bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using complex systems mapping to build a strategic public health response to mental health in England
Authors: Stansfield Jude , Cavill Nick , Marshall Louise , Robson Claire , Rutter Harry 
Published: August 2021

PurposeThis paper aims to use systems mapping as a tool to develop an organisation-wide approach to public mental health to inform strategic direction within a national public health agency.

Design/methodology/approachTwo workshops were facilitated with internal staff from a wide range of public health policy teams working in small groups to produce paper-based maps. These were collated and refined by the project team and digitised.

FindingsThe approach engaged a range of teams in forming a shared understanding and producing a complex system map of the influences on population mental health and well-being, where current policy initiatives were addressing them and what the gaps and priorities were. Participants valued the approach which led to further study and organisational commitment to the whole system working as part of national public mental health strategy.

Research limitations/implicationsThe approach was limited to internal stakeholders and wider engagement with other sectors and community members would help further the application of complex system approaches to public mental health.

Originality/valueIt was a valuable process for developing a whole-organisation approach and stimulating thinking and practice in complex system approaches. The paper provides a practical example of how to apply systems mapping and its benefits for organising public mental health practice.
Balancing medical education with service in the workplace: a qualitative case study
Authors: Fish Rebecca Mary , Gawne Suzanne Jane , Machin Laura 
Published: August 2021

Purpose
Finding a balance between the provision of quality individualized care and the ongoing education of junior doctors had been flagged as a concern at a large National Health Service (NHS) teaching hospital in the north of England. In response to this, the organization introduced an intervention designed to improve educational culture by providing support to educators, leaders and clinical staff.

Design/methodology/approach
This paper features themed results from eight in-depth interviews with educators, consultants and junior doctors to describe and evaluate the process and impact.

Findings
Factors that contributed to a positive educational environment included trainees and educators feeling valued, the presence of supportive leaders and the provision of a safe space for learning. Perceived barriers included time constraints, differing motivation and the generic format of formal education. Participants reflected on how the Wrap Around project helped improve the workplace educational culture and offered suggestions for further improvement including the provision of ongoing feedback to learners about their performance.

Originality/value
Research aimed at recognizing and resolving the perceived tensions between the priorities of education and health-care delivery has been flagged as a gap in the literature. The authors argue that developing and enhancing collaborative leadership and educational culture within an organization can reduce these tensions for those working on the front line. Future work should focus on addressing the perceived distinction between the two within services.
Tackling energy poverty through social intrapreneurship in large-scale energy companies
Authors: Manjon Maria-Jose , Merino Amparo , Cairns Iain 
Published: August 2021

PurposeThe purpose of this paper is to present advances towards a social intrapreneurship department within energy corporations. By drawing on the literature on social intrapreneurship and stakeholder theory, this paper provides a conceptual proposal for an organisational structure. This paper builds on the notion of bridging and boundary organisations, to suggest an organisational innovative structure as a social intrapreneurship endeavour focussing on the increasing salience of weak stakeholders in energy corporations from the energy justice approach.Design/methodology/approachThis paper draws on the literatures on social intrapreneurship and stakeholder theory, to provide arguments and an organisational proposal to alleviate energy poverty in energy corporations.FindingsThe results are presented in a conceptual process model for the development of Social Energy Department units within large energy companies, illustrating their embeddedness in both societal and company-level processes to facilitate social intrapreneurship initiatives that would alleviate energy poverty in the just transition.Practical implicationsThe paper promises novel insights at the nexus of social enterprise and organisational change. The practical applicability is particularly promising, as it focusses on integrating novel units in energy companies and stimulates further research on models of social intrapreneurship to tackle energy poverty.Originality/valueThe paper offers both practical and theoretical contributions to the stakeholder theory field with insights from social intrapreneurship and organisational stakeholder theory in the context of a specific social problem – energy poverty, energy justice and the just energy transition.
“Living-with-dying”: the elderly’s language of terminal illness
Authors: Maci Stefania M. 
Published: August 2021

