bluuebunny/crossref_metadata_2025_split huggingface dataset:
Introduction: Welcome to the Program
Authors: Epstein Elizabeth E. , McCrady Barbara S. 
Published: July 2023

Abstract
This chapter introduces the basics of the Women’s Group Treatment for Substance Use Disorder program. It provides information about how this treatment can help, how to decide if someone has an alcohol or drug problem, how to define risky drinking, and why a treatment program specifically for women is important. Details are given on the program, including the types of coping skills that are taught, the structure of each session, and what participants can expect in the treatment. The goal of abstinence is also discussed. The chapter covers options and coping skills to get to abstinence, the level of care a participant may need based on the pre-treatment assessment, and how women can use this workbook.
Session 8: Connecting with Others, Dealing with Alcohol/Drug-Related Thoughts
Authors: Epstein Elizabeth E. , McCrady Barbara S. 
Published: July 2023

Abstract
Session 8 helps clients revisit their social network for general support and for abstinence and to add or strengthen existing social connections by choosing and spending time with people they enjoy, to whom they can turn for support and caring, who will support their abstinence, who are not toxic to them, and who will treat them well. Clients also learn how to handle their thoughts about their drinking or drug use, and skills to cope with their thoughts that might lead to alcohol or drug use. At the end of the session clients will identify upcoming high-risk situations and develop plans to cope without using alcohol or drugs. The therapist also will review homework for the upcoming week.
Session 10: Anger Management; Relapse Prevention I: Seemingly Irrelevant Decisions
Authors: Epstein Elizabeth E. , McCrady Barbara S. 
Published: July 2023

Abstract
Session 10 will teach clients about anger management skills. They will learn to use a behavior chain to identify anger triggers, thoughts and feelings that lead to aggressive behavior, and consequences. They then will practice new thoughts and behavioral responses to achieve better outcomes and enhance their self-confidence and autonomy. The session also covers a relapse prevention skill called “seemingly irrelevant decisions” to help clients identify risky decisions that may seem unrelated to drinking or drug use but that actually increase the chances that they will use alcohol or drugs. At the end of the session clients will identify upcoming high-risk situations and develop plans to cope without using alcohol or drugs. The therapist also will review homework for the upcoming week.
Session 11: Problem-Solving
Authors: Epstein Elizabeth E. , McCrady Barbara S. 
Published: July 2023

Abstract
In this session, clients will learn problem-solving, a key cognitive behavioral therapy skill that they can use instead of drinking or using drugs to deal with problems. Clients will practice the skill in the session via exercises using the handouts and worksheets. Letting go of things that are identified as “not in my control” is discussed as an important step in problem-solving. Tools such as acceptance and mindfulness will be incorporated into the problem-solving strategy menu. At the end of the session clients will identify upcoming high-risk situations and develop plans to cope without using alcohol or drugs. The therapist also will review homework for the upcoming week.
Session 12: Relapse Prevention II; Maintenance Planning
Authors: Epstein Elizabeth E. , McCrady Barbara S. 
Published: July 2023

Abstract
This final session provides psychoeducation on slips, relapses, relapse prevention, and long-term maintenance of recovery from alcohol use disorder or substance use disorder. Clients will learn how to identify and respond to warning signs of a potential slip or relapse to alcohol or drug use and how they should handle slips or relapses if they do occur. Clients will develop a firm plan to help them maintain the gains they have made during treatment and will create a relapse contract that will commit them to a plan should they have a slip or relapse. At the end of the session clients will identify upcoming high-risk situations and develop plans to cope without using alcohol or drugs.
The Rwandan Experience
Authors: Ly E. John 
Published: July 2023

