bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions of rewards among volunteer caregivers of people living with AIDS working in faith‐based organizations in South Africa: a qualitative study
Authors: Akintola Olagoke 
Published: June 2010

BackgroundVolunteer caregivers are a critical source of support for the majority of people living with HIV and AIDS in southern Africa, which has extremely high HIV/AIDS prevalence rates. While studies have shown that volunteer caregiving is associated with negative health and socio‐economic outcomes, little is known about the positive experiences of volunteers in the home‐based care context in South Africa. The purpose of this study is to explore the perception of rewards among volunteers working in home‐based care settings.MethodsThis study uses a qualitative design. Qualitative interviews were conducted with a purposively selected sample of 55 volunteer caregivers using an interview schedule containing open‐ended questions.ResultsVolunteer caregivers derived intrinsic rewards related to self‐growth and personal (emotional and psychological) development on the job; they also derived satisfaction from community members taking a liking for them and expressing a need for their services. Volunteers felt gratified by the improvements in their health behaviours, which were a direct consequence of the experiences of caring for terminally ill patients with AIDS. Extrinsic rewards came from appreciation and recognition shown by patients and community members. Extrinsic rewards also accrued to volunteers when the services they rendered made their patients happy. Perhaps the greatest sources of extrinsic rewards are skills and competencies acquired from training and experience while caring for their patients, and volunteers' ability to make a difference in the community.ConclusionsInsights into volunteer caregiver rewards provide opportunities for policy makers and programme managers to develop a model of home‐based care that facilitates the accrual of rewards to volunteers alongside volunteers' traditional duties of patient care. Programme managers could employ these insights in recruiting and assisting volunteers to identify and reflect on rewards in the caregiving situation as a means of reducing the burden of care and sustaining volunteer interest in caregiving.
Dramatic increase of third-generation cephalosporin-resistant E. coli in German intensive care units: secular trends in antibiotic drug use and bacterial resistance, 2001 to 2008
Authors: Meyer Elisabeth , Schwab Frank , Schroeren-Boersch Barbara , Gastmeier Petra 
Published: June 2010

Abstract
Introduction
The objective of the present study was to analyse secular trends in antibiotic consumption and resistance data from a network of 53 intensive care units (ICUs).

Methods
The study involved prospective unit and laboratory-based surveillance in 53 German ICUs from 2001 through 2008. Data were calculated on the basis of proportions of nonduplicate resistant isolates, resistance densities (that is, the number of resistant isolates of a species per 1,000 patient-days) and an antimicrobial usage density (AD) expressed as daily defined doses (DDD) and normalised per 1,000 patient-days.

Results
Total mean antibiotic use remained stable over time and amounted to 1,172 DDD/1,000 patient-days (range 531 to 2,471). Carbapenem use almost doubled to an AD of 151 in 2008. Significant increases were also calculated for quinolone (AD of 163 in 2008) and third-generation and fourth-generation cephalosporin use (AD of 117 in 2008). Aminoglycoside consumption decreased substantially (AD of 86 in 2001 and 24 in 2008). Resistance proportions were as follows in 2001 and 2008, respectively: methicillin-resistant Staphylococcus aureus (MRSA) 26% and 20% (P = 0.006; trend test showed a significant decrease), vancomycin-resistant enterococcus (VRE) faecium 2.3% and 8.2% (P = 0.008), third-generation cephalosporin (3GC)-resistant Escherichia. coli 1.2% and 19.7% (P < 0.001), 3GC-resistant Klebsiella pneumoniae 3.8% and 25.5% (P < 0.001), imipenem-resistant Acinetobacter baumannii 1.1% and 4.5% (P = 0.002), and imipenem-resistant K. pneumoniae 0.4% and 1.1%. The resistance densities did not change for MRSA but increased significantly for VRE faecium and 3GC-resistant E. coli and K. pneumoniae. In 2008, the resistance density for MRSA was 3.73, 0.48 for VRE, 1.39 for 3GC-resistant E. coli and 0.82 for K. pneumoniae.

