bluuebunny/crossref_metadata_2025_split huggingface dataset:
Re‐thinking family‐centred care across the continuum of children's healthcare
Authors: Franck L. S. , Callery P. 
Published: April 2004

AbstractBackground  The terms family‐centred care (FCC) and family‐centred services (FCS) are used interchangeably across the continuum of children's healthcare to encompass concepts of: parental participation in children's healthcare; partnership and collaboration between the healthcare team and parents in decision‐making; family‐friendly environments that normalize as much as possible family functioning within the healthcare setting; and care of family members as well as of children. However, authors from different professional and policy perspectives have used different definitions and literatures when arguing the evidence for FCC and FCS.Method  A critical literature review and theoretical discussion exploring common concepts and issues forming the basis for a research agenda further strengthening of the evidence base for FCC. A systematic identification of constructs, concepts and empirical indicators is developed and applied to exemplars in pain and asthma that span the continuum of children's healthcare across acute and community settings.Conclusions  The extent to which the concepts are supported by research and applied in practice remains unclear. We propose that re‐thinking of FCC is required in order to develop a more coherent programme of research into the application of FCC theory in children's healthcare.
Prevalence of Eimeria spp. in Sows at Piglet‐producing Farms in Germany
Authors: Daugschies A. , Imarom S. , Ganter M. , Bollwahn W. 
Published: April 2004

SummaryThe prevalence of Eimeria infections was investigated in an initial survey in 54 sow herds of small (five sows) to large (1600 sows) size by random sampling (n = 1204). All sows of four Eimeria‐positive medium‐sized farms (63 or 130 sows) were re‐examined 40–99 days after the first visit. A follow‐up survey over the whole reproductive cycle was subsequently performed in a positive herd of 130 animals where faecal samples of 43 sows were repeatedly collected on seven successive farm visits. In 44 farms (81.5%) parasite stages (eggs of strongylids, Trichuris, Ascaris, Strongyloides, oocysts of Eimeria and Isospora) were identified in sow faeces, strongylids being the most prevalent intestinal parasites (34 farms resembling 63%) followed by Eimeria spp. (28 farms resembling 52%). Of the 1204 random samples collected during the initial survey 8.6% contained Eimeria oocysts. Oocysts of E. polita and E. debliecki were present in each of 25 Eimeria‐positive samples selected for species differentiation. Eimeria suis was diagnosed in 84%, E. scabra in 60%, E. porci in 52%, E. perminuta in 49% and E. spinosa in 20% of these specimens. At the second visit the prevalence rates of Eimeria infections had either increased or decreased. In the follow‐up study Eimeria infections were found to be most frequent (82%) at the service station. At the quarantine unit and the gestation stable 50 and 48% of the 43 sows were Eimeria positive. The lowest prevalence of Eimeria infection was observed in the farrowing unit (14%). With respect to the reproductive state of the sows highest infection rates were seen 2 weeks after weaning (72%) continuously decreasing until 2 weeks after farrowing (14%). A periparturient rise of oocyst excretion was not observed. The infestation rate remained low until 1 week before weaning (16%). Low infection intensities clearly dominated. Clinical disease was not associated with Eimeria infection.
G and P Genotypes of Group A Rotavirus from Diarrhoeic Calves Born to Cows Vaccinated against the NCDV (P[1],G6) Rotavirus Strain
Authors: Barreiros M. A. B. , Alfieri A. F. , Médici K. C. , Leite J. P. G. , Alfieri A. A. 
Published: April 2004

