bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Limited Role of Citizens in Shaping Healthcare Policies
Authors: Esfandiari Shahrokh 
Published: May 2010

AbstractCitizens everywhere are seeking a greater role to influence their government decision‐making. This interest in policymaking decisions has forced governments to adopt new methods to involve citizens. Although most governments acknowledge the need of their citizens' active participation in their healthcare plans, they do very little to facilitate such involvements. The toughest challenge of most healthcare systems is to get providers to acknowledge the importance of patients' choices in the health decision‐making process and to develop strategies to disseminate this information into clinical decisions. There is no gold standard among actively participating citizens in choosing policies that affect their day‐to‐day lives. There is also no evidence to support the idea that citizens' participation in decision‐making undermines the role of democratically elected representatives. If governments are interested in eliminating the apparent democratic deficit in healthcare policymaking, they need to create a vehicle that safely transfers information to their citizens and make it physically, socially, and culturally accessible to the community.
Health System Strengthening Beyond the MDGs for Maternal and Child Health in Malawi: Lessons from Policy Analysis
Authors: Daire Judith Melinda , Khalil Doris D. 
Published: May 2010

AbstractThe article aims to draw the attention of advocators and policy makers in Malawi to consider the context of Malawi as they adopt and implement the components of health system strengthening. It analyzes the context of Maternal and Child Health (MCH) policies in Malawi from 1964 to 2008 and identifies constraints encountered in implementing MCH policies. In addition the article draws conclusion from the study results and makes recommendations. The study found out that the contextual factors that influence MCH policies in Malawi were similar to the constraints encountered in implementing the policies in the health system. Therefore the paper recommends that health systems strengthening that will sustain improved health outcomes beyond achieving the Millennium Development Goals (MDGs) need to take into consideration the influencing factors of the context in which health systems operate. Ultimately, health system strengthening for achieving MDGs should be regarded as means for achieving sustained health outcomes not an end in itself.
How to Find the Right Approach to Quality Measurement: Determinants of Quality and Its Measurement in Healthcare
Authors: Thielscher Christian 
Published: May 2010

AbstractMeasuring quality in health care is an important as well as frequent issue for polic makers and other parties. However, many attempts to measure quality fail. This paper analyzes typical reasons for failures and derives a set of determinants whose application decides on measurement success: the disease studied, the type of treatment studied, definition of “outcome,” purpose of quality measurement, time and location of treatment, measurement technique, and expected reasons for and amounts of quality differences. By discussing determinants in detail, a list of questions that should be answered before starting quality measurement is developed. Because determinants are equally important for investigators and policy makers, issues specific to the latter are discussed in an additional paragraph.
Social Capital and Health in Latin America: Ecological and Individual Level Analyses
Authors: Sapag Jaime C. , Kawachi Ichiro 
Published: May 2010

AbstractBackground: Several studies have evaluated the relationship between social capital and health in North America and Western Europe, although data remain scarce in Latin America. We examined the associations between indicators of social capital and health outcomes in nine Latin American countries. Methods: Design: Cross‐sectional ecological and individual‐level analyses of the relationships between social capital and health outcomes. Setting: Nine Latin American countries (Argentina, Brazil, Chile, Colombia, Dominican Republic, Mexico, Peru, Uruguay, and Venezuela), included in the World Values Survey. Subjects: 14,591 adults over 18 years. Main outcome measures: life expectancy at birth, infant mortality rate, under‐5 mortality rate, and maternal mortality rate (ecological analyses), and odds ratios of reporting good (as opposed to poor) self‐rated health (individual‐level analyses). Results: Trust was significantly correlated with life expectancy at the cross‐national level (r=0.72, p=0.03), and marginally significantly correlated with the maternal mortality rate (r=−0.61, p=0.09). Neither voluntary group participation nor church attendance was correlated with aggregate population health indicators. At the individual level, higher trust was significantly correlated with better self‐rated health in five of the nine countries. Group membership was correlated with better health in three countries. Church attendance was correlated with worse health in Mexico and the Dominican Republic. Conclusions: Our findings provide preliminary support for the relevance of social capital as a determinant of health in the Latin American region. However, further research is warranted on refining the measurement of social capital in this region.
Medical and Public Health Civic Action Programs: Using Health Engagement as a Tool of Foreign Policy
Authors: Avery George H , Boetig Bradley J 
Published: May 2010

