bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Malik Ambar ki Pipeline’: Reconstructing the Past Through Community Memories
Authors: Mubayi Yaaminey
Published: November 2020

Situated in the arid heart of the Deccan, Daulatabad has been the centre of historic settlements dating back to the first millennium ad. Its geo-political significance lies in its location along sub-continental trade and pilgrimage routes, causing it to be named ‘Khadki’ or window to the south, a strategic position that prompted Mohammed bin Tughlaq to shift his capital from Delhi to Daulatabad. However, the reason for the continued relevance of Daulatabad as an important settlement is the paradoxical ability of human communities to access and manage water in an arid and inhospitable environment. From the water cisterns of the nearby Ellora caves to wells, baolis, tanks and talaabs, natural and man-made, the landscape burgeons with evidence of the human ability to salvage every drop of water, both underground and overground. Nowhere is this skill more ably demonstrated than in the hydrological works of Malik Ambar, an Abyssinian slave who rose to become the de facto ruler of the Nizamshahi dynasty in the sixteenth to seventeenth centuries and is still recognised as a hero by the local community today.

Much has been written about this remarkable personality, his origins in the Kambata region of Ethiopia, his travel to the sub-continent via the Arab slave trade, his rise to become the Vakil us Saltanat of the Nizam Shahis of Ahmadnagar and his legendary defence of the kingdom against Mughal expansion into the Deccan. This article, however, explores a less-known aspect of Ambar’s career, his role in constructing an extraordinary system of water management that enhanced the capacities of Daulatabad fort to enable it to support a large garrison and indeed, become a second capital of the Nizamshahi sultanate. Through site-based interactions and conversations with the local community, the personality of Malik Ambar as a local hero and his influence in the region has been reconstructed, enabling an interesting perspective of a historic personage ‘from below’.
Scoping Review of Family Interventions That Support the Physical Health of Caregivers
Authors: Poon Abner W. C. , Lappin Julia M. , Cassidy Alyssa , Breckenridge Jan
Published: November 2020

Purpose:

Family interventions have been developed to support carers of people with mental illness, but not much is known about how such interventions can improve carers’ physical health. This review aimed to identify and analyze existing family interventions that addressed the physical health of carers.

Methods:

A scoping review was conducted to identify peer-reviewed journal articles on family interventions with physical health components. A total of six articles were found and analyzed thematically to identify the family interventions, physical health components of the interventions, and associated physical health outcomes.

Results:

Synthesis of the findings from relevant articles showed that the development of physical health components in family interventions is emerging and at an early stage. However, most studies had physical health as a minor area focusing mainly on stress and sleep.

Conclusions:

Family interventions would be more holistic if consideration of physical health issues was addressed as a core module.
Aesthetic Concepts and Interdisciplinary Approach in a Patient With Bilateral Cleft Lip and Palate and Missing Premaxilla: A Case Report
Authors: Abreu Amara , Londono Jimmy , Torosian Aram , Yu Jack , Levy-Bercowski Daniel
Published: November 2020

The smile is an important part of the individual’s facial expression, it allows the communication of emotions and ideas. However, its aesthetics can be severely compromised in patients with cleft lip and palate due to multiple missing, malformed and malposed teeth, abnormal soft tissue morphology, upper lip scar tissue, and altered anatomy in the lower third of the face. This clinical case reports the interdisciplinary treatment approach of a young male patient with complete bilateral cleft lip and palate and missing premaxilla. Prosthodontic rehabilitation included a zirconia-based fixed dental prosthesis, with pink porcelain to camouflage the bony defect and restore the facial and dental aesthetics. Maxillary second premolars received lithium disilicate crowns to obtain a more harmonious smile line and adequate occlusion. A resin-bonded fixed partial denture restored a missing mandibular central incisor. Tooth proportions, gingival contours and facial ratios routinely used in noncleft patients, were used to achieve a consonant smile. The final restorations satisfied the patient’s expectations, restored an aesthetically pleasant smile, and provided an adequate occlusion.
A Qualitative Assessment of Bone Mineral Density in Individuals With Hemifacial Microsomia: A Cone-Beam Computed Tomography Study
Authors: ElNaghy Rahma , Bous Rany , Chinoy Afriti , Kumar Anand , Valiathan Manish
Published: November 2020

Objective:

The purpose of this study is to utilize cone-beam computed tomography (CBCT) to compare the bone mineral density (BMD) on the affected versus nonaffected side, among individuals with hemifacial microsomia (HFM).

Methods:

This retrospective study included 9 patients with HFM. Pretreatment CBCT volumes were imported into Invivo5 software, which was used to measure BMD through Hounsfield units (HU) in 3 regions of the mandible; inferior to the lower lateral incisors, inferior to the first molar and at the ramus inferior to the sigmoid notch. Each region was measured at the buccal cortical bone, lingual cortical bone, and cancellous bone. The densities on the right and left sides were compared by Wilcoxon signed-rank test.

