bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-reported incidence of accidental exposures to patients' blood and body fluids by resident doctors in Nigeria
Authors: Olubuyide I.O. , Olawuyi F. 
Published: September 2007

An anonymous survey of 149 resident doctors was conducted to estimate the ex tent of accidental exposures to blood and body fluids of patients over a one-year period. There was a total of 1142 exposures. Ninety-three percent of respondents reported one or more exposure incident(s). Analysis of events and procedures leading to accidental exposures revealed that recapping needles was involved in 17%, suturing accounted for 14%, setting up intravenous lines 11%, cuts with scalpel 9% and phlebotomy 9%. Surgical residents had a threefold greater risk of exposure compared with medicine residents. No trend was found for accidental expo sures by level of residency training. Seventy-four percent of the residents used universal precautions 50% or less of the time. Only half of the doctors could recall formal instruction on correct course of action after exposure and 5% of them had as undergraduates hepatitis B vaccine prior to the commencement of venepuncture duties. All but one of the residents' exposures were not reported to the Staff Medical Services Department. The doctor who reported was neither tested for hepatitis B virus or human immunodeficiency virus nor was he properly treated. Only 5 (4.6%) of the contaminating patients were evaluated serologi cally for their status of these viruses. These data emphasize the need for increased efforts toward improved early and continu ing education, prevention and correct management of accidental exposures to blood or body fluids of patients by resident doctors in Nigeria. No recent study exists that exclusively addresses this problem in doctors in tropical Africa.
Condensation and Mould: The Canadian Experience
Authors: Rayner K.F. 
Published: September 2007

It has been estimated that up to 20% of the UK housing stock is significantly affected by dampness and associated mould growth. The effects on the health of the occu pants of affected homes are well documented. The recent imposition of VAT at 17.5% on domestic fuel is generally regarded as likely to worsen the problem. However, this deteri orating situation puts me in mind of a recent study tour to Canada where the problem of dampness in housing is being tackled very differently to the United Kingdom. Are there any lessons to be learnt?
Obesity among female university students in the United Arab Emirates
Authors: Amine E.K. , Samy M. 
Published: September 2007

The aim of the study was to determine the prevalence of obesity among female students from the United Arab Emirates University. A sample of 566 students was taken. Body weight and height were measured. The stu dents were interviewed to collect data on age, home Emirate, obesity in childhood, obesi ty among parents, food intake between meals, the consumption of fast foods and physical activity. A student was considered overweight when the body weight was 110-120% of the reference weight of height and was considered obese when the body weight exceeds 120 % of the reference value. The results show that 10.8% of the students were overweight and 30.6% were obese. While the prevalence of obesity increased with age, obesity among stu dents was associated with obesity during childhood, the presence of obesity among one or both parents, food intake between meals and in particular fast foods. Limited physical exer cise and long afternoon napping were important contributors to the development of obesi ty.
Female circumcision and its health implications
Authors: Ebong R.D. 
Published: September 2007

A total of 400 subjects was randomly selected from 40 villages in the Uruan Local Government Area of Akwa Ibom State for the study. The purposes of the study were to: i. identify the 'established benefits' of female circumcision; ii. identify the health hazards that accompany the practice; and iii. create awareness among community members of the ill-effects of the practice. The study discovered a strong belief in the established benefits and poor appreciation of the health hazards of female circumcision by the participants. Recommendations were made for more efforts in public health education programmes on the ill-effects of the practice. Studies were also recommended to be conducted in other parts of the country to assess the level of awareness on the ill-effects of such an operation and the institution of educational programmes where applicable.
South African communities' perceptions and priorities for well-being
Authors: Beke Andy K. , Kocks Daniel J. , Meyer Amanda , Comm B. 
Published: September 2007

