bluuebunny/crossref_metadata_2025_split huggingface dataset:
Life is back to normal and yet not – partners’ and patient’s experiences of life of the first year after colorectal cancer surgery
Authors: Ohlsson‐Nevo Emma , Andershed Birgitta , Nilsson Ulrica , Anderzén‐Carlsson Agneta 
Published: September 2011

Aim.  To describe the experience of life the first year after surgery from the perspective of persons treated for colorectal cancer and their partners.Background.  Colorectal cancer is a common cancer form, and treatment can cause unpleasant side effects such as sexual dysfunction and bowel problems. Partners struggle to keep family life normal and provide support. Little is known about couples’ experiences a year after treatment for colorectal cancer.Design.  Qualitative descriptive.Methods.  Individual semi‐structured interviews with 13 persons treated for colorectal cancer and their partners, a total of 26 participants.Results.  One theme was identified in the study; ‘Life is back to normal and yet not’: participants described living a normal but different life than before. Three subthemes were identified; ‘Life has a shadow of death’, ‘The treated body sets the rules’ and ‘To share or not share the illness’.Conclusions.  Findings showed that both the patients’ and their partners’ lives were influenced by uncertainty and the condition of the patient. Attitudes varied towards sharing the illness. It was found that information needs varied both within and between couples. A future challenge to healthcare personnel is the obligation to meet the needs of both patients and their partners on the illness trajectory and recovery after treatment for colorectal cancer.Relevance to clinical practice.  Findings enhance the understanding of the impact of colorectal cancer on both patients and partners. Healthcare personnel need to assess both the patient’s and partner’s need for information, support and assistance. Support groups could be an effective tool for providing information, communication and support. Future studies are needed to evaluate such groups.
Female nurses’ sensitivity to male genitalia‐related care in mainland China
Authors: Zang Yu‐Li , Chung Loretta YF , Wong Thomas KS , Chan Moon Fai 
Published: September 2011

Aims. To discover the latent psychosocial construct of female nurses’ sensitivity to male genitalia‐related care in the context of sexual conservativeness.Background. Many nursing activities involve direct exposure or contact with male external genitalia. In the sexually conservative culture and the predominance of female nurses, this area is the subject of continuing interest and investigation.Design. Methodological research design.Methods. An item pool related to male genitalia‐related care was generated through a panel of experts and then reduced to a short form questionnaire, the Female Nurses’ Sensitivity to Male Genitalia Related Care scale. Using data from a purposive sample of 588 female nurses, the structure of the questionnaire was examined using structural equation modelling. The validity was examined against existing scales.Results. The 13‐item Female Nurses’ Sensitivity to Male Genitalia Related Care scale has a two‐factor structure with high internal consistency (α = 0·87) and test–retest reliability of 0·90. Nearly all model fit measures reach the criteria of being an acceptable model fit except chi‐squared statistics. Scores on Female Nurses’ Sensitivity to Male Genitalia Related Care can be best predicted by that of brief Fear of Negative Evaluation Scale, Embarrassability Scale and Situational Susceptibility to Embarrassment Scale.Conclusions. The anxiety of projecting a positive image and the pursuit of sexual propriety may underpin female nurses’ sensitivity to male genitalia‐related care. This trait can be measured by the 13‐item female nurses’ sensitivity‐male genitalia‐related care scale with satisfactory psychometric properties including internal consistency, reliability, content validity and construct validity.Relevance to clinical practice. Particular attention shall be paid to the negative effects of social rules or norms including sexual propriety rules over (female) nurses’ perceptions, attitudes and behaviours. Strengthening nursing education in this regard is important to overcome negative effects on female nurses of male genitalia‐related care.
Comparison of tools for the assessment of inappropriate prescribing in hospitalized older people
Authors: Luo Ruoyin , Scullin Claire , Mullan Andrea M. P. , Scott Michael G. , McElnay James C. 
Published: September 2011

