[DYNAMICS OF CEREBROSPINAL FLUID PRESSURE IN CEREBROCRANIAL INJURIES]

Sveikatos Apsauga. Sep, 1963  |  Pubmed ID: 14087140

Thioridazine in the Treatment of Mentally Retarded Children. (A Four-year Retroactive Evaluation)

Canadian Psychiatric Association Journal. Apr, 1967  |  Pubmed ID: 6040449

[Surgical Treatment of Occlusive Lesions of the Branches of the Aortic Arch]

Khirurgiia. Mar, 1975  |  Pubmed ID: 1094176

[10-year Experience of Surgical Treatment of Occlusive Diseases of the Aorta and Main Arteries]

Kardiologiia. Jun, 1976  |  Pubmed ID: 799183

The authors report the results of 1268 reconstructive operations in cases of various ischaemic syndromes. Surgical technique and indications for surgery are discussed. The clinical material consists of 115 reconstructive operations on the supraaortic branches, 462 operations in the aortoiliac segment, 57 reconstructions of the abdominal aorta and its visceral branches, as well as 652 reconstructive procedures on the arteries below the inguinal ligament. The latter operations include 70 femorotibial venous bypasses in patients with rest pain and gangrene.

[Treatment of Lesions of the Proximal Portion of the Vertebral Arteries]

Khirurgiia. May, 1977  |  Pubmed ID: 325279

Documented Clinical Experiences of Primary Care RN Students: a Preliminary Report

Nursing Research. Sep-Oct, 1977  |  Pubmed ID: 587924

A student-patient encounter form was developed for documenting patients' visits in the practicums of three primary care courses--obstetric-gynecology, pediatrics, and general adult patients--and from January 1973 to June 1974, 22 registered nurse students completed 1,027 student-patient encounter forms. Health problems were identified, using the Weed system and classified by the International Classification of Disease adapted for use in the United States. The study demonstrated that the encounter form facilitated the documentation of base-line data for student practicums. Preliminary analysis of the data revealed that: 1) health problems of patients classified as "without sickness" were important in the case loads of registered nurse students in obstetric-gynecologic and pediatric practicums; 2) health problems of patients classified as "symptoms of ill-defined conditions" were also important in all three student practicums, particularly with general adult patients: and 3) students encountered a cluster of health problems in dealing with patients in the three practicums. The study suggested a need to develop a classification scheme for health problems encountered in primary care nursing services.

[Clinical Aspects of Circulatory Disorders in the Vertebral Arteries and the Possibilities for Their Surgical Treatment]

Kardiologiia. Aug, 1978  |  Pubmed ID: 691960

Experience in the follow-up of 84 patients who underwent operation for transient cerebral vascular insufficiency in the vertebro-basilar bed is summarized. It was found that most patients with abnormally tortuous or anomalously branching vertebral arteries had transient disorders of the carciac rhythm or increased arterial pressure. Operative treatment of such patients contributes to correction of the neurologic symptoms and leads to normalization of the cardiac rhythm and arterial pressure.

Patient Encounters by Primary Care Nurse Students

Research in Nursing & Health. Apr, 1978  |  Pubmed ID: 247540

The Evolution of a Public Health Nursing Performance Evaluation Tool

The Journal of Nursing Administration. Apr, 1979  |  Pubmed ID: 254701

A tool was developed to evaluate the performance of nurses in a large public health department. Nursing staff were involved in the development process and received inservice education in some aspects of performance that would be measured by the tool. The evaluation tool is used to assess performance in four areas: clinical practice, supervision and management, professional growth and research. The authors wish to express their appreciation to the following individuals in the Chicago Department of Health who worked so diligently in the development of the Performance Evaluation Tool and the inservice education program described in this paper: Elizabeth Velten, Lee Gross, JoAnn Macon, Mitchi Oki, Carol Corcoran, Hazel Barclay, Carrie Manley, Evelyn Ribic, Etherlene Palmer, Zettie Richardson. The authors also acknowledge the guidance of Ms. Claudie Leckeisik during the preparation of this manuscript.

A Program Evaluation of Four Workshops Designed to Prepare Nurse Faculty in Health Assessment

The Journal of Nursing Education. Apr, 1980  |  Pubmed ID: 6246059

Health Problems Encountered by Nurse-practitioners and Physicians in Obstetric-gynecologic Ambulatory Care Clinics

American Journal of Obstetrics and Gynecology. Jun, 1981  |  Pubmed ID: 7246654

This study documents the distribution of health problems managed by obstetric-gynecologic nurse-practitioners (OB-GYN NPs) and obstetrician-gynecologists in community-based ambulatory care settings, and examines the effects of provider group on the distribution of health problems. A proportional sampling technique was used in selecting a sample of 3,873 visits for analysis from a total of 5,889 patient visits made to three community-based clinics during an 18-week period from February to June, 1978. A Patient Encounter Form was devised to record basic encounter data and the health problems managed by providers. The International Classification of Diseases, 9th revision (ICD-9-CM) was used as the coding system. Results indicated: (1) in each clinic, the distribution of health problems based on the three-digit headings of ICD-9-CM differed significantly between the OB-GYN NPs and the obstetrician-gynecologists; (2) the distributions of frequently reported health problems were clinically similar for OB-GYN NPs and obstetrician-gynecologists; and (3) the distributions of health problems with V codes were clinically similar for the two provider groups. Data indicate the OB-GYN NP caseloads are similar to those of obstetrician-gynecologists in frequently managed health problems and in wellness emphases. Nurse-practitioners are appropriate collaborators with obstetrician-gynecologists in the provision of primary health care for women.

Health Problems Encountered by Nurse Practitioners and Physicians

Nursing Research. May-Jun, 1982  |  Pubmed ID: 6918922

The effects of specialty, setting, and provider group on the distributions of health problems managed by nurse practitioners and physicians in obstetric-gynecology, adult medicine, pediatrics, and family practice specialties are studied. Proportional samples by clinic were drawn from a total of 39,243 patient visits made to 16 ambulatory care clinics during an 18-week period. A Patient Encounter Form was used as the instrument and the ICD-9-CM was used as the coding system. Distributions of health problems differed between nurse practitioners and physicians in each clinic. Specialty affected the distributions of health problems managed by both provider groups. Setting affected the distributions of health problems for all specialties except the distributions of health problems not related to diseases or injuries (V codes) in family practice. Provider group effects were inconclusive. Community-based settings seem especially appropriate for nurse practitioner practice.

