bluuebunny/crossref_metadata_2025 huggingface dataset:
Poor consistency in evaluating South African adults with neurogenic dysphagia
Authors: Andrews Mckinley , Pillay Mershen
Published: January 2017

Background: Speech-language therapists are specifically trained in clinically evaluating swallowing in adults with acute stroke. Incidence of dysphagia following acute stroke is high in South Africa, and health implications can be fatal, making optimal management of this patient population crucial. However, despite training and guidelines for best practice in clinically evaluating swallowing in adults with acute stroke, there are low levels of consistency in these practice patterns.Objective: The aim was to explore the clinical practice activities of speech-language therapists in the clinical evaluation of swallowing in adults with acute stroke. Practice activities reviewed included the use and consistency of clinical components and resources utilised. Clinical components were the individual elements evaluated in the clinical evaluation of swallowing (e.g. lip seal, vocal quality, etc.)Methods: The questionnaire used in the study was replicated and adapted from a study increasing content- and criterion-related validity. A narrative literature review determined what practice patterns existed in the clinical evaluation of swallowing in adults. A pilot study was conducted to increase validity and reliability. Purposive sampling was used by sending a self-administered, electronic questionnaire to members of the South African Speech-Language-Hearing Association. Thirty-eight participants took part in the study. Descriptive statistics were used to analyse the data and the small qualitative component was subjected to textual analysis.Results: There was high frequency of use of 41% of the clinical components in more than 90% of participants (n = 38). Less than 50% of participants frequently assessed sensory function and gag reflex and used pulse oximetry, cervical auscultation and indirect laryngoscopy. Approximately a third of participants showed high (30.8%), moderate (35.9%) and poor (33.3%) consistency of practice each. Nurses, food and liquids and medical consumables were used usually and always by more than 90% of participants.Conclusion: Infrequent use of clinical components and high variability in clinical practice among speech-language therapists calls for uniform curricula in the clinical evaluation of swallowing at South African universities and for continued professional development post-graduation. Different contexts and patient symptoms contribute towards varied practice; however, there is still a need to improve consistency of practice for quality health care delivery. A research-based policy for the clinical swallowing evaluation for a resource-limited context is also needed.
Clinically relevant magnetic resonance imaging (MRI) findings in elite swimmers’ shoulders
Authors: Celliers Arno , Gebremariam Fekade , Joubert Gina , Mweli Thami , Sayanvala Husain , Holtzhausen Louis
Published: January 2017

Background: Shoulder pain is the most common and well-documented site of musculoskeletal pain in elite swimmers. Structural abnormalities on magnetic resonance imaging (MRI) of elite swimmers’ symptomatic shoulders are common. Little has been documented about the association between MRI findings in the asymptomatic shoulder versus the symptomatic shoulder.Objective: To assess clinically relevant MRI findings in the shoulders of symptomatic and asymptomatic elite swimmers.Method: Twenty (aged 16–23 years) elite swimmers completed questionnaires on their swimming training, pain and shoulder function. MRI of both shoulders (n = 40) were performed and all swimmers were given a standardised clinical shoulder examination. Results: Both shoulders of 11 male and 9 female elite swimmers (n = 40) were examined. Eleven of the 40 shoulders were clinically symptomatic and 29 were asymptomatic. The most common clinical finding in both the symptomatic and asymptomatic shoulders was impingement during internal rotation, with impingement in 54.5% of the symptomatic shoulders and in 31.0% of the asymptomatic shoulders. The most common MRI findings in the symptomatic and asymptomatic shoulders were supraspinatus tendinosis (45.5% vs. 20.7%), subacromial subdeltoid fluid (45.5% vs. 34.5%), increased signal in the AC Joint (45.5% vs. 37.9%) and AC joint arthrosis (36.4% vs. 34.5%). Thirty-nine (97.5%) of the shoulders showed abnormal MRI features.Conclusion: MRI findings in the symptomatic and asymptomatic shoulders of young elite swimmers are similar and care should be taken when reporting shoulder MRIs in these athletes. Asymptomatic shoulders demonstrate manifold MRI abnormalities that may be radiologically significant but appear not to be clinically significant.
Exploring the bio-behavioural link between stress, allostatic load & micronutrient status
Authors: Augustine Little Flower , Nair Krishnapillai Madhavan , Rao Sylvia Fernandez , Rao Mendu Vishnu Vardhana , Ravinder Punjal , Laxmaiah Avula
Published: January 2017

Background & objectives:

Allostatic load (AL) is a cumulative measure of physiological deregulation and is influenced by multiple factors including nutrition. The objectives of the study were to assess AL among adolescent boys (15-19 yr) and delineate its association with psychological stress and micronutrient status.

Methods:

A cross-sectional, school-based study was conducted among 370 adolescent boys of five higher secondary schools from Hyderabad, India. Perceived stress, adolescent life event stress (ALES), psychological morbidity and coping were measured. Biomarkers of AL included dehydroepiandrosterone sulphate, 12-h urinary cortisol, interleukin-6, C-reactive protein, lipid profile, body mass index and blood pressure. Micronutrient status with respect to iron (haemoglobin, ferritin, hepcidin, soluble transferrin receptor), folate, vitamins B12, C and A were analyzed in a sub-sample of 146 boys. AL score ≥3 was calculated from eight biomarkers.

Results:

Fourteen per cent participants had no AL but 34.3 per cent had AL score of ≥ 3. Unadjusted means of ALES scores were significantly different (P = 0.045) among participants with low [mean, 95% confidence interval (CI): 580, 531-629] and high (663, 605-721) AL. After controlling for confounders, the means were significantly different for controllable life event sub-scale of ALES (P = 0.048). Adjusted hepcidin concentrations were significantly higher among participants with high AL (means, 95% CI, 27.2, 24.0-30.8 for high AL; 22.1, 20.2-24.2 μg/l for low AL, P = 0.014).

