bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating the economic impact of a political conflict on tourism: The case of the Catalan separatist challenge
Authors: Álvarez-Díaz Marcos , González-Gómez Manuel , Otero-Giráldez María Soledad
Published: July 2018

As an industry, tourism tends to be extremely responsive and vulnerable to political instabilities. Recently, a political conflict occurred in Spain, a leader in international tourism. In October 2017, the regional parliament of Catalonia asserted its independence from Spain, engendering a negative impact on the tourism sector of Catalonia. The main goal of our study is to assess the economic impact of the Catalan separatist challenge on the region’s tourism sector during the last quarter of 2017. To this end, we conducted a counterfactual analysis, based on forecasts generated by a seasonal autoregressive moving average model and an artificial neural network. The forecasts allowed us to calculate the projected number of international and domestic tourist visitors that would have travelled to Catalonia, had the separatist challenge not occurred. According to our results, the Catalan tourist sector effectively forfeited close to €200 million in revenue from the international tourism market, and around €27 million in revenue from the domestic market. These amounts differ from the economic gains attained by the other Spanish Mediterranean regions that compete with Catalonia to attract tourists.
A Paradigm Shift in Batterer Intervention Programming: A Need to Address Unresolved Trauma
Authors: Voith Laura A. , Logan-Greene Patricia , Strodthoff Terri , Bender Anna E.
Published: July 2018

Intimate partner violence (IPV) is a significant public health problem affecting women, men, and children across the United States. Batterer intervention programs (BIPs) serve as the primary intervention for men who use violence, employing three primary modalities: psychoeducation, cognitive–behavioral therapy (CBT), and other forms of group therapy such as alcohol or drug treatment. However, research indicates that program effectiveness of the primary BIP modalities is limited, due, in part, to the theoretical underpinnings guiding intervention such as learned behavior (psychoeducation), patriarchy as the root cause (Duluth model), and “dysfunctional” thinking (CBT). Considering the mental, physical, and economic toll of IPV on families and the limited effectiveness of current intervention approaches, an assessment of the strengths and weaknesses of current modalities and an incorporation of the latest science addressing violence prevention and cessation are paramount. This article draws upon existing theories of trauma and the etiologies of violence perpetration and proposes an alternative model of care for men with IPV histories. Experiences of childhood adversity and trauma have well-established associations with a range of negative sequelae, including neurological, cognitive, behavioral, physical, and emotional outcomes. Childhood trauma is also associated with later violence and IPV perpetration. Thus, incorporating trauma-informed care principles and trauma interventions into programming for IPV perpetrators warrants further investigation. Practice and policy implications of a trauma interventions for men with IPV histories, as well as areas for future research, are discussed.
Watching Players: An Exploration of Media Enjoyment on Twitch
Authors: Wulf Tim , Schneider Frank M. , Beckert Stefan
Published: July 2018

Video game streaming platforms have reached high popularity within the last years. As one of these popular platforms, Twitch provides users with the opportunity to participate in several gaming situations: They can simultaneously watch in-game actions, the streamer playing the game, and additionally, they can interact with the streamer and other viewers by using the chat. In an online survey, the current study explored how individuals ( N = 548) experience media enjoyment when using Twitch. Findings indicate that social aspects of using Twitch predominantly contribute to enjoyment. Approaches toward the phenomenon of video game streaming as well as implications for research on the usage of second screens and Social TV are discussed.
Cost-Effectiveness of Initial Revision Digit Amputation Performed in the Emergency Department Versus the Operating Room
Authors: Gil Joseph A. , Goodman Avi D. , Harris Andrew P. , Li Neill Y. , Weiss Arnold-Peter C.
Published: July 2018

Background: The objective of this study was to determine the comparative cost-effectiveness of performing initial revision finger amputation in the emergency department (ED) versus in the operating room (OR) accounting for need for unplanned secondary revision in the OR. Methods: We retrospectively examined patients presenting to the ED with traumatic finger and thumb amputations from January 2010 to December 2015. Only those treated with primarily revision amputation were included. Following initial management, the need for unplanned reoperation was assessed and associated with setting of initial management. A sensitivity analysis was used to determine the cost-effectiveness threshold for initial management in the ED versus the OR. Results: Five hundred thirty-seven patients had 677 fingertip amputations, of whom 91 digits were initially primarily revised in the OR, and 586 digits were primarily revised in the ED. Following initial revision, 91 digits required unplanned secondary revision. The unplanned secondary revision rates were similar between settings: 13.7% digits from the ED and 12.1% of digits from the OR ( P = .57). When accounting for direct costs, an incidence of unplanned revision above 77.0% after initial revision fingertip amputation in the ED would make initial revision fingertip amputation in the OR cost-effective. Therefore, based on the unplanned secondary revision rate, initial management in the ED is more cost-effective than in the OR. Conclusions: There is no significant difference in the incidence of unplanned/secondary revision of fingertip amputation rate after the initial procedure was performed in the ED versus the OR.
Building a Hand and Upper Extremity Transplantation Program: Lessons Learned From the First 20 Years of Vascularized Composite Allotransplantation
Authors: Mendenhall Shaun D. , Brown Stav , Ben-Amotz Oded , Neumeister Michael W. , Levin L. Scott
Published: July 2018

