bluuebunny/crossref_metadata_2025_split huggingface dataset:
The efficacy of hybrid therapy as first‐line regimen for Helicobacter pylori infection compared with sequential therapy
Authors: Oh Dong Hyun , Lee Dong Ho , Kang Kyu Keun , Park Young Soo , Shin Cheol Min , Kim Nayoung , Yoon Hyuk , Hwang Jin Hyeok , Jeoung Sook Hyang , Kim Jin Wook , Jang Eun Sun , Jung Hyun Chae 
Published: January 2014

AbstractBackground and AimRecent prospective studies have shown that the sequential therapy has not achieved the target Helicobacter pylori eradication rate of > 80% in Korea. The aim of this study was to therefore assess the efficacy of the hybrid therapy as a first‐line treatment for H. pylori eradication in a prospective trial.MethodsFrom December 2012 to August 2013, 184 patients with confirmed H. pylori infections received either the 14‐day hybrid therapy or the 14‐day sequential therapy. Eradication outcomes were evaluated using a 13C‐urea breath test at least 4 weeks after treatment cessation.ResultsA total of 184 patients (90 receiving hybrid treatment and 94 receiving sequential treatment) completed the study. The eradication rates of the hybrid and sequential therapy groups were 81.1% (73/90; 95% confidence interval [CI] = 73.0–89.2%) and 79.8% (75/94; 95%CI = 71.7–87.9%), respectively, by intention‐to‐treat analysis (P = 0.821). By per protocol analysis, eradication rates were 85.9% (73/85; 95%CI = 78.5–93.3%) and 82.0% (73/89; 95%CI = 74.0–89.9%; P = 0.489), respectively. There were no significant intergroup differences in treatment compliance or discontinuation induced by severe side effects.ConclusionsThe hybrid therapy achieved acceptable eradication rate (85.9%), but not statistically significantly higher rates than the sequential therapy (82.0%). Further studies are therefore needed to identify first‐line treatments with even better eradication rates in the Korean population.
Randomized trial of 2‐L polyethylene glycol + ascorbic acid versus 4‐L polyethylene glycol as bowel cleansing for colonoscopy in an optimal setting
Authors: Moon Chang Mo , Park Dong Il , Choe Young Ghil , Yang Dong‐Hoon , Yu Yeon Hwa , Eun Chang Soo , Han Dong Soo 
Published: January 2014

AbstractBackground and AimPrior studies have reported 2‐L polyethylene glycol (PEG) plus ascorbic acid (PEG + Asc) is an effective alternative to standard 4‐L PEG for bowel preparation before colonoscopy, but they are limited because of some confounders. Therefore, we compared the efficacy, patient compliance, satisfaction, and safety of 2‐L PEG + Asc versus 4‐L PEG for bowel cleansing in optimal preparation strategies.MethodsIn this prospective, randomized, single‐blind trial, consenting outpatients were randomly assigned to one of two arms. All colonoscopies were scheduled in the morning and cleansing solutions were administered as a split‐dose regimen. Bowel‐cleansing efficacy in three different segments was measured on a five‐point scale with four‐point overall grading. Patients' opinions of the preparation regimens were obtained by questionnaire.ResultsThere was no significant difference between the 2‐L PEG + Asc (159/163; 97.5%) and 4‐L PEG (162/164; 98.8%) with respect to the overall success of bowel cleansing (mean difference = −1.3 [−4.1–∞]). Patient compliance, acceptability, and satisfaction were better in the 2‐L PEG + Asc arm than the 4‐L PEG arm (P < 0.05). Additionally, the incidence of side effects was lower in the 2‐L PEG + Asc than the 4‐L PEG (overall, 57.7% vs 73.2%, P < 0.05). However, no significant difference was seen in patients' rating of taste.ConclusionsIn an optimal preparation setting, 2‐L PEG + Asc has equal efficacy as a bowel cleanser prior to colonoscopy as 4‐L PEG, with the advantages of better patient compliance, satisfaction, and safety.
Effect of Multiple Pharmacy Use on Medication Adherence and Drug–Drug Interactions in Older Adults with Medicare Part D
Authors: Marcum Zachary A. , Driessen Julia , Thorpe Carolyn T. , Gellad Walid F. , Donohue Julie M. 
Published: January 2014

