bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender differences on chest pain perception associated with acute myocardial infarction in Chinese patients: a questionnaire survey
Authors: Khan Jane JB , Albarran John W , Lopez Violet , Chair Sek Y 
Published: September 2010

Aims.  To investigate gender differences in chest pain perception among Chinese patients with acute myocardial infarction.Background.  Thrombolytic therapy is beneficial to outcomes of acute myocardial infarction if administered within 12 hours from the onset of chest pain. However, cardiac symptom interpretation may impact time of presentation to hospital. Differences in cardiac symptom reports by gender partly explain misdiagnoses and delays in treatment, particularly among women. Whether, such trends apply to Chinese patients with myocardial infarction is unknown.Design.  A descriptive prospective study.Methods.  Using questionnaires, data on demographic variables, the number of patients reporting chest pain and other chest sensations at the onset of acute myocardial infarction and chest pain intensity, description, location and radiation across the chest were collected.Results.  A total of 128 participants equally divided by gender were recruited. Chest pain was more prevalent among men than women (84·37% vs. 67·19%, p < 0·05). Although no statistical significance was found, Chinese men had higher mean chest pain intensity scores (7·54 SD 2·35 vs. 7·51 SD 2·25) and reported less atypical chest pain (0·00% vs. 9·3%) compared with women. Men had more upper right sided chest pain (40·74% vs. 20·93%, p = 0·038) whereas women experienced increased neck pain and pain to the upper central chest, middle central chest, upper central back, middle central back and middle right back regions.Conclusions.  Discreet gender differences in chest pain perceptions exist between Chinese men and women, with the latter group, who may be considered as a high‐risk group for missed and delayed diagnosis from myocardial infarction, reporting more atypical presentations.Relevance to clinical practice.  Irrespective of culture, women with myocardial infarction tend to present with atypical chest pain symptoms and therefore they should be aggressively investigated.
The role of antenatal pelvic floor muscle exercises in prevention of postpartum stress incontinence: a randomised controlled trial
Authors: Mason Linda , Roe Brenda , Wong Helen , Davies Jane , Bamber Jayne 
Published: September 2010

Aim.  This article reports a randomised controlled trial to determine the efficacy of antenatal pelvic floor muscle exercises in the primary prevention of postpartum stress incontinence in primiparous women.Background.  Pelvic floor muscle exercises are effective in treating stress incontinence, yet prevention studies demonstrate equivocal findings.Design.  Randomised controlled trial.Method.  Pregnant women recruited from two hospitals in North‐west England were randomised to an intervention (n = 141) or control group (n = 145). Data were collected from 2005–2006. The intervention comprised four sessions of taught pelvic floor muscle exercise training during pregnancy and 8–12 maximal contractions repeated twice daily at home. A modified Bristol Female Lower Urinary Tract Symptom questionnaire, Leicester Impact Scale and Three Day Diary were administered at 20 and 36 weeks of pregnancy and three months postpartum.Results.  The intervention group was more likely to exercise their pelvic floor muscles compared to controls at 36 weeks (p = 0·019) and three months (0·022), reporting fewer episodes of incontinence and a lower score on the Leicester Impact Scale. However, these differences were not statistically significant.Conclusion.  Significant differences were not demonstrated between the groups in relation to incontinence episodes and degree of bother of symptoms postpartum, although trends indicate a positive effect. Further research is necessary to address issues of adherence and the effect of pelvic floor muscle exercise undertaken during pregnancy on postpartum stress urinary incontinence.Relevance to clinical practice.  A proportion of women did not meet the required attendance at antenatal class, furthermore, few exercised their pelvic floor muscles during pregnancy according to instructions. Health professionals need to find ways to instruct and motivate women to perform pelvic floor muscles exercises regularly during pregnancy and the postpartum.
Mediating roles of social support on poststroke depression and quality of life in patients with ischemic stroke
Authors: Huang Chiung‐Yu , Hsu Mei‐Chi , Hsu Shin‐Pin , Cheng Pei‐Ching , Lin Shu‐Fen , Chuang Chia‐Hui 
Published: September 2010

