bluuebunny/crossref_metadata_2025 huggingface dataset:
L'analisi economica come argomentazione giuridica
Authors: Tuzet Giovanni
Published: June 2020

RIASSUNTO:In primo luogo l’articolo considera l’analisi economica come un tipo di argomentazione giuridica. Gli argomenti che fanno leva sulle conseguenze economiche di un atto giuridico vengono considerati come una forma di argomentazione consequenzialista e viene osservato che tali argomenti competono con molti altri nel contesto dell’interpretazione e dell’applicazione giudiziale del diritto. In secondo luogo viene considerata la pretesa dell’analisi economica di concepire le norme giuridiche come incentivi e viene osservato che tale prospettiva dipende da una serie di argomenti metodologici e una serie di argomenti circa i valori da massimizzare e la razionalità degli agenti economici. ABSTRACT:Firstly, the article takes economic analysis as a type of legal argumentation. The arguments that leverage the economic consequences of legal acts are a form of consequentialist argumentation and it is noted that these arguments compete with many others in the context of judicial interpretation and application of law. Secondly, the claim of economic analysis to conceive of legal norms as incentives is considered and it is observed that this perspective depends on a series of methodological arguments and of arguments about the values to be maximized and the rationality of economic agents.
Onze proposições sobre o direito do trabalho desde a perspectiva ecossocialista
Authors: Seferian Gustavo
Published: June 2020

RESUMO:O presente artigo propõe onze sugestões à reflexão e prática do Direito do Trabalho pautadas no ecossocialismo. De caráter ensaístico, o texto elucida as principais características do ecossocialismo enquanto linha teórico-política, e partindo da premissa que vivemos uma crise de civilização – da qual o meio ambiente e o Direito do Trabalho são parte –, indica espaços e caminhos à disputas à recomposição juslaboral para o século XXI, sempre pautado na perspectiva da proteção das trabalhadoras e trabalhadores e na urgência de articulação de esforços para contenção tática do ecocídio capitalista.ABSTRACT:This article proposes eleven suggestions to the reflection and practice of Labor Law based on the ecosocialism. The text elucidates the main features of ecossocialism as a theoretical-political program, and based on the premise that we are experiencing a crisis of civilization-  of which the environment and Labor Law are a part- , indicates spaces and paths to disputes the Labor Law recomposition for the XXI century, always based on the perspective of the protection of workers and the urgency to take efforts for a tactical containment of capitalist ecocide.
A terceirização, o STF e o estado de exceção
Authors: Dutra Renata Queiroz , Mattos Bianca Silva
Published: June 2020

RESUMO:O presente artigo tem o objetivo de estudar a terceirização, com foco nas modificações proporcionadas pela Reforma Trabalhista, pela Lei da Terceirização e, sobretudo, pelo novo entendimento do Supremo Tribunal Federal, que ampliou as possibilidades para a utilização desta modalidade, tornando-a irrestrita. Para a concretização desta finalidade, foi imprescindível um exame dos eventos históricos que marcaram essa forma de subcontratação, bem como uma análise nos elementos argumentativos que marcam a formação do novo entendimento do Supremo, bem como de que maneira essas modificações se articulam com os paradigmas de Estado Constitucional. Dessa forma, surge como principal indagação se estas novas disposições estão alinhadas aos preceitos dispostos no texto constitucional e em que medida, concretizando o projeto neoliberal, se aproximam da ideia de Estado de exceção. ABSTRACT:This article aims to study outsourcing, focusing on the changes provided by the Labor Reform, Outsourcing Law and, above all, from the new understanding of the Federal Supreme Court, which expanded the possibilities for the use of this modality, making it unrestricted. Therefore, in order to achieve this objective, an examination of the historical events that marked this form of subcontracting, considerations about the new understanding of the Supreme, and how these modifications are articulated with the paradigms of Constitutional State were essential. Thus, it appears as the main question whether these new provisions are aligned with the precepts set in the constitutional text and to what extent, concretizing the neoliberal project approach the idea of State of exception.
Investigación en Historia: Ciudad, Memoria y Arquitectura
Authors: Pérgolis-Valsecchi Juan Carlos
Published: June 2020

Hacer investigación en Ciudad y Arquitectura implica situarse en un lugar y un momento, en el espíritu del tiempo de aquello que se quiere investigar. Esto se basa en dos conceptos: la idea de Zeitgeist, ese corpus de objetos y actitudes culturales que deben ser observadas simultáneamente; y la idea de sujeto en proceso. Investigar la historia de la Ciudad y la Arquitectura es, entonces, hacer teoría, porque no se puede hacer la una sin la otra. Desde este punto de vista, se intenta observar algunos referentes del proceso: el Tiempo, como materia prima; la Interpretación de Fuentes; las Dicotomías Espacio-Lugar y Memoria-Historia; y las Representaciones Sociales y los Imaginarios. Para concluir, señalando que ser objetivo no implica ser neutro ante los acontecimientos de la Historia, porque así se puede acceder a la pluralidad de significados de la Arquitectura y la Ciudad.
FOSFORİK ASİDİN REJENERE SELÜLOZ ESASLI LİFLER ÜZERİNE ETKİSİ
Authors: TUNÇEL Kemal Şahin
Published: June 2020

