bluuebunny/crossref_metadata_2025 huggingface dataset:
Public Relations' Influence on the News
Authors: Turk Judy VanSlyke
Published: July 2017

The study examines how much influence one group of sources—public information officers for six state government agencies—had on daily newspaper content through the information they provided journalists. About half the information provided by PIOs was used in subsequently published news stories, and the topics the PIOs identified as salient to their agencies were the same topics given salience in media coverage. But the study also indicates public relations information, though it was used, was not the major source of information on which journalists relied. Fewer than half of all published stories that dealt with one of the six state agencies actually included PIO-provided information.
Managerial Innovation in Newspaper Organizations
Authors: Polansky Sharon H. , Hughes Douglas W.W.
Published: July 2017

A national sample of daily newspaper publishers and editors provides the first look at the dimensions of newspaper managerial innovativeness. A positive relationship was found between the innovativeness of newspaper managers and daily circulation. The data also show newsroom morale is perceived to be higher among innovative managers at large newspapers. Counter-hypothetically, innovativeness of newspaper organizational management was found to be unresponsive to direct market competition. Finally, managerial experience and publisher involvement (as perceived by editors) were shown to be significantly related to management innovativeness. The authors consider the impact of innovation on newspaper organizational health and on the newspaper industry's future.
Running Newspapers or Building Empires: Analysis of Gannett's Ideology
Authors: Smith Carol
Published: July 2017

Using the theoretical perspective of organizational ideology, this study examines Gannett corporate publications to determine typical “themes” communicated to employees and stockholders. The findings support, but complicate, previous studies' conclusions. Several themes are identified with variations among publications.
Does Newspaper Call-in Line Expand Public Conversation?
Authors: Aucoin James
Published: July 2017

This comparison of a call-in column and letters to editor finds that the column expanded public dialogue. However, call-in column contents were more likely to be primarily opinion with relatively few facts.
Training Participation and Gender: Analyzing Individual Barriers Across Different Welfare State Regimes
Authors: Massing Natascha , Gauly Britta
Published: June 2017

Lifelong learning is becoming increasingly important in today’s societies. Individuals need to develop their skills through training in order to be successfully integrated in the labor market. We use data from the Programme for the International Assessment of Adult Competencies to investigate gender differences in training across 12 countries. We analyze participation and perceived barriers to training for women in comparison with men and control for family structure and employment. As institutional framework, we use four different welfare state regimes to show how policies can affect the decision to participate. Our results show that different welfare regimes have an impact on the extent adults take part in training and on their perceived barriers. In all countries except Belgium and the Nordic states, men are more likely to participate in training. However, this inequality disappears once controlling for further individual characteristics. Our research provides insights why adults are deterred from engaging in training.
Interval Timing Is Preserved Despite Circadian Desynchrony in Rats: Constant Light and Heavy Water Studies
Authors: Petersen Christian C. , Mistlberger Ralph E.
Published: June 2017

The mechanisms that enable mammals to time events that recur at 24-h intervals (circadian timing) and at arbitrary intervals in the seconds-to-minutes range (interval timing) are thought to be distinct at the computational and neurobiological levels. Recent evidence that disruption of circadian rhythmicity by constant light (LL) abolishes interval timing in mice challenges this assumption and suggests a critical role for circadian clocks in short interval timing. We sought to confirm and extend this finding by examining interval timing in rats in which circadian rhythmicity was disrupted by long-term exposure to LL or by chronic intake of 25% D2O. Adult, male Sprague-Dawley rats were housed in a light-dark (LD) cycle or in LL until free-running circadian rhythmicity was markedly disrupted or abolished. The rats were then trained and tested on 15- and 30-sec peak-interval procedures, with water restriction used to motivate task performance. Interval timing was found to be unimpaired in LL rats, but a weak circadian activity rhythm was apparently rescued by the training procedure, possibly due to binge feeding that occurred during the 15-min water access period that followed training each day. A second group of rats in LL were therefore restricted to 6 daily meals scheduled at 4-h intervals. Despite a complete absence of circadian rhythmicity in this group, interval timing was again unaffected. To eliminate all possible temporal cues, we tested a third group of rats in LL by using a pseudo-randomized schedule. Again, interval timing remained accurate. Finally, rats tested in LD received 25% D2O in place of drinking water. This markedly lengthened the circadian period and caused a failure of LD entrainment but did not disrupt interval timing. These results indicate that interval timing in rats is resistant to disruption by manipulations of circadian timekeeping previously shown to impair interval timing in mice.
Water and Antimicrobial Agent Permation of PU and PHEIMA Membranes in Relation to their Surface and Bulk Properties
Authors: Pulat Mehlika , Abbasoglu Ufuk
Published: July 2017

Four types of polyurethane (PU) and two types of 2-polyhydroxyethylmethacrylate (PHEMA) membranes were prepared by convenient methods. Surface properties, water and antibacterial agent permeabilities of PU membranes were investigated. Water permeability values were determined in the region of 2000 g/m2 * 24 h. The membranes were found to have sufficient permeability toward antibacterial agents of 1% Silver Sulfadiazine and Bacitracin 10,000 UI-Neomycin sulphate 100 mg ointment.
Factors Related to College Students’ Decisions to Report Sexual Assault
Authors: Spencer Chelsea , Stith Sandra , Durtschi Jared , Toews Michelle
Published: June 2017

