bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nested or exclusive? The role of identities on blame attribution during the Great Recession
Authors: Guinjoan Marc , Bermúdez Sandra 
Published: July 2019

AbstractDespite an increasing number of studies assessing the importance of institutions as regards to accountability, it still remains to be known whether and how an individual's national and regional identity shapes the attribution of responsibilities in multi‐level settings. By focusing on the economic crisis that affected Europe since 2008, we argue that identity‐based assessments of responsibility for the crisis will occur solely among individuals who hold exclusively national or regional identities and who live in regions that have nationalist aspirations. This will be in contrast to individuals that have exclusively identities who live in regions that lack nationalist aspirations, as well as dual‐identity individuals, irrespective of where they live. We test our arguments by using data from Catalonia and Madrid (Spain) and Bavaria and Lower Saxony (Germany). In line with our expectations, our results show that, in minority nationalist regions such as Catalonia, an individual's identity will crucially determine which level of government is blamed for the economic crisis, while this will not occur in regions with no nationalist aspirations. The article reveals the existence of an additional determinant of blame attribution in some specific multi‐level arrangements and contributes to the understanding of the tensions between identity politics and blame avoidance.
Optimal Abort Rules for Multiattempt Missions
Authors: Levitin Gregory , Finkelstein Maxim , Huang Hong‐Zhong 
Published: July 2019

AbstractMany real‐world systems use mission aborts to enhance their survivability. Specifically, a mission can be aborted when a certain malfunction condition is met and a risk of a system loss in the case of a mission continuation becomes too high. Usually, the rescue or recovery procedure is initiated upon the mission abort. Previous works have discussed a setting when only one attempt to complete a mission is allowed and this attempt can be aborted. However, missions with a possibility of multiple attempts can occur in different real‐world settings when accomplishing a mission is really important and the cost‐related and the time‐wise restrictions for this are not very severe. The probabilistic model for the multiattempt case is suggested and the tradeoff between the overall mission success probability (MSP) and a system loss probability is discussed. The corresponding optimization problems are formulated. For the considered illustrative example, a detailed sensitivity analysis is performed that shows specifically that even when the system's survival is not so important, mission aborting can be used to maximize the multiattempt MSP.
Dental‐related function and oral health in relation to eating performance in assisted living residents with and without cognitive impairment
Authors: Liu Wen , Shaw Clarissa , Chen Xi 
Published: July 2019

AbstractAimsDespite the physiologic relationship, there is a lack of evidence on how dental‐related function and oral health impact eating performance. This study aims to examine the association of eating performance with dental‐related function and oral health among assisted living residents.Methods and resultsThis study was a secondary analysis of observational data collected from an instrument development study. Participants included 90 residents with normal to severely impaired cognition from three assisted livings. Multilevel mixed‐effects ordered logistic models were used. The dependent variable was eating performance measured by the single “eating” item (scored from 0 to 4 on level of dependence). Independent variables were resident age, gender, dental‐related function, and oral health. The resident and facility clustering effects accounted for 88% of variance in eating performance, among which 84% was explained by dental‐related function and oral health. Eating performance was associated with dental‐related function (coefficient = −0.10, 95% CI = −0.19, −0.01, P = .025), and was not associated with other characteristics.ConclusionEating performance is influenced by the complex relationship with dental‐related function and oral health. Novel interventions using interdisciplinary partnerships are needed to maintain dental‐related function and oral health to optimize eating performance.
Spatially constrained regionalization with multilayer perceptron
Authors: Govorov Michael , Beconytė Giedrė , Gienko Gennady , Putrenko Viktor 
Published: July 2019

AbstractIn this article, multilayer perceptron (MLP) network models with spatial constraints are proposed for regionalization of geostatistical point data based on multivariate homogeneity measures. The study focuses on non‐stationarity and autocorrelation in spatial data. Supervised MLP machine learning algorithms with spatial constraints have been implemented and tested on a point dataset. MLP spatially weighted classification models and an MLP contiguity‐constrained classification model are developed to conduct spatially constrained regionalization. The proposed methods have been tested with an attribute‐rich point dataset of geological surveys in Ukraine. The experiments show that consideration of the spatial effects, such as the use of spatial attributes and their respective whitening, improve the output of regionalization. It is also shown that spatial sorting used to preserve spatial contiguity leads to improved regionalization performance.
On the globalization of English: Some internal factors
Authors: Kim Chin W. 
Published: July 2019

