bluuebunny/crossref_metadata_2025 huggingface dataset:
LIBERAL IDEAS AND STATE REGULATION ON THE WAY OF SOCIO-ECONOMIC DEVELOPMENT OF UKRAINE
Authors: S. M. Prylypko  , T. Kasiliunas
Published: March 2020

The main purpose of the article is to substantiate the socio-economic development of Ukraine on the basis of partnerships between market participants, where the state acts as the main regulator of socio-economic processes. The article emphasizes that the current liberal ideas prevailing in Ukraine regarding the further development of the state’s economy do not meet the existing prerequisites for the development of market relations. It is emphasized that state ideology should consolidate society around integrated ideas of development in social, economic and technological directions. The opinion is expressed that in order to modernize the Ukrainian economy, it is necessary to implement the state regulation of the economy, which should form the skills of doing business on the terms of partnership, which is realized in turn, through the remuneration of workers, and it should increase the general level of welfare of the country’s population. It is justifies that liberal ideas in the economy should be limited to the time of formation of social and cultural preconditions for the development of free trade and the capital movement. It is concluded that state regulation of the economy is the optimal way of socio-economic development of Ukraine. In the absence of a proper resource base for Ukraine’s socio-economic development, the country’s economic policy should strengthen state regulation of economic relations. The economy of the country should be aimed at raising the well-being of the population and forming a culture of doing business, rather than enriching the owners of means of production at any cost. Socialization of the economy should occur not by increasing social payments, but by raising wages through the distribution of corporate profits. Increasing opportunities for people to access social goods is the key to creating a new quality of intellectual capital in the country. In order to develop the country’s economy, it is first of all necessary to form social and cultural preconditions. Liberal ideas of free movement of capital, in particular towards the outflow from Ukraine, can only be implemented after stabilization of the country’s economy and its progressive growth. State regulation in the economy is not only the control of the movement of financial flows, but also the control of the movement of labor and the prevention and cessation of loss of intellectual potential of Ukraine. The state as an economic entity should be impersonal, and any actions of officials should be the actions of the state, not of a specific power or political force. While building the economy of a country with rigid government regulation, economic agents must acquire the skills to fulfil contractual terms, and government entities are no exception. Only after we learn how to negotiate and fulfil contractual obligations will we be able to speak about the mitigation of government intervention in the economy. State regulation of the economy in Ukraine today is the only way to stop chaotic development.
Comprehensive Assessment of the Geoecological Situation of Mining Areas (on the Example of Solikam Urban District)
Authors: Karfidova E.A. , Makeev V.M. , Sizov A.P. , Kravchenko I.M.
Published: March 2020

The methods for the complex assessment of the geoenviromental situation in a mining region based on the integration of open data from the ROSREESTR (The Federal Service For State Registration, Cadastre And Cartography), the ROSPRIRODNADZOR (Federal Service for Supervision of Natural Resources), Google Earth, scientific publications and other sources, in particular, related to the analysis of neotectonic and geodynamic problems in the region are considered. The conclusions are made as a result of the analysis of the geoenviromental situation on the example of the Solikamsk urban district and the recommendations are proposed: a land management program and the formation of geoecological data in the Unified State Register of Real Estate quarters (polluted, degraded and disturbed lands) - as an information basis for the regional model of spatial planning of mining regions.
Os benefícios da extubação paliativa na qualidade de morte
Authors: Peixoto Mariana Fernandes , Nascimento Fabio Bruno Silva , Silva Beatriz Paschoini Andrade , Silveira Daniela Santana Polati
Published: March 2020

O estudo tem como objetivo apresentar revisão acerca do processo da extubação paliativa assim como seus benefícios na qualidade de morte. Considerou-se o período de 2012 a meados de 2017 e foram utilizados documentos científicos obtidos nas plataformas de dados, SciELO, PubMed, Embase, Cochrane. A busca foi realizada utilizando os descritores Extubação, Cuidados Paliativos  e, Comunicação em inglês e português.  Para o estudo selecionou-se 19 artigos, as quais 33,33% apresentaram o cuidado paliativo associado a qualidade de morte, 38,88% apresentaram os cuidados paliativos inseridos na unidade de terapia intensiva, 27,77% realizaram a extubação paliativa para uma melhor qualidade de morte. Nos artigos selecionados observou-se a importância da equipe multidisciplinar bem preparada, assim como uma boa comunicação com a família e paciente, bem como o desfecho de uma extubação paliativa na qualidade de morte.
Capacidade para o trabalho, fatores ocupacionais e socioeconômicos de mulheres economicamente ativas
Authors: Marcacine Patricia Ribeiro , Castro Sybelle De Souza , Accioly Marilita Falangola , Castro Shamyr Sulyvan de , Pinto Juliana Martins , Walsh Isabel Aparecida Porcatti de
Published: March 2020

