bluuebunny/crossref_metadata_2025 huggingface dataset:
A randomized controlled trial of infraorbital block using ketamine 1% for intra- and postoperative analgesia in children for ambulatory cleft lip correction
Authors: Ramlan Andi Ade Wijaya , Ratnaningrum Apriliana , Marsaban Arif Hari Martono
Published: March 2021

BACKGROUND In Indonesia, cleft lip correction surgery is often done as a social program in remote areas with limited resources. This study aimed to assess the effectiveness of ketamine, a cheaper and more accessible alternative, as a local analgesia in infraorbital block and to determine the possibility of ketamine as an alternative local analgesic drug for intraoperative and postoperative periods.

METHODS This was a randomized controlled trial in children aged 2 months to 5 years who underwent cleft lip correction surgery at Cipto Mangunkusumo Hospital in 2016. Subjects were randomly divided into two groups: ketamine and bupivacaine. Standard general anesthesia with endotracheal intubation was performed in each group. Bilateral intraoral infraorbital block was performed using ketamine 1% 0.5 ml or bupivacaine 0.25% 0.5 ml. Postoperative evaluation includes pain scores based on the face, leg, activity, cry, and consolability (FLACC) scale and analgesic duration.

RESULTS A total of 36 subjects were enrolled in this study, with 18 in each group. Both groups received the same total amount of fentanyl addition intraoperatively (p = 1). The postoperative FLACC pain scale scores between the two groups were not different, with p>0.05 in every measurement. The mean duration of postoperative analgesia in the ketamine group was longer than the bupivacaine group (15–13.49 hours, p = 0.031).

CONCLUSIONS Infraorbital block with 1% ketamine 0.5 mg/kg was similarly effective for intraoperative and postoperative analgesia but had a longer duration than that with 0.25% bupivacaine 0.5 ml in ambulatory cleft lip correction.
Exploring a non-universal understanding of waged work and its consequences: sketching out employment activation for people with an intellectual disability
Authors: Dearing Kim
Published: March 2021

Background:

Supported Employment has been advocated for by successive governments and policymakers alike as the best approach to employment inclusion for people with an intellectual disability who are in receipt of social care. Yet only 5.2% of this demographic are in any form of work and these numbers have been persistently stagnant for many years.

Aims:

This study aimed to explore the employment landscape and grapple with the intersecting layers of policy consequence for people who have an intellectual disability, and are in receipt of social care, who wish to engage with work preparation employment support.

Methods:

As an active participant in the field, this study was ethnographic and conducted at a new job club that had been established in England. In addition, three further sites of complementary data were explored in Wales, through interviews and focus groups.

Findings:

This study demonstrates that there is a mismatch between how evidence informs policy, and how funding is allocated to support with work preparation. Those unable to secure Supported Employment services are, instead, navigating extreme employment disadvantage and scant opportunities, in the open labour market. Further, bound up in this analysis is evidence of a non-universal understanding of waged work where any form of financial remuneration is welcome.

Discussion and conclusion:

Overall, with a mismatch between evidence that informs policy, policy rhetoric, realistic employment prospects, and available work, without a fundamental employment policy shift, the very low employment rates within this demographic will not increase.
Use of a knowledge exchange event strategy to identify key priorities for implementing deprescribing in primary healthcare in Nova Scotia, Canada
Authors: Kennie-Kaulbach Natalie , Kehoe Sarah , Whelan Anne Marie , Reeve Emily , Bai Isaac , Burgess Sarah , Kits Olga , Isenor Jennifer E.
Published: March 2021

Background:

Deprescribing, the process of dose reduction or stopping of medication(s) that may no longer be required, may improve medication use and patient outcomes. A collaborative interprofessional deprescribing research team was formed in 2017 in Nova Scotia (NS), Canada with the goal of investigating potential deprescribing initiatives which could be translated to primary healthcare in NS. The knowledge-to-action framework, which includes knowledge exchange, was used to guide the work of this team. Preliminary work involved knowledge inquiry and synthesis through a scoping review of deprescribing strategies in primary healthcare, a qualitative study to understand influences on deprescribing by local practitioners, and an analysis that combined the two.

Aims and objectives:

To describe and reflect on how an interactive knowledge exchange event strategy was used to (1) share the results, including knowledge tools, of previously conducted deprescribing research with stakeholders; (2) identify priorities for the development and implementation of collaborative deprescribing strategies in primary healthcare in NS.

Key conclusions:

The knowledge exchange event strategy utilised in this project achieved the planned objectives of sharing research results, raising awareness about deprescribing, and providing direction for future initiatives. The successful implementation of the knowledge exchange event hinged on many factors such as hiring a research coordinator; limiting the in-person event to one half-day; and using a variety of strategies for participant engagement both before and after the event. Other research teams could adopt a similar knowledge exchange event process as an approach for sharing research results and identifying future research and translation priorities.
Taking a policy process approach to illuminate the political nature of disability policymaking
Authors: Giordono Leanne
Published: March 2021

Background:

In an era of increased polarisation, identity politics and growing reliance on using evidence to make disability policy decisions – evidence-based policymaking – how much do we know about the process by which disability policy decisions are made and the use of evidence therein?

Aims and objectives:

The objective of this Practice Paper is to introduce key policy process frameworks, highlight connections between models of disability and the policy process, and identify opportunities for disability scholars, analysts and advocates to use a policy process approach.

