bluuebunny/crossref_metadata_2025 huggingface dataset:
Regime type, issues of contention, and economic sanctions: Re-evaluating the economic peace between democracies
Authors: Wallace Geoffrey P R
Published: May 2013

Past studies have applied insights from the democratic peace to show that democracies are also less likely to sanction one another compared to other regime types. More recent work challenges this finding by arguing that the economic peace between democracies largely disappears once methodological improvements are included along with the particular behavior of the United States as market hegemon. This article cautions that these critiques may themselves be an artifact of particularities in past data on economic sanctions. Using a larger and more representative sanctions dataset, the analysis shows that democracies do seem less likely on average to sanction each other. Furthermore, the United States does not appear to be unique in its sanctioning behavior compared to other democracies. However, the article proposes a middle ground between proponents and skeptics of an economic peace between democracies. The analysis shows that the pacifying effects of joint democracy only operate for security related sanctions, while in non-security related matters democratic constraints are less evident. The results point to the importance of considering more closely the choice of data on sanctions, but also the need to take into account the issues under contention for episodes of economic coercion.
The Future of Music Education
Authors: Miksza Peter
Published: May 2013

Professional discussion of curricular change and innovation is essential for maintaining and increasing the positive effects that music education can have on schoolchildren. Much recent discourse about curricular change has focused on critiques of the traditional large-ensemble model of music education, technological innovation applied to teaching music, and the incorporation of popular music idioms. I propose counterpoints to these commonly discussed topics and offer suggestions for redirecting advocacy efforts and for reconsidering dispositions toward large-ensemble instruction. Rather than discard the current curricular models as inadequate, we can exercise patience and reflect while building on what currently exists.
Toward Convergence
Authors: Tobias Evan S.
Published: May 2013

Knowing how students engage with music outside school music programs can help music educators and their programs evolve. This article offers a look at music teaching and learning in terms of how people are increasingly interacting with music in participatory ways that involve digital technologies and media. This participatory culture offers a means for aligning music education more closely with how people engage with music in contemporary society. The article shows how convergence of older and newer media and such engagement as remixing, creating mash-ups, and interacting with others can provide students with exciting means of connecting to ways of being musical in contemporary society.
South Indian Solkattu and Western Music Pedagogy
Authors: Wood Brandon Keith
Published: May 2013

Part of the classical music tradition of South India, solkattu reinforces the statement “If you can say it, you can play it.” This system of percussive syllables can help young musicians approach rhythm training in a way not usually available to students in Western countries. This article offers applications for a music curriculum. The approach can help students be more accurate in both their sense of rhythm and their rhythmic performance.
Flocking of multi-agent dynamic systems with virtual leader having the reduced number of informed agents
Authors: Atrianfar Hajar , Haeri Mohammad
Published: May 2013

In this paper, three fundamental properties of a potential field-based flocking algorithm, i.e. merging of neighbouring graphs during the system evolution, collision avoidance and convergence of position of the centre of mass of informed agents to that of virtual leader are discussed. Next, these properties are utilized to determine required number of informed agents based on initial position of uninformed ones and consequently reduce the domain of search in optimization problems defined for finding the optimal number of required informed agents. Finally, a new optimization framework is proposed, which benefits Voronoi diagrams in order to reduce the number of informed agents required for velocity convergence of the whole group. This optimization framework reduces computational complexity in the cost of lower optimality.
Co-constructing family identities through young children’s telephone-mediated narrative exchanges
Authors: Cameron Catherine Ann , Gillen Julia
Published: May 2013

This article explores telephone interactions between young children and adult family members as contributing insights to the co-construction of identities within both the nuclear and the extended family. The authors deploy methods of linguistic ethnography to enrich the scope of interpreting the data beyond textual analysis. The study’s premise was that intimate relatives have knowledgeable appreciation of their child’s affective and cognitive worlds that they can call upon to enhance emerging language use and narrative productions, even in distanced communications. Talking over the telephone has the potential to scaffold children’s skills in offering clear, cohesive communications, and elaborated narratives. Examination of the corpora of four preschool children in interaction with a family member on the telephone showed them to employ extensive expressive power to negotiate considerable communicative space in having both emotional and cognitive needs met; identities are co-constructed as stories about persons and experiences are shared.
A Polytomous Extension of the Generalized Distance Discriminating Method
Authors: Sun Jianan , Xin Tao , Zhang Shumei , de la Torre Jimmy
Published: May 2013

This article proposes a generalized distance discriminating method for test with polytomous response (GDD-P). The new method is the polytomous extension of an item response theory (IRT)-based cognitive diagnostic method, which can identify examinees’ ideal response patterns (IRPs) based on a generalized distance index. The similarities between observed response patterns and IRPs for polytomous response situation are measured by the index of GDD-P, and the attribute patterns can be recognized via the relationship between attribute patterns and IRPs. Feasible designs about polytomous Q-matrix and scoring items for polytomous response are also discussed. In simulation, the classification accuracy of the GDD-P method for the test with polytomous response was investigated, and results indicated that the proposed method had promising performance in recognizing examinees’ attribute patterns.
Dying at home – is it better: A narrative appraisal of the state of the science
Authors: Higginson Irene J , Sarmento Vera P , Calanzani Natalia , Benalia Hamid , Gomes Barbara
Published: May 2013

Background:

Achieving home care and home death is increasingly used as an outcome measure of palliative care services.

