bluuebunny/crossref_metadata_2025_split huggingface dataset:
Doctors’ perceptions of the prognostic benefit of statins in patients who have had myocardial infarction
Authors: Sapre N. , Mann S. , Elley C. R. 
Published: June 2008

AbstractBackground: We wished to assess how General Practitioners (GPs) and cardiologists perceive and communicate the benefits of therapy with statins (hydroxymethylglutaryl‐coenzyme A reductase inhibitors) in a patient following myocardial infarction.Methods: We interviewed 20 GPs and 22 cardiologists to determine treatment policy and ways of expressing its benefits to a patient after myocardial infarction with moderate dyslipidaemia. We asked what drug and dosage they would recommend and how they would express potential benefits of therapy, given a range of options including reduced relative and absolute risk of events.Results: Most GPs would start a low dose (10–20 mg/day) of simvastatin (the only freely prescribable funded statin in New Zealand) whereas cardiologists would commence 40 mg/day immediately (P = 0.001). All but one cardiologist would justify therapy to the patient by citing a reduced chance of a major adverse cardiovascular event. Nine GPs and one cardiologist estimated a gain of more than 5 years of life from statin therapy. Cardiologists were more optimistic than GPs about relative risk reduction (P = 0.04). Only 50% of GPs and 68% of cardiologists were able to estimate an absolute risk reduction over 5 years, such estimates varying widely with no significant difference in responses between the groups (P = 0.2). No doctors felt comfortable using number needed to treat or odds ratio.Conclusion: There were substantial differences between the two groups of clinicians in perception and policy of statin therapy, frequent overestimation of treatment benefits and a reluctance to impart numerical estimates of benefit to patients.
Use of fresh‐frozen plasma at Royal Darwin Hospital: a retrospective audit
Authors: Moylan S. , Szabo F. , Scott H. , Kwok G. 
Published: June 2008

AbstractBackground:  The aim of the study was to assess the appropriateness of use of fresh‐frozen plasma (FFP) at Royal Darwin Hospital against the National Health and Medical Research Council and Australian and New Zealand Society for Blood Transfusion guidelines.Methods:  A retrospective review of blood product request forms, online pathology storage system data, pathology records and clinical notes between 1 January 2006 and 31 December 2006 was carried out. The appropriateness of requests was assessed against existing guidelines. The percentage of appropriate and inappropriate FFP transfusions was obtained.Results:  Six hundred and forty‐eight of 950 units (68%) of FFP were used with an appropriate indication as per National Health and Medical Research Council/Australian and New Zealand Society for Blood Transfusion guidelines. Of the remaining units, 14% (137 units) was given without a clear indication and a decision of appropriateness could not be established for 17% (165 units) because of inadequate clinical or pathology information (e.g. coagulation results). Multiple issues around prescribing practice were identified.Conclusion:  There is significant use of FFP at Royal Darwin Hospital without clear clinical indication. The employment of a transfusion nurse to monitor use of FFP (and other blood products) and provide education is aimed at improving transfusion efficiency and patient safety.
Clinical applications of RANK‐ligand inhibition
Authors: Romas E. 
Published: June 2008

AbstractAn enhanced rate of bone remodelling fuelled by osteoclastogenesis mediates diseases such as osteoporosis, arthritic bone destruction, Paget’s disease and malignancy‐induced bone loss. Thus, the control of osteoclastogenesis is of major clinical importance. The receptor activator of nuclear factor κ B (RANK); its ligand, RANKL and decoy receptor, osteoprotegerin, are critical determinants of osteoclastogenesis, and increased RANK signalling is involved in several bone diseases, providing the rationale for RANKL inhibition. The effects of RANKL inhibition are being witnessed in clinical trials of neutralizing fully human monoclonal antibodies that target RANKL (e.g. denosumab) and which induce profound and sustained inhibition of bone resorption. The relative efficacy, cost‐effectiveness and side‐effects of targeted RANKL inhibition compared with conventional antiresorptive drugs (i.e. bisphosphonates) should be resolved by clinical trials in coming years.
Prioritizing quality indicator development across the healthcare system: identifying what to measure
Authors: Evans S. M. , Lowinger J. S. , Sprivulis P. C. , Copnell B. , Cameron P. A. 
Published: June 2008

