bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding meaning in life interventions in patients with advanced disease: A systematic review and realist synthesis
Authors: Guerrero-Torrelles Mariona , Monforte-Royo Cristina , Rodríguez-Prat Andrea , Porta-Sales Josep , Balaguer Albert 
Published: February 2017

Background: Among patients with advanced disease, meaning in life is thought to enhance well-being, promote coping and improve the tolerance of physical symptoms. It may also act as a buffer against depression and hopelessness. As yet, there has been no synthesis of meaning in life interventions in which contextual factors, procedures and outcomes are described and evaluated. Aims: To identify meaning in life interventions implemented in patients with advanced disease and to describe their context, mechanisms and outcomes. Design: Systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and realist synthesis of meaning in life interventions using criteria from the Realist And Meta-narrative Evidence Syntheses: Evolving Standards project. Data sources: The CINAHL, PsycINFO, PubMed and Web of Science databases were searched. Results: A total of 12 articles were included in the systematic review, corresponding to nine different interventions. Five articles described randomized controlled trials, two were qualitative studies, two were commentaries or reflections, and there was one pre–post evaluation, one exploratory study and one description of a model of care. Analysis of context, mechanisms and outcomes configurations showed that a core component of all the interventions was the interpersonal encounter between patient and therapist, in which sources of meaning were explored and a sense of connectedness was re-established. Meaning in life interventions were associated with clinical benefits on measures of purpose-in-life, quality of life, spiritual well-being, self-efficacy, optimism, distress, hopelessness, anxiety, depression and wish to hasten death. Conclusion: This review provides an explanatory model of the contextual factors and mechanisms that may be involved in promoting meaning in life. These approaches could provide useful tools for relieving existential suffering at the end of life.
Workers’ rights and transatlantic trade relations: The TTIP and beyond
Authors: Tyc Aneta 
Published: February 2017

AbstractIn the context of the working-class backlash against free trade represented by Brexit, the recent surge of right-wing political parties in Europe and the 2016 US presidential election, it is timely to take stock of the threats to jobs and wages posed by recent negotiations over the Transatlantic Trade and Investment Partnership. The European Commission selectively relied on econometric analyses, predicting a positive impact of the Transatlantic Trade and Investment Partnership. Its proposed legal text on ‘Trade and sustainable development’ fell short of the European Parliament’s negotiating guidelines, which themselves failed to ensure protection of labour standards. The activities of corporate lobbies threatened the effective protection of workers’ rights. Major risks to workers’ rights are posed by discrepancies between US and European Union labour and social law and labour standards. The most recent legal text lacks compliance monitoring provisions and sanction mechanisms against member states failing to ratify core labour conventions. The investment court system does not resolve the problems of the discredited investor-state dispute settlement mechanism for which it is the proposed replacement. The year 2016 has provided a foretaste of the dislocation likely from trade and investment regulation that sees social and environmental standards and labour rights simply as barriers to corporate profits.
Protocols for the Treatment of Essential Hypertension and Type II Diabetes Mellitus by Pharmacists in Ambulatory Care Clinics
Authors: Tiggelaar John M. 
Published: February 2017

During the last several years, the pharmacist has acted as a primary-care provider for patients with selected chronic illnesses at an urban county health department. The pharmacist's responsibilities include examining patients, ordering laboratory tests and X-rays, and adjusting or prescribing medication. In order to comply with health department regulations requiring the use of protocols by non-physician practitioners, and to better define the pharmacist's role, pharmacy protocols for the treatment of essential hypertension and type II diabetes mellitus have been developed. The protocols provide specific guidelines for the pharmacist involved in primary patient care. In addition, they describe a procedure for the selection and referral of patients. These protocols can serve as a sound foundation by which other pharmacists involved with primary patient care treat essential hypertension and type II diabetes mellitus. They can easily be modified to suit a pharmacist's particular needs and situation.
Evaluation of Temazepam and Diphenhydramine as Hypnotics in a Nursing-Home Population
Authors: Stewart Ronald B. , Meuleman John R. , Nelson Richard C. , Clark R. Lee 
Published: February 2017