Key conclusions:

Wider use of policy process frameworks can enhance our understanding of the political nature of the disability policy decision-making process and conditions that influence how evidence is used to inform disability policy.
Drawing hidden figures of disability: youth and adults with disabilities in Canada
Authors: Prince Michael J.
Published: March 2021

Background:

While governments draw on survey data to inform policy choices, the design, application, and interpretation of surveys can generate certain images of disability and ignore many others.

Aims and objectives:

This article draws attention to social circumstances of people with disabilities often unacknowledged in research evidence: hidden figures of disability.

Methods:

Selected results from the Canadian Survey on Disability are examined with a focus on working-age youth and adults (aged 15 to 64) with a range of disabilities.

Findings:

Five figures of disability and corresponding conceptual models are identified. These hidden figures of disability are the uncounted, those with needs unsupported, youth in multiple transitions, potential workers, and what may be called ‘the fearful’. Several models of disability are identified intersecting with the evidence. These are the absent citizen, biomedical model and charitable model, social and economic integration model, human rights and full citizenship, and psycho-emotional model of affective disablism and ableism.

Discussion:

Hidden figures of disability are more than statistical tests and texts; more than calculations derived from quantitative research where people become a data point. The function of drawing hidden figures is to disclose and describe the bodily experiences of people with disabilities in their social positions and structural contexts.

Conclusion:

We need to see the production of evidence for policy not as painting a portrait but as portraits in the plural, and appreciate not only what is in the frame but also what faces and forms of knowledge get glossed over or brushed aside.
Theoretical analysis of surface-shape-induced decorrelation noise in multi-wavelength digital holography
Authors: Piniard Matthieu , Sorrente Béatrice , Hug Gilles , Picart Pascal
Published: March 2021

This paper presents analytical modelling for describing the speckle noise decorrelation in phase data from two- or multiple-wavelength digital holography. A novel expression for the modulus of the coherence factor is proposed for the case of two-wavelength speckle decorrelation from imaging roughness and surface shape through an optical system. The expression permits us to estimate the speckle decorrelation phase noise in surface shape measurements. The theoretical analysis is supported by realistic simulations including both the surface roughness and shape. The results demonstrate the very good agreement between the modulus of the coherence factor estimated with the simulation and the one calculated with theory.
Generation of optically synchronized pump–signal beams for ultrafast OPCPA via the optical Kerr effect
Authors: Alexandridi Christina , Délen Xavier , Druon Frederic , Georges Patrick , Martin Luc , Mathieu François , Papadopoulos Dimitris
Published: March 2021

In recent years, multi-petawatt laser installations have achieved unprecedented peak powers, opening new horizons to laser–matter interaction studies. Ultra-broadband and extreme temporal contrast pulse requirements make optical parametric chirped pulse amplification (OPCPA) in the few-picosecond regime the key technology in these systems. To guarantee high fidelity output, however, OPCPA requires excellent synchronization between pump and signal pulses. Here, we propose a new highly versatile architecture for the generation of optically synchronized pump–signal pairs based on the Kerr shutter effect. We obtained

>

550

µ

J

pump pulses of 12 ps duration at 532 nm optically synchronized with a typical ultrashort CPA source at 800 nm. As a proof-of-principle demonstration, our system was also used for amplification of

∼

20

µ

J

ultra-broadband pulses based on an OPCPA setup.
Visual Perception in AR/VR
Authors: Baraas Rigmor C. , Imai Francisco , Yöntem Ali Özgür , Hardeberg Jon Y.
Published: March 2021

In an online OSA Incubator Meeting, top industry and academic
researchers explored the importance of accounting for aspects of the human
visual system to take augmented and virtual reality to the next step.
Cancer Holography for Personalized Medicine
Authors: Nolte David D.
Published: March 2021

Digital holography can measure the 3D physiology and motion of
cancer cells, allowing identification of effective chemotherapies for
patients.
Creating clear and informative image-based figures for scientific publications
Authors: Jambor Helena , Antonietti Alberto , Alicea Bradly , Audisio Tracy L. , Auer Susann , Bhardwaj Vivek , Burgess Steven J. , Ferling Iuliia , Gazda Małgorzata Anna , Hoeppner Luke H. , Ilangovan Vinodh , Lo Hung , Olson Mischa , Mohamed Salem Yousef , Sarabipour Sarvenaz , Varma Aalok , Walavalkar Kaivalya , Wissink Erin M. , Weissgerber Tracey L.
Published: March 2021

Scientists routinely use images to display data. Readers often examine figures first; therefore, it is important that figures are accessible to a broad audience. Many resources discuss fraudulent image manipulation and technical specifications for image acquisition; however, data on the legibility and interpretability of images are scarce. We systematically examined these factors in non-blot images published in the top 15 journals in 3 fields; plant sciences, cell biology, and physiology (n = 580 papers). Common problems included missing scale bars, misplaced or poorly marked insets, images or labels that were not accessible to colorblind readers, and insufficient explanations of colors, labels, annotations, or the species and tissue or object depicted in the image. Papers that met all good practice criteria examined for all image-based figures were uncommon (physiology 16%, cell biology 12%, plant sciences 2%). We present detailed descriptions and visual examples to help scientists avoid common pitfalls when publishing images. Our recommendations address image magnification, scale information, insets, annotation, and color and may encourage discussion about quality standards for bioimage publishing.
Variation in HIV care and treatment outcomes by facility in South Africa, 2011–2015: A cohort study
Authors: Bor Jacob , Gage Anna , Onoya Dorina , Maskew Mhairi , Tripodis Yorghos , Fox Matthew P. , Puren Adrian , Carmona Sergio , Mlisana Koleka , MacLeod William
Published: March 2021

Background

Despite widespread availability of HIV treatment, patient outcomes differ across facilities. We propose and evaluate an approach to measure quality of HIV care at health facilities in South Africa’s national HIV program using routine laboratory data.

