bluuebunny/crossref_metadata_2025_split huggingface dataset:
Large-Scale Organizational and Managerial Change in Health Care: A Review of the Literature
Authors: Ferlie Ewan 
Published: February 2018

This paper takes an overview of the organizational and managerial literature on recent large-scale change efforts within health care organizations. Such literature refers to issues of enhanced policy significance, as a succession of such changes has swept through health care, at an international level. Interpretive and case study method have been widely employed in this field. While the literature is emergent, key empirical concerns can be identified: (1) Changing roles and relationships, with the rise of management and the challenge to clinical domination; some argue that radical deprofessionalization now is evident, while others take a more nuanced view. (2) The impact of marketization, with health care becoming more of a commodity; various models of a health care ‘quasi market’ have been formulated. (3) Understanding the process of change in health care organizations, such as the development of a management of change literature. New theoretical frameworks have been developed, notably ‘the reform cycle’ as a way of understanding progressive cycles of organizational reform, the impact on health care of the rise of the new public management, and examining the demedicalization thesis through the more generic literature on professions. The paper concludes with a discussion of what this research base could contribute to policy-making.
Nursing, Knowledge and Practice
Authors: Allen Davina 
Published: February 2018

Recent commentators have suggested that academic knowledge is irrelevant to nursing practice and may actually undermine nursing's traditional caring ethos. Furthermore, by making nursing more academic, it is claimed that ‘natural’ but non-academic carers are prevented from pursuing a career in nursing. Debates about the relationship between nursing, knowledge and practice have a long history and have to be understood in terms of wider political and economic issues relating to nursing, its status within society and the changing role of nurses within the health services division of labour. One crucial issue is nursing's status as women's work. Critics of developments in nurse education draw an ideological equation between nursing work and the traditional female role. From this perspective the qualities that make a good nurse cannot be taught, rather they are founded on ‘natural’ feminine skills. Irrespective of whether caring is ‘natural’ or not, it is questionable as to whether, for today's nurses, being caring is sufficient. The shape of nursing jurisdiction is a long way removed from its origins in the Victorian middle-class household. In addition to their traditional caring role, contemporary nurses may also have complex clinical, management and research responsibilities, as well as being crucial co-ordinators of service provision. It is suggested that these and future developments in health services make the need for an educated nursing workforce even more pressing. In order to adequately prepare nurses for practice, however, it is vital that nurse education reflects the reality of service provision.
Distributional Dilemmas in Health Policy: Large Benefits for a Few or Smaller Benefits for Many?
Authors: Choudhry Niteesh , Slaughter Pamela , Sykora Kathy , Naylor C. David 
Published: February 2018

Objectives: To examine funding priorities assigned by health ministry officials when choosing between clinical programs that offer similar overall benefits distributed in different ways (e.g. large gains for a few versus small gains for many), and to compare the relative magnitude of any distributional bias to age biases. Methods: A survey consisting of paired hypothetical health care programs was mailed to the 135 most senior officials of the Health Ministry in Ontario, Canada (population 11.5 million). Respondents were asked to assume they were members of a panel allocating a fixed sum of money to one of two programs in each pair. All program descriptions included the number of persons affected each year by a given disease and the average survival gains from the hypothetical programs. Some scenarios also mentioned the side-effects associated with programs and/or the average age of the beneficiaries. Results: Four respondents had retired/died. Of 131 eligible respondents, 80/131 (61%) provided usable responses. Asked to choose between providing large benefits to a few citizens and small benefits to a great many, 23% (95% CI: 14%, 33%) of respondents were unable to decide, but 55.8% (95% CI: 47%, 70%) favored providing large benefits to fewer patients. Eliminating the 23% unable to decide, 47/62 or 76% (CI: 63%, 86%) expressed a distributional preference. With a smaller distributional discrepancy, indecision increased, with 35% of respondents having no preference and the remainder split almost evenly between the two programs. Other scenarios showed that health officials' pro-youth biases were only slightly larger than their distributional preferences and that distributional preferences were magnified when combined with minor differences in average ages of beneficiaries. Conclusions: A substantial minority of health care decision-makers had difficulty choosing between programs with similar overall gains and distributional differences — a result consistent with the utilitarian assumptions of cost-effectiveness analysis. However, when distributional differences were large, decision-makers clearly favored large gains for a few beneficiaries rather than small gains for many. Policy analysts should explicitly weigh distributional issues along with aggregate health gains when addressing resource allocation problems.
What makes online substance-use interventions engaging? A systematic review and narrative synthesis
Authors: Milward Joanna , Drummond Colin , Fincham-Campbell Stephanie , Deluca Paolo 
Published: February 2018