AbstractRational, aims and objective  The aim of the present study was to compare the ease of use and the capability of four approaches [Medication Appropriateness Index (MAI), the Beers' criteria 2003, the Improved Prescribing in the Elderly Tool (IPET) and Health Plan Employer Data and Information Set (HEDIS)] in assessing changes in medication appropriateness in elderly patients over a period of hospitalization.Methods  A retrospective observational study in two hospitals in Northern Ireland using the four measures was undertaken, involving a cohort of 192 patients (aged > 65 years). Medication appropriateness assessments were made at three stages during the patients' hospital ‘journey’, that is, at admission, during their inpatient stay and at discharge. The identifying rates of inappropriate prescribing in elderly patients in hospital used validated screening tools: MAI, the Beers' criteria 2003, the IPET and HEDIS.Results  The MAI was the most comprehensive approach but was also the most time consuming to apply. Data derived using the MAI indicated clearly that there was improved medication appropriateness over the three hospital stay stages (P < 0.001). Although this trend was also significant for the Beers' criteria 2003 (P < 0.05) and the IPET (P < 0.05) approaches, the HEDIS was unable to differentiate changes in appropriateness over time. There was a good correlation between data derived using the MAI and the Beers' criteria 2003 and the IPET approaches; this correlation was not evident for the HEDIS.Conclusions  The MAI is the most convincing tool in evaluating medication appropriateness, but is very time consuming to apply. Beers' criteria 2003 and the IPET perform to an acceptable standard within the clinical setting and are more practical in their application. The HEDIS, although simplest to apply, does not have the sensitivity to measure change in appropriateness over time.
A tailored educational intervention improves doctor's performance in managing depression: a randomized controlled trial
Authors: Shirazi Mandana , Lonka Kirsti , Parikh Sagar V. , Ristner Gunilla , Alaeddini Farshid , Sadeghi Majid , Wahlstrom Rolf 
Published: September 2011

AbstractRational and objectives  To assess the effects of a tailored and activating educational intervention, based on a three‐stage modified Prochaska model of readiness‐to‐change, on the performance of general physicians in primary care (GPs) regarding management of depressive disorders.Methods  Parallel group, randomized control trial. Primary hypothesis was that performance would improve by 20 percentage units in the intervention arm. The setting was primary care in southern Tehran. The participants were 192 GPs stratified on stage of readiness‐to‐change, sex, age and work experience. The intervention was a 2‐day interactive workshop for a small group of GPs' at a higher stage of readiness‐to‐change (‘intention’) and a 2‐day interactive large group meeting for those with lower propensity to change (‘attitude’) at the pre‐assessment. GPs in the control arm participated in a standard educational programme on the same topic. The main outcome measures were validated tools to assess GPs' performance by unannounced standardized patients, regarding diagnosis and treatment of depressive disorders. The assessments were made 2 months before and 2 months after the intervention.Results  GPs in the intervention arm significantly improved their overall mean scores for performance regarding both diagnosis, with an intervention effect of 14 percentage units (P = 0.007), and treatment and referral, with an intervention effect of 20 percentage units (P < 0.0001). The largest improvement after the intervention appeared in the small group: 30 percentage units for diagnosis (P = 0.027) and 29 percentage units for treatment and referral (P < 0.0001).Conclusions  Activating learning methods, tailored according to the participants' readiness to change, improved clinical performance of GPs in continuing medical education and can be recommended for continuing professional development.
Influencing factors of community mental health nurses caring for people with schizophrenia in Taiwan
Authors: CHENG J‐F. , HUANG X‐Y. , HSU Y‐S. , SU C‐H. 
Published: September 2011

