bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of an alternative model for establishing mesopic luminance
Authors: Yao Q , Fotios S
Published: September 2018

To determine mesopic luminance for a given photopic luminance and scotopic/photopic (S/P) ratio, the Commission Internationale de l’Eclairage (CIE) recommended system utilizes an equation. Whilst being accurate, it requires several iterations to achieve a stable result and requires the use of an adaptation coefficient. This article proposes an alternative approach, a model developed using a Rational Taylor function which does not require either iteration or an adaptation coefficient. Road lighting tends to use average photopic luminances in the range of 0.1 to 3 cd/m2; within this range, the model has an average error of 0.28% against the iteration approach, which is sufficient for most practical purposes.
Development of LED-based standard source for total luminous flux calibration
Authors: Nakazawa Y , Godo K , Niwa K , Zama T , Yamaji Y , Matsuoka S
Published: September 2018

For total luminous flux calibration by a sphere-spectroradiometer system in 2π geometry, a new LED-based standard light source (standard LED) covering the full visible wavelength range has been developed. The developed standard LED has sufficient spectral power over the full visible wavelength range using UV-LED dies of different peak wavelengths in combination with red, green and blue phosphors. By evaluating spectrum flatness based on the magnitude of the second derivative, the spectrum of the standard LED was customised to minimise the measurement uncertainty. Properties of the standard LED such as the luminous intensity distribution, stability and reproducibility were also evaluated. The evaluation results indicate that the standard LED has good properties as a standard light source for the 2π total spectral radiant flux scale. Furthermore, the result of an operating current dependence suggests that the standard LED has benefits as a standard source that conventional standard lamps do not have.
Nurse Prescribing From the Global Vantage Point: The Intersection Between Role and Policy
Authors: Ladd Elissa , Schober Madrean
Published: September 2018

Nurses around the world are increasingly prescribing and managing pharmaceutical agents. Prescribing by nurses is currently based on varying nursing roles, depending on national and regional norms and practices. Prescribing occurs within the advance practice, advanced level, and task-sharing roles, depending on the country. It is evolving both within and outside of traditional regulatory frameworks. Therefore, the purpose of this article is to describe the nurse prescribing globally among various nursing roles that support and facilitate the practice. We gathered practice, statutory, and regulatory information from gray and peer-reviewed literature, Google search and Google scholar, government websites, PubMed, and CINAHL electronic databases. In contrast to previous global policy reviews that focus primarily on high-income nations, our findings suggest that nurse prescribing occurs extensively in all six continents. Nurse prescribing within the context of advanced practice nursing occurs mostly in high-income countries. However, the predominant model of nurse prescribing from the global context occurs within the advanced level role by postbasic or postprofessional nurses. Additional nurse prescribing occurs through less formal task-sharing arrangements, primarily in low- to middle-income countries. In general, nurse prescribing is evolving rapidly around the world but within highly variable roles and regulatory frameworks. Codifying these roles by strengthening of educational and regulatory standards may serve to enhance the health system capacity, especially in low- to middle-income countries.
Are You Ready?
Authors: Cobb Kinsley
Published: September 2018

This is a reflection on being a chaplain. This reflection is an expression of the many emotional challenges I have encountered on any given day. This reflection could also be used to help new chaplains assimilate into the ministry.
Reflection: A Supervisor’s Journey through Middle Earth
Authors: Mutter Kelvin F.
Published: September 2018

A brief metaphorical reflection on the work of supervision that draws on Tolkien's Lord of the Rings trilogy.
Integrating Pastoral and Clinical Identities: A Narrative Inquiry of Pastoral Counselors
Authors: Cheney Gregory J.
Published: September 2018

Narrative inquiry methodology was used to understand the lived experiences of two ordained pastoral counselors who obtained licensure as clinical mental health professionals, particularly in terms of their identity development and integration of pastoral and clinical identities. Data analysis from semi-structured interviews revealed rich experiences with five themes: the journey; God’s call; self and identity; the role of mentors; and relationships. Implications for research and practice associated with pastoral counseling and counselor education are discussed.
Islam, The Holy Qur’an, and Medical Decision-Making: The Experience of Middle Eastern Muslim Families with Children Undergoing Bone Marrow Transplantation in the United States
Authors: Ragsdale Judith R. , Othman Mohammad , Khoury Ruby , Dandoy Christopher E. , Geiger-Behm Karen , Mueller Mark , Mussallam Eyad , Davies Stella M.
Published: September 2018

Some Arabic-speaking Muslim family members of children requiring bone marrow transplantation receive medical care for their children in the United States. Muslim family members’ use of Islam in the course of their child’s bone marrow transplantation was studied using grounded theory, a qualitative research method. Eighteen members of Middle Eastern Muslim families with a total of 13 children receiving bone marrow transplantation were interviewed by an Arabic-speaking healthcare provider. Interviews were coded by an interdisciplinary team. Seven key themes were identified.
Spiritual Care in a Social Media Landscape
Authors: Gorrell Angela
Published: September 2018