Public Health Nursing Practice - an Educator's View

Nursing Outlook. Jul-Aug, 1982  |  Pubmed ID: 6919877

[Surgical Treatment of Anomalies of the Vertebral Artery]

Khirurgiia. Sep, 1982  |  Pubmed ID: 7143967

Health Problems Encountered by Pediatric Nurse Practitioners and Pediatricians in Ambulatory Care Clinics

Medical Care. Feb, 1983  |  Pubmed ID: 6827871

This study documents the health problems managed by pediatric nurse practitioners (PNPs) and pediatricians and examines the effects of setting and provider group on the distribution of health problems. Proportional samples by clinic were selected from a total of 11,968 patient visits to five ambulatory care clinics during an 18-week period in 1978. A patient encounter form was devised and the ICD-9-CM was used as the coding system. Results indicated 1) distributions of health problems differed significantly between the PNPs and the pediatricians in each clinic; 2) setting significantly effected the distributions of both types of health problems; and 3) provider group significantly affected the distribution of health problems with V codes but not frequently reported problems given a setting. The PNPs caseloads differ from pediatrician caseloads in diagnostic categories and wellness emphases. Community-based settings seem to be especially appropriate for nurse practitioner practice.

Effectiveness of Public Health Nurse Home Visits to Primarous Mothers and Their Infants

American Journal of Public Health. May, 1983  |  Pubmed ID: 6837823

The purpose of this study was to determine the effects of public health nurse postpartum home visits by comparing the health outcomes of 67 randomly selected mother-infant pairs who had received such services with 43 randomly selected mother-infant pairs who had not received them. Health outcome variables were mother's health and health services utilization, infant's health and health services utilization, and mother's parenting practices. Data were collected from birth certificates, health service records, and by home interviews and observations at six months postpartum. No significant differences were noted between home-visited and not-home-visited mother-infant pairs for the majority of health outcome variables. Major, differential health assets and liabilities between groups of Black and White mother-infant pairs were observed.

Health Problems Encountered by Nurse Practitioners and Physicians in General Medicine Clinics

Research in Nursing & Health. Jun, 1984  |  Pubmed ID: 6565308

Distribution of health problems encountered by nurse practitioners and physicians in general/adult medicine clinics was studied. Proportional samples by clinics were selected from a total of 13,039 patient visits made to four clinics during an 18-week period in 1978. A Patient Encounter Form was used as the instrument and the ICD-9-CM as the coding system. Results showed that (a) 25.1% of the 13,039 patient visits were made to the nurse practitioners and 74.9% to the physicians, (b) 23 frequently reported health problems constituted more than 50% of all health problems seen by both provider groups, and (c) health problems with V codes constituted less than 30% of all health problems seen by both provider groups. Many similarities in health problems seen by nurse practitioners and physicians may indicate that nurse practitioners in the general/adult medicine specialty are used more to substitute for physicians in managing selected health problems than to complement medical practice.

Health Problems Encountered by Nurse Practitioners and Physicians in Family Practice Clinics

Western Journal of Nursing Research. Feb, 1985  |  Pubmed ID: 3850678

[Surgical Treatment of Twists and Loops of the Brachiocephalic Arteries]

Khirurgiia. Dec, 1986  |  Pubmed ID: 3546925

[Restoration of Blood Flow in the External Carotid Artery]

Vestnik Khirurgii Imeni I. I. Grekova. Mar, 1987  |  Pubmed ID: 3617378

The external carotid artery revascularization procedures were performed in 19 cases. Fourteen patients had ischemic stroke history. Ten patients had occluded the ipsilateral internal carotid artery to the stenosed external carotid artery. Six patients had occluded the common as well as internal carotid artery on the same side. Positive neurologic changes were obtained in 73.7% of the operated patients. The external carotid artery revascularization procedures are recommended in cases when the ipsilateral internal carotid artery is occluded.

Effectiveness of Public Health Nurse Home Visits to Primarous Mothers and Their Infants

NLN Publications. Aug, 1987  |  Pubmed ID: 3684536

[Value of Doppler Flowmetry and Angiography in Selecting Surgical Tactics in the Treatment of Occlusion of the Crural Arteries]

Khirurgiia. Jun, 1987  |  Pubmed ID: 2957544

[A Method of Reconstruction of the Orifice of the Vertebral Artery]

Khirurgiia. Dec, 1988  |  Pubmed ID: 3070132

Barriers to Advanced Education for Occupational Health Nurses

AAOHN Journal : Official Journal of the American Association of Occupational Health Nurses. Nov, 1988  |  Pubmed ID: 3190835

The Cluster Concept in Nursing Research

Nursing Outlook. Jul-Aug, 1988  |  Pubmed ID: 3387258

Innovative strategies are needed to promote research development in schools of nursing. At the University of Michigan School of Nursing, using a visiting professor to direct a research cluster project enhanced scholarly productivity among new faculty investigators and graduate students.

Interest of Major Corporations in Expanded Practice of Occupational Health Nurses

Research in Nursing & Health. Jun, 1988  |  Pubmed ID: 3399695

The purpose of this study was to ascertain the interest by executives of major corporations in having occupational health nurses engage in more advanced activities, and to ascertain the available support for advanced educational preparation for nurses. A questionnaire was sent to a systematic sample of 404 of the 808 executives of the Forbes 500 corporations with a 57% return rate. Over 90% of the corporations with health care departments employed registered nurses. Functions nurses currently performed varied by size of the corporation and by type of industry. Activities corporations would like nurses to perform were more advanced, such as conducting research, analyzing trends, and developing special health programs.

[Surgical Technic of Straightening Kinks of the Internal Carotid Arteries]

Khirurgiia. Dec, 1989  |  Pubmed ID: 2625883

The article describes surgical techniques used in 11 cases for correcting loops and pathological tortuosity of the internal carotid arteries. Resection of the proximal segment of the artery with its reimplantation into the bifurcation of the carotid artery is the technically simplest method. In marked degeneration of the arterial wall in the region of the loop, the latter must be resected and arterial end-to-end anastomosis established. The authors describe a method which they developed for resecting a high loop of the internal carotid artery.

[Technics of the Surgical Approach to the Vertebral Arteries]

Vestnik Khirurgii Imeni I. I. Grekova. May, 1989  |  Pubmed ID: 2800199

[Changes in the Internal Carotid Artery in Its Loop-shaped Kinking and Their Clinical Significance]

Khirurgiia. Sep, 1989  |  Pubmed ID: 2811161

Loops and kinks of the internal carotid, common carotid, and vertebral arteries which were resected in operations on 45 patients were examined histologically and histochemically. Gross pathological changes were found in the arterial wall in the region of the loops and kinks: destruction of the smooth muscles and elastic fibrils and fragmentation of the internal elastic membrane. Fibrous tissue prevailed in all layers of the arterial wall, forming its soft framework and in this way preventing the straightening out of the kinked artery or its loop. The changes were most marked in the loops of the internal carotid artery, microaneurysms with parietal thrombosis were even encountered. The findings of microscopic and histochemical study compel the surgeon to resort to excision of the loop or kink and subsequent establishment of an end-to-end anastomosis or replacement of the whole pathologically changed arterial segment by a graft of autologous vein, as the most radical method of surgical treatment of this pathological condition. In children and in some adults, however, favourable results can be produced by total mobilization of the loop, its downward transposition, resection of its proximal segment, and reimplantation into the bifurcation of the carotid artery.

