bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of a Cardiac Transitions of Care Pilot Program: A Prospective Study of Inpatient and Outpatient Clinical Pharmacy Services for Patients With Heart Failure Exacerbation or Acute Myocardial Infarction
Authors: Murphy Julie A. , Schroeder Michelle N. , Rarus Rachel E. , Yakubu Idris , McKee Sean O. P. , Martin Steven J. 
Published: November 2017

Background: Pharmacists may assist with reducing 30-day readmission rates for patients with heart failure (HF) exacerbation or acute myocardial infarction (AMI) by promoting medication adherence. Objective: To determine the change in 30-day readmission rates for patients with HF exacerbation or AMI after implementation of a “high-touch” standard of care. Methods: Patients admitted with HF exacerbation, non-ST-segment elevation AMI, or ST-segment elevation AMI from August 1, 2013, to June 30, 2015, were included in this prospective study. Patients were educated while in the inpatient setting and followed up in the outpatient setting through telephone contact and scheduling a medication therapy management (MTM) appointment with a pharmacist. Data were collected by pharmacy personnel involved in the implementation of the intervention. Results: Within the HF and AMI arms, 100 and 93 patients, respectively, were included in the study. The 30-day readmission rates were 24% and 17.2% for HF and AMI, respectively, which were not statistically significant when compared to historical institutional readmission rates prior to study initiation (18.2% for HF, P = .238; 11.4% for AMI, P = .252). Conclusion: A “high-touch” pharmacist-driven transitions of care program may affect 30-day readmission rates for patients with HF exacerbation or AMI; potential processes for initiating transitions of care programs are provided.
Continuous Quality Improvement Processes in Child Protection: A Systematic Literature Review
Authors: Zuchowski Ines , Miles Debra , Woods Cindy , Tsey Komla 
Published: November 2017

Purpose: Protecting children from mistreatment is a global concern, and further research and evaluation in child protection services is required. Continuous Quality Improvement (CQI) has demonstrated potential, but to date, there is no systematic review of studies that evaluate the application of CQI in child protection. Method: This systematic literature review examined the application of CQI in child protection services. The review identified published, English-language evaluations of CQI in child protection from 2000 to 2016 and critiqued the characteristics, methodological quality, and reported benefits of the included studies. Results: A search of social science electronic databases identified eight peer-reviewed studies, including six quantitative studies, one mixed-methods study, and one qualitative study. Discussion: The review highlighted that many studies on this topic lack specific validating data, but there is evidence that CQI models have some potential to improve processes for working with children and families by promoting implementation fidelity.
Social inequality in phase II cardiac rehabilitation attendance: The impact of potential mediators
Authors: Pedersen Maria , Egerod Ingrid , Overgaard Dorthe , Baastrup Marie , Andersen Ingelise 
Published: November 2017

Background: Cardiac rehabilitation participation is an essential component of the contemporary management of coronary heart disease. However, patients with low socioeconomic position are less likely to attend the rehabilitation programme. Aim: We aimed to explore the effect of potential mediators between socioeconomic position defined by educational attainment and cardiac rehabilitation attendance. Methods: Prospective observational study of patients with acute coronary syndrome ( N=302). Logistic regression and mediation analysis was conducted to explore mechanisms of non-attendance. Results: Thirty per cent attended full cardiac rehabilitation. Patients with low educational attainment, comorbidities, long commute to cardiac rehabilitation centre, and lone dwelling were less likely to attend full cardiac rehabilitation, whereas patients with high anxiety and depression score were more likely to attend full cardiac rehabilitation. Patients with low educational attainment had lower self-efficacy and longer commute compared with patients with high educational attainment. The potential mediators included in the study, however, did not have a significant mediation effect. Conclusion: Our study demonstrated a variety of mechanisms contributing to cardiac rehabilitation non-attendance. Further, the study demonstrated that non-attendance was especially related to the cardiac rehabilitation elements involving lifestyle modifications. However, the mechanisms explaining social inequality in full cardiac rehabilitation are still not fully understood.
Male IPV Perpetrator’s Perspectives on Intervention and Change: A Systematic Synthesis of Qualitative Studies
Authors: McGinn Tony , McColgan Mary , Taylor Brian 
Published: November 2017