Sexual assault is a serious problem on college campuses. Using a sample of 266 survivors of sexual assault during their college years, results from a multinomial regression identified factors linked with the odds of making either a formal report to university officials, an informal disclosure, or telling no one of the assault. Survivors were more likely to formally report the sexual assault to university officials if they had received sexual assault training, if the assault included vaginal or anal penetration, and if the survivor had a positive perception of the overall campus climate. Survivors were less likely to formally report the assault to university officials if the perpetrator was an acquaintance, friend, or dating partner compared with a stranger. Racial or ethnic minorities were less likely to formally report or informally disclose the assault. Our findings suggest that universities can aid survivors in reporting their sexual assault through education, training, and improving the overall campus climate.
Workplace Bullying and Work Engagement: A Self-Determination Model
Authors: Goodboy Alan K. , Martin Matthew M. , Bolkan San
Published: June 2017

This study modeled motivational mechanisms that explain the negative effects of workplace bullying on work engagement. Guided by self-determination theory, workplace bullying was predicted to decrease worker engagement indirectly, due to the denial of employees’ basic psychological needs and their intrinsic motivation to work. From a sample of 243 full-time employees, serial multiple mediation models revealed that the indirect relationships between workplace bullying and work engagement (i.e., vigor, dedication, absorption) were serially mediated by basic psychological needs and intrinsic motivation to work. In support of self-determination theory, this study revealed that workplace bullying indirectly disengages employees from their work by denying them of their autonomy and relatedness needs and thwarting their motivation to perform work in a fulfilling way.
Human Suffering and Divine Abuse of Power in Lamentations: Reflections on Forgiveness in the Context of South Africa's Truth and Reconciliation Process
Authors: Stiebert Johanna
Published: July 2017

The book of Lamentations depicts the historical event of the destruction of Jerusalem in emotive and graphic terms. Both the woman metaphor and the first-person account of a man of sorrows are charged with pathos. God, meanwhile, the perpetrator of violence, emerges as brutal and unforgiving. Here this disturbing contrast is examined from the background of South Africa's truth and reconciliation process. The essay interrogates the nature of forgiveness from a theological and contextual perspective, examines whether forgiveness ought to be conditional and if the God of Lamentations is eligible for amnesty.
Lutheran-Roman Catholic Agreement on Justification: Suggestions for Talking about God Today
Authors: Kelly Gerard
Published: July 2017

The recent agreements between Lutherans and Roman Catholics on the doctrine of justification was hailed as perhaps the most significant breakthrough of the modern ecumenical movement. This article looks briefly at the issues at stake on both sides and how these have been addressed in the Joint Declaration. Working with comments from Avery Dulles and Jürgen Moltmann, it argues that the Joint Declaration is important for the future orientation of the doctrine, in particular as an example of discourse about God. While recognising that each ecclesial family has and will retain its distinctive way of speaking about God, it is argued that for the sake of our common humanity we also need a common discourse. In what should be a challenge to both Protestants and Roman Catholics, it is proposed that such a discourse must be a sacramental discourse.
Paschal Imagery in the Gospel of John: A Narrative and Symbolic Reading
Authors: Lee Dorothy
Published: July 2017

Passover imagery is central to the narrative structure and theological content of the Fourth Gospel. The imagery begins in the testimony of John the Baptist, declaring Jesus to be the “Lamb of God”. The narrator expands the paschal overtones of this title to incorporate other Old Testament insights associated particularly with temple and cult. The feast of Passover develops into its own metaphorical field, pushing the narrative towards the cross as the climatic moment of revelation. On the way, paschal imagery incorporates not only the lamb but also the shepherd who lays down and takes up his life on behalf of the sheep. Passover becomes a major symbol in the Fourth Gospel, capturing vital, christological aspects of John's understanding of the cross.
Bonhoeffer and the Powers-that-Be
Authors: Moses John A.
Published: July 2017

This article traces the impact of the Hitler dictatorship on Dietrich Bonhoeffer: a highly perceptive and critical scholar who remained loyal to his Lutheran formation. Bonhoeffer strenuously maintained a strict Lutheran understanding of the role which history had decreed for the Protestant German Empire and its Emperors. Revolution in the Western sense was, therefore, never an option for German subjects; it was theologically unthinkable. However, with regard to Adolf Hitler, the situation demanded a radical revision, because Hitler proved to be a false ruler. Essentially, having declared war on his own helpless subjects, the Jews, Hitler had violated the Lutheran understanding of a legitimate ruler and, therefore, had to be removed from office.
Pacifica: Genesis and Progress of a Journal
Authors: Honner John
Published: July 2017