Conclusions
Although total antibiotic use did not change over time in German ICUs, carbapenem use doubled. This is probably due to the rise in 3GC-resistant E. coli and K. pneumoniae. Increased carbapenem consumption was associated with carbapenem-resistant K. pneumoniae carbapenemase-producing bacteria and imipenem-resistant A. baumannii.
Randomized Phase II Trial of All-Trans-Retinoic Acid With Chemotherapy Based on Paclitaxel and Cisplatin As First-Line Treatment in Patients With Advanced Non–Small-Cell Lung Cancer
Authors: Arrieta Oscar , González-De la Rosa Claudia H. , Aréchaga-Ocampo Elena , Villanueva-Rodríguez Geraldine , Cerón-Lizárraga Tania L. , Martínez-Barrera Luis , Vázquez-Manríquez María E. , Ríos-Trejo Miguel Ángel , Álvarez-Avitia Miguel Á. , Hernández-Pedro Norma , Rojas-Marín Carlos , De la Garza Jaime 
Published: June 2010

Purpose This randomized phase II trial evaluated whether the combination of cisplatin and paclitaxel (PC) plus all-trans retinoic acid (ATRA) increases response rate (RR) and progression-free survival (PFS) in patients with advanced non–small-cell lung cancer (NSCLC) with an acceptable toxicity profile and its association with the expression of retinoic acid receptor beta 2 (RAR-β2) as a response biomarker. Patients and Methods Patients with stages IIIB with pleural effusion and IV NSCLC were included to receive PC, and randomly assigned to receive ATRA 20 mg/m2/d (RA/PC) or placebo (P/PC) 1 week before treatment until two cycles were completed. RAR-β2 expression was analyzed in tumor and adjacent lung tissue. Results One hundred seven patients were included, 55 in the P/PC group and 52 in the RA/PC group. RR for RA/PC was 55.8% (95% CI, 46.6% to 64.9%) and for P/PC, 25.4% (95% CI, 21.3 to 29.5%; P = .001). The RA/PC group had a longer median PFS (8.9 v 6.0 months; P = .008). Multivariate analysis of PFS showed significant differences for the RA/PC group (hazard ratio, 0.62; 95% CI, 0.4 to 0.95). No significant differences in toxicity grade 3/4 were found between groups, except for hypertriglyceridemia (10% v 0%) in RA/PC (P = .05). Immunohistochemistry and reverse-transcriptase polymerase chain reaction assays showed expression of RAR-β2 in normal tissues of all tumor samples, but only 10% of samples in the tumor tissue. Conclusion Adding ATRA to chemotherapy could increase RR and PFS in patients with advanced NSCLC with an acceptable toxicity profile. A phase III clinical trial is warranted to confirm these findings.
Effect of Body Mass Index on Recurrences in Tamoxifen and Anastrozole Treated Women: An Exploratory Analysis From the ATAC Trial
Authors: Sestak Ivana , Distler Wolfgang , Forbes John F. , Dowsett Mitch , Howell Anthony , Cuzick Jack 
Published: June 2010

Purpose Third-generation aromatase inhibitors have been widely used in postmenopausal women for the adjuvant treatment of hormone receptor–positive breast cancer. As aromatase inhibitors work by inhibiting the conversion of androgens to estrogens in adipose tissue, we hypothesized that anastrozole may be more effective in women with a high body mass index (BMI). Patients and Methods The Arimidex, Tamoxifen Alone or in Combination (ATAC) study was a double-blind randomized clinical trial in which postmenopausal women with early-stage breast cancer were randomly assigned to receive oral daily anastrozole (1 mg) alone, tamoxifen (20 mg) alone, or the combination in a double-blind fashion. Analyses were based on the 100-month median follow-up for women with hormone receptor–positive breast cancers (estrogen [ER] and/or progesterone [PgR] positive). Here, we investigate the impact of BMI on recurrence and the relative benefit of anastrozole versus tamoxifen according to baseline BMI. Results Overall, women with a high BMI (BMI > 35 kg/m2) at baseline had more recurrences than those women with a low BMI (BMI < 23 kg/m2; adjusted hazard ratio [HR], 1.39; 95% CI, 1.06 to 1.82; Pheterogeneity = .03) and significantly more distant recurrences (adjusted HR, 1.46; 95% CI, 1.07 to 1.61; Pheterogeneity = .01). Overall, the relative benefit of anastrozole versus tamoxifen was nonsignificantly better in thin women compared to overweight women. Conclusion These results confirm the poorer prognosis of obese women with early-stage breast cancer. Recurrence rates were lower for anastrozole than tamoxifen for all BMI quintiles. Our results suggest that the relative efficacy of anastrozole compared to tamoxifen is greater in thin postmenopausal women and higher doses or more complete inhibitors might be more effective in overweight women, but this requires independent confirmation.
Are Mastectomy Rates Really Increasing in the United States?
Authors: Habermann Elizabeth B. , Abbott Andrea , Parsons Helen M. , Virnig Beth A. , Al-Refaie Waddah B. , Tuttle Todd M. 
Published: June 2010

