bluuebunny/crossref_metadata_2025 huggingface dataset:
No support that early selective dorsal rhizotomy increase frequency of scoliosis and spinal pain – a longitudinal population-based register study from four to 25 years of age
Authors: Lundkvist Josenby Annika , Westbom Lena
Published: November 2020

Spasticity interfering with gross motor development in cerebral palsy (CP) can be reduced with selective dorsal rhizotomy (SDR). Although reported, it is unknown if SDR surgery causes later spine problems. Using CP-registry data from a geographically defined population, the objectives were to compare frequency and time to scoliosis, and spinal pain up to adult age after SDR-surgery or not in all with same medical history, functional abilities, CP-subtype and level of spasticity at 4 years of age. Variables associated with scoliosis at 20 years of age were explored.

Method

In the total population with CP spastic diplegia in Skåne and Blekinge, born 1990–2006, 149 individuals had moderate to severe spasticity and no medical contraindications against SDR at 4 years of age and were included; 36 had undergone SDR at a median age of 4.0 years (range 2.5–6.6 years), and 113 had not.

Frequency of scoliosis and age when scoliosis was identified, and frequency of spinal pain at 10, 15, 20 and 25 years of age were analysed using Kaplan-Meier survival curves and Fisher’s exact test. Multivariable logistic regression was performed to identify variables to explain scoliosis at 20 years of age. Gross Motor Function Classification System (GMFCS) levels at 4 years of age were used for stratification.

Result

Frequency of scoliosis did not significantly differ between groups having had early SDR surgery or not. In GMFCS IV, the SDR group had later onset and lower occurrence of scoliosis (p = 0.004). Frequency of spinal pain did not differ between the groups (p- levels > 0.28). GMFCS level was the background variable that in the logistic regression explained scoliosis at 20 years of age.

Conclusion

Frequency of back pain and scoliosis in adulthood after early SDR are mainly part of the natural development with age, and not a surgery complication.
Professional oral care in end-of-life patients with advanced cancers in a hospice ward: improvement of oral conditions
Authors: Wu Ting-Ying , Liu Hsiu-Yueh , Wu Chien-Yi , Chen Hung-Cheng , Huang Shun-Te , Chen Ping-Ho
Published: November 2020

Background

In end-of-life patients with advanced cancers, oral examination, oral care, and oral re-examination are crucial. Although oral symptoms are among the major complaints of end-of-life patients, few studies have focused on oral care in these patients. In this study, the association between oral symptoms and oral dryness among end-of-life patients was examined, and improvement of oral conditions after oral care interventions by a professional dentist was quantified.

Methods

This prospective intervention study included 27 terminally ill patients with advanced cancers in a hospice ward. Professional oral care was administered every morning, and the improvement of oral conditions was assessed by comparing oral conditions before and after the intervention. Oral assessment was performed using the Oral Health Assessment Tool (OHAT) and Oral Assessment Guide. Oral dryness was evaluated through Clinical Diagnosis Classification of oral dryness and an oral moisture device. Oral cleanliness was evaluated using a bacterial counter, and tongue smears were collected forCandidaexamination; furthermore, oral function was recorded.

Results

The presence of oral mucositis was closely associated with severe oral dryness (odds ratio [OR] = 14.93; 95% confidence interval [CI]: 1.95–114.38). The level of oral debris retention was significantly related to the degree of oral dryness (OR = 15.97; 95% CI: 2.06–123.72). The group with higher scores (OHAT > 8), which represent poor oral conditions, showed severe oral dryness (OR = 17.97; 95% CI: 1.45–223.46). Total OHAT scores (median: 7 vs 2) and those of other subgroups (lip, tongue, gums and tissues, saliva, and oral cleanliness showed a significant decrease after the intervention. Furthermore, the occurrence of mucositis (47.1% vs 0%), candidiasis rate (68.8% vs 43.8%), oral dryness self-sensation (63.6% vs 9.1%), and severe oral debris (52.9% vs 11.8%) decreased significantly.

Conclusions

Proper oral care can improve oral health and hygiene, reduce the rate of mucositis, reduce the sensation of oral dryness, increase oral moisture, and reduce the chances of oral infections among end-of-life patients. Daily oral care is necessary and can alleviate oral discomfort, increase food intake, and increase the chances of communication between end-of-life patients and their families.
The evaluation of stomatology English education in China based on ‘Guanghua cup’ international clinical skill exhibition activity
Authors: Wang Xi , Liu Yangjingwen , Yang Le , Zhou Kai , Cao Yang , Hong Yun , Huang Shuheng , Lin Zhengmei
Published: November 2020

Background

English education in professional areas has become more and more important with the increasing internationalization of health profession education in countries around the world. In this study, we aimed to evaluate current Chinese stomatology English education based on Chinese participants’ ability to apply stomatology English during an international stomatology skill competition called the ‘Guanghua Cup activity’.

Methods

The registration rate of English and Chinese volunteers and the answer rate and accuracy of Chinese and international contestants on the English knowledge quiz were statistically described. A five-point Likert scale questionnaire was delivered to all participants. The data were analyzed using the Spearman test, Kruskal-Wallis rank sum test and Mann-Whitney U test.

