bluuebunny/crossref_metadata_2025 huggingface dataset:
Análise de correspondências de litogeoquímica de vulcanismos cenozoicos na porção setentrional da Província Borborema, Brasil
Authors: Werneck Luiza Silva , Magini Christiano , Salgueiro Ana Rita Gonçalves Neves Lopes
Published: November 2018

A correlação litogeoquímica entre amostras é geralmente realizada por meio de gráficos predefinidos na literatura ou de análises bivariadas entre cada um dos elementos analisados. Aplicar uma análise multivariada nos dados geoquímicos de um conjunto de amostras, que são multivariadas por natureza, permite tratar esses dados em um espaço dimensional reduzido, compreendendo assim os processos de comportamento dos indivíduos. A análise fatorial das correspondências (AFC) propicia ainda comparar indivíduos (linhas) e variáveis (colunas) quantitativas ou qualitativas de um conjunto de dados no mesmo espaço e de forma simétrica. Neste trabalho, a AFC de um conjunto de análises geoquímicas de amostras de rochas vulcânicas de idades cenozoicas da porção setentrional da Província Borborema relacionou a nova ocorrência vulcânica da cidade de Fortaleza ao vulcanismo alcalino de Fernando de Noronha (FN), distinguindo-os do vulcanismo Macau principalmente devido ao empobrecimento relativo em elementos terras raras (ETR). O método permitiu também distinguir similaridades geoquímicas entre Fortaleza e FN, tais como valores maiores de Na2O, K2O, Al2O3, TiO2, P2O5 e CaO2 e menores de SiO2 e MgO relativamente às rochas do vulcanismo Macau. Os elementos traço Rb, Nb, Th e Ga se correlacionam e aumentam ou diminuem juntos para cada um dos vulcanismos, enquanto Sr e Ba comportam-se inversamente ao conjunto Cr e Ni.
Integration of remote sensing and airborne geophysical data applied to geological mapping: a case study of the Vieirópolis region (Paraíba), Rio Grande do Norte Subprovince, Borborema Province
Authors: Araújo Neto José Ferreira de , Santos Glenda Lira , Souza Igor Manoel Belo de Albuquerque e , Barreto Sandra De Brito , Santos Lauro Cézar Montefalco de Lira , Bezerra João Pedro Santana , Carrino Thais Andressa
Published: November 2018

The integration of geological data obtained through fieldwork, remote sensing and airborne geophysics has been shown to be efficient in creation of precise geological maps. The Vieirópolis region, sited in the west of the Rio Grande do Norte Subprovince of the Borborema Province, is characteristically made up of rocks intensely deformed by transcurrent shear zones and late brittle structures which control the mineralization of gemmological and industrial minerals. ASTER GDEM and airborne geophysical images (magnetometry and gamma-ray spectrometry) were used in order to enhance the geological knowledge of this region and to facilitate the identification and delimitation of structures and lithologies mapped during stages of fieldwork. Thus, a geological map on a scale of 1:50,000 was achieved, made up of six main lithological units and three new shear zones (Vieirópolis, Lastro and São Pedro), as well as the NE-SW-trending Portalegre Shear Zone. Within the newly mapped structures, the Vieirópolis Shear Zone stands out due to its expressiveness. Aeromagnetometry data suggest that this zone originated on the edge of the Brejo das Freiras Subbasin, part of the Portalegre Shear Zone System. NW-SE, ESE-WNW and E-W lineaments were correlated to lesser extent brittle structures which sometimes transversely cut the regional foliation, allowing pegmatite fluids to rise. The RGB ternary composition map (K, eTh, eU) also corroborates the presence of these structures, besides helping to determine lithological units. In this case study, the integration of direct and indirect data showed to be essential for the understanding and producing of local geological map.
A study of molecular sequences, sexuality, and morphological variation in Plagiomnium carolinianum, P. maximoviczii, and P. rhynchophorum (Bryophyta, Mniaceae)
Authors: YI YAN-JUN , SUN ZHEN-WEI , HE SI , SULAYMAN MAMTIMIN
Published: November 2018

Morphologically, recognition of the genus Plagiomnium may be relatively easy. Yet identifications of closely related species have met great difficulties. The contemporary species delimitations of P. carolinianum, P. maximoviczii, and P. rhynchophorum largely based on sexuality as the sole distinction have not been satisfactory. As shown from literature, character variations among these three taxa were continuous and intergraded within or among different populations throughout a wide geographic range. No gametophytic characters could be reliably used to distinguish them from each other. Molecular phylogenetic analyses using ITS2 and rps4 gene were undertaken to resolve delineations for these three morphologically similar species. The results suggest that they form a well support monophyletic clade, which can be defined as representing one single species with two subspecies, i.e. P. rhynchophorum subsp. maximoviczii and P. rhynchophorum subsp. rhynchophorum. The present molecular study supports the treatment of P. carolinianum as synonym of P. rhynchophorum as purposed previously by Koponen based on morphology.
Heterogeneity of Scaling of the Observed Global Temperature Data
Authors: Blesić Suzana , Zanchettin Davide , Rubino Angelo
Published: November 2018

