bluuebunny/crossref_metadata_2025_split huggingface dataset:
Collaborative Care for Psychiatric Disorders in Older Adults: A Systematic Review
Authors: Dham Pallavi , Colman Sarah , Saperson Karen , McAiney Carrie , Lourenco Lillian , Kates Nick , Rajji Tarek K. 
Published: July 2017

Objective: To evaluate the mode of implementation, clinical outcomes, cost-effectiveness, and the factors influencing uptake and sustainability of collaborative care for psychiatric disorders in older adults. Design: Systematic review. Setting: Primary care, home health care, seniors’ residence, medical inpatient and outpatient. Participants: Studies with a mean sample age of 60 years and older. Intervention: Collaborative care for psychiatric disorders. Methods: PubMed, MEDLINE, Embase, and Cochrane databases were searched up until October 2016. Individual randomized controlled trials and cohort, case-control, and health service evaluation studies were selected, and relevant data were extracted for qualitative synthesis. Results: Of the 552 records identified, 53 records (from 29 studies) were included. Very few studies evaluated psychiatric disorders other than depression. The mode of implementation differed based on the setting, with beneficial use of telemedicine. Clinical outcomes for depression were significantly better compared with usual care across settings. In depression, there is some evidence for cost-effectiveness. There is limited evidence for improved dementia care and outcomes using collaborative care. There is a lack of evidence for benefit in disorders other than depression or in settings such as home health care and general acute inpatients. Attitudes and skill of primary care staff, availability of resources, and organizational support are some of the factors influencing uptake and implementation. Conclusions: Collaborative care for depressive disorders is feasible and beneficial among older adults in diverse settings. There is a paucity of studies on collaborative care in conditions other than depression or in settings other than primary care, indicating the need for further evaluation.
A Nine-Year Experience with Autologous Fat Transplantation
Authors: Bircoll Mel 
Published: July 2017

When I first introduced the concept of autologous fat transplantation (AFT) in 1984, many professionals responded with enthusiasm. Others, far more vocal, responded with skepticism and derision. This latter response was similar to the one received by liposuction when it was first introduced. Now, nine years later, AFT is used worldwide for a variety of cosmetic and reconstructive procedures. Its use has stimulated the study of injectable autologous materials, and the development of other autologous materials such as injectable collagen. It is indeed a procedure that points a way to the future.
Constricted Breast Deformity in Augmentation Mammoplasty
Authors: Yvorchuk William 
Published: July 2017

There has been a resurgence in the demand for elective breast enhancement over the latter portion of this decade. Endoscopic technology has expanded the techniques available for breast augmentation, and treatment programs for a number of breast deformities have been elucidated. The constricted and tuberous breast deformities have previously been defined, but there appears to be a lack of recognition of minor variations of the constricted breast deformity and, to date, there has been no satisfactory clinical classification of this relatively common entity. A proposal for the classification of the constricted breast deformity is presented along with a recommendation on the possible treatment for different variations of the deformity.
Micronutrient Alterations During Continuous Renal Replacement Therapy in Critically Ill Adults: A Retrospective Study
Authors: Kamel Amir Y. , Dave Nisha J. , Zhao Vivian M. , Griffith Daniel P. , Connor Michael J. , Ziegler Thomas R. 
Published: July 2017

