bluuebunny/crossref_metadata_2025 huggingface dataset:
Age at First Marriage and Fertility Decline in Dabat Health and Demographic Surveillance System Site, northwest Ethiopia: Decomposition analysis
Authors: Alazbih Nega Mihret , Kaya Assefa Hailemariam , Mengistu Mezgebu Yitayal , Gelaye Kassahun Alemu
Published: April 2020

Background: Fertility declines in Ethiopia have been documented since 1990s. Amhara National Regional State has recorded the most noticeable fertility decline. However, specific factors that explain the incipient course of fertility decline area and their relative contributions were not well investigated.Hence, the purpose of this study was to determine the factors that contributed for fertility decline, and to assess the variations in fertility that can be attributed to both changes in characteristics and reproductive behaviors of women aged 15–49 years. Methods: Cross sectional censuses were carried out in Dabat Health and Demographic Surveillance System site in 2008 and 2014. Data for 4,775 and 10,807 women with reproductive age in 2008 and 2014 were used for the analysis. Poisson regression model was employed to assess the trends of determinants of fertility, and Multivariate Decomposition technique was applied to evaluate observed changes in fertility. Results: The findings indicated that there was a reduction of an average 641 births per 1,000 women of the reproductive age during the year 2014 compared to the year 2008 in the surveillance site(P-value <0.001; 95% CI: -669.5, -582.4). This overall change in fertility during the study period was attributed to changing characteristics of women (78%)(P-value <0.001; 95%CI: -537.65, -462.32), and their reproductive behavior (22%)(P-value <0.001; 95% CI: -214.56 to -67.368). The drivers of the recent fertility decline during the study period were the shift observed in the age at first marriage, the change in the proportion of currently married women, the shift in women’s birth to later age and the change in women's education. Conclusion: This study indicated that the overall reduction in fertility was attributed to both changing characteristics of women and their reproductive behavior.The major contributors to the changes in fertility were the postponing of women’s first marriage to later age and the change in the proportion of currently married women over the study period. Encouraging women to complete at least secondary education are important to increase the age at first marriage and birth which intern accelerate the current fertility transition.
Global Scientific Output Trend for Akkermansia muciniphila Research: A Bibliometric and Scientometric Analysis
Authors: Dehghanbanadaki Hojat , Aazami Hossein , Raftar Shahrbanoo Keshavarz Azizi , Ashrafian Fatemeh , Ejtahed Hanieh-Sadat , Hashemi Ehsan , Tavassol Zahra Hoseini , Badi Sara Ahmadi , Siadat Seyed Davar
Published: April 2020

Background

Akkermansia muciniphila is an anaerobic bacterium residing in the healthy intestinal tract of host and its quantity has a negative correlation with various host diseases. This study for the first time provides a holistic bibliometric aspect of Akkermansia research in the literature and shows the hot topic terms of these articles in any period of time.

Methods

Scopus database was selected to retrieve documents relevant to Akkermansia in any language up to 2018. The bibliometric profile of Akkermansia articles including subject area, year distribution, citations, institutions, journals, authors, and countries was systematically characterized and the collaboration networks of authors and countries as well as the burst detection algorithm of the words in the titles, abstracts and keywords were visualized.

Results

There is a progressive growing trend in research on Akkermansia from 2004 to 2018 with a total of 668 articles during this period. Out of 518 original articles, there are 301 animal studies (222 studies on mice) and 150 human studies. Also, 65 various diseases were investigated in these studies. The most focused conditions are obesity (71 articles) and type2 diabetes (39 articles). The United States is the leading country on Akkermansia publications (n=184), followed by China (n=156). PLoS ONE is the most dominant journal with 34 Akkermansia publications. In addition, “cancer” is the hot topic of recent Akkermansia research.

Conclusion

Akkermansia research is of progressive interest during the last decade and the studies on this subject move towards its relationship with cancer and its promising effect on health.
A Novel Subband Fractional Delay Algorithm Based on the Filterbank of Cochlear Implant
Authors: Chen Yousheng , Chen Yan
Published: April 2020

