Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison of Drug Information Practice in Hospitals and Industry

To assess the type of information requested of a pharmaceutical manufacturer, requests received over a 12 month period in the Professional Services Department of Sterling Drug Inc were reviewed. To compare drug information services of Sterling Drug with those of pharmacist-operated drug information centers (DICs), requests were classified as to the nature of the question, category of requestor, and patient specificity. Questions regarding dosage or administration, drug identification, and adverse drug events were common in both DICs and industry. At Sterling Drug Inc the largest number of requests were for literature reprints or physician drug samples and dosage or administration. This contrasts with hospital-based DICs, where the largest number of requests pertained to therapeutic use and drug efficacy or adverse drug events. At Sterling and DICs few questions pertained to pharmacology, toxicology or poisoning, and pharmacokinetics. Physicians comprised the largest group of requestors in DICs. Professional and support staffing of DIC and industry drug information practice are compared. Staffing by PharmDs and RPhs was practically identical for drug information services regardless of whether the practice site was industry or DIC.
Psychosocial Clinical Pathway of Breast Cancer in Portuguese Women: The Distress, Emotional Control, Neuroticism, Social Support, Coping, Quality of Life and Body Image Perception's Changes over Time

Distressing events can lead to negative outcomes, such as post-traumatic stress symptoms; however, they can also lead to positive outcomes, being an experience of post-traumatic growth or benefit finding. In the context of cancer, the positive thinking may impact on important psychological outcomes, including depression, anxiety, positive well-being and health behaviors. There are few longitudinal studies in this area. Thus, the aim of this study was to investigate the psychosocial clinical pathway of Portuguese women with breast cancer (time 1 "diagnosis", time 2 "surgery" and time 3 "treatments"). A total of 30 women diagnosed with breast cancer were evaluated, on 3 separate occasions, in relation to: distress, emotional control, neuroticism, social support, body image perception, coping and quality of life (QoL). The non-parametric Friedman test was used to compare the variables on each occasion. The changes' analysis of the psychosocial pathway of breast cancer, illustrated the slight impact of breast cancer as a negative life event. These results show a good adjustment at all levels (emotional, social and physically). The levels of neuroticism and body image perception indicated significant changes throughout time. The results indicate that finding positive meaning in response to a distressing event, such as breast cancer, is psychologically protective and, thus, may indirectly influence the long-term occurrence of depressive symptoms and impaired QoL. Considering the rapidly growing population of Portuguese breast cancer survivors, it is important to better understand their treatment and survival experiences in further studies.
Meta-analysis: Noninvasive Coronary Angiography Using Computed Tomography Versus Magnetic Resonance Imaging

BACKGROUND Two imaging techniques, multislice computed tomography (CT) and magnetic resonance imaging (MRI), have evolved for noninvasive coronary angiography. PURPOSE To compare CT and MRI for ruling out clinically significant coronary artery disease (CAD) in adults with suspected or known CAD. DATA SOURCES MEDLINE, EMBASE, and ISI Web of Science searches from inception through 2 June 2009 and bibliographies of reviews. STUDY SELECTION Prospective English- or German-language studies that compared CT or MRI with conventional coronary angiography in all patients and included sufficient data for compilation of 2 x 2 tables. DATA EXTRACTION 2 investigators independently extracted patient and study characteristics; differences were resolved by consensus. DATA SYNTHESIS 89 and 20 studies (comprising 7516 and 989 patients) assessed CT and MRI, respectively. Bivariate analysis of data yielded a mean sensitivity and specificity of 97.2% (95% CI, 96.2% to 98.0%) and 87.4% (CI, 84.5% to 89.8%) for CT and 87.1% (CI, 83.0% to 90.3%) and 70.3% (CI, 58.8% to 79.7%) for MRI. In studies that included only patients with suspected CAD, sensitivity and specificity of CT were 97.6% (CI, 96.1% to 98.5%) and 89.2% (CI, 86.0% to 91.8%). Covariate analysis yielded a significantly higher sensitivity for CT scanners with more than 16 rows (98.1% [CI, 97.0% to 99.0%]; P < 0.050) than for older-generation scanners (95.6% [CI, 94.0% to 97.0%]). Heart rates less than 60 beats/min during CT yielded significantly better values for sensitivity than did higher heart rates (P < 0.001). LIMITATIONS Few studies investigated coronary angiography with MRI. Only 5 studies were direct head-to-head comparisons of CT and MRI. Covariate analyses explained only part of the observed heterogeneity. CONCLUSION For ruling out CAD, CT is more accurate than MRI. Scanners with more than 16 rows improve sensitivity, as do slowed heart rates. PRIMARY FUNDING SOURCE None.
Association of Leg-Length Inequality With Knee Osteoarthritis

