bluuebunny/crossref_metadata_2025_split huggingface dataset:
How delivery ward staff exercise power over women in communication
Authors: Sinivaara Maria , Suominen Tarja , Routasalo Pirkko , Hupli Maija 
Published: March 2004

Background.  Power is a central element in all social interactions. In order to act appropriately in different care situations, it is important to understand the meaning of power.Aim.  This paper reports a study whose aim was to describe delivery ward staff opinions about the exercise of power over women in communications.Methods.  Data were collected in 2000 using a questionnaire developed for the study with a convenience sample of 155 midwifery and nursing professionals in delivery wards in four Finnish hospitals.Results.  The results showed that in respondents’ opinions they worked for women's good and aimed at relationships based on a sense of equality and individuality. Negative power was used in situations where women's well‐being was threatened. The power used was verbal or non‐verbal.Conclusions.  The exercise of power is not only negative in nature. There are times, such as in life‐threatening situations, when it is crucial that the professional takes control and makes decisions immediately, and in that sense exercises power.
A systematic review to ascertain whether the standard needle is more effective than a longer or wider needle in reducing the incidence of local reaction in children receiving primary immunization
Authors: Davenport Julie M. 
Published: March 2004

Context.  Millions of doses of vaccines are given to children within the United Kingdom (UK) each year, yet there is conflicting national guidance on the length of needle to use. Prefilled syringes come supplied with 25 Gauge 16 millimetres long needles.Objectives.  A systematic review was completed to answer the clinical question of whether the standard needle is more effective than a longer and/or wider needle in reducing local reactions in children receiving primary immunizations.Methods.  Data sources: A comprehensive search strategy, including searching of electronic databases, hand searching, reference/citation searching, contacting researchers in the field and searching for unpublished literature. Study selection: Selection of studies was guided by the clinical question, the inclusion and exclusion criteria being applied by two people independently. Study quality assessment: An established quality checklist was used. Critical analysis of the quality of the components of the studies is included in the discussion. Data extraction: Two people independently applied a data extraction form, designed for the study.Results.  (1) Rev Man (a Windows‐based software package used by the Cochrane Collaboration) was used to perform a meta‐analysis on the binary results of two small studies using Relative Risk as the summary statistic 16 mm vs. 25 mm needle. (2) The pooled Relative Risk for redness was 2·52 [95% confidence interval (CI) fixed 1·70–3·72] P < 0·00001. (3) The pooled Relative Risk for swelling was 2·31 (95% CI fixed 1·55–3·43) P < 0·00003.Conclusion.  (1) The results are statistically very highly significant and favour the use of the 25 millimetre long needle. (2) No studies were identified to separate the effect of the gauge of the needle used, but the discussion shows that needle length is the most important variable. (3) The results should be incorporated into any future guidelines on vaccine administration in the UK.
Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand
Authors: Hardy Derrylea J. , O'Brien Anthony P. , Gaskin Cadeyrn J. , O'Brien Anthony J. , Morrison‐Ngatai Erina , Skews Georgina , Ryan Tom , McNulty Neil 
Published: March 2004

Background.  Numerous studies have employed the Delphi technique to seek expert opinion about aspects of clinical practice. When researching literature on the Delphi technique, however, we discovered discrepancies in its application, and a lack of detail when reporting design, administration, and analysis methods. Such lack of specificity hinders the replicability and assessment of the clinical and cultural validity and reliability of Delphi studies.Aim.  The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria.Methods.  Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three‐round reactive Delphi survey. Equal proportions of Maori and non‐Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarized responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2‐point bracket on the 5‐point Likert‐scale overall, or in one of the Maori nurse, non‐Maori nurse, or consumer groups. A mean rating of 4·5 after round 3 was set as the importance threshold.Findings.  Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark.Conclusions.  When rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost‐effective means of obtaining and prioritizing experts judgements.
Treatment protocols for demodicosis: an evidence‐based review
Authors: Mueller Ralf S. 
Published: March 2004

Abstract Publications discussing the treatment of demodicosis in the dog and cat are reviewed. Based on the evidence in the literature, amitraz rinses at 0.025–0.06% every 7–14 days, and oral daily ivermectin at 300 µg kg−1, milbemycin at 2 mg kg−1and moxidectin at 400 µg kg−1, respectively, can all be recommended for the treatment of generalized canine demodicosis. Ivermectin and moxidectin should be initiated at lower doses and patients monitored for possible adverse effects during therapy. In cats, 2% lime sulfur dips and amitraz rinses at 0.0125–0.025% have been used successfully.
Treatment of dermatophytosis in dogs and cats: review of published studies
Authors: Moriello Karen A. 
Published: March 2004

