bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adherence to aromatase inhibitors (AIs) in Hispanic patients with early stage breast cancer.
Authors: Philipovskiy Alexander , Campbell Aleli , Heydarian Rosalinda , Lin Krysta , Nahleh Zeina A. 
Published: May 2018

70 Background: Adherence to Aromatase Inhibitors (AIs) is essential for the effective prevention of breast cancer recurrence. We sought to evaluate adherence to AIs as well as possible factors behind non-adherence in a large American-Mexican border city with predominantly Hispanic population. Methods: After IRB approval, women with Stages I-III breast cancer treated at the Texas Tech breast care center in El Paso, TX were included if they were receiving adjuvant AI therapy. We utilized the validated Morisky Medication Adherence Scale (MMAS-8) to determine AI compliance. In addition, a question to indicate reasons for noncompliance was added. Results: 87 patients were enrolled, median age was 61 years; 78 (90%) were identified as Hispanic. The majority of participants were women of low socioeconomic status 53 (61%) with an annual income of < $15,000. MMAS-8 results showed 35 (40%) patients admitted to forgetting to take their AI pill. Additionally, 71 (82%) of the patients denied forgetting to take the AI pill within the past two weeks. 11 (13%) patients admitted to sometimes having difficulty remembering to take their AI medication, and 74 (85%) stated never or rarely having difficulty remembering to take their AI medication. 50 (57.5%) patients provided a reason why they did not take their AI pill, 35 (40%) cited forgetfulness, 14 (17%) cited other reasons including cost, limited insurance coverage, lack of transportation involved in obtaining the medication and timely prescription refills, and only 1(1%) due to side effects. Conclusions: Non-adherence to AI appears to be prevalent among Hispanic patients with breast cancer. Main causes of noncompliance are forgetfulness and financial reasons. Healthcare providers could reinforce educating patients about the importance of compliance. Financial assistance may also be helpful in improving AI compliance. Clinical trial information: NCT03144037.
Decision aids and health information technology: One size does not fit all.
Authors: Noyes Katia , Crabtree-Ide Christina , Holub David , Shayne Michelle , Rodriguez Jennifer , Rizvi Irfan , Fleming Fergal J. , Sharda Varsha , Sharda Pradeep , Bellohusen Patricia , Termer Nancy K. , Constine Louis S. 
Published: May 2018

74 Background: Nearly 3 million cancer survivors in the US reside in rural areas. Existing survivorship care models were developed mainly at large academic centers, and thus require adaption to meet the challenging needs of the rural community. Rural cancer survivors (RCS) face issues with coordination of care, decision-making, access to specialty services, supportive care resources, and time and resources required for travel. RCS are at greater risk for social isolation and inadequate emotional support. To address these challenges, many studies propose information technology (IT), mobile, and video solutions. We assessed the potential of online and mobile video technology applications to reduce barriers to survivorship care for RCS, families, and caregivers. Methods: We conducted 2 in-person focus groups with rural care managers, providers, and public health professionals, and one virtual cross-disciplinary focus group of patients, caregivers, and provider stakeholders to evaluate acceptability of video modules. Using a Community-Based Participatory Research approach, we worked with community partners to design and develop materials that adequately addressed their needs. Results: Focus group results indicate that video modules added little value for RCS due to sporadic internet access, limited patient IT literacy, vision and memory problems, and patient difficulty interpreting information. Therefore, we designed and piloted a paper RCS Checklist to be taken to appointments, available in waiting areas or through care managers, and to serve as a guide for shared patient-provider decision-making. The resulting checklist includes evidence-based information about survivorship care goals and approaches, care coordination strategies, information about local cancer supportive services, health insurance reimbursement, state disability policies, psychosocial support, and stress-reduction tips. Conclusions: In some special patient populations like RCS, use of health IT for patient empowerment and care coordination may be a poor choice. Engaging relevant stakeholders in the development of location-specific communication and decision aid materials is paramount to successful engagement of patients and caregivers.
The impact of physician communication on diabetes management in cancer survivors.
Authors: Okaka Yvonne , Muellers Kimberly A. , Wisnivesky Juan P. , Lin Jenny J. 
Published: May 2018