Results

Among the 194 students, the English and Chinese volunteer registration rate was 7.73 and 30.93%, respectively. The answer rate of Chinese contestants and international contestants in the English quiz was 25 and 75%, with an accuracy rate of 50 and 66.70%, respectively. The questionnaire was graded by Likert five-level classification. There was a positive correlation between the use of English textbooks in classes and the communication with international teachers and students in the competition (Rs = 0.348, p = 0.016). English volunteers had more preparation in English before the competition, more opportunities to communicate with international peers, and greater improvement in English ability than the contestants and Chinese volunteers (p < 0.001). After the competition, all participants paid more attention to stomatology English (p < 0.001).

Conclusions

Chinese stomatology students have difficulty in stomatology English application. The ‘Guanghua Cup’ helps to improve English proficiency of English volunteers and arouses the interest of stomatology English for all participants. Chinese stomatology school needs to strengthen and reach a consensus in stomatology English education.
Changes in practitioners’ attitudes, perceived training needs and self-efficacy over the implementation process of an evidence-based parenting program
Authors: Côté Marie-Kim , Gagné Marie-Hélène
Published: November 2020

Background

Evidence-based family support programs such as the Triple P – Positive Parenting Program have the potential to enhance the well-being of children and families. However, they cannot achieve their expected outcomes if insufficient attention is paid to the implementation process. It has been demonstrated that practitioners’ attitudes towards evidence-based programs (EBPs), perceived training needs and self-efficacy for working with parents influence implementation outcomes (e.g., program acceptability, adoption, adherence and sustainability). At the same time, the experience of being involved in the implementation process of an EBP could enhance practitioners’ perceptions of the initiative. This study aimed to assess changes in practitioner’s attitudes, perceived training needs and self-efficacy over a two-year EBP implementation process, in interaction with their appraisal of their organization’s capacity to implement the EPB.

Methods

In the province of Quebec, Canada, Triple P was implemented and evaluated in two communities. Ninety-nine practitioners from various organizations completed questionnaires shortly before their training in Triple P and two years later.

Results

Findings show that practitioners who displayed more initial skepticism regarding their organization’s capacity to implement the program reported greater improvements in attitudes over time, while practitioners who showed more optimism at baseline reported a greater decrease in their perceived training needs. Practitioners’ self-efficacy increased moderately regardless of perceived organizational capacity.

Conclusions

These results are encouraging given that more positive perceptions of EBPs could foster the systematic use of these programs in communities, for the potential benefit of a greater number of families.
Potentially inappropriate testing for vitamin D deficiency: a cross-sectional study in Switzerland
Authors: Essig Stefan , Merlo Christoph , Reich Oliver , Trottmann Maria
Published: November 2020

Background

There is consensus that vitamin D supplementation is often indicated but population-based screening by laboratory testing for vitamin D deficiency is inadequate. Testing should be restricted to people at high risk of severe deficiency. This study describes the current lab testing for vitamin D deficiency in the adult population of Switzerland.

Methods

We assessed Swiss health insurance data (SWICA) for incidence of lab testing for vitamin D levels, comparing the years 2015 and 2018. Claims were analyzed for associations between lab testing and age, sex, medical indications, insurance status and geographic location in multivariable regression analyses. We also estimated the costs of vitamin D testing.

Results

Data from 200,043 and 200,046 persons for 2015 and 2018, respectively, were analyzed. Vitamin D level was tested in 14% of the sample population in 2015 and 20% in 2018. Testing increased by 69% for individuals aged 26–30. Testing was associated with being middle-aged to young senior citizens, female, medical indications (pregnancy, renal disease, osteoporosis, hyperparathyroidism, HIV, glucocorticoid intake), more chronic conditions, having a mandatory insurance with a low deductible, additional insurance coverage, and living in urban areas. We estimate that the total laboratory cost to mandatory insurance was about 90 million Swiss francs in 2018.

Conclusions

Despite recommendations for routine vitamin D supplementation, vitamin D testing of low risk individuals is common and increasing in Switzerland.
Equity and efficiency of health care resource allocation in Jiangsu Province, China
Authors: Li Qian , Wei Jianjun , Jiang Fengchang , Zhou Guixiang , Jiang Rilei , Chen Meijuan , Zhang Xu , Hu Wanjin
Published: November 2020

Background

Jiangsu was one of the first four pilot provinces to engage in comprehensive health care reform in China, which has been on-going for the past 5 years. This study aims to evaluate the equity, efficiency and productivity of health care resource allocation in Jiangsu Province using the most recent data, analyse the causes of deficiencies, and discuss measures to solve these problems.

Methods

Data were extracted from the Jiangsu Health/Family Planning Statistical Yearbook (2015–2019) and Jiangsu Statistical Yearbook (2015–2019). The Gini coefficient (G), Theil index (T) and health resource density index (HRDI) were chosen to study the fairness of health resource allocation in Jiangsu Province. Data envelopment analysis (DEA) and the Malmquist productivity index (MPI) were used to analyse the efficiency and productivity of this allocation.

Results

From 2014 to 2018, the total amount of health resources in Jiangsu Province increased. The G of primary resource allocation by population remained below 0.15, and that by geographical area was between 0.14 and 0.28; additionally, the G of health financial resources was below 0.26, and that by geographical area was above 0.39. T was consistent with the results for G and Lorenz curves. The HRDI shows that the allocated amounts of health care resources were the highest in southern Jiangsu, except for the number of health institutions. The average value of TE was above 0.93, and the DEA results were invalid for only two cities. From 2014 to 2018, the mean TFPC in Jiangsu was less than 1, and the values exceeded 1 for only five cities.

