bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do the organizational reforms of general practice care meet users’ concerns? The contribution of the Delphi method
Authors: Krucien Nicolas , Le Vaillant Marc , Pelletier‐Fleury Nathalie 
Published: June 2011

AbstractContext  The debate over primary care reform in France, as in most OECD countries, centres on questions about efficacy and accessibility. Do these reforms actually respond to the users’ concerns?Objective  The objective of this study was to identify the importance that users attribute to different aspects of general practice (GP) care.Design  The method used was a variant of the classical Delphi approach, called Delphi ‘ranking‐type’. Between May and September 2009, 74 experts aged over 18 were recruited by ‘snowballing’ sampling. Three iterative rounds were required to identify the core aspects through a consensus‐building approach.Results  It is shown that users attribute a very high importance to the ‘doctor–patient relationship’ dimension. The following aspects ‘GP patient information about his/her illness’, ‘Clarity of communication and explanation’, and ‘Whether the GP seemed listen to the patient’ were evaluated by 96% of the experts as being of high importance. The coordination of GP was also considered as a very important aspect for 85% of the experts. In contrast, the aspects that belong to the organizational dimension appeared to be of relatively low importance for users.Conclusions  Our results support a comprehensive approach of care and argue in favour of care reorganization following the patient‐centred model. To promote organizational care reforms through the prism of the doctor–patient relationship could thus be a fruitful way to insure a better quality of care and the social acceptability of the reforms.
Association of the aldosterone synthase gene −344T>C polymorphism with essential hypertension and glucose homeostasis: A case–control study in a Han Chinese population
Authors: Li Xiao‐Mu , Ling Yan , Lu Da‐Ru , Lu Zhi‐Qiang , Yi Qian‐Lu , Liu Ying , Chen Hong‐Yan , Gao Xin 
Published: June 2011

Summary1. Aldosterone is a hormone that affects both blood pressure and glucose homeostasis. We studied the association of the aldosterone synthase gene (CYP11B2) polymorphism −344T>C with essential hypertension (EH) and glucose homeostasis in people in China.2. We investigated the polymorphism −344T>C in CYP11B2 using a case–control study design (1059 cases and 1120 controls). Genotyping was carried out by matrix‐assisted laser desorption/ionization time‐of‐flight mass spectroscopy using a MassARRAY platform.3. The aldosterone synthase gene −344T>C polymorphism was found to be associated with EH (odds ratio 1.252; 95% confidence interval 1.067–1.468; Padd = 0.006). The −344C variant was found to be significantly associated with increased systolic blood pressure (Padd = 0.003) and diastolic blood pressure (Padd = 0.024) in controls and increased plasma aldosterone levels (Padd = 0.0001) in EH cases. The −344C variant was also found to be significantly associated with increased fasting glucose (Prec = 0.003) in controls. In the subgroup containing 893 EH cases without a history of diabetes or hypoglycaemia medications, the −344C variant was found to be associated with increased fasting and postprandial plasma glucose levels (Padd = 0.0001, Padd = 0.001, respectively) and decreased pancreatic β‐cell function and insulin sensitivity (Padd = 0.030, Pdom = 0.019, respectively) by homeostasis model assessments.4. In this Han Chinese population, the −344T/C polymorphism of the CYP11B2 gene was found to be associated with EH and glucose homeostasis, both of which might be mediated by plasma aldosterone levels, insulin sensitivity and β‐cell function.
Infant deaths due to heparin overdose: Time for a concerted action on prevention
Authors: Monagle Paul , Studdert David M , Newall Fiona 
Published: June 2011

AbstractHeparin is one of the most commonly used drugs in tertiary paediatric centres. Across the last decade, targeted research has been directed towards improving the level of evidence supporting paediatric‐specific recommendations for the use and management of heparin in infants and children. In contrast, little effort has been directed towards improving the safe use of heparin despite a plethora of fatal and non‐fatal heparin‐related errors being reported in the lay press. This short report highlights the need for united and concerted action to develop strategies aimed at minimising avoidable infant deaths related to heparin errors.
A partnership for sustainable lake environment: collaborative monitoring and research on Laguna de Bay, Philippines, for management of resource use and ecosystem conservation
Authors: Herrera E. C. , Nadaoka K. , Blanco A. C. , Hernandez E. C. 
Published: June 2011