BACKGROUND Leg-length inequality is common in the general population and may accelerate development of knee osteoarthritis. OBJECTIVE To determine whether leg-length inequality is associated with prevalent, incident, and progressive knee osteoarthritis. DESIGN Prospective observational cohort study. SETTING Population samples from Birmingham, Alabama, and Iowa City, Iowa. PATIENTS 3026 participants aged 50 to 79 years with or at high risk for knee osteoarthritis. MEASUREMENTS The exposure was leg-length inequality, measured by full-limb radiography. The outcomes were prevalent, incident, and progressive knee osteoarthritis. Radiographic osteoarthritis was defined as Kellgren and Lawrence grade 2 or greater, and symptomatic osteoarthritis was defined as radiographic disease in a consistently painful knee. RESULTS Compared with leg-length inequality less than 1 cm, leg-length inequality of 1 cm or more was associated with prevalent radiographic (53% vs. 36%; odds ratio [OR], 1.9 [95% CI, 1.5 to 2.4]) and symptomatic (30% vs. 17%; OR, 2.0 [CI, 1.6 to 2.6]) osteoarthritis in the shorter leg, incident symptomatic osteoarthritis in the shorter leg (15% vs. 9%; OR, 1.7 [CI, 1.2 to 2.4]) and the longer leg (13% vs. 9%; OR, 1.5 [CI, 1.0 to 2.1]), and increased odds of progressive osteoarthritis in the shorter leg (29% vs. 24%; OR, 1.3 [CI, 1.0 to 1.7]). LIMITATIONS Duration of follow-up may not be long enough to adequately identify cases of incidence and progression. Measurements of leg length, including radiography, are subject to measurement error, which could result in misclassification. CONCLUSION Radiographic leg-length inequality was associated with prevalent, incident symptomatic, and progressive knee osteoarthritis. Leg-length inequality is a potentially modifiable risk factor for knee osteoarthritis. PRIMARY FUNDING SOURCE National Institute on Aging.
Stigma, Social Relationship and HIV Testing in the Workplace: Evidence from South Africa ∗

This paper explores whether a worker's unwillingness to make his/her HIV-positive status or test-taking experience known by colleagues impedes his/her decision to test for HIV. After analyzing the new survey data provided by employees working for a large multinational enterprise in South Africa (2009-2010), this study finds that this unwillingness is negatively associated with test-taking (at the enterprise's on-site clinic) of workers who are extensively networked with close colleagues (i.e., know their phone numbers). It appears that the expected disutility associated with HIV/AIDS-related stigma prohibits test uptake. When introducing HIV counseling and testing programs into a corporate sector, providing all workers with an excuse to test in the workplace and/or inducing them to privately test outside the workplace may be effective in encouraging the uptake.
Open Notes: Doctors and Patients Signing On

Few patients read their doctors' notes, despite having the legal right to do so. As information technology makes medical records more accessible and society calls for greater transparency, patients' interest in reading their doctors' notes may increase. Inviting patients to review these notes could improve understanding of their health, foster productive communication, stimulate shared decision making, and ultimately lead to better outcomes. Yet, easy access to doctors' notes could have negative consequences, such as confusing or worrying patients and complicating rather than improving patient-doctor communication. To gain evidence about the feasibility, benefits, and harms of providing patients ready access to electronic doctors' notes, a team of physicians and nurses have embarked on a demonstration and evaluation of a project called OpenNotes. The authors describe the intervention and share what they learned from conversations with doctors and patients during the planning stages. The team anticipates that "open notes" will spread and suggests that over time, if drafted collaboratively and signed by both doctors and patients, they might evolve to become contracts for care.
Systematic Review: Factors Associated With Risk for and Possible Prevention of Cognitive Decline in Later Life

