bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is primary angioplasty an acceptable alternative to thrombolysis? Quantitative and qualitative study of patient and carer satisfaction
Authors: Sampson Fiona C , O’Cathain Alicia , Goodacre Steve 
Published: July 2010

AbstractObjective  The National Infarct Angioplasty Project assessed the feasibility of establishing a comprehensive primary angioplasty service. We aimed to compare satisfaction at intervention hospitals offering angioplasty‐based care and control hospitals offering thrombolysis‐based care.Design  Mixed methods, with postal survey of patients and their carers, supported by semi‐structured interviews.Setting and participants  Survey of 682 patients and 486 carers, and interviews with 33 patients and carers, in eight English hospitals.Interventions  Primary angioplasty or thrombolysis.Main outcome measures  Satisfaction with treatment.Results  Responses were received from 595/682 patients (87%) and 418/486 carers (86%). Satisfaction with overall care was high at both intervention and control sites (78% vs. 71% patients rated their care as ‘excellent’, P = 0.074). Patient satisfaction was higher at intervention sites for some aspects of care such as speed of treatment (80% vs. 67%‘excellent’, P = 0.001). Convenience of visiting was rated lower at intervention sites by carers (12% vs. 1%‘poor’, P = 0.001). During interviews, carers reported that they accepted the added inconvenience of visiting primary angioplasty sites in the context of this life‐saving treatment. Patient satisfaction with discharge and aftercare was lower in both treatment groups than for other aspects of care.Conclusions  Reorganization of care to offer a primary angioplasty service was acceptable to patients and their carers. Satisfaction levels were high regardless of the type of care received, with the exception of discharge and aftercare.
Patient perceptions of carrying their own health information: approaches towards responsibility and playing an active role in their own health – implications for a patient‐held health file
Authors: Forsyth Rowena , Maddock Carol A. , Iedema Rick A. M. , Lassere Marissa 
Published: July 2010

AbstractObjective  To elicit patients’ views on whether they could contribute to improvements in their care by carrying their own health information to clinician encounters; and to consider the implications for the development of a patient‐held health file (PHF).Background  Increasing rates of chronic disease lead to health care being delivered by multiple care providers often at distributed geographic locations. As a way of increasing the availability of patient information to care providers our project will trial a PHF. Patients carry these files to doctors’ appointments where clinicians record data for other doctors or the patient. Increasing the availability of patient information is anticipated to enhance the safety and quality of care delivery and improve health outcomes.Study design  Qualitative semi‐structured interviews were conducted with 10 patients. Participants were evenly distributed in terms of gender, aged 60 years or greater and visited at least two specialists and one general practitioner.Findings  In this exploratory study, patients who were currently active in decision making about their own health already recorded some health information. They were receptive to carrying their information and thought they should take some responsibility for their health. Patients who were more passive in making decisions about their health did not perceive a need to carry their own information and felt that their doctors communicated adequately.Conclusion  Patient‐held health files provide an opportunity for patients to access their health information. Such files have the potential to improve health outcomes for patients who adopt both active and passive roles in relation to their own health and engaging with their health information.
Critical appraisal guidelines for assessing the quality and impact of user involvement in research
Authors: Wright David , Foster Claire , Amir Ziv , Elliott Jim , Wilson Roger 
Published: July 2010

AbstractBackground  The involvement of service users in the design and conduct of health research has developed significantly in the UK in recent years. Involving service users is now seen as a core component of good research practice for all forms of health research. Given the important role that users have in health research, it is necessary to develop guidelines for their effective involvement. Whilst guidelines are currently being formulated, there remain no criteria with which to assess user involvement in published studies and funding applications.Objective  This study offers guidelines for appraising the quality and impact of user involvement in published papers and grant applications.Methods  Appraisal guidelines for user involvement have been developed on the basis of available literature and experiences from studies involving cancer patients and carers in the design and conduct of research.Findings  Nine appraisal criteria have been developed. Criteria include issues such as ‘Is the rationale for involving users clearly demonstrated?’, ‘Is the level of user involvement appropriate?’, ‘Is the recruitment strategy appropriate?’, and ‘Is the nature of training appropriate?’Conclusion  Generating and applying guidelines is vital if the impact of user involvement agenda in health research is to be understood.
Training family physicians in shared decision making for the use of antibiotics for acute respiratory infections: a pilot clustered randomized controlled trial
Authors: Légaré France , Labrecque Michel , LeBlanc Annie , Njoya Merlin , Laurier Claudine , Côté Luc , Godin Gaston , Thivierge Robert L. , O’Connor Annette , St‐Jacques Sylvie 
Published: July 2010

