bluuebunny/crossref_metadata_2025 huggingface dataset:
Low Pharmacist Counseling Rates in the Kansas City, Missouri, Metropolitan Area
Authors: Fritsch Michelle A , Lamp Kenneth C
Published: May 2017

Objective

To quantify the percentage of patients counseled by community-based pharmacists.

Methods

Phase I consisted of a 15-minute observational period of pharmacist counseling in 50 randomly selected pharmacies in the Kansas City, MO, area. In phase II, a survey was mailed to the same pharmacies to obtain policies, self-reported rates of counseling, baseline workload, and personnel information, as well as perceived communication barriers.

Results

Forty-six of 50 pharmacies were observed in phase I after excluding 10 ineligible pharmacies and adding 6 replacement pharmacies. Pharmacists provided counseling in only 14 of the 46 pharmacies (30%). Nineteen percent (20/106) of all patients received pharmacist-initiated counseling. Pharmacists in independent pharmacies were observed counseling a significantly higher percentage of patients than were pharmacists in chain pharmacies (44% vs. 11%; p = 0.014). Technicians were observed counseling 5 patients in chain pharmacies. Detailed verbal counseling, defined as four or more of a group of major counseling components, was provided to only 8 of the 20 patients who were counseled by a pharmacist (40%; 8% of all patients). In phase II, 31 of 51 surveys (61%) were returned. During the requested survey time period, pharmacies estimated that approximately five prescriptions were filled every 15 minutes, 51.5% of which were new. Pharmacists in chain pharmacies reported dispensing greater numbers of prescriptions than did pharmacists in independent pharmacies. These data and the reported counseling rates indicated that 50% of all patient prescriptions should be counseled. This is a higher rate than actually observed. All pharmacies reported that pharmacists completed the counseling; however, 10% of the respondents reported that technicians also counseled patients. Contrary to the findings in phase I, slightly more than 50% of the pharmacists reported using detailed verbal counseling.

Conclusions

The overall observed rate of counseling in community pharmacies is low. In the Kansas City area, independent pharmacists counsel a greater than average percentage of their patients. Even if the national counseling rate is double what was observed, millions of patients are leaving pharmacies without the benefit of pharmacotherapeutic guidance. If pharmacists are slow to meet these challenges, other service providers will relieve pharmacists of that responsibility.
Ceftibuten: A New Expanded-Spectrum Oral Cephalosporin
Authors: Guay David RP
Published: May 2017

Objective

To review the antimicrobial activity, pharmacokinetics, clinical efficacy, and tolerability of ceftibuten, a new expanded-spectrum oral cephalosporin.

Data Sources

Literature was identified by a MEDLINE search (January 1983–June 1996) of the medical literature, review of English-language literature and bibliographies of these articles, and data on file.

Study Selection

Clinical efficacy data were selected from all published and unpublished trials and abstracts that mentioned ceftibuten. Additional information concerning in vitro susceptibility, safety, chemistry, and pharmacokinetic profile of ceftibuten also was reviewed.

Data Synthesis

Ceftibuten, an oral expanded-spectrum cephalosporin, has a broad spectrum of activity against many gram-negative and selected gram-positive organisms, including Streptococcus pneumoniae, Streptococcus pyogenes, Moraxella catarrhalis, and Haemophilus influenzae. Ceftibuten is stable to hydrolysis by many common p-lactamases. Ceftibuten is rapidly and almost completely absorbed from the gastrointestinal tract and is primarily eliminated renally as unchanged drug. The elimination half-life of ceftibuten is slightly longer than 2 hours. Efficacy has been demonstrated in a number of clinical trials in adults and children with upper and lower respiratory tract infections (e.g., acute otitis media, pharyngitis, sinusitis, bronchitis) and urinary tract infections. The adverse effect profile is equal to that of comparator agents.

Conclusions

Ceftibuten is an alternative to other antimicrobial agents with convenient once-daily dosing in the treatment of upper and lower respiratory tract infections. Similar to other oral expanded-spectrum cephalosporins, ceftibuten has antimicrobial activity against common pathogens of the respiratory tract and is stable in the presence of many β-lactamases. The clinical choice of an oral expanded-spectrum cephalosporin will be based on patient acceptance, frequency of administration, and cost.
Necrotizing Soft Tissue Infections Reported with Nonsteroidal Antiinflammatory Drugs
Authors: Kahn Laura H , Styrt Barbara A
Published: May 2017

background: Recent reports of necrotizing fasciitis in children with varicella who received a nonsteroidal antiinflammatory drug (NSAID) recall earlier concerns regarding the possibility of relationships between infections and NSAIDs. We searched the Food and Drug Administration's Spontaneous Reporting System (SRS) for necrotizing soft tissue infections reported in conjunction with the use of NSAIDs, to identify common features.

methods: A computer search of NSAID listings in the adverse event database recovered reports with codes for selected infection and necrosis-related diagnostic categories. From review of individual reports classified under these codes, cases were selected if the terms “necrotizing fasciitis,” “necrotic,” or “gangrenous” appeared in the adverse drug reaction description. Demographic, drug use, and disease course information were gathered.

findings: Thirty-three cases were identified, of which 10 were fatal. Over two-thirds of the patients were younger than 40 years. Thirty (91%) had a possible portal of entry for infection. Most received NSAIDs for acute conditions including varicella, trauma, and postoperative or postpartum pain; 7 received an NSAID by intramuscular injection. Specific NSAIDs accounting for most reports were also among those likely to be most heavily used in the relevant populations.

