bluuebunny/crossref_metadata_2025 huggingface dataset:
Interventions to Improve Gait in Older Adults with Cognitive Impairment: A Systematic Review
Authors: Zhang Weihong , Low Lee‐Fay , Gwynn Josephine Diana , Clemson Lindy
Published: December 2018

Objectives

To review intervention programs that measure gait to investigate what features of the intervention may contribute to improving gait in older adults with cognitive impairment or dementia.

Design

Systematic review using Medline, Cinahl, Scopus, PsychInfo, Amed, Embase, Web of Science, and PubMed for original research published in English between January 1, 2000, and July 23, 2018, to identify interventional controlled trials. Narrative synthesis was undertaken.

Results

Of 6,379 citations, 36 articles met inclusion criteria. Interventions were categorized as medication or medical devices (8 studies), exercise (19 studies), and exercise plus cognitive training (9 studies). Antidementia medication may improve gait variability in people with Alzheimer's disease. Exercise programs focusing on strength and balance training, especially when combined with functional mobility training, improve gait in people with mild cognitive impairment or dementia. Exercise plus cognitive training programs combining strength and balance training, functional mobility training, and training on attention and executive function also improve gait.

Conlusion

Physical and cognitive factors affect gait performance, and both should be addressed in intervention programs. Physical exercises including functional mobility training, especially walking, have better results than physical programs with only static, resistance, and flexibility training. Cognitive intervention should be concomitant with physical exercises rather than separate, with a focus on attention and executive function. Combining physical training with cognitive training in a functional context may assist older adults with cognitive impairment generalize from training to everyday activity.J Am Geriatr Soc 67:381–391, 2019.
Quality of End‐of‐Life Care and Its Association with Nurse Practice Environments in U.S. Hospitals
Authors: Lasater Karen B. , Sloane Douglas M. , McHugh Matthew D. , Aiken Linda H.
Published: December 2018

Objectives

The purpose of this study is twofold: (1) to describe the quality of end‐of‐life care in US hospitals from the perspective of hospital nurses; and (2) to evaluate the relationship between the nurse practice environment and end‐of‐life care quality.

Design

Cross‐sectional analysis of multiple linked secondary data sources.

PARTICIPANTS and SETTING

A total of 12,870 direct care registered nurses in 491 acute‐care hospitals.

Measurements

Measures of end‐of‐life care quality and nurse practice environment were derived from the 2016 RN4CAST‐US survey of nurses. Nurses reported on end‐of‐life care quality for patients for whom death within a year would not be surprising. Nurse practice environment was measured using the Practice Environment Scale of the Nursing Work Index, a National Quality Forum validated scale.

Results

Most nurses gave their hospitals an unfavorable evaluation of end‐of‐life care overall (58%) and said patients often experience painful procedures that were unlikely to change their outcome (53%). The best predictor of poor quality was the nurse practice environment. Nurses in the best environments were 55% less likely than nurses in poor environments to rate their hospital's overall end‐of‐life care quality unfavorably (odds ratio = 0.45; 95% confidence interval = 0.39–0.52; P < .001).

Conclusion

Quality of end‐of‐life care in US hospitals is imperfect and is significantly worse in hospitals with poor nurse practice environments than in hospitals with the best environments. This study reinforces the importance of nurses in providing high‐quality end‐of‐life care. J Am Geriatr Soc 67:302–308, 2019.
Post‐Acute Care among Older Adults with Stage I to III Colorectal Cancer
Authors: Kenzik Kelly M. , Williams Grant R. , Bhatia Smita , Balentine Courtney J.
Published: December 2018

BACKGROUND

Little information is available on the long‐term use of post‐acute care among older patients with colorectal cancer (CRC), relative to individuals without cancer. This study examines the use of post‐acute care among older cancer survivors (>65 y) with CRC and compares it with noncancer patients up to 5 years from surgery.

DESIGN

Retrospective cohort.

SETTING

SEER‐Medicare.

PARTICIPANTS

Patients treated for stage I to III CRC between January 1, 2000, and December 31, 2011 (n = 40 812) and noncancer Medicare beneficiaries hospitalized for noncancer treatment matching on age, sex, race, comorbidity, and Medicaid dual eligibility.

MEASUREMENTS

Incident post‐acute care claims (skilled nursing, long‐term care facility, and home health) from 0 to 100 days, 101 to 365 days, and 1 to 5 years from hospitalization.

RESULTS

The median age was 77 years. All patients had surgery, 34% received chemotherapy, and 27% received surgery and adjuvant therapy. The cumulative incidence of any post‐acute care within 100 days of hospitalization was 45.7% for stage III, 37.9% for stage I/II, and 39% for controls (p < .001). Within the CRC cohort only, the cumulative incidence of post‐acute care was 2.9% (stage I/II) and 4.2% (stage III, p < .001) from 101 to 365 days and 15.8% (stage I/II) and 16.9% (stage III, p < .001) from 1 to 5 years. Increasing age, ostomies, and neoadjuvant or adjuvant therapy were associated with increased hazard of all post‐acute patients within 100 days from hospitalization. From 1 to 5 years from diagnosis, adjuvant therapy was associated with greater exclusive home health care use.

