bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suprapubic catheter insertion is an outpatient procedure: cost savings resultant on closing an audit loop
Authors: Khan Azhar , Abrams Paul 
Published: February 2009

OBJECTIVETo explore, by an audit, the regional practice of inserting a suprapubic catheter (SPC), and to prospectively determine the proportion of patients that can be successfully managed on an outpatient basis in one department.METHODSBoth local and regional practice were determined by a retrospective analysis of the hospital database for all cases of SPC insertion between April 2005 and March 2006. In addition, a questionnaire was e‐mailed to each of 11 urology departments. Locally, from August 2006 onwards, all patients scheduled for SPC insertion were referred to a new clinic, where the SPC was inserted using a new SPC kit and the Seldinger technique.RESULTSLocally, 66 patients (mean age 70 years, range 26–93) had a SPC inserted between April 2005 and March 2006; 49 had an elective procedure while 17 were emergency admissions. The median (range) hospital stay was 3.5 (1–85) days. Within the region, 480 SPCs were inserted in theatre during the same period, of which 52% (249) were inserted as elective inpatients, 11% (52) were inserted as a day case, and 37% (179) had SPCs as emergency admissions. A nurse‐led outpatient service was available in two hospitals, where 89% of patients seen in the clinic had successful insertion under local anaesthesia, and only 11% were referred for insertion under general anasthesia. Between August 2006 and July 2007, 50 of 54 patients had a SPC inserted successfully in the new SPC clinic. There were no major complications. The cost benefits of adopting an outpatient management strategy were significant, at ≈£GB 100 000/year in our hospital, £790 000/year in the region and £9 500 000/year for the UK.CONCLUSIONAn outpatient procedure for a SPC is safe and feasible in most patients, and its widespread use would produce considerable cost savings.
Predicting the outcome of prostate biopsy: comparison of a novel logistic regression‐based model, the prostate cancer risk calculator, and prostate‐specific antigen level alone
Authors: Hernandez David J. , Han Misop , Humphreys Elizabeth B. , Mangold Leslie A. , Taneja Samir S. , Childs Stacy J. , Bartsch Georg , Partin Alan W. 
Published: February 2009

OBJECTIVESTo develop a logistic regression‐based model to predict prostate cancer biopsy at, and compare its performance to the risk calculator developed by the Prostate Cancer Prevention Trial (PCPT), which was based on age, race, prostate‐specific antigen (PSA) level, a digital rectal examination (DRE), family history, and history of a previous negative biopsy, and to PSA level alone.PATIENTS AND METHODSWe retrospectively analysed the data of 1280 men who had a biopsy while enrolled in a prospective, multicentre clinical trial. Of these, 1108 had all relevant clinical and pathological data available, and no previous diagnosis of prostate cancer. Using the PCPT risk calculator, we calculated the risks of prostate cancer and of high‐grade disease (Gleason score ≥7) for each man. Receiver operating characteristic (ROC) curves for the risk calculator, PSA level and the novel regression‐based model were compared.RESULTSProstate cancer was detected in 394 (35.6%) men, and 155 (14.0%) had Gleason ≥7 disease. For cancer prediction, the area under the ROC curve (AUC) for the risk calculator was 66.7%, statistically greater than the AUC for PSA level of 61.9% (P < 0.001). For predicting high‐grade disease, the AUCs were 74.1% and 70.7% for the risk calculator and PSA level, respectively (P = 0.024). The AUCs increased to 71.2% (P < 0.001) and 78.7% (P = 0.001) for detection and high‐grade disease, respectively, with our novel regression‐based models.CONCLUSIONSROC analyses show that the PCPT risk calculator modestly improves the performance of PSA level alone in predicting an individual’s risk of prostate cancer or high‐grade disease on biopsy. This predictive tool might be enhanced by including percentage free PSA and the number of biopsy cores.
Can dutasteride delay or prevent the progression of prostate cancer in patients with biochemical failure after radical therapy? Rationale and design of the Avodart after Radical Therapy for Prostate Cancer Study
Authors: Schröder Fritz H. , Bangma Chris H. , Wolff Johannes M. , Alcaraz Antonio , Montorsi Francesco , Mongiat‐Artus Pierre , Abrahamsson Per‐Anders , McNicholas Tom A. , Castro Ramiro S. , Nandy Indrani M. 
Published: February 2009

