bluuebunny/crossref_metadata_2025 huggingface dataset:
Resilience in Urban African American Adolescents: The Protective Enhancing Effects of Neighborhood, Family, and School Cohesion Following Violence Exposure
Authors: DiClemente Cara M. , Rice Catherine M. , Quimby Dakari , Richards Maryse H. , Grimes Cordelia T. , Morency Mirinda M. , White Candice D. , Miller Kevin M. , Pica Jason A.
Published: November 2016

Exposure to violence (ETV) poses a serious threat to adolescents’ safety and well-being; however, some adolescents who grow up in such toxic environments are able to thrive due to a combination of internal and external characteristics. The current study examines the role of cohesion across contexts (i.e., family, school, and community) as moderating the relation between ETV and positive internal outcomes characteristic of resilient youth (i.e., ethnic identity, positive affect, and self-esteem) in a sample of low-income, urban, African American adolescents ( N = 269, 60% female) from seventh grade to eighth grade. Results indicated that greater cohesion in each context was directly related to more positive outcomes. Family and neighborhood cohesion additionally served as protective enhancing factors for males exposed to high levels of violence. These findings expand the current research on positive youth development and help locate potential environmental targets for prevention and intervention research.
The Role of Extrafoveal Vision in Source Code Comprehension
Authors: Orlov Pavel A. , Bednarik Roman
Published: November 2016

Understanding software engineers’ behaviour plays a vital role in the software development industry. It also provides helpful guidelines for teaching and learning. In this article, we conduct a study of the extrafoveal vision and its role in information processing. This is a new perspective on source code comprehension. Despite its major importance, the extrafoveal vision has been largely ignored by previous studies. The available research has been focused entirely on the foveal information processing and the gaze fixation position. In this work, we share the results of a gaze-contingent study of source code comprehension by expert ( N = 12) and novice ( N = 12) programmers in conditions of the restricted extrafoveal vision. The window-moving paradigm was employed to restrict the extrafoveal area of vision as participants comprehend two source code examples. The results indicate that the semantic preview allowed by the extrafoveal vision provides tangible benefits to expert programmers. When the experts could not use the semantic information from the extrafoveal area, their fixation duration increased to duration similar to novices. The experts’ performance dropped in the restricted-view mode, and they required more time to solve the tasks.
Latent Structure of Scores From the Emotional and Behavioral Screener
Authors: Lambert Matthew C. , January Stacy-Ann A. , Pierce Corey D.
Published: November 2016

The Emotional and Behavioral Screener (EBS) is a recently developed teacher-reported brief screening instrument for identifying students who are at-risk of an emotional or behavioral disorder (EBD). Although prior research supports the technical adequacy of scores from the EBS, there is a gap in the literature regarding strong evidence of the factor structure underlying EBS scores. This study investigated the latent structure of scores from the EBS in a sample of 646 elementary students who were rated by their teachers in a 2-week screening period. Single-factor confirmatory factor analysis (CFA) and bifactor models were used to test the hypothesis that EBS scores are a measure of both overall emotional and behavioral risk and students’ externalizing and internalizing behaviors. Results supported a bifactor structure, in that scores from the EBS can be considered to represent a general factor (i.e., risk of EBD) and two group factors (i.e., externalizing and internalizing domains). Findings have implications for interpreting scores when using the EBS as a universal screener for the risk of EBD.
Detecting Enteral Nutrition Residues and Microorganism Proliferation in Feeding Tubes via Real‐Time Imaging
Authors: Yamaoka Ippei , Kagawa Tomohiro , Mizugai Kazuya , Ebisu Goro
Published: November 2016

Background: Enteral nutrition (EN) residues that persist in feeding tubes provide substrates for microorganisms to proliferate and occlude the tubes. Visible EN residues in tubes are easily identified, but smaller residues can persist. We developed a new imaging technique to visualize EN residues and proliferation of microorganisms in feeding tubes. Materials and Methods: (1) Feeding tubes containing EN labeled with fluorescent dye and either with or without various types or amounts of thickeners were flushed once with water and then seeded with Pseudomonas aeruginosa Xen05 with recombinant luciferase DNA. (2) Because EN fluoresces intrinsically, EN in the feeding tubes without fluorescent dye was repeatedly flushed until the intrinsic fluorescence levels reached background levels. Fluorescent images of EN residues and bioluminescent images of microorganisms were acquired via an optical imaging system. Results: (1) Fluorescence images showed that the amount of EN residues increased at various sites in tubes depending on EN viscosity and the thickening agent, and bioluminescence images showed that microorganism proliferation was associated with a commensurate increase in EN residues. (2) The intrinsic fluorescence of EN also enabled the detection of EN residues in tubes even in the absence of fluorescence dye. Higher EN viscosity required more flushes to reach undetectable levels. Conclusion: EN residues and microorganism proliferation in enteral feeding tubes were detected on fluorescence and bioluminescence images, respectively. This simplified approach allowed the real‐time visualization of EN residues and microorganisms in feeding tubes.
Negative Responses to Disclosure of Sexual Victimization and Victims’ Symptoms of PTSD and Depression: The Protective Role of Ethnic Identity
Authors: Nikulina Valentina , Bautista Adrian , Brown Elissa J.
Published: November 2016

