bluuebunny/crossref_metadata_2025 huggingface dataset:
Standardization of oral chemotherapy delivery to improve patient safety: A pilot study.
Authors: Desai Tejas , Carvalho Maritza , Fung Ron , Ahuja Devi , Gollee Simerjit , Almeida Bernadette , Grewal Gurpreet , Enright Katherine
Published: February 2017

90

Background: Oral chemotherapy (OC) presents unique challenges to patient safety. In contrast with parenteral chemotherapy, patient education and comprehension are crucial to the safe administration of OC, appropriate toxicity interventions and patient adherence. At Trillium Health Partners we identified a lack of standardization to OC education and monitoring, that resulted in gaps in patient care. Using the American Society of Clinical Oncology/Oncology Nursing Society 2013 chemotherapy safety standards as guidance, we developed and piloted a multi-disciplinary oral chemotherapy care pathway (OCCP) to improve the approach to education and monitoring of patients newly started on OC. Methods: Patients newly started on OC between 03/15–06/15 were enrolled by 2 participating physicians representing a predominantly lung/GI practice. Baseline data was abstracted retrospectively in the 3 months prior to the pilot to reflect all study participants. The OCCP included in-person and telephone assessments by an oncology pharmacist and nurse over 2 cycles of OC. Pilot outcomes included pharmacy interventions, dose modification for toxicity, medication errors, the percent of prescriptions on computerized physician order entry (CPOE), adherence documentation and comprehension of treatment plan. Results: The pilot enrolled 20 patients and compared them against 21 baseline patients. During the pilot there were improvements in the percentage of patients who had pharmacy interventions, documentation of adherence and assessment of comprehension of the treatment plan as well as a reduction in dose modifications due to toxicity (Table 1). Conclusions: Use of a newly developed oral chemotherapy care pathway demonstrated both feasibility as well as improvements in a variety of key patient safety indicators. These results suggest that implementation of a standardized oral chemotherapy care pathway can feasibly improve patient safety outcomes. [Table: see text]
Electronic operative reports to support quality improvement and patient-centered care.
Authors: Mukhi Shaheena , Maloney Elaine , Agent-Katwala Mary , Porter Geoff
Published: February 2017

95

Background: Operative reports (OP) for cancer surgery are usually narrated, although they provide inconsistent and incomplete information for patient care. National standards for cancer OP were unavailable until 2007. Over 10 years, surgeons in four Canadian provinces have transitioned from narrative to electronic synoptic reporting (ESP) for specific cancers. The electronic OP are now considered a patient medical record and integral to subsequent patient care. Surgeons are using electronic reports for quality assurance, billing, medical-legal conflict resolution and research. Methods: Disease-site expert panels were formed to bring together surgeons to discuss, identify, develop and form consensus on a core set of elements for breast, colorectal, ovary, endometrial, lung, prostate, and thyroid cancer surgeries and 64 quality indicators to set practice standards to consistently and comprehensively record pre-operative, operative procedures, intra-operative observations and pathology, clinical stage findings, complications and outcomes. These standards were implemented using ESP in four provinces and a mixed methods evaluation was carried out. Results: 245 surgeons in academic and community hospitals piloted and implemented pan-Canadian standards and generated 2000 synoptic reports and 729 discharge summaries over six months. In comparison to narrative reports, surgeons reported that the electronic synoptic reports: Capture complete and essential content (89% - 96%), 50% more; Contain 25 – 50 items vs. 2000 narrated words; Faster completion and turnaround time (5- 15 minutes) vs. 5 days; Rapid transmission to patient charts (91% in 1 hour and 97% within 24 hours) vs. 30 – 90 days; Result in cost savings $90/case; Enable performance measurement of surgical care to assess quality and outcome of surgery (e.g., residual disease and survival in patients) and length of aggressive vs. non-aggressive surgery and hospital stay (5.49 hours and 8.39 days vs. 3.06 hours and 6.83 days). Conclusions: Surgeons are building partnerships with key players to strategize best approaches to enable a system-wide adoption and implementation of synoptic operative reporting and quality of care measurement across Canada.
Survival After Early-Stage Breast Cancer of Women Previously Treated for Depression: A Nationwide Danish Cohort Study
Authors: Suppli Nis P. , Johansen Christoffer , Kessing Lars V. , Toender Anita , Kroman Niels , Ewertz Marianne , Dalton Susanne O.
Published: February 2017

Purpose

The aim of this nationwide, register-based cohort study was to determine whether women treated for depression before primary early-stage breast cancer are at increased risk for receiving treatment that is not in accordance with national guidelines and for poorer survival.

Material and Methods

We identified 45,325 women with early breast cancer diagnosed in Denmark from 1998 to 2011. Of these, 744 women (2%) had had a previous hospital contact (as an inpatient or outpatient) for depression and another 6,068 (13%) had been treated with antidepressants. Associations between previous treatment of depression and risk of receiving nonguideline treatment of breast cancer were assessed in multivariable logistic regression analyses. We compared the overall survival, breast cancer–specific survival, and risk of death by suicide of women who were and were not treated for depression before breast cancer in multivariable Cox regression analyses.

Results

Tumor stage did not indicate a delay in diagnosis of breast cancer in women previously treated for depression; however, those given antidepressants before breast cancer had a significantly increased risk of receiving nonguideline treatment (odds ratio, 1.14; 95% CI, 1.03 to 1.27) and significantly worse overall survival (hazard ratio, 1.21; 95% CI, 1.14 to 1.28) and breast cancer–specific survival (hazard ratio, 1.11; 95% CI, 1.03 to 1.20). Increased but nonsignificant estimated risks were also found for women with previous hospital contacts for depression. In subgroup analyses, the association of depression with poor survival was particularly strong among women who did not receive the indicated adjuvant systemic therapy.

