bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute-on-chronic liver failure: definition, prognosis and management
Authors: Amin Ahmed , Mookerjee Rajeshwar P
Published: November 2019

Acute-on-chronic liver failure (ACLF) is a recently described entity in chronic liver disease defined by acute hepatic decompensation, organ failure and a high risk of short-term mortality (usually less than 4 weeks). This condition is distinct from acute liver failure and stable progression of cirrhosis in numerous ways, including triggering precipitant factors, systemic inflammation, rapid progression and a potential for recovery. While a clear definition of ACLF has been forwarded from a large European Consortium study, some heterogeneity remains in how patients present and the types of organ failure, depending on whether they are described in Asian or European studies. Active alcoholism, acute alcoholic hepatitis and infections are the most frequent precipitants for ACLF. Underpinning the pathophysiology of ACLF is a state of persistent inflammation and immune dysfunction, collectively driving a systematic inflammatory response syndrome and an increased propensity to sepsis. Prevention and early treatment of organ failure are key in influencing survival. Given increasing organ shortage and more marginal grafts, liver transplantation is a limited resource and emphasises the need for new therapies to improve ACLF outcomes. Recent data indicate that liver transplantation has encouraging outcomes even in patients with advanced ACLF if patients are carefully selected during the permissive window of clinical presentation. ACLF remains a significant challenge in the field of hepatology, with considerable research and resource being channelled to improve upon the definition, prognostication, treatment and unravelling of mechanistic drivers. This Review discusses updates in ACLF definition, prognosis and management.
Leadership development in New Zealand and Australian medical schools: needs analysis
Authors: Lyons Oscar , McHardy Karina , Bagg Warwick , Wilkinson Tim
Published: November 2019

Background

Leadership is a core competency of doctors. However, specific learning outcomes for leadership are often not well defined in medical school curricula. This article uses New Zealand (NZ) and Australian medical school curricula as a case example for conducting a needs analysis of leadership learning outcomes.

Aims

To identify which elements of medical leadership development are already met by Australian Medical Council (AMC) Outcomes for Graduates, which elements are missing, and which missing elements might reasonably be included in prequalification curricula in NZ and Australia.

Methods

The Medical Leadership Competency Framework (MLCF) was selected as the reference framework for a general needs analysis of leadership development in the AMC curriculum.

To identify curriculum gaps, we first assessed the achievability of MLCF Domains at an undergraduate level. We then considered whether the AMC Outcomes for Graduates would satisfy each MLCF Domain. Where MLCF Domains were judged unachievable at the undergraduate level, we considered whether foundations were sufficiently laid for future development.

Results

Five of eight (63%) undergraduate MLCF Domains and 7 of 12 (58%) postgraduate domains were found to be already satisfied by the AMC Outcomes for Graduates.

Some key elements of leadership as described in the MLCF are not yet encapsulated in the AMC Outcomes for Graduates. Two particularly notable absences are audit and quality improvement.

Conclusions

Leadership is multidimensional. Some dimensions may be more appropriately learnt after medical school. There are, however, significant gaps in current curricula in Australia and NZ as defined by the AMC. These could be met more effectively using the MLCF.
An Unrestricted Learning Procedure
Authors: Mendelson Shahar
Published: November 2019

We study learning problems involving arbitrary classes of functions
F
, underlying measures μ, and targets
Y
. Because
proper
learning procedures, i.e., procedures that are only allowed to select functions in
F
, tend to perform poorly unless the problem satisfies some additional structural property (e.g., that
F
is convex), we consider
unrestricted learning procedures
that are free to choose functions outside the given class.

We present a new unrestricted procedure whose sample complexity is almost the best that one can hope for and holds for (almost) any problem, including heavy-tailed situations. Moreover, the sample complexity coincides with what one could expect if
F
were convex, even when
F
is not. And if
F
is convex, then the unrestricted procedure turns out to be proper.
Pyridoxal-5′-Phosphate Promotes Immunomodulatory Function of Adipose-Derived Mesenchymal Stem Cells through Indoleamine 2,3-Dioxygenase-1 and TLR4/NF-κB Pathway
Authors: Li Cong , Huang Jinxian , Zhu Huasu , Shi Qing , Li Dong , Ju Xiuli
Published: November 2019

Adipose-derived mesenchymal stem cells (A-MSCs) are promising cellular therapies for the treatment of immune-mediated diseases. Non-gene editing technologies can improve the immune regulatory function of A-MSCs. Our preliminary experiments revealed that an active form of vitamin B6—pyridoxal-5′-phosphate (PLP)—plays an important role in regulating gene expression and cytokine secretion in A-MSCs in vivo. To further clarify the effect of PLP on receptors and cytokines related to the immune regulatory function of A-MSCs, a series of experiments were designed to verify the relationships between PLP and A-MSCs in vitro. Initially, A-MSCs were obtained, and cytokine secretion and the expression of IDO1, NF-κB, and Toll-like receptors in PLP-stimulated A-MSCs were evaluated. In addition, coculture was used to detect A-MSCs-mediated apoptosis of CD3+CD8+ T lymphocytes. These results showed that A-MSCs stimulated with PLP were highly proliferative, consistent with their pluripotent capacity. Further, the surface receptors TLR3, TLR4, IDO1, and NF-κB were upregulated, while TLR6 was downregulated. Concurrently, A-MSCs preconditioned with PLP had the greatest inhibitory effect on CD3+CD8+ T lymphocyte proliferation, indicating that PLP altered the immune regulatory function of A-MSCs through the regulation of TLRs and IDO1 expression.
Oxidative Stress Indexes for Diagnosis of Health or Disease in Humans
Authors: Sánchez-Rodríguez Martha A. , Mendoza-Núñez Víctor Manuel
Published: November 2019

