bluuebunny/crossref_metadata_2025 huggingface dataset:
Die Selbstmodernisierung des Industriesystems. Herausforderungen für das Management von Human-Ressourcen
Authors: Rosner Siegfried
Published: June 2021

Der Unternehmung kommt immer mehr der Charakter einer quasi-öffentlichen Institution zu, weil die Einflüsse der soziopolitischen Rahmenbedingungen auf die Unternehmenspolitik stark zugenommen haben. So dringt durch den gesellschaftlichen Wertewandel auch das gewachsene Verlangen nach Mitsprache und Mitgestaltung in die Wirtschaftsorganisation ein und wirkt dort als Modernisierungsimpuls. Die Unternehmen können das darin angelegte Produktivitätspotential nur ausschöpfen, wenn sie die veränderten Werthaltungsansprüche und Arbeitszeitbedürfnisse der Mitarbeiter als konstruktive Herausforderung für die Neugestaltung ihrer Arbeits- und Personalpolitik begreifen. Mit der über den Einzelbetrieb hinausgehenden Nutzung der Produktivkraft Partizipation wird die Modernisierung industrieller Gesellschaften selbstbezüglich, weil sie als eine demokratische Modernisierung bereits industriell moderner Strukturen bezeichnet werden kann.
Möglichkeiten der Früherkennung von Führungstalent im außerfachlichen Bereich: Arbeiten zum “Deutschen CPI”
Authors: Weinert Ansfried B.
Published: June 2021

Führungspotential ist eine knappe und sehr wertvolle Ressource. Viele Unternehmen bemühen sich außerordentlich darum, Führungspotential möglichst früh - unter Bewerbern wie unter Mitarbeitern - identifizieren und fördern zu können. In diesem Beitrag wird ein neues Instrument kurz skizziert, das Personen mit Führungskompetenz von solchen mit Führungsinkompetent, bereits in einem frühen Alter und mit hoher Treffsicherheit, identifizieren kann.
Unterstützung der Personalarbeit durch die Koppelung von PC und Großrechner
Authors: Flecken Herbert
Published: June 2021

Im folgenden praxisorientierten Beitrag wird der gekoppelte Einsatz von vernetzten Personal Computern mit dem Großrechner erläutert. Nach einer Darstellung der PC-Verbindung zum Großrechner wird das PC-Netzwerk im Personalwesen dargestellt, wobei der Autor insbesondere auf die Aufgabenverteilung im Netzwerk und die Datensicherheit eingeht. Auf diese Weise werden von der Zeiterfassung über Datenbankfunktionen bis zum allgemeinen Berichtswesen ein bedeutender Teil der Aufgaben im Personalbereich von der EDV unterstützt. Je nach Anwendung wird dabei auf die Großrechner- beziehungsweise PC-Technologie zurückgegriffen.
Chancengleichheit auch für obere Führungskräfte
Authors: Wohlgemuth André C.
Published: June 2021

Die Bedeutung der Führungskräfte für den Unternehmungserfolg wird wieder vermehrt hervorgehoben. Viele große Unternehmungen verfügen deshalb über institutionalisierte Förderungs- und Entwicklungsprogramme. Was hingegen oft fehlt, ist ein modernes, computerunterstütztes Instrument zur effizienten und objektiven Handhabung aller entscheidungsrelevanten Daten für die Nachfolgeplanung sowie zur Beurteilung des Führungspotentials der gesamten Unternehmung. Die seit längerem bekannten Personal-Informationssysteme (PIS) sind hierfür ungeeignet. Anhand des Pionierprojektes einer Schweizer Großbank wird gezeigt, wie eine praktikable Lösung aussehen kann und welche Erfahrungen damit gemacht wurden.
Computergestützte Personalentwicklung in mittelständischen Unternehmen
Authors: Rumpf Hartmut
Published: June 2021

Zunächst wird die Relevanz von Personalentwicklung und Personalentwicklungsplanung für mittelständische Unternehmen herausgestellt, ehe dann aufgrund von Datenvielfalt sowie Erfordernissen nach Objektivität und Schnelligkeit die Notwendigkeit eines Computereinsatzes konstatiert wird Die Möglichkeiten eines Computereinsatzes zur Personalentwicklung und Personalentwicklungsplanung werden dann durch Beschreibung des Systems CPE erläutert.
PC-gestützte Managementfortbildung mit PLUS-P
Authors: Braun Christiane , Oberschulte Hans
Published: June 2021

Der vorliegende Beitrag stellt Einsatzmöglichkeiten von Untemehmensplanspielen zur Managementfortbildung dar. Am Beispiel des PC-gestützten Planspiels PLUS-P wird auch die Vermittlung neuer Inhalte der Managementfortbildung, wie vernetztes Denken und Agieren im Systemzusammenhang, aufgezeigt. Nach Einführung und Hinweisen zur technischen Umsetzung erfolgt die Eingrenzung der mit PLUS-P angesprochenen Zielgruppen. Schwerpunktmäßig wird der Spielverlauf ab Spielbeginn mit unterschiedlichen Sichtweisen des Spielers beziehungsweise des Spielleiters erläutert.
Weiterbildungskonzepte deutscher Unternehmen
Authors: Pullig Karl-Klaus
Published: June 2021

Mehr als 100 aktuelle Weiterbildungsprogramme größerer deutscher Unternehmen wurden daraufhin untersucht

(1) welche Weiterbildungskonzeptionen heute als typisch gelten können und (2) welche zukunftsweisenden Akzente sie enthalten.

