bluuebunny/crossref_metadata_2025 huggingface dataset:
Convection Initiation Caused by Heterogeneous Low-Level Jets over the Great Plains
Authors: Gebauer Joshua G. , Shapiro Alan , Fedorovich Evgeni , Klein Petra
Published: June 2018

Observations from three nights of the Plains Elevated Convection at Night (PECAN) field campaign were used in conjunction with Rapid Refresh model forecasts to find the cause of north–south lines of convection, which initiated away from obvious surface boundaries. Such pristine convection initiation (CI) is relatively common during the warm season over the Great Plains of the United States. The observations and model forecasts revealed that all three nights had horizontally heterogeneous and veering-with-height low-level jets (LLJs) of nonuniform depth. The veering and heterogeneity were associated with convergence at the top-eastern edge of the LLJ, where moisture advection was also occurring. As time progressed, this upper region became saturated and, due to its placement above the capping inversion, formed moist absolutely unstable layers, from which the convergence helped initiate elevated convection. The structure of the LLJs on the CI nights was likely influenced by nonuniform heating across the sloped terrain, which led to the uneven LLJ depth and contributed toward the wind veering with height through the creation of horizontal buoyancy gradients. These three CI events highlight the importance of assessing the full three-dimensional structure of the LLJ when forecasting nocturnal convection over the Great Plains.
Ketamine and rapidly acting antidepressants: Breaking the speed of sound or light?
Authors: Berk Michael , Loo Collen , Davey Christopher G , Harvey Brian H
Published: June 2018

There is an urgent need for rapidly acting antidepressants. Current therapies share a delayed onset of action, contrasting with drugs of abuse that have rapid psychotropic effects but cause tolerance and dependence. A key uncertainty is whether there is a finite speed limit imposed by the critical role of homeostatic adaptive mechanisms that underpin the efficacy and onset of available psychotropic agents and whether this is mutable with emerging agents with potential rapid onset, in particular ketamine.
Supported decision-making from the perspectives of mental health service users, family members supporting them and mental health practitioners
Authors: Kokanović Renata , Brophy Lisa , McSherry Bernadette , Flore Jacinthe , Moeller-Saxone Kristen , Herrman Helen
Published: June 2018

Background:

Supporting the decision-making of mental health service users fulfils professional, ethical and moral obligations of mental health practitioners. It may also aid personal recovery. Previous research on the effectiveness of supported decision-making interventions is limited.

Aims:

The study aims to explore from several perspectives the barriers and facilitators to supported decision-making in an Australian context. Supported decision-making was considered in terms of interpersonal experiences and legal supported decision-making mechanisms.

Methods:

In all, 90 narrative interviews about experiences of supported decision-making were conducted and analysed. Participants were mental health service users who reported diagnoses of schizophrenia, psychosis, bipolar disorder and severe depression; family members supporting them and mental health practitioners, including psychiatrists. The data were analysed thematically across all participants.

Results:

Negative interpersonal experiences in the mental health care system undermined involvement in decision-making for people with psychiatric diagnoses and family carers. Mental health practitioners noted their own disempowerment in service systems as barriers to good supported decision-making practices. All groups noted the influence of prevailing attitudes towards mental health service users and the associated stigma and discrimination that exist in services and the broader community. They believed that legal supported decision-making mechanisms facilitate the participation of mental health service user and their family supporters in supported decision-making.

Conclusions:

Enabling supported decision-making in clinical practice and policy can be facilitated by (1) support for good communication skills and related attitudes and practices among mental health practitioners and removing barriers to their good practice in health and social services and (2) introducing legal supported decision-making mechanisms.
Bootstrap Variance Estimation for Semiparametric Finite Population Distribution Function Estimator
Authors: Adhya Sumanta
Published: June 2018

Estimating finite population distribution function (FPDF) emerges as an important problem to the survey statisticians since the pioneering work of Chambers and Dunstan [1] . It unifies estimation of standard finite population parameters, namely, mean and quantiles. Regarding this, estimating variance of FPDF estimator is an important task for accessing the quality of the estimtor and drawing inferences (e.g., confidence interval estimation) on finite population parameters. Due to non-linearity of FPDF estimator, resampling-based methods are developed earlier for parametric or non-parametric Chambers–Dunstan estimator. Here, we attempt the problem of estimating variance of P-splines-based semiparametric model-based Chambers–Dunstan type estimator of the FPDF. The proposed variance estimator involes bootstrapping. Here, the bootstrap procedure is non-trivial since it does not imitate the full mechanism of two-stage sample generating procedure from an infinite hypothetical population (superpopulation). We have established the weak consistency of the proposed resampling-based variance estimator for specific sampling designs, e.g., simple random sampling. Also, the satisfactory empirical performance of the poposed estimator has been shown through simulation studies and a real life example.
Survivors’ Perspectives on Recovery From Commercial Sexual Exploitation Beginning in Childhood
Authors: Bruhns Maya E. , del Prado Alicia , Slezakova Jana , Lapinski Alexander J. , Li Toni , Pizer Becky
Published: June 2018