We investigated the scaling properties of two datasets of the observed near-surface global temperature data anomalies: the Met Office and the University of East Anglia Climatic Research Unit HadCRUT4 dataset and the NASA GISS Land–Ocean Temperature Index (LOTI) dataset. We used detrended fluctuation analysis of second-order (DFA2) and wavelet-based spectral (WTS) analysis to investigate and quantify the global pattern of scaling in two datasets and to better understand cyclic behavior as a possible underlying cause of the observed forms of scaling. We found that, excluding polar and parts of subpolar regions because of their substantial data inhomogeneity, the global temperature pattern is long-range autocorrelated. Our results show a remarkable heterogeneity in the long-range dynamics of the global temperature anomalies in both datasets. This finding is in agreement with previous studies. We additionally studied the DFA2 and the WTS behavior of the local station temperature anomalies and satellite-based temperature estimates and found that the observed diversity of global scaling can be attributed both to the intrinsic variability of data and to the methodology-induced variations that arise from deriving the global temperature gridded data from the original local sources. Finally, we found differences in global temperature scaling patterns of the two datasets and showed instances where spurious scaling is introduced in the global datasets through a spatial infilling procedure or the optimization of integrated satellite records.
Effects of Parameterized Boundary Layer Structure on Hurricane Rapid Intensification in Shear
Authors: Zhang Jun A. , Rogers Robert F.
Published: November 2018

This study investigates the role of the parameterized boundary layer structure in hurricane intensity change using two retrospective HWRF forecasts of Hurricane Earl (2010) in which the vertical eddy diffusivity Km was modified during physics upgrades. Earl undergoes rapid intensification (RI) in the low-Km forecast as observed in nature, while it weakens briefly before resuming a slow intensification at the RI onset in the high-Km forecast. Angular momentum budget analysis suggests that Km modulates the convergence of angular momentum in the boundary layer, which is a key component of the hurricane spinup dynamics. Reducing Km in the boundary layer causes enhancement of both the inflow and convergence, which in turn leads to stronger and more symmetric deep convection in the low-Km forecast than in the high-Km forecast. The deeper and stronger hurricane vortex with lower static stability in the low-Km forecast is more resilient to shear than that in the high-Km forecast. With a smaller vortex tilt in the low-Km forecast, downdrafts associated with the vortex tilt are reduced, bringing less low-entropy air from the midlevels to the boundary layer, resulting in a less stable boundary layer. Future physics upgrades in operational hurricane models should consider this chain of multiscale interactions to assess their impact on model RI forecasts.
Bulk Protein and Oil Prediction in Soybeans Using Transmission Raman Spectroscopy: A Comparison of Approaches to Optimize Accuracy
Authors: Singh Rajveer , Wrobel Tomasz P. , Mukherjee Prabuddha , Gryka Mark , Kole Matthew , Harrison Sandra , Bhargava Rohit
Published: November 2018

Rapid measurements of protein and oil content are important for a variety of uses, from sorting of soybeans at the point of harvest to feedback during soybean meal production. In this study, our goal is to develop a simple protocol to permit rapid and robust quantitative prediction of soybean constituents using transmission Raman spectroscopy (TRS). To develop this approach, we systematically varied the various elements of the measurement process to provide a diverse test bed. First, we utilized an in-house-built benchtop TRS instrument such that suitable optical configurations could be rapidly deployed and analyzed for experimental data collection for individual soybean grains. Second, we also utilized three different soybean varieties with relatively low (33.97%), medium (36.98%), and high protein (41.23%) contents to test the development process. Third, samples from each variety were prepared using whole bean and three different sample treatments (i.e., ground bean, whole meal, and ground meal). In each case, we modeled the data obtained using partial least squares (PLS) regression and assessed spectral metric-based multiple linear regression (metric-MLR) approaches to build robust prediction models. The metric-MLR models showed lower root mean square errors (RMSEPs), and hence better prediction, compared to corresponding classical PLS regression models for both bulk protein and oil for all treatment types. Comparing different sample preparation approaches, a lower RMSEPs was observed for whole meal treatment and thus the metric-MLR modeling with ground meal treatment was considered to be optimal protocol for bulk protein and oil prediction in soybean, with RMSEP values of 1.15 ± 0.04 (R2 = 0.87) and 0.80 ± 0.02 (R2 = 0.87) for bulk protein and oil, respectively. These predictions were nearly two- to threefold better (i.e., lower RMSEPs) than the corresponding NIR spectroscopy measurements (i.e., secondary gold standards in grain industry). For content prediction in whole soybean, incorporating physical attributes of individual grains in metric-MLR approach show up to 22% improvement in bulk protein and a relatively mild (up to ∼5%) improvement in bulk oil prediction. The unique combination of metric-MLR modeling approach (which is rare in the field of grain analysis) and sample treatments resulted in improved prediction models; using the physical attributes of individual grains is suggested as a novel measure for improving accuracy in prediction.
“I wonder what lies beyond that horizon?”
Authors: Fergie Doseena
Published: November 2018

