bluuebunny/crossref_metadata_2025 huggingface dataset:
Semantic Effects in Morphological Priming: The Case of Hebrew Stems
Authors: Farhy Yael , Veríssimo João
Published: December 2018

To what extent is morphological representation in different languages dependent on semantic information? Unlike Indo-European languages, the Semitic mental lexicon has been argued to be purely “morphologically driven”, with complex stems represented in a decomposed format (root + vowel pattern) irrespectively of their semantic properties. We have examined this claim by comparing cross-modal root-priming effects elicited by Hebrew verbs of a productive, open-ended class (Piel) and verbs of a closed-class (Paal). Morphological priming effects were obtained for both verb types, but prime-target semantic relatedness interacted with class, and only modulated responses following Paal, but not Piel primes. We explain these results by postulating different types of morpho-lexical representation for the different classes: structured stems, in the case of Piel, and whole-stems (which lack internal morphological structure), in the case of Paal. We conclude that semantic effects in morphological priming are also obtained in Semitic languages, but they are crucially dependent on type of morpho-lexical representation.
Is the d2 Test of Attention Rasch Scalable? Analysis With the Rasch Poisson Counts Model
Authors: Baghaei Purya , Ravand Hamdollah , Nadri Mahsa
Published: December 2018

The d2 test is a cancellation test to measure attention, visual scanning, and processing speed. It is the most frequently used test of attention in Europe. Although it has been validated using factor analytic techniques and correlational analyses, its fit to item response theory models has not been examined. We evaluated the fit of the d2 test to the Rasch Poisson Counts Model (RPCM) by examining the fit of six different scoring techniques. Only two scoring techniques—concentration performance scores and total number of characters canceled—fit the RPCM. The individual items fit the RPCM, with negligible differential item functioning across sex. Graphical model check and likelihood ratio test confirmed the overall fit of the two scoring techniques to RPCM.
Nothing to Lose? An Examination of Prison Misconduct Among Life-Without-Parole Inmates
Authors: Sorensen Jonathan R. , Reidy Thomas J.
Published: December 2018

Inmates serving life-without-parole (LWOP) have been described as having “nothing to lose” by virtue of their sentence, leading to an assumption that they are more prone to disciplinary violations. This study refutes such an argument and is consistent with research demonstrating that LWOP inmates do not pose a disproportional risk for disciplinary misconduct. Results from our study comparing LWOP with parole-eligible, life-sentenced (LWP) inmates revealed neither significant differences in the total violation count nor the time to commission of an act of disciplinary misconduct. Trajectories of misconduct showed slightly higher prevalence of misconduct among LWOP inmates, a pattern of declining prevalence during the first 18 months of confinement, and a convergence with LWP inmates thereafter. The failure of assumptions of high violence risk for LWOP inmates has important public policy and correctional implications.
Safe Spaces, Agency, and Connections to “Regular Stuff”: What Makes Permanent Supportive Housing Feel Like “Home”
Authors: Chan Dara V.
Published: December 2018

Permanent, supportive housing for people with a history of homelessness is often a first step toward regaining stability in other life areas, but such housing may not always feel like “home.” Whether supportive housing feels like “home” has received increasing attention due to links with positive identity reconstruction, housing stability, and improved community engagement. This qualitative study explored what makes supportive housing feel like “home” for individuals who were once homeless. Semi-structured interviews were completed among 37 adults with physical and/or psychiatric disabilities who were currently living in congregate or independent permanent housing in Boston, Massachusetts. Three themes emerged regarding what makes housing feel like “home”: (a) safe spaces, (b) connections to “regular stuff” and past occupations, and (c) agency to choose and pursue personal goals. Feelings of “home” were associated with a safe, peaceful environment where participants preferred to spend time in solitary activities. However, housing that felt like “home” also provided a base to engage in daily routines and community activities, reconnecting participants to “everyday things people do.” Findings are interpreted related to constructing a new, nonhomeless identity, and current issues of social isolation and limited community integration affecting individuals who were once homeless.
Social Networks and Labor Market Inequality: A Role-playing Activity to Teach Difficult Concepts
Authors: Gillis Alanna , Taylor Brionca
Published: December 2018

Role-playing activities, as a form of active learning, enable instructors to teach difficult concepts in ways that better facilitate student learning. This note tests the effectiveness of a role-playing activity that simulates the job market: Most students play job seekers seeking employment, and a few play the employers who make employment decisions. However, students are constrained in that they can only talk to students they already know or meet during the game. We find two major results: (1) Students successfully achieved the learning goals from the activity, including understanding the basics of social networks and how social networks reproduce inequality in the labor market, and (2) students enjoyed the activity and felt like they learned a lot. We were especially pleased that these results were true even of students typically unengaged in the courses. Overall, we recommend role-playing activities to other instructors teaching difficult concepts to successfully engage all students.
New Body of Cohesion Research at a Macrolevel
Authors: Siebold Guy L.
Published: December 2018

