bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to pharmacist prescribing: a scoping review comparing the UK, New Zealand, Canadian and Australian experiences
Authors: Zhou Mingming , Desborough Jane , Parkinson Anne , Douglas Kirsty , McDonald David , Boom Katja 
Published: July 2019

Abstract

Objectives
Non-medical prescribers, including pharmacists, have been found to achieve comparable clinical outcomes with doctors for certain health conditions. Legislation supporting pharmacist prescribing (PP) has been implemented in the United Kingdom (UK), Canada and New Zealand (NZ); however, to date, Australian pharmacists have not been extended prescribing rights. The purpose of this review was to describe the barriers to PP found in the literature from the UK, Canada, NZ and Australia, and examine the implications of these for the development of PP in Australia.

Methods
We conducted a scoping review, which included peer-reviewed and grey literature, and consultation with stakeholders. Sources – Scopus, PubMed and CINAHL; Google Scholar, OpenGrey and organisational websites from January 2003 to March 2018 in the UK, Canada, NZ and Australia. Inclusion criteria – articles published in English, related to implementation of PP and articulated barriers to PP.

Key findings
Of 863 unique records, 120 were reviewed and 64 articles were eligible for inclusion. Three key themes emerged: (1) Socio-political context, (2) Resourcing issues and (3) Prescriber competence. The most common barriers were inadequate training regarding diagnostic knowledge and skills, inadequate support from authorities and stakeholders, and insufficient funding/reimbursement.

Conclusions
If implementation of PP is to occur, attention needs to be focused on addressing identified barriers to PP implementation, including fostering a favourable socio-political context and prescriber competence. As such, a concerted effort is required to develop clear policy pathways, including targeted training courses, raising stakeholder recognition of PP and identifying specific funding, infrastructure and resourcing needs to ensure the smooth integration of pharmacist prescribers within interprofessional clinical teams.
Evaluating recruitment methods of patients with advanced cancer: a pragmatic opportunistic comparison
Authors: Edwards Zoe , Bennett Michael I , Petty Duncan , Blenkinsopp Alison 
Published: July 2019

Abstract

Background
Recruitment of patients with advanced cancer into studies is challenging.

Objective
To evaluate recruitment methods in a study of pharmacist-led cancer pain medicine consultations and produce recommendations for future studies.

Method
Two methods of recruitment were employed: (1) community-based (general practitioner computer search, identification by general practitioner, community pharmacist or district nurse and hospital outpatient list search) and (2) hospice-based (in and outpatient list search). Patients identified in method 1 were invited by post and in method 2 were invited face-to-face. Information was designed in collaboration with patients and carers.

Results
A total of 128 patients were identified (85 from the community and 43 from the hospice), and 47 met the inclusion criteria. Twenty-three agreed to take part and 19 completed the study, 17 of whom were already under specialist palliative care. Recruitment rates were 7% for community-based methods and 40% for hospice. The recruitment methods differed in intensity of resource use. Recruitment via letter and a lack of engagement by healthcare professionals were found to be barriers. Facilitators included the researcher having personal involvement in recruitment.

Conclusion
The overall recruitment rate was in line with other studies for this patient cohort. Attempts to identify and engage patients through community-based postal contact were less effective than where personal contact with patients was both possible and occurred. Methods were less successful at recruiting patients who were not already engaged with hospice services.
Inequality of opportunity and (unequal) opportunities in the youth labour market: How is the Arab world different?
Authors: DIMOVA Ralitza , STEPHAN Karim 
Published: July 2019

AbstractThe Middle East and North Africa (MENA) labour market is emblematic of widespread youth unemployment and high discouragement rates, experiencing disproportionately high levels of unemployment among educated young people. Using ILO School‐to‐Work Transition Surveys for Egypt, Jordan and Tunisia, the authors explore whether this is related to inequality of opportunity or to deeper structural characteristics that create a mismatch between skill demand and supply on the labour market. The low availability of high‐skilled jobs and the low value placed on skills gained through the system of vocational training are found to have high explanatory power.
Risk of malignancy in patients with psoriasis: a 15‐year nationwide population‐based prospective cohort study in Korea
Authors: Lee J.W. , Jung K.J. , Kim T.G. , Lee M. , Oh J. , Jee S.H. , Lee M.G. 
Published: July 2019