interpretation: Common features of these rare case reports of necrotizing soft tissue infections with NSAID use include characteristics such as age, portal of infection entry, indication for NSAID use, route of administration, and individual NSAIDs. The total number of SRS cases does not suggest that necrotizing infection is frequent with NSAIDs or likely without other risk factors. Controlled observational studies would help to define any causal contribution of these factors to the evolution of severe infection.
Acute Pain Management: Operative or Medical Procedures and Trauma
Authors: Follin Sheryl L , Charland Scott L
Published: May 2017

Objective

To review the topics presented in the Agency for Health Care Policy and Research (AHCPR) Clinical Practice Guideline for Acute Pain Management and provide updated information on therapeutic issues as necessary.

Data Sources

AHCPR Clinical Practice Guideline for Acute Pain Management: Operative or Medical Procedures and Trauma. A MEDLINE search (1990 to June 1996) of English-language literature pertaining to pain assessment and management was performed. Reference lists from relevant articles also served as a literature source.

Study Selection and Data Extraction

All articles identified from the data sources were evaluated. Relevant information, as determined by the authors, was included in the review.

Data Synthesis

Inadequate acute pain management continues to be recognized as a problem due to limited health professional education on the treatment of pain, inadequate patient empowerment, negative connotations associated with opioid analgesics (e.g., fear of “addiction”), federal regulations associated with prescribing opioid analgesics, and difficulty in assessing pain. The widespread inadequacy in pain management prompted the development of the AHCPR Clinical Practice Guideline for Acute Pain Management, which was published in 1992. In addition to reviewing the pain guideline, this article includes updated information on ketorolac tromethamine, tramadol, local anesthetics, sedation, regional anesthetic techniques, and the management of opioid adverse effects.

Conclusions

The AHCPR Clinical Practice Guideline for Acute Pain Management is a comprehensive, yet functional, review for clinicians. Most issues relating to acute pain assessment and management are adequately discussed. Overall, this guideline is a worthwhile general resource to clinicians. It is important, however, for clinicians managing acute pain issues to supplement this guideline with more detailed and current information.
Use of Gabapentin in Pain Management
Authors: Wetzel Charles H , Connelly Julie F
Published: May 2017

There have been many proposed uses for gabapentin, including midscapular pain secondary to radiation myelopathy, RSD, neuropathic pain, postherpetic neuralgia, and migraine prophylaxis. However, the published reports consist of a small number of patients and limited data. Limited data provided in published case reports do not allow adequate evaluation of expected adverse effects or efficacy. It is unclear whether gabapentin is more effective for a specific type of pain and how gabapentin may compare with placebo or other therapeutic alternatives. Therefore, randomized, double-blind, placebo-controlled, prospective studies are warranted to further elucidate gabapentin uses beyond what is recommended by the Food and Drug Administration. Gabapentin should only be considered for pain management after well-established therapies have failed to produce desired outcomes.
Interdisciplinary implementation of tacrolimus intravenous standard concentration in hematopoietic stem cell transplantation recipients
Authors: Shank Brandon R , Deaver Melissa , Baker Angela , Myers Alan L , Zhang Yan-Ping , Anderegg Brent , Bassett Roland , Westmoreland Michael
Published: May 2017

Purpose

Reduction in waste of intravenous (IV) tacrolimus, an immunosuppressant used to prevent graft-versus-host disease in allogeneic hematopoietic stem cell transplantation recipients, was evaluated after standardizing the concentration.

Methods

A single-center, retrospective cohort study at a large academic comprehensive cancer center was performed comparing patient-specific intravenous tacrolimus doses (tacrolimus doses in 50, 100, or 250 mL of normal saline based on manufacturer’s recommended concentration) to tacrolimus intravenous standard concentration (tacrolimus 1 mg in 250 mL of normal saline) continuous intravenous infusion titrated to prescribed dose. The cohort study was performed on two hematopoietic stem cell transplantation nursing units consisting of a prepilot phase during which time patient-specific intravenous tacrolimus doses were compounded and administered, followed by the pilot phase during which patients received tacrolimus intravenous standard concentration. The primary endpoint was reduction in tacrolimus intravenous bags wasted. Secondary endpoints were drug cost savings, decreased intravenous infusion line supplies, decrease in time needed to execute dose changes, reduction in infusion pump alerts, and number of patient safety events.

Results

Compared to the prepilot phase, there was a 64% reduction in tacrolimus intravenous bags wasted during the pilot phase ( p = 0.029), resulting in a mean monthly total cost savings of $224.31 for pilot units. Intravenous pump line use was reduced by 18% ( p = 0.067), yielding a monthly total cost savings of $84.02 for pilot units. The median time needed to execute dose changes and intravenous pump overrides was significantly reduced ( p < 0.0001, p < 0.0001, respectively).

