bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Meaning of the Elderly Sexuality in the Nursing Consultation Context
Authors: Saraiva Renata Jabour , Rosas Ann Mary Machado Tinoco Feitosa , Valente Geilsa Soraia Cavalcanti , Marques Ermelinda Maria Bernardo Gonçalves 
Published: September 2017

Objective: Comprehend the meaning of the elderly sexuality in the nursing consultation context.
Method: A qualitative research, of Alfred Schutz’s phenomenological sociological approach. 41 participants, being Brazilian and Portuguese elderly. The used scene was the teaching-assistance academic unit Institute of Health Care São Francisco de Assis – Rio de Janeiro – Brazil and Health School – Polytechnical Institute of Guarda – Portugal.
Results: The analysis of the contextualization of the reason-why and its categories: Interpretations of sexuality and sex between elderly; Cultural aspects involved among the elderly.
Conclusion: The lack of correct interpretation between the sexuality meaning and sex contributes to the insight of preventive clinical care, just as for sex-related pathologies.
Keywords: Nursing; Consultation; Elderly; Teaching; Education; Sexuality; Sex.
Quality Of Care As Perceived By Patients In A Brazilian Hospital: A Non-Randomized Interventional Study
Authors: Taets Gunnar Glauco De Cunto , Lopes Camila Mendonça de Moraes , Borba-Pinheiro Claudio Joaquim , Dantas Estelio Henrique Martin 
Published: September 2017

Objective: To assess patients’ perceptions of the quality of care delivered by staff who underwent training about humanized care in a private hospital in Rio de Janeiro, Brazil.
Method: This was an exploratory study. The convenience sample consisted of 30 patients, and data were collected via pre-intervention questionnaires, followed by post-intervention questionnaires after a training sessions with 44 employees working in a cardiac intensive unit of a private general hospital in Rio de Janeiro, Brazil. Dependent variables were analyzed using McNemar’s nonparametric test for repeated measures, considered suitable because of the nominal scale. Percentage differences were calculated using the following equation: ∆%=[(post-test – pre-test)*100/test] with significance set at <0.05.
Results: Improvements were observed in quality of patient care (Δ% = 38.1%, p = 0.031) and clarification of patients’ clinical condition (Δ% = 25%, p = 0.021), in addition to perceived room temperature (Δ % = 40%, p = 0.008) and ambient noise (Δ% = 52.6%, p = 0.002).
Conclusion: Quality of care improved significantly after staff training, demonstrating the essential nature of ongoing education.
Time-dependent Occurrence Rate of Electromagnetic Cyclotron Waves in the Solar Wind: Evidence for the Effect of Alpha Particles?
Authors: Zhao G. Q. , Feng H. Q. , Wu D. J. , Chu Y. H. , Huang J. 
Published: September 2017

Abstract
Previous studies revealed that electromagnetic cyclotron waves (ECWs) near the proton cyclotron frequency exist widely in the solar wind, and the majority of ECWs are left-handed (LH) polarized waves. Using the magnetic field data from the STEREO mission, this Letter carries out a survey of ECWs over a long period of 7 years and calculates the occurrence rates of ECWs with different polarization senses. Results show that the occurrence rate is nearly a constant for the ECWs with right-handed polarization, but it varies significantly for the ECWs with LH polarization. Further investigation of plasma conditions reveals that the LH ECWs take place preferentially in a plasma characterized by higher temperature, lower density, and larger velocity. Some considerable correlations between the occurrence rate of LH ECWs and the properties of ambient plasmas are discussed. The present research may provide evidence for the effect of alpha particles on the generation of ECWs.
Genetic Determinants of Radiographic Knee Osteoarthritis in African Americans
Authors: Liu Youfang , Yau Michelle S. , Yerges-Armstrong Laura M. , Duggan David J. , Renner Jordan B. , Hochberg Marc C. , Mitchell Braxton D. , Jackson Rebecca D. , Jordan Joanne M. 
Published: September 2017