AbstractThe problem of failing states and the resulting increase in armed conflict has provoked a reexamination of foreign and security policies used to support the legitimacy of the state. One set of tools that are used in this instance are health engagement programs such as military Medical Civic Action Programs. This article examines the logic of the programs from the perspective of social contract theory and proposes criteria for developing these interventions in a manner consistent with the strategic goal of stabilizing the state. Case studies in Iraq and Bangladesh are used to illustrate proper planning and implementation of health engagement programs.
Assessing the Potential Role of Indian Homeopathic Practitioners in HIV Education and Prevention
Authors: George Sheba , Nyamathi Adey , Lowe Ann , Singh Vijay , Khurana Anil , Taneja Divya 
Published: May 2010

AbstractBased on eight focus group interviews with homeopathic practitioners in New Delhi and Pune, India, this study describes current HIV education/prevention practices of Indian homeopathic practitioners and qualitatively assesses the barriers and facilitators to integrating HIV prevention/education into homeopathic practice. We found that HIV/AIDS is in fact a subject of conversation and clinical evaluation in Indian homeopathic settings; yet practitioners are not well‐equipped to address this need. Our findings highlight the critical importance of (1) increasing theoretical and practical HIV knowledge and educational resources among practitioners, (2) integrating the unique features of homeopathy into the allopathic foundations of HIV education/prevention efforts, (3) addressing societal factors such as widespread stigma, fear, and ignorance among both patients and practitioners, and (4) addressing the challenges of dealing with socially sensitive and taboo topics such as sexuality through focused communication training. Education for Indian homeopaths may contribute to better prevention of HIV in India.
Disease Mongering in Psychiatry: Is It Fact or Fiction?
Authors: Saddichha Sahoo 
Published: May 2010

AbstractDisease mongering starts at the top of recent accusations being hurled at psychiatry. It is used to refer to the attempts by pharmaceutical companies or others who have similar interests, to enlarge the market for a treatment by convincing people that they are sick and need medical intervention. This paper critically analyses the ‘for’ and ‘against’ arguments of disease mongering in psychiatric disorders, both new and old, such as Bipolar disorders, ADHD, Restless legs syndrome, Premenstrual dysphoric disorder, female sexual dysfunction, social phobia, metabolic syndrome and road rage disorder.
The Global Role of the Doctor in Healthcare
Authors: Gordon David , Lindgren Stefan C. 
Published: May 2010

AbstractMedical care is deficient in many parts of the world, while in richer countries the costs and complexities of health care are rising unsustainably. Thus, societies need to understand what it is that only doctors can do and what can or should be done by other members of the healthcare team. The duty of doctors to examine their accountability to society as a whole is critical, in order not to continue blindly to do what has always been done. We argue that doctors may not need, in the future to undertake all their traditional roles, while other new roles may emerge instead. A synthesis of these elements is necessary to propose a policy and philosophy for the future global role of the doctor. Only when we have defined this, is the stage set for medical education to produce a person equipped to fulfill that role.
Use of the Balanced Scorecard to Assess Provincial Hospital Performance in Afghanistan
Authors: Chang Christine S , Bonhoure Philippe , Alam Sahibullah , Hansen Peter , Burnham Gilbert 
Published: May 2010