AbstractMeasuring healthcare quality has become an increasingly important task for regulating bodies and healthcare institutions. Strategically chosen quality indicators provide a means of understanding the quality and safety of the healthcare system. Current frameworks developed to determine aspects of care to be measured do not provide the level of precision required to ensure that indicators are best selected to enable focused action to improve health. We propose a clearly structured process for selecting indicators at a national and local level based on six steps: (i) identify the problem for which measurement is needed, (ii) identify the perspective from which to measure, (iii) focus measurement on transition points through the health system, (iv) identify the type of probe required, (v) apply evaluation criteria to prioritize indicator selection and action and (vi) test the indicator in the clinical setting to which it will be applied. These steps should form the basis of a framework to drive quality indicator development.
Outcomes and predicting response in anaemic chemotherapy patients treated with epoetin alfa. A multicentre, 4‐month, open‐label study in Australia and New Zealand
Authors: Bell D. , Grimes D. , Gurney H. , Dalley D. , Blackwell T. , Fox R. , Jeffery M. 
Published: June 2008

AbstractBackground:  The aim of the study was to evaluate the effectiveness, safety, and clinical outcomes of erythropoietin therapy in the treatment of anaemic cancer subjects receiving chemotherapy and to examine hypochromic red blood cell measurement as an indicator of functional iron sufficiency and as a predictor of responsiveness or non‐responsiveness to erythropoietin therapy.Methods:  Patients who had a non‐myeloid malignancy, had Hb ≤ 11.0 g/dL, had a life expectancy of more than 6 months, were 18 years or older, were receiving chemotherapy and would continue to be treated for at least 2 months were given s.c. epoetin alfa three times a week.Results:  Haemoglobin levels increased significantly at all time periods compared with baseline and the number of transfusions received decreased significantly at all time periods compared with baseline. Quality of life as measured by Functional Assessment of Cancer Therapy‐Anaemia showed significant increases at months 2 and 4 and there were significant improvements in the fatigue subscale at both time points (P < 0.05). Significant improvements at end‐point were observed for the physical, emotional and functional well‐being, and additional concern subscales (all P < 0.05). Haematocrit and reticulocytes increased significantly at end‐point compared with at baseline (haematocrit 33.4 vs 28.3%, P < 0.001; reticulocytes 105.8 vs 78.6 × 109/dL, P = 0.005). The percentage of hypochromic red blood cells did not show predictive value for response to treatment status.Conclusion:  Epoetin alfa improved haemoglobin levels and quality of life in anaemic cancer patients receiving chemotherapy.
Safety and efficacy results from an international Expanded Access Programme to bortezomib for patients with relapsed and/or refractory multiple myeloma: a subset analysis of the Australian and New Zealand data of 111 patients
Authors: Quach H. , Horvath N. , Cannell P. , Mikhael J. R. , Butcher B. E. , Prince H. M. 
Published: June 2008

AbstractBackground: Bortezomib has been shown to be a safe and efficacious for the treatment of relapsed and refractory multiple myeloma (MM). Here we report a subset analysis of Australian and New Zealand data from the International Extended Access Programme for bortezomib.Methods: Patients with more than or equal to two prior lines of therapy were given bortezomib 1.3 mg/m2 (i.v. bolus days 1, 4, 8, 11) for up to eight 21‐day cycles (C). Dexamethasone, 20 mg/day p. o. on the day of, and day after, bortezomib was added after C2 for progressive disease or after C4 for stable disease. Efficacy was assessed using modified Southwest Oncology Group criteria in the intent‐to‐treat group. Results were compared between the Australian and New Zealand and international cohort.Results: One hundred and eleven patients from 16 centres (55% men, median age 61.9 years) had a median of 5.2 ± 2.8 treatment cycles of bortezomib. Among them, 82% had ≥3 prior therapies. Grade 3–4 treatment‐related adverse events were reported in 57 patients (52%); the most common were thrombocytopenia (25.7%), anaemia (8.3%), peripheral neuropathy (7.3%) and diarrhoea (7.3%). Responses were evaluable in 106 patients: 22% achieved a best response of complete response/response and 20% partial response (overall response rate of 42%). Median times to first and best responses were 42 days and 69 days, respectively. Compared with the international cohort, the cohorts from Australian and New Zealand showed inferior overall response rates (54 vs 42%, P = 0.001), possibly due to heavier pretreatment (82% greater than or equal to three prior therapies vs 68%, P < 0.001).Conclusion: Our analysis confirms that bortezomib is safe and effective in relapsed and refractory MM in a real‐life clinical setting.
THE EFFECT OF GRADING PRACTICES ON GENDER DIFFERENCES IN ACADEMIC PERFORMANCE
Authors: Bonesrønning Hans 
Published: June 2008