Background: Upper extremity transplantation is a quality-of-life enhancing treatment for select patients with upper extremity loss. This article reviews the preoperative, intraoperative, and postoperative challenges in the upper extremity transplantation process and the lessons learned from the first 2 decades of hand transplantation. Methods: Key components of the author’s hand transplantation protocol including patient selection, donor screening, surgical rehearsal, donor procurement, transplantation, immunosuppression, and patient outcome reporting/follow-up are reported to assist other teams who wish to establish a hand transplantation program. Results: There have been many advancements in the first 20 years of hand transplantation including better patient selection criteria, the recent addition of pediatric patients, improved surgical techniques such as the use of virtual surgical planning, and improved immunosuppression protocols. Improvement has also taken place in the tracking and reporting of hand transplant outcomes, but more work is clearly needed to fully define the benefits of transplantation, especially for pediatric patients. Conclusions: Over the past 20 years, significant progress has been made in upper extremity transplantation although a number of challenges remain including how to best document and share outcome measures, optimize immunosuppression, and diagnose/treat rejection. The authors encourage upper extremity transplant programs to report their experience and protocols to advance hand transplantation as standard of care for properly selected individuals.
The evaluation of a home-based paediatric nursing service: concept and design development using the Kirkpatrick model
Authors: Jones Catherine , Fraser Jennifer , Randall Sue
Published: July 2018

Background

A new paediatric hospital-in-the-home nursing service required evaluation.

Aims

To determine whether the education and training provided for nursing staff employed in the service was effective.

Methods

This paper presents the way in which a training evaluation model supported the design and evaluation of a training programme for registered nurses working in an out-of-hospital, home-based nursing service for paediatric patients.

Results

The Kirkpatrick model provides a framework for evaluating the effectiveness of workforce training for any industry including healthcare (Kirkpatrick, 2009).

Conclusions

That the Kirkpatrick model is an appropriate framework to evaluate a nursing training programme, but it is imperative to evaluate all levels of the model to be able to ascertain the success of the training and the impact on clinical practice.
Safety considerations for performing robotic surgery in the presence of a permanent pacemaker
Authors: Ubee Sarvpreet S , Selvan Masilamani , Chandrashekar Rangaswamy , Cooke Peter
Published: July 2018

With increasing experience, more complex patients are undergoing robotic surgery but the patient safety during these procedures remains paramount. Being a relatively recent technique of minimal access surgery, the safety and feasibility of robotic surgery is still under scrutiny. We recently performed two robotic procedures in patients who have permanent cardiac pacemaker. We believe this is the first published report through which it is shared and discussed, the preoperative and intraoperative management for these patients along with the importance of WHO checklist for safely performing robotic procedures. The importance of pre-procedure planning and briefing cannot be emphasised enough as these along with intraoperative management remain the key step in dealing with an adverse cardiac event due to permanent pacemaker malfunction.
A nurse-led audit on the incidence and management of inadvertent hypothermia in an operating theatre department of an Irish hospital
Authors: Healy Kathy , O’Sullivan Anne , McCarthy Lavinia
Published: July 2018

Inadvertent perioperative hypothermia (IPH) is a common problem associated with perioperative patients which can have significant consequences for them during surgery and in the immediate postoperative period. Recognising and managing IPH remains an important aspect of perioperative nursing and is a significant factor in maintaining patient safety, achieving positive surgical outcomes and patient satisfaction.

A nurse-led clinical audit was undertaken in the operating theatre department of a major teaching hospital in Ireland to establish the incidence and management of IPH in the department. One hundred (n = 100) patients were included in the audit, both children and adults. Results of the audit were used to inform quality improvement initiatives, with the purpose of improving patient care standards in the operating theatre department in that hospital.
Measuring Geographic and Wealth Inequalities in Health Distribution as Tools for Identifying Priority Health Inequalities and the Underprivileged Populations
Authors: Shawky Sherine
Published: July 2018

Background

Currently, there is no consensus on standard measure that can be routinely part of the health information systems to alert countries to inequalities in health and identify the priority health inequality conditions.

Objectives

To identify the health inequality measures relevant for assessing geographic and wealth inequalities; use the measures as a demonstration to what can happen in practice to recognize the geographic and wealth-related priority health inequalities within a country; and identify the geographic and wealth underprivileged populations.

Method

Egypt data were used as demonstration. Pearson coefficient of correlation was calculated to compare the various geographic and wealth health inequality measures. T test was used to identify significant correlations. The relevant inequality measures were used to rank geographic and wealth health inequalities and identify the underprivileged populations.

Results

The wealth inequalities in health measured by the concentration index provide a familiar and perform adequately in identifying economic inequalities in health. However, the geographic health inequalities identified by the index of dissimilarity appear to provide a more comprehensive profile of health inequalities within a country.

