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This paper provides an introduction to issues surrounding the participation rights of young people in research and the implications of their growing involvement in research as well as providing a discourse on the ethical implications related to consent. The unique contribution of this paper is that it considers children’s rights in respect to the increasing opportunities for young people to take part in evaluation research. The aim of this paper, therefore, is to acknowledge the growing involvement for young people in research and the implications of ensuring that their rights of participation are respected. Secondly, we will consider the children’s rights legislation and our obligations as researchers to implement this. Finally, we will explore consent as an issue in its own right as well as the practicalities of accessing participants. This paper will postulate that any research about young people should involve and prioritize at all stages of the research process; including participation in decision-making. We conclude by identifying five key principles, which we believe can help to facilitate the fulfilment of post-primary pupils’ ability to consent to participate in trials and evaluative research. [ABSTRACT FROM AUTHOR]

This paper evaluates how technical assistive devices for manual materials handling were analysed in the literature in a warehousing context. Works that discuss the economic and/or human factors impact of assistive devices on the warehousing system or the people employed therein were identified in a systematic literature review. Building on a conceptual framework proposed in this paper, our evaluation of the literature shows which types of assistive devices were analysed in the past, and from which perspective these devices were examined. Some works studied the devices exclusively from an operator well-being or an efficiency perspective, while several works analysed the devices' performance in terms of both dimensions. Several works contained in our literature sample highlighted trade-offs between both ergonomic and economic measures and, within the first category, between alternative ergonomic indicators, which shows that assistive devices have to be evaluated carefully in light of their intended application. The paper further identifies research gaps and emphasises the need to understand the interactions between human- and system-related variables that can be supported by assistive devices in designing effective manual materials handling systems. [ABSTRACT FROM AUTHOR]

Objectives: To compare data based on computerized and paper versions of health status questionnaires (HSQs) for sampling patient-reported outcomes (PROs) in patients with fibromyalgia (FM). In addition, to examine associations between patient characteristics (age, education, computer experience) and differences between versions. Finally, to evaluate the acceptability of computer-based questionnaires among patients with FM.Method: The study population comprised female patients diagnosed with FM. All patients completed six HSQs: the Fibromyalgia Impact Questionnaire (FIQ), the Major Depression Inventory (MDI), the 36-item Short Form Health Survey (SF-36), the painDETECT questionnaire (PDQ), the Coping Strategies Questionnaire (CSQ), and the Generalized Anxiety Disorder Self-Assessment Questionnaire (GAD-10), both on paper and using a touch screen. One HSQ was tested at a time in a repeated randomized cross-over design. The two versions were completed with a 5-min interval and between each HSQ the participants had a 5-min break. Means, mean differences with 95% confidence intervals (CIs), medians, median differences, and intraclass correlation coefficients (ICCs) were calculated for all HSQs, including relevant subscales. Associations between patient characteristics and differences between versions were explored using Spearman's correlation coefficients.Results: Twenty women, mean age 48.4 years, participated in the study. Except for one item, ICCs between touch-screen and paper versions of the HSQs examined indicated acceptable agreement (ICC = 0.71-0.99). Overall, mean and median differences revealed no differences between versions. No significant associations were observed for patient characteristics. None of the participants preferred paper questionnaires over computerized versions.Conclusions: The computerized HSQs using a touch screen gave comparable results to answers given on paper and were generally preferred by the participants. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of magnesium sulfate for prevention of eclampsia on blood loss at time of cesarean delivery (CD). Methods: We conducted an electronic based search using the following databases: MEDLINE, PUBMED and the Cochrane Library. The search terms were “magnesium sulfate”, “preeclampsia” and “randomized”. Inclusion criteria were randomized controlled trials of women with preeclampsia who delivered with or without magnesium sulfate therapy for seizure prophylaxis. Only trials with placebo or no treatment comparison groups were included. Primary outcome was postpartum hemorrhage. Secondary outcomes were estimated blood loss, change in hemoglobin, blood transfusion and eclampsia. Results: Five trials met inclusion criteria. The incidence of postpartum hemorrhage was similar between the two groups [magnesium sulfate: 754/4482 (17%); no magnesium sulfate: 775/4427 (18%); RR 0.97, 95% CI 0.88–1.06]. There was no statistical difference between any of the other blood loss outcomes reported in the included studies. The rate of eclampsia with magnesium sulfate was significantly lower than with placebo (42/5604, 0.7%, versus 107/5600, 1.9%; RR 0.40, 95% CI 0.28–0.57). Conclusions: Magnesium sulfate does not appear to affect blood loss intrapartum and postpartum in women with preeclampsia. Magnesium sulfate, therefore, should be continued during CD, given the benefit of seizure prophylaxis without any increased risk of hemorrhage. [ABSTRACT FROM PUBLISHER]

Purpose: Infants who remain in-utero after their due date are exposed to increasing risk of infection, late stillbirth and delivery complications. Much of the current literature on post-term outcomes is based on short term observations and the impacts may be substantially greater in the long term. The aim of this work is to perform a systematic review and meta-analysis to quantify the cognitive or educational impacts of post term delivery.Methods: Systematic review was performed by the two authors using Medline database (1960-2017). A title search was performed to identify likely relevant literature. Exposure terms were clarified to identify papers where the exposure was related to delivery after the infants' due date. Primary outcome was cognitive score. A quality assessment and data extraction pro forma was completed by both reviewers for all studies deemed to satisfy the inclusion and exclusion criteria. Meta-analysis used adjusted results where available. Small-study bias was assessed visually using a funnel plot and then formally tested using Egger's regression asymmetry test.Results: Medline was searched on the 4 July 2018; and produced a list of 1318 publications. Of these, 43 abstracts were screened, and of these a total of 10 full-text papers were reviewed. A further three papers were identified during this review and contributed to a total of 13 papers. The publications dated from 1969 to 2017. Two studies presented a binary outcome for cognitive measures and combined estimates found that the risk of a low cognitive score was higher in post-term infants compared to term infants (odds ratio [OR] 1.06 [1.04-1.08]). Four papers presented the association with mean cognitive measures and post-term delivery, and all demonstrated a mean reduction in scores in the post-term group. A combined estimate showed strong evidence of a reduction in cognitive scores across the four studies (-1.90 [-3.50 to -0.31]). There was little evidence of heterogeneity in the studies which reported cognitive outcomes (other p-values >.2).Conclusion: This meta-analysis has found that post term birth (>41 + 6 weeks) is associated with small but significant negative effects on cognitive outcomes when compared with delivery at, or around term. The effect, while small, is compounded by a common exposure and appears consistent in the studies identified. Less evidence was found for a measurable impact on early developmental measures or educational outcomes. This may further help inform the debate on the timing of otherwise uncomplicated pregnancies and further trials in this area. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) contact tracing is typically conducted in resource-limited settings with paper forms, but this approach may be limited by inefficiencies in data collection, storage, and retrieval and poor data quality. In Botswana, we developed, piloted, and evaluated a mobile health (mHealth) approach to TB contact tracing that replaced the paper form–based approach for a period of six months. For both approaches, we compared the time required to complete TB contact tracing and the quality of data collected. For the mHealth approach, we also administered the Computer System Usability Questionnaire to 2 health care workers who used the new approach, and we identified and addressed operational considerations for implementation. Compared to the paper form–based approach, the mHealth approach reduced the median time required to complete TB contact tracing and improved data quality. The mHealth approach also had favorable overall rating, system usefulness, information quality, and interface quality scores on the Computer System Usability Questionnaire. Overall, the mHealth approach to TB contact tracing improved on the paper form–based approach used in Botswana. This new approach may similarly benefit TB contact tracing efforts in other resource-limited settings. [ABSTRACT FROM PUBLISHER]