Bu çalışmada, rejenere selüloz liflerinin en önemli üyelerinden biri olan viskoz rayon lifleri ele alınmıştır. Bu liflerin termal stabilizasyonu için 25°C’de fosforik asit ile kimyasal ön işlem yapılmıştır. Fosforik asidin viskoz lifleri üzerinde ki etkisi 235°C’de farklı sürelerde gerçekleşen ısıl işlemler ile stabilizasyon süresinin bir fonksiyonu olarak değerlendirilmiştir. Isıl işlemler sonrasında; iplik numarası, lif kalınlığı, yoğunluk ve mukavemet gibi fiziksel ve yapısal özelliklerde ki değişimler incelenmiştir. Stabilizasyon süresinin artmasıyla lif kalınlığı ve iplik numarası azalırken, yoğunluk değerleri artmıştır. Gerilme mukavemeti ise, belirli bir stabilizasyon süresine kadar azalma eğilimindeyken, 45 dakikalık stabilizasyon işlemiyle beraber artmıştır. Diferansiyel tarama kalorimetrisi (DSC) yöntemi ile de viskoz rayon liflerinin termal özelliklerindeki değişimler gösterilmiştir. Stabilizasyon süresi arttıkça viskoz rayon liflerinin kristal yapısındaki değişimler sebebiyle bozunma endotermi yaklaşık olarak 109°C azalmıştır. 45 dakikalık ısıl işlemden sonra bozunma endotermi neredeyse yok olmuştur. Aynı zamanda ısıl işlemlerden sonra viskoz rayon liflerinde beyazdan siyaha doğru renk değişimleri gözlenmiştir.
SENTIMENT ANALYSIS FROM SOCIAL MEDIA COMMENTS
Authors: ÇELİK Özer , OSMANOĞLU Usame Ömer , ÇANAKÇI Büşra
Published: June 2020

Nowadays, many firms and companies are curious about what people think and want and they are working in this direction. For this reason, it is tried to learn the ideas and emotions of people in various ways. However, as it is impossible to process and analyze a large number of emotions and thoughts with human hands, emotion analysis gain more importance. The emotions and thoughts of the people are analyzed and acted according to these requests through the emotion analysis which is quite functional in social networks. The aim of this study is to realize the learning with the data sets obtained from the interpretations made to the social platforms of the determined brands and to transfer the subject of the emotion analysis to the researchers in the best way. The range of accuracy rates reached is wide because of the disadvantages such as not paying attention to the rules of writing on social media or other digital platforms. In our study, a accuracy rate of 70% was achieved. This demonstrates the usefulness of machine learning in interpretation classification and emotion analysis.
INVESTIGATION OF FLEXURAL BEHAVIOR OF REINFORCED CONCRETE BEAMS PRODUCED WITH SELF COMPACTING AND NORMAL CONCRETE
Authors: CENGİZ Salih , KAMANLI Mehmet , ÜNAL Alptuğ
Published: June 2020

In the construction industry, which is constantly evolving and open to new technologies, concrete has been used to build constructions and has great importance, but unless enough vibration application during casting process, occur gaps between the concrete components, therefore the physical and mechanical properties of concrete cannot be forecasted accurately. Self-compacting concrete does not require vibration or compaction, it saves workmanship and time, and has high performance. Because of less workmanship and shorter production time, the self-compacting concretes offer the possibility of making the construction more economical. In this study, the flexural behavior of the reinforced concrete beams produced with self-compacting and normal concrete were investigated in terms of damage mechanics. Flexural behavior, shear capacity, energy absorption capacity and fracture type of both concrete types was investigated and results were compared. Variables of the samples are the ratio of the stirrup, and the concrete type. Totally 8 pieces of 1/2 scale beams used in this study. The specimens tested with 4-point bending test. When all the results were examined, it was observed that the beams produced with self-compacting concrete consumed more energy.
ISM 2.45 GHz MİKROŞERİT İMPLANT ANTEN TASARIMI VE DOKU İÇİ ÖLÇÜMLERİ
Authors: ALPER Fatih , COŞKUN Özlem
Published: June 2020

Bu çalışmada doku içi uygulamalar için kullanılabilecek özgün bir mikroşerit implant anten tasarımı önerilmiştir. Anten boyutu 30 mm*28 mm*1.59 mm olarak tasarlanmıştır. Tasarımında dielektrik sabiti 4.3, kayıp tanjantı 0.025 ve yüksekliği 1.52 mm olan FR4 taban malzemesi kullanılmıştır. İmplant antenin analizi CST Microwave Studio programında gerçeklenmiştir. İstenilen değerler elde edildikten sonra ise doku modeli oluşturularak deri doku içerisine implant anten yerleştirilmiştir. Tasarlanan mikroşerit implant antenin ISM bandında 2.45 GHz’de geri dönüş kaybı ve SAR değeri ölçülmüştür. Yapılan ölçümler sonucunda doku içi ve doku dışı sırasıyla geri dönüş kaybı -18 dB ve -33 dB, SAR değeri ise 153 W/kg olarak gözlemlenmiştir. Daha sonra antenin baskı-devre teknolojisi ile gerçeklenmesi yapılıp, deri dokusunun özelliklerini gösteren bir fantom sıvı oluşturulmuş ve anten bu sıvı içine yerleştirilmiştir. Son olarak da tasarımı yapılan antenin simülasyon ve deney sonuçları değerlendirilerek literatürdeki diğer çalışmalarla karşılaştırılması yapılmıştır. Deri dokusu içerisindeki ölçüm sonuçlarının da benzetim sonuçları ile oldukça uyumlu olduğu gözlemlenmiştir.
YERE NÜFUZ EDEN RADAR YÖNTEMİ İLE BALAST KİRLİLİĞİNİN BELİRLENMESİ
Authors: BAYRAK Mehmet Çağrı , TİGDEMİR Mesut , KARAŞAHİN Mustafa , ÇAKMAK Olcay
Published: June 2020