AbstractBackground: Continuous renal replacement therapy (CRRT) is commonly used to provide renal replacement therapy in the intensive care unit. Limited published data suggest that CRRT may lead to depletion of water‐soluble vitamins and trace elements. The goal of this study was to identify the incidence of trace element and vitamin deficiencies in critically ill patients during CRRT. Materials and Methods: This study is based on a retrospective chart review of patients who were referred to Emory University Hospital’s nutrition support services and had at least 1 serum micronutrient level measured during CRRT (thiamin, pyridoxine, ascorbic acid, folate, zinc, and copper) between April 1, 2009, and June 1, 2012. Results: Seventy‐five patients were included in the study. Nine of 56 patients (16%) had below‐normal whole blood thiamin concentrations, and 38 of 57 patients (67%) had below‐normal serum pyridoxine levels. Serum ascorbic acid and folate deficiencies were identified among 87% (13 of 15) and 33% (3 of 9) of the study patients, respectively. Nine of 24 patients had zinc deficiency (38%), and 41 of 68 patients had copper deficiency (60%). Of the 75 total subjects, 60 patients (80%) had below‐normal levels of at least 1 of the micronutrients measured. Conclusions: The incidence of various micronutrient deficiencies in critically ill patients who required CRRT was higher than previously reported. Prospective studies are needed to determine the impact of CRRT on micronutrient status and the potential clinical and metabolic efficacy of supplementation in the intensive care unit setting.
Diagnostic Yield and Outcomes of Computed Tomography of the Head in Critically Ill Nontrauma Patients
Authors: Finkelmeier Fabian , Walter Sophie , Peiffer Kai-Henrik , Cremer Anjali , Tal Andrea , Vogl Thomas , Zeuzem Stefan , Fichtlscherer Stephan , Friedrich-Rust Mireen , Bojunga Jörg , Farnik Harald 
Published: July 2017

Background: Computed tomography of the head (HCT) is a widely used diagnostic tool, especially for emergency and trauma patients. However, the diagnostic yield and outcomes of HCT for patients on medical intensive care units (MICUs) are largely unknown. Methods: We retrospectively evaluated all head CTs from patients admitted to a single-center MICU during a 5-year period for CT indications, diagnostic yield, and therapeutic consequences. Uni- and multivariate analyses for the evaluation of risk factors for positive head CT were conducted. Results: Six hundred ninety (18.8%) of all patients during a 5-year period underwent HCT; 78.7% had negative CT results, while 21.3% of all patients had at least 1 new pathological finding. The main indication for acquiring CT scan of the head was an altered mental state (AMS) in 23.5%, followed by a new focal neurology in 20.7% and an inadequate wake up after stopping sedation in 14.9% of all patients. The most common new finding was intracerebral bleeding in 6.4%. In 6.7%, the CT scan itself led to a change of therapy of any kind. Admission after resuscitation or a new focal neurology were independent predictors of a positive CT. Psychic alteration and AMS were both independent predictors of a higher chance of a negative head CT. Positive HCT during MICU is an independent predictor of lower survival. Conclusions: New onset of focal neurologic deficit seems to be a good predictor for a positive CT, while AMS and psychic alterations seem to be very poor predictors. A positive head CT is an independent predictor of death for MICU patients.
Establishing Clinical Pharmacy Services With Prescribing Privileges in a Federally Qualified Health Center Primary Care Clinic
Authors: Jun Jeany K. 
Published: July 2017

Objectives: To describe the process and cost of establishing clinical pharmacy services with prescribing privileges in a federally qualified health center (FQHC) primary care clinic. Setting: The primary care clinic was located in a low-income area of Southern California and served patients with Medicaid and Medicare. The primary care clinic had preventive medicine and family medicine physicians, a family medicine residency program, behavioral health services, and a registered dietician. Practice Innovation: New clinical pharmacy services were established at this FQHC primary care clinic. The medication assistance program was a stepping stone to establish rapport with the physicians. Credentialing and privileging was implemented for clinical pharmacists. An open protocol collaborative practice agreement was developed to allow clinical pharmacists to manage ambulatory patients. Results: From August 2014 to June 2015, the clinical pharmacist interacted with 392 patients and spent 336 hours educating patients and providing disease state management. The pharmacist also provided consults to residents and providers. Diabetic patients made up 76% of all clinical pharmacy encounters. There were 86 face-to-face clinical pharmacy appointments with the pharmacist. The average time for clinical pharmacy appointments was 77 minutes. Conclusion: By describing ways to develop rapport with providers, how to credential and privilege pharmacists, and explain resources and costs of setting up a service, the hope is that more clinical pharmacists will be able to incorporate into independent or FQHC primary care clinics for improved management of ambulatory patients.
Relationship between moral distress and ethical climate with job satisfaction in nurses
Authors: Asgari Sharareh , Shafipour Vida , Taraghi Zohreh , Yazdani-Charati Jamshid 
Published: July 2017

