bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reasons for selecting an initial route of heroin administration and for subsequent transitions during a severe HIV epidemic
Authors: Bravo María J. , Barrio Gregorio , De La Fuente Luis , Royuela Luis , Domingo Laura , Silva Teresa 
Published: May 2003

ABSTRACTAim  To identify the most important reasons for selecting a particular route of heroin administration and for subsequent transitions during a period of epidemic HIV transmission. To study temporal trends in these reasons.Design  Cross‐sectional survey.Participants  Nine hundred heroin users in three Spanish cities: 305 in Seville, 297 in Madrid and 298 in Barcelona.Measurements  A separate analysis was made of the reasons for five types of behaviour: (a) selecting injection as the initial usual route of heroin administration (URHA); (b) changing the URHA to injection; (c) never having injected drugs; (d) selecting the smoked or sniffed route as the initial URHA; and (e) changing the URHA to a non‐injected route. Subjects were invited to evaluate the importance of each reason included in a closed list. Spontaneously self‐perceived reasons were also explored in an open‐ended question for each of the five types of behaviour studied.Findings  The primary reason selected for each type of behaviour was: (a) pressure of the social environment; (b) belief that injection is a more efficient route than smoking or sniffing heroin; (c) concern about health consequences (especially fears of HIV and overdose), and fear of blood or of sticking a needle into one's veins; (d), pressure of the social environment and (e) concern about health consequences and vein problems. For women, having a sexual partner who injected heroin played a decisive role in initiating or changing to injection. Few people spontaneously mentioned market conditions for purchasing heroin as an important reason for any behaviour, nor did many mention risk of overdose as reasons for (c) or (d).Conclusions  These findings should be considered when designing interventions aimed at preventing initiation of injecting or facilitating the transition to non‐injected routes.
Family structure and adolescent cigarette smoking in eleven European countries
Authors: Bjarnason Thoroddur , Davidaviciene Aleksandra G. , Miller Patrick , Nociar Alojz , Pavlakis Andreas , Stergar Eva 
Published: May 2003

ABSTRACTAims  This study seeks to establish (1) if different types of non‐traditional family structures are related equally to adolescent cigarette smoking; (2) if each type of family structure is related equally to adolescent smoking in different countries and (3) if differences in such patterns can be explained by the prevalence of such family structures in each country.Design  Self‐reported cigarette smoking among 33 978 students in Cyprus, France, Hungary, Iceland, Ireland, Lithuania, Malta, Slovak Republic, Slovenia, Sweden and the United Kingdom is analysed with multi‐level hierarchical regression models.Findings  Adolescents living with both biological parents smoke less than those living with single mothers, who in turn smoke less than those living with single fathers, mothers‐stepfathers, or with neither biological parent. Living with fathers‐stepmothers is associated with less smoking than living with single fathers, mother‐stepfathers, or with neither biological parent, but does not differ from living with both biological parents or single mothers. The effects of living with single mothers, single fathers, or with neither biological parent are stronger in countries where such family types are less common. Differences in the strength of effects between countries become non‐significant once the prevalence of each family type has been taken into account.Conclusions  Adolescents living with both biological parents smoke less than their counterparts in most other family types, and adolescents living with single mothers or fathers‐stepmothers smoke less than those living in other non‐traditional family structures. The strength of this pattern varies inversely with the prevalence of such households in each country.
Video lottery: winning expectancies and arousal
Authors: Ladouceur Robert , Sévigny Serge , Blaszczynski Alexander , O'Connor Kieron , Lavoie Marc E. 
Published: May 2003