There are diverse perceptions about the primary purpose of evaluation. In interprofessional education (IPE), there has been a perceived focus on evaluating against the outcome of improved collaborative practice and quality of care. This paper presents an exploration of the nature and purpose of evaluation methods commonly utilized in the IPE literature with its focus on outcomes-based evaluation and particularly the Kirkpatrick framework. It categorises recent evaluations of pre-qualification (pre-certification) IPE interventions. Of the 90 studies included, most evaluated soon after the educational intervention, only five specifically referred to an evaluation framework and the most frequently used tool was the RIPLS. There was a noteworthy reliance on students' self-rated perceptions of their attitudes towards collaborative practice collected through surveys, focus groups and interviews. There appears to be a need to reconsider the type of evaluation required. In conclusion, this paper offers recommendations for evaluation practice that is moving towards realist approaches; describes the longer term effects of interventions on attitudes and behaviour; develops and validates data collection tools including direct observation of practice and more comprehensively engages with all stakeholders to ensure that evaluation activities are not only focused on improving IPE but also on enhancing our understanding of interprofessional practice. [ABSTRACT FROM AUTHOR]

Aim: Documentation is a critical element in the function of the nursing team, and cannot be separated from high-quality, patient-centered care. The aim of this study was to compare the quality of nursing documentation in electronic and paper-based systems.Method: A retrospective descriptive study was designed to compare the quality of nursing documentation in electronic health records (EHR) versus paper-based documentation systems before and after the application of the electronic system.Results: Analysis of data found a significant difference in the quality of nursing documentation in the two hospitals both before and after the implementation of an EHR system (p < 0.001).Quality of nursing documentation in the electronic system was significantly better than that of paper-based documentation systems.Conclusion: Vocal-electronic systems help to improve quality of nursing documentation, suggesting this aspect may be essential to implementing a successful system in local settings. [ABSTRACT FROM AUTHOR]

Purpose: Postmicturition dribbling (PMD) is a stressful symptom in middle-aged men characterized by urinary leakage after the completion of normal voiding. Appropriate treatments have not yet been introduced. This study assessed the efficacy of treatment of PMD with 75 mg udenafil daily.Materials and Methods: The study included 138 men with regular sexual lifestyles. The Hallym PMD questionnaire (HPMDQ) was used to assess PMD symptoms. After all basic examinations, patients were randomly assigned to either udenafil or placebo. Patients completed the surveys, uroflowmetry (UFM), a bladder scan, and the paper test during the follow-up visit.Results: The mean age of the patients was 57.6 years. PMD with one of every three urinations was experienced by 59 patients (42.8%), whereas 45 patients (32.6%) experienced PMD with two of every three urinations. PMD with every urination was experienced by 34 patients (24.6%). More than half of the patients (89 patients, 65.4%) indicated that persistent PMD symptoms would likely result in moderate to severe discomfort in their daily activities. As time passed, the udenafil group showed significant improvement in PMD symptoms (p = 0.001).Conclusion: Udenafil 75 mg once daily can be an effective treatment for patients with PMD symptoms. [ABSTRACT FROM AUTHOR]

There is currently a need to identify feasible and effective interventions to help older individuals suffering from memory loss maintain functional independence and quality of life. To improve upon paper and pencil memory notebook interventions, the Digital Memory Notebook (DMN) application (app) was developed iteratively with persons with cognitive impairment. In this paper we detail a manual-based intervention for training use of the DMN app. A series of three case studies are described to illustrate the clinical process of the DMN intervention, the key components of the intervention and participants' perceptions of the intervention. The Reliable Change Index was applied to pre/post intervention scores that examined everyday memory lapses, daily functioning, coping self-efficacy, satisfaction with life, and quality of life with standardized measures. Following the intervention, two of three participants self-reported a clinically significant reduction in everyday memory lapses and improved everyday functioning. One participant reported clinically significant change in quality of life. All participants demonstrated clinically significant changes in their ability to cope with problems and build self-efficacy. Furthermore, all participants scored in the normative range post-intervention on the measure of satisfaction with life. Clinical observations and participant feedback were used for refinement of the DMN intervention (ClinicalTrials.gov NCT03453554). [ABSTRACT FROM AUTHOR]

Hypertension (HT) is associated with cardiovascular events and increased mortality, and identification of persons at risk in due time is therefore important. Finding a biomarker to identify those at risk will enable early preventive treatment, and high-sensitivity cardiac troponin (hs-cTn) seems to be a highly relevant candidate. To gather the existing knowledge on the association between hs-cTn and future HT, a systematic literature review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) reporting guidelines and using the PICOS system. Medline was searched until August 2018. Of 45 extracted papers, eleven papers were eligible for the study. None were randomized controlled trials. Three studies assessed hs-cTnI, eight studies assessed hs-cTnT. All studies found statistically significant associations between hs-cTn concentrations and future HT, but the studies included different types of blood pressure (diastolic, systolic, diurnal). Due to differences in troponin assay construction and test capability, a direct comparison of test performance in terms of specificity, sensitivity and predictive values was not possible, and a specific hs-cTn cutoff value for HT prediction could therefore not be defined. Furthermore, a number of conditions known to affect troponin concentrations (e.g. gender, renal function, and co-morbidities) were not sufficiently studied. All retrieved studies found significant associations between hs-cTn concentrations and future HT; although the findings are promising, the studies were too heterogeneous, and many conditions affecting troponin concentrations needs investigation at these low concentrations before hs-cTn can be considered a useful HT predictor. [ABSTRACT FROM AUTHOR]

Post-occupancy evaluation (POE) is a user-focused evaluation method, centered around understanding how dwellers occupy and use built environments. Collecting big data on user behavior has become essential for POE. In this paper, the limitations of current POE protocol data adoption and analysis methods are analyzed, and a quantitative research method based on machine vision (MV) to quantify users' spatio-temporal behavior for POE is developed, which can acquire high-resolution data more efficiently and accurately than the common methods in this field. In particular, the method of calculating user activity using frame difference algorithms fills the gap of quantifying user activity in POE research. The outdoor space of a kindergarten and the indoor space of a university library are selected to validate the method. After analyzing 4.5 million frames of data accumulated over 50 consecutive hours in the outdoor space, and 8.82 million frames of data accumulated over 98 consecutive hours in the indoor space, our method successfully analyzed usage of indoor and outdoor spaces and generated multiple quantitative indices of POE from high-resolution spatiotemporal behavior variables. The robustness, convenience, and practicability of this method in practical applications are verified. This method is simple to use, can adapt to a variety of built environments, and has a low cost. It has potential competitiveness for large-scale application. Quantitative POE research methods enhance the flow of information from space usage to spatial design and provide a data-driven basis for improving spatial sustainability, planning, design, and decision making. [ABSTRACT FROM AUTHOR]