Background: Moral distress and ethical climate are important issues in the workplace that appear to affect people’s quality of work life. Objectives: This study was conducted to determine the relationship of moral distress and ethical climate to job satisfaction in critical care nurses. Materials and methods: This descriptive-correlation study was conducted on 142 critical care nurses, selected from five social security hospitals in north Iran through census sampling. Data were collected using a demographic questionnaire, the Moral Distress Scale–Revised, the Olson’s Hospital Ethical Climate Survey, and the Brayfield and Rothe Job Satisfaction index. Ethical considerations: The research project was approved by the Ethics Committee of Mazandaran University of Medical Sciences and the Medical Deputy of the Social Security Organization. Findings: The mean scores obtained by the critical care nurses for moral distress, ethical climate, and job satisfaction were 87.02 ± 44.56, 3.51 ± 0.53, and 62.64 ± 9.39, respectively. Although no significant relationships were observed between moral distress and job satisfaction, the relationship between ethical climate and job satisfaction was statistically significant (p < 0.05). Conclusion: Identifying ethical stressors in the workplace and giving proper feedback to the authorities to eliminate these factors and improve the ethical climate in these workplaces can help enhance job satisfaction in nurses and lead to higher quality care.
Psychometrics of the Instrument Measuring Beliefs Related to Drug Abuse among Iranian College Students
Authors: Jalilian Farzad , Alavijeh Mehdi Mirzaei , Ahmadpanah Mohammad , Matin Behzad Karami , Ataee Mari , Eslami Ahmad Ali , Jouybari Touraj Ahmadi , Mahboubi Mohammad 
Published: July 2017

Background: Researchers in the field of drug abuse need standard instruments in order to investigate the underlying factors behind the inclination to use drugs in different groups of society so that they could be able to design preventive interventions based on those instruments. The aim of this study is psychometrics of the questionnaire of the beliefs related to drug abuse among Iranian male medical college students. Methods: This cross-sectional study was done on 425 male students who were randomly selected to participate voluntarily in the study conducted in two medical universities in Iran. The studied constructs included attitude, outcome expectation, outcome expectancies, self-control and subjective norms. Data were analyzed by SPSS software (ver. 21.0) and Amos software (ver. 21.0). Results: All of the loads of the exploratory factorial analysis were larger than 0.4. The calculated Kaiser–Meyer–Olkin (KMO) value was 0.906. Overall, five factors under investigation accounted for 61.15 per cent of the variance in the hypothesized model. Cronbach’s alpha for the measured constructs including attitude, outcome expectation, outcome expectancies, self-control and subjective norms were 0.92, 0.90, 0.91, 0.81 and 0.73, respectively. Conclusion: The investigated questionnaire is adequately reliable and valid for measurement of the constructs of attitude, outcome expectation, outcome expectancies, self-control and subjective norms for prediction of drug abuse among Iranian male medical college students.
Women Living with HIV/AIDS
Authors: Malik Anu , Dixit Shikha 
Published: July 2017

The main aim of this review article is to outline the factors linked to vulnerability of women to HIV infection and to understand the challenges and possible management of HIV among women. The review is a theoretical endeavour to understand women’s experiences of living with HIV. This review primarily focuses on studies in the Indian set-up, but to further substantiate the arguments and describe the relevant concepts it also takes into account literature from other cultures. On the basis of studies included in this article, it can be surmised that women are more susceptible to HIV due to cultural barriers, health vulnerabilities and social structures. They show less awareness about the treatment facilities, prevention strategies and perceived risk of infection. Women have to face numerous challenges after the infection, such as lack of social support, a higher level of stigma and discrimination, decreased quality of life, mental health issues and adverse coping. To prevent the spread of HIV among women as well as men, it is necessary to plan strategies which deal with empowerment of women, education and awareness regarding the vulnerabilities and knowledge and challenges of HIV infection. There is also a need to address the management of HIV among the infected and even those at risk. This article describes the possible interventions based on existing literature. The review also attempts to suggest certain future directions for the research.
Influence of Emotional Labour on Job Satisfaction among Employees of Private Hospitals
Authors: Kaur Sandeep , Malodia Luxmi 
Published: July 2017

