bluuebunny/crossref_metadata_2025_split huggingface dataset:
The economic and clinical benefits of adequate insulin initiation and intensification in people with type 2 diabetes mellitus
Authors: Asche C. V. , Bode B. , Busk A. K. , Nair S. R. 
Published: August 2011

Aim: To study the clinical and economic benefits associated with adequate and early initiation and intensification of insulin in people with type 2 diabetes mellitus (T2DM).Methods: A systematic review was performed using published articles from January 2000 to August 2010 that linked intervention, disease, study design and outcomes. Studies were further classified as initiation and intensification based on predefined criteria. Individual studies in systematic reviews and meta‐analysis were searched and included if relevant.Results: A total of 2690 articles were screened with 76 (40 initiation and 36 intensification) studies included. Most initiation studies had mean baseline HbA1c values of >8.5%. The endpoint HbA1c values were reduced with insulin treatment in these studies, with endpoint values ranging from 6.6 to 9.8%. Similar results were seen with the intensification studies (endpoint HbA1c: 6.4–9.6%). Addition of insulin to oral antidiabetics (OADs) resulted in better glycaemic control in most studies. Blood glucose levels reduced substantially with OADs + insulin compared with OADs alone. Quality of life outcomes and treatment satisfaction were reported in six studies and not significantly different for insulin vs. OADs. Hypoglycaemic events were manageable with insulin initiation. However, all insulin types were associated with weight gain although the comparison with OADs elicited varying results.Conclusions: Proactive management with early insulin initiation and intensification should be considered in people with T2DM in inadequate glycaemic control. The economic benefits with early initiation and intensification have to be fully explored.
Oestrogen alters adipocyte biology and protects female mice from adipocyte inflammation and insulin resistance
Authors: Stubbins R. E. , Najjar K. , Holcomb V. B. , Hong J. , Núñez N. P. 
Published: August 2011

Aims: Obesity is associated with insulin resistance, liver steatosis and low‐grade inflammation. The role of oestrogen in sex differences in the above co‐morbidities is not fully understood. Our aim was to assess the role oestrogen has in modulating adipocyte size, adipose tissue oxidative stress, inflammation, insulin resistance and liver steatosis.Methods: To determine the role oestrogen has in the above co‐morbidities related to obesity, we randomized C57BL/6J mice into four groups (15 mice per group): (i) male, (ii) non‐ovariectomized female (novx), (iii) ovariectomized female (ovx) and (iv) ovariectomized female mice supplemented with 17β estradiol (ovx‐E). Mice received either a low‐fat (LF) or a high‐fat (HF) diet for 10 weeks. Outcomes measured were bodyweight, body fat, adipocyte diameter, adipose tissue lipolysis markers, adipose tissue oxidative stress, inflammation, insulin resistance and liver steatosis.Results: Male and ovx‐female mice consuming the HF diet had a higher propensity of gaining weight, specifically in the form of body fat. Oestrogen protected female mice from adipocyte hypertrophy and from developing adipose tissue oxidative stress and inflammation. Moreover, novx‐female and ovx‐female+E mice had higher phosphorylated levels of protein kinase A and hormone sensitive lipase, markers associated with lipolysis. Additionally, male and ovx female mice had a higher propensity of developing liver steatosis and insulin resistance. In contrast, oestrogen protected female mice from developing liver steatosis and from becoming insulin resistant.Conclusion: We show that oestrogen protects female mice from adipocyte hypertrophy and adipose tissue oxidative stress and inflammation. Furthermore, oestrogen prevented female mice from developing liver steatosis and from becoming insulin resistant.
Commissioning specialist diabetes services for adults with diabetes: summary of a Diabetes UK Task and Finish Group report
Authors: Goenka N. , Turner B. , Vora J. ,   on behalf of the Diabetes UK Task and Finish group
Published: August 2011

