bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Electronic Health Record Integration for Down Syndrome Guidelines
Authors: Santoro Stephanie L. , Bartman Thomas , Cua Clifford L. , Lemle Stephanie , Skotko Brian G. 
Published: August 2018

OBJECTIVES:
Established guidelines from the American Academy of Pediatrics for the care of patients with Down syndrome are often not followed. Our goal was to integrate aspects of the guidelines into the electronic health record (EHR) to improve guideline adherence throughout a child’s life span.

METHODS:
Two methods of EHR integration with age-based logic were created and implemented in June 2016: (1) a best-practice advisory that prompts an order for referral to genetics; and (2) a health maintenance record that tracks completion of complete blood cell count and/or hemoglobin testing, thyrotropin testing, echocardiogram, and sleep study. Retrospective chart review of patients with Down syndrome and visits to locations with EHR integration (NICUs, primary care centers, and genetics clinics) assessed adherence to the components of EHR integration; the impact was analyzed through statistical process control charts.

RESULTS:
From July 2015 to October 2017, 235 patients with Down syndrome (ages 0 to 32 years) had 466 visits to the EHR integration locations. Baseline adherence for individual components ranged from 51% (sleep study and hemoglobin testing) to 94% (echocardiogram). EHR integration was associated with a shift in adherence to all select recommendations from 61.6% to 77.3% (P &lt; .001) including: genetic counseling, complete blood cell count and/or hemoglobin testing, thyrotropin testing, echocardiogram, and sleep study.

CONCLUSIONS:
Integrating specific aspects of Down syndrome care into the EHR can improve adherence to guideline recommendations that span the life of a child. Future quality improvement should be focused on older children and adults with Down syndrome.
Negative Chest Radiography and Risk of Pneumonia
Authors: Lipsett Susan C. , Monuteaux Michael C. , Bachur Richard G. , Finn Nicole , Neuman Mark I. 
Published: August 2018

BACKGROUND AND OBJECTIVES:
The ability of the chest radiograph (CXR) to exclude the diagnosis of pneumonia in children is unclear. We sought to determine the negative predictive value of CXR in children with suspected pneumonia.

METHODS:
Children 3 months to 18 years of age undergoing CXRs for suspected pneumonia in a tertiary-care pediatric emergency department (ED) were prospectively enrolled. Children currently receiving antibiotics and those with underlying chronic medical conditions were excluded. The primary outcome was defined as a physician-ascribed diagnosis of pneumonia independent of radiographic findings. CXR results were classified as positive, equivocal, or negative according to radiologist interpretation. Children with negative CXRs and without a clinical diagnosis of pneumonia were managed for 2 weeks after the ED visit. Children subsequently diagnosed with pneumonia during the follow-up period were considered to have had false-negative CXRs at the ED visit.

RESULTS:
There were 683 children enrolled during the 2-year study period, with a median age of 3.1 years (interquartile range 1.4–5.9 years). There were 457 children (72.8%) with negative CXRs; 44 of these children (8.9%) were clinically diagnosed with pneumonia, and 42 (9.3%) were given antibiotics for other bacterial syndromes. Of the 411 children with negative CXRs who were managed without antibiotics, 5 were subsequently diagnosed with pneumonia within 2 weeks (negative predictive value of CXR 98.8%; 95% confidence interval 97.0%–99.6%).

CONCLUSIONS:
A negative CXR excludes pneumonia in the majority of children. Children with negative CXRs and low clinical suspicion for pneumonia can be safely observed without antibiotic therapy.
Grupos funcionales fitoplanctónicos en una laguna algal de alta tasa usada para la biorremediación de lixiviados de rellenos sanitarios
Authors: Sardi Saavedra Antonella , Madera  Parra Carlos , Peña Enrique Javier , Cerón Víctor Alfonso , Mosquera Jaime 
Published: August 2018