This article provides recollections of the origins and development of the journal Pacifica from the perspective of one of the founding editors, with particular reference to the journal's first ten years. It reflects on the circumstances and cooperation that brought Pacifica into being, on the early contributions of Pacifica to theology in the Australasian and Western Pacific regions, and on the contributions of Pacifica to ecumenism and dialogue with wider society.
Jesus Christ: The Question to Cultures
Authors: Moloney Francis J.
Published: July 2017

Who Jesus Christ is and what he asks for from all who claim to be responding to his call to “follow” cannot be “controlled” or “contained” by any religion, any culture or any history. The life and teaching, death and resurrection of Jesus of Nazareth stand as a challenge to the absolutisation of any particular culture, religion or history.
Social Justice and Preferential Love for the Poor: Towards True Harmony in Interfaith Relationships
Authors: Banawiratma J. B.
Published: July 2017

Interreligious dialogue will stay on the situation of “gasping breath” unless it becomes interreligious communication and a movement in the context of the conflictual historical human conditions. These movements are the partial realisation of God's kingdom, which lies in the climate of justice and preferential love for the poor. Harmony without justice and preferential love is a superficial harmony, which covers injustice and violence. The priority of praxis is not a strategy to approach other religions. It flows directly out of Christian faith: to follow Christ radically is to follow him in praxis. Responsibility to make our common life more human is our praxis of faith. To enter into the mystery of harmony means to be touched by the eschatological harmony of God's kingdom and to be beware of stopping at a superficial harmony.
Towards a Theology of Procreation: An Examination of the Vatican Instruction Donum Vitae
Authors: Daniel William
Published: July 2017

The Instruction of the Congregation for the Doctrine of the Faith regarding in vitro fertilization and other forms of modern reproductive technology attempted to build on previous Church doctrine, especially on the Encyclical “Humanae Vitae” of Pope Paul VI (1968) and the Congregation's own Declaration on Abortion (1974). It is argued that it misunderstands and misrepresents both documents, and that a better case can be made for the Congregation's position than it makes itself. In brief, the main case against IVF is based, not on its treatment of the embryo or the future child, but on its failure to respect the dignity of the parents as procreators.
On the Road to Unity?
Authors: Geldbach Erich
Published: July 2017

There are three contributions at work in today's ecumenical movement: an ecumene of spirituality, an ecumene of justice, and an ecumene of theological dialogue. At present the theological dialogue, an ecumene of consensus, dominates possibilities. In particular, as reception of the BEM documents indicates, ecclesiological issues remain unresolved and a barrier to further progress.
Bartolomé de Las Casas: Defender of the Indians
Authors: Gutiérrez Gustavo
Published: July 2017

There are three parts to this article. The first offers a brief commentary on the situation in Latin America, including an effort to understand the situation from the under-side of history, from the point of view of the Indians. The second part is concerned with Las Casas' vision and his protest against the Catholic European invasion. The third and concluding part explores those lessons for us today which can be drawn from Las Casas' witness.
Rational Faith
Authors: Osborn Eric
Published: July 2017

This article explores three overlooked contemporary arguments concerning faith (raised by Iris Murdoch, Boyce Gibson, and Hans Küng). It shows how these arguments found expression at the beginning of Christian thought, and consider their weaknesses and strengths.
Whither New Evangelism?
Authors: Pieris Aloysius
Published: July 2017

The evangelistic fervour of the West is misplaced. It appears to assume the conversion of Asia to European Christianity rather than the conversion of its own colonial tendencies, a conversion which would come about if the church attended to the Gospel that belongs particularly to the poor and to the rejection of Mammon already present in traditional Asian religions.
Selective Conscientious Objection
Authors: Collins Peter
Published: July 2017

The article begins and ends with an examination of the 1992 Act of the Australian Parliament which accepted the principle of conscientious objection to particular wars, noting both the strengths and weaknesses of the legislation. The body of the article considers the notion of conscientious objection and the more complex moral implications of selective conscientious objection.
Christianity and World Religions: The Judgement of Karl Barth
Authors: Thompson Geoffrey
Published: July 2017

Hans Frei's description of Karl Barth's theological method as one of ‘ ad hoc correlation’ invites a new assessment of the relationship between §17 of the Church Dogmatics (‘Revelation as the Abolition of Religion’) and the wider argument in which it is set. On the basis of such an assessment, the claim is made in this article that §17 is an intrusion into an otherwise integrated theological argument and is occasioned only by Barth's attempt to correlate this wider argument to a then prevailing theory regarding Christianity's relationship to other religions.
The Quest for the Historical Essence of Ernst Troeltsch
Authors: Hogan Trevor
Published: July 2017

Until the seventies, Karl Barth's picture of Ernst Troeltsch (1865–1923) dominated the Anglo-phone reception of Troeltsch. In this reading, Troeltsch is the last of the great liberal protestant theologians who endeavoured to save Christianity by romanticising the Enlightenment. But that was Barth's Troeltsch. The past twenty years of Troeltsch studies have undermined this hegemonic view to recover a proto—postmodern thinker who recognised the profound cultural implications of the epistemological views embedded in modern science as in history and sociology. For Troeltsch the implications of epistemological relativity and historical relativism required the historicisation of the essence of Christianity. It also required a reformulation of the central doctrines of Christian faith; this was Troeltsch's theological project. Finally, it required a search for a modern form of Christian faith which authenticated personal mysticism and achieved normative Christian community life within a broader domain of a secular social democratic polity.
“White Man Got No Dreaming Him Go “Nother Way” — Albert Muta
Authors: Martin John Hilary
Published: July 2017

