bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolución de la legislación brasileña sobre donación y trasplante de órganos
Authors: Victorino João Paulo , Karsburg Larissa Lemos , Brito Emanuele Seicenti , Ventura Carla Aparecida Arena
Published: March 2020

El trasplante de órganos representa uno de los capítulos más exitosos en la historia de la salud mundial. Esta práctica terapéutica ya no es asociada, como otrora, al riesgo del procedimiento, sino a la oportunidad de ofrecer una nueva vida al receptor. El trasplante depende de la aceptación de la donación de órganos que, por involucrar aspectos relacionados con la vida y la muerte, implica dilemas éticos que estimulan la formulación de normas a su respecto. Este estudio tuvo comoobjetivo reflexionar sobre la evolución de la legislación brasileña que regula el Sistema Nacional de Trasplantes en lo que se refiere al proceso donación-trasplante, teniendo como foco los aspectos bioéticos asociados a la temática. Se identificó que la comprensión de la legislación en materia de salud propicia una actuación basada en los derechos fundamentales y la dignidad humana por parte del profesional de la salud. Desde esta perspectiva, es esencial que los profesionales de la salud posean, además de conocimientos técnicos, conocimientos jurídicos y comprensión de las normas existentes y su evolución, con el fin de garantizar los derechos fundamentales de las personas.
Análise das publicações sobre os comitês de ética em pesquisa em Scientific Electronic Library Online (Scielo)
Authors: Almeida Neto João Beccon , Franco Tulio Batista
Published: March 2020

Considerando a importância do trabalho desenvolvido pelos Comitês de Ética em Pesquisa (CEPs) e sua implicação com a própria história da formação da bioética, o objetivo deste artigo é analisar as fontes de informação sobre os Comitês de Ética em Pesquisa envolvendo seres humanos presentes na Scientific Eletronic Library Online (SciELO), a fim de mapear os principais aspectos do campo nesta área. Trata-se de pesquisa exploratória descritiva com técnica de análise de revisão sistemática para coleta de dados. Foram recuperados 137 resumos, dos quais foram analisados 41. Pela análise dos dados, verifica-se que há uma intensificação nas publicações sobre este tema a partir de 2010, não apresentando uma clara concentração num periódico específico. A maior parte dos estudos é de cunho teórico e varia entre análises exploratórias de orientação descritiva sobre o papel dos CEPs e críticas sobre a forma em que estes elaboram seus pareceres. Observa-se uma intensificação do debate em relação à análise das pesquisas sociais. Nesse sentido, quatro questões nos parecem marcantes: (a) a ingerência promovida pelos CEPs em relação ao método das pesquisas; (b) a questão da análise ética das pesquisas oriundas das ciências humanas não pode ser vista como uma relação de inclusão ou exclusão; (c) a burocratização dos CEPs; e (d) a questão em relação à necessidade de acreditação dos CEPs.
La urgente tarea de estructurar una bioética latinoamericana
Authors: Kottow Miguel
Published: March 2020

Las raíces históricas que determinan el actual contexto material y cultural de Latinoamérica se remontan a la colonización eurocéntrica que durante tres siglos destruyó la estructura social y económica indígena e invalidó sus tradiciones y creencias. Las independencias nacionales logradas en el siglo XIX reemplazaron la dominación española por un neocolonialismo de hegemonía criolla coligada con economías transnacionales, entregada a afanes modernistas modelados en torno al centro anglosajón. Con la globalización económica impulsada por un capitalismo neoliberal que se ha impuesto sobre modelos políticos fracasados, el mundo cambió su dicotomía política ­–Occidente capitalista-Oriente socialista– por una división horizontal en Norte próspero y regiones Sur entrampadas en luchas políticas y adoleciendo de severas falencias socioeconómicas.
The Council of Europe's Reference Framework of Competences for Democratic Culture: Policy context, content and impact
Authors: Barrett Martyn
Published: March 2020

The Council of Europe's Reference Framework of Competences for Democratic Culture (RFCDC) was published in April 2018, and is currently being implemented in a number of Council of Europe member states. The RFCDC consists of three main components: a conceptual model of the competences
that learners need to acquire in order to respond appropriately and effectively to democratic and intercultural situations; validated and scaled descriptors and learning outcomes for all of the competences in the model; and guidance for ministries of education and education practitioners on
curriculum, pedagogy, assessment, teacher education, the whole-school approach, and building learners' resilience to radicalization. This article describes the policy background that motivated and accompanied the development of the RFCDC, and the process through which it was developed. It
also provides an overview of the contents of the RFCDC, and an explanation of the impact that the framework is beginning to have on Council of Europe actions in the sphere of formal education.
'Boosting resilience' and 'safeguarding youngsters at risk': Critically examining the European Commission's educational responses to radicalization and violent extremism
Authors: Christodoulou Eleni
Published: March 2020

