bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parental consent for neuroimaging in paediatric research
Authors: Morgan A. T. , Reilly S. , Eadie P. , Watts A. , Simpson C. 
Published: July 2009

AbstractBackground  Functional magnetic resonance imaging (fMRI) is increasingly applied in paediatric research. Parents typically provide research consent for their children; yet, no study has examined the rates of consent, nor factors influencing parental decision making for consent. The present study aimed to determine the proportion of parents that would consent to their child undergoing an fMRI study, and to elicit the reasons, motivators and detractors affecting their decision.Methods  Ninety parents of children aged 6 years were invited to participate in a postal survey study.Results  Fifty‐three parents (59%) responded and one‐third (34%, 18/53) reported that they would consent. The main reason for consent was that participation could benefit children in the future (89%, 16/18). Common reasons for not consenting included that fMRI may be anxiety‐provoking (54%), or was an unnecessary medical procedure (23%).Conclusions  Our preliminary data suggest that researchers may have to approach three times the number of participants required in order to recruit a suitable number of healthy children to fMRI studies. Further research examining the influence of recruitment approaches (e.g. phone vs. postal) and the various factors influencing decision making regarding consent is required. For example, careful examination of the language used in describing the procedure could facilitate parental understanding about fMRI and alleviate anxiety associated with the procedure. This is an important consideration for recruitment to future fMRI studies given that anxiety was a key factor influencing parental non‐consent.
Chronic antigenic stimuli as a possible explanation for the immunodepression caused by liver cirrhosis
Authors: Márquez M , Fernández-Gutiérrez C , Montes-de-Oca M , Blanco M J , Brun F , Rodríguez-Ramos C , Girón-González J A 
Published: July 2009

SummaryThe objectives of this work were the analysis of the functional characteristics of circulating monocytes and T lymphocytes in patients with liver cirrhosis, and evaluation of the relationship with an increased exposure to antigens due to bacterial translocation. Forty patients with liver cirrhosis (20 with compensated cirrhosis and 20 with ascitic decompensation) and 20 healthy control subjects were studied. Bacterial translocation was evaluated by serum levels of lipopolysaccharide binding protein (LBP). Macrophage activation was studied by CD40 antigen expression. T lymphocytes were analysed for activation (CD25+, CD122+), effector function (CD8+CD45RO+CD57+), apoptosis (CD95+) and regulatory abilities, either by analysis of the membrane expression of co-stimulatory molecules CD80, CD86 and CD28, or by quantification of regulatory T cells CD4+CD25highforkhead box P3 (FoxP3). The percentage of activated monocytes and T lymphocytes in patients was increased significantly. The proportions of effector senescent cells and of those near to apoptosis were also significantly higher. With respect to these proportions, there were no significant differences between patients in function of the presence or absence of decompensation or in function of the increased or normal values of LBP. Conversely, those patients with elevated levels of LBP presented a significantly higher frequency of regulatory T cells than those with normal levels. In conclusion, patients with liver cirrhosis showed an intensive activation state with a higher percentage of cells committed to activation-induced death, even in non-advanced stages. It is possible that bacterial permeability and endotoxaemia contribute to the expansion of those lymphocyte populations implicated in the prevention of a more severe antigen-induced immunopathology.
Sex differences in the association between albumin and all‐cause and vascular mortality
Authors: Grimm G. , Haslacher H. , Kampitsch T. , Endler G. , Marsik C. , Schickbauer T. , Wagner O. , Jilma B. 
Published: July 2009