Land is an essential value for the Australian Aboriginal people, intimately associated with the Dreaming, which is best characterized as a religious value. It was during the Dreaming that the earth was formed and particular land was assigned to particular communities as a permanent responsibility and trust: you were to take care of the land and the land would take care of you. The attitude of immigrant settlers to the land has been different: Australia is a place tto be settled, planted and worked. This matches the Christian understanding that religious identity is not located in a physical place, since the Eucharistic assembly is the central locus of Christian identity. But it is also at the breaking of bread that Christians find their attachment to the earth. The article argues that Christians need to learn to live in and with the land they inhabit, since it is the land which provides the ultimate context for the Eucharistic assembly.
Bringing the Unspeakable to Speech in Hosea
Authors: McKinlay Judith
Published: July 2017

There appear to be, in Hosea, traces of the “unspeakable”, part of the text's very being, albeit its underside, relating to stories of Baal and his female partners. If Asherah was part of the Israelite religious world, then religious images which may have been associated with a feminine image of deity might be expected to retain this reference, even as they are re-used and adapted in new contexts for new tasks. It is possible that the attempt to suppress the image of female divinity has not been total and that the voice of the feminine will not remain “unspeakable” despite Hosea's efforts.
Finding the Way in an Age of Religious Pluralism: The Relevance of William Law and the Christian Mystical Tradition
Authors: Pickard Stephen K.
Published: July 2017

This article explores some of the important theological dynamics relevant to the Christian mystical tradition and suggests ways in which this tradition, in all its variety, might contribute to Christian self-understanding within the context of religious pluralism. It pursues this through an examination of the spiritual and theological pilgrimage of the eighteenth century Anglican divine, William Law (1686–1761).
Realistic Hope or Imaginative Exploration? The Identity of Job's Arbiter
Authors: Wilson Lindsay
Published: July 2017

Recent studies have highlighted the importance of the litigation motif in Job. A key strand of this motif is Job's calling on a legal functionary to come to his aid. Many attempts have been made to identify such a figure, with the debate largely focusing on whether God or a third party is being summoned. It has been argued that Job's underlying desire is for a restored relationship with God, yet neither God nor a person other than God is on view. Indeed, no identifiable figure is envisaged, for Job is exploring any imaginable possibility, rather than hoping realistically. Such a view does most justice to difficult verses like 16:21 and 17:3, and is reinforced by the use in each passage of a different title to describe the figure. One consequence of this conclusion is that crucial passages like 16:18–22 and 19:25–27 are not to be understood as Job affirming a confident faith in either his vindication or resurrection.
Suffering “Has a Smooth Shape, Smooth as a Black Night. There Are No Handles.”
Authors: Williams Rosemary
Published: July 2017

The quid-pro-quo stance to human suffering is prominent in psychological practice, in everyday life, and in attitudes to survivors of the Holocaust. In this view, suffering is the consequence of unrighteousness. Old Testament Wisdom literature as a whole is non-determinative about the cause of suffering, but much theology and christology still remains determinative, to the harm of suffering human beings.
“Antichristologies”: A Comparison of Juan Luis Segundo and Burton Mack
Authors: Irvine Andrew
Published: July 2017

Relating the historical Jesus to images of Jesus in Christian tradition and to the experiences of a contemporary audience has proven a burdensome task in the modern period. In the present day, various disjunctions and entanglements with religious and non-religious features of social life intensify the crisis of identity experienced by many Christians. Juan Luis Segundo and Burton Mack stand out as two interpreters of the historical Jesus who have approached the problem in different ways, not so much to restore the tradition for their audience as to subject it to radical historical criticism. As this study demonstrates, hermeneutics does not solve the larger problem of contemporary Christian identity but it does enable exchange between very different accounts of the problem, in turn clarifying what is at stake in the interpretive task: an interpreter's present conduct in the world.
Creeds as Anti-Personnel Lines
Authors: Hamilton Andrew
Published: July 2017

The recent excommunication of Tissa Balasuriya raised the question of the propriety of requiring Christians to subscribe to credal statements specially composed to meet their case. In this article the author reflects on two credal statements imposed on Nestorius and Berengarius. Both have been regarded as notorious heretics, and the credal statements tendered to them had significant subsequent influence. An examination of the effect of the two credal statements may suggest appropriate questions to put to the more recent use of such statements.
Some Disputed Questions about Confirmation
Authors: Hill John
Published: July 2017