College-aged women experience high rates of sexual victimization. Their postassault symptoms are associated with the types of responses they receive from the people to whom they disclose these experiences. Negative responses are pervasive and associated with poorer outcomes. The current study examined whether a strong sense of ethnic identity and comfort with the mainstream culture moderate the association between negative responses to the first disclosure of sexual victimization and symptoms of posttraumatic stress disorder (PTSD) and depression. A diverse sample (10% Black/African American, 51% White, 39% Other, and 66% Hispanic) of undergraduate women was recruited from two urban, Eastern United States universities for this online study. Participants reported histories of sexual victimization, demographics, responses to sexual assault disclosure (i.e., victim blame, treating the victim differently, taking control, distraction, and egocentric reactions), symptoms of PTSD and depression, and their ethnic identity and mainstream cultural comfort. Thirty-seven percent ( n = 221) endorsed an experience of sexual victimization, and 165 disclosed it to someone. Hierarchical ordinary least squares regressions revealed that a stronger sense of ethnic identity was associated with fewer symptoms of PTSD for those women who experienced higher levels of control, distraction, and egocentric responses from the first disclosure recipient. A strong sense of affiliation with the mainstream culture did not protect survivors who reported receiving negative responses to disclosure against symptoms of PTSD or depression. Ethnic affiliation may protect women against PTSD when they receive high levels of negative messages about sexual victimization experiences.
Parenting Styles, Identity Development, and Adjustment in Career Transitions
Authors: Cordeiro Pedro Miguel Gomes , Paixão Maria Paula , Lens Willy , Lacante Marlies , Luyckx Koen
Published: November 2016

Drawing from self-determination theory, this study examines how does perceived parenting and psychological needs relate to identity development and psychosocial adjustment in Portuguese 12th-grade students ( N = 462) who prepare the transition to higher education or to the job market. Path model results revealed two distinct pathways: a “growth-oriented pathway” from need-supporting parenting to integrated career exploration, commitment-making and well-being via need satisfaction and a “vulnerability” pathway from need-thwarting parenting to both diminished well-being and ill-being through need frustration. Findings suggest that perceived parental support is a protective factor, and parental thwarting a risk factor for career decision-making, but this relation is mediated by the adolescents’ subjective feelings of psychological need satisfaction and frustration. Altogether, they suggest the need to customize interventions with adolescents to address “bright” and “dark” trajectories of identity development and establish a supportive counseling climate that facilitates the exploration of different aspects of self-environment in career transition periods.
Multi-objective optimization design of a multi-layer honeycomb sandwich structure under blast loading
Authors: Wang Zongqian , Zhou Yunbo , Wang Xianhui , Zhang Xinlei
Published: November 2016

In order to improve the shielding performance of the underbody protective structure of military vehicles when subjected to explosive events, a multi-layer honeycomb sandwich structure is proposed. Full consideration of the computing response of the underbody protective structure under blast loading is a large-scale and strongly non-linear problem; a reasonably simplified finite element model is constructed in this paper. LS-DYNA software was employed to simulate blast loading by using the *LOAD_BLAST equation and to compute the dynamic responses of the vehicle; then, full-scale experiments were performed to validate the accuracy of the numerical simulation. The geometric dimensions and the shape parameters of the multi-layer honeycomb sandwich structure are selected as the design variables, thereby establishing a response surface and a mathematical optimization model by employing the design-of-experiments method. A Pareto spatial optimal set is obtained by applying a multi-objective genetic algorithm. Eventually, using the normal-boundary intersection algorithm an optimum design was obtained, which can apparently enhance the shielding performance of the underbody protective structure of military vehicles without increasing the mass.
How well does a linear static finite element analysis predict measured strains from a nuclear package tie-down system during rail transportation?
Authors: Cummings Andrew , Rothwell Glynn , Matthews Christian
Published: November 2016