Aim:

To appraise the state of the science on dying at home.

Methods:

Appraisal and narrative review developed from a plenary presentation at the European Association for Palliative Care (EAPC) 2012 meeting examining the research on variations and trends in place of death, factors associated with dying in the preferred place, presenting evidence on outcomes for those dying at home and suggesting future research questions.

Results:

Meeting patients’ preferences and creating home-like environments has been a major concern for hospice and palliative care since its inception. During the 20th century, in many countries, hospital deaths increased and home deaths reduced. Despite the fact that this trend has been halted or reversed in some countries (notably the United States, Canada and, more recently, the United Kingdom) in the last 5–20 years, a home death is still a distant reality for the majority, even though evidence shows it is the most commonly preferred place to die. Epidemiological studies identified factors associated with home death, including affluence, patients’ preferences, provision of home care and extended family support. Evidence about the benefits of home care is conflicting, but recent data suggest that holistic well-being may be greater at home.

Implications:

We call for further analyses of variations in place of care and place of death and robust studies on how patients and families formulate and change preferences over time. Regular monitoring of outcomes, quality and costs of palliative home care is urged.
Development of a supportive care measure for economic evaluation of end-of-life care using qualitative methods
Authors: Sutton Eileen J , Coast Joanna
Published: May 2013

Background:

An imperative to assess the economic impact of care at the end of life is emerging in response to national policy developments in a number of settings. Current focus on health benefits in economic evaluation may not appropriately capture benefits of interventions at the end of life. No instruments are available for measuring such benefits for economic evaluation of end-of-life care.

Aim:

To develop a descriptive system for a measure for use in economic evaluation of end-of-life care.

Design:

An initial phase of in-depth interviews was conducted to develop conceptual attributes for inclusion in a measure; a second phase of semi-structured repeat interviews with a subsample of informants was carried out to clarify and confirm the final set of attributes and to develop meaningful wording for a measure.

Setting/participants:

In total, 23 older people from three groups across the dying trajectory: older people (1) within the general population, (2) living in residential care and (3) receiving palliative care.

Results:

Interviews suggested that the important domains to include within this framework from the perspective of those approaching the end-of-life are choice/having a say in decision-making, love and affection/being with people who care, freedom from physical suffering, freedom from emotional suffering, dignity and self-respect, support, and preparation. A full descriptive system comprising seven questions, each representing one attribute, was developed.

Conclusion:

Economic evaluation should reflect the broader benefits of end-of-life care. Although the supportive care measure developed here requires validation and valuation, it provides a substantial step forward in appropriate economic evaluation of end-of-life care.
Psittacid Herpesvirus 3 Infection in the Eclectus Parrot (Eclectus roratus) in Australia
Authors: Gabor M. , Gabor L. J. , Peacock L. , Srivastava M. , Rosenwax A. , Phalen D.
Published: May 2013

Psittacid herpesvirus 3 (PsHV-3) has recently been implicated as the cause of a severe respiratory disease in Bourke’s parrots ( Neopsephotus bourkii) in the United States. In this report, the clinical manifestations and gross and microscopic lesions of PsHV-3 infection in 2 eclectus parrots ( Eclectus roratus) in Australia are described. The presence of a PsHV-3 infection was confirmed by polymerase chain reaction amplification and sequencing of PsHV-3 DNA using degenerate and PsHV-3 primers. Electron microscopy of infected cells demonstrated the assembly of herpesvirus virions as well as intranuclear tubular structures. The detection of PsHV-3 in Australia in 2 eclectus parrots broadens the list of known affected species and confirms the presence of this virus in Australia.
Copper Toxicosis in New Zealand White Rabbits (Oryctolagus cuniculus)
Authors: Ramirez C. J. , Kim D. Y. , Hanks B. C. , Evans T. J.
Published: May 2013

Six 12- to 14-month-old New Zealand White rabbits were diagnosed with copper toxicosis. These rabbits were part of a group of 110 purchased and shipped overnight for research purposes. On arrival, the group experienced an abrupt diet change. Eight died over 3 weeks and 6 were submitted for postmortem examination. Microscopic findings included severe centrilobular to midzonal hepatocellular necrosis with rhodanine stain–positive copper granules in the remaining hepatocytes. Mild periportal fibrosis and biliary hyperplasia, hemoglobinuric nephrosis, and splenic erythrophagocytosis were also observed. Hepatic copper concentrations were elevated, ranging from 319 to 997 ppm. Clinical disease was not previously observed in younger rabbits gradually transitioned from the supplier’s copper-supplemented diet. Copper toxicosis likely occurred in these rabbits from a combination of (1) increased duration of copper supplementation leading to increased hepatocellular stores and (2) stress leading to anorexia and release of hepatocellular copper stores similar to chronic copper toxicosis as described in sheep.
Changes in self-efficacy beliefs over time: Contextual influences of gender, rank-based placement, and social support in a competitive orchestra environment
Authors: Hendricks Karin S.
Published: May 2013