Abstract
Following the Rawandan genocide in 1994 which left the country devastated, Rwanda and its Ministry of Health embarked on an ambitious rebuilding plan that was focused on health equity. Rwanda established health as a human right in its 2003 constitution; it developed a national health insurance program; and it insisted that foreign health aid align with its national strategic plan. Within this broader context, these study investigators were able to demonstrate dramatic gains in maternal and child health system coverage and population-level health outcomes, in the country’s poorest region, through a series of interventions that focused on strengthening healthcare systems.
Can Checklists Improve Perinatal Outcomes?
Authors: Walker Andrea 
Published: July 2023

Abstract
With the success of the WHO Safe Surgery Checklist, the “checklist strategy” to improve clinical outcomes has permeated multiple areas of healthcare. The WHO Safe Childbirth checklist (SCC) includes 28 evidence-based essential birth practices that occurred before birth, before pushing, within 1 minute of delivery, and within 1 hour of delivery. These items are thought to improve maternal and neonatal outcomes if followed. This randomized controlled study found that despite documented improvement in adherence to the Safe Childbirth Checklist in the peripartum period, there was no improvement in maternal or neonatal outcomes, suggesting that the use of a checklist alone is not sufficient to impact outcomes.
DOTS-Plus
Authors: Garg Tushar 
Published: July 2023

Abstract
Multidrug-resistant tuberculosis (TB) is a major issue in global health, prompting concerns from multilateral agencies and donor organizations about the ability of low- and middle-income countries (LMICs) to effectively treat patients with this disease as a result of poor health infrastructure and the perceived inability to ensure that patients receive and take their specialized antibiotic regimens. The DOTS-Plus program for patients with drug-resistant TB described in this study provides individualized, patient-centered care in a community-based, outpatient, and low-resource environment. With this program, 83% of the patients completing at least 4 months of treatment achieved a probable cure. This study catalyzed changes to guidelines and practice of treating every drug-resistant case in an in-patient hospital setting and highlighted the limits of the standardized short-course approach to TB treatment.
Economic Growth and Child Undernourishment
Authors: Gun Arkaprabha 
Published: July 2023

Abstract
Nutrition is essential to survival, and malnutrition is a large contributor to under-5 mortality globally. This study examines the effect that state-level economic growth has on nutritional outcomes in children in India. The authors estimated the odds ratio of the children being underweight, stunted, or suffering from wasting, given a 5000 Indian rupees (INR) increase in the state per capita income. The authors found that the likelihood of a child experiencing undernourishment does not vary as a result of state-level economic growth. This implies that increased GDP/economic growth is insufficient to improve childhood nutrition status, but instead that targeted policies and interventions may be necessary.
Implicit Bias in Pain Management
Authors: Huang Kuang-Ning , Carpenter Cristina Rivera 
Published: July 2023

Abstract
Implicit biases involve associations outside conscious awareness that lead to a negative outcome based on race, class, or sexual orientation. In this study, Hispanic patients with long bone fractures were twice as likely as non-Hispanic white patients to receive no pain medications in the emergency room, and when they did receive pain medications, the doses were smaller. Multiple studies have documented similar phenomena, and unfortunately this study is just one of many examples in healthcare that shows patients may be treated differently as a result of implicit bias.
Race-Based Medicine—Is It Biological or Profit Driven?
Authors: Crawford Nadra 
Published: July 2023

Abstract
The African-American Heart Failure Trial (A-HeFT) was performed after retrospective subgroup analyses of Vasodilator Heart Failure Trial (V-HeFT) I and II trial data showed a significant improvement in mortality in Blacks using ISDN combined with hydralazine. A-HeFT is a randomized, placebo-controlled, double-blind trial of 161 sites throughout the United States, whose aim was to determine if there is a survival benefit with the addition of ISDN and hydralazine to standard therapy in a single ethnic group—Blacks—with advanced heart failure. The study found that the addition of isosorbide dinitrate (ISDN) and hydralazine (BiDil) to standard therapy improved survival, reduced hospitalization, and enhanced quality of life in participants.
How Do Locals Feel about Expats in Global Health?
Authors: Fukushima Jack , Jumbe Arnold 
Published: July 2023