AbstractBackgroundThe association between psoriasis and risk of malignancy has not been thoroughly evaluated in a large longitudinal cohort of Asian population.ObjectiveTo determine the long‐term risk of malignancy in Korean adult patients with psoriasis.MethodsWe conducted a nationwide population‐based prospective cohort study with a 15‐year observational period. During the baseline period (1997–2000), total 1 773 786 Korean subjects who received health insurance from the National Health Insurance System were enrolled and 5788 subjects were defined as a psoriasis group. The number of new‐onset malignancy was collected during the observational period (2001–2015).ResultsPatients with psoriasis had a higher adjusted hazard ratio (aHR) for development of overall malignancy [aHR 1.08, 95% confidence interval (CI) 1.00–1.18] and gastric cancer (aHR 1.31, 95% CI 1.08–1.58) compared to controls. The risks of non‐Hodgkin lymphoma and non‐melanoma skin cancer were significantly increased only in patients with psoriasis who received systemic treatments (aHR 2.86, 95% CI 1.07–7.61 and aHR 3.93, 95% CI 1.47–10.47, respectively).ConclusionPsoriasis is associated with long‐term risk for overall malignancy in Koreans, which was primarily driven by the increased risk of gastric cancer.
Cost analysis of using Magee scores as a surrogate of Oncotype DX for adjuvant treatment decisions in women with early breast cancer
Authors: de Lima Mariana A.G. , Clemons Mark , Van Katwyk Sasha , Stober Carol , Robertson Susan J. , Vandermeer Lisa , Fergusson Dean , Thavorn Kednapa 
Published: July 2019

AbstractBreast cancer is the most common cancer in women worldwide. Most current guidelines recommend using multigene profiling assays to aid the decision on the addition of chemotherapy to adjuvant hormone therapy for women who present with early‐stage, hormone receptor‐positive, HER2‐negative disease. One of these assays is the Oncotype DX, which predicts the disease recurrence risk and adjuvant chemotherapy benefits. Given its high cost, there is an economic incentive to evaluate its surrogates, such as the Magee equations. We assessed health system costs associated with the use of the Magee scores. A probabilistic decision tree was used to calculate the difference in mean health system costs based on data obtained from a randomized trial and the published literature. Costs were calculated from a perspective of Canada's publicly funded health care system. A series of sensitivity analysis was conducted to assess the robustness of the study findings. The Magee equations were associated with a total cost savings of C$100 per patient (95% CI, −C$3068 to C$5022) compared with standard of care. The difference in costs was highly sensitive to the extent that the Magee scores could reduce the frequency of adjuvant chemotherapy and Oncotype DX requests.
Difficulty of the decision‐making process in emergency departments for end‐of‐life patients
Authors: Douplat Marion , Berthiller Julien , Schott Anne‐Marie , Potinet Véronique , Le Coz Pierre , Tazarourte Karim , Jacquin Laurent 
Published: July 2019

AbstractBackgroundIn emergency departments, for some patients, death is preceded by a decision of withholding or withdrawing life‐sustaining treatments. This concerns mainly patients over 80, with many comorbidities. The decision‐making process of these decisions in emergency departments has not been extensively studied, especially for noncommunicating patients.AimThe purpose of this study is to describe the decision‐making process of withholding and withdrawing life‐sustaining treatments in emergency departments for noncommunicating patients and the outcome of said patients.DesignWe conducted a prospective multicenter study in three emergency departments of university hospitals from September 2015 to January 2017.ResultsWe included 109 patients in the study. Fifty‐eight (53.2%) patients were coming from nursing homes and 52 (47.7%) patients had dementia. Decisions of withholding life‐sustaining treatment concerned 93 patients (85.3%) and were more frequent when a surrogate decision maker was present 61 (65.6%) versus seven (43.8%) patients. The most relevant factors that lead to these decisions were previous functional limitation (71.6%) and age (69.7%). Decision was taken by two physicians for 80 patients (73.4%). The nursing staff and general practitioner were, respectively, involved in 31 (28.4%) and two (1.8%) patients. A majority of the patients had no advance directives (89.9%), and the relatives were implicated in the decision‐making process for 96 patients (88.1%). Death in emergency departments occurred for 47 patients (43.1%), and after 21 days, 84 patients (77.1 %) died.ConclusionThere is little anticipation in end‐of‐life decisions. Discussion with patients concerning their end‐of‐life wishes and the writing of advance directives, especially for patients with chronic diseases, must be encouraged early.
Serious Illness and End‐of‐Life Treatments for Nurses Compared with the General Population
Authors: Bynum Julie , Passow Honor , Austin Andrea , Carmichael Donald , Grodstein Francine 
Published: July 2019

