bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk of Bankruptcy among Applicants to Disability Insurance
Authors: Gross Tal , Trenkamp Brad
Published: November 2015

Background . Poor health can lead to financial instability and, eventually, bankruptcy. We examined how entrance into the Social Security Disability Insurance (SSDI) program was associated with bankruptcy filings among those who had a disability and applied to the SSDI program. Methods . We merged dockets from U.S. bankruptcy courts that cover 2000 through 2009 to administrative records on all SSDI applicants from 2000 through 2003 (adults aged > 18, N = 1,500,607). We estimated logistic regression models for bankruptcy declaration within one year of the decision to allow applicants onto the SSDI program. Results . Being allowed onto the SSDI program was associated with a decreased risk of bankruptcy (adjusted odds ratio = 0.754). The association was negative and statistically significant for all age groups, including older applicants nearing eligibility for Medicare. Conclusions . The findings contribute to a growing body of research suggesting that increased aid to adults with a disability can reduce financial instability.
Effects of Health Insurance on Tumor Stage, Treatment, and Survival in Large Cohorts of Patients with Breast and Colorectal Cancer
Authors: Zhang Yefei , Franzini Luisa , Chan Wenyaw , Xu Hua , Du Xianglin L.
Published: November 2015

To examine the impact of health insurance status on tumor stage at diagnosis, treatment rendered, and overall survival, we identified 52,566 breast cancer patients and 34,316 colorectal cancer patients aged 20 or older in 2007–2010 from Texas Cancer Registry. Those aged younger than 65 years without health insurance coverage had significantly higher risks of mortality than those with private health insurance regardless of tumor stage, chemotherapy, or surgery for colorectal cancer. However, in patients younger than 65 years with breast cancer, the risk of mortality was not significantly higher for those who received chemotherapy or cancer-directed surgery in patients without insurance coverage compared with those with private health insurance. In Medicare beneficiaries aged 65 years or older, risk of mortality was not significantly different between those with Medicare only and those with additional private health insurance, except an increased mortality in patients without chemotherapy for breast and colorectal cancer and in those without receiving surgery for colorectal cancer.
Reported Use of Electronic Health Records to Implement Evidence Based Approaches to Colorectal Cancer Screening in Community Health Centers
Authors: Cole Allison M. , Tu Shin-Ping , Fernandez Maria E. , Calo William A. , Hotz James , Wolver Susan
Published: November 2015

Background . Community health centers (CHCs) are critical sources of primary care for medically underserved populations. Electronic health records (EHRs) are important for implementation of evidence-based approaches for cancer control. Methods . Cross-sectional study of CHCs from the Cancer Prevention Control Research Network’s community health center Clinic Characteristics Survey. Proportions of CHCs using EHR data to: 1) measure colorectal cancer screening, 2) deliver reports, and 3) provide patient reminders for colorectal cancer screening. Results . Only 27% of CHCs perceive EHR system’s colorectal cancer screening data as very accurate. Over half (57%) of respondent CHCs with EHRs reported it is easy or very easy to do colorectal cancer screening activities using EHR systems. Conclusions . Poor EHR data quality and cumbersome EHR systems may be significant barriers to implementation of evidence-based approaches to colorectal cancer screening in CHCs.
Oral Health Status of Children Attending a Mobile Dental Clinic—A Comparative Study
Authors: Enciso Reyes , Sundaresan Santosh , Yekikian Matthew , Mulligan Roseann
Published: November 2015

Periodicity of dental visits for children is based on age and disease susceptibility. Frequently mobile dental clinics are unable to provide follow-up care at recommended intervals. This study compared the oral health of children attending the mobile clinic (MC) twice with matched children by age, gender, race, and ZIP code attending for the first time. Dental charts (n=888) were reviewed and scored for decayed and filled surfaces. Seventy-eight children (mean age 9.6 years; 98.7% Hispanic) attended the clinic twice over a mean interval between visits of 1.5 years. These children had statistically significant lower rates of decay in deciduous and permanent tooth surfaces than matched children visiting the clinic for the first time (p<.05; p<.001), and significantly less decay in their deciduous and permanent teeth than at the first visit (p<.001; p<.05). Mobile clinics can be effective in decreasing the decay in teeth, even when the interval between visits is longer than current recommendations.
Concordance between Individual vs. Area-Level Socioeconomic Measures in an Urban Setting
Authors: Narla Nirmala P. , Pardo-Crespo Maria R. , Beebe Timothy J. , Sloan Jeff , Yawn Barbara , Williams Arthur R. , Juhn Young J.
Published: November 2015