Bu çalışmada, demiryolu altyapısındaki kirlenmeye bağlı kusurları yere nüfuz eden radar (GPR) kullanarak tespit etmek amacıyla İstanbul-Edirne demiryolu hattının Çatalca bölgesinde çalışmalar yürütülmüştür. Yenilenen demiryolu hattında yenileme çalışmalarından önce ve sonra ölçümler yapılmıştır. Ayrıca balast numunesi alınarak kirlilik derecesi belirlenmiştir. Yapılan değerlendirmeye göre eski demiryolunda balast tabakasının aşırı deformasyonu, balast cepleri ve balast kirliliği tespit edilmiştir. Yenileme sonrasında altyapı tabakaları tespit edilmiştir. Eski ve yeni demiryolu hattında yapılan radar ölçüm sonuçları karşılaştırmalı olarak sunulmuştur.
Mapping and Modeling of Discussions Related to Gastrointestinal Discomfort in French-Speaking Online Forums: Results of a 15-Year Retrospective Infodemiology Study
Authors: Schäfer Florent , Faviez Carole , Voillot Paméla , Foulquié Pierre , Najm Matthieu , Jeanne Jean-François , Fagherazzi Guy , Schück Stéphane , Le Nevé Boris
Published: June 2020

Background

Gastrointestinal (GI) discomfort is prevalent and known to be associated with impaired quality of life. Real-world information on factors of GI discomfort and solutions used by people is, however, limited. Social media, including online forums, have been considered a new source of information to examine the health of populations in real-life settings.

Objective

The aims of this retrospective infodemiology study are to identify discussion topics, characterize users, and identify perceived determinants of GI discomfort in web-based messages posted by users of French social media.

Methods

Messages related to GI discomfort posted between January 2003 and August 2018 were extracted from 14 French-speaking general and specialized publicly available online forums. Extracted messages were cleaned and deidentified. Relevant medical concepts were determined on the basis of the Medical Dictionary for Regulatory Activities and vernacular terms. The identification of discussion topics was carried out by using a correlated topic model on the basis of the latent Dirichlet allocation. A nonsupervised clustering algorithm was applied to cluster forum users according to the reported symptoms of GI discomfort, discussion topics, and activity on online forums. Users’ age and gender were determined by linear regression and application of a support vector machine, respectively, to characterize the identified clusters according to demographic parameters. Perceived factors of GI discomfort were classified by a combined method on the basis of syntactic analysis to identify messages with causality terms and a second topic modeling in a relevant segment of phrases.

Results

A total of 198,866 messages associated with GI discomfort were included in the analysis corpus after extraction and cleaning. These messages were posted by 36,989 separate web users, most of them being women younger than 40 years. Everyday life, diet, digestion, abdominal pain, impact on the quality of life, and tips to manage stress were among the most discussed topics. Segmentation of users identified 5 clusters corresponding to chronic and acute GI concerns. Diet topic was associated with each cluster, and stress was strongly associated with abdominal pain. Psychological factors, food, and allergens were perceived as the main causes of GI discomfort by web users.

Conclusions

GI discomfort is actively discussed by web users. This study reveals a complex relationship between food, stress, and GI discomfort. Our approach has shown that identifying web-based discussion topics associated with GI discomfort and its perceived factors is feasible and can serve as a complementary source of real-world evidence for caregivers.
Data-Driven Personalization of a Physiotherapy Care Pathway: Case Study of Posture Scanning
Authors: Korhonen Olli , Väyrynen Karin , Krautwald Tino , Bilby Glenn , Broers Hedwig Anna Theresia , Giunti Guido , Isomursu Minna
Published: June 2020

Background

Advanced sensor, measurement, and analytics technologies are enabling entirely new ways to deliver health care. The increased availability of digital data can be used for data-driven personalization of care. Data-driven personalization can complement expert-driven personalization by providing support for decision making or even by automating some parts of decision making in relation to the care process.

Objective

The aim of this study was to analyze how digital data acquired from posture scanning can enhance physiotherapy services and enable more personalized delivery of physiotherapy.

Methods

A case study was conducted with a company that designed a posture scan recording system (PSRS), which is an information system that can digitally record, measure, and report human movement for use in physiotherapy. Data were collected through interviews with different stakeholders, such as health care professionals, health care users, and the information system provider, and were analyzed thematically.

Results

Based on the results of our thematic analysis, we propose three different types of support that posture scanning data can provide to enhance and enable more personalized delivery of physiotherapy: 1) modeling the condition, in which the posture scanning data are used to detect and understand the health care user’s condition and the root cause of the possible pain; 2) visualization for shared understanding, in which the posture scanning data are used to provide information to the health care user and involve them in more collaborative decision-making regarding their care; and 3) evaluating the impact of the intervention, in which the posture scanning data are used to evaluate the care progress and impact of the intervention.

