bluuebunny/crossref_metadata_2025_split huggingface dataset:
Matching Evaluation Approaches to Levels of Complexity
Authors: Ofek Yuval 
Published: June 2016

Background: Despite rapid advances in research on the evaluation of complex interventions, debate on evaluation methods and approaches still mainly revolves around the conventional and mostly outdated positivist–constructivist dichotomy. The lack of a clear conceptual and theoretical framework from which to choose appropriate evaluation approaches and methods means that approaches are often misused by both researchers and practitioners. Research design: Using three case studies, this article shows how different approaches should and should not be used in practice according to levels of nonlinearity. Both the theoretical development and the case studies presented in this article rely heavily on interviews conducted by the author with program management and staff, evaluation managers, heads of evaluation units, and evaluators in several countries across two continents, along with a quantitative survey. Results: This article expands the classic discussion on evaluation approaches, adapting it to current managerial demands, increased complexity, and newly developed methodologies. It suggests an operational tool for categorizing evaluations and then matching evaluation approaches to the circumstances and the evaluation objectives. Conclusion: The findings suggest that approaches which are not congruent with levels of nonlinearity may hinder attempts to accurately evaluate results, causing dissatisfaction of evaluation commissioners from the evaluation process and methods applied. In contrast, analyzing the nonlinear and structural elements of complexity separately allows an extended categorization of evaluation approaches to be matched to the nonlinearity of programs to be evaluated.
Combined exercise is more effective than aerobic exercise in the improvement of fall risk factors: a randomized controlled trial in community-dwelling older men
Authors: Sousa Nelson , Mendes Romeu , Silva André , Oliveira José 
Published: June 2016

Objective: To compare the long-term effects of two community-based exercise programs on fall risk factors, such as balance, postural control, mobility and leg strength, in community-dwelling older men. Design: Single-blinded randomized controlled trial, comparing three groups, with follow-ups at eight, 16, 24 and 32 weeks. Setting: Older men independent-living residing in Maia city, Portugal. Participants: A total of 66 older men (aged 69.0 ±4.9 years) were randomly assigned to an aerobic exercise group ( n = 22), a combined aerobic and resistance exercise group ( n = 22) or a control group ( n = 22). Interventions: Both community-based exercise programs consisted of three sessions each week for 32 consecutive weeks and were planned for moderate-to-vigorous intensity. The control group had no exercise intervention. Measurements: Main outcomes were measured by the Timed Up and Go Test, functional reach test, 30-second chair stand test and 6-minute walk test, on five different occasions. Results: Repeated measures of analysis of covariance revealed significant main effects between time × group interaction in all outcomes over time (Timed Up and Go Test: p < 0.001; functional reach test: p = 0.002; 30–second chair stand: p = 0.001; 6-minute walk test: p < 0.001). Both exercise groups reported improvements; however, better performance was identified in the combined aerobic and resistance exercise group compared with the aerobic exercise group (–20.3% vs. –9.1% on the Timed Up and Go Test, +27.5% vs. +10.9% on the functional reach test, +20.8% vs. +7.3% on 30-second chair stand, +10.9% vs. +3.5% on 6-minute walk test). Conclusions: Adding resistance exercise to aerobic exercise improves factors associated with an increased risk of falls. However, both exercise regimes, combined or aerobic alone, are more effective than no exercise in the reduction of fall risk factors. ClinicalTrials.org #NCT01874132
Fathers’ Perception, Practice, and Challenges in Young Child Care and Feeding in Ethiopia
Authors: Bilal Selamawit , Spigt Mark , Czabanowska Kasia , Mulugeta Afework , Blanco Roman , Dinant GeertJan 
Published: June 2016