Area-level socioeconomic status (SES) measures have been used as a proxy in child health research when individual SES measures are lacking, yet little is known about their validity in an urban setting. We assessed agreement between census block-group and individual-level SES measures obtained from a caregiver telephone survey in Jackson County, Missouri. Associations with prevalence of childhood overweight (OW), low birth weight (LBW), and household smoking exposure were examined using logistic regression models. Seven hundred eighty-one households were surveyed: 49% male, 76% White, mean child age 9.4 years. We found misclassification rates of 20–35% between individual vs. area-level measures of education and income; Kappa indices ranged from 0.26–0.36 indicating poor agreement. Both SES measures showed an inverse association with LBW and smoking exposure. Area-level SES measures may reflect a construct inclusive of neighborhood resources; routine substitution of these measures should be interpreted with caution, despite similar correlations with health outcomes.
Improving Access to Vision Care for People Who are Homeless through Eyeglasses Recycling
Authors: Lam Janna , Robertson Kirstin , Robertson Wesley , Bernstein Rebecca
Published: November 2015

Visual impairment disproportionately affects the health and function of people who are homeless. A common and correctable cause of visual impairment is refractive error. However, eyeglasses remain an unmet need for the poor and underinsured. This report describes eyeglasses recycling and vision screening to reduce the burden of correctable visual impairment.
“My House Is the Hospital”: Housing and Health and Wellbeing among Persons Living with HIV/AIDS in Northern Malawi
Authors: Mkandawire Paul , Arku Godwin , Atari Odwa , Madut Kon , Luginaah Isaac , Dixon Jenna
Published: November 2015

This paper reports findings of a qualitative study and draws on the political ecology of health framework to examine the links between housing and health among people living with HIV/AIDS (PLWAs) in Northern Malawi in a wider context in which the epidemic has overburdened the country’s hospitals, thereby transferring the responsibility for care from government to families. The findings suggest that poor housing conditions, rooted in colonial and postcolonial policy failure, may undermine the amount, as well as the quality, of palliative care available to PLWAs. It was also found that the high cost of renting, discrimination, and poor landlord-tenant relationships imposed significant financial and emotional burden on PLWAs, thereby undermining their ability to meet dietary needs, stay healthy, and adhere to treatment. Furthermore, customary norms around property inheritance hampered women’s housing security and their ability to cope with the disease. The paper concludes by making relevant policy recommendations.
Improving Treatment Completion Rates for Latent Tuberculosis Infection: A Review of Two Treatment Regimens at a Community Health Center
Authors: Lines Gregory , Hunter Paul , Bleything Sarah
Published: November 2015

Background . Prophylactic treatment of latent tuberculosis infection (LTBI) is necessary for controlling TB in low-incidence settings. However, treatment is often limited by poor completion rates. Methods . At a community health center serving low-income Hispanics, treatment completion among patients accepting 12 weekly doses of isoniazid (INH) plus rifapentine (RPT) administered as directly observed therapy (DOT) was compared with that among patients accepting nine months of daily self-administered INH during 2012 and 2013 (n=139). Results . Among patients who agreed to treatment, INH-RPT combination therapy was associated with higher completion rates (OR 3.06; 95% CI, 1.23–7.62; p=.016) when compared to INH only. Overall completion rates were 77.8% (35/45) for INH-RPT combination therapy and 52.1% (49/94) for INH monotherapy. Conclusions . High completion rates for LTBI treatment can be achieved at a community health center using INH-RPT administered via DOT. Greater success treating with INH-RPT may be attributed to DOT strategy and a shorter treatment regimen.
Invasive Cervical Cancer Incidence Disparities in New Jersey—a Spatial Analysis in a High Incidence State
Authors: Roche Lisa M. , Niu Xiaoling , Henry Kevin A.
Published: November 2015

Although invasive cervical cancer incidence has declined, disparities persist. We identified spatial clusters of census tracts with elevated invasive cervical cancer incidence rates using New Jersey State Cancer Registry cases 20 years or older diagnosed in 2005–2009. Each cluster’s population was compared with the rest of New Jersey’s population on demographic and socioeconomic characteristics. Odds ratios that assessed associations between statistically significant characteristics (from a univariate comparison of cases in the clusters versus cases in the rest of New Jersey) and being a case in a cluster versus being a case in the rest of New Jersey were calculated from logistic regression models. Significant incidence clusters were identified around Newark, Trenton, and Camden. Being Black (all areas), Hispanic (Newark, Camden), unmarried (Newark), and uninsured/Medicaid-insured (Trenton) were significantly associated with being a case in these areas. These study results can be used to target invasive cervical cancer prevention efforts more effectively.
Implementing the Dementia Carers Support Initiative of the National Institute for Health and Care Excellence in a sub-Saharan African Setting
Authors: Ojagbemi Akin , Daley Stephanie
Published: November 2015

Global estimates suggest that by 2040, over 71% of people living with dementia worldwide will reside in low- and middle-income countries, especially in sub-Saharan Africa. In this region, informal caregivers, who are mostly close family members, may number over nine times the number of dementia patients. This group of carers often lacks the support they require for their exceptional effort. The United Kingdom’s National Institute for Health and Care Excellence (NICE) provides access to tailored psychosocial interventions as part of a comprehensive support for carers of patients with dementia. This paper appraises organizational considerations in introducing this initiative into the resource-poor health care delivery system typical of many sub-Saharan African settings. It concludes that one initial step in that direction may be the introduction—through a developmental change management framework led by all stakeholders—of a tailored carers’ information package into the routine care for dementia.
The Affordable Care Act and Implications for Health Care Services for American Indian and Alaska Native Individuals
Authors: Ross Raven E. , Garfield Lauren D. , Brown Derek S. , Raghavan Ramesh
Published: November 2015