Methods and findings

Data were extracted from South Africa’s National Health Laboratory Service (NHLS) Corporate Data Warehouse. All CD4 counts, viral loads (VLs), and other laboratory tests used in HIV monitoring were linked, creating a validated patient identifier. We constructed longitudinal HIV care cascades for all patients in the national HIV program, excluding data from the Western Cape and very small facilities. We then estimated for each facility in each year (2011 to 2015) the following cascade measures identified a priori as reflecting quality of HIV care: median CD4 count among new patients; retention 12 months after presentation; 12-month retention among patients established in care; viral suppression; CD4 recovery; monitoring after an elevated VL. We used factor analysis to identify an underlying measure of quality of care, and we assessed the persistence of this quality measure over time. We then assessed spatiotemporal variation and facility and population predictors in a multivariable regression context.

We analyzed data on 3,265 facilities with a median (IQR) annual size of 441 (189 to 988) lab-monitored HIV patients. Retention 12 months after presentation increased from 42% to 47% during the study period, and viral suppression increased from 66% to 79%, although there was substantial variability across facilities. We identified an underlying measure of quality of HIV care that correlated with all cascade measures except median CD4 count at presentation. Averaging across the 5 years of data, this quality score attained a reliability of 0.84. Quality was higher for clinics (versus hospitals), in rural (versus urban) areas, and for larger facilities. Quality was lower in high-poverty areas but was not independently associated with percent Black. Quality increased by 0.49 (95% CI 0.46 to 0.53) standard deviations from 2011 to 2015, and there was evidence of geospatial autocorrelation (p < 0.001). The study’s limitations include an inability to fully adjust for underlying patient risk, reliance on laboratory data which do not capture all relevant domains of quality, potential for errors in record linkage, and the omission of Western Cape.

Conclusions

We observed persistent differences in HIV care and treatment outcomes across South African facilities. Targeting low-performing facilities for additional support could reduce overall burden of disease.
High variation in immune responses and parasite phenotypes in naturally acquired Trypanosoma cruzi infection in a captive non-human primate breeding colony in Texas, USA
Authors: Padilla Angel M. , Yao Phil Y. , Landry Tre J. , Cooley Gretchen M. , Mahaney Susan M. , Ribeiro Isabela , VandeBerg John L. , Tarleton Rick L.
Published: March 2021

Trypanosoma cruzi, the causative agent of human Chagas disease, is endemic to the southern region of the United States where it routinely infects many host species. The indoor/outdoor housing configuration used in many non-human primate research and breeding facilities in the southern of the USA provides the opportunity for infection byT.cruziand thus provides source material for in-depth investigation of host and parasite dynamics in a natural host species under highly controlled and restricted conditions. For cynomolgus macaques housed at such a facility, we used a combination of serial blood quantitative PCR (qPCR) and hemoculture to confirm infection in >92% of seropositive animals, although each method alone failed to detect infection in >20% of cases. Parasite isolates obtained from 43 of the 64 seropositive macaques were of 2 broad genetic types (discrete typing units, (DTU’s) I and IV); both within and between these DTU groupings, isolates displayed a wide variation in growth characteristics and virulence, elicited host immune responses, and susceptibility to drug treatment in a mouse model. Likewise, the macaques displayed a diversity in T cell and antibody response profiles that rarely correlated with parasite DTU type, minimum length of infection, or age of the primate. This study reveals the complexity of infection dynamics, parasite phenotypes, and immune response patterns that can occur in a primate group, despite being housed in a uniform environment at a single location, and the limited time period over which theT.cruziinfections were established.
Boosting understanding of Lassa Fever virus epidemiology: Field testing a novel assay to identify past Lassa Fever virus infection in blood and oral fluids of survivors and unexposed controls in Sierra Leone
Authors: Akpogheneta Onome , Dicks Steve , Grant Donald , Kanneh Zainab , Jusu Brima , Edem-Hotah Joseph , Kanneh Lansana , Alhasan Foday , Gbakie Michael , Schieffelin John , Ijaz Samreen , Tedder Richard , Bower Hilary
Published: March 2021

Background

Despite identification 50 years ago, the true burden of Lassa Fever (LF) across Africa remains undefined for reasons including research focus on hospitalised patients, lack of validated field-feasible tools which reliably identify past infection, and the fact that all assays require blood samples making large-scale surveys difficult. Designated a priority pathogen of epidemic potential requiring urgent research by the World Health Organisation, a better understanding of LF sero-epidemiology is essential to developing and evaluating new interventions including vaccines. We describe the first field testing of a novel species-neutral Double Antigen Binding Assay (DABA) designed to detect antibodies to LF in plasma and oral fluid.