ObjectivesTo assess the association between multiple pharmacy use and medication adherence and potential drug–drug interactions (DDIs) in older adults.DesignCross‐sectional propensity score‐weighted analysis.Setting2009 claims data.ParticipantsA nationally representative sample of 926,956 Medicare Part D beneficiaries aged 65 and older continuously enrolled in fee‐for‐service Medicare and Part D that year who filled one or more prescriptions at a community retail or mail order pharmacy.MeasurementsMultiple pharmacy use was defined as concurrent (overlapping time periods) or sequential use (non‐overlapping time periods) of ≥2 pharmacies in the year. Medication adherence was calculated using a proportion of days covered of 0.80 or greater for eight therapeutic categories (beta‐blockers, renin angiotensin system antagonists, calcium channel blockers, statins, sulfonylureas, biguanides (metformin), thiazolidinediones, and dipeptidyl peptidase‐IV inhibitors). Potential DDIs arising from use of certain drugs across a broad set of classes were defined as the concurrent filling of two interacting drugs.ResultsOverall, 38.1% of the sample used multiple pharmacies. Those using multiple pharmacies (concurrently or sequentially) consistently had higher adjusted odds of nonadherence (ranging from 1.10 to 1.31, P < .001) across all chronic medication classes assessed after controlling for sociodemographic, health status, and access to care factors than single pharmacy users. The adjusted predicted probability of exposure to a DDI was also slightly higher for those using multiple pharmacies concurrently (3.6%) than for single pharmacy users (3.2%, adjusted odds ratio (AOR) = 1.11, 95% confidence interval (CI) = 1.08–1.15) but lower in individuals using multiple pharmacies sequentially (2.8%, AOR = 0.85, 95% CI = 0.81–0.91).ConclusionsFilling prescriptions at multiple pharmacies was associated with lower medication adherence across multiple chronic medications and a small but statistically significant greater likelihood of DDIs in concurrent pharmacy users.
Subversive Subjects: Rule-Breaking and Deception in Clinical Trials
Authors: Dresser Rebecca 
Published: January 2014

Scientific reports about clinical research appear objective and straightforward. They describe a study's findings, methods, subject population, number of subjects, and contribution to existing knowledge. The overall picture is pristine: the research team establishes the requirements of study participation and subjects conform to these requirements. Readers are left with the impression that everything was done correctly, by the book.In other places, however, one finds a different and messier picture of clinical research. In this picture, research subjects deviate from the prescribed plan. One author contrasted the “tidy graphics” and “crisp prose” of theNew England Journal of Medicine'sHIV/AIDS trial publications with reports that subjects shared medications and broke other trial rules. Awareness of this behavior, he wrote, could lead insiders to “conclude that knowledge was resting on something rather less solid than bedrock.”
Supporting Second Victims of Patient Safety Events: Shouldn't These Communications Be Covered by Legal Privilege?
Authors: de Wit Mélanie E. , Marks Clifford M. , Natterman Jeffrey P. , Wu Albert W. 
Published: January 2014

The harmful impact of an adverse event ripples beyond injured patients and their families to affect physicians, nurses, and other health care staff that are involved. These “Second Victims” may experience intense feelings of anxiety, guilt, and fear. They may doubt their clinical competence or ability to continue working at all. Some go on to suffer post-traumatic stress disorder and depression.Medical institutions long ignored this problem, preferring to believe that adverse events, or “errors,” occur due to incompetence — the unfortunate work of a few “bad” practitioners who deserve, if anything, a reprimand for their negligence. Study after study has rejected this attribution and shown that adverse events in health care stem primarily from systemic flaws, not “bad apples.” Devastating errors, in other words, can, do, and always will happen in the care of competent, well-trained, and caring practitioners.
Another Look at the Legal and Ethical Consequences of Pharmacological Memory Dampening: The Case of Sexual Assault
Authors: Chandler Jennifer A. , Mogyoros Alexandra , Rubio Tristana Martin , Racine Eric 
Published: January 2014

