bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of an expert system for pre-diagnosis of hypertension, diabetes mellitus type 2 and metabolic syndrome
Authors: Urrea Claudio , Mignogna Alexis
Published: July 2020

This study involved the development of an expert system for the pre-diagnosis of hypertension, diabetes mellitus type 2 and metabolic syndrome. The expert system has been developed using web technologies, PHP, Apache and MySQL with CLIPS tool; the expert system includes three algorithms designed by the authors, one for each disease. The objective of this study is to provide an expert system capable of performing a pre-diagnosis for early detection of hypertension, diabetes mellitus type 2 and metabolic syndrome. The methodology to build the system consists in associated risk factors, clinical variables diagnosis criteria based on World Health Organization standards in three algorithms and then develop a program that interacts with users, besides the expert system is compared with the existing expert systems in order to show its originality and innovation. The rules of systems are designed using CLIPS systems and the Architecture Apache, MySQL and PHP for the user interface and database. The system was validated by 72 patient(s) and 3 real doctors, the total result over 72 patient(s) is low risk 16.6 percent, moderate risk 30.5 percent, moderate high risk 13.8 percent, high risk 23.6 percent, very high risk 15.2 percent, and the doctors’ feedback was similar to that shown by the system. The number of rules to create the algorithms and the criteria used were adequate and sufficient to obtain the pre-diagnosis of each disease; in addition, the languages used to design and create the web application were stable. All users who used the system obtained similar results to those obtained by doctors.
Gender moderation and moderating gender: Sexual content policies in Twitch’s community guidelines
Authors: Zolides Andrew
Published: July 2020

With the rise in prominence of live-streaming as a cultural production, a form of socialization, and an economic marketplace, this article is concerned with the ways content moderation policies and community guidelines implicitly foster harmful understandings of gender. Looking at Twitch specifically, I demonstrate through discourse analysis of platform policy documents as well as community discourse in relation to a 2018 update to the Twitch Community Guidelines as to how gender is understood, constructed, and ultimately reinforced through dominant ideological frames. I argue that the sexual politics of Twitch (and other streaming sites) resulting in marginalized and hegemonic patriarchal gender relations is a consequence of more than misogynistic culture but is in fact reinforced through the platform and the enacted policies associated with that platform. This results in cultural, social, and economic disadvantages for women online and is reflective of platform moderation’s impact on larger gendered divides across digital media spaces.
Who cares for carers? How discursive constructions of care work marginalized early childhood educators in Ontario’s 2018 provincial election
Authors: Powell Alana , Langford Rachel , Albanese Patrizia , Prentice Susan , Bezanson Kate
Published: July 2020

In the Canadian province of Ontario, the early childhood education and care workforce continues to be undervalued, underpaid and burdened with challenging working conditions. Drawing on Fairclough and Lazar, this study employed a feminist critical discourse analysis to explore the discourses of care work present in the 2018 childcare platforms of three major parties: the Liberal Party, the New Democratic Party and the Progressive Conservative Party. This critical discourse analysis provided an opportunity to consider the absence and presence of early childhood education and care discourses in the election platforms, and the consequences this has for the advancement of the workforce. The findings indicate that the early childhood education and care workforce remained largely invisible in the 2018 childcare platforms. When present, educators were often constructed as components of the early childhood education and care system’s stability. In addition, a discourse of ‘maternal care burden’ emerged in some platforms, which initially suggested progressive recognition of the gendered reality of care and care work for women in Ontario. However, the critical discourse analysis illuminates that the maternal-care-burden discourse, while suggesting that mothers are freed to enter the paid workforce, actually reinforces notions of care as women’s work. As well, this discourse further marginalizes the early childhood education and care workforce by downloading one group’s caring responsibilities to a new group of invisible carers – early childhood educators. In light of these findings, the need to disrupt discourses that continue to devalue the early childhood education and care workforce is considered as researchers and advocates seek to assert care labour as an essential public responsibility and a critical concern in political dialogue.
The hidden complexity of early childhood educators’ work: The Exemplary Early Childhood Educators at Work study
Authors: Press Frances , Harrison Linda , Wong Sandie , Gibson Megan , Cumming Tamara , Ryan Sharon
Published: July 2020

A considerable body of research suggests that knowledgeable and skilled educators are key to the quality of early childhood services. However, the skills and knowledge of educators is subject to being underestimated and contested. In response, the Exemplary Early Childhood Educators at Work Study has been designed to bring to light the distinctive nature of the work of early childhood educators and its complexity. The study draws its sample from centre based early childhood services that are rated as high quality by the Australian Children's Education and Care Quality Authority (ACECQA).
With shadows, dust and mud: Activating weathering-with pedagogies in early childhood education
Authors: Rooney Tonya , Blaise Mindy , Royds Felicity
Published: July 2020

