bluuebunny/crossref_metadata_2025 huggingface dataset:
Modelling tourism receipts and associated risks, using long-range dependence models
Authors: Pérez-Rodríguez Jorge V , Santana-Gallego María
Published: February 2019

Tourism receipts have important policy implications for destination countries in terms of government revenues and the management of tourism-related policies. This article uses time series models to analyse the risk exposure reflected in the growth rates of tourism revenues. To do so, we apply risk management measures based on value-at-risk (VaR) and the expected shortfall (ES), analysing monthly data for six Spanish regions from January 2004 to March 2017. Two main results were obtained. Firstly, tourism receipt growth rates present negative long-range dependence. In other words, they have intermediate memory or anti-persistence and therefore show signs of dependence between widely separated observations. Moreover, we detected the existence of long-range dependence in these volatilities in one of the six regions considered. Secondly, we show that VaR based on Generalized Autoregressive Conditional Heteroscedasticity (GARCH)-type models is a valid means of analysing the risk exposure of tourism receipt growth rates, doing so by evaluating various in-sample and out-of-sample VaR thresholds and the ES.
Up and down and sideways: Collaboration, friction and ethnographic representations of orthodontics for children
Authors: Wickström Anette
Published: February 2019

In this article, I discuss collaboration and my experiences of involving orthodontists when representing orthodontic practice. Drawing on an ethnographic study with children and young people getting fixed appliances, the aim is to understand the politics of the practitioners’ receptions of the research result. First, I explore the power balance involved in researching expertise in general. Studying up and down and sideways in a multidirectional collaboration, I demonstrate that direct focus on the practitioners’ reactions to the ethnographic representations can reveal the political and social processes in institutions that deeply affect the lives of children. Secondly, the ethnographic examples show the specific changing conditions within the field of orthodontics that influenced how my analysis was received by the orthodontists. I argue that the result of collaboration, in the form of both agreement and friction, serves as knowledge about the burning questions of the institutional network under study.
Disabling discourses and ableist assumptions: Reimagining social justice through education for disabled people through a critical discourse analysis approach
Authors: Van Aswegen Jennifer , Shevlin Michael
Published: February 2019

Responding to the special issue call Capital and Capability, this paper undertakes a critical policy analysis of a recently published Irish labour market activation strategy for people with disabilities through a discourse analytical framework. Drawing on a disability studies lens informed by Foucault’s theory of discourse, the study reveals a hegemonic policy rhetoric within the pages of this policy document that is deeply embedded in neoliberal assumptions about the role and value of education. Through a critical disability studies lens, this study draws attention to the concepts of disablism and neoliberal ableism, whilst highlighting in particular how rhetoric is a means by which ableist culture perpetuates itself. In response to the disparities surrounding the employment of disabled people, the Comprehensive Employment Strategy for People with Disabilities 2015–2024was launched into policy in October 2015. This strategy represents a significant policy event in the Irish disability policy landscape, warranting further questioning, interrogation and analysis. This paper aims to reveal the framework of thinking that lies within the discursive contours of this strategy and to assess the implications therein for inclusive education policy and practice. In keeping with the aim of the special issue, the study explores the potential of a capabilities approach in creating a discursive policy space where social justice througheducation for disabled people can be imagined.
Student Perceptions of Institutional Care: Making Sense of Hardship Funding as a Retention Tool
Authors: Wagner Erica L. , Sanchez Becky , Haley Karen
Published: February 2019

This article focuses on how a financial support initiative improved student persistence at an urban commuter institution. Existing research acknowledges that financial concerns of university students may keep them from feeling connected to their institution thereby increasing the likelihood of stopping out. There is less study of how recipients of just-in-timefinancial support make sense of the award—and how those perceptions may help institutions better understand recipients’ sense of belonging. Through an exploratory qualitative research study, we contribute to the retention literature broadly and specifically to the idea of student perceptions of institutional care. We also present guiding principles for creating a successful hardship initiative that supports students financially and emotionally at their most critical time.
The forgotten father in obstetric medicine
Authors: Kothari A , Thayalan K , Dulhunty J , Callaway L
Published: February 2019

The role of fathers prior to conception, during pregnancy, and in the post-partum period has generally not been a key consideration for Obstetric Physicians. However, this view may need challenging. This paper outlines the key importance of fathers in all phases of obstetric medical care. We review the contribution of paternal factors such as genetics, health, and lifestyle to fetal development, pregnancy complications, and maternal and neonatal wellbeing. The role of fathers in complex care decisions during pregnancy is also reviewed. Postpartum, fathers have a substantial role in shaping the future of the family unit through encouraging breastfeeding and creating a supportive environment for motherhood. This review proposes areas for future research and recommends an evidence-based change in practice in obstetric medicine that focuses on recognizing the role of fathers in the pregnancy journey.
Coenzyme Q10 supplementation reduces peripheral oxidative stress and inflammation in interferon-β1a-treated multiple sclerosis
Authors: Moccia Marcello , Capacchione Antonio , Lanzillo Roberta , Carbone Fortunata , Micillo Teresa , Perna Francesco , De Rosa Anna , Carotenuto Antonio , Albero Roberto , Matarese Giuseppe , Palladino Raffaele , Brescia Morra Vincenzo
Published: February 2019

Background:

Oxidative stress is a driver of multiple sclerosis (MS) pathology. We evaluated the effect of coenzyme Q10 (CoQ10) on laboratory markers of oxidative stress and inflammation, and on MS clinical severity.

