bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimation and prediction system for multi‐state disease process: application to analysis of organized screening regime
Authors: Chang Chi‐Ming , Lin Wen‐Chou , Kuo Hsu‐Sung , Yen Ming‐Fang , Chen Tony Hsiu‐Hsi 
Published: August 2007

AbstractRationale, aims and objectives  The disease progression of cancer and non‐malignant chronic disease often involve a multi‐state transition. However, estimation of parameters and prediction regarding the multi‐state disease process are complex. This study aimed to develop an estimation and prediction system with a computer‐assisted software using SAS/SCL as a platform to predict the risk of any outcome arising from the underlying multi‐state process with or without the incorporation of individual characteristics.Method  The computer‐aided system is first constructed following the theoretical framework of stochastic process. The functions provided in this software include model specification, formulation of likelihood function, parameter estimation, model validation and model prediction. An example of breast cancer screening for a high‐risk group in Taiwan was used to demonstrate the usefulness of this software.Results  The natural history of breast cancer of a three‐state disease process has been demonstrated. Two suspected risk factors, late age at first full‐term pregnancy and obesity, were considered by the form of the proportional hazard model. Formulation of intensity matrix, likelihood function, assignment of initial values, and parameter constraint and estimation were successfully demonstrated in model specification. Model validation suggested a good fit of the constructed model. The application of model prediction enables one to project the effectiveness of organized screening by different inter‐screening intervals from a policy level or from an individual basis.Conclusions  A computer‐aided estimation and prediction system for multi‐state disease process was developed and demonstrated. This system can be applied to data with the property of multi‐state transitions in association with events or disease.
A model to analyse costs and benefit of intensified diabetic foot care in Austria
Authors: Habacher Wolfgang , Rakovac Ivo , Görzer Evelyn , Haas Waltraud , Gfrerer Robert J. , Wach Paul , Pieber Thomas R. 
Published: August 2007

AbstractRationale, aims and objectives  The diabetic foot is a common late complication among diabetic patients and due to its consequences an important financial burden for society. Intensified treatment has proved to reduce amputation rates, but in Austria so far no data have been available about financial implications and long‐term effects of intensified treatment. The objective was to retrieve cost data for intensified treatment of diabetic foot ulcers and to estimate the long‐term outcome.Methods  A retrospective data analysis of 119 ulcers was done to get outcomes and costs for intensified treatment in a specialized outpatient hospital department in an Austrian setting. One‐year results were categorized according to the San Antonio wound classification. Using a Markov model upon these data, long‐term outcomes and costs for intensified treatment and for standard care were calculated.Results  Costs for intensified treatment until healing vary from €1071 (range: 99–4089) per case to €7844 (range: 104–25 615) depending on the lesion’s grade. One‐year healing rates are 85.2% for grade A and 71.7%, 84.6% and 33.3% for the grades B, C and D respectively. The model‐based comparison for treatment costs shows a cost reduction of 29.8% per patient year in grade A ulcerations and 49.7% in grade D for intensified versus standard treatment due to lower amputation rates.Conclusions  These results are the first cost data for diabetic foot care in Austria and demonstrate the advantages of intensified care over standard care in terms of patient‐oriented outcome and financial impact pleading for the implementation of specialized foot care facilities and referral guidelines to standardize and improve treatment.
The patient's daily activities in acute psychiatric care
Authors: LEPOLA I. , VANHANEN L. 
Published: August 2007