Despite the Radicalisation Awareness Network (RAN) being tasked with being a core policy tool of the European Union and helping to shape its research funding agenda on preventing violent extremism, very little is known about how it operates, the practices and activities it engages with
and the discourses it mobilizes to do so. This study fills this gap through an in-depth investigation into RAN's working group on education, critically examining the construction and enactment of discourses and practices related to the prevention of violent extremism through education. Combining
a critical engagement of organizational practices with a discourse analysis of the various RAN EDU outputs, such as manifestos, policy papers and videos, it offers an examination of the discursive terrain of the European Commission, revealing the normative values and ideological assumptions
underpinning it, as well as the subject-positioning of students and teachers involved.
Pedagogical knowledge in English language teaching: A lifelong-learning, complex-system perspective
Authors: Dadvand Babak , Behzadpoor Foad
Published: March 2020

Pedagogical knowledge has been the subject of theoretical and empirical studies. However, no research has so far integrated the existing scholarship with data to develop and validate a framework for pedagogical knowledge in English language teaching informed by lifelong-learning, complex-system
perspectives. In the absence of such research, we used a mixed method research design through a systematic review of the literature, semi-structured interviews with experienced teachers (N=10) and teacher educators (N=10), as well as a survey of 336 practising teachers in Iran to: (1) develop
a framework for pedagogical knowledge; and (2) validate this framework by designing a self-assessment questionnaire for pedagogical knowledge. Our analyses yielded a nine-component model that included: knowledge of subject matter; knowledge of teaching; knowledge of students; knowledge of
classroom management; knowledge of educational context; knowledge of democracy, equity and diversity; knowledge of tests/exams; knowledge of learning; and knowledge of (professional) self. Within this nine-factor framework, each component of pedagogical knowledge consists of a number of subcomponents.
The proposed framework highlights the multidimensionality and complexity of pedagogical knowledge, and the mutually constitutive relationships among different knowledge domains.
“Dark Sides” of Organization’s Life: the Opportunities of Drawing Techniques
Authors: Chernyaeva Tatiana I.
Published: March 2020

The study of organizations and organizational behavior proceeds from a rational understanding of the tasks and resources of personnel management. At the same time, the phenomena of organizational disruption remain a marginal topic of organizational research. The history of studying the phenomena of the “dark side” has about twenty years, but the question of recursive methodology remains open.
The study used the “Metaphor” drawing technique proposed by A.I. Prigozhin. The participants were employees and heads of inspection divisions of the Federal Tax Service of Russia (239 people). An analysis of the drawings of organizations revealed the “dark sides” of organizational life: the conflict between official rhetoric and organizational reality; anxiety and alienation, decisions of the corruption plan, inconsistency of theory and practice, poor meaningfulness of organizational processes, powerful subject-object organizational communications, practices of domination, submission and organizational violence.
Visual Diary: How Photos Represent the Context of Field Research
Authors: Polukhina Elizaveta V. , Strelnikova Anna V. , Vanke Alexandrina V.
Published: March 2020

The article addresses the possibility of using visual data in field research. The article is based on the visual data obtained in the frame of the author's research projects of 2017—2019, aimed at studying everyday life of industrial workers in Yekaterinburg and the transformation of industrial territories in Moscow. The article is the additional visual material to the authors methodological manual “How to Collect Data in the Field [Qualitative] Research”. The authors have shown both the analytical significance of visual materials and their didactic potential. The article demonstrates how the research practice of photographing is organically integrated into the classical stages of fieldwork — access to the field, data collection, analysis and presentation of the results. At the same time, photographs are the relevant source of data about everyday life of citizens — material culture, spatial practices, emotions, identities. The authors make an attempt to visualize the process of field research, show the process of conducting projects through the photographs and demonstrate the genre of empirical materials as a visual diary.
Effects of raw materials on the quality of catering services at daycare centers
Authors: Kinyingi Jacinta Wanjiku
Published: March 2020

This study examined the effect of raw materials on the quality of catering services in daycare centers in Nyeri Town Constituency, Kenya. The development and growth of a child depend to a great extent on what they consume as food. For a good development of a child, there is a need to consider the quality of food he or she takes. This is in relation to nutritional value, quantities per intake, quality in relation to cleanness, methods of cooking and its presentation to the child.  This high level of participation in childcare centers is attributed to an increasing awareness that early childhood centers are considered critical support in the development of young human beings to become useful citizens. The study targeted all 16-day care centers in Nyeri Town Constituency which are licensed to operate. A total of 64 respondents were targeted which included the managers of the daycare centers and three staff members working in catering sections as follows: stores, production, and service formed the respondents. This study employed a purposive sampling technique in selecting the constituency in the county where the research was carried out. The R-value is 0.689 which indicates a strong correlation. The R2 value indicates how much of the dependent variable (quality of catering services), can be explained by the independent variable (effects of raw materials’). This study concludes that the management of the catering departments in daycare centers should ensure different types of food are stored in different rooms.
Employees’ workplace well-being and work engagement of divine word colleges’ employees in Ilocos region, Philippines
Authors: Abun Damianus , Magallanes Theogenia , Foronda Grace Sylvia Lalaine , Encarnacion Mary Joy
Published: March 2020

