bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meta‐analysis: the effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment
Authors: Szajewska H. , Horvath A. , Piwowarczyk A. 
Published: September 2010

Aliment Pharmacol Ther 2010; 32: 1069–1079SummaryBackground  Problems with currently recommended Helicobacter pylori eradication therapies include unsatisfactory eradication rates and/or therapy‐associated side effects.Aim  To investigate the effects of Saccharomyces boulardii as supplementation to standard triple therapy on H. pylori eradication rates and therapy‐associated side effects.Methods  The Cochrane Library, MEDLINE and EMBASE databases were searched in July 2010, with no language restrictions, for randomized controlled trials (RCTs); additional references were obtained from reviewed articles.Results  Five RCTs involving a total of 1307 participants (among them only 90 children) met the inclusion criteria. Compared with placebo or no intervention, S. boulardii given along with triple therapy significantly increased the eradication rate [four RCTs, n = 915, relative risk (RR) 1.13, 95% confidence interval (CI) 1.05–1.21] and reduced the risk of overall H. pylori therapy‐related adverse effects (five RCTs, n = 1305, RR 0.46, 95% CI 0.3–0.7), particularly of diarrhoea (four RCTs, n = 1215, RR 0.47, 95% CI 0.32–0.69). There were no significant differences between groups in the risk of other adverse effects.Conclusion  In patients with H. pylori infection, there is evidence to recommend the use of S. boulardii along with standard triple therapy as an option for increasing the eradication rates and decreasing overall therapy‐related side effects, particularly diarrhoea.
Colon capsule endoscopy vs. colonoscopy in patients at average or increased risk of colorectal cancer
Authors: Sacher‐Huvelin S. , Coron E. , Gaudric M. , Planche L. , Benamouzig R. , Maunoury V. , Filoche B. , Frédéric M. , Saurin J.‐C. , Subtil C. , Lecleire S. , Cellier C. , Coumaros D. , Heresbach D. , Galmiche J. P. 
Published: September 2010

Aliment Pharmacol Ther 2010; 32: 1145–1153SummaryBackground  Colon capsule endoscopy (CCE) is a new, non‐invasive technology.Aim  To conduct a prospective, multicentre trial to compare CCE and colonoscopy in asymptomatic subjects enrolled in screening or surveillance programmes for the detection of colorectal neoplasia.Methods  Patients underwent CCE on day one and colonoscopy (gold standard) on day two. CCE and colonoscopy were performed by independent endoscopists.Results  A total of 545 patients were recruited. CCE was safe and well‐tolerated. Colon cleanliness was excellent or good in 52% of cases at CCE. Five patients with cancer were detected by colonoscopy, of whom two were missed by CCE. CCE accuracy for the detection of polyps ≥6 mm was 39% (95% CI 30–48) for sensitivity, 88% (95% CI 85–91) for specificity, 47% (95% CI 37–57) for positive predictive value and 85% (95% CI 82–88) for negative predictive value. CCE accuracy was better for the detection of advanced adenoma, in patients with good or excellent cleanliness and after re‐interpretation of the CCE videos by an independent expert panel.Conclusions  Although well‐tolerated, CCE cannot replace colonoscopy as a first line investigation for screening and surveillance of patients at risk of cancer. Further studies should pay attention to colonic preparation (Clinicaltrial.gov number NCT00436514).
A novel mutation in the connexin 26 gene (GJB2) in a child with clinical and histological features of keratitis–ichthyosis–deafness (KID) syndrome
Authors: Koppelhus U. , Tranebjærg L. , Esberg G. , Ramsing M. , Lodahl M. , Rendtorff N. D. , Olesen H. V. , Sommerlund M. 
Published: September 2010