Methods:

We included 60 relapsing–remitting patients with MS treated with interferon beta1a 44μg (IFN-β1a) with CoQ10 for 3 months, and with IFN-β1a 44μg alone for 3 more months (in an open-label crossover design). At baseline and at the 3 and 6-month visits, we measured markers of scavenging activity, oxidative damage and inflammation in the peripheral blood, and collected data on disease severity.

Results:

After 3 months, CoQ10 supplementation was associated with improved scavenging activity (as mediated by uric acid), reduced intracellular reactive oxygen species production, reduced oxidative DNA damage, and a shift towards a more anti-inflammatory milieu in the peripheral blood [with higher interleukin (IL)-4 and IL-13, and lower eotaxin, granulocyte-macrophage colony-stimulating factor (GM-CSF), hepatocyte growth factor (HGF), interferon (IFN)-γ, IL-1α, IL-2R, IL-9, IL-17F, macrophage inflammatory proteins (MIP)-1α, regulated on activation-normal T cell expressed and secreted (RANTES), tumor necrosis factor (TNF)-α, and vascular endothelial growth factor (VEGF). Also, CoQ10 supplementation was associated with lower Expanded Disability Status Scale, fatigue severity scale, Beck’s depression inventory, and the visual analogue scale for pain.

Conclusions:

CoQ10 supplementation improved scavenging activity, reduced oxidative damage, and induced a shift towards a more anti-inflammatory milieu, in the peripheral blood of relapsing–remitting MS patients treated with 44μg IFN-β1a 44μg. A possible clinical effect was noted but deserves to be confirmed over longer follow ups.
Clinical characteristics and prognosis in patients with chronic thromboembolic pulmonary hypertension and a concomitant psychiatric disorder
Authors: Tajima Hiroshi , Kasai Hajime , Tanabe Nobuhiro , Sugiura Toshihiko , Miwa Hideki , Naito Akira , Suda Rika , Nishimura Rintaro , Sanada Takayuki Jujo , Sakao Seiichiro , Tatsumi Koichiro
Published: February 2019

Chronic thromboembolic pulmonary hypertension (CTEPH) can cause right heart failure. A concomitant psychiatric disorder (PD) is thought to increase the risk of acute pulmonary thromboembolism; however, whether PDs are associated with deterioration in CTEPH pathophysiology is unclear. In this study, we evaluated the clinical characteristics and prognoses in patients with CTEPH and a co‐existing PD. We retrospectively identified 229 consecutive patients (mean age = 58.7 ± 12.5 years; 160 women) with CTEPH and categorized them according to whether they had a PD (PD group; n = 22, 9.7%) or not (non‐PD group; n = 207, 90.3%). We compared the clinical characteristics, respiratory function, hemodynamics, and clinical courses in the two groups. Those in the PD group had significantly lower exercise tolerance compared to the non‐PD group (6‐min walk test, 309.5 ± 89.5 m vs. 369.4 ± 97.9 m, P = 0.008, percent vital capacity 85.5% ± 17.3% vs. 96.0% ± 15.5%, P = 0.003) and partial pressure of oxygen (PaO2) (54.4 ± 8.6 mmHg vs. 59.3 ± 10.7 mmHg, P = 0.039). Three‐year survival was significantly poorer in the PD group compared to the non‐PD group (66.1% vs 89.7%, P = 0.0026, log‐rank test), particularly in patients who underwent surgery (62.2% vs 89.5%, P < 0.001, log‐rank test). A concomitant PD was associated with low exercise tolerance and impaired respiratory function in patients with CTEPH and predicted poor survival, especially in those who underwent a pulmonary endarterectomy.
Targeting relatives: Impact of a cardiac rehabilitation programme including basic life support training on their skills and attitudes
Authors: González-Salvado Violeta , Abelairas-Gómez Cristian , Gude Francisco , Peña-Gil Carlos , Neiro-Rey Carmen , González-Juanatey José Ramón , Rodríguez-Núñez Antonio
Published: February 2019

Background

Training families of patients at risk for sudden cardiac death in basic life support (BLS) has been recommended, but remains challenging. This research aimed to determine the impact of embedding resuscitation training for patients in a cardiac rehabilitation programme on relatives' BLS skill retention at six months.

Design

Intervention community study.

Methods

Relatives of patients suffering acute coronary syndrome or revascularization enrolled on an exercise-based cardiac rehabilitation programme were included. BLS skills of relatives linked to patients in a resuscitation-retraining programme (G-CPR) were compared with those of relatives of patients in a standard programme (G-Stan) at baseline, following brief instruction and six months after. Differences in skill performance and deterioration and self-perceived preparation between groups over time were assessed.

Results

Seventy-nine relatives were included and complete data from 66 (G-Stan=33, G-CPR=33) was analysed. Baseline BLS skills were equally poor, improved irregularly following brief instruction and decayed afterwards. G-CPR displayed six-month better performance and lessened skill deterioration over time compared with G-Stan, including enhanced compliance with the BLS sequence ( p = 0.006 for group*time interaction) and global resuscitation quality ( p = 0.007 for group*time interaction). Self-perceived preparation was higher in G-CPR ( p = 0.002).