Background: In recent years, microphone array method is gradually applied to speech enhancement of cochlear implant, and the delay parameter is the main parameter of microphone array beamforming technology. Due to the size limitation of cochlear implant, the microphone spacing is very small. In algorithm implementation, delay parameter usually corresponds to fractional sampling point. It is necessary to use fractional delay filter to realize the interpolation of integer sampling points. The traditional fractional delay method is to interpolate sampling points in the whole frequency band of speech. However, the speech frequency band itself is very wide, so the error of the present fractional delay method in cochlear is still large. Methods: We propose a fractional delay algorithm based on the filter bank of cochlear implant. The algorithm deduces and calculates the mathematical expression of the fractional delay filter of each subband, and forms a full band fractional delay filter algorithm to minimize the delay error of the whole band. Realization and results: Through the analysis of the system response curve and the calculation of the delay error, it can be seen that the system response corresponding to the fractional delay of each subband in the cochlear filter bank has only a small deviation from the ideal fractional delay filter. Therefore, the error of the fractional delay filter designed in this paper is very small, which can meet the requirements of cochlear implant using microphone array technology for the precision of delay parameters. Discussions: In this paper, the implementation algorithm of subband fractional delay filter is applied to signal acquisition of cochlear implant. Considering the space condition and delay parameters in the actual application scenario, the value of fractional delay can be any continuous real number between 0 and 3, and the error situation of the algorithm can be calculated and analyzed in this range. If the algorithm is extended to other applications, the numerical range of fractional delay can be extended. From the statistics of the average error, it can be seen that the average error of the proposed algorithm in the whole frequency band is extremely small, which can meet the needs of the accuracy of the delay parameters in the application of cochlear implant. Conclusions: The proposed fractional delay filter based on the minimum subband error of cochlear implant can not only realize the local fractional delay minimization, but also the error minimization of the whole frequency band.
Analysis of association between MALAT1 haplotype and the severity of Normal Tension Glaucoma (NTG)
Authors: Yue Jinliang , Zheng Shu-feng
Published: April 2020

Background: The haplotype in MALAT1 affects its expression and is correlated with human diseases like Normal Tension Glaucoma (NTG), although its detailed mechanism remains unclear. Methods: Quantitative real-time PCR was performed to assess the expression of MALAT1, miR-1 and IL-6 in the serum of NTG patients with different haplotypes of MALAT1, as well as in HUVEC and HTMC cells transfected with MALAT1. ELISA was used to analyze the IL-6 level in the serum of NTG patients. RNFL thickness, RA and C/D ratio were calculated for NTG patients. A luciferase assays was carried out to evaluate the inhibitory effect of miR-1 on MALAT1 and IL-6 expression. Western blot was used to analyze the IL-6 protein level in HUVEC and HTMC cells transfected with MALAT1.Results: Accordingly, GGGT haplotype was demonstrated to be associated with a decreased risk of NTG. The MALAT1 level in serum of NTG patients carrying GGGT haplotype was significantly decreased compared with NTG patients carrying other haplotypes, along with elevated miR-1 expression and diminished IL-6 expression. NTG patients carrying GGGT haplotype had thicker RNFL and RA, but a smaller C/D ratio. Sequence analysis found potential target sites of miR-1 on MALAT1 and IL-6, and luciferase assay confirmed the inhibitory effect of miR-1 on MALAT1 and IL-6 expression. Meanwhile, MALAT1 also down-regulated miR-1 expression and consequently up-regulated IL-6 expression. Conclusion: This study presented evidence for a regulatory network containing MALAT1, miR-1 and IL-6, and further demonstrated the effect of MALAT1 haplotype on the risk and severity of NTG.
A novel radio-sensitization method for lung cancer therapy: enhanced radiosensitization induced by antigens/antibodies reaction after targeting tumor hypoxia using Bifidobacterium
Authors: Yang Juan , Wu Zhouxue , Chen Yao , Hu Chuanfei , Li Dong , Liao Yin , Li Yi , Wen Qinglian , Chen Yue , Fu Shaozhi , Wu Jingbo
Published: April 2020

Background：The hypoxic microenvironment of solid tumors reduces the susceptibility of cancer cells to radiotherapy. Current treatments are focused on the development of anti-cancer agents that selectively target tumor cells with no toxicity to healthy tissue. Bacteria colonize and destroy tumors and have emerged as biological vectors that can survive in the tumor microenvironment. Methods：In this study, a Lewis lung carcinoma transplant mouse model was established and treated with a combination of bifidobacterium infantis (Bi), its specific monoclonal antibodies (Ab) and radiotherapy (RT). 18F-FDG PET/CT and 18F-FMISO PET/CT imaging were performed to monitor tumor growth and hypoxia in the tumor tissue. Phosphorylated histone (γ-H2AX), the proliferation index (Ki-67), platelet endothelial cell adhesion molecules (CD31), tumor necrosis factor-α (TNF-α), hypoxia inducible factor-1α (HIF-1α) and glucose transporter 1 (Glut-1) levels were assessed through immunohistochemistry. Results：The results showed that the combined treatment group (Ab+ Bi+ RT) displayed delayed tumor growth and prolonged the survival of mice. The combined treatment group also had lower levels of HIF-1α, Glut-1, and CD31 expression, and a lower uptake of FDG and FMISO. The tumors treated with the combination therapy also had lower levels of hypoxia, and increased γ-H2AX and TNF-α expression. Conclusion：Taken together, these data suggest that the combination of bifidobacterium infantis and its specific monoclonal antibodies can markedly improve the efﬁcacy of radiotherapy for the treatment of lung cancer.
Influence of Tumor Location on Short- and Long-Term Outcomes After Laparoscopic Surgery for Rectal Cancer: A Propensity Score Matched Cohort Study
Authors: Yang Hong , Yao Zhendan , Cui Ming , Xing Jiadi , Zhang Chenghai , Zhang Nan , Liu Maoxing , Xu Kai , Tan Fei , Su Xiangqian
Published: April 2020

