bluuebunny/crossref_metadata_2025_split huggingface dataset:
A policy‐oriented review of strategies for improving the outcomes of services for substance use disorder patients*
Authors: Humphreys Keith , McLellan A. Thomas 
Published: June 2011

ABSTRACTAims  To inform policy makers on available options for improving the effectiveness of treatments for substance use disorders and to stimulate debate about treatment improvement strategies among public officials, clinical providers, care managers, service users, families and researchers.Methods  We draw on the scientific literature and our public policy experiences in two countries (the United Kingdom and the United States) to give an overview of policies which may improve care for individuals with substance use disorders. We divide such policies into ‘process‐focused quality improvement strategies’ that attempt to change some aspect of treatment (e.g. increased retention, greater use of evidence‐based practices) and ‘patient‐focused strategies’ that attempt to reward outcomes directly (e.g. contingency management for patients, payment by results for providers).Findings  Many policies of both types are poorly developed, have shown poor results, or both. The evidence is clear that process‐focused quality improvement strategies can change what providers do and how treatment programs work, but such changes have thus far demonstrated only minimal impact on patient outcomes. Patient‐focused strategies face challenges including treatment providers avoiding hard‐to‐treat patients or spending inordinate time relocating patients after treatment to assess outcome. However, policies that reward in‐treatment outcomes and policies that allow the patient to purchase desired recovery support services show more promise. As policy makers go forward in this endeavor, they can do an enormous service to their countries and the field by embedding careful evaluation studies alongside new treatment outcome improvement initiatives.
Electronic prescribing increases uptake of clinical pharmacologists' recommendations in the hospital setting
Authors: Taegtmeyer Anne B. , Curkovic Ivanka , Rufibach Kaspar , Corti Natascia , Battegay Edouard , Kullak‐Ublick Gerd A. 
Published: May 2011

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Electronic prescribing reduces drug prescription errors and therefore improves patient safety.• Whether electronic prescribing compared with prescribing on paper facilitates the implementation of clinical pharmacologists' recommendations in the care of patients hospitalized with medical problems is not known.WHAT THIS STUDY ADDS• The use of electronic prescriptions when compared with handwritten prescriptions increased the uptake of clinical pharmacologists' recommendations for improving drug safety in hospitalized patients.AIMS To determine whether electronic prescribing facilitates the uptake of clinical pharmacologists' recommendations for improving drug safety in medical inpatients.METHODS Electronic case records and prescription charts (either electronic or paper) of 502 patients hospitalized on medical wards in a large Swiss teaching hospital between January 2009 and January 2010 were studied by four junior and four senior clinical pharmacologists. Drug‐related problems were identified and interventions proposed. The implementation and time delays of these proposed interventions were compared between the patients for whom paper drug charts were used and the patients for whom electronic drug charts were used.RESULTS One hundred and fifty‐eight drug‐related problems in 109 hospital admissions were identified and 145 recommendations were made, of which 51% were implemented. Admissions with an electronic prescription chart (n= 90) were found to have 2.74 times higher odds for implementation of the change than those with a paper prescription chart (n= 53) (95% confidence interval 1.2, 6.3, P= 0.018, adjusted for any dependency introduced by patient, ward or clinical team; follow‐up for two cases missing). The time delay between recommendations being made and their implementation (if any) was minimal (median 1 day) and did not differ between the two groups.CONCLUSIONS Electronic prescribing in this hospital setting was associated with increased implementation of clinical pharmacologists' recommendations for improving drug safety when compared with handwritten prescribing on paper.
Activin‐A: a novel critical regulator of allergic asthma
Authors: Kariyawasam H. H. , Semitekolou M. , Robinson D. S. , Xanthou G. 
Published: June 2011