Abstract The recent literature on the treatment of dermatophytosis in dogs and cats was reviewed. Based uponin vitrostudies using isolated infected hairs and controlled or fieldin vivostudies, the following topical treatments were consistently found to be antifungal (i.e. antidermatophyte): lime sulfur (1:16), 0.2% enilconazole rinses, and a combined 2% miconazole/chlorhexidine shampoo. Animals or hairs were either bathed or rinsed once or twice weekly. Itraconazole, griseofulvin and terbinafine were evaluated in controlled or field studies, most commonly involving cats. Griseofulvin (50 mg kg−1) was reported to cure infected animals in 41–70 days. Itraconazole (10 mg kg−1once daily or in a combined daily/pulse therapy 10 mg kg−1once daily for 28 days and then week on/week off) was reported to cure infected animals in 56–70 days. Low‐dose itraconazole (1.5–3.0 mg kg−1) in 15‐day cycles required 1–3 cycles (15–45 days). Various doses of terbinafine (5–40 mg kg−1) were reportedly used to treat dogs or cats. The higher doses of terbinafine (> 20 mg kg−1) were required to achieve a mycological cure; the number of treatment days to cure varied from 21 to > 126 days. Lufenuron was reported anecdotally to be an effective cure, however, this was not substantiated in controlled studies. Finally, fungal vaccines were not found to be effective against challenge exposure, however, there is evidence that they may be useful in treatment protocols.
Clinical efficacy of metal stents for the treatment of focal abdominal aortic stenosis
Authors: Eftekhar Kathy , Young Noel , Fletcher John , Bester Lourens , Wong Louise , Puttaswamy Vikram 
Published: March 2004

SUMMARYSeven patients (four women and three men) who underwent primary stenting of infrarenal abdominal aortic stenosis over a 4‐year period are reported. The patients ranged between 44 and 77 years of age. All were referred for treatment of disabling claudication. Self‐expanding stents with balloon assistance were used. A single complication, a retroperitoneal haematoma, requiring surgical intervention occurred in one patient. Patients had either complete resolution of symptoms (five of seven) or a substantial decrease in their claudication symptoms. Primary stenting is a safe and effective treatment for severe abdominal aortic stenosis.
Modelling rising groundwater and the impacts of salinization on terrestrial remnant vegetation in the Blackwood River Basin
Authors: Hodgson Geoff , Hatton Tom , Salama Ramsis 
Published: March 2004

Summary  Southwest Western Australia has a particularly rich biodiversity. Clearing for agriculture has greatly reduced the extent of native vegetation in wheatbelt catchments; it also set into train hydrogeological and hydrological changes that are still evolving toward a new equilibrium. With those changes come widespread land salinization that presents a further risk to remnant vegetation, particularly in low portions of the landscape. The equilibrium position of shallow groundwater was modelled for the Blackwood Catchment, and used to assess the extent of risk to a set of remnant vegetation classes. A total of 37 368 ha of remnant vegetation was identified to be at risk of salinization when hydrological equilibrium is reached. Further hydrological modelling assessed the rate of development of these watertables (and hence the rate of impact on remnants), as well as the potential to protect remnants by controlling groundwater recharge with revegetation. The results demonstrate that only high levels of revegetation are effective at protecting high value remnants in the longer term. The timing of events is dependant on the accuracy of estimating recharge.
Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial
Authors: Haines Terry P , Bennell Kim L , Osborne Richard H , Hill Keith D 
Published: March 2004

AbstractObjective To assess the effectiveness of a targeted, multiple intervention falls prevention programme in reducing falls and injuries related to falls in a subacute hospital.Design Randomised controlled trial of a targeted multiple intervention programme implemented in addition to usual care compared with usual care alone.Setting Three subacute wards in a metropolitan hospital specialising in rehabilitation and care of elderly patients.Participants 626 men and women aged 38 to 99 years (average 80 years) were recruited from consecutive admissions to subacute hospital wards.Intervention Falls risk alert card with information brochure, exercise programme, education programme, and hip protectors.Main outcome measures Incidence rate of falls, injuries related to falls, and proportion of participants who experienced one or more falls during their stay in hospital.Results Participants in the intervention group (n = 310) experienced 30% fewer falls than participants in the control group (n = 316). This difference was significant (Peto log rank test P = 0.045) and was most obvious after 45 days of observation. In the intervention group there was a trend for a reduction in the proportion of participants who experienced falls (relative risk 0.78, 95% confidence interval 0.56 to 1.06) and 28% fewer falls resulted in injury (log rank test P = 0.20).Conclusions A targeted multiple intervention falls prevention programme reduces the incidence of falls in the subacute hospital setting.
A case-crossover study of transient risk factors for occupational acute hand injury
Authors: Sorock G S , Lombardi D A , Hauser R , Eisen E A , Herrick R F , Mittleman M A 
Published: March 2004

