bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary care providers’ knowledge, attitudes and practices of medical abortion: a systematic review
Authors: Subasinghe Asvini K , Deb Seema , Mazza Danielle 
Published: December 2019

BackgroundDespite the availability of medical abortifacients, and their potential use in primary care, only a small proportion of primary healthcare professionals provide medical abortion services. Understanding the perspectives of primary care providers on delivering medical abortion is pertinent to identifying barriers to medical abortion service provision and increasing access for women globally.ObjectiveTo understand the knowledge, attitudes and practices of primary healthcare providers regarding medical abortion services.DesignFour databases (Medline, EMBASE, Web of Science (WOS) and Scopus) were searched using search terms related to medical abortion and primary care. The Joanna Briggs Institute Critical Appraisal tools were used to appraise the methodological quality of studies included.ResultsSome 22 studies were identified, conducted across 15 countries, comprising 6072 participants. Study participants comprised doctors and residents (n=8), nurses and nursing students (n=5), and pharmacists (n=3) and six studies were conducted with mixed samples of providers. Medical abortion was deemed acceptable by some doctors, but fear of criminal prosecution, in countries where abortion is still restrictive, left doctors and nurses circumspect about providing medical abortion. Pharmacists referred women to other providers with only a small proportion dispensing medical abortifacients. General practitioners, nurses and trainees had mixed knowledge of medical abortion and emphasised the need for training on delivery of medical abortion and dissemination of guidelines. Conversely, pharmacists reported poor knowledge regarding medical abortion regimens and complications.ConclusionsIncreased dissemination of training and resources is pertinent to supporting primary care providers delivering medical abortion services and to increasing access for women on a global scale.
Evaluation of a Level I trauma center provider training in patient-centered alcohol brief interventions using the Behavior Change Counseling Index rated by standardized patients
Authors: Darnell Doyanne , Parker Lea , Engstrom Allison , Fisher Dylan , Diteman Kaylie , Dunn Christopher 
Published: December 2019

BackgroundTraumatic injury requiring hospitalization is common in the USA and frequently related to alcohol consumption. The American College of Surgeons requires that Level I and II verified trauma centers implement universal alcohol screening and brief intervention for injured patients. We examined whether Level I trauma center provider skill in patient-centered alcohol brief interventions improved after training and whether professional role (eg, nursing, social work) and education were associated with these skills.MethodsWe present evaluation data collected as part of training in alcohol brief interventions embedded within a larger clinical trial of a collaborative care intervention targeting posttraumatic stress disorder and related comorbidities. Sixty-five providers from 25 US Level I trauma centers engaged in a 1-day workshop, with 2 hours dedicated to training in patient-centered alcohol brief interventions followed by 6 months of weekly coaching in a collaborative care model. Providers completed standardized patient role-plays prior to and 6 months after the workshop training. The standardized patient actors rated provider quality of alcohol brief interventions immediately after each role-play using the Behavior Change Counseling Index (BECCI), a pragmatic measure designed to assess the quality of behavior change counseling, an adaptation of motivational interviewing suitable for brief healthcare consultations about behavior change.ResultsSeventy-two percent of providers completed both standardized patient role-play assessments. A statistically significant improvement in overall BECCI scores (t(41)=−2.53, p=0.02, Cohen’sd=−0.39) was observed among those providers with available pre–post data. Provider professional role was associated with BECCI scores at pre-training (F(3, 58)=11.25, p<0.01) and post-training (F(3, 41)=8.10, p<0.01).DiscussionFindings underscore the need for training in patient-centered alcohol brief interventions and suggest that even a modest training helps providers engage in a more patient-centered way during a role-play assessment.Level of evidenceLevel V, therapeutic/care management.
Interaction analysis of systolic blood pressure and glycosylated hemoglobin in diabetic retinopathy: A Chinese sample
Authors: Meng Xiangying , Zhang Yuanhao , Kong Qing , Lv Yubao , Hu Hailin , Chen Tao , Tang Zihui 
Published: December 2019

