bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fear of blood, injury, and injections, and its relationship to dental anxiety and probability of avoiding dental treatment among 18‐year‐olds in Norway
Authors: VIKA MARGRETHE , SKARET ERIK , RAADAL MAGNE , ÖST LARS‐GÖRAN , KVALE GERD 
Published: March 2008

Background:  More knowledge about the relationship between blood–injury–injection phobia (BIIP) and dental anxiety (DA) may give new clinically relevant information in the assessment and management of children with DA.Objective:  The aims of this study were to explore the relationships between BIIP and DA, and to explore to what extent the two subtypes of BIIP in combination with DA are related to self‐reported probability of avoiding dental treatment if a dental injection is needed.Methods:  The subjects were a random sample of 1385 18‐year‐olds attending high schools in a county of Norway, and the data were collected by use of questionnaires completed in classrooms. The survey instruments applied were Dental Fear Survey, Injection Phobia Scale‐Anxiety, and Mutilation Questionnaire.Results:  About 11% of the subjects with DA and subtypes of BIIP, respectively, reported high probability of avoiding dental treatment in a situation where a dental injection was possibly needed. In multiple regression analysis, only DA contributed to self‐reports of high probability of avoiding dental treatment.Conclusion:  The results indicate that among adolescents, BIIP is relatively often connected with DA. Clinical implications are discussed.
Solitary median maxillary central incisor syndrome occurring together with oromandibular‐limb hypogenesis syndrome type 1: a case report of this previously unreported combination of syndromes
Authors: LERTSIRIVORAKUL JINDA , HALL ROGER K. 
Published: March 2008

Background. Solitary median maxillary central incisor syndrome is a unique developmental abnormality, involving the central incisor tooth germs, occurring with and without systemic involvement. This syndrome has been recorded in association with many other midline developmental anomalies and several known syndromes. Its presence, together with oromandibular‐limb hypogenesis syndrome type 1, has not previously been reported.Case report. A 3‐year‐old girl was presented with early childhood caries and a solitary median maxillary central incisor. She had a median submucosal cleft palate and severe micrognathia with hypoglossia. In addition, she had short stature, eating difficulty, and hearing and speech problems. Comprehensive dental treatment for severe early childhood caries was accomplished with a 3‐month follow‐up appointment to monitor the oral health. The multidisciplinary consultation important for further management has been established.Conclusion. The results suggested that when a solitary median maxillary incisor tooth presents, a paediatrician and a geneticist should be asked to carefully examine the patient for other craniofacial malformations and especially midline systemic problems.
The meaning of caring for people with malodorous exuding ulcers
Authors: Lindahl Elisabeth , Norberg Astrid , Söderberg Anna 
Published: March 2008

AbstractTitle. The meaning of caring for people with malodorous exuding ulcers.Aim. This paper is a report of a study to illuminate the meaning of caring for people with malodorous exuding ulcers.Background. Managing ulcers is complicated and consensus on assessment and treatment difficult to reach. Nurses need knowledge and skills to provide good care. They must stay close and be exposed to contamination and suffering. They must provide care without violating patients and we need to further explore this challenge.Method. A convenience sample of ten participants was recruited. Participants had experience of caring for people with malodorous exuding ulcers and were employed in primary health or hospital care in Sweden. Narrative interviews were conducted during late 2002 to early 2005 and interpreted using a phenomenological‐hermeneutic method.Findings. Themes were formulated: ‘Facing the wound’ when nurses reveal what is meant to be concealed and perceive patients’ vulnerability; ‘Facing one’s own defencelessness’ when feeling invaded, helpless and ashamed; ‘Struggling to shield one’s own defencelessness’ was achieved by striving to be in control, striving to endure and seeking a way out. ‘Struggling to shield patients’ vulnerability’ was about alleviating patients’ additional suffering by striving to spare patients, pushing boundaries, making uncomfortable decisions and sharing togetherness. When failing to shield their own defencelessness and patients’ vulnerability, nurses run the risk of experiencing desolation.Conclusion. Physical proximity and bodily suffering affect nurses. Caring for people with ulcers calls for improved interprofessional cooperation in order to provide the best treatments and care. Further education for these nurses is needed, as well as support from managements and organizations.
Evaluating outcomes of the emergency nurse practitioner role in a major urban emergency department, Melbourne, Australia
Authors: Jennings Natasha , O'Reilly Gerard , Lee Geraldine , Cameron Peter , Free Belinda , Bailey Michael 
Published: March 2008