Conclusion

There is a need for a feasible inequality measure in the health information systems. A country’s geographic health distribution measured by the index of dissimilarity appears to provide a feasible first-step alarm to inform and guide the uptake of equity-sensitive policies.
A factor VIII–nanobody fusion protein forming an ultrastable complex with VWF: effect on clearance and antibody formation
Authors: Muczynski Vincent , Casari Caterina , Moreau François , Aymé Gabriel , Kawecki Charlotte , Legendre Paulette , Proulle Valerie , Christophe Olivier D. , Denis Cécile V. , Lenting Peter J.
Published: July 2018

Key Points

The fusion between FVIII and anti-VWF nanobodies increases affinity for VWF 25-fold without compromising FVIII activity. Stabilized VWF binding results in a twofold enhanced circulatory survival of FVIII and reduced anti-FVIII antibody formation.
Relapsed and refractory nodular lymphocyte-predominant Hodgkin lymphoma: an analysis from the German Hodgkin Study Group
Authors: Eichenauer Dennis A. , Plütschow Annette , Schröder Lena , Fuchs Michael , Böll Boris , von Tresckow Bastian , Diehl Volker , Borchmann Peter , Engert Andreas
Published: July 2018

Key Points

Patients with relapsed or refractory NLPHL have a favorable overall prognosis. Treatment of relapsed or refractory NLPHL should be chosen individually.
A randomised cross over study to evaluate the performance of a novel ankle dorsiflexion measurement device for novice users
Authors: Worsley Peter R. , Conington Caitlan , Stuart Holly , Patterson Alice , Bader Dan L.
Published: July 2018

Background

The ankle joint is a common site of musculoskeletal pathology. Measurement of its functional range of motion is a primary indicator for rehabilitation outcomes in therapy settings. The present study was designed to assess reliability and validity of a new standardised method using a D‐Flex device to assess ankle range of motion.

Methods

A cohort of 20 healthy volunteers were recruited to measure the weight‐bearing ankle range of motion using three assessment tools, namely, a goniometer, inclinometer and the D‐Flex measurement devices. Repeated measures were performed both between and within observers for each device over a 48 h period. Performance evaluation of each device and their reliability was assessed using intra‐class correlation coefficients and Bland and Altman plots.

Results

Although significant correlations (p < 0.05) were observed between devices, there were large mean differences in ankle range of motion values ranging from 4.3°‐15.7°. The D‐flex produced the highest inter‐ and intra‐rater reliability (ICCs 0.76–0.95), compared to values of 0.55–0.85 and 0.32–0.71 for the goniometer and inclinometer, respectively. The Bland and Altman plots revealed a low mean observer difference for the D‐Flex (mean difference = 0.7°), with the vast majority of data coincident within the 95% confidence intervals. For both the goniometer and inclinometer mean differences were higher, with values of 3.1° and 5.7° respectively.

Conclusion

The results of the present study provide evidence to support the use of the D‐Flex system as a valid, portable, and easy to use alternative to the weight‐bearing lunge test when assessing ankle dorsiflexion ROM in healthy participants.
Letter to the editor in response to estimating the burden of antimicrobial resistance: a systematic literature review
Authors: Wozniak Teresa M.
Published: July 2018

The systematic review published by Naylor et al. in April 2018 highlights methodological assumptions and biases that occur in studies investigating the burden of antimicrobial resistance (AMR). They note that, due to both the large diversity of statistical approaches and perspectives chosen, the current evidence base of the burden of AMR is highly variable. Certainly, these conclusions are valid and the authors present a very thorough analysis of the currently published literature with a broad array of drug-bug combinations. But readers are left with limited direction of estimating the current best available estimate of the health and economic burden of AMR. Such estimates are desperately needed to inform clinical management and for priority setting activities and initiative to curbing the global threat of AMR.
Symbiont photosynthesis in giant clams is promoted by V-type H+-ATPase from host cells
Authors: Armstrong Eric J. , Roa Jinae N. , Stillman Jonathon H. , Tresguerres Martin
Published: July 2018

Giant clams (genus Tridacna) are the largest living bivalves and, like reef-building corals, host symbiotic dinoflagellate algae (Symbiodinium) that significantly contribute to their energy budget. In turn, Symbiodinium rely on the host to supply inorganic carbon (Ci) for photosynthesis. In corals, host “proton pump” vacuolar-type H+-ATPase (VHA) is part of a carbon concentrating mechanism (CCM) that promotes Symbiodinium photosynthesis. Here, we report that VHA in the small giant clam (Tridacna maxima) similarly promotes Symbiodinium photosynthesis. VHA was abundantly expressed in the apical membrane of epithelial cells of T. maxima’s siphonal mantle tubule system which harbors Symbiodinium. Furthermore, application of the highly specific pharmacological VHA inhibitors bafilomycin A1 and concanamycin A significantly reduced photosynthetic O2 production by ∼40%. Together with our observation that exposure to light increased holobiont aerobic metabolism ∼five-fold, and earlier estimates that translocated fixed carbon exceeds metabolic demand, we conclude that VHA activity in the siphonal mantle confers strong energetic benefits to the host clam through increased supply of Ci to algal symbionts and subsequent photosynthetic activity. The convergent role of VHA in promoting Symbiodinium photosynthesis in the giant clam siphonal mantle tubule system and coral symbiosome suggests VHA-driven CCM is a common exaptation in marine photosymbioses that deserves further investigation in other taxa.
Recent advances in understanding bile duct remodeling and fibrosis
Authors: Scrushy Marinda , O'Brien April , Glaser Shannon
Published: July 2018