Conclusion

Women previously treated for depression constitute a large subgroup of patients with breast cancer who are at risk for receiving nonguideline breast cancer treatment, which probably contributes to poorer overall and breast cancer–specific survival.
Family Perspectives on Hospice Care Experiences of Patients with Cancer
Authors: Kumar Pallavi , Wright Alexi A. , Hatfield Laura A. , Temel Jennifer S. , Keating Nancy L.
Published: February 2017

Purpose

To determine whether hospice use by patients with cancer is associated with their families’ perceptions of patients’ symptoms, goal attainment, and quality of end-of-life (EOL) care.

Methods

We interviewed 2,307 families of deceased patients with advanced lung or colorectal cancer who were enrolled in the Cancer Care Outcomes Research and Surveillance study (a multiregional, prospective, observational study) and died by 2011. We used propensity-score matching to compare family-reported outcomes for patients who did and did not receive hospice care, including the presence and relief of common symptoms (ie, pain, dyspnea), concordance with patients’ wishes for EOL care and place of death, and quality of EOL care. We also examined associations between hospice length of stay and these outcomes among hospice enrollees.

Results

In a propensity-score-matched sample of 1,970 individuals, families of patients enrolled in hospice reported more pain in their patient compared with those not enrolled in hospice. However, families of patients enrolled in hospice more often reported that patients received “just the right amount” of pain medicine (80% v 73%; adjusted difference, 7 percentage points; 95% confidence interval [CI], 1 to 12 percentage points) and help with dyspnea (78% v 70%; adjusted difference, 8 percentage points; 95% CI, 2 to 13 percentage points). Families of patients enrolled in hospice also more often reported that patients’ EOL wishes were followed (80% v 74%; adjusted difference, 6 percentage points; 95% CI, 2 to 11 percentage points) and “excellent” quality EOL care (57% v 42%; adjusted difference, 15 percentage points; 95% CI, 11 to 20). Families of patients who received > 30 days of hospice care reported the highest quality EOL outcomes.

Conclusion

Hospice care is associated with better symptom relief, patient-goal attainment, and quality of EOL care. Encouraging earlier and increased hospice enrollment may improve EOL experiences for patients with cancer and their families.
Desigualdade espacial na mortalidade por agressão no estado do Rio Grande do Norte, Brasil: 2010 a 2014
Authors: Amador Ana Edimilda , Marques Marilane Vilela , Nunes Aryelly Dayane Silva , Duarte Miranda Gabriella Morais , Ribeiro Barbosa Isabelle
Published: February 2017

Introdução: As mortes por agressão se destacam no Brasil, constituindo a primeira causa de morte entre as causas externas. Objetivo: analisar a distribuição espacial da mortalidade por agressão no Estado do Rio Grande do Norte no período de 2010 a 2014, buscando identificar o padrão dessa distribuição por meio de uma análise geoestatística. Métodos: estudo ecológico que analisou 6.035 óbitos ocorridos nos 167 municípios do estado registrados no Sistema de Informação sobre Mortalidade. Calculou-se a taxa média de mortalidade no período e analisou-se a distribuição espacial, a intensidade e a significância dos aglomerados por meio do índice de Moran Global, MoranMap e LisaMap. Para a produção dos mapas, foi utilizado o TerraView 4.2.2. Resultados: As mortes por agressão atingiram principalmente o sexo masculino (93,3%), a faixa etária de 20-29 anos (40,1%), os pardos (75%) e os solteiros (70%). A Região de Saúde de maior registro foi a Metropolitana com 3.038 óbitos. O índice de Moran Global (I) foi de 0.35505 (p=0,01), mostrando que os valores estão autocorrelacionados no espaço. Os resultados do MoranMap e do LisaMap mostraram que houve formação de clusters significativos nas regiões metropolitana e Oeste do estado. Conclusão: a mortalidade por agressões está desigualmente distribuída no estado do Rio Grande do Norte, apresentando clusters de alta mortalidade em duas regiões do estado.
Koivun paakkutaimien juurten kasvupotentiaali ja istutusajankohta
Authors: Rikala Risto
Published: February 2017

Koivun paakkutaimia on istutettu perinteisesti yksivuotisina, kylvövuotta seuraavana keväänä ennen lehtien puhkeamista. Tässä tutkimuksessa tarkastellaan mahdollisuutta istuttaa taimet jo kylvövuoden kesällä ja syksyllä. Koivun paakkutaimien juurten kasvupotentiaalia tutkittiin kasvihuonekokeissa kasvukauden eri vaiheissa sekä seurattiin eri ajankohtina istutettujen koivun paakkutaimien alkumenestystä peltokokeissa. Yksivuotisten koivun paakkutaimien juurten kasvu alkoi keväällä hitaasti ja nopeutui selvästi vasta kesäkuun alun jälkeen, kun lehdet olivat saavuttaneet täyden koon. Keväällä kylvettyjen ja samana kesänä, eri ajankohtina istutettujen, taimien juurten kasvupotentiaali oli voimakkainta ensimmäisellä istutuskerralla heinäkuun puolessavälissä ja heikkeni suoraviivaisesti kohti syksyn istutuskertoja. Pellolle perustetuissa istutusajankohtakokeissa sääolosuhteiltaan normaalin vuoden heinä–elokuussa istutetut koivun paakkutaimet menestyivät yhtä hyvin tai paremmin kuin seuraavana keväänä istutetut taimet. Koivun paakkutaimien kesäistutus edellyttää kuitenkin huolellista taimien käsittelyä ja hoitoa koko istutusketjun ajan.
Hakkuukoneenkuljettajien aikuiskoulutus oppilaiden arvioimana
Authors: Juntunen Marja-Liisa
Published: February 2017

Tutkimuksessa selvitettiin metsäoppilaitoksissa metsäkoneenkäytön jatkolinjoilla vuosina 1989–1991 olleiden oppilaiden taustatietoja ja erityisesti sitä, miten oppilaat täyttivät kurssien pääsyvaatimukset. Oppilaiden arvioita saamastaan koulutuksesta tutkittiin myös. Aineistona oli jatkolinjojen 16 kurssia ja niiden 173 oppilasta.
Luonnon muutosten havainnointi ja merkitys kuvaparien arviointi -menetelmää käyttäen
Authors: Kilpeläinen Tuija
Published: February 2017