Aims and objectives.  The aim of this study was to evaluate the impact of the introduction of Emergency Nurse Practitioner Candidates (ENPC) on waiting times and length of stay of patients presenting to a major urban Emergency Department (ED) in Melbourne, Australia.Background.  As part of a Victorian state funded initiative to improve patient outcomes, the role of the Emergency Nurse Practitioner has been developed. The integration and implementation of this role, is not only new to the Alfred Emergency and Trauma Centre but to EDs in Melbourne, Australia, with aims of providing holistic and comprehensive care for patients.Design.  A retrospective case series of all patients with common ED diagnostic subgroups were included. The ENPC group (n = 572) included all patients managed by the ENPC and the Traditional Model (TM) group (n = 2584) included all patients managed by the traditional medical ED model of care. Outcome measures included waiting times and length of stay.Results.  Statistically significant differences were evident between the two groups in waiting times and length of stay in the ED. The overall median waiting time for emergency patients to be seen by the ENPC was less than for the TM group [median (IQR): ENPC 12 (5·5–28) minutes; TM 31 (11·5–76) minutes (Wilcoxon p < 0·001)]. Length of stay in the ED was also significantly reduced in the ENPC group [median (IQR): ENPC 94 (53·5–163·5) minutes; TM 170 (100–274) minutes (Wilcoxon p < 0·001)]. The comparison of overall waiting times for ENPC shifts vs. non‐ENPC shifts revealed significant differences [median (IQR): ENPC rostered 24 (9–52) minutes; ENPC not rostered 33 (13–80·5) minutes (Wilcoxon p < 0·001)].Conclusions.  This study has demonstrated that ENPCs implementation in Melbourne, Australia were associated with significantly reduced waiting times and length of stay for emergency patients. Emergency Nurse Practitioners should be considered as a potential long term strategy to manage increased service demands on EDs.Relevance to clinical practice.  This study is the first in Australia with a significant sample size to vigorously compare ENPC waiting times and length of stay outcomes with the TM model of care in the ED. The study suggests that ENPCs can have a favourable impact on patient outcomes with regard to waiting times and length of stay.
Pulse dynamics and microbial processes in aridland ecosystems
Authors: Collins Scott L. , Sinsabaugh Robert L. , Crenshaw Chelsea , Green Laura , Porras‐Alfaro Andrea , Stursova Martina , Zeglin Lydia H. 
Published: March 2008

Summary

Aridland ecosystems cover about one‐third of terrestrial environments globally, yet the extent to which models of carbon (C) and nitrogen (N) cycling, developed largely from studies of mesic ecosystems, apply to aridland systems remains unclear.
Within aridland ecosystems, C and N dynamics are often described by a pulse‐reserve model in which episodic precipitation events stimulate biological activity that generate reserves of biomass, propagules and organic matter that prime the ecosystem to respond rapidly to subsequent precipitation events.
The role of microbial C and N processing within the pulse‐reserve paradigm has not received much study. We present evidence suggesting that fungi play a critical and underappreciated role in aridland soils, including efficient decomposition of recalcitrant C compounds, N‐transformations such as nitrification, and nutrient storage and translocation of C and N between plants and biotic soil crusts. While fungi may perform some of these functions in other ecosystems, this ‘fungal loop’ assumes particular importance in the N cycle in aridlands because water availability imposes even greater restrictions on bacterial activity and physicochemical processes limit accumulation of soil organic matter (SOM).
We incorporate these findings into a Threshold‐Delay Nutrient Dynamics (TDND) model for aridland ecosystems in which plant responses to pulsed precipitation events are mediated by a fungal loop that links C and N cycling, net primary production (NPP) and decomposition in aridland soils.
Synthesis. Arid ecosystems are highly sensitive to global environmental change including N deposition and altered precipitation patterns; yet, models from mesic ecosystems do not adequately apply to aridland environments. Our ‘fungal loop’ N cycle model integrates spatial structure with pulse dynamics and extends the pulse‐reserve paradigm to include the key role of microbial processes in aridland ecosystem dynamics.
Maximum size distributions in tropical forest communities: relationships with rainfall and disturbance
Authors: Poorter Lourens , Hawthorne William , Bongers Frans , Sheil Douglas 
Published: March 2008

