bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social inequalities in oral health and in use of oral health care services among adolescents in Uganda
Authors: OKULLO I. , ÅSTRØM A. N. , HAUGEJORDEN O. 
Published: August 2004

Summary.Objective. The aim of this study was to describe clinical and self‐perceived indicators of oral health status and the use of oral health care services by social and demographic characteristics.Methods. In 2001, a cross‐sectional random sample survey was conducted in urban and rural settings in Uganda (Kampala and Lira, respectively), and 1146 secondary school students with a mean age of 15·8 years completed questionnaires in school. Dental caries was recorded by one examiner on a random subsample of 372 students.Results. Logistic regression analyses revealed that being an urban resident was associated with higher odds for having dental caries (dmft > 0), seeking care because of toothache (delayed treatment demand) and being dissatisfied with one's own oral health status [adjusted odds ratio (OR) = 1·5–2·1]. Being an urban resident was associated with lower odds for oral health care attendance generally and for having missing teeth in particular (adjusted OR = 0·6–0·4). Students who had parents with a higher education and those with weak social ties were, respectively, less and more likely to be dissatisfied with their oral health status. As compared to caries‐free participants, the odds for being dissatisfied with oral health and delayed treatment demand increased significantly with an increasing dmft score (adjusted OR = 2·1–3·2).Conclusion. Urban students were most likely to have a dmft > 0 and to rate their oral health status negatively. Having received dental care and the prevalence of missing teeth, and delayed treatment demand were, respectively, most and least prevalent among rural students. Dental caries at different diagnostic cut‐off points and weak social ties affected self‐reported oral health negatively, independently of social and demographic characteristics.
Species composition and abundance of aphids in Australian hop gardens and their impact on spatiotemporal patterns of Carlavirus epidemics
Authors: Pethybridge S. J. , Madden L. V. , Griggs J. , Wilson C. R. 
Published: August 2004

The species composition and abundance of aphids in commercial cv. Agate and cv. Super Pride hop gardens in Tasmania, Australia, were characterized over three seasons (1999–2001). Gunns Plains recorded 14 aphid species and Bushy Park 11 species, with nine of these common to both sites. The majority of aphids were trapped in the first 2 months (October and November) of active hop growth in all three seasons. Cultivar and geographical location had significant effects on the abundance of total aphids (species pooled) trapped and several individual aphid species in the three seasons. In general, significantly more aphids (total and individual species) were trapped in cv. Agate than cv. Super Pride gardens, and higher numbers were trapped at Bushy Park than at Gunns Plains. This coincided with a higher incidence of plants infected by carlaviruses in cv. Agate gardens at both locations. Differences in the spatiotemporal dynamics of Carlavirus epidemics were described by fitting a stochastic model to the data, with parameters for local spread within the garden (contagion) and background infection (disease increase unrelated to infected plants within the gardens). Local spread of Hop latent virus (HpLV) and Hop mosaic virus (HpMV) was indicated within all gardens. For HpMV in cv. Agate at Gunns Plains, however, infections caused by immigrant viruliferous aphids were also apparent. Using join‐count statistics, spatial aggregation of both virus diseases was found for all years, except for the initial year (1999) when incidence was low. Clusters of diseased plants extended to greater distances for HpLV than for HpMV. Based on spatial and spatiotemporal analyses, local spread (mechanical transmission and/or aphid movement within the garden) appears to be the dominant factor in the epidemics of HpLV. Aphid immigration from outside the crop over time may play a more significant role for HpMV epidemics, at least for one location.
How one could once become a registered nurse in the United States without going to a hospital training school
Authors: Bullough Vern L 
Published: August 2004

Distant learning in nursing is both a new and old concept. This paper examines an early example of correspondence schools in nursing, namely the Chautauqua School which over the course of its existence enrolled over 20 000 students. Its closing was due in large part to the opposition of organized nursing which had become institutionalized in the hospital training school. It was not until the 1990's when license recertification was required that long distant nursing again assumed importance.
Tracheal agenesis: management of the first 10 months of life
Authors: Baroncini‐Cornea S. , Fae M. , Gargiulo G. , Gentili A. , Lima M. , Pigna A. , Pilu G. , Tancredi S. , Turci G. 
Published: August 2004