AbstractBecause of a wide range of factors, English has become a global and international language, of incomparable spread and utility in the world today. A number of these factors have been external factors linked to the power and politics of language, but other reasons have been linked to a number of internal factors, including ‘capaciousness’, ‘simplicity’, ‘flexibility’, ‘great literature’ and ‘a simple script’.
World Englishes in English language teaching
Authors: Sadeghpour Marzieh , Sharifian Farzad 
Published: July 2019

AbstractThis study explores the perceptions of English language teachers about the place and relevance of world Englishes (WEs) in English language teaching (ELT) in Australia. For this aim, 56 English teachers from all Kachruvian Circles working in Australia were interviewed. The interviews were thematically and qualitatively analysed and the results indicate that all participants were aware of the emergence of WEs. Most of the participants perceived WEs relevant to ELT in Australia; however, they believed that the inclusion of WEs in ELT may not be practical and should not go beyond developing learners’ awareness of the existence of diversity in the landscape of English. The disconnection between teachers’ theoretical knowledge about WEs and practical knowledge on how to integrate WEs into ELT, and contextual factors such as time constrains and students’ expectations were found to undermine teachers’ confidence for teaching English as a pluricentric language.
The mediation effect of multiple gestations on the association between in vitro fertilisation and severe maternal morbidities: a retrospective cohort study
Authors: Tan Jing , Qi Ya-Na , Zhang Jing , Wang Wen , Zhang Gui-Ting , Zou Kang , Liu Xing-Hui , Sun Xin 
Published: July 2019

ObjectiveTo investigate whether the association between in vitro fertilisation (IVF) and severe maternal morbidity (SMM) was mediated by multiple gestations.DesignA retrospective cohort study.SettingThe study was conducted at six hospitals in China.ParticipantsPregnant women at 20 gestational weeks or longer.Outcome measureThe outcome was SMM, which was a composite of potential life-threatening conditions, the use of critical medical interventions, or the status of maternal near-miss that occurred during pregnancy, childbirth or within 42 days of pregnancy termination, as defined by WHO.ResultsIn total, 22 368 eligible pregnant women were included, among whom 497 (2.2%) received IVF, and 776 developed SMM (incidence 34.7/1000 live births, 95% CI 32.3/1000 to 37.1/1000). Four multivariable logistic regression models were constructed. Model 1, without including the variable of multiple gestations, showed that IVF was associated with higher risk of SMM (adjusted OR (aOR) 1.54, 95% CI 1.03 to 2.29). Model 2, assessing the association between IVF and multiple gestations, showed that IVF was strongly associated with multiple gestations (aOR 14.75, 95% CI 11.38 to 19.10). Model 3, by adding the variable of multiple gestations to model 1, showed that IVF was not statistically associated with SMM (aOR 0.89, 95% CI 0.58 to 1.36), but multiple gestations were associated with higher risk of SMM (aOR 5.92, 95% CI 4.88 to 7.83). Model 4, investigating the association between IVF and SMM among singleton pregnancies, showed no statistically significant association (aOR 0.70, 95% CI 0.37 to 1.32). An additional analysis by adding the interaction term of IVF by multiple gestations to model 3 showed no statistical significance of the interaction term (aOR 1.15, 95% CI 0.36 to 3.68), confirming the absence of exposure-mediator interaction.ConclusionsUsing the established rule for judging mediation effect, the results suggested that multiple gestations might mediate the association between the use of IVF and higher risk of SMM. Further prospective studies are warranted to test our finding.
Barriers to smoking cessation: a qualitative study from the perspective of primary care in Malaysia
Authors: Chean Kooi-Yau , Goh Lee Gan , Liew Kah-Weng , Tan Chia-Chia , Choi Xin-Ling , Tan Kean-Chye , Ooi Siew-Ting 
Published: July 2019