The horizon can mean many things to individuals. The author gives an account of those within her ‘sphere of influence’ who enabled her to stand on their broad shoulders to face the challenges and bask in the joys within the tertiary sector and, around the world. Having been raised in an atmosphere of colonisation where assimilation was the norm, the writer extrapolates her encounter with the education system to find her ‘true’ identity and place within the ‘system’. How does one transfer the learnings of living in ‘two worlds’ to a largely non-Indigenous student cohort? How can one remain true to oneself when writing a PhD thesis within a Western system? Finally, as a Churchill Fellowship recipient, the writer travelled the world to seek out how other Indigenous nations around the world have found ways to heal the wounds of colonisation. This writer has experienced the horizon as both a challenger and a nurturer of knowledge.
Environmental peacebuilding: Towards a theoretical framework
Authors: Dresse Anaïs , Fischhendler Itay , Nielsen Jonas Østergaard , Zikos Dimitrios
Published: November 2018

Environmental peacebuilding represents a paradigm shift from a nexus of environmental scarcity to one of environmental peace. It rests on the assumption that the biophysical environment’s inherent characteristics can act as incentives for cooperation and peace, rather than violence and competition. Based on this, environmental peacebuilding presents cooperation as a win-win solution and escape from the zero-sum logic of conflict. However, there is a lack of coherent environmental peacebuilding framework and evidence corroborating the existence of this environment-peace nexus. Building on a multidisciplinary literature review, this article examines the evolution of environmental peacebuilding into an emerging framework. It unpacks the concept and explains its main building blocks (conditions, mechanisms and outcomes) to develop our understanding of when, how and why environmental cooperation can serve as a peacebuilding tool. It assembles these building blocks into three generic trajectories (technical, restorative and sustainable environmental peacebuilding), each characterised according to their own causality, drivers and prerequisites, and illustrated with concrete examples. Finally, this article draws attention to the remaining theoretical gaps in the environmental peacebuilding literature, and lays the foundations for an environmental peacebuilding research agenda that clarifies if and how environmental cooperation can spill over across borders, sectors and scales towards sustainable peace.
Stern, gwiazda or star: Screening receptive vocabulary skills across languages in monolingual and bilingual German–Polish or German–Turkish children using a tablet application
Authors: Schaefer Blanca , Ehlert Hanna , Kemp Lisa , Hoesl Kristina , Schrader Verena , Warnecke Clarissa , Herrmann Frank
Published: November 2018

There is a need to provide bilingual assessments and reference data to identify those who struggle to acquire their heritage language (L1) or the language spoken in the country of residence (L2). However, bilingual assessments and data are still sparse. Therefore, the aim was to use a tablet application to screen receptive vocabulary in different languages and discuss this data in the context of lexical acquisition theories. Forty-four monolingual German, 15 bilingual German–Polish and 21 German–Turkish-speaking children aged between 3;5 (3 years and 5 months) and 6;1 were assessed. All children completed the German version of the Receptive Vocabulary Screener (RVS), a tablet application testing 20 nouns and 20 verbs, and two standardized vocabulary sub-tests. Additionally, the bilingual children completed the Turkish or Polish version of the RVS. Internal consistency showed that the RVS is a reliable tool for research purposes and validity was confirmed by significant and moderate to strong correlations with the two standardized vocabulary sub-tests. Monolingual children outperformed bilingual children when performance comparisons were solely based on the German items. However, group differences were not significant when total vocabulary was used, i.e. the number of words bilingual children named across both versions. For bilingual children, L1 and L2 scores did not differ, i.e. they showed a similar performance on the L1/L2 subtest. Paternal education, but not maternal education, was significantly correlated to vocabulary scores. Children with more translation equivalents, i.e. words they know in both languages, and with a higher level of language proficiency showed higher scores on the screener. The app provided a valuable opportunity to assess lexical knowledge across different languages. Results indicated that total vocabulary and translation equivalents must be considered to evaluate bilingual children’s lexical knowledge.
Five-year follow-up of a cluster-randomized controlled trial of a client-centred activities of daily living intervention for people with stroke
Authors: Hedman Annicka , Eriksson Gunilla , von Koch Lena , Guidetti Susanne
Published: November 2018

Objective:

To compare five-year outcomes and changes over time of a client-centred activities of daily living (ADL) intervention versus usual ADL interventions for people with stroke and their significant others.

Design:

Five-year follow-up of a cluster-randomized controlled trial where a client-centred ADL intervention ( n = 129) or usual ADL interventions ( n = 151) were delivered to people with stroke.

