bluuebunny/crossref_metadata_2025_split huggingface dataset:
Walking the Line: Navigating Market and Gift Economies of Care in a Consumer‐Directed Home‐Based Care Program for Older Adults
Authors: TORRES JACQUELINE M. , KIETZMAN KATHRYN G. , WALLACE STEVEN P. 
Published: December 2015

Policy Points:
Policies that cut or restrict formal long‐term services and supports for older adults can either push caregivers to provide uncompensated care or leave older adults with unmet needs for care.
Increased pressure to provide uncompensated care to older adults in the aftermath of cuts in formal services can have negative economic and health consequences for both related and nonrelated caregivers.
Policies that assume (implicitly or explicitly) that related caregivers can readily fill gaps in care (and that unrelated caregivers will not) should be reassessed. Both related and unrelated caregivers face financial and health‐related barriers to filling gaps in formal services for older adults.
ContextPaid caregivers of low‐income older adults navigate their role at what Hochschild calls the “market frontier”: the fuzzy line between the “world of the market,” in which services are exchanged for monetary compensation, and the “world of the gift,” in which caregiving is uncompensated and motivated by emotional attachment. We examine how political and economic forces, including the reduction of long‐term services and supports, shape the practice of “walking the line” among caregivers of older adults.MethodsWe used data from a longitudinal qualitative study with related and nonrelated caregivers (n = 33) paid through California's In‐Home Supportive Services (IHSS) program and consumers of IHSS care (n = 49). We analyzed the semistructured interviews (n = 330), completed between 2010 and 2014, using a constructivist grounded theory approach.FindingsRelated and nonrelated caregivers are often expected to “gift” hours of care above and beyond what is compensated by formal services. Cuts in formal services and lapses in pay push caregivers to further “walk the line” between market and gift economies of care. Both related and nonrelated caregivers who choose to stay on and provide more care without pay often face adverse economic and health consequences. Some, including related caregivers, opt out of caregiving altogether. While some consumers expect that caregivers would be willing to “walk the line” in order to meet their needs, most expressed sympathy for them and tried to alter their schedules or go without care in order to limit the caregivers’ burden.ConclusionsGiven economic and health constraints, caregivers cannot always compensate for cuts in formal supports by providing uncompensated time and resources. Similarly, low‐income older adults are not competitive in the caregiving marketplace and, given the inadequacy of compensated hours, often depend on unpaid care. Policies that restrict formal long‐term services and supports thus leave the needs of both caregivers and consumers unmet.
How Effective Are Incident‐Reporting Systems for Improving Patient Safety? A Systematic Literature Review
Authors: STAVROPOULOU CHARITINI , DOHERTY CAROLE , TOSEY PAUL 
Published: December 2015

Policy Points:
Incident‐reporting systems (IRSs) are a method of error reporting to enable organizational learning. Despite their significant cost, however, little is known about their effectiveness for improving patient safety.
Our systematic literature review found no strong evidence that IRSs perform better than other forms of reporting. In addition, although we show that IRSs can improve clinical settings and processes, we found little evidence that they ultimately improve outcomes or enable cultural changes.
IRSs could work more effectively if the reportable incidents used are defined more clearly and the IRSs have clinical ownership and integration with wider safety programs.
ContextIncident‐reporting systems (IRSs) are used to gather information about patient safety incidents. Despite the financial burden they imply, however, little is known about their effectiveness. This article systematically reviews the effectiveness of IRSs as a method of improving patient safety through organizational learning.MethodsOur systematic literature review identified 2 groups of studies: (1) those comparing the effectiveness of IRSs with other methods of error reporting and (2) those examining the effectiveness of IRSs on settings, structures, and outcomes in regard to improving patient safety. We used thematic analysis to compare the effectiveness of IRSs with other methods and to synthesize what was effective, where, and why. Then, to assess the evidence concerning the ability of IRSs to facilitate organizational learning, we analyzed studies using the concepts of single‐loop and double‐loop learning.FindingsIn total, we identified 43 studies, 8 that compared IRSs with other methods and 35 that explored the effectiveness of IRSs on settings, structures, and outcomes. We did not find strong evidence that IRSs performed better than other methods. We did find some evidence of single‐loop learning, that is, changes to clinical settings or processes as a consequence of learning from IRSs, but little evidence of either improvements in outcomes or changes in the latent managerial factors involved in error production. In addition, there was insubstantial evidence of IRSs enabling double‐loop learning, that is, a cultural change or a change in mind‐set.ConclusionsThe results indicate that IRSs could be more effective if the criteria for what counts as an incident were explicit, they were owned and led by clinical teams rather than centralized hospital departments, and they were embedded within organizations as part of wider safety programs.
Interventions to enhance maternal awareness of decreased fetal movement: a systematic review
Authors: Winje BA , Wojcieszek AM , Gonzalez‐Angulo LY , Teoh Z , Norman J , Frøen JF , Flenady V 
Published: December 2015

