bluuebunny/crossref_metadata_2025 huggingface dataset:
A women’s perspective on premenstrual syndrome: a qualitative interview study
Authors: Labots-Vogelesang Marijke , Andringa Rachel Kooiman , Teunissen Doreth A M , Janssen Antoine LM Lagro
Published: July 2019

BMWH-D-18-00422
A women’s perspective on premenstrual syndrome: a qualitative interview study

Abstract
Background: Women who present with Premenstrual Syndrome (PMS) to healthcare professionals experience a lot of problems on their psychosocial functioning. Little is known however about the influence of PMS on the daily life of women in the general population. The aim of the present study is to improve our understanding of the perspective of women with PMS in the general population.
Methods: We recruited women with PMS via local newspapers and social media. We performed semi-structured interviews.
Results: We interviewed twenty women between 27 and 49 years of age. Physical and in particular psychological symptoms of PMS have a strong influence on the quality of life of women. Three themes emerged from our analysis. Women mentioned disturbance in their preferred roles of being a good mother and wife; experienced PMS as a life controlling condition and they used active and passive coping strategies with different expectations of healthcare.
Conclusion: The symptoms of PMS affect women at the level of their social role of femininity. These women are in need of acknowledgement and support as well from family and friends as from healthcare providers.
Word count: 3772 (abstract 211)

Keywords: Premenstrual Syndrome, Women’s Health, Social Role, Femininity, Interview, Coping, Acknowledgement
Development and Validation of a Brief Self-Assessed Wisdom Scale
Authors: Fung Sai-fu , Chow Esther Oi-wah
Published: July 2019

Background

This longitudinal study aimed to develop a nine-item Brief Self-Assessed Wisdom Scale (BSAWS) derived from the original 40-item Self-Assessed Wisdom Scale (SAWS).

Methods

The psychometric properties of the shortened scale were evaluated based on a sample of 157 older adults. The factor structure and dimensionality of the original SAWS were examined using confirmatory factor analysis. Subsequent explorative factor analysis of the BSAWS supported the construct validity of the shortened scale.

Results

The internal consistency, criterion validity and construct validity of the shortened scale were also evaluated and the results indicated that the BSAWS possesses good psychometric properties and is comparable with the full version.

Conclusions

This scale refinement may help researchers and practitioners conduct epistemological surveys or clinical research related to wisdom.
Geriatric scores can predict long-term survival rate after hip fracture surgery
Authors: Casa Carmen da , Pablos-Hernández Carmen , González-Ramírez Alfonso , Julián-Enriquez José Miguel , Blanco Juan F
Published: July 2019

Background

The management of hip fractures is nowadays mainly performed in Orthogeriatric Units, one of whose fundamental tools is the application of geriatric scores. The purpose of this study is to establish the potential usefulness of Barthel Index, Katz Index, Lawton-Brody Index and Physical Red Cross Scale geriatric scores as predictors of survival rate and readmission rate in older patients after hip fracture surgery.

Methods

We designed a prospective single-center observational study, including 207 older adults over age 65 who underwent hip fracture surgery in the first half of 2014 and followed up to September 2018. Cumulative survival and readmission rates were analyzed by Kaplan-Meier; group comparison, by Log-Rank and hazard ratio, by Cox regression.

Results

We found statistical differences (p<0.001) for cumulative survival rate by every geriatric score analyzed (BI HR=0.98 [0.97,0.99]; KI HR=1.24 [1.13-1.37]; LBI HR=0.80 [0.74,0.87]; PCRS HR=1.67 [1.37,2.04]). Furthermore, we could determinate an inflection point for survival estimation by Barthel Index (BI 0-55/60-100*, p<0.001, HR=2.37 [1.59,3.53]), Katz Index (KI A-B/C-G*, p<0.001, HR=0.38 [0.26,0.56], and Lawton-Brody Index (LBI 0-3/4-8*, p<0.001, HR=3.40 [2.09,5.25]). We reveal a correlation of the Charlson Index (p=0.002) and Katz Index (p=0.041) with number of readmissions for the study period.

Conclusions

The geriatric scores analyzed are related to the cumulative survival rate after hip fracture surgery for more than 4 years, independently of other clinical and demographic factors. Katz Index in combination with Charlson Index could also be a potential predictor of the number of readmissions after surgery for hip fracture patients.
Neoadjuvant chemoradiotherapy followed by surgery benefits patients aged 75 years or older with locally advanced rectal cancer
Authors: Liu Xiaoliang , Hu Ke , Zhang Fuquan , Hou Xiaorong , Xiao Yi , Lian Xin , Sun Shuai , Liu Zhikai , Yan Junfang , Miao Zheng
Published: July 2019