Setting:

Multicentre study including 16 inpatient or home-based rehabilitation units.

Participants:

People with stroke and significant others.

Intervention:

The client-centred ADL intervention aimed at enabling agency in daily activities and participation in everyday life and at reducing caregiver burden.

Main measures:

For people with stroke, perceived participation (Stroke Impact Scale), independence in ADL, life satisfaction, and use of formal/informal care were measured. For significant others, caregiver burden, life satisfaction, and mood (Hospital Anxiety and Depression Scale) were assessed.

Results:

Five years post-intervention, data were collected from 145 people with stroke (intervention group: n = 71/control group: n = 74) and 75 significant others (intervention group: n = 36/control group: n = 39). For those with stroke, the Participation domain of the Stroke Impact Scale showed no group differences at year five (68.9 vs 75.4, P = 0.062) or in changes over time. At year five, the control group had better outcomes regarding Other help/supervision. Significant others in the control group were more likely to show signs of depression at year five (odds ratio = 22.3; P < 0.001).

Conclusion:

The client-centred ADL intervention appears to render similar long-term effects as usual ADL interventions for people with stroke, but for significant others signs of depression might be reduced.
Superior fluid cognition in trained musicians
Authors: Meyer Jim , Oguz Pinar Gupse , Moore Katherine Sledge
Published: November 2018

The effect of intensive music training on cognitive function continues to gain interest as research reveals a positive enhancement on overall cognitive ability, including memory, attention, and executive function. The purpose of the present study was to extend this research by using a standardized fluid intelligence test—the National Institute of Health Toolbox Cognitive Battery—to measure how music training is related to fluid intelligence. Fluid intelligence is the ability to think abstractly and solve problems. This task battery included measures of episodic memory, working memory, attention, executive function, and processing speed. Musicians with extensive experience scored significantly higher in fluid cognition than did non-musicians and less-trained musicians. These results add support to the mounting evidence of the positive relationship between music training and cognitive function, and this study provides a blueprint for future research using standardized measures to investigate expertise in musicians.
Music improvisation modulates emotional memory
Authors: Diaz Abrahan Veronika M. , Shifres Favio , Justel Nadia R.
Published: November 2018

Music improvisation is a technique frequently used in the music therapy field. Its application involves emotional support, cognitive evaluation or cognitive/motor rehabilitation. However, its effect as a valid treatment to moderate memory has not been studied. The aim of the present study is to investigate the effect of music improvisation on emotional memory, in adults with or without musical training. Participants watched emotional or neutral images, and rated simultaneously how emotional they felt the images were, from 0 to 10 ( nothing to highly arousing). Later, participants were exposed to a treatment (music improvisation, imitation, or silence). Immediately afterwards, recall and recognition were evaluated. After a week, free recall and recognition were tested again. The main findings of this study were that music improvisation improves free recall and recognition of neutral and emotional images. The results also indicated that musicians showed better emotional memory performance than non-musicians.
Spanish maritime experience in Southern Africa during the Early Modern Period
Authors: Santana Pérez Germán
Published: November 2018

Apparently, the Treaty of Tordesillas dismissed the possibility of Spanish shipping via Africa and the Cape of Good Hope. The preferred route to Asia was via Cape Horn or Acapulco. In this article we will show that access to Southern Africa was not entirely closed to the Spanish between the 16th and 18th centuries. We will analyse shipping in this period and, above all, we will discuss the enlightened reforms of the 18th century that changed the connecting routes between Spain and the Philippines, making them pass through Cape Town, as well as the hostility shown to the Hispanic presence in those waters by great powers like the Netherlands. Based on these connections, we will discuss the exchange of plants between Spain and Southern Africa.
Sources and methods in the British impressment debate
Authors: Dancy J. Ross
Published: November 2018

British naval impressment has been the subject of debate for centuries. In the 18th century, it produced political debates and resistance from maritime communities, and it was generally disliked by naval officers tasked with pressing men into naval service. After the effective end of the practice in 1815, it was hotly debated in parliament and finally abolished in the mid-19th century. Since then, impressment has been the topic of a scholarly debate that has become increasingly active over the last two decades. In the 21st century, impressment matters for its political and moral implications. The modern debate has, regrettably, broken down and entrenched historians into camps where the different sides have begun to talk past one another, rather than examining how different approaches to the subject actually fit together. This article examines the current state of the debate and offers a path forward that illustrates that none of the scholarly approaches are mutually exclusive. Rather, they can be combined to produce a greater historical understanding of the 18th-century Atlantic world.
The Revival of Labour Movement Studies in Argentina: Old and Lost Agendas
Authors: Atzeni Maurizio , Grigera Juan
Published: November 2018

