bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of multidirectional mechanical vibration on peripheral circulation of humans
Authors: Button C. , Anderson N. , Bradford C. , Cotter J. D. , Ainslie P. N. 
Published: May 2007

SummaryThe physiological response of humans to vibration has intrigued researchers for some time, and recently in relation to its potential as a non‐pharmacological means to improve peripheral blood flow. A new vibration device [Arapal Technologies Ltd (ATL), Christchurch, New Zealand] for pain relief that purportedly delivers multidirectional vibration waveforms, has been developed. The aim of the study was to quantify the effect of 30 min of mechanical vibration (60 Hz) using two ATL massage devices concurrently upon local peripheral blood flow in healthy humans. On the basis of past work it was expected that acute exposure of the body to the vibratory stimulus would increase local peripheral blood flow. In a randomized cross‐over design, mean blood flow (MBF) to the calf was measured using venous occlusion plethysmography before, during 3 min and after 30 min exposure to the vibratory devices or placebo (non‐vibratory) devices. Statistical analysis revealed no consistent differences between conditions and considerable individual variability. The MBF increase tended to be higher in the vibration condition than the placebo condition (P = 0·16, 95% likely range = −14·4% to 82·2%), the mean increase from resting blood flow at the post‐test was 26 ± 49% in the vibration condition and 12 ± 39% in the placebo condition. It took approximately 22 min of exposure to the vibratory stimulus to elicit peak blood flow (18 min with the placebo). Improvements in local blood flow may be beneficial in the therapeutic alleviation of pain or other symptoms resulting from acute or chronic musculoskeletal injuries.
A Spanish version of the Experiences in Close Relationships (ECR) adult attachment questionnaire
Authors: ALONSO‐ARBIOL ITZIAR , BALLUERKA NEKANE , SHAVER PHILLIP R. 
Published: May 2007

AbstractA Spanish adaptation of the Experiences in Close Relationships (ECR) measure of the 2 dimensions of adult attachment (K. A. Brennan, C. L. Clark, & P. R. Shaver, 1998) was created using a back‐translation procedure. Called the ECR‐S, the new scale displays the same 2‐factor structure as the English‐language ECR in both university and community samples and is reliable in both the internal consistency and the temporal stability senses. In a sample of married and cohabiting couples, the 2 subscales of the ECR‐S, anxiety and avoidance, are orthogonal and correlate with other theoretically appropriate variables (scores on K. Bartholomew and L. M. Horowitz’s, 1991, measure of adult attachment style, relationship status, and various dimensions of love and couple satisfaction). Cross‐cultural differences between American and Spanish results are briefly discussed.
Is it all about intimacy? Age, menopausal status, and women’s sexuality
Authors: BIRNBAUM GURIT E. , COHEN OHAD , WERTHEIMER VERED 
Published: May 2007

AbstractTwo studies examined the contribution of aging to various aspects of sexual functioning. Study 1 examined the association between age and sexual response among 289 women. Results showed that aging and relationship length were associated with relatively low sexual desire, excitement, and intimacy, with sexual intimacy mediating the association between relationship length and sexual excitement. Furthermore, the negative association between aging and sexual desire was particularly pronounced among women experiencing lower sexual intimacy. In Study 2, 93 women were classified according to menopausal status. Findings paralleled those of Study 1, indicating that postmenopausal state was negatively associated with sexual desire, mainly among women who experienced low sexual intimacy. Implications for the understanding of sexuality of women at midlife are discussed.
Of vigilance and invisibility – being a patient in technologically intense environments
Authors: Almerud Sofia , Alapack Richard J , Fridlund Bengt , Ekebergh Margaretha 
Published: May 2007