Intersex has been a topic of much discussion in courses on sex and gender in the academy. Rather than focusing on what intersex people I are, i this growing body of work has examined the challenges that intersex people face, which include systematic oppression, discrimination and human rights violations (Ghattas [24]; FRA [21]; Carpenter [5]; Crocetti et al. [10]). Intersex activists and advocates have asserted the human rights of intersex people, including the right to freedom from discrimination; the right to protection from torture and other cruel, harmful or degrading treatment; and the right to health (Horowicz [30]; Behrens [2]). Intersex rights movements and a range of international organisations and supranational legal bodies (including the United Nations, the Council of Europe and Yogyakarta Principles + 10) condemn cosmetic medical interventions on intersex minors and the routine termination of intersex foetuses on grounds of medical "abnormality" (Holmes [31]; Crocetti et al. [10]). [Extracted from the article]

Student feedback literacy has been the subject of much conceptual literature; however, relatively little intervention research has investigated how and if it can be developed. Further, no evaluation of the current empirical literature has been conducted to assess which elements of feedback literacy can be successfully improved in practice, and which elements need further investigation. This paper seeks to explore how different aspects of feedback literacy have been developed in higher education. A scoping review was conducted to address the foci, nature and success of interventions. The review found evidence that educational interventions enhanced feedback literacy in students, such as managing perceptions and attitudes, and having more confidence and agency in the feedback process. While some interventions have an effect on influencing student feedback literacy, both improved study design and intervention design are required to make the most of future feedback literacy interventions. [ABSTRACT FROM AUTHOR]

Multilevel modelling (MLM) is the most frequently used approach for evaluating interventions with clustered data. MLM, however, has some limitations that are associated with numerous obstacles to model estimation and valid inferences. Longitudinal multiple-group (LMG) modelling is a longstanding approach for testing intervention effects using cluster-sampled data that has been superseded by the rise of MLM approaches, but the LMG approach can have advantages when research questions do not pertain to predicting variability at the higher levels. In this paper, we first review the advantages and limitations of MLM and LMG approaches. Second, steps in the estimation of an LMG model are presented, with some recent upgrades and changes in the modelling strategy that have particular utility for evaluating interventions. We discuss the advantages of the LMG approach as a guided confirmatory model-testing framework and how the approach places a premium on avoiding Type II errors, particularly when complex interactions are potentially at play. [ABSTRACT FROM AUTHOR]

Objective: The prognosis for ovarian cancer patients remains poor. A key to maximizing survival rates is early detection and treatment. This requires an accurate prediction of malignancy. Our study seeks to improve the accuracy of prediction by focusing on early subjective assessment of malignancy. We therefore investigated the assessment of patients themselves in comparison to the assessment of physicians.Methods: One thousand three hundred and thirty patients participated in a prospective and multicenter study in six hospitals in Berlin. Using univariate analysis and multivariate logistic regression models, we measured the accuracy of the early subjective assessment in comparison to the final histological outcome. Moreover, we investigated factors related to the assessment of patients and physicians.Results: The patients' assessment of malignancy is remarkably accurate. With a positive predictive value of 58%, the majority of patients correctly assessed a pelvic mass as malignant. With more information available, physicians achieved only a slightly more accurate prediction of 63%.Conclusions: For the first time, our study considered subjective factors in the diagnostic process of pelvic masses. This paper demonstrates that the patients' personal assessment should be taken seriously as it can provide a significant contribution to earlier diagnosis and thus improved therapy and overall prognosis. [ABSTRACT FROM AUTHOR]

Background: It is inconclusive nowadays for the association between infant's gender and their mothers' risk of developing postpartum depression (PPD). In addition, a complete overview is missing. A meta-analysis of cohort and case-control studies was performed to address the question of whether women who gave birth to a female infant were at an increased risk of developing PPD, compared with those giving birth to a male infant.Methods: Unrestricted searches were conducted, with an end date parameter of 31 January 2018, of PubMed, Embase, Google Scholar, Cochrane Libraries, and Chinese databases, to identify studies that met pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates.Results: Twenty-three studies involving 119,736 women were included for analysis. Overall, mothers who gave birth to a female infant experienced a significantly increased risk of developing PPD compared with the reference group (OR = 1.15, 95%CI: 1.01-1.31; p = .03). However, substantial heterogeneity (p < .00001; I2 = 75%) was observed across studies. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results. No evidence of publication bias was observed.Conclusions: Although the role of potential bias and evidence of heterogeneity should be carefully evaluated, the present study suggests women giving birth to a girl are associated with a higher risk of developing PPD when compared with those giving birth to a boy. Improving family and social communication and reducing gender preference should be important components of any such interventions.Statement of significanceProblem or issue Interestingly, the known risk factors leading to PPD are basically the same in different regions and cultures, but the gender of the infant seems to be an exception.What is already known Some studies conducted in traditional western countries indicated that there is a weak or null association between infant's gender and risk of PPD, while others suggested a positive association. In contrast, studies conducted in Nigeria, India, Turkey and China showed that mothers giving birth to a female infant were at a higher risk of developing PPD.What this paper adds Today, the association between infant's gender and risk of developing postpartum depression (PPD) is still uncertain; additionally, a complete overview is missing. Our study represents the first meta-analysis of risk of PPD associated with infant's gender. [ABSTRACT FROM AUTHOR]

Review of: Rosenstock J, Perkovic V, Johansen, OE, et al. Effect of linagliptin vs placebo on major cardiovascular events in adults with type 2 diabetes and high cardiovascular and renal risk: the CARMELINA randomized clinical trial. JAMA. 2019;321:69-79. McGuire DK, Alexander JH, Johansen OE, et al. Linagliptin effects on heart failure and related outcomes in individuals with type 2 diabetes mellitus at high cardiovascular and renal risk in CARMELINA. Circulation. 2019;139:351-361. These two papers describe the findings from the CARMELINA trial (Cardiovascular and Renal Microvascular Outcome Study with Linagliptin): the first paper reported results for the primary cardiovascular composite outcome (cardiovascular [CV] death, nonfatal myocardial infarction [MI], or nonfatal stroke; 3-point major adverse cardiovascular event [3P-MACE]) and the key secondary renal composite outcome (renal death, end-stage kidney disease, or sustained ≥40% decrease in eGFR from baseline); the second paper reported secondary analyses of heart failure (HF) and related outcomes. The CARMELINA trial was a randomized, placebo-controlled, multicenter non-inferiority trial of adults with type 2 diabetes mellitus (T2DM) and elevated CV and renal risk. After a median 2.2-year follow-up of 6979 participants, patients allocated to linagliptin demonstrated no increase in the risk of 3P-MACE versus placebo: hazard ratio (HR) 1.02 [95% confidence interval (CI) 0.89-1.17]; P < 0.001 for non-inferiority. There was also no increase in the risk of hospitalization for HF for linagliptin versus placebo (HR 0.90 [0.74-1.08]). There was no increased risk of progression to end-stage kidney disease or death due to kidney disease (HR 0.87 [0.69-1.10]). Additionally, progression of albuminuria occurred less frequently in patients who received linagliptin versus placebo (HR 0.86 [0.78-0.95]). Overall, no new safety findings were identified for linagliptin, and no increased risk of hypoglycemia was observed for linagliptin versus placebo. Together, these findings from the CARMELINA trial reaffirm treatment guidelines for choosing additional therapies for patients with T2DM at elevated CV and/or renal risk, and provide new information on the role of linagliptin in the management of T2DM. [ABSTRACT FROM AUTHOR]

