bluuebunny/crossref_metadata_2025_split huggingface dataset:
Introducing Priority Setting and Resource Allocation in Home and Community Care Programs
Authors: Urquhart Bonnie , Mitton Craig , Peacock Stuart 
Published: February 2008

Objective To use evidence from research to identify and implement priority setting and resource allocation that incorporates both ethical practices and economic principles. Method Program budgeting and marginal analysis (PBMA) is based on two key economic principles: opportunity cost (i.e. doing one thing instead of another) and the margin (i.e. resource allocation should result in maximum benefit for available resources). An ethical framework for priority setting and resource allocation known as Accountability for Reasonableness (A4R) focuses on making sure that resource allocations are based on a fair decisionmaking process. It includes the following four conditions: publicity; relevance; appeals; and enforcement. More recent literature on the topic suggests that a fifth condition, that of empowerment, should be added to the Framework. The 2007-08 operating budget for Home and Community Care, excluding the residential sector, was developed using PBMA and incorporating the A4R conditions. Results Recommendations developed using PBMA were forwarded to the Executive Committee, approved and implemented for the 2007-08 fiscal year operating budget. In addition there were two projects approved for approximately $200,000. Conclusion PBMA is an improvement over previous practice. Managers of Home and Community Care are committed to using the process for the 2008-09 fiscal year operating budget and expanding its use to include mental health and addictions services. In addition, managers of public health prevention and promotion services are considering using the process.
Facilitating Organizational Mergers: Amalgamation of Community Care Access Centres
Authors: Mercer Kevin 
Published: February 2008

Background The development of 14 Local Health Integration Networks (LHINs) in Ontario necessitated the re-organization of Community Care Access Centres (CCACs). The achievement of LHIN objectives was contingent upon the organizations responsible for home and long-term care placement being aligned within the LHIN geographic boundaries. This re-alignment required 42 provincial organizations to re-structure, integrate and reduce to 14. Assessment of problem This project was focused on the amalgamation of two CCACs in the Waterloo Wellington LHIN. Both were distinctly different due to their organizational evolution, the composition of the region and leadership approach. The different organizational cultures, if not managed properly, could result in a derailing of several current projects that were underway and were also key to the overall health system transformation agenda. A literature search provided a plethora of critiques of organizational change approaches and practical suggestions. Of particular relevance was a report to the Royal Commission on Health Care in 2002 that authenticates the dismal success in health care to meet change objectives. The project included a joint planning day for the leadership teams of the two organizations followed by an Organizational Readiness Assessment conducted by the Canadian Council on Health Services Accreditation (CCHSA). Results Both activities brought the leadership and staff of Waterloo and Wellington together, started the integration process and solicited staff participation. A follow-up survey of the leadership teams revealed the effectiveness of the project in advancing integration between the two organizations and recognizing organizational cultural differences. The CCHSA Organizational Readiness Assessment process was viewed as an effective means for advancing the integration of the two organizations, particularly as it relates to allowing the staff groups to define for themselves the benefits of the merger. Lessons and messages The lack of hard evidence on the benefits of a merger could have been problematic in terms of resistance to change if the CCHSA process had not been used. The readiness assessment report provided 49 recommendations that served as baseline information needed for the design of a change strategy that is anchored in knowledge of variation in organizational culture, practice, communications, client service and leadership style.
Venlafaxine–Propafenone Interaction Resulting in Hallucinations and Psychomotor Agitation
Authors: Gareri Pietro , Fazio Pasquale De , Gallelli Luca , Fazio Salvatore De , Davoli Alessandro , Seminara Giuseppe , Cotroneo Antonino , Sarro Giovambattista De 
Published: February 2008