Background Online substance-use interventions are effective in producing reductions in harmful-use. However, low user engagement rates with online interventions reduces overall effectiveness of interventions. Identifying optimal strategies with which to engage users with online substance-use interventions may improve usage rates and subsequent effectiveness. Objectives (1) To identify the most prevalent engagement promoting strategies utilised to increase use of online substance-use interventions. (2) To determine whether the identified engagement promoting strategies increased said use of online substance-use interventions. Review methods The reviewed followed Cochrane methodology. Databases were searched for online substance-use interventions and engagement promoting strategies limited by study type (randomised controlled trial). Due to heterogeneity between engagement promoting strategies and engagement outcomes, meta-analytic techniques were not possible. Narrative synthesis methods were used. Results Fifteen studies were included. Five different engagement promoting strategies were identified: (1) tailoring; (2) delivery strategies; (3) incentives; (4) reminders; (5) social support. The most frequently reported engagement promoting strategies was tailoring (47% of studies), followed by reminders and social support (40% of studies) and delivery strategies (33% of studies). The narrative synthesis demonstrated that tailoring, multimedia delivery of content and reminders are potential techniques for promoting engagement. The evidence for social support was inconclusive and negative for incentives. Conclusions This review was the first to examine engagement promoting strategies in solely online substance-use interventions. Three strategies were identified that may be integral in promoting engagement with online substance-use interventions. However, the small number of eligible extracted studies, inconsistent reporting of engagement outcomes and diversity of engagement features prevent firmer conclusions. More high-quality trials examining engagement are required.
The Role of Prognostic Scoring Systems in Assessing Surgical Candidacy for Patients With Vertebral Metastasis: A Narrative Review
Authors: Cassidy John Tristan , Baker Joseph F. , Lenehan Brian 
Published: February 2018

Study Design: Narrative review. Objectives: To review the relevant literature regarding scoring systems for vertebral metastases and quantify their role in contemporary orthopedic practice. Methods: A literature search of PubMed, Google Scholar, and Embase was performed on February 7, 2017. Eight scoring systems were selected for detailed review—7 of which were scores focused solely on patient prognosis (Tokuhashi, Tomita, Bauer, Oswestry Spinal Risk Index, Van der Linden, Rades, and Katagiri). The eighth system reviewed was the Spinal Instability Neoplastic Score, which examines for impending spinal instability in patients with vertebral metastases and represents a novel approach compared with hitherto scoring systems. Results: The Bauer and Oswestry Spinal Risk Index have the most accurate prognostic predictive ability, with the newer Oswestry Spinal Risk Index being favored by the contemporary literature as it demands less investigation and is therefore more readily accessible. There was a growing trend in studies designed to customize scoring systems for individual cancer pathological subtypes. The Spinal Instability Neoplastic Score shows good reliability for predicting instability among surgeons and oncologists. Conclusions: The increased understanding of cancer pathology and subsequent development of customized treatments has led to prolonged survival. For patients with vertebral metastases, this affects surgical candidacy not only on the basis of prognosis but also provides prolonged opportunity for the development of spinal instability. Scoring systems have a useful guidance role in these deciding for/against surgical intervention, but in order to remain contemporary ongoing review, development, and revalidation is mandatory.
Combination Therapy with Tenofovir Disoproxil Fumarate/Emtricitabine/Elvitegravir/Cobicistat Plus Darunavir Once Daily in Antiretroviral-Naive and Treatment-Experienced Patients: A Retrospective Review
Authors: Naccarato Mark J. , Yoong Deborah M. , Fong Ignatius W. , Gough Kevin A. , Ostrowski Marian A. , Tan Darrell H. S. 
Published: February 2018