Background/rationale: The carbon dioxide (CO2) challenge has been reliably used in laboratory settings as a panicogen in clinical populations. However, the magnitude of these effects on healthy and non-clinical control populations are not clear. The aim of this meta-analysis and systematic review is to provide quantitative estimates of those effects. Specifically, the current paper will evaluate the relative efficacy of the CO2 challenge in eliciting both subjective and physiological arousal in healthy and non-clinical control populations.Method: A total of 16 articles with 35 independent samples were included in the meta-analysis, while 37 studies with 74 independent samples were included in the systematic review.Results: Both the meta-analysis and systematic review found the CO2 challenge to elicit an increase in subjective distress via self-reported anxiety and fear. Physiological responses via blood pressure and heart rate were heterogeneous in studies sampled, with no significant changes observed across studies. Moderator analyses revealed the variations in findings may be attributed to participant screening and invasive sampling.Discussion: Findings highlight the CO2 challenge as a useful tool in the provocation of subjective distress. Implications for both the use of the CO2 challenge and its anticipated effects in healthy and non-clinical control populations are discussed. [ABSTRACT FROM AUTHOR]

This paper calls for a critical reframing of masculinity as an intersectional construct in the HIV epidemic and in public health. In-depth qualitative interviews were conducted with a sample of 56 Black men who have sex with men and women in the San Francisco Bay Area. Men described their sexual identities and practices via complex narratives of masculinity that drew on subordinated and resourceful adaptations to the structural effects of racism, economic marginalisation and homophobia. By focusing on men whose experience of masculinity operates outside fixed identity categories, the paper draws attention to the intersectionality that is, by necessity, constitutive of men's lived experiences. Findings suggest the value of an integrative framework for understanding Black masculinities as processes and practices simultaneously informed by structural inequalities (racism, economic marginalisation and/or homophobia, in particular) and cultural meanings of gender. By utilising an intersectional approach, public health and sociology can better understand the concurrent resilience and vulnerability of masculinities, while building an interdisciplinary understanding of the symbolic role of Black masculinities in the USA, as well as a means by which to promote health and well-being in and through these gendered contexts. [ABSTRACT FROM AUTHOR]

Objective: Road traffic laws explicitly refer to a safe and cautious driving style as a means of ensuring safety. For automated vehicles to adhere to these laws, objective measurements of safe and cautious behavior in normal driving conditions are required. This paper describes the conception, implementation and initial testing of an objective scoring system that assigns safety indexes to observed driving style, and aggregates them to provide an overall safety score for a given driving session.Methods: The safety score was developed by matching safety indexes with maneuver-based parameter ranges processed from an existing highway traffic data set with a newly developed algorithm. The concept stands on the idea that safety, rather than suddenly changing from a safe to an unsafe condition at a certain parameter value, can be better modeled as a continuum of values that consider the safety margins available for interactions among multiple vehicles and that depend on present traffic conditions. A sensitivity test of the developed safety score was conducted by comparing the results of applying the algorithm to two drivers in a simulator who were instructed to drive normally and risky, respectively.Results: The evaluation of normal driving statistics provided suitable ranges for safety parameters like vehicle distances, time headways, and time to collision based on real traffic data. The sensitivity test provided preliminary evidence that the scoring method can discriminate between safe and risky drivers based on their driving style. In contrast to previous approaches, collision situations are not needed for this assessment.Conclusions: The developed safety score shows potential for assessing the level of safety of automated vehicle (AV) behavior in traffic, including AV ability to avoid exposure to collision-prone situations. Occasional bad scores may occur even for good drivers or autonomously driving vehicles. However, if the safety index becomes low during a significant part of a driving session, due to frequent or harsh safety margin violations, the corresponding driving style should not be accepted for driving in real traffic. [ABSTRACT FROM AUTHOR]

Trends of delayed childbearing have accompanied declining birth rates and increasing numbers of childless adults in the USA. Women may postpone parenting in order to save money, find a partner, and get a 'family-friendly' job, but this reproductive strategy may not always be effective. This paper uses two waves of longitudinal data to track childless women's reproductive decision-making and behaviours. During wave 1, interviews were conducted with 72 childless US women between the ages of 25 and 40 about their reproductive desires and intentions. Approximately four years later, a subset of the original sample participated in surveys to assess consistencies between fertility intentions and outcomes, and in-depth interviews to elicit information about changes in their lives that transpired. Whereas some wave 2 participants had fulfilled their goal of becoming parents, the majority were still employing a delaying strategy or had declined to have children. Delayed childbearing was individually strategic for those who could garner resources to be in a better financial or social position to have and raise children, while others kept facing barriers that prevented them from realising their reproductive goals or changed their mind about their fertility intentions and desires. [ABSTRACT FROM AUTHOR]

Diacylglycerol (DAG) supplementation has been shown to be associated with the health improvement of patients with diabetes mellitus, although this efficacy is uncertain. We quantitatively examined the effect of dietary DAG on fasting serum glucose and insulin concentrations by conducting a meta-analysis of randomized controlled trials. Potential papers were initially searched from electronic databases of Medline, Embase, and Cochrane Library. Inclusion criteria required the trial to be randomized, with triacylglycerol (TAG) controlled with fasting serum glucose or insulin concentration as one of the end points. Information was extracted independently by two reviewers and the effect of DAG was examined using Review Manager 4.2. Results showed that DAG reduced fasting serum insulin concentration significantly compared with TAG (weighted mean difference [WMD] = -8.23 pmol/l; 95% confidence interval [CI], -15.17 to -1.28 pmol/l; p = 0.02). In addition, DAG supplementation reduced fasting serum glucose concentration greatly (WMD = -0.10 mmol/l; 95% CI, -0.24 to 0.04 mmol/l; p = 0.18), and this effect was significantly correlated with the duration of intervention (fasting serum glucose concentration = 1.075-0.012; duration of intervention; p = 0.04; r = 0.90). In conclusion, DAG supplementation improved fasting serum glucose and insulin concentrations compared with TAG, and the effect on glucose was significantly correlated with the duration of intervention. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine the citation impact of open access (OA) and non-OA journals published in India in health and medical sciences journals and to explore whether OA journals received more citations than non-OA journals. An evaluative scientometric approach was used to analyze the citations of articles published in Indian health and medical science journals indexed in Scopus. Of the total 241 Indian health and medical science journals indexed in Scopus, 79 OA and 61 non-OA journals were selected for the study. Harzing's Publish or Perish software was used to extract the publication and citation data from Google Scholar for 2011–2016. Five alternate hypotheses were formulated to examine whether there is any difference between the impact of OA and non-OA journals. The results showed there is an obvious citation advantage for OA health and medical science journals compared with non-OA journals. However, The Mann-Whitney U Test analysis revealed no significant difference in the citations impacts of OA and non-OA journals, rejecting all the alternate hypotheses of the study. Since this study is the first to explore the citation impact of OA and non-OA journals in the subject of health and medical science published in India, it offers theoretical implication for examination of citation impact of OA and non-OA journals in other subjects. The study is a useful guide to journal publishers and health researchers providing information on where to publish and the journals to subscribe. [ABSTRACT FROM AUTHOR]