In recent years sociological research on labour in Argentina has re-flourished. This revival has seen a turn towards the Anglo-Saxon and international traditions of workplace and trade union studies, but it has been generally one-sided, focusing on the relatively successful experiences of trade unions’ organized workers in formal sector workplaces. This has represented a considerable departure from the pre-2001 crisis research’s agenda that focused on unemployment, poverty and the new forms of community based organizations generated by workers in non-work situations. The return to the institutionalized sphere in the analysis of work issues can be partially explained by the changes in the economic and political environment alongside the return to ‘normality’ of the capital–labour relationship. However, it also signals a tendency in labour studies, in Argentina and beyond, of using the union form as the main organizational frame of reference in the analyses of conflict and workers’ representation.
Peel strength characterisation on ply/ply interface using wedge and T-peel/pull-type tests
Authors: Satheesh Britto , Tonejc Maximilian , Potakowskyj Larissa , Pletz Martin , Fauster Ewald , Kaynak Baris , Schledjewski Ralf
Published: November 2018

Thermoplastic tapes have found a prominent place in automated tape placement (ATP), due to their reduced processing time. ATP also offers significant reduction in labour; however, the most attractive aspect is the use of its welding properties. Welding or diffusion bonding is necessary for two thermoplastic materials to bond to each other through the combined effect of heating and consolidation pressure. The work published in this article shows how various thermoplastic tape materials with different material properties are bonded to each other using a direct flame-type ATP process. Contact angle and differential scanning calorimetry measurements help understanding of the processing needs of the considered materials. The samples obtained after ATP are sent for peel testing using a wedge peel test principle, so that the force required to separate the bonding is identified. A T-peel test/pull test is also employed to cross-compare peel results obtained through wedge peel testing. The main aim of the work is to study the quality of connection between the two plies with different material interfaces and also how friction might contribute to peel force when wedge peeling is used. A numerical model is also implemented to show the effects of this friction.
Moral distress in paediatric oncology: Contributing factors and group differences
Authors: Pergert Pernilla , Bartholdson Cecilia , Blomgren Klas , af Sandeberg Margareta
Published: November 2018

Background:

Providing oncological care to children is demanding and ethical issues concerning what is best for the child can contribute to moral distress.

Objectives:

To explore healthcare professionals’ experiences of situations that generate moral distress in Swedish paediatric oncology.

Research design:

In this national study, data collection was conducted using the Swedish Moral Distress Scale-Revised. The data analysis included descriptive statistics and non-parametric analysis of differences between groups.

Participants and research context:

Healthcare professionals at all paediatric oncology centres in Sweden were invited to participate. A total of 278 healthcare professionals participated. The response rate was 89%.

Ethical considerations:

In its advisory statement, the Regional Ethical Review Board decided that the study was of such a nature that the legislation concerning ethical reviews was not applicable. All participants received written information about the aim of the study and confidentiality. Participants demonstrated their consent by returning the survey.

Findings:

The two situations with the highest moral distress scores concerned lack of competence and continuity of personnel. All professional groups reported high levels of disturbance. Nurses rated significantly higher frequencies and higher total Moral Distress Scale scores compared to medical doctors and nursing assistants.

Discussion:

Lack of competence and continuity, as the two most morally distressing situations, confirms the findings of studies from other countries, where inadequate staffing was reported as being among the top five morally distressing situations. The levels of total Moral Distress Scale scores were more similar to those reported in intensive care units than in other paediatric care settings.

Conclusion:

The two most morally distressing situations, lack of competence and continuity, are both organisational in nature. Thus, clinical ethics support services need to be combined with organisational improvements in order to reduce moral distress, thereby maintaining job satisfaction, preventing a high turnover of staff and ensuring the quality of care.
Development networks and urban growth in small cities
Authors: Varna Georgiana , Adams David , Docherty Iain
Published: November 2018

Real estate development is an intensely social process dependent on rich networks of relations between public and private sector actors. Previous work has explored how far such relations are formalised in large cities through shared coalitions of interest intended to promote urban growth. Relatively little attention has been given to networks in smaller cities, which is the concern of this paper. Drawing on detailed research in a small Scottish city, the paper explores how its local network was characterised by strong reliance on network construction and reproduction through trust and reputation. Significantly, within such local networks, competition and collaboration can exist side by side, without subsuming normal tensions into consistent agendas or formally defined ‘partnerships’. Controlling land for urban expansion provides a particular focus for these tensions, since it can allow certain interests to gain network dominance. These findings raise important concerns around whether small cities should rely on informal networks to promote growth instead of constructing formal coalitions that may attract more externally based actors. Such choices have profound implications for the capacity and transparency of development networks, and thus for the accountability of the urban development process.
Rescuing the Industry-Based Competition to Determine the Performance of Foreign Subsidiaries in the Brazilian Host Market
Authors: Thome Karim Marini , Medeiros Janan Joslin , de Alcântara Juciara Nunes
Published: November 2018