Interpretation & conclusions:

Build-up of AL was found in adolescent boys and was positively associated with life event stress. Iron nutrition and stress exhibited a positive association through hepcidin. The study provides a link between iron nutrition, physiological deregulation and stress.
Natural menopause among women below 50 years in India
Authors: Pallikadavath Saseendran , Ogollah Reuben , Singh Abhishek , Dean Tara , Dewey Ann , Stones William
Published: January 2017

Background & objectives:

The age at which menopause naturally occurs may reflect nutritional and environmental circumstances as well as genetic factors. In this study we examined natural menopause as a marker of women's health at the population level in India and in some major States.

Methods:

Data from the Indian District Level Household Survey (DLHS) carried out during 2007-2008 covering 643,944 ever-married women aged 15-49 yr were used; women of older ages were not included in this survey. Since not all women in this age group had achieved natural menopause at the time of survey, Cox proportional hazard regression models were employed to obtain the median age of women reporting a natural menopause, excluding those who underwent hysterectomy. Hazard ratios (HRs) were estimated for key socio-economic and reproductive variables that could potentially affect the age at natural menopause <40 yr.

Results:

Overall, menopause prior to age 40 was reported by approximately 1.5 per cent of women. In the national data set, significant associations with age at natural menopause were identified with marriage breakdown or widowhood, poverty, Muslim religious affiliation, ‘scheduled caste’ status, not having received schooling, rural residence, having never used contraceptive pills, not been sterilized or had an abortion, low parity and residence in the western region. Within data from five selected States examined separately, the strength of these associations varied.

Interpretation & conclusions:

Associations of natural menopause with sociocultural, family planning and demographic variables were noted. Most importantly, there was an association with poverty that would require further investigation as to causality. The proportion of women experiencing early menopause may represent a useful overall indicator of women's health. The data are reassuring with regard to possible late effects of sterilization on ovarian function.
An audit of colistin use in neonatal sepsis from a tertiary care centre of a resource-limited country
Authors: Jasani Bonny , Kannan Sridharan , Nanavati Ruchi , Gogtay Nithya J. , Thatte Urmila
Published: January 2017

Background & objectives:

Sepsis due to multidrug-resistant Gram-negative pathogens is a challenge for clinicians and microbiologists and has led to use of parenteral colistin. There is a paucity of data regarding safety and efficacy of intravenous colistin use in neonates. The objective of this retrospective analysis was to study the efficacy and safety of intravenous colistin in the treatment of neonatal sepsis.

Methods:

An audit of the data from neonates, admitted to a neonatal intensive care unit of a tertiary care hospital during January 2012 to December 2012, and who received intravenous colistin was carried out.

Results:

Sixty two neonates received intravenous colistin (52 preterm and 10 term) for the treatment of pneumonia, bloodstream infections and meningitis. The isolated pathogens in decreasing order of frequency were Acinetobacter baumannii, Klebsiella pneumonia and Pseudomonas aeruginosa. Of the total 62 neonates, 41 (66.12%) survived and 21 (33.87%) died. Significantly higher mortality was observed in neonates with lower body weights (P < 0.05). A significant association of mortality was found in those with sepsis due to Klebsiella species. Only one of seven with this infection survived as against 15 of the 23 who grew other organisms [P = 0.03; crude odds ratio = 11.25 (1.2, 110.5)]. None of the neonates developed neurotoxicity or nephrotoxicity.

Interpretation & conclusions:

This retrospective study in neonates with sepsis showed that intravenous colistin was safe and effective in the treatment of neonatal sepsis. Further, well–controlled, prospective clinical trials need to be done to corroborate these findings.
Tropospheric water vapour isotopologue data (H216O, H218O, and HD16O) as obtained from NDACC/FTIR solar absorption spectra
Authors: Barthlott Sabine , Schneider Matthias , Hase Frank , Blumenstock Thomas , Kiel Matthäus , Dubravica Darko , García Omaira E. , Sepúlveda Eliezer , Mengistu Tsidu Gizaw , Takele Kenea Samuel , Grutter Michel , Plaza-Medina Eddy F. , Stremme Wolfgang , Strong Kim , Weaver Dan , Palm Mathias , Warneke Thorsten , Notholt Justus , Mahieu Emmanuel , Servais Christian , Jones Nicholas , Griffith David W. T. , Smale Dan , Robinson John
Published: January 2017

Abstract. We report on the ground-based FTIR (Fourier transform infrared) tropospheric water vapour isotopologue remote sensing data that have been recently made available via the database of NDACC (Network for the Detection of Atmospheric Composition Change; ftp://ftp.cpc.ncep.noaa.gov/ndacc/MUSICA/) and via doi:10.5281/zenodo.48902. Currently, data are available for 12 globally distributed stations. They have been centrally retrieved and quality-filtered in the framework of the MUSICA project (MUlti-platform remote Sensing of Isotopologues for investigating the Cycle of Atmospheric water). We explain particularities of retrieving the water vapour isotopologue state (vertical distribution of H216O, H218O, and HD16O) and reveal the need for a new metadata template for archiving FTIR isotopologue data. We describe the format of different data components and give recommendations for correct data usage. Data are provided as two data types. The first type is best-suited for tropospheric water vapour distribution studies disregarding different isotopologues (comparison with radiosonde data, analyses of water vapour variability and trends, etc.). The second type is needed for analysing moisture pathways by means of H2O, δD-pair distributions.
A BRDF–BPDF database for the analysis of Earth target reflectances
Authors: Breon Francois-Marie , Maignan Fabienne
Published: January 2017