Spatial cognitive performance is impaired in later adulthood but it is unclear whether the metacognitive processes involved in monitoring spatial cognitive performance are also compromised. Inaccurate monitoring could affect whether people choose to engage in tasks that require spatial thinking and also the strategies they use in spatial domains such as navigation. The current experiment examined potential age differences in monitoring spatial cognitive performance in a variety of spatial domains including visual-spatial working memory, spatial orientation, spatial visualization, navigation, and place learning. Younger and older adults completed a 2D mental rotation test, 3D mental rotation test, paper folding test, spatial memory span test, two virtual navigation tasks, and a cognitive mapping test. Participants also made metacognitive judgments of performance (confidence judgments, judgments of learning, or navigation time estimates) on each trial for all spatial tasks. Preference for allocentric or egocentric navigation strategies was also measured. Overall, performance was poorer and confidence in performance was lower for older adults than younger adults. In most spatial domains, the absolute and relative accuracy of metacognitive judgments was equivalent for both age groups. However, age differences in monitoring accuracy (specifically relative accuracy) emerged in spatial tasks involving navigation. Confidence in navigating for a target location also mediated age differences in allocentric navigation strategy use. These findings suggest that with the possible exception of navigation monitoring, spatial cognition may be spared from age-related decline even though spatial cognition itself is impaired in older age. [ABSTRACT FROM AUTHOR]

As a threat for transportation system, traffic crashes have a wide range of social consequences for governments. Traffic crashes are increasing in developing countries and Iran as a developing country is not immune from this risk. There are several researches in the literature to predict traffic crash severity based on artificial neural networks (ANNs), support vector machines and decision trees. This paper attempts to investigate the crash injury severity of rural roads by using a hybrid clustering and classification approach to compare the performance of classification algorithms before and after applying the clustering. In this paper, a novel rule-based genetic algorithm (GA) is proposed to predict crash injury severity, which is evaluated by performance criteria in comparison with classification algorithms like ANN. The results obtained from analysis of 13,673 crashes (5600 property damage, 778 fatal crashes, 4690 slight injuries and 2605 severe injuries) on rural roads in Tehran Province of Iran during 2011–2013 revealed that the proposed GA method outperforms other classification algorithms based on classification metrics like precision (86%), recall (88%) and accuracy (87%). Moreover, the proposed GA method has the highest level of interpretation, is easy to understand and provides feedback to analysts. [ABSTRACT FROM PUBLISHER]

Online spaces are increasingly important for our collective consciousness and provide an opportunity to document changing ideas, subjectivities and experiences surrounding new reproductive technologies. This paper reports on the first study of egg donation and online discussion boards in UK-based forums. Using thematic analysis, we investigated how donors use online forums and explored how they present themselves as possible donors in online spaces. Three major themes were identified: 'using online forums to exchange knowledge and experiences', 'egg donation as a gift' and 'having a drive to donate'. Findings from the study reveal how donors enter online spaces looking for advice, presenting themselves as available and weaving themselves into an online community. There exist multiple ways in which donors construct and narrate their own participation in the process of egg donation. Presenting a donor identity in these online forums is not a straightforward matter of helping by giving but also involves a specific drive. While more research is needed on the range of possible motivations, this study gives a better understanding of the available online information and the co-construction of donor identities on discussions boards. [ABSTRACT FROM AUTHOR]

The role of reference and information service has been redefined in some Chinese university libraries. In these libraries the focus of reference and information service has transformed into information analysis. University libraries have been a participant in the management and evaluation in scientific research, technological innovation, and discipline construction. The information analysis service of Zhejiang University Library is a typical case. Zhejiang University library established an information analysis group in 2009 in reference and information service division. To further guarantee the professionalism of service, the information analysis service center was set up in 2018 as a separate division. Over the past decade, information analysis service has played the potential of library in supporting decision-making, scientific research and innovation, discipline construction, research performance evaluation, etc. Information analysis service makes the popularity and status of the university library improve continuously. The evolution of information analysis service of Zhejiang University Library is reviewed in this paper, from the initial stage to the expansion stage, and then to the establishment of professional division. Approaches to promote the progress of information analysis service are summarized. The future goals are also discussed from the perspectives of strengthening the innovation mind-set, librarian development, and information analysis literacy. [ABSTRACT FROM AUTHOR]

Maslow's "Hierarchy of Needs" theory—which hypothesized that if human lower level "deficiency needs" were not met, higher level "growth needs" would be impaired—has received substantial theoretical attention. However, less attention has been given to whether the theory is supported by empirical data in school-aged youth from the USA. In this paper, we begin by reviewing Maslow's theory and highlighting the extent of deficiency needs in USA school-aged children. Then, we (a) introduce the Success Program—a school-based child and family intervention program designed to address non-cognitive barriers to learning—as a vehicle for addressing some of these needs, and (b) summarize Success Program evaluation research that has been conducted over the past 13 years, considering alignment of the research findings with the principles of Maslow's theory. Our findings highlight preliminary support for the notion that basic needs fulfillment may contribute to growth needs satisfaction; however, further examination of Maslow's theory is clearly warranted. [ABSTRACT FROM AUTHOR]

Longitudinal evaluation of interprofessional programming is necessary to understand the impact of interprofessional education (IPE) for collaborative practice. Attitude is one measure of intended behavior. The Interprofessional Attitude Scale (IPAS) was developed as an improved measure to examine the readiness for interprofessional education and collaborative practice. As a means to pilot a protocol for a longitudinal comprehensive evaluation of an interprofessional program with 13 health professional programs in 6 health science faculties, the IPAS was administered over a 3-year period to three cohorts of students. The results of the IPAS indicated no significant differences detected across the 3 years. Although there was a significant difference on the Patient Centredness subscale for Cohorts 2 and 3 the effect size was small. Previous experience in an interprofessional course was a predictor of more positive patient centeredness attitudes, but other IPE experience and years of education were not predictors of any interprofessional attitudes. Students from the Medicine & Dentistry (M&D) faculty ranked significantly lower on the teamwork roles and responsibilities subscale compared to the other faculties, except Rehabilitation Medicine (RM). However, once the outliers in RM were removed, there was a significant difference on this subscale between RM and M&D. This paper outlines the challenges with using the IPAS as part of a comprehensive program evaluation and identifies issues with longitudinal data collection for evaluation with large student cohorts. [ABSTRACT FROM AUTHOR]

This paper explores alcohol-related sexual storytelling. In a qualitative study of more than 100 male participants in the night-time economy in Norway, many told animated and cheerful stories laced with erotic excitement. However, a minority of men also told sex stories characterised by aggressive, belittling and degrading language. We propose that this minority of men may employ such locker room talk to: (i) achieve male bonding and intimacy, (ii) explore ambiguous and confusing sexual experiences and/or (iii) excuse sexual events characterised by overt aggression. We draw on theories of masculinity and homosociality and a narrative framework and show that for some men, sexual relationships with women are strongly influenced by their relations with other men. We discuss how these stories reflect degrading attitudes towards women and how they produce and legitimise sexual violence. [ABSTRACT FROM AUTHOR]