Seventeen nursing home residents with sleeping problems were enrolled in a randomized, double-blind, crossover trial of temazepam 15 mg, diphenhydramine (DPH) 50 mg, and placebo. Each drug was given for five consecutive nights with a 72-hour washout period between drugs. Subjects were assessed three times weekly with tests of psychomotor and cognitive function and four times weekly with observer sleep diaries and morning sleep questionnaires. Three subjects failed to complete the study. By report of the subjects, DPH resulted in shorter sleep latency than did placebo (t = 2.77, p < 0.05). On the fifth night, use of DPH was associated with longer duration of sleep than temazepam (t = 2.88, p < 0.05). No significant difference in tests of neurologic function was noted although, compared with placebo, subjects performed more poorly on seven of eight tests while taking temazepam and five of eight tests while taking DPH. Several instances of daytime hypersomnolence were noted in subjects taking temazepam and DPH, but none in subjects given placebo.
Antibiotic Prophylaxis in Open-Heart Surgery Patients: Comparison of Cefamandole and Cefuroxime
Authors: Peterson Charles D. , Lake Kathleen D. , Arom Kit V. , Love Kathryn R. 
Published: February 2017

The efficacy of cefamandole and cefuroxime in preventing postoperative wound infections was compared in 3037 patients undergoing open-heart surgery. Antibiotic prophylaxis in 1467 patients having coronary artery bypass and valve replacement surgery was cefamandole 2 g iv preoperatively followed by 2 g q6h for five days postoperatively; 1570 patients received cefuroxime 1.5 g iv preoperatively then 1.5 g iv q12h for threedays postoperatively. Postoperative wound infections (sternal and leg wounds) were studied in each treatment group. In the cefamandole study group, 27 patients (1.8 percent) developed postoperative wound infections (9 sternal and 18 leg wounds). In the cefuroxime treatment group, 19 patients (1.2 percent) developed postoperative wound infections (9 sternal and 10 leg wounds). Overall, no statistical difference was found between the two antibiotics in preventing postoperative wound infections. However, in patients having valve replacement surgery, cefuroxime was found statistically more effective than cefamandole prophylaxis in preventing sternal wound infections (no infections in 284 patients compared with five infections in 205 patients, respectively, p = 0.01). The most common organism isolated from infected wounds with cefamandole was Staphylococcus aureus followed by S. epidermidis compared with cefuroxime which had S. epidermidis followed by S. aureus. Cefuroxime was found to be as effective as cefamandole and considerably less expensive in preventing postoperative wound infections in patients undergoing open-heart surgery.
Effect of Ranitidine on Chloroquine Disposition
Authors: Ette Ene I. , Brown-Awala Esther A. , Essien Ettiene E. 
Published: February 2017

Ten healthy, male volunteers (aged 19–27 yr; weight 62–67 kg) were randomly distributed into control and test groups of five subjects each in a controlled study on the effect of ranitidine on chloroquine disposition. The control group subjects received two tablets of chloroquine sulfate (300-mg base) only. The test group subjects received ranitidine 250 mg hs for four days prior to the administration of chloroquine sulfate and throughout the sample collection period. Blood samples (5 ml) were collected from the time of the chloroquine administration to the seventh day after drug administration. The samples were analyzed for chloroquine content by a combination of thin-layer chromatography and ultraviolet spectrophotometry. The Wilcoxon test at 0.05 significance level was used to compare the disposition parameters between control and test groups. Ranitidine therapy was associated with no significant alterations in chloroquine oral clearance rate, elimination rate constant, and apparent volume of distribution. Unlike cimetidine, ranitidine does not interact pharmacokinetically with chloroquine. Ranitidine, therefore, may be the H2-receptor antagonist of choice for ulcer patients receiving chloroquine.
The Contribution of Epidemiology to the Study of Drugs
Authors: Porta Miquel S. , Hartzema Abraham G. 
Published: February 2017