Background:Workers with acute hand injuries account for over 1 000 000 emergency department visits annually in the United States.Aims:To determine potential transient risk factors for occupational acute hand injury.Methods:Subjects were recruited from 23 occupational health clinics in five northeastern states in the USA. In a telephone interview, subjects were asked to report the occurrence of seven potential risk factors within a 90-minute time period before an acute hand injury. Each case also provided control information on exposures during the month before the injury. The self-matched feature of the study design controlled for stable between-person confounders.Results:A total of 1166 subjects were interviewed (891 men, 275 women), with a mean age (SD) of 37.2 years (11.4). The median time interval between injury and interview was 1.3 days. Sixty three per cent of subjects had a laceration. The relative risk of a hand injury was increased when working with equipment, tools, or work pieces not performing as expected (11.0, 95% CI 9.4 to 12.8), or when using a different work method to do a task (10.5, 95% CI 8.7 to 12.7). Other transient factors in decreasing order of relative risk were doing an unusual task, being distracted, and being rushed. Wearing gloves reduced the relative risk by 60% (0.4, 95% CI 0.3 to 0.5). Occupational category, job experience, and safety training were found to alter several of these effects.Conclusion:The results suggest the importance of these transient, potentially modifiable factors in the aetiology of acute hand injury at work. Attempts to modify these exposures by various strategies may reduce the incidence of acute hand injury at work.
Long term effects of exposure to automobile exhaust on the pulmonary function of female adults in Tokyo, Japan
Authors: Sekine K , Shima M , Nitta Y , Adachi M 
Published: March 2004

Aims:To investigate the chronic effects of air pollution caused mainly by automobiles in healthy adult females.Methods:Respiratory symptoms were investigated in 5682 adult females who had lived in the Tokyo metropolitan area for three years or more in 1987; 733 of them were subjected to pulmonary function tests over eight years from 1987 to 1994. The subjects were divided into three groups by the level of air pollution they were exposed to during the study period. The concentrations of nitrogen dioxide and suspended particulate matter were the highest in group 1, and the lowest in group 3.Results:The prevalence rates of respiratory symptoms in group 1 were higher than those in groups 2 and 3, except for wheezing. Multiple logistic regression analysis showed significant differences in persistent phlegm and breathlessness. The subjects selected for the analysis of pulmonary function were 94, 210, and 102 females in groups 1, 2, and 3, respectively. The annual mean change of FEV1in group 1 was the largest (−0.020 l/y), followed by that in group 2 (−0.015 l/y), and that in group 3 (−0.009 l/y). Testing for trends showed a significant larger decrease of FEV1with the increase in the level of air pollution.Conclusions:The subjects living in areas with high levels of air pollution showed higher prevalence rates of respiratory symptoms and a larger decrease of FEV1compared with those living in areas with low levels of air pollution. Since the traffic density is larger in areas with high air pollution, the differences among the groups may reflect the effect of air pollution attributable to particulate matter found in automobile exhaust.
Pre-employment urine drug testing of hospital employees: future questions and review of current literature: Table 1
Authors: Levine M R , Rennie W P 
Published: March 2004

Background:Patient safety and optimisation of worker performance are high current priorities. Arguments over employee drug testing have been debated over the past two decades.Aims:To review prior information to reveal how current principles and practices regarding pre-employment drug testing of health care workers evolved, and to explore pressing current and future issues.Methods:A literature search of Medline from 1980 to 1999 was performed. This yielded seven citations that reported results of pre-employment drug testing of health care workers, which we critically reviewed.Results:The process by which a rational testing process was developed for pre-employment urine drug screening in the health care field is illustrated. Also depicted are some important principles, inequities, and shortcomings of the system. The range of positive tests was wide, from 0.25% to 12%. Testing was not always applied uniformly to all health care workers. It became apparent that positive tests also require medical review to determine if they were truly due to illicit substance use.Conclusions:Although pre-employment drug testing programmes in the health care industry have been firmly in place for many years, it is unclear whether such strategies have achieved their stated purposes. The next step is to study whether such programmes are effective at accomplishing specific goals, such as decreasing absenteeism, turnover, accidents, and medical errors, in order to justify continuing pre-employment testing versus changing to an alternative testing strategy.
The effectiveness of ergonomic interventions on return-to-work after low back pain; a prospective two year cohort study in six countries on low back pain patients sicklisted for 3–4 months
Authors: Anema J R , Cuelenaere B , van der Beek A J , Knol D L , de Vet H C W , van Mechelen W 
Published: March 2004

