bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Norovirus Outbreak at a Long-Term-Care Facility: The Role of Environmental Surface Contamination
Authors: Wu Henry M. , Fornek Mary , Schwab Kellogg J. , Chapin Amy R. , Gibson Kristen , Schwab Edna , Spencer Charles , Henning Kelly 
Published: April 2006

AbstractBackground:The role of environmental surface contamination in the propagation of norovirus outbreaks is unclear. An outbreak of acute gastroenteritis was reported among residents of a 240-bed veterans long-term-care facility.Objectives:To identify the likely mode of transmission, to characterize risk factors for illness, and to evaluate for environmental contamination in this norovirus outbreak.Methods:An outbreak investigation was conducted to identify risk factors for illness among residents and employees. Stool and vomitus samples were tested for norovirus by reverse transcription polymerase chain reaction (RT-PCR). Fourteen days after outbreak detection, ongoing cases among the residents prompted environmental surface testing for norovirus by RT-PCR.Results:One hundred twenty-seven (52%) of 246 residents and 84 (46%) of 181 surveyed employees had gastroenteritis. Case-residents did not differ from non-case-residents by comorbidities, diet, room type, or level of mobility. Index cases were among the nursing staff. Eight of 11 resident stool or vomitus samples tested positive for genogroup II norovirus. The all-cause mortality rate during the month of the outbreak peak was significantly higher than the expected rate. Environmental surface swabs from case-resident rooms, a dining room table, and an elevator button used only by employees were positive for norovirus. Environmental and clinical norovirus sequences were identical.Conclusion:Extensive contamination of environmental surfaces may play a role in prolonged norovirus outbreaks and should be addressed in control interventions.
Ecological models of alcohol outlets and violent assaults: crime potentials and geospatial analysis
Authors: Gruenewald Paul J. , Freisthler Bridget , Remer Lillian , LaScala Elizabeth A. , Treno Andrew 
Published: April 2006

ABSTRACTAims  Empirical tests of relationships between alcohol outlets and violence are generally conducted with statistical controls for correlates related to characteristics of people and the places in which they live. Crime potentials theory asserts that certain subpopulations are disposed to participate in criminal activities (population potentials) and certain neighborhoods are more likely to be places where crimes occur (place potentials). The current study assesses the degree to which measures of the different geographic distributions of these potentials contribute to violent crime.Design  Cross‐sectional data on hospital discharges for violent assaults were obtained for residents of 1637 zip code areas in California. Assault rates were related to measures of population and place characteristics using spatial statistical models corrected for spatial autocorrelated error.Findings  Rates of assault were related to population and place characteristics within zip code areas, and with characteristics of populations living in adjacent zip code areas. Assault rates were greater in densely populated, poor minority urban areas with greater residential instability. Assault rates were also greater in zip code areas adjacent to densely populated urban areas. Assault rates were related significantly to local densities of off‐premise alcohol retail establishments, not bars. However, densities of bars moderated substantially effects related to local population characteristics. Bars were related significantly to violence in unstable poor minority areas and in rural middle‐income areas of the state.Conclusion  Population and place characteristics are associated with rates of violence across spatial areas. Alcohol outlets directly affect and moderate potentials for violence associated with socio‐demographic groups.
An outbreak of hepatitis B virus infection among methamphetamine injectors: the role of sharing injection drug equipment
Authors: Vogt Tara M. , Perz Joseph F. , Van Houten Clayton K. , Harrington Robert , Hansuld Tia , Bialek Stephanie R. , Johnston Robert , Bratlie Rachel , Williams Ian T. 
Published: April 2006

