bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender-Specific Differences in Corporal Punishment and Children’s Perceptions of Their Mothers’ and Fathers’ Parenting
Authors: Mehlhausen-Hassoen David
Published: April 2019

Corporal punishment is a widespread phenomenon and a common malformation of parenting. Gender is a core category of social order and family structure. Gender-specific differences in parenting and violent behavior have been studied for many years. Yet, relatively little is known about the impact of gender interactions on parent-to-child physical violence or the impact of such violence on children’s perceptions of their parents’ behavior. This study used data collected from 618 students in academic institutions in northern Israel to examine the relationship between different gender interactions (e.g., mother–daughter, mother–son, father–daughter, and father–son) and the frequency of corporal punishment experienced by the respondents when they were in elementary school (between the ages 6 and 12). This study also examined whether gender interactions influence the relationship between corporal punishment and respondents’ perceptions of their parents’ behavior, namely the perceived parenting the respondents received during childhood. Cross tabulations and repeated measures were used to analyze the data. Significantly fewer daughters (as compared with sons) experienced corporal punishment and significantly fewer daughters experienced corporal punishment from both parents. Corporal punishment had a significant negative impact on the perceived parent–child relationship. Violent parental behavior had a significantly stronger effect on the perception of the father–child relationship, as compared with the perception of the mother–child relationship, even when the mother was the violent parent. These findings point to the importance of gender interactions in research and psychosocial practice.
Female Intimate Partner Violence Survivors’ Experiences With Disclosure to Informal Network Members
Authors: Johnson Ingrid Diane , Belenko Steven
Published: April 2019

With the growing recognition of the importance of disclosure to informal network members (INMs) in shaping experiences for survivors of intimate partner violence (IPV), numerous quantitative studies have examined these processes, but have not provided detailed descriptive analyses of the disclosure process. Yet, these descriptive data can be a rich contribution in their own right given the dearth of knowledge about IPV disclosure. This article presents in-depth descriptive data on a Mid-Atlantic metropolitan area sample of 200 female IPV survivors’ experiences with disclosure to their INMs (collected using a one-time, online survey). Most survivors (66%) disclosed to at least one INM during their initial violent relationship. The three most commonly experienced reactions to disclosure were INMs listening to the survivors’ feelings, urging the survivors to talk about how they felt, and expressing that the violent partners’ behaviors were problematic. The three least commonly experienced reactions were INMs blaming survivors or saying that they deserved to be treated that way, offering financial assistance, and telling them to stop talking about the incident(s). Among survivors who disclosed to their INMs, 93.9% agreed that disclosure to their INMs helped them in some way. Survivors had disclosure experiences that were relatively comparable with other survivor samples, indicating good external validity. The findings regarding reactions to disclosure were also comparable with previous studies, although the extant published literature was quite limited. Young female survivors experience a variety of reactions from their INMs, most often experiencing supportive and subjectively “positive” reactions. As the research delving into the influences and impacts of disclosure expands, close attention should be paid to how these variables are being collected and disseminated so that we have a better understanding of what happens during disclosure to INMs.
Lactation Support for LGBTQIA+ Families
Authors: Chetwynd Ellen M. , Facelli Victoria
Published: April 2019

Background:

Despite a documented underutilization of healthcare by the LGBTQIA+ community due to fear of mistreatment, reproduction incurs a likely dependence on the medical system. Within breastfeeding medicine, the language used for breastfeeding or chestfeeding has broadened and there is an emphasis on inclusion of all types of gender identities; however, that care can be heavily biased toward the inclusion of all breasts/chests in infant feeding.

Research aim:

The purpose of this case study was to examine the impact of queer identity on the gestational and postpartum experience of a bisexual woman married to, and parenting with, a transgender man. It draws into perspective the need to practice in accordance with patients’ self-described gender and parenting roles.

Results:

The parenting roles of this couple were the same as any married, straight, cisgender couple, yet the family identified as queer. The mother in this case experienced low milk production, but the father had had chest reconstructive surgery and started hormones so that they could enter parenthood as the family they had envisioned for themselves. At no point was there any consideration that the father induce milk production for his baby or that chest reconstructive surgery had been mistimed. Their pregnancy support team was supportive of their gender identities and parenting roles, yet they still found themselves orienting and educating the healthcare team throughout their pregnancy and postpartum experience.

