bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community Professionals’ Management of Client Care: A Mixed-Methods Systematic Review
Authors: Kolehmainen Niina , Francis Jill , Duncan Edward , Fraser Cynthia 
Published: January 2010

Objectives To review the literature on individual community professionals’ caseload management (behaviours related to assessment, treatment and discharging of clients) to identify the main themes and concepts, and to synthesize the findings to inform practice, policy and research. Methods Publications were systematically identified from electronic databases, hand searches of bibliographies, and contact with professional organizations. There were no restrictions on language, the nature of publications or publication year. Procedures were systematically applied for quality appraisal and data extraction. Qualitative and descriptive quantitative methods were used for data analysis and synthesis. Results Search criteria yielded 2048 papers of which 42 papers met the inclusion criteria. Thirty-five percent of these were based on research, the rest on professionals’ experiences. The papers covered 16 professional and 20 client populations, and their quality was generally poor. Analysis identified six broad themes: definitions of caseload management, caseload measurement and ‘tools’, models of caseload management practice, client- professional relationship, discharging and professional guidance. Six papers presented issues that related to but did not fit within these themes. Current caseload management tools and models of caseload management practice had a poor evidence base. Five papers described benefits of team-based approaches. Professional guidance for caseload management is limited in detail and relevance to daily practice. Conclusions Although there is a considerable literature on caseload management, it is not possible to make summative conclusions. Policy-makers and professional bodies should encourage and support development of research evidence about the ways to achieve effective, efficient and equitable caseload management. Health and social care services considering implementing caseload management tools or models of practice should critically appraise their basis, and consider their potential advantages as well as disadvantages.
Scoping Review and Approach to Appraisal of Interventions Intended to Involve Patients in Patient Safety
Authors: Peat Maggie , Entwistle Vikki , Hall Jill , Birks Yvonne , Golder Su 
Published: January 2010

Objective To review the literature on the involvement of patients in efforts to promote their own or others’ safety while using health care services. Method A total of 1933 reports were identified as potentially relevant and 745 of these were included in the review (437 descriptions of interventions, 299 comment or opinion pieces and 42 discussions or studies of patients’ willingness and ability to adopt safety-promoting behaviours). Results The rate of publication on these topics has increased, especially in the USA and UK. However, there is scant evidence of the impact of patient involvement initiatives on safety outcomes and there has been little exploration of patients’ willingness and ability to adopt particular safety-oriented behaviours. We identified three broad routes by which patients’ actions might contribute to their safety by helping to make sure that: their treatment is appropriate for them (informing the management plan); treatment is given as planned and according to appropriate protocols (monitoring and ensuring safe delivery of treatment); and problems and risks within health care systems are identified and reduced (informing systems improvements). Conclusions An approach for appraising interventions intended to promote patient involvement in patient safety should involve: identification of the routes by which interventions assume patients’ actions might contribute to their safety; identification of the conditions that would need to be met for patients to behave and contribute as the interventions (implicitly) assume; examination of the extent to which the intervention supports fulfilment of those conditions; and consideration of the potential negative effects of the intervention.
Learning About Patient Safety: Organizational Context and Culture in the Education of Health Care Professionals
Authors: Pearson Pauline , Steven Alison , Howe Amanda , Sheikh Aziz , Ashcroft Darren , Smith Pam 
Published: January 2010

Objectives This study investigated the formal and informal ways pre-registration students from medicine, nursing, physiotherapy and pharmacy learn about keeping patients safe. This paper gives an overview of the study and explores findings in relation to organizational context and culture. Methods The study employed a phased design using multiple qualitative methods. The overall approach drew on ‘illuminative evaluation’. Ethical approval was obtained. Phase 1 employed a convenience sample of 13 pre-registration courses across the UK. Curriculum documents were gathered, and course directors interviewed. Phase 2 used eight case studies, two for each professional group, to develop an in-depth investigation of learning across university and practice by students and newly-qualified practitioners in relation to patient safety, and to examine the organizational culture that students and newly-qualified staff are exposed to. Analysis was iterative and ongoing throughout the study, using frameworks agreed by all researchers. Results Patient safety was felt to have become a higher priority for the health care system in recent years. Incident reporting was a key feature of the patient safety agenda within the organizations examined. Staff were often unclear or too busy to report. On the whole, students were not engaged and may not be aware of incident reporting schemes. They may not have access to existing systems in their organization. Most did not access employers’ induction programmes. Some training sessions occasionally included students but this did not appear to be routine. Conclusions Action is needed to develop an efficient interface between employers and education providers to develop up-to-date curricula for patient safety.
Quinine-Quinidine Mix-Ups Still Happen; APSF Offers Recommendations for Safe Postop Opioid Administration and Monitoring
Authors: Cohen Michael R. , Smetzer Judy L. 
Published: January 2010