Conclusions

The adoption of digital tools in physiotherapy has remained low. Physiotherapy has also lacked digital tools and means to inform and involve the health care user in their care in a person-centered manner. In this study, we gathered insights from different stakeholders to provide understanding of how the availability of digital posture scanning data can enhance and enable personalized physiotherapy services.
DenTiUS Plaque, a Web-Based Application for the Quantification of Bacterial Plaque: Development and Usability Study
Authors: Vila-Blanco Nicolás , Freire Vicente , Balsa-Castro Carlos , Tomás Inmaculada , Carreira María J
Published: June 2020

Background

In the dentistry field, the analysis of dental plaque is vital because it is the main etiological factor in the 2 most prevalent oral diseases: caries and periodontitis. In most of the papers published in the dental literature, the quantification of dental plaque is carried out using traditional, non-automated, and time-consuming indices. Therefore, the development of an automated plaque quantification tool would be of great value to clinicians and researchers.

Objective

This study aimed to develop a web-based tool called DenTiUS and various clinical indices to evaluate dental plaque levels using image analysis techniques.

Methods

The tool was executed as a web-based application to facilitate its use by researchers. Expert users are free to define experiments, including images from either a single patient (to observe an individual plaque growth pattern) or several patients (to perform a group characterization) at a particular moment or over time. A novel approach for detecting visible plaque has been developed as well as a new concept known as nonvisible plaque. This new term implies the classification of the remaining dental area into 3 subregions according to the risk of accumulating plaque in the near future. New metrics have also been created to describe visible and nonvisible plaque levels.

Results

The system generates results tables of the quantitative analysis with absolute averages obtained in each image (indices about visible plaque) and relative measurements (indices about visible and nonvisible plaque) relating to the reference moment. The clinical indices that can be calculated are the following: plaque index of an area per intensity (API index, a value between 0 and 100), area growth index (growth rate of plaque per unit of time in hours; percentage area/hour), and area time index (the time in days needed to achieve a plaque area of 100% concerning the initial area at the same moment). Images and graphics can be obtained for a moment from a patient in addition to a full report presenting all the processing data. Dentistry experts evaluated the DenTiUS Plaque software through a usability test, with the best-scoring questions those related to the workflow efficiency, value of the online help, attractiveness of the user interface, and overall satisfaction.

Conclusions

The DenTiUS Plaque software allows automatic, reliable, and repeatable quantification of dental plaque levels, providing information about area, intensity, and growth pattern. Dentistry experts recognized that this software is suitable for quantification of dental plaque levels. Consequently, its application in the analysis of plaque evolution patterns associated with different oral conditions, as well as to evaluate the effectiveness of various oral hygiene measures, can represent an improvement in the clinical setting and the methodological quality of research studies.
Development and Feasibility of a Mobile Health–Supported Comprehensive Intervention Model (CIMmH) for Improving the Quality of Life of Patients With Esophageal Cancer After Esophagectomy: Prospective, Single-Arm, Nonrandomized Pilot Study
Authors: Cheng Chao , Ho Rainbow Tin Hung , Guo Yan , Zhu Mengting , Yang Weixiong , Li Yiran , Liu Zhenguo , Zhuo Shuyu , Liang Qi , Chen Zhenghong , Zeng Yu , Yang Jiali , Zhang Zhanfei , Zhang Xu , Monroe-Wise Aliza , Yeung Sai-Ching
Published: June 2020

Background

Patients with esophageal cancer often experience clinically relevant deterioration of quality of life (QOL) after esophagectomy owing to malnutrition, lack of physical exercise, and psychological symptoms.

Objective

This study aimed to evaluate the feasibility, safety, and efficacy of a comprehensive intervention model using a mobile health system (CIMmH) in patients with esophageal cancer after esophagectomy.

Methods

Twenty patients with esophageal cancer undergoing the modified McKeown surgical procedure were invited to join the CIMmH program with both online and offline components for 12 weeks. The participants were assessed before surgery and again at 1 and 3 months after esophagectomy. QOL, depressive symptoms, anxiety, stress, nutrition, and physical fitness were measured.

Results

Of the 20 patients, 16 (80%) completed the program. One month after esophagectomy, patients showed significant deterioration in overall QOL (P=.02), eating (P=.005), reflux (P=.04), and trouble with talking (P<.001). At the 3-month follow-up, except for pain (P=.02), difficulty with eating (P=.03), dry mouth (P=.04), and trouble with talking (P=.003), all other QOL dimensions returned to the preoperative level. There were significant reductions in weight (P<.001) and BMI (P=.02) throughout the study, and no significant changes were observed for physical fitness measured by change in the 6-minute walk distance between baseline and the 1-month follow-up (P=.22) or between baseline and the 3-month follow-up (P=.52). Depressive symptoms significantly increased 1 month after surgery (P<.001), while other psychological measures did not show relevant changes. Although there were declines in many measures 1 month after surgery, these were much improved at the 3-month follow-up, and the recovery was more profound and faster than with traditional rehabilitation programs.

Conclusions

The CIMmH was feasible and safe and demonstrated encouraging efficacy testing with a control group for enhancing recovery after surgery among patients with esophageal cancer in China.

Trial Registration

Chinese Clinical Trial Registry (ChiCTR-IPR-1800019900); http://www.chictr.org.cn/showprojen.aspx?proj=32811.
Design and Implementation of a Multilevel Intervention to Reduce Hepatitis C Transmission Among Men Who Have Sex With Men in Amsterdam: Co-Creation and Usability Study
Authors: Prinsenberg Tamara , Zantkuijl Paul , Zuilhof Wim , Davidovich Udi , Schinkel Janke , Prins Maria , van der Valk Marc
Published: June 2020

Background

In the Netherlands, transmission of hepatitis C virus (HCV) occurs primarily among men who have sex with men (MSM). Early HCV testing of at-risk MSM and immediate initiation of treatment will prevent onward transmission, but this may not be sufficient to eliminate HCV in a population with ongoing risk behaviors. Therefore, targeted socioculturally acceptable preventive measures, including behavioral interventions, are urgently needed. Currently, little contextually appropriate information about HCV or risk reduction interventions is available.