Abstract. Land surface reflectance is not isotropic. It varies with the observation geometry that is defined by the sun, view zenith angles, and the relative azimuth. In addition, the reflectance is linearly polarized. The reflectance anisotropy is quantified by the bidirectional reflectance distribution function (BRDF), while its polarization properties are defined by the bidirectional polarization distribution function (BPDF). The POLDER radiometer that flew onboard the PARASOL microsatellite remains the only space instrument that measured numerous samples of the BRDF and BPDF of Earth targets. Here, we describe a database of representative BRDFs and BPDFs derived from the POLDER measurements. From the huge number of data acquired by the spaceborne instrument over a period of 7 years, we selected a set of targets with high-quality observations. The selection aimed for a large number of observations, free of significant cloud or aerosol contamination, acquired in diverse observation geometries with a focus on the backscatter direction that shows the specific hot spot signature. The targets are sorted according to the 16-class International Geosphere-Biosphere Programme (IGBP) land cover classification system, and the target selection aims at a spatial representativeness within the class. The database thus provides a set of high-quality BRDF and BPDF samples that can be used to assess the typical variability of natural surface reflectances or to evaluate models. It is available freely from the PANGAEA website (doi:10.1594/PANGAEA.864090). In addition to the database, we provide a visualization and analysis tool based on the Interactive Data Language (IDL). It allows an interactive analysis of the measurements and a comparison against various BRDF and BPDF analytical models. The present paper describes the input data, the selection principles, the database format, and the analysis tool
The compact Earth system model OSCAR v2.2: description and first results
Authors: Gasser Thomas , Ciais Philippe , Boucher Olivier , Quilcaille Yann , Tortora Maxime , Bopp Laurent , Hauglustaine Didier
Published: January 2017

Abstract. This paper provides a comprehensive description of OSCAR v2.2, a simple Earth system model. The general philosophy of development is first explained, followed by a complete description of the model's drivers and various modules. All components of the Earth system necessary to simulate future climate change are represented in the model: the oceanic and terrestrial carbon cycles – including a book-keeping module to endogenously estimate land-use change emissions – so as to simulate the change in atmospheric carbon dioxide; the tropospheric chemistry and the natural wetlands, to simulate that of methane; the stratospheric chemistry, for nitrous oxide; 37 halogenated compounds; changing tropospheric and stratospheric ozone; the direct and indirect effects of aerosols; changes in surface albedo caused by black carbon deposition on snow and land-cover change; and the global and regional response of climate – in terms of temperature and precipitation – to all these climate forcers. Following the probabilistic framework of the model, an ensemble of simulations is made over the historical period (1750–2010). We show that the model performs well in reproducing observed past changes in the Earth system such as increased atmospheric concentration of greenhouse gases or increased global mean surface temperature.
Merginų žinios apie soliariume skleidžiamos ultravioletinės spinduliuotės poveikį sveikatai bei deginimosi elgsena
Authors: Kirvaitienė Jolita , Maželienė Žaneta , Barragan Ferrer Diana , Vaičiulevičienė Albina
Published: January 2017

Pasaulio sveikatos organizacijos (PSO) duomenimis,
pasaulyje kasmet nustatoma apie 132 000 piktybinės
melanomos atvejų, o atliktų mokslinių tyrimų,
susijusių su dirbtinės ultravioletinės spinduliuotės
(UV) poveikiu sveikatai, išvados priskyrė ultravioletinių
spindulių šaltinius prie didžiausios vėžio
pavojaus kategorijos kartu su alkoholiu, cigaretėmis
ir asbestu. Neatsakinga elgsena naudojantis soliariumų
teikiamomis paslaugomis jauname amžiuje gali
sąlygoti odos nudegimus, priešlaikinį odos senėjimą,
akių pažeidimus, imuninės sistemos susilpnėjimą,
odos ir akių melanomą, o informuotumas apie
ultravioletinės spinduliuotės poveikį sveikatai susijęs
su saugia jaunų merginų deginimosi soliariume
elgsena, todėl mūsų tyrimo tikslas – įvertinti Kauno
kolegijos Medicinos fakulteto merginų žinias apie
ultravioletinės spinduliuotės poveikį sveikatai ir deginimosi
soliariume elgseną. Anketinėje apklausoje
dalyvavo 562 Kauno kolegijos Medicinos fakulteto
studentės. Analizuojant apklausos duomenis nustatyta,
kad soliariumo paslaugomis bent kartą per mėnesį
ir dažniau naudojosi ketvirtadalis Kauno kolegijos
Medicinos fakulteto merginų, gyvenančių bei
besimokančių didmiestyje, didžiosios dalies respondenčių
deginimosi soliariume vieno seanso trukmė
- vidutiniškai iki 10 min. Dažniau deginosi ir naudojosi
soliariumo siūlomomis akcijomis ir abonentais
merginos, pradėjusios soliariumų paslaugomis
naudotis iki 18 metų amžiaus. Dauguma respondenčių
žinojo, kad soliariume skleidžiama ultravioletinė
spinduliuotė veikia jų sveikatą. Naudojimasis soliariumų
teikiamos nuolaidomis bei akcijomis buvo
susijęs su įvaizdžiu. Vėliau pradėjusių naudotis soliariumų
teikiamomis paslaugomis merginų elgsena
buvo saugesnė: jos dažniau rinkosi deginimosi trukmę
atsižvelgiant į odos tipą, jautrumą, soliariumo
gamintojo rekomendacijas ir dažniau dengė randus,
tatuiruotas kūno vietas. Dauguma merginų, kurios
stengėsi laikytis deginimosi soliariume taisyklių
(rekomendacijų), deginantis dėjosi apsauginius akinius,
pažymėtus CE ženklu.
Profesinis stresas ir jo poveikis mokytojų sveikatai: kiekybinės apklausos duomenys
Authors: Bubelienė Daiva , Merkys Gediminas
Published: January 2017