Background: To evaluate the efficacy and treatment related morbidity of neoadjuvant chemoradiotherapy and surgery in elderly patients (aged 75 years or older) with locally advanced rectal cancer (LARC).
Methods: We reviewed clinical records of elderly patients with LARC treated with neoadjuvant chemoradiotherapy from January 2008 to June 2017 at our institute. A dose of 45-50Gy in 25 fractions was delivered to pelvis. The primary tumor received a dose of 55Gy concomitantly. The concurrent chemotherapy included capecitabine alone and capecitabine plus oxaliplatin (Xelox). Surgery was performed for suitable patients at least 6 weeks after neoadjuvant treatment. Overall survival (OS), disease specific survival (DSS), disease free survival (DFS) and local control (LC) were calculated with Kaplan-Meier method. Univariate and multivariate analyses were performed with cox proportional hazards model. A two-side value of P<0.05 was defined as statistical significance.
Results: A total of 85 patients were enrolled in this study, the median age was 80 years old (range: 75-90 years). After neoadjuvant treatment, surgery was performed in 56 patients (65.9%). Twelve patients (21.4%) obtained pathological complete response (pCR). The incidence of grade 3 or greater acute hematological, gastrointestinal and genitourinary toxicities were 10.7%, 5.2% and 1.8%, respectively. Seven patients (12.5%) experienced postoperative complications. The median follow-up duration was 35.7 months (range: 4.3-100.3 months), The 3-year OS, DSS, DFS and LC were 68.9%, 75.8%, 68.2% and 83.9%, respectively. Surgery was a significant prognostic factor for OS (HR: 10.092, 95%CI: 2.082-36.351, P<0.001), DSS (HR: 4.681, 95%CI: 1.971-11.113, P<0.001), DFS (HR: 5.509, 95%CI: 1.964-15.454, P=0.001) and LC (HR: 3.089, 95%CI: 1.244-11.669, P=0.019). Clinical T downstaging after neoadjuvant treatment was significantly associated with better DFS (HR: 4.554, 95%CI: 1.601-12.958, P=0.004).
Conclusion: In patients aged 75 years or older with LARC, neoadjuvant chemoradiotherapy followed by surgery was well tolerated with promising survival outcomes, which should be strongly suggested if medically suitable.
Does chemoradiotherapy benefit elderly patients with esophageal squamous cell cancer? A propensity-score matched analysis on multicenter data (3JECROG R-03A)
Authors: Liu Xiao hong , Chen Mingqiu , Han Chun , Wang Xin , Zhao Yidian , Pang Qingsong , Sun Xinchen , Li Gaofeng , Zhang Kaixian , Li Ling , Qiao Xueying , Lin Yu , Chen Junqiang , Xiao Zefen
Published: July 2019

Aim
The aim of the present study was to investigate the prognostic factors in elderly patients with esophageal squamous cell carcinoma (ESCC) treated with concurrent chemoradiotherapy (CRT) or radiotherapy alone (RT-alone), and to establish the efficacy of CRT.
Methods
The clinical data of patients with ESCC treated with RT-alone or CRT were collected and retrospectively reviewed. The overall survival (OS) rates and the clinical characteristics correlated with survival were analyzed statistically. Propensity score matching (PSM) analyses were used to compensate for differences in baseline characteristics between the CRT and RT-alone groups to confirm the survival difference.
Results
A total of 729 patients fulfilling the inclusion criteria were reviewed. Diabetes, primary tumor volume (pTV), primary tumor location (pTLo), clinical T stage,(cT) clinical N stage (cN), clinical M stage (cM) and short-term response to RT were independent factors influencing OS (P=0.002-0.044). The 5-year OS rate was 26.6%, 26.0% and 30.1% in the whole cohort, RT-alone and CRT groups, respectively. The survival difference between RT alone and CRT was not significant before or following PSM. Compared with the corresponding subgroups treated with RT alone, CRT significantly benefited patients with diabetes (P=0.003), cT4 (P=0.030) and cN0 (P=0.049), whereas no benefit was identified between CRT and RT alone in the other subgroups, including cT1-3, cN1, cM, pTLo, pTV, age and gender.
Conclusions
CRT with the current chemotherapy regimens may not improve the survival of elderly ESCC patients compared to RT-alone, except in patients with cT4 stage, cN0 stage or diabetes. However, due to the limitation of the retrospective nature of the current study, further clinical trials are required for confirmation.

Key words: Concurrent chemoradiotherapy; Elderly; Esophageal squamous cell carcinoma; Survival
Bone metastases at initial diagnosed breast cancer — A retrospective study based on SEER database
Authors: Wang Zheng , Tang Xiaoli , Zhang Qi , Wu Xiaoqing , Yang Meiyuan , Jin Zhixiang , Wang Daorong
Published: July 2019

Background

To explore the features of incidence proportions and long-term survivals of breast cancer patients with bone metastasis when first diagnosed.

Methods

Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute. Stratifications were made according to molecular subtype, age, sex, race and other factors. We performed multivariable logistic and Cox regression analysis to detect predictors of occurrence of bone metastasis at first diagnosis and factors related to all-cause mortality.

Results

We identified 310789 patients with breast cancer within the study period. Approximately 3.6% patients were diagnosed as bone metastasis within the entire cohort and 50.5% of the metastasis cohort. The highest incidence was from the cohorts of HR+/HER2+ (5.0% of the entire cohort). N3, metastases to brain, lung and liver were associated with higher possibility of developing bone metastases. For survival, HR+/HER2+ experience the longest survival time (41 months) and triple-negative patients had the shortest survival period (10 months). lymph node status other than N0 and distal metastasis to brain, lung and liver as possible factors which were associated with higher all-cause mortality.

