bluuebunny/crossref_metadata_2025 huggingface dataset:
Edutainment: Role-Playing versus Serious Gaming in Planning Education
Authors: Pojani Dorina , Rocco Roberto
Published: February 2020

This exploratory study assesses the utility, in terms of learning and conceptualizing planning, of a role-playing exercise (the Great Planning Game [GPG]) and a serious game (Polis PowerPlays [PPP]) employed in a planning theory course offered at The University of Queensland in Australia. The study reveals that role-playing and serious gaming are equally engaging and help planning students learn and embody different roles while having fun. No great differences can be discerned in terms of learning effectiveness. With regard to teaching style, the GPG is more passive and tends to encourage collaboration, whereas the PPP is more dynamic and fosters competition. Both activities help students discover aspects of planning—and planning stakeholders—which they may not have considered before. Most participating students appear to regard planning as a pluralist pursuit. Communication and public participation are viewed as central to planning processes. However, traces of incrementalism and rationality are also present. While students believe in equity planning (i.e., advocacy from within the system), radical social justice approaches that challenge the status quo are notably absent. Overall, the authors conclude that these activities cannot fully replace guided and structured instruction but, as “whole task practices,” are a desirable complement to direct instruction.
Family Influence on Academic and Life Satisfaction: A Social Cognitive Perspective
Authors: Vautero Jaisso , Taveira Maria do Céu , Silva Ana Daniela , Fouad Nadya A.
Published: February 2020

Family influence is a key factor in many aspects of career development; however, very little research has examined the relationship between family and well-being. Drawing on social cognitive career theory, this study examined the influence of the family on college students’ academic and overall life satisfaction. The participants were 312 college students at a south Brazilian university who completed measures of family influence, along with measures of environmental supports and barriers, academic self-efficacy, goal progress, academic satisfaction, life satisfaction, and positive affect. Academic and life satisfaction were each well predicted in the model ( R2 = .69 and .42, respectively). Results suggest that family expectations had a negative contribution in the model, and family support seemed to be very positive for academic and life satisfaction. The findings inform the practice, evidencing which family factors can booster and which can hamper college students’ academic and overall life satisfaction.
Locomotion of a self-propulsive pitching plate in a quiescent viscous fluid
Authors: Wang Li
Published: February 2020

The locomotion of a flexible plate pitching in a quiescent viscous fluid is numerically studied by using the lattice Boltzmann method (LBM) for the fluid and a finite element method (FEM) for the plate, with an immersed boundary (IB) method for the fluid–structure interaction (FSI). In the simulation, the leading edge of the plate undergoes a prescribed pitching motion, and the entire plate moves freely due to the fluid–plate interaction. The effects of the pitching amplitude, bending rigidity, plate-to-fluid mass ratio and Reynolds number on the propulsive performance of the flexible plate are examined in a range of parameters. The numerical results show that a certain flexibility can remarkably improve the propulsive speed and efficiency. The optimal parameters for the pitching plate are obtained, i.e. [Formula: see text] ([Formula: see text] is a non-dimensional frequency, with [Formula: see text] means rigid plate and larger [Formula: see text] means more flexible) and 20° ≤  α0 ≤ 25° ( α0 is the pitching amplitude). The comparisons of three plate-to-fluid mass ratios (1.0, 2.5 and 5.0) show that the mass of the plate decreases the propulsive speed, but contrarily increases the efficiency. The results obtained in the present study provide an insight into the understanding of the performance of self-propulsive plate in pitching motion and can further guide the engineering design of micro aerial vehicles.
Post-needling soreness and trigger point dry needling for hemiplegic shoulder pain following stroke
Authors: Mendigutía-Gómez Ana , Quintana-García María T , Martín-Sevilla Miriam , de Lorenzo-Barrientos Diego , Rodríguez-Jiménez Jorge , Fernández-de-las-Peñas César , Arias-Buría José L
Published: February 2020

Objectives:

To determine the presence of post-needling induced pain in subjects who had suffered a stroke and received trigger point (TrP) dry needling (DN), and to investigate the effects of including TrP-DN into a rehabilitation program for shoulder pain in this population.

Methods:

A randomized clinical trial was conducted. Sixteen patients who had suffered a stroke and presented with shoulder pain were randomly assigned to receive rehabilitation alone or rehabilitation combined with DN. Both groups received a neurorehabilitation session including modulatory interventions targeting the central nervous system. Patients in the DN group also received a single session of DN over active TrPs in the shoulder musculature. A numerical pain rating scale (NPRS, 0–10) was used to asses post-needling induced pain at 1 min, 24 h, and 72 h after needling. Shoulder pain (NPRS, 0–10) was assessed at baseline, and 3 and 7 days after DN in both groups.

Results:

Five (62%) patients receiving TrP-DN reported post-needling induced pain. Post hoc analysis found that post-needling induced pain decreased significantly at 24 and 72 h (both p < 0.001) after DN. Patients receiving TrP-DN plus rehabilitation exhibited greater decreases in shoulder pain intensity at 3 days (Δ = −4.2, 95% confidence interval (CI) = −5.8 to −2.6) and 7 days (Δ = −4.3, 95% CI = −5.9 to −2.7) after the intervention compared with those receiving rehabilitation alone (all p < 0.001).