Surveys were conducted using a pre-tested questionnaire in 1991 and 1993 in South Africa to find out how the people perceive the government's social responsibility with special reference to the provision of free health care and other determinants of well-being. Provision of jobs for the unemployed and free education were identified to be the main priorities. Free health care ranked as the fifth priority. The study supports the call for increasing participation of communities in determining and prioritising their needs. It also calls on health care professionals to support the communities by advocating for policies that are directed twoards the perceived needs of the community and to use the present available resources efficiently.
Do the homeless get a fair deal from General Practitioners?
Authors: Wood N. , Wilkinson C. , Kumar A. 
Published: September 2007

Many studies have indicated the health status of homeless people to be typically poorer than that of the general population, with various studies indicating a high prevalence of psychiatric illness, drug or alcohol misuse and associated socio-medical problems. The Bristol Primary Healthcare Project is an agency which was established to provide a local health care service tailored to the needs of people who are homeless. The present study was carried out as part of an evaluation of the service offered locally to homeless people by General Practitioners (GPs). A postal questionnaire survey of 155 general practices within the Avon FHSA area was carried out. Both fundholding and non-fundholding practices were included, within an area including inner city, urban and rural/semi-rural locations. One hundred and seventeen completed questionnaires were returned, providing a response rate of 75%. Twenty-seven percent of practices would fully register a homeless person who seeks to register at the practice, 24% would treat as immediate and necessary and 33% would treat as a temporary resident. Four percent of fundholding practices surveyed would fully register homeless persons and 55% of inner city practices would do so. Seventy-nine percent of doctors indicated that homeless patients were more difficult to treat than other patients. The most frequent problems associated with registering homeless persons were perceived to be the associated social problems (90% of respondents agreed), the lack of medical records (88% agreed), the complex health problems (79% agreed) and the associated alcohol or substance misuse (78% agreed). The study has highlighted a need for government to consider providing incentives to GPs to register homeless people without resulting in adverse effects on their contract targets. The reluctance of some practices to register these patients varied by area and type of practice with doctors at fundholding practices being the most reluctant. There is an identified need for further health education and promotion work and initiatives exemplified by the Bristol Primary Healthcare Project for people who are homeless.
Assessment of the functional status of elderly subjects in Qassim Region, Saudi Arabia
Authors: Al-Mahadi Mohammed A. , Elzubier Ahmed G. 
Published: September 2007

A cross-sectional study was carried out on a sample of elderly subjects aged 65 years and above, resident in Qassim region, in central Saudi Arabia. The sample size was 266 subjects (12%). The study objective was to assess the subjects' functional activities in the form of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Wadu, the Muslim tradition of washing before the main five daily prayers was included in the ADL. The results showed that impairment of ADL, ADL and Wadu, and IADL was observed in 12.4%, 7.9% and 54.4% of subjects. Advancing age and female gender were found to be negatively, while male gender and having an occupation were found to be positively associated with functional activity.
A baseline study of tobacco use among the staff of Aligarh Muslim University, Aligarh, India
Authors: Yunus M. , Khan Z. 
Published: September 2007

A cross-sectional study of 2,439 university employees and research scholars was carried out using the questionnaire method. The objective was to assess the prevalence and type of tobacco usage and to collect background data for planning health education programmes. The overall prevalence of tobacco usage was 51.5% among males and 30.3% among females. There were no female smokers, the preferred habit of tobacco usage among women being chewing. The prevalence of smoking among non-teaching staff members was significantly higher. Among females, the prevalence of tobacco chewers was higher in non- teaching staff members. Tobacco usage (both smoking and usage of other forms) rose with age. However, even at 20 - 30 years of age 25.4% of males were addicted to smoking. A majority of 60.6% had smoked for more than 10 years. Among the staff members (both teaching and non-teaching) the reason for smoking was either to relax or because of addiction, whereas the research scholars smoked to improve their image or for enjoyment/pleasure. The reasons given by users of other forms of tobacco were boredom, to pass the time or for no reason at all. Among non-users, the majority were aware of the harmful effects of smoking. Family pressure and traditions were also important reasons for not smoking. The study provides a clear picture of tobacco usage within the University.
Some Peoples' Psychological Experiences of Attending a Sexual Health Clinic and having a Sexually Transmitted Infection
Authors: Holgate H.S. , Longman C. 
Published: September 2007

