bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysing Crisis Parliamentary Discourse in Greece: Whom Should We Blame?
Authors: Ladi Stella , Tsagkroni Vasiliki 
Published: April 2019

AbstractThis article analyses differences in the varieties of political rhetoric on structuring and legitimizing argumentation and strategies during periods of economic and political crisis. Driven by developments in theory about blame‐shifting and the exogenization of the causes of crisis as well as employing advanced techniques of analysis, it focuses on the parliamentary bailout debates in Greece during the crisis period (2009–2015). By means of computer‐assisted content analysis it analyses the content of arguments on blame‐shifting. It shows that blame‐shifting is much more complex that just blaming the external enemy and often takes the form of historical blame‐shifting, turning the blame onto previous governments. It reveals that party leaders often use a much more polemic discourse than members of parliament. Finally, it shows that blame‐shifting diminishes once a party comes to power, following arguments on representative versus responsible government.
Barriers to managing medications appropriately when patients have restrictions on oral intake
Authors: To The‐Phung , Brien Jo‐Anne , Story David A. 
Published: April 2019

SummaryRationale, aims, and objectivesInvestigation of several serious adverse events in our organization highlighted that medications were managed inappropriately when patients have oral intake restrictions. The aim of this work was to identify the barriers to optimal medication management when patients have restrictions on their oral intake.MethodData were feedback and comments obtained between 2011 and 2014 from a hospital‐wide quality assurance project. Data had not been purposefully collected and were in response to a general request for feedback regarding managing oral medications when patients have oral intake restrictions. Data came from a range of clinical staff and from various forums associated with the quality assurance project, including 37 presentations, 34 group meetings, and over 50 one‐on‐one meetings, as well as emails and other sources.Data were analysed using the thematic analysis approach. Data were coded inductively, and the domains of the Theoretical Domains Framework were used to categorize the data. Subthemes and themes were then developed.ResultsBarriers could be broadly grouped into systems‐level issues (organizational guidance and work environment) and the individual person–level issues (staff knowledge and beliefs). These barriers highlight the complexity of the medication management task. The lack of standardized guidance and consistent terminology regarding medication administration when patients have restrictions on oral intake, particularly when fasting or nil by mouth, were important systems factors, as were workflow issues and the “culture” of the environment in which staff practiced. Lack of knowledge about medication administration, social influences, and role interpretation were important individual person factors.ConclusionSystems‐ and individual person–level issues were significant contributors to inappropriate medication management when patients have oral intake restrictions. Many of the barriers may be addressed with systems approaches such as hospital‐wide guidance that simplifies and standardize oral medication administration instructions, particularly regarding fasting and nil by mouth terminology.
Role of oral health‐related behaviors in education inequalities in chronic periodontitis among Sri Lankan men
Authors: Wellappuli Nimali , Ekanayake Lilani 
Published: April 2019

AbstractAimsThe aims of the present study were to determine education inequalities in chronic periodontitis (CP) among Sri Lankan men and whether oral health behaviors explain education inequalities in CP.MethodsData from 720 males who participated in a study to determine the prevalence of CP in 30‐60‐year‐olds in Colombo district, Sri Lanka, were used for the present study. An interviewer administered a questionnaire obtained information about sociodemographics and oral health behaviors. Following the assessment of periodontal parameters, case definitions proposed by the Centers for Disease Control/American Academy of Periodontology were used to define periodontitis.ResultsEducation gradients were observed in relation to CP, smoking, betel quid chewing, alcohol use, and dental utilization. Education gradients in CP remained, but attenuated after adjustments for smoking, betel quid chewing, alcohol use, and dental utilization. Current smoking and current alcohol use explained 4%‐38% and 6%‐15% of the associations between education and CP, respectively. The education gradient in CP remained following simultaneous adjustment for all behaviors, but lost significance for 11‐13 years of education.ConclusionOf the oral health behaviors considered, current smoking contributed the most to education inequalities in CP, explaining 4%‐38% of the education differences in CP.
Who Gives Birth in the Water? A Retrospective Cohort Study of Intended versus Completed Waterbirths
Authors: Sidebottom Abbey C. , Vacquier Marc , Simon Kathrine , Fontaine Patricia , Dahlgren‐Roemmich Dawn , Hyer Barbara , Jackson Jody , Steinbring Shannon , Wunderlich Whitney , Saul Lisa 
Published: April 2019