Background: The objective of this study was to evaluate (1) the association of blood pressure (BP) profiles and glucose profiles with diabetic retinopathy (DR) and (2) the interaction between BP profiles and glucose profiles in DR in a Chinese sample. Methods: This was a cross-sectional study of 984 DR patients. Demographic data, BP profiles, glucose profiles, renal function parameters, and medical histories were recorded. All the participants underwent testing for DR with digital nonmydriatic fundus photography and image analysis, using a standardized protocol. A multiple variable logistic regression (MLR) was employed to detect the associations and interactions of BP profiles and glucose profiles with DR. Results: Systolic blood pressure (SBP) and glycated hemoglobin (HbA1c) were significantly correlated with DR ([Formula: see text] for SBP, [Formula: see text]; [Formula: see text] for HbA1c, [Formula: see text]). An interaction between SBP and HbA1c was detected in a multiple logistic regression (MLR) model after adjustment for relevant potential confounders ([Formula: see text], [Formula: see text]). Conclusion: The present study suggested that SBP and HbA1c were independently and significantly associated with DR and that SBP interacted with HbA1c to impact on DR.
The Üstikuddus sherbiti in the treatment of abnormal cold and dry-type depression patients with comorbid anxiety: A randomized and controlled clinical trial
Authors: Gul Aman , Memtily Nassirhadjy , Mijit Pirdun , Imin Mihriban , Rui Hua , Wushuer Palidan , Talifu Ainiwaer 
Published: December 2019

Objective: To evaluate the clinical effect of Üstikuddus sherbiti (US), a traditional herbal prescription of Uyghur medicine, in the treatment of cold and dry-type major depression disorder (MDD) patients with comorbid anxiety. Methods: A total of 150 cold and dry-type depressive patients with comorbid anxiety were randomly divided into three groups of 50 patients; then they were, respectively, treated with US, modern medicine Fluoxetine, and the combination of Fluoxetine and US. The depression degrees of patients were evaluated zero and six weeks after the treatment based on the Hamilton Anxiety Scale (HAMA), in the clinical study. Analysis of variance (ANOVA) was used to detect significant differences at various time points or among the three groups. Statistical analysis was performed by SPSS version 21.0. Results: The main results are as follows: After taking the medicine, the depressive condition of patients with comorbid anxiety in the three groups was getting better with the passage of time; particularly, the clinical efficacy of US combined with Fluoxetine was significantly improved, indicating that the effect of combined treatment is better than treatment with pure Fluoxetine or pure US treatment. Statistical difference exists between the end time point within groups, but not among the three groups. Moreover, in the detection process of the patient’s physical indicators, no obvious side effects were found. These results together suggested that US can strengthen the curative effect of modern medicine in the treatment of depression, which would lay a foundation for studying the molecular mechanism and potential target of US. Conclusion: Fluoxetine and US combination therapy played a significant role in the treatment of depressive symptoms, suggesting that it can improve the curative effect of depression. The study provided a new way of thinking to clarify the US molecular mechanism for the treatment of depression and potential target.
Reproductive Outcomes of Women with Polycystic Ovarian Syndrome Following In-Vitro Fertilization — A Meta-Analysis and Systematic Review
Authors: Tan I-Ferne , Lim Audrey J. R. , Indran Inthrani R. , Kramer Michael S. , Yong Eu-Leong 
Published: December 2019