ObjectivesThis qualitative study aims to construct a model of the barriers to smoking cessation in the primary care setting.DesignIndividual in-depth, semistructured interviews were audio-taped, then verbatim transcribed and translated when necessary. The data were first independently coded and then collectively discussed for emergent themes using the Straussian grounded theory method.Participants and settingFifty-seven current smokers were recruited from a previous smoking related study carried out in a primary care setting in Malaysia. Current smokers with at least one failed quit attempts were included.ResultsA five-theme model emerged from this grounded theory method. (1) Personal and lifestyle factors: participants were unable to resist the temptation to smoke; (2) Nicotine addiction: withdrawal symptoms could not be overcome; (3) Social cultural norms: participants identified accepting cigarettes from friends as a token of friendship to be problematic; (4) Misconception: perception among smokers that ability to quit was solely based on one’s ability to achieve mind control, and perception that stopping smoking will harm the body and (5) Failed assisted smoking cessation: smoking cessation services were not felt to be user-friendly and were poorly understood. The themes were organised into five concentric circles based on time frame: those actionable in the short term (themes 1 and 2) and the long term (themes 3, 4, 5).ConclusionsFive themes of specific beliefs and practices prevented smokers from quitting. Clinicians need to work on these barriers, which can be guided by the recommended time frames to help patients to succeed in smoking cessation.
Age at identification, prevalence and general health of children with autism: observational study of a whole country population
Authors: Rydzewska Ewelina , Hughes-McCormack Laura Anne , Gillberg Christopher , Henderson Angela , MacIntyre Cecilia , Rintoul Julie , Cooper Sally-Ann 
Published: July 2019

ObjectivesReported childhood prevalence of autism varies considerably between studies and over time, and general health status has been little investigated. We aimed to investigate contemporary prevalence of reported autism by age, and general health status of children/young people with and without autism.DesignSecondary analysis of Scotland’s Census, 2011 data. Cross-sectional study.SettingGeneral population of Scotland.ParticipantsAll children (n=916 331) and young people (n=632 488) in Scotland.Main outcome measuresNumber (%) of children/young people reported to have autism and their general health status; prevalence of autism; prevalence of poor health (fair, bad and very bad health); odds ratios (95% confidence intervals) of autism predicting poor health, adjusted for age and gender and OR for age and gender in predicting poor health within the population with reported autism.ResultsAutism was reported for 17 348/916 331 (1.9%) children aged 0–15, and 7715/632 488 (1.2%) young people aged 16–24. The rate increased to age 11 in boys and age 10 in girls, reflecting age at diagnosis. Prevalence was 2.8% at age 10 (4.4% for boys; 1.1% for girls), and 2.9% at age 11 (4.5% for boys; 1.1% for girls). 22.0% of children and 25.5% of young people with autism reported poor health, compared with 2.0% and 4.4% without autism. Autism had OR=11.3 (11.0 to 11.7) in predicting poor health. Autistic females had poorer health than autistic males, OR=1.6 (1.5 to 1.8).ConclusionAccurate information on the proportion of autistic children and their health status is essential plan appropriate prevention and intervention measures and provide resources for those who may put demand on services designed for autistic people.
RAIN study: a protocol for a randomised controlled trial evaluating efficacy, safety and cost-effectiveness of intravenous-to-oral antibiotic switch therapy in neonates with a probable bacterial infection
Authors: Keij Fleur M , Kornelisse René F , Hartwig Nico G , Mauff Katya , Poley Marten J , Allegaert Karel , Reiss Irwin K M , Tramper-Stranders Gerdien A 
Published: July 2019