Epidemiology is concerned with the distribution of disease and health in human populations. Drugs are one of the factors that influence such a distribution. Pharmacoepidemiology can be defined as the application of epidemiologic knowledge, methods, and reasoning to the study of the effects (beneficial and adverse) and uses of drugs in human populations. Pharmacoepidemiology aims to describe, explain, control, and predict the effects and uses of pharmacologic treatment modalities in a defined time, space, and population. The present article is an introduction to the contributions of epidemiology to the study of drugs.
Reach and effectiveness of the HeartBeat Connections telemedicine pilot program
Authors: Benson Gretchen A , Sidebottom Abbey , Sillah Arthur , Boucher Jackie L , Miedema Michael D , Knickelbine Thomas , VanWormer Jeffrey J 
Published: February 2017

Introduction Innovative care delivery programs that support primary care providers are needed to reduce the burden of cardiovascular disease (CVD). HeartBeat Connections (HBC) is a primary prevention telemedicine program utilizing registered dietitian nutritionists (RDNs) and registered nurses (RNs) to deliver health coaching and medication therapy protocols for dyslipidaemia and hypertension among patients at high risk for developing CVD. Methods This retrospective cohort study documents the reach and six-month effectiveness of the HBC program for improving CVD risk factors. The sample included 1028 high-risk individuals aged 40–79 (without CVD or diabetes) served between 2010 and 2013 (326 participants, 702 eligible non-participants). Mixed-model analyses of variance were used to compare changes in outcome measures between baseline and six-month follow-up for participants and non-participants. Outcomes were also examined for three groups: non-participants, participants with 1–4 encounters, and participants with > 5 encounters. Results Nearly one-third of all eligible patients participated. There were no significant differences over time between HBC participants and non-participants in blood pressure or body mass. A higher proportion of HBC participants quit using tobacco (7.0 vs. 3.2%, p = 0.004) and achieved the low-density lipoprotein (LDL) program goal of < 100 mg/dL (8.9 vs. –1.1%, p = 0.009). Also, more favourable improvements in total and LDL cholesterol were observed among HBC participants with higher program engagement ( p < 0.05). Discussion The HBC telemedicine program resulted in significant improvement in some, but not all, CVD risk factors over six months. HBC reached many high-CVD-risk patients in the target region, which may confer population-level health benefits if this program can be scaled and sustained. Innovative, collaborative care delivery models like HBC can serve as a platform to systematically target and proactively engage at-risk populations, perhaps reducing patients’ CVD risk.
Dimensions of Patient Experience and Overall Satisfaction in Emergency Departments
Authors: Tanniru Mohan , Khuntia Jiban 
Published: February 2017

Objective: To determine the correlation between individual patient experience dimensions and overall patient satisfaction using text-based analysis of subjective comments of patients treated in emergency departments. Methods: Open-ended comments from 331 patients who visited the emergency departments of 4 hospitals were used for coding different dimensions of patient experience. Regression coefficients were calculated to assess the relationships between dimensions of patient experiences with overall satisfaction. Results: Positive and negative experience of nursing, communications, and infrastructure influence the overall satisfaction. Positive experience attributes of overall care quality influence overall satisfaction, whereas negative experience of the same does not have any influence. Further, experiences of interactions with doctors and scheduling do not have any effect on overall satisfaction in emergency departments. Conclusions: Emergency departments may get higher overall patient evaluations by focusing on positive aspects of care, nursing, communication, and infrastructure attributes. Doctors and scheduling (emergency) may be considered as expected quality attributes and so not surprising that they did not play a role in overall satisfaction.
What Kind of Urban? A Case Study of Kullu, A Small Indian Town
Authors: Mehra Diya 
Published: February 2017