Summary
Background. Keratitis–ichthyosis–deafness (KID) syndrome is a rare congenital ectodermal disorder, caused by heterozygous missense mutation in GJB2, encoding the gap junction protein connexin 26. The commonest mutation is the p.Asp50Asn mutation, and only a few other mutations have been described to date.
Aim. To report the fatal clinical course and characterize the genetic background of a premature male neonate with the clinical and histological features of KID syndrome.
Methods. Genomic DNA was extracted from peripheral blood and used for PCR amplification of the GJB2 gene. Direct sequencing was used for mutation analysis.
Results. The clinical features included hearing impairment, ichthyosiform erythroderma with hyperkeratotic plaques, palmoplantar keratoderma, alopecia of the scalp and eyelashes, and a thick vernix caseosa-like covering of the scalp. On histological analysis, features characteristic of KID syndrome, such as acanthosis and papillomatosis of the epidermis with basket-weave hyperkeratosis, were seen. The skin symptoms were treated successfully with acitretin 0.5 mg/kg. The boy developed intraventricular and intracerebral haemorrhage, leading to hydrocephalus. His condition was further complicated by septicaemia and meningitis caused by infection with extended-spectrum beta-lactamase-producing Klebsiella pneumoniae. Severe respiratory failure followed, and the child died at 46 weeks of gestational age (13 weeks postnatally). Sequencing of the GJB2 gene showed that the child was heterozygous for a novel nucleotide change, c.263C&gt;T, in exon 2, leading to a substitution of alanine for valine at position 88 (p.Ala88Val).
Conclusions. This study has identified a new heterozygous de novo mutation in the Cx26 gene (c.263C&gt;T; p.Ala88Val) leading to KID syndrome.
The influence of secular trend for height on ascertainment and eligibility for growth hormone treatment
Authors: Hughes Ian P. , Choong Catherine S. , Cotterill Andrew , Harris Mark , Davies Peter S. W. ,   on behalf of the Australasian Paediatric Endocrine Group (APEG)
Published: September 2010

SummaryObjective Assessment of short stature in many instances is based on a comparison with the Centers for Disease Control’s (CDC) growth curves. The secular trend for height may limit the utility of CDC data for contemporary populations. We investigate the effect of the secular trend on Australian and US populations.Design Describe CDC‐defined height SDS distributions of contemporary populations for different ages and genders. Compare observed means and standard deviations (SDs) to expected values of 0 and 1. Compare frequency of individuals shorter than the CDC‐1st centile to those shorter than 1st centile defined empirically from the contemporary population.Subjects Healthy Kids Queensland Survey 2006: 1686 boys, 1822 girls. Australian National Children’s Nutrition and Physical Activity Survey 2007: 2415 boys, 2379 girls. US National Health and Nutrition Examination Survey 2005–2006: 2160 boys, 2118 girls.Measurements Means, SDs and normality of CDC‐defined height SDS distributions. Frequency of individuals shorter than the CDC‐1st centile and shorter than an empirically defined 1st centile.Results In Australia, means of CDC‐defined height SDS distributions are always greater than 0 and the CDC‐1st centile identifies only the shortest 0·5% of children. Means may vary with age and occasionally between genders in contemporary populations. Normality and SDs of 1 are retained.Conclusions The secular trend has resulted in an underestimate of the number of Australian children eligible for GH treatment using the CDC‐1st centile cut‐off. Contemporary, local data should be used to construct standards. Using the 2nd CDC centile would approximate the 1st local centile until new standards are constructed. The secular trend does not account for the gender bias in GH therapy.
A systematic review of health‐related quality of life instruments used for people with venous ulcers: an assessment of their suitability and psychometric properties
Authors: Palfreyman Simon J , Tod Angela M , Brazier John E , Michaels Jonathan A 
Published: September 2010

Aims and objectives. To review the quality of life questionnaires used to measure the impact of venous ulceration and to evaluate their psychometric properties.Background. Venous leg ulcers have a negative impact on quality of life. Health‐related quality of life can be measured using structured questionnaires. Nurses are the primary care providers for patients with venous ulceration and are ideally placed to assess and develop these types of questionnaires. There may also be an opportunity to use such quality of life instruments to measure the impact of nursing interventions in other areas where nurses are the key care providers.Design. Systematic review.Method. Studies were sought that used quality of life instruments to evaluate the impact of venous ulceration. Fourteen electronic bibliographical databases and 11 Internet‐based health services research related resources were searched. In addition, grey literature was sought and the reference lists of relevant articles checked. Data were extracted regarding the type of instrument used, sample, number of items and domains and psychometric performance of the instrument.Results. The initial search identified a total of 338 potential citations. After review, a total of 31 studies were included: 17 used generic and 14 used disease‐specific instruments. Five different types of generic and seven disease‐specific instruments were identified. There was significant heterogeneity between the studies in terms of study design, aetiology of ulceration and times of assessment. The disease‐specific instruments showed limitations in relation to their applicability to venous ulcer patients because of flaws in design or validation.Conclusions. The literature on quality of life related to venous ulceration failed to sufficiently distinguish between those with different causes of leg ulceration. There appeared to be problems with the ability of current quality of life instruments to detect changes in quality of life related to ulcer healing.Relevance to clinical practice. There appears to be an opportunity for nurses to develop a health‐related quality of life health‐related quality of life instruments to evaluate their impact on patient outcomes. Such instruments could potentially allow nursing interventions to be assessed more effectively than the recently proposed nursing metrics.
Perceived levels of satisfaction with the preoperative assessment service experienced by patients undergoing general anaesthesia in a day surgery setting
Authors: Fraczyk Linda , Godfrey Helen 
Published: September 2010

