bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Rating of Compliance in Chronic Hemodialysis Patients
Authors: Mai François M , Busby Keith , Bell Robert C 
Published: January 2017

Objective: To develop a clinical rating scale of treatment compliance for use in chronic hemodialysis patients and to test its reliability and validity. Method: Forty-eight of 65 patients undergoing hemodialysis treatment at the Ottawa General Hospital during June 1994 met criteria for inclusion and completed the study. Patients underwent a 10–15-minute interview, with 1 of 2 independent clinical interviewers, regarding diet, fluid intake, prescribed medication usage, smoking, alcohol or drug use, and hemodialysis treatment attendance. Following each interview, a predesigned 3-point rating scale evaluating compliance in each of 6 domains (yielding an 18-point total score) to the treatment regimen was completed. Compliance ratings on 10 patients assessed independently by both interviewers were used to establish scale reliability. Criterion validity was assessed by correlating compliance scale scores with 3 biological measures (weight gain [kg], K+ [mmol/l], and PO4 [mmol/l]). Results: Reliability between clinical interviewers using the overall compliance scale score (Intraclass correlation coefficient = 0.825) as well as component subscales was high (kappa values, 0.33–1.00). Biological measures of compliance correlated well with each other but poorly with clinical ratings (range 0.01–0.16). Biological measures identified compliance as being poorer than that found with the clinical interview scale. Conclusions: The Compliance Rating Scale (CRS) was shown to be reliable but was not well-validated against selected biological measures. Discrepancies between these 2 methods of assessing compliance may be due to differing underlying compliance constructs or patient or interviewer biases. The CRS has value as a patient education tool in that it can be used to instruct patients regarding the benefits of adhering to the treatment regimen.
Characteristics of Problem Gambling in a Canadian Context: A Preliminary Study Using a DSM-IV-Based Questionnaire
Authors: Beaudoin Carole M , Cox Brian J 
Published: January 2017

Objective: To develop a self-report instrument to assess diagnostic criteria and associated features of pathological gambling in order to learn more about the characteristics of individuals who seek treatment for gambling problems in a Canadian setting. Method: Fifty-seven adults seeking treatment for gambling problems at the Addictions Foundation of Manitoba were assessed. Results: There was substantial variation in the endorsement of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) symptoms. Lying to family members or friends and “chasing” previous gambling losses were frequently reported, while more serious consequences (for example, relationship breakup, job losses) were less frequent. DSM-IV ratings were correlated (r = 0.59) with the South Oaks Gambling Screen. Many individuals reported gambling as a way to alleviate dysphoric mood, and 30% reported receiving mental health services in the past. Approximately 50% reported suicidal ideation, although recent suicide attempts were not common. Conclusion: These preliminary results of Canadian adults seeking treatment for gambling problems suggest a somewhat different profile from many United States studies, which often rely on older male pathological gamblers. More systematic investigation of the presence of major depression and other psychiatric disorders is warranted. Consistent with demographic data collected at the Addictions Foundation of Manitoba, it appears that video lottery terminals play a major role in the type of problem gambling experience seen in Canadian settings.
Panic Disorder in Schizophrenia
Authors: Labbate Lawrence A , Young P Christopherson , Arana George W 
Published: January 2017

Objective: To determine the frequency of panic attacks and panic disorder inpatients with chronic schizophrenia or schizoaffective disorder. Method: Fifty-three male outpatients meeting Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for chronic schizophrenia or schizoaffective disorder were administered sections of the Structured Clinical Interview for DSM-IV (SCID). If panic attacks were reported, patients were queried about treatment and about onset relative to psychotic symptoms. Results: Forty-nine patients were sufficiently organized to participate in the evaluation. Twenty-one (43%) experienced panic attacks, and 16 (33%) had current or past panic disorder. Eight (50%) of the 16 with panic disorder had been treated for panic. Substance dependence was not associated with having panic attacks or current or past panic disorder. Patients with paranoid schizophrenia were more likely than patients with schizoaffective or undifferentiated schizophrenia to have experienced panic attacks (57% versus 20%, %2 = 6.0, P < 0.02) or panic disorder (47% versus 10%, χ2 = 6.9, P < 0.01). Conclusion: Panic attacks and panic disorder are common in men with schizophrenia or schizoaffective disorder. Panic disorder may be an overlooked comorbid diagnosis in patients with schizophrenia.
Review Board Outcomes for Involuntary Patients in Provincial Psychiatric Hospitals
Authors: Komer William J , O'Reilly Richard L , Cernovsky Zack , Dunbar Sandra 
Published: January 2017