CONCLUSIONS

Survivorship planning among older CRC patients should include discussions of post‐acute care following cancer therapy, even several years after treatment. J Am Geriatr Soc 67:937–944, 2019.
Patient and carer experience of blended diet via gastrostomy: a qualitative study
Authors: Phillips G.
Published: December 2018

Background

Home enteral feeding is becoming increasingly prevalent within the UK. The use of commercial prescription formula is considered best practice; however, increasingly, patients are choosing to use blended diet via gastrostomy. There is anecdotal evidence suggesting both physical and social benefits, although there are concerns regarding the safety and efficacy of this method of feeding. The present study explores the experiences of patients who are currently using or have used this method of feeding in the past.

Methods

Patients currently using or having previously used blended diet via gastrostomy were identified. Patients and their carers, where applicable, were invited to participate in a semi‐structured interview. The data were transcribed and themes were identified.

Results

Thematic analysis of the data collected showed that patients had an overall positive experience of blended diet with few or no identified disadvantages. Participants reported improvements in gastrointestinal symptoms, as well as general wellbeing, in addition to the social benefits of their family member being included in family mealtimes. Reference was made to the lack of support for this method of feeding and the desire for blended diet to be offered as an alternative to commercial enteral feed.

Conclusions

This research highlights the benefits of blended diet via gastrostomy as an alternative to commercial formula. More research is needed to develop evidence‐based guidelines for patients and the healthcare professionals supporting them.
Office treatment of large endometrial polyps using truclear 5C: Feasibility and acceptability
Authors: Ceci Oronzo , Franchini Mario , Cannone Rossella , Giarrè Giovanna , Bettocchi Stefano , Fascilla Fabiana D. , Cicinelli Ettore
Published: December 2018

Aim

This retrospective multicenter study was carried out to evaluate feasibility, effectiveness and patient acceptability of a small diameter hysteroscopic tissue removal system in the treatment of large endometrial polyps (≥20 mm), usually not removed in an office setting.

Methods

Hundred and forty‐six women with a single greater than 10‐mm diameter polyp considered for polypectomy between April 2016 and August 2017. Sixty‐five of these patients had a polyp size greater than 20 mm. All hysteroscopic polypectomy, using Hysteroscopic Tissue Removal system (TruClear 5C System Medtronic), were performed in an office setting with vaginoscopic approach.

Results

Procedural success, time to complete the polypectomy and patient pain scores were evaluated. Polyps less than 20 mm were completely removed in 79/81 cases (97.53%). The completeness of greater than or equal to 20‐mm polyp removal was achieved in 63/65 cases (96.92%). The median time for polypectomy was 4.19 ± 1.03 min for polyps less than 20 mm and 4.97 ± 1.30 min for polyps greater than or equal to 20 mm, respectively. Pain was minimal and brief, and the mean pain score measured on a 10‐point visual analog scale at the end of polypectomy showed no significant difference between the two groups. In 4/79 (5.06%) cases with polyps less than 20 mm and in 4/63 (6.35%) cases with polyps greater than or equal to 20 mm women reported moderate pain. All specimens were adequate for pathologic measurements.

Conclusion

Hysteroscopic treatment of polyps greater than or equal to 20 mm in size with TruClear 5C is feasible and well tolerated in an office setting with no significant difference regarding completeness compared to polyps less than 20 mm, but with a minimal increase in procedure times.
Attaining Multicultural Citizenship through Indigenous‐Language Instruction: Successful Kichwa Misfires and the Modeling of Modernist Language Ideologies in Ecuador
Authors: Limerick Nicholas
Published: December 2018

In recent years, state policymakers have responded to the demands of Indigenous peoples with cultural and linguistic recognition, and such recognition has influenced how traditionally marginalized peoples self‐identify. This article examines how teachers in an intercultural bilingual school in Quito, Ecuador, coach students to speak successively in Spanish and Kichwa in greetings and songs as they model languages as discrete, commensurate, and orderly. Through semiotic processes of diagrammaticity, multilingual ways of speaking align with nonlinguistic markers, such as regional forms of dress, to illustrate a sanctioned form of Indigeneity as the identities of the students. Drawing on the concept of “misfire,” the article shows how, in the process, the students speak “incorrectly” in Kichwa but successfully illustrate their citizenship identities for non‐Kichwa‐speakers. Such actions foreground sanctioned traits, helping students to pass through public spaces and gain funding for intercultural bilingual education. State recognition thus paradoxically orients use of Indigenous languages towards those who do not understand them.
Re‐Channeling Language: The Mutual Restructuring of Language and Infrastructure among DeafBlind People at Gallaudet University
Authors: Edwards Terra
Published: December 2018