Conclusion:

This trial found that 50% of stroke patients receiving DN experienced post-needling induced pain, a side effect that almost disappeared 72 h after the intervention without any additional therapeutic action. In addition, the inclusion of TrP-DN into a rehabilitation session was effective at decreasing shoulder pain in these patients.
Acupuncture for stroke: perceptions and possibilities
Authors: Robinson Nicola , Ye Tian , Ronan Patricia , Garbelli Pietro Emanuele , Smithard David
Published: January 2020

Objective:

To investigate perceptions and acceptability of, and attitudes towards, acupuncture for post-acute stroke and rehabilitation care by exploring the views of different stakeholders.

Methods:

Three electronic surveys were conducted to gauge the breadth of knowledge and acceptance of acupuncture in post-acute stroke and rehabilitation care among three stakeholder groups: (1) traditional acupuncturists registered with the British Acupuncture Council (BAcC); (2) National Health Service (NHS) professionals attending the 2017 UK Stroke Forum conference; and (3) the UK network of Stroke Club co-ordinators.

Results:

Of 278 NHS respondents, 31% were doctors. Over half (52%) of all NHS respondents reported they had insufficient knowledge about acupuncture, its effectiveness (23%) or how to refer (21%). Only 12% had previously referred stroke patients for acupuncture but 46% thought that there was role for acupuncture in post-acute stroke care (50% were unsure). Two thirds of BAcC acupuncturist respondents had treated at least one stroke patient, with 70.1% having treated 1–5 stroke patients and 71% having provided treatment in the last year, most commonly for motor impairment (88.2%). Of 99 Stroke Club coordinators who responded, only seven had ever been asked about acupuncture by patients, but most felt there would be interest.

Conclusion:

Interest in the provision of acupuncture for post-acute stroke care was expressed by both NHS practitioners and acupuncturists. Further research is required on the acceptability of acupuncture to patients as well as evidence of its clinical and cost effectiveness.
Why do soldiers swap illicit pictures? How a visual discourse analysis illuminates military band of brother culture
Authors: MacKenzie Megan
Published: January 2020

Military service members have been taking and circulating illicit images for decades, and soldier-produced illicit images are a regular and coherent category of international images. Focusing on two case studies – Abu Ghraib images and images of hazing – the argument put forward in this article is that soldier-generated illicit images are not simply photographic evidence, or accidental by-products, of exceptional military activities; rather, these images – and the practices associated with these images – are central to, and reinforce aspects of, military band of brother culture. Soldier-produced illicit images establish a visual vernacular that normalizes particular practices within military communities. Moreover, the practices of producing, circulating and consuming these images convey explicit messages to service members about acceptable behaviour and norms around loyalty and secrecy. A method of visual discourse analysis is developed and employed to examine the acts captured in soldier-generated illicit images as well as the practices linked to the production, circulation and consumption of images. Building on existing work on military culture and images and international relations, this article makes a unique contribution by systematically analysing soldier-produced illicit images in order to gain insights about internal military culture and group dynamics.
Geopersonality of Preventable Death in the United States: Anger-Prone States and Opioid Deaths
Authors: Gerhart James , Duberstein Paul , Paull Danielle , O’Mahony Sean , Burns John , DeNicolo Martin , Hoerger Michael
Published: February 2020

Background:

Opioid overdoses have reached epidemic levels in the United States and have clustered in Northeastern and “Rust Belt” states. Five Factor Model (FFM) personality traits also vary at the state level, with anger-prone traits clustered in the Northeast region. This study tested the hypothesis that state-level anger proneness would be associated with a greater increase in rates of opioid overdose death.

Methods:

This was a secondary analysis of state-level data on FFM traits, opioid overdose deaths, and other classes of preventable death. Robust mixed models tested whether change in rates of opioid overdose death from 2008 to 2016 was moderated by state-level anger proneness.

Results:

State-level anger proneness was significantly associated with greater increases in rates of opioid overdose deaths (B = 1.01, standard error = 0.19, P < .001, 95% confidence interval: 0.63-1.39). The slope of increase in opioid overdose death rates was 380% greater in anger-prone states and held after adjustment for potential confounders such as state-level prevalence of major depressive disorder, number of mental health facilities, and historical patterns of manufacturing decline. A similar pattern was observed between state-level anger proneness and benzodiazepine overdose deaths but was not significant for the latter after adjustment for potential confounders.