The patient's daily activities in acute psychiatric careThis study is part of a research project entitled:‘Towards patient‐focused nursing on an acute psychiatric ward’. The aim of the project is to describe the changes taking place in nursing activities during a research project. This paper is a qualitative analysis of the patient's daily activities in acute psychiatric care. The data were collected by observing, selectively, seven patients for 61 h. The constant comparative method was used in data analysis. On the basis of the data analysis, the categories listed below were identified.1 The core category of the patient's daily activities was‘being a patient’.2 Being a patient mainly consisted of being alone without meaningful activities.3 Participating in the daily routines of the ward consisted of being alone while being together with others.4 Being together was initiated by either the patient or the nurse. The aim of being together was to satisfy the acute basic needs of the patients.5 Being together on the initiative of the nurse meant participating in the daily routines of the ward.Because the data were collected by observation, no insight into the patients’desires, expectations and thoughts could be presented. The findings challenged the nursing staff to develop a more therapeutic daily routine in acute psychiatric care. It was also of importance to change the patients’meaningless existence into a meaningful participation in the daily activities on the ward.
Monitoring the outcome of case management and community care: the care programme approach support system (CPASS)
Authors: BOWERS L. 
Published: August 2007

Monitoring the outcome of case management and community care: the care programme approach support system (CPASS)This study reports the findings of an audit of community care outcomes, for the seriously mentally ill, in one health district in the UK. An innovative community care and case management system for this client group was introduced in 1993. As part of that organizational change, data were collected continuously on the severity of client problems. A satisfaction survey of a random sample of clients and carers has now also been completed. This report is thus able to compare feedback on service performance using two methodologies. As both the problem rating scales and the satisfaction surveys were designed specifically to cover the same 12 domains of client problems, data from both can be integrated easily. The 12 domains also structure the assessment tools used by nurses and social workers, and form the basis of minimum standard specifications of community care provision. Selected data from the audits are presented, and the utility of these results for further local service developments are assessed. The methodology used can be recommended as a means of continuous audit of joint services for those with serious and enduring mental health problems.
A descriptive study of multidisciplinary mental health staff moving to the community: the demographic and educational issues
Authors: BUGGE C. , SMITH L. N. , SHANLEY E. 
Published: August 2007

A descriptive study of multidisciplinary mental health staff moving to the community: the demographic and educational issuesMental health care philosophy has moved from the containment of patients within institutions to the integration of clients within the community.‘Caring for People’(a Department of Health report) and the subsequent legislation enshrined the philosophical shift in law. Previous policy reports had indicated that staff required training to move from a hospital‐based service to a community‐based service, but did not propose content, and no systematic study of the needs of mental health staff has been carried out. Therefore, this study aimed to identify the skill and information needs of a group of multidisciplinary staff in preparation for the movement from hospital to community settings. The study design was a descriptive survey sampling of a total multidisciplinary population in Scotland. Data were collected using questionnaires and semistructured interviews with a small volunteer subsample of respondents. This paper presents the first set of study findings related to the demographic and educational issues. Differences between hospital and community staff and between health care assistants and qualified staff are demonstrated for demographic and educational factors. Proposals are made for managers, professionals, educators and researchers.
Changing lake dynamics and sequence stratigraphy of synrift lacustrine strata in a half‐graben: an example from the Triassic Ischigualasto–Villa Unión Basin, Argentina
Authors: MELCHOR RICARDO NÉSTOR 
Published: August 2007

