bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient and primary care delays in the diagnostic pathway of gynaecological cancers: a systematic review of influencing factors
Authors: Williams Pauline , Murchie Peter , Bond Christine 
Published: January 2019

BackgroundGynaecological cancers are the second most common female cancer type, with survival rates in the UK lower than in many comparable countries. A potentially important factor in the UK’s poorer cancer outcomes is diagnostic delay; gynaecological cancers are the cancer type most likely to be affected by less timely diagnosis.AimTo examine current evidence for factors that contribute to patient and primary care delays in the diagnostic pathway of gynaecological cancer.Design and settingA systematic review of the available literature.MethodPRISMA guidelines were followed. MEDLINE and Embase databases and the Cochrane Library were searched using three terms: primary care; gynaecological cancer; and delay. Citation lists of all identified articles were searched. Two authors independently screened the titles, abstracts, and full texts of publications. Data extraction was performed by one author and quality assured by a second reviewer in a 20% sample of selected articles. Synthesis was narrative.ResultsA total of 1253 references was identified, of which 37 met the inclusion criteria. Factors associated with delayed diagnosis were categorised as either patient factors (patient demographics, symptoms or knowledge, and presentation to the GP) or primary care factors (doctor factors: patient demographics, symptoms or knowledge, and referral process); and system factors (such as limited access to investigations).ConclusionDelayed diagnosis in the patient and primary care intervals of the diagnostic journey of gynaecological cancer is complex and multifactorial. This review identifies areas of future research that could lead to interventions to enable prompter diagnosis of gynaecological cancers.
Continuity of care in general practice at cancer diagnosis (COOC-GP study): a national cohort study of 2853 patients
Authors: Hurtaud Aline , Aubin Michèle , Ferrat Emilie , Lebreton Julien , Paillaud Elena , Audureau Etienne , Bastuji-Garin Sylvie , Chouaid Christos , Boisnault Philippe , Clerc Pascal , Canouï-Poitrine Florence 
Published: January 2019

BackgroundAt cancer diagnosis, it is unclear whether continuity of care (COC) between the patient and GP is safeguarded.AimTo identify patient–GP loss of COC around the time of, and in the year after, a cancer diagnosis, together with its determinants.Design and settingA post-hoc analysis of data from a prospective cohort of GPs in France, taken from a survey by the Observatoire de la Médecine Générale.MethodA prospective GP cohort (n = 96) filed data on patients who were diagnosed with incident cancer between 1 January 2000 and 31 December 2010. COC was assessed by ascertaining the frequency of consultations and the maximal interval between them. (In France, patients see their referring/named GP in most cases.) A loss of COC was measured during the trimester before and the year after the cancer diagnosis, and the results compared with those from a 1-year baseline period before cancer had been diagnosed. A loss of COC was defined as a longer interval (that is, the maximum number of days) between consultations in the measurement periods than at baseline. Determinants of the loss in COC were assessed with univariate and multivariate logistic regression models.ResultsIn total, 2853 patients were included; the mean age was 66.1 years. Of these, 1440 (50.5%) were women, 389 (13.6%) had metastatic cancer, and 769 (27.0%) had a comorbidity. The mean number of consultations increased up to, and including, the first trimester after diagnosis. Overall, 26.9% (95% confidence interval [CI] = 25.3 to 28.6) of patients had a loss of COC in the trimester before the diagnosis, and 22.3% (95% CI = 20.7 to 23.9) in the year after. Increasing comorbidity score was independently associated with a reduction in the loss of COC during the year after diagnosis (adjusted odds ratio [OR] comorbidity versus no comorbidity 0.61, 95% CI = 0.48 to 0.79); the same was true for metastatic status (adjusted OR metastasis versus no metastasis 0.49, 95% CI = 0.35 to 0.70).ConclusionAs COC is a core value for GPs and for most patients, special care should be taken to prevent a loss of COC around the time of a cancer diagnosis, and in the year after.
Efficacy of Methotrexate in Real-world Management of Giant Cell Arteritis: A Case-control Study
Authors: Koster Matthew J. , Yeruva Karthik , Crowson Cynthia S. , Muratore Francesco , Labarca Cristian , Warrington Kenneth J. 
Published: January 2019