Einige Ergebnisse der Analyse: Als Folge der Bemühungen, Weiterbildung möglichst bedarfs- bzw. transferorientiert zu betreiben, verzichten einige (große) Unternehmen bereits ganz auf die üblichen Weiterbidungsprogramme und Weiterbildungsangebote zugunsten gezielter Hilfestellungen bei konkreten, abteilungsspezifischen Bildungsproblemen oder zugunsten langfristiger Personalentwicklungs- und Organisationsentwicklungsprozesse; andere versuchen den Weiterbildungsbedarf genauer zu ermitteln und über Vor- und Nachbereitungen den Nutzen zu erhöhen. Die Sozialkompetenz gilt neben der Fachkompetenz unbestritten als förderungswürdig. Bildungskooperationen mit Verbänden, anderen Unternehmen, Bildungsinstitutionen ect. nehmen zu. Die zentralen Weiterbildungsabteilungen verstehen sich oft als Anbieter umfangreicher Dienstleistungen.
Berufsorientierung und Identifikationsbereitschaft in Japan
Authors: Marten-Grubinger Barbara , Stengel Martin
Published: June 2021

Im Rahmen einer Untersuchung japanischer Arbeitnehmer zur Analyse ihrer Einstellungen zu Arbeit und Freizeit haben wir unter anderem die beiden Konstrukte “Berufsorientierung” und “Identifikationsbereitschaft” verwendet. Unsere Fragestellung dabei war, welche Schwierigkeiten zu befürchten seien, wenn japanische Arbeitnehmer in ausländischen Unternehmen beschäftigt sind. An zwei Phänomenen wollten wir beispielhaft herausarbeiten, wo Brüche in der vielbeschworenen Arbeitsmoral der Japaner auszumachen sind: am Generationenwechsel und an der Rolle der Japanerin im heutigen Arbeitsleben Japans. Die Ergebnisse aus dieser Studie haben wir verglichen mit Daten aus Studien in den USA und der (alten) Bundesrepublik. Aus den Ergebnissen lassen sich auch in Japan Konfliktpotentiale ableiten zwischen den Zielen der großen Organisationen der Wirtschaft und den Zielen, die der einzelne für wichtig hält.
Advances in the diagnosis and treatment of keratoconus
Authors: Atalay Eray , Özalp Onur , Yıldırım Nilgün
Published: June 2021

Keratoconus had traditionally been considered a rare disease at a time when the imaging technology was inept in detecting subtle manifestations, resulting in more severe disease at presentation. The increased demand for refractive surgery in recent years also made it essential to more effectively detect keratoconus before attempting any ablative procedure. Consequently, the armamentarium of tools that can be used to diagnose and treat keratoconus has significantly expanded. The advances in imaging technology have allowed clinicians and researchers alike to visualize the cornea layer by layer looking for any early changes that might be indicative of keratoconus. In addition to the conventional geometrical evaluation, efforts are also underway to enable spatially resolved corneal biomechanical evaluation. Artificial intelligence has been exploited in a multitude of ways to enhance diagnostic efficiency and to guide treatment. As for treatment, corneal cross-linking treatment remains the mainstay preventive approach, yet the current main focus of research is on increasing oxygen availability and developing new strategies to improve riboflavin permeability during the procedure. Some new combined protocols are being proposed to simultaneously halt keratoconus progression and correct refractive error. Bowman layer transplantation and additive keratoplasty are newly emerging alternatives to conventional keratoplasty techniques that are used in keratoconus surgery. Advances in tissue engineering and regenerative therapy might bring new perspectives for treatment at the cellular level and hence obviate the need for invasive surgeries. In this review, we describe the advances in the diagnosis and treatment of keratoconus primarily focusing on newly emerging approaches and strategies.
A midwife’s exploration into how power & hierarchy influence both staff and patient safety
Authors: Elliott-Mainwaring Helen
Published: June 2021

My experiences as a legitimate informal whistle-blower have afforded me an understanding of the dichotomy that is Trust allegiance and misplaced brand loyalty over and above both patient and staff safety, such that when poor care is spoken of as a potential or experienced from either angle, the general rule within healthcare management is not to acknowledge, reflect, mitigate and learn in order to improve, but instead to gaslight, deny and subordinate such that from a staff safety perspective they are caught between a rock and a hard place. This paper explores some of the opportunities which healthcare organizations could embrace to positively influence the effects of power and hierarchy on staff safety.

Aims

This paper discusses the bigger picture of maternity services safety.

Methods

This is a discussion piece.

Findings

For some healthcare staff it is preferable to remain quiet, not rock the proverbial boat, and maintain deeply loyal allegiances to their employers over and above public protection. For others, the journey of honesty, integrity and tenacity carries a high price in terms of personal energy, health and financial compromise.