This article is concerned with the re‐channeling of language. It asks: what role does the material environment play in turning a visual language into a tactile language? To pursue that question, I examine language and infrastructure among DeafBlind people at Gallaudet University. Since 2005, aspects of the local urban landscape have been designed with the practices of Deaf people in mind. Recently, under the influence of the protactile movement, attention has turned to the tactile dimensions of design. As advisors, practitioners, and consultants contributing to these efforts, DeafBlind people seek not only to broaden the range of sensory channels linking them to their environment, but also to create environments that reinforce those connections across linguistic, sensory, and environmental domains. Drawing on the notion of “channel” as it has been applied and developed in linguistic anthropology and related fields, I argue that the re‐channeling of language among DeafBlind people at Gallaudet implicates channels of transmission. It cannot, however, be reduced to an effect of their affordances. Rather, the signer's perceptions of what is possible in communication are shaped by more general perceptions of what is possible in life, and what is possible in life depends on infrastructure.
Electronic nicotine delivery systems: Oral health implications and oral cancer risk
Authors: Sultan Ahmed S. , Jessri Maryam , Farah Camile S.
Published: December 2018

There is a paucity of evidence surrounding the potential detrimental effects of electronic nicotine delivery systems (ENDS) for both systemic and oral health. The effects of conventional cigarettes on the development of oral cancer are well known; however, the role of ENDS in oral carcinogenesis is yet to be elucidated. Furthermore, the exponential rise of the use of ENDS by the general public means that dental healthcare providers are more likely to encounter questions on their safety in the oral cavity, and on their effectiveness as a smoking cessation aid. Herein, we review the most up to date literature on the systemic and oral health complications of ENDS. Moreover, evidence‐based recommendations on the use of ENDS as a smoking cessation tool within the dental setting are discussed.
Unintentional Injuries in Primary and Secondary Schools in the United States, 2001‐2013
Authors: Zagel Alicia L. , Cutler Gretchen J. , Linabery Amy M. , Spaulding Alicen B. , Kharbanda Anupam B.
Published: December 2018

BACKGROUND

Unintentional injuries are the leading cause of youth morbidity. However, limited nationally representative data are available to characterize the occurrence of unintentional injuries at US schools. Given this paucity, we characterized secular trends in unintentional injuries at schools that led to emergency department (ED) visits.

METHODS

A retrospective analysis of the National Electronic Injury Surveillance System‐All Injury Program from 2001 to 2013 compared injuries occurring at schools to injuries occurring elsewhere in youth ages 5‐18 years. Incidence rates were calculated using weighted frequency estimates as numerators and US population estimates as denominators.

RESULTS

School injuries accounted for 21% of unintentional injury‐related ED visits, with an estimated annual incidence rate of 1385 injuries per 100,000 5‐ to 18‐year‐olds. Middle school‐aged youth (10‐13 years) had the highest annual incidence rate (1640 per 100,000 youth) compared with younger and older counterparts. School injuries were more likely to be due to sports/recreation than nonschool injuries (55% vs 41%, p < .0001). Importantly, no detectable change in incidence rates of school injuries between 2001 and 2013 was found (p = .11).

CONCLUSIONS

Stagnant annual incidence rates of unintentional injuries at schools and large numbers of school‐based injuries demonstrate that school‐based injuries are a notable opportunity for future prevention efforts.
Improbable lesion in a child
Authors: Almeida Filipa T , Campos Manuel A , Carvalho Sofia D , Brito Celeste
Published: December 2018

See Answer
Comparing the RELTRAD and Born‐Again/Evangelical Self‐Identification Approaches to Measuring American Protestantism
Authors: Smith Gregory A. , Sciupac Elizabeth Podrebarac , Gecewicz Claire , Hackett Conrad
Published: December 2018

The question of how Protestantism (including evangelicalism) is measured in social science research is of keen importance to those seeking to understand religion in American life. In this article, we compare and contrast two of the leading techniques for classifying Protestants. One of these approaches (the RELTRAD approach) categorizes respondents as evangelical Protestants, mainline Protestants, or black Protestants mainly on the basis of their denominational affiliation. By contrast, the self‐identification method utilizes information about a respondent's race and a yes/no question that asks respondents directly whether they consider themselves born‐again or evangelical Christians to create similar categories. We show that there is considerable overlap, though not perfect correlation, between the two approaches. Both methods produce similar estimates of the size of Protestant subgroups, and they paint similar religious and demographic portraits of the evangelical, mainline, and black Protestant communities. As a result, we argue that the self‐identification method can be an effective proxy for RELTRAD when RELTRAD is unavailable as a measurement option.
Choose the Method for Aggregating Religious Identities that Is Most Appropriate for Your Research
Authors: Hackett Conrad , Schwadel Philip , Smith Gregory A. , Podrebarac Sciupac Elizabeth , Gecewicz Claire
Published: December 2018

Some U.S. surveys measure many religious identities, including detailed Protestant affiliations. Researchers must decide how to aggregate these diverse identities. There are now a variety of options for aggregating religious groups into categories. Depending on the research question, it may be appropriate to use one of the existing options or to develop an aggregation strategy tailored to the project in question.
Constructing Images of the Divine: Latent Heterogeneity in Americans’ Impressions of God
Authors: Davis Nicholas T. , Federico Christopher M.
Published: December 2018