Cholestatic liver disease encompasses a detrimental group of diseases that are non-discriminatory in nature. These diseases occur over every age range from infancy (biliary atresia) to geriatrics (hepatitis). They also cover both genders in the form of primary sclerosing cholangitis in men and primary biliary cholangitis in women. Oftentimes, owing to the disease progression and extensive scarring, the treatment of last resort becomes a liver transplant. In this review, we will briefly discuss and explore new avenues of understanding in the progression of cholestatic liver disease and possible therapeutic targets for intervention. The greater our understanding into the idiopathic nature of cholestatic liver disease, the better our chances of discovering treatment options to halt or reverse the progression, reducing or eliminating the need for expensive and risky transplants.
To select relevant features for longitudinal gene expression data by extending a pathway analysis method
Authors: Tian Suyan , Wang Chi , Chang Howard H.
Published: July 2018

The emerging field of pathway-based feature selection that incorporates biological information conveyed by gene sets/pathways to guide the selection of relevant genes has become increasingly popular and widespread. In this study, we adapt a gene set analysis method – the significance analysis of microarray gene set reduction (SAMGSR) algorithm to carry out feature selection for longitudinal microarray data, and propose a pathway-based feature selection algorithm – the two-level SAMGSR method. By using simulated data and a real-world application, we demonstrate that a gene’s expression profiles over time can be considered as a gene set. Thus a suitable gene set analysis method can be utilized or modified to execute the selection of relevant genes for longitudinal omics data. We believe this work paves the way for more research to bridge feature selection and gene set analysis with the development of novel pathway-based feature selection algorithms.
The Semantic Differentialmethod As a Tool of Studying of the Specific Character of Religious Consciousness
Authors: Мурсалимова Юлия , Mursalimova Yuliya
Published: July 2018

The studying of the specific character of the word meaningreligious component is currently important area of modern social linguistics, psycholinguistics, interpersonal communication. We have made an attempt to describe verbalized part of an individual religious consciousness based on the material of own experimental observation, questionnaire with the application of semantic differential method. The questionnaire results according to the semantic differential method and empirical data are person-centered as the specificity of socio-psycholinguistic approach consists in a researcher’s examining language activity through an intermediary – recipient and assigning the task to see, hear and experience the word and its meaning from the point of another perceiving person’s view. The studying of religious word meaning identification with the application of socio-psycholinguistic methods, including the analyzing of verbalized part of religious consciousness, gives the opportunity to feature social, psychological and its other components and represents an extensive field for a researcher to study the specific character of the religious behavior of Muslims and Orthodox Christians living in Republic of Bashkiria.
The Realization of Strategy of Generalization In Metadiscourse (On the Example of English Narrative Discourse)
Authors: Федотова Оксана , Fedotova Oksana
Published: July 2018

The paper deals with the fiction communication between the author and the reader. Fiction text consists from factual information and from metadiscourse which guides the reader through the text. The paper shows that on the level of metadiscourse the author touches upon general issues which are not directly connected with the fictional reality of the story. The author’s address to the reader is formed with the help of abstract lexical sets. The most important lexical sets are “man” and “the surrounding world”. The paper shows that different lexical sets are used with different frequency in different historical periods. The most permanent lexical sets are “man and woman”, “family”, “mental activity”, “emotional state”, “attitude to other people”, “cooperation with other people”. These sets are formed with the help of the same vocabulary items in different historical periods. Such lexical sets as “society” and “the surrounding world” undergo considerable changes.
The Communicative Approach to the Intercultural Competence Development of University Students In the Process of Foreign Language Teaching
Authors: Илюшина А. , Ilyushina A.
Published: July 2018

The article deals with the main ideas of the communicative approach as methodological background to the development of intercultural competence of nonlinguistic students in foreign language teaching. The author underlines the advantages of wide use of communicative and discussion teaching technologies in modern higher education, describes the structural peculiarities and stages of their realization. It is concluded that discussion appears to be an effective form of intercultural competence development in terms of the communicative approach.
"People against": protests and protesters in virtual social networks
Authors: Ушкин Сергей , Ushkin Sergey
Published: July 2018

The monograph examines the role of virtual social networks in the development of "belolentochnye" protest movement in Russia in 2011—
2012, the Work done in the sociology of social networks, political sociology and sociology of youth, using both
quantitative and qualitative methodology. For researchers and University professors, as well as graduate students and senior students
courses-sociologists, political scientists, philosophers, specialists in the field
state and municipal management.
Total Hockey Optimizes Omnichannel Facility Locations
Authors: Millstein Mitchell A. , Campbell James F.
Published: July 2018

Omnichannel distribution, which blends brick-and-mortar retailing and e-commerce, is a key challenge for today’s supply chains. In this paper, we report on a study to design an omnichannel distribution system for Total Hockey, a growing U.S. sporting goods retailer in a competitive environment. Management strongly believes that e-commerce success will depend on high service levels characterized by one- or two-day delivery and initially thought that a new omnichannel warehouse located on the East Coast could support its expansion plans. To study the situation, we developed a profit-maximizing optimization model for locating omnichannel warehouses that supports both e-commerce and store shipments. The model uses estimates of e-commerce demand by metropolitan statistical area (MSA) across the United States, while incorporating management’s sales expectations regarding the value of high service levels, e-commerce sales lost to competitors’ stores, and reverse cannibalism from Total Hockey’s own retail stores. Multiple warehouse sizes allow modeling of nonlinear inventory costs. The facility-location optimization model allows exploration of multiple solutions and an assessment of the impact of higher service levels. The results of the study were contrary to management expectations and suggested a significant redesign of the distribution system. We report results for several analyses, implementation details, and managerial insights for omnichannel distribution.
ANÁLISE DA DECISÃO DE RECEBIMENTO DA DENÚNCIA DE INCITAÇÃO AO CRIME DE ESTUPRO – INQUÉRITO 3.932/DF – COM BASE NA TEORIA ARGUMENTATIVA DE NEIL MACCORMICK
Authors: Correia Daniel Camurça , Gonçalves Ana Cristina Viana Loureiro , Lima Luzélia Falcão Rocha
Published: July 2018