A prior special issue of this journal attempts to broaden the perspective on military cohesion. While such broadening is desirable, the lead issue author incorporates only a narrow portion of relevant literature, makes misleading assertions, does not distinguish the difference between conducting studies and carrying out social scientific research, and fails to appreciate the advances made in scalable microlevel cohesion research. This commentary notes the limited literature cited, summarizes the distinction between a study and science, and suggests issues and concepts to be addressed to make a stronger start in research on military cohesion at the meso- and macrolevels.
What should be in hospital doctors' continuing professional development?
Authors: Jones Lorelei , Moss Fiona
Published: December 2018

Objective

To ask those most affected by continuing professional development for senior doctors – patients, other professional groups and doctors themselves – what it needs to encompass.

Design

The nominal group technique.

Participants

Six groups of between seven and nine members (n = 49). Separate groups were held for nurses and therapists (n = 9), patient representatives (n = 8), medical directors (n = 8), consultants (n = 8) and medical trainees (n = 7). An additional group consisted of ‘Darzi Fellows’ (n = 9), trainee doctors who were undertaking a leadership fellowship.

Setting

Groups were held at the Royal Society of Medicine in London.

Main outcome measures

Priorities for the content of continuing professional development for senior hospital doctors, ranked in order of importance. Themes derived from analysis of group discussions.

Results

We present the ranked priorities of different groups for what should be included in continuing professional development for senior hospital doctors. Analysis of group discussions identified the following three themes: developing and supporting the system of care; changes in the way medicine is practised; and personal wellbeing and caring for colleagues.

Conclusions

The implication of our findings for providers of continuing professional development is to consider the balance of content. Doctors and other healthcare professionals need to keep up with scientific advances and technical developments. But in addition, they need to be adept at working with the system changes required for translation of research into practice, the development of new ways of working, and for the organisational changes that underpin continual quality and safety improvement.
Senior stakeholder views on policies to foster a culture of openness in the English National Health Service: a qualitative interview study
Authors: Martin Graham Paul , Chew Sarah , Dixon-Woods Mary
Published: December 2018

Summary

Objectives

To examine the experiences of clinical and managerial leaders in the English healthcare system charged with implementing policy goals of openness, particularly in relation to improving employee voice.

Design

Semi-structured qualitative interviews.

Setting

National Health Service, regulatory and third-sector organisations in England.

Participants

Fifty-one interviewees, including senior leaders in healthcare organisations (38) and policymakers and representatives of other relevant regulatory, legal and third-sector organisations (13).

Main outcome measures

Not applicable.

Results

Participants recognised the limitations of treating the new policies as an exercise in procedural implementation alone and highlighted the need for additional ‘cultural engineering’ to engender change. However, formidable impediments included legacies of historical examples of detriment arising from speaking up, the anxiety arising from increased monitoring and the introduction of a legislative imperative and challenges in identifying areas characterised by a lack of openness and engaging with them to improve employee voice. Beyond healthcare organisations themselves, recent legal cases and examples of ‘blacklisting’ of whistle-blowers served to reinforce the view that giving voice to concerns was a risky endeavour.

Conclusions

Implementation of procedural interventions to support openness is challenging but feasible; engineering cultural change is much more daunting, given deep-rooted and pervasive assumptions about what should be said and the consequences of mis-speaking, together with ongoing ambivalences in the organisational environment about the propriety of giving voice to concerns.
Fuzzy robust backstepping with estimation for the control of a robot manipulator
Authors: Hacioglu Yuksel , Yagiz Nurkan
Published: December 2018

In this study, a new fuzzy robust backstepping controller with estimation is proposed for the control of a robot manipulator. Backstepping control is preferred because the Lyapunov function that is used in stability analysis and the feedback control law that is used for control purpose are defined systematically during controller design. Fuzzy logic units are designed to update the gains of the backstepping controller. Then, the proposed controller is applied to a robot manipulator that is to track a trajectory in a three-dimensional space while it is subjected to external disturbances and parameter variations. The numerical results demonstrate and verify the successful performance of the proposed controller.
Effects of Guided Reflection on Diabetes Self-Care: A Randomized Controlled Trial
Authors: Fearon-Lynch Jennifer A. , Sethares Kristen A. , Asselin Marilyn E. , Batty Kristine , Stover Caitlin M.
Published: December 2018