ABSTRACTThis paper adds to the debate about the sources of the gender gaps in student outcomes by highlighting explanations related to interactions between teachers and students. The evidence comes from the lower secondary school in Norway. The teachers' grading practices are the focal point of the analysis. First, it is shown that girls are exposed to easier grading than boys. Thereafter, evidence is provided that both boys and girls are negatively affected when the teacher practises easy grading. The boys' responses to easy grading are more uniformly negative than the girls' responses. Some exploratory analyses that make use of information about the students' school motivations are provided to make sense of these findings.
ECONOMIC PERFORMANCE AND PUBLIC INFRASTRUCTURE: AN APPLICATION TO GREEK MANUFACTURING
Authors: Mamatzakis Emmanuel Constantine 
Published: June 2008

ABSTRACTTo comprehend the impact of public infrastructure on economic performance this paper provides a measure of productivity growth as derived from duality theory. This productivity growth is decomposed into the components of technical change, returns to scale and the effects of public infrastructure, the variable of our interest. In an application, we opt for Greek manufacturing so as to investigate whether the decline in its growth rate is partly explained by public infrastructure. Despite some variation in the estimation results of shadow shares across industries, public infrastructure asserts a cost saving effect in most industries, though it also appears that traditional labour‐intensive industries with lower level of technological advancement do not benefit from the provision of public infrastructure. The estimation results further demonstrate that while public infrastructure enhanced productivity growth over the sample period for most industries, low infrastructure investment in the 1970s and the 1980s undermined productivity growth.
PLAGIARISM AND ITS IMPACT ON THE ECONOMICS PROFESSION
Authors: Arce Daniel G. , Enders Walter , Hoover Gary A. 
Published: June 2008

ABSTRACTThis paper integrates survey data on economists' experiences and perceptions of plagiarism with a game‐theoretic model of author strategies to investigate whether information is being efficiently transmitted within the profession. The surveys reveal editorial misperceptions of the nature of plagiarism (e.g., plagiarism versus copyright infringement) and narrow assumptions about who bears the cost of plagiarism. Further, a wide disparity in author strategies to protect intellectual property rights exists, due to uncertainty over editorial response. These considerations are shown to lead to a Pareto‐dominated publication process. By contrast, simple measures such as a code of ethics and web‐based anti‐plagiarism software can improve the flow of information.
THE LABOUR MARKET IMPACT OF THE UK DISABILITY DISCRIMINATION ACT: EVIDENCE FROM THE REPEAL OF THE SMALL FIRM EXEMPTION
Authors: Jones Melanie K. , Jones Jonathan 
Published: June 2008

ABSTRACTThis paper uses data from the Quarterly Labour Force Survey in the UK (1997–2006) and changes in the coverage of the Disability Discrimination Act (DDA), that result from the removal of the small firm exemption, to assess the labour market impact of the legislation. The data support a narrowing of the employment gap between the disabled and non‐disabled over the post DDA period. However, the evidence based on small firms does not support this being a direct result of the employment provisions of the DDA.
The impact of maternal depression in pregnancy on early child development
Authors: Deave T , Heron J , Evans J , Emond A 
Published: June 2008