Background: With globalization, world has become so competitive that every organization is cracking the hard nut to obtain the reward from this. Service sector has been working on the mantra that customer is the king. Purpose: The objective of this study is to find out the influence of emotional labour on job satisfaction among employees in selected private hospitals of Punjab. The data were collected from 586 employees through stratified random sampling. Methods: Dutch questionnaire on emotional labour (D-QEL) developed and validated by Näring, Briët & Brouwers (2007) and job satisfaction tool by Sharma and Tripathy (2010) were used to collect the data. Descriptive statistics was applied to check the level of emotional labour and job satisfaction, t-test and ANOVA were applied for testing hypothesis. Structural equation modelling was applied to find out the influence of emotional labour on job satisfaction. Conclusions: There was no significant difference in the level of emotional labour and job satisfaction for demographic variables such as age, gender, marital status, designations and years of experience. There was a significant influence of emotional labour on job satisfaction of the employees in selected private hospitals of Punjab. Emotional labour was negatively related with job satisfaction. Out of various dimensions of emotional labour: deep acting and emotional consonance had emerged as major cause of job satisfaction
Efficiency of Microfinance Institutions in India: A Stochastic Distance Function Approach
Authors: Kumar Nitin , Sensarma Rudra 
Published: July 2017

We examine the efficiency–outreach debate in the context of Indian microfinance institutions (MFIs). We employ the stochastic distance function approach for 75 MFIs during 2004–2011. We find that there are significant inefficiency effects but efficiency is improving over time. Among the determinants of inefficiency, average loan balance per borrower and number of women borrowers appear to improve efficiency. This suggests that the efficiency–outreach debate is more nuanced than that presented in the literature and depends on the way outreach is defined. Profitability, size and leverage seem to increase efficiency, whereas age of the MFI is associated with higher inefficiency. JEL Classification: G21, C51, C33 Disclaimer: The views expressed in the research article are solely of the authors and not of the organizations to which they belong. All the errors, omissions etc. if any, are the responsibility of the authors.
Publish or perish: Dr Victor Webster and cardiazol treatment in Western Australia, 1937–1938
Authors: Martyr Philippa 
Published: July 2017

Objective: To examine the role of Dr Victor Henry Webster (1905–1980) in the introduction of cardiazol therapy to Western Australia in November 1937. Method: A range of primary and secondary sources were consulted. Results: Webster experimented with cardiazol treatment at Heathcote Reception Home, and published his findings in April 1938, at the same time as Ellery and Lear, but was not able to publish his results in a nationally-recognised journal. As a result, his contribution to early cardiazol treatment in Australia has been largely forgotten. Conclusions: Webster made a genuine contribution to the introduction of cardiazol treatment in Australia, and his story illustrates the need to publish early findings of new physical therapies.
Supervision: ‘a random bag of arrangements’? Perspectives from psychiatrists on how to improve clinical teaching
Authors: Cheung Gary , Stephan Alice 
Published: July 2017

Objective: The aim of this study was to explore psychiatrists’ perspectives on how clinical teaching and supervision can be improved in postgraduate psychiatric training. Method: All New Zealand members of the Royal Australian and New Zealand College of Psychiatrists (fellows: n=367; affiliates: n=167) were invited to participate in an online survey that collected responses to two open-ended questions. The responses were then analysed qualitatively. Results: A total of 27% psychiatrists responded. Two major themes emerged: supervisor competencies and the workplace educational environment, with subthemes of supervisor training, feedback and culture change. Conclusions: Suggestions to improve clinical teaching and supervision included defining supervisor teaching competencies, instituting evidence-based faculty development, a feedback structure and strengthening leadership support for workplace-based education.
Activity-based funding in mental health: a disastrous path
Authors: de Jong Gideon 
Published: July 2017