The sacrament of confirmation has been for some time the subject of much theological debate and diverse pastoral practice. Across the Christian spectrum, and within individual churches, there has been little agreement on the meaning of the rite, on its sacramental status, on its minister, on the appropriate age and preparation of the subject, and so on. While some of this confusion is gradually yielding to increased awareness of the history and evolution of the rite, there is evidence that the problem has been exacerbated by common logical fallacies, an understanding of which may clarify the issue.
In the Name of Who? Levinas and the Other Side of Theology
Authors: Veling Terry A.
Published: July 2017

”Theology's About Face” makes a tentative and initial link between theology and the ethical concerns of Levinas' writing, particularly around his notion of responsibility for the face of the other as presented in his first major work, Totality and Infinity. “Being Faced” echoes themes from Levinas' second major work, Otherwise Than Being or Beyond Essence. This essay explores the metaphor of “being faced” (with the sense of persecution and obligation this “forces” upon us) in contrast to our more familiar and usual stance of “facing being” (with the sense of anxiety and questioning this produces in us).
Racial Inequality and Black Homicide: An Analysis of Felony, Nonfelony and Total Rates
Authors: Corzine Jay , Huff-Corzine Lin
Published: July 2017

Blau and Blau's (1982) suggestion that racial/ethnic economic inequality is an important source of violent crime has generated several empirical investigations during the last decade, but their findings have been inconclusive. In this study, we argue that their proposition should be tested for economically disadvantaged groups rather than for the total populations of political units. Consistent with recent reformulations of the frustration-aggression hypothesis, we predict that racial inequality has a stronger effect on nonfelony than felony homicide rates. Testing this idea for black homicide rates in SMS As, we indeed find that racial income inequality has a positive, significant influence on nonfelony homicides only. We conclude by recommending that future attempts at specifying the Blaus' model should focus on the perceptual dimension of the theory.
Details and Dynamics: Mental Models of Complex Systems in Game-Based Learning
Authors: Wasserman Joe A. , Banks Jaime
Published: June 2017

Background. Although the effectiveness of game-based learning (GBL) is well-supported, much less is known about the process underlying it. Nevertheless, developing a mental model that matches the game system, which in turn models a real-world system, is a promising proposed process.

Aim. This article explores the first steps in model matching: identifying the entities and (complex) relations in a game system.

Method. Participants ( N = 30) played the analog game DOMINION and completed a multi-step mental model mapping exercise. Categories of entities in mental model maps were inductively identified with grounded theory coding, while complex relations in mental model maps were identified via content analysis.

Results. Participants described formal game entities, player actions, sociality, learning processes, and subjective experience in their mental model maps. Participants identified very few complex relations—and no feedback loops—in their mental model maps.

Conclusions. Games—and analog games specifically—provide a breadth of resources for model matching and GBL. Through gameplay, learners come to affix conceptual meanings to material objects, a process dubbed lamination.
Social Skills Training in Groups with Developmentally Disabled Adults
Authors: Hall James A. , Schlesinger David J. , Dineen John P.
Published: July 2017

This first of two social work studies with developmentally disabled adults evaluates the effectiveness of a social skills training package in a replication of Bales (1980). Two groups of four trainees from vocational training programs were organized at two sites, respectively (n = 8). Both groups received a 12-session training package designed to improve social skills in four domains. A multiple baseline design across skills was used to evaluate effectiveness for individuals in each group, with skills assessed using a 16-situation role-play test. As a result of training, participants improved in skill performance using the role-play test, but an in-vivo assessment showed little change. Thus it was concluded that the treatment package was effective in improving social skills, but not powerful enough to effect significant changes in other settings. Suggestions are given concerning treatment effectiveness and implications for social work practice.
Drug Interactions Involving Renal Transport Mechanisms: An Overview
Authors: Kosoglou Teddy , Vlasses Peter H.
Published: July 2017

The renal anatomy, physiology, and cellular mechanisms involved in tubular transport of organic acids (anions) and bases (cations) are reviewed. Drugs that are renally secreted are prone to significant and complex drug-drug interactions, and knowledge of the underlying mechanisms is important. Several clinical studies involving commonly used cationic drugs (e.g., cimetidine, trimethoprim, and procainamide) are cited as examples of drug interactions involving renal transport mechanisms.
Evaluation of Cefonicid Use in a General Hospital
Authors: Rodríguez Carlos , Colomé Esteve , Arnau Josep M. , Jodar Ramón , Montoro Bruno , Cano Manuel , Laporte Joan-Ramón
Published: July 2017

Recently marketed drugs have limited experience in clinical use. Follow-up evaluation is therefore needed, particularly when these drugs are “restricted use” medicines, such as the second-generation cephalosporins. We present a follow-up of the first use of cefonicid, which was carried out after its substitution for cefuroxime in our hospital. The indication for use, dosing, therapeutic effects, and possible adverse reactions were recorded in 210 of the first 319 medical-surgical inpatients who received cefonicid. Cefonicid was administered to patients who could have been treated with free-use antibiotics on at least 128 occasions; these were cases of community-acquired pneumonia without any risk factor, urinary tract infections, acute exacerbations in patients with chronic lung disease, surgical prophylaxis, and intraabdominal infections. One fatal case of Stevens-Johnson syndrome was seen. Other recorded adverse events were two skin reactions, one tachyarrhythmia with evidence of low cardiac output, six episodes of phlebitis, and nine superinfections during treatment with cefonicid. The use of cefonicid instead of cefuroxime was associated with 20 percent cost savings; however, this study shows that optimal antibiotic prescribing may produce much greater savings.
Increased 6-Hydroxycortisol Excretion in Pregnant Women: Implication of Drug-Metabolizing Enzyme Induction
Authors: Ohkita Chieko , Goto Mitsuyoshi
Published: July 2017