The purpose of this study was to evaluate the effects of guided reflection on self-care behaviors, confidence scores, and diabetes knowledge among adults with diabetes. A randomized controlled trial with a pre/posttest design was used to generate data from a convenience sample of 62 adults with diabetes recruited from a single site. After viewing a 30-minute video on how to manage diabetes, participants were randomized to a control group (CG) (usual care) or an intervention group (IG). The IG further engaged in a reflection educational session. For 8 weeks, the IG isolated diabetes-related events weekly, critically analyzed them using Gibbs’s reflective questions, and recorded their analysis in a journal. They also shared their perspective relative to using the journal in an audiotaped interview. Main measures included baseline and 8-week clinical outcomes (self-care maintenance, monitoring, management, and confidence scores and diabetes knowledge scores) and intervention acceptability. Compared to the CG, the IG had no statistically significant difference in self-care measures over time, although scores trended in the anticipated direction. Importantly, both groups had statistically significant improvement in self-care scores. Furthermore, there was statistically significant improvement in diabetes knowledge among IG participants. Informatively, IG critically analyzed 147 diabetes-related events concentrating on blood glucose, diet, exercise, monitoring, medication, sleep pattern, and health care visits. Participants found the guided reflection activity highly acceptable. Combined educational and reflection interventions are effective approaches for improving self-care outcomes and diabetes knowledge among adults with diabetes. Research concentrating on purposeful patient reflection is warranted in a larger sample paying careful attention to study limitations.
Early initiation of palliative care is associated with reduced late-life acute-hospital use: A population-based retrospective cohort study
Authors: Qureshi Danial , Tanuseputro Peter , Perez Richard , Pond Greg R , Seow Hsien-Yeang
Published: December 2018

Background:

Early palliative care can reduce end-of-life acute-care use, but findings are mainly limited to cancer populations receiving hospital interventions. Few studies describe how early versus late palliative care affects end-of-life service utilization.

Aim:

To investigate the association between early versus late palliative care (hospital/community-based) and acute-care use and other publicly funded services in the 2 weeks before death.

Design:

Retrospective population-based cohort study using linked administrative healthcare data.

Setting/participants:

Decedents (cancer, frailty, and organ failure) between 1 April 2010 and 31 December 2012 in Ontario, Canada. Initiation time before death (days): early (⩾60) and late (⩾15 and <60). ‘Acute-care settings’ included acute-hospital admissions with (‘palliative-acute-care’) and without palliative involvement (‘non-palliative-acute-care’).

Results:

We identified 230,921 decedents. Of them, 27% were early palliative care recipients and 13% were late; 45% of early recipients had a community-based initiation and 74% of late recipients had a hospital-based initiation. Compared to late recipients, fewer early recipients used palliative-acute care (42% vs 65%) with less days (mean days: 9.6 vs 12.0). Late recipients were more likely to use acute-care settings; this was further modified by disease: comparing late to early recipients, cancer decedents were nearly two times more likely to spend >1 week in acute-care settings (odds ratio = 1.84, 95% confidence interval: 1.83–1.85), frailty decedents were three times more likely (odds ratio = 3.04, 95% confidence interval: 3.01–3.07), and organ failure decedents were four times more likely (odds ratio = 4.04, 95% confidence interval: 4.02–4.06).

Conclusion:

Early palliative care was associated with improved end-of-life outcomes. Late initiations were associated with greater acute-care use, with the largest influence on organ failure and frailty decedents, suggesting potential opportunities for improvement.
Lifetime Punishments for Mentally Ill Juvenile Rampage School Shooters: No Hope for the Future?
Authors: Farr Kathryn
Published: December 2018

This study examines the roles of age and mental health in the processing of 10 adolescent rampage school shooters who had shown signs of mental instability prior to their rampage, but were tried and convicted as adults and sentenced to life or almost life in prison. Findings from court transcripts show that expert witnesses for the defense provided evidence of mental illness in all cases; however, the court determined that the diagnoses failed to meet the insanity standard or did not qualify as a significant mitigating circumstance. The reality of the boys’ actual guilt, the low competency standard, and the transfer of jurisdiction from Juvenile Court to criminal court all worked against their defense. Although in recent years the Supreme Court has ruled that because of the lesser development of children, life sentences for juveniles constitute cruel and unusual punishment, appeals on behalf of these boys have been routinely denied. Cross-national comparisons reveal the rarity of school shootings outside the United States and suggest that juvenile justice processing in many countries is far less punitive than that in the United States.
Where Are We Going? Where Have We Been?: The Climate for Diversity within Urban Planning Educational Programs
Authors: Greenlee Andrew J. , Jackson April , Garcia-Zambrana Ivis , Lee C. Aujean , Chrisinger Benjamin
Published: December 2018

This paper summarizes findings from a nationwide survey of degree-seeking urban planning students regarding the climate for diversity within their degree programs. This study examines interactions within the classroom, with faculty, with peers, and with professional planners. From May to October 2016, we surveyed 451 students and conducted in-depth interviews with 25 students. Our results show that while the majority of students report a positive climate for diversity within their programs, many still report occurrences of bias and discrimination, describe the shortcomings of a lack of planning faculty diversity, and perceive persistent challenges around diversity within planning practice.
Learning Skills, System Equity, and Implicit Bias Within Ontario, Canada
Authors: Parekh Gillian , Brown Robert S. , Zheng Samuel
Published: December 2018