Straipsnis skirtas atskleisti sąryšius tarp pedagogų
profesinio streso ir dirbančių pedagogų sveikatos
būklės. Studijos teorinė koncepcija remiasi darbine
hipoteze, kad pedagogo profesija pasižymi padidėjusiu
stresu, dideliu psichiniu krūviu ir tai ilgainiui
neigiamai paveikia dirbančių pedagogų sveikatos
būklę. Pristatomi Lietuvos pedagogų (N=961) kiekybinės
apklausos duomenys. Profesiniam stresui
matuoti panaudoti 25 pirminiai kintamieji, atspindintys
įvairius darbinius stresorius. Iš pirminių kintamųjų
sudarytos 8 poskalės ir jungtinė skalė, pasižyminčios
tinkama psichometrine kokybe. Pedagogų
sveikatos būklei vertinti taikyta subjektyvaus
savijautos įsivertinimo skalė, susidedanti iš 19-kos
klinikinių simptomų ir pasižyminti tinkama psichometrine
kokybe. Maždaug kas trečias mokytojas
(32,65 proc.) kenčia nuo padidėjusio profesinio
streso ir maždaug kas ketvirtam mokytojui (29,03
proc.) sistemingai pasireiškia konkretūs klinikiniai
simptomai. Tarp jungtinių „profesinio streso“ ir
„klinikinių simptomų“ skalių egzistuoja vidutinio
stiprumo labai patikimas koreliacinis ryšys (r =0,50;
p=0,000). Naudojant diskriminacinę analizę buvo
ieškoma, kurie klinikiniai simptomai leidžia visų
geriausiai atskirti (diskriminuoti) pedagogų grupes,
pasižyminčias sąlygiškai aukštu ir žemu stresuotumu.
Paaiškėjo, kad dvi kontrastinės grupės skiriasi
pagal visus 19-ka klinikinių simptomų. Visų geriausiai
minėtas kontrastines pedagogų grupes skiria
psichinę sveikatą ir psichinį išsekimą atspindintys
simptomai.
Studentų mitybos įpročių analizė
Authors: Senikienė Žibuoklė , Lukoševičius Augustas , Jurkštienė Vilma , Šimonienė-Kazlauskienė Genovaitė , Gintilienė Milda
Published: January 2017

Visuomenė vis labiau domisi mityba, jos poveikiu sveikatai. Sveika mityba padeda saugoti ir stiprinti sveikatą, išvengti daugelio ligų. Vien sveikas maistas negarantuoja, kad sveikata bus gera, tačiau suteikia galimybę ją saugoti ir stiprinti. Sveikata, darbingumas, grožis labai priklauso nuo paties žmogaus pastangų. O sveika, visavertė mityba daro teigiamą poveikį žmogaus fiziniam ir protiniam vystymuisi, darbingumui bei ilgaamžiškumui. Sveika mityba yra sveikatos pagrindas. Žmogus turi maitintis atsižvelgiant į maisto racioną. Maisto racionas - tai baltymų, riebalų, angliavandenių, vitaminų, mineralinių medžiagų bei vandens kiekis, kurį žmogus turi gauti per parą. Nuo pat kūdikystės žmogus yra susijęs su mityba ir tai yra viena svarbiausių aplinkos sąlygų, veikiančių organizmą. Sveikos mitybos įpročiai formuojasi ankstyvame amžiuje, todėl aktualu analizuoti tiek mokinių, tiek studentų mitybos ypatumus. Metodai. Tyrime dalyvavo 396 18-25metų jaunuoliai, iš kurių 168 (42,42 proc.) buvo vyrai ir 228 (57,58 proc.) moterys. 114 (28,8 proc.) visų apklaustųjų mokosi Lietuvos sveikatos mokslų universitete (LSMU), 70 (17,7 proc.) Kauno technologijų universitete (KTU), 76 (19,2 proc.) Kauno kolegijoje (KK), 86 (21,7 proc.) Lietuvos sporto universitete (LSU), o likę 50 (12,6 proc.) jaunuolių dirba ir šiuo metu niekur nesimoko. Didžioji dalis apklaustųjų merginų (33,3 proc.) mokosi LSMU, jos sudaro 19,2 proc. visų respondentų. Daugiausia apklaustų vaikinų studijuoja LSU (25,0 proc.), jie sudaro 10,6 proc. visų respondentų. Vaikinų ir merginų pasiskirstymas tarp universitetų yra statistiškai reikšmingas (p=0,005). Statistinė analizė atlikta naudojant SPSS (Statistical Package for the Social Science) programinį statistinės analizės paketą. Rezultatai. Respondentai suskaičiavo savo racioną pagal 24 valandų apklausos metodiką, naudojantis mitybos tyrimo atlasu, užrašant duomenis apie maisto produktus, suvartotus per praėjusią parą (baltymai, angliavandeniai, riebalai). Maisto racioną sudarė – baltymai - 14,22 proc., riebalai – 41,25 proc., angliavandeniai – 38,16 proc.; vaikinai vidutiniškai suvartojo 2914 kcal , merginos – 2100 kcal. Respondentų atsakymai rodo, kad dauguma merginų (56,2 proc.) daržoves valgo kiekvieną dieną, vaikinai pagal statistinį vidurkį mažiau - 43,38 proc. Kasdien saldumynus vartoja 75 proc. apklaustųjų, 2-3 kartus per savaitę – 17 proc. respondentų, išvis stengiasi nevartoti 8 proc. studentų. Energetinius gėrimus vartoja 62,37 proc. 18 – 25 metų jaunuolių, o 10,6 proc. juos vartoja reguliariai. Tai rodo didelį šių gėrimų populiarumą, kadangi daugiau kaip pusė jauno amžiaus žmonių yra išbandę šių gėrimų poveikį. Baltymų suvartojimas atitinka normą, riebalų sunaudojama per daug, angliavandenių suvartojama per mažai. Suvartojamų kilokalorijų kiekis atitinka norminius reikalavimus.
15-19 metų amžiaus paauglių gyvensena ir sveikata: dienos režimo ypatumai
Authors: Strazdienė Neringa , Strukčinskienė Birutė , Norkienė Sigutė
Published: January 2017

