bluuebunny/crossref_metadata_2025_split huggingface dataset:
Loss of doctor-to-doctor communication: Lessons from the reconfiguration of mental health services in England
Authors: Chew-Graham Carolyn , Slade Mike , MontÂna Carolyn , Stewart Mairi , Gask Linda 
Published: March 2008

Objective To explore the tensions across the primary-secondary interface when referral from primary care is to a team and to inform service developments in other specialties. Methods A nested qualitative study within a randomized controlled trial of primary care and Community Mental Health Teams (CMHTs) in Croydon and Manchester, UK. For the qualitative study, interviews were carried out with general practitioners (GPs), psychiatrists and managers or clinical leads of the CMHTs. Results GPs described the need for access to specialist knowledge, which they perceived to lie with the psychiatrist, and referral to a team was not perceived to allow this access. A personal threshold was identified by GPs after which they referred the patient to secondary care. CMHTs and psychiatrists recognized that this personal threshold differed between GPs, but their criteria for accepting referrals did not seem to allow for a flexible response to referral requests, leading to the referral being labelled as ‘inappropriate’. The lack of direct doctor-to-doctor communication was perceived by respondents to contribute to a fragmentation of patient care. Strategies were described whereby the system was bypassed to achieve doctor-to-doctor communication, which undermined the team. Conclusions Development of intermediate or ‘Tier 2’ services beyond the mental health services, where the GP refers to a team rather than to a specialist (hospital consultant) could benefit from reflecting on experiences with mental health services. There is a danger that new community services for the physically ill will engender the same level of confusion and discontent described by GPs and other health professionals in this study who are concerned with mental health care. Flexibility is needed within care pathways, including the provision of direct doctor-to-doctor communication together with approaches to minimize the marginalization of non-medical professionals.
The effect of age and procedure on resource use for patients with cerebrovascular disease
Authors: Kuwabara Kazuaki , Matsuda Shinya , Imanaka Yuichi , Fushimi Kiyohide , Hashimoto Hideki , Ishikawa Koichi 
Published: March 2008

Objective Many studies have described the impact of population ageing on health care expenditures, but few have assessed its impact on specific diseases adjusted for severity and procedure. This study examined the relationship between an ageing population and resource use in patients with cerebrovascular disease (CVD). Methods A total of 13,856 CVD patients were treated in 82 academic and 92 community hospitals. Demographic variables, clinical variables, length of stay (LOS) and total charges were analysed by age group (under 65 years, 65-74 years and 75 years or older). The independent effects of age on LOS and total charge were determined using multivariate analysis. Results There were 5172 (37%) patients under 65 years of age, 4096 (30%) 65-74 years and 4588 (33%) 75 years or older. Intracranial infarction or ischaemia was diagnosed in 69% of the patients, haemorrhage in 23% and subarachnoid haemorrhage in 9%. The overall mortality was 6% (5% in under 65 years, 5% in 65-74 years and 9% in 75 years or older; P < 0.001). There were significant differences in the proportion of procedures performed in each age category. Age and procedure were significantly associated with LOS, particularly the latter. Age had no significant association with total charge, but procedure was highly associated. Conclusions Ageing has no significant impact on total charge. Instead policy-makers should acknowledge the effect of procedures on health care costs, conduct economic evaluations and monitor use of procedures.
Improving access to primary care: Eight case studies of introducing Advanced Access in England
Authors: Pope Catherine , Banks Jon , Salisbury Chris , Lattimer Val 
Published: March 2008

Objective To examine the implementation of ‘Advanced Access’ as a means of improving access to primary care. Methods Qualitative case studies of eight English general practices undertaken as part of a mixed method study. Results There was considerable variation in the interpretation and implementation of Advanced Access. Practices claiming to operate this system often did not follow its key principles. Differences between practice access systems centred on the use of ‘same-day’ appointments. The association of Advanced Access with same-day appointment systems was problematic as it both created antagonism to, and diverged from, the Advanced Access model. Practice staff did not necessarily share the conceptualisation of demand that underpinned Advanced Access. Other policies and targets provided further incentives to diverge from the model and these factors were compounded by informal organizational behaviours, notably the exercise of discretion, which led to adaptation. Conclusion Advanced Access was diluted because it became confused with same-day appointment systems and other incentives and targets. Its guiding philosophy of ‘manageable demand’ appeared counter-intuitive to staff in the context of general practice, which made its implementation problematic. As a result, the system was adapted and modified.
The treatment of deep shoulder infection and glenohumeral instability with debridement, reverse shoulder arthroplasty and postoperative antibiotics
Authors: Cuff D. J. , Virani N. A. , Levy J. , Frankle M. A. , Derasari A. , Hines B. , Pupello D. R. , Cancio M. , Mighell M. 
Published: March 2008

