bluuebunny/crossref_metadata_2025 huggingface dataset:
Needs Assessment for a Medical Home Curriculum for Pediatric Residents
Authors: Turchi Renee M. , Narayan Aditee , Esquivel Michelle , Serwint Janet R.
Published: November 2017

Several studies and the Accreditation Council for Graduate Medical Education recommend integration of medical home (MH) concepts into pediatric resident training. There is a paucity of research depicting the current landscape of pediatric resident MH education. We hypothesized formal MH curricula in pediatric residency education are limited and pediatric residency programs desire incorporating MH education into curricula. A national needs assessment of pediatric residency programs was conducted assessing inclusion of MH concepts in training. Outcomes assessed were perceived importance of including MH concepts, satisfaction of current curriculum, content taught, resources available, and barriers encountered. Fifty-six programs (28%) completed the survey, majority academic programs. Nearly 75% indicated interest in incorporating MH concepts. Fifty-one percent of programs reported faculty knowledgeable in MH concepts/implementation and 11% reported access to readily available resources. Barriers included resident schedules, faculty teaching time, funding, and not faculty priority. Pediatric program directors report interest and need for improved MH training but identify implementation barriers.
Tandem autologous/allogeneic hematopoietic cell transplantation with bortezomib maintenance therapy for high-risk myeloma
Authors: Green Damian J. , Maloney David G. , Storer Barry E. , Sandmaier Brenda M. , Holmberg Leona A. , Becker Pamela S. , Fang Min , Martin Paul J. , Georges George E. , Bouvier Michelle E. , Storb Rainer , Mielcarek Marco
Published: November 2017

Key Points

Patients with high-risk multiple myeloma have a median survival of <3 years. Tandem autologous/allogeneic hematopoietic cell transplantation with bortezomib maintenance therapy improves survival in these patients.
A foot-care program to facilitate self-care by the elderly: a non-randomized intervention study
Authors: Omote Shizuko , Watanabe Arisu , Hiramatsu Tomoko , Saito Emiko , Yokogawa Masami , Okamoto Rie , Sakakibara Chiaki , Ichimori Akie , Kyota Kaoru , Tsukasaki Keiko
Published: November 2017

Objective

We aimed to evaluate a foot-care awareness program designed to improve foot morphology, physical functioning, and fall prevention among the community-dwelling elderly. Eleven independent community-dwelling elderly women (aged 61–83 years) were provided with foot-care advice and shown effective foot-care techniques to perform regularly for 6 months, and compared with a control group of 10 elderly women who did not receive any intervention. Measurements of foot form, functional capacity, subjective foot movement, and physical function were taken at baseline and 6-month follow-up.

Results

At follow-up, improvements were seen in the intervention group in foot morphology, subjective foot movement, foot pressure, and balance. In the intervention group, 90% of women had maintained or improved foot form and none of them had fallen during the post-intervention period, compared to the control group where 30% improved foot form (p = 0.0075) and four (40%) of them had fallen. Therefore, a foot-care program may have the potential to prevent falls and improve mobility among the elderly.

Trial Registration UMIN-CTR No. UMIN000029632. Date of Registration: October 19, 2017
Improving adherence in mental health service users with severe mental illness in South Africa: a pilot randomized controlled trial of a treatment partner and text message intervention vs. treatment as usual
Authors: Sibeko Goodman , Temmingh Henk , Mall Sumaya , Williams-Ashman Peter , Thornicroft Graham , Susser Ezra S. , Lund Crick , Stein Dan J. , Milligan Peter D.
Published: November 2017

Objectives

Medication non-adherence is a significant problem in treatment of severe mental disorders and is associated with poor clinical outcomes and increased demand on services. Task-shifting interventions incorporating mobile health may improve adherence in mental health service users in low- and middle-income countries. Seventy-seven participants were recruited from a psychiatric hospital in Cape Town, with 42 randomized to receive the intervention and 35 to treatment as usual. Intervention pairs underwent treatment-partner contracting and psychoeducation, and received monthly text message reminders of clinic appointments. Primary outcomes were intervention acceptability and feasibility. Secondary outcome for efficacy were adherence to clinic visit; relapse; quality of life; symptomatic relief and medication adherence.

Results

Treatment partner and psychoeducation components were acceptable and feasible. The text message component was acceptable but not feasible in its current form. Efficacy outcomes favoured the intervention but did not reach statistical significance. A treatment-partner intervention is acceptable and feasible in a low- and middle-income setting. Work is needed to ensure that additional components of such interventions are tailored to the local context. Appropriately powered efficacy studies are needed.

Trial Registration PACTR PACTR201610001830190, Registered 21 October 2016 (Retrospectively registered)
Screening in Trauma for Opioid Misuse Prevention (STOMP): study protocol for the development of an opioid risk screening tool for victims of injury
Authors: Brown Randall , Deyo Brienna , Riley Chelsea , Quanbeck Andrew , Glass Joseph E. , Turpin Rebecca , Hetzel Scott , Nicholas Christopher , Cruz Maireni , Agarwal Suresh
Published: November 2017

Background

Opioid addiction and overdose are epidemic in the U.S. Victims of traumatic injury are at greater than average risk for opioid misuse and related complications. Potential risk screens and preventive interventions in this clinical population remain under-investigated. The current project seeks to develop and pilot the implementation of a screening tool for opioid risk at American College of Surgeons (ACS) Level I and Level II trauma centers.

