bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers and levers towards knowledge management configurations
Authors: Martini Antonella , Pellegrini Luisa 
Published: August 2005

PurposeSeeks to discuss barriers/drivers to the selection and implementation of different knowledge management configurations in the process of product innovation.Design/methodology/approachBuilding on literature and the previous survey‐based research results, this study compares on a longitudinal perspective the approaches of two companies with similar conditions but adopting different choices in terms of ICT and organisational tools to support the knowledge management process.FindingsCase studies highlight how firms adopting a KMC that differ from the one indicated by the previous survey‐based research model show an intention to align to it in the near future. Hence, it seems that a match exists between the configuration expected from the model and the intended configuration planned by the company. Using longitudinal case studies the paper analyses the barriers that hamper the transition of firms toward the approach that better suits their contingent situation. These barriers are mainly at the level of industry trend, lack of culture from users and loss of champions. This paper also analyses the enablers, which strengthen the alignment between the configuration expected from the model and the intended configuration the company planned. These are the social interaction between employees, the pressures from headquarters, the internal commitment from top managers, the technological development and the ICT maturity.Originality/valueThe paper validates two hypotheses. H1: there is a match between the configuration expected from the research model (driven by contingencies) and the intended configuration planned by the company: the contingent approaches which disagree with the model represent different stages of maturity within an evolutionary path which drives toward the configuration expected from the model. H2: there are barriers/enablers, which hamper/foster the transition toward the intended configuration. It also analyses the barriers.
Transverse myelitis following general and epidural anaesthesia in a paediatric patient
Authors: Martinez‐Garcia E. , Pelaez E. , Roman J. C. , Perez‐Gallardo A. 
Published: August 2005

SummaryA 13‐year‐old girl developed transverse myelitis 2 weeks after an uncomplicated, combined general and epidural anaesthetic for orthopaedic surgery. Since epidural anaesthesia had been used, a causal relationship might have been assumed. We review the aetiology and pathogenesis of acute transverse myelitis and the role of anaesthesia in this disorder. Although a causal relationship cannot be assumed and regional anaesthesia in children is considered safe, we would like to re‐emphasise the management principles and practices that may improve the benefit‐to‐risk ratio of these techniques.
Growth hormone improves protein catabolism and growth in prepubertal children with HIV infection
Authors: Hardin Dana S. , Rice Julie , Doyle Marilyn E. , Pavia Andrew 
Published: August 2005

SummaryIntroduction Poor linear growth and weight loss are well documented in children with human immunodeficiency virus (HIV) infection and past studies in adults and children have reported that loss of lean tissue mass (LTM) associated with accelerated rates of protein catabolism. We undertook this study to test the hypothesis that human recombinant GH would improve linear height in HIV‐infected children. Our second goal was to determine if GH could reverse protein catabolism in HIV‐infected children.Methods We studied six HIV‐infected children (mean age 9·2 years, Tanner stage I, CD4 counts 110 000–292 000, two girls, four boys). Measures of protein turnover were conducted using the stable isotope 1‐[13C] leucine. Body composition was measured by dual X‐ray absorptiometry (DXA) scan for determination of LTM. Viral burden and IGF‐1 levels were measured. Studies were conducted at baseline and 6 months.Results The baseline growth velocity of these children was only 3·9 cm/year. After 6 months of GH, growth velocity increased to 7·9 cm/year. Protein catabolism, represented as leucine rate of appearance (Ra) in the fasted state, was high at baseline, but decreased significantly after 6 months of GH therapy. Lean tissue mass significantly improved in all subjects. Viral burden did not increase significantly in any subject during GH therapy.Conclusion These results suggest that GH improves height and weight and reduces protein catabolism in HIV‐infected children without negative effect on viral burden.
Tumour surveillance imaging in patients with extrapituitary tumours receiving growth hormone replacement
Authors: Chung T. T. , Drake W. M. , Evanson J. , Walker D. , Plowman P. N. , Chew S. L. , Grossman A. B. , Besser G. M. , Monson J. P. 
Published: August 2005