PurposeThis study aims to examine the way in which elderly people, men and women, with a terminal illness use language to construct a narrative about their “living-with-dying” experience.Design/methodology/approachThis investigation is a secondary analysis based on a corpus of health and illness narratives collected by the Health Experiences Research Group at the University of Oxford and published by the DIPEx charity (available at:http://healthtalk.org/home).FindingsThis study shows that there are qualitative differences in the way in which not only elderly people but also men and women report their experience with terminal illness and their relation to death.Originality/valueUnderstanding the different perspectives from which elderly people narrate their experiences of how they live while dying from terminal illness can help health professionals to develop more effective all-inclusive health policies and practices in end-of-life care.
Constructing a professional identity as an in-home carer
Authors: Blundell Catherine Jane 
Published: August 2021

Purpose
The purpose of this paper is to examine the ways in which foreign live-in carers are able to construct agentive identities which counteract negative discourses regarding care work, sex and nationality.

Design/methodology/approach
Interviews with women working as carers in Bologna form the basis of this research which focuses on “small stories”. Using positioning analysis, both the immediate context where the narrative takes place and the wider societal discourses being referenced are examined. Subsequently, common recurrent discourses related to being a foreign carer in Italy are identified.

Findings
The interviewees make strategic use of prevailing negative discourses to construct counter narratives to avoid being positioned as low-skilled workers and to permit them to reject negative stereotypes of what it means to be a carer. In addition, more positive identities are constructed.

Practical implications
These findings suggest that a sociolinguistic approach can help towards a better understanding of the lived-experiences of foreign care workers, as it can reveal aspects of carers’ lives which do not easily fit into the categories which are often the focus of larger-scale, thematic studies.

Originality/value
This paper combines an analysis of content together with an analysis of the construction of narrative to present a more complete picture of the reality of working as a carer today.
Whole‐genome analysis of Klebsiella pneumoniae from bovine mastitis milk in the U.S.
Authors: Zheng Zhiyi , Gorden Patrick J. , Xia Xiaoqin , Zheng Ying , Li Ganwu 
Published: August 2021

SummaryDairy cattle mastitis has long been one of the most common and costly diseases in the dairy industry worldwide, due to its significant impact on milk production and animal welfare. Among all mastitis causing bacterial pathogens, Klebsiella pneumoniae causes the largest milk loss. To better understand the genomic features of this population, 180 K. pneumoniae strains isolated from dairy cattle mastitis milk in 11 U.S. states were sequenced. The phylogenetic analysis classified all mastitis‐causing K. pneumoniae into two major phylogroups, with exclusive predominance in phylogroup KpI. Analysis of more than 61 sequence types, 51 capsular types and 12 lipopolysaccharide O‐antigen types revealed great genomic diversity of this K. pneumoniae population. Approximately 100 gene units in accessory genomes were detected with significantly higher prevalence in bovine mastitis strains, compared to human‐sourced or dairy environmental strains. The most notable genes were identified associated with ferric citrate uptake, lactose fermentation and resistance to heavy metals. The acquired antimicrobial resistance genes were identified in sporadic mastitis strains. This comprehensive genomic epidemiological study provides insights for a better understanding of the virulence of mastitis‐causing K. pneumoniae strains and may lead to the development of novel diagnostic tools and preventive strategies.
‘Facing it Together’: Early Caregiving Responses to Vancouver's HIV/AIDS Epidemic
Authors: Klassen Benjamin 
Published: August 2021

AbstractThis article utilises oral history interviews with long‐term survivors and caregivers in Vancouver, British Columbia to foreground the importance of gay men's early HIV/AIDS caregiving work. Caregiving was essential to the health and resilience of Vancouver's gay community and served as a political response to homophobic discourses that demonised gay men and devalued the lives of people living with HIV/AIDS. This analysis of the practical and political significance of HIV/AIDS caregiving demonstrates that historians must find better ways to recover the often‐untold histories of men's caregiving and domesticity and appreciate their significance to the success of social movements.
Delirium Reduction by Analgesia Management in Hip Fracture surgery (DRAM‐HF): Exploration of perceived facilitators and barriers
Authors: Hunter Carol Lu , Ni Chroinin Danielle , McEvoy Lynette , Chuan Alwin 
Published: August 2021