Vaikų ir paauglių dienos režimas yra svarbus sveikatos
veiksnys intensyvaus brendimo ir mokymosi
mokykloje laikotarpiu. Gebėjimas teisingai pasirinkti
veiklos ir poilsio kaitos būdus sąlygoja vaikų
ir paauglių protinį darbingumą ir sveikatą. Paaugliai
dažnai vis dar nesugeba tinkamai apskaičiuoti savo
jėgų, galimybių ir laiko, o tai susiję su neįsisąmoninta
dienotvarkės svarba.
Tyrimo tikslas buvo analizuoti 15-19 metų amžiaus
paauglių gyvenseną ir sveikatą, pagrindinį dėmesį
skiriant dienos režimo ypatumams. Tyrimo metu atlikta
apklausa raštu. Tirti Vakarų Lietuvos regiono
devynių bendrojo ugdymo mokyklų 410 mokinių.
Tiriamųjų amžius - 15-19 metų.
Tyrimo rezultatai parodė, kad kasdien tinkamo dienos
režimo laikosi kas dešimtas 15-19 metų amžiaus
paauglys. Dienotvarkės laikymasis berniukų
ir mergaičių grupėse statistiškai nesiskiria. Kasdien
pusryčiauja apie pusė paauglių. Dauguma paauglių
ruošia pamokas nepailsėję. Mažiau negu pusė berniukų
ir apie pusė mergaičių namų darbus ruošia ne
ką tik grįžę iš mokyklos, bet pavalgę pietus ir pailsėję
po pamokų mokykloje. Mergaitės laikosi tinkamesnio
dienos režimo, negu berniukai. Mažiau negu
penktadalis mergaičių ir penktadalis berniukų darbo
dienomis miegojo bent 8 val. per parą. Mokslininkų
siūlomų miego rekomendacijų (9-10 val. miego
per parą) laikėsi tik dešimtadalis 15-19 metų amžiaus
berniukų ir dar mažiau mergaičių. Savaitgaliais
9 ir daugiau valandų per parą miegojo arti pusės
tirtų mergaičių ir berniukų. Tyrimas parodė, kad
paaugliai per mažai ilsisi, eina per vėlai miegoti ir
per mažai miega darbo dienomis. Ne visi paaugliai
pusryčiauja ir daugumos jų dienos režimas yra netinkamas.
Changes In Mortality Trends Of Road Traffic Injuries In Lithuania Over 1971-2014
Authors: Strukčinskienė Birutė , Bauer Robert , Strukčinskaitė Vaiva , Norkienė Sigutė
Published: January 2017

The goal of this study was to analyze the changes in
mortality trends of road traffic injuries for the whole
population in transitional Lithuania over 1971
to 2014. Special attention was paid to the potential
effect of the activities at macro and micro-level, and
the socio-economic changes after the Independence
in 1991. The data were derived from the Department
of Statistics for the Government of the Republic
of Lithuania, the Archives of Health Information
Centre, and the Institute of Hygiene in Lithuania.
The numbers have been based on the International
Classification of Diseases (ICD) of the World
Health Organization (WHO). Trends were estimated
by the use of logarithmic regression. During the
study, trends before the Independence in 1991 and
after the Independence were compared.
The study revealed that during the 44-year study period,
a total of 38,982 people died from road traffic
injuries in Lithuania. Men deceased 3.2 times more
than that of women. About 40% of those killed in
road traffic crashes were pedestrians. The mortality
rates of road traffic injuries showed no significant
change over the pre-independence period (1971-
1991) for the whole group. However, during the
post-independence period (1992-2014), the mortality
rates of road traffic injuries in the country significantly
decreased for the whole population. Before
the Independence (1971-1991), no change was
presented nor in men and nor in women subgroups,
whereas after the Independence (1992-2014), road
traffic injury deaths fell significantly in both sexes.
In addition, over the post-independence period, a
significant decrease in pedestrian mortality trends
for the whole population, and in men and women
subgroups was observed. The study confirmed that
sustainable preventive measures at macro and micro
levels had possible impact on fatal road traffic injuries
in the country. Socioeconomic changes, political
reforms, education activities, safe environment
creation, legislation, and improved healthcare seem
to have contributed to the significant decrease of
fatal road traffic injuries in transitional Lithuania.
Continuous and permanent injury prevention and
road safety promotion work is recommended for
road safety management.
Kaklo atpalaidavimo ir akių mankštos poveikis regėjimui
Authors: Miklius Tomas , Razbadauskas Artūras , Sučylaitė Jūratė
Published: January 2017

Tyrimas atliktas 2016 m. sausio – balandžio mėnesiais. Tyrime dalyvavo 90 atrinktų asmenų, turinčių toliaregystę (45 asmenys) ir trumparegystę (45 asmenys). Tiriamųjų atrankos ir regėjimo atstatymo programos efektyvumo vertinimo tikslais naudotos regėjimo aštrumo vertinimo (Sneleno) ir teksto skaitymo lentelės. Jei, vertinant Sneleno lentele, regos aštrumas buvo mažesnis už 1,0, buvo nustatomas trumparegystės sutrikimas. Jei teksto skaitymo lentelėje perskaitomas šriftas buvo didesnis už 12, buvo nustatomas toliaregystės sutrikimas. Visi tiriamieji buvo suskirstyti į tris grupes. I grupės tiriamieji: trumparegiai (n=15) ir toliaregiai (n=15) - 10 dienų atliko akių pratimus, II grupės tiriamiesiems: trumparegiams (n=15) ir toliaregiams (n=15) - 10 dienų taikyta postizometrinė relaksacija, III grupės tiriamiesiems: trumparegiams (n=15) ir toliaregiams (n=15) - 10 dienų taikyta postizometrinė relaksacija kartu su akių pratimais. Regėjimo atstatymo programa taikyta kasdien, iš viso 10 dienų. Taikytas statistinis duomenų apdorojimas. Tyrimas atliktas laikantis etikos principų. Tyrimo rezultatai parodė, kad toliaregių ir trumparegių rega pagerėjo, taikant visas metodikas. Atliekant postizometrinę relaksaciją kartu su akių pratimais, toliaregių ir trumparegių grupėse statistiškai reikšmingai pagerėjo regėjimas. Kaklo ir pečių juostos postizometrinė relaksacija efektyviai gerina trumparegių regėjimą. Postizometrinės relaksacijos kartu su akių pratimais ir atskirai postizometrinės relaksacijos poveikis regėjimui statistiškai nesiskiria (p=0.589, p>0.05). Akių pratimai turėjo teigiamą, bet statistiškai nereikšmingą poveikį toliaregių ir trumparegių regėjimui (p>0,05).
Naujojo antikoagulianto – dabigatrano – saugumas ir efektyvumas taikant elektrinę kardioversiją
Authors: Šerpytis Pranas , Palšauskaitė Rasa , Navickas Giedrius , Tamošiūnas Tomas , Šerpytis Rokas , Skromovas Viktoras , Kačiūrinas Dimitrijus , Butkutė Eglė
Published: January 2017