SummaryA total of 71 group A rotavirus field strains, detected by polyacrylamide gel electrophoresis and enzyme immune assay, were submitted to genotyping by a multiplex nested‐reverse transcription‐polymerase chain reaction (RT‐PCR). Faecal samples were obtained from calves with diarrhoea, between January 2000 and December 2001, from 14 dairy and beef cattle herds located in Mato Grosso do Sul, São Paulo and Paraná States, Brazil. Thirty‐five rotavirus field strains were detected in faeces from calves born to vaccinated dams with inactivated commercial vaccine containing the rotavirus strain P[1],G6 from seven herds while 36 rotavirus field strains were obtained from diarrhoeic calves from other seven herds without rotavirus vaccination. Identification of P and G rotavirus genotypes was possible in 94.3% (67/71) of the strains. However, G genotype could not be identified in two strains, P genotype in another strain and both genotypes were not detected in a third strain. P and G rotavirus genotype associations were identified in rotavirus field strains from non‐vaccinated and vaccinated herds at similar rates of 94.4% (34/36) and 94.3% (33/35), respectively. In non‐vaccinated herds binary combinations were P[1],G6 (three herds; 12 strains), P[1],G8 (three herds; six strains), P[5],G6 (two herds; 10 strains) and P[11],G8 (one herd; four strains). The genotype P[11],G6 was the most frequent (three herds; 12 strains) in vaccinated herds, followed by P[5],G6 (two herds; three strains), and P[11],G8 (two herds; eight strains). Mixed infections were observed in one non‐vaccinated herd (two strains) and in four vaccinated herds (10 strains). Identification of binary combinations was not possible in one strain from non‐vaccinated herds and two strains from vaccinated herds. Unusual genotypes were more frequent (91.4%) in non‐vaccinated herds than those from prototypes of bovine rotavirus strains. Nebraska calf diarrhoea virus (NCDV)‐like genotype was found in none of the rotavirus field strains detected in diarrhoeic calves born of vaccinated dams.
Growth of Streptococcus uberis in Skim Milk Obtained from Holstein and Jersey Dairy Cows During Different Stages of Lactation
Authors: Rambeaud M. , Almeida R. A. , Oliver S. P. 
Published: April 2004

SummaryA study was conducted to determine if skim milk obtained from uninfected mammary glands of healthy Holstein and Jersey dairy cows during different stages of lactation influenced in vitro growth of Streptococcus uberis. Three strains of S. uberis (UT366, UT387 and UT888) were used to evaluate growth of S. uberis in skim milk from Jersey (n = 16) and Holstein (n = 15) cows in early (n = 11 cows), mid‐ (n = 8 cows) or late lactation (n = 12 cows). Growth of S. uberis in skim milk from Holstein and Jersey cows was similar (P = 0.385). However, growth of S. uberis was significantly lower in skim milk from mammary glands of cows obtained at mid‐ and late lactation compared with growth in skim milk obtained during early lactation (P = 0.007). Variation (P < 0.0001) in growth among different strains of S. uberis as well as a significant (P < 0.0001) stage of lactation by S. uberis strain interaction was observed. Results of this study provide evidence concerning the variability of S. uberis growth in skim milk obtained during different stages of lactation. Differences in the ability of S. uberis to grow in milk may be related to virulence of this important mastitis pathogen.
The effect of diverticular disease on the colonic J pouch
Authors: Da Silva G. M. , Kaiser R. , Börjesson L. , Colqhoun P. , Lobo C. , Khandwala F. , Thornton J. , Efron J. , Vernava A. M. , Weiss E. G. , Wexner S. D. , Gervaz P. , Nogueras J. J. 
Published: April 2004

AbstractObjective  The aim of this study was to assess the impact of the diverticular disease (DD) on function and on postoperative complications of the colonic J‐pouch (CJP) with pouch‐anal anastomosis.Methods  Patients who underwent a CJP between December 1990 and August 2001, were retrospectively reviewed. The presence of DD in the CJP was assessed on pouchogram prior to ileostomy closure. A questionnaire designed to evaluate the degree of continence (total incontinence score (IS): 0 = worst, 20 = best) and pouch evacuation (total evacuation score (ES): 0 = worst, 28 = best) was used for comparison between patients with DD and those without DD (NDD).Results  Sixty‐six patients (47 males; 19 females) with a median age of 68 years (range 28–87 years) were included. The median follow‐up period was 22 months (range 2–106 months). Twenty‐four patients comprised the DD group and 42 were in the NDD group. The two groups were comparable for age, gender and time from ileostomy closure; all patients with postoperative chemoradiation therapy were in the NDD group. The total ES and IS total did not significantly differ between the two groups with a P‐value of 0.11 and 0.09 respectively. Furthermore, there was no significant difference in the total incidence of pouch complications between the two groups (3 strictures, 1 leak, 1 fistula in the NDD group vs. 1 pelvic sepsis in the DD group; P = 0.4).Conclusions  The presence of DD in a CJP does not seem to impact pouch function or the postoperative complication rate.
Surgery for occult rectal prolapse
Authors: Brown A. J. , Anderson J. H. , McKee R. F. , Finlay I. G. 
Published: April 2004