American Indian and Alaska Native (AI/AN) populations report poor physical and mental health outcomes while tribal health providers and the Indian Health Service (IHS) operate in a climate of significant under funding. Understanding how the Patient Protection and Affordable Care Act (ACA) affects Native American tribes and the IHS is critical to addressing the improvement of the overall access, quality, and cost of health care within AI/AN communities. This paper summarizes the ACA provisions that directly and/or indirectly affect the service delivery of health care provided by tribes and the IHS.
“The Vagina is a Very Tricky Little Thing Down There”: Cervical Health Literacy among Incarcerated Women
Authors: Ramaswamy Megha , Kelly Patricia J.
Published: November 2015

The objective of this study was to understand factors associated with women’s ability to engage in cervical cancer prevention and follow-up care given ongoing criminal justice involvement. We conducted four focus groups with 45 incarcerated women to assess barriers to cervical health promotion, and used a grounded theory method to analyze data. We administered the Short Test of Functional Health Literacy in Adults to assess general health literacy as a standalone factor related to cervical health promotion. Ninety-one percent of participants had adequate health literacy scores. However, we found that the women had varying levels of cervical health literacy, which we operationalized as knowledge, beliefs, and self-efficacy related to cervical health promotion. Practitioners should establish broader interventions to empower women with criminal justice histories to take control of their own cervical health and focus on communicating updated recommendations to improve cervical health understanding, beliefs, and practices among high-risk women.
Results of a Health Education Message Intervention on HPV Knowledge and Receipt of Follow-up Care among Latinas Infected with High-risk Human Papillomavirus
Authors: Sanderson Maureen , Khabele Dineo , Brown Claudine L. , Harbi Khalil , Alexander Leah R. , Coker Ann L. , Fernandez Maria E. , Brandt Heather M. , Fadden Mary K. , Hull Pamela C.
Published: November 2015

A clinic-based intervention study was conducted among high-risk human papillomavirus (HPV)-infected Latinas aged 18-64 years between April 2006 and May 2008 on the Texas-Mexico border. Women were randomly assigned to receive a printed material intervention (n=186) or usual care (n=187) and were followed at three months, six months, and 12 months through telephone surveys and review of medical records. The HPV knowledge of nearly all women had increased greatly, but only two-thirds of women reported they had received follow-up care within one year of diagnosis regardless of additional health education messaging. Our findings suggest that, regardless of type of health education messaging, Latinas living on the Texas-Mexico border are aware that follow-up care is recommended, but they may not receive this care. Individual, familial and medical care barriers to receipt of follow-up care may partially account for the higher rates of cervical cancer mortality in this region.
The Healthy Weight Disparity Index: Why We Need It to Solve the Obesity Crisis
Authors: Taylor Wendell C. , Paxton Raheem J. , Fischer Leah S. , Bellows Laura L.
Published: November 2015

Objective . This study assessed the usefulness of the Healthy Weight Disparity Index (HWDI) to evaluate income disparities related to obesity. We compared state based body mass index (BMI) rankings with HWDI rankings. Methods . National data from the 2010 Behavioral Risk Factor Surveillance System were used to estimate mean BMI levels in each of the 50 states (plus Washington, D.C.) by income level. Income-related disparities were described with the HWDI. Kappa statistics analyzed the concordance between the two rankings. Results . State-based BMI and the HWDI rankings were not concordant. For example, Washington, D.C. was ninth for lowest mean BMI yet ranked 49th on the HWDI. West Virginia ranked 42nd and 5th, and Mississippi ranked 51st on both the BMI and HWDI, respectively. Discussion . State-based BMI and HWDI rankings present divergent perspectives on the obesity crisis. We recommend adding HWDI rankings to BMI rankings to reflect fully patterns of obesity and subgroup differences.
Barriers and Facilitators to Engaging Communities in Gender-Based Violence Prevention following a Natural Disaster
Authors: Sloand Elizabeth , Killion Cheryl , Gary Faye A. , Dennis Betty , Glass Nancy , Hassan Mona , Campbell Doris W. , Callwood Gloria B
Published: November 2015

