Miracle-dz/UniFAR-FTUs huggingface dataset:
Pressure ulcer guideline development and dissemination in Europe.

AIMS AND OBJECTIVES To explore the current state of pressure ulcer guideline development and dissemination, from national to local level (i.e. nursing homes) in six European countries: England, Germany, Italy, the Netherlands, Portugal and Sweden. BACKGROUND Pressure ulcers are a persistent problem in healthcare institutions. Their prevalence is influenced by many factors, one of them being the development and dissemination of pressure ulcer guidelines. These are difficult and complex processes and it is not clear whether they differ between European countries. DESIGN Literature review and semi-structured interviews. METHOD Interviews were conducted in six countries at national and nursing home level. RESULTS Four countries had national pressure ulcer prevention and treatment guidelines. Portugal had no national guidelines and Sweden had shifted the responsibility to regional level. All participating nursing homes had pressure ulcer guidelines except those in Portugal. Control and monitoring of guideline dissemination was carried out only in Sweden and England. CONCLUSIONS All countries studied have national or regional pressure ulcer prevention and treatment guidelines, except Portugal. Portugal is also the only country where none of the nursing homes included had pressure ulcer guidelines. Because the dissemination of such guidelines does not imply actual implementation, further research should focus on the implementation process. RELEVANCE TO CLINICAL PRACTICE Clinical guidelines, like pressure ulcer guidelines, are important tools in guiding the care processes in healthcare institutions. Successful dissemination of guidelines from national level to individual healthcare institutions is a first and necessary step in actually applying them. Monitoring of the guideline dissemination process is therefore essential.
EFFECT OF THE LIPID PROFILE DIFFERS WITH TUBERCULOSIS SUBJECT INNOVATION TO ELIMINATE – A REVIEW

The lipid profile was strongly affected by pulmonary tuberculosis in the Serum levels of total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG). Serum cholesterol in pulmonary TB patients is lower than healthy controls, if it is a risk factor or a consequence of the disease itself. To detect the differences in lipid profile between Karaikal district, TB patients, and controls and to test and find whether there is changes after treatment or not aiming to prove if the difference is a risk factor for tuberculosis or a consequence of the disease itself. From the recorded data of a medical college laboratory, we analysed fasting serum lipid profile of serum cholesterol (Chol), triglycerides (TG), low density lipoproteins (LDL) and high density lipoproteins (HDL). Then a follow up of lipid profile was done. We confirmed from the chief of laboratory that the Samples for lipid profile from healthy controls were also drawn and recorded. We distinguished 30 new TB patients, 14 women and 16 men with a mean age (SD) of 33.4 and 13.25 years. There were 16 pulmonary TB and 14 other forms as pleural (5), TB lymphadenitis (5), TB peritonitis (4) plus 15 controls. Regarding the whole studied group, only serum triglyceride was significantly lower before treatment than control group (P<0.01) while both serum cholesterol and HDL showed a significant increase after treatment than before it (P<0.01 for both). Regarding pulmonary tuberculosis patients, both serum cholesterol and triglycerides were significantly lower on diagnosis than healthy controls (P<0.05 for both) and only serum cholesterol increased significantly after treatment than before it (P<0.01). Conclusions and recommendations: Hypercholesterolemia in Karaikal, district patients with pulmonary TB is present at the time of diagnosis. However, it proved to be a consequence of the disease rather than a risk factor as serum cholesterol significantly increased in both pulmonary TB and in the whole group after treatment.
Prediction of pre‐eclampsia with maternal mid‐trimester total renin, inhibin A, AFP and free β‐hCG levels

We wanted to study if maternal serum mid‐trimester total renin, inhibin A, AFP or free β‐hCG levels predict the development of pre‐eclampsia. Maternal serum alpha‐fetoprotein (AFP) and human chorion gonadotrophin (β‐hCG) were evaluated in the screening programme for Down syndrome in 4356 patients prospectively. Data on pregnancy outcome were available in 1242 women. Pregnancy‐induced hypertension (PIH) developed in 69 women, 282 women with uneventful pregnancy outcome were selected for controls. Serum total renin and inhibin A levels were measured retrospectively in the trisomy screening samples of 69 and 30 patients who later developed PIH, and in 282 and 7 patients, respectively, who had an uneventful pregnancy outcome. No significant differences were found in the levels of maternal mid‐trimester serum total renin, inhibin A or free β‐hCG levels between PIH and healthy women. The multiples of the median (MoM) of AFP values were significantly higher in the subgroup of patients who later developed severe pre‐eclampsia than in patients with mild pre‐eclampsia or gestational hypertension and healthy pregnant women. Maternal mid‐trimester serum levels of total renin, inhibin A and free β‐hCG are not predictive for development of PIH. High mid‐trimester serum AFP values may help in the prediction of severe pre‐eclampsia. Copyright © 1999 John Wiley & Sons, Ltd.
An audio-visual attention system for online association learning