Background: Patients with drug-resistant HIV often require complex antiretroviral regimens. However, combining fixed-dose combination tablets such as tenofovir–disoproxil–fumarate, emtricitabine, and cobicistat-boosted elvitegravir (TDF/FTC/EVG/cobi) with darunavir (DRV) can provide a simple, once-daily (QD), 2-tablet regimen for patients with drug-resistant HIV. Primary objective was to determine the percentage of patients with HIV-1 RNA <40 copies/mL at 48 weeks. Methods: We performed a retrospective chart review of patients initiated on TDF/FTC/EVG/cobi plus DRV. Results: Among the 21 included patients, prior resistance showed a median of 2 nucleoside reverse transcriptase inhibitor mutations, 1 nonnucleoside reverse transcriptase mutation, and 1 protease inhibitor mutation. At week 48, 14 (67%) patients achieved HIV-1 RNA <40 copies/mL, 1 patient experienced viral rebound, and 6 (29%) had missing data or discontinued therapy. No patient discontinued for adverse events. Conclusion: According to this observational study, QD TDF/FTC/EVG/cobi plus DRV is considered safe, well tolerated, and generally effective in suppressing HIV drug-resistant virus.
Early-onset invasive aspergillosis and other fungal infections in patients treated with ibrutinib
Authors: Ghez David , Calleja Anne , Protin Caroline , Baron Marine , Ledoux Marie-Pierre , Damaj Gandhi , Dupont Mathieu , Dreyfus Brigitte , Ferrant Emmanuelle , Herbaux Charles , Laribi Kamel , Le Calloch Ronan , Malphettes Marion , Paul Franciane , Souchet Laetitia , Truchan-Graczyk Malgorzata , Delavigne Karen , Dartigeas Caroline , Ysebaert Loïc 
Published: February 2018

Key Points
Ibrutinib may be associated with invasive fungal infections especially IA. Most infections usually occur during the first months of treatment, often in patients with other risk factors for fungal infections.
Complete genome sequence of Pseudomonas alcaliphila JAB1 (=DSM 26533), a versatile degrader of organic pollutants
Authors: Ridl Jakub , Suman Jachym , Fraraccio Serena , Hradilova Miluse , Strejcek Michal , Cajthaml Tomas , Zubrova Andrea , Macek Tomas , Strnad Hynek , Uhlik Ondrej 
Published: February 2018

AbstractIn this study, following its isolation from contaminated soil, the genomic sequence of
Pseudomonas alcaliphila
strain JAB1 (=DSM 26533), a biphenyl-degrading bacterium, is reported and analyzed in relation to its extensive degradative capabilities. The
P. alcaliphila
JAB1 genome (GenBank accession no. CP016162) consists of a single 5.34 Mbp-long chromosome with a GC content of 62.5%. Gene function was assigned to 3816 of the 4908 predicted genes. The genome harbors a bph gene cluster, permitting degradation of biphenyl and many congeners of polychlorinated biphenyls (PCBs), a ben gene cluster, enabling benzoate and its derivatives to be degraded, and phe gene cluster, which permits phenol degradation. In addition,
P. alcaliphila
JAB1 is capable of cometabolically degrading cis-1,2-dichloroethylene (cDCE) when grown on phenol. The strain carries both catechol and protocatechuate branches of the β-ketoadipate pathway, which is used to funnel the pollutants to the central metabolism. Furthermore, we propose that clustering of MALDI-TOF MS spectra with closest phylogenetic relatives should be used when taxonomically classifying the isolated bacterium; this, together with 16S rRNA gene sequence and chemotaxonomic data analyses, enables more precise identification of the culture at the species level.
Guided self-help in a brave new world
Authors: Delgadillo Jaime 
Published: February 2018

SummaryCognitive–behavioural therapy self-help offers an accessible and efficient way to treat common mental disorders. The evidence-based self-help movement has an important foothold in the healthcare arena. This article surveys the emergence of self-help at a particular social and historical junction, and summarises key lessons from experimental and practice-based studies.Declaration of interestNone.
The Endocrine and Metabolic Characteristics of a Large Bardet-Biedl Syndrome Clinic Population
Authors: Mujahid Safa , Hunt Katharine F , Cheah Yee S , Forsythe Elizabeth , Hazlehurst Jonathan M , Sparks Kathryn , Mohammed Shehla , Tomlinson Jeremy W , Amiel Stephanie A , Carroll Paul V , Beales Phillip L , Huda Mohammed S B , McGowan Barbara M 
Published: February 2018