AbstractObjectives: An assessment of provincial hospitals in Afghanistan was carried out in 2007 to measure performance against the national standards and guidelines in the Essential Package of Hospital Services. Methods: Assessment instruments were developed through consultation with the Ministry of Public Health and key stakeholders. Teams of six persons spent three days at each of the 30 provincial hospitals. Results are displayed using a balanced score card approach. Results: Considerable variation exists across hospitals. Administrative management domains, patient satisfaction and community involvement tended to be higher scoring. Financial systems, quality and safety, and ethics and value domains and indicators were lower. Discussion: This assessment demonstrates a wide range of performance of provincial hospitals nationally. This may reflect the diversity of funding, funding levels, and characteristics of facilities. Despite these challenges the level of performance in many hospitals is surprisingly good. Conclusion: Assessment of hospital performance when displayed using the balanced score card approach can provide meaningful information for policy formulation and assist hospital management in improvement of services.
Global Perspectives of Pharmacy Education and Practice
Authors: Anderson Claire , Bates Ian , Futter Billy , Gal Diane , Rouse Mike , Whitmarsh Sarah 
Published: May 2010

AbstractPharmacists have been shown to reduce morbidity and mortality, reduce medication errors, improve rational use and prescribing of medicines, and increase access to health care and medicines. Unfortunately, in many countries there is a severe shortage of appropriately‐trained pharmacists and pharmaceutical human resources. The WHO UNESCO FIP Pharmacy Education Taskforce is steering sustainable pharmacy education and pharmacy workforce action to support and strengthen local, national, regional and international efforts. The Taskforce advocates for a needs‐based approach, which aims to meet the pharmaceutical needs of the local population. This paper explains the concept of needs‐based education, describes the work of the Pharmacy Education Taskforce, and explores key issues in pharmacy education development and quality assurance.
Reflections on the Pandemic Influenza A (H1N1) Experience in Argentina
Authors: Vazquez Hebe , Dignani Cecilia , Bologna Rosa , Rojas Magda , Stamboulian Daniel 
Published: May 2010

AbstractThe explosive outbreak of pandemic influenza A (H1N1) in Argentina lasted about six weeks, from mid May to late June, with widespread transmission across the country. Influenza virus represented 82.13% of the cases reporting respiratory virus. Consultations for influenza‐like illness in general practices and emergency departments peaked at 309 consultations for every 10,000 inhabitants. Children and young adults were the age groups most affected. From 7 May to 31 October, 2009, 10,248 confirmed cases, 12,471 hospitalizations for severe respiratory disease, and 600 deaths were reported to the Ministry of Health. The most affected group was children under 5 years of age (hospitalization rate 72.99/100,000), followed by the 45–54 year age group. In this latter group, the most frequent preexisting conditions were cardiovascular, respiratory, and metabolic diseases. As in other countries, obesity and pregnancy were risk factors for increased morbidity. The experience of this first pandemic wave has taught us that coordinated work, community education, early treatment with antiviral drugs, and vaccine administration during the next season for high‐risk groups are likely to be fundamental tools against the next pandemic wave.
Access to Care versus Access to Coverage: What Can We Learn from the Louisiana State Hospital Model?
Authors: Clark Mary A. 
Published: May 2010

AbstractPublicly‐funded direct access‐to‐care models are so clearly inadequate in most of the United States that little attention has been devoted to them as alternatives to insurance expansions for low‐income populations. Louisiana's state hospital system is an unusually comprehensive access‐to‐care model in a particularly poor state. This paper describes a series of improvements made in the Louisiana State University (LSU) hospital system under the rubric of a healthcare effectiveness campaign begun in 1997. They have made Louisiana's access‐to‐care model a workable avenue for providing healthcare services for its low‐income population. But financial instability and shortfalls threaten the sustainability of the LSU hospital system both in terms of annual operating budgets and money for capital improvements.
Associative and Phonological Priming Effects after Letter Search on the Prime
Authors: Kahan Todd A. , Sellinger John J. , Broman-Fulks Joshua J. 
Published: May 2010