This research adds to the growing body of music self-efficacy literature by profiling changes in instrumental performance self-efficacy perceptions of 157 high school student musicians over the course of a 3-day competitive honor orchestra festival in order to clarify contextual influences upon self-efficacy perceptions within a high-stakes music performance environment. Student participants completed surveys, participated in interviews, and were observed by a team of researchers over the course of the festival. Reported instrumental performance self-efficacy beliefs were profiled over time by characteristics of gender, orchestra placement, and influence of competitive environment versus social support. Repeated measures analysis revealed a significant general increase in students’ instrumental performance self-efficacy beliefs over time, with a delayed increase in self-efficacy beliefs of females placed in the top orchestra. Qualitative data from interviews, observations, and open-ended survey responses were analyzed according to the sources of self-efficacy and in relation to statistical results. Findings suggest a strong influence of enactive mastery experience for all students, and a negative influence of competitive environment upon female self-beliefs. Recommendations include providing positive enactive mastery experiences for all students, and teacher awareness of student differences by gender, competitive placement, and influence of social support.
Decreased Range of Motion Is Associated With Structural Hip Deformity in Asymptomatic Adolescent Athletes
Authors: Yuan Brandon J. , Bartelt Robert B. , Levy Bruce A. , Bond Jeffrey R. , Trousdale Robert T. , Sierra Rafael J.
Published: May 2013

Background:

Decreased hip range of motion (ROM) is a common finding in patients with femoroacetabular impingement (FAI).

Purpose:

To report the prevalence of decreased hip ROM in asymptomatic adolescent athletes and to correlate examination findings to signs of FAI on radiographs and magnetic resonance imaging (MRI).

Study Design:

Cross-sectional study (prevalence); Level of evidence, 3.

Methods:

A total of 226 adolescent athletes presenting for state-mandated preparticipation physical examinations were assessed. Hip internal rotation was measured with the participant supine and the hip flexed to 90°. All participants with ≤10° of internal rotation were invited to return for standard radiographs and MRI of both hips. An age-matched control group, with >10° of internal rotation, underwent MRI examination only. Twenty-six athletes (13 study and 13 control) returned for clinical and radiographic examinations.

Results:

Nineteen athletes (34 hips, 8%) were found to have <10° of internal rotation. Eight athletes (13 hips, 3%) also had a positive anterior impingement sign. Thirteen of 19 athletes participated in the radiographic portion of the study. Of these 13 participants, 4 had limited internal rotation unilaterally, leaving 22 hips in the study group. Eight of 13 participants (15 hips, 68%) had a cam-type deformity evident on plain radiographs, and 4 participants (7 hips, 32%) had a positive radiographic crossover sign. The average α angle measured from radial MRI sequences was 58.1° in the study group versus 44.3° in the control group ( P < .001). Fifteen hips (68%) in the study group had abnormal MRI findings within the acetabular labrum or cartilage compared with 10 of 26 hips (38%) in the control group (odds ratio, 3.4; P = .078).

Conclusion:

Eight percent of asymptomatic teenagers had limited internal rotation on examination; 68% of these had radiographic findings suggestive of FAI. More than two thirds of these participants had evidence of asymptomatic hip pathological lesions on MRI.
Posttraumatic Migraine as a Predictor of Recovery and Cognitive Impairment After Sport-Related Concussion
Authors: Kontos Anthony P. , Elbin R.J. , Lau Brian , Simensky Steven , Freund Brin , French Jonathan , Collins Michael W.
Published: May 2013

Background:

Although previous research has demonstrated that patients with posttraumatic migraine (PTM) after concussion report more symptoms and cognitive deficits after injury than do those without PTM, it is not known whether these effects persist beyond the first week of injury or whether PTM predicts recovery time.

Purpose:

To determine whether PTM during the first week after injury predicts (1) cognitive impairment and symptoms in the second week after injury and (2) overall recovery time.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Participants were 138 male high school football players with a mean age of 15.96 years (SD, 1.18 years; range, 13-19 years). They were classified into 3 groups: PTM (headache, nausea, and photosensitivity or phonosensitivity), headache (headache without the other PTM symptoms), or no headache (no headache or PTM symptoms). The Immediate Post-concussion Assessment and Cognitive Test (ImPACT) was used to assess cognitive performance and symptoms at baseline, postinjury days 1-7, and postinjury days 8-14. Recovery time data were collected from medical records.