We present an audio-visual attention system for speech based interaction with a humanoid robot where a tutor can teach visual properties/locations (e.g ”left”) and corresponding, arbitrary speech labels. The acoustic signal is segmented via the attention system and speech labels are learned from a few repetitions of the label by the tutor. The attention system integrates bottom-up stimulus driven saliency calculation (delay-and-sum beamforming, adaptive noise level estimation) and top-down modulation (spectral properties, segment length, movement and interaction status of the robot). We evaluate the performance of different aspects of the system based on a small dataset.
Factors Affecting Prevalence and Extent of Intimate Partner Violence in Ukraine

This study examined the prevalence and ecological correlates of intimate partner violence against women in Ukraine. A nationally representative sample of ever-married female respondents of the 2007 Ukraine Demographic Health Survey was used for this analysis. Findings suggest that although numerous ecological factors predict women’s experiences of emotional, physical, and sexual intimate partner violence, two factors were common correlates of all three forms of violence: the frequent intoxication of women’s partners and the exhibition of marital controlling behaviors by male perpetrators. Implications for the development of effective programming to prevent violence against Ukrainian women are provided.
Impaired Glucose Metabolism in Heroin and Methadone Users

Plasma glucose and insulin responses to both oral and intravenous glucose stimulation were evaluated in heroin and methadone addicts, compared to healthy control subjects. Both groups of addicts had an altered response to oral and intravenous glucose load. These phenomena were linked to a reduced insulin response. Moreover, increased fasting insulin levels in both groups of addicts were observed. These data show that both heroin and methadone addiction may alter glucose metabolism, and, furthermore, stress the findings of similarities between opiate addicts and non-insulin dependent diabetics.
Education and debate North of England evidence based guidelines development project: guideline for the primary care management of dementia

This guideline aims to provide recommendations to assist general practitioners manage people with all forms of dementia and help their carers. This is a summary version of the full guideline. The areas covered were developed in conjunction with the guideline development group. They were felt to reflect areas that were important in daily clinical practice. The guideline is for the management of patients with dementia; although it covers the area of screening instruments, it is not meant to cover the area of differential diagnosis. All recommendations are for general practitioners and apply to patients attending general practice with dementia. The development group assumes that doctors will use their knowledge and judgment in applying the principles and recommendations given below in managing individual patients, since the recommendations may not be appropriate for all circumstances. Doctors must decide to adopt any particular recommendation in the light of available resources and the circumstances of individual patients. Throughout this guideline categories of evidence (cited as I, II, or III) and the strength of recommendations (A, B, C, or D) are as described in previous method papers and the full version of the guideline. 2 A summary of categories of evidence and strength of recommendations is given in the box.
The theory of latent vulnerability: Reconceptualizing the link between childhood maltreatment and psychiatric disorder

Abstract Maltreatment in childhood is associated with a significantly increased likelihood of psychiatric disorder that endures across the life span. If disorders emerge they tend to be more severe and less responsive to treatment. We introduce the concept of latent vulnerability as a way of conceptualizing the nature of this psychiatric risk. We argue that vulnerability to mental health problems can be understood as changes in a suite of neurocognitive systems that reflect adaptation or altered calibration to early neglectful or maltreating environments. Altered threat processing is presented as one exemplar candidate system. Heightened neurocognitive vigilance to threat is argued to reflect a calibration to an early at-risk environment that becomes maladaptive (and instantiates vulnerability) in the longer term. Other neurocognitive domains, including reward and memory processing, represent equally promising candidates for indexing latent vulnerability and warrant future enquiry. We suggest that the operationalization of latent vulnerability has the potential to guide a preventative psychiatry approach. Intervention currently occurs at two stages when maltreatment is confirmed: first, by addressing issues of risk; and second, by providing clinical intervention if a child meets criteria for psychiatric disorder. We argue that indexing latent vulnerability represents a third intervention opportunity, with the potential to target an indicated prevention approach for the most vulnerable children, offsetting risk trajectories before psychiatric disorders emerge.
Review and Evaluation of Mindfulness-Based iPhone Apps