Freight rail is often the preferred method for transportation of dangerous goods. One particular application is the use of rail to convey radioactive material in purpose-built packages. During transit, packages are secured to a rail wagon bed with a tie-down system. The design of tie-down systems varies considerably depending on the package type and rail vehicle; for example, shackles, turnbuckles, tie rods, gravity wells or transport frames are all commonly used. There are also a large number of different packages in existence that all vary in size and mass, typically 1–7 m in length and 100 kg–100 t in mass. Despite the uniqueness of many transport configurations, the design of tie-down systems is always carried out using a limited set of design load cases as defined in the appropriate Codes of Practice and Standards. Many authors have suggested that the load cases within the standards need revision or question which load cases should apply to which scenario. In a previous experiment, accelerations and strains have been measured on a freight wagon and transport frame of a heavy package during a routine rail journey. From these data, a new insight into the magnitude and nature of loading has been gained. In the present study, the measured accelerations have been used as input to a finite element model of the transport frame, and a method based on correlation between predicted and measured strains has been developed to determine an appropriate low-pass filter cut-off frequency, fc, which separates quasi-static loading from raw dynamic data. The residual dynamic measurements have been assessed using signal processing techniques to understand their significance. The finite element model has also been used to assess the presence of contact and boundary nonlinearities and how they affect the agreement between measured and predicted strains.
Pregnant women’s attitudes about topical microbicides for the prevention and treatment of bacterial vaginosis during pregnancy
Authors: Catallozzi Marina , Fraiz Lauren Dapena , Hargreaves Katharine M , Zimet Gregory D , Stanberry Lawrence R , Ratner Adam J , Gelber Shari E , Rosenthal Susan L
Published: November 2016

We sought to understand pregnant women’s product preference and likelihood of use of topical microbicides for bacterial vaginosis (BV) prevention and treatment. Pregnant women (N = 196) in a obstetrics clinic completed a survey between June 2014 and January 2015 about vaginal product use for BV. This cross-sectional study explored product preferences, likelihood of product use for BV management and father of the baby (FOB) involvement. Most participants were under 30 (68%) and underrepresented minorities (47% Hispanic, 21% African-American). Most women preferred the gel (69%). Only 30% were likely to use either product for prevention of BV; 76% if high risk for BV; 83% treatment of BV. Anticipated FOB involvement in decision-making included that 46% would ask his opinion, 38% would inform him of the decision and 7% would need approval. Most (87%) would ask the FOB for reminders and 66% for insertion help. Those under 30 were more likely to agree to ask the FOB for reminders (p < 0.01) and insertion help (p = 0.05). African-American women were less likely to have their FOB help with insertion (p < 0.01). Product preferences may be less critical than risk perception. Involvement of the FOB in decision-making may be vital.
De novo HIV infection diagnoses in a Department of Dermatology and Venereology in Lisbon, Portugal
Authors: Mendes-Bastos Pedro , Brasileiro Ana , Matos-Pires Eugénia , Rodrigues Isaura , Marques Cristina , Coelho-Macias Vasco , Fernandes Cândida
Published: November 2016

Background

Portugal has the highest prevalence rate of HIV infection in Western Europe. The proportion of patients with a late diagnosis, carried out in full-blown AIDS stage, remains high. Skin and mucous membrane manifestations are not rare in these patients.

Objective

A demographic, clinical, and laboratorial characterization of patients with de novo HIV infection diagnosis made in the Department of Dermatology and Venereology of a central hospital in Lisbon, Portugal.

Methods

Retrospective review of medical records of adult patients newly diagnosed with HIV infection (reactive immunoassay for antibodies to HIV-1/HIV-2 or HIV p24 antigen) in the Dermatology and Venereology Department of a Portuguese central hospital in the period between January 2005 and December 2013.

Results

During the study period, 97 new cases were diagnosed, 70 men and 27 women. The median age at diagnosis was 36 years. Of the total, 50 cases were diagnosed with a concomitant sexually transmitted infection (STI), more frequently syphilis and ano-genital HPV infection. The remaining 47 patients were diagnosed with other dermatological conditions such as prurigo nodularis, psoriasis, and Kaposi’s sarcoma. The duration of complaints that lead to medical attention ranged from <1 week to 8 years, being significantly lower in patients diagnosed with a concomitant STI ( p < 0.01). Basal viral load was also lower in this group of patients ( p < 0.05). Of all the new diagnosed cases, 80% of patients are currently retained in care.

Conclusion

This study grants a descriptive overview of de novo HIV infection diagnoses performed by dermatovenereologists in a central hospital in Lisbon, Portugal. As in the past, the importance of Dermato–Venereology for HIV infection diagnosis remains present in daily clinical practice.
A Window of Opportunity for Cognitive Training in Adolescence
Authors: Knoll Lisa J. , Fuhrmann Delia , Sakhardande Ashok L. , Stamp Fabian , Speekenbrink Maarten , Blakemore Sarah-Jayne
Published: November 2016

In the current study, we investigated windows for enhanced learning of cognitive skills during adolescence. Six hundred thirty-three participants (11–33 years old) were divided into four age groups, and each participant was randomly allocated to one of three training groups. Each training group completed up to 20 days of online training in numerosity discrimination (i.e., discriminating small from large numbers of objects), relational reasoning (i.e., detecting abstract relationships between groups of items), or face perception (i.e., identifying differences in faces). Training yielded some improvement in performance on the numerosity-discrimination task, but only in older adolescents or adults. In contrast, training in relational reasoning improved performance on that task in all age groups, but training benefits were greater for people in late adolescence and adulthood than for people earlier in adolescence. Training did not increase performance on the face-perception task for any age group. Our findings suggest that for certain cognitive skills, training during late adolescence and adulthood yields greater improvement than training earlier in adolescence, which highlights the relevance of this late developmental stage for education.
Examination of changes in the Turkish hydropower development, regulation, and planning
Authors: Celik Ahmet Ozan , Kiricci Volkan
Published: November 2016