This study explored the process of exiting and recovery from commercial sexual exploitation beginning in childhood, utilizing semistructured interviews with 11 adult female survivors who had been out of the commercial sex industry for at least six months. The narratives were analyzed using consensual qualitative research. Participants described a complex interface of internal motivation and external resources in the exiting process. They identified a need for comprehensive, nonjudgmental services across all stages of change, in order to support a profound reconstruction of identity and community. Subgroup comparisons revealed that women who were exploited at younger ages were more vulnerable to coercive and dehumanizing exploitation and required especially intensive services. These results support the methods of many survivor-led programs for sexually exploited youth. Implications of survivors’ perspectives for counseling, research, and advocacy are discussed.
The Seven Challenges® Comprehensive Counseling Program: Effectiveness for Adults with Substance Use Problems
Authors: Korchmaros Josephine D.
Published: June 2018

This study examined the acceptability and effectiveness of The Seven Challenges®, a comprehensive substance use counseling program focused on decision making, compared with commonly provided, or “standard,” cognitive-behavioral substance use treatment implemented with a focus on abstinence. Results, based on data from 71 adult drug court clients, indicated higher acceptability of The Seven Challenges than standard cognitive-behavioral treatment as reflected in treatment satisfaction, honesty, and disclosure, as well as perceived impact of treatment. Results also showed that The Seven Challenges was as effective as standard cognitive-behavioral treatment at improving vocational engagement and was more effective at reducing substance use, related problems, and internal mental distress. The Seven Challenges was also effective at reducing criminal activity, whereas clients of the standard cognitive-behavioral treatment appeared to increase criminal activity. These findings strengthen the existing evidence base of The Seven Challenges as a comprehensive counseling program addressing substance use, mental health problems, and criminality.
Do low-paid workers benefit from the urban escalator? Evidence from British cities
Authors: Velthuis Sanne , Sissons Paul , Berkeley Nigel
Published: June 2018

Cities are characterised as places of increased human capital accumulation, dynamic labour markets and faster wage growth: in short, places where workers can get ahead. Studies suggest that urban workers can benefit from faster learning and from better job matching. This article assesses the extent to which cities act as escalators for workers in low-wage jobs using panel data from Great Britain covering the period 2009–2014. When defining low pay using a standard national wage threshold, workers in London, the largest city, are significantly more likely to make a transition from low- to higher-paid employment than workers in non-urban areas. However, the use of a national wage threshold to measure progression from low pay is sensitive to geographic variations in wage levels. When using an alternative, occupation-based definition of low pay there is little to no evidence of faster wage growth in London or other large British cities, suggesting that low-paid workers do not benefit significantly from faster learning or more efficient job matching in cities. The findings, once adjusted for differences in the wage distribution, fail to identify an urban escalator effect for those in low-paid employment, suggesting that there is a fairly consistent set of underlying factors shaping progression from low pay across geographies.
When People Co-occur With Good or Bad Events: Graded Effects of Relational Qualifiers on Evaluative Conditioning
Authors: Hughes Sean , Ye Yang , Van Dessel Pieter , De Houwer Jan
Published: June 2018

Studies on evaluative conditioning show that a change in liking can occur whenever stimuli are paired. Such instances of attitude change are known to depend on the type of relation established between stimuli (e.g., “Bob is a friend of Mike” vs. “Bob is an enemy of Mike”). Research has so far only compared assimilative and contrastive relational qualifiers (e.g., friend vs. enemy). For the first time, we compared the effect of nonoppositional qualifiers on attitude change in an evaluative conditioning procedure (e.g., “Bob causes Positive Outcomes” vs. “Bob predicts Positive Outcomes”). Differential effects of nonoppositional relational qualifiers were observed on explicit and implicit evaluations. We discuss the implications of our findings for attitude research, theories of attitude change, and optimizing evaluative conditioning for changing attitudes in applied settings.
The Influence of Graft Tensioning Sequence on Tibiofemoral Orientation During Bicruciate and Posterolateral Corner Knee Ligament Reconstruction: A Biomechanical Study
Authors: Moatshe Gilbert , Chahla Jorge , Brady Alex W. , Dornan Grant J. , Muckenhirn Kyle J. , Kruckeberg Bradley M. , Cinque Mark E. , Turnbull Travis Lee , Engebretsen Lars , LaPrade Robert F.
Published: June 2018

Background:

During multiple knee ligament reconstructions, the graft tensioning order may influence the final tibiofemoral orientation and corresponding knee kinematics. Nonanatomic tibiofemoral orientation may result in residual knee instability, altered joint loading, and an increased propensity for graft failure.

Purpose:

To biomechanically evaluate the effect of different graft tensioning sequences on knee tibiofemoral orientation after multiple knee ligament reconstructions in a bicruciate ligament (anterior cruciate ligament [ACL] and posterior cruciate ligament [PCL]) with a posterolateral corner (PLC)–injured knee.

Study Design:

Controlled laboratory study.

