bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of designs of protective uniforms on firefighters’ performance during moderate physical exercises
Authors: Ciesielska-Wróbel Izabela , DenHartog Emiel , Barker Roger
Published: June 2017

The aim of this study was to verify whether the minor differences in the design of uniforms and their fit can be quantified in terms of their impact on firefighters’ cardiorespiratory parameters and subjective perception of these uniforms. The impact of minor design improvements compared to the existing designs of personal protective clothing (PPC) is still relatively difficult to quantify due to the lack of sensitive devices used in smart measuring methodologies; however, the perception of these slight differences is reported by PPC users. The impact of these design differences in PPC on firefighters was studied via physiological tests based on occupation-related activities in which cardiorespiratory parameters were monitored and three-dimensional (3D) silhouette scanning was performed on the firefighters. Apart from heart rate (beats/min), none of the other measured physiological parameters, for example, oxygen consumption (VO2, ml/min) demonstrated statistically significant differences when firefighters were testing uniforms: ergonomic (ER), standard (ST), bulky (BU), and reference outfit (RO), the latter being T-shirt and shorts. A statistically significant correlation was found between parameters measured via 3D body scanning and selected cross-sections of the silhouettes as well as subjective assessments of easiness of specific movement performance during the physiological test and assessment of bulkiness of the uniforms. There is a limited influence of the minor design differences between firefighters’ uniforms on the selected physiological parameters of the subjects wearing them. The outcome of the study can be utilized when performing the test on subjects and improving designs of PPC.
Encouraging usage of an endangered ancestral language: A supportive role for caregivers’ deictic gestures
Authors: Yuksel Peri , Brooks Patricia J.
Published: June 2017

Many ancestral languages (AL) are at imminent risk of extinction due to societal changes that pressure minority communities to assimilate with dominant cultures and forego usage of their AL. This study aimed to encourage caregiver–child dyads to converse in Lazuri, an endangered AL in Rize, Turkey. Dyads ( N = 59; child age M = 30.7 months, range 15–48) were asked to speak Lazuri while playing with culturally appropriate toys for 20minutes. Utterances were coded for language and accompanying gestures. With children speaking mostly in Turkish, caregivers experienced difficulties maintaining AL usage, yet were generally compliant with instructions. Caregivers more often produced deictic gestures when speaking Lazuri than when speaking Turkish, suggesting that children’s lack of AL proficiency influenced their gesturing. Moreover, caregivers who produced more gesture–speech combinations in the AL had children who produced more AL utterances, after controlling for the amount of AL input. Results indicate the feasibility of enhancing AL input through directed toy-play in contexts of language endangerment. In such contexts, deictic gestures may be especially valuable in grounding AL usage in the immediate context.
Maintained Physical Activity Induced Changes in Delay Discounting
Authors: Sofis Michael J. , Carrillo Ale , Jarmolowicz David P.
Published: June 2017

Those who discount the subjective value of delayed rewards less steeply are more likely to engage in physical activity. There is limited research, however, showing whether physical activity can change rates of delay discounting. In a two-experiment series, treatment and maintenance effects of a novel, effort-paced physical activity intervention on delay discounting were evaluated with multiple baseline designs. Using a lap-based method, participants were instructed to exercise at individualized high and low effort levels and to track their own perceived effort. The results suggest that treatment-induced changes in discounting were maintained at follow-up for 13 of 16 participants. In Experiment 2, there were statistically significant group-level improvements in physical activity and delay discounting when comparing baseline with both treatment and maintenance phases. Percentage change in delay discounting was significantly correlated with session attendance and relative pace (min/mile) improvement over the course of the 7-week treatment. Implications for future research are discussed.
Noninvasive Quantitative Assessment of Hepatic Steatosis by Proton Magnetic Resonance Spectroscopy Among Adult Patients Receiving Home Parenteral Nutrition
Authors: Huijbers Angelique , Wanten Geert , Dekker Helena Maria , van der Graaf Marinette
Published: June 2017

Background: Intestinal failure–associated liver disease is a frequent complication in patients with chronic intestinal failure (CIF), with steatosis as a dominant feature in adults. Proton magnetic resonance spectroscopy (1H‐MRS) is a noninvasive method to quantify liver fat content (LFC). In this study, LFC was assessed with 1H‐MRS, taking into account the possible accumulation of paramagnetic components of home parenteral nutrition (HPN) that may disturb these measurements. Methods: LFC was measured in 15 adult CIF patients who had been receiving HPN for >6 months. 1H‐MR spectra were obtained with a 3 Tesla magnetic resonance (MR) system, with a method correcting for the presence of paramagnetic ions. Patients with low (<5%) versus high (≥5%, steatosis) LFC were compared with nonparametric statistical tests. Results: 1H‐MRS analysis revealed steatosis in 5 patients (median, 10.3%), while 10 patients had normal LFC (median, 0.9%). In all patients, the 1H‐MRS results indicated the presence of various amounts of paramagnetic constituents in the liver. Patients with steatosis had higher alanine aminotransferase values than patients without steatosis (median, 60 vs 28 U/L). Unexpectedly, in the steatosis group, the frequency of HPN use was lower, with significant lower total HPN and carbohydrate calories. In 1 patient, MR spectra were of inferior quality, with broadened resonances after infusion with a ferric compound. Conclusion: 1H‐MRS enables reliable noninvasive assessment of LFC in patients receiving long‐term HPN, if correcting for possible accumulation of paramagnetic components in the liver. However, LFC determination by 1H‐MRS is not recommended after a recent ferric compound infusion.
Comparing the effect of Cawthorne–Cooksey and Frenkel exercises on balance in patients with multiple sclerosis: a randomized controlled trial
Authors: Afrasiabifar Ardashir , Karami Fatemeh , Najafi Doulatabad Shahla
Published: June 2017

Objective:

To evaluate the effect of Cawthorne–Cooksey and Frenkel exercises on balance in patients with multiple sclerosis.