Objective: To add to our understanding of change processes by analyzing perpetrators’ perspectives on intervention. Method: Fourteen databases were searched and 27 articles reporting relevant qualitative findings were identified. Analytic coding was applied across the findings and discussion sections of all 27 study reports to form an interpretive account of the data set. Studies were also grouped according to their perceived theoretical standpoints, and a summary of themes in each grouping is presented. Findings: Study participants were largely positive about their experiences in intervention; new learning such as conflict interruption techniques and new communication skills were commonly cited benefits. Perpetrators attend perpetrator intervention programs with a range of motivations, ranging from a determination to change who they are, to a determination to avoid a custodial sentence. The most common barriers to change, found in this analysis, were cognitive distortions, emotional dysregulation, gendered social constructions, and self-esteem issues. Conclusion: Further qualitative investigation, of rigor, with the intention-to-treat population of intimate partner violence perpetrators involved in perpetrator programs is needed. At this point, we would venture that qualitative research, with perpetrators, underlines the precept that formidable barriers to change exist in this population. The centrality of group work to perpetrator interventions should be reconsidered in light of the complexity of the change task and in light of the heterogeneity of this population.
Evaluating the potential for pharmacists to prescribe oral anticoagulants for atrial fibrillation
Authors: Sandhu Roopinder K. , Guirguis Lisa M. , Bungard Tammy J. , Youngson Erik , Dolovich Lisa , Brehaut Jamie C. , Healey Jeff S. , McAlister Finlay A. 
Published: November 2017

Background: Oral anticoagulant therapy (OAC) to prevent atrial fibrillation (AF)–related strokes remains poorly used. Alternate strategies, such as community pharmacist prescribing of OAC, should be explored. Methods: Approximately 400 pharmacists, half with additional prescribing authority (APA), randomly selected from the Alberta College of Pharmacists, were invited to participate in an online survey over a 6-week period. The survey consisted of demographics, case scenarios assessing appropriateness of OAC (based on the 2014 Canadian Cardiovascular Society AF guidelines) and perceived barriers to prescribing. Regression analysis was performed to determine predictors of knowledge. Results: A total of 35% (139/397) of pharmacists responded to the survey, and 57% of these had APA. Depending on the case scenario, 55% to 92% of pharmacists correctly identified patients eligible for stroke prevention therapy, but only about a half selected the appropriate antithrombotic agent; there was no difference in the knowledge according to APA status. In multivariable analysis, predictors significantly associated with guideline-concordant prescribing were having the pharmacist interact as part of an interprofessional team ( p = 0.04) and direct OAC (DOAC) self-efficacy (confidence in ability to extend, adapt, initiate or alter prescriptions; p = 0.02). Barriers to prescribing OAC for APA pharmacists included a lack of AF and DOAC knowledge and preference for consulting the physician first, but these same pharmacists also identified difficulty in contacting the physician as a major barrier. Interpretation and Conclusion: Community pharmacists can identify patients who would benefit from stroke prevention therapy in AF. However, physician collaboration and further training on AF and guidelines for prescribing OAC are needed.
Decreased platelet number in multiple sclerosis during alemtuzumab infusion: a common, transient and clinically silent phenomenon
Authors: Puthenparampil Marco , Rinaldi Francesca , Federle Lisa , Cazzola Chiara , Perini Paola , Gallo Paolo 
Published: November 2017

