bluuebunny/crossref_metadata_2025 huggingface dataset:
Promoting evidence-based practice and raising concerns: considerations for the newly-qualified midwife
Authors: Allen Katie , Anderson Gail
Published: July 2019

Although newly-qualified midwives have achieved the professional standards required to become autonomous practitioners, many doubt their capabilities and decision-making skills, often comparing their limited clinical experience to that of senior midwives. As a result, it may prove challenging to ensure that evidence-based practice and the professional standards are upheld when confronted with resistance to change in practice. This article will discuss these challenges for the newly-qualified midwife, exploring the promotion of evidence-based practice in relation to providing breastfeeding support and advice; dealing with poor professional practice in relation to supporting mothers to breastfeed; and the stigmatised issue of whistle-blowing.
EYFS training: part 6 – physical development: Get physical
Authors: Goddard Charlotte
Published: July 2019

What are the training opportunities for practitioners on physical development, and how can provision in this area be improved? By Charlotte Goddard
Change in action
Authors: Russell Meredith Jones
Published: July 2019

From solar panels to waste management, Meredith Jones Russell explores how settings can ensure they are an eco-friendly business
Matrix Shanks Transformations
Authors: Brezinski Claude , Redivo-Zaglia Michela
Published: July 2019

Shanks' transformation is a well know sequence transformation for accelerating the convergence of scalar sequences. It has been extended to the case of sequences of vectors and sequences of square matrices satisfying a linear difference equation with scalar coefficients. In this paper, a more general extension to the matrix case where the matrices can be rectangular and satisfy a difference equation with matrix coefficients is proposed and studied. In the particular case of square matrices, the new transformation can be recursively implemented by the matrix $\varepsilon$-algorithm of Wynn. Then, the transformation is related to matrix Pad\'{e}-type and Pad\'{e} approximants. Numerical experiments showing the interest of this transformation end the paper.
Advances in tumour endoprostheses: a systematic review
Authors: Smolle Maria A. , Andreou Dimosthenis , Tunn Per-Ulf , Leithner Andreas
Published: July 2019

Tumour endoprostheses have facilitated limb-salvage procedures in primary bone and soft tissue sarcomas, and are increasingly being used in symptomatic metastases of the long bones. The objective of the present review was to analyse articles published over the last three years on tumour endoprostheses and to summarize current knowledge on this topic. The NCBI PubMed webpage was used to identify original articles published between January 2015 and April 2018 in journals with an impact factor in the top 25.9% of the respective category (orthopaedics, multidisciplinary sciences). The following search-terms were used: tumour endoprosthesis, advances tumour endoprosthesis, tumour megaprosthesis, prosthetic reconstruction AND tumour. We identified 347 original articles, of which 53 complied with the abovementioned criteria. Articles were categorized into (1) tumour endoprostheses in the shoulder girdle, (2) tumour endoprostheses in the proximal femur, (3) tumour endoprostheses of the knee region, (4) tumour endoprostheses in the pelvis, (5) (expandable) prostheses in children and (6) long-term results of tumour endoprostheses. The topics of interest covered by the selected studies largely matched with the main research questions stated at a consensus meeting, with survival outcome of orthopaedic implants being the most commonly raised research question. As many studies reported on the risk of deep infections, research in the future should also focus on potential preventive methods in endoprosthetic tumour reconstruction.

Cite this article: EFORT Open Rev 2019;4:445-459. DOI: 10.1302/2058-5241.4.180081
Short communication: An overview of the trematodes fauna of pool frog Pelophylax lessonae (Camerano, 1882) in the Volga Basin, Russia: 2. Larval stages
Authors: CHIKHLYAEV IGOR V , RUCHIN ALEXANDER B , FAYZULIN ALEXANDER I
Published: July 2019

Abstract. Chikhlyaev IV, Ruchin AB, Fayzulin AI. 2019. Short communication: An overview of the trematodes fauna of the pool frog Pelophylax lessonae (Camerano, 1882) in the Volga Basin, Russia: 2. Larval stages. Nusantara Bioscience 11: 106-111. This paper presents data on the trematodes fauna of the pool frog Pelophylax lessonae (Camerano, 1882) from 13 regions of the Volga Basin. It consolidates data from different authors over the past 30 years, supplemented by our own research results. There are authentically known findings of 10 trematodes species at the larval stage of development. The species Codonocephalus urniger (Rudolphi, 1819), mtc., Neodiplostomum spathoides Dubois, 1937, mtc. and Pharyngostomum cordatum (Diesing, 1850), mtc. have been observed for the first time in the given host on the territory of Russia and Volga basin. For each species of trematodes, there is the following information is included: taxonomic position, localization, area of detection, biology, definitive hosts, geographic distribution and degree of host-specificity.
A publicidade no Brasil: identidades profissionais e organização do trabalho nas agências
Authors: Rocha Everardo , Aucar Bruna
Published: July 2019

Este trabalho pretende realizar uma interpretação do mundo da publicidade e das identidades profissionais nele negociadas através da teoria da ação coletiva de Howard Becker. O objetivo é pensar as várias funções e denominações corporativas elaboradas dentro de uma agência de propaganda no Brasil. Os elos cooperativos e redes de convenções estabelecidos no campo foram determinantes para o reconhecimento da profissão e para a materialização desse tipo específico de comunicação. Atores sociais e suas ações são partes determinantes da produção do conhecimento e da construção das identidades em um determinado sistema social. Neste sentido, é possível entender o discurso que a publicidade deposita na cultura, analisando o resultado da ação conjunta e coordenada de identidades profissionais cuja colaboração é necessária para que o trabalho se realize.
A publicidade com o argumento na origem. Uma abordagem exploratória das marcas cidade do Porto e Vinho do Porto
Authors: Lobo Paula , Ferreira Ivone
Published: July 2019

