bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of infant care in primary health services in Southern and Northeastern Brazil
Authors: Santos Andréia Soprani dos , Duro Suele Manjourany Silva , Cade Nágela Valadão , Facchini Luiz Augusto , Tomasi Elaine 
Published: February 2018

OBJECTIVE: To assess the quality of the health care provided to children aged under one year old performed by primary health services in the South and Northeast regions of Brazil. METHODS: This is a cross-sectional, population-based study carried out in 2010 with 7,915 children aged from one to four years, whose homes are located in the areas of health service coverage. We described the prevalence of procedures and guidelines, such as weight and height measurement, vaccination, newborn blood spot screening, evaluation of umbilical cord, instruction on breastfeeding and introduction of new food, and their respective 95% confidence intervals. The differences were analyzed using the chi-square test of heterogeneity and linear trend. We considered the main outcome of high-quality infant care if the child had received all recommended procedures and guidelines in the first year of life. For this analysis, we used the Poisson regression considering hierarchical model. RESULTS: There was low prevalence for the instruction on breastfeeding in the first week of life (58.8%, 95%CI 57.5–60.0) and on the introduction of new food in the fourth month care. The prevalence of high-quality in childcare was 42.0% (95%CI 40.5–43.5). The adjusted analysis according to hierarchical model indicated greater probability of this outcome in the Northeast region (PR = 1.17, 95%CI 1.09–1.26), in smaller municipalities (PR = 1.17, 95%CI 1.03–1.33), and in municipalities with 50,000 and 99,000 inhabitants (PR = 1.20, 95%CI 1.09–1.34). CONCLUSIONS: The Northeast region has higher-quality infant care services, which can be explained by the consolidation of the Family Health Strategy in that region.
Outcomes of Heart Failure Admissions Under Observation Versus Short Inpatient Stay
Authors: Masri Ahmad , Althouse Andrew D. , McKibben Jeffrey , Thoma Floyd , Mathier Michael , Ramani Ravi , Teuteberg Jeffrey , Marroquin Oscar , Lee Joon S. , Mulukutla Suresh R. 
Published: February 2018

Background

Patients with heart failure (HF) are admitted either under observation (OBS) or inpatient stays; however, there is little data on whether this designation reflects the clinical status of a patient, with significant logistical and financial implications. We sought to compare the outcomes of patients with
HF
admitted OBS versus inpatient stay (≤2 days; INPT).

Methods and Results

From January 1, 2008 to September 30, 2015, our multisite health system saw 21 339 unique patients totaling 52 493 hospital admissions with a primary diagnosis of
HF
. Patients were excluded if they underwent cardiac surgery (n=611), heart transplantation (n=187), or left ventricular assist device insertion (n=198), or if they died during hospitalization (n=1839). Of the remaining 50 654 discharges, 2 groups were identified:
INPT
group and
OBS
group. Outcomes were
HF
readmission, all‐cause readmission, and all‐cause mortality within 1 year of discharge. Hazard ratios were computed using the Andersen‐Gill method in the Cox proportional‐hazards model. A total of 8709 admissions (17%) occurred in the INPT group and 2648 admissions (5%) occurred in the
OBS
group.
HF
readmission rate at 1 year was 55.3% in
INPT
versus 66.5% in
OBS
(hazard ratio, 0.75; 95% confidence interval, 0.71–0.80;
P
<0.01). All‐cause readmission rate at 1 year was 70.7% in
INPT
versus 82.5% in
OBS
(hazard ratio, 0.74; 95% confidence interval, 0.70–0.78;
P
<0.01). All‐cause mortality at 1 year occurred in 25.2% of
INPT
versus 24.2% of
OBS
(hazard ratio, 1.03; 95% confidence interval, 0.95–1.12;
P
=0.46).