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site ( www.ismp.org ), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
Development and Implementation of a Pharmacy Fall Prevention Program
Authors: Beasley Burl , Patatanian Edna 
Published: January 2010

Purpose Describe the development, implementation, and outcomes of a pharmacy fall prevention program (PFPP) that incorporates medication profile review and a medication fall risk score to identify high-risk patients. Summary Falls are a common cause of morbidity and mortality among elderly patients in the United States. Injury-related falls may contribute to frequent visits to emergency departments (EDs) and hospitals, as well as functional and emotional decline. Falls account for more than 10% of ED visits and more than 5% of hospital visits. Numerous reports describe common risk factors associated with falls of hospitalized patients and which safety measures should be taken to prevent or eliminate falls. The fall prevention program has a positive financial impact by reducing injury falls in hospitalized patients. During the first 2 years of implementation, the injury fall rate decreased from 2.06 to 1.07 per 1,000 patient-days (48%). The total falls rate decreased from 5.13 to 3.59 per 1,000 patient-days (30%). This program showed a savings of $217,000 per year in prevented falls. Conclusion Incorporating medications and their related adverse effects into a fall prevention program is an integral part of a multidisciplinary approach to reduce total falls and related injuries. The decrease in falls has improved patient safety and quality of care.
A Retrospective Review of Short-Term Outcomes after Switching Patients from Clopidogrel to Alternative Antiplatelet Therapy
Authors: Fjeldheim Renae , Welch Justin , Koo Ji 
Published: January 2010

Purpose To describe a process used at one facility to switch patients receiving clopidogrel to another antiplatelet therapy when appropriate. Additionally, to evaluate adverse effects in these patients and estimate drug acquisition cost savings. Methods Clinical pharmacists reviewed patient charts and recommended switching antiplatelet therapy where appropriate, based on established facility criteria. Charts were later reviewed in an outcomes assessment for those patients who were switched. Primary outcomes assessed included ischemic and bleeding events; secondary outcomes included net change in use of proton pump inhibitors or histamine H2 antagonists, headache, gastrointestinal (GI) upset, allergy, and clopidogrel reinitiation. Drug acquisition cost savings was also estimated. Results A total of 560 patient charts were reviewed, and 373 clopidogrel prescriptions were discontinued. Outcomes were assessed for 215 patients. In total, 20.9% of patients were taking clopidogrel for indications outside the established criteria. Patients were switched to aspirin (48.8%), Aggrenox plus aspirin (29.3%), Aggrenox only (14%), no antiplatelet (7.4%), or warfarin (0.5%). The total ischemic event rate was 5.6%, with all cerebrovascular ischemic events occurring in patients taking Aggrenox plus aspirin. The mean bleeding rate was 5.6%, with 1 major bleeding event. Headache, GI upset, and allergy were reported only in patients taking Aggrenox (with or without additional aspirin). Primarily because of adverse effects of Aggrenox, 23 patients were restarted on clopidogrel. Estimated drug acquisition cost savings at 12 months was approximately $136,500. Conclusions A large number of patients were taking clopidogrel for indications and/or durations outside established guidelines, and most were satisfactory candidates for other antiplatelet medications. Adverse ischemic and bleeding events were comparable with rates previously reported in literature. Patients who were switched to Aggrenox plus aspirin had the highest rates of ischemic events and adverse drug reactions, and were most likely to restart clopidogrel. Nearly 90% of patients tolerated the new antiplatelet therapy at the time of the outcomes review. As a result, the facility was able to appreciate a drug acquisition cost savings.
Dronedarone
Authors: Cada Dennis J. , Levien Terri L. , Baker Danial E. 
Published: January 2010

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing inservices. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent in print and are also available online. Monographs can be customized to meet the needs of a facility. Subscribers to The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The December 2009 monograph topics are on ustekinumab, pralatrexate injection, vigabatrin, bepotastine besilate ophthalmic solution 1.5%, and ganciclovir ophthalmic gel 0.15%. The DUE is on ustekinumab.
New Drug Approvals: Silodosin for Benign Prostatic Hyperplasia
Authors: Cantrell Matthew A , Bream-Rouwenhorst Heather R , Hemerson Phyllis , Magera James S 
Published: January 2010