The purpose of the study was to determine the correlation between workplace well-being and work engagement of Divine Word Colleges’ employees in the Ilocos Region. In order to support the study, theories were presented and related literature and studies were reviewed. The study used a descriptive correlational research design. The respondents of the study were all employees of the Colleges. In carrying out the study, validated questionnaires were used and in tabulating and interpreting the data, weighted mean and Pearson r were used. The study found that there is a correlation between workplace well-being and work engagement of employees of Divine Word Colleges in Region I, Philippines
Oman’s Diplomacy Strategy
Authors: Albasoos Hani , Maashani Musallam
Published: March 2020

The role of Omani diplomacy is visible in promoting its foreign policy and fulfilling the Sultan’s vision. Since 1970, Oman adopted a different foreign policy in both regional and international arenas characterized by independence, pragmatism, and moderation. This approach was reshaped after Sultan Qaboos bin Said seized rule. His first order of business was to accelerate the steps towards modernizing the Sultanate by adopting a nation-wide social, educational, and cultural reform often referred to as the Omani Renaissance. To translate the Sultan’s vision to reality, the Ministry of Foreign Affairs (MOFA) has adopted a well-structured mechanism that will enhance diplomatic relations with various countries of the world. This research highlights Oman’s diplomacy strategy post-1970. It focuses on Oman’s foreign policy doctrine and examines the different categories of diplomacy that have been practiced in achieving Oman's foreign policy. The research includes the following types of diplomacy: official, mediation, tolerance and co-existence, economy, cultural, water, poet, aviation, and non-governmental diplomacy. This paper attempts to contribute to academia by providing a comprehensive outlook on Oman’s diplomacy, focusing on this topic from a practical point of view. It presents Omani diplomacy through dialogue and negotiations. It assembles a clear direction for the reader based on information, including personal communication with Omani diplomats.

Since 1970, Oman adopted a different foreign policy in both regional and international arenas characterized by independence, pragmatism, and moderation. This approach was reshaped after Sultan Qaboos bin Said seized rule. His first order of business was to accelerate the steps towards modernizing the Sultanate by adopting a nation-wide social, educational, and cultural reform often referred to as the Omani Renaissance. To translate the Sultan's vision to reality, the Ministry of Foreign Affairs (MOFA) has adopted a well-structured mechanism that will enhance diplomatic relations with various countries of the world. This research highlights Oman's diplomacy strategy post-1970. It focuses on Oman's foreign policy doctrine and examines the different categories of diplomacy that have been practiced in achieving Oman's foreign policy. The research includes the following types of diplomacy: official, mediation, tolerance and co-existence, economy, cultural, water, poet, aviation, and non-governmental diplomacy.
Why does task conflict influence team creativity?
Authors: Khan Muhammad Kamran , Shafi Maria , Khan Shakeel , Khan Waseem
Published: March 2020

Although task conflict is usually seen to be beneficial to team creativity, the relationship is still unclear because of the mixed results. This research investigated why task conflicts resulted in some positive outcomes in terms of team creativity. Drawing on minority dissent theory, this study examined the conflict-creativity relationship by focusing on the mediating role of team reflexivity. We collected the sample data from 338 employees and 67 supervisors (67 teams) across three different sectors (banking, pharmaceuticals, and insurance) in Pakistan to support our hypotheses. We used bootstrapping analysis and the Sobel test to check for the mediation analysis. The results indicated that task conflict increases team reflexivity, team reflexivity facilitated team creativity, and thus, task conflict positively influenced team creativity via team reflexivity. The theoretical and practical implications of this study plus future directions are further discussed.
Exploring optimum percentage of fly-ash as a replacement of cement for enhancement of concrete properties
Authors: Gull Sarvat , Wani Shoib B. , Amin Ishfaq
Published: March 2020

Researchers and decision makers are continuously looking out to determine the potential and effectiveness of fly-ash as a partial replacement of cement in concrete. The current study is carried out to check the optimum or nearly optimum quantity of fly-ash with which cement should be replaced to get most of the properties of concrete enhanced and to give the idea about the quantities of fly-ash that can be used in a better way and better cause so that a proper management scheme of its usage and disposal can be implied. Further, a comparison is given between normal concrete and fly-ash concrete to show the properties which can be enhanced by proper utilization of fly-ash as a partial replacement of cement. After carrying out the lab experiments, it has been seen that the replacement of fly-ash in concrete has resulted in general increase in compressive strength, flexural strength and splitting tensile strength up to 15% replacement and after then the strength is decreased considerably than that of normal concrete. Addition of fly-ash in concrete has resulted in decrease in the water absorption of concrete and hence decreases in permeability of concrete. There is a progressive increase in workability with increase in percentage of fly-ash in concrete. The current study has led to a conclusion that in order to achieve best results in use of fly-ash concrete, the fly-ash used for replacing cement in concrete should have the required properties as specified by the standards and proper techniques of processing fly-ash as well as mixing of fly-ash with cement must be employed.
Strategy for Disease Diagnosis, Progression Prediction, Risk Group Stratification and Treatment – Case of COVID-19
Authors: Vihinen Mauno
Published: March 2020

