bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating Passenger Car Equivalents on Level Freeway Segments Experiencing High Truck Percentages and Differential Average Speeds
Authors: Zhou Jianan , Rilett Laurence , Jones Elizabeth , Chen Yifeng
Published: October 2018

In the Highway Capacity Manual (HCM), the passenger car equivalent (PCE) of a truck is used to account for the impacts of trucks on traffic flow. The 2010 HCM PCE values were estimated by the equal-density method using a FRESIM simulation. It was determined that the truck PCE for level freeway segments was 1.5 for all conditions. In the 2016 HCM, the PCE values were based on VISSIM simulation output at 1 min intervals along a three-lane, 13 mile (8 mile level and 5 mile graded) section of a roadway. It was determined that the truck PCE for level freeway segments was 2.0. It is hypothesized in this paper that the HCM PCE values are not appropriate for the western United States, which consistently experiences truck percentages higher than 25%, the maximum truck percentage published in the HCM PCE table. The HCM PCE procedure assumes that truck and passenger cars travel at the same average free-flow speed on level terrain. However, many heavy trucks in the western United States have speed limiters to improve fuel economy, and therefore travel slower than the speed limit. The interaction of high truck percentages and large speed differences may result in moving bottlenecks when trucks pass other trucks at low speed differentials. This may lead to an increased delay for the following passenger car vehicles. The 2016 HCM PCEs are based on three-lane simulations where the PCE is calculated based on near-capacity flows. This approach might not be appropriate for western states where these conditions rarely exist. This paper examines these effects using data from I-80 in western Nebraska. The paper develops new PCE values based on the 2010 HCM equal-density approach using calibrated CORSIM and VISSIM simulation models. It was found that the PCE values in the HCM 2010 and HCM 2016 underestimate the effect of heavy trucks on level terrain freeways that experience high truck percentages, and where different vehicle types have large differences in average free-flow speeds.
Acute pesticide poisoning and related factors among farmers in rural Western Iran
Authors: Afshari Maryam , Poorolajal Jalal , Assari Mohammad Javad , Rezapur-Shahkolai Forouzan , Karimi-Shahanjarini Akram
Published: October 2018

Although acute pesticide poisoning (APP) is known to be a major health concern among farmers in developing countries, knowledge of its prevalence and risk factors is limited. The purpose of this study was to investigate the prevalence and a broad range of potential work-related risk factors of APP among Iranian farmers and farm workers. This cross-sectional study was conducted in rural areas of the Twiserkan County in Iran. In this study, there were 474 farmers and farm workers who had used pesticide 1 week before data collection. Participants were selected from 104 villages. Data were gathered using a questionnaire and analyzed using STATA (version 14.2 SE). Binary logistic regression and multinomial logistic regression were employed. The results of this study showed that 286 (60.3%) farmers and farm workers who applied pesticides suffered from work-related APP. Most frequent APP symptoms were runny nose (29.8%) and headache (25.1%). Five risk factors were identified, including annual income ( p < 0.05), number of farming years (odds ratio (OR) = 0.31), number of spraying years (OR = 2.40), place of pesticide storage (OR = 2.69), and type of sprayer ( p < 0.05). The results of this study indicated that APP is prevalent among the studied farmers. Some work-related factors play an important role in APP among Iranian rural farmers. In addition, the magnitude of these risk factors differed significantly by severity of acute and somatic pesticide poisoning.
Learning to be enterprising in school through an inquiry-based pedagogy
Authors: Pepin Matthias
Published: October 2018

In the French-speaking province of Québec in Canada, entrepreneurship was officially introduced into the Québec Education Program (QEP) in 2001. Entrepreneurship is viewed there as a learning tool associated with the conduct of entrepreneurial projects; that is, student-led action projects that respond to a community need by creating a good, offering a service or organizing an event. The purpose of this article is to report on an investigation conducted into a school shop at primary school level to document what it means to learn to be enterprising in school. The results show that, to learn to be enterprising (i.e. to learn to plan and implement an action project), pupils have to be fully engaged in the creation of the shop and in the inquiry processes to be conducted. Thus they need to be able to identify problems arising, analyse the environment, devise solutions and implement them. Moreover, learning to be enterprising entails learning through being enterprising. Two main learning points were enabled by the inquiry processes based on the school shop experience: (1) the integration of multiple disciplinary contents from the QEP, and (2) critical reflection on society.
Inequality in the Indian Water Sector: Challenges and Policy Options
Authors: Kumar M. Dinesh , Saleth R. Maria
Published: October 2018