Objective.To determine the effect of methotrexate (MTX) on relapse risk and glucocorticoid (GC) use in a large single-institution cohort of patients with giant cell arteritis (GCA).Methods.Patients diagnosed with GCA from 1998 to 2013 with confirmed evidence of temporal artery biopsy and/or radiographic evidence of large vessel vasculitis were identified. Each patient with GCA treated with adjunct MTX (case) was matched to a similar patient with GCA treated only with GC (control). GC requirements and relapse events before and after MTX initiation (or corresponding index date) were compared using rate ratios (RR).Results.Eighty-three cases and 83 controls were identified and compared. No significant differences in age, demographics, laboratory variables, baseline disease characteristics, or mean initial prednisone doses were observed. Median [interquartile range (IQR)] time from GCA diagnosis to MTX initiation in cases was 39 (13–80) weeks and the median (IQR) starting dose was 13.5 (10–15) mg/week. RR comparing relapse rates before and after MTX initiation/index date were significantly reduced in both cases (RR 0.32, 95% CI 0.24–0.41) and controls (RR 0.60, 95% CI 0.43–0.86). The decrease in relapse rate was significantly greater in patients taking MTX than in those taking GC alone (p = 0.004). Rates of GC discontinuation did not differ between groups.Conclusion.In this large single-institution cohort, the addition of MTX to GC decreased the rate of subsequent relapse by nearly 2-fold compared to patients taking GC alone. MTX may be considered as adjunct therapy in patients with GCA to decrease the risk of further relapse events.
Predicting Which Children with Juvenile Idiopathic Arthritis Will Not Attain Early Remission with Conventional Treatment: Results from the ReACCh-Out Cohort
Authors: Guzman Jaime , Henrey Andrew , Loughin Thomas , Berard Roberta A. , Shiff Natalie J. , Jurencak Roman , Huber Adam M. , Oen Kiem , Gerhold Kerstin , Feldman Brian M. , Scuccimarri Rosie , Houghton Kristin , Chédeville Gaëlle , Morishita Kimberly , Lang Bianca , Dancey Paul , Rosenberg Alan M. , Barsalou Julie , Bruns Alessandra , Watanabe Duffy Karen , Benseler Susanne , Duffy Ciaran M. , Tucker Lori B. 
Published: January 2019

Objective.To estimate the probability of early remission with conventional treatment for each child with juvenile idiopathic arthritis (JIA). Children with a low chance of remission may be candidates for initial treatment with biologics or triple disease-modifying antirheumatic drugs (DMARD).Methods.We used data from 1074 subjects in the Research in Arthritis in Canadian Children emphasizing Outcomes (ReACCh-Out) cohort. The predicted outcome was clinically inactive disease for ≥ 6 months starting within 1 year of JIA diagnosis in patients who did not receive early biologic agents or triple DMARD. Models were developed in 200 random splits of 75% of the cohort and tested on the remaining 25% of subjects, calculating expected and observed frequencies of remission and c-index values.Results.Our best Cox logistic model combining 18 clinical variables a median of 2 days after diagnosis had a c-index of 0.69 (95% CI 0.67–0.71), better than using JIA category alone (0.59, 95% CI 0.56–0.63). Children in the lowest probability decile had a 20% chance of remission and 21% attained remission; children in the highest decile had a 69% chance of remission and 73% attained remission. Compared to 5% of subjects identified by JIA category alone, the model identified 14% of subjects as low chance of remission (probability < 0.25), of whom 77% failed to attain remission.Conclusion.Although the model did not meet our a priori performance threshold (c-index > 0.70), it identified 3 times more subjects with low chance of remission than did JIA category alone, and it may serve as a benchmark for assessing value added by future laboratory/imaging biomarkers.
Use of Anakinra in Hospitalized Patients with Crystal-associated Arthritis
Authors: Liew Jean W. , Gardner Gregory C. 
Published: January 2019