AbstractLaguna de Bay is the second largest inland waterbody in South‐east Asia. Considering its large size, its competing and conflicting water resource users, and increasing threats to its ecological integrity, coherent and participative relationship between and among its stakeholders is crucial for its sustainable management. This study discusses the foundation and framework, and the research results, of an ongoing joint monitoring and research collaboration between an academic institution and a government agency directed to the Laguna de Bay environment. Spatial and temporal monitoring of climatic, hydrodynamic and water quality lake variables were carried out collaboratively through field surveys and laboratory analyses. The lake’s temporal and spatial dynamics under changing atmospheric conditions were investigated through field monitoring efforts, coupled with three‐dimensional hydrodynamic and water quality modelling. Contrary to common perception, these study results indicated significant vertical and diurnal variations in lake variables, in spite of a shallow average water depth of 2.5 m. Intense atmospheric heating (≈800 W m−2), accentuated by the lake’s high turbidity (16–32 FTU), generated density differences along the vertical axis and caused stratification. Higher biological activity, with significantly correlated pH, dissolved oxygen and chlorophyll‐a variations during the dry season, is strongly related to the stable solar irradiance, reduced lake water volume and inflow of nutrient‐rich seawater from Manila Bay and Metro Manila sewage. The observed bottom hypoxic conditions (2–4 mg L−1), concurrent with the absence of thermal overturn, are suggestive of the importance of diel wind‐induced mixing and attest to the eutrophic condition of the lake. Numerical modelling analysis indicated that lake water quality was significantly affected by aquaculture operations and polluted seawater intrusions. Scenario simulations on bathymetric evolution demonstrated morphological changes that contributed to the eutrophic vulnerability of Laguna de Bay, in addition to anthropogenic‐based stressors. Given the natural inclination of tropical lakes to eutrophic conditions, actions across boundary, resource and responsibility sharing, and expansion of intellectual horizon through partnership, are vital for the rational and systematic resolution of lake water resource allocations and ecological preservation.
Integrated basin management in the Lake Biwa and Yodo River Basin
Authors: Bamba Y. 
Published: June 2011

AbstractThe Lake Biwa and Yodo River Basin contains Lake Biwa, Japan’s largest lake, which is located in the most upstream area of the Shiga Prefecture. The lake supplies a major part of the water used in the basin and also stabilizes the water flow of the Yodo River. It is also significant in that the water of the Yodo River is used repeatedly as it flows from Lake Biwa to Osaka Bay. Historically, the basin has been home to national capitals and possesses abundant history and cultural assets related to water. However, the basin also has experienced a long history of conflict related to flood and drought between upstream and downstream areas. Although the Lake Biwa Comprehensive Development Plan (1972) and Mother Lake 21 Plan (2000) worked well in solving the conflicts and basin issues, several remaining problems are still identified. The ‘Renaissance of Lake Biwa and Yodo River Basin Area Project’ (2005) urges establishment of an integrated basin management system, and the Shiga Prefecture is involved in continuing discussion with related organizations. Several viewpoints are highlighted, including: (i) Conservation and enhancement of a harmonious relationship between humans and water; (ii) Cooperation of upstream and downstream areas, and integration of measures of basin management and (iii) A sustainable system for basin management.
Effect of temperaments on quality of life and social adaptation in depressive patients with mood disorder
Authors: Takai Yoshifumi , Terao Takeshi , Goto Shinjiro , Hoaki Nobuhiko , Wang Yumei , Araki Yasuo 
Published: June 2011