Oxidative stress (OS) is the imbalance between oxidant and antioxidant molecules, in favor of oxidants, that causes aging and disease. Many studies have been published that demonstrate the relationship between OS and human health and disease; however, the following questions arise: (i) how are we sure that the OS is present in a biological process? (ii) Is the OS reported in the different investigations equivalent? (iii) What are the best oxidant and antioxidant markers for OS diagnosis? (iv) Can we establish the types and the intensity of the OS? (v) Does OS index could be useful for research and/or application in clinical medicine? In this regard, several indexes have been proposed to measure OS in humans relative to the state of health and disease, among which the following can be highlighted:Oxidative Stress Index(OSI),Tiol Ratios(-SH/TT, -SS/-SH, and-SS/TT),Glutathione Ratio(GSSG/GSH),Oxidative Stress Score(OSS), andOXY-index. Therefore, the aim of this review is to present the state of the art of knowledge about OS indexes for diagnosis of health or disease in humans. We searched for articles in English or Spanish in the PubMed/MEDLINE and Scopus electronic databases published up until May 2019. The keywords used were “oxidative stress,” “index,” and “oxidative stress index.” It was identified 11479 records in both databases, and 490 articles were analyzed. Our review suggests that all indexes analyzed allow diagnose and differentiate the OS related to human health and disease. Also, the studies on OSI, Oxy-score, and OSS indexes have proven to be reliable, practical, and with clinical utility. However, it is necessary to continue with longitudinal studies, especially assess the usefulness of the indexes in the clinical prognosis, and make comparative studies between the different indexes.
Dendritic Cells Loaded with Heat Shock-Conditioned Ovarian Epithelial Carcinoma Cell Lysates Elicit T Cell-Dependent Antitumor Immune Responses In Vitro
Authors: Flores Iván , Hevia Daniel , Tittarelli Andrés , Soto Dafne , Rojas-Sepúlveda Daniel , Pereda Cristián , Tempio Fabián , Fuentes Camila , Falcón-Beas Cristian , Gatica Jimena , Falcón-Beas Felipe , Galindo Mario , Salazar-Onfray Flavio , González Fermín E. , López Mercedes N.
Published: November 2019

Ovarian epithelial carcinoma (OEC) is the most frequent ovarian tumor, characterized by a high mortality in advanced stages where conventional therapies are not effective. Based on the role of the immune system in the progression of this disease, immunotherapy using checkpoint blockade has been considered as a therapeutic alternative. Nevertheless, its results do not match up to the positive results in entities like melanoma and other malignancies, suggesting the need to find other therapies to be used alone or in combination. Dendritic cell- (DC-) based vaccines have shown promising results in several types of cancer, such as melanoma, prostate, and lung cancers, due to the essential role played by DCs in the activation of specific T cells, thus using other ways of activating the immune response than immune checkpoint blockade. During the last decade, we have used DC-based vaccines loaded with an allogeneic heat shock-conditioned melanoma cell lysate in the treatment of advanced stage patients in a series of clinical trials. In these studies, 60% of treated patients showed immunological responses which correlated positively with improved survival. Considering the relevance of ovarian cancer and the promising results of our DC-based vaccine, we show here that heat shock-conditioned cell lysates derived from ovarian epithelial carcinoma cell lines have the potential to induce the phenotypic and functional maturation of human DC, which in turn, is able to induce an efficient CD4+ and CD8+ T cell-mediated immune responses against ovarian cancer cell lines in vitro. In summary, OEC heat shock-conditioned cell lysate-loaded DCs may be considered for future combined immunotherapy approaches against ovarian tumors.
ОСОБЛИВОСТІ ПОВЕДІНКОВИХ ЧИННИКІВ РИЗИКУ ОСНОВНИХ НЕІНФЕКЦІЙНИХ ЗАХВОРЮВАНЬ У ГРУПАХ ЕКОНОМІЧНО АКТИВНОГО НАСЕЛЕННЯ
Authors: Vlasyk L. Y.
Published: November 2019

Мета: визначити особливості поведінкових чинників ризику в певних групах економічно активного населення, які можуть бути враховані при впровадженні профілактичних інформаційно-мотиваційних технологій на рівні первинної медичної допомоги.

Матеріали і методи. Проведено поетапне дослідження особливостей поширеності поведінкових чинників ризику основних неінфекційних захворювань серед економічно активного населення, відібрано 1252 анкети для аналізу. При аналізі вибірки вибрано довірчий рівень 95 %. Використано соціологічні (анкетування, інтерв’ювання, спостереження) та статистичні методи.