Conclusions

We recommend routine bone screen at first diagnosis within high risk patients.
Developing a Consolidated Research Career Competency Framework for Allied Health Professionals
Authors: Harris Jennifer Deborah , Grafton Kate , Cooke Jo
Published: July 2019

Background
Allied Health Professionals (AHPs) form a significant part of the healthcare workforce, and have a great potential to improve services through research and research informed practice. However, there is a lack of tradition in undertaking research alongside practice in these professional groups. Barriers include clinical caseload pressures, a lack of training and consequent lack of confidence in practitioners. Practice managers are ill-equipped to monitor and guide staff research development. Uni-professional competency frameworks can act as further barriers to research culture across the healthcare system that is moving toward multi-disciplinary research focussing on the patient. A common framework, acceptable to all AHPs might be helpful in planning and developing clinical career pathways.
Methods
Aim: to develop a consolidated framework of research competency to help plan and guide research activity throughout AHP clinical-academic careers. The study was conducted in three phases. Phase one identified existing AHP research frameworks (AHPRF) through expert consultations and literature searches. Phase two involved thematic content of the AHPRFs to develop a single consolidated framework. Phase three included a workshop with experts to validate and adapt the framework for practice.
Results
19 AHPRFs were identified. A consolidated framework was shaped by content analysis of the AHPRFs resulting in a consolidated framework of eight sections, each containing a series of competencies. Each section relates to an analytic theme within the content analysis, and the competencies were based on analytic sub-categories of themes. The final framework was further shaped by the phase three workshop into a set of ‘stem’ competency statements that can be adapted to reflect different levels of expertise. It also includes a set of guiding principles for use.
Conclusion
The consolidated framework was entitled ‘Shaping Better Practice Through Research: A Practitioner Framework’ by stakeholders, thus emphasising its ambition to embed research activity into practice. It instigates a new perspective within AHP research by offering practitioners and managers a tool that can be applied across public, private and voluntary settings for AHPs in all disciplines. Its ambition is to develop capacity in the AHPs that can undertake research to improve services and the health of service users.
Nasopharyngeal carriage, spa types and drug susceptibility profiles of Staphylococcus aureus from healthy children under 5 years in eastern Uganda
Authors: Kateete David , Asiimwe Benon B , Mayanja Raymond , Mujuni Brian , Bwanga Freddie , Najjuka Christine F , Källander Karin , Rutebemberwa Elizeus
Published: July 2019

Background

Staphylococcus aureus carriage is a known risk factor for staphylococcal disease. However, the carriage rates vary by country, demographic group, etc. This study aimed to determine the S. aureus carriage rate in Ugandan children, and track Staphylococcus strains that can cause infection in Uganda.

Methods

Nasopharyngeal samples (one per child) from 742 healthy children under 5 years living in Iganga/Mayuge Health & Demographic Surveillance Site in eastern Uganda were processed for isolation of S. aureus. Genotyping was performed by spa typing and pulse field gel electrophoresis.

Results

The processed samples yielded 144 S. aureus isolates (one per sample/child) therefore, the S. aureus carriage rate in the children was 19.4% (144/742). Further, 45 (31.3%, 45/144) of the isolates were methicillin resistant (MRSA) yielding a carriage rate of 6.1% (45/742). All MRSA isolates were susceptible to vancomycin, linezolid and clindamycin however, compared to methicillin susceptible S. aureus (MSSA) isolates (68.8%, 99/144), MRSA were more resistant to non-beta-lactam antimicrobials –tetracycline (91.1%, 41/45), trimethoprim/sulfamethoxazole (73.3%, 33/45), erythromycin (75.6%, 34/99), chloramphenicol (60%, 19/99), gentamicin (55.6%, 25/45) and ciprofloxacin (35.6%, 16/45). Furthermore, an MRSA isolate was mupirocin resistant and 42 (93.3%, 42/45) were multidrug resistant (MDR); three (3%, 3/99) MSSA isolates were mupirocin and clindamycin resistant while 61 (61.6%, 61/99) were MDR. All MSSA/MRSA isolates were susceptible to rifampicin, vancomycin and linezolid but only two were pan-susceptible to the tested antibiotics. Seven spa types were detected in MRSA, of which t064 & t037 were predominant and associated with SCCmec types I & IV, respectively. Fourteen spa types were detected in MSSA, of which t645 & t4353 were predominant.

Conclusions

S. aureus (MSSA/MRSA) carriage rate in children in rural eastern Uganda is high and comparable to rates for hospitalized patients in Kampala city. Detection of mupirocin resistance is worrying as it could rapidly increase in a low-income setting should mupirocin be used for staphylococcal decolonization. Further, S. aureus strains of spa types t064, t037, t645 & t4353 are prevalent and could be responsible for majority of staphylococcal infections in Uganda.
Prevalence and Predictors of Computer Vision Syndrome among Secretary Employees working in Jimma University, Southwest Ethiopia: A Cross Sectional Study at Jimma University
Authors: Tesfa Mekonnin , Sadik Mohammed Ibrahim , Markos Yohannes , Aleye Leyla Temam
Published: July 2019

Background

Computer vision syndrome (CVS) is a group of ocular and extra-ocular symptoms experienced in relation to computer use. Nearly 60 million people suffer from CVS globally with a million of new cases occurring each year. The discomfort associated with this disorder result in increased error rate, reduced job satisfaction and work productivity. The problem has become a workplace concern among computer users especially in those occupationally exposed. The magnitude of CVS and its determinants are not well known in Ethiopia. Therefore, the aim of this study was to determine prevalence and predictors of computer vision syndrome among secretaries working in Jimma University, Ethiopia.

Methods

An institution based cross-sectional study was conducted on a total of 217 secretary employees working in Jimma University. An interviewer administered pre-tested structured questionnaire was used to collect data. Collected data was analyzed using SPSS version 20.0. Multivariable logistic regression analysis was done to identify the independent predictors for CVS.

Results

A total of 217 secretaries were included in the study and all of them were females. The prevalence of CVS among study participants was 75.6%. Blurred vision 88(40.6%), extra-ocular symptoms 75(34.6%), eyestrain 66(30.4%) and headache 63(29.0%) were the most commonly reported symptoms of CVS. Factors significantly associated with CVS were duration of occupation (AOR=3.165; 95% CI=1.16, 8.57), average time spent on computer per day (AOR=3.163; 95% CI=1.52, 6.59), computer brightness adjustments (AOR=2.81; 95% CI=1.22, 6.47) and awareness on CVS and its prevention measures (AOR=5.385; 95% CI= 2.55, 11.35).