Hydropower has a critical role in supplying the energy demand and sustaining the economic and industrial growth in Turkey. Over the past decade, several policy changes have been made to improve the contribution of hydropower in overall national energy production. Turkey is utilizing less than half of the hydropower potential and planning to employ almost full of its potential within the next 10 years. For this plan to be realized there is a need to analyze the strengths and weaknesses of the past and recent regulations. Implications from such an analysis are believed to be necessary for a better national energy strategy. This work fills this gap and presents analysis of data representing utilized and unutilized hydropower potential obtained from the official sources. The analysis coupled with the recent policy changes was discussed within the context of sustainable hydropower structure. The unutilized hydropower potential plays a crucial role in national energy security. It is also evident that hydropower alone will not be meeting the rapidly increasing demand. So far, however, researchers have shown an increased interest in unutilized hydropower potential; there has been no detailed analysis about identifying characteristics of this potential and developing strategies in terms of required technological investments. The efforts toward realizing the long-term national energy security goals need to consider establishing research development and manufacturing capabilities of domestic hydropower equipment which will fit the need to reduce foreign dependence on hydropower energy technology.
Response of chironomids to Neolithic land-use change in north-west Ireland
Authors: Taylor Karen J , Stolze Susann , Beilman David W , Potito Aaron P
Published: November 2016

This study provides the first decadally resolved chironomid and organic geochemistry record of the Irish Neolithic from a small lake adjacent to the Carrowkeel-Keshcorran complex in County Sligo, Ireland. Chironomid (non-biting midge fly) sub-fossils and lake sediment geochemistry (δ13C, δ15N and C:N) from the Templevanny Lough core were used to assess the timing and magnitude of within-lake responses to Neolithic farming activity. When compared with decadally resolved pollen and macroscopic charcoal records from the same core, the limnological data show a direct influence of prehistoric farming on a freshwater lake system through nutrient loading and lake eutrophication. Elevated nutrient levels, suggesting a more productive lake system, and a subsequent turnover in the chironomid community indicate a period of intensive farming activity from c. 3790–3620 BC in the early Neolithic. This was followed by a decline in farming with short periods of small-scale human activity, exemplified through nutrient loading and short-lived increases in eutrophic chironomid taxa during the middle to late Neolithic. A return of farming activity can be seen in all proxy data in the late Neolithic ( c. 2720–2480 BC). The chironomid community composition typically lagged land-use change by c. 10–20 years and exhibited predictable and proportional responses to agricultural activity. The timing and magnitude of limnological changes show that land-use, rather than climate, is the main control on chironomids at Templevanny Lough, thus showing the potential prominence of the anthropogenic signal during the Neolithic.
All age–depth models are wrong, but are getting better
Authors: Trachsel Mathias , Telford Richard J
Published: November 2016

The construction of accurate age–depth relationships and a realistic assessment of their uncertainties is one of the fundamental prerequisites for comparing and correlating late Quaternary stratigraphical proxy records. Four widely used age–depth modelling routines – CLAM, OxCal, Bacon and Bchron – were tested using radiocarbon dates simulated from varved sediment stratigraphies. All methods produce mean age–depth models that are close to the true varve age, but the uncertainty estimation differs considerably among models. Age uncertainties are usually underestimated by CLAM, whereas age uncertainties produced by Bchron are often too large. With OxCal and Bacon, the setting of model-specific parameters influences the estimated uncertainties, which vary from too large to too small. The variability of sediment accumulation rates is underestimated by CLAM but overestimated by Bacon and Bchron. Bayesian age–depth models mainly improve the assessment of uncertainties of age–depth models.
Lakes ecosystem response to Holocene climate changes and human impact in the Southern Urals: Diatom and geochemical proxies
Authors: Maslennikova Anna Valer’evna , Udachin Valery N
Published: November 2016

Major changes in the Holocene were identified based on a diatom and geochemical analysis of sediment cores from Lakes Ufimskoe and Syrytkul (the Southern Urals). The Lake Ufimskoe ecosystem in the Central mountain area is identified to be highly sensitive to variations in temperature. Meanwhile, Lake Syrytkul is more responsive to climate aridization because of its limnological characteristics and less precipitation in the piedmont area. Climate events were the main drivers for lake ecosystems dynamics throughout almost the whole history of the lakes. The records of lake sediments reflect several climate events noted elsewhere in the Northern Hemisphere: Lateglacial–Holocene transition (~12,000–11,600), Preboreal oscillation (~11,200–11,000 cal. BP), climate warming and aridization (~9700–9600 cal. BP), warming and increase in precipitation since 9000 cal. BP, climate aridization at ~5800 cal. BP, cooling since 4000 cal. BP, and warming at ~2500 cal. BP. Climate warming of the last hundred years was not reflected in lake sediment records because of the significant human impact on the lake ecosystem. The upper sediments of both lakes are enriched in As, Bi, Sb, Te, Sn, Cd, Cu, Zn and Pb because of the influence of the Karabash copper smelter. However, the significant changes of the Lake Syrytkul ecosystem are not related to the technogenic impact and explained mainly by the dam construction. The changes in diatom communities identified in Lake Ufimskoe, which is located in an area geologically sensitive to acidification, are related to the acidification and heavy metal loading on the water area.
Diagnostic checks in mixture cure models with interval-censoring
Authors: Scolas Sylvie , Legrand Catherine , Oulhaj Abderrahim , El Ghouch Anouar
Published: November 2016