IntroductionHigh morbidity and mortality rates of proven bacterial infection are the main reason for substantial use of intravenous antibiotics in neonates during the first week of life. In older children, intravenous-to-oral switch after 48 hours of intravenous therapy has been shown to have many advantages and is nowadays commonly practised. We, therefore, aim to evaluate the effectiveness, safety and cost-effectiveness of an early intravenous-to-oral switch in neonates with a probable bacterial infection.Methods and analysisWe present a protocol for a multicentre randomised controlled trial assessing the non-inferiority of an early intravenous-to-oral antibiotic switch compared with a full course of intravenous antibiotics in neonates (0–28 days of age) with a probable bacterial infection. Five hundred and fifty patients will be recruited in 17 hospitals in the Netherlands. After 48 hours of intravenous treatment, they will be assigned to either continue with intravenous therapy for another 5 days (control) or switch to amoxicillin/clavulanic acid suspension (intervention). Both groups will be treated for a total of 7 days. The primary outcome will be bacterial (re)infection within 28 days after treatment completion. Secondary outcomes are the pharmacokinetic profile of oral amoxicillin/clavulanic acid, the impact on quality of life, cost-effectiveness, impact on microbiome development and additional yield of molecular techniques in diagnosis of probable bacterial infection.Ethics and disseminationThis study has been approved by the Medical Ethics Committee of the Erasmus Medical Centre. Results will be presented in peer-reviewed journals and at international conferences.Trial registration numberNCT03247920
BMI trajectories and risk factors among 2-11-year-old children by their immigrant status: evidence from the Longitudinal Study of Australian Children
Authors: Zulfiqar Tehzeeb , Burns Richard A , D’Este Catherine , Strazdins Lyndall 
Published: July 2019

ObjectiveThis study aimed to identify body mass index (BMI) trajectories and their predictors in Australian children by their maternal immigrant status.MethodsData on 4142 children aged 2–3 years were drawn from the birth cohort of the Longitudinal Study of Australian Children. BMI was calculated according to the International Obesity Task Force cut-off points. Immigrant status was determined by the Australian Bureau of Statistics and the United Nations Development Programme, Human Development Index criteria. Latent class growth analysis estimated distinct BMI trajectories, and multinomial logistic regression analysis examined factors associated with these BMI trajectories.ResultsTwo BMI groups and six BMI trajectories were identified. The stable trajectories group included high-risk (10%, n=375), moderate-risk (5%, n=215) and low-risk (68%, n=2861) BMI trajectories. The changing trajectories group included delayed-risk (6%, n=234), gradual-risk (8%, n=314) and declining-risk (3%, n=143) BMI trajectories. We found some evidence that children of immigrants from low-and middle-income countries were more likely to have moderate-risk and high-risk BMI trajectories compared with low-risk BMI trajectory. However, these associations were insignificant in fully adjusted models. The explanatory risk factors for moderate-risk and high-risk BMI trajectory were birth weight, family socioeconomic position, and organised sports participation. Our results also suggest that 4–7 years of age may be important for the prevention of overweight/obesity in children.DiscussionA better understanding of the risk factors associated with distinct BMI trajectories in immigrant children will inform effective preventive strategies. Some of these risk factors such as non-participation in organised sports, and high screen time, may also impede the integration of immigrant children into the host culture. Obesity prevention strategies aimed at increasing physical activities in immigrant children could help deliver a social and health benefit by increasing social integration among children of immigrants and Australians.
Patient–physician relationship and use of gut feeling in cancer diagnosis in primary care: a cross-sectional survey of patients and their general practitioners
Authors: Pedersen Anette Fischer , Andersen Christina Maar , Ingeman Mads Lind , Vedsted Peter 
Published: July 2019