Conclusion

The equity of basic medical resources was better than that of financial resources, and the equity of geographical allocation was better than that of population allocation. The overall efficiency of health care resource allocation was high; however, the total factor productivity of the whole province has declined due to technological regression. Jiangsu Province needs to further optimize the allocation and increase the utilization efficiency of health care resources.
Socio-emotional and adaptive behaviour in children treated for severe anaemia at Lira Regional Referral Hospital, Uganda: a prospective cohort study
Authors: Ssemata Andrew Sentoogo , Opoka Robert Opika , Ssenkusu John Mbaziira , Nakasujja Noeline , John Chandy C. , Bangirana Paul
Published: November 2020

Background

Severe anaemia is a global public health challenge commonly associated with morbidity and mortality among children < 5 years of age in Sub-Saharan Africa. However, less is known about the behavioural performance of children < 5 years surviving severe anaemia in low resource settings. We investigated social-emotional and adaptive behaviour in children < 5 years diagnosed with severe anaemia in Northern Uganda.

Methods

We conducted a hospital based prospective cohort study among children 6—42 months who were treated for severe anaemia (n = 171) at Lira Regional Referral Hospital, Uganda. Socio-emotional and adaptive behaviour were assessed 14 days post discharge using the Bayley Scales of Infant and Toddler Development, 3rd edition. Age-adjusted z-scores for each domain were calculated using scores from healthy community children (n = 88) from the same environment for each age category. Multiple linear regression was used to compare z-scores in the social-emotional and adaptive behaviour scales between the two groups after adjusting for weight-for-age z-score, social economic status, mother’s education, father’s education and father’s employment on all the scales.

Results

Compared with healthy community controls, children with severe anaemia had poorer [adjusted mean scores (standard error)], socio-emotional [− 0.29, (0.05) vs. 0.01, (0.08), P = 0.002]; but not overall/ composite adaptive behaviour [− 0.10, (0.05) vs. − 0.01, (0.07), P = 0.343]. Within the adaptive behaviour subscales, children with SA displayed significantly poorer scores on the community use [adjusted mean score (standard error)], [− 0.63, (0.10) vs. − 0.01, (0.13), P < 0.001]; and leisure [− 0.35, (0.07) vs. − 0.02, (0.07), P = 0.036] skills.

Conclusion

This study suggests that severe anaemia in children < 5 years is associated with poor social-emotional scores in the short-term post clinical recovery in Northern Uganda. We recommend long-term follow-up to determine the course of these problems and appropriate interventions to reduce the behavioural burden among children < 5 years surviving severe anaemia in Uganda.
Sun, sea and sex: a review of the sex tourism literature
Authors: Lu Timothy Siliang , Holmes Andrea , Noone Chris , Flaherty Gerard Thomas
Published: November 2020

Background

Sex tourism is defined as travel planned specifically for the purpose of sex, generally to a country where prostitution is legal. While much of the literature on sex tourism relates to the commercial sex worker industry, sex tourism also finds expression in non-transactional sexual encounters. This narrative review explores current concepts related to travel and sex, with a focus on trans-national sex tourism.

Methods

The PubMed database was accessed to source relevant literature, using combinations of pertinent search terms. Only articles published in the English language were selected. Reference lists of published articles were also examined for relevant articles.

Results

With regard to preferred destinations, South/Central America and the Caribbean were more likely to receive tourists looking for casual sex. Longer duration of travel, travelling alone or with friends, alcohol or drug use, being younger and being single were factors associated with higher levels of casual sex overseas. The majority of literature retrieved on sex workers focused on risk behaviours, sexually transmitted infections (STI), mobility of sex workers and how these factors affected their lives. Sex tourists require better access to effective methods of preventing HIV, such as pre-exposure prophylaxis, and better education on HIV prevention. Drugs and alcohol play a major role as risk factors for and cofactors in casual sexual behaviour while abroad.

Conclusions

Travellers need to be informed of the increased risks of STI before travel. They should be aware of the local prevalence of STIs and the risks associated with their sexual practices when they travel, including engaging with commercial sex workers, having unprotected sexual intercourse and becoming victims of sexual violence.
Governing the gold rush into emerging markets: a case study of Indonesia’s regulatory responses to the expansion of Chinese-backed online P2P lending
Authors: Tritto Angela , He Yujia , Junaedi Victoria Amanda
Published: November 2020

Peer-to-peer (P2P) lending has the potential to boost financial inclusion in emerging markets. This paper contributes to the literature on fintech governance in emerging Asian markets. It examines the case of the Indonesian government’s approach in regulating the P2P lending sector using both primary interviews and secondary firm-level data. Driven by regulation tightening in China and regulatory gaps in Indonesia, Chinese investments became the largest in this sector contributing, however, to growing risks from illegal business practices. The Indonesian government responded by creating new regulations and institutions, mitigating risks without stifling the potential for financial inclusion. We conclude a proactive approach towards monitoring and regulating emerging high-tech industries should be sought by strengthening links with industry and civil society, and through international cooperation for policy and knowledge sharing.
An update on vessel preparation in lower limb arterial intervention
Authors: Ormiston William , Dyer-Hartnett Shelagh , Fernando Rukshan , Holden Andrew
Published: November 2020

Background

Plain balloon angioplasty has traditionally been used to treat lower limb arterial disease but can be limited by significant residual stenosis, vessel recoil, dissection, and by late restenosis. Appropriate vessel preparation may significantly improve short and long-term outcomes. We aim to give an overview of some of the devices currently available, or under investigation, for vessel preparation in the lower limb.