IntroductionMost waterbirth studies have been conducted outside the United States with a primary focus on birth outcomes. Studies to date provide limited information about how often women choosing waterbirth end water immersion before the birth and about the reasons for tub exit. This study examines a cohort of women intending a hospital‐based waterbirth and documents the timing and reasons for tub exit. Demographic, clinical, and intrapartum care provider characteristics among women completing waterbirth were compared with those who exited the water prior to birth.MethodsThis is a collaborative, multisite study from 2 health systems (8 hospitals) using retrospective electronic health records from August 2014 through December 2017.ResultsOf 576 women who entered the waterbirth tub, 48% exited prior to the birth. The primary reasons for exit were maternal choice (50%), medical indication (32%), and provider decision (13%). Women exiting in the first stage did so primarily by choice (57%), whereas medical indication (42%) was the most common reason among women exiting in the second stage. Women who completed waterbirth did not differ from those who exited prior to birth with regard to age, race, ethnicity, country of origin, language, marital status, or intrapartum care provider specialty. Women completing waterbirth were more likely to have previously given birth (72% vs 47%) and to have a provider with more water immersion births during the study period (65% vs 55%).DiscussionGiving birth in the tub was associated with parity and intrapartum care provider experience. Half of the women intending waterbirth in this study exited the tub, with variation in exit reason by stage and provider type. It is important for women to understand that they or their provider may change the birth plan based on labor progress and maternal experience.
The CKD‐DETECT study: An RCT aimed at improving intention to initiate a kidney health check in Australian practice nurses
Authors: Sinclair Peter M. , Kable Ashly , Levett‐Jones Tracy , Holder Carl , Oldmeadow Christopher J. 
Published: April 2019

AbstractBackgroundThe burden of Chronic Kidney Disease (CKD) on the Australian health system is growing. Efforts to reverse this trend have not been successful. This paper evaluates the effectiveness of a targeted asynchronous web based e‐learning module on general practice nurses’ behavioural intentions in relation to opportunistic screening practices for people at risk of CKD.DesignDouble blinded pre‐post interventional randomised control design.MethodsParticipants were nurses working in general practice settings in Australia. Participants were randomised to a knowledge based active control or targeted behavioural based intervention which were delivered using asynchronous e‐learning modules. The intervention was designed to influence the behavioural constructs of the theory of planned behaviour (TPB): attitude, subjective norm and perceived behavioural control (PBC).ResultsOf the 420 participants, we analysed the primary and secondary outcomes for 212 (50.47%) who had complete follow up data. There were no significant differences (p 0.424, [d] 0.04) in behavioural intention between the intervention and control groups at follow‐up, when controlling for baseline values. However, regression models assessing the relationship between the change in the TPB constructs and behavioural intention at follow‐up for all participants, regardless of study arm, demonstrated a significant change in intention to initiate a kidney health check. Although these changes could not be attributed to the effect of the intervention. Attitude (r2 = 0.3525, p 0.0004) and PBC (r2 = 0.3510, p 0.0005) models accounted for approximately 35% of the explained variance in behavioural intentions and social norm (r2 = 0.3297, p 0.0171) accounted for approximately 33% of the variance. When all TPB constructs were included in the model, 37% of the variance in intention was explained.ConclusionA targeted behavioural online intervention was no more effective than a knowledge based online program to improve primary health care nurses’ intention to initiate a kidney health check in people at risk of chronic kidney disease.Relevance to clinical practiceCollaborative efforts are required by all staff working in general practice to develop models of care to improve screening practices for chronic kidney disease. Future research should focus on interventions that improve collaboration between health care professionals in the primary care setting and public health campaigns to increase awareness of risks of CKD and the importance of screening in the primary care setting.
The Roles of Parents in Shaping Fathering Across Generations in Cebu, Philippines
Authors: Gettler Lee T. , Kuo Patty X. , Bas Abet , Borja Judith B. 
Published: April 2019