Os efeitos da globalização e as alterações económicas das últimas décadas têm intensificado as reflexões académicas sobre o desenvolvimento de estratégias de branding com vista à promoção de lugares: países, territórios, cidades.Sabemos que uma boa marca não só acrescenta traços identitários positivos, como constrói ligações emocionais, molda as percepções dos consumidores sobre a realidade, influenciando os seus comportamentos. No caso de uma marca lugar ou marca-cidade “it is a powerful mediator of culture, communities, and people and if it has positive reputation it will make it easier to compete for attention, resources, people, jobs, and money.” (Morgan, Pritchard and Pride, 2011: 5).A intensificação da concorrência entre cidades, num mercado progressivamente mais global, tem aumentado a necessidade de desenvolver estratégias organizadas de marketing e a atualização constante de campanhas de divulgação (Kavaratzis, 2005; Kavaratzis & Asworth, 2006) já que, atualmente, se um lugar não cumpre os requisitos valorizados pelos seus públicos-alvo, outro lugar, algures no mundo, o fará. Neste contexto, consideramos que as questões da identidade têm assumido um papel cada vez mais preponderante na construção das marcas-cidade, uma vez que a identidade é uma ferramenta crucial na constituição dos valores de uniqueness e autenticidade da marca, traços que são, hoje, cada vez mais valorizados pelos públicos-alvo e que representam vantagens competitivas sólidas e muito difíceis de ser reproduzidas pela concorrência. A identidade de uma marca é algo único que representa uma mais-valia insubstituível para os seus públicos.A par das marcas-cidades ou marcas lugar, as marcas associadas a uma localização geográfica ou de origem têm igualmente demonstrado o valor estratégico da inclusão dessa dimensão de lugar na sua identidade. Este artigo propõe-se a analisar a forma como esta dimensão identitária do território e do imaginário a ele associado é operacionalizada nas estratégias de branding de marcas tipicamente associadas ao lugar, como as marcas-cidade, e de marcas que tiram partido de uma associação histórica a um determinado espaço geográfico. No âmbito desta análise, interessou-nos particularmente reflectir sobre a coexistência de marcas-cidade e marcas fortemente associadas à cidade como é o caso, aqui em análise, da marca da cidade do Porto, cuja identidade histórica se encontra inexoravelmente associada a outra marca de traços identitários muito fortes, em boa parte coincidentes com os da própria identidade da cidade, que é a marca Vinho do Porto.
A crise humanitária como tema publicitário: algumas questões éticas e jurídicas
Authors: Amorim Ana
Published: July 2019

Face à globalização dos mercados e à dimensão eminentemente emocional e simbólica das decisões económicas, o recurso à crise humanitária como tema publicitário, que voltou a verificar-se recentemente numa campanha da Benetton, recupera o problema da dignidade da pessoa humana enquanto valor absoluto universal conformador do conteúdo das mensagens. O respeito pela dignidade da pessoa humana enquadra-se no princípio da licitude previsto no regime jurídico da publicidade. Na era digital, apesar da escassa celeridade e eficácia dos mecanismos sancionatórios tradicionais da publicidade ilícita, a lesão de valores constitucionais na comunicação comercial tende a desencadear uma tutela informal, que constitui manifestação da consciência ética da comunidade.
McIntyre, L. (2018). Post-truth. Cambridge, MA: MIT Press
Authors: Sá Rêgo Patrícia De Matos
Published: July 2019

https://doi.org/10.14195/2183-5462_34_25
Incursão pelos modelos de análise da imagem publicitária
Authors: Ferreira Ivone
Published: July 2019

O protagonismo da imagem nos media beneficia as disciplinas que melhor domínio tenham dos seus mecanismos. Entre elas, a Publicidade destaca-se sem esforço pois, num momento em que a comunicação vê acentuada a sua dimensão imagética e, com ela, um certo carácter superficial, fragmentado e/ou desprovido de contexto, esta disciplina enfatiza o poder da imagem para a comunicação e a persuasão sob a capa de uma permanente sedução. Consequentemente, a Publicidade emerge na cultura contemporânea como um discurso de cunho marcadamente imagético, capaz de contagiar todos os outros (Ferreira, 2012), vulneráveis ao poder sedutor da imagem e de uma cultura que se define a partir dela. Desta forma, a sua associação à Retórica, enquanto “faculdade de teorizar sobre o que é adequado em cada caso para convencer” (Aristóteles, 1355b), embora inevitável, não surge isenta de obstáculos, nomeadamente no que diz respeito à escolha do modelo de análise mais adequado para abordar a especificidade da imagem publicitária. Este artigo percorre os modelos semiótico-retóricos de análise da imagem publicitária de Roland Barthes (1964), Durand (1964), Péninou (1973), Grupo µ (1987), Floch (1981), Sonesson (1993), Umberto Eco (1997), Martine Joly (1999) e José Saborit (1999).
Diversidad sexual: imaginarios y actitudes en estudiantes de enseñanzas medias y superiores mexicanos
Authors: Rodríguez Otero Luis Manuel , Facal Fondo Teresa
Published: July 2019