Utilizing illustrative examples based on empirical data, this article attempts to provide an indicative assessment of the growing magnitude of inequality in access to water in India. This assessment was made within an analytical framework that highlights variations across water-using sectors such as rural agriculture and urban, as well as across different sources of water such as groundwater, surface water and others. The dimensions of inequality analysed include: inequality in access to common pool groundwater resources (both inter-generational and intra-generational inequality); inequality caused by monopolistic groundwater markets; inequality in access to common property water from river catchments; inequality in access to subsidized water from public irrigation schemes; and inequality in access to water from municipal water supply systems. The article also discusses the role of major factors which contribute to the inequality in the access to water in different contexts, such as lack of well-defined water use rights, inequality in the ownership of land and other rural assets, spatial and topographical issues such as tail-end and downstream aspects, ineffective water and energy pricing policies, inadequate or poorly designed infrastructure and suboptimal water sector investment. The article concludes by providing feasible policy options and possible implementation principles to reduce inequality in access to water across sectors, sources and regions.
Dynamics and evaluation of a nonlinear energy sink integrated by a piezoelectric energy harvester under a harmonic excitation
Authors: Li Xiang , Zhang Ye-Wei , Ding Hu , Chen Li-Qun
Published: October 2018

The harmonically excited structure coupled with the nonlinear energy sink (NES) and a piezoelectric harvester is investigated. The complexification-averaging method is developed to analyze ordinary differential equations which also include one first order differential equation. Effects of varying parameters for the piezoelectric harvester on the saddle-node bifurcation and the Hopf bifurcation are explored. Analytical results of the amplitude–frequency response curves are verified by the numerical evidence. Global bifurcations for NES parameters are presented. Comparisons of periodic results for bifurcation diagrams are performed both numerically and analytically as well as their stable ranges. The integration of nonlinear vibration suppression and energy harvesting is discussed. The output voltage, power, displacement transmissibility, and average energy are calculated to explore the integration. Quasi-periodic responses near the resonance frequency contribute to effectively reducing the resonant amplitude and improving the bandwidth of energy harvesting, as well as targeted energy transfer. Results confirm that the integration of vibration suppression and piezoelectric energy harvesting can be enhanced by adjusting cubic nonlinearity.
Pluralistic Leadership: Bringing Diverse Voices to the Table
Authors: Kezar Adrianna
Published: October 2018

How can colleges and universities harness the leadership potential of the diverse individuals on campus and bring their collective wisdom and experience to bear on today's tough challenges? A recent study conducted by the author suggests just what kind of effort is required. Here she offers a new leadership framework for ensuring that individuals with a broad range of perspectives are fully engaged in campus leadership.
From Classroom to Learning Community
Authors: Klein Thomas
Published: October 2018

When a faculty member decides to take the plunge and enter the world of learning communities, what changes? Everything, says the author.
New Technologies: Changing how we work with Students
Authors: Blimling Gregory S.
Published: October 2018

Today's students, technologically savvy from an early age, expect technical sophistication from their campuses and curricula. Higher education must keep pace with new technologies while addressing the policy issues that they inevitably raise.
Hogwarts: The Learning Community
Authors: Levine Jodi H. , Shapiro Nancy S.
Published: October 2018

Looking for insights into what makes for a challenging and supportive learning environment? Try the bookshelf of almost any nine-year-old.
Reel Lives
Authors: Brown Scott C.
Published: October 2018

Here are two documentary videos that allow us to view up close the complexity of the student experience.
Students and Their Parents: Where Do Campuses Fit In?
Authors: Forbes Karen J.
Published: October 2018

What do students need from parents? What do students need from us? The answers to these questions are constantly shifting in response to changing social attitudes and new ways of understanding student development. The author explores these changes and suggests a new way to think about the role of campus staff in the parent-student relationship.
Bringing: Social Class: To the Diversity Challenge
Authors: Putten Jim Vander
Published: October 2018

We need, says the author, to stop pretending that class doesn't exist and begin to critically consider it as rigorously as we do race and gender.
W.E.B. DUBOIS: Role Model and Mentor for African American Undergraduate Men
Authors: Rowley Larry L.
Published: October 2018

With the dearth of African American men in academe, African American college men have few opportunities to be mentored by those who can best help them make sense of their experience. The author proposes a creative alternative.
Helping Students Make Their Way to Adulthood: Good Company for the Journey
Authors: Magolda Marcia B. Baxter
Published: October 2018

By the time they graduate from college, most students still have not achieved the kind of self-authorship that would allow them to think independently, make choices, and pursue their dreams. What can we do to help them develop this capacity before they graduate so they can make the most of their college experience? One way, says the author, is to be better company.
The Underside of Service Learning
Authors: Jones Susan R.
Published: October 2018

Service learning has been heralded as a transformative and positive experience for most students, but what about those students who just don't get it? These students can often make the service-learning experience difficult and uncomfortable for everyone involved. The author examines this underside of service learning and suggests how to manage it.
Bringing Technology to the Learning Enterprise: A Talk with Carole A. Barone of Educause
Authors: Harwood John T. , Barone Carole A.
Published: October 2018