A novel strategy is presented for reliable diagnosis and progression prediction of diseases with special attention to COVID-19 pandemy. A plan is presented for how the model can be implemented worldwide in healthcare and how novel treatments and targets can be detected. The idea is based on poikilosis, pervasive heterogeneity and variation at all levels, systems and mechanisms. Poikilosis in diseases can be taken account in pathogenicity model, which is based on distribution of three independent condition measures – extent, modulation and severity. Pathogenicity model is a population or cohort-based description of disease components. Evidence-based thresholds can be applied to the pathogenicity model and used for diagnosis as well as for early detection of patients in risk of developing the most severe forms of the disease. Analysis of patients with differential course of disease can help in detecting biomarkers of diagnostic and prognostic significance. A practical and feasible plan is presented how the concepts can be implemented in practice. Collaboration of many actors, including the World Health Organization and national health authorities, will be essential for success.
Combating Recent Pandemic of COVID-19 - An Urgent Solution
Authors: Roy Indrani
Published: March 2020

This article investigates whether the weather has any role in spreading the COVID-19 and how that knowledge can be used to arrest this fast spreading disease. It highlights that Temperature and Humidity both are extremely important for transmitting the virus- temperature being the stronger factor. A dry, cool environment is the most favourable state for spread of the virus. In fact, high temperature environment significantly reduces the risk from the virus. Regulating Temperature and Humidity level can provide drastic results to stop and arrest the outbreak. Some urgent solutions are proposed based on that knowledge. The novelty of such approach is- it can be applied overnight and implemented immediately across the globe. It is very cost effective and practically without side effects. No vast amount of funding is required to adopt these measures. These actions are likely to reduce the spread of the disease dramatically and it is expected that these measures will be implemented on an emergency basis worldwide.
Artificial Magnetic Pattern Arrays Probed by Polarized Neutron Reflectivity
Authors: Gorkov Dmitry , Toperverg Boris P. , Zabel Hartmut
Published: March 2020

Traditionally, neutron scattering is an essential method for the analysis of spin structures and spin excitations in bulk materials. Over the last 30 years, polarized neutron scattering in terms of reflectometry has also contributed largely to the analysis of magnetic thin films and magnetic multilayers. More recently it has been shown that polarized neutron reflectivity is, in addition, a suitable tool for the study of thin films laterally patterned with magnetic stripes or islands. We provide a brief overview of the fundamental properties of polarized neutron reflectivity, considering different domain states, domain fluctuations, and different domain sizes with respect to the neutron coherence volume. The discussion is exemplified by a set of simulated reflectivities assuming either complete polarization and polarization analysis, or a reduced form of polarized neutron reflectivity without polarization analysis. Furthermore, we emphasize the importance of the neutron coherence volume for the interpretation of specular and off-specular intensity maps, in particular when studying laterally non-homogeneous magnetic films. Finally, experimental results, fits, and simulations are shown for specular and off-specular scattering from a magnetic film that has been lithographically patterned into a periodic stripe array. These experiments demonstrate the different and mutually complementary information that can be gained when orienting the stripe array parallel or perpendicular to the scattering plane.
Liquid-Liquid Equilibrium Behavior and In Vitro Digestion Simulation of Medium Chain Fatty Acids
Authors: Pereira Ericsem , Meirelles Antonio J. A. , Maximo Guilherme J.
Published: March 2020

The absorption of medium-chain fatty acids (MCFA) depends on the solubility of these components in the gastric fluid. Parameters such as the total MCFA concentration, carboxyl ionization level, and carbon chain length affect the solubility of these molecules. Moreover, the enzymatic lipolysis of solubilized triacylglycerol (TAG) molecules may depend on the carbon chain length of the fatty acids (FAs) components and their positions on the glycerol backbone. This present study aimed at investigating the effect of electrolyte usually formed during the gastric digestion phase on the solubility of MCFA, and evaluating the influence of the FA carbon chain length on the lipolysis rate during the in vitro digestion simulation. The results obtained here showed that the increasing of electrolyte concentrations tend to decrease the mutual solubility of systems composed by the caproic and caprylic fatty acids + sodium chloride, sodium bicarbonate, and potassium chloride solutions. We also observed that a conventional version of the thermodynamic UNIQUAC model was able to correlate the liquid-liquid phase behavior of the electrolyte solutions. Regarding the in vitro digestion simulation, the experimental data indicated that the action of the pancreatic enzyme occurred preferentially in TAG molecules comprised of short and medium-chain fatty acids.
Knockout of MMP3 Weakened Solid Tumor Organoids and Cancer Extracellular Vesicles
Authors: Taha Eman A. , Sogawa Chiharu , Okusha Yuka , Kawai Hotaka , Oo May Wathone , El-Seoudi Abdellatif , Lu Yanyin , Nagatsuka Hitoshi , Kubota Satoshi , Satoh Ayano , Okamoto Kuniaki , Eguchi Takanori
Published: March 2020

