bluuebunny/crossref_metadata_2025 huggingface dataset:
Associação entre eliptocitose e esferocitose hereditária em um idoso
Authors: Birchal Bruno Moura e Oliveira , Coelho Junior Luilson Geraldo , Piau Carlos Eduardo Lins Franca , Dadalti Guilherme Miyakawa , Soares Joaquim Domingos
Published: August 2019

A anemia é muito prevalente em idosos; todavia, a eliptocitose hereditária, uma anemia hereditária caracterizada pela presença de eritrócitos em forma elíptica no sangue periférico; raramente causa anemia sintomática em pacientes idosos. A eliptocitose esferocítica é uma anemia hereditária com caráter autossômico dominante. A associação entre essas duas eritroenzimopatias hereditárias é rara e seu curso varia com alterações da forma eritrocitária, observando-se a presença simultânea de eliptocitose e esferocitose no sangue periférico. A hemólise pode variar de média a moderada intensidade. Relatamos o caso de uma paciente adulta idosa com eliptocitose esferocítica revelada após 26 anos, sendo realizada a esplenectomia para resolução do quadro de hemólise.
O Governo do Filósofo
Authors: Menezes Luiz Maurício Bentim da Rocha
Published: August 2019

According to Glaucon’s conception of justice, the government is constituted by a contract which determines the legal and the just. From its constitution the ruler may control the subjects’ justice without being subject to the contract himself. To reinforce Thrasymachus’ speech Glaucon will offer Socrates a challenge where the latter has to prove that justice is superior to injustice. Thus, it is Socrates’ task to show this under any counterfactual circumstance, always bringing benefit to the one who acts justly. The difficulty in responding to the challenge proposed by Glaucon is shown by the case in the Republic where the fulfillment of justice seems not to bring benefits, but penalty to the agent. This is precisely the case of the Philosopher Ruler and his coercion (ananke) to rule. For that one must understand the reason why the philosopher is coerced to rule, not as a matter of choice, but something whose denial is made impossible due to justice. Socrates’ solution to the challenge of justice starts from the definitions of political justice, where each citizen is compelled to do his own duty, and psychic justice, defined as a harmony between the parts of the soul. Our argument shows that the justice within the philosopher’s soul itself is justified by the necessity of fulfilling the justice in Kallipolis, as well as allowing good government.
Construção de um Tesauro Brasileiro de Turismo
Authors: Rejowski Mirian , Barbanti Cristina Hilsdorf
Published: August 2019

Este artigo trata da construção do Tesauro Brasileiro de Turismo a partir de um estudo explicativo, com base na análise documental das teses de doutorado sobre turismo produzidas de 1975 a 2015, na bibliografia especializada publicada no país até 2016 e na visão de especialistas coletada em 2017. O Tesauro Brasileiro de Turismo tem sua estrutura composta por 17 categorias, cujos termos específicos estabelecem entre si relações conceituais no campo do turismo. O tesauro foi implantado em plataforma online mediante o software TemaTres. Adotou-se a noção de turismo como um campo científico sob uma abordagem multirreferencial, sem limitações de fronteiras disciplinares, e considerando também a prática turística. O processo de estruturação dos termos do tesauro revelou a amplitude e a complexidade desse campo em suas variadas interfaces disciplinares e sua potencialidade enquanto instrumento de apoio às pesquisas em turismo.
Estudo sobre a Adoção de Práticas de Contabilidade Gerencial em Empresas Hoteleiras de Florianópolis, SC, Brasil
Authors: Lunkes Rogério João , Costa Carla Helen , Bortoluzzi Daiane Antonini , Rosa Fabricia Silva da
Published: August 2019

O objetivo deste estudo é analisar a adoção de práticas de contabilidade gerencial em empresas hoteleiras. Para atingir esse objetivo, um questionário foi aplicado a 15 hotéis da grande Florianópolis, SC, Brasil, filiados à Associação Brasileira da Indústria de Hotéis (ABIH), no período de abril de 2014 a maio de 2016. Com essa limitação, os resultados servem para o escopo específico e mostram que a contabilidade gerencial é adotada em grande parte das empresas hoteleiras pesquisadas. Dos resultados, pode-se destacar o uso dos métodos de custeio por absorção e de custeio padrão, a utilização do orçamento para planejamento anual e controle de custos, medidas de rentabilidade e análise de rentabilidade do produto e de clientes, e análise dos pontos fortes e fracos e da posição dos concorrentes. Isso mostra que geralmente os hotéis adotam práticas tradicionais, de primeiro e segundo estágio. Entre as possíveis mudanças apontadas pelos gestores hoteleiros para os próximos três anos está a utilização de medidas não financeiras relacionadas à inovação e à gestão baseada em atividades.
Turismo Otaku
Authors: Brazo Dionísio De Almeida , Fonseca Filho Ari Da Silva
Published: August 2019

A proposta do presente artigo foi demonstrar os resultados dos estudos acerca da tipologia Turismo Otaku, sendo esta compreendida como segmentação do turismo cultural. Os objetivos específicos foram: levantar as produções bibliográficas acerca do Turismo Otaku e mundialização; investigar as motivações destes turistas no que tange seus comportamentos, interesses e consumo; por fim, analisar essa tipologia do turismo, destacando seu potencial e principais destinos visitados. A pesquisa foi de cunho exploratório, pautada em pesquisa bibliográfica com autores que abordam o Turismo, tais como Molina (2003), Rodrigues (2001), Urry (2007); o turismo cultural foi embasado especialmente em Pereiro Pérez (2009); a Cultura Pop Japonesa em Sato (2007), Nagado (2007), Oka (2005); o processo de Territorialização, Desterritorialização e Reterritorialização (TDR) em Ortiz (2000/2006) e Turismo Otaku em Simon (2015) e Fernandes (2013). Realizamos também uma pesquisa virtual, por meio de questionário, com perguntas abertas e fechadas, para traçar o perfil, interesses e motivações do público em questão. Contudo, destacamos a dificuldade que é aproximar o turismo das pesquisas sobre a cultura pop japonesa, visto as restritas produções bibliográficas acerca do tema.
O Valor Atribuído à Culinária Tradicional
Authors: Beleze Ronaldo Luiz , Bahls Álvaro Augusto Dealcides Silveira Moutinho , Krause Rodolfo Wendhausen
Published: August 2019

