bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Rise and Irrelevance of the State: Political Views from a Peasant Community of the 2016 Peruvian Presidential Election
Authors: Vincent Susan 
Published: December 2018

AbstractThis case study of a peasant community in the Peruvian central highlands examines how vibrant political engagement in the 1970s became indifference during the 2016 Peruvian presidential election. It focuses on changing livelihood activities over the past three decades. Thirty years ago, community incomes were based on farming and wage labor, and community members were activists in worker–peasant organizations to achieve better market and work conditions. Now, small‐scale agriculture and formal employment have declined and livelihoods are precarious. The state addresses this through decentralized spending and cash transfers. Despite this unprecedented state support, the community had no interest in the 2016 national election. Instead, their attention was focused on the municipality, which delivers the new funds in Peru's decentralized government system. Rather than leveraging job and income creation, these funds condemn the people to ongoing precarity because the state has avoided the structural changes that would create viable jobs and markets for their products. These concerns find no organized political expression, as recent analysis of Peruvian politics reveals a weak party system and fragmented civil society. This situation poses significant challenges to political organizations that would seek more equitable structural transformations.
Life, Death, and Dialysis: Medical Repatriation and Liminal Life among Undocumented Kidney Failure Patients in the United States
Authors: Kline Nolan 
Published: December 2018

AbstractAnthropological research on policy and health underscores how policy reflects cultural ideologies and results in marginalizing specific populations. Ethnographic inquiry can further reveal the broader, unexpected effects of policy change. In this article, I describe how state legislators in Georgia revised an existing entitlement program to specifically exclude undocumented immigrants with kidney failure from receiving life‐sustaining care. This health policy change converged with broader efforts to financialize the US health system and resulted in undocumented immigrant patients dying; being medically repatriated to their countries of birth; placed in private, for‐profit dialysis centers; or obtaining care through a burdensome process involving a public hospital's emergency room. Drawing from Mbembe's concept of necropolitics, I show how policy changes left undocumented kidney failure patients in a state between life and death, revealing the hidden outcomes of policies targeting immigrants. As anti‐immigrant policies continue to be proposed in the United States, findings from this article provide a cautionary tale about the sweeping consequences of legislation that targets immigrants.
Project Governance beyond Foreign Aid: Mediating Neoliberalism in Lithuania
Authors: Mikhaylova Marina 
Published: December 2018

AbstractScholars have shown that foreign aid projects reconfigure social relations and political institutions, but projects are a novel form of governance that has significant social and political effects in other national and transnational contexts. My argument is based on seventeen months of ethnographic research at nonprofit organizations that work with youth in Lithuania. These organizations operate primarily through projects, which are publicly or privately financed initiatives open to competition. Individuals who are part of the project system get recruited into social roles and adopt terminology linked to European Union and transnational discourses. The project system transforms institutional relations, as organizations orient toward multiple sources of financing at different national and international levels, and prompts individuals to reconceptualize their activities as apolitical project work. Project governance, which is based on competition and short‐term initiatives, aligns with and reinforces some features of neoliberalism. However, individuals have complex and sometimes contradictory orientations to neoliberalism in that they also critique the state and the transnational project system. Projects not only highlight transformations of the political economy but also provide new resources to resist state withdrawal and aspects of neoliberalism.
“A Dot on a Map”: Cartographies of Erasure in Garifuna Territory
Authors: Brondo Keri Vacanti 
Published: December 2018

AbstractThis article explores the complexities of territorial dispossession in a post‐Washington‐Consensus global development policy context. In particular, it explores a contemporary development paradox in Honduras: the transnational recognition of the rights of indigenous people alongside massive land dispossession of the Afro‐Indigenous Garifuna in the name of development. Cartography is considered both in terms of physical mapping projects and ideological boundary‐making through rhetorical dispossession. In state‐sponsored communal mapping projects from the late 1990s into the early 2000s, the Garifuna were denied both currently inhabited land and that which they historically accessed. Anything that sat beyond mapped borders became “open” to foreign purchase. Legislation passed after the 2009 coup d’état further erased the Garifuna's historical occupation of coastal lands by embracing "model city” development and megatourism. Despite post–Washington Consensus development discourses of equality and official rhetoric of inclusion and celebration of indigenous rights, this case study demonstrates cartographic processes continue to erase Garifuna historical rights to territory.
Monoclonal anti‐CD47 interference in red cell and platelet testing
Authors: Velliquette Randall W. , Aeschlimann Judith , Kirkegaard Julie , Shakarian Gayane , Lomas‐Francis Christine , Westhoff Connie M. 
Published: December 2018