OBJECTIVETo describe the Avodart after Radical Therapy for prostate cancer Study (ARTS), investigating the use of dutasteride (a dual 5α‐reductase inhibitor that suppresses intraprostatic dihydrotestosterone, reduces tumour volume and improves other markers of tumour regression in prostate cancer) to prevent or delay disease progression in patients with biochemical recurrence after therapy with curative intent.PATIENTS AND METHODSAn increasing serum prostate‐specific antigen (PSA) level after radical prostatectomy (RP) or radiotherapy (RT) is indicative of recurrent prostate cancer and typically pre‐dates clinically detectable metastatic disease by several years. ARTS is an ongoing European multicentre trial in which patients are stratified by previous therapy (RP with or without salvage RT vs primary RT) and randomized to double‐blind treatment with dutasteride 0.5 mg or placebo once daily for 2 years. Eligible patients will have a PSA doubling time (DT) of 3–24 months. Biochemical recurrence is defined as three increases in PSA level from the nadir, with each increase ≥4 weeks apart and each PSA level ≥0.2 ng/mL, and a final PSA level of ≥0.4 ng/mL (after RP) or ≥2 ng/mL (after primary RT). Study endpoints include time to PSA doubling, time to disease progression, treatment response (PSA decrease or an increase of ≤15% from baseline), changes in PSA and PSADT, and changes in anxiety (Memorial Anxiety Scale for Prostate Cancer).CONCLUSIONSARTS will be the first study to evaluate the effects of dutasteride on PSADT, disease progression and treatment response in patients with biochemical failure after RP or RT, and should help to elucidate the potential role of dual 5α‐reductase inhibition in prostate cancer.
Qualitative modelling and indicators of exploited ecosystems
Authors: Dambacher Jeffrey M. , Gaughan Daniel J. , Rochet Marie‐Joëlle , Rossignol Philippe A. , Trenkel Verena M. 
Published: February 2009

AbstractImplementing ecosystem‐based fisheries management requires indicators and models that address the impacts of fishing across entire ecological communities. However, the complexity of many ecosystems presents a challenge to analysis, especially if reliant on quantification because of the onerous task of precisely measuring or estimating numerous parameters. We present qualitative modelling as a complementary approach to quantitative methods. Qualitative modelling clarifies how community structure alone affects dynamics, here of exploited populations. We build an array of models that describe different ecosystems with different harvesting practices, and analyse them to predict responses to various perturbations. This approach demonstrates the utility of qualitative modelling as a means to identify and interpret community‐level indicators for systems that are at or near equilibrium, and for those that are frequently perturbed away from equilibrium. Examining the interaction of ecological and socio‐economic variables associated with commercial fisheries provides an understanding of the main feedbacks that drive and regulate exploited ecosystems. The method is particularly useful for systems where the basic relationships between variables are understood but where precise or detailed data are lacking.
PROFITS AND PLAGIARISM: THE CASE OF MEDICAL GHOSTWRITING
Authors: ANEKWE TOBENNA D. 
Published: February 2009

ABSTRACTThis paper focuses on medical ghostwriting in the United States. I argue that medical ghostwriting often involves plagiarism and, in those cases, can be treated as an act of research misconduct by both the federal government and research institutions. I also propose several anti‐ghostwriting measures, including: 1) journals should implement guarantor policies so that researchers may be better held accountable for their work; 2) research institutions and the federal government should explicitly prohibit medical ghostwriting and outline appropriate penalties; and 3) a publicly available database should be created to record researchers' ethics violations.
LIVING TO THE BITTER END? A PERSONALIST APPROACH TO EUTHANASIA IN PERSONS WITH SEVERE DEMENTIA
Authors: GASTMANS CHRIS , DE LEPELEIRE JAN 
Published: February 2009