Background: This study aimed to evaluate the short- and long-term outcomes after laparoscopic resection for low rectal cancer (LRC) compared with mid/high rectal cancer (M/HRC). Methods: Patients with rectal cancer undergoing laparoscopic resection with curative intent were retrospectively reviewed between 2009 and 2015. After matched 1:1 by using propensity score analysis, perioperative and oncological outcomes were compared between LRC and M/HRC groups. Multivariate analysis was performed to identify independent factors of overall survival (OS) and disease-free survival (DFS). Results: Of 373 patients who met the criteria for inclusion, 260 patients were matched for the analysis. Laparoscopic surgery for LRC required longer operative time (P＜0.001) and more blood loss volume (P＜0.001) compared with M/HRC, and the LRC group tended to have a higher incidence of postoperative complications (18.5% vs. 10.0%, P=0.051). There was no significant difference in local recurrence between the two groups (6.2% vs. 2.3%, P=0.216), whereas distant metastasis was more frequent in LRC patients compared with M/HRC (19.2% vs. 9.2%, P=0.021). The LRC group showed significantly inferior 5-year OS (78.1% vs. 88.8%, P=0.008) and DFS (76.2% vs. 89.0%, P=0.004) compared with the M/HRC group. Multivariate analysis indicated that tumor location was an independent predictor of OS (HR=2.095, 95% CI 1.142-3.843, P=0.017) and DFS (HR=2.320, 95% CI 1.251-4.303, P=0.008). Conclusion: Tumor location of the rectal cancer significantly affected the clinical and oncological outcomes after laparoscopic surgery, and it was an independent predictor of OS and DFS.
Percutaneous intramedullary screw fixation in lateral malleolar ankle fractures
Authors: Abulsoud Mohamed Ibrahim , Sebaie Adnan Al , Darwish Ahmed , Moawad Mohamed , Elzahed Ehab , El-Ghaffar Tarek M Abd , Elmarghany Mohammed , Elgeushy Ahmed
Published: April 2020

Background: To evaluate the outcome of percutaneous fixation of lateral malleolar ankle fractures by intramedullary screw.Methods: Twenty-five patients with Weber A and Weber B displaced lateral malleolus fractures were retrospectively reviewed after they had done closed reduction and percutaneous internal fixation with an intramedullary fully threaded screw with a washer. A 3.5-mm, fully threaded, self- tapping bone screw. The length of the screw varies between 90 mm and 110 mm, depending on the fracture location and pattern.Results: All fractures united within an average time to union of 5.86 ± 1.74 weeks. There were no deep wound infections or complaints of painful hardware. At the latest follow-up, functional results were excellent in 16 patients (64%) good in 8 patients (32 %), fair in one patient (4%).Conclusion Percutaneous intramedullary screw fixation is a good easy technique in the management of lateral malleolar fracture that provides good clinical and radiological results as it is rapid, minimally invasive and without prominent hardware.
‘Nitrification kinetics and microbial community dynamics of attached biofilm in wastewater treatment’
Authors: Skoyles Adam , Chaganti Subba Rao , Mundle Scott O. C. , Weisener Chris G.
Published: April 2020

A comparative bench-scale and field site analysis of BioCord was conducted to investigate seasonal microbial community dynamics and its impact on nitrogen removal in wastewater. This was assessed using metabolite (NO3−) stable isotope analysis, high-throughput sequencing of the 16S rRNA gene, and RT-qPCR of key genes in biological treatment representing nitrification, anammox, and denitrification. Bench-scale experiments showed an increase in nitrifiers with increasing ammonia loading resulting in an ammonia removal efficiency up to 98 ± 0.14%. Stable isotope analysis showed that 15ɛ and δ18ONO3 could be used in monitoring the efficiency of the enhanced biological nitrification. In the lagoon field trials, an increase in total nitrogen promoted three principle nitrifying genera (Nitrosomonas, Nitrospira, Candidatus Nitrotoga) and enhanced the expression of denitrification genes (nirK, norB, and nosZ). Further, anaerobic ammonia oxidizers were active within BioCord biofilm. Even at lower temperatures (2–6°C) the nitrifying bacteria remained active on the BioCord.
Protection against Mitochondrial Oxidative-Stress by Flesh-Extract of Edible Freshwater Snail Bellamya bengalensis Prevents Arsenic Induced DNA and Tissue Damage
Authors: Ali Sk. Sajed , Medda Nandita , Dutta Sangita M. , Patra Ritesh , Maiti Smarajit
Published: April 2020

Aims:

Arsenic has carcinogenic properties because of the formation of Reactive Oxygen Species (ROS). ROS damages different macromolecules, tissues and organs, and severely exhausts cellular antioxidants.

Background:

Cytosolic and mitochondrial contribution of ROS production by arsenic are not well reported. In regard to the issues of therapy against arsenic or any other toxicity, natural product has gained its popularity due to its less side-effects and non-invasive nature.