Purpose After the National Institutes of Health Consensus Statement in 1990, breast-conserving surgery (BCS) became more common while mastectomy rates decreased. However, several recently published single-institution studies have reported an increase in mastectomy rates in the past decade. We conducted a population-based study to evaluate national trends in the surgical treatment of breast cancer from 2000 through 2006. Patients and Methods Using the Surveillance, Epidemiology, and End Results database, we conducted a retrospective cohort analysis of women undergoing surgical treatment for breast cancer. We evaluated variation in mastectomy rates by demographic and tumor factors and calculated differences in mastectomy rates across time. We utilized logistic regression to identify time trends and patient and tumor factors associated with mastectomy, testing for significance using two-sided methods. Results We identified 233,754 patients diagnosed with ductal carcinoma in situ or stage I to III unilateral breast cancer from 2000 to 2006. The proportion of women treated with mastectomy decreased from 40.8% in 2000 to 37.0% in 2006 (P < .001). These patterns were maintained across patient and tumor factors. Although the unilateral mastectomy rate decreased during the study period, the contralateral prophylactic mastectomy rate increased. Women were less likely to receive mastectomy over time (odds ratio, 1.18 for 2000 v 2006; 95% CI, 1.14 to 1.23; P < .0001), after adjusting for patient and tumor factors. Conclusion In contrast to single-institution studies, our population-based analysis found a decrease in unilateral mastectomy rates from 2000 to 2006 in the United States. Variations in referral patterns and patient selection are potential explanations for these differences between single institutions and national trends.
Autopsy Findings in Eight Patients With Fatal H1N1 Influenza
Authors: Harms Paul W. , Schmidt Lindsay A. , Smith Lauren B. , Newton Duane W. , Pletneva Maria A. , Walters Laura L. , Tomlins Scott A. , Fisher-Hubbard Amanda , Napolitano Lena M. , Park Pauline K. , Blaivas Mila , Fantone Joseph , Myers Jeffrey L. , Jentzen Jeffrey M. 
Published: June 2010

Abstract
A novel H1N1 influenza A virus emerged in April 2009, and rapidly reached pandemic proportions. We report a retrospective observational case study of pathologic findings in 8 patients with fatal novel H1N1 infection at the University of Michigan Health Systems (Ann Arbor) compared with 8 age-, sex-, body mass index–, and treatment-matched control subjects. Diffuse alveolar damage (DAD) in acute and organizing phases affected all patients with influenza and was accompanied by acute bronchopneumonia in 6 patients. Organizing DAD with established fibrosis was present in 1 patient with preexisting granulomatous lung disease. Only 50% of control subjects had DAD. Peripheral pulmonary vascular thrombosis occurred in 5 of 8 patients with influenza and 3 of 8 control subjects. Cytophagocytosis was seen in all influenza-related cases. The autopsy findings in our patients with novel H1N1 influenza resemble other influenza virus infections with the exception of prominent thrombosis and hemophagocytosis. The possibility of hemophagocytic syndrome should be investigated in severely ill patients with H1N1 infection.
The Sensitivity and Specificity of p16INK4a Cytology vs HPV Testing for Detecting High-Grade Cervical Disease in the Triage of ASC-US and LSIL Pap Cytology Results
Authors: Denton Karin J. , Bergeron Christine , Klement Petra , Trunk Marcus J. , Keller Thomas , Ridder Ruediger 
Published: June 2010