Methodology/Principal findings

Paired plasma and oral fluid were collected in Sierra Leone from survivors discharged from Kenema Government Hospital Lassa Fever Unit between 1980 and 2018, and from controls recruited in Freetown in 2019. Epidemiological sensitivity and specificity of the DABA measured against historical diagnosis in survivors and self-declared non-exposed controls was 81.7% (95% CI 70.7%– 89.9%) and 83.3% (72.7%- 91.1%) respectively in plasma, and 71.8% (60.0%– 81.9%) and 83.3% (72.7%– 91.1%) respectively in oral fluid. Antibodies were identified in people infected up to 15 years and, in one case, 40 years previously. Participants found oral fluid collection easy and painless with 80% happy to give an oral fluid sample regularly.

Conclusions/Significance

Given the difficulties of assay validation in a resource-limited setting, including unexpected exposures and diagnostics of varying accuracy, the new assay performed well in both plasma and oral fluid. Sensitivity and specificity are expected to be higher when case/control ascertainment is more definitive and further work is planned to investigate this. Even at the performance levels achieved, the species-neutral DABA has the potential to facilitate the large-scale seroprevalence surveys needed to underpin essential developments in LF control, as well as support zoonotic investigations.
First and second waves of coronavirus disease-19: A comparative study in hospitalized patients in Reus, Spain
Authors: Iftimie Simona , López-Azcona Ana F. , Vallverdú Immaculada , Hernández-Flix Salvador , de Febrer Gabriel , Parra Sandra , Hernández-Aguilera Anna , Riu Francesc , Joven Jorge , Andreychuk Natàlia , Baiges-Gaya Gerard , Ballester Frederic , Benavent Marc , Burdeos José , Català Alba , Castañé Èric , Castañé Helena , Colom Josep , Feliu Mireia , Gabaldó Xavier , Garrido Diana , Garrido Pedro , Gil Joan , Guelbenzu Paloma , Lozano Carolina , Marimon Francesc , Pardo Pedro , Pujol Isabel , Rabassa Antoni , Revuelta Laia , Ríos Marta , Rius-Gordillo Neus , Rodríguez-Tomàs Elisabet , Rojewski Wojciech , Roquer-Fanlo Esther , Sabaté Noèlia , Teixidó Anna , Vasco Carlos , Camps Jordi , Castro Antoni
Published: March 2021

Many countries have seen a two-wave pattern in reported cases of coronavirus disease-19 during the 2020 pandemic, with a first wave during spring followed by the current second wave in late summer and autumn. Empirical data show that the characteristics of the effects of the virus do vary between the two periods. Differences in age range and severity of the disease have been reported, although the comparative characteristics of the two waves still remain largely unknown. Those characteristics are compared in this study using data from two equal periods of 3 and a half months. The first period, between 15th March and 30th June, corresponding to the entire first wave, and the second, between 1st July and 15th October, corresponding to part of the second wave, still present at the time of writing this article. Two hundred and four patients were hospitalized during the first period, and 264 during the second period. Patients in the second wave were younger and the duration of hospitalization and case fatality rate were lower than those in the first wave. In the second wave, there were more children, and pregnant and post-partum women. The most frequent signs and symptoms in both waves were fever, dyspnea, pneumonia, and cough, and the most relevant comorbidities were cardiovascular diseases, type 2 diabetes mellitus, and chronic neurological diseases. Patients from the second wave more frequently presented renal and gastrointestinal symptoms, were more often treated with non-invasive mechanical ventilation and corticoids, and less often with invasive mechanical ventilation, conventional oxygen therapy and anticoagulants. Several differences in mortality risk factors were also observed. These results might help to understand the characteristics of the second wave and the behaviour and danger of SARS-CoV-2 in the Mediterranean area and in Western Europe. Further studies are needed to confirm our findings.
New generalized-X family: Modeling the reliability engineering applications
Authors: Wang Wanting , Ahmad Zubair , Kharazmi Omid , Ampadu Clement Boateng , Hafez E. H. , Mohie El-Din Marwa M.
Published: March 2021

As is already known, statistical models are very important for modeling data in applied fields, particularly in engineering, medicine, and many other disciplines. In this paper, we propose a new family to introduce new distributions suitable for modeling reliability engineering data. We called our proposed family a new generalized-Xfamily of distributions. For the practical illustration, we introduced a new special sub-model, called the new generalized-Weibull distribution, to describe the new family’s significance. For the proposed family, we introduced some mathematical reliability properties. The maximum likelihood estimators for the parameters of the new generalized-X distributions are derived. For assessing the performance of these estimators, a comprehensive Monte Carlo simulation study is carried out. To assess the efficiency of the proposed model, the new generalized-Weibull model is applied to the coating machine failure time data. Finally, Bayesian analysis and performance of Gibbs sampling for the coating machine failure time data are also carried out. Furthermore, the measures such as Gelman-Rubin, Geweke and Raftery-Lewis are used to track algorithm convergence.
Endotracheal intubation of COVID-19 patients by paramedics using a box barrier: A randomized crossover manikin study
Authors: Feldman Oren , Samuel Nir , Kvatinsky Noa , Idelman Ravit , Diamand Raz , Shavit Itai
Published: March 2021

Background

In the prehospital setting, endotracheal intubation (ETI) may be required to secure the coronavirus disease 2019 (COVID-19) patient airway. It has been suggested that the use of a protective barrier can reduce possible aerosol delivery from patients to clinicians during ETI. We sought to assess the performance of ETI by paramedics wearing personal protective equipment with and without the use of a box barrier.