SummaryObjective  GH replacement is widely used in the management of patients with adult‐onset (AO)‐GH deficiency (GHD). In most cases, AO‐GHD arises as a result of pituitary/peripituitary tumours and/or their treatment, but the effect of GH replacement on recurrence/regrowth of these tumours is unknown. The aim of this study was to examine the effect of GH replacement in a group of patients with primary tumours of the parasellar region, many of which (e.g. craniopharyngioma, glioma or germ cell tumours) might be anticipated to have a higher recurrence rate than secretory and nonsecretory anterior pituitary tumours.Patients and design  We report here our experience of prospective imaging in 50 consecutive patients (21 males; mean age 45·9 years) with nonanterior pituitary parasellar tumours treated with GH. All had severe GHD (peak serum GH 9 mU/l or less on dynamic testing) and were treated with an identical dose–titration regimen to maintain serum IGF‐I concentrations between the median and upper end of the age‐adjusted normal range. The primary diagnoses were: craniopharyngioma (28), germ cell tumour (8), arachnoid cyst (4), meningioma (4), glioma (4) and mensenchymal tumour (2). External pituitary irradiation had been given to 37 (74%) of patients.Measurements  Surveillance imaging (magnetic resonance imaging (MRI) 70%, computed tomography (CT) 16%, both 14%) was performed at baseline (prior to GH), at 6–12 months, and then again yearly or as clinically indicated. Median follow‐up was 36 months (range 7–129 months). All images were reviewed by the same radiologist.Results  Four patients had an apparent increase in tumour volume but in only one patient was it considered necessary to abandon GH replacement. In two of the four cases marginal increases in cystic parasellar tumours were not progressive; and in the fourth case apparent recurrence of a suprasellar germ cell tumour was shown to be acellular fibrous tissue only on biopsy. In all other cases either the appearances were unchanged or the amount of tissue was reduced during long‐term follow‐up on GH.Conclusions  Overall, GH appears safe with respect to tumour recurrence over this time period in this patient group. Comparison with similar prospective series in patients not receiving GH replacement is desirable.
Androgen receptor polymorphism (CAG repeats) and androgenicity
Authors: Canale D. , Caglieresi C. , Moschini C. , Liberati C. D. , Macchia E. , Pinchera A. , Martino E. 
Published: August 2005

SummaryObjective  Polymorphism of the androgen receptor (AR) has been related to various pathophysiological conditions, such as osteoporosis and infertility. The objectives of this study were to evaluate the frequency of distribution in a normal Italian population and to assess CAG repeats (CAGr) in other conditions, such as hypoandrogenism, potentially influenced by AR polymorphism.Patients and measurements  CAGr polymorphism was determined in a group of 91 healthy normoandrogenized subjects, 29 hypoandrogenized patients (hypoplasia of prostate and seminal vesicles, reduced beard or body hair, etc.) and 29 infertile patients by direct sequencing.Results  The mean (± SD) number of CAG repeats [(CAGr)n] was 21·5 (± 1·7) in the control group, 21·4 (± 2·0) in the infertile patients and 24·0 (± 2·9) in the hypoandrogenic males. The difference was statistically significant between this last group and the other two (P < 0·0001), while there was no difference between normal controls and infertile patients. The frequency distribution showed a shift towards higher CAG length in hypoandrogenized patients compared to controls and infertile patients. If we used a cut‐off point of 24·9 (2 SD above the mean), the percentage of patients with 25 or more CAGr repeats was 38% among hypoandrogenized patients, 7% among infertile patients and 5% among the control group. In hypoandrogenized subjects (CAGr)n correlated slightly with testis and prostate volume. The number of CAG repeats was not associated with any of the hormonal parameters, including testosterone, evaluated in the three groups.Conclusions  Our normal population, representing subjects from Central Italy, is superimposable on other European populations with regard to (CAGr)n distribution. Hypoandrogenic males have a shift in the frequency distribution towards longer (CAGr)n. Infertile patients are not statistically different from the control group. These findings suggest that, given the same amount of circulating testosterone, as in our hypoandrogenized and control group, the final net androgenic phenotypical effect is due to AR polymorphism.
Eighty‐four consecutive cases of tinea faciei in Siena, a retrospective study (1989–2003)
Authors: Romano C. , Ghilardi A. , Massai L. 
Published: August 2005

