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A study evaluating the effect of Educational Needs Assessment Tool (ENAT) focused patient education, on health outcomes in patients with Rheumatoid Arthritis: Protocol of an ongoing study

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Open Journal of Nursing 2013年第2期3卷 287-292页

作者： Bernadette Hardware Claire Hale Dawn Johnson Jackie Hill tracey young Adewale Adebajo Academic and Clinical Unit for Musculoskeletal Nursing Institute of Rheumatic and Musculoskeletal Medicine University of Leeds Leeds UK Academic and Clinical Unit for Musculoskeletal Nursing School of Healthcare University of Leeds Leeds UK Medical Statistics School of Health and Related Research University of Sheffield Sheffield UK R&D Department Barnsley Hospital NHS Foundation Trust Barnsley UK

Aims and objectives: To evaluate the effectiveness of a patient education tool (the ENAT) on self efficacy, patient knowledge, health outcomes and its usability in practice. Background: The effectiveness and value of patient education in rheumatoid arthritis have been questioned. The ENAT was developed to help the nurses to provide more focused, individualized and relevant education. The psychometric properties of the ENAT have been assessed. Design: This study is a single blind randomized controlled trial using both quantitative and qualitative methodology. The primary outcome is patient self efficacy. Secondary outcomes are physical function, psychological status, pain levels, social interaction and patient knowledge of disease. Methods: 130 RA patients will be randomized into an experimental (EG) or control group (CG). The EG patients will complete the ENAT prior to seeing a Clinical Nurse Specialist (CNS) at weeks 0, 16 and 32. The CNS will use the ENAT as a template to meet patients perceived educational needs in addition to the usual care. The CG will receive their usual care from the CNS without the aid of the ENAT. To determine the ENAT’s usability, semi-structured quailtative interviews will take place with the practitioners and a sample of patients once they have completed the quantitative arm of the study. Results: The study commenced in April 2011 and the results are expected to be available after April 2013. Conclusions: It is hypothesized that nurses’ use of the ENAT will lead to increased patient self efficacy, and improved patient knowledge and health outcomes among the patients who used it. Furthermore, it is hypothesized that the ENAT will be easy for staff and patients to use. Relevance to clinical practice: The ENAT was developed to assess the perceived educational needs of patients with rheumatoid arthritis and thus help the nurses to provide more focused, individualised and relevant education.

关键词： Educational Needs Assessment Tool Protocol Rheumatoid Arthritis Self Management Patient Education

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Short-term antioxidant diet prevents hyperfiltration in young male rat kidney subjected to ischemia/reperfusion injury

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Open Journal of Molecular and Integrative Physiology 2013年第1期3卷 36-41页

作者： Yuriy Slyvka Felicia V. Nowak tracey M. Hayes Sharon R. Inman Department of Biomedical Sciences Ohio University Athens USA Program in Molecular and Cellular Biology Ohio University Athens USA

Objectives: The process of transplantation is associated with exposure to both long and short cold and warm ischemic times that result in ischemia/reperfusion injury. Oxidative stress contributes to tissue fibrosis, renal dysfunction, and/or rejection. Treatments that scavenge oxygen free radicals and have antioxidant properties can ameliorate the damaging results in renal grafts following ischemia/reperfusion injury. The present study tests the hypothesis that an antioxidant-fortified diet given to rats before and after renal ischemia/reperfusion injury will reduce the kidney damage that results and improve renal function. Endothelial and inducible nitric oxide synthases may change with tissue injury, including ischemia/ reperfusion. Materials and Methods: Male Wistar rats were subjected to ischemia/reperfusion injury at 7 or 19 weeks of age with or without dietary antioxidant supplementation. One week later, glomerular filtration rate, mean arterial pressure and urinary nitric oxide were measured, and renal endothelial and inducible nitric oxide synthases examined. Results: The glomerular filtration rate was elevated more than two-fold above the normal range? at 8 weeks in animals on the regular diet exposed to ischemia/reperfu- sion, while in the 8 week antioxidant-fortified diet group the glomerular filtration rate was normal. Also, in 8 week rats, levels of endothelial nitric oxide synthase protein in cortex were higher on the regular than on the antioxidant-fortified diet. Conclusion: Early after ischemia/reperfusion injury renal endothelial nitric oxide synthase levels rise, possibly contributing to vascular dilation and hyperperfusion, and an antioxidant-fortified diet can ameliorate these changes in the younger age group.

关键词： Antioxidants Ischemia/Reperfusion Kidney Nitric Oxide Synthase

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Colorectal cancer in patients under 50 years of age:A retrospective analysis of two institutions' experience

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World Journal of Gastroenterology 2013年第34期19卷 5651-5657页

作者： Elizabeth A Myers Daniel L Feingold Kenneth A Forde tracey Arnell Joon Ho Jang Richard L Whelan Department of Colon and Rectal Surgery St. Luke’s Roosevelt Hospital Department of Surgery College of Physicians and SurgeonsColumbia University

