bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pregnancy loss and risk of later dementia: A nationwide cohort study, Denmark, 1977–2017
Authors: Basit Saima , Wohlfahrt Jan , Boyd Heather A. 
Published: April 2019

AbstractIntroductionPregnancy losses may be associated with increased risks of dementia.MethodsWe conducted a register‐based cohort study in 1,243,957 women with ≥1 pregnancy in Denmark in the period 1977–2015. Using Cox regression, we estimated hazard ratios (HRs) comparing risks of dementia in women with and without pregnancy losses.ResultsDuring 21,672,433 person‐years of follow‐up, 261,279 women experienced a pregnancy loss, and 2188 women were diagnosed with dementia. Stillbirth was associated with an 86% increased risk of dementia overall (HR 1.86, 95% confidence interval [CI] 1.28–2.71). By contrast, miscarriage was not associated with later risk of dementia overall (single miscarriage, HR 0.99, 95% CI 0.87–1.12; recurrent miscarriages, HR 1.06, 95% CI 0.84–1.35). Adjustment for cardiovascular disease, hypertension, and diabetes did not meaningfully alter the association magnitudes.DiscussionStillbirth and dementia may share underlying mechanisms, suggesting that a history of stillbirth should be considered when assessing dementia risk in women.
A New Route from Moral Disagreement to Moral Skepticism
Authors: RISBERG OLLE , TERSMAN FOLKE 
Published: April 2019

AbstractMoral disagreement is sometimes thought to pose problems for moral realism because it shows that we cannot achieve knowledge of the moral facts the realists posit. In particular, it is ‘fundamental’ moral disagreement—that is, disagreement that is not due to distorting factors such as ignorance of relevant nonmoral facts, bad reasoning skills, or the like—that is supposed to generate skeptical implications. In this paper, we show that this version of the disagreement challenge is flawed as it stands. The reason is that the epistemic assumptions it requires are incompatible with the possibility of fundamental disagreement. However, we also present an alternative reconstruction of the challenge that avoids the problem. The challenge we present crucially invokes the principle that knowledge requires ‘adherence’. While that requirement is usually not discussed in this context, we argue that it provides a promising explanation of why disagreement sometimes leads to skepticism.
Online Repression and Self-Censorship: Evidence from Southeast Asia
Authors: Ong Elvin 
Published: April 2019

AbstractGovernments around the world have crafted new laws to threaten, arrest, prosecute and incarcerate online political activists. While the primary effect of online repression is to silence criticism and forestall collective action, a secondary effect is to induce self-censorship among the masses. Yet scant research examines how self-censorship works, nor discusses its implications for entrenching authoritarianism and encouraging democratic backsliding. This article proposes a simple expected utility model of self-censorship, arguing that citizens will more likely self-censor when the expected costs of online political expression outweigh its benefits. Analysing the fourth wave of the Asian Barometer survey of 10,216 respondents across eight Southeast Asian countries, I find that higher income politically engaged social media users are indeed less likely to express their political opinions. Additionally, this correlation holds in states where online repression is most severe, but is non-existent in countries where online repression is moderate or low.
Herd factors influencing free fatty acid concentrations in bulk tank milk
Authors: Wiking Lars , Bjerring Martin , Løkke Mette Marie , Løvendahl P. , Kristensen T. 
Published: April 2019