This panel study examines the influence of the industry-based competition factor on the performance of 399 foreign subsidiaries in the Brazilian host market from 2008 to 2011. Regression analysis was carried out on panel data using weighted least squares as the estimator. The performance of foreign subsidiaries has been significantly influenced in a negative way because of the concentration of the Brazilian host market and the technology intensity level of the sector in which the subsidiaries operate. The subsidiaries should not neglect the criteria of industry-based competition. These firms should develop strategies to position themselves in specific sectors, looking to lower market concentration and lower the level of technological intensity for higher performance. Suggestions for future research are also given.
Emergence of Mobile Financial Services in Ghana: Concerns for Use among Informal Sector Women Entrepreneurs
Authors: Dziwornu Raymond K. , Anagba Kingsley K. , Aniapam Ampem D.
Published: November 2018

Mobile financial services (MFS) have emerged in recent years as an indispensable tool to promote financial inclusion in emerging economies like Ghana. This article investigated the factors affecting MFS use among 300 women entrepreneurs in the informal sector in Ghana, using multinomial logit model. Knowledge of MFS, trust of services provided, nearness to agents and privacy of information are more likely to drive MFS use. In addition to embarking on aggressive radio and television advertisement, service operators should deploy more agents and invest in reliable infrastructure to build users’ trust to increase MFS use.

JEL Classification: D12, G20
Primary Care 2.0: Design of a Transformational Team-Based Practice Model to Meet the Quadruple Aim
Authors: Brown-Johnson Cati G. , Chan Garrett K. , Winget Marcy , Shaw Jonathan G. , Patton Kendra , Hussain Rumana , Olayiwola J. Nwando , Chang Sang-ick , Mahoney Megan
Published: November 2018

A new transformational model of primary care is needed to address patient care complexity and provider burnout. An 18-month design effort (2015-2016) included the following: (1) Needs Finding, (2) Integrated Facility Design, (3) Design Process Assessment, and (4) Development of Evaluation. Initial outcome metrics were assessed. The design team successfully applied Integrated Facility Design to primary care transformation design; qualitative survey results suggest that design consensus was facilitated by team-building activities. Initial implementation of Quadruple Aim–related outcome metrics showed positive trends. Redesign processes may benefit from emphasis on team building to facilitate consensus and increased patient involvement to incorporate patient voices successfully.
Changes in local context and electoral support for the populist radical right: Evidence from Finland
Authors: Patana Pauliina
Published: November 2018

Immigration, economic hardship, and the European Union (EU) are typically emphasized as key concerns for the electorates of European populist radical right (PRR) parties. At the subnational level, however, these parties perform increasingly well in areas relatively unaffected by ethnic diversity, postindustrial economic decline, or transnationalism. What explains this paradox? Through a novel longitudinal analysis of rich municipal electoral, economic, and demographic data from Finland, this study uncovers the conditions under which immigration, economic hardship, and EU transfers influence support for the PRR. Although levels of ethnic diversity or economic hardship poorly predict support for these parties, they find fertile ground in areas undergoing rapid ethnic changes or economic decline. Growing reliance on EU funds, in contrast, decreases their anti-EU appeals. Thus, by clearly differentiating structural conditions from cyclical effects, this study helps reconcile rival theoretical perspectives on social contact and receptiveness toward immigrants and debates over the economy’s effects on these parties’ performance.
Determinants influencing inbound arrivals to Africa
Authors: Viljoen Armand , Saayman Andrea , Saayman Melville
Published: November 2018

The goal of this research was to investigate the determinants that influence foreign tourism arrivals to the African continent, firstly as a collective and secondly in different regions, with the aim to foster a greater understanding of how African countries and regions can grow their tourism economies. Using static and dynamic panel estimators, two key findings were identified from this research: (1) tourism to the continent is influenced by income in developed countries, prices, telecommunication infrastructure and geographical factors as well as conservation efforts and (2) the regions in Africa do not all react the same to changes in these factors.
Pioglitazone — current profile
Authors: Brunetti Paolo
Published: November 2018

Ploglitazone is a thiazolidinedione that specifically reduces insulin resistance in type 2 diabetes. It has been thoroughly investigated in clinical trials and since its market introduction in 1999 has been prescribed to many patients worldwide. In both monotherapy and combination therapy controlled trials, pioglitazone has proved to be an effective anti-hyperglycaemic agent, reducing fasting plasma glucose and displaying dose-dependent, long-term reductions in glycosylated haemoglobin (HbA1C) compared with placebo. Furthermore, in combination studies, insulin resistance and beta-cell function were significantly improved over baseline and placebo, as measured by HOMA. Pioglitazone also significantly reduced the levels of circulating triglycerides and increased high-density lipoprotein cholesterol without affecting total or low-density lipoprotein cholesterol. In all clinical trials, pioglitazone has been well-tolerated. It may be that the effects of pioglitazone on diabetic dyslipidaemia are at least as important as its effects on lowering blood glucose.
The clinical significance of PPARα and γ agonism
Authors: Staels Bart
Published: November 2018