Given that social media extends both connection and suffering that occurs in physical spaces into digital spaces, issues of connection and suffering are increasingly integrated across people’s online and in-person lives. Spiritual care in a new media landscape necessitates spiritual care practitioners who are invested in listening to, exploring, and ministering to people's social media experiences, both their joys and their laments.
Inventory routing for defense: Moving supplies in adversarial and partially observable environments
Authors: Blom Michelle , Shekh Slava , Gossink Don , Miller Tim , Pearce Adrian R
Published: September 2018

Future defense logistics will be heavily reliant on autonomous vehicles for the transportation of supplies. We consider a dynamic logistics problem in which: multiple supply item types are transported between suppliers and consuming (sink) locations; and autonomous vehicles (road-, sea-, and air-based) make decisions on where to collect and deliver supplies in a decentralized manner. Sink nodes consume dynamically varying demands (whose timing and size are not known a priori). Network arcs, and vehicles, experience failures at times, and for durations, that are not known a priori. These dynamic events are caused by an adversary, seeking to disrupt the network. We design domain-dependent planning algorithms for these vehicles whose primary objective is to minimize the likelihood of stockout events (where insufficient resource is present at a sink to meet demand). Cost minimization is a secondary objective. The performance of these algorithms, across varying scenarios, with and without restrictions on communication between vehicles and network locations, is evaluated using agent-based simulation. We show that stockpiling-based strategies, where quantities of resource are amassed at strategic locations, are most effective on large land-based networks with multiple supply item types, with simpler “shuttling”-based approaches being sufficient otherwise.
Heuristic Patterns of Ethical Decision Making
Authors: Hartmann David J. , McLaughlin Olivia
Published: September 2018

This article describes the context of ethical decision making in research and suggests that direct attention to the ways in which decisions are actually made in such environments is needed. A decision-making model based on the literature on heuristic processing is proposed and is followed by a review of the method, data, and results of the authors’ research on this model. The implications of the research are developed, and a research agenda is outlined. Key findings were that competent actors do indeed process ethics problems heuristically and in ways that interweave intuitive, affective, and more rational phases. This processing does not typically follow a simple progressive pattern but evidences a sort of trial-and-error processing that is consistent with the logic of heuristic processing more generally. Finally, while diverse, participant-level processing attempts appear to follow patterns which are associated with the experience and training of the actors.
Optimizing contrast-enhanced cone-beam CT protocol to facilitate simultaneous visualization of neurovascular pathologies and surrounding structures of interest
Authors: Duckworth Edward AM , Chintalapani Gouthami , Camstra Kevin M , Kan Peter
Published: September 2018

Objective

Contrast-enhanced cone-beam computed tomography (CBCT) imaging is commonly used for evaluating neurovascular stents and their relationship to the parent artery or vascular pathologies such as arteriovenous malformations (AVMs) and dural arteriovenous fistulas (dAVFs) in the context of surrounding anatomical structures. The purpose of this study was to understand the effects of varying concentrations of contrast medium used in CBCT imaging for optimal visualization of various endovascular devices and anatomical pathologies.

Methods

Thirty-five patients with various neurovascular pathologies were included in the study. Contrast-enhanced CBCT images (20 s DR, Siemens syngo DynaCT, Siemens AG, Forchheim, Germany) were acquired in all cases, with varying dilutions of contrast medium, from 1% to 30%. The injection rate was kept constant at 3 cc/sec with an X-ray delay of two sec, and a total volume of 66 cc of diluted contrast was administered. Results from visual and quantitative analysis were reported.

Results

Ten percent dilution of contrast medium resulted in the best image differentiation between flow-diverter devices and the parent artery. Concentrations as low as 2.5% contrast medium also resulted in identifying AVMs in the context of the surrounding brain parenchyma, whereas 20% to 30% dilution provided the best visualization of residual AVMs with prior Onyx embolization and dAVFs in the presence of bony structures.

Conclusions

Simultaneous visualization of brain parenchyma, bony structures, devices, and pathological anatomy using contrast-enhanced CBCT imaging is feasible with appropriate doses of iodinated contrast, and should be tailored to the individual case based on the goals of CBCT.
A timetable optimization model and an improved artificial bee colony algorithm for maximizing regenerative energy utilization in a subway system
Authors: Liu Hongjie , Tang Tao , Guo Xiwang , Xia Xisheng
Published: September 2018

Maximizing regenerative energy utilization in subway systems has become a hot research topic in recent years. By coordinating traction and braking trains in a substation, regenerative energy is optimally utilized and thus energy consumption from the substation can be reduced. This article proposes a timetable optimization problem to maximize regenerative energy utilization in a subway system with headway and dwell time control. We formulate its mathematical model, and some required constraints are considered in the model. To keep the operation time duration constant, the headway time between different trains can be different. An improved artificial bee colony algorithm is designed to solve the problem. Its main procedure and some related tasks are presented. Numerical experiments based on the data from a subway line in China are conducted, and improved artificial bee colony is compared with a genetic algorithm. Experimental results prove the correctness of the mathematical model and the effectiveness of improved artificial bee colony, which improves regenerative energy utilization for the experimental line and performs better than genetic algorithm.
Modelling, design and analysis of offset, non-orthogonal and profile-shifted face gear drives
Authors: Fu Xuezhong , Fang Zongde , Cui Yanmei , Hou Xiangying , Li Jianhua
Published: September 2018