Objective:To report a case of visual hallucinations and psychomotor agitation probably induced by an interaction between venlafaxine and propafenone.Case Summary:An 85-year-old woman was admitted for evaluation of a mood disorder on March 20, 2006. Her general practitioner had prescribed sertraline for treatment, which had started about 6 months earlier. The patient's medical history included hypertension, supraventricular tachycardia, chronic bronchitis, and arthritis, for which she received ramipril, ticlopidine, torsemide, theophylline, acetaminophen, and triazolam. The patient had also received propafenone 150 mg every 12 hours for 3 years. Results of biochemical tests were normal; however, a computed tomography (CT) scan of the brain showed signs of cortical atrophy. Sertraline was discontinued after a few days because of its reduced effectiveness and was replaced with extended-re lease venlafaxine 75 mg/day. No other changes to the patient's drug therapy were made. Four weeks later, because of the persistence of psychiatric disturbance, the venlafaxine dosage was increased to 150 mg/day. Ten days later the patient returned to our observation due to the onset of visual hallucinations lasting about 2 hours, especially at night, and psychomotor agitation. Venlafaxine was discontinued, with a complete remission of hallucinations and psychomotor agitation in about 4 days. The Naranjo probability scale indicated a probable relationship between venlafaxine and the patient's symptoms. Citalopram was started one month later for the persistence of mood disorders, with no adverse effects.Discussion:A CT scan documented signs of cortical atrophy in our patient's brain but excluded vascular brain injury, while clinical evaluation and anamnesis excluded a relationship between hallucinations and cortical atrophy. Genetic and pharmacologic factors may be involved in venlafaxine-induced adverse effects. Venlafaxine is metabolized primarily by CYP2D6 and is a substrate of P-glycoprotein. Propafenone, a known substrate and inhibitor of both CYP2D6 and P-glycoprotein, could therefore be involved in venlafaxine-induced hallucinations through the increase of venlafaxine plasma concentrations.Conclusions:To prevent the onset of clinical disturbances during venlafaxine treatment, we suggest careful evaluation of concomitant treatment with CYP2D6 or P-glycoprotein inhibitors (eg, propafenone) and, when possible, venlafaxine serum concentration monitoring.
Lifestyle or Life-Saving Medicines? A Primary Healthcare Professional and Consumer Opinion Survey on Over-the-Counter Statins
Authors: Vamvakopoulos Joannis E , Kountouri Melpomeni , Marshall Tom , Greenfield Sheila M 
Published: February 2008

Background: Over-the-counter (OTC) simvastatin 10 mg became available in the UK in July 2004 with the aim of improving primary prevention of ischemic heart disease. Objective: To document the views of the main stakeholders (general practitioners [GPs], community pharmacists, and consumers) on issues pertaining to the reclassification of simvastatin to OTC availability, highlight differences between stakeholder groups, and identify factors likely to influence consumer behavior. Methods: A self-administered questionnaire survey of GPs, community pharmacists, and potentially eligible consumers was carried out 8 months after the UK launch of OTC simvastatin. Participants were asked about their awareness of the drug, their willingness to use such medicines, and their views on relevant management practices. Results: Awareness of OTC simvastatin was high among GPs but limited among consumers. Although OTC availability was favored by pharmacists, consumers and GPs generally thought it was not a good idea. GPs and pharmacists cited increased consumer choice as the most important likely benefit; consumers thought potential savings to the National Health Service were equally important. Medication misuse and neglect of lifestyle risk factors were unanimously considered to be the most important likely risks. Unlike the majority of pharmacists, most GPs thought that current dosing guidelines were inappropriate, but there was consensus that long-term nonadherence would probably curtail any treatment benefit. Most respondents agreed that GPs should be informed if their patients were using OTC statins but disagreed as to the best way to communicate this information. Conclusions: OTC availability of statins did not appear to be considered a popular public health intervention by consumers and GPs, as the drugs were widely perceived as being prone to misuse. However, OTC availability was favored by pharmacists, who saw this as empowering both for consumers and themselves. Key issues in dispensing, managing, and evaluating the public health impact of this intervention remain outstanding.
Presence of Innovation Adoption-Facilitating Elements in Hospitals, and Relationship to Implementation of Clinical Guidelines
Authors: Okafor Mark C , Thomas Joseph 
Published: February 2008