In response to the perception that climate change is too abstract and its consequences too far-reaching for us to make a difference, recent feminist environmental humanities scholars have drawn attention to connections that can be forged by noticing the intermingling of bodies, relations, materials, places and movements in the world. Inspired by these ideas, Tonya Rooney has proposed that there is potential in working with child–weather relations as a pedagogical response to making climate change more connected and immediate for young children. Mindy Blaise and her colleagues have also shown how ‘matters of fact’ dominate early childhood teaching, and call for new pedagogies that attend to ‘matters of concern’, such as climate change. In this article the authors build on these ideas by drawing also on María Puig de la Bellacasa’s suggestion that we extend our concern to ‘matters of care’ as an ‘ethically and politically charged practice’. The authors report on their work with educators and children in an Australian-based preschool where they have started to engage with matters of concern and matters of care to create new types of pedagogies that they call ‘weathering-with pedagogies’. These are situated, experimental, embodied, relational and ethical, and, the authors suggest, reflect a practice of care, thus providing young children with new ways of responding to climate change. The authors take as their starting point Donna Haraway’s invitation to ‘muddy the waters’ as a way to stir up the possibilities, tensions and challenges in doing such work.
Effects of nozzle geometries and needle lift on steadier string cavitation and larger spray angle in common rail diesel injector
Authors: He Zhixia , Zhou Han , Duan Lian , Xu Min , Chen Zhou , Cao Tianyi
Published: July 2020

The cavitating flow in diesel injector nozzles plays a vital role in spray atomization and formation of fuel–air mixture, since vortex-induced string cavitation has recently been found a much more influence on spray compared to the ordinary geometry-induced film cavitation. In this study, in order to investigating string cavitation and its’ enhancement on spray, the visualization experimental platform for the real-size optical tapered-hole nozzle was built based on the high-pressure common rail fuel injection system. Groups of optical nozzles with different geometries were designed for exploring the couple effects of several nozzle geometric parameters, including nozzle sac chamber depth, nozzle-hole position height and needle lift, on the three-dimension vortex flow structure and then on the string cavitation and spray characteristics. Results indicated that the string cavitation characteristics are tightly associated with couple characteristics of the parameters. The stable and strong string cavitation during the whole injection process can be obtained in the Min-sac nozzle with the high hole position under the low needle lift. The string cavitation extends to the nozzle-hole outlet, and subsequently induces the special hollow cone spray with air in the spray center location and corresponding a larger spray cone angle even under not so high injection pressure.
Attitudes toward assisted death amongst doctors in Northern Portugal
Authors: Gonçalves Ferraz
Published: July 2020

Introduction

Context: In Portugal assisted death was approved in February 2020 by the Parliament, although the law is not yet in force.

Objectives

To find out what doctors think about those practices.

Methods

A link to a questionnaire was sent by email three times, at intervals of one week, to the doctors registered in the Northern Section of the Portuguese Medical Association, before the Parliamentary approval.

Results

The questionnaire was returned by 1148 (9%) physicians. A minority of doctors would practice a form of assisted death under the present law or if it was legalized, but a higher percentage think that euthanasia should be legalized, and more would like to have that option if they themselves were in a terminal phase of a disease. Religion has a strong influence on the attitudes of doctors, so too does their contact with patients in a terminal phase, as doctors who deal with more patients with far advanced diseases are more likely to be unfavorable to assisted death. On the other hand, younger doctors are more in favor of these practices.

Conclusion

The small percentage of questionnaires sent back is a weakness in this study and casts doubts on the generalizability of the conclusions. However, this is, so far, the best approximation to the opinions of Portuguese doctors on assisted death.
Pornography and Sexual Aggression: Can Meta-Analysis Find a Link?
Authors: Ferguson Christopher J. , Hartley Richard D.
Published: July 2020

Whether pornography contributes to sexual aggression in real life has been the subject of dozens of studies over multiple decades. Nevertheless, scholars have not come to a consensus about whether effects are real. The current meta-analysis examined experimental, correlational, and population studies of the pornography/sexual aggression link dating back from the 1970s to the current time. Methodological weaknesses were very common in this field of research. Nonetheless, evidence did not suggest that nonviolent pornography was associated with sexual aggression. Evidence was particularly weak for longitudinal studies, suggesting an absence of long-term effects. Violent pornography was weakly correlated with sexual aggression, although the current evidence was unable to distinguish between a selection effect as compared to a socialization effect. Studies that employed more best practices tended to provide less evidence for relationships whereas studies with citation bias, an indication of researcher expectancy effects, tended to have higher effect sizes. Population studies suggested that increased availability of pornography is associated with reduced sexual aggression at the population level. More studies with improved practices and preregistration would be welcome.
Multimodal Supervised Exercise Significantly Improves Walking Performances Without Changing Hemodynamic Parameters in Patients With Symptomatic Lower Extremity Peripheral Artery Disease
Authors: Calanca Luca , Lanzi Stefano , Ney Barbara , Berchtold André , Mazzolai Lucia
Published: July 2020