SummaryActivin‐A is a pleiotropic cytokine that belongs to the TGF‐β superfamily and plays an important role in fundamental biological processes, such as development and tissue repair. Growing evidence proposes a crucial role for activin‐A in immune‐mediated responses and associated diseases, with both enhancing and suppressive effects depending on the cell type, the cytokine micromilieu and the context of the response. Several recent studies have demonstrated a striking increase in activin‐A expression in experimental models of asthma, as well as, in the asthmatic airway in humans. Importantly, a strong immunoregulatory role for activin‐A in allergic airway disease, with suppression of T helper (Th) type 2 cell‐driven allergic responses and protection against the development of cardinal features of the asthmatic phenotype was revealed by in vivo functional studies. Activin‐A‐mediated immunosuppression is associated with induction of functional allergen‐specific regulatory T cells. In human asthma, although activin‐A levels are increased in the airway epithelium and submucosal cells, the expression of its signalling components is markedly decreased, pointing to decreased regulation. Nevertheless, a rapid activation of the activin‐A signalling pathway is observed in the airway of individuals with asthma following inhalational allergen challenge, suggestive of an inherent protective mechanism to control disease. In support, in vitro studies using human airway epithelial cells have demonstrated that endogenous activin‐A suppresses the release of inflammatory mediators, while it induces epithelial repair. Collectively, compelling evidence suggests that activin‐A orchestrates the regulation of key events involved in the pathogenesis of allergic asthma. The critical role of activin‐A in allergic airway responses places this cytokine as an exciting new therapeutic target for asthma.
Cite this as: H. H. Kariyawasam, M. Semitekolou, D. S. Robinson and G. Xanthou, Clinical & Experimental Allergy, 2011 (41) 1505–1514.
The effect of sexual self‐concept on sexual health behavioural intentions: a test of moderating mechanisms in early adolescent girls
Authors: Pai Hsiang‐Chu , Lee Sheuan , Yen Wen‐Jiuan 
Published: June 2011

pai h.‐c., lee s. & yen w.‐j. (2012) The effect of sexual self‐concept on sexual health behavioural intentions: a test of moderating mechanisms in early adolescent girls. Journal of Advanced Nursing68(1), 47–55.AbstractAim.  The purpose of this study was to examine whether normative beliefs would act as a moderator of the main relationship between sexual self‐concept and sexual heath behavioural intentions.Background.  Sexual self‐concept has been defined as an individual’s evaluation of his or her own sexual feelings and actions. Research has shown that sexually related behaviours are associated with sexual self‐concept and perceived parental/peer approval of sexual behaviour.Methods.  We conducted cross‐sectional research, using face‐to‐face interviews, to assess sexual self‐concept, normative beliefs and sexual health behavioural intention. This study was conducted with 534 adolescent female participants, aged 12–15 years, in Taiwan. Data was collected between September and December 2009. We conducted structural equation modelling to examine the proposed conceptual model.Findings.  We found that individuals with a high score on sexual self‐concept (i.e. who had stronger erotic feelings) were less likely to believe that they would behave in ways that would protect their sexual health (i.e. low behavioural intention, β = −0·44, t = −8·43, P < 0·001). The hypothesized moderating role of normative beliefs was also supported. Those with a greater tendency to believe that their parents/peers approved of sex (i.e. normative beliefs) were more likely to have a positive sexual self‐concept (β = 0·57, P < 0·001), and were less likely to protect their sexual health (β = −0·19, P < 0·01). The findings showed that, together, normative beliefs and sexual self‐concept accounted for 24·9% of the variance in girls’ sexual health behavioural intentions.Conclusions.  We recommend that interventions that target sexual health behavioural intentions for this population would be more effective if such interventions targeted normative beliefs and helped adolescent females to clarify their sexual self‐concept.
Electronic prescribing reduces prescribing error in public hospitals
Authors: Shawahna Ramzi , Rahman Nisar‐Ur , Ahmad Mahmood , Debray Marcel , Yliperttula Marjo , Declèves Xavier 
Published: June 2011