O objetivo deste estudo foi avaliar a capacidade para o trabalho e verificar a influência das características sociodemográficas e ocupacionais em mulheres economicamente ativas. Trata-se de um estudo transversal, com mulheres trabalhadoras na cidade de Uberaba-MG, em 2014. Na avaliação da capacidade para o trabalho utilizou-se o Índice Capacidade para o Trabalho. A idade das participantes variou de 18 a 82 (42,70±13,74) anos. Destaca-se que 21,20% das mulheres apresentaram ótima capacidade para o trabalho, 32,3% boa, 19,3% moderada e 4,10% baixa. As mulheres que se declararam chefes de família, que usavam medicamentos, as mais velhas e as que já se afastaram do trabalho apresentaram capacidade significativamente menores. Ainda, quanto maior a renda mensal individual, melhor foi esta. A avaliação e acompanhamento por meio do Índice de Capacidade pata o Trabalho pode subsidiar as ações de regulação das relações entre trabalho e saúde, e complementar os exames dos programas de saúde ocupacional.
Conhecimento e satisfação dos usuários de uma unidade básica sobre os serviços de saúde
Authors: Honda Gilda Mayumi Garcez da Silva , Lima Jéssica Carvalho , Accioly Marilita Falangola , Martins Lislei Jorge Patrizzi , Shimano Suraya Gomes Novais , Walsh Isabel Aparecida Porcatti de
Published: March 2020

Este é um estudo quantitativo, realizado em 2015, com o objetivo de verificar o conhecimento e satisfação dos usuários de uma Unidade Básica de Saúde do Município de Uberaba, MG sobre os serviços do Sistema Único de Saúde. Foi aplicado um questionário semiestruturado a usuários que aguardavam atendimento na sala de espera. Participaram 370 usuários, sendo 273 (73,8%) mulheres, com idades idade entre 18 e 99 (45,19±16,47) anos. A média de satisfação com os serviços em uma escala de 0 a 10 foi de 7,26±2,21. A investigação do conhecimento dos participantes sobre a os serviços oferecidos pela Unidade Básica de Saúde indicou que a vacinação (88,4%), acompanhamento pré-natal (81,6%), tratamento dentário (81,4%), saúde bucal (75,4%) e exame preventivo para câncer de colo de útero (74,3%) foram os mais reconhecidos. A maioria desconhece o serviço de acompanhamento para cessação tabágica (53%). Na avaliação do conhecimento dos serviços da Rede de Atenção à saúde (55,1%) e que cuidados de baixa complexidade e gravidade poderiam ser resolvidas na Unidade Básica (60,8%) responderam adequadamente. Os usuários são esclarecidos quanto: à universalidade e a gratuidade, ações de prevenção de doenças e promoção da saúde, mas demonstraram dificuldade em associar a atenção básica como assistência integral à saúde.
Atividades grupais para trabalhadores com distúrbios osteomusculares relacionados ao trabalho: relato de experiência
Authors: Sousa Alline Alves de , Toledo Thais De Souza , Salum Edneia De Oliveira , Lima Jéssica Carvalho , Marcacine Patricia Ribeiro , Soares Camila , Walsh Isabel Aparecida Porcatti de
Published: March 2020

Este é um estudo descritivo, com o objetivo de relatar as experiências de atividade grupal com trabalhadores com Lesões por Esforços Repetitivos / Distúrbio Osteomusculares Relacionados ao Trabalho, realizado no segundo semestre de 2019. Participaram seis trabalhadores, com idades variando entre 49 e 62 anos (55,16±4,45), sendo cinco (83,3%) mulheres. Entre os relatos associados ao sofrimento destaca-se as dores crônicas intensas que contribuem para o surgimento de medo, angústia, ansiedade e depressão. As intervenções indicaram que a abordagem grupal permitiu o compartilhamento dos sentimentos e fortaleceram as relações de confiança entre os trabalhadores e os profissionais, possibilitando a criação de estratégias individuais e coletivas para o enfrentamento do sofrimento.
PELATIHAN WALL SQUAT LEBIH MENINGKATKAN KEKUATAN OTOT TUNGKAI DAN KEMAMPUAN DOLPHIN KICK
Authors: Racutisyah Dana , Subagio Irmantara , Wijono Wijono
Published: March 2020

Penelitian ini bertujuan untuk mengetahui pengaruh pelatihan wall squat dan lungs terhadap kekuatan otot tungkai dan kemampuan dolphin kick saat under water pada renang  gaya bebas 50 meter. Desain penelitian pada penelitian berikut adalah ekperiment semu (quasi experiment). Rancangan penelitian ini memakai Non-Randomized Control Group Pre Test-Post Test Design. Program latihan wall squat dan lunges dilakukan selama 6 minggu dengan intensitas 40% - 60% dan meningkat sesuai program setiap 2 minggu sekali dengan jumlah set sebanyak 3 set, waktu istirahat selama 1 – 2 menit antar set. Berdasarkan uji LSD menunjukkan bahwa pelatihan wall squat lebih meningkatkan kekuatan otot tungkai dan kemampuan dolphin kick daripada pelatihan lungs dan eklompok kontrol. Pelatihan wall squat adalah pelatihan yang efektif guna meningkatkan kekuatan otot tungkai dan kemampuan dolphin kick saat under water renang 50 meter gaya bebas.Kata kunci: wall squat, lungs, kekuatan otot tungkai, dolphin kick.
PENGEMBANGAN MODEL PEMBELAJARAN PENGENALAN AIR BERBASIS PERMAINAN UNTUK SISWA KELAS IV SDN CIPINANG CIMPEDAK 05 PAGI JAKARTA TIMUR
Authors: Abdul Harry Bharetto , Wiradihardja Sudradjat , Nuraini Sri
Published: March 2020