How do individuals psychologically organize their images of the divine? Most work on this topic is factor‐analytic in nature, finding that God images vary with respect to love, judgment, and engagement. However, few studies look at how individuals spontaneously combine these divine dimensions into composite images of God. To fill this gap, we subject data from the 2010 Baylor Religion Survey to latent class analysis and find evidence for five depictions of God: (1) a poorly defined, uninvolved deity; (2) a loving, nonjudgmental deity who is engaged with humanity; (3) a nullity or nonentity; (4) a loving deity who is neither judgmental nor engaged with humanity; and (5) a loving deity who is also both judgmental and engaged. We then present evidence that individuals holding these images vary in their denominational background, religious attitudes and behaviors, and general traits. Our findings suggest that individuals may impose not only a dimensional structure on images of the divine, but a categorical one as well.
A pilot study investigating circulating trimethylamineN‐oxide and its precursors in dogs with degenerative mitral valve disease with or without congestive heart failure
Authors: Karlin Emily T. , Rush John E. , Freeman Lisa M.
Published: December 2018

Background

Pathophysiologic mechanisms for the development and progression of degenerative mitral valve disease (DMVD) remain elusive. Increased concentrations of circulating trimethylamineN‐oxide (TMAO) and its precursors choline andl‐carnitine are associated with the presence and severity of heart disease in people.

Objectives

To determine if differences exist in plasma concentrations of TMAO, choline, orl‐carnitine among dogs with DMVD and congestive heart failure (CHF), dogs with asymptomatic DMVD, and healthy control dogs.

Animals

Thirty client‐owned dogs: 10 dogs with CHF secondary to DMVD, 10 dogs with asymptomatic DMVD, and 10 healthy control dogs.

Methods

A pilot cross‐sectional study in which echocardiography was performed and fasting plasma concentrations of TMAO, choline, andl‐carnitine (total and fractions) were measured.

Results

TMAO (P = .03), totall‐carnitine (P = .03), carnitine esters (P = .05), and carnitine esters to free carnitine ratio (E/F ratio;P = .05) were significantly higher in dogs with CHF compared to those with asymptomatic DMVD. TMAO (P = .02), choline (P = .01), totall‐carnitine (P = .01), carnitine esters (P = .02), free carnitine (P = .02), and E/F ratio (P = .009) were significantly higher in dogs with CHF compared to healthy controls.

Conclusions and Clinical Importance

Dogs with CHF secondary to DMVD had higher concentrations of TMAO compared to both asymptomatic DMVD dogs and healthy controls. Larger prospective studies are warranted to determine if TMAO plays a role in the development or progression of DMVD or CHF.
The effects of grazing regimes on phenological stages, intervals and divergences of alpine plants on the Qinghai‐Tibetan Plateau
Authors: Li Yu , Dong Shikui , Gao Qingzhu , Zhang Yong , Liu Shiliang , Swift David , Ganjurjav Hasbagan , Hu Guozheng , Wang Xuexia , Yan Yulong , Wu Hongbao , Luo Wenrong , Ge Yiqing , Li Yan , Zhao Zhenzhen , Gao Xiaoxia , Li Shuai , Song Jiahui
Published: December 2018

Questions

The impact of grazing on the phenology of alpine plants has not been deeply explored. In particular, how the phenology of all species in the alpine plant community is affected by grazing has seldom been monitored.

Study Site

Qinghai‐Tibetan Plateau of China.

Methods

A linear mixed model was used to explore the effect of grazing regimes (continuous grazing, grazing exclusion and rotational grazing), species, and individuals of species on phenological stages at the community level. One‐wayANOVAwas used to examine the difference in phenological stage across different species under the same grazing regime and timing of the phenological stages of each species across different grazing regimes. Pearson correlation analysis was used to explore linkages between plant phenology and leaf traits, linkages between phenological stages, as well as their intervals across different species.

Results

The green‐up and withering time of different species both exhibited various response patterns to grazing regimes. The flowering time of most species was delayed by grazing, whereas the fruiting time of most species remained stable across grazing regimes. There were significant linkages between phenological stages and leaf traits; for example fruiting time was negatively related to the ratio of leaf N content (LNC) to leaf P content (LPC) under all grazing regimes. The phenological stages themselves, and their intervals, showed close relations; for example fruiting time was positively related to withering time, and negatively related to its interval. The divergence was higher during the flowering time than during other phenological stages. The divergence of all phenological stages was highest under grazing exclusion.