Results:

The PTM group performed worse on verbal memory than did the headache group at 8-14 days after injury. The PTM group performed worse on visual memory, reaction time, and symptoms than did the other groups at 1-7 days and 8-14 days after injury. The PTM group was 7.3 times (95% confidence interval, 1.80-29.91) more likely to have protracted recovery (>20 days) than the no headache group and 2.6 times (95% confidence interval, 1.10-6.54) more likely than the headache group.

Conclusion:

Results suggest that PTM is associated with cognitive impairments and protracted recovery and that headache alone is not a good predictor of recovery.
Awareness assessment of harmful effects of mercury in a health care set-up in India
Authors: Halder Nabanita , Peshin Sharda Shah , Pandey Ravindra Mohan , Gupta Yogendra Kumar
Published: May 2013

Mercury, one of the most toxic heavy metals, is ubiquitous in environment. The adverse health impact of mercury on living organisms is well known. The health care facilities are one of the important sources of mercury release into the atmosphere as mercury items are extensively used in hospitals. To assess the awareness about mercury toxicity and the knowledge of proper handling and disposal of mercury-containing items in health care set–up, a questionnaire-based survey was carried out amongst doctors ( n = 835), nurses ( n = 610) and technicians ( n = 393) in government hospitals, corporate hospitals and primary health care centres in the Indian states of Delhi, Uttar Pradesh and Haryana. The study was conducted using a tool-containing pretested structured multiple-choice questionnaire. Analysis of the results using STATA 11.1 software highlighted that overall awareness was more in corporate sector. However, percentage range of knowledge of respondents irrespective of health care sector was only between 20 and 40%. Despite the commitment of various hospitals to be mercury free, mercury containing-thermometer/sphygmomanometer are still preferred by health professionals. The likely reasons are availability, affordability, accuracy and convenience in use. There is an urgent need for source reduction, recycling and waste minimization. Emphasis must be laid on mercury alternative products, education and training of health personnel and public at large, about correct handling and proper clean up of spills.
The Association of Serum Bilirubin Levels on the Outcomes of Severe Sepsis
Authors: Patel Jayshil J. , Taneja Amit , Niccum David , Kumar Gagan , Jacobs Elizabeth , Nanchal Rahul
Published: May 2013

Purpose:

Admission serum bilirubin levels have been incorporated into severity of illness scoring systems in critical illness as a marker of liver dysfunction. The purpose of our study is to determine the independent association of serum bilirubin with mortality in severe sepsis and septic shock.

Methods:

We conducted a retrospective study of adult patients admitted with severe sepsis and septic shock. We excluded patients with a prior history of liver disease. We identified the highest serum bilirubin within 72 hours of admission and stratified bilirubin levels into ≤1 mg/dL (normal), 1.1 to 2 mg/dL (abnormal up to 2 mg/dL), and >2 mg/dL. We sought to determine the independent association of hyperbilirubinemia with mortality and length of intensive care unit stay in persons with severe sepsis and septic shock.

Results:

A total of 251 patients met criteria for severe sepsis. In all, 200 patients had a bilirubin of <1 mg/dL, and 51 had a bilirubin of >1 mg/dL. Of these 51, 12 had a bilirubin >2 mg/dL. Mortality was 12%, 24%, and 42% in persons with a bilirubin ≤1, 1.1 to 2, and >2 mg/dL, respectively. Compared to those with a bilirubin ≤ 1 mg/dL, adjusted odds of mortality in patients were 3.85 (95% confidence interval [CI] 1.21-12.2) and 9.85 (95% CI 1.92-50.5) times higher in persons with bilirubin levels between 1.1 and 2 and >2 mg/dL, respectively.

Conclusion:

After multivariable adjustment for potential confounding factors, elevated serum bilirubin levels within 72 hours of admission are associated with an increased risk of mortality in patients with severe sepsis and septic shock. Prospective studies are warranted to further validate our findings.
Intimate Partner Violence
Authors: Lamis Dorian A. , Leenaars Lindsey S. , Jahn Danielle R. , Lester David
Published: May 2013

The current study examined the relations among several risk factors—hopelessness, depressive symptoms, perceived burdensomeness, thwarted belongingness, alcohol-related problems, and intimate partner violence (victimization and perpetration)—and suicide ideation, as measured by the Modified Scale for Suicide Ideation, in college students ( n = 994). In addition, the overlap between being a victim and perpetrator of various types of intimate partner violence was examined. Results indicated substantial overlap in the victim and perpetrator roles, up to 96.6% for negotiation. In the negative binomial regression analysis, reports of hopelessness, depressive symptoms, perceived burdensomeness, thwarted belongingness, and alcohol-related problems all significantly predicted suicide ideation in the expected direction. However, none of the revised Conflict Tactics Scale subscales predicted suicide ideation above and beyond the established risk factors. Implications are offered for the improved identification and treatment of suicidal thoughts and behaviors among college students.
Experimental investigation of thermoforming carbon fibre-reinforced polyphenylene sulphide composites
Authors: Han Peidong , Butterfield Joe , Price Mark , Buchanan Saul , Murphy Adrian
Published: May 2013