SummaryTracheal agenesis is a potentially lethal congenital anomaly, appearing only at birth. We describe a newborn preterm infant who presented with immediate respiratory distress and no audible cry. There was almost complete tracheal agenesis with a very short segment of distal trachea (only two tracheal rings) arising from the anterior wall of the esophagus, before dividing into the mainstem bronchi. The anomaly was unsuspected prenatally, as the scan showed pyloric atresia and complex congenital cardiac disease. Despite the patient's difficult course, with correction of the rare‐associated malformations (cardiac and gastrointestinal tract anomalies), the fact that the child is lively and neurologically normal for her age, requires that we now consider the patency of the airway and the possibility of surgical correction, in accordance with a good quality of life.
Airway management during an EXIT procedure for a fetus with dysgnathia complex
Authors: Baker Paul A , Aftimos Salim , Anderson Brian J 
Published: August 2004

SummaryNonsyndromal dysgnathia is a rare disorder with a probable genetic basis characterized by a hypoplastic or absent mandible (agnathia), microstomia, microglossia, and ear anomalies secondary to a defect in the ventral portion of the first branchial arch caused by defective neural crest migration or proliferation. Dysgnathic newborn infants often suffer fatal respiratory failure from airway obstruction. Nineteen children with isolated dysgnathia complex are described in the literature – six were stillborn, eight died shortly after birth, and only five survived infancy. All survivors required tracheostomy to maintain an airway. It is difficult to intubate the trachea of these children and early airway management planning is important. We report a neonate who presented with a prenatal ultrasound diagnosis of severe micrognathia, polyhydramnios and a family history of severe micrognathia. Airway management was achieved with fiberoptic intubation through a laryngeal mask airway (LMATM) during an ex utero intrapartum treatment procedure. Fiberoptic intubation was hampered by copious amounts of amniotic fluid. This child and her sibling are the first two siblings with isolated dysgnathia complex to have survived infancy and provide further support for a genetic basis to this condition.
Is tissue coring a real problem after caudal injection in children
Authors: Baris Sibel , Guldogus Fuat , Baris Yakup Sancar , Karakaya Deniz , Kelsaka Ebru 
Published: August 2004

SummaryBackground : The aim of this study was to determine whether tissue coring occurs with 22‐G hollow needle and 22‐G caudal block needle during caudal injection in children, as well as evaluating the nature of the coring material if it did occur.Methods : Seventy children were randomly allocated to two groups and caudal block was performed with either 22‐G hollow (group I) or 22‐G caudal block (group II) needle under general anesthesia. The needles and guides were washed with 0.5 ml of 70% ethanol in a sterile tube and were evaluated by a pathologist blinded to the type of needle used, for the type and number of cells.Results : Nucleated cells, which have no mitotic activity, were present in 8.5% in each study group and bloody material was present in 8.5 and 2.8%, in group I and II, respectively. Non‐nucleated epidermal cells were detected in 94.2 and 97.1% of the patients in group I and II, respectively. However, cells with mitotic activity from the stratum basale were not detected in any slides.Conclusions : The incidence of transporting nucleated epidermal cells with no mitotic activity from stratum spinosum during puncture for caudal block is low and no differences exist between different types of needle used. However, it may also suggest that transporting nucleated cells with mitotic activity from the stratum basale may be possible during caudal puncture.
Jet injector compared with oral midazolam for preoperative sedation in children
Authors: Fine Brad , Castillo Rose , McDonald Tim , Paisansathan Chanannait , Zsigmond Elemer , Hoffman William E. 
Published: August 2004