This article proposes the application of a profile-shifted grinding disc to generate an offset, non-orthogonal and profile-shifted face gear. A detailed investigation of the modelling, tooth geometry and contact characteristics of the offset, non-orthogonal and profile-shifted face gear has been conducted. The mathematical models of the profile-shifted shaper cutter, profile-shifted pinion, profile-shifted grinding disc and offset, non-orthogonal and profile-shifted face gear are established. Considering the topological modification, the tooth surface equation of the offset, non-orthogonal and profile-shifted face gear is deduced. Based on the undercutting and pointing of the tooth surface, the limiting tooth width of the offset, non-orthogonal and profile-shifted face gear is determined, and a mathematical model of tooth contact analysis of the offset, non-orthogonal and profile-shifted face gear drive is established with the alignment errors. Using the approach presented in this article, an example of an offset, non-orthogonal and profile-shifted face gear drive and analytical results are presented.
A new model for predicting the mechanical efficiency of ball screws based on the empirical equations for the friction torque of rolling bearings
Authors: Zhou Chang-Guang , Feng Hu-Tian , Ou Yi
Published: September 2018

Based on the empirical equations for the friction torque of rolling bearings, this article proposes a new model for predicting the friction torque and mechanical efficiency of ball screws. Meanwhile, a novel measuring system is constructed to obtain the mechanical efficiency of ball screws, where both the axial load and rotational speed are stable and adjustable. The experimental results at a rotational speed of 1000 r/min agree well with the theoretical values calculated by the present method, which show that the mechanical efficiency of ball screws increases with increasing axial load. Moreover, the model built in this article is more applicable to a relatively high-speed condition. The new model can be easily used to obtain the friction torque and mechanical efficiency for ball screws, which is essential for improving the performance of ball screws and the computer numerical control machine tools.
Revisiting subject knowledge in citizenship education: Understanding power and agency
Authors: Jerome Lee , Lalor John
Published: September 2018

Citizenship educators have not yet developed a satisfactory framework for describing the conceptual knowledge at the heart of their subject and the complex ways in which students develop understanding. By focusing on how young people (10–18 years of age) use the core citizenship concepts of power and agency, this research provides an insight into how students learn. Our analysis of young people’s work reveals that many of them are operating with a pre-political or politically naïve understanding of the world which limits their ability to understand power and agency. Some students have gone on to develop a greater sense of their own agency within complex chains of influence, which demonstrates a more nuanced understanding of power and agency, rooted in a more political reading of world. We conclude that our findings may help citizenship teachers to plan more consciously to tackle this area of conceptual understanding.
Lessons learned and new directions regarding Discharge Direct from Adult Intensive Care Units Sent Home (DISH): A narrative review
Authors: Basmaji John , Lau Vincent , Lam Joyce , Priestap Fran , Ball Ian M
Published: September 2018

Purpose

To perform a narrative review of the literature regarding the discharge of patients directly to home (DDH) from the intensive care unit, and to identify patient characteristics and clinical outcomes associated with this practice.

Methods

We searched MEDLINE and EMBASE from 1946 to present. We also manually searched the references of relevant articles. A two-step review process with three independent reviewers was used to identify relevant articles based on predetermined inclusion/exclusion criteria.

Results

Four studies were included in the final review. Two studies were retrospective and two studies were prospective that shared data from the same patient cohort. All were single center studies. Two of the four studies outlined clinical outcomes associated with DDH.

Conclusions

This study highlights the relative dearth in the literature regarding the increasingly common practice of DDH, underscores the importance of further studies in this area, and identifies future important foci of research.
Rawls’s duty of assistance and relative deprivation: Why less is more and more is even more
Authors: Rolf Jan Niklas
Published: September 2018

John Rawls’s case for a duty of assistance is partially premised on the assumption that liberal societies have an interest in assisting burdened societies to become well-ordered: Not only are well-ordered peoples inherently peaceful, but negative spillover effects would also disappear where peoples have a just or decent institutional order. Drawing on relative deprivation theory, this article argues that the kind of limited assistance that Rawls proposes to help burdened societies to become well-ordered would not reduce but actually increase international terrorism and unwanted immigration by raising unwarranted expectations and enhancing the resources that are needed to emigrate. Thus, if Rawls is concerned about negative externalities, he should argue for either more extensive assistance or no assistance at all.
Evaluation of the Use of Exenatide Once-Weekly Suspension Autoinjector Among Patients With Type 2 Diabetes Mellitus and Health Care Professionals
Authors: LaRue Susan , Springer Jane , Noderer Michael , Meehan James , Wysham Carol H.
Published: September 2018

Background:

Ease of injection is important to patients. An autoinjector was developed to deliver exenatide, a glucagon-like peptide-1 receptor agonist for type 2 diabetes mellitus. For autoinjection, 0.06-mm exenatide-containing microspheres are suspended in medium-chain triglycerides. Herein, we report design verification and usability testing of the autoinjector for exenatide once-weekly suspension (QWS) delivery.