AbstractObjectivesIn tandem with the implementation of a multidisciplinary protocol which was successful in reducing delirium after hip fracture surgery (DRAM‐HF), we sought to investigate enablers and barriers to same.MethodsSingle‐centre, prospective, before‐and‐after questionnaire targeted at health‐care professionals involved in DRAM‐HF. We assessed respondent‐reported enablers and barriers to the multidisciplinary protocol, using 0‐100 agreement scales and free‐text responses.ResultsA total of 134 preintervention and 124 postintervention responses were collated (out of 200, response rates 67% and 62%, respectively). Preintervention support for DRAM‐HF was 100% (n = 130) and postintervention 95.9% (n = 116).Study design was well received with a mean score of 76.7 (SD 19.7) for being easy to understand. Support for additional computer alert systems was also high (mean 73.6, SD 23.9). Free‐text responses emphasised the need for integration of ward pharmacists into medication optimisation (n = 31) and upskilling nurse practitioners (n = 23).ConclusionWhilst generally supported, DRAM‐HF implementation may be streamlined by optimising electronic delivery, offering targeted education and expanding roles.
Subcutaneous panniculitis‐like T‐cell lymphoma in a 14‐year‐old female homozygous for HAVCR2 mutation
Authors: Frederiks Aaron J , Spagnolo Dominic V , Ramachandran Shanti , Brand Roland 
Published: August 2021

ABSTRACTSubcutaneous panniculitis‐like T‐cell lymphoma (SPTCL) is a rare cytotoxic T‐cell lymphoma preferentially involving subcutis. A link between patients with SPTCL and HAVCR2 mutations has recently been discovered. We present a 14‐year‐old girl of Chinese heritage who was diagnosed with SPTCL in the context of homozygous HAVCR2 status for c.245A>G p. (Tyr82Cys) and achieved complete remission after treatment with cyclosporin and steroids. Dermatologists should be aware of the diagnostic, management and familial genetic counselling utility of HAVCR2 for investigating and managing patients with SPTCL.
Hospital survival outcomes in acute respiratory distress syndrome patients receiving veno‐venous extracorporeal membrane oxygenation for longer than 28 days: A retrospective study
Authors: Umei Nao , Ichiba Shingo , Genda Yuki , Mase Hiroshi , Sakamoto Atsuhiro 
Published: August 2021

AbstractThe successful use of prolonged (ie, >28 days) veno‐venous extracorporeal membrane oxygenation (V‐V ECMO) is being increasingly reported. However, limited data are available on its outcomes. This study investigated the outcomes of acute respiratory distress syndrome (ARDS) patients on prolonged ECMO support. We retrospectively evaluated 57 patients requiring V‐V ECMO for ARDS between 2015 and 2020. The patients were divided into two groups according to ECMO duration: (a) ≤28 days group (n = 43, 75%) or (b) >28 days (n = 14, 25%) group. Clinical characteristics, complications, and outcomes between these two groups were statistically compared. There were no significant differences in demographics, comorbidity, ARDS etiology, and severity scores between the two groups. However, the mechanical ventilation period before ECMO initiation was significantly longer in the >28 days group than in the ≤28 days group (10.5 days vs. 1 day; P < .05). The incidence of positive bacterial blood culture results during ECMO was significantly higher in the >28 days group than in the ≤28 days group (43% vs. 9%; P < .05). Additionally, the hospital survival rate was significantly lower in the >28 days group than in the ≤28 days ECMO group (21% vs. 60%; P < .05). Prolonged ECMO was associated with worse hospital survival outcomes. Early initiation of ECMO along with meticulous care and appropriate treatment against infection during ECMO could improve the hospital survival of ARDS patients on prolonged ECMO support.
Characterization of in vitro 3D cultures
Authors: Mousavi Nabi 
Published: August 2021

