bluuebunny/crossref_metadata_2025 huggingface dataset:
QRS Fragmentation and Sudden Cardiac Death in the Obese and Overweight
Authors: Narayanan Kumar , Zhang Lin , Kim Candice , Uy‐Evanado Audrey , Teodorescu Carmen , Reinier Kyndaron , Zheng Zhi‐Jie , Gunson Karen , Jui Jonathan , Chugh Sumeet S.
Published: March 2015

Background

Obesity has been associated with significantly greater risk of sudden cardiac death (
SCD
); however, identifying the obese patient at highest risk remains a challenge. We evaluated the association between
QRS
fragmentation on the 12‐lead electrocardiogram and
SCD
, in obese/overweight subjects.

Methods and Results

In the ongoing prospective, community‐based Oregon Sudden Unexpected Death Study (population approximately 1 million), we performed a case‐control analysis, comparing obese/overweight
SCD
victims with obese/overweight controls from the same geographic region. Archived
ECG
s prior and unrelated to the
SCD
event were used for cases and all
ECG
measurements were assessed in blinded fashion. Fragmentation was defined as the presence of
RSR
’ patterns and/or notching of the R/S wave in at least 2 contiguous leads. Analysis was limited to
ECG
s with
QRS
duration <120 ms. Overall prevalence of fragmentation was higher in cases (n=185; 64.9±13.8 years; 67.0% male) compared with controls (n=405; 64.9±11.0 years; 64.7% male) (34.6% versus 26.9%,
P
=0.06). Lateral fragmentation was significantly more frequent in cases (8.1% versus 2.5%;
P
<0. 01), with non‐significant differences in anterior and inferior territories. Fragmentation in multiple territories (≥2) was also more likely to be observed in cases (9.7% versus 4.9%,
P
=0.02). In multivariable analysis with consideration of established
SCD
risk factors, lateral fragmentation was significantly associated with
SCD
(
OR
2.84; 95%
CI
1.01 to 8.02;
P
=0.05).

Conclusion

QRS
fragmentation, especially in the lateral territory is a potential risk marker for
SCD
independent of the ejection fraction, among obese/overweight subjects in the general population.
Modernity and Its Doubles: Uncanny Spaces of Postwar Japan
Authors: Adriasola Ignacio
Published: March 2015

Screening the Japanese Gothic

Actress M stands on a platform placed on the desks in a large auditorium, surrounded by students who stare despondently at her. She turns, seeking the camera over her shoulder; she pushes her white dress down as a fan makes it swell and rise above her knees. Dwarfed by the auditorium's heavy pointed arches, Actress M's pale, overexposed figure flickers like a photographic ghost. She has become Marilyn Monroe.
Portraiture and the Ethics of Alterity: Giacometti vis-à-vis Levinas
Authors: Costello Leo
Published: March 2015

One of the primary critical investigations around the work of Alberto Giacometti has been his experience of a crisis in representation: the anguished realization of his inability to re-create his perceptions. Indeed, while this crisis came to the fore at various times in his life, it forms the hinge on which his career is taken to turn, because it marked his rejection of the principles of Surrealism. As the oft-repeated story goes, when André Breton heard that Giacometti had returned to study from live models, he scoffed, saying, “Everyone knows what a head looks like.” Breton was right to sense the chasm that separated him from Giacometti, but the latter's reply, that “no one has ever really looked at a face before,” suggests that Breton had failed to grasp the nature of the divide. Giacometti's return to study from life was precipitated by a profound sense of doubt about the most apparently basic artistic transaction, that of looking carefully and representing what he has seen. This skepticism about the very possibility of representation, which was nonetheless coupled with an abiding sense of purpose about the importance of attempting it, was central to Giacometti's approach to the figure. Giacometti knew well that artists before him, Cézanne and Picasso in particular, had shared a similar mix of compulsion and suspicion about representation. Giacometti, however, seems not only to have understood the extent of that dilemma to a degree that his predecessors had not, but to have been compelled by it. In short, the more that doubt seemed to fill Giacometti in the face of the Other, the more urgent the task of trying to represent it became.
Inscription and Castration in Picasso's The Painter and His Model, 1927
Authors: Melius Jeremy
Published: March 2015

In the spring of 1927, Picasso produced a large painting known as The Painter and His Model, now in Tehran. Perhaps because of its current location, the work has, until recently, gone largely unremarked in the literature on the artist. Nonetheless, it stands as his most arresting single canv as of the late 1920s—perhaps the strangest period of the artist's production—and indeed as one of the supreme achievements of his career. In ways we have yet to grasp fully, the late ′20s marked a crucial turning point for Picasso: a moment of crisis, which seemed to require a tot al reexamination of his means. Over the course of 1927 in part icular, his work took on a troubled, almost desperate air as Picasso reengaged wit h Cubism's most difficult lessons, and const ant ly courted—at times even willed—aesthet ic failure. At no t ime had the art ist worked against himself with such intensit y, or with such bewildering results.
Design Choices and Their Implications for 3D Mid-Air Manipulation Techniques
Authors: Bossavit Benoît , Marzo Asier , Ardaiz Oscar , De Cerio Luis Diaz , Pina Alfredo
Published: March 2015