The functional group (FG) approach is used to predict the response of the composition of phytoplankton species to changes in the environmental conditions. We assessed for the first time the dynamics of phytoplankton communities in a High-Rate Algal Pond (HRAP), implemented for the bioremediation of landfill leachate, and using morphology-based functional groups (MBFG), under the American tropics conditions. These groups were later correlated with the physical and chemical variables of the system. Water samples were taken for biological, physical and chemical analysis for seven months. In addition, phytoplankton biovolumes were estimated and a canonical correlation analysis was performed to explain the relation between physical and chemical variables and FGs. Subsequently, the HRAP treated a medium-age leachate characterized by high concentrations of nutrients. Four MBFGs were identified (IV, V, VI and VII). Group V, conformed by phytoflagellates, was found to be dominant during the entire study period. This group proliferate in environments with high concentrations of organic matter, while contributing to the transformation of the contaminants present in the leachate. The largest biovolumes of Groups V and VII occurred during periods of low water levels and dissolved organic carbon. Finally, we show that the MBFG technique may be useful in understanding the dynamics of the phytoplankton community in the HRAP used for the treatment of landfill leachate.
On Reliability in a Multicomponent Stress-Strength Model with Power Lindley Distribution
Authors: Pak Abbas , Gupta Arjun Kumar , Khoolenjani Nayereh Bagheri 
Published: August 2018

In this paper we study the reliability of a multicomponent stress-strength model assuming that the components follow power Lindley model. The maximum likelihood estimate of the reliability parameter and its asymptotic confidence interval are obtained. Applying the parametric Bootstrap technique, interval estimation of the reliability is presented. Also, the Bayes estimate and highest posterior density credible interval of the reliability parameter are derived using suitable priors on the parameters. Because there is no closed form for the Bayes estimate, we use the Markov Chain Monte Carlo method to obtain approximate Bayes estimate of the reliability. To evaluate the performances of different procedures, simulation studies are conducted and an example of real data sets is provided.
Estudio de caso de un proceso participativo desde el diseño industrial con mujeres en la cárcel de San Diego, Cartagena de Indias*
Authors: Álvarez Fernando , Vanwambeke Estelle 
Published: August 2018

Este artículo presenta el proceso investigativo que recoge la experiencia de codiseño como herramienta participativa promovida por estudiantes y docentes de Diseño Industrial, desarrollada en el marco del proyecto Diseño popular, cadenas productivas y construcción de paz, con 30 mujeres de la cárcel de San Diego, Cartagena de Indias, Colombia. Debido a la situación de exclusión y marginación social, política y económica de las reclusas, esta iniciativa promovió -a través de la elaboración de artesanías- el empoderamiento, la autonomía, la autogestión, el rescate de su identidad y un nuevo y alentador proyecto de vida para estas mujeres.
Presentación
Authors: Vásquez Cruz Olga Del Pilar 
Published: August 2018

A lo largo de estos 20 años, la revista Trabajo Social ha presentado a sus lectores diferentes facetas de la discusión entre investigación e intervención, propia de nuestra constitución profesional. Aunque no es unánime la manera en que estas se distinguen a la vez que se articulan, algunas autoras como Paula Vargas y Nora Muñoz (2013, 125) señalan cómo "la intervención es vivenciada por el profesional paso a paso, en un ejercicio permanente de reflexión-acción-reflexión para el que la investigación resulta ser un dispositivo articulador y transversal"1. Los artículos que conforman este número son una muestra de hasta dónde es posible, y necesario, seguir pensando y actuando en torno a esta articulación.Varios de los artículos nos plantean como imperante repensar, recrear y redefinir la intervención desde lecturas de contexto amplias, que den cabida a la complejidad y que permitan evidenciar la apuesta política, de cambio, de quien moviliza la acción. Una muestra de esto es el escrito de María Luisa Mussot, quien se centra en la reflexión contextualizada en la América latina de la década de 1990, pleno auge del neoliberalismo, época que transita por reformas que tienden a la activación económica y, en materia de estructura estatal, a su reducción y modernización vía privatización. En contraste con las acciones de promoción de la economía, se profundizan el desempleo, la pobreza y las desigualdades en la región. Para la autora, frenar estos efectos deriva en intervenciones sociales basadas en lo que ella enuncia como un "modelo asistencial cientificista" o de "intervención social dirigida", sustentadas en la idea de individualizar el logro del bienestar en el sujeto y en la familia a partir de su agencia en el mercado. En este escenario, la exigua asistencia estatal opera solo para quienes, definitivamente, mostraban situaciones difíciles de superar con el esfuerzo propio, como mujeres jefas de hogar, población indígena, niños, entre otros; sin duda, sujetos de interés para el Trabajo Social.
Entrevista con María Eugenia Martínez Giraldo
Authors: Leal Leal Gloria E. , Ramírez María Himelda 
Published: August 2018