Objective  Postpartum depression in mothers is associated with developmental problems in their children. Many women who are depressed following childbirth are also depressed during pregnancy. The aim of this study was to examine the associations between maternal depressive symptoms during pregnancy and child development at 18 months of age.Design  A prospective cohort study, Avon Longitudinal Study of Parents and Children.Setting  The former county of Avon, southwest England.Population  All pregnant women in the defined area with delivery dates between April 1991 and December 1992, 9244 women and their children.Methods  Data were collected antenatally, at 18 and 32 weeks of gestation and at 8 weeks and 8 months postnatally, through postal questionnaires, including a self‐report measure of depression (Edinburgh Postnatal Depression Scale [EPDS]). By the time their child was 18 months old, women completed five further questionnaires about their children’s health and development.Main outcome measure  Child development at 18 months using a modified Denver Developmental Screening Test (modified DDST).Results  Applying the standard 12/13 cutoff, 1565 (14%) women were depressed antenatally but not at either time‐points postnatally. Employing the modified DDST, 893 (9%) children were developmentally delayed at 18 months of age. Persistent depression (EPDS ≥ 10 at both time‐points) is associated with developmental delay (adjusted OR 1.34, 95% CI 1.11–1.62). Applying the 12/13 and 14/15 cutoffs gave similar results. After further adjustment for postnatal depression, the effect sizes were slightly attenuated.Conclusions  These findings highlight the importance of depression in pregnancy. Some effects on child development attributed to postpartum depression are caused in part by depressive symptoms during pregnancy.
Ethnicity and gestational diabetes in New York City, 1995–2003
Authors: Savitz DA , Janevic TM , Engel SM , Kaufman JS , Herring AH 
Published: June 2008

Objective  To characterise the patterns of occurrence of gestational diabetes among a wide range of ethnic groups that reside in New York City.Design  Birth records and hospital discharge data were linked to more accurately assess the risk of gestational diabetes by ethnicity, compare risk in US‐born to foreign‐born women, and assess time trends.Setting  New York City.Population  All singleton live births occurring between 1995 and 2003.Methods  Multivariable binomial regression analysis of ethnicity and gestational diabetes, yielding adjusted risk ratios with non‐Hispanic white women as the referent.Main outcome measure  Diagnosis of gestational diabetes on birth certificate or in hospital discharge.Results  Adjusted relative risks (aRRs) were modestly elevated for African‐Americans and sub‐Saharan Africans and somewhat higher (<2.0) for non‐Hispanic Caribbeans, Hispanic Caribbeans, Central Americans, and South Americans. The aRR was 4.7 (95% CI = 4.6–4.9) for South Central Asians (with an absolute gestational diabetes risk of 14.3%), 2.8 (95% CI = 2.7–3.0) among South‐East Asian and Pacific Islanders, and 2.3 (95% CI = 2.2–2.4) among East Asians. Among South Central Asians, the greatest risks were found for women from Bangladesh (aRR = 7.1, 95% CI = 6.8–7.3). Foreign‐born women consistently had higher risk than US‐born women. Risk for gestational diabetes increased over time among South Central Asians, some Hispanic groups, and African‐Americans.Conclusions  Risk of gestational diabetes appears to vary markedly among ethnic groups, subject to potential artefacts associated with screening and diagnosis. These differences would have direct implications for health care and may suggest aetiologic hypotheses.
Abortion‐related complications in Cambodia
Authors: Fetters T , Vonthanak S , Picardo C , Rathavy T 
Published: June 2008

Introduction  Although termination of pregnancy (termination) has been legal in the Kingdom of Cambodia since 1997, a number of barriers to safe termination services persist and many women continue to induce their own terminations or seek unsafe services that result in complications requiring ‘post‐abortion’ care.Objective  To describe the complications of miscarriage and failed terminations and document the magnitude of the resulting morbidity in the Cambodian public sector.Design  Cross‐sectional descriptive study.Setting  Public sector hospitals and health centres.Sample  Stratified multistage sampling design included all hospitals (n = 71), 14% of eligible high‐level health centres (n = 58) and 22% of eligible low‐level health centres (n = 57).Methods  Data collectors used a standardised questionnaire to record information on diagnosis, reproductive history and treatment from 629 women seeking care for termination or miscarriage‐related complications in study facilities over a 3‐week period.Main outcome measures  Annual estimate of cases, clinical symptoms, severity distribution of morbidity, ratio of complications to live births and incidence of abortion complications for Cambodian public health facilities.Results  In 2005, an estimated 31 579 women with complications of miscarriage or terminations were treated in Cambodian government facilities; 80% of these women sought care at a health centre. Forty percent of all women seeking care for complications either reported or showed strong clinical evidence of prior attempted terminations. Nearly 17% of these women were in the second trimester of pregnancy and 42% of them presented with high severity complications. The annual incidence of termination and miscarriage complications (abortion complications) was 867 per 100 000 women of reproductive age. The projected ratio of complications was 93 per 1000 live births.Conclusions  To reduce maternal morbidity in Cambodia, women must be encouraged to seek safe termination services or seek postabortion care without delay. Additionally, providers need further training, and facilities greater commitment, to provide safe terminations and care for complications of unsafe terminations and miscarriage.
Lithium dilution cardiac output and oxygen delivery in conscious dogs with systemic inflammatory response syndrome
Authors: Butler Amy L. , Campbell Vicki L. , Wagner Ann E. , Sedacca Cassidy D. , Hackett Timothy B. 
Published: June 2008