Penelitian ini bertujuan untuk : (1) mengembangkan model pembelajaran pengenalan air berbasis permainan untuk siswa SD Kelas IV, (2) menentukan efektivitas pengembangan model pembelajaran dengan desain yang dikemukakan oleh Bord&Gall melalui empat tahap yaitu (1) tahap identifikasi dan analisis kebutuhan, (2) tahap pengembangan desain dan draf model pembelajaran pengenalan air berbasis permainan untuk siswa SD kelas IV, (3) tahap pengujian (tinjauan ujicoba dan ahli ), dan (4) implementasi model pembelajaran pengenalan air berbasis permainan untuk siswa SD kelas IV. Pengumpulan data dengan menggunakan observasi, kuesioner, dan dokumentasi. Analisis data dilakukan secara deskriptif, kualitatif, dan kuantitatif. Hasil dari penelitian ini adalah sebuah pembelajaran pengenalan air berbasis permainan untuk siswa SD kelas IV yang terdiri dari 27 permainan. Menurut para ahli permainan, renang dan ujicoba, dapat disimpulkan bahwa pengembangan model pembelajaran pengenalan air berbasis permainan untuk siswa SD kelas IV adalah efektif untuk meningkatkan tekhnik berenang siswa SD kelas IV. Kata kunci : Pengembangan Model Pembelajaran, Berbasis Permainan
PENGEMBANGAN PENDEKATAN EVALUASI THE MOST SIGNIFICANT CHANGE TECHNIQUE DALAM PEMBELAJARAN PENDIDIKAN JASMANI OLAHRAGA DAN KESEHATAN
Authors: Gustiawati Resty , Fahrudin Fahrudin , Kurniawan Febi , Indah Eka Purnama
Published: March 2020

Penelitian ini berjudul “Pengembangan Pendekatan Evaluasi The Most Significant Change Technique dalam Pembelajaran Pendidikan Jasmani Olahraga dan Kesehatan”. Penelitian ini bertujuan untuk Mengembangkan Pendekatan Evaluasi The Most Significant Change Technique (MSC) dalam Pembelajaran pendidikan jasmani olahraga dan kesehatan dalam upaya mengetahui hasil partisipatif peserta didik dalam pembelajaran pendidikan jasmani olahraga dan kesehatan (PJOK). Pendekatan Evaluasi MSC ini menggunakan teknik bercerita untuk mengumpulkan bukti/ data yang diinginkan, serta memberikan informasi perubahan positif dan negatifnya. Penelitian ini menggunakan Pendekatan kualitatif dan kuantitatif, menggunakan metode penelitian pengembangan Research & Development (R &D) dari Borg dan Gall. Teknik Pengumpulan data dimulai dari analisis kebutuhan akan pengembangan pendekatan evaluasi, pembuatan draft produk awal, validasi ahli, perbaikan produk, uji coba skala kecil, revisi, uji coba lapangan, revisi, hasil akhir. Sampel penelitian dalam survey analisis kebutuhan 10 orang guru pendidikan jasmani olahraga dan kesehatan (PJOK), hasil dari analisis kebutuhan diperoleh data bahwa guru pendidikan jasmani membutuhkan pengembangan pendekatan evaluasi untu menilai partisipasi siswa dalam pembelajaran yang bersifa kualitatif. Kemudian pengujian pendekatan evaluasi partisipasi ini dalam uji coba skala kecil sebanyak 30 siswa dan  uji lapangan utama sebanyak 60 siswa di SMPN 2 Jayakerta. Segala bentuk kendala dalam implementasi Asesmen dan masukan para praktisi telah di revisi demi kesempurnaan asesmen pendekatan evaluasi partisipatif. Dengan demikian Asesmen pendekatan evaluasi partisipatif dinyatakan layak di gunakan dalam mengevaluasi partisipasi siswa dalam proses pembelajaran pendidikan jasmani olahraga dan kesehatan di sekolah menengah pertama. Kata Kunci: Pendekatan Evaluasi, The Most Significant Change Technique, Pembelajaran, Pendidikan Jasmani Olahraga dan Kesehatan.
PENGARUH LATIHAN TABATA TERHADAP KEMAMPUAN VO2MAX ATLET SEPAKBOLA PS. TUNGKAL ULU U-21
Authors: Daya Wawan Junresti , A. Palmizal
Published: March 2020

Penelitian ini bertujuan untuk melihat pengaruh latihan tabata terhadap kemampuan Vo2max atlet sepakbola Tungkal Ulu U-21. Jenis penelitian adalah eksperimen. Metode yang digunkan dalam penelitian ini adalah dalam bentuk one group pretest-posttest design. Populasi dalam penelitian ini adalah atlet sepakbola PS. Tungkal Ulu U-21 yang berjumlah 18 orang. Teknik sampling menggunakan total sampling atau dengan kata lain sampel keseluruhan yang berjumlah 18 orang peserta. Hasil penelitian menunjukan bahwa pengaruh latihan tabata terhadap kemampuan Vo2max atlet sepakbola PS. Tungkal Ulu U-21 thitung > ttabel yaitu sebesar: th 12.889 dan tt 1.739 pada tingkat kepercayaan α 0,05 (95%). dengan kata lain terdapat pengaruh yang signifikan dari latihan tabata terhadap kemampuan Vo2max atlet sepakbola PS. Tungkal Ulu U-21. Kata Kunci: Latihan Tabata, Vo2max PENGARUH LATIHAN TABATA TERHADAP KEMAMPUAN VO2MAX ATLET SEPAKBOLA PS. TUNGKAL ULU U-21
Situation Awareness–Oriented Patient Monitoring with Visual Patient Technology: A Qualitative Review of the Primary Research
Authors: Tscholl David W. , Rössler Julian , Said Sadiq , Kaserer Alexander , Spahn Donat R. , Noethiger Christoph B.
Published: March 2020

