bluuebunny/crossref_metadata_2025_split huggingface dataset:
The changes in biochemical parameters due to wine consumption depending on gender
Authors: Gažarová Martina , Chlebová Zuzana , Predná Lenka , Chlebo Peter , Habánová Marta 
Published: October 2016

The aim of this study was to investigate the effect of red wine consumption on the lipid profile and glucose in the group of male (13 men aged 34 - 64 years) and the group of female (11 women aged 28 - 57 years). Research consisted of moderate red wine consumption for 6 weeks. The dose of alcohol ranged from 200 to 300 mL per day of red wine Lemberger (Winery Masaryk, Slovakia). The blood samples were obtained after overnight fasting and were collected at baseline and after three days, three weeks and six weeks of wine consumption. Differences between male and female subjects were reflected in the results of different biochemical parameters in the dynamics of wine consumption. We found out that while in females the total cholesterol level did not change significantly and had a predominantly downward trend, for male subjects we observed at the beginning the slight increase of the levels, which, however, after 6 weeks of consumption significantly decreased from an initial value of 5.75 ±1.32 mmol.L-1 to 5.35 ±1.25 mmol.L-1 (p <0.05). The blood concentration of triglycerides in the dynamics of the experiment did not change significantly in either one gender, although small differences were observed, because while the female subjects had triglyceride development over consumption upward trend in male subjects it was vice versa. LDL-cholesterol changed significantly only in the group of female. Level of this lipid parameter decreased significantly during the six weeks of consumption of Lemberger from an initial value 3.37 ±0.68 mmol.L-1 to the lowest 2.99 ±0.61 mmol.L-1, which was recorded in the third week of consumption (p <0.0001), but statistically significant differences versus baseline we monitored after three days and six weeks of consumption (p <0.01). In the group of male, we did not observe such significant changes, but it should be noted, that the men had changes in LDL-cholesterol downward direction and all the values were in the range of benchmarks. In the group of female, HDL-cholesterol increased to 2.05 ±0.6 mmol.L-1 after six weeks of consumption from baseline of 1.7 ±0.69 mmol.L-1, and the difference was statistically significant (p <0.05), in the group of male, its level changed first significantly after three days of consumption of steep increase (1.46 ±0.61 mmol.L-1, p <0.05), and for the next six weeks, it was the significantly increase (1.59 ±0.5 mmol.L-1, p <0.01). The glucose concentration did not change significantly in the dynamics of wine consumption among men and women, and all the values were between the limits of the standard.
Through a Glass, Darkly: The Challenge of Integration of the Science and the Art of Medicine.
Authors: Wyer Peter , Silva Suzana Alves 
Published: October 2016

We have entered a new phase in the dialogue between proponents of evidence-based medicine and humanistic medicine. Over 30 years of parallel development of patient-centered and evidence-based care make possible concrete approaches to the integration of the fruits of these developments. Such integration is of increasing importance to the viability of today’s highly structured and regulated healthcare environment. Attempts at integrated model building on the part of proponents of both EBM and humanistic care have suffered from common deficiencies. These include the failure to distinguish between decision-making and practice models, failure to illuminate processes traversing categories of knowledge and information, failure to embrace the principles of relationship-centered care and failure adequately to address the epistemological issues inherent to the integration of the experiential and scientific domains of clinical practice. A published model-building attempt is used to illustrate what a correction of such limitations might look like. Efforts to develop person-centered care as an integrated and patient-centered vision of healthcare are encouraged.
Exploring the macro level barriers that affect Iranian GPs’ diagnosis and management of depression disorders
Authors: Shirazi Mandana , Gandomkar Roghayeh , Ponzer Sari , Silen Charlotte 
Published: October 2016