Humanitarian workers in disaster settings report a dramatic increase in gender-based violence (GBV). This was true after the 2010 Haiti earthquake when women and girls lost the relative security of their homes and families. Researchers from the United States Virgin Islands and the United States mainland responded by collaborating with Haitian colleagues to develop GBV-focused strategies. To start, the research team performed a situational analysis to insure that the project was culturally, ethically, and logistically appropriate. The aim of this paper is to describe how the situational analysis framework helped the researchers effectively approach this community. Using post-earthquake Haiti as an exemplar, we identify key steps, barriers, and facilitators to undertaking a situational analysis. Barriers included logistics, infrastructure, language and community factors. Facilitators included established experts, organizations and agencies. Researchers in such circumstances need to be respectful of community members as experts and patient with local environmental and cultural conditions.
A Scoping Review of the Literature: Content, Focus, Conceptualization and Application of the National Standards for Culturally and Linguistically Appropriate Services in Health Care
Authors: Estrada Robin Dawson , Messias DeAnne K. Hilfinger
Published: November 2015

With the aim of addressing inequalities and disparities in health care access and outcomes, in 2001 the United States Department of Health and Human Services Office of Minority Health (OMH) established National Standards for Culturally and Linguistically Appropriate Services (CLAS). In 2010 the OMH solicited public, private and government input which was incorporated into the Enhanced National CLAS Standards. To date there have been no formal reviews of the published literature on the CLAS Standards. The aim of this scoping review was to identify the scientific and professional literature related to the CLAS standards and describe the content, focus, conceptualization and application of these publications, with the goal of providing insights and directions for further research and application of the CLAS standards.
Multiple Intimate Partner Violence Experiences: Knowledge, Access, Utilization and Barriers to Utilization of Resources by Women of the African Diaspora
Authors: Sabri Bushra , Huerta Julia , Alexander Kamila A. , St.Vil Noelle M. , Campbell Jacquelyn C. , Callwood Gloria B.
Published: November 2015

Objective . This study examined knowledge, access, utilization, and barriers to use of resources among Black women exposed to multiple types of intimate partner violence in Baltimore, Maryland and the U.S. Virgin Islands (USVI). Methods . We analyzed quantitative survey data collected by 163 women recruited from primary care, prenatal or family planning clinics in Baltimore and the USVI. In addition we analyzed qualitative data from in-depth interviews with 11 women. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using thematic analysis. Results . A substantial proportion of Black women with multiple types of violence experiences lacked knowledge of, did not have access to, and did not use resources. Barriers to resource use were identified at the individual, relationship, and community levels. Conclusion . There is need for programs to develop awareness, promote access and utilization of resources, and eliminate barriers to resource use among abused Black women.
Using a Community-Engaged Approach to Develop a Bilingual Survey about Psychosocial Stressors among Individuals of Mexican Origin
Authors: Symanski Elaine , Karpman Michelle , Jimenez Maria , Lopez David S. , Felknor Sarah A. , Upadhyaya Mudita , Strom Sara S. , Bondy Melissa L.
Published: November 2015

Hypertension is on the rise among Hispanics and is highest among those of Mexican origin. Recent studies have found a positive association between air pollution and blood pressure and hypertension. Moreover, a link between hypertension and adverse socioeconomic conditions is well established. However, less is known about psychosocial stressors, although their impact on coronary heart disease has been shown. To address this gap in the literature, community perspectives of the health consequences of environmental exposures and psychosocial stressors experienced among the Mexican-origin population in Houston, Texas were obtained through participation in focus groups, the establishment of a Neighborhood Council of Advisors (NCA), and the testing of a pilot questionnaire. Taken together, the findings from the community were used to develop a culturally sensitive, bilingual questionnaire for an investigation of the combined effects of environmental and psychosocial stressors on hypertension among individuals of Mexican origin.
Nowhere and Northwest, Brent and Britain: Geographies of Elsewhere in Zadie Smith’s NW
Authors: Slavin Molly
Published: November 2015

My primary argument in this paper is that in NW, Zadie Smith’s characters work against dominant conceptions of the city of London and chart their own maps and geographies through the postcolonial urban space. By articulating their own understandings of London, and making these understandings a key part of the narrative of the city and the novel, they are able to turn what many think of as a peripheral space – Brent – into a central part of Britain and London, and likewise are able to convert what many think of as nowhere (NW) into a place with a strong identity: northwest (NW) London.
Elsewheres of Diaspora: Dionne Brand’s In Another Place, Not Here
Authors: Quynn Kristina
Published: November 2015

Dionne Brand’s novel reorders conventions of narrative and diaspora to make visible the hidden elsewhere in representing the feminine, lesbian, queer in a story of love, loss, and migration. In the process, her work offers an alternative mode for writing about the African Diaspora and the experiences of Black migrant women of the Caribbean and Canada.
Dislocation, Dismemberment, Dystopia: From Cyberpunk to the Fiction of Wendell Berry and Ann Pancake
Authors: Wanat Matt
Published: November 2015

Wendell Berry’s Remembering (1988) and Ann Pancake’s Strange as this Weather Has Been (2007) offer examples of a contemporary discourse on dislocation and dismemberment generally more characteristic of dystopian speculative fiction (SF). In the case of Berry’s and Pancake’s works, this common SF theme is applied to regional, non-speculative novels about the marginalization of rural places for the sake of industrial agriculture and the economics of extraction. In each of these novels, as in SF like Frank Miller and Geof Darrow’s graphic novel Hard Boiled (1990-92), bodily dismemberment reflects a larger sense of displacement and environmental devastation resulting from commercial exploitation of people and the places in which they work and live.
Tango’s Elsewhere: Japan
Authors: Fares Gustavo
Published: November 2015