Accessible summary
Encouraging people with schizophrenia to live in the community is the current health‐care policy, but community living is difficult for clients and their families.
Influencing factors in home care need to be identified so as to guide service delivery for community‐dwelling clients with schizophrenia and their families.
Four categories and 12 subcategories of influencing factors were identified, which have positive and negative effects on nursing roles and the functions of public health nurses in the mental health home‐visiting service in Taiwan.
The influencing factors were found to support the importance of home care services.
AbstractThe purpose of this study was to explore the influencing factors in the substantive theory of home care for people with schizophrenia in Taiwan. The grounded theory of Strauss and Corbin approach was used. Semi‐structured one‐to‐one in‐depth interviews were utilized to collect data. Constant comparative analysis continued during the open, axial and selective coding processes until data saturation occurred. Participants were selected using theoretical sampling, and the final sample in this study consisted of a total of 29 community nurses (18 public health nurses and 11 home health nurses) who provided community mental health home‐visiting services. The public health nurses and home health nurses both conducted a total of 16 (eight carers and eight clients) home visits. Four categories and 12 subcategories of influencing factors were identified; these factors have both positive and negative effects on nursing roles and the functions of public health nurses in the mental health home‐visiting service in Taiwan. The influencing factors identified support the importance of home care services.
Patterns of interventions and the effect of coalitions and sociality on male fitness
Authors: KULIK LARS , MUNIZ LAURA , MUNDRY ROGER , WIDDIG ANJA 
Published: September 2011

AbstractIn group living animals, especially among primates, there is consistent evidence that high‐ranking males gain a higher reproductive output than low‐ranking males. Primate studies have shown that male coalitions and sociality can impact male fitness; however, it remains unclear whether males could potentially increase their fitness by preferentially supporting and socializing with females. Here we investigate patterns of male interventions and the effect of coalitions and sociality on male fitness in rhesus macaques (Macaca mulatta) with particular focus on male–female interactions. We combined behavioural observations collected on Cayo Santiago with genetic data analysed for male reproductive output and relatedness. Our results revealed that the ten top‐ranking males provided the majority of all male support observed. In contrast to other primates, male rhesus macaques mainly formed all‐down coalitions suggesting that coalitions are less likely used to enhance male dominance. Males supporting females during and before their likely conception were not more likely to fertilize those females. We also found no evidence that males preferably support their offspring or other close kin. Interestingly, the most important predictor of male support was sociality, since opponents sharing a higher sociality index with a given male were more likely to be supported. Furthermore, a high sociality index of a given male–female dyad resulted in a higher probability of paternity. Overall, our results strengthen the evidence that sociality affects fitness in male primates, but also suggest that in species in which males queue for dominance, it is less likely that males derive fitness benefits from coalitions.
Promoter ‐817C>T Variant of B Lymphocyte Stimulator Gene (BLyS) and Susceptibility to Endometriosis‐Related Infertility and Idiopathic Infertility in Brazilian Population
Authors: Christofolini D. M. , Cavalheiro C. M. , Teles J. S. , Lerner T. G. , Brandes A. , Bianco B. , Barbosa C. P. 
Published: September 2011

AbstractMany theories have been proposed to explain the development of endometriosis, and recently, autoimmune aetiology has been suggested. Besides, it is well known that endometriosis, especially the advanced disease, may impair fertility. B lymphocyte stimulator (BLyS) is a cytokine produced by macrophages and is necessary for normal B cell development. One of the most studied polymorphisms is the ‐817C/T in the promoter region of the gene. We aimed to assess the association between endometriosis‐related infertility and idiopathic infertility and the BLyS ‐817C/T polymorphism in a Brazilian population. We performed a case–control study comprising 165 infertile women with endometriosis, 83 with idiopathic infertility and 145 fertile and assessed the association with BLys ‐817C/T polymorphism. BLyS ‐817C/T polymorphism was detected using TaqMan PCR. The results were analysed statistically, and a P‐value < 0.05 was considered significant. The results disclosed similar genotype and allelic frequencies between endometriosis‐related infertility (P = 0.225) and control group, regardless of the disease stage (P = 0.213 and P = 0.462, respectively). However, a statistically significant difference was observed regarding idiopathic infertile group (P = 0.048) compared with controls. Considering the dominant and recessive inheritance models, no significant differences in both endometriosis and idiopathic infertility group were found. The genotype frequencies were in Hardy–Weinberg equilibrium in all studied groups. The results point to a possible association between BLyS ‐817C/T polymorphism and idiopathic infertility in Brazilian population.
The Mild Inflammatory Response in Febrile Neutropenic Lymphoma Patients with Low Risk of Complications is More Pronounced in Patients Receiving Tobramycin Once Daily Compared with Three Times Daily
Authors: Torfoss D. , Sandstad B. , Mollnes T. E. , Høiby E. A. , Holte H. , Bjerner J. , Bjøro T. , Gaudernack G. , Kvalheim G. , Kvaløy S. 
Published: September 2011