Conclusion

This study revealed that CVS was highly prevalent among secretary employees working in Jimma University. Duration of occupation, average time spent on computer per day, awareness about CVS and its prevention measures and adjustments of computer brightness were the independent factors associated with computer vision syndrome. Secretaries should aware that CVS is a problem that can be prevented by proper use of computer at work place and therefore a means to increase their awareness should be considered.
A RE-AIM Evaluation of a multi-modal real-world intervention for dementia risk reduction
Authors: Stirling Christine , Merl Helga , Arunachalam Indra , Turner Ashley , King Carolyn
Published: July 2019

Background

This implementation study evaluated a novel community-based Memory Wellness Program targeting dementia risk reduction through increasing health knowledge and health promoting behaviours in older adults. The nurse-led eight-week program involved the following behaviour change strategies: goal-setting, education, group activity, and introduction to the use of iPads and Misfit activity trackers. The multi-model program was delivered in a realworld setting using pop-up clinics run by a Registered Nurse, across 18 different sites.

Methods

Using a quasi-experimental mixed methods design, and a RE-AIM framework, the study evaluated the reach, effectiveness, adoption, implementation and maintenance of the MWP. A total of 179 older adults aged 65 years and over participated in the evaluation across eighteen locations in three states and a territory of Australia. Paired t-tests were carried out on all pretest-posttest clinical data. In-depth interviews were conducted with seventeen participants and staff.

Results

Engagement in the program was associated with improved cognition, lowered BP and stress and increased engagement with technology. There was a trend towards reduced feelings of loneliness. Participants’ main motivations for undertaking the program were to improve memory, meet new people and improve technology use and computer literacy, with most participants reporting that these goals had been met through the program. The program was effective across multiple sites demonstrating it can successfully be implemented in different contexts and that the range of behaviour change techniques suit a useful multi-modal program.

Conclusions

This evaluation of a community-based Memory Wellness Program demonstrated increased cognitive function in older adults presenting with concerns about their cognition and memory. The statistically significant results and medium to large effect sizes suggest that further research is warranted to assess the efficacy of multi-modal community-based programs for improving memory and mental health with a focus on dementia risk reduction in older adults.
The Response of Second Line Chemotherapy Platinum Resistant Ovarian Cancer in Sudan: 2013-2017
Authors: Alshykh Mohammed Altyb , Essa Mohammed Elmujtba Adam , Suleiman Yousra Abdelmoniem , Osman Sherihan Mohammed Elkundi , Haron Mutwaly Defealla Yousif , Hussein Mustafa Mohamed Ali , Abdelrahim Shiemaa Emad , Osman Leena Habeeb Allah , Mohamed Saja Hassan , Rahama Salma Ismaeel , Ali Saneyya Alsir , Abdullahi Sadiya Aminu , Musa Suha Abdallah , Ahmed Abdelkareem A.
Published: July 2019

Background

Ovarian carcinoma is the fifth leading cause of cancer death worldwide. The tumor mostly associated with variant factors such as advance age, early menstruation and gene association. We aimed to highlight the effectiveness of the second line chemotherapy in the management of ovarian cancer patients in Sudan.

Methods

The data were collected from the hospital patient’s records for five years period of time, included 62 patients with ovarian cancer who is treated by the second line platinum resistant chemotherapy.

Result

The peak prevalence of the patients was found in Aljazeera state, and the least in Algadarif state. Age group above 55 years was the most affected group. The vast majority of patients showed partially mass disappearing, completes and continue growing tumor respectively. All patients received variant cycles of chemotherapy as fellow 3, 6, 2, 4, 5, 1 cycle respectively. 79.4% of the patients had achieved the normal value of cancer antigen 125 (CA125) levels after the treatment. 50% of patients had 1-2 months interval time before the cancer recurrence, 32.2% had 3-4 months and 17.8% had 5-6 months before the disease recurrence. The serous adenocarcinoma was found to be the most histological type in all the patients and the least two types were observed are cell carcinoma and serous papillary.

Conclusion

Our findings suggested that, Aljazeera state citizens were more vulnerable to resist the first line chemotherapy than others. The Sudanese patients with ovarian cancer may have better response to Gemzar.
Comparing the safety and efficacy of endovascular treatment versus bypass surgery for infrarenal aortic occlusion: a single-center experience
Authors: Wang Jingjing , Shao Jiang , Qiu Chenyang , Fang Lijing , Li Kang , Lei Jinsong , Xu Leyin , Zhang Xin , Liu Xiu , Lai Zhichao , Liu Bao
Published: July 2019

Background

Infrarenal aortic occlusion (IAO) is a complete occlusion of infrarenal aorta, which is the most complicated and severe subclass of aortoiliac occlusive disease(AIOD). The first-line treatment for IAO is bypass surgery due to its favorable patency rate. As endovascular technique advances, several retrospective studies have reported their endovascular experience for IAO. However, whether endovascular treatment(EVT) is comparable to bypass surgery for IAO required further study. This research was to study the safety and efficacy of EVT for IAO compared to bypass surgery.

Methods

From 2003 to 2017, 44 consecutive patients with IAO was treated with EVT(n=16) or aortofemoral bypass surgery(n=28). The therapeutic strategy depended on patient’s will and state of health. Demographics, comorbidity, mortality, complication rate, and symptom-free survival proportion was compared by T-tests or chi-square test, to illustrate the safety and efficacy of EVT and bypass surgery.