77 Background: As cancer survivors live longer and many die from other comorbidities, it becomes increasingly important to understand factors associated with self-management behaviors for common comorbidities such as diabetes (DM). Provider guidance and inclusive communication have been found to promote self- management behaviors (SMB) in patients with DM. This study aims to explore the impact of provider communication on DM SMB in cancer survivors with DM. Methods: Patients with pre-existing DM who were newly diagnosed with early-stage breast, prostate, colorectal or lung cancer were enrolled. The Summary of Diabetes Self-Care Activities instrument was used to assess patients’ SMBs. The Patient Reaction Assessment scale was used to assess physician communication. Additional survey questions elicited the range of DM self-care recommendations made by patients’ healthcare providers. Mann-Whitney U test was used to assess the association between provider recommendations and communication and SMBs. Results: Of the 74 patients enrolled, the average age was 62 years and 64% were female. Patients who reported their healthcare providers recommended exercise reported more days of specific physical activity (median 5 vs. 0, p = 0.029). Patients who reported that their providers recommended checking their sugar checked their blood sugar more days out of the last 7 days (median 4 vs. 0, p < 0.001). Patients who reported that is hard to talk to their provider about how their treatment is going reported eating more sweets per week (median 2 vs. 1, p = 0.015) and fewer vegetables (median 0 vs. 1, p = 0.043). Conversely, patients who felt that their providers were interested in them as a person reported following a healthful eating plan for more days in a week (median 5.5 vs. 2, p = 0.016) and checked their feet more often (median 6.5 vs. 0, p = 0.008). Conclusions: Cancer survivors with DM whose healthcare providers recommend specific DM SMBs and who report better provider relationships perform DM SMBs more often. Healthcare providers should recognize that supportive recommendations for diet and exercise may improve survivors’ self-management of comorbidities.
Diabetes outcomes in patients with a history of breast cancer.
Authors: Hinyard Leslie J. , Schoen Martin W , Chen Jiajing , Tu Yifan , Rodin Miriam B. 
Published: May 2018

8 Background: While diabetes is known to worsen breast cancer (BC) outcomes, little is known about the effect of BC on diabetes outcomes. This study examined differences in outcomes diabetic patients with and without a history of BC. Methods: Data from NHANES 2010 – 2016 was used to identify female patients self-reporting diabetes mellitus (DM). Comparisons of DM outcomes for persons reporting a history of BC versus without any cancer were made using Chi-Square and separate analyses were conducted for younger (less than 65) and older (65 and older) respondents. Analyses were conducted using SAS survey procedures (Cary, NC) and were weighted to account for the sampling scheme. Results: The analytic cohort consisted of 1347 patients, of which 80 (6.3%, weighted) reported a history of breast cancer. 785 (62.4%, weighted) of the full sample was under age 65. Of those under 65, 3% (weighted) reported history of BC and 11.8% (weighted) of those over 65% reported BC. In diabetics under 65, respondents with BC were more likely to report physical limitations keep them from working and physical, mental, and emotional limitations (p = .001, and p = 0.03, respectively) and were less likely to use insulin (p = .01) than respondents without BC. In respondents 65 and older, women with BC were more likely to report problems with memory and confusion (p = .002) and less likely to rate their general health as excellent or very good (p = .01) compared to those without BC. No differences were found for demographic characteristics, retinopathy, heart disease, or stroke for either age group. Conclusions: In this population of patients with diabetes, history of BC was associated with physical and emotional limitations in younger patients and general health status and memory and confusion in older patients. Understanding the intersection of multiple chronic conditions is important for improving quality of life and clinical outcomes in BC survivors.
Feasibility and fidelity of a reiki intervention for cancer patients by family caregivers.
Authors: Chen Yea-Jyh , Petrinec Amy , Radziewicz Rosanne M. 
Published: May 2018

