bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incentives for lifestyle changes in patients with coronary heart disease
Authors: Kärner Anita , Tingström Pia , Abrandt‐Dahlgren Madeleine , Bergdahl Björn 
Published: July 2005

Aim.  This paper reports a study exploring how patients in the rehabilitation phase of coronary heart disease experience facilitating and constraining factors related to lifestyle changes of importance for wellbeing and prognosis.Background.  Lifestyle change is important but complex during rehabilitation after a myocardial infarction or angina pectoris. The intentions to perform behaviours and to experience control over facilitators and constraints are important determinants of behaviour.Methods.  A total of 113 consecutive patients below 70 years of age (84 men and 29 women) were interviewed within 6 weeks of a cardiac event and again after 1 year. Interview transcriptions and notes taken by hand were qualitatively analysed using the phenomenographic framework. The distribution of statements among the categories identified was quantitatively analysed. The data were collected in 1998–2000.Findings.  Four main categories portrayed patients’ experiences of facilitating or constraining incentives for lifestyle changes. ‘Somatic incentives’ featured bodily signals indicating improvements/illness. ‘Social/practical incentives’ involved shared concerns, changed conditions including support/demand from social network, and work/social security issues. Practical incentives concerned external environmental factors in the patients’ concrete context. ‘Cognitive incentives’ were characterized by active decisions and appropriated knowledge, passive compliance with limited insights, and routines/habits. ‘Affective incentives’ comprised fear of and reluctance in the face of lifestyle changes/disease, lessened self‐esteem, and inability to resist temptations. Cognitive incentives mostly facilitated physical exercise and drug treatment. Social/practical incentives facilitated physical exercise and diet change. Physical exercise and diet changes were mainly constrained by somatic, social, and affective incentives.Conclusion.  The results illustrate important incentives that should be considered in contacts with patients and their families to improve the prospects of positively affecting co‐operation with suggested treatment and lifestyle changes.
Burnout contagion among intensive care nurses
Authors: Bakker Arnold B. , Le Blanc Pascale M. , Schaufeli Wilmar B. 
Published: July 2005

Aim.  This paper reports a study investigating whether burnout is contagious.Background.  Burnout has been recognized as a problem in intensive care units for a long time. Previous research has focused primarily on its organizational antecedents, such as excessive workload or high patient care demands, time pressure and intensive use of sophisticated technology. The present study took a totally different perspective by hypothesizing that – in intensive care units – burnout is communicated from one nurse to another.Methods.  A questionnaire on work and well‐being was completed by 1849 intensive care unit nurses working in one of 80 intensive care units in 12 different European countries in 1994. The results are being reported now because they formed part of a larger study that was only finally analysed recently. The questionnaire was translated from English to the language of each of these countries, and then back‐translated to English. Respondents indicated the prevalence of burnout among their colleagues, and completed scales to assess working conditions and job burnout.Results.  Analysis of variance indicated that the between‐unit variance on a measure of perceived burnout complaints among colleagues was statistically significant and substantially larger than the within‐unit variance. This implies that there is considerable agreement (consensus) within intensive care units regarding the prevalence of burnout. In addition, the results of multilevel analyses showed that burnout complaints among colleagues in intensive care units made a statistically significant and unique contribution to explaining variance in individual nurses’ and whole units’ experiences of burnout, i.e. emotional exhaustion, depersonalization and reduced personal accomplishment. Moreover, for both emotional exhaustion and depersonalization, perceived burnout complaints among colleagues was the most important predictor of burnout at the individual and unit levels, even after controlling for the impact of well‐known organizational stressors as conceptualized in the demand‐control model.Conclusion.  Burnout is contagious: it may cross over from one nurse to another.
Health‐related quality of life after revascularization for peripheral arterial occlusive disease: long‐term follow‐up
Authors: Wann‐Hansson Christine , Hallberg Ingalill Rahm , Risberg Bo , Lundell Anders , Klevsgard Rosemarie 
Published: July 2005