Main text

Vessel preparation devices include those that remove plaque (atherectomy devices) and those that modify plaque.

The four groups of plaque removing atherectomy devices are defined by their plaque removal method: Directional, rotational orbital and excimer laser are categories of devices investigated for plaque modification.

Intravascular lithotripsy devices generate sonic pulsatile pressure waves that pass into the vessel wall cracking calcified plaques whilst sparing soft tissue. This enables dilatation of calcified lesions at low pressure by conventional balloons and enables full stent expansion.

Other balloon based vessel preparation devices were designed to modify plaque and produce more controlled, lower pressure luminal expansion without major dissections and potentially with less recoil than conventional angioplasty balloons. Scoring balloons have a helical nitinol element attached to the balloon that scores plaque facilitating uniform luminal enlargement. Further specialty balloons have been developed in recent years, including the Chocolate, Phoenix and Serranator balloons. Finally, the temporary Spur self-expanding retrievable nitinol stent has a series of radially aligned spurs that are driven into the vessel wall by post-dilatation, potentially improving drug delivery.

Conclusion

Lesion specific vessel preparation aims to improve both short and long term outcomes through improved penetration of anti-proliferative drug, maximising luminal gain, reducing the need for stent placement and minimising intimal injury. Some forms of vessel preparation appear to improve short term outcomes; long-term outcomes remain uncertain. An overview of some of the multiple devices available for vessel preparation is presented.
CT chest findings in patients infected with COVID-19: review of literature
Authors: Hefeda Mohamed Mohamed
Published: November 2020

Background

Coronavirus disease 2019 (COVID-19) is a highly infectious disease causing severe respiratory distress syndrome that was first discovered by the end of 2019 in Wuhan, China.

Main text

A wide variety of CT findings in COVID-19 have been reported in different studies, and the CT findings differ according to the stage of the disease and disease severity and associated co-morbidities. We will discuss each sign separately and its importance in diagnosis and prognosis.

Conclusion

CT plays a pivotal role in the diagnosis and management of COVID-19 pneumonia. The typical appearance of COVID-19 pneumonia is bilateral patchy areas of ground glass infiltration, more in the lower lobes. The appearance of other signs like consolidation, air bronchogram, crazy pavement appearance, and air bubble signs appear during the course of the disease. In the context of pandemic, the CT chest can be used as a screening tool in symptomatic patients as it is cheaper, available, and time saving.
Improvement in Symptoms and Health-Related Quality of Life in Acromegaly Patients: A Systematic Review and Meta-Analysis
Authors: Broersen Leonie H A , Zamanipoor Najafabadi Amir H , Pereira Alberto M , Dekkers Olaf M , van Furth Wouter R , Biermasz Nienke R
Published: November 2020

Background

Whereas biochemical response is often used as a primary study outcome, improvement in symptoms and health-related quality of life (HRQoL) is the relevant goal for patients to consider treatment successful. We performed a systematic review and meta-analysis to assess the effect of treatment on symptoms and HRQoL in acromegaly.

Methods

Seven electronic databases were searched for longitudinal studies assessing patient-reported symptoms or HRQoL in acromegaly. Meta-analyses were performed to assess differences during treatment for the Acromegaly Quality of Life Questionnaire (AcroQoL) and Patient-Assessed Acromegaly Symptom Questionnaire (PASQ), and standardized mean difference (SMD) for individual symptoms (interpretation: 0.2 small, 0.5 moderate, and 0.8 large effect). Treatment-naive and previously treated patients were assessed separately.

Results

Forty-six studies with 3301 patients were included; 24 contributed to quantitative analyses. Thirty-six studies used medication as main treatment, 1 transsphenoidal adenomectomy, and 9 various treatments. Symptoms and HRQoL both improved: AcroQoL increased 2.9 points (95% CI, 0.5 to 5.3 points), PASQ decreased –2.3 points (95% CI, –1.3 to –3.3 points), and individual symptom scores decreased for paresthesia –0.9 (95% CI, –0.6 to –1.2), hyperhidrosis –0.4 (95% CI, –0.1 to –0.6), fatigue –0.3 (95% CI, –0.1 to –0.6), arthralgia –0.3 (95% CI, –0.1 to –0.5), headache –0.3 (95% CI, 0.0 to –0.6), and soft-tissue swelling –0.2 (95% CI, 0.0 to –0.4).

Conclusion

Symptoms and HRQoL improved during acromegaly treatment. Consensus is needed on which symptoms should be included in a potential core outcome set, taking into account symptom frequency, severity, and sensitivity to change, which can be used in clinical practice and as outcome in trials.
Efficacy of Micronized Progesterone for Sleep: A Systematic Review and Meta-analysis of Randomized Controlled Trial Data
Authors: Nolan Brendan J , Liang Bonnie , Cheung Ada S
Published: November 2020

Context

Preclinical data has shown progesterone metabolites improve sleep parameters through positive allosteric modulation of the γ-aminobutyric acid type A receptor. We undertook a systematic review and meta-analysis of randomized controlled trials to assess micronized progesterone treatment on sleep outcomes.

Evidence Acquisition

Using preferred reporting items for systematic review and meta-analysis guidelines, we searched MEDLINE, Embase, PsycInfo, and the Cochrane Central Register of Controlled Trials for randomized controlled trials of micronized progesterone treatment on sleep outcomes up to March 31, 2020. This study is registered with the International Prospective Register of Systematic Reviews, number CRD42020165981. A random effects model was used for quantitative analysis.

