bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preliminary effects and acceptability of a co-produced physical activity referral intervention
Authors: Buckley Benjamin JR , Thijssen Dick HJ , Murphy Rebecca C , Graves Lee EF , Whyte Greg , Gillison Fiona , Crone Diane , Wilson Philip M , Hindley Daniel , Watson Paula M 
Published: June 2019

Objectives: To explore the preliminary effects and acceptability of a co-produced physical activity referral intervention. Study Design: Longitudinal design with data collected at baseline and post a 12-week physical activity referral intervention. Setting: Community leisure centre. Methods: In all, 32 adults with controlled lifestyle-related health conditions took part in a physical activity referral intervention (co-produced by a multidisciplinary stakeholder group) comprising 12 weeks subsidised fitness centre access plus four behaviour change consultations. A complete case analysis ( t-tests and magnitude-based inferences) was conducted to assess baseline-to-12-week change in physical activity, cardiometabolic, and psychological measures. Semi-structured interviews were conducted ( n = 12) to explore experiences of the intervention. Results: Mean improvements were observed in cardiorespiratory fitness (3.6 mL kg-1 min-1 [95% confidence interval: 1.9–5.4], p < .001) and moderate-to-vigorous physical activity (12.6 minutes per day [95% confidence interval: 4.3–29.6], p = .013). Participants were positive about the support received from exercise referral practitioners, but experienced some challenges in a busy and under staffed gym environment. Conclusions: A co-produced physical activity referral intervention elicited short-term improvements in physical activity and cardiometabolic health. Further refinements may be required, via ongoing feedback between stakeholders, researchers and service users, to achieve the intended holistic physical activity focus of the intervention, prior to a definitive trial.
Video consultations in palliative care: A systematic integrative review
Authors: Jess Mia , Timm Helle , Dieperink Karin B 
Published: June 2019

Background: There is extensive need for palliative care worldwide, but access to care remains inadequate, especially for non-cancer patients. Video consultations are a promising tool in the provision of home-based palliative care, but an overview of evidence solely on video consultations in palliative care is lacking. Aim: To review and synthesize current evidence regarding the use of video consultations in general and specialized palliative care to various patient groups. Design: A systematic integrative review with a narrative synthesis was undertaken in accordance with PRISMA (2009) guidelines. PROSPERO #: CRD42018095383 Data sources: PubMed, Embase, CINAHL, and PsychINFO were searched for primary research articles published between 2005 and 2018. In addition, reference lists of included articles were hand searched. Results: The search resulted in 813 articles; 39 articles were included in the review, consisting of mixed methods ( n = 14), qualitative ( n = 10), quantitative ( n = 10), and case studies ( n = 5). The studies mainly focused on specialized palliative care to adult patients with cancer in high income countries. Through data analysis, six themes addressing advantages/disadvantages and facilitators/barriers were identified: (1) Redesign of care, (2) Communication, (3) User perceptions, (4) Technology, (5) Privacy issues, and (6) Economic implications. Conclusion: Using video technology in palliative care has both advantages and disadvantages. However, evidence beyond the focus on specialized palliative care and patients with cancer is limited. Future research should focus on how and when video consultations might replace in-person specialized palliative care and video consultations in general palliative care, in low and middle income countries; and involve patients with a non-cancer diagnosis.
Treatment of Crowe IV developmental dysplasia of the hip with cementless total hip arthroplasty and shortening subtrochanteric osteotomy
Authors: Liu Tang , Wang Sisi , Huang Guoliang , Wang Wanchun 
Published: June 2019

