Miracle-dz/UniFAR-FTUs huggingface dataset:
Technological Change in Health Care: A Global Analysis of Heart Attack

Evidence from the United States suggests that technological change is a key factor in understanding both medical expenditure growth and recent dramatic improvements in the health of people with serious illnesses. Yet little international research has examined how the causes and consequences of technological change in health care differ worldwide. Seeking to illuminate these issues, this volume documents how use of high-technology treatments for heart attack changed in fifteen developed countries over the 1980s and 1990s. Drawn from the collaborative effort of seventeen research teams in fifteen countries, it provides a cross-country analysis of microdata that illuminates the relationships between public policies toward health care, technology, costs, and health outcomes.The comparisons presented here confirm that the use of medical technology in treatment for heart attack is strongly related to incentives, and that technological change is an important cause of medical expenditure growth in all developed countries. Each participating research team reviewed the economic and regulatory incentives provided by their country's health system, and major changes in those incentives over the 1980s and 1990s, according to a commonly used framework. Such incentives include: the magnitude of out-of-pocket costs to patients, the generosity of reimbursement to physicians and hospitals, regulation of the use of new technologies or the supply of physicians, regulation of competition, and the structure of hospital ownership. Each team also reviewed how care for heart attacks has changed in their country over the past decade.The book will be of enormous importance to health economists, medical researchers and epidemiologists, and policymakers.Mark McClellan is Associate Professor of Economics and of Medicine and, by courtesy, of Health Research and Policy, Stanford University. He is a National Fellow, the Hoover Institution. Daniel P. Kessler is Associate Professor of Economics, Law, and Policy in the Graduate School of Business, Stanford University, and a Research Fellow, the Hoover Institution.
Ätiopathogenese der chronisch entzündlichen Darmerkrankungen

Etiopathogenesis of Inflammatory Bowel Diseases Genetic and environmental factors and an abnormal activation of the immune system are the pathogenetic key determinants discussed in inflammatory bowel diseases. The identification of NOD2 variants as susceptibility markers for Crohn’s disease offers a link between these factors though many questions remain to be solved. Several other genetic susceptibility markers have been identified either typical for Crohn’s disease, ulcerative colitis, or for both entities. The genetic influence seems to be more prominent in Crohn’s disease than in ulcerative colitis.
Haut trifft Gelenk: Chancen und Herausforderungen der Therapie von Psoriasis und Psoriasis-Arthritis

Immunologische Krankheitsbilder stellen gerade junge Ärztinnen und Ärzte – sei es in der Diagnostik oder Therapie – vor große Herausforderungen. Aus diesem Grund möchten wir die neue Rubrik «AutoimmunCampus» im KARGER KOMPASS vorstellen, die fachliche (von der Pathogenese bis zur Klinik und Therapie), aber auch berufspolitische Themen adressiert. In der ersten Ausgabe führt der «Blickfang Pathogenese» kompakt in die Entstehung der Psoriasis und Psoriasis-Arthritis ein. Ziel soll es sein, die teils komplexen pathogenetischen Zusammenhänge insbesondere für ein besseres Verständnis der modernen, zielgerichteten Therapien zu vermitteln. In dem Folgebeitrag von Dr. Charlotte Krausewitz und Dr. MUDr. Valentin S. Schäfer steht die Differentialdiagnostik der Psoriasis-Arthritis im Fokus. Hier werden klinisch relevante Befunde für eine Sicherung der Diagnose, aber auch mögliche Pitfalls dargestellt und diskutiert. Der Beitrag bietet, wiederum sehr praxisnah und alltagsrelevant, einen klinischen Leitfaden, um Patienten frühzeitig zu erkennen und zu therapieren. Neben dem klinischen Fokus spielen auch digitale Themen eine wichtige Rolle. Dr. Tobias Müller stellt in seinem Beitrag digitale Tools zur Unterstützung der Differenzialdiagnose für Ärzte und Patienten vor. Hier könnte – gerade für Erkrankungen, welche eine interdisziplinäre Behandlung benötigen – eine Chance liegen, um unsere Patienten in Zukunft über möglichweise größere Distanzen hinweg gemeinsam therapieren zu können. Wir hoffen, dass Ihnen die neue Kategorie einen Mehrwert liefert und freuen uns sehr über Ihre Rückmeldungen.
A study of the early implementation of the community matron policy in three Primary Care Trusts in England

