bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tocainide: A New Oral Antiarrhythmic
Authors: Hasegawa Guy R. , McLeod Donald C. 
Published: May 2016

Tocainide is an orally active lidocaine analog indicated for the suppression of ventricular arrhythmias. It is electrophysiologically similar to lidocaine and produces minimal hemodynamic and electrocardiographic changes. Oral bioavailability is virtually complete, elimination half-life is 11–15 hours, and 40 percent of a dose is excreted unchanged in urine. Tocainide therapy is commonly associated with gastrointestinal and neurologic side effects that generally are well tolerated. Rash, aggravation of arrhythmias, and worsening of heart failure may also occur. While tocainide does not consistently suppress arrhythmias following myocardial infarction, it does control chronic ventricular arrhythmias, being particularly effective in patients responsive to lidocaine. Tocainide has not been shown to be more effective than quinidine or procainamide. Tocainide should be a useful agent in patients who are unable to tolerate other antiarrhythmics, who are responsive to lidocaine, or who have been troubled with Q-T prolongation with or without torsade de pointes.
Molindone and Hepatotoxicity
Authors: Bhatia Subhash C. , Banta Lawrence E. , Ehrlich Donald W. 
Published: May 2016

An adolescent male with chronic schizophrenic disorder, paranoid type, was treated with molindone. He developed hepatotoxicity in the early treatment phase as evidenced by flu-like symptoms and laboratory abnormalities of liver functions. These symptoms and his hepatic functions improved on discontinuing molindone. Similar liver function trends were seen on reintroduction and subsequent withdrawal of the drug. Hepatic hypersensitivity has not been reported previously with the use of this drug. It is suggested that clinicians should be aware of this association and should assess hepatic functions in patients who develop a prodromal flu-like syndrome with this drug, especially in the early treatment phase.
Postpericardiotomy Syndrome
Authors: McClendon Candace E. , Leff Richard D. , Clark Edward B. 
Published: May 2016

Postpericardiotomy syndrome, a frequent complication of open-heart surgery, is characterized by fever, chest pain, and pericardial and pleural effusions. These signs may develop 1 to 12 weeks after intracardiac surgery in ∼30 percent of patients. Although the etiology of the syndrome is unknown, evidence points to a viral and/or autoimmune cause. Postpericardiotomy syndrome is diagnosed after excluding other conditions such as endocarditis and pneumonia. In many cases, the syndrome is self-limiting and occurs only once, but in other cases the symptoms have recurred as many as eight times. When the symptoms recur, management is more difficult because optimal pharmacologic treatment is not known. Antiinflammatory agents, such as salicylates and steroids, represent the drugs most commonly used. Although analgesics with codeine or oxycodone are important for the patients' symptomatic relief, early recognition of the syndrome is the key to limiting the discomfort and possible complications associated with this condition.
Dilemmas in Primary Care: Antibiotic Treatment of Acute Otitis Media
Authors: True Bev Lorraine , Helling Dennis K. 
Published: May 2016

Antibiotic treatment of acute otitis media (AOM) accounts for a significant number of all antibiotic prescriptions each year. In the primary care setting, initial antibiotic selection is rarely based on direct evidence, such as cultures of middle ear fluid. Initial antibiotic therapy by the primary care practitioner involves the evaluation and application of information related to prevalence of infecting organisms; in vitro antibiotic spectrum and penetration into middle ear fluid; initial cure rate, relapse and recurrence rates; and antibiotic cost, safety, and convenience. The influence of these factors on the initial antibiotic choice for AOM is reviewed. Several therapeutic dilemmas confronting the prescriber are discussed and a rational approach to initial antibiotic therapy is presented.
Fixed Drug Eruption of the Penis Due to Co-Trimoxazole
Authors: Amir Jacob , Shuper Avinoam , Varsano Izhak , Livni Ella , Mimouni Marc 
Published: May 2016

