bluuebunny/crossref_metadata_2025_split huggingface dataset:
Collaboration between adult patients and practitioners when making decisions about prescribing opioid medicines for chronic non-cancer pain in primary care: a scoping review
Authors: Bathia Nirlas Shantilal , McAskill Robyn E , Hancox Jennie E , Knaggs Roger D 
Published: June 2021

Background: Long-term opioid therapy (>12 months) is not effective for improving chronic non-cancer pain and function. Where patients are not experiencing pain relief with long-term opioids, the opioid should be tapered and discontinuation considered. Practitioners may find it challenging to tell patients experiencing pain that they are better off reducing or not taking medicines that do not help. This review aims to ascertain what is published about: (1) the interaction and (2) the nature of the relationship between practitioners and patients when prescribing opioids for chronic non-cancer pain in primary care. Method: A scoping review of English-language qualitative, quantitative or mixed-method studies in databases including: MEDLINE, Embase, PsycINFO, AMED, BNI, CINALH EMCARE and HMIC. The identified papers were reviewed to provide a descriptive summary of the literature. Results: The review identified 20 studies. The studies used a range of methods including interviews, focus groups, audio and video recordings of clinical consultations, telephone survey and data from patient records. One study reported that researchers had engaged with a patient advisory group to guide their research. Patients expressed the importance of being treated as individuals, not being judged and being involved in prescribing decisions. Practitioners expressed difficulty in managing patient expectations and establishing trust. Opioid risk and practitioner suspicion shape opioid prescribing decisions. There is a paucity of literature about how precisely practitioners overcome interactional challenges and implement personalised care in practice. Conclusion: The studies in this review ascertain that practitioners and patients often find it challenging to achieve shared decisions in opioid review consultations. Effective communication is essential to achieve good clinical practice. Collaborative research with PPI partners should be aimed at identifying communication practices that support practitioners to achieve shared decisions with patients when reviewing opioids for chronic non-cancer pain.
Determinants of neonatal sepsis among neonates delivered in Southwest Ethiopia 2018: A case-control study
Authors: Dirirsa Dejene Edosa , Dibaba Degefa Bekem , Gonfa Alemayehu Dessale 
Published: June 2021

Introduction: Neonatal sepsis is one of the principal causes of neonatal morbidity and mortality. In spite of interventions with different preventive methods, the burden of neonatal sepsis is being reported in different parts of Ethiopia. For further interventions, identifying its determinants is found to be essential. Objective: The study aimed to assess the determinants of neonatal sepsis among neonates delivered in Southwest Ethiopia in 2018. Methods: A hospital-based case-control study was conducted in Southwest Ethiopia from May 2018 to August 2018. Systematic random sampling technique was used to select study participants; Cases were neonates diagnosed with sepsis and controls were neonates without sepsis. Data were entered into Epi info version 7.2 and analyzed using Statistical Package for Social Sciences version 23. Bi-variable logistic regression was used to identify determinants of neonatal sepsis and those variables with a p-value < 0.05 in the multivariable logistic regression analysis were considered as significantly associated at a 95% confidence interval. Results: The findings from the multivariable logistic regression revealed that history of meconium-stained amniotic fluid (adjusted odds ratio [95% confidence interval] = 9.2 [1.1, 19.8]), history of foul-smelling liquor (adjusted odds ratio [95% confidence interval] = 5.2 [1.2, 22.3]), history of maternal sexually transmitted infection/urinary tract infection (adjusted odds ratio [95% confidence interval[ = 4.7 [1.1, 19.7]), history of vascular catheter (adjusted odds ratio [95% confidence interval] = 4.7 [1.11, 20]), and low birth weight (adjusted odds ratio [95% confidence interval] = 5.3 [1.3, 28.9]) were identified as determinants of neonatal sepsis. Conclusion: Generally, history of meconium-stained amniotic fluid, foul-smelling liquor, maternal history of the sexually transmitted disease, urinary tract infection, low birth weight, and the vascular catheter was identified as determinants of neonatal sepsis. Health education should be provided for pregnant mothers regarding health care-seeking behavior. Similarly, diagnoses and care should be accessible on time for foul-smelling liquor, premature rupture of membrane, and low birth weight.
COVID-19 and aging: Identifying measures of severity
Authors: Neves Maria Teresa , de Matos Leonor Vasconcelos , Vasques Ana Carolina , Sousa Inês Egídio , Ferreira Inês , Peres Susana , Jesus Susana , Fonseca Cândida , Mansinho Kamal 
Published: June 2021