Aims:  The aim of this study was to investigate the effects of temperament on quality of life and social adaptation in depressive patients with mood disorder.Methods:  Forty‐six consecutive depressive outpatients were investigated by using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego‐Autoquestionnaire version, the Munich Personality Test, the World Health Organization Quality of Life 26 (WHO QOL 26), and the Social Adaptation Self‐evaluation Scale (SASS). The unpaired t‐test, Pearson's r and multiple regression analysis were used to assess three variables (age, the number of temperaments and/or personality types, and Hamilton Depression Rating Scale scores) as independent variables with the scores of WHO QOL 26 and SASS as the dependent variables.Results:  The number of temperaments and/or personalities and Hamilton Depression Rating Scale scores were significantly and negatively associated with WHO QOL 26 scores while only the number of temperaments and/or personalities was significantly and negatively associated with SASS scores.Conclusions:  The findings suggest that the combination of temperaments and/or personality types assessed with the Temperament Evaluation of Memphis, Pisa, Paris and San Diego‐Autoquestionnaire version and the Munich Personality Test may worsen both quality of life and social adaptation and that some temperaments and/or personality types in combination may be subclinical manifestations of mood disorders.
The effect of clearing on plant composition in mulga (Acacia aneura) dry forest, Australia
Authors: FENSHAM R. J. , DWYER J. M. , EYRE T. J. , FAIRFAX R. J. , WANG J. 
Published: June 2011

AbstractDespite high deforestation rates in dry forests there are few assessments of the impacts of this transformation on biodiversity. This study addresses the impact of clearing on plant species composition and diversity in mulga (Acacia aneura) forests of Queensland, Australia using data collected from either side of 58 clearing boundaries, incorporating data on site and management conditions. The physical and climatic conditions of the study sites were narrowly constrained but had greater influence on plant composition and richness than clearing per se. In general, the abundance of perennial forbs and shrubs was higher in cleared forest compared with adjacent intact forest and there was no significant difference in abundance of other plant life forms. Perennial forb richness diminished with the age of clearings, particularly where acid sub‐soils had been exposed and shrubs proliferated. Where deforestation in the mulga dry forests is not accompanied by the establishment of exotic pasture it has a relatively benign effect on plant diversity, mulga itself remains in high density as small trees and the integrity of the forest could be maintained with restoration.
Serum lipids level assessed in early pregnancy and risk of pre‐eclampsia
Authors: Demirci Oya , Tuğrul Ahmet Semih , Dolgun Nihal , Sözen Hamdullah , Eren Sadiye 
Published: June 2011

AbstractAim:  The purpose of this study investigated the relationship between early pregnancy plasma lipid concentrations and risk of pre‐eclampsia.Material and Methods:  In a prospective cohort study, maternal blood samples were collected between 10–20 weeks of gestation. From the cohort, we selected 30 women who developed pre‐eclampsia and 320 who remained normotensive and served as control subjects. Linear logistic regression test was used for confounding factors identification.Results:  Women who subsequently developed pre‐eclampsia had higher concentrations of fasting plasma, total cholesterol and triglycerides than in those remaining normotensive group. After using linear logistic regression analyses for the potential confounding factors, triglyceride concentrations were significantly higher in pre‐eclamptic cases as compared with control.Conclusion:  Early pregnancy dyslipidemia, particularly hypertriglyceridemia appears associated with increased risk of pre‐eclampsia.
History of pediatric regional anesthesia
Authors: Brown T.C.K. 
Published: June 2011

SummaryThe history of local and regional anesthesia began with the discovery of the local anesthetic properties of cocaine in 1884. Shortly afterwards nerve blocks were being attempted for surgical anesthesia. Bier introduced spinal anesthesia in 1898, two of his first six patients being children. Spinal anesthesia became more widely used with the advent of better local anesthetics, stovaine and procaine in 1904–1905. Caudals and epidurals came into use in children much later. In the early years these blocks were performed by surgeons but as other doctors began to give anaesthetics the specialty of anesthesia evolved and these practitioners gradually took over this role. Specific reports of their use in children have increased as pediatric anesthesia has developed. Spinals and other local techniques had periods of greater and lesser use and have not been universally employed. Initial loss of popularity seemed to relate to improvements in general anaesthesia. The advent of lignocaine (1943) and longer acting bupivacaine (1963) and increasing concern about postoperative analgesia in the 1970–1980s, contributed to the increased use of blocks.
Metformin for gestational diabetes in routine clinical practice
Authors: Goh J. E. L. , Sadler L. , Rowan J. 
Published: June 2011