Results

The demographics and pre-operative Rutherford classification equally distributed in the two groups(P>0.05). As for technical success, comorbidities, mortality, complication rate, and Rutherford classification after procedures, clinical success, no significant difference was observed(P>0.05). The median post-procedure hospital stay was 4 days in the EVT group and was significantly shorter than that of the bypass, which was 11 days(P<0.05). As for short-term and long-term results, the 1-year, 3-year, and 5-year the cumulative symptom-free survival rates were 85.7%, 85.7% and 85.7% in the EVT group, 100%, 94.1% and 80.7% in the aortofemoral bypass group. There was no significant difference in symptom-free survival rate between the two groups according to log-rank test (P=0.92)

Conclusions

The safety and efficacy of EVT were comparable to that of anatomic bypass surgery for IAO. EVT could be a feasible option for IAO.
Why are patients discontented after total knee arthroplasty when the orthopedic surgeons are contented?
Authors: Mahdi Aamir , Svantesson Mia , Wretenberg Per , Hälleberg Maria
Published: July 2019

Background

Total knee arthroplasty is a common procedure with generally good results. However, there are still patients who are discontented without known explanation. Contentment and discontentment have previously been captured by quantitative designs, but there is a lack of qualitative studies regarding these patients’ experiences. Qualitative knowledge might be useful in creating strategies to decrease the discontentment rate.

Methods

Of the 348 patients who responded to a letter asking if they were contented or discontented with their surgery, 61 (18%) reported discontentment. After excluding patients with documented complications and those who declined to participate, semi-structured interviews were conducted with 44 patients. The interviews were analyzed according to qualitative content analysis. The purpose was to describe patients’ experiences of discontentment one year after total knee arthroplasty.

Results

The patients experienced unfulfilled expectations and needs regarding unresolved and new problems, limited independence, and need for buttresses. They were bothered by pain and stiffness, and worried that changes were complications as a result of surgery. They described inability to perform daily activities and valued activities. They also felt a need for buttresses, and a lack of respect and continuity, support from health care, and information adapted to their needs.

Conclusion

Patient expectation seems to be the major contributing factor in patient discontentment after knee replacement surgery. This qualitative study sheds light on the meaning of unfulfilled expectations, in contrast to previous quantitative studies. The elements of unfulfilled expectations need to be dealt with both on the individual staff level and on the organizational level. For instance, increased continuity of healthcare staff and facilities may help to improve patient contentment after surgery.
Seeking Resilience: The Care Capacity Goals of Family Carers and the Role of Technology in Achieving Them
Authors: Leslie Myles , Gray Robin Patriccia , Eales Jacquie , Fast Janet , Magnaye Andrew , Khayatzadeh-Mahani Akram
Published: July 2019

Background

As global populations age, governments have come to rely heavily on family carers (FCs) to care for older adults and reduce the demands made of formal health and social care systems. Under increasing pressure, FCs’ resilience and the sustainability of their unpaid care work have become pressing issues. This paper explores FCs’ care-related work goals and how those goals do, or do not, link to technology.

Methods

We employed a sequential mixed-method approach using focus groups followed by an online survey about FCs’ goals. We held 10 focus groups and recruited 25 FCs through a mix of convenience and snowball sampling strategies. Carer organizations helped recruit 599 FCs from across Canada to complete an online survey. Participants’ responses to an open-ended question in the survey were included in our qualitative analysis. An inductive approach was employed using qualitative thematic content analysis methods to examine and interpret the resulting data. We used NVIVO 12 software for data analysis.

Results

We identified two care quality improvement goals of FCs providing care to older adults: enhancing and safeguarding their caregiving capacity. To enhance their capacity to care, FCs sought: 1) foreknowledge about their care recipients’ changing condition, and 2) improved navigation of existing support systems. To safeguard their own wellbeing, and so to preserve their capacity to care, FCs sought to develop coping strategies as well as opportunities for mentorship and socialization.

Conclusions

We conclude that a paradigm shift is needed to reframe caregiving from a current deficit frame focused on limitations (burden of care) towards a more empowering frame (sustainability and resiliency). The fact that FCs are seeking strategies to enhance and safeguard their capacities to provide care means they are approaching their unpaid care work from the perspective of resilience. Their goals and technology suggestions imply a shift from understanding care as a source of ‘burden’ towards a more ‘resilient’ and ‘sustainable’ model of caregiving. Our case study findings show that technology can assist in fostering this resiliency but that it may well be limited to the role of an intermediary that connects FCs to information, supports and peers.
Functional and anatomical characterization of a non-leaking bilateral cystoid macular edema induced by paclitaxel therapy for ovarian cancer: a case report
Authors: Hoffmann Stephan , Ganster David , Sidoroff Patrick , Mennel Stefan
Published: July 2019