Aim and objective.  Primary aim – to explore patient satisfaction with preoperative assessment for day surgery and compare patient satisfaction between two specialties, General Surgery and Urology. Secondary aim – to compare numbers of patients being preoperatively assessed in General Surgery and Urology.Background.  Patient‐centred care is increasingly gaining significance, and patient satisfaction is an outcome measure assuming greater importance [Department of Health (2005) Creating a Patient Led NHS. Crown Copyright, London]. There is a paucity of literature on patient satisfaction with preoperative assessment. This article reports the findings of a study investigating satisfaction levels in patients undergoing preoperative assessment for general anaesthesia in a day surgery setting.Design.  Cross‐sectional survey using a questionnaire.Method.  A questionnaire was distributed to General Surgery and Urology patients on their day of admission in one general hospital. The questionnaire was designed to capture data on the type of preoperative assessment received and satisfaction levels of patients’ experiences of the preoperative assessment service. The questionnaire was completed by 275 patients.Results.  There were no significant differences in expressed satisfaction between specialties with the preoperative assessment service or the type of preoperative assessment experienced. However, more General Surgery respondents felt preoperative assessment prepared them for hospital admission than Urology respondents, a chi‐square test revealed a significant difference between the specialties (p = 0·046). Although patients expressed overall satisfaction with preoperative assessment, their responses reveal there are key issues. Several themes emerged indicating that exchange of preoperative information, a supportive attitude, anxiety and fearfulness, proceedings and aftercare are significant aspects of preoperative assessment for patients.Conclusions.  Although there is some satisfaction, this study reveals that various aspects of this preoperative assessment service could be improved. This information will help inform future development of the preoperative assessment service.Relevance to practice.  If preoperative assessment is to be patient centred, enjoying high levels of patient satisfaction, attention to patients’ individual needs must be a priority.
Routines and rituals: a grounded theory of the pain management of drug users in acute care settings
Authors: McCreaddie May , Lyons Imogen , Watt Debbie , Ewing Elspeth , Croft Jeanette , Smith Marion , Tocher Jennifer 
Published: September 2010

Aim.  This study reviewed the perceptions and strategies of drug users and nurses with regard to pain management in acute care settings.Background.  Drug users present unique challenges in acute care settings with pain management noted to be at best suboptimal, at worst non‐existent. Little is known about why and specifically how therapeutic effectiveness is compromised.Design.  Qualitative: constructivist grounded theoryMethod.  A constructivist grounded theory approach incorporating a constant comparative method of data collection and analysis was applied. The data corpus comprised interviews with drug users (n = 11) and five focus groups (n = 22) of nurses and recovering drug users.Results.  Moral relativism as the core category both represents the phenomenon and explains the basic social process. Nurses and drug users struggle with moral relativism when addressing the issue of pain management in the acute care setting. Drug users lay claim to expectations of compassionate care and moralise via narration. Paradoxically, nurses report that the caring ideal and mutuality of caring are diminished. Drug users’ individual sensitivities, anxieties and felt stigma in conjunction with opioid‐induced hyperalgesia complicate the processes. Nurses’ and hospitals’ organisational routines challenge drug user rituals and vice versa leading both protagonists to become disaffected. Consequently, key clinical issues such as preventing withdrawal and managing pain are left unaddressed and therapeutic effectiveness is compromised.Conclusion.  This study provides a robust account of nurses’ and drug users’ struggle with pain management in the acute care setting. Quick technological fixes such as urine screens, checklists or the transient effects of (cognitive‐based) education (or training) are not the answer. This study highlights the need for nurses to engage meaningfully with this perceptibly ‘difficult’ group of patients.Relevance to clinical practice.  The key aspects likely to contribute to problematic interactions with this patient cohort are outlined so that they can be prevented and, or addressed.
Non‐nutritive sucking relieves pain for preterm infants during heel stick procedures in Taiwan
Authors: Liaw Jen‐Jiuan , Yang Luke , Ti Yin , Blackburn Susan Tucker , Chang Yue‐Cune , Sun Liang‐Wen 
Published: September 2010