Aims:To study occurrence and effectiveness of ergonomic interventions on return-to-work applied for workers with low back pain (LBP).Methods:A multinational cohort of 1631 workers fully sicklisted 3–4 months due to LBP (ICD-9 codes 721, 722, 724) was recruited from sickness benefit claimants databases in Denmark, Germany, Israel, Sweden, the Netherlands, and the United States. Medical, ergonomic, and other interventions, working status, and return-to-work were measured using questionnaires and interviews at three months, one and two years after the start of sickleave. Main outcome measure was time to return-to-work. Cox’s proportional hazards model was used to calculate hazard ratios regarding the time to return-to-work, adjusted for prognostic factors.Results:Ergonomic interventions varied considerably in occurrence between the national cohorts: 23.4% (mean) of the participants reported adaptation of the workplace, ranging from 15.0% to 30.5%. Adaptation of job tasks and adaptation of working hours was applied for 44.8% (range 41.0–59.2%) and 46.0% (range 19.9–62.9%) of the participants, respectively. Adaptation of the workplace was effective on return-to-work rate with an adjusted hazard ratio (HR) of 1.47 (95% CI 1.25 to 1.72; p < 0.0001). Adaptation of job tasks and adaptation of working hours were effective on return-to-work after a period of more than 200 days of sickleave with an adjusted HR of 1.78 (95% CI 1.42 to 2.23; p < 0.0001) and 1.41 (95% CI 1.13 to 1.76; p = 0.002), respectively.Conclusions:Results suggest that ergonomic interventions are effective on return-to-work of workers long term sicklisted due to LBP.
Building camps and work related injuries
Authors: Tüchsen F , Hannerz H 
Published: March 2004

Aims:To focus on one possible predictor of reported work related injuries—the role of living in building-site camps versus daily commuting from home to construction sites.Methods:A cohort of construction workers was collected, based on personnel files from contractors involved in the building of the Great Belt Bridge. The files included information on employment periods and whether or not the employees lived in building-site camps. The cohort was followed up for injuries reported to the National Work Environment Authority.Results:Construction workers living in camps reported 217 accidents, of which 24 were serious or fatal. Among those not living in camps we found 262 accidents, of which 29 were serious or fatal. The relative risk for all accidents for camp versus non-camp was 0.84 (95% CI 0.69 to 1.00). The respective figure for serious or fatal accidents was RR = 0.85 (95% CI 0.47 to 1.52).Conclusion:Results suggest that high accident rates at large construction sites may be reduced, if commuting is replaced by living on-site.
Biological monitoring of kidney function among workers occupationally exposed to trichloroethylene
Authors: Green T , Dow J , Ong C N , Ng V , Ong H Y , Zhuang Z X , Yang X F , Bloemen L 
Published: March 2004

Aims:To investigate the nephrotoxic potential of trichloroethylene in a currently exposed population using sensitive urinary markers of kidney toxicity.Methods:Renal dysfunction was monitored in a cross-sectional study of 70 workers currently exposed to trichloroethylene. An age and sex matched control population of 54 individuals was drawn from hospital and administrative staff.Results:The mean exposure to trichloroethylene, estimated from urinary trichloroacetic acid concentrations, was 32 ppm (range 0.5–252 ppm) with an average duration of exposure of 4.1 years (range 1–20 years). Significant differences between the exposed and control populations were found for nephrotoxicity markers N-acetylglucosaminidase (NAG) and albumin, and for the mode of action marker, formic acid. However, neither NAG nor albumin showed a significant correlation with either the magnitude or duration of exposure to trichloroethylene. There was a significant correlation between urinary formic acid and trichloroacetic acid concentrations. Within the exposed population there were dose dependent increases in urinary methylmalonic acid concentrations and urinary glutathione S-transferase α activity. Although still within the control range, these changes were clearly dose dependent and consistent with one of the proposed mechanisms of trichloroethylene induced kidney toxicity.Conclusion:Although there was no evidence of kidney toxicity within the population studied, the results suggest that kidney damage could occur at exposure concentrations higher (>250 ppm) than those encountered in this study.