Results:

Overall, the BMD on the affected side tended to show slightly lower values when compared with the nonaffected side. Differences ranged from 14 HU at the lingual cortical plate of the first molar region to 234 HU at the buccal cortical plate of the ramus region. Differences were only statistically significant at the ramus region for the buccal ( P = .002) and lingual ( P < .001) cortical plates and at the lower incisor region at the buccal cortical plate ( P = .016) and cancellous bone ( P = .044). The differences, however, did not seem to be clinically significant.

Conclusions:

The current study shows that the quality of bone on the affected side may be slightly reduced but did not seem to be clinically significant. This should be accounted for during surgical and orthodontic planning for patients with HFM.
Nonlinear soil deformability effects on the seismic damage mechanisms of brick and stone masonry arch bridges
Authors: Bayraktar Alemdar , Hökelekli Emin
Published: November 2020

Masonry arch bridges, which were generally built using brick and stone materials, still form a significant part of the highway and railway networks in the World. The subsoil deformability may considerably affect seismic damage mechanics of masonry arch bridges. The paper investigates the effects of nonlinear foundation soil behavior on the seismic damage mechanisms of brick and stone semicircular masonry arch bridges. Direct soil-structure interaction (SSI) approach is taken into account in the 3 D finite element models of the masonry arch bridge-foundation-soil interaction systems including contact, finite and infinite elements. Nonlinear behaviors of masonry units and homogenous soil domain are modeled using the Concrete Damage Plasticity (CDP) and Mohr-Coulomb failure criteria. The selected ground motion is matched and deconvoluted for hard and medium soil domains. Seismic damage mechanisms of brick and stone masonry arch bridges subjected to combined longitudinal and vertical deconvolved ground motion components are obtained for hard, medium, and partially hard and medium soil domains and are compared with each other.
A Scoping Review of the Whole School, Whole Community, Whole Child Model
Authors: Willgerodt Mayumi A. , Walsh Elaine , Maloy Caitlin
Published: November 2020

The Whole School, Whole Community, Whole Child (WSCC) model is a student-centered approach that focuses on a culture of health to support student success. Despite its use, the empirical evidence supporting the model is unclear. We conducted a scoping review to understand the research supporting WSCC as a model for student/school health. The search included studies published in English language peer-reviewed journals from 2014 to 2020. Eight articles met criteria for review. Overall, findings from this review reveal a relatively small body of research specific to the WSCC model. Because WSCC is presented as a model for schools throughout the United States, the development of a larger body of research supporting the model as an evidence-based framework will enhance credibility and confidence in the model. School nurses, as leaders, coordinators, and advocates, are well positioned to test and disseminate the model to those seeking to introduce WSCC in their school or district.
The Communication Skills and Family Resources in the University Students: The Moderating Effect of Encoding Skills and Commitment to Family
Authors: Kataoka Yusuke , Tsuchiya Koji
Published: November 2020

Background:

Although communication skills can lead to family resources, the association between communication skills in adolescents and family resources remains to be examined multi-dimensionally. Therefore, we examined whether family resources are predicted by six categories of communication skills. Further, we examined the moderating effect of encoding skills and commitment to family in the association between decoding skills and family resources.

Method:

One hundred forty university students completed several questionnaires assessing communication skills, family resources, and commitment to family.

Results:

Results indicated that expressivity in communication skills positively predicted cohesion and trust in family strength, and regulation of interpersonal relationships negatively predicted balance between individual family members and the family system. Additionally, analysis showed that commitment to family moderated relationships between “deciphering ability” and trust in family strength in family resources. The hypothesis that trust in family strength is negatively predicted by deciphering ability among those low in commitment to family is supported.

Discussion:

It can be effective in clinical support to help individuals express feelings and needs to enhance family resources needed to bounce back from a crisis. However, in individuals low in commitment to family, when a practitioner helps individuals with high deciphering ability enhance their commitment to family, it is important to help prevent negative family relationships caused by experiencing mental burdens generated by family dynamics.
Impact of the implementation of a pharmacist-driven immunosuppression drug monitoring protocol for hematopoietic stem cell transplant recipients
Authors: Gawedzki Paula , Collins Jennifer
Published: November 2020

For patients with serious hematologic malignancies, hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment option. Majority of HSCT recipients receive tacrolimus as part of their immunosuppressive regimen. The purpose of this study is to evaluate the clinical impact of a pharmacist driven immunosuppression drug monitoring protocol for HSCT recipients on tacrolimus.

This was a single-center, pre-post interventional study conducted at the University of Chicago Medical Center. Data collected via chart review includes the immunosuppressive agent used, interacting medications, adverse events, dose adjustments, drug concentrations, time to engraftment, and diagnosis of GVHD.

Following the incorporation of a therapeutic drug monitoring protocol, the percentage of therapeutic tacrolimus levels was similar to when there was no protocol in place; 68% versus 64%, respectively (p = 0.34). There were 18 total adverse events observed in the pre-protocol group versus 10 in the post-protocol group (p = 0.03). Nephrotoxicity was the most common adverse event occurring in 23% of patients in the pre-protocol group and 15% of patients in the post-protocol group (p = 0.18). In the post-protocol group, there were 20 patients with two or more interacting drugs versus two patients in the pre-protocol group (p < 0.05). Additionally, the post-protocol group had 12 instances of an empiric dose adjustment made whereas the pre-protocol group had three instances (p = 0.006).

