bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palliative care delivery across health sectors: A population-level observational study
Authors: Tanuseputro Peter , Budhwani Suman , Bai Yu Qing , Wodchis Walter P 
Published: June 2016

Background: Little population-level information exists about the delivery of palliative care across multiple health sectors, important in providing a complete picture of current care and gaps in care. Aim: Provide a population perspective on end-of-life palliative care delivery across health sectors. Design: Retrospective population-level cohort study, describing palliative care in the last year of life using linked health administrative databases. Setting/participants: All decedents in Ontario, Canada, from 1 April 2010 to 31 March 2012 ( n = 177,817). Results: Across all health sectors, about half (51.9%) of all decedents received at least one record of palliative care in the last year of life. Being female, middle-aged, living in wealthier and urban neighborhoods, having cancer, and less multi-morbidity were all associated with higher odds of palliative care receipt. Among 92,276 decedents receiving palliative care, 84.9% received care in acute care hospitals. Among recipients, 35 mean days of palliative care were delivered. About half (49.1%) of all palliative care days were delivered in the last 2 months of life, and half (50.1%) had palliative care initiated in this period. Only about one-fifth of all decedents (19.3%) received end-of-life care through publicly funded home care. Less than 10% of decedents had a record of a palliative care home visit from a physician. Conclusion: We describe methods to capture palliative care using administrative data. Despite an estimate of overall reach (51.9%) that is higher than previous estimates, we have shown that palliative care is infrequently delivered particularly in community settings and to non-cancer patients and occurs close to death.
Validity of Guatemalan Mother’s Self-Reported Breast-Feeding Practices of 3-Month-Old Infants
Authors: Mazariegos Monica , Slater Christine , Ramirez-Zea Manuel 
Published: June 2016

Introduction: Breast-feeding practices (BFPs) can be assessed by interviewing the mother about current feeding practices and with a 24-hour recall. It is crucial to establish the accuracy of these methods, which are commonly used by public health decision makers to design health policies aimed at increasing exclusive breast-feeding rates. Objective: We aimed to validate 2 self-report BFP instruments using the dose-to-mother deuterium oxide turnover technique (DMDOT) as the reference method. Methods: Breast-feeding practices were assessed by interviewing the mother about current feeding practices and with a 24-hour recall in 36 Guatemalan mother–infant pairs. The validity of these instruments was assessed using DMDOT as the reference method. Results: Both self-report instruments overestimated exclusively breast-fed (EBF) infants. Infants classified as EBF were 50% by the reported current feeding practice, 61% by the 24-hour recall, and only 36% using DMDOT. Sensitivity to detect EBF infants from the mother’s self-report was 92% (95% CI: 62%-99%) while from the 24-hour recall was 100% (95% CI: 72%-100%, P < .01). However, specificity for both instruments was low, at 74% (95% CI: 51%-89%) for reported current feeding practice and at 61% (95% CI: 39%-79%) for the 24-hour recall ( P < .01). Conclusion: Both reported current feeding practice and the 24-hour recall instruments overestimated exclusive breast-feeding. Nevertheless, the use of reported current feeding practice provided more accurate data to assess BFPs in a public health setting. Furthermore, population-based surveys should consider the overestimation of exclusive breast-feeding caused when using these BFP instruments.
Arthur Ferguson MacCallan CBE, MD, FRCS (1872–1955), trachoma pioneer and the ophthalmic campaign in Egypt 1903–1923
Authors: MacCallan Michael 
Published: June 2016