Abstract:
Background: Paclitaxel is a member of the taxane family used for cancer therapy. Ovarian cancer is treated with Paclitaxel in first- and in second- line therapy. Cystoid macular edema without fluorescein leakage is a rare side effect of Paclitaxel treatment.
Case presentation: We report the case of a 59-year-old female with ovarian cancer treated with paclitaxel. The patient received 21 cycles of adjuvant chemotherapy and was presented with bilateral gradual vision loss due to macular edema after paclitaxel treatment. Optical coherence tomography revealed a bilateral cystoid macular edema. Fluorescence angiography demonstrated the unusual finding of non-leakage in the late phases of the angiogram. Microperimetric findings of both eyes confirmed the visual deficits. After cessation of the paclitaxel therapy, vision, OCT and microperimetric findings returned to normal. Also, color vision testing demonstrated no persistent defect after therapy cessation.
Conclusion: Paclitaxel induced bilateral maculopathy is a rare side effect of chemotherapy. Cessation of the Paclitaxel drug therapy leads to complete functional and anatomical resolution of drug induced side effects. Vision, microperimetric defects, color perception as also anatomical defects detected by OCT change to normal after drug cessation.
Taxane induced bilateral maculopathy is a rare disease which should be known by ophthalmologists as also oncologists. Paclitaxel therapy must be counseled to report any vision problems during the treatment period because early recognition of a rare non leaking CME can facilitate appropriate intervention to reverse visual compromise and minimize any potential long-term ophthalmologic sequelae.
Assessment of Biotechnological Potential of Cyanobacteria and Microalgae Strains from IPPAS Culture Collection
Authors: Sidorov R.A. , Starikov A.Yu. , Voronkov A.S. , Medvedeva A.S. , Krivova Z.V. , Pakholkova M.S. , Bachin D.V. , Bedbenov V.S. , Gabrielyan D.A. , Zayadan B.K. , Bolatkhan K. , Los D.A.
Published: July 2019

As a result of screening of spore-forming bacteria, a B-13186 strain with a wide spectrum of antagonistic activity identified as Brevibacillus laterosporus by the analysis of sequences of variable sites of 16S rRNA was selected. Morphological, cultural and biochemical characteristics of the strain were studied. A distinctive feature of the strain is the presence of a canoe-like inclusion formed in sporangia and attached to the mature spore, as well as the ability to synthesize round-shaped crystalline inclusions. The strain was shown to be active against various species of gram-positive bacteria including A search for strains capable of simultaneously producing high amounts of several biologically valuable compounds and/or having high biomass productivity has been carried out. The growth characteristics and biochemical composition of 12 microalgae and cyanobacteria strains from the IPPAS Collection in the exponential and stationary growth phases were studied. All the strains had high growth rates (doubling time 6-22 h). The strains of Cyanobacterium sp. IPPAS B-1200, Chlorella sp. IPPAS C-1210, Nannochloris sp. IPPAS C-1509, Cyanidium caldarium IPPAS P-510 and Vischeria sp. IPPAS H-242 demonstrated the highest biotechnological potential and can be used for the production of various types of biofuel, pigments, feed and food additives, including those with high content of eicosapentaenoic (20:5 Δ5,8,11,14,17) acid content. microalgae, cyanobacteria, biochemical composition, fatty acids, valuable metabolites, growth characteristics This work was supported by a grant from the Russian Science Foundation [no. 14-14-00904]
Highly Active Modified Variants of Recombinant Phospholipase А2 from Streptomyces violaceoruber for Effective Biosynthesis in Yeasts
Authors: Sannikova E.P. , Malysheva A.V. , Klebanov F.A. , Kozlov D.G.
Published: July 2019

The capacity of yeast to produce the highly active variants of PLA2 has been confirmed. The high-active variants were based on the original enzyme from the strain А-2688 of Streptomyces violaceoruber. To reduce the enzyme toxicity and to increase its expression, various approaches were tested including point mutations, construction of artificial N- and/or C-end pro-regions, hybridization with other proteins and engineering or inactivation of glycosylation sites. As a main result, the modified PLA2 enzymes were obtained which have the same secretion level as their low-active predecessors, but specific activity of which was at least tenfold higher. As the main feature, the selected mutants were characterized by a lower affinity for Ca2+ that probably accounts for their low toxicity (and high expression capacity) at the stage of biosynthesis and their ability to activate under special conditions, e.g. during the egg yolk fermentation. The data obtained can provide a basis for the cost reduction of highly active PLA2 enzyme preparations in industries where the application of high calcium concentrations is allowed.

recombinant phospholipase А2, Streptomyces violaceoruber, yeasts, secretion, producer strain

The work was initiated by the Innovation Center Biriuch - New Technologies, Ltd., and was supported within the framework of the State Assignment no. 595-00004-18 PR.
Politics of Female Identity in Traditional Java through the Prism of Pramoedya A. Toer’s Gadis Pantai
Authors: Sofi Muhammad Jauhari
Published: July 2019

Identity is political rather than natural. It is always influenced by the politics of race, class, gender, religion, education, disability, and so on. This paper examines the complexity of political forces that shape female identity at the beginning of the 20th century Java and the reaction the women show in response to the circumstances where they find themselves, with reference to Pramoedya Ananta Toer’s Gadis Pantai. The novel, which is based on the true story of his own grandmother, portrays the life of a practice wife of priyayi, the hereditary governing class of Java. Using interpretive analysis and close reading of the text, the study argues that feudal and patriarchal circumstances help shape female identity in the 20th century Java. Women are doubly discriminated; they find themselves subject to higher powers, i.e. the powers of the feudal lord and the male. However, throughout the novel, the author displays a brand-new female image different from the socially dominant discourses, an image that has qualities of rebellious fervor to trouble the discriminating social category of identity.
Improved genetic algorithm for parameters identification of cart-double pendulum
Authors: Dan Yuanhong , Xu Peng , Zhang Wei , Tan Zhi
Published: July 2019

