bluuebunny/crossref_metadata_2025_split huggingface dataset:
Teledermatology on the Faroe Islands
Authors: Jemec Gregor B. E. , Heidenheim Michael , Dam Tomas N. , Vang Edith 
Published: August 2008

AbstractThe use of teledermatology as an adjunct to conventional clinical dermatology on the Faroe Islands is described. The service is based on a nurse‐led dermatological clinic, and teledermatology is combined with specialist visits for more complex diagnosis or procedures.
Tissue estimation of protein gene product 9.5 (PGP 9.5) expression and apoptosis in vitiligo
Authors: Aroni Kyriaki , Grapsa Antonia , Lazaris Andreas C. , Kavantzas Nikolaos , Kordosis Theodoros , Patsouris Efstratios S. 
Published: August 2008

AbstractBackground  Vitiligo is probably the end result of different interacting processes.Objective  To determine the possible roles of neural and apoptotic mechanisms in the pathogenesis of vitiligo.Methods  Fifty‐six biopsies from 28 patients with generalized vitiligo (28 from depigmented lesional areas and 28 from clinically nondepigmented skin at the periphery of the same areas) were examined; the panaxonal marker neuropeptide protein gene product 9.5 (PGP 9.5) and apoptosis were investigated using immunohistochemistry.Results  Statistically significant differences were detected in the numbers of PGP 9.5‐positive nerve fibers/axons in the papillary dermis between the center and periphery of the lesions (i.e. increased at the center in comparison with the periphery). A statistically significant inverse association was found between PGP 9.5 immunostaining in the dermis at the lesion center and the duration of the disease. When apoptosis and PGP 9.5 expression were compared, there was an identical distribution of PGP 9.5‐positive nerve fibers/axons and apoptotic cells in the epidermis (i.e. basal in the lesion center; diffuse at the lesion periphery).Conclusions  There is a possible connection between the neural and apoptotic pathogenetic theories of vitiligo.
Drug‐induced Sweet's syndrome secondary to hepatitis C antiviral therapy
Authors: Gheorghe Liana , Cotruta Bogdan , Trifu Viorel , Cotruta Cristina , Becheanu Gabriel , Gheorghe Cristian 
Published: August 2008

AbstractPegylated interferon‐alpha in combination with ribavirin currently represents the therapeutic standard for the hepatitis C virus infection. Interferon based therapy may be responsible for many cutaneous side effects. We report a case of drug‐induced Sweet's syndrome secondary to hepatitis C antiviral therapy. To our knowledge, this is the first reported case of Sweet's syndrome in association with pegylated interferon‐alpha therapy.
Corynebacterium‐associated skin infections
Authors: Blaise Géraldine , Nikkels Arjen F. , Hermanns‐Lê Trihn , Nikkels‐Tassoudji Nazli , Piérard Gérald E. 
Published: August 2008

AbstractBackground  Corynebacterium spp. are diphtheroid bacteria responsible for pitted keratolysis, a common plantar infection confined to the thick stratum corneum.Aim  To study a series of demographic features of patients suffering from pitted keratolysis, and to present a review of the Corynebacterium‐associated infections, including pitted keratolysis, erythrasma, and trichobacteriosis.Materials and methods  A 2‐year, two‐center, prospective survey assessed the demographics of pitted keratolysis, including age, gender, site of infection, symptoms, patients’ complaints, the use of protective and/or occlusive shoes, seasonality of diagnosis, drug intake, associated skin signs (including dyshidrosis, erythrasma, and trichobacteriosis), recurrences, and previous diagnoses and treatments.Results  The mean age of the 53 patients with pitted keratolysis was 24.9 years (range, 10–57 years). The male to female ratio was 7.8 : 1. The soles of both feet were commonly involved (92.4%). Pressure‐bearing areas were the usual sites of infection, ranging from restricted involvement of the toes (12/53, 22.6%) to spreading to the entire plantar surface (15/53, 28.3%). A total of 36 (68%) of the 53 patients complained of hyperhidrosis. An unpleasant smell and pain were noted by 35 (66%) and 25 (47%) of the 53 patients, respectively. Occlusive and protective shoes were worn in 51 (96.2%) and 31 (58.4%) of the 53 cases, respectively.Conclusion  Pitted keratolysis commonly affects young male patients wearing protective shoes for professional reasons, inducing a moist and warm environment. Hyperhidrosis, an unpleasant smell, and pain are the main clinical complaints.
Considering patient non‐participation in health care
Authors: Eldh Ann Catrine , Ekman Inger , Ehnfors Margareta 
Published: August 2008