Manipulation is one of the most important tasks required in virtual environments and thus it has been thoroughly studied for widespread input devices such as mice or multi-touch screens. Nowadays, the Kinect sensor has turned mid-air interaction into another affordable and popular way of interacting. Mid-air interaction enables the possibility of interacting remotely without any physical contact and in a more natural manner. Nonetheless, although some scattered manipulation techniques have been proposed for mid-air interaction, there is a lack of evaluations and comparisons that hinders the selection and development of these techniques. To solve this issue, we gathered four design choices that can be used to classify mid-air manipulation techniques. Namely, choices are based on the required number of hands, separation of translation–rotation, decomposition of rotation, and interaction metaphors. Furthermore, we developed, adapted, and compared three manipulation techniques selected for studying the implications of the design choices. These implications are useful to select among already existing techniques as well as to inform technique developers.
Do 3D Moviegoers Enjoy Screenings More than 2D Moviegoers?—On the Impact of 3D Fantasy Movie Perception on Enjoyment
Authors: Sobieraj Sabrina , Krämer Nicole C.
Published: March 2015

As 3D movie screenings have recently seen an increase in popularity, it would appear that 3D is finally ready to stand the test of time. To examine the effect of 3D on the experience of enjoyment, we refer to the model of entertainment by Vorderer, Klimmt, and Ritterfeld (2004), according to which both technological and personal prerequisites can induce enjoyment. The model was further adapted for the cinema context by including the appeal of special effects, fanship, age, and gender. To ascertain the impact of the suggested prerequisites, we conducted a field study comparing the enjoyment experiences of 2D and 3D audiences watching the same fantasy movies in a between-subjects design (N = 289). Results showed that the technological features of stereoscopic 3D cannot predict enjoyment. However, the feeling of presence, the appeal of the special effects, and fanship are predictors of enjoyment.
A Constructional-Cognitive Analysis of Chinese Directionals
Authors: Fong Ronald
Published: March 2015

This paper investigates the syntactic and semantic behaviour of directional items in Mandarin Chinese, proposing a constructional-cognitive model. Simultaneously, it argues against the traditional analysis of directionals as part of a compound. Instead, they are treated as proper larger constructions signaling subordination, based upon structural and functional evidence. Particularly, the verbs of motion are presented as catenative verbs (Aarts 2011, Huddleston and Pullum et al 2002) similar to those found in English, showing event complexity (eg Jackendoff 2002, Levin and Rappaport Hovav 2005). The two events then constitute mental spaces at the conceptual structure (Fauconnier 1994, 1997) and project into the entire motion-directional construction, which reflects the mappings of language and thought.
Cognitive Linguistics in the Year 2015
Authors: Janda Laura A.
Published: March 2015

Cognitive linguistics views linguistic cognition as indistinguishable from general cognition and thus seeks explanation of linguistic phenomena in terms of general cognitive strategies, such as metaphor, metonymy, and blending. Grammar and lexicon are viewed as parts of a single continuum and thus expected to be subject to the same cognitive strategies. Significant developments within cognitive linguistics in the past two decades include construction grammar and the application of quantitative methods to analyses.
Paradoxes of Social Policy
Authors: Brady David , Bostic Amie
Published: March 2015

Korpi and Palme’s (1998) classic “The Paradox of Redistribution and Strategies of Equality” claims that universal social policy better reduces poverty than social policies targeted at the poor. This article revisits Korpi and Palme’s classic, and in the process, explores and informs a set of enduring questions about social policy, politics, and social equality. Specifically, we investigate the relationships between three dimensions of welfare transfers—transfer share (the average share of household income from welfare transfers), low-income targeting, and universalism—and poverty and preferences for redistribution. We analyze rich democracies like Korpi and Palme, but we also generalize to a broader sample of developed and developing countries. Consistent with Korpi and Palme, we show (1) poverty is negatively associated with transfer share and universalism; (2) redistribution preferences are negatively associated with low-income targeting; and (3) universalism is positively associated with transfer share. Contrary to Korpi and Palme, redistribution preferences are not related to transfer share or universalism; and low-income targeting is neither positively associated with poverty nor negatively associated with transfer share. Therefore, instead of the “paradox of redistribution” we propose two new paradoxes of social policy: non-complementarity and undermining. The non-complementarity paradox entails a mismatch between the dimensions that matter to poverty and the dimension that matters to redistribution preferences. The undermining paradox emphasizes that the dimension (transfer share) that most reduces poverty tends to increase with the one dimension (low-income targeting) that reduces support for redistribution.
The Dynamics of Opportunity and Insurgent Practice
Authors: Bloom Joshua
Published: March 2015