Conclusions:

Caring for the LGBTQIA+ community requires us to recognize our assumptions and act in affirming ways for all parents, regardless of their family constellation.
Injection-molded PP composites reinforced with talc and nanoclay for automotive applications
Authors: Nofar Mohammadreza , Ozgen Elif , Girginer Burcu
Published: April 2019

In this study, a commercially available polypropylene (PP) copolymer with 30-wt% talc was used as a reference material. Two different PP copolymers with 30- and 20-wt% talc were also taken as alternatives. Despite the reference PP compound, the other two alternatives are still under development and never used for the production of any exterior trim part in automotive industry. These three PP compounds were injection molded with fixed mold and barrel temperatures. Then, the samples were molded at different mold and barrel temperatures to investigate the effects of processing parameters on the mechanical and thermal properties of the final product. Finally, the effect of addition of 1-, 3- and 5-wt% nanoclay on the final properties of the PP with 20-wt% talc was explored. Differential scanning calorimeter was used to analyze the crystallization behavior of the samples. Tensile, bending, and Izod and Charpy impact tests were performed on these samples. Heat deflection temperatures and Vicat softening points were also measured. The X-ray diffraction analysis was performed to see the dispersion of the nanoclay in the PP matrix.
Unintended outcomes effects of the European Union and the International Monetary Fund on Hungary's public sector and administrative reforms
Authors: Török Zoltán
Published: April 2019

This article investigates European Union and International Monetary Fund influence on Hungary's public sector reforms in the period 2004–2013, that is, a time period that saw the initiation of the European Union's Excessive Deficit Procedure (the whole period) and an International Monetary Fund bailout programme (2008–2010). In this case, public sector reforms became derailed from the externally proposed trajectory and took the opposite direction: instead of fostering decentralization of the state administration and deepening the Europeanization process, Hungary's restructuring of the public sector delivered centralization and a ‘power grab’ that eventually impinged on some core values of the European Union ‘constitution’ (the acquis communautaire). This study aims to explain this empirical puzzle by in-depth analysis of how external influence was exerted and became interwoven with dynamically changing domestic factors in circumstances of conditionality. The research is framed by existing policy transfer and public sector reform theories. The article argues that the Hungarian case provides evidence of the unintended consequences of European Union-driven public sector reforms.
Exploiting conditionality: EU and international actors and post-NPM reform in Ireland
Authors: MacCarthaigh Muiris , Hardiman Niamh
Published: April 2019

Between 2008 and 2015, Ireland undertook unprecedented and systemic public sector reforms in a polity not traditionally considered a prominent reformer. While some of these reforms comprised part of the loan programme agreement with EU and international actors, many others did not. This article argues that the crisis in Ireland provided a window of opportunity to introduce reforms that political and administrative elites had previously found difficult to implement. The authority of the Troika was invoked to provide legitimacy for controversial initiatives, yet some of the reforms went further than the loan programme strictly required. A number of these concerning organisational rationalisation, the public service ‘bargain’ and transversal policy coordination are considered here. Agreements were negotiated with public sector unions that facilitated sharp cuts in pay and conditions, reducing the potential for opposition to change. The reform effort was further legitimated by the reformers’ post-New Public Management, whole-of-government discourse, which situated considerations of effectiveness and efficiency in a broader framework of public service quality and delivery.
Have policy process scholars embraced causal mechanisms? A review of five popular frameworks
Authors: van der Heijden Jeroen , Kuhlmann Johanna , Lindquist Evert , Wellstead Adam
Published: April 2019

Over 30 years, several key frameworks and theories of the policy process have emerged which have guided a burgeoning empirical literature. A more recent development has been a growing interest in the application of a ‘causal mechanism’ perspective to policy studies. This article reviews selected theories of the policy process (Multiple Streams Approach, Advocacy Coalition Framework, Punctuated Equilibrium Theory, Narrative Framework Theory, and Institutional Analysis and Development Framework) and reports on an exploratory meta-analysis and synthesis to gauge the take-up of causal-mechanistic approaches. The findings suggest that there has been limited application of causal mechanisms and calls for more theoretical and empirical work on that aspect. Given the overlapping frameworks exploring different aspects of the policy process, further research informed by causal-mechanism approaches points to a new generation of inquiry across these and other policy process theoretical frameworks.
Design for manufacture and assembly of a polycentric paediatric prosthetic knee
Authors: Mangera Taahirah , Kienhöfer Frank , Carlson Kristian , Conning Mariette , Purkis Tamsin , Govender Gonasagren
Published: April 2019

Design for manufacture and assembly is a critical step in the product design life cycle. In this study, design for manufacture and assembly theory was applied to the design of a polycentric paediatric prosthetic knee to resolve assembly and manufacture issues prior to product prototyping. Assembly time and efficiency prior and subsequent to design for assembly analysis was calculated. By combining redundant parts and improving the ease of alignment, orientation, and insertion of various parts through modification of part features, a 10.1% increase in assembly efficiency was achieved. Design for manufacture analysis was then performed for die casting of the component. Undercut features were removed and replaced with the use of standard components, reducing the assembly time of the component by reducing the complexity of parts. Proposed design changes were verified using finite element analysis to simulate the loading conditions of a polycentric prosthetic knee as per the ISO10328:2006 standard for methods of testing prostheses. An overall improvement of 13.6% in assembly efficiency was achieved after the design for manufacture and assembly analysis. The improvement is due to the decrease in assembly insertion time and eliminating small parts and parts in areas that were difficult to access. The reduction in assembly time will directly reduce the labour cost for assembly of the manufactured product. This case study illustrates how design for manufacture and assembly theory can be applied to the design of biomedical equipment to reduce the need for prototype re-work and the consequent costs.
Combination immunosuppressant therapy and lupus nephritis outcome: a hospital-based study
Authors: Chen Y M , Hung W T , Liao Y W , Hsu C Y , Hsieh T Y , Chen H H , Hsieh C W , Lin C T , Lai K L , Tang K T , Tseng C W , Huang W N , Chen Y H
Published: April 2019