Design:

It was a three-arm parallel randomized controlled trial study.

Setting:

Outpatient clinic.

Subjects:

Patients with multiple sclerosis.

Interventions:

Subjects in the intervention groups completed a 12-week program consisted of Cawthorne–Cooksey or Frenkel exercises. The control group only received routine care.

Main measures:

The outcome measure was the Berg Balance Scale.

Results:

Seventy-two patients completed the study. At the end of the intervention, there was a statistically significant improvement in Berg Balance Scale in the Cawthorne–Cooksey group ( n = 24) in comparison with the other two groups ( P = 0.001). In the Frenkel group ( n = 23), the improvement was statistically greater than the changes in the control group ( n = 25), but it did not appear to be clinically significant. The Berg Balance Scale score increased to 8.9 in the Cawthorne–Cooksey group and 2.3 in the Frenkel group, while it decreased to 1.2 in the control group. When comparing inter-group changes, Berg Balance Scale showed significant improvements in favor of the Cawthorne–Cooksey group after the intervention ( P < 0.05).

Conclusion:

This study demonstrated that in comparison with Frenkel and the control groups, a program of Cawthorne–Cooksey exercise is more effective in improving balance in patients with multiple sclerosis.
A randomized controlled trial of a modified wheelchair arm-support to reduce shoulder pain in stroke patients
Authors: Pan Ruihuan , Zhou Mingchao , Cai Hao , Guo Youhua , Zhan Lechang , Li Mei , Yang Zhijing , Zhu Leying , Zhan Jie , Chen Hongxia
Published: June 2017

Objective:

To evaluate the effect of modified wheelchair arm-support to mitigate hemiplegic shoulder pain and reduce pain frequency in stroke patients.

Design:

A single-blind randomized controlled trial using computer-generated simple randomization.

Setting:

Participants recruited from inpatients at the Guangdong Provincial Hospital of Chinese Medicine.

Subjects:

A total of 120 patients with stroke were divided into two groups.

Interventions:

All subjects underwent basic rehabilitation training and wheelchair assistance with eight weeks follow-up period. Patients in the treatment group additionally received modified wheelchair arm-support for at least 60 minutes a day, six days a week, for four weeks.

Outcome measures:

Primary outcome was measured by the Visual Analogue Pain Scale or Numeric Pain Rating Scale. Secondary outcome was measured using the Upper Extremity Fugl-Meyer Assessment scale, Modified Barthel Index and Quality of Life Index. Measurements were made at 4 weeks and 12 weeks, following the intervention.

Results:

Patients age from 21 to 83 years (mean ± SD = 62.41 ± 12.26). The average duration of disease was 1.9 ± 1.3 months. At four weeks, the median of pain intensity was higher in the control group (median, interquartile range = 3, 5.75 vs. 2, 3.75; P = 0.059). At 12 weeks, the median of pain intensity was higher in the control group (median, interquartile range = 3, 5.00 vs. 0, 1.00; P < 0.001). At 12 weeks, patients with shoulder pain were higher in the control group (6 vs. 1; P < 0.05).

Conclusion:

Using the modified wheelchair arm-support could lead to the mitigation of hemiplegic shoulder pain and reduction in pain incidence in stroke patients. It may also improve the patients’ quality of life.
Use of buccal morphine in the management of pain in children with life-limiting conditions: Results of a laboratory study
Authors: McCulloch Renée , Sattar Mohammed , Henderson Ellen M , Lane Majella E , Bluebond-Langner Myra
Published: June 2017

Background:

Children and infants with impaired swallow or compromised enteral absorption require alternative routes for administration of analgesia. Recent clinical guidance and practice for paediatric palliative care teams, who often treat such children, supports buccal morphine sulphate as a fast acting, effective and easily administered agent for pain relief. However, a consideration of the physicochemical properties and potency of morphine would suggest that it is not a suitable candidate for delivery via the transmucosal route, raising questions about its use in children and infants.

Aim:

To explore the permeability of buccal morphine sulphate in an established ex vivo porcine buccal mucosa as a necessary step in examining efficacy for use in children with life-limiting conditions and life-threatening illnesses.

Design:

A permeation study conducted with morphine sulphate in an ex vivo porcine buccal tissue model. Flux values and pharmacokinetic data were used to calculate the plasma values of morphine that would result following buccal administration in a 20kg child.

Results:

Results show that the estimated steady state plasma values of morphine sulphate following buccal administration in this model do not achieve minimum therapeutic concentration.