Methods

The project began with an online survey, which was sent to Wisconsin trauma center medical directors and trauma coordinators for the purpose of gathering information on current substance use screening practices. Next, a focus group of trauma center staff was convened to discuss barriers and facilitators to screening, resources available and needed to support trauma patients with opioid use disorders, and measurable clinical observations that could indicate a patient’s potential risk for opioid misuse. Data from the surveys and focus group were combined to inform the data collection instruments that are currently being administered to patients recruited from the University of Wisconsin Hospital Trauma Inpatient and Orthopedic Surgery Services. Eligible and consenting patients complete standardized measures of socio-demographics, substance use history, opioid misuse risk, mental health, medical history, and injury and pain severity. Follow up visits at weeks 4, 12, and 24 after hospital discharge assess hypothesized risk factors for opioid addiction and opioid use disorder diagnosis. At the completion of patient data collection, a forward stepwise regression will identify factors of most significant risk of the development of opioid use disorder after traumatic injury. This modeling will inform the development of a novel opioid risk screening tool, which will undergo pilot implementation at 4 Wisconsin ACS Level I and Level II trauma centers, using an evidence-based implementation strategy with roots in systems engineering.

Discussion

Positive findings from the proposed work would lead to improved, standardized opioid risk screening practices among victims of traumatic injury. The ultimate goal of this and future work is to reduce the likelihood of opioid misuse, addiction, and related complications, such as overdose and death.

Trial registrationClinicaltrials.gov registration number: NCT02861976. Date of registration: Feb 9, 2016
Cognitive ability and risk of post-traumatic stress disorder after military deployment: an observational cohort study
Authors: Nissen Lars R. , Karstoft Karen-Inge , Vedtofte Mia S. , Nielsen Anni B.S. , Osler Merete , Mortensen Erik L. , Christensen Gunhild T. , Andersen Søren B.
Published: November 2017

Background

Studies of the association between pre-deployment cognitive ability and post-deployment post-traumatic stress disorder (PTSD) have shown mixed results.

Aims

To study the inflence of pre-deployment cognitive ability on PTSD symptoms 6–8 months post-deployment in a large population while controlling for pre-deployment education and deployment-related variables.

Method

Study linking prospective pre-deployment conscription board data with post-deployment self-reported data in 9695 Danish Army personnel deployed to different war zones in 1997–2013. The association between pre-deployment cognitive ability and post-deployment PTSD was investigated using repeated-measure logistic regression models. Two models with cognitive ability score as the main exposure variable were created (model 1 and model 2). Model 1 was only adjusted for pre-deployment variables, while model 2 was adjusted for both pre-deployment and deployment-related variables.

Results

When including only variables recorded pre-deployment (cognitive ability score and educational level) and gender (model 1), all variables predicted post-deployment PTSD. When deployment-related variables were added (model 2), this was no longer the case for cognitive ability score. However, when educational level was removed from the model adjusted for deployment-related variables, the association between cognitive ability and post-deployment PTSD became significant.

Conclusions

Pre-deployment lower cognitive ability did not predict post-deployment PTSD independently of educational level after adjustment for deployment-related variables.
Breast Cancer Pathology Turnaround Time in Botswana
Authors: Martei Yehoda M. , Narasimhamurthy Mohan , Prabhakar Pooja , Hutson Jeré , Setlhako Dipho I. , Chiyapo Sebathu , Ramogola-Masire Doreen , Makozhombwe Ignetious , Feldman Michael , Kayembe Mukendi K.A. , Grover Surbhi
Published: November 2017

Purpose

Quality pathology is critical for timely diagnosis and management of breast cancer. Few studies have analyzed pathology turnaround time (TAT) in sub-Saharan Africa. The purpose of this study was to quantify TAT for breast cancer specimens processed by the National Health Laboratory and Diagnofirm Laboratory in Gaborone, Botswana, and additionally compare TAT before and after 2012 to evaluate the effect of pathology scale-up interventions by the Ministry of Health and Wellness.

Methods

Retrospective analyses of TAT were performed for breast specimens submitted to the two laboratories from 2011 to 2015. TAT was calculated as the time from specimen collection and receipt in the laboratory to the date of final report sign-out. Descriptive statistics and rank sum test were used to compare temporal trends in TAT before and after 2012.

Results

A total of 158 breast biopsy, 219 surgical, and 218 immunohistochemistry (IHC) specimens were analyzed. The median TAT in 2015 was 6 and 7 days for biopsy and IHC specimens, respectively, and 57.5 days for surgical specimens. There was a significant decrease in median TAT for biopsy specimens from 21.5 days in 2011 to 2012 compared with 8 days in 2013 to 2015 ( P < .001). There was also a significant decrease in median TAT for IHC specimens during the same period ( P < .001). However, there was no significant decline in median TAT for surgical specimens.