Evidence Synthesis

Our search strategy retrieved 9 randomized controlled trials comprising 388 participants. One additional unpublished trial was found. Eight trials enrolled postmenopausal women. Compared with placebo, micronized progesterone improved various sleep parameters as measured by polysomnography, including total sleep time and sleep onset latency, though studies were inconsistent. Meta-analysis of 4 trials favored micronized progesterone for sleep onset latency (effect size, 7.10; confidence interval [CI] 1.30, 12.91) but not total sleep time (effect size, 20.72; CI -0.16, 41.59) or sleep efficiency (effect size, 1.31; CI -2.09, 4.70). Self-reported sleep outcomes improved in most trials. Concomitant estradiol administration and improvement in vasomotor symptoms limit conclusions in some studies.

Conclusions

Micronized progesterone improves various sleep outcomes in randomized controlled trials, predominantly in studies enrolling postmenopausal women. Further research could evaluate the efficacy of micronized progesterone monotherapy using polysomnography or validated questionnaires in larger cohorts.
The emerging role of quantitative imaging in asthma
Authors: Krings James G , Wenzel Sally E , Castro Mario
Published: November 2020

Quantitative imaging of the lung has proved to be a valuable tool that has improved our understanding of asthma. CT, MRI, and positron emission tomography have all been utilized in asthma with each modality having its own distinct advantages and disadvantages. Research has now demonstrated that quantitative imaging plays a valuable role in characterizing asthma phenotypes and endotypes, as well as potentially predicting future asthma morbidity. Nonetheless, future research is needed in order to minimize radiation exposure, standardize reporting, and further delineate how imaging can predict longitudinal outcomes. With future work, quantitative imaging may make its way into the clinical care of asthma and change our practice.
A IDEIA DE EQUILÍBRIO POLÍTICO DE BENJAMIN CONSTANT NO CONSTITUCIONALISMO BRASILEIRO: PODER JUDICIÁRIO COMO NOVO PODER MODERADOR?
Authors: Lima Martonio Mont'Alverne Barreto , Gonçalves Ítalo Reis
Published: November 2020

Objetivo: Partindo da hipótese de que, no Brasil redemocratizado, o Poder Judiciário desempenha função análoga à do Poder Moderador da Constituição Imperial de 1824 e promove acúmulo de poder e desequilíbrio político, o artigo busca apresentar criticamente alguns dos principais postulados da teoria constitucional de limitação de poder de Benjamin Constant e, com base nesta, investigar a atuação jurídico-política dos juízes e tribunais nacionais (em especial, do Supremo Tribunal Federal), que desempenham papel fundamental na dinâmica democrática do País.Metodologia: Adota-se, quanto à natureza, metodologia aplicada, pois pretende oferecer respostas práticas sobre a jurisdição constitucional no Brasil; quanto ao objetivo, metodologia explicativa, pois pretende delimitar a relação entre a teoria de Benjamin Constant e a judicialização da política, assim como identificar algumas das principais consequências desse fenômeno para a democracia nacional; quanto à abordagem do problema, metodologia qualitativa, pois pretende analisar e interpretar a expansão funcional dos juízes e tribunais sobre controvérsias políticas e morais sem limitá-la a elementos numéricos específicos. Através principalmente de revisão bibliográfica, investigação legislativa e análise de casos, desenvolve-se pesquisa verticalizada sobre a temática proposta.Resultados: Conclui-se que a ideia de manutenção de equilíbrio político através da atuação majoritária de juízes e tribunais, novos pretensos agentes externos, neutros e reativos, viabiliza que o Poder Judiciário ultrapasse as suas amarras constitucionais e decida qualquer controvérsia política ilimitadamente, usurpando a soberania popular e fragilizando o pacto democrático estabelecido pela Constituição Federal de 1988. A solução para o desequilíbrio político não reside na autoridade de um agente político superior; mas sim na ativa atuação política popular e efetivação do sistema de freios e contrapesos.Contribuições: O artigo, através de análise histórico-política das bases teóricas do constitucionalismo nacional, elucida alguns dos mais relevantes pontos da teoria de Benjamin Constant e de como esta foi recepcionada pelo constitucionalismo nacional e ainda oferece algumas possíveis explanações sobre a judicialização da política brasileira e a sua influência sobre o delineamento jurídico-político do Brasil redemocratizado.
NEGLIGÊNCIA GRAVE: A FALTA DA EXACTA DILIGENTIA
Authors: Reis Clayton , Portela Irene
Published: November 2020