The Development of Graduate Nursing Education. A Survey of Home Care Programs

Caring : National Association for Home Care Magazine. Feb, 1989  |  Pubmed ID: 10292092

Home Health Care

Annual Review of Nursing Research. 1990  |  Pubmed ID: 2206622

[Surgeries on the Carotid Arteries]

Khirurgiia. Aug, 1990  |  Pubmed ID: 2259183

The article lays emphasis on the main causes of restenosis after endarterectomy from the bifurcation of the carotid artery and shows the methods of its prevention. A new method for endarterectomy of the bifurcation of the carotid artery is suggested, which consists in reimplantation of the internal carotid artery. The authors claim this method to be optimal in combined affection: atherosclerotic constriction of carotid artery bifurcation and pathological tortuosity of the internal carotid artery. The authors possess an experience in 351 operations on the carotid arteries, 177 of them were conducted for loops and kinks of the carotid arteries; 152, for endarterectomy in atherosclerotic affection of the carotid arteries; and 22 for other, less frequently encountered affections of the carotid arteries.

Health Promotion and Disease Prevention: Toward Excellence in Nursing Practice and Education

Nursing Outlook. May-Jun, 1992  |  Pubmed ID: 1614893

Case Management Within Home Care: Old Ideas and New Themes

Home Healthcare Nurse. Jan-Feb, 1994  |  Pubmed ID: 8113096

Investigation of Conductometric Humidity Sensors

Talanta. Jun, 1997  |  Pubmed ID: 18966843

Sensors for determining humidity in air have been described and investigated. Sensing film of the devices was prepared from polyvinylalcohol and graphitized carbon black disperse phase. The composition, thermal treatment and design of sensing films were investigated and optimized. An optimized humidity sensor has better metrological parameters as compared with its prototype (response time approximately 45 s, detection limit 0.17%, slope 6.25 +/- 0.05 Theta/R.H., standard deviation of measurement 0.15%, standard deviation of analytical signal in the graduation equation 8.29Theta). Such construction of sensors have prospects in analytical practice.

Reducing Percutaneous Injuries in the OR by Educational Methods

AORN Journal. Sep, 2000  |  Pubmed ID: 11004962

Exposure to bloodborne pathogens (e.g., HIV, hepatitis B, hepatitis C) through percutaneous injuries is an occupational risk for health care workers, especially those in the OR. The incidence of disease continues to rise, although occupational exposures often go unreported. Percutaneous injury prevention methods have included use of safety devices, practice changes, and educational programs. An educational intervention to increase awareness of risk, provide suggestions for injury reduction, and encourage reporting of exposures was performed at a university teaching hospital. Preliminary qualitative results show increased exposure reporting, increased use of personal protective equipment, and increased awareness of disease exposure risk among OR personnel.

Public Health and Home Care: Historical Roots & Current Partnerships

Caring : National Association for Home Care Magazine. Nov, 2000  |  Pubmed ID: 11151564

This article explores the evolution of home care from a component of public health services to its current position in the American health care system. Values related to public health and philanthropic roots are discussed in contrast to the current business orientation. Because nursing was the initial, and remains the primary, discipline in home care, examples from nursing service and education are used to illustrate this evolution. Educational implications are highlighted because of the importance of educational systems in supplying personnel to the field.

Baccalaureate Nursing Education Development in 2 Baltic Countries: Outcomes 10 Years After Initiation

Nursing Outlook. May-Jun, 2001  |  Pubmed ID: 11416817

Baccalaureate nursing education began in the Baltic countries of Latvia and Lithuania ten years ago to prepare nursing teachers and leaders.

The HANDS Project: Studying and Refining the Automated Collection of a Cross-setting Clinical Data Set

Computers, Informatics, Nursing : CIN. May-Jun, 2002  |  Pubmed ID: 12021607

The consistent availability of a core set of clinical nursing data is essential to promote quality patient care. Although important work to improve terminology and enhance comparability of data is underway, the efforts do not address the immediate need for useful nursing data sets and valid methods of collection at the point of data entry. The Hands-on Automated Nursing Data System (HANDS) project is dedicated to refining a feasible methodology for gathering, storing, and retrieving a standardized nursing data set. To date the project team has developed and tested a prototype research tool that is automated and contains the structured terminologies (North American Nursing Diagnosis Association, Nursing Outcomes Classification, and Nursing Interventions Classification) to represent nursing diagnoses, outcomes, and interventions, respectively. The Phase I project development activities are reported in this article, along with Phase II and III plans for testing and refining the methodology under actual clinical conditions. Results and lessons learned during Phase I are reported.

Health Outcomes of Incarcerated Pregnant Women and Their Infants in a Community-based Program

Journal of Midwifery & Women's Health. Sep-Oct, 2002  |  Pubmed ID: 12361349

An experimental, community-based, residential program, focused on health promotion, was established in 1990 for incarcerated pregnant women with short-term sentences and histories of drug abuse in a large, midwestern metropolitan area in the United States. Infants resided with mothers after birth. Prenatal care, delivery, postpartum, and family-planning services were initiated and provided by a nurse-midwifery service. Community-based health care, job training, and drug rehabilitation were provided for women during pregnancy through the fourth postpartum month. Program participants' prenatal, delivery, postpartum, and neonatal health outcomes are presented and compared with those of incarcerated women in the same state prison system who experienced usual correctional facility care and support. Program participants represented a group of obstetrically high-risk women. Health outcomes for both groups of incarcerated women and their infants were similar and more optimal than would have been expected given their preexisting health conditions and risk factors.

Patient Satisfaction Outcomes in Nurse-managed Centers

Outcomes Management. Oct-Dec, 2002  |  Pubmed ID: 12385169

Patient satisfaction remains one of the critical benchmarks of primary care delivery. Although much of the research reporting outcomes related to nurse-managed centers (NMC) has included patient satisfaction, most of the reports have been limited to individual clinical settings. This study collected satisfaction data from 7 NMCs operated by 4 different academic institutions. Results demonstrated 3 components of patient satisfaction: patient perceptions of care, phone contact, and the patient's willingness to return to or recommend the clinic. Consistent with previous research, professional responsiveness and respect and courtesy from nurse practitioners were rated high on the composite satisfaction levels from a heterogeneous sample of consumers.

Educational Implications of Nurse Practitioner Students and Medical Residents' Attitudes Toward Managed Care

Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing. Sep-Oct, 2002  |  Pubmed ID: 12434319

The increasing number of individuals enrolled in managed care organizations is a key consideration when planning effective models of education for future health care professionals. This study compares attitudes toward managed care between medical residents (MRs) (n = 431) and advanced practice nursing students (APNSs) (n = 153) in a Midwestern U.S. state, and it reports the results of a factor analysis of the attitude survey. MRs and APNSs completed a 34-item questionnaire. Results show that MRs were more likely than APNSs to believe that cost has priority over quality of care in a managed care setting and that managed care threatens the autonomy of health care providers. APNS were more likely than MRs to believe that managed care encourages preventive health care. Other comparisons related to Medicaid, capitation, practice guidelines, and success factors are discussed. Findings indicate that MRs were more inclined to see managed care as an economic threat to quality of care than APNSs. At the same time, MRs were somewhat less enthusiastic about practice guidelines and patient outcomes as measures of success in managed care settings than APNSs. Educational implications of findings are discussed.