Tutkimuksen tarkoituksena oli selvittää, millaisia havaintoja eräoppaat, metsätieteilijät ja biologit tekivät dioina kuvatuista luonnonympäristön muutoksista sekä millaisia merkityksiä he näille muutoksille antoivat. Tutkimusmenetelmänä käytettiin luonnonympäristön muutoksista kertovia diakuvapareja (kuva ennen muutosta ja muutoksen jälkeen) ja niihin liittyvää kyselylomaketta. Tavoitteena oli myös selvittää, miten kehitetty kuvaparien arviointi -menetelmä toimii luonnon muutosten arvioinnissa. Tutkimukseen osallistui kolme ryhmää: eräoppaat, metsätieteilijät ja biologit (N = 112). Tulokset osoittavat, että menetelmä on toimiva arvioitaessa luonnon muutoksia ja niiden merkityksiä. Tutkittavat antoivat kuvista tekemilleen havainnoille merkityksiä enimmäkseen esteettisyyden, muiden tunne-elämysten, oman toiminnan mahdollisuuden ja tehtyjen toimien perusteella. Metsätieteilijöiden vastaukset erityisesti metsään suuntautuvia toimia kohtaan olivat myönteisempiä kuin muiden tutkittujen ryhmien.
Etelä-Pohjanmaan metsäkeskuksen alueen metsävarat ja niiden kehitys 1968–97
Authors: Tomppo Erkki , Henttonen Helena , Korhonen Kari , Aarnio Alpo , Ahola Arto , Heikkinen Juha , Ihalainen Antti , Mikkelä Heli , Tonteri Tiina , Tuomainen Tarja
Published: February 2017

Tässä julkaisussa esitetään valtakunnan metsien yhdeksänteen inventointiin (VMI9) perustuvat Etelä-Pohjanmaan metsäkeskuksen alueen metsävaratiedot ja niiden muutokset 1968–97 sekä analysoidaan muutosten syitä. Lisäksi artikkelissa kuvataan VMI:n maastomittaus, tuloslaskenta ja luotettavuuden arviointimenetelmät.
Männyn kuivaoksa- ja latvusrajan silmävaraisen arvioinnin tarkkuus
Authors: Kiviluoma Pasi , Uusitalo Jori
Published: February 2017

Tutkimuksessa selvitettiin männyn kuivaoksa- ja latvusrajan silmävaraisen arvioinnin tarkkuutta. Tutkimusaineisto koostui kahdesta erillisestä mittauskokeesta. Arvioinnin suoritti kokeessa 1 seitsemän ja kokeessa 2 kymmenen henkilöä. Koehenkilöinä toimivat kummassakin kokeessa Aureskoski Oy:n metsäosaston toimihenkilöt. Arvioitavia puita oli yhteensä 63. Koejärjestelyistä johtuen tutkimuksessa voitiin tarkastella erikseen silmävaraisen arvioinnin tarkkuutta yleisesti, arvioijakohtaista vaihtelua sekä koulutuksen vaikutusta mittaustarkkuuteen.
Maiseman huomioonottavan metsikkökuvioinnin tuottaminen paikkatietojärjestelmällä
Authors: Store Ron
Published: February 2017

Tutkimuksessa kehitettiin menetelmä, jossa paikkatietojärjestelmän avulla tarkennetaan metsäsuunnittelussa käytettävää puuston ja kasvupaikan perusteella tehtyä metsikkökuviointia maisemallisesti tärkeissä kohteissa, kuten vesistöjen rannoilla sekä virkistysreittien ja teiden varsilla. Lisäksi uuden metsikkökuvioinnin kuviot ryhmitellään paikkatietoanalyysien avulla maisemaluokkiin, joita hyödynnetään hakkuita kohdennettaessa.
Sahauskelpoisen erikoispuun laatuvaatimukset ja käyttö Savo-Karjalan alueella
Authors: Kärki Timo
Published: February 2017

Tutkimuksessa on analysoitu Suomessa vähemmän käytettyjen puulajien, ns. erikoispuulajien, laatu- ja mittavaatimuksia sekä käyttöä Savo-Karjalan alueella. Työssä käsitellyt puulajit ovat laadukas mänty, kuusi ja koivu sekä lehtikuusi, kataja, haapa, leppä, pihlaja ja Suomessa luontaisena kasvavat jalot lehtipuut.
Siemenviljelyssiemenen käytön kannattavuus männyn kylvössä
Authors: Ahtikoski Anssi
Published: February 2017

Tutkimuksessa selvitettiin siemenviljelyssiemenen käytön kannattavuutta männyn kylvössä. Siemenviljelyssiemenellä kylvetyssä metsikössä hakkuutulojen nykyarvo on suurempi kuin tavallisella metsikkökeräyssiemenellä kylvetyssä metsikössä. Toisaalta siemenviljelyssiemenen hehtaarikohtaiset kylvökustannukset ovat kalliimmat kuin käytettäessä tavallista siementä. Tässä vertailtiin siemenviljelyssiemenellä kylvetyn metsikön hakkuutulojen nykyarvoa siemenviljelyssiemenen kylvökustannuksiin. Vertailussa käytettiin kolmea laskentakorkokantaa: 3, 5 ja 8 prosenttia.
Puuston tasearvo ja puutaseen ongelma metsälön tilinpäätöksessä
Authors: Hakkarainen Juha , Hyttinen Pentti , Tiilikainen Kimmo
Published: February 2017