Objetivo: A proposta da presente pesquisa detém-se na análise da culpa na modalidade da negligência, por entender que se trata de conduta grave por parte das pessoas, decorrente de um proceder inadequado e desatento em face da realidade vivencial. A negligência, uma das vertentes da culpa, é indicativa da omissão, do descaso, da incúria, da desídia, da desatenção, da displicência e da falta de cuidado e cautela do agente que, no geral, causam danos que poderiam ser evitados, porque previsíveis, se não fosse o descolamento da pessoa diante do caso concreto.Metodologia: A presente investigação apoia-se no método hipotético-dedutivo, mediante a pesquisa da doutrina, da legislação e da jurisprudência, por intermédio da leitura de livros, de artigos científicos e dos diplomas legais que tratam sobre o tema.Resultados: A falta de cuidado extrapola os limites da conduta necessária do agente na ordem jurídica, que o jurista qualifica como descaso absoluto; uma verdadeira falta de amor e solidariedade da pessoa. O efeito dessa desídia produz danos de magnitude na pessoa da vítima, com a consequente responsabilização do agente que faltou com os primários deveres de vigilância e o cuidado necessário para evitar o mal não desejado. As pesquisas realizadas no Superior Tribunal de Justiça demonstram inúmeras situações em que a postura negligente do agente produziu danos expressivos, sendo uma grande parte deles de natureza irreversível. É com extremada razão que alguns jurisconsultos, dentre eles Pontes de Miranda, situam a negligência grave ao lado do dolo. A falta de cuidado do agente é tão extremada, que ele procedeu como se tivesse a intenção de produzir o dano. Essa ausência de carinho, de atenção e de cuidado qualifica a pessoa que não se encontra preparada para conviver no ambiente social. O agente converte-se em um ser humano desconectado dos fatos sociais presentes em todos os segmentos da vida comunitária; submetem a situações de riscos a integridade das pessoas e os valores da sociedade, subvertendo-os por meio do seu comportamento desprovido de razão. Portanto, a negligência, na sua modalidade magna, identifica uma culpa grave que produz danos expressivos e irreversíveis, constituindo uma das formas de culpa com efeitos nocivos mais repelidos pelo ordenamento jurídico. A sociedade contemporânea necessita de paz e confiança nos cidadãos conscientes e responsáveis, que contribuam para a construção de uma comunidade justa, ética e humana.
Institutionalizing research capacity strengthening in LMICs: A systematic review and meta-synthesis
Authors: Vicente-Crespo Marta , Agunbiade Ojo , Eyers John , Thorogood Margaret , Fonn Sharon
Published: November 2020

Background: Evidence on effective strategies to ensure sustainability of research capacity strengthening interventions in low- and middle-income country (LMIC) institutions is lacking. This systematic review identified publications describing research capacity building programs and noted their effect, their contexts, and the mechanisms, processes and social actors employed in them.

Methods: We searched online databases for the period 2011-2018. Inclusion criteria were that the publications 1) described the intervention; 2) were implemented in LMICs; 3) were based in, or relevant to, university staff or post docs; 4) aimed to improve research capacity; 5) aimed to effect change at the institutional level. Two reviewers screened titles, abstracts and full text in consecutive rounds, a third resolved disagreements. Two people extracted the data of each full text using a data extraction tool covering data relevant to our question.

Results: In total 4052 citations were identified and 19 papers were included, which referred to 14 interventions. Only three interventions mentioned using a conceptual framework to develop their approach and none described using a theory of change to assess outcomes. The most frequent inputs described were some method of formal training, promotion of a research-conducive environment and establishment of research support systems. A range of outcomes were reported, most frequently an increased number of publications and proportion of staff with PhDs. When factors of success were discussed, this was attributed to a rigorous approach to implementation, adequate funding, and local buy-in. Those who mentioned sustainability linked it to availability of funds and local buy-in. The lack of a common lexicon and a framework against which to report outcomes made comparison between initiatives difficult.

Conclusions: The reduced number of interventions that met the inclusion criteria suggests that programs should be well-described, evaluated systematically, and findings published so that the research capacity strengthening community can extract important lessons.
УПРАВЛЕНИЕ ПЕРЕВОЗКАМИ ЗАПАСНЫХ ЧАСТЕЙ ТРАНСПОРТНЫХ СРЕДСТВ
Authors: Preobrazhenskiy Yuriy Petrovich , Kostrova Vera Nikolaevna , Plotnikov Alexander Alexeevich
Published: November 2020

В статье рассматривается задача, связанная с поставками запасных частей транспортных средств. Решение ее базируется на имитационном подходе. Приведены результаты проведенного моделирования.
Concepts and Operationalisation of Reproductive Decisions
 Implementation in Austria, Germany and Switzerland

Authors: Philipov Dimiter , Bernardi Laura
Published: November 2020

Recently the difference between actual and hypothetical fertility (fertility gap) has served as an indication to enforce family policies with the purpose to increase births. This paper examines the relevance of hypothetical fertility measured with fertility ideals and intentions, to the estimation of the gap. Based on a literature review we discuss the meaning of these concepts and their operationalisation with empirical observations in three German-speaking countries (Austria, Germany, and Switzerland). Although the concept of societal ideal fertility is ambiguous it can be useful for understanding reproductive decisions when measured scrupulously. Operationalisation of short-term and long-term fertility intentions is discussed, along with their realisation. Analyses of intentions should rest on a theoretical background, such as the Miller-Pasta framework and the socio-psychological theory of planned behaviour. The latter is implemented in Austria and Germany using GGS data. The paper concludes that the fertility gap can be misleading both because the indicator of actual fertility as well as indicators of intended fertility can be imprecise. Useful policy-relevant information can be received by a specific form of the gap, when realisation of individual short-term intentions is considered.
Transition from Cohabitation to Marriage. The Role of Marital Attitudes in Seven Western and Eastern European Countries
Authors: Žilinčíková Zuzana , Hiekel Nicole
Published: November 2020

Using longitudinal panel data from the Generations and Gender Surveys on 2,847 cohabiters from seven countries, we examine the role of marital attitudes in the transition from cohabitation to marriage and compare the strength of this association between Western and Eastern Europe. We expect a positive attitude towards marriage to increase the likelihood of cohabiters marrying. We also expect the association between personal attitudes and marriage formation to be weaker among cohabiters from Eastern Europe, due to stronger normative pressure to marry in contexts where cohabitation is less prevalent.