ABSTRACTAim  To identify risk factors for acute hepatitis B virus (HBV) infection among Wyoming methamphetamine injectors.Design  A case–control study conducted in the setting of an outbreak.Setting  A county in central Wyoming, United States.Participants  Cases were identified through surveillance and contact tracing and were defined as Natrona County, Wyoming, residents who were either symptomatic or confirmed serologically to be acutely infected with HBV during January–August, 2003. Controls were susceptible to HBV infection. All participants identified themselves as methamphetamine injectors.Measurements  Participants were administered a survey that inquired about risk factors for HBV infection, including drug use practices and sexual behaviors. Controls were also tested serologically for acute HBV infection.Findings  Among the 18 case‐patients and 49 controls who participated in the study, sharing water used to prepare injections and/or rinse syringes was associated with HBV infection (94% of case‐participants versus 44% of controls; OR = 21.9, 95% CI: 2.7, 177.8), as was sharing cotton filters (89% of case‐participants versus 52% of controls; OR = 7.4, 95% CI: 1.5, 35.6); sharing syringes was not statistically associated. In logistic regression models adjusted for age, sex, and interview site, sharing rinse water and sharing cotton remained statistically associated.Conclusions  Methamphetamine use has become increasingly prevalent in the United States. Our findings highlight the need for awareness of risks associated with injection drug use and sharing behaviors. Enhanced hepatitis B vaccination programs and educational campaigns that target methamphetamine injectors specifically, including those living in rural areas, should be developed and implemented.
Subjective responses to initial experience with cocaine: an exploration of the incentive–sensitization theory of drug abuse
Authors: Lambert Nadine M. , McLeod Marsha , Schenk Susan 
Published: April 2006

ABSTRACTAims  This study investigated the relationship between positive and negative subjective responses at the time of initial cocaine use with adult cocaine dependence and life‐time use rates. Psychostimulant pre‐exposure, regular smoking or stimulant treatment before initiation were examined to explore the incentive sensitization theory of addiction.Participants  A total of 202 adult participants who had tried cocaine on at least one occasion were studied prospectively from childhood into adulthood. The cocaine‐initiated group included 89 who met Diagnostic and Statistical Manual version IV (DSM‐IV) criteria for attention deficit hyperactive disorder (ADHD) and 113 age‐matched controls.Design  Five childhood and three adulthood interviews provided data on ages of initiation into cocaine and life‐time use of cocaine from ages 16–40 years. Correlations of each subjective response and analyses of variance (ANOVAs) of cocaine ‘liking’ and ‘wanting’ with DSM‐III‐R cocaine dependence and life‐time use provided support for the validity of the measures. ANOVA provided evidence of the effect of psychostimulant pre‐exposure on ‘liking’ and ‘wanting’. Logistic regression modeled the prediction of dependence and life‐time use with the independent variables of ‘liking’ and ‘wanting’, psychostimulant pre‐exposure and participant characteristics.Results  When cocaine was first tried, ‘liking’ and ‘wanting’ were significant predictors of cocaine dependence and life‐time use. Mean ‘liking’ or ‘wanting’ responses did not differ by participant characteristics. Those who were pre‐exposed by regular smoking or stimulant treatment had higher ‘liking’ and ‘wanting’ scores; but participants who were pre‐exposed by both stimulant treatment and regular smoking reported the lowest liking and the highest wanting responses, consistent with the incentive sensitization theory. Logistic regression showed that the ‘liking’ and ‘wanting’ responses increased significantly the odds of DSM‐III‐R cocaine dependence and life‐time use.Conclusion  In this sample, subjective ‘liking’ and ‘wanting’ measured risk for cocaine abuse.
Nasopharyngeal oxygen insufflation following pre‐oxygenation using the four deep breath technique
Authors: Taha S. K. , Siddik‐Sayyid S. M. , El‐Khatib M. F. , Dagher C. M. , Hakki M. A. , Baraka A. S. 
Published: April 2006

SummaryThis paper evaluates the effectiveness of nasopharyngeal oxygen insufflation following preoxygenation using the four deep breath technique within 30 s, on the onset of haemoglobin desaturation during the subsequent apnoea. Thirty ASA I or II patients were randomly allocated to one of two groups. In the study group (n = 15), pre‐oxygenation was followed by insufflation of oxygen at a flow of 5 l.min−1 via a nasopharyngeal catheter commenced at the onset of apnoea. In the control group, pre‐oxygenation was not followed by nasopharyngeal oxygen insufflation (n = 15). In the control group, Spo2 fell to 95% within a mean (SD) apnoea time of 3.65 (1.15) min, whereas in the study group, Spo2 was maintained in all patients at 100% throughout the 6 min of apnoea, at which point apnoea was terminated and positive pressure ventilation commenced. We conclude that nasopharyngeal oxygen insufflation following pre‐oxygenation using the four deep breath technique can delay the onset of haemoglobin desaturation for a significant period of time during the subsequent apnoea.
The effect of fundal pressure at Caesarean section on maternal haemodynamics
Authors: Kim T. Y. , Ryu D. H. 
Published: April 2006