Lupus nephritis (LN) is the leading cause of mortality in lupus patients. This study aimed to investigate the treatment outcome and renal histological risk factors of LN in a tertiary referral center. Between 2006 and 2017, a retrospective observational study enrolled 148 biopsy-proven LN patients. After propensity score matching, 75 cases were included for further analysis. The classification and scoring of LN were assessed according to the International Society of Nephrology/Renal Pathology Society. Treatment response was evaluated by daily urine protein and urinalysis at two years after commencing induction treatment and the development of end-stage renal disease (ESRD). In total, 50.7% patients achieved complete remission (CR) or partial remission (PR), while 49.3% patients were categorized as nonresponders. Therapeutic responses in terms of CR/PR rates were associated with Systemic Lupus Erythematosus Disease Activity Index scores (odds ratio (OR): 1.34, 95% confidence interval (CI): 1.12–1.60, p = 0.001). Moreover, higher baseline creatinine levels (hazard ratio (HR): 2.10, 95% CI: 1.29–3.40, p = 0.003), higher renal activity index (HR: 1.30, 95% CI: 1.07–1.58, p = 0.008) and chronicity index (HR: 1.40, 95% CI: 1.06–1.85, p = 0.017) predicted ESRD. Among pathological scores, cellular crescents (HR: 4.42, 95% CI: 1.01–19.38, p = 0.049) and fibrous crescents (HR: 5.93, 95% CI: 1.41–24.92, p = 0.015) were independent risk factors for ESRD. In conclusion, higher lupus activity was a good prognostic marker for renal remission. Renal histology was predictive of ESRD. Large-scale prospective studies are required to verify the efficacy of mycophenolate in combination with azathioprine or cyclosporine in LN patients.
Hydroxychloroquine treatment during pregnancy in lupus patients is associated with lower risk of preeclampsia
Authors: Seo M R , Chae J , Kim Y M , Cha H S , Choi S J , Oh S , Roh C -R
Published: April 2019

Background

Hydroxychloroquine (HCQ) is regarded as a mainstay in the treatment of systemic lupus erythematosus (SLE) because of its efficacy in preventing flares, achieving remission, and reducing overall mortality. However, the impact of HCQ on pregnancy outcomes remains controversial.

Objective

We aimed to investigate the effect of HCQ on pregnancy outcomes in patients with SLE.

Methods

We performed a retrospective cohort study of 151 pregnancies in 122 patients with SLE (80 pregnancies in the HCQ treatment group and 71 pregnancies in the HCQ nontreatment group). We reviewed baseline characteristics including maternal comorbidities such as antiphospholipid syndrome, lupus nephritis, and autoimmune hepatitis. Pregnancy outcomes (preeclampsia, preterm delivery, and fetal growth restriction) and neonatal outcomes (gestational age at delivery and birth weight) were compared between HCQ treatment and nontreatment groups.

Results

Preeclampsia was significantly less complicated (7.5% vs 19.7%, p = 0.032) and neonatal birth weight was significantly greater (2757.0 ± 583.5 g vs 2542.3 ± 908.3 g, p = 0.001) in the HCQ treatment group than in the HCQ nontreatment group. Multiple logistic analysis adjusting for body mass index (BMI), lupus nephritis, serum uric acid, and estimated glomerular filtration rate revealed HCQ treatment was associated with exceedingly lower risk of preeclampsia in SLE pregnancy (odds ratio (OR) 0.106 (confidence interval (CI) 0.017–0.671)). Other independent risk factors for preeclampsia were a high prepregnancy BMI (OR 1.575 (CI 1.114–2.227)) and low eGFR level (OR 0.931 (CI 0.886–0.979)) before pregnancy.

Conclusion

Our data showed pregnancy outcomes in SLE patients can be improved in the HCQ treatment group with about 90% reduction of preeclampsia.
Patient’s informational privacy in prehospital emergency care: Paramedics’ perspective
Authors: Koskimies Eini Marianne , Koskenniemi Jaana , Leino-Kilpi Helena
Published: April 2019

Background:

As a fundamental human right in healthcare, informational privacy creates the foundation for patient’s safety and the quality of care. However, its realization can be a challenge in prehospital emergency care, considering the nature of the work.

Objectives:

To describe patient’s informational privacy, its realization, and the factors related to the realization in prehospital emergency care from the perspective of paramedics.

Research design:

A descriptive questionnaire study was conducted. The data were analyzed with inductive content analysis.

Participants and research context:

The participants (n = 26) were paramedics in one of the 22 rescue departments in Finland.

