bluuebunny/crossref_metadata_2025_split huggingface dataset:
The context of care matters: Older people's existential loneliness from the perspective of healthcare professionals—A multiple case study
Authors: Sundström Malin , Blomqvist Kerstin , Edberg Anna‐Karin , Rämgård Margareta 
Published: April 2019

AbstractAimTo explore existential loneliness among older people in different healthcare contexts from the perspective of healthcare professionals.BackgroundProfessionals meet and care for older people in most care contexts and need to be prepared to address physical, psychological, social and existential needs. Addressing existential loneliness can be both challenging and meaningful for professionals and is often not prioritised in times of austerity.DesignA multiple case study design was used.MethodsFocus group interviews were conducted with healthcare professionals (n = 52) in home, residential, hospital and palliative care settings. The analysis was performed in two steps: firstly, a within‐case analysis of each context was conducted, followed by a cross‐case analysis.FindingsDifferences and similarities were observed among the care contexts, including for the origin of existential loneliness. In home care and residential care, the focus was on life, the present and the past, compared to hospital and palliative care, in which existential loneliness mainly related to the forthcoming death. The older person's home, as the place where home care or palliative care was received, helped preserve the older person's identity. In hospital and palliative care, as in institutional care, the place offered security, while in residential care, the place could make older people feel like strangers. Creating relationships was considered an important part of the professionals’ role in all four care contexts, although this had different meanings, purposes and conditions.ConclusionsThe context of care matters and influences how professionals view existential loneliness among older people and the opportunities they have to address existential loneliness.Implications for practiceSupport for professionals must be tailored to their needs, their education levels and the context of care. Professionals need training and appropriate qualifications to address existential loneliness related to existential aspects of ageing and care.
Trapped in the Past? The Reproduction of Poverty and Marginality in a Hungarian Manorial Village
Authors: Németh Krisztina 
Published: April 2019

AbstractThis article is an examination of the (re)‐production of poverty and marginality among former manorial servants and their descendants in a Hungarian manorial village. Manorial servants were a large subgroup of the agrarian proletariat in interwar Hungary; their long‐term, rural poverty – sometimes conceptualised as ‘traditional’ – has been aggravated by territorial stigmatisation and represents a specific case even within the context of rural poverty. However, the manorial settlement examined here (now the village of ‘Longfield’) is an extreme case given that a highly successful large‐scale farm has remained in the locality despite a long series of social, political, and economic changes. The presence of this farm influenced both this locality’s developmental path and its room for economic manoeuvring, as well as local people’s living strategies and life chances. The empirical basis for this analysis is a collection of 34 family‐history interviews conducted in ‘Longfield’. This article encompasses the continuities and discontinuities both in people’s narratives and in social and economic structures, and is thus an investigation of the dynamic relationships between and among lived poverty, perceptions of territorial stigmatisation which shape local living strategies, and intra‐ and intergenerational patterns of social and spatial (im)mobility.
Afterword: Tough Questions; Hard Problems; Incremental Progress
Authors: Sterelny Kim 
Published: April 2019

AbstractThe papers in this issue have specific and focused targets that are essential for making incremental progress on the very difficult problem of identifying the coevolutionary interactions of cognition and culture. The purpose of this paper is to discern the shape of a few of the large problems that loom over these more narrowly focussed papers, and to explain and assess the ways these papers contribute to their solution. The background problems described are (a) the character of the selective interactions between the evolution of culture and of cognition; (b) the special features of cumulative cultural evolution; and (c) the place of language in an account of cognition–culture coevolution. The paper ends with some reflections on the extraordinarily difficult challenge of testing scenarios in this field.
Study protocol for a randomised controlled trial of carvedilol versus variceal band ligation in primary prevention of variceal bleeding in liver cirrhosis (CALIBRE trial)
Authors: Tripathi Dhiraj , Hayes Peter Clive , Richardson Paul , Rowe Ian , Ferguson James , Devine Peter , Mathers Jonathan , Poyner Christopher , Jowett Sue , Handley Kelly , Grant Margaret , Slinn Gemma , Ahmed Khaled , Brocklehurst Peter 
Published: April 2019