Background: Polycystic ovarian syndrome (PCOS) is a common cause of infertility in women. In-vitro fertilization (IVF) is required in 20–30% of women with PCOS trying to conceive. This is associated with increased risk of multiple gestation and ovarian hyperstimulation syndrome. Improvements in IVF techniques, safety standards, and the increased use of frozen embryos in recent years have lead to improved outcomes for women with PCOS. We performed a systematic review and meta-analysis to compare these outcomes with women without PCOS. Search Methods: A search of PubMed, EMBASE, the Cochrane Central Register of clinical trials, and Scopus databases for all articles published until November 16th, 2017 identified 21 studies comparing IVF outcomes in PCOS and non-PCOS women. Inclusion criteria were Rotterdam criteria PCOS, comparable IVF regimes, immediate IVF outcomes, and pregnancy outcomes. Studies were excluded if the control group included any PCOS criteria, donor oocytes, or in-vitro maturation. Outcomes: No difference was observed in live birth rate per cycle in women with vs. without PCOS (RR [Formula: see text] 1.01 [0.89, 1.16]; [Formula: see text] 82%), but the live birth rate per first cycle in PCOS cycles (RR [Formula: see text] 0.93 [0.88, 0.99]) was slightly lower. There was also no difference in the clinical pregnancy rate (RR 1.02 [0.89, 1.17]) or biochemical pregnancy rate (RR 1.03 [0.99, 1.08]) observed between the two groups. PCOS was associated with a significantly higher number of oocytes retrieved (mean difference [Formula: see text] 3.6; 95% CI [2.8, 4.4]), risk of miscarriage (RR 2.90 [2.09, 4.02]), and risk of ovarian hyperstimulation syndrome (RR 3.42 [2.28, 5.13]) per cycle. Conclusion: Despite a widespread perception of poor reproductive potential, women with PCOS experience IVF outcomes similar to those without PCOS. Although there is a slightly lower live birth rate during their first stimulation cycle, success rates are similar after multiple cycles. PCOS is associated with a higher risk of ovarian hyperstimulation syndrome. Further studies are required to mitigate this risk.
EL INFITNO FAÚSTICO: SPINOZA, GOETHE EN LA CONCIENCIA DE LA MODERNIDAD
Authors: Pineda Santoyo Víctor Manuel 
Published: December 2019

La obra de Spinoza expresa la tentativa de demostración más radical de la existencia de Dios y, de manera no menos enfática, de la refutación de la existencia del diablo. El sello de su obra se reconoce de inmediato en esta cuestión y, aunque su perspectiva es claramente diferenciable del resto de los llamados “argumentos ontológicos”, en razón del segundo tópico, inaugura una especie de “argumento antiontológico” que cumplía con una tarea indispensable en la historia del pensamiento: la confirmación de la existencia de aquello que expresa una perfección absoluta y la refutación de aquello que expresa la negación. El elenco formulado en función de esta negación forma parte de un programa ilustrado de su filosofía y se empeñaba en encontrar causas inmanentes que explicaran la presencia del mal, o de lo malo, en el orden de las cosas. Orientada hacia la destrucción de los fundamentos de la ficción del mal, su filosofía combatió enfáticamente la superstición, la voluntad como atributo de un Dios revelado, el antropomorfismo que ampara a todos nuestros prejuicios sobre el bien y el mal. No conocemos otra preocupación semejante en la historia de la filosofía. ¿Para qué refutar la existencia del diablo y para qué demostrar la de Dios?
Implementation of High-Intensity Stepping Training During Inpatient Stroke Rehabilitation Improves Functional Outcomes
Authors: Moore Jennifer L. , Nordvik Jan E. , Erichsen Anne , Rosseland Ingvild , Bø Elisabeth , Hornby T. George ,   for the FIRST-Oslo Team, Barkenæs Tonje , Bratlie Hanne , Byhring Miriam , Grimstad Ingvild , Hågå Magnus , Halvorsen Joakim , Henderson Chris , Mbalilaki Julia-Aneth , Rimehaug Stein-Arne , Sæther Kirsten , Tomren Thomas , Vergoossen Karen 
Published: December 2019

Background and Purpose—
Therapeutic strategies that capitalize on the intrinsic capacity for neurological recovery early poststroke to improve locomotion are uncertain. Emerging data suggest that task-specific stepping practice provided at higher cardiovascular intensities may be critical dosage parameters that could maximize locomotor recovery. The purpose of this investigation was to determine the comparative effectiveness of providing high-intensity training on locomotor capacity early poststroke as compared with usual care.

Methods—
A quasi-experimental design was used to compare changes in stepping activity (StepWatch), walking, and balance outcomes during usual care (n=56) versus high-intensity stepping intervention (n=54) in inpatient stroke patients. Primary outcomes assessed weekly included self-selected and fastest gait speed, 6-minute walk test, and the Berg Balance Scale, with secondary outcomes of Swedish Postural Assessment Scale for Stroke-Norwegian version, Functional Ambulation Category, 30-s sit-to-stand, strength (average manual muscle testing), and Barthel Index. Regression analyses identified relationships between demographics, baseline function, and training activities (steps per day; duration achieved, 70%–85% maximum heart rates) and primary outcomes at discharge.