Diabet. Med. 28, 1082–1087 (2011)AbstractAims  To compare maternal and neonatal outcomes in women with gestational diabetes treated with diet, metformin and/or insulin in routine clinical practice in a single centre.Methods  We analysed prospectively collected data from the National Women’s Health database for all women with gestational diabetes who delivered between January 2007 and December 2009. Since June 2007, women requiring medication have been given a choice of either metformin or insulin treatment, except women with a fetal abdominal circumference less than the 10th percentile, who were not offered metformin.Results  There were 1269 women with gestational diabetes; treatment was diet in 371, insulin in 399 and metformin in 465 (249 metformin alone, 216 metformin and insulin). Women treated with metformin and/or insulin had significantly higher BMIs compared with those in the diet group (P < 0.001) and had a higher fasting glucose at diagnosis (p < 0.001). Women treated with insulin had higher rates of Caesarean delivery (45.6% insulin, 37% metformin, 34% diet, P = 0.02) than women treated with metformin or diet. They also had higher rates of preterm births (19.2% insulin, 12.5% metformin, 12.1% diet, P = 0.005), customized large‐for‐gestational‐age infants (18.5% insulin, 12.5% metformin, 12.4% diet, P = 0.02), neonatal admissions (18.7% insulin, 12.7% metformin, 14.0% diet, P = 0.04) and neonatal intravenous dextrose use (11.1% insulin, 5.1% metformin, 7.4% diet, P = 0.004). Neonatal outcomes were similar between diet‐ and metformin‐treated women.Conclusions  In routine practice, use of metformin in gestational diabetes was associated with fewer adverse outcomes compared with insulin, but baseline differences between treatment groups may have contributed to this.
A systematic review of the validity and reliability of sedentary behaviour measures used with children and adolescents
Authors: Lubans D. R. , Hesketh K. , Cliff D. P. , Barnett L. M. , Salmon J. , Dollman J. , Morgan P. J. , Hills A. P. , Hardy L. L. 
Published: June 2011

SummaryThe aim of this review was to evaluate the reliability and validity of methods used to assess the multiple components of sedentary behaviour (i.e. screen time, sitting, not moving and existing at low energy expenditure) in children and adolescents. Twenty‐six studies met our inclusion criteria and were reviewed. Thirteen studies reported the reliability of self‐ and proxy‐report measures of sedentary behaviour and seven of these were found to have acceptable test–retest reliability. Evidence for the criterion validity of self‐ and proxy‐report measures was examined in three studies with mixed results. Seven studies examined the reliability and/or validity of direct observation and the findings were generally positive. Five studies demonstrated the utility of accelerometers to accurately classify sedentary behaviour. Self‐report measures provide reliable estimates of screen time, yet their validity remains largely untested. While accelerometers can accurately classify participants' behaviour as sedentary, they do not provide information about type of sedentary behaviour or context. Studies utilizing measures of sedentary behaviour need to more adequately report on the validity and reliability of the measures used. We recommend the use of objective measures of sedentary behaviour such as accelerometers, in conjunction with subjective measures (e.g. self‐report), to assess type and context of behaviour.
Falling Back on Old Habits? A Comparison of the Social and Unemployment Crisis Reactive Policy Strategies in Germany, the UK and Sweden
Authors: Chung Heejung , Thewissen Stefan 
Published: June 2011