SummaryIn 20 women undergoing Caesarean section, we determined brachial arterial blood pressure, heart rate and cardiac output (using an oesophageal Doppler probe) just after uterine incision and during the application of extra‐abdominal uterine fundal pressure to facilitate delivery. Mean (SD) systolic aortic flow time (354.3 (35.4) ms), cardiac output (3.85 (0.68) l.min−1), heart rate (80.6 (14.2) beats.min−1) and blood pressure (84.7 (12.1) mmHg) decreased when fundal pressure was applied compared with after uterine incision (397.6 (31.6) ms, 4.69 (0.78) l.min−1, 95.1 (14.0) beats.min−1and 100.3 (12.0) mmHg, respectively; p < 0.05). Peak velocity and stroke distance of the aortic flow when fundal pressure was applied was similar to after uterine incision. The mothers and babies were not observed to be clinically compromised. The results suggest that applying fundal pressure to facilitate Caesarean delivery produces significant haemodynamic effects but the impact of these effects may be clinically insignificant.
Effects of a cinnamon extract on plasma glucose, HbA1c, and serum lipids in diabetes mellitus type 2
Authors: Mang B. , Wolters M. , Schmitt B. , Kelb K. , Lichtinghagen R. , Stichtenoth D. O. , Hahn A. 
Published: April 2006

AbstractBackground  According to previous studies, cinnamon may have a positive effect on the glycaemic control and the lipid profile in patients with diabetes mellitus type 2. The aim of this trial was to determine whether an aqueous cinnamon purified extract improves glycated haemoglobin A1c (HbA1c), fasting plasma glucose, total cholesterol, low‐density lipoprotein (LDL), high‐density lipoprotein (HDL) and triacylglycerol concentrations in patients with type 2 diabetes.Methods  A total of 79 patients with diagnosed diabetes mellitus type 2 not on insulin therapy but treated with oral antidiabetics or diet were randomly assigned to take either a cinnamon extract or a placebo capsule three times a day for 4 months in a double‐blind study. The amount of aqueous cinnamon extract corresponded to 3 g of cinnamon powder per day.Results  The mean absolute and percentage differences between the pre‐ and post‐intervention fasting plasma glucose level of the cinnamon and placebo groups were significantly different. There was a significantly higher reduction in the cinnamon group (10·3%) than in the placebo group (3·4%). No significant intragroup or intergroup differences were observed regarding HbA1c, lipid profiles or differences between the pre‐ and postintervention levels of these variables. The decrease in plasma glucose correlated significantly with the baseline concentrations, indicating that subjects with a higher initial plasma glucose level may benefit more from cinnamon intake. No adverse effects were observed.Conclusions  The cinnamon extract seems to have a moderate effect in reducing fasting plasma glucose concentrations in diabetic patients with poor glycaemic control.
Exhaled markers of oxidative stress in idiopathic pulmonary fibrosis
Authors: Psathakis K. , Mermigkis D. , Papatheodorou G. , Loukides S. , Panagou P. , Polychronopoulos V. , Siafakas N. M. , Bouros D. 
Published: April 2006

