bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in Clinical Markers During A Short-Term Transfer Program of Adult Cystic Fibrosis Patients from Pediatric to Adult Care
Authors: Welsner Matthias , Sutharsan Sivagurunathan , Taube Christian , Olivier Margarete , Mellies Uwe , Stehling Florian
Published: July 2019

Background:

Transition from child-oriented to adult-oriented health care in Cystic Fibrosis (CF) has become more important over recent decades as the survival of people with this disease has increased. The transition process usually begins in adolescence, with full transfer completed in early adulthood.

Objective:

This study investigated the impact of a short-term transfer program on clinical markers in an adult CF cohort still being managed by pediatricians.

Methods:

Clinically relevant data from the year before (T-1), the time of Transfer (T) and the year after the transfer (T+1) were analysed retrospectively.

Results:

39 patients (median age 29.0 years; 64% male) were transferred between February and December 2016. Lung function had declined significantly in the year before transfer (in % predicted: Forced Expiratory Volume in 1 second (FEV), 62.8vs.57.7,p<0.05; Forced Vital Capacity (FVC), 79.9vs.71.1,p<0.05), but remained stable in the year after transfer (in % predicted: FEV: 56.3; FVC 68.2). BMI was stable over the whole observational period. There was no relevant change in chronic lung infection withP. aeruginosa, Methicillin-Resistant Staphylococcus aureus (MRSA) andBurkholderiasp. during the observation period. The number of patient contacts increased significantly in the year after versus the year before transfer (inpatient: 1.51vs.2.51,p<0.05; outpatient: 2.67vs.3.41,p<0.05).

Conclusions:

Our data show that, within the framework of a structured transfer process, it is possible to transfer a large number of adult CF patients, outside a classic transition program, from a pediatric to an adult CF center in a short period of time, without any relevant changes in clinical markers and, stability.
A Review of the Traffic Accidents and Related Practices Worldwide
Authors: Mohammed Ali Ahmed , Ambak Kamarudin , Mosa Ahmed Mancy , Syamsunur Deprizon
Published: July 2019

A traffic accident, a traffic collision or crash occurs when a vehicle collides with another vehicle, pedestrian, animal, road barriers, or any stationary obstruction such as a tree or a utility pole. Traffic collisions may result in injury, death, vehicle damage and possession damage. Motor vehicle collisions cause death and disability as well as a financial burden. Traffic accidents cause many losses especially of human life, property damages, and loss of resources. Indeed, even in strife influenced countries such as Afghanistan, Libya, Pakistan, and Yemen, road traffic remains the most common cause of fatal injuries, causing between two and eight times more fatalities than war and lawful mediation. The World Health Organization (WHO) 2013 assessed the traffic casualty rate in the Eastern Mediterranean Region (EMR) to be the second most elevated rate universally after the African Region and extending a few other countries in the region. The aim of this paper was to enrich the global highway safety knowledge by revealing the catastrophic impact of traffic accidents on the economy of the societies and the safety of the common worldwide.
Minocycline Inhibits the Enhanced Antidromic Stimulation-induced Sensitization of C-Fibers Following Intradermal Capsaicin Injection
Authors: Gong Kerui , Lin Qing
Published: July 2019

Background:

Our previous studies indicated that retrograde signaling initiating from the spinal cord was mediated by the plasticity of Dorsal Root Ganglion (DRG) neurons. Both retrograde signaling and neuronal plasticity contributed to neurogenic inflammation, which were modulated by the activity of Satellite Glial Cells (SGCs). Thus, we want to know whether retrograde signaling is involved in the hypersensitivity of nociceptive afferents, and whether this process is affected by the plasticity of DRG neurons and glia.

Objective:

The study aims to examine if retrograde signaling can induce hypersensitivity of primary afferent nociceptors and if hypersensitivity involves glial modulation.

Methods:

Antidromic Electrical Stimulation (ES) of dorsal roots was used to mimic retrograde signaling activity. C- primary nociceptive afferent activity was recorded for testing the effect of antidromic ES. In a separate group, intradermal capsaicin injection to the ipsilateral hindpaw was used to prime DRG nociceptive neurons. For the third group, a glial inhibitor, minocycline, was pre-administered to test glial modulation in this process.

Results:

Antidromic ES sensitized the responses of C-fibers to nociceptive mechanical stimuli. For rats subjected to intradermal capsaicin injection, C fibers experienced more drastic sensitization induced by antidromic ES, shown as a greater response and longer duration, implying that sensitization correlates with the activation of DRG neurons.

Minocycline pretreatment significantly blocked the priming effect of capsaicin on C-fiber sensitization induced by antidromic ES, indicating the involvement of SGCs in DRG neuronal sensitization.

Conclusion:

Retrograde signaling may be one of the important mechanisms in neurogenic inflammation-mediated nociception, and this process is subjected to satellite glial modulation.
A gramática no ensino de línguas baseado em tarefas
Authors: Castro Catarina
Published: July 2019

