bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non‐somatic effects of patient aggression on nurses: a systematic review
Authors: Needham Ian , Abderhalden Christopher , Halfens Ruud J.G. , Fischer Joachim E. , Dassen Theo 
Published: January 2005

Aim.  This paper describes a systematic review of the predominant non‐somatic effects of patient assault on nurses.Background.  Patient aggression towards nurses is a longstanding problem in most nursing domains. Although reports on the consequences of physical aggression are more numerous, the non‐physical effects create much suffering.Method.  A systematic review of literature from 1983 to May 2003 was conducted using the Medline, CINAHL, PsychINFO and PSYINDEX databases. Articles from international journals in English or German and reporting at least three non‐somatic responses to patient aggression were included.Findings.  The electronic search produced 6616 articles. After application of the inclusion and exclusion criteria, 25 texts from eight countries and four domains of nursing remained. Twenty‐eight main effects were found, and these were categorized using a system suggested by Lanza and including bio‐physiological, emotional, cognitive, and social dimensions. The predominant responses were anger, fear or anxiety, post‐traumatic stress disorder symptoms, guilt, self‐blame, and shame. These main effects occurred across most countries and nursing domains.Conclusion.  Despite differing countries, cultures, research designs and settings, nurses’ responses to patient aggression are similar. Standardized questionnaires could help improve estimations of the real prevalence of non‐somatic effects. Given the suffering caused by non‐somatic effects, research should be aimed at preventing patient aggression and at developing better ways to prepare nurses to cope with this problem.
Changes in community nursing in Australia: 1995–2000
Authors: Kemp Lynn A. , Harris Elizabeth , Comino Elizabeth J. 
Published: January 2005

Aim.  This paper reports a study whose aim was to examine the congruence between community nurses’ perceptions and the realities of changes in their work.Background.  There have been increasing challenges to the delivery of community nursing services in Australia over the past decade. Acute care sector changes and the recent focus on health promotion, prevention, early identification and intervention adds pressure and creates tensions for community nurses, which are well‐documented in the literature. There is, however, a lack of empirical evidence of actual changes in community nurses’ workloads and the focus of their work. Validation of nurses’ perceptions would enable them to have a stronger voice in the future development of community health care.Methods.  Four sources of data were used: community health client administrative data 1995–2000; occasions of service data 1995–2000; staffing numbers 1998–2001; and interviews with 14 community nurses in late 2001.Results.  Documentary evidence shows that there has been a large increase in the number of adult clients, and all clients are increasingly receiving a shorter, more intensive, clinically focussed service and are then discharged from care, rather than receiving a lower intensity service over a longer period of time. Staffing numbers have not increased to match this higher acuity and intensity. These changes were echoed by the nurses, who reported that expanded acute care roles were impacting on their workload and resulting in a loss of holistic primary health care focus. There has been a lack of leadership and proactive planning by community nurses in response to these changes.Conclusion.  Community health care in Australia is shifting from primary to short‐term clinical care. Greater opportunities for community nurses to engage proactively in defining and promoting their role in the health care system are needed in order to ensure an appropriate balance of acute clinical and holistic primary health care in the community.
Effects of nateglinide on myocardial microvascular reactivity in Type 2 diabetes mellitus – a randomized study using positron emission tomography
Authors: Bengel F. M. , Abletshauser C. , Neverve J. , Schnell O. , Nekolla S. G. , Standl E. , Schwaiger M. 
Published: January 2005

