Miracle-dz/UniFAR-FTUs huggingface dataset:
Out-of-pocket payments for health care services in Bulgaria: financial burden and barrier to access.

BACKGROUND In recent years, Bulgaria has increasingly relied on out-of-pocket payments as one of the main sources of health care financing. However, it is largely unknown whether the official patient charges, combined with informal payments, are affordable for the population. Our study aimed to explore the scale of out-of-pocket payments for health care services and their affordability. METHODS Data were collected in two nationally representative surveys, conducted in Bulgaria in 2010 and 2011, using face-to-face interviews based on a standardized questionnaire. To select respondents, a multi-stage random probability method was used. The questionnaire included questions on the out-of-pocket payments for health care services used by the respondent during the preceding 12 months. RESULTS In total, 75.7% (2010) and 84.0% (2011) of outpatient service users reported to have paid out-of-pocket, with 12.6% (2010) and 9.7% (2011) of users reporting informal payments. Of those who had used inpatient services, 66.5% (2010) and 63.1% (2011) reported to have made out-of-pocket payments, with 31.8% (2010) and 18.3% (2011) reporting to have paid informally. We found large inability to pay indicated by the need to borrow money and/or forego services. Regression analysis showed that the inability to pay is especially pronounced among those with poor health status and chronic diseases and those on low household incomes. CONCLUSION The high level of both formal and informal out-of-pocket payments for health care services in Bulgaria poses a considerable burden for households and undermines access to health services for poorer parts of the population.
An exploratory study into the health beliefs and behaviours of British Indians with type II diabetes

Aim To explore the influence of health beliefs and behaviours on diabetes management in British Indians, as successful management of diabetes is dependent on underlying cultural beliefs and behaviours. Background British South Asians are six times more likely to suffer from type II diabetes than those in the general population. Yet, little research has been carried out into beliefs about diabetes among the British Indian population. Method The study used semi-structured interviews, a structured vignette and a pile-sorting exercise. In all, 10 British Indians were interviewed at a General Practice in North West London. Findings Those interviewed were informed about their diabetes but had difficulties in adapting their diet. Themes identified included causal beliefs of diabetes, use of alternative therapies, moderation of food, adaption of exercise regimes and sources of information. All were aware of avoiding certain foods yet some still continued to consume these items. Participants expressed the need for culturally sensitive forums to help manage their diabetes.
Erosion and mobility in granular collapse over sloping beds

[1] We describe laboratory experiments of granular material flowing over an inclined plane covered by an erodible bed, designed to mimic erosion processes of natural flows travelling over deposits built up by earlier events. Two controlling parameters are the inclination of the plane and the thickness of the erodible layer. We show that erosion processes can increase the flow mobility (i.e., runout) over slopes with inclination close to the repose angle of the grains θr by up to 40%, even for very thin erodible beds. Erosion efficiency is shown to strongly depend on the slope of the topography. Entrainment begins to affect the flow at inclination angles exceeding a critical angle θc ≃ θr/2. Runout distance increases almost linearly as a function of the thickness of the erodible bed, suggesting that erosion is mainly supply-dependent. Two regimes are observed during granular collapse: a first spreading phase with high velocity followed by a slow thin flow, provided either the slope or the thickness of the erodible bed is high enough. Surprisingly, erosion affects the flow mostly during the deceleration phase and the slow regime. The avalanche excavates the erodible layer immediately at the flow front. Waves are observed behind the front that help to remove grains from the erodible bed. Steep frontal surges are seen at high inclination angles over both rigid or erodible bed. Finally, simple scaling laws are proposed making it possible to obtain a first estimate of the deposit and emplacement time of a granular collapse over a rigid or erodible inclined bed.
Amygdala and ventrolateral prefrontal cortex activation to masked angry faces in children and adolescents with generalized anxiety disorder.