Conclusion:

These data strongly suggest that morphine sulphate is not suitable for buccal administration and that further research is needed to establish its efficacy in relief of pain in children with life-limiting conditions and life-threatening illnesses.
Striatal changes underlie MPEP-mediated suppression of the acquisition and expression of pramipexole-induced place preference in an alpha-synuclein rat model of Parkinson’s disease
Authors: Loiodice Simon , McGhan Portia , Gryshkova Vitalina , Fleurance Renaud , Dardou David , Hafidi Aziz , Nogueira da Costa Andre , Durif Franck
Published: June 2017

Impulsive-compulsive disorders in Parkinson’s disease patients have been described as behavioural or substance addictions including pathological gambling or compulsive medication use of dopamine replacement therapy. A substantial gap remains in the understanding of these disorders. We previously demonstrated that the rewarding effect of the D2/D3 agonist pramipexole was enhanced after repeated exposure to L-dopa and alpha-synuclein mediated dopaminergic nigral loss with specific transcriptional signatures suggesting a key involvement of the glutamatergic pathway. Here, we further investigate the therapeutic potential of metabotropic glutamate receptor 5 antagonism in Parkinson’s disease/dopamine replacement therapy related bias of reward-mediated associative learning. We identified protein changes underlying the striatal remodelling associated with the pramipexole-induced conditioned place preference. Acquisition and expression of the pramipexole-induced conditioned place preference were abolished by the metabotropic glutamate receptor 5 antagonist 2-methyl-6-phenylethynyl (pyridine) (conditioned place preference scores obtained with pramipexole conditioning were reduced by 12.5% and 125.8% when 2-methyl-6-phenylethynyl (pyridine) was co-administrated with pramipexole or after the pramipexole conditioning, respectively). Up-regulation of the metabotropic glutamate receptor 5 was found in the dorsomedial-striatum and nucleus accumbens core. Activation of these two brain sub-regions was also highlighted through FosB immunohistochemistry. Convergent molecular and pharmacological data further suggests metabotropic glutamate receptor 5 as a promising therapeutic target for the management of Parkinson’s disease/dopamine replacement therapy related reward bias.
The end of the Global South and the cultures of the South
Authors: Papastergiadis Nikos
Published: June 2017

As the Global South is increasingly interpenetrated by neoliberal and authoritarian regimes, the idea of the South as a site of emancipatory resistance and exotic cultural difference has ended. This article offers an alternative route into the cultures of the South. It focuses on the shifting forms of the South in contemporary visual art and outlines the possibilities of the non-coercive forms of cultural exchange and the cartographies of a cosmopolitanism from below. This perspective on the South is most evident in in the stories of embodied solidarity that stand in contrast to the top-down visions of socio-economic development and cultural homogenization.
The Association between Social Jetlag, the Metabolic Syndrome, and Type 2 Diabetes Mellitus in the General Population: The New Hoorn Study
Authors: Koopman Anitra D.M. , Rauh Simone P. , van ‘t Riet Esther , Groeneveld Lenka , van der Heijden Amber A. , Elders Petra J. , Dekker Jacqueline M. , Nijpels Giel , Beulens Joline W. , Rutters Femke
Published: June 2017

Only a few studies have investigated the metabolic consequences of social jetlag. Therefore, we examined the association of social jetlag with the metabolic syndrome and type 2 diabetes mellitus in a population-based cohort. We used cross-sectional data from the New Hoorn Study cohort ( n = 1585, 47% men, age 60.8 ± 6 years). Social jetlag was calculated as the difference in midpoint sleep (in hours) between weekdays and weekend days. Poisson and linear regression models were used to study the associations, and age was regarded as a possible effect modifier. We adjusted for sex, employment status, education, smoking, physical activity, sleep duration, and body mass index. In the total population, we only observed an association between social jetlag and the metabolic syndrome, with prevalence ratios adjusted for sex, employment status, and educational levels of 1.64 (95% CI 1.1-2.4), for participants with >2 h social jetlag, compared with participants with <1 h social jetlag. However, we observed an interaction effect of median age (<61 years). In older participants (≥61 years), no significant associations were observed between social jetlag status, the metabolic syndrome, and diabetes or prediabetes. In the younger group (<61 years), the adjusted prevalence ratios were 1.29 (95% CI 0.9-1.9) and 2.13 (95% CI 1.3-3.4) for the metabolic syndrome and 1.39 (95% CI 1.1-1.9) and 1.75 (95% CI 1.2-2.5) for diabetes/prediabetes, for participants with 1-2 h and >2 h social jetlag, compared with participants with <1 h social jetlag. In conclusion, in our population-based cohort, social jetlag was associated with a 2-fold increased risk of the metabolic syndrome and diabetes/prediabetes, especially in younger (<61 years) participants.
Interleukin 1 Receptor Antagonist Anakinra, Intravenous Immunoglobulin, and Corticosteroids in the Management of Critically Ill Adult Patients With Hemophagocytic Lymphohistiocytosis
Authors: Wohlfarth Philipp , Agis Hermine , Gualdoni Guido A. , Weber Johannes , Staudinger Thomas , Schellongowski Peter , Robak Oliver
Published: June 2017

Background:

Hemophagocytic lymphohistiocytosis (HLH) causes multiple organ dysfunction frequently leading to intensive care unit (ICU) referral and/or death. We report on a series of critically ill adult patients treated with a non-etoposide-based regimen including interleukin 1 antagonist anakinra, intravenous immunoglobulin (IVIG), and/or corticosteroids (CS) for HLH.