IntroductionLiver cirrhosis is the fifth largest cause of adult deaths, and a major complication, variceal bleeding is associated with a 1-year mortality of 40%. There is uncertainty on the first-line therapy for prevention of variceal bleeding owing to a lack of adequately powered trials comparing non-selective beta blockers, in particular carvedilol, with variceal band ligation.Methods and analysisCALIBRE is a multicentre, pragmatic, randomised controlled, open-label trial with an internal pilot. The two interventions are carvedilol 12.5 mg od or variceal band ligation (VBL). Patients with liver cirrhosis and medium to large oesophageal varices that have never bled are eligible for inclusion. The primary outcome is any variceal bleeding within 1 year of randomisation. Secondary endpoints include time to variceal bleed, mortality, transplant-free survival, adverse events, complications of cirrhosis, health-related quality of life, use of healthcare resources, patient preference and use of alternative or crossover therapies. The sample size is 2630 patients over a 4-year recruitment period, across 66 hospitals in the UK.Ethics and disseminationThe study has been approved by a National Health Service (NHS) Research Ethics Committee (REC) (reference number 18/NE/0296). The results of this trial will be submitted for publication in a peer reviewed journal. Participants will be informed via a link to a preview of the publication. A lay summary will also be provided via email or posted to participants prior to publication (ISRCTN reference number: 73887615).
Acceptance, adherence and dropout rates of individuals with COPD approached in telehealth interventions: a protocol for systematic review and meta-analysis
Authors: Alghamdi Saeed Mardy , Janaudis-Ferreira Tania , Alhasani Rehab , Ahmed Sara 
Published: April 2019

IntroductionTelehealth interventions have the potential of improving exacerbation and health outcomes for individuals with chronic obstructive pulmonary disease (COPD), by delivering care in between clinical visits. However, the precise impact on avoiding exacerbation and reducing the incidence of hospital readmissions remains inconclusive. This lack of knowledge on the effectiveness of telehealth for COPD care might be due to non-adherence or partial adherence to intervention programmes and/or the withdrawal of participants over the course of previous studies.ObjectivesTo conduct a systematic review of trials of telehealth interventions (including randomised control trials (RCT), crossover and pre-post studies) to: (1) estimate the acceptance, adherence and dropout rates; (2) identify the reasons for dropout from telehealth interventions among individuals with COPD; (3) evaluate the impact of trial-related, sociodemographic and intervention-related factors on the acceptance, adherence and dropout rates and (4) estimate the extent to which the acceptance, adherence and dropout rates impact outcomes in comparison with usual monitoring.Methods and analysisA systematic literature review of four databases from earliest records to November 2018 will be carried out using CINAHL, Medline (Ovid), Cochrane Library and Embase. Randomised and non-randomised control studies will be included, in addition to crossover and pre-studies post-studies comparing telehealth with standard monitoring among individuals with COPD only. Two independent reviewers will screen all relevant abstracts and full-text studies to determine eligibility, assess the risk of bias and extract the data using structured forms. If the included studies are sufficiently homogenous in terms of interventions, populations and objectives, a meta-analysis will be performed.Ethics and disseminationEthical considerations are not required for this research.Trial registration numberCRD42017078541.
Interdisciplinary handover between obstetric nursing and neonatal physician teams: an observational study
Authors: Arora Anshul , Kannampallil Thomas , Abraham Joanna 
Published: April 2019