Abstract
There are an abundance of short-term medical trips, including global health training programs that send partially trained or untrained learners to “help” in the medical field; other programs include medium- to longer-term healthcare providers from high-income countries (HICs) who travel to low- and middle-income countries (LMICs) to work in healthcare. Each program has varying levels of preparation, cultural sensitivity training, and partnerships with the host country or facility. The visiting provider(s) and their services may or may not have been specifically requested by the host country. These providers may not adhere to the same credentialing standards they adhere to in their own country, and may not have a full understanding of the health system into which they are traveling. This study aims to understand how the healthcare professionals in the LMICs perceive those who are coming from the HICs. In doing so, the study authors bring up ethical considerations around the themes of medical colonialism, recognizing and understanding power dynamics, cultural competency, and sustainability.
Isoniazid for Preventing TB in HIV-Positive People
Authors: Laux Timothy S. 
Published: July 2023

Abstract
Tuberculosis (TB) is a major cause of morbidity and mortality in patients with HIV. This study looked at patients with HIV-1 infection who were starting or continuing antiretroviral therapy (ART) and the use of 12 months of isoniazid to prevent active TB disease. They found that isoniazid preventive therapy (IPT) provided protection against active TB with a number needed to treat (NNT) of 25. This shows that in moderate- or high-burden TB settings, HIV-1 positive individuals on ART should receive 12 months of IPT for prevention of incident TB with few exceptions.
A National Program to Introduce Impregnated Bednets to Address Malaria in Gambia
Authors: Parker Jessica C. 
Published: July 2023

Abstract
The Gambia initiated a National Insecticide Impregnated Bednet Programme (NIBP) after a controlled trial of insecticide-treated bednets was found to lower child mortality. The goal of the study was to determine if implementation of insecticide-treated bednets at a national level would result in a significant reduction in child mortality and would be cost-effective. Five geographic areas were selected, and the authors compared childhood mortality in populations using insecticide-treated bednets to those using untreated nets. Despite poor compliance in some of the groups, the authors found an overall reduction in childhood mortality in populations using insecticide-treated nets, albeit with a significant and likely prohibitive cost.
Solidarity Trial
Authors: Agarwal Anup 
Published: July 2023

Abstract
In February 2020, when the COVID-19 pandemic started, there was no known therapy for COVID-19 but multiple repurposed drugs were being considered as potential treatments. To study these drugs in a fast-tracked manner, the World Health Organization (WHO) initiated a multi-center, international, simple adaptive trial of 4 potential therapies including remdesivir, hydroxychloroquine, lopinavir, and interferon with the primary outcome of mortality reduction. The trial was completed within 7 months to conclusively answer that none of the 4 drugs was found to have any benefit on mortality reduction, or on initiation of ventilation among non-ventilated patients. These results would help government and policymakers in low- and middle-income countries to streamline resources for COVID-19 away from these 4 drugs.
Oral Maintenance Therapy for Cholera in Adults
Authors: Chatterjee Pranab 
Published: July 2023

Abstract
Cholera and non-cholera diarrheal illnesses are an important cause of morbidity and mortality in low- and middle-income countries (LMICs). The major challenge in management of diarrheal illness is treatment of dehydration. In resource-denied settings, where supplies for intravenous (IV) fluid administration can be scarce, an oral substitute can be a lifesaving modality. This study administered oral fluids in one group in addition to giving IV fluids, compared with IV fluid administration only in another group. There was a difference of nearly 15.5 L of total IV fluids needed between the oral therapy group and the IV fluid group, with the oral therapy group having a significantly smaller IV fluid requirement. This study, conducted in the infancy of clinical trials, was instrumental in identifying the reduction in need for IV fluid support with the addition of oral fluids to the management strategy for cholera.
Does Helping Babies Breathe Training Help Reduce Neonatal Mortality?
Authors: Sikder Shegufta Shefa 
Published: July 2023