Conclusion

The scale-up of pathology personnel and infrastructure by the Ministry of Health and Wellness significantly reduced median TAT for biopsy and IHC specimens. TAT for surgical specimens remains suboptimal. Efforts are currently under way to decrease TAT for surgical specimens to 7 days.
RhoC regulates the actin remodeling required for phagosome formation during FcγR-mediated phagocytosis
Authors: Egami Youhei , Kawai Katsuhisa , Araki Nobukazu
Published: November 2017

Phagosome formation is a complicated process that requires spatiotemporally regulated actin reorganization. We found that RhoC GTPase is a critical regulator of FcγR-mediated phagocytosis in macrophages. Our live-cell imaging revealed that RhoC, but not RhoA, is recruited to phagocytic cups engulfing IgG-opsonized erythrocytes (IgG-Es). RhoC silencing through RNAi, CRISPR/Cas-mediated RhoC knockout, and the expression of dominant-negative or constitutively active RhoC mutants suppressed the phagocytosis of IgG-Es. Moreover, RhoC-GTP pulldown experiments showed that endogenous RhoC is transiently activated during phagosome formation. Notably, actin-driven pseudopod extension, which is required for the formation of phagocytic cups, was severely impaired in cells expressing the constitutively active mutant RhoC-G14V, which induced abnormal F-actin accumulation underneath the plasma membrane. mDia1 (encoded by DIAPH1), a Rho-dependent actin nucleation factor, and RhoC were colocalized at the phagocytic cups. Similar to what was seen for RhoC, mDia1 silencing through RNAi inhibited phagosome formation. Additionally, the coexpression of mDia1 with constitutively active mutant RhoC-G14V or expression of active mutant mDia1-ΔN3 drastically inhibited the uptake of IgG-Es. These data suggest that RhoC modulates phagosome formation be modifying actin cytoskeletal remodeling via mDia1.
Continuous training and certification in neonatal resuscitation in remote areas using a multi-platform information and communication technology intervention, compared to standard training: A randomized cluster trial study protocol
Authors: Delgado Carlos Alberto , Gómez Pomar Enrique M. , Velásquez Pablo , Sánchez Víctor , Shimabuku Roberto , Huicho Luis ,   RCPNEOPERU Study Group
Published: November 2017

Background: About 10% of all newborns may have difficulty breathing and require support by trained personnel. In Peru, 90% of deliveries occur in health facilities. However, there is not a national neonatal resuscitation and certification program for the public health sector. In addition, the Andes and the Amazon regions concentrate large rural remote areas, which further limit the implementation of training programs and the accomplishment of continuous certification. Neonatal resuscitation training through the use of information, communication and technology (ICT) tools running on computers, tablets or mobile phones, may overcome such limitations. This strategy allows online and offline access to educational resources, paving the way to more frequent and efficient training and certification processes.

Objective: To evaluate the effects of a neonatal resuscitation training and certification program that uses a multi-platform ICT (MP-ICT) strategy on neonatal health care in remote areas.

Methods: We propose to conduct the study through a cluster-randomized trial, where the study and analysis unit is the health care facility. Eligible facilities will include primary and secondary health care level facilities that are located in provinces with neonatal mortality rates higher than 15 per 1,000 live births. We will compare the proportion of newborns with a heart rate ≥100 beats per minute at two minutes after birth in health care facilities that receive MP-ICT training and certification implementation, with those that receive standard training and certification.

Discussion: We expect that the intervention will be shown as more effective than the current standard of care. We are prepared to include it within a national neonatal resuscitation training and certification program to be implemented at national scale together with policymakers and other key stakeholders. 

Trial registration: ClinicalTrials.gov Nº NCT03210194 

Status of the study: This study is enrolling participants by invitation only.

Study protocol version 1.1 – March 31st, 2017
Chemical characterization of faecal sludge in the Kumasi metropolis, Ghana
Authors: Fanyin-Martin Ato , Tamakloe Wilson , Antwi Edward , Ami Johannes , Awarikabey Emmanuel , Apatti Justice , Mensah Moses , Chandran Kartik
Published: November 2017

Background: Faecal sludge (FS) represents a huge resource, which when tapped and made use properly can be of great benefit to many. However, the key to tapping this resource lies in proper characterisation, in order to make known the constituents and thereby determine the end-use.

Methods: Three sources of FS from 43 communities in the Kumasi metropolis of Ghana were characterised in terms of their total solids content, chemical oxygen demand (COD), pH, nitrogen, phosphorous and lipid contents. FS from pit latrines, public septage and private septage were analysed.

Results: On average, lipid content was found to be in the range of 8.82 – 9.66% of dry FS depending on the source of FS. Total solids were between 0.79 and 4.68%, while the COD was between 9495 and 45611mg/L. Phosphorus content was in the range of 137 – 520mg/L, while nitrogen was 649 – 4479mg/L. Most FS samples were generally alkaline in nature.

