bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fingerprint of tropical climate variability and sea level in sediments of the Cariaco Basin during the last glacial period
Authors: Deplazes Gaudenz , Meckler Anna Nele , Peterson Larry C. , Hamann Yvonne , Aeschlimann Beat , Günther Detlef , Martínez‐García Alfredo , Haug Gerald H. 
Published: December 2018

AbstractHigh‐resolution palaeorecords of climate are critical to improving current understanding of climate variability, its sensitivity and impact on the environment in the past and in the future. Sediments from the Cariaco Basin off the coast of Venezuela have proven to be sensitive recorders of tropical palaeoclimate variability down to an annual scale. However, the fingerprint of climate and sea level in the sediments of the last glacial period is still not completely understood. In this study, lamination analysis of sediments from the Cariaco Basin is extended to the last glacial period. Detailed sedimentological and geochemical analysis (laser ablation–inductively coupled plasma–mass spectrometry) reveals couplets of light‐coloured, terrigenous‐rich and dark‐coloured, biogenic opal‐rich laminae, which are interpreted to reflect the seasonal migration of the Intertropical Convergence Zone. In addition, a previously undescribed, nearly pure terrigenous lamina type is observed, which is referred to hereafter as a ‘C‐layer’. The C‐layers in the sedimentary sequence are interpreted as flood layers that originate from local rivers. The occurrence of these C‐layers is investigated for two core locations in the Cariaco Basin over the last 110 kyr by continuous X‐ray fluorescence scanning. Dansgaard–Oeschger oscillations are most clearly traced by proxies reflecting productivity and marine organic matter content of the sediment. In contrast, the abundance of terrigenous material differs at times between the two sites. On an interglacial to glacial timescale, the ability to record events causing C‐layers is likely to be influenced by changes in sea level and source proximity. On a millennial scale, both sediment cores contain more C‐layers during warmer interstadials compared with colder stadials during Marine Isotope Stage 3. This finding implies that interstadials were not only wetter than stadials, but probably also characterized by increased rainfall variability, leading to an enhanced frequency of flooding events in the hinterland of the Cariaco Basin.
Do Employees’ Sickness Absences React to a Change in Costs for Firms? Evidence from a Natural Experiment*
Authors: Böheim René , Leoni Thomas 
Published: December 2018

AbstractWe analyse the impact of a social security reform that changed the costs incurred by firms due to sickness absences. The reform abolished a compulsory insurance for firms, which insured them against the wages paid to sick blue‐collar workers. During the first year after its introduction, we estimate that the reform resulted in about 6.3 percent fewer sickness absences, and in about 8.6 percent fewer absence days. We do not find evidence for changes in hiring or firing, and we find only limited workforce composition changes. We do not find spillover effects on the absences of white‐collar workers. Robustness checks confirm these results.
Selective Attention and the Information Environment: Citizens’ Perceptions of Political Problems in the 2015 Swiss Federal Election Campaign
Authors: Wüest Bruno 
Published: December 2018

AbstractIn the course of election campaigns, voters pay only selectively attention to particular aspects of political problems. Such selective attention is necessary because the costs of becoming competent on many political problems are great. Normatively, however, such selective attention is not desirable because it lowers the chance that voters will reach well‐balanced and competent decisions. This contribution establishes the aspects of the four most salient problems from the 2015 Swiss federal election campaign: immigration, welfare, the economy and European integration. It further reveals that selective attention is higher among those who are interested in politics and who learn problem‐specific information on salient problems, and lower among those who are well‐educated, who engage in personal discussions, who use traditional media, and who learn problem‐specific information on less salient problems. Finally, it concludes that selective attention should be avoided in order to strengthen the citizens’ level of information on political problems.
The Rise of Cultural Issues as an Opportunity for the Right? Insights from the 2015 Swiss Election
Authors: Kurella Anna‐Sophie , Rosset Jan 
Published: December 2018