AbstractWe analyzed the performance of p16INK4a immunocytochemistry on a series of 810 retrospectively collected atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL) cases with available biopsy follow-up data, including 94 cases of cervical intraepithelial neoplasia (CIN) 2 and 128 cases of CIN 3. Human papillomavirus (HPV) testing was performed from the same residual liquid-based cytologic specimen, and results for both tests were correlated with histologic follow-up data. Sensitivity values for high-grade CIN (HGCIN) confirmed on biopsy within 6 months were 92.6% (ASC-US) and 92.2% (LSIL) for cytotechnologists’ reviews of p16 cytology and 90.1% (ASC-US) and 95.7% (LSIL) for HPV testing. Sensitivity rates of initial pathologists’ reviews were slightly lower, 76.4% to 80.1%, with levels comparable to cytotechnologists’ results after adjudication. The specificity of p16 cytology for HGCIN detection was significantly higher than for HPV testing for cytotechnologists and pathologists: 63.2% to 71.1% (p16 cytology) vs 37.8% for HPV in ASC-US (P &lt; .001) and 37.3% to 53.3% (p16 cytology) vs 18.5% for HPV in LSIL (P &lt; .001). This evaluation of the diagnostic performance of p16 cytology confirms the potential of this stain for the efficient triage of ASC-US and LSIL cytologic results.
Comparative Examination of Androgen Receptor Reactivity for Differential Diagnosis of Sebaceous Carcinoma From Squamous Cell and Basal Cell Carcinoma
Authors: Asadi-Amoli Fahimeh , Khoshnevis Farid , Haeri Hayedeh , Jahanzad Issa , Pazira Reza , Shahsiah Reza 
Published: June 2010

Abstract
Sebaceous carcinoma (SEB) is the most important malignant tumor of the eyelid. Early diagnosis and proper treatment significantly improve the outcome. SEB should be differentiated histopathologically from basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
In this study, the expression of androgen receptor (AR) in SEB, SCC, and BCC was evaluated. AR was positive in all 19 SEB cases. Of 18 BCCs, 6 (33%) showed focal nuclear immunoreactivity. The 18 SCCs showed no nuclear immunoreactivity.
AR is a sensitive marker for SEB, especially in less differentiated tumors. Along with other markers and morphologic features, AR can be helpful in the diagnosis of SEB and its differentiation from SCC and BCC.
Immunophenotypic Variations of Burkitt Lymphoma
Authors: Kelemen Katalin , Braziel Rita M. , Gatter Ken , Bakke Tony C. , Olson Susan , Fan Guang 
Published: June 2010

Abstract
Burkitt lymphoma (BL) exhibits a characteristic immunophenotype that is positive for pan–B-cell antigens and CD10 and expresses clonal surface immunoglobulins (SIgs). We evaluated 35 BLs and identified atypical immunophenotypes in 4 including SIg light chain negativity in 4, negativity for B-cell antigens in 2, lack of CD10 in 1, and CD4 expression in 1. All 4 cases showed morphologic features characteristic of BL, and all were confirmed by cytogenetic analysis. The 4 BL cases included 1 girl, 2 men with HIV/AIDS, and a third man with a history of heart transplantation. Two patients died shortly after diagnosis; the other 2 completed hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone with highly active antiretroviral therapy and achieved complete remission. Our study indicates that an unusual immunophenotype is not uncommon in BL. If the immunophenotype is interpreted in isolation, the diagnosis could be missed. Recognizing the variability of immunophenotype is essential for establishing an accurate diagnosis of BL.
Array Comparative Genomic Hybridization of Peripheral Blood Granulocytes of Patients With Myelodysplastic Syndrome Detects Karyotypic Abnormalities
Authors: Vercauteren Suzanne M. , Sung Sandy , Starczynowski Daniel T. , Lam Wan L. , Bruyere Helene , Horsman Douglas E. , Tsang Peter , Leitch Heather , Karsan Aly 
Published: June 2010

Abstract
The diagnosis of myelodysplastic syndromes (MDSs) relies largely on morphologic and karyotypic abnormalities, present in about 50% of patients with MDS. Array-based genomic platforms have identified copy number alterations in 50% to 70% of bone marrow samples of patients with MDS with a normal karyotype, suggesting a diagnostic role for these platforms. We investigated whether blood granulocytes harbor the same copy number alterations as the marrow of affected patients. Of 11 patients, 4 had cytogenetic abnormalities shown by conventional karyotyping involving chromosomes 5, 8, 11, 20, and X, and these changes were seen in the granulocytes of all 4 patients by using array comparative genomic hybridization (aCGH). Cryptic alterations were identified at a significantly higher level in marrow CD34+ cells compared with granulocytes (P &lt; .0001). These data suggest that aCGH analysis of circulating granulocytes may be useful in detecting gross karyotypic alterations in patients with MDS when marrow examination has failed or not been done.
Laboratory-Diagnosed Sexually Transmitted Infections in Former Foster Youth Compared With Peers
Authors: Ahrens Kym R. , Richardson Laura P. , Courtney Mark E. , McCarty Carolyn , Simoni Jane , Katon Wayne 
Published: June 2010