Background: The fact that general practitioners (GPs) find it difficult to detect and treat depression is a worldwide concern. This is also the case in Iran, where this study was conducted. Educational interventions have been used to support GPs in their work when treating patients with depression disorders.Objective: To explore GPs' views regarding macro level barriers of the management of depression in primary care settings.Methods: In this qualitative study, semi-structured interviews exploring GPs’ views, beliefs and experiences regarding the diagnosis and treatment of depression were done. A purposeful sampling to obtain a broad range of views was carried out among GPs that had previously participated in an educational intervention study. Eleven GPs were interviewed and their views were probed in depth to get rich descriptions to ensure trustworthiness of the data. The data were analyzed by using qualitative content analysis.Results: GPs’ beliefs regarding macro level barriers emerged as 2 significant themes Organizational and Society-Related factors. The Organizational factors included barriers related to the local health network system and organizational support and the Society-Related factors included economic, cultural and social factors. The individual GP´s opinions about management strategies seemed not to be related to their perceptions of macro level barriers.Conclusion: The results of this study imply that a number of macro level obstacles were of great importance when managing patients with depression disorders. In order to improve the effectiveness of CME events they should be tailored for the actual context and the infrastructural issues that is, organizational and societal factors should be addressed.
What patients know: evidence-based medicine and its discontents in the U.S.
Authors: Tanenbaum Sandra 
Published: October 2016

Almost 20 years ago, the New England Journal of Medicine published this author’s article entitled, “What Physicians Know” [1]. In it, I raised epistemological challenges to evidence-based medicine (EBM), noting the limitations of probabilistic knowledge for patient care. Since that time, EBM has put down strong roots in medicine and health policy but research policy, at least in the U.S., has begun to acknowledge the shortcomings of EBM’s hierarchy of knowing and now inches toward a more pluralistic view of medical knowledge. In 2010, the Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute (PCORI), a public-private entity charged with defining, facilitating and funding patient-centered comparative effectiveness research (CER). Not only does PCORI expressly recognize the limits of RCTs and the strengths of other statistical study designs, but it legitimizes individual patient and practitioner knowledge as a component of medical decision-making. PCORI's Methodology Committee presented its draft report to the Board on May 10, 2012, and a month earlier, the Institute had announced the funding of 50 pilot research projects. Upon review, both the report and the proposed projects can be said to more often, but not always, challenge the tenets of traditional EBM and value what patients know.
Carer-centred care: general practice support to family caregivers
Authors: Pyer Michelle , Campbell Jackie , Ward Alison 
Published: October 2016

Rationale, aims and objectivesIn February 2009 the UK’s Department of Health invited bids for funding to host demonstrator sites in order to test new approaches to working with and for carers within the national Carers’ Strategy [1; 2]. This paper discusses some of the findings of the local level evaluation of one of the host sites, situated in Northamptonshire. MethodsA mixed-method approach was used to gather data from a range of participant groups. This paper presents the findings of two of those methods; a postal survey of carers and an audit of support offered by general practices. ResultsThe findings of the evaluation show a considerable improvement in the extent to which carers’ roles were identified by their surgeries, however there is a need to ensure that this information is recorded and used in ways which benefit carers. Carers noted challenges in dealing with practice staff, particularly administrative staff who were not aware of their needs. Practices noted a range of services which were offered to carers, however carers were not always aware that these were available, suggesting that further publication of these opportunities is needed. ConclusionsThe paper argues the importance of the role undertaken by carers, and signals the range of ways in which General Practice can support or inhibit these activities.
Examining preference of elderly for adding indication to the prescription label (Rx Label)
Authors: Sakharkar Prashant , Zargarzadeh Amir , Law Anandi 
Published: October 2016