The effect of pregnancy on hepatic drug-metabolizing enzyme activity was investigated in nine healthy pregnant women using the ratio of 6-hydroxycortisol (6-OHF), to total 17-hydroxycorticosteroid (17-OHCS) in 24-hour urine as an index of the hepatic monooxygenase activity. The values of 6-OHF and the ratio (713 ± 250 μg/d and 0.323 ± 0.242; mean ± SD) before delivery were significantly higher than they were during early puerperium (395 ± 145 μg/d and 0.114 ± 0.055) and approximately three months after delivery (237 ± 67 μg/d and 0.066 ± 0.034). Although the values three months after delivery were comparable to those found in the nonpregnant group (n = 10; 228 ± 48 μg/d and 0.081 ± 0.031), 6-OHF values one week after delivery were significantly higher than those observed in the control group. These observations suggest that drug-metabolizing enzyme induction may occur during pregnancy.
Outcome of Cholesterol Screening in a Community Pharmacy
Authors: Ibrahim Osama M. , Catania Patrick N. , Mergener Michael A. , Supernaw Robert B.
Published: July 2017

The purpose of our study was to determine if a community pharmacist could affect total blood cholesterol (TBC) of ambulatory patients by a program of education, consultation cholesterol screening. Of 241 initially screened individuals, 57 patients with TBC <5.17 mmol/L (>200 mg/dL) met the inclusion criteria of this six-month study. Of these, 51 completed the study. Outcome was determined by changes in TBC measured during the initial screening and after two follow-up visits. Pharmacist intervention included obtaining TBC concentrations and reporting the results to patients, teaching patients about the role of cholesterol in illness and health, explaining risk factors associated with cardiovascular disease providing follow-up communication with patients. Data were analyzed using ANOVA, Mann-Whitney chi-square. The mean TBC was 5.84 mmol/L (225.7 mg/dL) for the study group and 4.23 mmol/L (163.8 mg/dL) for participants with TBC <5.17 mmol/L (<200 mg/dL) (p<0.0001). There was a significant difference (p = 0.0124) in mean age for the study group (36.4 years) versus other participants (30.0 years) but no difference in distribution by gender (p = 0.18). ANOVA showed significant differences in TBC during the three visits (p<0.0001). There was a significant decrease in mean TBC concentrations between visits 1 and 2 and between visits 1 and 3 (p<0.0001), but no difference between visits 2 and 3 (p = 0.48). Compared with mean baseline values, 81.4 and 72.6 percent of the patients had a decline in TBC at visits 2 and 3, respectively. Cholesterol screening, as part of a patient education program performed by a community pharmacist, was associated with significant serum cholesterol reductions in patients with elevated concentrations.
Is Heparin Really Necessary in the Lock and, If So, How Much?
Authors: Weber D. Raymond
Published: July 2017

The literature on the issue of whether heparin is necessary in an intermittent peripheral venous access device (lock) is critically reviewed. Issues explored include loss of patency, development of phlebitis, duration of lock placement, type of cannula material, sample size, risk of toxicity with heparin flush solutions, risk of clot embolism, and physical or chemical incompatibilities. Available studies indicate that heparin is not necessary to maintain fluoroethylenepropylene (FEP-Teflon) peripheral venous access devices unless the lock is used to obtain blood specimens. Considering the benefit-to-risk ratio for the use of heparin, it is advisable to maintain FEP-Teflon locks with normal saline alone. When locks are used to obtain blood specimens, as in a pharmacokinetic study, then a dilute heparin flush solution should be used. Whether heparin is necessary for the maintenance of locks composed of other materials is uncertain. Newer, less thrombogenic materials such as ethylene tetrafluoroethylene may also obviate the need for heparin, but comparative trials in a larger number of patients are needed for confirmation. When heparin is used, an effort should be made to avoid systemic toxicities by using the lowest known effective concentration (10 units/mL) pending further studies.
Therapeutic Strategies for Myasthenia Gravis
Authors: Keys Patricia A. , Blume Robert P.
Published: July 2017

