bluuebunny/crossref_metadata_2025_split huggingface dataset:
Availability and affordability of biologic versus non-biologic anticancer medicines: a cross-sectional study in Punjab, Pakistan
Authors: Saqib Anum , Iftikhar Sadia , Sarwar Muhammad Rehan 
Published: June 2018

ObjectivesPrime focus of this study was to evaluate the availability and affordability of originator brands (OBs) and lowest price generics (LPGs) of prescribed biologic and non-biologic anticancer medicines.Design, settings and participantsA descriptive, cross-sectional survey was conducted in 22 cancer-care hospitals (18 public hospitals and 4 private hospitals) and 44 private pharmacies in Punjab, Pakistan. Sampling population consisted of 4483 patients with cancer aged ≥18 years. The availability was determined by classifying anticancer medicines in four categories: absent/unavailability (medicines not present in any surveyed facility), low availability (medicines present in <50% of surveyed facilities), fairly high availability (medicines present in 50%–74% of surveyed facilities) and high availability (medicines present in >75% of surveyed facilities). Medicines were affordable if overall cost of all the prescribed anticancer medicines were 20% of the household capacity to pay. Data were analysed by using Statistical Packages for Social Sciences (IBM SPSS Statistics for Windows, V.21.0).ResultsA total of 5060 patients with cancer were approached out of which 4483 patients were included in the survey. Overall, 10 103 anticancer drugs were prescribed. Among them, 96.3% were non-biologics and 3.7% were biologics. Oncologists were reluctant to prescribe biologics due to high prices. 58.1% of non-biologics were affordable; whereas, the affordability of biologics was 3.3%. A total of 43.9% of both biologic and non-biologic OBs were available; whereas, their affordability was 44.2%. On the other hand, the availability of LPGs was 21.3%, and their affordability was 66.1%. For low-income patients, the affordability of non-biologics was 31.6% and the affordability of biologics was 1.1%.ConclusionsMost of the patients with cancer were prescribed non-biologics due to their low price and better affordability. In contrast to OBs, LPGs of both biologics and non-biologics had less availability but more affordability.
Cost-effectiveness analysis of internet-mediated cognitive behavioural therapy for depression in the primary care setting: results based on a controlled trial
Authors: Holst Anna , Björkelund Cecilia , Metsini Alexandra , Madsen Jens-Henrik , Hange Dominique , Petersson Eva-Lisa L , Eriksson Maria CM , Kivi Marie , Andersson Per-Åke Å , Svensson Mikael 
Published: June 2018

ObjectiveTo perform a cost-effectiveness analysis of a randomised controlled trial of internet-mediated cognitive behavioural therapy (ICBT) compared with treatment as usual (TaU) for patients with mild to moderate depression in the Swedish primary care setting. In particular, the objective was to assess from a healthcare and societal perspective the incremental cost-effectiveness ratio (ICER) of ICBT versus TaU at 12 months follow-up.DesignA cost-effectiveness analysis alongside a pragmatic effectiveness trial.SettingSixteen primary care centres (PCCs) in south-west Sweden.ParticipantsNinety patients diagnosed with mild to moderate depression at the PCCs.Main outcome measureICERs calculated as (CostICBT−CostTaU)/(Health outcomeICBT−Health outcomeTaU)=ΔCost/ΔHealth outcomes, the health outcomes being changes in the Beck Depression Inventory-II (BDI-II) score and quality-adjusted life-years (QALYs).ResultsThe total cost per patient for ICBT was 4044 Swedish kronor (SEK) (€426) (healthcare perspective) and SEK47 679 (€5028) (societal perspective). The total cost per patient for TaU was SEK4434 (€468) and SEK50 343 (€5308). In both groups, the largest cost was associated with productivity loss. The differences in cost per patient were not statistically significant. The mean reduction in BDI-II score was 13.4 and 13.8 units in the ICBT and TaU groups, respectively. The mean QALYs per patient was 0.74 and 0.79 in the ICBT and TaU groups, respectively. The differences in BDI-II score reduction and mean QALYs were not statistically significant. The uncertainty of the study estimates when assessed by bootstrapping indicated that no firm conclusion could be drawn as to whether ICBT treatment compared with TaU was the most cost-effective use of resources.ConclusionsICBT was regarded to be as cost-effective as TaU as costs, health outcomes and cost-effectiveness were similar for ICBT and TaU, both from a healthcare and societal perspective.Trial registration numberID NR 30511.
Comorbidities and the use of comedications in people living with HIV on antiretroviral therapy in Japan: a cross-sectional study using a hospital claims database
Authors: Ruzicka Daniel J , Imai Kentaro , Takahashi Kenichi , Naito Toshio 
Published: June 2018