Este trabalho analisa o recebimento da denúncia (Inquérito 3.932/DF) ofertada pelo Ministério Público Federal em desfavor do Deputado Federal Jair Bolsanaro (PSC-RJ), pela suposta prática do crime de incitação ao crime, ao declarar que a Deputada Federal Maria do Rosário (PT-RS) “não merece ser estuprada por ser muito ruim, muito feia, não faz meu gênero”, acrescentando que, se ele fosse estuprador, "não iria estuprá-la porque ela não merece". O objetivo é avaliar se a decisão tomada foi adequadamente fundamentada, sob a ótica da teoria da argumentação jurídica desenvolvida por Neil MacCormick. O artigo se divide em quatro partes. A primeira seção traz um panorama da teoria da argumentação jurídica de Neil MacCormick. Em seguida, apresenta os argumentos interpretativos c como necessários para avaliar se uma decisão judicial está corretamente fundamentada. A terceira seção trata da coerência e da consistência como complementos à análise da fundamentação adequada da decisão judicial. A quarta seção pontua os argumentos apresentados na decisão sob exame, identificando os argumentos linguísticos, sistêmicos e teleológicos-deontológicos. Como resultado, a decisão do STF pode ser considerada legítima, por utilizar argumentos interpretativos de ordem jurídica e prática e apresentar coerência narrativa e normativa e consistência argumentativa.
A PRINCIPIOLOGIA DA MULTIPARENTALIDADE E OS DIREITOS FUNDAMENTAIS
Authors: Lopes Liliane Nunes Mendes , Santos Edilton Meireles de Oliveira
Published: July 2018

A família experimenta novas formações, tendo como esteio o vínculo criado através do afeto entre os indivíduos nas relações. A parentalidade não pode ser entendida apenas pelos laços sanguíneos, pois perpassa por questões mais subjetivas. No conflito entre a parentalidade biológica e a socioafetiva, tem-se buscado uma solução mais digna à pessoa humana, qual seja, a coexistência de ambas, gerando a multiparentalidade. O artigo tem como objetivo identificar o tratamento jurídico conferido pelo Direito Brasileiro ao tema, com base nos princípios constitucionais e gerais, buscando compreender a relação entre a multiparentalidade e os direitos fundamentais. Metodologicamente utiliza-se uma abordagem qualitativa, a partir de revisão bibliográfica do campo e de análise normativa e principiológica da legislação federal e constitucional sobre o tema. Na pesquisa se demonstrou a fundamentação principiológica para o reconhecimento da multiparentalidade, pautada nos direitos fundamentais na Constituição de 1988, com foco especial na filiação. A multiparentalidade não encontra ainda respaldo expresso no ordenamento jurídico brasileiro, e a repercussão dos seus diversos efeitos merece aprofundados estudos capazes de avaliar os benefícios e prejuízos porventura gerados com o seu reconhecimento.
PROPAGANDA POLÍTICA NO PRINCIPADO ROMANO: A FAMÍLIA COMO UM ELEMENTO DA CONSTITUIÇÃO
Authors: Taborda Maren Guimarães , Flores Alfredo De J.
Published: July 2018

Trata o presente ensaio de analisar o momento de transformação da constituição romana, na qual a civitas interferiu na família, servindo a reforma dos costumes de elemento de propaganda. A primeira hipótese explicitada é a de que, em Roma, até a época da instauração da monarquia militar, o direito público não dizia respeito às relações familiares.  Com a constituição do principado, surgiu um conjunto normativo que, interferindo diretamente na organização da família e na liberdade de escolha individual, acabou trazendo para o campo da política a solução dos conflitos intrafamiliares, com a criação de procedimentos judiciais públicos, não submetidos à lógica do processo formulário (semiprivado), principalmente para disciplinar as relações sexuais (os juízos públicos de adultérios) e, por conseguinte, equacionar a questão da natalidade. O método utilizado na investigação é o histórico-jurídico, porque a historicidade do direito é constitutiva e parte integrante dos acontecimentos. Ao estilo do realismo histórico, o estudo procura compreender e explicar os fundamentos da prática política e a propaganda, os quais foram as bases do novo regime, com o auxílio dos resultados científicos da investigação histórico-jurídica sobre o tema (revisão bibliográfica) e das fontes documentais primárias (textos de juristas, políticos e historiadores da Antiguidade Clássica).
AS RELAÇÕES REPRODUTORAS NOS ESPAÇOS DE ENSINO
Authors: Do Amaral Augusto Jobim , Martins Fernanda
Published: July 2018