AbstractObjective: This study examined how parental caregiving and parent–child closeness are associated with future fathering among 335 Filipino men who are participants in a long‐running birth cohort study.Background Few studies have multidecade longitudinal data to test the pathways through which parenting is transmitted across generations, with most relevant research conducted in the United States, Europe, and other similar settings. The roles of mothers and fathers in shaping their sons' future parenting is particularly understudied despite fathers having the potential to positively influence child health and development.Method: Participants' mothers (Generation 1 [G1]) reported on caregiving during Generation 2 (G2) participants' early life, and the G2 males reported parent–child closeness during adolescence. G2 fathers reported on their own child‐care involvement and the salience of caregiving to their parenting identity. We tested whether parent–child closeness moderated the effect of early‐life care to predict later‐life fathering.Results: G1‐G2 closeness moderated the association between G1 parents' caregiving and G2 fathers' parenting identity (for both G1 parents) and caregiving time (for G1 fathers only). When the G1‐G2 mother–son relationship was not close, there was a negative correlation between G1 maternal care and G2 fathers' caregiving identity. For G2 men who were close to their fathers, there were positive associations between G1 paternal care and G2 fathers' caregiving identity and time, respectively. Among G2 men who were not close to their fathers, the slopes relating G1 paternal care to G2 fathers' caregiving identity and time, respectively, were negative.Conclusion: These findings reflect that developmental experiences with both mothers and fathers are predictive of men's identity as parents in adulthood and that closeness between fathers and sons moderates whether sons' paternal care tends to emulate or diverge from their fathers' caregiving patterns.
The Interplay Between Adolescents' Friendships and the Exchange of Help: A Longitudinal Multiplex Social Network Study
Authors: van Rijsewijk Loes G. M. , Snijders Tom A. B. , Dijkstra Jan Kornelis , Steglich Christian , Veenstra René 
Published: April 2019

The aim of this study was to unravel the interrelatedness of friendship and help, and to examine the characteristics of friendship and help networks. The effects of mutual versus one‐sided help relations on friendship initiation and maintenance, and vice versa, were examined. Friendship and help networks were analyzed (N = 953 students; 41 classrooms; Mage = 12.7). The results illustrate that friendship and help networks show some similarities, but only partly overlap and have distinct characteristics. Longitudinal multiplex social network analyses showed that mutual help was important for the maintenance of friendship, but not for the initiation of friendship. Further, particularly mutual friendships provided a context in which help took place. Implications of these findings are discussed.
Delivering bad news
Authors: Nunn Kenneth 
Published: April 2019

AbstractNews in medicine has an obligation to be helpful, accurate, comprehensible for the intended audience and part of an on‐going professional relationship that enables the best outcomes available. These obligations have special poignancy when the news is bad, the patient is a child and the news scene is a busy medical practice, clinic or hospital. This paper aims to outline specific ways of being helpful when delivering bad news, within the constraints of daily practice, to a wide variety of developmentally different children at different stages in the family life cycle. The paper specifies the purpose, tasks, obstacles and practicalities of giving adverse information about the health of children in our clinical work. Adverse news needs to be embedded within delivering news more generally in our work. This presupposes a trusting relationship, an accurate understanding of the news to be delivered and a capacity to communicate medical complexity to the intended audience. There are multiple audiences for our medical news, at different developmental stages, each of whom needs help to ‘hear the news’ in different ways. Each developmental period within a broader family life cycle is briefly addressed. The limited evidence‐base is outlined with a view to what the clinician can do to foster maximal support, understanding and on‐going cooperation. The interplay between realism and optimism is highlighted so that accuracy and helpfulness are wedded as meaningfully and sensitively as possible. The aim is to be helpful rather than pursue an ideal of the unfaltering, polished and flawlessly performing clinician.
Definition of excessive daytime sleepiness in the general population: Feeling sleepy relates better to sleep‐related symptoms and quality of life than the Epworth Sleepiness Scale score. Results from an epidemiological study
Authors: Thorarinsdottir Elin H. , Bjornsdottir Erla , Benediktsdottir Bryndis , Janson Christer , Gislason Thorarinn , Aspelund Thor , Kuna Samuel T. , Pack Allan I. , Arnardottir Erna S. 
Published: April 2019