Conclusion

This interdisciplinary quality improvement initiative led to increased efficiency, reduction in waste, and decreased intravenous pump alerts utilizing tacrolimus intravenous standard concentration.
Experimental investigations on the sandwich composite beams and panels with elastomeric foam core
Authors: Nazari AR , Hosseini-Toudeshky H , Kabir MZ
Published: May 2017

In this paper, the load-carrying capacity and failure mechanisms of sandwich beams and panels with elastomeric foam core and composite laminate face sheets are investigated. For this purpose, the flexural behavior of laminated composite beams and panels (applied as face sheets) is firstly investigated under three-point bending and central concentrated loads, respectively. Then, the same examination is conducted for the sandwich beams and panels, in which the proposed elastomeric foam is utilized as the core material. It is shown that the failure mechanisms which are associated to the core in the sandwich structures with crushable foams are not considered in the examined sandwich structures. The collapse of the sandwich specimens, examined here, is observed due to the failure of the skins in some steps. By multi-step collapse of these specimens via separately failure of the top and bottom skins, a considerable amount of energy is absorbed between these steps. Due to non-brittle behavior of the core material under loading, a large compression resistance is observed after failure of the top skin which led to the recovery of the load-carrying capacity in the sandwich beams. A similar behavior for the sandwich panels led to the increase of the ultimate strength after appearance of the failure lines on the top skin. The general outcomes of this investigation promise a good influence for the application of elastomeric foam as core material for sandwich structures.
Modulation of Tryptophan/Serotonin Pathway by Probiotic Supplementation in Human Immunodeficiency Virus–Positive Patients: Preliminary Results of a New Study Approach
Authors: Corano Scheri Giuseppe , Fard Saeid Najafi , Schietroma Ivan , Mastrangelo Andrea , Pinacchio Claudia , Giustini Noemi , Serafino Sara , De Girolamo Gabriella , Cavallari Eugenio Nelson , Statzu Maura , Laghi Luca , Vullo Annamaria , Ceccarelli Giancarlo , Vullo Vincenzo , d’Ettorre Gabriella
Published: May 2017

Background:

To date, no data are available regarding the effects of probiotics on the pathway of tryptophan/serotonin metabolism among human immunodeficiency virus (HIV) 1–infected individuals. Because a condition of dysbiosis might be responsible for the altered use of tryptophan described in this population, the aim of this study was to investigate the link between probiotic supplementation and serotonin levels in combined antiretroviral therapy–treated patients and the subsistence of an interplay with inflammation.

Methods:

We conducted a pilot study that included 8 HIV-positive subjects. We collected blood and fecal samples before and after 6 months of probiotic supplementation, to measure the level of serotonin in serum and tryptophan in stool, the expression of CD38 and HLA-DR on peripheral CD4+ T lymphocytes (as immune activation markers), the expression of indoleamine 2,3-dioxygenase 1 messenger RNA (mRNA) and IFN-γ mRNA (as markers of tryptophan metabolism and systemic inflammation).

Results:

After probiotic supplementation, we observed a significant increase in concentration of serum serotonin ( P = .008) and a decreased level of tryptophan in plasma. Moreover, a significant reduction in CD38 and HLA-DR expression on the surface of peripheral CD4+ T cells ( P = .008) and a reduced expression of indoleamine 2,3-dioxygenase 1 mRNA on peripheral blood mononuclear cells ( P = .04) were observed.

Conclusions:

Considering that this probiotic (Vivomixx® in EU; Visbiome® in USA) has an influence on tryptophan metabolism, larger studies on this topic are needed.
Greater sensitivity to multiple sclerosis disability worsening and progression events using a roving versus a fixed reference value in a prospective cohort study
Authors: Kappos Ludwig , Butzkueven Helmut , Wiendl Heinz , Spelman Timothy , Pellegrini Fabio , Chen Yi , Dong Qunming , Koendgen Harold , Belachew Shibeshih , Trojano Maria ,   On Behalf of the Tysabri® Observational Program (TOP) Investigators
Published: May 2017

Background:

Confirmed Expanded Disability Status Scale (EDSS) progression occurring after a fixed-study entry baseline is a common measure of disability increase in relapsing-remitting multiple sclerosis (RRMS) studies but may not detect all disability progression events, especially those unrelated to overt relapses.

Objective:

To evaluate possible measures of disability progression unrelated to relapse using EDSS data over ≈5.5 years from the Tysabri® Observational Program (TOP).

Methods:

TOP is an ongoing, prospective, open-label study in RRMS patients receiving intravenous 300 mg natalizumab every 4 weeks. Measures of increasing disability were assessed using as a reference either study baseline score or a “roving” system that resets the reference score after ⩾24- or ⩾48-week confirmation of a new score.

Results:

This analysis included 5562 patients. Approximately 70% more EDSS progression events unrelated to relapse and 50% more EDSS worsening events overall were detected with a roving reference score (cumulative probability: 17.6% and 29.7%, respectively) than with a fixed reference baseline score (cumulative probability: 10.1% and 20.3%, respectively).

