bluuebunny/crossref_metadata_2025_split huggingface dataset:
СУЧАСНІ УЯВЛЕННЯ ПРО ГРАНУЛОЦИТАРНИЙ АНАПЛАЗМОЗ ЛЮДИНИ
Authors: Klymnyuk S. I. , Romanyuk L. B. , Shkilna M. I. 
Published: November 2017

Мета роботи – узагальнити дані про етіологію, епідеміологічні особливості, клінічні прояви та підходи до лабораторної діагностики гранулоцитарного анаплазмозу людини (ГАЛ).Підкреслено, що ця хвороба набуває поширення в багатьох країнах Європи та Україні внаслідок наявності ареалів для її векторів – іксодових кліщів. Звернено увагу на строкатість її клінічних ознак, що ускладнює ранню діагностику захворювання і вимагає ретельного лабораторного підтвердження.Висновок. В Україні дослідження щодо ГАЛ перебувають на початковому етапі. З великою ймовірністю можна припустити, що на більшості території України ГАЛ реєструється під діагнозом інших нозологій, які передаються іксодовими кліщами, що пов’язано з подібністю окремих клінічних проявів цих інфекцій, а також недостатньою базою для їх лабораторної діагностики, з одного боку, та відсутністю настороженості дільничних лікарів та інфекціоністів щодо ГАЛ – з іншого.
УРАЖЕННЯ НЕРВОВОЇ СИСТЕМИ У ДІТЕЙ, АСОЦІЙОВАНІ З ВІРУСОМ VARICELLA-ZOSTER
Authors: Prokopiv O. V. , Prykuda N. M. 
Published: November 2017

Мета роботи – вивчити особливості клінічного перебігу специфічних неврологічних ускладнень, асоційованих з вірусом Varicella-Zoster, у дітей.Пацієнти і методи. Спостереження проведено у 47 дітей віком від 2 місяців до 17 років з неврологічними ускладненнями вітряної віспи (ВВ), які знаходилися на стаціонарному лікуванні у Львівській обласній інфекційній клінічній лікарні (ЛОІКЛ) упродовж 2000–2016 рр. Діагноз вітряної віспи базувався на типових клінічних проявах хвороби, даних епідеміологічного анамнезу, результатах загальноприйнятих лабораторних та імунологічних досліджень.Висновки. Атактична форма енцефаліту, діагностована у 80,9 % хворих на вітряну віспу дітей з неврологічними ускладненнями, розвинулася на етапі спаду гострих проявів хвороби – у періоді підсихання кірочок і характеризувалася доброякісним перебігом, що свідчить про інфекційно-алергічний ґенез цього ускладнення. Вогнищевий енцефаліт, спричинений безпосереднім впливом вірусу Varicella-Zoster, спостерігали у 12,5 % дітей; перші клінічні симптоми дифузного ураження речовини мозку та черепних нервів виникали на ранніх термінах хвороби (2–4-а доба). Ішемічний інсульт як ускладнення інфекційного васкуліту, асоційованого з вірусом Varicella-Zoster, що розвинувся у 4-річної дитини, спростовує традиційні уявлення про трактування вітряної віспи як хвороби дитячого віку з легким перебігом.
НЕКОТОРЫЕ АСПЕКТЫ ДЕФЕКТОВ ОКАЗАНИЯ ХИРУРГИЧЕСКОЙ ПОМОЩИ
Authors: Indiaminov S. I. , Davranova A. E. 
Published: November 2017