Objective This study was performed to document the clinical and radiographic results of consecutive patients with Crowe IV developmental dysplasia of the hip (DDH) treated by cementless total hip arthroplasty (THA) using an S-ROM femoral component with shortening derotational subtrochanteric osteotomy. Methods Twenty-three hips of 21 patients with Crowe IV DDH were treated by cementless THA combined with shortening derotational subtrochanteric osteotomy from January 2005 to January 2011. The mean preoperative modified Harris hip score (mHHS) and University of California, Los Angeles (UCLA) activity score were 40.7 and 4.2, respectively. Results The mean follow-up was 105 months. The mean mHHS and UCLA score improved to 87.0 and 9.1, respectively, at the latest follow-up. Nine of the 23 hips had a negative Trendelenburg sign. One of the 23 hips was outside the Lewinnek acetabular cup inclination safe range, and 3 of the 23 hips were outside the Lewinnek acetabular cup anteversion safe range. The probability of prosthesis survival was 100% at 5 years and 91.3% at 10 years. Conclusion Patients with Crowe IV DDH can be treated by cementless THA combined with shortening derotational subtrochanteric osteotomy. This method can greatly improve hip joint function and relieve pain without significant complications.
Radiotherapy activates autophagy to increase CD8+ T cell infiltration by modulating major histocompatibility complex class-I expression in non-small cell lung cancer
Authors: Zeng Hai , Zhang Weijia , Gong Yan , Xie Conghua 
Published: June 2019

Objective Radiotherapy is reported to enhance immune responses in cancer, but appropriate doses and mechanisms remain to be investigated. This study explored whether autophagy is involved in the regulation of major histocompatibility complex class I (MHC-I) expression and CD8+ T cell infiltration at different radiation doses. Methods Non-small cell lung cancer (NSCLC) cell lines A549 and H1975 were exposed to different doses of radiation. The levels of autophagy and MHC-I expression were examined 6 hours after irradiation. The effects of the autophagy inhibitor chloroquine (CQ) on MHC-I expression were also investigated, as well as the relationship between autophagy and MHC-1 expression. Pathological specimens from 69 NSCLC patients were collected, and immunohistochemistry was used to detect MHC-1 expression and CD8+ T cell infiltration in tumors. Results Irradiation induced autophagy and MHC-I expression during a single radiation dose from 2 to 20 Gy in a dose-dependent manner. CQ downregulated MHC-I expression. Immunohistochemistry indicated that MHC-I levels were positively correlated with the infiltration of CD8+ T cells in NSCLC cells (R2 = 0.713). Conclusions Autophagy induced MHC-I expression and increased CD8+ T cell infiltration. A single radiation dose of 20 Gy induced the strongest CD8+ T cell infiltration.
Understanding the Emergence of Authoritarian Capitalist States: Looking Backward to See Forward
Authors: Willoughby John 
Published: June 2019

This paper examines how contemporary analysts can use the analytical legacy of earlier Marxist writers on fascism and authoritarianism to understand the present. I argue that the emergence of dictatorial rule in a capitalist society once organized by parliamentary institutions can best be interpreted as a response to an intensifying crisis of representation within parliamentary democracy. These crises come as changing material conditions disrupt systems of patronage and support that had previously integrated or embedded populations into a deceptively stable capitalist growth process. This analysis draws on Marx’s original analysis in The Eighteenth Brumaire, Gramsci’s and Trotsky’s writings during the interwar period, and the early postwar analysis of Nicos Poulantzas. The article does not find the state monopoly capitalist tradition of this era to be particularly useful for understanding present (or past) periods of capitalist authoritarianism. JEL Classification: B1, B2, B3, B5
Medically Assisted Dying in Canada: “Beautiful Death” Is Transforming Nurses’ Experiences of Suffering
Authors: Bruce Anne , Beuthin Rosanne 
Published: June 2019