Pre-consolidated carbon fibre-reinforced polyphenylene sulphide (CF/PPS) laminates were thermoformed into V-shaped parts via designed out of autoclave thermoforming experiments. The different processing conditions tested in the experiment have resulted in final part angles whose differences ranged from 2.087 to 3.431° from the original mould angle. The test results show that processing conditions influenced finished part dimensions as the final sample angles were found to decrease relative to the tooling dimensions, as mould temperature increases. Higher mould temperature conditions produce thinner parts due to the thermal expansion of mould tools. The mould temperature of 170°C, which can produce parts with high degree of crystallinity as well as small size of crystal, has been established as the optimal thermoforming condition for CF/PPS composites.
Temporal Predictability Facilitates Action, Not Perception
Authors: Thomaschke Roland , Dreisbach Gesine
Published: May 2013

Expectancy for upcoming action requirements is a fundamental prerequisite for human control of action. In the research reported here, we investigated which part of cognitive processing benefits from temporal predictability. In a binary forced-choice paradigm, visual targets were preceded by different intervals. In one condition, targets could be predicted by the length of the intervals. In other conditions, response goals or response effectors could be predicted by the length of the intervals. Behavioral advantages were observed when response effectors were temporally predictable, whereas temporal predictability of response goals and target stimuli was not sufficient. The findings thus show that temporal expectancy in speeded choice-reaction tasks facilitates late, effector-specific motor processing. These findings are of importance not only for our basic understanding of action control but also for any human-machine interaction that involves system delays.
What Predicts Successful Literacy Acquisition in a Second Language?
Authors: Frost Ram , Siegelman Noam , Narkiss Alona , Afek Liron
Published: May 2013

In the study reported here, we examined whether success (or failure) in assimilating the structure of a second language can be predicted by general statistical-learning abilities that are nonlinguistic in nature. We employed a visual-statistical-learning (VSL) task, monitoring our participants’ implicit learning of the transitional probabilities of visual shapes. A pretest revealed that performance in the VSL task was not correlated with abilities related to a general g factor or working memory. We found that, on average, native speakers of English who more accurately picked up the implicit statistical structure embedded in the continuous stream of shapes better assimilated the Semitic structure of Hebrew words. Languages and their writing systems are characterized by idiosyncratic correlations of form and meaning, and our findings suggest that these correlations are picked up in the process of literacy acquisition, as they are picked up in any other type of learning, for the purpose of making sense of the environment.
Quantifying uncertainty in isotope dendroclimatology
Authors: Loader NJ , Young GHF , McCarroll D , Wilson RJS
Published: May 2013

To maximise the potential of the tree-ring isotopic signal for palaeoclimate research it is essential to understand and characterise the natural variability between individual trees. This study explores the nature of inter-tree isotopic variability and evaluates the implications for developing robust palaeoclimate reconstructions. We confirm levels of natural inter-tree variability similar to those reported in previous studies, but demonstrate, using a large data set of isotopic measurements determined from individual rings of 100 trees, that to obtain a representative regional environmental signal and to reduce problems when combining records, higher levels of replication than those typically adopted in isotope dendroclimatology may need to be considered.
Effect of chronic alcohol drinking on rat liver microsomal nitroreductive metabolism of Nifurtimox and Benznidazole
Authors: Mecca MM de , Bartel LC , Castro JA
Published: May 2013

Nifurtimox (Nfx) and benznidazole (Bz) have serious toxic side effects. Manufacturers warn about significant adverse effects when simultaneous alcohol consumption is being made, but its mechanism is not known. The levels and toxicity of these drugs are linked to their liver microsomal nitroreduction to reactive metabolites. In this study, we analyzed whether alcohol drinking enhanced those nitroreductive processes. Male and female Sprague-Dawley rats, 5–6 weeks old (125–150 g body weight) were used. They were fed ad libitum for 28 days with Lieber and De Carli control or alcohol regular liquid diets. The rats were separated into two dietary groups: ethanol and control group. Both were pair fed with the respective diet. Their liver microsomes were isolated and the nicotinamide adenine dinucleotide phosphate-dependent nitroreduction of Nfx and Bz were determined. Alcohol drinking significantly induced microsomal nitroreduction of these drugs in male rats (11% for Nfx and 41% for Bz) but not in females. The activity observed in the alcohol-induced male rats was 100% inhibited by diphenyleneiodonium and attributable to P450 reductase. Inductive effects of alcohol drinking on nitroreductive activation of both drugs might be only partially involved in the harmful interactions described.
For the past yet to come: Utopian conceptions of time and becoming
Authors: Firth Rhiannon , Robinson Andrew
Published: May 2013

