bluuebunny/crossref_metadata_2025 huggingface dataset:
Directions in Higher Education: A Marketing Perspective
Authors: Uncles Mark D.
Published: May 2018

Higher education is a service industry – a terrific success story by most measures of industrial success. Across the globe, ever-rising numbers of students are enrolled in programs. In this essay, a marketing perspective is used to examine changes in higher education, with a focus on the identification of new opportunities. Where students are regarded as partners, new sources of value will arise around value-in-development, value-in-delivery, and value-in-consumption. Furthermore, with the explosion of data capture, analysis and visualisation, we can measure and evaluate these sources of value and are equipped to adopt an evidence-based approach to the provision of higher education. Certain directions, however, are raising serious concerns for students, providers and regulators. Transformation is disruptive, leading to uncertainty, anxiety, even fear, but by applying marketing concepts and analytics we will be better placed to assess opportunities, weigh up fears, and help set the direction of higher education.
Amyloid positron emission tomography candidates may focus more on benefits than risks of results disclosure
Authors: Lingler Jennifer H. , Roberts J. Scott , Kim Hyejin , Morris Jonna L. , Hu Lu , Mattos Meghan , McDade Eric , Lopez Oscar L.
Published: May 2018

Introduction

Given mounting calls to disclose biomarker test results to research participants, we explored factors underlying decisions by patients with mild cognitive impairment to receive amyloid imaging results.

Methods

Prospective, qualitative interviews were conducted with 59 participants (30 = mild cognitive impairment patients, 29 = care partners) from the scan arm of a randomized controlled trial on the effects of amyloid PET results disclosure in an Alzheimer Disease Research Center setting.

Results

Sixty‐three percent of the participants were female, with an average age of 72.9 years, and most had greater than a high school level of education (80%). Primary motivations included: (1) better understanding one's mild cognitive impairment etiology and prognosis to plan ahead, and (2) learning one's brain amyloid status for knowledge's sake, regardless of whether the information is actionable. Most participants demonstrated an adequate understanding of the scan's limitations, yet instances of characterizing amyloid PET as a definitive test for Alzheimer's disease occurred. Mention of potential drawbacks, such as negative psychological outcomes, was minimal, even among care partners.

Discussion

Findings demonstrate a risk of disproportionate focus on possible benefits of testing among amyloid scan candidates and suggest a need to clearly emphasize the limitations of amyloid PET when counseling cognitively impaired patients and their families before testing. Future research should examine whether minimizing drawbacks at the pre‐imaging stage has adverse consequences on results disclosure.
Effects of Paroxetine on Motor and Cognitive Function Recovery in Patients with Non-Depressed Ischemic Stroke: An Open Randomized Controlled Study
Authors: Pan Xiao-Ling , Chen Hong-Fang , Cheng Xing , Hu Chuan-Chen , Wang Jian-Wei , Fu Ya-Ming , Kong Hui-Mei , Shao Hui-Jun
Published: May 2018

Introduction: To investigate the effects of paroxetine (PAR) on motor and cognitive function recovery in patients with non-depressed ischemic stroke (nD-AIS).

Methods: One hundred sixty-seven patients hospitalized for non-depressed acute ischemic stroke were selected and divided into treatment (T) and control (C) groups using a random number table. All patients received conventional secondary ischemic stroke prevention and rehabilitation training; patients in Group T additionally received treatment with PAR (10 mg/day during week 1 and 20 mg/day thereafter) for 3 months. The follow-up observation lasted 6 months. The Fugl–Meyer motor scale (FMMS), Montreal cognitive assessment (MoCA), and Hamilton depression scale (HAMD) were used on D0, D15, D90, and D180 (T0, 1, 2, and 3, respectively; D180 = 90 days after treatment cessation) after study initiation, and scores were compared between the groups.

Results: The FMMS and MoCA scores differed significantly between Groups T and C at T2 and T3 (p < .05); by contrast, these scores did not differ significantly between the groups at T1 (p > .05). Furthermore, the HAMD scores differed significantly between the two groups at T3 (p < .05), but not at T1 and T2 (p > .05).

Conclusions: PAR treatment may improve motor and cognitive function recovery in patients with nD-AIS. Moreover, PAR may reduce the occurrence of depression after stroke.
Mutual Trust and the Dark Horse of Civil Justice
Authors: STORSKRUBB Eva
Published: May 2018

How to understand and deal with the principle of mutual trust, its emanations, interpretations, and imperatives has in recent years become one of the central and most critical issues in the development of the Area of Freedom Security and Justice (AFSJ). Civil justice may be the dark horse with respect to mutual trust among the policy areas of the AFSJ in the sense that it may show useful but hitherto hidden possibilities and have an un-tipped winning strategy. In particular, the balancing safeguards in legislation, the importance of which have been confirmed in case law, are important to ensure the fundamental right to a fair trial. However, that does not mean that mutual trust does not pose challenges in the context of civil justice. Hence, it remains important to focus on how—normatively, and by which regulatory means—to support mutual trust as well as how to balance, and perhaps limit, its implementation in order to enhance its legitimacy. In addition, the recent pressures towards harmonisation need to be carefully analysed.
Understanding why older adults choose to seek non-urgent care in the emergency department: the patient’s perspective
Authors: Goodridge Donna , Stempien James
Published: May 2018

Objectives

Older adults make up a significant proportion of patients seeking care in the ED, with about 25% of these visits classified as “non-urgent.” This study explored older adults’ understandings, expectations of and self-reported reasons for seeking care and treatment provided in the ED.