Objective

The objective of this project was to develop an intervention to reduce HCV transmission among MSM in Amsterdam through a co-creation process, with the input of men from the targeted community directly impacting intervention content, design, and implementation.

Methods

We developed a multilevel intervention targeting 6 levels: individual, community, professional, context, patient, and network. The intervention was developed in close cooperation between health professionals, gay community members, commercial stakeholders, and stakeholders from within the gay community. The co-creation process had 4 phases: a needs assessment, stakeholder engagement, co-creation, and implementation. The co-creation phase continued until consensus was reached between the researchers and community members on the intervention content and design. The final intervention, NoMoreC, was completed within 2 years, and implementation started in February 2018.

Results

NoMoreC includes web-based and face-to-face components as well as an anonymous HCV testing service. The NoMoreC website provides information about hepatitis C, HCV transmission routes, risk reduction strategies, testing and treatment options, and partner notification. The face-to-face component comprises a risk reduction toolbox, training for health professionals, and providing tailored advice to sex on premises venues. NoMoreC is promoted by an active voluntary campaign team.

Conclusions

Involving the community and stakeholders in the creation of NoMoreC has been the main strength of this project. It has resulted in an intervention with various components that resonates with the gay community at risk of HCV infection. The uptake and acceptability of the described intervention will be evaluated in the future. The description of the co-creation process and implementation of the project may serve as a rich and useful source for others who want to develop culturally and context appropriate HCV interventions.
User Perceptions of Virtual Hospital Apps in China: Systematic Search
Authors: Wang Yuan , Liu Yuqiao , Shi Yancui , Yu Yanjun , Yang Jucheng
Published: June 2020

Background

Virtual hospital apps are mobile apps that offer functionalities of online consultation, medical guidance, health community forums, referrals, outpatient appointments or virtual hospital-to-home care services. With an increasing number of online medical and health care consulting services, virtual hospital apps have made health care more accessible and fairer for all, especially in China. However, they have occurred without control or regulation. User evaluation can provide directions to help apps optimize identification, lower risks, and guarantee service quality.

Objective

We aimed to conduct a systematic search for virtual hospital apps in China. To get a global view, virtual hospital apps were assessed and characterized by means of quantitative analysis. To get a local view, we conducted a content feedback analysis to explore user requirements, expectations, and preferences.

Methods

A search was conducted of the most popular Apple and Android app stores in China. We characterized and verified virtual hospital apps and grouped apps according to quantification analysis. We then crawled apps and paid attention to corresponding reviews to incorporate users’ involvement, and then performed aspect-based content labeling and analysis using an inductive approach.

Results

A total of 239 apps were identified in the virtual hospital app markets in China, and 2686 informative corresponding reviews were analyzed. The evidence showed that usefulness and ease of use were vital facts for engagement. Users were likely to trust a consulting service with a high number of downloads. Furthermore, users expected frequently used apps with more optimization to improve virtual service. We characterized apps according to 4 key features: (1) app functionalities, including online doctor consultation, in-app purchases, tailored education, and community forums; (2) security and privacy, including user data management and user privacy; (3) health management, including health tracking, reminders, and notifications; and (4) technical aspects, including user interface and equipment connection.

Conclusions

Virtual hospitals relying on the mobile internet are growing rapidly. A large number of virtual hospital apps are available and accessible to a growing number of people. Evidence from this systematic search can help various types of virtual hospital models enhance virtual health care experiences, go beyond offline hospitals, and continuously meet the needs of individual end users.
Sociodemographic Representativeness in a Nationwide Web-Based Survey of the View of Men on Involvement in Health Care Decision-Making: Cross-Sectional Questionnaire Study
Authors: Birkeland Søren F , Haakonsson Anders K , Pedersen Susanne S , Rottmann Nina , Barry Michael J , Möller Sören
Published: June 2020

Background

Being able to generalize research findings to a broader population outside of the study sample is an important goal in surveys on the internet. We conducted a nationwide, cross-sectional, web-based survey with vignettes illustrating different levels of patient involvement to investigate men’s preferences regarding participation in health care decision-making. Following randomization into vignette variants, we distributed the survey among men aged 45 to 70 years through the state-authorized digital mailbox provided by the Danish authorities for secure communication with citizens.

Objective

This study aimed to investigate the sociodemographic representativeness of our sample of men obtained in a nationwide web-based survey using the digital mailbox.

Methods

Response rate estimates were established, and comparisons were made between responders and nonresponders in terms of age profiles (eg, average age) and municipality-level information on sociodemographic characteristics.

Results

Among 22,288 men invited during two waves, a total of 6756 (30.31%) participants responded to the survey. In adjusted analyses, responders’ characteristics mostly resembled those of nonresponders. Response rates, however, were significantly higher in older men (odds ratio [OR] 2.83 for responses among those aged 65-70 years compared with those aged 45-49 years, 95% CI 2.58-3.11; P<.001) and in rural areas (OR 1.10 compared with urban areas, 95% CI 1.03-1.18; P=.005). Furthermore, response rates appeared lower in areas with a higher tax base (OR 0.89 in the highest tertile, 95% CI 0.81-0.98; P=.02).