Arthur Ferguson MacCallan was an ophthalmic surgeon who undertook his pioneering work in Egypt between 1903 and 1923. He established the Egyptian ophthalmic infrastructure which, on his departure, consisted of 23 operational hospital units, treating 134,000 new patients, having trained some 100 ophthalmic surgeons. He also established the Memorial Ophthalmic Laboratory at Giza which is still operational today. MacCallan became a world authority on trachoma. He pioneered the ‘MacCallan Classification’ which was the first grading system to standardise the stages of trachoma. He used this grading internally from 1905, continuing his research into trachoma over the ensuing years. In 1952, the WHO adopted the ‘MacCallan Classification’ as its standard. There has recently been a revival of interest in MacCallan’s work. First, the International Coalition for Trachoma Control (ICTC) inaugurated the ‘ICTC MacCallan Medal’ in 2014 as a contribution towards achieving the WHO’s target date for the Global Elimination of Blinding Trachoma (‘GET 2020’). Second, MacCallan’s work with the military hospitals has been recognised by Moorfields Eye Hospital on their World War I Commemorative History Board. Thus, MacCallan’s pioneering spirit, his humanitarian campaign for the relief of suffering and his accomplishments of over a century ago continue to resonate with the profession today.
Psychometric evaluation of the Moral Distress Scale–Revised among Iranian Nurses
Authors: Soleimani Mohammad Ali , Sharif Saeed Pahlevan , Yaghoobzadeh Ameneh , Panarello Bianca 
Published: June 2016

Background: Experiencing moral distress is traumatic for nurses. Ignoring moral distress can lead to job dissatisfaction, improper handling in the care of patients, or even leaving the job. Thus, it is crucial to use valid and reliable instruments to measure moral distress. Objective: The purpose of this study was to determine the reliability and the validity of the Persian version of the Moral Distress Scale–Revised among a sample of Iranian nurses. Research design: In this methodological study, 310 nurses were recruited from all hospitals affiliated with the Qazvin University of Medical Sciences from February 2014 to April 2015. Data were collected using a demographic questionnaire and the Moral Distress Scale–Revised. The construct validity of the Moral Distress Scale–Revised was evaluated using principal component analysis and confirmatory factor analysis. Internal consistency reliability was assessed with Cronbach’s alpha. Ethical considerations: This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. Findings: The construct validity of the scale showed four factors with eigenvalues greater than one. The model had a good fit ( χ2(162) = 307.561, χ2/ df = 1.899, goodness-of-fit index = .904, comparative fit index = .927, incremental fit index = .929, and root mean square error of approximation (90% confidence interval) = .049 (.040–.057)) with all factor loadings greater than .5 and statistically significant. Cronbach’s alpha coefficients were .853, .686, .685, and .711for the four factors. Moreover, the model structure was invariant across different income groups. Discussion and conclusion: The Persian version of the Moral Distress Scale–Revised demonstrated suitable validity and reliability among nurses. The factor analysis also revealed that the Moral Distress Scale–Revised has a multidimensional structure. Regarding the proper psychometric characteristics, the validated scale can be used to further research about moral distress in this population.
Reflections on using a postgraduate educational environment measure
Authors: Joiner Adam B , Dearman Samuel P 
Published: June 2016

Objectives: The aim was to use an educational environment measure to learn more about our postgraduate psychiatry education program, in order to gain further insights into areas for development. The educational environment includes such things as atmosphere and facilities. A secondary aim was to explore if different types of trainees experienced any aspects of the educational environment differently. Conclusions: The education environment measure used was able to reveal areas of the educational environment which trainees did not feel were adequate, as well as differences between how different trainees perceive some aspects of the educational environment. This allowed us to understand where improvements which we had not previously considered should be made to the educational environment.
Psychosocial Risk Factors for Postoperative Pain in Ankle and Hindfoot Reconstruction
Authors: Mulligan Ryan P. , McCarthy Kevin J. , Grear Benjamin J. , Richardson David R. , Ishikawa Susan N. , Murphy G. Andrew 
Published: June 2016