Objectives:

Here, as an ethnomedicine, the flesh-extract (BBE; 100mg/100g bw) of Bellamya bengalensis (an aquatic mollusk) was applied in arsenic intoxicated (0.6 ppm/100g bw/for 28 days alone or in combination with BBE) experimental rats. Our objective was to study the anti-oxidative and anti-apoptotic role of BBE in hepato-gastrointestinal tissue damage by arsenic.

Methods:

DNA fragmentation assay, catalase activity (gel-zymogram assay) suggests that BBE has a strong protective role against arsenic toxicity, which is decisively demonstrated in hepatic histoarchitecture study by HE (hematoxylin and eosin) staining and by intestinal PAS (Periodic Acid Schiff) staining.

Results:

Measurement of mitochondrial-membrane-potential by fluorescent microcopy clearly demonstrated less membrane damage and lower release of the redox-active inner-membrane product (cytochrome-C, ubiquinone, etc.) in BBE supplemented group compared to that of the only arsenic fed group. The present study clearly suggests that mitochondrial disintegrity is one of the major causes of ROS mediated tissue damage by arsenic.

Conclusions:

This study also offers an option for prevention/treatment against arsenic toxicity and its carcinogenicity by widely available low-cost, non-invasive Bellamya extract by protecting cytoskeleton, DNA and mitochondria in the cell.
Functional Foods for Management of Diarrhea and Malnutrition in Rats Emphasizing on Nucleotides Role
Authors: Al-Okbi Sahar Youssef , Mohamed Rasha Salah , Al-Siedy Enas Sabry Kotb , Mohammed Shaimaa Elsayed
Published: April 2020

Background:

Diarrhea and malnutrition are major health problems in developing countries.
Inflammation, high oxidative stress, poor nutritional status, and fatty liver were encountered
during such diseases. Patents for diarrhea and malnutrition management (WO2007/130882A2,
WO00/37106A1, WO2014/152420, and CA2987364A1) were published.

Objective:

The objective was to introduce anti-diarrhea functional foods with a preventive effect on
malnutrition.

Methods:

Two processing techniques were applied for preparing functional foods (formula 1 ingredients
were made into cookies followed by grinding; formula 2 ingredients were pre-cooked, dried,
and mixed in powder form) that were evaluated in a rat model of diarrhea with malnutrition (DM).
Formula 2 was also assessed when mixed with nucleotides. The ingredients were edible plants that
possess an anti-diarrheal effect with high protein sources (legumes and casein).

Results:

Induction of diarrhea with malnutrition, high oxidative stress, inflammation, accumulation
of liver fat, and histopathological changes were demonstrated in DM control compared to normal
control. The functional foods produced variable improvement in growth curves, food efficiency ratio,
hemoglobin, hematocrit and plasma zinc, protein, albumin, globulin, lipase activity, and MDA.
Formula 1 was superior in improving intestinal histopathology while formula 2 was more efficient
in elevating plasma iron. Formula 2 with nucleotides was the best in improving growth curves, alkaline
phosphatase, and reducing liver fat. Intestinal mucosa reduced glutathione and nitrite showed
an efficient significant reduction on treatment with formula 2 with or without nucleotides. The formulas
showed an anti-diarrheal effect by improving feces weight and moisture content.

Conclusion:

Studied functional foods showed an anti-diarrheal effect and malnutrition improvement
with different degrees.
Exploring the Effectiveness of an Integrated Physical Activity and Psychosocial Program Targeting At-Risk Adolescent Girls: Protocol for the Girls United and on the Move (GUM) Intervention Study
Authors: Caperchione Cristina M , Hargreaves Nicole , Sabiston Catherine M , Berg Stephen , Kowalski Kent C , Ferguson Leah J
Published: April 2020

Background

Adolescents are highly susceptible to negative self-perceptions, likely due to their social cues and environment. The presence of these negative self-perceptions has been shown to adversely impact levels of physical activity (PA). Although PA has the ability to foster improved self-perceptions, the rates of PA among adolescents continue to descend, with girls appearing to be most susceptible to these declines. At-risk adolescent girls, who may experience a number of negative preceding lifestyle conditions, may be exceptionally vulnerable to declines in PA. There are a high number of adolescent girls from low-income and abusive households in British Columbia, Canada, thus indicating a need for a program to relay the importance of PA and healthy lifestyle behaviors.

Objective

This paper aims to describe the protocol of the Girls United and on the Move (GUM) pragmatic intervention, an integrated PA and psychosocial program aimed at improving self-compassion, social connectedness, and overall self-perceptions among at-risk adolescent girls.

Methods

Using a quasi-experimental mixed methods approach, the GUM intervention was conducted in 5 schools in British Columbia, Canada. Adolescent girls aged 11 to 15 years who were identified as at risk were included in the study. The 9-week intervention, co-delivered by a PA/health promotion–trained researcher and a registered social worker, involved a PA component and a psychosocial component with evidence-based topics addressing the concerns of the adolescent girls. The following outcomes were evaluated: PA, self-compassion, social support, leader supportiveness, and sport enjoyment and commitment. Program acceptability and satisfaction was also examined. Outcome measures were assessed at baseline (week 1), week 6, and postintervention (week 9), and interview data concerning program acceptability and satisfaction were collected at postintervention from a subsample of participants.