El sistema sexo-género hace referencia a un proceso mediante el cual socialmente se dicotomiza, estereotipiza y jerarquiza a la población.Tomando en consideración a 20 estudiantes universitarios y preuniversitarios, se plantea una investigación cualitativa con el objetivo de identificar la percepción social que poseen sobre la homosexualidad, la bisexualidad y la transexualidad y analizar los posibles efectos en la salud.Los resultados evidencian que existe un gran calado de mitos, estereotipos y percepciones estigmatizantes entre los jóvenes, por lo que se considera que las medidas de promoción de la igualdad y la diversidad facilitadoras de la deconstrucción de los estigmas.
Apresentação
Authors: Teixeira Júnior José Gonçalves
Published: July 2019

Apresentação do Dossiê Revisitando a Educação em Ciências e em Matemática
Quando o futebol é de mulheres: suspeitas, regulações e transgressões no campo dos gêneros e sexualidades
Authors: Moreira Maria de Fátima Salum , Prado Vagner Matias do , Cavaleiro Maria Cristina
Published: July 2019

O estudo discute a percepção que jovens jogadoras de futebol possuem de si mesmas, frente às relações de gênero e sexualidade a partir de pesquisa que envolveu observações de treinos e seis entrevistas semiestruturadas com uma equipe feminina de município do interior paulista. Ao compreender as sexualidades e o gênero como construções sócio-históricas, problematiza-se a prática do futebol e os dispositivos que produzem “modos de ser mulher” a partir de políticas normalizadoras. Conclui-se que regimes normativos de gênero regulam os corpos das jovens atletas frente a um esporte considerado como masculino; gerenciam modos possíveis de estilização corporal das jogadoras; e instituem regras que visam afastá-las de uma possível aproximação com o desejo lesbiano. Tais achados desvelam o futebol como prática social generificada e generificante, produtora de corpos/subjetividades que são gerenciados pelos dispositivos de gênero e sexualidade. Também permitem (re)pensar as relações estabelecidas entre gênero, sexualidade e práticas corporais.

PALAVRAS-CHAVE: Futebol Feminino. Relações de Gênero. Lesbofobia.
Fatores favorecedores e comprometedores na qualidade acadêmica do ensino de Odontologia
Authors: Medina Patrícia Figueiredo , Bezerra Teresa Olinda Caminha , Gouvêa Cresus Vinicius Depes de
Published: July 2019

O estudo objetivou identificar os fatores favorecedores e os comprometedores da qualidade do ensino do curso de graduação em Odontologia da Universidade Federal Fluminense. Trata-se de uma pesquisa exploratória realizada em duas etapas distintas, porém com enfoque integrado. As percepções dos professores e dos alunos foram coletadas por meio de questionários. Para a análise dos dados utilizou-se a Análise de Conteúdo, a estatística descritiva e inferencial. Verificou-se que, na visão acadêmica dos segmentos estudados, o principal fator favorecedor foi qualidade do corpo docente e comprometimento. Já em relação aos comprometedores foram apontados como principais: falta de componentes tais como: competência, motivação, assiduidade, comprometimento e comportamento democrático, por parte de alguns professores; falta de integração e interdisciplinaridade entre as disciplinas; programas curriculares tradicionais, antigos e deficientes.

PALAVRAS-CHAVE: Ensino de Odontologia. Qualidade do ensino. Diretrizes Curriculares. Fatores favorecedores e comprometedores.
Imagens dos cientistas Jean-Baptiste de Lamarck e Charles Darwin: o que alunos concluintes do ensino médio sabem sobre eles?
Authors: Breunig Eduarda Tais , Amaral Aléxia Santos , Goldschmidt Andréa Inês
Published: July 2019

A pesquisa buscou investigar as concepções de setenta e oito alunos de terceiro ano do ensino médio de escolas públicas, a respeito da imagem e do nome de dois cientistas importantes para a Biologia e as implicações destas relacionadas à Ciência, através de dois questionários, compostos por duas partes. Inicialmente foi aplicado o primeiro, que investigou o reconhecimento de cientistas através de imagens sem nomeação e uma segunda parte, contendo outras imagens dos cientistas; porém, nominadas. Os resultados mostraram que o uso de imagens ainda é restrito em sala de aula; não tendo sido reconhecidos de forma significativa nenhum dos cientistas, principalmente, quando não foi mencionado os nomes. Além disso, muitas concepções reducionistas sobre cientistas e sobre a ciência foram identificadas.

PALAVRAS-CHAVE: Cientistas. Educação em Ciências. Ensino de Ciências.
Análise das concepções de formadores de professores de Química acerca da inclusão de alunos com deficiência no ensino superior
Authors: Teixeira Júnior José Gonçalves , Souza Nayara Costa
Published: July 2019

Este trabalho tem como objetivo investigar as concepções de formadores de professores de Química sobre as possibilidades e potenciais dificuldades para ensinar conceitos químicos para licenciandos com deficiências. Mais do que um diagnóstico, compreende-se que as concepções dos formadores de professores acerca da inclusão influenciam também, as concepções dos futuros professores de Química. Para isso, os formadores de uma instituição de ensino superior foram entrevistados, a fim de levá-los a refletir sobre suas metodologias, as necessidades de adaptação, assim como as possíveis dificuldades em lidar com esses alunos. Os resultados apontaram que, embora alguns dos docentes tenham se mostrado receptivos às possibilidades da educação de alunos com necessidades educacionais especiais, nenhum deles sente-se preparado para atuar na diversidade.