Результати. Встановлено, що більшість респондентів (53,79 %) не споживала достатню кількість фруктів, дещо менше (41,80 %) – овочів, абсолютна більшість (77,97 %) рідко споживала рибу та обмежувала сіль (71,00 %), лише 42,17 % респондентів займалися певними фізичними вправами (від зарядки до 4–5 разів на тиждень тривалістю не менше 30 хв). Поширеність тютюнокуріння серед економічно активного населення склала 27,88 %, серед чоловіків – 35,99 %, серед жінок – 20,06 %, причому серед жінок основної групи «ринок» він вищий (25,00 %), ніж серед жінок «інші категорії» (15,09 %) (р˂0,01). Жінки, які працюють на ринку, піддаються впливу тютюнового диму (активне куріння та вторинний тютюновий дим) так само як чоловіки, проте значно частіше (65,63 %), ніж жінки інших категорій (41,51 %) (р˂0,001). Куріння жінок підвищує ризик зловживання алкоголем (ВШ (OR) 3,717 95 % ДІ (CI) (2,369–5,829)). Найчастіше серед проблем із здоров’ям респонденти відзначали стрес, перевтому (34,30 %). За даними респондентів, кожний другий враховував поради лікаря, майже кожний четвертий дотримувався їх, проте відчутний результат спостерігали лише у питаннях харчування.

Висновки. Виявлені гендерні, вікові, за місцем зайнятості особливості харчової поведінки,  фізичної активності, тютюнокуріння та вживання алкоголю рекомендовано враховувати лікарям первинної медичної допомоги при проведенні профілактичних втручань у щоденній практиці.
МУЛЬТИСЕКТОРАЛЬНИЙ ПІДХІД У НАДАННІ МЕДИЧНОЇ ДОПОМОГИ ХВОРИМ НА ІНФАРКТ МІОКАРДА ЯК ВАЖЛИВА СКЛАДОВА ГРОМАДСЬКОГО ЗДОРОВ’Я
Authors: Terenda N. O. , Shulgai A. G. , Slobodian N. O. , Romanyuk L. M.
Published: November 2019

Мета: обґрунтувати мультисекторальний підхід у наданні медичної допомоги хворим на інфаркт міокарда (ІМ).

Матеріали і методи. Використано методи системного підходу та системного аналізу для комплексного дослідження проблем надання медичної допомоги хворим на ІМ та концептуального моделювання для обґрунтування мультисекторального підходу в наданні медичної допомоги хворим на інфаркт міокарда.

Результати. Важливим доменом оптимізованої системи надання медичної допомоги хворим на ІМ є мультидисциплінарна робоча система з чітко визначеними структурними та організаційними технологіями, інтеграційними зв’язками, яка буде ефективно працювати та виконувати свої завдання тільки при застосуванні мультисекторального підходу.

Якісний та ефективний процес надання медичної допомоги пацієнтам з ІМ буде відбуватись тільки при наявності якісного та ефективного фундаменту, що включає процеси та рішення на рівні державних органів влади, територіальних громад, соціальних служб, громадських організацій та засобів масової інформації. Значну роль у боротьбі з факторами ризику (ФР) розвитку ІМ, ранній госпіталізації пацієнтів з ІМ, призначенні оптимального лікування відіграє соціальне середовище, в якому перебуває пацієнт.

Висновки. Міжсекторальна співпраця і міждисциплінарна структурна та функціональна координація дій у наданні медичної допомоги хворим на ІМ забезпечить рівноправний доступ пацієнтів до спеціальних медичних послуг, удосконалення та розширення комунікаційних зв’язків різної спрямованості, що дозволить покращити якість життя пацієнтам з ІМ.
ГРИП ТА ПИТАННЯ ВАКЦИНАЦІЇ ДІТЕЙ
Authors: Nykytyuk S. O. , Boyarchuk O. R. , Levenets S. S. , Matsipura S. V. , Zagorskaya O. M.
Published: November 2019

Мета: підвищити обізнаність населення, медичних працівників, студентів щодо епідемічної ситуації на грип і ГРВІ та можливих наслідків захворювання і методів їх профілактики шляхом донесення інформації до широкого загалу не тільки медиками, але і громадськими організаціями.

Матеріали і методи. Проаналізовано показники вакцинації проти грипу за 2018 р. серед населення Тернопіль­ської області, враховуючи  дані Тернопільського обласного лабораторного центру МОЗ України.

Результати. Вакцинація від грипу необхідна дітям, здоровим дорослим людям, а також пацієнтам із високим ризиком виникнення та тяжким перебігом інфекцій. За даними ВООЗ, щороку зростає рівень захворюваності та випадки тимчасової непрацездатності на грип та ГРВІ, що призводить до значних економічних збитків. У роботі проаналізовано сучасні можливі методи профілактики і хіміотерапії грипу в людей, рекомендовані ВООЗ. Проведено аналіз вірусів, що циркулювали в 2018 р., та методи профілактики грипу за 2018 р. у Тернопільській області серед дорослого і дитячого населення. Розраховано можливі показники захворюваності на наступний епідемічний сезон із урахуванням штамів вірусів грипу, які будуть циркулювати. Показано необхідність зростання ролі громадських організацій, зокрема всеукраїнської ГО «Батьки за вакцинацію», в питанні профілактики даних захворювань.

