bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of a new rapid immunoassay for the detection of Helicobacter pylori in faeces: a prospective pilot study
Authors: Trevisani L. , Sartori S. , Rossi M. R. , Ruina M. , Matarese V. , Gullini S. , Abbasciano V. 
Published: February 2005

SummaryBackground : Detection of Helicobacter pylori antigen in faeces is a valid method to diagnose H. pylori infection. Presently available stool tests are performed in the laboratory, and diagnostic report is delayed.Aim : To evaluate a new rapid stool test in a pre‐treatment setting and to compare it with a validated laboratory stool test.Methods : A total of 105 patients underwent gastroscopy with brush cytology, and biopsies for histology and rapid urease test, to assess H. pylori presence. Helicobacter pylori‐status was considered positive if at least two tests were positive; negative if all tests were negative; indeterminate if one test was positive and two negative. Stool specimens were tested using either a rapid immunoassay kit (ImmunoCard STAT) or a laboratory enzyme immunoassay kit (Hp StAR).Results : Sixty patients were infected with H. pylori, 44 non‐infected, one indeterminate. The sensitivity and specificity of ImmunoCard STAT were 85 and 93%; those of Hp StAR were 88 and 100% (not significant).Conclusions : ImmunoCard STAT seems a reliable method for detecting H. pylori in untreated patients. It could replace laboratory stool tests, as it is easy and can be performed quickly. These characteristics might be a breakthrough for diagnosing H. pylori in the doctor's office.
Capacity to make financial decisions among people with mild intellectual disabilities
Authors: Suto W. M. I. , Clare I. C. H. , Holland A. J. , Watson P. C. 
Published: February 2005

AbstractBackground Although there has been growing recognition of the importance of enabling people with intellectual disabilities (ID) to be more directly involved in managing their own financial affairs, so far, little is known about this aspect of their decision‐ making.Method Using vignettes and semi‐structured interviews, the financial decision‐making abilities of men and women with mild ID (n = 30; mean FSIQ = 61.80; SD = 10.59) were compared with those of their counterparts in the ‘general population’ (n = 16; mean FSIQ = 101.56; SD = 7.62) and ‘very able’ individuals (n = 14; mean FSIQ = 123.93; SD = 7.60).Results Whilst the financial decision‐making abilities of participants with ID were generally weaker than those of other participants, the differences were not discrete, and many individuals were judged to be able to make at least some personal financial decisions. For all three groups, understanding information relevant to the decision, and reasoning with it, were the hardest parts of the process.Conclusions The findings support a functional approach to the assessment of financial decision‐making for both legal and clinical purposes, but raise concerns about mental incapacity legislation and assessment.
Social outcomes in adulthood of children with intellectual impairment: evidence from a birth cohort
Authors: Hall I. , Strydom A. , Richards M. , Hardy R. , Bernal J. , Wadsworth M. 
Published: February 2005

AbstractBackground  Social Policy for people with intellectual disabilities (ID) continues to evolve, but little is known about the lives to which such policies are applied. We aimed to use a prospective follow‐up of a British birth cohort to identify children with mild and more severe intellectual impairment, and compare a range of social outcomes in adulthood with people in the rest of the cohort.Method  We used data from the MRC National Survey for Health and Development. Intellectual impairment was identified by intelligence tests and educational history. Adult outcome measures included employment and social class, education, marriage and children, home ownership, social networks and community use.Results  We identified 111 people with mild intellectual impairment (2.7%) and 23 with severe intellectual impairment (0.6%) at age 15/16. By the age of 43, there were 52 people remaining in the mild impairment group and 14 in the severe impairment group. In adulthood those with intellectual impairment enjoyed contact with friends and family, and joined in informal social activities. Although the mild intellectual impairment group were less likely to attain the following social outcomes than people with normal intellectual functioning, 67% had jobs, 73% were married, 62% had children and 54% owned their own homes. 12% participated in adult education. People with more severe intellectual impairment were less likely to attain these outcomes.Conclusions  These outcomes highlight issues in current social policy and suggest efforts should be directed particularly towards promoting educational opportunities and developing social inclusion for people with ID.
Wolf–Hirschhorn syndrome – two case‐study reports focusing particularly on long‐term survival
Authors: Lopes O. , Barton G. , Morgan J. 
Published: February 2005

