increases in copy number improve growth by small steps and provide more targets for rare sequence alterations (10−9 per cell per division) that can stably improve growth. After sequence alteration, selection favours loss of the still mutant gene copies that accelerated adaptation. The results strongly support the amplification‐reversion model for fast adaptation and argue against the alternative idea of ‘stress‐induced mutagenesis’.
Role of dopamine D2and D3receptors in mediating the U‐50,488H discriminative cue: comparison with methamphetamine and cocaine
Authors: Yoshizawa Kazumi , Narita Minoru , Mori Tomohisa , Miyatake Mayumi , Isotani Kana , Tomiyasu Shiro , Tsukiyama Yoshi , Suzuki Tsutomu 
Published: November 2010

ABSTRACTSubstitutions of the dopamine D2or D3receptor agonists for the discriminative stimulus effect induced by U‐50,488H, methamphetamine (METH) and cocaine in rats were examined. The D2receptor agonist R‐propylnorapomorphine [(−)‐NPA] failed to substitute for U‐50,488H cue, while the D3receptor‐preferred agonist (+/–)‐7‐hydroxy‐dipropylaminotetralin hydrobromide (7‐OH‐DPAT) produced dose‐related increases in drug‐appropriate responding up to 0.03 mg/kg, which fully substituted. At doses greater than 0.03 mg/kg of 7‐OH‐DPAT, there was a dose‐dependent decrease in the percentage of responses on the U‐50,488H‐appropriate lever. Furthermore (−)‐NPA and 7‐OH‐DPAT at high doses substituted for the discriminative stimulus effect induced by both METH and cocaine, indicating that 7‐OH‐DPAT at high doses may interact with D2receptors. These results suggest that the stimulation of D2receptor may be critical for the production of the discriminative stimulus effect induced by METH and cocaine, whereas the stimulation of D3receptor may contribute to the production of the U‐50,488H cue.
Using monosodium glutamate to initiate ethanol self‐administration in inbred mouse strains
Authors: McCool Brian A. , Chappell Ann M. 
Published: November 2010

ABSTRACTVoluntary oral ethanol consumption in rodents is generally limited by strong taste‐aversion in these species. Historically, this has been overcome by combining ethanol with a sweetener, typically sucrose or saccharine, and then slowly ‘fading’ away the sweetener. While useful in most instances, this approach has not proven as successful for some inbred strains of mice (e.g. DBA/2J) despite consistent evidence in the literature that these same strains express strong conditioned place preference for intraperitoneal‐ or intragastric‐administered ethanol. Importantly, DBA/2J mice express a polymorphism in a ‘sweet’ taste receptor subunit gene that reduces the potency of sweet substances in these mice. We hypothesized that the presence of this polymorphism might help explain the contrasting behavioral findings of weak voluntary oral ethanol consumption following sucrose‐fade yet robust conditioned place preference for ethanol in this strain. To test this, we compared ethanol consumption initiated by either a ‘traditional’ sucrose‐fade or a fade from an alternative tastant, monosodium glutamate (MSG). We found that in both C57BL/6J and DBA/2J mice, the MSG‐fade produced robust increases in home cage ethanol consumption relative to the traditional sucrose‐fade. This increased ethanol intake following MSG‐fade was evident across a range of ethanol concentrations. Our findings suggest the potential utility of the MSG‐fade to establish stable voluntary oral ethanol consumption in mice, particularly ethanol ‘non‐preferring’ strains such as DBA/2J and lend additional support to the notion that ethanol consumption in DBA/2J mice is limited by pronounced taste aversion.
Utility of contrast‐enhanced ultrasonography with Sonazoid in radiofrequency ablation for hepatocellular carcinoma
Authors: Masuzaki Ryota , Shiina Shuichiro , Tateishi Ryosuke , Yoshida Haruhiko , Goto Eriko , Sugioka Yosuke , Kondo Yuji , Goto Tadashi , Ikeda Hitoshi , Omata Masao , Koike Kazuhiko 
Published: November 2010