Objective.The etiology of knee osteoarthritis (OA), the most common form of arthritis, is complex and may differ by race or ethnicity. In recent years, genetic studies have identified many genetic variants associated with OA, but nearly all the studies were conducted in European whites and Asian Americans. Few studies have focused on the genetics of knee OA in African Americans.Methods.We performed a genome-wide association study of radiographic knee OA in 1217 African Americans from 2 North American cohort studies: 590 subjects from the Johnston County Osteoarthritis Project and 627 subjects from the Osteoarthritis Initiative. Analyses were conducted in each cohort separately and combined in an inverse variance fixed effects metaanalysis, which were then included in pathway analyses. We additionally tested 12 single-nucleotide polymorphisms robustly associated with OA in European white populations for association in African Americans.Results.We identified a genome-wide significant variant inLINC01006(minor allele frequency 12%; p = 4.11 × 10−9) that is less common in European white populations (minor allele frequency < 3%). Five other independent loci reached suggestive significance (p < 1 × 10−6). In pathway analyses, dorsal/ventral neural tube patterning and iron ion transport pathways were significantly associated with knee OA in African Americans (false discovery rate < 0.05). We found no evidence that previously reported OA susceptibility variants in European whites were associated with knee OA in African Americans.Conclusion.These results highlight differences in the genetic architecture of knee OA between African American and European whites. This finding underscores the need to include more diverse populations in OA genetics studies.
Serologic Evidence of Gut-driven Systemic Inflammation in Juvenile Idiopathic Arthritis
Authors: Fotis Lampros , Shaikh Nurmohammad , Baszis Kevin W. , Samson Charles M. , Lev-Tzion Raffi , French Anthony R. , Tarr Phillip I. 
Published: September 2017

Objective.Accumulating evidence links juvenile idiopathic arthritis (JIA) to nonhost factors such as gut microbes. We hypothesize that children with new-onset JIA have increased intestinal bacterial translocation and circulating lipopolysaccharide (LPS).Methods.We studied systemic treatment-naive patients with JIA [polyarticular JIA, n = 22, oligoarticular JIA, n = 31, and spondyloarthropathies (SpA), n = 16], patients with established inflammatory bowel disease–related arthritis (IBD-RA, n = 11), and 34 healthy controls. We determined circulating IgG reactivity against LPS, LPS-binding protein (LBP), α-1-acid glycoprotein (α-1AGP), and C-reactive protein (CRP) in plasma or serum from these patients and controls. Juvenile Arthritis Disease Activity Score (JADAS-27) was calculated for patients with JIA.Results.Circulating anticore LPS antibody concentrations in patients with polyarticular JIA (p = 0.001), oligoarticular JIA (p = 0.024), and SpA (p = 0.001) were significantly greater than in controls, but there were no significant intergroup differences. Circulating LBP concentrations were also significantly greater in patients with polyarticular JIA (p = 0.001), oligoarticular JIA (p = 0.002), and SpA (p = 0.006) than controls, as were α-1AGP concentrations (p = 0.001, 0.001, and 0.003, respectively). No differences were observed between controls and patients with IBD-RA in any of the assays. Circulating concentrations of LBP and α-1AGP correlated strongly with CRP concentrations (r = 0.78 and r = 0.66, respectively). Anticore LPS antibody levels and CRP (r = 0.26), LBP (r = 0.24), and α-AGP (r = 0.22) concentrations had weaker correlations. JADAS-27 scores correlated with LBP (r = 0.66) and α-1AGP concentrations (r = 0.58).Conclusion.Children with polyarticular JIA, oligoarticular JIA, and SpA have evidence of increased exposure to gut bacterial products. These data reinforce the concept that the intestine is a source of immune stimulation in JIA.
Positron Emission Tomography/Computerized Tomography in Newly Diagnosed Patients with Giant Cell Arteritis Who Are Taking Glucocorticoids
Authors: Clifford Alison H. , Murphy Elana M. , Burrell Steven C. , Bligh Mathew P. , MacDougall Ryan F. , Heathcote J. Godfrey , Castonguay Mathieu C. , Lee Min S. , Matheson Kara , Hanly John G. 
Published: September 2017

