bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integration of Routine Rapid HIV Screening in an Urban Family Planning Clinic
Authors: Criniti Shannon M. , Aaron Erika , Hilley Amy , Wolf Sandra 
Published: November 2011

Introduction: Family planning centers can play an important role in HIV screening, education, and risk‐reduction counseling for women who are sexually active. This article describes how 1 urban Title X–funded family planning clinic transitioned from using a designated HIV counselor for targeted testing to a model that uses clinic staff to provide integrated, routine, nontargeted, rapid HIV testing as standard of care. Methods: Representative clinic staff members developed an integrated testing model that would work within the existing clinic flow. Education sessions were provided to all staff, signs promoting routine HIV testing were posted, and patient and clinician information materials were developed. A review of HIV testing documentation in medical charts was performed after the new model of routine, nontargeted, rapid HIV testing was integrated, to determine any changes in patient testing rates. A survey was given to all staff members 6 months after the transition to full integration of HIV testing to evaluate the systems change process. Results: Two years after the transition, the rate of patients with an HIV test in the medical chart within the last 12 months increased 25.5%. The testing acceptance rate increased 17%. Sixteen HIV seropositive individuals were identified and linked into medical care. All surveyed clinic staff agreed that offering routine HIV screening to all patients is very important, and 78% rated the integration efforts as successful. Discussion: Integrating routine HIV screening into a family planning clinic can be critical to identifying new HIV infections in women. This initiative demonstrated that routine, nontargeted, rapid HIV screening can be offered successfully as a standard of care in a high‐volume, urban, reproductive health care setting. This description and evaluation of the process of changing the model of HIV testing in a clinic setting is useful for clinicians who are interested in expanding routine HIV testing in their clinics.
Postpartum Depression and Correlated Factors in Women Who Received In Vitro Fertilization Treatment
Authors: Lee Shu‐Hsin , Liu Lin‐Chuan , Kuo Pi‐Chao , Lee Maw‐Sheng 
Published: November 2011

Introduction: Postpartum depression is a significant mental health problem that occurs more frequently in the first 4 weeks postpartum and also may occur later during the first postpartum year. Women who receive in vitro fertilization (IVF) treatment have a particular perinatal experience that may create postpartum mental health concerns. The purpose of this cross‐sectional study was to evaluate factors associated with postpartum depression in women who received IVF treatment. Methods: Sixty of 71 eligible postpartum women who were treated at an infertility treatment center and who conceived by IVF were included in this study, which used a self‐administered, structured questionnaire. Results: The prevalence of postpartum depression was 25%, including mild (16.7%), moderate (6.7%), and severe (1.7%). Pearson correlation analysis showed that the frequency of receiving IVF treatment and perceived stress were positively correlated with postpartum depression, whereas family function and social support were negatively correlated with postpartum depression. Multiple regression analysis showed that the frequency of receiving IVF treatment, birth method, and social support were significant predictive factors for postpartum depression when covariates were controlled (R2 56.6%). Discussion: A higher frequency of IVF treatment, cesarean birth, and inadequate social support increase the possibility of postpartum depression, and clinicians should provide appropriate anticipatory education or counseling.
Postpartum Care: Evaluation and Experience Among Care Providers and Care Receivers
Authors: Valbø Annelill , Iversen Hilde Hestad , Kristoffersen Marit 
Published: November 2011