PALAVRAS-CHAVE: Educação inclusiva. Formação de professores de Química. Concepção de professores.
Kejadian Drop Foot Setelah Anestesi Spinal
Authors: Wicaksono Satrio Adi , Priambodo Bhimo
Published: July 2019

Latar Belakang: Komplikasi neurologi setelah prosedur anestesi spinal dapat disebabkan oleh cedera saraf secara langsung, hipotensi yang berat, henti jantung, masalah terkait peralatan, efek yang tidak diinginkan dari obat, pemberian obat yang tidak benar, dan kesalahan lokasi penyuntikan. Namun komplikasi neurologi serius yang disebabkan oleh anestesi regional jarang terjadi. Drop Foot merupakan salah satu komplikasi langsung dari cedera saraf.Kasus: Seorang wanita berusia 44 tahun telah dijadwalkan untuk operasi histerektomi. Pasien mengalami penurunan daya lihat, visus mata kanan 1/300 sedangkan mata kiri adalah 1/~. Melalui teknik aseptik, 25 G jarum spinal disuntikan di interspatium L3-L4. Ruang subarachnoid dicapai setelah beberapa kali suntikan. Setelah itu, bupivakain spinal 0,5% 20 mg diinjeksikan.Satu hari setelah operasi, pasien menyadari bahwa ia tidak mampu menggerakkan kaki kirinya dan kaki kanan normal. Kasus ini dikonsulkan ke bagian neurologi dan rehabilitasi medik dan akupuntur. Tiga minggu pascaoperasi kekuatan motorik skala 1, sensorik hampir kembali normal, sensasi panas di kulit hampir hilang. Setelah 4 minggu, sebagian kekuatan motorik telah pulih, 8 minggu kemudian pulih total.Pembahasan: Jenis dan luasnya cedera saraf dapat bervariasi sesuai dengan orientasi jarum. Ketika bevel sejajar dengan sumbu panjang saraf, jarum lebih mudah untuk melewati serabut saraf. Saat jarum menyilang ke serabut saraf, lukanya lebih besar. Beberapa gangguan sensorik dan kelemahan anggota gerak dapat berlangsung lebih dari satu tahun. Pemeriksaan konduksi saraf berguna untuk melokalisasi dan menilai cedera saraf. Tanda-tanda denervasi pada elektromiogram (EMG) setelah cedera saraf akut membutuhkan 18-21 hari untuk berkembang.Kesimpulan: Dalam kasus ini, komplikasi muncul segera setelah pemulihan dari anestesi spinal dan pasien mengalami pemulihan total setelah 2 bulan. Komplikasi neurologi ini muncul dan diterapi dengan kortikosteroid, obat anti inflamasi, dan akupunktur tanpa adanya efek samping.
Ethnobotanical and ethnoecological study of the most important edible, medicinal and industrial species in the grasslands of Khalil Abad region, Zarrin Dasht, Fars province, Iran
Authors: Kord Kourosh , Abedi Fatemeh , Kazemeini Hamidreza , Shahsavari Somayeh , Solati Kamal
Published: July 2019

It is vital to record and preserve indigenous knowledge on plants to prevent loss of this valuable information. The indigenous knowledge about herbal drugs can provide us with useful information, such as their phytotherapeutic activities for the treatment of various diseases. This study investigated the indigenous knowledge regarding the use of medicinal plants for the treatment of human diseases and disorders in Khalil Abad region, Zarrin Dasht County, Fars province (Iran) from January to May 2017. Questionnaires were distributed among the subjects and traditional herbal information were recorded. The medicinal plants in this region are predominantly bush, including Zataria multiflora Boiss, Peganum harmala L., Alhagi persarum Boiss. & Buhse and Astragalus sp. The results of this study indicate that the residents of Khalil Abad village use various medicinal plants for nutritional and medicinal purposes. This is the first report of the ethnobotany of the region and the medicinal plants of indigenous knowledge of this region could be used as a source for new drugs.
A relation between the curvature ellipse and the curvature parabola
Authors: Benedini Riul P. , Oset Sinha R.
Published: July 2019

At each point in an immersed surface in ℝ4 there is a curvature ellipse in the normal plane which codifies all the local second order geometry of the surface. Recently, at the singular point of a corank 1 singular surface in ℝ3, a curvature parabola in the normal plane which codifies all the local second order geometry has been defined. When projecting a regular surface in ℝ4 to ℝ3 in a tangent direction, corank 1 singularities appear generically. The projection has a cross-cap singularity unless the direction of projection is asymptotic, where more degenerate singularities can appear. In this paper we relate the geometry of an immersed surface in ℝ4 at a certain point to the geometry of the projection of the surface to ℝ3 at the singular point. In particular we relate the curvature ellipse of the surface to the curvature parabola of its singular projection.
Continuous CM-regularity of semihomogeneous vector bundles
Authors: Küronya Alex , Mustopa Yusuf
Published: July 2019

We ask when the CM (Castelnuovo–Mumford) regularity of a vector bundle on a projective varietyXis numerical, and address the case whenXis an abelian variety. We show that the continuous CM-regularity of a semihomogeneous vector bundle on an abelian varietyXis a piecewise-constant function of Chern data, and we also use generic vanishing theory to obtain a sharp upper bound for the continuous CM-regularity of any vector bundle onX. From these results we conclude that the continuous CM-regularity of many semihomogeneous bundles — including many Verlinde bundles whenXis a Jacobian — is both numerical and extremal.
Aristotle and Crossing the Boundaries between the Sciences
Authors: Judson Lindsay
Published: July 2019

