bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cow’s milk and ovalbumin‐specific IgG and IgA in children with eczema: low β‐lactoglobulin‐specific IgG4 levels are associated with cow’s milk allergy
Authors: Savilahti Emma M. , Viljanen Mirva , Kuitunen Mikael , Savilahti Erkki 
Published: March 2012

To cite this article: Savilahti EM, Viljanen M, Kuitunen M, Savilahti E. Cow’s milk and ovalbumin‐specific IgG and IgA in children with eczema: low β‐lactoglobulin‐specific IgG4 levels are associated with cow’s milk allergy. Pediatric Allergy Immunology 2012: 23: 590–596.AbstractTolerance to allergens may partly depend on allergen‐specific IgG and IgG subclasses and IgA antibodies. We investigated whether specific IgG and IgG subclasses and IgA antibodies to β‐lactoglobulin, α‐casein, and ovalbumin differed between infants who had verified cow’s milk allergy (CMA) and infants with cow’s milk (CM)‐associated eczema, but negative CM oral challenge. The study population comprised 95 infants with clinical eczema that was by history associated with the consumption of CM. After an elimination period, a double‐blind, placebo‐controlled (DBPC) CM oral challenge confirmed CMA in 45 infants. Skin prick tests (SPT) were performed with CM and hen’s egg. Serum levels of IgE antibodies to CM and hen’s egg were measured with UniCAP (Phadia, Uppsala, Sweden), and levels of IgA, IgG, IgG1, and IgG4 antibodies to β‐lactoglobulin, α‐casein, and ovalbumin were measured with enzyme‐linked immunosorbent assay. We observed that infants with CMA had lower IgG4 levels to β‐lactoglobulin than infants with negative DBPC CM challenge (p = 0.004). Positive CM SPT was associated with lower IgG4 levels to α‐casein (p = 0.04). The relation of CM IgE to β‐lactoglobulin and α‐casein IgG4 was higher in CMA than in infants with negative challenge (p < 0.002 and 0.0001). Positive egg SPT was associated with elevated levels of specific IgG to ovalbumin, β‐lactoglobulin, and α‐casein as well as IgA to α‐casein (p < 0.04). Our study thus shows that low β‐lactoglobulin‐specific serum IgG4 levels may differentiate eczematous infants with CMA from infants who have eczema with only suspected association with CM.
Effect of lactose on gut microbiota and metabolome of infants with cow’s milk allergy
Authors: Francavilla Ruggiero , Calasso Maria , Calace Laura , Siragusa Sonya , Ndagijimana Maurice , Vernocchi Pamela , Brunetti Luigia , Mancino Giuseppe , Tedeschi Giuseppe , Guerzoni Elisabetta , Indrio Flavia , Laghi Luca , Miniello Vito L. , Gobbetti Marco , De Angelis Maria 
Published: March 2012

To cite this article: Francavilla R, Calasso M, Calace L, Siragusa S, Ndagijimana M, Vernocchi P, Brunetti L, Mancino G, Tedeschi G, Guerzoni E, Indrio F, Laghi L, Miniello VL, Gobbetti M, De Angelis M. Effect of lactose on gut microbiota and metabolome of infants with cow’s milk allergy. Pediatric Allergy Immunology 2012: 23: 420–427.AbstractAllergic infants have an unusual gastrointestinal microbiota with low numbers of Bifidobacterium/Lactobacilli and high levels of Clostridium, staphylococci and Escherichia coli. Hydrolyzed formula used to treat these infants is deprived of lactose that instead may influence the gut microbial composition. The aim of the present study is to investigate the influence of lactose on the composition of the gut microbiota and metabolome of infants with cow’s milk allergy. Infants prospectively enrolled received an extensively hydrolyzed formula with no lactose for 2 months followed by an identical lactose‐containing formula for an additional 2 months. Healthy, age‐gender‐matched infants were used as controls. The following determinations were performed before and after the introduction of lactose in the diet: enumeration of cells present in the feces using FISH, counts of viable bacterial cells and gas‐chromatography mass spectrometry/solid‐phase microextraction analysis. The addition of lactose to the diet significantly increases the counts of Bifidobacteria and lactic acid bacteria (p < 0.01), decreases that of Bacteroides/clostridia (p < 0.05) reaching counts found in healthy controls; lactose significantly increases the concentration of total short‐chain fatty acids (p < 0.05). The addition of lactose to an extensively hydrolyzed formula is able to positively modulate the composition of gut microbiota by increasing the total fecal counts of Lactobacillus/Bifidobacteria and decreasing that of Bacteroides/Clostridia. The positive effect is completed by the increase of median concentration of short chain fatty acids, especially for acetic and butyric acids demonstrated by the metabolomic analysis.
Do clinical pathways enhance access to evidence‐based acute myocardial infarction treatment in rural emergency departments?
Authors: Kinsman Leigh D. , Rotter Thomas , Willis Jon , Snow Pamela C. , Buykx Penny , Humphreys John S. 
Published: March 2012