Conclusions

HF
admissions designated INPTs were associated with lower readmission rates and equivalent mortality to those designated OBS.
Hurricane with a History: Hawaiian Newspapers Illuminate an 1871 Storm
Authors: Businger Steven , Nogelmeier M. Puakea , Chinn Pauline W. U. , Schroeder Thomas 
Published: February 2018

Abstract
High literacy rates among Native Hawaiians in the nineteenth century and publication of more than 100 Hawaiian-language newspapers from 1834 to 1948 produced the largest archive of indigenous writing in the Western Hemisphere. These newspapers extend our knowledge of historical environmental events and natural disasters back into the early nineteenth century and deeper into precontact times. Articles reporting observations of meteorological events allowed the authors to reconstruct the track and intensity of an 1871 hurricane that brought devastation to the islands of Hawaii and Maui and to discern historical patterns of droughts and floods in Hawaii. These findings illustrate the value of Hawaiian-language newspapers as resources for science research and science education.
An Empirical Model for Estimating Soil Thermal Diffusivity from Texture, Bulk Density, and Degree of Saturation
Authors: Xie Xiaoting , Lu Yili , Ren Tusheng , Horton Robert 
Published: February 2018

Abstract
Soil thermal diffusivity κ is an essential parameter for studying surface and subsurface heat transfer and temperature changes. It is well understood that κ mainly varies with soil texture, water content θ, and bulk density ρb, but few models are available to accurately quantify the relationship. In this study, an empirical model is developed for estimating κ from soil particle size distribution, ρb, and degree of water saturation Sr. The model parameters are determined by fitting the proposed equations to heat-pulse κ data for eight soils covering wide ranges of texture, ρb, and Sr. Independent evaluations with published κ data show that the new model describes the κ(Sr) relationship accurately, with root-mean-square errors less than 0.75 × 10−7 m2 s−1. The proposed κ(Sr) model also describes the responses of κ to ρb changes accurately in both laboratory and field conditions. The new model is also used successfully for predicting near-surface soil temperature dynamics using the harmonic method. The results suggest that this model provides useful estimates of κ from Sr, ρb, and soil texture.
Police behavior (part I)
Authors: Cruse Daniel , Rubin Jesse 
Published: February 2018

Police and citizen behavior occurring during radio patrol activities was studied in Miami. Four specially trained policemen-observers rated behavior of 12 observed patrolmen interacting with 1,400 citizens during 1,000 separate contacts. Police behavior was found to be predominantly controlling in nature. Citizen behavior was predominantly cooperative and nonviolent. Stress was perceived by patrolmen in 7% of calls and altered police behavior in 1.5% of calls, a small but significant amount. Surprisingly, neither citizen behavior nor types of neighborhoods affected police behavior. Inactivity on patrol increased both police controlling behavior and police fatigue. Recommendations are made regarding police research, training and operations.
Sexual Relationships between Therapist and Patient—different Countries, Different Treatment
Authors: Coleman Phyllis G. 
Published: February 2018

This article discusses legal and ethical problems that may result from therapists having sexual relations with current or former patients. A comparative analysis of the approach of several different countries revealed a consensus that such relationships should be absolutely prohibited. Additionally, the apparent reluctance to address the issue of sexual relationships between therapists and former patients in the United States is often reflected throughout the world. Not intended to be an exhaustive or scientific survey, this article reviews primarily anecdotal information to raise awareness of the universality of possible harm to the patient who becomes sexually involved with either her current or her former therapist. The article proposes rules that would respond to potential harm suffered by patients. Because it has been proved that patients suffer as a result of such relationships with current therapists, the author concludes that such behavior should be legally and ethically proscribed regardless of the country in which treatment occurs. However, because there is no evidence of actual harm resulting from sexual relationships following proper termination, the author recommends that such relationships be presumed acceptable. This presumption would be rebutted by proof of actual harm to the former patient. Based on the fact that proper termination requires successful resolution of the transference and countertransference, the author suggests certain guidelines for making this determination and advocates the use of an independent therapist as the final decision-maker.
The Augmentation of Revision Anterior Cruciate Ligament Reconstruction With Modified Iliotibial Band Tenodesis to Correct the Pivot Shift: A Computer Navigation Study
Authors: Porter Mark D. , Shadbolt Bruce , Pomroy Samantha 
Published: February 2018