Background Nurses witness pain and distress up close and consequently experience their own suffering. A narrative study of Canadian nurses’ participating in medical assistance in dying found nurses’ previous witnessing of unresolved end-of-life suffering has shaped their acceptance of medical assistance in dying. Little is known about the impact of participating in medically assisted dying on nurses’ suffering. Purpose To explore how nurses’ overall experience of suffering is shaped by participating in medical assistance in dying. Methods Qualitative secondary analysis using narrative inquiry and thematic analysis. Results Nurses’ narratives are chronologically organized addressing experiences of suffering before medical assistance in dying was a legal option and after its implementation. An overarching narrative before the availability of medical assistance in dying is (1) a culture of nurses’ taken-for-granted suffering: feeling terrible. After medical assistance in dying, two key narratives describe (2) transformational feelings of a beautiful death and (3) residual discomfort. Nurses found their suffering transformed when participating in medical assistance in dying; end-of-life care was satisfying and gratifying. And yet, unanswered questions due to worries of becoming desensitized and ongoing deeper questioning remain. Conclusions Participating in medical assistance in dying has positively impacted nurses and starkly contrasts their previous experiences caring for those with unbearable suffering. Further research is needed to explore becoming desensitized and long-term emotional impact for nurses.
Clinical Characteristics and Nonconvulsive Seizures in Young Children With Abusive Head Trauma
Authors: Oh Ahyuda , Olson Larry D. , Chern Joshua J. , Kim Hyunmi 
Published: June 2019

Aim: We aimed to evaluate putative predictors of symptoms and signs at admission for nonconvulsive seizure and to examine the impact of nonconvulsive seizures on short-term outcomes. Method: We retrospectively collected consecutive abusive head trauma patients (<36 months of age) from the trauma registry at Children’s Healthcare of Atlanta between 2009 and 2014. Multiple logistic regression was performed to assess the putative predictors for the occurrence of nonconvulsive seizures including clinical seizures, altered mental status, respiratory difficulty, and cardiac arrest at admission, while controlling for age, sex, and injury severity. The Mann-Whitney U test and the Fisher exact test were used to compare the short-term outcomes between patients with and without nonconvulsive seizures. Results: Two hundred seventy patients with abusive head trauma were identified (male = 55.6%). The median age was 4 months (interquartile range = 2-8 months). Among 70 patients who underwent continuous electroencephalography (EEG), 40 had nonconvulsive seizures (57%) and 21 developed nonconvulsive status epilepticus (30%). Altered mental status at admission was associated with the occurrence of nonconvulsive seizures (odds ratio = 6.8, 95% confidence interval = 1.2-38.2, P = .03). Comparing patients with no seizures, those with nonconvulsive seizures were more likely to stay longer at hospital (9 days vs 14 days, P = .04) and to need rehabilitation (50.0% vs 63.2%, P = .03). Conclusions: Nonconvulsive seizures and nonconvulsive status epilepticus was highly prevalent in young pediatric patients with abusive head trauma. Presenting with altered mental status at admission was found to predict the occurrence of nonconvulsive seizures. Nonconvulsive seizures had an unfavorable impact on short-term outcomes.
Secular Trends in Sedentary Behavior Among High School Students in the United States, 2003 to 2015
Authors: Ryu Seungho , Kim Heontae , Kang Minsoo , Pedisic Zeljko , Loprinzi Paul D. 
Published: June 2019

Purpose: To evaluate secular trends in recreational sedentary behavior among high school students in the United States between 2003 and 2015. Design: A series of cross-sectional assessments over a 12-year period. Setting: Data from the 2003 to 2015 Youth Risk Behavior Surveillance System was used. Participants: Samples of 10 978 to 14 894 adolescents, drawn every 2 years: 2003 to 2015. Measures: The evaluated recreational self-reported sedentary behaviors included TV hours and computer hours that are not schoolwork. Results: For the entire sample, and using polynomial orthogonal coefficients via regression modeling, there was an upward linear trend for total sedentary behavior hours (β = 0.03; p = .001), a downward linear trend in TV watching (β = −0.06; p < .001), and an upward linear trend in computer use (β = 0.08; p < .001) from 2003 to 2015. Similar linear trends ( p < .001) were observed across several subpopulations, including the groups by gender, race/ethnicity, and body mass index. However, various subpopulations differed in TV watching, with black or African American, and obese adolescents having the highest TV watching hours, respectively (eg, 3.82 h/d vs 3.13 h/d in 2015; blacks vs whites; p < .05). Various subpopulations also differed in computer use, with obese adolescents (4.26 h/d in 2015) having the highest computer use. Conclusion: There were significant changes from 2003 to 2015 in sedentary behavior patterns in the US adolescent population. Total recreational sedentary behavior increased in this period. Specifically, TV viewing decreased while computer use increased. Continued monitoring of sedentary behavior trends is needed to better understand the changing behaviors of American adolescents and how they relate to changes chronic disease risk.
Depressive and anxiety symptom prevalence in childhood-onset systemic lupus erythematosus: A systematic review
Authors: Quilter MC , Hiraki LT , Korczak DJ 
Published: June 2019