Conclusions

The shifts in flowering time were advantageous for these plants to adapt to grazing, as flowering time can regulate interspecific temporal patterns and maintain the stability of subsequent phenological stages. Among grazing regimes, grazing exclusion led to greatest divergence of phenological stages across species, which possibly creates potential reproductive gaps.
Acquisition of obligate mutualist symbionts during the larval stage is not beneficial for a coral host
Authors: Hartmann Aaron C. , Marhaver Kristen L. , Klueter Anke , Lovci Michael T. , Closek Collin J. , Diaz Erika , Chamberland Valérie F. , Archer Frederick I. , Deheyn Dimitri D. , Vermeij Mark J. A. , Medina Mónica
Published: December 2018

Theory suggests that the direct transmission of beneficial endosymbionts (mutualists) from parents to offspring (vertical transmission) in animal hosts is advantageous and evolutionarily stable, yet many host species instead acquire their symbionts from the environment (horizontal acquisition). An outstanding question in marine biology is why some scleractinian corals do not provision their eggs and larvae with the endosymbiotic dinoflagellates that are necessary for a juvenile's ultimate survival. We tested whether the acquisition of photosynthetic endosymbionts (family Symbiodiniaceae) during the planktonic larval stage was advantageous, as is widely assumed, in the ecologically important and threatened Caribbean reef‐building coral Orbicella faveolata. Following larval acquisition, similar changes occurred in host energetic lipid use and gene expression regardless of whether their symbionts were photosynthesizing, suggesting the symbionts did not provide the energetic benefit characteristic of the mutualism in adults. Larvae that acquired photosymbionts isolated from conspecific adults on their natal reef exhibited a reduction in swimming, which may interfere with their ability to find suitable settlement substrate, and also a decrease in survival. Larvae exposed to two cultured algal species did not exhibit differences in survival, but decreased their swimming activity in response to one species. We conclude that acquiring photosymbionts during the larval stage confers no advantages and can in fact be disadvantageous to this coral host. The timing of symbiont acquisition appears to be a critical component of a host's life history strategy and overall reproductive fitness, and this timing itself appears to be under selective pressure.
How do anxious children attempt to regulate worry? Results from a qualitative study with an experimental manipulation
Authors: Normann Nicoline , Esbjørn Barbara Hoff
Published: December 2018

Objective

The objective of this study was to explore how anxiety‐disordered children attempt to regulate their worry.

Design

An experimental manipulation was applied, followed by a qualitative interview.

Methods

Thirty children aged 7–13 were enrolled in this study. Each child was presented with a black mystery box, was told that shortly he/she would have to feel what was inside the box, and was then left alone for 4 min, prior to commencing the task. The purpose of the experimental manipulation was to induce slight levels of worry in the child, so that he/she could better report on worry regulation strategies. Afterwards, an interview about how the child had regulated worry during the experimental manipulation and in everyday life was undertaken. The interviews were coded using thematic analysis.

Results

Five main themes were uncovered. These were (1) internal regulation of worry, for example, thinking about something else and self‐reassurance talk, (2) external regulation of worry, for example, behavioural avoidance and distraction, (3) perceived effect of strategies, (4) shifting between strategies, and (5) absence of a strategy.

Conclusions

Our results demonstrate that anxious children use a variety of behavioural and cognitive strategies to regulate worry. They use these strategies in combination, they generally perceive them as ineffective, and they sometimes do not report any strategy for attempting to regulate their worry. These results indicate that clinicians should be curious about which strategies anxious children use to regulate their worry, how these strategies interact with each other, and how they are implemented by the child.

Practitioner points

Using an experimental manipulation followed by an interview, this study sought to investigate how anxious children seek to regulate their worries.

Anxious children attempt to regulate their worry with use of behavioural regulation strategies, such as avoidance and distraction, and with use of cognitive regulation strategies, including thinking about something else, self‐reassurance talk, and thought suppression.

Sometimes, however, anxious children are not able to report a regulation strategy for a specific worry episode, suggesting that they may not always have a strategy or that they lack the introspective ability to report what they did.

Clinicians should be aware that anxious children may use internal (cognitive) regulation strategies while at the same time using behavioural regulation strategies, such as avoidance.
Neurocognitive function in moderate–severe pediatric atopic dermatitis: A case–control study
Authors: L. Kruse Lacey , Cices Ahuva , Fishbein Anna B. , Paller Amy S.
Published: December 2018

Background/Objectives

Epidemiological studies have shown an increased prevalence of attention deficit hyperactivity disorder (ADHD) in children with atopic dermatitis (AD), but many of the features of ADHD may occur as a result of the poor sleep and itch distraction associated with AD.

Methods

A case–control study was performed in children aged 6‐17 years with moderate/severe AD compared with age‐/sex‐matched healthy controls. Participants were screened for ADHD using Vanderbilt assessments.

Results

Seventeen patients with AD and 18 controls completed the study. Two children with AD (11.7%) and one control (5.56%) met screening criteria for ADHD via parent‐completed Vanderbilt assessments; AD patients were not significantly more likely to screen positive for ADHD (P = 0.47), or comorbid behavior disorders (P = 0.23). However, AD patients were more likely than controls to exhibit ADHD‐associated behaviors, most significantly inattention.

Conclusions

Our AD cohort did not have a significantly increased prevalence of ADHD. Certain neurocognitive symptoms are increased in children with moderate‐to‐severe AD compared to controls.
Neonatal skin care: Developments in care to maintain neonatal barrier function and prevention of diaper dermatitis
Authors: Burdall Oliver , Willgress Liam , Goad Nina
Published: December 2018

Background

Understanding the importance of the barrier function of the skin of preterm and term neonates is crucial in effective neonatal skin and diaper care. This literature search aimed to review the development of different practices in neonatal care to maintain skin barrier function, in turn preventing diaper dermatitis.