Background: Despite evidence of benefit from implementation of clinical guidelines, numerous studies have found suboptimal guideline compliance among health professionals. Objective: To determine the presence in US hospitals of innovation adoptionfacilitating elements (IAE), assess associations between organizational characteristics and presence of IAE, and assess associations between presence of IAE and implementation of specific clinical guidelines. Methods: A mail survey of pharmacy directors in a national random sample of 236 general medical and surgical hospitals with more than 25 beds stratified by state was conducted. Key variables were presence of IAE, the leader's openness to change, centralization, formalization, complexity, size, and guideline implementation. Survey items from preexisting scales were revised for this study. Content validity of survey scales was assessed using expert panel ratings. Cognitive interviews were conducted during survey development to confirm that items were interpreted consistently across respondents. A modified Dillman approach was used to survey 236 hospitals. Results: The survey response rate was 69.5%. On average, sample hospitals had implemented 66.9% of IAE inquired about in the survey. Openness to change (p < 0.001), participation in decision-making (p < 0.001), and formalization (p < 0.001) were significantly associated with presence of IAE. However, complexity (p = 0.135) and hospital active bed size (p = 0.195) were not associated with presence of IAE. There was a positive association between presence of IAE and guideline implementation based on an overall score (p = 0.045); however, when guidelines were examined individually, only 1 of the 4 had a positive association (p = 0.029). Conclusions: There was a modest presence of IAE in the US hospitals reported here and significant positive association of leaders' openness to change, centralization, and formalization with presence of IAE in hospitals. Findings also indicate that presence of IAE within a hospital is associated with higher levels of clinical guideline implementation.
Nationwide Survey of Subjectively Reported Adverse Drug Reactions in Sweden
Authors: Isacson Dag , Johansson Linnea , Bingefors Kerstin 
Published: February 2008

Background: Adverse drug reactions (ADRs) and the safety of drugs continue to be widely discussed. However, information on the prevalence of subjectively experienced ADRs (SADRs) and their subsequent burden in the general population is largely lacking. Objective: To analyze, from an epidemiologic perspective, SADRs with respect to occurrence and health status. Methods: A cross-sectional mail survey to a random national sample in Sweden of inhabitants aged 18–84 years was conducted; 61% (N = 4875) of the sample answered the questionnaire. Self-reported SADRs occurring during a 2-week period of using prescription, over-the-counter (OTC), or herbal drugs were classified according to Meyler's classification of ADRs. Self-perceived health status was assessed with a visual analog scale graded from 0 (worst possible health/death) to 1 (perfect health). Results: SADRs were reported by 6.4% of the total study sample, 10.2% of the 2851 users of prescription drugs, 1.0% of the 2862 users of OTC drugs, and 0.1% of the 1352 users of herbal drugs. Of the total sample, 3.3% reported SADRs of the nervous system, 2.6% of the gastrointestinal system, and 0.6% of the cardiovascular system. Users of prescription drugs with SADRs reported a mean health status score of 0.655, while those who did not report SADRs scored 0.744. Among users of OTC and herbal drugs, the corresponding scores were 0.720 and 0.818, respectively. Those in the population who did not use any drugs rated their health status as 0.846. Conclusions: Both the prevalence of SADRs and the magnitude of the decrease in subjective health status in respondents experiencing them reflect the importance of individual subjective perceptions for public health. However, in a cross-sectional study like this, causal relationships cannot be firmly established. Further, other factors, such as comorbidity or disappointment with treatment outcomes, could be associated with the decrease in health status.
Clinical Pharmacists' Role in Improving Osteoporosis Treatment Rates Among Elderly Patients with Untreated Atraumatic Fractures
Authors: Nadrash T Ann , Plushner Susyn Lynn , Delate Thomas 
Published: February 2008

Background: Missed opportunities for osteoporosis detection and treatment following fractures, especially in the elderly, are common. Clinical pharmacy specialist (CPS) intervention may positively impact this deficiency. Objective: To examine the impact of a CPS-managed intervention to identify, screen, and initiate appropriate osteoporosis pharmacotherapy in elderly patients after an atraumatic fracture. Methods: This was a prospective quality improvement analysis. Hospitalized and ambulatory patients who had a diagnosis of atraumatic fracture between July 2002 through August 2003 but were not on osteoporosis pharmacotherapy were identified by CPSs. Bone mineral density (BMD) screening and osteoporosis pharmacotherapy recommendations were made by a CPS when appropriate. Descriptive analyses were performed to determine the proportion of patients initiated on osteoporosis pharmacotherapy or receiving a recommended BMD evaluation. Results: A total of 137 (40 inpatient and 97 ambulatory) female patients were included. The mean ages ± SD of inpatient and ambulatory patients were 83 ± 8 and 70 ± 7 years, respectively. Overall, 50% (n = 69) of patients either initiated their recommended osteoporosis pharmacotherapy (48% [n = 19] and 30% [n = 29] of inpatient and ambulatory patients, respectively) or received a recommended BMD screening (42 ambulatory patients were recommended and 50% [n = 21] completed a BMD test). Of the patients who completed a BMD test, 17 (81%) were osteoporotic. All 17 were initiated on osteoporosis pharmacotherapy. Conclusions: Using a systematic approach to identify patients in need of osteoporosis pharmacotherapy, a CPS-managed intervention resulted in clinically meaningful osteoporosis treatment initiation rates.
Psychopathy and deception detection using indirect measures
Authors: Klaver Jessica R. , Lee Zina , Spidel Alicia , Hart Stephen D. 
Published: February 2008