Background Depressive and anxiety symptoms are common in children and youth and may impact outcomes for individuals with childhood-onset systemic lupus erythematosus. Research into the prevalence of depressive and anxiety symptoms and childhood-onset systemic lupus erythematosus comorbidity has reported conflicting results. Objective To synthesize current knowledge regarding the prevalence of depressive and anxiety symptoms in childhood-onset systemic lupus erythematosus. Methods Studies were identified through a comprehensive search of MEDLINE, EMBASE, PsychINFO, LILACS and Web of Science (from database inception to July 2018) using MESH headings and keywords for ‘lupus erythematosus’, and ‘depression’ or ‘anxiety’. Included studies measured depressive and/or anxiety symptoms prospectively among children and youth aged 8 to 21 years with a diagnosis of childhood-onset systemic lupus erythematosus. Neuropsychiatric systemic lupus erythematosus was included. Studies without use of validated screening tools for major depressive disorder or anxiety disorders were excluded, as were studies where diagnosis was by retrospective analysis of patient charts. Data were extracted by two independent coders and where discrepancies occurred, agreement was reached by consensus. Results In total, 70 studies met the criteria for full text review and of these, 14 were included in the final analysis. The majority (70%) of studies were of cross-sectional design, with sample sizes ranging from 20 to 100 (mean = 48) participants. The mean age of participants was 15.9 years and participants were predominantly female. Prevalence rates for depressive symptoms ranged from 6.7% to 59%. Anxiety symptom prevalence was 34% to 37%. All studies employed self-report instruments to assess depressive and anxiety symptoms; none of the studies utilized a semi-structured diagnostic interview to make psychiatric diagnoses. Significant heterogeneity precluded meta-analysis of the data. Conclusions Depressive and anxiety symptoms may be common comorbidities of childhood-onset systemic lupus erythematosus; however, current research is limited by a paucity of studies, small sample sizes and an inability to confirm psychiatric diagnoses. Future research addressing these limitations is needed.
Processes toward the end of life and dialysis withdrawal Physicians’ and nurses’ perspectives
Authors: Axelsson Lena , Benzein Eva , Lindberg Jenny , Persson Carina 
Published: June 2019

Background: Nurses and physicians in nephrology settings provide care for patients with end-stage kidney disease receiving hemodialysis treatment along a complex illness trajectory. Aim: The aim was to explore physicians’ and nurses’ perspectives on the trajectories toward the end of life involving decisions regarding hemodialysis withdrawal for patients with end-stage kidney disease. Research design and participants: A qualitative research approach was used. Four mixed focus group interviews were conducted with renal physicians (5) and nurses (17) in Sweden. Qualitative content analysis was used to analyse data. Ethical considerations: Ethical approval was obtained (Dnr 2014/304-31). Findings and discussion: Findings illuminated multi-faceted, intertwined processes encompassing healthcare professionals, patients, and family members. The analysis resulted in four themes: Complexities of initiating end-of-life conversations, Genuine attentiveness to the patient’s decision-making process, The challenge awaiting the family members’ processes, and Negotiating different professional responsibilities. Findings showed complexities and challenges when striving to provide good, ethical care which are related to beneficence, nonmaleficence, and self-determination, and which can give rise to moral distress. Conclusion: There are ethical challenges and strains in the dialysis context that healthcare professionals may not always be prepared for. Supporting healthcare professionals in not allowing complexities to hinder the patient’s possibilities for shared decision-making seems important. An open and continual communication, including family meetings, from dialysis initiation could serve to make conversations involving decisions about hemodialysis withdrawal a more natural routine, as well as build up a relationship of trust necessary for the advance care planning about the end of life. Healthcare professionals should also receive support in ethical reasoning to meet these challenges and handle potential moral distress in the dialysis context.
Global Financial Crisis: Dynamics of Liquidity Risk in Emerging Asia
Authors: Kumar Suraj , Prasanna Krishna 
Published: June 2019