ObjectivesTo investigate the prevalence of chronic comorbidities and the use of comedications in people living with HIV (PLWH) and on antiretrovirals in Japan, by using a hospital claims database.DesignObservational, retrospective, cross-sectional study.SettingA hospital claims database of Japanese hospitals that have advanced medical treatment capabilities (ie, advanced treatment hospitals, general hospitals, acute care hospitals), which include those providing acute and chronic care (excluding nursing homes or hospices).ParticipantsA total of 1445 PLWH aged ≥18 years and with a prescription record of antiretrovirals between January 2010 and December 2015 were identified from the database.Outcome measuresThe number and types of chronic comorbidities, as well as the number and types of comedications, in different age groups of the PLWH.ResultsThe median (range) age of patients was 45 (18–90) years, and 90.4% were men. Of the 1445 patients, 972 (67.3%) had at least one chronic comorbidity. Common chronic comorbidities included lipid disorders (31.6%), diabetes (26.8%), hypertension (18.2%) and hepatitis B/C coinfection (18.2%). Patients in the older age groups had greater numbers of chronic comorbidities. The most common chronic comorbidities in the older age groups were hypertension, diabetes and lipid disorders. The majority of patients used at least one comedication, and those in the older age groups used greater numbers of comedications. The most common therapeutic category of comedication included antacids, antiflatulents and antiulcerants (31.7%). Of 151 malignancies reported in 117 patients, 84 were AIDS-defining cancers and 67 were non-AIDS-defining cancers.ConclusionsChronic comorbidities and comedications were common among PLWH in Japan taking antiretrovirals; particularly among older patients, who more frequently used comedications. This suggests the need for giving special attention to the appropriate management of this patient population.
Prevalence and clustering of cardiovascular risk factors: a cross-sectional survey among Nanjing adults in China
Authors: Hong Xin , Ye Qing , He Jing , Wang Zhiyong , Yang Huafeng , Qi Shengxiang , Chen Xupeng , Wang Chenchen , Zhou Hairong , Li Chao , Qin Zhenzhen , Xu Fei 
Published: June 2018

ObjectivesTo estimate prevalence and clustering of cardiovascular risk factors (CRFs), and investigate the association between relevant characteristics and CRF clustering among adults in eastern China.DesignCommunity-based cross-sectional study.SettingData were collected by interview survey, physical measurements and laboratory examinations from the 2011 Nanjing Chronic Disease and Risk Factor Surveillance.ParticipantsA representative sample of 41 072 residents aged ≥18 years volunteered to participate in the survey, with a response rate of 91.3%. We excluded 1232 subjects due to missing data or having a history of cardiovascular diseases; a total of 39 840 participants were included in the analysis.Outcome measuresPrevalence and clustering of five major CRFs including hypertension, diabetes, dyslipidaemia, overweight or obesity and current smoking.ResultsOf 39 840 participants (mean age 47.9±16.2 years), 17 964 (45.1%) were men and 21 876 (54.9%) were women. The weighted prevalence of CRFs ranged between 6.2% for diabetes and 35.6% for overweight or obesity. The proportion of CRFs tended to be higher in men, the elderly, participants who lost a life partner, or lived in rural areas, or had lower level of education and total annual income. Overall, 30.1% and 35.2% of participants had one and at least two CRFs, respectively. Multivariate logistic regression revealed that men, older age, loss of a life partner, lower level of socioeconomic status, rural areas, insufficient physical activity or unhealthy diets were positively associated with CVD risk factor clustering, compared with their counterparts.ConclusionsHigh regional prevalence of hypertension, dyslipidaemia, overweight or obesity and their clustering are present in Nanjing. The Nanjing government should develop effective public health policies at the regional level especially for high-risk groups, such as enhancing the public’s health awareness, organising health promotion programmes, implementing smoke-free law, producing healthy nutrient foods, providing free or low-cost public sports and fitness facilities.
Pathways linking socioeconomic status to small-for-gestational-age (SGA) infants among primiparae: a birth cohort study in China
Authors: Luo Xiu , Liu Lingfei , Gu Huaiting , Hou Fang , Xie Xinyan , Li Xin , Meng Heng , Zhang Jiajia , Xu Shunqing , Song Ranran 
Published: June 2018