Conclusion:

In this long-term observational RRMS dataset, a roving EDSS reference value was more efficient than a study baseline EDSS reference in detecting progression/worsening events unrelated to relapses and thus the transition to secondary progressive disease.
Reliability of peripheral arterial tonometry in patients with heart failure, diabetic nephropathy and arterial hypertension
Authors: Weisrock Fabian , Fritschka Max , Beckmann Sebastian , Litmeier Simon , Wagner Josephine , Tahirovic Elvis , Radenovic Sara , Zelenak Christine , Hashemi Djawid , Busjahn Andreas , Krahn Thomas , Pieske Burkert , Dinh Wilfried , Düngen Hans-Dirk
Published: May 2017

Endothelial dysfunction plays a major role in cardiovascular diseases and pulse amplitude tonometry (PAT) offers a non-invasive way to assess endothelial dysfunction. However, data about the reliability of PAT in cardiovascular patient populations are scarce. Thus, we evaluated the test-retest reliability of PAT using the natural logarithmic transformed reactive hyperaemia index (LnRHI). Our cohort consisted of 91 patients (mean age: 65±9.7 years, 32% female), who were divided into four groups: those with heart failure with preserved ejection fraction (HFpEF) ( n=25), heart failure with reduced ejection fraction (HFrEF) ( n=22), diabetic nephropathy ( n=21), and arterial hypertension ( n=23). All subjects underwent two separate PAT measurements at a median interval of 7 days (range 4–14 days). LnRHI derived by PAT showed good reliability in subjects with diabetic nephropathy (intra-class correlation (ICC) = 0.863) and satisfactory reliability in patients with both HFpEF (ICC = 0.557) and HFrEF (ICC = 0.576). However, in subjects with arterial hypertension, reliability was poor (ICC = 0.125). We demonstrated that PAT is a reliable technique to assess endothelial dysfunction in adults with diabetic nephropathy, HFpEF or HFrEF. However, in subjects with arterial hypertension, we did not find sufficient reliability, which can possibly be attributed to variations in heart rate and the respective time of the assessments. Clinical Trial Registration Identifier: NCT02299960.
A method for experiential learning and significant learning in architectural education via live projects
Authors: Rodriguez Carolina M
Published: May 2017

In many schools of architecture worldwide, design studios are frequently isolated from everyday life and tend to focus on theory without experience. In countries with complex social problems, such as Colombia, experiential learning can offer valuable opportunities for architectural education to become an agency for social reconstruction and peace building. This works proposes a teaching method which centres on the promotion of significant learning, through live projects as a complement to studio-based projects. Bloom’s revised taxonomy and Fink’s taxonomy for levels of knowledge were used as references. In order to develop and test this method, 15 different live projects were designed, built and analysed over the course of four years. These involved the participation of 170 undergraduate learners, various national and international teachers, six sponsors from the construction industry and 12 children’s foundations. The findings reveal valuable insights into the development of intellectual, physical and emotional dimensions through these experiences.
Location, libation and leisure: An examination of the use of licensed venues to help challenge sexual violence
Authors: Gunby Clare , Carline Anna , Taylor Stuart
Published: May 2017

Anti-rape campaign messages have increasingly targeted men in order to educate them on the law of (sexual) consent. The 18–24 age demographic are at increased risk of experiencing sex offences, with over half of these crimes involving alcohol consumption. The interactions which culminate in alcohol-involved rape often commence in night-time venues, making intuitive sense for prevention campaigns to be based within licensed establishments. The Night Time Economy, however, comprises venues where people go to drink, have fun, take ‘time out’ and which are characterised and criticised for their promotion of sexism. This article therefore asks: how useful are licensed spaces in promoting rape prevention discourses amongst young men? To this end, the article analyses 41 students’ discussions (across six focus groups) regarding a rape prevention campaign that ran in one English city and that directed its prevention advice at males. In doing so, we argue that environments which incite narratives of loss of control and hypersexuality compromise the ability to counter sexual offending. We also argue that the presence of sexually violent advertising within licenced spaces undermines considerably the call to end gendered violence.
Design of improved optimal and suboptimal deadlock prevention for flexible manufacturing systems based on place invariant and reachability graph analysis methods
Authors: Pan Yen-Liang , Tseng Ching-Yun , Row Ter-Chan
Published: May 2017

Flexible manufacturing systems exhibit a high degree of resource sharing. Since the parts advancing through the system compete for a finite number of resources, a deadlock may occur. Accordingly, many pioneers make efforts in the issue. However, how to obtain maximally permissive supervisors in deadlock flexible manufacturing system is an extremely difficult and time-consuming problem. In existing literature, place invariant) and graph analysis method are merged called maximal number of forbidding First Bad Marking (FBM) problem to obtained optimal controllers with a small number of control places. However, this prevention just can be used in some special nets. For general cases, deadlocks could still exist. Therefore, this paper tries to propose one improved iterative deadlock prevention policy to solve above disadvantage. Experimental results show that the proposed improved policy can be used in all kinds of nets. In other words, it does improve the drawback of conventional maximal number of forbidding First Bad Marking (FBM) problem technology.
Crowd-sourced advocacy: Promoting disability rights through online storytelling
Authors: Trevisan Filippo
Published: May 2017