AbstractObjective  The aim of this study was to depict patient non‐participation as described by a diverse group with recent experiences of being patients.Background  Patient participation is regarded as a primary condition for optimal quality of care, suggesting that non‐participation should be avoided. A common understanding of the concept of patient non‐participation is needed. A discrepancy in definitions of patient non‐participation has been found in health‐care interactions, health‐care classifications and health‐care research, and little is known of what patient non‐participation represents to patients.Study design  A survey consisting of closed‐ended and open‐ended questions was administered to persons that had recently been patients to gather respondents’ descriptions of what they considered as patient non‐participation. Qualitative content analysis was used to analyse free‐text descriptions, and descriptive statistics were used for the close‐ended alternatives.Findings  Lacking information (e.g. not being provided with appropriate information) and lacking recognition (e.g. not being listened to and/or lacking recognition as an individual with individual needs and concerns) were significant aspects of patient non‐participation. Furthermore, non‐participation encompassed facing organization‐centred, as opposed to patient‐centred, health care as well as feeling insecure in health care interactions.Conclusion  The findings provide input for a better understanding of what patients experience as non‐participation. Organising for the caregivers to be able to thoroughly listen to the patients’ illness narratives would easily reduce the risk of patient’s experiencing what is described as non‐participation and would provide a sound base for patient learning needs.
BRCA mutation‐negative women from hereditary breast and ovarian cancer families: a qualitative study of the BRCA‐negative experience
Authors: Bakos Alexis D. , Hutson Sadie P. , Loud Jennifer T. , Peters June A. , Giusti Ruthann M. , Greene Mark H. 
Published: August 2008

AbstractBackground  When women from families with a known BRCA1 or BRCA2 mutation test negative for the family mutation, it is assumed that they will transition their personal cancer risk perception from high to average risk. However, there are scant data regarding the experience of mutation‐negative women after genetic testing disclosure, particularly related to the shift of risk perception from assumed mutation‐positive to actual mutation‐negative. This study was designed to explore cancer risk perception and the experience of being a mutation‐negative woman within a known BRCA1/2 mutation‐positive family.Methods  We employed a qualitative descriptive design and convened a sample of 13 women who contributed in‐depth, semi‐structured telephone interviews (audio‐recorded and transcribed verbatim) and performed qualitative content analysis with NVivo 2.0 software.Results  Six major content areas emerged from interview data: (i) rationale for initial involvement in the breast imaging study, (ii) rationale for continued participation, (iii) experience of living in a multiple‐case family, (iv) risk perception: the personal meaning of mutation‐negative status, (v) opinions regarding cancer aetiology and (vi) communication patterns between mutation‐negative and mutation‐positive family members.Conclusions  Living in a hereditary breast and ovarian cancer family is a complex experience that affects cognitive, emotional and social functioning. Our findings indicate that mutation‐negative women may have unmet psychosocial needs that must be addressed by health‐care professionals, particularly in the primary‐care setting following genetic disclosure of a potentially reassuring result regarding their lack of the very high cancer risks associated with BRCA1/2 mutations.
Improving informed consent: pilot of a decision aid for women invited to participate in a breast cancer prevention trial (IBIS‐II DCIS)
Authors: Juraskova I , Butow P , Lopez A , Seccombe M , Coates A , Boyle F , McCarthy N , Reaby L , Forbes JF 
Published: August 2008