Profesora del Departamento de Trabajo Social de la Universidad Nacional de Colombia de 1971 a 1995. Trabajadora social egresada de la Pontificia Universidad Javeriana, especialista en Administración Social Pública. Integrante fundadora del Grupo Mujer y Sociedad. Sus publicaciones giran en torno a la historia e investigación en el Trabajo Social y en los estudios de género, mujer y desarrollo; entre ellas se destacan Historia de Trabajo Social en Colombia (1900-1975), "El Trabajo Social en Colombia de Profesión a Disciplina" (Revista Acción Crítica, Celats, 1989) y Cartografía de Mujeres. Para Pensar los Derechos (2003). Directora de la Carrera de Trabajo Social (1985-1987) y del Departamento de Trabajo Social de La Universidad Nacional de Colombia (1987-1990). Medalla María Carulla de Vergara, Resolución 012, 2003 del Conets. Profesora destacada por sus aportes a la Universidad. Conmemoración de los 40 años de la Facultad de Ciencias Humanas de la Universidad Nacional de Colombia.
Türkiye’de 2013 ve 2018 Yılı Fen Bilimleri Dersi Öğretim Programlarının Temel Öğeler Açısından Karşılaştırılması
Authors: DEVECİ İsa 
Published: August 2018

Bu araştırmada 2013 ve 2018 Fen Bilimleri Dersi Öğretim
Programları’nın (FBDÖP) temel öğeler (amaç, içerik, öğrenme-öğretme süreci, ölçme-değerlendirme)
açısından karşılaştırması amaçlanmıştır. Karşılaştırmalı eğitim
araştırmalarında sıklıkla yararlanılan yatay yaklaşım tercih edilmiştir. Nitel olarak tasarlanmış bu araştırmada döküman analizi yöntemi kullanılmıştır. Araştırmada
döküman olarak 2013 ve 2018 yıllarında yayınlanan FBDÖP’lerden yararlanılmıştır.
Araştırma sonucunda; amaçlar açısından 2018 yılı öğretim programında farklı
olarak girişimcilik becerisi, evrensel ahlak değerleri, milli ve kültürel
değerler, fen, mühendislik ve girişimcilik uygulamaları, muhakeme ve karar
verme becerilerinden bahsedilmiştir. 2013 ve 2018 yılı FBDÖP’ler kazanımlar
açısından incelendiğinde 2018 yılı öğretim programında sayı olarak azalış
olduğu belirlenmiştir. Ayrıca bazı kavramlara yönelik kazanımların kaldırıldığı
ve bazı kavramların verilmesinde ise sınıf düzeyinde değişikliğe gidildiği
belirlenmiştir. Öğrenme-öğretme süreci açısından öğrenci rolüne bakıldığında;
2018 yılı öğretim programında; öğrencilerin model ve ürün oluşturması, proje
tasarlaması, ürün tanıtması, kendilerini sözel, görsel ve yazılı olarak ifade
etmesi, problemlere disiplinler arası bakış açısıyla bakmasına vurgu
yapılmıştır. Bu süreçte öğretmenlerden; öğrencilere ürün geliştirebilmeleri,
buluş yapabilmeleri ve üst düzey düşünebilmelerini sağlayacak görevler vermesi,
fen, teknoloji, matematik ve mühendislik disiplinlerini bütünleştirmelerini
sağlaması beklenmiştir. Diğer taraftan strateji, yöntem ve teknikler açısından,
2013 ve 2018 yılı FBDÖP’lerde bir farklılığın olmadığı görülmüştür. Ölçme
değerlendirme anlayışı açısından ise 2018 yılı öğretim programında ölçme ve
değerlendirmeye yönelik herhangi bir yöntem, teknik ya da araçtan bahsedilmediği,
kullanılacak uygun yöntem, teknik ya da araçların öğretmenlerin tercihine
bırakıldığı anlaşılmıştır. Bu sonuçlara bağlı olarak yeni öğretim programlarındaki
farklılıklar konusunda fen bilimleri öğretmenlerinin bilgilendirilmesine
yönelik hizmet içi eğitimlerin düzenlenmesi faydalı olabilir.
Use of cervical length, measured by transvaginal sonography at 22 to 26 weeks, as a predictor of preterm labour in twin pregnancy
Authors: Saini Ricky , Yadav Reena , Pathak B. 
Published: August 2018