AbstractWe evaluated inflammatory markers in febrile neutropenic lymphoma patients undergoing high‐dose chemotherapy with autologous stem cell support. Based on MASCC scores, our patients had a low risk of serious complications and a perspective of a benign initial clinical course of the febrile neutropenia. We also studied the impact of tobramycin given once versus three times daily on these immune markers. Sixty‐one patients participating in a Norwegian multicentre prospective randomized clinical trial, comparing tobramycin once daily versus three times daily, given with penicillin G to febrile neutropenic patients, constituted a clinically homogenous group. Four patients had bacteraemia, all isolates being Gram‐positive. Thirty‐two patients received tobramycin once daily, and 29 patients received tobramycin three times daily. Blood samples were taken at the onset of febrile neutropenia and 1–2 days later. All samples were frozen at −70 °C and analysed at the end of the clinical trial for C‐reactive protein (CRP), procalcitonin (PCT), complement activation products, mannose‐binding lectin (MBL) and 17 cytokines. We found a mild proinflammatory response in this series of patients. CRP was non‐specifically elevated. Ten patients with decreased MBL levels showed the same mild clinical and proinflammatory response. Patients receiving tobramycin once daily showed a more pronounced proinflammatory response compared with patients receiving tobramycin three times daily. Overall, febrile neutropenic cancer patients with a benign clinical course show a mild proinflammatory immune response.
The stable carbon isotopic composition of organic material in platform derived sediments: implications for reconstructing the global carbon cycle
Authors: OEHLERT AMANDA M. , LAMB‐WOZNIAK KATHRYN A. , DEVLIN QUINN B. , MACKENZIE GRETA J. , REIJMER JOHN J. G. , SWART PETER K. 
Published: September 2011

AbstractIn pelagic carbonate sediments, the degree to which the δ13C values of inorganic and organic fractions co‐vary has been used to interpret rates of production, burial and decomposition of organic carbon. This relationship is relatively consistent through time, permitting estimates of organic carbon production and preservation. However, as the majority of pelagic sediments older than 200 Myr have been subducted, carbonate sediments deposited in epeiric seas and platforms are often substituted for pelagic carbonates in analyses of ancient global carbon cycling. There are well‐known pitfalls to using shallow marine carbonate materials, including diagenesis, semi‐isolation of depositional environments and input of different types of sediments with varying inorganic δ13C (δ13Cinorganic) values, which can obscure any global signatures. One method used to assess whether global changes in δ13C are accurately represented by δ13Cinorganic records is to examine variations in the δ13C of co‐occurring organic material (δ13Corganic). If a δ13Corganic record co‐varies with a co‐occurring δ13Cinorganic record, it is argued that the signals must be related to variations in the global carbon cycle. This assumption has been investigated by analysing the isotopic composition of the organic carbon preserved in the uppermost 150 m of periplatform sediments recovered during ODP Leg 166 from the western margin of Great Bahama Bank. The δ13Corganic values measured in this study were compared to previously published δ13Cinorganic records measured on identical samples, thus allowing a study of the correlation between the two records through time. These analyses showed that the correlation coefficient between δ13Cinorganic and δ13Corganic increased from the proximal location (Site 1005, r2 = 0·1), to the distal site (Site 1006, r2 = 0·63). The importance of platform‐derived carbonate and organic material at the proximal location, Site 1005, is reflected in the absence of a co‐variation between inorganic and organic δ13C records, which exhibit no correlation on the platform itself. In contrast, the co‐variance in δ13C values at the basinal location, Site 1006, is explained by a two‐point mixing model, which demonstrates the importance of both pelagic and platform‐derived carbonate and organic carbon in generating the positive correlation between the organic and inorganic δ13C values; this results in a correlation between δ13Cinorganic and δ13Corganic records at Site 1006 that is unrelated to global carbon cycling. Such data question the applicability of using δ13Corganic values to support the ability of δ13Cinorganic values to record global carbon cycling in carbonates recovered from environments where multiple sources of carbonate and organic carbon contribute to the bulk δ13C signal.
The spatial distribution of coarse surface grains and the stability of gravel river beds
Authors: PIEDRA MIGULE M. , HAYNES HEATHER , HOEY TREVOR B. 
Published: September 2011