Introduction: There have been substantial alterations in the structure of postpartum care over the last several decades. Our aim was to investigate the perceived quality of, and satisfaction with, postpartum care among caregivers and care receivers in the maternity ward of a community hospital in Norway with about 2600 births per year. Methods: We conducted a cohort study of women giving birth and the caregiving staff in the maternity ward during a 7‐month period. A questionnaire, with a Cronbach α coefficient above 0.8, was filled in anonymously, both by the staff in the ward and by the women. The questionnaire explored the respondents’ evaluations of the information offered by the staff; the teaching of skills in child care and establishment of breastfeeding; assistance with practical tasks like making beds, serving meals, and keeping order in the room; visiting rules; level of noise in the ward; whether the pediatric service was adequate; length of the stay; and to what extent caregivers were able to respond to the individual needs of the mothers. Finally, the questionnaire explored the degree of kindliness communicated by the staff. Five extra questions in the women's questionnaire explored their personal experiences in the ward. Results: The care receivers’ evaluations of the maternity ward did not differ significantly from that of the caregivers in questions related to overall care and service. However, the mothers rated the importance of assistance with child care during the night significantly higher than did the staff. Responses to questions addressing noise in the ward demonstrated a higher tolerance among the mothers compared with the staff. In addition, mothers tended (but not a statistically significant result) to rate the quality of the teaching of child‐care skills lower, compared with the staff's ratings. Discussion: By exploring both the caregivers’ and care receivers’ evaluations and expectations of the actual services in the maternity ward, areas for enhancement of the quality of the ward and its services can be detected and carried out. The present study revealed 2 areas needing further focus: assistance with child care during the night and teaching of child‐care skills during the stay. We believe that investigations that collect data from both caregivers and care receivers, by using adapted and validated questionnaires to gather information on quality and satisfaction with the maternity ward, are mandatory for improvement and continuous adaptation of health services.
Australian Midwives’ Knowledge of Antenatal and Postpartum Depression: A National Survey
Authors: Jones Cindy J. , Creedy Debra K. , Gamble Jenny A. 
Published: November 2011

Introduction: Emotional care provided by midwives may improve health and well‐being; reduce stress, trauma, and depressive symptoms; and enhance maternal outcomes in childbearing women. The provision of intrapartum and postpartum emotional care can be challenging and requires a good knowledge base for the provider to screen and assist distressed women. This study assessed Australian midwives’ levels of knowledge and learning needs regarding antenatal depression and postpartum depression. Methods: Eight hundred and fifteen members of the Australian College of Midwives completed a postal survey, which consisted of 20 items drawn from the literature and the National Baseline Survey—Health Professional Knowledge Questionnaire. Results: On average, respondents correctly answered 62.9% of items related to antenatal depression and 70.7% of questions about postpartum depression. Many midwives were unable to identify the risk factors (70.6%) or prevalence of antenatal depression (49.6%). Nearly all (98.3%) respondents underestimated the percentage of antenatally depressed women that attempts suicide. Significant percentages of midwives did not correctly identify the incidence (44.4%), onset period (71%), and treatment options (32%) associated with postpartum depression. About half did not understand the use of antidepressant medications (48.6%) and incorrectly reported that the Edinburgh Postnatal Depression Scale was a suitable instrument to assess symptoms of psychotic depression (43.8%). Discussion: There are key knowledge deficits relating to onset of, assessment of, and treatment for depressive symptoms during the antenatal and postpartum periods. There is a need for continuing professional education to improve midwives’ knowledge and competency in the assessment and care of women suffering depression.
Knowledge of Human Papillomavirus Among Publicly and Privately Insured Women
Authors: Kennedy Sara , Osgood Rebekah , Rosenbloom Laura , Feinglass Joseph , Simon Melissa 
Published: November 2011

Introduction: The purpose of this study was to identify characteristics associated with high and low levels of human papillomavirus (HPV) knowledge among women presenting for HPV vaccination.Methods: Surveys were administered to women presenting for HPV vaccination at 2 distinct clinics: a private obstetrics and gynecology office with predominantly privately insured patients and a resident clinic with primarily Medicaid‐insured patients. Nine outcome measures were collected in addition to open‐ended response questions regarding motivation for vaccination.Results: Forty‐six women were recruited from the resident clinic, and 39 women were recruited from the private clinic. Knowledge scores differed significantly between the 2 recruitment sites: mean score of 19.7 at the resident clinic compared to a mean score of 24.9 at the private clinic (P < .0001, power = 80%). After controlling for age, zip code poverty prevalence, educational attainment, and parental educational attainment, clinical site was no longer independently associated with knowledge score. Rather, having attended at least 1 year of college was the only measured item independently associated with a higher HPV knowledge score. Reported condom use, having a regular sexual partner, history of an abnormal Papanicolaou (Pap) test, and having received a Pap test within the previous year were not independently associated with knowledge scores. Themes for motivation to vaccinate include protection from cervical cancer and prevention of HPV infection.Discussion: Knowledge of HPV among women presenting for vaccination was significantly associated with educational attainment of some college. Common themes of low knowledge include the viral etiology of cervical cancer, the clinical presentation of HPV infection, and the lack of complete protection against cervical cancer with the HPV vaccine.
Trends in Midwife‐Attended Births, 1989 to 2007
Authors: Declercq Eugene 
Published: November 2011