This article sheds light on the emergent advocacy technique of building policy counter-narratives by crowd-sourcing, organizing, and disseminating personal life stories online. Focusing on the case of disability rights groups in the United Kingdom, this article uses qualitative in-depth content analysis to examine 107 blog posts containing personal disability stories published in 2012–2013 by two anti-austerity groups. Although each of these groups managed its blogs differently, with one carefully curating stories and the other publishing crowd-sourced narratives without any form of editing, they generated virtually identical counter-narratives. These accounts challenged the dominant news narrative that presented disability welfare claimants as ‘cheats’ and ‘scroungers’. They did so by retaining the overarching structure of the dominant narrative – which functioned as the de facto coordinating mechanism for the crowd-sourced counter-narrative – and replacing its content with three alternative arguments drawn from personal life stories. The implications of this new advocacy technique for disabled people and other marginalized groups are discussed. This includes considerations about the development of a form of story-based advocacy that is both effective and respectful of the people who ‘lend’ their lived experiences for advocacy purposes. This article concludes by highlighting the need for research to investigate whether the new voices that emerge through these processes are ‘being heard’ and can successfully re-frame public discourse about sensitive policy issues.
The Use of Computerized Decision Support Systems in Preventive Cardiology—Principal Results from the National Precard® Survey in Denmark
Authors: Bonnevie Lise , Thomsen Troels , Jørgensen Torben
Published: May 2017

Background

The PRECARD® program has been used for electronic cardiovascular disease (CVD) risk assessment and management in Denmark since 1999. The use of and attitudes toward the program are reported.

Design and Methods

Using an Internet and postal survey to all Danish general practitioners, a total of 592 Danish general practitioners participated in the Internet part of the survey (response rate 19%) and 291 in the postal survey (response rate 73%).

Results

in all, 21.5% of the GPs use PRECARD®, whereas 10% are ex-users. The program is used on average once a week and 64% of the users report that PRECARD® prolongs the consultation somewhat or a lot Both users and ex-users perceive the program to have a favourable effect on the patients, and as an improvement to the dialogue between GP and patient Reasons for no longer using the program are varied, such as technical problems and lack of routine with the program.

Conclusions

Our results indicate that an electronic risk management tool like PRECARD®, is perceived as a quality improvement in preventive cardiology in primary care. However the use of the program is not optimal and it may prolong the consultation. Eur J Cardiovasc Prev Rehabil 12:52-55 © 2005 The European Society of Cardiology
The SaM (Screening and Monitoring) Approach to Cardiovascular Risk-Reduction in Primary Care—Cyclic Monitoring and Individual Treatment of Patients at Cardiovascular Risk using the Electronic Medical Record
Authors: Rabinowitz Israel , Tamir Ada
Published: May 2017

Background

Cardiovascular disease (CVD) prevention suffers from a major gap between clinical evidence (information) and clinical practice (implementation). Insufficient control risk factor levels and under-utilization of aspirin, statins, angiotensin-converting enzyme (ACE) inhibitors and beta-blockers are well-known examples.

Methods

The SaM (Screening and Monitoring) approach was devised by a family physician in order to facilitate closure of this gap. It does so by providing solutions to problems in the fields of information and implementation. A simple manipulation of the electronic medical record used in the practice serves to facilitate cyclic monitoring of patients with cardiovascular risk factors. Technological and human resources available in the primary care setting are used. The approach is described in the first part of the article. The second part presents results obtained by employing the approach on one family physician's patient population.

Results

The final results demonstrate a marked improvement over time in risk factor levels and use of medications in accordance with Indications. The values achieved are superior to those reported in the literature. Blood pressure in hypertensive patients 134/75 mmHg; haemoglobin A1c 7.27%; low-density lipoprotein-cholesterol in patients with CVD or diabetes, 97mg/dl; patients with CVD receiving anti-thrombotic medication, 94%; dyslipidaemic patients with CVD or diabetes receiving lipid-lowering drugs, 90%; post myocardial infarction patients receiving beta-blockers, 76%; hypertensive diabetics or patients with chronic heart failure (CHF) receiving ACE-inhibitors/angiotensin receptor blockers, 86%.

Conclusions

In this one-practice pilot-study, the SaM approach was employed with marked improvement in risk factor levels and use of appropriate medications. This may translate into reductions in morbidity and mortality in a larger population. Eur J Cardiovasc Prev Rehabil 12:56-62 © 2005 The European Society of Cardiology
Socio-Economic Status in Relation to Risk Factors Associated with Cardiovascular Disease, in Healthy Individuals from the ATTICA Study
Authors: Panagiotakos Demosthenes B. , Pitsavos Christos , Manios Yannis , Polychronopoulos Evangelos , Chrysohoou Christina A. , Stefanadis Christodoulos
Published: May 2017

Background

Social status has been related with the prevalence and incidence of cardiovascular disease. The aim of this study is to investigate the relationships between socio-economic status (SES) and clinical and biochemical factors related to coronary heart disease, in a sample of cardiovascular disease-free men and women.

Design

Cross-sectional survey.

Methods

During 2001-2002, 1514 men (20-87 years old) and 1528 women (20-89 years old) from the Attica region (Greece) were randomly enrolled into the study. Trends in established and emerging cardiovascular risk factors were examined across the participants' socio-economic status. A special index was developed (years of school by annual income) and three socio-economic classes were created.

Results

An inverse relationship was found regarding all lipids and glucose levels across the tertiles of the SES index. An inverse association was observed between body mass index, waist-to-hip ratio and SES in men, but not in women. Furthermore, compared to the lowest tertile, individuals who were classified in the highest SES tertile had lower levels of C-reactive protein, fibrinogen, homocysteine, tumour necrosis factor-α, interleukin-6 levels and white blood cell counts, even after adjusting for various potential confounders. Finally, a considerable proportion of men and women reported lack of health knowledge and education.