Models for interval-censored survival data presenting a fraction of “cure” or “immune” patients have recently been proposed in the literature, particularly extending the mixture cure model to interval-censored data. However, little is known about the goodness-of-fit of such models. In a mixture cure model, the survival distribution of the entire population is improper and expressed in terms of the survival distribution of uncured individuals, i.e. the latency part of the model, and the probability to experience the event of interest, i.e. the incidence part. To validate a mixture cure model, assumptions made on both parts need to be checked, i.e. the survival distribution of uncured individuals, the link function used in the latency and the linearity of the covariates used in the both parts of the model. In this work, we investigate the Cox-Snell and deviance residuals and show how they can be adapted and used to perform diagnostics checks when all subjects are right- or interval-censored and some subjects are cured with unknown cure status. A large simulation study investigates the ability of these residuals to detect a departure from the assumptions of the mixture model. Developed techniques are applied to a real data set about Alzheimer’s disease.
Self-Stigma and Veteran Culture
Authors: Harding Shari
Published: November 2016

Self-stigma is a salient concept in mental health care. Consequences of self-stigma include increased morbidity and decreased engagement with the health care system. Cultural factors may affect self-stigma and its consequences. This article utilizes the Giger and Davidhizar transcultural assessment model to explore veteran culture and self-stigma. Veterans have their own cultural values that can affect nursing care. Operation Iraqi Freedom and Operation Enduring Freedom veterans are seeking care in community settings more often than within the VA system; therefore, all nurses should be aware of the cultural needs of veterans including the impact of self-stigma.
Designing a Digital Medical Management Training Simulator Using Distributed Cognition Theory
Authors: Rybing Jonas , Prytz Erik , Hornwall Johan , Nilsson Heléne , Jonson Carl-Oscar , Bang Magnus
Published: November 2016

Background. Training of medical professionals is important to improve care during mass-causality events. Therefore, it is essential to extend knowledge on how to design valid and usable simulation-based training environments.

Purpose. This article investigates how distributed cognition and simulation theory concepts can guide design of simulation-based training environments. We present the design and user evaluation of DigEmergo, a simulator for training and assessing emergency medicine management.

Design approach. A prior Distributed Cognition in Teamwork (DiCoT) analysis of the Emergo Train System (ETS) guided the design process. The design objective of DigEmergo was to be useful, usable, retain distributed cognition features of ETS, and strengthen validity and output reliability.

Evaluation. Eight expert ETS instructors participated in a formative system evaluation. The Technology Assessment Model (TAM) questionnaire was used to measure usefulness and ease of use. Observations and post-test interviews were conducted to contextualize the measures.

Results. The results showed that DigEmergo was perceived as somewhat to quite useful and somewhat easy to use. Overall, expert users considered DigEmergo promising and successful in retaining core ETS features.

Conclusions. The study indicates that a design methodology based on distributed cognition and simulation theory can be successfully combined to guide simulator (re)design and strengthen simulator validity.
Racial Differences in Associations of Perceived Health and Social and Physical Activities With Advance Care Planning, End-of-Life Concerns, and Hospice Knowledge
Authors: Noh Hyunjin , Kim Junghyun , Sims Omar T. , Ji Shaonin , Sawyer Patricia
Published: November 2016

Associations of perceived health and social and physical activities with end-of-life (EOL) issues have been rarely studied, not to mention racial disparities in such associations. To address this gap, this study examined racial differences in the associations of perceived health and levels of social and physical activities with advance care planning, EOL concerns, and knowledge of hospice care among community-dwelling older adults in Alabama. Data from a statewide survey of 1044 community-dwelling older adults on their long-term care needs were analyzed using descriptive statistics and logistic and linear regressions. Results showed that black older adults were less likely to know about or document advance care planning and to have accurate knowledge of hospice care; however, despite their poorer perceived health, black older adults reported fewer EOL concerns. Higher levels of perceived health and social and physical activities were associated with knowledge about advance care planning among white older adults but not among black older adults. Both black and white older adults with poorer perceived health and lower levels of social and physical activities tended to have more EOL concerns and less knowledge of hospice care. These findings suggest that interventions to address suboptimal levels of perceived health and social and physical activities among black older adults may increase knowledge of advance care planning. Also, supportive services to address EOL concerns should be targeted at older adults with poorer perceived health and limited participation in social and physical activities.
Financial Incentives to Encourage Value-Based Health Care
Authors: Scott Anthony , Liu Miao , Yong Jongsay
Published: November 2016