Sob o Patrimônio Cultural Imaterial Culinário (PCIC) dos destinos turísticos, encontramse inseridos os princípios do Slow Food, na medida em que valorizam os “saberes e fazeres” de uma comunidade acerca de suas produções alimentares, conservando e promovendo identidades culturais e o meio ambiente. O objetivo deste trabalho é apresentar o valor que os visitantes do Parque Nacional dos Lençóis Maranhenses atribuem à culinária típica e seus possíveis desdobramentos. Com uma metodologia descritiva e quantitativa, um instrumento de pesquisa foi aplicado em janeiro e julho de 2015, resultando em 360 questionários válidos. A análise dos dados (através de estatística descritiva, regressão logística e Anova Unidirecional) revelou alto valor atribuído à culinária para a maioria do universo relacionado (cerca de 70%). Esse grupo de visitantes está disposto a gastar mais e se deslocar por mais tempo do que os demais. Todos os grupos estão dispostos a se deslocar por mais tempo para desfrutar de passeios com o foco na culinária típica do que com outros atrativos. Porém, a satisfação com a culinária não acompanha o valor atribuído ao PCIC. A culinária ofertada não figura entre as principais preferências dos visitantes (estas são as iguarias dos povoados). Conclui-se que a gestão e promoção de produtos turísticos culinários típicos, com enfoque no movimento Slow Food, é viável como o principal fator agregador de qualidade para o referido destino, visando estender a estadia de seus visitantes, promover e conservar o PCIC dos povoados, que estão pressionados a se adaptarem à concorrência dos restaurantes locais.
Influência de Fatores Contingenciais na Adoção de Artefatos de Custos Tradicionais e Modernos na Rede Hoteleira do Paraná
Authors: Santos Cleston Alexandre dos , Zonatto Vinícius Costa da Silva
Published: August 2019

A literatura sugere que os fatores contingenciais ambiente, tecnologia, estratégia, estrutura e porte organizacional, seja com maior ou menor intensidade, influenciam os atributos do sistema de contabilidade gerencial (SCG), mais especificamente na adoção de artefatos do sistema de custeio. No entanto, há poucas evidências entre tais relacionamentos especificamente no setor hoteleiro. Este artigo objetiva evidenciar a influência desses fatores na adoção de artefatos tradicionais e modernos de custos na rede hoteleira do estado do Paraná. Trata-se de um estudo descritivo, com procedimentos de interrogação, elaborado mediante a aplicação de pesquisa de campo realizada entre novembro e dezembro de 2015 com 40 hotéis. A análise dos dados utilizou estatística descritiva e correlação canônica. Os achados indicam que a maioria dos hotéis pesquisados adotam de forma plena os artefatos tradicionais de custos. Quanto aos modernos, boa parte dos investigados não tem planos para sua adoção, o que reforça a predominância de artefatos tradicionais nas organizações. Mesmo em hotéis de grande porte, em que se espera que os SCG apresentem estruturas mais sofisticadas, artefatos tradicionais como instrumento de suporte à tomada de decisão ainda têm sido utilizados. Conclui-se que os fatores contingenciais estrutura e estratégia influenciam mais na adoção de artefatos modernos de custos do que de tradicionais na rede hoteleira do estado do Paraná.
Tourism, an Underestimated Driving Force for the Creative Economy
Authors: Richards Greg
Published: August 2019

This study examines the relationship between tourism and the creative economy. An increasing number of countries, regions and cities are developing policies to link tourism and creativity to economic growth and support cultural and creative activities. As a result, different models of “creative tourism” have emerged. Case studies of creative tourism development are described from different parts of the world, and their effects are examined. Particular attention is paid to the role of knowledge, which the Organisation for Economic Cooperation and Development (OECD) sees as central to the development of creative tourism. Because tourism can be a tool for the circulation of knowledge and creation of links between creative individuals, it can arguably support the development of the creative economy.
Prostate cancer profiles and associated factors in Criciúma – Santa Catarina, Brazil
Authors: Koseki Ives Alexandre Yutani , Benedet Matheus Rosso , Sá Guilherme De , Conti Rafael De , Bernardi Roberto Meister , Silva André Rodrigues Da , Ronchi Daniel Izé , Madeira Kristian
Published: August 2019

Background: Prostate cancer is the second most incident of the male population in Brazil. The aim of this study is to analyze the frequency of risk factors associated to the evolution of the prostate cancer and the impact of conducting examinations in the age range (55-69 years old), in assisting health professionals to manage and prevent the disease. Methods: A case-control study was performed on patients from 2011 to 2016 in Criciúma – SC, Brazil. The sample was divided into two groups, one with biopsy for prostate adenocarcinoma (case; n = 124) and the other with a negative biopsy (control; n = 251). The following variables were compared between the two groups: age, family history of prostate cancer, prostate specific antigen, and altered digital rectal examination. Results: In the case group, ranging between 55-69 years old, there was a significant higher of altered digital rectal examination (p < 0.001, odds ratio 15.5 and positive predictive value 91.3%), prostate-specific antigen ≥ 4 ng/mL (p < 0.001, odds ratio 7.02 and positive predictive value 56.2%) and when both exams were altered (p < 0.001, odds ratio was 19.63 and the positive predictive value was 90.5%). Conclusion: This findings show that, mainly between 55-69 years old, there is a significant correlation between positive biopsy, altered digital rectal examination, and PSA ≥ 4 ng/mL.
Determinantes sociais da saúde e prevenção secundária do câncer do colo do útero no Estado do Amazonas, Brasil
Authors: Viana Juliana Nascimento , Moysés Rosana Pimentel Correia , Espir Thais Tibery , Sousa Gabriela Amaral De , Barcellos José Fernando Marques , Alves Maria da Graça Pereira
Published: August 2019