The thiazolidinediones are synthetic ligands for nuclear peroxisome proliferator activated receptors (PPARs). PPARγ is a transcription factor, which in adipose tissue promotes adipocyte differentiation and also induces apoptosis of terminally differentiated insulin-resistant adipocytes. This promotes the appearance of smaller insulin-sensitive cells. PPARγ ctivation also stimulates the genes controlling triglyceride lipolysis, fatty acid uptake and storage in adipose tissue. It induces a diversion of fatty acids away from muscle and influences the expression of adipocytokines leading to improved insulin signalling in muscle and liver. It may also regulate genes involved in insulin signalling. These all result in an increase in insulin sensitivity. PPARγ s also expressed in atherosclerotic lesion foam cells and its activation may exert anti-inflammatory actions and stimulate expression of genes involved in the reverse cholesterol transport pathway. Thiazolidinediones also improve lipoprotein metabolism and this activity is most pronounced for agents that activate PPARα such as may be the case for pioglitazone.
The need for outcome studies in type 2 diabetes
Authors: Dormandy John
Published: November 2018

Outcome studies use primary end points such as overall mortality or major morbidity to demonstrate that treatments deliver meaningful clinical benefits. Historically it was thought that most of the cardiovascular morbidity due to diabetes was related to microvascular disease, providing a marker for macrovascular disease. In diabetes an outcome study would measure all-cause death, cardiac death and cardiovascular morbidity (end points related to macrovascular disease), whereas conventional trials in diabetes have used surrogate end points, such as blood pressure, microvascular disease (retinopathy, nephropathy) or glycaemic control, which may not predict clinical benefits in the prevention of macrovascular end points. Although outcome trials are increasingly required by regulatory or funding agencies, few have been performed in diabetes; most data have come from trials with surrogate end points or subgroup analyses of cardiovascular outcome trials. Methodological constraints, particularly the large patient populations and long follow-up required, partly explain the lack of outcome studies in diabetes.

The PROspective pioglitAzone Clinical Trial In macroVascular Events (PROactive) is a macrovascular outcome study in patients with type 2 diabetes. It will involve approximately 4,000 patients who will receive pioglitazone or placebo in addition to their existing therapy. Principal end points will be all-cause mortality and severe disability due to macrovascular complications. PROactive should provide important data on the impact of therapy on the incidence of cardiovascular complications in type 2 diabetes.
Current strategies in the management of high cholesterol
Authors: Rees Alan
Published: November 2018

Randomised controlled trials uniformly show that lowering low-density lipoprotein (LDL) cholesterol results in a predictable and consistent reduction in coronary heart disease (CHD) events. The Heart Protection Study showed that the relative risk reduction in major vascular events was consistent irrespective of the LDL level at baseline. There appears to be no lower threshold level. Trials show that the greater the reduction in LDL, the greater the CHD risk reduction observed.

The management of dyslipidaemia is likely to follow the example of hypertension, such that the effective regulation of the lipid profile will be achieved by combination drug therapy.
Ezetimibe — future development
Authors: Allen Chris
Published: November 2018

The ENHANCE study will assess the effect of ezetimibe plus simvastatin in patients with heterozygous familial hypercholesterolaemia. Carotid artery intima-media thickness will be measured, which is able to predict a progression to cardiovascular or cerebrovascular events.

The SEAS study will evaluate whether treatment with ezetimibe and simvastatin, compared with placebo, will reduce the risk of major cardiovascular events in patients with aortic stenosis.

The SHARP study will measure major vascular events in patients with chronic kidney disease or who are receiving dialysis. Ezetimibe and simvastatin treatment will be compared with placebo.
Raising HDL-C and lowering triglycerides: benefits beyond LDL-C modification
Authors: Shepherd James
Published: November 2018

Reduction of low-density lipoprotein cholesterol (LDL-C) is central to the management of cardiovascular risk associated with dyslipidaemia. Yet, at best, this strategy is only capable of a reduction of about 50% in ischaemic vascular disease. Therefore, there is still a need for interventive strategies to improve the situation. Triglyceride lowering and high-density lipoprotein cholesterol (HDL-C) elevation feature prominently in this context, a viewpoint increasingly adopted by international treatment guidelines. This article reviews current thinking on the subject and offers additional treatment strategies for the dyslipidaemic patient.
Residual cardiovascular risk and practical management of type 2 diabetes
Authors: Fisher Miles , Campbell Ian W
Published: November 2018