Methods

This qualitative study involved semi-structured interviews with CTAS 4-5 patients conducted at randomly selected times and days during ED visits at three Saskatoon facilities in 2016. Thematic analysis was used to analyze interview data.

Results

115 patients over age 65 years (mean age 79.1 years) were interviewed. While the majority had independently or with family made the decision to attend the ED, almost one-third of patients (31.6%) reported that they had been referred to the ED by general practitioners or specialists. Few respondents indicated the visit was the result of their general practitioner not being available. Most participants cited comprehensiveness and convenience of diagnostic and treatment services in a single location as the primary motivation for seeking treatment in the ED, which was especially important to those in poor health, without family supports, or with functional limitations, personal mobility and/or transportation challenges. Other common motivations were availability of after-hours care and perceived higher quality care compared to primary care.

Conclusions

Accessibility to comprehensive care, availability, quality of care and positive past experiences were key considerations for older adults seeking treatment of non-urgent concerns. Older adults will likely continue to use EDs for non-urgent medical care until trusted, “one-stop” settings that better addresses the needs of this population are more widely available.
Application of quality improvement analytic methodology in emergency medicine research: A comparative evaluation
Authors: Harries Bruce , Filiatrault Lyne , Abu-Laban Riyad B.
Published: May 2018

Objective

Quality improvement (QI) analytic methodology is rarely encountered in the emergency medicine literature. We sought to comparatively apply QI design and analysis techniques to an existing data set, and discuss these techniques as an alternative to standard research methodology for evaluating a change in a process of care.

Methods

We used data from a previously published randomized controlled trial on triage-nurse initiated radiography using the Ottawa ankle rules (OAR). QI analytic tools were applied to the data set from this study and evaluated comparatively against the original standard research methodology.

Results

The original study concluded that triage nurse-initiated radiographs led to a statistically significant decrease in mean emergency department length of stay. Using QI analytic methodology, we applied control charts and interpreted the results using established methods that preserved the time sequence of the data. This analysis found a compelling signal of a positive treatment effect that would have been identified after the enrolment of 58% of the original study sample, and in the 6th month of this 11-month study.

Conclusions

Our comparative analysis demonstrates some of the potential benefits of QI analytic methodology. We found that had this approach been used in the original study, insights regarding the benefits of nurse-initiated radiography using the OAR would have been achieved earlier, and thus potentially at a lower cost. In situations where the overarching aim is to accelerate implementation of practice improvement to benefit future patients, we believe that increased consideration should be given to the use of QI analytic methodology.
Issue Ownership and Electoral Rule: Empirical Evidence from Japan
Authors: Kim Yong Jae
Published: May 2018

This article examines the effects of electoral systems on issue ownership. This study argues that electoral rules significantly affect issue ownership because they prompt candidates to adopt different types of electoral campaigns. Compared to the single non-transferable vote (SNTV) system, the mixed-member majoritarian (MMM) system prods candidates to change the pattern of electoral campaigns from candidate-centred to issue-centred competition. In particular, partisan issue effects are more effective in gaining votes under the MMM. To support the argument, I find evidence from content analyses of party manifestos and multinomial logistic regression models of electoral surveys between the pre-reform and post-reform elections in Japan.
Dimensions of Radiocarbon Variability within Sedimentary Organic Matter
Authors: Bao Rui , McNichol Ann P , McIntyre Cameron P , Xu Li , Eglinton Timothy I
Published: May 2018

Organic carbon (OC) radiocarbon (14C) signatures in marine surface sediments are highly variable and the causes of this heterogeneity remain ambiguous. Here, we present results from a detailed 14C-based investigation of an Arabian Sea sediment, including measurements on organic matter (OM) in bulk sediment, specific grain size fractions, and OC decomposition products from ramped-pyrolysis-oxidation (RPO). Our results show that 14C ages of OM increase with increasing grain size, suggesting that grain size is an important factor controlling the 14C heterogeneity in marine sediments. Analysis of RPO decomposition products from different grain size fractions reveals an overall increase in age of corresponding thermal fractions from finer to coarser fractions. We suggest that hydrodynamic properties of sediment grains exert the important control on the 14C age distribution of OM among grain size fractions. We propose a conceptual model to account for this dimensionality in 14C variability that invokes two predominant modes of OM preservation within different grain size fractions of Arabian Sea sediment: finer (<63 µm) fractions are influenced by OM-mineral grain aggregation processes, giving rise to relatively uniform 14C ages, whereas OM preserved in coarser (>63 µm) fractions includes materials encapsulated within microfossils and/or entrained fossil (14C-depleted) OC hosted in detrital mineral grains. Our findings highlight the value of RPO for assessment of 14C age variability in sedimentary OC, and for assessing mechanisms of OM preservation in aquatic sediments.
CLASSIFICATION OF CUBIC HOMOGENEOUS POLYNOMIAL MAPS WITH JACOBIAN MATRICES OF RANK TWO
Authors: DE BONDT MICHIEL , SUN XIAOSONG
Published: May 2018