OBJECTIVESAs key team members caring for people with advanced illness, nurses teach patients and families about managing their illnesses and help them to understand their options. Our objective was to determine if nurses' personal healthcare experience with serious illness and end‐of‐life (EOL) care differs from the general population as was shown for physicians.DESIGNObservational propensity‐matched cohort study.SETTINGFee‐for‐service Medicare.PARTICIPANTSNurses' Health Study (NHS) and a random 20% national sample of Medicare beneficiaries aged 66 years or older with Alzheimer's disease and related dementias (ADRD) or congestive heart failure (CHF) diagnosed in the hospital.MEASUREMENTSCharacteristics of care during the first year after diagnosis and the last 6 months of life (EOL).RESULTSAmong 57 660 NHS participants, 7380 had ADRD and 5375 had CHF; 3227 ADRD patients and 2899 CHF patients subsequently died. Care patterns in the first year were similar for NHS participants and the matched national sample: hospitalization rates, emergency visits, and preventable hospitalizations were no different in either disease. Ambulatory visits were slightly higher for NHS participants than the national sample with ADRD (13.1 vs 12.5 visits; P < .01) and with CHF (13.7 vs 12.5; P < .001). Decedents in the NHS and national sample had similar acute care use (hospitalization and emergency visits) in both diseases, but those with ADRD were less likely to use life‐prolonging treatments such as mechanical ventilation (10.9% vs 13.5%; P = .001), less likely to die in a hospital with a stay in the intensive care unit (10.4% vs 12.1%; P = .03), and more likely to use hospice (58.9% vs 54.8%; P < .001). CHF at the EOL results were similar.CONCLUSIONSNurses with newly identified serious illness experience similar care as the general Medicare population. However, at EOL, nurses are more likely to choose less aggressive treatments than the patients for whom they care. J Am Geriatr Soc 67:1582–1589, 2019
Focusing on the hospital stay or everyday life with cancer: Parents’ experiences of choosing a central access device for their child with cancer
Authors: Bergviken Hanna , Nilsson Stefan 
Published: July 2019

AbstractPurposeThe aim of this study was to gain insights into the experiences of parents of children with cancer in conjunction with their decisions on the type of central access device that their child would have.Design and MethodsThe qualitative study design was chosen to maximize the likelihood of capturing the full range of the phenomenon, that is the parents’ experiences from decision‐making. Open interviews were conducted between December 2015 and January 2016 with 17 parents of children who had been diagnosed with cancer in 2014–2015. The interviews were analyzed using inductive qualitative content analysis.ResultsThe analysis of the decision‐making process data yielded four subcategories: (a) Feeling overwhelmed owing to limited information and alienation within the healthcare system, (b) the burden of making a quick medical decision without having the big picture, (c) receiving conflicting views and approaches from the healthcare professionals, and (d) including the child's perspective. Those four subcategories were condensed into the following main category: focusing on the hospital stay and treatment or on everyday life with cancer.Practice ImplicationsHealthcare professionals need to be aware that they may influence the parents’ decision, and they should consider that parents are often naïve in their situation. To optimize the decision, its timing should be carefully chosen. Parents often take the child's perspective and interpret the child's reactions as reflecting a wish to avoid needle jabs or to live an unhindered everyday life. Healthcare professionals informing families about central access devices need to address both hospital stays and everyday life with cancer, and they need to adopt a child‐centered approach.
Non‐equivalence in old‐ and new‐flagellum daughter cells of a proliferative division in Trypanosoma brucei
Authors: Abeywickrema Movin , Vachova Hana , Farr Helen , Mohr Timm , Wheeler Richard J. , Lai De‐Hua , Vaughan Sue , Gull Keith , Sunter Jack D. , Varga Vladimir 
Published: July 2019

SummaryDifferentiation of Trypanosoma brucei, a flagellated protozoan parasite, between life cycle stages typically occurs through an asymmetric cell division process, producing two morphologically distinct daughter cells. Conversely, proliferative cell divisions produce two daughter cells, which look similar but are not identical. To examine in detail differences between the daughter cells of a proliferative division of procyclic T. brucei we used the recently identified constituents of the flagella connector. These segregate asymmetrically during cytokinesis allowing the new‐flagellum and the old‐flagellum daughters to be distinguished. We discovered that there are distinct morphological differences between the two daughters, with the new‐flagellum daughter in particular re‐modelling rapidly and extensively in early G1. This re‐modelling process involves an increase in cell body, flagellum and flagellum attachment zone length and is accompanied by architectural changes to the anterior cell end. The old‐flagellum daughter undergoes a different G1 re‐modelling, however, despite this there was no difference in G1 duration of their respective cell cycles. This work demonstrates that the two daughters of a proliferative division of T. brucei are non‐equivalent and enables more refined morphological analysis of mutant phenotypes. We suggest all proliferative divisions in T. brucei and related organisms will involve non‐equivalence.
Adolescents with an entity theory of personality are more vigilant to social status and use relational aggression to maintain social status
Authors: Lee Hae Yeon , Yeager David S. 
Published: July 2019