Rationale and aim To examine preference of the elderly for adding indication (medication use/purpose) to prescription label, reasons for their preference and its association with demographic characteristics. Methods A convenience sample of 143 patients of age 65 or older, who took at least one prescription medication every day were interviewed using a structured questionnaire. The data were analyzed for descriptive statistics, correlation for demographic characteristics with participant’s preference for adding indication to prescription label using the Chi-square and Fisher’s exact test. Regression analysis was conducted to predict participant’s preference. Results Participants were ethnically diverse, majority being female (60.8%), with average age of 76.9 yrs. Twenty nine percent participants had more than high school education. About 91% participants preferred adding indications to their prescription label for the reasons: “managing medication by category” (29%), “distinguishing medications” (69%), and “reducing confusion” (29%). Adult daycare centers and community pharmacy participants with lower than high school education showed higher preference for adding indication for reducing confusion and distinguishing medication, respectively. Whereas, Hispanic/Latino participants of adult daycare centers preferred for the reason, distinguishing medications (p<0.05). Age, race/ethnicity and education were found to be good predictors of their preference. Conclusion The elderly showed higher preference for adding indication to the prescription label for improving their ability to distinguish medications and reduce confusion. Our results suggest a need for adopting recently released USP patient-centered prescription label standards, which also include adding indication to the Rx labels.
Anomalous enhancement of Seebeck coefficients of the graphene/hexagonal boron nitride composites
Authors: Nakamura Jun , Akaishi Akira 
Published: October 2016

Abstract
Thermoelectric devices convert heat energy to electric power. The dimensionless thermoelectric figure of merit, ZT, is used as a standard criterion for efficiency of thermoelectric conversion. This criterion requires a high Seebeck coefficient, a high electric conductivity, and a low thermal conductivity. In this regard, PbTe, BiTe, and their alloys consisting of relatively heavier elements have been found to show higher values of ZT. In this paper, we focus on the potential of graphene-based composites as thermoelectric materials. Graphene was considered to be a disadvantageous material because of its extremely high thermal conductance and relatively low Seebeck coefficient. However, it has been reported recently that a structural modulation is an effective way of raising the thermoelectric ability of graphene. We introduce the recent progress in the design of graphene-based materials for thermoelectric devices. In particular, we provide a focused investigation of our recent progress regarding the thermopower enhancement in nanoarchitectonics, superlattices, and composites consisting of graphene and hexagonal BN nanoribbons. It has been shown that low-dimensional modulations are effective ways of obtaining a high thermoelectric performance of graphene-based materials.
Enhanced diffraction of MeV γ-rays by mosaic crystals
Authors: Matsuba Shunya , Hayakawa Takehito , Shizuma Toshiyuki , Nishimori Nobuyuki , Nagai Ryoji , Sawamura Masaru , Angell Christopher T. , Fujiwara Mamoru , Hajima Ryoichi 
Published: October 2016

Abstract
The diffraction of γ-rays by mosaic Si crystals with thicknesses of 20, 40, and 80 mm and by a 2-mm-thick perfect Si crystal in a transmission Laue geometry was measured using a high-flux 60Co source with an intensity of 2.2 TBq. The measured diffraction intensities at 1.17 and 1.33 MeV using 40- and 80-mm-thick mosaic crystals were enhanced by a factor of approximately 8.6 compared with those of the perfect Si crystal. The integrated reflectivity is well described in statistical dynamical theory by taking into account γ-ray absorption inside the crystals.
Referência e contrarreferência no cotidiano da atenção à saúde de Divinópolis-MG, Brasil: o suporte às decisões da atenção primária Reference and counter-reference in everyday health care in Minas Gerais, Brazil: the support to decisions of primary care
Authors: Melo Duane Ferreira de Melo Ferreira , Criscuolo Maria Beatriz Rodrigues Criscuolo Rodrigues , Viegas Selma Maria Fonseca 
Published: October 2016