Apesar de não ser um aspeto central, o ensino da gramática – isto é, o recurso a tarefas específicas e/ou a outro tipo de estratégias com a finalidade de chamar a atenção dos estudantes para determinados aspetos linguísticos sem que deixe de haver um foco predominante na mensagem – desempenha um papel importante no Ensino de Línguas Baseado em Tarefas (ELBT), sendo incorreto reivindicar o contrário. Não obstante, também é verdade que, no ELBT, se procura evitar o ensino explícito de itens linguísticos predeterminados, que tende a ser privilegiado nos métodos tradicionalmente adotados no ensino de segundas línguas (L2), por não ser considerado um procedimento compatível com o processo de aquisição de L2, à luz do que sobre ele se sabe. Partindo da clarificação do conceito de foco na forma, o presente artigo tem como finalidade exemplificar, em particular, o modo como, no ELBT, se pode trabalhar a gramática e promover a atenção dos estudantes de Português como Língua Estrangeira, de nível inicial, para estruturas e aspetos linguísticos específicos, com recurso a tarefas com foco e a estratégias metodológicas.
Como 'vender' a língua portuguesa? Promoção do português dentro de duas comunidades na América do Norte
Authors: Scetti Fabio
Published: July 2019

Este artigo apresenta uma análise sobre as ideologias linguísticas que representam a nova posição da língua portuguesa dentro de duas comunidades portuguesas instaladas na América do Norte: em Montreal, Québec, no Canadá, e na cidade de Bridgeport, Connecticut, nos Estados Unidos da América. Enquanto as matrículas nas escolas comunitárias dentro dos dois grupos estão diminuindo, os atores destas instituições estão mobilizando discursos sobre o poder do português como uma língua de negócios, uma língua global. Utilizando uma abordagem etnográfica, observamos discursos das instituições e dos próprios falantes que deixam a posição de língua de herança (LH) para ‘vender’ uma nova língua do futuro. Observamos, então, como se mantém um paradigma nacionalista que vê uma nação equivaler ao uso duma língua, que nesse caso prevê o uso duma norma, para reforçar esta nova posição. A nossa metodologia qualitativa, baseada na observação participante e em entrevistas semiestruturadas, nos permitiu articular à análise discursiva com uma análise das práticas linguísticas, com enfoque na perceção e na identificação do que é o ‘bom’ português. As práticas mistas ou híbridas continuam a ser interrogadas segundo os repertórios de cada falante e em cada contexto, permitindo pôr em questão as ideologias de ‘pureza’ da língua.
'Feedback para que te quero?' Estudo sobre o Feedback direto e indireto em tarefas de escrita
Authors: Gonçalves Liliana , Figueiredo Carlos Filipe Guimarães , Jatobá Júlio Reis
Published: July 2019

As mais recentes propostas didático-pedagógicas consideram ser fundamental fornecer algum tipo de resposta aos trabalhos escritos dos estudantes (Hyland 2003; Sheen 2010), não só para que os aprendentes desenvolvam as suas capacidades de escrita, mas também para que melhorem a própria proficiência na língua-cultura. Neste sentido, o presente artigo apresentará, primeiramente, os diferentes tipos de resposta que podem ser dados aos estudantes, nomeadamente o feedback escritodo professor, o encontro (face a face) professor-aluno(s) e o feedback dos colegas (Hyland 2003; Liu & Hansen 2002). Em seguida, analisaremos trabalhos escritos realizados pelos nossos aprendentes de nível B1, concentrando a nossa atenção no feedback escrito do professor com o intuito de entendermos se o mesmo tem algum impacto no melhoramento dos textos dos aprendentes e qual será o feedback escrito mais eficaz para atingir esse objetivo. De entre as conclusões a que nos foi possível chegar, ressalta-se uma evidente melhoria dos textos dos aprendentes depois de concluída a fase de reescrita da tarefa em questão. Concluímos também que, para os níveis intermédios, o feedback escrito múltiplo ou misto é o que pode ser mais eficaz na correção e/ou reescrita.
Português língua de acolhimento para migrantes senegaleses em Rio Grande, RS, Brasil
Authors: Leiria Lúcia Lovato , Telles Luciana Pilatti , De Freitas Adriano Luz Ribeiro
Published: July 2019

A imagem do Brasil como país de oportunidades atraiu imigrantes em busca de melhores condições de vida. Em Rio Grande, RS, é considerável o número de senegaleses nessa condição, criando-se a demanda para o ensino de português línguade acolhimento a imigrantes. Este artigo resulta de reflexões sobre um projeto de extensão desenvolvido para promover a integração desses sujeitos na cultura local pelo ensino/aprendizagem do português. Buscou-se também, no referido projeto, oferecer-lhes bases linguísticas para a interação em língua portuguesa; propiciar-lhes o contato com gêneros textuais típicos do mundo do trabalho; e promover competências de compreensão de textos relacionados ao ambiente de trabalho e ao dia a dia. Adotaram-se os fundamentos da Sociolinguística Interacional (Gumperz 1982) e da Antropologia Cultural (Matta 2001). Do ponto de vista pedagógico, selecionou-se a Abordagem Baseada em Tarefas (Janowska 2014; Willis 1996), visando a atender necessidades específicas do grupo. No geral, os aprendizes demonstraram facilidades de aquisição do vocabulário e algumas dificuldades nos níveis fonético e fonológico, como a distinção entre /z/ e /ʒ/; /s/ e /ʃ/; /l/ e /ʎ/. Quanto ao impactos ocial, essa ação contribuiu para o ingresso de alguns alunos no mercado de trabalho formal.
O ensino da língua portuguesa no âmbito da iniciativa 'Faixa e Rota'
Authors: Pestana Luís Filipe
Published: July 2019