This article examines a number of critical-theoretical, utopian alternatives to the dominant temporal conception of ‘homogeneous empty time’. It explores the ways in which difference is theorized within the field of time, and the ways in which relations to the past and future can be constructed non-sequentially. It focuses on four related theories. Nietzsche’s theory of eternal return is shown to be inspired by a critique of backward-looking views of time and an orientation to an abundance of the present. Benjamin’s theory of messianic time combines the immediacy of ‘now-time’ with a non-successive connection to past and future times. Deleuze’s Bergsonian view of time suggests the simultaneity of the past with the present, and the possibility of constructing connections between different zones of time and actualizing these zones in the present. Agamben’s theory of temporal play focuses on immediacy, the redemption of the past, and the abandonment of the mastery of history. Each of these theories is discussed in terms of its own conception of time, its difference from dominant conceptions of time, and its relationship to utopia. While offering four distinct alternatives, the theorists all critique alienated and objectivist views of time, and offer different varieties of temporal rhizomatics and polyphony. The juxtaposition of these theories provides the underpinnings for temporal utopianism as a new field of study. The idea of temporal utopianism demonstrates that utopia can be a temporal as well as a spatial phenomenon, and that the experience of time characteristic of capitalist modernity is contingent rather than necessary. It thus points towards a rupture with the sense of closure generated by dominant conceptions of time, creating temporal zones in which utopian spaces can be actualized.
A systematic selection method for the development of cancer staging systems
Authors: Lin Yunzhi , Chappell Richard , Gönen Mithat
Published: May 2013

The tumor–node–metastasis (TNM) staging system has been the anchor of cancer diagnosis, treatment, and prognosis for many years. For meaningful clinical use, an orderly, progressive condensation of the T and N categories into an overall staging system needs to be defined, usually with respect to a time-to-event outcome. This can be considered as a cutpoint selection problem for a censored response partitioned with respect to two ordered categorical covariates and their interaction. The aim is to select the best grouping of the TN categories. A novel bootstrap cutpoint/model selection method is proposed for this task by maximizing bootstrap estimates of the chosen statistical criteria. The criteria are based on prognostic ability including a landmark measure of the explained variation, the area under the receiver operating characteristic (ROC) curve, and a concordance probability generalized from Harrell’s c-index. We illustrate the utility of our method by applying it to the staging of colorectal cancer.
MCAR is not necessary for the complete cases to constitute a simple random subsample of the target sample
Authors: Galati John C , Seaton Katherine A
Published: May 2013

Missing data is the norm rather than the exception in complex epidemiological studies. Complete-case analyses, which discard all subjects with some data values missing, are known to be valid under the very restrictive assumption that the response mechanism is missing completely at random (MCAR). While conditions weaker than MCAR are known under which estimators of regression coefficients are unbiased, one often comes across the view in the literature that MCAR is necessary for the complete cases to form a simple random subsample of the target sample. In this paper, we explain why this is not the case, and we distill an assumption weaker than MCAR under which the simple random subsample condition holds, which we call available at random (AAR). Moreover, we show that, unlike MCAR, AAR response mechanisms can be missing not at random (MNAR). We also suggest how approximate AAR mechanisms might arise in practice through cancellation of selection and drop-out effects, and we conclude that before pooling partially complete and complete cases into an analysis, the investigator should consider how selection might impact on the representativeness of the cases included in the pooled analysis (compared to those comprising the complete cases only).
Assessing Business Student Thinking Skills
Authors: Smith Gerald F.
Published: May 2013

The development of student thinking skills is a major goal of business education. As with other such goals, student outcomes assessment must be undertaken to measure goal achievement. Thinking is difficult to teach; it is also difficult to assess. The purpose of this article is to improve management educators’ understanding of student thinking skills, how they can be developed, and how they can be assessed, thereby enabling business schools to graduate students who can think effectively. The article begins by reviewing major conceptual perspectives on higher order thinking and how related skills have been assessed in higher education. It then provides an account of business student thinking skills that highlights the role of thinking-relevant knowledge and the need to have students integrate and apply their thinking skills in practical situations. After explaining how the business school context and thinking skills content shape assessment efforts, the article identifies shortcomings in how business students are being taught to think, shortcomings that persist in part because of deficiencies in assessment practices. It proposes ways of improving the teaching and assessment of thinking in business schools.
Concrete Steps for Assessing the “Soft Skills” in an MBA Program
Authors: Ingols Cynthia , Shapiro Mary
Published: May 2013