Conclusion

This exploration into how power & hierarchy influence both staff and patient safety has identified and briefly explored some of the tensions created by misplaced brand loyalty inherent within healthcare institutions, and the legacy of harms resulting.
Epigenetics and sarcoidosis
Authors: Konigsberg Iain R. , Maier Lisa A. , Yang Ivana V.
Published: June 2021

Epigenetic modifications are emerging as important regulatory mechanisms of gene expression in lung disease, given that they are influenced by environmental exposures and genetic variants, and that they regulate immune and fibrotic processes. In this review, we introduce these concepts with a focus on the study of DNA methylation and histone modifications and discuss how they have been applied to lung disease, and how they can be applied to sarcoidosis. This information has implications for other exposure and immunologically mediated lung diseases, such as chronic beryllium disease, hypersensitivity pneumonitis, and asbestosis.
A comprehensive database for integrated analysis of omics data in autoimmune diseases
Authors: Martorell-Marugán Jordi , López-Domínguez Raúl , García-Moreno Adrián , Toro-Domínguez Daniel , Villatoro-García Juan Antonio , Barturen Guillermo , Martín-Gómez Adoración , Troule Kevin , Gómez-López Gonzalo , Al-Shahrour Fátima , González-Rumayor Víctor , Peña-Chilet María , Dopazo Joaquín , Sáez-Rodríguez Julio , Alarcón-Riquelme Marta E. , Carmona-Sáez Pedro
Published: June 2021

Background

Autoimmune diseases are heterogeneous pathologies with difficult diagnosis and few therapeutic options. In the last decade, several omics studies have provided significant insights into the molecular mechanisms of these diseases. Nevertheless, data from different cohorts and pathologies are stored independently in public repositories and a unified resource is imperative to assist researchers in this field.

Results

Here, we present Autoimmune Diseases Explorer (https://adex.genyo.es), a database that integrates 82 curated transcriptomics and methylation studies covering 5609 samples for some of the most common autoimmune diseases. The database provides, in an easy-to-use environment, advanced data analysis and statistical methods for exploring omics datasets, including meta-analysis, differential expression or pathway analysis.

Conclusions

This is the first omics database focused on autoimmune diseases. This resource incorporates homogeneously processed data to facilitate integrative analyses among studies.
Concomitant acute myocardial infarction and acute pulmonary embolism caused by paradoxical embolism: a case report
Authors: Chen Weiwei , Yu Zhixi , Li Siming , Wagatsuma Kenji , Du Beibei , Yang Ping
Published: June 2021

Background

Due to its low incidence and diverse manifestations, paradoxical embolism (PDE) is still under-reported and is not routinely considered in differential diagnoses. Concomitant acute myocardial infarction (AMI) and acute pulmonary embolism (PE) caused by PDE has rarely been reported.

Case presentation

A 45-year-old woman presented with acute chest pain and difficulty with breathing. Multiple imaging modules including ECG, echocardiography, emergency cardioangiogram (CAG), and CT angiography of the pulmonary arteries showed acute occlusion of the posterolateral artery and acute PE. After coronary aspiration, no residual stenosis was observed. One month later, a bubble study showed inter-atrial communication via a patent foramen ovale (PFO). The AMI in this patient was finally attributed to PDE via the PFO. PFO closure was performed, and long-term anticoagulation was prescribed to prevent recurrent thromboembolic events.

Conclusions

PDE via PFO is a rare etiology of AMI, especially in patients with concomitant AMI and PE. Clinicians should be vigilant of this possibility and close the inter-atrial channel for secondary prevention.
Benchmarking of provider competencies and current training for prevention and management of obesity among family medicine residency programs: a cross-sectional survey
Authors: Orjuela-Grimm Manuela , Butsch W. Scott , Bhatt-Carreño Silvia , Smolarz B. Gabriel , Rao Goutham
Published: June 2021

Background

U.S. physicians lack training in caring for patients with obesity. For family medicine, the newly developed Obesity Medicine Education Collaborative (OMEC) competencies provide an opportunity to compare current training with widely accepted standards. We aimed to evaluate the current state of obesity training in family medicine residency programs.

Methods

We conducted a study consisting of a cross-sectional survey of U.S. family medicine residency program leaders. A total of 735 directors (including associate/assistant directors) from 472 family medicine residency programs identified from the American Academy of Family Physicians public directory were invited via postal mail to complete an online survey in 2018.

Results

Seventy-seven program leaders completed surveys (16% response rate). Sixty-four percent of programs offered training on prevention of obesity and 83% provided training on management of patients with obesity; however, 39% of programs surveyed reported not teaching an approach to obesity management that integrates clinical and community systems as partners, or doing so very little. Topics such as behavioral aspects of obesity (52%), physical activity (44%), and nutritional aspects of obesity (36%) were the most widely covered (to a great extent) by residency programs. In contrast, very few programs extensively covered pharmacological treatment of obesity (10%) and weight stigma and discrimination (14%). Most respondents perceived obesity-related training as very important; 65% of the respondents indicated that expanding obesity education was a high or medium priority for their programs. Lack of room in the curriculum and lack of faculty expertise were reported as the greatest barriers to obesity education during residency. Only 21% of the respondents perceived their residents as very prepared to manage patients with obesity at the end of the residency training.

Conclusion

Family medicine residency programs are currently incorporating recommended teaching to address OMEC competencies to a variable degree, with some topic areas moderately well represented and others poorly represented such as pharmacotherapy and weight stigma. Very few program directors report their family medicine residents are adequately prepared to manage patients with obesity at the completion of their training. The OMEC competencies could serve as a basis for systematic obesity training in family medicine residency programs.
General practitioners’ experiences of emergency care and treatment planning in England: a focus group study
Authors: Huxley Caroline J. , Eli Karin , Hawkes Claire A. , Perkins Gavin D. , George Rob , Griffiths Frances , Slowther Anne-Marie
Published: June 2021

Background

Emergency Care and Treatment Plans are recommended for all primary care patients in the United Kingdom who are expected to experience deterioration of their health. The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) was developed to integrate resuscitation decisions with discussions about wider goals of care. It summarises treatment recommendations discussed and agreed between patients and their clinicians for a future emergency situation and was designed to meet the needs of different care settings. Our aim is to explore GPs’ experiences of using ReSPECT and how it transfers across the primary care and secondary care interface.