Aims. This study examined the effectiveness of non‐nutritive sucking on preterm infant pain, changes in infant behaviour and frequency of abnormal physiological signals during heel stick procedures in Taiwan.Background. Preterm infants’ repetitive exposure to painful procedures may result in changes to brain organisation. Pain management should be a priority in neonatal care.Design. Randomised control trial.Methods. Preterm infants (gestational age 28·9–37 weeks) were randomised to two groups: those receiving (experimental,n = 52) or not receiving non‐nutritive sucking (control,n = 52) during heel stick procedures. Pain was measured before (for three minutes), during and after (during 10‐minute recovery) heel stick procedures by the Premature Infant Pain Profile, changes in infant behaviour and abnormal physiological parameters.Results. Infants in both groups had similar odds ratios for pain and moderate‐to‐severe pain (0·57 and 0·58, respectively), after adjusting for time effects, postconceptional age, heel stick duration, painful experiences and baseline Premature Infant Pain Profile score. The pain scores of infants with non‐nutritive sucking were significantly lower than those of non‐nutritive sucking infants at all eight phases of the heel stick procedures. Infants undergoing heel stick procedures in the experimental group had lower rates ratios for ‘grimace’ and ‘hand to mouth or face’ behaviours than control infants (0·73 and 0·78, respectively).Conclusion. Non‐nutritive sucking effectively reduced pain, particularly mild to moderate pain and behavioural responses to pain in infants receiving heel stick procedures, suggesting that nurses can offer this intervention to relieve pain in preterm infants undergoing invasive procedures.Relevance to clinical practice. Infants should be given an appropriate‐sized pacifier for comfort during painful procedures. Nurses need to be informed about the effectiveness of non‐nutritive sucking, its analgesic mechanisms and how to use and incorporate it into practice.
The predictors of adopting a health‐promoting lifestyle among work site adults with prediabetes
Authors: Chen Shu‐Fen , Lin Chiu‐Chu 
Published: September 2010

Aim and objective.  To examine how prediabetes knowledge, health beliefs and self‐efficacy of health behaviour contribute to work site adults adopting a health‐promoting lifestyle and to analyse these three factors as independent variables to identify key predictors of adopting health‐promoting lifestyles.Background.  Health providers use health‐promoting lifestyle interventions as the primary approach in preventing diabetes. However, many influential factors make it difficult for individuals to adopt a health‐promoting lifestyle. Furthermore, no previous study has examined prediabetes knowledge, health beliefs, self‐efficacy of health behaviour and health‐promoting lifestyle in work site adults with prediabetes, especially among Asians.Design.  This was a cross‐sectional study of 260 adults at four work sites in southern Taiwan.Method.  Patients with prediabetes were given a cross‐sectional questionnaire about prediabetes knowledge, health beliefs, self‐efficacy of health behaviour and health‐promoting lifestyle. Multiple stepwise regression analysis was used to determine predictors of implementing health‐promoting lifestyles.Results.  In general, this study found that over age 45 and a BMI above 25 kg/m2 are risk factors for prediabetes. A 47·5% variance in implementing health‐promoting lifestyle was explained by a model that included self‐efficacy of health behaviour (beta = 0·519, p < 0·001), perceived action barrier (beta = −0·207, p = 0·001) and perceived action benefits (beta = 0·129, p = 0·023).Conclusions.  Work site health care units should identify prediabetes cases and teach diet control strategies for reducing body weight. By designing behaviour self‐regulation protocol to promote self‐management for prediabetic individuals, organisations could enhance self‐efficacy and delay further development of diabetes.Relevance to clinical practice.  Findings guide the clinical assessment (e.g. self‐efficacy) of prediabetic adults regarding their health‐promoting lifestyles and provide effective guidelines for designing lifestyle interventions to prevent prediabetes in high‐risk groups.
An outcomes evaluation of an Australian Hospital in the Nursing Home admission avoidance programme
Authors: Crilly Julia , Chaboyer Wendy , Wallis Marianne , Thalib Lukman , Polit Denise 
Published: September 2010