Вступ. Експертний розбір випадків з приводу неналежного виконання медичними працівниками професійних обов’язків представляє досить складним завданням у зв’язку з тим, що відсутній комплексний підхід до проведення різних видів експертиз, єдина загальноприйнята термінологія щодо найменувань дефектів, існує різнє трактування експертами ідентичних дій медичного персоналу. Тому потрібне подальше вдосконалення ефективності аналізу дефектів надання медичної допомоги в конкретних групах, диференційованих за окремими медичними спеціальностями, потребує розробки питання визначення тяжкості шкоди, заподіяної здоров’ю пацієнта в результаті неналежного виконання лікарем своїх професійних обов’язків.Мета дослідження – аналіз характеру дефектів надання хірургічної допомоги за матеріалами судово-медичних експертиз, направлених на запобігання виникненню ускладнень і несприятливих наслідків у хірургічній практиці.Матеріал і методи. Для досягнення поставленої мети нами були проаналізовані 36 комісійних судово-медичних експертиз у справах про неналежне виконання медичним персоналом своїх професійних обов'язків у лікувально-профілактичних установах Самаркандської області за 2016 рік.Результати. Проаналізовано несприятливі наслідки і дефекти надання хірургічної допомоги на всіх етапах її надання. Встановлено, що найбільша кількість зазначених експертними комісіями дефектів була допущена на стаціонарному етапі надання допомоги – 13 випадків (92,8 %). Найчастіше спостерігалися дефекти хірургічної допомоги (57 %). При цьому переважали дефекти діагностики (64,3 %), в основному у вигляді нерозпізнання основної патології (55,6 %), а також у вигляді дефектів хірургічного лікування (40 %); які виникали в основному через суб’єктивні причини, що склало (85,7 %), у вигляді неповноцінного обстеження хворого (75 %).Висновки. Більшість дефектів надання медичної допомоги хірургічного профілю допускалися на госпітальному етапі 92,9 % в основному ЦРЛ 53,8 %. У результаті більшість з них (71,4 %) сприяли настанню смерті.
Study of Laemostenus species across Zagros and Central zone of Iran, with the description of seven new cavernicolous species and notes on subgenus Iranosphodrus (Coleoptera: Carabidae: Sphodrini)
Authors: TAHAMI MOHADESEH SADAT , MUILWIJK JAN , LOHAJ ROMAN , SADEGHI SABER 
Published: November 2017

The species belonging to the Sphodrine genus Laemostenus Bonelli, 1810 from central and southern Zagros Mts. and central zones of Iran were studied. Two new species-groups of the subgenus Antisphodrus Schaufuss, 1865 are proposed, and seven new species belonging to subgenera Antisphodrus Schaufuss, 1865 and Iranosphodrus Lohaj & Casale, 2011 are described. Morphological characters of the habitus and shape of male genitalia were used to delimit the species. New species of subgenus Antisphodrus are: L. (A.) zagrosensis sp. nov. and L. (A.) speleophilus sp. nov. from Chaharmahal and Bakhtiari province, and L. (A.) farsicus sp. nov. from Fars province (zagrosensis species-group); Laemostenus (A) zakariyiensis sp. nov. from Fars province (aequalis species-group), and L. (A.) shirazensis sp. nov. from Fars province (glasunowi species-group). Based on the newly collected material, the subgenus Iranosphodrus is redefined and two new species from Yazd province are described: L.(I.) yazdensis sp. nov. and L.(I.) troglophilus sp. nov. An identification key for the Laemostenus species of the studied area is provided, and a check list for Iranian representatives of subgenera Antisphodrus and Iranosphodrus are given.
Reactions to symptoms of mental disorder and help seeking in Sabah, Malaysia
Authors: Shoesmith Wendy Diana , Borhanuddin Awang Faisal Bin Awang , Yong Pau Lin Pauline , Abdullah Ahmad Faris , Nordin Norhayati , Giridharan Beena , Forman Dawn , Fyfe Sue 
Published: November 2017

Background: A better understanding is needed about how people make decisions about help seeking. Materials: Focus group and individual interviews with patients, carers, healthcare staff, religious authorities, traditional healers and community members. Discussion: Four stages of help seeking were identified: (1) noticing symptoms and initial labelling, (2) collective decision-making, (3) spiritual diagnoses and treatment and (4) psychiatric diagnosis and treatment. Conclusion: Spiritual diagnoses have the advantage of being less stigmatising, giving meaning to symptoms, and were seen to offer hope of cure rather than just symptom control. Patients and carers need help to integrate different explanatory models into a meaningful whole.
Stavenhagen and the Nation: Ethnicity, Community, and Political Project
Authors: Loza Jorgelina 
Published: November 2017