SummaryConsecutive cases of tinea faciei diagnosed in Siena between 1989 and 2003 were studied retrospectively for differences in clinical form, demographic data and species of dermatophyte isolated. The series consisted of 84 cases (59 females, 25 males) with a mean age of 27 years. Mean age of females (32.4 years) was significantly greater than that of males (14.2 years). The dermatophytes most frequently isolated were Microsporum canis (38 cases) and Trichophyton rubrum (31 cases). Clinical form was typical of tinea in 54 subjects (64.3%) and was tinea incognito because of inappropriate therapy in the other 30 (35.7%) subjects. The mean age of patients with the typical form (19.2 years) was significantly lower than that of those with tinea incognito (41.1 years). All cases in the age range 6–15 years had typical tinea, whereas the maximum frequency of cases with tinea incognito was 46–50 years. In the group with tinea incognito there was a majority of women and the dermatophytes isolated differed with gender. No such difference was observed in the group with typical tinea.
Cunninghamella pneumonia in postbone marrow transplant patient: first case report from India
Authors: Sivakumar S. , Mathews Mary S. , George Biju 
Published: August 2005

Summary Cunninghamella bertholletiae, a rare causative agent of mycosis among immunocompromised patients has been reported with increased frequency from western countries in recent years. We report a case of C. bertholletiae pulmonary infection in a 42‐year‐old male patient who developed graft‐vs.‐host disease following bone marrow transplantation. In spite of intensive antifungal chemotherapy following clinical diagnosis, he died of pulmonary failure. To our knowledge this is the first report from India and third report of post‐BMT C. bertholletiae infection ever published.
Malassezia and Candida colonisation on glans penis of circumcised men
Authors: Atilla Aridoğan I. , Ilkit Macit , Izol Volkan , Ates Aylin 
Published: August 2005

SummaryThe Malassezia yeast are members of the normal human cutaneous flora in adults. They also are reported as part of the microflora of the male genital region in mostly uncircumcised males. It has been reported that Malassezia sympodialis and Malassezia globosa are the most frequent yeast belonging to the resident microflora of the penis as in other human skin areas. The aim was to evaluate the prevalence of Malassezia and Candida yeast colonisation on the glans penis of circumcised males. Impression preparations were made on modified Dixon agar. The isolates were identified by morphological and physiological characteristics. A total of 245 circumcised males were included in the study. Of the 245 patients examined, 55 (22.4%) were found to have a mycologically proven yeast fungi on their glans penis. In 17 (30.9%) Malassezia, in 36 (65.5%) Candida, in one (1.8%) Malassezia and Candida, and in one (1.8%) Saccharomyces strains were detected. Malassezia furfur (66.7%) was the most common species among the lipophilic yeast, followed by Malassezia globosa (11.1%), Malassezia obtusa (11.1%) and Malassezia slooffiae (11.1%). Candida albicans was the most common non‐lipophilic yeast (46.0%), that was isolated among the other yeast, followed by unidentified Candida strains (18.9%), Candida tropicalis (8.1%), Candida glabrata (8.1%), Candida parapsilosis (8.1%), Candida zeylanoides (5.4%), Candida guilliermondii (2.7%) and Saccharomyces cerevisiae (2.7%). The results of this study showed that Malassezia species were also colonised like Candida on the glans penis of circumcised males.
Acute colonic pseudo‐obstruction following major orthopaedic surgery
Authors: Norwood M. G. A. , Lykostratis H. , Garcea G. , Berry D. P. 
Published: August 2005