Results

A total of 101 participants were invited to participate in the GUM intervention. Reporting of the results is projected for the fall of 2020.

Conclusions

It is anticipated that the GUM intervention will enhance PA while also improving self-compassion, social connectedness, and overall self-perceptions among at-risk adolescent girls. The findings of this research will contribute to the literature concerning PA and various psychosocial factors that impact the physical and mental health of at-risk adolescent girls.

Trial Registration

Clinicaltrials.gov NCT03567200; https://clinicaltrials.gov/ct2/show/NCT03567200.

International Registered Report Identifier (IRRID)

DERR1-10.2196/15302
How Geographical Isolation and Aging in Place Can Be Accommodated Through Connected Health Stakeholder Management: Qualitative Study With Focus Groups
Authors: Chen Sonia Chien-I , Liu Chenglian , Wang Zhenyuan , McAdam Rodney , Brennan Michael , Davey Shirley , Cheng Teng Yuan
Published: April 2020

Background

In remote areas, connected health (CH) is needed, but as local resources are often scarce and the purchasing power of residents is usually poor, it is a challenge to apply CH in these settings. In this study, CH is defended as a technological solution for reshaping the direction of health care to be more proactive, preventive, and precisely targeted—and thus, more effective.

Objective

The objective of this study was to explore the identity of CH stakeholders in remote areas of Taiwan and their interests and power in order to determine ideal strategies for applying CH. We aimed to explore the respective unknowns and discover insights for those facing similar issues.

Methods

Qualitative research was conducted to investigate and interpret the phenomena of the aging population in a remote setting. An exploratory approach was employed involving semistructured interviews with 22 participants from 8 remote allied case studies. The interviews explored perspectives on stakeholder arrangements, including the power and interests of stakeholders and the needs of all the parties in the ecosystem.

Results

Results were obtained from in-depth interviews and focus groups that included identifying the stakeholders of remote health and determining how they influence its practice, as well as how associated agreements bring competitive advantages. Stakeholders included people in government sectors, industrial players, academic researchers, end users, and their associates who described their perspectives on their power and interests in remote health service delivery. Specific facilitators of and barriers to effective delivery were identified. A number of themes, such as government interests and power of decision making, were corroborated across rural and remote services. These themes were broadly grouped into the disclosure of conflicts of interest, asymmetry in decision making, and data development for risk assessment.

Conclusions

This study contributes to current knowledge by exploring the features of CH in remote areas and investigating its implementation from the perspectives of stakeholder management. It offers insights into managing remote health through a CH platform, which can be used for preliminary quantitative research. Consequently, these findings could help to more effectively facilitate diverse stakeholder engagement for health information sharing and social interaction.
Building a Successful Massive Open Online Course About Multiple Sclerosis: A Process Description
Authors: Claflin Suzi B , Gates Rachael , Maher Maree , Taylor Bruce V
Published: April 2020

Background

Over the course of a year, we developed and tested a 6-week massive open online course (MOOC) on multiple sclerosis (MS) in consultation with the MS community. The course targeted the MS community and interested laypeople and was titled Understanding MS. The primary purpose of the course was to improve MS knowledge, health literacy, and resilience among participants. The final version of the MOOC made available for open enrollment was ranked first among all MOOCs released in 2019 (n>2400) based on participant reviews.

Objective

The aim of this study was to present a detailed description and assessment of the development process of the Understanding MS MOOC.

Methods

The development process included a course development focus group; the creation of more than 50 content videos and related text, quizzes, activities, and discussion prompts; the creation of original images and animations; a pilot study; and collaborations with people living with MS, MS nurses, allied health care practitioners, and neurologists and researchers from 4 universities.

Results

Overall, the process was efficient and effective. With a few small changes, we recommend this approach to those seeking to develop a similar course. This process led to the development of a highly reviewed MOOC with excellent user satisfaction.

Conclusions

We identified 5 key lessons from this process: (1) community support is essential, (2) stakeholder involvement improves content quality, (3) plan for research from the beginning, (4) coordination between the academic lead and project manager team ensures a consistent voice, and (5) a network of collaborators is a key resource.
Assessment of Patient Satisfaction With Dermatology Clinics According to Clinic Type: Mixed Methods Study
Authors: Costigan Jennifer , Feldman Sue S , Lemak Mark
Published: April 2020

Background

Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey responses are considered significant indicators of the quality of care and patient satisfaction. There is a pressing need to improve patient satisfaction rates as CAHPS survey responses are considered when determining the amount a facility will be reimbursed by the Centers of Medicare and Medicaid each year. Low overall CAHPS scores for an academic medical center’s dermatology clinics were anecdotally attributed to clinic type. However, it was unclear whether clinic type was contributing to the low scores or whether there were other factors.

Objective

This study aimed to determine where the efforts of patient satisfaction improvement should be focused for two different types of dermatology clinics (private and rapid access clinics).