Objective.Large vessel uptake on positron emission tomography/computerized tomography (PET/CT) supports the diagnosis of giant cell arteritis (GCA). Its value, however, in patients without arteritis on temporal artery biopsy and in those receiving glucocorticoids remains unknown. We compared PET/CT results in GCA patients with positive (TAB+) and negative temporal artery biopsies (TAB−), and controls.Methods.Patients with new clinically diagnosed GCA starting treatment with glucocorticoids underwent temporal artery biopsy and PET/CT. Using a visual semiquantitative approach, 18F-fluorodeoxyglucose (FDG) uptake was scored in 8 vascular territories and summed overall to give a total score in patients and matched controls.Results.Twenty-eight patients with GCA and 28 controls were enrolled. Eighteen patients with GCA were TAB+. Mean PET/CT scores after an average of 11.9 days of prednisone were higher in patients with GCA compared to controls, for both total uptake (10.34 ± 2.72 vs 7.73 ± 2.56; p = 0.001), and in 6 of 8 specific vascular territories. PET/CT scores were similar between TAB+ and TAB− patients with GCA. The optimal cutoff for distinguishing GCA cases from controls was a total PET/CT score of ≥ 9, with an area under the receiver-operating characteristic curve of 0.75, sensitivity 71.4%, and specificity 64.3%. Among patients with GCA, these measures correlated with greater total PET/CT scores: systemic symptoms (p = 0.015), lower hemoglobin (p = 0.009), and higher platelet count (p = 0.008).Conclusion.Vascular FDG uptake scores were increased in most patients with GCA despite exposure to prednisone; however, the sensitivity and specificity of PET/CT in this setting were lower than those previously reported.
Do Comorbidities Play a Role in Hand Osteoarthritis Disease Burden? Data from the Hand Osteoarthritis in Secondary Care Cohort
Authors: Damman Wendy , Liu Rani , Kroon Féline P.B. , Reijnierse Monique , Huizinga Tom W.J. , Rosendaal Frits R. , Kloppenburg Margreet 
Published: September 2017

Objective.Because the association and its clinical relevance between comorbidities and primary hand osteoarthritis (OA) disease burden is unclear, we studied this in patients with hand OA from our Hand OSTeoArthritis in Secondary care (HOSTAS) cohort.Methods.Cross-sectional data from the HOSTAS study were used, including consecutive patients with primary hand OA. Nineteen comorbidities were assessed: 18 self-reported (modified Charlson index and osteoporosis) and obesity (body mass index ≥ 30 kg/m2). Mean differences were estimated between patients with versus without comorbidities, adjusted for age and sex: for general disease burden [health-related quality of life (HRQOL), Medical Outcomes Study Short Form-36 physical component scale (0–100)] and disease-specific burden [self-reported hand function (0–36), pain (0–20; Australian/Canadian Hand OA Index), and tender joint count (TJC, 0–30)]. Differences above a minimal clinically important improvement/difference were considered clinically relevant.Results.The study included 538 patients (mean age 61 yrs, 86% women, 88% fulfilled American College of Rheumatology classification criteria). Mean (SD) HRQOL, function, pain, and TJC were 44.7 (8), 15.6 (9), 9.3 (4), and 4.8 (5), respectively. Any comorbidity was present in 54% (287/531) of patients and this was unfavorable [adjusted mean difference presence/absence any comorbidity (95% CI): HRQOL −4.4 (−5.8 to −3.0), function 1.9 (0.4–3.3), pain 1.4 (0.6–2.1), TJC 1.3 (0.4–2.2)]. Number of comorbidities and both musculoskeletal (e.g., connective tissue disease) and nonmusculoskeletal comorbidities (e.g., pulmonary and cardiovascular disease) were associated with disease burden. Associations with HRQOL and function were clinically relevant.Conclusion.Comorbidities showed clinically relevant associations with disease burden. Therefore, the role of comorbidities in hand OA should be considered when interpreting disease outcomes and in patient management.
Mortality and Functionality after Stroke in Patients with Systemic Lupus Erythematosus
Authors: Rossides Marios , Simard Julia F. , Svenungsson Elisabet , von Euler Mia , Arkema Elizabeth V. 
Published: September 2017