Tutkimuksessa vertailtiin eri vaihtoehtoja puuston omaisuusarvon ja sen tilikausittaisen muutoksen käsittelemiseksi metsälön tuloslaskelmassa ja taseessa. Eri puutasemenetelmien soveltuvuutta metsätalouden tilakohtaisen kannattavuusseurannan tilinpäätöksen tarpeisiin vertailtiin sekä teoreettisesti että empiirisesti. Metsälön tilinpäätöksen tavoitteeksi on asetettu samanaikainen realisoituneen tuloksen ja puuston markkinahintaisen varallisuusaseman selvittäminen.
Kymen metsäkeskuksen alueen metsävarat ja niiden kehitys 1966–98
Authors: Tomppo Erkki , Korhonen Kari , Henttonen Helena , Ihalainen Antti , Tonteri Tiina , Heikkinen Juha
Published: February 2017

Tässä julkaisussa esitetään valtakunnan metsien yhdeksänteen inventointiin (VMI9) perustuvat Kymen metsäkeskuksen alueen metsävaratiedot ja niiden muutokset 1966–1998 sekä analysoidaan muutosten syitä. Lisäksi artikkelissa kuvataan yleispiirteet otantamenetelmästä. Inventoinnin otantamenetelmää, maastomittauksia ja tuloslaskentaa kehitettiin yhdeksättä inventointia varten. Menetelmä on kuvattu Etelä-Pohjanmaan tulosjulkaisun yhteydessä (Metsätieteen aikakauskirja 2B/1998). Kymen metsäkeskuksen alue muuttui vuonna 1996, minkä vuoksi tähän julkaisuun laskettiin uudelleen nykyisen alueen tulokset viidennestä inventoinnista lähtien. Alue on poikkeuksellinen koko maassa, koska sinne on keskittynyt suuri osa maan puunjalostuskapasiteetista. Metsäteollisuus käytti Kymen metsäkeskuksen alueella vuonna 1997 kotimaista raakapuuta 11,48 milj. m ja tuontipuuta 4,66 milj. m sekä sahahaketta ym. yli 4 milj. m. Koko maan metsäteollisuuden puunkäyttö oli 64,20 milj. m. Laajan teollisuuskapasiteetin vuoksi alueen metsät ovat olleet tehokkaassa käytössä. Metsiä hakattiin 1950- ja 1960-luvuilla yli kestävän suunnitteen. Metsien uudistaminen ja soiden ojitus alkoivat lisätä kasvua ja poistuman jäätyä entiselle tasolle tai jopa laskettua myös varanto alkoi lisääntyä. Se on noussut 1960-luvun puolen välin 78 milj. m:sta 113 milj. m:iin (45 %). Puuston vuotuinen kasvu on samaan aikaan noussut 3,44 milj. m:sta 4,88 milj. m:iin (42 %). Hakkuut ovat 1990-luvulla vilkastuneet, mutta poistumaa suurempi kasvu on lisännyt varantoa edelleen. Metsien uudistamisen seurauksena kasvatushakkuiden tarpeessa olevia metsiä on runsaasti. Metsälain tarkoittamia erityisen tärkeitä elinympäristöjä on 1,2 % ja kaikkia metsien monimuotoisuuden kannalta tärkeitä habitaatteja, avainbiotooppeja, 6,8 % yhdistetystä metsä-, kitu- ja joutomaan alasta.33333333
Tradición clásica en El arco y la lira de Octavio Paz
Authors: Chazarreta Daniela Evangelina
Published: February 2017

En el artículo se analizan algunas de las significaciones de la presencia de la tradición clásica en El arco y la lira de Octavio Paz. Para ello, en primer lugar, se desentraña el marco teórico concerniente a una revisión de la categoría de tradición en el contexto de la literatura latinoamericana; a partir de allí y en segundo lugar, se ocupa de revisar cómo el orbe griego clásico asoma en El arco y la lira a partir de dos ejes fundamentales: el contrapunto entre modernidad y antigüedad y el contrapunto entre lo helénico clásico y lo oriental en términos de definir lo propio a través de la otredad.
Elsewhere
Authors: Qureshi Bilal
Published: February 2017

Ava DuVernay's Queen Sugar arrives at a defining moment in American cultural life, as politics and art converge in an unprecedented moment for black creativity. The unapologetic emergence of full-fledged black subjectivity onscreen runs parallel to a new chapter in the civil rights movement. Black Lives Matter has propelled long-overdue conversations about policing, the prison-industrial complex, inequality, and structural barriers into the mainstream. The ongoing renaissance in television enabled by streaming platforms and new revenue models has opened doors for artists to explore these issues with revived creative freedom. The feisty sitcoms and criminal dramas that have contained black lives for far too long have been surpassed in quality by works more ambitious, aesthetically daring, and politically relevant. Whether it is FX's Atlanta created by and starring Donald Glover, Marvel's Luke Cage on Netflix, or the intergenerational family politics of Queen Sugar, there isn't a more exciting time to watch black lives matter and shimmer on American screens.
Patrullajes marítimos en el occidente de la Nueva España. Propuesta naval, defensiva y comercial de un funcionario novohispano (1742)
Authors: Ríos Guadalupe Pinzón
Published: February 2017

Este trabajo analiza un proyecto enviado al rey por parte del gobernador de la Nueva Galicia donde se proponía la construcción de dos goletas financiadas por el erario real con las que se patrullarían las costas de Nueva Galicia y la California. Con ello se enviarían refuerzos diversos al noroeste a combatir las revueltas indígenas, fomentar navegaciones locales y reducir la presencia de embarcaciones enemigas. El proyecto permite reflexionar sobre las problemáticas y posibilidades económicas existentes en las costas del Pacífico novohispano durante la primera parte del siglo XVIII y apreciar las primeras medidas reformistas que alcanzaron las costas novohispanas.