Objective: To identify long-term trends and compare different psychiatric hospitals with regard to outcomes of involuntary certification. Method: Data on outcomes of involuntary certification were obtained from the London and St Thomas Psychiatric Hospitals for 1987 to 1997, from the Psychiatric Patient Advocate Office pertaining to 10psychiatric hospitals for 1987 to 1993, and from published data from the North Bay Psychiatric Hospital for 1992 to 1994. Data were compared regarding outcome variables. Results: There are variable rates and proportions among the psychiatric hospitals for outcomes of involuntary certification, including patients choosing to withdraw their applications to Review Boards, physicians cancelling involuntary certificates by completing Form 5s, and Review Boards rescinding certificates. Overall, few certificates were rescinded by the Boards, a trend that was even more pronounced in recent years. Conclusions: Patients who are in psychiatric hospitals on an involuntary basis are infrequently released from hospital as a result of a Review Board rescinding their certificate.
The Productive Ward Program™
Authors: Van Bogaert Peter , Van heusden Danny , Verspuy Martijn , Wouters Kristien , Slootmans Stijn , Van der Straeten Johnny , Van Aken Paul , White Mark 
Published: January 2017

Aim To investigate the impact of the quality improvement program “Productive Ward – Releasing Time to Care™” using nurses’ and midwives’ reports of practice environment, burnout, quality of care, job outcomes, as well as workload, decision latitude, social capital, and engagement. Background Despite the requirement for health systems to improve quality and the proliferation of quality improvement programs designed for healthcare, the empirical evidence supporting large-scale quality improvement programs impacting patient satisfaction, staff engagement, and quality care remains sparse. Method A longitudinal study was performed in a large 600-bed acute care university hospital at two measurement intervals for nurse practice environment, burnout, and quality of care and job outcomes and three measurement intervals for workload, decision latitude, social capital, and engagement between June 2011 and November 2014. Results Positive results were identified in practice environment, decision latitude, and social capital. Less favorable results were identified in relation to perceived workload, emotional exhaustion. and vigor. Moreover, measures of quality of care and job satisfaction were reported less favorably. Conclusion This study highlights the need to further understand how to implement large-scale quality improvement programs so that they integrate with daily practices and promote “quality improvement” as “business as usual.”
Planning Health Care for People with HIV Infection and Aids
Authors: McCann Kathryn , Wadsworth Emma , Beck Eduard J. 
Published: January 2017

In recent years planners of health services have been urged to design a comprehensive range of services which are responsive to the needs of people with HIV infection and AIDS and those who might be worried about HIV transmission. Models of care have been tried and tested and pilot services which aim to inform the development of the services scrutinised. Though in general this community care is seen as the preferred option with adequate backup support from acute services. More than anything, there is a recognition that the service must be responsive to local needs. Because patterns of HIV infection and prevalence of AIDS are so variable there is no substitute for the systematic development of timely local knowledge as the basis of local planning.
Performance-Related Pay for Health Service Professionals: The Italian Experience
Authors: Adinolfi Paola 
Published: January 2017

Italy has significant experience of performance-related pay (PRP) for health service professionals: a system which links part of doctors' remuneration to their productivity dates back to 1938. This paper reports on a two-year field research, carried out on the Italian National Health Service, which investigates the objectives, design and implementation of PRP, as well as its operation and effectiveness. First, the evolution of PRP schemes over the latest 25 years is reconstructed, and the range of covert and overt objectives underlying the use of PRP are unravelled. Then, after having highlighted the main structural and cultural factors which negatively affect PRP effectiveness, a critical evaluation of PRP is attempted, drawing on the analysis of both hard performance data and the subjective perceptions of stakeholders. The conclusion is that PRP led to problems and unforeseen consequences in most of the hospitals examined, due to both structural factors, mainly some flaws in PRP design, and cultural constraints, mainly the values of health professionals. However, the case of a Northern Italian hospital proves that, despite the constraining environmental setting, there is still scope for managerial intervention in the implementation process which is sufficient to guarantee PRP effectiveness. This indicates that the implementation process far outweighs the significance of structural and cultural constraints, and that PRP is a powerful tool at management disposal to increase employees' performance and commitment.
Human Immunodeficiency Virus Surveillance at a Sexually Transmitted Diseases Clinic in Copenhagen
Authors: Worm Anne-Marie , Kvinesdal Birgit 
Published: January 2017