SummaryBackground : This study compared onset of sedation and satisfaction with two needleless jet injectors with the oral route for the administration of midazolam.Methods : Forty‐five children ages 1–6 years were randomly assigned to receive either 0.5 mg kg−1 oral midazolam, 0.2 mg kg−1 subcutaneous midazolam by J‐Tip injector or 0.2 mg kg−1 intramuscular midazolam by Bioject injector. After midazolam administration the children were monitored for oxygen saturation, heart rate and level of sedation (0, alert; 1, calm; 2, drowsy; 3, dozing; 4, asleep) every 2 min for 20 min by a physician blinded to the route of administration. Patient satisfaction, resistance to treatment, success of delivery, problems with separation, and acceptance of mask at the time of induction were evaluated after midazolam treatment.Results : The Bioject showed a faster onset of sedation than either the J‐Tip injector or the oral midazolam (P < 0.05). The children were significantly less satisfied with the Bioject and J‐Tip administration vs oral midazolam (P < 0.05). There were no differences in resistance, success of delivery, problems with separation, mask acceptance, arterial oxygen saturation or heart rate.Conclusion : Despite children being less satisfied with Bioject injection of midazolam, the procedure is safe, effective and provides a more rapid onset of preoperative sedation in children than either the J‐Tip injection or oral route.
The Effects of State Mental Health Parity Legislation on Perceived Quality of Insurance Coverage, Perceived Access to Care, and Use of Mental Health Specialty Care
Authors: Bao Yuhua , Sturm Roland 
Published: August 2004

Objective. To assess the impacts of recent state mental health parity legislation on perceived quality of health insurance coverage, perceived access to needed health care, and use of mental health specialty services by individuals with likely need for mental health care.Data Sources. The study sample came from two waves of a national household survey first fielded in 1997–1998 and then in 2000–2001. The analysis used a subset of the sample.Study Design. The study took the Difference‐in‐Difference‐in‐Difference approach to investigate changes in self‐perceived quality of health insurance coverage and access to needed health care, and use of mental health specialty care by the group with mental disorders (relative to those without) in states with parity legislation of different comprehensiveness (relative to the nonparity states) in the years after the law (relative to before the law).Principal Findings. Overall, there were no significant or consistent effects of the parity legislation. Descriptive statistics showed significant changes in some (but not all) outcome variables, but these results disappeared in detailed statistical analyses by controlling for important covariates.Conclusions. The null findings of the effects of state mental health parity mandates suggest that under ERISA (Employee Retirement Income Security Act), the scope of state parity legislation may have been restricted because of large proportion of self‐insured employers. Furthermore, comprehensiveness of state legislation appears to be related to the traditional level of use of mental health specialty care, which becomes another confounder for the potential policy effects.
Monitoring Visual Status: Why Patients Do or Do Not Comply with Practice Guidelines
Authors: Sloan Frank A. , Brown Derek S. , Carlisle Emily Streyer , Picone Gabriel A. , Lee Paul P. 
Published: August 2004

Objective. To determine factors affecting compliance with guidelines for annual eye examinations for persons diagnosed with diabetes mellitus (DM) or age‐related macular degeneration (ARMD).Data Sources/Study Setting. Nationally representative, longitudinal sample of individuals 65+ drawn from the National Long‐Term Care Survey (NLTCS) with linked Medicare claims records from 1991 to 1999.Study Design. Medicare beneficiaries were followed from 1991 to 1999, unless mortality intervened. All claims data were analyzed for presence of ICD‐9 codes indicating diagnosis of DM or ARMD and the performance of eye exams. The dependent variable was a binary indicator for whether a person had an eye exam or not during a 15‐month period. Independent variables for demographics, living conditions, supplemental insurance, income, and other factors affecting the marginal cost and benefit of an eye exam were assessed to determine reasons for noncompliance.Data Collection/Extraction Methods. Panel data were created from claims files, 1991–1999, merged with data from the NLTCS.Principal Findings. The probability of having an exam reflected perceived benefits, which vary by patient characteristics (e.g., education, no dementia), and factors associated with the ease of visit. African Americans were much less likely to be examined than were whites.Conclusions. Having an exam reflects multiple factors. However, much of the variation in the probability of an exam remained unexplained as were reasons for the racial differences in use.
Nursing‐Sensitive Outcome Implementation and Reliability Testing in a Tertiary Care Setting
Authors: Behrenbeck Julia G. 
Published: August 2004