BACKGROUNDAnti‐CD47 (Hu5F9‐G4) is a human monoclonal immunoglobulin G (IgG)4 antibody that is in clinical trials to treat hematologic or solid malignancies. CD47, a glycoprotein expressed on all cells, binds to signal‐regulatory protein α on macrophages and regulates phagocytosis. Blocking CD47 is thought to enhance phagocytosis and promote antitumor responses. Here, we evaluate drug interference in pretransfusion testing, determine mitigation strategies, and compare interference with anti‐CD38 (Daratumumab).STUDY DESIGN AND METHODSSamples from four patients were tested by standard methods. Anti‐IgG (Immucor monoclonal Gamma‐clone and Ortho BioClone) were used, and dithiothreitol and enzyme‐treated RBCs were tested. Allo‐adsorption was performed with papain treated RBCs, pooled platelets, or with commercial human platelet concentrate. Platelet antibody testing was performed according to manufacturer's instructions.RESULTSAll plasma samples reacted 3+ to 4+ in all phases with all red blood cells (RBCs) by all methods including immediate spin. Stronger reactivity was observed with D– RBCs with titers as high as 16,384 at indirect antiglobulin testing. Reactivity at indirect antiglobulin testing using Gamma‐clone anti‐IgG (which does not detect IgG4) was only weakly positive and confirmed to be carryover agglutination. Plasma reacted with dithiothreitol, trypsin, papain, α‐chymotrypsin, or warm autoantibody removal medium (W.A.R.M., Immucor) treated RBCs. Direct antiglobulin testing and autocontrol were negative or weak with 3+ reactive eluates. Reactivity was removed by multiple alloadsorptions with papain‐treated cells or pooled platelets. Polyethylene glycol adsorption was invalid due to precipitation of antibody.CONCLUSIONAnti‐CD47 (Hu5F9‐G4) interferes with all phases of pretransfusion testing, including ABO reverse typing. To remove interference requires multiple RBC alloadsorptions and/or the use of monoclonal Gamma‐clone anti‐IgG in the indirect antiglobulin testing.
Distribution and extent of electronic medical record utilisation in eye units across the United Kingdom: a cross-sectional study of the current landscape
Authors: Lim Shin Bin , Shahid Humma 
Published: December 2018

ObjectivesOphthalmology units across the UK vary widely in their adoption of electronic medical records (EMR). There is a lack of evidence to show the extent and progress of EMR adoption. The aim of this study was to capture a snapshot of the current landscape of EMR use, as a baseline for comparison in future studies.SettingAn electronic survey questionnaire was sent to all NHS ophthalmology Units in the UK.ParticipantsA total of 104 National Health Service (NHS) ophthalmology units participated in the survey, which was carried out over 6 months from December 2013 to June 2014.Primary and secondary outcome measuresRespondents were asked about technology usage pertaining to specific processes in the clinic workflow. This allowed us to determine the extent of EMR usage and details about current use or planned implementation by each unit.Results77.6% (n=104) of NHS ophthalmology units responded. 45.3% (n=48) of units were currently using an EMR and a further 26.4% (n=28) of units plan to implement EMR within 2 years. 70.8% of units with a current EMR system use Medisoft. EMR is used by all clinicians in 37.5% and by all subspecialties offered at the unit in 27.0%. In 56.3%, new clinical notes are entered into EMR only by clinicians. All imaging devices are networked to EMR in 28.3%. In 46.7%, EMR is accessible by other specialties within the same hospital. 71.1% would recommend EMR to a colleague.ConclusionsEMR has the potential to address current limitations of patient information transfer and sharing in ophthalmology. It is pleasing to see a significant proportion of units already engaging with EMR or having plans to do so in the near future. However, differing EMR systems and lack of remote access mean further optimisation of these record systems are needed to allow data transfer between units.
Cohort profile: internal migration in sub-Saharan Africa—The Migration and Health in Malawi (MHM) study
Authors: Anglewicz Philip , VanLandingham Mark , Manda-Taylor Lucinda , Kohler Hans-Peter 
Published: December 2018