Using technology's enormous potential to support student learning requires that we enter a new world—one that our students already inhabit. John Harwood and Carole Barone reflect on this and other challenges.
What Hole Do: Elite Colleges Play?
Authors: Arnold Karen D.
Published: October 2018

Prestigious institutions have always had a reputation for producing top leaders. Why is this? Do they truly offer a superior education or simply connections and influence? And what about students who attend good, but not elite, colleges? Does everyone have a chance to make it to the top?
The Provost's Seminar: Building Community and Commitment
Authors: Kraybill Donald B.
Published: October 2018

A thorough orientation program for new educators can do more than introduce them to and make them more comfortable at their new institution—it has the ability to nurture a culture of learning and build important bridges between academic and student affairs.
A Woman's Education
Authors: Renn Kristen A.
Published: October 2018

What can we learn from Jill Ker Conway's story?
The Tensions of Creating a Good First-Year Experience Program: The Alpha Seminar
Authors: Allen Jeanie K.
Published: October 2018

As more and more colleges and universities experiment with programs for first-year students, the kinds of challenges involved are becoming increasingly apparent. The director of the First-Year Experience program at Drury University reflects on these challenges, the tensions they bring, and what to do about them.
What Would Boyer Do
Authors: Bucher Glenn R. , patton Jenell J.
Published: October 2018

Few have had as great an impact in as many areas of higher education as the late Ernest Boyer. Today's educators, faced with issues that were embryonic or nonexistent in Boyer's day, are well served by revisiting his beliefs and ideas and asking themselves what he would do.
Universities as Learning Organizations
Authors: Tinto Vincent
Published: October 2018

One of the most important steps colleges and universities can take in becoming learning organizations is to reorganize their educational activities to encourage shared, connected learning experiences.
Retooling America's Public Universities
Authors: Gee E. Gordon , Spikes Dolores R.
Published: October 2018

Here are some of the tough issues facing public universities as they struggle to redefine their roles while holding onto the promise of providing widespread access to high-quality and affordable education.
Holding Students to High expectations is Everybody's Business
Authors: Blake J. Herman , Evenbeck Scott E. , Melodia Annamarie
Published: October 2018

Our job is not to weed out students who don't belong, but to provide the means for all to achieve at high levels.
Practice in Language Partners
Authors: Bevis Teresa Brawner
Published: October 2018

This program at the University of Arkansas pairs up international students with native English speakers—or “coaches,” as they are called—to practice conversation and improve their spoken English. The result for the international students is more confidence and a higher level of engagement in class and out. The coaches are also seeing some surprising benefits.
Learning More, Spending Less
Authors: Guskin Alan
Published: October 2018

As colleges and universities struggle to restructure in the face of growing pressures to reduce costs and increase accountability, they would do well to turn their attention to the one area affected by both these concerns—student learning.
Call Me by the Names of the Things that I Love
Authors: Fisch Michael
Published: October 2018

Ceremonial robes like birds’ wings, vans full of chafing dishes, Greek dancers dropping their pants. Where do these fit on a young man's résumé?
Higher Education Becomes a Mature Industry
Authors: Levine Arthur
Published: October 2018

Colleges and universities can no longer expect the support and freedom the government gives to young, burgeoning industries. It's time to grow up.
Abandoned its Students
Authors: Willimon William H.
Published: October 2018

A chaplain at Duke University, assigned the task of looking into the relationship between students’ academic and social lives, says yes, we have abandoned students. In an effort to give students their freedom, he explains, we have neglected to give them their roots.
I Am Here Because they Were There
Authors: Hallowell Edward M.
Published: October 2018

A psychiatrist at Harvard Medical School reflects on his own education, revealing the importance of the individual teachers in his life. He asks, How can we make room on our campuses for the teacher-student connection, the human connection, to happen?
When Learning Hurts
Authors: Shatzman Aaron M.
Published: October 2018

Without hard labor can there be education?
The Future of Affirmative Action
Authors: Wilson Reginald
Published: October 2018

Is affirmative action as we know it gone? If so, what will take its place?
Helping Students from: Tribal Colleges Succeed
Authors: Braithwaite Charles A.
Published: October 2018

The author spent eight months at a tribal college to investigate not only what will help Native Indian students succeed as they move to predominately Anglo colleges and universities, but also what we can learn from the strengths of tribal colleges.
Getting Students Involved from the Get-Go: Summer Reading Programs across the Country’
Authors: Fidler Dorothy S.
Published: October 2018

About Campus asked Dorothy Fidler at the University of South Carolina to do an informal survey of colleges to learn more about their summer reading programs. Here is what she found.
Why We Should Encourage Student Activism
Authors: Chickering Arthur W.
Published: October 2018