A língua portuguesa encontra-se numa fase de grande expansão na República Popular da China (RPC). Os contactos económico-comerciais têm levado a que cada vez mais chineses procurem cursos de língua portuguesa como forma de aceder a melhores oportunidades de trabalho. A iniciativa Faixa e Rota, apresentada pelo presidente Xi Jinping (Zhang 2017), veio exacerbar esta situação: a inclusão do mundo lusófono nesta grande estratégia faz com que haja uma maior procura por profissionais de diferentes áreas que falem português. É fundamental compreender o que é a iniciativa Faixa e Rota e como pode afectar o ensino da língua portuguesa na RPC. Partindo da situação actual do idioma, existem propostas que podem ser postas em prática nos próximos anos para responder às necessidades do mercado chinês reforçando o papel da língua portuguesa na região da Ásia-Pacífico.
Sobre os limites didáticos dos falsos amigos espanhol-português
Authors: Carballido Xurxo Fernández
Published: July 2019

Os denominados falsos amigos são uma questão muito tratada nos trabalhos sobre a relação entre a língua portuguesa e a língua espanhola. As possíveis aproximações variam segundo os interesses de cada uma das abordagens: a lexicografia, a lexicologia, a semântica, a tradutologia ou o ensino de línguas estrangeiras. Este artigo quer ser mais um contributo, porém, não tem como objetivo compilar ou classificar falsos amigos, mas tentar estabelecer alguns limites ao uso didático do falso amiguismo.
Spare Rib and Underwater Livecams
Authors: Brant Clare
Published: July 2019

https://www.bl.uk/spare-rib  Digital citizens of the future may have sorted a gender politics which works for everybody. A utopian hope, yes; in case not, and in any case, I would want them to know that in the 1960s, 70s and 80s, there was a worldwide women’s movement full of daring thinkers and brave activists. So often history is written by the victors; web resources at least prolong the availability of alternative versions. What’s known as second wave feminism worked largely through print and word of mouth, but is now partially recuperable through podcasts, oral history and digital archives. Spare Ribe was a polemical, practical monthly magazine published in Britain from 1972 to 1993. It’s available again, newly digitised at the British Library.  Underwater Livecams.  I like to imagine that future netizens will know more about the oceans than we do. But they should know that some of their predecessors are passionately curious about life underwater, and that there were webcams which livestreamed from depths no human had seen before.
Association of Online Learning Behavior and Learning Outcomes for Medical Students: Large-Scale Usage Data Analysis
Authors: Bientzle Martina , Hircin Emrah , Kimmerle Joachim , Knipfer Christian , Smeets Ralf , Gaudin Robert , Holtz Peter
Published: July 2019

Background

Digital learning environments have become very common in the training of medical professionals, and students often use such platforms for exam preparation. Multiple choice questions (MCQs) are a common format in medical exams and are used by students to prepare for said exams.

Objective

We aimed to examine whether particular learning activities contributed more strongly than others to users’ exam performance.

Methods

We analyzed data from users of an online platform that provides learning materials for medical students in preparation for their final exams. We analyzed whether the number of learning cards viewed and the number of MCQs taken were positively related to learning outcomes. We also examined whether viewing learning cards or answering MCQs was more effective. Finally, we tested whether taking individual notes predicted learning outcomes, and whether taking notes had an effect after controlling for the effects of learning cards and MCQs. Our analyses from the online platform Amboss are based on user activity data, which supplied the number of learning cards studied and test questions answered. We also included the number of notes from each of those 23,633 users who had studied at least 200 learning cards and had answered at least 1000 test exam questions in the 180 days before their state exam. The activity data for this analysis was collected retrospectively, using Amboss archival usage data from April 2014 to April 2017. Learning outcomes were measured using the final state exam scores that were calculated by using the answers voluntarily entered by the participants.

Results

We found correlations between the number of cards studied (r=.22; P<.001) and the number of test questions that had been answered (r=.23; P<.001) with the percentage of correct answers in the learners’ medical exams. The number of test questions answered still yielded a significant effect, even after controlling for the number of learning cards studied using a hierarchical regression analysis (β=.14; P<.001; ΔR2=.017; P<.001). We found a negative interaction between the number of learning cards and MCQs, indicating that users with high scores for learning cards and MCQs had the highest exam scores. Those 8040 participants who had taken at least one note had a higher percentage of correct answers (80.94%; SD=7.44) than those who had not taken any notes (78.73%; SD=7.80; t23631=20.95; P<.001). In a stepwise regression, the number of notes the participants had taken predicted the percentage of correct answers over and above the effect of the number of learning cards studied and of the number of test questions entered in step one (β=.06; P<.001; ΔR2=.004; P<.001).

Conclusions

These results show that online learning platforms are particularly helpful whenever learners engage in active elaboration in learning material, such as by answering MCQs or taking notes.
A Systematic Framework for Analyzing Patient-Generated Narrative Data: Protocol for a Content Analysis
Authors: Zolnoori Maryam , Balls-Berry Joyce E , Brockman Tabetha A , Patten Christi A , Huang Ming , Yao Lixia
Published: July 2019

Background

Patient narrative data in online health care forums (communities) are receiving increasing attention from the scientific community for implementing patient-centered care. Natural language processing (NLP) methods are gaining more and more attention because of the enormous data volume. However, state-of-the-art NLP still cannot meet the need of high-resolution analysis of patients’ narratives. Manual qualitative analysis still plays a pivotal role in answering complicated research questions from analyzing patient narratives.

Objective

This study aimed to develop a systematic framework for qualitative analysis of patient-generated narratives in online health care forums.

Methods

Our systematic framework consists of 4 phases: (1) data collection, (2) data preparation, (3) content analysis, and (4) interpretation of the results. Data collection and data preparation phases are constructed based on text mining methods for identifying appropriate online health forums for data collection, differentiating posts of patients from other stakeholders, protecting patients’ privacy, sampling, and choosing the unit of analysis. Content analysis phase is built on the framework method, which facilitates and accelerates the identification of patterns and themes by an interdisciplinary research team. In the end, the focus of interpretation of the results phase is to measure the data quality and interpret the findings regarding the dimensions and aspects of patients’ experiences and concerns in their original contexts.