This article examines the kind of urbanisation that is emerging in Kullu, a small but quickly growing North Indian mountain town. It does this both within the context of the town itself, but also by studying its relationship to nearby villages that are increasingly a part of the town’s remit as it emerges as a new metropolitan region. What the article seeks to highlight is that despite rising incomes, urban and spatial expansion and in-migration, many of the markers of new urban growth commonly found in other metropolitan Indian cities are absent in Kullu. These include increasing corporate real estate development, middle class and public consumptive cultures, neoliberal experiments with governance and rising urban inequality. The article locates the area’s tepid response to the templated ‘new’ Indian urban in a continuing orientation and attunement of Kullu residents to the high alpine Himalayan landscape within which the town is located and by which it is hemmed wherein belonging and dwelling are predicated on a continuing attentiveness to the unfolding landscape, and on rurality, in which many urban residents continue to have a stake. This, even as relatively widespread land distribution among those considered ‘local’ ensures a relatively well-distributed and languid prosperity in the area as a whole. In this context, the article argues for the rethinking of singular definitions of urbanisation and of the relationship between urban and rural areas, particularly in light of dominant metropolitan experiences, and to consider the alternative forms of urban life that Kullu presents. Simultaneously, however, it discusses new and emerging fault lines that threaten Kullu’s existing rural–urban compact in the concluding section, namely new youth cultures and the building practices of locals themselves.
Brazilian dietary patterns and the dietary approaches to stop hypertension (DASH) diet-relationship with metabolic syndrome and newly diagnosed diabetes in the ELSA-Brasil study
Authors: Drehmer Michele , Odegaard Andrew O. , Schmidt Maria Inês , Duncan Bruce B. , Cardoso Letícia de Oliveira , Matos Sheila M. Alvim , Molina Maria del Carmen B. , Barreto Sandhi M. , Pereira Mark A. 
Published: February 2017

Abstract
Background
Studies evaluating dietary patterns, including the DASH diet, and their relationship with the metabolic syndrome and diabetes may help to understand the role of dairy products (low fat or full fat) in these conditions. Our aim is to identify dietary patterns in Brazilian adults and compare them with the (DASH) diet quality score in terms of their associations with metabolic syndrome and newly diagnosed diabetes in the Brazilian Longitudinal Study of Adult Health-the ELSA-Brasil study.

Methods
The ELSA-Brasil is a multicenter cohort study comprising 15,105 civil servants, aged 35–74 years at baseline (2008–2010). Standardized interviews and exams were carried out, including an OGTT. We analyzed baseline data for 10,010 subjects. Dietary patterns were derived by principal component analysis. Multivariable logistic regression investigated associations of dietary patterns with metabolic syndrome and newly diagnosed diabetes and multivariable linear regression with components of metabolic syndrome.

Results
After controlling for potential confounders, we observed that greater adherence to the Common Brazilian meal pattern (white rice, beans, beer, processed and fresh meats), was associated with higher frequencies of newly diagnosed diabetes, metabolic syndrome and all of its components, except HDL-C. Participants with greater intake of a Common Brazilian fast foods/full fat dairy/milk based desserts pattern presented less newly diagnosed diabetes. An inverse association was also seen between the DASH Diet pattern and the metabolic syndrome, blood pressure and waist circumference. Diet, light foods and beverages/low fat dairy pattern was associated with more prevalence of both outcomes, and higher fasting glucose, HDL-C, waist circumference (among men) and lower blood pressure. Vegetables/fruit dietary pattern did not protect against metabolic syndrome and newly diagnosed diabetes but was associated with lower waist circumference.