As reflexões que serão desenvolvidas nesse texto buscam evidenciar as relações de poder e a dominação como mecanismos de reprodução social nos âmbitos de ensino. Ainda pretende apresentar uma possível postura para a prática educativa que questione os antigos métodos de ensino a partir de suas bases epistemológicas.  Assim, a partir das teorias de Bourdieu sobre a reprodução de estratificações sociais com base na perpetuação de um ensino impositivo tanto no ambiente familiar quanto escolar, busca-se elaborar uma conexão deste “modelo reprodutor” sugerido pelo autor com as teorias foucaultinas de governabilidade e disciplina desenvolvidos pelas instituições sociais e políticas, presente entre elas o próprio ensino. Julga-se, dessa forma. como condição de possibilidade para a adoção dessa nova postura o respeito ao Outro, através da ética da alteridade, e, no contexto do debate acerca da falência dos monólogos acadêmicos.
O CHAIN ROMANCE DWORKINIANO E AS PRIVATIZAÇÕES BRASILEIRAS: EM DEFESA DO RECONHECIMENTO DAS TEORIAS ECONÔMICAS COMO FONTES FORMAIS OPCIONAIS DO DIREITO
Authors: Fonseca Alexandre Müller
Published: July 2018

O presente artigo argumenta que as decisões judiciais justificadas por meio de casos precedentes não podem ser replicadas para qualquer caso. Por meio de um exemplo histórico brasileiro, as privatizações de estatais ocorridas na década de 1990, sustenta-se que esse modelo de raciocínio jurídico pode levar a consequências danosas. O artigo se contrapõe ao chamado “romance em cadeia” de Ronald Dworkin, alegando que o uso de teorias anexas ao direito para auxiliar na resolução de um caso desse tipo é explicativamente superior. Dito isso, defende-se que as teorias anexas ao direito, tal qual ocorre com a doutrina jurídica, sejam reconhecidas enquanto fontes opcionais do direito.
Efeitos da Inovação no Direito Administrativo brasileiro. Queremos saber o que vão fazer com as novas invenções
Authors: De Araujo Valter Shuenquener
Published: July 2018

Resumo Este texto tem como objetivo analisar como as inovações tecnológicas influenciam os mais diversos institutos do Direito Administrativo e impõem novas soluções normativas e teóricas. Ao longo deste trabalho, há uma abordagem focada em três tópicos específicos, em que a inovação tecnológica exerce (e exercerá) forte influência: poder de polícia, regime jurídico dos agentes públicos e controle da Administração Pública.
Política pública de cotas sociais na educação superior: da percepção do problema a (in)eficiência do programa
Authors: Tiujo Edson Mitsuo
Published: July 2018

O presente artigo destina-se ao estudo das etapas do processo de elaboração, implementação e execução da política pública de cotas sociais para o ingresso dos estudantes oriundos das escolas públicas nas universidades públicas. O artigo abordará os prognósticos e possíveis soluções em cada uma das etapas do seu processo de criação, culminando, ao final, com a verificação da (in)eficiência do programa de reserva de vagas, especialmente, quanto ao problema da “trajetória inversa” dos estudantes das escolas públicas. O método de abordagem é o hipotético dedutivo, por meio da argumentação e do raciocínio jurídico e político, visando atingir o resultado da eficiência ou ineficiência do programa.
Regime das incapacidades e pessoa com deficiência
Authors: Gama Guilherme Calmon Nogueira da , Nunes Marina Lacerda
Published: July 2018

O presente artigo objetiva estudar o tema da capacidade civil e suas implicações, tendo em vista as profundas mudanças legislativas operadas pela Convenção Internacional dos Direitos da Pessoa com Deficiência e pelo Estatuto da Pessoa com Deficiência (Lei nº 13.146/2015), que provocaram uma releitura da teoria das incapacidades, sob a ótica da inclusão da pessoa com deficiência na sociedade e da promoção de sua dignidade e direitos fundamentais. Outrossim, trata da ressignificação do instituto da curatela e da introdução do procedimento da tomada de decisão apoiada no direito brasileiro, enfatizando a esfera existencial da pessoa.
Interim report identifies priority issues to address in the Mental Health Act
Authors: Quaile Alistair
Published: July 2018

Alistair Quaile provides an overview of initial findings from the independent review of the Mental Health Act 1983
The NHS at 70
Authors: Dunkley-Bent Jacqueline
Published: July 2018

As the NHS celebrates its 70th birthday, Jacqueline Dunkley-Bent celebrates the advances that have been made to maternity care, and details how you can drive change
Student midwives' education needs and their experience of attending a bereavement education workshop
Authors: Doherty Jean , Coughlan Barbara , Casey Brenda , Lloyd Barbara , Sheehy Lucille , Brosnan Mary , Barry Theresa , McMahon Anne , Cullen Sarah
Published: July 2018

Background

Clinical training should be efficient, intellectually rigorous, and integrated into practice. This interactive workshop was developed to support student midwives in bereavement care.

Aims

To improve student midwives' confidence in providing bereavement care to parents after pregnancy loss and perinatal death.

Methods

Two focus groups were held, where students' (n=12) discussed their experiences of attending the workshop, barriers and facilitators to gaining confidence, and any further education needs.

Findings

All students agreed that the workshop increased their confidence, and said that role-plays were the most beneficial aspect of the day. Lack of exposure and support from mentors and senior staff was seen as the largest barrier to gaining further confidence.