AbstractEquipment and procedures developed during the past several decades have made the modern intensive care unit (ICU) the hospital’s most technologically advanced environment. In terms of patient care, are these advances unmitigated gains? This study aimed to develop a knowledge base of what it means to be critically ill or injured and cared for in technologically intense environments. A lifeworld perspective guided the investigation. Nine unstructured interviews with intensive care patients comprise its data. The qualitative picture uncovered by a phenomenological analysis shows that contradiction and ambivalence characterized the entire care episode. The threat of death overshadows everything and perforates the patient’s existence. Four inter‐related constituents further elucidated the patients’ experiences: the confrontation with death, the encounter with forced dependency, an incomprehensible environment and the ambiguity of being an object of clinical vigilance but invisible at the personal level. Neglect of these issues lead to alienating ‘moments’ that compromised care. Fixed at the end of a one‐eyed clinical gaze, patients described feeling marginalized, subjected to rituals of power, a stranger cared for by a stranger. The roar of technology silences the shifting needs of ill people, muffles the whispers of death and compromises the competence of the caregivers. This study challenges today’s caregiving system to develop double vision that would balance clinical competence with a holistic, integrated and comprehensive approach to care. Under such vision, subjectivity and objectivity would be equally honoured, and the broken bonds re‐forged between techne, ‘the act of nursing’, and poesis, ‘the art of nursing’.
Achieving comprehensive critical care
Authors: Derham Catherine 
Published: May 2007

AbstractThe policy document, Comprehensive Critical Care, suggested that patients with critical care needs should expect the same standard of care wherever they are nursed, be that in a traditional critical care setting or in a general ward area. It is recognized that in order for this to occur, the developmental needs of ward nurses need to be met to enable them to care for patients with level 1 and level 2 needs. A second document, The Nursing Contribution to the Provision of Comprehensive Critical Care for Adults: A strategic Programme of Action, proposed a programme of action and outlined five priority areas to be considered to ensure the success of comprehensive critical care. Education, training and workforce development was one of the areas outlined, and thus, in response, the role of the practice development facilitator was created as a means of developing the critical care knowledge, skills and practice in ward areas. It became apparent that education and training alone were insufficient to ensure that the aims of comprehensive critical care were realized. The way in which the nurses approached and organized their work and the availability of resources had a great impact on the ability of staff to care for these patients. It is argued that achieving comprehensive critical care is complex and that a multi‐dimensional approach to the implementation of policy is essential in order to realize its aims.
The extent and application of patient diaries in Danish ICUs in 2006
Authors: Egerod Ingrid , Schwartz‐Nielsen Kathrine Hvid , Hansen Glennie Marie , Lærkner Eva 
Published: May 2007

AbstractThe aim of this study was to describe the extent and application of patient diaries in Danish intensive care units (ICUs) in 2006. Following critical illness, many patients experience disturbed and disconnected memories. Patient diaries in the ICU have been introduced locally by nurses in the Scandinavian countries and the UK as a means to improve cognitive recovery and prevent psychological trauma following critical illness. Descriptive design, using qualitative key informant telephone interviews (n= 19) was used as the source of data. A semi‐structured interview guide was used and field notes from the interviews were mailed to the informants for verification and additional information. Nineteen out of 48 Danish ICUs use patient diaries. Patient diaries are mainly used for sedated, ventilated patients during critical illness. The purpose of diaries was mainly to assist memory due to post‐ICU amnesia. There was no systematic follow‐up after the ICU stay. The study showed a number of legal and ethical issues that still need to be resolved. Patient diaries are ambiguous documents that are neither the property of the hospital nor the patient. The diaries have been implemented at Danish ICUs without a plan for the assessment of their effect, thus bypassing established control mechanisms that evaluate the usefulness of an intervention, such as Health Technology Assessment or nursing research.
Education in a Homeless Shelter to Improve the Nutrition of Young Children
Authors: Yousey Yvonne , Leake Jacquelyn , Wdowik Melissa , Janken Janice K. 
Published: May 2007

ABSTRACT
Objective: To improve the nutritional status of homeless children by implementing an educational program for their mothers and the cafeteria staff at a homeless shelter.Design: Program evaluation including before and after measures of mothers' nutritional knowledge and nutritional quality of foods served in the cafeteria.Sample: Fifty‐six mothers with children aged 18 months to 6 years and 3 cafeteria staff.Intervention: Four nutrition classes developed by a registered nutritionist were taught to mothers by clinic nurses; 3 nutrition classes were taught to the cafeteria staff by the nutritionist.Results: Mothers scored higher on posttests than on pretests, indicating improved nutritional knowledge. Minimal differences in the nutritional quality of foods served to residents were observed after staff education.Conclusions: This project demonstrates the challenges of altering the nutritional status of children in a homeless shelter. Despite mothers showing better knowledge of nutritional requirements for children, the types of food served in the cafeteria were an obstacle to them in practicing what they had learned. The cafeteria staff's ability to demonstrate their learning was impeded by the constraints of food donations. Educational strategies may need to be augmented by policies to improve the nutritional status of children in homeless shelters.
A Formative Evaluation to Develop a School Health Nursing Early Intervention Model for Adolescent Substance Use
Authors: Pirskanen Marjatta , Laukkanen Eila , Pietilä Anna‐Maija 
Published: May 2007