AbstractContextBardet-Biedl syndrome (BBS) is a rare autosomal recessive disorder in which previous reports have described obesity and a metabolic syndrome.ObjectiveWe describe the endocrine and metabolic characteristics of a large BBS population compared with matched control subjects.DesignWe performed a case-control study.SettingThis study was performed at a hospital clinic.PatientsStudy patients had a clinical or genetic diagnosis of BBS.Main Outcome MeasurementsOur study determined the prevalence of a metabolic syndrome in our cohort.ResultsA total of 152 subjects were studied. Eighty-four (55.3%) were male. Mean (± standard deviation) age was 33.2 ± 1.0 years. Compared with age-, sex-, and body mass index–matched control subjects, fasting glucose and insulin levels were significantly higher in subjects with BBS (glucose: BBS, 5.2 ± 1.2 mmol/L vs control, 4.9 ± 0.9 mmol/L, P = 0.04; insulin: BBS, 24.2 ± 17.0 pmol/L vs control, 14.2 ± 14.8 pmol/L, P &lt; 0.001). Serum triglycerides were significantly higher in subjects with BBS (2.0 ± 1.2 mmol/L) compared with control subjects (1.3 ± 0.8 mmol/L; P &lt; 0.001), but total cholesterol, high-density lipoprotein, and low-density lipoprotein were similar in both groups. Systolic blood pressure was higher in the BBS group (BBS, 135 ± 18 mm Hg vs control subjects, 129 ± 16 mm Hg; P = 0.02). Alanine transaminase was raised in 34 (26.8%) subjects with BBS, compared with five (8.9%) control subjects (P = 0.01). The rate of metabolic syndrome, determined using International Diabetes Federation criteria, was significantly higher in the BBS group (54.3%) compared with control subjects (26% P &lt; 0.001). Twenty-six (19.5%) of male subjects with BBS were hypogonadal (serum testosterone, 9.9 ± 5.3 mmol/L), but significant pituitary abnormalities were uncommon. Subclinical hypothyroidism was present in 24 of 125 (19.4%) patients with BBS, compared with 3 of 65 (4.6%) control subjects (P = 0.01).ConclusionsInsulin resistance and the metabolic syndrome are increased in adult patients with BBS compared with matched control subjects. Increased subclinical hypothyroidism in the BBS cohort needs further investigation.
Connection Between BMI-Related Plasma Metabolite Profile and Gut Microbiota
Authors: Ottosson Filip , Brunkwall Louise , Ericson Ulrika , Nilsson Peter M , Almgren Peter , Fernandez Céline , Melander Olle , Orho-Melander Marju 
Published: February 2018

Abstract

Context
Emerging evidence has related the gut microbiome and circulating metabolites to human obesity. Gut microbiota is responsible for several metabolic functions, and altered plasma metabolome might reflect differences in the gut microbiome.

Objective
To identify a plasma metabolite profile associated with body mass index (BMI) in a general population and investigate whether such metabolite profile is associated with distinct composition of the gut microbiota.

Design
Targeted profiling of 48 plasma metabolites was performed in a population of 920 Swedish adults (mean age, 39 years; 53% women) from the ongoing Malmö Offspring Study using targeted liquid chromatography–mass spectrometry. Gut microbiota was analyzed by sequencing the 16S ribosomal RNA gene (V1-V3 region) in fecal samples of 674 study participants.

Results
BMI was associated with 19 metabolites (P &lt; 0.001 for all), of which glutamate provided the strongest direct association (P = 5.2e-53). By orthogonal partial least squares regression, a metabolite principal component predictive of BMI was constructed (PCBMI). In addition to glutamate, PCBMI was dominated by branched-chain amino acids (BCAAs) and related metabolites. Four gut microbiota genera (Blautia, Dorea, Ruminococcus, and SHA-98) were associated with both BMI and PCBMI (P &lt; 8.0e-4 for all). When simultaneously regressing PCBMI and metabolite-associated gut bacteria against BMI, only PCBMI remained statistically significant.