Diabet. Med. 28, 1494–1500 (2011)AbstractThe increasing prevalence of diabetes, the drive to develop community services for diabetes and the Quality and Outcomes Framework for diabetes have led to improvements in the management of diabetes in primary care settings, with services traditionally provided only in specialist care now provided for many patients with diabetes by non‐specialists. Consequently, there is a need to redefine roles, responsibilities and components of a specialist diabetes service to provide for the needs of patients in the National Health Service (NHS) today. The delivery of diabetes care is complex and touches on almost every aspect of the health service. It is the responsibility of those working within commissioning and specialist provider roles to work together with people with diabetes to develop, organize and deliver a full range of integrated diabetes care services. The local delivery model agreed within the local diabetes network, comprising specialist teams, primary care teams, commissioners and people with diabetes, should determine how the diabetes specialist services are organizsed. It should identify the roles and responsibilities of provider organizations to ensure that the right person provides the right care, at the right time, and in the right place. We summarize a report entitled ‘Commissioning Diabetes Specialist Services for Adults with Diabetes’, which has been produced, as a ‘Task and Finish’ group activity within Diabetes UK, to assist managers, commissioners and healthcare professionals to provide advice on the structure, roles and components of specialist diabetes services for adults.
Establishing an evidence base for frequency of monitoring glycated haemoglobin levels in patients with Type 2 diabetes: projections of effectiveness from a regression model
Authors: Oke J. L. , Stevens R. J. , Gaitskell K. , Farmer A. J. 
Published: August 2011

Diabet. Med. 29, 266–271 (2012)AbstractAims  Glycated haemoglobin (HbA1c) is monitored to guide treatment decisions in relation to glycaemic goals over time. Changes between two consecutive HbA1c tests result not only from deterioration or improvement in glycaemic control, but also from biovariability and measurement error. We model how this short‐term variability impacts on HbA1c monitoring.Methods  Using data from a randomized trial of non‐insulin treated patients with Type 2 diabetes we fitted a random‐effects model for progression and variability of HbA1c. We estimated how many tests where HbA1c ≥ 7.5% (58.5 mmol/mol) would be false‐positive (underlying HbA1c < 7.5% but test ≥ 7.5% owing to variability) vs. true‐positive, in people with initial HbA1c between 6.5% and 7.3% (48 mmol/mol and 56 mmol/mol).Results  Participants (n = 320) had mean (SD) age 66 (10) years, BMI 31.3 (6.0) kg/m2 and median HbA1c was 7.1% (54 mmol/mol) with interquartile range 6.6% (49 mmol/mol) to 7.7% (61 mmol/mol). Mean (95% CI) change in HbA1c was 0.1% (1 mmol/mol) with 95% confidence interval 0.05% (0.5 mmol/mol) to 0.15% (2 mmol/mol) per 6 months. The minimum interval at which a true‐positive test is more likely than a false positive test is 270 days for a starting HbA1c of 6.9% (52 mmol/mol) and 360 days at a starting value of 6.5% (48 mmol/mol).Conclusion  In patients with initial HbA1c close to treatment goal, retesting at 6 months would yield more true‐positive than false‐positive tests. For patients with lower initial HbA1c, retesting at 6 months would yield more false than true‐positive tests. In all patients, retesting at 12 months yields more true than false‐positive tests. In very few patients would retesting at 3 months be justified.
Factors associated with delayed hospital arrival among patients with acute myocardial infarction: a cross‐sectional study in Greece
Authors: Brokalaki H. , Giakoumidakis K. , Fotos N.V. , Galanis P. , Patelarou E. , Siamaga E. , Elefsiniotis I.S. 
Published: August 2011