[Complications of Carotid Endarterectomy]

Medicina (Kaunas, Lithuania). 2002  |  Pubmed ID: 12474685

Carotid endarterectomy has been shown to be beneficial in patients with high-grade carotid stenosis. This benefit will be realized only if the operation is performed safely. We determined the ratio of operative complications and sought to identify the risk factors for operative stroke and death from carotid endarterectomy.

Variation Correction Algorithm: Analysis of Phase Suppression and Thermal Profile Fidelity for Proton Resonance Frequency Magnetic Resonance Thermometry at 0.2 T

Journal of Magnetic Resonance Imaging : JMRI. Feb, 2003  |  Pubmed ID: 12541231

To develop and analyze the performance of the variation correction algorithm (VCA), a phase correction technique that mitigates the contribution of background phase variations by combining accurate alignment of echoes, K-space-based phase correction (as opposed to spatial polynomials), and extraction of alias-free phase difference images.

The Effects of Nurse Staffing on Adverse Events, Morbidity, Mortality, and Medical Costs

Nursing Research. Mar-Apr, 2003  |  Pubmed ID: 12657982

Nurse staffing levels are an important working condition issue for nurses and believed to be a determinant of the quality of nursing care and patient outcomes.

Establishing the Validity, Reliability, and Sensitivity of NOC in an Adult Care Nurse Practitioner Setting

Outcomes Management. Apr-Jun, 2003  |  Pubmed ID: 12715604

The purpose of this study was to provide evidence of the inter-rater reliability, validity, and sensitivity of a subset of Nursing Outcomes Classification (NOC) measures, including 26 found to be "most clinically useful" in a nurse practitioner setting (NPS). Selected NPS results are compared to those obtained from a larger 10-site study. Results indicated that the measures are valid, reliable, and sensitive as clinical measures of nursing outcomes. Proper education of users can enhance psychometrics. Suggestions for strengthening the measures and further study are outlined.

Toward Collecting a Standardized Nursing Data Set Across the Continuum: Case of Adult Care Nurse Practitioner Setting

Outcomes Management. Jul-Sep, 2003  |  Pubmed ID: 12881972

Viable strategies are needed to move toward collection of a standardized nursing data set across settings for eventual use in examining nursing effectiveness. One strategy is to introduce potential nurse adopters to subsets of valid setting-specific standardized terms and measures to support adoption and initial implementation. The present study was designed to identify the "most clinically useful" NANDA (North American Nursing Diagnoses Association) diagnoses, NOC (Nursing Outcomes Classifications) outcomes, and NIC (Nursing Intervention Classifications) interventions pertinent to the adult care nurse practitioner setting. Ultimately, clinicians must recognize, however, that they will need to use additional terms and measures outside the subsets to more fully describe the nursing care provided.

Occupational Nursing Service in a Small Manufacturing Plant: Interventions and Outcomes

International Journal of Nursing Terminologies and Classifications : the Official Journal of NANDA International. Oct-Dec, 2003  |  Pubmed ID: 14768128

To describe the health needs presented by workers in a small industrial setting, describe the occupational health nursing (OHN) services provided, and examine the effectiveness of these services.

Financial Performance of Academic Nurse-managed Primary Care Centers

Nursing Economic$. Jul-Aug, 2003  |  Pubmed ID: 14509875

Assessing the Reliability, Validity, and Sensitivity of Nursing Outcomes Classification in Home Care Settings

Journal of Nursing Measurement. 2003  |  Pubmed ID: 15274522

The purpose of this study is to provide evidence of the validity, inter-rater reliability, and sensitivity of 36 clinically useful of Nursing Outcomes Classification (NOC) results for Home Care (HC) settings. The results of inter-rater reliability, criterion-related validity, and sensitivity evaluations of 36 NOC outcomes were compiled from a 10-site regional evaluation of the NOC. Findings of HC and all sites data were contrasted. More than 90% of the inter-rater reliability scores on the 36 NOC outcome label ratings were within one point, with a substantial number of absolute agreements. All but six of the criterion measures were significantly associated with the corresponding NOC outcomes, and most mean change scores were zero or positive. This was impressive evidence of the adequacy of these measures for reliable and valid use in practice.

Toward Integrating a Common Nursing Data Set in Home Care to Facilitate Monitoring Outcomes Across Settings

Journal of Nursing Measurement. 2003  |  Pubmed ID: 15274523

The purpose of our research is to identify a realistic subset of North American Nursing Diagnosis Association (NANDA), Nursing Outcome Classification (NOC), and Nursing Interventions Classification (NIC) terms specific to the home care (HC) setting. A subset of 89 NOC outcomes were identified for study in HC through a baseline survey. Three research assistants then observed the care of 258 patients to whom the 89 NOC outcomes applied and recorded the associated NANDA and NIC terms. Follow-up surveys and focus groups were conducted with the nurses and research assistants. There were 81 different NANDA and 226 NIC labels used to describe study patients' care. Only 36 of the 89 NOC labels studied were deemed clinically useful for HC. We found that expert opinion about terminology usage before actual experience under practice conditions is unreliable.

Caffeine Impairs Glucose Metabolism in Type 2 Diabetes

Diabetes Care. Aug, 2004  |  Pubmed ID: 15277438

Carotid Artery Atherosclerotic Plaque: Clinical and Morphological-immunohistochemical Correlation

Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. Nov, 2004  |  Pubmed ID: 15507852

The purpose of the study was to: 1) investigate carotid atherosclerotic plaque morphology and immunohistochemistry (IHC) with respect to the localization sites of Chlamydia pneumoniae, 2) find correlations between plaque morphology and clinical sonographical characteristics, and 3) determine the correlation between abundance of C. pneumoniae and complexity of the plaque.

Diabetes on a Cardiovascular Ward: Adherence to Current Recommendations

Southern Medical Journal. Nov, 2004  |  Pubmed ID: 15586590

Improving diabetes and blood pressure control decreases the incidence and progression of microvascular disease. Likewise, screening for microvascular complications is beneficial in the early detection and treatment of these disorders. However, adherence to practice guidelines for screening and treatment in patients with diabetes is suboptimal. This study describes a group of patients with diabetes who were admitted to a cardiology service at an academic medical center.