Results

We demonstrated the usability of the proposed systematic framework using 2 case studies: one on determining factors affecting patients’ attitudes toward antidepressants and another on identifying the disease management strategies in patient with diabetes facing financial difficulties. The framework provides a clear step-by-step process for systematic content analysis of patient narratives and produces high-quality structured results that can be used for describing patterns or regularities in patients’ experiences, generating and testing hypotheses, and identifying areas of improvement in the health care systems.

Conclusions

The systematic framework is a rigorous and standardized method for qualitative analysis of patient narratives. Findings obtained through such a process indicate authentic dimensions and aspects of patient experiences and shed light on patients’ concerns, needs, preferences, and values, which are the core of patient-centered care.

International Registered Report Identifier (IRRID)

RR1-10.2196/13914
Effectiveness of a Walking Program Involving the Hybrid Assistive Limb Robotic Exoskeleton Suit for Improving Walking Ability in Stroke Patients: Protocol for a Randomized Controlled Trial
Authors: Tsurushima Hideo , Mizukami Masafumi , Yoshikawa Kenichi , Ueno Tomoyuki , Hada Yasushi , Gosho Masahiko , Kohno Yutaka , Hashimoto Koichi , Iizumi Yuichi , Kikuchi Toshihiro , Matsumura Akira ,   Hit2016 Study Group
Published: July 2019

Background

Gait disturbance often occurs in stroke survivors. Recovery of walking function is challenging, as some gait disturbance due to hemiparesis often remains even after rehabilitation therapy, presenting a major obstacle towards regaining activities-of-daily-living performance and achieving social reintegration.

Objective

This study aims to clarify the effectiveness of a walking program involving the wearable Hybrid Assistive Limb (HAL-TS01) robotic exoskeleton for improving walking ability in stroke patients with hemiparesis and stagnant recovery despite ongoing rehabilitation.

Methods

This is a multicenter, randomized, parallel-group, controlled study (HAL group, n=27; control group, n=27). The study period includes preintervention observation (until stagnant recovery), intervention (HAL-based walking therapy or conventional rehabilitation; 5 weeks), and postintervention observation (2 weeks). Following provision of informed consent and primary registration, the patients undergo conventional rehabilitation for preintervention observation, during which the recovery of walking ability is monitored to identify patients with stagnant recovery (based on weekly assessments using the 10-meter maximum walking speed [MWS] test). Patients with an MWS of 30-60 m/minute and insufficient weekly improvement in MWS undergo secondary registration and are randomly assigned to undergo HAL-based walking therapy (HAL group) or conventional rehabilitation (control group). The primary outcome is the change in MWS from baseline to the end of the 5-week intervention.

Results

This study began in November 2016 and is being conducted at 15 participating facilities in Japan.

Conclusions

Assessments of walking ability vary greatly and it is difficult to define the threshold for significant differences. To reduce such variability, our study involves conducting conventional rehabilitation to the point of saturation before starting the intervention. Stagnation in the recovery of walking ability despite conventional rehabilitation highlights the limits of current medical care. The present study may bring evidence that HAL-based therapy can overcome such limitations and induce added recovery of walking ability, which would promote the use of HAL technology in the clinical setting.

Trial Registration

UMIN Clinical Trials Registry UMIN000024805; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000028545
A Good Practice–Compliant Clinical Trial Imaging Management System for Multicenter Clinical Trials: Development and Validation Study
Authors: Shin Youngbin , Kim Kyung Won , Lee Amy Junghyun , Sung Yu Sub , Ahn Suah , Koo Ja Hwan , Choi Chang Gyu , Ko Yousun , Kim Ho Sung , Park Seong Ho
Published: July 2019

Background

With the rapid increase in utilization of imaging endpoints in multicenter clinical trials, the amount of data and workflow complexity have also increased. A Clinical Trial Imaging Management System (CTIMS) is required to comprehensively support imaging processes in clinical trials. The US Food and Drug Administration (FDA) issued a guidance protocol in 2018 for appropriate use of medical imaging in accordance with many regulations including the Good Clinical Practice (GCP) guidelines. Existing research on CTIMS, however, has mainly focused on functions and structures of systems rather than regulation and compliance.

Objective

We aimed to develop a comprehensive CTIMS to meet the current regulatory guidelines and various required functions. We also aimed to perform computerized system validation focusing on the regulatory compliance of our CTIMS.

Methods

Key regulatory requirements of CTIMS were extracted thorough review of many related regulations and guidelines including International Conference on Harmonization-GCP E6, FDA 21 Code of Federal Regulations parts 11 and 820, Good Automated Manufacturing Practice, and Clinical Data Interchange Standards Consortium. The system architecture was designed in accordance with these regulations by a multidisciplinary team including radiologists, engineers, clinical trial specialists, and regulatory medicine professionals. Computerized system validation of the developed CTIMS was performed internally and externally.

Results

Our CTIMS (AiCRO) was developed based on a two-layer design composed of the server system and the client system, which is efficient at meeting the regulatory and functional requirements. The server system manages system security, data archive, backup, and audit trail. The client system provides various functions including deidentification, image transfer, image viewer, image quality control, and electronic record. Computerized system validation was performed internally using a V-model and externally by a global quality assurance company to demonstrate that AiCRO meets all regulatory and functional requirements.