This article reviews the literature on the use of financial incentives to improve the provision of value-based health care. Eighty studies of 44 schemes from 10 countries were reviewed. The proportion of positive and statistically significant outcomes was close to .5. Stronger study designs were associated with a lower proportion of positive effects. There were no differences between studies conducted in the United States compared with other countries; between schemes that targeted hospitals or primary care; or between schemes combining pay for performance with rewards for reducing costs, relative to pay for performance schemes alone. Paying for performance improvement is less likely to be effective. Allowing payments to be used for specific purposes, such as quality improvement, had a higher likelihood of a positive effect, compared with using funding for physician income. Finally, the size of incentive payments relative to revenue was not associated with the proportion of positive outcomes.
The Anesthetic Challenges of Lung Biopsy–Associated Intrathoracic Hemorrhage in a Child With Suprasystemic Pulmonary Hypertension
Authors: Clopton Rachel Gabrielle , Friesen Robert , Partrick David , Wilson Neil , Jaggers James , Ivy David Dunbar , Schwartz Lawrence Israel , Ing Richard John
Published: November 2016

Children with suspected pulmonary hypertension must undergo extensive and invasive evaluations to establish a definitive diagnosis. A previously healthy 4-year old girl, newly diagnosed with suprasystemic pulmonary hypertension required multiple lung biopsies. Each procedure was associated with significant bleeding. The challenging anesthetic management of lung biopsy in the presence of suprasystemic pulmonary hypertension is described.
Lasers for Onychomycosis
Authors: Gupta Aditya K. , Foley Kelly A. , Versteeg Sarah G.
Published: November 2016

Many studies that have been recently published investigate the efficacy of laser treatment for onychomycosis. These studies support the current US Food and Drug Administration (FDA) approval of lasers for the ‘temporary increase in clear nail’. Clear nail growth is an important treatment goal for patients; however, many do not realise that laser treatment is not a cure for onychomycosis. The current article briefly reviews why lasers may be theoretically effective in treating onychomycosis and critically reviews published laser studies for onychomycosis in light of the standards employed in drug trials. Treatment regimens, efficacy endpoints, and the unit of analysis (nails vs patients) vary widely among published laser studies. Complete cure, mycological cure, and clinical improvement rates in laser studies are not reported or use such disparate criteria that comparison among studies is not possible. The US FDA has recently published guidelines for the use of medical devices in clinical trial design for onychomycosis. Future laser studies should adopt the FDA’s guidelines to allow for more consistency within the field and focus on the efficacy of lasers as monotherapy for onychomycosis.
Friction Blisters on the Hands Treated Successfully Using 2-Octyl Cyanoacrylate: A Case Report
Authors: Gearhart Peter A. , Gaspar Michael P. , Jacoby Sidney M.
Published: November 2016

Background:

Friction blisters on the hand are challenging to treat as conventional dressings are prone to saturation, contamination, and loosening with active hand use and other mechanical stresses. Alternative methods and materials for dressing hand blisters warrant exploration.

Case Summary:

A 48-year-old male surgeon presented with friction blisters over his bilateral thumbs. The patient complained of significant difficulty in keeping his dressings clean and dry, significant pain with hand hygiene, and functional limitations at work. The patient’s blisters were dressed with 2-octyl cyanoacrylate (Dermabond; Ethicon US LLC, Somerville, New Jersey), applied directly onto the wound bed. The patient was able to perform his normal duties immediately, without the need for additional intervention. Six days postapplication, the Dermabond sloughed off, revealing an epithelialized surface.

Conclusion:

Dermabond is a promising agent for dressing unroofed blisters of the hand, as it provides a barrier to moisture and contamination, while allowing the wound to epithelialize, without functional cost.
Managing communication and cultural barriers in intercultural service encounters
Authors: Kenesei Zsofia , Stier Zsofia
Published: November 2016

Understanding how satisfaction can be guaranteed when participants arrive from different and diverse national cultures is of crucial importance. The objective of our study is to identify key factors that influence the participants involved in intercultural service encounters in their efforts to solve problems arising during encounters within a hotel context. As part of our study, we carried out in-depth interviews with representatives from both the service provider and the customer. A comprehensive framework was constructed based on the analyses of the interviews with the help of constructivist grounded theory, in order to identify the factors that may prove to be significant in intercultural service encounters. Findings of the study highlight the potential communication and cultural barriers faced by participants of the interaction when their efforts to solve problems, as they transpire, ultimately depends on their personal characteristics and experience as well as their knowledge of and openness to other cultures. Managerial implications of this study suggest that flexibility of the service employees’ behaviour and their adaptation to customer needs are an important part of training programs, but also need to include elements of intercultural sensitivity. An important implication for marketers is that they should reflect on the basic expectations of customers relating to the need for adaptation or the need for exploring the differences. While it is important to know and react properly to customers’ expectations, it is just as important to manage them through communication tools.
Outdoor recreation participants’ motivations, experiences and vacation activity preferences
Authors: Aşan Kübra , Emeksiz Murat
Published: November 2016