It may try our patience, but it's a great educational tool.
Electronic Fraud on Campus
Authors: Sauter David M.
Published: October 2018

Changing grades, falsifying documents, creating bogus diplomas—these used to be harder to do. In today's electronic environment, it's surprisingly easy. The author explores the extent of the problem and how colleges and universities can protect themselves and society at large from the consequences of educational fraud.
Doing Good Work
Authors: McGovern Elizabeth
Published: October 2018

When one person's cause is another person's dinner
The Senior Year Experience
Authors: Gardner John N.
Published: October 2018

Higher education needs to do a lot more for seniors than simply hand them a diploma. We have a moral obligation to define and improve the senior year experience to ensure student success after graduation. Here, the architect of the freshman year experience explains why seniors now deserve our special attention and what it would take to give it to them.
Dealing with Student Credit Card DEBT
Authors: Stanford William E.
Published: October 2018

While most students use credit cards responsibly, it is estimated that more than one in ten students do not. These students are at risk for accumulating a level of debt that can seriously undermine their future. What can, and should, we do to help?
Where Powerful Partnerships Begin
Authors: Potter David L.
Published: October 2018

As we, staff and faculty alike, undertake the job of transforming our colleges and universities into learning-centered institutions, what can we use to guide our efforts? How can we move beyond our separate areas of expertise to cultivate a shared vision of what learning is and the best ways to make it happen? The author, who recently chaired a national task force on collaboration, provides some answers.
Dreams, Alive and Well and Living in Boone
Authors: Williams Lee Burdette
Published: October 2018

A hundred students, a hundred carefully crafted life plans
From the Inner City to the Ivy League
Authors: Sherlin Joe H.
Published: October 2018

A recent book chronicles one student's struggle.
The College of New Jersey First Year Experience: A Learning Partnership
Authors: Perry Mary-Elaine
Published: October 2018

Here is a first-year experience program that has succeeded in integrating academic rigor with a variety of cocurricular experiences, including a strong service-learning program. The result is a true partnership among faculty, staff, and students.
Towards a synthesis of formal, non-formal and informal pedagogies in popular music learning
Authors: Ng Hoon Hong
Published: October 2018

Informal pedagogy is closely associated with popular music practices, its methods known to engage students in authentic music learning that develops critical and independent thinking skills, social skills, creativity and self-identity, among others. However, formal and non-formal pedagogies also have relevant roles to play in popular music learning in the classroom, though their roles and interactions with informal pedagogy may require exploration. A recent survey conducted in Singapore schools suggests that a significant number of music teachers have never engaged their students in popular music practices, and they have no confidence in adopting appropriate pedagogies to effectively enable popular music learning. This article seeks to address the issue by reviewing relevant pedagogies and how they are employed in popular music programmes in two Singapore secondary schools. I will first examine the current discussion on formal, non-formal and informal pedagogies and their implications for music teaching and learning. Secondly, I will relate the discussion to two empirical case studies which adopt these learning approaches in popular music classes to examine their applications and how they interact in actual classroom situations. Based on this, I will suggest that a synthesis of these pedagogies in constant, complementary dialogue within and beyond the classroom paves the way towards a complete and holistic curriculum and learner experience.
Care coordinator assistants: Job satisfaction and the importance of teamwork in delivering person-centered dementia care
Authors: Nowaskie Dustin , Carvell Carly A , Alder Catherine A , LaMantia Michael A , Gao Sujuan , Brown Steve , Boustani Malaz A , Austrom Mary Guerriero
Published: October 2018

As the prevalence of persons with dementia increases, a larger, trained, and skilled healthcare workforce is needed. Attention has been given to models of person-centered care as a standard for dementia care. One promising role to deliver person-centered care is the care coordinator assistant. An inquiry about care coordinator assistant’s job satisfaction is reasonable to consider for retention and quality improvement purposes. We evaluated care coordinator assistants' job satisfaction quantitatively and qualitatively. This study was part of a Centers for Medicare & Medicaid Services Health Care Innovation Award to the Indiana University School of Medicine. Sixteen care coordinator assistants, predominately female, African American or Caucasian, college graduates with a mean age of 43.1 years participated. Care coordinator assistants wrote quarterly case reports to share stories, lessons learned, and/or the impact of their job and completed the revised Job Satisfaction Inventory and Job in General scales during the second year of the Centers for Medicare & Medicaid Services award. For the Job Descriptive Index subscales promotion, supervision, and coworkers and Job in General, care coordinator assistants scored similar to normative means. Care coordinator assistants reported significantly higher satisfaction on the work subscale and significantly lower satisfaction on the pay subscale compared to normative data. Care coordinator assistants completed 119 quarterly case reports. Job satisfaction and teamwork were recurring themes in case reports, referenced in 47.1% and 60.5% of case reports, respectively. To address the demands of increasing dementia diagnoses, care coordinator assistants can constitute a compassionate, competent, and satisfied workforce. Training care coordinator assistants to work together in a team to address the needs of persons with dementia and caregivers provides a viable model of workforce development necessary to meet the growing demands of this population.
Model-free control of a quadrotor using adaptive proportional derivative-sliding mode control and robust integral of the signum of the error
Authors: Li Zhi , Ma Xin , Li Yibin
Published: October 2018