Aims and objectives.  To examine the incidence of prescribing errors in a main public hospital in Pakistan and to assess the impact of introducing electronic prescribing system on the reduction of their incidence.Background.  Medication errors are persistent in today’s healthcare system. The impact of electronic prescribing on reducing errors has not been tested in developing world.Design.  Prospective review of medication and discharge medication charts before and after the introduction of an electronic inpatient record and prescribing system.Methods.  Inpatient records (n = 3300) and 1100 discharge medication sheets were reviewed for prescribing errors before and after the installation of electronic prescribing system in 11 wards.Results.  Medications (13,328 and 14,064) were prescribed for inpatients, among which 3008 and 1147 prescribing errors were identified, giving an overall error rate of 22·6% and 8·2% throughout paper‐based and electronic prescribing, respectively. Medications (2480 and 2790) were prescribed for discharge patients, among which 418 and 123 errors were detected, giving an overall error rate of 16·9% and 4·4% during paper‐based and electronic prescribing, respectively.Conclusion.  Electronic prescribing has a significant effect on the reduction of prescribing errors.Relevance to clinical practice.  Prescribing errors are commonplace in Pakistan public hospitals. The study evaluated the impact of introducing electronic inpatient records and electronic prescribing in the reduction of prescribing errors in a public hospital in Pakistan.
The dilemma of diabetic patients living with hypoglycaemia
Authors: Wu Fei‐Ling , Juang Jyuhn‐Huarng , Yeh Mei Chang 
Published: June 2011

Aims.  To examine the impact of the threat of hypoglycaemic episodes on people with diabetes in Taiwan.Background.  Intensive diabetes treatment in people with diabetes helps them to achieve better glycaemic control. However, it also causes more frequent hypoglycaemic episodes and has an impact on their overall quality of life. Hypoglycaemia is accompanied by various distressing symptoms which may cause excessive fear, affecting decision making in hypoglycaemic management.Design.  Purposive sampling and in‐depth, face‐to‐face interviews were used to collect data.Methods.  Semi‐structured interviews were conducted from July 2008–January 2009 with 17 individuals treated with insulin who had previous hypoglycaemic episodes. Data were analysed using qualitative content analysis.Results.  Four themes were generated from the analysis, ‘inability to control fluctuations in health’, ‘challenges to interpersonal relationships’, ‘facing the disease alone’ and ‘finding a balance between competing symptoms’.Conclusions.  Hypoglycaemia is a major health issue for many people with diabetes. Understanding individuals’ experiences with hypoglycaemic episodes should help practitioners become more fully involved in promoting self‐management. We identified key areas that health care providers should address, including concerns about patient education and professional support for people with diabetes experiencing hypoglycaemia, to enhance problem solving skills for them and their families.Relevance to clinical practice.  We recommend that health care providers make proper use of support groups for family caregivers or other important individuals in the lives of people with diabetes to provide education, clarification, support and guidance. In addition, health care providers also need to provide clients with hypoglycaemia‐related emotional support, while enhancing diabetes self‐management and problem‐solving skills.
Non‐invasive, dynamic imaging of murine intestinal motility
Authors: Kwon S. , Sevick‐Muraca E. M. 
Published: May 2011

AbstractBackground  After intravenous (i.v.) administration, indocyanine green (ICG) is known to be secreted into bile from the liver via the biliary tracts, enabling fluorescent delineation of the intestine. In addition, ICG is a near‐infrared (NIR) excitable fluorophore, capable of providing exogenous contrast for rapid NIR fluorescence imaging. We sought to quantify the intestinal motility using dynamic NIR fluorescence imaging after injection of ICG.Methods  C57BL6 mice were dynamically imaged immediately before and up to 24 h after i.v. and intradermal (i.d.) injection of 50 and 10 μL of ICG, respectively. Necropsy was also performed 1 h postinjection and the entire gastrointestinal tract was isolated and exposed for ex vivo fluorescence imaging.Key Results  The secretion of ICG‐laden fluorescent bile into the duodenum was observed in vivo and confirmed in situ. Different patterns of the intestinal motility, such as peristaltic and segmental motions, were dynamically imaged in vivo. Our imaging data showed that the frequency of contractions ranged from 27 to 35 cycles min−1 and the propagation velocity of peristaltic waves ranged from 0.82 ± 0.5 to 2.04 ± 1.12 cm s−1.Conclusions & Inferences  Dynamic NIR fluorescence imaging with injection of ICG can provide a method for diagnostic motility testing for intestinal motility disorders or dysfunction and for potential evaluation of therapeutic agents.
Day length is a key regulator of transcriptomic responses to both CO2 and H2O2 in Arabidopsis
Authors: QUEVAL GUILLAUME , NEUKERMANS JENNY , VANDERAUWERA SANDY , VAN BREUSEGEM FRANK , NOCTOR GRAHAM 
Published: June 2011