Conclusions

Overall, the general population of men aged 45 to 70 years was represented very well by the responders to our web-based survey. However, the imbalances identified highlight the importance of supplementing survey findings with studies of the representativeness of other characteristics of the sample like trait and preference features, so that proper statistical corrections can be made in upcoming analyses of survey responses whenever needed.
Perceptions of Digital Health Education Among European Medical Students: Mixed Methods Survey
Authors: Machleid Felix , Kaczmarczyk Robert , Johann Doreen , Balčiūnas Justinas , Atienza-Carbonell Beatriz , von Maltzahn Finn , Mosch Lina
Published: June 2020

Background

Digital health technologies hold promise to enhance patient-related outcomes, to support health care staff by reducing their workload, and to improve the coordination of care. As key users of digital health technologies, health care workers are crucial to enable a meaningful digital transformation of health care. Digital health literacy and digital skills should become prerequisite competencies for health professionals to facilitate the implementation and leverage the potential of digital technologies to improve health.

Objective

We aimed to assess European medical students’ perceived knowledge and opinions toward digital health, the status of digital health implementation in medical education, and the students’ most pressing needs.

Methods

The explanatory design of our mixed methods study was based on an online, anonymous, self-administered survey targeted toward European medical students. A linear regression analysis was used to identify the influence of the year of medical studies on the responses. Additional analysis was performed by grouping the responses by the self-evaluated frequency of eHealth technology use. Written responses to four qualitative questions in the survey were analyzed using an inductive approach.

Results

The survey received a total of 451 responses from 39 European countries, and there were respondents for every year of medical studies. The majority of respondents saw advantages in the use of digital health. While 40.6% (183/451) felt prepared to work in a digitized health care system, more than half (240/451, 53.2%) evaluated their eHealth skills as poor or very poor. Medical students considered lack of education to be the reason for this, with 84.9% (383/451) agreeing or strongly agreeing that more digital health education should be implemented in the medical curriculum. Students demanded introductory and specific eHealth courses covering data management, ethical aspects, legal frameworks, research and entrepreneurial opportunities, role in public health and health systems, communication skills, and practical training. The emphasis lay on tailoring learning to future job requirements and interprofessional education.

Conclusions

This study shows a lack of digital health-related formats in medical education and a perceived lack of digital health literacy among European medical students. Our findings indicate a gap between the willingness of medical students to take an active role by becoming key players in the digital transformation of health care and the education that they receive through their faculties.
Influence of Mass and Social Media on Psychobehavioral Responses Among Medical Students During the Downward Trend of COVID-19 in Fujian, China: Cross-Sectional Study
Authors: Lin Yulan , Hu Zhijian , Alias Haridah , Wong Li Ping
Published: June 2020

Background

An extensive amount of information related to the novel coronavirus (COVID-19) pandemic was disseminated by mass and social media in China. To date, there is limited evidence on how this infodemic may influence psychobehavioral responses to the crisis.

Objective

The aim of this study is to assess the psychobehavioral responses to the COVID-19 outbreak and examine their associations with mass and social media exposure.

Methods

A cross-sectional study among medical and health sciences students from the Fujian Medical University in Fuzhou, China, was conducted between April 6-22, 2020.

Results

A total of 2086 completed responses were received. Multivariable analyses demonstrated that four constructs of the Health Belief Model (HBM)—higher perception of susceptibility (odds ratio [OR] 1.44; 95% CI 1.07-1.94), severity (OR 1.32; 95% CI 1.10-1.59), self-efficacy (OR 1.61; 95% CI 1.21-2.15), and perceived control or intention to carry out prevention measures (OR 1.32; 95% CI 1.09-1.59)—were significantly associated with a higher mass media exposure score, whereas only three constructs—higher perception of severity (OR 1.43; 95% CI 1.19-1.72), self-efficacy (OR 1.85; 95% CI 1.38-2.48), and perceived control or intention to carry out prevention measures (OR 1.32; 95% CI 1.08-1.58)—were significantly associated with a higher social media exposure score. Lower emotional consequences and barriers to carry out prevention measures were also significantly associated with greater mass and social media exposure. Our findings on anxiety levels revealed that 38.1% (n=795; 95% CI 36.0-40.2) of respondents reported moderate-to-severe anxiety. A lower anxiety level was significantly associated with higher mass and social media exposure in the univariable analyses; however, the associations were not significant in the multivariable analyses.

Conclusions

In essence, both mass and social media are useful means of disseminating health messages and contribute to the betterment of psychobehavioral responses to COVID-19. Our findings stress the importance of the credibility of information shared through mass and social media outlets and viable strategies to counter misinformation during a pandemic.
Psoriasis Google Trends (Preprint)
Authors: Garcia-Souto Fernando , Pereyra-Rodriguez Jose Juan
Published: June 2020

BACKGROUND

In recent years, the internet has become an essential tool where people seek information about health care.

OBJECTIVE

The aim of this study is to use data from Google Trends to analyze worldwide public interest in psoriasis and its different treatment modalities, and to analyze the possible seasonality of searches.

METHODS

A worldwide search was carried out through Google Trends from 2004 to 2019. A combination of terms related to psoriasis treatments was introduced. Joinpoint regression was performed. Google Trends assigns a relative search volume index to the search terms. Comparison annual relative search volume, annual percentage change, and average annual percentage change (AAPC) were analyzed to assess loss or gain of interest.