ABSTRACTThe number of people suffering from dementia will rise considerably in the years to come. This will have important implications for society. People suffering from dementia have to rely on relatives and professional caregivers when their disorder progresses. Some people want to determine for themselves their moment of death, if they should become demented. They think that the decline in personality caused by severe dementia is shocking and unacceptable. In this context, some people consider euthanasia as a way to avoid total deterioration. In this article, we discuss some practical and ethical dilemmas regarding euthanasia in persons with severe dementia based on an advance euthanasia directive. We are using a personalist approach in dealing with these ethical dilemmas.
AUTONOMY AND ETHICAL TREATMENT IN DEPRESSION
Authors: BIEGLER PAUL 
Published: February 2009

ABSTRACTAntidepressant medication and evidence‐based psychotherapy have largely equivalent efficacy in the management of the common, less severe grades of depression. As a result, several national guidelines recommend that either can be used in the treatment of this disorder. Psychotherapy, however, differs in that it assists insight into how the depressed person appraises and manages the stressors that frequently trigger depressive episodes. I argue that the self‐knowledge achieved through psychotherapy has moral value in that it promotes the autonomy of stressor‐related decisions. I further argue that such an effect comprises a compelling moral reason for doctors to see evidence‐based psychotherapy not as merely optional, but as a necessary treatment for their patients with depression.
A RIGHT TO REPRODUCE?
Authors: QUIGLEY MUIREANN 
Published: February 2009

ABSTRACTHow should we conceive of a right to reproduce? And, morally speaking, what might be said to justify such a right? These are just two questions of interest that are raised by the technologies of assisted reproduction. This paper analyses the possible legitimate grounds for a right to reproduce within the two main theories of rights; interest theory and choice theory.
THE DUTY TO DIE AND THE BURDENSOMENESS OF LIVING
Authors: CHOLBI MICHAEL 
Published: February 2009

ABSTRACTThis article addresses the question of whether the arguments for a duty to die given by John Hardwig, the most prominent philosophical advocate of such a duty, are sound. Hardwig believes that the duty to die is relatively widespread among those with burdensome illnesses, dependencies, or medical conditions. I argue that although there are rare circumstances in which individuals have a duty to die, the situations Hardwig describes are not among these.After reconstructing Hardwig's argument for such a duty, highlighting his central premise that ill, dependent, or aged individuals can impose unfair burdens upon others by continuing to live, I clarify precisely what Hardwig intends by his thesis that many of us have a duty to die. I then show that an important disanalogy exists between an uncontroversial example in which an individual has a duty to die and the situations in which Hardwig proposes individuals have a duty to die. More specifically, in situations where a duty to die exists, an individual's having a duty to die logically implies that those she burdens have a right to kill that individual in self‐defense. I then suggest that the burdens that ill, dependent, or aged individuals impose on their families, loved ones, or caregivers do not constitute the kind of threat that warrants the latter killing the former in self‐defense. Hence, the duty to die is much rarer than Hardwig supposes.
PUBLICATION ETHICS AND THE GHOST MANAGEMENT OF MEDICAL PUBLICATION
Authors: SISMONDO SERGIO , DOUCET MATHIEU 
Published: February 2009

ABSTRACTIt is by now no secret that some scientific articles are ghost authored – that is, written by someone other than the person whose name appears at the top of the article. Ghost authorship, however, is only one sort of ghosting. In this article, we present evidence that pharmaceutical companies engage in the ghost management of the scientific literature, by controlling or shaping several crucial steps in the research, writing, and publication of scientific articles. Ghost management allows the pharmaceutical industry to shape the literature in ways that serve its interests.This article aims to reinforce and expand publication ethics as an important area of concern for bioethics. Since ghost‐managed research is primarily undertaken in the interests of marketing, large quantities of medical research violate not just publication norms but also research ethics. Much of this research involves human subjects, and yet is performed not primarily to increase knowledge for broad human benefit, but to disseminate results in the service of profits. Those who sponsor, manage, conduct, and publish such research therefore behave unethically, since they put patients at risk without justification. This leads us to a strong conclusion: if medical journals want to ensure that the research they publish is ethically sound, they should not publish articles that are commercially sponsored.
RISK DETECTION IN INDIVIDUAL HEALTH CARE: ANY LIMITS?
Authors: PALMBOOM GER , WILLEMS DICK 
Published: February 2009