Methods:

Eight adult (≥18 years) ICU patients having received treatment with anakinra ± IVIG ± CS for HLH between March 2014 and March 2016 at a large tertiary care university hospital (Medical University of Vienna, Vienna, Austria) were retrospectively analyzed.

Results:

Eight patients (median age: 38 years; range: 20-58 years; 4 males and 4 females) received anakinra together with IVIG (n = 7) and/or high-dose CS (n = 5) for suspected reactive HLH (median H-score: 214; range: 171-288). Seven (88%) patients required vasopressors and invasive mechanical ventilation and 6 (75%) patients required renal replacement therapy (median Sequential Organ Failure Assessment [SOFA] score at HLH diagnosis: 9.5; range: 6-14). Six patients showed a significant decline in the SOFA score at 1 and 2 weeks following treatment initiation ( P = .03), and the remainder 2 patients experienced early death. Five patients survived to ICU discharge, 4 of them could further be discharged from hospital (hospital survival rate: 50%). No overt treatment-related toxicity was noted.

Conclusion:

Anakinra in combination with IVIG and/or CS resulted in a hospital survival rate of 50% in 8 critically ill adult patients with HLH despite a vast degree of organ dysfunction and the need for aggressive ICU treatment. Further research on non-etoposide-based treatment strategies for HLH in critically ill adults is warranted.
Measuring Sleep in the Intensive Care Unit: A Critical Appraisal of the Use of Subjective Methods
Authors: Jeffs Emma L. , Darbyshire Julie L.
Published: June 2017

Objectives:

To collate and appraise the use of subjective measures to assess sleep in the intensive care unit (ICU).

Design:

A systematic search and critical review of the published literature.

Data Sources:

Medline, Scopus, and Cumulative Index to Nursing and Allied Health Literature were searched using combinations of the key words “Sleep,” “Critical Care,” “Intensive Care,” and “Sleep Disorders,” and this was complemented by hand searching the most recent systematic reviews on related topics.

Study Eligibility Criteria:

Papers were limited to non-gray English-language studies of the adult population, published in the last 10 years.

Outcome Measures:

Primary outcomes were the number and categorization of quantitative studies reporting measures of sleep, the number of participants for each data collection method, and a synthesis of related material to appraise the use of survey tools commonly used for sleep measurement in the ICU.

Results:

Thirty-eight papers reported quantitative empirical data collection on sleep, 17 of which used a primary method of subjective assessment of sleep by the patient or nurse. Thirteen methods of subjective sleep assessment were identified. Many of these tools lacked validity and reliability testing.

Conclusions:

Research using questionnaires to assess sleep is commonplace in light of practical barriers to polysomnography or other measures of sleep. A methodologically sound approach to tool development and testing is crucial to gather meaningful data, and this robust approach was lacking in many cases. Further research measuring sleep subjectively in ICU should use the Richards Campbell Sleep Questionnaire, and researchers should maintain a commitment to transparency in describing methods.
Study of composite vascular scaffold combining with differentiated VSMC- and VEC-like cells in vitro and in vivo
Authors: Liu Xuqian , Wang Jie , Dong Fusheng , Song Peng , Li Hexiang , Hou Yali
Published: June 2017

Although research into the tissue engineering of vessels has proceeded at a tremendous pace, many deficiencies still need to be resolved. A well-adopted constructed vessel requires both functional and structural properties to stimulate the native vessel and resist stress and tension in vivo. In the present study, we developed a novel three-layer composite vascular scaffold consisting of differentiated vascular smooth muscle cell-, vascular endothelial cell-like cells, and a rabbit acellular vascular matrix (ACVM)-0.25% HLC-I scaffold. HE staining, immunohistochemical assays, immunofluorescence assays (IFAs), and scanning electron microscopy were performed to monitor the growth status of cells on the scaffold material in vitro. After the vascular endothelial cell -vascular smooth muscle cell-scaffold was implanted into nude mice for three, six, and nine weeks, samples were harvested from the implanted mice and observed visually or by HE staining and IFAs for cell viability and morphology. Additionally, burst pressure resistance experiments were used to assess the maximal pressure that the engineered vessel could resist. We found that the engineered vascular endothelial cell-vascular smooth muscle cell-scaffold vessel possessed favorable biocompatibility and considerable strength, matching native vessels in vivo and in vitro, and may be significant in the future clinical implantation of tissue-engineered vasculature.
Dynamic Interplay of Pharmacy Learners During a Solid Organ Transplantation Learning Experience
Authors: Sin Jonathan H. , Li Hanlin , Jandovitz Nicholas , King Madeline , Tsapepas Demetra S.
Published: June 2017