AbstractObjective:  The objective of this study is to measure the impact of a five‐step implementation process for an acute myocardial infarction (AMI) clinical pathway (CPW) on thrombolytic administration in rural emergency departments.Design:  Cluster randomised controlled trial.Setting:  Six rural Victorian emergency departments participated.Intervention:  The five‐step CPW implementation process comprised (i) engaging clinicians; (ii) CPW development; (iii) reminders; (iv) education; and (v) audit and feedback.Main outcome measures:  The impact of the intervention was assessed by measuring the proportion of eligible AMI patients receiving a thrombolytic and time to thrombolysis and electrocardiogram.Results:  Nine hundred and fifteen medical records were audited, producing a final sample of 108 patients eligible for thrombolysis. There was no significant difference between intervention and control groups for median door‐to‐needle time (29 mins versus 29 mins; P = 0.632), proportion of those eligible receiving a thrombolytic (78% versus 84%; P = 0.739), median time to electrocardiogram (7 mins versus 6 mins; P = 0.669) and other outcome measures. Results showed superior outcome measures than other published studies.Conclusions:  The lack of impact of the implementation process for a chest pain CPW on thrombolytic delivery or time to electrocardiogram in these rural hospitals can be explained by a ceiling effect in outcome measures but was also compromised by the small sample. Results suggest that quality of AMI treatment in rural emergency departments (EDs) is high and does not contribute to the worse mortality rate reported for AMIs in rural areas.
Differences between patients' expectations and satisfaction with nursing care in a private hospital in Jordan
Authors: Abdel Maqsood Amal Samir , Oweis Arwa I , Hasna Fadia Shawqi 
Published: March 2012

Abdel Maqsood AS, Oweis AI, Hasna FS. International Journal of Nursing Practice 2012; 18: 140–146Differences between patients' expectations and satisfaction with nursing care in a private hospital in JordanA descriptive correlation study was conducted to describe the differences between patient expectations and satisfaction with nursing care, and to determine the relationships among patient's satisfaction with nursing care and selected sociodemographic variables. A convenience sample of 250 patients with different medical, surgical and gynaecologic diagnoses was recruited to participate in the study, which was carried out at a private hospital in Amman. Two research instruments and a sociodemographic data form were used for data collection: The Patient Expectations Questionnaire and Patient Satisfaction with Nursing Care Quality Questionnaire. The results indicated that patients were more satisfied with technical and ethical aspects of nursing care whereas they were less satisfied with nursing care during the night shift as well as with professional information provided by the nurses. The difference between patients' expectations and satisfaction was statistically significant. Patients' opinions regarding their expectations and their satisfaction with nursing care can be considered as an important opportunity for nurses to plan and implement appropriate strategies that improve the quality of nursing care.
Which is the best method to estimate the actual ureteral length in patients undergoing ureteral stent placement?
Authors: Kawahara Takashi , Ito Hiroki , Terao Hideyuki , Yoshida Minoru , Ogawa Takehiko , Uemura Hiroji , Kubota Yoshinobu , Matsuzaki Junichi 
Published: March 2012