Conclusions

Relatives of patients suffering acute coronary syndrome or revascularization enrolled on a cardiac rehabilitation programme showed poor BLS skills. A resuscitation-retraining cardiac rehabilitation programme resulted in relatives' higher BLS awareness, skill retention and confidence at six months compared with the standard programme. This may suggest a significant impact of this formula on the family setting and support the active role of patients to enhance health education in their environment.
Cardiovascular effects of space radiation: implications for future human deep space exploration
Authors: Mitchell Adam , Pimenta Dominic , Gill Jaspal , Ahmad Haris , Bogle Richard
Published: February 2019

Background

A manned mission to Mars has been contemplated by the world's largest space agencies for a number of years. The duration of the trip would necessitate a much longer exposure to deep space radiation than any human has ever been exposed to in the past. Concern regarding cancer risk has thus far stalled the progress of deep space exploration; however, the effect of space radiation on the cardiovascular system is significantly less well understood.

Discussion

Damage by radiation in space is mediated by a number of sources, including X-rays, protons and heavier charged atomic nuclei (HZE ions, the high-energy component of galactic cosmic rays). Previously, only lunar mission astronauts have been exposed to significant deep space radiation, with all other missions being low earth orbits only. The effect of this radiation on the human body has been inconclusively studied, and the long-term damage caused to the vascular endothelium by this radiation due to the effect of high-energy particles is not well known.

Conclusion

Current radiation shielding technology, which would be viable for use in spacecraft, would not eliminate radiation risk. Similar to how a variety of shielding techniques are used every day by radiographers, again without full risk elimination, we need to explore and better understand the effect of deep space radiation in order to ensure the safety of those on future space missions.
Prevalence and Associations, by Age Group, of IPV Among AGYW in Rural South Africa
Authors: Selin Amanda , DeLong Stephanie M. , Julien Aimée , MacPhail Catherine , Twine Rhian , Hughes James P. , Agyei Yaw , Hamilton Erica L. , Kahn Kathleen , Pettifor Audrey
Published: February 2019

The prevalence of intimate partner violence (IPV) is alarmingly high among South African adolescent girls and young women (AGYW). Limited data exist exploring how IPV prevalence and its risk factors differ by age. Study data were from the baseline visit of HPTN 068, a randomized controlled trial (RCT) conducted from 2011 to 2015 in Mpumalanga, South Africa. A cohort of 2,533 AGYW, aged 13 years to 20 years, answered survey questions on demographics and behaviors, including their experiences of physical and sexual violence ever and in the past 12 months. We calculated the prevalence of IPV and related risk factors, as well as prevalence ratios with 95% confidence intervals, stratified by age. Nearly one quarter (19.5%, 95% CI = [18.0, 21.2]) of AGYW experienced any IPV ever (physical or sexual) by a partner. The prevalence of any IPV ever among AGYW aged 13 years to 14 years, 15 years to 16 years, and 17 years to 20 years was 10.8%, 17.7%, and 32.1%, respectively. Key variables significantly associated with any IPV ever across all age groups included borrowing money from someone outside the home in the past 12 months, ever having had vaginal sex, ever having had anal sex, and consuming any alcohol. Few statistically significant associations were unique to specific age groups. The history of IPV among the youngest AGYW is a critical finding and should be a focus of prevention efforts.
Physical Function and Quality of Life After Resection of Mobile Spine Chondrosarcoma
Authors: Paulino Pereira Nuno Rui , Janssen Stein J. , Stoop Nicky , Hartveldt Stefan , Chen Yen-Lin E. , DeLaney Thomas F. , Hornicek Francis J. , Schwab Joseph H.
Published: February 2019

Study Design:

Retrospective cohort study.

Objectives:

(1) To assess patient-reported outcomes—physical function, pain, and quality of life—in patients who underwent resection of a mobile spine chondrosarcoma. (2) To assess complications (90 days), readmissions, reoperations, oncological outcomes, and neurologic status.

Methods:

Thirty-three patients with spinal conventional chondrosarcoma resection between 1984 and 2014 at one hospital were included. The primary outcome measures were—minimally 6 months after surgery—the EuroQol 5 Dimensions (EQ5D), PROMIS–Physical Function, PROMIS–Pain Intensity, and Oswestry (ODI) Disability Index, or Neck (NDI) Disability established in 14 out of 20 alive (70.0%) patients. Complications, readmission, reoperations, oncological outcomes, and neurological status were reported for the complete cohort of 33 patients.

Results:

After spine chondrosarcoma resection, patients (n = 14) reported worse physical function (median 43, range 22-61, P = .026), worse quality of life (median EQ5D 0.70, range 0.04-1, P = .022), and comparable pain intensity (median 47, range 31-56, P = .362) when compared with US general population values. The median NDI/ODI was 25 (range 0-72) indicating mild to moderate disability. Patients undergoing reoperation had worse patient-reported outcomes than those who did not. Eighteen (55.5%) out of 33 patients suffered complications (90 days), 14 (42.4%) had unplanned readmission, and 13 (39.4%) underwent reoperation. Intralesional resection was associated with increased readmission, reoperation, and recurrence rate.

Conclusions:

Chondrosarcoma affects quality of life and physical function and its treatment frequently results in complications and reoperations. Our findings can be used to inform future patients about expected outcomes.
A previously unreported type of extra-articular triplane fracture: A revised classification system
Authors: Yung Colin S , Kuong Evelyn E , Chow Wang
Published: February 2019

Background:

Atypical triplane fractures are defined as triplane fractures that are intra-articular but affect the non-weight-bearing area of the tibia plafond or extra-articular triplane fractures where the epiphyseal fracture line exits outside the articulating cortex of the medial malleolus. These fractures are scarcely reported in the literature. Here, we study the fracture pattern, mechanisms, and recommendations for management.