Although there was no significant difference in percentage of therapeutic tacrolimus levels, pharmacist involvement resulted in improved safety outcomes such as management of drug interactions and incidence of adverse events.
“Do You Guys Take Showers with Your Children?”: Gendered Embodiment and the Legitimation of Italian Fathering Practices
Authors: Mercuri Eugenia
Published: November 2020

This work aims at investigating gendered embodiment in fathering practices in a national context, Italy, where understandings of fatherhood, at the institutional as well as the individual level, are still more centered on the provider ideal than on a model of nurturing and caring fatherhood. This qualitative research on Italian first-time fathers of children under three years of age focused on men’s participation in routine, instrumental, and material childcare practices, exploring the potential for a transformation in both the meanings attached to fatherhood as well as to aspects related to embodiment and constructions of masculinity that sustain inequalities. The findings show that, while participation in hands-on childcare plays an important role in the construction of intimate father-child relationships, a legitimation of men’s bodies’ involvement in interaction with children is still missing, especially for care practices that overlap with constructions of motherhood.
Effects of Individualized Dietary Phosphate Control Program With a Smartphone Application in Hemodialysis Patients in Taiwan
Authors: Chiang Yung-Chen , Chang Ya-Ping , Lin Ssu-Chin , Lin Chin , Hsu Pi-Hsiu , Hsu Yu-Juei , Wu Tsung-Jui
Published: November 2020

Background:

Hyperphosphatemia in end-stage renal disease patients is prevalent and associated with increasing cardiac mortality. Restricting dietary phosphate intake is a key element in controlling hyperphosphatemia, but most patients fail due to lack of knowledge and sustainability. In this study, we aimed to examine whether incorporating a smartphone application (APP) into a multidisciplinary caring system can decrease the prevalence of hyperphosphatemia in hemodialysis patients.

Methods:

We designed a quasi-experimental study to enroll patients undergoing regular hemodialysis and assigned them to receive APP-assisted caring program (ACP group, n = 30) or standard education caring program (SCP group, n = 30). Both caring programs targeting dietary phosphate control were administered. Patients’ general characteristics, self-care efficacy scales, knowledge test of phosphate control, and results of monthly blood biochemistry were analyzed.

Findings:

Knowledge of diet phosphate control and self-care efficacy were significantly higher in the ACP group. Notably, the knowledge improvement was higher in patients aged over 60 years. Compared to the SCP group, the percentage of patients with successful hyperphosphatemia control was significantly higher in the ACP group ( p = 0.0398).

Conclusion:

The APP-assisted caring program benefits patients with regular hemodialysis to achieve better dietary phosphate control without compromising proper protein intake.
Major trauma centre Lead Clinicians: An evaluation of current practice in major trauma centres in England
Authors: Sabin Emma Jane , Cole Elaine
Published: November 2020

Background

NHS England requires there to be a clinical consultant with managerial responsibility for the Major Trauma Centre (MTC) service, who holds the title of MTC Lead Clinician. The objective of this study was to investigate the role of MTC Lead Clinician in England. Firstly, identifying the parent speciality of the current cohort and their background and training. Further aims were to ascertain what attracted clinicians to the position and to explore ideas about how to train the next generation of MTC Lead Clinicians.

Methods

Survey-based data collection was performed. Included were current MTC Lead Clinicians, or those with equivalent job descriptions, for adult major trauma. Paediatric MTCs and Trauma Units were excluded. Fixed choice questions were analysed using descriptive statistics. Open-ended questions were interpreted using thematic analysis.

Results

The response rate for the survey was 81.81%. The largest proportion of respondents were Emergency Medicine Physicians (38.9%). Previous senior leadership roles were identified as valuable previous experience. Regular attendance at conferences was deemed to be of more importance than specific training courses. Leadership, management, and financial skills were identified as key areas for further training. There was variance in both the job role and the time allocated for these duties between centres.

Conclusion

Currently there is variation in the parent specialty, role responsibilities and preparation for MTC Lead Clinicians in England. Our findings suggest that guidance on appropriate training, clarity in responsibilities and fostering leadership and managerial skills are important as the role develops for the future.
“They’re not bad parents. They’ve just made bad choices.”: Mental health clinicians’ perspectives of parents involved with child protective services
Authors: Yoo Hana , Racorean Stefana , Barrows Victoria
Published: November 2020