We evaluated the outcome of multimodal supervised exercise training (SET) on walking performances and different hemodynamic parameters (ankle/toe-brachial index [ABI/TBI], and transcutaneous oxygen pressure [TcPO2]) in patients with symptomatic lower extremity peripheral artery disease (PAD). Whether hemodynamic parameters predict walking performances at baseline and following SET was also investigated. Fontaine stage II PAD’s patients following a 3-month SET were retrospectively included. Hemodynamic parameters and walking performances (pain-free [PFWD], maximal [MWD], and 6-minute [6MWD] walking distance) were measured in each patient. Eighty-five symptomatic PAD patients were included. Following SET, PFWD, MWD, and 6MWD significantly increased (+142%, +94%, +14%; respectively; P ≤ .001). Toe-brachial index significantly increased (MD: 0.04 ± 0.01; P = .02), whereas ABI and TcPO2 did not change significantly. At baseline, patients with higher TBI and TcPO2 performed significantly better (PFWD: β = 0.25, P = .01 for TBI; PFWD: β = 0.30, P = .005, and MWD: β = 0.22, P = .04, for TcPO2). No significant relationship was observed at baseline between ABI and walking performances. Baseline values of hemodynamic parameters did not significantly correlate with changes in walking performances. Multimodal SET significantly improves walking performances. Following SET, no significant changes in ABI and TcPO2 were observed. Toe-brachial index values significantly improved after SET. However, this increase was very modest and its clinical relevance remains questionable. Although baseline TBI and supine TcPO2 values predict baseline walking performances, no association was found between baseline hemodynamic parameters and changes in walking performances following SET.
Reversible data hiding scheme based on pixel-value differencing in dual images
Authors: Kim Pyung-Han , Ryu Kwan-Woo , Jung Ki-Hyun
Published: July 2020

In this article, a new reversible data hiding scheme using pixel-value differencing in dual images is proposed. The proposed pixel-value differencing method can embed more secret data as the difference value of adjacent pixels is increased. In the proposed scheme, the cover image is divided into non-overlapping blocks and the maximum difference value is calculated to hide secret bits. On the sender side, the length of embeddable secret data is calculated by using the maximum difference value and the log function, and the decimal secret data are embedded into the two stego-images after applying the ceil function and floor function. On the receiver side, the secret data extraction and the cover image restoration can be performed by using the correlation between two stego-images. After recovering the cover image from two stego-images, the secret data can be extracted using the maximum difference value and the log function. The experimental results show that the proposed scheme has a higher embedding capacity and the proposed scheme differs in embedding the secret data depending on the characteristics of the cover image with less distortion. Also, the proposed scheme maintains the degree of image distortion that cannot be perceived by the human visual system.
Research and simulation analysis of thermal performance and hygrothermal behavior of timber-framed walls with different external thermal insulation layer: Cork board and anticorrosive pine plate
Authors: Fu Haiyan , Ding Yewei , Li Minmin , Cao Yu , Xie Wenbo , Wang Zheng
Published: July 2020

In order to improve the comfort of the living environment, the thermal performance and temperature–humidity regulation of the exterior walls of two timber-framed structure buildings is theoretically calculated and experimentally studied in this study. Both of the two buildings are located in Nanjing, China, the hot-summer and cold-winter zone. Then WUFI is used to simulate and predict the changes of temperature, relative humidity, and water content of the two timber-framed structure buildings, to strengthen the theoretical analysis of the thermal and humidity coupling of the external walls, and to propose an optimal design scheme for the insulation and temperature and humidity regulation of the external walls. The main results show that the tested thermal conductivity is basically consistent with the predicted value, which prove that WUFI simulation can effectively predict the thermal insulation performance of the external wall. The two timber-framed structure buildings are both suitable for the cold areas, and the reasonable optimization of the design of the structure is the key to the insulation of the building wall. Timber-framed structure is proved to have good temperature–humidity regulation effect. The moisture content of the two timber-framed structure buildings is stable, and the annual temperature and winter humidity are within the appropriate humidity range, which indicates that the wall design is suitable for Nanjing hot-summer and cold-winter climate zone. Four types of wall structure indoor mold spore germinations are less likely, which is not easy to produce the mold. The above research aims to optimize the design of the energy-saving wall of the timber-framed structure and create a comfortable and healthy living environment.
Understanding key constraints and practice design in Rugby Union place kicking: Experiential knowledge of professional kickers and experienced coaches
Authors: Pocock Chris , Bezodis Neil E , Davids Keith , Wadey Ross , North Jamie S
Published: July 2020