ABSTRACT
Objective: To improve an early intervention (EI) triggered by the Adolescents' Substance Use Measurement (ADSUME) as a method to prevent substance abuse among adolescents. We assessed how ADSUME and EI work in practice and how EI could be improved.Design and sample: School health nurses (n=10) tested ADSUME and EI on 14‐ to 18‐year‐old adolescents (n=228). Six months later, these nurses and their professional partners were invited to assess EI in focus group interviews.Methods: Four focus group interviews involving a total of 24 nurses and partners were implemented. Interview data were analyzed with qualitative content analysis.Results: ADSUME concretized assessment, activated profound dialogue, and proved to be an important part of EI. It was important to assess the adolescent's resources in addition to the ADSUME score. EI worked well in confidential dialogues after the adolescent and the PHN reached a consensus on the level of concern about the adolescent's substance use. The recommended EI enabled individual brief intervention in all four stages of substance use, from abstinence or experimental use to hazardous use.Conclusions: EI was improved practically, and the contents of the intervention were reformulated. It is important to integrate EI with the preventive efforts of the school.
Using a Community‐Based Outreach Program to Improve Breast Health Awareness Among Women in Hong Kong
Authors: Chan Sophia S. C. , Chow Denise M. K. , Loh Edith K. Y. , Wong David C. N. , Cheng Karis K. F. , Fung Wendy Y. C. , Cheung Polly S. Y. 
Published: May 2007

ABSTRACT
Objective: To evaluate the effectiveness of a community‐based health education program via a mobile van to promote the awareness of breast cancer and breast self‐examination (BSE) practice among women in Hong Kong.Design: One group pretest/posttest design.Sample and measurements: Seven hundred and seventy‐seven women in Hong Kong completed a self‐administered questionnaire before and after a breast health education program from May 2002 to March 2003.Results: About half were aware of breast health and breast diseases (53.7%) and breast screening methods (48.6%) before the intervention. It was found that women who had received instruction on BSE practice, and those who were aware of breast screening methods, breast health, and breast diseases were more likely to have had prior BSE practice. Most indicated their willingness to practice BSE regularly (93.3%) and to pass on the BSE knowledge to their relatives and friends (92%) in the posttest.Conclusions: The outreach health education program has successfully reached women living in the 18 districts in Hong Kong. It appears to be useful in raising the awareness of breast health and BSE practice among the women, but longer term follow‐up is required to ascertain its sustainability.
Impairment in Color Perception in Migraine With and Without Aura
Authors: De Marinis Milena , Rinalduzzi Steno , Accornero Neri 
Published: May 2007

Objective.—To assess visual perception in 40 patients suffering from migraine with aura (MA), 40 patients suffering from migraine without aura (MO), and 40 controls.Background.—Visual perception abnormalities are a common feature in both MA and MO.Methods.—We performed luminance and color central perimetry. Black and white pattern reversal visual‐evoked potentials were also assessed.Results.—Luminance perimetry was similar in patients and controls. Color perimetry instead revealed an impairment in the perception of red (“quantitative perception index”) in migraine patients; this impairment was more pronounced in patients with MA (P < .001) than in those with MO (P < .05) and was related to the degree of photophobia recorded before testing. A subgroup of MO patients who had a migraine attack shortly after being tested also displayed a marked impairment in the perception of blue. This subgroup of patients had a statistically significant (P < .001) lower perception of blue than the rest of the MO patients, who had a migraine attack later; they also had a high degree of unpleasant perceptions after testing. Black and white visual evoked potentials were similar in patients and controls.Conclusion.— The impairment in visual perception of red, which was more marked in MA than in MO patients, may be related to the degree of photophobia recorded before testing. The reduced perception of blue, which only occurred in a subgroup of MO patients in the premonitory phase of the migraine attack, probably occurs through mechanisms that involve dopaminergic function. We cannot exclude the possibility that the visual stimulations induced the migraine attack in this subgroup of MO patients shortly after they were tested.
ED Treatment of Migraine Headache: Factors Influencing Pharmacotherapeutic Choices
Authors: Hurtado Timothy R. , Vinson David R. , Vandenberg J. Toby 
Published: May 2007