The tumor organoid (tumoroid) model in three-dimensional (3D) culture systems has been developed to reflect more closely the in vivo tumors than 2D-cultured tumor cells. Notably, extracellular vesicles (EVs) are efficiently collectible from the culture supernatant of gel-free tumoroids. Matrix metalloproteinase (MMP) 3 is a multi-functional factor playing crucial roles in tumor progression. However, roles of MMP3 within tumor growth and EVs have not unveiled. Here, we investigated the protumorigenic roles of MMP3 on integrities of tumoroids and EVs. We generated MMP3-knockout (KO) cells using the CRISPR/Cas9 system from rapidly metastatic LuM1 tumor cells. Moreover, we established fluorescent cell lines with palmitoylation signal-fused fluorescent proteins (tdTomato and enhanced GFP). Then we confirmed the exchange of EVs between cellular populations and tumoroids. LuM1-tumoroids released large EVs (300-1000 nm) and small EVs (50-200 nm) while the knockout of MMP3 resulted in the additional release of broken EVs from tumoroids. The loss of MMP3 leads to a significant reduction in tumoroid size and to the development of the necrotic area within tumoroids. MMP3 and CD9 (a category-1 EV marker tetraspanin protein) were significantly down-regulated in MMP3-KO cells and their EV fraction. These weakened phenotypes by MMP3 KO were markedly rescued by the addition of MMP3-rich EVs or conditioned medium (CM) collected from LuM1-tumoroids, which caused a dramatic rise in the expression of MMP3, CD9, and Ki-67 (a marker of proliferating cells) in the MMP3-null/CD9-low tumoroids. Notably, MMP3 enriched in tumoroids-derived EVs and CM deeply penetrated into recipient MMP3-KO tumoroids, resulting in a remarkable enlargement of solid tumoroids, while MMP3-null EVs did not. These data demonstrate that EVs can mediate molecular transfer of MMP3 resulting in increasing the proliferation and CD9+ tumorigenesis, indicating crucial roles of MMP3 in tumor progression.
Inhibitors of SARS-CoV-2 Main Protease from a Library of Marine Natural Products: A Virtual Screening and Molecular Modeling Study
Authors: Gentile Davide , Patamia Vincenzo , Scala Angela , Sciortino Maria Teresa , Piperno Anna , Rescifina Antonio
Published: March 2020

The current emergency due to the worldwide spread of the COVID-19 caused by the new SARS-CoV-2 is a great concern for global public health. Already in the past, the outbreak of severe acute respiratory syndrome (SARS) in 2003 and Middle Eastern respiratory syndrome (MERS) in 2012 demonstrates the potential of coronaviruses to cross-species borders and further underlines the importance of identifying new-targeted drugs. An ideal antiviral agent should target essential proteins involved in the lifecycle of SARS-CoV. Currently, some HIV protease inhibitors (i.e., Lopinavir) are proposed for the treatment of COVID-19, although their effectiveness was not yet assessed. The main protease (Mpro) provides a highly validated pharmacological target for the discovery and design of inhibitors. We identified potent Mpro inhibitors employing computational techniques that entail the screening of a Marine Natural Product (MNP) library. MNP library was screened by hyphenated pharmacophore model, and molecular docking approaches. Molecular dynamics and re-docking further confirmed the results obtained by structure-based techniques and allowed to highlight some crucial aspects. Seventeen potential SARS-CoV-2 Mpro inhibitors have been identified among the natural substances of marine origin. As these compounds were extensively validated by a consensus approach and by molecular dynamics, the likelihood that at least one of these compounds could be bioactive is excellent.
Sex-specific impact of patterns of imageable tumor growth on survival of primary glioblastoma patients
Authors: Whitmire Paula , Rickertsen Cassandra R , Hawkins-Daarud Andrea , Carrasco Eduardo , Lorence Julia , De Leon Gustavo , Curtin Lee , Bayless Spencer , Clark-Swanson Kamala , Peeri Noah , Corpuz Christina , Angeles Christine Paula Lewis-de los , Bendok Bernard , Gonzalez-Cuyar Luis , Vora Sujay , Mrugala Maciej M , Hu Leland , Wang Lei , Porter Alyx , Kumthekar Priya , Johnston Sandra , Egan Kathleen , Gatenby Robert , Canoll Peter , Rubin Joshua , Swanson Kristin
Published: March 2020