There is consensus in Latin America that the modern states of the region emerged from a communal project based on the existence of pre-national societies. It remains important, however, to ask who the actors behind this construct are and how they understand the discourse of the nation promoted by those states. Rodolfo Stavenhagen, who took a critical view of the processes of construction of this modern organizational form, approached the concept of the nation as a construct that took into account the coalition of prevailing forces and could be disputed by those seeking to play a leading role in it. En América Latina, ya constituye un consenso afirmar que los estados modernos de la región emergen de un proyecto comunitario a partir de la existencia de sociedades pre-nacionales. Resulta urgente preguntarse por los actores que forman parte de dicha construcción y la forma en que reciben el discurso nacional promovido por el Estado. Rodolfo Stavenhagen, quien sostuvo una mirada crítica sobre los procesos de construcción de esta forma organizativa moderna, nos permite pensarla como una construcción que puede dar cuenta de la coalición de fuerzas vigente y ser disputada por aquellos que exigen tener un rol protagónico en la misma.
High-pitch dual-source paranasal sinus CT in agitated patients with maxillofacial trauma: analysis of image quality, motion artifacts, and dose aspects
Authors: Frellesen Claudia , Wichmann Julian L , Tischendorf Patricia , Scholtz Jan-Erik , Beeres Martin , Vogl Thomas J , Bauer Ralf W 
Published: November 2017

Background Image quality benefits from high-pitch scanning in agitated patients by reducing acquisition time. Purpose To compare image quality and exposure parameters in patients with maxillofacial trauma on second- and third-generation dual-source computed tomography (DSCT). Material and Methods Four groups were compared. Group 1 was examined on second-generation DSCT (120 kV/50 mAs, pitch 3.0). The other three groups were examined on third-generation DSCT. Group 2 was scanned with 120 kV/50 mAs, pitch 2.2. Automated exposure control (AEC) was used in group 3 and group 4 with pitch factors of 2.2 and 3.0, respectively. Images of third-generation DSCT were reconstructed with iterative reconstruction (IR), of second-generation DSCT with filtered back-projection. CTDIvol, acquisition time, and image quality were compared. Results Thirty patients were included in each group. Average CTDIvol (2.76 ± 0.00 mGy, 2.66 ± 0.00 mGy, 0.74 ± 0.23 mGy, and 0.75 ± 0.17 mGy) was significantly lower on third-generation DSCT with AEC ( P < 0.001). Subjective image quality was rated worst in group 4 due to strong high-pitch artifacts, while in the remaining three groups it was rated good or very good with good inter-observer agreement (k > 0.64). Average acquisition time was significantly shorter with third-generation DSCT (0.47 s, 0.36 s, 0.38 s, 0.30 s; P < 0.001). Conclusion Third-generation DSCT yields faster acquisition times and substantial dose reduction with AEC. A pitch of 2.2 should be preferred, as it results in fewer artifacts. If AEC is used, latest IR ensures that diagnostic image quality is guaranteed.
Social and Cultural Innovation: Research Infrastructures Tackling Migration
Authors: Pozzo Riccardo , Virgili Vania 
Published: November 2017

Abstract‘Social and Cultural Innovation’ is a syntagma that is receiving increased usage among researchers since it was the title chosen by the European Strategy Forum Research Infrastructures for the working group that deals with research infrastructures primarily connected with Social Sciences and the Humanities. Innovation refers to the creation of new products and services by bringing a new idea to the market. Economic growth turns on infrastructures, which provide access to services and knowledge, e.g. by overcoming the digital divide. The current migrant and refugee crisis has made it clear with extraordinary effectiveness that a most urgent objective is to work out policies of social and cultural innovation to the advantage of new citizens – policies that will make them feel welcome in full dignity.
Survey of risks and benefits communication strategies by research nurses
Authors: Nusbaum Lika , Douglas Brenda , Estrella-Luna Neenah , Paasche-Orlow Michael , Damus Karla 
Published: November 2017

Background: An ethical, informed consent process requires that potential participants understand the study, their rights, and the risks and benefits. Yet, despite strategies to improve communication, many participants still lack understanding of potential risks and benefits. Investigating attitudes and practices of research nurses can identify ways to improve the informed consent process. Research question: What are the attitudes, practices, and preparedness of nurses involved in the informed consent process regarding communication of risks and benefits? Research design: A survey was developed and administered online to a national purposive sample of 107 research nurses with experience obtaining informed consent for clinical trials. Survey responses stratified by selected work-related characteristics were analyzed. Ethical considerations: Participants were instructed they need not answer each question and could stop at any time. They consented by clicking “accept” on the email which linked to the survey. The study was approved by the Northeastern University Institutional Review Board, Boston, Massachusetts (NU-IRB Protocol #: 13-06-17). Findings: Most research nurses (87%) used a teach-back method to assess participant comprehension, while 72% relied on their intuition. About one-third did not feel prepared to communicate related statistics. About 20% did not feel prepared to tailor information, and half did not feel competent using supplemental materials to enhance risks and benefits comprehension. Only 70% had received training in the informed consent process which included in-person training (84%), case studies (69%), online courses (57%), feedback during practice sessions (54%), and simulation, such as role playing (49%) and viewing videos (45%). Perceived preparedness was significantly associated with greater informed consent experience and training. Conclusion: Research nurses may have inadequate training to encourage, support, and reinforce communication of risks and benefits during the informed consent process. Relevant purposeful education and training should help to improve and standardize the ethical informed consent process.
Earlier Goals of Care Discussions in Hospitalized Terminally Ill Patients and the Quality of End-of-Life Care: A Retrospective Study
Authors: Gieniusz Marzena , Nunes Rosane , Saha Valerie , Renson Audrey , Schubert Finn David , Carey Jeanne 
Published: November 2017