AbstractObjective  An ‘occult’ rectal prolapse may be diagnosed during investigation of altered bowel habit. It has been suggested that the outcome of surgery for these patients may be associated with results that are inferior to those achieved in patients with overt rectal prolapse. This study compares the results of surgery for ‘occult’ and overt rectal prolapse in terms of mortality, morbidity and change in bowel habit.Patients and methods  A retrospective review was undertaken of consecutive patients undergoing surgery for rectal prolapse during the decade 1988–98. Resection rectopexy was the treatment of choice except in patients with faecal incontinence who underwent sutured rectopexy. Those patients who were unfit for an abdominal operation were offered a perineal procedure. Outcome measures were mortality, morbidity, prolapse recurrence, constipation and faecal incontinence. Data were retrieved from case note review, clinical assessment, telephone consultation or postal questionnaire.Results  Rectal prolapse surgery was undertaken in 69 patients with an overt prolapse and 74 patients with an ‘occult’ prolapse. Patients in the ‘occult’ prolapse group were significantly younger than those with overt prolapse (P = 0.0002). There were significantly more perineal procedures in the overt prolapse group compared with the ‘occult’ prolapse group (54%vs 5%, P = 0.0001). There were no deaths within 28 days of surgery. Major surgical complications occurred in 5 patients (3.5%). Seven patients (10%) experienced recurrent prolapse. Rectal prolapse surgery reduced the incidence of St. Mark's grade 4 faecal incontinence from 38% to 19% in the overt prolapse group (P = 0.023) and from 49% to 22% in the ‘occult’ prolapse group (P < 0.001). Following surgery the incidence of constipation increased in the ‘occult’ group from 39% to 50% but decreased in the overt prolapse group from 42% to 35%.Conclusions  Surgery for an ‘occult’ rectal prolapse is unlikely to benefit patients whose principle symptom is constipation. Approximately half of those patients whose ‘occult’ rectal prolapse is associated with faecal incontinence will have their bowel habit improved by prolapse surgery.
Colorectal cancer in the young: a 12‐year review of patients 30 years or less
Authors: Kam M. H. , Eu K. W. , Barben C. P. , Seow‐Choen F. 
Published: April 2004

AbstractObjectives  As the incidence of young colorectal cancer is rising, a review of the characteristics of such malignancy in those under 30 years of age is timely at this stage.Patients and methods  Thirty‐nine patients (21 M, 18 F) were operated upon over a 12‐year period in a single centre. The mean age was 25 years and median follow‐up was 20 months.Results  Rectal bleeding, change in bowel habit and abdominal pain were the commonest symptoms. Six patients had a positive family history, while four others were diagnosed as index cases of familial adenomatous polyposis. Rectal tumours made up 43% of all colorectal cancers diagnosed. Seventy percent of patients presented at an advanced stage, but curative resection was attempted for 29 patients. Eight underwent palliative resections, 1 had an ileostomy while another underwent a bypass procedure. Eleven patients have died, 14 had no evidence of recurrent disease while 3 were still alive with recurrent disease.Conclusion  Age does not affect survival, and early endoscopy is recommended for all with persistent symptoms. Early diagnosis, radical resection and adjuvant therapy still form the cornerstone in management of colorectal cancer in this age group.
Small bowel malignancies: A review of 29 patients at a single centre
Authors: Kam M. H. , Barben C. P. , Eu K. W. , Seow‐Choen F. 
Published: April 2004