Fixed eruption of the penis, due to co-trimoxazole, is described in two boys. The eruption was accompanied by severe swelling of the penis, urine retention, and pain during micturition. The migration inhibiting factor assay for co-trimoxazole was negative, but the mast cell degranulation test was strongly positive, suggesting reaginic hypersensitivity reaction.
Cost Justification of Clinical Pharmacy Services on a General Surgery Team: Focus on Diagnosis-Related Group Cases
Authors: Bertch Karen E. , Hatoum Hind T. , Willett Michael S. , Witte Kenneth W. 
Published: May 2016

We used a novel approach to cost-justify clinical pharmacy services on a general surgery team in nine diagnosis-related group cases. The clinical pharmacist monitored nine patients longitudinally on a general surgery team from admission to discharge and intervened in their therapeutic management. Each recommendation was analyzed for rationale, acceptance, perceived impact on quality and/or cost of patient care, whether self-initiated or solicited, and impact on patient outcome. Types of recommendations and outcomes were categorized by process and outcome measurement criteria. Total cost avoidance per patient was calculated using costs of drug therapy, laboratory tests, and length of stay. Accounting for cost of clinical pharmacy services, net cost avoidance per patient was calculated. The clinical pharmacist made 101 recommendations on nine patients. Physicians accepted 82 percent of the recommendations; 77 percent of the recommendations were self-initiated and 23 percent were solicited. Recommendations had a perceived impact on cost, quality, or both at 13, 31, and 56 percent, respectively. Most recommendations (79 percent) brought patient therapy to a level of conformance with current standards of practice as documented in the medical literature. Recommendations that potentially preserved a major organ function by preventing drug-induced toxicity or the exacerbation of existing problems constituted 16 percent of the total. None of the accepted recommendations adversely affected patient outcome and 23 percent directly resulted in a measurable positive outcome in patient care. A total of four hospital days was potentially saved for two cases. Based on objective outcome criteria, a 1.9-day increase in therapeutic control was documented per patient. Total cost avoidance was $465.12 per patient and the cost of clinical pharmacy services was $23.66 per patient; net cost avoidance was therefore $441.46 per patient. For the duration of the study, the clinical pharmacist documented that similar input was required and actually provided to 40 percent of the patients admitted to the service. Based on an annual census of 1000 patients, the projected annual net cost avoidance was $176 584.
Do Biologics Protect Patients With Psoriasis From Myocardial Infarction? A Retrospective Cohort
Authors: Gulliver Wayne P. , Randell Shane , Gulliver Susanne , Connors Sean , Bachelez Hervé , MacDonald Don , Gladney Neil , Morrissey Andrea , Fleming Patrick 
Published: May 2016

Background: Psoriasis is a chronic immune-mediated inflammatory disorder that affects approximately 2% to 3% of the population, which translates to 17 million in North America and Europe and approximately 170 million people worldwide. Although psoriasis can occur at any age, most cases develop before age 40 years. Some larger studies have noted bimodal age at onset with the first peak occurring at approximately age 30 years and the second peak at around 55 to 60 years, but most patients have a younger age of onset (15-30 years). Psoriasis is associated with multiple comorbidities, decreased quality of life, and decreased longevity of life. Two recent systematic reviews and a meta-analysis concluded that psoriasis patients are at increased risk of major adverse cardiovascular events. Multiple studies confirm that many of the comorbidities found in patients with psoriasis are also important risk factors for cardiovascular disease, stroke, diabetes mellitus, hypertension, hyperlipidemia, obesity, and metabolic syndrome. Methods: We conducted a retrospective cohort study using charts from a dermatology clinic combined with an administrative database of patients with moderate to severe psoriasis in Newfoundland and Labrador, Canada. We examined the role of clinical predictors (age of onset of psoriasis, age, sex, biologic use) in predicting incident myocardial infarction (MI). Results: Logistic regression revealed that age of onset (odds ratio [OR], 8.85; P = .005), advancing age (OR, 1.07; P < .0001), and being male (OR, 3.64; P = .018) were significant risk factors for the development of MI. Neither biologic therapy nor duration of biologic therapy were statistically significant risk factors for the development of MI. Our study found that in patients with psoriasis treated with biologics, there was a nonsignificant trend in reduced MI by 78% (relative risk, 0.18; 95% confidence interval, 0.24-1.34; P = .056). Conclusion: Our study demonstrated a trend toward decreased MI in patients with moderate to severe psoriasis on biologics. Patients with an early age of onset of psoriasis (<25 years) were nearly 9 times more likely to have an MI. Clinicians should consider appropriate cardiovascular risk reduction strategies in patients with psoriasis.
How do lesbian and gay people experience dementia?
Authors: McParland James , Camic Paul M 
Published: May 2016

