bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Analysis of Substance Use Among Adolescents From Smaller Places
Authors: Donnermeyer Joseph F , Scheer Scott D. 
Published: April 2008

ABSTRACTThis study examined trends in substance use among 12th grade students who live in smaller places. Subjects from smaller places were defined as those residing in nonmet‐ropolitan and metropolitan counties who reported growing up on a farm, in the country (i.e., living in an unincorporated rural area but not on a farm) or in a small town (i.e, living in a place with fewer than 50,000 residents that is not a suburb or located next to a larger place). Six types of smaller places were created from a cross‐tabulation of nonmetropolitan‐metropolitan status and where subjects reported growing up. Substance‐use rates among 12th graders residing in these six types of smaller places from 1976 to 1997 at three‐year intervals were compared, based on data available from the Monitoring the Future study. For past‐year alcohol use, some differences were found by place, with farm youth showing the lowest rates. Large differences were exhibited for past‐year marijuana use, both across nonmetropolitan‐metropolitan status and across youth from farm, country and small‐town locations within nonmetropolitan counties. Rates of past‐year illicit drug use were essentially the same regardless of location. Overall, when significant differences were found, most revealed less use for the more rural location.
Itinerant Surgical and Medical Specialist Care in Kansas: Report of a Survey of Rural Hospital Administrators
Authors: Kellerman Rick , Ast Terry , Dorsch John , Frisch Larry 
Published: April 2008

ABSTRACTIn most rural areas, specialist nonprimary care, when available, is provided by “itinerant” physicians and surgeons who periodically visit from a distant home base. Little is known about current usage and acceptability of itinerant specialists in rural communities. Administrators of hospitals in rural and frontier Kansas counties were asked to report the frequency of itinerant care in their facilities, the home base of each specialist and a listing of procedures performed during specialist visits. Administrators were also asked to respond on a Likert scale to six questions inviting their assessment of itinerant care. Responses were received from 53 of 56 hospitals. All offered at least one monthly session of itinerant medical or surgical care. The most common specialties represented were cardiology (in 87 percent of hospitals), urology (68 percent), orthopedics (68 percent) and radiology (60 percent). General surgeons consulted in over 80 percent of responding hospitals. Psychiatrists, dermatologists and neurologists were rarely available in the hospitals surveyed. Administrators generally rated itinerant care highly, though some expressed concern about revenue lost when specialists performed procedures in their home‐base office or hospital. No associations were found between amount of care offered and potential explanatory variables such as hospital size, distance from subregional centers, or percentage of patients hospitalized locally. Furttier study is needed to better understand differences in itinerant specialist utilization and acceptance among rural Kansas hospitals. Because Kansas demographics are similar to those of many other American rural areas, such study may offer insights applicable to other regions.
Access and Issues of Equity in Remote/Rural Areas
Authors: Bull C. Neil , Krout John A. , Rathbone‐McCuan Eloise , Shreffler M. Jean 
Published: April 2008

ABSTRACT:This article reports on a workshop in which the major focus was a review of the barriers that prevent access to the array of community‐based services available to the rural elderly. The demographics of the elderly were outlined and key components of the service system described. Attention was given to access hospital‐based care, the closing of hospitals and the reasons for bypassing rural hospitals for those in large towns or cities. Special emphasis also was given to mental health services and their uneven accessibility. A review of the policy implications closed the workshop.
Public Health Rural Health Priorities in America: Where You Stand Depends on Where You Sit
Authors: Gamm Larry , Hutchison Linnae 
Published: April 2008