ObjectiveWe investigated the content and quality of communication of interservice interprofessional handover between obstetric nurses and neonatal physicians for high-risk deliveries.DesignObservational study.SettingLabour and delivery unit at a tertiary care hospital.MethodWe audio-recorded handovers between obstetric and neonatal teams (n=50) and conducted clinician interviews (n=29). A handover content framework was developed and used to qualitatively code missing core and ancillary content and their potential for adverse events.Results26 (52%) handovers missed one or more clinical content elements; a third of the handovers missed at least one core clinical content element. Increase in the number of missed clinical content elements increased the odds of potential adverse events by 2.39 (95% CI1.18 to 5.37). Both residents and nurses perceived handovers to be of low quality and inconsistent and attributed it to the lack of a structured handover process.ConclusionStreamlining handover processes by instituting standardisation approaches for both information organisation and communication can improve the quality of neonatal handovers.
An Improved Group Similarity-Based Association Rule Mining Algorithm in Complex Scenes
Authors: Duan Guiduo , Wang Xiaotong , Huang Tianxi , Kurths Jürgen 
Published: April 2019

Association rule (AR) mining in complex scene has attracted extensive attention of researchers in recent years. Typically, many researchers focused on an algorithm itself and ignored a generalization method to improve the performance of AR mining. Tuna et al., presented a general data structure Speeding-Up AR Structure with Inverted Index Compression (SAII) which could be utilized in most of the existing algorithms to improve their performance IEEE Trans. Cybern. 46(12) (2016) 3059–3072. However, we found that this algorithm consumes a lot of time in re-ordering data because a one-to-one comparison method is used in this process, which is the main reason that the speeding-up structure is difficult to establish when coping with much more large amount of data. To overcome these problems, this paper aims to propose an improved speeding-up AR algorithm based on group similarity and Apache Spark framework to further reduce the memory requirements and runtime. Our simulation results on the police business big dataset make clear that our improved approach performs well and is more suitable for a big data environment.
Automated Congressional Redistricting
Authors: Levin Harry A. , Friedler Sorelle A. 
Published: April 2019

Every 10 years, when states are forced to redraw their congressional districts, the process is intensely partisan, and the outcome is rarely fair and democratic. In the past few decades, the growing capabilities of computers have offered the promise of objective, computerized redistricting. Unfortunately, the redistricting problem can be shown to be NP-Complete, but there are a number of heuristics that are effective. We specifically define the redistricting problem and analyze several variations of a new divide and conquer algorithm, comparing the compactness and population deviation of our new algorithm to existing algorithms and the actual districts. We offer a comparative component-based analysis that demonstrates the strengths and weaknesses of each algorithm component and the type of input. The comparative analysis shows that there are several ways to produce valid redistricting plans, but each approach has benefits and consequences.
Our new algorithm produces valid results to the redistricting problem in almost every state that undergoes congressional redistricting, offering a new solution to this challenging real-world problem. In one version, the algorithm produces plans with the optimal population deviation in 42 out of 43 multi-district states, which is better than most algorithms in the literature. While compactness scores vary, this approach offers new opportunities to improve population deviation. Our output files comply with the accepted format at most government hearings and redistricting competitions, so the results would be compatible with most public participation efforts in 2020.
Vitamin D Signaling Suppresses Early Prostate Carcinogenesis in TgAPT121 Mice
Authors: Fleet James C. , Kovalenko Pavlo L. , Li Yan , Smolinski Justin , Spees Colleen , Yu Jun-Ge , Thomas-Ahner Jennifer M. , Cui Min , Neme Antonio , Carlberg Carsten , Clinton Steven K. 
Published: April 2019

Abstract

We tested whether lifelong modification of vitamin D signaling can alter the progression of early prostate carcinogenesis in studies using mice that develop high-grade prostatic intraepithelial neoplasia that is similar to humans. Two tissue-limited models showed that prostate vitamin D receptor (VDR) loss increased prostate carcinogenesis. In another study, we fed diets with three vitamin D3 levels (inadequate = 25 IU/kg diet, adequate for bone health = 150 IU/kg, or high = 1,000 IU/kg) and two calcium levels (adequate for bone health = 0.5% and high = 1.5%). Dietary vitamin D caused a dose-dependent increase in serum 25-hydroxyvitamin D levels and a reduction in the percentage of mice with adenocarcinoma but did not improve bone mass. In contrast, high calcium suppressed serum 1,25-dihydroxyvitamin D levels and improved bone mass but increased the incidence of adenocarcinoma. Analysis of the VDR cistrome in RWPE1 prostate epithelial cells revealed vitamin D–mediated regulation of multiple cancer-relevant pathways. Our data support the hypothesis that the loss of vitamin D signaling accelerates the early stages of prostate carcinogenesis, and our results suggest that different dietary requirements may be needed to support prostate health or maximize bone mass.