AbstractWell‐exposed Triassic rift strata from the Ischigualasto–Villa Unión Basin (NW Argentina) include a 80 to ca 515 m thick lacustrine‐dominated package that can be correlated across a half‐graben using key stratigraphic surfaces (sequence boundaries, lacustrine flooding surfaces and forced regressive surfaces). The characteristics of the synrift lacustrine fill in different parts of the half‐graben have been examined and the mechanisms controlling sedimentation inferred. A variety of sedimentary environments are recognized including; volcaniclastic floodplain, mildly saline lake and playa lake, offshore lacustrine, delta front to fluvial‐dominated and wave‐dominated deltas, distributary and fluvial channel, and interdistributary bay. The succession can be divided into four stratigraphic sequences (SS1 to SS4), the oldest of which (SS1) contains volcaniclastic, fluvial and saline lake deposits; it is thickest close to the western border fault zone, reflecting more rapid subsidence here. Accommodation exceeded sediment and water input during SS1. The second and third sequences (SS2 and SS3) mark the onset of widespread lacustrine sedimentation, reflecting a balance between accommodation creation and water and sediment fluxes. Sequences SS2 and SS3 are represented by offshore meromictic lacustrine and deltaic deposits, the latter mostly sourced from the flexural and southern axial margins of the half‐graben. The presence of stacked parasequences bound by lacustrine flooding surfaces is related to climatically induced lake‐level fluctuations superimposed on variable rates of subsidence on the controlling rift border fault zone. The youngest sequence (SS4) is represented by the deposits of littoral lacustrine and shallow shelf deltas distinguished by a change in lithofacies, palaeocurrents and sandstone composition, suggesting a switch in sediment supply to the footwall margin to the NW. The change in the sediment source is related to reduced footwall uplift, the possible presence of a relay ramp and/or supply from a captured antecedent drainage network. During SS4, the rate of creation of accommodation was exceeded by the sediment and water discharge. The stratigraphic evolution of lacustrine strata in the half‐graben was mainly controlled by tectonic processes, including subsidence rate and the growth and evolution of the border fault zone, but changing climate (inducing changes in water balance and lake level) and autocyclic processes (delta lobe switching) were also important.
Phloem‐based resistance to green peach aphid is controlled by Arabidopsis PHYTOALEXIN DEFICIENT4 without its signaling partner ENHANCED DISEASE SUSCEPTIBILITY1
Authors: Pegadaraju Venkatramana , Louis Joe , Singh Vijay , Reese John C. , Bautor Jaqueline , Feys Bart J. , Cook Graeme , Parker Jane E. , Shah Jyoti 
Published: August 2007

SummaryGreen peach aphid (GPA) Myzus persicae (Sülzer) is a phloem‐feeding insect with an exceptionally wide host range. Previously, it has been shown that Arabidopsis thaliana PHYTOALEXIN DEFICIENT4 (PAD4), which is expressed at elevated levels in response to GPA infestation, is required for resistance to GPA in the Arabidopsis accession Columbia. We demonstrate here that the role of PAD4 in the response to GPA is conserved in Arabidopsis accessions Wassilewskija and Landsberg erecta. Electrical monitoring of aphid feeding behavior revealed that PAD4 modulates a phloem‐based defense mechanism against GPA. GPA spends more time actively feeding from the sieve elements of pad4 mutants than from wild‐type plants, and less time feeding on transgenic plants in which PAD4 is ectopically expressed. The activity of PAD4 in limiting phloem sap uptake serves as a deterrent in host‐plant choice, and restricts aphid population size. In Arabidopsis defense against pathogens, all known PAD4 functions require its signaling and stabilizing partner EDS1 (ENHANCED DISEASE SUSCEPTIBILITY1). Bioassays with eds1 mutants alone or in combination with pad4 and with plants conditionally expressing PAD4 under the control of a dexamethasone‐inducible promoter reveal that PAD4‐modulated defense against GPA does not involve EDS1. Thus, a PAD4 mode of action that is uncoupled from EDS1 determines the extent of aphid feeding in the phloem.
Why do some apheresis donors donate blood just once?
Authors: Ringwald J. , Lange N. , Rabe C. , Zimmermann R. , Strasser E. , Hendelmeier M. , Strobel J. , Eckstein R. 
Published: August 2007