Aims. The purposes of this study were to examine the associations among social support, poststroke depression and quality of life among patients with first‐time ischemic stroke and to further test the impact of the dimensions of social support on poststroke depression and quality of life. The proposed models included mediation hypotheses to examine the mediating roles of social support.Background. Although considerable attention has recently been devoted to explaining why poststroke depression and poor quality of life are frequent concomitants of stroke, little empirical work has been conducted to test predictions based on these models, especially in Taiwan.Design. A cross‐sectional, descriptive correlation design was used.Methods. The 102 patients with first‐time ischemic stroke aged 32–90 (mean = 64·5, SD 11·8) were recruited from a large general hospital in Taiwan and through face‐to‐face survey interviews. The participants were assessed using the Social Support Inventory, Centre for Epidemiologic Studies Depression Scale, Barthel Index, the Instrumental Activities of Daily Living and Quality of Life Index‐Stroke Version. The models were tested and confirmed through the application of structural equations with proposed variables.Results. Nearly half of the Taiwanese patients with stroke felt depressed. Social support fully mediated the prediction of quality of life by age and partially mediated the prediction of quality of life by functional ability. Social support partially mediated the prediction of poststroke depression by functional ability.Conclusion. This study provides researchers and nurses with increased understanding of the mediating role of social support between functional ability and poststroke depression/quality of life. Social support may be a promising intervening variable in stroke outcome.Relevance to clinical practice. The results suggest several clinical implications. The inclusion of social support in poststroke depression and quality of life after stroke may help nurses in planning stroke programme development, patient education, effective and efficient use of health care resources and effective rehabilitation, especially in those individuals who lack support or who are involved in stressful situations.
A systematic review of the literature: workplace violence in the emergency department
Authors: Taylor Jessica L , Rew Lynn 
Published: September 2010

Aims and objectives. To synthesise the body of literature on workplace violence in the emergency department and to identify characteristics of intervention studies that are the basis for guiding best practice modelling in the clinical setting. The research question addressed was what are the characteristics and findings of studies since 2004 on workplace violence in the emergency department?Background. Emergency departments are prone to increased incidents of workplace violence. Workplace violence in the health care setting has become a hot topic of policy, political debate and research in recent years. Despite the research that has been carried out in this area, little consensus exists as to what are the best practices for mitigating violence in this setting.Design. Systematic literature review.Methods. Search using four online databases, including MEDLINE, CINAHL, PsycINFO and the Dissertations and Theses Full Text Database.Results. Most research focused on the incidence rates of workplace violence in the emergency department and effects on staff. There was a significant lack of intervention studies to provide a framework for guiding evidence‐based practice. Themes of under‐reporting violence, barriers and attitudes towards reporting, description and characterisation of incidents of violence, predisposing factors and the concept of safety or lack of fear were all major content areas addressed in the literature.Conclusions. Incidence of workplace violence in the emergency department has been well documented in numerous published studies. Emergency department workers are exposed to significant rates of physical and verbal abuse. Under‐reporting of workplace violence in the emergency department is common and contributes to the difficulty in accurately tracking violence.Relevance to clinical practice. Future research must move beyond descriptive studies to include more advanced research methods. Few practice‐guiding implications can be gained from this body of research because of the lack of intervention studies.
Psychometric properties of the Chinese version of the Bipolar Spectrum Diagnostic Scale
Authors: Chu Hsin , Lin Chuan‐Ju , Chiang Kai‐Jo , Chen Chiung‐Hua , Lu Ru‐Band , Chou Kuei‐Ru 
Published: September 2010

Aim and objectives.  The aim of this study was to test the psychometric properties of the Chinese version of the Bipolar Spectrum Diagnostic Scale (C‐BSDS) in a Chinese population to serve as an aid to clinical diagnosis of bipolar disorders.Background.  Bipolar spectrum disorders are often misdiagnosed because of the wide range of symptoms seen in patients. The consequences of delayed diagnoses or misdiagnoses can be devastating.Design.  A cross‐sectional research design.Method.  Two hundred patients with affective disorders from a psychiatric outpatient clinic in Taiwan were enrolled. Internal consistency reliability and two‐week test–retest reliability were performed to evaluate the reliability of the C‐BSDS. Expert content validity and factor analysis were used for testing construct validity. To evaluate sensitivity and specificity, the Chinese version of the Mini International Neuropsychiatric Interview (MINI) was used as the gold standard for diagnosis.Results.  The internal consistency coefficient measured by intra‐class correlation (ICC) was 0·81, the test–retest reliability coefficient was 0·85 and the expert validity was 0·85. For construct validity, ‘irritable and hyper‐energetic factors’ and ‘depressed and lack of energy factors’ were extracted by factor analysis. These two factors reflected the structure of the original scale and accounted for 33·27% of the variance. The optimal cut‐off was 12, which yielded a sensitivity of 74 and a specificity of 0·97 for detecting bipolar disorder and for bipolar II disorder these were 0·79 and 0·68, respectively.Conclusions.  The C‐BSDS showed good reliability and validity, and the results were consistent with the English version of the BSDS. Therefore, the C‐BSDS is an effective tool for evaluation of a Chinese population.Relevance to clinical practice.  The BSDS can further increase the detection rate of bipolar disorders, especially bipolar II disorder, with satisfactory sensitivity and specificity. It can effectively assist with clinical screening of patients for bipolar spectrum disorders.
Debunking the ‘digital native’: beyond digital apartheid, towards digital democracy
Authors: Brown C. , Czerniewicz L. 
Published: September 2010