AbstractFree fatty acid (FFA) concentrations can be elevated in raw milk due to improper handling and management at the dairy farm, and high concentrations of FFA can lead to off flavors in milk. This study aimed to describe how the herd production system, milking system, feeding and technological factors impact on FFA concentrations in bulk tank milk. FFA concentrations in bulk milk samples from 259 organic and 3326 conventional herds were analyzed by FT-IR during one year. The FFA content was significantly lower in bulk milk from organic than conventional herds. This was most evident during the summer half-year when the organic cows graze pasture. Bulk milk from automatic milking systems (AMS) and tie-stalls contained greater concentrations of FFA than any other milking parlor systems. In AMS, high milking frequency was found to be the most significant contributor to elevated FFA content in milk. Moreover, a strong interaction was found between milking interval and production system (organic vs. conventional). The technical factors, pre-cooling, onset time for cooling after milk inlet, contact between milk and agitation also impacted on the FFA concentration, whereas other technical factors including centrifugal pump type, length and height of pumping line and type of AMS manufacturer were found to be without significant effect on FFA. Feeding variables, based on feeding plans and evaluation, only explained a small part of the variation in bulk milk FFA. Overall, this study demonstrated that AMS compared to other milking system contributes significantly to increased FFA concentration in bulk tank milk, and within AMS high milking frequency contributes to increased FFA concentration.
Exogenous phospholipase A2 affects inflammatory gene expression in primary bovine mammary epithelial cells
Authors: Kurz Jacqueline P. , Richards Mark P. , Garcia Matthew , Wang Zhongde 
Published: April 2019

AbstractThis Research Communication addresses the hypothesis that exogenously administered phospholipase A2 (PLA2) affects the inflammatory responses of bovine mammary epithelial cells (bMEC) in vitro with the aim of providing preliminary justification of investigation into the uses of exogenously administered PLA2 to manage or treat bovine mastitis. Primary bMEC lines from 11 lactating Holstein dairy cows were established and the expression of 14 pro-inflammatory genes compared under unchallenged and lipopolysaccharide (LPS)-challenged conditions, with and without concurrent treatment with bovine pancreatic PLA2G1B, a secreted form of PLA2. No differences in the expression of these genes were noted between PLA2-treated and untreated bMEC under unchallenged conditions. Following LPS challenge, untreated bMEC exhibited significant downregulation of CXCL8, IL1B, CCL20, and CXCL1. In contrast, PLA2-treated bMEC exhibited significant downregulation of IL1B and CCL20 only. These findings indicate that exogenous PLA2 affects the expression of some pro-inflammatory factors in immune-stimulated bMEC, but does not influence the constitutive expression of these factors. Further investigation of the influence of exogenous PLA2 in the bovine mammary gland is justified.
Prendre part au siècle des Lumières. Le concours académique et la culture intellectuelle au XVIIIesiècle
Authors: Caradonna Jeremy L. 
Published: April 2019

RésuméL’article propose une histoire culturelle du concours academique dans la France du XVIIIesiecle. Il met en avant trois arguments complementaires. Premierement, le concours academique etait une activite litteraire socialement diverse a laquelle participaient des milliers d’ecrivains amateurs ou professionnels, hommes et femmes, riches et pauvres. Deuxiemement, le concours etait peut-etre la pratique intellectuelle la plus democratique, permettant une participation a l’espace public des Lumieres. Enfin, les questions mises au concours par les academies touchaient souvent des sujets sociaux et politiques controverses. Tout compte fait, l’etude du concours academique offre un nouveau regard sur les Lumieres, en revelant une participation nombreuse et relativement egalitaire au debat intellectuel.
Le conclave des parieurs. Paris, opinion publique et continuité du pouvoir pontifical à Rome au XVIe siècle
Authors: Villard Renaud 
Published: April 2019

RésuméÀ Rome, au XVIe siècle, les principales scansions d’un pontificat donnent lieu à d’innombrables paris, qui mobilisent des moyens financiers considérables et suscitent l’enthousiasme de toute la société romaine. Les bulletins des parieurs révèlent la probabilité, pour les joueurs, d’un événement: ce faisant, ils centralisent les rumeurs et informations. La multiplication anarchique de paris finit par brouiller la réalité: comme des papes meurent ou sont élus sur les comptoirs des parieurs, il devient difficile de distinguer les chronologies réelles, de savoir si le pape est élu ou mort. Cette disparition de l’événement réel a des conséquences politiques inattendues: en singeant les conclaves par les paris, la foule invente un rituel parallèle à même de combler les vacances du pouvoir. La continuité du pouvoir pontifical, la pacification politique des États pontificaux, doit paradoxalement beaucoup aux parieurs qui, par leurs jeux, s’octroyaient les attributs du pouvoir souverain. Dans le même temps se développe la crainte d’une élection pontificale guidée non par l’Esprit saint, mais par les intérêts financiers en jeu, ce qui conduit le pouvoir pontifical à interdire ces paris, à contrôler la parole publique à Rome, pour que le secret du prince ne soit pas confisqué par la rue.
Southside Medical Homes Network: Linking Emergency Department Patients to Community Care
Authors: Marr Amy L. , Pillow Tyson , Brown Stephen 
Published: April 2019