Conclusions

The results suggest that all students could benefit from a workshop to increase confidence in bereavement care. The content of this workshop can be used in other maternity settings in Ireland and is recommended for all staff members caring for parents after perinatal bereavement or pregnancy loss.
Future-proofing simulation and clinical skills
Authors: Power Alison , Clapham Linda
Published: July 2018

Midwifery pre-registration education must adopt a range of learning and teaching approaches, including simulation and clinical skills sessions, to ensure that student midwives have the required skills and competencies to be admitted to the register. Simulation and clinical skills sessions, undertaken in the ‘safe’ environment of the classroom, enhance students' understanding, confidence and skills—particularly in managing obstetric emergencies, where in practice the needs of the woman take precedence over students' learning opportunities. The unpredictability of the clinical environment may lead to students not having the opportunity to manage an obstetric emergency until after they qualify. Setting up and facilitating simulation and clinical skills sessions is time-consuming for midwifery lecturers and not best use of their expertise, which is why specialist support in the form of laboratory/clinical skills technicians is critical to the smooth running of sessions and maintenance of costly equipment.
Small Animal Review
Authors: Tennant Bryn
Published: July 2018

Introduction:

Early identification and surgical management of anal sac gland adenocarcinoma that has not metastasised carries a good prognosis, with survival times in many dogs exceeding 4 years.
Foraging toys and environmental enrichment for parrots
Authors: Livingstone Madonna
Published: July 2018

Parrots are extremely popular pets, being kept for many reasons including as companions; for entertainment due to their often quirky personalities and their ability to talk; and for appreciation of their colourful plumage. Many are very long-lived, and their intelligence level is often underestimated. Behavioural problems due to poor welfare are widespread within the captive parrot population. Essentially, parrots are still behaviourally wild birds, therefore to understand the behaviour and husbandry requirements of the pet parrot we need to understand the behaviour of the wild counterpart. They are extremely social species and rely on conspecifics for preening, bonding, play and security. Many pet parrots are kept without conspecifics, therefore owners should be educated on the best way to provide care that meets the needs of parrots as well as possible within that constraint. Environmental enrichment and foraging toys are examined and discussed. Providing enrichment in multiple ways — visual, foraging toys, sound and play — will dramatically improve the welfare and quality of life for these birds.
All about … photography
Authors: Moorhouse Pete
Published: July 2018

Photography is more than a visual art form and can unlock conversations with children, explains Pete Moorhouse, who also offers some practical advice
Measles: Myths, truths and fake news
Authors: Armstrong Kirsty
Published: July 2018

With warnings of an expected increase in cases of measles this summer, Kirsty Armstrong gives a round up of the myths and truths surrounding the disease and the MMR vaccine
The role of the posterior bundle of the medial collateral ligament in posteromedial rotatory instability of the elbow
Authors: Hwang J-T. , Shields M. N. , Berglund L. J. , Hooke A. W. , Fitzsimmons J. S. , O’Driscoll S. W.
Published: July 2018

Aims

The aim of this study was to evaluate two hypotheses. First, that disruption of posterior bundle of the medial collateral ligament (PMCL) has to occur for the elbow to subluxate in cases of posteromedial rotatory instability (PMRI) and second, that ulnohumeral contact pressures increase after disruption of the PMCL.

Materials and Methods

Six human cadaveric elbows were prepared on a custom-designed apparatus which allowed muscle loading and passive elbow motion under gravitational varus. Joint contact pressures were measured sequentially in the intact elbow (INTACT), followed by an anteromedial subtype two coronoid fracture (COR), a lateral collateral ligament (LCL) tear (COR + LCL), and a PMCL tear (COR + LCL + PMCL).

Results

There was no subluxation or joint incongruity in the INTACT, COR, and COR + LCL specimens. All specimens in the COR + LCL + PMCL group subluxated under gravity-varus loads. The mean articular contact pressure of the COR + LCL group was significantly higher than those in the INTACT and the COR groups. The mean articular contact pressure of the COR + LCL + PMCL group was significantly higher than that of the INTACT group, but not higher than that of the COR + LCL group.

Conclusion

In the presence of an anteromedial fracture and disruption of the LCL, the posterior bundle of the MCL has to be disrupted for gross subluxation of the elbow to occur. However, elevated joint contact pressures are seen after an anteromedial fracture and LCL disruption even in the absence of such subluxation. Cite this article: Bone Joint J 2018;100-B:1060–5.
Mid-term results of alumina ceramic unlinked total elbow arthroplasty with cement fixation for patients with rheumatoid arthritis
Authors: Nishida K. , Hashizume K. , Nasu Y. , Ozawa M. , Fujiwara K. , Inoue H. , Ozaki T.
Published: July 2018

Aims

The aim of this study was to report the mid-term clinical outcome of cemented unlinked J-alumina ceramic elbow (JACE) arthroplasties when used in patients with rheumatoid arthritis (RA).

Patients and Methods

We retrospectively reviewed 87 elbows, in 75 patients with RA, which was replaced using a cemented JACE total elbow arthroplasty (TEA) between August 2003 and December 2012, with a follow-up of 96%. There were 72 women and three men, with a mean age of 62 years (35 to 79). The mean follow-up was nine years (2 to 14). The clinical condition of each elbow before and after surgery was assessed using the Mayo Elbow Performance Index (MEPI, 0 to 100 points). Radiographic loosening was defined as a progressive radiolucent line of >1 mm that was completely circumferential around the prosthesis.