Let$K$be any field with$\text{char}\,K\neq 2,3$. We classify all cubic homogeneous polynomial maps$H$over$K$whose Jacobian matrix,${\mathcal{J}}H$, has$\text{rk}\,{\mathcal{J}}H\leq 2$. In particular, we show that, for such an$H$, if$F=x+H$is a Keller map, then$F$is invertible and furthermore$F$is tame if the dimension$n\neq 4$.
Potato consumption and risk of pancreatic cancer in the HELGA cohort
Authors: Åsli Lene A. , Braaten Tonje , Olsen Anja , Tjønneland Anne , Overvad Kim , Nilsson Lena Maria , Renström Frida , Lund Eiliv , Skeie Guri
Published: May 2018

Potatoes have been a staple food in many countries throughout the years. Potatoes have a high glycaemic index (GI) score, and high GI has been associated with several chronic diseases and cancers. Still, the research on potatoes and health is scarce and contradictive, and we identified no prospective studies that had investigated the association between potatoes as a single food and the risk of pancreatic cancer. The aim of this study was to prospectively investigate the association between potato consumption and pancreatic cancer among 114 240 men and women in the prospective HELGA cohort, using Cox proportional hazard models. Information on diet (validated FFQ’s), lifestyle and health was collected by means of a questionnaire, and 221 pancreatic cancer cases were identified through cancer registries. The mean follow-up time was 11·4 (95 % CI 0·3, 16·9) years. High consumption of potatoes showed a non-significantly higher risk of pancreatic cancer in the adjusted model (hazard ratio (HR) 1·44; 95 % CI 0·93, 2·22,Pfor trend0·030) when comparing the highestv.the lowest quartile of potato consumption. In the sex-specific analyses, significant associations were found for females (HR 2·00; 95 % CI 1·07, 3·72,Pfor trend0·020), but not for males (HR 1·01; 95 % CI 0·56, 1·84,Pfor trend0·34). In addition, we explored the associations by spline regression, and the absence of dose–response effects was confirmed. In this study, high potato consumption was not consistently associated with a higher risk of pancreatic cancer. Further studies with larger populations are needed to explore the possible sex difference.
What is the effect of diet and/or exercise interventions on behavioural compensation in non-exercise physical activity and related energy expenditure of free-living adults? A systematic review
Authors: Silva Analiza M. , Júdice Pedro B. , Carraça Eliana V. , King Neil , Teixeira Pedro J. , Sardinha Luís B.
Published: May 2018

Non-exercise physical activity (NEPA) and/or non-exercise activity thermogenesis (NEAT) reductions may occur from diet and/or exercise-induced negative energy balance interventions, resulting in less-than-expected weight loss. This systematic review describes the effects of prescribed diet and/or physical activity (PA)/exercise on NEPA and/or NEAT in adults. Studies were identified from PubMed, web-of-knowledge, Embase, SPORTDiscus, ERIC and PsycINFO searches up to 1 March 2017. Eligibility criteria included randomised controlled trials (RCT), randomised trials (RT) and non-randomised trials (NRT); objective measures of PA and energy expenditure; data on NEPA, NEAT and spontaneous PA; ≥10 healthy male/female aged>18 years; and ≥7 d length. The trial is registered at PROSPERO-2017-CRD42017052635. In all, thirty-six articles (RCT-10, RT-9, NRT-17) with a total of seventy intervention arms (diet, exercise, combined diet/exercise), with a total of 1561 participants, were included. Compensation was observed in twenty-six out of seventy intervention arms (fifteen studies out of thirty-six reporting declines in NEAT (eight), NEPA (four) or both (three)) representing 63, 27 and 23 % of diet-only, combined diet/exercise, and exercise-only intervention arms, respectively. Weight loss observed in participants who decreased NEAT was double the weight loss found in those who did not compensate, suggesting that the energy imbalance degree may lead to energy conservation. Although these findings do not support the hypothesis that prescribed diet and/or exercise results in decreased NEAT and NEPA in healthy adults, the underpowered trial design and the lack of state-of-the-art methods may limit these conclusions. Future studies should explore the impact of weight-loss magnitude, energetic restriction degree, exercise dose and participant characteristics on NEAT and/or NEPA.
A bedtime milk snack does not impact RMR, substrate utilisation and appetite the following morning in mildly overweight males
Authors: Lay Arthur H. H. , Crabtree Daniel R. , Campbell Tom G. , Dreczkowski Gillian M. , Galloway Stuart D. R. , Tipton Kevin D. , Witard Oliver C.
Published: May 2018

Nighttime eating is often associated with a negative impact on weight management and cardiometabolic health. However, data from recent acute metabolic studies have implicated a benefit of ingesting a bedtime snack for weight management. The present study compared the impact of ingesting a milk snack containing either 10 (BS10) or 30 g (BS30) protein with a non-energetic placebo (BS0) 30 min before bedtime on next morning metabolism, appetite and energy intake in mildly overweight males (age: 24·3 (sem 0·8) years; BMI: 27·4 (sem 1·1) kg/m2). Next morning measurements of RMR, appetite and energy intake were measured using indirect calorimetry, visual analogue scales and an ad libitum breakfast, respectively. Bedtime milk ingestion did not alter next morning RMR (BS0: 7822 (sem 276) kJ/d, BS10: 7482 (sem 262) kJ/d, BS30: 7851 (sem 261) kJ/d, P=0·19) or substrate utilisation as measured by RER (P=0·64). Bedtime milk ingestion reduced hunger (P=0·01) and increased fullness (P=0·04) during the evening immediately after snack ingestion, but elicited no effect the next morning. Next morning breakfast (BS0: 2187 (sem 365) kJ, BS10: 2070 (sem 336) kJ, BS30: 2582 (sem 384) kJ, P=0·21) and 24 h post-trial (P=0·95) energy intake was similar between conditions. To conclude, in mildly overweight adults, compared with a non-energetic placebo, a bedtime milk snack containing 10 or 30 g of protein does not confer changes in next morning whole-body metabolism and appetite that may favour weight management.
Pre–post evaluation of a weight management service for families with overweight and obese children, translated from the efficacious lifestyle intervention Parenting, Eating and Activity for Child Health (PEACH)
Authors: Moores Carly J. , Miller Jacqueline , Daniels Lynne A. , Vidgen Helen A. , Magarey Anthea M.
Published: May 2018