Conclusions
We discovered associations between four gut microbiota genera (Blautia, Dorea, Ruminococcus, and SHA-98) and BMI-predictive plasma metabolites, including glutamate and BCAAs. Thus, these metabolites could be mediators between gut microbiota and obesity, pointing to potential future opportunities for targeting the gut microbiota in prevention of obesity.
Preoperative evaluation of neurovascular relationship in trigeminal neuralgia by three-dimensional fast low angle shot (3D-FLASH) and three-dimensional constructive interference in steady-state (3D-CISS) MRI sequence
Authors: Yang Dengfa , Shen Jianmin , Xia Xianwu , Lin Yeqing , Yang Tiejun , Lin Hanshun , Jin Yong , Zhou Kaiyu , Li Youcheng 
Published: February 2018

Objective:
The purpose of the study was to evaluate the value of high-resolution three-dimensional fast low angle shot (3D-FLASH) and three-dimensional constructive interference in steady-state (3D-CISS) MRI sequence solely or the combination of both in the visualization of neurovascular relationship in patients with trigeminal neuralgia (TN).

Methods:
65 patients with unilateral TN underwent 3D-FLASH and 3D-CISS imaging were retrospectively studied. Neurovascular relationship at the intracisternal segment of trigeminal nerve was reviewed by two experienced neuroradiologist, who was blinded to the clinical details. The imaging results were compared with the operative findings in all patients.

Results:
The accuracy and positive rates of the 3D-FLASH + CISS imaging (98.46, 92.31%) in judging the symptomatic side according to the presence of vascular contacts were higher than those of 3D-CISS (90.77%, 84.62) or 3D-FLASH (89.23, 83.08%) sequence. In addition, the statistical analysis showed the sensitivity and accuracy of 3D-FLASH + CISS imaging was higher than that of 3D-FLASH (p &lt; 0.05). The 3D-FLASH + CISS imaging was more accurate in determining the type of offending vessel than 3D-CISS or 3D-FLASH imaging.

Conclusion:
The retrospective study demonstrates that the combination of 3D-FLASH with 3D-CISS sequence well delineates the relationship between intracisternal segment of trigeminal nerve and adjacent vessels in terms of increased positive rates and accuracy.

Advances in knowledge:
The study firstly dealt with the combination of 3D-CISS and 3D-FLASH imaging in TN.
Evaluation of common in vitro used chemicals' effect on motility and chromatin stability of boar spermatozoa
Authors: TSAKMAKIDIS (Ι.Α. ΤΣΑΚΜΑΚΙΔΗΣ) I. A. , KHALIFA T. , LYMBEROPOULOS (Α.Γ. ΛΥΜΠΕΡΟΠΟΥΛΟΣ) A. G. , MICHOS (Η.Α. ΜΙΧΟΣ) I. A. , BOSKOS (Κ.Μ. ΜΠΟΣΚΟΣ) C. M. 
Published: February 2018

Chemicals such as heparin, calcium ionophore and dimethyl sulfoxide (DMSO) have been used in sperm's function evaluation assays, since they are facilitating the sperm capacitation and the induction of acrosome reaction. Many researchers modified porcine in vitro protocols purposing the improvement and validation of in vitro assays. The modification of the above mentioned chemicals' concentration could have a detrimental effect on sperm characteristics, relative to normal sperm function and fertilizing ability. The present study aimed to investigate in vitro effect of various concentrations of, a) heparin (2, 4, 6, 8 and 10 μg/ml), b) calcium ionophore A23187 (10, 20, 30 μΜ) and c) DMSO (1, 2, 3 % v/v), that have been used in sperm evaluation techniques, on chromatin instability and total motility of boar spermatozoa. Eight boars were used as semen donors, providing 20 ejaculates. Acridine orange test and subjective evaluation of semen by a microscope equipped with a heated plate were performed in order to evaluate chromatin integrity and motility, respectively. The results of this study showed that the addition of heparin, A23187 and DMSO at concentrations of 8 - 10 μ^πιΐ, 10 μΜ and 1%, respectively, can be used for in vitro handling of boar spermatozoa without reduction of their motility and chromatin quality.