bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effectiveness of intensive nursing care on seasonal variation of blood pressure in patients on peritoneal dialysis
Authors: Quan Lei , Dong Jie , Li Yanjun , Zuo Li 
Published: October 2011

quan l., dong j., li y. & zuo l. (2012) The effectiveness of intensive nursing care on seasonal variation of blood pressure in patients on peritoneal dialysis. Journal of Advanced Nursing68(6), 1267–1275.AbstractAim.  This article is a report of a study to reduce the seasonal variation of blood pressure in patients on peritoneal dialysis through an intensive programme of nursing care.Background.  The seasonal variation of blood pressure is a common phenomenon in patients on maintenance dialysis. Whether or not this variation can be reduced through a given intervention is unknown.Methods.  The programme of intensive nursing care including education on volume control, home blood pressure monitoring and intensified antihypertensive treatment, was implemented from December 2006. The blood pressure, fluid and sodium removal and defined daily doses of antihypertensive agents were measured at 1‐monthly intervals and averagely quarterly for seasonal values for spring, summer, autumn and winter, respectively, before (December 2005–November 2006) and after intervention (December 2006–November 2007).Findings.  A total of 76 clinically stable patients on peritoneal dialysis were enrolled and finally analysed. The mean age was 60·6 years, and dialysis duration was 23·2 months. Before intervention, there were important seasonal variations in systolic and diastolic blood pressure. After intensive nursing care was implemented, the seasonal variation of systolic blood pressure disappeared. The diastolic blood pressure still represented a season pattern, but the discrepancy between winter and summer decreased. There were no seasonal patterns of total fluid and sodium removal before and after intervention.Conclusions.  Intensive nursing care reduced the seasonal variation of blood pressure in patients on peritoneal dialysis. These data provided an evidence for implementing nurse‐centred interventions in this population.
Discriminating power of CPPQ‐Mohedo: a new questionnaire for chronic pelvic pain
Authors: Díaz Mohedo Esther , Barón López Fco J. , Pineda Galán Consolación , Dawid Milner Marc S. , Suárez Serrano Carmen , Medrano Sánchez Esther 
Published: October 2011

AbstractObjectives  In the absence of a gold‐standard tool to measure chronic pelvic pain (CPP), most studies on the prevalence of CPP use the NIH‐chronic prostatitis symptom index (CPSI) questionnaire. However, its suitability and relevance for use in both sexes have not yet been evaluated, and generalized interpretation of the results is therefore questionable. Accordingly, we designed a questionnaire that discriminates between patients with and without symptoms of CPP.Methods  We undertook a study to test the discriminating capacity for chronic pelvic pain questionnaire (CPPQ)‐Mohedo test for CPP among healthy and unhealthy individuals, and if this discrimination was similar for men and women. We did a matched study – 40 unhealthy men were matched by age with 40 unhealthy women – and each of those was matched with six healthy controls by age and sex (480 in total). To elaborate the questionnaire (CPPQ‐Mohedo), we started with the NIH‐CPSI, adapting the items referring to anatomic areas for women, changing the type of response and including various items on pelvic pain not previously recorded.Results  The NIH‐CPSI questionnaire [area under the receiver operating characteristic (ROC curve), 0.946] was very similar to that of the CPPQ‐Mohedo questionnaire (area under the ROC curve, 0.968), but the first required more items. CPPQ‐Mohedo showed similar discriminant capacity between men and women. The dimensions involved (pain and quality of life) showed internal consistency (Cronbach's alpha: 0.75).Conclusions  The CPPQ‐Mohedo questionnaire presented discriminating power in men and women with symptoms of CPP. This questionnaire may be used as a screening tool to identify patients and include them in treatment programmes, as an outcome assessment tool for treatment and clinical trials, or as a tool to assess the prevalence of CPP in epidemiologic studies.
How do practising clinicians and students apply newly learned causal information about mental disorders?
Authors: de Kwaadsteniet Leontien , Kim Nancy S. , Yopchick Jennelle E. 
Published: October 2011