BACKGROUND Many biological, behavioral, social, and environmental factors may contribute to the delay or prevention of cognitive decline. PURPOSE To summarize evidence about putative risk and protective factors for cognitive decline in older adults and the effects of interventions for preserving cognition. DATA SOURCES English-language publications in MEDLINE, HuGEpedia, AlzGene, and the Cochrane Database of Systematic Reviews from 1984 through 27 October 2009. STUDY SELECTION Observational studies with 300 or more participants and randomized, controlled trials (RCTs) with 50 or more adult participants who were 50 years or older, drawn from general populations, and followed for at least 1 year were included. Relevant, good-quality systematic reviews were also eligible. DATA EXTRACTION Information on study design, outcomes, and quality were extracted by one researcher and verified by another. An overall rating of the quality of evidence was assigned by using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria. DATA SYNTHESIS 127 observational studies, 22 RCTs, and 16 systematic reviews were reviewed in the areas of nutritional factors; medical factors and medications; social, economic, or behavioral factors; toxic environmental exposures; and genetics. Few of the factors had sufficient evidence to support an association with cognitive decline. On the basis of observational studies, evidence that supported the benefits of selected nutritional factors or cognitive, physical, or other leisure activities was limited. Current tobacco use, the apolipoprotein E epsilon4 genotype, and certain medical conditions were associated with increased risk. One RCT found a small, sustained benefit from cognitive training (high quality of evidence) and a small RCT reported that physical exercise helps to maintain cognitive function. LIMITATIONS The categorization and definition of exposures were heterogeneous. Few studies were designed a priori to assess associations between specific exposures and cognitive decline. The review included only English-language studies, prioritized categorical outcomes, and excluded small studies. CONCLUSION Few potentially beneficial factors were identified from the evidence on risk or protective factors associated with cognitive decline, but the overall quality of the evidence was low. PRIMARY FUNDING SOURCE Agency for Healthcare Research and Quality and the National Institute on Aging, through the Office of Medical Applications of Research, National Institutes of Health.
Health Care for Prisoners in Haiti

Prisoners have disproportionate health care needs. Meeting those needs in a prison environment is challenging, especially in such resource-poor countries as Haiti. Even so, before the January 2010 earthquake, local and international organizations, in collaboration with the Haitian government, had been making significant progress to provide for the health needs of prisoners. The effort screened and identified prisoners for infectious disease, initiated appropriate care and treatment, and prepared prisoners for release to the community. Not only is it possible to establish an adequate prison health care program in a resource-poor country, it is necessary. Without adequate management of prisoners' health needs, especially for such infectious diseases as HIV and tuberculosis, disease burden increases. Infectious disease can spread among prisoners and impact the public's health. Recovery for postearthquake Haiti, as any nation rebuilding following natural disaster or conflict, requires respect for rule of law. This includes humane detention and the delivery of justice and adequate health care for prisoners.
Recognising the need for palliative care in aged care

This definition clarifies the essence of palliative care, but further consideration is required to identify how this theory can be applied in practice. Perhaps the most difficult context in which to identify the need for palliative care is in the aged care setting. Residents of residential aged care facilities (RACFs) require accurate initial assessment and regular reappraisal to determine the appropriateness of a palliative approach to care. It is of utmost importance that this appraisal should be based on individual needs, rather than being diagnosis specific or prognosis based.
Low Health Literacy and Health Outcomes: An Updated Systematic Review