Methods

A randomized, crossover simulation study was performed in a simulation laboratory. Study participants were 18 paramedics actively working in the clinical environment. Participants’ performance of ETI via direct laryngoscopy (DL) with and without the use of a box barrier was assessed. The sequence of intubation was randomized to either BoxDL-first or DL-first. The primary outcome was the success rate of ETI on first-attempt. The secondary and tertiary outcomes were ETI success rates on three attempts and total intubation time, respectively.

Results

There were no differences between the DL group and the BoxDL group in one-attempt success rates (14/18 vs 12/18; P = 0.754), and in overall success rates (16/18 vs 14/18; P = 0.682). The mean (standard deviation) of the total intubation times for the DL group and the BoxDL group were 27.3 (19.7) seconds and 36.8 (26.2) seconds, respectively (P < 0.015).

Conclusions

The findings of this pilot study suggest that paramedics wearing personal protective equipment can successfully perform ETI using a barrier box, but the intubation time may be prolonged. The applicability of these findings to the care of COVID-19 patients remain to be investigated.
Does social health insurance prevent financial hardship in Mongolia? Inpatient care: A case in point
Authors: Dorjdagva Javkhlanbayar , Batbaatar Enkhjargal , Svensson Mikael , Dorjsuren Bayarsaikhan , Togtmol Munkhsaikhan , Kauhanen Jussi
Published: March 2021

Background

Protecting people from financial hardship and impoverishment due to health care costs is one of the fundamental purposes of the Mongolian health system. However, the inefficient, oversized hospital sector is considered one of the main shortcomings of the system. The aim of this study is to contribute to policy discussions by estimating the extent of catastrophic health expenditure and impoverishment due to inpatient care at secondary-level and tertiary-level public hospitals and private hospitals.

Methods

Data were derived from a nationally representative survey, the Household Socio-Economic Survey 2012, conducted by the National Statistical Office of Mongolia. A total of 12,685 households were involved in the study. “Catastrophic health expenditure” is defined as out-of-pocket payments for inpatient care that exceed a threshold of 40% of households’ non-discretionary expenditure. The “impoverishment” effect of out-of-pocket payments for inpatient care was estimated as the difference between the poverty level before health care payments and the poverty level after these payments.

Results

At the threshold of 40% of capacity to pay, 0.31%, 0.07%, and 0.02% of Mongolian households suffered financially as a result of their member(s) staying in tertiary-level and secondary-level public hospitals and private hospitals respectively. About 0.13% of the total Mongolian population was impoverished owing to out-of-pocket payments for inpatient care at tertiary-level hospitals. Out-of-pocket payments for inpatient care at secondary-level hospitals and private hospitals were responsible for 0.10% and 0.09% respectively of the total population being pushed into poverty.

Conclusions

Although most inpatient care at public hospitals is covered by the social health insurance benefit package, patients who utilized inpatient care at tertiary-level public hospitals were more likely to push their households into financial hardship and poverty than the inpatients at private hospitals. Improving the hospital sector’s efficiency and financial protection for inpatients would be a crucial means of attaining universal health coverage in Mongolia.
Understanding how and why audits work in improving the quality of hospital care: A systematic realist review
Authors: Hut-Mossel Lisanne , Ahaus Kees , Welker Gera , Gans Rijk
Published: March 2021

Background

Several types of audits have been used to promote quality improvement (QI) in hospital care. However, in-depth studies into the mechanisms responsible for the effectiveness of audits in a given context is scarce. We sought to understand the mechanisms and contextual factors that determine why audits might, or might not, lead to improved quality of hospital care.

Methods

A realist review was conducted to systematically search and synthesise the literature on audits. Data from individual papers were synthesised by coding, iteratively testing and supplementing initial programme theories, and refining these theories into a set of context–mechanism–outcome configurations (CMOcs).

Results

From our synthesis of 85 papers, seven CMOcs were identified that explain how audits work: (1) externally initiated audits create QI awareness although their impact on improvement diminishes over time; (2) a sense of urgency felt by healthcare professionals triggers engagement with an audit; (3) champions are vital for an audit to be perceived by healthcare professionals as worth the effort; (4) bottom-up initiated audits are more likely to bring about sustained change; (5) knowledge-sharing within externally mandated audits triggers participation by healthcare professionals; (6) audit data support healthcare professionals in raising issues in their dialogues with those in leadership positions; and (7) audits legitimise the provision of feedback to colleagues, which flattens the perceived hierarchy and encourages constructive collaboration.

Conclusions

This realist review has identified seven CMOcs that should be taken into account when seeking to optimise the design and usage of audits. These CMOcs can provide policy makers and practice leaders with an adequate conceptual grounding to design contextually sensitive audits in diverse settings and advance the audit research agenda for various contexts.