ABSTRACTBackground: Biomedical science is producing an avalanche of data about risk factors, often with a small predictive value, associated with a broad diversity of diseases. Prevention and screening are increasingly moving from public health into the clinic. Therefore, the question of which risk factors to investigate and disclose in the individual patient, becomes ethically increasingly urgent. In line with Wilson and Jungner's public health‐related 10 principles for screening, it seems crucial to distinguish important from unimportant health risks.Aim: to explore the ways in which clinicians distinguish important from unimportant health risks.Methods: We interviewed 36 respondents (gastroenterologists and gynaecologists/obstetrics) in 5 focus group interviews and 15 open in‐depth interviews on their interpretation of what makes a health risk important.Results: Physicians primarily interpreted importance as the severity of the possible harm, less often its probability. Possibilities of prevention or reassurance strongly influenced their judgment on importance.Discussion: It is not likely that interpreting ‘important’ as ‘severe’ will help in differentiating meaningful from meaningless risk knowledge. A more fundamental change in our ways of dealing with risk may be called for. We discuss existing literature on resilience as an alternative way to deal with risk. Balancing prevention and risk reduction with resilience could be a fruitful direction.
Prostate cancer stories in the Canadian print media: representations of illness, disease and masculinities
Authors: Halpin Michael , Phillips Melanie , Oliffe John L. 
Published: February 2009

AbstractDespite the popularity of print media as an information source for men with prostate cancer, the representation of prostate cancer within this medium remains relatively understudied. This article details the findings from an analysis of prostate cancer articles published in two Canadian national newspapers, The Globe and Mail and the National Post, from January 2001 through to December 2006. The 817 prostate cancer articles published during this period were retrieved and reviewed using manifest and latent analyses. Three article categories, illness perspectives, medical perspectives and supplementary were identified in the manifest analysis. The latent analysis was guided by the connections between masculinities and prostate cancer in the newspapers’ stories. Findings indicated a low frequency of articles that substantively discussed prostate cancer and that the descriptive content reproduced hegemonic masculine ideals, such as competition and stoicism. The presentation of a truncated illness trajectory and privileging of the curative aspects of biomedicine also depicted medicalised male bodies. Any discussion on the negative effects of treatment or explicit references to marginalised forms of masculinity was conspicuously absent. These findings support how representations of prostate cancer in Canadian newspapers predominately replicate detrimental ideologies and perspectives of men's health.
Doing being ‘on the edge’: managing the dilemma of being authentically suicidal in an online forum
Authors: Horne Judith , Wiggins Sally 
Published: February 2009

AbstractThose who attempt suicide have often been described as ‘crying for help’, and there are implications if such cries are not taken seriously. This paper examines how users of an Internet forum for ‘suicidal thoughts’ work up their authenticity in their opening posts, and how these are responded to by fellow forum users. Data were taken from two Internet forums on suicide over a period of one month and were analysed using discursive psychology. The analysis demonstrates that participants display their authenticity through four practices: narrative formatting, going ‘beyond’ depression, displaying rationality and not explicitly asking for help. Furthermore, both initial and subsequent posts worked up identities as being psychologically ‘on the edge’ of life and death. The analysis suggests that the forum in part works as a site for suicidal identities to be tested out, authenticated and validated by individuals. We conclude with some suggestions for the supportive work of suicide ‘postvention’.
Doing accountability: a discourse analysis of research ethics committee letters
Authors: O’Reilly Michelle , Dixon‐Woods Mary , Angell Emma , Ashcroft Richard , Bryman Alan 
Published: February 2009