Visual Patient technology is a situation awareness–oriented visualization technology that translates numerical and waveform patient monitoring data into a new user-centered visual language. Vital sign values are converted into colors, shapes, and rhythmic movements—a language humans can easily perceive and interpret—on a patient avatar model in real time. In this review, we summarize the current state of the research on the Visual Patient, including the technology, its history, and its scientific context. We also provide a summary of our primary research and a brief overview of research work on similar user-centered visualizations in medicine. In several computer-based studies under various experimental conditions, Visual Patient transferred more information per unit time, increased perceived diagnostic certainty, and lowered perceived workload. Eye tracking showed the technology worked because of the way it synthesizes and transforms vital sign information into new and logical forms corresponding to the real phenomena. The technology could be particularly useful for improving situation awareness in settings with high cognitive demand or when users must make quick decisions. This comprehensive review of Visual Patient research is the foundation for an evaluation of the technology in clinical applications, starting with a high-fidelity simulation study in early 2020.
Potential Inhibitors Targeting RNA-Dependent RNA Polymerase Activity (NSP12) of SARS-CoV-2
Authors: Ruan Zijing , Liu Chao , Guo Yuting , He Zhenqing , Huang Xinhe , Jia Xu , Yang Tai
Published: March 2020

A novel coronavirus (SARS-CoV-2) that is initially found to trigger human severe respiratory illness in Wuhan City of China in 2019, has killed 2,718 people in China by February 26, 2020, and which has been recognized as a public health emergency of international concern as well. And the virus has spread to more than 38 countries around the world. However, the drug has not yet been officially licensed or approved to treat SARS-Cov-2 infection. NSP12-NSP7-NSP8 complex of SARS-CoV-2, essential for viral replication and transcription, is generally regarded as a potential target to fight against the virus. According to the NSP12-NSP7-NSP8 complex (PDB ID: 6NUR) structure of SARS, two homologous models were established for virtual screening in the present study, namely NSP12-NSP7 interface model and NSP12-NSP8 interface model. Seven compounds (Saquinavir, Tipranavir, Lonafarnib, Tegobuvir, Olysio, Filibuvir, and Cepharanthine) were selected for binding free energy calculations based on virtual screening and docking scores. All seven compounds can combine well with NSP12-NSP7-NSP8 in the homologous model, providing drug candidates for the treatment and prevention of SARS-CoV-2.
What is the Effect of Using Mobile Augmented Reality in K12 Inquiry-Based Learning?
Authors: Pedaste Margus , Mitt Geidi , Jürivete Teele
Published: March 2020

A systematic review of the potential of implementing augmented reality (AR) in inquiry-based learning was conducted. We considered the purposes, potential advantages, application characteristics and the effects of using AR in inquiry-based learning. The findings reveal that AR, in the context of inquiry-based learning, is mostly implemented successfully to achieve cognitive and, less often, motivational and emotional learning goals. The AR solutions have mainly been applied in the Conceptualization and less in the Investigation phase. The affordances of AR in the Orientation, Conclusion and Discussion phase need to be applied in further studies.
The Outdoor Field Test of the 4T III-V on Si Tandem PV Module and Its Energy Yield Modeling
Authors: Araki Kenji , Tawa Hiroki , Saiki Hiromu , Ota Yasuyuki , Nishioka Kensuke , Yamaguchi Masafumi
Published: March 2020

The outdoor field test of the 4-terminal III-V on Si tandem photovoltaic module (specifically, InGaP/GaAs on Si) was investigated and performance model, considering spectrum change affected by fluctuation of atmospheric parameters, was developed and validated. The 4-terminal III-V on Si tandem photovoltaic module had about 40 % advantage in seasonal performance loss compared with standard InGaP/GaAs/InGaAs 2-terminal tandem photovoltaic module. This advantage is expanded in (subarctic zone) < (temperate zone) < (subtropical zone).
Impact of Credit Risk on Momentum & Contrarian Strategies: Evidence from South Asian Markets
Authors: Imran Hunjra Ahmed , Tayachi Tahar , Mehmood Rashid , Malik Sidra , Malik Zoya
Published: March 2020

We examine the profitability of the momentum and contrarian strategies in three South Asian markets i.e. Bangladesh, India and Pakistan. We also analyze, whether credit risk influences momentum and contrarian return for these markets from 2008 to 2014. We use Distance-to-default (DD) of Kealhofer, McQuown and Vasicek (KMV) model as a measure of credit risk. We calculate the credit risk and form the momentum and contrarian strategies of the firms on the basis of high, medium and low risk. We find that in all three markets, the momentum and contrarian returns are significant for medium and high credit risk portfolios and no momentum and contrarian returns for low credit risk portfolios.
Questões de gênero e sexualidade na escola: narrativas docentes
Authors: Morais Jacqueline de Fatima dos Santos , Baião Jonê Carla , De Freitas Claudia Jorge
Published: March 2020