AbstractAims  To evaluate effects of the oral antidiabetic insulinotropic agent nateglinide on myocardial blood flow (MBF) and microvascular reactivity in Type 2 diabetic patients.Methods  Forty‐seven Type 2 diabetic patients were randomly assigned 2 : 1 to nateglinide 120 mg (t.i.d., n = 33) or placebo (n = 14). At baseline and after 16 weeks of treatment, MBF was quantified using positron emission tomography with N‐13 ammonia at rest, during endothelial‐dependent stimulation by cold pressor test and during adenosine‐mediated vasodilation. Additional blood samples were taken to assess glycaemic control and lipid profile.Results  MBF at rest and during adenosine did not change during the study. The percentage of flow increase from rest during cold pressor test did not improve significantly in the nateglinide group vs. placebo (from 26.1 ± 37.2% to 29.1 ± 27.8% between week 0 to week 16 for nateglinide vs. 14.9 ± 37.1% to 18.1 ± 28.4% for placebo; P = 0.07 for nateglinide when adjusted for higher baseline values). Nateglinide decreased HbA1c by 0.4% (from 7.6 ± 0.9% to 7.2 ± 1.3%) compared to an increase of 0.5% in the placebo group (from 7.9 ± 0.8% to 8.4 ± 1.7%; P = 0.02 for nateglinide). No differences between the two groups were observed in insulin levels and lipid status.Conclusions  Nateglinide neither improved, nor impaired myocardial blood flow in Type 2 diabetic patients. Potential effects on endothelial‐dependent myocardial blood flow remain to be investigated further. Positron emission tomography is a sensitive approach to assess the effects of therapeutic agents on myocardial blood flow in patients with diabetes.
Unchanged incidence of diabetic nephropathy in Type 1 diabetes: a nation‐wide study in Iceland
Authors: Tryggvason G. , Indridason O. S. , Thorsson A. V. , Hreidarsson A. B. , Palsson R. 
Published: January 2005

AbstractAims  Diabetic nephropathy is an uncommon cause of end‐stage renal disease in Iceland in contrast to most industrialized countries. The aim of this study was to examine the incidence of diabetic nephropathy in Iceland.Methods  All patients diagnosed with Type 1 diabetes in Iceland before 1992 were studied retrospectively. Patients diagnosed before age 30, who were insulin dependent from the onset, were defined as having Type 1 diabetes. Diabetic nephropathy was defined as persistent proteinuria measured with a dipstick test (Albustix) on three consecutive clinic visits at least 2 months apart. Patients were followed to the end of year 1998, to their last recorded outpatient visit, or until death. The cumulative incidence of diabetic nephropathy was calculated with the Kaplan–Meier method and presented according to the duration of diabetes divided into 5‐year intervals.Results  A total of 343 patients with Type 1 diabetes were identified. The mean follow‐up period was 20.2 ± 11.4 (mean ± sd) years. Only 9.3% of patients were lost to follow‐up. Sixty‐five patients developed diabetic nephropathy. The cumulative incidence was 22.6% at 20 years and levelled off at 40.3% after approximately 35 years of diabetes duration. No significant changes in cumulative incidence were observed over time. Mean glycated haemoglobin was 8.4% in patients with proteinuria and 7.8% in a group of patients without proteinuria that was matched for age, gender and duration of diabetes (P = 0.04).Conclusions  The cumulative incidence of diabetic nephropathy in Iceland is comparable with previously reported cumulative incidence rates and has remained unchanged. Glycaemic control was significantly better in patients without proteinuria.
Interclinician variation in diabetes foot assessment— a national lottery?
Authors: Thompson L. , Nester C. , Stuart L. , Wiles P. 
Published: January 2005

AbstractAim  The aim was to evaluate variation among clinicians in the outcome of assessments of foot health status and risk status in patients with diabetes.Methods  Seventeen clinicians assessed three patients with diabetes using a standardized assessment form and risk classification system.Results  There was variation among clinicians in all aspects of the assessment; recording basic demographic information; taking a medical history; vascular and neurological assessments. Variation was also evident in the risk categories allocated to each of the three patients.Conclusions  As a consequence of the variation among clinicians in the foot assessment the same patient would have received different care pathways to monitor and manage their foot health depending upon which clinician undertook their initial assessment. We therefore recommend that more attention is placed on training for objective clinical testing, at both pre‐ and postgraduate levels.
Insulin treatment and cardiovascular disease; friend or foe? A point of view
Authors: Muis M. J. , Bots M. L. , Grobbee D. E. , Stolk R. P. 
Published: January 2005