The reporting of students’ Learning Skills on the Ontario provincial report card provides educators and families with insight into students’ work habits. However, the evaluation process is highly subjective. This study explores teachers’ perceptions around student learning across demographic and institutional factors. This exploratory study is the first of its kind in Canada and draws data from the Toronto District School Board (TDSB), the nation’s largest public board of education, serving approximately 246,000 students (2017-2018 data). Holding achievement as an independent variable, results indicate widespread differences in teachers’ perceptions across student demographic identities and reveals significant implications on postsecondary access.
Treatment adherence in HIV stigmatized environments in South Africa: stigma avoidance and medication management
Authors: Kalichman Seth C , Mathews Catherine , Banas Ellen , Kalichman Moira O
Published: December 2018

Stigmatization of HIV infection undermines antiretroviral therapy (ART) adherence. The current study examined strategies that people living with HIV employ to manage their ART in stigmatized environments. We conducted an anonymous survey with 439 patients receiving ART at a community clinic in Cape Town, South Africa. Measures included demographic and health characteristics, ART adherence, stigma experiences, efforts to conceal ART to avoid stigma (stigma–medication management strategies), and beliefs that ART nonadherence itself is stigmatizing. One in four participants had forgone taking their ART in social settings to avoid stigmatization, a behavior associated with younger age, experiencing greater stigma, and poorer ART adherence. Regression models found stigma–medication management strategies significantly predicted ART nonadherence over and above age, gender, alcohol use, and HIV stigma experiences. We also found that a significant majority of participants believed that having unsuppressed HIV and ART nonadherence are irresponsible and should be reprimanded by clinicians. Results show that the behavioral effects of stigma directly impede ART adherence. The behaviors that patients may employ to avoid stigma are amenable to interventions to directly improve ART adherence while managing stigma concerns.
Robust vehicle yaw stability controlby active front steering with active disturbance rejection controller
Authors: Wu Yan , Wang Lifang , Zhang Junzhi , Li Fang
Published: December 2018

Due to the complicated driving conditions, the influence of the external disturbance and the system uncertainty, the traditional active front-steering control methods which are based on the exact mathematical model cannot meet the control requirements. This article presents a new active front-steering control strategy which is based on active disturbance rejection control for vehicle yaw stability control. The proposed controller can dynamically estimate and compensate the total disturbance, which enables it to provide good control performance in a range of conditions without the need for a sophisticated vehicle model. In this article, the implementation of the active disturbance rejection control–based yaw stability controller is introduced in detail, and the convergence of the extended state observer and the stability of the whole controller are theoretically proved. In order to verify the effectiveness of the proposed control strategy, a co-simulation environment is used to carry out real-time simulations on typical driving conditions to verify the performances of the proposed controller. The simulation results show that the proposed controller can effectively improve the yaw stability of the vehicle and has strong robustness.
A Study on Role of Moderating Variables in Influencing Employees’ Acceptance of Information Technology
Authors: Dutta Payal , Borah Ashima Sharma
Published: December 2018

Penetration of information technology (IT) in almost every sector of the Indian economy is occurring at a very rapid pace. This has brought about a great transformation from a paper world to a digital world. Employees face new technological changes in their workplace almost every day. Some employees welcome the changes brought about by technology while others resist it and become defensive. These differences in employees’ reactions are influenced by a host of moderating variables existing in the environment. For the purpose of the present study, the researchers have adopted three moderating variables, namely, age, gender and experience (from the unified theory of acceptance and use of technology [UTUAT] model of Venkatesh, Morris, Davis, and Davis (2003, MIS Quarterly, 27, 3, 425–478). Hence, the article attempts to study the influence of the aforementioned moderating variables on the employees’ acceptance of IT at their workplace. The study has been conducted in the post offices falling under the Nalbari-Barpeta division of the Assam postal circle. The study is based on both the primary and secondary data.
The Effect of Perception of Complaint Management System on Purchase Intention: The Mediating Role of Cognitive Dissonance
Authors: Chadha S.K. , Kansal Purva , Goel Suriti
Published: December 2018

Traditionally, purchase intention has been a very popular dependent variable among the marketers and researchers. A very important antecedent of purchase intention is cognitive dissonance (CD). CD, in turn, is affected by a number of factors. One such factor is the risk of the consumer of not getting a proper redress solution in case he faces any problem with the product after its use. This risk is termed ‘the perceived recourse and redress risk (PRRR)’. It is used as a measure to analyse the efficiency of complaint management systems (CMSs). The study aims to analyse how consumers perceive the CMS of companies and its effect on the perception of CD with its subsequent effect on purchase intention. The study was carried out in the pre-purchase context on a sample of 600 respondents across five cities. The structural equation modeling (SEM) was used to analyse the data. The results indicated that among the eight dimensions of PRRR, only four dimensions affected the CD of customers, namely: no response, rudeness, extended delay and no action from customer care. The study leaves an implication for marketers to work on these dimensions and make the CMS more effective in order to increase the purchase intention of consumers.
Book Review: Tian Tao, David De Cremer and Wu Chunbo, Huawei: Leadership, Culture and Connectivity
Authors: Rastogi Parag
Published: December 2018