Background: Iliotibial band (ITB) tenodesis improves stability and functional outcomes when added to anterior cruciate ligament (ACL) reconstruction. Its precise indications are unknown. Persistence of the pivot shift after revision ACL reconstruction may be one indication. Hypothesis: The addition of ITB tenodesis for a persistent pivot shift after revision ACL reconstruction will improve stability and activity levels. Study Design: Cohort study; Level of evidence, 2. Methods: Adults with recurrent ACL ruptures underwent revision ACL reconstruction, followed by a pivot-shift test before the surgery ended. If the pivot shift was grade 0 or 1, no further surgery was performed (group 1). If it was grade 2 or 3, ITB tenodesis was performed (group 2). The pivot-shift test was performed, graded, and measured using computer navigation before revision ACL reconstruction and after revision ACL reconstruction with and without ITB tenodesis. Tegner activity scores were obtained 2 years after surgery. Groups were compared with regard to anterior translation and internal rotation during the pivot shift as well as Tegner activity scores ( P < .05). Results: There were 20 patients in group 1 and 18 in group 2. The mean anterior translation improved in group 1, from 17.7 ± 3.5 mm to 6.6 ± 1.9 mm, and group 2, from 18.5 ± 3.3 mm to 6.1 ± 1.2 mm, after revision ACL reconstruction ( P < .001), with no difference between the groups ( P = .15). After ITB tenodesis, the reduction in anterior translation in group 2 (5.3 ± 1.5 mm) became greater than that in group 1 (6.6 ± 1.9 mm) ( P = .03). In both groups after revision ACL reconstruction, there was a reduction in internal rotation (group 1: 24.2° ± 4.0° to 10.3° ± 1.1°; group 2: 25.4° ± 3.7° to 14.6° ± 2.8°; P < .001), but this change was less in group 2 ( P = .02). After ITB tenodesis, internal rotation in group 2 (8.3° ± 2.6°) became less than that in group 1 (10.3° ± 1.1°) ( P = .02). The mean Tegner activity scores in group 1 were 8.1 ± 1.1 before surgery and 7.4 ± 0.9 after surgery, while in group 2 they were 7.0 ± 1.3 and 7.2 ± 0.4, respectively, and not significantly different ( P = .29). Conclusion: ITB tenodesis improved laxity, although it did not affect activity levels, when there was a persistent pivot shift after revision ACL reconstruction. Clinical Relevance: An indication to perform ITB tenodesis is the persistence of a grade ≥2 pivot shift after revision ACL reconstruction.
Case Mix Measurement in English Hospitals: An Evaluation of Five Methods for Predicting Resource Use
Authors: Söderlund Neil , Gray Alastair , Milne Ruairidh , Raftery James 
Published: February 2018

Objectives: The introduction of an internal market in the British National Health Service (NHS) has highlighted the importance of developing appropriate, valid and timely measures of hospital activity, both for the purposes of specifying and monitoring contracts and for evaluating the success of the NHS reforms in general. This paper compares the validity of five case mix methods (Diagnosis Related Groups (DRGs); Healthcare Resource Groups (HRGs) versions 1 and 2; specialty classification; a simple age categorization) in predicting resource use. Methods: Two data sets were used to compare different case mix methods. A 3% random sample (n ≃ 300 000) of the 1992/3 Hospital Episodes Statistics was used to test their ability to predict variation in length of stay, and a second set of individually costed patient episodes from two hospitals (n ≃ 40 000) was used to test their ability to explain cost variation. Analysis of variance models were used to assess the fit of each of the case mix systems to test data and a simple significance test of differences in mean squared error between models was applied. Results: All case mix methods performed poorly on untrimmed data. When lengths of stay greater than 29 days were excluded, version 2 of HRGs explained 31% of total variance in length of stay and 25% of cost variation. DRGs explained less variance but performed better than HRGs version 1. For a typical hospital patient population consisting of a range of specialties, the difference in explanatory power between HRGs V2 and DRGs was statistically significant at the 5% level for sample sizes of approximately 2000 or greater. For individual specialties, the minimum sample size required for the difference between the groupers to be significant ranged from around 300 to over 2000. Conclusions: The locally developed HRGs version 2 system appears to offer superior performance in terms of resource homogeneity to other currently available approaches. It is also more adaptable and cheaper than imported alternatives and has been formally endorsed by the UK medical Royal Colleges.
How Can Payback from Health Services Research Be Assessed?
Authors: Buxton Martin , Hanney Steve 
Published: February 2018