Political opportunity theory has proven extremely generative, highlighting the importance of macro-structural shifts in making established authorities vulnerable to insurgent challenge. But as critics point out, political opportunity theory flattens both culture and agency, and has fared poorly in explaining the timing of insurgency. Re-theorizing opportunity as leveraged by particular practices, rather than independently conferring to groups, redresses these limits, revealing the proximate causes of mobilization and influence. For a strategic test, this article revisits the forging ground of opportunity theory. Why did President Harry S. Truman, initially an apologist for the slow pace of racial reform in 1945–46, suddenly become an avid advocate of civil rights? Opportunity scholars argue that macro-structural forces caused Truman to advocate civil rights, generating the opportunity for insurgency by blacks as a group. But event structure analysis reveals how Black Anti-colonialist practices leveraged opportunities afforded by the earlier Progressive Challenge to compel Truman to adopt civil rights advocacy. Civil rights advocacy, in turn, allowed Truman to repress Black Anti-colonialist practices, even while setting the stage for the Civil Rights Movement to come. Different forms of insurgent practice leveraged opportunities created by different institutional cleavages; the same opportunities did not advantage all insurgency by a social group.
Separate paths, same direction? De-standardization of male employment biographies in East and West Germany
Authors: Simonson Julia , Gordo Laura Romeu , Kelle Nadiya
Published: March 2015

Until the mid-1980s, labour markets in Germany were characterized by a high level of employment stability. Employment biographies of men were dominated by full-time employment in both East and West Germany and were hence quite similar in this respect, despite the two regions’ enormously different institutional settings. Since that time however, important changes have occurred. Labour markets have become more flexible, as have employment biographies. However, the process towards de-standardization and increased discontinuity in employment biographies began in East Germany later than it did in the West. East German change started namely in 1990, when the German Democratic Republic was incorporated into the Federal Republic of Germany. This study uses the German Socio-Economic Panel (SOEP) to analyse how men’s employment patterns in Germany have changed over three different birth cohorts. Through the use of sequence analysis the authors not only observe an increase of non-standard episodes in such biographies, such as unemployment and part-time work, but also investigate whether employment biographies have on the whole become more discontinuous in nature. In addition, the authors analyse the main differences in trends observed in East as opposed to West Germany as a result of differing societal and economic changes. The results of this analysis show evidence of de-standardization in employment in both regions. However, this trend follows a separate path in each region, with the process being faster in East Germany than in the West.
Mesenchymal Dental Pulp Cells Attenuate Dentin Resorption in Homeostasis
Authors: Zheng Y. , Chen M. , He L. , Marão H.F. , Sun D.M. , Zhou J. , Kim S.G. , Song S. , Wang S.L. , Mao J.J.
Published: March 2015

Dentin in permanent teeth rarely undergoes resorption in development, homeostasis, or aging, in contrast to bone that undergoes periodic resorption/remodeling. The authors hypothesized that cells in the mesenchymal compartment of dental pulp attenuate osteoclastogenesis. Mononucleated and adherent cells from donor-matched rat dental pulp (dental pulp cells [DPCs]) and alveolar bone (alveolar bone cells [ABCs]) were isolated and separately cocultured with primary rat splenocytes. Primary splenocytes readily aggregated and formed osteoclast-like cells in chemically defined osteoclastogenesis medium with 20 ng/mL of macrophage colony-stimulating factor (M-CSF) and 50 ng/mL of receptor activator of nuclear factor κB ligand (RANKL). Strikingly, DPCs attenuated osteoclastogenesis when cocultured with primary splenocytes, whereas ABCs slightly but significantly promoted osteoclastogenesis. DPCs yielded ~20-fold lower RANKL expression but >2-fold higher osteoprotegerin (OPG) expression than donor-matched ABCs, yielding a RANKL/OPG ratio of 41:1 (ABCs:DPCs). Vitamin D3 significantly promoted RANKL expression in ABCs and OPG in DPCs. In vivo, rat maxillary incisors were atraumatically extracted (without any tooth fractures), followed by retrograde pulpectomy to remove DPCs and immediate replantation into the extraction sockets to allow repopulation of the surgically treated root canal with periodontal and alveolar bone–derived cells. After 8 wk, multiple dentin/root resorption lacunae were present in root dentin with robust RANKL and OPG expression. There were areas of dentin resoprtion alternating with areas of osteodentin formation in root dentin surface in the observed 8 wk. These findings suggest that DPCs of the mesenchymal compartment have an innate ability to attenuate osteoclastogenesis and that this innate ability may be responsible for the absence of dentin resorption in homeostasis. Mesenchymal attenuation of dentin resorption may have implications in internal resorption in the root canal, pulp/dentin regeneration, and root resorption in orthodontic tooth movement.
Construction of a garment for an integrated liquid cooling system
Authors: Bartkowiak Grażyna , Dąbrowska Anna , Włodarczyk Bogdan
Published: March 2015