Objective.In this retrospective observational study, we assess the efficacy and safety of the interleukin 1 receptor antagonist anakinra in medically complex, hospitalized patients with acute gout and calcium pyrophosphate crystal arthritis.Methods.Adult inpatients treated with anakinra from 2014 to 2017 were identified for inclusion. Charts were reviewed for demographics, comorbidities, laboratory data, pain scores, joint involvement, prior treatment, dosing and response to anakinra, concurrent infections, and surgical interventions. Response to anakinra treatment was determined from review of provider documentation, as well as recorded pain scores on a numeric scale.Results.We identified 100 individuals accounting for 115 episodes of arthritis. This population was 82% male, with an average age of 60 years. Comorbidities included renal disease (45%) and history of organ transplantation (14%). Twenty-nine episodes of arthritis occurred in the perioperative setting. Concurrent infection was present in 34 episodes. Eighty-six episodes of arthritis had partial or complete response to anakinra within 4 days of treatment initiation; 66 episodes had partial or complete response within 1 day of anakinra administration. Anakinra was well tolerated.Conclusion.To our knowledge, this is the largest observational study of anakinra use in the inpatient setting for the acute treatment of crystal-associated arthritis. We observed a rapid response to anakinra, with 75% of episodes significantly improving or completely resolving within 4 days of the first dose. Our data also support the use of this biologic agent in individuals with infections, as well as perioperative individuals and immunosuppressed transplant recipients.
Improving Benefit-harm Assessment of Therapies from the Patient Perspective: OMERACT Premeeting Toward Consensus on Core Sets for Randomized Controlled Trials
Authors: Andersen Kathleen M. , Cheah Jonathan T.L. , March Lyn , Bartlett Susan J. , Beaton Dorcas , Bingham Clifton O. , Brooks Peter M. , Christensen Robin , Conaghan Philip G. , D’Agostino Maria-Antonietta , de Wit Maarten , Dueck Amylou C. , Goodman Susan M. , Grosskleg Shawna , Hill Catherine L. , Howell Martin , Mackie Sarah L. , Richards Bethan , Shea Beverly , Singh Jasvinder A. , Strand Vibeke , Tugwell Peter , Wells George A. , Simon Lee S. 
Published: January 2019

Objective.Outcome Measures in Rheumatology (OMERACT) convened a premeeting in 2018 to bring together patients, regulators, researchers, clinicians, and consumers to build upon previous OMERACT drug safety work, with patients fully engaged throughout all phases.Methods.Day 1 included a brief introduction to the history of OMERACT and methodology, and an overview of current efforts within and outside OMERACT to identify patient-reported medication safety concerns. On Day 2, two working groups presented results; after each, breakout groups were assembled to discuss findings.Results.Five themes pertaining to drug safety measurement emerged.Conclusion.Current approaches have failed to include data from the patient’s perspective. A better understanding of how individuals with rheumatic diseases view potential benefits and harms of therapies is essential.
The Third Biennial 2018 OMERACT First-time Participant Program: A Qualitative and Quantitative Study
Authors: Sloan Victor S. , Grosskleg Shawna , Wells George , Singh Jasvinder A. 
Published: January 2019

Objective.To assess the expanded/refined first-time participant training program.Methods.We conducted a refined new participant program at OMERACT 2018 on days 1–4, in which first-time participants provided feedback with online surveys and a nominal group on Day 4.Results.Twenty first-time participants attended the introductory session and 8–12 attended followup sessions. A high proportion valued the newbie session (100%), rating it overall (91%), content-wise (62%), for presentation quality (82%), and value for the money (82%) as outstanding or good. The nominal group technique identified opportunities for further improvement of breakouts/voting.Conclusion.The expanded new participant training program is valued by attendees.
Une théorie économique de l’exploitation salariale
Authors: Cartelier Jean 
Published: January 2019

La thèse défendue dans ce qui suit est que le salaire n’est pas le prix d’une marchandise (bien ou service) s’établissant sur un marché ; il est le paiement par lequel des individus, ne pouvant être producteurs de marchandises, acceptent de travailler au sein d’une entreprise sous le contrôle et pour le compte d’un entrepreneur. La différence entre le statut de salarié et celui de l’individu marchand est à la source d’une exploitation inhérente à la relation salariale (exploitation identifiée par Marc Fleurbaey comme étant la M-exploitation ). JEL : A 10, B 20, J 30
Paiements, esclavage et exploitation : éléments d’un triptyque
Authors: Darmangeat Christophe 
Published: January 2019