Conclusion:

These findings suggest that states characterized as more anger prone have experienced greater increases in opioid overdose deaths.
What Are You Afraid Of? Managing Staff Fear and Anxiety With Agitated Patients
Authors: Stewart Caroline , Reeves Lesli
Published: January 2020

INTRODUCTION: Mental health workers frequently encounter situations in which patients display agitation and escalating behaviors, increasing the risk for assaults, injuries, time off, and possible termination. These factors contribute to increased fear and anxiety when engaging with agitated patients in the psychiatric setting. AIM: The aim of this quality improvement project was to explore how a multilevel approach of psychiatric simulation training, psychiatric emergency code support, enhanced crisis prevention intervention training, and self-care education addressed staff fear and anxiety related to managing agitated patients. METHOD: Data collection was done by voluntary pre and post simulation training surveys, medical record review of high-risk violent patients, documented psychiatric emergency code debriefings, implementation of enhanced crisis prevention education, and voluntary self-care evaluations completed by mental health workers at staff retreats. RESULTS: Findings with psychiatric simulation showed effectiveness in improving role clarity, confidence, and feelings of preparedness for managing crisis situations. Review of code debriefings identified safety as the highest problem. Small work groups were created to address individualized elements that were expressed by mental health workers as safety concerns. Self-care education through staff retreats increased awareness on prevention of compassion fatigue and burnout, while allowing mental health workers to engage in activities that promote and improve cohesiveness of the team. CONCLUSIONS: These approaches effectively addressed management of fear and anxiety with agitated patients as well as solidified the notion that a multilevel approach is necessary.
Perceived Harms of Waterpipe Tobacco Heating Sources Among Young Adult Waterpipe Tobacco Smokers
Authors: Lipkus Isaac M. , Cobb Caroline O. , Eissenberg Thomas
Published: January 2020

Background. Waterpipe tobacco smoking is associated with many negative health outcomes due to toxicants produced by heating the tobacco using charcoal or electrical heaters. Little is known about how young adult waterpipe tobacco smokers perceive harms of these heating sources. Aims. To examine young adult waterpipe tobacco smokers’ perceived harms of electrical heaters and charcoal to heat waterpipe tobacco. Method. This online cross-sectional study enrolled 18- to 32-year-olds who smoked waterpipe tobacco within the past 30 days. Participants completed measures assessing, for each heating source, amount and knowledge of toxicants released (e.g., carbon monoxide, cancer-causing chemicals), perceived safety, worry about inhaling toxicants, perceived health risk, desire to quit, and intention to smoke in the next month. Question order for knowledge of and perceived harms was counterbalanced for each heating source. Results. Analyses were based on responses from 199 participants. Perceived harms for both heating sources were average to low. Despite some question order effects, participants viewed charcoal as more harmful than electrical heaters. Participants knew more about chemicals released from charcoal than electrical heaters. Greater knowledge of chemicals released by both heating sources correlated positively with perceived harms. Perceived harms were associated with a stronger desire to quit, yet unrelated with likelihood of smoking waterpipe during the next month. Discussion. Many young adult waterpipe tobacco smokers view charcoal as more harmful than electrical heaters, although knowledge about harms for each heating source is poor. Conclusion. Interventions are needed to inform the public about harms of waterpipe heating sources in order to curb use.
Weak psoas and spine extensors potentially predispose to hip fracture
Authors: Kim Keong-Hwan , Lee Jun Hee , Lim Eic Ju
Published: January 2020

Introduction:

We performed a computed tomography analysis of muscle composition characteristics in hip fracture patients and non-hip fracture controls.

Methods:

In total, 43 patients (9 men, 34 women) were included in the hip fracture group, matched 1 to 1 with non-hip fracture controls. Muscle cross-sectional areas were measured in axial CT scan at the body level of the 4th lumbar vertebra (L4), intervertebral disc level between the 5th lumbar vertebra and the 1st sacral vertebra (L5-S1) and just below level of the lesser trochanter (LT). Attenuation was also evaluated through the mean Hounsfield unit (HU) in these areas.

Results:

The cross-sectional area per weight (CSA/Wt, mm2/kg) of psoas muscle and extensor muscles of the spine showed a significant difference between the 2 groups at both L4 (9.7 vs. 12.4, p  < 0.001 and 26.3 vs. 29.2, p  = 0.025) and L5-S1 (9.6 vs. 11.5, p  = 0.001 and 8.8 vs. 10.3, p  = 0.041) levels. In addition, the HU of these muscles differed significantly between the 2 groups at both L4 (33.3 vs. 47.6, p  < 0.001 and 13.7 vs. 30.2, p  < 0.001) and L5-S1 (39.7 vs. 52.6, p  < 0.001 and 3.8 vs. 15.1, p  = 0.012) levels. There was no difference in abdominal wall, gluteal, or thigh compartment musculature between the groups.

