bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges of introducing a professional eID card within health care
Authors: Hedström Karin , Karlsson Fredrik , Söderström Fredrik 
Published: March 2016

Purpose
The purpose of this paper is to examine the challenges that arise when introducing an electronic identification (eID) card for professional use in a health-care setting.

Design/methodology/approach
This is a case study of an eID implementation project in healthcare. Data were collected through interviews with key actors in a project team and with eID end users. The authors viewed the eID card as a boundary object intersecting social worlds. For this analysis, the authors combined this with an electronic government initiative challenge framework.

Findings
The findings of this paper illustrate the interpretative flexibility of eID cards and how eID cards as boundary objects intersect social worlds. The main challenges of implementing and using eID cards in healthcare are usability, user behaviour and privacy. However, the way in which these challenges are interpreted varies between different social worlds.

Practical implications
One of the implications for future practice is to increase our understanding of the eID card as a socio-technical artefact, where the social and technical is intertwined, at the same time as the eID card affects the social as well as the technical. By using a socio-technical perspective, it is possible to minimise the potential problems related to the implementation and use of eID.

Originality/value
Previous research has highlighted the need for more empirical research on identity management. The authors contextualise and analyse the implementation and use of eID cards within healthcare. By viewing the eID card as a boundary object, the authors have unveiled its interpretative flexibility and how it is translated across different social worlds.
Missed opportunities for introducing transformational government
Authors: Mawela Tendani , Ochara Nixon Muganda , Twinomurinzi Hossana 
Published: March 2016

Purpose
The purpose of this paper is to trace the trajectory of the Gauteng Freeway Improvement Project, an electronic tolling (e-tolling) programme based in South Africa, to argue for the importance of taking advantage of similar public project opportunities to introduce the concept of Transformational Government (t-government).

Design/methodology/approach
The research uses an interpretive perspective and utilizes actor–network theory (ANT) to identify the roles and interests of the various stakeholders within the project and assess how each stakeholder could have better influenced the project’s sustainability using a t-government approach.

Findings
The findings suggest that in the midst of waning global actor interest, and strong local displeasure about specific public projects, public participation offers an ideal opportunity to introduce the notion of t-government, the use of information and communication technologies (ICT) to transform government for citizen benefits. The research allowed the authors to posit that public participation projects are solid and indispensable avenues for introducing t-government. Part of this claim is hinged on the view that the specific e-toll project carries a visible ICT artefact, which has embodied its own patterns of use characterized by various viewpoints, values, opinions and rhetoric.

Practical implications
The paper elevates the importance of t-government as a means to bring about practical transformation in government using public projects. The paper suggests how governments can use public participatory approaches to assimilate a new way of working in government.

Originality/value
This paper contributes to research on the emerging discourse on t-government. The paper also highlights the utility of ANT as a tool for understanding the dynamic public sector ICT programmes, their associated complexities and unintended consequences.
Gestational weight gain, prepregnancy body mass index and offspring attention‐deficit hyperactivity disorder symptoms and behaviour at age 10
Authors: Pugh SJ , Hutcheon JA , Richardson GA , Brooks MM , Himes KP , Day NL , Bodnar LM 
Published: March 2016