Conclusions

We developed a Good Practice–compliant CTIMS—AiCRO system—to manage large amounts of image data and complexity of imaging management processes in clinical trials. Our CTIMS adopts and adheres to all regulatory and functional requirements and has been thoroughly validated.
Impact of an Intensive Care Information System on the Length of Stay of Surgical Intensive Care Unit Patients: Observational Study
Authors: Havel Camille , Selim Jean , Besnier Emmanuel , Gouin Philippe , Veber Benoit , Clavier Thomas
Published: July 2019

Background

The implementation of computerized monitoring and prescription systems in intensive care has proven to be reliable in reducing the rate of medical error and increasing patient care time. They also showed a benefit in reducing the length of stay in the intensive care unit (ICU). However, this benefit has been poorly studied, with conflicting results.

Objective

This study aimed to show the impact of computerization on the length of stay in ICUs.

Methods

This was a before-after retrospective observational study. All patients admitted in the surgical ICU at the Rouen University Hospital were included, from June 1, 2015, to June 1, 2016, for the before period and from August 1, 2016, to August 1, 2017, for the after period. The data were extracted from the hospitalization report and included the following: epidemiological data (age, sex, weight, height, and body mass index), reason for ICU admission, severity score at admission, length of stay and mortality in ICU, mortality in hospital, use of life support during the stay, and ICU readmission during the same hospital stay. The consumption of antibiotics, biological analyses, and the number of chest x-rays during the stay were also analyzed.

Results

A total of 1600 patients were included: 839 in the before period and 761 in the after period. Only the severity score Simplified Acute Physiology Score II was significantly higher in the postcomputerization period (38 [SD 20] vs 40 [SD 21]; P<.05). There was no significant difference in terms of length of stay in ICU, mortality, or readmission during the stay. There was a significant increase in the volume of prescribed biological analyses (5416 [5192-5956] biological exams prescribed in the period before Intellispace Critical Care and Anesthesia [ICCA] vs 6374 [6013-6986] biological exams prescribed in the period after ICCA; P=.002), with an increase in the total cost of biological analyses, to the detriment of hematological and biochemical blood tests. There was also a trend toward reduction in the average number of chest x-rays, but this was not significant (0.55 [SD 0.39] chest x-rays per day per patient before computerization vs 0.51 [SD 0.37] chest x-rays per day per patient after computerization; P=.05). On the other hand, there was a decrease in antibiotic prescribing in terms of cost per patient after the implementation of computerization (€149.50 [$164 USD] per patient before computerization vs €105.40 [$155 USD] per patient after computerization).

Conclusions

Implementation of an intensive care information system at the Rouen University Hospital in June 2016 did not have an impact on reducing the length of stay.
Web-Based Intervention Effects on Mild Cognitive Impairment Based on Apolipoprotein E Genotype: Quasi-Experimental Study (Preprint)
Authors: Tsolaki Anthoula C , Tsolaki Magda , Pandria Niki , Lazarou Eftychia , Gkatzima Olymbia , Zilidou Vasiliki , Karagianni Maria , Iakovidou-Kritsi Zafiroula , Kimiskidis Vasilios K , Bamidis Panagiotis D
Published: July 2019

BACKGROUND

Apolipoprotein E (APOE) ε4 allele is a major genetic risk factor for Alzheimer disease and mild cognitive impairment (MCI). Computer-based training programs can improve cognitive performance in elderly populations. However, the effects of computer-based interventions on MCI APOE ε4 carriers have never been studied before.

OBJECTIVE

The effects of different web-based interventions and the APOE isoform-specific differences in training outcomes are investigated.

METHODS

Using a quasi-experimental study design, 202 participants with MCI aged 60 years and older took part in three different intervention programs (physical and cognitive [Long-Lasting Memories, or LLM], cognitive [Active Control, or AC], or physical intervention [Physical Training Control, or PTC]) via an innovative information and communication technologies exergaming platform. Participants in each interventional group were subdivided into APOE ε4 carriers and non–APOE ε4 carriers. All participants underwent an extensive neuropsychological evaluation before and after the training, blood tests, and brain imaging.

RESULTS

All interventions resulted in multiple statistically significant cognitive benefits after the intervention. Verbal learning (California Verbal Learning Test: immediate recall test score—LLM: P=.04; AC: P<.001), working memory (digit span forward and backward test scores—AC: P=.03; PTC: P=.02 and P=.006, respectively), and long-term memory (California Verbal Learning Test: delayed recall test score—LLM: P=.02; AC: P=.002; and PTC: P=.02) were improved. There was no statistically significant difference among the intervention effects. APOE ε4 presence moderates intervention effects as the LLM intervention improved only their task-switching processing speed (Trail Making Test, Part B: P=.03) and the PTC intervention improved only the working memory (digit span backward: P=.03). No significant performance alteration was noted for the APOE ε4+ cognitive AC training group.