Methods:

This is a retrospective study of all triplane fractures identified from 2012 to 2016 in a tertiary referral center. There were 10 atypical triplane fracture patterns identified in this cohort. All patients were followed up with an average of 19 months. A modified atypical triplane fracture classification was devised and compared with previously reported classification systems. Clinical outcomes measured included treatment complications, ankle range of motion, and time needed to return to sports.

Results:

We identified a new extra-articular triplane fracture variant with an anteromedial epiphyseal sleeve fragment (fracture variant). There were no long-term complications from operative closed reduction and percutaneous screw fixation. Operative cases had earlier ankle mobilization and regained full range of motion (12.8 weeks vs 13.3 weeks) earlier. The average time to return to sports was 5.2 months.

Conclusions:

We propose a modified classification for atypical triplane fractures and recommend closed reduction and percutaneous screw fixation for displaced atypical triplane fractures.

Level of Evidence:

IV (Case Series).
What Matters at the End of Life: A Qualitative Study of Older Peoples Perspectives in Southern Denmark
Authors: Hanson Stine , Brabrand Mikkel , Lassen Annmarie T. , Ryg Jesper , Nielsen Dorthe S.
Published: February 2019

What matters at the end of life (EOL) among the older population in Denmark is poorly investigated. We used focus groups and in-depth interviews, to identify perspectives within the EOL, along with what influences resuscitation, decision making, and other treatment preferences. We included eligible participants aged ≥65 years in the Region of Southern Denmark. Five focus groups and nine in-depth interviews were conducted, in total 31 participants. We found a general willingness to discuss EOL, and experiences of the process of dying were present among all participants. Three themes emerged during the analysis: (a) Being independent is crucial for the future, (b) Handling and talking about the EOL, and (c) Conditions in Everyday Life are Significant. Life experiences seemed to affect the degree of reflection of EOL and the decision-making process. Knowing your population of interest is crucial, when developing an approach or using an advance care plan from another setting.
Benefits of Using an Appropriately Formulated Wipe to Clean Diapered Skin of Preterm Infants
Authors: Vongsa Rebecca , Rodriguez Karien , Koenig David , Cunningham Corey
Published: February 2019

The skin of premature infants is underdeveloped rendering it more prone to break down and irritation. Therefore, special care is needed to protect premature skin and ensure it is not adversely affected. Many health care professionals advise using just water and cloth to clean diapered skin after a bowel movement despite evidence that shows improved infant skin health with the use of modern appropriately formulated baby wipes. This article describes the unique physiology of premature infant skin, reviews clinical evidence comparing use of baby wipes to water and cloth, and describes attributes of appropriately formulated baby wipes.
Does Medicaid Insurance Provide Sufficient Access to Pediatric Orthopedic Care Under the Affordable Care Act?
Authors: Nguyen Jenny , Anandasivam Nidharshan S. , Cooperman Daniel , Pelker Richard , Wiznia Daniel H.
Published: February 2019

The Patient Protection and Affordable Care Act had a profound impact on health insurance coverage of children. Given the importance of pediatric specialty care, this study assessed access to pediatric orthopedic urgent care for a child’s likely operative distal radius fracture. Researchers called 180 pediatric orthopedic surgeons in 8 states requesting appointments for the caller’s fictitious 11-year-old child who suffered a distal radius fracture. Each office was called twice to assess the ability to obtain an appointment for Medicaid and privately insured patients. Overall, significantly fewer offices scheduled appointments for Medicaid than privately insured patients (38.3% vs 82.8%, P < .001). Patients with Medicaid in states without Medicaid expansion were more successful in obtaining appointments than patients with Medicaid in states with Medicaid expansion (41 [47%] vs 28 [30%]; P < .001; 95% confidence interval = 0.3-0.9). Pediatric Medicaid patients experienced reduced access to care, and this access was worse in states that had expanded Medicaid eligibility.
Liquid water film on the outer surface of a half-submerged rotating drum
Authors: Trang Christ , Ahmed Rahman , Kaosar Mohammed Golam
Published: February 2019

In this study, a two-dimensional computational model describing the rise and development of thin liquid water film on a rotating drum is presented. The liquid water flow is predicted by solving the Navier–Stoke equation using computational fluid dynamics neglecting the end effects of the rotating drum side wall along width. The liquid film on a half-submerged rotating drum was modeled by volume of fluid to determine the thickness and quality of the liquid film on a rotating drum. Computational results show that the liquid film on the rising side is smooth, whereas the film on the plunging point is complex. For a 300 r/min of 75 mm rotating drum, it takes ∼300 ms to develop the film from the rising point to fall to the plunging point. Air is entrained in plunging side by the falling film from the rising side.
A role for IL-34 in osteolytic disease of multiple myeloma
Authors: Baghdadi Muhammad , Ishikawa Kozo , Nakanishi Sayaka , Murata Tomoki , Umeyama Yui , Kobayashi Takuto , Kameda Yosuke , Endo Hiraku , Wada Haruka , Bogen Bjarne , Yamamoto Satoshi , Yamaguchi Keisuke , Kasahara Ikumi , Iwasaki Hiroshi , Takahata Mutsumi , Ibata Makoto , Takahashi Shuichiro , Goto Hideki , Teshima Takanori , Seino Ken-ichiro
Published: February 2019