ABSTRACTGrowth day length, CO2 levels and H2O2 all impact plant function, but interactions between them remain unclear. Using a whole‐genome transcriptomics approach, we identified gene expression patterns responding to these three factors in Arabidopsis Col‐0 and the conditional catalase‐deficient mutant, cat2. Plants grown for 5 weeks at high CO2 in short days (hCO2) were transferred to air in short days (SD air) or long days (LD air), and microarray data produced were subjected to three independent studies. The first two analysed genotype‐independent responses. They identified 1549 genes differentially expressed after transfer from hCO2 to SD air. Almost half of these, including genes modulated by sugars or associated with redox, stress or abscisic acid (ABA) functions, as well as light signalling and clock genes, were no longer significant after transfer to air in LD. In a third study, day length‐dependent H2O2‐responsive genes were identified by comparing the two genotypes. Two clearly independent responses were observed in cat2 transferred to air in SD and LD. Most H2O2‐responsive genes were up‐regulated more strongly in SD air. Overall, the analysis shows that both CO2 and H2O2 interact with day length and photoreceptor pathways, indicating close networking between carbon status, light and redox state in environmental responses.
Maize seed and stem roots differ in response to neighbouring weeds
Authors: AFIFI M , SWANTON C 
Published: May 2011

Afifi M & Swanton C (2011). Maize seed and stem roots differ in response to neighbouring weeds. Weed Research51, 442–450.SummaryLight signals such as the red to far‐red ratio (R/FR) reflected from stem and leaf surfaces of neighbouring weeds can trigger a shade avoidance response in maize seedlings, resulting in a reduction in root biomass. In this experiment, we tested the hypothesis that maize roots originating from seed or stem tissue differed in their response to the R/FR ratio reflected from neighbouring weeds. Laboratory experiments were conducted under conditions of non‐limiting resources using perennial ryegrass as a model weed species. The above‐ground reduction in the R/FR ratio reflected from neighbouring weeds delayed the emergence of the root radicle and reduced the root relative growth rate from emergence until the fourth leaf tip stage of maize. At this leaf stage, no effect was observed on root length or surface area of the root radicle or seminal roots. In contrast, crown root length, diameter, surface area and number were all reduced, compared with crown roots grown under weed‐free conditions. These changes accounted for the observed reduction in total root biomass and volume. This is the first study to report that maize roots originating from seed or stem tissue differ in their response to the proximity of neighbouring weeds.
Signalling by the global regulatory molecule ppGpp in bacteria and chloroplasts of land plants
Authors: Tozawa Y. , Nomura Y. 
Published: May 2011