Although psychotherapeutic treatment (e.g., counseling and therapy) is often offered to clients involved with child protective services (CPS), the existing literature includes few voices of mental health clinicians regarding their work and clients in the child welfare system. The current study seeks to address this gap by exploring clinicians’ views on the issue of child maltreatment and CPS-involved parents’ parenting. Thematic analysis of semi-structured interviews revealed that clinicians acknowledged the strengths of CPS-involved parents as well as the challenges that may have made their parenting difficult. For strengths, clinicians identified parents’ desire to care for their child, motivation to improve their parenting, and commitment to their child. Identified challenges included a lack of parenting knowledge, substance use, and limited resources and support. Overall, clinicians in this study presented a balanced perspective that attended to both the “good” and the “bad” in their clients’ parenting. They viewed CPS-involved parents as more than the sum of their problematic parenting behaviors and understood incidents of child maltreatment within the parents’ contexts. At the same time, their interviews noted that a variety of individual and sociostructural challenges faced by CPS-involved parents must be addressed in order to resolve child maltreatment and prevent parents’ repeated involvement in the child protection system.
Justice in waiting: The harms and wrongs of temporary refugee protection
Authors: Buxton Rebecca
Published: November 2020

Temporariness has become the norm in contemporary refugee protection. Many refugees face extended periods of time waiting for permanent status, either in camps or living among citizens in their state of asylum. Whilst this practice of keeping refugees waiting is of benefit to states, I argue that not only is it harmful to refugees but it also constitutes an injustice. First, I outline the prevalence of temporary assistance in the refugee protection regime. Second, I outline the orthodox view on temporary refugee protection – it is acceptable as long as it is not indefinite. I then spend the remainder of the article considering four arguments against temporary refugee protection: the plan argument, the reciprocity argument, the domination argument, and the compounding injustice argument. I contend that the first two arguments, which already feature in the literature, merely show that temporary protection is harmful to refugees. My own arguments on domination and compounding injustice show, instead, that giving refugees temporary protection constitutes an injustice. The domination argument allows us to critique the current practice of temporary refugee protection, whereas the compounding injustice argument shows that temporariness in any form constitutes an injustice.
Whose program is this? Negotiations in designing a student-initiated and student-led Jewish-Arab/Palestinian dialogue program on campus
Authors: Skorkowich Yael , Arieli Daniella , Simonovich Javier , Gur Pauline , Atamleh Bseel
Published: November 2020

This research examines the Nice 2 Meet U intervention program which, unlike other programs promoting dialogue between Arab/Palestinian and Jewish students on Israeli campuses, was a grassroots program initiated and moderated by students. The program was designed jointly by the initiators, the participants and the researcher/advisor using action research. The objective of the current study was to describe the negotiations among all the partners with respect to a central dilemma: should the program include political discourse on the Israeli-Palestinian conflict? The research proposes seeing the negotiations over designing grassroots conflict intervention programs as an arena in which the participants' academic, ethno-national and gender positions intersect and shape knowledge-power relations. Alongside the risks inherent in this process, it also offers potential for creating transformative spaces that challenge traditional patterns of power relations and encourage students to take part in changing the social atmosphere on campus.
Intimate Partner Violence and Perinatal Post-Traumatic Stress and Depression Symptoms: A Systematic Review of Findings in Longitudinal Studies
Authors: Paulson Julia L.
Published: November 2020

The link between maternal violence exposure and adverse obstetric outcomes is well-documented, but less is understood about the relationship between intimate partner violence (IPV) exposure and perinatal post-traumatic stress symptoms(PTSS) and depression in women around the world. A systematic review was conducted to synthesize empirical literature on the associations between IPV (e.g., before pregnancy, during pregnancy, postpartum) and post-traumatic stress and depression symptoms in the perinatal period. This review acknowledged the effects of IPV exposure timing, timing of assessment, and IPV subtypes. Forty-seven longitudinal studies met inclusion criteria and were reviewed to determine the effects of IPV exposure on perinatal mental health. Findings suggested a strong relationship between IPV exposure and perinatal mental health. Results were more consistent between perinatal mental health and IPV sustained close to or during the perinatal period than for lifetime IPV exposure. In general, physical, sexual, and psychological IPV were independently associated with perinatal depression and PTSS. Findings underscore the importance of theoretically driven research and the development of treatment protocols for women worldwide.
Economic Development Effects of Major and Minor League Teams and Stadiums
Authors: Agha Nola , Rascher Daniel
Published: November 2020

Professional teams and leagues claim new stadiums lead to economic development. To test this, we utilize data from the Census Bureau on net establishment and employment changes across 871 Metropolitan and Micropolitan Statistical Areas from 2004 to 2012. Difference-in-differences and panel data techniques allow for a cross-sectional and time series comparison for both teams and new stadia in both professional and development leagues. Nearly all results from hundreds of models are insignificantly different from zero. Results from between- and random-effects models suggest that teams move into markets that already have higher employment and establishment growth. (JEL R58, H71, L83, Z28)
The G-Protein Coupled Formyl Peptide Receptors and Their Role in the Progression of Digestive Tract Cancer
Authors: Tian Cuimeng , Chen Keqiang , Gong Wanghua , Yoshimura Teizo , Huang Jiaqiang , Wang Ji Ming
Published: November 2020