Methods:

Ten nonpaired, fresh-frozen human cadaveric knees were utilized for this study. After reconstruction of both cruciate ligaments and the PLC and proximal graft fixation, each knee was randomly assigned to each of 4 graft tensioning order groups: (1) PCL → ACL → PLC, (2) PCL → PLC → ACL, (3) PLC → ACL → PCL, and (4) ACL → PCL → PLC. Tibiofemoral orientation after graft tensioning was measured and compared with the intact state.

Results:

Tensioning the ACL first (tensioning order 4) resulted in posterior displacement of the tibia at 0° by 1.7 ± 1.3 mm compared with the intact state ( P = .002). All tensioning orders resulted in significantly increased tibial anterior translation compared with the intact state at higher flexion angles ranging from 2.7 mm to 3.2 mm at 60° and from 3.1 mm to 3.4 mm at 90° for tensioning orders 1 and 2, respectively (all P < .001). There was no significant difference in tibiofemoral orientation in the sagittal plane between the tensioning orders at higher flexion angles. All tensioning orders resulted in increased tibial internal rotation (all P < .001). Tensioning and fixing the PLC first (tensioning order 3) resulted in the most increases in internal rotation of the tibia: 2.4° ± 1.9°, 2.7° ± 1.8°, and 2.0° ± 2.0° at 0°, 30°, and 60°, respectively.

Conclusion:

None of the tensioning orders restored intact knee tibiofemoral orientation. Tensioning the PLC first should be avoided in bicruciate knee ligament reconstruction with concurrent PLC reconstruction because it significantly increased tibial internal rotation. We recommend that the PCL be tensioned first, followed by the ACL, to avoid posterior translation of the tibia in extension where the knee is primarily loaded during most activities. The PLC should be tensioned last.

Clinical Relevance:

This study will help guide surgeons in decision making for the graft tensioning order during multiple knee ligament reconstructions.
Tissue-Engineered Total Meniscus Replacement With a Fiber-Reinforced Scaffold in a 2-Year Ovine Model
Authors: Patel Jay M. , Ghodbane Salim A. , Brzezinski Andrzej , Gatt Charles J. , Dunn Michael G.
Published: June 2018

Background:

Meniscus injuries and associated meniscectomies cause patients long-term pain and discomfort and can lead to joint deterioration.

Purpose:

To evaluate a collagen-hyaluronan sponge reinforced with synthetic resorbable polymer fiber for total meniscus reconstruction in a long-term ovine model.

Study Design:

Controlled laboratory study.

Methods:

Eleven skeletally mature sheep were implanted with the total meniscus scaffold. At 2 years, explants were evaluated biologically (radial/circumferential histology, immunofluorescence) and mechanically (compression, tension), and articular surfaces were examined for damage.

Results:

The fiber-reinforced scaffold induced formation of functional neomeniscus tissue that was intact in 8 of 11 animals. The implant was remodeled into organized circumferentially aligned collagen bundles to resist meniscus hoop stresses. Moreover, type II collagen and proteoglycan deposition near the inner margin suggested a direct response to compressive stresses and confirmed fibrocartilage formation. Cartilage damage was observed, but end-stage (severe) joint deterioration associated with meniscectomy was avoided, even with limitations regarding the ovine surgical procedure and postoperative care.

Conclusion:

A fiber-reinforced total meniscus replacement device induces formation of functional neomeniscus tissue that has the potential to prevent catastrophic joint deterioration associated with meniscectomy.

Clinical Relevance:

An off-the-shelf meniscus device that can be remodeled into functional tissue and thus prevent or delay the onset of osteoarthritis could address a widespread clinical need after meniscus injury.
Past Due: Combinations of Utility and Housing Hardship in the United States
Authors: Finnigan Ryan , Meagher Kelsey D.
Published: June 2018

Millions of households in the United States are forced to juggle different basic needs. Housing and utility costs consume the majority of many households’ monthly incomes. Consequences for missed payments include large fees, utility shutoffs, and evictions. Either hardship puts households at risk of losing adequate shelter. This study examines the prevalence and persistence of different combinations of housing and/or utility hardship using nationally representative panel data from the Survey of Income and Program Participation (SIPP). It also predicts transitions into these hardship combinations following commonly studied household dynamics: income changes, household composition changes, and poor health. Utility hardship is both more common and persistent than housing hardship, and households experiencing utility hardship have more disadvantaged characteristics. Entries into poor health are the strongest predictors of hardship. Other shocks predict one form of hardship more than the other. Most notably, income losses predict housing hardship but not utility hardship.
Introduction of the trapezoidal thermodynamic technique method for measuring and mapping the efficiency of waste-to-energy plants: A potential replacement to the R1 formula
Authors: Vakalis Stergios , Moustakas Konstantinos , Loizidou Maria
Published: June 2018