In this article, a robust model-free trajectory tracking control strategy is developed for a quadrotor in the presence of external disturbances. The proposed strategy has an outer-inner-loop control structure. The outer loop controls the position with adaptive proportional derivative-sliding mode control and generates the desired attitude angles for the inner loop corresponding to the given position, velocity, and heading references, while the robust integral of the signum of the error method is applied to the inner loop to guarantee fast convergence of attitude angles. Asymptotic tracking of the three-dimensional trajectories is proven by the Lyapunov stability theory. The effectiveness of the proposed controller is demonstrated with the simulation results by comparing with other model-free quadrotor trajectory tracking controllers.
A model-based velocity controller for chaotization of flexible joint robot manipulators
Authors: Miranda-Colorado Roger , Aguilar Luis T , Moreno-Valenzuela J
Published: October 2018

This article presents a model-based velocity controller able to induce a chaotic motion on n-degrees of freedom flexible joint robot manipulators. The proposed controller allows the velocity link vector of a robot manipulator to track an arbitrary, chaotic reference vector field. A rigorous theoretical analysis based on Lyapunov’s theory is used to prove the asymptotic stability of the tracking error signals when using the proposed controller, which implies that a chaotic motion is induced to the robotic system. Experimental results are provided using a flexible joint robot manipulator of two degrees of freedom. Finally, by using Poincaré maps and Lyapunov exponents, it is shown that the behavior exhibited by the robot joint positions is chaotic.
Networks of radical contention: The co-constitutive relations between structural conditions and public relations strategies and tactics in the committee in solidarity with the people of El Salvador
Authors: Valencia Ricardo J. , Jones Patrick
Published: October 2018

In the 1980s, the Committee in Solidarity with the People of El Salvador (CISPES) became a key node in a vast network of political opposition against US foreign policy. In this article, we argue that these webs of political opposition constitute the geographies on which the public relations (PR) strategies deployed by CISPES were pursued and corresponding political opportunities were structured. We use newspaper analysis, interviews, and archival research to map three such networks in an effort to understand the changing climate in which CISPES pursued its political agenda during the 1980s. We conceptualize these networks as ‘networks of contention’ and contend that variations in these networks correspond to CISPES’ efforts to take advantage of unforeseeable political opportunities, which raised the profile of CISPES as well as its overall position as a radical activist organization opposing the Reagan government. We conclude by arguing that an attention to networks of contention is necessary for understanding both the strategies and tactics pursued by PR activists and the political opportunities that shape those tactics and strategies. Our analysis is sympathetic with the sociocultural ‘turn’ in the PR theory that assesses structural and contextual constraints on the strategies and tactics deployed by PR professionals. In the end, this article argues that the networks of contention that organizations find themselves in during particular moments of political crisis play a key role in shaping the kinds of strategies and tactics available to pursue them. We also contend that the collision between relationship management strategies and the contexts in which they are embedded suggests that the tactics and strategies pursued by PR professionals have to be embedded in and are structured by perpetually changing sociopolitical environments, which often refuse management and require constant strategic adaptation and flexibility.
Data in the smart city: How incongruent frames challenge the transition from ideal to practice
Authors: Madsen Anders Koed
Published: October 2018

This paper presents an analysis of interviews, focus groups and workshops with employees in the technical administration in the municipality of Copenhagen in the year after it won a prestigious Smart City award. The administration is interpreted as a ‘most likely’ to succeed in translating the idealised version of the smart city into a workable bureaucratic practice. Drawing on the work of Orlikowski and Gash, the empirical analysis identifies and describes two incongruent ‘technological frames’ that illustrates different ways of making sense of data and the smart city within this single organisational unit. One is called the experimentalist’s credo and it is characterised by inspiration from the development of an Internet of Things as well as a readiness to learn from the open source community in software development. The other is called the data-owners vocation and it is characterised by a more situated approach that interprets data as strategic and political. It is argued that the existence of these frames provides two insights relevant for the literature on smart cities. First, they illustrate that one should be careful not to reify the smart city as a phenomenon that can be criticised in generic terms. Second, they suggest that even if there exists a transition toward the implementation of a technocratic smart city paradigm across public administrations, this paradigm is not unique in its focus on markets and evidence in governance.
Personality in a Hierarchical Model of Psychopathology
Authors: Widiger Thomas A. , Sellbom Martin , Chmielewski Michael , Clark Lee Anna , DeYoung Colin G. , Kotov Roman , Krueger Robert F. , Lynam Donald R. , Miller Joshua D. , Mullins-Sweatt Stephanie , Samuel Douglas B. , South Susan C. , Tackett Jennifer L. , Thomas Katherine M. , Watson David , Wright Aidan G. C.
Published: October 2018