Background and Objectives  More knowledge about the reasons for non‐return of blood donors (BD) would enable blood donation services (BDS) to improve the efficacy of recruitment and retention programmes. We interviewed returning (RBD) and non‐returning apheresis BDs (NRBD) of our university hospital‐based BDS.Materials and Methods  A questionnaire was sent to 1218 individuals who passed the initial health check with no more than one subsequent blood donation. A similar questionnaire was answered by 235 randomly incoming RBDs. We asked for age, sex, profession, education level, motives to donate blood and, if applicable, reasons for non‐return. These data were compared between NRBDs and RBDs and were analysed in relationship to the reasons for non‐return.Results  We received 267 answered questionnaires (21·9%). As 32 individuals indicated that they had been permanently deferred and 47 BDs had donated blood elsewhere, 188 NRBDs remained for further analysis. We found more women than men among NRBDs. Medical professions were less likely to return than students and trainees. Individuals motivated by personal experience, remuneration or a free health check were more likely to return than others. Whereas logistic reasons were of highest relevance for non‐return in general, women indicated anxiety of blood donation as reason for non‐return more often than men.Conclusion  Reducing women's anxiety of blood donation, reminding medical professions more intensively on blood donation and appealing to personal experience or a free health check may be the most promising approaches to increase BDs’ return rates.
A metabolism cage for quantitative urine collection and accurate measurement of water balance in adult cats (Felis catus)
Authors: Hendriks By W. H. , Wamberg S. , Tarttelin M. F. 
Published: August 2007

Introduction  Metabolism cages play a pivotal role in nutritional science as they are often used in experiments to determine nutrient requirements of animals, dietary nutrient digestibilities, endogenous excretions, glomerular filtration rates, mineral balance, 24‐h urinary excretion rates, etc. Such cages are a convenient way to obtain accurate data on the amount and frequency of excreta produced by animals. The accuracy of the procedures and equipment used for the measurement of excreta production, however, is often neglected, casting doubt on the results obtained. Recently, Wamberg et al. (1996b) showed that the recovery of urine collection from mink (Mustela vison) housed in a standard metabolism cage ranged from 68 to 88% in the fed state and 62–78% in the fasted state. This magnitude of under‐collection of urine will have a significant impact on data where quantitative urine collection is paramount, such as endogenous urinary excretions, and 24‐h urinary excretion rates. The main reason for the incomplete collection of urine in mink was attributed to the cross‐contamination of faeces with urine (Wamberg et al. 1996b).The domestic cat is a strict carnivore and has been noted to excrete relatively concentrated urine (Chew 1965; Anderson 1982). Under‐collection of urine, therefore, has a major impact on the measurement of excretion rates of urinary constituents and any subsequent derived data. The cat, furthermore, has been noted for oliguria, anuria and spraying of urine while held in metabolism cages (Worden et al. 1960; Klatt et al. 1975; Matandos and Franz 1980; Russo et al. 1986), making the domestic cat a difficult animal from which to collect excreta quantitatively.The main objective of this study was to validate quantitative urine collection from cats housed in specially designed metabolism cages fitted with a urine/faeces collection system when fed a nutritionally balanced diet and in the feed‐restricted state. Furthermore, the accuracy of water balance measurements using the metabolism cages and urine/faeces collection system was assessed in adult cats.
Effects of Lamb Sucking on the Bacterial Flora of Teat Duct and Mammary Gland of Ewes
Authors: Gougoulis DA , Kyriazakis I , Tzora A , Taitzoglou IA , Skoufos J , Fthenakis GC 
Published: August 2007

ContentsWe aimed (i) to determine differences in bacterial flora of teat duct and mammary gland of ewes before and after suckling, (ii) to evaluate factors potentially affecting those. We collected samples of teat duct material and mammary secretion from 11 ewes immediately before and after sucking by lambs, as well as 120 min later. We processed samples bacteriologically and compared changes in infection by the Sign Test. We isolated bacteria from 3.5% duct and 1.5% secretion samples before suckling. Respective figures post‐suckling were 10.6% and 2.0%, and 120 min later 6.8% and 1.5%. We recorded differences in infection of duct samples before and after suckling in 40 cases; bacteria were isolated before suckling from six samples, whereas after it from 34 (p < 0.001). Also, we recorded differences in samples collected after suckling and 120 min later in 12 cases; bacteria were isolated immediately post‐suckling from eight samples, whereas 120 min later from four (p = 0.375). No significant changes were seen for secretion. We found neither difference between ewes with single or twin lambs, nor among stages of lactation. Mostly, we isolated staphylococci: 70% of isolates before suckling, 80% of isolates after it, 91% of isolates 120 min later. After suckling we also isolated two Mannheimia haemolytica strains. Suckling predisposes to entrance of bacteria into the teat; however, increased teat infections did not result in mammary infections. Isolation of M. haemolytica post‐suckling indicates that lambs act as source of infection for this pathogen.
Distribution of Androgen Receptor in the Porcine Uterus throughout Pregnancy
Authors: Słomczyńska M , Duda M , Burek M , Knapczyk K , Czaplicki D , Koziorowski M 
Published: August 2007