AIM:To investigate the epidemiological characteristics of colorectal cancer(CRC)in patients under 50 years of age across two ***:Records of patients under age 50 years of age who had CRC surgery over a 16 year period were assessed at two *** following documents where reviewed:admission notes,operative notes,and discharge *** main study variables included:age,presenting symptoms,family history,tumor location,operation,stage/differentiation of disease,and post operative *** of disease was classified according to the American Joint Committee on Cancer TNM staging system:tumor depth;node status;and ***:CRC was found in 180 patients under age50 years(87 females,93 males;mean age 41.4±6.2years).young patients accounted for 11.2%of cases during a 6 year period for which the full data set *** percent had a 1stdegree and 12%a 2nd degree family CRC *** all patients(94%)were symptomatic at diagnosis;common symptoms included:bleeding(59%),obstruction(9%),and abdominal/rectal pain(35%).Evaluation was often delayed and bleeding frequently attributed to *** stage CRC(Stage 3 or 4)was noted in 53%of *** tumors were distal to the splenic flexure(77%)and 39%involved the *** patients(95%)had segmental resections;6 patients had subtotal/total *** differentiated tumors were noted in 12%and mucinous lesions in 19%of patients of which most had Stage 3 or 4 ***-two patients(13%)developed recurrence and/or progression of disease to *** patients(ages 42,42and 49 years)went on to develop metachronous primary colon cancers within 3 to 4 years of their initial ***:CRC was common in young patients with no family *** patients with symptoms merit a timely evaluation to avoid presentation with late stage CRC.

关键词： Colorectal cancer Colorectal cancer screening Sporadic colorectal cancer Early-age onset colorectal cancer Sigmoidoscopy

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Boceprevir early-access for advanced-fibrosis/cirrhosis in Asia-pacific hepatitis C virus genotype 1 non-responders/relapsers

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World Journal of Gastroenterology 2015年第28期21卷 8660-8669页

作者： Wattana Sukeepaisarnjaroen Tri Pham Tewesak Tanwandee Saroja Nazareth Sam Galhenage Lindsay Mollison Leanne Totten Alan Wigg Rosalie Altus Anton Colman Brenda Morales Sue Mason tracey Jones Nadine Leembruggen Vince Fragomelli Cheryl Sendall Richard Guan Dede Sutedja Soek Siam Tan Yock young Dan Yin Mei Lee Widjaja Luman Eng Kiong Teo Yin Min Than Teerha Piratvisuth Seng Gee Lim Srinagarind Hospital Cabramatta Practice Siriraj Hospital Bangkok Royal Perth Hospital Fremantle Hospital Flinders Medical Centre Royal Adelaide Hospital Austin Hospital Royal Prince Alfred Hospital John Hunter Hospital Nepean Hospital Cairns Base Hospital Mount Elizabeth Medical Centre Gleneagles Hospital Selayang Hospital National University Health System Yong Loo Lin School of Medicine National University of Singapore Changi General Hospital NKC Institute of Gastroenterology and Hepatology Prince of Songkla University

AIM:To examined the efficacy and safety of treatment with boceprevir,PEGylated-interferon and ribavirin(PR)in hepatitis C virus genotype 1(HCVGT1) PR treatmentfailures in ***:The Boceprevir Named-Patient Program provided boceprevir to HCVGT1 PR *** physicians were invited to contribute data from their patients:baseline characteristics,ontreatment responses,sustained virological response at week 12(SVR12),and safety were collected and *** analysis was performed to determine predictors of ***:150 patients were enrolled from Australia,Malaysia,Singapore and Thailand(Asians = 86,Caucasians = 63).Overall SVR12 was 61%(Asians= 59.3%,Caucasians = 63.5%).SVR12 was higher in relapsers(78%) compared with non-responders(34%).On-treatment responses predicted SVR,with undetectable HCVRNA at week 4,8 and 12 leading to SVR12 s of 100%,87%,and 82%respectively,and detectable HCVRNA at week 4,8 and 12,leading to SVR12 s of 58%,22%and 6%*** patients were similar to Caucasian patients with regards to on-treatment *** with cirrhosis(n= 69) also behaved in the same manner with regards to on-treatment *** with the IL28 B CC genotype(80%) had higher SVRs than those with the CT/TT(56%) genotype(P = 0.010).Multivariate analysis showed that TW8 and TW12 responses were independent predictors of *** adverse events occurred in 18.6%:sepsis(2%),decompensation(2.7%) and blood transfusion(14%).Discontinuations occurred in 30.7%,with 18.6%fulfilling stopping ***:Boceprevir can be used successfully in PR treatment failures with a SVR12 > 80%if they have good on-treatment responses;however,discontinuations occurred in 30%because of virological failure or adverse events.

关键词： Chronic hepatitis C Treatment failure Rapid virological response Lead-in Null response Partial response Relapse Cirrhosis Response guidedtherapy

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Planned Psychiatric Admissions to Reduce Emergency Presentations： A Retrospective Cohort Study of Adolescents

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Psychology Research 2014年第1期4卷 25-30页

作者： Mohammed Usman tracey Dryden-Mead Catherine Crouch Women's and Children's Hospital Adelaide South Australia Women's and Children's HealthNetwork--Adolescent Outreach Service for CAMHS Adelaide South Australia Forensic Mental Health ServiceAdelaide South Australia

Self-harm in young people has significant costs to the individual, family, community, and the health care system. Evidence-based strategies to address this issue is limited. Our study aims to present evidence for the strategy of utilizing planned admissions to reduce emergency presentations of adolescents who self-harm. A retrospective cohort study of individuals who were offered planned admissions to the state wide in patient adolescent psychiatric unit in South Australia. Of the participants studied, there was a mean reduction of 50% presentations to the emergency department following planned admission. Overall, there was a 64% reduction in emergency representations in this cohort. This study presents evidence for planned admissions as a means of reducing emergency presentation in adolescents who self-harm.

关键词：队列研究青少年招生精神卫生保健证据参与者

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