This article analyzes a proposal sent to the king by the governor of Nueva Galicia to construct two barquentines, financed by the royal treasury, to patrol the coasts of Nueva Galicia and California. These barquentines would provide reinforcements to the northeast areas to combat indigenous revolts, foment local exploration, and reduce the presence of enemy ships. The project reveals the economic problems and possibilities present, as well as the early reformist measures implemented, in the novohispanic Pacific coasts during the first half of the eighteenth century.
Baltic Paganism in Lithuanian Neoshamanic Communities
Authors: Aleknaitė Eglė
Published: February 2017

In this paper, I aim to provide an analysis of various Lithuanian Neoshamanic groups’ relationships to a local Pagan tradition and to show the impact of socio-political context on the popularity of shamanic interpretations of Indo-European religious traditions and various possibilities of expressions of interest in local Indo-European customs. Building on 2009–2015 fieldwork data and analysis of published scholarly and Neoshamanic texts, I present the Lithuanian Neoshamanic milieu, discuss scholarly interpretations of shamanic elements in the Baltic religious tradition, examine interpretations of the local Pagan tradition relevant to Lithuanian Neoshamanic communities, consider Lithuanian Neopagan attitudes to shamanic interpretations of the Baltic tradition, and analyze the impact of Lithuanian socio-political context.
Derrida: da razão pura à razão marrana
Authors: Matos Olgária Chain Féres
Published: February 2017

Resumo: O pensamento político de Derrida testemunha as consequências da racionalidade logocêntrica de dominação e das guerras que fizeram dos indivíduos seres sem domicílio fixo. Este ensaio tem como objetivo discutir alguns elementos do pensamento filosófico e político do autor, observando especialmente suas relações com os conceitos de identidade e territorialização. Por fim, o ensaio discute a tarefa da desconstrução e sua relação com a ética e a política da amizade.
Revista de Saúde Pública in scientific publications on Violence and Health (1967-2015)
Authors: Schraiber Lilia Blima , Barros Claudia , d’Oliveira Ana Flávia Pires Lucas , Peres Maria Fernanda Tourinho
Published: February 2017

ABSTRACT This article retrieved the publications from the Revista de Saúde Pública journal (from 1967 to 2015) on violence and health, on the SciELO and PubMed bases, by searching for the terms “violence”, “suicide”, “aggression”, “bullying”, and “external causes”, registered in any part of the text. We found 130 articles (the first one published in 1974). We observed: increase of publications over time, with decrease in the last five years; similar production volume in lethal and non-lethal violence; later publication of the latter; few studies in qualitative research; mostly descriptive production; and visualization of the problem more by the acts than by contexts or motivations and aggressors. Social markers were little approached, appearing, from largest to smallest frequency, social class, gender, race/ethnicity, and generation. Human rights were little used and only recently used as analytical framework, connected more to gender than to social class. Although Revista de Saúde Pública has registered the theme in its publications, consolidating it as scientific production line, there is still great explanatory theoretical rarefaction and little intersectionality between violence, social inequalities, and human rights.
FDA Approval Summary: Nivolumab in Advanced Renal Cell Carcinoma After Anti-Angiogenic Therapy and Exploratory Predictive Biomarker Analysis
Authors: Xu James Xunhai , Maher V. Ellen , Zhang Lijun , Tang Shenghui , Sridhara Rajeshwari , Ibrahim Amna , Kim Geoffrey , Pazdur Richard
Published: February 2017

On November 23, 2015, the U.S. Food and Drug Administration approved nivolumab (OPDIVO, Bristol-Myers Squibb Company) for patients with advanced renal cell carcinoma (RCC) who have received prior anti-angiogenic therapy. The approval was based on efficacy and safety data demonstrated in an open-label, randomized study of 821 patients with advanced RCC who progressed after at least one anti-angiogenic therapy. Patients were randomized to nivolumab or everolimus and followed for disease progression. The primary end point was overall survival. Subsequent therapies, including everolimus for patients who developed progressive disease on the nivolumab arm, were allowed, but no cross-over was permitted. The median overall survival was 25.0 months on the nivolumab arm and 19.6 months on everolimus arm (hazard ratio: 0.73; 95% confidence interval: 0.60–0.89). The confirmed response rates were 21.5% versus 3.9%; median durations of response were 23.0 versus 13.7 months, and median times to response were 3.0 versus 3.7 months in the nivolumab and everolimus arms, respectively. A statistically significant improvement in progression-free survival was not observed in this trial. The safety profile of nivolumab in renal cell cancer was similar to that in other disease settings. However, the incidence of immune-mediated nephritis appeared to be higher in patients with RCC.
BILDUNGSROMAN FOR CHARACTER EDUCATION IN HIGHER EDUCATION: AN INDONESIAN CONTEXT
Authors: Novianti Nita
Published: February 2017

Considering the lack of research on character education in higher education, this paper proposes that Bildungsroman, a genre concerned with a protagonist’s development and education from childhood to adulthood, fits perfectly into the recent need of literary works for teaching character education in college. Employing literature review, this paper argues that Bildungsroman satisfies the major requirements for literary works for character education in college drawn from O’Sullivan (2004). Bildungsroman also provides a rich source for cultivation of character traits as stipulated by the Indonesian Department of National Education (2010). Furthermore, the general theme of self-development is highly appropriate to the nature of character education in higher education, namely as a continuation and consolidation of the character developed in college students’ previous education. It is expected that the present study will contribute to the teaching of character education through literature, although further studies are required in order to explore the effective teaching and learning techniques.
Urinary extract profiles of illegal substances at psychiatry and dependency clinics: three years report
Authors: Tanyeri Pelin , Yazici Ahmet Bulent , Buyukokuroglu Mehmet Emin , Yazici Esra , Erol Atila
Published: February 2017