Introduction: Rates of births attended by certified nurse‐midwives (CNMs) rose throughout the 1990s and into the early part of this century, when rates leveled at about 7%. Methods: The data in this report are based on records gathered as part of the US National Standard Certificate of Live Birth from the public use Web site, VitalStats, that allows users to create and download specialized tables. Results: For the first time since such data were available in 1989, births attended by CNMs declined from the previous year in absolute terms, as a proportion of all births, and as a proportion of vaginal births. After an all‐time high of 317,168 in 2006, CNM‐attended births declined marginally to 316,811 in 2007. With total births reaching a US record of 4,316,233 births, the CNM proportion of total births declined for the fifth straight year to 7.3%, the same proportion as in 1999. Births attended by “other midwives” rose substantially to 23,943 although some of that increase may be the result of misclassification of CNM births in some states into the other midwife category. Discussion: The proportion of CNM births has remained steady at between 7.3% and 7.6% since 1999. However, when the number of births attended by CNMs is combined with the number attended by other midwives, their number reached an all‐time high in 2007.
Examining the Content Validity of the Birthing Unit Design Spatial Evaluation Tool Within a Woman‐Centered Framework
Authors: Sheehy Annabel , Foureur Maralyn , Catling‐Paull Christine , Homer Caroline 
Published: November 2011

Introduction: The environment for birth influences women in labor. Optimal birthing environments have the potential to facilitate normal labor and birth. The measurement of optimal birth units is currently not possible because there are no tools. An audit tool, the Birth Unit Design Spatial Evaluation Tool (BUDSET), was developed to assess the optimality of birthing environments. The BUDSET is based on 4 domains (fear cascade, facility, aesthetics, support), each comprising design principles that are further differentiated into specific assessable design items. In the process of developing measurement tools, content validity must be established. The aim of this study was to establish the content validity of the BUDSET from the perspective of women and midwives.Methods: This was a mixed‐methods study with a survey assessing agreement with BUDSET items and in‐depth interviews. Survey results were analyzed using an item‐level content validity index and a survey‐level validity index. Interview data were analyzed using a directed content analysis approach. The study was conducted in 2 locations—a major maternity hospital and a midwifery research center, both in Australia. Study participants were 10 women and 2 midwifery academics.Results: The survey revealed that content‐related validity varied according to the BUDSET domain, with the domains of facility and support established as content valid by most participants. The domains of the fear cascade and aesthetic were less strong, particularly among pregnant women. Interview data analysis provided content validity evidence of both the fear cascade and aesthetic domains. A further 4 subthemes of fear cascade also were identified: foreign space, medical‐hospital‐emergency, being sterile/clinical, and protecting the woman from the environment. Content validity evidence for facility and support domains also was established.Discussion: This study has established that the BUDSET is content valid for assessing the optimality of birthing environments. Some further refinement of the tool is now possible.
Phenoloxidase: a key component of the insect immune system
Authors: González‐Santoyo Isaac , Córdoba‐Aguilar Alex 
Published: November 2011