The problem of a hot microclimate in the workplace, leading to an almost constant thermal strain, concerns people employed worldwide in such sectors as the metallurgical, mining, and glass industries. Additional strain is caused by the protective clothing worn, which is usually made of aluminized fabrics impermeable to water vapor. Publications reporting hazards resulting from the prolonged exposure of workers to a hot microclimate emphasize that it is necessary to eliminate or decrease heat accumulation in the human body. This paper presents the steps involved in the design of a liquid cooling garment (LCG) reducing the thermal discomfort experienced by workers exposed to hot environments, in which impermeable aluminized protective clothing, preventing sweat evaporation, must be worn. The construction of the new LCG is based on a specially developed knitted spacer fabric with a channel structure in which a tube system distributing cooling liquid is placed.
Measuring textile adsorption of body odor compounds using proton-transfer-reaction mass spectrometry
Authors: Yao Lei , Laing Raechel M , Bremer Philip J , Silcock Patrick J , Leus Michelle J
Published: March 2015

This paper describes a method for determining the differential adsorption of body odor compounds by three types of yarn/fiber (cotton, polyester, wool) using proton-transfer-reaction mass spectrometry (PTR-MS). Each type exhibited different adsorption profiles. Decanal and cyclohexanone adsorbed more to wool than to either cotton or polyester. Ethylbenzene and butanoic acid methyl ester adsorbed more to polyester than to either cotton or wool. Cotton was a weaker adsorbent than polyester and wool for all odor compounds tested. Phenol was adsorbed highly by all three yarns. The study validated the use of PTR-MS to assess the adsorption of volatile compounds by textile fibers/yarns, and demonstrated its potential to be used as a rapid means of assessing the kinetics of odor adsorption and release by existing and modified materials.
Ballistic armor for special applications
Authors: Madej-Kiełbik Longina , Błaszczyk Wojciech , Osiewała-Just Lidia , Łandwijt Marcin , Struszczyk Marcin H , Kucińska-Król Iwona
Published: March 2015

The goal of this study was to build upon the composite, ballistic armor used for special applications. These armors are intended for protecting some of the most critical elements of vessels, called “cabling,” that are wires that act as the conductors for information or electricity. They are based on specially compressed ultra-high molecular weight polyethylene fibrous materials. Considering the shape of the cables, which is specific to each ship, the armors were made as two variants that differed in both the profile and the structure of the composite. To protect them from the destructive impact of the marine environment, their external surfaces were covered with a special polymeric protective coat. The ballistic tests confirmed the presumed ballistic properties of the armors.
Can Non-full-probability Internet Surveys Yield Useful Data? A Comparison with Full-probability Face-to-face Surveys in the Domain of Race and Social Inequality Attitudes
Authors: Simmons Alicia D. , Bobo Lawrence D.
Published: March 2015

The authors investigate the potential utility of Web-based surveys of non-full-probabilistically sampled respondents for social science research. Specifically, they compare demographic, attitude response, and multivariate model results produced by two distinct survey modalities: the traditional full-probability sample face-to-face survey and the non-full-probability Web survey. Using data from the 2009 Race Cues, Attitudes, and Punitiveness Survey (RCAPS), the 2008 General Social Survey (GSS), and the 2008 American National Election Study (ANES), the authors find that (1) the unweighted demographic differences between surveys tend to be slight; (2) in comparison with GSS and ANES respondents, RCAPS respondents are more interested in politics and ideologically polarized; (3) in comparison with ANES respondents, RCAPS respondents are more racially and socially conservative, often selecting the most extreme response option; (4) when the dependent variable is a more general and abstract measure of social attitudes, the multivariate models generated by the ANES and RCAPS show several differences that are trivial in magnitude, but when the dependent variable is a more specific and concrete measure, the models show remarkable similarity; and (5) RCAPS multivariate models consistently explain more variance than ANES models. Overall, these findings show both substantial similarities across the two survey modalities as well as a few clear, reasonably well-specified differences.
South African clinical psychology’s response to cultural diversity, globalisation and multiculturalism: a review
Authors: Johnston Emma R
Published: March 2015

This article reviews responses of South African clinical psychologists to multicultural issues within an increasingly diverse and globalised context. Psychological perspectives on diversity, multiculturalism, and globalisation are presented initially as background to a review of multicultural and cross-cultural clinical psychological research conducted within the South African context. The discussion is located within the context of South African psychologists’ historical response to multicultural issues, within a unique socio-political situation. Implications for ongoing development of relevant clinical psychology services to address the diverse needs of all sectors of South African society are also discussed.
Control strategy for four-wheel independent drive electric vehicles under failure of motor drive systems
Authors: Xin Xiaoshuai , Zheng Hangen , Xu Hongbing , Qin Gang
Published: March 2015

Four-wheel independent drive electric vehicle cannot follow the driver’s command when one or more motor drive systems fail, which may lead to some serious accidents when the vehicle is running. In order to deal with this problem, a control strategy is proposed in this paper to maintain the stability of 4WID electric vehicle under the failure of motor drive systems. Firstly, failure states of motor drive systems are analysed and classified into Failure-Driving mode and Failure-Stopping mode according to the ability of the vehicle to drive safely. Secondly, a two-layer-control model is designed to maintain the vehicle performance and stability by controlling the remaining normal working motor drive systems for Failure-Driving mode. Thirdly, a control algorithm is designed to help the driver stop the vehicle safely in Failure-Stopping mode. Simulation based on Matlab/Simulink and veDYNA demonstrate that the proposed control strategy can maintain the stability of the 4WID electric vehicle in both Failure-Driving mode and Failure-Stopping mode.
Application of Eshelby’s Solution to Elastography for Diagnosis of Breast Cancer
Authors: Shin Bonghun , Gopaul Darindra , Fienberg Samantha , Kwon Hyock Ju
Published: March 2015