Modelo do estudo: este foi um estudo ecológico transversal e descritivo. Objetivo do estudo: conhecer os determinantes sociais de saúde associados com a prevenção secundária do câncer do colo do útero no período de 2010 a 2014. Metodologia: a unidade amostral foi os 62 municípios do estado do Amazonas. Os dados secundários utilizados foram do Sistema de Informação do Câncer do Colo do Útero (SISCOLO), do Sistema de Informação da Atenção Básica (SIAB), do Instituto Brasileiro de Geografia e Estatística (IBGE) e do Atlas de Desenvolvimento Humano do Brasil. Resultados: baixa cobertura do exame Preventivo do câncer do colo do útero para mulheres de 25 a 64 anos, sendo a faixa etária com menor adesão ao rastreio, a de 60 a 64 anos. A média de analfabetismo feminino na idade de 25 anos ou mais, no Estado, foi de 25,01%, e este indicador apresentou correlação com a baixa cobertura do exame Preventivo para o câncer do colo do útero em todos os anos. A pouca cobertura da Estratégia Saúde da Família também se associou a baixa adesão ao rastreio. Além disso, a Proporção de Municípios com Amostras Insatisfatórias dos exames citopatológicos apresentou-se acima da meta preconizada pelo Ministério da Saúde. Conclusão: estratégias de promoção da saúde voltadas a adesão ao rastreio devem considerar o nível de escolaridade das mulheres e o fortalecimento da Atenção Primária à Saúde pautada no rastreio não oportunístico; estas devem ser uma das prioridades das políticas públicas nos municípios do Estado.
Consumo de macro e micronutrientes de idosos com diabetes mellitus tipo 2 atendidos no núcleo de apoio ao idoso
Authors: Burgos Maria Goretti Pessoa de Araújo , Santos Eryka Maria Dos , Morais Andréia Albuquerque Cunha Lopes , Santos Priscilla Alves , Melo Nathalia Caroline de Oliveira , Costa Marcele Batista Madeiro
Published: August 2019

Objetivo: Avaliar o consumo de macro e micronutrientes em idosos diabéticos atendidos no Núcleo de Atenção ao Idoso da Universidade Federal de Pernambuco (NAI/UFPE). Métodos: Estudo transversal com idosos saudáveis (n=66) e com diabetes (n=55) do NAI/UFPE. Obteve-se dados de prontuários e/ou questionários de frequência alimentar. Análise dietética realizada através do DietWin Professional 2008 e para estatística utilizou-se teste t-Student, admitindo-se nível de significância para p<0,05.  Resultados: Os resultados mostraram a prevalência do sexo feminino em ambos os grupos (73,8% no grupo saudável e 86,6% no grupo de idosos com diabetes), sendo idosos saudáveis com média de idade de 72,5 ± 6,2 anos, e grupo com diabetes com média de idade de 61,8 ± 5,0 anos (p<0,05). O excesso de peso prevaleceu no grupo com diabetes (67%) quando comparado ao grupo saudável (49,2%; p<0,027). A ingestão calórica dos pacientes com diabetes foi maior (1257,94 kcal) em relação aos indivíduos saudáveis (970,81 kcal; p=0,01). O mesmo ocorreu para consumo de sódio (1810,12 mg x 592,92 mg), cálcio (721,44 mg x 286,23 mg), zinco (8,73 mg x 6,26 mg), magnésio (266,22 mg x 128,60 mg), vitamina A (442,35 µg x 131,83 µg) e E (4,59 mg x 1,45 mg) (p<0,01 para todas as variáveis). Por outro lado, observou-se consumo inferior de potássio (1580,83 mg x 2349,23 mg; p<0,01) e proteína (9% x 17%; p<0,01). Conclusão: Foi identificado um padrão alimentar hipercalórico nos idosos com diabetes, acompanhado de excesso de sódio, cálcio, magnésio e zinco, com reduzido consumo proteico e de potássio.
Estado nutricional e qualidade de vida de pacientes em hemodiálise
Authors: Bernardo Mayara Ferreira , Santos Eryka Maria Dos , Cavalcanti Mikaella Carla de França , Lima Denise Sandrelly Cavalcanti De
Published: August 2019

Introdução: Na Doença Renal Crônica Avançada, o paciente necessita de uma terapia renal substitutiva, dentre elas, a hemodiálise (HD). Apesar dos benefícios da HD, este procedimento afeta o estado nutricional e a qualidade de vida (QV) do doente.

Objetivo: Correlacionar o estado nutricional ao nível de QV de pacientes em HD.

Metodologia: Estudo transversal, com pacientes em HD há pelo menos 3 meses. O estado nutricional foi avaliado pelo índice de massa corporal (IMC), circunferência do braço (CB), circunferência muscular do braço (CMB), prega cutânea tricipital (PCT), albumina (Alb) e creatinina (Cr) séricas e a QV pelo Medical Outcomes Study-36 – Item Short Form Health Survey (SF-36). As pontuações geradas pelo SF-36 foram correlacionadas com os indicadores do estado nutricional através do Coeficiente de Correlação de Pearson e/ou Spearman´s.