This thesis presents a qualitative multiple case study which examines the early implementation of the community matron policy in three primary care trusts in England. The community matron was a new role in nursing, introduced by the Department of Health in 2004, as part of its strategy for the management of long term conditions (DH, 2005e). There was a paucity of research literature underpinning the policy and the implementation of the community matron role in England. A descriptive multiple case study was used as it generates a richness of data using multiple data collection methods, ideally positioned to investigate phenomena in context and contemporaneously. In addition to documentary material, 49 participants were recruited across the three case study sites, from community matrons, active case managers, health and social care colleagues and patients. A total of 30 interviews, 33 observations and one focus group were undertaken between 2006 and 2008. Framework Analysis was used to interpret the data and critical sensemaking was applied as a heuristic to gain insight into the findings.This study explored the early role implementation from the perspective of the community matron. It found that the community matron role had been adopted with regard to the national model but there was variation in its implementation between case study sites, seen in service structures, eligibility criteria and caseload management. Practitioners had exercised professional discretion to flex local service models to fit their ways of practice and professional decision making, although this may not have been conscious behaviour. They also expanded the role to include psychosocial support, beyond the nationally defined functions. Advanced practice was integral to the role; whilst there appeared to be a medical influence on this aspect of role development; practitioners had adopted traditionally medical tasks and incorporated them into nursing practice, making such roles their own. Community matrons described experiencing resistance to the role initially from some district nurses and GPs, outlining how they adopted strategies to address these and promote acceptance of the role. As such, individual community matrons were the key change agents. They experienced dissonance between organisational values and professional values, which they addressed by reinterpreting collective targets such as reducing hospital admissions into individual patient outcomes related to improved quality of life. Critical sensemaking gives a unique perspective on the implementation of national policy, through the lens of the community matron, highlighting the experience of nursing role development at an individual and team level, and the ways in which variation can occur. Further research is needed into nursing policy implementation to better understand the processes at play nationally and organisationally. Critical sensemaking might be used to inform how implementation can be effective and sustainable.
Saturday, March 17, 2007

Several approaches have been taken to model the features of Alzheimer's Disease in mice. Good models now exist that develop plaques and tangles, and some show degenerative features of the disease. These models are now being used to test a wide range of possible therapeutic approaches, and several possible treatments have gone into clinical trials. An overview of the models, and the translational research showing greatest promise will be presented.
The Virotoxin Model of HIV-1 Enteropathy: Involvement of GPR15/Bob and Galactosylceramide in the Cytopathic Effects Induced by HIV-1 gp120 in the HT-29-D4 Intestinal Cell Line

Background: Malabsorption and diarrhea are common, serious problems in AIDS patients, and are in part due to the incompletely understood entity HIV enteropathy. Our prior in vitro work has shown that increased transepithelial permeability and glucose malabsorption, similar to HIV enteropathy, are caused by HIV surface protein gp120, although the mechanism remains unclear. Results: We studied the effects of HIV surface protein gp120 on the differentiated intestinal cell line HT-29-D4, specifically the effects on microtubules, transepithelial resistance, and sodium glucose cotransport. gp120 induced extensive microtubule depolymerization, an 80% decrease in transepithelial resistance, and a 70% decrease in sodium-dependent glucose transport, changes closely paralleling those of HIV enteropathy. The effects on transepithelial resistance were used to study potential inhibitors. Neutralizing antibodies to GPR15/Bob but not to CXCR4 (the coreceptor allowing infection with these HIV strains) inhibited these effects. Antibodies to galactosylceramide (GalCer) and a synthetic analog of GalCer also inhibited the gp120-induced changes, suggesting the involvement of GalCer-enriched lipid rafts in gp120 binding to intestinal epithelial cells. Conclusion: We conclude that direct HIV infection and gp120-induced cytopathic effects are distinct phenomena. While in vivo confirmation is needed to prove this, gp120 could be a virotoxin significantly contributing to HIV enteropathy.
Face Off!