BROKALAKI H., GIAKOUMIDAKIS K., FOTOS N.V., GALANIS P., PATELAROU E., SIAMAGA E. & ELEFSINIOTIS I.S. (2011) Factors associated with delayed hospital arrival among patients with acute myocardial infarction: a cross‐sectional study in Greece. International Nursing Review58, 470–476Background:  It is proven that early admission to hospital contributes significantly to the successful management of acute myocardial infarction (AMI).Aim:  This study aimed to examine the factors associated with delayed hospital arrival among patients with AMI.Methods:  A cross‐sectional study among 477 AMI patients was conducted during a 2‐year period in two large tertiary hospitals in Greece. Structured face‐to‐face interviews were conducted and information regarding their socio‐demographic characteristics, medical history and factors that might be correlated with delayed hospital arrival were collected.Results:  The main factors that were found to be correlated with delayed hospital arrival among AMI patients were the absence of companion/attendant/escort present during the AMI [odds ratio (OR) 2.1, 95% confidence interval (CI) 0.98–4.4, P = 0.049], previous medical history of diabetes mellitus (OR 3.4, CI 1.6–7.2, P = 0.002), absence of dyspepsia (OR 9.2, CI 3.6–23.3, P < 0.001) and nausea/vomiting symptoms (OR 16.9, CI 4.1–69.1, P < 0.001), and also being at a distance of more than 10 km from the hospital (OR 19.6, CI 5.4–70.6, P < 0.001).Conclusion:  A number of factors that might delay hospital arrival among patients with AMI should be taken into account in healthcare service planning. Health policy actions that will improve the accessibility to healthcare services, the restructuring of the Greek primary healthcare system and the provision of effective patient education by nurses could reduce the pre‐hospital delay.Limitations:  The study was conducted in two hospitals which limits the generalization of the findings. Also, the onset of AMI symptoms relied on self‐report by the patients.
Factors influencing midwifery migration from the United Kingdom to Australia
Authors: Sidebotham M. , Ahern K. 
Published: August 2011

SIDEBOTHAM M. & AHERN K. (2011) Factors influencing midwifery migration from the United Kingdom to Australia. International Nursing Review58, 498–504Background:  Within the current literature on the globalization of the healthcare workforce, it is difficult to separate the migration experience of nurses from that of midwives. As more countries are moving to offer direct entry educational programmes and provide separate registration for midwives, information specific to that professional group will be required to guide workforce planners and inform employment practice. This qualitative study tracks the migration experience of midwives moving between the UK and Australia.Methods:  A purposeful sample of 18 midwives who had migrated from the UK to one state in Australia was interviewed within a descriptive phenomenological framework. Data were analysed using thematic coding within Nvivo (QSR International, Melbourne, Australia).Results:  The strongest motivator for migration was to improve the family's lifestyle. Push factors included disillusionment with working conditions, standard of living in the UK and national politics. The majority of midwives had organized their own entry visa and employment. Most midwives had occupied senior positions in the UK but accepted employment initially within entry‐level positions in Australia.Discussion:  Despite both countries offering similar standards of living, the majority of midwives expected to achieve an improvement in family lifestyle in Australia. Midwives indicated they were prepared to lose professional status and seniority of position to gain a better overall lifestyle for their family. To examine the long‐term sustainability of international recruitment processes, further research is indicated to examine the ongoing experience and integration of migrant midwives into the workforce in Australia.
Help‐seeking behaviours in childbearing women in Ghana, West Africa
Authors: Farnes C. , Beckstrand R.L. , Callister L.C. 
Published: August 2011

FARNES C., BECKSTRAND R.L. & CALLISTER L.C. (2011) Help‐seeking behaviours in childbearing women in Ghana, West Africa. International Nursing Review58, 491–497Aim:  The purpose of this ethnographic study was to examine the health‐seeking behaviours of Ghanaian childbearing women.Background:  The Ashanti consider pregnancy to be a vulnerable time when risk increases that women may be affected by witchcraft and develop sunsumyare. Preparation for positive birth outcomes include biomedical, ethnomedical and faith‐based interventions.Design:  A sample of 42 childbearing Ghanaian women participated in audiotaped interviews. Transcribed interviews were coded and categorized into themes.Findings and discussion:  The overriding theme was health seeking to ensure positive pregnancy outcomes. Subthemes included accessing multiple sources of care simultaneously, feeling vulnerable to spiritual illness, seeking spiritual protection and disclosing multiple sources of care.Conclusion:  Childbearing is an essential part of the gender identity of Ashanti women. Witchcraft mentality provides a way for a woman to manage her life challenges.Implications for practice:  Cultural beliefs and practices have profound effects on health‐seeking behaviours. It is becoming increasingly important that healthcare providers perform cultural and spiritual assessments and inquire about complementary sources of health care.
A study on the decontamination of insoles colonized by Trichophyton rubrum: effect of terbinafine spray powder 1% and terbinafine spray solution 1%
Authors: Feuilhade de Chauvin M. 
Published: August 2011