Background : Sex is recognized as a significant determinant of outcome among glioblastoma patients, but the relative prognostic importance of glioblastoma features has not been thoroughly explored for sex differences.
Methods : Combining multi-modal MR images, biomathematical models, and patient clinical information, this investigation assesses which pretreatment variables have a sex-specific impact on the survival of glioblastoma patients (299 males and 195 females).
Results : Among males, tumor (T1Gd) radius was a predictor of overall survival (HR=1.027, p=0.044). Among females, higher tumor cell net invasion rate was a significant detriment to overall survival (HR=1.011, p<0.001). Female extreme survivors had significantly smaller tumors (T1Gd) (p=0.010 t-test), but tumor size was not correlated with female overall survival (p=0.955 CPH). Both male and female extreme survivors had significantly lower tumor cell net proliferation rates than other patients (M p=0.004, F p=0.001, t-test).
Conclusion : Despite similar distributions of the MR imaging parameters between males and females, there was a sex-specific difference in how these parameters related to outcomes.
What will it take? Using an Implementation Research Framework to Identify Facilitators and Barriers in Implementing a School-Based Referral System for Sexual Health Services
Authors: Leung Emily , Wanner Kathryn J. , Senter Lindsay , Brown Amanda , Middleton Dawn
Published: March 2020

Background Across the United States, sexually transmitted infections and unintended pregnancy rates are alarmingly high among youth. Schools, due to their proximity and access to youth, can increase student access to sexual health services (SHS) by creating referral systems (RS) to link students to school- and community-based SHS. From 2013-2018, the Centers for Disease Control and Prevention’s Division of Adolescent and School Health funded 17 Local Education Agencies (LEA) to partner with priority schools and stakeholders to develop and implement RS to increase student access to SHS. Cicatelli Associates Inc. (CAI) was funded to provide capacity-building to LEA. In 2016-2017, CAI conducted case studies at two LEA, both large and urban sites, but representing different geographical and political contexts, to elucidate factors that influence RS implementation. Methods Nineteen LEA and community-based healthcare (CBH) staff were interviewed in the Southeastern (n=9) and Western U.S. (n=10). Key constructs (e.g., leadership engagement, resources, state and district policies) across the five domains of the Consolidated Framework for Implementation Research (CFIR) framework guided the methodology and analysis. Qualitative data was analyzed using the Framework Method and contextual factors and themes that led to RS implementation were identified. Results Interviewees strongly believed that school-based RS can decrease STI, HIV and unintended pregnancy and increase students’ educational attainment. We identified the following contextual key factors that facilitate successful implementation and integration of an RS: enforcing state and district policies, strong LEA and CBH collaboration, positive school culture towards adolescent health, knowledgeable and supportive staff, leveraging of existing resources and staffing structures, and influential district and school building-level leadership and champions. Notably, this case study challenged our initial assumptions that RS are easily implemented in states with comprehensive SHS policies. Rather, our conversations revealed how districts and local-level policies can have significant impact and influence to impede or promote those policies. Conclusions Through the use of the CFIR framework, the interviews identified important contextual factors and themes associated with LEAs’ implementation barriers and facilitators. The study’s results present key recommendations that other LEA can consider to optimize integration of RS-related evidence-based practices, systems, and policies in their districts.
Ocular biomarkers for cognitive impairment in nonagenarians; a prospective cross-sectional study
Authors: de Kreeke Jacoba Alida van , Legdeur Nienke , Badissi Maryam , Nguyen H. Ton , Konijnenberg Elles , Tomassen Jori , Kate Mara ten , Braber Anouk den , Maier Andrea B. , Tan H. Stevie , Verbraak Frank D. , Visser Pieter Jelle
Published: March 2020

Background: Ocular imaging receives much attention as a source of potential biomarkers for dementia. In the present study, we analyze these ocular biomarkers in cognitively impaired and healthy participants in a population aged over 90 years (= nonagenarian), and elucidate the effects of age on these biomarkers. Methods: For this prospective cross-sectional study, we included individuals from the EMIF-AD 90+ study, consisting of a cognitively healthy (N=67) and cognitively impaired group (N=33), and the EMIF-AD PreclinAD study, consisting of cognitively healthy controls aged ≥60 (N=198). Participants underwent Optical Coherence Tomography (OCT) and fundus photography of both eyes. OCT was used to asses total and individual inner retinal layer thickness in the macular region (Early Treatment Diabetic Retinopathy Study circles) as well as peripapillary retinal nerve fiber layer thickness, fundus images were analyzed with Singapore I Vessel Assessment to obtain 7 retinal vascular parameters. Values for both eyes were averaged. Differences in ocular biomarkers between the 2 nonagenarian groups were analyzed using linear regression, differences between the individual nonagenarian groups and controls were analyzed using generalized estimating equations. Results: Ocular biomarkers did not differ between the healthy and cognitively impaired nonagenarian groups. Both nonagenarian groups differed in most ocular biomarkers from the younger controls. Conclusion: Ocular biomarkers were not associated with cognitive impairment in nonagenarians, making their use as a screening tool for dementing disorders in this group limited. However, ocular biomarkers were significantly associated with chronological age, which were very similar to those ascribed to occur in Alzheimer’s Disease.
A Systematic Review to Assess the Effectiveness of Technology-Based Interventions to Address Obesity in Children
Authors: McMullan Megan , Millar Rachel , Woodside Jayne
Published: March 2020

Background

Childhood obesity is associated with a multitude of co-morbidities, including hypertension, hyperlipidaemia, cardiovascular disease and type 2 diabetes. Childhood obesity can also affect a young person’s social, emotional and mental health if they encounter negative prejudice and social marginalisation. Given the prevalence of overweight and obese children globally, it is imperative that effective interventions are developed. Children are receptive to information conveyed via digital means, therefore, the use of technology may play a crucial role in interventions to reduce childhood obesity. This systematic review aimed to review and critically appraise the literature published to date in relation to the effectiveness of technology-based interventions, employed as secondary prevention, in addressing childhood obesity.