Ethical considerations:

The study received ethical approval from the ethics committee of the University of Turku (Finland). Permission for the study was given by the collaborating rescue department.

Findings:

Paramedics described patient’s informational privacy as patients’ right to their own health records, as protection of the patient’s health records, and as comprehensive respect of the patient’s privacy by the persons involved in the patient’s care. In general, informational privacy was described as being realized regarding confidentiality, reporting, and maintaining the patient’s health records. However, it was also described as being dependent on the context, and some areas in need of improvement were identified. Promoting and preventing factors related to the realization were also identified. The promoting factors were paramedics’ professional activity, environment, training, and guidelines. The preventing factors were the nature of the work, paramedics’ attitudes, and the lack of knowledge concerning informational privacy among paramedics, the collaborating authority, patients, and relatives.

Discussion and conclusion:

Paramedics had a multidimensional understanding of informational privacy and the factors related to its realization. However, its realization varies, and more research and education are therefore needed to enhance the realization and to provide equal and high-quality care for all the patients in prehospital emergency care.
Poverty Reduction and Human Development: Impact of ENRICH Programme on Income Poverty in Bangladesh
Authors: Nargis Farhana
Published: April 2019

This article aims to analyse the impact of the ENRICH programme (a holistic microfinance programme with multiple intervention) in poverty alleviation. It is based on a survey of 1,800 households selected both in programme implemented and control areas. The cost of basic needs method was used in this study to calculate the poverty lines for the year 2015. This study shows that there has been a significant impact of the ENRICH programme on poverty. The programme has resulted in an additional 10 percentage point poverty reduction in the programme areas, besides contributing to a decrease in the number of extremely poor households over time. Moreover, it has contributed to social and community development with its participants feeling more respected and dignified than before.
The Impact of International Student Mobility Programs on Brazilian Students’ Perceptions of Entrepreneurialism
Authors: de Sandes-Guimaraes Luisa Veras , Ribeiro Artur Tavares Vilas Boas , Axel-Berg Justin Hugo , de Rosso Manços Guilherme , Plonski Guilherme Ary
Published: April 2019

This article assesses whether or not students with international exchange experience return to their home countries with qualitatively different perspectives on the way universities can play a role in fostering innovation and entrepreneurship ecosystems. It includes survey data collected from 516 Brazilian undergraduates asked to rank characteristics of an entrepreneurial university on a scale from 1 to 5. The findings of this study suggest that those with international experience tended to emphasize connections between university and nonacademic partners, compared with nontraveling counterparts, who emphasized the importance of infrastructure in the university. Therefore, use of such programs may have an impact upon the structure of ST&I (Science Technology and Innovation) systems.
Retrospective analysis of infectious laryngotracheitis in backyard chicken flocks in California, 2007–2017, and determination of strain origin by partial ICP4 sequencing
Authors: Blakey Julia , Stoute Simone , Crossley Beate , Mete Aslı
Published: April 2019

Infectious laryngotracheitis (ILT) can cause severe losses in backyard flocks (BYFs) and commercial poultry. The prevalence of ILT, the circulating strains of ILT virus (ILTV) in BYFs, and the correlation of disease in BYF and commercial operations, is largely unknown. Of 8,656 BYF submissions, 88 cases of ILT were diagnosed at the California Animal Health and Food Safety Laboratory System in 2007–2017. ILT diagnosis by year varied from 0.19% to 1.7% of the total BYF submissions, with the highest number of cases submitted from Amador and Riverside counties. Moderate tracheitis, conjunctivitis, and occluded tracheal lumen were commonly reported gross anatomic lesions. Microscopically, inflammation and edema were observed in the trachea, lung, and conjunctiva; 62 (70%) cases had intranuclear inclusion bodies (INIBs), with 10 cases containing INIBs only in conjunctival sections. To analyze the circulating ILTV strains and to differentiate between field and vaccine strains of ILTV, real-time PCR and sequencing of 996 base pairs of the infected-cell polypeptide 4 ( ICP4) gene was performed on 15 ILTV-positive tracheal samples and compared to reference field and vaccine ILTV ICP4 sequences in GenBank. Fourteen strains were identical or closely related to the chicken embryo origin live virus vaccine strains, and one strain was closely related to a Chinese isolate, the USDA reference strain, and a vaccine strain. The presence of ILT in BYFs in counties with high commercial poultry concentrations demonstrates a risk for disease transmission and emphasizes the importance of continued surveillance and improved biosecurity in BYFs.
A two-year prospective study of small poultry flocks in Ontario, Canada, part 1: prevalence of viral and bacterial pathogens
Authors: Brochu Nancy M. , Guerin Michele T. , Varga Csaba , Lillie Brandon N. , Brash Marina L. , Susta Leonardo
Published: April 2019