AbstractBackground  Experts estimate that the prevalence of antibiotics use exceeds the prevalence of bacterial acute respiratory infections (ARIs).Objective  To develop, adapt and validate DECISION+ and estimate its impact on the decision of family physicians (FPs) and their patients on whether to use antibiotics for ARIs.Design  Two‐arm parallel clustered pilot randomized controlled trial.Setting and participants  Four family medicine groups were randomized to immediate DECISION+ participation (the experimental group) or delayed DECISION+ participation (the control group). Thirty‐three FPs and 459 patients participated.Intervention  DECISION+ is a multiple‐component, continuing professional development program in shared decision making that addresses the use of antibiotics for ARIs.Main outcome measures  Throughout the pilot trial, DECISION+ was adapted in response to participant feedback. After the consultation, patients and FPs independently self‐reported the decision (immediate use, delayed use, or no use of antibiotics) and its quality. Agreement between their decisional conflict was assessed. Two weeks later, patients assessed their decisional regret and health status.Results  Compared to the control group, the experimental group reduced its immediate use of antibiotics (49 vs. 33% absolute difference = 16%; P = 0.08). Decisional conflict agreement was stronger in the experimental group (absolute difference of Pearson’s r = 0.26; P = 0.06). Decisional regret and perceptions of the quality of the decision and of health status in the two groups were similar.Discussion and conclusions  DECISION+ was developed successfully and appears to reduce the use of antibiotics for ARIs without affecting patients’ outcomes. A larger trial is needed to confirm this observation.
O‐antigen diversity and lateral transfer of the wbe region among Vibrio splendidus isolates
Authors: Wildschutte Hans , Preheim Sarah P. , Hernandez Yasiel , Polz Martin F. 
Published: July 2010

SummaryThe O‐antigen is a highly diverse structure expressed on the outer surface of Gram‐negative bacteria. The products responsible for O‐antigen synthesis are encoded in the wbe region, which exhibits extensive genetic diversity. While heterogeneous O‐antigens are observed within Vibrio species, characterization of these structures has been devoted almost exclusively to pathogens. Here, we investigate O‐antigen diversity among coastal marine Vibrio splendidus‐like isolates. The wbe region was first identified and characterized using the sequenced genomes of strains LGP32, 12B01 and Med222. These regions were genetically diverse, reflective of their expressed O‐antigen. Additional isolates from physically distinct habitats in Plum Island Estuary (MA, USA), including within animal hosts and on suspended particles, were further characterized based on multilocus sequence analysis (MLSA) and O‐antigen profiles. Results showed serotype diversity within an ecological setting. Among 48 isolates which were identical in three MLSA genes, 41 showed gpm genetic diversity, a gene closely linked to the wbe locus, and at least 12 expressed different O‐antigen profiles further suggesting wbe genetic diversity. Our results demonstrate O‐antigen hyper‐variability among these environmental strains and suggest that frequent lateral gene transfer generates wbe extensive diversity among V. splendidus and its close relatives.
Identification of the dominant sulfate‐reducing bacterial partner of anaerobic methanotrophs of the ANME‐2 clade
Authors: Schreiber Lars , Holler Thomas , Knittel Katrin , Meyerdierks Anke , Amann Rudolf 
Published: July 2010