We retrospectively reviewed 21 patients (22 shoulders) who presented with deep infection after surgery to the shoulder, 17 having previously undergone hemiarthroplasty and five open repair of the rotator cuff. Nine shoulders had undergone previous surgical attempts to eradicate their infection. The diagnosis of infection was based on a combination of clinical suspicion (16 shoulders), positive frozen sections (> 5 polymorphonuclear leukocytes per high-power field) at the time of revision (15 shoulders), positive intra-operative cultures (18 shoulders) or the pre-operative radiological appearances. The patients were treated by an extensive debridement, intravenous antibiotics, and conversion to a reverse shoulder prosthesis in either a single- (10 shoulders) or a two-stage (12 shoulders) procedure.At a mean follow-up of 43 months (25 to 66) there was no evidence of recurrent infection. All outcome measures showed statistically significant improvements. Mean abduction improved from 36.1° (sd 27.8) pre-operatively to 75.7° (sd 36.0) (p < 0.0001), the mean forward flexion from 43.1° (sd 33.5) to 79.5° (sd 43.2) (p = 0.0003), and mean external rotation from 10.2° (sd 18.7) to 25.4° (sd 23.5) (p = 0.0037). There was no statistically significant difference in any outcome between the single-stage and the two-stage group.
Low molecular weight heparin impairs tendon repair
Authors: Virchenko O. , Aspenberg P. , Lindahl T. L. 
Published: March 2008

Thrombin has many biological properties similar to those of growth factors. In a previous study, we showed that thrombin improves healing of the rat tendo Achillis. Low molecular weight heparin (LMWH) inhibits the activity and the generation of thrombin. We therefore considered that LMWH at a thromboprophylactic dose might inhibit tendon repair. Transection of the tendo Achillis was carried out in 86 rats and the healing tested mechanically. Low molecular weight heparin (dalateparin) was either injected a few minutes before the operation and then given continuously with an osmotic mini pump for seven days, or given as one injection before the operation. In another experiment ,we gave LMWH or a placebo by injection twice daily. The anti-factor Xa activity was analysed. Continuous treatment with LMWH impaired tendon healing. After seven days, this treatment caused a 33% reduction in force at failure, a 20% reduction in stiffness and a 67% reduction in energy uptake. However, if injected twice daily, LMWH had no effect on tendon healing. Anti-factor Xa activity was increased by LMWH treatment, but was normal between intermittent injections. Low molecular weight heparin delays tendon repair if given continuously, but not if injected intermittently, probably because the anti-factor Xa activity between injections returns to normal, allowing sufficient thrombin stimulation for repair. These findings indicate the need for caution in the assessment of long-acting thrombin and factor Xa inhibitors.
Variations in acetabular anatomy with reference to total hip replacement
Authors: Murtha P. E. , Hafez M. A. , Jaramaz B. , DiGioia A. M. 
Published: March 2008

Three-dimensional surface models of the normal hemipelvis derived from volumetric CT data on 42 patients were used to determine the radius, depth and orientation of the native acetabulum. A sphere fitted to the lunate surface and a plane matched to the acetabular rim were used to calculate the radius, depth and anatomical orientation of the acetabulum. For the 22 females the mean acetabular abduction, anteversion, radius and normalised depth were 57.1° (50.7° to 66.8°), 24.1° (14.0° to 33.3°), 25 mm (21.7 to 30.3) and 0.79 mm (0.56 to 1.04), respectively. The same parameters for the 20 males were 55.5° (47.7° to 65.9°), 19.3° (8.5° to 32.3°), 26.7 mm (24.5 to 28.7) and 0.85 mm (0.65 to 0.99), respectively. The orientation of the native acetabulum did not match the safe zone for acetabular component placement described by Lewinnek. During total hip replacement surgeons should be aware that the average abduction angle of the native acetabulum exceeds that of the safe zone angle. If the concept of the safe zone angle is followed, abduction of the acetabular component should be less than the abduction of the native acetabulum by approximately 10°.
Arthroscopy in primary synovial chondromatosis of the hip
Authors: Boyer T. , Dorfmann H. 
Published: March 2008