Background: The role of fathers in proper nutrition of young children has not been a frequent topic of studies. Mothers are usually the primary caregivers for young children. However, the father is often responsible for the financial choices of the household, especially in developing countries; we wondered to what extent fathers were involved in child feeding. Objective: This study aimed to investigate the extent of perceptions, practices, and challenges of fathers from low-income settings in routine child care, particularly in relation to child-feeding practices. Methods: A qualitative study was conducted in northern Ethiopia. Ten fathers, who had children between 6 and 23 months, were participated in the study. To validate fathers’ comments, 10 mothers (from different households) also participated. In-depth interviews and focus group discussions were carried out. A thematic analysis was completed to identify emergent themes within the data. Results: In general, traditional fathers, fathers in transition, and modern fathers are the 3 types of fathers identified based on their perception, practice, and challenges of routine child care and feeding. Conclusion: Our findings provide new insight to the literature in describing fathers’ roles and challenges in routine child-care and feeding practices. We have developed a model that could help researchers, programmers, policy makers, and health workers to approach fathers in different child intervention research and plans. Our findings suggest that targeting fathers may be a worthwhile approach and that it seems justifiable to plan interventions involving fathers.
Impact of a Multidisciplinary Bundle on Time to Antibiotic Administration in Septic SICU Patients
Authors: Almalki Ohoud , Levine Alexander R. , Turner Elizabeth , Newman Kelly , DeMoya Marc , Lee Jarone , Bittner Edward A. , Lin Hsin 
Published: June 2016

Purpose: The goal of this study was to investigate barriers to timely antibiotic administration in septic surgical intensive care unit (SICU) patients and examine the impact of a multidisciplinary bundle on the time from prescription to antibiotic administration. Methods: This was a pre- and postintervention study that consisted of 3 phases: (1) preintervention phase, retrospective evaluation of data, (2) intervention implementation, and (3) a postintervention phase. A nurse survey was conducted to identify barriers to rapid antibiotic administration during phase 1. Based on this survey, multidisciplinary interventions included adding antibiotics to the automatic dispensing cabinet, educating monthly staff, and providing an antibiotic dosing table to all prescribers, which is attached to the computer workstations. Our multidisciplinary team consisted of the ICU medical directors, nurse managers, nurses, a critical care fellow, and ICU pharmacists. Results: The percentage of antibiotics that were received within 60 minutes was 26.3% in the pregroup versus 84.0% in the postgroup ( P < .001). The mean total prescriber to patient time was 110 minutes in the pregroup versus 58.4 minutes in the postgroup ( P < .001). Conclusion: We achieved a higher rate of timely antibiotic administration among septic SICU patients by implementing process changes based on barriers identified by the nurses.
Can SLE classification rules be effectively applied to diagnose unclear SLE cases?
Authors: Mesa A , Fernandez M , Wu W , Narasimhan G , Greidinger EL , Mills D K 
Published: June 2016

Objective The objective of this paper is to develop novel classification criteria to distinguish between unclear systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD) cases. Methods A total of 205 variables from 111 SLE and 55 MCTD patients were evaluated to uncover unique molecular and clinical markers for each disease. Binomial logistic regressions (BLRs) were performed on currently used SLE and MCTD classification criteria sets to obtain six reduced models with power to discriminate between unclear SLE and MCTD patients that were confirmed by receiving operating characteristic (ROC) curve. Decision trees were employed to delineate novel classification rules to discriminate between unclear SLE and MCTD patients. Results SLE and MCTD patients exhibited contrasting molecular markers and clinical manifestations. Furthermore, reduced models highlighted SLE patients exhibiting prevalence of skin rashes and renal disease while MCTD cases show dominance of myositis and muscle weakness. Additionally decision tree analyses revealed a novel classification rule tailored to differentiate unclear SLE and MCTD patients (Lu-vs-M) with an overall accuracy of 88%. Conclusions Validation of our novel proposed classification rule (Lu-vs-M) includes novel contrasting characteristics (calcinosis, CPK elevated and anti-IgM reactivity for U1-70K, U1A and U1C) between SLE and MCTD patients and showed a 33% improvement in distinguishing these disorders when compared to currently used classification criteria sets. Pending additional validation, our novel classification rule is a promising method to distinguish between patients with unclear SLE and MCTD diagnosis.
Industry policy in Asia’s demographic giants: China, India and Indonesia compared
Authors: Barnes Tom 
Published: June 2016