Purpose. The goal of the current study was to examine psychopathy and indirect measures of deception detection.Methods. Undergraduate students (N=444) viewed video clips of adult male offenders telling true and false stories about crimes. For each story, participants rated indirect measures of deception (thinking hard, nervousness, emotional arousal, and attempting to control behaviour) and credibility. Participants also chose the story they believed to be true and rated the confidence in their decision. Offenders were rated on the psychopathy checklist – revised.Results. Consistent with past research, deception detection accuracy was at chance level and unrelated to confidence. Ratings on indirect measures by undergraduates did not distinguish true and false statements in offenders. Psychopathic offenders were less successful at deception than non‐psychopathic offenders. Psychopathic traits were associated with lower perceived credibility during deception and ratings of thinking harder while lying.Conclusions. The results suggest that indirect measures of deception detection may be less useful in offender samples. Further, the findings are consistent with the general inability of psychopathic offenders to demonstrate superior deception skills in empirical studies. Indirect measures of deception uniquely related to psychopathic traits offer new insight into the relationship between psychopathy and deception.
Improving haemodialysis patients' understanding of phosphate‐binding medication: A pilot study of a psycho‐educational intervention designed to change patients' perceptions of the problem and treatment
Authors: Karamanidou Christina , Weinman John , Horne Rob 
Published: February 2008

Objectives. To evaluate a psycho‐educational intervention aimed to improve understanding of the need for phosphate control, provide a rationale for phosphate‐binding medication (PBM) and explain its mode of action.Design. A controlled intervention study comparing the effect of a self‐regulatory theory‐based psycho‐educational intervention versus standard care control on knowledge of phosphate control and beliefs about PBM.Method. End‐stage renal disease (ESRD) patients were assigned to either an intervention group (N = 19) or control group (N = 20). Both groups were assessed at baseline, at 1‐month post‐intervention and at 4‐month post‐intervention. The intervention group was also assessed immediately post‐intervention.Results. The intervention had an immediate impact post‐intervention on all outcome variables examined. It was also successful in improving knowledge, treatment coherence, medication outcome efficacy beliefs, and general understanding of treatment in the intervention group in comparison to the control group, an effect which was sustained through to the second follow‐up.Conclusions. A simple intervention was successful in changing patients' understanding and some beliefs around treatment thought to influence adherence behaviour. Further research is needed to inform the design of a more complex intervention targeting the specific beliefs influencing behaviour in order to facilitate treatment adherence.
Building bridges to observational perspectives: A grounded theory of therapy processes in psychosis
Authors: Dilks Sarah , Tasker Fiona , Wren Bernadette 
Published: February 2008

Objectives. This study set out to explore therapy processes in psychosis with an initial focus on reflexivity and how this might be expressed in therapy conversations.Design. Leiman's (2000) definition of reflexivity was used as a starting‐point for an exploratory investigation of the use of language as reflective activity. Grounded theory was chosen as an appropriate methodology to distil an explanatory account across the qualitative data collected.Method. Six psychologist‐client pairs supplied three tapes of therapy sessions spread out across the course of therapy. Each participant was separately interviewed on two occasions to ascertain their views of therapy and of the emerging grounded theory.Results. A grounded theory was developed conceptualizing the processes and activities in psychological therapy in psychosis.Conclusions. ‘Building bridges to observational perspectives’ summarizes the core process in psychological therapy in psychosis. Therapy in psychosis is understood as intimately ‘linking the social and internal world’ in a dialogical process aimed at enhancing the client's ‘functioning in the social world’ rather than at specifically developing the private mental experience of reflexivity or mentalizing.
Neues zur „Johanneischen Frage“?
Authors: Mariev Sergei 
Published: February 2008