In 2006, our School of Management began the serious path of assessing both the “hard skills” (such as accounting, finance, and strategy) and the “soft skills” (such as leadership, team work, and ethics) of our MBA Program. The data generated from examining the “soft skills” that we want students to learn within our Organization Behavior courses quickly noted performance gaps between what the faculty hoped our students were learning and what students demonstrated that they knew. In this article, we will describe our assessment methods in detail, exploring three methods of assessment that we developed to assess “soft skills”, specifically: using a commercially available 360-degree instrument, building our own instrument based on well-established theory, and reaching out to experts. We share how we transformed various course-embedded deliverables into useable data and how we “closed the loop” and changed the curriculum within our MBA Program. We provide processes and instruments that could be used by other institutions struggling to make measureable (assessable and actionable) any of their own soft-skill MBA competencies.
High-dose methotrexate in adult oncology patients: A case-control study assessing the risk association between drug interactions and methotrexate toxicity
Authors: Chan April J , Rajakumar Irina
Published: May 2013

Introduction

High-dose methotrexate, defined as dose ≥1 g/m2, is commonly used in chemotherapy protocols. Certain drugs such as acyclovir, allopurinol, proton pump inhibitors and some antibiotics have been associated with delayed renal clearance of methotrexate and may predispose patients to toxicities. Currently, no specific recommendations exist on adjusting the high-dose methotrexate regimen in the presence of potential interacting drugs. This study aims to determine whether presence of interacting drugs is associated with delayed methotrexate clearance.

Methods

This was a case-control study of adult oncology patients who received their first cycle of high-dose methotrexate. Cases were defined as patients who experienced delayed methotrexate clearance, as indicated by serum methotrexate level ≥ 0.1 umol/L at 72 h. The primary endpoint was the frequency of presence of interacting drugs between cases and controls. These were compared using Fisher's exact test. Where possible, adjustment for significant baseline differences that can affect methotrexate clearance was made using logistic regression. The secondary endpoint was frequency of methotrexate-related clinical toxicities between groups and included myelosuppression, nephrotoxicity, hepatotoxicity and mucositis.

Results

From January 2004 to March 2011, 73 patients met study criteria, of which 23 were defined as cases. Significant baseline differences were methotrexate dose received (9116 mg ± 4339 versus 6054 mg ± 2874, p=0.012) and renal impairment (5 versus 0, p = 0.002). The presence of interacting drugs was not associated with delayed methotrexate clearance (OR 0.91, 95% CI 0.24–3.38, p > 0.999). After adjusting for methotrexate dose, drugs observed more frequently (allopurinol, proton pump inhibitors and sulfamethoxazole/trimethoprim) were not associated with delayed methotrexate clearance ( p = 0.95, 0.59 and 0.20, respectively). Cases experienced more severe anemia (grade 2.52 versus 1.68, p = 0.007) and higher rates of mucositis (65.2% versus 20.0%, p < 0.001).

Conclusion

This study showed no significant association between presence of interacting drugs and delayed methotrexate clearance. Patients who experienced delayed methotrexate clearance had higher incidence of severe anemia and mucositis.
Championing Person-First Language
Authors: Jensen Mary E. , Pease Elizabeth A. , Lambert Kris , Hickman Diane R. , Robinson Ora , McCoy Kathleen T. , Barut Jennifer K. , Musker Kathleen M. , Olive Dana , Noll Connie , Ramirez Jeffery , Cogliser Dawn , King Joan Kenerson
Published: May 2013

At the heart of recovery-oriented psychiatric mental health care are the dignity and respect of each person and the ways in which helping professionals convey a person’s uniqueness, strengths, abilities, and needs. “Person-first language” is a form of linguistic expression relying on words that reflect awareness, a sense of dignity, and positive attitudes about people with disabilities. As such, person-first language places emphasis on the person first rather than the disability (e.g., “person with schizophrenia” rather than “a schizophrenic”). This article champions the use of person-first language as a foundation for recovery-oriented practice and enhanced collaborative treatment environments that foster respect, human dignity, and hope.
The effect of vitamin D-related interventions on multiple sclerosis relapses: a meta-analysis
Authors: James Eleanor , Dobson Ruth , Kuhle Jens , Baker David , Giovannoni Gavin , Ramagopalan Sreeram V
Published: May 2013

Observational studies have shown an association between lower vitamin D levels and higher risk of relapse among people with multiple sclerosis (MS). This has raised interest in potential clinical benefits of vitamin D supplementation in the management of MS. The objectives were to examine the effect of vitamin D based interventions on the relative risk of relapse in MS. Any randomised controlled trial assessing the effect on the relative risk of relapse of any formulation or dose of vitamin D, in participants with MS, was eligible. The inverse variance with random effects model in Review Manager 5.1 was used to calculate the odds ratio of relapses in high dose vitamin D treated patients vs. controls. Five studies were published as of September 2012, yielding a total of 129 high-dose vitamin D-treated patients and 125 controls. We found no significant association between high-dose vitamin D treatment and risk of MS relapse (OR 0.98, 95% CI 0.45–2.16). In conclusion, although no significant association between high-dose vitamin D treatment and risk of MS relapses was found, the studies were limited by several methodological limitations. Further larger, more prolonged studies are merited.
A case of hereditary diffuse leukoencephalopathy with axonal spheroids caused by a de novo mutation in CSF1R masquerading as primary progressive multiple sclerosis
Authors: Saitoh Ban-yu , Yamasaki Ryo , Hayashi Shintaro , Yoshimura Satoshi , Tateishi Takahisa , Ohyagi Yasumasa , Murai Hiroyuki , Iwaki Toru , Yoshida Kunihiro , Kira Jun-ichi
Published: May 2013