Parenting, Eating and Activity for Child Health (PEACH) is a multi-component lifestyle intervention for families with overweight and obese children. PEACH was translated from an efficacious randomised-controlled trial (RCT) and delivered at scale as PEACH Queensland (QLD) in Queensland, Australia. The aim of this study is to explore pre–post changes in parenting, and child-level eating, activity and anthropometry, in the PEACH QLD service delivery project. PEACH QLD enrolled 926 overweight/obese children (817 families). Pre-programme evaluation was completed for 752 children and paired pre–post-programme evaluation data were available for 388 children. At baseline, children with pre–post-programme data were (mean) 8·8 years old, and at follow-up were 9·3 years old, with mean time between pre–post-programme measures of 0·46 years. Outcomes reflected each domain of the PEACH programme: parenting, eating behaviour of the child and activity behaviours (means reported). Parents reported improvements in parenting self-efficacy (3·6 to 3·7,P=0·001). Children had improved eating behaviours: eating more daily serves of vegetables (2·0 to 2·6,P=0·001) and fewer non-milk sweetened beverages (0·9 to 0·6,P=0·001) and discretionary foods (2·2 to 1·5,P=0·001). Children spent more time in moderate-to-vigorous physical activity (86 to 105 min/d,P=0·001) and less time in sedentary screen-based behaviours (190 to 148 min/d,P=0·001). Consequently, there were significant improvements in mean BMIz(−0·112;P<0·001) and weight status (healthy weight/overweight/obese/morbidly obese prevalence from 0/22/33/45 % to 2/27/34/37 %,P<0·001). When delivered at scale, PEACH remains an effective family-based, multi-component, lifestyle weight management programme for overweight and obese children whose families engage in the programme.
Quantifying diversity in parametric design: a comparison of possible metrics
Authors: Brown Nathan C. , Mueller Caitlin T.
Published: May 2018

To be useful for architects and related designers searching for creative, expressive forms, performance-based digital tools must generate a diverse range of design solutions. This gives the designer flexibility to choose from a number of high-performing designs based on aesthetic preferences or other priorities. However, there is no single established method for measuring diversity in the context of computational design, especially in the field of architecture. This paper explores different metrics for quantifying diversity in parametric design, which is an increasingly common digital approach to early-stage exploration, and tests how human users perceive these diversity measurements. It first provides a review of existing methodologies for measuring diversity and describes how they can be adapted for parametrically formulated design spaces. This paper then tests how these different metrics align with human perception of design diversity through an online visual survey. Finally, it offers a quantitative comparison between the different methods and a discussion of their attributes and potential applications. In general, the comparison indicates that at the level of diversity difference that becomes visually meaningful to humans, the measurable difference between metrics is small. This paper informs future researchers, developers, and designers about the measurement of diversity in parametric design, and can stimulate further studies into the perception of diversity within sets of design options, as well as new design methodologies that combine architectural novelty and performance.
Gesture-based system for next generation natural and intuitive interfaces
Authors: Huang Jinmiao , Jaiswal Prakhar , Rai Rahul
Published: May 2018

We present a novel and trainable gesture-based system for next-generation intelligent interfaces. The system requires a non-contact depth sensing device such as an RGB-D (color and depth) camera for user input. The camera records the user'sstatichand pose and palm centerdynamicmotion trajectory. Both static pose and dynamic trajectory are used independently to provide commands to the interface. The sketches/symbols formed by palm center trajectory is recognized by the Support Vector Machine classifier. Sketch/symbol recognition process is based on a set of geometrical and statistical features. Static hand pose recognizer is incorporated to expand the functionalities of our system. Static hand pose recognizer is used in conjunction with sketch classification algorithm to develop a robust and effective system for natural and intuitive interaction. To evaluate the performance of the system user studies were performed on multiple participants. The efficacy of the presented system is demonstrated using multiple interfaces developed for different tasks including computer-aided design modeling.
Use of analogies, metaphors, and similes by students and reviewers at an undergraduate architectural design review
Authors: Dogan Fehmi , Taneri Batuhan , Erbil Livanur
Published: May 2018

This study investigates the use of similarities in the form of analogy, metaphor, and simile by students and reviewers in an undergraduate architectural design review. In contrast to studies conductedin vitrosettings, this study emphasizes the importance of studying analogies, metaphors, and similes in a natural setting. All similarity relationships were coded according to their type, the level of expertise, range, frequency, goal, value judgment, and depth. The results indicate that analogies, metaphors, and similes were used spontaneously and without any difficulty by both reviewers and students. Reviewers, however, were almost twice as likely to evoke similarities. Metaphor was the most frequently used similarity relationship among the three. It was found that there was a significant relationship between the level of expertise and type of similarity, with students more likely to use analogies and less likely to use similes. It was also found that goal is the most important factor, with a significant relation to all other variables, and that embodiment is often invoked in both students’ and reviewers’ metaphors. We conclude that design education should take full advantage of students’ natural ability to benefit from similarity relationships.
The risk of urban yellow fever resurgence in Aedes-infested American cities
Authors: Massad Eduardo , Amaku Marcos , Coutinho Francisco Antonio Bezerra , Struchiner Claudio José , Lopez Luis Fernandez , Coelho Giovanini , Wilder-Smith Annelies , Burattini Marcelo Nascimento
Published: May 2018