CONCLUSIONS

None of the applied interventions could be identified as the optimal one; it is suggested, however, that combined cognitive and physical training and physical training via exergaming may be more effective for the high-risk MCI ΑPOE ε4+ subgroup.
Using Complexity Assessment to Inform the Development and Deployment of a Digital Dashboard for Schizophrenia Care: Case Study (Preprint)
Authors: Gremyr Andreas , Andersson Gäre Boel , Greenhalgh Trisha , Malm Ulf , Thor Johan , Andersson Ann-Christine
Published: July 2019

BACKGROUND

Health care is becoming more complex. For an increasing number of individuals, interacting with health care means addressing more than just one illness or disorder, engaging in more than one treatment, and interacting with more than one care provider. Individuals with severe mental illnesses such as schizophrenia are disproportionately affected by this complexity. Characteristic symptoms can make it harder to establish and maintain relationships. Treatment failure is common even where there is access to effective treatments, increasing suicide risk. Knowledge of complex adaptive systems has been increasingly recognized as useful in understanding and developing health care. A complex adaptive system is a collection of interconnected agents with the freedom to act based on their own internalized rules, affecting each other. In a complex health care system, relevant feedback is crucial in enabling continuous learning and improvement on all levels. New technology has potential, but the failure rate of technology projects in health care is high, arguably due to complexity. The Nonadoption, Abandonment, and challenges to Scale-up, Spread, and Sustainability (NASSS) framework and complexity assessment tool (NASSS-CAT) have been developed specifically to help identify and manage complexity in technology-related development projects in health care.

OBJECTIVE

This study aimed to use a pilot version of the NASSS-CAT instrument to inform the development and deployment of a point-of-care dashboard supporting schizophrenia care in west Sweden. Specifically, we report on the complexity profile of the project, stakeholders’ experiences with using NASSS-CAT, and practical implications.

METHODS

We used complexity assessment to structure data collection and feedback sessions with stakeholders, thereby informing an emergent approach to the development and deployment of the point-of-care dashboard. We also performed a thematic analysis, drawing on observations and documents related to stakeholders' use of the NASSS-CAT to describe their views on its usefulness.

RESULTS

Application of the NASSS framework revealed different types of complexity across multiple domains, including the condition, technology, value proposition, organizational tasks and pathways, and wider system. Stakeholders perceived the NASSS-CAT tool as useful in gaining perspective and new insights, covering areas that might otherwise have been neglected. Practical implications derived from feedback sessions with managers and developers are described.

CONCLUSIONS

This case study shows how stakeholders can identify and plan to address complexities during the introduction of a technological solution. Our findings suggest that NASSS-CAT can bring participants a greater understanding of complexities in digitalization projects in general.
Analysis of Mental Health Disease Trends Using BeGraph Software in Spanish Health Care Centers: Case Study (Preprint)
Authors: Góngora Alonso Susel , de Bustos Molina Andrés , Sainz-De-Abajo Beatriz , Franco-Martín Manuel , De la Torre Díez Isabel
Published: July 2019

BACKGROUND

In the era of big data, networks are becoming a popular factor in the field of data analysis. Networks are part of the main structure of BeGraph software, which is a 3D visualization application dedicated to the analysis of complex networks.

OBJECTIVE

The main objective of this research was to visually analyze tendencies of mental health diseases in a region of Spain, using the BeGraph software, in order to make the most appropriate health-related decisions in each case.

METHODS

For the study, a database was used with 13,531 records of patients with mental health disorders in three acute medical units from different health care complexes in a region of Spain. For the analysis, BeGraph software was applied. It is a web-based 3D visualization tool that allows the exploration and analysis of data through complex networks.

RESULTS

The results obtained with the BeGraph software allowed us to determine the main disease in each of the health care complexes evaluated. We noted 6.50% (463/7118) of admissions involving unspecified paranoid schizophrenia at the University Clinic of Valladolid, 9.62% (397/4128) of admissions involving chronic paranoid schizophrenia with acute exacerbation at the Zamora Hospital, and 8.84% (202/2285) of admissions involving dysthymic disorder at the Rio Hortega Hospital in Valladolid.

CONCLUSIONS

The data analysis allowed us to focus on the main diseases detected in the health care complexes evaluated in order to analyze the behavior of disorders and help in diagnosis and treatment.
Needle Stick Injury and Their Related Factors: A Five-Year Review in Hospital Selayang- Malaysia (Preprint)
Authors: Idris Iszaid ,   Infectious Control Nurses
Published: July 2019

BACKGROUND

Needle stick injuries (NSIs) are major risk for blood-borne pathogen exposure in hospital. A benchmark for the prevalence of NSIs would allow hospital to compare data with those of other institutions and also assist with the development of measures to minimize NSIs. .

OBJECTIVE

To determine the incidence of accidental NSIs from 2013 to 2017 at same time to promote awareness among the healthcare workers (HCW) in Selayang Hospital, Malaysia.

METHODS

This was a retrospective cohort using secondary data obtained from the medical records. Descriptive and inferential statistics were computed to analyse the data.

RESULTS

A total of 220 NSIs cases and out of witch majority were female (n=165, 75%) compared to male (n=55, 25%) with ratio of 3:1 respectively. The average age was 30.6± 7.0 SD. Most common causes NSIs which was hypodermic needle (n=126, 57.27%) follow by stylet needle (n=40, 18.18%) however suture needle (ORs=5.4, p-Value=0.03) shows significant association with time of injury. There were 44 cases of NSIs per year. All HCW are follow-up with some HCW received post exposure prophylaxis.

CONCLUSIONS

Various measures must be implemented in hospital setting to minimize the risk of sustaining NSIs. The health promotion play key role to deliver information to HCW.
The Systematic Medical Appraisal Referral and Treatment Mental Health Project: Quasi-Experimental Study to Evaluate a Technology-Enabled Mental Health Services Delivery Model Implemented in Rural India (Preprint)
Authors: Maulik Pallab K , Devarapalli Siddhardha , Kallakuri Sudha , Bhattacharya Amritendu , Peiris David , Patel Anushka
Published: July 2019

BACKGROUND

Although around 10% of Indians experience depression, anxiety, or alcohol use disorders, very few receive adequate mental health care, especially in rural communities. Stigma and limited availability of mental health services contribute to this treatment gap. The Systematic Medical Appraisal Referral and Treatment Mental Health project aimed to address this gap.