The evidence base for the optimal management of people with type 2 diabetes has increased dramatically over the last 10 years. Modern management of type 2 diabetes goes beyond glucose lowering and encompasses interventions to impact upon the cluster of cardiovascular risk factors associated with this complex condition. Large, randomised clinical trials have provided evidence for the use of antidiabetic agents, lipid-modulating therapies and antihypertensive agents in order to reduce cardiovascular morbidity and mortality in this high-risk group of patients. Such a multifactorial approach can become an issue for patients in terms of decreased compliance due to increased tablet burden and the complexity of drug regimen. Furthermore, despite optimal care in line with current best practice, people with type 2 diabetes still have a residual risk for cardiovascular disease compared with their counterparts without this condition. Pharmacological agents with additional benefits on cardiovascular risk factors may provide a future strategy for the optimal management of people with type 2 diabetes.
Look Who’s Talking: Using creative, playful arts-based methods in research with young children
Authors: Blaisdell Caralyn , Arnott Lorna , Wall Kate , Robinson Carol
Published: November 2018

Young children are often ignored or marginalised in the drive to address children’s participation and their wider set of rights. This is the case generally in social research, as well as within the field of Arts-Based Education Research. This article contributes to the growing literature on young children’s involvement in arts-based research, by providing a reflective account of our learning and playful engagement with children using creative methods. This small pilot project forms part of a larger international project titled Look Who’s Talking: Eliciting the Voices of Children from Birth to Seven, led by Professor Kate Wall at the University of Strathclyde. Visiting one nursery in Scotland, we worked with approximately 30 children from 3 to 5 years old. Seeking to connect with their play-based nursery experiences, we invited children to participate in a range of arts-based activities including drawing, craft-making, sculpting, a themed ‘play basket’ with various props, puppetry and videography. In this article, we develop reflective, analytical stories of our successes and dilemmas in the project. We were keen to establish ways of working with children that centred their own creativity and play, shaped by the materials we provided but not directed by us. However, we struggled to balance our own agenda with the more open-ended methods we had used. We argue that an intergenerational approach to eliciting voice with young children – in which adults are not afraid to shape the agenda, but do so in responsive, gradual and sensitive ways – creates the potential for a more inclusive experience for children that also meets researcher needs.
Electroporation of the Liver: More Than 2 Concurrently Active, Curved Electrodes Allow New Concepts for Irreversible Electroporation and Electrochemotherapy
Authors: Ritter Andreas , Bruners Philipp , Isfort Peter , Barabasch Alexandra , Pfeffer Joachim , Schmitz Jula , Pedersoli Federico , Baumann Martin
Published: November 2018

Irreversible electroporation and electrochemotherapy are 2 innovative electroporation-based minimally invasive therapies for the treatment of cancer. Combining nonthermal effects of irreversible electroporation with local application of chemotherapy, electrochemotherapy is an established treatment modality for skin malignancies. Since the application of electrochemotherapy in solid organs is a promising approach, this article describes a novel electrode configuration and field generating method. For the treatment of hepatic malignancies, the shape of the electric field should resemble a spherical 3-dimensional geometry around the target tissue inside the liver. To adapt the actual shape of the field, the probe is designed in computer-aided design with a live link to a computer simulation software: Changes in design can be revalued quickly, regarding different quality criteria for field strength inside and outside the tumor. To rate these criteria, a set of formulas with weighting coefficients has been included. As a result of this design process, a needle-shaped prototype applicator has been built, designed for an intracorporal electroporation-based treatment. It can be used as percutaneous, image-guided, minimally invasive treatment option for malignant liver tumors. The shaft of the probe is used as central electrode and fitted with additional 4 expandable electrodes. These satellite electrodes are hollow, thus serving as injectors for chemotherapeutic agents within the area of the electric field. This configuration can be used for electrochemotherapy as well as irreversible electroporation. By placing 5 electrodes with just one needle, the procedure duration as well as the radiation dose can be reduced tremendously. Additionally, the probe offers an option to adapt the field geometry to the tumor geometry by connecting the 5 electrodes to 5 individually chosen electric potentials: By fine-tuning the ablation zone via the potentials instead of adjusting the location of the electrode(s), the procedure duration as well as the radiation dose will decrease further.
Students’, parents’ and teachers’ views about the resources required by school nurses in Perth, Western Australia
Authors: McCluskey Alison , Kendall Garth , Burns Sharyn
Published: November 2018

Background

Nurses play a significant role in promoting health in schools; however, they are often poorly resourced to do so.

Aims

The aim of the study was to identify the perceptions of students, parents and teachers regarding the resources school nurses require in order to practise effectively in the secondary school environment in Perth, Western Australia.

Methods

One-on-one interviews were conducted with parents, teachers, nurses, school principals and school counsellors. Focus groups were conducted at three schools with students in years 10, 11 and 12, parents and teachers. Interviews and focus group data were analysed using thematic analysis.

Results

It was acknowledged that nurses in all schools were under-resourced, with large student numbers contributing to high workloads. The importance of privacy during a visit to the school nurse was highlighted by students. All stakeholders discussed the advantages of nurses completing extra qualifications, in addition to an undergraduate degree. Appropriate support and supervision were also highlighted.

Conclusions

School nurses need to thoroughly document and describe the work that they do and collaborate within the school community to advocate for increased resources. There is a great need for further research regarding the school nurse role involving the whole school community, and most importantly the students.