Este texto discute uma experiência de formação docente, vivida como um processo de diálogo entre docentes de uma escola de ensino fundamental, cuja temática foi gênero e sexualidade. Trata-se do compartilhamento de narrativas e de reflexões produzidas no campo escolar, por professores e professoras que vivem os dilemas de enfrentar solitariamente o tema da sexualidade e do gênero em tempos de criminalização dessas discussões. Algumas das narrativas dos 30 sujeitos que participaram do debate são material privilegiado de nosso artigo. Buscamos recuperar os sentidos dos discursos produzidos na roda de conversa bem como refletir sobre as experiências. Narrar em espaços coletivos, como o espaço de uma roda de conversa, se configura como importante estratégia formadora numa perspectiva emancipadora, como a defendia Paulo Freire. As discussões sobre gênero e sexualidade na escola vêm crescendo na medida em que crescem também movimentos conservadores que buscam silenciar aqueles e aquelas que fogem à norma cis heterossexual e colocam para os espaços sociais, sua “presença incômoda”.
Patients with Combination of Cardiovascular Diseases and Type 2 Diabetes in RECVASA and REGION Registries: Multimorbidity, Outcomes and Potential Effect of Dapagliflozin in the Russian Clinical Practice
Authors: Loukianov M. M. , Kontsevaya A. V. , Myrzamatova A. O. , Khudyakov M. B. , Okshina E. Y. , Kudryashov E. V.
Published: March 2020

Aim. To evaluate the structure of multimorbidity, outcomes and the potential effect of dapagliflozin in patients with a combination of cardiovascular disease (CVD) and type 2 diabetes in Russian clinical practice.

Material and methods. The data of 10 registries with the inclusion of 22957 people, including 4370 with type 2 diabetes in 6 regions of the Russian Federation, were analyzed. Scenarios for reducing mortality from all and cardiovascular causes and hospitalizations for CVD were simulated among groups of patients with diabetes combined with myocardial infarction (MI) and diabetes combined with heart failure with reduced ejection fraction (HFrEF) based on data from the Federal Registry of diabetes, the RECVASA and REGION registries, relative risks associated with analyzed adverse events from the DECLARE study.

Results. When analyzing the data of all 22957 patients with CVD included in the registries, it was found that the proportion of patients with comorbid diabetes was on average 19.0%. Of the various diagnoses of CVD, the combination with diabetes was most often recorded in patients that had MI – 2.0%, stroke – 22.5% and heart failure – 24.0%. In the RECVASA registry (Ryazan) for 4 years of follow-up of 699 patients with a combination of CVD and diabetes mortality from all causes was 20.9%, and from cardiovascular causes – 15.6%. The simulated number of potentially prevented cardiovascular deaths with dapagliflozin taking in patients with diabetes combined with MI for 4 years in Russia will be 39124, and 37440 cardiovascular hospitalizations. The number of potentially preventable deaths from all causes among patients with diabetes combined with HFrEF will be 4543, cardiovascular deaths in 1995, and the number of prevented cardiovascular hospitalizations will be 7072.

Conclusion. According to data from the registries of CVD patients in 6 regions of the Russian Federation, it was revealed that in real clinical practice the proportion of people with comorbid diabetes averaged 19% both at the outpatient and hospital stages. These subgroups of multimorbid patients have both the highest risk of developing fatal and non-fatal cardiovascular complications, and the largest number of indications for prescribing drugs that affect the prognosis due to effects on both CVD and diabetes.
The Role of Red Yeast Rice Based Preparations for Non-Pharmacological Correction of Dyslipidemia in Patients with Low and Moderate Cardiovascular Risk (Expert Opinion)
Authors: Ezhov M. V. , Catapano A. , Escobar C. , Kukharchuk V. V. , Voevoda M. I. , Drapkina O. M. , Shalnova S. A. , Starodubova A. V. , Gurevich V. S. , Shaposhnik I. I. , Bolshakova O. O. , Oynotkinova O. S. , Alieva A. S.
Published: March 2020

The Russian Federation is among countries with high cardiovascular risk. Hypercholesterolemia is a leading risk factor for the development of atherosclerotic cardiovascular diseases. To achieve low-density lipoprotein cholesterol (LDL-C) targets, such approaches as lifestyle changes and pharmacological correction, based on the use of statins, are applied. At the same time, a significant proportion of the population has moderate hypercholesterolemia and is characterized by low or moderate cardiovascular risk. Although first-line recommendations should be followed, a healthy lifestyle alone is not enough to achieve target levels of LDL-C, which means that even people with low to moderate risk may end up with the prospect of lifelong therapy with lipid-lowering drugs. These individuals do not have an indication for lipid-lowering therapy, and they are usually recommended a change in diet and supplementation. Innovative nutritional strategies have been developed to manage dyslipidemia. They were based either on changing some “risky” food components or on encouraging the consumption of “healthy” functional foods and/or nutraceuticals. Nutraceuticals (registered as food supplements in Russia) is an innovative way to help control LDL-C at low and moderate risk individuals without lipid-lowering drugs and as nutritive support for the cholesterol-lowering diet. Red yeast rice (RYR) based preparations have been already developed and available at the moment. RYR based preparations can be considered in patients with low and moderate cardiovascular risk, who have not reached the target level of LDL-C and have no indications for statin therapy or have statin intolerance. RYR based preparations contains a statin-like substance monacolin K in a dose of 3 mg. In randomized clinical trials, it was proved that the use of high-quality RYR nutraceutical leads to a decrease in LDL-C by an average of 20% without increasing the risk of side effects like for statins. Evaluation of dietary supplements and functional foods should necessarily include not only evidence of beneficial effects with respect to effects on the lipid profile and atherosclerosis, but also proven good tolerability. The manufacturing standard for these products is also important, guaranteeing component standardization and quality. RYR analogues should guarantee the absence of mycotoxin in their composition. In Russia, programs are needed for the primary prevention of atherosclerotic cardiovascular diseases with effects on hypercholesterolemia at the population level.
Proposing a cross-cultural peer support programme to enhance Chinese direct entry students’ academic performance and learning experience
Authors: Gao Xiaowen
Published: March 2020