Background There is growing evidence for the positive impact of mindfulness on wellbeing. Mindfulness-based mobile apps may have potential as an alternative delivery medium for training. While there are hundreds of such apps, there is little information on their quality. Objective This study aimed to conduct a systematic review of mindfulness-based iPhone mobile apps and to evaluate their quality using a recently-developed expert rating scale, the Mobile Application Rating Scale (MARS). It also aimed to describe features of selected high-quality mindfulness apps. Methods A search for “mindfulness” was conducted in iTunes and Google Apps Marketplace. Apps that provided mindfulness training and education were included. Those containing only reminders, timers or guided meditation tracks were excluded. An expert rater reviewed and rated app quality using the MARS engagement, functionality, visual aesthetics, information quality and subjective quality subscales. A second rater provided MARS ratings on 30% of the apps for inter-rater reliability purposes. Results The “mindfulness” search identified 700 apps. However, 94 were duplicates, 6 were not accessible and 40 were not in English. Of the remaining 560, 23 apps met inclusion criteria and were reviewed. The median MARS score was 3.2 (out of 5.0), which exceeded the minimum acceptable score (3.0). The Headspace app had the highest average score (4.0), followed by Smiling Mind (3.7), iMindfulness (3.5) and Mindfulness Daily (3.5). There was a high level of inter-rater reliability between the two MARS raters. Conclusions Though many apps claim to be mindfulness-related, most were guided meditation apps, timers, or reminders. Very few had high ratings on the MARS subscales of visual aesthetics, engagement, functionality or information quality. Little evidence is available on the efficacy of the apps in developing mindfulness.
The role of reflection in the effects of community service on adolescent development: a meta-analysis.

This meta-analysis assessed the effect of community service on adolescent development and the moderation of this effect by reflection, community service, and adolescent characteristics to explicate the mechanisms underlying community service effects. Random effects analyses, based on 49 studies (24,477 participants, 12-20 years old), revealed that community service had positive effects on academic, personal, social, and civic outcomes. Moderation analyses indicated that reflection was essential; the effect for studies that include reflection was substantial (mean ES = .41) while community service in the absence of reflection yielded negligible benefits (mean ES = .05). Effects increased when studies include more frequent reflection and community service, reflection on academic content, and older adolescents. These findings have implications for understanding and improving community service.
Retrospective cause analysis of troponin I elevation in non-CAD patients

Background: Troponin I is one of the most commonly tested biochemical markers in the emergency room (ER) and in the hospital setting. Besides coronary artery disease (CAD), demand ischemia with underlying tachycardia, anemia, hypertensive emergency, congestive heart failure, kidney disease, sepsis, and pulmonary embolism have also been reported to cause troponin I elevations. Few reports have excluded patients with CAD, and no study has summarized the proportion of these factors relative to an increased troponin I level. Methods: The aim of this retrospective study was to investigate the level of contribution of causative factors in troponin I elevation. Charts of patients tested for troponin I during an ER visit or during hospitalization were collected. Patients with known CAD, abnormal stress tests, cardiac catheterizations, or discharge without an adequate cardiac evaluation were excluded. Logistic regression was used to identify predictors of elevated troponin I levels. Results: A total of 586 patients were investigated in this study. Age, hemoglobin (Hb), heart rate (HR), glomerularfiltration rate, atrial fibrillation, congestive heart failure (CHF), and sepsis were significant predictors of elevated troponin I by analysis in univariate logistic regression (all P < .001). In multivariate logistic regression, sepsis, CHF, age, Hb, and HR were independent predictors of troponin I (all P < .01). A simple clinical scoring system was generated with 1 score on patients with age ≥ 60, Hb < 10 g/dL, and HR ≥ 100 beats per minute (bpm). The prevalence of elevated troponin I was 4%, 16%, 38%, and 50% for patients with scores of 0, 1, 2, and 3, respectively. In patients without sepsis and CHF, the chances of elevated troponin I were 2%, 11%, 28%, and 43%. Conclusions: Sepsis was found to be the strongest independent cause of elevated troponin I levels in non-CAD patients. The scoring system composed of age, hemoglobin (Hb), and heart rate (HR) can assist clinical evaluation of elevated troponin I test in non-CAD patients.
Family physicians' perspectives on care of dementia patients and family caregivers.

OBJECTIVE To identify factors that facilitate or impede family physicians in ambulatory care of patients with dementia and the family caregivers of such patients. DESIGN Explanatory qualitative analyses of focus group discussions. SETTING Large, medium, and small urban; suburban; and rural family practices from various regions of the province of Quebec. PARTICIPANTS Twenty-five family doctors whose practices had at least 75% ambulatory patients; of these patients, an estimated minimum of 20% were 65 years old or older and at least 2% suffered from dementia. METHOD Physicians were recruited by telephone to be paid participants in their regions in focus groups studying aspects of dementia care in ambulatory settings. Grounded theory and constant comparative methods were used to explore data from 3 French-speaking focus groups and 1 English-speaking focus group. MAIN FINDINGS Physicians were 72% male, had a mean of 21.3 years in practice, and spent about 87% of their professional time in office practice. An estimated 38.7% of their patients were 65 years old or older, and 5.6% of these patients had Alzheimer disease or related dementias. Physicians were comfortable caring for these patients and their family caregivers but thought much of this care should come from support services offered elsewhere. Physicians admitted they had little knowledge of these services and had little interest in acquiring information about them. Government-run, community-based health and social service centres were the "black boxes" to which they referred patients and their caregivers for any form of help. Inconsistencies in the services offered by these centres were noted. CONCLUSION; While family doctors are seeking a more seamless form of interdisciplinary dementia care, a large amount of that care comes from support services about which physicians are not well informed and are not interested in learning.
Kidnapping in Taiwan

