bluuebunny/crossref_metadata_2025_split huggingface dataset:
Household Debt and Relation to Intimate Partner Violence and Husbands' Attitudes toward Gender Norms: A Study among Young Married Couples in Rural Maharashtra, India
Authors: Reed Elizabeth , Donta Balaiah , Dasgupta Anindita , Ghule Mohan , Battala Madhusudana , Nair Saritha , Silverman Jay G. , Jadhav Arun , Palaye Prajakta , Saggurti Niranjan , Raj Anita 
Published: April 2017

Objective. Evidence has linked economic hardship with increased intimate partner violence (IPV) perpetration among males. However, less is known about how economic debt or gender norms related to men's roles in relationships or the household, which often underlie IPV perpetration, intersect in or may explain these associations. We assessed the intersection of economic debt, attitudes toward gender norms, and IPV perpetration among married men in India. Methods. Data were from the evaluation of a family planning intervention among young married couples ( n=1,081) in rural Maharashtra, India. Crude and adjusted logistic regression models for dichotomous outcome variables and linear regression models for continuous outcomes were used to examine debt in relation to husbands' attitudes toward gender-based norms (i.e., beliefs supporting IPV and beliefs regarding male dominance in relationships and the household), as well as sexual and physical IPV perpetration. Results. Twenty percent of husbands reported debt. In adjusted linear regression models, debt was associated with husbands' attitudes supportive of IPV (β=0.015, p=0.004) and norms supporting male dominance in relationships and the household (β=0.006, p=0.003). In logistic regression models adjusted for relevant demographics, debt was associated with perpetration of physical IPV (adjusted odds ratio [AOR] = 1.4, 95% confidence interval [CI] 1.1, 1.9) and sexual IPV (AOR=1.6, 95% CI 1.1, 2.1) from husbands. These findings related to debt and relation to IPV were slightly attenuated when further adjusted for men's attitudes toward gender norms. Conclusion. Findings suggest the need for combined gender equity and economic promotion interventions to address high levels of debt and related IPV reported among married couples in rural India.
Chronic Liver Disease-Associated Hospitalizations among Adults with Diabetes, National Inpatient Sample, 2001–2012
Authors: Byrd Kathy K. , Mehal Jason M. , Schillie Sarah F. , Holman Robert C. , Haberling Dana , Murphy Trudy 
Published: April 2017

Objective. Many people with diabetes have a variety of diabetes-related complications. Among the variety of conditions associated with diabetes, however, liver diseases are less well recognized. As such, we aimed to describe chronic liver disease (CLD)-associated hospitalization rates among U.S. adults with diabetes from 2001–2012. Methods. We used a nationally representative database of hospitalizations, the National Inpatient Sample, to determine CLD-associated hospitalization rates among U.S. adults aged ≥18 years with and without diabetes, from 2001–2012. Hospitalizations listing an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for CLD on the discharge record were selected for analysis and were further classified by diabetes status based on concurrent presence of a diabetes ICD-9-CM code. We calculated average annual age-adjusted hospitalization rates and 95% confidence intervals (CIs), and conducted a test for trend. Results. For 2001–2012, the total age-adjusted CLD-associated hospitalization rate among adults with diabetes (1,680.9 per 100,000 population; 95% CI 1,577.2, 1,784.6) was approximately four times the rate of adults without diabetes (424.2 per 100,000 population; 95% CI 413.4, 435.1). Total age-adjusted hospitalization rates of adults with and without diabetes increased 59% and 48%, respectively, from 2001–2002 to 2011–2012 ( p<0.001). Hepatitis C- and chronic hepatitis and cirrhosis-associated hospitalizations comprised the largest proportion of total CLD-associated hospitalizations among adults with and without diabetes. Conclusion. Providers should be aware of the potential existence of CLD among adults with diabetes and counsel patients on preventive methods to avoid progressive liver damage.
Sociodemographic and Clinical Risk Factors Associated With Tuberculosis Mortality in the United States, 2009-2013
Authors: Hannah Haylea A. , Miramontes Roque , Gandhi Neel R. 
Published: April 2017