Throughout the world there is a growing recognition that health care should be research-led. This strengthens the requirement for expenditure on health services research to be justified by demonstrating the benefits it produces. However, payback from health research and development is a complex concept and little used term. Five main categories of payback can be identified: Knowledge; research benefits; political and administrative benefits; health sector benefits; and broader economic benefits. Various models of research utilization together with previous assessments of payback from research helped in the development of a new conceptual model of how and where payback may occur. The model combines an input-output perspective with an examination of the permeable interfaces between research and its environment. The model characterizes research projects in terms of Inputs, Processes, and Primary Outputs. The last consist of knowledge and research benefits. There are two interfaces between the project and its environment. The first (Project Specification, Selection and Commissioning) is the link with Research Needs Assessment. The second (Dissemination) should lead to Secondary Outputs (which are policy or administrative decisions), and usually Applications (which take the form of behavioural changes), from which Impacts or Final Outcomes result. It is at this final stage that health and wider economic benefits can be measured. A series of case studies were used to assess the feasibility both of applying the model and the payback categorization. The paper draws various conclusions from the case studies and identifies a range of issues for further work.
Planning the Development of Cystic Fibrosis Gene Carrier Screening
Authors: Beech Roger , Bekker Hilary 
Published: February 2018

Objectives: It is now possible to test individuals to assess their cystic fibrosis gene carrier status and a range of strategies for screening the population have been piloted. The objective of this research was to develop a planning framework which health care planners and purchasers can use to assess the overall quantifiable outcomes and direct costs resulting from a year of alternative screening strategies and the ways costs and outcomes evolve over time. Beyond broader ethical and clinical considerations the information provided by such a framework is needed to support decisions surrounding the development of screening programmes. Design: Operational Research modelling techniques were used to develop the planning framework. To help illustrate the framework it was then used to assess the quantifiable outcomes and direct costs of three of the main alternative screening strategies: From antenatal clinics, ‘2-step’ screening where females are tested first followed by a screening invitation to the partners of female carriers, and ‘couple’ screening where both partners must agree to be tested at the outset; and from primary practice clinics ‘active’ contact of attenders. Quantifiable outcomes are defined as the number of individuals informed of their carrier status and the number of carriers, carrier couples, and affected fetuses detected. Direct costs are those associated with the recruitment and testing of individuals and the subsequent counselling of any gene carriers or carrier couples identified. Results are based on services for a resident population of 250 000 at two time points, year one and a year at ‘steady state’. Results: The resultant framework estimates the number of individuals tested using data on the size of the target population, the proportion of that population alerted to the screening service, and the proportion who agree to be tested when approached. Given service users, prevalence data are used to assess service outcomes. Given the number of individuals approached and the subsequent demands for services, service costs can be estimated. Preliminary results indicate that in the short-term health care purchasers and planners who favour screening are likely to opt for antenatal strategies. Although the high coverage of the primary practice strategy leads to high outcomes in year one, relative to the antenatal strategies, it also leads to very high costs. At ‘steady state’, cost and outcome differences between the strategies are less marked. Conclusion: This paper provides a framework which can be used to provide information to support decision-making surrounding the development of screening services. The methodology fills an important void in the literature and complements research elsewhere by health economists and by geneticists and their research colleagues. Preliminary findings based upon use of the approach demonstrate the need for continued research to further refine and improve the methodology.
Comparing Costs of Monitoring Glaucoma Patients: Hospital Ophthalmologists versus Community Optometrists
Authors: Coast Joanna , Spencer Ian C. , Smith Lee , Spry Paul G. D. 
Published: February 2018

Objectives: To compare the costs of monitoring stable glaucoma patients by community optometrists and hospital ophthalmologists. Methods: A cost analysis was conducted alongside a randomised controlled trial which compared the accuracy and acceptability of measurement in each form of care. The viewpoints of the health service and of patients were considered. Costs were assessed using a number of different methods. Sensitivity analysis was conducted for key variables. Results: The baseline analysis reflected heavily the different length of time between follow-up in the two arms of the trial (10 months (average) for hospital, 6 months for optometrists). It showed annual cost per patient for hospital ophthalmologists varied from £14.50 to £59.95, and community optometrist costs varied from £68.98 to £108.98. Assuming a 6-month follow-up interval for the hospital ophthalmologists, costs varied from £24.16 to £99.92. Conclusions: Recommendations about the least costly form of follow-up must depend on the context in which the decision is being taken and the scale of change envisaged. If the aim is to recoup resources from hospitals in order to pay for monitoring in the community, community monitoring is unlikely to be the least costly option.
Socio-Economic Status and Visits to Physicians by Adults in Ontario, Canada
Authors: McLsaac Warren , Goel Vivek , Naylor David 
Published: February 2018