This study considers aspects of the experiences of a group of people attending a sexual health clinic and receiving the diagnosis of a sexually transmitted infection (STI). The study was conducted in the form of action research using a qualitative approach. Participants consisted of eight attenders at a sexual health clinic who had been diagnosed with a sexually transmitted infection. Counselling skills and techniques were used through out semi-structured interviews to explore participants' feelings about these issues. Thematic analysis was used to generate themes of importance to the participants. Some people who had been to a sexual health clinic and received a diagnosis of a sex ually transmitted infection were found to experience feelings of anxiety, stigma and isola tion. This study is of value to all those working in the field of sexual health with an inter est in understanding the issues that are important to the client group.
The Growing Influence of Non Governmental Organisations (NGOs) in International Health: Challenges and Opportunities
Authors: Akukwe C. 
Published: September 2007

The growing influence of non governmental organizations (NGOs) in international health is occurring in the face of major challenges and opportunities. These challenges include the continued increases in global poverty status, the growing influence of private-funded health systems, the need for sustainability of external-funded programs, and the clamour for com munity participation in the planning and management of external-funded programs. Opportunities include the near universal recognition of the indispensable roles of NGOs by bilateral institutions and governments, the current emphasis on global trade by developed countries, and the need to develop political and economic systems that are equi table and promote social development. This article is an overview of these challenges and how these challenges can become excellent opportunities for NGOs to improve the health and social development of target communities in developing countries.
Against women: are we looking after our General Practitioners? GPs' views of the 1990 part-time contract
Authors: Littlewood Jenny , Beer Naomi , Lazou Elizabeth , Webb Enid , Saunders Mary 
Published: September 2007

A postal survey was conducted looking at the roles and experiences of General Practitioners on part-time contracts. This involved their perception of the attitudes of their colleagues and patients to their part-time status, and the consequences of these for their professional development. Of the 130 General Practitioners with part-time contracts in the one Regional Health Authority that was being surveyed 77.7% responded; 74.3% of the respondents were women. Of the women General Practitioners who responded to this particular question, the predominant age-bands were 31-40 years [41.4% (41)] and 41-50 [19.2% (19)], whilst male General Practitioners were more evenly spread across the age bands. The results showed that the majority of General Practitioners took up part-time contracts to enable them to look after their dependants, though a sizeable minority wished for free time or to relieve stress from a full-time contract. Forty percent said that they felt excluded from decision making about continuity of patient care and practice policy. Just under forty percent also stated that their workload was excessive in comparison with their full-time counterparts. Further, many expressed the opinion that they were financially penalised. The cost effective correlation between the increased availability of General Practitioners (particularly women) for patient care, and the costly medical education and training of such General Practitioners not being 'wasted' for several years was also noted together for the need for ongoing (or continual) medical education and training. The findings of this survey suggest there are many unresolved issues involved in satisfactory part-time contracting arrangements for General Practitioners. This particularly affects women General Practitioners. Whilst the RCP policy statement addresses education and training for general practice, the question of not losing out in relation to training opportunities and promotion is not addressed. The unresolved effects of the intra-professional differences in opportunities may affect the inter-professional functioning of the primary health care team and ultimately continuity and quality of care for patients.
Sexual function changes during the 5 years after high-dose treatment and hematopoietic cell transplantation for malignancy, with case-matched controls at 5 years
Authors: Syrjala Karen L. , Kurland Brenda F. , Abrams Janet R. , Sanders Jean E. , Heiman Julia R. 
Published: September 2007