Background: The association between physician-directed goals of care discussions (GOCDs) and the use of aggressive interventions in terminally ill patients has not been well characterized in the literature. We examined the associations between the timing of physician-directed GOCDs in terminally ill patients and the use of aggressive interventions, probability of dying in the inpatient setting, and intensive care unit (ICU) utilization. Methods: This retrospective cohort study included patients admitted to our urban community hospital in 2015 who had a terminal diagnosis on admission and either died on an inpatient unit or were discharged to hospice. The primary independent variable was the number of days from admission to GOCD, expressed as a proportion of the patient’s length of stay (LOS). We used robust variance Poisson and zero-inflated negative binomial regression, as appropriate, to estimate the associations between goals of care timing and risk of having an intervention, risk of dying in the inpatient setting, odds of ICU admission, and ICU LOS. Results: A total of 197 cases were included. After adjusting for age, language, gender, insurance, dementia, and decision maker (patient versus surrogate decision maker), later GOCD was significantly associated with greater risk of having an aggressive intervention (risk ratio [RR] = 1.04, 95% confidence interval [CI] = 1.02-1.06), greater risk of death as an inpatient (RR = 1.04, 95% CI = 1.02-1.06), and greater odds of ICU admission (odds ratio = 1.19, 95% CI = 1.02-1.39). Conclusion: Later GOCDs were associated with greater risk of aggressive interventions and death as an inpatient and greater odds of ICU admission. Goals of care discussion should be done routinely and early during the hospitalization of terminally ill patients.
The Use of Corticosteroids as Adjuvant Therapy for Painful Bone Metastases: A Large Cross-Sectional Survey of Palliative Care Providers
Authors: White Patrick , Arnold Robert , Bull Janet , Cicero Brandon 
Published: November 2017

Context: Bone metastases are a common complication in patients with advanced cancer but little is known regarding current practice patterns of palliative care providers when prescribing corticosteroids as adjuvant therapy for painful bone metastases. Objective: To identify current practice patterns among palliative care providers when prescribing corticosteroids for the treatment of painful bone metastases. Methods: A cross-sectional, online survey of the membership of the American Academy of Hospice and Palliative Medicine. Providers were asked to report how frequently they prescribed corticosteroids as adjuvant therapy in patients with painful bone metastases, and to specify the corticosteroid, dosage, treatment duration, and the gastroprotective strategy most frequently utilized. Results: Seven hundred sixty-five participants responded to the survey and 600 (78%) of respondents completed the survey. Ninety-eight percent of respondents completing the survey reported having prescribed corticosteroids as adjuvant pain therapy, and 66% ordered corticosteroids for the majority of their patients with painful bone metastases. Dexamethasone was the most widely prescribed corticosteroid. Eight milligrams divided twice daily was the most common dosage selected and once started, it was usually continued indefinitely. Conclusion: Corticosteroids are commonly prescribed as adjuvant therapy in the treatment of painful bone metastases in patients with limited life expectancy. Dexamethasone is the most commonly selected corticosteroid by American palliative care providers with variation existing among providers regarding dosing schedule, treatment duration, and gastroprotective strategies. Clinical trials comparing a total daily dose of four versus eight milligrams of dexamethasone would be clinically useful to inform evidence-based practice.
The Experience of Hospital Death: Assessing the Quality of Care at an Academic Medical Center
Authors: Carey Elise C. , Dose Ann M. , Humeniuk Katherine M. , Kuan Yichen C. , Hicks Ashley D. , Ottenberg Abigale L. , Tilburt Jon C. , Koenig Barbara 
Published: November 2017