ObjectiveTo assess offspring attention‐deficit hyperactivity disorder (ADHD) symptoms and emotional/behavioural impairments at age 10 years in relation to maternal gestational weight gain (GWG) and prepregnancy body mass index (BMI).Design and settingLongitudinal birth cohort from Magee‐Womens Hospital, Pittsburgh, Pennsylvania (enrolled 1983–86).PopulationMother–infant dyads (n = 511) were followed through pregnancy to 10 years.MethodsSelf‐reported total GWG was converted to gestational‐age‐standardised z‐scores. Multivariable linear and negative binomial regressions were used to estimate effects of GWG and BMI on outcomes.Main outcome measuresChild ADHD symptoms were assessed with the Conners’ Continuous Performance Test. Child behaviour was assessed by parent and teacher ratings on the Child Behaviour Checklist (CBCL) and Teacher Report Form, respectively.ResultsThe mean (SD) total GWG (kg) was 14.5 (5.9), and 10% of women had a pregravid BMI ≥30 kg/m2. Prepregnancy obesity (BMI of 30 kg/m2) was associated with increased offspring problem behaviours including internalising behaviours (adjusted β 3.3 points, 95% CI 1.7–4.9), externalising behaviours (adjusted β 2.9 points, 95% CI 1.4–4.6), and attention problems (adjusted β 2.3 points, 95% CI 1.1–3.4) on the CBCL, compared with normal weight mothers (BMI of 22 kg/m2). There were nonsignificant trends towards increased offspring impulsivity with low GWG among lean mothers (adjusted incidence rate ratio 1.2, 95% CI 0.9–1.5) and high GWG among overweight mothers (adjusted incidence rate ratio 1.7, 95% CI 0.9–2.8), but additional outcomes did not differ by GWG z‐score. Results were not meaningfully different after excluding high‐substance users.ConclusionsIn a low‐income and high‐risk sample, we observed a small increase in child behaviour problems among children of obese mothers, which could have an impact on child behaviour in the population.Tweetable abstractMaternal obesity is associated with a small increase in child behaviour problems.
Impact of State Public Health Spending on Disease Incidence in the United States from 1980 to 2009
Authors: Verma Reetu , Clark Samantha , Leider Jonathon , Bishai David 
Published: March 2016

ObjectiveTo understand the relationship between state‐level spending by public health departments and the incidence of three vaccine preventable diseases (VPDs): mumps, pertussis, and rubella in the United States from 1980 to 2009.Data SourcesThis study uses state‐level public health spending data from The Census Bureau and annual mumps, pertussis, and rubella incidence counts from the University of Pittsburgh's project Tycho.Study DesignOrdinary least squares (OLS), fixed effects, and random effects regression models were tested, with results indicating that a fixed effects model would be most appropriate model for this analysis.Principal FindingsModel output suggests a statistically significant, negative relationship between public health spending and mumps and rubella incidence. Lagging outcome variables indicate that public health spending actually has the greatest impact on VPD incidence in subsequent years, rather than the year in which the spending occurred. Results were robust to models with lagged spending variables, national time trends, and state time trends, as well as models with and without Medicaid and hospital spending.ConclusionOur analysis indicates that there is evidence of a significant, negative relationship between a state's public health spending and the incidence of two VPDs, mumps and rubella, in the United States.
Cost Variation in Diabetes Care across Dutch Care Groups?
Authors: Mohnen Sigrid M. , Molema Claudia C. , Steenbeek Wouter , van den Berg Michael J. , de Bruin Simone R. , Baan Caroline A. , Struijs Jeroen N. 
Published: March 2016

ObjectiveThe introduction of bundled payment for diabetes care in the Netherlands led to the origination of care groups. This study explored to what extent variation in health care costs per patient can be attributed to the performance of care groups. Furthermore, the commonly applied simple mean aggregation was compared with the more advanced generalized linear mixed model (GLMM) to benchmark health care costs per patient between care groups.Data SourceDutch 2009 nationwide insurance claims data of diabetes type 2 patients (104,544 patients, 50 care groups).Study DesignBoth a simple mean aggregation and a GLMM approach was applied to rank care groups, using two different health care costs variables: total treatment health care costs and diabetes‐specific specialist care costs per diabetes patient.Principal FindingsCare groups varied slightly in the first and mainly in the second indicator. Care group variation was not explained by composition. Although the ranking methods were correlated, some care groups’ rank positions differed, with consequences on the top‐10 and the low‐10 positions.ConclusionsDifferences between care groups exist when an appropriate indicator and a sophisticated aggregation technique is used. Currently applied benchmarking may have unfair consequences for some care groups.
A microscopy study of hyphal growth of Penicillium rubens on gypsum under dynamic humidity conditions
Authors: van Laarhoven Karel A. , Huinink Hendrik P. , Adan Olaf C. G. 
Published: March 2016