Chronic inflammation is a causative factor of many cancers, although it originally acts as a protective host response to the loss of tissue homeostasis. Many inflammatory conditions predispose susceptible cells, most of which are of epithelial origin, to neoplastic transformation. There is a close correlation between digestive tract (DT) cancer and chronic inflammation, such as esophageal adenocarcinoma associated with Barrett’s esophagus, helicobacter pylori infection as the cause of stomach cancer, hepatitis leading to liver cirrhosis and subsequent cancer, and colon cancer linking to inflammatory bowel diseases and schistosomiasis. A prominent feature of malignant transformation of DT tract epithelial cells is their adoption of somatic gene mutations resulting in abnormal expression of proteins that endow the cells with unlimited proliferation as well as increased motility and invasive capabilities. Many of these events are mediated by Gi-protein coupled chemoattractant receptors (GPCRs) including formyl peptide receptors (FPRs in human, Fprs in mice). In this article, we review the current understanding of FPRs (Fprs) and their function in DT cancer types as well as their potential as therapeutic targets.
Carotid Restenosis Following Endarterectomy in Patients Managed With Single Antiplatelet Therapy Versus Dual Antiplatelet Therapy
Authors: Glotzer Owen S. , Rojas Elianne , Bouchard David Roberge , Hill Susanna S. , Harad F. Todd , Zhang Zugui , Bowser Kathryn E.
Published: November 2020

Background:

Antiplatelet therapy is a cornerstone in the management of carotid artery disease following carotid endarterectomy (CEA). There is a paucity of data regarding the effect of dual antiplatelet therapy (DAPT) on restenosis rates.

Methods:

A retrospective review of patients who underwent CEA from January 1, 2007 to December 31, 2013 was performed at a single center. Study groups consisted of subjects who received DAPT and those who received single antiplatelet therapy (SAPT) following CEA. Restenosis was evaluated by carotid duplex. Severity and timing of restenosis, postoperative complications, and reinterventions were compared between study groups.

Results:

Between January 1, 2007 and December 31, 2013, 1453 patients underwent CEA. The SAPT group consisted of 245 patients and the DAPT group consisted of 1208 patients. No difference in restenosis was identified between groups at less than 6 weeks (6.5% vs. 11.7% 50-79% stenosis, 0% vs. 2.2% 80-99% stenosis, 2.2% vs. 0.6% occlusion, p = 0.368), and 6 weeks to 2 years (20.6% vs. 17.9% 50-79% stenosis, 1.1% vs. 1.0% 80-99% stenosis, 1.6% vs. 0.4% occlusion, p = 0.242). A higher rate of restenosis in SAPT was found greater than 2 years from surgery (68.4% vs. 82.4% <50% stenosis, 29.9% vs. 16.1% 50-79% stenosis, 0% vs. 0.6% 80-99% stenosis, 1.7% vs. 0.9% occlusion p = 0.004). This finding persisted on multivariable analysis with 31.6% of the SAPT group showing >50% stenosis vs. 17.6% of the DAPT group (adjusted OR 0.48, 95% CI 0.30-0.76, p = 0.002). In a propensity matched-population, 32.7% of the SAPT group demonstrated restenosis vs. 13.7% of the DAPT group (adjusted OR 0.35, 95% CI 0.16-0.77, p = 0.009). There was no difference in the need for reintervention between study groups (DAPT 3.8% vs SAPT 3.3%, p = 0.684).

Conclusion:

Following CEA, patients on DAPT exhibited lower rates of late restenosis. Despite this finding, a clinical difference in reintervention was not found during this study period.
Covered Endovascular Repair of Innominate Artery Bifurcation After Thoracic Blunt Trauma
Authors: Pereira-Neves António , Gouveia Ricardo , Dias-Neto Marina , Duarte-Gamas Luís , Rocha-Neves João , Teixeira José
Published: November 2020

Innominate artery (IA) injury is a rare entity with most patients dying before reaching the hospital. While open surgery remains the standard treatment, the endovascular approach is attractive as it may reduce perioperative morbidity and mortality. We report a case of IA blunt injury extending to the subclavian artery with pseudoaneurysm formation successfully treated with covered stenting of IA and its bifurcation. A 49-year-old male was admitted after suffering multiple trauma due to a high energy impact motorcycle crash. In the emergency room, the patient was hypotensive with a Glasgow coma score of 15. On physical examination, he had right peri-orbital ecchymosis, left otorrhagia and an open patella fracture. The computed tomographic angiography (CTA) revealed enlargement of the mediastinum and a 29 mm pseudoaneurysm involving the right brachiocephalic trunk and its bifurcation. Under general anesthesia, a covered balloon-expandable stent (CBES) was then placed in the IA followed by kissing stent of its bifurcation with an additional 2 covered balloon-expandable stents. Final subtraction angiography demonstrated complete pseudoaneurysm exclusion and stent patency without additional complications. No neurologic deficits or other intervention-related complications were found in the postoperative period. At 10 months follow-up, the patient remained asymptomatic and with palpable distal pulses. Endovascular management of IA injury may provide a good alternative to open surgery with low perioperative morbidity and mortality.
Acute Effects of Whole-Body Vibration Exercises at 2 Different Frequencies Versus an Aerobic Exercise on Some Cardiovascular, Neuromotor and Musculoskeletal Parameters in Adult Patients With Obesity
Authors: Tamini Sofia , De Micheli Roberta , Tringali Gabriella , Bernardo-Filho Mario , Sartorio Alessandro
Published: November 2020