AbstractBackground Several observational studies have shown that higher insulin levels are associated with an increased risk of cardiovascular disease. If higher endogenous insulin levels are causally related to cardiovascular disease, one might expect an increased risk of cardiovascular disease in patients treated with insulin, as this results in high circulating insulin levels. Such risk elevation might counteract the benefits of tight glucose control. Our objective was to explore the relationship between insulin therapy and cardiovascular disease in Type 1 and Type 2 diabetes mellitus using information from available literature.Summary of comment Several experimental studies in animals and humans support the presence of a harmful effect of insulin on the vascular endothelium. In prospective follow‐up studies increased insulin dosage was associated with increased risks of cardiovascular disease, although confounding by indication could not be excluded. Randomized controlled trials in diabetic patients, comparing conventional with intensive glucose‐lowering treatment, although showing a reduction in microvascular disease, showed no significant difference in the incidence of cardiovascular disease. The results with respect to exposure to insulin are, however, difficult to interpret due to insufficient information on exposure to insulin levels as well as confounding by glycaemic control and body mass index. In addition, these studies were not designed to address the question whether higher insulin use relates to increased cardiovascular risk.Conclusion Published research provides conflicting evidence as to whether exposure to high levels of exogenous insulin in diabetes mellitus affects the risk of cardiovascular disease. The currently available studies have a number of serious methodological restraints that limit accurate interpretation and conclusions in this area.
‘Disappearing diabetes’—resolution of apparent Type 1 diabetes in a patient with AIDS and cytomegalovirus (CMV) infection
Authors: Evans E. M. , Nye F. , Beeching N. J. , Gill G. V. 
Published: January 2005

AbstractA 30‐year‐old African female with established acquired immunodeficiency syndrome (AIDS) and no history of diabetes, presented in severe diabetic ketoacidosis (DKA). Blood pH was 6.96, serum bicarbonate 5 mmol/l, plasma glucose (PG) 33.0 mmol/l, and urine heavily positive for ketones. She responded to standard treatment and was established on twice‐daily subcutaneous insulin. Four months later her insulin was stopped because of hypoglycaemic attacks on small doses. A glucose tolerance test (GTT) at 6 months postdiagnosis was normal (fasting PG 4.4 mmol/l and 2 h PG 7.5 mmol/l), and at 12 months random PG was 4.1 mmol/l and HbA1c 4.3%. The onset of her apparent Type 1 diabetes coincided with an HIV‐associated cytomegalovirus (CMV) infection, and a reversible ‘CMV insulitis’ may be an explanation. Alternatively, the patient may have had what has recently been described as ‘atypical diabetes’ in African or Afro‐Caribbean diabetic patients. Here resolution of diabetes may occur after presentation, though complete return to normoglycaemia after true DKA is very unusual.
Effects of Widespread Fish Introductions on Paedomorphic Newts in Europe
Authors: DENOEL MATHIEU , DZUKIC GEORG , KALEZIC MILOS L. 
Published: January 2005

Abstract:  As a result of factors such as global warming, habitat destruction, and species introduction, amphibians are declining worldwide. No one, however, has analyzed the status of polymorphic amphibian species at a national or continental scale, although some local reports exist. Our aim was to report on the loss of intraspecific heterochrony as a loss to diversity in determining the consequences of fish stocking on European populations of paedomorphic newts. Paedomorphosis is a polymorphism in which larval traits are retained in the adult stage. We surveyed 39 paedomorphic populations of the alpine (
Triturus alpestris) and palmate (T. helveticus) newts, all but one of which initially occupied fishless ponds and lakes in France, Italy, Slovenia, Bosnia, Montenegro, and Greece. Exotic fishes were found in 44% of the studied aquatic habitats, with a 100% presence in Montenegro. At all sites paedomorphs disappeared and metamorphs declined. Only fish explained these population changes because alternative factors such as drying were not significant. More catastrophically, fish introductions occurred in habitats known to support the largest populations of newts and even some endemic subspecies. If management and legislative measures are not taken to stop fish stocking, protect paedomorphs as conservation units at national and international levels, and restore natural habitats, all the largest paedomorphic populations may disappear in the near future. Their disappearance would represent a loss of one of the rare, fascinating examples of intraspecific heterochrony.
Contact Sensitization in 1094 Children Undergoing Patch Testing over a 7‐Year Period
Authors: Seidenari Stefania , Giusti Francesca , Pepe Patrizia , Mantovani Lucia 
Published: January 2005