Background The cause and clinical significance of the transient decrease in platelet (PLT) count observed in relapsing remitting multiple sclerosis (RRMS) during alemtuzumab administration remain undefined. The aim of this study was to analyse the kinetics and clinical relevance of early onset thrombocytopaenia in alemtuzumab-treated RRMS. Methods A total of 26 patients with RRMS were included in a longitudinal study. Blood samples were collected immediately before the first alemtuzumab infusion (D0), and after 3 days (D3), 28 days (D28) and 49 days (D49). PLT, red blood cell (RC), leucocyte and lymphocyte counts, haemoglobin (Hb) concentration and haematocrit (Htc) were measured. Patients with MS were clinically evaluated every day of drug infusion and then at D28 and D49 to verify the presence of signs or symptoms suggestive of thrombocytopaenia. Results PLT number significantly decreased at D3 ( p < 0.005) and was associated with a decrease in RC count ( r: 0.53, p < 0.01), Hb ( r: 0.42, p = 0.05) and Htc ( r: 0.53, p < 0.01). A progressive reversion of PLT number to normal values was observed at D28 and D49. A mild thrombocytopaenia was observed in 12 patients (46.2%), 8 of which (66.6%) had PLT nadir values at D3, and 4 (33.3%) at D28. No sign or symptom suggestive of thrombocytopaenia was observed. A strong correlation between pretreatment and nadir PTL counts ( r: 0.59, p < 0.005) was observed; indeed, mild thrombocytopaenia was observed more frequently in these patients with a baseline PTL count lower than 230 × 109/L (83.3% versus 42.9%, p < 0.05). Conclusions The early PLT decrease in alemtuzumab-treated patients is transient, mild, not associated with clinically relevant events and is probably related to the cytokine-released syndrome. Notwithstanding this, our findings suggest the opportunity for PLT monitoring during infusion and in the following 2 months, since a decrease in PLT count may occur.
Do Structural Changes of the Foot Influence Plantar Pressure Patterns During Various Stages of Pregnancy and Postpartum?
Authors: Ramachandra Preetha , Kumar Pratap , Kamath Asha , Maiya Arun G. 
Published: November 2017

Background. The foot of a pregnant woman undergoes morphological changes with the advancement of pregnancy. It is important to understand the structural changes of the foot during pregnancy and postpartum because any such change may alter the plantar pressure pattern and the entire foot biomechanics. Method. Primigravidae with a gestational age of 12 weeks or less, aged between 18 and 35 years were included in the study. They were prospectively studied across 5 time periods during pregnancy and postpartum. The measures recorded were length, width, navicular height, truncated foot length and normalized navicular height, truncated ratio of the foot, and the static plantar pressure pattern. Repeated-measures ANOVA was done to analyze the changes across various time periods. Results. All the foot parameters, except foot length and truncated foot length, showed significant differences across various time periods of pregnancy and postpartum (P < .001). It was found that the static plantar pressures also varied significantly (P ≤ .001).The maximum pressure was recorded at the hindfoot of the dominant leg. Conclusion. The feet of pregnant women tend to get pronated as pregnancy advances but do not reach baseline values even at 6 weeks postpartum. Pregnant women tend to bear more weight on the dominant foot with an increased static hindfoot pressure as pregnancy progresses. Levels of Evidence: Prognostic study, Level I: Prospective
Recovery benefits of using a heat and moisture exchange mask during sprint exercise in cold temperatures
Authors: Seifert John G , Frost Jeremy , St Cyr John A 
Published: November 2017

Objectives: Breathing cold air can lead to bronchoconstriction and peripheral vasoconstriction, both of which could impact muscular performance by affecting metabolic demands during exercise. Successful solutions dealing with these physiological changes during exercise in the cold has been lacking; therefore, we investigated the influence of a heat and moisture exchange mask during exercise in the cold. Methods: There were three trial arms within this study: wearing the heat and moisture exchange mask during the rest periods in the cold, no-mask application during the rest periods in the cold, and a trial at room temperature (22°C). Eight subjects cycled in four 35 kJ sprint sessions with each session separated by 20 min rest period. Workload was 4% of body mass. Results: Mean sprint times were faster with heat and moisture exchange mask and room temperature trial than cold, no-mask trial (133.8 ± 8.6, 134.9 ± 8.8, and 138.0 ± 8.4 s (p = 0.001)). Systolic blood pressure and mean arterial pressure were greater during the cold trial with no mask (15% and 13%, respectively), and heart rate was 10 bpm less during the third rest or recovery period during cold, no mask compared to the heat and moisture exchange mask and room temperature trials. Subjects demonstrated significant decreases in vital capacity and peak expiratory flow rate during the cold with no mask applied during the rest periods. Conclusions: These negative responses to cold exposure were alleviated by the use of a heat and moisture exchange mask worn during the rest intervals by minimizing cold-induced temperature stress on the respiratory system with subsequent maintenance of cardiovascular function.
Patient Engagement in Kidney Research: Opportunities and Challenges Ahead
Authors: Molnar Amber O. , Barua Moumita , Konvalinka Ana , Schick-Makaroff Kara 
Published: November 2017