AbstractAims  This study investigates the effects of video lottery players’ expectancies of winning on physiological and subjective arousal.Design  Participants were assigned randomly to one of two experimental conditions: high and low winning expectancies.Setting  Participants played 100 video lottery games in a laboratory setting while physiological measures were recorded. Level of risk‐taking was controlled.Participants  Participants were 34 occasional or regular video lottery players. They were assigned randomly into two groups of 17, with nine men and eight women in each group.Intervention  The low‐expectancy group played for fun, therefore expecting to win worthless credits, while the high‐expectancy group played for real money.Measurements  Players’ experience, demographic variables and subjective arousal were assessed. Severity of problem gambling was measured with the South Oaks Gambling Screen. In order to measure arousal, the average heart rate was recorded across eight periods.Findings  Participants exposed to high as compared to low expectations experienced faster heart rate prior to and during the gambling session. According to self‐reports, it is the expectancy of winning money that is exciting, not playing the game.Conclusions  Regardless of the level of risk‐taking, expectancy of winning is a cognitive factor influencing levels of arousal. When playing for fun, gambling becomes significantly less stimulating than when playing for money.
Severe myocardial ischaemia during mask induction of anaesthesia in an infant with unknown critical supravalvular aortic stenosis
Authors: Driessen J. J. , Van Oort A. M. , Booij L. H. D. J. 
Published: May 2003

SummaryCongenital supravalvular aortic stenosis is an uncommon type of aortic obstruction. When critical, it represents an extreme variant of outflow tract obstruction with increased risk of cardiovascular instability during exercise or anaesthesia. We present a case of severe myocardial ischaemia during induction of anaesthesia with sevoflurane in a 3‐month baby with a presumed diagnosis of valvular aortic stenosis for which a percutaneous balloon dilatation of the aortic valve was scheduled.
Sexual hallucinations during and after sedation and anaesthesia
Authors: Balasubramaniam B. , Park G. R. 
Published: May 2003

SummarySexual hallucinations have been reported since the introduction of chloroform. Newer agents such as midazolam and propofol appear particularly prone to producing them. Some practitioners have been the victims of allegations resulting from the hallucinogenic effects of these drugs. Other individuals, including doctors, have used the amnesic effects of midazolam and other drugs to sexually assault victims. Clinicians should be aware of the risks to which they may inadvertently expose themselves if these drugs are not used carefully.
Survey of anaesthetic support staff in obstetric units in England and Wales
Authors: Qureshi A. M. , Stevens M. , Plaat F. 
Published: May 2003

SummaryIn order to determine the current level of support provided to anaesthetists on the labour suite, a postal questionnaire was sent to the lead consultants of the 257 obstetric units in England and Wales. One hundred and ninety‐five replied, a response rate of 76%. Of those who replied, only 1% of units experienced frequent delays to elective obstetric lists due to lack of an anaesthetic assistant and 141 units (72%) had a designated assistant for the labour ward. However, 58 units experienced delays waiting for an anaesthetic assistance in emergency situations (29%). One hundred and sixty‐eight units (86%) had an operating department practitioner/nurse (ODP/N) resident on call for the hospital, but not exclusively for the maternity unit. In 76% of units, midwives assisted the anaesthetist when inserting regional blocks in labour. More than one‐third of respondents thought that it would be appropriate to have a dedicated ODP/N resident on call for the labour ward who would also assist with labour analgesia blocks.
A comparison of the effect of two anaesthetic techniques on surgical conditions during gynaecological laparoscopy
Authors: Williams M. T. , Rice I. , Ewen S. P. , Elliott S. M. 
Published: May 2003

SummaryIn a prospective, randomised, controlled trial, we compared the effects of two anaesthetic techniques on surgical conditions during day‐case, gynaecological laparoscopic procedures in 40 female patients. Patients were allocated randomly to two groups, either to breathe spontaneously through a laryngeal mask airway or to receive a neuromuscular‐blocking agent (NMB) and have the lungs ventilated via a tracheal tube. We then measured the number of attempts of Verres' needle insertion, initial intra‐abdominal pressure, time to reach a steady 15 mmHg (1.97 kPa) of intra‐abdominal pressure, adequacy of the pneumoperitoneum, operative view and duration of operation. We found that the initial intra‐abdominal pressure was higher and the operation time shorter in the laryngeal mask group. The adequacy of the pneumoperitoneum for trocar placement was better in the NMB group. We conclude that the anaesthetic technique of spontaneously breathing through a laryngeal mask airway reduces total operation time. However surgeons should be aware of the different abdominal pressure patterns produced by each anaesthetic technique, and anaesthetists must consider the implications of the anaesthetic technique on surgical safety.
An evaluation of the modified Airway Management Device
Authors: Sivasankar R. , Bahlmann U. B. , Stacey M. R. , Sehgal A. , Hughes R. C. , Hall J. E. 
Published: May 2003