Introduction: We aimed to compare clinical features of older age group and young and middle-aged patients with COVID-19 and analyze mortality predictors. Methods: Retrospective analysis of ongoing collection of prespecified data, on a single institution, including patients hospitalized consecutively due to COVID-19 infection, from March to June 2020. Results: Of 195 patients, 56.9% were ⩾65 years (older age group). Older age group had multimorbidity ( p < 0.001). At admission Early Warning Score-2 ( p < 0.001), C-reactive protein, D-dimer, creatinine, anemia and lymphopenia were higher in older age group, as well as median time of hospitalization (14 vs 10 days, p = 0.004). Complications were more common in older age group, but there were no significant differences in admission to intensive care. There were 18 deaths, 16 in older age group. Modified Early Warning Score at admission (odds ratio = 1.60, 95% confidence interval = 1.07–1.37, p = 0.021) and C-reactive protein >5 mg/dL (odds ratio = 2.12, 95% confidence interval = 1.13–26.26, p = 0.034) were independent predictors of inhospital mortality in older age group but not in young and middle-aged. Conclusion: Older age group was at higher risk for complications and inhospital mortality. Identification of specific scores of severity for this population is essential to ensure that best care is provided.
The NICE Evidence Standards Framework for digital health and care technologies – Developing and maintaining an innovative evidence framework with global impact
Authors: Unsworth Harriet , Dillon Bernice , Collinson Lucie , Powell Helen , Salmon Mark , Oladapo Tosin , Ayiku Lynda , Shield Gary , Holden Joanne , Patel Neelam , Campbell Mark , Greaves Felix , Joshi Indra , Powell John , Tonnel Alexia 
Published: June 2021

Objective In 2018, the UK National Institute for Health and Care Excellence (NICE), in partnership with Public Health England, NHS England, NHS Improvement and others, developed an evidence standards framework (ESF) for digital health and care technologies (DHTs). The ESF was designed to provide a standardised approach to guide developers and commissioners on the levels of evidence needed for the clinical and economic evaluation of DHTs by health and care systems. Methods The framework was developed using an agile and iterative methodology that included a literature review of existing initiatives and comparison of these against the requirements set by NHS England; iterative consultation with stakeholders through an expert working group and workshops; and questionnaire-based stakeholder input on a publicly available draft document. Results The evidence standards framework has been well-received and to date the ESF has been viewed online over 55,000 times and downloaded over 19,000 times. Conclusions In April 2021 we published an update to the ESF. Here, we summarise the process through which the ESF was developed, reflect on its global impact to date, and describe NICE’s ongoing work to maintain and improve the framework in the context for a fast moving, innovative field.
Market Dynamics of Ensuring Financial Security and Sustainable Development of Enterprise
Authors: Khrapkina Valentina , Kobets Vitaliy , Stratonov Vasyl 
Published: June 2021

The paper substantiates the need to study the level of financial security of an enterprise. To study the dynamics of financial security of an enterprise we consider a system-dynamic model and simulation of distributed financial flows of a representative industrial enterprise under the impact of random factors, which reflect the threats affecting its financial security. Information on the financial statements of firms is often confidential, which leads to the need to develop a simulation model of a firm’s activities and to conduct experimental research based on the enterprise’s size and reserve fund ensuring its financial security. During simulation experiments, three scenarios for metallurgical enterprise (pessimistic scenario, optimistic scenario and most probable scenario) were investigated, and it was established that for at least half of the cases, an enterprise needs to form a reserve fund to maintain autonomous operations and ensure the necessary level of financial security. JEL Classifications: C1, C9, D33
Actual Frailty Conditions and Lifestyle Changes in Community-Dwelling Older Adults Affected by Coronavirus Disease 2019 Countermeasures in Japan: A Cross-Sectional Study
Authors: Shinohara Tomoyuki , Saida Kosuke , Tanaka Shigeya , Murayama Akihiko 
Published: June 2021