Abstract
Responses to target words typically are faster and more accurate after associatively related primes (e.g., "orange-juice") than after unrelated primes (e.g., "glue-juice"). This priming effect has been used as an index of semantic activation, and its elimination often is cited as evidence against semantic access. When participants are asked to perform a letter search on the prime, associative priming typically is eliminated, but repetition and morphological priming remain. It is possible that priming survives letter search when it arises from activity in codes that are represented before semantics. This experiment examined associative and phonological priming to determine whether priming from phonologically related rhymes would remain after letter search (e.g., "moose-juice"; rhyming items were orthographically dissimilar). When participants read the primes, equivalent associative and phonological priming effects were obtained; both effects were eliminated after letter search. The impact of letter search on semantic and phonological access and implications for the structural arrangement of lexical and semantic memory are discussed.
Things We Talk about, How Frequently, and to Whom: Frequency of Topics in Everyday Conversation as a Function of Gender, Age, and Marital Status
Authors: Sehulster Jerome R. 
Published: May 2010

Abstract
The questionnaire "Things I Talk About, How Frequently, and to Whom" measured the frequency with which people discussed 27 topics in everyday conversation. Twenty-three topics were subdivided into the topic in which content concerned a spectator perspective or a participant perspective. Factor analyses of 515 people yielded 5 factors for each perspective. Among the topic factors were beauty, worldly issues, everyday issues, hobbies, and sports and partying. Gender and age differences were observed not only in frequency of talk but also with whom people conversed. A detailed analysis of the kinds of spectator sports people talk about was included.
Electrocardiogram (EKG) Guided Peripherally Inserted Central Catheter Placement and Tip Position: Results of a Trial to Replace Radiological Confirmation
Authors: Moureau Nancy L. , Dennis Glenda L. , Ames Elizabeth , Severe Robyn 
Published: May 2010

Abstract
Background: The current standard of care for Peripherally Inserted Central Catheters (PICCs) is radiological confirmation of terminal tip location. Tip location practices in Europe have used electrocardiographic (EKG) guided positioning for central venous catheters for more than twenty years with tip positioning safely confirmed over thousands of insertions (Madias, 2003). The goal of this group was to confirm the findings of a study performed by Pittiruti and his team; and to establish safe function in the use of EKG guidance for verification of terminal tip position with PICCs placed at McKenzie Willamette Medical Center.
Methods: In 2008/2009 McKenzie Willamette Medical Center conducted a study to determine whether or not EKG guidance can be used as a reliable means to accurately place and confirm terminal tip location of PICCs. A group of trained nurses performed PICC placement using EKG guidance followed by radiological confirmation of SVC position. All PICCs placed from October 2008 to December 2009 were included in the study. Tip location was confirmed using either radiological confirmation alone, EKG plus radiological confirmation, or EKG alone.
Results: A total of 417 PICCs were placed during the study period. EKG guidance alone was used in the placement and confirmation of 168 PICCs. Both EKG and chest x-ray confirmation were used in the placement of 82 of the PICCs; 240 of the PICCs were placed with the use of EKG and then position correlated using the traditional chest x-ray procedure.
Discussion: EKG guided PICC placement proved accurate in consistently guiding the terminal tip to the superior vena cava (SVC). The procedure was easily taught and duplicated by members of the PICC team. The study demonstrated a definite correlation between the height (size) of the P-wave and the location of the terminal tip within the SVC. With knowledge of this correlation, transition from placing PICCs using EKG guidance with chest x-ray confirmation to confirmation of tip placement using just EKG guidance without chest x-ray confirmation was attained. Application of EKG placement/confirmation performed during insertion saves time previously spent waiting for x-ray confirmation readings, saves cost of chest x-ray, prevents patient exposure to radiation and saves time required for tip repositioning of malpositioned tips found after the end of the procedure.
Rosiglitazone and Cognitive Stability in Older Individuals With Type 2 Diabetes and Mild Cognitive Impairment
Authors: Abbatecola Angela M. , Lattanzio Fabrizia , Molinari Anna M. , Cioffi Michele , Mansi Luigi , Rambaldi Pierfrancesco , DiCioccio Luigi , Cacciapuoti Federico , Canonico Raffaele , Paolisso Giuseppe 
Published: May 2010

OBJECTIVE
Studies have suggested that insulin resistance plays a role in cognitive impairment in individuals with type 2 diabetes. We aimed to determine whether an improvement in insulin resistance could explain cognitive performance variations over 36 weeks in older individuals with mild cognitive impairment (MCI) and type 2 diabetes.