Conclusions: These results are amongst the first long-term characterization efforts for FS in terms of conventional and non-conventional characteristics, tailored towards typical treatment and novel resource recovery options, respectively.
PROFESSIONAL ORIENTATION AND MENTORING AS YOUTH POLICY INSTRUMENTS
Authors: Опарина Наталья , Oparina Natalya , Панова Е. , Panova E.
Published: November 2017

The article is based on the materials and results of scientifi c research, carried out in 2017 by lecturer of the department of personnel management and political analysis as an extension of interdepartmental scientifi c research in 2016 on the issue “Youth policy as key component of the system of development of qualifi ed human resources of Russian Far East Federal district”. The problem of attitude to work among young people is analyzed in the paper, as a consequence of the general trends: losing respect and high status “man of labor”, value of high level professionalism and employee personal qualities, focusing on the material aspect of employment. To solve this problem, the authors proposed the use of tools of professional orientation and mentoring as personal development tools in the sphere of youth policy, at both on the state and corporate levels.
«EMPLOYEE ENGAGEMENT CRISIS» OR ERRORS IN MANAGING ENGAGEMENT?
Authors: Коновалова Валерия , Konovalova Valyeriya
Published: November 2017

The article deals with the accumulated experience and problems of managing employee engagement in the public and private sectors. The data of international and national studies are presented, indicating that despite the eff orts made to manage employee engagement and signifi cant costs for the respective programs, its level either remains unchanged or decreases. The main reasons for the decrease in the level of employee engagement are identifi ed, including the professional burnout. On the basis of the analysis of the state of employee engagement management, the following problems are highlighted: 1) there is still no common understanding of the nature of engagement; 2) managers do not see a link between engagement and productivity growth, assess mainly short-term results, are not ready for the role of “an engaging leader; 3) companies do not represent the level of engagement that has developed to date, surveys are conducted irregularly, their results are not used to develop engagement; 4) engagement is often viewed as “as an HR project”, and not as a zone of overall management responsibility. Data are presented confi rming the convincing correlation between the power of corporate culture and the engagement, as well as the features of culture that contribute to increasing the level of engagement. The peculiarities of managing the employee engagement in the conditions of organizational changes are outlined.
WORKING WITH HUMAN RESERVE MANAGEMENT — AS THE TECHNOLOGY OF MANAGEMENT OF TALENTS
Authors: Кириллов Андрей , Kirillov Andrey
Published: November 2017

Support of the organization’s employees in personal and professional development and career growth, rational use of their potential in various directions and levels in the organization’s management system are the most important tasks that are called upon to solve the personnel reserve of management. To increase the eff ectiveness of this work, international experience in the sphere of talent management should be used, moreover, the author considers it expedient to consider work with the personnel reserve of the management as a talent management technology. The article considers the level of correlation of the processes of work with the personnel reserve of management and talent management, according to the opinion of employees of Russian organizations aged 21 and over who have higher education and discussed the feasibility of this approach. Primary empirical information was collected by a questionnaire survey of the working population (Moscow and Moscow region), aimed at a managerial career. The study found that the practice of talent management has become a strategically important component of the HR policy of any serious organization in Russia. However, not everyone realizes the importance of close correlation of the processes of work with the personnel reserve of management and talent management. The Russian theory of personnel management does not pay enough attention to talent management issues, and the practice of many Russian companies does not yet have a corresponding systematic approach.
APPLICATION OF FUNCTIONAL COST ANALYSIS IN HR MANAGEMENT
Authors: Межевов А. , Mezhevov A. , Зайцева Г. , Zayceva G. , Ахмадуллин А. , Ahmadullin A.
Published: November 2017

Many users think that functional cost analysis (FCA) is quite diffi cult to understand. Perhaps this is due to the fact that there is too little information explaining what it actually is. The aim of this work is the essence of functional-cost analysis, ease-of-use. FCA is a method for a systematic study of functions, the functionality of various objects and their costs. Advantage of FSA is the presence of a fairly simple computational and graphical methods to give a dual quantitative assessment of the identifi ed causal relationships. This advantage puts the FSA in a number of the most eff ective methods of the analysis which are not only technical, but also socio-economic systems, structures, methods of organizing and planning production management and scientific research. However, the work of the FSA is carried out in isolation from the economic calculations of the enterprises and unions. Therefore, the economic standards of existing production are not covered by the functional approach, based on substantive economic analysis, planning from the achieved level. Value analysis management system allows to perform the following activities: definition and implementation total cost analysis of business processes at the enterprise (marketing, production of goods and provision of services, marketing, quality management, warranty maintenance, etc.); functional analysis associated with the establishment and justification carried out by structural subdivisions of an enterprise functions in order to ensure production of high quality products and services; definition and analysis of basic, additional and unnecessary cost functional; comparative analysis of options for reducing costs in production, marketing and management by streamlining the functions of the structural divisions of the enterprise; analysis of integrated improved results of the company.
La formación en Administración: Reflexiones para la construcción de un Modelo Educativo
Authors: HERNANDEZ-MARTINEZ ANDRES GUILLERMO
Published: November 2017