Methods:

Exenatide QWS in a single-chamber cartridge is self-injected subcutaneously with three main steps: mix, unlock, and inject. Design verification testing used validated testing methodology. A summative validation study with simulated-use scenarios evaluated unassisted performance on critical tasks (ease of use and the injection process).

Results:

The autoinjector met specified design requirements for dose accuracy and torque/force. Of 104 participants enrolled (73 lay users, 16 health care professionals, and 15 pharmacists), 90 independently referred to instructions for use during testing. Users successfully achieved critical tasks on first attempt 87-100% of the time. Approximately 78% of participants successfully completed the full injection scenario, including 72% of lay users reporting visual or dexterity impairments. Initial use errors on critical tasks included not mixing well (n = 12), not removing needle cap (n = 8), and not holding needle to the skin for complete injection (n = 5). Untrained injection-naïve and trained injection-experienced lay users made the fewest errors (7% and 3%, respectively). Trained and untrained participants took 2:33 and 5:03 minutes, respectively, to complete a weekly injection.

Conclusions:

Users with a range of injection experience can rapidly learn to administer exenatide QWS autoinjector correctly, thus minimizing patient effort to manage their diabetes with injectable therapy.
Acquisition of resistance to androgen deprivation therapy in salivary duct carcinoma: A case report
Authors: Wasano Koichiro , Sakurai Kouhei , Kawasaki Taiji , Kusafuka Kimihide , Kasahara Masao , Kondo Naoki , Inada Ken-ichi , Ogawa Kaoru
Published: September 2018

Salivary duct carcinoma is a relatively rare salivary cancer, and most cases are androgen receptor -positive. Salivary duct carcinoma growth is suggested to be androgen dependent, which can reportedly be controlled by androgen deprivation therapy. However, the effectiveness and underlying molecular mechanisms of androgen deprivation therapy for salivary duct carcinoma remain unknown. We report a salivary duct carcinoma case (65-year-old man) arising from the parotid gland with metastasis to the neck lymph nodes and lungs. Androgen deprivation therapy was performed according to the same protocol for prostate cancer treatment. Expression levels of androgen receptor and FOXA1 (forkhead box A1) were immunohistochemically analyzed before and after androgen deprivation therapy. Although the tumor volume was partially diminished during the first 3 months, acquired resistance to androgen deprivation therapy occurred. FOXA1 was not detected in parotid gland after androgen deprivation therapy, whereas androgen receptor expression was positive. FOXA1 expression might be related to acquired androgen deprivation therapy resistance in salivary duct carcinoma.
Axial impact behavior and energy absorption of rubberized concrete with/without fiber-reinforced polymer confinement
Authors: Pham Thong M , Elchalakani Mohamed , Karrech Ali , Hao Hong
Published: September 2018

This study investigates the axial impact resistance and energy absorption of rubberized concrete with/without fiber-reinforced polymer confinement. The impact tests were carried out using an instrumented drop-weight testing apparatus. The experimental results have shown that rubberized concrete significantly reduced the maximum impact force of up to 50% and extended the impact duration. These characteristics make rubberized concrete a promising material for protective structures and particularly for future sustainable construction of rigid roadside barriers. Glass fiber–reinforced polymer confinement is a very effective method to improve the impact resistance for both conventional concrete and particularly for rubberized concrete. It was found that the rubberized concrete reduced the maximum impact force so that it transferred a lower force to a protected structure as well as a lower rebound force, which is desirable for protection of passengers in an incident of vehicle collision. Interestingly, the rubberized concrete showed a lower energy absorption capacity as compared to conventional concrete, where the exact reason for this is unknown to the authors. Therefore, further research is sought to provide more understanding of the response of rubberized concrete under impact and improve its energy absorption. This study explored experimentally the use of rubberized concrete as a promising sustainable construction material for applications to construction of columns in buildings located in seismic active zones or subjected to terrorist attack, security bollards and rigid road side barriers.
MRI of lobar holoprosencephaly in a cat with hypodipsic hypernatraemia
Authors: Shimbo Genya , Tagawa Michihito , Yanagawa Masashi , Miyahara Kazuro
Published: September 2018

Case summary

A 2-year-old neutered female domestic shorthair cat presented with a history of hypodipsia, recurrent hypernatraemia, pelvic limb ataxia and tremor. The serum arginine vasopressin level was low for the serum osmolality. MRI of the brain revealed a failure of separation of the cerebrum, which manifested as absence of the rostral part of the corpus callosum, fornix and septum pellucidum, thus resulting in a single fused ventricle. The diagnosis was lobar holoprosencephaly with hypodipsic hypernatraemia.