Abstract
The first hour of life is critical to newborn survival. This study conducted at 8 hospital in Tanzania highlights the effectiveness of a training and education curricula on neonatal mortality in settings that have previously failed to initiate resuscitative steps in a timely manner. This study shows that successful implementation of this program results in 47% reduction in early neonatal mortality (ENM) within 24 hours of training and 24% reduction in fresh still births after 2 years. The Helping Babies Breathe approach is simple and can be implemented readily at all deliveries, including those in low-resource settings, as it emphasizes low-cost interventions, including immediate drying and stimulation.
Sickle Cell Anemia in Children in Sub-Saharan Africa—What Is the Best Medicine?
Authors: Laux Timothy S. 
Published: July 2023

Abstract
Hydroxyurea is a myelosuppressive agent that raises the level of fetal hemoglobin in red blood cells and is well known to significantly reduce the frequency of sickle cell crises, chronic organ damage, and prolong survival. It is on the WHO list of essential medicines for the treatment of hemoglobinopathies. However, in areas where malaria and malnutrition are endemic there were concerns over whether toxicity risks may outweigh benefits. The REACH trial looked at the benefits versus risks of hydroxyurea in sickle cell patients in children in sub-Saharan Africa and found that hydroxyurea treatment reduced the rates of painful events, infection, transfusion and death with no increase in adverse events and in fact had a protective effect against malaria with a rate reduction of more than 50%.
Can Tranexamic Acid Stop Postpartum Hemorrhage?
Authors: Lindley Alexa , Montano Mariana , Molina Rose L. 
Published: July 2023

Abstract
Postpartum hemorrhage is the leading cause of maternal mortality worldwide. This chapter reviews the World Maternal Antifibrinolytic (WOMAN) trial that tested whether the administration of tranexamic acid prevents death and other adverse events from postpartum hemorrhage. The study found a statistically significant decrease in death from postpartum hemorrhage in patients who received tranexamic acid compared to those who received placebo, but with a large number needed to treat of 250. However, given that there were no complications associated with tranexamic acid treatment, this trial supports its use in postpartum hemorrhage, which is the leading cause of maternal mortality worldwide.
Magnesium Sulphate for Seizure Prophylaxis in Women with Preeclampsia
Authors: Walker Andrea 
Published: July 2023

Abstract
The article “Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: A randomized placebo-controlled trial” describes the first randomized trial that objectively evaluates the utility of magnesium sulphate therapy as prophylaxis against progression to eclamptic convulsions in a high-risk cohort of women. It specifically evaluates the effect of magnesium sulphate given before and after delivery on maternal progression to eclampsia and fetal/neonatal death. It also evaluates secondary outcomes such as maternal morbidity, magnesium toxicity, side effects of magnesium sulphate, and for those who received magnesium sulphate prior to delivery, it evaluates complications of the labor process.
Effects of Partograms on Birthing Outcomes in Developing Nations
Authors: Dean Nakyda 
Published: July 2023

Abstract
A partogram is a graphic representation of labor and was established as the gold standard of monitoring labor in the low-resource setting by the World Health Organization (WHO) in 1994. Obstructed labor is still a major cause of maternal and neonatal morbidity and mortality and can be prevented with the aid of the partogram. The careful use of the partogram, and the value of the alert and action line, can improve maternal-child health outcomes by early detection of abnormal progression of labor. Healthcare workers must receive continuing education to utilize this tool in real time to greatly impact maternal-child health outcomes.
Can Community Health Workers Effectively Provide Cognitive Behavioral Therapy–Based Services?
Authors: White Rebecca 
Published: July 2023

Abstract
This chapter examines the effectiveness of using non-specialists to provide mental health services. Trained mental health workers are a scarce resource globally, and task sharing has been implemented in primary care settings to improve access to evidence-based mental health treatment. This cluster randomized controlled trial conducted across 40 sites in rural Pakistan assesses the efficacy of non-specialists to provide cognitive behavioral therapy–based services for mothers with perinatal depression and outcomes for both mothers and infants 12 months post-delivery. Depression and disability were nearly 50% lower in the intervention group compared to the control group. Nutritional indicators of infants were same in both groups at 6 and 12 months. It concludes with a case study to examine concrete ways to implement recommendations from the study.
Improving Mental Health Access Where There Is No Psychiatrist
Authors: Chandrashekhar Riti , Walker Andrea 
Published: July 2023