Between 1985 and 2000, 120 patients underwent arthroscopic management for primary synovial chondromatosis of the hip. We report the outcome of 111 patients with a mean follow-up of 78.6 months (12 to 196). More than one arthroscopy was required in 23 patients (20.7%), and 42 patients (37.8%) went on to require open surgery. Outcomes were evaluated in greater detail in 69 patients (62.2%) treated with arthroscopy alone, of whom 51 (45.9%) required no further treatment and 18 (16.2%) required further arthroscopies. Of the 111 patients, 63 (56.7%) had excellent or good outcomes. At the most recent follow-up, 22 patients (19.8%) had undergone total hip replacement. Hip arthroscopy proved beneficial for patients diagnosed with primary synovial chondromatosis of the hip, providing good or excellent outcomes in more than half the cases.
Stimulation of the local femoral inflammatory response to fracture and intramedullary reaming
Authors: Morley J. R. , Smith R. M. , Pape H. C. , MacDonald D. A. , Trejdosiewitz L. K. , Giannoudis P. V. 
Published: March 2008

We have undertaken a prospective study in patients with a fracture of the femoral shaft requiring intramedullary nailing to test the hypothesis that the femoral canal could be a potential source of the second hit phenomenon. We determined the local femoral intramedullary and peripheral release of interleukin-6 (IL-6) after fracture and subsequent intramedullary reaming.In all patients, the fracture caused a significant increase in the local femoral concentrations of IL-6 compared to a femoral control group. The concentration of IL-6 in the local femoral environment was significantly higher than in the patients own matched blood samples from their peripheral circulation. The magnitude of the local femoral release of IL-6 after femoral fracture was independent of the injury severity score and whether the fracture was closed or open.In patients who underwent intramedullary reaming of the femoral canal a further significant local release of IL-6 was demonstrated, providing evidence that intramedullary reaming can cause a significant local inflammatory reaction.
The function of the hand after operations for obstetric injuries to the brachial plexus
Authors: Kirjavainen M. , Remes V. , Peltonen J. , Rautakorpi S. , Helenius I. , Nietosvaara Y. 
Published: March 2008

Hand function was evaluated in 105 patients who had been operated on in early infancy for brachial plexus birth palsy. The mean follow-up after surgery was for 13.4 years (5.0 to 31.5). Fine sensation, stereognosis, grip and pinch strength and the Raimondi scale were recorded. Fine sensation was normal in 34 of 49 patients (69%) with C5–6 injury, 15 of 31 (48%) with C5–7 and in 8 of 25 (32%) with total injury. Loss of protective sensation or absent sensation was noted in some palmar areas of the hand in 12 of 105 patients (11%). Normal stereognosis was recorded in 88 of the 105 patients (84%), whereas only 9 of the 105 (9%) had normal grip strength. The mean Raimondi scale scores were 4.57 (3 to 5) (C5–6), 4.26 (1 to 5) (C5–7) and 2.16 (0 to 5) in patients with total injury. The location of impaired sensation was related to the distribution of the root injury. Avulsion type of injury correlated with poor recovery of hand function.
Variation in the anatomy of the tibial plateau
Authors: Lankester B. J. A. , Cottam H. L. , Pinskerova V. , Eldridge J. D. J. , Freeman M. A. R. 
Published: March 2008