Place kicks present valuable opportunities to score points in Rugby Union, which are typically performed under varying constraints in competitive performance environments. Previous quantitative studies suggest these interacting constraints can influence fluctuations in place kick success. To further the understanding of how fluctuations in place kicking success emerge, our aim was twofold: i) to explore and identify the key constraints that professional place kickers and experienced place kicking coaches perceive to influence the difficulty of a place kick and ii) to understand the level to which current place kicking practice environments represent these key constraints experienced in performance environments. Six professional place kickers and six experienced place kicking coaches were interviewed. Using a deductive thematic analysis, 11 key constraints were identified: individual constraints of expectation for success and fatigue, task constraints of angle and distance to goalposts, environmental constraints of wind, weather, pitch, and crowd, and situational constraints of previous kicking performance, time remaining and current score margin. Place kicking is typically practised individually or with a small number of place kickers in isolation from team sessions. Where possible, coaches should be encouraged to include place kicking in simulated game scenarios during practice to represent key constraints from performance environments. Our study demonstrates how experiential knowledge can enrich the understanding of sport performance and inform the design of practice environments which simulate relevant constraints of competitive performance to enhance skill adaptation of athletes.
Investigating the Impact of Healthcare Environmental Design on Staff Security: A Systematic Review
Authors: MohammadiGorji Soheyla , Bosch Sheila J. , Valipoor Shabboo , De Portu Giuliano
Published: July 2020

Objective:

To systematically review the literature regarding the role of the physical environment in preventing or mitigating aggressive behavior toward healthcare professionals in acute care, outpatient, and psychiatric/behavioral health facilities.

Background:

Globally, the incidence of violence against healthcare professionals is alarming. Poor environmental design has been identified as a risk factor of violence toward employees. The design of the physical setting in which healthcare is provided may moderate the incidence and severity of violence against healthcare workers.

Methods:

We conducted electronic database searches of PubMed and CINAHL through November 2018.

Result:

Findings were organized according to four categories identified in the literature regarding crime prevention through environmental design (CPTED) including natural surveillance, access control, territoriality, and other CPTED elements. Fifteen studies (published between 1991 and 2017) met the inclusion criteria. Of the 15 studies, 4 incorporated environmental interventions. In the 11 remaining studies, physical environment attributes (i.e., layout, location, ambient conditions, equipment) were among the factors affecting violent incidents and staff security. Most study settings were hospital-based (11, with 10 of those specifically focused on emergency departments), followed by behavioral health facilities (4 studies). Design-focused recommendations, such as providing a second door in a triage room and a sub-waiting area inside the treatment zone, were summarized according to CPTED categories.

Conclusion:

This review suggests that the physical environment in healthcare facilities may affect the incidence of violence by patients or visitors against staff. Further research is needed to identify environmental design strategies that may protect the safety of healthcare professionals.
Tissue-engineered human embryonic stem cell-containing cardiac patches: evaluating recellularization of decellularized matrix
Authors: Hochman-Mendez Camila , Pereira de Campos Dilza Balteiro , Pinto Rafael Serafim , Mendes Bernardo Jorge da Silva , Rocha Gustavo Miranda , Monnerat Gustavo , Weissmuller Gilberto , Sampaio Luiz C , Carvalho Adriana Bastos , Taylor Doris A , de Carvalho Antonio Carlos Campos
Published: July 2020

Decellularized cardiac extracellular matrix scaffolds with preserved composition and architecture can be used in tissue engineering to reproduce the complex cardiac extracellular matrix. However, evaluating the extent of cardiomyocyte repopulation of decellularized cardiac extracellular matrix scaffolds after recellularization attempts is challenging. Here, we describe a unique combination of biochemical, biomechanical, histological, and physiological parameters for quantifying recellularization efficiency of tissue-engineered cardiac patches compared with native cardiac tissue. Human embryonic stem cell-derived cardiomyocytes were seeded into rat heart atrial and ventricular decellularized cardiac extracellular matrix patches. Confocal and atomic force microscopy showed cell integration within the extracellular matrix basement membrane that was accompanied by restoration of native cardiac tissue passive mechanical properties. Multi-electrode array and immunostaining (connexin 43) were used to determine synchronous field potentials with electrical coupling. Myoglobin content (~60%) and sarcomere length measurement (>45% vs 2D culture) were used to evaluate cardiomyocyte maturation of integrated cells. The combination of these techniques allowed us to demonstrate that as cellularization efficiency improves, cardiomyocytes mature and synchronize electrical activity, and tissue mechanical/biochemical properties improve toward those of native tissue.
A cost-utility analysis of increasing percutaneous coronary intervention use in elderly patients with acute coronary syndromes in six European countries
Authors: Forné C , Subirana I , Blanch J , Ferrieres J , Azevedo A , Meisinger C , Farmakis D , Tavazzi L , Davoli M , Ramos R , Brosa M , Marrugat J , Dégano I R ,   EUROTRACS Investigators
Published: July 2020

Aims

Percutaneous coronary intervention reduces mortality in acute coronary syndrome patients but the cost-utility of increasing its use in elderly acute coronary syndrome patients is unknown.