Objectives: To examine the association between socio-economic status, need for medical care and visits to physicians in a universal health insurance system. Methods: Cross-sectional analysis of the 1990 Ontario Health Survey, a population-based survey utilizing a multistage, randomized cluster sample. The analysis considered only those respondents who were 16 years of age or older from the province of Ontario, Canada: 21 272 males and 24 738 females. Results: There was no difference by education or income in persons having made at least one visit to a general practitioner in the previous year. High income persons were less likely to have made six or more visits to a general practitioner — odds ratio (OR) = 0.67, 95% CI = 0.52, 0.87 for men; OR = 0.66, 95% CI = 0.58, 0.75 for women — but more likely to have made at least one visit to a specialist — OR = 1.42, 95% CI = 1.15, 1.76 for men; OR = 1.25, 95% CI = 1.07, 1.45 for women. A person's need for medical care was the most important determinant of a physician visit. Conclusions: Self-reported visits to general practitioners in Canada are strongly influenced by a person's need for medical care and are appropriately related to socio-economic status. However, there is a residual association between higher socio-economic levels and greater use of specialist services.
Demographic features and clinical aspects of Behçet’s disease in Omani patients
Authors: Al Ghafri Aadil , Al Wahshi Humaid 
Published: February 2018

Objectives: Behçet’s disease is a chronic, relapsing, multisystem vasculitis of unknown etiology. Few reports support the hypothesis that Behçet’s disease has a primarily hereditary basis. It complicated diversified clinical features predominantly involving oral and genital ulcers, and ocular and cutaneous lesions. The clinical features of this disease have been described to be different according to geographical areas and gender. The objective of the study is to explore the demographic features and clinical aspects of Behçet’s disease in Omani patients and to compare the results with those of various reports in the region. Methods and results: In total, 56 Behçet’s disease patients were recruited, and clinical data parameters were recorded including age, sex, age at diagnosis, duration of symptoms till diagnosis, disease characteristics such as oral and genital ulcers, ocular manifestations, the presence of arthritis, and cutaneous lesions such as papulopustular lesions and erythema nodosum. Furthermore, other systemic involvement was studied including gastrointestinal, neurological, renal, and vascular manifestations. Laboratory tests of Behçet’s disease and treatment used were recorded in each patient. The onset was between 6 and 74 years with a male predominance. Oral ulcers were the most common manifestation, followed by genital ulcers, ocular lesions, and arthritis. Vascular lesions and gastrointestinal manifestations were less common. Cutaneous manifestations were rare in patients with Behçet’s disease. The frequency of neurological involvement was significantly high. There were no reported cardiac or urogenital manifestations. Conclusion: Behçet’s disease’s demographic features and clinical aspects in Omani patients showed quite significant geographical and gender differences which are comparable to other data in the area.
Prolyl 4-hydroxylase 2 promotes B-cell lymphoma progression via hydroxylation of Carabin
Authors: Jiang Wei , Zhou Xiaoyan , Li Zengxia , Liu Kaiyu , Wang Weige , Tan Renke , Cong Xiaoji , Shan Jiaoyu , Zhan Yanxia , Cui Zhaomeng , Jiang Lizhi , Li Quanfu , Shen Suqin , Bai Meirong , Cheng Yunfeng , Li Bin , Tan Minjia , Ma Dengke K. , Liu Jun O. , Dang Yongjun 
Published: February 2018

Key Points
P4HA2, associated with progression and poor overall survival in DLBCL patients, could serve as a novel biomarker and therapeutic target. P4HA2 counteracts the negative effect of Carabin on lymphoma by hydroxylation of Carabin at Pro306.