Multiple myeloma (MM) is a hematological malignancy that grows in multiple sites of the axial skeleton and causes debilitating osteolytic disease. Interleukin-34 (IL-34) is a newly discovered cytokine that acts as a ligand of colony-stimulating factor-1 (CSF-1) receptor and can replace CSF-1 for osteoclast differentiation. In this study, we identify IL-34 as an osteoclastogenic cytokine that accelerates osteolytic disease in MM. IL-34 was found to be expressed in the murine MM cell line MOPC315.BM, and the expression of IL-34 was enhanced by stimulation with proinflammatory cytokines or by bone marrow (BM) stromal cells. MM-cell–derived IL-34 promoted osteoclast formation from mouse BM cells in vitro. Targeting Il34 by specific small interfering RNA impaired osteoclast formation in vitro and attenuated osteolytic disease in vivo. In BM aspirates from MM patients, the expression levels of IL-34 in CD138+ populations vary among patients from high to weak to absent. MM cell–derived IL-34 promoted osteoclast formation from human CD14+ monocytes, which was reduced by a neutralizing antibody against IL-34. Taken together, this study describes for the first time the expression of IL-34 in MM cells, indicating that it may enhance osteolysis and suggesting IL-34 as a potential therapeutic target to control pathological osteoclastogenesis in MM patients.
Managing the airway catastrophe: Longitudinal simulation-based curriculum to teach airway management
Authors: Nguyen Lily H. P. , Bank Ilana , Fisher Rachel , Mascarella Marco , Young Meredith
Published: February 2019

Background

A longitudinal curriculum was developed in conjunction with anesthesiologists, otolaryngologists, emergency physicians and experts in medical simulation and education.

Methods

Residents participated in four different simulation-based training modules using animal models, cadavers, task trainers, and crisis scenarios using high fidelity manikins. Scenarios were based on various clinical settings (i.e. emergency room, operating room) and were followed by video-assisted structured debriefings. Participants completed both a self-assessment questionnaire and an exit survey using five-point Likert scales.

Results

31 otolaryngology residents participated in the curriculum. Residents reported simulation training significantly improved technical skills such as tracheostomy, cricothyroidotomy and pediatric intubation ( p < 0.05 for all). Non-technical skills, including communication, delegation and management were significantly improved on post-test surveys in simulated crisis scenarios ( p < 0.05 for all). 90 (28/31) of participants found simulations to be very realistic. Junior residents placed increased value on didactic teaching and procedural skills, while senior residents on crisis scenarios. Survey results indicated that > 90% (28/31) of participants found the modules of the curriculum to be useful and would recommend them to others.

Conclusion

A longitudinal simulation-based medical curriculum can be an effective method to teach airway management and teamwork skills to otolaryngology residents.
Swimming strategies and energetics of endothermic white sharks during foraging
Authors: Watanabe Yuuki Y. , Payne Nicholas L. , Semmens Jayson M. , Fox Andrew , Huveneers Charlie
Published: February 2019

Some fishes and sea turtles are distinct from ectotherms by having elevated core body temperatures and metabolic rates. Quantifying the energetics and activity of the regionally endothermic species will help us understand how a fundamental biophysical process (i.e. temperature-dependent metabolism) shapes animal ecology; however, such information is limited owing to difficulties in studying these large, highly active animals. White sharks, Carcharodon carcharias, are the largest fish with regional endothermy, and potentially among the most energy-demanding fishes. Here, we deployed multi-sensor loggers on eight white sharks aggregating near colonies of long-nosed fur seals, Arctocephalus forsteri, off the Neptune Islands, Australia. Simultaneous measurements of depth, swim speed (a proxy for swimming metabolic rate) and body acceleration (indicating when sharks exhibited energy-efficient gliding behaviour) revealed their fine-scale swimming behaviour and allowed us to estimate their energy expenditure. Sharks repeatedly dived (mean swimming depth, 29 m) and swam at the surface between deep dives (maximum depth, 108 m). Modal swim speeds (0.80–1.35 m s−1) were slower than the estimated speeds that minimize cost of transport (1.3–1.9 m s−1), a pattern analogous to a ‘sit-and-wait’ strategy for a perpetually swimming species. All but one shark employed unpowered gliding during descents, rendering deep (>50 m) dives 29% less costly than surface swimming, which may incur additional wave drag. We suggest that these behavioural strategies may help sharks to maximize net energy gains by reducing swimming cost while increasing encounter rates with fast-swimming seals.
Adult family carers’ perceptions of their educational needs when providing end-of-life care: a systematic review of qualitative research
Authors: Flemming Kate , Atkin Karl , Ward Chris , Watt Ian
Published: February 2019

Background: There is an increasing emphasis on the importance of the palliative and end-of-life care being provided in the community. Key to the success of this is the availability of information and educational support to facilitate carers in their role. The aim of the paper is to explore the educational needs of adult carers providing physical and other care to people at the end of life

Methods: A qualitative evidence synthesis was conducted using meta-ethnography. Five electronic databases were searched to January 2014, combining terms for: cancer, chronic obstructive pulmonary disease, neurodegenerative conditions, renal disease, heart failure and dementia, with terms for carers and education.