Prieširdžių virpėjimas (PV) – tai dažniausiai pasitaikantis
širdies ritmo sutrikimas. Vienas iš PV gydymo
būdų – elektrinė kardioversija. Ši procedūra
padidina trombembolijų riziką, todėl pacientai 3 savaites
prieš ir 4 savaites po kardioversijos turi vartoti
antikoaguliantus.
Tyrimo tikslas - įvertinti naujojo antikoagulianto –
dabigatrano – saugumą taikant elektrinę kardioversiją
pacientams su PV.
Atliktas prospektyvinis tyrimas, išanalizuoti 424
pacientų duomenys. Tiriamieji buvo suskirstyti į dvi
grupes: I grupė (n=204) – tiriamieji, kurie prieš kardioversiją
vartojo varfariną ir 3 savaites INR (TNS)
buvo palaikomas 2-3 intervale; II grupė (n=210)
– tiriamieji, kuriems 21 dieną prieš kardioversiją
buvo skiriamas dabigatranas (150 mg du kartus
per dieną). Tiriamiesiems, vartojusiems dabigatraną,
prieš kardioversiją buvo atlikta transezofaginė
echokardiografija.
Tyrimo rezultatai - transezofaginės echokardiografijos
metu intrakardinių trombų II gr. tiriamiesiems
nerasta. Sinusinis ritmas buvo atstatytas 189
(92,6%) tiriamiesiems, vartojusiems varfariną, ir
205 (97,6%) tiriamiesiems, vartojusiems dabigatraną.
Abiejose grupėse nebuvo nustatyta trombembolinių
komplikacijų ir kraujavimo.
Išvados - dabigatrano vartojimas prieš elektrinę kardioversiją
yra patikimas ir saugus metodas. Transezofaginė
echokardiografija nėra indukuotina pacientams,
vartojantiems dabigatraną.
Veidrodžio terapijos reikšmė motorinei bei sensorinei funkcijai, skausminiam sindromui bei asocijuotos galvos smegenų žievės reorganizacijai po persirgto insulto
Authors: Žilionytė Monika , Savickaitė Jurgita , Kederys Andrius , Varžaitytė Lina
Published: January 2017

Tyrimo tikslas – apžvelgti patikimais įrodymais
pagrįstą literatūrą apie veidrodinės terapijos (VT)
efektyvumą pacientams, persirgusiems galvos smegenų
insultu.
Tyrimo medžiaga ir metodai. Atliekant sisteminę
apžvalgą, mokslinių straipsnių paieška vykdyta
duomenų bazėse: PubMed, BioMedCentral,
Tylor&Francis, CohraneLibrary, ScienceDirect.
Mokslinių straipsnių paieška atlikta pagal kiekvienai
duomenų bazei pritaikytą specialią paieškos
strategiją. Paieškai buvo panaudoti šie raktažodžiai:
„mirror therapy“, „rehabilitation“, „stroke“,
„upper limb“, „recovery of function“, „mirror
movement“, „phantom limb pain „, „mirror visual
feedback“, „mirror neurons system“. Į sisteminę
apžvalgą įtraukti anglų kalba 2008–2016 metais
publikuoti atsitiktinių imčių kontroliuojami arba
kontroliuojami prieš ir po tyrimai, kuriuose buvo
vertinama VT įtaka paralyžiuotos galūnės motorinei
ir sensorinei funkcijai, skausmo intensyvumui bei
asocijuotos galvos smegenų žievės reorganizacijai.
Tyrimo rezultatai. Į sisteminę apžvalgą įtraukta 11
tyrimų. Tyrimuose buvo suformuotos dvi grupės: tiriamųjų,
kuriems buvo taikyta standartinė bei VT, ir
kontrolinė grupė, kuriai buvo taikoma tik standartinė
terapija. Daugelyje tyrimų VT taikyta vieną mėnesį.
Rezultatai buvo vertinami prieš taikytą terapiją
ir po jos. Apžvelgus visus šiuos 11 straipsnių stebime,
kad tose tiriamųjų grupėse, kuriose naudojama VT, ženkliai pagerėja pacientų paralyžiuotos galūnės
motorinė funkcija, padidėja vikrumas, sumažėja
skausmas.
Išvados. VT didina smegenų aktyvumą ipsilateralinėje
motorinėje žievėje, somatosensorinėje zonoje,
skatina asocijuotos žievės reorganizaciją, taip pat ji
padeda pasiekti geresnių rezultatų pacientams, patyrusiems
nedominuojančio pusrutulio insultą, sumažina
persirgus insultu atsiradusį skausmą bei padidina
po insulto sumažėjusį galūnių vikrumą. VT yra
veiksminga ne tik gydant ūmiu ir poūmiu insultu,
tačiau ir lėtiniu galvos smegenų insultu sergančius
pacientus.
Slaugytojų darbo aplinkos rizikos veiksnių ir pasitenkinimo gyvenimo kokybe sąsajos
Authors: Jonikaitė Raimonda , Brasaitė Indrė
Published: January 2017

Slaugytojai savo darbe susiduria su neigiamą įtaką
jų sveikatai, darbingumui ir fizinei būklei darančiais
veiksniais: dideliu fizinio darbu krūviu, budėjimu
naktimis, psichologiniu smurtu, organizaciniais
darbų trūkumais, darbo pareigų stresoriais. Nuo
šių veiksnių priklauso pasitenkinimas gyvenimu ir
darbu, kurie lemia kokybišką pacientų priežiūrą bei
saugą, darbuotojų išsaugojimą organizacijoje ir jų
įsipareigojimą organizacijai bei profesijai.
Tiriamąją imtį sudarė 69 intensyvios terapijos ir chirurgijos
skyrių slaugytojai, dirbantys Klaipėdos ligoninėse.
Tyrimas atliktas laikantis etikos principų.
Atliktas kiekybinis tyrimas. Apklausai naudotas Pasitenkinimo
gyvenimu klausimynas – trumpa forma.
Gauti duomenys apdoroti SPSS programa (22
versija).
Tyrimo rezultatai parodė, kad dažniausi slaugytojų
darbo aplinkos rizikos veiksniai yra intensyvus
darbas ir pacientų kėlimas rankomis. Slaugytojai
savo pasitenkinimą gyvenimu įvertino geriau nei
vidutiniškai. Vertinimo vidurkis buvo 66,8 proc.
balų iš 100 proc. maksimaliai galimų. Gauti tyrimo
rezultatai parodė, kad slaugytojų, kuriems dažniau
tenka kelti pacientus rankomis, pasitenkinimas
gyvenimu yra prastesnis.
Chaucer's Poetics and Purposes in the Legend of Good Women
Authors: Collette Carolyn P.
Published: January 2017