Myasthenia gravis (MG) is a complex autoimmune neurologic disorder of unknown etiology, characterized by fluctuating skeletal muscle weakness most commonly involving the muscles of the head, neck, and upper extremities. Autoantibodies directed against acetylcholine receptors on the postjunctional membrane decrease the numbers of functional acetylcholine receptors and cause membrane alterations, resulting in neuromuscular transmission failure. Diagnosis is established by history and physical examination, the “Tensilon Test,” and acetylcholine receptor antibody titers. Treatment modalities include drug therapy, thymectomy, and plasmapheresis. The drugs most commonly employed are anticholinesterases, corticosteroids, and immunosuppressive agents. Cyclosporine and intravenous immunoglobulin are promising investigational treatments. The purpose of the article is to review current concepts in the pathophysiology, immunopathology, diagnosis, and treatment of MG. Special emphasis is placed on the autoimmune form of the disease and the drugs employed in its management Standard regimens as well as some experimental treatment modalities are reviewed.
The Effect of Ex Vivo Factor XIII Supplementation on Clot Formation in Blood Samples From Cardiac and Scoliosis Surgery Patients
Authors: Shams Hakimi Caroline , Carling Malin S. , Hansson Emma C. , Brisby Helena , Hesse Camilla , Radulovic Vladimir , Jeppsson Anders
Published: June 2017

Excessive perioperative bleeding remains a substantial problem. Factor XIII (FXIII) contributes to clot stability, and it has therefore been suggested that supplementation with FXIII concentrate may improve perioperative hemostasis. We evaluated the effects of increasing doses of FXIII, alone or in combination with fibrinogen or platelet concentrate, in blood samples from 2 considerably different groups of surgical patients: cardiac and scoliosis surgery patients. Whole-blood samples were collected immediately after operation from cardiac and scoliosis surgery patients. The samples were supplemented with 3 clinically relevant doses of FXIII concentrate (+20%, +40%, and +60%), alone or in combination with a fixed dose of fibrinogen concentrate (+1.0 g/L) or fresh apheresis platelets (+92 × 109/L). Clot formation was assessed with rotational thromboelastometry (ROTEM). When the highest dose of FXIII concentrate was added, EXTEM clotting time was shortened by 10% in both cardiac and scoliosis surgery patients (95% confidence intervals: 2.4%-17% and 3.3%-17%, respectively), and FIBTEM maximum clot firmness was increased by 25% (9.3%-41%) in cardiac patients, relative to baseline. When fibrinogen was added, the dose-dependent effect of FXIII on clot stability was maintained, but the total effect was markedly greater than with FXIII alone, +150% (100%-200%) and +160% (130%-200%) for the highest FXIII dose in cardiac and scoliosis patients, respectively. Ex vivo supplementation with clinically relevant doses of FXIII improved clot formation moderately in blood samples from cardiac and scoliosis surgery patients, both alone and when given in combination with fibrinogen or platelet concentrate.
Co-scheduling Amdahl applications on cache-partitioned systems
Authors: Aupy Guillaume , Benoit Anne , Dai Sicheng , Pottier Loïc , Raghavan Padma , Robert Yves , Shantharam Manu
Published: June 2017

Cache-partitioned architectures allow subsections of the shared last-level cache (LLC) to be exclusively reserved for some applications. This technique dramatically limits interactions between applications that are concurrently executing on a multicore machine. Consider n applications that execute concurrently, with the objective to minimize the makespan, defined as the maximum completion time of the n applications. Key scheduling questions are as follows: (i) which proportion of cache and (ii) how many processors should be given to each application? In this article, we provide answers to (i) and (ii) for Amdahl applications. Even though the problem is shown to be NP-complete, we give key elements to determine the subset of applications that should share the LLC (while remaining ones only use their smaller private cache). Building upon these results, we design efficient heuristics for Amdahl applications. Extensive simulations demonstrate the usefulness of co-scheduling when our efficient cache partitioning strategies are deployed.
Parental health and psychosomatic symptoms in preschool children: A cross-sectional study in Scania, Sweden
Authors: Köhler Marie , Emmelin Maria , Rosvall Maria
Published: June 2017

Aim: The aim of the study was to assess the association between parental self-rated health and recurrent abdominal pain (RAP) in preschool children. Methods: A questionnaire, including questions about sociodemographic and psychosocial factors, lifestyle, parental and child health, was sent to parents of all 4-year-old children in Scania, Sweden. The response rate was 43.6%. The outcome was RAP and the main exposure was parental self-rated health (SRH). Covariates included sociodemographic, lifestyle and psychosocial factors. Logistic regression analyses were used in a five-step model to estimate the odds ratio (OR) and 95% confidence interval (CI) of parental SRH in relation to child RAP. Results: Logistic regression analysis showed higher odds of RAP among children whose parents reported domestic violence, economic worries and poor SRH (mothers OR = 2.1 (95% CI: 1.6, 2.7) and fathers OR = 1.5 (95% CI: 1.1, 2.0)). Adjustment for sociodemographic, lifestyle and psychosocial factors reduced the OR for RAP in the children of mothers with poor SRH (OR = 1.6 (95% CI: 1.2, 2.2)) and fathers with poor SRH (OR = 1.2 (CI 95%: 0.8, 1.7)). Poor SRH was associated with less reading to the child as well as parental perceptions of insufficiency in the interaction with the child. Conclusions: Health professionals have a key position to prevent psychosomatic symptoms in childhood by identifying the living conditions of children with RAP and particularly, to pay attention to parental poor health to identify if support to the family and/or child protection interventions are needed. Health professionals meeting adult patients with poor health should identify whether they are parents and have children who might need information, support and/or protection.
Prevalence and factors associated with non-utilization of healthcare facility for childbirth in rural and urban Nigeria: Analysis of a national population-based survey
Authors: Adewuyi Emmanuel O , Zhao Yun , Auta Asa , Lamichhane Reeta
Published: June 2017