Post-traumatic stress disorder (PTSD) is a “young” disorder formally recognized in the early 1980s, although the symptoms have been noted for centuries particularly in relation to military conflicts. PTSD may develop after a serious traumatic experience that induces feelings of intense fear, helplessness or horror. It is currently characterized by three key classes of symptoms which must cause clinically significant distress or impairment of functioning: (1) persistent and distressing re-experiencing of the trauma; (2) persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness; and (3) persistent symptoms of hyper-arousal. One of the possible symptoms within the second class is difficulty in remembering an important aspect of the traumatic event.PTSD is not an uncommon condition, with an estimated lifetime prevalence of about 7-9% based on studies conducted in the United States and Canada, with women at higher risk than men. While not everyone who experiences a significant trauma will go on to develop PTSD, about a third will do so. Sexual assault, along with other forms of assaultive violence, pose a comparatively high risk of PTSD.
The Right to Language
Authors: Humphries Tom , Kushalnagar Raja , Mathur Gaurav , Napoli Donna Jo , Padden Carol , Rathmann Christian , Smith Scott 
Published: January 2014

We argue for the existence of a state constitutional legal right to language. Our purpose here is to develop a legal framework for protecting the civil rights of the deaf child, with the ultimate goal of calling for legislation that requires all levels of government to fund programs for deaf children and their families to learn a fully accessible language: a sign language. While our discussion regards the United States, the argument we make is based on human rights and the nature of law itself, and can likely be adapted to any country.We begin with an introduction to the biological facts surrounding language acquisition and how these facts impact the deaf child, where lack of language has devastating effects on individuals and negative effects on society in general.
Adherence to the Request Criterion in Jurisdictions Where Assisted Dying is Lawful? A Review of the Criteria and Evidence in the Netherlands, Belgium, Oregon, and Switzerland
Authors: Lewis Penney , Black Isra 
Published: January 2014

Some form of assisted dying (voluntary euthanasia and/or assisted suicide) is lawful in the Netherlands, Belgium, Oregon, and Switzerland. In order for individual instances of assisted dying to be lawful in these jurisdictions, a valid request must precede the provision of assistance to die. Non-adherence to the criteria for valid requests for assisted dying may be a trigger for civil and/or criminal liability, as well as regulatory sanctions where the assistor is a medical professional.In this article, we review the criteria and evidence in respect of requests for assisted dying in the Netherlands, Belgium, Oregon, and Switzerland. Our aim is to establish whether individuals who receive assisted dying do so on the basis of valid requests.
The Role of Community, State, Territorial, and Tribal Public Health in Obesity Prevention
Authors: Sommers Janice K. , Heiser Claire 
Published: January 2014

Across the nation, local, state, territorial, and tribal governments are engaged in successful efforts to protect and promote the health of their citizens by supporting healthy eating and active living initiatives. The ten essential services define a role for public health at multiple levels of influence (see Table 1). These functions provide a framework for obesity prevention that is consistent with the systems approach presented by the Institute of Medicine in “Accelerating Progress in Obesity Prevention.”Governmental public health authorities can contribute to public health efforts to address obesity by monitoring prevalence of obesity and association risk factors, investigating the contributing factors, informing the public, and work with the citizens in their jurisdiction to develop solutions that fit the needs and sensibilities of the people.
Type 1 diabetes patients' experiences of, and need for, social support after attending a structured education programme: a qualitative longitudinal investigation
Authors: Rankin David , Barnard Kath , Elliott Jackie , Cooke Debbie , Heller Simon , Gianfrancesco Carla , Taylor Carolin , Lawton Julia ,   the UK NIHR DAFNE Study Group
Published: January 2014