Waste-to-energy plants have the peculiarity of being considered both as energy production and as waste destruction facilities and this distinction is important for legislative reasons. The efficiency of waste-to-energy plants must be objective and consistent, independently if the focus is the production of energy, the destruction of waste or the recovery/upgrade of materials. With the introduction of polygeneration technologies, like gasification, the production of energy and the recovery/upgrade of materials, are interconnected. The existing methodology for assessing the efficiency of waste-to-energy plants is the R1 formula, which does not take into consideration the full spectrum of the operations that take place in waste-to-energy plants. This study introduces a novel methodology for assessing the efficiency of waste-to-energy plants and is defined as the 3T method, which stands for ‘trapezoidal thermodynamic technique’. The 3T method is an integrated approach for assessing the efficiency of waste-to-energy plants, which takes into consideration not only the production of energy but also the quality of the products. The value that is returned from the 3T method can be placed in a tertiary diagram and the global efficiency map of waste-to-energy plants can be produced. The application of the 3T method showed that the waste-to-energy plants with high combined heat and power efficiency and high recovery of materials are favoured and these outcomes are in accordance with the cascade principle and with the high cogeneration standards that are set by the EU Energy Efficiency Directive.
Delivering improved patient and system outcomes for hospitalized older adults through an Acute Care for Elders Strategy
Authors: Sinha Samir K. , Bennett Jocelyn , Ramsden Rebecca , Bon Joanne , Chalk Tyler
Published: June 2018

Acute care hospitals are widely recognized as potentially high-risk environments for older adults. In 2010, Mount Sinai Hospital conceived its Acute Care for Elders (ACE) Strategy as a multi-component intervention to improve the care of hospitalized older adults. In order to determine its effectiveness, we conducted a quasi-experimental time series analysis of 12,008 older patients admitted non-electively for acute medical issues over a 6-year period. Despite a 53% increase in annual admissions of older patients between 2009/2010 and 2014/2015, Mount Sinai decreased total lengths of stay and readmissions and reduced the direct cost of care per patient, leading to net savings of CDN$4.2 million in 2014/2015. This article presents Mount Sinai’s ACE Strategy and discusses the benefits of implementing integrated evidence-based models across the continuum of care and how it is supporting the implementation of ACE Strategy models of care and care practices across Canada and beyond.
Establishing an integrated model of subacute care for the frail elderly
Authors: Boutette Mary , Hoffer Akos , Plant Jennifer , Robert Benoit , Sinden Danielle
Published: June 2018

The current health system in Ontario is not designed to meet the needs of frail older adults. This is particularly true for older adults hospitalized due to exacerbation of chronic illness or medical crisis. This article describes the Subacute Care Unit for the Frail Elderly (SAFE) program, one which is designed to serve frail older patients who are at risk of deconditioning or disability associated with prolonged hospitalization but who may safely return home or to a retirement home following up to 4 weeks of subacute care in a restorative environment. The program centres on an intense restorative and integrated care delivery model. The patient population is medically complex, requiring medical supervision and regular adjustment to the care plan to optimize medical status. Individuals are no longer acutely ill and are considered stable or stabilizing. Care and services are designed to improve outcomes for hospitalized frail older adults by proactively addressing the conditions that contribute to alternate level of care before the deconditioning associated with prolonged hospitalization is experienced.
Bioactive poly(etheretherketone) composite containing calcium polyphosphate and multi-walled carbon nanotubes for bone repair: Mechanical property and in vitro biocompatibility
Authors: Cao Jianfei , Lu Yue , Chen Hechun , Zhang Lifang , Xiong Chengdong
Published: June 2018

Poly(etheretherketone) exhibits good biocompatibility, excellent mechanical properties, and bone-like stiffness. However, the natural bio-inertness of pure poly(etheretherketone) hinders its applications in biomedical field, especially when direct bone-implant osteo-integration is desired. For developing an alternative biomaterial for load-bearing orthopedic application, combination of bioactive fillers with poly(etheretherketone) matrix is a feasible approach. In this study, a bioactive multi-walled carbon nanotubes/calcium polyphosphate/poly(etheretherketone) composite was prepared through a compounding and injection-molding process for the first time. Bioactive calcium polyphosphate was added to polymer matrix to enhance the bioactivity of the composite, and incorporation of multi-walled carbon nanotubes to composite was aimed to improve both the mechanical property and biocompatibility. Furthermore, the microstructures, surface hydrophilicity, and mechanical property of multi-walled carbon nanotubes/calcium polyphosphate/poly(etheretherketone) composite, as well as the cellular responses of MC3T3-E1 osteoblast cells to this material were investigated. The mechanical testing revealed that mechanical performance of the resulting ternary composite was significantly enhanced by adding the multi-walled carbon nanotubes and the mechanical values obtained were close to or higher than those of human cortical bone. More importantly, cell culture tests showed that initial cell adhesion, cell viability, and osteogenic differentiation of MC3T3-E1 cells were significantly promoted on the multi-walled carbon nanotubes/calcium polyphosphate/poly(etheretherketone) composite. Accordingly, the multi-walled carbon nanotubes/calcium polyphosphate/poly(etheretherketone) composite may be used as a promising bone repair material in dental and orthopedic applications.
Effect of PA66 nanofiber yarn on tensile fracture toughness of reinforced epoxy nanocomposite
Authors: Ahmadloo E , Gharehaghaji AA , Latifi M , Saghafi H , Mohammadi N
Published: June 2018