AbstractObjective  We analysed the incidence, clinical presentation and outcome of small bowel malignancies treated in the department.Patients and methods  From July 1993 to December 2001, 29 patients with small bowel malignancies were operated upon. The median age was 60 years (30–87 years), and there were 11 males and 18 females. The more frequently used diagnostic investigations included barium contrast studies, and CT scanning.Results  The most frequent complaint was abdominal pain, though other symptoms like abdominal mass, weight loss and change in bowel habit may also be present. Intestinal obstruction necessitated emergency operation in some cases. One case was treated as Crohn's stricture and two others, as irritable bowel syndrome for nearly 6 months before referral was made for surgery. Fifteen cases were secondaries to the small bowel, and forteen were primary small bowel malignancies. The secondaries were metastases from colorectal cancers (8), gynaecological cancers (5), breast (1) and transitional cell carcinomas (1). Of the 14 primary small bowel malignancies, there were 8 lymphomas, 4 adenocarcinaomas and 2 neuroendocrine tumours. Eleven of these patients were alive at mean follow‐up of 25 months (1–97 months) and 2 were lost to follow‐up. Only one of the secondary small bowel malignancies was alive at the time of review.Conclusion  Small bowel malignancy is a rate entity with pre‐operative diagnosis remaining difficult. Early surgical intervention with a high index of suspicion is required to improve survivial.
Extramammary Paget's disease of the perianal region
Authors: Tulchinsky H. , Zmora O. , Brazowski E. , Goldman G. , Rabau M. 
Published: April 2004

AbstractObjective  Perianal Paget's disease (PPD) is a rare entity. The standard treatment for either in situ or invasive extra mammary Paget's disease (EMPD) is surgical excision. Local recurrence and morbidity from surgery, especially in the elderly, can, however, be high. The aim of this article is to review our experience with PPD and question the currently preferred treatment approaches in light of its histopathology and therapeutic outcome.Patients and methods  A chart review of our patients with PPD from 1996 to 2002 was carried out to determine their outcome after treatment. Data from review of the literature are presented.Results  Five patients with in situ disease (four females, median age 68 years) were diagnosed as having PPD. A complete surgical excision was attempted in 4 patients and the fifth was treated by photodynamic therapy. At present, all patients are alive, two are free of disease, one has persistent disease and two have local recurrence.Conclusion  Considering the significant rate of recurrence even after wide local excision, the extent of surgery needed and the good prognosis with long‐term survival, we question whether nonsurgical modalities should be considered in place of surgery as primary treatment for noninvasive PPD, with radical surgery being reserved for failures or invasive disease.
Survival of rectal cancer patients in Denmark during 1994–99
Authors: Harling H. , Bülow S. , Kronborg O. , Møller L. N. , Jørgensen T. ,   the Danish Colorectal Cancer Group
Published: April 2004

AbstractObjective  As survival from rectal cancer in Denmark is below the European average, we analysed survival during the period of 1994–99 focusing upon improvement strategies.Method  All patients with a first‐time rectal cancer were registered in a national database during this 5‐year period. In the observational cohort study, data on patient age and gender, tumour stage, surgical procedures, adjuvant radiotherapy, anastomotic leakage, 30‐day mortality and long‐term survival were evaluated.Results  The database comprised 5021 patients. Sixty‐four percent had a localized tumour. Less than a third of patients with fixed tumours had pre‐operative radiotherapy and curative surgery was achieved in 70%. Anastomotic leakage occurred in 13%, and 30‐day mortality was 4% following abdominoperineal or anterior resection and 11% following a Hartmann's procedure. The relative 5‐year survival in the entire series was 39% in males and 47% in females, respectively. Following curative surgery the relative 5‐year survival was 55% in males and 63% in females, respectively. Survival was 71% in the subset of patients receiving curative total mesorectal excision.Conclusion  The average tumour stage upon diagnosis was probably more advanced compared to the other Nordic countries and pre‐operative radiotherapy was administered to a minority of patients with fixed tumours. The anastomotic leakage rate was relatively high, whereas the 30‐day mortality was comparable to other studies. Survival from rectal cancer in Denmark is still less favourable compared to the other Nordic and several European countries but improved from 1996 and onwards.
Stapled anopexy for short segment Hirschprungs disease in adults
Authors: Stiven P. H. , Carne P. W. G. , Frizelle F. A. 
Published: April 2004

AbstractTraditional treatment of short segment Hirschprungs disease in adult consists of major resectional procedures, often with the use of a temporary stoma. Patients with this disease may have significant morbidities that increase their risk of post‐operative morbidity and mortality. In an attempt to minimize the procedural related morbidity, we describe the application of the stapled anopexy technique to treat short segment Hirschprungs disease.
Pouchitis
Authors: Macafee D. A. L. , Abercrombie J. F. , Maxwell‐Armstrong C. 
Published: April 2004