Methods

We assessed the efficiency of increased percutaneous coronary intervention use compared to current practice in patients aged ≥75 years admitted for acute coronary syndrome in France, Germany, Greece, Italy, Portugal and Spain with a semi-Markov state transition model. In-hospital mortality reduction estimates by percutaneous coronary intervention use and costs were derived from the EUROpean Treatment & Reduction of Acute Coronary Syndromes cost analysis EU project (n = 28,600). Risk of recurrence and out-of-hospital all-cause mortality were obtained from the Information System for the Development of Research in Primary Care (SIDIAP) database from North-Eastern Spain (n = 55,564). In-hospital mortality was modelled using stratified propensity score analysis. The 8-year acute coronary syndrome recurrence risk and out-of-hospital mortality were estimated with a multistate survival model. The scenarios analysed were to increase percutaneous coronary intervention use among patients with the highest, moderate and lowest probability of receiving percutaneous coronary intervention based on the propensity score analysis.

Results

France, Greece and Portugal showed similar total costs/1000 individuals (7.29–11.05 m €); while in Germany, Italy and Spain, costs were higher (13.53–22.57 m €). Incremental cost-utility ratios of providing percutaneous coronary intervention to all patients ranged from 2262.8 €/quality adjusted life year gained for German males to 6324.3 €/quality adjusted life year gained for Italian females. Increasing percutaneous coronary intervention use was cost-effective at a willingness-to-pay threshold of 10,000 €/quality adjusted life year gained for all scenarios in the six countries, in males and females.

Conclusion

Compared to current clinical practice, broadening percutaneous coronary intervention use in elderly acute coronary syndrome patients would be cost-effective across different healthcare systems in Europe, regardless of the selected strategy.
Re-domesticating social media when it becomes disruptive: Evidence from China’s “super app” WeChat
Authors: Huang Ying , Miao Weishan
Published: July 2020

This article examines the emerging phenomenon of the non-use of WeChat Moments. Drawing upon semi-structured interviews with 21 users who used Moments for at least 6 months, then voluntarily discontinued their use of the feature, we discuss the complex dynamics of Moments use, exploring the implicit micro-behavioral process of social media practice. Countering the purported hyper-centrality of WeChat, we identified a periodic loop of “use, non-use, reuse” of Moments, suggesting that people suspend their use of Moments periodically to “re-domesticate” technology. Through the prism of the domestication approach, we argue that the re-domestication of Moments is a “reboot” of the whole process of domestication through four key stages: re-appropriation, re-objectification, re-incorporation, and re-conversion. Re-domestication is a process that allows people to take a retrospective look at their lives and transform Moments from a disruptive app feature into an instrumental apparatus conducive to their personal and professional well-being. By examining this process, we discuss how people use innovative ways to regain their autonomy and agency in their daily interactions with WeChat.
Pelvic-floor relaxation techniques using biofeedback – more effective therapy for chronic prostatitis/chronic pelvic pain syndrome
Authors: Pandey Manish , Shrivastava Vaibhav , Patidar Vijay , Dias Sabby , Trivedi Sameer
Published: July 2020

Objective:

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterized by pelvic pain and voiding symptoms, the management of which is challenging. The present study was designed to assess the efficacy of biofeedback and pelvic-floor relaxation treatment for CP/CPPS.

Methods:

A total of 84 patients diagnosed with CP/CPPS were randomly assigned to one of the two groups: conventional therapy (group A) and pelvic-floor muscle relaxation and biofeedback (group B). The Biofeedback and Electrical Stimulation apparatus was used for pelvic-floor muscle electrical stimulation and relaxation with biofeedback. National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores were evaluated at the start of therapy, after 3 months of treatment and at 6 months (3 months after last treatment received).

Results:

At 3 months, patients in both groups had a significant decrease (improvement in symptoms) in NIH-CPSI scoring. However, at 6 months, only 19 (47.5%) patients in group A maintained a fall in NIH-CPSI score >6 compared with 37 (94.8%) patients in group B ( p<0.05). At 6 months, there was significant decrease in NIH-CPSI score in group B, whereas in group A, scores had increased (worsening of symptoms).

Conclusions:

Pelvic-floor muscle relaxation and biofeedback training is a safe and effective treatment for CP/CPPS with sustained efficacy.
Exploring the equity impact of mobile health-based human immunodeficiency virus interventions: A systematic review of reviews and evidence synthesis
Authors: Nittas Vasileios , Ameli Vira , Little Madison , Humphreys David K
Published: July 2020

Objective

While mobile health-based human immunodeficiency virus (HIV) interventions are often designed to promote health equity, systematic differences in the use of and access to mobile technologies may counteract that and widen treatment gaps. This systematic review applies an equity lens to investigate whether existing research provides adequate evidence on the ethical implications of mHealth technologies in HIV treatment and prevention.

Methods

This study included a two-stage methodology, consisting of (a) a systematic review of systematic reviews and (b) an evidence synthesis of primary studies. For the review of reviews we searched eight electronic databases, eight electronic journals and Google Scholar. We also screened reference lists and consulted authors of included studies. Primary studies were extracted from eligible reviews. We based our data extraction and analysis on the Place of residence, Race, Occupation, Gender/Sex, Religion, Education, Socioeconomic status, Social capital and other disadvantage related characteristics (PROGRESS-Plus) framework and the use of harvest plots, focusing on the socio-demographic distribution of mHealth effects.