Relevance and novel information

To our knowledge, this is the first description of the MRI characteristics of lobar holoprosencephaly in a cat. This report suggests that MRI examination should be considered for precise diagnosis of hypodipsic hypernatraemia in young cats.
Musical creativity and the embodied mind
Authors: van der Schyff Dylan , Schiavio Andrea , Walton Ashley , Velardo Valerio , Chemero Anthony
Published: September 2018

The phenomenon of creativity has received a growing amount of attention from scholars working across a range of disciplines. While this research has produced many important insights, it has also traditionally tended to explore creativity in terms of the reception of products or outcomes, conceiving of it as a cognitive process that is limited to the individual domain of the creative agent. More recently, however, researchers have begun to develop perspectives on creativity that highlight the patterns of adaptive embodied interaction that occur between multiple agents, as well as the broader socio-material milieu they are situated in. This has promoted new understandings of creativity, which is now often considered as a distributed phenomenon. Because music involves such a wide range of socio-cultural, bodily, technological, and temporal dimensions it is increasingly taken as a paradigmatic example for researchers who wish to explore creativity from this more relational perspective. In this article, we aim to contribute to this project by discussing musical creativity in light of recent developments in embodied cognitive science. More specifically, we will attempt to frame an approach to musical creativity based in an 4E (embodied, embedded, enactive, and extended) understanding of cognition. We suggest that this approach may help us better understand creativity in terms of how interacting individuals and social groups bring forth worlds of meaning through shared, embodied processes of dynamic interactivity. We also explore how dynamical systems theory (DST) may offer useful tools for research and theory that align closely with the 4E perspective. To conclude, we summarize our discussion and suggest possibilities for future research.
¡Adelante! A Community Asset Mapping Approach to Increase College and Career Readiness for Rural Latinx High School Students
Authors: Arriero Elisabeth , Griffin Dana
Published: September 2018

Community asset mapping is an approach that school counselors can use to locate resources to meet the needs of families, schools, and communities. This article provides step-by-step instructions on how school counselors might use community asset mapping to address the needs of their population(s), illustrated with an example of implementation in a rural high school. The authors address implications for school counselor practice.
Chinese Investments in Spanish Football: A Case Study of RCD Espanyol New Management Trends After Rastar Purchase
Authors: Ginesta Xavier , Sellas Toni , Canals Mireia
Published: September 2018

The global football industry is changing clubs’ corporate identities. Historically, European football had strong local roots; sport organizations represented local values and fandom were regionally based. However, sporting competitiveness pushes clubs to search for new investors, and foreign investors in Europe are attracted by the popularity of European football. In this article, we analyse how Chinese capital and brands arrived in Barcelona, through the negotiations of a football club in 2016: the Reial Club Deportiu Espanyol (RCDE). RCDE is the club that has received the second most trophies in Catalonia, after FC Barcelona, since the beginning of the 20th century. Today, it has one of the most modern stadiums in Spain, designed using a business approach, and has become a corporate ambassador for the Chinese government’s strategy of becoming a “world football superpower” by 2050. Using a case study approach, this article analyses management and corporate identity changes in the organization due to the new Chinese owner: the Rastar Group.
Constructing the Meaning of “Family” in the Context of Out-of-Home Care: An Exploratory Study on Residential Care Leavers in Harare, Zimbabwe
Authors: Gwenzi Getrude Dadirai
Published: September 2018

Care leavers’ family lives are not well-documented in Global South literature. The West has seen an increase in studies focusing on the family concept. This article focuses on the concept of “family” and family membership from the perspective of care leavers. Data from semistructured interviews and “family lists” with 30 care leavers (aged 18–25) from Zimbabwe are presented. The findings suggest that although there is evidence of heteronormative definitions of “family” and ideas of “family” as biological, new definitions are coming up in the developing world. Some participants acknowledge nonbiological definitions of family based on connectivity, co-residence, affective practices, family contact, and other forms of family display in the context of out-of-home care. The Zimbabwean cultural influence is highlighted as a factor in care leavers’ constructions of “family” especially during the emerging adulthood stage. Practical implications for social policy, those working with care leavers, and wider society are discussed.
Is Worse Attention a Risk Factor for or a Consequence of Depression, or Are Worse Attention and Depression Better Accounted for by Stress? A Prospective Test of Three Hypotheses
Authors: Mac Giollabhui Naoise , Olino Thomas M. , Nielsen Johanna , Abramson Lyn Y. , Alloy Lauren B.
Published: September 2018