Resultados e Discussão: Participaram do estudo 37 pacientes, com idade média de 50,6 ± 13,0 anos, sendo 54,1% do sexo feminino. Segundo a avaliação do estado nutricional, houve prevalência de eutrofia (48,7%) pelo IMC e desnutrição de 37,8% evidenciada pela CB e CMB. Na avaliação bioquímica, 25,0% estavam com hipoalbuminemia e 18,9% com redução da Cr. A dimensão de QV mais comprometida foi a limitação por aspectos físicos. Na análise das correlações, parâmetros nutricionais (IMC, CB e Alb) estavam ligados à QV dos pacientes.

Conclusão: IMC, CB e Alb correlacionaram-se com dimensões do SF-36, indicando que alterações no estado nutricional podem influenciar o funcionamento físico e emocional desses pacientes.
Análise das reações adversas da vacina oral do rotavirus humano na cidade de Franca – SP
Authors: Lascala Maysa Rocha , Guiraldello Lidiane , Pereira Nathalia Nunes , Oliveira Thaís Martins , Castro Ana Luíza Elias De , Rosa Júnior Homero Antônio
Published: August 2019

Estudo de coorte, retrospectivo, que utilizou dados obtidos na Vigilância Epidemiológica da cidade de Franca, no interior do Estado de São Paulo, com o objetivo de analisar o tipo de reação e a cobertura da Vacina Oral de Rotavírus Humano (VORH). Este estudo foi realizado por discentes do curso de Medicina da Universidade de Franca, e analisado estatisticamente com teste de normalidade de D’Agostino e Pearson. As informações foram obtidas no SIPNI Web (Sistema de Informação do Programa Nacional de Imunização), e são referentes aos períodos de Janeiro/2007 a Novembro/2017. Notou-se uma baixa incidência de reações a VORH no período analisado equivalente a 0,077%, e quando presentes são de baixa morbidade, raramente cursando com complicações. A maioria dos casos ocorreu no sexo masculino e na primeira dose da vacina. No entanto, há ainda muito receio acerca da mesma, sendo, por essa razão, motivo de recusa da imunização por uma parte da população.
Provenance and weathering index of the Upper Cretaceous São Carlos Formation and its tectonic significance in the eastern Bauru Basin, SE Brazil
Authors: Neves Lara Ferreira , Batezelli Alessandro
Published: August 2019

Geochemistry of major and trace elements has been used as an important tool for the study of provenance and tectonic and climatic evolution of sedimentary basins. The São Carlos Formation is an Upper Cretaceous unit that lies on the eastern border of the Bauru Basin. Despite the paleontological and paleodepositional studies performed in this unit in the last years, little is known about the correspondence between tectonic and climatic conditions acting during the first stages of sedimentation. The hypothesis of this paper is to evaluate São Carlos and Araçatuba formations and understand the evolution of the eastern border of the basin. Thus, were conducted geochemical studies using X-ray fluorescence on sandstones, siltstones, and shales from the São Carlos Formation. According to the chemical weathering index, which presented values ranging from 57.12 to 71.58%, the oxides of major elements indicate that moderate weathering processes affected the source area, possibly associated with the arid-semiarid climate. Alkaline rocks, granites, gneisses, and metasediments were the main lithotypes of the source area. Ternary diagrams show that the tectonic environment was equivalent to the passive continental margin, coinciding with the Serra do Mar and, secondarily, Alto Paranaíba Uplift regions. Based on major and trace elements, their ratios, and published data on the basin, was elaborated a paleogeographic model of the eastern border of the Bauru Basin, concluding that the source area of the sediments was constituted by intermediate and felsic rocks, sometimes recycled by sedimentary processes.
Análise dos espaços de equilíbrio ambiental da região central de Vila Velha-ES
Authors: Ramos Larissa Leticia Andara , Palhano Patrícia Scarpat Thompson , Ramos Suzany Rangel
Published: August 2019

A cidade de Vila Velha passou por um processo de urbanização acelerado que, juntamente com a falta de planejamento urbano e a valorização imobiliária, substituiu ambientes naturais por espaços construídos que não favorecem a saúde e a qualidade de vida da população. Nesse contexto, este artigo objetiva analisar os espaços verdes, considerados neste trabalho como “espaços de equilíbrio ambiental” da Regional Grande Centro do município. A metodologia baseou-se no mapeamento das áreas, considerando Mendonça (2015), com auxílio do programa ArcGIS e tendo como referência o plano diretor, imagem de satélite e visitas locais. A análise constatou que os espaços de equilíbrio ambiental não são bem distribuídos, ficando concentrados nas Áreas de Preservação Permanente. Destaca-se ainda a importância dos espaços potenciais que podem ser utilizados para suprir a carência dessas áreas. Espera-se, assim, contribuir para novas pesquisas e futuras intervenções nos espaços livres da cidade.
Epoetin Beta and C‐Terminal Fibroblast Growth Factor 23 in Patients With Chronic Heart Failure and Chronic Kidney Disease
Authors: Eisenga Michele F. , Emans Mireille E. , van der Putten Karien , Cramer Maarten J. , Diepenbroek Adry , Velthuis Birgitta K. , Doevendans Pieter A. , Verhaar Marianne C. , Joles Jaap A. , Bakker Stephan J. L. , Nolte Ilja M. , Braam Branko , Gaillard Carlo A. J. M.
Published: August 2019

Background

In patients with chronic heart failure and chronic kidney disease, correction of anemia with erythropoietin‐stimulating agents targeting normal hemoglobin levels is associated with an increased risk of cardiovascular morbidity and mortality. Emerging data suggest a direct effect of erythropoietin on fibroblast growth factor 23 (
FGF
23), elevated levels of which have been associated with adverse outcomes. We investigate effects of erythropoietin‐stimulating agents in patients with both chronic heart failure and chronic kidney disease focusing on
FGF
23.