Eshelby’s solution is the analytical method that can derive the elastic field within and around an ellipsoidal inclusion embedded in a matrix. Since breast tumor can be regarded as an elastic inclusion with different elastic properties from those of surrounding matrix when the deformation is small, we applied Eshelby’s solution to predict the stress and strain fields in the breast containing a suspicious lesion. The results were used to investigate the effectiveness of strain ratio (SR) from elastography in representing modulus ratio (MR) that may be the meaningful indicator of the malignancy of the lesion. This study showed that SR significantly underestimates MR and is varied with the shape and the modulus of the lesion. Based on the results from Eshelby’s solution and finite element analysis (FEA), we proposed a surface regression model as a polynomial function that can predict the MR of the lesion to the matrix. The model has been applied to gelatin-based phantoms and clinical ultrasound images of human breasts containing different types of lesions. The results suggest the potential of the proposed method to improve the diagnostic performance of breast cancer using elastography.
Democracies in the plural
Authors: Ferrara Alessandro
Published: March 2015

This article aims at exploring one specific facet of pluralism: How can we conceive of a variety of democratic cultures that are not just local adaptations of one basic western-centric understanding of the democratic ethos? Drawing on Islamic, Jewish, Hindu, Buddhist and Confucian sources, a convergence among diverse democratic cultures is cursorily highlighted on such elements as the priority of the common good, the acceptance of pluralism, the desirability of collegial deliberation, the equality of citizens, and the value of individuality. Then two important points of dissonance are analysed in greater detail – (1) the idea of the priority of rights over duties and (2) the role of political conflict within a democratic polity – and shown not to be correlative with a divide between western and non-western contexts. Finally a typology of 4 kinds of democratic cultures is outlined.
The Importance of Love as a Basis of Marriage
Authors: Sprecher Susan , Hatfield Elaine
Published: March 2015

This study extended prior research on attitudes about the importance of love as a basis for marriage. With data from a sample of 4,245 college students, obtained over a 16-year period, we found that both men and women, but women to a slightly greater degree than men, rated love as important for entering marriage. Over the 16-year period of the study, the importance of love as a prerequisite for marriage decreased slightly for men. Other individual difference variables (beyond gender) that were found to be associated positively with viewing love as an important basis for marriage included being White (vs. Black), high self-esteem, restrictedness in sociosexuality (true for women only), and a secure attachment style. Participants were more undecided or ambivalent about whether love is necessary to maintain a marriage. The importance of love for maintaining marriage was rated slightly higher by women (than by men), less religious participants, those whose parents had divorced, and those who were unrestricted in their sociosexuality; this belief was not found to change over time.
Cultural Variation in Reports of Subjective Experience of Parent–Child Boundary Dissolution Among Emerging Adults
Authors: Jackson Ellen F. , Raval Vaishali V. , Bendikas-King Emily A. , Raval Pratiksha H. , Trivedi Shwetang S.
Published: March 2015

Parent–child boundary dissolution, the loss of psychological distinctiveness between parents and their children, has been linked with maladaptive child functioning in White middle-class groups in Western cultures, though cross-cultural findings are mixed. To further explore this variation, we used mixed methods to compare college students’ reports of frequency and subjective experience of parent beliefs and behaviors indicative of various types of parent–child boundary dissolution in India ( n = 110) and the United States ( n = 250). Internal reliability estimates were lower in the Indian sample, particularly for infantilization and role reversal. College students in India reported parent beliefs and behaviors considered to be indicative of enmeshment and role reversal in Western family psychology literature more frequently and perceived them more positively than U.S. participants, while no difference was found for psychological control and spousification. Overall, the findings question the cultural relevance of some dimensions of boundary dissolution in India.
Use of nasal fentanyl for cancer pain: A pharmacoepidemiological study
Authors: Fredheim Olav Magnus S , Mahic Milada , Skurtveit Svetlana , Borchgrevink Petter C
Published: March 2015

Background:

Breakthrough pain affects 40%–90% of patients with cancer pain. Nasal fentanyl is one of the recommended treatments, particularly if the breakthrough pain is of rapid onset.

Aim:

To investigate the prevalence of use of nasal fentanyl, to study which strong opioids have been used prior to nasal fentanyl and to examine which opioids are used concomitantly with nasal fentanyl.

Design:

Longitudinal cohort study based on death cohorts defined according to year of death.

Setting/participants:

The study is based on data from the complete national Norwegian Prescription Database. The study population included all persons in Norway who died in the years 2010, 2011 and 2012 and who had received nasal fentanyl with reimbursement for palliative treatment.