Abstract
This prospective study evaluated sexual function through 5 years after myeloablative allogeneic hematopoietic cell transplantation (HCT) for cancer to determine sexual function recovery and residual problems. Adults completed measures before HCT (N = 161), with survivors followed at 6 months and at 1, 2, 3, and 5 years. At 5 years case-matched controls also completed assessments. Analyses indicated that men and women differed in rates of being sexually active across time (P < .001) and in overall sexual function (P < .001). Both sexes declined in sexual activity rates and sexual function from before HCT to 6 months afterward (P ≤ .05). Activity rates recovered for men by 1 year (74%) and for women by 2 years (55%). Men improved from their 6-month nadir in sexual function by 2 years (P = .02), whereas women did not improve by 5 years (P = .17). Both male and female survivors were below controls in rates of sexual activity and sexual function at 5 years. Most women reported sexual problems (80% of survivors vs 61% of controls, P = .11); in contrast for men 46% of survivors versus 21% of controls (P = .05) reported problems. Thus, despite some recovery, sexual dysfunction remained a major problem for men and women after HCT. Aggressive efforts are needed to treat these deficits.
Enterococcal colonization of infants in a neonatal intensive care unit: associated predictors, risk factors and seasonal patterns
Authors: Hufnagel Markus , Liese Cathrin , Loescher Claudia , Kunze Mirjam , Proempeler Heinrich , Berner Reinhard , Krueger Marcus 
Published: September 2007

AbstractBackgroundDuring and shortly after birth, newborn infants are colonized with enterococci. This study analyzes predictors for early enterococcal colonization of infants in a neonatal intensive care unit and describes risk factors associated with multidrugresistant enterococci colonization and its seasonal patterns.MethodsOver a 12-month period, we performed a prospective epidemiological study in 274 infants admitted to a neonatal intensive care unit. On the first day of life, we compared infants with enterococcal isolates detected in meconium or body cultures to those without. We then tested the association of enterococcal colonization with peripartal predictors/risk factors by using bivariate and multivariate statistical methods.ResultsTwenty-three percent of the infants were colonized with enterococci. The three most common enterococcal species wereE. faecium(48% of isolates),E. casseliflavus(25%) andE. faecalis(13%). Fifty-seven percent of the enterococci found were resistant to three of five antibiotic classes, but no vancomycin-resistant isolates were observed. During winter/spring months, the number of enterococci and multidrug-resistant enterococci were higher than in summer/fall months (p = 0.002 and p < 0.0001, respectively). With respect to enterococcal colonization on the first day of life, predictors were prematurity (p = 0.043) and low birth weight (p = 0.011). With respect to colonization with multidrug-resistant enterococci, risk factors were prematurity (p = 0.0006), low birth weight (p < 0.0001) and prepartal antibiotic treatment (p = 0.019). Using logistic regression, we determined that gestational age was the only parameter significantly correlated with multidrug-resistant enterococci colonization. No infection with enterococci or multidrugresistant enterococci in the infants was detected. The outcome of infants with and without enterococcal colonization was the same with respect to death, necrotizing enterocolitis, intracerebral hemorrhage and bronchopulmonary dysplasia.ConclusionIn neonatal intensive care units, an infant's susceptibility to early colonization with enterococci in general, and his or her risk for colonization with multidrug-resistant enterococci in particular, is increased in preterm newborns, especially during the winter/spring months. The prepartal use of antibiotics with no known activity against enterococci appears to increase the risk for colonization with multidrug-resistant enterococci.
In vivo transcriptional targeting into the retinal vasculature using recombinant baculovirus carrying the human flt-1 promoter
Authors: Luz-Madrigal Agustín , Clapp Carmen , Aranda Jorge , Vaca Luis 
Published: September 2007

Abstract

Background
Endothelial cells are a target for gene therapy because they are implicated in a number of vascular diseases. Recombinant baculovirus have emerged as novel gene delivery vectors. However, there is no information available concerning the use of endothelial-specific promoters in the context of the baculovirus genome. In the present study, we have generated a recombinant baculovirus containing the human flt-1 promoter (BacFLT-GFP) driving the expression of the green fluorescent protein. Transcriptional gene targeting was analyzed in vitro in different mammalian cell lines and in vivo in adult rat retinal vasculature.