In both Eastern and Western European countries, we find a clear positive association between favourable views on marriage among cohabiters and their entry into marriage. Contrary to our expectations, we find evidence that this association is weaker in Western Europe. We discuss this finding in light of the greater postponement of marriage among Western European cohabiters, even among those with a positive attitude towards marriage, as well as the potentially greater significance of life course events and transitions that influence their decision to marry more strongly than is the case for their Eastern European counterparts.

This study extends the literature on the relationship trajectories of cohabiters by drawing attention to the normative context that may shape cohabiters’ opportunities and constrain behavioural choice in the marriage formation process. Ultimately, it contributes to an understanding of the consequences of the societal diffusion of cohabitation in Europe.
Towards a Comprehensive Understanding of Fertility: The Model of Dyadic Pathways
Authors: Brehm Uta , Schneider Norbert F.
Published: November 2020

In this theoretical contribution, we propose a comprehensive and integrative heuristic model to explain fertility, the Model of Dyadic Pathways (MDP). We show how existing models such as the Theory of Planned Behaviour often do not withstand empirical challenges, especially not individual self-reports in qualitative studies. Furthermore, existing models vary in their premises and foci, resulting in a collection of models which do not necessarily align with or supplement one another. For these reasons, these heuristic models have been widely criticised and, in practice, pieced together according to the research question and tradition of the researcher. Against this backdrop, we establish the MDP to reconnect theory with reality and to unify a variety of approaches. The MDP is grounded on the dyad of partners as the prevalent basis of fertility. It integrates reasoned and unreasoned fertility behaviour, the impact of individual- and couple-level life course, soci(et)al conditions, and the body as an “actor”. The model explicitly accounts for the variety of different real-life pathways that lead to fertility. It thereby encourages researchers to, first, consider all potentially relevant factors and their mechanisms and, second, think of fertility and its measurement as a multilinear process. Based on the presented elements a comprehensive model of fertility must cover, we suggest ways to improve surveys accordingly. Furthermore, we elaborate on the contributions and challenges the MDP presents to future fertility research.
Gender Role Attitudes in Germany, 1982-2016: An Age-Period-Cohort (APC) Analysis
Authors: Lois Daniel
Published: November 2020

The present study investigates the change of gender role attitudes in Germany between 1982 and 2016. Nine waves of the German General Social Survey are used (N = 26,389). In contrast to previous trend studies, which largely ignore age effects, a mechanism-based age-period-cohort model (Winship/Harding 2008) is applied. It becomes clear that age, period and cohort independently have an impact on gender role ideology. Compared to earlier research, new insights concerning the shape of cohort effects come to light: Specific to traditional gender ideology in Western Germany, it is apparent that the trend towards increasingly egalitarian attitudes comes to a halt in men born around 1956 and later and in women born 1966. For Eastern Germany we observe that the cohort-specific trend towards liberalisation in younger cohorts either is diminishing or even tends to reverse. This pattern of effects mainly mirrors the phases of the feminist movement in Western Germany and the rise and decline of the German Democratic Republic, respectively.
La capilla y el retablo de la Venerable Orden Tercera del convento de Capuchinos de Sevilla
Authors: Cabezas García Álvaro , Recio Mir Álvaro
Published: November 2020

Análisis de la capilla de la Venerable Orden Tercera del convento de Capuchinos de Sevilla, construida en el siglo XVIII, y del retablo de la misma, obra de Felipe Fernández del Castillo y que se creía desaparecido.
Pinturas y esculturas como metáforas argumentales en el cine de Pedro Almodóvar
Authors: Camarero Gómez Gloria
Published: November 2020

El presente trabajo estudia la presencia de pinturas y esculturas en el cine de Pedro Almodóvar y constata como estas, muchas veces, no constituyen meros elementos de atrezo, sino que tienen un valor de significado. Son metáforas argumentales, “claves para descifrar”. Definen los espacios de representación, caracterizan el comportamiento y los sentimientos de los protagonistas, aportan las claves temáticas, ilustran la acción y referencian tiempos y lugares. Incluso, diferencian las clases sociales. Se analiza así, el sentido que alcanzan obras de Tiziano, Warhol, Tàpies, Úrculo, Barceló, Bourgeois o Navarro en la filmografía almodovariana en general y en los ejemplos concretos de La piel que habito (2011), Julieta (2016) y Dolor y gloria (2019).
Un hito en el coleccionismo institucional contemporáneo en Andalucía: la formación de la colección de arte de la Fundación Cajasol
Authors: Vélez Alvez Juan María
Published: November 2020

Los orígenes de la Colección Cajasol se remontan a la fundación en 1842 de la primera de las cajas de ahorros que conformarían la entidad. Durante su historia se crea un conjunto de obras fruto de diferentes criterios de adquisición. Se trata de un proceso singular en el coleccionismo puesto que confronta diversos puntos de vista y criterios de adquisición que tienen como resultado una misma colección. Los fondos superan las cuatro mil obras, piezas que ofrecen una visión amplia del arte andaluz principalmente, aunque con unos planteamientos geográficos que disemina las fronteras cuando aborda lo contemporáneo. La cronología marca un amplio recorrido, desde el siglo XVII, con maestros del arte Barroco, al siglo XXI, con los nuevos lenguajes plásticos
Providing a specialist nursing service to cardiac patients
Authors: Christie Susanne
Published: November 2020