Background: The purpose of this study was to examine factors associated with pain after elective ankle and hindfoot reconstruction. Methods: Patients who underwent major ankle or hindfoot reconstruction over a 3-year period were identified. Retrospective chart review determined patient demographics, comorbidities, surgeries, tobacco, alcohol, and narcotic use, chronic pain, and mood disorders. Primary outcomes were cumulative amount of narcotic prescribed (morphine milligram equivalent dose) in the initial 90-day postoperative period, beyond 90 days, and visual analog pain score (VAS) at a minimum of 1-year follow-up. One hundred thirty-two patients (139 operations) met the inclusion criteria. Results: The average narcotic amount prescribed in the initial 90 days after surgery was 1711 mg (morphine equivalent), and narcotic prescriptions were required after 52 surgeries (35%) past 90 days. Preoperative narcotic use ( P < .01), chronic pain disorder ( P = .02), and mood disorder ( P < .01) were significant risk factors for continued narcotic use past 90 days. Tobacco use ( P = .01) and chronic pain disorder ( P < .01) also were significant risk factors for increased initial postoperative narcotic use. The average VAS score in 91 patients at an average of 2.7-year follow-up was 2.1. Mood disorder was a risk factor for increased VAS ( P < .01). No other associations were noted. Conclusion: Patients being treated for chronic pain, diagnosed with a mood disorder, taking any amount of narcotics preoperatively, or using tobacco products had a statistically significant increased risk for pain postoperatively. The presence of risk factors should prompt physicians to discuss pain management strategies before surgery. Level of Evidence: Level III, comparative series.
Association of the von Willebrand Factor–ADAMTS13 Ratio With Incident Cardiovascular Events in Patients With Peripheral Arterial Disease
Authors: Green David , Tian Lu , Greenland Philip , Liu Kiang , Kibbe Melina , Tracy Russell , Shah Sanjiv , Wilkins John T. , Huffman Mark D. , Liao Yihua , Lloyd Jones Donald , McDermott Mary M. 
Published: June 2016

Background: Platelet adhesion is mediated by von Willebrand factor (vWF), and disintegrin-like and metalloprotease domain with thrombospondin type-1 motif, number 13 (ADAMTS13) is a protease that cleaves vWF. A change in the balance between vWF and ADAMTS13 in favor of thrombosis might occur shortly before ischemic cardiovascular (CV) events. Objective: To determine whether vWF, ADAMTS13, and the ratio of vWF and ADAMTS13 change during the months preceding an acute CV event. Design: Prospective longitudinal observational study. Setting: Outpatient. Patients: A total of 595 participants with peripheral artery disease (PAD). Measurements: Blood samples were obtained every 2 months for up to 3 years and hemostatic factors examined at intervals preceding events. Results: Sixty-one participants (cases) experienced events and were matched to 122 PAD controls. During the 2-month interval prior to an event, cases (n = 48) had higher levels of the vWF and ADAMTS13 than controls (n = 95; P = .05), but significance was lost after adjusting for the baseline differences in myocardial infarction, unstable angina, and stroke. During the 10 months prior to an event, median values for vWF and the ratio of vWF and ADAMTS13 were higher in cases than in controls, but the differences were not statistically significant. However, in a subset of 20 patients with complete bimonthly data, there was a trend toward an increase in the ratio in the 10 months prior to a CV event ( P = .04). Conclusion: In patients with PAD experiencing an ischemic CV event, a significant increase in the ratio of vWF to ADAMTS13 prior to the event could not be confirmed, although there was a weak trend in this direction.
Staying connected with youth transitioning out of foster care: “Thank you for not giving up on me”
Authors: Mitchell Monique B , Vann Louisa H 
Published: June 2016

Summary Numerous research studies have addressed the experiences and outcomes of youth transitioning out of foster care; however, far fewer have addressed how to overcome the challenge of locating and retaining research participants from this population. This article contributes to the field by highlighting effective approaches to staying connected with (i.e., recruiting, relocating, and retaining) youth participants in longitudinal research studies. Two hundred ninety-four youth in the Southeastern United States participated in a longitudinal research study about their experiences as they transitioned out of foster care. Two years later, 80% of eligible participants from the baseline population ( n = 223) chose to participate in the second wave of data collection. Findings Case examples are presented to illustrate the practical applications of youth-centered and person-centered approaches to participant recruitment, relocation, and retention and how engaging with youth on a case by case basis can minimize attrition rates and maintain participant interest in the study. Application We affirm the importance of encouraging youth involvement in all phases of the research process, highlight the methodological approaches used to recruit, relocate, and retain participants, and discuss the value of establishing and maintaining meaningful connections with youth participants involved in longitudinal research.
The impact of personal budgets on unpaid carers of older people
Authors: Woolham John , Steils Nicole , Daly Guy , Ritters Katrina 
Published: June 2016