Results: A total of 35 papers were included in the review, reporting the experiences of over 900 carers. Throughout the illness trajectory carers were either enabled or hindered in their role by the nature and way information and education were provided. Enabling factors included: a sense of trust in health professionals; timely and accurate information delivered compassionately; access to professionals for information and support particularly during out-of-hours. Where carers experienced a lack of information or support this added to the strain of caring. Carers then felt the need to take on a more active role, acting both as an advocate and decision maker.

Conclusions: Carers express information and educational needs throughout the illness trajectory. The quality of health professionals’ communication with carers was fundamental in ensuring carers felt confident and supported. Timely access to information and support from appropriately qualified health professionals should be made available to carers, including the out-of-hours period.
Clinical and radiological features that predict malignant transformation in cystic lesions of the pancreas: a retrospective case note review
Authors: Keane Margaret G. , Dadds Hannah R. , El Sayed Ghassan , Luong Tu Vinh , Davidson Brian R. , Fusai Guiseppe K. , Thorburn Douglas , Pereira Stephen P.
Published: February 2019

Background: Pancreatic cystic lesions (PCL) are being detected with increasing frequency. Current methods of stratifying risk of malignant transformation are imperfect. This study aimed to determine the frequency of pancreatic malignancy in patients with PCL and define clinical and radiological features that predict malignant transformation in patients managed by surgery and/or surveillance.

Methods: A retrospective cohort of adults who were evaluated in a tertiary hepatopancreaticobiliary centre between January 2000 - December 2013 with a confirmed PCL and followed up for at least 5 years. All cystic lesions were discussed at a weekly multidisciplinary meeting.

Results: Of the 1,090 patients diagnosed with a PCL, 768 patients were included in the study: 141 patients were referred for immediate pancreatic resection, 570 entered surveillance while 57 had a malignant PCL which was unresectable at diagnosis (n=47) or were unfit for surgery (n=10). In those who were resected following presentation, malignancy was present in 38%. During follow-up 2% of those entering a surveillance programme underwent malignant transformation. Clinical and radiological features associated with a high-risk PCL included older age, symptoms, associated solid component or dilated main pancreatic duct. In intraductal papillary mucinous neoplasms, larger size was not a feature of malignant transformation (benign vs. malignant 30mm vs. 23mm; P= 0.012).

Conclusion: The sensitivity of standard diagnostic tests leading to immediate surgery for high-risk PCL (malignant or mucinous) was 92% but with a specificity of just 5%. Surveillance of PCL without high-risk features within a multidisciplinary meeting was associated with a low incidence of cancer development, supporting the use of worrisome clinical and radiological features in the initial stratification of PCL.
Social engagement after stroke – is it relevant to cognitive function? A cross-sectional analysis of UK Biobank data
Authors: Drozdowska Bogna A. , Celis-Morales Carlos A. , Lyall Donald M. , Quinn Terence J.
Published: February 2019

Background:Findings from studies in older adult populations suggest that measures of social engagement may be associated with health outcomes, including cognitive function. Plausibly the magnitude and direction of this association may differ in stroke.  The disabling nature of stroke increases the likelihood of social isolation and stroke survivors are at high risk of cognitive decline. We assessed the association between social engagement and cognitive function in a sample of stroke survivors.

Methods:We included available data from stroke survivors in the UK Biobank (N=8776; age range: 40-72; 57.4% male). In a series of regression models, we assessed cross-sectional associations between proxies of social engagement (frequency of family/friend visits, satisfaction with relationships, loneliness, opportunities to confide in someone, participation in social activities) and performance on domain specific cognitive tasks: reaction time, verbal-numerical reasoning, visual memory and prospective memory. We adjusted for demographics, health-, lifestyle-, and stroke-related factors. Accounting for multiple testing, we set our significance threshold at p<0.003.

Results:After adjusting for covariates, we found independent associations between faster reaction times and monthly family visits as compared to no visit (standardised beta=-0.32, 95% CI: -0.51 to -0.13, p=0.001, N=4,930); slower reaction times and religious group participation (standardised beta=0.25, 95% CI 0.13 to 0.38, p<0.001, N=4,938); and poorer performance on both verbal-numerical reasoning and prospective memory tasks with loneliness (standardised beta=-0.19, 95% CI: -0.29 to -0.08, p<0.001, N=2,074; odds ratio=0.66, 95% CI: 0.52 to 0.84, p=0.001, N=2,188; respectively). In models where all proxies of social engagement were combined, no associations remained significant.

Conclusions:We found limited task-specific associations between cognitive performance and proxies of social engagement, with only loneliness related to two tasks. Further studies are necessary to confirm and improve our understanding of these relationships and investigate the potential to target psychosocial factors to support cognitive function in stroke survivors.
A study update newsletter or Post-it® note did not increase postal questionnaire response rates in a falls prevention trial: an embedded randomised factorial trial
Authors: Rodgers Sara , Sbizzera Illary , Cockayne Sarah , Fairhurst Caroline , Lamb Sarah E. , Vernon Wesley , Watson Judith , Hewitt Catherine , Torgerson David J.
Published: February 2019

Background: Participants not returning data collection questionnaires is a problem for many randomised controlled trials. The resultant loss of data leads to a reduction in statistical power and can result in bias. The aim of this study was to assess whether the use of a study update newsletter and/or a handwritten or printed Post-it® note sticker increased postal questionnaire response rates for participants of a randomised controlled trial.