Methods

This study used a concurrent mixed methods design. Secondary data derived from the University of Alabama at Birmingham Hospital’s Press Ganey website were analyzed for clinic type comparisons and unstructured data were qualitatively analyzed to further enrich the quantitative findings. The University of Alabama at Birmingham Hospital is an academic medical center. The data were analyzed to determine the contributors responsible for each clinic not meeting national benchmarks. Thereafter, a review of these contributing factors was further performed to assess the difference in CAHPS scores between the private and rapid access clinics to determine if clinic type was a contributing factor to the overall scores.

Results

The data sample included 821 responses from May 2017 to May 2018. Overall, when both private clinics and rapid access clinics were viewed collectively, majority of the patients reported stewardship of patient resources as the most poorly rated factor (367/549, 66.8%) and physician communication quality as the most positively rated factor (581/638, 91.0%). However, when private clinics and rapid access clinics were viewed individually, rapid access clinics contributed slightly to the overall lower dermatology scores at the academic medical center.

Conclusions

This study determined that different factors were responsible for lower CAHPS scores for the two different dermatology clinics. Some of the contributing factors were associated with the mission of the clinic. It was suspected that the mission had not been properly communicated to patients, leading to misaligned expectations of care at each clinic.
The Role of Virtual Reality in Improving Health Outcomes for Community-Dwelling Older Adults: Systematic Review
Authors: Dermody Gordana , Whitehead Lisa , Wilson Graham , Glass Courtney
Published: April 2020

Background

Virtual reality (VR) delivered through immersive headsets creates an opportunity to deliver interventions to improve physical, mental, and psychosocial health outcomes. VR app studies with older adults have primarily focused on rehabilitation and physical function including gait, balance, fall prevention, pain management, and cognition. Several systematic reviews have previously been conducted, but much of the extant literature is focused on rehabilitation or other institutional settings, and little is known about the effectiveness of VR apps using immersive headsets to target health outcomes among community-dwelling older adults.

Objective

The objective of this review was to evaluate the effectiveness of VR apps delivered using commercially available immersive headsets to improve physical, mental, or psychosocial health outcomes in community-dwelling older adults.

Methods

Peer-reviewed publications that included community-dwelling older adults aged ≥60 years residing in residential aged care settings and nursing homes were included. This systematic review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness evidence. The title of this review was registered with JBI, and the systematic review protocol was registered with the International Prospective Register of Systematic Reviews.

Results

In total, 7 studies that specifically included community-dwelling older adults were included in this review. VR apps using a head-mounted display led to improvements in a number of health outcomes, including pain management, posture, cognitive functioning specifically related to Alzheimer disease, and a decreased risk of falls. A total of 6 studies reported a statistically significant difference post VR intervention, and 1 study reported an improvement in cognitive function to reduce navigational errors. Only one study reported on the usability and acceptability of the interventions delivered through VR. While one study used a distraction mechanism for pain management, none of the studies used gaming technology to promote enjoyment.

Conclusions

Interventions to improve health outcomes through VR have demonstrated potential; however, the ability to synthesize findings by primary outcome for the older adult population is not possible. A number of factors, especially related to frailty, usability, and acceptability, also need to be explored before more substantial recommendations on the effectiveness of VR interventions for older adults can be made.

Trial Registration

PROSPERO CRD42019143504; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=143504
Leadership Perspectives on Implementing Health Information Exchange: Qualitative Study in a Tertiary Veterans Affairs Medical Center (Preprint)
Authors: Dixon Brian E , Luckhurst Cherie , Haggstrom David A
Published: April 2020

BACKGROUND

The US Department of Veterans Affairs (VA) seeks to achieve interoperability with other organizations, including non-VA community and regional health information exchanges (HIEs).

OBJECTIVE

This study aims to understand the perspectives of leaders involved in implementing information exchange between VA and non-VA providers via a community HIE.

METHODS

We interviewed operational, clinical, and information technology leaders at one VA facility and its community HIE partner. Respondents discussed their experiences with VA-HIE, including barriers and facilitators to implementation, and the associated impact on health care providers. Transcribed interviews were coded and analyzed using immersion-crystallization methods.

RESULTS

VA and community HIE leaders found training to be a key factor when implementing VA-HIE and worked cooperatively to provide several styles and locations of training. During recruitment, a high-touch approach was successfully used to enroll patients and overcome their resistance to opting in. Discussion with leaders revealed the high levels of complexity navigated by VA providers and staff to send and retrieve information. Part of the complexity stemmed from the interconnected web of information systems and human teams necessary to implement VA-HIE information sharing. These interrelationships must be effectively managed to guide organizational decision making.