Висновки. Враховуючи низький відсоток вакцинованих людей, особливо дитячого населення, необхідно приділити велику увагу профілактиці грипу не тільки медикам, але і громадським організаціям.
ВПРОВАДЖЕННЯ У ПРОЦЕС НАВЧАННЯ ФАХІВЦІВ ПЕРВИННОЇ ЛАНКИ МЕДИЧНОЇ ДОПОМОГИ ВОЛИНСЬКОЇ ОБЛАСТІ СУЧАСНИХ ЗНАНЬ З ІНТЕГРОВАНОГО ВЕДЕННЯ ВИПАДКІВ ГІПЕРТЕНЗІЇ ТА ЦУКРОВОГО ДІАБЕТУ
Authors: Sichkoriz O. Ye. , Gutor T. H. , Kovalska O. R. , Rymarenko K. P.
Published: November 2019

Мета: проаналізувати можливості організації навчання фахівців первинної медичної допомоги Волинської області з питань профілактики неінфекційних захворювань та інтегрованого ведення пацієнтів із гіпертензією та цукровим діабетом.

Матеріали і методи. У роботі використано комплекс специфічних методів досліджень соціальної медицини, а також наукової педагогіки:  системного підходу та системного аналізу, медико-статистичний, моделювання, організаційного експерименту, контент-аналізу, інструментальний, емпіричний, навчально-дидактичний та наукового пізнання.

Результати. Дводенний навчальний курс «Інтегроване ведення випадків гіпертензії та діабету» розроблено національною групою експертів за технічної підтримки ВООЗ і запропоновано для подальшої імплементації в Україні. Цей курс є оптимальним для підготовки фахівців первинної медичної допомоги.

Методики тренінгу включають інтерактивні лекції, практичні заняття, розгляд клінічних випадків та відпрацювання практичних навичок. Обов’язковим є оцінювання занять, тренерів, тренінгу в цілому. До навчально-методичних матеріалів входять мультимедійні презентації лекцій, роздаткові матеріали для кожного учасника тренінгу.

Водночас заплановано запровадити розроблені дистанційні курси з питань неінфекційних захворювань, за успішне проходження яких сімейні лікарі зможуть отримувати бали безперервного професійного розвитку.

Висновки. Для забезпечення існування висококваліфікованої та якісної медичної допомоги необхідна наявність достатньої кількості професіоналів, навчених її надавати. Ключову роль у системі профілактики неінфекційних захворювань (зокрема гіпертензії та цукрового діабету) відіграють працівники, які працюють на первинній ланці медичної допомоги. Якщо вони пройдуть якісну підготовку з вищезазначених питань, існує реальна можливість того, що це матиме позитивний вплив на результати їхньої роботи з профілактики неінфекційних захворювань у пацієнтів.
Vowel Harmony and Disharmony Are Not Equivalent in Learning
Authors: Martin Alexander , White James
Published: November 2019

General vowel harmony and disharmony rules have comparable formal complexity but differ dramatically in typological frequency and phonetic motivation. Previous studies found no difference in learning between vowel harmony and disharmony; this putative equivalence has been used to discount the view that learners are influenced by substantive learning biases. In the current study, we use a more nuanced test to show that there is a clear difference in learning between vowel harmony and disharmony: learners readily infer a vowel harmony pattern, but not a disharmony pattern. The findings suggest that vowel disharmony is in fact strongly disfavored during learning.
Prose Fiction
Authors: Ribó Ignasi
Published: November 2019

This concise and highly accessible textbook outlines the principles and techniques of storytelling. It is intended as a high-school and college-level introduction to the central concepts of narrative theory – concepts that will aid students in developing their competence not only in analysing and interpreting short stories and novels, but also in writing them.

This textbook prioritises clarity over intricacy of theory, equipping its readers with the necessary tools to embark on further study of literature, literary theory and creative writing. Building on a ‘semiotic model of narrative,’ it is structured around the key elements of narratological theory, with chapters on plot, setting, characterisation, and narration, as well as on language and theme – elements which are underrepresented in existing textbooks on narrative theory. The chapter on language constitutes essential reading for those students unfamiliar with rhetoric, while the chapter on theme draws together significant perspectives from contemporary critical theory (including feminism and postcolonialism).

This textbook is engaging and easily navigable, with key concepts highlighted and clearly explained, both in the text and in a full glossary located at the end of the book. Throughout the textbook the reader is aided by diagrams, images, quotes from prominent theorists, and instructive examples from classical and popular short stories and novels (such as Jane Austen’s Pride and Prejudice, Franz Kafka’s ‘The Metamorphosis,’ J. K. Rowling’s Harry Potter, or Dostoyevsky’s The Brothers Karamazov, amongst many others).

Prose Fiction: An Introduction to the Semiotics of Narrative can either be incorporated as the main textbook into a wider syllabus on narrative theory and creative writing, or it can be used as a supplementary reference book for readers interested in narrative fiction. The textbook is a must-read for beginning students of narratology, especially those with no or limited prior experience in this area. It is of especial relevance to English and Humanities major students in Asia, for whom it was conceived and written.
1. Introduction
Authors: Ribó Ignasi
Published: November 2019

In this chapter, we will introduce some basic ideas about storytelling, and in particular about the narrative forms of literature and the ways in which they create meaning. We will also present the main genres into which literary narratives have been divided historically, and how these genres have evolved from their origins until today. We will then try to define and frame the two genres of prose fiction that are more common nowadays and from which we will draw the examples in this textbook: short stories and novels.
3. Setting
Authors: Ribó Ignasi
Published: November 2019