CONTEXT Vigilance for threat is a key feature of generalized anxiety disorder (GAD). The amygdala and the ventrolateral prefrontal cortex constitute a neural circuit that is responsible for detection of threats. Disturbed interactions between these structures may underlie pediatric anxiety. To date, no study has selectively examined responses to briefly presented threats in GAD or in pediatric anxiety. OBJECTIVE To investigate amygdala and ventrolateral prefrontal cortex activation during processing of briefly presented threats in pediatric GAD. DESIGN Case-control study. SETTING Government clinical research institute. PARTICIPANTS Youth volunteers, 17 with GAD and 12 without a psychiatric diagnosis. MAIN OUTCOME MEASURES We used functional magnetic resonance imaging to measure blood oxygenation level-dependent signal. During imaging, subjects performed an attention-orienting task with rapidly presented (17 milliseconds) masked emotional (angry or happy) and neutral faces. RESULTS When viewing masked angry faces, youth with GAD relative to comparison subjects showed greater right amygdala activation that positively correlated with anxiety disorder severity. Moreover, in a functional connectivity (psychophysiological interaction) analysis, the right amygdala and the right ventrolateral prefrontal cortex showed strong negative coupling specifically to masked angry faces. This negative coupling tended to be weaker in youth with GAD than in comparison subjects. CONCLUSIONS Youth with GAD have hyperactivation of the amygdala to briefly presented masked threats. The presence of threat-related negative connectivity between the right ventrolateral prefrontal cortex and the amygdala suggests that the prefrontal cortex modulates the amygdala response to threat. In pediatric GAD, amygdala hyperresponse occurs in the absence of a compensatory increase in modulation by the ventrolateral prefrontal cortex.
Monkey Prefrontal Neurons Reflect Logical Operations for Cognitive Control in a Variant of the AX Continuous Performance Task (AX-CPT)

Cognitive control is the ability to modify the behavioral response to a stimulus based on internal representations of goals or rules. We sought to characterize neural mechanisms in prefrontal cortex associated with cognitive control in a context that would maximize the potential for future translational relevance to human neuropsychiatric disease. To that end, we trained monkeys to perform a dot-pattern variant of the AX continuous performance task that is used to measure cognitive control impairment in patients with schizophrenia (MacDonald, 2008; Jones et al., 2010). Here we describe how information processing for cognitive control in this task is related to neural activity patterns in prefrontal cortex of monkeys, to advance our understanding of how behavioral flexibility is implemented by prefrontal neurons in general, and to model neural signals in the healthy brain that may be disrupted to produce cognitive control deficits in schizophrenia. We found that the neural representation of stimuli in prefrontal cortex is strongly biased toward stimuli that inhibit prepotent or automatic responses. We also found that population signals encoding different stimuli were modulated to overlap in time specifically in the case that information from multiple stimuli had to be integrated to select a conditional response. Finally, population signals relating to the motor response were biased toward less frequent and therefore less automatic actions. These data relate neuronal activity patterns in prefrontal cortex to logical information processing operations required for cognitive control, and they characterize neural events that may be disrupted in schizophrenia. SIGNIFICANCE STATEMENT Functional imaging studies have demonstrated that cognitive control deficits in schizophrenia are associated with reduced activation of the dorsolateral prefrontal cortex (MacDonald et al., 2005). However, these data do not reveal how the disease has disrupted the function of prefrontal neurons to produce the observed deficits in cognitive control. Relating cognitive control to neurophysiological signals at a cellular level in prefrontal cortex is a necessary first step toward understanding how disruption of these signals could lead to cognitive control failure in neuropsychiatric disease. To that end, we translated a task that measures cognitive control deficits in patients with schizophrenia to monkeys and describe here how neural signals in prefrontal cortex relate to performance.
Usage of leisure time by disabled males and females from the Lublin Region.