ObjectivesEvidence about the relationship between socioeconomic status (SES) and small-for-gestational-age (SGA) infants was insufficient among Chinese primiparae. In addition, factors that may mediate this relationship are poorly understood. The purpose of this study was to investigate the risk of and mediators between SES and SGA.DesignRetrospective cohort study.SettingWuhan, Hubei, China.MethodParticipants were recruited from patients who gave birth in the maternity care hospital of Wuhan between September 2012 and October 2014. Logistic regression models were used to estimate the association between SES and SGA. Pathway analysis was performed to examine the contribution of maternal lifestyles and pregnancy-induced hypertension syndrome (PIH) to the relationship between SES and SGA. Total effect, direct effect and indirect effect of SES on SGA were measured. Effect sizes were evaluated by unstandardised estimates (B) and standardised estimates (ß).ResultsAmong 8737 primiparae, 927 (10.61%) pregnant women had babies with SGA. High SES was inversely associated with risk of SGA (OR 0.856; 95% CI 0.737 to 0.995) after adjustment for potential confounders. Maternal obstetric characteristics, lifestyles and PIH completely mediated SES and SGA (indirect effect: B=−0.067, 95% CI −0.108 to –0.026). The indirect effect of SES was strengthened by PIH (B=−0.029), a multivitamin supplement (B=−0.021), prepregnancy body mass index (BMI) ≥18.50 (B=−0.009) and prepregnancy BMI ≥18.50 to gestational weight gain (GWG) not below the Institute of Medicine (IOM) recommendations (B=−0.003).ConclusionsWomen from high SES predicted lower risk of PIH, more chances to take a multivitamin supplement during early pregnancy, keeping prepregnancy BMI ≥18.50 kg/cm2and gaining adequate gestational weight which was not below IOM recommendations. Furthermore, lower risk of PIH, more chances to take a multivitamin supplement, prepregnancy BMI ≥18.50 kg/cm2and GWG not below IOM recommendations were associated with a lower risk of SGA infants.
Medicare Accountable Care Organizations Are Not Associated With Reductions in the Use of Low-Value Coronary Revascularization
Authors: Hollingsworth John M. , Nallamothu Brahmajee K. , Yan Phyllis , Ward Sarah , Lin Sunny , Colla Carrie H. , Lewis Valerie A. , Ayanian John Z. , Hollenbeck Brent K. , Ryan Andrew M. 
Published: June 2018

Background:
Because specialty care accounts for half of Medicare expenditures, improving its value is critical to the success of Medicare accountable care organizations (ACOs) in curbing spending growth. However, whether ACOs have reduced low-value specialty care without compromising use of high-value services remains unknown.

Methods and Results:
Using national Medicare data, we identified 2 cohorts: beneficiaries for whom the value of coronary revascularization is lower (those with ischemic heart disease without angina, congestive heart failure, or recent admission for acute myocardial infarction) and beneficiaries for whom its value is higher (those with recent acute myocardial infarction admission). We then determined the provider groups who cared for the cohorts, distinguishing between those participating (n=298) and those not participating in a Medicare ACO (1329). After measuring the provider groups’ use of coronary artery bypass grafting and percutaneous coronary intervention among the 2 cohorts, we fit multivariable models to test the statistical significance of rates of change in low- and high-value revascularization after ACO participation. During the pre-ACO period, participating and nonparticipating provider groups had similar rates of low- and high-value revascularization. Our multivariable model results show that rates of change for low- and high-value coronary revascularization were not altered by a provider group’s participation in a Medicare ACO (lower value: difference, −0.04 per year; 95% confidence interval, −0.11 to 0.03; higher value: difference, 0.96 per year; 95% confidence interval, −0.46 to 2.4).