AbstractPrevious studies of surface particle structures in gravel‐bed rivers, in particular coarse‐grain clusters, conclude that these bedforms increase bed stability and reduce sediment transport rates. However, few studies have quantitatively analysed the effect of the surface distribution of coarse grains, in isolation or arranged into distinct bedforms, on particle entrainment, focussing on descriptions of bedform formation and mechanical behaviour. A novel image analysis technique was employed that allowed recognition of coarse grains and calculation of particle cluster areas. Under laboratory conditions, increasing discharges were applied to a unimodal sand‐gravel bed. The size class containing the D90 size was painted in ultraviolet paint. Image analysis software was used to identify this size class on digital images of the bed surface taken under ultraviolet light. Both the total surface area occupied by ultraviolet grains and the area of accumulations of connected grains were related to the threshold shear stress for entrainment. As discharge magnitude increased, coarse grains actively grouped together forming fewer, larger accumulations of coarse particles. Lower values of critical bed shear stress occurred for beds with higher degrees of clustering; beds are more stable when coarse grains are distributed more evenly over the bed surface; this implies that using bed surface composition as a descriptor of bed resistance to entrainment may need to be complemented by a descriptor of the spatial distribution of the coarsest grains.
Sedimentology of a wet, pre‐vegetation floodplain assemblage
Authors: FRALICK PHILIP , ZANIEWSKI KAMIL 
Published: September 2011

AbstractDescriptions of fluvial systems operating prior to significant terrestrial macrophyte vegetation have concentrated on assessing the impact of plant evolution on channel style; this is probably in part due to the scarcity of well‐developed floodplain successions in fluvial assemblages of these ages. This study describes wet, pre‐vegetation floodplain deposits and processes observed and inferred from a continuous succession of drill core through an extensive, 1·4 Ga, delta‐top channel–floodplain assemblage forming a portion of the Sibley Group, Ontario, Canada. Sub‐aerial deposits are dominated by flaser, wavy and lenticular bedded, fine‐grained sandstones, siltstones and mudstones, with abundant small mudstone rip‐up clasts. Soft‐sediment deformation of these units is ubiquitous, with loading and injection features being the most prominent. Thicker medium‐grained sandstone beds, representing crevasse splays, commonly have poorly developed protosols in their upper portions. Well‐laminated sediments with wave ripples, and only rarely containing rip‐up clasts and soft‐sediment deformation, were deposited in floodplain ponds. These deposits differ from post‐vegetation floodplain sediments in having: (i) better preservation of layering without rootlet bioturbation; (ii) dominance of rippled sand on the floodplain, probably due to lack of vegetation‐induced baffling; (iii) large‐scale generation of small, intraformational clasts; (iv) desiccation crack fills consisting of peds and locally derived intraclasts, probably delivered during Horton overland flow during rainfall events; (v) ubiquitous soft‐sediment deformation features in sub‐aerial deposits; and (vi) well‐laminated, commonly oxidized sediment that accumulated in floodplain ponds. These attributes are the direct result of the lack of macrophyte vegetation, and produce floodplain assemblages that are distinctly different from those presently forming in similar climatic settings.