Significance:
This work shows that disrupting vitamin D signaling through diet or genetic deletion increases early prostate carcinogenesis through multiple pathways. Higher-diet vitamin D levels are needed for cancer than bone.
From Multiple Organ Support Therapy to Extracorporeal Organ Support in Critically Ill Patients
Authors: Ronco Claudio , Ricci Zaccaria , Husain-Syed Faeq 
Published: April 2019

Critically ill patients developing severe forms multiple organ dysfunction syndrome (MODS) may not be adequately supported by pharmacologic management. In these complex cases, a single form of extracorporeal organ support (ECOS) may be required, but multiple organ support therapy (MOST) is currently seen as a feasible approach. Severe renal dysfunction is a typical syndrome requiring renal replacement therapy (RRT) in the context of MODS. After more than a decade of RRT application in various intensive care settings, ECOS are not anymore seen as extraordinary or particularly aggressive techniques in MODS patients. Nowadays, a significant increase in the use of extracorporeal membrane oxygenation and extracorporeal carbon dioxide removal is occurring. When renal and cardio-pulmonary ECOS are used together, a multidisciplinary approach is necessary to minimize negative interactions and unwanted adverse effects. In this editorial, we focus on the organ crosstalk between the native and artificial organs, including the advantages and disadvantages of organ support on multiorgan function. Much of current experience on MOST has been gained upon RRT connected to other organ support therapies. Overall, available literature has not definitely established the ideal timing of these interventions, and whether early implementation impacts organ recovery and optimizes resource utilization is still a matter of open debate: it is possible that future research will be devoted to identify patient groups that may benefit from short- and long-term multiple organ support. Video Journal Club “Cappuccino with Claudio Ronco” at https://www.karger.com/Journal/ArticleNews/490694?sponsor=52
ФУНКЦІОНАЛЬНА ХАРАКТЕРИСТИКА ХВОРИХ НА ІНФАРКТ МІОКАРДА ІЗ СУПУТНІМИ ЗАХВОРЮВАННЯМИ ПЕРИФЕРІЙНИХ АРТЕРІЙ ТА ОСОБЛИВОСТІ ПІДХОДІВ ДО ЇХ ВІДНОВНОГО ЛІКУВАННЯ
Authors: Levytska L. V. 
Published: April 2019