Methods and Results

In the
EPOCARES
(Erythropoietin in CardioRenal Syndrome) study, we randomized 56 anemic patients (median age 74 [interquartile range 69–80] years, 66% male) with both chronic heart failure and chronic kidney disease into 3 groups, of which 2 received epoetin beta 50 
IU
/kg per week for 50 weeks, and the third group served as control. Measurements were performed at baseline and after 2, 26, and 50 weeks. Data were analyzed using linear mixed‐model analysis. After 50 weeks of erythropoietin‐stimulating agent treatment, hematocrit and hemoglobin levels increased. Similarly, C‐terminal
FGF
23 levels, in contrast to intact
FGF
23 levels, rose significantly due to erythropoietin‐stimulating agents as compared with the controls. During median follow‐up for 5.7 (2.0–5.7) years, baseline C‐terminal
FGF
23 levels were independently associated with increased risk of mortality (hazard ratio 2.20; 95%
CI
, 1.35‐3.59;
P
=0.002).

Conclusions

Exogenous erythropoietin increases C‐terminal
FGF
23 levels markedly over a period of 50 weeks, elevated levels of which, even at baseline, are significantly associated with an increased risk of mortality. The current results, in a randomized trial setting, underline the strong relationship between erythropoietin and
FGF
23 physiology in patients with chronic heart failure and chronic kidney disease.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00356733.
Clinical Outcomes During Admissions for Heart Failure Among Adults With Congenital Heart Disease
Authors: Agarwal Anushree , Dudley Carson W. , Nah Gregory , Hayward Robert , Tseng Zian H.
Published: August 2019

Background

Heart failure (
HF
) admissions in adults with congenital heart disease (
CHD
) are becoming more common. We compared in‐hospital and readmission events among adults with and without
CHD
admitted for
HF
.

Methods and Results

We identified all admissions with the primary diagnosis of
HF
among adults in the California State Inpatient Database between January 1, 2005 and January 1, 2012.
International Classification of Disease (ICD)
codes identified the type of
CHD
lesion, comorbidities, and in‐hospital and 30‐day readmissions events. Adjusted odds ratio (
AOR
, 95%
CI
) was calculated after adjusting for admission year, age, sex, race, household income, primary payor, and Charlson comorbidity index. Of 203 759 patients admitted for
HF
, 539 had
CHD
other than atrial septal defect. Compared with patients admitted for
HF
without
CHD
, those with
CHD
were younger, more often male, and had fewer comorbidities as determined by Charlson comorbidity index. On multivariate analysis,
CHD
patients admitted for
HF
had higher odds of length of stay ≥7 days (
AOR
2.5 [95%
CI
2.0–3.1]), incident arrhythmias (
AOR
2.8 [95%
CI
1.7–4.5]), and in‐hospital mortality (
AOR
1.9 [95%
CI
1.1–3.1]). Also,
CHD
patients had lower odds of readmission for
HF
(
AOR
0.6 [95%
CI
0.3–0.9]), but similar odds of other 30‐day readmission events. Complex
CHD
patients had higher odds of length of stay ≥7 days (
AOR
1.9 [95%
CI
1.1–3.3]) than patients with noncomplex
CHD
lesions, but similar odds of all other clinical outcomes.

Conclusions

Among patients admitted with the primary diagnosis of
HF
in California, adults with
CHD
have substantially higher odds of longer length of stay, incident arrhythmias, and in‐hospital mortality compared with non‐
CHD
patients. These results suggest a need for
HF
risk stratification strategies and management protocols specific for patients with
CHD
.
Out‐of‐Hospital Cardiac Arrest in Patients With and Without Psychiatric Disorders: Differences in Use of Coronary Angiography, Coronary Revascularization, and Implantable Cardioverter‐Defibrillator and Survival
Authors: Barcella Carlo Alberto , Mohr Grimur Høgnason , Kragholm Kristian Hay , Gerds Thomas Alexander , Jensen Svend Eggert , Polcwiartek Christoffer , Wissenberg Mads , Lippert Freddy Knudsen , Torp‐Pedersen Christian , Kessing Lars Vedel , Gislason Gunnar Hilmar , Søndergaard Kathrine Bach
Published: August 2019

Background

Healthcare disparities for psychiatric patients are common. Whether these inequalities apply to postresuscitation management in out‐of‐hospital cardiac arrest (
OHCA
) is unknown. We investigated differences in in‐hospital cardiovascular procedures following
OHCA
between patients with and without psychiatric disorders.

Methods and Results

Using the Danish nationwide registries, we identified patients admitted to the hospital following OHCA of presumed cardiac cause (2001‐2015). Psychiatric disorders were identified using hospital diagnoses or redeemed prescriptions for psychotropic drugs. We calculated age‐ and sex‐standardized incidence rates and incidence rate ratios (
IRR
s) of cardiovascular procedures during post‐
OHCA
admission in patients with and without psychiatric disorders. Differences in 30‐day and 1‐year survival were assessed by multivariable logistic regression in the overall population and among 2‐day survivors who received acute coronary angiography (
CAG
). We included 7288 hospitalized patients who had experienced an OHCA: 1661 (22.8%) had a psychiatric disorder. Compared with patients without psychiatric disorders, patients with psychiatric disorders had lower standardized incidence rates for acute
CAG
(≤1 day post‐
OHCA
) (
IRR
, 0.51; 95% CI, 0.45–0.57), subacute
CAG
(2–30 days post‐
OHCA
) (
IRR
, 0.40; 95% CI, 0.30–0.52), and implantable cardioverter‐defibrillator implantation (
IRR
, 0.67; 95%
CI
, 0.48–0.95). Conversely, we did not detect differences in coronary revascularization among patients undergoing CAG (
IRR
, 1.11; 95%
CI
, 0.94–1.30). Patients with psychiatric disorders had lower survival even among 2‐day survivors who received acute CAG: (odds ratio of 30‐day survival, 0.68; 95% CI, 0.52–0.91; and 1‐year survival, 0.66; 95% CI, 0.50–0.88).