Academic Nurse-managed Centers: Approaches to Evaluation

Outcomes Management. Jan-Mar, 2004  |  Pubmed ID: 14740586

A comprehensive evaluation plan was developed to assess the outcomes of a multiuniversity project to support the development of academic nurse-managed centers (ANMCs). The evaluation included measuring ANMC impact on the clients and communities served, on students, and on the sponsoring faculties and universities. This article includes a discussion of the processes used in evaluation plan development, the variables measured, the tools developed to measure selected variables, and a summary of evaluation findings. Recommendations for use of selected evaluation components across ANMCs are presented.

Using FTE and RVU Performance Measures to Assess Financial Viability of Academic Nurse-managed Centers

Nursing Economic$. May-Jun, 2004  |  Pubmed ID: 15211915

Financial performance measures are essential to improve the fiscal management of academic nurse-managed centers (ANMCs). Measures are compared among six ANMCs in a consortium and against an external, self-sustainable, profitable ANMC and national data for family practice physicians. Performance measures help identify a center's strengths and weaknesses facilitating the development of strategies aimed at a variety of targets (business practices related to revenue and costs) to improve financial viability. Using a variety of financial performance measures to inform decision making will aid ANMCs in keeping their doors open for business.

Modified Graphitized Carbon Black As Transducing Material for Reagentless H2O2 and Enzyme Sensors

Talanta. Oct, 2005  |  Pubmed ID: 18970240

Direct electron transfer between redox enzymes and electrodes is the basis for the third generation biosensors. We established direct electron transfer between quinohemoprotein alcohol dehydrogenase (PQQ-ADH) and modified carbon black (CBs) electrodes. Furthermore, for the first time, this phenomenon was observed for pyrroloquinoline quinone (PQQ)-dependent glucose dehydrogenase (PQQ-GDH). Reagentless enzyme biosensors suitable for the determination of ethanol, glucose and sensors for hydrogen peroxide were designed using CB electrodes and screen-printing technique. Aiming to create an optimal transducing material for biosensors, a set of CB batches was synthesized using the matrix of Plackett-Burman experimental design. Depending on the obtained surface functional groups as well as the nano-scale carbon structures in CBs batches, the maximal direct electron transfer current of glucose and ethanol biosensors can vary from 20 to 300 nA and from 30 to 6300 nA for glucose and ethanol, respectively. Using modified CB electrodes, an electrocatalytic oxidation of H(2)O(2) takes place at more negative potentials (0.1-0.4V versus Ag/AgCl). Moreover, H(2)O(2) oxidation efficiency depends on the amount and morphology of fine fraction in the modified CBs.

Selecting Control Interventions for Clinical Outcome Studies

Western Journal of Nursing Research. Apr, 2005  |  Pubmed ID: 15781908

In the current research environment the design and management of control groups is becoming more complex. The selection of a control group design is dependent on study goals, presence and quality of existing interventions, urgency of the problem or issue being addressed by the intervention, and factors related to the study site. The purpose of the presentation is to identify various approaches to the design of control groups in experimental studies and to identify their strengths, limitations, and applications. A case study exemplifies the issues associated with control group selection and design.

[Carotid Artery Atherosclerotic Stenosis, Plaque Structure and Stroke]

Medicina (Kaunas, Lithuania). 2005  |  Pubmed ID: 15864007

The main indication for carotid endarterectomy is severity of stenosis carotid artery. Several studies have shown the relationship between carotid plaque morphology and cerebrovascular disorders. The purpose of this study was to evaluate the structure of carotid plaque and correlate carotid plague morphology with neurological symptoms, stroke risk factors, severity of carotid stenosis and operative stroke.

Risk of Carotid Endarterectomy in Patients with Cerebral Infarction

Angiologii͡a I Sosudistai͡a Khirurgii͡a = Angiology and Vascular Surgery. 2005  |  Pubmed ID: 16034330

Stroke is a clinical diagnosis, but there is uncertainty as to the relative risks of surgery in patients with a visible infarction on brain CT. It is not clear whether visible infarction is associated with higher operative risk and poor outcome or is simply an indicator of a more "severe" stroke. Some studies have indicated that CT evidence of stroke carries an increased risk, other studies have found that patients with a low density and without significant shift on CT, with a stable neurological deficit and a normal level of consciousness can safely undergo carotid endarterectomy. Our aim was to answer a the specific question whether visible brain infarction on CT increases the operative risk of carotid endarterectomy, with special attention to the neurological complications. This analysis involved 105 patients with a visible brain infarct on CT scan who underwent carotid endarterectomy in Vilnius University Emergency Hospital. Carotid endarterectomy was performed in 86 men and in 19 women with mean carotid stenosis 87%, ranging from 42% to 99% by angiography. Clinical symptoms of stroke were present in 95 patients (86 carotid and 9 vertebrobasilar). Carotid endarterectomy underwent 76 patients with symptomatic carotid stenosis, 16 patients with symptoms of contralateral carotid artery, 9 patients with vertebrobasilar symptoms and 4 patients with nonspecific symptoms. Among symptomatic patients there were 46 patients with unilateral carotid stenosis and 30 patients with bilateral stenosis. Angiography of asymptomatic patients (n=29) revealed unilateral carotid lesions in 9 cases, bilateral stenosis in 8 patients and concomitant bilateral carotid and vertebral stenosis in 12 patients. The postoperative mortality rate was 2.9%, a new stroke occurred in 1.9%. The total rate of complications--4.8%. Patients with visible brain infarction on CT scan can safely undergo carotid endarterectomy with a standard operative risk, but risks modelling will be required if we are to target surgery most effectively at individuals.

Measuring Quality in Nurse-managed Centers Using HEDIS Measures

Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality. Jan-Feb, 2005  |  Pubmed ID: 16416887

Nurse-managed centers (NMCs) provide viable options for primary healthcare and contribute substantially to filling access gaps for vulnerable populations. The purposes of this paper are to (a) describe a pilot application and adaptation of eight Health Plan Employer Data and Information Set (HEDIS) measures to six NMCs, (b) report the findings from the quality assessments, and (c) compare findings to national HEDIS data. The eight quality assessment areas are asthma, cervical cancer screening, childhood immunizations, depression, diabetes, hypertension, mammography screening, and smoking cessation. The NMCs achieved or exceeded HEDIS 50th percentile levels in a number of important clinical areas, but did not attain the 50th percentile level in others. Thus, HEDIS measures are relevant for the assessment of care quality and provide useful data for quality improvement in NMCs.

National Consensus on Data Elements for Nurse Managed Health Centers

Nursing Outlook. Mar-Apr, 2006  |  Pubmed ID: 16597526

This report presents a summary of the findings from the National Network for Nurse Managed Health Centers Data Consensus Conference. Nationally, nurse-managed health centers are increasingly offering communities another option for access to high-quality primary care. The lack of agreed upon, standardized data elements for these centers has limited the ability to present clear information about their contributions as well as to inform policy related to their support and development. Fifty-three national invitees came to consensus in Washington, DC on the critical data elements for a national database for nurse-managed health centers. This database includes both clinical and financial/business practices elements. Consensus was not reached around some clinical areas. These areas are briefly discussed as well as the plans for next stages of data collection.