This study investigates the behavioural relationship between outdoor recreation and vacation tourism in order to facilitate the marketing of nature activities as tourism products. In determining the outdoor recreation behaviour, motivations were explored on the basis of the recreation experience preference theory, and experiences were explored on the basis of the experience economy theory. In order to determine the vacation behaviour, which is an important market segmentation variable, vacation activity preferences were investigated. The implementation was accomplished within the scope of the outdoor recreationists in Eskişehir, Turkey. The data were collected through face-to-face and web surveys and analysed with the support of structural equation modelling. As the result of the analyses suggests, significant relationships were found among outdoor recreation motivations, nature experiences and vacation activity preference structures.
Telehealth solutions to enable global collaboration in rheumatic heart disease screening
Authors: Lopes Eduardo LV , Beaton Andrea Z , Nascimento Bruno R , Tompsett Alison , dos Santos Julia PA , Perlman Lindsay , Diamantino Adriana C , Oliveira Kaciane KB , Oliveira Cassio M , Nunes Maria do Carmo P , Bonisson Leonardo , Ribeiro Antônio LP , Sable Craig ,   on behalf of the Programa de RastreamentO da Valvopatia Reumática (PROVAR) investigators
Published: November 2016

Background

The global burden of rheumatic heart disease is nearly 33 million people. Telemedicine, using cloud-server technology, provides an ideal solution for sharing images performed by non-physicians with cardiologists who are experts in rheumatic heart disease.

Objective

We describe our experience in using telemedicine to support a large rheumatic heart disease outreach screening programme in the Brazilian state of Minas Gerais.

Methods

The Programa de Rastreamento da Valvopatia Reumática (PROVAR) is a prospective cross-sectional study aimed at gathering epidemiological data on the burden of rheumatic heart disease in Minas Gerais and testing of a non-expert, telemedicine-supported model of outreach rheumatic heart disease screening. The primary goal is to enable expert support of remote rheumatic heart disease outreach through cloud-based sharing of echocardiographic images between Minas Gerais and Washington. Secondary goals include (a) developing and sharing online training modules for non-physicians in echocardiography performance and interpretation and (b) utilising a secure web-based system to share clinical and research data.

Results

PROVAR included 4615 studies that were performed by non-experts at 21 schools and shared via cloud-telemedicine technology. Latent rheumatic heart disease was found in 251 subjects (4.2% of subjects: 3.7% borderline and 0.5% definite disease). Of the studies, 50% were preformed on full functional echocardiography machines and transmitted via Digital Imaging and Communications in Medicine (DICOM) and 50% were performed on handheld echocardiography machines and transferred via a secure Dropbox connection. The average time between study performance date and interpretation was 10 days. There was 100% success in initial image transfer. Less than 1% of studies performed by non-experts could not be interpreted.

Discussion

A sustainable, low-cost telehealth model, using task-shifting with non-medical personal in low and middle income countries can improve access to echocardiography for rheumatic heart disease.
Sex differences in stroke: Review of current knowledge and evidence
Authors: Girijala Raghavendra L , Sohrabji Farida , Bush Ruth L
Published: November 2016

Stroke is a leading cause of death among women in the United States, and women are more affected by stroke than men. With women living longer than men, women experience not only a higher incidence of stroke but also more negative outcomes. Despite its lethal impact and high morbidity rate, the road from innovative bench research to improved clinical outcomes has been slow. This review explores the differential physiology, epidemiology, and clinical presentation of stroke between men and women, as well as the current status of laboratory and clinical data.
Special competencies for psychological assessment of torture survivors
Authors: Huminuik Kirby
Published: November 2016

In spite of the absolute prohibition against torture in international law, this grave human rights abuse is still practiced systematically and with impunity in the majority of countries around the world. Mental health professionals can play a positive role in the fight against torture and impunity, by developing competencies to assess the psychological sequelae of torture. High-quality psychological evidence can help to substantiate allegations of torture, thereby increasing the likelihood of success in civil, administrative, and criminal proceedings. This article will orient mental health professionals to issues specific to forensic assessment of torture survivors. It provides a brief introduction to the sociopolitical context of torture, reviews literature on the psychological sequelae of torture, introduces the reader to key competencies, offers information on strategies for producing documentary evidence and expert opinion, highlights ethical considerations, and suggests areas for development in the field.
‘Who ent dead, badly wounded’: The everyday life of pretty and grotesque bodies in urban Trinidad
Authors: Kerrigan Dylan
Published: November 2016