Results:

Of those who died from cancer in 2010, 2011 and 2012, 611 persons (2%) received dispensed prescriptions of nasal fentanyl. Two-thirds had received other short-acting strong opioids before nasal fentanyl. One quarter did not receive a long-acting opioid concomitantly with nasal fentanyl, but 68% of these received only one dispensed prescription of nasal fentanyl. Of those who received a long-acting opioid together with nasal fentanyl, transdermal fentanyl was the most common drug (65%). One-third received another short-acting opioid concomitantly with nasal fentanyl.

Conclusion:

The use of nasal fentanyl was surprisingly low. There is a need for clinical research addressing the use of nasal fentanyl without a long-acting opioid for background pain and the use of nasal fentanyl together with another short-acting opioid.
Perspectives on the role of the speech and language therapist in palliative care: An international survey
Authors: O’Reilly Aoife C , Walshe Margaret
Published: March 2015

Background:

Speech and language therapists can improve the quality of life of people receiving palliative care through the management of communication and swallowing difficulties (dysphagia). However, their role in this domain is poorly defined and little is understood about the current international professional practice in this field.

Aims:

To examine how speech and language therapists perceive their role in the delivery of palliative care to clients, to discover current international speech and language therapist practices and to explore the similarities and differences in speech and language therapists’ practice in palliative care internationally. This will inform professional clinical guidelines and practice in this area.

Design:

Anonymous, non-experimental, cross-sectional survey design.

Participants:

Speech and language therapists working with adult and paediatric palliative care populations in Republic of Ireland, United Kingdom, United States, Canada, Australia and New Zealand where the speech and language therapist profession is well established.

Method:

Purposive and snowball sampling were used to recruit participants internationally using gatekeepers. An online survey was disseminated using Survey Monkey ( http://www.surveymonkey.com ).

Results:

A total of 322 speech and language therapists responded to the survey. Speech and language therapist practices in palliative care were similar across continents. Current speech and language therapist practices along with barriers and facilitators to practice were identified. The need for a speech and language therapist professional position paper on this topic was emphasised by respondents.

Conclusion:

Internationally, speech and language therapists believe they have a role in palliative care. The speech and language therapist respondents highlighted that this area of practice is under-resourced, under-acknowledged and poorly developed. They highlighted the need for additional research as well as specialist training and education for speech and language therapists and other multidisciplinary team members in the area of palliative care.
Chronically homeless persons’ participation in an advance directive intervention: A cohort study
Authors: Leung Alexander K , Nayyar Dhruv , Sachdeva Manisha , Song John , Hwang Stephen W
Published: March 2015

Background:

Chronically homeless individuals have high rates of hospitalization and death, and they may benefit from the completion of advance directives.

Aim:

To determine the rate of advance directive completion using a counselor-guided intervention, identify characteristics associated with advance directive completion, and describe end-of-life care preferences in a group of chronically homeless individuals.

Design:

Participants completed a survey and were offered an opportunity to complete an advance directive with a trained counselor.

Participants:

A total of 205 residents of a shelter in Canada for homeless men (89.1% of those approached) participated from April to June 2013.

Results:

Duration of homelessness was ⩾12 months in 72.8% of participants, and 103 participants (50.2%) chose to complete an advance directive. Socio-demographic characteristics, health status, and health care use were not associated with completion of an advance directive. Participants were more likely to complete an advance directive if they reported thinking about death on a daily basis, believed that thinking about their friends and family was important, or reported knowing their wishes for end-of-life care but not having told anyone about these wishes. Among individuals who completed an advance directive, 61.2% named a substitute decision maker, and 94.1% expressed a preference to receive cardiopulmonary resuscitation in the event of a cardiorespiratory arrest if there was a chance of returning to their current state of health.

Conclusion:

A counselor-guided intervention can achieve a high rate of advance directive completion among chronically homeless persons. Most participants expressed a preference to receive cardiopulmonary resuscitation in the event of a cardiorespiratory arrest.
Experiences of burden, needs, rewards and resilience in family caregivers of people living with Motor Neurone Disease/Amyotrophic Lateral Sclerosis: A secondary thematic analysis of qualitative interviews
Authors: Weisser Fabia B , Bristowe Katherine , Jackson Diana
Published: March 2015

Background:

Family caregivers of people with Motor Neurone Disease/Amyotrophic Lateral Sclerosis, an incurable, mostly rapidly fatal neurodegenerative disease, face many challenges. Although there is considerable research on caregiver burden in Motor Neurone Disease/Amyotrophic Lateral Sclerosis, there is less knowledge of the positive aspects of caring.

Objective:

To explore the experiences of family caregivers of people with Motor Neurone Disease/Amyotrophic Lateral Sclerosis, specifically the relationship between positive and negative experiences of caring, and to identify possible ways to better support these caregivers.

Methods:

Secondary thematic analysis of 24 semi-structured qualitative interviews conducted longitudinally with 10 family caregivers. Interviews explored rewarding and unrewarding aspects of caring.

Results:

Themes emerged around burden, needs, rewards and resilience. Resilience included getting active, retaining perspective and living for the moment. Burden was multifaceted, including social burden, responsibility, advocacy, ambivalence, guilt and struggling with acceptance. Rewards included being helped and ‘ticking along’. Needs were multifaceted, including social, practical and psychological needs. The four main themes were interrelated. A model of coping was developed, integrating resilience (active/positive), burden (active/negative), needs (passive/negative) and reward (passive/positive).