AbstractBackground: The 14 neighborhoods surrounding University of Chicago Hospitals (UCH) have both Chicago's highest “ambulatory-care-sensitive condition” hospitalization rates and lack of community-based care. To address these problems, in 2004, the Southside Medical Homes (SMH) Network began linking emergency department (ED) patients with 18 community providers. The ED-based patient navigator (patient advocate) is an integral component of this network, and both their current and developing roles will be discussed.Methods: Six navigators worked in the UCH-ED approached eligible patients that are flagged by the ED electronic tracking system. Patients were offered the services provided by primary-care referral and appropriate dental, mental health, and substance abuse facilities. Appointments were scheduled, and pertinent ED medical data was faxed to the outlying sites. Navigator roles were expanding with SMH to include: (1) focus on frequent user/chronic disease populations such as sickle cell disease where advocates will expedite a multidisciplinary clinic referral; (2) navigator training to better inform patients of the specific benefits a “medical home” provides for preventive and psychosocial care; (3) and improving navigator, and secondarily, patient knowledge, of community resources: health-education sites, vocational programs, advocacy agencies, support groups, etc.Results/Conclusions: Data through 01 July 2007 show a monthly average of 950 ED patients surveyed and 80% of these accepting follow-up referral services. Of those patients with ED-scheduled appointments (43%) in community clinics, network data shows patients returning to their referred providers: 39% of patients have been ≥2 times. The navigator role is evolving with the expansion of SMH to include: (1) frequent-user population referrals; (2) preventive health education; and (3) utilization of community resources.
The treatment of acute psychotic episode: discrepancy between routine practice and evidence. The project SIEP-DIRECT's
Authors: Lora Antonio , Corlito Giuseppe , Miceli Maurizio , Munzio Walter Di , Lasalvia Antonio , Tanini Andrea , Mari Luisa , Casacchia Massimo , Magnani Nadia , Cristofalo Doriana , Semisa Domenico , Ruggeri Mirella 
Published: April 2019

SUMMARYAims– To evaluate the quality of psychiatric care during the acute psychotic episode and the early post-acute period.Methods– Data concerning 24 indicators, drawn from NICE recommendations, were collected in 19 Departments of Mental Health, in the frame of the SIEP-DIRECT's Project to evaluate the implementation of NICE recommendations in Italian Mental Health Services.Results– The treatment of the acute episode in the Italian Mental Health Services is not based only on admissions in Psychiatric Ward in General Hospitals, but also on intensive home based care. The utilization of day hospital facilities for treating acute episodes is less frequent, as the presence of home based follow up after discharge. About of Departments of Mental Health did not have clinical guidelines concerning the pharmacological treatment in this area. However usually the standard practices followed NICE recommendations in terms of prescribed dosages, monitoring side effects and rationale for shifting to atypical antipsychotic drugs. Antipsychotic drugs, atypical or conventional, were frequently prescribed concurrently, while utilization of atypical antipsychotic drugs was increasing.Conclusions– The results show critical points concerning on one hand the scarce diffusion of clinical guidelines, on other hand the connection between standard practices, clinical guidelines and marketing of atypical antipsychotic drugs. It should be reinforced the role of the community and particularly at service level the capacity of community mental health teams to treat the acute patients.Declaration of Interest:none.
The SIEP-DIRECT's Project on the discrepancy between routine practice and evidence. An outline of main findings and practical implications for the future of community based mental health services
Authors: Ruggeri Mirella , Lora Antonio , Semisa Domenico 
Published: April 2019