Clients Served and Services Provided by Academic Nurse-managed Centers

Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing. Nov-Dec, 2006  |  Pubmed ID: 17141716

Currently, no national database for academic nurse-managed centers (ANMCs) exists. These primary care services remain somewhat invisible in the policy and reimbursement areas of the American primary care system and, consequently, are undersupported. The purpose of this article is to describe client and service data from a national study of ANMCs. A cross-sectional survey design was used to collect data from ANMC directors. Usable data were received from 64 centers. ANMCs in the sample were relatively small in terms of patients and volume. Client and service profiles demonstrated variation, which seemed to be reflective of needs relative to populations and communities served. Nearly half of the ANMCs responding served clients of all ages, with services representing the breadth of primary care (i.e., health maintenance and management of minor acute and common chronic illnesses). Evidence of community-focused care was also noted. The reported use of standardized nursing language was low. Standardized medical taxonomies were more commonly used, with International Classification of Diseases, Ninth Revision being the most common. ANMCs provide a small but substantial amount of primary care services in communities served. Findings indicated a need for ANMCs to improve the documentation of their contributions through the use of standardized taxonomies to provide aggregated reporting for policy and research purposes.

Impact of Academic Nurse-managed Centers on Communities Served

Journal of the American Academy of Nurse Practitioners. May, 2007  |  Pubmed ID: 17489960

This paper presents findings from six community focus groups that addressed the impact of academic nurse-managed centers (ANMCs) on the overall community being served as well as the quality of care provided in the centers.

Satisfaction with a School-based Teen Health Center: a Report Card on Care

Pediatric Nursing. Mar-Apr, 2007  |  Pubmed ID: 17542231

Evaluations of the quality of School-Based Health Center (SBHC) care, both satisfaction and outcomes, have been developed by several state SBHC initiatives. However, few of these patient satisfaction surveys have been rigorously evaluated. An adolescent patient satisfaction based on a grading rubric familiar to the adolescents was developed and used to assess care at a nurse-managed teen health center. Satisfaction data on 190 encounters were collected in one SBHC using a report card rubric. The adolescent patients represented grades 6th through 8th, and were almost equally distributed between girls (55.9%) and boys (44.1%). This SBHC was a part of a university consortium of nurse-managed centers. Results demonstrated high satisfaction (approximately 3.7 out of 4) with care using a reliable tool (a = .84) designed for adolescents, which incorporated a grading rubric for the evaluation criteria. The nurse practitioner received high marks for listening to the students and treating the students with respect. Yet, statistical differences by grade level were found. The satisfaction tool was found to be reliable (alpha = .84) and consistent with adolescent's perspectives on satisfaction with health care. The study is the first published report that specifically examined student satisfaction with care in a nurse-managed SBHC. Overall satisfaction with care received high "grades" from both first time and repeat users, and from boys and girls.

Magnetic Resonance Imaging and Model Prediction for Thermal Ablation of Tissue

Journal of Magnetic Resonance Imaging : JMRI. Jul, 2007  |  Pubmed ID: 17659563

To monitor and predict tissue temperature distributions and lesion boundaries during thermal ablation by combining MRI and thermal modeling methods.

Non-Cartesian Data Reconstruction Using GRAPPA Operator Gridding (GROG)

Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine / Society of Magnetic Resonance in Medicine. Dec, 2007  |  Pubmed ID: 17969027

A novel approach that uses the concepts of parallel imaging to grid data sampled along a non-Cartesian trajectory using GRAPPA operator gridding (GROG) is described. GROG shifts any acquired data point to its nearest Cartesian location, thereby converting non-Cartesian to Cartesian data. Unlike other parallel imaging methods, GROG synthesizes the net weight for a shift in any direction from a single basis set of weights along the logical k-space directions. Given the vastly reduced size of the basis set, GROG calibration and reconstruction requires fewer operations and less calibration data than other parallel imaging methods for gridding. Instead of calculating and applying a density compensation function (DCF), GROG requires only local averaging, as the reconstructed points fall upon the Cartesian grid. Simulations are performed to demonstrate that the root mean square error (RMSE) values of images gridded with GROG are similar to those for images gridded using the gold-standard convolution gridding. Finally, GROG is compared to the convolution gridding technique using data sampled along radial, spiral, rosette, and BLADE (a.k.a. periodically rotated overlapping parallel lines with enhanced reconstruction [PROPELLER]) trajectories.

[Results of Carotid Endarterectomy in Diabetic Patients]

Medicina (Kaunas, Lithuania). 2007  |  Pubmed ID: 17986840

Patients with diabetes mellitus have been shown to have an increased incidence of complications after major vascular surgery. The objective of this study was to evaluate the results of carotid endarterectomy in diabetic patients, to determine if results differ from nondiabetic patients, and to examine the risk factors for poor outcome among diabetic patients.

Characteristics of Schools of Nursing Operating Academic Nurse-managed Centers

Nursing Outlook. Nov-Dec, 2007  |  Pubmed ID: 18061013

Academic nurse-managed centers (ANMCs) can be important sites for addressing the tripartite mission of the academy. Yet, limited information about numbers of ANMCs and the schools sponsoring them is available. This paper presents an update on schools of nursing (SONs) operating ANMCs. A survey was sent to 683 deans and directors of baccalaureate and higher-degree SONs, with 565 responding (response rate: 83%). Ninety-two SONs indicated they had one or more ANMCs. The largest percentage of the SONs with ANMCs were classified as doctoral/research-intensive or extensive universities, a proportion much higher than the national percent of SONs in this category. Schools of Nursing were financially supporting centers at a lower percentage of actual costs than was reported in earlier studies, although grants continue to be a major source of funding. Academic nurse-managed centers are likely to be supported by SONs with substantial research, practice, faculty, and student resources. Overall, the national number of ANMCs seems stationary over the past two decades.

Evaluating Home Health Care Nursing Outcomes with OASIS and NOC

Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing / Sigma Theta Tau. 2008  |  Pubmed ID: 18302595

To determine the sensitivity and responsiveness of the Outcome and Assessment Information Set (OASIS) and the Nursing Outcomes Classification (NOC) to the effects of home healthcare nursing interventions.

[Impact of Diabetes Mellitus on Other Cardiovascular Risk Factors in Patients with Stenosis of the Internal Carotid Artery]

Terapevticheskiĭ Arkhiv. 2008  |  Pubmed ID: 18326227

To examine cardiovascular risk factors, clinical features and their impact on the results of carotid endarterectomy in diabetic patients with stenosis of the internal carotid artery.