In Ontario, within the past few years, there has been a marked increase in the number of non-commercial poultry flocks (referred to as “small flocks”). Small poultry flocks may act as a reservoir of avian and zoonotic pathogens, given the flocks’ limited access to veterinary services, inadequate biosecurity practices, and increased risk of contact with wild birds. Despite these potential risks, there is a scarcity of data concerning the prevalence of poultry and zoonotic pathogens among these flocks. To assess the baseline prevalence of bacterial and viral infectious pathogens, prospective surveillance of small flock postmortem submissions to the Animal Health Laboratory was conducted over a 2-y period. With the owner’s consent, a postmortem examination and pre-set tests for infectious agents were conducted. A total of 160 submissions, mainly chickens (84%), were received. Among bacterial pathogens, Brachyspira spp., Mycoplasma synoviae, Campylobacter spp., Mycoplasma gallisepticum, and Salmonella spp. were detected in 37%, 36%, 35%, 23%, and 3% of tested submissions, respectively. Among viral pathogens, infectious bronchitis virus, fowl adenovirus, infectious laryngotracheitis virus, avian reovirus, and infectious bursal disease virus were detected in 39%, 35%, 15%, 4%, and 1% of submissions, respectively. We detected non-virulent avian avulavirus 1 from two chickens in a single submission, and low-pathogenic H10N8 influenza A virus from a single turkey submission. Our study provides baseline prevalence of viral and bacterial pathogens circulating in Ontario small flocks and may help animal and human health professionals to educate small flock owners about disease prevention.
Recommendations for a National Research Agenda in UDL: Outcomes From the UDL-IRN Preconference on Research
Authors: Smith Sean J. , Rao Kavita , Lowrey K. Alisa , Gardner J. Emmett , Moore Eric , Coy Kimberly , Marino Matthew , Wojcik Brian
Published: April 2019

Universal Design for Learning (UDL) is a framework that continues to receive increased attention at federal and state levels. The benefits of UDL include providing an approach to curriculum and instructional design that creates flexible instructional goals, methods, materials, and assignments. Despite the growing popularity of UDL in national policies, measuring the implementation of the UDL framework remains elusive. In March 2017, the research committee of the Universal Design for Learning–Implementation and Research Network (UDL-IRN) convened a preconference of researchers and practitioners to discuss and make recommendations for a national research agenda. Four workgroups address issues related to UDL. These included (a) operationalizing and applying UDL, (b) instruments for the measurement of UDL, (c) teacher education/professional development (PD) in UDL, and (d) UDL tools, technologies, and resources. The results of the workgroups’ effort to identify issues and strategic actions in UDL implementation and research are reported.
Tessier 30 Median Mandibular Hard and Soft Tissue Cleft, One-Stage Reconstruction Using a Template-Guided Resorbable “U”-Shaped Plate
Authors: Walker Tom W. M. , Ahmadi-Lari Nazanin , Pellatt Annie , Cobb Alistair R. M.
Published: April 2019

Midline clefts of the lower lip, tongue, and mandible are a rare type of facial cleft classified as “Tessier 30.” We present the case of a female patient with an isolated Tessier 30 facial cleft affecting the tongue, lower lip, and mandibular symphysis with ankyloglossia. This was reconstructed with a template-guided resorbable “U”-shaped plate at 10 months of age. The procedure was carried out in one stage, which avoided the need for a repeat general anesthetic for the patient. We had a successful outcome with normal dental eruption and we believe such an approach could be considered as a relevant treatment modality for future cases.
A micromechanics-based damage model for compressive behavior analysis of impacted composite laminates
Authors: Lou Xiaofei , Han Xuecheng , Cai Hongneng
Published: April 2019

The compressive strength of composite laminates decreases seriously after being subjected to impact loading, which is an important item to be considered in the usage of composite material. In this paper, a micromechanics-based damage model is proposed to study the compressive behavior of impacted composite laminates. The micro stresses of fiber and matrix are calculated by stress amplification factors and then used to judge the failure mechanisms according to corresponding physical failure criteria. A progressive damage model based on different failure statuses of constituents is established to study the degradation of material properties. The bi-linear cohesive model is used in the research of delamination onset and propagation. The compressive behaviors of quasi-isotropic composite laminates subjected to different impact energies are investigated by this proposed method. Good agreements in terms of structure responses, failure mechanisms, and residual compressive strengths are obtained between numerical results and experimental data. The matrix cracking and delamination caused by impact loading are responsible for the initiation and propagation of buckling, which leads to the final collapse of entire laminates. Based on the numerical investigations of material parameters, the increment of mode II interlaminar fracture toughness is capable of improving the residual compressive strength significantly.
Incidence of Acute Kidney Injury in Intermittent Versus Continuous Infusion of Polymyxin B in Hospitalized Patients
Authors: Alvarado Reyes Yarelis , Cruz Raquel , Gonzalez Julia , Perez Yeiry , Wolowich William R.
Published: April 2019