Summary This paper focuses on the impact of a personal budget – either in the form of a direct payment or managed personal budget – on the role of unpaid carers of older budget holders. Data were collected via postal survey of 1500 unpaid carers and semi-structured interviews with 31 carers. Findings Unpaid carers played a central role in supporting older budget holders irrespective of the type of budget received. The allocation of a personal budget may have decreased the amount of ‘hands-on’ care they provided, enabling them to do different things for and with the person cared for, but most did not relinquish direct involvement in care provision. Both kinds of personal budget provided greater flexibility to juggle caring tasks with other roles, such as childcare or paid employment. However, carers supporting direct payment users did experience higher levels of stress. This seemed linked to the additional responsibilities involved in administering the direct payment. Carers seemed relatively unsupported by their local Adult Social Care Department: the survey found that only one in five said they had ever received a carer assessment. Application The findings offer a detailed exploration of the impact of personal budgets on carers, suggesting that even in countries with relatively well-developed systems of support for carers such as England their impact remains overlooked. The paper may be of interest to social work practitioners, managers, academics and social work policy specialists working in countries that have, or are about to introduce, personal budgets or other forms of cash-for-care scheme.
Budesonide, but not dexamethasone, blunted the response of aldosterone to renin elevation by suppressing angiotensin converting enzyme upon high-altitude exposure
Authors: Li Hui-Jie , Zheng Cheng-Rong , Chen Guo-Zhu , Qin Jun , Zhang Ji-Hang , Yu Jie , Zhang En-Hao , Huang Lan 
Published: June 2016

Introduction: Inhaled budesonide is a novel approach to prevent acute mountain sickness (AMS). However, its mechanism is not completely understood. We aimed to investigate the effects of budesonide and dexamethasone on renin–angiotensin–aldosterone system in AMS prevention. Materials and methods: Data were obtained from a randomised controlled trial including 138 participants. The participants were randomly assigned to receive budesonide, dexamethasone or placebo as prophylaxis before they travelled to 3450 m altitude from 400 m by car. Their plasma concentrations of renin, angiotensin-converting enzyme (ACE) and aldosterone were measured at both altitudes. Results: All parameters were comparable among the three groups at 400 m. After high-altitude exposure of 3450, renin in all groups increased significantly; the ACE, aldosterone concentrations, as well as the aldosterone/renin ratio, rose markedly in the dexamethasone and placebo groups but not in the budesonide group. Moreover, the aldosterone/renin ratio correlated closely with ACE concentration. Conclusions: Upon acute high-altitude exposure, budesonide, but not dexamethasone, blunted the response of aldosterone to renin elevation by suppressing angiotensin converting enzyme.
The effects of telmisartan on the nuclear factor of activated T lymphocytes signalling pathway in hypertensive patients
Authors: Huang Sha-Sha , He Si-Li , Zhang Yuan-Ming 
Published: June 2016

Hypothesis: Previous studies provide links between the nuclear factor of activated T lymphocytes (NFAT) signalling pathway and the development of hypertension. Our preliminary studies indicate that telmisartan can block Kv1.3 potassium channels and effectively inhibit potassium current densities, along with Kv1.3 mRNA and protein expression levels. This paper aims to investigate whether telmisartan has an inhibitory effect on the NFAT signalling pathway after activation and proliferation of peripheral blood T lymphocytes in Kazakh patients with essential hypertension (EH) from Xinjiang, China. Materials and methods: T lymphocytes were isolated using the immunomagnetic cell sorting method (MACS). The mRNA expression of NFATc1, IL-6 and TNF-α was measured by quantitative polymerase chain reaction (qRT-PCR) and relative protein levels were evaluated by Western blot. T cell samples from 50 hypertensive Kazakh patients from Xinjiang were randomly divided into control, telmisartan, cyclosporin A (CsA), VIVIT, and 4-aminopytidine (4-AP) groups. Peripheral blood T lymphocytes were first activated and proliferated in vitro, then incubated for 48 h under different treatment conditions before determination of protein and mRNA expression of NFATc1, IL-6, and TNF-α by Western blot and qRT-PCR analyses, respectively. Results: There were no significant differences in cardiovascular risk factors among the patients with samples assigned to the five groups ( p > 0.05). Expression of NFATc1, IL-6, and TNF-α mRNA and protein was significantly reduced in T lymphocytes in all treatment groups (telmisartan, CsA, VIVIT, and 4-AP) compared with controls. Conclusions: Antihypertensive function and inhibitory effects of telmisartan on the T lymphocyte NFAT signalling pathway are unlikely to affect the normal immune function of hypertensive patients. Telmisartan may exert anti-inflammatory effects by inhibition of the NFAT signalling pathway in the T lymphocytes of hypertensive patients.
Questionable Interventions: The Enduring Myth of Laissez-Faire
Authors: Keaney Michael 
Published: June 2016