BackgroundDecreased fetal movement is associated with adverse pregnancy and birth outcomes; timely reporting and appropriate management may prevent stillbirth.ObjectivesDetermine effects of interventions to enhance maternal awareness of decreased fetal movement.Search strategyCinahl, The Cochrane Library, EMBASE, MEDLINE, PsycINFO and SCOPUS databases; without limitation on language or publication year.Selection criteriaRandomised or non‐randomised studies evaluating interventions to enhance maternal awareness of decreased fetal movement.Data collection and analysisTwo authors independently extracted data and assessed quality.Main resultsWe included 23 publications from 16 studies of fair to poor quality. We were unable to pool results due to substantial heterogeneity between studies. Three randomised controlled trials (RCTs) and five non‐randomised studies (NRSs), involving 72 888 and 115 435 pregnancies, respectively, assessed effects of interventions on stillbirth and perinatal death. One large cluster RCT (n = 68 654) reported no stillbirth reduction, one RCT (n = 3111) reported significant stillbirth reduction, and one RCT (n = 1123) was small with no deaths. All NRSs favoured intervention over standard care; three studies (n = 31 131) reported significant reduction, whereas two studies (n = 84 304) reported non‐significant reductions in stillbirth or perinatal deaths. Promising results from NRSs warrant further research. We found no evidence of increased maternal concern following interventions. No cost‐effectiveness data were available.ConclusionsWe found no clear evidence of benefit or harm; indirect evidence suggests improved pregnancy and birth outcomes. The optimal approach to support women in monitoring their pregnancies needs to be established. Meanwhile, women need to be informed about the importance of fetal movement for fetal health.Tweetable abstractThe benefits and risks of interventions to increase pregnant women's awareness of fetal movement are unclear.
Constitutive Effects of Lead on Aryl Hydrocarbon Receptor Gene Battery and Protection by β‐carotene and Ascorbic Acid in Human HepG2 Cells
Authors: Darwish Wageh S. , Ikenaka Yoshinori , Nakayama Shouta M. M. , Mizukawa Hazuki , Ishizuka Mayumi 
Published: December 2015

AbstractLead (Pb) is an environmental pollutant that can get entry into human body through contaminated foods, drinks, and inhaled air leading to severe biological consequences, and has been responsible for many deaths worldwide. The objectives of this study were 1st to investigate the modulatory effects of environmentally relevant concentrations of Pb on AhR gene battery, which is controlling xenobiotics metabolism. 2nd, trials to reduce Pb‐induced adverse effects were done using some phytochemicals like β‐carotene or ascorbic acid. Human hepatoma (HepG2) cell lines were exposed to a wide range of Pb concentrations varying from physiological to toxic levels (0 to 10 mg/L) for 24 h. High Pb concentrations (1 to 10 mg/L) significantly reduced phase I (CYP1A1 and 1A2) and phase II (UGT1A6 and NQO1) xenobiotic metabolizing enzyme mRNA expression in a mechanistic manner through the AhR regulation pathway. Additionally, these Pb concentrations induced oxidative stress in HepG2 cells in terms of production of reactive oxygen species (ROS) and induced heme oxygenase‐1 mRNA expression in a concentration‐dependent phenomenon. Coexposure of HepG2 cells to physiological concentrations of some micronutrients, like β‐carotene (10 μM) or ascorbic acid (0.1 mM), along with Pb (1 mg/L) for 24 h significantly reduced the levels of ROS production and recovered AhR mRNA expression into the normal levels. Thus, consumption of foods rich in these micronutrients may help to reduce the adverse effects of lead in areas with high levels of pollution.
A phase II study of cyclophosphamide, etoposide, vincristine and prednisone (CEOP) Alternating with Pralatrexate (P) as front line therapy for patients with peripheral T‐cell lymphoma (PTCL): final results from the T‐ cell consortium trial
Authors: Advani Ranjana H. , Ansell Stephen M. , Lechowicz Mary J. , Beaven Anne W. , Loberiza Fausto , Carson Kenneth R. , Evens Andrew M. , Foss Francine , Horwitz Steven , Pro Barbara , Pinter‐Brown Lauren C. , Smith Sonali M. , Shustov Andrei R. , Savage Kerry J. , M. Vose Julie 
Published: December 2015