Methods

We conducted five focus groups with GPs in areas being served by hospitals in England that have implemented ReSPECT. Participants were asked about their experience of ReSPECT, how they initiate ReSPECT-type conversations, and their experiences of ReSPECT-type recommendations being communicated across primary and secondary care. Focus groups were transcribed and analysed using Thematic Analysis.

Results

GPs conceptualise ReSPECT as an end of life planning document, which is best completed in primary care. As an end of life care document, completing ReSPECT is an emotional process and conversations are shaped by what a ‘good death’ is thought to be. ReSPECT recommendations are not always communicated or transferable across care settings. A focus on the patient’s preferences around death, and GPs’ lack of specialist knowledge, could be a barrier to completion of ReSPECT that is transferable to acute settings.

Conclusion

Conceptualising ReSPECT as an end of life care document suggests a difference in how general practitioners understand ReSPECT from its designers. This impacts on the transferability of ReSPECT recommendations to the hospital setting.
Maternal and neonatal outcomes in transverse and vertical skin incision for placenta previa
Authors: Fan Dazhi , Zhang Huishan , Rao Jiaming , Lin Dongxin , Wu Shuzhen , Li Pengsheng , Chen Gengdong , Zhou Zixing , Liu Juan , Chen Ting , Chen Fengying , Guo Xiaoling , Liu Zhengping
Published: June 2021

Background

Placenta previa, a serious obstetric issue, should be managed by experienced teams. The safe and appropriate mode of delivery for placenta previa is by cesarean delivery. However, no studies were found comparing either maternal or neonatal outcomes for different skin incision in women with placenta previa. The aim of this study was to compare maternal and neonatal outcomes by skin incision types (transverse compared with vertical) in a large cohort of women with placenta previa who were undergoing cesarean delivery.

Methods

This was a retrospective cohort study carried out between January 2014 and June 2019. All pregnant women with placenta previa had confirmed by ultrasonologist before delivery and obstetrician at delivery. The primary outcome was the estimated blood loss during the surgery and within the first 24 hours postoperatively. Mean (standard deviation), median (interquartile range) or frequency (percentage) was reported to variables. Appropriate parametric and nonparametric tests were used to analyses.

Results

The study included 1098 complete records, 332 (30.24%) cases in the vertical skin incision group and 766 (69.76%) cases in the transverse skin incision group. Those with vertical incision showed a higher percentage of preterm delivery, anterior placenta, abnormally invasive placenta, and history of previous cesarean delivery, and a lower percentage of first pregnancy, in vitro fertilization, and emergency cesarean delivery. After controlling for confounding factors, higher incidence of post-partum hemorrhage (OR 5.47, 95% CI 3.84–7.79), maternal intensive care unit (OR 4.30, 95% CI 2.86–6.45), transfusion (OR 5.97, 95% CI 4.15–8.58), and 5-min APGAR< 7 (OR 9.03, 95% CI 1.83–44.49), a more estimated blood loss (β 601.85, 95%CI 458.78–744.91), and a longer length of hospital stay after delivery (β 0.54, 95%CI 0.23–0.86) were found in the vertical skin incision group.

Conclusions

Our data demonstrated that transverse skin incision group showed the better perinatal outcomes in women with placenta previa. Future collaborative studies are needed to be done by centers for placenta previa to have a better understanding of the characteristics and the outcomes of the disease in the choosing skin incision.
Fixation stability after surgical treatment of strabismus and biofeedback fixation training in amblyopic eyes
Authors: Maneschg Otto Alexander , Barboni Mirella Telles Salgueiro , Nagy Zoltán Zsolt , Németh János
Published: June 2021

Background

Visual fixation may be affected in amblyopic patients and, moreover, its stability may be associated with the effects of amblyopic treatments on visual performance in patients with strabismus. Therefore, fixation stability is a relevant biomarker that might predict the recurrence of amblyopia after a therapeutic intervention. Microperimetric biofeedback fixation training (BFT) can stabilize visual fixation in adult patients with central vision loss. It was the purpose of the present study to evaluate the effects of BFT on fixation stability in adult amblyopic patients after surgical intervention to treat strabismus.

Methods

Participants were 12 patients with strabismus (mean age = 29.6 ± 8.5 years; 6 females) and 12 healthy volunteers (mean age = 23.8 ± 1.5 years; 9 females). The protocol included ophthalmological and microperimetric follow-ups to measure fixation stability and macular sensitivity. BFT was applied monocularly to four amblyopic eyes either on the spontaneous preferential retinal locus or to a fixation area closer to the anatomical fovea after surgical treatment of strabismus.

Results

Baseline measurements showed significantly altered microperimetric average threshold in amblyopic eyes compared to fellow eyes (p = 0.024) and compared to control eyes (p < 0.001). Fixation was unstable in amblyopic eyes compared to control eyes (p < 0.001). Fixation stability did not significantly change after surgical alignment of strabismus (p = 0.805). BFT applied to operated eyes resulted in a more stable fixation with improvements of about 50% after three months of training.