AbstractThe experience of industry policy in the wider Asian region contrasts significantly with many of the neoliberal policy prescriptions prevalent in Australia today. Using the automotive industry as a comparative case study, this article compares industry policy in three demographic and geographic giants of the region: China, India and Indonesia. China’s dominant position has benefited from a highly ‘interventionist’ industry policy which places strict conditions on foreign carmakers in joint ventures. This policy has also influenced the emergence of a thriving domestic industry, with state-owned enterprises leading the way. While India has also emerged as a major auto producer, its industry policy has moved away from the joint venture model since the 1990s, with fully foreign-owned operations now playing a much bigger role. In contrast, Indonesia retains a version of the joint venture model while local industry is dominated by Japanese capital. The record of industry policy in these countries challenges the idea that more ‘liberal’ economic systems lead to stronger domestic industries or firms.
Transduction of hematopoietic stem cells to stimulate RNA interference against feline infectious peritonitis
Authors: Anis Eman A , Dhar Madhu , Legendre Alfred M , Wilkes Rebecca P 
Published: June 2016

Objectives The goals of the study were: (1) to develop and evaluate non-replicating lentivirus vectors coding for feline coronavirus (FCoV)-specific micro (mi)RNA as a potential antiviral therapy for feline infectious peritonitis (FIP); (2) to assess the feasibility of transducing hematopoietic stem cells (HSCs) with ex vivo introduction of the miRNA-expressing lentivirus vector; and (3) to assess the ability of the expressed miRNA to inhibit FCoV replication in HSCs in vitro. Methods HSCs were obtained from feline bone marrow and replicated in vitro. Three lentiviruses were constructed, each expressing a different anti-FCoV miRNA. HSCs were stably transduced with the miRNA-expressing lentivirus vector that produced the most effective viral inhibition in a feline cell line. The effectiveness of the transduction and the expression of anti-FCoV miRNA were tested by infecting the HSCs with two different strains of FCoV. The inhibition of coronavirus replication was determined by relative quantification of the inhibition of intracellular viral genomic RNA synthesis using real-time, reverse-transcription PCR. The assessment of virus replication inhibition was determined via titration of extracellular virus using the TCID50 assay. Results Inhibition of FCoV was most significant in feline cells expressing miRNA-L2 that targeted the viral leader sequence, 48 h postinfection. miRNA-L2 expression in stably transduced HSCs resulted in 90% and 92% reductions in FIPV WSU 79-1146 genomic RNA synthesis and extracellular virus production, respectively, as well as 74% and 80% reduction in FECV WSU 79-1683 genomic RNA synthesis and extracellular virus production, respectively, as compared with an infected negative control sample producing non-targeting miRNA. Conclusions and relevance These preliminary results show that genetic modification of HSCs for constitutive production of anti-coronavirus miRNA will reduce FCoV replication.
Reirradiation of Pediatric Tumors Using Hypofractionated Stereotactic Radiotherapy
Authors: Gultekin Melis , Cengiz Mustafa , Sezen Duygu , Zorlu Faruk , Yildiz Ferah , Yazici Gozde , Hurmuz Pervin , Ozyigit Gokhan , Akyol Fadil , Gurkaynak Murat 
Published: June 2016