SummaryTo remediate indoor fungal growth, understanding the moisture relations of common indoor fungi is crucial. Indoor moisture conditions are commonly quantified by the relative humidity (RH). RH is a major determinant of the availability of water in porous indoor surfaces that fungi grow on. The influence of steady‐state RH on growth is well understood. Typically, however, the indoor RH constantly changes so that fungi have to endure frequent periods of alternating low and high RH. Knowledge of how common indoor fungi survive and are affected by the low‐RH periods is limited. In particular, the specific effects of a drop in RH on the growth of the mycelium remain unclear. In this work, video microscopy was used to monitor hyphal growth of Penicillium rubens on gypsum substrates under controlled dynamic humidity conditions. The effect of a single period of low RH (RH = 50–90%) interrupting favourable conditions (RH = 97%) was tested. It was found that hyphal tips ceased to extend when exposed to any tested decrease in RH. However, new hyphal growth always emerges, seemingly from the old mycelium, suggesting that this indoor fungus does not rely only on conidia to survive the humidity patterns considered. These findings are a fundamental step in unravelling the effect of RH on indoor fungal growth.
Increased Serum Level of Growth Differentiation Factor 15 (GDF‐15) is Associated with Coronary Artery Disease
Authors: Wang Xia , Chen Lei‐Lei , Zhang Qing 
Published: March 2016

AbstractAimThere is evidence suggesting that inflammatory responses play a critical role in the development of coronary artery disease (CAD). Growth differentiation factor 15 (GDF‐15) is a stress‐responsive cytokine. It increases during inflammatory processes and is associated with cardiometabolic risk. However, the relation between GDF‐15 and CAD remains largely unknown. Herein, we aimed to evaluate serum GDF‐15 levels and predictive values in patients with CAD.MethodsSerum levels of GDF‐15 in 105 patients with CAD and 96 healthy controls were measured by the enzyme‐linked immunosorbent assay. Gensini scores were used to assess severity of CAD. The correlations between the serum GDF‐15 levels and Gensini scores were examined using Spearman's correlation. Receivers operating characteristic (ROC) curve analysis was performed to determine the predictive values of GDF‐15 levels.ResultsWe found that serum GDF‐15 levels were significantly increased in CAD group compared with healthy controls group (P < 0.001). Additionally, a positive correlation was observed between GDF‐15 and the Gensini score (r = 0.85, P < 0.001). Moreover, the area under the ROC curve assay yielded a satisfactory result of 0.96 (95% confidence interval 0.94–0.98; P < 0.001), and the serum GDF‐15 level had a 80.0% sensitivity and 91.7% specificity for predicting CAD.ConclusionsThese data suggested that increased GDF‐15 levels were positively associated with CAD, and GDF‐15 might be a useful adjunct in discriminating CAD.
Meta‐Analysis of Gene Expression Patterns in Animal Models of Prenatal Alcohol Exposure Suggests Role for Protein Synthesis Inhibition and Chromatin Remodeling
Authors: Rogic Sanja , Wong Albertina , Pavlidis Paul 
Published: March 2016

BackgroundPrenatal alcohol exposure (PAE) can result in an array of morphological, behavioral, and neurobiological deficits that can range in their severity. Despite extensive research in the field and a significant progress made, especially in understanding the range of possible malformations and neurobehavioral abnormalities, the molecular mechanisms of alcohol responses in development are still not well understood. There have been multiple transcriptomic studies looking at the changes in gene expression after PAE in animal models; however, there is a limited apparent consensus among the reported findings. In an effort to address this issue, we performed a comprehensive re‐analysis and meta‐analysis of all suitable, publically available expression data sets.MethodsWe assembled 10 microarray data sets of gene expression after PAE in mouse and rat models consisting of samples from a total of 63 ethanol (EtOH)‐exposed and 80 control animals. We re‐analyzed each data set for differential expression and then used the results to perform meta‐analyses considering all data sets together or grouping them by time or duration of exposure (pre‐ and postnatal, acute and chronic, respectively). We performed network and Gene Ontology enrichment analysis to further characterize the identified signatures.ResultsFor each subanalysis, we identified signatures of differential expressed genes that show support from multiple studies. Overall, the changes in gene expression were more extensive after acute EtOH treatment during prenatal development than in other models. Considering the analysis of all the data together, we identified a robust core signature of 104 genes down‐regulated after PAE, with no up‐regulated genes. Functional analysis reveals over representation of genes involved in protein synthesis, mRNA splicing, and chromatin organization.ConclusionsOur meta‐analysis shows that existing studies, despite superficial dissimilarity in findings, share features that allow us to identify a common core signature set of transcriptome changes in PAE. This is an important step to identifying the biological processes that underlie the etiology of fetal alcohol spectrum disorders.
Indigenous Australians with non–small cell lung cancer or cervical cancer receive suboptimal treatment
Authors: Whop Lisa J , Bernardes Christina M , Kondalsamy‐Chennakesavan Srinivas , Darshan Deepak , Chetty Naven , Moore Suzanne P , Garvey Gail , Walpole Euan , Baade Peter , Valery Patricia C 
Published: March 2016