AbstractThis paper interrogates the currently pervasive discourse of the ‘net generation’ finding the concept of the ‘digital native’ especially problematic, both empirically and conceptually. We draw on a research project of South African higher education students' access to and use of Information and Communication Technologies (ICTs) to show that age is not a determining factor in students' digital lives; rather, their familiarity and experience using ICTs is more relevant. We also demonstrate that the notion of a generation of ‘digital natives’ is inaccurate: those with such attributes are effectively a digital elite. Instead of a new net generation growing up to replace an older analogue generation, there is a deepening digital divide in South Africa characterized not by age but by access and opportunity; indeed, digital apartheid is alive and well. We suggest that the possibility for digital democracy does exist in the form of a mobile society which is not age specific, and which is ubiquitous. Finally, we propose redefining the concepts ‘digital’, ‘net’, ‘native’, and ‘generation’ in favour of reclaiming the term ‘digitizen’.
Net generation students: agency and choice and the new technologies
Authors: Jones C. , Healing G. 
Published: September 2010

AbstractBased on research investigating English first‐year university students, this paper examined the case made for a new generation of young learners often described as the Net Generation or Digital Natives in terms of agency and choice. Generational arguments set out a case that links young people's attitudes and orientations to their lifelong exposure to networked and digital technologies. This paper drew on interview data from mixed methods research to suggest that the picture is more complex than the equation of exposure to new technologies and a generational change of attitudes and capacities. Starting from the position that interaction with technology is mediated by activity and an intentional stance, we examined the choices students make with regard to the technologies they engage with. We explored the perceived constraints students face and the way they either comply or resist such constraints. We concluded that agency actively shapes student engagement with technology but that an adequate conception of agency must expand beyond the person and the self to include notions of collective agency identifying the meso level as an activity system that mediates between the students and their technological setting.
Beyond natives and immigrants: exploring types of net generation students
Authors: Kennedy G. , Judd T. , Dalgarno B. , Waycott J. 
Published: September 2010

AbstractPreviously assumed to be a homogenous and highly skilled group with respect to information and communications technology, the so‐called Net Generation has instead been shown to possess a diverse range of technology skills and preferences. To better understand this diversity, we subjected data from 2096 students aged between 17 and 26 from three Australian universities to a cluster analysis. Through this analysis, we identified four distinct types of technology users: power users (14% of sample), ordinary users (27%), irregular users (14%) and basic users (45%). A series of exploratory chi‐square analyses revealed significant associations between the different types of technology users and the university that students attended, their gender and age and whether the student was local or international. No associations were found for analyses related discipline area, socio‐economic status or rurality of residence. The findings are discussed in light of the rhetoric associated with commentaries about the Net Generation, and suggestions about their implications for teaching and learning in universities are offered.
Creating a multidisciplinary low back pain guideline: anatomy of a guideline adaptation process
Authors: Harstall Christa , Taenzer Paul , Angus Donna K. , Moga Carmen , Schuller Tara , Scott N. Ann 
Published: September 2010

AbstractRationale, aims and objectives  A collaborative, multidisciplinary guideline adaptation process was developed to construct a single overarching, evidence‐based clinical practice guideline (CPG) for all primary care practitioners responsible for the management of low back pain (LBP) to curb the use of ineffective treatments and improve patient outcomes.Methods  The adaptation strategy, which involved multiple committees and partnerships, leveraged existing knowledge transfer connections to recruit guideline development group (GDG) members and ensure that all stakeholders had a voice in the guideline development process. Videoconferencing was used to coordinate the large, geographically dispersed GDG. Information services and health technology assessment experts were used throughout the process to lighten the GDG's workload.Results  The GDG reviewed seven seed guidelines and drafted an Alberta‐specific guideline during 10 half‐day meetings over a 12‐month period. The use of ad hoc subcommittees to resolve uncertainties or disagreements regarding evidence interpretation expedited the process. Challenges were encountered in dealing with subjectivity, guideline appraisal tools, evidence source limitations and inconsistencies, and the lack of sophisticated evidence analysis inherent in guideline adaptation. Strategies for overcoming these difficulties are discussed.Conclusion  Guideline adaptation is useful when resources are limited and good‐quality seed CPGs exist. The Ambassador Program successfully utilized existing stakeholder interest to create an overarching guideline that aligned guidance for LBP management across multiple primary care disciplines. Unforeseen challenges in guideline adaptation can be overcome with credible seed guidelines, a consistently applied and transparent methodology, and clear documentation of the subjective contextualization process. Multidisciplinary stakeholder input and an open, trusting relationship among all contributors will ensure that the end product is clinically meaningful.
Interhospital variation in appropriateness of cataract surgery
Authors: Llorente César , Blasco Juan A. , Quintana José M. , Bilbao Amaia , Alberdi Txomin , Lacalle Juan R. , Begiristain José M. , Baré Marisa ,   the IRYSS‐Cataract Group
Published: September 2010