CONCLUSIONS

Organizational leaders perceived information sharing to be of essential value in delivering high-quality, coordinated health care. The VA continues to increase access to outside care through the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act. Along with this increase in non-VA medical care, there is a need for greater information sharing between VA and non-VA health care organizations. Insights by leaders into barriers and facilitators to VA-HIE can be applied by other national and regional networks that seek to achieve interoperability across health care delivery systems.
Application of the 2017 KDIGO Guideline for the Evaluation and Care of Living Kidney Donors to Clinical Practice
Authors: Garg Amit X. , Levey Andrew S. , Kasiske Bertram L. , Cheung Michael , Lentine Krista L. ,   on behalf of the KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors Work Group and Evidence Review Team
Published: April 2020

The Kidney Disease: Improving Global Outcomes (KDIGO) 2017 “Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors” was developed to assist medical professionals who evaluate living kidney donor candidates and provide care before, during, and after donation. This guideline Work Group concluded that a comprehensive approach to donor candidate risk assessment should replace eligibility decisions on the basis of assessments of single risk factors in isolation. To address all issues important to living donors in a pragmatic and comprehensive guideline, many of the guideline recommendations were on the basis of expert consensus opinion even when no direct evidence was available. To advance available evidence, original data analyses were also undertaken to produce a “proof-of-concept” risk projection model for kidney failure. This was done to illustrate how the community can advance a new quantitative framework of risk that considers each candidate’s profile of demographic and health characteristics. A public review by stakeholders and subject matter experts as well as industry and professional organizations informed the final formulation of the guideline. This review highlights the guideline framework, key concepts, and recommendations, and uses five patient scenarios and 12 guideline statements to illustrate how the guideline can be applied to support living donor evaluation and care in clinical practice.
Natural Resources Law in Australia: Principles and Practices
Authors: Kelly Danial
Published: April 2020

What is the jurisprudential approach taken to Natural Resources Law in Australia? The ultimate source of law in Australia is Commonwealth of Australia Constitution Act however the Constitution does not specifically include an environment or natural resources power and the Commonwealth government can only make laws under the heads of power provided by the Constitution. This paper considers how natural resources law has developed as environmental protection law, especially the Environment Protection and Biodiversity Conservation Act. Also discussed is the approach taken by the Northern Territory of Australia in relation to natural resources law. The discussion unearths the developing jurisprudence in Australian natural resources law that seems to increasingly favour environmental protection over human development.
Appeal Against Acquittal By The Prosecutor: Critical Comments on The Indonesian Constitutional Court Decision
Authors: Pangaribuan Aristo
Published: April 2020

In 2013, the Indonesian Constitutional Court ended the debate concerning the constitutional validity of the right to appeal against acquittal by the prosecutor. Such a question has a long history not only in the Indonesian judicial system. In their decision, the court concluded that the government should have the power to appeal against acquittal to the Supreme Court because of its supervisory function over the lower courts. However, the decision was not unanimous, and there was one dissenting opinion from justice Harjono, who is in favor of protecting the rights of the acquitted defendant. This article is trying to examine the decision and underlined the issue of two competing values, namely ﬁnality, and accuracy that was debated in the decision, even though the court did not explicitly mention it. In the end, this article ﬁnds that the court gives more importance to the accuracy of the conviction and less to their ﬁnality.
CEO facial masculinity and firm financial outcomes
Authors: Mills Jackson , Hogan Karen M.
Published: April 2020

In this paper, we explore relationships between CEO facial width, a proxy for testosterone levels during adolescence, and financial management decisions. Using methodology from prior research, we collect a sample of 968 S&P 500 CEO profiles and analyze them to determine the facial width-to-height ratio (fWHR). We expect that greater CEO facial width will be associated with riskier, more aggressive financial policies. We find that higher CEO facial width-to-height ratio (fWHR) is associated with more aggressive financial management decisions. Specifically, we find a positive relationship between CEO fWHR and firm leverage and a negative relationship between CEO fWHR and firm cash holdings. These relationships are also observed among subsamples where CEOs are likely to wield substantial influence over financial management policies, such as long-tenured CEOs. We do not find evidence that CEO selection process explains the observed relationship between fWHR and financial policies. Thus, it appears that the relationships documented between CEO fWHR and firm financial policies are likely consistent with managerial preference and that high testosterone levels may induce CEOs to pursue aggressive financial policies. We show that high-fWHR CEOs tend to own a smaller fraction of their firms. This suggests an increased priority for more masculine CEOs on pursuing their own best interests (diversification in their personal portfolios) ahead of signaling alignment with shareholders, while the reverse is true for CEOs with lower fWHRs. The results are robust to the inclusion of industry and year fixed effects and firm-year controls. This paper adds to the literature that shows individual differences in CEOs, in this case, CEO masculinity, can predict differences in the financial managerial characteristics of firms and financial policies.
The Role of Intrapreneurship on the Growth of Iron and Steel Manufacturing Companies in Bulawayo, Zimbabwe
Authors: Madzikova Alex , Nani Gwendoline Vusumuzi
Published: April 2020