AbstractThe innate immune system in insects is composed of a large variety of specific and non‐specific responses that are activated in response to the presence of foreign agents. One important element in such responses is the enzyme phenoloxidase (PO). Here, we review recent progress in PO research and discuss new applications in the emerging field of ecological immunology. Phenoloxidase produces indole groups, which are subsequently polymerized to melanin. The enzymatic reactions in turn produce a set of intermediate products such as quinones, diphenols, superoxide, hydrogen peroxide, and reactive nitrogen intermediates, which are important during defense against bacterial (gram+ and −), fungal, and viral agents. Phenoloxidase requires a complex system of activation and inhibition that involves various cell types, PO zymogens, inhibitor enzymes, and signaling molecules. Finally, research in evolutionary ecology has studied the costs of PO in terms of resource use and pleiotropic relations with other key traits and functions. These studies indicate that PO is a costly trait, whose production and maintenance have fitness costs for hosts. Phenoloxidase does not seem to be an indicator of resistance but rather of host condition. Finally, we put forward some basic directions for future investigation of PO aimed at explaining its activating system, its substrates, its coordination with other immune components to fight off pathogens, and variation in PO in relation to gender, life stages, seasonality, and across different host species.
How important are tariffs and nontariff barriers in international markets for fresh fruit?
Authors: Rickard Bradley J. , Lei Lei 
Published: November 2011

AbstractInternational markets for agricultural products are often subject to a range of trade barriers, and horticultural products are no exception. This article examines the economic implications of tariffs and sanitary and phytosanitary (SPS) regulations that are applied to global markets for fresh apples and fresh oranges. We calculate regional‐level tariff rates and ad valorem equivalents for SPS barriers following the price‐wedge approach. A simulation model is developed and used to assess the price, quantity, and welfare implications of reducing tariffs, removing SPS barriers, and removing SPS barriers that have been identified as a Specific Trade Concern (STC) by the World Trade Organization. Results suggest that a 36% reduction in global tariffs would lead to greater welfare gains than would the elimination of SPS measures in apple markets. However, in orange markets, we find that SPS measures have much larger economic implications for producers and consumers. Here, a 36% reduction in tariffs would lead to smaller overall welfare effects compared to removal of all SPS measures, and only slightly larger effects than those from removal of STCs alone.
Nontraditional crops, traditional constraints: The long‐term welfare impacts of export crop adoption among Guatemalan smallholders
Authors: Carletto Calogero , Kilic Talip , Kirk Angeli 
Published: November 2011

AbstractThis article documents the long‐term welfare effects of household nontraditional agricultural export (NTX) adoption. We use a panel dataset that spans the period 1985–2005, and employ difference‐in‐differences estimation to investigate the long‐term impact of nontraditional agricultural export adoption on changes in household consumption status and asset position in the Central Highlands of Guatemala. Given the heterogeneity in adoption patterns, the analysis differentiates the impact estimates based on a classification of households that takes into account the timing and duration of nontraditional agricultural export adoption. The results show that while, on average, welfare levels have improved for all households irrespective of adoption status and duration, the extent of improvement has varied across groups. Long‐term adopters exhibit the smallest increase in the lapse of two decades, in spite of some early gains. Conversely, early adopters who withdrew from nontraditional agricultural export production after reaping the benefits of the boom period of the 1980s are found to have fared better and shown greater improvements in durable asset position and housing conditions than any other category.
Osseointegration – communication of cells
Authors: Terheyden Hendrik , Lang Niklaus P. , Bierbaum Susanne , Stadlinger Bernd 
Published: November 2011