Background: Substance abuse is a serious problem all over the world. There are many studies report the illegal substance use profile but few studies present their toxicology laboratory analysis. This study reports a quantitative profile of (Urine Drug Screening)) for illegal substances in Sakarya-Turkey.Methods: This study presents the urine analysis of all illegal substances which were made in the laboratory of Sakarya Training Research Hospital between March 2012 and February 2015. The results obtained from socio-demographic data and urine tests of patients were analyzed by examining their hospital record files. Urine drug screening was conducted with immunoassay quantitative analysis.Results: People subjected to substance analysis (n=2948) ages vary between 12 and 76, their mean age was 28.30±9.46. 96.74% (n=2852) of them were males. Substance positivity was determined in 34.73% of all patients (n=1024/2948) and their ages varied between 14 and 70 and their mean age was 29.39±9.65. Distribution of the urine positivity of the substances contained: marijuana 79, 5% (n=814), amphetamine 30.17% (n=309), ecstasy 23.74% (n=199), benzodiazepine 9,1% (n=94), synthetic cannabinoid 4.9% (n=12/243); opioid 5.2% (n=54), cocaine 1.67% (n=14) and multiple substance 29.9% (n=308).Conclusions: According to this study, marijuana is the most frequently used substance and multiple substance use is common. Synthetic cannabinoid seems to take place rapidly among the users. Updating the kits is important to reach the correct information in drug screening tests.
Variation of hemodynamic response following induction and tracheal intubation: etomidate vs midazolam
Authors: Pegu Binod , Pathak Deba Gopal , Dutta Suneeta , Khakhlary Bublee
Published: February 2017

Background: Induction and endotracheal intubation are invariably associated with certain cardiovascular changes during anaesthesia practice and can lead to sudden swings of blood pressure, arrhythmias, MI and cardiovascular collapse especially in geriatric and haemodynamically unstable patients. Therefore it is desirable to use a safer agent with fewer adverse effects to minimise these complications. Present prospective randomized study is designed to compare the haemodynamic alterations and various adverse effects following induction with etomidate and midazolam.Methods: Hundred ASA I and II patients of age group 18-60 years scheduled for elective surgical procedure under general anesthesia were randomly divided into two groups of 50 each receiving etomidate (0.3mg/kg) and midazolam (0.15mgk/kg) as an induction agent. Vital parameters before and after induction and thereafter at specified time interval following laryngoscopy and intubation were recorded for comparison. Adverse effect viz. pain on injection, apnea and myoclonic activity were also carefully watched.Results: Demographic variables in both the groups were comparable. Patients in both the groups showed little change in mean arterial pressure (MAP) and heart rate (HR) from baseline value (p >0.05). Pain on injection and myoclonic activity were seen in etomidate group while delayed awakening was seen with Midazolam group.Conclusions: This study concludes that both etomidate and midazolam provides haemodynamic stability but Midazolam can be preferred as an induction agent in view of fewer side effects.
A comparative study of efficacy of argyreia speciosa and orlistat for their anti-obesity action in high fat diet induced obese rats
Authors: Patil Suhas H. , Rajbhoj Satkar , Bhalerao Seema V. , Jha Puja , Limaye Manasi V. , Vaidya Mohanish U.
Published: February 2017

Background: To compare the anti-obesity action of Argyreia speciosa root extract with standard anti-obesity drug orlistat. Healthy Sprague-Dawley rats (100-200g, n=50) were obtained from the animal house. Dose of Orlistat was 32.4mg/kg/day and Dose of Argyreia speciosa root was 500mg/kg/day.Methods: Food induced obesity model was used. Following parameters were evaluated: Total Cholesterol (mg/dl), Triglyceride (mg/dl), HDL-cholesterol (mg/dl), LDL cholesterol (mg/dl), atherogenic index, serum lipase (U/L). Analysis was done by one way ANOVA followed by post-hoc test and Graph Pad Prism version 5.00 was used for the analysis.Results: Total cholesterol, triglcerides, LDL cholesterol and Atherogenic index was significantly lesser in the rats fed with CD+O group and CD+ASE group than in the animals from CD group (p<0.05). It was also significantly lesser in the rats fed with CD+O+ASE than in the animals from CD group (p<0.05). HDL cholesterol was significantly greater in the rats fed with CD+O group and CD+ASE group than in the animals from CD group (p<0.05). It was also significantly greater in the rats fed with CD+O+ASE than in the animals from CD group (p<0.05).Conclusions: ASE significantly reduces total cholesterol (mg/dl), triglyceride (mg/dl), LDL cholesterol (mg/dl) and atherogenic index, it significantly increases HDL- cholesterol (mg/dl) and it is comparable to orlistat. Thus the anti-obesity action of ASE is comparable to orlistat.
Cost variation analysis of antipsychotic drugs available in Indian market: an economic perspective
Authors: Shah Nishita P. , Chincholkar Aparna S. , Wagh Ranjit J. , Siddiqui Waseem A.
Published: February 2017

Background: Pricing of drugs plays a very important role in a developing country like India especially in the management of chronic conditions. There exists a huge price variation among the different brands of the same drug. Hence this study was planned to find out variation in prices of antipsychotic drugs marketed in India. The objective was to compare the percentage price variation and cost ratio of various formulations of oral and parenteral antipsychotic drugs available in the Indian market.Methods: Cost of oral and parenteral antipsychotic drugs available in the Indian market manufactured by different companies, in the same strength, number and dosage form was obtained from http://www.medguideindia.com. The percentage price variation and cost ratio of each formulation was calculated.Results: Among the typical group of antipsychotic drugs, Tab Haloperidol 0.25mg shows maximum price variation of 650% and a cost ratio of 7.5 followed by Tab Trifluoperazine 1mg having a price variation of 555.5% and a cost ratio of 6.55. Among the atypical group of drugs, tab Risperidone 3mg shows a price variation of 2282.35% with a cost ratio of 23.82 followed by Tab Risperidone 4mg with a price variation of 1976.92 % and a cost ratio of 20.76.Conclusions: There is a wide variation between the minimum and maximum cost among the different brands of the same drug in the same formulations. Combined efforts are needed from the regulatory authorities, pharmaceutical companies, physicians and pharmacist towards controlling the prices and attaining maximum economic benefits for the patient.
Editorial
Authors: De Mattos Izabel Missagia , De Moura Marlene Castro Ossami , Viana Sibeli Aparecida
Published: February 2017