Method: This study was a factorial trial embedded within a host trial of a falls-prevention intervention among men and women aged ≥65 years under podiatric care. Participants were randomised into one of six groups: newsletter plus handwritten Post-it®; newsletter plus printed Post-it®; newsletter only; handwritten Post-it® only; printed Post-it® only; or no newsletter or Post-it®. The results were combined with those from previous embedded randomised controlled trials in meta-analyses.

Results: The overall 12-month response rate was 803/826 (97.2%) (newsletter 95.1%, no newsletter 99.3%, printed Post-it® 97.5%, handwritten Post-it® 97.1%, no Post-it® 97.1%). The study update newsletter had a detrimental effect on response rates (adjusted odds ratio 0.14, 95% CI 0.04 to 0.48, p<0.01) and time to return the questionnaire (adjusted hazard ratio 0.86, 95% CI 0.75 to 0.99, p=0.04). No other statistically significant differences were observed between the intervention groups on response rates, time to response, and the need for a reminder.

Conclusions: Post-it® notes have been shown to be ineffective in three embedded trials, whereas the evidence for newsletter reminders is still uncertain.
Health care seeking for maternal and newborn illnesses in low- and middle-income countries: a systematic review of observational and qualitative studies
Authors: Lassi Zohra S. , Middleton Philippa , Bhutta Zulfiqar A. , Crowther Caroline
Published: February 2019

Background: In low- and middle-income countries, a large number of maternal and newborn deaths occur due to delays in health care seeking. These delays occur at three levels i.e. delay in making decision to seek care, delay in access to care, and delay in receiving care. Factors that cause delays are therefore need to be understand to prevent and avoid these delays to improve health and survival of mothers and babies.   

Methods: A systematic review of observational and qualitative studies to identify factors and barriers associated with delays in health care seeking.

Results: A total of 159 observational and qualitative studies met the inclusion criteria. The review of observational and qualitative studies identified social, cultural and health services factors that contribute to delays in health care seeking, and influence decisions to seek care. Timely recognition of danger signs, availability of finances to arrange for transport and affordability of health care cost, and accessibility to a health facility were some of these factors.

Conclusions: Effective dealing of factors that contribute to delays in health care seeking would lead to significant improvements in mortality, morbidity and care seeking outcomes, particularly in countries that share a major brunt of maternal and newborn morbidity and mortality.

Registration: PROSPERO CRD42012003236.
ПРОИЗВОДСТВО ПРОТИВОТАНКОВЫХ БОЕПРИПАСОВ В СССР НАКАНУНЕ И В НАЧАЛЕ ВЕЛИКОЙ ОТЕЧЕСТВЕННОЙ ВОЙНЫ
Authors: Balys Andrey Nikolaevich , Khartova Elena Sergeevna
Published: February 2019

Цель. Неудачи Красной Армии в начальный период войны – тема уже давно вызывающая повышенный интерес со стороны исследователей и общественности. Вопрос не теряет своей актуальности, как из-за многогранности самой проблемы, так и из-за того, что в научный оборот постоянно вводятся все новые факты и материалы. Статья посвящена исследованию одной из причин неудач Красной Армии во второй половине 1941 г. – слабой защищенность наших войск от танковых ударов со стороны противника. Автор ставит целью раскрыть причины неудовлетворительного снабжения войск необходимыми противотанковыми боеприпасами накануне войны, особенно к 76-мм дивизионному орудию РККА, оказавшемуся единственно эффективным способом борьбы со всеми типами вражеских танков летом-осенью 1941 года, в том числе и с танками с усиленной броневой защитой.Метод или методология проведения работы. Теоретико-методологической основой работы являются общие принципы историзма и объективности. В соответствии выдвинутой целью исследования автор использовал и частные исторические методы: логический, системный, хронологический, актуализации, периодизации. Статья написана на основе архивных материалов, хранящихся в Государственном архиве Российской Федерации (ГАРФ) и Российском государственном военном архиве (РГВА), которые впервые вводятся в научный оборот. Также при написании статьи были использованы и сборники опубликованных по теме Великой Отечественной войны документов.Результаты. С помощью данных документов и материалов показаны особенности работы снаряжательных и корпусных заводов наркомата боеприпасов СССР в области производства бронебойных снарядов в 30-е – начале 40-х гг. ХХ века, а также влияние этих особенностей на степень обеспеченности бронебойными боеприпасами частей Красной Армии накануне войной и в ходе боевых действий на разных участках советско-германского фронта. Делается вывод о том, что неудовлетворительное положение дел в области производства противотанковых снарядов в предвоенные годы стало одной из главных причин поражений Красной Армии в начальный период Великой Отечественной войны.Область применения результатов. Практическая значимость работы определяется тем, что вводимые в научный оборот новые архивные данные и сформированные в статье выводы могут быть использованы при дальнейшем изучении различных аспектов не только темы неудач Красной армии в начальный период войны, но и истории Отечества советского периода в целом.
РАЗВИТИЕ СИСТЕМЫ ПРОСВЕЩЕНИЯ В г. КРАСНОЯРСКЕ В 1921–1926 гг. (НА МАТЕРИАЛАХ ГАЗЕТЫ «КРАСНОЯРСКИЙ РАБОЧИЙ»)
Authors: Bershadskaya Svetlana Vyacheslavovna , Aisner Larisa Yurievna
Published: February 2019