AbstractThe present research proposed that one social‐cognitive root of adolescents' willingness to use relational aggression to maintain social status in high school is an entity theory of personality, which is the belief that people's social status‐relevant traits are fixed and cannot change. Aggregated data from three studies (N = 882) showed that first‐year high school adolescents in the United States who endorsed more of an entity theory were more likely to show cognitive and motivational vigilance to social status, in terms of judgments on a novel social categorization task and reports of goals related to demonstrating social status to peers. Those with an entity theory then showed a greater willingness to use relational aggression, as measured by retrospective self‐reports, responses to a hypothetical scenario, and a choice task. Discussion centers on theoretical and translational implications of the model and of the novel measures.
Extension at the coast of the Makran subduction zone (Iran)
Authors: Normand Raphaël , Simpson Guy , Bahroudi Abbas 
Published: July 2019

AbstractIn the Makran subduction zone, earthquake focal mechanisms and geodetic data indicate that the deforming prism currently experiences N–S compression. However, palaeostress inversions performed on normal faults observed along the coast reveal local stress components consistent with N‐S extension. Previously proposed mechanisms such as gravitational collapse are not favoured by N–S compression and surface uplift. We propose that the observed kinematics result from transient stress reversals following large earthquakes. During the interseismic period (now), the region experiences N–S compression. However, following a large reverse rupture on the subduction interface, stresses in the inner wedge relax, enabling a brief period of extensional faulting before a compressive stress state is re‐established. This mechanism, also observed in other subduction zones, requires low overall stresses in the upper plate and that the margin ruptures in large megathrust earthquakes that result in nearly complete stress drops.
Considering spatiotemporal processes in big data analysis: Insights from remote sensing of land cover and land use
Authors: Comber Alexis , Wulder Michael 
Published: July 2019

AbstractData are increasingly spatio‐temporal—they are collected some‐where and at some‐time. The role of proximity in spatial process is well understood, but its value is much more uncertain for many temporal processes. Using the domain of land cover/land use (LCLU), this article asserts that analyses of big data should be grounded in understandings of underlying process. Processes exhibit behaviors over both space and time. Observations and measurements may or may not coincide with the process of interest. Identifying the presence or absence of a given process, for instance disentangling vegetation phenology from stress, requires data analysis to be informed by knowledge of the process characteristics and, critically, how these manifest themselves over the spatio‐temporal unit of analysis. Drawing from LCLU, we emphasize the need to identify process and consider process phase to quantify important signals associated with that process. The aim should be to link the seriality of the spatio‐temporal data to the phase of the process being considered. We elucidate on these points and opportunities for insights and leadership from the geographic community.
Braj B. Kachru and Asian Englishes
Authors: Bolton Kingsley 
Published: July 2019

AbstractThis article discusses the range and scope of Braj Kachru's interests in Indian English and Asian Englishes, which were crucial to the development of world Englishes as a whole. The article begins with a discussion of the WE paradigm shift and then proceeds to highlight Kachru's contribution to Asian Englishes before moving on to provide an account of the contemporary dynamics of Asian Englishes from a sociolinguistic perspective. In this context, it is important to note that the field of ‘Asian Englishes’ owes much of its origins and development to the pioneer intellectual work of Braj Kachru from the 1960s onwards.
Is quality affordable for community health systems? Costs of integrating quality improvement into close-to-community health programmes in five low-income and middle-income countries
Authors: Kumar Meghan Bruce , Madan Jason J , Achieng Maryline Mireku , Limato Ralalicia , Ndima Sozinho , Kea Aschenaki Z , Chikaphupha Kingsley Rex , Barasa Edwine , Taegtmeyer Miriam 
Published: July 2019

IntroductionCountries aspiring to universal health coverage view close-to-community (CTC) providers as a low-cost means of increasing coverage. However, due to lack of coordination and unreliable funding, the quality of large-scale CTC healthcare provision is highly variable and routine data about service quality are not trustworthy. Quality improvement (QI) approaches are a means of addressing these issues, yet neither the costs nor the budget impact of integrating QI approaches into CTC programme costs have been assessed.MethodsThis paper examines the costs and budget impact of integrating QI into existing CTC health programmes in five countries (Ethiopia, Indonesia, Kenya, Malawi, Mozambique) between 2015 and 2017. The intervention involved: (1) QI team formation; (2) Phased training interspersed with supportive supervision; which resulted in (3) QI teams independently collecting and analysing data to conduct QI interventions. Project costs were collected using an ingredients approach from a health systems perspective. Based on project costs, costs of local adoption of the intervention were modelled under three implementation scenarios.ResultsAnnualised economic unit costs ranged from $62 in Mozambique to $254 in Ethiopia per CTC provider supervised, driven by the context, type of community health model and the intensity of the intervention. The budget impact of Ministry-led QI for community health is estimated at 0.53% or less of the general government expenditure on health in all countries (and below 0.03% in three of the five countries).ConclusionCTC provision is a key component of healthcare delivery in many settings, so QI has huge potential impact. The impact is difficult to establish conclusively, but as a first step we have provided evidence to assess affordability of QI for community health. Further research is needed to assess whether QI can achieve the level of benefits that would justify the required investment.