Results—

Following implementation of high-intensity stepping, average steps per day (5777±2784) were significantly greater than during usual care (3917±2656;
P
<0.001). Statistically different and clinically meaningful changes in self-selected speed (0.39±0.28 versus 0.16±0.26 m/s) and fastest gait speed (0.47±0.41 versus 0.17±0.38 m/s; both
P
<0.001) were observed following high-intensity interventions versus usual care and at every assessment throughout the length of stay. Changes in Berg Balance Scale and 6-minute walk test were also statistically and clinically different between groups, while secondary measures of Functional Ambulation Category and strength were also different at discharge. Primary predictors of improved walking capacity were steps per day, baseline impairments, and age.

Conclusions—
Provision of high-intensity stepping training applied during inpatient rehabilitation resulted in significantly greater walking and balance outcomes. This training paradigm should be further tested in other contexts to determine the generalizability to real-world and community settings.
<p class="HeadingRunIn"><strong>Synopsis of the genus <em>Phlegmariurus</em> (Lycopodiaceae) in Colombia</strong></p>
Authors: ØLLGAARD BENJAMIN 
Published: December 2019

This article presents the results of a study of a large material of Colombian Lycopodiaceae, describing 75 species of the genus Phlegmariurus, some of them subdivided into several varieties. Their nomenclature, distribution and habitats are indicated, and problems of species delimitation and infraspecific variation are discussed. All species are illustrated, and studied specimens are cited. An attempt has been made to group the species, mainly following the clades of recent molecular studies. The following taxa are described as new to science: Phlegmariurus cocuyensis, P. cruentus var. exilis, P. cruentus var. illimitatus, P. idroboi, and P. josesantae.
Free Trade Agreements in the World Trade System: Substance and Semantics
Authors: Athukorala Prema-chandra 
Published: December 2019

Over the past three decades, free trade agreements (FTAs) have become an integral and enduring part of the global trading system. The number of FTAs notified to the World Trade Organization increased from 19 in 1990 to 292 by January 2019.1 However, debate on the economic case for following the FTA path as an alternative to multilateral and unilateral trade liberalisation is far from settled. The purpose of this note is to assess key themes of this policy debate. The focus is solely on the economic rationale of FTAs, even though political considerations play a key role in the proliferation of FTAs. JEL Codes: F13, F15, F55
Disability among patients with schizophrenia: A hospital-based study
Authors: Fakorede Omokehinde O , Ogunwale Adegboyega , Akinhanmi Akinwande O 
Published: December 2019

Background: Schizophrenia has been described as the most disabling mental disorder, and patients with schizophrenia have been said to be disabled mostly in self-care, occupation, sexual relation and social relationship domains. Previous authors have studied disability among this study population. However, the limitations of these previous works include non-report of the prevalence rates of disability, report on disability limited to only a particular domain of life and the utilization of disability instruments fraught with significant weaknesses. Aim: To determine the prevalence, severity, domains and correlates of disability among outpatients with schizophrenia at the Neuropsychiatric Hospital, Aro, Abeokuta in Ogun State, Nigeria. Methods: It was a cross-sectional study conducted among three hundred consenting adult outpatients with schizophrenia attending the Neuropsychiatric Hospital, Aro, Abeokuta, Ogun State. Each participant was interviewed with the sociodemographic questionnaire, Mini International Neuropsychiatric Interview, Positive and Negative Syndrome Scale (PANSS) and the 36-item World Health Organization Disability Assessment Schedule. Results: The prevalence of disability was 78% (with 22% having no disability in any of the domains). Most were disabled in the mild to moderate range. Seventy-seven percent (77%) had mild to moderate disability while only 1% had severe disability. Excluding those free of disability, 98.7% of those with disability had mild to moderate form while only 1.3% had severe form. Highest prevalence rates for disability were reported in the ‘participation in society’ and ‘getting along’ domains while the lowest rates were reported in the ‘activities’ (household, work, school) and ‘self-care’ domains. Of all the sociodemographic and clinical variables explored, only the PANSS positive, negative and total scores demonstrated significant relationships with disability. Conclusion: Consistent with existing literature, disability is very prevalent among patients with schizophrenia and it is associated with higher levels of illness severity. Clinicians have a role in limiting disability by focusing on early and comprehensive treatment approaches.
Female financial advisers: Where art thou?
Authors: Richards Daniel W , Roberts Helen , Whiting Rosalind H 
Published: December 2019