87 Background: Reiki is a complementary therapy that has been reported to decrease symptoms of stress and promote relaxation. Standards for administrating Reiki have not been established. Additionally, patients with advanced cancer and their family caregivers (FCGs) encounter challenges during the illness experience that preclude them from participating in stress reducing therapies offered outside the home. The purpose of this study was to evaluate the feasibility and fidelity of an “at-home” reiki intervention performed by the FCG of patients with cancer. Methods: Twelve cancer patients and their FCGs were recruited from oncology outpatient facilities in the Greater Cleveland area. A certified Reiki educator provided two 4-hour courses for the FCGs to learn the basics and practice. To develop and promote intervention fidelity, the FCG maintained a daily diary recording frequency, interval, time of day, and position of Reiki practice. The Reiki educator called the FCG weekly to monitor usage, protocol adherence (60-minutues daily practice for three weeks) and answer questions. Satisfaction with the intervention was measured on completion of the study. Results: Compliance to the study protocol was high in this sample. The majority of day-to-day practice episodes (110/126; 87%) were delivered and completed by FCGs over a three week period. Diary entries indicated FCGs were prone to practice Reiki 45 minutes (72%) per day, once daily (79-93%), in a lying position (82%) and in the evening (61%). Deterioration in a patients’ health was most frequently cited for lack of adherence to daily Reiki practice. A few patients and FCGs reported practice time duration as a barrier. Both patients and FCGs reported a high satisfaction with the Reiki intervention. Follow-up phone calls by a Reiki educator were described as supportive by the FCGs. Conclusions: At-home Reiki was reported as feasible with high compliance and satisfaction to the study protocol. Findings will inform protocol refinement to address the limitations of Reiki practice barriers. This study provides initial support for the administration of an “at home” Reiki intervention in a larger sample to further validate fidelity criteria and treatment effects.
Revised World Health Organization (WHO)’s causality assessment of adverse events following immunization—a critique
Authors: Puliyel Jacob , Naik Pathik 
Published: May 2018

The World Health Organisation (WHO) has recently revised how adverse events after immunization (AEFI) are classified. Only reactions that have previously been acknowledged in epidemiological studies to be caused by the vaccine are classified as a vaccine-product–related-reaction. Deaths observed during post-marketing surveillance are not considered as ‘consistent with causal association with vaccine’, if there was no statistically significant increase in deaths recorded during the small Phase 3 trials that preceded it. Of course, vaccines noted to have caused a significant increase in deaths in the control-trials stage would probably not be licensed. After licensure, deaths and all new serious adverse reactions are labelled as ‘coincidental deaths/events’ or ‘unclassifiable’, and the association with vaccine is not acknowledged. The resulting paradox is evident. The definition of causal association has also been changed. It is now used only if there is ‘no other factor intervening in the processes’. Therefore, if a child with an underlying congenital heart disease (other factor), develops fever and cardiac decompensation after vaccination, the cardiac failure would not be considered causally related to the vaccine. The Global Advisory Committee on Vaccine Safety has documented many deaths in children with pre-existing heart disease after they were administered the pentavalent vaccine. The WHO now advises precautions when vaccinating such children. This has reduced the risk of death. Using the new definition of causal association, this relationship would not be acknowledged and lives would be put at risk. In view of the above, it is necessary that the AEFI manual be revaluated and revised urgently. AEFI reporting is said to be for vaccine safety. Child safety (safety of children) rather than vaccine safety (safety for vaccines) needs to be the emphasis.
Depression, quality of life and cortisol: a cross-sectional study of caregivers of patients with Alzheimer’s disease
Authors: Bernardi Emanuela , de Oliveira Francisco Gabriel Katiuscia , Bernardi Luana , Renée Hilgemberg Gláucia , de Gregório Elizama , Cláudio Francisco Nunes da Silva Weber , Eurich Mazur Caryna , Rabel Corso Etiene , Maria Silva Valério Juliana , Diedrich Camila , Sartori Bonini Juliana 
Published: May 2018