Tian Tao, David De Cremer and Wu Chunbo, Huawei: Leadership, Culture and Connectivity, 2018, New Delhi: SAGE Publications, 360 pp., ₹450. ISBN: 9386062054.
Book Review: Cristina B. Gibson and Susan G. Cohen, Virtual Teams That Work: Creating Conditions for Virtual Team Effectiveness
Authors: Krishnan Shalini
Published: December 2018

Cristina B. Gibson and Susan G. Cohen, Virtual Teams That Work: Creating Conditions for Virtual Team Effectiveness, 2003, San Francisco, CA: Jossey-Bass, 436 pp., ₹2,162.09. ISBN: 0-7879-6162-0.
Progesterone receptor expression in proliferating cancer cells of hormone-receptor-positive breast cancer
Authors: Ueno Takayuki , Saji Shigehira , Chiba Tomohiro , Kamma Hiroshi , Isaka Hirotsugu , Itoh Hiroki , Imi Kentaro , Miyamoto Kaisuke , Tada Manami , Sasano Hironobu , Toi Masakazu , Imoto Shigeru
Published: December 2018

Breast cancer has been suggested to have two distinct driving mechanisms: the hormone receptor and the growth factor receptor pathways. We hypothesized that each driving system produces a different expression pattern of estrogen-regulated genes, such as progesterone receptor, in proliferating cells. Progesterone receptor and Ki67 expressions were assessed by dual-fluorescence immunohistochemistry in estrogen-receptor-positive breast cancer tissues. Two distinct proliferating cell populations were observed: progesterone-receptor-positive and progesterone-receptor-negative. In the training cohort, tissues with progesterone-receptor-positive proliferating cells were associated with lower grade and better disease-free survival (p = 0.0055 and 0.0026, respectively). These associations were confirmed in the validation cohort from the neoadjuvant endocrine trial JFMC34 (p = 0.033 and 0.0003, respectively). In the validation cohort, patients with progesterone-receptor-positive proliferating cells responded better to endocrine therapy and had a lower Oncotype DX Recurrence Score. In the multivariate analysis, progesterone receptor status of proliferating cells, but not progesterone receptor or Ki67 alone, was an independent predictor of disease-free survival in both cohorts (p = 0.0043 and 0.0026). In conclusion, the progesterone receptor status of proliferating cancer cells was associated with histological grade and Recurrence Score, and a potent prognostic factor in estrogen-receptor-positive breast cancers. Results suggest that different driving systems generate different expression patterns of progesterone receptor in proliferating cancer cells. Further studies are warranted to validate the findings.
An evaluation of a pilot specialist smoking cessation clinic in a mental health setting
Authors: Davis Amelia , Ngo Hanh , Coleman Mathew
Published: December 2018

Objectives:

Smoking rates in people with mental illness in Australia remain alarmingly high whilst they have been declining in the general population. This study reviews a smoking cessation programme in a mental health service, as a pilot for future studies and program development. We aim to assess the effectiveness of this intervention and the ease of implementation after upskilling the clinical workforce.

Methods:

Part A – a retrospective analysis of patients attending the Smokers’ Clinic, ( n = 44) over a period of 18 months. Part B – survey of ease of implementation and change in practice of the resident medical officers (RMOs; n = 8) following their clinical placement.

Results:

For the entire clinic population, the mean reduction in expired carbon monoxide was approximately 43%, with 34% of patients achieving abstinence. Females were 3.4 times more likely to be successful than males. Seventy-five per cent of RMOs found learning about nicotine dependence and smoking cessation ‘easy’, and 88% continued to offer smoking cessation after their placement.

Conclusions:

The Smokers’ Clinic was successful in helping tobacco smokers with mental illness to reduce or cease smoking. Specialist skill and experience is not required to manage smoking cessation in a mental health setting.
Nurse Leadership Development in Malta
Authors: Hughes Victoria , Wright Rebecca , Cassar Maria
Published: December 2018

Introduction: Leadership development has been studied extensively in many of the larger countries around the world, but there has been very limited research on nursing leadership development within small island countries. Purpose: Explorative semistructured interviews underpinned by a phenomenological philosophy were conducted to seek understanding of the meaning attributed to the nursing leadership development within the Maltese culture. Method: Six nurse leaders from administration, advanced practice, and academic backgrounds participated in semistructured interviews. Thematic data analysis was conducted with a focus on the competencies of nurse leadership within the context of authentic leadership theory. Results: Themes moved from a general discussion of the wider cultural setting (Cultural Integration) to a more focused observation of practical factors that contribute to leadership growth (Developing as a Leader), to a personal reflection on their own experiences and journeys (Self-Reflection in Leadership). Indeed, 15 subthemes supported the broad themes addressed in the present study, providing additional context and detail. Discussion: Nurse leadership strategies identified during this study may be effective in similar small island cultures.
Five Approaches to Qualitative Comparison Groups in Health Research: A Scoping Review
Authors: Lindsay Sally
Published: December 2018