Conclusions

An inverse association between SES and factors related to cardiovascular risk exists, but the causal pathway itself requires more detailed explanation before the social status can have explanatory power.
“Nobody Sees It, Nobody Gets Mad”: Social Media, Privacy, and Personal Responsibility Among Low-SES Youth
Authors: Marwick Alice , Fontaine Claire , boyd danah
Published: May 2017

While few studies examine the online privacy practices or attitudes of young people of low socio-economic status (SES), they are often at the most risk of and most susceptible to privacy violations. This participatory, collaborative study of 28 low-SES young adults in the New York City area investigates how they view online information sharing. Like most Americans, our participants viewed online privacy as an individual responsibility. We make two primary contributions. First, participants revealed extensive awareness of the risks of sharing information online, and many avoided social media, self-censored, or obfuscated their contributions as a result. Second, many participants had extensive experience with policing and physical surveillance and were aware they could not avoid such encounters through their own efforts. This window into structural discrimination provides an alternate frame to that of “individual responsibility” that educators and researchers can use to conceptualize how privacy is violated online. Framing online privacy violations as inevitable and widespread may not only help foster activist anger and strategic resistance but also avoid the victim-blaming narratives of some media literacy efforts. By examining the experiences of these young people, who are often left out of mainstream discussions about privacy, we hope to show how approaches to managing the interplay of on- and offline information flows are related to marginalized social and economic positions.
A Comparative Biomechanical Analysis of 2 Double-Row, Distal Triceps Tendon Repairs
Authors: Dorweiler Matthew A. , Van Dyke Rufus O. , Siska Robert C. , Boin Michael A. , DiPaola Mathew J.
Published: May 2017

Background:

Triceps tendon ruptures are rare orthopaedic injuries that almost always require surgical repair. This study tests the biomechanical properties of an original anchorless double-row triceps repair against a previously reported knotless double-row repair.

Hypothesis:

The anchorless double-row triceps repair technique will yield similar biomechanical properties when compared with the knotless double-row repair technique.

Study Design:

Controlled laboratory study.

Methods:

Eighteen cadaver arms were randomized into 2 groups. One group received the anchorless repair and the other received the knotless anchor repair. A materials testing system (MTS) machine was used to cycle the repaired arms from 0° to 90° with a 2.5-pound weight for 1500 cycles at 0.25 Hz. Real-time displacement of the tendon was measured during cycling using a probe. Load to failure was performed after completion of cyclic loading.

Results:

The mean displacement with the anchorless technique was 0.77 mm (SD, 0.25 mm) at 0° (full elbow extension) and 0.76 mm (SD, 0.38 mm) at 90° (elbow flexion). The mean displacement with the anchored technique was 0.83 mm (SD, 0.57 mm) at 0° and 1.01 mm (SD, 0.62 mm) at 90°. There was no statistically significant difference for tendon displacement at 0º ( P = .75) or 90º ( P = .31). The mean load to failure with the anchorless technique was 618.9 N (SD, 185.6 N), while it was 560.5 N (SD, 154.1 N) with the anchored technique, again with no statistically significant difference ( P = .28).

Conclusion:

Our anchorless double-row triceps repair technique yields comparable biomechanical properties to previously described double-row triceps tendon repair techniques, with the added benefit of avoiding the cost of suture anchors.

Clinical Relevance:

This anchorless double-row triceps tendon repair can be considered as an acceptable alternative to a knotless anchor repair for triceps tendon ruptures.
Poor Adherence With Medication Refill and Medical Supplies Maintenance as Risk Factors for Inpatient Asthma Admission in Children
Authors: Poowuttikul Pavadee , Hart Benjamin , Thomas Ronald , Secord Elizabeth
Published: May 2017

Background. Asthma results in significant pediatric hospitalizations in the inner city. Many asthmatic children were admitted to our hospital as a result of lack of medications or medical supplies that had been previously prescribed (“ran out,” “broken,” or “lost”). Objective. To identify the incidence of children admitted for asthma because of lack of prescribed medications/supplies and to assess risk factors for poor adherence between groups. Methods. This was a prospective chart review of 200 asthmatic children admitted to Children’s Hospital of Michigan, Detroit. The data included asthma severity, lack of prescribed medications/medical supplies, and outpatient management. Results. In all, 35.5% or 71/200 of asthmatic children admitted had lack of prescribed medication/supplies (9% lacked both). The most common deficiency was β2-agonist (20.5%; 41/200). Teenagers had the highest lack of medications/medical supplies (55.6%; 5/9) compared with toddlers (17.2%; 16/93) and preschoolers (17.9%; 5/28). Patients with severe persistent asthma had a higher incidence of lacking medicine (31.8%; 7/22) compared with 25% (14/56) with moderate persistent asthma and 23.4% (15/64) of mild asthmatics. We found the lack of asthma medical supplies, including nonfunctioning or lost nebulizers/spacers, in 44.4% (4/9) of teenagers, 17.2% (16/93) of toddlers, and 21.4% (6/28) of preschool-aged children. We found no significant difference in these deficiencies whether patients were managed by asthma specialists or primary care providers. Conclusions. Significant numbers of asthmatic children admitted reported lack of prescribed medications/medical supplies. The most severe asthmatics were most likely to run out of medications. Interventions targeted at these deficiencies may avoid hospitalizations.
National Assembly Elections in Kuwait, 2016
Authors: Das Hirak Jyoti
Published: May 2017