Study Objective.—To evaluate the factors that influence clinicians' choices of parenteral medications in the emergency department (ED) management of migraine headache.Background.—Migraine headache is a common problem in the United States. Many migraineurs require periodic ED management. Though a large variety of parenteral medications are used by ED clinicians in the treatment of migraine, little research has been directed to the reasons why providers use the medications they do.Methods.—This study used a self‐administered questionnaire for providers from 3 geographically distinct EDs to evaluate their pharmacotherapeutic preferences in the treatment of uncomplicated migraine based on a fictitious scenario. Factors influencing medication choices were rated on a 5‐point Likert scale and analyzed descriptively. Hypothetical practice patterns from the questionnaires were compared with actual practice patterns from a prior study from the same institutions.Results.—Eighty‐three percent of surveys were returned, the majority from attending physicians (71%), as their initial drugs‐of‐choice providers preferred dopaminergic antiemetics (93%) and parenteral NSAIDs (22%). If initial therapy failed, opioids (40%) with nonspecific antiemetics (24%) were preferred as second‐line agents. Choice of therapy was influenced (in descending order) by medication availability and its antimigraine properties, the providers' training, current departmental practice patterns, and national practice guideline recommendations. Opioid use was influenced by patients' failure to respond to ED and outpatient alternatives and the presence of contraindications/intolerances to non‐opioids. When these results were compared to a prior study of actual practice patterns, a range of discordance was observed, which varied significantly by institution.Conclusion.—Emergency clinicians report that a variety of factors influence their parenteral pharmacotherapy in the management of patients with migraine headache. The comparison of hypothetical practice patterns with actual practice patterns reveals a range of institution‐specific discordance. There is discordance between providers' responses to a fictitious scenario and their previously recorded practice patterns with regional variation.
Emergency Department Management of Acute Migraine in Children in Canada: A Practice Variation Study
Authors: Richer Lawrence , Graham Lee , Klassen Terry , Rowe Brian 
Published: May 2007

Objectives.—Evidence‐based guidelines for the treatment of children with migraine are limited given the paucity of randomized controlled trials, especially in the emergency department (ED). Our objectives were to: (1) characterize the treatment of children with migraine in the ED; (2) determine whether treatment varies in pediatric versus mixed (pediatric and adult) EDs.Methods.—Children aged 5 to 17 years presenting to 4 regional emergency departments in Edmonton, Alberta, Canada during the 2003/2004 fiscal year with a diagnostic code of headache or migraine were selected. A standardized retrospective chart abstraction was performed and migraine or probable migraine cases were classified based on the International Classification of Headache Disorders II.Results.—Three hundred and eighty‐two cases were identified of which 48.7% (n = 186/382) met sufficient criteria for migraine. No treatment was given in 44.2% (n = 169/382). Simple oral analgesics (23.3%; n = 89/182) and dopamine antagonists (metoclopramide and prochlorperazine; 20.7%; n = 79/182) were prescribed first‐line most commonly. Opiate medications (5.5%), ketorolac (4.7%), dihydroergotamine (1%) were prescribed first‐line infrequently. There was a significant difference in the management choices between pediatric and mixed adult/pediatric EDs (χ2= 19.695; df = 5; P= .001). The pediatric ED was more likely to prescribe a dopamine antagonist (12.9 vs 6.8%; P= .044) while the mixed adult/pediatric EDs were more likely to prescribe an opiate (28.1% vs 18.4%; P= .031). Children with migraine in all EDs were significantly more likely to receive drug therapy (68.3% vs 42.9%; P < .001) or a dopamine antagonist (32.3% vs 9.7%; P < .001). Polypharmacy (31.2%; n = 119/382) and neuroimaging (29.1%; n = 111/382) were common. Outcome was poorly documented overall. No adverse events were recorded.Conclusions.—Significant variation in practice in the management of acute headaches in children was observed between mixed population and pediatric‐only emergency physicians in the same city. Most children do not receive any drug therapy. Children presenting to the pediatric ED were significantly more likely to receive a dopamine antagonist while opiates were prescribed more commonly in the mixed ED. More clinical trials are required in children to clarify areas of clinical uncertainty on which evidence‐based practice guidelines can be formed.
Central Overexpression of Angiotensin AT1A Receptors Prevents Dopamine D2 Receptor Regulation of Alcohol Consumption in Mice
Authors: Moore Rosanna , Krstew Elena V. , Kirchhoff Jeppe , Davisson Robin L. , Lawrence Andrew J. 
Published: May 2007