AbstractThis article presents an explanation for the success of the right in the 2015 Swiss parliamentary election based on the spatial model of voting. Since there is no party combining economically left with culturally authoritarian policy stances, voters with that preference combination face a difficult electoral choice. We show that they are more likely to abstain, and that those voters who turn out are more likely to cast votes for the right who represents them on cultural issues. We argue that this behavior is due to the fact that voters with this culturally conservative and economically left preferences attach more weight to cultural issues when making an electoral choice. On the aggregate, both findings imply an underrepresentation of economically left interests in the election result, and lead to a disproportional vote share for the right.
The impact of blood type on transfusion after major emergency abdominal surgery
Authors: Schack Anders , Oreskov Jakob Ohm , Ekeloef Sarah , Brodersen Thorsten , Ostrowski Sisse Rye , Gögenur Ismail , Burcharth Jakob 
Published: December 2018

BACKGROUNDABO dependent variation in von Willebrand factor (vWF) and factor VIII have an impact on hemostasis. Several contradictory studies have investigated the influence of ABO blood type in surgical hemorrhage. Emergency surgery is associated with an increased risk of perioperative hemorrhage leading to inferior clinical outcomes. The aim of this study was to investigate if patients with blood type O received more transfusions with blood components compared with non‐O patients after major emergency abdominal surgery.STUDY DESIGN AND METHODSThis retrospective observational study combined perioperative data including hemoglobin with transfusion data in patients undergoing emergency surgery at a university hospital between January 2010 and October 2016. The primary outcome was postoperative transfusion stratified into early transfusion, within 24 hours after surgery, and late transfusion from 24 hours to 7 days (POD7) after surgery.RESULTSA total of 869 patients were included, 363 patients with blood type O (42.0%) and 501 (58.0%) with blood type non‐O. We found no difference in the need for transfusion with 42 (11.6%) patients with blood type O and 66 (13.2%) patients with blood type non‐O receiving early transfusion and 39 (13.4%) and 48 (11.9%) of O and non‐O patients, respectively, receiving late transfusion. Multivariate logistic regression analysis showed an adjusted OR of 0.915 (95% CI 0.569–1.471) for early transfusion and an adjusted OR of 1.307 (95% CI 0.788–2.169) for late transfusion in patients with blood type O. Likewise, no difference was seen with respect to the change in hemoglobin levels before and after surgery as well as transfused volume.CONCLUSIONWe did not find an association between transfusion or perioperative changes in hemoglobin with respect to blood type ABO.
Use of multiple indicators to assess the pollution condition of urban streams: a case study of Bloemspruit, Free State Province, South Africa
Authors: Belle Gladys , Fossey Annabel , Esterhuizen Leana 
Published: December 2018

AbstractThe Bloemspruit in the Free State, South Africa, is being polluted by increasing anthropogenic activities alongside the stream. Water quality, macro‐invertebrate diversity and macro‐invertebrate habitats were studied to determine the extent of pollution. Pollution condition was quantified by calculating several indicators. The study revealed that Bloemspruit is highly polluted for the majority of the sampling sites. Two sites had fair water quality, while the water quality at the other sites was either marginal or poor. SASS 5 scores revealed that most macro‐invertebrate families present were pollution tolerant, indicating the poor state of the water. According to the modified IHAS (mIHAS) scores, macro‐invertebrate habitats at two sites were fair, seven adequate/fair and two poor. The relatively low values of the IHI scores confirm that the majority of the sites were affected by human activities. One site was classified as being largely modified because of the degrading effect of a wastewater treatment plant (WWTP) nearby.
Personalized evidence based medicine: predictive approaches to heterogeneous treatment effects
Authors: Kent David M , Steyerberg Ewout , van Klaveren David 
Published: December 2018