This study sought to find out the role of intrapreneurship on the growth of iron and steel manufacturing companies in Bulawayo, Zimbabwe. A post-positivist paradigm, a mixed method approach and a cross sectional design were adopted for the investigation. Three hundred and fifteen (315) middle management and supervisory staff drawn from twenty-two (22) iron and steel manufacturing companies in Bulawayo participated. Multiple stratified random sampling and heterogeneous purposive sampling were used to choose two hundred (200) respondents for the quantitative study and eight participants for the qualitative study respectively. Questionnaires and in-depth interviews were the data collecting instruments for quantitative and qualitative data respectively. Quantitative data was analysed using descriptive and inferential statistics and qualitative data was thematically analysed. Findings revealed that innovativeness, proactiveness, and risk taking were the key dimensions of intrapreneurship. Both quantitative and qualitative analyses showed the prominent measures of company growth in the iron and steel manufacturing companies as financial, employee numbers, productivity, and product range. Statistically intrapreneurship was found to be correlated to the growth of the iron and steel manufacturing companies. The study drew the following conclusions. Firstly, intrapreneurship is not a preferred strategy for driving growth in the iron and steel manufacturing companies in Bulawayo. Secondly, financial and product range were identified as the key measures of company growth. Thirdly, company support for intrapreneurship and individual’s intrapreneurial disposition were statistically linked to company growth. The study recommended that companies should motivate and support employees’ innovativeness, proactiveness, and risk taking through ideas, actions and work. Measurement of company growth should be expanded to include qualitative measures.
How much is a public park worth? An ex ante methodology for impact and cost-benefit analysis on the example of Millenáris Széllkapu in Budapest
Authors: Iváncsics Vera , Szendrei Zsolt , Obertik József , Balás Gábor
Published: April 2020

Establishing a public park raises a number of methodological issues. The model worked out by HÉTFA Research Institute is suitable for cost-benefit analysis and ex ante viability test of a public park integrated into urban landscape. The paper presents the model by the example of a planned public park at one of the busiest centers of Budapest, the junction of Margit Boulevard and Millennium Park. Such a comprehensive economic evaluation for public parks has not been made in Hungary. First the mechanism of effects was set up, and by using the hedonic price method the project’s costs and benefits were presented with national and international statistical indicators and benchmarks. The investment, that has been started in 2016 with in the initial planning and demolition pays for itself by 2019. The results are tested with sensitivity analysis, which has inter alia shown that if we count by the general approach of the project management - costs are expected to increase by 10% and benefits are to reduce by 10% - investment returns for the city and their inhabitants for 2030. Furthermore, without the effect of property appreciation - the investment turns positive by 2061 thanks only to indirect social, economic, environmental benefits. According to our analysis, the park's development, which relaxes a built-in highly populated urban fabric, has become an economically profitable investment as a result of significant beneficial external effects.
Intuitive spatial interaction in landscape design
Authors: Jakaitis Jonas , Zukas Jonas
Published: April 2020

Research in landscape architecture (LA) is an important area to improve natural, anthropogenic, social and economic sustainability. The focus point of the article is territory of historical greenery (THG) of LA, which originates as a result of interaction between material environment design and society. The study of THG problems today is based on the innate human right to live in a harmonious space of both aesthetic material and natural environment. Environmental quality criteria are important to understand the nature and human interaction embodied in LA as an expression of applied art. Therefore, urban spaces formed by the anthropogenic objects of LA, require studies of the systemic relationship between the material and natural environment and its function as a whole. Based on heuristic, qualitative and quantitative research methods and literature review of case studies, the article discusses the problems of interaction between contemporary society, historic legacy and natural processes. In this article, authors explore the natural human abilities to perceive and interact with the environment on the intuitive level. Universal design aims provide a value basis for social, cultural and functional interaction harmonization of the environment on the intuitive level. More universal and intuitive approach reveals the potential to enhance spatial interaction with the THG and to improve quality of its future management and development scenarios.
THE KNOWLEDGE OF EARLY CHILDHOOD EDUCATION TEACHERS ABOUT NATURAL DISASTER MANAGEMENT
Authors: Solfiah Yeni , Risma Devi , - Hukmi , Kurnia Rita
Published: April 2020

Disaster management
Pembelajaran Audio Visual Dalam Mengembangkan Bahasa Anak Dalam Membaca Al-Qur’an Di Tk Rahmat Damai Aceh
Authors: Fatmawati Fatmawati
Published: April 2020

The researcher aims to see the language development of children through visual audio with group B children with a sample taken 37 children consisting of one class B1 totaling 19 people who made 10 children as the control class and 18 more as the experimental class. Population and Research SamplesPopulation is all data that researchers pay attention to in a scope, and a predetermined time. In this study the subject is determined as a source of data relevant to the problem under study to study and draw conclusions. The sample is the population or subject chosen and determined as a source of data or sources of information from the study. Sampling is done by purposive sampling technique which means it is a technique of determining the sample with certain considerations. Based on the results of research students in classes B1 and B2 show that 3 students get high test results, then 22 students get test results with enough categories, and 12 students get the test results in the low category, in knowing and how in the paragraph. A student is called complete learning if he / she scores at least 75 of the ideal grade. In a class students are called complete learning if the class there are at least 85% of students who complete. Keywords : Audio visual, develops children's language