Conclusions:

Poorer quantity and quality of psoas muscle and extensor muscles of the spine rather than whole body muscles may contribute to falls and were characteristic features of the hip fracture patients in this series. These findings should be considered when recommending a preventive exercise and rehabilitation protocol.
Métis women gathering: visiting together and voicing wellness for ourselves
Authors: Flaminio Anna Corrigal , Gaudet Janice Cindy , Dorion Leah Marie
Published: February 2020

Given the limited research by Métis women, and with Métis women, this article focuses on the impact of Métis women gathering for the purpose of sharing Métis women’s knowledge. The aim of our research is to learn Métis women’s perspectives, specifically the ways in which gathering and visiting together affects our wellness. The geographical focus was specific to kinship systems along the South Saskatchewan river, near St. Louis, Saskatchewan. This land/river place was chosen given our shared family connections to this area. We applied Métis-specific research methodologies, epistemologies, and pedagogies, including the importance of gathering with Métis women in our homes and on our land. Our community-engaged and visiting methodology included mixed-methods, such as participant engagement, evaluation forms, ceremony, gatherings, semi-structured interviews, and learning-by-doing. The research demonstrates that through Métis women visiting, gathering, and sharing Métis women’s cultural and spiritual knowledge, Métis women experienced a greater sense of wellness. The findings focus on key themes, including (a) Importance of Métis women gathering together; (b) Visiting is changing; (c) Learning-by-doing and kinship; (d) Métis women’s gatherings, community, and wellness; (e) Métis-specific spaces to share stories; and (f) Pride in Métis women’s identity.
A multiscale wear model for reciprocating rod stepseal under mixed lubricating conditions based on linear elasticity
Authors: Ran Hongliang , Wang Shaoping , Liu Di
Published: January 2020

The macroscale simulation methods are commonly used to study the wear of reciprocating seals to analyze macroscopic effects on the seal wear. There is a lack of numerical method for analyzing the wear of reciprocating seal under mixed lubricating conditions. According to experimental studies, some microscopic factors, including lubrication characteristics and surface roughness, are important for wear of reciprocating seal. Hence, in the presented research, a numerical model is proposed to analyze the effects of microscopic factors on reciprocating rod stepseal wear. O-ring of the stepseal is considered to be hyper elastic, while Turcon ring of the stepseal, which directly contacts with rod surface, is assumed to be linear elastic. The effects of microscopic aspects, including lubrication characteristics, are highlighted and analyzed. Furthermore, the seal wears under different operating conditions are analyzed and discussed. The simulation results show that the seal wears during outstroke and instroke are different. With the rod speed increasing, the wear distance rate increases during outstroke, while decreases during instroke. The seal wear increases with the sealed pressure increasing and/or compression rate increasing. With the increase in the fluid viscosity, the wear of the seal increases during outstroke and decreases during instroke. With the increase in the seal surface roughness, the seal wear decreases during outstroke and increases during instroke.
Real-time evaluation pros and cons: Lessons from the Gavi Full Country Evaluation in Zambia
Authors: Simuyemba Moses C. , Ndhlovu Obrian , Moyo Felicitas , Kashinka Eddie , Chompola Abson , Sinyangwe Aaron , Masiye Felix
Published: February 2020

The Full Country Evaluations were Gavi-funded real-time evaluations of immunisation programmes in Bangladesh, Mozambique, Uganda and Zambia, from 2013 to 2016. The evaluations focused on providing evidence for improvement of immunisation delivery in these countries and spanned all phases of Gavi support. The process evaluation approach of the evaluations utilised mixed methods to track progress against defined theories-of-change and related milestones during the various stages of implementation of the Gavi support streams. This article highlights complexities of this type of real-time evaluation and shares lessons learnt on conducting such evaluation from the Zambian experience. Real-time process evaluation is a complex evaluation methodology that requires sensitivity to the context of the evaluation, catering for various information needs of stakeholders, and establishment of mutually beneficial relationships between programme implementers and evaluators. When used appropriately, it can be an effective means of informing programme decisions and aiding programme improvement for both donors and local implementers.
Educational inequality in patient-reported outcomes but not mortality among cardiac patients: Results from the national DenHeart survey with register follow-up
Authors: Christensen Anne V. , Juel Knud , Ekholm Ola , Thrysoee Lars , Thorup Charlotte B. , Borregaard Britt , Mols Rikke E. , Rasmussen Trine B. , Berg Selina K.
Published: February 2020

Aims: This study aimed to explore whether educational level is associated with mental and physical health status, anxiety and depression symptoms and quality of life at hospital discharge and predicts cardiac events and all-cause mortality 1 year after hospital discharge in patients with ischaemic heart disease, arrhythmias, heart failure or heart valve disease. Methods: The DenHeart survey is cross-sectional and combined with data from national registers. Information on educational level and co-morbidity at hospital discharge and cardiac events and mortality 1-year post-discharge was obtained from registers. Patient-reported outcomes included SF-12, Hospital Anxiety and Depression Scale and HeartQoL. Multivariate linear and logistic regression and Cox proportional hazards regression models were used. Results: A total of 13,145 patients were included. A significant educational gradient was found in patient-reported mental and physical health status, anxiety and depression symptoms and quality of life, with lower educational groups reporting worse outcomes in adjusted analyses. No association was found between educational level and risk of cardiac events or all-cause mortality within 1 year after hospital discharge in adjusted analyses. Conclusions: In a large population of patients with cardiac disease a significant educational gradient was found in mental and physical health and quality of life at hospital discharge. There was, however, no association between educational level and risk of cardiac events or mortality 1 year after hospital discharge.
Differentiating distance in local and hyperlocal news
Authors: Freeman Julie
Published: February 2020