-
Ser mochileiro: uma constituição social e pessoal do “mochilar”
Authors: Falcão Denise
Published: February 2017

Este artigo discute e apresenta a representação social e pessoal do ser mochileiro contemporâneo, aproximando a construção histórica-social-acadêmica e a óptica dos sujeitos mochileiros, a partir dos múltiplos olhares acerca dos viajantes e do ato de viajar. Partindo da aproximação/diferenciação entre turistas e viajantes, e da mudança do foco econômico das viagens para o aspecto relacional, essa investigação adentra o universo subjetivo dos mochileiros desvelando sua constituição identitária. Essa intrínseca relação sujeito-ação, viajante-viagem, que desloca o sujeito a um tempo/espaço descontínuos e provoca, pela vivência da alteridade, um duplo estranhamento no ser e estar diferente de si mesmo e do outro, faz com que a “mochilagem”, para além de uma forma alternativa de viagem, seja uma experiência de vida e represente um jeito de ser e estar no mundo: o ser mochileiro. Para alcançar os sentidos e significados dessa experiência humana, utilizou-se a abordagem qualitativa com múltiplos métodos de pesquisa: Pesquisa bibliográfica; Pesquisa de campo com observação de campo; Entrevistas semiestruturadas; Amostragem pelo método bola de neve e análise de dados.
O Caminho de Santiago em Gaia. Itinerário religioso – itinerário turístico
Authors: Ponte Graça Nunes da , Rama María De la Cruz del Río , Álvarez-García José
Published: February 2017

Na atual conjuntura, o turismo religioso tem adquirido uma importância crescente, em que se registram cada vez mais peregrinações. O caminho de peregrinação de Santiago, para além da sua inegável vertente religiosa e cultural, é também uma realidade turística, assumindo uma capacidade de contribuir estrategicamente para o desenvolvimento regional e local. Um dos caminhos que conduz os peregrinos até Santiago de Compostela – o Caminho Central Português – atravessa toda a cidade de Vila Nova de Gaia, ao longo de cerca de 15 quilômetros. Esse pequeno trajeto é o objeto de estudo deste trabalho, em que a sua análise implicou não só uma pesquisa bibliográfica, mas também uma pesquisa de campo no sentido de detectar a viabilidade de revitalizar este tipo de itinerário, de forma a tornar a peregrinação mais aprazível e, simultaneamente, fornecer ao peregrino toda a informação que ele necessita tendo ainda a possibilidade de conhecer um pouco da cidade por onde está passando. São ainda apresentadas algumas ações de dinamização e promoção que podem contribuir para incentivar um turismo sustentável e responsável.
Barbara Newelska 1919–2012
Authors: Stefańska Dorota
Published: February 2017

Tekst ten ma charakter biograficzny i przedstawia losy potomkini polskiej ziemiańskiej rodziny w XX w., od szczęśliwych lat dwudziestolecia międzywojennego, poprzez dramatyczny okres okupacji i nie mniej trudne powojenne lata rządów komunistycznych. Barbara Newelska, związana z majątkiem w Boczkach, jest wnuczką Adama – brata Marcelego Nenckiego biochemika o światowej sławie. Obok dostępnych źródeł publikowanych w tekście autorka wykorzystuje bogate materiały pochodzące ze zbiorów rodzinnych Barbary Newelskiej.
Dostępność transportowa od jednostek straży pożarnych do budynków zlokalizowanych na terenach zalewowych w powiecie zduńskowolskim
Authors: Borowska-Stefańska Marta
Published: February 2017

W artykule za cel przyjęto ocenę dostępności transportowej z jednostek straży pożarnych do budynków zlokalizowanych na terenach zalewowych w powiecie zduńskowolskim. Do wyznaczania terenów zalewowych wykorzystano mapy zagrożenia powodziowego oraz dokumenty planistyczne, w tym studia uwarunkowań i kierunków zagospodarowania przestrzennego. Na tej podstawie dokonano identyfikacji obiektów zlokalizowanych na terenach zagrożonych powodziami, przy wykorzystaniu Bazy Danych Obiektów Topograficznych. Baza ta posłużyła również do lokalizacji jednostek straży pożarnych wpisanych do Krajowego Systemu Ratowniczo-Gaśniczego i wytypowanych do współpracy z systemem Państwowego Ratownictwa Medycznego, które znajdują się na obszarze analizowanego powiatu oraz gmin z nim bezpośrednio sąsiadujących. Stwierdzono, że w granicach terenów zalewowych badanych gmin znajduje się łącznie 514 budynków. Do 41 obiektów jest zapewniony dojazd z komend miejskich jednostek PSP w czasie do 8 minut oraz do 79 w czasie do 15 minut. W przypadku nadejścia powodzi do pozostałych budynków dojazd jest możliwy w czasie do 15 minut z jednostek OSP.
Historyczne i społeczne czynniki rozwoju małych miast – przykłady Uniejowa i Dąbia
Authors: Kulawiak Anita
Published: February 2017

Ważnym warunkiem rozwoju miast są czynniki lokalne (endogeniczne). Obecnie wiele miast właśnie w lokalnej tradycji i tożsamości oraz w oparciu na wewnętrznym potencjale przyrodniczym i społecznym poszukuje pomysłu na kształtowanie nowego, unikalnego wizerunku miasta, jego promocję czy docelowo rozwój. Artykuł koncentruje się na ukazaniu roli, jaką czynniki endogeniczne odgrywają w rozwoju miasta na przykładzie dwóch wybranych jednostek: Uniejowa położonego w województwie łódzkim oraz Dąbia nad Nerem zlokalizowanego w województwie wielkopolskim. O ich wyborze zadecydowało z jednej strony podobieństwo pod względem warunków przyrodniczych, z drugiej zaś znacząca różnica w obecnym poziomie rozwoju społeczno-gospodarczego. Kapitał endogenny jest identyfikowany przede wszystkim z istniejącym potencjałem historycznym oraz społecznym.
The Relationship Between Obesity and Smoking to Hypertension Incidence
Authors: Lasianjayani Tifani , Martini Santi
Published: February 2017