RESULTS

Our study reflects an increase interest in secukinumab (AAPC 33.7), ixekizumab (AAPC 23.3), and apremilast (AAPC 21.4). It shows less interest in methotrexate (AAPC –3.6), retinoids (AAPC –9.8), cyclosporine (AAPC –9.8), phototherapy (AAPC –6.3), etanercept (AAPC –14.9), infliximab (AAPC –14), and adalimumab (AAPC –5.8). Seasonality was found in the search term “psoriasis.”

CONCLUSIONS

Secukinumab, ixekizumab, and apremilast have been the treatments that have aroused the most interest. Our results show current psoriasis search trends and its different treatments based on Google Trend analysis.
Development and Feasibility of a Digital Acceptance and Commitment Therapy–Based Intervention for Generalized Anxiety Disorder: Pilot Acceptability Study (Preprint)
Authors: Hemmings Nicola R , Kawadler Jamie M , Whatmough Rachel , Ponzo Sonia , Rossi Alessio , Morelli Davide , Bird Geoffrey , Plans David
Published: June 2020

BACKGROUND

Generalized anxiety disorder (GAD) is characterized by excessive worry that is difficult to control and has high comorbidity with mood disorders including depression. Individuals experience long wait times for diagnosis and often face accessibility barriers to treatment. There is a need for a digital solution that is accessible and acceptable to those with GAD.

OBJECTIVE

This paper aims to describe the development of a digital intervention prototype of acceptance and commitment therapy (ACT) for GAD that sits within an existing well-being app platform, BioBase. A pilot feasibility study evaluating acceptability and usability is conducted in a sample of adults with a diagnosis of GAD, self-referred to the study.

METHODS

Phase 1 applied the person-based approach (creation of guiding principles, intervention design objectives, and the key intervention features). In Phase 2 participants received the app-based therapeutic and paired wearable for 2 weeks. Self-report questionnaires were obtained at baseline and posttreatment. The primary outcome was psychological flexibility (Acceptance and Action Questionnaire-II [AAQ-II]) as this is the aim of ACT. Mental well-being (Warwick-Edinburgh Mental Well-being Scale [WEMWBS]) and symptoms of anxiety (7-item Generalized Anxiety Disorder Assessment [GAD-7]) and depression (9-item Patient Health Questionnaire [PHQ-9]) were also assessed. Posttreatment usability was assessed via self-report measures (System Usability Scale [SUS]) in addition to interviews that further explored feasibility of the digital intervention in this sample.

RESULTS

The app-based therapeutic was well received. Of 13 participants, 10 (77%) completed the treatment. Results show a high usability rating (83.5). Participants found the digital intervention to be relevant, useful, and helpful in managing their anxiety. Participants had lower anxiety (d=0.69) and depression (d=0.84) scores at exit, and these differences were significantly different from baseline (P=.03 and .008 for GAD-7 and PHQ-9, respectively). Participants had higher psychological flexibility and well-being scores at exit, although these were not significantly different from baseline (P=.11 and .55 for AAQ-II and WEMWBS, respectively).

CONCLUSIONS

This ACT prototype within BioBase is an acceptable and feasible digital intervention in reducing symptoms of anxiety and depression. This study suggests that this intervention warrants a larger feasibility study in adults with GAD.
Comorbidities might be a risk factor for the incidence of COVID-19: Evidence from a web-based survey of 780,961 participants (Preprint)
Authors: Alam Mohammad Rahanur , Kabir Md. Ruhul , Reza Sompa
Published: June 2020

BACKGROUND

The global pandemic of COVID-19 is posing the biggest threat to humanity through its ubiquitous effect of unfathomable magnitude. It has been responsible for over four hundred thousand death worldwide to date. There has been evidence that various comorbidities have a higher risk associated with case fatality.

OBJECTIVE

Although COVID-19 is a viral disease, there might be an association between different comorbidities and the occurrence of the disease. Our study aims to determine the association between the COVID-19 infection and pre-existing comorbidities such as asthma, diabetes, liver disease, lung disease, heart disease, kidney disease, hypertension, and obesity through a web-based self-reported survey.

METHODS

Sociodemographic and medical history data on different comorbidities were collected by a web-based self-reported survey between 25th March 2020 to 4th June 2020 by the Nexoid United Kingdom. Univariate and multivariate logistic regression analyses were done using these risk factors as independent variables.

RESULTS

A total of 780,961 participants from 183 different countries and territories participated in this study. Among them, 1516 participants were diagnosed with COVID-19 prior to this study. A significant risk association was observed for age above 60 years, female gender as well as different pre-existing disease conditions such as diabetes, kidney disease, liver disease, and heart diseases. Asthma and diabetes were the major dominant comorbidities among patients, and patients with existing diabetes were 1.464 (AOR: 1.464; 95% CI: 1.228-1.744) times more likely to develop the disease than others who did not diagnose as diseased.

CONCLUSIONS

Older adults, female as well as people with comorbidities such as diabetes mellitus, heart disease, kidney disease, and liver disease, are the most vulnerable population for COVID-19. However, further studies should be carried out to explain the pathway of these risk associations.