In this chapter, we will discuss in some detail how the environments of the storyworld are arranged in narrative. We will begin by defining what we understand by environment and the crucial role of environments in building the world of short stories and novels. We will then distinguish two basic ways to arrange environments into a fictional setting: as a topographical layout of natural and artificial things in space or as atmospheric relationships between those same things and the characters of the story. This distinction will allow us to present a typology with four major kinds of setting that may be found in prose fiction: irrelevant, functional, mental, and symbolic. We will then see how literary narratives use description to represent the setting and induce in the reader’s mind a vivid image of the storyworld. Finally, we will discuss the notion of verisimilitude and show how literary description can be used to encourage readers to read fictional stories as if they were happening in the ‘real’ world.
5. Narration
Authors: Ribó Ignasi
Published: November 2019

First, we need to define more precisely what we mean by narration and the relationship between narration and the story being narrated. Then we will look more closely at the two figures of discourse involved in narration, the narrator and the narratee, outlining the types most commonly found in prose fiction. We will then examine the concept of focalisation, an important and closely related aspect of narration, which refers to the point of view or perspective adopted by the narrator of the story. Next, we will discuss in more detail the basic means by which narrators can represent events, characters, and environments: telling and showing. But narrators, besides representing the existents of the storyworld, often also make comments about them. To conclude the chapter, therefore, we will consider the use of explicit and implicit commentary in prose fiction.
6. Language
Authors: Ribó Ignasi
Published: November 2019

In this chapter, we will present some key insights about the language of short stories and novels, mostly derived from rhetoric and stylistics, without fleshing out all the linguistic details. To begin with, we need to explain what we mean by style, a characteristic set of linguistic features that is sometimes attributed to the implied author of a story, but also to the real author, or even to a group of authors or to a whole culture. Then, we will discuss the notion of foregrounding, which can help us to identify with more precision the features that distinguish literary from everyday language. Foregrounding in prose fiction can involve different aspects of language, such as the use of figurative devices or figures of speech. After reviewing the most significant of these devices for narrative prose, we will examine the use of symbols and allegory in short stories and novels, an aspect of discourse that brings together language and theme. We will end the chapter by briefly pointing out the importance of literary translation in giving readers access to the rich variety of prose fiction stories written all over the world.
Throughput Analysis of Energy-Efficient Combined Packet Combining-Aggressive Packet Combining Scheme in Two State Scenarios
Authors: Kundu Mayuri , Sarkar Argha , Chakraborty Swarnendu Kumar
Published: November 2019

Packet combining (PC) and aggressive packet combining (APC) are studied earlier in several kinds of literature. Both schemes have shortcomings to achieve higher throughput. In this paper, PC-APC scheme is proposed to attain higher throughput. Combination of these two schemes shows the
remarkable result in some of the cases based on the state of the communication channel. Also the rate of erroneous packet delivery decrease in this scheme. Here the benefits of both schemes (PC and APC) are obtained as well as it eliminates the detriments. The comparisons of PC, APC and PC-APC
schemes with respect to bandwidth and power consumption issues are particularly focused on. Throughput can be optimized through PC-APC assisted schemes.
From tokens to key players: The influence of board gender and ethnic diversity on corporate discrimination lawsuits
Authors: Abebe Michael , Dadanlar Hazel
Published: November 2019

Does the appointment of more women and ethnic minority directors on corporate boards help combat discriminatory work environments? This empirical study addresses this question by exploring the occurrence of large-scale discrimination lawsuits. Drawing from social identity theory and empathy-based perspectives, we propose that a greater presence of female and minority directors on boards reduces the likelihood of large-scale discrimination lawsuits given their propensity to advocate for underrepresented groups in the workplace. Our analysis of data from 452 US firms from 2010–2015 indicates that a higher proportion of female and minority directors on boards is associated with a lower likelihood of such lawsuits. Specifically, the likelihood of such lawsuits is lower where there are three or more (a critical mass) female and minority directors. “Token” appointments (one or two female or minority directors) do not reduce the occurrence of these lawsuits. Further, the joint presence of minority and female directors on boards significantly reduces the likelihood of such lawsuits. Finally, we found that female CEOs help in reducing the occurrence of such lawsuits when the board has two or more female directors. Overall, our findings highlight the utility of greater gender and ethnic diversity on boards in combating workplace discrimination.
The problem with stories about teacher “burnout”
Authors: Santoro Doris A.
Published: November 2019

When teachers talk about leaving the profession, they are commonly described as “burnt out.” But for many, argues Doris Santoro, that’s not the real story. In truth, most teachers enter teaching because they want to pursue moral commitments to the well-being of their students, colleagues, and communities. In-depth interviews with experienced teachers as well as studies of teachers’ resignation letters suggest that moral concerns are what led many of them to quit, as well: They leave not because they’ve become exhausted by the demands of the work but, rather, because school policies are preventing them from doing the good and just work they aspire to do.
Student growth measures: What we’ve been missing
Authors: Watson Michael
Published: November 2019

The move toward assessments that measure student growth, rather than just proficiency, has been perceived as an improvement in state accountability systems. However, Michael Watson explains that, for many students, these measures present an incomplete picture. Because they are based on grade-level assessments, any growth achieved by students who are above or below grade level is lost. He recommends the use of adaptive assessments that incorporate material from multiple grade levels.
On Leadership: Gen Z on race and teaching
Authors: Starr Joshua P.
Published: November 2019