Background: Stress can impact human health in multiple ways. Among the related mechanisms are the hormonal systems of the hypothalamic–pituitary–adrenal axis, which produces cortisol. Current research aims to evaluate the relationship between the daily variation of salivary cortisol dosages and the level of stress in caregivers of patients with Alzheimer's disease (AD). Methods: A sociodemographic questionnaire was applied to 25 caregivers, as well as the 36 Item Short-Form Health Survey and Beck’s Depression Inventory. In the 25 patients of the caregivers, the Instrumental Activities of Daily Living of the patient and Clinical Dementia Rating were assessed. Saliva samples were collected to assess the cortisol level of the caregivers three times over one day for each caregiver, (morning, afternoon and evening) to investigate the correlation of the aforementioned questionnaires with the age and degree of kinship among caregivers of elderly patients to investigate the correlation with the results of the previously described tests, and the age and degree of relatedness of caregivers and elderly patients. Results: There was a significant positive correlation between daily cortisol levels and increasing caregiver age. However, the daily dosage of salivary cortisol was not significantly associated with the stress level of the caregivers of patients with AD, suggesting that this is not a good neuroendocrine marker of response to mood disorders. This fact can be related to intrinsic and extrinsic factors to the caregiver. Conclusions: Compared with previous studies that correlate cortisol and stress in humans, our findings suggest that the stress mechanism may be more complex and depend on more factors than the levels of this hormone. Thus, further work is required to delineate possible cortisol modulators, as well as the type of stress that target this population and their ability to adapt and face adversity in their work.
Predicting lithium treatment response in bipolar patients using gender-specific gene expression biomarkers and machine learning
Authors: Eugene Andy R. , Masiak Jolanta , Eugene Beata 
Published: May 2018

Background: We sought to test the hypothesis that transcriptiome-level genes signatures are differentially expressed between male and female bipolar patients, prior to lithium treatment, in a patient cohort who later were clinically classified as lithium treatment responders. Methods: Gene expression study data was obtained from the Lithium Treatment-Moderate dose Use Study data accessed from the National Center for Biotechnology Information’s Gene Expression Omnibus via accession number GSE4548. Differential gene expression analysis was conducted using the Linear Models for Microarray and RNA-Seq (limma) package and the Random Forests machine learning algorithm in R. Results: In pre-treatment lithium responders, the following genes were found having a greater than 0.5 fold-change, and differentially expressed indicating a male bias: RBPMS2, SIDT2, CDH23, LILRA5, and KIR2DS5; while the female-biased genes were: HLA-H, RPS23, FHL3, RPL10A, NBPF14, PSTPIP2, FAM117B, CHST7, and ABRACL. Conclusions: Using machine learning, we developed a pre-treatment gender- and gene-expression-based predictive model selective for lithium responders with an ROC AUC of 0.92 for men and an ROC AUC of 1 for women.
Life experience and the asymmetry of the human auditory system: clinical and auditory science laboratory implications
Authors: Hewitt Dale 
Published: May 2018

It is now almost 60 years since Doreen Kimura first described the asymmetries of the human auditory system (HAS). It is 30 years since Kenneth Hugdahl, and almost 15 years since David Poeppel, did the same. Our knowledge of these asymmetries is now considerable and detailed. Here we review some of the literature concerning what is known about the asymmetry of the HAS, and use it to construct a simple model of how the central and peripheral components work together. The model details some of the asymmetry, the life-experience-dependant maturation of this asymmetry throughout the first two decades, possible reasons for the population variance in speech-in-noise perception, the central role of the corpus callosum, the involvement of the efferent auditory pathways, and the corticofugal control of the peripheral auditory system. Although our knowledge of HAS asymmetry remains incomplete, this should not prevent the introduction of required changes to the current practices of audiologists and auditory science researchers, practices which fail to recognize the existence of any asymmetry in the HAS. The model described here suggests a clear need for: “asymmetry sensitive” hearing test tools that provide normative data for the lifespan, closer childhood and aging-adult hearing monitoring, and the development of a range of auditory training modules. Notably, the model suggests that without such tools our HAS asymmetry knowledge will remain incomplete. The status quo is a preoccupation with understanding hearing through knowledge of the peripheral hearing system, no answers for those with a “normal audiogram” but with an obvious difficulty hearing speech-in-noise, limited success cochlear implant rehabilitation, and missed opportunities to successfully intervene with childhood hearing/speech/language development problems.
Evaluating the impact of integrated development: are we asking the right questions? A systematic review
Authors: Ahner-McHaffie Tessa W , Guest Greg , Petruney Tricia , Eterno Alexandra , Dooley Brian 
Published: May 2018