AbstractAlthough long‐term processes of welfare state development have been investigated frequently, there is a surprising gap in knowledge on short‐term reactions of states to sudden events. This article aims to fill this gap by examining the reactive policies, i.e. immediate policy responses to urgent social matters, of governments to the current economic crisis. We focus on social and unemployment policies of the three welfare regime ideal types of Esping‐Andersen's typology, namely Germany, the UK and Sweden. We apply long‐term policy development theories, most notably the convergence and path dependence theories, to understand the choices made in the different reactive policy strategies of these countries. In addition, we scrutinize whether we find similarities between the reactive policies and the converging structural welfare state developments. We use comparable data from various European and national data sources for the two years directly following the recent crisis, namely 2008 and 2009. Our analysis shows that, at least for the three countries under investigation, countries seem to have fallen back on ‘old habits’ by adopting social and unemployment reactive policies that can be identified based on their institutional legacies. This suggests that reactive policy strategies can be explained by different dynamics than the more structural long‐term policy developments, and in our case we find evidence in support for the path dependence theory.
The Impact of the Crisis on Australian Social Security Policy in Historical Perspective
Authors: Saunders Peter , Deeming Chris 
Published: June 2011

AbstractThe Labor government was elected in November 2007 with a commitment to reject the labour market deregulation and other neo‐liberal policies of its predecessor, promote equality of opportunity and tackle entrenched social and economic disadvantage by implementing a new social inclusion agenda. In response to the financial crisis which had begun at the end of 2007 and had turned into a full global recession by the middle of 2008, the government introduced two substantial stimulus packages funded from the large budget surplus it had inherited from its predecessor. The fiscal stimulus has helped Australia to become the only advanced economy to avoid a technical recession (to date), although there is concern that the downturn has created a situation where social policy is being driven by political expediency rather than by the principles and commitments set out in the government's pre‐election social policy manifesto. Against this background, this article examines how the latest crisis has shaped social security policy in Australia and compares the recent policy response with the policy response to earlier crises. Analysis focuses not just on what was actually done, but also on the constraining role of prevailing economic and political circumstances and on the processes that were used to drive reform in a wage earners' welfare state.
Economic Crisis and Welfare Retrenchment: Comparing Irish Policy Responses in the 1970s and 1980s with the Present
Authors: Dukelow Fiona 
Published: June 2011

AbstractThis article juxtaposes the impact of the current economic crisis on the Irish welfare state with the impact of the international economic crisis of the 1970s which had a sustained effect in Ireland during much of the 1980s. The analysis focuses on the consequences for social security programmes during both crisis periods, each of which was marked by intractable socio‐economic and budgetary pressures. However, while elements of welfare retrenchment can be observed during the economic crisis of the 1980s, these appeared more difficult to instigate and sustain in comparison to the present period. As an inter‐temporal qualitative case study, this article aims to identify key drivers influencing why welfare retrenchment has more readily occurred and, it would appear so far, at a potentially deeper level than during the 1980s. As of yet the economic crisis is unabated, and as welfare state changes typically occur in relatively slow motion (Castles 2010), outcomes of the process remain uncertain. However, it seems that if Ireland continues on the path it has instigated, the liberal disposition of the Irish welfare state will intensify.
Explaining Welfare Reforms in Italy between Economy and Politics: External Constraints and Endogenous Dynamics*
Authors: Maino Franca , Neri Stefano 
Published: June 2011

AbstractSince the end of the ‘golden age’ of the welfare state, in Italy as in most European countries the reform of social protection has progressively emerged as one of the key issues in political debate. In this article we describe the evolution of the Italian welfare state over the past three decades, highlighting the distinctiveness of each decade. The analysis is mainly focused on three policy sectors: pension, health care and social assistance. After a policy stalemate, which lasted throughout the 1980s, far‐reaching reforms took place in the 1990s and in the early 2000s. We will argue that the sequence of reforms was the result of a change that had both endogenous and exogenous sources. In particular, relevant changes in the political system emerged after 1992 and international constraints on public expenditure and debt combined to stimulate co‐operation between the government and its social partners in the case of pension reforms and joint policy‐making between central government and the regions in health care and social assistance reforms. During the 2000s, actors continued to carry out agreed reforms to adjust the pension system, even though co‐operation was made difficult by the conflicts on the labour market front. In health and social care, which are matters devolved to the regions after the 1990s and the 2001 constitutional reform, central government and the regions sought to implement and stabilize new mechanisms for the governance of both sectors. Although conflict alternated with co‐operation, nevertheless both external and internal constraints induced actors, often reluctantly, to develop and institutionalize joint policy‐making.