Cart-double pendulum is a typical nonlinear under-actuated mechanical device, and highly sensitive to modeling error and external disturbance. Motion control of double pendulum is a very complex and difficult task, especially when it turns to real-time situation because a minor difference between kinetic model and actual device could lead to the necessity of significant adjustments according to control laws comparing to the usage of simulation controller. The use of accurate kinetic model is the key factor for fast transition from simulation to real-time operation. An improved genetic algorithm (IGA), which includes orthogonal experiment design, feedback mutation, pairing operation based on Hamming distance, and variable precision crossover operation, is introduced to identify the physical parameters of a double pendulum. The improved genetic algorithm (IGA) can overcome the shortcomings of the traditional genetic algorithm (TGA), for instance, premature convergence, and get results closer to the global optimal solution. The results of experiments demonstrate the effectiveness of the proposed method.
Does Acupuncture Have Any Benefit in the IVF Treatment of Couples with Unexplained Infertility; A Prospective Randomized Controlled Trial
Authors: Gonen Songul Ece , Kadirogullari Pınar , Seckin Kerem Doga , Borekci Bunyamin
Published: July 2019

Objective: We aimed to investigate the effect of acupuncture performed as an adjuvant therapy to in vitro fertilization, on pregnancy rates by performing acupuncture on the day of embryo transfer, one hour before the procedure and one hour after the procedure.Study Design: In this open-label randomized prospective controlled study, 60 unexplained infertility patients enrolled for in vitro fertilization treatment were randomized by a computer-based number generator for acupuncture performance and no-treatment. All patients received rFSH (Gonal-F®) for ovulation induction and the antagonist Cetrorelix (Cetrotide®) to prevent premature ovulation. Ovulation was triggered by using hCG (Ovitrelle®) and egg collection was done after 36-48 hours. In the study group, acupuncture was performed by intradermal needling, bilaterally with a sterile needle, both one hour before and one hour after the embryo transfer. Acupuncture was not performed on the control group. The results of the treatment were evaluated 12 days after embryo transfer.Results: Thirty patients were randomized into the study group and 30 patients were randomly placed in the control group. Although there was no statistically significant difference between groups in terms of β-hCG positivity, it was 43.3% in the study group and 36.7% in the control group (p>0.05).Conclusion: The success rate of in vitro fertilization was higher in terms of pregnancy rate in the patient group who received acupuncture procedure as well, but the difference was not statistically significant. This may be due to the type of acupuncture procedure selected or insufficient sample size. As a result, further studies involving larger numbers of participants and using different acupuncture techniques are needed.
ГИСТОЛОГИЧЕСКАЯ ХАРАКТЕРИСТИКА ТКАНЕЙ ПРИ ПРОЛАПСЕ ГЕНИТАЛИЙ
Authors:   Ташкентский институт усовершенствования врачей, Ф.Д. Каримова , М.Г. Гиясова
Published: July 2019

Currently, pelvic prolapse is a dangerous disease associated with the irreversible development of the pathology of the pelvic organs. The main cause of this pathological condition is the weakening or damage of the connective tissue-muscle structures of the pelvic floor.
ВОЗДЕЙСТВИЕ РАЗЛИЧНЫХ ФАКТОРОВ НА БИОПЛЕНКУ МИКРООРГАНИЗМОВ
Authors:   Ташкентская медицинская академия Узбекистан, З.А. Нурузова , Р.А. Байматов , С.Т. Жумамуродов
Published: July 2019

This article analyzes the last 10-year review of the literature on the structure and factors of influence on the biofilm of microorganisms, collected materials on the results of the effects of substances of both plant origin and chemical nature. Information is given on whether they can contribute to the formation of biofilms or, on the contrary, to its destruction
Anaesthesia for the Growing Brain
Authors: Raviraj Divya , Engelhardt Thomas , Hansen Tom G.
Published: July 2019

Despite the long history of paediatric anaesthesia, there is still much to be discovered regarding how
exposure to anaesthesia affects the developing brain. Given that commonly used anaesthetic agents are thought to
exert their effect via N-Methyl-D-Aspartate (NMDA) and gamma-aminobutyric acid A (GABAA) receptors, it is
biologically plausible that exposure during periods of vulnerable brain development may affect long term outcome.
There are numerous animal studies which suggest lasting neurological changes. However, whether this risk
also applies to humans is unclear given the varying physiological development of different species and humans.
Human studies are emerging and ongoing and their results are producing conflicting data. The purpose of this
review is to summarize the currently available evidence and consider how this may be used to minimize harm to
the paediatric population undergoing anaesthesia.
Design, In Silico Modelling, and Functionality Theory of Novel Folate Receptor Targeted Rutin Encapsulated Folic Acid Conjugated Keratin Nanoparticles for Effective Cancer Treatment
Authors: Kunjiappan Selvaraj , Panneerselvam Theivendren , Govindaraj Saravanan , Parasuraman Pavadai , Baskararaj Suraj , Sankaranarayanan Murugesan , Arunachalam Sankarganesh , Babkiewicz Ewa , Jeyakumar Aarthi , Lakshmanan Muthulakshmi
Published: July 2019

Objective:

Site-specific and toxic-free drug delivery, is an interesting area of research. Nanoengineered
drug delivery systems possess a remarkable potential for effective treatment of various types of
cancers.

Methods:

In this study, novel Folic Acid (FA) conjugated keratin nanoparticles (NPs) were assembled with
encapsulation and delivery of Rutin (Rt) into breast cancer cells through the overexpressed folate receptor. The
biocompatible, Rt encapsulated FA conjugated keratin NPs (FA@Ker NPs) were successfully formulated by a
modified precipitation technique. Their morphological shape and size, size distribution, stability, and physical
nature were characterized and confirmed. The drug (Rt) encapsulation efficiency, loading capacity and release
kinetics were also studied.

