bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethics in Health Administration: A Practical Approach for Decision Makers, 3rd Edition
Authors: Brown David
Published: March 2017

Ethics in Health Administration: A Practical Approach for Decision Makers (3rd ed.) is a four-section, 16-chapter book that provides health practitioners with practical applications to ethics in the health and helping professions. These applications provide health professionals with suggestions and recommendations to assist them with ethical issues and dilemmas.
Early-Dynamic Positron Emission Tomography (PET)/Computed Tomography and PET Angiography for Endoleak Detection After Endovascular Aneurysm Repair
Authors: Drescher Robert , Gühne Falk , Freesmeyer Martin
Published: March 2017

Purpose: To propose a positron emission tomography (PET)/computed tomography (CT) protocol including early-dynamic and late-phase acquisitions to evaluate graft patency and aneurysm diameter, detect endoleaks, and rule out graft or vessel wall inflammation after endovascular aneurysm repair (EVAR) in one examination without intravenous contrast medium. Technique: Early-dynamic PET/CT of the endovascular prosthesis is performed for 180 seconds immediately after intravenous injection of F-18-fluorodeoxyglucose. Data are reconstructed in variable time frames (time periods after tracer injection) to visualize the arterial anatomy and are displayed as PET angiography or fused with CT images. Images are evaluated in view of vascular abnormalities, graft configuration, and tracer accumulation in the aneurysm sac. Whole-body PET/CT is performed 90 to 120 minutes after tracer injection. Conclusion: This protocol for early-dynamic PET/CT and PET angiography has the potential to evaluate vascular diseases, including the diagnosis of complications after endovascular procedures.
Adherence of Heart Transplant Recipients to Prescribed Medication and Recommended Lifestyle Habits
Authors: Brocks Y. , Zittermann A. , Grisse D. , Schmid-Ott G. , Stock-Gießendanner S. , Schulz U. , Brakhage J. , Benkler A. , Gummert J. , Tigges-Limmer Katharina
Published: March 2017

Introduction:

Nonadherence may cause severe health problems in heart transplant (HTx) recipients.

Research Questions:

The present study aimed to investigate adherence to prescribed medication and recommended lifestyle habits in post-HTx patients and to assess associations between adherence, quality of life (QOL), and psychological well-being.

Design:

A questionnaire package was sent to all HTx patients from our clinic (n = 858) to answer questions anonymously on medication adherence, dietary recommendations (avoidance of raw animal products and ice cream), pet keeping (risk of zoonosis), anxiety and depression, QOL, and posttraumatic stress disorders.

Results:

Of the contacted patients, 524 (61%) responded and 505 fulfilled the inclusion criteria (age ≥18 years and ability to understand German). Of the study participants, 72.4% reported taking their medications very correctly, 72.2% stated consuming alcohol less often than once a week, 58.3% performed physical exercise at least once a week, one-third reported eating nonrecommended foods, 22.1% stated pet keeping, and 4.3% reported smoking. Adherence to prescribed medication was positively associated with age ( P < .001) and mental QOL ( P = .015) but was unrelated to eating nonrecommended foods ( P > .05). Depressiveness correlated inversely with physical QOL ( r = −0.232; P < .01) and mental QOL ( r = −0.411; P < .01). Stress disorders and minor stressful events were reported by 7.8% and 46.6%, respectively. Stress disorders correlated inversely with mental QOL ( r = −0.282; P < .01) and physical QOL ( r = −0.422; P < .01).

Discussion:

Many HTx patients adhere to prescribed medications and health advice. Nevertheless, nonadherence is a problem, especially in younger HTx patients, indicating the need for a nonadherence crisis intervention program for long-term HTx patients.
Rising Need for Health Education Among Renal Transplant Patients and Caregiving Competence in Care Providers
Authors: Xie Jianfei , Ming Yingzi , Ding Siqing , Wu Xiaoxia , Liu Jia , Liu Lifang , Zhou Jianda
Published: March 2017

Background:

Health education positively affects the efficacy of self-management and should be carried out according to the status of patients’ needs, knowledge, and the competence of the primary caregivers.

Objectives:

This study was to investigate the needs of health education knowledge in transplant patients and the competence of the primary caregivers.

Methods:

This is a cross-sectional study using a convenient sampling approach. Self-report questionnaires were applied to 351 renal transplantation patients and their primary caregivers.