Background: Studies evaluating the risk of developing acute kidney injury (AKI) with different dosing strategies of polymyxin B are limited. Objectives: To compare the incidence of AKI in patients treated with intermittent versus continuous polymyxin B therapy. Secondary objectives included time to onset of AKI, hospital length of stay (LOS), and all-cause hospital mortality. Variables associated with an increased risk of AKI were evaluated. Methods: A retrospective record review was conducted at a single center in Puerto Rico. Adult patients (≥18 years old) treated with polymyxin B (first course) for at least 48 hours from 2013-2015 were evaluated. Patients with a creatinine clearance <10 mL/min and/or on renal replacement were excluded. Results: A total of 69 patients were included: 42 in the continuous infusion and 27 in the intermittent dosing group. Incidence of AKI was not significantly different between the groups (intermittent 41% vs continuous 31%, P = 0.4). No difference was found in the onset of nephrotoxicity, hospital LOS, or all-cause hospital mortality. Variables associated with increased risk of AKI were baseline serum creatinine, age, and intensive care unit admission. Patients with a body mass index (BMI) >25 kg/m2 on polymyxin B via continuous infusion had a significantly higher cumulative incidence of AKI ( P = 0.016). Conclusion and Relevance: No difference in the risk of polymyxin B nephrotoxicity was found between intermittent and continuous infusion administration. Administration of polymyxin B via a continuous infusion may result in a higher risk of AKI in patients with a BMI >25 kg/m2.
Single- vs 2-Screw Lag Fixation of the Medial Malleolus in Unstable Ankle Fractures
Authors: Mandel Jessica , Behery Omar , Narayanan Rajkishen , Konda Sanjit R. , Egol Kenneth A.
Published: April 2019

Background:

The purpose of this study was to determine the efficacy of medial malleolar fixation with 1 vs 2 screws.

Methods:

Between April 2013 and February 2017, 196 patients who presented at 2 hospitals within one academic institution with an unstable rotational ankle fracture with a medial fracture and were treated operatively by a trained orthopedic surgeon were identified. These patients’ charts were reviewed and their injury, radiographic, surgical, and follow-up data recorded. Medial malleolus fragment size was assessed on the anteroposterior (AP) and lateral views of the initial injury radiograph. Functional outcome was assessed using Maryland Foot Score (MFS). Patients were grouped based upon the number of screws utilized to fox the medial malleolar fragment. Data were assessed using Fisher exact tests and independent t tests with SPSS, version 23.

Results:

Out of the 196 patients who met inclusion criteria, 47 patients (24%) were fixed with 1 medial malleolar screw and 149 patients (76%) were fixed with 2 screws. There were no differences among patients who received 1 vs 2 screws with regard to age, gender, body mass index, American Society of Anesthesiologists grade, or smoking status. The average malleolar fragment size was smaller in those treated with 1 screw on both the AP and lateral radiographic views than those with 2 screws ( P = .009, P = .001, respectively). There was no difference between groups in ankle dorsiflexion or plantarflexion at 1 year postoperation ( P = .451, P = .581). Patients who received 1 screw did not differ from those who received 2 screws with respect to Maryland Foot Scores ( P = .924). There was no difference in rate of revision surgery or need for hardware removal between groups ( P = .093). Furthermore, time to healing and postoperative complication rate did not differ between groups.

Conclusion:

The use of a single screw for medial malleolar fixation provided stable fixation to allow ankle fracture healing, without an increase in complications. This information is especially important in situations when the fragment is too small to accommodate multiple fixation points.

Level of Evidence:

Level III, retrospective case-control study.
Utilization of small broken riceberry flour in gluten-free bread
Authors: Rakkhumkaew Numfon , Boonsri Yuparat , Sukchum Arunwadee
Published: April 2019

The aim of this study was to develop gluten-free bread formulations based on small broken riceberry flour, by using different ratios of rice flour and xanthan gum. Small broken riceberry and rice flour could be classified as low in amylose content (15.70 g and 20.50 g/100 g dry matter for small broken riceberry and rice flour, respectively). Additionally, small broken riceberry flour contained a total phenolic and total anthocyanin content approximately 500 times higher than that of rice flour. The addition of increased amounts of small broken riceberry flour and xanthan gum resulted in darker coloured gluten-free bread. However, there was no significant difference regarding moisture and specific volume. The increase of small broken riceberry flour and xanthan gum also led to a significant increase in the firmness of bread crumbs. The sensory evaluation showed differences in flavour, texture and overall liking, since adding small broken riceberry flour tended to make gluten-free bread more favourable. Bread containing rice flour and small broken riceberry flour in the ratio of 30:70 and 1.0% xanthan gum was selected on the basis of the sensory quality. Moreover, such bread also contained high levels of total phenolic and anthocyanin content.
On-the-fly scheduling versus reservation-based scheduling for unpredictable workflows
Authors: Gainaru Ana , Sun Hongyang , Aupy Guillaume , Huo Yuankai , Landman Bennett A , Raghavan Padma
Published: April 2019