BACKGROUND Approximately 80 million Americans have limited health literacy, which puts them at greater risk for poorer access to care and poorer health outcomes. PURPOSE To update a 2004 systematic review and determine whether low health literacy is related to poorer use of health care, outcomes, costs, and disparities in health outcomes among persons of all ages. DATA SOURCES English-language articles identified through MEDLINE, CINAHL, PsycINFO, ERIC, and Cochrane Library databases and hand-searching (search dates for articles on health literacy, 2003 to 22 February 2011; for articles on numeracy, 1966 to 22 February 2011). STUDY SELECTION Two reviewers independently selected studies that compared outcomes by differences in directly measured health literacy or numeracy levels. DATA EXTRACTION One reviewer abstracted article information into evidence tables; a second reviewer checked information for accuracy. Two reviewers independently rated study quality by using predefined criteria, and the investigative team jointly graded the overall strength of evidence. DATA SYNTHESIS 96 relevant good- or fair-quality studies in 111 articles were identified: 98 articles on health literacy, 22 on numeracy, and 9 on both. Low health literacy was consistently associated with more hospitalizations; greater use of emergency care; lower receipt of mammography screening and influenza vaccine; poorer ability to demonstrate taking medications appropriately; poorer ability to interpret labels and health messages; and, among elderly persons, poorer overall health status and higher mortality rates. Poor health literacy partially explains racial disparities in some outcomes. Reviewers could not reach firm conclusions about the relationship between numeracy and health outcomes because of few studies or inconsistent results among studies. LIMITATIONS Searches were limited to articles published in English. No Medical Subject Heading terms exist for identifying relevant studies. No evidence concerning oral health literacy (speaking and listening skills) and outcomes was found. CONCLUSION Low health literacy is associated with poorer health outcomes and poorer use of health care services. PRIMARY FUNDING SOURCE Agency for Healthcare Research and Quality.
Oseltamivir Compared With the Chinese Traditional Therapy Maxingshigan–Yinqiaosan in the Treatment of H1N1 Influenza

BACKGROUND Observational studies from Asia suggest that maxingshigan-yinqiaosan may be effective in the treatment of acute H1N1 influenza. OBJECTIVE To compare the efficacy and safety of oseltamivir and maxingshigan-yinqiaosan in treating uncomplicated H1N1 influenza. DESIGN Prospective, nonblinded, randomized, controlled trial. (ClinicalTrials.gov registration number: NCT00935194) SETTING Eleven hospitals from 4 provinces in China. PATIENTS 410 persons [corrected] aged 15 to 69 [corrected] years with laboratory-confirmed H1N1 influenza. INTERVENTION Oseltamivir, 75 mg twice daily; maxingshigan-yinqiaosan decoction (composed of 12 Chinese herbal medicines, including honey-fried Herba Ephedrae), 200 mL 4 times daily; oseltamivir plus maxingshigan-yinqiaosan; or no intervention (control). Interventions and control were given for 5 days. MEASUREMENTS Primary outcome was time to fever resolution. Secondary outcomes included symptom scores and viral shedding determined by using real-time reverse transcriptase polymerase chain reaction. RESULTS Significant reductions in the estimated median time to fever resolution compared with the control group (26.0 hours [95% CI, 24.0 to 33.0 hours]) were seen with oseltamivir (34% [95% CI, 20% to 46%]; P < 0.001), maxingshigan-yinqiaosan (37% [CI, 23% to 49%]; P < 0.001), and oseltamivir plus maxingshigan-yinqiaosan (47% [CI, 35% to 56%]; P < 0.001). Time to fever resolution was reduced by 19% (CI, 0.3% to 34%; P = 0.05) with oseltamivir plus maxingshigan-yinqiaosan compared with oseltamivir. The interventions and control did not differ in terms of decrease in symptom scores (P = 0.38). Two patients who received maxingshigan-yinqiaosan reported nausea and vomiting. LIMITATIONS Participants were young and had mild H1N1 influenza virus infection. Missing viral data precluded definitive conclusions about viral shedding. CONCLUSION Oseltamivir and maxingshigan-yinqiaosan, alone and in combination, reduced time to fever resolution in patients with H1N1 influenza virus infection. These data suggest that maxingshigan-yinqiaosan may be used as an alternative treatment of H1N1 influenza virus infection. PRIMARY FUNDING SOURCE Beijing Science and Technology Project and Beijing Nova Program.
Clinical Decision Rules for Excluding Pulmonary Embolism: A Meta-analysis