On the basis of what Aristotle says in the Posterior Analytics about how sciences are differentiated and about the impermissibility (save in some exceptional cases) of ‘kind-crossing’, many commentators suppose that when it comes to his scientific practice, Aristotle treats the boundaries of the sciences as impermeable, so that if subject-matter X is the business of one science, it simply cannot (save for the exceptional cases) be the business of another. I call this the impermeable boundary theory of the sciences: knowledge is divided into watertight compartments, determined by their distinct genera, and what goes on in one compartment cannot turn up in another. I argue that, even if this is a correct account of Aristotle’s position in the Analytics, the view that he accepts the impermeable boundary theory when it comes to his scientific and philosophical work outside the Analytics is simply untenable.
Homoclinics for singular strong force Lagrangian systems
Authors: Izydorek Marek , Janczewska Joanna , Mawhin Jean
Published: July 2019

We study the existence of homoclinic solutions for a class of Lagrangian systems
$\begin{array}{}
\frac{d}{dt}
\end{array} $(∇Φ(u̇(t))) + ∇uV(t, u(t)) = 0, where t ∈ ℝ, Φ : ℝ2 → [0, ∞) is a G-function in the sense of Trudinger, V : ℝ × (ℝ2 ∖ {ξ}) → ℝ is a C1-smooth potential with a single well of infinite depth at a point ξ ∈ ℝ2 ∖ {0} and a unique strict global maximum 0 at the origin. Under a strong force condition around the singular point ξ, via minimization of an action integral, we will prove the existence of at least two geometrically distinct homoclinic solutions u± : ℝ → ℝ2 ∖ {ξ}.
Simultaneous Inference of Treatment Effect Modification by Intermediate Response Endpoint Principal Strata with Application to Vaccine Trials
Authors: Zhuang Yingying , Huang Ying , Gilbert Peter B.
Published: July 2019

In randomized clinical trials, researchers are often interested in identifying an inexpensive intermediate study endpoint (typically a biomarker) that is a strong effect modifier of the treatment effect on a longer-term clinical endpoint of interest. Motivated by randomized placebo-controlled preventive vaccine efficacy trials, within the principal stratification framework a pseudo-score type estimator has been proposed to estimate disease risks conditional on the counter-factual biomarker of interest under each treatment assignment to vaccine or placebo, yielding an estimator of biomarker conditional vaccine efficacy. This method can be used for trial designs that use baseline predictors of the biomarker and/or designs that vaccinate disease-free placebo recipients at the end of the trial. In this article, we utilize the pseudo-score estimator to estimate the biomarker conditional vaccine efficacy adjusting for baseline covariates. We also propose a perturbation resampling method for making simultaneous inference on conditional vaccine efficacy over the values of the biomarker. We illustrate our method with datasets from two phase 3 dengue vaccine efficacy trials.
Patients with acute cervical insufficiency without intra-amniotic infection/inflammation treated with cerclage have a good prognosis
Authors: Mönckeberg Max , Valdés Rafael , Kusanovic Juan P. , Schepeler Manuel , Nien Jyh K. , Pertossi Emiliano , Silva Pablo , Silva Karla , Venegas Pía , Guajardo Ulises , Romero Roberto , Illanes Sebastián E.
Published: July 2019

Background

The frequency of intra-amniotic infection/inflammation (IAI/I) in patients with midtrimester cervical insufficiency is up to 50%. Our purpose was to determine the perinatal outcomes of cervical cerclage in patients with acute cervical insufficiency with bulging membranes, and to compare the admission-to-delivery interval and pregnancy outcomes according to the results of amniotic fluid (AF) analysis and cerclage placement.

Methods

This was a retrospective cohort study including singleton pregnancies with cervical insufficiency between 15 and 26.9 weeks in two tertiary health centers. IAI/I was defined when at least one of the following criteria was present in AF: (a) a white blood cell (WBC) count >50 cells/mm3; (b) glucose concentration <14 mg/dL; and/or (c) a Gram stain positive for bacteria. Three different groups were compared: (1) absence of IAI/I with placement of a cerclage; (2) amniocentesis not performed with placement of a cerclage; and (3) IAI/I with or without a cerclage.

Results

Seventy patients underwent an amniocentesis to rule out IAI/I. The prevalence of IAI/I was 19%. Forty-seven patients underwent a cerclage. Patients with a cerclage had a longer median admission-to-delivery interval (33 vs. 2 days; P < 0.001) and delivered at a higher median gestational age (27.4 vs. 22.6 weeks; P = 0.001) than those without a cerclage. The neonatal survival rate in the cerclage group was 62% vs. 23% in those without a cerclage (P = 0.01). Patients without IAI/I who underwent a cerclage had a longer median admission-to-delivery interval (43 vs. 1 day; P < 0.001), delivered at a higher median gestational age (28 vs. 22.1 weeks; P = 0.001) and had a higher neonatal survival rate (67% vs. 8%; P < 0.001) than those with IAI/I.

Conclusion

The pregnancy outcomes of patients with midtrimester cervical insufficiency and bulging membranes are poor as they have a high prevalence of IAI/I. Therefore, a pre-operative amniocentesis is key to identify the best candidates for the subsequent placement of a cerclage.
Impact of cell-free fetal DNA on invasive prenatal diagnostic tests in a real-world public setting
Authors: Herraiz Ignacio , Villalba Ana , Ajuria Eliam , Barasoain Alba , Mendoza Ana , Pizarro Nazaret , Escribano David , Galindo Alberto
Published: July 2019

Objective

To evaluate the impact of cell-free fetal DNA (cfDNA) test on the number of invasive tests carried out in a public hospital that does not include this test in its services.