Results

A total of 8786 citations resulted in 19 eligible reviews and 39 eligible primary studies. Existing reviews did not provide any analyses of the equity impacts of mobile health-based HIV initiatives. Information availability was higher in primary studies, predominantly suggesting no social gradient of mobile health-based HIV interventions. Overall, evidence remains weak and not sufficient to allow for confident equity statements.

Conclusions

Despite the negative force of socio-demographic inequities and the emerging nature of mobile health technologies, evidence on the equity implications of mobile health interventions for HIV care remains scarce. Not knowing how the effects of mobile health technologies differ across population subgroups inevitably limits our capacities to equitably adopt, adjust and integrate mobile health interventions towards reaching those disproportionally affected by the epidemic.
A Revised Ecological Model of Occupational Stress: Applications to 9-1-1 Telecommunicators
Authors: Meischke Hendrika , Beaton Randal , Lilly Michele , Tu Ann , Revere Debra
Published: July 2020

Background: A cohesive body of scientific evidence has documented the adverse impacts of occupational stress on worker health and safety and, to a lesser extent, on organizational outcomes. How such adverse impacts may be prevented and/or ameliorated are important to understand, but progress has been limited due to the lack of a robust and comprehensive theoretical model of occupational stress. Methods: Building on a review of existing theoretical models of occupational stress and an ecological framework, a multilevel conceptual model of occupational stress and strain is proposed that identifies various and potentially interacting sources of occupational stressors as well as potential protective factors. Results: The revised ecological model proposed herein embraces a broad conceptualization of outcomes and includes an individual worker, work unit (team) performance as well as organizational level outcomes; for example, resilience/dysfunction. Conclusion/Application to Practice: This model provides occupational health nurses with an improved understanding of occupational and worker health as well as guidance in developing targeted interventions and generating new lines of occupational stress research.
Update on the Biomechanics of the Craniocervical Junction, Part II: Alar Ligament
Authors: Ishak Basem , Glinski Alexander von , Dupont Graham , Lachkar Stefan , Yilmaz Emre , Iwanaga Joe , Unterberg Andreas , Oskouian Rod , Tubbs R. Shane , Chapman Jens R.
Published: July 2020

Study Design:

In vitro biomechanical study.

Objective:

The strength of the alar ligament has been described inconsistently, possibly because of the nonphysiological biomechanical testing models, and the inability to test the ligament with both attachments simultaneously. The purpose of this biomechanical model was to reevaluate the alar ligament’s tensile strength with both bony attachments, while also keeping the transverse ligament intact, all in a more physiological biomechanical model that mimics the mechanism of traumatic injury closely.

Methods:

Eleven fresh-frozen occipito-atlanto-axial (C0-C1-C2) specimens were harvested from individuals whose mean age at death was 77.4 years (range 46-97 years). Only the alar and transverse ligaments were preserved, and the bony C0-C1-C2 complex was left intact. Axial tension was exerted on the dens to displace it posteriorly, while the occipito-axial complex was fixed anteriorly. A device that applies controlled increasing force was used to test the tensile strength (M2-200, Mark-10 Corporation).

Results:

The mean force required for the alar ligament to fail was 394 ± 52 N (range 317-503 N). However, both the right and left alar ligaments ruptured simultaneously in 10 specimens. The ligament failed most often at the dens (n = 10), followed by occipital condyle rupture (n = 1). The transverse ligament remained intact in all specimens.

Conclusions:

When both the right and left alar ligament were included, the total alar ligament failure occurred at an average force of 394 N. The alar ligament failed before the transverse ligament.
A novel cell-free formulation for the treatment of knee osteoarthritis generates better patient-reported health outcomes in more severe cases
Authors: Delgado-Enciso Ivan , Paz-Garcia Juan , Valtierra-Alvarez Jose , Preciado-Ramirez Jorge , Olmedo-Buenrostro Bertha A , Delgado-Enciso Josuel , Guzman-Esquivel Jose , Barajas-Saucedo Carlos E , Ceja-Espiritu Gabriel , Rodriguez-Sanchez Iram P , Martinez-Fierro Margarita L , Zaizar-Fregoso Sergio A , Tiburcio-Jimenez Daniel , Plata-Florenzano Jorge E , Paz-Michel Brenda
Published: July 2020

Background:

The bioactive cell-free formulation (BIOF2) for cartilage regeneration has shown a major therapeutic response in severe knee osteoarthritis. However, its effect on patients with mild or moderate stages of the disease has not been studied.

Objective:

To evaluate the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, minimal clinically important improvement (MCII) and sleep disturbances in mild, moderate, and severe stages of knee osteoarthritis (OA) with the novel cell-free formulation treatment (BIOF2).