Objectives: The objectives of our study were (1) to determine risk factors associated with tuberculosis (TB)–specific and non–TB-specific mortality among patients with TB and (2) to examine whether risk factors for TB-specific mortality differed from those for non–TB-specific mortality. Methods: We obtained data from the National Tuberculosis Surveillance System and included all patients who had TB between 2009 and 2013 in the United States and its territories. We used multinomial logistic regression analysis to determine the adjusted odds ratio (aOR) of each risk factor for TB-specific and non–TB-specific mortality. Results: Of 52 175 eligible patients with TB, 1404 died from TB, and 2413 died from other causes. Some of the risk factors associated with the highest odds of TB-specific mortality were multidrug-resistant TB diagnosis (aOR = 3.42; 95% CI, 1.95-5.99), end-stage renal disease (aOR = 3.02; 95% CI, 2.23-4.08), human immunodeficiency virus infection (aOR = 2.63; 95% CI, 2.02-3.42), age 45-64 years (aOR = 2.57; 95% CI, 2.01-3.30) or age ≥65 years (aOR = 5.76; 95% CI, 4.37-7.61), and immunosuppression (aOR = 2.20; 95% CI, 1.71-2.83). All of these risk factors except multidrug-resistant TB were also associated with increased odds of non–TB-specific mortality. Conclusion: TB patients with certain risk factors have an elevated risk of TB-specific mortality and should be monitored before, during, and after treatment. Identifying the predictors of TB-specific mortality may help public health authorities determine which subpopulations to target and where to allocate resources.
The evolution of directors duties: bridging the divide between corporate governance and corporate social responsibility
Authors: Clarke Thomas 
Published: April 2017

However challenging the prospects, there are growing indications of large corporations taking their social and environmental responsibilities more seriously, and of these issues becoming more critical in the business agenda. The substance of company reports is changing, from purely environmental reporting up until 1999, to sustainability reporting (social, environmental and economic), which has become the mainstream approach of global companies. Though some of the expressed concern may be part of the discourse of political correctness, there does appear to be a significant shifting of opinion among executives. At the confluence of these multiple emerging initiatives and trends towards greater corporate social and environmental responsibility, there is emerging a dynamic stakeholder model for driving enlightened shareholder value (or more expansively, stakeholder values). This article examines how the duty to promote the success of the company offers legal encouragement to pursue responsible strategies on the part of directors and managers, and how legal and moral liability is converging. Similarly, the effect of the modern prudent investor rule is that institutional investor decision-makers are given latitude to follow a wide range of diversified investment strategies, provided their choice of investments is rational and economically defensible, they may sustain a portfolio balanced by environmental, social and governance criteria.
Strategies of Iranian nurses to overcome professional discrimination: An explorative qualitative study
Authors: Shohani Masoumeh 
Published: April 2017

Background: Discrimination is a situation in which individuals receive unequal social benefits in return for equal roles they play. They react to such a situation in different ways. Objective: This study aims at identifying the strategies used by Iranian nurses to overcome professional discrimination. Research design: This qualitative study was conducted with the participation of 23 nurses who worked in hospitals in the cities of Tehran, Tabriz, and Ilam. They were selected based on purposive sampling. Data were collected using deep and unstructured interviews in a period of time between May 2013 and June 2014. Interviews were simultaneously analyzed using conventional content analysis method after being transcribed. Ethical consideration: This study was approved by the Regional Committee of Medical Research Ethics. Also, voluntary participation, anonymity, and confidentiality were considered. Finding: “Presenting a positive image of oneself,” “objection,” and “expectation” were three themes extracted through data analysis. Discussion: Organizational discrimination puts nurses under stress and pressure. Nurses react to unfair behavior in different ways. These reactions are harmful to an organization and lead to negative consequences. Conclusion: Professional discrimination has made nurses adopt strategies which would lead to such consequences, which in turn influences their performance as nurses.
Ethics interventions for healthcare professionals and students: A systematic review
Authors: Stolt Minna , Leino-Kilpi Helena , Ruokonen Minka , Repo Hanna , Suhonen Riitta 
Published: April 2017