ContentsThe uterus is a well‐known target of endocrine, paracrine and autocrine acting molecules among which steroid hormones (oestrogens, androgens and progesterone) are of special importance. The uterine tissues (endometrium and myometrium) undergo morphological and physiological changes which are associated with changes in expression of steroid hormone receptors. Androgen receptors (AR) that mediate the action of androgens have already been detected in porcine uteri during the oestrous cycle and early pregnancy. To evaluate the role of AR in uterine physiology, the presence of ARmRNA and AR protein localization in the porcine uterus from day 10 to day 90 of pregnancy and in the uterus from the foetus of day 90 postcoitum (p.c.) and from the neonatal 1‐day‐old piglet was studied. ARmRNA was detected in the porcine endometrium up to day 18 p.c., while AR protein was detectable in glandular epithelium and stromal cells as through day 90 of pregnancy. AR was also detected in the myometrium on all investigated days of pregnancy; however, on day 90, the immunostaining was present only in a limited number of cells. AR immunostaining was clearly demonstrated in the uterus of the female foetuses on day 90 as well as in the uterus of 1‐day‐old piglets. The physiological relevance of this finding needs further elucidation.
Continuing the dialogue: postcolonial feminist scholarship and Bourdieu — discourses of culture and points of connection
Authors: Anderson JM , Reimer Kirkham S , Browne AJ , Lynam MJ 
Published: August 2007

Continuing the dialogue: postcolonial feminist scholarship and Bourdieu — discourses of culture and points of connection Postcolonial feminist theories provide the analytic tools to address issues of structural inequities in groups that historically have been socially and economically disadvantaged. In this paper we question what value might be added to postcolonial feminist theories on culture by drawing on Bourdieu. Are there points of connection? Like postcolonial feminists, he puts forward a position that aims to unmask oppressive structures. We argue that, while there are points of connection, there are also epistemologic and methodologic differences between postcolonial feminist perspectives and Bourdieu's work. Nonetheless, engagement with different theoretical perspectives carries the promise of new insights — new ways of ‘seeing’ and ‘understanding’ that might enhance a praxis‐oriented theoretical perspective in healthcare delivery.
Relatives’ presence in connection with cardiopulmonary resuscitation and sudden death at the intensive care unit
Authors: Hadders Hans 
Published: August 2007

Relatives’ presence in connection with cardiopulmonary resuscitation and sudden death at the intensive care unit Within Norwegian intensive care units it is common to focus on the needs of the next of kin of patients undergoing end‐of‐life care. Offering emotional and practical support to relatives is regarded as assisting them in the initial stages of their grief process. It has also become usual to encourage relatives to be present at the time of death of close relatives. How can dignified end‐of‐life care coexist with the sometimes turbulent and dramatic character of intensive care in the highly technological environment of intensive care units? This paper describes a case study based on an incident that took place at the intensive care unit (ICU) of Trondheim University Hospital, Norway, in which the relatives of a newly deceased patient voiced unusually strong dissatisfaction with the way they were excluded in connection with cardiopulmonary resuscitation (CPR). The next of kin's criticism highlights an important paradox as well as a degree of inconsistency in lifesaving and end‐of‐life care at the ICU. I argue that an investigation of the multiple identities within medical practice can illuminate the potential for clashes between lifesaving and end‐of‐life care, as described and analysed in this paper.