SummaryOver the past decade, 3D culture models of human and animal cells have found their way into tissue differentiation, drug development, personalized medicine and tumour behaviour studies. Embryoid bodies (EBs) are in vitro 3D cultures established from murine pluripotential stem cells, whereas tumoroids are patient‐derived in vitro 3D cultures. This thesis aims to describe a new implication of an embryoid body model and to characterize the patient‐specific microenvironment of the parental tumour in relation to tumoroid growth rate. In this thesis, we described a high‐throughput monitoring method, where EBs are used as a dynamic angiogenesis model. In this model, digital image analysis (DIA) is implemented on immunohistochemistry (IHC) stained sections of the cultures over time. Furthermore, we have investigated the correlation between the genetic profile and inflammatory microenvironment of parental tumours on the in vitro growth rate of tumoroids. The EBs were cultured in spinner flasks. The samples were collected at days 4, 6, 9, 14, 18 and 21, dehydrated and embedded in paraffin. The histological sections were IHC stained for the endothelial marker CD31 and digitally scanned. The virtual whole‐image slides were digitally analysed by Visiopharm® software. Histological evaluation showed vascular‐like structures over time. The quantitative DIA was plausible to monitor significant increase in the total area of the EBs and an increase in endothelial differentiation. The tumoroids were established from 32 colorectal adenocarcinomas. The in vitro growth rate of the tumoroids was followed by automated microscopy over an 11‐day period. The parental tumours were analysed by next‐generation sequencing for KRAS, TP53, PIK3CA, SMAD4, MAP2K1, BRAF, FGFR3 and FBXW7 status. The tumoroids established from KRAS‐mutated parental tumours showed a significantly higher growth rate compared to their wild‐type counterparts. The density of CD3+ T lymphocytes and CD68+ macrophages was calculated in the centre of the tumours and at the invasive margin of the tumours. The high density of CD3+ cells and the low density of CD68+ cells showed a significant correlation with a higher growth rate of the tumoroids. In conclusion, a novel approach for histological monitoring of endothelial differentiation is presented in the stem cell‐derived EBs. Furthermore, the KRAS status and density of CD3+ T cells and macrophages in the parental tumour influence the growth rate of the tumoroids. Our results indicate that these parameters should be included when tumoroids are to be implemented in personalized medicine
Involvement of the effect of renal hypoperfusion medications on vancomycin trough concentration: A secondary analysis using a retrospective observational data
Authors: Hirai Toshinori , Hanada Kazuhiko , Iwamoto Takuya , Itoh Toshimasa 
Published: August 2021

AbstractThis study examined the association between vancomycin (VCM) trough concentration and confounding factors including renal hypoperfusion medications which include angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers, loop/thiazide diuretics, or non‐steroidal anti‐inflammatory drugs. This secondary analysis included patients aged >15 years who were administered VCM intravenously between June 2015 and August 2017 at the Tokyo Women's Medical University Medical Center East. We investigated predictors for three (initial, mean, and final) dose‐normalized VCM trough concentration (dose‐normalized VCMtrough) as outcome using a multiple linear regression analysis. In total, 208 patients were analysed (use of loop/thiazide diuretics: 48 [23%]). Multiple linear regression analysis revealed that the initial dose‐normalized VCMtrough was negatively correlated with estimated glomerular filtration rate (eGFR) (p = 0.028) and positively correlated with the use of loop/thiazide diuretics (p = 0.003). Meanwhile, there was a positive correlation between the mean dose‐normalized VCMtrough and age (p = 0.023). The mean dose‐normalized VCMtrough was negatively correlated with eGFR (p < 0.001) and serum albumin (p < 0.001). The final dose‐normalized VCMtrough was positively associated with age (p = 0.034) and negatively associated with eGFR (p = 0.032) and serum albumin (p = 0.007). Clinicians should closely monitor VCM trough concentration while receiving VCM and loop/thiazide diuretics.
Comparisons of oxygen gradient ektacytometry parameters between sickle cell patients with or without α‐thalassaemia
Authors: Boisson Camille , Renoux Céline , Nader Elie , Gauthier Alexandra , Poutrel Solène , Rab Minke , Fort Romain , Bertrand Yves , Stauffer Emeric , Cannas Giovanna , Kebaili Kamila , Virot Emilie , Hot Arnaud , Sheehan Vivien , van Beers Eduard , van Wijk Richard , Joly Philippe , Connes Philippe 
Published: August 2021