Epoxy resin as a thermoset polymer is frequently used in engineering applications. Its nature as a thermoset resin results in brittleness of material structure, which ultimately leads to low toughness; so its modification with thermoplastic polymers is of prime interest. This work aims at studying of tensile properties and morphological characterization of Polyamide 66 (PA66) nanofiber yarn reinforced epoxy nanocomposite. Decrease in elastic modulus and enhancement in tensile toughness were achieved by increasing the nanofiber yarn contents. River pattern, crack branching, and nanofiber yarn pull-out were various toughening mechanisms confirmed via scanning electron microscopic images.
Synergistic effect of cumulative corticosteroid dose and immunosuppressants on avascular necrosis in patients with systemic lupus erythematosus
Authors: Kwon H H , Bang S Y , Won S , Park Y , Yi J H , Joo Y B , Lee H S , Bae S C
Published: June 2018

Objectives

Avascular necrosis (AVN) is one of the most common causes of organ damage in patients with systemic lupus erythematosus (SLE) and often causes serious physical disability. The aims of this study were to investigate clinical risk factors associated with symptomatic AVN and to analyze their synergistic effects in a large SLE cohort in Korea.

Methods

Patients with SLE were enrolled and followed from 1998 to 2014 in the Hanyang BAE Lupus cohort, and damage was measured annually according to the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). AVN was confirmed by imaging study if patients had symptoms. To determine risk factors for AVN, clinical, laboratory and therapeutic variables were analyzed by logistic regression. Relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S) were calculated to measure interactions between significant variables.

Results

Among 1219 SLE patients, symptomatic AVN was the most common type of musculoskeletal damage (10.8%, n = 132). SLE patients with AVN showed an earlier onset age, demonstrated AVN more commonly in conjunction with certain other clinical manifestations such as renal and neuropsychiatric disorders, and received significantly higher total cumulative corticosteroid dose and immunosuppressive agents than did patients without AVN. However, in multivariable analysis, only two variables including use of a cumulative corticosteroid dose greater than 20 g (odds ratio (OR) 3.62, p = 0.015) and use of immunosuppressants including cyclophosphamide or mycophenolate mofetil (OR 4.51, p < 0.001) remained as significant risk factors for AVN. Patients with cumulative corticosteroid dose > 20 g and immunosuppressant use had a 15.44-fold increased risk for AVN, compared with patients without these risk factors ( p < 0.001). RERI, AP and S, which define the strength of interactions between two risk factors, were 9.01 (95% confidence interval (CI) 1.30–16.73), 0.58 (95% CI 0.36–0.81) and 2.66 (95% CI 1.42–4.99), respectively, supporting the presence of synergistic interactions in the development of symptomatic AVN in our Korean lupus cohort.

Conclusions

An individual risk assessment for AVN development should be made prior to and during treatment for SLE, especially in patients with high-dose corticosteroid and immunosuppressant use regardless of clinical manifestations and disease activity.
Absence of sustained breast cancer incidence inflation in a national mammography screening programme
Authors: Morrell Stephen , Gregory Marli , Sexton Kerry , Wharton Jessica , Sharma Nisha , Taylor Richard
Published: June 2018

Objective

To investigate the impact of population mammography screening on breast cancer incidence trends in New Zealand.

Methods

Trends in age-specific rates of invasive breast cancer incidence (1994–2014) were assessed in relation to screening in women aged 50–64 from 1999 and 45–69 following the programme age extension in mid-2004.

Results

Breast cancer incidence increased significantly by 18% in women aged 50–64 compared with 1994–98 (p<0.0001), coinciding with the 1999 introduction of mammography screening, and remained elevated for four years, before declining to pre-screening levels. Increases over 1994–99 incidence occurred in the 45–49 (21%) and 65–69 (19%) age groups following the 2004 age extension (p<0.0001). Following establishment of screening (2006–10), elevated incidence in the screening target age groups was compensated for by lower incidence in the post-screening ⩾70 age groups than in 1994–98. Incidence in women aged ⩾45 was not significantly higher (+5%) after 2006 than in 1994–98. The cumulated risk of breast cancer in women aged 45–84 for 1994–98 was 10.7% compared with 10.8% in 2006–10.

Conclusions

Increases in breast cancer incidence following introduction of mammography screening in women aged 50–64 did not persist. Incidence inflation also occurred after introduction of screening for age groups 45–49 and 65–69. The cumulated incidence for women aged 45–84 over 2006–10 after screening was well established, compared with 1994–98 prior to screening, shows no increase in diagnosis. Over-diagnosis is not inevitable in population mammography screening programmes.
End-of-life care in a nursing home: Assistant nurses’ perspectives
Authors: Holmberg Bodil , Hellström Ingrid , Österlind Jane
Published: June 2018

Background:

Worldwide, older persons lack access to palliative care. In Sweden, many older persons die in nursing homes where care is provided foremost by assistant nurses. Due to a lack of beds, admission is seldom granted until the older persons have complex care needs and are already in a palliative phase when they move in.

Objective:

To describe assistant nurses’ perspectives of providing care to older persons at the end of life in a nursing home.