Objetivo: Compreender, na percepção dos profissionais e gestores da Atenção Primária à Saúde (APS), o sistema de referência e contrarreferência na atenção à saúde e o suporte às decisões dos profissionais da APS.Métodos: Estudo qualitativo, delineado pelo Estudo de Casos Múltiplos Holísticos, fundamentado na Sociologia Compreensiva do Cotidiano com 41 participantes. Resultados: O suporte às decisões dos profissionais da APS ao encaminhar os usuários é dependente do fluxo e da regulação das demandas referenciadas; do tempo de espera do usuário para o atendimento; pode ser prejudicado pelos encaminhamentos desnecessários e ilegíveis e pela visão dos profissionais sobre o sistema.Conclusão: A Saúde é um processo social, de construção coletiva, e que precisa vencer o paradigma assistencialista e curativista, o consumo excessivo de consultas com elevado índice de encaminhamentos.
Facilidades e dificuldades das enfermeiras gerentes na implementação da gerência do cuidado no ambiente hospitalar Facilities managers and difficulties of nurses in the implementation of environmental management of care hospital
Authors: Fernandes Marcelo Costa , Silva Francisca Maria Pereira da , Costa Stéphany Pereira da , Andrade Mayara Evangelista de 
Published: October 2016

Objetivo: Analisar as facilidades e dificuldades das enfermeiras gerentes na implementação da gerência do cuidado no ambiente hospitalar. Métodos: Trata-se de um estudo descritivo, com abordagem qualitativa realizado no período de outubro a novembro de 2012, em um hospital público de nível terciário da cidade de Fortaleza-CE. A coleta de dados foi feita através de entrevista semiestruturada, a técnica utilizada para a interpretação dos dados foi à análise de conteúdo. Resultados: Foram encontrados como fatores facilitadores no desenvolvimento da gerência do cuidado o apoio da líder do setor de enfermagem do hospital e a relação dialética entre os membros da equipe. Como fatores impeditivos observaram-se a estrutura física do hospital e a falta de pessoal. Conclusão: O estudo busca sensibilizar a discussão sobre a gerência do cuidado, pois a articulação entre as atividades gerenciais e de cuidado, é importante para inovação e renovação do processo de trabalho do enfermeiro.
Acesso e vínculo ao tratamento de tuberculose na atenção primária em saúde Acess and link to treatment of tuberculosis in primary health care
Authors: Neves Rubia Rodrigues , Ferro Priscila dos Santos , Nogueira Laura Maria Vidal , Rodrigues Ivaneide Leal Ataíde 
Published: October 2016

Objetivo: Avaliar o acesso aos serviços de atenção primária à saúde para o controle da tuberculose, identificando as facilidades e dificuldades, além de analisar a forma como os doentes são acolhidos pela equipe multidisciplinar. Método: Estudo operacional realizado em cinco Unidades Básicas de Saúde do município de Belém. Constituíram a amostra 34 doentes com tuberculose. Estudo aprovado pelo Comitê de Ética em Pesquisa, sob Parecer nº 206.875.Resultados: Constatou-se como facilidades para o acesso ao tratamento a proximidade da Unidade Básica de Saúde à residência dos doentes, o pouco tempo de espera para a consulta e o vínculo com a equipe de saúde. Como dificuldade identificou-se a não realização de visitas domiciliares. Conclusão: O fortalecimento do vínculo, a garantia de acesso e o acolhimento pela equipe de saúde são fatores que podem contribuir para o sucesso do tratamento. Descritores: tuberculose; acesso aos serviços de saúde; atenção primária em saúde.
A diagnostic study on heavy rainfall induced by Typhoon Utor (2013) in South China: 1. Rainfall asymmetry at landfall
Authors: Meng Weiguang , Wang Yuqing 
Published: October 2016