Objectives:  To define the best modality for estimating ureteral length in patients undergoing ureteral stent placement.Methods:  This study enrolled 151 patients (169 ureters) undergoing stent insertion. In all of them, an intravenous urography and non‐contrast computed tomography were carried out. The actual ureteral length was determined by direct measurement using a 5‐Fr ureteral catheter. A multivariate analysis evaluated the association between the ureteral length and each of the following parameters: body height, body surface area, ureteral trace by intravenous urography, linear distance (liner distance 1) from the ureteropelvic junction to the ureterovesical junction by intravenous urography, linear distance (liner distance 2) from the mid kidney to the ureterovesical junction by intravenous urography, and the distance from the level of the renal vein to the ureterovesical junction by axial computed tomography (axial computed tomography distance).Results:  The mean actual ureteral length was 23.2 cm (median 24 cm, range 16–29 cm). The Spearman correlation coefficients for body height, body surface area, ureteral trace, liner distance 1, liner distance 2 and axial computed tomography distance were 0.3126, 0.3076, 0.4541, 0.5230, 0.4796 and 0.6168, respectively. Axial computed tomography distance showed the best correlation with the actual ureteral length.Conclusion:  The axial computed tomography distance as calculated by the axial computed tomography can more reliably predict the actual ureteral length than other parameters. Further studies are required to show the best method for estimating the actual ureteral length in patients undergoing ureteral stent placement.
Suppressive effect of pregnant serum on murine dendritic cell function
Authors: Bozorgmehr Mahmood , Zarnani Amir Hassan , Nikoo Shohreh , Moazzeni Seyed Mohammad 
Published: March 2012

AbstractAim:  Tolerance to the semi‐allogenic fetal graft by the maternal immune system is a medical enigma. Many aspects of immunoregulation at the feto–maternal interface have been clarified, but systemic effects of pregnancy on the immune system are still elusive. The present study was undertaken to determine whether mid‐pregnancy mouse serum has an inhibitory effect on dendritic cells (DC) function.Material and Methods:  Mid‐gestational sera were obtained from allogenic pregnant Balb/c mice (Balb/c × C57BL/6) on days 9–11 of gestation. Splenic DC were purified from Balb/c mice, and treated with mid‐pregnancy mouse serum. Antigen pulsed DC were injected into mice palms. After 5 days, draining lymph nodes were removed, cultured in the presence of cognate antigen, and proliferation of responding cells was measured by 3H‐thymidin incorporation. Interleukin (IL)‐10 and interferon‐gamma (IFN‐γ) production by stimulated lymph node antigen‐specific cells was also measured in culture supernatants using sandwich ELISA.Results:  Treatment of DC with pregnant mouse serum markedly blocked their ability to induce antigen‐specific lymphocyte proliferation and IFN‐γ and IL‐10 production by primed lymph node cells in comparison with non‐pregnant serum‐treated DC.Conclusion:  Pregnant mouse serum has an inhibitory effect on DC capacity to induce antigen‐specific proliferation and cytokine secretion by lymph node cells. The suppressive effects of pregnant serum on DC could be considered as one of the mechanisms responsible for the systemic immunomodulation observed during pregnancy.
Factors affecting medical and nursing staff reporting of child abuse
Authors: Ben Natan M. , Faour C. , Naamhah S. , Grinberg K. , Klein‐Kremer A. 
Published: March 2012

BEN NATAN M., FAOUR C., NAAMHAH S., GRINBERG K. & KLEIN‐KREMER A. (2012) Factors affecting medical and nursing staff reporting of child abuse. International Nursing Review59, 331–337Aim:  The purpose of the current research was to examine whether the theory of planned behaviour (TPB) succeeds in predicting nursing and medical staff reporting of suspected child abuse.Background:  Despite the rising incidence of child abuse in Israel, medical and nursing staff reports of suspected child abuse remain low.Methods:  This descriptive, correlational, cross‐sectional study was based on TPB. The Child Abuse Report Intention Scale questionnaire was administered to 143 nurses and 42 doctors who work with children in various departments of a central Israeli hospital and in a large affiliated community‐based clinic. Descriptive, correlational and linear regression statistics were calculated.Results:  Objection to child abuse, views of professional responsibility on this issue, degree of self‐control and subjective beliefs, affect reporting of suspected child abuse. Differences in reporting are evident between doctors and nurses and also between medical and nursing staff from the Arab and Jewish sectors. Doctors report more than nurses and Jewish staff members report more than their Arab colleagues. Medical and nursing staff's number of own children has a direct effect on their inclination to report child abuse.Conclusions:  The TPB model succeeds in partly predicting medical and nursing staff reporting of suspected child abuse. This model can serve as a basis for intervention plans aimed at developing medical and nursing simulations of coping with conflict issues involving child abuse in an attempt to eradicate and treat inadequate reporting.
Substance use and sexual risk behaviour among HIV‐positive men who have sex with men in specialized out‐patient clinics
Authors: Dirks H , Esser S , Borgmann R , Wolter M , Fischer E , Potthoff A , Jablonka R , Schadendorf D , Brockmeyer N , Scherbaum N 
Published: March 2012