It is unclear whether impaired cognition is a risk factor for depression or a consequence of depression, or whether both depression and impaired cognition are caused by a third underlying process (e.g., stress). These three hypotheses were tested in 523 adolescents assessed annually for depression, attentional functioning, and childhood/recent life stress. Baseline switching, sustained, and selective attention did not predict first onset of depression or depressive symptoms. Divided attention predicted depressive symptoms only. Piecewise growth modeling indicated that the trajectory of switching attention declined prior to first onset of depression; there was evidence of significant recovery in switching attention following first onset of depression. Structural equation modeling indicated that impaired switching attention prospectively predicted higher depressive symptoms and that higher depressive symptoms predicted worse selective and switching attention. Further, childhood stress prospectively predicted higher depressive symptoms via switching attention and worse switching attention via depressive symptoms.
Patient Characteristics and Predictors of Return to Sport at 12 Months After Anterior Cruciate Ligament Reconstruction: The Importance of Patient Age and Postoperative Rehabilitation
Authors: Edwards Peter K. , Ebert Jay R. , Joss Brendan , Ackland Timothy , Annear Peter , Buelow Jens-Ulrich , Hewitt Ben
Published: September 2018

Background:

Preventing and mitigating the risk of reinjury after anterior cruciate ligament reconstruction (ACLR) rest on variables including age, surgical restoration of knee stability, adequate physical function, and thorough and complete postoperative rehabilitation, but to what degree these factors influence return to sport is unclear.

Purpose:

To investigate factors predictive of return to sport 12 months after ACLR. The factors specifically evaluated were strength, hop function, self-reported knee function, patient age, and quality of postoperative rehabilitation.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

This study evaluated 113 patients approximately 12 months after ACLR using a rehabilitation grading tool, the subjective International Knee Documentation Committee (IKDC) form, and a return-to-sport battery consisting of maximal isokinetic quadriceps and hamstring strength and 4 functional hop tests. Mann-Whitney U tests and chi-square analyses were used to determine differences between patients who had or had not returned to sport. A subsequent binary logistic hierarchical regression determined the factors predictive of a patient’s return to sport. In those patients who had returned to sport, relationships between either age or level of rehabilitation and passing the return-to-sport battery were also investigated.

Results:

Complete rehabilitation (adjusted odds ratio [OR], 7.95; P = .009), age ≤25 years (adjusted OR, 3.84; P = .024), and higher IKDC scores ( P < .001) were predictive of return to sport at 12 months. In participants who had returned to sport, 21% passed the return-to-sport battery compared with only 5% who did not. Of those who had returned to sport, 37% who underwent complete rehabilitation passed the return-to-sport battery as opposed to 5% who underwent incomplete rehabilitation. In patients aged ≤25 years, only 48% underwent complete rehabilitation, despite having returned to sport. Additionally, in this group of patients, 40% underwent complete rehabilitation and passed the physical performance battery as opposed to only 4% who did not undergo complete rehabilitation.

Conclusion:

Younger patients and higher subjective IKDC scores were predictive of return to sport. Patients who completed 6 months of rehabilitation incorporating jumping and agility tasks had a higher rate of return to sport, suggesting that postoperative rehabilitation is important in predicting return to sport. Specialists and physical therapists alike should stress the importance of thorough postoperative rehabilitation and adequate neuromuscular strength and function to patients whose goals are to return to sport.
Schooling Effects on Literacy Skills During the Transition to School
Authors: Kim Matthew H. , Morrison Frederick J.
Published: September 2018

The current study used a regression discontinuity (RD) design to characterize more precisely the link between schooling and literacy by examining whether and how different grade-level, practice-as-usual schooling experiences uniquely predict specific literacy subskills during the transition to school. Data from 334 children revealed moderate positive effects of prekindergarten, kindergarten, and first grade schooling on decoding, while kindergarten and first grade schooling predicted comprehension skills. There was no significant effect of schooling at any grade level on expressive vocabulary or sound awareness. Results were robust to different RD estimation methods and highlight the heterogeneity of schooling effects on early literacy skill development. Implications for understanding early literacy development in the context of regular, public schooling are discussed.
At Risk for Emotional Harm in the Emergency Department: Older Adult Patients’ and Caregivers’ Experiences, Strategies, and Recommendations
Authors: Goodridge Donna , Martyniuk Steven , Stempien James
Published: September 2018

Background: Emergency departments (ED) serve a critical role in addressing the health care needs of older adults, although organizational and provider characteristics can result in unintended negative outcomes for this population, such as emotional harm. This study aimed to describe the patient experience of older adults in the ED and generate recommendations for enhancing their experience. Methods: Data from focus groups and individual interviews of older adults and caregivers who had visited the ED were thematically analyzed. Results: Ten focus groups and individual interviews of 41 older adults and 15 caregivers were conducted. Health system and provider factors affecting the patient experience were identified. Participants negotiated their experience using diverse strategies. Recommendations for improving the ED experience were generated. Conclusions: Older adults attending the ED are at risk for health care-related emotional harm unrelated to their entrance complaint, which could be mitigated by addressing organizational and attitudinal factors.
The Impact of Age-Related Macular Degeneration on Quality of Life and Its Association With Demographic Data: Results From the NEI VFQ-25 Questionnaire in a Norwegian Population
Authors: Schippert Ana Carla , Jelin Elma , Moe Morten C. , Heiberg Turid , Grov Ellen Karine
Published: September 2018