Background: The ethics and value bases in healthcare are widely acknowledged. There is a need to improve and raise awareness of ethics in complex systems and in line with competing needs, different stakeholders and patients’ rights. Evidence-based strategies and interventions for the development of procedures and practice have been used to improve care and services. However, it is not known whether and to what extent ethics can be developed using interventions. Objectives: To examine ethics interventions conducted on healthcare professionals and healthcare students to achieve ethics-related outcomes. Research design: A systematic review. Methods: Five electronic databases were searched: CINAHL, the Cochrane Library, Philosopher’s Index, PubMed and PsycINFO. We searched for published articles written in English without a time limit using the keywords: ethic* OR moral* AND intervention OR program OR pre-post OR quasi-experimental OR rct OR experimental AND nurse OR nursing OR health care. In the four-phased retrieval process, 23 full texts out of 4675 citations were included in the review. Data were analysed using conventional content analysis. Ethical consideration: This systematic review was conducted following good scientific practice in every phase. Findings: It is possible to affect the ethics of healthcare practices through professionals and students. All the interventions were educational in type. Many of the interventions were related to the ethical or moral sensitivity of the professionals, such as moral courage and empowerment. A few of the interventions focused on identifying ethical problems or research ethics. Conclusion: Patient-related outcomes followed by organisational outcomes can be improved by ethics interventions targeting professionals. Such outcomes are promising in developing ethical safety for healthcare patients and professionals.
How work setting and job experience affect professional nurses’ values
Authors: Fernández-Feito Ana , Palmeiro-Longo María del Rosario , Hoyuelos Salomé Basurto , García-Díaz Vanesa 
Published: April 2017

Background: The development of professional values in nursing is directly related to quality and ethical clinical practise and may also increase practitioner and patients’ satisfaction. Some factors, such as work setting or work experience, can influence the importance granted to the professional values of nursing. Objectives: To compare in primary care nurses and hospital care nurses the importance granted to professional values and to contrast this perception as a function of professional experience. Research design, participants and research context: Descriptive cross-sectional study. Participants were 380 nursing professionals from the public health system (primary care and hospital care). Three dimensions were analysed: ethics, professional expertise and professional mastery. Data were collected from January to June 2015. Ethical considerations: We obtained permission from the Ethics Committee and participants’ informed consent. Findings: Hospital care professionals attached more importance to all the values analysed, regardless of their work experience. Ethical values, such as confidentiality and respect for the person, were considered to be very important in both systems. Values related to professional expertise obtained lower scores, especially in primary care. In general, professionals with more than 20 years’ experience granted less importance to the values. Conclusion: The professional setting influenced the importance assigned to professional nursing values, and clear differences were observed between primary and hospital care. The domain of ethics was considered the most important. It is necessary to reflect on the significance attributed to professional values, especially in more expert nursing staff.
Dysregulation of energy metabolism in multiple sclerosis measured in vivo with diffusion-weighted spectroscopy
Authors: Bodini Benedetta , Branzoli Francesca , Poirion Emilie , García-Lorenzo Daniel , Didier Mélanie , Maillart Elisabeth , Socha Julie , Bera Geraldine , Lubetzki Catherine , Ronen Itamar , Lehericy Stephane , Stankoff Bruno 
Published: April 2017

Objective: We employed diffusion-weighted magnetic resonance spectroscopy (DW-MRS), which allows to measure in vivo the diffusion properties of metabolites, to explore the functional neuro-axonal damage and the ongoing energetic dysregulation in multiple sclerosis (MS). Methods: Twenty-five patients with MS and 18 healthy controls (HC) underwent conventional magnetic resonance imaging (MRI) and DW-MRS. The apparent diffusion coefficient (ADC) of total N-acetyl-aspartate (tNAA) and creatine–phosphocreatine (tCr) were measured in the parietal normal-appearing white matter (NAWM) and in the thalamic grey matter (TGM). Multiple regressions were used to compare metabolite ADCs between groups and to explore clinical correlations. Results: In patients compared with HCs, we found a reduction in ADC(tNAA) in the TGM, reflecting functional and structural neuro-axonal damage, and in ADC(tCr) in both NAWM and TGM, possibly reflecting a reduction in energy supply in neurons and glial cells. Metabolite ADCs did not correlate with tissue atrophy, lesional volume or metabolite concentrations, while in TGM metabolite ADCs correlated with clinical scores. Conclusion: DW-MRS showed a reduction in tCr diffusivity in the normal-appearing brain of patients with MS, which might reflect a state of ongoing energy dysregulation affecting neurons and/or glial cells. Reversing this energy dysregulation before neuro-axonal degeneration arises may become a key objective in future neuroprotective strategies.
Pharmacology, pharmacokinetics, and metabolism of the DNA-decoy AYX1 for the prevention of acute and chronic post-surgical pain
Authors: Mamet Julien , Harris Scott , Klukinov Michael , Yeomans David C , Donahue Renee R , Taylor Brad K , Eddinger Kelly , Yaksh Tony , Manning Donald C 
Published: April 2017