Introduction Because of the countermeasures to prevent the spread of coronavirus disease 2019 (COVID-19) in Japan, it is easy to predict that the suspension of local activities and changes in lifestyle that lead to decreased activity will result in increased frailty and prefrailty rates in older adults. Objective To clarify the actual frailty conditions and lifestyle changes among community-dwelling older adults affected by COVID-19 countermeasures in Japan. Methods This cross-sectional study was conducted between May 8 and June 12, 2020. Self-reported questionnaires were distributed to 1,078 older adults aged ≥65 years. We used the frailty screening index to assess frailty status and developed the Questionnaire for Change of Life (QCL) to assess lifestyle changes, the amount of daily movement, leg muscle strength, meal size, worry or anxiety, and opportunities to talk to people. The differences in prevalence rates of frailty, prefrailty, and robustness between this study and the reference based on the Japanese meta-analysis were verified using the chi-square goodness of fit test. We compared each of the QCL results among the frailty, prefrailty, and robust groups using Fisher’s exact test. Results Of 680 older adults (63.1%) analyzed, 60 (8.8%) had frailty and 354 (52.1%) had prefrailty. There was a significant difference between the observed and expected prevalence based on the reference (p = 0.018). The frailty status was significantly associated with lifestyle changes. In participants with frailty, the amount of daily movement, leg muscle strength, and meal size significantly decreased (p < 0.001), whereas worry or anxiety significantly increased (p = 0.040). In contrast, regardless of the frailty status, opportunities to talk to people decreased. Conclusion The prevalence of frailty and prefrailty might have increased due to the effects of COVID-19 countermeasures. Moreover, the lifestyle of community-dwelling older adults affected by COVID-19 countermeasures has changed. Lifestyle changes were more pronounced among older adults with frailty.
Erschaffen von Führungswirklichkeiten: Eine Reflexion zum Stand der Führungsforschung an Hand eines Falles “gelungener” Führung zu notwendiger Veränderung
Authors: Schneider Ursula 
Published: June 2021

Ausgangspunkt für die folgenden Überlegungen war mein Erstaunen über die zunächst nicht übersehbare transformatorische Wirkung einer einzelnen Führungsperson in einer mittelständischen Unternehmung. Das widersprach dem Hintergrundschema eines systemischen Führungsverständnisses, vor dem ich die Ereignisse zu interpretieren versuchte. Es entsprach demgegenüber Strömungen im Zeitgeist, die im charismatischen Trouble Shooter a’ la Iacocca oder im neuen Manager esoterischen Zuschnitts auf die Führungsperson abstellende Erklärungsmuster für ein Phänomen anbieten, das gemeinhin mit Führung bezeichnet wird. Der Widerspruch zwischen der Erkenntnis komplexer Zusammenhänge, die monokausale Steuerungsvostellungen als Mythos entlarven und dem hartnäckigen Überleben von Ansätzen, die Führungspersonen und Geführten erlauben, sich als Täter resp. Opfer zu erleben, scheint mir nur durch die Aufgabe einer realistisch-positivistischen Position auflösbar: Führung ist dann als durch Interaktion und soziale Zuschreibung konstitutiertes Phänomen zu verstehen. Solche Phänomene unterliegen bezüglich ihrer Erforschung einer nicht durchbrechbaren Zirkelschlußproblematik, die durch Forschungsmethodik gemildert, nicht aber prinzipiell aufgehoben werden kann. Die Aufhebung findet im Ansatz gerade durch die als voraussetzungsvoll zu beklagende externe Position der Forscher statt, weil letztere einen Austausch subjektiven Erlebens und Verständigung (Metakommunikation) über Unterschiede in diesem Erleben möglich macht. Aus dieser Perspektive wird im vorliegenden Fall zuletzt sogar fraglich, ob die auf der symbolischen Ebene stark betonten Veränderungen tatsächlich so auf die materielle Ebene durchschlagen, daß von transformatorischer Führung gesprochen werden kann.
Kennzahlensystem für die Steuerung der betrieblichen Personalarbeit
Authors: Schulte Christof 
Published: June 2021

Kennzahlen sind in vielen Untemehmensbereichen ein erprobtes Controlling-Instrument zur Planung und Steuerung. Im Personalwesen ist der Einsatz derzeit noch relativ wenig verbreitet. Eine wesentliche Ursache dafür ist darin zu sehen, daß viele personalwirtschaftliche Sachverhalte qualitativer Natur, und somit einer Messung nur schwer zugänglich sind. Hinzu kommt, daß sich für eine Vielzahl von beobachtbaren Größen keine kausalen Zusammenhänge finden lassen. Gleichzeitig steigt in den Unternehmen der Wunsch, zum einen das Personalwesen als Funktion und zum anderen personalwirtschaftliche Sachverhalte transparent zu machen, da Personalpolitik als zentraler Erfolgsfaktor immer stärker in den Vordergrund rückt. Um aktives Controlling auch im Personalwesen sicherzustellen, sind aussagefähige Meßinstrumente erforderlich. Hauptanliegen des Beitrages ist es, mitarbeiterbezogene Maßnahmen zu bewerten und im Sinne einer Steuerung Handlungsempfehlungen bei Soll-/Ist-Abweichungen zu geben. Hierzu wird ein Kennzahlensystem vorgestellt, dessen Aufbau sich an zentralen personalpolitischen Zielen orientiert.
Ansatzpunkte des Personal-Controllings in der Entgeltpolitik
Authors: Fischer Jürgen 
Published: June 2021