During four study periods, each of 3–4 weeks' duration in 1987 and 1988, all patients attending the Copenhagen outpatient Venereal Disease Clinic were encouraged to have a test for human immunodeficiency virus (HIV) antibody. Anonymous testing or testing for research purposes only without any data was also offered. Patients known to be HIV antibody-positive were not re-tested. A total of 1753 patients (1118 men, 635 women) were counselled and testing recommended. Testing was refused by 255 patients, 57 of whom had been tested (all negative) within the previous 3 months. HIV serology was therefore unknown in 11.7% (198 of 1696 persons), including 120 of 922 heterosexual men (13%), 16 of 159 homo/bisexual men (10%) and 62 of 615 women (10%). There was no substantial difference between the four study periods in the numbers refusing the test. Sixteen of the 1498 patients tested were HIV antibody-positive, including one woman and 3 men with a history of intravenous drug abuse and 11 homo/bisexual men; one heterosexual man with HIV antibodies had no known risk behaviour. It is concluded that HIV testing with informed consent at a sexually transmitted disease clinic will not include all persons, and therefore will not exclude a self-selection bias. Surveillance studies using unlinked HIV testing are therefore necessary and it is recommended that they should be performed in Denmark. In this study, unlinked HIV testing of the serum specimens taken for syphilis serology would have decreased the percentage of non-attenders' from 12.4% to 0.8% during the final study period.
Self-Medication by Women Attending a Genitourinary Medicine Clinic
Authors: Russell J M , Barton S E , Lawrence A G 
Published: January 2017

A questionnaire was completed by 103 symptomatic women attending a busy, walk-in genitourinary medicine clinic in London before seeing a doctor. This questionnaire asked about the patients' own diagnosis of symptoms, previous remedies and their source. The answers were compared to their past history and current diagnosis. Of symptomatic women 56% had used a self-administered remedy prior to attending the clinic. This was significantly associated with a history of a previous episode of genital infection which had produced similar symptoms to the current problem. Forty-three percent of those who used self-medication reported some improvement in symptoms and more than 50% tolerated longer than 10 days of symptoms before attending the clinic.
HIV/AIDS in Poland: A Society in Need of the State
Authors: Misztal Barbara A. 
Published: January 2017

Eastern Europe's recent revolutions theoretically should provide a new opportunity for communities affected by HIV. By looking at the Polish case I will try to evaluate how these opportunities have been utilized. Although, compared with the numbers of the AIDS cases and the HIV-infected in the West, Polish numbers are small, a lack of proper medical infrastructure and a lack of basic equipment to prevent the spread of AIDS has made the situation dramatic. Until the end of the 1980s responses to HIV/AIDS were carried out according to the prevailing old bureaucratic mode without any co-operation with affected groups. The new situation after the revolution has provided opportunities for members of affected groups to emerge and organize. However, at the same time, the increase in public intolerance and indifference towards the fate of its weakest members has been, to some degree, facilitated by many aspects of transitional period. In the process of breaking the state's monopoly on power and in the creation of local community structures, the danger of excessive parochialism and struggles for power emerges. New authorities, trying to preserve some social cohesion in the face of economic hardship, are faced with a society which lost the ability to recognize where the demarcation line runs between rights and demands to protect egoistic interests.
Welfare State Regimes and Welfare Citizenship
Authors: Taylor-Gooby Peter 
Published: January 2017

This article links together three themes in recent discussion of welfare. First, the extent to which current patterns of state welfare provision are likely to continue has been called into question. Disillusion with the traditional model derives in part from government response to economic pressures, in part from the likelihood that changes in demography, employment and popular expectations will increase demands on the state, and in part from the tendency of theorists to advocate pluralist, decentralized, mixed economy and civil society-based solutions to problems. Secondly, traditional notions of welfare citizenship have been challenged because they fail to take into account the wide variety of paths which different systems have pursued in their development and because they fail to include the impact of state policy on the private sphere of home and family in their analysis. Thirdly, vigorous controversy about the categorization of welfare states surrounds the work of Esping-Andersen (1990). The claim that state welfare cannot be sustained is found to be unconvincing. However, the arguments do focus attention on issues of social care and the impact of policy on women. This has strong implications for the way in which theories of welfare citizenship discuss the relation between state policy and the public and private spheres of social life. Esping-Andersen's model uses the extent of decommodification in relation to formal wage-labour to distinguish the ideal types of liberal, social democratic and conservative/corporatist regimes. State intervention is limited in the liberal model, extensive in the social democratic model and substantial but directed at maintaining the stratification order of the market in the conservative model. An analysis that includes both uncommodified care work in the home and the position of women in the formal labour market implies that different struggles will develop in the various regime types in response to current pressures on the welfare state. In liberal regimes, equal opportunities have been pursued through law rather than direct state intervention: the result is that gender conflicts become increasingly subsumed to the class conflicts of the market. In social democracy a substantial state sector provides both opportunities for women's advancement in employment and socialized care facilities that help to make this possible; pressure on spending leads to conflicts between public and private sector workers (who see the former as parasitic) which increasingly involve gender conflicts. Under conservative/corporatism, where women's opportunities to enter paid employment have been relatively limited, gender conflicts increasingly concern access to paid work. These predictions offer opportunities for the empirical testing of the model.
Effect of Breast Cancer Screening after Age 65
Authors: Chen Hsiu-Hsi , Tabar Laszlo , Fagerberg Gunnar , Duffy Stephen W 
Published: January 2017