INTRODUCTION Free time in the life of both the disabled and those who are able bodied is the time of leisure, recovery and entertainment. The disabled utilize more energy and strength for everyday functioning compared to the able bodied, therefore, an adequate managing of the leisure time they possess is of great importance. This is confirmed by the latest results of American studies. OBJECTIVES The primary objective of the presented study is the presentation of the various of managing and organizing leisure time among disabled males and females living in the Lublin Region, with the consideration of statistical significance. MATERIALS AND METHOD A total of 360 disabled people were examined--187 females and 173 males, with physical, mental, complex and sensory disability. The study was conducted by a diagnostic survey with the use of a questionnaire form. RESULTS The results of own studies show small variation in the aspects of managing and organizing free time according to the respondents' gender. During their leisure time, both males and females watch TV, listen to the radio, read books and go for walks. They obtain information concerning offers for spending free time from the media, specialist institutions, associations and acquaintances, and expect assistance in the organization of their leisure time from specialist institutions, associations, and family members. The respondents are most interested in participating in a stay in a rehabilitation spa, permanent activities for the disabled, and trips. To-date they have participated in walking tours, bicycle tours, outdoor bivouacs and pilgrimages in the company of their family members and friends.
Striving to respond to palliative care patients' pain at home: a puzzle for family caregivers.

PURPOSE/OBJECTIVES to describe the types of pain patients in palliative care at home experience and how family caregivers assess them and intervene. RESEARCH APPROACH qualitative using grounded theory. SETTING family caregivers' homes. PARTICIPANTS 24 family caregivers of patients with advanced cancer receiving palliative care at home. METHODOLOGIC APPROACH semistructured interviews and field notes. Data analysis used Strauss and Corbin's recommendations for open, axial, and selective coding. MAIN RESEARCH VARIABLES pain, pain management, family caregivers, palliative care, and home care. FINDINGS caregivers assessed different types of pain and, therefore, were experimenting with different types of interventions. Not all family caregivers were able to distinguish between the different pains afflicting patients, and, consequently, were not selecting the most appropriate interventions. This often led to poorly managed pain and frustrated family caregivers. CONCLUSIONS The accurate assessment of the types of pain the patient is experiencing, coupled with the most appropriate intervention for pain control, is critical for optimal pain relief as well as supporting the confidence and feelings of family caregivers who are undertaking the complex process of cancer pain management. INTERPRETATION nurses involved with patients receiving palliative care and their family caregivers should be aware of all types of pain experienced by the patient and how caregivers are managing the pain. Nurses should be knowledgeable about different pain relief interventions to help family caregivers obtain accurate information, understand their options, and administer these interventions safely and effectively.
The Impact of Nasal Surgery on Sleep Quality

Objective (1) Evaluate the impact of nasal airway surgery on sleep quality using validated outcome measurements, (2) compare the utility of Epworth Sleepiness Scale (ESS) versus Pittsburgh Sleep Quality Index (PSQI) as a reflection of sleep quality, and (3) identify perioperative variables that might correlate with a beneficial effect of nasal surgery on sleep quality. Study Design Prospective outcome study of patients with symptomatic nasal obstruction undergoing nasal airway surgery. Setting Academic medical center. Methods Patients completed the Nasal Obstruction Symptom Evaluation (NOSE) scale, ESS, PSQI, and Ease-of-Breathing and Sleep Quality Likert scales preoperatively and 3 months postoperatively. A nonparametric analysis compared pre- and postoperative values, and associations were examined using Spearman correlations. Results Sixty-one patients completed the study. Mean NOSE scores decreased significantly from 68.2 preoperatively to 17.5 three months after surgery. Mean ESS scores and PSQI scores improved (P < .0001) over that same interval (7.5 to 5.3 and 7.8 to 4.6, respectively). There was a correlation seen between the degree of change in both NOSE scores and Ease-of-Breathing scores and the change in sleep quality measured using the PSQI or Sleep Quality Likert scores. The PSQI correlated better with Sleep Quality Likert scores than the ESS. Overall, 86.9% of subjects reported subjective improvement in sleep quality postoperatively. Conclusion In patients undergoing nasal airway surgery there may be a secondary improvement in subjective sleep quality. The degree of change in sleep quality correlates with the severity of nasal obstruction preoperatively and the degree of improvement in obstruction with surgery.
Reduced performance difference between sexes in master mountain and city marathon running