AbstractBackground  Low serum albumin levels are associated with cardiovascular disease and mortality risk. This study evaluated the predictive value of low serum albumin for all‐cause‐mortality in a large Viennese patient cohort and investigated sex differences in the association between serum albumin and mortality.Materials and methods  Serum albumin concentrations of 285 930 patients, who attended the General Hospital Vienna between 1992 and 2002, were evaluated and linked with the Austrian Death Registry. The median observation period was 7·4 ± 4·0 years and the death rate was 16·8%. For Cox regression analysis, albumin levels were divided into deciles, the highest category served as reference value. To analyse associations between albumin and mortality independent of liver function, results were adjusted for cholinesterase, which indicates protein synthesis capacity of the liver.Results  Hazard ratios for all‐cause‐mortality increased linearly with decreasing albumin levels from 1·05 in the 9th to 2·98 in the 1st decile. Adjusted for cholinesterase, the relative risk for mortality was still 1·91 in the lowest category. Compared with women, men had an average 50% increased risk of death in almost every decile, adjusting for cholinesterase reduced the sex difference to a 10–20% higher mortality risk for men. In critically ill patients, hazard ratios for all‐cause‐mortality ranged from 4·5 in the 9th decile to 9·5 in the lowest albumin category.Conclusion  This study demonstrates a strong inverse association between serum albumin and mortality in a large patient cohort. The predictive value of low albumin was remarkably higher in men than in women.
Waiting list management: priority criteria or first‐in first‐out? A case for total joint replacement
Authors: Escobar Antonio , Quintana José Ma , González Marta , Bilbao Amaia , Ibañez Berta 
Published: July 2009

AbstractBackground  Total joint replacements are interventions with large waiting times from indication to the surgery management. These patients can be managed in two ways; first‐in first‐out or through a priority tool. The aim of this study was to compare real time on waiting list (TWL) with a priority criteria score, developed by our team, in patients awaiting joint replacement due to osteoarthritis.Methods  Consecutive patients placed on waiting list were eligible. Patients fulfilled a questionnaire which included items of our priority tool and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) specific questionnaire. Other priority items were extracted from the clinical history. The priority tool gives a score from 0 to 100 points, and three categories (urgent, preferent and ordinary). We studied the differences among categories and TWL by means of one‐way analysis of variance. Correlational analysis was used to evaluate association among priority score and TWL and WOMAC baseline and gains at 6 months with priority score and TWL.Results  We have studied 684 patients. Women represented 62% of sample. The mean age was 70 years. There were not association between the categories of priority score and TWL (P = 0.12). The rho correlation coefficient between TWL and priority score was −0.11. Among baseline WOMAC scores and priority score, the rho coefficients were 0.79, 0.7 and 0.52 with function, pain and stiffness dimensions, respectively. There were differences in the mean scores of WOMAC dimensions according to the three priority categories (P < 0.001) but no with TWL categories. Data of gains in both health‐related quality of life dimensions at 6 months were similar, with differences according to priority categories but no regarding TWL.Conclusions  The results of the study support the necessity of implementing a prioritization system instead of the actual system if we want to manage the waiting list for joint replacement with clinical equity.
Mental health consumers' perceptions of receiving recovery‐focused services
Authors: Marshall Sarah L. , Oades Lindsay G. , Crowe Trevor P. 
Published: July 2009

AbstractRationale, aims and objectives  This study examines the experiences of mental health service consumers engaged in various recovery‐focused support practices as well as examining consumer valuing of these activities.Method  A self‐report questionnaire was developed drawing on key aspects of the Collaborative Recovery Model (CRM) (responsibility, collaboration, autonomy, motivation, needs, goals, homework). Ninety‐two adult consumers from metropolitan, regional and rural non‐government organizations and public mental health services in eastern Australian states completed the questionnaire.Results  Consumers using services provided by CRM‐trained workers identified significant changes to service delivery in relation to frequency with which they were encouraged to take responsibility for their recovery, degree to which they collaborated with staff and the extent to which they were encouraged to complete homework activities to assist them to achieve their goals, when compared with consumers using traditional services. The key aspects of the CRM were valued by consumers. No differences were found in terms of overall ratings of clinician helpfulness in assisting recovery between the two groups.Conclusions  Consumers are able to perceive recovery‐focused service changes. Although preliminary, this is a significant step towards assessing the operationalization of recovery principles from the consumer's perspective.
A multi‐intervention approach on drug therapy can lead to a more appropriate drug use in the elderly. LIMM‐Landskrona Integrated Medicines Management
Authors: Bergkvist Anna , Midlöv Patrik , Höglund Peter , Larsson Lisa , Eriksson Tommy 
Published: July 2009