SummaryThe present study tested the impact of α‐thalassaemia on oxygen gradient ektacytometry in sickle cell anaemia (SCA). Three SCA groups were compared: (i) no α‐thalassaemia (four α‐genes, n = 62), (ii) silent α‐thalassaemia (three α‐genes, n = 35) and (iii) homozygous α‐thalassaemia (two α‐genes, n = 12). Red blood cell (RBC) deformability measured in normoxia was not different between the three groups. The lowest RBC deformability reached at low oxygen partial pressure (pO2) was greater and the pO2 at which RBC started to sickle was lower in the two α‐genes group compared to the other groups. Our present study showed an effect of α‐thalassaemia on oxygen gradient ektacytometry in SCA.
Developmental screening of three‐year‐old children with sickle cell disease compared to controls
Authors: Wang Winfred , Freeman Molly , Hamilton Latacha , Carroll Yvonne , Kang Guolian , Moen Joseph , Smeltzer Matthew P. , Schreiber Jane , Heitzer Andrew M. , Estepp Jeremie , Aygun Banu 
Published: August 2021

SummaryWe previously found that neurodevelopmental deficits commonly occurred in three‐year‐olds with sickle cell disease (SCD), but clinical significance was uncertain because a comparison group was lacking. Our objective in the current study was to prospectively compare neurodevelopment in three‐year‐old children with SCD to an age‐appropriate control group. The Brigance Preschool Screen II is a neurodevelopmental screening examination which can be administered in 15–20 min. SCD patients (Group 1) were compared with community controls of similar age and ethnicity enrolled in daycare/preschool (Group 2). SCD patients who were receiving hydroxycarbamide treatment were also compared (Group 3). Two hundred forty‐five three‐year‐olds were evaluated: Group 1, 111; Group 2, 114; and Group 3, 20. The below cut‐off rate on the Brigance test was higher in Group 1 (73%) than in Group 2 (61%; P = 0·04). In multivariate analysis of Group 1 patients, only lower household income and more persons living in the home were independent predictors of this. Patients with SCD and matched controls had high rates of ‘failing’ the Brigance test. The below cut‐off rate in untreated children with SCD was associated with low household income and increased number of persons living in the home.
COVID‐19 and coagulopathy
Authors: Sarkar Malay , Madabhavi Irappa V. , Quy Pham Nguyen , Govindagoudar Manjunath B. 
Published: August 2021

AbstractThe SARS‐CoV‐2 is a new coronavirus responsible for the COVID‐19 disease and has caused the pandemic worldwide. A large number of cases have overwhelmed the healthcare system worldwide. The COVID‐19 infection has been associated with a heightened risk of thromboembolic complications. Various mechanisms are leading to the high thrombotic risk in COVID‐19 patients such as inflammation, endotheliitis, hyperviscosity, and hypercoagulability. We searched PubMed, EMBASE, and CINAHL from January 2020 to December 2020. We used the following search terms: COVID‐19, coagulopathy, and thrombosis. We reviewed the epidemiology, clinical features, mechanisms, and treatment of COVID‐19‐associated coagulopathy.
Geographic disparities in heart transplantation persist under the new allocation policy
Authors: Hess Nicholas R. , Seese Laura M. , Sultan Ibrahim , Wang Yisi , Hickey Gavin W. , Kilic Arman 
Published: August 2021

AbstractBackgroundThis study evaluated the impact of the 2018 heart allocation policy change on geographic disparities in United States orthotopic heart transplantation (OHT).MethodsThe United Network for Organ Sharing registry was queried to measure geographic disparity in OHT rates between pre‐policy and post‐policy change eras. We performed multilevel Poisson regression to measure region‐level OHT rates. We derived an allocation priority‐adjusted median incidence rate ratio (MIRR) for each policy era, a measure of median change in OHT rates between regions.Results5958.78 waitlist person‐years were analyzed, comprising 6596 OHT procedures (3890 pre‐policy and 2706 post‐policy). Median region‐level OHT rate was .94 transplants/person‐years before and 1.51 transplants/person‐years after the policy change (P < .001). The unadjusted OHT MIRR across regions was 1.29 (95% CI 1.00–1.50) pre‐policy change and 1.17 (95% CI 1.00–1.43) post‐policy change, suggesting that the region‐related variance in OHT rates decreased under the new allocation. After adjustment for allocation priority risk factors, the MIRR pre‐policy change was 1.13 (95% CI 1.01–1.32) and post‐policy change was 1.15 (95% CI 1.00–1.35).ConclusionsGeography accounts for ∼10% of the disparity among United States OHT rates. Despite broader heart sharing, the updated allocation policy did not substantially alter the existing geographic disparities among OHT recipients.