Accessible online at: http://BioMedNet.com/karger In the early 1960s, emotion was considered an epiphenomenon by most experimental psychologists. According to Schacter and Singer’s [1962] influential theory, affect was merely a form of cognition with no independent status as a psychological construct of any importance. By the late 1970s, however, emotion had been rehabilitated as a motivational mechanism largely through the efforts of researchers focusing on the study of facial expression. The Psychology of Facial Expression must be understood within the context of this brief history of emotion theory. The Psychology of Facial Expression attempts to assess the link between faces and emotion, reviewing and critiquing current theory and offering some provocative alternatives. Its starting point is the Facial Expression Program described in the first chapter by Russell and Fernandez-Dols. The Facial Expression Program is a ‘prototypical’ version of what the editors believe is the currently standard theory of emotion and facial expression. According to this view, emotions are spontaneously expressed through facial expressions; however, these observable manifestations of affect may be overridden in accordance with cultural or personal norms (i.e., ‘display rules’) that may dictate the inhibition or production of particular emotional expressions. For historical reasons, most researchers have focused on the first part of this assertion, in the effort to demonstrate that – contrary to the Schacter and Singer view – emotion is more than just cognition plus arousal. Unfortunately, one consequence of this effort has been a tendency to neglect or even overlook the second part of this assertion, which is critically necessary for understanding the role of facial expression during social interaction. In addition, because psychologists have traditionally been concerned with internal intraindividual variables (like emotion), there has been a tendency to virtually equate facial expression with emotional expression, a position never held by the groundbreaking investigators of the 1960s. In fact, Ekman and Friesen [1969] wrote several early papers focusing on nonemotional facial expressions although these works have received relatively little attention. Reflecting this limited perspective, only two tenets of Russell and Fernandez-Dols’s Facial Expression Program include mention of nongenuine or
Cancer and the Skeleton

1. Structure and Physiology of the Normal Skeleton 2. Pathophysiology of Myeloma Bone Disease 3. Bone Metastases - Incidence and Complications 4. Pathophysiology of Bone Metastasis 5. Bone Metastases - Morphology 6. Hypercalcemia 7. Diagnostic - Nuclear Medicine 8. Radiology and MRI 9. Biochemical Markers of Malignant Bone Disease 10. Bone Metastases - General Approaches to Systemic Treatment 11. Bone Metastases - Radiotherapy 12. Clinical Use of Radioisotopes for Bone Metastases 13. Pain - Mechanisms, Assessment, and Management 14. Mechanisms of Action of Bisphosphonates in Tumor Bone Disease 15. Management of Myeloma Bone Disease 16. Bisphosphonates in Breast Cancer and Other Solid Tumors 17. Spinal Stabilization 18. Osteoporosis in Cancer Patients 19. Index
Vitamin D deficiency as a risk factor of type 2 diabetes in children and adolescents

Obesity is a global problem, more and more children have a weight above the norm. Obesity is related to circulatory system and metabolic disorders. Relations between obesity and metabolic disorders are known, however factors affecting the risk of such syndromes may extend beyond mentioned relations. Existence of vitamin D receptors in many of body cells, especially in pancreas islets of Langerhans indicates the possibility of significant role played by vitamin D in glucose homeostasis. Several epidemiological studies have reported that low 25-hydroxy vitamin D levels, the most common vitamin D indicator in plasma, very frequent in obese children, is correlated with insulin resistance. Moreover, mechanism of vitamin D is associated both with calcium level in tissues, that regulate insulin synthesis and insulin secretion, and direct secretion of pancreatic beta cells. Parathormone PTH, often defined as obesity indicator, is also crucial. Its high level indicates the risk of metabolic disorders. There is no doubt that reducing of body mass together with complementation of vitamin D insufficiency is the best solution for obese children to decrease the risk of incidence and limit the consequences of type 2 diabetes, one of most common civilization disease.
Diet, Body Size and the Energy Costs of Locomotion in Saltatory Primates