We investigate the gender imbalance in the financial advising industry by analysing 32 in-depth qualitative interviews of female and male financial advisers in Australia and New Zealand. Using the framework of organisational structures, advisers’ preferences and stereotypical discrimination, we identify barriers for women and the adaptive strategies they employ to overcome them. Findings show that sales-based structures, servicing client needs, difficulties networking, a dominant masculine management culture and the gendered nature of flexible work inhibit women’s careers in financial advice. Strategies to overcome these barriers are finding the ‘right’ manager, receiving mentoring, selective networking and establishing a partnership arrangement with another adviser. JEL Classification: M12, M14
Systematic Review: Genetic Associations for Prognostic Factors of Urinary Bladder Cancer
Authors: Lipunova Nadezda , Wesselius Anke , Cheng Kar K , van Schooten Frederik J , Cazier Jean-Baptiste , Bryan Richard T , Zeegers Maurice P 
Published: December 2019

Introduction: Many germline associations have been reported for urinary bladder cancer (UBC) outcomes and prognostic characteristics. It is unclear whether there are overlapping genetic patterns for various prognostic endpoints. We aimed to review contemporary literature on genetic associations with UBC prognostic outcomes and to identify potential overlap in reported genes. Methods: EMBASE, MEDLINE, and PubMed databases were queried for relevant articles in English language without date restrictions. The initial search identified 1346 articles. After exclusions, 112 studies have been summarized. Cumulatively, 316 single-nucleotide polymorphisms (SNPs) were reported across prognostic outcomes (recurrence, progression, death) and characteristics (tumor stage, grade, size, age, risk group). There were considerable differences between studied outcomes in the context of genetic associations. The most commonly reported SNPs were located in OGG1, TP53, and MDM2. For outcomes with the highest number of reported associations (ie, recurrence and death), functional enrichment annotation yields different terms, potentially indicating separate biological mechanisms. Conclusions: Our study suggests that all UBC prognostic outcomes may have different biological origins with limited overlap. Further validation of these observations is essential to target a phenotype that could best predict patient outcome and advance current management practices.
Cohort profile: ADEF Helsinki – a longitudinal register-based study on exposure to alcohol and drugs during foetal life
Authors: Koponen Anne M , Nissinen Niina-Maria , Gissler Mika , Sarkola Taisto , Autti-Rämö Ilona , Kahila Hanna 
Published: December 2019

Purpose: The need for longitudinal studies on prenatal substance exposure (PSE) extending into adulthood is widely recognised. In particular, studies on the dual effect of exposure to substances and adverse childhood experiences are needed. This register-based matched cohort study investigates the effect of this dual exposure on the health and development of youth with PSE. The follow-up is from birth to young adulthood. Participants: The exposed youth were born in 1992–2001 to mothers with a significant substance misuse problem during pregnancy. The mothers were identified in primary care maternity clinics in the Helsinki metropolitan area and referred for intensified pregnancy follow-up in a tertiary care setting (HAL-clinics). Data from hospital medical records were collected for the mothers during the pregnancy follow-up and linked with register data from multiple national health and social welfare registers obtained for each mother–child dyad from birth until the end of 2015–2018. Similar register data were gathered for three matched mother–child dyads without any evidence of the mother’s substance misuse in national health and social welfare registers. The study consists of 615 exposed and 1787 unexposed youth aged 15–24 years. Findings to date: A majority of the exposed youth (64%) had been in out-of-home care at least once compared with 8% among the unexposed. Outpatient and inpatient hospital care due to mental or behavioural disorders were two to three times more common among the exposed than among the unexposed. The exposed had less often completed secondary school education and had more often needed social assistance. Future plans: The data comprise a wide range of information on infant health, youth’s mental and somatic health and development, out-of-home care history, and mother’s life situation at the delivery and later health. Risk and protective factors for different long-term developmental outcomes in adolescence or in young adulthood will be studied.