AbstractRationale, aims and objectives  New causal theories explaining the aetiology of psychiatric disorders continuously appear in the literature. How might such new information directly impact clinical practice, to the degree that clinicians are aware of it and accept it? We investigated whether expert clinical psychologists and students use new causal information about psychiatric disorders according to rationalist norms in their diagnostic reasoning. Specifically, philosophical and Bayesian analyses suggest that it is rational to draw stronger inferences about the presence of a disorder when a client's presenting symptoms are from disparate locations in a causal theory of the disorder than when they are from proximal locations.Method  In a controlled experiment, we presented experienced clinical psychologists and students with recently published causal theories for different disorders; specifically, these theories proposed how the symptoms of each disorder stem from a root cause. Participants viewed hypothetical clients with presenting proximal or diverse symptoms, and indicated either the likelihood that the client has the disorder, or what additional information they would seek out to help inform a diagnostic decision.Results  Clinicians and students alike showed a strong preference for diverse evidence, over proximal evidence, in making diagnostic judgments and in seeking additional information. They did not show this preference in the control condition, in which they gave their own opinions prior to learning the causal information.Conclusion  These findings suggest that experienced clinical psychologists and students are likely to use newly learned causal knowledge in a normative, rational way in diagnostic reasoning.
Nurse‐led health promotion interventions improve quality of life in frail older home care clients: lessons learned from three randomized trials in Ontario, Canada
Authors: Markle‐Reid Maureen , Browne Gina , Gafni Amiram 
Published: October 2011

AbstractObjective  This paper explores the lessons learned from a series of three randomized controlled trials that included 498 community‐living frail older adults (≥65 years) using home care services in Southern Ontario, Canada. Each study was designed to evaluate the effectiveness of different multi‐component nurse‐led health promotion and disease prevention (HPDP) interventions.Methods  The nurse‐led HPDP interventions were 6‐ or 12‐month multi‐component and evidence‐based strategies targeting known risk factors for functional decline and frailty. Across the three studies, a common approach was used to measure the change in health‐related quality of life (HRQOL) (SF‐36) and the costs of use of health services (Health and Social Services Utilization Inventory) from baseline to the end of the intervention.Results  The main lesson learned from the three studies is that nurse‐led HPDP interventions for frail older home care clients provide greater improvements in HRQOL compared with usual home care. Such approaches are highly acceptable to this population and can be implemented using existing home care resources. Nurse‐led HPDP interventions should include multiple home visits, multidimensional screening and assessment, multi‐component evidence‐based HPDP strategies, intensive case management, inter‐professional collaboration, providers with geriatric training and experience, referral to and coordination of community services, and theory use.Conclusion  The results of the three trials underscore the need to reinvest in nurse‐led HPDP interventions in home care to optimize HRQOL and promote ageing in place in the target population of frail older adults. More studies are needed to evaluate the effectiveness of additional nurse‐led HPDP interventions in other contexts and settings.
Exploring the care experience of patients undergoing spinal surgery: a qualitative study
Authors: Davis Rachel E. , Vincent Charles , Henley Ania , McGregor Alison 
Published: October 2011

AbstractPurpose  This exploratory study sought to explore the patient experience of the surgical journey from decision to operate, to hospitalization, discharge and subsequent recovery.Design  Patients attended one of two focus group discussions.Patient sample  Seven patients that had undergone surgery for spinal stenosis or disc prolapsed participated, aged between 48–75 years (mean age 59); five were male.Methods  Patients’ attitudes towards the information and care they received from the point of the decision to operate through to post‐operative recovery were explored. Particular attention was paid to patients’ information needs, support provided, general understanding of the processes and ways in which care could have been improved.Results  Patients identified nine main ‘needs’ they felt played an integral part in enhancing the patient experience including the need for reduced waiting times, for better information and preparation, to be proactive, to speak up and ask questions, to feel safe and to be treated with dignity and respect; and the need for ongoing support, human contact, and; continuity of care.Conclusion  These findings suggest that there are several measures that could be taken to improve the patient's surgical experience. In particular, providing appropriate information to patients in a timely manner and ensuring that support and advice is easily accessible for those patients that need it are key areas for improvement.
‘It's easier just to separate them’: practice constructions in the mental health care and support of younger people with dementia and their families
Authors: ROACH P. , KEADY J. , BEE P. 
Published: October 2011