The categorical model of classification in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders is sorely problematic. A proposed solution is emerging in the form of a quantitative nosology, an empirically based dimensional organization of psychopathology. More specifically, a team of investigators has proposed the Hierarchical Taxonomy of Psychopathology (HiTOP). The purpose of this article is to discuss the potential role, importance, and implications of personality within the HiTOP dimensional model of psychopathology. Suggested herein is that personality provides a foundational base for the HiTOP dimensional model of psychopathology. Implications concern the potential value of the early assessment of and screening for personality as well as the development of protocols for the treatment of personality trait domains, which may in turn contribute to substantial improvements in quality of life as well as mental and physical health.
The Canadian Plastic Surgery Workforce Analysis: Forecasting Future Need
Authors: Morzycki Alexander , Retrouvey Helene , Alhalabi Becher , Efanov Johnny Ionut , Al-Youha Sarah , Ahmad Jamil , Tang David T.
Published: October 2018

Background:

Projecting the demand for plastic surgeons has become increasingly important in a climate of scarce public resource within a single payer health-care system. The goal of this study is to provide a comprehensive workforce update and describe the perceptions of the workforce among Canadian Plastic Surgery residents and surgeons.

Methods:

Two questionnaires were developed by a national task force under the Canadian Plastic Surgery Research Collaborative. The surveys were distributed to residents and practicing surgeons, respectively.

Results:

Two-hundred fifteen (49%) surgeons responded, with a mean age of 51.4 years (standard deviation [SD] = 11.5); 78% were male. Thirty-three percent had been in practice for 25 years or longer. More than half of respondents were practicing in a large urban center. Fifty-nine percent believed their group was going to hire in the next 2 to 3 years; however, only 36% believed their health authority/provincial government had the necessary resources. The mean desired age of retirement was 67 years (SD = 6.4). We predict the surgeons-to-population ratio to be 1.55:100 000 and the graduate-to-retiree ratio to be 2.16:1 within the next 5 to 10 years. Seventy-seven (49%) residents responded. Most were “very satisfied” with their training (61%) and operative experience (90%). Eighty-nine percent of respondents planned to pursue addqitional training after residency, with 70% stating that the current job market was contributing to their decision. Most residents responded that they were concerned with the current job market.

Conclusions:

The results of this study predict an adequate number of plastic surgeons will be trained within the next 10 years to suit the population’s requirements; however, there is concern that newly trained surgeons will not have access to the necessary resources to meet growing demands. Furthermore, there is an evident shortage of those practicing in rural areas. Many trainees worry about the availability of jobs, despite evidence of active recruitment. The workforce may benefit from structured career mentorship in residency and improved transparency in hiring practices, particularly to attract young surgeons to smaller communities. It may also benefit from a coordinated national approach to recruitment and succession planning.
Outcomes of an accelerated nonsurgical management protocol for hip fractures in the elderly
Authors: Lim Wei Xiang , Kwek Ernest Beng Kee
Published: October 2018

The majority of hip fractures in elderly patients are managed surgically with superior outcomes. However, for patients who refuse surgery or are deemed medically unfit, traction used to be the mainstay of nonsurgical treatment, which is associated with prolonged hospitalization and inpatient complications from immobility. This study, therefore, aims to evaluate the outcomes of an early wheelchair mobilization protocol as an alternative nonsurgical treatment option. This is a retrospective study of 87 elderly patients who were managed nonsurgically for their hip fractures over a 1-year period. The accelerated rehabilitation protocol did not have them on traction but were instead mobilized with assistance as soon as possible after admission. Variables collected electronically include patient demographics, fracture characteristics, inpatient mobilization milestones, inpatient complications, Modified Functional Ambulation Classification (MFAC), Modified Barthel Index (MBI) scores, and radiological findings. Patients who were younger, could sit up earlier and had a shorter length of stay, were able to ambulate better at 6 months ( p value < 0.05). Patients with femoral neck fractures and shorter length of stay had better MFAC scores. A total of 58% of patients with radiological follow-up had displacement of their fractures with age, type of fracture, and length of stay as predictors ( p value < 0.05) The Charlson’s score, day to sitting up, and day to transfer affect fracture healing ( p value < 0.05). The mean length of stay was 17 days and the 1-year mortality was 18%. Surgical therapy remains the preferred choice of management for patients with hip fractures. Early wheelchair mobilization leads to a shorter length of stay compared to traditional traction methods and comparable 1-year mortality rates with operative management. Despite this, complication rates remain high and only 48% of patients achieved ambulation by 1 year, with healing in only 24% of fractures.
What makes leaders resilient? An exploratory interview study
Authors: Förster Charlotte , Duchek Stephanie
Published: October 2018