Reading the Legend of Good Women within the context of Chaucer's other poetry, this article addresses the difficulties modern readers encounter with the tone and style of the Legend by a close reading of Chaucer's multiple registers of speech, his mixing of French and English vocabulary and his poetic choices of phrasing, narrative pace, and rhythm. It argues that the Legend is not an outlier in the canon of Chaucer's poetry, but closely related to Anelida and Arcite as well as Troilus and Criseyde. It reads the supposed awkwardness of the language and the compressed, seemingly rushed portions in several narratives as reflections of Chaucer's larger project to transform exemplary narratives purportedly about women's fidelity in love into stories examining a wider variety of social interactions that contribute to or undermine the creation of social harmony, stories in which women's desires and choices are often central.
“Pite renneth soone in gentil herte”: Ugly Feelings and Gendered Conduct in Chaucer's Legend of Good Women
Authors: Burger Glenn
Published: January 2017

This article reads the Legend of Good Women alongside two late-fourteenth-century conduct texts for women, the Livre du Chevalier de La Tour Landry and the Ménagier de Paris. It argues that the dysphoric emotional states felt by the Legend's women not only make erotic love illegible as an ennobling emotional experience, but also embody disturbing states of obstructed agency that threaten to undo established affective relations between the aesthetics of love and the social. In contrast, contemporary conduct texts for women construct emotion in ideologically satisfying ways by writing women good in their roles as wives and household managers, thereby providing a clearly legible alternative to fin' amor and its definitions of noble subjectivity.
The Thought and Feel of Virtuous Wifehood: Recovering Emotion in the Legend of Good Women
Authors: Shutters Lynn
Published: January 2017

Despite studies arguing for an ironic or sincere depiction of loving women in the Legend of Good Women, scholars have not yet sufficiently examined the cognitive, affective, and performative processes that constitute love in either the poem itself or its late medieval cultural context. Adopting formalist methodologies, this article identifies Chaucer's Legend as an important document in the recovery of late medieval formulations of marital affection, particularly as they relate to women. Chaucer's Legend suggests that marital affection was a contentious emotion in the later Middle Ages subject to multiple, competing formulations. Because marital love was an emotion in progress, the Legend presents love as both an ethical injunction and an epistemological quandary in which the stakes for women are especially high.
United Service in Divisive Times: The Pittsburgh Council of Churches, 1916–1929
Authors: Flynn Tyler B.
Published: January 2017

Despite the disruption of the Great Steel Strike of 1919 and the fundamentalist-modernist controversy of the 1920s, the Pittsburgh Council of Churches managed to hold together a fragile coalition for the cause of social betterment in the Steel City. Their noteworthy service record reveals a Protestant establishment eager to appear strong in the face of mounting criticism of indifference as well as a sincere desire to do good.
Prevalence of CTX-M beta-Lactamases in Escherichia coli from community-acquired urinary tract infections and associated risk factors among women in Cameroon
Authors: Djuikoue Ingrid Cecile , Njajou Omer , Kamga Hortense Gonsu , Fokunang Charles , Bongoe Adamo , Bruno Ela Ondo , Tadjoung Paulin , Linjouom Abdou Aziz , Kakam Caroline , Ngogang Jeanne
Published: January 2017

Background: In recent years, a worldwide dissemination of CTX-M beta-lactamase-type in Escherichia coli strains isolates from community-acquired urinary tract infections (CA-UTI) has been observed. However little is known on the prevalence and risk factors of this global threat in developing countries. Objective: The aim of this study was to study the prevalence and risk factors for CA-UTI in Yaoundé, Cameroon. Methods: Eighty six patients with urinary E.coli infection recruited from 10 health structures in the town of Yaoundé, Cameroon. After taking the first urine, faeces were collected from the patients for the study of the intestinal flora. The sample collection of faeces was done on a selected gel of enterobacteria resistant to third generation of cephalosporin. The molecular typing of extended-spectrum -lactamase (ESBL) was carried out. Results: Eighty-six strains of E. coli from 86 patients were included. We found that 39 (45.3%) strains produced an extendedspectrum beta-lactamase. Among risk factors, previous use of antibiotic and the dry season were associated with the presence of an ESBL-producing strain in the urine. All ESBL were identified as CTX-M. The production of CTX-M was found to be significantly associated with resistance to fluoroquinolones, aminoglycosides and to the association of trimethoprim-sulfamethazole. Conclusions: The prevalence of CTX-M ESBL in Yaoundé, Cameroon, provides new evidence on the global dissemination of CTX-M and the extent of this phenomenon in developing countries.
Inappropriate admissions or inadequate discharges of frail elderly: Competing program theories and implementation challenges in an intermediate care intervention
Authors: Nørgaard Birgitte , Skjøt-Arkil Helene , Nissen Nina , Mogensen Christian Backer
Published: January 2017