From a search of MRI reports on knees, 20 patients were identified with evidence of early anteromedial osteoarthritis without any erosion of bone and a control group of patients had an acute rupture of the anterior cruciate ligament. The angle formed between the extension and flexion facets of the tibia, which is known as the extension facet angle, was measured on a sagittal image at the middle of the medial femoral condyle. The mean extension facet angle in the control group was 14° (3° to 25°) and was unrelated to age (Spearman’s rank coefficient, p = 0.30, r = 0.13). The mean extension facet angle in individuals with MRI evidence of early anteromedial osteoarthritis was 19° (13° to 26°, SD 4°). This difference was significant (Mann-Whitney U test, p < 0.001). A wide variation in the extension facet angle was found in the normal control knees and an association between an increased extension facet angle and MRI evidence of early anteromedial osteoarthritis. Although a causal link has not been demonstrated, we postulate that a steeper extension facet angle might increase the duration of loading on the extension facet during the stance phase of gait, and that this might initiate failure of the articular cartilage.
Ninety-day mortality after elective total hip replacement
Authors: Parry M. , Wylde V. , Blom A. W. 
Published: March 2008

Thromboprophylaxis after elective orthopaedic surgery remains controversial. Recent guidelines from the National Institute for Clinical Excellence (NICE) have suggested that low molecular weight heparin should be given to all patients undergoing total hip replacement. The British Orthopaedic Association is currently debating this guideline with NICE, as it is not clear whether published evidence supports this view. We present the early mortality in our unit after total hip replacement using aspirin as chemical thromboprophylaxis. The 30-day and 90-day mortality after primary total hip arthroplasty was zero. We compare this with that reported previously from our unit without using chemical thromboprophylaxis. With the introduction of routine aspirin thromboprophylaxis, deaths from cardiovascular causes have dropped from 0.75% to zero. These results demonstrate that there is a strong argument for the routine administration of aspirin after elective total hip replacement.
The results of a proximally-coated cementless femoral component in total hip replacement
Authors: Kim Y.-H. 
Published: March 2008

This study reviewed the results of a cementless anatomical femoral component to give immediate post-operative stability, and with a narrow distal section in order not to contact the femoral cortex in the diaphysis, ensuring exclusively metaphyseal loading. A total of 471 patients (601 hips) who had a total hip replacement between March 1995 and February 2002 were included in the study. There were 297 men and 174 women. The mean age at the time of operation was 52.7 years (28 to 63). Clinical and radiological evaluation were performed at each follow-up. Bone densitometry was carried out on all patients two weeks after operation and at the final follow-up examination. The mean follow-up was 8.8 years (5 to 12). The mean pre-operative Harris hip score was 41 points (16 to 54), which improved to a mean of 96 (68 to 100) at the final follow-up. No patient complained of thigh pain at any stage. No acetabular or femoral osteolysis was observed and no hip required revision for aseptic loosening of either component. Deep infection occurred in two hips (0.3%) which required revision. One hip (0.2%) required revision of the acetabular component for recurrent dislocation. Bone mineral densitometry revealed a minimal bone loss in the proximal femur. This cementless anatomical femoral component with metaphyseal loading but without distal fixation produced satisfactory fixation and encourages proximal femoral loading.
Reconstruction of type II pelvic resection with a new peri-acetabular reconstruction endoprosthesis
Authors: Falkinstein Y. , Ahlmann E. R. , Menendez L. R. 
Published: March 2008

We report our early experience with a new peri-acetabular reconstruction endoprosthesis used for pelvic reconstruction after tumour resection. The outcome of 21 patients who underwent limb salvage following type II pelvic resection and reconstruction using the peri-acetabular reconstruction prosthesis between 2000 and 2006 was retrospectively reviewed. This prosthesis was designed to use the remaining part of the ilium to support a horizontally placed acetabular component secured with internal fixation and bone cement. Into this device a constrained acetabular liner is positioned which is articulates with a conventional femoral component to which a modular extension and modular head are attached. The mean follow-up was 20.5 months (1 to 77). The most common complications were deep infection, superficial wound infections, and dislocation. The mean musculoskeletal tumor society functional outcome score for the survivors was 20.1(11 to 27). We recommend the use of the peri-acetabular reconstruction prosthesis for reconstruction of large defects after type II pelvic resection, as this design has a greater inherent stability over other available prostheses.
The Date of the Life of the Patriarch Ignatius Reconsidered
Authors: Tamarkina Irina 
Published: February 2008