Objective.To investigate mortality and functional impairment after stroke in systemic lupus erythematosus (SLE).Methods.Using Swedish nationwide registers, we identified 423 individuals with SLE and 1652 people without SLE who developed a first-ever ischemic or hemorrhagic stroke (1998–2013) and followed them until all-cause death or for 1 year. HR for death after ischemic or hemorrhagic stroke and the risk ratio of functional impairment (dependence in either transferring, toileting, or dressing) 3 months after ischemic stroke were estimated.Results.One year after stroke, 22% of patients with SLE versus 16% of those without SLE died. After ischemic stroke, patients with SLE had an increased risk of death (HR 1.85, 95% CI 1.39–2.45), which was attenuated after controlling for SLE-related comorbidities (HR 1.41, 95% CI 1.04–1.91). Functional impairment at 3 months was increased in SLE by almost 2-fold (risk ratio 1.73, 95% CI 1.16–2.57). After hemorrhagic stroke, patients with SLE had an HR of 2.30 (95% CI 1.38–3.82) for death, which was increased even during the first month.Conclusion.Compared to subjects without SLE, mortality after ischemic stroke increases after the first month in individuals with SLE, and functionality is worse at 3 months. SLE is associated with all-cause death after hemorrhagic stroke even during the first month. A shift of focus to patient functionality and prevention of hemorrhagic strokes is required.
Comparative Effectiveness of Tumor Necrosis Factor Agents and Disease-modifying Antirheumatic Therapy in Children with Enthesitis-related Arthritis: The First Year after Diagnosis
Authors: Weiss Pamela F. , Xiao Rui , Brandon Timothy G. , Pagnini Ilaria , Wright Tracey B. , Beukelman Timothy , Morgan-DeWitt Esi , Feudtner Chris 
Published: September 2017

Objective.To characterize the effect of anti-tumor necrosis factor (TNF) therapy compared to conventional synthetic disease-modifying antirheumatic drugs (csDMARD) in children with enthesitis-related arthritis (ERA) over the first year after diagnosis.Methods.We conducted a multicenter retrospective comparative effectiveness study of children diagnosed with ERA. We estimated the effect of anti-TNF therapy on clinical variables (active joint count, tender entheses count) and patient-reported pain and global assessment of disease activity over the first year after diagnosis using state-of-the-art comparative effectiveness analytic methods.Results.During the study period, 217 patients newly diagnosed with ERA had a total of 965 clinic visits the first year after disease diagnosis. Children [median age 11.6 yrs, interquartile range 10–14] were treated with anti-TNF monotherapy (n = 33, 15.2%), csDMARD monotherapy (n = 73, 33.6%), or both (n = 52, 23.9%) in the first year after disease diagnosis. There was a statistically significant improvement in the primary outcome, active joint count, over time in children who received an anti-TNF drug versus those who did not (p = 0.03). Additionally, use of anti-TNF therapy versus no anti-TNF therapy was associated with less patient-reported pain (p < 0.01) and improved disease activity over time as assessed by the clinical Juvenile Arthritis Disease Activity Score (p < 0.01). The magnitude of estimated effect on clinical outcomes was uniformly greater, with the exception of tender entheses count, in children treated with an anti-TNF drug versus a csDMARD.Conclusion.During the first year after diagnosis, anti-TNF exposure was associated with benefits for several clinically meaningful outcomes in children with enthesitis-related arthritis.
Approach to Membranous Lupus Nephritis: A Survey of Pediatric Nephrologists and Pediatric Rheumatologists
Authors: Boneparth Alexis , Radhakrishna Suhas M. , Greenbaum Larry A. , Yen Eric , Okamura Daryl M. , Cooper Jennifer C. , Mason Sherene , Levy Deborah M. , Sule Sangeeta D. , Jensen Paul T. , Yildirim-Toruner Cagri , Ardoin Stacy P. , Wenderfer Scott E. 
Published: September 2017