The article argues that the notion of space is central to the understanding of globalism and globalization since these two terms are, after all, closely related to the diffusion and displacements of economic, political, and cultural forms throughout space. The article discusses the historical development of the tango in Argentina, its movement to Europe first, and Japan later, and the changes these migrations brought about in the dance and the music. These changes are witness to the transformations cultural products undergo when they move from cultural centers to peripheries, from “somewhere” to “elsewhere.” The articles proposes that the tango’s displacements between Argentina and Japan altered the geographic distance between the two territories and contributed to the culture of both nations.
“Written for the National Labor Tribune ”: Community Formation through Poetry in Pittsburgh’s Labor Newspaper
Authors: Jaquette Brianne
Published: November 2015

“‘Written for the National Labor Tribune ’: Community Formation through Poetry in Pittsburgh’s Labor Newspaper” argues that the poetry in the nineteenth-century newspaper the National Labor Tribune acted as a space for public dissent in the lives of the laborers who were readers of the paper. Like most nineteenth-century newspapers the paper contained literature; however, unlike most nineteenth-century papers, the National Labor Tribune printed literature from readers all over the country who were not professional writers but were working-class laborers. Those laborers, who doubled as amateur poets, wrote into the paper and corresponded with each other to form a network outside of the mainstream circulation of print culture. The readers of the paper used this network to establish their own community where they voiced support for labor organizations, critiqued business practices of their employers, and described their lived experiences. In a time that saw the growth of corporations and repeated clashes between laborers and industrialists, the National Labor Tribune gave its readers a space to voice their concerns through literature. The poets of the Labor Tribune used writing to solidify the community of laborer brought together by the paper and to imagine the possibility of change in labor practices through the collective action encouraged by the paper.
Punk Rock, Thatcher, and the Elsewhere of Northern Ireland: Rethinking the Politics of Popular Music
Authors: Martínez Robert
Published: November 2015

This essay focuses on the political efficacy of popular music to critique dominant ideologies concerning nationhood and personal identity. During Margaret Thatcher’s tenure as prime minister of Britain, punk rock and post-punk music flourished as a mode of expression to challenge the ways in which Thatcher’s conservative agenda affected British social life. This study examines the theoretical possibility that punk rock can serve as a mode of critique and addresses how punk rock music in Northern Ireland attempted to disrupt the Thatcherite position on the conflict in Northern Ireland (also known as The Troubles).
Like Nowhere Else: Tourism and the Remaking of Place in Julian Barnes’s England, England
Authors: Nitsch Judi
Published: November 2015

This essay begins with Raymond Williams’ The Country and the City to consider the context of literary place-production and to analyze a novel about tourism development in our neoliberal moment. In focusing on contemporary place-production at the state level, both city and country are subject to shifts in their cultural significance, dictated by a service-centered tourist economy: the country is sold as former somewhere or perpetual elsewhere; the city is marketed as former elsewhere or perpetual somewhere. Neoliberal markets, of course, will decide. My review of tourism studies and my analysis of Julian Barnes’ England, England reveal the complex revisions of domestic hinterlands in the pursuit of touristic profit and nationalist nostalgia. Within those revisions, the powerful tropes of country and city, elsewhere and somewhere, converge and diverge in the hybrid product of Sir Jack’s free-market fantasy land, England, England.
The Rural Black Nowhere: Invisibility, Urbannormativity, and the Geography of Indifference
Authors: Lawrence David Todd
Published: November 2015

This essay seeks to examine the association between race and space by interrogating the complicated relationship of two non-urban spaces: Pinhook, Missouri and Cairo, Illinois. Pinhook, an African American village, was destroyed on May 2nd, 2011 when the U.S. Army Corps of Engineers intentionally breached the front side levee of the Birds Point-New Madrid floodway in an attempt to lower historically high Mississippi River levels at and south of Cairo. While the circumstances of Pinhook’s destruction suggest an oppositional relationship between the two towns, we contend that both are the victims of the consequences of racialized space, white supremacy, and urbannormativity. An examination of the destruction of Pinhook and the historical context behind it helps to demonstrate the ways in which these two towns, separated by a river and approximately twenty-five miles, rather than being at odds, have both become examples of “black nowheres,” locales among the unimportant, invisible, and too oft-ignored geographies of America.
“At Least This Is an Actual Place”: The Places and Displacements of Freedom
Authors: Narcisi Lara
Published: November 2015