PurposeThe Migration and Health in Malawi (MHM) study focuses on a key challenge in migration research: although it has long been established that migration and health are closely linked, identifying the effect of migration on various health outcomes is complicated by methodological challenges. The MHM study uses a longitudinal panel premigration and postmigration study design (with a non-migrant comparison group) to measure and/or control for important characteristics that affect both migration and health outcomes.ParticipantsData are available for two waves. The MHM interviewed 398 of 715 migrants in 2007 (55.7%) and 722 of 1013 in 2013 (71.3%); as well as 604 of 751 (80.4%) for a non-migrant reference group in 2013. The total interviewed sample size for the MHM in both waves is 1809. These data include extensive information on lifetime migration, socioeconomic and demographic characteristics, sexual behaviours, marriage, household/family structure, social networks and social capital, HIV/AIDS biomarkers and other dimensions of health.Findings to dateOur result for the relationship between migration and health differs by health measure and analytic approach. Migrants in Malawi have a significantly higher HIV prevalence than non-migrants, which is primarily due to the selection of HIV-positive individuals into migration. We find evidence for health selection; physically healthier men and women are more likely to move, partly because migration selects younger individuals. However, we do not find differences in physical or mental health between migrants and non-migrants after moving.Future plansWe are preparing a third round of data collection for these (and any new) migrants, which will take place in 2018. This cohort will be used to examine the effect of migration on various health measures and behaviours, including general mental and physical health, smoking and alcohol use, access to and use of health services and use of antiretroviral therapy.
Are healthcare aides underused in long-term care? A cross-sectional study on continuing care facilities in Canada
Authors: Arain Mubashir A , Deutschlander Siegrid , Charland Paola 
Published: December 2018

ObjectivesOver the last 10 years, appropriate workforce utilisation has been an important discussion among healthcare practitioners and policy-makers. The role of healthcare aides (HCAs) has also expanded to improve their utilisation. This evolving role of HCAs in Canada has prompted calls for standardised training, education and scope of practice for HCAs. The purpose of this research was to examine the differences in HCAs training and utilisation in continuing care facilities.DesignFrom June 2014 to July 2015, we conducted a mixed-method study on HCA utilisation in continuing care. This paper presents findings gathered solely from the prospective cross-sectional survey of continuing care facilities (long-term care (LTC) and supportive living (SL)) on HCA utilisation.Setting and participantsWe conducted this study in a Western Canadian province. The managers of the continuing care facilities (SL and LTC) were eligible to participate in the survey.Primary outcome measuresThe pattern of HCAs involvement in medication assistance and other care activities in SL and LTC facilities.ResultsWe received 130 completed surveys (LTC=64 and SL=52). Our findings showed that approximately 81% of HCAs were fully certified. We found variations in how HCAs were used in SL and LTC facilities. Overall, HCAs in SL were more likely to be involved in medication management such as assisting with inhaled medication and oral medication delivery. A significantly larger proportion of survey respondents from SL facilities reported that medication assistance training was mandatory for their HCAs (86%) compared with the LTC facilities (50%) (p value <0.01).ConclusionThe utilisation of HCAs varies widely between SL and LTC facilities. HCAs in SL facilities may be considered better used according to their required educational training and competencies. Expanding the role of HCAs in LTC facilities may lead to a cost-effective and more efficient utilisation of workforce in continuing care facilities.
The burden of cancer attributable to modifiable risk factors: the Australian cancer-PAF cohort consortium
Authors: Arriaga Maria E , Vajdic Claire M , Canfell Karen , MacInnis Robert , Hull Peter , Magliano Dianna J , Banks Emily , Giles Graham G , Cumming Robert G , Byles Julie E , Taylor Anne W , Shaw Jonathan E , Price Kay , Hirani Vasant , Mitchell Paul , Adelstein Barbara-Ann , Laaksonen Maarit A 
Published: December 2018