Background: Emerging global transformations - including a new Sustainable Development Agenda - are revealing increasingly interrelated goals and challenges, poised to be addressed by similarly integrated, multi-faceted solutions. Research to date has focused on determining the effectiveness of these approaches, yet a key question remains: are synergistic effects produced by integrating two or more sectors? We systematically reviewed impact evaluations on integrated development interventions to assess whether synergistic, amplified impacts are being measured and evaluated. Methods: The International Initiative for Impact Evaluation’s (3ie) Impact Evaluation Repository comprised our sampling frame (n = 4,339). Following PRISMA guidelines, we employed a three-stage screening and review process. Results: We identified 601 journal articles that evaluated integrated interventions. Seventy percent used a randomized design to assess impact with regard to whether the intervention achieved its desired outcomes. Only 26 of these evaluations, however, used a full factorial design to statistically detect any synergistic effects produced by integrating sectors. Of those, seven showed synergistic effects. Conclusions: To date, evaluations of integrated development approaches have demonstrated positive impacts in numerous contexts, but gaps remain with regard to documenting whether integrated programming produces synergistic, amplified outcomes. Research on these program models needs to extend beyond impact only, and more explicitly examine and measure the synergies and efficiencies associated with linking two or more sectors. Doing so will be critical for identifying effective integrated development strategies that will help achieve the multi-sector SDG agenda.
Typification of the nameStatice calcarae(Plumbaginaceae), basionym of the threatened endemicLimonium calcarae
Authors: Troia Angelo , Falci Amedeo Alberto , Pasta Salvatore 
Published: May 2018

AbstractLimonium calcarae(basionymStatice calcarae), a rare diploid species endemic to Sicily, is one of the few members of the genus that occurs in the inland areas of the island. According to IUCN criteria, it has been assessed as critically endangered but recent data on its distribution, demography and threats affecting its populations are lacking. A lectotype is designated, preserved at PAL, and isolectotypes have been traced and verified in other European herbaria.
Use of Short Peripheral Intravenous Catheters: Characteristics, Management, and Outcomes Worldwide
Authors: Alexandrou Evan , Ray‐Barruel Gillian , Carr Peter J. , Frost Steven A. , Inwood Sheila , Higgins Niall , Lin Frances , Alberto Laura , Mermel Leonard , Rickard Claire M. ,   the OMG Study Group
Published: May 2018

BACKGROUNDPeripheral intravenous catheter (PIVC) use in health care is common worldwide. Failure of PIVCs is also common, resulting in premature removal and replacement.OBJECTIVETo investigate the characteristics, management practices, and outcomes of PIVCs internationally.DESIGNCross‐sectional study.SETTING/PATIENTSHospitalized patients from rural, regional, and metropolitan areas internationally.MEASUREMENTSHospital, device, and inserter characteristics were collected along with assessment of the catheter insertion site. PIVC use in different geographic regions was compared.RESULTSWe reviewed 40,620 PIVCs in 51 countries. PIVCs were used primarily for intravenous medication (n = 28,571, 70%) and predominantly inserted in general wards (n = 22,167, 55%). Two‐thirds of all devices were placed in non‐recommended sites such as the hand, wrist, or antecubital veins. Nurses inserted most PIVCs (n = 28,575, 71%); although there was wide regional variation (26% to 97%). The prevalence of idle PIVCs was 14% (n = 5,796). Overall, 10% (n = 4,204) of PIVCs were painful to the patient or otherwise symptomatic of phlebitis; a further 10% (n = 3,879) had signs of PIVC malfunction; and 21% of PIVC dressings were suboptimal (n = 8,507). Over one‐third of PIVCs (n = 14,787, 36%) had no documented daily site assessment and half (n = 19,768, 49%) had no documented date and time of insertion.CONCLUSIONSIn this study, we found that many PIVCs were placed in areas of flexion, were symptomatic or idle, had suboptimal dressings, or lacked adequate documentation. This suggests inconsistency between recommended management guidelines for PIVCs and current practice.