Objective:To review the pharmacology, pharmacokinetics, clinical trials, and safety of silodosin, a recently approved α1A-adrenergic receptor (AR) antagonist for benign prostatic hyperplasia (BPH).Data Sources:English-only articles obtained from MEDLINE (1966–October 2009) using the search terms silodosin and KMD-3213 were reviewed. In addition, a search of International Pharmaceutical Abstracts (1970–October 2009) was conducted.Study Selection and Data Extraction:Available English-language articles were reviewed, as well as abstracts from available non-English articles.Data Synthesis:Silodosin reduces urinary symptoms associated with BPH in as little as 1 day after initiation. The largest clinical trial conducted to date demonstrated a decrease in International Prostate Symptom Score of –6.4 ± 6.63 points compared to –3.5 ± 5.84 in patients receiving placebo (p < 0.0001). Silodosin also improved urinary flow rates by approximately 2.8 ± 3.44 mL/sec, which is comparable to other α1-AR antagonists. The usual dose of silodosin is 8 mg once daily and should be reduced to 4 mg for patients with moderate renal dysfunction. Use is contra indicated in patients with severe renal and hepatic impairment or taking strong CYP3A4 inhibitors. In clinical trials, the most prevalent adverse effects were ejaculatory disturbances, occurring in approximately 28% of patients, although only 2.8% of patients discontinued treatment due to this adverse effect. Preliminary data suggest that, similar to other third-generation α1A-AR antagonists, silodosin has little potential to cause significant cardiovascular adverse effects such as orthostatic hypotension or syncope. To confirm these findings, long-term studies are still needed, especially in patients taking antihypertensive agents and in those with a history of intolerance to other α1-AR antagonists.Conclusions:Silodosin was approved by the Food and Drug Administration in 2008. Long-term studies demonstrating improvement in clinically Important outcomes of BPH have yet to be published. In addition, pharmacoeconomic analyses would assist in defining its current place in therapy. Until this information is available, silodosin may be best reserved as an alternative to other second- and third-generation α1-AR antagonists.
Medication Changes Prior to Hospitalization for Obstructive Lung Disease: A Case-Crossover Study
Authors: Velthove Karin J , Leufkens Hubert GM , Schweizer René C , Solinge Wouter W van , Souverein Patrick C 
Published: January 2010

Background: Hospitalizations have always been seen as a solid outcome parameter in pharmacoepidemiology. However, the period leading to hospitalization and prehospital management of the patient are equally important. Objective: To evaluate medication changes in the period prior to hospitalization for obstructive lung disease and to quantify the association between medication use and the risk of hospitalization. Methods: We conducted a case-crossover study using the PHARMO record linkage system, which contains drug dispensing data from community pharmacies and hospital admission data. Patients included in the study were adults hospitalized for obstructive lung disease between 2005 and 2007. The index date of the case period was the date of hospitalization, and control moments were set at 3, 6, 9, and 12 months before admission. For each patient, all prescriptions prior to the date of hospitalization were identified. Medication use was ascertained in a 90-day time window prior to each case or control moment. Results: We identified 1481 patients who were hospitalized for obstructive lung disease. It appeared that respiratory medication use increased in the 90 days prior to hospitalization. Hospitalization was associated with the use of 3 or more respiratory drugs (OR 2.2; 95% CI 1.8 to 2.8), systemic glucocorticoids (OR 4.5; 95% CI 3.8 to 5.4), and antibiotics (OR 3.1; 95% CI 2.7 to 3.6). Conclusions: The use of systemic glucocorticoids, antibiotics, and other respiratory drugs increased prior to hospitalization for obstructive lung disease. These results could be indicative of the development and/or treatment of an exacerbation. There is a need for markers to detect exacerbations in an early phase in order to start treatment as early as possible and possibly prevent hospitalizations for obstructive lung disease.
Variation of Preferred Orientation in Oriented Clay Mounts as a Result of Sample Preparation and Composition
Authors: Dohrmann R. , Rüping K. B. , Kleber M. , Ufer K. , Jahn R. 
Published: January 2010