PURPOSETo describe the NOC outcomes most relevant for specialty nursing practice and in selected field sites representing the continuum of care; to assess the adequacy of measures (reliability, validity, sensitivity, specificity, practicality); and to describe the linkages among nursing diagnoses, interventions, and outcomes in clinical decision making.METHODSData were collected on 434 patients during the 12‐month data collection period at a tertiary care center: cardiac surgery intensive care (n= 76), cardiac transplant unit (n= 153), and medical unit (n= 205). Medical diagnoses of patients on the two cardiac units were related to cardiac disease. Medical diagnoses of patients on the medical unit were extremely varied (ranging from e.g., gout to pneumonia). Data were collected on 65 separate outcome labels for a total of 633 ratings.FINDINGSIn the cardiac transplant ICU, data were collected on 42 outcomes: 30 had an average interrater reliability of ≥85%, and 16 had an absolute agreement interrater reliability of ≥85%. In the cardiac surgery ICU, data were collected on 30 outcomes: 25 had an average interrater reliabilty of ≥85%, 6 had an absolute agreement interrater of ≥85%. In the medical unit, data were collected on 45 outcomes: 41 had an average interrater reliability of ≥85%, 14 had an absolute agreement interrater reliability of ≥85%. Four outcomes have been implemented into the documentation system for all patients: Tissue Integrity: Skin and Mucous Membranes, Mobility Level, Knowledge: Disease Process, and Coping.CONCLUSIONSOverall, nursing staff were very positive about having the opportunity to participate in nursing research. Staff were able to think about the relative status of their patient and how nursing care contributes to the patient's recovery. They appreciated the opportunity to discuss this with a colleague during the interrater exercise. Increased familiarity with NOC allows staff members to determine which outcomes comprise core nursing‐sensitive outcomes for their clinical setting.
Transcultural Adaptation of NANDA Taxonomy II to a Brazilian Context
Authors: Marlene Michel Jeanne Liliane , Botura Leite de Barros Alba Lucia 
Published: August 2004

PURPOSETo translate NANDA Taxonomy II into Brazilian Portuguese.METHODSSemantic equivalence was obtained through a process of translation and back translation, supervised by a professor (RN and PhD) expert in using nursing diagnoses taxonomy both in teaching and in clinical practice. Conceptual equivalence was attained by presenting the original text, the translation and the back translation of the labels, definitions, defining characteristics or risk factors, and related factors to a group of expert nurses from different specialties who are proficient in English in order to analyze them and to verify if the terms presented in each diagnosis are suitable to the Brazilian nurses' practice reality, making suggestions as appropriate. The results of this analysis and the suggestions were then discussed by a committee with expertise in this kind of work and nursing diagnosis until consensus could be reached.FINDINGSSome difficulties were found in the translation process because of the structural differences between English and Portuguese, and also because many diagnostic concepts are presented in different ways in the book. With the Portuguese translation, trouble occurs because of alphabetical order. Even if this is only a matter of organization, when discussing which one could be the correct form of these diagnostic concepts, a more important question emerged: What really composes the concept? We believe the concept is general, and should not contain components from the other axes. For instance, we think incontinence is better than bowel incontinence, because “bowel” is on the axis topology. We await a response from NANDA in order to continue the work.CONCLUSIONSProviding Brazilian nurses with NANDA Taxonomy II adapted to Brazilian nursing practice will allow them to continue clinical application of this classification, as well as develop research projects.
Translation of Books about Nursing Diagnosis: Experience of Technical Proofreaders From the South of Brazil
Authors: Almeida Miriam de Abreu , Soares Maria Augusta , Unicovsky Margarita Rubin , Valéria Giordani Araújo  
Published: August 2004