AbstractResearch ethics committees (RECs) are charged with adjudicating the ethical status of research projects, and determining the conditions necessary for such projects to proceed. Both because of their position in the research process and because of the controversial nature of ethical judgements, RECs’ views and decisions need to be accountable. In this paper we use techniques of discourse analysis to show how REC decision letters ‘do’ accountability. Using a sample of 260 letters from three datasets, we identify a range of discursive devices used in letters written by RECs. These include drawing attention to: the process behind the decision, including its collaborative nature; holding the applicants accountable, by implying that any decision made by the REC can be attributed to the performance of the applicants; referring to specialist expertise; and calling upon external authorities. These tactics ‘do’ accountability by showing that routines of ethical assessment have been enacted, by establishing the factuality of claims, and by managing questions of fault and blame attribution. They may, however, also risk undermining legitimacy by failing to acknowledge the inherent contestability of ethical decision making or the limited nature of the cultural authority accorded to RECs, and thus may appear as an illegitimate exercise of power.
PISA and the Transition into the Labour Market
Authors: Bertschy Kathrin , Cattaneo M. Alejandra , Wolter Stefan C. 
Published: February 2009

AbstractThis paper uses unique Swiss longitudinal data that include information on Programme for International Student Assessment (PISA) 2000 scores and the pathways chosen after completing compulsory school. Descriptive results show that students in vocational training, who obtained lower PISA results, are significantly more likely to be in an inadequate employment situation 2 years after finishing vocational training. Further analysis shows, however, that it is the type of vocational training pursued at upper secondary level that is decisive for a successful transition. Nevertheless, individual PISA scores have an indirect impact on the transition results, as they are an important factor explaining which pupils are more likely to get into an intellectually demanding vocational training and which ones are not.
Immigration Policy, Equilibrium Unemployment, and Underinvestment in Human Capital
Authors: Lumpe Christian , Weigert Benjamin 
Published: February 2009

AbstractWe analyse the impact of different immigration policies on human capital investment in a search‐theoretic model. This class of models features unemployment and underinvestment in human capital. The underinvestment in human capital can be solved by combining immigration policy with appropriate education subsidies. Extending the model with respect to different skill groups allows to analyse the observed bimodal skilled immigration of the USA.
Changing Returns to Education During a Boom? The Case of Ireland
Authors: McGuinness Seamus , McGinnity Frances , O'Connell Philip J. 
Published: February 2009

AbstractIreland experienced dramatic growth in the economy and employment in the second half of the 1990s. This paper examines the consequences of that boom for returns to education and wage inequality using data from the Living in Ireland Survey for the years 1994, 1997, and 2001. Rapid economic growth is often expected to lead to increased returns to education and thus to rising wage inequality. We find fairly stable returns to education and falling wage inequality for men throughout the period, partly due to strong demand for unskilled labour, which helped maintain low‐skilled wages. For women the wage premium for a university degree fell between 1997 and 2001, as did wage inequality. We argue that for women, low‐skilled wages may have been kept up by the introduction of the minimum wage in 2000, and high‐skilled wages fell due to a rapid rise in the supply of highly qualified women.
Training and Low‐pay Mobility: The Case of the UK and the Netherlands
Authors: Pavlopoulos Dimitris , Muffels Ruud , Vermunt Jeroen K. 
Published: February 2009

AbstractThis paper investigates the effect of training on low‐pay mobility in the UK and the Netherlands. We contribute to the literature by estimating the ‘true’ effect of training correcting for measurement error and transitory fluctuations — random shocks — of earnings. This is accomplished by using a random‐effects multinomial logit model with a latent structure to take account of the measurement error. Our results indicate that although the countries have rather different training practices, training increases the likelihood for moving from low to higher pay and reduces the likelihood for a transition from higher pay to low pay. However, in the UK, contrary to what we expected, work‐related or firm‐specific training programmes but not general training programmes pay off better for the intermediate‐ and the higher‐educated workers. No effect of training is found for the low‐educated workers. The lower‐skilled seem to gain less than the high‐skilled from firms' investments in human capital in the UK.