Jonathan Franzen’s provocatively-titled 2010 novel, Freedom , interrogates the way this term became an all-encompassing propagandistic code word to justify any American action on a global or individual scale. The novel asks us to question whether “freedom” has come to mean simply a sense of entitlement, enabling our dominion over every available locale. This article examines the ways in which Freedom highlights the microcosmic desire to impact our spaces—for ourselves, for our families, for our friends—as indicative of an intrinsic and destructive passion for exercising our freedom in ways that make no one free. Specifically, this article argues that the problem—for both America as a whole and the novel’s unhappy family in particular—involves a misplaced belief in the power of location to act as a substantial force for change. Franzen’s characters nevertheless consistently seek “elsewheres,” a term used here to describe the unknown spaces that act as empty signifiers in and through which they hope to distill a self. The novel demonstrates that the pursuit of these “elsewheres” as a perceived external solution to internal conflict only demonstrates how circumscribed their, and all of our, alleged freedoms really are.
Impact of applying brief educational program on nurses knowledge, attitude, and practices toward pain management
Authors: Abozead Shalabia El-Sayead , Al-Kalaldeh Mahmoud , Al-Tarawneh Omar
Published: November 2015

Background: The role of pain education is well established in improving knowledge and attitude towards the adherence to pain assessment and management.

Methods: A brief pain education program was delivered to assess nurses' knowledge and attitude towards pain assessment and management. The "KASRP" scale was used at three phases; pre, post, and three months' follow-up phases. Subsequent eight months observation on using pain assessment sheets was also performed.

Results: One hundred and four nurses were assessed at the beginning, followed by 92 at the immediate post-test, and 70 at the follow-up. Although nurses scored lowest in having knowledge and attitudes prior to the program, a significant improvement was evident after delivering pain education. In addition, nurses' competency in pain assessment was maintained over the three months of assessment. Younger nurses with shorter clinical experience were found more reactive to the program than older nurses.

Conclusions: A brief nurse-driven pain education has improved nurses' knowledge and attitude towards pain management.
A class of new exact solutions of the equations governing the steady plane flows of incompressible fluid of variable viscosity
Authors: Naeem Rana Khalid , Ahmed Mushtaq
Published: November 2015

The objective of this paper is to indicate a class of new exact solutions of the equations governing the steady plane flows of incompressible fluid of variable viscosity. The class consists of the stream function characterized by equation (2). Exact solutions are determined for  and  When is arbitrary we can construct an infinite set of streamlines and the velocity components, viscosity function, generalized energy function  and temperature distribution . Therefore, an infinite set of solutions to flow equations. When  is not arbitrary, there are two values of  and therefore, two exact solutions to flow equations. The streamlines are presented through Fig.(1–56) for some chosen from of f(r).
A different lens: Changing perspectives using Photo-Elicitation Interviews
Authors: Torre Daniela , Murphy Joseph
Published: November 2015

The purpose of this systematic literature review is to document how scholars in various fields have used Photo-Elicitation Interview (PEI), explain the benefits and obstacles to using this method, and explain how and why education researchers should use PEI. The key features of PEI are that a researcher or participant takes pictures about a research topic that are then used to elicit dialogue during an interview. The results of our review suggest that education scholars and school practitioners can use PEI methods to better understand school communities and the children, parents, and school staff who inhabit them. Utilizing this technique, the research community will be better positioned to speak on behalf of school stakeholders when contributing to policy discussions and when seeking solutions to improving schools.
The discursive construction of lower-tracked students: Ideologies of meritocracy and the politics of education
Authors: Anderson Kate T.
Published: November 2015

This study considers the discursive construction of a particular type of student in Singapore - the lowest-tracked, Normal Technical (NT), secondary school student. Shaped by meritocratic policies, educational practices, and ideologies common to many late-modern societies, students in the NT track are institutionally and individually constructed through the results of high-stakes testing regimes and essentialist views of ability. This article extends an understanding of the NT student as a widely held, deficit construction in Singapore by considering its use as an ideological label in interpersonal and institutional discourse. I consider how school leaders’ and government commentaries about NT students’ abilities, opportunities, and supposed characteristics provide insights about the processes through which students are recruited into institutional categories of deficit and risk¾i.e. differentiated instruction, ascribed ability, and these processes’ translation into educational structures and practice in the name of meritocracy. While the illustration of this phenomenon is uniquely Singaporean, implications include concerns about equity, constructions of ability, and ideologies of merit common to late modern society.
Environmental and climate changes reflected in the Domuraty 2 section (NE Poland) based on analysis of plant macroremains
Authors: Stachowicz-Rybka Renata
Published: November 2015