Institutions with established clinical pharmacy services have the ability to offer focused patient care learning experiences, often led by a clinical specialist, for pharmacy residents and pharmacy students. Since all parties are continually involved in professional development and lifelong learning, the aforementioned groups can all be considered “pharmacy learners.” By utilizing the dynamic interplay and collaboration between pharmacy learners through direct and nondirect patient care activities, experiential and educational opportunities may be improved and enhanced for each learner. A tiered learning approach engages individuals in areas such as direct patient care, patient education, presentations, research projects, career development, and the feedback process. We describe our experience during a solid organ transplantation learning experience using a layered learning practice model that included a clinical pharmacy specialist, a postgraduate year 2 specialty pharmacy resident, a postgraduate year 1 pharmacy resident, and a pharmacy student.
Regional Nerve Blocks for Equine Dentistry
Authors: Rice Molly K.
Published: June 2017

Regional nerve blocks are necessary to facilitate equine oral surgery in the standing sedated patient. Step-by-step instruction on how to perform common regional nerve blocks are discussed, including infraorbital, maxillary, middle mental, and inferior alveolar nerve blocks. Regional nerve blocks are critical when performing dental procedures in the standing horse.1 The infraorbital and maxillary nerve blocks provide anesthesia of the infraorbital nerve, which is a branch of the maxillary nerve. Both nerve blocks provide adequate anesthesia for all maxillary dental procedures.1 When the infraorbital nerve block is utilized, care must be taken to advance the needle into the infraorbital foramen in order to appropriately anesthetize the caudal maxillary teeth. Mandibular dental procedures require anesthesia of the inferior alveolar nerve, which is a branch of the mandibular nerve. Local anesthesia at the level of the mental foramen will result in anesthesia of ipsilateral incisors and canines, while anesthesia at the level of the mandibular foramen will anesthetize the entire ipsilateral mandibular dental quadrant. All nerve blocks should have the injection site aseptically prepared prior to the procedure. The 4 most common dental nerve blocks are described step by step.
Apical Microleakage in Root Canals Obturated With 2 Different Endodontic Sealer Systems in Canine Teeth of Dogs
Authors: Lothamer Chad W. , Anderson Ashley , Hetzel Scott J , Adrian Alex I. , Snyder Christopher , Goldschmidt Stephanie , Soukup Jason W.
Published: June 2017

An apical dye leakage test was utilized to compare 2 endodontic sealer systems commonly used in veterinary endodontic treatment. Rotary instrumentation followed by injection of 2 different sealers (GuttaFlow 2 and AH Plus) and a single master cone obturation technique were compared. Following obturation and restoration, specimens were immersed in India ink for 48 hours. A tooth mineral clearing technique was utilized to render the tooth samples transparent. Subsequently, the apices were evaluated for prevalence and magnitude of apical dye penetration under magnification. Statistical analysis of the results revealed no significant differences in the prevalence or magnitude of apical dye penetration between groups.
Modeling, control design, and influence analysis of catapult-assisted take-off process for carrier-based aircrafts
Authors: Zhen Ziyang , Jiang Ju , Wang Xinhua , Li Kangwei
Published: June 2017

This paper addresses the problems of modeling, control design, and influence analysis of the steam catapult-assisted take-off process of the carrier-based aircrafts. The mathematical models of the carrier-based aircraft, steam catapult, landing gears, and the environmental factors including deck motion and bow airflow have been established to express the aircraft dynamics in the take-off process. An engineering method based automatic flight control system has been designed, which is divided into the longitudinal channel and lateral channel. The influences of the preset control surface, ship deck motion, ship bow airflow, and automatic flight control system system are tested by a series of simulations. The simulation results show that the elevator angle preset is necessary in the stage of accelerated running on the ship deck and the deck motion is the most important factor for safe take-off, while the ship bow airflow is beneficial for climbing up of the aircraft. The automatic flight control system gives the guarantee of safety and performance in the take-off process of the carrier-based aircraft.
Strictly-lower-convex-function-constructing disturbance observer based adaptive back stepping control for hypersonic flight vehicles
Authors: Zuo Jingxing , Wu Yunjie , Sun Lianghua
Published: June 2017

This study concerns with the attitude and velocity tracking control problem for the longitudinal model of hypersonic flight vehicles, which is nonlinear in aerodynamics with model uncertainties and external disturbances. By employing back stepping sliding mode method and the strictly-lower-convex-function-constructing nonlinear disturbance observer (SNDOB), a novel composite controller is proposed to guarantee the system tracking error to converge to a small region containing the origin. Besides, several proper adaptive laws are also introduced to make the controller avoid of the differential explosion problem and be chatter-free. Compared with other robust flight control approaches, key novelties of the developed method are that one new SNDOB is proposed and drawn into the virtual control laws at each step to compensate the disturbances and that adaptive laws are utilized to simplify the tedious and complicated differential operations. Finally, it is demonstrated by the simulation results that the new method exhibits not only an excellent robustness but also a better disturbance rejection performance than the convention approach.
Just healthcare and human flourishing: Why resource allocation is not just enough
Authors: Hewitt Jayne
Published: June 2017

Over many years, different theories have been developed to guide the social practices and policies of institutions so that they demonstrate equal concern and respect for all, and satisfy the requirements of justice. Although the normative principles described in a theory may support just institutions, whether this results in just outcomes will depend on how the decisions that implement the principles are made and actioned. As a societal institution charged with caring for people, ensuring just outcomes is a distinct concern in healthcare. Relationships within this institution are constitutive of human flourishing and are also important to justice. Yet, it is not possible to create, maintain or evaluate interpersonal relationships in the same manner as institutions because rather than being universal and impartial, they are particular and partial. Consequently, the link between theories of justice that guide decision-making in relation to structures or institutions, and the relationships that influence those with a proximate effect on individuals, is not explicit. To address this gap, this article argues that a focus on human flourishing provides a nexus between the decision-making for just institutions and just outcomes for individuals.
Sustainability in care through an ethical practice model
Authors: Nyholm Linda , Salmela Susanne , Nyström Lisbet , Koskinen Camilla
Published: June 2017

Background:

While sustainability is a key concept in many different domains today, it has not yet been sufficiently emphasized in the healthcare sector. Earlier research shows that ethical values and evidence-based care models create sustainability in care practice.