Background AYX1 is an unmodified DNA-decoy designed to reduce acute post-surgical pain and its chronification with a single intrathecal dose at the time of surgery. AYX1 inhibits the transcription factor early growth response protein 1, which is transiently induced at the time of injury and triggers gene regulation in the dorsal root ganglia and spinal cord that leads to long-term sensitization and pain. This work characterizes the AYX1 dose-response profile in rats and the link to AYX1 pharmacokinetics and metabolism in the cerebrospinal fluid, dorsal root ganglia, and spinal cord. Results The effects of ascending dose-levels of AYX1 on mechanical hypersensitivity were measured in the spared nerve injury model of chronic pain and in a plantar incision model of acute post-surgical pain. AYX1 dose-response profile shows that efficacy rapidly increases from a minimum effective dose of ∼ 0.5 mg to a peak maximum effective dose of ∼ 1 mg. With further dose escalation, the efficacy paradoxically appears to decrease by ∼ 30% and then returns to full efficacy at the maximum feasible dose of ∼ 4 mg. The reduction of efficacy is associated to doses triggering a near-saturation of AYX1 metabolism by nucleases in the cerebrospinal fluid and a paradoxical reduction of AYX1 exposure during the period of early growth response protein 1 induction. This effect is overcome at higher doses that compensate for the effect of metabolism. Discussion AYX1 is a competitive antagonist of early growth response protein 1, which is consistent with the overall increased efficacy observed as dose-levels initially escalate. Chemically, AYX1 is unprotected against degradation by nucleases. The sensitivity to nucleases is reflected in a paradoxical reduction of efficacy in the dose-response curve. Conclusions These findings point to the importance of the nuclease environment of the cerebrospinal fluid to the research and development of AYX1 and other intrathecal nucleotide-based therapeutics.
Impact of Design on Patient Participation in Healthcare in a Rural Health Clinic in Appalachia: A Qualitative Pilot Study
Authors: Haddox John Christopher 
Published: April 2017

Objectives: A pilot study exploring how elderly patients of a rural outpatient health clinic in Appalachia perceive design elements of the facility as imposing barriers to healthcare participation. Background: Outpatient clinics play a critical role in the delivery of healthcare in rural settings in Appalachia. While the concept of patient participation in healthcare does not enjoy a widely adopted, standardized definition, it is believed that patients who are more actively engaged in their healthcare will potentially realize improved health outcomes. This study examines the role facility design could play in participation. Methods: A pilot qualitative study was conducted involving focus groups with a targeted elderly population of a rural outpatient clinic in southern West Virginia. The goal was to assess the perceptions of impacts of clinical design elements on participation. Results: Patients identified and characterized 10 design-related elements they felt impacted participation. Conclusions: The design of the outpatient clinic has the potential to impact the level of engagement of patients in the healthcare process, thus providing another leverage point for improving population health in rural settings.
A case of acute acquired obstructive hydrocephalus in a cat with suspected ischaemic cerebellar infarct
Authors: Raimondi Francesca , Lourinho Filipa , Scott Harry , Shihab Nadia 
Published: April 2017

Case summary A case of acquired acute obstructive hydrocephalus that developed as a complication of an ischaemic infarct in the vascular territory of the rostral cerebellar artery is described in an adult domestic shorthair cat. The clinical findings, diagnostic investigations, treatment and prognosis are reported. MRI findings are described in detail. Relevance and novel information This is the first report of obstructive hydrocephalus as a complication of an ischaemic infarct in the region of the rostral cerebellar artery in a cat. MRI findings are described in detail with regard to the recognition of the early signs of obstructive hydrocephalus. A brief review of the literature is included, as this complication has been frequently reported in humans.
Changes Within Clinical Practice After a Randomized Controlled Trial of Knee Arthroscopy for Osteoarthritis
Authors: Amin Nirav H. , Hussain Waqas , Ryan John , Morrison Shannon , Miniaci Anthony , Jones Morgan H. 
Published: April 2017