Methods:

An open-label, nonrandomized, baseline-controlled, parallel group study on patients with mild, moderate, and severe knee OA was conducted to evaluate the effect of intra-articular administration of BIOF2. Clinical improvement was determined through the WOMAC score and MCII, whereas sleep disturbances were measured through a Likert scale questionnaire.

Results:

At 6 months post-treatment, the mean decrease in the total WOMAC score was 16.4 +/- 4.7%, 49.9 +/- 6.4%, and 62.7 +/- 4.5% in the patients with mild, moderate, and severe disease, respectively ( p < 0.001, analysis of variance test). MCII at 6 months was 18%, 78%, and 100% for mild, moderate, and severe disease, respectively ( p < 0.001, likelihood-ratio χ 2 test). Concerning sleep disturbances, 60% of the patients with severe OA had important sleep problems before beginning treatment, and those difficulties were overcome 6 months after treatment. Only 18% of the patients with mild disease and 16% with moderate disease had serious sleep disturbances at the beginning of the study, and there was slight improvement after treatment. No adverse events were recorded during follow-up.

Conclusion:

BIOF2 generates better patient-reported health outcomes (on pain, stiffness, function, and sleep) in the more severe cases of knee OA.
From National Liberation War to Self-defense: A Historical Glance at Öcalan’s Perspective on Violence
Authors: Türk H. Bahadır
Published: July 2020

The leader of the Kurdistan Workers’ Party ( Partiya Karkerên Kurdistan or PKK), Abdullah Öcalan, has played a crucial role in shaping the road map of the PKK since the founding of the organization in 1978. His ideas have substantially influenced the structure of the PKK. This article analyzes whether Abdullah Öcalan’s perspective on violence changed over the period between the founding of the PKK and the present. Using an interpretive–textual method, the study examines Öcalan’s approach to the question of violence before and after his imprisonment on the island of İmralı in 1999. The study attempts to make sense of how his perspective on violence was constructed and developed during these two periods. To achieve this goal, the study demonstrates the differences and similarities in Öcalan’s approach to the concept of violence during these two periods. Accordingly, it is argued that Öcalan’s perspective on violence is marked by continuity rather than a rupture.
Each for Equal: Gender Inequity in Dentistry in Australia
Authors: Silva M. , Teoh L.
Published: July 2020

Objective:

While there is an increasing number of women entering the dental profession, they are still underrepresented in leadership roles in major dental organizations, academia, and journal boards. Keynote and invited speaking roles in professional and scientific conferences recognize expertise and leadership and are key factors in career advancement and academic promotions. The aim of this study was to investigate gender differences in representation at dental continuing professional development (CPD) events and conferences in Australia.

Methods:

An analysis of the gender of speakers was conducted with CPD and conference programs that are publicly available online from the federal and Victorian branches of the Australian Dental Association, the peak national body for dentists.

Results:

The planned 2020 Victorian Branch CPD program featured 30 events, with a mean 2.5 speakers per event. There were 58 scientific presentations in the schedule, 22 (38%) of which were allocated to female speakers. Seven CPD events in 2020 included only female speakers, and 13 included only male speakers. The 37th and 38th Australian Dental Congresses featured 25% and 36% of female speakers, respectively. All keynote speakers were male for both events, and men accounted for 86% and 93% of international speakers.

Conclusions:

While women are approaching parity in local and state-level CPD events, there is a large discrepancy in the male-to-female speaker ratio for major national conferences. Suggestions to improve gender imbalance include having women on the convening committee and developing and implementing policies to address the imbalance. There has been significant progress in addressing gender inequity in dentistry, but gender-balanced leadership in major conferences still needs to be addressed.

Knowledge Transfer Statement:

The findings of this study show that while women may be approaching parity with small continuing professional development events, they are still underrepresented as speakers in major conferences. It is recommended that active policies be implemented to reduce the imbalance to ensure gender-balanced leadership in one aspect of the dental profession in Australia.
The popular sovereignty continuum: Civil and political society in contemporary South Africa
Authors: Finn Brandon M
Published: July 2020

Partha Chatterjee’s work on postcolonial politics articulates the limits of participation and governance in contexts of stark inequality. Chatterjee’s argument can be stretched within the South African context of protest and political contestation as it demonstrates that civil and political societies are fluid, political categories. From student to shack dweller movements, political society in South Africa disrupts top-down, dichotomous notions of ‘administration’ or ‘governance’. I outline that the interactions between Chatterjee’s political and civil society overlap with one another, but importantly, that this overlap determines the broader, shifting continuum of popular sovereignty that these two fields act within. Ordinary ‘populations’ of political society are able to infiltrate the ‘sanitized walls’ of civil society, contexts in which ‘political society’ sometimes draws on the language of rights and institutions such as the courts as well as practices of mobilization and disruption. South African mobilization illustrates the usefulness of engaging with the inequalities of governance via categories of civil and political society, but also shows that these are complicated and contested fields within the country’s political and democratic framework. We cannot understand the notions of either political or civil society without contextualizing these processes within a framework that allows for the shifting continuum, and acknowledgement of the possibility of the existence of popular sovereignty. It is this broader, structural categorization, within which the forces of political and civil society fluidly interact that we need to conceptualize popular sovereignty in Chatterjee’s description of ‘most of the world.’
Magnitude thresholds and spatial footprints of damage from induced earthquakes
Authors: Baird Bridger W , Liel Abbie B , Chase Robert E
Published: July 2020