This paper describes experiences of sexuality stigma among same-sex attracted men in Zimbabwe and analyses the consequences of such experiences for healthcare seeking. It draws on qualitative research carried out in Harare in 2017, which included in-depth interviews with sixteen gay and bisexual men, and key informant interviews with three representatives of organisations that work with gay men. There were numerous stories about sexuality stigma in the study participants´ social environments, including at home, in local communities and in healthcare facilities. We first offer a description of these and then go on to trace the implications of stigma on the relations between men who have sex with men on the one hand and the healthcare sector on the other. We conceive of stigma as a pushing force that exerts pressure on and in these relations, and identify five types of consequences of this. Stigma works to (1) produce geographical shifts in healthcare, (2) promote private over public care, (3) compartmentalise healthcare (with dedicated providers for queer persons), (4) deprofessionalise care, and (5) block access to appropriate healthcare altogether for some same-sex attracted men. Most of these consequences have negative implications for preventive or treatment-focused HIV programming. [ABSTRACT FROM AUTHOR]

Objectives: To assess the strength of association between cognitive tests and on-road driving ability in people with dementia by conducting a systematic review and meta-analysis.Methods: A literature search strategy was developed using terms related to dementia and driving. Fifteen databases were searched. Studies were selected if they investigated the predictive ability of cognitive tests and on-road fitness to drive in people with dementia. The primary author performed the initial screening of title and abstract of each paper. Two reviewers then independently checked whether the abstracts met the inclusion and exclusion criteria. The primary author also hand searched included studies, reference lists and conducted citation searches. Studies were quality assessed using Newcastle-Ottawa Quality Assessment Scale for Cohort and Case-Control Studies. A random effect model was employed to analyse effect size.Results: The initial search identified 6734 articles, of which 47 full-text articles were screened for inclusion. Thirty articles were included in the review and sixteen articles were included in the meta-analysis. Analysis showed statistically significant weak to moderate (0.3-0.4) relationships between cognitive measures and on-road driving for all cognitive domains except language.Conclusion: All cognitive domains apart from language showed a statistically significant moderate association with on-road driving outcome in patients with mild dementia. A composite cognitive battery is likely to be better than testing single cognitive domains in assessing fitness to drive in patients with dementia. [ABSTRACT FROM AUTHOR]

Dementia care mapping for neurorehabilitation (DCM-NR) is a tool designed to increase person-centred care (PCC) in neurorehabilitation settings. This paper reports pilot and feasibility testing of a cluster-randomized controlled trial assessing the effectiveness of DCM-NR at increasing PCC. Forty-one staff members, from four neurorehabilitation wards, were cluster-randomized to receive DCM-NR (experimental group) or care as usual (control). Measures of PCC, attitudes to people with brain injury, and PCC self-efficacy were taken at baseline and follow-up. The experimental group were also interviewed about their experiences of the trial. Twenty-nine participants completed the study. Participants generally found the intervention and trial to be acceptable. PCC was significantly higher in the experimental than the control group at follow-up, despite levels of exposure to the intervention being low. PCC self-efficacy increased in the control group, but not in the experimental group, perhaps reflecting an initial reduction in perceived competence following feedback. Neither group showed a change in attitudes to people with brain injury. The findings suggest that this cluster-randomized trial design is acceptable; that DCM-NR shows promise as a tool for increasing PCC; and highlight modifications to the protocol that could increase the success and theoretical value of a future large-scale study. [ABSTRACT FROM AUTHOR]

Background: This paper reports findings from a one-year UK knowledge exchange (KE) project completed in 2015. Stakeholders’ experiences of evaluation were explored in order to develop online resources to strengthen knowledge and capacity within the arts and health sector (www.creativeandcredible.co.uk). Methods: The project used mixed methods, including a survey, interviews and focus groups, guided by a Stakeholder Reference Group comprised of 26 leading UK evaluators, researchers, artists, health professionals, commissioners and funders. Results: The project identified opportunities for arts arising from current health and social care policy agendas. It also identified challenges including the lack of agreed evaluation frameworks and difficulties in evaluation practice. Conclusions: Co-production between stakeholders is needed to strengthen evaluation practice and support the development of the arts and health sector. Effective co-production can be undermined by structural and cultural barriers as well as unequal stakeholder relationships. The paper discusses recent initiatives designed to support best practice. [ABSTRACT FROM PUBLISHER]

Background: This paper explores previous research on art programming used within medical settings and program evaluations in this field. This paper will also describe a recently conducted research study evaluating the Arts For Life organization who sought out this research partnership in order to evaluate their standing with their programing goals. Methods: Collaboration between Arts For Life and Mars Hill University was established and a survey was developed in order to evaluate Arts For Life programming. Surveys were distributed and collected at the four Arts For Life stations. A total of 115 surveys were successfully completed and analyzed. Results: Resulted in positive responses supporting current Arts For Life programming. Conclusions: Arts For Life is viewed as providing a positive effect in the facilities where it is stationed. This research collaboration can likewise be used as a model for future partnerships between nonprofit organizations and undergraduate programs. [ABSTRACT FROM PUBLISHER]

Introduction: The microgrinding technique is used to study cochlear implant electrode positioning and cochlear trauma. It may be argued that this technique might cause damage to inner cochlear structures even without a cochlear implant insertion and thus it should not be recommended. Most papers do not explain how microgrinding is performed, referring to older papers for its description. Properly describing the technique and re-evaluating its safety may reassure researchers of their findings when studying trauma after cochlear implant insertion.Objective: To accurately describe the microgrinding technique and re-evaluate its safety to assess intracochlear trauma by studying non-implanted temporal bones.Methods: Four fresh temporal bones were removed before 24 hours postmortem and frozen at -20°C. Two were prepared for microgrinding before 24 hours of freezing and the others after 6 months. A descriptive analysis of the microscopic anatomy was performed, as well as a comparison between the bones processed within 24 hours of freezing and the bones frozen for 6 months.Results: A total of 80 surfaces was evaluated. Preservation of even the most delicate intracochlear and vestibular structures was observed, such as the crista ampullaris, Reissner's and basilar membranes, permitting an adequate micro-anatomical study. Artifacts were rare and did not interfere with the analysis. Bones studied before 24 hours postmortem exhibited better quality than those frozen for 6 months.Conclusions: The microgrinding technique accurately preserves the inner ear's membranous microscopic anatomy and thus it is useful to study cochlear implant electrode positioning and trauma inside the cochlea. Studies that aim to evaluate inner ear microanatomy should be performed with fresh bones or bones frozen for less than 24 hours since they exhibit a better micro-anatomical quality. [ABSTRACT FROM AUTHOR]