Methods

We performed two quantitative literature searches of English language studies: an initial literature search of studies published in the last 5 years was conducted using Cinahl, Medline, Embase, British Nursing Index, and DelphiS, followed by a second search of publications from 1990 to 2017 using the National Institute of Clinical Excellence Health Databases Advanced Search using key words, synonyms, and Boolean phrasing. Titles and abstracts were reviewed for relevance.

Results

One hundred ten studies were analyzed for the purpose of this review; however, data are of variable quality. Guidance can be drawn from the existing literature relating to best practice options for diaper area cleansing methods, diaper type selection, and use of barrier creams. More research is required into the benefit or otherwise of diaper‐free time.

Conclusions

Super‐absorbent diapers reduce moisture at skin level and reduce diaper dermatitis. Barrier creams carry benefit both in prevention and cure but do not provide a substitute for frequent diaper changes. The literature does not demonstrate superiority of one cleansing method over another, but neither the use of wipes nor water increases diaper dermatitis prevalence. Further studies are required to explore the potential benefit of diaper‐free time, taking due consideration of the practicalities, particularly for vulnerable neonates within the Intensive Care setting.
Why makers make what they make: motivations to contribute to open source hardware development
Authors: Hausberg J. Piet , Spaeth Sebastian
Published: December 2018

Open source software (OSS) and hardware (OSH) are two expressions of one broader concept and its related movement. One of the most fundamental questions relating to these phenomena is why developers contribute their private resources to these public goods. While this question has been discussed, theorized, and empirically investigated in the context of OSS, there has been no research so far in the context of OSH. Can we really assume the motivations behind the development of the OSH to be the same as those behind OSS? Based on the self‐determination theory (SDT), we provide original insights into the motivations behind contributions to OSH development. We collected data from the most common and active 3D printing communities, which are the main loci of OSH development. We thus have a unique cross‐sectional data set with participants from over 30 different countries using all kinds of different OSH platforms. Our analysis reveals several important findings: firstly, the motivations are in some aspects very similar to those in open source software notwithstanding different possibilities, hurdles, and incentives regarding the OSS and OSH. Above all, enjoyment‐based intrinsic motivation is a major factor affecting contribution levels. Secondly, among internalized extrinsic motivations, expected private benefits through improving own skills stands out. Thirdly, different factors of internalized extrinsic motivations can have different moderating effects on the effect of enjoyment‐based intrinsic motivation. Given the imminent changes in business models throughout manufacturing industries in order to adapt to the challenge that OSH will increasingly pose, our findings have important implications not only for OSH communities and 3D development platforms, but also for businesses that want and probably soon have to engage in open innovation.
Environmental assessments in the context of climate change: The role of the UN Economic Commission for Europe
Authors: Mayer Benoit
Published: December 2018

The United Nations Economic Commission for Europe (UNECE) has played an important role in the recognition of a customary international law obligation for States to conduct an environmental assessment (EA) when a proposed activity is likely to have a transboundary impact. It is unclear, at present, whether this customary norm applies to the impacts of an activity on the global environment. In recent years, the EA frameworks of many UNECE member States have been construed or revised so as to include consideration for the impact of proposed activities on climate change. The UNECE could help to establish this growing practice as a norm through the adoption of a dedicated instrument on EA in the context of climate change. This article documents ongoing developments in UNECE member States and discussions that have taken place under the auspices of the UNECE and discusses next steps.
Real‐Time Fiscal Forecasting Using Mixed‐Frequency Data*
Authors: Asimakopoulos Stylianos , Paredes Joan , Warmedinger Thomas
Published: December 2018

The sovereign debt crisis has increased the importance of monitoring budgetary execution. We employ real‐time data using a mixed data sampling (MiDaS) methodology to demonstrate how budgetary slippages can be detected early on. We show that in spite of using real‐time data, the year‐end forecast errors diminish significantly when incorporating intra‐annual information. Our results show the benefits of forecasting aggregates via subcomponents, in this case total government revenue and expenditure. Our methodology could significantly improve fiscal surveillance and could therefore be an important part of the European Commission's model toolkit.
Score estimation in the monotone single‐index model
Authors: Balabdaoui Fadoua , Groeneboom Piet , Hendrickx Kim
Published: December 2018

We consider estimation in the single‐index model where the link function is monotone. For this model, a profile least‐squares estimator has been proposed to estimate the unknown link function and index. Although it is natural to propose this procedure, it is still unknown whether it produces index estimates that converge at the parametric rate. We show that this holds if we solve a score equation corresponding to this least‐squares problem. Using a Lagrangian formulation, we show how one can solve this score equation without any reparametrization. This makes it easy to solve the score equations in high dimensions. We also compare our method with the effective dimension reduction and the penalized least‐squares estimator methods, both available on CRAN as R packages, and compare with link‐free methods, where the covariates are elliptically symmetric.
The tribe next door: The New Guinea Highlands in a postwar Papuan mission newspaper
Authors: Schram Ryan
Published: December 2018