Abstract
Many Byzantine texts are still provoking fierce debates over their dates of composition. The recent examples falling only into the 9th c. include the Bibliotheca of Photius, the Chronicle of George the Monk and the Life of the patriarch Nicephore by Nicetas the Deacon. In this article we will venture to call into question the accepted date of the no less well-known and important text, the Life of the patriarch Ignatius by Nicetas David the Paphlagonian.
Salvatore R. C. LILLA, Neuplatonisches Gedankengut in den ‘Homilien über die Seligpreisungen’ Gregors von Nyssa. Supplements to Vigiliae Christianae, 68
Authors: Pochoshajew Igor 
Published: February 2008

Abstract
Diese Veröffentlichung des verdienten Forschers entstand auf der Grundlage seines Vortrags auf dem 8. Internationalen Kolloquium über Gregor von Nyssa 1998 in Paderborn. Der Beitrag auf dem Gregorkolloquium wurde auf Anregung und mit Unterstützung von Hubertus R. DROBNER zur Monographie ausgebaut und herausgegeben. Die detaillierte und umfassende Darbietung des Quellenmaterials zu den entscheidenden Fragen der Gregorforschung, die das Buch von Lilla leistet, macht das Anliegen des Herausgebers verständlich. Es gelingt dem Autor, die Quellenforschung mit der geistesgeschichtlichen Betrachtung der Problematik zu einer spannenden Darstellung zu verbinden, womit er das gegebene Versprechen (S. XVII) uneingeschränkt einlöst. Darüber hinaus stellt die Studie von LILLA eine wertvolle Vervollständigung des Quellenapparats zu der Textausgabe von De Beatitudinibus von John F. CALLAHAN in Gregorii Nysseni Opera aus dem Jahr 1992 dar.
Production Strategy for Thin-Oil Columns in Saturated Reservoirs
Authors: Kabir C. S. , Agamini M. , Holguin R. A. 
Published: February 2008

Summary
Maximizing oil recovery in thin and ultrathin (&lt;30 ft) oil columns is a challenge because of coning or cresting of unwanted fluids, regardless of well orientation. Significant oil is left behind above the well completion even for horizontal wells when bottom- or edge-water invasion occurs.
Two depletion strategies may be enacted to improve recovery of the remaining oil. In the first option, a conventional horizontal is completed below the gas/oil contact (GOC). Once the well waters out, the well is recompleted in the gas zone. Completion occurs either at the crest for a small gas-cap reservoir or at the GOC, inducing reverse cone, for reservoirs with thick-gas columns. Alternatively, one can skip the initial oil completion, where gas disposition is a nonissue. Gravity-stable flooding is required to maximize reserves.
Extensive flow simulations in multiple, history-matched models have shown that the proposed strategy improves recovery significantly. Two field examples are presented to demonstrate the usefulness of the proposed method.
Using multivariate regression, simple correlations were developed for quick screening of the proposed approach. Experimental design formed the backbone of a parametric study involving various reservoir, fluid, and process variables. We tested and validated the correlations with independent sets of experimental and published field data.
Gas Lift Optimization for Long-Term Reservoir Simulations
Authors: Wang Pengju , Litvak Michael 
Published: February 2008

Summary
Although various gas lift optimization algorithms have been proposed in literature, few are suitable for long-term reservoir-development studies, which require the gas lift optimizer to be highly efficient, flexible, and powerful enough to handle complicated fluid flows and operational constraints while having minimal impact on simulator convergence rates. This paper investigates methods to address these important issues.
The gas lift optimization problem considered in this paper is to maximize daily hydrocarbon production by selecting optimally the well-production and lift-gas rates subject to pressure and rate constraints in nodes of the surface pipeline network (SPN) and to the amount of lift gas available. The problem is regarded as a well-management problem in a commercial reservoir simulator capable of simulating multiphase compositional fluid flow in reservoirs, well tubing strings, SPN systems, and separation facilities. The problem is solved in selected iterations of a reservoir-simulation timestep.
This paper proposed a method for the described gas lift optimization problem and investigated its performance against multiple existing methods. Case studies showed that the new method is capable of producing high-quality results while requiring less CPU time for optimization and having a smaller impact on reservoir-simulator convergence.
This paper also applied the concept of multiobjective optimization to smooth rate oscillations between adjacent iterations by sacrificing a certain amount of oil production. This method was proved to be successful in tested cases.