AbstractMany different subjective tools are being used to measure excessive daytime sleepiness (EDS) but the most widely used is the Epworth Sleepiness Scale (ESS). However, it is unclear if using the ESS is adequate on its own when assessing EDS. The aim of this study was to estimate the characteristics and prevalence of EDS using the ESS and the Basic Nordic Sleep Questionnaire (BNSQ) in general population samples. Participants aged 40 years and older answered questions about sleepiness, health, sleep‐related symptoms and quality of life. Two groups were defined as suffering from EDS: those who scored >10 on the ESS (with increased risk of dozing off) and those reporting feeling sleepy during the day ≥3 times per week on the BNSQ. In total, 1,338 subjects (53% male, 74.1% response rate) participated, 13.1% reported an increased risk of dozing off, 23.2% reported feeling sleepy and 6.4% reported both. The prevalence of restless leg syndrome, nocturnal gastroesophageal reflux, difficulties initiating and maintaining sleep and nocturnal sweating was higher among subjects reporting feeling sleepy compared to non‐sleepy subjects. Also, subjects reporting feeling sleepy had poorer quality of life and reported more often feeling unrested during the day than non‐sleepy subjects. However, subjects reporting increased risk of dozing off (ESS > 10) without feeling sleepy had a similar symptom profile as the non‐sleepy subjects. Therefore, reporting only risk of dozing off without feeling sleepy may not reflect problematic sleepiness and more instruments in addition to ESS are needed when evaluating daytime sleepiness.
Mechanical dilation, botulinum toxin A injection, and surgical myotomy with fundoplication for treatment of lower esophageal sphincter achalasia‐like syndrome in dogs
Authors: Grobman M. E , Hutcheson K. D. , Lever T. E. , Mann F. A. , Reinero C. R. 
Published: April 2019

AbstractBackgroundMegaesophagus (ME) carries a poor long‐term prognosis in dogs. In people, lower esophageal sphincter (LES) achalasia is a rare cause of ME that may respond to targeted intervention. Dogs with lower esophageal sphincter achalasia‐like syndrome (LES‐AS) have been described recently, warranting investigation of analogous targeted treatment.Hypothesis/ObjectivesEvaluate response of dogs with LES‐AS to LES mechanical dilation and botulinum toxin A (BTA) injections, with or without surgical myotomy and fundoplication. We hypothesized that clinical and videofluoroscopic swallow study (VFSS) features of LES‐AS would improve after treatment targeting functional LES obstruction.AnimalsFourteen client‐owned dogs with LES‐AS diagnosed by VFSS.MethodsRetrospective study. Dogs diagnosed with LES‐AS underwent treatment between April 2015 and December 2017. Outcome measures included client perception of clinical severity, body weight (BW), body condition score (BCS), regurgitation frequency, and VFSS parameters (ME, esophageal motility, gastric filling). Dogs with positive responses were considered candidates for LES myotomy with fundoplication.ResultsBy a median IQR of 21 (IQR, 14‐25) days after mechanical dilation and BTA, clients reported clinical improvement in 100% of dogs, BW increased 20.4% (IQR, 12.7%‐25%), pre‐ and post‐treatment BCS was 3 (IQR, 3‐4) and 5 (IQR, 4‐5), respectively, and frequency of regurgitation decreased by 80% (IQR, 50%‐85%). Duration of effect was 40 (IQR, 17‐53) days. Despite clinical improvement, ME and abnormal esophageal motility persisted in 14 dogs. Six dogs subsequently underwent myotomy and fundoplication and maintained improvement observed after mechanical dilation and BTA.Conclusions and Clinical ImportanceDogs with LES‐AS experienced significant, temporary, clinical improvement after mechanical dilation and BTA. Preliminary results suggest myotomy with fundoplication provide lasting clinical benefit despite persistence of ME.
The Anthropology of Plastics: An Agenda for Local Studies of a Global Matter of Concern
Authors: Pathak Gauri , Nichter Mark 
Published: April 2019