Dynamics of MRI-Guided Thermal Ablation of VX2 Tumor in Paraspinal Muscle of Rabbits

IEEE Transactions on Bio-medical Engineering. Mar, 2008  |  Pubmed ID: 18334392

This study combines fast magnetic resonance imaging (MRI) and model simulation of tissue thermal ablation for monitoring and predicting the dynamics of lesion size for tumor destruction. In vivo experiments were conducted using radiofrequency (RF) thermal ablation in paraspinal muscle of rabbit with a VX2 tumor. Before ablation, turbo-spin echo (TSE) images visualized the 3-D tumor (necrotic core and tumor periphery) and surrounding normal tissue. MR gradient-recalled echo (GRE) phase and magnitude images were acquired repeatedly in 3.3 s at 30-s intervals during and after thermal ablation to follow tissue temperature distribution dynamics and lesion development in tumor and surrounding normal tissue. Final lesion sizes estimated from GRE magnitude, post-ablation TSE, and stained histologic images were compared. Model simulations of temperature distribution and lesion development dynamics closely corresponded to the experimental data from MR images in tumor and normal tissue. The combined use of MR image monitoring and model simulation has the potential for improving pretreatment planning and real-time prediction of lesion-size dynamics for guidance of thermal ablation of tumors.

Dual MET-EGFR Combinatorial Inhibition Against T790M-EGFR-mediated Erlotinib-resistant Lung Cancer

British Journal of Cancer. Sep, 2008  |  Pubmed ID: 19238632

Despite clinical approval of erlotinib, most advanced lung cancer patients are primary non-responders. Initial responders invariably develop secondary resistance, which can be accounted for by T790M-EGFR mutation in half of the relapses. We show that MET is highly expressed in lung cancer, often concomitantly with epidermal growth factor receptor (EGFR), including H1975 cell line. The erlotinib-resistant lung cancer cell line H1975, which expresses L858R/T790M-EGFR in-cis, was used to test for the effect of MET inhibition using the small molecule inhibitor SU11274. H1975 cells express wild-type MET, without genomic amplification (CNV = 1.1). At 2 microM, SU 11274 had significant in vitro pro-apoptotic effect in H1975 cells, 3.9-fold (P = 0.0015) higher than erlotinib, but had no effect on the MET and EGFR-negative H520 cells. In vivo, SU11274 also induced significant tumour cytoreduction in H1975 murine xenografts in our bioluminescence molecular imaging assay. Using small-animal microPET/MRI, SU11274 treatment was found to induce an early tumour metabolic response in H1975 tumour xenografts. MET and EGFR pathways were found to exhibit collaborative signalling with receptor cross-activation, which had different patterns between wild type (A549) and L858R/T790M-EGFR (H1975). SU11274 plus erlotinib/CL-387,785 potentiated MET inhibition of downstream cell proliferative survival signalling. Knockdown studies in H1975 cells using siRNA against MET alone, EGFR alone, or both, confirmed the enhanced downstream inhibition with dual MET-EGFR signal path inhibition. Finally, in our time-lapse video-microscopy and in vivo multimodal molecular imaging studies, dual SU11274-erlotinib concurrent treatment effectively inhibited H1975 cells with enhanced abrogation of cytoskeletal functions and complete regression of the xenograft growth. Together, our results suggest that MET-based targeted inhibition using small-molecule MET inhibitor can be a potential treatment strategy for T790M-EGFR-mediated erlotinib-resistant non-small-cell lung cancer. Furthermore, optimised inhibition may be further achieved with MET inhibition in combination with erlotinib or an irreversible EGFR-TKI.

Analysis of MALDI FT-ICR Mass Spectrometry Data: a Time Series Approach

Analytica Chimica Acta. Aug, 2009  |  Pubmed ID: 19646586

Matrix-assisted laser desorption/ionization Fourier transform ion cyclotron resonance mass spectrometry is a technique for high mass-resolution analysis of substances that is rapidly gaining popularity as an analytic tool. Extracting signal from the background noise, however, poses significant challenges. In this article, we model the noise part of a spectrum as an autoregressive, moving average (ARMA) time series with innovations given by a generalized gamma distribution with varying scale parameter but constant shape parameter and exponent. This enables us to classify peaks found in actual spectra as either noise or signal using a reasonable criterion that outperforms a standard threshold criterion.

Detecting Glycan Cancer Biomarkers in Serum Samples Using MALDI FT-ICR Mass Spectrometry Data

Bioinformatics (Oxford, England). Jan, 2009  |  Pubmed ID: 19073586

MOTIVATION: The development of better tests to detect cancer in its earliest stages is one of the most sought-after goals in medicine. Especially important are minimally invasive tests that require only blood or urine samples. By profiling oligosaccharides cleaved from glycosylated proteins shed by tumor cells into the blood stream, we hope to determine glycan profiles that will help identify cancer patients using a simple blood test. The data in this article were generated using matrix-assisted laser desorption/ionization Fourier transform ion cyclotron resonance mass spectrometry (MALDI FT-ICR MS). We have developed novel methods for analyzing this type of mass spectrometry data and applied it to eight datasets from three different types of cancer (breast, ovarian and prostate). RESULTS: The techniques we have developed appear to be effective in the analysis of MALDI FT-ICR MS data. We found significant differences between control and cancer groups in all eight datasets, including two structurally related compounds that were found to be significantly different between control and cancer groups in all three types of cancer studied.

A General-purpose Baseline Estimation Algorithm for Spectroscopic Data

Analytica Chimica Acta. Jan, 2010  |  Pubmed ID: 20005331

A common feature of many modern technologies used in proteomics--including nuclear magnetic resonance imaging and mass spectrometry--is the generation of large amounts of data for each subject in an experiment. Extracting the signal from the background noise, however, poses significant challenges. One important part of signal extraction is the correct identification of the baseline level of the data. In this article, we propose a new algorithm (the "BXR algorithm") for baseline estimation that can be directly applied to different types of spectroscopic data, but also can be specifically tailored to different technologies. We then show how to adapt the algorithm to a particular technology--matrix-assisted laser desorption/ionization Fourier transform ion cyclotron resonance mass spectrometry--which is rapidly gaining popularity as an analytic tool in proteomics. Finally, we compare the performance of our algorithm to that of existing algorithms for baseline estimation. The BXR algorithm is computationally efficient, robust to the type of one-sided signal that occurs in many modern applications (including NMR and mass spectrometry), and improves on existing baseline estimation algorithms. It is implemented as the function baseline in the R package FTICRMS, available either from the Comprehensive R Archive Network (http://www.r-project.org/) or from the first author.

Toward a National Nurse-managed Health Center Data Set: Findings and Lessons Learned over 3 Years

Nursing Outlook. Mar-Apr, 2010  |  Pubmed ID: 20362778

Although primary care nurse-managed health centers (NMHCs) have gained increasing recognition, there are limited standardized clinical and financial data on these centers. The purpose of this paper is to present the process, benefits, and challenges in collecting standardized national data based on a consensus process from NMHCs over 3 consecutive years. The Institute for Nursing Centers (INC) NMHC Survey focuses on demographic, clinical, and financial data. A detailed codebook accompanied the INC NMHC Survey. A total of 42 NMHCs responded in at least 1 of the 3 years. Despite the challenges in collecting some of the data, especially for the first survey year, data quality improved remarkably when the INC NMHC Survey was repeated. Financial data seemed to be more easily reported than demographic or clinical data. NMHCs increase access to care, often for vulnerable populations, yet to date there are limited standardized clinical and financial data on these centers. The INC NHMC Survey and data described in this paper begins to address that gap.