AbstractBackground Expired breath condensate (EBC) has never been used to explore the level of oxidative stress in idiopathic pulmonary fibrosis (IPF). Therefore, the aim of this study was to measure the levels of H2O2and 8‐isoprostane, as biomarkers of oxidative stress, in the EBC of patients with IPF.Materials and methods We investigated 16 patients with IPF and 15 healthy subjects as the control group. The levels of H2O2 and8‐isoprostane were measured in the EBC of all subjects and were compared between the IPF and control groups. In patients with IPF, H2O2 and8‐isoprostane were further correlated with pulmonary function tests (PFTs), the resting pO2and the differential cell count from the bronchoalveolar lavage fluid (BALF).Results The mean (95%CI) concentration of H2O2was increased in the patients with IPF compared with the normal subjects (0·36, 0·24–0·47 µM vs. 0·16, 0·10–0·23 µM,P = 0·003).The mean (95%CI) concentration of 8‐isoprostane was also increased in the patients with IPF compared with the controls (74, 38–110 pg mL−1vs. 33, 28–39 pg mL−1,P = 0·02). In the patients with IPF, the diffusing capacity of the lung for carbon monoxide was negatively correlated with the levels of H2O2in EBC (P = 0·03,r = −0·58). No other correlation was found between the oxidative stress markers in the EBC and PFT values, pO2or BALF cell count.Conclusions Our data suggest that H2O2 and8‐isoprostane are increased in the EBC of patients with IPF. H2O2may be correlated with the severity of the disease in IPF.
Speculum ‘self‐insertion’: a pilot study
Authors: Wright Deborah , Fenwick Jennifer , Stephenson Pam , Monterosso Leanne 
Published: April 2006

Aim. This paper reports phase II of a pilot study that aimed to determine whether self‐insertion of a speculum by women undergoing a pap smear would be more comfortable and lead to an improvement in satisfaction and a decrease in anxiety associated with this procedure.Background. Research demonstrates that pelvic examinations are considered by most women to be unpleasant and are routinely associated with embarrassment, apprehension, fear and often some level of discomfort and/or pain.Design. The study used quantitative and qualitative data collection techniques. Phase I (described elsewhere) tested the newly developed Speculum Self‐Insertion Satisfaction Questionnaire for content validity, internal consistency and clarity. Phase II pilot study tested the technique of speculum self‐insertion. Women's general level of anxiety was measured using the State Trait Anxiety Inventory, both before and after they performed the self‐insertion procedure. Women's satisfaction and acceptance of the procedure was measured using the Speculum Self‐Insertion Satisfaction Questionnaire and explored through the use of qualitative research techniques.Participants. A total of 198 women attending family planning clinics in Perth, Western Australia, between September and December 2003 were invited to participate in the study. One hundred and thirty‐three women agreed to self‐insert their own speculum.Results. The study demonstrated that speculum self‐insertion was acceptable to most women, especially younger women. Nearly 91% of women either agreed or strongly agreed that they were satisfied with the experience of self‐insertion and would choose to self‐insert the speculum again. This included the women who had not previously had a speculum examination. The quality of specimen collected was not detrimentally affected by speculum self‐insertion.Conclusions. The results of this pilot research, while needing to be replicated in a larger study, demonstrate that offering women the opportunity to self‐insert a speculum during a routine pelvic examination is an acceptable, innovative, simple and cost‐neutral change in clinical practice that increases women's comfort and satisfaction and potentially makes sexual health screening less threatening to women of all ages.Relevance to clinical practice. Speculum self‐insertion may encourage women's attendance at clinics for regular screening. Early diagnosis and treatment will result in better health outcomes for women, families and the community at large.
Nursing best practice statements: an exploration of their implementation in clinical practice
Authors: Ring Nicola , Malcolm Cari , Coull Alison , Murphy‐Black Tricia , Watterson Andrew 
Published: April 2006

Aims and objectives.  To explore implementation of the first five Best Practice Statements from the perspective of nurses involved in their development.Background.  Best Practice Statements were introduced in Scotland to encourage consistent evidence‐based nursing practice. As a new initiative, research was required to investigate their clinical implementation.Design and methods.  In this descriptive study, semi‐structured interviews of a purposive sample of nurses (n = 15) were undertaken. Content analysis was used to identify themes emerging from the interview data.Findings.  Four main themes emerged from analysis of transcripts: variations in use of the Best Practice Statements; benefits to patients; benefits to practitioners; and, barriers and drivers to use. Amongst participants, personal users adopted the statements in their own practice but enablers also actively encouraged others to use the statements. Whether participants acted as enablers depended on individual, team and organizational factors. The ability of participants to act as leaders was influential in determining their ability both to facilitate local implementation and to encourage others to regard the Best Practice Statements as a priority for implementation.Conclusions.  This exploratory study highlighted examples of patients and practitioners benefiting from the Best Practice Statements. Such findings suggest these statements could become a useful tool in promoting evidence‐based nursing practice. However, implementation of the Best Practice Statements varied between participants and their organizations. Nurses who were most effective in promoting local implementation of the Best Practice Statements adopted facilitator and leadership roles within their organizations.Relevance to practice.  By relating research findings to the literature on guideline and research utilization, this study gives further insight into the implementation of evidence‐based practice by nurses. In particular, it supports the conclusion that to be truly effective, initiatives to promote evidence‐based practice require nurses to act as local facilitators and leaders.
Motor nerve blockade potency and toxicity of non‐racemic bupivacaine in rats
Authors: Trachez M. M. , Zapata‐Sudo G. , Moreira O. R. , Chedid N. G. B. , Russo V. F. T. , Russo E. M. S. , Sudo R. T. 
Published: April 2006