El trabajo muestra los resultados de un trabajo de revisión y reflexión, que fundamenta la construcción del modelo educativo para la Escuela de Administración de la Universidad del Rosario. Este estudio se enmarca en el proceso de estratégico emprendido por la Escuela desde el año 2015. El principal objetivo del trabajo es dar sentido y unidad a los diferentes esfuerzos de la dimensión educativa de la escuela, en sus diferentes niveles de formación. Para ello, aborda en primer lugar la noción de modelo educativo, luego se concentra en desarrollar los elementos que configuran el modelo como son: los propósitos, los procesos de educativos, algunos de los elementos más importantes de la enseñanza y de los entornos educativos.
Orientación al mercado de exportación de las PYME exportadoras del Departamento del Atlántico
Authors: Acevedo Navas Christian , Paramo Morales Dagoberto , Rodríguez Albor Gustavo
Published: November 2017

Se muestran los hallazgos de una investigación tendiente a medir el grado de orientación al mercado de exportación por parte de las pequeñas y medianas empresas exportadoras del Departamento del Atlántico, Colombia. El fundamento teórico reposa sobre los conceptos de orientación al mercado (OM) y orientación al mercado de exportación (OME). Se desarrolló un estudio cuantitativo, descriptico y no experimental de campo. Se aplicó un cuestionario de 66 afirmaciones tipo Likert a una muestra de 35 empresas. Se llevó a cabo un Análisis de Componentes Principales (ACP) y un Análisis de Cluster, mediante el software SPSS-21. Se observó un grado de OME medio a medio-alto para toda la muestra (3,3), con diferencias significativas entre dimensiones. A partir de esas diferencias, las empresas fueron clasificadas en tres grupos, de acuerdo con sus niveles de audacia y orden en su OME: Empresas tímidas, empresas entusiastas y empresas encaminadas.
R&D Investments in the Presence of Knowledge Spillover and Debt Financing: Can Risk Shifting Cure Free Riding?
Authors: Ning Jie , Babich Volodymyr
Published: November 2017

In an industry with knowledge spillover and debt financing, equilibrium investments in research and development (R&D) projects are subject to three economic forces. First, knowledge spillover among firms enables free dissemination of new technologies and produces investment synergies. Second, knowledge spillover also causes free riding: in equilibrium, firms underinvest in R&D expecting to benefit from investments by others. Third, debt financing creates incentive for risk shifting: equity holders overinvest in riskier R&D projects. We study how interactions among these forces affect a firm’s investment decisions and equilibrium industry outcomes using a three-stage game between two firms and the external debt market. We characterize subgame perfect, Pareto-dominant equilibria and show that for some parameter choices, free riding and risk shifting cancel each other in the decisions of individual firms, resulting in the first-best investments. Interestingly, for some cases, the equilibrium with first-best investments becomes possible only when risk shifting by one firm enables free riding by the other firm. We also show that debt can be used by firms as a commitment device in a multistage game. This value of debt is shared with investors, who can earn positive profits despite being perfectly competitive. This enriches the understanding of the financial pecking order theory by showing that even firms with unlimited internal capital may prefer external debt financing.

This paper has been accepted for the Manufacturing & Service Operations Management Special Issue on Interface of Finance, Operations, and Risk Management.
An introduction to ethical theory for healthcare assistants
Authors: Rodger Daniel , Blackshaw Bruce
Published: November 2017

This article will explore and summarise the four main ethical theories that have relevance for healthcare assistants. These are: utilitarianism, deontology, virtue ethics and principlism. Understanding different ethical theories can have a number of significant benefits, which have the potential to shape and inform the care of patients, challenge bad practice and lead staff to become better informed about areas of moral disagreement.
Managing exudate and maceration in venous leg ulceration within the acute health setting
Authors: Brown Annemarie
Published: November 2017

Exudate has beneficial effects in normal wound healing but detrimental consequences for chronic wounds. Practitioners need to identify and treat its cause, and manage the exudate and prevent if from damaging periwound skin. Management involves dressings of the most appropriate absorbency and other products, and avoiding maceration of periwound skin; compression therapy is the gold standard treatment for treating oedema and venous leg ulceration. Nurses in acute settings may not have the skills to implement or maintain compression therapy; this article is intended for nurses who may have to manage these patients temporarily while they are admitted to secondary care and may not have the skills.
A 100 patient clinical evaluation of an alternating pressure replacement mattress in a home-based setting
Authors: Stephen-Haynes Jackie , Callaghan Rosie
Published: November 2017

Background:

alternating pressure air mattresses (APAMs) support the prevention and management of pressure ulcers. A health and care NHS trust was seeking an APAM that would improve clinical outcomes in relation to pressure ulcers while considering financial cost. An APAM existed that could meet the trust's needs but there was a lack of evidence over its use in a community/home setting. This study examined the effect of using the Dual Professional (IQ Medical) APAM for patients at a high risk of pressure ulceration. It also determined patient and family satisfaction, and the views of clinicians in relation to clinical outcomes. Additionally, infection prevention and control, servicing, maintenance and electrical biomechanical engineer input were considered.

Method:

a prospective observational study was undertaken of 100 patients in their own homes following a pilot study of 10 patients. The period of the evaluation was from one day up to 295 days, with a mean average of 83 days, and a total of 5809 bed days.

Results:

with a regimen of regular repositioning of patients and a good diet, the APAM was effective in preventing pressure ulceration in the 100 patients who were at a high or very high risk of skin breakdown and pressure ulceration.