AbstractAfter striking the Philippines on 11 August 2013, Typhoon Utor made its second landfall over southern South China on 14 August and brought heavy rainfall, causing widespread damages after its landfall. The heavy rainfall associated with Utor includes three main episodes: rainfall at landfall, postlandfall rainfall in the inner core region, and postlandfall rainfall induced by the intensification of southwesterly monsoon flow. In part 1 the rainfall at landfall is analyzed and diagnosed using the surface mesonet observations and the high‐resolution European Centre for Medium‐Range Weather Forecasting Interim reanalysis (ERA‐Interim) data. Results show that when Utor approached and made landfall over the southern coast of South China, it was embedded in a deep‐layer (200–850 hPa) easterly northeasterly vertical wind shear (VWS) environment with heavy rainfall mostly occurring downshear left in its southwestern quadrant. Under a favorable environment with moderate convective available potential energy and moderate low‐level VWS, a surface cold pool was found in the west‐southwestern quadrants of Utor triggered by the middle‐lower tropospheric dry air intrusion from inland to the north. Both frontogenesis and quasi‐balanced, ageostrophic Q‐vector diagnostics demonstrate that the quasi‐balanced forcing near the surface cold cool contributed to the enhancement of convection in the west‐southwestern quadrants of Utor. It is concluded that the environmental VWS and the consequent surface cold pool dynamics play an important role in rainfall asymmetry in Utor when it made landfall over the southern coast of South China.
Climatic drivers for multidecadal shifts in solute transport and methane production zones within a large peat basin
Authors: Glaser Paul H. , Siegel Donald I. , Chanton Jeffrey P. , Reeve Andrew S. , Rosenberry Donald O. , Corbett J. Elizabeth , Dasgupta Soumitri , Levy Zeno 
Published: October 2016

AbstractNorthern peatlands are an important source for greenhouse gases, but their capacity to produce methane remains uncertain under changing climatic conditions. We therefore analyzed a 43 year time series of the pore‐water chemistry to determine if long‐term shifts in precipitation altered the vertical transport of solutes within a large peat basin in northern Minnesota. These data suggest that rates of methane production can be finely tuned to multidecadal shifts in precipitation that drive the vertical penetration of labile carbon substrates within the Glacial Lake Agassiz Peatlands. Tritium and cation profiles demonstrate that only the upper meter of these peat deposits was flushed by downwardly moving recharge from 1965 to 1983 during a Transitional Dry‐to‐Moist Period. However, a shift to a moister climate after 1984 drove surface waters much deeper, largely flushing the pore waters of all bogs and fens to depths of 2 m. Labile carbon compounds were transported downward from the rhizosphere to the basal peat at this time producing a substantial enrichment of methane in Δ14C with respect to the solid‐phase peat from 1991 to 2008. These data indicate that labile carbon substrates can fuel deep production zones of methanogenesis that more than doubled in thickness across this large peat basin after 1984. Moreover, the entire peat profile apparently has the capacity to produce methane from labile carbon substrates depending on climate‐driven modes of solute transport. Future changes in precipitation may therefore play a central role in determining the source strength of peatlands in the global methane cycle.
Time scales of foam stability in shallow conduits: Insights from analogue experiments
Authors: Spina L. , Scheu B. , Cimarelli C. , Arciniega‐Ceballos A. , Dingwell D.B. 
Published: October 2016

AbstractVolcanic systems can exhibit periodical trends in degassing activity, characterized by a wide range of time scales. Understanding the dynamics that control such periodic behavior can provide a picture of the processes occurring in the feeding system. Toward this end, we analyzed the periodicity of outgassing in a series of decompression experiments performed on analogue material (argon‐saturated silicone oil plus glass beads/fibers) scaled to serve as models of basaltic magma. To define the effects of liquid viscosity and crystal content on the time scale of outgassing, we investigated both: (1) pure liquid systems, at differing viscosities (100 and 1000 Pa s), and (2) particle‐bearing suspensions (diluted and semidiluted). The results indicate that under dynamic conditions (e.g., decompressive bubble growth and fluid ascent within the conduit), the periodicity of foam disruption may be up to several orders of magnitude less than estimates based on the analysis of static conditions. This difference in foam disruption time scale is inferred to result from the contribution of bubble shear and bubble growth to inter‐bubble film thinning. The presence of particles in the semidiluted regime is further linked to shorter bubble bursting times, likely resulting from contributions of the presence of a solid network and coalescence processes to the relative increase in bubble breakup rates. Finally, it is argued that these experiments represent a good analogue of gas‐piston activity (i.e., the periodical rise‐and‐fall of a basaltic lava lake surface), implying a dominant role for shallow foam accumulation as a source process for these phenomena.