In Trinidad two distinct bodies scar everyday cultural life. One is the Carnivalesque – a naked, commodified, and sexualised body of the popular bikini and beads type of Carnival portrayals called ‘pretty mas’. The other body is the grotesque – a dead, maimed, and murdered body appearing frequently in news media and in daily discussions on social media as the murder rate locally reaches one person every day. From the mid 1980s to the present, the numbers and visibility of these bodies in the same everyday spaces has increased. While there is no causal connection, fieldwork suggests cultural conversation between two representations of the body, between laughter and grief, jouissance and mutilation, celebration and fear exists in Trinidad. Through ethnographic fieldnotes, historical data, discourse analysis and the cultural theories of Guy Debord, Mikhail Bakhtin, Lloyd Best and Antonio Benítez-Rojo, this article explores the cultural correlation between everyday images (sexual and violent) of the body in Trinidadian society and their impact on the constitution of subjectivity, nationhood and segregation locally.
Estimation of indoor radon, thoron and their decay products’ concentrations along with annual inhalation dose in dwellings of Punjab, India
Authors: Saini Komal , Sahoo B. K. , Bajwa Bikramjit Singh
Published: November 2016

In the present study, indoor radon and thoron concentrations were assessed using a newly developed pin hole-based twin cup dosimeter with a single-entry face in some areas of Punjab state, India. The equilibrium equivalent concentrations of radon and thoron were estimated directly by using the newly developed progeny (decay products) sensors designed by Bhabha Atomic Research Centre, Mumbai, India. The average radon and thoron concentrations in the study region were found to be 61.6 ± 18.6 Bq/m3 and 68.0 ± 30.8 Bq/m3, respectively, while the average equilibrium equivalent concentrations of radon and thoron were 25.9 ± 7.7 Bq/m3 and 2.2 ± 0.7 Bq/m3, respectively. Calculated average equilibrium factor for radon and thoron was 0.45 and 0.04, respectively, in the present study. The annual inhalation dose that was calculated from the present observed concentrations varied from 1.1 to 4.1 mSv/year with an average value of 2.4 mSv/year, which is well within the reference level of 10mSv/year recommended by International Commission on Radiological Protection. The study shows that thoron is a significant contributor to the inhalation dose, which is about 29% of the total inhalation dose.
Permanently online and permanently procrastinating? The mediating role of Internet use for the effects of trait procrastination on psychological health and well-being
Authors: Reinecke Leonard , Meier Adrian , Aufenanger Stefan , Beutel Manfred E , Dreier Michael , Quiring Oliver , Stark Birgit , Wölfling Klaus , Müller Kai W
Published: November 2016

A growing number of studies suggest that Internet users frequently utilize online media as “tools for procrastination.” This study thus investigated the relationship between trait procrastination, Internet use, and psychological well-being in a representative sample of N = 1,577 German Internet users. The results revealed that trait procrastination was associated with an increased use of leisure-related online content and impaired control over Internet use. As a result, Internet users high in trait procrastination showed a higher risk of experiencing negative consequence of Internet use in other life domains. These negative repercussions of insufficiently self-regulated Internet use partially accounted for the correlation between trait procrastination and impaired well-being (i.e. stress, anxiety, and depression). These findings underline the role of online media as an instrument for dysfunctional task delay among Internet users. Implications of the results are discussed with regard to media use and self-control in general and procrastinatory media use in specific.
Too hot to trust: Examining the relationship between attractiveness, trustworthiness, and desire to date in online dating
Authors: McGloin Rory , Denes Amanda
Published: November 2016

This study expands upon previous research by examining how the enhancement of a dating profile picture might influence perceptions of interpersonal trustworthiness and how this relationship might further influence the perceived attractiveness and desire to date the respective individual. Participants were exposed to one of four online dating profile conditions and were then asked to rate the attractiveness of the person in the profile, as well as their perceived trustworthiness. The results revealed that men in this study perceived a more attractive female profile picture as less trustworthy, while women found a male with a more attractive profile picture to be more trustworthy. An indirect effects model also revealed that perceived trustworthiness mediates the relationship between similarity and attractiveness, though these effects were not moderated by the picture manipulation itself. Finally, this study found that individuals have greater intentions to date individuals whose profile pictures are perceived as more attractive.
Critical service learning: A participatory pedagogical approach to global citizenship and international mindedness
Authors: Wasner Victoria
Published: November 2016

International mindedness and global citizenship are two key terms within international education, which underpin much of the discourse within the International Baccalaureate Diploma Programme. This article proposes how a participatory approach to education for international mindedness and global citizenship can help educators within international schools to encourage students to think critically about reality beyond their ‘ivory tower isolation’, questioning the inequalities in the world that surrounds them. The article shows how the use of a critical, participatory pedagogy within the field of service learning can be employed in order to explore what global citizenship and international mindedness mean in the context of the International Baccalaureate Diploma Programme. The article also proposes that this participatory, critical inquiry involves engaging students as researchers as an effective pedagogy in order to bring about new knowledge and understandings relating to the concepts of global citizenship and international mindedness.