Can the boss take the heat? Is he or she tough enough for the job? Can they take it, endure the pressure, tolerate or stand up to it? Although we know that resilient leaders are essential for a healthy and efficient workforce, the resilience of leaders itself is still largely unexplored. Our study aims to identify distinctive resilience factors in leadership and help close this research gap. We interviewed 27 leaders from various industrial sectors, German regions and leadership positions. In a qualitative content analysis, we identified 77 individual, situational and behavioural factors that seem to impact on the resilience of leaders. We divided these factors into meaningful categories and integrated them into a framework appropriate for leadership. This framework shows that in addition to individual traits and abilities, situational factors (private and work environment) and behavioural factors (personal and interpersonal behaviour) are highly important and that leaders’ resilience results from an interaction of these factors. As most of the identified factors can be directly influenced by the leader or the organization, our study provides important insights into the effective development and nurturing of leaders’ resilience. Furthermore, the findings can be a helpful starting point for future empirical studies.
Empowerment among generations
Authors: Singh Usha , Weimar Daniel
Published: October 2018

The study investigates differences in people’s attitudes towards empowerment among generations and other demographic variables as there are only few insights available so far. Therefore, a combination of a hierarchical and a non-hierarchical cluster analysis is used, leading to two clusters termed ‘empowered employees’ and ‘less empowered employees’. Chi-square tests are applied to investigate the differences in the demographic variables among the clusters. Furthermore, a discriminant analysis is carried out to check the segmentation strength and the consistency of the clusters. Additionally, multivariate ordinary least squares (OLS) and logit estimations are used as a robustness check. Results indicate that people from Generation X and the Post-war Generation are more likely to tend towards empowerment than Baby Boomers.
Antibiotic resistance, virulence factors and genotyping of Uropathogenic Escherichia coli strains
Authors: Raeispour Maryam , Ranjbar Reza
Published: October 2018

Background

The way of treating different types of infectious diseases is really important. Using genotyping method, we can determine the genetic relatedness between the organisms with different resistance profile from different sources. The aim of this study was to determine antibiotic resistance and genotyping of uropathogenicEscherichia coli(UPEC) strains using pulsed field gel electrophoresis (PFGE).

Method

Escherichia coli(E. coli) strains were recovered from the patients with urinary tract infections (UTI) whom admitted in several major hospitals in Tehran. Antibiotic susceptibility testing was done according to CLSI guideline. The present of some virulence factor have been detected using PCR assay. Genotyping of the strains was performed by PFGE and all PFGE profiles were subjected to data processing.

Result

In total, 60E. colistrains were subjected to the study. Most ofE. coliisolates were resistant to cefepime (100%) and cephalothin (74%) and susceptible to imipenem (100%), vancomycin (100%) and doxycycline (100%). Among the UPEC isolates the prevalence of fimbriae type I (fimH), hemolysin (hlyA) and aerobactin (aer) genes were 89%, 60% and 90%, respectively. The PFGE differentiatedE. colistrains into 33 different genetic clusters. Majority (30%) of them including PFGE type 11 generated 15 bands, while PFGE type 2 was the lowest (2%) prevalent group with 9 bands.

Conclusion

The result showed that the antibiotic resistance is escalating rapidly. UPEC strains causing infections are more likely to harbor certain virulence genes. Our finding also showedE. colistrains isolated under the study were belonged to the diverse clones.
Paradoxical GH Increase During OGTT Is Associated With First-Generation Somatostatin Analog Responsiveness in Acromegaly
Authors: Scaroni Carla , Albiger Nora , Daniele Andrea , Dassie Francesca , Romualdi Chiara , Vazza Giovanni , Regazzo Daniela , Ferraù Francesco , Barresi Valeria , Maffeis Valeria , Gardiman Marina Paola , Cannavò Salvatore , Maffei Pietro , Ceccato Filippo , Losa Marco , Occhi Gianluca
Published: October 2018

Context

The oral glucose tolerance test (OGTT) is considered the most useful method for diagnosing active acromegaly and for patient follow-up after neurosurgery. Despite its widespread use, only a few small studies have so far focused on patients’ clinical features associated with different GH responsiveness to OGTT.

Objective

We aimed to investigate the association between glucose-induced GH response and endocrine profiles, clinical manifestations, and response to therapy in a large cohort of patients with acromegaly.