AbstractBackground and Aims:  Kupffer imaging in contrast‐enhanced ultrasonography (CEUS) with Sonazoid, which lasts for 60 min or longer, may be useful in ultrasound‐guided percutaneous tumor ablation. The utility of Sonazoid in radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) was investigated in this study.Methods:  We analyzed a total of 716 HCC nodules that were detected on dynamic computed tomography in 316 patients. Detectability of these nodules was compared between CEUS and conventional ultrasonography. The effectiveness in the treatment was assessed by comparing the mean numbers of treatment sessions of RFA in patients treated with CEUS and that in historical controls matched for tumor and background conditions.Results:  Detectability of tumor nodule was 83.5% in conventional ultrasonography and 93.2% in CEUS (P = 0.04). Sixty‐nine nodules in 52 patients were additionally detected with CEUS. The number of additionally detected tumor nodules was positively correlated with serum albumin level (P = 0.016). The number of RFA sessions was 1.33 ± 0.45 with CEUS as compared to 1.49 ± 0.76 in the historical controls (P = 0.0019).Conclusions:  CEUS with Sonazoid is useful for HCC detection in patients with a well‐conserved liver function reservoir. The decrease in RFA session numbers indicated the utility of Sonazoid in RFA treatment of HCC.
Validation of an extension of the international non‐invasive criteria for the diagnosis of hepatocellular carcinoma to the characterization of macroscopic portal vein thrombosis
Authors: Sorrentino Paolo , Tarantino Luciano , D'Angelo Salvatore , Terracciano Luigi , Ferbo Umberto , Bracigliano Alessandra , Panico Luigi , De Chiara Giovanni , Lepore Mariolina , De Stefano Noe , Fiorentino Francesco , Vecchione Raffaela 
Published: November 2010

AbstractBackground and Aim:  We aimed to validate the non‐invasive criteria for the characterization of portal vein thrombosis (PVT) in patients with cirrhosis and hepatocellular carcinoma (HCC). In a prospective study, we examined the impact of arterial hypervascularity, as established by the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases recommendations for the non‐invasive diagnosis of HCC, as a criterion for characterizing macroscopic PVT (EASL/AASLD extension criteria).Methods:  A total of 96 cases of PVT detected using ultrasonography in patients with cirrhosis and HCC were included in the study. When coincidental arterial hypervascularity was detected by contrast perfusional ultrasonography and helical computed tomography, the thrombus was considered malignant according to our EASL/AASLD extension criteria. In all cases, an ultrasound‐guided biopsy examination of the thrombus was performed.Results:  Coincidental hypervascularity was found in 54 of 96 nodules (56.2%), and all were malignant upon biopsy (100% positive predictive value). Twenty‐four (25%) had negative results with both techniques (non‐vascular thrombus). Biopsies showed HCC in five non‐vascular thrombi (5.3% of all thrombi) and in 13 of 18 thrombi with a hypervascularity result from only one technique.Conclusions:  The EASL/AASLD extension criteria for non‐invasive diagnosis of malignant thrombosis were satisfied in 75.2% of malignant thrombi; thus, a biopsy is frequently required in this setting. However, in the presence of coincidental hypervascularity of a thrombus with both techniques, a biopsy is not required (absolute positive predictive value for malignancy). Relying on imaging techniques in thrombi could miss the diagnosis of malignant portal invasion in up to 24.9% of cases.
Impact of Helicobacter pylori CagA diversity on gastric mucosal damage: An immunohistochemical study of East‐Asian‐type CagA
Authors: Abe Takashi , Kodama Masaaki , Murakami Kazunari , Matsunari Osamu , Mizukami Kazuhiro , Inoue Kunimitsu , Uchida Masahiro , Okimoto Tadayoshi , Fujioka Toshio , Uchida Tomohisa , Moriyama Masatsugu , Yamaoka Yoshio 
Published: November 2010