Among the Gulf Cooperation Council (GCC) countries, Kuwait not only has the oldest constitution but also has a vibrant parliament. Kuwait has sent elected representatives to the National Assembly since 1963 that shares the legislative responsibilities with the Amir. In the last decade Kuwait National Assembly has confronted the government on various issues, especially on corruption charges and incompetence of individual ministers. It has led to frequent disruptions and dissolution of the assembly five times since 2003. The 2016 elections has returned a large number of deputies with inclination to traditional opposition and though it bodes well for democratization in the oil-rich Gulf state, it raises questions about going back to the era of disruptions and dissolutions seen during 2008–2012.
(Un)beliveable wages? An analysis of minimum wage policies in Europe from a living wage perspective
Authors: Fabo Brian , Belli Sharon Sarah
Published: May 2017

Minimum wage is one of the most debated issues in the labour policy area. Often perceived as a trade-off between employment and equality in earnings, the debate on minimum wage is highly polarized. With regard to the undergoing discussions on the Social Pillar of the European integration, we aim to extend the debate to include the aspect of minimum living standards, by empirically showing the gap between minimum wages and the minimum living wages in the peripheral countries of the European Union.

JEL Classification:J39
The progress of Chinese burn medicine from the Third Military Medical University—in memory of its pioneer, Professor Li Ao
Authors: Li Haisheng , Wang Fengjun , Zhou Junyi , Peng Yizhi , Zhang Jiaping , Peng Xi , Luo Qizhi , Yuan Zhiqiang , Yan Hong , Peng Daizhi , He Weifeng , Liang Guangping , Huang Yuesheng , Wu Jun , Luo Gaoxing
Published: May 2017

Professor Li Ao was one of the founders of Chinese burn medicine and one of the most renowned doctors and researchers of burns in China. He established one of the Chinese earliest special departments for burns at Third Military Medical University (TMMU) in 1958. To memorialize Professor Li Ao on his 100th birthday in 2017 and introduce our extensive experience, it is our honor to briefly review the development and achievement of the Chinese burn medicine from TMMU. The epidemiology and outcomes of admitted burn patients since 1958 were reviewed. Furthermore, main achievements of basic and clinical research for the past roughly 60 years were presented. These achievements mainly included the Chinese Rule of Nine, fluid resuscitation protocol, experience in inhalation injury, wound treatment strategies, prevention and treatment of burn infections, nutrition therapy, organ support therapies, and rehabilitation. The progress shaped and enriched modern Chinese burn medicine and promoted the development of world burn medicine.
Epithelial cell behaviours during neurosensory organ formation
Authors: Kapsimali Marika
Published: May 2017

Perception of the environment in vertebrates relies on a variety of neurosensory mini-organs. These organs develop via a multi-step process that includes placode induction, cell differentiation, patterning and innervation. Ultimately, cells derived from one or more different tissues assemble to form a specific mini-organ that exhibits a particular structure and function. The initial building blocks of these organs are epithelial cells that undergo rearrangements and interact with neighbouring tissues, such as neural crest-derived mesenchymal cells and sensory neurons, to construct a functional sensory organ. In recent years, advances in in vivo imaging methods have allowed direct observation of these epithelial cells, showing that they can be displaced within the epithelium itself via several modes. This Review focuses on the diversity of epithelial cell behaviours that are involved in the formation of small neurosensory organs, using the examples of dental placodes, hair follicles, taste buds, lung neuroendocrine cells and zebrafish lateral line neuromasts to highlight both well-established and newly described modes of epithelial cell motility.
Iterative reconstruction in single-source dual-energy CT angiography: feasibility of low and ultra-low volume contrast medium protocols
Authors: Hou Ping , Feng Xiangnan , Liu Jie , Zhou Yue , Jiang Yaojun , Jiang Xiaochen , Gao Jianbo
Published: May 2017

Objective:

To evaluate the feasibility of using contrast medium (CM) of low and ultra-low volumes and injection rates in aortic CT angiography (CTA) through the joint application of single-source dual-energy CT (ssDECT) and adaptive statistical iterative reconstruction (ASIR).

Methods:

120 patients with known or suspected aortic dissection underwent aortic CTA and were equally divided into 3 groups. Conventional 120-kVp scan with a CM volume of 70 ml and an injection rate of 5 ml s−1 was performed on Group A. Groups B and C underwent ssDECT scan with CM volumes of 0.6 and 0.4 ml kg−1, respectively. 40% and 50% ASIR algorithms were applied for Groups B and C, respectively. A five-point grading scheme was utilized to subjectively evaluate the image quality, and the CT value and contrast-to-noise ratio were recorded as objective measures. The radiation dose was also evaluated.

Results:

Groups B and C had equivalent subjective scores and CT values as Group A, whereas they had higher or equivalent contrast-to-noise ratios. Group B had 40.1% and 30% reductions on CM volume and injection rate, respectively, than Group A. Group C further resulted in 19.2% and 22% lesser CM volume and injection rate than Group B. The average effective radiation doses for the study groups were 22.5–24.5% lower than the control group.

Conclusion:

With the aid of ASIR and ssDECT for aortic CTA, it is feasible to adopt low and ultra-low CM volumes and injection rates while obtaining good quality images.