International students’ learning experience is essential for student satisfaction and retention which can be improved by personalised learning. Peer-to-peer cross culture PAL could be an effective way in achieving personalised learning of international students.
Extended programmes: widening participation by narrowing content
Authors: Reilly Dawn , Luo Jing , Sun Wenxian Hetty , Warren Elizabeth
Published: March 2020

While the benefits of generic foundation years such as year zero on the Extended programmes including the efficient use of resources has been fully explored, in this piece we argue that a bespoke year zero design, with a focus on a narrower range of subject-specific topics enhances the experience of the students on our Extended programmes and is worth the investment.
Editorial Team - title page
Authors: Keyms Gillian
Published: March 2020

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Situating observations as part of a teaching portfolio
Authors: Breen Paul
Published: March 2020

This opinion piece draws upon research in the field of teacher development and educational development to argue for the use of teaching portfolios as a developmental tool into which observations and observational data can be integrated. Looking at observations from developmental perspectives rather than for the purposes of appraisal allows teaching professionals and practitioners to feel more comfortable about the very idea of observations. Furthermore, the use of portfolios can serve as a means of presenting vignettes of practice that tell the story of teachers' journeys on a professional continuum that is "a process of becoming" and one that is never finished (Mann, 2005).
Detection of Renal Hypoxia Configuration in Patients with Lupus Nephritis: A Primary Study Using Blood Oxygen Level‒Dependent MR Imaging
Authors: Zheng Zhengfeng , Wang Yanyan , Yan Tiekun , Jia Junya , Li Dong , Wei Li , Shang Wenya , shi huilan
Published: March 2020

Background Renal microstructure and function are closely associated with homeostasis of oxygenation. Analyzing renal blood oxygen level‒dependent (BOLD) magnetic resonance imaging (MRI) examination results will provide information on the biological status of the kidneys. The current study was performed to explore the hypoxia mode of the entire renal parenchyma in patients with lupus nephritis (LN). Methods Twenty-three adult patients with LN and eighteen healthy volunteers were recruited. R2* values were acquired through the use of the BOLD MRI analysis technique. The narrow rectangular region of interest was used to explore the hypoxia configuration in entire depths of renal parenchyma. Acquired sequential R2* data were fitted by using four categories of mathematic functions. The tendency of R2* data in both patients with LN and healthy volunteers was also compared through the use of repeated-measures analysis of variance. Results R2* data from the superficial cortex to deep medulla displayed two patterns, called a sharp uptrend style and a flat uptrend style. After sequential R2* data were fitted individually with the use of four mathematic formulas, the multiple-compartment Gaussian function showed the highest goodness of fit. Compared with two categories of R2* value styles, the R2* tendency of entire parenchyma in patients with LN was different from that in healthy volunteers. Conclusions Deep renal medullary oxygenation was not always overtly lower than oxygenation in superficial renal cortical zone. Renal parenchyma oxygenation manifestation could be described through the use of a Gaussian function model. The deoxygenation tolerance capability was damaged in patients with LN.
Insight into Blood Pressure Targets for Universal Coverage of Hypertension Services in Iran: The 2017 ACC/AHA versus JNC 8 Hypertension Guidelines
Authors: Mahdavi Mahdi , Parsaeian Mahboubeh , Mohajer Bahram , Modirian Mitra , Ahmadi Naser , Yoosefi Moein , Mehdipour Parinaz , Djalalinia Shirin , Rezaei Nazila , Haghshenas Rosa , Pazhuheian Forough , Madadi Zahra , Sabooni Mahdi , Razi Farideh , Samiee Siamak Mirab , Farzadfar Farshad
Published: March 2020

Background: We assessed and compared the prevalence, awareness, treatment, and control of hypertension in Iran under two hypertension guidelines; the 2017 ACC/AHA with an aggressive blood pressure target 130/80 mm Hg and commonly used guideline JNC8 with 140/90 mm Hg. We shed light on the implications of 2017 ACC/AHA for population subgroups and high-risk individuals eligible for non-pharmacologic and pharmacologic therapies. Methods: Data were obtained from the Iran national STEPS 2016 study. Participants included 27 738 adults ≥25 years as a representative sample of Iranians. The logistic regression models with a survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension. Results: The prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2-30.6), which soared to 53.7% (52.9-54.4) by 2017 ACC/AHA. Awareness, treatment, and control were 59.2% (58.0-60.3), 80.2% (78.9-81.4), and 39.1% (37.4-40.7) based on JNC8, which dropped to 37.1% (36.2-38.0), 71.3% (69.9-72.7), and 19.6% (18.3-21.0) respectively by 2017 ACC/AHA. By new guideline, adults 25-34 years had the largest increase in prevalence (from 7.3% to 30.7%). They also had the lowest awareness and treatment rate but the highest control rate (36.5%) among age groups. Compared with JNC8, under 2017 ACC/AHA, 24%, 15%, 17%, and 11% more individuals with dyslipidaemia, high triglyceride, diabetes, and cardiovascular disease (CVD) events respectively fell into the hypertensive category. Yet, based on 2017 ACC/AHA, 68.2% of individuals falling into a hypertensive group were supposed to receive medications (versus 95.7% in JNC8). LDL cholesterol, physical activity, and one unit of Body Mass Index were found to change blood pressure by -3.56 (-4.38, -2.74), -2.04 (-2.58, -1.50), and 0.48 (0.42, 0.53) mm Hg respectively. Conclusions: Switching from JNC8 to 2017 ACC/AHA highlighted sharp increases in prevalence and drastic declines in awareness, treatment, and control in Iran. By the 2017 ACC/AHA, more young adults and those with chronic comorbidities fell into the hypertensive category, thus might benefit from earlier interventions such as lifestyle modifications. The low control rate among treated individuals calls for a critical review of hypertension services in Iran.
Healthcare Utilization and Out-of-Pocket Expenditures Associated with Depression in Adults: A Cross-Sectional Analysis in Nepal
Authors: Rajan Selina , Rathod Sujit D , Luitel Nagendra P , Murphy Adrianna , Roberts Tessa , Jord Mark JD
Published: March 2020