Objective: To describe vision-related quality of life (VRQoL) in a Norwegian population of patients with newly diagnosed neovascular age-related macular degeneration (nAMD), and to evaluate the association with demographic data of age, gender, and civil status (married, cohabitants/unmarried, not cohabitants). Method: The Norwegian version of the National Eye Institute Visual Functioning Questionnaire–25 (NEI VFQ-25) questionnaire was administered to 145 patients recently diagnosed with nAMD. We used descriptive statistics and bivariate analysis to determine the distribution of demographic parameters and a possible association between demographic parameters and NEI VFQ-25 scores. Spearman correlation was employed to analyze the NEI VFQ-25 items and subscales scores. Results: Mean ( SD) VFQ-25 total score was 78.5 (14.7). The scores per subscales varied from 64.7 to 89.7. No significant difference was revealed between demographic parameters and the NEI VFQ-25 items, except for one item (being with others) when comparing paired and nonpaired participants. Conclusion: In a Norwegian population with newly diagnosed nAMD, VRQoL is reported at a high baseline level. This is an important information for the health care personnel when discussing expectations during treatment with the patient. Age, gender, and civil status did not affect VRQoL.
Visualizing the Increasing Effect of Racial Resentment on Political Ideology among Whites, 1986 to 2016
Authors: LeCount Ryan Jerome
Published: September 2018

The author constructs an over-time coefficient plot to allow visualized evaluation of the role played by indicators of racial resentment on political ideology among Whites since 1986. The visualization makes clear that the role of racial resentment in the formation of political ideology is one that (1) has been a consistently significant factor in U.S. politics for 30 years and (2) was increasing in importance prior to the candidacy of Donald Trump.
Effects of Government Expenditure on Private Investment in Nigerian Economy (1980–2016)
Authors: Akinlo Taiwo , Oyeleke Olusola Joel
Published: September 2018

This study examined the effect of government expenditure on private investment in Nigeria during the period 1980–2016. The error correction model analysis was used in the study to analyze the relationship between the two variables. The study found that there is a long-run relationship among the variables and that the interest rate and inflation have negative but significant impact on private investment in the long run. On the other hand, government expenditure has positive but insignificant impact on private investment in the long run. In the short run, government expenditure and interest rate have a significant positive impact on private investment in Nigeria, while GDP per capita and inflation negatively impact private investment. The study concluded that there is the need for the government to increase its expenditure particularly on the provision of more infrastructural facilities as this will attract more investment from within and outside the country.
Shame/Honor, Guilt/Innocence, Fear/Power: A Missiological Response to Simon Cozens and Geoff Beech
Authors: Whiteman Darrell
Published: September 2018

There has been a significant increased interest among academic missiologists and mission practitioners in applying the concepts of shame/honor, guilt/innocence, and to a lesser extent fear/power, in cross-cultural ministry. This article responds to Simon Cozens’s and Geoff Beech’s contributions and notes the weaknesses of characterizing entire cultures as oriented to shame, guilt, or fear. Despite the caution of overgeneralization and stereotyping, there are some strengths in these concepts, which have been helpful in cross-cultural ministry. They should also be used to enable Western missionaries to discover the weaknesses and blind spots in their own ministry, biblical interpretations, and theology.
Access to HPV vaccination for boys in the United Kingdom
Authors: Prue Gillian , Grimes David , Baker Peter , Lawler Mark
Published: September 2018

Human papillomavirus (HPV) is a common sexually transmitted infection. There is a well-established link between HPV and the development of cervical cancer, but HPV infection is also associated with vaginal and vulvar cancer, head and neck cancers as well as anal cancers in both sexes and penile cancer in men. Despite this, since its introduction in 2008, the United Kingdom has included only girls in its vaccination programme and, in 2017, suggested that it was not cost effective to extend the vaccine to adolescent boys. Men-who-have-sex-with-men (MSM) have been offered the HPV vaccine in the United Kingdom since 2016. A number of countries (21 to date) have implemented a universal HPV vaccination programme, with many countries arguing that female-only vaccination programmes protect males via herd immunity and that MSM will be protected via targeted vaccination programmes, although these may be limited in their effectiveness. Following an advocacy campaign to extend the HPV vaccination programme to boys in the United Kingdom, in July 2018 the Joint Commission for Vaccination and Immunisation recommended that boys should be included alongside 12/13-year-old girls in a school-based programme. Given that this decision has been delayed by many years, it is imperative that the UK Government and Department of Health implement this vaccine programme as quickly as possible and by September 2019 at the latest, that a catch-up programme for boys is introduced and, given the feminisation of HPV, that information materials on HPV vaccination that are targeted at boys, their parents and teachers are made widely available.
Morphological Analysis of Tibiofibular Disruption Using CT images in Ankle Fractures with Unstable Syndesmotic Injury
Authors: Bae Su-Young , Lee Jung-Hwan , Shin Woo-Jin
Published: September 2018

Category:

Trauma

Introduction/Purpose:

We aimed to investigate the diagnostic value of CT scan and the morphologic pattern of distal tibiofibular disruption associated with fracture-type or concomitant avulsion fractures in cases of ankle fracture with unstable syndesmosis requiring surgical fixation.