Conclusions

Fixation stability improvements following BFT highlight its potential use in adult amblyopic eyes after the surgical alignment of the strabismus. Future investigations may also consider applying this method in combination with standard treatments to improve vision in amblyopic patients.
Impacts of COVID-19 and social isolation on academic staff and students at universities: a cross-sectional study
Authors: Leal Filho Walter , Wall Tony , Rayman-Bacchus Lez , Mifsud Mark , Pritchard Diana J. , Lovren Violeta Orlovic , Farinha Carla , Petrovic Danijela S. , Balogun Abdul-Lateef
Published: June 2021

Background

“The impacts of the Coronavirus Disease 2019 (COVID-19) pandemic and the shutdown it triggered at universities across the world, led to a great degree of social isolation among university staff and students. The aim of this study was to identify the perceived consequences of this on staff and their work and on students and their studies at universities.

Method

The study used a variety of methods, which involved an on-line survey on the influences of social isolation using a non-probability sampling. More specifically, two techniques were used, namely a convenience sampling (i.e. involving members of the academic community, which are easy to reach by the study team), supported by a snow ball sampling (recruiting respondents among acquaintances of the participants). A total of 711 questionnaires from 41 countries were received. Descriptive statistics were deployed to analyse trends and to identify socio-demographic differences. Inferential statistics were used to assess significant differences among the geographical regions, work areas and other socio-demographic factors related to impacts of social isolation of university staff and students.

Results

The study reveals that 90% of the respondents have been affected by the shutdown and unable to perform normal work or studies at their institution for between 1 week to 2 months. While 70% of the respondents perceive negative impacts of COVID 19 on their work or studies, more than 60% of them value the additional time that they have had indoors with families and others. .

Conclusions

While the majority of the respondents agree that they suffered from the lack of social interaction and communication during the social distancing/isolation, there were significant differences in the reactions to the lockdowns between academic staff and students. There are also differences in the degree of influence of some of the problems, when compared across geographical regions. In addition to policy actions that may be deployed, further research on innovative methods of teaching and communication with students is needed in order to allow staff and students to better cope with social isolation in cases of new or recurring pandemics.
Disparity in the quality of COVID-19 data reporting across India
Authors: Vasudevan Varun , Gnanasekaran Abeynaya , Sankar Varsha , Vasudevan Siddarth A. , Zou James
Published: June 2021

Background

Transparent and accessible reporting of COVID-19 data is critical for public health efforts. Each Indian state has its own mechanism for reporting COVID-19 data, and the quality of their reporting has not been systematically evaluated. We present a comprehensive assessment of the quality of COVID-19 data reporting done by the Indian state governments between 19 May and 1 June, 2020.

Methods

We designed a semi-quantitative framework with 45 indicators to assess the quality of COVID-19 data reporting. The framework captures four key aspects of public health data reporting – availability, accessibility, granularity, and privacy. We used this framework to calculate a COVID-19 Data Reporting Score (CDRS, ranging from 0–1) for each state.

Results

Our results indicate a large disparity in the quality of COVID-19 data reporting across India. CDRS varies from 0.61 (good) in Karnataka to 0.0 (poor) in Bihar and Uttar Pradesh, with a median value of 0.26. Ten states do not report data stratified by age, gender, comorbidities or districts. Only ten states provide trend graphics for COVID-19 data. In addition, we identify that Punjab and Chandigarh compromised the privacy of individuals under quarantine by publicly releasing their personally identifiable information. The CDRS is positively associated with the state’s sustainable development index for good health and well-being (Pearson correlation: r=0.630, p=0.0003).

Conclusions

Our assessment informs the public health efforts in India and serves as a guideline for pandemic data reporting. The disparity in CDRS highlights three important findings at the national, state, and individual level. At the national level, it shows the lack of a unified framework for reporting COVID-19 data in India, and highlights the need for a central agency to monitor or audit the quality of data reporting done by the states. Without a unified framework, it is difficult to aggregate the data from different states, gain insights, and coordinate an effective nationwide response to the pandemic. Moreover, it reflects the inadequacy in coordination or sharing of resources among the states. The disparate reporting score also reflects inequality in individual access to public health information and privacy protection based on the state of residence.
Work-life balance predicted work ability two years later: a cohort study of employees in the Swedish energy and water sector
Authors: Berglund Erik , Anderzén Ingrid , Andersén Åsa , Lindberg Per
Published: June 2021

Background

Work-life balance (WLB) is the extent to which individual’s multiple life roles and demands carry over between each role. WLB can be divided into work interference with personal life (WIPL) and personal life interference with work (PLIW). This study aimed to investigate longitudinal associations between WIPL, PLIW and work ability outcomes.

Methods

In this cohort study, 224 employees in the energy and water sector in Sweden were followed-up over 2 years. Three questions derived from the Work Ability Index were used for measuring work ability outcome: current work ability compared with lifetime best; work ability regarding physical; and mental demands. Logistic regression models were used to analyse longitudinal associations between work ability and WIPL and WIPL respectively, controlling for workplace (company), position at work, experience of leadership quality, demographics, and work ability.