AbstractBackground  The clinical features of this rare chromosomal syndrome are described in two individuals. Our limited knowledge of the natural history of this disorder has made it difficult to counsel parents as well as outline specific treatment and management plans.Method  Interviews were undertaken with subjects, carers and next of kin, and the literature was searched.Results  Pertinent features of the syndrome are reported.Main Conclusions  These two cases highlight that long‐term survival may occur and that accurate diagnosis is paramount so that healthcare professionals are able to provide accurate information.
Enhancing primary health care services for adults with intellectual disabilities
Authors: Melville C. A. , Finlayson J. , Cooper S.‐A. , Allan L. , Robinson N. , Burns E. , Martin G. , Morrison J. 
Published: February 2005

AbstractBackground  Primary health care teams have an important part to play in addressing the health inequalities and high levels of unmet health needs experienced by people with intellectual disabilities (ID). Practice nurses have an expanding role within primary health care teams. However, no previous studies have measured their attitudes, knowledge, training needs, and self‐efficacy in their work with people with ID.Methods  All practice nurses working in a defined area were identified. A purpose‐designed questionnaire to measure nurse attitudes, knowledge, training needs and self‐efficacy was developed and piloted. All practice nurses were then invited to participate. Data from completed questionnaires were entered onto PC and analysed.Results  Of a total of 292 practice nurses 201 (69%) participated. Whilst 89% (n = 179) of participants reported having infrequent contact, 25% (n = 50) reported a growing workload with people with ID. Only 8% (n = 16) had ever received any training in communicating with people with ID. A knowledge gap regarding the health needs of people with ID was identified. Eighty‐six per cent reported having experienced specific difficulties during previous appointments, and only 23% thought they had sufficient case note information at appointments, but 68% did not modify the duration of their appointments with people with ID. Conversely, responses demonstrated that practice nurses have a high level of experience and qualification in general nursing, have positive attitudes to working with people with ID, and high self‐efficacy scores were identified for work with people with ID. The practice nurses viewed ID to be a high priority area for future training.Conclusions  Primary health care teams have a key role in tackling the unmet health needs of people with ID. Whilst this project has identified factors that may impact on the accessibility of services, it has also identified practice nurses as having positive attitudes and high self‐efficacy scores in their work with people with ID. This indicates that they should be targeted for specific training in this area, which may make an important contribution in enhancing future accessibility of primary health care services for people with ID.
The relationships among three factors affecting the financial decision‐making abilities of adults with mild intellectual disabilities
Authors: Suto W. M. I. , Clare I. C. H. , Holland A. J. , Watson P. C. 
Published: February 2005

AbstractBackground Among adults with intellectual disabilities (IDs), there is a need not only to assess financial decision‐making capacity, but also to understand how it can be maximized. Although increased financial independence is a goal for many people, it is essential that individuals’ decision‐making abilities are sufficient, and many factors may affect the development of such abilities.Method As part of a wider project on financial decision‐making, we analysed previous data from a group of 30 adults with mild IDs, identifying correlations among four variables: (i) financial decision‐making abilities; (ii) intellectual ability; (iii) understanding of some basic concepts relevant to finance; and (iv) decision‐making opportunities in everyday life.Results The analysis indicated a direct relationship between ID and basic financial understanding. Strong relationships of a potentially reciprocal nature were identified between basic financial understanding and everyday decision‐making opportunities, and between such opportunities and financial decision‐making abilities.Conclusions The findings suggest that the role of intellectual ability in determining financial decision‐making abilities is only indirect, and that access to both basic skills education and everyday decision‐making opportunities is crucial for maximizing capacity. The implications of this are discussed.
Patients’ perceptions of cultural factors affecting the quality of their medical encounters
Authors: Nápoles‐Springer Anna M. , Santoyo Jasmine , Houston Kathryn , Pérez‐Stable Eliseo J. , Stewart Anita L. 
Published: February 2005