With the implementation of the Affordable Care Act (ACA), many homeless persons who previously lacked health insurance gained medical coverage. This paper describes the experiences of homeless persons in accessing and using primary care services, post-implementation of the ACA. Twenty-six semi-structured interviews were completed with homeless persons and primary care providers/staff. Via thematic analysis, themes were identified, categorized by: factors which influence primary care access and use patterns, and strategies to promote consistent primary care use. Maintaining insurance and leveraging systems-based strategies to support primary care access and use may address health disparities and promote health equity. [ABSTRACT FROM AUTHOR]

This paper examines the ways in which certain fractions of urban educated women residing in Hanoi, Vietnam communicate with their daughters about sex and pleasure, and the various meanings attributed to these verbal interchanges. Drawing on a limited number of qualitative in-depth interviews, the findings suggests that these intimate conversations were framed by discourses concerning the purity of 'modern' women. A distinct lack of sexual knowledge and experience, along with a more generalised shyness in communicating about sexual matters, continue to be highly indicative of those deemed to be 'women of purity', especially before marriage. Such beliefs and allied practices were adhered to not only by mothers, but also by women themselves, exerting significant influence on the determination and expression of sexual perceptions and behaviours. [ABSTRACT FROM AUTHOR]

Cultural values and practices influence many aspects of sexual and reproductive health and rights - from access to and quality of health education and services, to gender roles and responsibilities, to family planning and sexual freedoms. Culture is frequently marginalised in epidemiologically driven analyses of sexual and reproductive health and rights yet remains central to the ways in which inequalities within these fields manifest themselves and are engaged with in society. Using Papua New Guinea (PNG) as a case example, this paper sheds light on the enabling and restrictive role of culture in efforts to work towards equity and justice for gender and sexually diverse people. Drawing on four case stories, we offer insight into where culture can and has been deployed to redress serious inequalities in what is often a hostile environment. In these stories we illustrate how practical justice provides an innovative way to approach issues to do with sexual and reproductive health, particularly as they relate to enhancing the lives of people in visible, grassroots ways. In this way, given evidence, good normative judgement and the opportunity to do good and be fair, practical justice may be seen to be taking place. [ABSTRACT FROM AUTHOR]

This paper describes findings from an institutional ethnography that arose out of the concerns of women living with HIV in Ontario, Canada, regarding the disclosure of their HIV status while accessing perinatal care. The enquiry traces the connections between women's experiences of perinatal care, the activities of healthcare providers delivering such care and the ruling relations that organise women's experiences and healthcare providers' activities. Focusing on HIV disclosure as a concern expressed by women, the findings make visible the day-to-day, routinised practices of healthcare providers working in perinatal care for women living with HIV, as well as the ideological discourses of 'fear of contagion' and 'AIDS hysteria' that contributed to producing the kinds of care experiences that were articulated by women. Opportunities to strengthen perinatal care policies and practices for women living with HIV are discussed. [ABSTRACT FROM AUTHOR]

Background: The identification of women at risk for preterm birth should allow interventions which could improve neonatal outcome. Fetal fibronectin, a glycoprotein which acts normally as glue between decidua and amniotic membranes could be a good marker of impending labour when its concentration in cervicovaginal secretions between 22 and 36 weeks of gestation is ≥50 ng/mL. Many authors worldwide have tested this marker with many different methodologies and clinical settings, but conclusions about its clinical use are mixed. It is time for a comprehensive update through a systematic review and meta-analysis.Methods: We searched PubMed, Cochrane Library, and Embase, supplemented by manual search of bibliographies of known primary and review articles, international conference papers, and contact with experts from 1-1990 to 2-2018. We have selected all type of studies involving fetal fibronectin test accuracy for preterm delivery. Two authors independently extracted data about study characteristics and quality from identified publications. Contingency tables were constructed. Reference standards were preterm delivery before 37, 36, 35, 34, and 32 weeks, within 28, 21, 14, or 7 d and within 48 h. Data were pooled to produce summary likelihood ratios for positive and negative tests results.Results: One hundred and ninety-three primary studies were identified allowing analysis of 53 subgroups. In all settings, none of the summary likelihood ratios were >10 or <0.1, thus indicating moderate prediction, particularly in asymptomatic women and in multiple gestations.Conclusions: The fetal fibronectin test should not be used as a screening test for asymptomatic women. For high-risk asymptomatic women, and especially for women with multiple pregnancies, the performance of the fetal fibronectin test was also too low to be clinically relevant. Consensual use as a diagnostic tool for women with suspected preterm labor, the best use policy probably still depends on local contingencies, future cost-effectiveness analysis, and comparison with other more recent available biochemical markers. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to examine the effects of emergency avoidance behaviors on the kinematics and injuries of electric two-wheeler (ETW) riders.Methods: Four typical riding postures of ETW riders before collisions, including one normal posture and three avoidance postures, were identified through analysis of 298 videos of vehicle to ETW accidents. Crash simulations were then performed using the Total Human Model of Safety (THUMS) occupant model, ETW and a sedan finite element (FE) model, and the kinematics of ETW riders were compared. The risk of head injury and lower extremity injury was also investigated.Results: When the struck foot position of the ETW rider was lower than the ETW pedal, the lower extremity was struck by the sedan bumper and ETW frame from the right and left side respectively, and the upper body of the rider rotated around the hood leading edge. At a car velocity of 40 km/h, the rider was at high risk of head injury and the tibia was fractured. The medial cruciate ligament (MCL) was ruptured in both the 20 km/h and 40 km/h collisions. When the struck foot position of the ETW rider was higher than the pedal, the lower extremity was hit by the bumper and then rebounded. In this situation, the bending moments of the femur and tibia, as well as the bending angle and shear displacement of the knee joint were less than the injury threshold in all crash simulations. Furthermore, when the head was turned toward the colliding car, the risk of head injury varied with the emergency avoidance posture.Conclusions: The height of the struck foot relative to the ETW pedal influenced the rider's global kinematics, and head and lower extremity injuries risk. In the struck side foot landing and both feet landing postures, the lower extremity was restrained and compressed by the ETW frame, resulting in a high risk of tibia fracture and MCL rupture. Reducing the impact velocities could effectively mitigate the injury risk of the ETW riders; however, loading patterns remain an important factor influencing the risk of lower extremity injury. [ABSTRACT FROM AUTHOR]

Existing research provides evidence at the module level of systematic differences in patterns of assessment, marks achieved and distributions of marks between different disciplines. This paper examines those issues at the degree course level, and suggests reasons for the presence or absence of those module-level relationships at this higher level. The analysis finds that both discipline and institution have large and roughly equal impact on the balance between assessment types. However, contrary to the suggestions in the literature, that balance has virtually no independent impact on degree outcomes. The analysis also discovers that, while there is only a small independent impact of disciplines on average degree marks compared to the institutional impact, disciplines do have a larger relative impact on the distribution of those marks. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate feasibility, including usability and utility, of the Computerized Symptom Capture Tool for Menopause (C-SCAT-M), a symptom heuristics application (app) for the iPad, with midlife women.Methods: Thirty midlife women aged 40-60 and experiencing symptoms they associated with menopause were recruited through flyers posted on a university campus, primary care and women's health clinics. The C-SCAT-M guided participants to identify symptoms they experienced, draw temporal and causal relationships between symptoms and identify symptom clusters. Women were encouraged to think aloud as they encountered questions or problems and their comments were audio recorded. After completing the C-SCAT-M, they completed a 22-item acceptability survey and a demographic survey. Data were downloaded from catalyst website and analyzed using SPSS.Results: Women completed the C-SCAT-M with minimal difficulty, with most indicating that using the app was very/extremely easy and most (57%) preferred using the iPad app to paper. Most women stated that the final diagrams were very/extremely accurate depictions of their symptom clusters and relationships (77%).Conclusion: The C-SCAT-M demonstrated initial feasibility, including usability and utility, for collecting data about symptom clusters experienced by midlife women. [ABSTRACT FROM AUTHOR]