SummaryPeripheral T‐cell lymphomas (PTCL) have suboptimal outcomes using conventional CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy. The anti‐folate pralatrexate, the first drug approved for patients with relapsed/refractory PTCL, provided a rationale to incorporate it into the front‐line setting. This phase 2 study evaluated a novel front‐line combination whereby cyclophosphamide, etoposide, vincristine and prednisone (CEOP) alternated with pralatrexate (CEOP‐P) in PTCL. Patients achieving a complete or partial remission (CR/PR) were eligible for consolidative stem cell transplantation (SCT) after 4 cycles. Thirty‐three stage II‐IV PTCL patients were treated: 21 PTCL‐not otherwise specified (64%), 8 angioimmunoblastic T cell lymphoma (24%) and 4 anaplastic large cell lymphoma (12%). The majority (61%) had stage IV disease and 46% were International Prognostic Index high/intermediate or high risk. Grade 3–4 toxicities included anaemia (27%), thrombocytopenia (12%), febrile neutropenia (18%), mucositis (18%), sepsis (15%), increased creatinine (12%) and liver transaminases (12%). Seventeen patients (52%) achieved a CR. The 2‐year progression‐free survival and overall survial, were 39% (95% confidence interval 21–57) and 60% (95% confidence interval 39–76), respectively. Fifteen patients (45%) (12 CR) received SCT and all remained in CR at a median follow‐up of 21·5 months. CEOP‐P did not improve outcomes compared to historical data using CHOP. Defining optimal front line therapy in PTCL continues to be a challenge and an unmet need.
How I manage Evans Syndrome and AIHA cases in children
Authors: Miano Maurizio 
Published: December 2015

SummaryThe management of Evans Syndrome in children is challenging due to the lack of evidence‐based data on treatment. Steroids, the first‐choice therapy, are successful in about 80% of cases. For children who are resistant, relapse or become steroid‐dependent, rituximab is considered a valid second‐line treatment, with the exception of those with an underlying diagnosis of autoimmune lymphoproliferative syndrome who may benefit from other options such as mycophenolate mofetil and sirolimus. Better knowledge of the immunological mechanisms underlying cytopenias and the availability of new immunosuppressive drugs can be helpful in the choice of more targeted therapies that would enable the reduction of the use of long‐term steroid administration or other more aggressive options, such as splenectomy or stem cell transplantation. This manuscript provides an overview of the pathogenic background of the disease, and suggests a clinical approach to diagnosis and treatment with a particular focus on the management of relapsing/resistant disease.
Semi‐quantitative myocardial perfusion measured by computed tomography in patients with refractory angina: a head‐to‐head comparison with quantitative rubidium‐82 positron emission tomography as reference
Authors: Qayyum Abbas Ali , Kühl Jørgen Tobias , Kjaer Andreas , Hasbak Philip , Kofoed Klaus Fuglsang , Kastrup Jens 
Published: December 2015