On construit une base de données portant sur 240 sociétés afin de tester les relations entre stockage, esclavage et paiements. Les résultats confirment globalement les propositions d’Alain Testart. Les paiements constituent un indice globalement sûr de la présence de la richesse et de l’exploitation et, à de très rares exceptions près, c’est au sein de cet ensemble social que se rencontre l’esclavage. Dans une perspective matérialiste, l’origine techno-économique des paiements doit toutefois être située, au-delà du seul stockage alimentaire, plus largement dans la production de biens meubles, durables et nécessitant une importante quantité de travail. JEL Codes : Z13, B14
Le corps dans la culture hypermoderne. Représentations et valeurs
Authors: Tapia Claude 
Published: January 2019

Cet article traite de la problématique des rapports entre les représentations sociales concernant le corps et des évolutions culturelles et sociales plus globales. Il apparaît dans notre analyse que le corps, au cours de diverses étapes, depuis le début du xx	e siècle, peut être appréhendé comme le siège de nombreuses transformations, et aussi comme le lieu d’inscription des signes de la libération morale et sexuelle, bref comme l’écran sur lequel se projette la lutte incessante du conservatisme et de la modernité. L’évolution des représentations sociales révélée par les productions littéraires, le cinéma, le théâtre ou la danse… renseigne sur le statut ambigu du corps dans l’imaginaire social et sur les tendances contradictoires qui s’esquissent à notre époque.
Les nouveaux corps du capitalisme
Authors: Linhart Danièle 
Published: January 2019

Cet article vise à identifier la nature du management des corps des salariés dans le cadre du travail « post taylorien ». Malgré un travail qui devient de plus en plus abstrait, l’organisation spatiale des corps comme la focalisation sur le bien-être corporel occupent, dans le management moderne, une place importante, qui peut paraître intrigante. On fait ici l’hypothèse qu’il s’agit de modeler l’identité et les représentations des cadres, ingénieurs, experts, en leur faisant prendre conscience qu’ils sont des salariés subordonnés comme les autres, par une gestion de leur inscription spatiale qui les renvoie à l’image de forces de travail contrôlées. Si le taylorisme visait à rapprocher l’homme de l’état de machine, le management moderne utilise les corps comme vecteurs de disciplinarisation, pour y incorporer en même temps qu’une identité de subordonné, un vécu individuel composé d’aspirations narcissique et de satisfactions liées non pas tant au respect de la professionnalité mais qu’à une bienveillante prise en charge du bien-être.
La psyché du corps connecté et transformé, entre contenance et augmentation
Authors: Tordo Frédéric 
Published: January 2019

Avec Freud, puis Anzieu, nous avons appris qu’une fonction psychique se développe par étayage sur une fonction corporelle dont elle transpose le fonctionnement sur le plan psychique. Ce texte parcourt une hypothèse complémentaire à l’ère du corps hypermoderne : les fonctions psychiques trouvent un appui sur la technologie, et ses fonctions, qu’elles transcrivent dans la psyché. La fonction de contenance/augmentation est présentée : à la technologie qui épouse la surface du corps, ou simplement à laquelle le sujet est « connecté », répond la fonction contenante d’une partie du Moi – que nous nommons Moi-cyborg . Ce qui implique une extension des limites du Moi, donc de la surface psychique. Une vignette clinique illustrera cette fonction, et la manière dont elle colmate, artificiellement, une psychopathologie de la contenance.
Des corps hypermodernes
Authors: Le Breton David 
Published: January 2019

Dans nos sociétés contemporaines, le corps est devenu une sorte de terminal pour l’individu, un objet fluide, transformable, un work in process . Pour les uns, il s’agit de le transformer, de s’en jouer, d’autres veulent s’en débarrasser, la plupart, sans doute, ne s’en soucient guère, ils le considèrent comme l’incarnation de leur expérience du monde et ne songent nullement à le congédier ou à l’« améliorer ». Ainsi des centaines de millions de marcheurs à travers le monde disent leur bonheur de vivre l’incarnation sensible de leur rapport au monde, sans souci de performance ou d’efficacité. Pour le transhumanisme, il est surnuméraire, lieu de la fragilité de la condition humaine il convient de s’en débarrasser. Les limites du corps interrogent les limites du lien social et les limites de soi.
Psychanalyse et médecine, ou la « méthode Balint »
Authors: Meslem Mustapha 
Published: January 2019