The aftermath of the global financial crisis that began in 2007 in the United States and has yet to end has demonstrated the durability of policies and analytical frameworks that have characterised the neoliberal era. Among these has been a strong rhetorical commitment to market-based institutions as synonymous with individual freedom, in contradistinction to the inefficient, bureaucratic state. This has disguised what amounts to a reconfiguration of state power during the last 40 years, such that it is arguably more pervasive than during the preceding Keynesian era. The books under review here each reveal the ideological character of laissez-faire while in various ways hinting at its mythological properties. This mythical aspect is most prominently displayed by Edmund Phelps’ treatment of ‘corporatism’ as responsible for our current ills, when it is in fact integral to contemporary political economy, and cannot be otherwise, absent truly revolutionary change. Cahill D (2014) The End of Laissez-Faire? On the Durability of Embedded Neoliberalism. Cheltenham: Edward Elgar. Phelps E (2013) Mass Flourishing: How Grassroots Innovation Created Jobs, Challenge, and Change. Princeton, NJ: Princeton University Press. Van Apeldoorn B, de Graaff N and Overbeek H (eds) (2014) The State-Capital Nexus in the Global Crisis. London: Routledge. Weiss L (2014) America Inc.? Innovation and Enterprise in the National Security State. Ithaca, NY: Cornell University Press.
The Effect of Corticosteroid Withdrawal on Glucose Metabolism and Anti-GAD Antibodies in Simultaneous Pancreas–Kidney Transplant Patients
Authors: Ribeiro Rogério Silicani , Cristelli Marina , Amor Antonio J. , Guerrero Vanessa , Ferrer Joana , Ricart María José , Esmatjes Enric 
Published: June 2016

Context: Corticosteroid withdrawal may reduce insulin resistance; however, it could also influence pancreatic autoantibody profile in simultaneous pancreas–kidney (SPK) transplant patients. Objective: To evaluate the effect of corticosteroid withdrawal on glucose metabolism and anti-glutamic acid decarboxylase (GAD) antibody titers in SPK patients with type 1 diabetes after 12 months of follow-up. Design: In this retrospective study, fasting glucose and glycated hemoglobin (A1c) were compared before and after 3, 6, and 12 months of corticosteroid withdrawal in 80 SPK patients. In addition, weight, anti-GAD, and C-peptide levels were compared before and after withdrawal. Finally, fasting and postglucose, insulin, and C-peptide levels were compared before and after withdrawal in 25 patients undergoing oral glucose tolerance test (OGTT). Results: Fasting glucose levels did not change during corticosteroid discontinuation. After 12 months, A1c slightly increased from 4.6% (0.4%) to 4.8% (0.6%) ( P < .01) and C-peptide decreased from 2.8 (1.1) ng/mL to 2.4 (1.3) ng/mL ( P <. 01). In patients submitted to OGTT, glucose, insulin, and C-peptide levels did not change. There was no alteration in the proportion of anti-GAD positive tests (41% vs 45%). Anti-GAD titers remained stable or decreased in 70% of positive patients. Conclusion: Corticosteroid withdrawal has no significant effect on glucose metabolism and on anti-GAD profile among SPK patients.