Abstract: Purpose: To assess levels of agreement on priority areas among state and local rural health leaders nationwide Methods: Analysis of responses to a mail survey sent to 999 rural health leaders, with 501 responses. Respondents were asked to rank importance to rural health of focus areas named in Healthy People 2010 Findings: There was substantial agreement on top rural health priorities among state and local rural health leaders across the 50 states. “Access to quality health services” was the top priority among leaders of state‐level rural agencies and health associations, local rural public health agencies, rural health clinics and community health centers, and rural hospitals. It was the top priority across all 4 major census regions of the nation as well. The next 4 top‐ranking rural priorities–“heart disease and stroke,”“diabetes,”“mental health and mental disorders,” and “oral health”–were selected as 1 of the top 5 rural priorities by one third or more of respondents across most groups and regions. At the same time, some observed differences in rural health priorities suggest opportunities for community partnership strategies or for regional multistate policy initiatives by states sharing similar rural health priorities.
A Framework and Action Agenda for Quality Improvement in Rural Health Care
Authors: Calico Forrest W. , Dillard Carole D. , Moscovice Ira , Wakefield Mary K. 
Published: April 2008

Abstract: Purpose: The Agency for Healthcare Research and Quality and the federal Office of Rural Health Policy collaborated to convene an expert group to address issues of quality improvement in the rural health care environment Outcomes: The group identified issues, barriers, and opportunities related to bringing rural health care into the mainstream of the national quality “revolution.” A framework for rural quality and specific action steps was proposed. Recommendations were made in the areas of workforce, organizational performance, measurement, dissemination of innovation, and external factors impacting quality. Specific recommendations included fostering development of rural consortia, relevant quality measures for the rural environment, technical assistance capacity, appropriate financial incentives, leadership capacity, and databases
Predictive Accuracy of Rural Physicians' Stated Retention Plans
Authors: Pathman Donald E. , Konrad Thomas R. , Agnew Christopher R. 
Published: April 2008

Abstract: Context: The retention of rural physicians is a difficult phenomenon to study because job changes–the outcome of interest–take years to unfold. One common way to study retention is to ask rural practitioners through surveys how much longer they expect to remain in their current positions and use these statements of “anticipated retention” as an expedient proxy measure of actual retention Purpose: To test the predictive accuracy of rural physicians' stated retention plans and test the hypotheses that predictions are more accurate for certain physicians, such as those with more experience, more control of their work situations, and at less risk for job burnout Methods: A 1991 mail survey (national stratified random sample) prospectively queried rural physicians' retention plans, and a follow‐up survey 5 to 6 years later determined if and when respondents (N = 405, 67.5% combined response rate) had moved Findings: Retention predictions for the entire cohort corresponded remarkably well to the group's actual retention, with the proportion remaining each year deviating by only a few percentage points from what the group collectively expected. Predictions for individuals were also moderately accurate: 4 of 5 physicians who predicted remaining at least 5 years did so; 2 of 3 who predicted remaining less than 5 years indeed left before 5 years. Predictions of job changes in less than 2 years tended to be more accurate than predictions of 2 to 5 years. Physicians' predictions were more accurate when they worked in practices they owned (greater control) and were on‐call 2 or fewer times each week (lower burnout risk). Accuracy was not greater with any of 5 measures of experience Conclusions: Rural generalist physicians are moderately accurate when reporting how much longer they will remain in their jobs, validating the use of anticipated retention in rural health workforce studies
Oral Health Status of Children and Adolescents by Rural Residence, United States
Authors: Vargas Clemencia M. , Ronzio Cynthia R. , Hayes Kathy L. 
Published: April 2008

Abstract: Context: The limited information available on the oral health status of rural children in the United States makes it difficult to devise policy strategies to address perceived problems Purpose: To document the oral health status and dental care utilization of US children by place of residence. Methods: Data from National Health Interview Surveys for 1995, 1997, and 1998, and from the third National Health and Nutrition Examination Survey (1988–1994) were analyzed Findings: Children residing in rural areas were more likely to be uninsured for dental care than were children from urban areas (41.1% versus 34.7%). A greater percentage of rural than urban children reported unmet dental needs (7.5% versus 5.6%); there was no difference in selfreported poor dental status. Urban children were more likely than rural children to have visited the dentist in the past year (73.6% versus 69.9%) and were also more likely to be regular users of dental care (61.7% versus 51.4%). Differences in percentage of rural and urban children with caries lesions and caries experience were not significant Conclusions: Children residing in rural areas have less access to and utilization of dental care compared to children residing in urban areas. Moreover, poor rural children display less utilization of dental services than poor urban children. Differences in the sum of decayed and filled primary teeth and the sum of decayed, missing, and filled permanent teeth were not significant
A Description of the Southern Rural Access Program's Practice Management Strategies
Authors: Adams Graham L. , Holloman Curtis E. , Nye Jeannie M. , Salain Rita , Glenn Kelli G. , Harrison Sally , Patterson Mary M. 
Published: April 2008