AbstractBackground  Patients and clinicians report difficulties with the process of informed consent to clinical trials and audiotape audits show that critical information is often omitted or poorly presented. Decision aids (DAs) may assist in improving consent.Aims  This study piloted a DA booklet for a high priority breast cancer prevention trial, IBIS‐II DCIS, which compares the efficacy of an aromatase inhibitor (anastrozole) with tamoxifen in women who have had surgery for ductal carcinoma in situ (DCIS).Method  Thirty‐one Australian women participating in the IBIS‐I breast cancer prevention trial and who are currently in follow‐up agreed to read the IBIS‐II DCIS participant information sheet and the DCIS DA booklet, complete a set of standardized questionnaires, and provide feedback on the DA via a semi‐structured phone interview.Results  Women found the DA helpful in deciding about trial participation, reporting that it aided their understanding over and above the approved IBIS‐II DCIS participant information sheet and was not anxiety provoking. Women’s understanding of the rationale and methods of clinical trials and the IBIS‐II DCIS trial was very good; with more than 80% of items answered correctly. The only areas that were not understood well were the concepts of randomization and blinding.Conclusions  This study suggests that the DA will be acceptable to and valued by potential participants in the IBIS‐II DCIS study. The revised DA is currently being evaluated prospectively in a randomized controlled trial. If successful, such DAs could transform the consent process to large clinical trials and may also reduce dropout rates.
Engaging the public in priority‐setting for health technology assessment: findings from a citizens’ jury
Authors: Menon Devidas , Stafinski Tania 
Published: August 2008

AbstractObjectives  To assess the feasibility of using a citizens’ jury to elicit public values on health technologies and to develop criteria for setting priorities for health technology assessment (HTA).Methods  Sixteen individuals were selected from 1600 randomly sampled residents of the Capital Health Region in Alberta, Canada. They participated in a 2½ day jury which comprised presentations by ‘expert witnesses’, who represented innovators, patients, health‐care policy‐makers and clinicians, as well as a series of small and large group priority‐setting exercises based on actual examples of technologies that had recently been considered for assessment by local and national HTA bodies. The session was audio‐taped, and transcripts were independently reviewed by two researchers using content analytical techniques in order to ensure that no important concepts expressed by individual jurors were missed during group development of the final list of priority‐setting criteria. Jurors evaluated the process by completing self‐administered, semi‐structured questionnaires at the end of the session. Responses were analysed using qualitative methods.Results  The jury identified 13 criteria, which they subsequently ranked in order of importance. The top two criteria included ‘potential to benefit a number of people’ and ‘extends life with quality’. Based on feedback from questionnaires, jurors valued the opportunity to become engaged in such a process, and expressed interest in participating in future juries.Conclusions  Citizens’ juries offer a feasible approach to involving the public in priority‐setting for HTA. Furthermore, technologies that may benefit a number of people and improve quality of life appear to be of greatest importance to the public.
Citizens’ juries in planning research priorities: process, engagement and outcome
Authors: Gooberman‐Hill Rachael , Horwood Jeremy , Calnan Michael 
Published: August 2008

AbstractBackground  Involving members of the public in setting priorities for health research in becoming increasingly common practice. One method used in public involvement exercises is the citizens' jury.Objective  This article examines some challenges and benefits of citizens' juries, including issues relating to process, public engagement and outcome.Design  In Bristol, UK, a citizens' jury was held with the aim of identifying local priorities for research into health and social care. This jury is used as an example through which key issues in public involvement and jury processes are explored.Setting and Participants  The Bristol Citizens' Jury comprised 20 members of the public (`jurors'), an oversight panel and a steering group. The jurors met at 11 consecutive sessions during 2006 over a period of 16 weeks, which culminated in a written report. All the sessions were audio‐recorded, five sessions were observed and video‐recorded, and 16 jurors completed written feedback forms at the end of the jury process.Findings and conclusion  In this article we discuss degree and timing of public involvement in the process of health research; the role of context; representation of communities; processes of deliberation and knowledge production; and how constraints of time and cost may affect public involvement. It was clear that jurors who took part in the Bristol Citizens' Jury were engaged and committed. This engagement may be related to jurors' belief in their ability to shape future research alongside concern about the relevance of the issues under discussion. Opposing emotions of tension and harmony are a crucial part of the deliberation process.
Patient Advice and Liaison Services: results of an audit survey in England
Authors: Evans David , Powell Jane , Cross Tanya 
Published: August 2008