Conclusions

Psychiatric patients had a lower probability of receiving post‐
OHCA CAG
and implantable cardioverter‐defibrillator implantation compared with nonpsychiatric patients but the same probability of coronary revascularization among patients undergoing CAG. However, their survival was lower irrespective of angiographic procedures.
Home‐Based Cardiac Rehabilitation Alone and Hybrid With Center‐Based Cardiac Rehabilitation in Heart Failure: A Systematic Review and Meta‐Analysis
Authors: Imran Hafiz M. , Baig Muhammad , Erqou Sebhat , Taveira Tracey H. , Shah Nishant R. , Morrison Alan , Choudhary Gaurav , Wu Wen‐Chih
Published: August 2019

Background

Center‐based cardiac rehabilitation (
CBCR
) has been shown to improve outcomes in patients with heart failure (
HF
). Home‐based cardiac rehabilitation (
HBCR
) can be an alternative to increase access for patients who cannot participate in
CBCR
. Hybrid cardiac rehabilitation (
CR
) combines short‐term
CBCR
with
HBCR,
potentially allowing both flexibility and rigor. However, recent data comparing these initiatives have not been synthesized.

Methods and Results

We performed a meta‐analysis to compare functional capacity and health‐related quality of life (hr‐
QOL
) outcomes in HF for (1)
HBCR
and usual care, (2) hybrid
CR
and usual care, and (3)
HBCR
and
CBCR
. A systematic search in 5 standard databases for randomized controlled trials was performed through January 31, 2019. Summary estimates were pooled using fixed‐ or random‐effects (when I
2
>50%) meta‐analyses. Standardized mean differences (95%
CI
) were used for distinct hr‐
QOL
tools. We identified 31 randomized controlled trials with a total of 1791
HF
participants. Among 18 studies that compared
HBCR
and usual care, participants in
HBCR
had improvement of peak oxygen uptake (2.39 mL/kg per minute; 95%
CI
, 0.28–4.49) and hr‐
QOL
(16 studies; standardized mean difference: 0.38; 95%
CI
, 0.19–0.57). Nine
RCT
s that compared hybrid
CR
with usual care showed that hybrid
CR
had greater improvements in peak oxygen uptake (9.72 mL/kg per minute; 95%
CI
, 5.12–14.33) but not in hr‐
QOL
(2 studies; standardized mean difference: 0.67; 95%
CI
, −0.20 to 1.54). Five studies comparing
HBCR
with
CBCR
showed similar improvements in functional capacity (0.0 mL/kg per minute; 95%
CI,
−1.93 to 1.92) and hr‐
QOL
(4 studies; standardized mean difference: 0.11; 95%
CI
, −0.12 to 0.34).

Conclusions

HBCR
and hybrid
CR
significantly improved functional capacity, but only
HBCR
improved hr‐
QOL
over usual care. However, both are potential alternatives for patients who are not suitable for
CBCR
.
Combined Effect of Income and Medication Adherence on Mortality in Newly Treated Hypertension: Nationwide Study of 16 Million Person‐Years
Authors: Lee Hokyou , Park Jong Heon , Floyd James S. , Park Sungha , Kim Hyeon Chang
Published: August 2019

Background

Low socioeconomic status and poor medication adherence are known to be associated with increased morbidity and mortality among patients with hypertension, but their combined effects have not been studied. We therefore evaluated the joint association of household income and medication adherence with death and cardiovascular disease in patients newly treated for hypertension.

Methods and Results

This was a nationwide cohort study using the Korean National Health Insurance database. We included 1 651 564 individuals, aged 30 to 80 years, with newly treated hypertension and no prior cardiovascular disease and followed them for 10 years. Main exposures were household income in quintiles and adherence to antihypertensive medication, estimated by medication possession ratio: good (≥0.8), moderate (0.5 to <0.8), or poor (<0.5). The primary outcomes were all‐cause and cardiovascular deaths. Higher mortality risk was observed in patients with low income (adjusted hazard ratio=1.50, 99%
CI
=1.46‐1.53; lowest versus highest quintile) and poor medication adherence (adjusted hazard ratio=1.66, 99%
CI
=1.63‐1.68; poor versus good adherence). When compared with the highest‐income and good‐adherence group, adjusted hazard ratio (99%
CI
) of death was 1.56 (1.52‐1.61) for highest‐income poor‐adherers, 1.46 (1.41‐1.51) for lowest‐income good‐adherers, and 2.46 (2.38‐2.54) for lowest‐income poor‐adherers (
P
for interaction <0.001).