SUMMARYAims– To highlight the major discrepancies that emerged between evidence and routine practice in the framework of the SIEP-DIRECT's Project (DIscrepancy betweenRoutine practice andEvidence in psychiatricCommunityTreatments onSchizophrenia). The Project was conducted in 19 Italian mental health services (MHS), with the aims of: a) evaluating the appropriateness of the NICE Guidelines for Schizophrenia in the Italian context, b) developing and testing a set of 103 indicators that operationalised preferred clinical practice requirements according to the NICE Guidelines, and c) evaluating their actual application in Italian MHSs.Methods– The indicators investigated five different areas: common elements in all phases of schizophrenia; first episode treatment; crisis treatment; promoting recovery; the aggressive behaviour management.Results– The NICE recommendations examined were judged in most instances to be appropriate to the Italian MHS context, and the indicators fairly easy to use. The more severe and frequently encountered evidence-practice discrepancies were: lack of written material, guidelines, and information to be systematically provided to users; lack of intervention monitoring and evaluation; difficulty in implementingspecific and structured forms of intervention; difficulty in considering patients' family members as figures requiring targeted support themselves and who should also be regularly involved in the patient care process.Conclusions– The key actions to be undertaken to favour implementation of evidence-based routine practices are: focussing on mental illness onset and family support/involvement in care; planning training activities aimed at achieving specific treatment goals; encouraging MHS participation in evaluation activities; identifying thresholds for guideline application and promoting specific guideline implementation actions; and activating decision making and resource allocationprocesses that rely more strictly on evidence and epidemiological assessment. These considerations are of value for rethinking the model of community psychiatry in Italy as well as in other countries.Declaration of Interest: None.
Childhood sexual abuse and psychosis: aetiology and mechanism
Authors: Bebbington Paul 
Published: April 2019

AbstractThe aim of this Editorial is to describe the association between child sexual abuse and psychosis, and to consider potential mechanisms for the association. The association is strongly supported by the literature. Evidence from a variety of sources is triangulated in order to create a plausible model of the link, which can then be used to direct future research. The mechanisms are certainly complex, and there is evidence of interacting contributions at genetic, neurophysiological, behavioural, cognitive and emotional levels. Child sexual abuse is an important antecedent in psychosis, both theoretically and clinically. At the theoretical level, it potentially illuminates mechanisms by which psychotic symptoms are generated, at the clinical level it opens possibilities for improving cognitive-behavioural approaches to treatment.Declaration of Interest: None.
Predictors of employment status change over 2 years in people with schizophrenia living in Europe
Authors: Marwaha Steven , Johnson Sonia , Bebbington Paul E. , Angermeyer Matthias C. , Brugha Traolach S. , Azorin Jean-Michel , Killian Reinhold , Hansen Karina , Toumi Mondher 
Published: April 2019

SUMMARYAim– To examine the associations of job acquisition and loss in a representative, prospective community sample of people with schizophrenia living in the UK, France and Germany.Method– A representative sample of twelve hundred and eight people with schizophrenia were recruited from selected secondary mental health services in the U.K, France and Germany and followed up for 2 years. Information on demographic details, psychotic symptoms and work status was collected.Results– The odds of getting jobs were increased by being resident in Marseille, Leipzig, Hemer and Heilbronn and by a higher regional general population employment rate. The odds were reduced by living in Lyon, a later illness onset, a longer length of illness, a continuous illness course and more severe negative psychotic symptoms. Previous vocational training reduced the odds of losing employment, whilst living in Lyon or Leipzig, harmful use of alcohol and more positive psychotic symptoms at baseline all increased the odds.Conclusions– In addition to illness related factors, area of residence and local labour market conditions appear to be important in explaining employment status change in people with schizophrenia.Declaration of Interest: All authors declare there are no conflicts of interest. This study was funded by grants from Lundbeck A/S and from the German Federal Ministry of Education and Research.
Outcome reporting bias in clinical trials
Authors: Esposito Eleonora , Cipriani Andrea , Barbui Corrado 
Published: April 2019