Western ideologies of imperialism conceptualise time as heterogeneous in that they assume that colonised lands are outside of historical time. In this respect, the discursive construction of an empty frontier has been crucial to colonial dispossession. Yet colonial discourses become dominant through their circulation, and so the savage spaces they imagine take on a life of their own when they are revoiced. Papuan Times, a newspaper published by graduates of an industrial mission school at Kwato Island in the colonial Territory of Papua and New Guinea after the Second World War, produces subaltern agency in its reports on the pacification of the Highlands. While its news articles reproduce the heterogeneous chronotope of colonial discourse, articles describing the missionary work of former Kwato students in the Highlands reimagine the Highlands frontier as a horizon of social transformation. The Papuan Times strategy reflects the fact that a community's pursuit of the good exists in relation to others which constrain it, and, more generally, that an anthropology of the good is also an anthropology which recognises the fraught coexistence of a plurality of values.
Consultant led peer assisted learning model
Authors: Yoong Andrel , Mukundu Nagesh Navin , Rye Dupinderjit Singh , Devaraj Vikram
Published: December 2018

Background

Undergraduate medical students frequently report inadequate basic surgical skills such as suturing and knot tying. In recent years, peer assisted learning (PAL) has proven to be an effective method of teaching basic surgical skills. The consistency of the teaching and the quality of the content may be questionable in these workshops. This study aimed to develop a consultant led peer assisted learning model (CL‐PAL) to facilitate the quality‐controlled delivery of basic suturing skills in undergraduate medical education.

Methods

A video on basic suturing techniques was developed with the assistance of an experienced plastic and reconstructive surgeon. Sixty students were recruited and allocated to four workshops across 2 days. Each student was provided with a pre and post workshop form to self‐assess their confidence levels with different suturing techniques and theories of suturing. Three PAL facilitators rotated through student stations to address any concerns and to improve the learning experience.

Results

From the post‐workshop assessment, students expressed increased confidence in handling surgical instruments, suturing and understanding sharp safety. Following this workshop, 90% of the students reported that they were more likely to attend self‐directed learning sessions to maintain their acquired skills. Workshop providers also had an opportunity to develop teaching skills such as communication and the demonstration of suturing skills.

Conclusion

CL‐PAL uses technology aided resources created by an experienced surgeon to facilitate the delivery of high quality basic surgical teaching. This model is not only applicable to basic skills training but can also be developed for applications in other specialties.

In recent years, peer‐assisted learning (PAL) has proven to be an effective method of teaching basic surgical skills
Effects of a programme to advance scholarly writing
Authors: Rohan Annie , Fullerton Judith
Published: December 2018

Background

Scholarly writing, although central to the completion of doctoral studies, is often not supported by systematic teaching/learning approaches that specifically help students to convey scholarship through writing. The purpose of this project was to promote writing as an essential component of scholarship, provide opportunities for students to develop a self‐awareness of confidence in writing and challenges to writing, and to improve writing competence.

Methods

An innovative set of peer‐supported interventions was embedded within a core foundational course in a Doctor of Nursing Practice (DNP) programme during the first academic semester as part of a continuing quality improvement process to improve DNP student writing. The first curriculum innovation was a substantive writing assignment, in which students exchanged papers with a classmate and were required to critique both writing conventions (e.g. criteria such as punctuation and citation) and structural and thesis‐driven aspects of writing (e.g. criteria such as clarity, organisation and the use of paragraph leading sentences). Students then read their papers aloud, without hesitation while reading, in order to identify any discrepancies between the written words and the audible ‘plain language’ that would be necessary to enhance clarity. The second innovation was an optional writing workshop in which students received coaching from interdisciplinary mentors and from their peers.

Results

Evaluation of the implementation of this innovation suggests that mentorship, peer support and the use of commonly spoken language may be useful tools for improving the writing competencies of DNP students.

Discussion

Students with broad diversity in writing competency, including low levels of proficiency, benefitted from a writing‐enriched curriculum given at the start of the course of study.

DNP faculty may not themselves be prepared to mentor students for doctoral‐level writing
Increasing the adsorption capabilitiy of mordenite and Y zeolites via post‐synthesis chemical/physical treatments in order to remove cationic dyes from polluted water
Authors: Esmaeili Samaneh , Zanjanchi Mohammad Ali , Golmojdeh Hossein , Mizani Farhang
Published: December 2018

Different post‐synthesis approaches were used to increase the adsorption abilities of zeolite mordenite and Y in removal of cationic dye molecules as typical dyestuff pollutants. Various methods including acid leaching, alkaline treatment, dealumination with hexafluorosilicate, sonication and combination of them were employed to alter the porous structure of various types of selected zeolites. The dealumination (due to acid leaching), desilication (due to alkaline treatment) and disintegration (due to shear forces generated by ultrasound waves) were responsible for the alteration of pores size and accessibility in mordenite. Acid leaching combined with irradiation of ultrasound was found to be most effective technique in adsorption of rhodamine B as a large dye molecule into mordenite. In the case of zeolite Y, a chemical treatment with ammonium hexafluorosilicate resulted in considerable improvement of adsorption of rhodamine B.
Parametric Identification of Carbon Nanotube Nanocomposites Constitutive Response
Authors: Formica Giovanni , Taló Michela , Lanzara Giulia , Lacarbonara Walter
Published: December 2018