AbstractObjective  To assess the extent national standards for Patient Advice and Liaison Services (PALS) were achieved across England.Context  PALS are an important element of patient and public involvement strategy in England. Seven national standards for PALS were identified. Previous research has not assessed PALS across all trust types in England.Design  Audit survey as part of a mixed method ‘realistic evaluation’ in which regularities of context, mechanism and outcome are hypothesized and tested.Setting and participants  PALS based in 570 NHS trusts in England between October and December 2005.Main outcome measures  Self reported achievement against PALS national standards.Results  Three hundred and thirty‐six valid responses were received, a response rate of 65%. However because some PALS serve more than one trust, this represents an estimated 76% of trusts. Overall, PALS rated themselves highly against all the standards, though somewhat less highly against standard 2 (seamlessness across health and social care) and standard 6 (acting as a catalyst for culture change). There was a wide range of responses with regard to PALS budget, staffing and activity levels, and statistically significant associations between levels of funding and staffing and higher levels of performance.Conclusions  The overall response rate was good so there can be a high degree of confidence in the reliability of the results. The results indicate the challenging context in which PALS are operating. Although the majority of PALS are single trust PALS, there is a high degree of variation in key mechanism factors such as budget and staffing.
When doctors disagree: a qualitative study of doctors’ and parents’ views on the risks of childhood food allergy
Authors: Hu Wendy , Grbich Carol , Kemp Andrew 
Published: August 2008

AbstractObjective To examine the views of doctors which underpin clinical practice variation concerning an uncertain health risk, and the views of parents who had sought advice from these doctors, using the example of childhood food allergy.Study design Qualitative study involving in‐depth interviews and participant observation over 16 months. Focus groups and consultation audio‐recordings provided corroborative data.Setting Three specialist allergy clinics located in one metropolitan area.Participants Eighteen medical specialists and trainees in allergy, and 85 parents (from 69 families) with food allergic children.Results Doctors expressed a spectrum of views. The most divergent views were characterized by: scientific scepticism rather than precaution in response to uncertainty; emphasis on quantifiable physical evidence rather than parental histories; professional roles as providers of physical diagnosis and treatment rather than of information and advocacy; libertarian rather than communitarian perspectives on responsibility for risk; and values about allergy as a disease and normal childhood. Parents held a similar, but less divergent range of views. The majority of parents preferred more moderate doctors’ views, with 43% (30 of 69) of families expressing their dissatisfaction by seeking another specialist opinion. Many were confused by variation in doctors’ opinions, preferring relationships with doctors that recognized their concerns, addressed their information needs, and confirmed that they were managing their child’s allergy appropriately.Conclusions In uncertain clinical situations, parents do not expect absolute certainty from doctors; inflexible certainty may not allow parental preferences to be acknowledged or accommodated, and is associated with the seeking of second opinions.
Sequencing of substance use and affective morbidity in 166 first‐episode bipolar I disorder patients
Authors: Baethge Christopher , Hennen John , Khalsa Hari‐Mandir Kaur , Salvatore Paola , Tohen Mauricio , Baldessarini Ross J 
Published: August 2008