Background The performance in master marathoners has been investigated in flat city marathons but not in mountain marathons. This study examined changes in the sex differences in performance across time in female and male master runners competing in a mountain marathon compared to a flat city marathon. Methods The association between age and performance of finishers in the Jungfrau Marathon, Switzerland, with 1830 meter changes in altitude and a flat city marathon (Lausanne Marathon), Switzerland, were analyzed from 2000 to 2011. Results In both events, athletes in the 35–44 years age group showed the highest number of finishers. In the mountain marathon, the number of female master runners aged > 35 years increased in contrast to female finishers aged < 35 years, while the number of male finishers was unchanged in all age groups. In the city marathon, the number of female finishers was unchanged while the number of male finishers in the age groups for 25–34-year-olds and 35–44-year-olds decreased. In female marathoners, performance improved in athletes aged 35–44 and 55–64 years in the city marathon. Male marathoners improved race time in age group 45–54 years in both the city marathon and the mountain marathon. Female master runners reduced the sex difference in performance in the 45–54-year age group in both competitions and in the 35–44-year age group in the mountain marathon. The sex difference in performance decreased in the 35–44-year age group from 19.1% ± 4.7% to 16.6% ± 1.9% in the mountain marathon (r2 = 0.39, P = 0.03). In age groups 45–54 years, the sex difference decreased from 23.4% ± 1.9% to 15.9% ± 6.1% in the mountain marathon (r2 = 0.39, P < 0.01) and from 34.7% ± 4.6% to 11.8% ± 6.2% in the city marathon (r2 = 0.39, P < 0.01). Conclusion These findings suggest that female master runners aged 35–54 years reduced sex differences in their performance in both mountain and city marathon running.
The theory of met expectations applied to expatriate adjustment: the role of crosscultural training

This study will test two hypotheses to determine whether the formation of expectations (prior to the global assignment) affects expatriates' adjustment. This study utilized a sample of seventy-three expatriates who completed questionnaires approximately ten months after arriving in their host countries. All the expatriates had predeparture cross-cultural training, but the training varied in perceived relevance. The expatriates were assigned either to countries where their native language was spoken (e.g. Americans in the UK) or to countries where their native language was not spoken (e.g. Americans in France). The results of the mediated regression analysis suggest that the more tailored and relevant the pre-departure cross-cultural training, the more expectations were either met or positively exceeded. Analyses suggest that both cross-cultural training and the language spoken in the host country affect the accuracy of expatriates' expectations prior to the assignment - and that having accurate expectations, in turn, positively affects cross-cultural adjustment. The results from this study encourage organizations to develop programmes that will ensure their expatriates have realistic expectations prior to their global assignments (e.g. through tailored cross-cultural training).
A Test and Extension of the Demand/Control/Social Support Model: Prediction of Wellness/Health Outcomes in Greek Teachers

The present study investigated the relationship between job characteristics, coping strategies and job satisfaction, burnout and somatic complaints in 215 Greek secondary school teachers in the urban area of Thessaloniki, as part of the EUROTEACH project (11 countries, 2164 teachers). The study aimed at testing the hypotheses of the Demand-Control-Social support model (Karasek, 1979); and examining whether additional job characteristics (working hours, environmental risks, meaningfulness and physical exertion) as well as the inclusion of coping strategies could improve the model. Instruments included the Leiden Quality of Work Questionnaire for Teachers; the SCL-90 somatisation scale; the Maslach Burnout Inventory; and the CISS. Results indicated that all three components of the original model are associated with the outcomes with some associations being nonlinear. However, the moderating effects of control and social support are not supported by the data. Regarding coping, results indicated that coping variables can explain variance in most of the outcomes of the study, in addition to all job characteristics. Regarding the additional job characteristics, meaningfulness of work is the most important predictor. In order to understand these findings better, the Greek data were compared to that of the EUROTEACH group. This comparison revealed that the Greek teachers differ from their European counterparts in most study variables. The direction is mainly to the positive side, with the exception of the experience of less control on the job. The implications of these findings concerning model-based studies on teachers are discussed.
Identification of a non-growth factor role for GM-CSF in advanced atherosclerosis: promotion of macrophage apoptosis and plaque necrosis through IL-23 signaling.