Aim.  This paper reports a study to measure quality of life, before and after revascularization, in patients with intermittent claudication and critical limb ischaemia from a long‐term perspective.Background.  Patients with peripheral arterial occlusive disease have a number of problems which affect their quality of life and a successful revascularization results in immediate improvements in quality of life. However, knowledge of the durability of the improvements is sparse. Therefore, research on the outcomes of treatment and nursing care should investigate the long‐term effects on quality of life and daily activities.Methods.  A quasi‐experimental longitudinal follow‐up study was conducted with 80 patients with intermittent claudication and 62 with critical ischaemia. Assessment with the Nottingham Health Profile was made before revascularization and 6 months, 12 months and up to 4 years afterwards. The data were collected between 1995 and 2000.Results.  Quality of life was improved 6 and 12 months after revascularization in patients with intermittent claudication in energy, pain, emotional reactions and physical mobility, while those with critical limb ischaemia also had improvements in pain and sleep. The improvement in pain was particularly evident for both groups and remained significantly improved up to 4 years after revascularization. Patients with critical limb ischaemia, however, deteriorated significantly with regard to physical mobility between 12 months and 4 years. Being a woman and belonging to the critical ischaemia group was significantly associated with high total Nottingham Health Profile score. Thus, patients with intermittent claudication had more durable benefits from revascularization than those with critical limb ischaemia. However, both groups had less pain than at baseline after 4 years.Conclusion.  The degree to which quality of life was durable over time seems to depend on the severity of the disease and gender. Patients with critical limb ischaemia were older, had more other diseases and a lower quality of life than patients with intermittent claudication, which confirmed that patients with critical limb ischaemia need more ongoing nursing support to maintain independence in daily life a long time after revascularization.
Employment transitions for older nurses: a qualitative study
Authors: Andrews Joyann , Manthorpe Jill , Watson Roger 
Published: July 2005

Aim.  This paper aims to explore the influences on employment related decision making in respect of nurses over 50 in the United Kingdom. It investigates the retirement and labour market relationship through the diverse experiences of older nurses and stakeholders in nursing.Background.  The ageing of the United Kingdom nursing workforce constitutes a potential challenge for the National Health Services. There is evidence of increasing efforts to address this issue by encouraging older nurses to remain in the profession, dissuading early retirement and attracting nurses who have retired to return to nursing. However, decision‐making by older nurses is influenced by a wide spectrum of factors and perceived employment options.Background.  The paper is based on research commissioned by the Joseph Rowntree Foundation as part of its Transitions Over 50 programme. It derives from concern about inadequate knowledge of, and under‐developed policy responses to, the ageing United Kingdom workforce and the specific implications of this age shift for the nursing labour market. The research consisted of interviews with nurses over 50 and key stakeholders in nursing in the United Kingdom. Stakeholders included employers, advisers and policy makers in nursing.Method.  Interviews with older nurses and stakeholders in nursing were conducted over a period of 12 months. They included face‐to‐face and telephone semi‐structured interviews with 84 nurses over 50 and 18 key stakeholders in nursing in the United Kingdom. Stakeholders included employers, advisers and policy‐makers.Findings.  Employers, policy makers and advisers and older nurses all identified a range of influences on nurses’ employment decisions including a lack of flexible hours, the stress of work, pension‐related expectations and the pace of change. Some of these related to negative aspects of work that led nurses to leave (‘push’ factors), and others to the presence of positive factors in nursing or in pension options (‘pull’ factors).Conclusion.  The study highlighted the need for increased implementation of more flexible hours of work and greater availability of part‐time hours for older nurses. It revealed the salience of improved pay, adequate and flexible pensions provision, and opportunities for continued professional development to the recruitment and retention of older nurses.
Abdominal surgery, pain and anxiety: preoperative nursing intervention
Authors: Lin Li‐Ying , Wang Ruey‐Hsia 
Published: July 2005