AbstractObjective  Acute colonic pseudo‐obstruction (ACPO) has been linked with multiple aetiologies including orthopaedic surgery. However, the actual incidence and natural progression are not well described in these patients. We aim to assess the incidence of ACPO in patients undergoing elective orthopaedic procedures, and to examine for potential exacerbating factors.Patients and methods  All patients from the orthopaedic directorate that had abdominal imaging in the five years from August 1998 to August 2003 were identified from radiology archives. A manual search of the patients' notes was conducted with data recorded on the patients' history, operative details and their postoperative course including their haematological and biochemical results. Details regarding their ACPO were documented with respect to the onset of symptoms, how the diagnosis was achieved, what treatment was instigated and how the condition progressed. A control group of age and sex matched patients was included for comparison.Results  Thirty‐five patients with ACPO were identified. The operations included 21 hip replacements, 10 knee replacements and 4 spinal operations. The incidence of ACPO was 1.3%, 0.65% and 1.19%, respectively. In comparison to control patients, patients with ACPO had a lower postoperative serum sodium (P = 0.001), a higher serum urea (P = 0.021) and remained in hospital longer (P < 0.001).Conclusion  ACPO is uncommon in orthopaedic patients, however, its occurrence results in prolonged hospital stay. Attention to patients' postoperative fluid balance and biochemical status may reduce the incidence.
Pedicled flaps in the treatment of nonhealing perineal wounds
Authors: Menon A. , Clark M. A. , Shatari T. , Keh C. , Keighley M. R. B. 
Published: August 2005

AbstractIntroduction  A persistent sinus is an annoying complication following proctectomy. We examined the experience of a single colorectal surgeon in treating this condition using pedicled flaps.Methods  Case note review of all patients undergoing gracilis muscle transposition, Rectus abdominis muscle flap or omental flap for persistent perineal sinus.Results  Seventeen patients were identified: seven had gracilis muscle transposition, eight had omental transposition and two had a rectus abdominis flap. 13/17 patients who underwent a flap had a persistent sinus following proctectomy for Inflammatory bowel disease. Four patients who had a gracilis muscle transposition achieved healing. Seven out of eight patients had good results with omental transposition. One patient did well after a rectus abdominis flap.Conclusions  A gracilis transposition is a relatively simple operation with minimal morbidity useful for superficial sinuses not requiring a muscle bulk. A rectus abdominis flap is a more complex specialized procedure with better results especially in dealing with larger cavities but it may compromise future stoma sites. Omentoplasty has excellent results, but is only available in some patients.
Impact of librarians in first‐year medical and dental student problem‐based learning (PBL) groups: a controlled study
Authors: Koufogiannakis Denise , Buckingham Jeanette , Alibhai Arif , Rayner David 
Published: August 2005

AbstractBackground:  Librarians at the University of Alberta have been involved with teaching undergraduate medical and dental education for several years. After 1 year of increased librarian involvement at the problem‐based learning (PBL), small‐group level, informal feedback from faculty and students suggested that librarians’ participation in PBL groups was beneficial. There was, however, no real evidence to support this claim or justify the high demand on librarians’ time.Objectives:  The study aimed to determine whether having a librarian present in the small‐group, problem‐based learning modules for first‐year medical and dental students results in an improved understanding of evidence‐based medicine concepts, the nature of medical literature, and information access skills.Methods: One hundred and sixty‐four first‐year medical and dental students participated in the study. There were a total of 18 PBL groups, each with approximately nine students and one faculty tutor. Six librarians participated and were assigned randomly to the six intervention groups. Students were given pre‐ and post‐tests at the outset and upon completion of the 6‐week course.Results: Post‐test scores showed that there was a small positive librarian impact, but final exam scores showed no impact. There was also no difference in attitudes or comfort levels between students who had a librarian in their group and those who did not.Conclusions:  Impact was not sufficient to warrant continued participation of librarians in PBL. In future instruction, librarians at the John W. Scott Health Sciences Library will continue to teach at the larger group level.
Examination of the impact of information‐skills training on the academic work of health‐studies students: a single case study
Authors: Appleton Leo 
Published: August 2005

AbstractAim:  To examine the impact of information‐skills training on the academic studies of student midwives. Objectives include ascertaining whether student confidence increases, learning experiences are enhanced and academic standards are improved.Methods:  A student midwives’ discussion group at a higher education institution, plus an in‐depth interview with the students’ course leader.Results:  Students reported increased confidence in using library and information resources. Appropriate and timely information‐skills training embedded into health‐studies curricula can lead to students becoming independent and lifelong learners, as well as improving the standard of their academic work.Conclusion:  Information skills for health‐studies curricula in higher education can be developed and delivered collaboratively by both library and academic staff. This can have very positive effects on both student perceptions and experiences and standards of teaching and learning.
Information needs of United Kingdom primary care clinicians1
Authors: Swinglehurst Deborah A. 
Published: August 2005