Journalism studies has undergone a geographic turn in which considerable research has sought to reconceptualise understandings of place and space in the digitally networked environment. This article argues that the concept of distance, as the physical spaces between places, has largely been overlooked in journalism research but could add a useful dimension when examining the construction and consumption of local and hyperlocal news. Empirical research into the news contexts of a geographically large rural Australian municipality, and the diverse experiences of two towns situated a sizable distance apart, reveals a paradox in the place-making value of news. While closeness between newsrooms and audiences benefits the development of a sense of community, outlets at a greater distance from smaller towns are more likely to offer balanced political coverage of public interest matters. These findings suggest that there is a need for a well-developed theory of distance that can account for the complexities of news contexts within and between ruralities.
Managing orthodontic appliances in everyday life: A qualitative study of young people’s experiences with removable functional appliances, fixed appliances and retainers
Authors: Kettle Jennifer E , Hyde Amy C , Frawley Tom , Granger Clare , Longstaff Sarah J , Benson Philip E
Published: February 2020

Objective:

To compare young people’s experiences of wearing a range of orthodontic appliances.

Design:

A cross-sectional, qualitative study with purposive sampling.

Setting:

UK dental teaching hospital.

Participants:

Twenty-six orthodontic patients aged 11–17 years.

Methods:

Patients participated in in-depth semi-structured interviews. All interviews were transcribed verbatim and analysed thematically.

Results:

Young people reported physical, practical and emotional impacts from their appliances. Despite these reported impacts, participants described ‘getting used’ to and, therefore, not being bothered by their appliance. Framework analysis of the data identified a multi-dimensional social process of managing everyday life with an appliance. This involves addressing the ‘dys-appearance’ of the body through physically adapting to an appliance. This process also includes psychological approaches, drawing on social networks, developing strategies and situating experiences in a longer-term context. Engaging in this process allowed young people to address the physical, practical and emotional impacts of their appliances.

Conclusion:

This qualitative research has identified how young people manage everyday life with an appliance. Understanding this process will help orthodontists to support their patients.
Diversion, Rights and Social Justice
Authors: Smith Roger
Published: February 2020

This article draws on historical understandings and contemporary models of diversion in order to develop a critical framework and agenda for progressive practice. The argument essentially revolves around the contention that typically diversionary interventions have been constrained by the contextual and ideological frames within which they operate. They have in some cases been highly successful in reducing the numbers of young people being drawn into the formal criminal justice system; however, this has largely been achieved pragmatically, by way of an accommodation with the prevailing logic of penal practices. Young people have been diverted at least partly because they have been ascribed a lesser level of responsibility for their actions, whether by virtue of age or other factors to which their delinquent behaviour is attributed. This ultimately sets limits to diversion, on the one hand, and also offers additional legitimacy to the further criminalisation of those who are not successfully ‘diverted’, on the other. By contrast, the article concludes that a ‘social justice’ model of diversion must ground its arguments in principles of children’s rights and the values of inclusion and anti-oppressive practice.
How argumentative writing stifles open-mindedness
Authors: Southworth James
Published: January 2020

A longstanding assumption within higher education is that there is a clear link between argumentative writing and critical thinking. In this paper, I challenge this assumption. I argue that argumentative writing genres of persuasion, inquiry, and consensus fail to target students’ open-mindedness, which is an important aspect of critical thinking. In particular, argumentative writing genres do not challenge students to confront key cognitive biases, namely confirmation bias and motivated reasoning, when engaging in moral, political, and/or social questions. The motivation to conduct a balanced selection of evidence as well as an unbiased interpretation of evidence is overshadowed by the motivation to preserve one’s prior beliefs. The structure of argumentative writing genres thereby stifles open-mindedness and can even nurture dogmatism. As a result, in our goal to develop students’ critical thinking skills through argumentative writing, we may be doing more harm than good.
Cardiac disease and stroke: Practical implications for personalised care in cardiac-stroke patients. A state of the art review supported by the Association of Cardiovascular Nursing and Allied Professions
Authors: Hendriks Jeroen , Andreae Christina , Ågren Susanna , Eriksson Helène , Hjelm Carina , Walfridsson Ulla , Ski Chantal F , Thylén Ingela , Jaarsma Tiny
Published: January 2020

Cardiac and stroke conditions often coexist because of common risk factors. The occurrence of stroke may have significant consequences for patients with cardiac conditions and their caregivers and poses a major burden on their lives. Although both cardiac and stroke conditions are highly prevalent, primary stroke prevention in cardiac patients is crucial to avert disabling limitations or even mortality. In addition, specific interventions may be needed in the rehabilitation and follow-up of these patients. However, healthcare systems are often fragmented and are not integrated enough to provide specifically structured and individualised management for the cardiac-stroke patient. Cardiac rehabilitation or secondary prevention services are crucial from this perspective, although referral and attendance rates are often suboptimal. This state of the art review outlines the significance of primary stroke prevention in cardiac patients, highlights specific challenges that cardiac-stroke patients and their caregivers may experience, examines the availability of and need for structured, personalised care, and describes potential implications for consideration in daily practice.
Republicanism, EU democracy and differentiated (dis-)integration
Authors: Patberg Markus
Published: February 2020