Aim.  This paper reports a study examining the effects of preoperative nursing intervention for pain on abdominal surgery preoperative anxiety and attitude to pain, and postoperative pain.Method.  In a randomized controlled study conducted between January and August 2001, patients undergoing abdominal surgery in a medical center in southern Taiwan were randomly assigned to an experimental (n = 32) or control group (n = 30). The experimental group received routine care and preoperative nursing intervention for pain, while the control group received routine care only. A structured questionnaire including an anxiety scale, pain attitude scale, and Brief Pain Inventory was used to assess the results.Results.  Participants in the experimental group experienced a significant decrease in preoperative anxiety and a significant improvement in preoperative pain attitude. They also had statistically significantly lower postoperative pain intensity for 4 hours after surgery and lower highest pain intensity within the first 24 hours after surgery. Perceived pain interference during position changes, deep breathing/coughing, and moments of emotion in the experimental group was statistically significantly lower than that of the control group in the same situations. The experimental group also started out‐of‐bed activities 1·5 days earlier.Conclusion.  Preoperative nursing intervention for pain has positive effects for patients undergoing abdominal surgery. The intervention used in this study could serve as a guide for nurses to improve the pain care of these patients.
Subcutaneous fat accumulation and BMI associated with risk for pulmonary embolism in patients with proximal deep vein thrombosis: a population study based on 23 796 consecutive autopsies
Authors: ÖGREN M. , ERIKSSON H. , BERGQVIST D. , STERNBY N.‐H. 
Published: July 2005

Abstract.Objective.  Although deep vein thrombosis (DVT) and pulmonary embolism (PE) are manifestations of the same disease, far from all patients develop PE. Our objective was to investigate risk‐modifying factors.Setting, subjects and design.  Between 1970 and 1982, 23 796 autopsies, representing 84% of all in‐hospital deaths in the Malmö City population, were performed, using a standardized procedure. In a case–control study nested in a population‐based cohort of patients with proximal DVT, the relationship between PE and body mass index (BMI), thoracic and abdominal subcutaneous (SC) fat thickness was evaluated.Results.  Proximal DVT was found in 15%, of which 58% were women. Mean age in men was 4.5 years lower than in women (P < 0.001). Fifty per cent of the patients had PE, half of which were fatal. Similar age‐ and gender distribution was found in cases and controls. Patients in the upper tertile of BMI, abdominal and thoracic SC fat thickness had, in comparison with mid‐tertile, and independent of age, gender and death from cancer disease, an increased odds (95% CI) for PE of 1.24 (1.04–1.47) (P = 0.014), 1.28 (1.07–1.53) (P = 0.006) and 1.35 (1.13–1.61) (P = 0.001), respectively, whereas in patients of the lower tertiles, a negative association was found.Conclusions.  We found no differences in age‐ and gender distribution between PE cases and controls. BMI and SC fat thickness were markers of disease progression from proximal DVT to PE. The highly significant and independent association indicates that SC obesity may be of greater importance in venous thromboembolism as compared with cardiovascular diseases related to visceral (abdominal) obesity with lipid‐ and glucose metabolic disturbances.
Cancer risk of patients with ischaemic syndromes
Authors: PEHRSSON S. K. , LINNERSJÖ A. , HAMMAR N. 
Published: July 2005

Abstract.Introduction.  Angiogenesis constitutes the regulation of collateral formation in subjects with ischaemic syndromes and is also a prerequisite for cancer progression. Patients with severe symptomatic ischaemic syndromes may have a reduced ability for angiogenesis and thus a lower risk to develop cancer.Subjects and methods.  Patients below 80 years and treated for acute myocardial infarction (AMI), angina pectoris (AP), intermittent claudication (IC) or undergoing revascularization during 1972–1991 in Stockholm county (n = 63 921) were followed regarding cancer incidence 1972–2000. Cancer incidence was compared with that of the general population of Stockholm County by standardized incidence ratios (SIR).Results.  An increased incidence of cancer overall compared with the general population was seen in patients treated for AMI [SIR men 1.08 (95% Confidence Interval 1.04–1.11) and women 1.15 (1.09–1.21)], AP [men 1.16 (1.11–1.21) and women 1.06 (1.00–1.12)] and IC [men 1.48 (1.31–1.64) and women 1.43 (1.17–1.68)]. This increase was mainly due to an increased incidence of tobacco‐related cancer. In patients undergoing revascularization no increase in incidence was seen [SIR men 0.97 (0.91–1.03) and women 1.06 (0.91–1.20)].Conclusion.  Patients with mild to moderate symptomatic ischaemic syndromes are, as expected, at increased risk of subsequently develop tobacco‐related cancer. A lack of increased cancer risk in patients undergoing revascularization could be due to a reduced ability for angiogenesis in patients with severe atherosclerotic disease but may also be related to lifestyle changes.
Non‐steroidal anti‐inflammatory drugs for the prevention and treatment of cancer
Authors: PEREG D. , LISHNER M. 
Published: July 2005