Résumé Michael Balint a perpétué l’école de Budapest en Angleterre, avec la création des « Groupes de recherche formation » qui deviendront les « groupes Balint ». Il est l’un des instigateurs du Middle Group, dont le principal porte-parole sera Donald W. Winnicott. Il inventera et développera les notions d’investissement mutuel, de fonction apostolique, de défaut fondamental, de régression et de confusion des langues.
Approche systémique et défense des droits de l’Homme
Authors: Pregno Gilbert 
Published: January 2019

L’approche systémique nous introduit à la pensée complexe, à la prise en compte de la globalité, elle nous invite avec la deuxième cybernétique à définir notre responsabilité et notre engagement non pas seulement dans la solution des difficultés, mais aussi dans son maintien. Après plus d’un demi-siècle, l’approche systémique revêt encore son caractère innovateur, ce dont témoigne l’abondance de pratiques et d’outils. Quelle attitude prendre par rapport à la question des droits de l’homme dont le non-respect peut envahir la vie des personnes que nous prenons en charge et impacte les institutions dont nous faisons partie ? Il s’avère qu’un engagement pour les droits humains, leur défense, se marie fort bien avec la démarche du systémicien. Si le systémicien interpelle la place du symptôme, le défenseur des droits humains prolonge la pensée et l’intervention du premier pour positionner nos institutions et notre société face aux injustices qu’elles produisent et qui ne trouvent pas leur origine dans le système familial. Cette interface est riche et remet l’intervenant face à ses responsabilités qui l’obligent à se questionner sur sa place à lui dans le contexte plus large qui est celui de sa pratique et de la place qu’il occupe dans les institutions, de la société dans laquelle il vit et de la planète qu’il habite.
Fortification, mining, and charcoal production: landscape history at the abandoned medieval settlement of Hohenwalde at the Faule Pfütze (Saxony, Eastern Ore Mountains)
Authors: Tolksdorf Johann Friedrich , Schubert Matthias , Schröder Frank , Petr Libor , Herbig Christoph , Kočár Petr , Bertuch Mathias , Hemker Christiane 
Published: January 2019

Abstract. Geoarchaeological reconstructions of land-use changes may help to reveal driving cultural factors and incentives behind these processes and relate them to supra-regional economic and political developments. This is particularly true in the context of complete abandonment of a settlement. Here we present a case study from the site of Faule Pfütze, a small catchment in the Eastern Ore Mountains (Saxony). The historical record of this site is confined to the report of a settlement called Hohenwalde in 1404 CE and two later references to the then-abandoned settlement in 1492 and 1524 CE in this area. Combined geoarchaeological studies allowed for the reconstruction of several phases of land use. While a first phase of alluvial sedimentation occurred during the late 12th century, archaeological evidence for a permanent settlement is absent during this period. The onset of settlement activity is identified during the late 14th century and included a hitherto unknown massive stone building. Mining features are present nearby and are dated to the early 15th century. The local palynological record shows evidence for reforestation during the mid 15th century and thereby corroborates the time of abandonment indicated by written sources. These processes are discussed in the context of a local political conflict (Dohna Feud) leading to the redistribution of properties and the development of a mining economy during this time. Later land use from the mid 16th century onwards appears restricted to charcoal production, probably in the context of smelting works operating in nearby Schmiedeberg as indicated by rising lead concentrations in the alluvial record.
Een transitievergoeding bij overlijden?
Authors: van der Zalm I. 
Published: January 2019

Een transitievergoeding bij overlijden? Een snelle tegemoetkoming aan nabestaanden voor kosten als gevolg van het overlijden van een naaste?
In Denemarken hebben nabestaanden recht op een zogenaamde transitievergoeding (‘overgangsbeløb’). Deze eenmalige gestandaardiseerde vergoeding is bedoeld om kort na het ongeval te voorzien in dekking van diverse uitgaven die het gevolg zijn van het overlijden. In dit artikel zal worden ingegaan op deze transitievergoeding en zal worden onderzocht of een dergelijke figuur ook van betekenis zou kunnen zijn voor het Nederlandse stelsel, nu artikel 6:108 BW niet voorziet in een dergelijke figuur.