AbstractObjective:Compare cardiac index (CI) and oxygen delivery index (DO2I) in conscious, critically ill dogs to control dogs; evaluate the association of CI and DO2I with outcome.Design:Prospective non‐randomized clinical study.Setting:Veterinary teaching hospital.Animals:Eighteen client‐owned dogs with systemic inflammatory response syndrome (SIRS) and 8 healthy control dogs.Measurements and Main Results:CI of dogs with SIRS was measured using lithium dilution at times 0, 4, 8, 16, and 24 hours. Data collected included physical exam, arterial blood gas (ABG) and hemoximetry. CI of control dogs was measured 3 times with 1 measurement of ABG. Mean CI ± SE in SIRS patients was 3.32 ± 0.95 L/min/m2; lower than controls at 4.18 ± 0.22 L/min/m2(P<0.001). Mean DO2I ± SE in SIRS patients was 412.91 ± 156.67 mL O2/min/m2; lower than controls at 785.24 ± 45.99 mL O2/min/m2(P<0.001). There was no difference in CI (P=0.49) or DO2I (P=0.51) for dogs that survived to dischargeversusthose that did not. There was no difference in mean CI (P=0.97) or DO2I (P=0.50) of survivorsversusnon‐survivors for 28‐day survival. Survivors had lower blood glucose (P=0.03) and serum lactate concentrations (P=0.04) than non‐survivors.Conclusions:CI and DO2I in conscious dogs with SIRS were lower than control dogs, which differs from theories that dogs with SIRS are in a high cardiac output state. CI and DO2I were not significantly different between survivors and non‐survivors. Similar to previous studies, lactate and glucose concentrations of survivors were lower than non‐survivors.
Emergency case admissions at a large animal tertiary university referral hospital during a 12‐month period
Authors: Dolente Brett A. , Lindborg Susan , Russell Gail , Southwood Louise L. 
Published: June 2008

AbstractObjective: To collate and describe emergency admissions to a large animal tertiary university referral hospital during a 12‐month period.Design: Prospective clinical study.Setting: Large animal tertiary university referral hospital.Animals: Large animal emergency patient admissions.Interventions: None.Measurements and main results: Information obtained from the medical record included the presenting complaint, clinical problem, admission time, duration of clinical signs before presentation, diagnostic procedures performed, therapies administered, and therapeutic procedures performed during the first 24 hours following admission, and survival to discharge. The most common category listed for the presenting complaint and clinical problem categories was gastrointestinal. Most emergency cases were admitted during the evening and in late spring, summer, and early fall. Most cases had a duration of clinical signs before presentation of >2 hours and ≤8 hours (27%) or >8 hours and ≤24 hours (29%). The most common diagnostic procedures performed during the first 24 hours were palpation per rectum, ultrasonographic examination, radiographs, and abdominocentesis. Antimicrobials, fluids, and nonsteroidal anti‐inflammatory drugs were the most common therapies administered. Approximately 25% of cases required surgery. An exploratory celiotomy was performed in approximately 15% of cases. Enterotomy, intestinal resection and anastomosis, cesarean section, or joint or sheath lavage was each performed in <5% of cases. Overall survival to discharge was 74%.Conclusions: Large animal emergency clinicians are required to have knowledge on a wide range of diseases and should be proficient at performing numerous procedures on an emergency basis. Gastrointestinal disease is the most common type of emergency and the diagnostic and therapeutic procedures performed during the first 24 hours following admission are a reflection of this type of case. Only 25% of cases required surgery. Additional research in the form of a multicenter study and surveying both private and university practitioners needs to be performed to further define the necessary skills for an ‘ideal’ large animal emergency clinician.