Research in the Domuraty 2 section was focused on a series of lacustrine-river-swamp deposits in which the full spectrum of vegetation and climate changes was recognised in a detailed analysis of plant macroremains and a comparison with the results of pollen analysis. Based on plant macrofossil data, two (Dom II, Dom III) of three palynologically documented warm units were distinguished in the Domuraty succession. The palaeobotanical data from the Domuraty succession document several successive local vegetation changes in both interglacial and glacial periods, which can be related to global climate oscillations. The succession of local vegetation stands and changes in the vegetation, climate, water level, and trophy during the period of the Domuraty succession were analysed and compared with corresponding parameters of the Augustovian and Ferdynandovian interglacials. The taxonomically most diverse unit is Warm unit Dom II, with the highest share of taxa with high thermal requirements, which was compared to the older Augustovian (A II) and younger Ferdynandovian (F II) units. The comparison of the Domuratovian interglacial flora to that of the Korchevian interglacial in Belarus shows high similarity; most of the extinct taxa or taxa unknown in the present-day flora are common to the Korchevian and Domuratovian floras, suggesting similar age for these two communities. However, the Domuratovian flora lacks a few species important to the Korchevian flora, such as Stratiotes goretskyi, Carex rostrata-pliocenica, Brasenia sp., Caulinia antiqua, Aldrovanda borysthenica, and A. zusii.
The Shivers of Knowledge
Authors: Schoeller Félix
Published: November 2015

Aesthetic chills occur in artistic, scientific and religious context. We introduce a theoretical framework relating them to humans’ vital need for cognition. We discuss the implications of such a framework and the plausibility of our hypothesis. Numerous references to chills are introduced (quotes from, inter alios, artists, physicists and mathematicians).
Burnout, depression and anxiety in preclinical medical students: a cross-sectional survey
Authors: van Venrooij Lennard T. , Barnhoorn Pieter C. , Giltay Erik J. , van Noorden Martijn S.
Published: November 2015

Objective: The purpose of this study was to assess the prevalences and correlates of adverse affective states (burnout-, depression- and anxiety-related symptoms) among preclinical medical students.

Methods: Self-report questionnaires were sent to all preclinical medical students of Leiden University Medical Center (n=1311). Burnout-related symptoms were measured using the Maslach Burnout Inventory-General Survey (MBI-GS), depression and anxiety-related symptoms and vitality using the Symptom Questionnaire-48 (SQ-48). Furthermore, duration of sleep, quality of life (SF-36), need for recovery, happiness and dispositional optimism were assessed and analysed in relation to affective symptoms using regression analysis.

Results: Among the 433 responders (response rate=33.0%), prevalences of self-reported burnout-, depression- and anxiety-related symptoms were 46.0% (n=199), 27.0% (n=117) and 29.1% (n=126), respectively. Independent correlates for burnout-related symptoms were <6 h sleep per night (p=0.02), low happiness (p<0.001) and a high need for recovery (p<0.001). Independent correlates for both depression- and anxiety-related symptoms were low optimism (p<0.001; p<0.001, respectively), low happiness (p<0.001; p=0.001, respectively) and a high need for recovery (p=0.03; p<0.001, respectively).

Conclusion: Prevalences for adverse affective states were high among preclinical medical students and mainly associated with personality trait-related factors and need for recovery, rather than work-related factors. These findings suggest that being a medical student increases one’s risk to adverse affective states, and should inspire preventative initiatives.
An Evaluation of Serum Procalcitonin and C-Reactive Protein Levels as Diagnostic and Prognostic Biomarkers of Severe Sepsis
Authors: Szederjesi Janos , Almasy Emoke , Lazar Alexandra , Huțanu Adina , Badea Iudita , Georgescu Anca
Published: November 2015

Background: Recommendations have been made, following the multicenter Surviving Sepsis Campaign study, to standardize the definition of severe sepsis with reference to several parameters such as haemodynamic stability, acid-base balance, bilirubin, creatinine, International Normalized Ratio (INR), urine output and pulmonary functional value of the ratio between arterial oxigen partial pressure and inspiratory oxigen concentration. Procalcitonin (PCT) is considered to be a gold standard biomarker for the inflammatory response, and recent studies have shown that it may help to discover whether a seriously ill person is developing sepsis. C-reactive protein (CRP) is also used as a marker of inflammation in the body, as its blood levels increase if there is any inflammation in the body. The aim of this study was to evaluate serum procalcitonin and C-reactive protein levels as diagnostic and prognostic biomarkers of severe sepsis.

Material and method: Sixty patients, diagnosed as being “septic”, were admitted to the intensive care unit (ICU). Based on laboratory results and clinical findings a diagnosis of “severe sepsis“ was made, and correlated with PCT and CRP values. The APACHE II, SAPS II and SOFA severity scores were calculated, analyzed and correlated with PCT and CRP.

Results: Fifty two patients (86.67%) presented with criteria for severe sepsis. Multivariate correlation analysis indicated a significant positive association between procalcitonin and all severity scores (APACHEII p<0.0001, SOFA p<0.0001, SAPS II p<0.0001). CRP proved to be significantly correlated only with the SAPS II score (p=0.0145). Mortality rate was high, with 48 patients (80%) dying. There was no significant correlation between the levels of the PCT and CRP biomarkers and severe sepsis (p=0.2059 for PCT, p=0.6059 for CRP).