AbstractAnthropology has largely ignored plastics, even as they have emerged as the paradigmatic material—and problem—of our times. In this article, we make the case for an anthropology of plastics as a priority for environmental and medical anthropological research. Drawing from exploratory fieldwork in India, we briefly highlight the benefits and risks of different types of plastics, identify areas for anthropological investigations of human–plastic entanglements, and unpack major debates about plastic control. We recommend analyses that take into account the social life of plastics and the life cycle of plastic production, consumption, circulation, disposal, retrieval, and decomposition. We propose a facilitator role for anthropologists in bringing environmental NGOs and the plastic industry to the table to reduce the human and environmental health risks related to widespread reliance on plastics. Overall, we argue that anthropological analyses are urgently needed to address environmental and global health concerns related to plastics.
Inappropriate activation of pacemaker magnet response mode by CPAP masks
Authors: Schwartz Yosef , Wasserlauf Jeremiah , Sahakian Alan V. , Knight Bradley 
Published: April 2019

AbstractBackgroundWhile electromagnetic interference is widely recognized as a cause of noise detected by cardiac implanted electronic devices (CIEDs), we report on two cases of inappropriate activation of magnet response mode due to magnets in continuous positive airway pressure (CPAP) masks.MethodsTwo patients with St. Jude Medical dual‐chamber pacemakers (Assurity DR 2240; St. Jude Medical, St. Paul, MN, USA) were discovered on routine outpatient device interrogation to have magnet response events that correlated with nightly use of their CPAP masks. A magnet response event was reproduced by positioning one CPAP mask over the patient's pulse generator site. The magnetic flux density was measured using a Gauss meter.ResultsIt was found that their CPAP masks had magnetic clips that were used to secure the headgears. These appeared to be transiently positioned within sufficient proximity of the patients’ CIEDs to activate magnet response events during sleep. The measured magnetic field density adjacent to a mask magnet was 136 Gauss.ConclusionClinicians managing CPAPs and CIEDs should be aware of magnetic interference with the potential for inappropriate activation of magnet response mode. CPAP masks that are secured with magnetic clips should be avoided in patients with CIEDs, since this can result in inappropriate asynchronous pacing in pacemakers or potential failure to deliver life‐saving tachytherapies in patients with implanted cardioverter‐defibrillators.
Atrioventricular conduction in patients undergoing pacemaker implant following self‐expandable transcatheter aortic valve replacement
Authors: Ghannam Michael , Cunnane Ryan , Menees Daniel , Grossman Michael P. , Chetcuti Stanley , Patel Himanshu , Deeb Michael , Jongnarangsin Krit , Pelosi Frank , Oral Hakan , Latchamsetty Rakesh 
Published: April 2019

AbstractBackgroundHeart block requiring a pacemaker is common after self‐expandable transcatheter aortic valve replacement (SE‐TAVR); however, conduction abnormalities may improve over time. Optimal device management in these patients is unknown.ObjectiveTo evaluate the long‐term, natural history of conduction disturbances in patients undergoing pacemaker implantation following SE‐TAVR.MethodsAll patients who underwent new cardiac implantable electronic device (CIED) implantation at Michigan Medicine following SE‐TAVR placement between January 1, 2012 and September 25, 2017 were identified. Electrocardiogram and device interrogation data were examined during follow‐up to identify patients with recovery of conduction. Logistic regression analysis was used to compare clinical and procedural variables to predict conduction recovery.ResultsFollowing SE‐TAVR, 17.5% of patients underwent device placement for new atrioventricular (AV) block. Among 40 patients with an average follow‐up time of 17.1 ± 8.1 months, 20 (50%) patients had durable recovery of AV conduction. Among 20 patients without long‐term recovery, four (20%) had transient recovery. The time to transient conduction recovery was 2.2 ± 0.2 months with repeat loss of conduction at 8.2 ± 0.9 months. On multivariate analysis, larger aortic annular size (odds ratio: 0.53 [0.28–0.86]/mm, P = 0.02) predicted lack of conduction recovery.ConclusionsHalf of the patients undergoing CIED placement for heart block following SE‐TAVR recovered AV conduction within several months and maintained this over an extended follow‐up period. Some patients demonstrated transient recovery of conduction before recurrence of conduction loss. Larger aortic annulus diameter was negatively associated with conduction recovery.