Purpose of Review: Patient engagement in research is increasingly recognized as an important component of the research process and may facilitate translation of research findings. To heighten awareness on this important topic, this review presents opportunities and challenges of patient engagement in research, drawing on specific examples from 4 areas of Canadian kidney research conducted by New Investigators in the Kidney Research Scientist Core Education and National Training (KRESCENT) Program. Sources of Information: Research expertise, published reports, peer-reviewed articles, and research funding body websites. Methods: In this review, the definition, purpose, and potential benefits of patient engagement in research are discussed. Approaches toward patient engagement that may help with translation and uptake of research findings into clinical practice are highlighted. Opportunities and challenges of patient engagement are presented in both basic science and clinical research with the following examples of kidney research: (1) precision care in focal and segmental glomerulosclerosis, (2) systems biology approaches to improve management of chronic kidney disease and enhance kidney graft survival, (3) reducing the incidence of suboptimal dialysis initiation, and (4) use of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in kidney practice. Key Findings: Clinical research affords more obvious opportunities for patient engagement. The most obvious step at which to engage patients is in the setting of research priorities. Engagement at all stages of the research cycle may prove to be more challenging, and requires a detailed plan, along with funds and infrastructure to ensure that it is not merely tokenistic. Basic science research is several steps removed from the clinical application and involves complex scientific concepts, which makes patient engagement inherently more difficult. Limitations: This is a narrative review of the literature that has been partly influenced by the perspectives and experiences of the authors and focuses on research conducted by the authors. The evidence base to support the suggested benefits of patient engagement in research is currently limited. Implications: The formal incorporation of patients’ priorities, perspectives, and experiences is now recognized as a key component of the research process. If patients and researchers are able to effectively work together, this could enhance research quality and efficiency. To effectively engage patients, proper infrastructure and dedicated funding are needed. Going forward, a rigorous evaluation of patient engagement strategies and their effectiveness will be needed.
Minor stroke due to large artery occlusion. When is intravenous thrombolysis not enough? Results from the SITS International Stroke Thrombolysis Register
Authors: Mazya Michael V , Cooray Charith , Lees Kennedy R , Toni Danilo , Ford Gary A , Bar Michal , Frol Senta , Moreira Tiago , Sekaran Lakshmanan , Švigelj Viktor , Wahlgren Nils , Ahmed Niaz 
Published: November 2017

Purpose Beyond intravenous thrombolysis, evidence is lacking on acute treatment of minor stroke caused by large artery occlusion. To identify candidates for additional endovascular therapy, we aimed to determine the frequency of non-haemorrhagic early neurological deterioration in patients with intravenous thrombolysis-treated minor stroke caused by occlusion of large proximal and distal cerebral arteries. Secondary aims were to establish risk factors for non-haemorrhagic early neurological deterioration and report three-month outcomes in patients with and without non-haemorrhagic early neurological deterioration. Method We analysed data from the SITS International Stroke Thrombolysis Register on 2553 patients with intravenous thrombolysis-treated minor stroke (NIH Stroke Scale scores 0–5) and available arterial occlusion data. Non-haemorrhagic early neurological deterioration was defined as an increase in NIH Stroke Scale score ≥4 at 24 h, without parenchymal hematoma on follow-up imaging within 22–36 h. Findings The highest frequency of non-haemorrhagic early neurological deterioration was seen in 30% of patients with terminal internal carotid artery or tandem occlusions (internal carotid artery + middle cerebral artery) (adjusted odds ratio: 10.3 (95% CI 4.3–24.9), p < 0.001) and 17% in extracranial carotid occlusions (adjusted odds ratio 4.3 (2.5–7.7), p < 0.001) versus 3.1% in those with no occlusion. Proximal middle cerebral artery-M1 occlusions had non-haemorrhagic early neurological deterioration in 9% (adjusted odds ratio 2.1 (0.97–4.4), p = 0.06). Among patients with any occlusion and non-haemorrhagic early neurological deterioration, 77% were dead or dependent at three months. Conclusions Patients with minor stroke caused by internal carotid artery occlusion, with or without tandem middle cerebral artery involvement, are at high risk of disabling deterioration, despite intravenous thrombolysis treatment. Acute vessel imaging contributes usefully even in minor stroke to identify and consider endovascular treatment, or intensive monitoring at a comprehensive stroke centre, for patients at high risk of neurological deterioration.
Flight metabolic rate of Locusta migratoria in relation to oxygen partial pressure in atmospheres of varying diffusivity and density
Authors: Snelling Edward P. , Duncker Rebecca , Jones Karl K. , Fagan-Jeffries Erinn P. , Seymour Roger S. 
Published: November 2017