The rise in the number of anthropogenic small- to moderate-magnitude earthquakes in the central United States raises questions about the damageability of the built environment in such events. This study examines the performance of modern light-frame wood buildings, including single, multifamily, and commercial constructions, in earthquakes with moment magnitudes of 3–6, using dynamic analysis of building models subjected to ground motions recorded in past induced events in North America. We focus on first onset of damage, for example, wallboard or wallpaper cracking, and nails popping out. The results show that earthquakes with magnitudes less than 4–4.25 are unlikely to cause damage to modern constructions. However, moderate-magnitude events can cause damage over a wide geographic area (more than 30 mi from the earthquake epicenter, or 40 or more miles from a wastewater injection well). These results can be used to suggest setback distances between injection wells and certain neighborhoods or facilities, and magnitude thresholds for post-earthquake inspections.
Maternal childbirth experience in induced and spontaneous labour measured in a visual analog scale and the factors influencing it; a two-year cohort study
Authors: Adler Katti , Rahkonen Leena , Kruit Heidi
Published: July 2020

Background

Poor maternal childbirth experience plays a role in family planning and subsequent pregnancies. The aim of this study was to compare childbirth experiences in induced and spontaneous labor and to investigate the factors influencing the childbirth experience.

Methods

This two-year cohort study included all women with term singleton pregnancies in cephalic presentation aiming for vaginal delivery at Helsinki University Hospital between January 2017 and December 2018. Maternal satisfaction in the childbirth experience was measured after delivery using a Visual Analog Scale (VAS) score. A low childbirth experience score was defined as VAS < 5. The characteristics and delivery outcomes of the study population were collected in the hospital database and analyzed by SPSS.

Results

A total of 18,396 deliveries were included in the study, of which 28.9% (n = 5322) were induced and 71.1% (n = 13 074) were of spontaneous onset. The total caesarean delivery rate was 9.3% (n = 1727). Overall, 4.5% (n = 819) of the women had a low childbirth experience VAS score. The women who underwent labor induction were less satisfied with their birth experience compared to women with spontaneous onset of labor [7.5% (n = 399) vs. 3.2% (n = 420); p < 0.001]. Poor childbirth experience was associated with primiparity [OR 2.0 (95% CI 1.6–2.4)], labor induction [OR 1.6 (95% CI 1.4–1.9)], caesarean delivery [OR 4.5 (95% CI 3.7–5.5)], operative vaginal delivery [OR 3.3 (95% CI 2.7-4.0)], post-partum hemorrhage [OR 1.3 (95% CI 1.1–1.6)], and maternal infections [OR 1.7 (95% CI 1.3–2.4)].

Conclusions

Poor childbirth experience was associated with labor induction, primiparity, operative delivery, and labor complications, such as post-partum hemorrhage and maternal infections. These results highlight the aspects of care for which patient experience may be improved by additional support and counselling.
Exploring the attitudes of health science students in Spain and Bolivia towards death. A cross sectional survey
Authors: Pérez- de la Cruz Sagrario , Ramírez Ivonne
Published: July 2020

Background

One of the most difficult and stressful tasks faced by health science students is having to cope with death and dying due to the emotional burden of the same. Furthermore, the moral, ethical and professional values of future health professionals are influenced by the cultures where they live.

Purpose

This study sought to compare and analyze the perception on end of life among a sample of health science students in Spain and Bolivia.

Methods

A descriptive, cross-sectional and multi-centric study. The total sample (548 students) was comprised of three groups: medical, nursing and physiotherapy students, of whom 245 were from Bolivia, and 303 were Spanish students. The measurement instruments used were the Bugen’s Coping with Death Scale and the Death Self-Efficacy Scale by Robbins.

Results

No statistically significant differences were observed between Spanish and Bolivian students (t (546) = − 0.248, p = 0.804) using the Bugen scale. This implies that there are no differences between the perception of both groups of students and that both groups use similar strategies to cope with death. Additionally, the beliefs and attitudes of both groups were similar, with Bolivian students presenting a trend towards improved scores. No differences were found between Spain and Bolivia in the results obtained on the Robbins scale, with students from both countries displaying similar skills and capabilities for facing death.

Conclusions

The beliefs on death of health science students from Spain and Bolivia were not affected by the respective cultures, type of degree studied, students’ age, or the country of origin, however, we found that students in Bolivia value death as something more natural than their Spanish counterparts.

Practice implications

To appropriately prepare students for this topic, education on coping with death and dying must be included within the university curriculum.

Trial registration

2016DEC018.