Abstract.Non‐steroidal anti‐inflammatory drugs (NSAIDs), both cyclooxygenase‐2 (COX‐2) selective and nonselective inhibitors, are amongst the most popular medications worldwide. Whilst their anti‐inflammatory effect is well known, recent studies have demonstrated an unexpected effect in both the prevention and treatment of several types of cancer. The anticancerous effect of NSAIDs is believed to be mainly due to the inhibition of COX‐2, which is overexpressed in many types of cancer and may play a major role in tumourigenesis. In this review, we will describe the possible mechanisms for NSAIDs anticancer effect and summarize the major clinical studies in cancer prevention and treatment. We will also discuss the effect of the recent reports of adverse cardiovascular effects on anticancer research of the selective COX‐2 inhibitors.
Dietary fat intake and early mortality patterns – data from The Malmö Diet and Cancer Study
Authors: LEOSDOTTIR M. , NILSSON P. M. , NILSSON J‐Å. , MÅNSSON H. , BERGLUND G. 
Published: July 2005

Abstract.Objectives.  Most current dietary guidelines encourage limiting relative fat intake to <30% of total daily energy, with saturated and trans fatty acids contributing no more than 10%. We examined whether total fat intake, saturated fat, monounsaturated, or polyunsaturated fat intake are independent risk factors for prospective all‐cause, cardiovascular and cancer mortality.Design.  Population‐based, prospective cohort study.Setting and subjects.  The Malmö Diet and Cancer Study was set in the city of Malmö, southern Sweden. A total of 28 098 middle‐aged individuals participated in the study 1991–1996.Main outcome measures.  Subjects were categorized by quartiles of relative fat intake, with the first quartile used as a reference point in estimating multivariate relative risks (RR; 95% CI, Cox's regression model). Adjustments were made for confounding by age and various lifestyle factors.Results.  Women in the fourth quartile of total fat intake had a significantly higher RR of cancer mortality (RR 1.46; CI 1.04–2.04). A significant downwards trend was observed for cardiovascular mortality amongst men from the first to the fourth quartile (P = 0.028). No deteriorating effects of high saturated fat intake were observed for either sex for any cause of death. Beneficial effects of a relatively high intake of unsaturated fats were not uniform.Conclusions.  With the exception of cancer mortality for women, individuals receiving more than 30% of their total daily energy from fat and more than 10% from saturated fat, did not have increased mortality. Current dietary guidelines concerning fat intake are thus generally not supported by our observational results.
Methanol outbreak in Norway 2002–2004: epidemiology, clinical features and prognostic signs
Authors: HOVDA K. E. , HUNDERI O. H. , TAFJORD A.‐B. , DUNLOP O. , RUDBERG N. , JACOBSEN D. 
Published: July 2005

Abstract.Objectives.  Knowledge on methanol poisoning does mainly come from clinical studies. We therefore report epidemiological, clinical and prognostic features from the large methanol outbreak in Norway in 2002–2004 where the new antidote fomepizole was the primary antidote in use. Design and subjects.  Combined prospective and retrospective case series study of 51 hospitalized patients who were confirmed poisoned with methanol, of whom nine died. In addition, eight patients died outside hospital. Most patients were admitted in a late stage and because of symptoms. Treatment consisted of alkali, fomepizole (71%) and haemodialysis (73%).Results.  The median serum methanol was 25.0 mmol L−1 (80 mg dL−1) (range 3.1–147.0 mmol L−1), median pH was 7.20 (6.50–7.50), and median base deficit 22 mmol L−1 (range 0–31). The most frequent clinical features reported were visual disturbances (55%), dyspnoea (41%), and gastrointestinal symptoms (43%). Twenty‐four per cent were comatose on admission, of whom 67% died. There was a trend towards decreasing pCO2 with decreasing pH amongst the patients surviving. The opposite trend was demonstrated in the dying; the difference was highly significant by linear regression analyses (P < 0.001).Conclusions.  Methanol poisoning still has a high morbidity and mortality, mainly because of late diagnosis and treatment. Respiratory arrest, coma and severe metabolic acidosis (pH < 6.90, base deficit >28 mmol L−1) upon admission were strong predictors of poor outcome. Early admission and ability of respiratory compensation of metabolic acidosis was associated with survival.
Health Care during Transition and Health Systems Reform: Evidence from the Poorest CIS Countries
Authors: Bonilla‐Chacin Maria E. , Murrugarra Edmundo , Temourov Moukim 
Published: July 2005