Whole-body vibration exercise (WBVE), a nonimpact, viable and safe type of exercise, has been reported to be useful in the physical rehabilitation of obesity. Aim of the study was to compare the acute effects of WBVE with a session of walking and running (AER) on cardiovascular, neuromotor and musculoskeletal parameters in obese subjects. Sixteen adult obese subjects performed 3 tests (WBVE at 30 and 45 Hz, AER) randomly in different days. An increase in heart rate was recorded after AER and 45 Hz WBVE (p < 0.001), while only AER increased systolic ( p = 0.003) and diastolic blood pressure ( p = 0.004) and ratings of perceived exertion ( p < 0.001). All 3 exercises determined lactate increase [AER p < 0.001, 45 Hz ( p = 0.04), 30 Hz ( p = 0.03) WBVE] and sit-and-reach (AER p = 0.002, 45 and 30 Hz WBVE p < 0.001) and fingertip-to-floor improvements (AER p = 0.003, 30 and 45 Hz WBVE p < 0.001), while only 30 Hz WBVE determined improvement in stair climbing test ( p < 0.05). Considering the lack of effects of 30 Hz WBVE on the cardiovascular system and fatigue and its positive effect on flexibility and muscle power, this procedure can be considered an appropriate exercise protocol for the obese population.
A practical approach to the management of cerebral amyloid angiopathy
Authors: Kozberg Mariel G , Perosa Valentina , Gurol M Edip , van Veluw Susanne J
Published: November 2020

Cerebral amyloid angiopathy is a common small vessel disease in the elderly involving vascular amyloid-β deposition. Cerebral amyloid angiopathy is one of the leading causes of intracerebral hemorrhage and a significant contributor to age-related cognitive decline. The awareness of a diagnosis of cerebral amyloid angiopathy is important in clinical practice as it impacts decisions to use lifelong anticoagulation or nonpharmacological alternatives to anticoagulation such as left atrial appendage closure in patients who have concurrent atrial fibrillation, another common condition in older adults. This review summarizes the latest literature regarding the management of patients with sporadic cerebral amyloid angiopathy, including diagnostic criteria, imaging biomarkers for cerebral amyloid angiopathy severity, and management strategies to decrease intracerebral hemorrhage risk. In a minority of patients, the presence of cerebral amyloid angiopathy triggers an autoimmune inflammatory reaction, referred to as cerebral amyloid angiopathy-related inflammation, which is often responsive to immunosuppressive treatment in the acute phase. Diagnosis and management of cerebral amyloid angiopathy-related inflammation will be presented separately. While there are currently no effective therapeutics available to cure or halt the progression of cerebral amyloid angiopathy, we discuss emerging avenues for potential future interventions.
Assessing the Supportiveness of Healthcare Environments’ Light and Color: Development and Validation of the Light and Color Questionnaire (LCQ)
Authors: Lindahl Jeanette , Thulesius Hans , Rask Mikael , Wijk Helle , Edvardsson David , Elmqvist Carina
Published: November 2020

Aim:

The aim of this study was to develop and evaluate a self-report instrument measuring patients’, family members’, and staff’s perceived support from light and color in the physical environment of an emergency department (ED)—the Light and Color Questionnaire (LCQ).

Background:

The physical care environment is an important part of a comprehensive caring approach in all levels of care not only for patients but also for family members and staff. However, no existing self-report questionnaire assessing the extent to which light and color are perceived as being supportive in the physical care environment from the users’ perspective was found.

Method:

The LCQ was developed as part of a pre–post study in which an ED serving 125,000 people was refurbished and remodeled using evidence-based design. The LCQ consists of six items for light and five items for color and assesses awareness/orientation, safety/security, functional abilities, privacy, personal control, and stimulation. The study was carried out in four steps: constructions of items, assessment of face validity, data collection, and data analysis.

Result/Conclusion:

Psychometric evaluation of the two versions, LCQ-Patient/Family member and LCQ-Staff, showed satisfactory content and internal validity (>90%) and high internal consistency (Cronbach’s coefficient α = .9) to support the use of the questionnaire for research and development purposes. Explorative factor analysis of a total of 600 questionnaire responses confirmed light and color as distinctive and independent dimensions creating perceptions of more or less supportiveness for respondents. The LCQ instrument may be useful for architects, administrators, and researchers of healthcare environments.
‘Mind the gap’: Responding to the indeterminable in migration
Authors: Shubin Sergei
Published: November 2020