SummaryThe anaerobic oxidation of methane (AOM) with sulfate as terminal electron acceptor is mediated by consortia of methanotrophic archaea (ANME) and sulfate‐reducing bacteria (SRB). Whereas three clades of ANME have been repeatedly studied with respect to phylogeny, key genes and genomic capabilities, little is known about their sulfate‐reducing partner. In order to identify the partner of anaerobic methanotrophs of the ANME‐2 clade, bacterial 16S rRNA gene libraries were constructed from cultures highly enriched for ANME‐2a and ANME‐2c in consortia with Deltaproteobacteria of the Desulfosarcina/Desulfococcus group (DSS). Phylogenetic analysis of those and publicly available sequences from AOM sites supported the hypothesis by Knittel and colleagues that the DSS partner belongs to the diverse SEEP‐SRB1 cluster. Six subclusters of SEEP‐SRB1, SEEP‐SRB1a to SEEP‐SRB1f, were proposed and specific oligonucleotide probes were designed. Using fluorescence in situ hybridization on samples from six different AOM sites, SEEP‐SRB1a was identified as sulfate‐reducing partner in up to 95% of total ANME‐2 consortia. SEEP‐SRB1a cells exhibited a rod‐shaped, vibrioid, or coccoid morphology and were found to be associated with subgroups ANME‐2a and ANME‐2c. Moreover, SEEP‐SRB1a was also detected in 8% to 23% of ANME‐3 consortia in Haakon Mosby Mud Volcano sediments, previously described to be predominantly associated with SRB of the Desulfobulbus group. SEEP‐SRB1a contributed to only 0.3% to 0.7% of all single cells in almost all samples indicating that these bacteria are highly adapted to a symbiotic relationship with ANME‐2.
GeneFISH – an in situ technique for linking gene presence and cell identity in environmental microorganisms
Authors: Moraru Cristina , Lam Phyllis , Fuchs Bernhard M. , Kuypers Marcel M. M. , Amann Rudolf 
Published: July 2010

SummaryOur knowledge concerning the metabolic potentials of as yet to be cultured microorganisms has increased tremendously with the advance of sequencing technologies and the consequent discoveries of novel genes. On the other hand, it is often difficult to reliably assign a particular gene to a phylogenetic clade, because these sequences are usually found on genomic fragments that carry no direct marker of cell identity, such as rRNA genes. Therefore, the aim of the present study was to develop geneFISH – a protocol for linking gene presence with cell identity in environmental samples, the signals of which can be visualized at a single cell level. This protocol combines rRNA‐targeted catalysed reporter deposition – fluorescence in situ hybridization and in situ gene detection. To test the protocol, it was applied to seawater samples from the Benguela upwelling system. For gene detection, a polynucleotide probe mix was used, which was designed based on crenarchaeotal amoA clone libraries prepared from each seawater sample. Each probe in the mix was selected to bind to targets with up to 5% mismatches. To determine the hybridization parameters, the Tm of probes, targets and hybrids was estimated based on theoretical calculations and in vitro measurements. It was shown that at least 30%, but potentially the majority of the Crenarchaeota present in these samples harboured the amoA gene and were therefore likely to be catalysing the oxidation of ammonia.
Microbial communities acclimate to recurring changes in soil redox potential status
Authors: DeAngelis Kristen M. , Silver Whendee L. , Thompson Andrew W. , Firestone Mary K. 
Published: July 2010

SummaryRapidly fluctuating environmental conditions can significantly stress organisms, particularly when fluctuations cross thresholds of normal physiological tolerance. Redox potential fluctuations are common in humid tropical soils, and microbial community acclimation or avoidance strategies for survival will in turn shape microbial community diversity and biogeochemistry. To assess the extent to which indigenous bacterial and archaeal communities are adapted to changing in redox potential, soils were incubated under static anoxic, static oxic or fluctuating redox potential conditions, and the standing (DNA‐based) and active (RNA‐based) communities and biogeochemistry were determined. Fluctuating redox potential conditions permitted simultaneous CO2 respiration, methanogenesis, N2O production and iron reduction. Exposure to static anaerobic conditions significantly changed community composition, while 4‐day redox potential fluctuations did not. Using RNA : DNA ratios as a measure of activity, 285 taxa were more active under fluctuating than static conditions, compared with three taxa that were more active under static compared with fluctuating conditions. These data suggest an indigenous microbial community adapted to fluctuating redox potential.
Temporal dynamics and genetic diversity of chemotactic‐competent microbial populations in the rhizosphere
Authors: Buchan Alison , Crombie Burnette , Alexandre Gladys M. 
Published: July 2010