Conclusion:

selection of pressure redistributing surfaces should be based on holistic patient assessment, including risk assessment, mobility levels, grade of pressure damage and clinical judgment.
Drugs used in respiratory conditions
Authors: Robertson Deborah
Published: November 2017

In this article our ‘bite sized’ pharmacology series, we will look at the pharmacological actions of drugs used in respiratory conditions. This article will illustrate the common therapeutic interventions in asthma and chronic obstructive pulmonary disease and examine the main types of drug used in these interventions and their pharmacodynamic actions.
The role of arthroereisis of the subtalar joint for flatfoot in children and adults
Authors: Bernasconi Alessio , Lintz François , Sadile Francesco
Published: November 2017

Subtalar arthroereisis has been reported as a minimally-invasive, effective and low-risk procedure in the treatment of flatfoot mainly in children but also in adults. It has been described as a standalone or adjunctive procedure, and is indicated in the treatment of flexible flatfoot, tibialis posterior tendon dysfunction, tarsal coalition and accessory navicular syndrome. Different devices for subtalar arthroereisis are currently used throughout the world associated with soft-tissue and bone procedures, depending on the surgeon rather than on standardised or validated protocols. Sinus tarsi pain is the most frequent complication, often requiring removal of the implant. To date, poor-quality evidence is available in the literature (Level IV and V), with only one comparative non-randomised study (Level II) not providing strong recommendations. Long-term outcome and complication rates (especially the onset of osteoarthritis) are still unclear.

Cite this article: EFORT Open Rev 2017;2:438–446. DOI: 10.1302/2058-5241.2.170009
Savages and saviours in Icíar Bollaín’s También la lluvia/Even the Rain
Authors: Smith Andrea Meador
Published: November 2017

Acclaimed Spanish director Icíar Bollaín’s También la lluvia/Even the Rain (2010) is a fictionalized account of the Cochabamba Water Wars of 2000, whose title alludes to local protestors’ claim that the US-based corporation Bechtel sought to control and tax even the rain water that peasants collected. While También la lluvia may be a thoughtful attempt to denounce the oppression of native peoples, it in fact epitomizes the white saviour trope that has been prevalent in American and British cinema for years. In this study, I argue that the film adheres to what sociologist Joe Feagin calls a ‘white racial frame’ that perpetuates the perceived universality of the white European gaze by depicting fictional filmmakers Costa and Sebastián as ‘white saviour’ figures and indigenous community leader Daniel as a ‘noble savage’. The result is a film made by and for white westerners that replicates traditional western ways of portraying racial and cultural difference.
Melancholia and memory in Ciudad Juárez: Lourdes Portillo’s Señorita Extraviada/Missing Young Woman (2001) and the communal mourning of feminicide
Authors: Palmer Lucia Mulherin
Published: November 2017

Engaging with the sizeable scholarship on Lourdes Portillo’s 2001 documentary Señorita Extraviada/Missing Young Woman, this article investigates the potential of the visual image to create a form of radical melancholy that resists containment by the persistent patriarchal frameworks used to interpret the Juárez feminicide. Taking Señorita Extraviada as a historically important feminist text documenting a crucial moment in grassroots women’s activism against the gender violence systematically expressed in Ciudad Juárez, Mexico, this article discusses the film’s resistant potential. Engaging with Rosa Linda Fregoso’s measured praise and critique of the film, the article proposes other vantage points through which to interpret the film to highlight some of Portillo’s affective and abstracting techniques that undermine the patriarchal meanings underlying the religious iconography used by grassroots women’s groups to protest the violence and impunity. By putting Fregoso into dialogue with theoretical concepts from Alicia Schmidt Camacho and Laura Marks on memory and melancholia, this article argues for an affective reading of Señorita Extraviada as a politicized narrative expressing feminicidal melancholia through depictions of rituals of mourning, mobilizations of activism and the production of liminal space between presence and absence, life and death.
A Java software agent framework for hard real-time manufacturing control
Authors: Theiss Sebastian , Kabitzsch Klaus
Published: November 2017

Multiagent systems (MAS) have widely been recognized as a suitable software engineering approach to design distributed,
flexible, and robust control-systems, as are needed to cope with current and future challenges in manufacturing. Yet,
applying MAS for real-time control has been subject to several concessions so far. This paper presents a real-time Java
multiagent platform, which allows both agent execution and distributed interaction under hard real-time conditions. The
paper covers the architecture and implementation of such a platform, the integration of a domain knowledge model into the
communication flow, and finally an analytical response time model including interactions, to actually proove the real-time
capability of a distributed MAS.
An agent-based approach for dependable planning of production sequences in automated production systems
Authors: Rehberger Sebastian , Spreiter Lucas , Vogel-Heuser Birgit
Published: November 2017