Results

The mean MEPI scores significantly improved from 40 (10 to 75) points preoperatively to 95 (30 to 100) points at final follow-up (p < 0.0001). Complications were noted in ten elbows (ten patients; 11%). Two had an intraoperative humeral fracture which was treated by fixation and united. One had a postoperative fracture of the olecranon which united with conservative treatment and one had a radial neuropathy which resolved. Further surgery was required for one with a dislocation, three with an ulnar neuropathy and one with a postoperative humeral fracture. Revision with removal of the components was performed in one elbow due to deep infection. There was no radiographic evidence of loosening around the components.With any revision surgery or revision with implant removal as the endpoint, the rates of survival up to 14 years were 93% (95% confidence interval (CI), 83.9 to 96.6) and 99% (95% CI 91.9 to 99.8), respectively, as determined by Kaplan-Meier analysis.

Conclusion

With the appropriate indications, the mid-term clinical performance of the cemented JACE TEA is reliable and comparable to other established TEAs in the management of the elbow in patients with RA. Cite this article: Bone Joint J 2018;100-B:1066–73.
The learning curve associated with robotic-arm assisted unicompartmental knee arthroplasty
Authors: Kayani B. , Konan S. , Pietrzak J. R. T. , Huq S. S. , Tahmassebi J. , Haddad F. S.
Published: July 2018

Aims

The primary aim of this study was to determine the surgical team’s learning curve for introducing robotic-arm assisted unicompartmental knee arthroplasty (UKA) into routine surgical practice. The secondary objective was to compare accuracy of implant positioning in conventional jig-based UKA versus robotic-arm assisted UKA.

Patients and Methods

This prospective single-surgeon cohort study included 60 consecutive conventional jig-based UKAs compared with 60 consecutive robotic-arm assisted UKAs for medial compartment knee osteoarthritis. Patients undergoing conventional UKA and robotic-arm assisted UKA were well-matched for baseline characteristics including a mean age of 65.5 years (sd 6.8) vs 64.1 years (sd 8.7), (p = 0.31); a mean body mass index of 27.2 kg.m2 (sd 2.7) vs 28.1 kg.m2 (sd 4.5), (p = 0.25); and gender (27 males: 33 females vs 26 males: 34 females, p = 0.85). Surrogate measures of the learning curve were prospectively collected. These included operative times, the Spielberger State-Trait Anxiety Inventory (STAI) questionnaire to assess preoperative stress levels amongst the surgical team, accuracy of implant positioning, limb alignment, and postoperative complications.

Results

Robotic-arm assisted UKA was associated with a learning curve of six cases for operating time (p < 0.001) and surgical team confidence levels (p < 0.001). Cumulative robotic experience did not affect accuracy of implant positioning (p = 0.52), posterior condylar offset ratio (p = 0.71), posterior tibial slope (p = 0.68), native joint line preservation (p = 0.55), and postoperative limb alignment (p = 0.65). Robotic-arm assisted UKA improved accuracy of femoral (p < 0.001) and tibial (p < 0.001) implant positioning with no additional risk of postoperative complications compared to conventional jig-based UKA.

Conclusion

Robotic-arm assisted UKA was associated with a learning curve of six cases for operating time and surgical team confidence levels but no learning curve for accuracy of implant positioning. Cite this article: Bone Joint J 2018;100-B:1033–42.
The validity of the Mirels score for predicting impending pathological fractures of the lower limb
Authors: Howard E. L. , Shepherd K. L. , Cribb G. , Cool P.
Published: July 2018

Aims

The aim of this study was to validate the Mirels score in predicting pathological fractures in metastatic disease of the lower limb.

Patients and Methods

A total of 62 patients with confirmed metastatic disease met the inclusion criteria. Of the 62 patients, 32 were female and 30 were male. The mean age of patients was 65 years (35 to 89). The primary malignancy originated from the breast in 27 (44%) patients, prostate in 15 (24%) patients, kidney in seven (11%), and lung in four (6%) of patients. One patient (2%) had metastatic carcinoma from the lacrimal gland, two patients (3%) had multiple myeloma, one patient (2%) had lymphoma of bone, and five patients (8%) had metastatic carcinoma of unknown primary. Plain radiographs at the time of initial presentation were scored using Mirels system by the four authors. The radiographic components of the score (anatomical site, size, and radiographic appearance) were scored two weeks apart. Inter- and intraobserver reliability were calculated with Fleiss’ kappa test. Bland-Altman plots were created to compare the variances of the individual components of the score and the total Mirels score.

Results

Kappa values for the interobserver variability of the components of the Mirels score were k = 0.554 (95% CI 0.483 to 0.626) for site, k = 0.342 (95% CI 0.285 to 0.400) for size, k = 0.443 (95% CI 0.387 to 0.499) for radiographic appearance, and k = 0.294 (95% CI 0.258 to 0.331)for the total score. Kappa values for the intra-observer reliability were k = 0.608 (95% CI 0.506 to 0.710) for site, k = 0.579 (95% CI 0.487 to 0.670) for size, k = 0.614 (95% CI 0.522 to 0.703) for radiographic appearance, and k = 0.323 (95% CI 0.266 to 0.379) for total score.

Conclusion

Our study showed fair to moderate agreement between authors when using the Mirels score, and moderate to substantial agreement when authors rescored radiographs. The Mirels score is subjective and lacks reproducibility in predicting the risk of pathological fracture. Cite this article: Bone Joint J 2018;100-B:1100–5.