Aims and objectivesTo explore patients' experiences of, views about and need for, social support after attending a structured education programme for type 1 diabetes.BackgroundPatients who attend structured education programmes attain short‐term improvements in biomedical and quality‐of‐life measures but require support to sustain self‐management principles over the longer term. Social support can influence patients' self‐management practices; however, little is known about how programme graduates use other people's help.DesignThis study was informed by the principles of grounded theory and involved concurrent data collection and analysis. Data were analysed using an inductive, thematic approach.MethodsIn‐depth interviews were undertaken postcourse, six and 12 months later, with 30 adult patients with type 1 diabetes recruited from Dose Adjustment for Normal Eating courses in the United Kingdom.ResultsPatients' preferences for social support from other people ranged from wanting minimal involvement, to benefiting from auxiliary forms of assistance, to regular monitoring and policing. New self‐management skills learnt on their courses prompted and facilitated patients to seek and obtain more social support. Support received/expected from parents varied according to when patients were diagnosed, but parents' use of outdated knowledge could act as a barrier to effective support. Support sought from others, including friends/colleagues, was informed by patients' domestic/employment circumstances.ConclusionThis study responds to calls for deeper understanding of the social context in which chronic illness self‐management occurs. It highlights how patients can solicit and receive more social support from family members and friends after implementing self‐care practices taught on education programmes.Relevance to clinical practiceHealth professionals including diabetes specialist nurses and dietitians should explore: patients' access to and preferences for social support; how patients might be encouraged to capitalise on social support postcourse; and new ways to inform/educate people within patients' social networks.
Physical and sexual intimate partner violence, women's health and children's behavioural functioning: entry analysis of a seven‐year prospective study
Authors: Symes Lene , Maddoux John , McFarlane Judith , Nava Angeles , Gilroy Heidi 
Published: January 2014

Aims and objectivesTo increase knowledge of physical and sexual intimate partner violence against women, its impact on women's health and children's behavioural functioning.BackgroundPhysical assault and sexual assault frequently co‐occur. Women who experience both physical and sexual violence are at risk of poorer health outcomes than women who experience only physical violence. The behavioural functioning of children of women who experience partner violence may be adversely affected.DesignCross‐sectional, using baseline data from a seven‐year prospective study.MethodsData related to severity of abuse (both physical and sexual) and the outcome measures of maternal (n = 300) mental health measures, risk of lethality, chronic pain and child (n = 300) behavioural functioning were analysed.ResultsHigher physical abuse scores were significantly correlated with higher sexual abuse scores, and higher levels of physical abuse were associated with higher maternal anxiety and higher child externalisation scores. Higher levels of sexual abuse were associated with higher maternal somatisation and post‐traumatic stress disorder symptoms and higher child internalisation scores and total problems.ConclusionsThese initial findings suggest that children have behavioural functioning and coping that is closely related to their mothers' functioning, which is based on the type of abuse experienced by the mothers. As we gain a greater understanding of these issues, we will be better able to develop effective policies and therapeutic interventions to help abused women and their children.Relevance to clinical practiceFindings for the mental health functioning of women participating in this study add to the overwhelming evidence for the importance of screening for partner violence when women present for health care and for the need for effective assistance services for women who have or are currently experiencing partner violence. They also support emerging research that indicates the great need to provide effective services for the children of abused women.
A Food Service Intervention Improves Whole Grain Access at Lunch in Rural Elementary Schools
Authors: Cohen Juliana F. W. , Rimm Eric B. , Bryn Austin S. , Hyatt Raymond R. , Kraak Vivica I. , Economos Christina D. 
Published: January 2014

ABSTRACTBACKGROUNDWhole grain (WG) options are often limited in schools, which may impact rural, low‐income students who rely on school meals for a substantial portion of their food intake. This study examined the changes in the availability and quantity of WG and refined grain foods offered in schools participating in the Creating Healthy, Active and Nurturing Growing‐up Environments (CHANGE) study, a randomized, controlled intervention among rural communities (4 intervention and 4 control).METHODSFoods were assessed using production records, recipes, and nutrition labels from breakfast and lunch over 1 week during fall 2008 and spring 2009. Key informant interviews were conducted with school food service directors in the spring 2009.RESULTSThe CHANGE intervention schools significantly increased the average percent of school days WGs were offered (p = .047) and the amount of WGs offered/food item (ounces) at lunch compared with control schools (p = .02). There was a significant decrease in the percent of students with access to refined grains at lunch compared with control schools (p = .049), although there were no significant differences in WG availability during breakfast.CONCLUSIONSThe CHANGE schools improved WG availability, enabling student's WG consumption to be closer to national recommendations.
Piloting “Sodabriety”: A School‐Based Intervention to Impact Sugar‐Sweetened Beverage Consumption in Rural Appalachian High Schools
Authors: Smith Laureen H. , Holloman Christopher 
Published: January 2014