RATIONALE Granulocyte macrophage colony-stimulating factor (GM-CSF, Csf2) is a growth factor for myeloid-lineage cells that has been implicated in the pathogenesis of atherosclerosis and other chronic inflammatory diseases. However, the role of GM-CSF in advanced atherosclerotic plaque progression, the process that gives rise to clinically dangerous plaques, is unknown. OBJECTIVE To understand the role of GM-CSF in advanced atherosclerotic plaque progression. METHODS AND RESULTS Ldlr(-/-) mice and Csf2(-/-)Ldlr(-/-) mice were fed a Western-type diet for 12 weeks, and then parameters of advanced plaque progression in the aortic root were quantified. Lesions from the GM-CSF-deficient mice showed a substantial decrease in 2 key hallmarks of advanced atherosclerosis, lesional macrophage apoptosis and plaque necrosis, which indicates that GM-CSF promotes plaque progression. Based on a combination of in vitro and in vivo studies, we show that the mechanism involves GM-CSF-mediated production of interleukin-23, which increases apoptosis susceptibility in macrophages by promoting proteasomal degradation of the cell survival protein Bcl-2 (B-cell lymphoma 2) and by increasing oxidative stress. CONCLUSIONS In low-density lipoprotein-driven atherosclerosis in mice, GM-CSF promotes advanced plaque progression by increasing macrophage apoptosis susceptibility. This action of GM-CSF is mediated by its interleukin-23-inducing activity rather than its role as a growth factor.
Spatial Attachment-Site Preferences of Macroectoparasites on Atlantic Sturgeons Acipenser oxyrinchus in Minas Basin, Bay of Fundy, Canada

Abstract Although parasite habitat preference is well studied, it is rarely rigorously evaluated statistically because of many zero intensities. Attachment-site preference and intensities of 2 macroectoparasite species (Caligus elongatus and Calliobdella vivida) of Atlantic sturgeon, Acipenser oxyrinchus Mitchill, in Minas Basin, Bay of Fundy, Canada, were characterized with the use of zero-inflated negative binomial statistical models that included a fork-length offset to control for body size. Three other parasites were encountered, sometimes in high numbers on various body sites, but too few counts overall prevented construction of meaningful statistical models. Of 26 sturgeons, prevalence of (1) C. elongatus (Copepoda) was 85%, mainly on caudal fins and nonfin body sites; (2) C. vivida (Hirudinea) was 81%, mainly on the pelvic and pectoral fins, and dorsal and ventral–lateral body sites; (3) Dichelesthium oblongum (Copepoda) was 31% within the gills or burrowed into the musculature at the base of fins; (4) Argulus stizostethii (Crustacea: Branchiura) was 8%; and (5) Nitzschia sturionis (Monogenea) was 12%. Only D. oblongum was associated with visible damage, mainly as lesions on gills and soft tissues. Characterizing parasite prevalences within the Bay of Fundy is important because some parasites affect fish health and population biology.
Homicide in Finland and Sweden

Five important changes can be detected in the homicidal crime of Finland and Sweden. From the mid-seventeenth century to the mid-eighteenth, concurring with the establishing of the modern centralized state, homicide rates dropped significantly. In the long term, the local variation in Swedish homicide rates decreased, probably because of the rise of the centralized state; however, the case was different in Finland, partly because of a less efficient central administration before the twentieth century. During the period 1700–2000, there was a clear social marginalization of lethal violence; this change took place earlier in Sweden than in Finland. There was a relative shift from instrumental (economy-related) to expressive violence. In the twentieth century, concurring with general urbanization, there was a considerable privatization of lethal violence in both countries as homicides moved from public places to private. The social and historical data suggest that homicide participants may have become more deviant from the mainstream society than they used to be. Overall, Nordic homicidal crime has had two major components since the early modern period. The high offending rates of the marginal lowest-stratum male population have been a stable phenomenon for five centuries. Sudden changes in homicide rates have typically been caused by young males with more heterogeneous social backgrounds.