ObjectivesUnprotected sexual intercourse between men who have sex with men (MSM) is the most common route of HIV infection in Germany. Approximately 70% of newly infected people are MSM. Substance use is a determinant of sexual risk behaviour in the general population, but also in the MSM subpopulation. There are only a few studies, from the USA, on the correlation between substance use and sexual risk behaviour in HIV‐infected MSM in specialized care.MethodsIn a German sample of 445 HIV‐infected MSM treated in specialized out‐patient clinics, the influence of substance use on sexual risk behaviour was investigated. Information was obtained from subjects using self‐report questionnaires and a structured interview.ResultsRecreational drug use was common. The prevalences of cannabis addiction (4.5%), harmful use of cannabis (4.3%) and harmful use of dissociative anaesthetics (0.4%) were higher than in the general German male population. A substantial proportion of patients reported unprotected insertive (32.9%) and receptive (34.6%) anal intercourse during the last 12 months. Use of cannabis, amyl nitrite, dissociative anaesthetics, cocaine, amphetamines and erectile dysfunction medication was significantly correlated with unprotected sexual contacts. Substance use in the context of sexual activity significantly increased sexual risk behaviour.ConclusionsSubstance use, especially in the context of sexual activity, should be taken into account when developing new prevention and intervention programmes aimed at reducing sexual risk behaviour in HIV‐infected MSM currently in specialized care.
Estimation of International Migration in Post‐Soviet Republics
Authors: Makaryan Shushanik 
Published: March 2012

AbstractWhen annual migration data lack reliability, scholars apply alternative methods for estimating international migration. Yet, researchers note that alternative approaches have primarily been tested on developed countries, rather than developing countries that usually have dramatic migration shifts. I close this research gap. I use the example of 15 former Soviet republics to demonstrate several conclusions. First, I show that such alternative approaches as immigration‐by‐origin data of receiving countries do not result in reliable and valid estimates of post‐Soviet migration, given the large variation that exists in how former Soviet republics define “migrant”. Second, I demonstrate that population censuses, while a more superior alternative, fail to capture temporary migrants. In developing countries, the international emigration is mainly due to temporary (undocumented labour) migration. Third, I suggest that scholars and policy‐makers should apply household surveys as a possible alternative. However, while this method seems promising, given the limited use of household surveys in migration measurement in the post‐Soviet republics, future research by both scholars and applied researchers should explore the advantages and limitations of household surveys as an alternative source for estimation of migration. Finally, I outline methodological guidelines that researchers and scholars can advance on migration issues in the post‐Soviet region.
An examination of materialism, conspicuous consumption and gender differences
Authors: Segal Brenda , Podoshen Jeffrey S. 
Published: March 2012