AbstractIn X-ray diffraction (XRD) analysis, preparation of oriented clay specimens enhances their 00l reflections by arranging basal surfaces parallel to the specimen surface. In one-dimensional modeling of XRD intensities, degree of preferred orientation is one of the variable parameters and a user may choose different σ* values for different minerals. The usual assumption is, however, that the layers of all clay minerals that are present exhibit a similar degree of preferred orientation to that of the clay mineral flakes parallel to the basal plane. If the orientation of individual clay minerals is significantly different, and if this is not taken into account, the relative proportions of the constituent minerals cannot be modeled accurately. The actual or so-called ‘preferred’ orientation is a potentially large source of error in any attempt at quantitative XRD analysis because it cannot be assumed to be constant among different minerals and may also vary as a result of pretreatment. In the present study the influence of sample composition and sample pretreatment on the degree of preferred orientation was determined using the parameter σ*. A statistical parameter was calculated to determine and ensure the reproducibility of σ* measurements. The most important result was that, when mixed together, clay minerals influence each other in terms of the degree of preferred orientation. Among individual samples, the degree of preferred orientation can be different for each clay mineral. The power of sonication used in sample pretreatment of a pure kaolinite and a pure illite had no significant influence on the degree of preferred orientation. The changes in intensities upon variation of the tilting angle (χ) allowed for calculation of σ* of smectites in pure samples, in admixtures, and in samples treated in two different ways (air-dried and glycerol-intercalated), which is reported here for the first time. Smectites are very fine grained with flexible morphology which is believed to be the reason for their tendency to exhibit poor orientation (σ* = 22°); further research is required to establish whether this is a general feature of smectites. After glycerol treatment a soil smectite showed a slightly better orientation compared to the air-dried pattern. The results of the study illustrate the difficulty of predicting changes in preferred orientation of clay mineral admixtures, even if non-platy minerals such as clay-sized quartz are added. In general, σ* decreased when non-platy minerals were added, which is explained by changes in geometry of the specimen. Not all clay minerals, however, showed simultaneous changes in their orientation behavior.
AFM Study of Smectites in Hybrid Langmuir-Blodgett Films: Saponite, Wyoming Bentonite, Hectorite, and Laponite
Authors: Szabó Tamás , Wang Jun , Volodin Alexander , van Haesendonck Chris , Dekany Imre , Schoonheydt Robert A. 
Published: January 2010

AbstractThe sizes and shapes of single clay mineral layers are difficult to determine though they are important parameters which determine the final properties of clay polymer nanocomposites and of ultrathin clay mineral films. To determine these sizes and shapes, hybrid monolayers of clay minerals (saponite, hectorite, Wyoming bentonite, and Laponite) and Rhodamine B octadecyl ester Perchlorate (RhB18) were prepared using the Langmuir-Blodgett (LB) technique and studied with atomic force microscopy (AFM). The AFM images reveal monolayers of elementary clay mineral layers, which are randomly oriented and have a wide range of sizes. The layers have typical shapes: lath-like for hectorite, plates for Wyoming bentonite, a mixture of laths and plates for saponite, and aggregates of very small layers of Laponite. Two types of layers were present in the LB films of saponite, Wyoming bentonite, and hectorite in a 40:60 ratio: (1) single layers 0.96 nm thick hybridized with RhB18; and (2) particles consisting of two clay layers with an intercalated monomolecular layer of water molecules and hybridized with RhB18. The Laponite particles in the hybrid LB films consist mainly of aggregates of two and three single layers.
Birnessites with Different Average Manganese Oxidation States Synthesized, Characterized, and Transformed to Todorokite at Atmospheric Pressure
Authors: Cui Haojie , Qiu Guohong , Feng Xionghan , Tan Wenfeng , Liu Fan 
Published: January 2010

AbstractTodorokite is a common manganese oxide mineral, with a tunnel structure, found in Earth surface environments, and is easily synthesized from layered birnessite. The aim of the current study was to prepare birnessites with different average manganese oxidation states (AOS) by controlling the MnO4−/Mn2+\$\end{document} ratio in concentrated NaOH or KOH. A series of (Na,K)-birnessites, Na-birnessites, and K-birnessites with different AOS was synthesized successfully in strongly alkaline media. The (Na,K)-birnessites and Na-birnessites prepared in NaOH clearly contained both large (500–1000 nm) and small (40–400 nm), plate-shaped crystallites. The K-birnessites prepared in KOH media consisted mostly of irregular (100–200 nm), plate-shaped crystallites. The degree of transformation of birnessite to todorokite at atmospheric pressure decreased as the AOS values of (Na,K)-birnessites and Na-birnessites increased from 3.51 to 3.80. No todorokite was present when a Na-birnessite with an AOS value of 3.87 was used as the precursor. Pyrophosphate, which is known to form strong complexes with Mn3+ at a pH range of 1–8, was added to a suspension of (Na,K)-birnessites in order to sequester the available Mn3+ in (Na,K)-birnessites. Removal of Mn3+ from birnessite MnO6 layers by pyrophosphate restricted transformation to todorokite — no (Na,K)-birnessite transformed to todorokite after pyrophosphate treatment. The interlayer K+ initially within (Na,K)-birnessites could not be completely ion-exchanged with Mg2+ to form todorokite at atmospheric pressure. No todorokite was forthcoming from K-birnessites even from those with small AOS values (3.50).