Results
BacFLT-GFP evoked the highest levels of expression in the endothelial cell line BUVEC-E6E7-1, similar to those reached by recombinant baculovirus carrying the CMV promoter (112% relative to BacCMV-GFP, n = 4). Interestingly, BacFLT-GFP directed high levels of expression in rat glioma C6 and in human glioblastoma CH235 cells (34.78% and 47.86% relative to BacCMV-GFP, respectively). Histone deacetylase inhibitors such as butyrate or trichostatin A enhanced the transcriptional activity of both BacCMV-GFP and BacFLT-GFP. Thus, in this study histone deacetylation appears to be a central mechanism for the silencing of baculovirus, independently of the promoter utilized. In vivo transcriptional targeting was demonstrated in adult rat retinal vasculature by intravitreal delivery of BacFLT-GFP and immunohistochemical staining with von Willebrand factor (vWF). Analysis by fluorescence microscopy and deconvolved three-dimensional confocal microscopy of retinal whole mounts obtained after 3 days of baculovirus injection showed that most GFP-expressing cells localized to the inner limiting membrane (ILM) and ganglion cell layer (GCL) and colocalize with vWF (70%, n = 10) in blood vessels, confirming the endothelial phenotype of the transduced cells.

Conclusion
Taken together, our results indicate that the restricted expression in endothelial cells mediated by the flt-1 promoter is not affected by the context of the baculovirus genome and demonstrate the potential of using recombinant baculovirus for transcriptional targeted gene expression into the eye vasculature.
Management of difficult personality disorder patients
Authors: Norton Kingsley 
Published: September 2007

‘…therapy often becomes part of the problem rather than vice versa’. George Lockwood, 1992Ten per cent of the general adult population have a diagnosable personality disorder (Zimmerman & Coryell, 1990) and in 4% this is clinically severe (Tyrer, 1988). The clinical management of such patients may be difficult. However, much clinical difficulty is generated by interpersonal aspects deriving from the particular interaction of the patient and psychiatrist involved and the respective roles they play.
Randomized Phase II Study of Erlotinib Combined With Bevacizumab Compared With Bevacizumab Alone in Metastatic Renal Cell Cancer
Authors: Bukowski Ronald M. , Kabbinavar Fairooz F. , Figlin Robert A. , Flaherty Keith , Srinivas Sandy , Vaishampayan Ulka , Drabkin Harry A. , Dutcher Janice , Ryba Sarah , Xia Qi , Scappaticci Frank A. , McDermott David 
Published: September 2007

Purpose Bevacizumab (Bev) has clinical activity in advanced renal cell carcinoma (RCC), and, when combined with erlotinib (Erl), has shown encouraging objective response rate (ORR) and progression-free survival (PFS). We performed a phase II, randomized, double-blind, multicenter, placebo-controlled trial to assess whether Erl provides additional clinical benefit with regard to PFS and ORR when combined with Bev in first-line treatment of metastatic RCC. Patients and Methods One hundred four patients received intravenous Bev (10 mg/kg) every 2 weeks in combination with oral Erl (150 mg) or placebo daily. Patients were treated until progression or toxicity. Results A landmark analysis was performed 9 months after enrollment was completed (median follow-up, 9.8 months). Sixty-five patients had discontinued therapy; time to study discontinuation did not differ between the two treatment groups. The median PFS was 9.9 months (Bev + Erl [B+E]) versus 8.5 months (Bev; hazard ratio = 0.86; 95% CI, 0.5 to 1.49; P = .58). ORR (complete plus partial) was 14% (B+E) versus 13% (Bev). One complete response occurred in the B+E group. Median survival was 20 months for B+E but not reached for Bev. The most common grade 3/4 adverse events (> 5% of patients) were hypertension, rash, proteinuria, diarrhea, and hemorrhage. One treatment-related death occurred on study (GI perforation, B+E group). Conclusion The addition of Erl to Bev was well tolerated, but did not provide additional clinical benefit compared with Bev alone. Bev has encouraging clinical activity for previously untreated metastatic RCC patients.