PurposeTo estimate the Australian cancer burden attributable to lifestyle-related risk factors and their combinations using a novel population attributable fraction (PAF) method that accounts for competing risk of death, risk factor interdependence and statistical uncertainty.Participants365 173 adults from seven Australian cohort studies. We linked pooled harmonised individual participant cohort data with population-based cancer and death registries to estimate exposure-cancer and exposure-death associations. Current Australian exposure prevalence was estimated from representative external sources. To illustrate the utility of the new PAF method, we calculated fractions of cancers causally related to body fatness or both tobacco and alcohol consumption avoidable in the next 10 years by risk factor modifications, comparing them with fractions produced by traditional PAF methods.Findings to dateOver 10 years of follow-up, we observed 27 483 incident cancers and 22 078 deaths. Of cancers related to body fatness (n=9258), 13% (95% CI 11% to 16%) could be avoided if those currently overweight or obese had body mass index of 18.5–24.9 kg/m2. Of cancers causally related to both tobacco and alcohol (n=4283), current or former smoking explains 13% (11% to 16%) and consuming more than two alcoholic drinks per day explains 6% (5% to 8%). The two factors combined explain 16% (13% to 19%): 26% (21% to 30%) in men and 8% (4% to 11%) in women. Corresponding estimates using the traditional PAF method were 20%, 31% and 10%. Our PAF estimates translate to 74 000 avoidable body fatness-related cancers and 40 000 avoidable tobacco- and alcohol-related cancers in Australia over the next 10 years (2017–2026). Traditional PAF methods not accounting for competing risk of death and interdependence of risk factors may overestimate PAFs and avoidable cancers.Future plansWe will rank the most important causal factors and their combinations for a spectrum of cancers and inform cancer control activities.
Can process mining automatically describe care pathways of patients with long-term conditions in UK primary care? A study protocol
Authors: Litchfield Ian , Hoye Ciaron , Shukla David , Backman Ruth , Turner Alice , Lee Mark , Weber Phil 
Published: December 2018

IntroductionIn the UK, primary care is seen as the optimal context for delivering care to an ageing population with a growing number of long-term conditions. However, if it is to meet these demands effectively and efficiently, a more precise understanding of existing care processes is required to ensure their configuration is based on robust evidence. This need to understand and optimise organisational performance is not unique to healthcare, and in industries such as telecommunications or finance, a methodology known as ‘process mining’ has become an established and successful method to identify how an organisation can best deploy resources to meet the needs of its clients and customers. Here and for the first time in the UK, we will apply it to primary care settings to gain a greater understanding of how patients with two of the most common chronic conditions are managed.Methods and analysisThe study will be conducted in three phases; first, we will apply process mining algorithms to the data held on the clinical management system of four practices of varying characteristics in the West Midlands to determine how each interacts with patients with hypertension or type 2 diabetes. Second, we will use traditional process mapping exercises at each practice to manually produce maps of care processes for the selected condition. Third, with the aid of staff and patients at each practice, we will compare and contrast the process models produced by process mining with the process maps produced via manual techniques, review differences and similarities between them and the relative importance of each. The first pilot study will be on hypertension and the second for patients diagnosed with type 2 diabetes.Ethics and disseminationEthical approval has been provided by East Midlands–Leicester South Regional Ethics Committee (REC reference 18/EM/0284). Having refined the automated production of maps of care processes, we can explore pinch points and bottlenecks, process variants and unexpected behaviour, and make informed recommendations to improve the quality and efficiency of care. The results of this study will be submitted for publication in peer-reviewed journals.
Pregnancy-associated cancers and birth outcomes in children: a Danish and Swedish population-based register study
Authors: Momen Natalie C , Arendt Linn Håkonsen , Ernst Andreas , Olsen Jørn , Li Jiong , Gissler Mika , Ramlau-Hansen Cecilia H 
Published: December 2018