Background: Despite attempts to improve universal healthcare coverage (UHC) in low income countries like Nepal, most healthcare utilization is still financed by out-of-pocket (OOP) payments, with detrimental effects on the poorest and most in need. Evidence from high income countries shows that depression is associated with increased healthcare utilization, which may lead to increased OOP expenditures, placing greater stress on families. To inform policies for integrating mental healthcare into UHC in LMIC, we must understand healthcare utilization and OOP expenditure patterns in people with depression.Aims: We examined associations between symptoms of depression and frequency and type of healthcare utilization and OOP expenditure among adults in Chitwan District, Nepal.Methods: We analysed data from a population-based survey of 2040 adults in 2013, who completed the PHQ-9 screening tool for depression and answered questions about healthcare utilization. We examined associations between increasing PHQ-9 score and healthcare utilization frequency and OOP expenditure using negative binomial regression. We also compared utilization of specific outpatient service providers and their related costs among adults with and without probable depression, determined by a PHQ-9 score of 10 or more.Results: We classified 80 (3.6%) participants with probable depression, 70.9% of whom used some form of healthcare in the past year compared to 43.9% of people without probable depression. Mean annual OOP healthcare expenditures were $118 USD in people with probable depression, compared to $110 USD in people without. With each unit increase in PHQ-9 score, there was a 14% increase in total healthcare visits (95% CI 7%-22%, p<0.0001) and $9 USD increase in OOP expenditures (95% CI $2-$17; p<0.0001). People with depression sought most healthcare from pharmacists (30.1%) but reported the greatest expenditure on specialist doctors ($36 USD).Conclusions: In this population-based sample from Central Nepal, we identified dose-dependent increases in healthcare utilization and OOP expenditure with increasing PHQ-9 scores. Future studies should evaluate whether provision of mental health services as an integrated component of UHC can improve overall health and reduce healthcare utilisation and expenditure, thereby alleviating financial pressures on families.
Influence of femoral implant design modification on anterior knee pain and patellar crepitus in patients who underwent total knee arthroplasty without patella resurfacing
Authors: Huang Yifan , Gao Yuhang , Ding Lu , Liu Bo , Liu Jianguo , Qi Xin
Published: March 2020

Background : The incidence of patient dissatisfaction due to multiple factors, especially anterior knee pain (AKP) and patellar crepitus after total knee arthroplasty (TKA), remain a concern. Improvements in the femoral component of the traditional prosthesis could reduce the incidence of these complications in TKA performed with patellar resurfacing. This study aimed to explore whether TKA without patellar resurfacing benefits from this modification in femoral implant design with regard to AKP and patellar crepitus.
Methods : Sixty-two patients (85 knees) who underwent TKA with the modern prosthesis and 62 age- and sex-matched patients (90 knees) fitted with the traditional prosthesis were enrolled in this study. The incidence of AKP and patellar crepitus, and Knee Society Score (KSS) was recorded. Statistical analyses were performed to determine whether there were differences between the groups.
Results: The incidence of AKP was significantly lower in the study group compared with the control group at the 3-month and 1-year follow-ups (4.7% vs. 13.3% [ p =0.048] and 3.5% vs. 13.3% [ p =0.021], respectively). The incidence of patellar crepitus was significantly lower in the study group compared with the control group at the 3-month and 1-year follow-ups (15.3% vs. 34.4% [ p =0.004] and 10.6% vs. 28.9% [ p =0.002], respectively). There was no significant difference in KSS between the groups.
Conclusion : Results revealed that TKA without patellar resurfacing benefited from the femoral implant design modification with regard to AKP and patellar crepitus. These data may be meaningful to surgeons who use the modern prosthesis and omit resurfacing the patella in their patients.
Keywords : total knee arthroplasty, femoral component, prosthesis design, anterior knee pain, patellar crepitus
Measuring the effectiveness of digital nursing technologies: Development of a comprehensive digital nursing technology outcome framework based on a scoping review
Authors: Krick Tobias , Huter Kai , Seibert Kathrin , Domhoff Dominik , Wolf-Ostermann Karin
Published: March 2020