SummaryThe contribution of chemotaxis to the competitive colonization of the rhizosphere for the vast majority of the soil community is unknown. We have developed and applied a molecular diagnostic tool, based on a gene encoding the central regulator of bacterial chemotaxis (cheA), to characterize and temporally track specific populations of native microbes with chemotaxis potential that are present in soil exposed to two rhizospheres: wheat and cowpea. The data show that the chemotactic‐competent communities present in the rhizospheres of the two plants are distinct and less diverse than the bulk soil, indicating the development of unique microbial communities. Consistent with the supposition that selection and recruitment of specific soil microbes takes place in the rhizosphere, the dynamics of specific cheA phylotypes provides support for the hypothesis that chemotaxis provides a competitive advantage to some soil microbes. This is the first study to examine and profile the genetic diversity of chemotaxis genes in natural populations. As such, it illustrates our limited understanding of microbial chemotaxis for the majority of soil microbes. It also highlights the value of a culture‐independent approach for examining chemotaxis populations in order to build empirical lines of evidence for its role in structuring of microbial assemblages.
Hepatitis B and C seropositivity among nursing students at a Turkish university
Authors: Irmak Z. , Ekinci B. , Akgul A.F. 
Published: July 2010

IRMAK Z., EKINCI B. & AKGUL A.F. (2010) Hepatitis B and C seropositivity among nursing students at a Turkish university. International Nursing Review57, 365–369Background:  Viral hepatitis infections are major health problems, which are especially prevalent in developing countries. In particular, health care workers are at high risk for contracting viral hepatitis. Therefore, preventive measures to minimize occupational exposure to blood borne pathogens are needed to protect both health care workers and nursing students.Objectives:  To determine the prevalence of Hepatitis B and C infections and risk factors among nursing students.Methods:  Venous bloods were obtained from nursing students and were serologically tested using the ELISA method. A questionnaire form was also used to obtain data related to demographic and socio‐economic characteristics of the participants.Results:  0.7% of the nursing students were serologically positive for HBsAg, 17.0% for Anti‐HBs and 7.5% were positive for Anti‐HBc (IgG). No statistical relationship was determined between all independent variables and the results of serologic tests.
Family planning practice and related factors of married women in Ethiopia
Authors: Ko I.S. , You M.A. , Kim E.S. , Lee T.W. , Kim S. , Kim Y.M. , Nam J.J. , Lee H.K. 
Published: July 2010

KO I.S., YOU M.A., KIM E.S., LEE T.W., KIM S., KIM Y.M., NAM J.J., LEE H.K. (2010).Family planning practice and related factors of married women in Ethiopia. International Nursing Review57, 377–382Background:  The family planning (FP) practice rate of Ethiopian women of reproductive age is lower than in most other sub‐Saharan African countries.Aim:  To examine the status of FP practice and identify intrapersonal, interpersonal and community factors associated with FP practice among married Ethiopian women in a rural area.Methods:  A cross‐sectional survey was conducted with a convenient sample of 193 married women of reproductive age. A structured questionnaire, which was modified based on the Ethiopian Demographic Health Survey, was used. Multiple logistic regression analysis was conducted to identify factors associated with FP practice at three levels: intrapersonal, interpersonal and community.Results:  Almost 67% of women were currently using at least one FP method and most women obtained FP methods from the public health sector. Short‐term methods such as pills and injections were most commonly used. FP practice was significantly associated with willingness to use long‐term or permanent FP methods in future and spousal discussion about FP.Conclusions:  Both intrapersonal and interpersonal factors were related to FP practice. Community factors, however, need to be further assessed using various methods to plan a comprehensive and more culturally acceptable community‐based FP program. Caution is needed to generalize the findings because of the convenient sample, but community‐based FP programs emphasizing long‐term or permanent methods and male involvement in FP counseling would be successful strategies to increase FP practice.Implications for nursing practice:  Nurses and midwives need to be trained to provide knowledge and skills for long‐term or permanent FP methods for service quality.
Nurses' and midwives' knowledge and perceptions of their role in genetic teaching
Authors: Gharaibeh H. , Oweis A. , Hamad K.H. 
Published: July 2010