AbstractObjective  The aim of this study was to identify key domains of cultural competence from the perspective of ethnically and linguistically diverse patients.Design  The study involved one‐time focus groups in community settings with 61 African–Americans, 45 Latinos and 55 non‐Latino Whites. Participants’ mean age was 48 years, 45% were women, and 47% had less than a high school education. Participants in 19 groups were asked the meaning of ‘culture’ and what cultural factors influenced the quality of their medical encounters. Each text unit (TU or identifiable continuous verbal utterance) of focus group transcripts was content analysed to identify key dimensions using inductive and deductive methods. The proportion of TUs was calculated for each dimension by ethnic group.Results  Definitions of culture common to all three ethnic groups included value systems (25% of TUs), customs (17%), self‐identified ethnicity (15%), nationality (11%) and stereotypes (4%). Factors influencing the quality of medical encounters common to all ethnic groups included sensitivity to complementary/alternative medicine (17%), health insurance‐based discrimination (12%), social class‐based discrimination (9%), ethnic concordance of physician and patient (8%), and age‐based discrimination (4%). Physicians’ acceptance of the role of spirtuality (2%) and of family (2%), and ethnicity‐based discrimination (11%) were cultural factors specific to non‐Whites. Language issues (21%) and immigration status (5%) were Latino‐specific factors.Conclusions  Providing quality health care to ethnically diverse patients requires cultural flexibility to elicit and respond to cultural factors in medical encounters. Interventions to reduce disparities in health and health care in the USA need to address cultural factors that affect the quality of medical encounters.
Unmet expectations in primary care and the agreement between doctor and patient: a questionnaire study
Authors: Hooper Richard , Rona Roberto J , French Claire , Jones Margaret , Wessely Simon 
Published: February 2005

AbstractBackground  Questionnaires completed respectively by doctor and patient may give conflicting views of what actions the doctor took during a consultation in primary care. This disagreement will affect an assessment of whether patient expectations of care were met, and may itself be influenced by fulfilment of expectations.Objective  To investigate how patient expectations, and patient and doctor reports of doctor's actions in a primary care setting are associated.Design  Questionnaire survey.Setting  Fifty Royal Navy, Army and Royal Air Force medical centres.Participants  A total of 117 members of the British Armed Forces with a health problem identified by a screening questionnaire, and their medical officers.Main outcome measures  Patient and doctor reports following a consultation indicating whether the doctor gave a prescription, made a referral or did tests, and patient expectations of these outcomes.Results  Agreement between patient and doctor (kappa) was 0.81 for prescribing, 0.69 for referral and 0.54 for tests. The prevalence of unmet expectations was higher when estimated from doctors’ reports than from patients’ reports (prescription P = 0.016; referral P = 0.065; tests P = 0.092; difference of 6% in each case). Patient and doctor were more likely to disagree on what happened if the action reported by the doctor did not match the patient's expectations (all P < 0.01, except for when doctor reported doing tests P = 0.058).Conclusion  Whether or not a doctor's actions appear to fulfil patient expectations in a primary care consultation depends on whether those actions are reported by the doctor or the patient.
The OPTION scale: measuring the extent that clinicians involve patients in decision‐making tasks
Authors: Elwyn Glyn , Hutchings Hayley , Edwards Adrian , Rapport Frances , Wensing Michel , Cheung Wai‐Yee , Grol Richard 
Published: February 2005