Background: Preterm labour and delivery contributes significantly to perinatal morbidity and mortality in twin gestation. Measurement of cervical length during antenatal period and subsequent follow up may identify women at risk for preterm labour. The purpose of this study was to determine if measurement of cervical length at 22 to 26 weeks can be used as a predictor of preterm labour in twin pregnancy.Methods: This prospective observational study was carried out in 50 women with twin gestation in a tertiary care teaching hospital. Cervical length was measured using transvaginal sonography and repeated every four weeks till delivery. Cervical length of ≤30 mm was taken as short cervix and delivery before 37 weeks was taken as preterm delivery.Results: Total of 18 out of 50 women (36%) delivered between 32 to 34 weeks, 14 out of 50 (28%) delivered between 34 to 37 weeks, 7 out of 50 (14%) delivered at less than 32 weeks. Therefore, total preterm deliveries at less than 37 weeks were 78%. Total 11 out of 50 (22%) delivered at term i.e. at more than 37weeks. In women, who had short cervical length (≤ 30 mm) at the time of presentation, 14 out of 37 (38 %) delivered between 30 to 34 weeks, 12 out of 37 (32 %) women delivered between 34 to 37 weeks, 5 out of 37 (14%) delivered at ≤ 30 weeks. Rest 6 out of 37 (16 %) delivered after 37 weeks.Conclusions: Short cervical length of ≤30 mm on transvaginal sonography at 22-26 weeks of gestation in twin pregnancy may be used as a screening tool in prediction of preterm labour in asymptomatic twin pregnancy.
Dysfunctional uterine bleeding: ormeloxifene versus combined oral contraceptive pills
Authors: Luthra Sonia , Dwivedi A. D. 
Published: August 2018

Background: Dysfunctional uterine bleeding is abnormal bleeding that occurs in the absence of recognizable pelvic pathology, general medical disease, or pregnancy. Globally, health care systems are focusing on low morbidity and low cost therapeutic interventions. Hence, medical treatment for DUB is high on the priority list. This comparative study was conducted to analyse the efficacy of ormeloxifene and combined oral contraceptive pills in reducing the blood loss and endometrial thickness in cases of DUB.Methods: This prospective study was conducted on women with dysfunctional uterine bleeding, who attended Gynaecology OPD at Hind Institute of Medical Sciences, between August 2015 and April 2016. After applying inclusion and exclusion criteria, 72 women diagnosed with DUB were enrolled randomly in two groups A and B. Group A was treated by Ormeloxifene and Group B patients were treated with combined oral contraceptive pills for three consecutive cycles. The efficacies of the studied drugs were compared by analyzing the mean change in the pre and post treatment PBAC score, haemoglobin level and endometrial thickness using unpaired t-test.Results: Ormeloxifene was found to be significantly more effective (p <0.0001) than OCPs in controlling the menstrual blood loss (79% reduction in group A Vs 55.5% reduction in group B). Reduction in endometrial thickness was also more in the group receiving Ormrloxifene, however this was statistically not significant (p = 0.19). No major side effect observed with the use of Ormeloxifene.Conclusions: Ormeloxifene can be an effective and safe therapy in the treatment of Dysfunctional uterine bleeding.
Comparison of near miss obstetric events and maternal deaths in a tertiary care teaching hospital from Eastern India
Authors: Naik Sushree Samiksha , Ghosh Subhra 
Published: August 2018

Background: Obstetrics near miss is an important indicator that reflects the quality of obstetrics care in a health facility. Timely audit of the obstetrics near miss data would help in reducing maternal mortality.Methods: A retrospective chart review of the maternal near miss (MNM) and death based on WHO 2009 criteria was carried out in a tertiary care teaching hospital from Eastern India over 12 months. Main outcome measures were severe acute maternal morbidity (MNM) and maternal deaths.Results: During the study period, there were 9204 deliveries, 116 near miss cases, and 69 maternal deaths. The MNM incidence ratio was 13.75/1000 live births, MNM to mortality ratio was 1.68:1, and mortality index was 37.3%. A total of 126 cases were referred, while 5 cases were booked at our hospital. Hypertensive disorders accounted for the highest number of near miss cases (40.5%), followed by sepsis (31%), haemorrhage (18%), and dystocia (10%). The mortality index was 36.58%, 33.33%, 19.23%, and 07.6% for hypertensive disorders, sepsis, haemorrhage, and dystocia, respectively. Most common causes of maternal deaths were hypertensive disorders, followed by systemic infections, HELLP syndrome, embolism, haemorrhage, malaria, and ruptured uterus. On bivariate analysis, there was an increased risk of maternal death in those illiterate, incomplete antenatal check-up (<3), multipara, preterm pregnancy, and home delivery.Conclusions: Hemorrhage and hypertensive disorders are the leading causes of MNM events and mortality. Early identification, remedial measures, and timely treatment would help to decrease the burden of maternal near miss and mortality.
Maternal and fetal outcome of pregnancy complicated by convulsions
Authors: Fonseca Michelle , Joshi Aditi 
Published: August 2018