ABSTRACTHypertension is a disease that causes morbidity and mortality about 20–50% of all deaths. In the worldwide, about 927 people suffer hypertension and that number will be increase to 29,2 in 2025. Obesity and smoking are one of risk factors to hypertension incidence. The purpose of this research was to analayze the relationship between obesity and smoking to hypertension incidence. The cross sectional design is used in this research and involved 75 samples who ware selected from cardiology’s patients at Haji Hospital Surabaya by simple random sampling on May 2014. The variables are sex, obesity, and smoking behavior. In the smoking behavior data, the history of smoking, filters used, smoking periode, total cigarette, and types of cigarette are used. In this research, crosstabulation with Chi Square test is used on data analysis. There are 45 people (60%) had hypertension and 64,4% from sample with hypertension was women. The result of this research showed that there was a significant relationship between obesity and hypertension (p = 0,014) with coeffisient contingension about 0,299. Otherwise, there was no a significant relationship between history of smoking (p = 0,211), filters used (p = 0,378), smoking periode (p = 1,000), smoker criteria (p = 0,848), and types of cigarette (p = 0,673) to hypertension incidence. The conclution of this research was only obesity which had a relationship with hypertension incidence.Keywords: hypertension, sex, obesity, smoking behavior
Breast Cancer Risk Analysis by the Use of Hormonal Contraceptives and Age of Menarche
Authors: Dewi Gusti Ayu Triara , Hendrati Lucia Yovita
Published: February 2017

ABSTRACTThe number of cases of breast cancer is increasing every year and it’s a serious health problem in the world, including in Indonesia. Breast cancer is type of cancer that is most dominant in Indonesia. High estrogen exposure is one of factor that can increase the risk of breast cancer in women. This study was conducted to determine the relationship of estrogen exposure through the use of hormonal contraceptives and age of menarche with breast cancer incidence in women. Type of this study is observational analytic and use case control design. All of women breast cancer patients of Dr. Soetomo Hospital in 2013 were the population of case. All of woman non breast cancer patients who done breast examination at Dr Soetomo Hospital in 2013 were the population of control. The number of respondents in this study were 90 respondents were drawn from population using simple random sampling method. The variables studied were the use of hormonal contraceptives and age of menarche. The results of the analysis used binary logistic regression (α = 5%) indicated that the use of hormonal contraceptives (p = 0,028; OR = 3,266) and age of menarche (p =0,031; OR = 3,492) has an significant correlation with incidence of breast cancer in women at Dr. Soetomo Hospital in 2013. It is expected that the community can be more accurate in determining the duration of hormonal contraception usage and avoid lifestyle can accelerate the occurrence of menarche.Keywords: breast cancer, risk factor, hormonal contraceptives, age of                             menarche, estrogen
The Relationship between Stroke Patients Characteristics and Family Support with Compliance Rehabilitation
Authors: Wardhani Irma Okta , Martini Santi
Published: February 2017

ABSTRACTStroke is a cerebrovascular disease, it is brain function disorders associated with the disease of the blood vessels that supply the brain. The impact of stroke is paralysis. Family support is things that are needed to be considered in the treatment of stroke patients. It is very involved in the compliance rehabilitation of patients to prevent the re-occurrence of stroke. Characteristics of stroke patients may also affect the compliance rehabilitation. The purpose of this research is to determine the relationship between stroke patients characteristics and family support to compliance rehabilitation at the Medical Rehabilitation Unit RSU Haji Surabaya. This research was an analytic observational research with cross sectional design. The subjects of this research are taken using total population technique. The independent variables in this research is family support. The dependent variable is compliance rehabilitation. The results of this research are presented in the form of frequency distributions and calculate the strength of the relationship with Phi coefficient. The result of this research shows that there is a strong relationship between family support and compliance rehabilitation (r=0.582). There are weak relationship between ages (r=-0,027), gender (r=0,092), level of education (r= -0,295), work (r=0,098), and marital status (r=0,319). The conclusion is family support may affect compliance rehabilitation of stroke patients. It is recommended for health workers to provide counseling to improve family support in curing stroke patients.Keywords: depression, family support, compliance rehabilitation
The Correlation between Family Support with the Quality of Life of Patients with Diabetes Mellitus
Authors: Retnowati Nilla , Satyabakti Prijono
Published: February 2017

ABSTRACTDiabetes mellitus is a disease that will accompany a lifetime and require long term treatment so that it can reduce quality of life of the patients. This study aim to analyze the correlation between family support with the quality of life of patients with diabetes mellitus. This study was analytic observational with cross-sectional design. The population was all patients with diabetes mellitus who visited Tanah Kalikedinding Health Center in January to March 2014. Patients was diagnosed diabetes mellitus through laboratory test using blood serum venous plasma. The number of respondents was 45 respondents that were chosen using simple random sampling method. Variables studied were family support, respondent’s characteristics (age, gender, education level, income, marital status and employment status), duration of diabetes, diabetes complications and quality of life. The results of Chi-square test with continuity correction Fisher’s exact test showed that variables that were significantly correlated with the quality of life such as family support (p=0.000), education level (p=0.039), income (p=0.034), marital status (p=0.003) and diabetes complications (p=0.007). The results of Mantel- Haenszel test showed that all the studied variables were confounding the correlation between family support with the quality of life. Confounding variable that have the greatest contribution was diabetes complications. The conclusion is that family support is significantly correlated with the quality of life of patients with diabetes mellitus in Tanah Kalikedinding Health Center. Health centers are expected to carry out health promotion and health education programs for patients with diabetes mellitus and their families to improve the quality of life of the patients.Keywords: diabetes mellitus, quality of life, family support, diabetes complications, marital status