Objective:

The aim of this study was to gain further understanding of the ethical values central to the realization of sustainability in care and to create an ethical practice model whereby these basic values can be made perceptible and active in care practice.

Research design:

Part of the ongoing “Ethical Sustainable Caring Cultures” research project, a hermeneutical application research design was employed in this study.

Participants:

Dialogues were used, where scientific researchers and co-researchers were given the opportunity to reflect on ethical values in relation to sustainability in care.

Findings:

An ethical practice model with ethos as its core was created from the results of the dialogues. In the model, ethos is encircled by the ethical values central to sustainability: dignity, responsibility, respect, invitation, and vows.

Discussion:

The model can be used as a starting point for ethical conversations that support carers’ reflections on the ethical issues seen in day-to-day care work and the work community, allowing ethical values to become visible throughout the entire care culture.

Conclusion:

It is intended as a tool whereby carers can more deeply understand an organization’s common basic values and what they entail in regard to sustainability in care.
The Audit Expectation Gap between Companies and Their Auditors: An Exploratory Study
Authors: Boterenbrood Rob
Published: June 2017

This exploratory study aims to provide insight into the audit expectation gap between companies and their auditors measured by the materiality for the financial statement as a whole, defined for the purpose of this paper as the materiality gap. This gap, conceived as a component of the audit expectation gap, is little examined in literature. In order to investigate the existence of a materiality gap, financial statement preparers of the selected companies were asked to estimate the materiality of their financial statement. This was subsequently compared with the outcome of the materiality used by the auditor based on the audit file. Moreover, to obtain more insight into the possible materiality gap, a survey was sent out to the partners of the audit firm involved. This study shows that materiality levels assumed by the preparers of financial statements were lower than the materiality actually applied by the auditors.
State Security, Societal Security, and Human Security
Authors: Hama Hawre Hasan
Published: June 2017

Generally speaking, the traditional approach of security mainly regards states as a sole referent object of security and refutes any attempt to broaden the concept of security. This understanding is known as a realist approach. This approach, however, has been recently challenged by the Copenhagen School, the Welsh School, and the human security approach. The Copenhagen School assumes that there is now a duality of security: state security and societal security. However, both the Welsh School and the human security school look at individuals as a sole referent object of security. This article critically reviews the traditional approaches of security, the Copenhagen School, the Welsh School, and the human security approach. This article finally argues that the Copenhagen School could successfully broaden the concept of security, and therefore, it is more convincing when compared to other schools.
Role of magnetic resonance spectroscopy to differentiate high-grade gliomas from metastases
Authors: Wang Qun , Zhang JiaShu , Xu WeiLin , Chen XiaoLei , Zhang JianMin , Xu BaiNan
Published: June 2017

This study is to measure the diagnostic examination quality of magnetic resonance spectroscopy in differentiating high-grade gliomas from metastases. PubMed, Embase, and Chinese Biomedical databases were systematically searched for relevant studies published through 10 July 2016. Based on the data from eligible studies, heterogeneity and threshold effect tests were performed; pooled sensitivity, specificity, and areas under summary receiver-operating characteristic curve of magnetic resonance spectroscopy were calculated. Finally, seven studies with a total of 261 patients were included. Quantitative synthesis of studies showed that pooled sensitivity/specificity of Cho/NAA and Cho/Cr ratio in peritumoral region was 0.85 (95% confidence interval: 0.79–0.90)/0.93 (95% confidence interval: 0.80–0.99) and 0.86 (95% confidence interval: 0.76–0.92)/0.86 (95% confidence interval: 0.73–0.94). The area under the curve of the summary receiver-operating characteristic curve was 0.95 and 0.90. Pooled sensitivity, specificity, and area under the curve of magnetic resonance spectroscopy to identify high-grade gliomas from metastases were 0.85 (95% confidence interval: 0.79–0.90), 0.84 (95% confidence interval: 0.75–0.90), and 0.90, respectively. We concluded that magnetic resonance spectroscopy demonstrated moderate diagnostic performance in distinguishing high-grade gliomas from metastases. Furthermore, Cho/NAA ratio showed higher specificity and higher value of area under the curve than Cho/Cr ratio in peritumoral region. We suggest that Cho/NAA ratio of peritumoral region should be used to improve diagnostic accuracy of magnetic resonance spectroscopy for differentiating high-grade gliomas from metastases.
Evolving Motivations: Patients’ and Caregivers’ Perceptions About Seeking Myotonic Dystrophy (DM1) and Huntington’s Disease Care
Authors: LaDonna Kori A. , Watling Christopher J. , Ray Susan L. , Piechowicz Christine , Venance Shannon L.
Published: June 2017