Summary

The diversity and structure of communities are partly determined by how species partition resource gradients. Plant size is an important indicator of species position along the vertical light gradient in the vegetation.
Here, we compared the size distribution of tree species in 44 Ghanaian tropical forest communities, using data from 880 one‐hectare plots and over 118 000 trees belonging to more than 210 species.
The size distribution of forest species showed a continuous normal or log‐normal distribution, with many canopy species and a few large species, and varied from community to community. Multiple regression showed that this variation is related to rainfall and to disturbance.
Size distributions in wet forests were less skewed than those in dry forests, with a smaller proportion of big species and a smaller size range. At the same time they exhibited tighter species packing, resulting in higher species richness. Communities with high disturbance have less species packing and lower species richness.
Synthesis. We conclude that the factors that constrain organism size and species coexistence in these tropical forest tree communities differ from those known to operate on a number of well‐studied animal communities.
Marital status, feeling depressed and self‐rated health in rural female primary care patients
Authors: Rohrer James E. , Bernard Matthew E. , Zhang Yan , Rasmussen Norman H. , Woroncow Halina 
Published: March 2008

AbstractObjective  To determine whether marital status and self‐assessed mental health are independent risk factors for poor self‐rated overall health among female primary care patients.Design  We conducted a cross‐sectional survey of family medicine patients treated in a clinic in rural Minnesota. Complete responses were obtained from 723 women. Self‐ratings of mental health, demographics and symptoms were used to predict self‐rated overall health.Results  Women who were single, divorced or otherwise not married, or widowed had lower odds of good self‐rated overall health (OR = 0.39, P = 0.004) compared with married women. Women who were 65 years of age and over (OR = 0.31, P = 0.017), women who rated themselves as depressed (OR = 0.54, P = 0.029), and women who reported more physical symptoms (OR = 0.78, P = 0.000) also were less likely to have good health, compared with younger women, women who did not feel depressed, and women with fewer physical symptoms, respectively. Education was not independently related to health in this sample. Worry was related to health in the univariate analysis but not after controlling for self‐assessed depression.Conclusions  In order to improve overall health among rural women seen in primary care settings, special attention may need to be directed at women who are single, are older, report more physical symptoms, and feel depressed. Programmes should include self‐help materials, support groups and counselling services addressing social isolation, employment and financial hardship.
Factors associated with physical activity of patients with osteoarthritis of the lower limb
Authors: Rosemann Thomas , Kuehlein Thomas , Laux Gunter , Szecsenyi Joachim 
Published: March 2008