AbstractThe use of evidence from clinical trials to support decisions for individual patients is a form of “reference class forecasting”: implicit predictions for an individual are made on the basis of outcomes in a reference class of “similar” patients treated with alternative therapies. Evidence based medicine has generally emphasized the broad reference class of patients qualifying for a trial. Yet patients in a trial (and in clinical practice) differ from one another in many ways that can affect the outcome of interest and the potential for benefit. The central goal of personalized medicine, in its various forms, is to narrow the reference class to yield more patient specific effect estimates to support more individualized clinical decision making. This article will review fundamental conceptual problems with the prediction of outcome risk and heterogeneity of treatment effect (HTE), as well as the limitations of conventional (one-variable-at-a-time) subgroup analysis. It will also discuss several regression based approaches to “predictive” heterogeneity of treatment effect analysis, including analyses based on “risk modeling” (such as stratifying trial populations by their risk of the primary outcome or their risk of serious treatment-related harms) and analysis based on “effect modeling” (which incorporates modifiers of relative effect). It will illustrate these approaches with clinical examples and discuss their respective strengths and vulnerabilities.
Identifying cut-off scores for job demands and job control in nursing professionals: a cross-sectional survey in Germany
Authors: Zeike Sabrina , Ansmann Lena , Lindert Lara , Samel Christina , Kowalski Christoph , Pfaff Holger 
Published: December 2018

ObjectivesNurses are generally found to be vulnerable to burnout, but nurses working in cancer care are even more so, since this profession is characterised by continuous confrontation with suffering and death. This study was designed to identify cut-off scores for job strain, that is, low job control and high job demands, for a sample of nurses working in breast cancer care. The main goal was to find cut-off scores, which predict the risk of nurses of developing a mental disorder from high job strain.DesignThe design was a cross-sectional survey study.SettingThe study is based on an employee survey in breast cancer centres in Germany.Participants688 nurses received a questionnaire; 329 nurses from 33 hospitals participated in the survey (return rate: 50.2%).Primary and secondary outcome measuresDependent variable: psychological well-being, measured by the WHO-5 Well-being Index; independent variables: job control and job demands, measured by the Job Content Questionnaire (JCQ).ResultsMultivariable analysis indicates that low job control and high job demands are prognostic factors for low well-being. In a receiver operating curve (ROC) analysis, the cut-off scores, which demonstrated a maximum Youden index, were 34.5 for job control and 31.4 for job demands. The combination of both scales from a logistic regression analysis resulted in an area under the curve of 0.778. Sensitivity and specificity are 70.3% and 74.2%, respectively. The total of correct classification was 63.3%.ConclusionThe determined cut-off scores indicate that there is a risk of becoming psychologically ill from a high workload when an individual reaches a score of ≤34.5 for job control and ≥31.4 for job demands. The described method of establishing risk-based cut-off scores is promising for nursing practice and for the field of occupational health. Transferability and generalisability of the cut-off scores should be further analysed.
Integrated decision-making model for community-based rehabilitation service utilisation among persons with severe mental illness in China: protocol for a cross-sectional, mixed-methods study
Authors: Wang Ruoxi , Tang Shangfeng , Shaw Ian , Feng Zhanchun , Chen Zhuo , Luo Yuxiong , Song Hongxun , Wu Tailai , Fu Qian , Fu Hang , Huang Yueying , Chen Xiaoyu , Feng Da 
Published: December 2018

IntroductionA common problem low-income and middle-income countries face is the scarcity of community-based rehabilitation (CBR) resources and low service utilisation among persons with severe mental illness (SMI). Despite this problem, the factors and pathways followed influencing one’s decision on service utilisation in China have not been fully comprehended. This study aims to develop a theory-based model that systematically describes the integrated decision-making process of mental health CBR utilisation among persons with SMI in China.Methods/DesignThis cross-sectional, mixed-methods study involves three main stages and is expected to last 3 years, from January 2018 to December 2020. In stage 1, the Social Exchange Theory is deployed as an analytical framework to comprehensively capture factors associated with tendency to use CBR services in China using semistructured interview methodology involving patients with SMI, their primary caregivers and CBR service providers. In stage 2, interpretive structural modelling will be applied to analyse the relationships between factors in different dimensions, at different levels and with different levels of impact. Stage 3 involves a multiregion survey among at least 300 family decision-makers (either the patient or their caregivers) in six communities in three cities to statistically validate the initial model derived in stage 2 using a further structural equation modelling.Ethics and disseminationEthical approval was granted by the Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology (No 2017S319). All interviewees will be provided with written information about the study, and a signed consent will be retrieved prior to the interview. Rules on confidentiality and anonymity of data will be strictly followed. The findings of this study will be disseminated via international and domestic peer-reviewed journals, reports, conference presentations and symposium discussions. Reports will be submitted to the National Natural Science Foundation of China.
Individual cognitive stimulation therapy for people with intellectual disability and dementia: protocol of a feasibility randomised controlled trial
Authors: Ali Afia , Brown Emma , Spector Aimee , Aguirre Elisa , Hassiotis Angela 
Published: December 2018