Results:

The observed results of molecular docking and density functionality theory of active drug (Rt) showed
a strong interaction and non-covalent binding of the folate receptor and facilitation of endocytosis in breast
cancer cells. Further, in vitro cytotoxic effect of FA@Ker NPs was screened against MCF-7 cancer cells, at 55.2
µg/mL of NPs and found to display 50% of cell death at 24h. Moreover, the NPs enhanced the uptake of Rt in
MCF-7 cells, and the apoptotic effect of condensed nuclei and distorted membrane bodies was observed. Also,
NPs entered into the mitochondria of MCF-7 cells and significantly increased the level of ROS which led to cell
death.

Conclusion:

The developed FA@Ker NPs might be a promising way to enhance anti-cancer activity without
disturbing normal healthy cells.
Pengembangan buku panduan permainan tradisional untuk meningkatkan kemampuan motorik kasar anak usia 5-6 tahun
Authors: Sulistyaningtyas Reza Edwin , Fauziah Puji Yanti
Published: July 2019

Penelitian ini bertujuan untuk: (1) mengembangkan desain buku panduan permainan tradisional untuk meningkatkan perkembangan motorik kasar anak usia 5-6 tahun dan (2) mengetahui kelayakan dan efektifitas panduan permainan tradisional untuk meningkatkan perkembangan motorik kasar. Jenis penelitian ini adalah penelitian dan pengembangan (Research & Development). Model pengembangan menggunakan ADDIE yang terdiri dari 5 tahap yaitu: analyze, design, development, implementation dan evaluation. Subjek yang digunakan untuk uji coba produk pada tahap implementasi sebanyak 4 kelas kelompok B (usia 5-6 tahun) yang terdiri dari 66 anak. Teknik pengumpulan data menggunakan pedoman wawancara, angket, observasi dan lembar unjuk kerja. Teknik analisis data menggunakan t-test dengan taraf signifikansi 0.05. Permainan tradisional dalam buku panduan diantaranya adalah permainan egrang tempurung/bathok, lompat tali dan engklek. Hasil perhitungan uji t-test diperoleh nilai α = 0.000, nilai tersebut kurang dari 0.05 (<0.05). Kesimpulan yang diperoleh bahwa buku panduan permainan tradisional efektif untuk meningkatkan kemampuan motorik kasar. Developing traditional games handbook to improve gross motor ability of 5-6 years-old AbstractThe research aimed to: (1) develop traditional games handbook to improve gross motor ability of 5-6 Years-Old Children, (2) knowing the apropriate by expert and effevtiveness of traditional games handbook to improve gross motor ability of 5-6 years-old. This type of research is research and development (R & D). The development model which was used in this research was ADDIE model. The model consisted of five steps, that was: analyze, design, develop, implement and evaluate. The subjects used for implementation steps were 4 groups into class B (5-6 years-old children) who were consisting of 66 children. Collecting data used interview guidelines, questionnaire, observation and children performance sheet. Data analysis techniques was t-test with significance level 0.05. The development of traditional games handbook was as egrang tempurung/bathok, lompat tali and engklek. The result of validation by expert and teachers found that the developed products are categorized into a “good” category. The development of traditional games is declared effective in improving the gross motor ability of children.
Аналіз результатів хірургічного лікування переломів дистального відділу плечової кістки
Authors: Loskutov O.E. , Domanskyi A.N. , Zherdev I.I. , Lushnya S.L.
Published: July 2019

Внутрішньосуглобові переломи дистального відділу плечової кістки, незважаючи на значну кількість різноманітних сучасних методів лікування, залишають високу питому вагу незадовільних результатів — 15–40 %, і хворі визнаються інвалідами у 18–20 % випадків. Консервативні методи лікування не дають можливості розпочати ранню функціональну активність у зв’язку з виникаючою нестабільністю уламків та сприяють розвитку контрактур у ліктьовому суглобі. Проведений ретроспективний аналіз результатів лікування хворих із переломами дистального відділу плечової кістки показав незадовільні результати, пов’язані з діагностичним, тактичними і технічними помилками, у 22 % хворих. Стабільно-функціональний остеосинтез переломів дистального відділу плечової кістки з можливістю активного раннього відновлення функції ліктьового суглоба сприяють зниженню термінів непрацездатності та дають позитивні результати в 78 % хворих.
Віково-статева характеристика постраждалих з інфекційними ускладненнями політравми в результаті ДТП
Authors: Guriev S.A. , Tanasienko P.V. , Kovalishen I.V.
Published: July 2019

Визначення клініко-епідеміологічних характеристик, таких як вік, стать, обставини виникнення травми, її механізм, дозволяє науково обґрунтовано вказувати на їх роль у розвитку інфекційних ускладнень серед постраждалих із політравмою в результаті дорожньо-транспортної пригоди (ДТП). Для вирішення завдань нашого дослідження нами був сформований ретроспективний масив дослідження, в яке увійшли 196 постраждалих з інфекційними ускладненнями та політравмою через ДТП. Проведене дослідження вказало, що серед постраждалих із політравмою в результаті ДТП інфекційні ускладнення найчастіше розвиваються у чоловіків і жінок вікової категорії 21–30 років. Серед постраждалих з інфекційними ускладненнями політравми як в результаті ДТП, так і через інші причини, превалюють особи працездатного віку 20–60 років, що було виявлено у 80,0–84,3  % випадків. Найрідше інфекційні ускладнення політравми реєструвались у постраждалих вікової категорії понад 71 рік, однак в основній групі вони виявлялись у 1,8 раза рідше, ніж у контрольній.