AbstractObjective  In patients with osteoarthritis (OA), moderate physical activity (PA) can reduce the progress of joint damage. PA is therefore an important target of in the non‐surgical treatment of OA. To know about factors associated with PA can increase the success of interventions aiming at increasing PA. The aim of the study was to determine predictors of PA in patients suffering from OA to the hip or to the knee.Methods  In total, 1250 outpatients from 75 general practices were consecutively approached, 1021 returned questionnaires containing sociodemographic data, and short forms of the International Physical Activity Questionnaire (IPAQ), the Arthritis Impact Measurement Scale and the Patient Health Questionnaire to assess concomitant depression. A hierarchical stepwise multiple linear regression analysis with the IPAQ continuous score as dependent variable was performed.Results  Comparison of our findings with General population suggests that the overall PA of OA patients is decreased. Main predictors of PA were physical limitation to the lower body (beta = −0.179; P = 0.001), social contacts (P = −0.134; P < 0.001), pain (beta =−0.120; P = 0.001), age (beta = −0.110; P = 0.004) and the body mass index (beta =−0.043; P < 0.001).Conclusion  The findings emphasize the influence of physical as well as psychosocial factors on PA of patients with OA and should help to tailor future interventions more appropriately. Further research is needed to determine if these tailored interventions will result in better compliance and in increased PA.
Do gynaecology outpatients use the Internet to seek health information? A questionnaire survey
Authors: Neelapala Padmaja , Duvvi S. K. , Kumar G. , Kumar B. N. 
Published: March 2008

AbstractBackground  The Internet is a rich source of medical information and the general opinion among doctors is that the number of patients attending clinics with information from a web search is increasing. The purpose of this study was to assess the demographics of those who access the Internet and their attitudes towards the quality and usefulness of information provided by the Internet. This study also looked at the various sources of health information and the satisfaction rates.Design  Cross‐sectional observational study. The study group consisted of a cohort of women attending the gynaecology outpatient clinic at a district general hospital in the United Kingdom. In total, 484 patients attending the gynaecology outpatient clinic completed a questionnaire which included 13 structured questions regarding access to and attitudes towards the Internet and other health sources of information.Setting  Questionnaires were distributed to 564 women attending gynaecology outpatient clinics for 3 months from 1 June 2005.Results  A total of 484 patients (85.6%) completed the questionnaire. Age range was 41–65 years and the median education level was completion of General Certificate of Secondary Education (GCSE). In total, 360/484 (74%) had sought health information about their condition from a variety of sources before attending the outpatient clinic. In total, 399/484 (82.4%) respondents had access to the Internet. Of 399 with access, 107 (26.8%) of the patients used the Internet to find information about their condition before their appointment. General practitioners remain as the primary source of health information, mainly to improve the knowledge of the condition. A total of 78/107 (73.3%) who had used the Internet before their appointment would like to continue using the Internet as a health information resource.Conclusion  A significant proportion of patients had access to the Internet to find health information. The widespread availability and increased usage of medical websites by patients raises important issues regarding the need for quality control and impacts on the doctor–patient relationship.
Effects of occupational violence on Australian general practitioners’ provision of home visits and after‐hours care: a cross‐sectional study
Authors: Magin Parker J. , Adams Jon , Sibbritt David W. , Joy Elyssa , Ireland Malcolm C. 
Published: March 2008

AbstractRationale, aims and objectives  Occupational violence is increasingly recognized as a problem in general practice, and has been suggested as adversely affecting general practitioners’ (GPs) provision of services to patients. The aim of this study was to investigate the association of experiences of violence and perceptions of risk of violence with provision of after‐hours GP care and home visits.Method  A questionnaire‐based cross‐sectional survey of GPs in three Australian Urban Divisions of General Practice was used.Results  Five hundred and twenty‐eight GPs completed the survey (response rate 49%). Of the GPs surveyed, 63.7% were subjected to some form of violence in the previous 12 months. Risk of violence influenced 10.2% of GPs’ delivery of in‐hours home visits and 22.0% of GPs’ delivery of after‐hours home visits. A further 4.7% of GPs reported not performing after‐hours home visits at all during the previous 12 months because of safety concerns. On logistic regression, gender, location of practice and country of medical qualification were significantly associated with provision of in‐hours and after‐hours home visits. Experience of violence during the previous 12 months was not significantly associated with provision of home visits.Conclusions  This study’s finding of GPs’ self‐reported restriction of practice and withdrawal from home visits and after‐hours calls in response to risk of violence represents a significant primary health care issue. GPs’ decision to provide after‐hours calls and home visits is complex, and the finding of lack of significant association of experiences of violence with provision of home visits and after‐hours calls is likely to be due to the cross‐sectional nature of the study.
Prevalence and type of pre‐analytical problems for inpatients samples in coagulation laboratory
Authors: Salvagno Gian L. , Lippi Giuseppe , Bassi Antonella , Poli Giovanni , Guidi Gian C. 
Published: March 2008