Objective To assess the effect of mammographic screening for breast cancer in women aged 65 years or over. Setting The Swedish two county trial of screening for breast cancer, in which 77 080 women aged 40–74 (21 925 aged 65–74) were randomly allocated to receive regular mammographic screening for breast cancer, and 55 985 women aged 40–74 (15 344 aged 65–74) were allocated to an unscreened control group Methods One group was screened every 33 months on average, except for those aged 40–49 at randomisation who were screened every 24 months. The control group was screened once at the conclusion of the trial. The main statistical analysis was the comparison of cumulative mortality with 13 years of follow up between the screened and control groups, in age groups 50–64 and 65–74, using Poisson regression. This was complemented by subsidiary analyses assessing the lead time, sensitivity, and predicted mortality from the size, node status, and grade of tumours diagnosed in the screened and control groups. Results In the age group 65–74 at randomisation there was a significant reduction in breast cancer mortality in the screened group, with a relative mortality of 0 68 and 95% confidence interval of 0 51 to 0 89. This was backed up by the results of the analyses of lead time, sensitivity, and tumour characteristics Conclusions Women aged 65 or more who are regularly screened can expect a reduced risk of dying from breast cancer.
Cost Comparison of Different Methods of Screening for Cystic Fibrosis
Authors: Morris Joan K , Oppenheimer Peter M 
Published: January 2017

Objective To compare the costs of several proposed methods of screening for cystic fibrosis. Setting England and Wales. Methods The costs of screening carried out at hospital antenatal clinics, general practitioner (GP) antenatal consultations, GP surgeries, and at work were estimated using data from demonstration projects. Couple screening, stepwise screening, and screening of individuals were considered. Results Couple screening at antenatal hospital clinics was the least expensive per carrier couple detected, amounting to £35 700 (£142 900 for each potential cystic fibrosis fetus detected). The costs of the reagents (£25 per test) accounted for over 60% of this total. Conclusions Antenatal screening, in addition to being the most cost effective method of screening, is also medically the screening method of choice as it provides information at the latest time when effective preventive action can be taken and at a time when all people to be screened are likely to be accessible. If the costs of the reagents could be reduced to £5 (still higher than the costs of most diagnostic reagents) the cost for each pregnant carrier couple offered screening would be reduced by 50% to about £18 000, and the cost of offering screening to 684 000 pregnant couples in England and Wales would be about 91/2 instead of £19m.
Genetic and Environmental Influences on Growth
Authors: Rona Roberto J , Chinn Susan 
Published: January 2017

Objectives — To provide an overview of the factors associated with growth in primary school children in England and Scotland and to provide information about the secular trend of growth in the last 20 years. Setting — Representative English and Scottish samples and an English inner city sample. Methods — The study had a mixed longitudinal design from 1972 to 1994. Between 8000 and 10 000 children participated in each survey. Height was measured in at least 95% of the children in most surveys, and 75% to 85% of parents provided information about family background. Main results are based on published information. Multiple regression was used for most of the analyses. Results — Parents' height, child's birth weight, mother's age at child's delivery, ethnic background and, in white children, family size are the only factors markedly associated with height. Variables that have traditionally been used to assess the possible effect of social conditions were generally not associated with height. The height increase was more marked in Scotland than England over the period 1972 to 1990, and the differences in height of children in the two countries is now minimal. Conclusions — Most factors cannot be neatly classified as purely genetic or environmental, but seem to indicate that genes are relatively more important. Social factors usually assessed in growth studies do not have an important effect on growth. The marked increase of height over time indicates that the environment and social conditions have allowed children to grow taller. Sibship size is the only factor that was shown to be related to the secular trend in growth.
Referral Criteria for Growth Screening
Authors: Hulse J A 
Published: January 2017

Population height screening studies performed over the past 20 years have shown that between 17 and 21% of children with heights below the third centile have organic disease, of whom about 20% will be new diagnoses. The likelihood of organic disease increases to 50% for children with heights below −3 SDs. The age of screening will also influence the outcome as both acquired disease and disorders with progressive growth slowing, such as Turner's syndrome, are more likely to be detected by screening at an older age. Height velocity as a screening tool has evoked interest for many years as, despite technical problems, slowly growing children are thought more likely to have disease. Inclusion of height or height/weight relations may further improve screening sensitivity. It may assist in the early detection of coeliac disease or eating disorders in older children. A minimum of three measurements is required to define an individual's growth pattern and, preferably, five or six measurements spread over the preschool and primary school years. The value of extension of growth screening to the secondary school age group remains uncertain. Children should be screened for both height and weight and referred when there are major discrepancies between these two measurements (more than three centile bands). A two level system of referral with a community assessment for some children and a direct referral to a growth clinic for children with more severe growth disturbance may be the best use of resources.