Accessible summaryThere is currently no standard provision of care for younger people with dementia and their families in the UK and there is little involvement of families in care provision and care planning.Specialist services for young‐onset dementia are consistently recommended in published and grey literature but continue to be overlooked in UK healthcare policy and service development.Staff experience difficulty working with family relationships because they are complex and family members often have different views and opinions about the best approach to care.Recommendations are made for the implementation of family‐centred working in dementia care to increase the effectiveness of care for families living with a diagnosis of young‐onset dementia.AbstractThere is no standard model of specialist care for younger people with dementia (onset before the age of 65 years) and specialist service provision varies widely throughout the UK. In order to gain a clearer picture about ways in which clinical staff work with younger people with dementia, semi‐structured interviews were conducted with dementia care staff working in the north‐west of England. Interviews focused on exploring daily working practices and the meaning placed on clinical decision making when involving family/carers in routine practice. Content analysis generated three core themes: (1) Maintaining Separation: how clinical staff conceptualize the meaning of ‘family’ in the provision of dementia care services; (2) Providing Practical Help: the focus in care provision on assisting families with aspects of daily life such as finances, education and physical care; and (3) Acknowledging the Family Context: how staff understand and interact with family members in an attempt to initiate care, utilizing biographically informed practice. By understanding how staff view their role in providing younger people with dementia with effective, high‐quality dementia care, it is anticipated that a more family‐centred approach can be integrated into already established patterns of working that more holistically meet the needs of this group.
Mortality from infectious diseases among refugees and immigrants compared to native Danes: a historical prospective cohort study
Authors: Norredam M. , Olsbjerg M. , Petersen J. H. , Bygbjerg I. , Krasnik A. 
Published: October 2011

SummaryObjectives  Refugees and immigrants are likely to be vulnerable to mortality from infectious diseases as a result of high prevalences in their countries of origin and barriers in access to healthcare in the recipient countries. Consequently, we aimed to compare and investigate differences in mortality from infectious diseases among refugees and immigrants and native Danes.Methods  A register‐based, historical prospective cohort design. All refugees (n = 29 139) and family‐reunited immigrants (n = 27 134) who, between 1 January1993 and 31 December1999, were granted the right to reside in Denmark were included and matched 1:4 on age and sex with native Danes. Civil registration numbers were cross‐linked to the Register of Causes of Death, and fatalities owing to infectious diseases (based on ICD‐10 diagnosis) were identified. Mortality ratios were estimated separately for men and women by migrant status and region of birth; adjusting for age and income; using a Cox regression model, after a mean follow‐up of 10–12 years after arrival.Results  Female [hazard ratio (HR) = 4.15; 95% CI: 2.38, 7.25] and male (HR = 2.05; 95% CI: 1.27, 3.33) refugees experienced significantly higher mortality risks from infectious diseases than did native Danes, as was the case for male immigrants (HR = 2.39; 95% CI: 1.20, 4.76) but less so for female immigrants (HR = 1.23; 95% CI: 0. 50‐3.01). Mortality by region of origin was notably higher for individuals from North Africa and sub‐Saharan Africa.Conclusions  Higher mortality among refugees and immigrants than among the native population should lead to reflections on medical reception systems in recipient countries and subsequent possibilities of access to specialised diagnostic and curative healthcare.
Difference in keratinase activity of dermatophytes at different environmental conditions is an attribute of adaptation to parasitism
Authors: Sharma Anima , Chandra Subhash , Sharma Meenakshi 
Published: October 2011