Qualitative researchers have much to gain by using comparison groups. Although their use within qualitative health research is increasing, the guidelines surrounding them are lacking. The purpose of this article is to explore the extent to which qualitative comparison groups are being used within health research and to outline the lessons learned in using this type of methodology. Through conducting a scoping review, 31 articles were identified that demonstrated five different types of qualitative comparison groups. I highlight the key benefits and challenges in using this approach.
Working With Asian Language Interpreters in Qualitative Research: A Comparative Study
Authors: Wong Grace , Koziol-McLain Jane , Glover Marewa
Published: December 2018

Health researchers employ health interpreters for research interviews with linguistically diverse speakers. Few studies compare inconsistencies between different interpretations of the same interview data. We compared interpreted with independently reinterpreted English language transcripts from five in-home family interviews conducted in five different Asian languages. Differences included augmented, summarized, and/or omitted information. Researchers should ensure that they, and their interpreters, follow rigorous processes for credible qualitative data collection, and audit their interpreted data for accuracy. Different interpretations of the same data can be incorporated into analyses.
The Push and Pull of Self-Managing Mild COPD: An Evaluation of Participant Experiences of a Nurse-Led Telephone Health Coaching Intervention
Authors: Coventry Peter A. , Blakemore Amy , Baker Elizabeth , Sidhu Manbinder , Fitzmaurice David , Jolly Kate
Published: December 2018

Health coaching is a novel population intervention to support self-management but it is untested in people with mild disease. People with chronic obstructive pulmonary disease with mild dyspnea are a population excluded from supported self-management and whose illness might progress without intervention. We explored participants’ experiences about how health coaching motivated behavior change. Interviews were conducted with 21 intervention and 10 control participants at 6 months, and 20 intervention participants at 12 months. Participants were identified from a randomized controlled trial of telephone health coaching. Data were analyzed using the framework method. Participants positively enacted behavior change to become more physically active. Participants took advantage of environmental affordances to pull themselves toward activity targets, or relied on being pushed to be more active by the health coach or significant others. Behavior change was maintained where efforts to be more active were built into the everyday lifeworld of participants.
Bumetanide for Autism Spectrum Disorder in Children: A Review of Randomized Controlled Trials
Authors: James B. Jordan , Gales Mark A. , Gales Barry J.
Published: December 2018

Objective: To evaluate clinical trials using bumetanide in autism spectrum disorder (ASD) treatment. Data Sources: PubMed and Ovid MEDLINE (1946 to October 2018) were searched using terms bumetanide and autism. Bibliographies were reviewed for other relevant trials. Study Selection and Data Extraction: English language, randomized, controlled, clinical trials in humans were evaluated. Three trials met all inclusion criteria. Data Synthesis: Oral bumetanide was studied in 208 patients, 2 to 18 years old, with ASD. Trials evaluated bumetanide’s impact on core behavioral features using several different autism assessment scales. All trials used the Childhood Autism Rating Scale to assess improvement at 90 days, with one trial finding statistical significance. The Clinical Global Impressions Scale identified statistically significant improvements in 2 of the 3 trials. The Autism Behavioral Checklist and Social Responsiveness Scales identified statistical benefit in the 2 trials utilizing those outcomes. Behaviors most improved by bumetanide included social communication, interactions, and restricted interest. No dose-effect correlation was identified in the dose-ranging trial. Adverse effects, including hypokalemia and polyuria, occurred more often with higher doses and resulted in withdrawal rates of 17% to 43%. Bumetanide 0.5 mg twice daily was the most studied and best tolerated dose. Limitations included unclear clinical success definitions and evaluation methodology variability. Relevance to Patient Care and Clinical Practice: No effective treatment options for core ASD symptoms have been approved. This review presents preliminary safety and efficacy data for bumetanide in ASD. Conclusions: Low-dose oral bumetanide may be useful in patients with moderate to severe ASD when behavioral therapies are not available.
Voting for Green? U.S. Support for Environmental Projects in the Multilateral Development Banks
Authors: Braaten Daniel , Orozco Maui , Strand Jonathan R.
Published: December 2018

This article examines the drivers of American support for environmental projects in the multilateral development banks (MDBs). We first describe how U.S. Executive Directors are guided by Congressional directives regarding environmental aspects of MDB projects. The article then turns to statistical analysis of the strategic and normative drivers of U.S. positions on MDB projects. Our analysis finds mixed support for environmental factors driving U.S. votes. The United States is more inclined to vote against “dirty” projects (i.e., mining, coal, and oil) rather than specifically support “green” projects (i.e., projects related toward climate change or biodiversity). The overall environmental performance of a country had a minor influence on whether the United States would support proposals from that country, but the United States was much more likely to disapprove of a project if a project failed to undergo an environmental analysis or failed the analysis in anyway.
A comparison of response in the presence or absence of a delay in induction therapy with bortezomib, lenalidomide, and dexamethasone
Authors: Schepers Allison J , Jones Alexis R , Reeves Brandi N , Tuchman Sascha A , Bates Jill S
Published: December 2018