AbstractBackgroundLung cancer and cervical cancer are higher in incidence for Indigenous Australians and survival is worse compared with non‐Indigenous Australians. Here we aim to determine if being Indigenous and/or other factors are associated with patients receiving “suboptimal treatment” compared to “optimal treatment” according to clinical guidelines for two cancer types.MethodsData were collected from hospital medical records for Indigenous adults diagnosed with cervical cancer and non–small cell lung cancer (NSCLC) and a frequency‐matched comparison group of non‐Indigenous patients in the Queensland Cancer Registry between January 1998 and December 2004. The two cancer types were analyzed separately.ResultsA total of 105 women with cervical cancer were included in the study, 56 of whom were Indigenous. Indigenous women had higher odds of not receiving optimal treatment according to clinical guidelines (unadjusted OR 7.1; 95% CI, 1.5–33.3), even after adjusting for stage (OR 5.7; 95% CI, 1.2–27.3). Of 225 patients with NSCLC, 198 patients (56% Indigenous) had sufficient information available to be analyzed. The odds of receiving suboptimal treatment were significantly higher for Indigenous compared to non‐Indigenous NSCLC patients (unadjusted OR 1.9; 95% CI, 1.0–3.6) and remained significant after adjusting for stage, comorbidity and age (adjusted OR 2.1; 95% CI, 1.1–4.1).ConclusionsThe monitoring of treatment patterns and appraisal against guidelines can provide valuable evidence of inequity in cancer treatment. We found that Indigenous people with lung cancer or cervical cancer received suboptimal treatment, reinforcing the need for urgent action to reduce the impact of these two cancer types on Indigenous people.
Aflatoxin B1 impairs mitochondrial functions, activates ROS generation, induces apoptosis and involves Nrf2 signal pathway in primary broiler hepatocytes
Authors: Liu Yan , Wang Wenjun 
Published: March 2016

AbstractAflatoxin B1 (AFB1) is known as a mycotoxin that causes various health problems in animals, but the precise mechanism of AFB1 on mitochondrial functions and apoptosis in primary broiler hepatocytes (PBHs) is not clear. The objective of this study was to investigate the effects of AFB1 on the mitochondrial functions, reactive oxygen species (ROS) generation, apoptosis and nuclear factor erythroid 2‐like factor 2 (Nrf2)‐related signal pathway in PBHs. Here, the mitochondrial membrane potential (MMP), ROS generation, antioxidative genes and apoptosis in PBHs induced by AFB1 were investigated. The results showed that AFB1 evoked mitochondrial ROS generation, decreased MMP and induced apoptosis in PBHs. AFB1 increased the percentage of apoptotic cells, and expression of caspase‐9 and caspase‐3, upregulated messenger RNA (mRNA) expression of Nrf2 and downregulated mRNA expressions of NAD(P)H: quinine oxidoreductase 1, superoxide dismutase and Heme oxygenase 1 in PBHs. The expression of Bax was also observed in cytoplasm. These findings suggested AFB1 results in a significant impairment of mitochondrial functions, activates ROS generation, induces apoptosis, and is involved in Nrf2 signal pathway through mitochondria ROS‐dependent signal pathways in PBHs.
Worry processes in patients with persecutory delusions
Authors: Startup Helen , Pugh Katherine , Dunn Graham , Cordwell Jacinta , Mander Helen , Černis Emma , Wingham Gail , Shirvell Katherine , Kingdon David , Freeman Daniel 
Published: March 2016