IntroductionCognitive stimulation therapy (CST) is a psychosocial intervention for dementia. Group CST is effective in reducing cognitive decline and improving quality of life in patients with dementia. There is some evidence that individual CST (iCST) may be beneficial in reducing cognitive decline. People with intellectual disability (ID) have an increased risk of dementia. However, there are no published studies of CST in people with ID and dementia. This protocol describes the feasibility and acceptability of a randomised controlled trial of iCST delivered by carers to people with ID and dementia, compared with treatment as usual (TAU). The results of this study will inform the design of a future definitive randomised controlled trial.Methods and analysisThe iCST intervention has been adapted for this trial. Forty dyads (individuals with ID and their carer) will be randomised to either iCST or TAU. The manualised intervention comprises 40 iCST sessions delivered by a carer for 30 min, twice a week, over 20 weeks. The primary outcome will be process measures assessing the feasibility and acceptability of the intervention and trial procedures. The secondary outcome will be changes in the scores of outcome measures (cognition, functional ability and quality of life in individuals with ID, and caregiver burden, competence in managing dementia, and anxiety and depression in carers). Data will be collected at baseline, 11 weeks and at 21 weeks. A process evaluation will examine adherence to iCST and will include qualitative interviews with participants to identify aspects of the intervention that were or were not successful.Ethics and disseminationThe study has received ethical approval. The results of the study will be presented at conferences and submitted to a peer reviewed journal.Trial registration numberISRCTN18312288; Pre-results.
Effect of adjusting the challenge–skill balance for occupational therapy: study protocol for a randomised controlled trial
Authors: Yoshida Ippei , Hirao Kazuki , Kobayashi Ryuji 
Published: December 2018

IntroductionOccupational therapy (OT) is defined as the promotion of client health and well-being through a client-centred practice. However, there is a tendency to rely on the therapist’s experiences and values, and there is a difference between the client’s and therapist’s perceptions regarding the current activity that the client is engaged in. In previous studies that have applied ‘flow’, activities supported by OT in elderly people were analysed, indicating a difference in recognition. Therefore, we thought that more effective OT could be implemented by adjusting the challenge–skill (ACS) balance, and we invented a novel process termed as ACS balance for OT. The purpose of this study is to verify the effect of ACS-OT on clients in the recovery rehabilitation unit and to prepare a protocol for randomised controlled trial (RCT) implementation.Method and analysisThis single-blind RCT will recruit 80 clients aged 50–99 years admitted to the recovery rehabilitation unit who meet eligibility criteria. Clients will be randomly allocated to receive ACS-OT or standard OT. Both interventions will be performed during the clients’ residence at the unit. The primary outcome measure will be subjective quality of life and will be measured at entry into (pre) and at discharge from (post) the unit and at 3 months afterwards (follow-up). Outcomes will be analysed using a linear mixed model fitted with a maximum likelihood estimation.Ethics and disseminationThis protocol has been approved by the ethics review committee of the Tokyo Metropolitan University (No.17020). Results of this trial will be submitted for publication in a peer-reviewed journal.Trial registration numberUMIN-CTR number, UMIN000029505; Pre-results.
Short-term effect of a chronic pain self-management intervention delivered by an easily accessible primary healthcare service: a randomised controlled trial
Authors: Nøst Torunn Hatlen , Steinsbekk Aslak , Bratås Ola , Grønning Kjersti 
Published: December 2018