Abstract
There is a dearth of mental health professionals globally. This shortage is disproportionally pronounced in low- and middle-income countries (LMICs). To address the shortage, collaborative care models (CoCM) have been proposed which consider primary care providers (PCP) and behavioral health providers (such as social workers) as mental health professional substitutes who operate under the guidance of a psychiatrist. This study is among the first to evaluate CoCM implementation in LMICs. It reviews the impact of the intervention on PCP behaviors to screen, diagnose, and treat mental illness, as well as clinical outcomes in patients with depression, showing a 49% improvement in clinical response to depression.
Aspirin in Acute Stroke
Authors: Bender Jessica 
Published: July 2023

Abstract
According to a 2013 Global Burden of Disease study, stroke was the second largest contributor to age-adjusted disability-adjusted life years (DALYs) in developing countries. Access to thrombolytic therapy for stroke within 4.5 hours of symptom onset remains a major logistical challenge in most parts of the Global South. This study was done to assess the efficacy of aspirin in the setting of acute ischemic stroke in preventing short term death and disability. The study results suggest that aspirin results in modest reduction in death and disability when given in the acute period after presumed ischemic stroke. The increased burden of stroke and subsequent loss of DALYs in the Global South suggests that aspirin use in acute stroke is a worthwhile intervention.
Introduction: Some Context
Authors: Weiner Saul J. , Schwartz Alan 
Published: July 2023

Abstract
The introduction to the second edition is designed to provide the reader who is not familiar with research on contextual error with an overview of the fundamental concepts and terms, followed by a brief description of each chapter, laying out a rationale for the body of work and placing it in a historical context. For instance, studies on contextualization of care build on the work of George Engel’s biopsychosocial model by introducing an empirical framework and set of tools for characterizing and measuring a dimension of quality that has previously been sidelined with non-specific terms like “art of medicine” and “humanistic care.” The authors argue that contextualizing care to prevent contextual error is a clinician competency that should be systematically taught, assessed, and then reinforced in clinical practice.
Measuring the Problem
Authors: Weiner Saul J. , Schwartz Alan 
Published: July 2023

Abstract
Chapter 2, “Measuring the Problem,” transitions from anecdotes and hypotheses to systematic inquiry. Contextual error is characterized as a subtype of medical error that has been overlooked because it is not detectable utilizing conventional methods for detecting error. The authors describe observing physician decision-making directly by sending unannounced standardized patients (USPs) into doctors’ practices to portray cases that challenge physicians to think contextually. Doing so is methodologically challenging as it entails training actors to adopt the personae of real patients while adhering to a script, creating fake medical records, and gaining the trust of physicians who consent not to know when a USP is recording them. The work demonstrates that when patients drop hints that there are life factors interfering with their care, doctors often miss them, instead sending them out with plans that look appropriate on paper but, in fact, are not if one takes into account the context.
The Problem Is Everywhere
Authors: Weiner Saul J. , Schwartz Alan 
Published: July 2023

Abstract
Chapter 3, “The Problem Is Everywhere,” describes the next phase of work, in which hundreds of actual patients, carrying concealed audio recorders, recorded their visits with their physicians. This approach captures how often context matters in actual practice and how often effective care really hinges on a personalized approach in which individual life circumstances are a key factor in planning. The chapter describes the development of a coding system, termed “Content Coding for Contextualization of Care” or “4C,” designed to study actual patient interactions and their outcomes. It also delves into the complex process of conducting the research itself, including the legal and ethical implications of covert audio recording as well as the potential concerns of participants, clinicians, and patients alike.