Research design:

Data were collected in semi-structured individual interviews and analyzed with inductive qualitative content analysis.

Participants and research context:

Seven assistant nurses from a nursing home in Sweden were randomly selected.

Ethical consideration:

The research was approved by the local ethics committee.

Results:

Three main categories emerged; “Death a natural part of life”; “The older person’s well-being”; and “Care in the moment of death”; and seven sub-categories. The assistant nurses described themselves as knowing the older persons well enough to provide good end-of-life care. This was achieved by making small-talk while providing daily care. Relying on experience-based knowledge, they strove to provide end-of-life care built upon respect and engagement with the ambition to strengthen older persons’ dignity, for example, by lowering the tempo of care at the end of life, in spite of organizational restrictions.

Discussion:

The assistant nurses offered attentive end-of-life care, focusing upon bodily care. The existential needs of the older persons were not foregrounded.

Conclusion:

To develop their work, and to promote an ethical foundation for such care, assistant nurses might need support and education to be able to offer a care more in line with the aims of palliative care. Furthermore, the organization of care needs to promote, not impede, the realization of this development.
Drowning Prevention: Assessment of a Classroom-Based Water Safety Education Program in Vietnam
Authors: Ramos William Dominic , Greenshields Joel Thomas , Knee Eric N. , Kreitl Beth K. , Espirito Kevin J.
Published: June 2018

Youth drowning continues to be a primary public health issue globally with Eurasian countries experiencing some of the highest recorded rates of injury and death in aquatic settings. The country of Vietnam is currently working toward reducing the number of youth drowning fatalities. Part of these efforts is the introduction of an in-school water safety educational program. For this study, pilot pre/post data were acquired and used to assess overall knowledge acquisition and changes in knowledge of youth in grades 1 to 5 in central Vietnam. A total of 229 schools participated, resulting in 40 198 usable surveys. The results indicated that overall there was a significant change in scores with an acceptable effect size between measures. Mean scores for each of the water safety messages were rated as acceptable (above 90%), satisfactory (between 70% and 90%), and areas of concern (under 70%). Recommendations were made to program leaders about identified areas of concern.
The profession of arms and the profession of accounting numbers – Accounting, the military and war: A review
Authors: Cobbin Phillip E , Burrows Geoffrey H
Published: June 2018

Within the accounting history literature, there exists a small sub-realm that focuses on the nexus between accounting and war and accounting and the military. This article is a review of 55 articles published in the new millennium (2000–2017) ranging across a 420-year period, encompassing many wars and periods of peace, and involving multiple countries. Several accounting issues including procedures, costing, budgeting, disclosure, financing, efficiency gender and culpability emerge. The availability of existing accounting knowledge forms the basis of the review, with accounting shown to be adaptive and reactive to the needs of the military (and the state) in peacetime and wartime emergency. Specifically, in applying existing accounting knowledge, accounting contributes to the military or war. Where new accounting knowledge is developed, accounting is influenced either by the needs of the military or the dictates of war.
Numerical analysis of the influence of inertial loading over morphing trailing edge devices
Authors: Tripp Nicolás G , Mirasso Aníbal E , Preidikman Sergio
Published: June 2018

Larger and more flexible wind turbine blades are currently being manufactured. Those highly flexible blades suffer from loading of aeroelastic nature which increases the fatigue damage. Smart blade concepts are being developed to reduce the aerodynamic loading. The state of the art favors the discrete deformable trailing edge concept. Many authors have reported adequate performance of this type of actuators in reducing the blade vibrations. However, the question of whether the actuator can maintain its authority under strong external loading remains still answered. To solve this question, actuator models that include the loading produced by the blade vibration are required. In this article, a smart morphing trailing edge model is presented that includes the inertial forces produced by the blade dynamics. The model is applied to a commercial actuator and the influence of its parameters is analyzed. Finally, a simple estimation of the inertial loading produced by a 35-m wind turbine blade at the flutter instability condition is analyzed to understand the design requirements of this type of systems.
A structural model of ultra-microelectrodes for shear-force based scanning electrochemical microscopy
Authors: Venkatesh Vijay , Northcutt Robert , Heinemann Christian , Sundaresan Vishnu Baba
Published: June 2018

The incorporation of a shear-force (SF) feedback in scanning electrochemical microscopy (SECM) hardware has enabled topographically resolved electrochemical imaging of electroactive substrates. Despite the versatility of SECM-SF imaging, structural response of the ultra-microelectrode (UME) to various excitation inputs is poorly understood and predictive mathematical models for characterizing dynamic behavior, particularly at high operating frequencies (>100 kHz), are absent. In this article, we present a finite element model to characterize SF behavior by modeling the UME as a rigid cantilever with two distributed piezoelectric wafers (dither and receiver) and demonstrate the model’s ability to predict experimentally observed SF behavior. The obtained SF response under different dither-to-receiver distances for various UME geometries and loading conditions provides insight to the optimum placement of piezoelectric wafers on the UME for achieving a high SF amplitude at SF-sensitive frequencies. In addition, the variations in SF response under different dither-to-receiver orientations indicate the existence of a system transfer function that is dependent on the operating modes of the receiver. The agreement between simulated and experimental results suggests that the finite element model along with the experimental methodology can be extended to automated SF imaging using SECM hardware.
The Promotion of Avoidable Ignorance in the British Journal of Social Work
Authors: Gambrill Eileen
Published: June 2018