PROSPERO registration

CRD42016039882.
Longitudinal associations between poor reading skills, bullying and victimization across the transition from elementary to middle school
Authors: Turunen Tiina , Poskiparta Elisa , Salmivalli Christina , Niemi Pekka , Lerkkanen Marja-Kristiina
Published: March 2021

Students with poor reading skills and reading difficulties (RDs) are at elevated risk for bullying involvement in elementary school, but it is not known whether they are at risk also later in adolescence. This study investigated the longitudinal interplay between reading skills (fluency and comprehension), victimization, and bullying across the transition from elementary to middle school, controlling for externalizing and internalizing problems. The sample consists of 1,824 students (47.3% girls, T1 mean age was 12 years 9 months) from 150 Grade 6 classrooms, whose reading fluency and comprehension, self-reported victimization and bullying, and self-reported externalizing and internalizing problems were measured in Grades 6, 7, and 9. Two cross-lagged panel models with three time-points were fitted to the data separately for reading fluency and comprehension. The results indicated that poorer fluency and comprehension skills in Grade 6 predicted bullying perpetration in Grade 7, and poorer fluency and comprehension skills in Grade 7 predicted bullying perpetration in Grade 9. Neither fluency nor comprehension were longitudinally associated with victimization. The effects of reading skills on bullying perpetration were relatively small and externalizing problems increased the risk for bullying others more than poor reading skills did. However, it is important that those who struggle with reading get academic support in school throughout their school years, and social support when needed.
Seroprevalence of COVID-19 infection in a rural district of South India: A population-based seroepidemiological study
Authors: Inbaraj Leeberk Raja , George Carolin Elizabeth , Chandrasingh Sindhulina
Published: March 2021

Objectives

We aimed to estimate the seroprevalence of COVID-19 in a rural district of South India, six months after the index case.

Methodology

We conducted a cross-sectional study of 509 adults aged more than 18 years. From all the four subdistricts, two grampanchayats (administrative cluster of 5–8 villages) were randomly selected followed by one village through convenience. The participants were invited for the study to the community-based study kiosk set up in all the eight villages through village health committees. We collected socio-demographic characteristics and symptoms using a mobile application-based questionnaire, and we tested samples for the presence of IgG antibodies for SARS CoV-2 using an electro chemiluminescent immunoassay. We calculated age-gender adjusted and test performance adjusted seroprevalence.

Results

The age-and gender-adjusted seroprevalence was 8.5% (95% CI 6.9%- 10.8%). The unadjusted seroprevalence among participants with hypertension and diabetes was 16.3% (95% CI:9.2–25.8) and 10.7% (95% CI: 5.5–18.3) respectively. When we adjusted for the test performance, the seroprevalence was 6.1% (95% CI 4.02–8.17). The study estimated 7 (95% CI 1:4.5–1:9) undetected infected individuals for every RT-PCR confirmed case. Infection Fatality Rate (IFR) was calculated as 12.38 per 10000 infections as on 22 October 2020. History of self-reported symptoms and education were significantly associated with positive status (p < 0.05)

Conclusion

A significant proportion of the rural population in a district of south India remains susceptible to COVID-19. A higher proportion of susceptible, relatively higher IFR and a poor tertiary healthcare network stress the importance of sustaining the public health measures and promoting early access to the vaccine are crucial to preserving the health of this population. Low population density, good housing, adequate ventilation, limited urbanisation combined with public, private and local health leadership are critical components of curbing future respiratory pandemics.
Using graphic modelling to identify modifiable mediators of the association between area-based deprivation at birth and offspring unemployment
Authors: Bogie James , Fleming Michael , Cullen Breda , Mackay Daniel , Pell Jill P.
Published: March 2021

Background

Deprivation can perpetuate across generations; however, the causative pathways are not well understood. Directed acyclic graphs (DAG) with mediation analysis can help elucidate and quantify complex pathways in order to identify modifiable factors at which to target interventions.

Methods and findings

We linked ten Scotland-wide databases (six health and four education) to produce a cohort of 217,226 pupils who attended Scottish schools between 2009 and 2013. The DAG comprised 23 potential mediators of the association between area deprivation at birth and subsequent offspring ‘not in education, employment or training’ status, covering maternal, antenatal, perinatal and child health, school engagement, and educational factors. Analyses were performed using modified g-computation. Deprivation at birth was associated with a 7.3% increase in offspring ‘not in education, employment or training’. The principal mediators of this association were smoking during pregnancy (natural indirect effect of 0·016, 95% CI 0·013, 0·019) and school absences (natural indirect effect of 0·021, 95% CI 0·018, 0·024), explaining 22% and 30% of the total effect respectively. The proportion of the association potentially eliminated by addressing these factors was 19% (controlled direct effect when set to non-smoker 0·058; 95% CI 0·053, 0·063) for smoking during pregnancy and 38% (controlled direct effect when set to no absences 0·043; 95% CI 0·037, 0·049) for school absences.