A Comparative Resident Site Visit Project: a Novel Approach for Implementing Programmatic Change in the Duty Hours Era

Academic Medicine : Journal of the Association of American Medical Colleges. Jul, 2010  |  Pubmed ID: 20592509

The Duke University Medical Center Internal Medicine Residency Program did not reach its anticipated quota of applicants during the 2008 National Residency Matching Program. Post-Match feedback regarding workload prompted an effort to redesign the general medicine service. As part of that effort, Duke program leaders sought to learn how peer programs accommodated Accreditation Council for Graduate Medical Education (ACGME) regulations. They launched the Resident Site Visit Project (RSVP).In 2008, Duke resident teams visited six other academic internal medicine residency programs based in university hospitals in the eastern United States. They conducted a systematic survey using a standardized questionnaire, interviewed program leaders and residents, and observed workflow directly. The RSVP identified strategies for accommodating ACGME rules in service design and also highlighted challenges shared by all of the programs.Discussion of the shared challenges yielded six core principles that directly guided Duke's general medicine service redesign: emphasize patient safety, reduce resident work compression, create educational opportunities, ensure automatic duty hours compliance, preserve essential program attributes, and involve stakeholders in the process of change.The Duke RSVP is an approach to programmatic change that applies information collected during site visits in defining core principles for program redesign. Collaboration between programs through resident site visits facilitates innovation, creates a foundation for change that increases stakeholder involvement, and generates opportunities for multicenter research.

Corneal Shaping and Ablation of Transparent Media by Femtosecond Pulses in Deep Ultraviolet Range

Journal of Cataract and Refractive Surgery. Sep, 2010  |  Pubmed ID: 20692573

To assess the performance of a newly developed solid-state femtosecond ultraviolet (UV) laser system in corneal ablation.

Quality of Care in Nurse-managed Health Centers

Nursing Administration Quarterly. Jan-Mar, 2011  |  Pubmed ID: 21157262

The purposes of this article are to: (a) describe the first, national, collection of quality measures for nurse-managed health centers (NMHCs); (b) present the quality findings; (c) compare findings with national ambulatory care benchmarks; and (d) discuss the feasibility of national quality data collection, including NMHCs' experiences with data submission and the utilization of findings.

Investigation of the Insulin-like Growth Factor-1 Signaling Pathway in Localized Ewing Sarcoma: a Report from the Children's Oncology Group

Cancer. Nov, 2011  |  Pubmed ID: 21480204

The insulin-like growth factor-1 (IGF-1) signaling pathway plays an important role in the pathology of Ewing sarcoma (ES). Retrospective studies have suggested that levels of IGF-1 and IGF binding protein 3 (IGFBP-3) are correlated with the outcome of patients with ES.

[Risk of Stroke and Death After Carotid Endarterectomy]

Medicina (Kaunas, Lithuania). 2011  |  Pubmed ID: 21956139

The benefit of carotid endarterectomy is highly dependent on surgical risk. The aim of this study was to evaluate the incidence of stroke and death after carotid endarterectomy, risk factors for poor outcomes, and importance of surgeon's competence.

Multiple Stromal Populations Contribute to Pulmonary Fibrosis Without Evidence for Epithelial to Mesenchymal Transition

Proceedings of the National Academy of Sciences of the United States of America. Dec, 2011  |  Pubmed ID: 22123957

There are currently few treatment options for pulmonary fibrosis. Innovations may come from a better understanding of the cellular origin of the characteristic fibrotic lesions. We have analyzed normal and fibrotic mouse and human lungs by confocal microscopy to define stromal cell populations with respect to several commonly used markers. In both species, we observed unexpected heterogeneity of stromal cells. These include numerous cells with molecular and morphological characteristics of pericytes, implicated as a source of myofibroblasts in other fibrotic tissues. We used mouse genetic tools to follow the fates of specific cell types in the bleomcyin-induced model of pulmonary fibrosis. Using inducible transgenic alleles to lineage trace pericyte-like cells in the alveolar interstitium, we show that this population proliferates in fibrotic regions. However, neither these cells nor their descendants express high levels of the myofibroblast marker alpha smooth muscle actin (Acta2, aSMA). We then used a Surfactant protein C-CreER(T2) knock-in allele to follow the fate of Type II alveolar cells (AEC2) in vivo. We find no evidence at the cellular or molecular level for epithelial to mesenchymal transition of labeled cells into myofibroblasts. Rather, bleomycin accelerates the previously reported conversion of AEC2 into AEC1 cells. Similarly, epithelial cells labeled with our Scgb1a1-CreER allele do not give rise to fibroblasts but generate both AEC2 and AEC1 cells in response to bleomycin-induced lung injury. Taken together, our results show a previously unappreciated heterogeneity of cell types proliferating in fibrotic lesions and exclude pericytes and two epithelial cell populations as the origin of myofibroblasts.

Outcome for Adolescent and Young Adult Patients with Osteosarcoma: A Report from the Children's Oncology Group

Cancer. Jan, 2012  |  Pubmed ID: 22252521

BACKGROUND: There are conflicting data regarding age as a prognostic factor in osteosarcoma. The authors conducted a study evaluating the impact of age on prognosis in children and young adults with osteosarcoma enrolled on North American cooperative group trials. METHODS: Patients with high-grade osteosarcoma of any site enrolled on North American cooperative group trials CCG-7943, POG-9754, INT-0133, and AOST0121 were included in this study. Primary tumor site, age, sex, ethnicity, histologic response, and presence of metastatic disease at diagnosis were evaluated for their impact on overall survival (OS) and event-free survival (EFS). RESULTS: A total of 1054 patients were eligible and had complete data available for the study. Age was not significantly associated with any other presenting covariate analyzed except sex. Age 18 or older was associated with a statistically significant poorer EFS (P = .019) and OS (P = .043). The 10-year EFS and OS in patients <10, 10 to 17, and ≥18 years old were 55%, 55%, 37% and 68%, 60%, 41%, respectively. The poorer EFS in patients ≥18 years old was because of an increased rate of relapse. Presence of metastatic disease at diagnosis, poor histologic response, and pelvic tumor site were also associated with a poorer prognosis. In multivariate analysis, age continued to be associated with poorer EFS (P = .019) and OS (P = .049). CONCLUSIONS: In osteosarcoma, age 18 to 30 years is associated with a statistically significant poorer outcome because of an increased rate of relapse. Poorer outcome in adolescent and young adult patients is not explained by tumor location, histologic response, or metastatic disease at presentation. Cancer 2012;. © 2012 American Cancer Society.