Abstract:  Contact sensitization in children is frequent. However, because exposure to sensitizing agents varies rapidly, it is of utmost importance to perform a periodic evaluation of patch test results. Our purpose was to compare our data on contact sensitization in children during the past 7 years to our previous 1988–1994 findings, in order to identify emerging allergens and update our pediatric series. From 1995 to 2001, 1094 consecutive children were examined. Of these, 997 patients were patch tested with our pediatric series, which includes 30 allergens, whereas 97 underwent patch testing with 46 allergens. A total of 570 children proved allergic (52.1%). The highest sensitization rate was observed in children under 3 years of age. No differences between atopic dermatitis patients and nonatopic ones were observed in the sensitization rate. Neomycin, nickel, wool alcohols, thimerosal, and ammoniated mercury gave most of the positive responses. With respect to 1988–1995 data, allergy to substances such as neomycin, nickel, wool alcohols, thimerosal, ammoniated mercury, propolis, potassium dichromate, and thiuram mix proved more frequent. In conclusion, as sensitization rates to different allergens show great variations over time, periodic evaluations of patch test results in children is necessary in order to update the test trays.
Alagille Syndrome: Cutaneous Manifestations in 38 Children
Authors: Garcia Maria Amelia , Margarita Ramonet , Mirta Ciocca , Hugo Cabrera , Pablo Lapunzina , Estela Alvarez , De Davila Maria Teresa 
Published: January 2005

Abstract:  The Alagille syndrome is one of the most common inherited disorders causing chronic liver disease during childhood. During the 1990s, 38 children with Alagille syndrome were evaluated at two pediatric centers in Buenos Aires, Argentina. Characteristic clinical, humoral, and cutaneous features were analyzed. The average age of diagnosis was 29 months old (range of between 2 months and 15 years). Cholestasis was evident in 92% of patients during the neonatal period. Family antecedents related to the syndrome were found in 18.5% of the patients. Peculiar facies developed in 85% of patients. Chronic cholestasis and pruritus were observed in all of the patients and jaundice was evident in 78%. Eighty‐four percent of the patients had heart disease (pulmonary stenosis, intraauricular communication, intraventricular communication), 76% of them showed growth retardation, and vertebrae abnormalities were found in 63%. Embryotoxon appeared in 76% of patients, and renal disturbances in 21%. Eleven children (28%) had xanthomas, in the neck, elbows, palms, helixes, inguinal area, gluteus, and knees. The earliest findings appeared in the first months of life, and the latest at 5 years of age. The xanthomas located in the folds had a stony aspect. Cholesterol levels ranging from 220 to 1600 mg percentage (mg%) were demonstrated in all of the children with xanthomas. Liver transplantation was performed in seven of the patients (18.4%). Two of them died after this operation. The disappearance of xanthomas after transplantation was remarkable in all of the patients.
Audiovisual touch‐screen computer‐assisted self‐interviewing for donor health histories: results from two years experience with the system
Authors: Katz Louis M. , Cumming Paul D. , Wallace Edward L. , Abrams Philip S. 
Published: January 2005