AbstractPouchitis is one of the commonest and most debilitating complications of a restorative proctocolectomy. The cause remains elusive, though a number of approaches have been shown to alleviate the condition. This review outlines current evidence relating to pouchitis, obtained from randomised and nonrandomised studies. Medline, the Bath Information Data Service (BIDS) and PubMed were searched using the keywords ‘pouchitis’ and ‘inflammatory bowel disease’. In addition, articles were cross‐referenced, and the abstracts of recent colorectal meetings studied.
Radical Mastectomy in 20 Ruminants
Authors: Cable Christina S. , Peery Kara , Fubini Susan L. 
Published: April 2004

Objective—To describe a surgical technique for radical mastectomy in ruminants and to report experience and outcome in 20 animals.Study Design—Retrospective study.Animals—Seventeen goats and 3 cows.Methods—Medical records of ruminants that had radical mastectomy between June 1, 1987 and June 1, 2003 were reviewed. Follow‐up information was obtained by telephone interview of owners.Results—One animal died within 24 hours from complications of gangrenous mastitis and another died from necrotizing cellulitis. Eighteen animals were discharged and follow‐up information was available for 15 animals; 12 animals lived at least 1 year postoperatively.Conclusions—Ruminants with severe but localized diseases of the udder did well after radical mastectomy. The procedure was well tolerated, made the animals more comfortable, and potentially prolonged their lives as pets.Clinical Relevance—Radical mastectomy can be a safe and effective procedure for ruminants with udder disease, with few complications.
Being Strong: How Black West‐Indian Canadian Women Manage Depression and Its Stigma
Authors: Schreiber Rita , Stern Phyllis Noerager , Wilson Charmaine 
Published: April 2004

Purpose: To discover how women from a nondominant cultural background (West Indian)experience and manage depression.Design: Explanatory using grounded theory.Methods: Semistructured interviews were conducted with 12 Black West‐Indian Canadian women who experienced depression. Between 1994 and 1996, the first author engaged in participant observation.Findings: The women used the basic social process they called “being strong” to manage or ameliorate depression. Being strong included “dwelling on it,”“diverting myself,” and “regaining my composure.” For most of the women, the range of available life choices was limited to the three processes; however, a few engaged in “trying new approaches.” These women were less limited in their range of cultural and behavioral boundaries than were the others, and began tentatively to explore other options for themselves.Conclusions: Black West‐Indian Canadian women in this study managed their depression in culturally defined ways by being strong and not showing vulnerability. Because being strong was also evident in a previous study of dominant‐culture women as a prelude to depression, the process may be widespread in women prone to depression. The findings provide helpful information for intervening in an unfamiliar culture.
An Historical Analysis of Disclosure of Terminal Status
Authors: Krisman‐Scott Mary Ann 
Published: April 2004

Purpose: To examine the concept of disclosure of terminal status and trace its development and implementation over time. An individual's ability to make appropriate end‐of‐life decisions, exert some control over the place and manner of death, and prepare self and significant others for this loss depends on knowing that life is drawing to a close.Organizing Framework: An analysis of disclosure of terminal status was performed within the context of American social, political, and cultural history from 1930 to 1990.Methods: A combination of manual and computerized search mechanisms was performed utilizing popular, nursing, medical, sociological, psychological, and thanatological literature from 1930 to 1990. The articles and books obtained through these searches were scanned and those articles and books that dealt with health care disclosure issues were selected. Works included in the review were 149 articles and 22 books.Findings: A long‐standing tradition of nondisclosure exists in the medical profession. Societal events in the 1950s and 1960s influenced individuals' perceptions of death, individual rights, and physician responsibility, and culminated in some change in this tradition in the 1970s. The magnitude of this change is unknown. Current practice has not been investigated. This topic is rarely addressed in nursing literature even though nursing care is influenced by physicians' practice.Conclusions: A tradition of nondisclosure prohibits patients from managing the end of their lives and making choices about their manner of death. Nursing care of terminally ill patients is compromised when patients are uninformed.