Intermediate care interventions are increasingly being implemented in the health services to avoid hospitalizing elderly frail patients with complex medical issues, often referred to as inappropriate or unwarranted admissions. This paper presents a theory-based stakeholder evaluation of an intervention involving hospitals, community care and general practitioners (GPs) in a Danish region with the overall objective to reduce the number of (inappropriate) hospital admissions for the frail elderly of 65 years or older. In a controlled study design elderly acutely ill patients were randomized to care and treatment either by a district nursing team or in an emergency department (ED) – both interventions with a 48-hour time limit. The district nursing teams were given access to various telemedicine solutions. In the programme theory analysis the stakeholders’ normative theories, situation theories and causal theories were studied. Competing programme theories and barriers and facilitators were identified. Data were collected in interviews with stakeholders (managers, nurses, hospital physicians and GPs) and from the literature. The intervention included a regional hospital, four municipalities and 166 GPs servicing a mixed urban and rural region in Denmark.  Four district nursing teams, eight GPs, three hospital physicians and two project managers were interviewed between January and March 2015. The stakeholder’s programme theories were both concordant and competing; the GPs in particular were sceptical of the purported objective of reducing the number of inappropriate hospital admissions; they would rather see a reduction in the number of inappropriate hospital discharges. Our results indicate a compromised implementation process.
A Percepção dos Fatores de Erosão no Processo de Construção da Marca Samsung no Brasil
Authors: Schmitt Camila Da Silva , Scharf Edson Roberto
Published: January 2017

Devido a hipercompetitividade no mercado, a preocupao e necessidade de se planejar adequadamente as estratgias mercadolgicas so essenciais (Too, Harvey Too, 2010). Nesse domnio as marcas so utilizadas pelas empresas como estratgia para criar valor e diferenciao, para que possam se distanciar dessa concorrncia. Marcas fortes tendem a criar uma vantagem competitiva duradoura (Tavares, 1998; Bedbury, 2002; Keller Machado, 2006; Aaker, 2007; Scharf, 2007). Porm, mesmo consolidadas no mercado, marcas slidas esto vulnerveis aos fatores que causam sua eroso. Nesse contexto, este artigo pretendeu estabelecer a percepo dos fatores de eroso no processo de construo de marcas slidas, analisando as aes estratgicas incorporadas e trabalhadas pela marca Samsung no Brasil. Para responder as indagaes ostentadas, foram utilizados dados primrios instaurados nas entrevistas realizadas com executivos estrategistas da marca, e informaes advindas tambm de dados secundrios com anlise documental de artigos publicados sobre a marca investigada. Quanto aos fatores de eroso estabelecidos, alguns foram percebidos integralmente como erosivo pelos executivos, como o caso da Proliferao de concorrentes e Presso por resultados a curto prazo. Com a anlise das informaes se abarcou o estabelecimento de outros fatores que causam eroso na perspectiva de marca no contexto brasileiro.
Mensuração da Consciência de Patrocínio em um Evento B2B
Authors: Silva Clarice Mara Sousa e , Paula Verica Marconi Freitas de , Moriguchi Stella Naomi , Paula Veronica Angelica Freitas de
Published: January 2017

Este estudo prope investigar a conscincia de patrocnio, com o objetivo de verificar como as marcas dos patrocinadores so lembradas e associadas pelos participantes aps a realizao de um evento no ambienteBusiness-to-Business,com base na proposta deMeenaghan e O'Sullivan (2013). Utilizando anlise de contedo e anlise estatstica descritiva, estapesquisa exploratrio-descritiva verificou nveis relevantes de conscincia de patrocnio por parte dos respondentes. Vale ressaltar que, no caso do principal patrocinador, o alto nvel de conscincia pode ser explicado por um processo de associao semntica que relacionou o tema do evento a ele, uma empresa que comercializa e desenvolve softwares de gesto empresarial. Ao mesmo tempo, essa forte associao pode terdiminudo a ateno e memria em relao aos demais patrocinadores.Verificou-se tambm que oambushing(uma associao que um indivduo faz entre um evento e uma marca, quando esta no est, de fato, patrocinando o referido evento) esteve presente de maneira acentuada na mensurao de memria induzida, quando comparada memria espontnea. Esses resultados evidenciam a importncia de uma ampla gesto do patrocnio, por promotores e patrocinadores de eventos, dada sua importncia enquanto ao estratgica de marketing para alavancar novos negcios, fidelizar clientes e incrementar a valorizao de suas marcas.
Programas de Endomarketing na Indústria de Produtos Orgânicos: Estudo do Marketing de Relacionamento
Authors: Graziano Graziela Oste , Oswaldo Yeda Cirera , Pizzinatto Andrea Kassouf , Elias Spers Valéria Rueda
Published: January 2017

O estudo buscou este trabalho buscou investigar a aplicabilidade da utilizao, no agronegcio da ferramenta do marketing de relacionamento nos Programas de endomarketing (voltados ao pblico interno, os colaboradores). Foram investigadas na pesquisa 12 empresas, tendo assim uma amostra por convenincia. Pode-se concluir que os objetivos dos Programas de Endomarketing esto direcionados para promover o bem-estar, buscar o comprometimento e a capacitao, e informar os colaboradores. Os maiores benefcios oferecidos pelos Programas de Endomarketing, apontados pelas empresas, so: Estimulam participao de todos os colaboradores da organizao; Melhoram as atitudes e comportamentos dos colaboradores com relao ao emprego; Criam e promovem idias nas organizaes voltadas ao bom atendimento ao cliente; Contribuem para a melhoria dos ndices de produtividade; Favorecem o recrutamento e seleo; e Incluem os planos de carreira como instrumentos de motivao. Este estudo representa a assuno do Marketing de Relacionamento em 50% das empresas contatadas, j que a investigao nos pontos de venda permitiu a verificao de 24 empresas.
The Moderating Effect of Attachment Styles (Anxiety And Avoidance) on Consumer Intention
Authors: Vieira Valter Afonso , Monteiro Rodrigo
Published: January 2017

This paper investigates firm-focused customer attachment styles relationship, rather than general or interpersonal attachment styles. We proposed a theoretical framework and analyzed the customers attachment styles and their moderating effect on happiness, commitment, loyalty, satisfaction and preference for closeness. In Study 1, we survey clients from main banks in Brazil, who evaluated their relationship with banks. In Study 2, we survey clients from insurance agent broker. The results showed that the anxiety avoidance interaction had negative association with switching intention. Second, the outcomes suggested that the anxiety avoidance interaction attenuates the main effect of all marketing variables on repurchase intention and switching intention, creating a three-way interaction.