Objective.To describe treatment practices for childhood pure membranous lupus nephritis (MLN).Methods.Survey study of Childhood Arthritis and Rheumatology Research Alliance and American Society of Pediatric Nephrology members.Results.There were 117 respondents who completed the survey (60 pediatric nephrologists, 57 pediatric rheumatologists). Steroids and nonsteroid immunosuppression (NSI) were routinely used by the majority for MLN. Mycophenolate mofetil was the favored initial NSI. Nephrologists used steroids (60% vs 93%) and NSI (53% vs 87%) less often than did rheumatologists for MLN without nephrotic syndrome (NS).Conclusion.Pediatric rheumatologists and nephrologists both recommend steroids and NSI for children with MLN, with or without NS.
Muscle Deficits in Rheumatoid Arthritis Contribute to Inferior Cortical Bone Structure and Trabecular Bone Mineral Density
Authors: Baker Joshua F. , Long Jin , Mostoufi-Moab Sogol , Denburg Michele , Jorgenson Erik , Sharma Prerna , Zemel Babette S. , Taratuta Elena , Ibrahim Said , Leonard Mary B. 
Published: September 2017

Objective.Rheumatoid arthritis (RA) is associated with muscle loss, osteoporosis, and fracture. We examined associations between skeletal muscle mass, strength, and quality and trabecular and cortical bone deficits in patients with RA and healthy controls.Methods.Participants, ages 18–75 years, completed whole-body dual-energy x-ray absorptiometry and peripheral quantitative computed tomography (pQCT) of the tibia to quantify appendicular lean mass and fat mass indices (ALMI, FMI), muscle density at the lower leg, trabecular bone density, and cortical bone thickness. Age-, sex-, and race-specific Z scores were calculated based on distributions in controls. Associations between body composition and pQCT bone outcomes were assessed in patients with RA and controls. Linear regression analyses assessed differences in bone outcomes after considering differences in body mass index (BMI) and body composition.Results.The sample consisted of 112 patients with RA (55 men) and 412 controls (194 men). Compared to controls, patients with RA had greater BMI Z score (p < 0.001), lower ALMI Z score after adjustment for FMI (p = 0.02), lower muscle strength Z score (p = 0.01), and lower muscle density Z score (p < 0.001). Among RA, ALMI Z scores were positively associated with trabecular density [β: 0.29 (0.062–0.52); p = 0.01] and cortical thickness [β: 0.33 (0.13–0.53; p = 0.002]. Associations were similar in controls. Bone outcomes were inferior in patients with RA after adjusting for BMI, but similar to controls when adjusting for body composition. Radiographic damage and higher adiponectin levels were independently associated with inferior bone outcomes.Conclusion.Patients with RA exhibit deficits in cortical bone structure and trabecular density at the tibia and a preserved functional muscle-bone unit. A loss of mechanical loading may contribute to bone deficits.
Le marché comme forme de régulation politique
Authors: Ansaloni Matthieu , Trompette Pascale , Zalio Pierre-Paul 
Published: September 2017