Aedes aegypti, historically known as yellow fever (YF) mosquito, transmits a great number of other viruses such as Dengue, West Nile, Chikungunya, Zika, Mayaro and perhaps Oropouche, among others. Well established in Africa and Asia, Aedes mosquitoes are now increasingly invading large parts of the American continent, and hence the risk of urban YF resurgence in the American cities should because of great concern to public health authorities. Although no new urban cycle of YF was reported in the Americas since the end of an Aedes eradication programme in the late 1950s, the high number of non-vaccinated individuals that visit endemic areas, that is, South American jungles where the sylvatic cycle of YF is transmitted by canopy mosquitoes, and return to Aedes-infested urban areas, increases the risk of resurgence of the urban cycle of YF. We present a method to estimate the risk of urban YF resurgence in dengue-endemic cities. This method consists in (1) to estimate the number of Aedes mosquitoes that explains a given dengue outbreak in a given region; (2) calculate the force of infection caused by the introduction of one infective individual per unit area in the endemic area under study; (3) using the above estimates, calculate the probability of at least one autochthonous YF case per unit area produced by one single viraemic traveller per unit area arriving from a YF endemic or epidemic sylvatic region at the city studied. We demonstrate that, provided the relative vector competence, here defined as the capacity to being infected and disseminate the virus, of Ae. aegypti is greater than 0.7 (with respect to dengue), one infected traveller can introduce urban YF in a dengue endemic area.
Association of influenza outbreaks with advanced pediatric medical support
Authors: Guyther Jennifer , Lichenstein Richard , Gao Yonghong , Zhou James A. , Ajao Adebola , Bajaj Priti K. , Combs Veronica A. , King James C.
Published: May 2018

Retrospective data evaluated increases in advanced medical support for children with medically attended acute respiratory illness (MAARI) during influenza outbreak periods (IOP). Advanced support included hospitalisation, intensive care unit admission, or mechanical ventilation, for children aged 0–17 years hospitalised in Maryland's 50 acute-care hospitals over 12 influenza seasons. Weekly numbers of positive influenza tests in the Maryland area defined IOP for each season as the fewest consecutive weeks, including the peak week containing at least 85% of positive tests with a 2-week buffer on either side of the IOP. Peak IOP (PIOP) was defined as four consecutive weeks containing the peak week with the most number of positive influenza tests. Off-PIOP was defined as the ‘shoulder’ weeks during each IOP. Non-influenza season (NIS) was the remaining weeks of that study season. Rate ratios of mean daily MAARI-related admissions resulting in advanced medical support outcomes during PIOP or Off-PIOP were compared with the NIS and were significantly elevated for all 12 study seasons combined. The results suggest that influenza outbreaks are associated with increased advanced medical support utilisation by children with MAARI. We feel that this data may help preparedness for severe influenza epidemics or pandemic.
Macao Report: Informed Consent in a Multilingual and Multicultural Region, a Bioethical Challenge
Authors: RAPOSO VERA LÚCIA
Published: May 2018

Complying with the requirements of informed consent for medical procedures can sometimes be problematic, even when the hospitals are located in countries that are uniform in their language and cultural values. However, when hospitals are located in countries with diverse linguistic and ethnic communities, it becomes particularly challenging. This article examines how Macao, with four predominant languages—Mandarin, Portuguese, Cantonese and English—and two very strong cultures, Western and Chinese, strives to meet the challenges of informed consent. The situation is made even more complicated by a healthcare delivery in Macao that is mostly guided by Chinese ethical and cultural perspectives, whereas its law is inspired by the Western model.
Her Uterus, Her Medical Decision? Dismantling Spousal Consent for Medically Indicated Hysterectomies in Saudi Arabia
Authors: MUAYGIL RUAIM
Published: May 2018

Against the background of a recommended hysterectomy, this article examines the current requirement in Saudi Arabia for the husband’s consent for any medical procedure that affects the reproductive ability of his wife. The history and background of this decree is explained, along with the major arguments for its support. Additionally, the legitimacy of the requirement is discussed from the Islamic and legal perspectives. Special attention is given to relevant cultural considerations, such as the family unit, the medical community, and the larger Saudi society. Arguments advocating for discontinuing the requirement are offered along with measures to implement in order to overcome this social artifact.
Patient Engagement at the Household Level: A Feasible Way to Improve the Chinese Healthcare Delivery System Toward People-Centred Integrated Care
Authors: LIU ZIYU
Published: May 2018

Influenced by the people-centered integrated care (PCIC) model, Healthy China 2030 was drafted recently with a special concern given to patient engagement. Although there are three levels of engagement (i.e., individual, household, community), patients are more likely to be empowered and activated through an individualistic approach. Thus, engaging patients at the household level appear to have been overlooked so far. Supported by ethical values and practical evidence, this article attempts to address the importance of engaging patients at the household level in shaping the Chinese healthcare system with the PCIC model orientation, and thus recommends four strategies for empowering and activating patients at the household level in the Chinese context.
Access to Healthcare: A Central Question within Brazilian Bioethics
Authors: GARRAFA VOLNEI , CUNHA THIAGO ROCHA DA , MANCHOLA CAMILO
Published: May 2018