Patient-centered care provision is challenging under ideal circumstances; myotonic dystrophy (DM1) and Huntington’s disease (HD) are examples of chronic, progressive health conditions that may challenge its limits. If we can understand how care unfolds in these conditions, health care providers may be better equipped to address patients’ needs. Constructivist grounded theory informed data collection and analysis. Fourteen patients with DM1 or HD, and 10 caregivers participated in semistructured interviews. Constant comparative analysis was used to identify themes. Participants attended clinic to seek expert information and social support. Medical management, altruism, and support provided the motivation. However, motivations evolved, with clinic becoming more important for caregivers as patients deteriorated. Clinic was conceptualized as a “safe space” to actively participate in health care and research. In the absence of disease-halting or curative treatments, participants perceived that they derived a therapeutic benefit from seeking care and from engaging in education and advocacy.
Effect of damage on the free radial oscillations of an incompressible isotropic tube
Authors: Arya Kriti , Sarangi Somnath
Published: June 2017

The effect of damage on the finite-amplitude, free radial oscillations of an arbitrary incompressible, isotropic, homogeneous cylindrical tube is investigated. Pressure is applied to the inner and outer surfaces of the damaged cylinder and constrained from both ends. A purely radial motion is observed when the pressure is removed. The corresponding equation of motion is obtained, incorporating the effect of damage. A simple exponential front factor damage function is introduced in the tube problem. The damage function is a function of the first invariant of the left Cauchy–Green deformation tensor and is dependent on its maximum previous ever value. It is found that the period of oscillation for a thin-walled neo-Hookean membrane varies with the damage function. In contrast, the respective period for an undamaged neo-Hookean membrane is a constant. The described study may help in the surgical procedure of angioplasty, performed during inflammatory diseases such as atherosclerosis. During angioplasty, owing to inflation of the balloon, the arterial wall is damaged; this study may help to gain more insight on the surgical procedure. Both thick- and thin-walled analysis of the damaged cylindrical tube are performed and compared with the undamaged case. Several results are inferred and illustrated graphically for two types of parent material model, namely Gent and neo-Hookean.
Risk of Dementia in Adults With ADHD: A Nationwide, Population-Based Cohort Study in Taiwan
Authors: Tzeng Nian-Sheng , Chung Chi-Hsiang , Lin Fu-Huang , Yeh Chin-Bin , Huang San-Yuan , Lu Ru-Band , Chang Hsin-An , Kao Yu-Chen , Yeh Hui-Wen , Chiang Wei-Shan , Chou Yu-Ching , Tsao Chang-Huei , Wu Yung-Fu , Chien Wu-Chien
Published: June 2017

Objective:This study aimed to investigate the association between adults with ADHD and the risk of developing dementia. Method: Utilizing National Health Insurance Research Database of Taiwan, ADHD patients were identified and compared with age- and gender-matched controls (1:3). Results: Of the study participants, 37 (5.48%) developed dementia compared with 81 (4.0%) in the control group. Cox proportional hazards regression analysis revealed that the study participants were more likely to develop dementia. The crude hazard ratio (HR) is 3.418 (95% confidence interval [CI] = [2.289, 5.106], p < .001), and adjusted HR is 4.008 (95% CI = [2.526, 6.361], p < .001) in risk of developing dementia after adjusted for age, gender, comorbidities, geographical area of residence, urbanization level of residence, and monthly income. Conclusion: Adults with ADHD have a 3.4-fold risk of developing dementia, and other large or national data sets should be explored to support the current findings.
Invitations to dignity and well-being: cultural safety through Indigenous pedagogy, witnessing and giving back!
Authors: Richardson Catherine , Carriere Jeannine , Boldo Vicky
Published: June 2017

In this article, three Métis authors, engaged in human service, share their conceptualization of cultural safety in educational settings. Their examples pertain more specifically to learning moments where Indigenous pedagogy is used to convey aspects of the colonial history and various forms of violence towards Indigenous peoples in Canada. In cases where there is a diverse or multicultural learning group, housed within a dominant Euro-Canadian culture, cultural safety can be designed to create a learning environment that promotes increased trust, sharing and exploration of “risky subjects”. This article is structured around a presentation of a pedagogy developed by Jeannine Carriere and Cathy Richardson in an Indigenous cultural sensitization training for child and youth mental health practitioners in British Columbia. Their approach encircles first-person testimony shared by Vicky Boldo, provides a structure for witnessing such testimony and then invites feedback from Vicky in relation to cultural safety for those who educate from Indigenous perspectives. The authors address the issue of backlash and White guilt that are often evoked when truths about violent histories are brought to the fore.
Making Meaningful Clinical Use of Biomarkers
Authors: Selleck Matthew J , Senthil Maheswari , Wall Nathan R
Published: June 2017

This review discusses the current state of biomarker discovery for the purposes of diagnostics and therapeutic monitoring. We underscore relevant challenges that have defined the gap between biomarker discovery and meaningful clinical use. We highlight recent advancements in and propose a way to think about future biomarker development.
Suppression of Breast Cancer Metastasis Using Stapled Peptides Targeting the WASF Regulatory Complex
Authors: Cowell John K , Teng Yong , Bendzunas N George , Ara Roxan , Arbab Ali S , Kennedy Eileen J
Published: June 2017