AbstractThe hyperphosphorylated guanine ribonucleotide ppGpp mediates the stringent response in bacteria. Biochemical and genetic studies of this response in Escherichia coli have shown that the biosynthesis of ppGpp is catalysed by two homologous enzymes, RelA and SpoT. RelA is activated in response to amino acid starvation, and SpoT responds to abiotic physical stress beside nutritional stress. All free‐living bacteria, including Gram‐positive firmicutes, contain RelA‐SpoT homologues (RSH). Further, novel ppGpp biosynthetic enzymes, designated small alarmone synthetases (SASs), were recently identified in a subset of bacteria, including the Gram‐positive organism Bacillus subtilis, and were shown to consist only of a ppGpp synthetase domain. Studies suggest that these SAS proteins contribute to ppGpp signalling in response to stressful conditions in a manner distinct from that of RelA‐SpoT enzymes. SAS proteins currently appear to always occur in addition to RSH enzymes in various combinations but never alone. RSHs have also been identified in chloroplasts, organelles of photosynthetic eukaryotes that originated from endosymbiotic photosynthetic bacteria. These chloroplast RSHs are exclusively encoded in nuclear DNA and targeted into chloroplasts. The findings suggest that ppGpp may regulate chloroplast functions similar to those regulated in bacteria, including transcription and translation. In addition, a novel ppGpp synthetase that is regulated by Ca2+ as a result of the presence of two EF‐hand motifs at its COOH terminus was recently identified in chloroplasts of land plants. This finding indicates the existence of a direct connection between eukaryotic Ca2+ signalling and prokaryotic ppGpp signalling in chloroplasts. The new observations with regard to ppGpp signalling in land plants suggest that such signalling contributes to the regulation of a wider range of cellular functions than previously anticipated.
Debunking the manual handling myth: An investigation of manual handling knowledge and practices in the Australian private health sector
Authors: Kay Kate , Glass Nel 
Published: May 2011

Kay K, Glass N. International Journal of Nursing Practice 2011; 17: 231–237Debunking the manual handling myth: An investigation of manual handling knowledge and practices in the Australian private health sectorNursing care involves complex patient handling tasks. Strategies to address associated manual handling issues commonly include training programmes, despite conflicting evidence regarding training efficacy for manual handling injury reduction. Resultant knowledge acquisition and skills transfer from training programmes are prerequisites for subsequent practice changes in the clinical setting. This paper draws upon the findings from a questionnaire completed by 100 nurses in an Australian private hospital in 2008. A substantial knowledge deficit was identified, despite previous training undertaken by participants. A striking finding was that although 82% (n = 82) of nurses surveyed believed they used safe manual handling practices, only 18% (n = 15) of these nurses correctly answered items assessing manual handling knowledge. The study suggests prudence in the assumption of skills and knowledge acquisition during manual handling training. It informs the development of future implementation strategies, and provides a contributory explanation for the limited application of recommended practices after training completion.
A novel educational programme to improve knowledge regarding health care‐associated infection and hand hygiene
Authors: Fitzpatrick Maureen , Everett‐Thomas Ruth , Nevo Igal , Shekhter Ilya , Rosen Lisa F , Scheinman Stephen R , Arheart Kristopher L , Birnbach David J 
Published: May 2011

Fitzpatrick M, Everett‐Thomas R, Nevo I, Shekhter I, Rosen LF, Scheinman SR, Arheart KL, Birnbach DJ. International Journal of Nursing Practice 2011; 17: 269–274A novel educational programme to improve knowledge regarding health care‐associated infection and hand hygieneLack of hand hygiene by health‐care workers is the most significant cause of health care‐associated infection. This programme was designed to make health‐care workers want to wash their hands, to change their knowledge regarding hand hygiene and health care‐associated infection, and influence practice. Improvement between pre‐ and post‐test scores was statistically significant. Compliance is a multifactorial problem that involves knowledge and behaviour. Educational awareness and frequent reminders are critical to maintain high rates of hand hygiene compliance.
Impact of hand injury on patients: Psychosocially oriented nurse care
Authors: Tocco Ilaria , Salini Elena , Bassetto Franco 
Published: May 2011

Tocco I, Salini E, Bassetto F. International Journal of Nursing Practice 2011; 17: 275–279Impact of hand injury on patients: Psychosocially oriented nurse carePsychological and social post‐traumatic adjustments consequent to hand injury deeply affect patients' needs. Nurses are the professional figures who, within the surgery, work more closely in terms of frequency and time with patients: a targeted nurse training must be implemented. A systematic review was conducted to assess hand‐injured patients nurse care. In total, 335 articles were identified, of which 20 met inclusion criteria. Issues identified included psychological response to hand injury, social implications, nurse's recognition and assessment of psychosocial needs, appropriate intervention. The results show how important it is to train nurses who are well prepared to deal with the psychological status when caring for hand‐injured patients, in order to set the most correct psychosocial assistance.