This article explores the current situation regarding the importance of access to healthcare in relation to the genesis and context of bioethics developed in Brazil, a country in which healthcare is understood through the national constitution to be a universal right of its population. Since the onset of the development of Brazilian bioethics at the beginning of the 1990s, topics relating directly and indirectly to the field of public health have been a priority in the bioethics agenda. The article considers the socioeconomic context within which conflicts occur, an issue that has been addressed in other scientific articles on bioethics in Latin America. It presents the main conceptual bases of intervention bioethics, a critical approach that has been developed as a reference point in this region, with the aim of analyzing (bio)ethical issues and indicating solutions that relate specifically to the different forms of social exclusion that influence the health conditions and lives of people in Brazil, as well as in other peripheral countries in the Southern Hemisphere and of the world in general. The article calls attention to some of the problems and challenges that the Brazilian public health system has been facing. An international agenda of “universal health coverage” is one of the main global threats to implementing the universal right to healthcare as it has been understood in Brazil.
An Archeology of Corruption in Medicine
Authors: LITTLE MILES , LIPWORTH WENDY , KERRIDGE IAN
Published: May 2018

Corruption is a word used loosely to describe many kinds of action that people find distasteful. We prefer to reserve it for the intentional misuse of the good offices of an established social entity for private benefit, posing as fair trading. The currency of corruption is not always material or financial. Moral corruption is all too familiar within churches and other ostensibly beneficent institutions, and it happens within medicine and the pharmaceutical industries. Corrupt behavior reduces trust, costs money, causes injustice, and arouses anger. Yet it persists, despite all efforts since the beginnings of societies. People who act corruptly may lack conscience and empathy in the same way as those with some personality disorders. Finding ways to prevent corruption from contaminating beneficent organizations is therefore likely to be frustratingly difficult. Transparency and accountability may go some way, but the determined corruptor is unlikely to feel constrained by moral and reporting requirements of this kind. Punishment and redress are complicated issues, unlikely to satisfy victims and society at large. Both perhaps should deal in the same currency—material or social—in which the corrupt dealing took place.
Posterior Cerebellar Volume and Executive Function in Young Adults With Congenital Heart Disease
Authors: Semmel Eric S. , Dotson Vonetta M. , Burns Thomas G. , Mahle William T. , King Tricia Z.
Published: May 2018

Objectives:As the number of adolescents and young adults (AYAs) surviving congenital heart disease (CHD) grows, studies of long-term outcomes are needed. CHD research documents poor executive function (EF) and cerebellum (CB) abnormalities in children. We examined whether AYAs with CHD exhibit reduced EF and CB volumes. We hypothesized a double dissociation such that the posterior CB is related to EF while the anterior CB is related to motor function. We also investigated whether the CB contributes to EF above and beyond processing speed.Methods:Twenty-two AYAs with CHD and 22 matched healthy controls underwent magnetic resonance imaging and assessment of EF, processing speed, and motor function. Volumetric data were calculated using a cerebellar atlas (SUIT) developed for SPM. Group differences were compared withttests, relationships were tested with Pearson’s correlations and Fisher’s r to z transformation, and hierarchical regression was used to test the CB’s unique contributions to EF.Results:CHD patients had reduced CB total, lobular, and white matter volume (d=.52–.99) and poorer EF (d=.79–1.01) compared to controls. Significant correlations between the posterior CB and EF (r=.29–.48) were identified but there were no relationships between the anterior CB and motor function nor EF. The posterior CB predicted EF above and beyond processing speed (ps<.001).Conclusions:This study identified a relationship between the posterior CB and EF, which appears to be particularly important for inhibitory processes and abstract reasoning. The unique CB contribution to EF above and beyond processing speed alone warrants further study. (JINS, 2018,24, 939–948)
WOODFORD'S APPROACH TO ROBUST POLICY ANALYSIS IN A LINEAR-QUADRATIC FRAMEWORK
Authors: Kwon Hyosung , Miao Jianjun
Published: May 2018

This paper extends Woodford's approach to the robustly optimal monetary policy to a general linear quadratic framework. We provide algorithms to solve for a time-invariant linear robustly optimal policy in a timeless perspective and for a time-invariant linear Markov perfect equilibrium under discretion. We apply our methods to a New Keynesian model of monetary policy with persistent cost-push shocks and inflation persistence. We find that the robustly optimal commitment inflation is less responsive to a cost-push shock when the shock is more persistent and that the robustly optimal discretionary policy is more responsive to lagged inflation when inflation is more persistent.
The validity of mid-upper arm circumference as an indicator of low BMI in population screening for undernutrition: a study among adult slum dwellers in eastern India
Authors: Das Priyanka , Khatun Argina , Bose Kaushik , Chakraborty Raja
Published: May 2018

Objective

To explore the possibility for a statistically appropriate value of mid-upper arm circumference (MUAC) to identify the state of severe undernutrition, based on very low BMI, among adult Indian slum dwellers.