One approach to achieve flexibility and dependability for the control of automated production systems (aPS) is
agent-oriented software engineering (AOSE). In this paper, the modular decoupling of the supervisory control, most
significantly the planning of production sequences and transfer routes, from the distributed real-time control of the
plant resources is demonstrated by the use of agents. The resulting product management agent (PMA) represents the
technical process of the manufactured product and conducts a discrete reasoning algorithm to derive appropriate production
plans by the use of graph-search and also by interaction with the underlying resource agents (RA). It is shown, that for
a given production system, dependable solutions are automatically generated in regard to a given product recipe. Further
it is deduced, that the solutions are calculated and evaluated by the PMA within a deterministic time duration. This is
argued on the fact, that the computation complexity does not exceed polynomial time and is mostly predetermined by the
design parameters of the plant. Thus, it gives a reasonable approach for the use in a real-time environment. Additionally,
through separation of supervisory and field control, a modular software engineering is achieved, offering the advantage
that the PMA and the resource agents can be reused, by solely adapting the knowledge bases and without the need for
modifying the planning algorithms after a reconfiguration of the aPS.
Softwareagenten zur zuverlässigen Durchführung dezentraler multiphysikalischer Simulationen
Authors: Vögeli Desirée , Jazdi Nasser , Grabmaier Sebastian , Jüttner Matthias , Weyrich Michael , Göhner Peter , Rucker Wolfgang M.
Published: November 2017

Zur Ermittlung des Systemverhaltens werden beim Engineering in Kombination mit der modellgestützten Entwicklung häufig
Simulationen eingesetzt. Dieser Beitrag stellt einen agentenkoordinierten Ansatz für die parallele Simulation von
multiphysikalischen Problemstellungen auf heterogenen Rechenressourcen vor. Durch die unterschiedlichen eingesetzten
Simulationsmethoden steigt hierbei die Zuverlässigkeit beim Erreichen der Ergebnisse.
Das Informationsverhalten von Streamern und Zuschauern bei Social Live-Streaming Diensten am Fallbeispiel YouNow
Authors: Scheibe Katrin , Zimmer Franziska , Fietkiewicz Kaja J.
Published: November 2017

In den letzten Jahren hat eine neue Art von Social Media an Popularität gewonnen, nämlich die Social Live-Streaming Services (SLSSs). Ein besonders bei Jugendlichen und jungen Erwachsenen beliebter SLSS ist YouNow, der auch im Fokus unserer Fallstudie steht. SLSSs ermöglichen dem Nutzer in Echtzeit zu streamen, mit den Zuschauern zu interagieren und von diesen auf verschiedene Weisen belohnt zu werden. In dieser Studie wurde das Informationsverhalten der Nutzer von SLSSs unter Anwendung sowohl der Lasswell Formel als auch des Nutzen- und Belohnungsansatzes (Uses and Gratification Theory) analysiert. Dabei werden fünf Forschungsfragen beantwortet: Aus welchen Motiven verwenden die Zuschauer und Streamer YouNow? Welches Informationsproduktionsverhalten zeigen die Nutzer? Welche Rechtsverstöße lassen sich während des Streamings beobachten? Welches Multi-Channel-Verhalten weisen Nutzer von YouNow auf? Und, wie bewerten sie die Qualität von YouNow? Um Antworten auf diese Fragen zu erhalten, wurde zum einen eine Online Umfrage (N = 123) durchgeführt und zum anderen Echtzeitübertragungen systematisch beobachtet (N = 2.021).
Repeated Bronchoscopy - Treatment of Severe Respiratory Failure in a Fire Victim
Authors: Petris Ovidiu Rusalim , Bologa Cristina , Sorodoc Victorita , Lionte Catalina
Published: November 2017

A case of respiratory failure in a domestic fire victim presenting with 1-3-degree skin burns on 10% of the total body surface, is reported. Forty-eight hours after admission to hospital, the patient developed severe respiratory failure that did not respond to mechanical ventilation. Severe obstruction of the airway had resulted from secretions and deposits of soot forming bronchial casts. The patient required repeated bronchoscopies to separate and remove the bronchial secretions and soot deposits. An emergency bronchial endoscopic exam was crucial in the patient’s survival and management. The patient was discharged from the hospital after twenty-four days.
The Use of Continuous Ketamine for Analgesia and Sedation in Critically Ill Patients with Opioid Abuse: A Case Series
Authors: Treu Cierra N. , Groth Christine M. , Patel Jignesh H.
Published: November 2017

Managing pain and agitation in patients with opioid abuse is becoming more common in intensive care units. Tolerance to commonly used agents is often observed, leading to inadequate pain control and increased agitation. Ketamine’s unique mechanism of action and opioid-sparing effects make it an ideal agent for patients with suboptimal response to opioid therapy.

This report describes our experience using continuous ketamine infusions for analgesia and sedation in four mechanically ventilated patients with histories of opioid abuse that had suboptimal response to standard therapy. Ketamine was successful in improving analgesia and sedation in three patients while reducing the need for other analgesics and sedatives with minimal adverse effects.