ABSTRACT
Flying insects have the highest mass-specific metabolic rate of all animals. Oxygen is supplied to the flight muscles by a combination of diffusion and convection along the internal air-filled tubes of the tracheal system. This study measured maximum flight metabolic rate (FMR) during tethered flight in the migratory locust Locusta migratoria under varying oxygen partial pressure (PO2) in background gas mixtures of nitrogen (N2), sulfur hexafluoride (SF6) and helium (He), to vary O2 diffusivity and gas mixture density independently. With N2 as the sole background gas (normodiffusive–normodense), mass-independent FMR averaged 132±19 mW g−0.75 at normoxia (PO2=21 kPa), and was not limited by tracheal system conductance, because FMR did not increase in hyperoxia. However, FMR declined immediately with hypoxia, oxy-conforming nearly completely. Thus, the locust respiratory system is matched to maximum functional requirements, with little reserve capacity. With SF6 as the sole background gas (hypodiffusive–hyperdense), the shape of the relationship between FMR and PO2 was similar to that in N2, except that FMR was generally lower (e.g. 24% lower at normoxia). This appeared to be due to increased density of the gas mixture rather than decreased O2 diffusivity, because hyperoxia did not reverse it. Normoxic FMR was not significantly different in He-SF6 (hyperdiffusive–normodense) compared with the N2 background gas, and likewise there was no significant difference between FMR in SF6-He (normodiffusive–hyperdense) compared with the SF6 background gas. The results indicate that convection, not diffusion, is the main mechanism of O2 delivery to the flight muscle of the locust when demand is high.
Empreitada de obra pública rodoviária por preço global
Authors: Vieira Alberto de Lima 
Published: November 2017

1. Contrato Administrativo - cláusulas exorbitantes; 2. Aplicação supletiva dos princípios da teoria geral dos contratos; 3. Empreitada a preço fixo ou global; 4. Alterações de projetos e de quantitativos; 5. Alterações contratuais decorrentes das variações; 6. Álea normal e invariabilidade do projeto; 7. Manutenção das condições efetivas da proposta. princípio constitucional e exigência da boa fé; 8. Conclusão.
Processo legislativo - Controle jurisdicional - Liminar
Authors: Mello Celso Antônio Bandeira de 
Published: November 2017

-Legitimidade ativa de parlamentar para ação de controle de processo legislativo.- A concessão de medida liminar exige prova pré-constituída dos pressupostos de plausibilidade jurídica e de lesão grave ou irreparável.
Teto de remuneração - Ação popular - Ação de inconstitucionalidade por omissão
Authors: Pertence José Paulo Sepúlveda 
Published: November 2017

- Pedido de cumprimento imediato do art. 37, n. XI da Constituição Federal, na redação da emenda Constitucional nº 19/98.- Competência do Supremo Tribunal Federal para apreciar o pedido pela via de ação de inconstitucionalidade por omissão.- Impropriedade, para esse fim, de ação popular.
Constituição Estadual - Aposentadoria - Tempo de serviço
Authors: Nóbrega Haroldo Ferraz da 
Published: November 2017

-Inconstitucionalidade do art. 14 do ADCT da Constituição do Estado do Espírito Santo que reduz para vinte anos o tempo de serviço para aposentadoria voluntária do servidor público.- Violação do art. 40, n° III, alínea c da Constituição Federal.
Servidor público - Regime jurídico único - Direito adquirido
Authors: Pereira Miguel Frauzino 
Published: November 2017

- Tempo de serviço: integração ao regime jurídico único de servidores da União anteriormente sob o regime da legislação trabalhista: direito adquirido à contagem do tempo anterior à conversão de regime jurídico para todos os efeitos (L. 8.112/90, art. 100), incluído o deferimento de "anuênios" ou licença prêmio por assiduidade; inconstitucionalidade do art. 7º da L. 8./72/91.