Prompted by Miriam Tedeschi’s (2021) article, this commentary attempts to unsettle the dominant understanding of a relation in migration research that prioritises linkages between people, places, and organisations while treating boundaries as limits to overcome. Building on geographers’ earlier engagements with Adorno, Levinas, and extending this conversation to include Blanchot, the analysis attempts to move beyond the hold of mastery on a relation with alterity. This commentary argues for an interruptive non-relation that resists the appropriation and affirms the dispersion of the self by the alterity it cannot internalise. It offers an alternative response to difference in migration that avoids bringing it to unifying continuity. Instead of treating interruptions in migration as gaps to be resolved through language, I consider the possibility of a neutral writing that reflects the powerlessness to say the unspeakable. In a movement of inscription and effacement, neutral writing invokes the unspeakable pain and affliction that exceeds the concepts to which it gives rise. The neuter answers for the non-subject of loss and trauma, the nothing often haunting international migrants.
A Christian college in a food truck? Christian study centers and moral formation
Authors: Hansen Andrew
Published: November 2020

The task of moral formation has long been an important purpose of higher education in the United States. However, pluralism and lack of moral consensus within secular universities present significant challenges to accomplishing this task. One possible solution is Christian study centers, which offer thick moral cultures that can form students at secular universities within the Christian tradition. Anselm House’s Fellows Program at the University of Minnesota illustrates such a context and suggests avenues for future research.
Characteristics of nursing encounters in primary healthcare in remote areas: A survey of nurses’ patient record documentation and self-report
Authors: Lundberg Anna , Gyllencreutz Lina , Saveman Britt-Inger , Boman Erika
Published: November 2020

To meet both current and future competence needs, improved and updated understanding of nurses’ scope of practice when working in remote communities is needed. The aim was to describe and analyze the characteristics of nursing encounters in primary healthcare in remote areas. The setting for the study was an island community in Finland. Nurses’ patient record documentation and self-reports on patient encounters were surveyed ( n = 1062). Patients aged ≥65 years accounted for most encounters. Great variety in the encounters was seen, though some nursing tasks and patient conditions were overrepresented. For patient safety reasons, it is important to review how nurses maintain competence regarding those tasks and conditions encountered less often. Primary healthcare services should focus on the broader determinants of health. However, a more disease-oriented focus was seen. To ensure quality of care in primary healthcare in remote areas, there is a need for standardized routines for monitoring patients and documenting findings and performed interventions.
The Room Where It Happens: Reflections on Being a Black Woman in the Academy
Authors: Warren Patricia Y.
Published: November 2020

The Black Lives Matter movement emerged in 2013 as a result of George Zimmerman being acquitted for the death of Trayvon Martin. Until recently, the movement was mostly limited to violence inflicted on Black and Brown bodies at the hands of the police. More recently scholars, have extended the movement to include the experiences of minorities in academia with the purpose of addressing the institutional biases along with the racial and ethnic micro-aggressions that result from them. The purpose of this essay is to explore micro-aggressions and how they have impacted my life as a Black female scholar in the academy. In my discussion, I provide direct accounts of racialized and gendered experiences that have shaped me. The experiences highlighted in this essay reflect the broader challenges that minority faculty experience when they attempt to be gain visibility and respect in their disciplines.
Contiguity, constituencies, and the political representation of minorities
Authors: Forest Benjamin , Medeiros Mike
Published: November 2020

Contiguity is commonly treated as an essential, albeit noncontroversial quality of electoral districts. In contrast, we argue that the virtues ascribed to contiguity – discouraging gerrymandering, facilitating democratic deliberation, and mirroring political communities – either have weak justifications in practice or do not have a clear association with contiguity per se. Moreover, contiguity can impose significant constraints on minority representation when minorities live in segregated, widely separated settlements. We use examples from Canada to demonstrate the effects of contiguity on minority representation by creating sets of non-contiguous constituencies that substantially increase the number of districts with minority majorities. More generally, we argue that scholars should pay more attention to how the conflation of contiguity and political community are woven into state practices.
“No thanks, I don’t want to see snakes again”: a qualitative study of pain management versus preservation of cognition in palliative care patients
Authors: Wegier Pete , Varenbut Jaymie , Bernstein Mark , Lawlor Peter G. , Isenberg Sarina R.
Published: November 2020

Background

Towards the end of life, use of opioid analgesics becomes more common in patients to control pain and improve quality of life. While pain medication may help manage pain, unwanted cognitive side effects are frequently noted. This balancing act presents a trade-off for patients between pain relief and adverse effects, where the desire to relieve pain must be evaluated against the desire to maintain cognitive clarity and may represent a difficult decision for patients receiving palliative care. Our goal was to understand how patients’ decision making about pain medications balances the pain relief from those medications against the cognitive decline often associated with them.

Methods

We conducted qualitative semi-structured interviews with patients receiving home-based palliative care from a program in Toronto, Canada. Interview recordings were transcribed and analyzed using thematic analysis.

Results

Thirty-one interviews were conducted. Some patients preferred cognitive preservation over pain management because of a sense that cognition is central to their identity, the desire to maintain lucidity, a desire to continue participating in work or hobbies, and fear of addiction. Conversely, some patients preferred pain management over cognitive preservation because of a desire to avoid suffering, an inability to sleep without medications, or an acceptance of some cognitive compromise. A few patients attempted to find balance through tapering drugs, limiting their use of breakthrough analgesic doses, or using alternative strategies.