Methods

An electronic search strategy was undertaken in Medline and Embase, covering publications up to and including 12th July 2018. Randomised controlled trials assessing the effectiveness of technology-based interventions on weight-related outcomes in children, aged 8 to 18, published only in the English language, were included.

Results

From an initial search total of 1,012 studies, 11 met the inclusion criteria. They were assessed for methodological quality using the Cochrane Risk of Bias Tool for Randomised Controlled Trials and were analysed using a narrative approach. The findings of this review showed a limited potential of technology-based interventions, employed as secondary prevention, to address childhood obesity. Of the eleven studies reviewed, three (27%) showed a positive relationship between technology-based interventions and weight-related outcomes in overweight or obese children.

Conclusions

This review suggests that technology-based interventions, primarily active video games, as well as internet or web-based interventions and mobile phone communications, may, with further research, have the potential to impact positively on weight-related outcomes. It is difficult to determine the degree of efficacy of these technology-based interventions, as only two databases were searched, selecting only English language articles. Moreover, the included studies demonstrated a lack of high-quality evidence. The lack and heterogeneity of studies with technology-based interventions is a further limitation.
Gender differences and occupational factors for the risk of obesity in the Italian working population
Authors: Tecco Cristina Di , Fontana Luca , Adamo Giovanna , Petyx Marta , Iavicoli Sergio
Published: March 2020

Background Obesity is a multifactorial condition and a major risk factor associated with several non-communicable diseases, such as cardiovascular disease, and with a higher risk of premature death and disability. Sex-specific factors have key roles and must be taken into consideration in studying occupational factors associated with the risk of obesity. The aim of this study was to investigate gender differences in body mass index (BMI) in a large cohort representative of Italian workers and, correlating this index with several demographic and occupational variables, to verify sex- and work-dependent differences in the risk of obesity. Methods We utilized data from INSuLa, a cross-sectional, nationally representative survey of the Italian worker population conducted in 2013 by the Italian Workers’ Compensation Authority to investigate health and safety at work. Analyses were run on a sample of 8,000 Italian workers, aged from 16 to 64 years. Logistic regression models were employed to assess gender differences in the relation between occupational characteristics and BMI. We adjusted for age, education, variables related to health protection at work, and chronic conditions and diseases. Results There were several significant differences in the BMI between males and females, linked to some occupational factors. For instance, female shift workers were 1.32 times (95% CI 1.11-1.57) more likely to be overweight or obese than normal-weight workers, and this association was maintained when controlling for confounders. The likelihood of overweight or obesity among women who worked 1-2 night shifts per week was significantly higher – 1.5-1.6 times – than those on day shifts. Conclusions Gender-specific differences in occupational factors associated with the risk of obesity are useful with a view to characterizing this risk and helping identify workplace-targeted intervention strategies.
Effect of stress coping ability and working hours on burnout among residents
Authors: Kijima Saori , Tomihara Kazuya , Tagawa Masami
Published: March 2020

Background: Burnout (BO) among residents leads to interruptions in training and even to exit from programs. Despite the implementation of working hour restrictions in the U.S. in 2013, the high rate of BO remains a serious problem. Therefore, with the aim of providing support for residents and evidence-based guidelines for working environments, we analyzed Japanese residents’ BO, training conditions, and associated factors, especially stress coping ability.Methods: In total, 37 teaching hospitals were randomly selected, and all residents in the third and fifteenth months of a residency program at these hospitals were targeted for this research. We analyzed the residents’ BO rates, associated factors, and interactions using response data from a self-administered questionnaire consisting of the Japanese versions of the Maslach Burnout Inventory (MBI) and the Sense of Coherence (SOC) scale, as well as items asking about their training environments, gender, and age.Results: Overall, 48 (49.5%) of 97 residents in 18 teaching hospitals (62 and 35 in the third and fifteenth months, respectively), whose average working hours were 63.3 hours per week, were judged as having BO, among whom, 33 (53.2%) and 15 (42.9%) had BO in the third and fifteenth months, respectively. Logistic regression analysis indicated that working hours and 10 items on the SOC scale (SOC10) were significant factors of BO. Two-way analysis of variance revealed that working hours was a significant variable for the MBI-emotional exhaustion score and SOC10 in the third and fifteenth months, respectively. Regarding the MBI-cynicism and professional efficacy scores, the SOC10 was a significant variable in both the third and fifteenth months. In addition, the high SOC group (SOC10>45) showed higher personal efficacy under longer working hours.Conclusion: About half of the Japanese residents were judged as having BO as early as the third month of training under regulations of working 40 hours per week. Individual stress coping ability and working hours were found to be significant factors for BO. Residents with high stress coping ability exhibited more personal efficacy with more working experiences, which suggests that the SOC scale could be a valuable tool to help foster a suitable training environment.
Influence of complete uncinate process removal on 2-year assessment of radiologic outcomes: subsidence and sagittal balance in patients receiving one-level anterior cervical discectomy and fusion
Authors: Noh Sung Hyun , Park Jeong Yoon , Kuh Sung Uk , Chin Dong Kyu , Kim Keun Su , Cho Yong Eun , Kim Kyung Hyun
Published: March 2020