ABSTRACTBACKGROUNDSugar‐sweetened beverages (SSBs) are the largest source of added sugar in the US diet. In adolescents aged 12‐19, these drinks account for 13% to 28% of total daily calories. Compared with other adolescents, those residing in Appalachia have the highest consumption rates of SSBs.METHODSUsing a Teen Advisory Council (TAC), a student‐designed and student‐led intervention was conducted at 2 high schools in a rural Appalachian county. Using repeated‐measures models design with Bonferroni correction, data were collected on daily and weekly consumption of SSBs and of water at baseline, immediately post‐intervention, and 30 days post‐intervention. Vending machine surveys were completed.RESULTSThe 186 participants reported purchasing SSBs from school vending machines (41.4%), cafeteria (36.5%), and school stores (7.7%). Daily SSB servings decreased from an average of 2.32 (SD = 2.14) to 1.32 (SD = 1.29) (p < .001). Weekly consumption decreased from an average of 4.30 (SD = 2.40) days/week to 2.64 (SD = 1.91) (p < .001). Water consumption increased 19% from baseline to immediately post‐intervention.CONCLUSIONSStudent‐directed efforts to support behavioral change are feasible and effective at affecting individual lifestyle behaviors. Small and manageable changes may lead to net improvements in lifestyle behaviors.
Elementary and Middle School Children's Acceptance of Lower Calorie Flavored Milk as Measured by Milk Shipment and Participation in the National School Lunch Program
Authors: Yon Bethany A. , Johnson Rachel K. 
Published: January 2014

ABSTRACTBACKGROUNDThe United States Department of Agriculture's (USDA) new nutrition standards for school meals include sweeping changes setting upper limits on calories served and limit milk offerings to low fat or fat‐free and, if flavored, only fat‐free. Milk processors are lowering the calories in flavored milks. As changes to milk impact school lunch participation and milk consumption, it is important to know the impact of these modifications.METHODSElementary and middle schools from 17 public school districts that changed from standard flavored milk (160‐180 kcal/8 oz) to lower calorie flavored milk (140‐150 kcal/8 oz) between 2008 and 2009 were enrolled. Milk shipment and National School Lunch Program (NSLP) participation rates were collected for 3 time periods over 12 months (pre‐reformulation, at the time of reformulation, and after reformulation). Linear mixed models were used with adjustments for free/reduced meal eligibility.RESULTSNo changes were seen in shipment of flavored milk or all milk, including unflavored. The NSLP participation rates dropped when lower calorie flavored milk was first offered, but recovered over time.CONCLUSIONSWhile school children appear to accept lower calorie flavored milk, further monitoring is warranted as most of the flavored milks offered were not fat‐free as was required by USDA as of fall 2012.
Rural‐Urban Disparities in School Nursing: Implications for Continuing Education and Rural School Health
Authors: Ramos Mary M. , Fullerton Lynne , Sapien Robert , Greenberg Cynthia , Bauer‐Creegan Judith 
Published: January 2014

AbstractPurposeLittle is known about the professional and educational challenges experienced by rural school nurses. We conducted this study to describe disparities between the urban and rural professional school nurse workforce in New Mexico and to identify how best to meet the continuing education needs of New Mexico's rural school nurse workforce.MethodsWe analyzed state data from a 2009 New Mexico Department of Health school nurse workforce survey (71.7% response rate). We included all survey respondents who indicated working as a school nurse in a public school setting in any grade K‐12 and who identified their county of employment (N = 311).FindingsRural school nurses were twice as likely as metropolitan nurses to provide clinical services to multiple school campuses (67.3% compared to 30.1%, P < .0001). They were less likely to hold a nursing degree at the baccalaureate level or higher (62.7% compared to 82.3%, P = .0002). Rural school nurses were less likely than metropolitan nurses to have received recent continuing education on anaphylaxis (P < .0001), asthma (P = .027), body mass index (BMI)/healthy weight (P = .0002), diabetes (P < .0001), lesbian, gay, bisexual and transgender (LGBT) health (P = .0004), and suicide risk identification and prevention (P = .015). Online courses and telehealth were identified by rural school nurses as among the preferred means for receiving continuing education.ConclusionsOur findings support the provision of online courses and telehealth content to address urban‐rural disparities in school nursing education and support rural school health.