Susanne Christie, Arrhythmia Nurse Specialist, NHS Tayside ( susanne.christie@nhs.scot ), runner-up in the Cardiovascular Nurse of the Year category of the BJN Awards 2020
The Anaemia Nurse Specialist Association launches new iron e-learning modules
Authors: Benton Sharon
Published: November 2020

The Anaemia Nurse Specialist Association (ANSA), one of the British Renal Society affiliate groups, provides an update on its exciting new e-learning modules
Launch of ANN UK mentorship programme
Authors: Thomas Nicola
Published: November 2020

The Association of Nephrology Nurses is lauching a pilot membership programme, aimed at registered nurses working in renal care, and particularly those of Black, Asian and minority ethnic heritage
Optimum growth conditions of Lactobacillus brevis LIPI13-2-LAB131 in β-galactosidase enzyme production
Authors: - Aafiyah Wahyu Nur Indah , ROHMATUSSOLIHAT ROHMATUSSOLIHAT , RAHAYU WINIATI PUDJI , SETYONINGRUM FITRI , PRIADI GUNAWAN , AFIANTI FIFI
Published: November 2020

Abstract. Indah AWN, Rohmatussolihat, Rahayu WP, Setyoningrum F, Priadi G, Afianti F. 2020. Optimum growth conditions of Lactobacillus brevis LIPI13-2-LAB131 in β-galactosidase enzyme production. Biodiversitas 21: 5403-5407. Deficiency of β-galactosidase enzyme causes lactose to become undigested in gastrointestinal system, therefore the system needs further addition of external β-galactosidase. The sources β-galactosidase enzyme varies from plants, animals, and microorganisms. In industrial applications, microorganisms have become a considered potential source of β-galactosidase. Lactobacillus brevis LIPI13-2-LAB131 had high β-galactosidase enzyme activity, which was 7.93 U/mL. The aim of this research was to optimize the growth condition of L. brevis LIPI13-2-LAB131 in order to produce maximum β-galactosidase enzyme activity. This research consisted of performing optimization processes using design expert 7.0 (DX7) program with response surface methodology (RSM) and partial purification of β-galactosidase enzyme. The results of this research showed that the optimum growth conditions of L. brevis LIPI13-2-LAB131 were in 1.48% lactose level, incubation temperature of 34.91 °C, incubation time of 48.48 hours, and 2.83% inoculum size with desirability value of 0.839. The result of enzyme purification showed that value of β-galactosidase enzyme activity increased up to 22.88 ± 0.29 U/mL with purification yield of 11.65%.
A vállalatméret szerepe a termelésben – A mérési módszer hatása
Authors: Szász Levente , Matyusz Zsolt , Demeter Krisztina
Published: November 2020

A szerzők cikkükben feltárják a vizsgált vállalatok mérete, termelésben alkalmazott gyakorlataik és a termelés során elért teljesítményük kapcsolatát. Részletes irodalomfeldolgozásuk eredménye arra utal, hogy a méretet, illetve annak kategorizálását a különböző kutatók következetlenül végezték, és ennek is köszönhetően vegyes eredmények születtek a méret szerepével kapcsolatban. Az ellentmondásos eredményekből kiindulva egy többoldalú, sokváltozós statisztikai módszertant alkalmaztak. Ennek eredményei azt mutatják, hogy a méretnek nincs közvetlen hatása a teljesítményre, viszont az egyes gyakorlatok használatát jelentősen befolyásolja. Nem bizonyult igaznak az a közkeletű feltevés sem, hogy a méret moderátorként befolyásolja az egyes termelési gyakorlatokkal elérhető teljesítményt.
Eladói kompetenciák mérése próbavásárlással
Authors: Durugy András , Kollár Péter , Madarász Imre
Published: November 2020

Az ügyfélszolgálat a legértékesebb személyes kapcsolati és kommunikációs eszköz. Alkalmazásában és vizsgálatában a mennyiség helyett a minőség felé tolódott el a hangsúly. A próbavásárlás mint vizsgálati eszköz felhasználható a személyes értékesítés vagy az ügyfélkiszolgálás minőségének mérésére. A dolgozat célja a kompetenciák mérése érdekében végzett próbavásárlás lehetőségeinek és módszereinek feltárása. A kutatás eredményeinek főkomponens-elemzése során viszonylag stabil faktorstruktúrát sikerült kialakítani, melynek belső konzisztenciáját az alfa mutatóval mérték a szerzők. Kutatásukból kiderült, hogy a próbavásárlás mint mérési metodika életképes és továbbfejlesztésre érdemes módszer. Az életképesség egyik feltétele a megfigyelt jelenségek finom kategorizálása és megfelelő kalibrálása, vagyis a jól alkalmazható mértékegység-standardok kialakítása.
A következő évtized marketingkommunikációja – Egy nemzetközi kutatás eredményei
Authors: Rekettye ifj. Gábor
Published: November 2020

A tanulmányban bemutatott kutatás célja annak feltárása, hogy a globális megatrendek által befolyásolt és megváltoztatott üzleti és marketingkörnyezet milyen hatással lesz a marketingkommunikáció alakulására az elkövetkező évtizedben. A kutatás nemzetközi jellege lehetőséget adott arra, hogy a szerző összehasonlítsa, hogy a fejlett, a feltörekvő és az átmeneti országokban a szakértők és véleményvezetők miképpen értékelik a globális megatrendek hatásait az adott ország üzleti környezetére, illetve mit gondolnak arról, hogy mindezek hatására hogyan fog alakulni a marketingkommunikáció.