Background: This study aimed to evaluate the efficacy and safety of hypofractionated stereotactic radiotherapy for reirradiation of recurrent pediatric tumors. Methods and Materials: The study included 23 pediatric patients who were reirradiated using hypofractionated stereotactic radiotherapy in the radiation oncology department between January 2008 and November 2013. In total, 33 tumors were treated—27 (82%) cranial and 6 (18%) extracranial. Hypofractionated stereotactic radiotherapy was administered due to recurrent disease in 31 (94%) tumors and residual disease in 2 (6%) tumors. The median total dose was 25 Gy (range: 15-40 Gy), and the median follow-up was 20 months (range: 2-68 months). Results: The 1-year and 2-year local control rates in the entire study population were 42% and 31%, respectively. The median local control time was 11 months (range: 0-54 months) following hypofractionated stereotactic radiotherapy. The patients with tumor response after hypofractionated stereotactic radiotherapy had significantly longer local control than the patients with post-hypofractionated stereotactic radiotherapy tumor progression (21 vs 3 months, P < .001). Tumor volume <1.58 cm3 was correlated (not significantly) with better local control (23 vs 7 months, P = .064). Conclusion: Reirradiation of pediatric tumors using hypofractionated stereotactic radiotherapy is a safe and effective therapeutic approach. This treatment modality should be considered as a treatment option in selected pediatric patients.
Ovarian cancer patients’ and their family members’ perspectives on novel vaccine and virotherapy trials
Authors: Radecki Breitkopf Carmen , Ridgeway Jennifer L , Asiedu Gladys B , Carroll Katherine , Tenney Meaghan , Jatoi Aminah 
Published: June 2016

Background/aims: Some of the most promising avenues of cancer clinical investigation center on immunotherapeutic approaches. These approaches have provided notable gains in cancer therapeutics with recent Food and Drug Administration approvals of agents of this class in several types of cancers, although gains for ovarian cancer lag behind. This study examined perceptions of therapeutic trials including immunotherapy and virotherapy among ovarian cancer patients and their family members. Methods: A total of 72 semi-structured qualitative interviews were conducted with 33 patients and 39 family members at two National Cancer Institute–designated comprehensive cancer centers. Eligible patients were diagnosed with epithelial ovarian, primary peritoneal, or fallopian tube carcinoma and had experience with clinical trial conversations; family members were nominated by patients and interviewed separately. Applied thematic analysis was used to understand and interpret the data. Results: More participants were aware of vaccine trials than virus trials, although more than half had heard of at least one of them. Initial reactions to vaccine trials were generally favorable. For many, childhood experience with vaccines lent a familiar frame of reference. Virus trials elicited more negative initial reactions, including the use of adjectives such as “scary” and “dreadful.” Viruses seemed contagious or difficult to control. Increased receptivity to these trials occurred in the context of limited therapeutic options and cancer recurrence. Most participants, including those not immediately drawn to these types of trials, indicated openness to learning more. Conclusion: Although vaccine and viral trials are both immunologically based therapeutic approaches, patients who are offered these trials may perceive their potential benefit and safety quite differently. There is a need to consider terminology, solicit and address “gut reactions,” and provide information that enables patients and their family members to better understand the science behind these trials.
Defining Taiwanese children’s health literacy abilities from a health promotion perspective
Authors: Liao Li-Ling , Liu Chieh-Hsing , Cheng Chi-Chia , Chang Tzu-Chau 
Published: June 2016

Background: Health literacy is related to health inequality, health behaviors, and health status. Globally, health literacy has primarily focused on adults and has been based on the medical model. It is necessary to understand children’s life experiences as they relate to health; thus, this study attempted to evaluate and describe the health literacy abilities of sixth-graders in Taiwan. Methods: Interviews were conducted with 10 teachers and 11 caregivers, and focus groups were conducted with 32 children. Health literacy abilities corresponding to real-life situations were identified from life skills and the Taiwanese Curriculum Guidelines for health education. Three expert meetings were held to redefine children’s health literacy using a health promotion perspective and confirmed indicators. Results: An operational definition of three aspects of children’s health literacy and 25 abilities was proposed: 11 functional health literacy abilities (e.g. understands the connection between personal health care behaviors and health); seven interactive health literacy abilities (e.g. obtains and understands information from various channels); and seven critical health literacy abilities (e.g. analyzes the relationship between personal needs and diet choices for a balanced diet). These indicators cover 10 health education categories. Conclusions: These findings highlight the importance of understanding Taiwanese children’s health literacy, and the urgency of developing an appropriate measurement tool. The definition and indicators in this study were identified using a child-centered approach focusing on children’s real-life experiences. The result serves as a solid basis for the development of the Taiwan Children’s Health Literacy Scale, and provides information for the decision-making sector on health education.
The relationship between insufficient milk perception and breastfeeding self-efficacy among Turkish mothers
Authors: Gökçeoğlu Emine , Küçükoğlu Sibel 
Published: June 2016