CLINICALTRIAL
Health Policy for Dialysis Care in Canada and the United States
Authors: Tonelli Marcello , Vanholder Raymond , Himmelfarb Jonathan
Published: June 2020

Contemporary dialysis treatment for chronic kidney failure is complex, is associated with poor clinical outcomes, and leads to high health costs, all of which pose substantial policy challenges. Despite similar policy goals and universal access for their kidney failure programs, the United States and Canada have taken very different approaches to dealing with these challenges. While US dialysis care is primarily government funded and delivered predominantly by private for-profit providers, Canadian dialysis care is also government funded but delivered almost exclusively in public facilities. Differences also exist for regulatory mechanisms and the policy incentives that may influence the behavior of providers and facilities. These differences in health policy are associated with significant variation in clinical outcomes: mortality among patients on dialysis is consistently lower in Canada than in the United States, although the gap has narrowed in recent years. The observed heterogeneity in policy and outcomes offers important potential opportunities for each health system to learn from the other. This article compares and contrasts transnational dialysis-related health policies, focusing on key levers including payment, finance, regulation, and organization. We also describe how policy levers can incentivize favorable practice patterns to support high-quality/high-value, person-centered care and to catalyze the emergence of transformative technologies for alternative kidney replacement strategies.
ATUALIDADE DA FILOSOFIA DA PRÁXIS E POLÍTICAS EDUCACIONAIS
Authors: Tolêdo Herculis Pereira
Published: June 2020

Resenha da obra “A atualidade da filosofia da práxis e políticas educacionais” organizada por Anita Helena Schlesener, André Luis de Oliveira e Tatiani Maria Garcia de Almeida, publicada pela editora da Universidade Tuiuti do Paraná (UTP) no ano de 2018. A obra traz uma reflexão crítica sobre a atualidade das políticas educacionais no Brasil, com as lentes do marxismo gramsciano.
PEDAGOGIA SOCIALISTA, EDUCAÇÃO POPULAR E EDUCAÇÃO DO CAMPO: problematizando a escola pública no/do campo
Authors: De Souza Maria Antônia , Ghedini Cecília Maria
Published: June 2020

O objetivo deste texto é problematizar as escolas públicas no/do campo e as possíveis contribuições da Pedagogia Socialista, Educação Popular e da Educação do Campo. Toma-se como referência a concepção da Educação do Campo construída nos movimentos sociais a partir do final da década de 1990 e a realidade das escolas públicas centradas, ainda, na concepção da Educação Rural. O estudo tem natureza bibliográfica e documental, com problematização fundamentada em ações coletivas realizadas em escolas no/do campo de duas regiões do estado do Paraná. Constata-se que a Pedagogia Socialista e Educação Popular, embora fundamentem ação de movimentos e organizações sociais, não estão no horizonte das políticas e práticas educacionais. A Educação do Campo tem sido problematizada em cursos de formação continuada de professores, com o intuito de dar visibilidade ao campo, ao trabalho e à identidade da escola do campo. São concepções que possuem vínculo com a educação da classe trabalhadora e que têm potencial para a organização pedagógica que valoriza trabalho, cultura e experiência. Os obstáculos para que elas exerçam força político-pedagógica nas escolas são de natureza histórico-estrutural, com desdobramentos na gestão da escola e nos processos de formação inicial de professores.
ANTONIO GRAMSCI Y DA CRÍTICA PEDAGÓGICA COMO CREACIÓN POLÍTICA
Authors: Pato Maria Cecilia
Published: June 2020

En el artículo se abordan las reflexiones y aportes de uno de los pensadores fundamentales de la filosofía política del Siglo XX, Antonio Gramsci, a la concepción de los procesos educativos en las sociedades contemporáneas. Se desarrollará la interpretación que se realiza de sus reflexiones, asumiéndolas en su peculiaridad y contribución al pensamiento crítico sobre la relación necesaria e ineluctable entre política y educación.
METODOLOGIAS ATIVAS NO ENSINO PROFISSIONALIZANTE: UMA EXPERIÊNCIA NA DISCIPLINA DE PESQUISA E DESENVOLVIMENTO DE PRODUTOS
Authors: Schorr Wildner Maria Claudete , Bagatini Lisângela
Published: June 2020

As metodologias ativas de ensino e aprendizagem são uma tendência pedagógica por se tratarem de estratégias que colocam o aluno no papel de corresponsável por sua trajetória educacional e o professor como facilitador das experiências relacionadas ao processo de aprendizagem. Tais metodologias foram escolhidas como objeto deste estudo a fim de desenvolver algumas das principais habilidades e competências requisitadas pelo mercado de trabalho atual, tendo em vista as dificuldades apresentadas por estudantes da área tecnológica de alimentos no que tange à resolução de problemas e condução de projetos demandados pelo setor produtivo. O objetivo desta pesquisa, portanto, consistiu em implementar estratégias ativas de ensino e aprendizagem baseada em problemas e projetos, além de avaliar as implicações dessas práticas na efetiva aprendizagem dos estudantes da disciplina de Pesquisa e Desenvolvimento de Produto, do Curso Técnico em Alimentos do Centro de Educação Profissional da Universidade do Vale do Taquari (Univates). A fim de mensurar a eficácia das metodologias utilizadas e verificar se os resultados esperados foram alcançados, desenvolveu-se um estudo de caso de caráter observacional e qualitativo, sem intervir sobre o objeto estudado, somente revelando-o tal como ele foi percebido. Salienta-se como benefícios alcançados ao final deste estudo, a desacomodação provocada aos envolvidos, em virtude de sua implementação.Palavras-chave: Metodologias ativas. Aprendizagem baseada em projetos. Ensino profissionalizante.