PDK’s CEO, Joshua Starr, observes that the incoming generation of teachers seems far more ready and willing than their older colleagues to talk explicitly about race. School and system leaders should actively support young educators’ eagerness to confront the history of racial inequities in our public schools.
Backtalk: Keep religion out of mindfulness
Authors: Armstrong Thomas
Published: November 2019

Mindfulness practices have become increasingly common in the United States and elsewhere in the world. The fact that mindfulness originally emerged out of Buddhism raises questions about whether public school teachers using it in their classrooms are violating the separation of church and state. Thomas Armstrong argues that contemporary mindfulness rests on a solid foundation of scientific research and can help students improve their self-regulation, executive functioning, sustained attention, and other school-worthy skills. There is a danger, however, that injecting Buddhist or Hindu-associated gestures, postures, words, or concepts into the teaching may violate the First Amendment. Public school teachers are enjoined to be scrupulously vigilant in presenting mindfulness practices in a totally secular way.
Utopian Conservation: Scientific Humanism, Evolution, and Island Imaginaries on the Galápagos Islands
Authors: Bocci Paolo
Published: November 2019

In 1959, the Charles Darwin Station and the Galápagos National Park were established, formally inaugurating conservation on the archipelago. In the same year, a utopian colony from the United States arrived. Whereas scholars have dismissed the latter and focused on the former, this essay unveils the science-inspired utopianism common to both enterprises. Investing science with the exclusive role of producing all knowledge and steering politics, leaders of the two initiatives aspired not only to protect nature but also to forge a new humanity. Describing how such ambitions burst along lines of race, class, and nationality, I argue that these enterprises consolidated the current understanding of the Galápagos as “pristine”: a site fit for research and tourism but unhospitable to (other) people. Drawing on archival and historical documents, this essay aims to reinvigorate two conversations: one between science and technology studies (STS) and conservation, and the other between STS and utopian studies. If recent attempts at bridging the divide between science and imagination have emphasized how powerful actors shape human society, this essay considers the long-lasting effects of scientific imaginaries on a politics of nature.
India, Palm Oil, and Ecologically Unequal Exchange: A Cross-national Analysis of Forest Loss
Authors: Sommer Jamie M. , Restivo Michael , Shandra John M.
Published: November 2019

Drawing on ecologically unequal exchange theory and previous research, we assess whether palm exports from low- and middle-income nations to India increase forest loss in exporting nations. Using ordinary least squares (OLS) regression for a sample of 91 low- and middle-income nations, we find support for our main hypothesis that palm exports sent from low- and middle-income nations to India are related to increased forest loss in the exporting nations. Our findings refine and expand upon ecologically unequal exchange theory by demonstrating that India, a middle-income nation, nevertheless is capable of positioning itself favorably in trading opportunities with other low- and middle-income nations. As India meets its needs for palm oil from abroad which is central to its economic growth and industrialization, their low- and middle-income trading partners bear more of the burden of environmental harms from the extraction and export of palm oil.
Evaluating Networks for Collaborative Planning and Management
Authors: Margerum Richard D. , Parker Robert
Published: November 2019

Collaboration is used to address a range of complex problems, but there is less research on ongoing collaboration networks. We use interviews, document analysis, focus groups, and a survey to evaluate transportation networks in Oregon. Participants were positive about network operations, but the research highlighted how a centralized network limited goal sharing and multilevel functioning. Information procedures built group expertise and defined the network’s practical authority, despite a broader mandate. Representing diffuse interests was a challenge that requires further research. These findings highlight options for designing and improving collaboration networks relevant to a range of planning and management settings.
Women’s Intention to Consent to Universal Screening for Intimate Partner Violence (IPV) at Well Baby Clinics
Authors: Ben Natan Merav , Ionov Anastasia , Baum Moshe , Gotkin Yulianna
Published: November 2019

The Israeli Ministry of Health requires medical and nursing staff in both hospitals and community settings, screen all women for Intimate Partner Violence (IPV). This study explored factors associated with the intention of Israeli women to consent to universal IPV screening during their visits to well baby clinics, using the Theory of Planned Behavior (TPB). Two hundred Jewish women of childbearing age completed a questionnaire based on the TPB. Only 52% of the women reported that they had undergone IPV screening conducted by nurses at well baby clinics in the last year. The TPB was found to predict 44% of the variance in women’s intention to consent to universal IPV screening, whereas control beliefs, perceived behavioral control, and normative beliefs with regard to universal screening, were found to be the most significant predictors. These findings may help design interventions aimed at raising women’s intentions to consent to universal IPV screening.
The Ministry of Information and the linguistic design of Britain’s World War II propaganda: What archival documents can tell us about political discourse
Authors: Spencer-Bennett Joe
Published: November 2019