Objectives:  Since bipolar disorder (BPD) patients have high rates of comorbid substance abuse, and the temporal relationships involved are unclear, we evaluated the sequencing of specific substance use and affective morbidity.Methods:  Prospective follow‐up (4.7 years) of 166 first‐episode DSM‐IV type I BPD patients with reliable, standardized assessments provided data for longitudinal analysis of temporal distribution of alcohol and cannabis use versus manic or depressive episodes or symptoms, using generalized estimating equation regression modeling.Results:  By quarters, cannabis use selectively and strongly preceded and coincided with mania/hypomania, and alcohol use preceded or coincided with depression, whereas substance use was unassociated with mood states in preceding quarters.Conclusions:  These preliminary findings suggest potentially predictive temporal associations, in which the abuse of cannabis or alcohol anticipated or corresponded with, but did not follow, affective morbidity, including selective association of cannabis with mania and alcohol with depression.
Short‐term course of neuropsychological abilities in middle‐aged and older adults with bipolar disorder
Authors: Depp Colin A , Savla Gauri N , Moore David J , Palmer Barton W , Stricker John L , Lebowitz Barry D , Jeste Dilip V 
Published: August 2008

Objectives:  There are few longitudinal studies of neurocognition in bipolar disorder, and the short‐term course of cognitive deficits in later‐life bipolar disorder is unknown.Methods:  We administered a battery of neurocognitive tests, repeated 1–3 years after baseline, to 35 community‐dwelling outpatients with bipolar disorder (mean age = 58), and compared their performance on a composite measure of cognitive functioning to that of demographically matched samples of normal comparison subjects (NCs; n = 35) and patients with schizophrenia (n = 35). Using regression analyses, we examined group differences in baseline performance, trajectory of change over time, and variability in performance across time. Within the bipolar group, we examined the impact of baseline severity and change in severity of psychiatric symptoms on intra‐individual change in neurocognitive performance.Results:  At baseline, the group with bipolar disorder differed in overall neurocognitive functioning from the NCs, but did not differ significantly from the schizophrenia group. The bipolar group did not differ from the NCs or schizophrenia group in the mean trajectory of change between time‐points, but the bipolar patients showed more intra‐individual variability over time than the NCs or schizophrenia group. In the bipolar group, change in neurocognitive function was not related to baseline or change in psychiatric symptom severity.Conclusions:  Middle‐aged and older community‐dwelling adults with bipolar disorder have greater short‐term variability in level of neurocognitive functioning relative to NCs or people with schizophrenia. The developmental course of and risk factors for cognitive deficits in bipolar disorder should be examined in future longitudinal studies.
Service delivery in older patients with bipolar disorder: a review and development of a medical care model
Authors: Kilbourne Amy M , Post Edward P , Nossek Agnes , Sonel Elif , Drill Larry J , Cooley Susan , Bauer Mark S 
Published: August 2008

Objectives:  Medical comorbidities, especially cardiovascular disease (CVD), occur disproportionately in older patients with bipolar disorder. We describe the development, implementation, and feasibility/tolerability results of a manual‐based medical care model (BCM) designed to improve medical outcomes in older patients with bipolar disorder.Methods:  The BCM consisted of (i) self‐management sessions focused on bipolar disorder symptom control, healthy habits, and provider engagement, (ii) telephone care management to coordinate care and reinforce self‐management goals, and (iii) guideline dissemination focused on medical issues in bipolar disorder. Older patients with bipolar disorder and a CVD‐related risk factor (n = 58) were consented, enrolled, and randomized to receive BCM or usual care.Results:  Baseline assessment (mean age = 55, 9% female, 9% African American) revealed a vulnerable population: 21% were substance users, 31% relied on public transportation, and 22% reported problems accessing medical care. Evaluation of BCM feasibility revealed high overall patient satisfaction with the intervention, high fidelity (e.g., majority of self‐management sessions and follow‐up contacts completed), and good tolerability (dropout rate <5%). Use of telephone contacts may have mitigated barriers to medical care (e.g., transportation).Conclusions:  The BCM is a feasible model for older, medically ill patients with bipolar disorder, and could be an alternative to more costly treatment models that involve co‐location and/or additional hiring of medical providers in mental health clinics. Future research directions pertinent to the development of the BCM and other medical care models for older patients with bipolar disorder include assessment of their long‐term effects on physical health and their cost‐effectiveness across different treatment settings.