ObjectivesTo investigate the effects on persons with chronic pain after 3 months of a group-based chronic pain self-management course compared with a drop-in, low-impact outdoor physical group activity on patient activation and a range of secondary outcomes.DesignAn open, pragmatic, parallel group randomised controlled trial. Analyses were performed using a two-level linear mixed model.SettingAn easily accessible healthcare service provided by Norwegian public primary healthcare.ParticipantsA total of 121 participants with self-reported chronic pain for 3 months or more were randomised with 60 participants placed in the intervention group and 61 placed in the control group (mean age 53 years, 88% women, 63% pain for 10 years or more).InterventionsThe intervention group was offered a group-based chronic pain self-management course with 2.5-hour weekly sessions for a period of 6 weeks. The sessions consisted of education, movement exercises and emphasised group discussions. The control group was offered a low-impact outdoor group physical activity in 1-hour weekly sessions that consisted of walking and simple strength exercises for a period of 6 weeks.Main outcomesThe primary outcome was patient activation assessed using the Patient Activation Measure. Secondary outcomes measured included assessments of pain, anxiety and depression, pain self-efficacy, sense of coherence, health-related quality of life, well-being and the 30 s chair to stand test.ResultsThere was no effect after 3 months of the group-based chronic pain self-management course compared with the control group for the primary outcome, patient activation (estimated mean difference: −0.5, 95% CI –4.8 to 3.7, p=0.802).ConclusionsThere was no support for the self-management course having a better effect after 3 months than a low-impact outdoor physical activity offered the control group.Trial registration numberNCT02531282; Results.
Evidence synthesis, practice guidelines and real-world prescriptions of new generation antidepressants in the treatment of depression: a protocol for cumulative network meta-analyses and meta-epidemiological study
Authors: Luo Yan , Chaimani Anna , Kataoka Yuki , Ostinelli Edoardo Giuseppe , Ogawa Yusuke , Cipriani Andrea , Salanti Georgia , Furukawa Toshi A 
Published: December 2018

IntroductionDepressive disorders are the most common, burdensome and costly mental disorders. Their treatments have developed through the past decades and we now have more than a dozen new generation antidepressants, while a series of guidelines have been published to provide recommendations over the years. However, there still may exist important gaps in this evidence synthesis and implementation process. Systematic reviews may not have been conducted in the most unbiased, informative and timely manners; guidelines may not have reflected the most up-to-date evidence; clinicians may not have changed their clinical decision-makings in accordance with the relevant evidence. The aim of this study is to examine the gaps between the ideally synthesised evidence, guideline recommendations and real-world clinical practices in the prescription of new generation antidepressants for major depression through the past three decades.Methods and analysisWe will conduct cumulative network meta-analyses (cNMAs) based on the comprehensive systematic review which has identified published and unpublished head-to-head randomised controlled trials comparing the following antidepressants in the acute phase treatment of major depression: agomelatine, amitriptyline, bupropion, citalopram, clomipramine, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, levomilnacipran, milnacipran, mirtazapine, nefazodone, paroxetine, reboxetine, sertraline, trazodone, venlafaxine, vilazodone and vortioxetine. The primary outcomes will be the proportions of patients who responded (efficacy) and who withdrew from treatment for any reasons (acceptability). We will conduct a random effects cNMA to synthesise evidence and obtain a comprehensive ranking of all new generation antidepressants based on their surface under the cumulative ranking curves. We will identify series of international clinical practice guidelines for the treatment of major depression of adults and summarise their recommendations. We will estimate real-world prescription patterns of antidepressants in the nationally representative samples in USA in the Medical Expenditure Panel Survey. We will compare and evaluate the gaps between the rankings according to cNMAs conducted at 5-year intervals between 1990 and 2015, recommendations in guidelines published in the ensuing 5 years and actual practices thereafter.Ethics and disseminationThis review does not require ethical approval. We will disseminate our findings through publications in peer-reviewed journals and presentations at conferences.Trial registration numberUMIN000031898.