Aim: The aim of this study was to assess the rural–urban differences in the prevalence and factors associated with non-utilization of healthcare facility for childbirth (home delivery) in Nigeria. Methods: Dataset from the Nigeria demographic and health survey, 2013, disaggregated by rural–urban residence were analyzed with appropriate adjustment for the cluster sampling design of the survey. Factors associated with home delivery were identified using multivariable logistic regression analysis. Results: In rural and urban residence, the prevalence of home delivery were 78.3% and 38.1%, respectively ( p < 0.001). The lowest prevalence of home delivery occurred in the South-East region for rural residence (18.6%) and the South-West region for urban residence (17.9%). The North-West region had the highest prevalence of home delivery, 93.6% and 70.5% in rural and urban residence, respectively. Low maternal as well as paternal education, low antenatal attendance, being less wealthy, the practice of Islam, and living in the North-East, North-West and the South-South regions increased the likelihood of home delivery in both rural and urban residences. Whether in rural or urban residence, birth order of one decreased the likelihood of home delivery. In rural residence only, living in the North-Central region increased the chances of home delivery. In urban residence only, maternal age ⩾ 36 years decreased the likelihood of home delivery, while ‘Traditionalist/other’ religion and maternal age < 20 years increased it. Conclusion: The prevalence of home delivery was much higher in rural than urban Nigeria and the associated factors differ to varying degrees in the two residences. Future intervention efforts would need to prioritize findings in this study.
Educational inequalities in hospital care for mortally ill patients in Norway
Authors: Elstad Jon Ivar
Published: June 2017

Aims: Health care should be allocated fairly, irrespective of patients’ social standing. Previous research suggests that highly educated patients are prioritized in Norwegian hospitals. This study examines this contentious issue by a design which addresses two methodological challenges. Control for differences in medical needs is approximated by analysing patients who died from same causes of death. Area fixed effects are used for avoiding that observed educational inequalities are contaminated by geographical differences. Methods: Men and women who died 2009–2011 at age 55–94 were examined ( N=103,000) with register data from Statistics Norway and the Norwegian Patient Registry. Educational differences in quantity of hospital-based medical care during the 12–24 months before death were analysed, separate for main causes of death. Multivariate negative binomial regression models were estimated, with fixed effects for residential areas. Results: High-educated patients who died from cancers had significantly more outpatient consultations at somatic hospitals than low-educated patients during an average observation period of 18 months prior to death. Similar, but weaker, educational inequalities appeared for outpatient visits for patients whose deaths were due to other causes. Also, educational inequalities in number of hospital admissions were marked for those who died from cancers, but insignificant for patients who died from other causes. Conclusions: Even when medical needs are similar for mortally ill patients, those with high education tend to receive more medical services in Norwegian somatic hospitals than patients with low education. The roles played by physicians and patients in generating these patterns should be explored further.
Group sequential designs for stepped-wedge cluster randomised trials
Authors: Grayling Michael J , Wason James MS , Mander Adrian P
Published: June 2017

Background/Aims:

The stepped-wedge cluster randomised trial design has received substantial attention in recent years. Although various extensions to the original design have been proposed, no guidance is available on the design of stepped-wedge cluster randomised trials with interim analyses. In an individually randomised trial setting, group sequential methods can provide notable efficiency gains and ethical benefits. We address this by discussing how established group sequential methodology can be adapted for stepped-wedge designs.

Methods:

Utilising the error spending approach to group sequential trial design, we detail the assumptions required for the determination of stepped-wedge cluster randomised trials with interim analyses. We consider early stopping for efficacy, futility, or efficacy and futility. We describe first how this can be done for any specified linear mixed model for data analysis. We then focus on one particular commonly utilised model and, using a recently completed stepped-wedge cluster randomised trial, compare the performance of several designs with interim analyses to the classical stepped-wedge design. Finally, the performance of a quantile substitution procedure for dealing with the case of unknown variance is explored.

Results:

We demonstrate that the incorporation of early stopping in stepped-wedge cluster randomised trial designs could reduce the expected sample size under the null and alternative hypotheses by up to 31% and 22%, respectively, with no cost to the trial’s type-I and type-II error rates. The use of restricted error maximum likelihood estimation was found to be more important than quantile substitution for controlling the type-I error rate.

Conclusion:

The addition of interim analyses into stepped-wedge cluster randomised trials could help guard against time-consuming trials conducted on poor performing treatments and also help expedite the implementation of efficacious treatments. In future, trialists should consider incorporating early stopping of some kind into stepped-wedge cluster randomised trials according to the needs of the particular trial.