SummaryIntroductionComputed tomography (CT) is a novel method for assessment of myocardial perfusion and has not yet been compared to rubidium‐82 positron emission tomography (PET). We aimed to compare CT measured semi‐quantitative myocardial perfusion with absolute quantified myocardial perfusion using PET and to detect stenotic territories in patients with severe coronary artery disease.Materials and methodsEighteen patients with stenosis narrowing coronary arteries ≥70% demonstrated on invasive coronary angiography underwent rest and adenosine stress imaging obtained by 320‐multidetector CT scanner and CT/PET 64‐slice scanner. CT measured myocardial attenuation density (AD) and perfusion index (PI) were correlated to absolute PET myocardial perfusion values.ResultsRest AD, rest and stress PI did not correlate to PET findings (r = 0·412, P = 0·113; r = 0·300, P = 0·259; and r = 0·508, P = 0·064, respectively). However, there was a significant correlation between stress AD and stress PET values (r = 0·670, P = 0·009) and between stress and rest differences for AD and PI with PET differences (r = 0·620, P = 0·006; and r = 0·639, P = 0·004, respectively). Furthermore, significant differences were observed between remote and stenotic territories for rest and stress AD (48 ± 14HU and 37 ± 16HU, P = 0·002; 76 ± 19HU and 58 ± 13HU, P<0·001, respectively), PI (9·6 ± 2·9 and 7·5 ± 3·1, P = 0·002; 21·6 ± 4·1 and 16·9 ± 3·9, P<0·001, respectively) and PET (0·96 ± 0·37 ml g−1 min−1 and 0·86 ± 0·26 ml g−1 min−1, P = 0·036; 2·07 ± 0·76 ml g−1 min−1 and 1·61 ± 0·76 ml g−1 min−1, P = 0·006, respectively).ConclusionsSemi‐quantitative CT parameters may be useful in the detection of myocardium subtended by stenotic coronary arteries.
Clinical symptoms predict concurrent social and global functioning in an early psychosis sample
Authors: Cacciotti‐Saija Cristina , Langdon Robyn , Ward Philip B. , Hickie Ian B. , Guastella Adam J. 
Published: December 2015

AbstractAimAlthough well established in chronic schizophrenia, the key determinants of functioning remain unknown during the early phase of a psychotic disorder. The aim of this study was to comprehensively examine the social cognitive, basic neurocognitive and clinical predictors of concurrent social functioning and global functioning in an early psychosis sample.MethodsThis study examined the relationship between social cognition, basic neurocognition and clinical symptoms with concurrent functioning in 51 early psychosis individuals. Assessments included a range of self‐report, observational and clinician‐rated measures of cognitive, symptom severity and functioning domains.ResultsResults revealed a significant association between self‐reported social function and lower levels of both social interaction anxiety and negative psychotic symptoms. A significant association was also observed between lower levels of negative psychotic symptoms and observed social functioning. Lastly, results demonstrated a significant association between reduced negative psychotic symptoms and clinician‐rated global functioning.ConclusionsClinical domains such as negative symptoms and social interaction anxiety significantly contribute to an optimal model predicting outcome during the early phase of a psychotic disorder. These clinical features may also provide useful markers of an individual's capacity for social participation. Clinical implications include the need for early targeted intervention to address social anxiety and negative psychotic symptoms to facilitate optimum patient outcome.
Pride, Shame, and the Trouble with Trying to Be Normal
Authors: Gideonse Theodore K. 
Published: December 2015

AbstractI performed 14 person‐centered ethnographies with methamphetamine‐using HIV‐positive men who have sex with men in San Diego, California, who were all subjects of the “anti‐meth apparatus,” a collection of government and nongovernment organizations focused on meth use and its sequelae. The apparatus attempts to coerce addicts to develop and perform certain identities and emotions, though addicts are capable of both passive acceptance and active disruption. In my research, those who failed to become the apparatus's ideal subject felt shame, while those who succeeded expressed pride. Those hovering in the middle experienced a perpetual struggle to become normal and rarely, if ever, succeeded.
Juvenile Transfers to Adult Court: An Examination of the Long‐Term Outcomes of Transferred and Non‐Transferred Juveniles
Authors: Taylor Melanie 
Published: December 2015