Background:Digital nursing technologies (DNT) comprise an expanding, highly diverse field of research, explored using a wide variety of methods and tools. Study results are therefore difficult to compare, which raises the question how effectiveness of DNT can be adequately measured. Methods currently used might not be sufficient for certain specific nursing contexts. A comprehensive outcome framework that shows the multitude of possible outcome areas could be useful to generate more comparable results. The aim of the present study is to develop an outcome framework for DNT and to indicate which outcome areas have been most frequently evaluated in previous studies and how this has been done.Methods:We combined an inductive and deductive approach to develop the framework. The numerical analysis is based on a scoping review focussing on the effectiveness of DNT for persons in need of care, formal or informal caregivers or care institutions. Nine databases were included in the screening: Medline, Scopus, CINAHL, Cochrane Library, ACM Digital Library, IEEE Xplore, the Collection of Computer Science Bibliographies, GeroLit and CareLit. Additional literature searches and expert interviews were included.Results:The developed framework comprises four outcome target groups and 47 outcome areas. There are considerable differences in the researched outcome areas for the individual outcome target groups. Persons in need of care were by far the most frequently surveyed, particularly with respect to their psychological health. There are much fewer studies on formal and informal caregivers, and it is particularly noticeable that the quality of life of both groups has rarely been investigated. Care process quality was most frequently researched for organisations.Conclusion:We were able to provide a comprehensive DNT outcome framework, thereby identifying the outcome tools used and the less researched outcome areas. We recommend a detailed investigation of all areas and tools in future research projects with a view to initiating a discussion on the differing importance of existing outcome areas and on a standardisation of outcome tools. We also recommend the development of outcome areas for the macro level of effectiveness assessment.
A systematic review of studies describing the influence of informal social support on psychological wellbeing in people bereaved by sudden or violent causes of death
Authors: Scott Hannah Rachel , Pitman Alexandra , Kozhuharova Petya , Lloyd-Evans Brynmor
Published: March 2020

Aims: Whilst any type of bereavement can be traumatic, bereavement through violent or sudden causes is associated with more severe negative health and wellbeing outcomes compared to other types of loss. Social support has been found to have a positive impact on wellbeing after traumatic events in general. However, this association appears to be less consistently demonstrated in studies that focus on bereavement, and the literature in this area has not yet been systematically reviewed. This study aimed to review the international literature to examine systematically whether there is an association between informal social support from family and friends after bereavement through sudden and/or violent causes and post-bereavement wellbeing.Methods: We conducted a systematic search for quantitative studies that tested for an association between social support and any outcome related to wellbeing after a sudden and/or violent loss. Included studies were assessed for quality, and findings were reported using the approach of narrative synthesis. The review was pre-registered on Prospero (registration number CRD42018093704).Results: We identified 16 papers that met inclusion criteria, 11 of which we assessed as being of good or fair quality and 5 as poor quality. 15 different wellbeing outcomes were measured across all studies. We found consistent evidence for an inverse association between social support and symptoms/presence of depression, predominantly consistent evidence for an inverse association between social support and symptoms/presence of post-traumatic stress disorder (PTSD), and conflicting evidence for an inverse association between social support and symptoms/presence of complicated grief.Conclusions: Our systematic review identified evidence to suggest that social support after sudden or violent bereavement is associated with a reduced severity of depressive and PTSD symptoms. Further longitudinal research is needed to explore potential causality in this relationship, widening the focus from common mental disorders to include other mental illnesses, wellbeing outcomes, and suicide-related outcomes after bereavement. There is also a need for consensus on the conceptualisation and measurement of social support. Our findings imply that interventions to improve access to and quality of social support may reduce the burden of mental illness after bereavement, and may therefore be worth investing in.
Physical activity types and risk of dementia in community-dwelling older people: the Three-City cohort.
Authors: Dupré Caroline , Bongue Bienvenue , Helmer Catherine , Dartigues Jean François , Hupin David , Roche Frédéric , Berr Claudine , Carriere Isabelle
Published: March 2020

Background

Physical activity may decrease the risk of dementia; however, previous cohort studies seldom investigated the different types of physical activity and household activities. Our objective was to analyze the links between two physical activity types and dementia in older people.

Methods

The study used data from the prospective observational Three-city cohort and included 1550 community-dwelling individuals aged 72 to 87 without dementia at baseline. Physical activity was assessed with the Voorrips questionnaire. Two sub-scores were calculated to assess household/transportation activities and leisure/sport activities. Restricted cubic spline and proportional hazard Cox models were used to estimate the non-linear exposure-response curve for the dementia risk and the appropriate activity level thresholds. Models were adjusted for possible confounders, including socio-demographic variables, comorbidities, depressive symptoms and APOE genotype.

Results

The median age was 80 years, and 63.6% of participants were women. After a median follow-up of 4.6 years, dementia was diagnosed in 117 participants (7.6%). An inverse J-shaped association was found between household/transportation physical activity sub-score and dementia risk, which means that the risk is lowest for the moderately high values and then re-increases slightly for the highest values. The results remained significant when this sub-score was categorized in three classes (low, moderate, and high), with hazard ratios (95% confidence interval) of 0.55 (0.35-0.87) and 0.62 (0.38-1.01) for moderate and high activity levels, respectively. No significant effect was found for leisure/sport activities.

Conclusions

The 5-year risk of dementia was significantly and negatively associated with the household/transportation activity level, but not with the leisure and sport activity sub-score. This highlights the importance of considering all physical activity types in 72 years or older people.