Objectives: On the basis of the experience of the Netherlands, this critical commentary will argue why activity-based funding (ABF) in mental health care is a disastrous path that Australia should not take. Conclusions: ABF leads to an exponential growth in health care spending as it encourages diagnostic inflation and overproductivity. It also leads to fraud and an increased bureaucracy that goes hand in hand with demoralisation among health workers. And finally, the increasing treatment claims leads to the reintroduction of productivity limitations, waiting lists and ultimately austerity measures in order to halt the untamed growth of spending.
Utilization of capecitabine plus oxaliplatin and 5-fluorouracil/folinic acid plus oxaliplatin in the adjuvant treatment of stage IIB and stage III colon cancer: A multi-centre, retrospective, chart review study
Authors: Sha Aaron , Abadi Shirin , Gill Sharlene 
Published: July 2017

Purpose First, to assess drug utilization rates of capecitabine plus oxaliplatin (CAPOX) versus 5-fluorouracil plus oxaliplatin (mFOLFOX6) regimens in the treatment of stage IIB and stage III colon cancer. Second, to assess patient characteristics used to select CAPOX versus FOLFOX therapy, dose-limiting toxicities, dose intensities and treatment completion rates. Methods Patients with resected stage IIB or stage III colon cancer from five British Columbia Cancer Agency centres treated with CAPOX or mFOLFOX6 were selected for the analysis. Protocol utilization rates, patient characteristics and toxicities of the two regimens were collected and compared by descriptive statistics. Results A total of 306 patients were included over study period. mFOLFOX6 is the most commonly used regimen with 69% utilization rate. CAPOX patients were younger (57 years old vs. 62 years old, p < 0.01), but no other significant differences were found. CAPOX was associated with more dose-limiting toxicities compared to mFOLFOX6 (95% vs. 82%, p < 0.01). Fewer patients completed the intended 24-week course of CAPOX compared to mFOLFOX6 (67% vs. 82%, p < 0.01). Conclusion FOLFOX is the most commonly utilized adjuvant treatment option for stage IIB and stage III colon cancer in British Columbia, and is associated with better tolerability and higher treatment completion rates.
Severe Fat Accumulation in Multiple Organs in Pediatric Autopsies
Authors: Bleeker Jeannette C , Visser Gepke , Wijburg Frits A , Ferdinandusse Sacha , Waterham Hans R , Nikkels Peter G J 
Published: July 2017

Background The observation of fat accumulation in different organs at pediatric autopsy may help determine the cause of death. However, a comprehensive study on fat accumulation and related etiologies is still lacking. Aim To investigate the incidence of fat accumulation in different organs in pediatric autopsies and their relevance to the cause of death. Methods From February 2004 until March 2015, fat accumulation was assessed in 561 routinely performed pediatric autopsies in our center. Age at death ranged from 14 weeks of gestation for fetuses to 16 years. Samples of liver, heart, kidney, and muscle were stained with Oil-Red-O and scored for fat accumulation by one pediatric pathologist. Results Fat accumulation in ≥1 organ(s) was present in 132 (39.8%) of 332 prenatal cases. Only 3 (0.9%) had fat accumulation in all 4 organs. For postnatal cases, fat accumulation in ≥1 organ(s) was present in 106 (46.3%) of 229 postnatal cases. Only 12 (5.2%) had fat accumulation in all 4 organs. Fat accumulation was mostly seen in liver, both in prenatal and postnatal cases. Fatty acid oxidation disorders were the only cause of death associated with severe fat accumulation in all 4 organs. No other etiologies could be linked directly to distribution or severity of fat accumulation. Conclusion Severe fat accumulation in at least 4 organs is a rare finding in pediatric autopsies, whereas fat accumulation in only the liver is relatively common. Severe fat accumulation in both liver, muscle, kidney, and heart was only seen in cases with fatty acid oxidation disorders.