We report the energetic costs of locomotion in five nocturnal, saltatory prosimians. Using data on nightly travel distance, locomotor frequencies, distance and height change in each locomotor mode, we calculated absolute and relative costs of locomotion. Locomotion contributes at most 2% to total daily metabolic energy costs, consistent with most estimates for quadrupedal species. Tarsius, the smallest, has the lowest absolute and relative cost of locomotion, but the third smallest, Avahi, has the highest absolute and relative costs of locomotion, followed by the largest species, Otolemur crassicaudatus, which incurs particularly high costs in upwards-directed locomotion. Lepilemur’s costs of locomotion are maintained at an unexpectedly low level by remarkably short nightly travel distances.
Melanocyte Destruction and Repigmentation in Vitiligo: A Model for Nerve Cell Damage and Regrowth

Melanocytes (MCs) are melanin-producing cells of the skin that are derived from neural crest cells. Vitiligo vulgaris is a common depigmentation disorder resulting from the destruction of functional MCs in the affected skin. The three prevailing pathomechanisms of vitiligo are the immune hypothesis, the neural hypothesis and the autocytotoxic hypothesis. None of these mechanisms has been conclusively proven. Melanoblasts (MBs) in the outer root sheath of the hair follicles are the reservoir cells for repigmentation. Recovery from vitiligo is initiated by activation and proliferation of these MBs, followed by upward migration to the nearby epidermis that forms perifollicular pigmentation islands. Migration, proliferation and differentiation of MCs and MBs are regulated by keratinocyte-derived factors and some coat color genes. Any therapy for vitiligo must explain not only the repopulation of MCs but also their functional development. In patients with vitiligo, MCs are destroyed in the skin, the eyes, and possibly the ears. However, the concept of vitiligo as a systemic disease will be clearly established only when the mechanisms involved in vitiligo are identified. Recent advances in the fields of neural crest cell culture and molecular genetics have opened new perspectives in the understanding of vitiligo. Not only will this result in better treatments for vitiligo patients, but possibly will also provide a key to triggering nerve cell regrowth in other nervous diseases.
CHOLECYSTOKININ IN THE ROSTRAL VENTROMEDIAL MEDULLA IN MODELS OF NEUROPATHIC PAIN AND MORPHINE ADMINISTRATION

States of abnormal pain induced by injuries to peripheral nerves share common features with opioid antinociceptive tolerance including mechanical and thermal hypersensitivity. Sustained administration of morphine in humans and in animals induces a state of abnormal pain (i.e., hyperalgesia) and may be associated with the development opioid antinociceptive tolerance. Persistent neuropathic pain states and opioid induced abnormal pain require descending facilitation arising from the rostral ventromedial medulla (RVM). Cholecystokinin (CCK), a pronociceptive peptide, may be up-regulated following opioid treatment and nerve injury in the brain and spinal cord. Therefore, it is hypothesized that CCK in the RVM may be up-regulated by sustained opioid administration and my consequently drive descending pain facilitatory mechanisms to produce hypersensitivity and antinociceptive tolerance. Acute systemic morphine administration produced a potentiation of CCK release in the RVM as measured using microdialysis techniques. Sustained systemic morphine administration sufficient to produce thermal and tactile hypersensitivity resulted in a significant increase in basal CCK release in the RVM. Spinal nerve ligation (SNL) produces similar behavioral hypersensitivity. CCK levels in the RVM also increased following SNL. These findings suggest that endogenous CCK released in the RVM drives descending facilitatory pathways to produce hypersensitivity following sustained morphine administration and neuropathic pain. Disease states such as neuropathic pain offer special challenges in drug design due to system changes that accompany these diseases. Here, novel peptides with agonist
Nursing at the Crossroads of Culture Caring