The WASF3 gene facilitates the metastatic phenotype, and its inactivation leads to suppression of invasion and metastasis regardless of the genetic background of the cancer cell. This reliance on WASF3 to facilitate metastasis suggests that targeting its function could serve as an effective strategy to suppress metastasis. WASF3 stability and function are regulated by the WASF Regulatory Complex (WRC) of proteins, particularly CYFIP1 and NCKAP1. Knockdown of these proteins in vitro leads to disruption of the WRC and suppression of invasion. We have used mouse xenograft models of breast cancer metastasis to assess whether targeting the WRC complex suppresses metastasis in vivo. Stapled peptides targeting the WASF3-CYFIP1 interface (WAHM1) and the CYFIP1-NCKAP1 interface (WANT3) suppress the development of lung and liver metastases. Targeting these critical protein-protein interactions, therefore, could potentially be developed into a therapeutic strategy to control cancer cell invasion and metastasis.
Parents’ Assessments of Disability in Their Children Using World Health Organization International Classification of Functioning, Disability and Health, Child and Youth Version Joined Body Functions and Activity Codes Related to Everyday Life
Authors: Illum Niels Ove , Gradel Kim Oren
Published: June 2017

Aim:

To help parents assess disability in their own children using World Health Organization (WHO) International Classification of Functioning, Disability and Health, Child and Youth Version (ICF-CY) code qualifier scoring and to assess the validity and reliability of the data sets obtained.

Method:

Parents of 162 children with spina bifida, spinal muscular atrophy, muscular disorders, cerebral palsy, visual impairment, hearing impairment, mental disability, or disability following brain tumours performed scoring for 26 body functions qualifiers (b codes) and activities and participation qualifiers (d codes). Scoring was repeated after 6 months. Psychometric and Rasch data analysis was undertaken.

Results:

The initial and repeated data had Cronbach α of 0.96 and 0.97, respectively. Inter-code correlation was 0.54 (range: 0.23-0.91) and 0.76 (range: 0.20-0.92). The corrected code-total correlations were 0.72 (range: 0.49-0.83) and 0.75 (range: 0.50-0.87). When repeated, the ICF-CY code qualifier scoring showed a correlation R of 0.90. Rasch analysis of the selected ICF-CY code data demonstrated a mean measure of 0.00 and 0.00, respectively. Code qualifier infit mean square (MNSQ) had a mean of 1.01 and 1.00. The mean corresponding outfit MNSQ was 1.05 and 1.01. The ICF-CY code τ thresholds and category measures were continuous when assessed and reassessed by parents. Participating children had a mean of 56 codes scores (range: 26-130) before and a mean of 55.9 scores (range: 25-125) after repeat. Corresponding measures were −1.10 (range: −5.31 to 5.25) and −1.11 (range: −5.42 to 5.36), respectively. Based on measures obtained at the 2 occasions, the correlation coefficient R was 0.84. The child code map showed coherence of ICF-CY codes at each level. There was continuity in covering the range across disabilities. And, first and foremost, the distribution of codes reflexed a true continuity in disability with codes for motor functions activated first, then codes for cognitive functions, and, finally, codes for more complex functions.

Conclusions:

Parents can assess their own children in a valid and reliable way, and if the WHO ICF-CY second-level code data set is functioning in a clinically sound way, it can be employed as a tool for identifying the severity of disabilities and for monitoring changes in those disabilities over time. The ICF-CY codes selected in this study might be one cornerstone in forming a national or even international generic set of ICF-CY codes for the benefit of children with disabilities, their parents, and caregivers and for the whole community supporting with children with disabilities on a daily and perpetual basis.
Does IFRS adoption decrease the cost of equity of the global tourism firms?
Authors: Feng Zhi-Yuan , Wang Ying-Chieh , Huang Hua-Wei
Published: June 2017

This article answers the question of whether the adoption of International Financial Reporting Standards (IFRS) reduces the cost of equity capital, with a focus on the tourism industry. We employ a set of global tourism companies and find that mandatory IFRS adoption has a significantly negative relation with the cost of equity capital. However, we find that this relation is varied with different business cultures and geographic areas. Moreover, from interactive analyses of country institutions for the relation between mandatory IFRS adoption and tourism firm’s cost of equity, we show that adopting IFRS complements the deficiencies of various country institutions, such as investor protection, the strength of legal enforcement, and corporate governance.
International tourism’s impact on regional autonomy
Authors: O’Brochta William
Published: June 2017

The relationship between increased tourism and increasing regional autonomy is quite nuanced and understudied. This article hypothesizes that only an increase in both regional air traffic and international tourism will impact the level of regional autonomy. Using the period after 10 countries were admitted to the European Union in 2004 as an example of a dramatic tourism increase, the article finds that countries with increased tourism, but without regional airports, did not experience a sudden increase in their regional autonomy. In Poland, however, the large number of growing regional airports and increased tourism did provoke regions to argue with the central government for more regional autonomy. These findings contribute to a better understanding of how international interventions impact regional decentralization preferences.