Results

Work ability compared to lifetime best were associated with WIPL in the adjusted logistic regression models (odds ratio (OR) 1.77, 95% confidence interval (CI) 1.15–2.73), and PLIW (OR 3.34, 95% CI 1.66–6.74). Work ability regarding physical demands was associated with WIPL (OR 1.60, 95% CI 1.07–2.40). Work ability regarding mental demands was associated with WIPL (OR 1.59, 95% CI 1.03–2.44) and PLIW (OR 2.88, 95% CI 1.31–6.32).

Conclusion

In this two-year longitudinal study, lower WIPL predicted good/excellent overall work ability compared with lifetime best, higher work ability regarding physical and mental demands, and lower PLIW predicted good/excellent overall work ability compared with lifetime best and higher work ability regarding and mental demands.
Differences in 5-year weight change between younger and older US firefighters
Authors: Mathias Kevin C. , Wu Yuchen , Stewart Donald F. , Smith Denise L.
Published: June 2021

Background

Research consistently finds that, on average, firefighters gain weight over time and some data indicate that younger firefighters are more likely to gain weight than older firefighters. The purpose of this study was to estimate the 5-year weight change among younger and older US firefighters.

Methods

Data from two occupational medical exams separated by 5 years (2009–2016) were examined from a cohort of US career firefighters in Virginia (males, n = 589; females, n = 67). The cohort was grouped into two age categories (< 45 years and ≥ 45 years). Weight change subgroups were Loss (decrease of > 3% body weight), Stable (within ±3% body weight) and Gain (increase of > 3% body weight). Multinomial logistic regression models and linear regression models were conducted to examine differences in the probability of being in a particular weight change category, weight change overall and by weight change category between younger and older firefighters.

Results

At baseline, 25 and 35% of younger (< 45 years) and older (≥ 45 years) were obese, respectively. Younger firefighters gained significantly (P < 0.05) more weight (3.0 ± 0.2 kg) than older firefighters (0.8 ± 0.5 kg). Younger firefighters were more likely to gain weight (53% versus 39%) and less likely (10% versus 20%) to lose weight as compared to older firefighters. Smaller weight gains were associated with age and BMI with the smallest increases observed in overweight and obese firefighters ≥45 years of age.

Conclusions

Health care providers should be attentive to weight gain, even among young non-obese firefighters, and counsel firefighters to avoid the additive risks of being older and heavier. In addition, weight loss/management programs should be promoted in the fire service to encourage healthy body weight and to prevent unhealthy weight gain among both young and old firefighters alike.
Pulmonary Nocardia infection in a child with idiopathic pulmonary hemosiderosis
Authors: Qin Lu , Zhang Fei-Zhou , Yang Tong-Yu , Tao Xiao-Fen , Tang Lan-Fang
Published: June 2021

Background

Idiopathic pulmonary hemosiderosis (IPH) encompasses a rare and agnogenic group of diffuse alveolar capillary hemorrhagic diseases. Corticosteroid treatment is the globally preferred therapeutic strategy for IPH; however, it can cause immunodeficiency. Nocardia infection often occurs in immunocompromised patients and primarily involves the pleura and lungs. Herein, we describe a case of pediatric pulmonary Nocardia infection after the corticosteroid treatment of IPH.

Case presentation

A 7-year-old girl presented with chief complaints of pale complexion persisting for 1 year and a cough for 20 days. Abundant hemosiderin-laden macrophages were detected in the gastric juice, which supported the diagnosis of IPH. Uninterrupted doses of corticosteroids were administered during the last hospitalization. After nearly 2 months of corticosteroids therapy, the patient began to cough and produce a purulent sputum. Next-generation sequencing of the bronchoalveolar lavage fluid revealed Nocardia abscessus (N. abscessus) DNA. Linezolid was administered with good response, and the patient was discharged after 18 days of hospitalization. Her symptoms and pulmonary lesions had recovered, and the IPH appeared to be well-controlled with low dose of corticosteroids in follow-up.

Conclusions

Nocardia infection should be considered in the differential diagnoses for IPH patients receiving corticosteroid therapy, especially in patients with poor response to conventional empirical antibiotic therapy. Next-generation sequencing of bronchoalveolar lavage fluid may be used to quickly identify the Nocardia. Sulfonamides or linezolid are effective for pediatric pulmonary Nocardia infection.
Mid-long-term results of total knee arthroplasty followed by ipsilateral total hip arthroplasty versus total hip arthroplasty subsequent to ipsilateral total knee arthroplasty: a case-control analysis
Authors: Liu Zunhan , Zeng Wei-Nan , Luo Zhenyu , Zhao Enze , Li Hao , Zhou Zongke
Published: June 2021

Background

The aim of the present study was to compare the outcomes of patients who underwent different sequences of ipsilateral total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Methods

We retrospectively identified 47 patients who underwent TKA followed by ipsilateral THA (THA-TKA) and 36 patients who received THA subsequent to ipsilateral TKA (TKA-THA) for rheumatoid arthritis or osteoarthritis between January 2008 and April 2014. Twenty-eight patients were selected for each group after case-control matching with preoperative demographics and protheses of THA. Clinical scores, radiographic results, complication rates, and survivorship were compared. The median duration of follow-up was 110 (range 80–149) months.

Results

Both groups showed significant improvement in Harris Hip Scores, Knee Society Score, and Short Form-12 at the last follow-up compared to baseline (p < .001). At the last follow-up, all clinical scores were actually lower in the THA-TKA group, but those differences were not statistically significant. Otherwise, there was no significant difference in radiological alignment or complication rates. The survivorship of THA and TKA in the THA-TKA group was 94.7 and 95.7%, respectively, compared with 92.4 and 100.0% in the TKA-THA group at 8 years (log rank, p = .939 and .187).