We report a sporadic case of hereditary diffuse leukoencephalopathy with axonal spheroids (HDLS) confirmed by biopsy and colony-stimulating factor 1 receptor ( CSF1R) sequencing. A 28-year-old woman developed progressive spastic gait and dysarthria. Brain T2/FLAIR-weighted magnetic resonance imaging showed bilateral high signal intensity lesions in the parietal deep white matter, which subsequently extended anteriorly. Biopsied brain specimens demonstrated demyelinated white matter tissue with axonal spheroids infiltrated with foamy macrophages, and CD8+ and CD4+ T cells. She had a heterozygous mutation, c.2381T>C (p.782 Ile>Thr), in CSF1R. This is the first genetically proven case of HDLS mimicking primary progressive multiple sclerosis.
Guidance from a Royal College, does it have the force of law?
Authors: Ritchie Andrew
Published: May 2013

When a Royal College issues clear guidance on clinical practice, do NHS Trusts throughout the UK have to comply with that and if so how long do the Trusts have to implement the changes? Is cost relevant to the decision? And if a Trust fails to implement the changes necessary to comply with the guidance and patients suffer as a result, will the Trust become liable in law for the injuries and damage caused? These were the issues in a recent clinical negligence claim brought by Mr L against the Mid Essex NHS Trust. Mr L suffered a transient ischaemic attack and attended his general practitioner and later his local A & E department. Neither referred him to the local TIA service. Eleven days later he suffered a massive stroke and is now paralysed down one side.
PI Quantum Reports Submission – Crystal Higgs
Authors: Rawson Edwina
Published: May 2013

The claim related to treatment Crystal Higgs received at Edgware Community Hospital, London, for a serious psychiatric condition. She was inappropriately allowed to go to a shop near the hospital, with only a student nurse. Crystal was not supervised properly by the student nurse and jumped to her death from a multi storey car park.
Ten years of maternity claims: an analysis of the NHS Litigation Authority data – key findings
Authors: Anderson Annette
Published: May 2013

Maternity claims, as a group, are the most expensive clinical negligence claims reported to the NHS Litigation Authority (NHSLA) and the second highest by volume. As a consequence, the NHS LA launched a project Ten Years of Maternity Claims – An Analysis of NHS Litigation Authority Data reviewing maternity claims with an incident date between 1 April 2000 and 31 March 2010. This analysis was initiated to enable key trends to be identified, and to share the learning widely within the National Health Service (NHS) with a long-term goal of reducing harm occurring to women and babies accessing maternity care. During this period there were 5087 claims with a total value of £3.1 billion. Between the years 2000 and 2009 there were 5.5 million births in England. In all, 0.1% of births were subject to a clinical negligence claim. In other words, the vast majority of births do not result in a clinical negligence claim, which supports the view that having a baby within the NHS is very safe. As part of the project, primary and secondary level studies were undertaken. The former analysed the occurrence of types of maternity claim and the financial costs associated with them. The most frequent categories identified related to the management of labour, which involves fetal heart rate monitoring (14.05%), Caesarean section (13.24%) and cerebral palsy (10.65%). The secondary level study reviewed four categories of maternity claims which were chosen subjectively from discussions with stakeholders. The categories identified were – antenatal ultrasound investigations, cardiotocograph interpretation, perineal trauma and uterine rupture. By undertaking additional in depth analysis the objective was to identify factors from which risk management recommendations could be formulated to facilitate learning from claims, with the aim of reducing cases of actual harm to mothers and babies. This article highlights the key findings from the study and suggests recommendations for ongoing learning within maternity services.
Failure to rescue: using rapid response systems to improve care of the deteriorating patient in hospital
Authors: Subbe Christian Peter , Welch John Robert
Published: May 2013

“Failure to rescue” is the inadequate or delayed response to clinical deterioration in hospitalized patients. Rapid response systems are a set of hospital-wide interventions that attempt to reduce failure to rescue by improving patient monitoring on general wards (the afferent component) and the reliability of the response to deterioration by a dedicated Critical Care Outreach Team, Rapid Response Team or Medical Emergency Team (the efferent component). The reliability of such systems depends on the faultless functioning of a “chain of survival” consisting of: (1) high-quality recording of vital signs; (2) the education and mind-set of staff at the bedside to recognize pathological patterns; (3) the reporting of abnormality to the efferent team; (4) a timely and appropriate response by the latter. Repeated feedback loops are crucial for an effective functioning of the chain.