AbstractRationale, aims and objectives  To evaluate if an integrated medicines management can lead to a more appropriate drug use in elderly inpatients.Method  The study was an intervention study at a department of internal medicine in southern Sweden. During the intervention period pharmacists took part in the daily work at the wards. Systematic interventions aiming to identify, solve and prevent drug‐related problems (DRPs) were performed during the patient's hospital stay by multidisciplinary teams consisting of physicians, nurses and pharmacists. DRPs identified by the pharmacist were put forward to the care team and discussed. Medication Appropriateness Index (MAI) was used to evaluate the appropriateness in the patients' drug treatment at admission, discharge and 2 weeks after discharge. In total 43 patients were included, 28 patients in the intervention group and 25 patients in the group which was used as control.Results  For the intervention group there was a significant decrease in the number of inappropriate drugs compared with the control group (P = 0.049). Indication, duration and expenses were the MAI‐dimensions with most inappropriate ratings, and the drugs with most inappropriate ratings were anxiolytics, hypnotics and sedatives.Conclusion  This kind of systematic approach on drug therapy can result in a more appropriate drug use in the elderly.
Chronic Care Team Profile: a brief tool to measure the structure and function of chronic care teams in general practice
Authors: Proudfoot Judith G. , Bubner Tanya , Amoroso Cheryl , Swan Edward , Holton Christine , Winstanley Julie , Beilby Justin , Harris Mark F. 
Published: July 2009

AbstractAim  At a time when workforce shortages in general practices are leading to greater role substitution and skill‐mix diversification, and the demand on general practices for chronic disease care is increasing, the structure and function of the general practice team is taking on heightened importance. To assist general practices and the organizations supporting them to assess the effectiveness of their chronic care teamworking, we developed an interview tool, the Chronic Care Team Profile (CCTP), to measure the structure and function of teams in general practice. This paper describes its properties and potential use.Method  An initial pool of items was derived from guidelines of best‐practice for chronic disease care and performance standards for general practices. The items covered staffing, skill‐mix, job descriptions and roles, training, protocols and procedures within the practice. The 41‐item pool was factor analysed, retained items were measured for internal consistency and the reduced instrument's face, content and construct validity were evaluated.Results  A three‐factor solution corresponding to non‐general practitioner staff roles in chronic care, administrative functions and management structures provided the best fit to the data and explained 45% of the variance in the CCTP. Further analyses suggested that the CCTP is reliable, valid and has some utility.Discussion  The CCTP measures aspects of the structure and function of general practices which are independent of team processes. It is associated with the job satisfaction of general practice staff and the quality of care provided to patients with chronic illnesses. As such, the CCTP offers a simple and useful tool for general practices to assess their teamworking in chronic disease care.
A structured questionnaire to assess patient compliance and beliefs about medicines taking into account the ordered categorical structure of data
Authors: Bondesson Åsa , Hellström Lina , Eriksson Tommy , Höglund Peter 
Published: July 2009

AbstractRationale, aims and objective  The objectives were to describe and evaluate the structured medication questionnaire and to improve data handling of results from the Morisky four‐item scale for patient compliance and Beliefs about Medicines Questionnaire‐specific (BMQ‐specific).Methods  A questionnaire was developed with the purpose of being used when identifying medication errors and assessing patient compliance to and beliefs about medicines.Results  A majority of the respondents (62%; CI 45–77%) had at least one medication error. Assuming that all items are equally important in the Morisky four‐item scale we presented four alternative ways to create a unidimensional global scale. A two‐dimensional global scale was also constructed. The results from the BMQ‐specific were presented in different ways, all taking into account that the scale has ordered verbal categories: at the level addressing each specific question, at the sub‐scales ‘concern’ and ‘necessity’ level and at the global level.Conclusions  The structured medication questionnaire can be used in daily practice as a tool to identify drug‐related problems. The choice of how to use and present data from those scales in research depends on patient characteristics and how discriminating one would like the scales to be.
Questionnaire instrument to assess knowledge of chronic kidney disease clinical practice guidelines among internal medicine residents
Authors: Agrawal Varun , Barnes Michael A. , Ghosh Amit K. , McCullough Peter A. 
Published: July 2009