BACKGROUND:  The donor history interview is an important aspect of blood safety, in part designed to identify unsuitable donors who may present a risk to blood recipients. There is evidence from behavioral science literature that use of computer‐assisted interviewing may be superior to face‐to‐face (FTF) and paper techniques in eliciting sensitive behavioral information of interest to blood collection facilities.STUDY DESIGN AND METHODS:  Audiovisual touch‐screen computer‐assisted donor self‐interviewing with the AABB Uniform Donor History Questionnaire was deployed for routine use in a regional blood center replacing FTF interviews. Donor and staff perception and satisfaction surveys were performed to assess acceptance of the system. Time studies of automated and manual methods were conducted. Rates of deferral of first‐time donors for high‐risk behaviors and rates of errors and omissions on donor interviewing for the two systems were tabulated and compared.RESULTS:  Donors and staff strongly preferred the automated system in all dimensions assessed. Donor time increased by 4 minutes but staff time declined by 5 minutes per interview. Identification of high‐risk behaviors among first‐time donors significantly increased. Rates of errors and omissions on donor history forms identified at audit were reduced.CONCLUSIONS:  Both blood donors and collections staff enthusiastically accepted the automated donor interviewing system. A well‐designed audiovisual touch‐screen donor self‐interviewing system is superior to face‐to‐face interviewing and most likely more effective than paper interviewing.
The influence of human platelet antigen match on the success of allogeneic peripheral blood progenitor cell transplantation following a reduced‐intensity conditioning regimen
Authors: Leitner Gerda C. , Stiegler Gabriele , Kalhs Peter , Greinix Hildegard T. , Rabitsch Werner , Sillaber Christian , Hoecker Paul , Panzer Simon 
Published: January 2005

BACKGROUND:  Allogeneic transplantation in elderly patients requires a dose‐reduced conditioning regimen. Owing to reduced‐intensity conditioning, host‐ and donor‐type immune responses may affect the early posttransplant period, whereas only later on donor‐derived reactions may ensue. Mismatches in the HLA system are known to be detrimental for the outcome of transplantation. Mismatches between donor and recipient for human platelet antigens (HPAs) may also affect the success of transplantation owing to serving as minor histocompatibility antigens and therefore rendering recipients at risk for graft‐versus‐host disease (GVHD) or graft rejection and inhibition of thrombopoiesis attributed to platelet (PLT) antibodies.PATIENTS AND METHODS:  Therefore, the occurrence of GVHD, incidence of relapse, need of PLT support, and outcome by analysis of 45 donor‐recipient pairs for HPA‐1, ‐2, ‐3, and ‐5 allotypes and screening for PLT antibodies were evaluated before transplantation and again 1 year thereafter.RESULTS:  Mismatches within the HPA system were not associated with an increased occurrence of transplant‐related mortality or GVHD, the onset of thrombopoiesis, the frequency of PLT transfusions, or the incidence of relapse. Neither were settings of homozygous donors versus heterozygous recipients (graft‐vs.‐host direction) nor homozygous recipients versus heterozygous donors (host‐vs.‐graft direction) associated with any adverse effects on the outcome of the transplantation.CONCLUSION:  Thus, the HPA match does not affect the outcome of transplantation after reduced‐intensity conditioning.
Impact of donor‐ and collection‐related variables on product quality in ex utero cord blood banking
Authors: Askari Sabeen , Miller John , Chrysler Gayl , McCullough Jeffrey 
Published: January 2005

BACKGROUND:  Optimizing product quality is a current focus in cord blood banking. This study evaluates the role of selected donor‐ and collection‐related variables.STUDY DESIGN AND METHODS:  Retrospective review was performed of cord blood units (CBUs) collected ex utero between February 1, 2000, and February 28, 2002. Preprocessing volume and total nucleated cell (TNC) counts and postprocessing CD34 cell counts were used as product quality indicators.RESULTS:  Of 2084 CBUs, volume determinations and TNC counts were performed on 1628 and CD34+ counts on 1124 CBUs. Mean volume and TNC and CD34+ counts were 85.2 mL, 118.9 × 107, and 5.2 × 106, respectively. In univariate analysis, placental weight of greater than 500 g and meconium in amniotic fluid correlated with better volume and TNC and CD34+ counts. Greater than 40 weeks’ gestation predicted enhanced volume and TNC count. Cesarean section, two‐ versus one‐person collection, and not greater than 5 minutes between placental delivery and collection produced superior volume. Increased TNC count was also seen in Caucasian women, primigravidae, female newborns, and collection duration of more than 5 minutes. A time between delivery of newborn and placenta of not greater than 10 minutes predicted better volume and CD34+ count. By regression analysis, collection within not greater than 5 minutes of placental delivery produced superior volume and TNC count.CONCLUSION:  Donor selection and collection technique modifications may improve product quality. TNC count appears to be more affected by different variables than CD34+ count.