AbstractJuveniles who are transferred to adult court are more likely to recidivate than non‐transferred juveniles, but limited research has examined how transfer can impact other life outcomes like attending college and employment. To examine this issue, data from theNationalLongitudinalSurvey ofYouth (1997) were analyzed from 1998 to 2011. It was found that court involvement during adolescence does not harm educational attainment. However, prosecution of juveniles in adult court significantly impairs earning potential well into adulthood. The current study provides further evidence of the long‐term harms caused by transfer and demonstrates how transfer further disrupts the desistance process.
Incomplete type of intestinal metaplasia has the highest risk to progress to gastric cancer: results of the Spanish follow‐up multicenter study
Authors: González Carlos A. , Sanz‐Anquela José Miguel , Companioni Osmel , Bonet Catalina , Berdasco María , López Consuelo , Mendoza Jorge , Martín‐Arranz Mª Dolores , Rey Enrique , Poves Elvira , Espinosa Laura , Barrio Jesús , Torres Mª Ángeles , Cuatrecasas Miriam , Elizalde Ignasi , Bujanda Luis , Garmendia Maddi , Ferrández Ángel , Muñoz Guillermo , Andreu Victoria , Paules Mª Jose , Lario Sergio , Ramírez Mª Jose ,   Study group, Gisbert Javier P. 
Published: December 2015

AbstractBackground and AimIn high or moderate risk populations, periodic surveillance of patients at risk of progression from gastric precursor lesions (PL) to gastric cancer (GC) is the most effective strategy for reducing the burden of GC. Incomplete type of intestinal metaplasia (IIM) may be considered as the best candidate, but it is still controversial and more research is needed. To further assess the progression of subtypes of IM as predictors of GC occurrence.MethodsA follow‐up study was carried‐out including 649 patients, diagnosed with PL between 1995–2004 in 9 participating hospitals from Spain, and who repeated the biopsy during 2011–2013. Medical information and habits were collected through a questionnaire. Based on morphology, IM was sub‐classified as complete (small intestinal type, CIM) and incomplete (colonic type, IIM). Analyses were done using Cox (HR) models.ResultsAt baseline, 24% of patients had atrophic gastritis, 38% CIM, 34% IIM, and 4% dysplasia. Mean follow‐up was 12 years. 24 patients (3.7%) developed a gastric adenocarcinoma during follow‐up. The incidence rate of GC was 2.76 and 5.76 per 1,000 person‐years for those with CIM and IIM, respectively. The HR of progression to CG was 2.75 (95% CI 1.06‐6.26) for those with IIM compared with those with CIM at baseline, after adjusting for sex, age, smoking, family history of GC and use of NSAIDs.ConclusionsIIM is the PL with highest risk to progress to GC. Sub‐typing of IM is a valid procedure for the identification of high risk patients that require more intensive surveillance.
Aggression in fragile X syndrome
Authors: Wheeler A. C. , Raspa M. , Bishop E. , Bailey D. B. 
Published: December 2015

AbstractBackgroundIndividuals with fragile X syndrome (FXS), especially men, have long been described as presenting with significant behavioural challenges. Despite this known aspect of the phenotype, there has been little research exploring the prevalence, frequency, nature or consequences of aggressive behaviour in FXS.MethodsThis study used survey methodology to gather caregiver reports on the types, frequency and severity of aggressive behaviour in 774 individuals with FXS.ResultsBased on caregiver report, nearly all (>90%) male and female individuals were reported to have engaged in some aggression over the previous 12 months, with a third of male cases and slightly fewer than 20% of female cases being described as engaging in moderate to severe aggression or being diagnosed or treated for aggression. Further, aggressive behaviours in male individuals were serious enough that 30% had caused injuries to caregivers and 22% had caused injuries to peers or friends. Sensory issues and hyperactivity were significant predictors of the frequency of aggressive acts, while sensory issues and anxiety were predictive of the severity of aggression. Traditional behaviour management techniques as well as medication was described as the most common and successful treatment options.ConclusionsAggressive behaviours are a significant concern for a subsample of both male and female individuals with FXS. Given that sensory concerns were predictive of both the frequency and the severity of aggression suggests these behaviours may be a reactive means of escaping uncomfortable situations.