This study investigates the dynamic impact of global and regional liquidity along with volatility on the liquidity of emerging Asian equity markets. Further, we empirically disentangle the effects of volatility and liquidity. We find that the external liquidity factors have a higher impact on domestic liquidity as compared to volatility. The impact of global volatility shocks was witnessed only during the Global Financial Crisis. Global factors have a higher influence on developed markets such as Japan and Singapore, while regional factors have a higher influence on emerging markets. These results indicate that liquidity serves as the channel of regional integration in Asia. The findings of this study provide useful insights to cross-sections of stakeholders in the investment industry. JEL Classification: G15, F21, F36
Disruption in Global Economic Governance
Authors: Bayer Kurt 
Published: June 2019

This article is concerned with problems and with the future of global economic governance. It does not deal with political, military or security questions, even though many of those are closely related to economic conditions. Recent decades have seen an increasing deterioration in the multilateral system of economic cooperation: its long-term dominant movers, the OECD (“Western”) countries, have not allowed the system to adjust adequately to the economic rise of emerging and developing countries; globalization, based on “Western” economic thinking and the concomitant unleashing of the forces of cross-border financial flows, has contributed (together with technological innovations) to gross inequalities and social disruption within countries; and the environmental damages caused by the global order (trade and investment) have led to massive degradation and climate change which threatens our way of life. Recent actions by the US president and nationalist tendencies in large parts of the world have further eroded the necessary spirit of cooperation. This article argues that in order to provide an adequate supply of global public goods, a regime of global rules is worth “saving,” if with both restructured content and institutional adjustments. Today, however, political developments do not favor a systematic re-ordering of global institutions. A multi-polar world will at best permit smaller cooperative agreements on individual issues by “coalitions of the willing,” based on countries’ and regions’ respective strategic interests. Plurilateralism, instead of multilateralism, will be the most likely, but more chaotic, organizing principle in the foreseeable future. Provision of global public goods, and the interests of smaller and weaker countries, and with that world stability, will suffer.
Differences in Cardiovascular Risk Factors in College Students: Midwest Versus Southwest
Authors: Herlosky Kristen N. , Tran Dieu-My T. 
Published: June 2019

Purpose: This study was designed to identify underlying cardiovascular risk factors among college students including lifestyle characteristics, health behaviors and knowledge, and perception of the risk factors. Method: College students ( N = 293), aged 19–36 years, enrolled at either a Midwestern or a Southwestern University in the United States, responded to three questionnaires: sociodemographic, knowledge of cardiovascular risk factors, and perception of cardiovascular risk factors. Anthropometric measures collected included blood pressure (BP), glucose, lipid panel, height, weight, and body mass index (BMI). Results: There were significant regional and gender differences in cardiovascular disease (CVD) risk among Southwestern and Midwestern college students. Students from the Southwest had a higher risk of developing CVD in 30 years compared to those in the Midwest; they also had a higher perceived risk. Males were more at risk of developing CVD than females but had a lower perceived risk than females. Dietary habits were similar between the two populations, and we found no significant differences in BMI. The two regions varied in BP levels, but the Midwestern students had significantly higher prevalence of elevated BP and Stage 2 hypertension. Conclusion: Our data suggest that college students are a high-risk population and tend to underestimate and misperceive their risk for developing CVD.