BACKGROUND Clinical probability assessment is combined with d-dimer testing to exclude pulmonary embolism (PE). PURPOSE To compare the test characteristics of gestalt (a physician's unstructured estimate) and clinical decision rules for evaluating adults with suspected PE and assess the failure rate of gestalt and rules when used in combination with d-dimer testing. DATA SOURCES Articles in MEDLINE and EMBASE in English, French, German, Italian, Spanish, or Dutch that were published between 1966 and June 2011. STUDY SELECTION 3 reviewers, working in pairs, selected prospective studies in consecutive patients suspected of having PE. Studies had to estimate the probability of PE by using gestalt or a decision rule and verify the diagnosis by using an appropriate reference standard. DATA EXTRACTION Data on study characteristics, test performance, and prevalence were extracted. Reviewers constructed 2 × 2 tables and assessed the methodological quality of the studies. DATA SYNTHESIS 52 studies, comprising 55 268 patients, were selected. Meta-analysis was performed on studies that used gestalt (15 studies; sensitivity, 0.85; specificity, 0.51), the Wells rule with a cutoff value less than 2 (19 studies; sensitivity, 0.84; specificity, 0.58) or 4 or less (11 studies; sensitivity, 0.60; specificity, 0.80), the Geneva rule (5 studies; sensitivity, 0.84; specificity, 0.50), and the revised Geneva rule (4 studies; sensitivity, 0.91; specificity, 0.37). An increased prevalence of PE was associated with higher sensitivity and lower specificity. Combining a decision rule or gestalt with d-dimer testing seemed safe for all strategies, except when the less-sensitive Wells rule (cutoff value ≤4) was combined with less-sensitive qualitative d-dimer testing. LIMITATIONS Studies had substantial heterogeneity due to prevalence of PE and differences in threshold. Many studies (63%) had potential bias due to differential disease verification. CONCLUSION Clinical decision rules and gestalt can safely exclude PE when combined with sensitive d-dimer testing. The authors recommend standardized rules because gestalt has lower specificity, but the choice of a particular rule and d-dimer test depend on both prevalence and setting.
Surgeon Practices and Attitudes toward the Control of Surgical-Site Infections in Jordan

The purpose of this study was to determine the attitudes and practices of Jordanian surgeons on the control of surgical-site infections, evaluated by the Center of Disease Control’s guidelines toward the prevention of surgical-site infections, in addition to gaining respondents opinions on infection control in Jordan. This study was conducted through the distribution of 75 questionnaires given to surgeons at five hospitals in Jordan. Additional insight on SSI infection control was gained through interviews with two cardiac surgeons and three infection control directors. The results of the survey were compared with the Center for Disease Control’s guide to surgical-site infection to determine surgeon compliance with international recommended guidelines in patient antiseptic bathing, setting and method of patient hair removal, and use of antibiotic prophylaxis, in addition to measuring respondents’ views toward their own compliance of preoperative, intraoperative, and postoperative infection control protocol. Of the 75 surveys distributed, 57 were returned indicating a 76% response rate. Survey results suggest that a significant portion of surgeons surveyed were not in compliance with CDC recommended guidelines, with only 47.4% recommending preoperative bathing, 29.8% of surgeons removing patient hair in the operating room, only 57.1% using clippers as a means to removing patient hair prior to surgery, and 12.3% not using antibiotic prophylaxis regularly. Yet, when surgeons were questioned as to how well they follow preoperative, intraoperative, and postoperative infection control protocol, 61.4%, 73.7%, and 72% respectively rated their adherence to these guidelines as “excellent” or “very good”. These results suggest the need for more education toward the prevention of surgical-site infections toward attending surgeons and surgical residents in addition to more effective surveillance of infection control programs at hospitals.