Цель. Статья посвящена развитию системы образования и просвещения в России в условиях перехода к новой системе социально-­экономических отношений (НЭП). Предметом анализа выступает реализация государственной образовательной политики на территории города Красноярска Енисейской губернии в период с 1921 по 1926 годы. Авторы статьи ставят целью охарактеризовать особенности развития системы просвещения на материалах региональной прессы и нормативно-правовых актов указанного периода.Методология проведения работы. Основу источниковой базы исследования составила региональная пресса – газета «Красноярский рабочий», изданная в г. Красноярске в период 1921–1926 гг. Методологическую основу исследования составили традиционные для исследований подобного рода принципы историзма и объективности.Результаты. Материалы данного периодического печатного издания имели очевидную социальную нацеленность публикуемых материалов: кроме публичного освещения проблем образования и просвещения, законодательных инициатив органов центральной власти, деятельности местных органов власти, ключевой целью подобных публикаций явилось привлечение общественного и государственного внимания к актуализровавшимся проблемам социокультурной сферы, в части организации работы с детьми и молодежью, решения «женского вопроса» и повседневной жизни жителей города, также роли педагогов в социокультурной динамике городского сообщества.Область применения результатов. Результаты исследования могут быть применены на занятиях в высших учебных заведениях по таким дисциплинам, как Отечественная история, краеведение, история педагогики и др.
ОБРЯДЫ, ПРАЗДНИКИ И ИГРЫ ЗИМНЕГО ЦИКЛА ГОРЦЕВ ДАГЕСТАНА В КОНЦЕ XIX - НАЧАЛЕ XX В. (ЭТНОЭКОЛОГИЧЕСКИЙ АСПЕКТ)
Authors: Ramazanova Zoya Buttaevna
Published: February 2019

Статья написана на полевом этнографическом материале, собранном автором по исследуемой проблеме. Обряды, праздники и игры зимнего цикла горцев Дагестана как компонент духовной культуры представляют большой интерес на современном этапе, так как отчасти входят в состав современного календаря, достаточно полно отражают экологические представления этносов и характеризуют разные области этнической культуры – приготовление и раздачу ритуальной пищи, ряжение, игры, песни, пляски и т.д. Целью данной статьи является выявление и рассмотрение (исследование) обрядов и праздников горцев Дагестана зимнего цикла, в связи с наметившимся в последнее время повышенным интересом к национальным истокам современной культуры, в частности, к духовной культуре. При написании статьи были использованы общенаучные методы (анализ, синтез), позволяющие рассматривать роль и место обрядов и праздников зимнего цикла горцев Дагестана в этнокультуре, показать общее и особенное в связи с различными условиями (социально-экономическими, этнографическими, экологическими), развитие отдельных регионов нагорного Дагестана. Вместе с общенаучными в статье использованы частные методы исследования: выявление конкретного, описательный метод и др. В статье мы пришли к следующим результатам. Рассматриваемые обряды и праздники зимнего цикла делятся на несколько групп. Первая группа связана с началом зимы и календарного года; вторая включает праздники середины зимы, которые содержали в себе идею пробуждения природы от зимнего сна и подготовки ее к весне. Значительное место в жизни народа занимали – зимние игры и развлечения. В заключении нашего исследования показано, что зима была временем отдыха после напряженного года. Помимо праздников чисто календарного характера (начало, середины зимы), в этнической культуре горцев Дагестана имелись различные формы традиционного досуга, создававшие праздничную ситуацию.
КУЛЬТ ПРИРОДЫ В ОБРЯДАХ ЖИЗНЕННОГО ЦИКЛА НАРОДА МАРИ (ПО МАТЕРИАЛАМ ЭКСПЕДИЦИЙ В МАРИЙСКУЮ АССР В 1930-50-Е ГГ.)
Authors: Lepeshkina Larisa Yurevna
Published: February 2019

Целью статьи является анализ символических воплощений природы в обрядах жизненного цикла мари по материалам этнографических экспедиций в Марийскую АССР в 1930–50-е гг. Актуальность темы исследования обусловлена экологическим кризисом, инициированным ростом индустриализации, и усилением антагонизма между человеком и природой. Обращение к историческому опыту мари позволяет выявить положительные примеры экоориентированного отношения к природной среде через обрядовые формы.Методология проведения работы. В основу исследования положен принцип историзма, дающий возможность проанализировать марийскую традиционную обрядность в условиях социокультурных перемен. Рассмотрение процесса взаимодействия между человеком и природой в обрядах жизненного цикла осуществляется посредством системного подхода, способствующего определению культурного потенциала марийских традиций. Также в статье применяются следующие методологические приемы: сравнительно-исторический, логический, ретроспективный, методы научного описания, обобщения, интерпретации неопубликованных источников, наблюдения и опроса при сборе автором полевых материалов.Источниками для изучения стали отчеты и полевые дневники советских этнографов, находящиеся в российских научных архивах.Результаты. Отчеты и полевые дневники советских этнографов, посетивших Марийскую АССР в 1930–50-е гг., рассмотрены с точки зрения отражения экологических представлений мари в обрядах жизненного цикла. Выявлено, что природа служила конструирующим элементом традиционной обрядности. Показано, что природная среда воспринималась в марийской культуре как мать, божество и член родовой общины. Согласно представлениям мари, одним из основных способов укрепления связи между человеком и природой было жертвоприношение. Воспоминание о природе при осуществлении обрядов жизненного цикла позволяло реализовывать следующие функции: предохранение от влияния злых сил, защита от небытия, формирование чувства солидарности.Область применения результатов – в образовательной и научно-­исследовательской деятельности.