Background: In 2002, Moseley et al published a randomized controlled trial (RCT) that showed no difference between knee arthroscopy and placebo for patients with osteoarthritis (OA). We wanted to assess the impact of the trial on clinical practice in the United States. Purpose/Hypothesis: To evaluate changes in knee arthroscopy practice before and after publication of the article by Moseley et al and to assess the effect of this landmark RCT on the behavior of practicing orthopaedic surgeons. We hypothesized that after publication of the Moseley trial, the overall frequency of knee arthroscopy would decrease, that the mean age of patients undergoing knee arthroscopy would decrease, and that the proportion of arthroscopies for a diagnosis of OA would decrease. Study Design: Descriptive epidemiology study. Methods: The State Ambulatory Surgery Database was used to analyze cases from 1998 to 2006, which were classified as meniscus tear, OA, or OA with meniscus tear. Changes in age, surgery rates, and case classification were evaluated before and after Moseley’s trial using Student t tests and analysis of variance. Results: After publication of the trial, the number of knee arthroscopies per year increased from 155,057 in 1998 to 172,317 in 2006 ( P ≤ .001). Mean patient age increased from 47.6 to 49.2 years ( P < .001). Meniscus tears increased from 69.1% to 70.8%, representing approximately 15,500 additional cases per year. OA decreased from 10.6% to 7.2%, representing approximately 4000 fewer cases per year. OA with meniscus tear increased from 20.3% to 22.0%, representing approximately 6400 additional cases per year. Conclusion: While overall age and rates of knee arthroscopy increased contrary to our hypothesis, we identified a decrease in rates of knee arthroscopy for OA after publication of the Moseley trial, demonstrating that well-publicized RCTs can influence patterns of clinical practice.
Outcomes After Posterior Cruciate Ligament (PCL) Reconstruction in Patients With Isolated and Combined PCL Tears
Authors: Mygind-Klavsen Bjarne , Nielsen Torsten Grønbech , Lind Martin Carøe 
Published: April 2017

Background: Posterior cruciate ligament (PCL) reconstructions are rarely performed compared with that for the anterior cruciate ligament (ACL). Purpose: To evaluate the clinical and functional outcome after isolated or multiligament PCL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent PCL reconstruction between 2002 and 2010 were included. Standardized follow-up was performed between 2012 and 2013 and consisted of subjective scores (Tegner activity score, Knee injury and Osteoarthritis Outcome Score [KOOS], and subjective International Knee Documentation Committee [IKDC] score) and objective measures, including knee laxity (KT-1000), extension strength, and overall IKDC score. Results: One hundred ninety-six patients were identified, of which 172 were available for postoperative follow-up: 39.3% with isolated PCL and 60.7% with multiligament injury. One hundred ten patients were available to complete both clinical follow-up and subjective questionnaires; 62 patients returned the subjective questionnaires. Mean follow-up was 5.9 years (range, 3.1-9.7 years). KOOS scores at follow-up in the isolated PCL group by subscale were 74 (symptoms), 76 (pain), 80 (activities of daily living), 55 (sport), and 55 (quality of life). Scores for patients in the multiligament group were 73 (symptoms), 79 (pain), 82 (activities of daily living), 53 (sport), and 56 (quality of life). Tegner scores were 4.5 and 4.4, respectively, and subjective IKDC scores were 63.8 and 65.0. The mean side-to-side difference in knee laxity was 2.7 mm in the isolated PCL group compared with 2.8 mm in the multiligament group. At 1-year follow-up there were significant differences in KOOS outcome scores between the isolated PCL subgroup and the multiligament subgroup, but no differences at final follow-up. Twelve patients (5%) had PCL revision surgery within the follow-up period. Conclusion: Despite the type of injury, there were only minor differences in knee laxity and subjective outcome scores between the isolated PCL group and the multiligament group. The overall revision rate in this study was 5.2%.