SummaryDermatophytes are a group of morphologically and physiologically related moulds, which cause well‐defined infection called dermatophytosis. The enzymatic ability of fungi to decompose keratin has long been interpreted as a key innovation in the evolution of animal dermatology. In the present study, keratinase activity profile among Trichophyton mentagrophytes, Trichophyton rubrum, Microsporum canis and Microsporum gypseum isolated on keratin substrates such as human hair, human nail and chicken feather at variable environmental conditions of temperature, pH and metal ions was elucidated. All the above‐mentioned fungal strains were isolated from soil using To‐KA‐Va baiting technique and keratinolytic activity was measured spectrophotometrically. In the temperature range of 30–40 °C and slightly alkaline pH (7.0–8.0), Trichophyton produced the highest activity of keratinase. It can be presumed that high enzyme production of Trichophyton species at normal body temperature range and pH could be an attribute for obligate anthropization in some dermatophytes.
Changes of renal vitamin D metabolic enzyme expression and calcium transporter abundance in obstructive nephropathy
Authors: ZHANG YAN , WU SHU‐YAN , GU SA‐SA , LV FU‐KOU 
Published: October 2011

ABSTRACT:The effects of urinary‐tract obstruction on renal function have been clarified. However, there is little known about the change of renal vitamin D metabolic enzyme expression and vitamin D‐dependent calcium transporting proteins expression in obstructive nephropathy. The male mice were subjected to unilateral ureteral obstruction (n = 10) or sham operation (n = 10). All mice were killed on day 7 after the surgical operation. Kidney sections were stained with Masson's trichrome and gene expression was analyzed by reverse transcription‐polymerase chain reaction (RT‐PCR) and real‐time PCR. The obstructed kidney exhibited interstitial fibrosis as shown by the strong collagen deposition in the interstitium. Quantitative PCR results showed the increase of 1‐OHase (P < 0.001) mRNA expression and the decrease of 24‐OHase (P < 0.01), CaBP‐9k (P < 0.01) and CaBP‐28k (P < 0.01) mRNA expression in obstructed kidney as compared to that of the Sham group. In addition, the mRNA expression of 1‐OHase and CaBP‐9k was significantly increased and decreased, respectively, in obstructed kidney as compared to that of the contra‐lateral kidney in unilateral ureteral obstruction (UUO) mice. Together, the present finding supports the hypothesis that the ureteral obstruction leads to the alteration of renal vitamin D metabolic enzyme expression and calcium transporter abundance, which may secondarily induce the abnormality of vitamin D endocrine system and bone health.
Leukaemic transformation of Philadelphia chromosome‐negative myeloproliferative neoplasms: are Asian patients different?
Authors: Cherian R. , Wong G. C. 
Published: October 2011

AbstractBackground:  Leukaemic transformation (LT) is rare in the natural history of Philadelphia(Ph) chromosome‐negative myeloproliferative disorders (MPD), and has a dismal prognosis. Little literature is available on Asian patients.Aims:  The aim of this study is to report a single institution experience of Asian patients who developed acute leukaemia after being diagnosed and treated for Ph chromosome‐negative MPDs, and to compare the findings of this series with similar studies from the literature.Methods:  Patients were recruited from the MPD registry of Singapore General Hospital, Department of Hematology. Clinical data including treatment modalities and duration of use in myeloproliferative phase, latency to LT, characteristics of leukaemia, chemotherapy administered and survival after LT were examined.Results:  Over a 29‐year period from 1980 to 2009, there were 22 Asian patients with LT of Ph chromosome‐negative MPD of which four had polycythaemia vera (PV), nine had essential thrombocythaemia (ET), seven had myelofibrosis (MF) and two had unspecified MPD at diagnosis. Primary treatment modality was Hydroxyurea (HU) during MPD phase. Median latency to LT was 14 years for PV, 10 years for ET and 1 year for MF. Median age at LT diagnosis was 67.5 years. Nine patients had complex cytogenetics, with abnormalities of chromosomes 5 and 7 being common.Overall, median survival was 2 months after LT. Eight patients who received induction chemotherapy had a median survival of 2.5 months. Survival was independent of MPD type and treatment administered. None received stem cell transplantation.Conclusions:  LT of Ph chromosome‐negative MPD is rare and uniformly fatal. Despite chemotherapy, survival was poor, and patients succumbed to refractory disease and infections. Asian patients did not have a more favourable outcome. It remains to be investigated whether upfront stem cell transplant may be a treatment option.
‘A Science of Tonal Love’? Drive and Desire in Twentieth‐Century Harmony: the Erotics of Skryabin
Authors: SMITH KENNETH 
Published: October 2011