Conclusions

Low socioeconomic status and poor adherence to antihypertensive medication are associated with increased mortality and cardiovascular disease risks, but patients with low income are subject to larger excess risks by nonadherence. This highlights the potential importance of promoting medication adherence for risk reduction, especially in low‐income patients with hypertension.
Is there a Central Andean Linguistic Area? A View from the Perspective of the “Minor” Languages
Authors: Urban Matthias
Published: August 2019

In this article, I reconsider the evidence for a Central Andean linguistic area. I suggest that there is no evidence for a clear-cut linguistic area comprising the entire Central Andes narrowly defined, and that perceived homogeneity is partially due to an overemphasis on the largest and surviving Central Andean language families, Quechuan and Aymaran. I show that none of the other Central Andean languages known sufficiently well match their typological profile to a high degree. I make a contribution to a more adequate picture by discussing some typological aspects tentatively recoverable for the extinct and poorly documented languages of the North-Central Andes. These suggest that the North was the site of linguistic traits contrasting with those of Quechuan and Aymaran.
Decadal–Multidecadal Variations of Asian Summer Rainfall from the Little Ice Age to the Present
Authors: Shi Hui , Wang Bin , Liu Jian , Liu Fei
Published: August 2019

Features of decadal–multidecadal variations of the Asian summer rainfall are revealed by analysis of the reconstructed Asian summer precipitation (RAP) dataset from 1470 to 2013. Significant low-frequency periodicities of the all-Asian rainfall (AAR) index (AARI) are found on decadal (8–10 yr), quasi-bidecadal (22 yr), and multidecadal (50–54 yr) time scales, as well as centennial time scales. The decadal and multidecadal peaks are mainly from the “monsoon Asia” area and the Maritime Continent, while the 22-yr peak is from the “arid Asia” area. A remarkable change of leading frequency from multidecadal to decadal after AD 1700 is detected across the entire Asian landmass. The leading empirical orthogonal function (EOF) modes on the decadal and multidecadal time scales exhibit a uniform structure similar to that on the interannual time scale, suggesting a cross-time-scale, in-phase variation of the rainfall across continental Asia and the Maritime Continent. Enhanced AAR on a decadal time scale is found associated with the mega-La Niña sea surface temperature (SST) pattern over the Pacific. The AARI–mega-ENSO (El Niño–Southern Oscillation) relationship is persistently significant except from 1820 to around 1900. Enhanced decadal AAR is also found to be associated with extratropical North Atlantic warming. The AARI–AMO (Atlantic multidecadal oscillation) relationship, however, is nonstationary. On the multidecadal time scale, the AAR is significantly related to the AMO. Mechanisms associated with the decadal–multidecadal variability of AAR are also discussed.
Multiple Flood Experiences and Social Resilience: Findings from Three Surveys on Households and Companies Exposed to the 2013 Flood in Germany
Authors: Kuhlicke Christian , Masson Torsten , Kienzler Sarah , Sieg Tobias , Thieken Annegret H. , Kreibich Heidi
Published: August 2019

Previous studies have explored the consequences of flood events for exposed households and companies by focusing on single flood events. Less is known about the consequences of experiencing repeated flood events for the resilience of households and companies. In this paper, we therefore explore how multiple floods experience affects the resilience of exposed households and companies. Resilience was made operational through individual appraisals of households and companies’ ability to withstand and recover from material as well as health and psychological impacts of the 2013 flood in Germany. The paper is based on three different datasets including more than 2000 households and 300 companies that were affected by the 2013 flood. The surveys revealed that the resilience of households seems to increase, but only with regard to their subjectively appraised ability to withstand impacts on mobile goods and equipment (e.g., cars, TV, and radios). In regard to the ability of households to withstand overall financial consequences of repetitive floods, evidence for nonlinear (quadratic) trends can be found. With regard to psychological and health-related consequences, the findings are mixed but provide tentative evidence for eroding resilience among households. Companies’ resilience increased with respect to material assets but appears to decrease with respect to ability to recover. We conclude by arguing that clear and operational definitions of resilience are required so that evidence-based resilience baselines can be established to assess whether resilience is eroding or improving over time.
Crime and colonisation in Australia’s Torres Strait Islands
Authors: Staines Zoe , Scott John
Published: August 2019

The overrepresentation of Indigenous Australians in the criminal justice system has been thoroughly documented over a number of decades. However, studies tend to adopt homogenising discourses that fail to acknowledge or deeply examine the diversity of Indigenous Australian experiences of crime, including across geographic and cultural contexts. This has prompted calls for a more thorough investigation of how experiences of crime differ across Australia’s Indigenous communities, including between remote Aboriginal and Torres Strait Islander communities. This paper forms part of a larger study, examining crime and justice in the Torres Strait Region, situated off the far northern tip of the State of Queensland. Here, we examine and compare reported crime trends in the Torres Straits with those in Queensland’s remote Aboriginal communities and Queensland State on the whole. We then draw upon existing anthropological, historical and other literature to explore possible explanations for differences in these crime rates. We find that crime rates are generally lower in the Torres Strait Region and that the different historical experiences of colonisation and policing may provide a partial explanation for this, particularly through the lens of social disorganisation theory.
Teachers’ Perceptions of Educational Inclusion for Migrant Children in Chinese Urban Schools: A Cohort Study
Authors: Liu Ting , Holmes Kathryn , Albright James
Published: August 2019

In recent decades, China has observed increasing numbers of rural–urban migrant children seeking education in Chinese cities, resulting in pressure on urban schools to accommodate these children. Drawing on pre- and post-survey and interview data with 215 primary school teachers in a metropolitan city in East China, the objectives of this article are to describe teachers’ perceptions of educational inclusion in both migrant and public schools, and to investigate changes in their beliefs from 2013 to 2016. Urban public school teachers indicated significant differences in perceptions compared with their first test, whereas no salient differences in perceptions was found among migrant school teachers. The qualitative analysis echoed the quantitative findings and provided further explanation for the complexity and particularity of these changes. Our study revealed that public schools have made great reforms in relation to educational inclusion for migrant students and that these initiatives in turn have produced changes on teachers’ perceptions and practices with migrant children. It should be noted, however, that teachers attribute the changes in their perceptions to external factors rather than the internal ones. In the light of these findings, the article discusses implications for further professional development programs for teachers in Chinese migrant schools.
Arabic Version of Learning Organization Survey Short-Form: Hospital Pharmacy Settings
Authors: Abdallah Wael , Johnson Craig , Nitzl Christian , Mohammed Mohammed Amin
Published: August 2019