Conclusions

Decision making around pain and pain management is a highly preference-sensitive process—with no clear right or wrong decisions, only the preferences of each patient. The findings from this study may influence the design of future patient-facing decision aids around pain management. Future studies should pilot interventions to better assist patients with this decision.
Methods for improving thermal tolerance in military personnel prior to deployment
Authors: Ashworth Edward Tom , Cotter James David , Kilding Andrew Edward
Published: November 2020

Acute exposure to heat, such as that experienced by people arriving into a hotter or more humid environment, can compromise physical and cognitive performance as well as health. In military contexts heat stress is exacerbated by the combination of protective clothing, carried loads, and unique activity profiles, making them susceptible to heat illnesses. As the operational environment is dynamic and unpredictable, strategies to minimize the effects of heat should be planned and conducted prior to deployment. This review explores how heat acclimation (HA) prior to deployment may attenuate the effects of heat by initiating physiological and behavioural adaptations to more efficiently and effectively protect thermal homeostasis, thereby improving performance and reducing heat illness risk. HA usually requires access to heat chamber facilities and takes weeks to conduct, which can often make it impractical and infeasible, especially if there are other training requirements and expectations. Recent research in athletic populations has produced protocols that are more feasible and accessible by reducing the time taken to induce adaptations, as well as exploring new methods such as passive HA. These protocols use shorter HA periods or minimise additional training requirements respectively, while still invoking key physiological adaptations, such as lowered core temperature, reduced heart rate and increased sweat rate at a given intensity. For deployments of special units at short notice (< 1 day) it might be optimal to use heat re-acclimation to maintain an elevated baseline of heat tolerance for long periods in anticipation of such an event. Methods practical for military groups are yet to be fully understood, therefore further investigation into the effectiveness of HA methods is required to establish the most effective and feasible approach to implement them within military groups.
Activation of Preoptic Arginine Vasopressin Neurons Induces Hyperthermia in Male Mice
Authors: Tabarean Iustin V
Published: November 2020

Arginine vasopressin (AVP) is a neuropeptide acting as a neuromodulator in the brain and plays multiple roles, including a thermoregulatory one. However, the cellular mechanisms of action are not fully understood. Carried out are patch clamp recordings and calcium imaging combined with pharmacological tools and single-cell RT-PCR to dissect the signaling mechanisms activated by AVP. Optogenetics combined with patch-clamp recordings were used to determine the neurochemical nature of these neurons. Also used is telemetry combined with chemogenetics to study the effect of activation of AVP neurons in thermoregulatory mechanisms. This article reports that AVP neurons in the medial preoptic (MPO) area release GABA and display thermosensitive firing activity. Their optogenetic stimulation results in a decrease of the firing rates of MPO pituitary adenylate cyclase-activating polypeptide (PACAP) neurons. Local application of AVP potently modulates the synaptic inputs of PACAP neurons, by activating neuronal AVPr1a receptors and astrocytic AVPr1b receptors. Chemogenetic activation of MPO AVP neurons induces hyperthermia. Chemogenetic activation of all AVP neurons in the brain similarly induces hyperthermia and, in addition, decreases the endotoxin activated fever as well as the stress-induced hyperthermia.
Prospective Evaluation of Incidental Pituitary Imaging Findings in the Sella Turcica
Authors: Kuo Michael , Maya Marcel M , Bonert Vivien , Melmed Shlomo
Published: November 2020

Purpose

Reported rates of incidentally discovered pituitary sellar lesions vary widely, at least in part because of the inadvertent inclusion of patients with a history suspicious for a pituitary disorder. We prospectively evaluated the incidence of truly incidental sellar findings detected on imaging at a large academic medical center.

Methods

Deidentified data were extracted from the electronic medical record of adults who underwent diagnostic computed tomography (CT) or magnetic resonance imaging (MRI) over a 1-year period for any cause unrelated to known or suspected pituitary disorder both in inpatient and outpatient settings. Patients with International Classification of Diseases, Ninth Revision, (ICD-9) and Tenth Revision (ICD-10) codes indicative of a sellar lesion and those with symptoms suggestive of sellar/parasellar mass effects were excluded.

Results

Of 9572 scans performed during the 1-year study period, 3840 met the inclusion criteria to comprise the study cohort; 13 were manually excluded because of findings or symptoms of sellar masses not otherwise captured. The overwhelming majority of evaluable images (n = 3782) showed no sellar lesions. Truly incidental sellar findings were detected in 45 (1.2%), most commonly among inpatients (P < .001). Partially empty sella and empty sella were the most frequent findings, and were twice as likely to be detected on MRI vs CT. All other incidentally discovered lesions, including one microadenoma and one macroadenoma, were detected only by MRI.

Conclusion

Frequency of incidental sellar lesions in patients with no known or suspected history of pituitary disorder is low. Given the small likelihood of aggressive behavior in these lesions, the clinical significance of truly incidentally discovered sellar lesions should not be overestimated.