Die Übertragung des Controlling-Gedankens auf die Personalwirtschaft hat zu einem breiten Spektrum von Personal-Controlling (PC) -Auffassungen geführt. Sowohl in der betrieblichen Praxis als auch in der Literatur haben die unterschiedlichsten Bemühungen, sich diesem Thema zu nähem, eine sehr gute Konjunktur. Dies gilt, obwohl, oder gerade weil man von einem einheitlichen und festen Begriffsverständnis noch weit entfernt ist. Mit dem vorliegenden Beitrag möchte ich zum einen die Bandbreite der PC-Idee aufzeigen und gleichzeitig mögliche Ansatzpunkte zur Lösung praktischer Gestaltungsprobleme im Instrumentalbereich der Entgeltpolitik skizzieren. Schließlich muß die “Wunderwaffe” PC auf ihre Anwendbarkeit in konkreten Aufgabenfeldern hin untersucht werden, um nicht als bloßes modisches Sprachspiel zu fungieren. All dies werde ich am Beispiel der betrieblichen Entgeltpolitik erörtern. Dieser Bereich ist aus mehreren Gründen für das PC von Bedeutung. Die Kosten für Löhne und Gehälter sind der größte Einzelposten innerhalb der Personalkosten. Nicht selten sind 5 % dieser Entgeltkosten mehr als der gesamte Jahresüberschuß eines Unternehmens. Hinzu kommt der kontinuierliche Anstieg der Lohnkosten je Produkteinheit. Entgelte sind i.d.R. als Investitionen in das Human-Kapital zu sehen, jedenfalls dann, wenn - wie im Fall von Nachwuchskräften - kein aktuell gleichwertiger Output in Form von produktiver Arbeitsleistung gegenübersteht. Daß Entgelte solche Investitionen auch schützen sollen, ist ein weiterer wichtiger Aspekt. Hinzu kommt, daß die entgeltpolitischen Spielräume, z.B. was die Leistungsdifferenzierung angeht, durch Tarifverträge und Mitbestimmungsrechte bzw. Interpretationen durch das BAG, stetig enger werden. Schließlich macht die Arbeitsmarktsituation jedenfalls im Bereich von Fach- und Führungskräften die Entgeltpolitik zu einer wichtigen Determinante des Untemehmenserfolges. Für das PC läßt sich dies alles auf den kurzen Nenner bringen: je schwieriger und enger das Fahrwasser, desto besser müssen die Navigationsinstrumente sein.
Die Gestaltung effizienter Entlohnungssysteme in Mittel- und Osteuropa – Ergebnisse einer empirischen Untersuchung
Authors: Holtbrügge Dirk 
Published: June 2021

Ausländische Investoren in den mittel- und osteuropäischen Staaten sind vielfach mit dem Problem konfrontiert, daß die angestrebten Lohnkostenvorteile durch eine im Vergleich zu den westlichen Industrieländern erheblich niedrigere Arbeitsproduktivität und Arbeitsqualität kompensiert oder zumindest erheblich reduziert werden. Als Hauptgrund dafür kann neben der technologischen Rückständigkeit der Maschinen und Werkzeuge sowie kontraproduktiven administrativen Eingriffen zentraler Behörden vor allem die ineffiziente Entgeltpolitik angeführt werden. Die substantielle Steigerung der Arbeitsproduktivität und -qualität sowie der Arbeitszufriedenheit der Mitarbeiter hängt somit in hohem Maße von der effizienten Gestaltung des betrieblichen Entlohnungssystems ab. Im folgenden wird zunächst die Effizienz unterschiedlicher Kriterien der Entgeltdifferenzierung untersucht. Sodann wird auf die Wertigkeit unterschiedlicher monetärer und nicht-monetärer Entgeltformen eingegangen, bevor abschließend die Leistungsund Zufriedenheitswirkung der Entgelthöhe analysiert wird. Die Ausführungen basieren auf einer empirischen Untersuchung in 18 Joint Ventures in der Rußländischen Föderalion, der Ukraine, Belarus, Polen, Tschechien, der Slowakei und Ungarn.
Systematic review on long-term adverse effects of inhaled corticosteroids in the treatment of COPD
Authors: Miravitlles Marc , Auladell-Rispau Ariadna , Monteagudo Mònica , Vázquez-Niebla Juan Carlos , Mohammed Jibril , Nuñez Alexa , Urrútia Gerard 
Published: June 2021