Висока поширеність кардіологічних захворювань і їх часте поєднання з різними коморбідними станами спричиняють ріст кількості пацієнтів, у яких лікувальні підходи виходять за межі загальноприйнятих стандартів. Поширеність захворювань периферійних артерій (ЗПА) зростає у всьому світі, причому пацієнти із ЗПА мають не тільки знижену якість життя, але й високий ризик таких серцево-судинних подій, як інсульт, інфаркт міокарда і смерть внаслідок серцево-судинних захворювань.
Мета – аналіз взаємозв'язків між наявністю коморбідної патології периферійних артерій і функціональними показниками хворих на інфаркт міокарда.
Матеріал і методи. Обстежено 371 хворого на гострий інфаркт міокарда з коморбідною патологією, в тому числі ЗПА, які проходили гостру фазу реабілітації. Вік пацієнтів становив (66,16±10,41) року. Серед обстежених було 249 (67,12 %) чоловіків і 122 жінки (32,88 %). Параметри внутрішньосерцевої гемодинаміки визначали, оцінюючи ехокардіоскопічні показники, виміряні на апараті Philips HD11XE, електрокардіографічні показники сер­це­вої діяльності вивчали за допомогою ЕКГ апарата «ЮТАС», біохімічні показники крові визначали загаль­ноприйнятими методами, використовуючи стандартні тестові системи (Пліва-Лахема, Чехія).
Результати. При вивченні зв'язків між супутньою патологією периферійних артерій у хворих на ІМ і число­вими функціональними показниками було зафіксовано пряму кореляцію між наявністю судинної патології та тривалістю анамнезу артеріальної гіпертензії, величиною систолічного та діастолічного артеріального тиску, товщиною стінок лівого шлуночка та розміром правого шлуночка, а також між наявністю судинної патології і індексом коморбідності. Доведено, що ЗПА є незалежним предиктором гіршого функціонального стану в пацієнтів із ІМ внаслідок поглиблення структурно-функціональних змін серця.
Висновки. Асоціація інфаркту міокарда з коморбідним захворюванням периферійних артерій є незалежним предиктором гіршого функціонального стану організму. Індекс коморбідності Чарльсона може слугувати інстру­ментом кількісної оцінки ступеня коморбідності у хворих на ІМ із ЗПА при визначенні функціонального статусу та плануванні реабілітації.
ОСОБЛИВОСТІ ХОЛІНЕРГІЧНОЇ РЕГУЛЯЦІЇ СЕРЦЯ ЩУРІВ РІЗНОЇ СТАТІ ПРИ ПОШКОДЖЕННІ МІОКАРДА ДЕКСАМЕТАЗОНОМ ТА ЗАСТОСУВАННІ L-КАРНІТИНУ ДЛЯ КОРЕКЦІЇ ДАНОГО СТАНУ
Authors: Pelykh V. Ye. , Sverediuk Yu. A. 
Published: April 2019

Глюкокортикоїди часто використовуються у лікуванні хронічних запальних захворювань, проте їх тривале застосування супроводжується розвитком ускладнень. Одним із таких ускладнень є пошкодження міокарда, а пошук нових засобів кардіопротекції передбачає вплив на різноманітні ланки патогенезу, в тому числі й на фізіологічні механізми, що забезпечують природну протекцію. Холінергічна ланка регуляції діяльності серця автономною нервовою системою здатна забезпечити такий захист серцю, і пошук речовин, що модулюють активність даної ланки, зумовлює актуальність даного дослідження.
Мета – оцінити інтенсивність брадикардії при введенні в яремну вену ацетилхоліну та електричному подразненні периферійного відрізка блукаючого нерва електричним струмом за умов пошкодження серця дексаметазоном, а також дії L-карнітину у тварин різної статі.
Матеріал і методи. Експерименти виконано на 48 статевозрілих білих безпородних щурах різної статі, яких було поділено на 4 групи. Інтенсивність брадикардії вивчали за допомогою електрокардіографії на комп'ютерному комплексі «КардіоЛаб СЕ» та електричного стимулятора «ЭСЛ-2».
Результати. У тварин різної статі по-різному змінюється реакція серця на подразнення блукаючого нерва залежно від дії досліджуваних лікарських засобів. У самців інтактної групи інтенсивність брадикардії вища в 1,6 раза порівняно із самками. За умов дії на організм тварин L-карнітину досліджуваний показник був вищий у самців у 3,3 раза, ніж у самок. Застосування лише дексаметазону спричинило інтенсивнішу реакцію у самців порівняно із самками на 35 %, а комбінації дексаметазону та L-карнітину – на 15 %.
Висновки. Дексаметазон (у дозі 350 мкг/кг маси тварини per os) подібно діє на холінореактивність синусового вузла серця щурів різної статі – зменшує чутливість холінорецепторів. На фоні дії дексаметазону холінореактивність синусового вузла тварин різної статі при впливі L-карнітину (в дозі 200 мг/кг маси тварини per os) змінюється по різному: у самок чутливість холінорецепторів різко знижується при компенсаторному зростанні інтенсивності вивільнення нейромедіатора у пресинаптичну щілину; у самців чутливість холінорецепторів залишається низькою при помірному зменшенні інтенсивності вивільнення ацетилхоліну.