Abstract: Context: Many state, federal, and foundation resources have been invested in improving the recruitment of primary care providers to rural communities. The Southern Rural Access Program of the Robert Wood Johnson Foundation (RWJF) has provided varying levels of support to several southern states to assist with retention of those providersPurpose: This study describes the strategies that 6 states used to develop and implement practice management technical assistance services for rural health care providersMethods: Practice managers in each of the 6 states were surveyed regarding how their service was structured, what types of entities were eligible, and the nature of the technical assistance offered. Information regarding what types of entities used the service, characteristics of the practices, and the number of practices served was also collectedFindings: The survey results showed that almost half (46%) of all practices assisted were private stand‐alone physician practices, with overall practice assessments being the practice management service rendered most often. Although the type of organizational home for the technical assistance services varied by state, overall states employed an average of 1.67 full‐time equivalent practice managers (0.81 full‐time equivalent supported by RWJF) and received an average of $136 055 per state from the RWJF for the 2‐year period beginning April 2002 for practice management supportConclusions: Overall, the study found that the type of organizational home did not appear to affect the type of technical assistance services offered. However, the type of organizational home did appear to affect what types of providers used the service, with trade associations assisting their members or constituents at least half the time
Rural and Urban Physicians' Perceptions Regarding the Role and Practice of the Nurse Practitioner, Physician Assistant, and Certified Nurse Midwife
Authors: Burgess Stephanie E. , Pruitt Rosanne H. , Maybee Patricia , Metz Arnold E. , Leuner Jean 
Published: April 2008

Abstract: Context: There is a dearth of literature citing the differences in rural and urban physicians' perceptions of the role and practice of nurse practitioners, physician assistants, and certified nurse midwives (nonphysician providers)Purpose: The purpose of this study was to investigate and compare differences, if any, between rural and urban primary care physicians' perceptions of the role and practice of nonphysician providersResults: Despite a 15.55% response rate using a mail‐out survey in South Carolina, data from 681 rural and urban primary care physicians indicated that they perceived that non‐physician providers possess the necessary skills and knowledge to provide primary care to patients, are an asset to a physician's practice, free the physician's time to handle more critically ill patients, and increase revenue for the practice, but increase the risk of patient care mistakes and a physician's time in administrative duties. Urban physicians' mean scores were higher for perceiving that nonphysician providers are able to see as many patients in a given day as a physician but experience impediments in the delivery of patient careConclusions: Results will be used to clarify physicians' perceptions regarding the role and practice of nonphysician providers to reduce impediments to patient care access
A Comparative Assessment of West Virginia's Financial Incentive Programs for Rural Physicians
Authors: Jackson Jodie , Shannon C. Ken , Pathman Donald E. , Mason Elaine , Nemitz James W. 
Published: April 2008

Abstract: Context:Financial incentive programs are increasingly being used as a strategy to recruit physicians to underserved rural areas. Critical evaluation of state‐supported programs is often lacking but is necessary to determine their efficacy and to improve outcomesPurpose: The purpose of this study was to assess 4 service‐contingent programs in West Virginia, a state with critical physician shortagesMethods: Survey instruments were developed to evaluate the effectiveness of these programs and to document the practice environments and career paths of obligated allopathic and osteopathic physicians compared with a control group of nonobligated rural practitioners. Data were also collected from physicians who were recipients of multiple incentive programs and from obligated physicians who had defaultedFindings: Responses from more than 60% of surveyed physicians indicated that the typical respondent was a married white male who was a midcareer family practice physician. Obligated physicians were more likely than nonobligated physicians to have graduated from a West Virginia medical school and residency program, to be influenced by financial factors in their career decisions, to provide care to uninsured patients, and to work in offices that offered sliding fee scales. Both groups of physicians demonstrated similar retention patterns, reported a high degree of job satisfaction, and expressed a need for more practice management trainingConclusions: Although these financial incentive programs were found to be effective in recruiting primary care physicians to medically under‐served areas of the state, the financial support of these programs was found to be too modest, and improved marketing of the programs was indicated
Recruitment of Rural Health Care Providers: A Regional Recruiter Strategy
Authors: Felix Holly , Shepherd Joy , Stewart M. Kathryn 
Published: April 2008