Few debates in political theory are challenged as much by the constant change of their empirical subject as those about democracy in the European Union (EU). With A Republican Europe of States, Richard Bellamy responds to the EU’s post-Lisbon era, which has been characterized by the euro crisis, conflicts over migration, the rise of Euroscepticism and Brexit. Keeping an eye on these contextual conditions and the related legal and political transformations, he has developed a general theory of international democracy aimed at securing non-domination between peoples and between citizens and their representatives at the international level, and elaborated its implications for the EU. The result is a distinctive version of demoi-cracy, whose firm centring on the nation-state as the natural locus of democracy is likely to be controversially discussed. In this article, I raise some critical considerations regarding the design of demoi-cratic institutions, the adequate understanding of EU citizenship and the normative credentials of differentiated (dis-)integration.
What did your child do today? Describing young children’s daily activities outside of school
Authors: Archbell Kristen A , Coplan Robert J , Rose-Krasnor Linda
Published: January 2020

The purpose of this study was to describe the daily activities of Canadian children outside of school. Participants were parents of N = 189 children (90 boys, 99 girls) in grades 1 to 3. The What Your Child Did Today parental telephone interview protocol was developed as a daily log of both the type and social context of children’s activities. Among the results, children spent almost half of their waking time in unstructured activities (e.g. free play), compared to 14 percent of on-screen, and 6 percent in structured activities (e.g. sports). Children spent about two-thirds of their time in the company of family followed by peers (22%), and only 10 percent of time was spent alone. Some gender differences were also noted (e.g. boys engaged in more screen time) and parental education was related to time spent in structured activities. Results are discussed in terms of implications for children’s socio-emotional development.
Research note: LED lighting – A global enterprise
Authors: Reese SB , Horowitz K , Mann M , Remo T
Published: January 2020

There is considerable focus on technology manufacturing locations and the value in funding innovation when upstream products are not manufactured within a domestic economy. Light-emitting diodes (LEDs) are such an upstream product. Here, we evaluate the value added along the supply chain of luminaires, a product that utilizes LEDs, using bottom-up cost modelling. Coupling the results with analysis of shipping cost and time, this analysis examines how advances in LEDs can incentivize LED luminaire adoption leading to the potential for significant domestic manufacturing effects even if the upstream products are produced in other economies.
ZILVERPASS Study: ZILVER PTX Stent vs Bypass Surgery in Femoropopliteal Lesions
Authors: Bosiers Marc , Setacci Carlo , De Donato Gianmarco , Torsello Giovanni , Silveira Pierre Galvagni , Deloose Koen , Scheinert Dierk , Veroux Pierfrancesco , Hendriks Jeroen , Maene Lieven , Keirse Koen , Navarro Tulio , Callaert Joren , Eckstein Hans-Henning , Teβarek Jörg , Giaquinta Alessia , Wauters Jeroen
Published: January 2020

Purpose: To report the 12-month results of a multicenter, prospective, randomized controlled trial to determine if the ZILVER PTX paclitaxel-eluting stent was noninferior in terms of safety and efficacy compared with surgical bypass. Materials and Methods: This is a study in symptomatic TransAtlantic Inter-Society Consensus (TASC) C and D femoropopliteal lesions comparing endovascular ZILVER PTX stenting vs surgical bypass surgery using a prosthetic graft ( ClinicalTrials.gov identifier NCT01952457). Between October 2013 and July 2017, 220 patients (mean age 68.6±10.5 years; 159 men) were enrolled and randomized to the ZILVER PTX treatment group (113, 51.4%) or the bypass treatment group (107, 48.6%). Most of the lesions were occlusions (208, 94.5%); the mean lesion length was 247.1±69.3 mm. The primary outcome measure was primary patency at 12 months, defined as no evidence of binary restenosis or occlusion within the target lesion or bypass graft based on a duplex-derived peak systolic velocity ratio <2.4 and no clinically-driven target lesion revascularization (TLR) in endovascular cases or reintervention to restore flow in the bypass. Results: The estimated 12-month primary patency rate was 74.5% (95% CI 66.3% to 82.7%) for the ZILVER PTX group vs 72.5% (95% CI 63.7% to 81.3%) for the bypass arm (p=0.998). Freedom from TLR at 12 months was 80.9% (95% CI 73.3% to 88.5%) for the ZILVER PTX group vs 76.2% (95% CI 68.0% to 84.4%) for the bypass group (p=0.471). The 30-day complication rate was significantly lower in the ZILVER PTX group (4.4% vs 11.3%, p=0.004). Also, procedure time and hospital stay were significantly shorter in the ZILVER PTX group (p<0.001 for both). Conclusion: With noninferior patency results, a lower complication rate, and shorter procedures and hospital stays, paclitaxel-eluting stenting might become a recommended treatment for long TASC C and D femoropopliteal lesions.
Use of Nevelia Dermal-Epidermal Regenerative Template in the Management of Ischemic Diabetic Foot Postsurgical Wounds
Authors: Uccioli Luigi , Meloni Marco , Izzo Valentina , Giurato Laura
Published: January 2020