AbstractObjective  To examine the psychometric properties of a revised scale, named ‘observing patient involvement in decision making’ (OPTION), by analysing its reapplication to a sample of routine primary care consultations. The OPTION instrument assesses to what degree clinicians involve patients in decision making.Design  Cross‐sectional assessment of medical interaction by two calibrated raters.Setting  Primary care.Participants  Twenty‐one general practitioners provided 186 consultations for assessment.Measurements  Observational score using the OPTION instrument.Results  Compared with the first version of the OPTION scale, the revised scale that uses a magnitude instead of an attitude scale, when applied to the same data set, resulted in improvement in the scale's reliability and to lower scores for the levels of involvement achieved by the practitioners. Factor analysis confirms that it is acceptable to regard the scale as a single construct. Although there is moderate variability when raters are assessed on an item by item basis, the agreements between raters at the level of the overall OPTION score is high (the intraclass correlation coefficient scores for total OPTION score was 0.77), a level that is acceptable for the evaluation of a set of consultations per practitioner (e.g. between 5 and 10 consultations), where aggregate scores would be used for determining overall performance.Conclusions  We conclude that OPTION is sufficiently reliable to be used for formal assessment at the level of the whole instrument (all 12 items).
Developing an assessment tool for evaluating community involvement
Authors: South Jane , Fairfax Pat , Green Eleanor 
Published: February 2005

AbstractBackground  Current UK policy has resulted in greater requirements for public and patient participation in health service planning and decision making. Organizations and services need to be able to monitor and evaluate the effectiveness and quality of their community involvement processes, but there are few appropriate evaluation tools or sets of indicators available. This paper reports on work within Bradford Health Action Zone to develop a self‐assessment tool for organizations on community involvement.Methods  A multi‐agency working group developed the tool. A literature search was undertaken and evaluation resources were reviewed. A set of benchmarks for community involvement in regeneration was utilized in developing the assessment areas. A range of individuals with expertise on community involvement practice and performance management was consulted. The tool was then piloted in two primary care trusts prior to final modifications.Results  The process resulted in the production of Well Connected – a self‐assessment tool on community involvement designed for organizations to assess their progress and identify areas for improvement. A scoring system assesses evidence of a strategic approach to community involvement, good practice throughout the organization, and a range of opportunities and support. Feedback from the pilots revealed that the tool had facilitated assessment of the strengths and weaknesses of organizational practices.Conclusion  The paper discusses some of the methodological challenges pertaining to the measurement of community involvement. Notwithstanding those challenges, it is argued that Well Connected provides a robust and practical framework that health organizations and their partners can use to assess practice.
Physicians’ opinions on patients’ requests for specific treatments and examinations
Authors: Toiviainen Hanna K , Vuorenkoski Lauri , Hemminki Elina 
Published: February 2005

AbstractObjective  The number of technologies used in health care is growing, patients’ educational level has risen, health and drug information is increasingly available and patients today are actively looking for information from different sources. The aim of the study was to investigate physicians’ opinions on patients’ requests for specific treatments and examinations.Design  The data were gathered as part of an annual physician's survey sent to all Finnish physicians (n = 16 698) by the Finnish Medical Association in March 2002. The response rate was 85% (n = 14 157). Physicians involved in clinical work were selected for this study (n = 12 255).Results  Half (53%, n = 6521) of the clinicians reported either ‘very often’, or ‘often’ receiving requests from patients for specific treatments or examinations, and of them, 76% (n = 4972) reported an increase in such requests. The younger clinicians received more often patient requests. Women physicians, those working in health centres, and non‐specialized clinicians reported more experience of, and an increase in patients making requests. Of those clinicians who received patient requests ‘very often’ or ‘often’, 24% (n = 1595) considered such requests as having a positive, and 43% (n = 2808) a negative, effect on patient care and interaction; clinicians who did not receive many patient requests had similar opinions. Older, men, those working in private practice and specialized clinicians had a more positive attitude towards such requests than other clinicians. The reasons given for the positive and negative opinions were varied.Conclusions  Active patients (consumer patients) are a reality in the Finnish health care system. Physicians have varying opinions on this phenomenon.
Bridging the divide between families and health professionals’ perspectives on family‐centred care
Authors: MacKean Gail L. , Thurston Wilfreda E. , Scott Catherine M. 
Published: February 2005