There are many definitions of culture. Often commonly understood is its meaning referring to a person who prefers social gatherings and the company of people whose likes include listening to classic music, and participating in social events. This behavior is reflective of a cultured person. However, other definitions of culture exist that are more pertinent to nursing. These include – culture as a way of life for an entire society including codes of manners, dress, language, religion, rituals, norms of behavior and systems of belief. Culture or civilization, taken in its wide ethnographic sense, is that, complex whole which includes knowledge, belief, art, morals, law, custom, and any other capabilities and habits acquired by man as a member of society (Allender and Spradley, 2001). Recently, the United Nations Economic, Social and Cultural Organization UNESCO (2002) described culture as “culture should be regarded as the set of distinctive spiritual, material, intellectual and emotional features of society or a social group, and that it encompasses, in addition to art and literature, lifestyles, ways of living together, value systems, traditions and beliefs”. Culture is the socially inherited characteristics of a human group that are transmitted from one generation to the next. Culture influences both a person’s cognitive and behavioral development and shapes a person’s way of experiencing health and illness. Initially, culture was defined by the British anthropologist Sir Edward Tylor in 1871 as the Nursing at the Crossroads of Culture Caring
Profil Kadar Glukosa Darah Pada Pasien Skin Tag

Introduction Skin tag (acrochordon) is benign tumor of connective tissue in the dermis of the most frequently encountered. Skin tag have a relationship with glucose metabolism disorders, especially diabetes mellitus and insulin resistance. Increased fasting blood glucose levels with polyuri, polydipsy and polyphagy one of the criteria for diagnosis of diabetes mellitus. Methods This study is a descriptive study with cross -sectional design involving 32 patients skin tag. Diagnosis of skin tag is made based on history, clinical examination. Then the patient's blood sample for examination of fasting blood glucose levels. Test results are presented in the form of descriptive data. Results In this study the majority of 27 patient skin tag (84.40%) had normal fasting blood glucose levels. Conclusion : Patients with skin tag generally have a normal fasting blood sugar levels. Keywords skin tag, fasting blood glucose levels, characteristic. Abstrak Pendahuluan Skin tag (acrochordon) adalah tumor jinak jaringan konektif pada dermis yang paling sering dijumpai. Skin tag mempunyai hubungan dengan gangguan metabolisme glukosa terutama penyakit diabetes mellitus dan resistensi insulin. Peningkatan kadar glukosa darah puasa disertai poliuri, polidipsi, polifagi merupakan salah satu kriteria untuk menegakkan diagnosis penyakit diabetes mellitus. Peningkatan kadar glukosa darah diduga dapat terjadi pada pasien skin tag. Metode Penelitian inimerupakan suatu studi deskriptif dengan rancangan potong lintang (cross sectional) yang melibatkan 32 pasien skin tag. Diagnosis skin tag ditegakkan berdasarkan anamnesis dan pemeriksaan klinis. Kemudian pada pasien dilakukan pengambilan sampel darah untuk pemeriksaan kadar glukosa darah puasa. Hasil pemeriksaan disajikan dalam bentuk data deskriptif. Hasil Pada penelitian ini didapati mayoritas pasien skin tak 27 orang (84.40%) mempunyai kadar glukosa darah puasa normal. Simpulan Pasien skin tag umumnya mempunyai kadar gula darah puasa normal. Kata kunci skin tag ,kadar glukosa darah puasa, karakteristik.
Being Indigenous

I take seriously the honor of commenting on ideas put forth by Michael Chandler in his essay ‘On being indigenous: an essay on the hermeneutics of “cultural identity. ”’ My intent herein is to offer personal reflections about the ways I read the essay, about the thoughts my readings evoked. In other words, this commentary is in personal dialogue with Chandler’s perspectives, a relational musing about the many ways to be, to think, and to think about being indigenous in the world. My reflections on Chandler’s essay, then, are both personal and professional. In addition to being a mother of three (no longer that young me), and given my professional career in the area of indigenous early childhood education and public health, I often think about the importance of children in life cycles. As an indigenous woman of mixed blood who continues to come to understand what it means to be a Cree woman, and as a professional whose work is with children and families, I care deeply about our children’s identity (and that of all children) and the survival of our nations in the face of ongoing accelerated change. My work is influenced and informed by years of education in Euro-Western academies and by the teachings of elders from diverse nations. My commentary draws from all of this experience. I thus begin my reflections with an anecdote captured by Cree elder Eddie Bellerose, an anecdote that highlights the continuity of life and our role as adults within that circle: ‘Grandfather, what is the purpose of life? ’ After a long time in thought, the old man looked up and said: ‘Grandson, children are the purpose of life. We were once children and someone cared for us, now it is our time to care. ’