Inhaled corticosteroids (ICSs) are indicated for the prevention of exacerbations in COPD; however, a significant proportion of patients at low risk of exacerbations are treated with ICSs. We conducted a systematic review including a diversity of types of study designs and safety outcomes with the objective of describing the risk of adverse effects associated with the long-term use of ICSs in patients with COPD.A total of 90 references corresponding to 83 studies were included, including 26 randomised clinical trials (RCTs), 33 cohort studies, and 24 nested case–control (NCC) studies. Analysis of 19 RCTs showed that exposure to ICSs for ≥1 year increased the risk of pneumonia by 41% (risk ratio 1.41, 95% CI 1.23–1.61). Additionally, cohort and NCC studies showed an association between ICSs and risk of tuberculosis and mycobacterial disease. There was a strong association between ICS use and local disorders such as oral candidiasis and dysphonia. The association between ICSs and the risk of diabetes and fractures was less clear and appeared significant only at high doses of ICSs.Since most patients with COPD are elderly and with frequent comorbidities, an adequate risk–benefit balance is crucial for the indication of ICSs.
Spatiotemporally specific roles of TLR4, TNF, and IL-17A in murine endotoxin-induced inflammation inferred from analysis of dynamic networks
Authors: Zamora Ruben , Chavan Sangeeta , Zanos Theodoros , Simmons Richard L. , Billiar Timothy R. , Vodovotz Yoram 
Published: June 2021

Abstract
Background
Bacterial lipopolysaccharide (LPS) induces a multi-organ, Toll-like receptor 4 (TLR4)-dependent acute inflammatory response.

Methods
Using network analysis, we defined the spatiotemporal dynamics of 20, LPS-induced, protein-level inflammatory mediators over 0–48 h in the heart, gut, lung, liver, spleen, kidney, and systemic circulation, in both C57BL/6 (wild-type) and TLR4-null mice.

Results
Dynamic Network Analysis suggested that inflammation in the heart is most dependent on TLR4, followed by the liver, kidney, plasma, gut, lung, and spleen, and raises the possibility of non-TLR4 LPS signaling pathways at defined time points in the gut, lung, and spleen. Insights from computational analyses suggest an early role for TLR4-dependent tumor necrosis factor in coordinating multiple signaling pathways in the heart, giving way to later interleukin-17A—possibly derived from pathogenic Th17 cells and effector/memory T cells—in the spleen and blood.

Conclusions
We have derived novel, systems-level insights regarding the spatiotemporal evolution acute inflammation.
Purple urine bag syndrome is a rare manifestation of bacteriuria on bladder catheter: case report
Authors: Mohib Othmane , Roland Thomas , Fontaine Margot , Laurent France , Rossi Camelia 
Published: June 2021

Abstract
Background
Purple urine bag syndrome (PUBS) is a complication of bacterial colonisation of bladder catheters in which urine turns purple in the tubing, as well as in the catheter bag. This rare phenomenon can be very worrisome and stressful for the patients and their families, as well as for the healthcare team taking care of them. Recognising this complication is essential in order to avoid misdiagnosis and erroneous treatment. We report a case of PUBS in a 71-year-old female patient.

Case presentation
A 71-year-old woman with previous medical history of schizophrenia was admitted to the emergency department for anorexia and suspicion of psychotic decompensation. Acute urine retention and rectal faecal impaction were clinically suspected and confirmed by bladder ultrasound and rectal examination, respectively. The patient underwent bladder catheterisation as well as a rectal enema. The day after her admission, our medical team was approached by the nurse in charge of the patient because of purple urine in her catheter bag and tubing. The diagnosis of PUBS was made with the help of the Oxford urine chart. A dipstick urinalysis revealed alkaline urine (pH = 8), and the urine culture was subsequently positive for Proteus mirabilis, which is sensitive to quinolones, beta-lactams and nitrofurantoin. The bladder catheter was changed. The patient received empiric antibiotic therapy with Levofloxacin 500 mg once daily. After obtaining the antibiogram, the targeted antibiotic therapy was adapted with oral Cefuroxime 500 mg three times a day for a total duration of seven days of antibiotic therapy. There was no recurrence of purple urine.

Conclusion
PUBS is a rare complication of bacteriuria, which induces a purple colouration of the tubing as well as the catheter bag. It is a simple spot diagnosis, as there is no other known cause of purple urine. This is why we believe that the Oxford urine chart represents a very interesting and easily accessible tool to help clinicians to investigate any abnormal urine colour.