AbstractObjectives  To describe and discuss key findings from a recent research project that challenge an increasingly prevalent theme, apparent in both family‐centred care research and practice, of conceptualizing family‐centred care as shifting care, care management, and advocacy responsibilities to families. The purpose of the research, from which these findings emerged, was to develop a conceptualization of family‐centred care grounded in the experiences of families and direct health‐care providers.Design  Qualitative research methods, following the grounded theory tradition, were used to develop a conceptual framework that described the dimensions of the concept of family‐centred care and their interrelationships, in the substantive area of children's developmental services. This article reports on and extends key findings from this grounded theory study, in light of current trends in the literature.Setting and participants  The substantive area that served as the setting for the research was developmental services at a children's hospital in Alberta, Canada. Data was collected through focus groups and individual interviews with 37 parents of children diagnosed with a developmental problem and 16 frontline health‐care providers.Findings  Key findings from this research project do not support the current emphasis in family‐centred care research and practice on conceptualizing family‐centred care as the shifting of care, care management, and advocacy responsibilities to families. Rather, what emerged was that parents want to work truly collaboratively with health‐care providers in making treatment decisions and on implementing a dynamic care plan that will work best for child and family.Discussion and conclusions  A definition of collaboration is provided, and the nature of collaborative relationships described. Contributing factors to the difficulty in establishing true collaborative relationships between families and health‐care professionals, where the respective roles to be played by health‐care professionals and families are jointly determined, are discussed. In light of these findings we strongly advocate for the re‐examination of current family‐centred care policy and practice.
Left Ventricular Function at Peak All-Out Anaerobic Exercise in Older Men
Authors: Sagiv Michael , Ben-Sira David , Sagiv Moran , Goldhammer Ehud 
Published: February 2005

<i>Background:</i> All-out anaerobic exercise may be dangerous for the older population, due to hypoxia and inappropriate blood pressure response. <i>Objectives:</i> This study compared and evaluated left ventricular function at peak all-out anaerobic effort in 12 well-trained older (58 ± 1 years) and 12 young men (22 ± 1 years). <i>Methods:</i> Subjects were studied by echocardiography at peak all-out anaerobic exercise, on a cycle ergometer. <i>Results:</i> Seven older subjects experienced ECG abnormalities. Significant (p < 0.05) differences between the older group and the young group, respectively, were noted for: cardiac output (9.8 ± 0.9 and 15.8 ± 0.9 l·min<sup>–1</sup>), left ventricular end-systolic pressure-volume ratio (4.7 ± 0.8 and 4.4 ± 4.9), left ventricular end-diastolic volume (104.8 ± 6.9 and 125.7 ± 6.2 ml), ejection fraction (67.1 ± 6.0 and 59.8 ± 5.5%), left ventricular end-systolic pressure volume ratio (4.4 ± 0.4 and 4.8 ± 0.3 ratio), and total peripheral resistance (966.0 ± 84.0 and 660 ± 82.8 dyn<i>·</i>s<sup>–1</sup><i>·</i>cm<sup>–5</sup>). <i>Conclusions:</i> Data suggest that during all-out anaerobic exercise, forces opposing ejection were not reduced enough to avoid left ventricular dysfunction and ECG abnormalities in the older subjects. This is attributed to functional changes with age in the myocardium and associated blood vessels, leading to impairment of left ventricular function and blunted inotropic and chronotropic responses to catecholamine. Therefore, an all-out anaerobic-type effort should not be given to an older subject due to the great hazardous potential.