Background: While angiotensin receptors are found on the soma and terminals of dopaminergic neurons, controversy surrounds the potential role of angiotensin in alcohol consumption.Methods: Using a transgenic mouse with a brain‐specific overexpression of angiotensin AT1A receptors (NSE‐AT1A mice), we have examined the role of angiotensin in alcohol consumption and alcohol‐induced regulation of the dopaminergic system.Results: The functional relevance of the overexpressed AT1A receptors was confirmed by an exaggerated rehydration response following 24‐hour dehydration. NSE‐AT1A mice showed a high preference for alcohol (similar to wild‐type mice); yet, raclopride treatment had no effect on alcohol consumption in NSE‐AT1A mice, while significantly reducing consumption in wild‐type mice. In contrast, NSE‐AT1A mice showed enhanced sensitivity to raclopride compared with wild types in terms of D2 receptor up‐regulation within the ventral mesencephalon. In addition, striatal D2 receptors in NSE‐AT1A mice were sensitive to up‐regulation by chronic alcohol consumption.Conclusions: Collectively, these data imply that while expression of angiotensin AT1A receptors on striatal neurons has no impact upon basal alcohol consumption or preference, AT1A receptors do modulate the sensitivity of dopamine D2 receptors to regulation by alcohol and the ability of a D2 receptor antagonist to reduce consumption.
AUDIT‐C as a Brief Screen for Alcohol Misuse in Primary Care
Authors: Bradley Katharine A. , DeBenedetti Anna F. , Volk Robert J. , Williams Emily C. , Frank Danielle , Kivlahan Daniel R. 
Published: May 2007

Background: The Alcohol Use Disorders Identification Test Consumption (AUDIT‐C) questions have been previously validated as a 3‐item screen for alcohol misuse and implemented nationwide in Veterans Affairs (VA) outpatient clinics. However, the AUDIT‐C's validity and optimal screening threshold(s) in other clinical populations are unknown.Methods: This cross‐sectional validation study compared screening questionnaires with standardized interviews in 392 male and 927 female adult outpatients at an academic family practice clinic from 1993 to 1994. The AUDIT‐C, full AUDIT, self‐reported risky drinking, AUDIT question #3, and an augmented CAGE questionnaire were compared with an interview primary reference standard of alcohol misuse, defined as a Diagnostic and Statistical Manual, 4th ed. alcohol use disorder and/or drinking above recommended limits in the past year.Results: Based on interviews with 92% of eligible patients, 128 (33%) men and 177 (19%) women met the criteria for alcohol misuse. Areas under the receiver operating characteristic curves (AUROCs) for the AUDIT‐C were 0.94 (0.91, 0.96) and 0.90 (0.87, 0.93) in men and women, respectively (p=0.04). Based on AUROC curves, the AUDIT‐C performed as well as the full AUDIT and significantly better than self‐reported risky drinking, AUDIT question #3, or the augmented CAGE questionnaire (p‐values <0.001). The AUDIT‐C screening thresholds that simultaneously maximized sensitivity and specificity were ≥4 in men (sensitivity 0.86, specificity 0.89) and ≥3 in women (sensitivity 0.73, specificity 0.91).Conclusions: The AUDIT‐C was an effective screening test for alcohol misuse in this primary care sample. Optimal screening thresholds for alcohol misuse among men (≥4) and women (≥3) were the same as in previously published VA studies.