OBJECTIVE

This study aimed to evaluate the effectiveness of an intervention in increasing the use of mental health services and reducing depression and anxiety scores among individuals at high risk of common mental disorders.

METHODS

A before-after study was conducted from 2014 to 2019 in 12 villages in Andhra Pradesh, India. The intervention comprised a community antistigma campaign, with the training of lay village health workers and primary care doctors to identify and manage individuals with stress, depression, and suicide risk using an electronic clinical decision support system.

RESULTS

In total, 900 of 22,046 (4.08%) adults screened by health workers had increased stress, depression, or suicide risk and were referred to a primary care doctor. At follow-up, 731 out of 900 (81.2%) reported visiting the doctor for their mental health symptoms, compared with 3.3% (30/900) at baseline (odds ratio 133.3, 95% CI 89.0 to 199.7; P<.001). Mean depression and anxiety scores were significantly lower postintervention compared with baseline from 13.4 to 3.1 (P<.001) and from 12.9 to 1.9 (P<.001), respectively.

CONCLUSIONS

The intervention was associated with a marked increase in service uptake and clinically important reductions in depression and anxiety symptom scores. This will be further evaluated in a large-scale cluster randomized controlled trial.
Memoria en conflicto. Los incas en El Calvario de Fuerte Quemado de Yocavil, Noroeste Argentino
Authors: Reynoso Alejandra , Pratolongo Gerónimo , Palamarczuk Valeria , Marchegiani Marina , Grimoldi M. Solange
Published: July 2019

This work intends to study the Inca occupation in El Calvario de Fuerte Quemado, an importantlate village (XI-XV century AD) of the Yocavil valley, which, when confused with another nearbysite, had been relegated from regional investigations. On this occasion, based on the planialtimetricsurvey of the settlement, the different sectors with evidence of Inca occupation are analyzed andthe results of the excavations carried out in three circular stone structures, known as “torreones”,are presented. The destruction of a local tomb under a rocky ledge for the construction of one ofthe Inca towers and the redeposition of part of the burial content under its floor are stressed. Weconsider that these data will be relevant to discuss the different interpretations of the relationshipbetween the Inca state and the local populations. The destruction of a significant structure for localhistorical memory by representatives of the Inca state, an event that has been hardly documented inarchaeology, reveals –beyond the negotiation strategies with local elites– the violent character of theimperial conquest.
ENTRE A PSICOGÊNESE E A LINGUÍSTICA: UMA ANÁLISE EM AQUISIÇÃO DE LINGUAGEM ESCRITA DE CRIANÇAS EM PROCESSO DE ALFABETIZAÇÃO
Authors: Lima Maria Aparecida Ramos , Dikson Dennys
Published: July 2019

Este trabalho apresenta, discute e analisa a aquisição de linguagem escrita em produções de atividades escolares de crianças em processos de alfabetização em uma turma de 2º ano do Ensino Fundamental I de uma Escola Municipal de Solidão-PE. Trouxemos, num primeiro plano, a teoria da Psicogênese da escrita, com Ferreiro e Teberosky (1999), e, num segundo, a da Aquisição da Linguagem Interacionista, através de De Lemos (1992, 1995), de Borges (2006, 2010), dentre outros, com o intuito de compreender o processo de construção escrita de um mesmo texto sob a ótica de duas noções que possuem lugares antagônicos de compreensão, revelando-se algumas proximidades e robustos distanciamentos. O estudo carrega um foco de abordagem qualitativa, crítica e reflexiva, com aplicação de atividades escritas em ambiente escolar, fomentadas por alunos em processo de aquisição inicial. A partir dessa bifurcação teórica, analisamos um único texto de cada aluno primeiro a partir da Psicogênese e, logo depois, à luz da Aquisição de Linguagem Interacionista. As discussões levadas à tona nos mostram o quanto cada teoria contribui no desenvolvimento de concepções acerca do sujeito, da língua, da linguagem e do próprio processo de aquisição escrita, situação que permite asseverar que os dados revelaram uma riqueza impressionante de significações circundantes nas produções escritas das crianças, afastando, de certa maneira, uma escrita de um sujeito tido como psicologizante, aproximando-se mais de um processo de escritura tendo como lugar de origem este sujeito imerso e sob efeito do funcionamento da linguagem, sempre.
Distribusi Dan Aktivitas Menggigit Nyamuk Genus Mansonia Yang Berpotensi Sebagai Vektor Filariasis di Wilayah Endemis Filariasis Desa Ligan dan Lhok Bout Aceh Jaya
Authors: Yulidar Yulidar , M.Diah Yasir , Wilya Veny , Zulhaida Andi
Published: July 2019