ObjectivesTo examine whether the quality of the patient–physician relationship, assessed by the general practitioner (GP) and the patient, associates with GPs’ use of gut feeling (GF) in cancer diagnosis.DesignCross-sectional questionnaire survey of cancer patients and their GPs.SettingDanish primary care.ParticipantsNewly diagnosed cancer patients and their GPs. Patients completed a questionnaire and provided the name of the GP to whom they have presented their symptoms. The named GP subsequently received a questionnaire.Primary and secondary outcome measuresGPs’ use of GF in the diagnostic process for the particular patient. GPs who answered that they used their GF ‘to a high degree’ or ‘to a very high degree’ were categorised as ‘used their GF to a great extent’. GPs who answered that they used their GF ‘to some degree’, ‘to a limited degree’ or ‘not at all’ were categorised as ‘limited or no use of GF’.ResultsGPs were less likely to use GF when they assessed relational aspects of the patient encounter as difficult compared with less difficult (OR=0.67; 95% CI 0.46 to 0.97). The physician-reported level of empathy was positively associated with use of GF (OR=2.60; 95% CI 1.60 to 4.22). The lower use of GF in difficult encounters was not modified by level of empathy.ConclusionsExperiencing relational aspects of patient encounter as difficult acted as a barrier for the use of GF in cancer diagnosis. Although physician-rated empathy increased use of GF, high empathy did not dissolve the low use of GF in difficult encounters. As diagnosis of cancer is a key challenge in primary care, it is important that GPs are aware that the sensitivity of cancer-related GF is compromised by a difficult patient–physician relationship.
Using prescribing very short answer questions to identify sources of medication errors: a prospective study in two UK medical schools
Authors: Sam Amir H , Fung Chee Yeen , Wilson Rebecca K , Peleva Emilia , Kluth David C , Lupton Martin , Owen David R , Melville Colin R , Meeran Karim 
Published: July 2019

ObjectiveTo assess the utility and ability of the novel prescribing very short answer (VSA) question format to identify the sources of undergraduate prescribing errors when compared with the conventional single best answer (SBA) question format and assess the acceptability of machine marking prescribing VSAs.DesignA prospective study involving analysis of data generated from a pilot two-part prescribing assessment.SettingTwo UK medical schools.Participants364 final year medical students took part. Participation was voluntary. There were no other inclusion or exclusion criteria.Outcomes(1) Time taken to mark and verify VSA questions (acceptability), (2) differences between VSA and SBA scores, (3) performance in VSA and (4) SBA format across different subject areas and types of prescribing error made in the VSA format.Results18 200 prescribing VSA questions were marked and verified in 91 min. The median percentage score for the VSA test was significantly lower than the SBA test (28% vs 64%, p<0.0001). Significantly more prescribing errors were detected in the VSA format than the SBA format across all domains, notably in prescribing insulin (96.4% vs 50.3%, p<0.0001), fluids (95.6% vs 55%, p<0.0001) and analgesia (85.7% vs 51%, p<0.0001). Of the incorrect VSA responses, 33.1% were due to the medication prescribed, 6.0% due to the dose, 1.4% due to the route and 4.8% due to the frequency.ConclusionsPrescribing VSA questions represent an efficient tool for providing detailed insight into the sources of significant prescribing errors, which are not identified by SBA questions. This makes the prescribing VSA a valuable formative assessment tool to enhance students’ skills in safe prescribing and to potentially reduce prescribing errors.
Collaboratively seeking to improve contraceptive counselling at the time of an abortion: a case study of quality improvement efforts in Sweden
Authors: Kilander Helena , Brynhildsen Jan , Alehagen Siw , Fagerkrantz Amanda , Thor Johan 
Published: July 2019

BackgroundMany women find it difficult to choose and initiate a contraceptive method at the time of an abortion. There is a gap between regular clinical practice and existing evidence on motivational and person-centred counselling, as well as on use of long-acting reversible contraception (LARC). This study aims to describe and evaluate a Quality Improvement Collaborative (QIC) designed to enhance contraceptive services, with regard to changes in healthcare professionals’ (HCPs’) counselling in clinical practice, and in women’s subsequent choice of, and access to, contraception.MethodsThree multiprofessional teams working in abortion services from three hospitals in Sweden, and two women contributing with user experience, participated in a QIC during the period March–November 2017. Using a case study design, we collected and analysed both quantitative and qualitative data.ResultsTeams agreed on QIC goals, including that ≥50% of women would start LARC within 30 days post-abortion, and tested multiple evidence-based changes, aided by the two women’s feedback. During the QIC, participating HCPs reported that they gained new knowledge and developed skills in contraceptive counselling at the time of an abortion. The teams welcomed the development of a performance feedback system regarding women’s post-abortion contraception. While the majority of women counselled during the QIC chose LARC, only 20%–40% received it within 30 days post-abortion.ConclusionThe QIC, incorporating user feedback, helped HCPs to develop capability in providing contraceptive services at the time of an abortion. Timely access to LARC remains a challenge in the present setting.