Conclusions:
We found no association between provider group participation in a Medicare ACO and use of low- or high-value coronary revascularization.
Mass Influxes and Protection in Europe: A Reflection on a Temporary Episode of an Enduring Problem
Authors: Koo John 
Published: June 2018

Abstract
This article assesses Temporary Protection (TP) in Europe in response to refugee crises. In 2001 the European Union (EU) adopted a Directive for TP to provide a regional response to a mass influx. It was considered that TP offered a double-win: addressing protection needs of asylum seekers, while enabling states to maintain control based on the understanding that asylum seekers would return home after a short period of stay. The Directive has been endorsed in UNHCR Guidelines on ‘Temporary Protection or Stay Arrangements’ (2014). Notwithstanding, the analysis in this article indicates that TP was a strategy that failed: it did not give states control nor promote solidarity between them. Failure explains its absence in the responses to the 2015–16 crisis. However, national forms of TP have re-emerged signalling efforts to re-assert control in the face of an enduring problem.
Os jardins sicilianos por Giuseppe Tomasi di Lampedusa
Authors: Dalla Bona Fabiano 
Published: June 2018

Percorrer o jardim literário significa traçar o diagrama de um mito que fascinou artistas e escritores em todos os séculos, mas que ao mesmo tempo significa refletir sobre a história civil e cultural dos locais onde encontrou a sua atuação aquele original conúbio entre arte e natureza que distingue o espaço do jardim. A relação entre literatura e natureza que envolve o interesse e as emoções de tantos autores, convida a refletir sobre a possibilidade de ler a paisagem natural como aquela de uma composição literária. O presente artigo trata dos jardins descritos por Giuseppe Tomasi di Lampedusa em duas de suas obras, O Leopardo e Recordações de infância. Discute-se o conceito de jardim, a tipologia dos jardins, o papel dos jardins na literatura sob o viés metodológico da crítica literária de Sicotte (2011), Nigro (2012; 1996) e Jakob (2005) e dos estudos da paisagem Terra (2013), Roger (2009) e Assunto (1994) entre outros.
Mad Men (AMC 2007-2015): relato, discurso, ejes temáticos
Authors: Rodríguez Jiménez. Leda 
Published: June 2018

El presente artículo propone un acercamiento a la serie de televisión Mad Men (AMC, 2007-2015) del guionista, director y productor norteamericano Matthew Weiner. Primeramente, el análisis se enfoca en el relato como suceso y como discurso. Esto quiere decir que considera tanto la instancia relatora –quién o qué narra- como los aspectos que competen a la recepción de la serie –a quién o a qué le narra- y, por tanto, a las diversas propiedades narrativas orientadas a la construcción de la mirada. En segundo término, el ejercicio analítico discurre sobre tres grandes ejes temáticos que, para quién escribe estas líneas, organizan buena parte de la estructura que compone el mundo representado. Estos ejes son: la prostitución como marca (identitaria y corporativa), la maternidad como obstáculo y la mujer como relato masculino. Aunque el artículo tiene sentido en sí mismo, se constituye como la continuación de un trabajo anterior que versa, grosso modo, sobre los espacios, las temporalidades y la forma del relato.
Business Development Independent Populist Economic Owned Enterprises as a Village
Authors: Sunada I Ketut , Sandi I Ketut 
Published: June 2018

Bumdes is a village business unit whose capital comes from village-owned funds . The goal is to float the village potential into an independent village. Thus it takes effort and strategic and appropriate tips to achieve that goal. The first tip is to establish a forum for the development of economic networks in this case is the establishment of BUMDES. Some of the things that can be done are: (i) development of human resources capability so as to provide added value in the management of village economic assets, (ii) integrating rural economic products so as to have good bargaining position in market network, (iii) (iv) strengthening village economic institutions, (v) developing supporting elements such as micro-credit, market information, technological and management support, economic infrastructure and communication networks as well as support for guidance and regulation.
A tradição da convenção: Nossos ossos, de Marcelino Freire
Authors: Soares da Silva Leandro 
Published: June 2018

<p>Neste artigo, o romance <em>Nossos ossos</em>, de Marcelino Freire, é ponto de partida para um estudo das formas convencionais que estruturam alguns textos literários acerca da homossexualidade. São apresentados os motivos pelos quais o livro, a despeito da temática, recorre a fórmulas tropológicas sobre personagens e experiências das pessoas LGBT que são tradicionais, no sentido de expressarem noções socialmente normatizadas. Assim, o romance possui a cesura de, por um lado, exibir notável domínio da linguagem literária e, por outro, reiterar convenções desgastadas para organizar os episódios de seu enredo. </p>
“Selvagens mais que o bruto polifemo”: a representação dos imigrantes em Estive em Lisboa e lembrei de você, de Luiz Ruffato
Authors: Silva Ívens Matozo , Matos Xênia Amaral , Martins Aulus Mandagará 
Published: June 2018