Introduction The subjective experience of dementia for lesbian and gay individuals is largely absent from the extant literature. This study aimed to explore what it means to experience dementia in this context given the documented psychosocial influences facing this population. A second aim was to develop understanding of these experiences within dyadic relationships. Method Ten semi-structured interviews were conducted with lesbian and gay individuals with dementia and people with whom they had a significant relationship and analysed using interpretative phenomenological analysis. Results Three superordinate themes, reflecting characteristics of participants’ experience, were identified: duality in managing dementia, giving yourself away vs. holding onto yourself and relationships as sheltered harbours. Ten subthemes indicated the processes that were adopted to adjust and make sense of the experience of dementia. These included decisions around concealment, ensuring safety and the promotion of personhood and couplehood. In line with findings for heterosexual couples, partners had an important role in maintaining the identity of the person with dementia. Conclusions Results suggest additional and distinct challenges, including experienced and perceived discrimination and heterosexism. In response to these conditions, interviewees worked to resist a ‘double stigma’ of dementia and sexuality. Findings indicated areas of improvement for dementia services, including training in inclusive practice.
The relationship between mineral composition, crystal structure and paragenetic sequence: the case of secondary Te mineralization at the Bird Nest drift, Otto Mountain, California, USA
Authors: Christy Andrew G. , Mills Stuart J. , Kampf Anthony R. , Housley Robert M. , Thorne Brent , Marty Joe 
Published: May 2016

AbstractAn unusually diverse array of 25 secondary Te oxysalt minerals has been documented from Otto Mountain, California, and 18 of these from the Bird Nest drift sublocality. A paragenetic sequence for these minerals is proposed, using observed overgrowth relationships plus spatial association data and data from other localities. Apart from Te and O, the components Pb, Cu and H are essential in the majority of the minerals. The atomic Cu/Te ratio decreases through the paragenetic sequence. This, and the occurrence of minerals with additional components such as Cl–, CO32–, SO42–and Fe3+at an intermediate stage, suggests nonmonotonic evolution of the parent fluids, reflecting differing access to or spatial distribution of various components. For the minerals with known crystal structures, two alternative 'structural units' were identified, one consisting only of the Te4+or Te6+oxyanion, while the other also included small, strongly-bound cations such as Cu2+. The degree of polymerization for the Te oxyanion correlated with the paragenetic sequence: the monomeric tellurate anions of early minerals were replaced progressively by dimers, chains and sheet structures, which may relate to a decreasing abundance of the 'network modifying' Cu2+cation, analogous to Bowen's discontinuous reaction series in igneous rock-forming silicates. No relationship was seen between paragenetic order and the larger type of structural unit, or structural complexity as defined by information content. This contrasts with results in the literature for evaporite sulfates and pegmatite phosphates. While structure–paragenesis relationships may be widespread, the exact nature of such relationships may be different for different chemical systems and different paragenetic environments.
Easier Said Than Done: Keys to Successful Implementation of the Distress Assessment and Response Tool (DART) Program
Authors: Li Madeline , Macedo Alyssa , Crawford Sean , Bagha Sabira , Leung Yvonne W. , Zimmermann Camilla , Fitzgerald Barbara , Wyatt Martha , Stuart-McEwan Terri , Rodin Gary 
Published: May 2016