Methods

This was a retrospective cohort study in singleton pregnancies with a high risk (>1:270) on the first-trimester screening for aneuploidies. The options of performing an invasive test or a cfDNA test were explained to all women, the latter being especially recommended to those with a 1:50–1:270 risk (Group 1). If the risk was >1:50 (Group 2), or nuchal translucency (NT) was >99th percentile or there were major malformations (Group 3), invasive test was recommended.

Results

A total of 755 of 14,398 (5.2%) cases had a high-risk first-trimester screening, of whom 46 cases were excluded due to incomplete follow-up. In the remaining 709 cases, the percentage of aneuploidies was 9.9% (70 cases) and 110 opted for a cfDNA test (15.5%). There were two true-positive results of cfDNA (one in Group 2 and another in Group 3). In Group 1, 67.4% [95% confidence interval (CI) 60.0%–72.1%, P < 0.01] fewer invasive procedures were performed in those who opted for a cfDNA test, without having false negatives.

Conclusion

Pregnant women with a 1:50–1:270 risk who opt for cfDNA save two out of three invasive tests, without affecting the aneuploidy detection rate.
A Rising Tide that Lifts no Boats. The European Union and the Development of the Transnational Economy of Crimigration
Authors: Rewizorski Marek
Published: July 2019

The author of the article focuses on investigating the relationship between the outbreak of irregular migration to Europe and the increasing importance of transnational criminal networks. The starting point is the assumption that the transnational economy of crimigration (TEC) is driven by the illicit activity of private actors (the supply side) and potential migrants who create the demand for this kind of services, often not realizing the full extent of the consequences of entering into contractual relationships with groups of smugglers (the demand side). It is also assumed that the dynamics of the transnational economy of crimigration is one of the main causes of the rising wave of irregular migration and the migration crisis in the European Union.
Des Unternehmers «volkstümliche» Biographie, oder: wie die Ruhrkohlenindustrie Geschichte machte
Authors: Roelevink Eva-Maria
Published: July 2019

A popular biography or: how the Ruhrcoal industry created history. The general assumption in our profession is that history it analyzed and written by qualified historians. Companies, industrialists and associations, however, are and were active in especially writing business history as well. It is evident that they commissioned commemorative publications for different reasons than historians wrote business history. By aiming to apply their business history frequently for political reasons of the present time, it turned out to be useful for them to hide the fact that the publications were commissioned working projects. By exemplifying the biography of Emil Kirdorf, written and published in 1936 by Walter Bacmeister, the article draws attention to the ambitions that motivated the industrialists to merchandise Emil Kirdorf's life during the 1930s.
Leaving Against Medical Advice From In-patients Departments Rate, Reasons and Predicting Risk Factors for Re-visiting Hospital Retrospective Cohort From a Tertiary Care Hospital
Authors: Hasan Obada , Adeel Samad Muhammad , Khan Hamza , Sarfraz Maryam , Noordin Shahryar , Ahmad Tashfeen , Nowshad Gul
Published: July 2019

Background: Approximately 1% to 2% of hospitalized patients get discharged or leave from the hospital against medical advice and up to 26% in some centers. They have higher readmission rate and risk of complications than patients who receive complete care. In this study we aimed to determine the rate of leave against medical advice (LAMA) and reasons for the same across different in-patient departments of a tertiary care hospital. Methods: Retrospective cohort study on patients admitted in all departments at our institute over a 1-year period. All patients who were admitted to an in-patient ward at the hospital and who left against medical advice by submitting a duly filled LAMA form were included. Univariate and multivariate logistic regression models with forward selection methods were employed. Revisit to hospital within 30 days; to clinic or emergency department was outcome variable for regression. Results: From June 2015 to May 2016 there were 429 LAMA patients, accounting for 0.7% of total admissions. Females were 223 (52%) compared to males 206 (48%). Finances were quoted as the most common reason for LAMA by 174 (41%) patients followed by domestic problems 78 (18%). Internal medicine was the service with the highest number of LAMA patients ie, 153 (36%) followed by Pediatric medicine with 73 (17%). Of the 429 patients, 147 (34%) patients revisited the hospital within 30 days. Sixty-one percent of these ‘bounced-back’ LAMA patients had worsening or persistence of same problem, or new problem/s had developed. In unadjusted bivariate logistic model, patients who were advised for follow-up during discharge against medical advice were four times more likely to revisit the hospital. Patients who were married had an increased odd of revisiting the hospital. Conclusion: Financial reasons are the most common stated reasons to LAMA. Patients who LAMA are at a high risk of clinical worsening and ‘bouncing back.’ This is the first study from our region on in-patient LAMA rates, to our knowledge. The results can be used for planning measures to reduce LAMA rates and its consequences.
Regular Antenatal Care Visits Predict Good Knowledge Among Post-natal Mothers Regarding Entitlements of Health Programs in Western India
Authors: Rupani Mihir P. , Patel Pathik M. , Meena Pooja R. , Patel Pooja P. , Patel Priskila A. , Paragda Priya K.
Published: July 2019