<p>O presente artigo possui o objetivo de analisar de que forma a situação dos imigrantes é representada na diegese <em>Estive em Lisboa e lembrei de você</em>(2009), de Luiz Ruffato, assim como verificar que identidades lhes são impostas pelas demais personagens. Para isso, embasamos nossa análise literária nos pressupostos teóricos desenvolvidos por Stuart Hall (2003) e Eric Landowski (2013). Através dos resultados obtidos, foi possível verificar as variadas situações de miséria e subdesenvolvimento pelas quais os imigrantes são representados no romance. Além disso, a identidade do imigrante que se dirige a sua antiga metrópole acaba adquirindo um valor e um peso metafórico fortemente negativo devido à depreciação da sua diferença. </p>
Losses and Productivity Parameters for Cladding Technology with Wet-Process Sprayed Mortar
Authors: Santos Denise Ribeiro dos , Morais Gabriela Alves Tenório de , Lordsleem Alberto Casado 
Published: June 2018

Background and Objective:The wet-process sprayed mortar is a potential solution to minimize the traditional application negative points. However, its use is still incipient and a recent technological innovation in several regions of Brazil. Few available parameters that attest gains to subsidize the budget, design, and execution of cladding are systematized. This paper aims to evaluate the industrialized mortar loss and labor productivity in the execution of internal and external cladding for buildings.Methods:The first step was to define the elements to characterize the constructive cladding technology with mechanical projection of mortar and method for effective data collection. The second step consisted in the accomplishment of the field research, which took into account the case studies in 08 buildings under construction. The third step intended to describe the best practices highlighted in the construction works analyzed and the fourth step described the identification of actions able to succeed in the implementation and operation of the system.Result:The results allowed verifying industrialized mortar loss varying from 6.38% to 150.02%, as well as masons’ productivity from 0.18M’hr/m2up to 5.91M’hr/m2. The present research also made it possible to identify factors influencing the increase in the loss indicator, such as the fresh mortar consistency, failure in the transport and control of bagged materials, and high thicknesses in the cladding layer. As for the factors that favored productivity, it is important to highlight: the experience of the masons involved, the mortar application to the windows, and good logistics for the transportation of bagged goods.Conclusion:Identification of the best practices, opportunities to improve production management, and obtainment of quantitative references comprise the main contributions of this research, which may help in adoption of this technology and solution of similar problems by construction companies.
FUNCIONALIDAD FAMILIAR Y CARIES DENTAL EN NIÑOS DE UNA INSTITUCION EDUCATIVA DE CARTAGENA DE INDIAS
Authors: Díaz Cárdenas Shyrley , Arrieta Vergara Katherine , Ramos Martínez Ketty 
Published: June 2018

Objetivo. Describir la presencia de caries dental y funcionalidad familiar en escolares de una institución pública de Cartagena. Métodos. Estudio descriptivo transversal. La muestra de 238 niños preescolares y de primaria, se seleccionó por muestreo probabilístico estratificado con reemplazo. Las mediciones clínicas se realizaron a través del índice de caries de COP y los criterios de Severidad ICDAS II y para medir funcionalidad familiar se usó el APGAR familiar. Los datos fueron analizados a partir de proporciones (análisis univariado) y a través del c2 para dar significancia estadística a las relaciones (análisis bivariado) utilizando el programa STATA 10.0®. Resultados. Se encontró una prevalencia de caries dental de 51 % (IC 95 %; 44-57), mayor para niños entre 8 y 9 años en 32 % (p = 0, 03) y en las niñas con 54 % (p = 0,03); 59 % (IC 95 %; 52-66) viven en familias disfuncionales. Al relacionarse la función familiar con la caries no se encontraron diferencias estadísticas significativas (p>0,05); sin embargo, al relacionar la caries con cada uno de los componentes evaluados en el Apgar familiar se encontró significancia estadística en el componente relacionado con los recursos familiares (p=0,04). Conclusiones. La carga de morbilidad oral con respecto a la presencia de caries dental en los niños es alta. La falta de recursos en las familias como espacio, tiempo y dinero estuvieron relacionadas con la presencia de la enfermedad.