Conclusions: The procalcitonin levels are highly correlated with the severity scores (APACHE II, SAPS II, SOFA) regularly used in ICUs and therefore can be used for determining the severity of the septic process. Quantitive procalcitonin and C-reactive protein analysis was not shown to be useful in diagnosing severe sepsis. However, PCT and CRP can be used to predict the fatal progression of the septic patient.
Acquired Tracheal Diverticulum as an Unexpected Cause of Endotracheal Tube Cuff Leak
Authors: Flores-Franco René Agustin , Silva-Alcaraz Jesús
Published: November 2015

Introduction: Tracheal diverticulum has been associated with problems during endotracheal intubation but there are no reports concerning air leakage around an endotracheal tube (ETT).

Case report: The case of an elderly woman under mechanical ventilatory support because an exacerbation of chronic obstructive pulmonary disease (COPD) is reported. She presented with an inexplicably air leak around the endotracheal tube not attributed to structural defects. The intra-cuff pressure value was as high as 30 mmHg to prevent an air leakage. Bronchoscopy revealed a tracheal diverticulum at the site ofthe tube cuff that allowed air leakage around it. The problem was overcome by re-intubating the patient with a larger diameter tube and positioning its distal end above the diverticular opening.

Discussion: Endotracheal tube air leak is a frequently neglected problem. COPD and other inflammatory conditions are associated with changes in the elastic properties of the airways resulting in tracheomegaly or acquired tracheal diverticulum. Both entities have been linked to problems during intubation or ventilation of patients. However tracheal diverticulum has not been described previously as a cause of air leakage.

Conclusion: Acquired tracheal diverticulum should be recognized as a cause of air leakage in the intubated patient, especially if associated with a normal or elevated intracuff pressure.
Architectural education online and in-class synergies: reshaping the course and the learner
Authors: Ioannou Olga
Published: November 2015

Architectural courses have been traditionally planned in the context of a physical classroom where the direct rapport of the students with the instructor is an unswerving condition for learning. This model was formed, however, at a time when learning was not impacted by technology. Although digital media have infiltrated architectural practice, they still elude architectural design education. The author argues that the integration of online educational practices in architectural curricula can benefit design education immensely by raising interaction and making students assume responsibility for their learning. To demonstrate the gains of online and in-class synergy in architectural education a blended course was set up at the postgraduate program of the National Technical University of Athens, School of Architecture. Current trends of online learning were carefully examined in regard to their compatibility with the architectural design culture of “learning by doing”. The course was eventually founded on the core principles of the connectivist model where learning consists of the ability to construct and traverse networks of connections (Downes, 2012). This approach was chosen because of its affinity to the design praxis where similarly students are required to make critical connections in order to map spatial phenomena and reconstruct the real. Course content was redesigned to comply with its new medium. Students were offered multiple channels of communication. They were also asked to contribute to the content material. Course data analysis demonstrated an unprecedented level of participation, exchange and student satisfaction as expressed in the surveys that followed the course’s completion.
Steroid sulfatase activity in subcutaneous and visceral adipose tissue: a comparison between pre- and postmenopausal women
Authors: Paatela Hanna , Wang Feng , Vihma Veera , Savolainen-Peltonen Hanna , Mikkola Tomi S , Turpeinen Ursula , Hämäläinen Esa , Jauhiainen Matti , Tikkanen Matti J
Published: November 2015

Objective

Adipose tissue is an important extragonadal site for steroid hormone biosynthesis. After menopause, estrogens are synthesized exclusively in peripheral tissues from circulating steroid precursors, of which the most abundant is dehydroepiandrosterone sulfate (DHEAS). Our aim was to study activity of steroid sulfatase, an enzyme hydrolyzing DHEAS, and expression of steroid-converting enzyme genes in subcutaneous and visceral adipose tissue derived from pre- and postmenopausal women.

Design

Serum and paired abdominal subcutaneous and visceral adipose tissue samples were obtained from 18 premenopausal and seven postmenopausal women undergoing elective surgery for non-malignant reasons in Helsinki University Central Hospital.

Methods

To assess steroid sulfatase activity, radiolabeled DHEAS was incubated in the presence of adipose tissue homogenate and the liberated dehydroepiandrosterone (DHEA) was measured. Gene mRNA expressions were analyzed by quantitative RT-PCR. Serum DHEAS, DHEA, and estrogen concentrations were determined by liquid chromatography–tandem mass spectrometry.

Results

Steroid sulfatase activity was higher in postmenopausal compared to premenopausal women in subcutaneous (median 379 vs 257 pmol/kg tissue per hour;P=0.006) and visceral (545 vs 360 pmol/kg per hour;P=0.004) adipose tissue. Visceral fat showed higher sulfatase activity than subcutaneous fat in premenopausal (P=0.035) and all (P=0.010) women. The mRNA expression levels of two estradiol-producing enzymes, aromatase and 17β-hydroxysteroid dehydrogenase type 12, were higher in postmenopausal than in premenopausal subcutaneous adipose tissue.

Conclusions

Steroid sulfatase activity in adipose tissue was higher in postmenopausal than in premenopausal women suggesting that DHEAS, derived from the circulation, could be more efficiently utilized in postmenopausal adipose tissue for the formation of biologically active sex hormones.