Conclusion:

Burden, resilience, needs and rewards are interrelated. Caregivers’ ability to cope with caring for a person with Motor Neurone Disease/Amyotrophic Lateral Sclerosis oscillates between positive and negative aspects of caring, being at times active, at times passive.

Clinical implications:

Coping is a non-linear process, oscillating between different states of mind. The proposed model could enable clinicians to better understand the caregiver experience, help family caregivers foster resilience and identify rewards, and develop appropriate individualised caregiver support plans.
The role of distress intolerance for panic and nicotine withdrawal symptoms during a biological challenge
Authors: Farris Samantha G , Zvolensky Michael J , Otto Michael W , Leyro Teresa M
Published: March 2015

Background:

Distress intolerance is linked to the maintenance of panic disorder and cigarette smoking, and may underlie both problems.

Method:

Smokers ( n = 54; 40.7% panic disorder) were recruited for an experimental study; half were randomly assigned to 12-hour nicotine deprivation and half smoked as usual. The current investigation consisted of secondary, exploratory analyses from this larger experimental study. Four distress intolerance indices were examined as predictors of anxious responding to an emotional elicitation task (10% carbon dioxide (CO2)-enriched air challenge); anxious responding was in turn examined as a predictor of post-challenge panic and nicotine withdrawal symptoms.

Results:

The Distress Tolerance Scale (DTS) was significantly negatively associated with anxious responding to the challenge ( β = −0.41, p = 0.017). The DTS was negatively associated with post-challenge increases nicotine withdrawal symptoms indirectly through the effect of anxious responding to the challenge (b = −0.485, CI95% (–1.095, –0.033)). This same indirect effect was found for post-challenge severity of panic symptoms (b = −0.515, CI95% (–0.888, –0.208)). The DTS was directly predictive of post-challenge increases nicotine withdrawal symptoms, in the opposite direction ( β = 0.37, p = 0.009), but not panic symptom severity.

Conclusions:

Anxious responding in response to stressful experiences may explain the impact of perceived distress intolerance on panic and nicotine withdrawal symptom expression.
Characteristics of airborne micro-organisms in a neurological intensive care unit: Results from China
Authors: Yu Yao , Yin Sufeng , Kuan Yi , Xu Yingjun , Gao Xuguang
Published: March 2015

Objective

To describe the characteristics of airborne micro-organisms in the environment in a Chinese neurological intensive care unit (NICU).

Methods

This prospective study monitored the air environment in two wards (large and small) of an NICU in a tertiary hospital in China for 12 months, using an LWC-1 centrifugal air sampler. Airborne micro-organisms were identified using standard microbiology techniques.

Results

The mean ± SD number of airborne bacteria was significantly higher in the large ward than in the small ward (200 ± 51 colony-forming units [CFU]/m3 versus 110 ± 40 CFU/m3, respectively). In the large ward only, the mean number of airborne bacteria in the autumn was significantly higher than in any of the other three seasons. A total of 279 airborne micro-organisms were identified (large ward: 195; small ward: 84). There was no significant difference in the type and distribution of airborne micro-organisms between the large and small wards. The majority of airborne micro-organisms were Gram-positive cocci in both wards.

Conclusion

These findings suggest that the number of airborne micro-organisms was related to the number of patients on the NICU ward.
A World without Causation: Big Data and the Coming of Age of Posthumanism
Authors: Chandler David
Published: March 2015

Advocates of Big Data assert that we are in the midst of an epistemological revolution, promising the displacement of the modernist methodological hegemony of causal analysis and theory generation. It is alleged that the growing ‘deluge’ of digitally generated data, and the development of computational algorithms to analyse them, has enabled new inductive ways of accessing everyday relational interactions through their ‘datafication’. This article critically engages with these discourses of Big Data and complexity, particularly as they operate in the discipline of International Relations, where it is alleged that Big Data approaches have the potential for developing self-governing societal capacities for resilience and adaptation through the real-time reflexive awareness and management of risks and problems as they arise. The epistemological and ontological assumptions underpinning Big Data are then analysed to suggest that critical and posthumanist approaches have come of age through these discourses, enabling process-based and relational understandings to be translated into policy and governance practices. The article thus raises some questions for the development of critical approaches to new posthuman forms of governance and knowledge production.
International Studies Must Be a Social Science: A Friendly Quarrel with PTJ
Authors: Neumann Iver B.
Published: March 2015

Contra Jackson, I am sceptical of splitting the category of phronesis into aesthetic and normative knowledge, for it invites a Kantian understanding of aesthetics as an exercise in detachment. I see scientific disciplines as genres held together by mutual disciplining, which means that they share a certain style. It is hard for me to see how systematic knowledge may emerge without there being some kind of generalisable intent in play. The scholarly ethos focuses on exactly this element of knowledge production. Sociology and ethics conspire to maintain science’s monopoly on systematic knowledge production.
Sustainability and shared smart and mutual – green growth (SSaM-GG) in Korean medical waste management
Authors: Koo Ja-Kong , Jeong Seung-Ik
Published: March 2015