Abstract The poorest seven countries of the former Soviet Union (CIS‐7) moved from a centralized system of health‐care funding and delivery to a range of institutional and financial arrangements. The different paths chosen have implied different results in terms of available resources, internal efficiency, health‐care inequality, and the corresponding incidence of public expenditures. This paper examines the level, composition and allocation of public spending on health, in light of the evolution of the health systems during the transition. The financial constraints experienced by CIS‐7 countries were reflected in the decrease of health‐care quality, the collapse of the already inefficient public health activities, and the increased incidence of out‐of‐pocket expenditures. These factors, alongside the increase in poverty, resulted in a decrease in health‐care utilization, suggesting that these countries may experience difficulties in achieving the health‐related Millennium Development Goals.
Bottom Up and Top Down? Community Development in Post‐Soviet Armenia: The Social Fund Model
Authors: Babajanian Babken V. 
Published: July 2005

Abstract The main objective of this article is to discuss the effectiveness of bottom‐up, community‐driven approaches in promoting community participation and building local capacity within the post‐Soviet social, institutional and political context of Armenia. In exploring this issue, the article examines the nature of local participation and social relations in rural communities in Armenia and the impact of the World Bank‐supported Armenia Social Investment Fund (ASIF) project on the existing forms of local social organization. One of the objectives of the ASIF project was to promote the participation of local communities in their own economic and social development. The research finds that the project did not change the existing patterns of local social organization and had no significant impact on the nature of participation in the beneficiary communities. Bottom‐up, capacity‐building interventions that mainly focus on changing patterns of interpersonal social relations may not be effective in fostering sustainable civic institutions without changes in the nature of a country's governance.
Principal features of impact‐generated hydrothermal circulation systems: mineralogical and geochemical evidence
Authors: NAUMOV MIKHAIL V. 
Published: July 2005

AbstractAny hypervelocity impact generates a hydrothermal circulation system in resulting craters. Common characteristics of hydrothermal fluids mobilized within impact structures are considered, based on mineralogical and geochemical investigations, to date. There is similarity between the hydrothermal mineral associations in the majority of terrestrial craters; an assemblage of clay minerals–zeolites–calcite–pyrite is predominant. Combining mineralogical, geochemical, fluid inclusion, and stable isotope data, the distinctive characteristics of impact‐generated hydrothermal fluids can be distinguished as follows: (i) superficial, meteoric and ground water and, possibly, products of dehydration and degassing of minerals under shock are the sources of hot water solutions; (ii) shocked target rocks are sources of the mineral components of the solutions; (iii) flow of fluids occurs mainly in the liquid state; (iv) high rates of flow are likely (10−4to 10−3 m s−1); (v) fluids are predominantly aqueous and of low salinity; (vi) fluids are weakly alkaline to near‐neutral (pH 6–8) and are supersaturated in silica during the entire hydrothermal process because of the strong predominance of shock‐disordered aluminosilicates and fusion glasses in the host rocks; and (vii) variations in the properties of the circulating solutions, as well as the spatial distribution of secondary mineral assemblages are controlled by temperature gradients within the circulation cell and by a progressive cooling of the impact crater. Products of impact‐generated hydrothermal processes are similar to the hydrothermal mineralization in volcanic areas, as well as in modern geothermal systems, but impacts are always characterized by a retrograde sequence of alteration minerals.