Abstract:Context:Access to care in rural areas is a major problem. Despite more than 20% of the US population residing in these areas, only 9% of physicians practice there. Extensive research has documented multiple issues that affect where physicians decide to locate and maintain practices. Creative strategies have been used to influence these recruitment and retention decisions. An emerging strategy, borne out of the Robert Wood Johnson Foundation's Southern Rural Access Program (SRAP), effectively uses a targeted regional approach to assist rural communities and health care facilities in assessing health care needs and recruiting primary care providersPurpose:This article examines the issues surrounding recruitment and retention of primary care providers to rural areas and describes the experiences of the regional recruitment strategy in several states and in particular in the Mississippi Delta region of ArkansasMethods:A case study approach is used to examine the targeted regional recruiter strategy in the Mississippi Delta region of ArkansasFindings:The regional recruiter strategy, which combines traditional recruitment efforts with community development activities, has been successful in recruiting health care providers to rural communities. The cost‐effective strategy can be easily replicated in other rural statesConclusions:Community factors affect provider decisions on practice locations. Addressing community factors in recruitment efforts through community development activities may increase their success
Strain‐Associated Variations in Abnormal PrP Trafficking of Sheep Scrapie
Authors: Jeffrey Martin , McGovern Gillian , Goodsir Caroline M. , González Lorenzo 
Published: April 2008

AbstractPrion diseases are associated with the accumulation of an abnormal form of the host‐coded prion protein (PrP). It is postulated that different tertiary or quaternary structures of infectious PrP provide the information necessary to code for strain properties. We show here that different light microscopic types of abnormal PrP (PrPd) accumulation found in each of 10 sheep scrapie cases correspond ultrastructurally with abnormal endocytosis, increased endo‐lysosomes, microfolding of plasma membranes, extracellular PrPd release and intercellular PrPd transfer of neurons and/or glia. The same accumulation patterns of PrPd and associated subcellular lesions were present in each of two scrapie strains present, but they were present in different proportions. The observations suggest that different trafficking pathways of PrPd are influenced by strain and cell type and that a single prion strain causes several PrPd–protein interactions at the cell membrane. These results imply that strains may contain or result in production of multiple isoforms of PrPd.
In Vitro Antifungal Susceptibility and Molecular Characterization of Clinical Isolates of
Fusarium verticillioides
(
F. moniliforme
) and
Fusarium thapsinum
Authors: Azor Mónica , Gené Josepa , Cano Josep , Sutton Deanna A. , Fothergill Annette W. , Rinaldi Michael G. , Guarro Josep 
Published: April 2008

ABSTRACT

A microdilution method was used to test 11 antifungal drugs against clinical isolates of
Fusarium thapsinum
and three different phylogenetic clades of
Fusarium verticillioides
that were characterized by sequencing a region of the β-tubulin gene. Terbinafine was the most-active drug against both species, followed by posaconazole against
F. verticillioides
.
Production of Enterocins L50A, L50B, and IT, a New Enterocin, by
Enterococcus faecium
IT62, a Strain Isolated from Italian Ryegrass in Japan
Authors: Izquierdo Esther , Bednarczyk Audrey , Schaeffer Christine , Cai Yimin , Marchioni Eric , Van Dorsselaer Alain , Ennahar Saïd 
Published: April 2008