AbstractBackground and Aims:  Recently, we successfully produced an anti‐East‐Asian‐type CagA‐specific antibody called α‐EAS Ab, which is specifically immunoreactive only with East‐Asian‐type CagA but not Western‐type CagA. In this study, the correlations between Helicobacter pylori CagA protein diversity and gastric mucosal condition was investigated using immunohistochemical staining with α‐EAS Ab in Japan.Methods:  There were 254 H. pylori‐positive patients enrolled in this study. α‐EAS Ab was used to determine the CagA phenotype instead of cagA sequencing, and, moreover, the histological findings and endoscopic gastric mucosal condition were evaluated according to the updated Sydney System and the Kimura–Takemoto classification system, respectively.Results:  A total of 224 (88.2%) of the patients were immunoreactive for α‐EAS Ab. The remaining 30 (11.8%) were negative for α‐EAS Ab, suggesting that they were infected with either Western‐type CagA or CagA‐negative strains (i.e. non‐East‐Asian‐type CagA strains). The grades of activity of gastritis, mucosal atrophy and intestinal metaplasia according to the updated Sydney System were significantly higher in patients infected with East‐Asian‐type CagA strains than those infected with non‐East‐Asian‐type CagA strains. The grade of endoscopic gastric mucosal atrophy evaluated using the Kimura–Takemoto classification system was similar. All 28 strains isolated from patients with gastric cancer possessed the East‐Asian‐type CagA.Conclusions:  Infection with East‐Asian‐type CagA H. pylori was more closely associated with gastric mucosal atrophy and gastric cancer than infection with non‐East‐Asian‐type CagA H. pylori. The efficiency of immunohistochemical analysis for CagA should be equivalent to that of cagA sequencing.
Navigating the labyrinth of Canadian undergraduate psychiatric nurse education
Authors: Morrissette Patrick J. 
Published: November 2010

ABSTRACTHistorically, the education and training of psychiatric nurses in Canada have only been available within a psychiatric institutional setting or community college. This trend, however, has experienced a recent shift with the establishment of a Canadian undergraduate programme. This development is symbolic of the profession's evolution and serves three primary purposes. First, it continues to address the psychiatric nursing shortage; second, it provides additional educational and career opportunities for students; and third, it serves to advance the psychiatric nursing profession. This essay reflects on a decade of undergraduate psychiatric nurse education and discusses the salient challenges and needs of learners and educators.
A psychometric analysis of the Mental Health Consumer Participation Questionnaire
Authors: Happell Brenda , Moxham Lorna , Platania‐Phung Chris 
Published: November 2010

ABSTRACTIf consumer participation is to be translated from rhetoric into reality, the attitudes of health professionals need to be addressed. Educational strategies can play an important role, but measures of attitudes are needed to determine the effectiveness of these strategies. This paper seeks to establish the Mental Health Consumer Participation Questionnaire (MHCPQ) on psychometric grounds, and explore attitude levels. Overall, the 150 nursing students who participated saw consumer participation in a favourable light, although this varied with the nature and extent of involvement. Psychometric properties, attitude structure, and attitude differences are reported. The MHCPQ displays good face validity and can be further developed and used in mental health‐care settings.
Retention of adolescents with substance dependence and coexisting mental health disorders in outpatient alcohol and drug group therapy
Authors: Pagey Bronwyn , Deering Daryle , Sellman Doug 
Published: November 2010

ABSTRACTThe aim of this study was to investigate characteristics that might enhance retention among adolescents attending outpatient alcohol and drug group therapy within a youth mental health setting. An important goal was to provide information for nurses and other clinicians who work with adolescents with coexisting substance use and mental health disorders. A retrospective file audit reviewed the files of 64 adolescents who attended a weekly alcohol and drug group between 2002 and 2004. Five characteristics were shown to have a significant impact on enhancing participant group retention. These were Māori and Pacific Island ethnicity, past or current legal charges, youth drug court (YDC) involvement, having a diagnosis of cannabis dependence, and a diagnosis of conduct disorder. Logistic regression found that YDC involvement on its own significantly predicted treatment retention. In an area of limited research, the findings from this study expand the literature on enhancing treatment retention for a vulnerable and hard‐to‐engage adolescent group with complex treatment needs, and highlight the need for further investigation of the potential role of the YDC. From a practice perspective, the findings support group therapy interventions as a cost‐effective treatment modality for assisting adolescents with coexisting substance use and mental health issues, including those with conduct disorder and YDC involvement.