AbstractBackgroundThe article provides the scientific documentation for the 3D animated film – “Osseointegration – Communication of cells”.AimThe aim of this article and of the film is to visualise the molecular and cellular events during the healing of an osseous wound after installation of a dental implant with special emphasis on the process of osseointegration.Material and ResultsIn this review article for didactic reasons the concept of the four phases of a healing soft tissue wound was transferred to a bone wound after insertion of a dental implant: haemostasis, inflammatory phase, proliferative phase and remodelling phase. Wound healing throughout these phases is the result of a coordinated action of different cell types which communicate with each other by their interaction using signalling molecules like cytokines, extracellular matrix proteins and small molecules. A regular sequence of cell types controlled by adequate concentrations of signalling molecules results in undisturbed healing. Disturbed healing is associated with a continuation of the early inflammatory phase and the development of a toxic wound environment. The latter is characterized by high counts of polymorphnuclear cells, high concentrations of toxic radicals and proteolytic enzymes and low concentrations of growth factors and extracellular matrix molecules. Clinically the development of a toxic wound environment should be avoided, e.g. by antibacterial measures.Discussion and ConclusionExperiencing implant osseointegration as a biological process may provide the clinician new targets to improve the therapy with dental implants.
Novel protein identification methods for biomarker discovery via a proteomic analysis of periodontally healthy and diseased gingival crevicular fluid samples
Authors: Baliban Richard C. , Sakellari Dimitra , Li Zukui , DiMaggio Peter A. , Garcia Benjamin A. , Floudas Christodoulos A. 
Published: November 2011

AbstractAimTo identify possible novel biomarkers in gingival crevicular fluid (GCF) samples from chronic periodontitis (CP) and periodontally healthy individuals using high‐throughput proteomic analysis.Materials and MethodsGingival crevicular fluid samples were collected from 12 CP and 12 periodontally healthy subjects. Samples were trypically digested with trypsin, eluted using high‐performance liquid chromatography, and fragmented using tandem mass spectrometry (MS/MS). MS/MS spectra were analysed using PILOT_PROTEIN to identify all unmodified proteins within the samples.ResultsUsing the database derived from Homo sapiens taxonomy and all bacterial taxonomies, 432 human (120 new) and 30 bacterial proteins were identified. The human proteins, angiotensinogen, clusterin and thymidine phosphorylase were identified as biomarker candidates based on their high‐scoring only in samples from periodontal health. Similarly, neutrophil defensin‐1, carbonic anhydrase‐1 and elongation factor‐1 gamma were associated with CP. Candidate bacterial biomarkers include 33 kDa chaperonin, iron uptake protein A2 and phosphoenolpyruvate carboxylase (health‐associated) and ribulose biphosphate carboxylase, a probable succinyl‐CoA:3‐ketoacid‐coenzyme A transferase, or DNA‐directed RNA polymerase subunit beta (CP‐associated). Most of these human and bacterial proteins have not been previously evaluated as biomarkers of periodontal conditions and require further investigation.ConclusionsThe proposed methods for large‐scale comprehensive proteomic analysis may lead to the identification of novel biomarkers of periodontal health or disease.
First results from the multicentre study Rehabilitation of Occupational Skin Diseases – Optimization and Quality Assurance of Inpatient Management (ROQ)
Authors: Skudlik Christoph , Weisshaar Elke , Scheidt Reginald , Elsner Peter , Wulfhorst Britta , Schönfeld Michael , John Swen Malte , Diepgen Thomas Ludwig ,   for the ROQ Study Group
Published: November 2011

Background and objectives. The German stepwise procedure of handling occupational skin diseases (OSDs) offers interdisciplinary integrated (inpatient/outpatient) rehabilitation measures [tertiary individual prevention (TIP)] for severe OSD. In 2005, a prospective cohort multicentre study was started in order to evaluate TIP.Methods. One thousand seven hundred and eighty‐eight patients with severe OSD were treated and educated in five clinics with follow‐up before and 4 weeks after return to work.Results. During the inpatient phase, there was a significant improvement in the severity of OSD (Osnabrueck Hand Eczema Severity Index, p < 0.001) and in the quality of life (Dermatology Life Quality Index, p < 0.001). These effects were largely sustained during the outpatient follow‐up phase and in the 4 weeks after return to work. Among all patients, 89.4% used topical steroids before TIP, including 52.5% using high‐grade topical steroids; 93.2% of the patients were able to refrain from using topical steroids before returning to work. As a result of TIP, return to work was possible for 1587 patients (88.8%).Conclusions. The primary objectives of TIP (return to work, improvement of OSD, enhancement of quality of life, and reduction in the use of topical steroids) were successfully met. The long‐term follow‐up (1 and 3 years after TIP) will examine whether these favourable outcomes can be sustained.