Patients

According to GH response to OGTT, patients were grouped as paradoxical (GH-Par) or nonparadoxical (GH-NPar), and their clinical and pathological features were compared in terms of pituitary tumor size, invasiveness, biochemical profiles, and response to therapy.

Results

The study concerned 496 patients with acromegaly. At diagnosis, those with GH-Par (n = 184) were older than those with GH-NPar (n = 312) (mean ± SD, 44.1 ± 13.7 years vs 40.5 ± 12.7 years; P < 0.01) and had smaller tumors (0.82 vs 1.57 cm3; P < 0.01) that less frequently invaded the cavernous sinus (15% vs 27%; P < 0.01). The GH-Par group also had a higher basal GH per volume ratio (14.3 vs 10.5 μg/L ⋅ cm3; P < 0.05) and a lower incidence of hyperprolactinemia (17% vs 30%; P < 0.01) than the GH-NPar group. Importantly, the GH-Par group had a higher rate of remission in response to somatostatin analogues (52% vs 26%; P < 0.01) and a more marked drop in IGF-1 and GH after 6 months of therapy.

Conclusions

Our data strongly suggest that serum GH responsiveness to oral glucose challenge reflects some important biological features of pituitary tumors and that the OGTT may have some prognostic value.
Hyperandrogenism in Female Athletes
Authors: Hirschberg Angelica Lindén
Published: October 2018

New regulations for eligibility of female athletes with hyperandrogenism are restricted to differences of sex development, normal response to testosterone, and middle distance track disciplines.
Herpesvirus Infections of the Nervous System
Authors: Baldwin Kelly J. , Cummings Christopher L.
Published: October 2018

PURPOSE OF REVIEW

This article reviews the spectrum of neurologic disease associated with human herpesvirus infections.

RECENT FINDINGS

As more patients are becoming therapeutically immunosuppressed, human herpesvirus infections are increasingly common. Historically, infections with human herpesviruses were described as temporal lobe encephalitis caused by herpes simplex virus type 1 or type 2. More recently, however, additional pathogens, such as varicella-zoster virus, Epstein-Barr virus, cytomegalovirus, and human herpesvirus 6 have been identified to cause serious neurologic infections. As literature emerges, clinical presentations of herpesvirus infections have taken on many new forms, becoming heterogeneous and involving nearly every location along the neuraxis. Advanced diagnostic methods are now available for each specific pathogen in the herpesvirus family. As data emerge on viral resistance to conventional therapies, newer antiviral medications must be considered.

Infections from the herpesvirus family can have devastating neurologic outcomes without prompt and appropriate treatment. Clinical recognition of symptoms and appropriate advanced testing are necessary to correctly identify the infectious etiology. Knowledge of secondary neurologic complications of disease is equally important to prevent additional morbidity and mortality. This article discusses infections of the central and peripheral nervous systems caused by herpes simplex virus type 1 and type 2, varicella-zoster virus, Epstein-Barr virus, cytomegalovirus, and human herpesvirus 6. The pathophysiology, epidemiology, clinical presentations of disease, diagnostic investigations, imaging characteristics, and treatment for each infectious etiology are discussed in detail.
Regional Anesthesia and Readmission Rates After Total Knee Arthroplasty
Authors: Chi Debbie , Mariano Edward R. , Memtsoudis Stavros G. , Baker Laurence C. , Sun Eric C.
Published: October 2018

BACKGROUND:

Total knee arthroplasty is a commonly performed procedure and an important contributor to national health care spending. Reducing the incidence of readmission could have important consequences for patient well-being and relevant financial implications. Whether regional anesthesia techniques are associated with decreased readmission rates and costs among privately insured patients remains unknown.

METHODS:

Using administrative claims data, we identified 138,362 privately insured patients 18–64 years of age who underwent total knee arthroplasty between 2002 and 2013. We then examined whether the use of a nerve block was associated with decreases in readmission rates and related costs during the 90 days after discharge. Our analyses were adjusted for potential confounding variables including medical comorbidities and previous use of opioids and other medications.

RESULTS:

After adjusting for patient demographics, comorbidities, and preoperative medication use, the adjusted 90-day readmission rate was 1.8% (95% confidence interval [CI], 1.1–2.4) among patients who did not receive a block compared to 1.7% (95% CI, 1.1–2.4) among patients who did (odds ratio, 0.99; 95% CI, 0.91–1.09; P = .85). The adjusted readmission-related postoperative cost for patients who did not receive a block was $561 (95% CI, 502–619) and $574 (95% CI, 508–639) for patients who did (difference, $13; 95% CI, −75 to 102; P = .74). This lack of statistically significant differences held for subgroup and sensitivity analyses.

CONCLUSIONS:

Nerve blocks were not associated with improved measures of long-term postoperative resource use in this younger, privately insured study population.