Design

Cross-sectional study on adults. Height and MUAC were recorded and BMI was computed. Chronic energy deficiency (CED) was determined using the WHO international guidelines as BMI<18·5 kg/m2and normal as BMI≥18·5 kg/m2. Besides calculating mean,sdand 25th, 50th and 75th percentile values, multiple linear regression analysis was undertaken to assess the associations between age, MUAC and BMI. Receiver-operating characteristic curve analysis was performed to determine the best MUAC cut-off to identify CED status. Theχ2test was used to assess significance of the difference in CED prevalence across MUAC categories.

Setting

An urban slum in Midnapore town, West Bengal State, India.

Subjects

Male (n467) and female (n488) Indian slum dwellers.

Results

MUAC of 22·7 and 21·9 cm, respectively, in males and females were the best cut-off points to differentiate CED from non-CED.

Conclusions

Results supported the validity of the WHO-recommended MUAC cut-offs for adults. There is still a need to establish statistically appropriate MUAC cut-offs to predict undernutrition and morbidity.
THE LATTICE OF VARIETIES OF STRICT LEFT RESTRICTION SEMIGROUPS
Authors: JONES PETER R.
Published: May 2018

Left restriction semigroups are the unary semigroups that abstractly characterize semigroups of partial maps on a set, where the unary operation associates to a map the identity element on its domain. This paper is the sequel to two recent papers by the author, melding the results of the first, on membership in the variety$\mathbf{B}$of left restriction semigroups generated by Brandt semigroups and monoids, with the connection established in the second between subvarieties of the variety$\mathbf{B}_{R}$of two-sided restriction semigroups similarly generated and varieties of categories, in the sense of Tilson. We show that the respective lattices${\mathcal{L}}(\mathbf{B})$and${\mathcal{L}}(\mathbf{B}_{R})$of subvarieties are almost isomorphic, in a very specific sense. With the exception of the members of the interval$[\mathbf{D},\mathbf{D}\vee \mathbf{M}]$, every subvariety of$\mathbf{B}$is induced from a member of$\mathbf{B}_{R}$and vice versa. Here$\mathbf{D}$is generated by the three-element left restriction semigroup$D$and$\mathbf{M}$is the variety of monoids. The analogues hold for pseudovarieties.
SIMILARITY OF OPERATORS ON TENSOR PRODUCTS OF SPACES AND MATRIX DIFFERENTIAL OPERATORS
Authors: GIL’ MICHAEL
Published: May 2018

Let ${\mathcal{H}}=\mathbb{C}^{n}\otimes {\mathcal{E}}$ be the tensor product of a Euclidean space $\mathbb{C}^{n}$ and a separable Hilbert space ${\mathcal{E}}$. Our main object is the operator $G=I_{n}\otimes S+A\otimes I_{{\mathcal{E}}}$, where $S$ is a normal operator in ${\mathcal{E}}$, $A$ is an $n\times n$ matrix, and $I_{n},I_{{\mathcal{E}}}$ are the unit operators in $\mathbb{C}^{n}$ and ${\mathcal{E}}$, respectively. Numerous differential operators with constant matrix coefficients are examples of operator $G$. In the present paper we show that $G$ is similar to an operator $M=I_{n}\otimes S+\hat{D}\times I_{{\mathcal{E}}}$ where $\hat{D}$ is a block matrix, each block of which has a unique eigenvalue. We also obtain a bound for the condition number. That bound enables us to establish norm estimates for functions of $G$, nonregular on the closed convex hull $\operatorname{co}(G)$ of the spectrum of $G$. The functions $G^{-\unicode[STIX]{x1D6FC}}\;(\unicode[STIX]{x1D6FC}>0)$ and $(\ln G)^{-1}$ are examples of such functions. In addition, in the appropriate situations we improve the previously published estimates for the resolvent and functions of $G$ regular on $\operatorname{co}(G)$. Since differential operators with variable coefficients often can be considered as perturbations of operators with constant coefficients, the results mentioned above give us estimates for functions and bounds for the spectra of differential operators with variable coefficients.
Zum Zusammenhang von motorischer und kognitiver Entwicklung im Vorschulalter
Authors: Jaščenoka Julia , Walter Franziska , Petermann Franz , Korsch Franziska , Fiedler Sören , Daseking Monika
Published: May 2018

Zusammenfassung. Inwieweit die motorische und kognitive Entwicklung von Kindern miteinander verbunden ist, wird seit langem kontrovers diskutiert. Insbesondere für die frühkindliche Förderung ist es von Bedeutung, das Zusammenspiel beider Entwicklungsbereiche genau zu analysieren, um passgenaue Fördermöglichkeiten zu entwickeln. Ziel dieser Arbeit ist es, den Zusammenhang von motorischen und kognitiven Leistungen zu untersuchen. Es wurden die Testergebnisse von 87 Kindern im Alter von drei bis sechs Jahren im Motoriktest LoMo 3 – 6 mit denen in der WPPSI-IV korreliert. Die Ergebnisse sprechen dafür, dass motorische Leistungen insbesondere mit visuellen Leistungen und der Verarbeitungsgeschwindigkeit assoziiert sind. Ein Subgruppenvergleich zwischen motorisch unterdurchschnittlich, durchschnittlich und überdurchschnittlich entwickelten Kindern zeigt, dass sich diese besonders in den Indizes Visuell-Räumliche Verarbeitung und Verarbeitungsgeschwindigkeit unterscheiden. Programme zur Bewegungsförderung sollten Aspekte der feinmotorischen Koordination, Objektkontrolle sowie der bilateralen Körperkoordination beinhalten, da diese Bereiche motorischer Kompetenz eng mit visuell-räumlichen Funktionen sowie der kognitiven Verarbeitungsgeschwindigkeit in Verbindung gebracht werden.
Zum Zusammenhang von Verhaltensauffälligkeiten in exekutiven Funktionen und Intelligenzleistungen in der WPPSI-IV
Authors: Fiedler Sören , Walter Franziska , Petermann Franz , Daseking Monika
Published: May 2018