Purpose

Lenalidomide, bortezomib, and dexamethasone (RVd) has emerged as a preferred induction therapy in multiple myeloma (MM) in the United States. Due to lenalidomide's teratogenic risk, patients and prescribers must comply with a risk evaluation and mitigation strategy (REMS) program. The REMS program limits dispensing to certain third-party specialty pharmacies, whose average prescription fill times are longer than in-house specialty pharmacies. In practice, a delay in procurement of lenalidomide may mean that patients start therapy with only bortezomib and dexamethasone, delaying the start of more effective triplet therapy. The primary objective of this study is to determine if a delay from start of bortezomib and dexamethasone to start of triplet therapy with lenalidomide impacts rate of achievement of very good partial response (VGPR) after four cycles of RVd.

Methods

This was a single-center retrospective review of adults with newly diagnosed MM who received RVd induction therapy at University of North Carolina Medical Center between April 2014 and June 2017. Patients who started lenalidomide ≥10 days after bortezomib comprised the “Delay” group, while those who started lenalidomide concurrently with bortezomib or within 1–9 days after bortezomib comprised the “No Delay” group. The primary outcome was VGPR or better response rate after four cycles of RVd.

Results

Thirty-eight patients met inclusion criteria. Nine patients (23.7%) experienced any delay in initiation of lenalidomide, with a mean delay of 7.8 days (range 1–18). Four patients (10.5%) experienced a delay ≥10 days. No patients in the Delay group were of reproductive potential, compared to 8.8% in the No Delay group ( p = 0.54). VGPR or better response rate did not differ between the Delay and No Delay groups (66.7% vs. 58.8%, p = 0.79). The mean number of lenalidomide prescriptions generated per RVd cycle was 1.35 (range 1–5, SD 0.74).

Conclusions

This study did not demonstrate an effect on clinical response after delays ≥10 days between bortezomib and lenalidomide initiation. No patients in the delay group were females of reproductive potential, which is the primary target for increased safety behind the REMS program.
Concomitant use of levofloxacin and fluconazole leading to possible torsades de pointes
Authors: Tilton Jessica J , Sadr Rozhan , Groo Vicki L
Published: December 2018

Prolongation of the corrected QT interval can lead to the deadly arrhythmia torsades de pointes. There are many risk factors for corrected QT prolongation, one being medication. The goal of this case report is to add to the limited literature surrounding the possibility of torsades de pointes when levofloxacin and fluconazole are used concomitantly. Additionally, provide guidance for patient factors that need to be assessed when prescribing the two drugs.
Wound healing complications with lenvatinib identified in a pharmacovigilance database
Authors: Cheng Connie , Nayernama Afrouz , Christopher Jones S , Casey Denise , Waldron Peter E
Published: December 2018

The U.S. Food and Drug Administration (FDA) has approved several vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors, including lenvatinib, for thyroid and renal malignancies. Inhibition of the VEGFR signaling pathway impairs angiogenesis and can disrupt wound healing. The objective of this work was to evaluate wound healing complications as a potential safety risk for patients treated with lenvatinib. We searched the FDA Adverse Event Reporting System (FAERS) database for postmarketing reports of wound healing complications with lenvatinib between 13 February 2015 (FDA approval date) and 15 February 2017. The search identified nine FAERS cases of lenvatinib-associated wound healing complications that were not previously reported in the medical literature. Seven cases involved postoperative wound healing complications, such as impaired healing or wound dehiscence. In our case series, the reported time to identification of delayed wound healing from tissue injury or surgery varied over a wide range (4–58 days). The time of initial lenvatinib exposure relative to the tissue injury was also highly varied in our series, which may have influenced the development and detection of impaired healing. FAERS case-level evidence suggests that lenvatinib may have contributed to wound healing complications based on temporality and biologic plausibility. Healthcare professionals should be aware of this safety risk to facilitate prompt recognition and risk mitigation.
Effect of friction on the mechanical behavior of wire rope with hierarchical helical structures
Authors: Liu Dabiao , Zheng Shimin , He Yuming
Published: December 2018

The effect of friction on the mechanical behavior of wire rope with hierarchical helical structures under tensile and bending loads is studied. A typical 7×7 wire rope with an independent wire rope core is considered. It is assumed that friction only occurs between adjacent helical wires in the core strand, and between the core wire and the double-helix wires in the outer strands. Based on Love’s thin rod theory, the mechanical responses of the rope under tensile and bending loads are analyzed, as well as the contact force. The effects of the chirality of rope and the initial helix angle of the wire on the distribution of the contact force are analyzed. It is shown that the effect of the chirality on the contact force of wires and stresses in the rope is insignificant. The global stiffness of the rope can be enhanced by the friction effect. The contact force of wires changes periodically with the winding angle of the centerline around the axis of the strand. The current model provides an effective method to assess the local deformation and stresses of the wire rope with consideration of the inter-wire friction.
High risk of complications using metal heads after ceramic fracture in total hip arthroplasty
Authors: Olmedo-Garcia Nuria I , Zagra Luigi
Published: December 2018

Background:

There is some uncertainty about the bearing to be used to substitute a broken ceramic. Using metal components (head or liner) may lead to catastrophic wear of the metal.