The manifest purpose of professional journals is to share important knowledge. Increasing revelations of flaws in the peer-reviewed literature shows that this purpose is often not honored and that inflated claims of knowledge as well as other concerns such as misrepresentations of disliked or misunderstood views are rife. In this article, avoidable misunderstandings of science and evidence-based practice (EBP) in publications in the British Journal of Social Work 2005–2016 are described as well as strategies used to forward misinformation. Such discourse misinforms rather than informs readers and decreases opportunities to accurately inform social workers about possibilities to help clients and to avoid harming them and to involve clients as informed participants. Those writing about avoidable ignorance highlight how it is used strategically, perhaps to neutralize what is viewed as dangerous knowledge—the process of EBP and science generally, which may threaten the status quo.
How Do Institutions Address Collective-Action Problems? Bridging and Bonding in Institutional Design
Authors: Olivier Tomás
Published: June 2018

Collective-action problems affect the structure of stakeholder networks differently in policy settings (Berardo and Scholz 2010). However, interactions in policy settings do not usually occur in an institutional vacuum; instead, they are guided and constrained by agreed-on rules. Therefore, to better understand behavior in these settings, it is important to understand the parameters that guide and constrain it. Combining arguments from game theory and social network analysis, this paper focuses on how the nature of collective-action problems affect the design of formal institutional arrangements. The cases are two institutional arrangements for the provision of high-quality drinking water, in New York City and in Boston. The design of these arrangements is measured through Networks of Prescribed Interactions (NPIs), capturing patterns of interactions mandated by formal rules. NPI structures in each case are then compared analyzing their structural measures and applying exponential random graph models (ERGMs). By comparing these NPIs, the paper assesses the effects of collective-action problems on the design of formal institutional arrangements. Results show that cooperation problems are associated with designs prescribing redundant interactions that create a balanced distribution of responsibilities among the key actors to the agreement.
The Compelling and Persistent Problem of Bipolar Disorder Disguised as Major Depression Disorder: An Integrative Review
Authors: Stiles Brandie M. , Fish Anne F. , Vandermause Roxanne , Malik Azfar M.
Published: June 2018

BACKGROUND: Up to 40% of patients with bipolar disorder are misdiagnosed, usually with major depression disorder. OBJECTIVE: The purpose was to describe the current state of the science of the misdiagnosis of bipolar disorder, with the ultimate goal of improving psychiatric diagnostic workups including screening. DESIGN: An integrative review was conducted using standard criteria for evaluating research articles. RESULTS: Forty-nine articles met the eligibility criteria. Articles explored patient-related and health care provider-related factors contributing to the misdiagnosis of bipolar disorder as well as consequences of misdiagnosis. Clinically oriented, reliable, and valid screening tools for bipolar disorder also were reviewed. CONCLUSIONS: Awareness of multiple, challenging patient-related factors and more comprehensive assessment and screening by health care providers may reduce misdiagnosis.
#Hookahlife: The Rise of Waterpipe Promotion on Instagram
Authors: Ben Taleb Ziyad , Laestadius Linnea I. , Asfar Taghrid , Primack Brian A. , Maziak Wasim
Published: June 2018

Introduction. Hookah smoking is becoming increasingly popular worldwide, especially among young adults. The growth of social media has also enabled sharing of opinions, experiences, and marketing related to hookah via user-generated content. Aim. To evaluate the portrayal and promotion of hookah on Instagram and to highlight public health challenges created by this content. Method. A qualitative content analysis was performed on a sample of 301 Instagram posts made with the hashtags #hookah or #shisha in October 2016. Results. Of the 301 coded posts, 279 were relevant to hookah. These posts were most commonly made by hookah lounges/bars (29.2%) and individual users (27.6%). Posters were most commonly from Russia (38.5%), the United States (18.6%), and Germany (10.7%). A total of 63.8% of the posts were promotional in nature; 19.7% of posts contained hashtags that expressed hookah identity or community (e.g., #hookahlife); 35.5% of posts associated nightlife activities with hookah smoking and 33.0% portrayed hookah smoking as a social activity. Only one post (0.4%) mentioned that hookah might have negative health effects. Likes were more common on posts depicting novel rather than traditional hookah designs ( p = .027). Conclusions. Images from Instagram may help in understanding health behaviors such as hookah smoking. Our results suggest that domestic and international hookah promotion is common on Instagram. Instagram posts cast hookah in an overwhelmingly positive light and may normalize hookah use through associations with nightlife, community, and hookah identity. Policy makers and researchers should explore approaches for reducing the volume of promotional posts and tailoring counter-marketing to the specific themes presented on social media.
Biologic Therapy Utilization in Patients With Moderate to Severe Psoriasis and Psoriatic Arthritis: An Observational Summary of Biologic Therapy Use in a Clinical Setting
Authors: Gulliver Wayne P. , Randell Shane , Gulliver Susanne , Gregory Valerie , Nagle Sean , Chambenoit Olivier
Published: June 2018