AbstractThis paper examines gender differences in terms of materialism, conspicuous consumption, brand loyalty and impulse buying. We build our hypotheses based on both existing marketing and consumption literature with an additional integration of historical and gender studies literature in order to further augment the study of materialism and its related variables. Our study used survey data from 1180 Americans living in four northeastern states. Results show that significant differences between the genders were found in terms of materialism, conspicuous consumption and impulse buying. No significant difference was found in terms of brand loyalty.
Use of Kiosks and Patient Understanding of Opt‐out and Opt‐in Consent for Routine Rapid Human Immunodeficiency Virus Screening in the Emergency Department
Authors: Haukoos Jason S. , Hopkins Emily , Bender Brooke , Al‐Tayyib Alia , Long Jeremy , Harvey Jeffrey , Irby Jessica , Bakes Katherine ,   for the Denver Emergency Department HIV Testing Research Consortium
Published: March 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:287–293 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  The objective was to evaluate patient acceptance and understanding of nontargeted opt‐out and opt‐in rapid human immunodeficiency virus (HIV) screening using computerized kiosks in the emergency department (ED).Methods:  This study was a prospective quasi‐experiment in an urban hospital with an annual ED and urgent care census of 120,000 visits. During medical screening, patients 13 years and older were offered rapid HIV screening using kiosks and opt‐out consent (October 2009) or opt‐in consent (December 2009). Random time blocks were used to administer structured surveys to evaluate patient understanding of the testing process.Results:  During the opt‐out phase, 6,602 were offered testing, and of these 3,993 (61%) did not opt‐out and 886 (13%) completed screening. During the opt‐in phase, 5,781 were offered testing, and of these 930 (16%) opted‐in and 389 (7%) completed screening (absolute difference = 6%, 95% confidence interval [CI] = 5% to 8%). During the opt‐out phase, 330 patients completed the survey. Of these, 201 (61%) did not opt‐out, but 108 (54%, 95% CI = 47% to 61%) responded that they had not been informed about an HIV test. Of the 84 patients who had been informed, 32 (38%, 95% CI = 28% to 49%) responded that they had not agreed to an HIV test. During the opt‐in phase, 416 completed the survey. Of these, 80 (19%) agreed to testing and two (3%, 95% CI = 0.3% to 9%) responded that they had not been informed about an HIV test. Of the 74 patients who had been informed, only two (3%, 95% CI = 0.3% to 9%) responded that they had not agreed to an HIV test.Conclusions:  Computerized kiosks can be successfully used to perform nontargeted rapid HIV screening in EDs. However, when using this approach, patient understanding of opt‐in consent is significantly better than opt‐out consent.
Optimizing Clinical Operations as Part of a Global Emergency Medicine Initiative in Kumasi, Ghana: Application of Lean Manufacturing Principals to Low‐resource Health Systems
Authors: Carter Patrick M. , Desmond Jeffery S. , Akanbobnaab Christopher , Oteng Rockefeller A. , Rominski Sarah D. , Barsan William G. , Cunningham Rebecca M. 
Published: March 2012

AbstractBackground:  Although many global health programs focus on providing clinical care or medical education, improving clinical operations can have a significant effect on patient care delivery, especially in developing health systems without high‐level operations management. Lean manufacturing techniques have been effective in decreasing emergency department (ED) length of stay, patient waiting times, numbers of patients leaving without being seen, and door‐to‐balloon times for ST‐elevation myocardial infarction in developed health systems, but use of Lean in low to middle income countries with developing emergency medicine (EM) systems has not been well characterized.Objectives:  To describe the application of Lean manufacturing techniques to improve clinical operations at Komfo Anokye Teaching Hospital (KATH) in Ghana and to identify key lessons learned to aid future global EM initiatives.Methods:  A 3‐week Lean improvement program focused on the hospital admissions process at KATH was completed by a 14‐person team in six stages: problem definition, scope of project planning, value stream mapping, root cause analysis, future state planning, and implementation planning.Results:  The authors identified eight lessons learned during our use of Lean to optimize the operations of an ED in a global health setting: 1) the Lean process aided in building a partnership with Ghanaian colleagues; 2) obtaining and maintaining senior institutional support is necessary and challenging; 3) addressing power differences among the team to obtain feedback from all team members is critical to successful Lean analysis; 4) choosing a manageable initial project is critical to influence long‐term Lean use in a new environment; 5) data intensive Lean tools can be adapted and are effective in a less resourced health system; 6) several Lean tools focused on team problem‐solving techniques worked well in a low‐resource system without modification; 7) using Lean highlighted that important changes do not require an influx of resources; and 8) despite different levels of resources, root causes of system inefficiencies are often similar across health care systems, but require unique solutions appropriate to the clinical setting.Conclusions:  Lean manufacturing techniques can be successfully adapted for use in developing health systems. Lessons learned from this Lean project will aid future introduction of advanced operations management techniques in low‐ to middle‐income countries.