Instruments économiques, mécanismes de marché, market-based solutions : les dispositifs marchands sont investis d’une visée instrumentale dans l’exercice de la régulation politique. Nous proposons d’interroger cette pragmatique du marché au cœur de l’action publique en nous intéressant au travail d’anticipation, d’instrumentation et de pilotage des comportements marchands déployés par les acteurs qui la portent. On appréhende la conception de ces dispositifs marchands à partir des espaces de définition et de négociation collectives impliquant un large éventail d’acteurs – scientifiques, industriels, consultants, experts, groupes d’intérêts – et mobilisant diverses formes de connaissances et d’anticipations. L’ingénierie des marchés conduit à une diversité d’arrangements institutionnels, constamment traversés par la tension entre orientation stratégique et ajustements des conduites économiques.
Gouverner (par) les prix. La fixation des prix des médicaments remboursés en France
Authors: Nouguez Étienne , Benoît Cyril 
Published: September 2017

Cet article examine la fixation des prix des médicaments remboursés par l’État, en France, depuis ses origines au sortir de la Seconde Guerre mondiale jusqu’au milieu des années 2010. Nous analysons les formes successives prises par cette politique, de l’administration unilatérale des prix mise en place de 1948 aux années 1980 à leur négociation dans le cadre de conventions entre un Comité interministériel et les industriels à partir du milieu des années 1990. Nous défendons la thèse selon laquelle ce contrôle des prix par l’État articule deux types de gouvernement du marché : un gouvernement des valeurs , visant à apprécier les médicaments à partir de principes de justice sociale (promouvoir la santé publique, respecter l’équilibre des dépenses d’Assurance maladie, favoriser la recherche et développement et l’emploi industriel) ; un gouvernement des conduites , visant à apprécier les médicaments à partir de considérations de justesse marchande (s’assurer que les prix établis orientent les conduites des industriels et des acteurs du marché dans le sens de l’intérêt général). Loin d’aller de soi, la détermination du « juste prix » donne alors lieu à des affrontements, au sein du Comité économique des produits de santé et dans les négociations entre le Comité et les industriels, entre des acteurs porteurs de conceptions plurielles et antagonistes de la justice sociale et de la justesse marchande.
Dans les coulisses des labels : régulation tripartite et marchés imbriqués
Authors: Fouilleux Ève , Loconto Allison 
Published: September 2017

Cet article s’intéresse aux modalités concrètes du gouvernement par régime de standardisation tripartite. Cette forme de régulation alliant standards volontaires, certification et accréditation est de plus en plus utilisée dans de nombreux domaines de l’activité économique. À partir du cas de l’agriculture biologique, pour laquelle la certification par tierce partie accréditée a été imposée par l’Union européenne à partir des années 1990, nous montrons que cette régulation repose en réalité sur une imbrication de marchés, dont nous explorons les caractéristiques et les effets. Les marchés des produits biologiques sont étroitement imbriqués dans trois marchés de services (le marché des standards, de la certification, et de l’accréditation), dont les dynamiques concurrentielles expliquent la trajectoire d’européanisation puis de globalisation du secteur. Nous soulignons aussi les limites de ce mode de régulation, dans lequel le contrôlé paie le contrôleur et qui fait peser l’essentiel du coût et des contraintes du contrôle sur les agriculteurs. Ces limites génèrent des critiques croissantes au sein du mouvement pour l’agriculture biologique, certains acteurs proposant de revenir aux formes participatives de contrôle non marchand forgées par les militants initiaux.
L’aveu : théorie psychanalytique et réalité juridique
Authors: de Mijolla-Mellor Sophie 
Published: September 2017

Les motivations de celui qui cherche à obtenir les aveux et de celui qui les donne ne sont pas nécessairement complémentaires. Au pourquoi des aveux se substitue dès lors une interrogation sur le comment, c’est-à-dire sur les modalités intrapsychiques de l’aveu. On évoquera ici à partir de la notion de « besoin d’avouer » un apport majeur de Theodor Reik à la psychanalyse et à la criminologie.