AbstractObjective  The aim of this study was to analyse the inter‐hospital variation in the appropriateness of cataract phacoemulsification in Spain.Methods  This observational, multicentre, prospective study involved patients aged 18–90 years. Each phacoemulsification intervention was classified as ‘necessary’, ‘appropriate’, ‘uncertain’ or ‘inappropriate’ according to explicit appropriateness criteria previously established using the RAND/UCLA methodology. A descriptive statistical analysis was performed, followed by univariate and multivariate logistic regression analysis, in order to examine the differences between hospitals.Results  In total, 5063 patients from 15 hospitals were enrolled. The percentage of patients in each hospital who inappropriately underwent phacoemulsification varied from 1.2% to 24.0% (P < 0.0001). The most common inappropriate scenario was that of patients with a simple, unilateral cataract with no limitation of their visual function, with a pre‐surgery visual acuity of ≥0.5 in both eyes, and for whom surgical correction would involve low technical complexity.Conclusions  The variation in appropriateness of phacoemulsification cannot be attributed solely to the clinical differences between the hospitals' patients. There is room for improvement in the appropriate indication of phacoemulsification. Measures based on the dissemination of appropriateness criteria might improve quality of care.
Shared care for hearing complaints: guideline effects on patient flow
Authors: Duijvestijn Jan A. , Grutters Janneke P. C. , Chenault Michelene N. , Joore Manuela A. , Manni Johannes J. , Anteunis Lucien J. C. 
Published: September 2010

AbstractRationale, aims and objectives  A national guideline was proposed to enable shared care in hearing complaints and therefore to change patient flows. In this study the effect of this guideline is evaluated.Methods  From a total of 3500 patients with hearing complaints, consulting the Ear Nose and Throat Department of a large non‐university hospital in the Netherlands in 2002, a random sample of 1000 patients was selected. Patient flow was simulated according to guideline criteria with as main outcome measures: the effect of the guideline on patient flow.Results  Simulation of the consensus guideline did not really alter patient flow, with 89% to 97% of the patients still being referred to the Ear Nose and Throat specialist or Audiological Centre. Age, ear operations in the past and asymmetric hearing loss are the most important factors determining whether a person is labelled as a patient in need of medical care.Conclusion  The present study emphasizes the importance of designing evidence‐based guidelines for shared care.
Patients Assessment of Chronic Illness Care (PACIC) in two Australian studies: structure and utility
Authors: Taggart Jane , Chan Bibiana , Jayasinghe Upali W. , Christl Bettina , Proudfoot Judy , Crookes Patrick , Beilby Justin , Black Deborah , Harris Mark F. 
Published: September 2010

AbstractAims  To validate the Patients Assessment of Chronic Illness Care (PACIC) among patients with chronic disease in the Australian context and to examine the relationship between patient‐assessed quality of care and patient and practice characteristics.Methods  Cross‐sectional analysis of baseline data in two independent health service intervention studies that involved patients with type 2 diabetes, ischaemic heart disease and/or hypertension in general practice. The first study involved 2552 patients from 60 urban and rural general practices. The second involved 989 patients from 26 practices in Sydney. Patients were mailed a questionnaire, which included the PACIC and Short Form Health Survey. Factor analysis was performed and the factor scores and total PACIC were analysed using multi‐level regression models against practice and patient characteristics.Results  Factor analysis revealed a two‐factor solution with similar loading of PACIC items in both studies: one for shared decision making and self‐management and the other for planned care. Practice characteristics were not related to PACIC scores. Scores were related to patient characteristics – education, retirement, type and number and duration of conditions.Conclusions  The two‐factor structure of the PACIC found in these Australian studies is different from the five‐factor structure found in the US and the European studies. This may be related to differences in the way patients interact with the health system especially the use of Team Care plans. The association of total scores with patient characteristics was consistent with those found in other studies including a lack of association with gender, age and ethnicity. These findings should be taken into consideration when comparing patient‐assessed quality of care between countries using this tool.