SummaryWe evaluated the modified Airway Management Device (AMDTM) in 60 spontaneously breathing anaesthetised patients. The insertion and removal of the device was very easy and atraumatic. The airway was secured on the first attempt in 41 patients (70%; 95% CI 57–80%). The most important problem was loss of airway, which occurred in 11 patients (19%; 11–30%) during maintenance of anaesthesia. The AMD was dislodged during maintenance in one patient. There was a loss of the airway in 12 patients (20%; 12–31%); in 10, it was maintained with simple airway manoeuvres or a laryngeal mask airway and tracheal intubation was required in two patients. Ten of these patients were male and two were female; the failure rate was 33% (12–31%) among the male patients and 6% (2–22%) among the female patients. The cuff volumes ranged from 4 ml to 80 ml and cuff pressures from 6 cm H2O to 92 cm H2O. Blood was seen on removal in three patients (6%; 2–16%) and nine patients (18%; 10–30%) experienced sore throat after removal of the device.
The effect of loading on the filtration performance of breathing system filters
Authors: Wilkes A. R. 
Published: May 2003

SummaryThe filtration performance of breathing system filters can be measured by challenging the filter with sodium chloride particles. However, the challenge itself may alter the filtration performance. This effect was determined by repeating a standard challenge test five times on one sample each of 18 different electrostatic filters and seven pleated hydrophobic filters. The penetration of sodium chloride particles through all 18 electrostatic filters increased as the load on the filter increased. In contrast, there was a decrease in penetration through six of the seven pleated hydrophobic filters (p < 0.0001). However, the changes in penetration values were small compared to the large range of penetration values of the filters, and the effect of loading on penetration values using the challenge specified in the European standard is small.
Effect of intra‐operative end‐tidal carbon dioxide partial pressure on tissue oxygenation
Authors: Akça O. , Liem E. , Suleman M.–I. , Doufas A. G. , Galandiuk S. , Sessler D. I. 
Published: May 2003

SummaryPostsurgical infection risk is correlated with subcutaneous tissue oxygenation. Mild hypercapnia augments cutaneous perfusion. We tested the hypothesis that peripheral tissue oxygenation increases as a function of arterial PCO2 in surgical patients. Twenty patients were randomly assigned to intra‐operative end tidal PCO2 of 3.99 (control) or 5.99 kPa (hypercapnia). All other anaesthetic management was per protocol. Tissue oxygen partial pressure, transcutaneous oxygen tension, cerebral oxygen saturation, and cardiac output were measured. Mean (SD) subcutaneous tissue oxygen tension was 8.39 (1.86) kPa in control and 11.84 (2.53) kPa hypercapnia patients (p = 0.014). Cerebral oxygen saturation was 55 (4)% for control vs. 68 (9)% for hypercapnia (p = 0.004). Neither cardiac index nor transcutaneous tissue oxygen tension differed significantly between the groups. Mild intra‐operative hypercapnia increased subcutaneous and cerebral oxygenation. Increases in subcutaneous tissue oxygen partial pressure similar to those observed in patients assigned to hypercapnia are associated with substantial reductions in wound infection risk.
Clear‐cut?: facilitating health librarians to use information research in practice
Authors: Booth Andrew , Brice Anne 
Published: May 2003