ABSTRACTLeonid Sabaneyev attested that Skryabin's compositions contained within them ‘a science of tonal love’, and Skryabin himself described his two Op. 57 pieces –Désir and Caresse dansée– as ‘new ways of making love’. But what makes this music so erotic in nature? The composer theorised about the nature of desire and sexuality in his writings, but this discussion rarely spills over into analysis of his compositional system. Given that Skryabin was so steeped in psychology throughout his life, I appeal to the work of Freud and Jacques Lacan, and particularly to their distinction between drive and desire (essentially, the fundamental instinct of the id versus its imaginary representation), a distinction found in Skryabin's own philosophical writings. But the progression between these two states bears comparison with both his philosophy and his harmonic processes, and I thus focus on the function of the dominant chord, exploring ways in which it can replicate the structures of drive and desire. In so doing, I scrutinise several piano miniatures to show that part of Skryabin's method of embodying drive in music lays out ambiguous chord structures which bear simultaneous tendencies to move in a number of different directions, as multivalent as the drive in the human subject. Further, I attempt to show that, out of mystical sonorities, Skryabin temporally unfolds a dialogue of different dominant ‘drives’, and eventually selects and nurtures a single one at the expense of others, a motion equivalent to desire.
Ethnic Differences in Appointment‐Keeping and Implications for the Patient‐Centered Medical Home—Findings from the Diabetes Study of Northern California (DISTANCE)
Authors: Parker Melissa M. , Moffet Howard H. , Schillinger Dean , Adler Nancy , Fernandez Alicia , Ciechanowski Paul , Karter Andrew J. 
Published: October 2011

ObjectiveTo examine ethnic differences in appointment‐keeping in a managed care setting.Data Sources/Study SettingKaiser Permanente Diabetes Study of Northern California (DISTANCE), 2005–2007, n = 12,957.Study DesignCohort study. Poor appointment‐keeping (PAK) was defined as missing >1/3 of planned, primary care appointments. Poisson regression models were used to estimate ethnic‐specific relative risks of PAK (adjusting for demographic, socio‐economic, health status, and facility effects).Data Collection/Extraction MethodsAdministrative/electronic health records and survey responses.Principal FindingsPoor appointment‐keeping rates differed >2‐fold across ethnicities: Latinos (12 percent), African Americans (10 percent), Filipinos (7 percent), Caucasians (6 percent), and Asians (5 percent), but also varied by medical center. Receiving >50 percent of outpatient care via same‐day appointments was associated with a 4‐fold greater PAK rate. PAK was associated with 20, 30, and 40 percent increased risk of elevated HbA1c (>7 percent), low‐density lipoprotein (>100 mm/dl), and systolic blood pressure (>130 mmHg), respectively.ConclusionsLatinos and African Americans were at highest risk of missing planned primary care appointments. PAK was associated with a greater reliance on same‐day visits and substantively poorer clinical outcomes. These results have important implications for public health and health plan policy, as primary care rapidly expands toward open access to care supported by the patient‐centered medical home model.
Electrical and Thermal Properties of Cr2GeC
Authors: Barsoum M. W. , Scabarozi T. H. , Amini S. , Hettinger J. D. , Lofland S. E. 
Published: October 2011

Herein we report on the 4–300 K resistivity, magnetoresistance, Hall and Seebeck coefficients and heat capacity of Cr2GeC. The results—analyzed within a two‐band model—confirm that Cr2GeC is a compensated conductor where the concentration of electrons and holes are almost equal; the same is true of the mobilities. The room‐temperature thermal conductivity is 22 W·(m·K)−1; roughly half the heat is carried by phonons, half by electrons. The heat capacity results confirm previous results.