Janani-Shishu Suraksha Karyakram (JSSK) and Janani Suraksha Yojana (JSY) were launched with the objective of increasing institutional deliveries. But, its knowledge among the post-natal mothers is not known. This research evaluated the knowledge of two national health programs among post-natal mothers and found out the predictors of good knowledge about the entitlements of these programs. A cross-sectional study was conducted on a sample of consecutively recruited 339 post-natal mothers who had delivered in a tertiary care hospital of western India. Data were collected from November 2016 to February 2017 by interview method using a questionnaire with questions about knowledge regarding the entitlements of JSSK and JSY. Multivariable analysis was carried out for predictors of good knowledge. Among the 339 post-natal mothers, 30% had a good knowledge regarding JSSK. Only 24% had heard about JSSK; 54% knew regarding free transport to the place of delivery; only 22% and 13%, respectively knew about free inter-facility transport in case of complications for pregnant women and sick infants, while 96% knew regarding free drop-back facility. Only one-fourth of the mothers knew regarding monetary benefit under JSY, while 28% of them had actually received the benefit. The number of antenatal care visits, having an occupation and belonging to Hindu religion significantly predicts good knowledge among postnatal mothers regarding JSSK. Knowledge among the post-natal mothers regarding the entitlements of JSSK and JSY is less while comparing with published literature and needs improvement. Regular ante-natal care (ANC) visits might improve their knowledge of these programs. There is a need to create awareness among hospital staff for the provision of reimbursement of costs incurred by post-natal mothers. There is also a need to carry out demand generation activities among mothers regarding the entitlements of JSSK and JSY.
High Stakes Require More Than Just Talk: What to Do About Corruption in Health Systems Comment on "We Need to Talk About Corruption in Health Systems"
Authors: Vian Taryn
Published: July 2019

Reluctance to talk about corruption is an important barrier to action. Yet the stakes of not addressing corruption in the health sector are higher than ever. Corruption includes wrongdoing by individuals, but it is also a problem of weak institutions captured by political interests, and underfunded, unreliable administrative systems and healthcare delivery models. We urgently need to focus on corruption as a health systems problem. In addition to supporting research to better understand the context and implications of corruption in health systems, this article suggests actions that public health professionals can do now to fight corruption.
Strategic Purchasing: The Neglected Health Financing Function for Pursuing Universal Health Coverage in Lowand Middle-Income Countries Comment on "What’s Needed to Develop Strategic Purchasing in Healthcare? Policy Lessons from a Realist Review"
Authors: Hanson Kara , Barasa Edwine , Honda Ayako , Panichkriangkrai Warisa , Patcharanarumol Walaiporn
Published: July 2019

Sanderson et al’s realist review of strategic purchasing identifies insights from two strands of theory: the economics of organisation and inter-organisational relationships. Our findings from a programme of research conducted by the RESYST (Resilient and Responsive Health Systems) consortium in seven countries echo these results, and add to them the crucial area of organisational capacity to implement complex reforms. We identify key areas for policy development. These are the need for: (1) a policy design with clearly delineated responsibilities; (2) a task network of organisations to engage in the broad set of functions needed; (3) more effective means of engaging with populations; (4) a range of technical and management capacities; and (5) an awareness of the multiple agency relationships that are created by the broader financing environment and the provider incentives generated by multiple financing flows.
Financing Long-term Care: Lessons From Japan
Authors: Ikegami Naoki
Published: July 2019

Long-term care (LTC) must be carefully delineated when expenditures are compared across countries because how LTC services are defined and delivered differ in each country. LTC’s objectives are to compensate for functional decline and mitigate the care burden of the family. Governments have tended to focus on the poor but Germany opted to make LTC universally available in 1995/1996. The applicant’s level of dependence is assessed by the medical team of the social insurance plan. Japan basically followed this model but, unlike Germany where those eligible may opt for cash benefits, they are limited to services. Benefits are set more generously in Japan because, prior to its implementation in 2000, health insurance had covered long-stays in hospitals and there had been major expansions of social services. These service levels had to be maintained and be made universally available for all those meeting the eligibility criteria. As a result, efforts to contain costs after the implementation of the LTC Insurance have had only marginal effects. This indicates it would be more efficient and equitable to introduce public LTC Insurance at an early stage before benefits have expanded as a result of ad hoc policy decisions.
Meeting the Challenge of the "Know-Do" Gap Comment on "CIHR Health System Impact Fellows: Reflections on ‘Driving Change’ Within the Health System"
Authors: Hunter David J.
Published: July 2019

Bridging the ‘know-do’ gap is not new but considerably greater attention is being focused on the issue as governments and research funders seek to demonstrate value for money and impact on policy and practice. Initiatives like the Canadian Institutes of Health Research (CIHR) Health System Impact (HSI) Fellowship are therefore both timely and welcome. However, they confront major obstacles which, unless addressed, will result in such schemes remaining the exception and having limited impact. Context is everything and as long as universities and research funders privilege peer-reviewed journal papers and traditional measures of academic performance and success, novel schemes seeking to break down barriers between researchers and end users are likely to have limited appeal. Indeed, for some academics they risk being career limiting. The onus should be on universities to welcome greater diversity and nurture and value a range of academic researchers with different skills matched to the needs of applied health system research. One size does not fit all and adopting a horses for courses approach would go a long way to solving the conundrum facing higher education institutions. At the same time, researchers need to show greater humility and acknowledge that scientific evidence is only one factor shaping policy and practice. To help overcome a risk of ideology and opinion triumphing over evidence, attention should be devoted to encouraging citizens to get actively involved in research. Research funders also need to give higher priority to how policy can be made to stick if the ‘know-do’ gap is to be closed.
Priority Setting on the Path to UHC: Time for Stronger Institutions and Stronger Health Systems: Response to Recent Commentaries
Authors: Norheim Ole F.
Published: July 2019