Zusammenfassung
Anhand dreier wichtiger Fragen (Schlusspartien der Excerpta Constantini und die Bestimmung der Verfassungszeit, die Frage nach dem Status der Excerpta Cod. Par. 1630 und der Exc. Salmasiana) habe ich zunächst die in der byzantinistischen Forschung aufgedeckten Probleme und die erarbeiteten Vorschläge zu ihrer Lösung skizziert, um sie in einem zweiten Schritt mit den Lösungsvorschlägen und dem argumentativen Vorgang Robertos zu kontrastieren. Aus diesem Vergleich geht m. E. hervor, dass die „Johanneische Frage“ in der Edition von Roberto keine originelle und unerwartete Lösung erfahren, sondern eine weitere Verwicklung erlitten hat.
Die Fehlentscheidungen bezüglich dieser drei Komponenten führen zu weiteren Verzerrungen: Viele Glossen aus der Suda, die Texte der Wiener Troica und der Hypothesis zur Odyssee wurden in das Corpus in Folge von Übereinstimmungen mit den zu Unrecht für Johannes von Antiochien erklärten Texten aufgenommen. Es versteht sich von alleine, dass alle Beobachtungen über die Quellen, den literarischen Wert und das weitere Schicksal der Chronik, die Roberto auf der Basis des von ihm zusammengezimmerten Corpus anstellt, im gleichen Maße als wissenschaftlich zuverlässig zu betrachten sind, in welchem die Ausführungen und Theorien es sind, welche die Aufnahme des entsprechenden Materials in das Corpus rechtfertigen.
Obwohl der interessierte Leser jetzt ein umfangreiches Dossier zur „Johanneischen Frage“ an die Hand bekommen hat, ist das Erscheinen dieses Bandes eher zu beklagen als zu begrüßen: Die allgemeine Verwirrung um Johannes von Antiochien ist damit nur größer geworden.
Seitenblick – Neues zum Konstantinopler Scheinsarkophag in Barletta
Authors: Schaaf Georg-D. , Krumeich Kirsten 
Published: February 2008

Abstract
Das Museo Civico von Barletta präsentiert ein zentrales Objekt seiner Sammlung, das bekannte spätantike Marmorrelief mit der Darstellung einer Apostelversammlung, im mittelalterlichen Kastell des Ortes mittlerweile in einer großzügigen und angemessenen Aufstellung (Abb. 1). Die drei Fragmente des Stücks sind auf einem Metallgestell nahezu paßgerecht aneinandergefügt, gut ausgeleuchtet und auch von den Seiten sowie der Rückseite her einsehbar. Reste von Zement, die bislang das Rund des Brunnenlochs füllten und die Oberfläche beeinträchtigten, wurden im Rahmen jüngster Restaurierungsmaßnahmen entfernt.
Charles ASTRUC, Marie-Louise CONCASTY, Cécile BELLON, Christian FÖRSTEL et al. (éds.), Catalogue des manuscrits grecs. Supplément grec, numéros 1 à 150
Authors: Hajdú Kerstin , Duursma Gerard 
Published: February 2008

Abstract
Genau 115 Jahre nach Erscheinen des dritten Bandes von Omonts „Inventaire sommaire“ – der das Supplément grec, den seit 1740 gesammelten und damit jüngsten Bestand griechischer Handschriften im Besitz der französischen Nationalbibliothek, lediglich kursorisch beschreibt – liegen hiermit für die ersten 150 Nummern dieses fonds ausführliche Katalogisate vor, wie sie der moderne wissenschaftliche Anspruch ersehnt. Sie beruhen im Grundsatz auf den Vorarbeiten der früheren Bibliothekare Astruc und Concasty aus den sechziger Jahren, die schon den Katalog zu Suppl. gr. 901–1371 verfaßt hatten; ihre Aufzeichnungen wurden jetzt überarbeitet, ergänzt und vereinheitlicht, die vielfältigen philologischen, kodikologischen und historischen Angaben über entsprechende Register zugänglich gemacht, so daß der Fachwelt ein nützliches und handliches Werkzeug beschert ist, das den ausgewählten Teil der Pariser Sammlung detailliert erschließt.