Objective: This study was conducted to investigate the relationship between perceived insufficient milk and breastfeeding self-efficacy levels among Turkish mothers. Methods: The study was conducted on 200 mothers whose infants were hospitalized and under treatment and who could breastfeed their infants in the newborn clinic of a university hospital in eastern Turkey between June 2013 and February 2014. A sampling method was not applied in the study, so the sample consisted of the population of the study. The ‘Personal Information Form’, ‘Breastfeeding Self-Efficacy Scale’ and ‘Perception of Insufficient Milk Questionnaire’ were used to collect the data. Data were analysed by using percentage distribution and arithmetic average; independent sample t test, Mann–Whitney U test, Kruskal–Wallis variance analysis, Pearson correlation analysis and Cronbach alpha reliability coefficiency in the SPSS 18.0 package program. Results: The study determined that advanced age, higher education level and higher income status, male gender of the child, planning of the pregnancy, many births, receiving breastfeeding education and the length of time that mothers planned to exclusively breastfeed affected breastfeeding self-efficacy and perception of milk sufficiency positively ( p<0.05). The study showed that, as breastfeeding self-efficacy levels of mothers increased, their perception of milk sufficiency also increased ( p<0.05). Conclusion: The study concluded that some factors related to the mother, infant, pregnancy and breastfeeding affected breastfeeding self-efficacy and the perception of milk insufficiency. As the breastfeeding self-efficacy level increased, the milk was perceived to be more sufficient.
Acute Kidney Injury Following Cardiac Surgery in Neonates and Young Infants
Authors: Kumar T. K. Susheel , Allen, CCP Jerry , Spentzas, MD Thomas , Berrios, CCP Lindsay , Shah, MD Samir , Joshi, MD Vijaya M. , Ballweg, MD Jean A. , Knott-Craig, MD Christopher J. 
Published: June 2016

Objective: Acute kidney injury (AKI) following cardiac surgery is a serious complication with a reported incidence of 30% to 50%. This study sought to determine the prevalence and risk factors for AKI among neonates and young infants undergoing repair of cardiac defects at an institution using novel perioperative strategies. Methods: A retrospective analysis of 102 consecutive infants (<2 months) undergoing repair of cardiac defects on cardiopulmonary bypass formed the study group. Cardiac diagnoses were stratified according to the Society of Thoracic Surgeons Congenital Heart Surgery (STAT) mortality categories. The prevalence of AKI within 72 hours was defined according to the three-stage Acute Kidney Injury Network criteria. Novel bypass strategies to preserve renal function included maintenance of higher hematocrit and high flow rates on cardiopulmonary bypass despite systemic hypothermia, and avoidance of albumin and milrinone in the perioperative period. Results: Mean age was 24 ± 19 days. Eighteen patients were less than 7 days of age at the time of surgery. Patient distribution according to STAT categories was as follows: 1 (n = 21), 2 (n = 12), 3 (n = 22), 4 (n = 28), and 5 (n = 19). The incidence of stages 1, 2, and 3 AKI in the population was 8% (n = 9), 2% (n = 2), and 0% (n = 0), respectively. On multivariate analysis higher STAT category was the only significant risk factor for AKI. Conclusion: Current incidence of AKI following cardiac surgery in young infants at our institution is low. Novel perioperative strategies may have contributed to the low observed incidence of AKI in our patient population. Increased complexity of heart disease was a risk factor for AKI.