Conclusions

Patients who underwent ipsilateral THA and TKA with different sequences achieved similar favorable outcomes. Total joint arthroplasty can be performed safely with excellent outcomes in patients with a history of prior ipsilateral THA or TKA.

Trial registration

The trial was registered in the Chinese Clinical Trial Registry (ChiCTR2000035147) dated 2 August 2020.
Combining paid work and family care for a patient at the end of life at home: insights from a qualitative study among caregivers in the Netherlands
Authors: Bijnsdorp Femmy M. , Onwuteaka-Philipsen Bregje D. , Boot Cécile R.L. , van der Beek Allard J. , Klop Hanna T. , Pasman H. Roeline W.
Published: June 2021

Background

Population ageing, an emphasis on home-based care of palliative patients and policies aimed at prolonging participation in the labour market are placing a growing demand on working family caregivers. This study aimed to provide insight into experiences with combining paid work and family care for patients at the end of life, factors facilitating and hindering this combination, and support needs.

Method

Semi-structured interviews were held between July 2018 and July 2019 with 18 working family caregivers of patients with a life-threatening illness who were living at home. Transcripts were analysed following the principles of thematic analysis.

Results

Some family caregivers could combine paid work and family care successfully, while this combination was burdensome for others. Family caregivers generally experienced a similar process in which four domains — caregiver characteristics, the care situation, the work situation and the context — influenced their experiences, feelings and needs regarding either the combination of paid work and care or the care situation in itself. In turn, experiences, feelings and needs sometimes affected health and wellbeing, or prompted caregivers to take actions or strategies to improve the situation. Changes in health and wellbeing could affect the situation in the four domains. Good health, flexibility and support at work, support from healthcare professionals and sharing care tasks were important in helping balance work and care responsibilities. Some caregivers felt ‘sandwiched’ between work and care and reported physical or mental health complaints.

Conclusions

Experiences with combining paid work and family care at the end of life are diverse and depend on several factors. If too many factors are out of balance, family caregivers experience stress and this impacts their health and wellbeing. Family caregivers could be better supported in this by healthcare professionals, employers and local authorities.
Modeling spatial determinates of teenage pregnancy in Ethiopia; geographically weighted regression
Authors: Tigabu Seblewongel , Liyew Alemneh Mekuriaw , Geremew Bisrat Misganaw
Published: June 2021

Background

In developing countries, 20,000 under 18 children give birth every day. In Ethiopia, teenage pregnancy is high with Afar and Somalia regions having the largest share. Even though teenage pregnancy has bad maternal and child health consequences, to date there is limited evidence on its spatial distribution and driving factors. Therefore, this study is aimed to assess the spatial distribution and spatial determinates of teenage pregnancy in Ethiopia.

Methods

A secondary data analysis was conducted using 2016 EDHS data. A total weighted sample of 3381 teenagers was included. The spatial clustering of teenage pregnancy was priorly explored by using hotspot analysis and spatial scanning statistics to indicate geographical risk areas of teenage pregnancy. Besides spatial modeling was conducted by applying Ordinary least squares regression and geographically weighted regression to determine factors explaining the geographic variation of teenage pregnancy.

Result

Based on the findings of exploratory analysis the high-risk areas of teenage pregnancy were observed in the Somali, Afar, Oromia, and Hareri regions. Women with primary education, being in the household with a poorer wealth quintile using none of the contraceptive methods and using traditional contraceptive methods were significant spatial determinates of the spatial variation of teenage pregnancy in Ethiopia.

Conclusion

geographic areas where a high proportion of women didn’t use any type of contraceptive methods, use traditional contraceptive methods, and from households with poor wealth quintile had increased risk of teenage pregnancy. Whereas, those areas with a higher proportion of women with secondary education had a decreased risk of teenage pregnancy. The detailed maps of hotspots of teenage pregnancy and its predictors had supreme importance to policymakers for the design and implementation of adolescent targeted programs.
Principles for pandemics: COVID-19 and professional ethical guidance in England and Wales
Authors: Smith Helen , Coulson-Smith Peta , Kennedy Mari-Rose , Birchley Giles , Ives Jonathan , Huxtable Richard
Published: June 2021

Background

During the arrival of the COVID-19 pandemic, various professional ethical guidance was issued to (and for) health and social care professionals in England and Wales. Guidance can help to inform and support such professionals and their patients, clients and service users, but a plethora of guidance risked information overload, confusion, and inconsistency.

Methods

During the early months of the pandemic, we undertook a rapid review, asking: what are the principles adopted by professional ethical guidance in England and Wales for dealing with COVID-19? We undertook thematic content analysis of the 29 documents that met our inclusion criteria.

Results

The 29 documents captured 13 overlapping principles: respect, fairness, minimising harm, reciprocity, proportionality, flexibility, working together, inclusiveness, communication, transparency, reasonableness, responsibility, and accountability.