Kidnapping had been rare in Taiwan until recently. Several high-profile cases in the late 1990s, victimizing both Taiwanese citizens and foreigners, startled the island state. This study is the first systematic examination of the social dynamics involved in kidnapping. Data came from court cases, questionnaires, and in-depth interviews from incarcerated inmates. Results showed that kidnappers' financial crises and friendships with ringleaders were two primary motives. Most kidnapping cases involved a small number of offenders who form an ad hoc kidnapping group. Victims were not randomly chosen and share a geographic tie with the offenders. The process of kidnapping is idiosyncratic in nature, as most kidnappers improvised their plans. The negotiation phase in kidnapping is done hastily, and the amount of ransom is often a compromised result of offenders' needs, victim's family's financial status, timing, and the offenders' perception of risks. Ways to prevent kidnapping are also discussed in this article.
Nitrous Oxide Activates GABAergic Neurons in the Spinal Cord in Fischer Rats

Background Findings to date indicate that nitrous oxide exerts its antinociceptive effect by activating descending noradrenergic neurons. The mechanism whereby descending inhibitory neurons, including noradrenergic neurons, produce antinociceptive effect remains unclear. Using c-Fos protein as a marker for neuronal activation, we examined whether spinal cord neurons activated by nitrous oxide are &ggr;-aminobutyric acid–mediated (GABAergic) neurons. Methods Adult male Fischer (a strain in which nitrous oxide shows strong antinociceptive properties) and Lewis (a strain in which nitrous oxide lacks antinociceptive properties) rats were exposed to either air (control) or nitrous oxide. Frozen sections of the spinal cord were either stained for c-Fos or double-stained for c-Fos and glutamic acid decarboxylase (a rate-limiting enzyme for GABA synthesis) and analyzed by standard or confocal microscopy. Results In Fischer rats, 90 min of 75% N2O administration increased the number of c-Fos–positive cells in the spinal cord approximately threefold as compared with the control group. The c-Fos–positive cells induced by nitrous oxide were almost entirely colocalized with glutamic acid decarboxylase–positive cells. In contrast, exposure did not change the number of c-Fos–positive cells in the spinal cord in Lewis rats. Conclusions Exposure to nitrous oxide activates GABAergic neurons in the spinal cord. The dose-dependence of GABAergic neuronal activation in the Fischer rats and its absence in the Lewis rat correlate with antinociceptive responses previously reported in these same circumstances. Together, we interpret these data to indicate that activation of GABAergic neurons in the spinal cord are involved in the antinociceptive action of nitrous oxide.
COGNITIVE PERFORMANCE IN MIDDLE-AGED ADULTS AS A FUNCTION OF TIME OF DAY AND TASK LOAD

The aim of this study was to explore the influence of task complexity and time of day on middleaged shift-workers. Two groups of twelve subjects participated to this experiment: one Junior group (aged 20-30) and one Senior group (aged 50-60). Performance was assessed in two tasks involving different cognitive load: a simple visual discrimination task and a complex mental arithmetic test. The former was considered as an immediate processing task requiring little memory and attention, whereas the latter required a high mental load in working memory and attention. The subjects were tested in both tasks at three different times of the day simulating the main shifts: morning, evening and night. In each task, the test session lasted 60 minutes, divided into two 30-minute periods separated by a 20-minute rest. The results showed slower mental processing in both tasks in Seniors revealed by increased reaction time. Accuracy was also decreased, but only in the complex arithmetic test with an increase in error rate which was not observed in the simple perceptual task. Mental speed in the calculation task was decreased in both groups during the night session, but there was no time-of-day effect in the simple task. The time course of accuracy during the second period of the night session showed increased errors in Juniors but a decreasing trend in Seniors. Altogether, these results demonstrate that performance deficits due to age appear rather early in the lifespan, particularly when tasks involve high memory and attention load. However, the opposite profiles between Seniors and Juniors on accuracy during the night suggest a possible difference in strategies between young and old subjects which could help Seniors to partly counteract their deficits due to age.
The Delphi Method Research Strategy in Studies of Information Systems

In this paper, we discuss the nature and use of the Delphi methodology in information systems research. More specifically, we explore how and why it may be used. We discuss criteria for evaluating Delphi research and define characteristics useful for categorizing the studies. We review Delphi application use in IS research over the last 23 years, summarize lessons learned from prior studies, offer suggestions for improvement, and present guidelines for employing this distinctly useful qualitative method in future information systems research studies.