RESEARCH DESIGN AND METHODS
A total of 97 older individuals (mean ± SD age 76 ± 6 years) who had recently (&lt;2 months) started an antidiabetes treatment of metformin (500 mg twice a day) (n = 30) or metformin (500 mg/day)+rosiglitazone (4 mg/day) (n = 32) or diet (n = 35) volunteered. The neuropsychological test battery consisted of the Mini-Mental State Examination (MMSE), Rey Verbal Auditory Learning Test (RAVLT) total recall, and Trail Making Tests (TMT-A and TMT-B) performed at baseline and every 12 weeks for 36 weeks along with clinical testing.

RESULTS
At baseline, no significant differences were found between groups in clinical or neuropsychological parameters. Mean ± SD values in the entire population were as follows: A1C 7.5 ± 0.5%, fasting plasma glucose (FPG) 8.6 ± 1.3 mmol/l, fasting plasma insulin (FPI) 148 ± 74 pmol/l, MMSE 24.9 ± 2.4, TMT-A 61.6 ± 42.0, TMT-B 162.8 ± 78.7, the difference between TMT-B and TMT-A [DIFFBA] 101.2 ± 58.1, and RAVLT 24.3 ± 2.1. At follow-up, ANOVA models tested changes in metabolic control parameters (FPI, FPG, and A1C). Such parameters improved in the metformin and metformin/rosiglitazone groups (Ptrend &lt; 0.05 in both groups). ANCOVA repeated models showed that results for the metformin/rosiglitazone group remained stable for all neuropsychological tests, and results for the diet group remained stable for the MMSE and TMT-A and declined for the TMT-B (Ptrend = 0.024), executive efficiency (DIFFBA) (Ptrend = 0.026), and RAVLT memory test (Ptrend = 0.011). Results for the metformin group remained stable for the MMSE and TMTs but declined for the RAVLT (Ptrend = 0.011). With use of linear mixed-effects models, the interaction term, FPI × time, correlated with cognitive stability on the RAVLT in the metformin/rosiglitazone group (β = −1.899; P = 0.009).

CONCLUSIONS
Rosiglitazone may protect against cognitive decline in older individuals with type 2 diabetes and MCI.
Survival of Patients With Type 1 Diabetes Receiving Renal Replacement Therapy in 1980–2007
Authors: Haapio Mikko , Helve Jaakko , Groop Per-Henrik , Grönhagen-Riska Carola , Finne Patrik 
Published: May 2010

OBJECTIVE
Risks of end-stage renal disease and premature death in patients with type 1 diabetes have declined over the past decades. Data on the survival of patients receiving renal replacement therapy (RRT) are, however, limited. We investigated whether survival of patients with type 1 diabetes receiving RRT has improved over time and whether improvement can be attributable to progress in dialysis treatment or diabetes care.

RESEARCH DESIGN AND METHODS
An incident cohort of all patients with type 1 diabetes (n = 1,604) starting chronic RRT in Finland between 1980 and 2005 were followed until death or end of follow-up on 31 December 2007. The control group (n = 1,556) consisted of patients with glomerulonephritis who started RRT. All patients were identified from the Finnish Registry for Kidney Diseases.

RESULTS
Median survival time of patients with type 1 diabetes increased progressively from 3.60 years during 1980–1984 to &gt;8 years in 2000–2005. In 2000–2005, the unadjusted relative risk of death was 0.55 compared with 1980–1984. After adjustment for the most important variables, the corresponding relative risk of death was only 0.23. For patients with glomerulonephritis, the adjusted relative risk decreased to a lesser extent to 0.30 (P = 0.007).

CONCLUSIONS
Survival of patients with type 1 diabetes and end-stage renal disease has improved since the 1980s despite a conspicuous increase in the age of patients who start RRT, suggesting not only true progress in dialysis therapy and overall treatment of patients with end-stage renal disease but possibly also improved management of diabetes.