Continuous ketamine infusions may be useful to facilitate mechanical ventilation in patients with histories of opioid abuse with minimal toxicity. More information is needed on the optimal dose and titration parameters.
Actual Dose-Reduction Strategies in Cardiac Computed Tomography
Authors: Cernica Daniel , Hodas Roxana , Himcinschi Elisabeta , Beganu Elena , Benedek Theodora
Published: November 2017

Computed tomography (CT) in cardiac examination is a powerful imaging tool that has developed rapidly during the last decade and continues to increase its potential by bringing novel technologies. Due to its noninvasive character, cardiac CT became a largely used method in detecting coronary diseases or functional issues at the expense of conventional coronary angiography. The accuracy of images has also increased, especially since new generation dual-source multi-slice detectors were developed. Although there are continuous improvements that serve to gain better-quality images, thus increasing their diagnostic accuracy, there is an inconvenient that became a serious topic for debate in the current literature: exposure to higher doses of radiation during cardiac CT examinations. Fortunately, physicians and manufacturers are taking into consideration the need to apply new strategies for radiation dose-reduction. Thus, this objective can be achieved by using patient-tailored dose-reduction strategies and by modulating the technical features of the CT scanners in order to gather high-quality images with minimal radiation exposure. The aim of this manuscript was to review the current literature data on dose-reduction strategies that are used for cardiovascular computed tomography scans.
Platelet-to-Lymphocyte Ratio and Neutrophil-to-Lymphocyte Ratio Predict Mucosal Disease Severity in Ulcerative Colitis
Authors: Akpinar Muhammet Yener , Ozin Yasemin Ozderin , Kaplan Mustafa , Ates Ihsan , Kalkan Ismail Hakki , Kilic Zeki Mesut Yalın , Yuksel Mahmut , Kayacetin Ertugrul
Published: November 2017

Background:We investigated the sensitivity of neutrophil to lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as well as a combination of NLR and PLR to predict endoscopic disease severity based on mucosal assessment in ulcerative colitis (UC).

Methods:The study group consisted 104 patients with active UC, 104 patients in remission, and 105 healthy individuals. Disease activity was described with Rachmilewitz endoscopic activity index (EAI). Curve analysis was used to determine the optimal cutoff values of NLR and PLR for obtaining remission. The patients with both PLR and NLR values higher than the cutoff values were coded as »high risk,« those with one parameter higher were coded as »moderate risk«, those with both parameters lower than the cutoff values were coded as »low-risk« patients.

Results:The mean NLR and PLR values in the endoscopically active disease group were higher than the others, with higher values in the endoscopic remission group compared with the control group (p<0.001). Rachmilewitz EAI in high-risk patients was significantly higher than that in others (p<0.001). In Cox regression analyses, moderate and high risk, high erythrocyte sedimentation rate and high EAI were found as independent predictors of endoscopic active disease.

Conclusions:This is the first study that investigated the use of NLR and PLR combination to assess endoscopic disease severity in UC. Either high NLR or PLR levels can predict active endoscopic disease. However, the use of these parameters in combination is more accurate in evaluating mucosal disease and inflammation in UC.
Legitimate Expectations, Historical Injustice, and Perverse Incentives for Settlers
Authors: Waligore Timothy
Published: November 2017

This article argues against privileging the expectations of settlers over those of dispossessed peoples. I assume in this article that historical rights to occupancy do not persist through all changes in circumstances, but a theory of justice should reduce perverse incentives to unjustly settle on land in hopes of legitimating occupancy. Margaret Moore, in her 2015 book,A Political Theory of Territory, tries to balance these intuitions through an argument based on legitimate expectations. I argue that Moore’s attempt to reduce perverse incentives (through expectation-altering institutional design) fails. Moore unduly privileges settler expectations, especially over those of indigenous peoples. I criticize United States court decisions resurrecting the expectations of past settlers in the allotment era (which share structural features with Moore’s arguments). Lastly, distinguishing between ‘final’ supersession of historical injustice through changing circumstances, and ‘dormant’ supersession, shows how indigenous claims to land and jurisdiction may revive.
Designing optimal nanofocusing with a gradient hyperlens
Authors: Shen Lian , Prokopeva Ludmila J. , Chen Hongsheng , Kildishev Alexander V.
Published: November 2017

We report the design of a high-throughput gradient hyperbolic lenslet built with real-life materials and capable of focusing a beam into a deep sub-wavelength spot of λ/23. This efficient design is achieved through high-order transformation optics and circular effective-medium theory (CEMT), which are used to engineer the radially varying anisotropic artificial material based on the thin alternating cylindrical metal and dielectric layers. The radial gradient of the effective anisotropic optical constants allows for matching the impedances at the input and output interfaces, drastically improving the throughput of the lenslet. However, it is the use of the zeroth-order CEMT that enables the practical realization of a gradient hyperlens with realistic materials. To illustrate the importance of using the CEMT versus the conventional planar effective-medium theory (PEMT) for cylindrical anisotropic systems, such as our hyperlens, both the CEMT and PEMT are adopted to design gradient hyperlenses with the same materials and order of elemental layers. The CEMT- and PEMT-based designs show similar performance if the number of metal-dielectric binary layers is sufficiently large (9+ pairs) and if the layers are sufficiently thin. However, for the manufacturable lenses with realistic numbers of layers (e.g. five pairs) and thicknesses, the performance of the CEMT design continues to be practical, whereas the PEMT-based design stops working altogether. The accurate design of transformation optics-based layered cylindrical devices enabled by CEMT allow for a new class of robustly manufacturable nanophotonic systems, even with relatively thick layers of real-life materials.