Plaque psoriasis affects approximately 2% to 3% of the global population, with psoriatic arthritis observed in approximately 20% to 30% of these individuals. Upon advances in research pathophysiology and treatment over the past decade, biologic therapies have been used more to treat moderate to severe psoriasis. In Canada, reimbursement bodies have defined prior authorization criteria to determine patient eligibility for funding of biologic treatments in moderate to severe plaque psoriasis. Generally, patients will have been treated with conventional therapies such as topical steroids, phototherapy, or systemic treatments such as methotrexate and cyclosporine before starting a biologic therapy. In difficult cases or severe flares in otherwise controlled disease, practitioners may augment the regimen with one or more conventional treatments. The objective of this observational report was to identify treatment pathways for psoriasis and psoriatic arthritis patients in Canada by examining initial biologic treatment and subsequent treatment optimization patterns for informed reimbursement discussions and decisions. A retrospective chart review was conducted at Newlab Clinical Research using medical records of patients who received at least 1 of 4 biologic agents approved at that time of the survey in Canada for the treatment of plaque psoriasis (adalimumab, etanercept, infliximab, ustekinumab). The study population consisted of patients who had moderate to severe plaque psoriasis, diagnosed by a dermatologist, for at least 6 months before the study index date and who attended Newlab Clinical Research between 2008 and 2013. All current and previous agents prescribed for the treatment of psoriasis were captured. A total of 248 patients with psoriasis treated with biologics were identified, of whom 27 (10.9%) were also diagnosed with psoriatic arthritis. Prior to initiating treatment with a biologic, most patients (72.1%) were treated with (or contraindicated to) methotrexate/cyclosporine. Treatment was supplemented with topical agents (70.6%) and/or followed by a course of ultraviolet light phototherapy (51.6%). Only 2.4% of patients were treated with a biologic first. Of 248 patients treated with biologics, almost half (47.6%) needed add-on therapy, whereas 16.5% of patients had an increase in dose or dosing interval. Furthermore, 14.1% of patients added a topical agent, 10.5% a topical steroid, or 6.5% a course of phototherapy while continuing biologic therapies. Finally, 30.4% of patients switched to another biologic treatment. Adalimumab was the most common agent used as a second-line agent (37.2%), and patients who started on adalimumab mainly switched to ustekinumab as a second-line agent (73.9%). Infliximab was the agent least often used as second-line therapy.
‘Networks that work too well’: intervening in algorithmic connections
Authors: van der Nagel Emily
Published: June 2018

Within the emerging field of critical algorithm studies, this article theorises that forced connections happen when algorithms exacerbate human actions in connecting otherwise disparate data points on digitally networked platforms to the subject of the data’s detriment. Although social media users may not have a comprehensive understanding of how algorithms work to make some content visible, when users form their own explanatory theories about these algorithms, they often intervene in these connections. Drawing on Michel de Certeau’s notion of strategies as the manipulations in which platforms engage to profile and control their users, and tactics as everyday acts of resistance, this article investigates two tactics within algorithmic cultures – Voldemorting, or not mentioning words or names in order to avoid a forced connection; and screenshotting, or making content visible without sending its website traffic – to demonstrate users’ understandings of the algorithms that seek to connect individuals to other people, platforms, content and advertisers, and their efforts to wrest back control.
Prenatal and perinatal risk factors and the clinical implications on autism spectrum disorder
Authors: Chien Yi-Ling , Chou Miao-Chun , Chou Wen-Jiun , Wu Yu-Yu , Tsai Wen-Che , Chiu Yen-Nan , Gau Susan Shur-Fen
Published: June 2018

Prenatal and perinatal factors may increase the risk of autism spectrum disorder. However, little is known about whether unaffected siblings of probands with autism spectrum disorder also share the phenomenon and whether the prenatal/perinatal factors are related to the clinical severity of autistic symptoms. We compared the frequency of prenatal and perinatal factors among 323 probands with autism spectrum disorder (mean age ± standard deviation, 10.7 ± 3.5 years; males, 91.0%), 257 unaffected siblings (11.7 ± 4.5; 42.8%), and 1504 typically developing controls (8.9 ± 1.6 years; 53.1%); and investigated their effects on the severity of autistic symptoms. We found that probands with autism spectrum disorder and their unaffected siblings had more prenatal/perinatal events than typically developing controls with higher numbers of prenatal/perinatal factors in probands than in unaffected siblings. The prenatal/perinatal events were associated with greater stereotyped behaviors, social-emotional problems, socio-communication deficits, and overall severity. We also found that six prenatal/perinatal factors (i.e. preeclampsia, polyhydramnios, oligoamnios, placenta previa, umbilical cord knot, and gestational diabetes) were associated with the severity of autistic symptoms, particularly stereotyped behaviors and socio-communication deficits. Our findings suggest that prenatal and perinatal factors may potentially moderate the clinical expression of autism spectrum disorder. The underlying mechanism warrants further research.