ObjectivesThis study aims to estimate the association between pregnancy-associated maternal cancers, diagnosed both prenatally and postnatally, and birth outcomes.DesignPopulation-based register study.SettingNational registers of Denmark and Sweden.ParticipantsA total of 5 523 365 children born in Denmark (1977–2008) and Sweden (1973–2006).Primary and secondary outcome measures: gestational age, birth weight, size for gestational age, Apgar score, caesarean section and sex were the outcomes of interest. ORs and relative risk ratios (RRR) with 95% CIs were estimated using logistic regression and multinomial logistic regression, respectively.ResultsIn this study, 2% of children were born to mothers with a diagnosis of cancer. Children whose mothers received a prenatal cancer diagnosis had higher risk of being born preterm (RRR: 1.77, 95% CI 1.64 to 1.90); low birth weight (RRR 1.84, 95% CI 1.69 to 2.01); low Apgar score (OR 1.36, 95% CI 1.20 to 1.56); and by caesarean section (OR: 1.69, 95% CI 1.59 to 1.80). Associations moved towards the null for analyses using postnatal diagnoses, but preterm birth (RRR: 1.13, 95% CI 1.09 to 1.17) and low birth weight (RRR: 1.14, 95% CI 1.09 to 1.18) remained statistically significant, while risk of caesarean section became so (OR: 0.95, 95% CI 0.91 to 0.98). Additionally, statistical significance was reached for large for gestational age (RRR: 1.06, 95% CI 1.01 to 1.11), high birth weight (RRR: 1.04, 95% CI 1.01 to 1.06) and caesarean section (OR: 0.95, 95% CI 0.91 to 0.98).ConclusionsResults suggest an association between pregnancy-associated cancers and adverse birth outcomes in the offspring. While this is strongest for prenatally diagnosed cancers, some smaller associations exist for postnatally diagnosed cancers, indicating that cancer itself could affect fetal development, or that cancer and adverse birth outcomes share risk factors. Future studies on maternal cancer during pregnancy should consider including some postnatal years in their exposure window.
Establishment of trauma treatment teams within a regional severe trauma treatment system in China: study protocol for a national cluster-randomised trial
Authors: Wang Yu , Liu Hui-Xin , Wang Yan-Hua , Zhang Ya-Jun , Zhang Jin-Jun , Huang Wei , Jiang Bao-Guo , Wang Tian-Bing 
Published: December 2018

IntroductionThe implementation of first aid processes for patients with trauma in China faces significant challenges. These challenges include long response times of prehospital first aid services, lack of information exchange between prehospital first aid services and in-hospital emergency services, lack of a professional rescue team in the majority of hospitals, and lack of standardised training for prehospital and in-hospital emergency personnel. The purpose of the trial is to guide the establishment of an urban trauma treatment system in China, highlight the construction of a trauma treatment system tailored to the Chinese context and improve levels of medical treatment by selecting approximately 100 counties across China as pilots to establish a regional trauma treatment system.Methods and analysisA cluster-randomised controlled trial will be performed in 98 county-level research institutes. Included research institutes will be randomised into an experimental group and a control group. Patients in both experimental and control groups will receive basic treatments. A trauma treatment team will be established in the experimental group. The primary outcome measure is in-hospital mortality rate of patients. The secondary outcome measures include mortality rate of patients within 30 days after trauma attack and within 30 days after discharge, the time between arrival in the institution and receiving consultation, and the time from admission to the start of surgery. The effects of establishment of trauma treatment teams on the treatment of severe trauma will be evaluated in all counties.Ethics and disseminationThe procedures have been approved by The Medical Ethics Committee of Peking University People’s Hospital (No.2017PHB098-01) and conform to the Declaration of Helsinki. Data will be collected and analysed in accordance with participant privacy laws and regulations. Results will be disseminated through policy briefs, workshops, peer-reviewed publications and conferences.Trial registration numberNCT03363880; Pre-results.