Conclusions

Combining a DAG with mediation analysis helped disentangle a complex public health problem and quantified the modifiable factors of maternal smoking and school absence that could be targeted for intervention. This study also demonstrates the general utility of DAGs in understanding complex public health problems.
Alan Turing-ek morfogenesiaren inguruan egindako ikerketaren analisi matematikoa
Authors: Apraiz Iza Jone , Marauri Bernedo Idoia
Published: March 2021

Artikulu honetan, Alan Turing matematikariak 1952an morfogenesiaren inguruan aurkeztu zuen The Chemical Basis of Morphogenesis, [19], lanaren zati bat aurkeztu eta matematikoki garatuko dugu. Horretarako, beharrezkoak diren matematikako kontzeptuak eta baliabideak azalduko ditugu. Konkretuki, Alan Turingek [19] artikuluko «Reactions and Diffusion in a Ring of Cells» (eraztun diskretuko eremua) eta «Continuous Ring of Tissue» (eraztun jarraituko eremua) ataletan gehiegi sakondu edo zehaztu gabe erabili zituen ekuazio diferentzialak, erreakzio-difusio ekuazioak, Fourieren serieak eta funtzioen linealizazioa azalduko ditugu, eta bi eremu horietan planteatutako ekuazio-sistemen soluzioak bilatzeko erabiliko ditugu. Artikulu hau UPV/EHUko Idoia Marauri ikasle ohiaren Gradu Amaierako Lanean oinarrituta dago.
A jövő intelligens technológiai és menedzsmentkérdései-avagy semmilyen szél nem jó annak, aki nem tudja milyen kikötőbe tart (Managerial questions of the future intelligent technologies, or there is no good wind for those who do not know which port they want to sail)
Authors: Duma László , Erdős Szilveszter
Published: March 2021

Az elmúlt évtizedek felgyorsult technológiai fejlődése komoly kihívásokat jelent mind a cégeknek, mind az egyéneknek. Intézményesített „jövőkezelésre” és ennek menedzselésére van szükség. A szerzők tanulmányukban át kívánják tekinteni a jövőkutatás, a technológiamenedzsment, az innovációmenedzsment és egyéb megközelítések releváns alapjait, viszonyait és lehetséges integrációjukat. Be kívánják mutatni a meghatározó területeket és trendeket. Keresik azokat a menedzsment-alapkérdéseket, tanulságokat és dilemmákat, amelyek minden olyan vállalatnak érdekesek és hasznosak lehetnek, amelyek a fejlődő technológia lehetőségeit szeretnék kiaknázni, vagy csak egyszerűen szeretnének a követhetetlenül gyors fejlődésben talpon maradni. _____________ The fast pace technology development creates a serious challenge both for individuals and for companies. There is a concept which attempts to handle this challenge by “institutional future management”. In their paper the authors survey the relevant concepts of future studies, technology management and other areas, and explore their connections and integration possibilities. They also would like to introduce some key technology trends, and at the same time some basic managerial questions, dilemmas, conclusions which might have importance to those corporations which have to survive in an environment determined by accelerated technology based innovation.
Continuing Medical Education Questions: April 2021
Authors: Kumar Anand Raman
Published: March 2021

Article Title: Endoscopy in Patients with Surgically Altered Anatomy
Cómo el sexo moldea la evolución del comportamiento: el caso de las preferencias en la reproducción humana
Authors:   Departamento de Psicología, Universidad Nacional de Colombia, Bogotá, Colombia, Moreno Naranjo Leonardo , Gutiérrez Germán ,   Departamento de Psicología, Universidad Nacional de Colombia, Bogotá, Colombia
Published: March 2021

La reproducción sexual es uno de los grandes hitos de la evolución de la vida en la Tierra; si bien pudo facilitar la generación de variabilidad genética, también impuso una serie de retos adaptativos en los organismos, tales como la búsqueda de parejas y las estrategias para asegurar la reproducción. La teoría de selección sexual ofrece hipótesis que permiten explicar cómo la búsqueda y la selección de parejas no son aleatorias o arbitrarias en los organismos complejos. Se plantea que existen unos criterios para seleccionar parejas reproductivas que se ven reflejados en mecanismos psicológicos denominados preferencias, las cuales pueden orientar la elección de parejas que tengan rasgos adaptativos y beneficiar o bien la supervivencia, o bien la reproducción futura de la descendencia que herede tales caracteres. El presente artículo aborda cómo las condiciones que impone la sexualidad moldean la evolución del comportamiento y cómo aquellos principios se aplican al emparejamiento humano. A partir de esto se plantean las principales preguntas que derivan de esta relación entre evolución, preferencias y selección de pareja.
Conhecimento, intelecto e memória na universidade parisiense: uma leitura tomasiana
Authors: Oliveira Terezinha
Published: March 2021

O objetivo deste artigo é estudar a relação existente entre o desenvolvimento intelectivo do sujeito e as ações por ele praticadas.
O ensino da filosofia no Brasil: um breve olhar sobre algumas das principais tendências no debate entre os anos de 1934 a 2008
Authors: Gelamo Rodrigo Pelloso
Published: March 2021

O propósito deste artigo é compreender o modo como o ensino da Filosofia é pensado na atualidade brasileira.
O embate do encontro: o currículo cultural da educação física como lugar de conflitos
Authors: Machado de Castro Silva Fidel , Nunes Mário
Published: March 2021

O embate do encontro: o currículo cultural da educação física como lugar de conflitos

Resumo: Neste artigo, tenciona-se aproximar, problematizar e refletir sobre a relação entre duas divindades gregas: Dionísio e Apolo - e o Currículo Cultural da Educação Física. Buscamos amparo metodológico na criação filosófico conceitual, pois sua utilização pode redesenhar relações estabelecidas e permitir jogar com elementos distintos e, inicialmente, não aproximáveis. Influenciados por Dionísio, ao final, trazemos duas criações pedagógicas a fim de transgredir os limites dados pelo "excesso de Apolo" na escrita acadêmica.Palavras-chave: Educação Física; Currículo Cultural; Filosofia.