Background:  Racemic [RS(±)] bupivacaine can be associated with severe cardiotoxicity. The S(–) isomer is known to be less neuro‐ and cardiotoxic, but demonstrates a lower potency to block motor activity than RS(±) bupivacaine. Thus, the potency and toxicity of a non‐racemic bupivacaine mixture were studied.Methods:  Gastrocnemic muscle twitches induced by electrical stimulation of sciatic nerves in rats were used to compare the impact by bupivacaine solutions on motor activity. Field stimulation at 1 Hz eliciting ventricular muscle twitches was used to investigate the effects on cardiac contractility. The lethal dose of each local anesthetic agent was determined following drug infusions during general anesthesia in mechanically ventilated rats.Results:  Non‐racemic (75S:25R) bupivacaine was more potent (P<0.05) than S(–) or R(+) enantiomers to block motor nerve activity. The concentrations of RS(±), 75S:25R, R(+) and S(–) bupivacaine to inhibit nerve conduction by 50% were 0.84 (0.37– 2.20), 0.84 (0.47–2.48), 2.68 (0.98–3.42) and 2.11 mM (1.5–4.03), respectively. Pronounced reductions in ventricular muscle twitches were observed with RS(±) and R(+) bupivacaine at low concentrations (0.5–4 µM). Lethal doses for 75S:25R (39.9 mg kg−1), and S(–) (34.7 mg kg−1) were higher (P<0.05) than for R(+) (16.2 mg kg−1) and RS(±) bupivacaine (18.4 mg kg−1), respectively.Discussion:  The potency of S(–) bupivacaine to block the motor activity in the sciatic nerve was enhanced when 25% of the S(–) isomer was replaced by the antipode R(+) bupivacaine. This effect was not associated with increased toxicity.
Timing of restorative proctectomy following subtotal colectomy in patients with inflammatory bowel disease
Authors: Dinnewitzer A. J. , Wexner S. D. , Baig M. K. , Oberwalder M. , Pishori T. , Weiss E. G. , Efron J. , Nogueras J. J. , Vernava A. M. 
Published: April 2006

AbstractBackground  There is no general consensus regarding the timing of restorative proctocolectomy (RPC) in patients who have undergone subtotal colectomy with end ileostomy (STC). The aim of this study was to determine the impact of timing of RPC in patients who have undergone subtotal colectomy and end ileostomy for inflammatory bowel disease (IBD).Methods  A retrospective medical record review of patients who had undergone RPC after STC was undertaken. Patients were divided into 3 groups according to timing of the completion proctectomy: ≤ 3 months, 4–7 months and > 7 months.Results  From 1990 to 2000, 91 patients had undergone RPC after STC for IBD. There were no statistically significant differences among the three groups relative to mean age, gender, final diagnosis, duration of disease, body mass index, comorbidity, extraintestinal manifestations, use of immunuosuppressives, or operative time. The number of intra‐operative complications were significantly higher in the ≤ 3 month group compared to the other groups. There was no significant difference in the overall incidence of postoperative complications among the 3 groups. Postoperative fistulas were significantly more common after RPC in Groups 1 and 2 as compared to Group 3.Conclusion  Restorative proctocolectomy performed within 3 months after the initial subtotal colectomy was associated with a significant increase in the incidence of intra‐operative complications. Although this increase was not statistically significant, there was a significantly higher incidence of fistula formation when RPC was undertaken at up to 7 months after the subtotal colectomy for IBD. Thus, if possible, early RPC after subtotal colectomy should be discouraged.