Since medical insurance was introduced in the Republic of Korea, there have been several increases concerning medical waste. In order to solve these problems, we have applied life cycle assessment and life cycle cost. But these methods cannot be a perfect decision-making tool because they can only evaluate environmental and economic burdens. Thus, as one of many practical methods the shared smart and mutual – green growth considers economic growth, environmental protection, social justice, science technology and art, and mutual voluntarism when applied to medical waste management in the Republic of Korea. Four systems were considered: incineration, incineration with heat recovery, steam sterilisation, and microwave disinfection. This research study aimed to assess pollutant emissions from treatment, transport, and disposal. Global warming potential, photochemical oxidant creation potential, acidifications potential, and human toxicity are considered to be environmental impacts. Total investment cost, transport cost, operation, and maintenance cost for the medical waste are considered in the economy evaluations though life cycle cost. The social development, science technology and art, and mutual voluntarism are analysed through the Delphi-method conducted by expert groups related to medical waste. The result is that incineration with heat recovery is the best solution. However, when heat recovery is impossible, incineration without heat recovery becomes the next best choice. That is why 95% of medical waste is currently treated by both incineration and incineration with heat recovery within the Republic of Korea.
Solid waste management scenarios for Cetinje in Montenegro
Authors: Yetis Ulku , Jakobsen Jens Bjørn , Dilek Filiz B , Kıyık Enver , Mugoša Sanja , Novović Jadranka , Kerestecioglu Merih
Published: March 2015

This study presents the options for source-segregation and selective collection of recyclable waste fractions for Cetinje, Montenegro, with the aim of meeting the European Union 50% waste recycling target in 2023, and extending collection and disposal system that builds on the existing strengths of the city. To this end, three options were considered: (1) source separation and separate collection of dry recyclable materials and central sorting of residual waste; (2) source separation and collection of co-mingled dry recyclable materials, and central sorting in a clean material recovery facility of comingled recyclables and central sorting of residual waste; (3) collection of mixed waste (current situation) and subsequent central sorting. Scenarios 1 and 2 were found to meet the European Union 50% recycling target in 2023, provided that a fast implementation of the new separate collection schemes to fine sort the co-mingled collected recyclable materials is available. Finally, a financial evaluation was made for the options and the investment and operational costs over a 20-year period were estimated. Unit costs for Scenario 3 were found to be lower than for Scenario 1 and 2. As Scenario 3 will not meet the future European Union recycling targets, Scenario 2 has been pointed as the most feasible scenario for Cetinje, with reference to the expected lower total costs compared with Scenario 1.
Outcome After Therapeutic Hypothermia in Term Neonates With Encephalopathy and a Syndromic Diagnosis
Authors: Mrelashvili Anna , Bonifacio Sonia L. , Rogers Elizabeth E. , Shimotake Thomas K. , Glass Hannah C.
Published: March 2015

The large randomized, controlled trials of therapeutic hypothermia for hypoxic-ischemic encephalopathy excluded neonates with congenital disorders. The objective of this study was to report our experience using hypothermia in neonates with signs of hypoxic-ischemic encephalopathy and a syndromic disorder or brain anomaly. Subjects were identified from a database of neonates admitted to the Neuro-Intensive Care Nursery at University of California, San Francisco. Of 169 patients fulfilling criteria for hypothermia, 8 (5%) had a syndromic disorder and were cooled per guidelines for nonsyndromic neonates. Perinatal characteristics of infants with and without syndromic disorder were not significantly different. Overall outcome was poor: 38% had evidence of acute hypoxic-ischemic injury, 3 subjects died, and 2 survivors had low developmental quotient (ie, 25). The risk versus benefit of therapeutic hypothermia for hypoxic-ischemic encephalopathy among neonates with congenital brain malformations or syndromic diagnoses is uncertain.
Intracranial Hypertension in Children
Authors: Masri Amira , Jaafar Amani , Noman Rasha , Gharaibeh Almutez , Ababneh Osama H.
Published: March 2015

This retrospective study aimed to describe the clinical presentations, possible causes, and outcomes of children with idiopathic intracranial hypertension who presented to the authors’ clinic. The mean age at onset of symptoms in the authors’ cohort of 19 children was 6 years (range: 7 months to 12 years). Most patients (90%) were under 11 years old and (84.2%) symptomatic. The probable cause was identified in 7/19 (37.0%) patients. The most common cause was vitamin D deficiency (26.3%). Other associated probably coincidental comorbidities included sinusitis (5/19, 26.3%), hypophosphatasia (1/19), Pyle disease (1/19), and measles vaccine (1/19). Apart from 2 patients who required lumboperitoneal shunt, the cerebrospinal fluid pressure returned to normal in all patients within a period of 6 weeks to 1 year (average, 5 months). Of those who followed up with the authors’ ophthalmologist, 30.7% developed optic atrophy or pallor; 75% of these patients had previous ocular comorbidities.