Scientific insights in the coming decade will clearly depend on the effective processing of large data sets generated by dynamic heterogeneous applications typical of workflows in large data centers or of emerging fields like neuroscience. In this article, we show how these big data workflows have a unique set of characteristics that pose challenges for leveraging HPC methodologies, particularly in scheduling. Our findings indicate that execution times for these workflows are highly unpredictable and are not correlated with the size of the data set involved or the precise functions used in the analysis. We characterize this inherent variability and sketch the need for new scheduling approaches by quantifying significant gaps in achievable performance. Through simulations, we show how on-the-fly scheduling approaches can deliver benefits in both system-level and user-level performance measures. On average, we find improvements of up to 35% in system utilization and up to 45% in average stretch of the applications, illustrating the potential of increasing performance through new scheduling approaches.
What Disgusts Consumers in the Hospitality Industry: The Consumer Reaction to Environmental Contamination Model
Authors: Almanza Barbara A.
Published: April 2019

The consumer reaction to environmental contamination model explains how consumers’ perceptions about cleanliness influence their behavior in hospitality and tourism settings. Research literature supports the model that proposes the influence of several variables on consumers’ emotional reaction of disgust when they experience some type of personal contact with the contamination. These variables include cultural beliefs, risk perception, knowledge about cleanliness and health, familiarity with the specific type of contamination, prior experience with an illness caused by unclean environmental conditions, location or setting, type of personal contact, and demographics. These variables may affect the level of disgust generated by possible contact with the environmental contamination with some part of the body. Examples from hospitality and tourism settings are offered, but the model may also be useful in other environmental contexts. More research is needed to better understand consumers’ reactions to contamination in hospitality and tourism environments.
Evidence of diffuse cerebellar neuroinflammation in multiple sclerosis by 11C-PBR28 MR-PET
Authors: Barletta Valeria T , Herranz Elena , Treaba Costantina A , Ouellette Russell , Mehndiratta Ambica , Loggia Marco L , Klawiter Eric C , Ionete Carolina , Jacob Sloane A , Mainero Caterina
Published: April 2019

Background:

Activated microglia, which can be detected in vivo by 11C-PBR28 positron emission tomography (PET), represent a main component of MS pathology in the brain. Their role in the cerebellum is still unexplored, although cerebellar involvement in MS is frequent and accounts for disability progression.

Objectives:

We aimed at characterizing cerebellar neuroinflammation in MS patients compared to healthy subjects by combining 11C-PBR28 MRI-Positron Emission Tomography (MR-PET) with 7 Tesla (T) MRI and assessing its relationship with brain neuroinflammation and clinical outcome measures.

Methods:

Twenty-eight MS patients and 16 healthy controls underwent 11C-PBR28 MR-PET to measure microglia activation in normal appearing cerebellum and lesions segmented from 7 T scans. Patients were evaluated using the Expanded Disability Status Scale and Symbol Digit Modalities Test. 11C-PBR28 binding was assessed in regions of interest using 60–90 minutes standardized uptake values normalized by a pseudo-reference region in the brain normal appearing white matter. Multilinear regression was used to compare tracer uptake in MS and healthy controls and assess correlations with clinical scores.

Results:

In all cerebellar regions examined, MS patients showed abnormally increased tracer uptake, which correlated with cognitive and neurological disability.

Conclusion:

Neuroinflammation is widespread in the cerebellum of patients with MS and related to neurological disability and cognitive impairment.
Patterns of geriatric health assessment use among community dwelling older Australian women over a 14-year period
Authors: Majeed Tazeen , Tavener Meredith , Dolja-Gore Xenia , Nair Balakrishnan , Chojenta Catherine , Byles Julie
Published: April 2019

Objective

To assess which older Australian women had Medicare subsidized health assessments between 1999 and 2013.

Methods

This study used prospective, longitudinal survey data from the 1921 to 1926 birth cohort of Australian Longitudinal Study on Women’s Health (ALSWH) linked with Medicare Australia data on health services use. Over 11,000 Australian women were included in the study. Latent class analysis was used to identify assessment patterns over time, accounting for death, and based on three categories (‘no assessment’; ‘assessment; ‘deceased’) for each year between 1999 and 2013. Further analysis explored the impact of health and sociodemographic characteristics on class membership.

Results

Of the women included in the latent class analysis, 37% never had any assessment and the remainder had had at least one assessment. After a steady uptake from 1999 to 2003, there was decline in uptake from 2003 onwards. A six-class model with sufficient homogeneity and reliable estimation was selected to represent assessment patterns and mortality risk, labelled as: ‘high mortality’ rate with little chance for assessment (12.4%), ‘intermediate mortality, low assessment’ (14.1%), ‘later mortality/low assessment’ (13.1%), ‘later mortality, high assessment’ (7.0%), ‘low mortality, low assessment’ (31.8%), ‘low mortality, high assessment’ (21.6%). Older women with certain conditions (such as diabetes, depression, heart disease) were more likely to be in the low assessment groups, and women with difficulty managing on income were more likely to be in low assessment groups.