Background: Many patients with cervical radiculopathy experience stenosis of the neural foramens due to cumulative osteophyte or uncovertebral joint hypertrophy. For cervical foraminal stenosis, complete uncinate process resection (UPR) is often conducted concurrently with anterior discectomy and fusion (ACDF). The aim of this study was to assess the clinical and radiological outcomes of ACDF with complete UPR versus ACDF without UPR. Methods: In total, 105 patients who performed one-level ACDF with a cage-and-plate construct between 2011 and 2015 were retrospectively reviewed. Among them, 37 patients had ACDF with complete UPR, and 68 patients had ACDF without UPR. Radiologic outcomes of disc height, C2–C7 lordosis, T1 slope, C2–C7 sagittal vertical axis (SVA), center of the sella turcica–C7 SVA (St-SVA), spino-cranial angle (SCA), and fusion rate were evaluated on plain X-ray at pre-operation, immediately post-operation, and at 2-year follow-up. Results: All of the clinical parameters improved at the 2-year follow up (P<0.0001). Improvement in visual analogue scale (VAS) scores for arm pain was significantly improved in the ACDF with complete UPR group immediately post-operation. All cervical sagittal parameters, including cervical lordosis, segmental angle, disc height, C2-C7 SVA, St-SVA, T1 slope, and SCA, were similar between the ACDF with complete UPR and ACDF without UPR groups. Differences in segmental angle, disc height, C2-C7 SVA, St-SVA, and SVA at 2-year follow up after preoperative examination, however, were statistically significant (p<0.05). Subsidence occurred in 23 patients (ACDF with complete UPR: 14 cases [37%] versus ACDF without UPR: 9 cases [13%]; p < 0.05). Conclusions: Cervical sagittal alignment after ACDF with complete UPR is not significantly different from that achieved with ACDF without UPR. However, subsidence appears to occur more often after ACDF with complete UPR than after ACDF without UPR, although with little to no clinical impact. More precise and careful selection of patients is needed when deciding on additional complete UPR.
The effect of yoga on sleep quality and insomnia in women with sleep problems: a systematic review and meta-analysis
Authors: Wang Weili , Chen Kuang-Huei , Pan Ying-Chieh , Yang Szu-Nian , Chan Yuan-Yu
Published: March 2020

Objectives: To examine the effectiveness and safety of yoga of women with sleep problems by performing a systematic review and meta-analysis. Methods: Medline/PubMed, ClinicalKey, ScienceDirect, Embase, PsycINFO, and the Cochrane Library were searched throughout the month of June, 2019. Randomized controlled trials comparing yoga groups with control groups in women with sleep problems were included. Two reviewers independently evaluated risk of bias by using the risk of bias tool suggested by the Cochrane Collaboration for programming and conducting systematic reviews and meta-analyses. The main outcome measure was sleep quality or the severity of insomnia, which was measured using subjective instruments, such as the Pittsburgh Sleep QualityIndex (PSQI),Insomnia Severity Index (ISI), or objective instruments such as polysomnography, actigraphy, and safety of the intervention. For each outcome, a standardized mean difference (SMD) and confidence intervals (CIs) of 95% were determined. Results: Nineteen studies in this systematic review included 1832 participants. The meta-analysis of the combined data conducted according to Comprehensive Meta-Analysis showed a significant improvement in sleep (SMD =−0.327, 95% CI=−0.506 to −0.148,P<0.001).Meta-analyses revealed positive effects of yoga using PSQI scores in 16 randomized control trials (RCTs), compared with the control group in improving sleep quality among women usingPSQI (SMD = −0.54; 95% CI = −0.89 to −0.19; P = 0.003). However, three RCTs revealed no effects of yoga compared to the control groupin reducing insomnia amongwomen using ISI (SMD = −0.13; 95% CI = −0.74 to 0.48; P = 0.69).Yoga was not associated with any serious adverse events. Discussion: This systematic review and meta-analysis demonstrated that yoga intervention in women can be beneficial whencompared to non-active control conditions in term of managing sleep problems.The moderator analyses suggest that participants in the non-breast cancer subgroup and participants in the non-peri/postmenopausal subgroup were associated with greater benefits, with a direct correlation of total class time with quality of sleep among other related benefits.