Aims and objectives.  To undertake an outcomes evaluation of a Hospital in the Nursing Home (HINH) admission avoidance programme.Background.  Admission avoidance type services such as Hospital in the Home have a place in improving service delivery for certain population groups. Research related to HINH has been limited, derived from various different health care systems internationally and results are varied.Design.  A quasi‐experimental study was conducted at one regional hospital. Routinely collected health information system data from two separate data sources were linked to undertake analysis.Methods.  Those in the intervention group were matched to a comparison group of patients on the basis of three characteristics (age, gender and diagnostic category). Other factors that could affect a patient’s hospital outcomes and length of stay (LOS) were statistically controlled for. Participants were aged care facility residents enrolled in a HINH programme (n = 62) and a matched group receiving usual in‐hospital care (n = 115). Emergency department (ED) outcome measures included LOS and re‐presentation. Hospital admission–related outcome measures included episode of care LOS, in‐hospital LOS and hospital readmission.Results.  A significant independent relationship between HINH programme enrolment and shorter in‐hospital LOS was identified even after adjusting for other characteristics OR 0·16 (95% CI 0·28, 0·99 p < 0·001).Conclusion.  The HINH model evaluated, with its focus on delivering acute care for aged care facility residents, can impact on health service delivery.Relevance to clinical practice.  With a demonstrated reduction in in‐hospital LOS, the available bed space created can be used for other patients perhaps waiting in the ED or waiting for surgery.
Evaluating complex public health interventions: theory, methods and scope of realist enquiry
Authors: Connelly James B. 
Published: September 2010

AbstractThe standard models used in the study of complex public health interventions are inadequate. They adopt a simple empiricist theoretical foundation and attempt to graft onto an essentially open social system a contrived laboratory experimentation typically in the form of a randomized, controlled trial. By understanding the ontological and epistemological claims of critical realism, it is possible to transcend the methodological inadequacy of the standard model approach. Critical realism posits a substantive causal theory, an end to fact‐value dualism, and a coherent and emancipatory model of social action; all of these features amount to a systematic and compelling account of public health practice and a coherent approach to evaluation of complex public health interventions.
Pain, physical functioning and quality of life of individuals awaiting total joint replacement: a longitudinal study
Authors: McHugh Gretl A. , Luker Karen A. , Campbell Malcolm , Kay Peter R. , Silman Alan J. 
Published: September 2010

AbstractObjectives  To investigate if pain, physical function and the quality of life changed among adults with osteoarthritis while on the waiting list for hip or knee joint replacement.Methods  A longitudinal study of patients listed for primary hip or knee joint replacement. Participants were interviewed at baseline (n = 105) and followed up at 3 (n = 84), 6 (n = 47) and 9 months (n = 24), or until their joint replacement. Measurement tools used were a visual analogue scale (VAS), Western Ontario and McMaster’s Universities (WOMAC) Osteoarthritis Index and the Medical Outcomes Study Short Form Health Survey (SF‐36).Results  Baseline data indicated high levels of pain as measured by VAS [mean 7.0 (SD 2.2)] and WOMAC pain [mean 11.2 (SD 3.5)]. At baseline, the mean physical function measured by WOMAC was 40.3 (SD 12.1). At the 3‐month follow‐up, there was significant deterioration in VAS pain scores (0.6; 95% CI mean difference 0.3, 1.0); WOMAC pain scores (1.2; 95% CI mean difference 0.7, 1.8) and WOMAC physical function scores (4.8; 95% CI mean difference 2.8, 6.7) compared with baseline.Conclusion  The often long wait for joint replacement surgery and deterioration in pain and physical function has highlighted the need for active management by health professionals while patients are on the waiting list.