Filariasis masih menjadi masalah pada masyarakat di desa Ligan dan desa Lhok Bout Kabupaten Aceh Jaya. Mansonia spp merupakan salah satu vektor filariasis di Indonesia. Penelitian ini bersifat cross sectional yang dilaksanakan pada bulan Pebruari-Desember 2017 di desa Ligandan Lhok Bout. Penangkapan nyamuk menggunakan metode umpan orang dalam dan luar rumah. Umpan orang duduk dalam kelambu. Hasil penelitian  didapatkan total jumlah nyamuk Mansonia spp tertangkap adalah 58 nyamuk terbagi atas 5 spesies yaitu 8 nyamuk Ma. bonnae, 5 Ma. uniformis,  38 Ma. annulata,  6 Ma. annulifera dan 1 Ma. indiana. Kepadatan masing-masing nyamuk hinggap dibadan orang perjam adalah Ma. bonnae 0,31, Ma. uniformis 0,25,Ma. annulata 1,94. Ma. annulifera 0,31 dan Ma. indiana 0,06. Sedangkan kepadatan nyamukhinggap dibadan orang permalam adalah Ma. bonnae 1,33, Ma. uniformis 0,83,Ma. annulata 6,33, Ma. annulifera 1,00 dan Ma. indiana 0,17. Kelimpahan nisbi masing-masing nyamuk tertangkap yaitu Ma. bonnae 1,60%, Ma. uniformis 1,00%,Ma. annulata 6,20%, Ma. annulifera 1,00% dan Ma. indiana 0,20%. Nyamuk Mansonia spp yang tertangkap bersifat endofagik. Berdasarkan kepadatan nyamuk tertinggi dan angka dominansi spesies mencapai 3,33% maka vektor filariasis potensial di desa Ligan dan Lhok Bout adalah Mansonia annulata.
LOGOTERAPIA: O CAMINHO E O PAPEL DOS VALORES NO PROCESSO TERAPÊUTICO
Authors: Rech Paulo Roberto
Published: July 2019

Após colocar brevemente alguns aspectos teóricos da logoterapia, este trabalho busca mostrar que a realização de valores, por parte do paciente, é importante e decisivo motor de transformação na própria vida. Partindo de algumas situações clínicas e confrontando com considerações do próprio Frankl, o artigo busca justificar que o logoterapeuta sinalize, sublinhe valores já vivenciados ou realizados pelo paciente, cite e mesmo proponha valores possíveis de serem realizados por ele. Os relatos clínicos apresentados mostram alguns resultados positivos, concluindo que a proposta é um possível caminho terapêutico.
RELAÇÕES DE ENSINO-APRENDIZAGEM NA PERSPECTIVA DA LOGOTERAPIA. A CONTRIBUIÇÃO DE VIKTOR FRANKL PARA A EDUCAÇÃO.
Authors: Silva Beatriz Dias da
Published: July 2019

O objetivo deste artigo é entender como se dão as relações de ensino-aprendizagem sob a perspectiva da logoterapia, trazendo para o campo pedagógico as contribuições desta teoria criada por Viktor Frankl, aplicando os conceitos da logoterapia na prática do pedagogo e procurando compreender o educando como um ser humano que busca o sentido da vida. Fundamenta-se este trabalho em uma revisão bibliográfica de publicações e textos científicos complementada por uma pesquisa de campo que analisa como acontecem na rotina escolar as relações de ensino-aprendizagem a partir da logoterapia que propõem uma educação que forme para a liberdade e a responsabilidade despertando a consciência dos indivíduos para a busca de sentido e o sentido da vida.
SAÚDE E SENTIDO DE VIDA: AS VIVÊNCIAS DO ENVELHECER
Authors: Espíndula Joelma Ana Gutiérrez , Ferreira Natália Nunes
Published: July 2019

O presente estudo tem por objetivo compreender como os idosos vivenciam a saúde, sentido de vida, e como os aspectos psicossociais influenciam no processo de envelhecer. A partir da metodologia descritiva-qualitativa, tendo como fundamento a abordagem da logoterapia e analise existencial de Frankl, a pesquisa abarca uma atitude integrativa, buscando concepções de vontade do sentido, sentido da vida, liberdade da vontade. Foram realizadas cinco entrevistas com idosos do grupo de extensão Girassol da UFRR. Na análise foram identificados eixos temáticos: experiências do cotidiano da velhice, relações Interpessoais como apoio social, saúde e dificuldades corpóreas deparadas no cotidiano, percepções da finitude e desejos e/ou sonhos a serem conquistados. A maioria dos participantes menciona a família como fundamental na vida do indivíduo, seguido de amigos e grupos sociais, apoiando-os no enfrentamento do cotidiano. Alguns colaboradores ressignificam a perda de seu trabalho quando até então não tiveram uma preparação para a aposentadoria. Pode-se perceber que mesmo diante da tensão vivida pelas transformações psicossociais eles se mostram na existência entre ser e dever-ser. Eles abordaram o tema do corpo, levando-os a respeitar os limites impostos pela realidade e buscar o bem-estar e a qualidade de vida cotidianamente.

Palavras: envelhecimento, aposentadoria, aspectos psicossociais, psicogerontologia e logoterapia.

HEALTH AND MEANING OF LIFE: AGING EXPERIENCES

This study’s aim was to understand how elderly individuals experience health and the meaning of life, and how psychosocial aspects influence the aging process. Using a descriptive-qualitative methodology based on the logotherapy approach and Frankl’s existential analysis, this study has an integrative nature, seeking conceptions of will to meaning, meaning of life, and freedom to activate will. Five interviews were held with elderly individuals from the UFRR’s extension group, Girassol. The following thematic axes were identified: routine aging experiences; interpersonal relationships as social support; health and bodily difficulties encountered in daily life; and perception of finitude and desires and/or dreams to be achieved. Most participants report that family is essential in an individual’s life, followed by friends and social groups, who help them cope with everyday life. Some resignify the loss of their occupations at a time they had not yet prepared for retirement. Even though they experience tension due to psychosocial transformations, they show themselves in existence between being and must-be. They addressed the body topic, which makes them respect limitations imposed by reality, seeking wellbeing and quality of life in everyday life.

Key words: aging, retirement, psychosocial aspects, psychogerontology, and logotherapy.