BACKGROUNDIn Brazil, nursing diagnosis appeared as a step in the nursing process in the late 1970s. In the late 1980s studies were initiated following an exchange between a group of professors from Federal University of Para Connecticut. In the 1990s literature began to appear that took into consideration nursing diagnoses, mainly in translated books.MAIN CONTENT POINTSThe main steps in the translation of books are translation of the original text into Portuguese, proofreading, technical proofreading, and a final reading. The technical proofreaders change parts of the text that do not correspond with the ideas and the style of the authors or that cannot be well understood by the final reader; revise technical terms, concepts, and description of procedures; correct possible failures in the translation because of a lack of technical knowledge; adapt information to the Brazilian situation; and add notes to clarify the ideas of the author, using footnotes.The original books we have translated include Handbook of Nursing Diagnosis, 6th ed. (Carpenito, 1995); Nurse's Pocket Guide: Nursing Diagnoses With Interventions, 5th ed. (Moorhouse & Doenges, 1996); Nursing Care Plans and Documentation: Nursing Diagnoses and Collaborative Problems, 2nd ed. (Carpenito, 1995); Applying Nursing Process: A Step‐by‐Step Guide, 4th ed. (Alfaro‐LeFevre, 1998); Handbook of Nursing Diagnosis, 8th ed. (Carpenito, 1999); and Nursing Diagnosis: Application to Clinical Practice, 8th ed. (Carpenito, 2000).Proofreading is a pleasant and rewarding activity. It provides closer contact with the authors, an opportunity to be in touch with the scientific knowledge and the English language, a way of being in touch with current literature, professional growth, and the exchange of experiences.The difficulties encountered included adaptation from the North American to the Brazilian situation (some terms cannot be translated because of the differences between the languages), the existence of nursing diagnoses that do not apply to the Brazilian situation, too many proofreaders for the same work, and a short deadline.CONCLUSIONSThe technical proofreading done by a group of nurses contributed to the accuracy and comprehension of the original work, allowing professional growth and the development of research in the area. The formation of a proofreading group, with no more than five professionals; discussions prior to, during, at the end of the task; consultation with experts in linguistics and in specific content areas, as well as with the author when necessary; the search for the vocabulary equivalence; and stimulation of scientific works in the technical proofreading area are all advisable strategies.
Evaluation of Altered Urinary Elimination in Patients With Chronic Renal Insufficiency
Authors: Barbosa Dulce Aparecida , Barreto Genia Pithon , Carminatte Deise Aparecida , Ramos Lea Luccas , Bettencourt Ana Rita 
Published: August 2004

PURPOSETo identify the defining characteristics and related factors of altered urinary elimination in patients with terminal chronic renal insufficiency.METHODSPhysical and clinical evaluations were carried out in order to identify altered urinary elimination, its defining characteristics and related factors using NANDA's theoretical referents. The study included hospitalized patients in the nephrology unit of a hospital in São Paulo, Brazil.FINDINGSA sample of 50 patients (22 males, 28 females) with end‐stage chronic renal insufficiency were evaluated; mean age was 44 years (range: 15–81); mean hospitalization time was 12 days (range: 2‐37). Altered urinary elimination was diagnosed in 26 (52%) patients. The defining characteristics compatible with NANDA's list were urinary frequency (observed in 24 patients; 92%) and dysuria (in 8 patients; 23%). Related factors were multiple causes in 25 (96%) patients and motorsensory disorders in 7 (26%) patients; infection was seen in 3 (12%) patients.CONCLUSIONSNANDA's theoretical referents, considered indicators of defining characteristics, and related factors were very relevant when accurately diagnosing altered urinary elimination.
Mixed Incontinence in Women: A New Nursing Diagnosis
Authors: Baena de Moraes Lopes Maria Helena , Higa Rosângela 
Published: August 2004

PURPOSETo substantiate the nursing diagnosis of mixed incontinence and demonstrate the need for its acceptance.METHODSInterviews with 148 women with complaints of urinary incontinence. Initial diagnoses were identified and these cases later discussed with a specialist in nursing diagnosis in order to reach a consensus.FINDINGSFifty women (34%) had stress urinary incontinence, 13 (9%) had urge incontinence, and 85 (57%) presented with characteristics specific to two types of incontinence (i.e., mixed incontinence). The age range of the women who presented mixed incontinence was 26–85 years (mean age: 49.16 ± 12.02 years); all reported stress urinary loss and a perception of urinary urgency. More than 50% of the women reported nocturia, increased urinary frequency, dribbling with increased abdominal pressure, inability to stop or start miction, inability to reach toilet in time, and inability to completely empty bladder.DISCUSSIONThe high frequency of mixed incontinence (57%) in this study may be a function of the complexity of these cases.CONCLUSIONSThe evidence found in medical and nursing literature indicates the need to include mixed incontinence as a nursing diagnosis. It is considered to be quite frequent in women with urinary incontinence and is generally more frequent than urge incontinence. Patients may receive inadequate treatment if this diagnosis is not recognized.