The purpose of this cross-sectional study is evaluate the effectiveness of a dermal-epidermal substitute (DES) composed of 3-dimensional porous matrix of type 1, purified, stabilized, bovin-origin collagen (Nevelia, SYMATESE, Chaponost, France) without a subsequent skin graft in the treatment ischemic postsurgical diabetic foot ulcers. This study group was composed of a sample of consecutive diabetic patients with critical limb ischemia and postsurgical wounds. All patients received a preset limb salvage protocol including the application of the DES, but none received a skin graft. Patients were closely followed until wound healing or different outcome. The outcome measures were healing, nonhealing, major amputation, and death evaluated at 1 and 2 years of follow-up. Forty-one patients were included. The average postsurgical wound area was 69.6 ± 50 cm2. Twenty-one patients (51%) healed; 10 patients (24%) did not heal after 1 year of follow-up; however, all of them achieved a mean ulcer size reduction >50%; 7 patients (17%) were amputees; 3 patients (7.3%) died. In a later follow-up (2 years), wounds in 8 additional patients healed. Successful revascularization was an independent predictor of healing (hazard ratio = 5.1, 95% confidence interval [CI] = 2.5-14-9; P = .0001), the postsurgical ulcer size (>50 cm2) was an independent predictor of nonhealing (hazard ratio = 6.2, 95% CI = 2.1-38.4; P = .0001) while recurrence of critical limb ischemia was an independent predictor of major amputation (odds ratio = 3.4, 95% CI = 1.1-4.5; P = .002). The DES composed of type 1 bovin-origin collagen is useful in the treatment of large postsurgical diabetic foot ulcers, even when the skin graft is not a suitable therapeutic option.
Livedo Racemosa: Clinical, Laboratory, and Histopathological Findings in 33 Patients
Authors: Pincelli Marcella Soares , Echavarria Alejandra Maria Jimenez , Criado Paulo Ricardo , Marques Gabriela Franco , Morita Thâmara Cristiane Alves Batista , Valente Neusa Yuriko Sakai , de Carvalho Josélio Freire
Published: January 2020

Livedo racemosa is a cutaneous finding characterized by a persistent, erythematous, or violaceous discoloration of the skin, in a broken, branched, discontinuous, and irregular pattern. A retrospective review of 33 cases with clinical diagnosis of livedo racemosa over the past 6 years was evaluated in the dermatology department of a tertiary care hospital. We found predominance in Caucasian women (78.8%); age ranged from 8 to 81 years, with a mean age of 36 years. Livedo racemosa was described as generalized in 12 patients (36.4%), although the main localization was on lower limbs (42%). After laboratory testing and histopathological examinations, 12 patients (36.4%) were classified with idiopathic livedo racemosa; secondary diseases were diagnosis in 21 patients (63.6%), including Sneddon’s syndrome, cutaneous polyarteritis nodosa, systemic lupus erythematosus, and others. Medical history of thrombotic events was described in 8 (24.2%) patients, and also 8 (24.2%) patients had abnormal results for 2 or more thrombophilia laboratory tests. Skin biopsy showed no histological abnormalities in 11 cases (33.3%), thrombosis of dermal blood vessels in 10 (30.3%), intimal/subintimal thickening in 7 (21.2%), and vasculitis in 5 (15.2%). In conclusion, livedo racemosa is a clinical feature that might be correlated to vascular disorders, such as thrombotic and/or hypercoagulable states, autoimmune diseases, and neoplastic diseases, or it can be secondary to specific medications. It is essential to establish a correct approach in cases of livedo racemosa, which includes anamnesis, physical examination, laboratory test, histological examination, and complementary examination according to clinical findings, in order to diagnosis underlying causes.
Recent developments in electrospun ZnO nanofibers: A short review
Authors: Blachowicz Tomasz , Ehrmann Andrea
Published: February 2020

Especially for the potential use as sensors, but also in all other applications in which an interaction with the environment occurs, nanofibrous materials are advantageous due to their large specific surface area. An interesting material for electrospinning is the semiconductor zinc oxide (ZnO) which is often used in photoelectric or sensory applications. Nanofibers containing ZnO can be produced, for example, by electrospinning polyvinylpyrrolidone/zinc nitrate from a dimethylformamide/ethanol solution, followed by calcination to remove the organic phase. Alternatively, the polymer/semiconductor blended nanofibers can be used which are often less brittle, but on the other hand offer less contact between ZnO and the environment. Finally, decorating a nanofiber mat with ZnO offers another possibility to prepare nanofibers with ZnO surface. Possible applications of electrospun ZnO nanofibers or nanofiber mats include gas sensing, microwave absorption, photocatalytic degradation or enhancement of supercapacitor electrodes. This short review gives an overview of the most recent electrospinning and after-treatment techniques to create pure and blended ZnO nanofibers and presents the broad variety of possible applications of this well-known semiconductor with some still surprising properties.
Role of health plan administrative claims data in participant recruitment for pragmatic clinical trials: An Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-term Effectiveness (ADAPTABLE) example
Authors: Shi Qian , Shambhu Sonali , Marshall Amanda , Rose-Kennedy Elaine , Robertson Holly , Paullin Mark , Jones William Schuyler , Cziraky Mark , Haynes Kevin
Published: February 2020

Aim:

The purpose of this study is to evaluate HealthCore/Anthem Research Network recruitment strategies, compare response and enrollment rates for different recruitment strategies, and describe demographic and clinical characteristics of responders and enrollees.