Aim:

The purpose of this article is to describe the long-term follow-up result of ceramic fracture replaced with metal-on-polyethylene (MoP).

Methods:

We report 3 cases of ceramic head fracture after ceramic-on-ceramic (CoC) total hip arthroplasty (THA) in which the broken ceramic was replaced with MoP.

Results:

All cases developed severe complications due to gross wear of the metal head: one developed a pseudotumour after a few months while the other 2 had significant local metallosis and toxic blood metal levels.

Conclusions:

When there is a fracture of a ceramic component, we advise caution with the use of metal heads, as small ceramic fragments can cause 3rd-body wear with massive metal debris and severe local and general complications.
Peripherally inserted central catheter, midline, and “short” midline in palliative care: Patient-reported outcome measures to assess impact on quality of care
Authors: Magnani Caterina , Calvieri Alice , Giannarelli Diana , Espino Margot , Casale Giuseppe
Published: December 2018

Objectives:

A prospective, observational study was conducted in our palliative care unit to assess the impact of peripherally inserted central catheters (PICCs), midline, and “short” midline catheters on the quality of care in cancer and non-cancer patients. The secondary objective was to assess pain and distress during vascular access device insertion.

Methods:

Patients were recruited if they underwent insertion of a PICC, midline, or “short” midline catheter as part of their standard care. The Palliative care Outcome Scale was used to assess changes in quality of care after vascular access device positioning. A numerical rating scale was used to measure pain intensity during catheter insertion.

Results:

Of the 90 patients enrolled, 52.2% were male with a mean age of 73.0 ± 13 years. Among these patients, 64.4% patients underwent “short” midline insertion, 26.7% PICC, and 8.9% midline catheter. The patients’ mean baseline Palliative care Outcome Scale score was 15.7 ± 5.6. Three days after vascular access device positioning, the patients’ mean Palliative care Outcome Scale score was 11.5 ± 5.5 (p < 0.0001). Mean pain score during vascular access device insertion was 1.26 ± 1.63, and mean procedural distress score was 1.78 ± 1.93.

Conclusion:

These findings suggest that medium-term intravenous catheters can have a favorable impact on quality of care and the procedures for these vascular access device insertions are well tolerated. Further research on the performance of different vascular access devices and their appropriateness in palliative care should be encouraged.
Spinal cord and infratentorial lesions in radiologically isolated syndrome are associated with decreased retinal ganglion cell/inner plexiform layer thickness
Authors: Filippatou Angeliki , Shoemaker Thomas , Esch Megan , Qutab Madiha , Gonzalez-Caldito Natalia , Prince Jerry L , Mowry Ellen M , Calabresi Peter A , Saidha Shiv , Sotirchos Elias S
Published: December 2018

Background:

The role of retinal imaging with optical coherence tomography (OCT) in assessing individuals with radiologically isolated syndrome (RIS) remains largely unexplored.

Objective:

To assess retinal layer thicknesses in RIS and examine their associations with clinical features suggestive of increased risk for conversion to multiple sclerosis (MS).

Methods:

A total of 30 RIS subjects and 60 age- and sex-matched healthy controls (HC) underwent retinal imaging with spectral-domain OCT, followed by automated segmentation of retinal layers.

Results:

Overall, retinal layer thicknesses did not differ between RIS and HC. However, RIS subjects with spinal cord (SC) lesions had lower ganglion cell + inner plexiform layer (GCIP) thickness compared to HC (−4.41 μm; p = 0.007) and RIS without SC lesions (–3.53 μm; p = 0.041). Similarly, RIS subjects with infratentorial (IT) brain lesions had lower GCIP thickness compared to HC (–4.07 μm; p < 0.001) and RIS without IT lesions (–3.49 μm; p = 0.029). Multivariate analyses revealed that the presence of SC or IT lesions were independently associated with lower GCIP thickness in RIS ( p = 0.04 and p = 0.03, respectively). Other patient characteristics, including sex, abnormal cerebrospinal fluid, and presence of gadolinium-enhancing or juxtacortical lesions, were not associated with retinal layer thicknesses.

Conclusion:

The presence of SC or IT lesions in RIS may be associated with retinal neuro-axonal loss, supporting the presence of more disseminated disease.