Purpose: Systematic screening for distress in oncology clinics has gained increasing acceptance as a means to improve cancer care, but its implementation poses enormous challenges. We describe the development and implementation of the Distress Assessment and Response Tool (DART) program in a large urban comprehensive cancer center. Method: DART is an electronic screening tool used to detect physical and emotional distress and practical concerns and is linked to triaged interprofessional collaborative care pathways. The implementation of DART depended on clinician education, technological innovation, transparent communication, and an evaluation framework based on principles of change management and quality improvement. Results: There have been 364,378 DART surveys completed since 2010, with a sustained screening rate of > 70% for the past 3 years. High staff satisfaction, increased perception of teamwork, greater clinical attention to the psychosocial needs of patients, patient-clinician communication, and patient satisfaction with care were demonstrated without a resultant increase in referrals to specialized psychosocial services. DART is now a standard of care for all patients attending the cancer center and a quality performance indicator for the organization. Conclusion: Key factors in the success of DART implementation were the adoption of a programmatic approach, strong institutional commitment, and a primary focus on clinic-based response. We have demonstrated that large-scale routine screening for distress in a cancer center is achievable and has the potential to enhance the cancer care experience for both patients and staff.
The impact of working shifts: exploring the views of UK paramedics
Authors: Kirby Kim , Moreland Stephanie , Pollard John 
Published: May 2016

There is limited research within the UK investigating the effects of shift work on paramedics. Paramedics have relatively high rates of sickness levels and there are links between shift work and health. This study explores UK paramedics’ perceptions of the impact of working shifts. Methods: Exploratory qualitative research was utilised to investigate the perceptions of UK paramedics on the impacts of working shifts. Two focus groups were completed involving 11 paramedics. The transcriptions were analysed using thematic analysis. Results: Paramedics described factors associated with working shifts that mirror research already completed within different occupations: effects on physical health, fatigue, family life, safety and performance; but paramedics additionally described factors that are more limited to working in the paramedic profession such as a broader range of psychological stressors and organisational factors. The theme of psychological health was a wider theme that went beyond shift work and encompassed the overall paramedic role and the unique and stressful nature of the work. Conclusions: This research has allowed an insight into the perceived effects of shift work on UK paramedics and exposes the challenges paramedics face in their working environment. There is a suggested link between the relatively high rates of sickness and the effects of shift work and paramedics’ overall working environment. Further exploration and recognition of the effects of shift work on UK paramedics is recommended.
Proteomic identification of non-erythrocytic alpha-spectrin-1 down-regulation in the pre-optic area of neonatally estradiol-17β treated female adult rats
Authors: Govindaraj Vijayakumar , Rao Addicam Jagannadha 
Published: May 2016

Abstract
It is well established that sexually dimorphic brain regions, which are critical for reproductive physiology and behavior, are organized by steroid hormones during the first 2 weeks after birth in the rodents. In our recent observation, neonatal exposure to estradiol-17β (E2) in the female rat revealed increase in cyclooxygenase 2 (COX-2) level, sexually dimorphic nucleus (SDN)-pre-optic area (POA) size and down-regulation of synaptogenesis related genes in POA in the adult stage. In the present study, using the same animal model, the protein profile of control and neonatally E2-treated POA was compared by 1D-SDS-PAGE, and the protein that shows a change in abundance was identified by LC-MS/MS analysis. Results indicated that there was a single protein band, which was down-regulation in E2-treated POA and it was identified as spectrin alpha chain, non-erythrocytic 1 (SPTAN1). Consistently, the down-regulation of SPTAN1 expression was also confirmed by reverse transcription polymerase chain reaction (RT-PCR) and Western blot analysis. The SPTAN1 was identified as a cytoskeletal protein that is involved in stabilization of the plasma membrane and organizes intracellular organelles, and it has been implicated in cellular functions including DNA repair and cell cycle regulation. The evidence shows that any mutation in spectrins causes impairment of synaptogenesis and other neurological disorders. Also, protein-protein interaction analysis of SPTAN1 revealed a strong association with proteins such as kirrel, actinin, alpha 4 (ACTN4) and vinculin (VCL) which are implicated in sexual behavior, masculinization and defeminization. Our results indicate that SPTAN1 expression in the developing rat brain is sexually dimorphic, and we suggest that this gene may mediate E2-17β-induced masculinization and defeminization, and disrupted reproductive function in the adult stage.
Feldenkrais method and functionality in Parkinson’s disease: a randomized controlled clinical trial
Authors: Teixeira-Machado Lavinia , de Araújo Fernanda M. , Menezes Mayara A. , Cunha Fabiane A. , Menezes Thainá , Ferreira Clecia da S. , DeSantana Josimari M. 
Published: May 2016

Abstract

Background:
The second most common age-related chronic neurodegenerative disease after Alzheimer’s disease is Parkinson’s disease (PD).