Advances in knowledge:

Low and ultra-low CM volumes and injection rates are feasible in CTA through the joint application of ssDECT and ASIR.
Updates on the diagnosis and treatment of prostate cancer
Authors: Gasnier Anne , Parvizi Nassim
Published: May 2017

Prostate cancer is the second most prevalent cancer in males worldwide and the commonest cancer in males in the UK. The recent updates on the diagnosis and treatment of prostate cancer were discussed at a multidisciplinary day event organized by the British Institute of Radiology and held in London in November 2016. This day covered the use of the prostate-specific antigen biomarker and of advanced imaging techniques such as multiparametric and whole-body MRI, choline positron emission tomography/CT and gallium-labelled prostate-specific membrane antigen for the detection of prostate cancer. In addition, the results of several trials assessing the management of the disease were discussed, in particular the Prostate Cancer Intervention Versus Observation Trial and Prostate Testing for Cancer and Treatment trials which evaluated the gain of intervention vs observation, and four randomized controlled trials comparing hypofractionated and standard radiotherapy regimen. Further to this event, this commentary highlights the topical issues relating to recently published guidelines and to trials for the management of prostate cancer where these were discussed.
СОВЛАДАНИЕ СО СТРЕССОВЫМИ И ПРОБЛЕМНЫМИ ДЛЯ ЛИЧНОСТИ СИТУАЦИЯМИ И СЛАБОВЫРАЖЕННЫЕ ДЕПРЕССИВНЫЕ РАССТРОЙСТВА У ЛИЦ МОЛОДОГО ВОЗРАСТА В ПЕРИОДЕ АДАПТАЦИИ
Authors: Uliukin Igor Mikhailovich , Grigoriev Stepan Grigorjevich
Published: May 2017

Цель. Изучить взаимосвязь совладания со стрессовыми и проблемными для личности ситуациями и слабовыраженных депрессивных расстройств у лиц молодого возраста.Материалы и методы. Обследовано 100 практически студентов первого курса (группы «М» и «Ж», в соотношении 1/1) педагогического университета в периоде адаптации к учебному процессу. Для психологической диагностики совладающего со стрессом поведения использована «Методика для психологической диагностики способов совладания со стрессовыми и проблемными для личности ситуациями» [Вассерман Л.И., и др., 2009]. Исследовались такие копинг-стратегии, как «Конфронтация», «Дистанцирование», «Самоконтроль», «Поиск социальной поддержки», «Принятие ответственности», «Бегство-избегание», «Планирование решения проблемы», «Положительная переоценка». Определение депрессивного фона настроения в клинически малой степени выраженности или неопределённости, и оценивание принадлежности синдрома к определённому классу депрессий проведено по «Шкале для экспресс-психологической диагностики слабоструктурированных депрессивных расстройств» [Беспалько И.Г., 2004]. Каждый участник подписывал форму информированного согласия на обследование. Статистическая обработка данных осуществлялась с помощью пакета прикладных программ Statistica 7.0.Результаты. Выявлены и проанализированы гендерная структура копинг-стратегий и их связь со слабовыраженными депрессивными расстройствами.Заключение. Показано, что для успешной адаптации студентов к учебному процессу необходимы создание в обучающих группах благоприятного психолого-педагогического микроклимата с целью формирования и индивидуализации умений самоорганизации в соответствии с личностными особенностями студентов; взаимодействие со студентами для преодоления трудностей в учебе; раннее выявление студентов группы риска и предупреждение у них возможных нарушений адаптации в период социализации посредством (при необходимости) психодиагностики и консультирования; решения личностных проблем в адаптационный период посредством оказания консультативной или иной другой помощи для предупреждений отклоняющегося поведения.
ИНФОРМАЦИОННО-КОГНИТИВНАЯ ЭФФЕКТИВНОСТЬ ДЕЯТЕЛЬНОСТИ ВРАЧА КАК ИНДИКАТОР КАЧЕСТВА МЕДИЦИНСКОЙ ПОМОЩИ
Authors: Khudonogov Igor Yurievich , Lipilkin Pavel Viktorovich , Kim Vyacheslav Vladislavovich
Published: May 2017

Цель. Изучение влияния непосредственной коммуникации пациента с врачом на различные информационно-когнитивные индикаторы качества медицинской помощи.Материалы и методы. Обследовано 100 пациентов (44 мужчин и 56 женщин) в возрасте от 18 до 72 лет. Социологическое обследование включало признаки, характеризующие толерантность пациентов к ущемлению прав, их лидерские качества, мотивационно-ценностную сферу, уровень личной ответственности за собственное здоровье и жизнь, познавательную активность и др. Выделялось два статуса пациентов – наличие (51 респондент – 1-я группа) или отсутствие (49 респондентов – 2-я группа) личного знакомства пациента с врачом.Результаты. По данным проведенного исследования личное знакомство пациента с врачом усиливает комплаентность в 2,2 раза (р<0,001); углубляет понимание собственной медицинской некомпетентности в 3,8 раза (р=0,05); усиливает желание получить дополнительные медицинские данные о своем здоровье в 7,7 раз (р<0,05); повышает интегральный показатель качества медицинской помощи практически двукратно.Заключение. Результаты проведенного исследования позволяют сделать вывод о том, что изучение качества медицинской помощи в сфере информационно-когнитивных взаимодействий является наиболее перспективным направлением развития дисциплины общественное здоровье и здравоохранение.