Conclusions

We intend this attempt to collate and outline the prominent principles to be helpful, particularly, for healthcare practice during the COVID-19 pandemic and, hopefully, for future pandemic planning. We also offer some reflections on the guidance and the principles therein. After describing the principles, we reflect on some of the similarities and differences in the guidance, and the challenges associated not only with the specific guidance reviewed, but also with the nature and import of “professional ethical guidance”.
Economic status and catastrophic health expenditures in China in the last decade of health reform: a systematic review and meta-analysis
Authors: Yuan Qingqing , Wu Yuxuan , Li Furong , Yang Min , Chen Dandi , Zou Kun
Published: June 2021

Background

In order to solve the problem of “expensive medical treatment and difficult medical treatment” for patients and improve the equity of medical services, China started the health-care reform in 2009, and proposed ambitious goals of providing fair and high-quality basic medical and health services to all citizens and reducing economic burden of diseases. This study was to systematically explore the association between population economic status and incidence of catastrophic health expenditures (CHE) in mainland China in the last decade since 2009 health reform.

Methods

This systematic review was reported according to the standard of preferred reporting items for systematic reviews and meta-analyses (PRISMA). We systematically searched Chinese Electronic literature Database of China Journal Full Text Database, Chinese Biomedical Journal Database, Wan fang Data Resource System, VIP Database, and English literature databases of PubMed, SCI, EMbase and Cochrane Library from January 2000 to June 2020, and references of included studies. Two reviewers independently selected all reports from 2000 to 2020 for empirical studies of CHE in mainland China, extracted data and evaluated the quality of the study. We conducted meta-analysis of the incidence of CHE and subgroup analysis according to the time of the study and the economic characteristics of residents.

Results

Four thousand eight hundred seventy-four records were retrieved and eventually 47 studies with 151,911 participants were included. The quality scores of most of studies were beyond 4 points (91.49%). The pooled incidence of CHE of Chinese residents in the last two decades was 23.3% (95% CI: 21.1 to 25.6%). The CHE incidence increased from 2000 to 2017, then decreased over time from 2017 to 2020. From 2000 to 2020, the CHE incidence in rural areas was 25.0% (95% CI: 20.9 to 29.1%) compared to urban 20.9% (95% CI: 18.3 to 23.4%); the CHE incidence in eastern, central and western China was 25.0% (95% CI: 19.2 to 30.8%), 25.4% (95% CI: 18.4 to 32.3%), and 23.1% (95% CI: 17.9 to 28.2%), respectively; the CHE incidence was 30.9% (95% CI: 22.4 to 39.5%), 20.3% (95% CI: 17.0 to 23.6%), 19.9% (95% CI: 15.6 to 24.1%), and 23.7% (95% CI: 18.0 to 29.3%) in poverty group, low-income group, middle-income group, and high-income group, respectively.

Conclusions

In the past two decade, the incidence of CHE in rural areas is higher than that of urban residents; higher in central areas than in eastern, western and other regions; in poverty households than in low-income, middle-income and high-income regions. Further measures should be taken to reduce the incidence of CHE in susceptible people.
Circulating ANGPTL8 levels and risk of kidney function decline: Results from the 4C Study
Authors: Zou Huajie , Xu Yongping , Meng Xiaoyu , Li Danpei , Chen Xi , Du Tingting , Yang Yan , Chen Yong , Shao Shiying , Yuan Gang , Zhou Xinrong , Hu Shuhong , He Wentao , Ma Delin , Xie Junhui , Zhang Benping , Zhang Jianhua , Li Wenjun , Liu Zhelong , Yu Xuefeng
Published: June 2021

Background

ANGPTL8, an important regulator of lipid metabolism, was recently proven to have additional intracellular and receptor-mediated functions. This study aimed to investigate circulating levels of ANGPTL8 and its potential association with the risk of kidney function decline in a cohort study.

Methods

We analysed 2,311 participants aged 40 years old and older from the China Cardiometabolic Disease and Cancer Cohort (4C) Study. Kidney function decline was defined as an estimated glomerular filtration rate (eGFR) less than 60 mL per minute per 1.73 m2 of body surface area, a decrease in eGFR of ≥ 30% from baseline, chronic kidney disease (CKD)-related hospitalization or death, or end-stage renal disease. The association between baseline ANGPTL8 levels and kidney function decline was assessed using multivariable-adjusted Cox proportional hazards models, and inverse possibility of treatment weight (IPTW) was utilized to prevent overfitting.

Results

There were 136 (5.9%) cases of kidney function decline over a median of 3.8 years of follow-up. We found that serum ANGPTL8 levels at baseline were elevated in individuals with kidney function decline compared to those without kidney function decline during follow-up (718.42 ± 378.17 vs. 522.04 ± 283.07 pg/mL, p < 0.001). Compared with the first quartile, multivariable-adjusted hazard ratio (95% confidence intervals [CIs]) for kidney function decline was 2.59 (95% CI, 1.41–4.77) for the fourth ANGPTL8 quartile. Furthermore, compared with patients in the first ANGPTL8 quartile, those in the fourth ANGPTL8 quartile were more likely to report a higher stage of CKD (relative risk: 1.33; 95% CI, 1.01–1.74). The conclusions of the regression analyses were not altered in the IPTW models. Multivariable-adjusted restricted cubic spline analyses suggested a linear relationship of ANGPTL8 with kidney function decline (p for nonlinear trend = 0.66, p for linear trend < 0.001).

Conclusions

Participants with higher circulating ANGPTL8 levels were at increased risk for kidney function decline, highlighting the importance of future studies addressing the pathophysiological role of ANGPTL8 in CKD.