The fight of the meeting: the curriculum of physical education as a place of conflicts 

Abstract: In this article, we intend to approximate the relationship between two Greek deities: Dionysus and Apollo - and the Cultural Curriculum of Physical Education. We seek methodological support in the conceptual philosophical creation, as its use can redesign established relationships and allow us to play with different and, initially, not approximable elements. Influenced by Dionísio, at the end, we bring two pedagogical creations in order to transgress the limits given by the "excess of Apollo" in academic writing.Keywords:  Physical Education; Cultural Curriculum; Philosophy.

La lucha de la reunión: el currículo cultural de la educación física como lugar de conflictos 

Resumén: En este artículo, tenemos la intención de aproximar la relación entre dos deidades griegas: Dioniso y Apolo, y el Currículo Cultural de Educación Física. Buscamos apoyo metodológico en la creación filosófica conceptual, ya que su uso puede rediseñar las relaciones establecidas y nos permite jugar con elementos diferentes e, inicialmente, no aproximables. Influenciado por Dionísio, al final, traemos dos creaciones pedagógicas para transgredir los límites dados por el "exceso de Apolo" en la escritura académica.Palabras clave: Educación Física; Curriculum Cultural; Filosofia

Data de registro: 02/03/2020Data de aceite: 05/08/2020
Remarks on the Structure of the Recherche de la Verité: The Role of Vision in God
Authors: Falcão Pricladnitzky Pedro
Published: March 2021

Remarks on the Structure of the Recherche de la Verité: The Role of Vision in God

Abstract: The present article will discuss the argumentative context in which Nicolas Malebranche presents the doctrine of the vision in God in his work, Recherche de la Verité. Malebranche is known for this doctrine about human cognition, and also for his occasionalistic view of causality, and such positions are only properly understood when put in the argumentative context designed by the author, which is not usually seen in commentaries. With this goal, we intend to look into the precise position of the vision of God in the Recherche and to identify the argument of the work as a whole. Thus, by seeing how the malebranchean theory of cognition fits in his philosophical project, we will be able to adequately reconstruct this important and influential philosophical doctrine of the seventeenth century.Keywords: Nicolas Malebranche. Recherche de la Verité. Vision in God.

Considerações sobre a Estrutura da Recherche de la Verité: O Papel da Visão em Deus

Resumo: No seguinte artigo abordamos o contexto argumentativo em que se insere a doutrina da visão em Deus de Nicolas Malebranche na sua obra, Recherche de la Verité. Ainda que Malebranche seja conhecido tanto por essa doutrina acerca da cognição humana, quanto pela sua visão ocasionalista da estrutura causal, tais posições só são adequadamente compreendidas quando as colocamos no contexto argumentativo projetado pelo autor, o que costumeiramente não é feito. Com isso, pretendemos situar a posição da visão em Deus na Recherche partindo, em um primeiro momento, da análise do fio condutor da obra. Desse modo, ao vislumbrarmos de que modo uma teoria da cognição se encaixa no projeto filosófico malebranchista, seremos capazes de reconstruir adequadamente essa importante e influente doutrina filosófica do século XVII.Palavras-chave: Nicolas Malebranche. Recherche de la Verité. Visão em Deus.

Remarques sur la Structure de la Recherche de la Verité: Le Rôle de la Vision em Dieu

Résumé: Dans l’article suivant, nous abordons le context argumentative dans lequel la doctrine de la vision en Dieu de Nicolas Malebranche est insérée dans la Recherche de la Verité. Bien que Malebranche soit connu à la fois pour cette doctrine de la cognition humaine et pour sa perspective ocasionelle de la structure causale, de tells positions ne sont correctement comprises que lorsque nous les plaçons dans le context argumentative conçu par l’auteur; ce qui n’est généralement pas fait. Avec cela, nous avons l’intention de situer la position de la vision en Dieu dans la Recherche comme fil conducteur de l’oeuvre. De cette façon, lorsque nous entrevoirons comment une théorie de la cognition s’intègre dans le projet philosophique malebranchiste, nous serons en conditions de reconstruire correctement cette important et influent doctrine philosophique du XVIIe siècle.Mots-clés: Malebranche. Recherche de la Verité. Vision em Dieu.

Data de registro: 04/05/2020Data de aceite: 26/08/2020
Eficácia no Ordenamento Jurídico Português da Declaração Universal dos Direitos do Homem
Authors: Rodrigues da Cunha Moreira Eduardo Henrique
Published: March 2021

Este trabalho visa analisar a eficácia da Declaração Universal dos Direitos do Homem (DUDH) no ordenamento jurídico português, abordando-se desde a posição doutrinária mais conservadora - que não atribui aos preceitos da DUDH a natureza de direitos constitucionais -, até a posição doutrinária mais liberal - que atribui à DUDH um valor supraconstitucional. Ao final, é exposta a posição do Tribunal Constitucional português, órgão que tem legitimidade no desenvolvimento do próprio direito constitucional, através da interpretação dada às normas da Constituição pelos juízes constitucionais.