AbstractBackground  Shoes worn with bare feet function as a fungal reservoir and lead to persistent dermatophytosis.Objective  This study was designed to evaluate two formulations of terbinafine (1% spray powder or solution) to treat the insoles of shoes colonized by skin scales infected with Trichophyton rubrum and to determine the contact time necessary to achieve decontamination.Methods  Infected skin scales weighing 0.5 g, taken from the feet of patients with confirmed T. rubrum infection, was dispersed onto insoles pre‐moistened with sterile saline solution (to mimic perspiration). Three types of insole were tested (felt, latex, leather). After inoculation, insoles were placed separately in new cardboard boxes at ambient temperature, and re‐humidified with sterile normal saline solution for 48 h before being treated; untreated insoles served as controls. Scales were scraped off at 48 h or 96 h, and dropped into tubes of Sabouraud agar, incubated at 27°C and examined at 3 and 6 weeks.Results  Cultures from all control insoles showed numerous T. rubrum colonies. In contrast, cultures from all insoles treated with a single application of terbinafine 1% spray solution or powder, and taken after 48 h or 96 h contact with the product, remained sterile at 3 weeks and 6 weeks.Conclusion  This study demonstrated the successful treatment of insoles colonized by T. rubrum‐infected skin scales. Terbinafine 1% spray solution and powder showed good efficacy; the dermatophyte could no longer be cultured 48 h after a single application of terbinafine.
An exploration of community learning disability nurses’ therapeutic role
Authors: Marsham Marian 
Published: August 2011

Accessible summary
Community Learning Disability Nurses were asked to talk about how they felt they had helped people in their care feel better.
They talked about helping as a positive approach to problems, making the most of existing help, understanding what it means to have a Learning Disability, using time and communication, and teaching and learning.
This is important because it can help people to understand the needs of people with learning disability and what help Community Learning Disabilities Nurses give.
SummaryThis literature review and primary qualitative research explores therapeutic role from the perspective of Community Learning Disability Nurses. Semi‐structured interviews, based on Critical Incident Technique (Psychol Bull, 51, 1954, 327), and descriptive phenomenological methodology were adopted to elicit data amenable to systematic content analysis (Mayring 2000). This resulted in the identification of six inductive categories (therapeutic optimism, maximising support networks, time as a therapeutic tool, creative communication, understanding Learning Disability and initiating learning). Three deducted categories were derived from relevant literature (nature of the events, outcomes of therapeutic role, and therapeutic relationship). The sample consisted of seven practicing Community Learning Disability Nurses with two or more years experience managing an adult caseload, recruited via a professional networking forum. A conceptual model was developed indicating the multicomponent and interconnected nature of the therapeutic role.
Astrocytes treated by lysophosphatidic acid induce axonal outgrowth of cortical progenitors through extracellular matrix protein and epidermal growth factor signaling pathway
Authors: de Sampaio e Spohr Tania Cristina Leite , Dezonne Rômulo Sperduto , Rehen Stevens Kastrup , Gomes Flávia Carvalho Alcantara 
Published: August 2011

J. Neurochem. (2011) 119, 113–123.AbstractLysophosphatidic acid (LPA) plays important roles in many biological processes, such as brain development, oncogenesis and immune functions, via its specific receptors. We previously demonstrated that LPA‐primed astrocytes induce neuronal commitment of cerebral cortical progenitors (Spohr et al. 2008). In the present study, we analyzed neurite outgrowth induced by LPA‐treated astrocytes and the molecular mechanism underlying this event. LPA‐primed astrocytes increase neuronal differentiation, arborization and neurite outgrowth of developing cortical neurons. Treatment of astrocytes with epidermal growth factor (EGF) ligands yielded similar results, suggesting that members of the EGF family might mediate LPA‐induced neuritogenesis. Furthermore, treatment of astrocytes with LPA or EGF ligands led to an increase in the levels of the extracellular matrix molecule, laminin (LN), thus enhancing astrocyte permissiveness to neurite outgrowth. This event was reversed by pharmacological inhibitors of the MAPK signaling pathway and of the EGF receptor. Our data reveal an important role of astrocytes and EGF receptor ligands pathway as mediators of bioactive lipids action in brain development, and implicate the LN and MAPK pathway in this process.
Dynamic monitoring of beating periodicity of stem cell‐derived cardiomyocytes as a predictive tool for preclinical safety assessment
Authors: Abassi Yama A , Xi Biao , Li Nan , Ouyang Wei , Seiler Alexander , Watzele Manfred , Kettenhofen Ralf , Bohlen Heribert , Ehlich Andreas , Kolossov Eugen , Wang Xiaobo , Xu Xiao 
Published: August 2011