Background: Convulsions in pregnancy pose serious morbidity and mortality to both mother and the fetus. Eclampsia being the most common cause. However, many medical disorders like epilepsy, cerebral malaria, meningitis, metabolic disorders etc can result in convulsions in pregnancy. This study was conducted to determine the prevalence of various aetiologies leading to convulsions and to assess how the various demographic-clinical characteristics affect the maternal as well as fetal outcome in patients with eclampsia as compared to those with convulsions other than eclampsia.Methods: This was an observational study conducted over a period of one and a half year at a tertiary institute in India. A total of 56 patients were studied in this duration. The primary objective was to determine the prevalence of the aetiologies causing convulsion as well as the maternal and fetal outcome of the pregnancy complicated by convulsions. The data regarding age, parity, mode of delivery, gestational age at birth, risk factors was obtained by a predesigned proforma.Results: A total of 56 patients were included in the study after screening 18,840 patients in the hospital. Hence the estimated prevalence of convulsions in pregnancy was 1:336 in this hospital. The most common aetiology noted was Eclampsia (69.6%) followed by epilepsy (16.1%). Others included Cerebral Malaria (3.6%), Hypocalcemia (3.6%), Neurocysticerosis (2%), Hypokalemia (1.8%) and Hypoglycemia (1.8%). Maternal case fatality rate was 3.6%. Total perinatal mortality was 14.2% of which 6 (10.7 %) were still birth.Conclusions: Eclampsia is a major cause of convulsions in pregnancy and considered to be the diagnosis unless proved otherwise. However other causes of convulsions should not be ignored. A thorough evaluation of the patient which lays a major emphasis on a detailed history taking and examination, form the crux of diagnosing the cause of convulsions and can expediate a timely and accurate treatment.
Análise do tipo, grau de novidade e dimensões da inovação: estudo de caso em uma vinícola localizada na Serra Gaúcha – Brasil
Authors: Welchen Vandoir , Olea Pelayo Munhoz , Ganzer Paula Patrícia , Chais Cassiane , Radaelli Adrieli Alves Pereira , Mukendi Joel Tshibamba 
Published: August 2018

Resumo: A inovação apresenta-se nas organizações na implantação de um produto, método de produção, marketing ou organizacional, novo ou significativamente melhorado, na empresa, em seu mercado ou no mundo, gerando competitividade. Com esta pesquisa teve-se como objetivo identificar inovações em uma empresa do ramo vitivinícola da Serra Gaúcha, entre 2005 e 2015. Realizou-se uma pesquisa qualitativa, por meio do estudo de caso único, exploratório, com entrevistas individuais em profundidade com o Diretor e o Enólogo da Vinícola. A análise de conteúdo foi baseada em Bardin (2009); foi utilizado o software NVivo 11® e realizada uma codificação a priori com base no referencial teórico. Na análise de conteúdo das entrevistas identificou-se que a Vinícola implementou 26 inovações, nas dimensões e nos tipos e graus de novidade. Constatou-se que as inovações apresentadas são resultado do trabalho familiar, com foco na qualidade, desenvolvendo vinhos finos de excelência.Palavras-chave: Inovação. Manual de Oslo. Vinícola. Serra Gaúcha. Analysis of the type, new degree and dimensions of innovation: a case study in a Winery located in the Serra Gaúcha – Brazil Abstract: Innovation presents itself in organizations in the process of a product implantation, method of production, marketing or organizational, launched or significantly improved, in the company, in its market or in the world, engendering competitiveness. The research had the objective of identifying innovations in a winery company in the Serra Gaúcha between 2005 and 2015. A qualitative research was conducted through a single, exploratory case study, through in-depth individual interviews with the Wine Director and Winemaker. For the content analysis, the software NVivo 11® was used and a priori codification was carried out based on the theoretical reference After analyzing the content of the interviews, it was identified the Winery implemented 26 innovations, in the dimensions, in the types and degrees of novelty. According to the interviewees, the innovations are results of the family work, focusing on developing the quality and excellence of fine wines.Keywords: Innovation. Oslo Manual. Winery. Serra Gaúcha.