Conclusion

Distinct assessment and mortality patterns were seen, with many women not having assessment, in particular those who had certain health conditions, were taking 3+ medications, had difficulty in managing on income, needed help or were in respite care, and had caring responsibilities. The findings point to a need to promote these assessments among older women, and to reduce financial barriers, even within the context of a heavily subsidized health care system.
Awareness as a dimension of health care access: exploring the case of rural palliative care provision in Canada
Authors: Pugh Arlanna , Castleden Heather , Giesbrecht Melissa , Davison Colleen , Crooks Valorie
Published: April 2019

Objectives

In Canada, the rural elderly population is increasing in size, as is their need for palliative care services in these settings. This analysis aims to identify awareness-associated barriers to delivering rural palliative care services, along with suggestions for improving service delivery from the perspective of local health care providers.

Methods

A total of 40 semi-structured interviews with various formal and informal health care providers were conducted in four rural and/or remote Canadian communities with limited palliative care resources. Interview data were thematically coded using Penchansky and Thomas’ five dimensions of access (i.e. availability, (geographic) accessibility, accommodation, acceptability and affordability). Saurman’s recently added sixth dimension of access – awareness – was also identified while coding and subsequently became the primary focus of this analysis.

Results

Identified barriers to palliative care awareness and suggestions on how to enhance this awareness, and ultimately palliative care delivery, corresponded with three key themes arising from the data: limited palliative care knowledge/education, communication and coordination. Participants recognized the need for more palliative care education, open lines of communication and better coordination of palliative care initiatives and local resources in their communities.

Conclusions

These findings suggest that identifying the barriers to palliative care awareness in rural communities may be foundational to addressing barriers to the other five dimensions of access. A thorough understanding of these three areas of awareness knowledge, communication and coordination, as well as the connections between them, may help enhance how rural palliative care is delivered in the future.
Effects of occupational socialization on United States secondary physical education teachers’ beliefs regarding curriculum design
Authors: Prior Laura F , Curtner-Smith Matthew D
Published: April 2019

The purpose of this study was to examine the effects of occupational socialization on the development of United States secondary physical education teachers’ beliefs and actions regarding curriculum design. Participants were 10 teachers. Data were collected with six qualitative techniques and analyzed using analytic induction and constant comparison. Three groups of teachers were identified: non-teachers, conservatives, and progressives. Key influences on the teachers’ beliefs and values were their orientations to teaching and coaching. These orientations had been formed during their acculturation and were untouched or reinforced by their physical education teacher education. The cultures in which they worked generally supported the non-teachers’ perspectives. Practical implications of the study focused on the need for careful selection of preservice teachers, ways in which to deliver physical education teacher education, and the need for increased accountability in schools.
Understanding knowledge, participation and learning in L2 collaborative writing: A metacognitive theory perspective
Authors: Chen Wenting , Hapgood Susanna
Published: April 2019

Although research about group interactions during second or foreign language (L2 or EFL) collaborative writing has proliferated in the last few decades, little is known about the role of psychological factors, like learners’ knowledge about collaborative writing, in affecting students’ patterns of interaction and learning in collaborative writing. Informed by metacognitive theory, this study used a mixed-method approach to investigate whether and how L2 students’ knowledge about collaborative writing affected their participation (patterns of interaction) and learning (languaging opportunities) during the collaborative writing process. Two parallel classes (one with explicit collaborative writing knowledge taught; one without) were compared and multiple sources of data (interviews, reflective journals, pair talk) were analysed for patterns of interaction, quality and quantity of language-related episodes (LREs). The statistical analyses of the data indicated that the participants who were provided more exposure to knowledge about collaborative writing tended to exhibit more collaborative patterns of interaction and produce more LREs. Qualitative analyses revealed that knowledge about collaborative writing affected participation and learning during three distinct stages: planning, writing, and revising. This study fills a gap in collaborative writing research to include a metacognitive theory perspective and sheds new light on L2 collaborative writing pedagogy.
Teachers perceptions about supporting youth participation in schools: Experiences from schools in England, Italy and Lithuania
Authors: Leek Joanna
Published: April 2019

The understanding of youth participation in the current article relates to ideas of citizenship and active involvement in global concerns. In this understanding of the term, schools are important agents for education for global citizenship, and play a role in the developing engagement of young people. Using data from focus groups with teachers ( n = 45) from secondary schools in England, Italy and Lithuania, the current research seeks to extend discussion of youth participation by identifying distinctive features of participation of students at the school level. Although research into youth civic participation is rapidly growing, this topic remains partially unexplored, particularly in relation to school settings, opportunities and benefits of developing students’ civic participation in schools. Findings are important for policy makers and teachers who attempt to promote civic participation in schools among students. The analysis shows that teachers’ concepts of youth participation are grounded in their cultural context, and teachers’ activities are undertaken intuitively. Analysis of teachers’ interviews led to the identification of four common overarching themes that relate to the significance of education policy, school leadership, teacher training, and youth–adult partnerships, all in the context of youth participation.