ABSTRACT

Enterococcus faecium
IT62, isolated from ryegrass in Japan, was shown to produce three different bacteriocins, two of which had molecular masses and amino acid sequences that corresponded to those of enterocin L50A and enterocin L50B. These peptides existed, however, as chemically modified forms that were either N formylated or N formylated and oxidized at Met
24
. The third bacteriocin, named enterocin IT, had a molecular mass of 6,390 Da, was made up of 54 amino acids, and did not correspond to any known bacteriocin. However, enterocin IT was identical to the C-terminal part of the 16-amino-acid-longer bacteriocin 32 (T. Inoue, H. Tomita, and Y. Ike, Antimicrob. Agents Chemother., 50:1202-1212, 2006). For the first time, the antimicrobial activity spectra for enterocins L50A and L50B were determined separately and included a wide range of gram-positive bacteria but also a few gram-negative strains that were weakly sensitive. Slight differences in the activities of enterocins L50A and L50B were observed, as gram-positive bacteria showed an overall higher level of sensitivity to L50A than to L50B, as opposed to gram-negative ones. Conversely, enterocin IT showed a very narrow antimicrobial spectrum that was limited to
E. faecium
strains, one strain of
Bacillus subtilis
, and one strain of
Lactococcus lactis
. This study showed that
E. faecium
IT62, a grass-borne strain, produces bacteriocins with very different activity features and structures that may be found in strains associated with food or those of clinical origin, which demonstrates that a particular enterocin structure may be widespread and not related to the producer's origin.
Inhibition of Herpes Simplex Virus Type 1 Infection by Cationic β-Peptides
Authors: Akkarawongsa Radeekorn , Potocky Terra B. , English Emily P. , Gellman Samuel H. , Brandt Curtis R. 
Published: April 2008

ABSTRACTPreviously, it was shown that cationic α-peptides derived from the human immunodeficiency virus TAT protein transduction domain blocked herpes simplex virus type 1 (HSV-1) entry. We now show that cationic oligomers of β-amino acids (“β-peptides”) inhibit HSV-1 infection. Among three cationic β-peptides tested, the most effective inhibition was observed for the one with a strong propensity to adopt a helical conformation in which cationic and hydrophobic residues are segregated from one another (“globally amphiphilic helix”). The antiviral effect was not cell type specific. Inhibition of virus infection by the β-peptides occurred at the postattachment penetration step, with a 50% effective concentration of 3 μM for the most-effective β-peptide. The β-peptides did not inactivate virions in solution, nor did they induce resistance to infection when cells were pretreated with the β-peptides. The β-peptides showed little if any toxicity toward Vero cells. These results raise the possibility that cationic β-peptides may be useful antiviral agents for HSV-1 and demonstrate the potential of β-peptides as novel antiviral drugs.
Crystal Structures of Biapenem and Tebipenem Complexed with Penicillin-Binding Proteins 2X and 1A from
Streptococcus pneumoniae
Authors: Yamada Mototsugu , Watanabe Takashi , Baba Nobuyoshi , Takeuchi Yasuo , Ohsawa Fukuichi , Gomi Shuichi 
Published: April 2008

ABSTRACT

Biapenem is a parenteral carbapenem antibiotic that exhibits wide-ranging antibacterial activity, remarkable chemical stability, and extensive stability against human renal dehydropeptidase-I. Tebipenem is the active form of tebipenem pivoxil, a novel oral carbapenem antibiotic that has a high level of bioavailability in humans, in addition to the above-mentioned features. β-lactam antibiotics, including carbapenems, target penicillin-binding proteins (PBPs), which are membrane-associated enzymes that play essential roles in peptidoglycan biosynthesis. To envisage the binding of carbapenems to PBPs, we determined the crystal structures of the trypsin-digested forms of both PBP 2X and PBP 1A from
Streptococcus pneumoniae
strain R6, each complexed with biapenem or tebipenem. The structures of the complexes revealed that the carbapenem C-2 side chains form hydrophobic interactions with Trp374 and Thr526 of PBP 2X and with Trp411 and Thr543 of PBP 1A. The Trp and Thr residues are conserved in PBP 2B. These results suggest that interactions between the C-2 side chains of carbapenems and the conserved Trp and Thr residues in PBPs play important roles in the binding of carbapenems to PBPs.