AbstractBackground:  The scope of primary care makes knowledge management in this context very challenging, especially as access to information increases and the role of primary care within the NHS expands.Objectives:  This paper reviews the literature on the information needs of primary care clinicians to enable evidence‐based decision making. Drawing on the literature, and using a specific example of a clinical informaticist service, some lessons are drawn on the role of information professionals in facilitating evidence‐based health care.Methods:  Literature review. Case study of clinical informaticist service.Conclusions:  There are numerous barriers to clinicians engaging with evidence‐based practice. However, providing evidence‐based information to clinicians’ questions in a user‐friendly format has the potential to facilitate changes in practice. The successful implementation of information services requires attention to both academic and service dimensions, fostering closer working relationships between clinicians and information professionals.
Australian occupational therapists' use of an online evidence‐based practice database (OTseeker)
Authors: McKenna Kryss , Bennett Sally , Dierselhuis Zoe , Hoffmann Tammy , Tooth Leigh , McCluskey Annie 
Published: August 2005

AbstractIntroduction:  Online databases can support the implementation of evidence‐based practice by providing easy access to research. OTseeker (http://www.otseeker.com), an electronic evidence database, was introduced in 2003 to assist occupational therapists to locate and interpret research.Objectives:  This study explored Australian occupational therapists’ use and perceptions of OTseeker and its impact on their knowledge and practice.Methods:  A postal survey questionnaire was distributed to two samples: (i) a proportionate random sample of 400 occupational therapists from all states and territories of Australia, and (ii) a random sample of occupational therapists working in 95 facilities in two Australian states (Queensland and New South Wales).Results:  The questionnaire was completed by 213 participants. While most participants (85.9%) had heard of OTseeker, only 103 (56.6%) had accessed it, with lack of time being the main reason for non‐use. Of the 103 participants who had accessed OTseeker, 68.9% had done so infrequently, 63.1% agreed that it had increased their knowledge and 13.6% had changed their practice after accessing information on OTseeker.Conclusion:  Despite OTseeker being developed to provide occupational therapists with easy access to research, lack of time was the main reason why over half of the participants in this study had not accessed it. This exploratory research suggests, however, that there is potential for the database to influence occupational therapists’ knowledge and practice about treatment efficacy through access to the research literature.
Acetaminophen, Aspirin, and Caffeine Versus Sumatriptan Succinate in the Early Treatment of Migraine: Results From the ASSET trial
Authors: Goldstein Jerome , Silberstein Stephen D. , Saper Joel R. , Elkind Arthur H. , Smith Timothy R. , Gallagher R. Michael , Battikha Jean‐Pierre , Hoffman Howard , Baggish Jeffrey 
Published: August 2005

Objective.—To address the need for a rigorous, direct comparison of prescription and over‐the‐counter (OTC) migraine drugs and to expand the database on early treatment of migraine.Background.—Most people who experience migraine use OTC medications to treat their symptoms, but no head‐to‐head clinical trials comparing these agents with prescription migraine therapies have been published. In addition, even though most migraineurs treat early in the attack, few studies have been conducted to reflect this treatment pattern.Methods.—We compared a combination of nonprescription migraine medication (acetaminophen 500 mg, aspirin 500 mg, and caffeine 130 mg) with a prescription migraine product (50 mg sumatriptan) in a randomized, controlled clinical trial in which subjects treated at the first sign of a migraine attack. Subjects who reported vomiting during more than 20% of migraine episodes or who required bedrest during more than 50% of migraine episodes were excluded from the study. Of the 188 subjects randomized, 171 took study medication and were included in the analysis.Conclusion.—The combination of acetaminophen, aspirin, and caffeine was significantly more effective (P > .05) than sumatriptan in the early treatment of migraine, as shown by superiority in summed pain intensity difference, pain relief, pain intensity difference, response, sustained response, relief of associated symptoms, use of rescue medication, disability relief, and global assessments of effectiveness. An additional, larger clinical trial is needed to confirm these results.