Randomised controlled trials (RCTs) are designed and powered to measure one single outcome, calledprimary outcome(Sibbald & Roland, 1998; Barbuiet al., 2007). The primary outcome is the pre-specified outcome of greatest clinical importance and is usually the one used in the sample size calculation (Accordini, 2007). In addition to the primary outcome, RCTs may have several other outcomes, calledsecondary outcomes. In contrast with the analysis of the primary outcome, the analysis of secondary outcomes and its interpretation may be complicated by at least two factors:1)the trial may not have enough statistical power to detect differences (so it is possible to incur in a type II error, that is failing to see a difference that is present);2)increasing the number of secondary outcomes generates the problem of multiplicity of analyses, that is the proliferation of possible comparisons in a trial (and increasing the number of comparisons increases the possibility to incur in a type I error, that is detecting significant differences by chance). For all these reasons, the results of the analysis of primary outcomes is considered less susceptible to bias than the analysis of secondary outcomes.
What have we learnt from 40 years of research on Intensive Case Management?
Authors: Marshall Max 
Published: April 2019

AbstractThe aims of the Editorial are to summarise what we know for certain from clinical trials of Intensive Case Management, and to highlight lessons for clinicians and researchers. I will upon two systematic reviews of trials of Intensive Case Management versus standard care or low intensity case management. Both incorporated a meta-regression which examined the effect of fidelity to the Assertive Community Treatment model on outcome. The effectiveness of Intensive Case Management was limited to improving patient satisfaction and reducing attrition. Intensive Case Management teams organised according to the Assertive Community Treatment model offered the additional benefit of reducing days in hospital, but only when the team's clients had been high users of hospital care over the previous 12 months. Four important lessons can be drawn: a) Changes to the process of care tend to affect process variables, not outcome variables. b) Complex interventions must be defined meticulously in clear terminology. c) Researchers must demonstrate that complex interventions have been properly implemented in clinical trials. d) It is important to remember that in a clinical trial a successful outcome is determined as much by the control group as by the intervention.
General Health Questionnaire-12 items: adaptation study to the Portuguese population
Authors: Laranjeira Carlos António 
Published: April 2019

SummaryAims – To assess the validity and reliability of the GHQ-12 in Portugal. Methods – Using a standard ‘forwardbackward’ translation procedure, the English language version of the questionnaire was translated into Portuguese. To test reliability the internal consistency was assessed by Cronbach's alpha coefficient. Validity was performed using convergent validity. Finally, the factor structure of the questionnaire was extracted by performing principal component analysis using varimax rotation. Results – In all 790 undergraduates entered into the study. Reliability analysis showed satisfactory result (Cronbach's alpha coefficient = 0.91). Convergent validity indicated a significant negative correlation between the GHQ-12 and social support scores as expected (r = -0.54, P < 0.001). The principal component analysis showed that the GHQ-12 was a measure with two-factor structure. Conclusion – The Portuguese version of the GHQ-12 has a good structural characteristic for measuring psychological well being.Declaration of Interest: None.
Residential care: Dutch and Italian residents of residential care facilities compared
Authors: Heer-Wunderink Charlotte De , Caro-Nienhuis Annemarie D. , Sytema Sjoerd , Wiersma Durk 
Published: April 2019

SummaryAims – Characteristics of patients living in residential care facilities and the availability of mental hospital- and residential beds in Italy and The Netherlands were compared to assess whether differences in the process of deinstitutionalisation have influenced the composition of their residential patient populations. Methods – Data from the Dutch UTOPIA-study (UTilization & Outcome of Patients In the Association of Dutch residential care providers) and the Italian PROGRES-study were used. Results – Dutch residents were more likely to suffer from substance or alcohol abuse than Italian residents. The latter were more likely to suffer from schizophrenia or a related disorder, less likely to have experienced mental hospital admissions and showed an overall shorter duration of stay in residential care facilities. Contrary to our expectations Dutch residents, who still have good access to long stay beds in mental hospitals, are not less disabled than Italian residents. Finally, the number of beds in residential care facilities per 10,000 inhabitants in the Netherlands is twice (6) as high as in Italy (3). Conclusions – The Italian and Dutch deinstitutionalisation processes have resulted in a different availability in the number of residential beds. However, it did not influence the overall level of functioning of both residential populations.Declaration of interest: An unconditional grant was received from the Alliance of the 22 Dutch independent residential care providers.