This article argues that metalinguistic documents in historical archives are a useful source for political discourse analysts to explore. With reference to the archives of the British Ministry of Information in World War II, it shows that such documents are revealing of the orders of discourse and the language ideologies that contribute to the production of political discourse. Archival documents can help us to understand the ways in which political actors conceive of the linguistic strategies that are typically the focus of our discourse analytic work. In a field which places great theoretical emphasis on the contextual significance of political language, archival documents thus represent a crucial, but hitherto overlooked, source of evidence. More specifically, the article demonstrates that the Ministry of Information’s civil servants paid a great deal of attention to language, working in highly reflexive ways to produce their discourse, and that one of the linguistic strategies that was particularly intensely discussed was the use of informal and personalised language. Those civil servants were working on a ‘synthetically personalised’ language half a century before discourse analysts began paying sustained attention to such a strategy.
Polarized perceptions, polarized preferences? Understanding the relationship between inequality and preferences for redistribution
Authors: Bobzien Licia
Published: November 2019

When studying the relationship between inequality and preferences for redistribution, it is often assumed – either implicitly or explicitly – that individuals are informed about actual levels of inequality. Newer research, however, challenges this assumption and shows that perceived inequality differs from actual inequality. Empirically, these inequality perceptions are rather good predictors for preferences for redistribution. This article argues that individuals answer the standard question for measuring preferences for redistribution based on their inequality perceptions. I conduct a simple regression analysis based on two waves of the ISSP (1999 and 2009) and show that (1) inequality perceptions are systematically linked to socio-economic variables as well as to ideological beliefs rather than to actual inequality. Then, I disaggregate the variance in inequality perceptions to a part which is explainable by socio-economic and ideological determinants (the common control variables for explaining preferences for redistribution) and an unexplained part. I show that (2) the explained as well as the unexplained variance part is associated with preferences for redistribution. I argue that this finding makes considering inequality perceptions practically relevant since standard control variables do not fully account for variation in perceived inequality.
A Review of Literature on Health-Related Quality of Life of Retinoblastoma Survivors
Authors: Belson Paula J. , Eastwood Jo-Ann , Brecht Mary-Lynn , Hays Ron D. , Pike Nancy A.
Published: November 2019

Background: Retinoblastoma is a malignant tumor of the eye that typically presents in early childhood and occurs in approximately 1 in 20,000 births. While active treatment of the tumor is typically completed in childhood, survivors often suffer from long-term effects from treatment including visual impairment, facial deformities, and fear of recurrence or secondary cancer. However, little is known how these long-term effects affect their health-related quality of life (HRQOL). Purpose: To review the literature on HRQOL in retinoblastoma survivors. Method: We searched three electronic databases from January 2005 to December 2018 for original research articles reporting on HRQOL or individual domains such as function, cognition, and psychosocial outcomes in retinoblastoma survivors. Results: A total of 59 articles were reviewed and 15 were identified as eligible. Five of the studies reported worse HRQOL in retinoblastoma survivors than controls or general population norms. Parent-proxy ratings were worse than survivors’ self-reports. Conclusion: Our findings confirm the need for further HRQOL research to assess the factors influencing long-term outcomes associated with treatment in adolescent and young adult retinoblastoma survivors. By identifying any potential deficits in specific domains of HRQOL, early interventions might be developed to improve HRQOL in retinoblastoma survivors.
Issues Involving International Adoption
Authors: Mounts Brandy , Bradley Loretta
Published: November 2019

Challenges in adoptive families are well-documented; however, a lack of empirical research on the preadoption preparation of prospective adoptive parents for these common challenges exists. The purpose of this study was to seek a more thorough understanding of the education and preparation adoptive parents receive regarding potential child issues in international adoption. A qualitative research design was utilized to gain more in-depth knowledge of the international adoption experience that included preadoption education, transitioning into a new family structure, and services utilized. Ten participants, who are parents of internationally adopted children, were recruited for this qualitative study. Three research questions were developed regarding the challenges adoptive parents experience, how preadoption services could be improved, and participants’ perceptions of preadoption training. The following six primary themes were identified: purpose, attachment, challenges experienced, inconsistent preparation, support systems, and families utilizing mental health services. Recommendations for professional practice are presented, including more current and consistent training for prospective adoptive parents as well as recommendations for increasing the numbers of family counselors with adoption expertise and enhancing counselor training to address adoption issues.
The impact of flushing with pre-filled saline syringes on the incidence of peripheral venous catheter failure: A quasi-experimental study
Authors: Saliba Patrick , Cuervo Guillermo , Hornero Ana , De Carli Gabriella , Marani Alessandra , Puro Vincenzo , Felisa López Ana , Iftimie Simona , Castro Antoni , Diaz-Brito Fernandez Vicens , Alvarez Moya Maria Carmen , Jimenez De La Rosa Cristina , Martínez-Sánchez José , Jimenez Emilio , Carratalà Jordi , Pujol Miquel
Published: November 2019

Background:

Short peripheral venous catheters are one of the most frequently used devices in hospitals. Peripheral venous catheter failure, defined as the unscheduled dysfunction of peripheral venous catheter, is common and frequently entails a new invasive procedure. Flushing the catheter maintains patency and could prolong peripheral venous catheter dwell time. The introduction of pre-filled saline flushing syringes as compared to manually filled saline flushing syringes could facilitate the frequency of catheter flushing, and subsequently it could reduce peripheral venous catheter failure rate.

Objective:

To demonstrate differences in overall peripheral venous catheter failure rates before and after the introduction of pre-filled saline flushing syringes and to assess the risk factors for peripheral venous catheter failure.

Methods:

Quasi-experimental design, before-and-after intervention study. Intervention: introduction of pre-filled saline syringes for flushing. Multicenter study conducted in medical and surgical wards of three European hospitals during a 9-month period (4 months pre-intervention, 5 months intervention). A multivariate Cox proportional model was used to identify factors associated with the occurrence of peripheral venous catheter failure.