Background: The quality of perimortem care received by patients who died at our hospitals was unknown. Objective: To describe the quality of hospital care experienced in the last week of life, as perceived by decedents’ families. Design: Telephone survey that included established measures and investigator-developed content. Setting: Large, tertiary care center known for high-quality, cost-effective care. Participants: Family members of 104 patients who died in-hospital (10% of annual deaths) over the course of 1 year. Intervention: None. Measurements: Participant perceptions of the decedent’s care, including symptom management, personal care, communication, and care coordination. Results: Decedents were mostly male (64%), white (96%), married (73%), and Christian (91%). Most survey participants were spouses of the decedent (68%); they were predominately white (98%), female (70%), and Christian (90%) and had a median age of 70 years (range, 35-91 years). Overall satisfaction was high. Pain, dyspnea, and anxiety or sadness were highly prevalent among decedents (73%, 73%, and 55%, respectively) but largely well managed. Most participants believed that decedents were treated respectfully and kindly by staff (87%) and that sufficient help was available to assist with medications and dressing changes (97%). Opportunities for improvement included management of decedents’ anxiety or sadness (29%) and personal care (25%), emotional support of the family (57%), communication regarding decedents’ illness (29%), and receiving contradictory or confusing information (33%). Conclusion: Despite high satisfaction with care overall, we identified important unmet needs. Addressing these gaps will improve the care of dying patients.
What Matters Most? A Mixed Methods Study of Critical Aspects of a Home-Based Palliative Program
Authors: Ankuda Claire K. , Kersting Kaileen , Guetterman Timothy C. , Haefner Jessica , Fonger Evan , Paletta Michael , Hopp Faith 
Published: November 2017

Background: Home-based palliative care programs have shown value in improving quality of care and lowering costs for seriously ill patients. It is unknown what specific elements of these programs matter most to patients and caregivers. Aim: To identify what services are critical and why they matter to patients in a home-based palliative program. Setting/Participants: A mixed methods study of 18 participants in the At Home Support (AHS) program in Southeast Michigan. Measurements: Two semistructured interviews were conducted for each participant, one while enrolled in AHS and another 3 months after the program ended to elicit the impact of AHS on their care. Qualitative theme data were merged with quantitative data on demographics, social and financial resources, symptoms, medical conditions, functional status, and utilization of health care while in AHS. Results: Four major themes of critical services reported by distinct populations of participants were described—medical support, endorsed by nearly every participant; emotional and spiritual support, endorsed by those with serious illness and symptom burden; practical assistance, endorsed by those with functional disability and isolation; and social services, endorsed by those in poverty. Medical monitoring was also described as critical but only by healthier participants. Conclusion: This study presents a conceptual model of the critical services in home-based palliative care and why these services are important to high-risk patients. This model may be used to guide further research and evaluation work on the benefits of home-based palliative care.
Multidisciplinary Training on Spiritual Care for Patients in Palliative Care Trajectories Improves the Attitudes and Competencies of Hospital Medical Staff: Results of a Quasi-Experimental Study
Authors: van de Geer Joep , Veeger Nic , Groot Marieke , Zock Hetty , Leget Carlo , Prins Jelle , Vissers Kris 
Published: November 2017

Objectives: Patients value health-care professionals’ attention to their spiritual needs. However, this is undervalued in health-care professionals’ education. Additional training is essential for implementation of a national multidisciplinary guideline on spiritual care (SC) in palliative care (PC). Aim of this study is to measure effects of a training program on SC in PC based on the guideline. Methods: A pragmatic multicenter trial using a quasi-experimental pretest–posttest design as part of an action research study. Eight multidisciplinary teams in regular wards and 1 team of PC consultants, in 8 Dutch teaching hospitals, received questionnaires before training about perceived barriers for SC, spiritual attitudes and involvement, and SC competencies. The effect on the barriers on SC and SC competencies were measured both 1 and 6 months after the training. Results: For nurses (n = 214), 7 of 8 barriers to SC were decreased after 1 month, but only 2 were still after 6 months. For physicians (n = 41), the training had no effect on the barriers to SC. Nurses improved in 4 of 6 competencies after both 1 and 6 months. Physicians improved in 3 of 6 competencies after 1 month but in only 1 competency after 6 months. Significance of Results: Concise SC training programs for clinical teams can effect quality of care, by improving hospital staff competencies and decreasing the barriers they perceive. Differences in the effects of the SC training on nurses and physicians show the need for further research on physicians’ educational needs on SC.