GHARAIBEH H., OWEIS A. & HAMAD K.H. (2010) Nurses' and midwives' knowledge and perceptions of their role in genetic teaching. International Nursing ReviewBackground:  There is a high incidence of birth defects and genetic disorders in Jordan. The purpose of this study was to explore Jordanian nurses' and midwives' knowledge and perceptions of their role in genetic teaching.Method:  A descriptive cross‐sectional design with a convenience sample of 200 registered nurses and midwives was used. Nurses and midwives were recruited from three maternal and child health hospitals located in the northern part of Jordan. Eligible participants who met the inclusion criteria were invited to participate in the study. A sociodemographic data form and a questionnaire concerning nurses' and midwives' attitudes and perceptions of their role in genetic teaching were developed for self‐administration.Results:  Findings indicated that the majority (86 per cent) of nurses and midwives had an inadequate level of knowledge regarding genetic teaching regarding their roles in obtaining family history and pedigrees, and providing genetic information for affected persons or high‐risk families. Furthermore, the findings indicated that nurses and midwives perceived that genetic teaching is the responsibility of other health professionals or the responsibility of genetic services centres rather than their responsibility.Conclusions:  Nurses and midwives need to be better educated about genetics to effectively assume new roles as genetic educators and counsellors. This study documented how Jordanian nurse educators have to work to generate a new cadre of people who are adequately prepared to deliver such a service and who identify with the need for this service.
The Long Road to Universalism? Recent Developments in the Financing of Long‐term Care in England
Authors: Comas‐Herrera Adelina , Wittenberg Raphael , Pickard Linda 
Published: July 2010

AbstractFollowing more than a decade of intense debate, the long‐term care system in England may be on the verge of major change. We argue that the current system can be characterized as a residual system where care is free only to those who cannot afford to pay for themselves, with access heavily targeted to those with the highest levels of needs and with no informal care, and with substantial local variation in access and means‐testing for home care. It is also characterized by a mixed economy of supply of care and a mixed economy of finance. The government Green Paper has proposed a major shift from diverse local systems to a new National Care Service, with a national entitlement to some public support for all those who are assessed as needing it. The government has also recently announced that it will make personal care at home free to those with the highest needs. If implemented, the proposals included in the Green Paper would, at minimum, introduce a ‘quasi‐universal’ system, in which some level of assistance is provided to all those with eligible social care needs.
Sustainability of Comprehensive Universal Long‐term Care Insurance in the Netherlands
Authors: Schut Frederik T. , Van Den Berg Bernard 
Published: July 2010

AbstractThe Netherlands was the first country that introduced a universal mandatory social health insurance scheme for covering a broad range of long‐term care (LTC) services provided in a variety of care settings. Compared with most other OECD countries, both total and public expenditure on LTC is high, particularly since the Dutch population is relatively young. On the other hand, coverage of LTC services is relatively comprehensive. In this article we examine the past experiences, current deficiencies and future prospects of LTC financing in the Netherlands. By rationing of supply and tight budgetary restrictions, the government managed to effectively control the growth of LTC expenditure, but at the expense of growing waiting lists and deteriorating quality of care. Reform plans aim to make the LTC system more efficient and consumer‐directed. We discuss whether the proposed reforms offer a perspective on a sustainable system of comprehensive LTC insurance. This is especially important in view of the ageing of the population and the expected increase in demand for LTC services. We conclude that the success of the reforms heavily depends on the definition of entitlements, the accuracy of needs assessment and the feasibility of determining appropriate client‐based budgets.