Objective: The objective of this study was to assess the psychometric properties of a translated Arabic version of the Learning Organization Survey (LOS-27) and to use this to evaluate staff perceptions about the organizational learning process in Kuwaiti hospital pharmacies. Setting: This study adopted a cross-sectional survey of the pharmacy employees in 6 hospital pharmacies in Kuwait. Results: The results indicated that the internal consistency of all composites was more than 0.7, except for one. All item loadings for the construct measurements were above 0.7. The standardized root mean square residual (SRMR) score showed a good fit with a value of 0.08. The intercorrelation among composites ranged from 0.34 to 0.68. Conclusions: The results indicate that the Arabic translation of the LOS-27 questionnaire has adequate levels of reliability and validity in comparison with the original US survey results. The overall average positive rate of composites was 64%. Therefore, the findings suggest that the hospital pharmacy staff surveyed in Kuwait were moderately positive in their perceptions about organizational learning in their organizations.
Study on velocity distribution of large particle in vertical slurry pipeline
Authors: Li-an Zhao , Tieli Wang , Wenqiang Han
Published: August 2019

Velocity distribution of vertical pipes with large particle slurry plays an important role in pipeline transportation of minerals in hydraulic coal mining and ocean mining industry. The experiments of particle fluidization and particle vertical lift are conducted and the fluidization data of three kinds of large particles are analyzed. The results show that the vortex resistance prevents particles from moving as the coarse particles move in vertical pipes. An additional coefficient method is proposed to study the vortex resistance by increasing the coefficient of vortex resistance before interference. Mathematical model is established to describe the drag coefficient of the vortex by analyzing the influence factors of the experimental data and the drag coefficient of the vortex. In addition, calculation model of the velocity distribution of large particles in vertical pipe is proposed by analyzing the force, the fluid, and the solid momentum. Moreover, the experimental data of particle transport in vertical pipes are utilized to verify and analyze the proposed model.
Neurofuzzy modelling of moisture absorption kinetics and its effect on the mechanical properties of pineapple fibre-reinforced polypropylene composite
Authors: Mercy J Lilly , Velmurugan R , Sasipraba T , Jacob Chrystella
Published: August 2019

Natural fibres possess low density, less abrasiveness, good strength and sound absorption capacity and its significance lies in being renewable and biodegradable. The mechanical characteristics and moisture absorption of pineapple fibres reinforced with polypropylene resin are focused in this study. Chopped fibres and unidirectional fibre mats of pineapple were reinforced with polypropylene resin to make pineapple fibre/polypropylene composites. The length of the pineapple fibres and the orientation of the layup of the fibre mats are varied to make composite specimens and the mechanical properties are tested. Moisture absorption studies were carried out and it was confirmed to follow Fickian diffusion. A total of 384 samples were tested and it was observed that all the samples reached its saturation in moisture absorption before 720 h and the strength was inversely proportional to the moisture absorbed. Specimens reinforced with unidirectional fibre mats of alternate orientation possessed high strength irrespective of the moisture absorbed when compared to the specimens reinforced with chopped fibres of random orientation. Neuro fuzzy modelling using ANFIS tool box in MATLAB was used to correlate the static mechanical properties of pineapple fibre-reinforced polymer under different moisture conditions, fibre orientations, fibre volume percentage, fibre size, etc.
Temperatures, food riots, and adaptation: A long-term historical analysis of England
Authors: De Juan Alexander , Wegenast Tim
Published: August 2019

A large body of research indicates that environmental conditions can influence the risk of social unrest. However, we know little about how these effects may change in the long run. Are they likely to remain constant or do they change over time – for example as a consequence of human adaptation? To investigate this question, we rely on a disaggregated analysis of England over a period of more than 300 years. Combining data on geo-referenced food riots with reconstructed climate data, we first assess the impact of annual temperatures on social unrest over the period 1500–1817. We then use our long-term time-series dataset to assess the temporal heterogeneity of year-to-year associations between temperatures and social conflict. Our models show a substantive negative correlation between temperatures and food riots in the aggregate. This association, however, seems to be highly inconsistent over time and largely confined to the 18th century. In addition, we find evidence of decadal processes of adaptation: past exposure to adverse weather conditions dampens the effect of current exposure. Taken together, these findings underline the importance of considering temporal heterogeneities when assessing the climate–conflict nexus and caution against any simple extrapolations of observable present-day effects of environmental conditions into the future.
IR in the Middle East: foreign policy analysis in theoretical approaches
Authors: Darwich May , Kaarbo Juliet
Published: August 2019

Research on international relations of the Middle East (IRME) has suffered from a schism between International Relations (IR) theory and regional particularities. To address this, scholars have offered corrective accounts by adding domestic factors to IR structural approaches. Studies on IRME thus reflect the turn to decision-making and domestic politics that has recently occurred. This article develops a critical analysis of the domestic politics orientation in IRME. We argue that this scholarship ignores work in foreign policy analysis (FPA) with its psychological-oriented and agent-based dimensions and that this constitutes a missed opportunity for the study of the region. The article offers suggestions for incorporating FPA research into IRME and argues that an FPA perspective offers an alternative and complementary approach to the eclectic frameworks predominant in the scholarship on IRME.