Results:

Data from 3853 peripheral venous catheters in 1915 patients were analyzed. Compared to pre-intervention period, a significant decrease in peripheral venous catheter failure rate was observed in the intervention period (57% vs 43.4%, p < 0.001). Independent factors associated with peripheral venous catheter failure were as follows: Charlson score ⩾4 (hazard ratio: 1.648; 95% confidence interval: 1.069–2.527), days of hospital stay ⩾10 (hazard ratio: 1.468; 95% confidence interval: 1.172–1.837), and catheter “D” (hazard ratio: 1.758; 95% confidence interval: 1.058–2.919).

Conclusion:

The use of pre-filled saline syringes significantly reduced peripheral venous catheter failure and increased catheter dwell time. Thus, it is important to reinforce the use of the pre-filled syringes for flushing to reduce the incidence of peripheral venous catheters’ failure.
Prevalence and Socio-economic Impacts of Malnutrition Among Children in Uganda
Authors: Adebisi Yusuff Adebayo , Ibrahim Kirinya , Lucero-Prisno Don Eliseo , Ekpenyong Aniekan , Micheal Alumuku Iordepuun , Chinemelum Iwendi Godsgift , Sina-Odunsi Ayomide Busayo
Published: November 2019

Malnutrition is one of the common problems that afflict the poor in low- and middle-income countries like Uganda. The rate of decline of malnutrition in the country has been very slow for the last 15 years. This problem is of utmost concern in this era of Sustainable Development Goals (SDGs) in which achieving the goals is imperative. The aim of our study was to review literature on the prevalence and socio-economic impacts of malnutrition among children under 5 in Uganda and provide recommendations to address identified gaps. This review assesses available evidences, including journal articles, country reports, the World Health Organization (WHO) reports, the United Nations International Children’s Emergency Funds (UNICEF) reports, and other reports on issues pertaining to malnutrition among children in Uganda. Malnutrition, poverty, and chronic diseases are interconnected in such a way that each of the factors influences the presence and permanence of the other, resulting in a synergistic impact. The prevalence of acute and severe malnutrition among children under 5 is above the World Health Assembly target to reduce and maintain the prevalence under 5% by 2025. There are also limited studies on etiology of anemia as regards its prevalence in Uganda. The study presents a better understanding of the social and economic impact of child malnutrition on the families and the country’s development. The study also strongly suggests that, for Uganda to achieve sustainable development goal 2, financial investments by the government are necessary to address nutrition in the early stages of an individual’s life.
Occupational inequality in health expectancy in Denmark
Authors: Brønnum-Hansen Henrik , Foverskov Else , Andersen Ingelise
Published: November 2019

Background: The pension age in Denmark is adjusted in line with projected increasing life expectancy without taking health differentials between occupational groups into account. The purpose was to study occupational disparities in partial life expectancy and health expectancy between the ages of 50 and 75. Methods: Register data on occupation and mortality were combined with data from the Danish part of Survey of Health, Ageing and Retirement in Europe in 2010–2014 ( N=3179). Expected lifetime without and with activity limitations and without and with long-term illness was estimated by Sullivan’s method and comparisons made between four occupational groups. Results: We found clear differences between occupational groups. Expected lifetime without activity limitations between the ages of 50 and 75 was about 4.5 years longer for men and women in high skilled white-collar occupations than for men and women in low skilled blue-collar occupations. Men in high skilled blue-collar and low skilled white-collar occupations could expect 2.3 and 3.8 years shorter lifetimes without activity limitations, respectively, than men in high skilled white-collar occupations. For women in low skilled white-collar occupations, lifetime without activity limitations was 2.6 years shorter than for women in high skilled white-collar occupations. Due to few observations, no results were obtained for women in the high skilled blue-collar group. The social gradient was also significant when health was measured by years without long-term illness. Conclusions: The results support implementation of a flexible pension scheme to take into account the health differentials between occupational groups.
Combined dynamic multi-feature and rule-based behavior for accurate malware detection
Authors: Belaoued Mohamed , Boukellal Abdelaziz , Koalal Mohamed Amir , Derhab Abdelouahid , Mazouzi Smaine , Khan Farrukh Aslam
Published: November 2019

Malware have become the scourge of the century, as they are continuously evolving and becoming more complex with increasing damages. Therefore, an adequate protection against such threats is vital. Behavior-based malware detection techniques have shown to be effective at overcoming the weaknesses of the signature-based ones. However, they are known for their high false alarms, which is still a very challenging problem. In this article, we address this shortcoming by proposing a rule-based behavioral malware detection system, which inherits the advantages of both signature and behavior-based approaches. We apply the proposed detection system on a combined set of three types of dynamic features, namely, (1) list of application programming interface calls; (2) application programming interface sequences; and (3) network traffic, which represents the IP addresses and domain names used by malware to connect to remote command-and-control servers. Feature selection and construction techniques, that is, term frequency–inverse document frequency and longest common subsequence, are performed on the three extracted features to generate new set of features, which are used to build behavioral Yet Another Recursive Acronym rules. The proposed malware detection approach is able to achieve an accuracy of 97.22% and a false positive rate of 4.69%.