Zusammenfassung. Der BRIEF-P basiert auf alltagsnahen kindlichen Verhaltensweisen im Bereich der exekutiven Funktionen, die durch Bezugspersonen beurteilt werden. Allgemein gilt dieses Verfahren als ökonomisch einsetzbares und ökologisch valides Instrument. In der vorliegenden Studie wurde untersucht, ob und welcher Zusammenhang zwischen exekutiven Funktionen (EF) und Intelligenz im Kindergartenalter besteht. Für eine Stichprobe von N = 169 Kindern im Alter von 2;6 bis 6;11 Jahren wurden Daten aus einem Elternfragebogen zum familiären Hintergrund, zu den EF des Kindes (BRIEF-P) und aus der Wechsler Preschool and Primary Scale of Intelligence – Fourth Edition (WPPSI-IV) analysiert. Es wurden Häufigkeitsanalysen zu den Defiziten in den EF, Korrelationen und Regressionsanalysen berechnet. Sowohl die primäre Skala Arbeitsgedächtnis (Updating) als auch der Gesamtwert EF des BRIEF-P tragen zur Vorhersage der Intelligenz (Gesamt-IQ) bei. Die Skala Inhibition und der Gesamtwert EF des BRIEF-P korrelieren signifikant mit drei der fünf primären und allen vier sekundären Indizes der WPPSI-IV. Aus der Perspektive der WPPSI-IV-Indizes sticht der Index Fluides Schlussfolgern hervor, mit dem fast alle erfassten EF-Bereiche des BRIEF-P korrelieren. Die Indizes der WPPSI-IV werden hinsichtlich ihrer Nähe zur fluiden Intelligenz diskutiert. Die EF spielen bereits im Vorschulalter eine wichtige Rolle für die kognitiven Leistungen. Die Ergebnisse werden im Zusammenhang von Sprachauffälligkeiten und ADHS betrachtet. Förder- und Interventionsprogramme sollten bereits in einem frühen Alter etabliert werden, um die Voraussetzungen für schulisches Lernen zu verbessern.
Intelligenzdiagnostik bei Kindern und Jugendlichen mit ADHS
Authors: Pauls Franz , Daseking Monika , Jacobs Claus , Werpup Lina , Petermann Franz
Published: May 2018

Zusammenfassung. Mit seiner neuartigen Indexstruktur bietet die Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V; Wechsler, 2014 , 2017 ) eine differenzierte Messung kognitiver Fähigkeiten. Es wurden die Leistungen von Kindern und Jugendlichen mit ADHS (n = 103) in der WISC-V mit einer parallelisierten Kontrollgruppe verglichen. Zusätzlich zur Analyse der Leistungen auf signifikante Gruppenunterschiede wurden für alle fünf Indexwerte, den Gesamt-IQ sowie die entsprechenden Untertests Effektgrößen bestimmt und miteinander verglichen. Für die Kinder mit ADHS zeigten sich auf allen fünf Indizes und dem Gesamt-IQ signifikant niedrigere Leistungen, wobei die größten Effekte in den Bereichen Arbeitsgedächtnis, Fluides Schlussfolgern und Gesamt-IQ gefunden wurden. Spezifische Minderleistungen bei ADHS ließen sich auch auf Untertestebene identifizieren. Die Ergebnisse der vorliegenden Studie bestätigen, dass die WISC-V als valides und sensibles Instrument zur Erfassung kognitiver Defizite bei Kindern mit Aufmerksamkeitsstörungen angesehen werden kann. In der klinischen Praxis kann die WISC-V-Profilanalyse wichtige Informationen zu einer vorab diagnostizierten ADHS liefern.
Welchen Einfluss hat ein Migrationshintergrund auf die kognitiven Leistungen in der WISC-V?
Authors: Daseking Monika , Pauls Franz , Petermann Franz , Becker Angelika
Published: May 2018

Zusammenfassung. Kinder mit Migrationshintergrund fallen in vielen Vergleichsstudien durch schwächere schulische Leistungen auf. Die vorliegende Studie analysiert auf Basis der Normstichprobe der deutschsprachigen WISC-V (N = 1085) verschiedene Einflussmerkmale auf die kognitiven Fähigkeiten von Kindern und Jugendlichen im Alter von 6;0 bis 16;11 Jahren und vergleicht dabei Kinder mit und ohne Migrationshintergrund. Es zeigt sich, dass nicht der Migrationshintergrund, sondern für Grundschulkinder der elterliche Bildungshintergrund und für Kinder ab Klassenstufe 5 die Schulform das eigentliche differentielle Entwicklungsmilieu darstellen, welches Leistungsunterschiede zwischen Kindern mit und ohne Migrationshintergrund erklärt. Allerdings zeigt sich gleichzeitig auch eine Ungleichverteilung von Kindern auf die entsprechenden Schulformen unter Berücksichtigung des Migrationshintergrunds. Für eine bessere Bildungsbeteiligung sollte die Förderung in der Bildungssprache Deutsch weiter ausgebaut werden.