AbstractIn 1999, staff at the universities of Sheffield and Oxford commenced an unfunded project to examine whether it is feasible to apply critical appraisal to daily library practice. This aimed to establish whether barriers experienced when appraising medical literature (such as lack of clinical knowledge, poor knowledge of research methodology and little familiarity with statistical terms) might be reduced when appraising research within a librarian's own discipline. Innovative workshops were devised to equip health librarians with skills in interpreting and applying research. Critical Skills Training in Appraisal for Librarians (CRISTAL) used purpose‐specific checklists based on the Users’ Guides to the Medical Literature. Delivery was via half‐day workshops, based on a format used by the Critical Appraisal Skills Programme. Two pilot workshops in Sheffield and Oxford were evaluated using a brief post‐workshop form. Participants recorded objectives in attending, their general understanding of research, and whether they had read the paper before the workshop. They were asked about the length, content and presentation of the workshop, the general format, organization and learning environment, whether it had been a good use of their time and whether they had enjoyed it. Findings must be interpreted with caution. The workshops were enjoyable and a good use of time. Although the scenario selected required no clinical knowledge, barriers remain regarding statistics and research methodology. Future workshops for librarians should include sessions on research design and statistics. Further developments will take forward these findings.
Clinical librarianship: a systematic review of the literature
Authors: Winning M. A. , Beverley C. A. 
Published: May 2003

AbstractClinical librarianship (CL), currently receiving renewed interest world‐wide, seeks to provide quality‐filtered information to health professionals at the point of need to support clinical decision‐making. This review builds upon the work of Cimpl (Bulletin of the Medical Library Association 1985, 73, 21–8) and attempts to establish the evidence base for CL. The objectives were to determine, from the literature, whether CL services are used by clinicians, have an effect on patient care, and/or clinicians’ use of literature in practice and/or are cost‐effective. The methodology used was a systematic review of the literature, following, where possible, the NHS Centre for Reviews and Dissemination (CRD) framework. Modifications to this methodology included the resources searched, and the critical appraisal checklist (CriSTAL) used. Two hundred and eighty‐four unique references were retrieved. Seventeen (16 unique) evaluative and a further 33 descriptive studies met the inclusion criteria. The quality of reporting of the literature was generally poor. CL programmes appear to be well‐used and received by clinicians. However, there is insufficient evidence available on their effect on patient care, clinicians’ use of literature in practice, and their cost‐effectiveness, thus highlighting the need for further high‐quality research.
Information skills training: a systematic review of the literature*
Authors: Brettle Alison 
Published: May 2003

AbstractThe objectives of this study were to undertake a systematic review to determine the effectiveness of information skills training, to identify effective methods of training and to determine whether information skills training affects patient care. A systematic review, using an iterative approach to searching, was employed. Studies selected for inclusion in the review were critically appraised using a tool used in previous reviews. A tabular approach was used to provide a summary of each paper allowing synthesis of results. One thousand, three hundred and fifty‐seven potentially relevant papers were located. On the basis of titles and abstracts, 41 potentially relevant studies were identified for potential inclusion. Further reading and application of the inclusion criteria left 24 studies for critical appraisal and inclusion in the review. Study designs included randomised controlled trials, cohort designs and qualitative studies. The majority of studies took place in US medical schools. Wide variations were found in course content and training methods. Eight studies used objective methods to test skills, two compared training methods and two examined the effects on patient care. There was limited evidence to show that training improves skills, insufficient evidence to determine the most effective methods of training and limited evidence to show that training improves patient care. Further research is needed in a number of areas.
A Delphi study to determine nursing research priorities in the North Glasgow University Hospitals NHS Trust and the corresponding evidence base
Authors: Kirkwood Michelle , Wales Ann , Wilson Anne 
Published: May 2003