Methods:

HealthCore/Anthem Research Network, a part of the Health Plan Research Network of the Patient-Centered Clinical Data Research Network, used administrative claims data to identify eligible health plan members for potential participation in the Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-term Effectiveness study. We approached health plan members, identified with a validated Patient-Centered Clinical Data Research Network common data model computable phenotype, and their clinical providers during November 2017 to August 2018. Providers were offered the option to exclude their patients’ participation in Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-term Effectiveness prior to our direct patient (member) outreach. Member identification was in two phases: Phase 1: 1 January 2006 to 1 April 2017, and Phase 2: 1 January 2006 to 2 February 2018. Phase 1 consisted of two batches of mail and one phone call per patient. In Phase 2, which included two similar batches of patients, outreach was via either mail or brochure and one phone call.

Results:

Phase 1 and Phase 2 included 133,373 and 51,777 members, respectively. We engaged 28,593 providers in Phase 1, and 5077 in Phase 2. In Phase 1, 264,158 mixed email/mail messages were delivered to 133,373 members, followed by 90,481 phone calls from November 2017 to February 2018. In Phase 2, after simple randomization to letter or brochure, 51,777 members were sent email/mail or mailed brochure in three waves from May 2018 to July 2018. In this 9-week period, 51,623 communications were sent to 25,914 members in the email/mail group, and 50,160 brochures to 25,863 in the brochure group. Following email/mail or mailed brochure outreach, 16,624 and 16,580 calls were made to the groups, respectively. Overall, 1549 health plan members visited the study portal by 1 September 2018; 355 electronically signed the Informed Consent Form and enrolled. Mailed brochures drove more portal visits in Phase 2, but a lower percentage of responders enrolled. Recruitment was better in Phase 2—2.3 enrollees per 1000 outreach members versus 1.8 in Phase 1.

Conclusion:

This study showed the ability of a health plan within Patient-Centered Clinical Data Research Network to identify potential study participants with administrative claims, and use different outreach methods to facilitate recruitment and enrollment for pragmatic clinical trials.
A Systematic Review of the Qualitative Evidence for the Use of Lifestyle Planning in People with Learning Disabilities
Authors: Rowe D. , Rudkin A.
Published: February 2020

Lifestyle planning (LP) for people with learning disabilities is largely supported by qualitative rather than quantitative research. LP is a time-consuming and potentially resource-intensive area of practice which is becoming more prevalent in the UK. We present the first systematic review of the qualitative evidence base for the use of LP in people with learning disabilities. Such evidence concerns the special characteristics of LP and its outcomes in descriptive rather than quantitative terms. Qualitative research is usually aimed at enhancing validity by grounding theory in data collected. Twenty-one studies passed eligibility criteria for inclusion in this review, but only ten provided any outcome data, the others being concerned with process only. A replicable search strategy was employed and the resulting original data sources were critically reviewed with respect to major concepts and categories in the areas of: planning process, choices and preferences, ethics and outcomes. Explicitly person-centred approaches such as essential lifestyle planning are contrasted with more service-led methods such as individual programme planning. There are major methodological limitations in much of the available literature and suggestions for future research to clarify matters are made. The current evidence base suggests that no form of LP has significantly better outcomes than any other form and that it is not clear if LP in general enhances outcomes. Ongoing use of person centred planning in particular is informed by ethical considerations and is evolving in its structure and function.
An Abuse of Disability? Assessing Treatment Outcome in Sexual Offenders with Learning Disabilities
Authors: Riding T. M.
Published: February 2020

There is growing recognition that, of the small proportion of people with learning disabilities who do offend, a disproportionate number are likely to have committed offences of a sexual nature. Perhaps of greater concern is the lack of empirical data to support the diversity of clinical interventions employed with this client group, and an absence of objective criteria for determining the outcome of such interventions. This paper describes initial findings of a study designed to assess treatment outcomes in eight male sexual offenders with learning disabilities currently detained in a special hospital. Data were collected through a range of quantitative research instruments in order to establish the utility of various assessment methods. Results obtained demonstrate positive shifts in several of the areas targeted during treatment. However, difficulties in the use of quantitative instruments with such inherently small samples are highlighted and discussed, and the paper, therefore, concludes by outlining how the research will develop hereafter through the development of a more qualitatively oriented, ordinal assessment instrument.