OBJECTIVES:The objective of this study was to evaluate the association between having resided in foster care and risk for sexually transmitted infection (STI) during young adulthood.METHODS:Multiple regression analyses were performed by using Waves I to III of the National Longitudinal Study of Adolescent Health (1994–2002) to evaluate the association between foster care status and STI biomarkers and risk behaviors. Female (N = 7563) and male participants (N = 6759) were evaluated separately. Covariates in all models included baseline age, race, ethnicity, parental education level, parental income level, and average neighborhood household income level.RESULTS:Female participants who had been in foster care were more likely to have Trichomonas (odds ratio [OR]: 3.23 [95% confidence interval (CI): 1.45–7.23) but not gonorrhea or chlamydia and reported increased sexual risk behaviors compared with nonfostered peers. Male participants who had been in foster care were more likely to have both gonorrhea (OR: 14.28 [95% CI: 2.07–98.28]) and chlamydia (OR: 3.07 [95% CI: 1.36–6.96]) but not Trichomonas and did not report a higher risk for most sexual risk behaviors than nonfostered peers.CONCLUSIONS:Results suggest that individuals who have been in foster care are at increased risk for STIs during young adulthood. The pattern of exposure may differ between male and female individuals. If findings are confirmed, they suggest that health care providers who work with these youth should adjust their STI screening practices. Child welfare agencies should also consider targeted interventions to reduce STI risk in this population.
Childhood Cancer Survivors: Transition to Adult-Focused Risk-Based Care
Authors: Henderson Tara O. , Friedman Debra L. , Meadows Anna T. 
Published: June 2010

BACKGROUND:The issues involved in transition from pediatric cancer care to adult-focused care differ from those in other childhood diseases, because malignant disease itself is no longer a problem. However, the potential for fatal outcome places a greater dependence on the pediatric oncology setting and delays this transition process, often beyond adolescence. Adverse long-term physical and psychological effects accompany survival for many of the cured children, and because these effects may not become manifest until adulthood, programs that support transition for childhood cancer survivors require the expertise of many subspecialists.OBJECTIVES:To describe the issues and barriers to successful transition programs for childhood cancer survivors when they are ready for adult-focused care.METHODS:We reviewed the literature and discuss the barriers to transition at the survivor, provider, and health care system levels for survivors of childhood cancer. We also critically assess the elements of successful transition programs.RESULTS:Education of survivors and providers regarding long-term health risks is necessary for a successful transition. This process should be gradual to address the educational needs of survivors, families, and health care professionals, determine “readiness” for transition, and address financial and insurance concerns. Because little is known regarding adverse long-term health-related sequelae beyond the fourth decade of life, research is needed to quantify and reduce the consequences of these morbidities.CONCLUSIONS:Transition programs for pediatric cancer survivors require experts who are knowledgeable regarding the long-term follow-up needs of childhood cancer survivors and who can provide a bridge between pediatric oncology and primary care that is risk based.
Use of Respiratory Syncytial Virus Surveillance Data to Optimize the Timing of Immunoprophylaxis
Authors: Panozzo Catherine A. , Stockman Lauren J. , Curns Aaron T. , Anderson Larry J. 
Published: June 2010

OBJECTIVE:
For children in the United States who are at high risk for severe respiratory syncytial virus (RSV) infection, the American Academy of Pediatrics (AAP) recommends administering immunoprophylaxis during the RSV season. We present an approach to using surveillance data to help guide application of AAP recommendations for immunoprophylaxis to local patterns of RSV outbreaks.

METHODS:
We analyzed data from laboratories that report consistently to the National Respiratory and Enteric Virus Surveillance System from 1992 to 2007. Local RSV seasons were defined and an immunoprophylaxis schedule was determined by using the median onset dates from each laboratory during 2002–2007. We applied these dates to 10 preceding years of RSV detection data. We compared how well the 5-year median-based method and a fixed date method were able to match the timing of immunoprophylaxis to the RSV season.

RESULTS:
Nineteen laboratories met our inclusion criteria and generally experienced only 1 RSV outbreak per season. Five years of data gave similar median onset/offset dates and season duration, as did 10 years and 15 years of data. The 5-year median schedule increased the number of seasons that children were protected at the season onset by 15% compared with a fixed start date of November 1 and identified communities that experienced RSV seasons with extended durations.

CONCLUSIONS:
The 5-year median method can be used to characterize timing of RSV seasons and optimally apply the current AAP recommendations for timing of palivizumab prophylaxis to the local community.