AbstractIntroduction  The National Kidney Foundation published Kidney Disease Outcomes Quality Initiative guidelines that recommend early detection and management of chronic kidney disease (CKD) and timely referral to a nephrologist. Many patients with CKD are seen by primary care doctors who maybe less experienced than a nephrologist to offer optimal early CKD care. It is not known whether postgraduate training adequately prepares a future internist in CKD management.Methods  We developed a 15‐item questionnaire instrument to assess knowledge of CKD guidelines among internal medicine residents in USA using an online survey programme. We studied the validity and reliability measures of our instrument.Results  The survey was completed by 166 PGY1 (postgraduate year one), 187 PGY2 and 126 PGY3. The questionnaire tested various aspects of CKD including definition, classification, identification of risk factors, laboratory evaluation, development of clinical action plan, identification of complications, anaemia and bone and mineral disorder, referral to a nephrologist and medication use. Validity was supported by the use of official guidelines and an expert panel of nephrologists to develop content and improvement in mean test performance with increasing level of training (PGY1 59.2 ± 13.5%, PGY2 62.6 ± 12.3% and PGY3 64.3 ± 12.2%; P = 0.002). The reliability coefficient for the questionnaire instrument (Cronbach's α) was 0.69.Conclusion  Our brief questionnaire is a valid and reliable instrument to assess knowledge of CKD guidelines among internal medicine residents and identify specific gaps for improvement.
What can complexity do for diabetes management? Linking theory to practice
Authors: Cooper Helen C. , Geyer Robert 
Published: July 2009

AbstractBackground  Diabetes presents a multifaceted picture with its rapidly rising prevalence associated with changing demographics and increasing levels of obesity in the developed world. Deaths from diabetes are predicted to rise by 25% over the next 10 years. The enormity of this public health challenge has been recognized the world over, but little attention has been paid to the theoretical frameworks underpinning practical management.Aim  This paper aims to introduce complexity theory and discuss its practical application to diabetes, focusing on a single ‘tool’ to provide an example of how theory can be linked to practice.Application  Critics have questioned the all inclusive nature of complexity seeing it as an intangible concept that fails to offer anything new to health care. However, few have appraised its practical application to a chronic disease that is currently managed using an outdated, linear, reduce and resolve model which fails to address the multiple interacting systems inherent within this condition.Discussion  This article proposes that complexity theory provides an interprofessional perspective for describing and understanding the processes involved, and provides working ‘tools’ for patients, carers and practitioners that capture the reality of managing this chronic disease in modern life.
Autonomy in relation to health among people with intellectual disability: a literature review
Authors: Wullink M. , Widdershoven G. , Van Schrojenstein Lantman‐de Valk H. , Metsemakers J. , Dinant G.‐J. 
Published: July 2009

AbstractBackground  Since the 1990s, individualisation, participation, normalisation and inclusion have been the main principles of care for people with intellectual disability (ID). Autonomy has become an important issue for these people. This review of the literature tried to answer the question: how do people with ID exercise autonomy in relation to health?Method  Searches in Cochrane, Medline and PsycINFO were based on the following aspects of autonomy: self‐determination, independence, self‐regulation and self‐realisation.Results  Thirty‐nine of 791 articles met our criteria, including 14 on self‐determination, seven on independence, 15 on self‐regulation and three on self‐realisation.Conclusions  In spite of decades of promoting autonomy, the exercise of autonomy in relation to health has so far rarely been an issue in the literature.
Gaussian‐Taylor signal‐to‐noise ratio estimation for scanning electron microscope images
Authors: SIM K.S. , LEE J.K. , LAI M.A. , TSO C.P. 
Published: July 2009