ObjectivesWorry may be common in patients with paranoia and a contributory causal factor in the occurrence of the delusions. A number of psychological mechanisms have been linked to the occurrence of worry in emotional disorders but these are yet to be investigated in psychosis. The primary aim of the study was to test the links between five main worry mechanisms – perseverative thinking, catastrophizing, stop rules, metacognitive beliefs, and intolerance of uncertainty – and the cognitive style of worry in patients with persecutory delusions.MethodOne hundred and fifty patients with persecutory delusions completed assessments of paranoia, worry, and worry mechanisms.ResultsWorry in patients with psychosis was associated with the following: a perseverative thinking style, an ‘as many as can’ stop rule, a range of metacognitive beliefs (cognitive confidence, worry as uncontrollable and the need to control thoughts), and intolerance of uncertainty. Higher levels of worry were associated with higher levels of paranoia. There was also evidence that intolerance of uncertainty and the metacognitive belief concerning the need to control thoughts were independently associated with paranoia.ConclusionsWorry in patients with persecutory delusions may well be understood by similar underlying mechanisms as worry in emotional disorders. This supports the use of interventions targeting worry, suitably modified, for patients with psychosis.Practitioner points

Worry is a significant concern for patients with paranoia

Worry in paranoia is likely to be caused by similar mechanisms as worry in emotional disorders

The results support the recent trial findings that standard techniques for treating worry in anxiety, suitably modified, are applicable for patients with paranoia

Limitations

The findings are limited by the self‐report nature of measures and by the study design which precludes any assumptions about the direction of causality between the psychological mechanisms and worry.
Effective Coverage Targets for Ocean Protection
Authors: O'Leary Bethan C. , Winther‐Janson Marit , Bainbridge John M. , Aitken Jemma , Hawkins Julie P. , Roberts Callum M. 
Published: March 2016

AbstractThe UN's globally adopted Convention on Biological Diversity coverage target for marine protected areas (MPAs) is ≥10% by 2020. In 2014, the World Parks Congress recommended increasing this to ≥30%. We reviewed 144 studies to assess whether the UN target is adequate to achieve, maximize, or optimize six environmental and/or socioeconomic objectives. Results consistently indicate that protecting several tens‐of‐percent of the sea is required to meet goals (average 37%, median 35%, modal group 21–30%), greatly exceeding the 2.18% currently protected and the 10% target. The objectives we examined were met in 3% of studies with ≤10% MPA coverage, 44% with ≤30% coverage, and 81% with more than half the sea protected. The UN's 10% target appears insufficient to protect biodiversity, preserve ecosystem services, and achieve socioeconomic priorities. As MPA coverages generated from theoretical studies inherently depend on scenario(s) considered, our findings do not represent explicit recommendations but rather provide perspective on policy goals.
Diagnostic value of haemoglobin A1c in post‐partum screening of women with gestational diabetes mellitus
Authors: Kim K.‐S. , Kim S.‐K. , Cho Y.‐W. , Park S. W. 
Published: March 2016

AbstractAimsThe aim of this study was to evaluate whether women with gestational diabetes mellitus could be screened using HbA1c for glucose metabolism status at 6–12 weeks post‐partum.MethodsWe enrolled 699 pregnant women diagnosed with gestational diabetes mellitus from October 2005 to December 2013. A 75–g oral glucose tolerance test (OGTT) and HbA1c measurement were performed at 6–12 weeks after delivery.ResultsThe prevalence of overt diabetes and pre‐diabetes were 5.2% (n = 36) and 49.1% (n = 343), respectively, when using the 75–g OGTT as the gold standard. HbA1c alone identified 2.9% (n = 20) as having overt diabetes and 32.2% (n = 225) as having pre‐diabetes. When American Diabetes Association cut‐offs were applied, the sensitivity and specificity for HbA1c to diagnose overt diabetes were 19.4% and 98.0%, respectively. Pre‐diabetes, according to the HbA1c criterion, had 41.2% sensitivity and 72.2% specificity. The misclassifications identified 97 positive differences, 233 negative differences and 369 ties (P < 0.05). The area under the receiver operating characteristic curves for detecting diabetes and pre‐diabetes were 0.615 [95% confidence interval (95% CI), 0.515 to 0.716] and 0.588 (95% CI, 0.545 to 0.630), respectively.ConclusionsHbA1c may not be sensitive enough for an accurate diagnosis, but it is highly specific for diagnosing overt diabetes at 6–12 weeks post‐partum in women with previous gestational diabetes mellitus.