Conclusions
The inverse associations found for the dietary pattern characterizing Brazilian fast foods and desserts, typically containing dairy products, with newly diagnosed diabetes, and for the DASH diet with metabolic syndrome, support previously demonstrated beneficial effects of dairy products in metabolism. The positive association with metabolic syndrome and newly diagnosed diabetes found for the pattern characterizing a typical Brazilian meal deserves further investigation, particularly since it is frequently accompanied by processed meat.
Trial registration NCT02320461. Registered 18 December 2014
Does drug-induced sleep endoscopy change the surgical decision in surgically naïve non-syndromic children with snoring/sleep disordered breathing from the standard adenotonsillectomy? A retrospective cohort study
Authors: Gazzaz Malak Jamal , Isaac André , Anderson Scott , Alsufyani Noura , Alrajhi Yaser , El-Hakim Hamdy 
Published: February 2017

Background Adenotonsillectomy is the most commonly performed operation for pediatric snoring/sleep disordered breathing (S/SDB). However, 20–40% of patients will fail to improve. Drug-induced sleep endoscopy (DISE) may provide a more individualized surgical plan and limit unsuccessful surgeries. The aim of this study was to assess the impact of DISE on surgical decision-making in surgically naïve children with S/SDB. Methods A retrospective observational cohort study was undertaken at the Stollery Children's Hospital. Patients 3–17 years of age who underwent DISE-directed surgery for S/SDB between January 2009 and December 2015 were eligible. We excluded other indications for tonsillectomy and syndromic children. The primary outcome was the level of agreement between a DISE-based surgical decision and the reference standard based on the American Academy of Pediatrics (AAP) guidelines via un-weighted Cohen's kappa. Secondary outcomes included the frequency and type of alternate surgical targets identified by DISE. The agreement on tonsil size between in-office physical assessment and DISE was also calculated. The effectiveness of DISE-directed surgery on postoperative S/SDB was not investigated. Results Five hundred fifty-eight patients were included. DISE changed the surgical plan in 35% of patients. Agreement between DISE-based and AAP clinical practice guidelines-based management was low (κ = 0.354 +/- 0.021 [95% CI 0.312–0.395]). An alternate diagnosis or surgical target was identified by DISE in 54% of patients. There was moderate agreement on tonsil size (κ = 0.44 [0.33–0.55]) between DISE and in-office clinical assessment. Conclusions This is a first phase diagnostic study, which demonstrates that DISE affects decision-making in surgically naïve children with S/SDB in up to 35% of patients. It has utility in individualizing first stage surgical treatments as well as identifying alternate targets for further surgical or medical therapy, while potentially limiting unsuccessful surgeries. Further studies to examine the effect of DISE on surgical outcomes are required.
Raja asterias population assessment in FAO GFCM GSA17 area
Authors: FERRÀ C. , FABI G. , POLIDORI P. , TASSETTI A. N. , LEONI S. , PELLINI G. , SCARCELLA G. 
Published: February 2017

Population structure and distribution of the starry ray, Raja asterias, were described based on data collected during yearly rapido trawl surveys (SoleMon), between 2005 and 2014 in the Northern and Central Adriatic Sea. A total of 306 individuals were caught, sex ratio was 1.04:1 in favor of males and length-weight relationships were obtained for the whole sample. Following the MEDITS scale, maturity was estimated, observing a higher number of immature individuals. Relative abundance significantly increased during the recent period with the highest values recorded at 5-30 m depths. Such increase could be related to the response of R. asterias to climatic change or to the decrease in fishing pressure in the area. Clear spatial segregation of individuals depending on their life stage was observed, with immature individuals inhabiting the coastal areas and adults more abundant at depths greater than 40 m. The comparison of the result of the present study with MEDITS survey outcomes in terms of distribution patterns, persistence areas of adults and juveniles and abundances indices, evidences that SoleMon survey seems to be more suitable in defining such features of the stock, likely due to the greater catchability of the rapido trawl in respect to the MEDITS trawl net. However, further investigations are needed to identify factors affecting the increasing abundance of this species, and develop an action plan for spatial management of fishing activities.