Methods:

104 cases images(preoperative plane radiographs and CT axial images) of ankle fractures needed syndesmotic fixation due to unstable syndesmosis on intraoperative stress test were retrospectively reviewed. We classified ankle fractures by Lauge-Hansen classification and AO-OTA classification. Also, associated tibiofibular avulsion fractures including anterior distal tibiofibular avulsion fractures and posterior malleolar fractures were identified. Classification of posterior malleolar fractures based on Bartonícek-Rammelt classification was conducted. We grouped morphologic patterns of distal tibiofibular disruption which is 10 mm proximal to the plafond on CT axial images. We divided them into no diastasis, symmetric diastasis, anterior open, and posterior open according to the diastasis pattern, and no translation, anterior translation, and posterior translation depending on sagittal translation. Chi-square test/Fisher’s exact test and adjusted residual analysis were used for statistical analysis.

Results:

On LH classification, SER in 78(75%), PER in 18(17.3%), and PA in 8(7.7%). AITFL avulsions were in 37(35.6%) and PM fractures in 58(55.8%). Diastasis patterns were recorded in 30(28.8%) of no diastasis, 41(39.4%) of symmetric diastasis, 3(2.9%) of anterior open, and 30(28.8%) of posterior open. Depending on sagittal translation, 53(51.0%) of no translation, 44(42.3%) of anterior translation, and 7(6.7%) of posterior translation. Neither diastasis nor sagittal translation was revealed by CT in 17.3% of all. Syndesmotic morphologic pattern was various in SER [no diastasis (35.9%, AR=2.7), posterior open (35.9%, AR=2.7), and anterior translation (48.7%, AR=2.3)] whereas PER had relatively consistent pattern (symmetric diastasis in 88.9%, AR=4.7). Tibiofibular avulsion fractures such as Charput and PM fracture did not create distinct feature of widening.

Conclusion:

In terms of syndesmotic disruption pattern by CT images, PER fractures tend to show simple symmetric diastasis pattern, but SER fractures have a variety of patterns including normal appearance. Even if associated avulsion fracture do not make certain diastasis feature on static CT images, we still have to be careful not to overlook the syndesmotic instability. Diagnostic value of static imaging such as CT may not be higher than expected if not accompanied with intraoperative dynamic stress test.
Selective Arthrodesis for Treatment of Symptomatic Müller-Weiss Disease
Authors: Cao Le , Miao Xu-dong
Published: September 2018

Category:

Midfoot/Forefoot

Introduction/Purpose:

Müller-Weiss Disease (MWD) is also known as Müller-Weiss Syndrome, which is reported an uncommon adult navicular osteonecrosis, frequently occurring in middle-aged and old females and characterized by compression and fragmentation of the lateral aspect of the navicular bone and progressive malformation. In this study, we report the results of selective midfoot and hindfoot arthrodesis for treating symptomatic MWD.

Methods:

From January 2006 to December 2011, 28 patients (31 feet) with MWD were treated with selective arthrodesis with tricortical autologous iliac crest block fixated by screws and plate and retrospectively reviewed. These included 24 females and 4 males, with an average age of 53.1 years (31-65 years), and an average symptoms duration of 8.6 years (1.5-13 years). The disease was staged according to Maceira, which included 3 feet in stage II, 15 feet in stage III, 7 feet in stage IV, and 6 feet in stage V. Pre- and postoperative visual analog scale (VAS) score, American Orthopaedic Foot & Ankle Society (AOFAS), radiologic examination, and patients’ satisfaction rate of the surgery were evaluated at an average of 6.6 years (4-12 years) following surgery.

Results:

Selective arthrodesis according to various symptoms and CT-scan findings related to MWD, 12 feet had talonavicular arthrodesis, 16 feet had talonavicular-cuneiform arthrodesis, and 3 feet had triple arthrodesis. The follow-up visit showed satisfactory outcomes, solid union was achieved in all cases, with average fusion time was 15.2 weeks (12-26 weeks). VAS score reducing from the preoperative 7.8 (7-9) to postoperative 2.3(0-4), whereas the AOFAS score improved from the preoperative 25.4 (19-42) to the postoperative 80.3 (73-88). The patient’s subjective ratings showed excellent results in 8 feet, good results in 18 feet, and fair outcomes in 5 feet.

Conclusion:

Selective arthrodesis according to various symptoms and CT-scan findings related to MWD, 12 feet had talonavicular arthrodesis, 16 feet had talonavicular-cuneiform arthrodesis, and 3 feet had triple arthrodesis. The follow-up visit showed satisfactory outcomes, solid union was achieved in all cases, with average fusion time was 15.2 weeks (12-26 weeks). VAS score reducing from the preoperative 7.8 (7-9) to postoperative 2.3(0-4), whereas the AOFAS score improved from the preoperative 25.4 (19-42) to the postoperative 80.3 (73-88). The patient’s subjective ratings showed excellent results in 8 feet, good results in 18 feet, and fair outcomes in 5 feet.