BACKGROUND AND PURPOSE Cardiac toxicity is a major concern in drug development and it is imperative that clinical candidates are thoroughly tested for adverse effects earlier in the drug discovery process. In this report, we investigate the utility of an impedance‐based microelectronic detection system in conjunction with mouse embryonic stem cell‐derived cardiomyocytes for assessment of compound risk in the drug discovery process.EXPERIMENTAL APPROACH Beating of cardiomyocytes was measured by a recently developed microelectronic‐based system using impedance readouts. We used mouse stem cell‐derived cardiomyocytes to obtain dose‐response profiles for over 60 compounds, including ion channel modulators, chronotropic/ionotropic agents, hERG trafficking inhibitors and drugs known to induce Torsades de Pointes arrhythmias.KEY RESULTS This system sensitively and quantitatively detected effects of modulators of cardiac function, including some compounds missed by electrophysiology. Pro‐arrhythmic compounds produced characteristic profiles reflecting arrhythmia, which can be used for identification of other pro‐arrhythmic compounds. The time series data can be used to identify compounds that induce arrhythmia by complex mechanisms such as inhibition of hERG channels trafficking. Furthermore, the time resolution allows for assessment of compounds that simultaneously affect both beating and viability of cardiomyocytes.CONCLUSIONS AND IMPLICATIONS Microelectronic monitoring of stem cell‐derived cardiomyocyte beating provides a high throughput, quantitative and predictive assay system that can be used for assessment of cardiac liability earlier in the drug discovery process. The convergence of stem cell technology with microelectronic monitoring should facilitate cardiac safety assessment.
TASK1 (K2P3.1) K+ channel inhibition by endothelin‐1 is mediated through Rho kinase‐dependent phosphorylation
Authors: Seyler C , Duthil‐Straub E , Zitron E , Gierten J , Scholz EP , Fink RHA , Karle CA , Becker R , Katus HA , Thomas D 
Published: August 2011

BACKGROUND AND PURPOSE TASK1 (K2P3.1) two‐pore‐domain K+ channels contribute substantially to the resting membrane potential in human pulmonary artery smooth muscle cells (hPASMC), modulating vascular tone and diameter. The endothelin‐1 (ET‐1) pathway mediates vasoconstriction and is an established target of pulmonary arterial hypertension (PAH) therapy. ET‐1‐mediated inhibition of TASK1 currents in hPASMC is implicated in the pathophysiology of PAH. This study was designed to elucidate molecular mechanisms underlying inhibition of TASK1 channels by ET‐1.EXPERIMENTAL APPROACH Two‐electrode voltage clamp and whole‐cell patch clamp electrophysiology was used to record TASK1 currents from hPASMC and Xenopus oocytes.KEY RESULTS ET‐1 inhibited TASK1‐mediated IKN currents in hPASMC, an effect attenuated by Rho kinase inhibition with Y‐27632. In Xenopus oocytes, TASK1 current reduction by ET‐1 was mediated by endothelin receptors ETA (IC50= 0.08 nM) and ETB (IC50= 0.23 nM) via Rho kinase signalling. TASK1 channels contain two putative Rho kinase phosphorylation sites, Ser336 and Ser393. Mutation of Ser393 rendered TASK1 channels insensitive to ETA‐ or ETB‐mediated current inhibition. In contrast, removal of Ser336 selectively attenuated ETA‐dependent TASK1 regulation without affecting the ETB pathway.CONCLUSIONS AND IMPLICATIONS ET‐1 regulated vascular TASK1 currents through ETA and ETB receptors mediated by downstream activation of Rho kinase and direct channel phosphorylation. The Rho kinase pathway in PASMC may provide a more specific therapeutic target in pulmonary arterial hypertension treatment.