AbstractThe aims of the study are to identify and prioritize research questions of importance to nurses in North Glasgow University Hospitals NHS Trust and to investigate and describe the existing evidence base for the highest priority questions identified. The consensus method known as the Delphi technique was used. Systematic searching of the literature for each question identified from the research priorities enabled the existing evidence base to be characterized. The following priorities were identified as the most important (in descending order of importance): Recruitment and Retention of Nursing Staff; Staff Stress & Morale; Training & Education of Nursing Staff; Infection Control; and Pain Management. The Delphi technique proved a useful method to determine and prioritize research areas in nursing.
Educational workshop improved information‐seeking skills, knowledge, attitudes and the search outcome of hospital clinicians: a randomised controlled trial
Authors: Cheng Grace Y. T. 
Published: May 2003

Abstract A double‐blind randomised controlled trial was conducted on a group of Hong Kong hospital clinicians. The objective was to test if a three‐hour educational workshop (with supervised hands‐on practice) is more effective (than no training) to improve clinical question formulation, information‐seeking skills, knowledge, attitudes, and search outcomes. The design was a post‐test‐only control group; recruitment by stratified randomization (by profession), blocked at 800. End‐user training was more effective than no training in improving clinical question formulation, in raising awareness, knowledge, confidence and use of databases, but had made no impact on preference for secondary databases. It changed the attitude of clinicians to become more positive towards the use of electronic information services (EIS). Participants had higher search performance and outcomes (satisfaction with information obtained (NNT = 3), EIS satisfaction (NNT = 3) and success in problem solving (NNT = 4)). The workshop improved knowledge and skills in evidence‐based searching, but this effect gradually eroded with time. Search logs confirmed that follow‐up is required if effects are to be sustained. Longer effects on search behaviours appear to be positive. A randomised controlled trial is valuable in identifying cause‐and‐effect relations and to quantify the magnitude of the effects for management decision‐making.
LISTENing to healthcare students: the impact of new library facilities on the quality of services
Authors: Haldane Graham C. 
Published: May 2003

AbstractFollowing a low assessment of ‘Learning resources’ provision by the Quality Assurance Agency, the librarian of Homerton College, School of Health Studies commenced the LISTEN Project, a long‐term study to monitor the effects of planned interventions on the quality of library provision. Surveys of entry‐to‐register student nurses & midwives were conducted in 1999 and 2001 by extensive questionnaires, inviting Likert‐scaled and free text responses. Following a college relocation, students made greater than expected use of a new health studies library in Cambridge, and significantly less use of the local teaching hospital library. Using both a satisfaction index and a non‐parametric test of mean scores, student evaluation of library services in Cambridge significantly improved following relocation. The physical accommodation and location of library services remain important to healthcare students. Identifiable improvements to the quality of services, however, will overcome initial resistance to change. Education providers must ensure the best mix of physical and electronic services for students who spend much of their time on clinical placement.
The Randomised Controlled Trial design: unrecognized opportunities for health sciences librarianship
Authors: Eldredge Jonathan D. 
Published: May 2003

Abstract Objectives: to describe the essential components of the Randomised Controlled Trial (RCT) and its major variations; to describe less conventional applications of the RCT design found in the health sciences literature with potential relevance to health sciences librarianship; to discuss the limited number of RCTs within health sciences librarianship. Methods: narrative review supported to a limited extent with PubMed and Library Literature database searches consistent with specific search parameters. In addition, more systematic methods, including handsearching of specific journals, to identify health sciences librarianship RCTs. Results: While many RCTs within the health sciences follow more conventional patterns, some RCTs assume certain unique features. Selected examples illustrate the adaptations of this experimental design to answering questions of possible relevance to health sciences librarians. The author offers several strategies for controlling bias in library and informatics applications of the RCT and acknowledges the potential of the electronic era in providing many opportunities to utilize the blinding aspects of RCTs. RCTs within health sciences librarianship inhabit a limited number of subject domains such as education. This limited scope offers both advantages and disadvantages for making Evidence‐Based Librarianship (EBL) a reality. Conclusion: The RCT design offers the potential to answer far more EBL questions than have been addressed by the design to date. Librarians need only extend their horizons through use of the versatile RCT design into new subject domains to facilitate making EBL a reality.