Hysteresis due to stick-slip energy dissipation in carbon nanotube (CNT) nanocomposites is experimentally observed, measured, and identified through a one-dimensional (1D) phenomenological model obtained via reduction of a three-dimensional (3D) mesoscale model. The proposed model is shown to describe the nanocomposite hysteretic response, which features the transition from the purely elastic to the post-stick-slip behavior characterized by the interfacial frictional sliding motion between the polymer chains and the CNTs. Parametric analyses shed light onto the physical meaning of each model parameter and the influence on the material response. The model parameters are determined by fitting the experimentally acquired force–displacement curves of CNT/polymer nanocomposites using a differential evolution algorithm. Nanocomposite beam-like samples made of a high performance engineering polymer and high-aspect-ratio CNTs are fabricated and tested in a bending mode at increasing deflection amplitudes. The entire time histories of the restoring force are fitted by the model through a unique set of parameters. The parameter identification is carried out for nanocomposites with various CNT weight fractions, so as to highlight the model capability to identify a wide variety of nanocomposite hysteretic behaviors through a fine tuning of its constitutive parameters. By exploiting the proposed model, a nanostructured material design and its optimization are made possible toward the exploitation of these promising materials for engineering applications.
Cross Wind Effects on Vehicle–Track Interactions: A Methodology for Dynamic Model Construction
Authors: Xu Lei , Zhai Wanming
Published: December 2018

An efficient and accurate model for the dynamic assessment of vehicle-track behavior subjected to cross wind actions is developed in this paper, where the wind–vehicle–track interaction is regarded as a coupled vibration system. First, a vehicle–track interaction model is proposed by taking the hypotheses of wheel/rail rigid contact and displacement complementarity. Unlike explicit force-based methods, the vehicle-track systems are wholly coupled by interaction matrices and load vectors, which are computationally more efficient than most of the existing methods and fairly accurate in low frequency vibrations. Then, the fluctuating cross winds are simulated by the fast Fourier transform technique from spectral representations with the consideration of spatial correlation of multipoint wind time histories and vehicle movement. The unsteady cross wind forces are obtained by introducing weighting function. Finally, a modeling framework, with the coupled interactions between cross winds, vehicle, and the tracks included, is built effectively. Through the validated dynamic model, the cross wind effects on vehicle-track dynamic performance can be fully revealed. Besides, it is concluded that the dynamic performance of vehicle-track systems differs significantly in various excitation modes, i.e., average cross wind, fluctuating cross wind, and track irregularities.
Hydraulic Modal Analysis in Theory and Practice
Authors: Mikota Gudrun , Manhartsgruber Bernhard , Hammerle Franz , Brandl Andreas
Published: December 2018

Theoretical and experimental modal analyses are treated for hydraulic systems modeled by discrete capacities, inductances, resistances, and fluid lines with dynamic laminar flow. Based on an approximate multi-degrees-of-freedom description, it is shown how hydraulic natural frequencies, damping ratios, and mode shapes can be identified from measured frequency response functions between flow rate excitation and pressure response. Experiments are presented for a pipeline system that includes three side branches and an accumulator. In view of practical applications, two different types of servovalve excitation as well as impact hammer excitation are considered. Pressure is measured by 19 sensors throughout the system. Results are compared in terms of frequency response functions between 50 and 850 Hz, the first five hydraulic modes, and weighted auto modal assurance criteria of experimental mode shapes. Out of the tested excitation devices, the servovalve is clearly preferred; if valves cannot be used, the impact hammer offers a reasonable workaround. For a reduced number of five sensors, different sensor arrangements are assessed by the respective weighted auto modal assurance criteria of experimental mode shapes. A theoretical hydraulic modal model provides a similar assessment. The quality of the theoretical model is confirmed by the weighted modal assurance criterion of theoretical and experimental mode shapes from servovalve excitation.
Time Domain Simulation of Lifting Bodies Acting at or Near the Free Surface With Vortex Particle Wakes
Authors: Gouveia Rachel , Fitzpatrick Stephanie , Costa Amanda , Kring David
Published: December 2018

Boundary element method (BEM) potential-flow solvers are regularly used in industrial applications due to their quick setup and computational time. In aerodynamics, vortex particle methods (VPM) are widely used with BEM potential-flow solvers for modeling lift. However, they are seldom applied to the ocean environment. This paper discusses the implementation of a VPM into Aegir, an existing time-domain, seakeeping, medium-fidelity, BEM potential-flow solver. The wake in the VPM is modeled using both a small dipole buffer wake sheet and vortex particles. It has been observed that this method captures both the details of complex wake patterns behind lift-producing surfaces and the expected lift force, thus improving the accuracy of the solution. Two new contributions presented in this paper include the extension of the VPM from previous source-based methods to a potential formulation and full interaction with free surface waves.