Objective:
The focus of this study was to improve the functional capabilities of the participants with PD.

Study groups:
The PD participants were randomized into two groups: Feldenkrais and control.

Methods:
The Feldenkrais group underwent 50 sessions of an exercise program based on the Feldenkrais method. The control group received educational lectures during this period. Unified Parkinson’s Disease Rate Scale (UPDRS – session III), mini-mental state evaluation (MMSE), Hoehn and Yahr scale, and functional tests (figure-of-eight walk test, timed-up-and-go test, rollover task, 360 degrees turn-in-place, functional-reach test, sitting-and-standing test, Berg balance scale (BBS), and hip-flexion strength) were assessed in both groups. Procedures during the 50 sessions were conducted in an appropriate room, twice-a-week, on alternate days and lasted 60 min.

Results:
Thirty subjects were randomly divided into two groups: the Feldenkrais (n=15) and the control (n=15) group. The Feldenkrais group presented significantly better in functional tests (p<0.05) when compared to the control group. The control group received lower scores after the 50-session period in the sitting/standing test (p=0.02), 360 degrees turn-in-place (p=0.01), and rollover test (p=0.01). Results of the BBS demonstrated significantly higher scores in the Feldenkrais group after treatment (p=0.004) when compared to the control group (p=0.01).

Conclusion:
The Feldenkrais lessons produced specific changes in functional mobility in PD participants.
Think outside the box – Interprofessional collaboration starts in the mind of teachers / Querdenken erlaubt – Interdisziplinarität beginnt in den Köpfen von Lehrenden
Authors: Boettcher Aisha Meriel , Cording Linda , Käuper Kristin Maria , Busch Susanne 
Published: May 2016

AbstractStudies indicate positive effects of interprofessional collaboration on the quality of health care. Interprofessional academic education of health care professionals is crucial for successful cooperation, although Terizakis & Gehring (2014, p. 24) state «a genuine understanding of interprofessional teaching […] hasn't developed yet.» The undefined usage of terminology and coexisting interprofessional study programs are only one part of the problem. Further consented interprofessional learning concepts and systematic knowledge regarding competencies and teaching experiences are lacking. The WHO (2010, pp. 27 f) recommends lecturers to generate a common understanding of interprofessionality. At Hamburg University of Applied Sciences a part-time study program in interprofessional health care and management started in September 2015. It was designed as a continuing education program for occupational-, physio-, and speech therapists, nurses and midwives. As a preparation for the program focus group discussions with staff members of the department „Pfege & Management» were conducted. The aim was to investigate their understanding of interprofessionality, learning and teaching. The results indicated a contextual understanding of interprofessionality, although the usage of the terminology remains blurred. The tension of a congruent interprofessional learning concept is to enhance scientific reflection of disciplines, as well as strengthening interprofessional aspects. Regarding the change in demands of the health care system, interprofessional collaboration is seen as a major resource. The research gap on disciplinary orientations in terms of enhancing professional identity on the one and interprofessionality as innovative construct on the other hand has to be filled.
Mit der Großstadt aus der Armut: Eine neue Theorie der Industrialisierung
Authors: Mathis Franz 
Published: May 2016

Abstract
There is no doubt that industrialization was the main cause of modern economic welfare. The reasons for more or less industrialization in various regions of the world have been discussed widely for decades. However, a closer examination reveals that none of the controversial arguments and explanations put forward stand the test of empirical scrutiny. What has previously been ignored is the central role of large cities in provoking industrialization. Given all the other preconditions necessary for industrialization, it was finally the mass markets of large cities that made industrial mass production profitable for potential entrepreneurs. Thus, wherever large cities and urban agglomerations emerged in the world, industrialization followed suit. In a global and comparative perspective, industrialization was not so much a matter of countries but rather a matter of regions dividing the world into highly urbanized, industrialized and more prosperous regions on the one side, and still primarily rural, preindustrial and poorer regions on the other..