AbstractRationale, aims and objectives  Total quality in coagulation testing is a necessary requisite to achieve clinically reliable results. Evidence was provided that poor standardization in the extra‐analytical phases of the testing process has the greatest influence on test results, though little information is available so far on prevalence and type of pre‐analytical variability in coagulation testing.Methods  The present study was designed to describe all pre‐analytical problems on inpatients routine and stat samples recorded in our coagulation laboratory over a 2‐year period and clustered according to their source (hospital departments).Results  Overall, pre‐analytic problems were identified in 5.5% of the specimens. Although the highest frequency was observed for paediatric departments, in no case was the comparison of the prevalence among the different hospital departments statistically significant. The more frequent problems could be referred to samples not received in the laboratory following a doctor’s order (49.3%), haemolysis (19.5%), clotting (14.2%) and inappropriate volume (13.7%). Specimens not received prevailed in the intensive care unit, surgical and clinical departments, whereas clotted and haemolysed specimens were those most frequently recorded from paediatric and emergency departments, respectively. The present investigation demonstrates a high prevalence of pre‐analytical problems affecting samples for coagulation testing.Conclusions  Full implementation of a total quality system, encompassing a systematic error tracking system, is a valuable tool to achieve meaningful information on the local pre‐analytic processes most susceptible to errors, enabling considerations on specific responsibilities and providing the ideal basis for an efficient feedback within the hospital departments.
Renin–angiotensin and endothelial nitric oxide synthase gene polymorphisms are not associated with the risk of incident type 2 diabetes mellitus: a prospective cohort study
Authors: Conen D. , Glynn R. J. , Buring J. E. , Ridker P. M , Zee R. Y. 
Published: March 2008

Abstract.Objective. The renin–angiotensin system and endothelial function have both been implicated in the pathogenesis of type 2 diabetes. The aim of this study was to assess the relationship between a set of well‐characterized genetic variants of the renin–angiotensin system and the endothelial nitric oxide synthase (NOS3) gene and the incidence of type 2 diabetes.Design. Prospective cohort study.Setting. Women’s Health Study, United States.Subjects. A total of 24 309 Caucasian women free of diabetes at baseline.Main outcome measures. Six previously characterized single nucleotide polymorphisms (NOS3 rs1800779, NOS3 rs3918226, NOS3 rs1799983, ACE rs1799752, AGT rs699 and AGTR rs5186) were genotyped. Cox proportional‐hazards models were constructed to compare the incidence of type 2 diabetes according to the different genotypes.Results. During a median follow‐up of 10.2 years (interquartile range 9.6–10.6 years), 999 women developed type 2 diabetes. The age‐adjusted incidence rates across the six genotypes were very similar, and ranged from 3.7 to 4.8 cases/1000 person‐years of follow‐up. The multivariable adjusted hazard ratios (95% confidence intervals) for rs1800779, rs3918226, rs1799983, rs1799752, rs699, and rs5186 were 1.01 (0.92–1.10), 1.09 (0.93–1.27), 0.95 (0.86–1.05), 1.04 (0.95–1.14), 1.08 (0.98–1.18), 1.01 (0.91–1.11), confirming the lack of association between the genotypes and incident type 2 diabetes. Stratification by body mass index revealed essentially unchanged results. Finally, there was no association between NOS3‐haplotypes and incident type 2 diabetes.Conclusion. We did not find an association between six well‐characterized genetic polymorphisms of the renin–angiotensin system or the NOS3 gene and the occurrence of type 2 diabetes.