SummaryA new and robust parameter estimation technique, named Gaussian‐Taylor interpolation, is proposed to predict the signal‐to‐noise ratio (SNR) of scanning electron microscope images. The results of SNR and variance estimation values are tested and compared with piecewise cubic Hermite interpolation, quadratic spline interpolation, autoregressive moving average and moving average. Overall, the proposed estimations for noise‐free peak and SNR are most consistent and accurate to within a certain acceptable degree compared with the others.
Older women's experiences of depression: a hermeneutic phenomenological study
Authors: ALLAN J. , DIXON A. 
Published: July 2009

Accessible summaryThis study describes what it was like for four older women to live with depression . . . Each woman was interviewed up to three times and we found:

Depression had a major effect on the women's beliefs about themselves, resulting in a self‐loathing and a feeling of failure.
The women's self‐loathing caused them to believe that other people thought badly of them, which led them to withdraw from family and friends.
Consequently, these older women were unable to be in meaningful relationships with other people. This contributed to them feeling alone and isolated.

The findings were supported by the themes of: self‐loathing; being overwhelmed by the feelings; hiding from the world; the struggle of everyday life; Being‐alone; misinterpreting self and other people; the stigma of mental illness – society and self; and seeking understanding from other people. The older women in this study were more able to talk to other people when met with understanding. The study identifies ways nurses can develop relationships with older women who have depression and how they can best help them. Nurses can build relationships based on understanding and trust by being caring, empathetic and respectful. When nurses and other people demonstrate a willingness to listen and understand the older woman's world then relationships are established. The findings can be a resource for older women with depression and people who want to understand depression from the perspective of older women who have experienced it . . . AbstractThis hermeneutic phenomenological study, informed by Max van Manen and Martin Heidegger, describes what it is like for four older women to live with depression. Each participant was interviewed up to three times. Interviews were semi‐structured, audiotaped and transcribed verbatim. Data were analysed using van Manen's methodological themes and Heidegger's philosophical concepts of Being‐in‐the‐world and Being‐with‐others. The themes that emerged were: self‐loathing; being overwhelmed by the feelings; hiding from the world; the struggle of everyday life; Being‐alone; misinterpreting self and other people; the stigma of mental illness – society and self; and seeking understanding from other people. The findings revealed that depression had a major effect on the women's beliefs about themselves, resulting in a self‐loathing and a feeling of failure. The participants described how their self‐loathing caused them to believe that other people thought badly of them, which led to their withdrawal. Their inability to connect contributed to them feeling alone and isolated. These women were more able to talk to other people when they were met with understanding. This has implications for the therapeutic nurse–patient relationship, which is fundamental to mental health nursing, because the relationship should be based upon an understanding of the patient's world.
Site of Intrauterine Artificial Insemination in the Bitch does not Affect Sperm Distribution within the Uterus
Authors: Fukushima FB , Malm C , Henry M , Gheller VA , Serakides R , Neves MM , Macedo SP , Figueiredo MS , Andrade MEJ , Chaves MS , Silva MX , Rezende CMF , Melo EG 
Published: July 2009

ContentsThe aim of this study was to evaluate the distribution of frozen–thawed spermatozoa within the uterine lumen and oviducts following intrauterine laparoscopic deposition at two sites. Twelve bitches of unknown reproductive history were randomly distributed into two groups. Semen (3 ml containing 300 × 106 frozen–thawed spermatozoa) was infused at the uterine body (UB group) or at the cranial tip of the left uterine horn. A 22‐G catheter was used to access the uterine lumen. Sperm cell distribution was evaluated after ovariohysterectomy performed 3 h after artificial insemination (AI). There was no difference between groups in mean time to perform AI. Spermatozoa were detected in all uterine segments, including the tip of both horns, but none was detected in the oviduct. The 22‐G catheter facilitated deposition of semen in the uterine lumen, particularly at the UB site. Sperm cell distribution occurred evenly along both horns, independent of the site of semen deposition.