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Work-related musculoskeletal disorders among nurses in various specialty areas in a Nigerian tertiary health institution
Authors: Bolarinde Samuel Olufemi , Oyewole Isaiah , Abobarin Adesola Felix
Published: July 2019

Objective: Musculoskeletal disorders (MSDs) are one of the major complaints in the work place. This study investigated the prevalence and pattern of work-related MSDs, risk factors and the strategies of management among nurses working in various specialty areas in a tertiary health institution in Nigeria. Methods: This cross-sectional survey recruited 150 nurses working in various specialty areas of a government own tertiary institution in South-west, Nigeria. Data were obtained on demographic characteristics, occupational profile, work-related musculoskeletal symptoms, perceptions on job risk factors and management strategies. Data were presented using descriptive statistics of percentages and frequency tables. Results: The most common MSD among the respondents was low back pain (LBP) (60.0%), followed by neck pain (48.0%), while elbow pain was the lowest work-related musculoskeletal pain (5.3%). Findings indicated that respondents working in Intensive Care Unit (100.0%), Dental Unit (100.0%), Accident and Emergency (77.8%), Orthopaedics (75.0%), Ear Nose and Throat (75.0%) and Medicine (72.7%) suffered from LBP more than other respondents in other specialty areas. Results also revealed that frequent bending (64.0%), prolonged standing (49.3%) and frequent lifting of patients (48.0%) were major factors that contributed to LBP among the respondents. Rest (56.0%), pain killer drugs (50.7%), and exercise (36.0 %) were the most preferred pain management strategies among the respondents, while only 12.0% preferred physiotherapy management. Conclusion: A great percentage of Nigerian nurses suffer from work-related MSDs in their professions with the low back being the most injured body part. Nurses working in Intensive Care Unit, Dental, Accident and Emergency and Orthopedics are more prone to work-related LBP. Education programs on back care and workplace ergonomics are recommended for reduction and prevention of occupational hazards among nurses.
A clinical study investigation the three months prognosis of patients with ischemic stroke treated with recombinant tissue plasminogen activator (rtPA) and its effective factors
Authors: Abbasi Vahid , Atalu Abolfazl , Sharghi Afshan , Taghvatalab Fatemeh
Published: July 2019

Objective: Currently, treating ischemic stroke by intravenous thrombolytic therapy has acceptable results in patients with stroke. This study aimed to evaluate the three months prognosis of patients treated with recombinant tissue plasminogen activator (rt-PA). Methods: This cross-sectional prospective study was conducted on 30 patients with cerebral ischemic stroke with the National Institutes of Health Stroke Scale (NIHSS) >5. Data such as demographic information, signs and symptoms, medical history, risk factors, focused neurological examination, and the NIHSS were collected for all patients. Then, all patients received 0.9 mg/kg of rt-PA as intravenous bolus doses and intravenous infusion under close monitoring in the emergency department. All patients were checked for necessary outcomes and also disability at the admission time, 7 days later and after three months all patients were checked again. All collected data were analyzed by appropriate tests using SPSS version 22. Results: Of all patients, 63.3% were males and 36.7% were females. The mean age of the patients was 62.37 ± 12.62 years with a range of 40-91 years. The mean of NIHSS was 12.46 ± 4.28 at admission time, in day seven it was 8.06 ± 3.72 and in month three after treatment it was 3.62 ± 2.31. There was a significant relationship between age, place of residence and NIHSS. Thirty percent of patients had NIHSS more than 15 at admission time and after 7 days this rate reached to 10% and three months later it declined to 6.7%. These differences were statistically significant. Conclusion: Intravenous thrombolytic therapy is associated with proper short term results in most patients with ischemic stroke.
Nem tudo está perdido: Arqueologia e histórias de vida na contextualização de objeto arqueológico do MAE/UFBA
Authors: Costa Carlos Alberto Santos
Published: July 2019

Neste artigo utilizo a perspectiva das “histórias de vida” com o objetivo de contextualizar e indicar o provável local de coleta feita por moradores locais de uma urna funerária, posteriormente resgatada pelo arqueólogo Valentín Calderón nos anos 60 do século XX, no município de Morro do Chapéu, Bahia. Tomando como ponto de partida a minha história e as minhas memórias pessoais, identifiquei interlocutores que viveram este episódio e fiz o enlace das suas “histórias de vida” com dados arqueológicos e com informações salvaguardadas no Mae/Ufba. Este caminho percorrido permitiu a obtenção de elementos comuns das “histórias de vida” dos diferentes atores sociais para a criação de uma nova narrativa sobre o objeto arqueológico. Assim, é possível compreender melhor esse objeto, então sob a salvaguarda do museu, e indicar caminhos futuros para novas pesquisas.
 
Abstract: In this article I use the perspective of “life histories” with the purpose of contextualizing and indicating the probable place of collection by local residents of a funeral urn, later rescued by the archaeologist Valentín Calderón in the 60s of the 20th century, in the municipality of Morro do Chapéu, Bahia. Taking as my starting point my story and my personal memories, I identified interlocutors who lived through this episode and linked their “life histories” with archaeological data and information safeguarded in Mae/Ufba. This path allowed me to obtain common elements of the “life histories” of the different social actors for the creation of a new narrative about the archaeological object. Thus, it is possible to better understand this object under the safeguard of the museum and indicate future paths for further research.