This paper contributes to the literature on the phenomenon termed mHealth through a critical examination of wearable posture-tracking technologies. The paper specifically reports on a qualitative document analysis of promotional materials for three devices, carried out with the aim of assessing their mode of operation, the logic underpinning their development and their purported benefits for users. Findings initially highlight how Lumo Lift and Lumo Back, made by the company Lumo Bodytech Inc., and Prana, made by Prana Tech LLC, are designed to enable haptic surveillance and discipline whereby the body is monitored and 'reprimanded' through the touch. These forms of interactive posture training are underpinned by scientific insight from fields such as biomechanics and by data science on consumer posture habits. In turn, the benefits for those engaging with commercial posture-tracking devices are said to include, unsurprisingly, better posture, but also a less tangible form of 'optimised' living. With these findings in mind, it is argued that the arrival of interactive posture technologies has two main implications. In one sense, whereas good posture has historically been imagined as a dividing line between 'civilized' humans and 'uncivilized' others, devices such as Lumo Lift make posture into a matter of posthuman optimisation: humans and non-humans are enfolded in the pursuit of self-betterment. In another sense, posture technologies are important in emboldening the wider mHealth phenomenon, privileging as they do the idea that commercial technologies are now allies and not foes when it comes to improving health. [ABSTRACT FROM AUTHOR]

Objective: The aim of the article is to describe the process of implementing the Estonian national second generation electronic prescription service (e-prescription) and determine if the objectives set by the Estonian government were fulfilled.Materials and Methods: The study presents an analysis of both retrospective and current data in the evaluation phase of a design research project. Sources include, among others, publicly available documents and previous evaluation studies.Results: According to all of the major stakeholders, the Estonian e-prescription service has very high usability and user satisfaction scores have been high. There is only little empirical evidence available to confirm if the benefits aimed for in the creation of the service were achieved. From a public administration viewpoint, the implementation of e-prescription has led to potential efficiency gains.Conclusion: The Estonian second-generation e-prescription system is widely used by citizens, healthcare providers and administrators alike. However, there are gaps in measuring the impact of the service, especially with respect to time savings and enhanced healthcare quality. Additional functionalities will be key drivers in creating benefits for all stakeholders. Future nationwide e-health services should have a more rigorous evaluation process carried out during the design and implementation stages. [ABSTRACT FROM AUTHOR]

Background: Glomerular filtration rate (GFR) measured by iohexol clearance using venous samples is widely used. Capillary sampling on filter paper is easier to perform, may be less painful and spares the blood volume. The purpose of the study was to validate a blood spot method for measuring GFR in children aged 6 years or younger suffering from chronic kidney disease (CKD).Methods: We examined 32 children with CKD, median age (range) 3.0 (0.3-6.2) years. Seven venous samples (10, 30/60, 120, 180, 210, 240, 300 min) were collected and GFR based on all samples was calculated for reference. Following injection of iohexol, blood spots were collected at 120, 180, 210 and 240 min and compared to the reference iohexol clearance.Results: Median (range) reference GFR was 65 (6-122) mL/min/1.73 m(2). The 2, 3 and 4-point blood spot GFR were highly correlated to the reference GFR (r = 0.947, 0.945, 0.937). The mean relative bias between 2-point blood spot and reference GFR was 7.2%, and only 2.3% in the patients with reference GFR < 60 mL/min/1.73 m(2). The diagnostic accuracy for 2-point blood spot was: 87.5% and 96.9% within ± 15% (P15) and ± 30% (P30) of the reference GFR respectively. In patients with GFR < 60 mL/min/1.73 m(2), both P15 and P30 were 100%.Conclusions: GFR calculation based on blood spot iohexol measurement is an alternative method to traditional venous iohexol measurement in children. Our study demonstrates strong agreement between the blood spot and the venous GFR with acceptable bias, precision and diagnostic accuracy, especially in patients with GFR < 60 mL/min/1.73 m(2). [ABSTRACT FROM AUTHOR]

The genitourinary syndrome of menopause (GSM) and stress urinary incontinence (SUI) are common clinical challenges for women’s health and quality of life. The laser treatment and particularly the vaginal erbium laser (VEL) may provide a new non-invasive treatment for both GSM and SUI. However, the estimation of the ultimate results of different laser treatments may be altered by different issues, such as patient selection, concomitant treatments, and long-term effect of vaginal laser thermotherapy. In the present paper, we present the protocol for a large multicenter study on the evaluation of the efficacy and safety of VEL for the treatment of GSM and SUI, the Vaginal Erbium Laser Academy Study (VELAS). This study will evaluate the effects of three laser applications in 1500 postmenopausal women. Subjective and objective symptoms will be evaluated prior to the first laser treatment with follow-up visits after 4 weeks from the last laser application, and subsequently after every 3 months for 1 year. Findings from the VELAS have the potential to affect clinical care practice and health decisions for millions of women world-wide for a non-hormonal treatment for GSM and a non-invasive treatment of SUI. [ABSTRACT FROM PUBLISHER]

Objective: In the treatment of chronic diseases, remission is commonly used as a meaningful treatment goal, synonymous with the absence of significant clinical signs and symptoms of a disease, but not representing a cure. The objective of this paper is to propose a definition for remission for use as an outcome to evaluate the long-term efficacy of therapies for chronic pain. Methods: Data from a randomized clinical trial (NCT01609972) testing the efficacy of spinal cord stimulation in low back and leg pain subjects was used to evaluate the association between pain and functional outcomes and identify the cut-off value to predict remission. Available data over 24-month assessment period included visual analog score (VAS), disability (Oswestry Disability Index [ODI]), patient and clinician global impression of change (PGIC and CGIC), and patient satisfaction. Cluster analysis, Pearson's correlation coefficients, sensitivity, and specificity analyses were used to evaluate its utility in predicting higher patient functionality and satisfaction. Results: Though the term remission has been used in the chronic pain field, a consistent definition has not been previously established. Based on the analysis of the clinical data, we propose that a sustained (≥6 months) pain score of ≤3.0 cm out of 10 cm on VAS be defined as remission. Applying this definition to the clinical trial data: subjects in remission at 24 months versus non-remitters were significantly more likely to be in the highest functional category of minimally disabled according to the ODI (31.5 vs. 8.2%, respectively, p = 0.001), and be 'very satisfied' (75.7 vs 22.6%, respectively, p < 0.001). Conclusions: The validity of the proposed definition of remission is supported by the persistence of remission in this study group, and its correspondence with patient satisfaction, and reduced disability. Further evaluation of the definition using clinical data from other long-term studies is needed. [ABSTRACT FROM AUTHOR]