Results:

Three-hundred nine valid questionnaires were included in the analysis. The intensive care unit environment, stress coping strategies, the operation procedure, anesthesia and adverse reactions, and hand hygiene were the 5 most poorly understood aspects in health education. Stress coping strategies, at-home self-monitoring of health, pulmonary infection prevention, dietary needs, and anesthesia and other adverse reactions were the top 5 health education needs. Decision and self-efficacy were the weakest caregiving competence. Significant positive correlations were observed between health education knowledge level and caregiving competence in the primary caregivers. Marriage, education level, career, expense reimbursement, and residence significantly contributed to the health education demand questionnaire model, whereas gender, age, ethnic group, education level, career, and expense reimbursement significantly contributed to health education knowledge questionnaire model ( P < .05).

Conclusion:

The renal transplant patients and their primary caregivers need health education on the intensive care unit environment, stress coping strategies, the operation procedure, and anesthesia and other adverse reactions. The primary caregivers need training in decision-making and self-efficacy.
Thirteen-Year Evaluation of the Management of Biliary Tract Complication After Deceased Donor Liver Transplantation
Authors: Shamsaeefar Alireza , Nikeghbalian Saman , Kazemi Kourosh , Motazedian Nasrin , Geramizadeh Bita , Malekhosseini Seyed Ali
Published: March 2017

Introduction:

Although patient and graft survival rate has increased in recent years, biliary complications after liver transplantation are associated with significant morbidity and mortality.

Methods and Materials:

We reviewed the database of 1930 patients who underwent deceased donor liver transplantation between 2000 and 2013. The patients had abnormal results in liver tests, as well as fever and jaundice. Abdominal sonography was performed, and if complication was identified, the patient underwent an interventional procedure by endoscopic retrograde cholangiopancreatography or percutaneous transhepatic cholangiography. If the complication was not resolved by the mentioned procedures, exploration of common bile duct and Roux-en-Y choledochojejunostomy or revision of Roux-en-Y choledochojejunostomy was done.

Results:

Our study group comprised 105 patients including 66 (63%) men and 39 (37.1%) women with a mean age of 36.7 ± 12.5 years (range: 15-66 years). Among 1930 patients, 105 (5.4%) cases presented with biliary complication after liver transplantation, of which 97 (5%) and 8 (0.4%) cases presented with biliary stricture and bile leak/biloma, respectively.

Conclusion:

In our study, most patients with biliary complications after liver transplantation responded to interventional procedures, with 37.1% requiring surgical exploration.
Love Wins?
Authors: Baumle Amanda K. , Compton D’Lane R.
Published: March 2017

For LGBT individuals who have experience exclusion from legal marriage, the choice to suddenly embrace an institution that they perceive as flawed, discriminatory, and symbolic of gender inequality can present irreconcilable differences.
“Straight Girls Kissing” Beyond the Elite Campus
Authors: Budnick Jamie
Published: March 2017

Our best sexuality theories are based on research that overlooks a clear pattern: Women with the lowest levels of education now report the highest lifetime prevalence of same-gender sex.
The Sadness of the Border Wall
Authors: Bacon David
Published: March 2017

A photoessay explores the history of the U.S.-Mexico border wall and how it affects those it separates.
Forgotten Plums and Funeral Potatoes
Authors: Jordan Jennifer A.
Published: March 2017

The author of Edible Memory on the durability of food memories and how identities and histories are revealed in the sharing of such memories.
A “Real” American Indian
Authors: Huyser Kimberly R.
Published: March 2017

Kimberly R. Huyser considers the power of stereotypes and self-image as she participates in a project to create modern images of Native Americans.
The Converging Gender Wage Gap 1980–2012
Authors: Upright Craig
Published: March 2017

The story of wage gaps in American labor is generally a story of improvement, but by separating data by cohort to follow women by age group across decades, we can spot persistent wage gaps–and even some that are widening.
Cobesity
Authors: Wilson Sven E.
Published: March 2017

Cobesity is a mounting trend in which spouses both experience obesity and its attendant health effects; Sven E. Wilson shows how cobesity is reinforcing health inequalities.
Intersex and the Social Construction of Sex
Authors: Davis Georgiann , Preves Sharon
Published: March 2017

Gender is a social construct often based on the assumption of a biological binary, but even the best lab tests cannot–and perhaps, need not–accurately divide all people into “male” or “female” sexes.
Instructions to Prospective Authors by Indian Biomedical Journals: An Opportunity to Promote Responsible Conduct of Research
Authors: Bhat Anup , Shah Akash , Sherighar Swathi G.
Published: March 2017

Journals provide instructions to prospective authors to facilitate the process of manuscript publication. The information provided under such instructions could be a potential opportunity to promote responsible conduct of research (RCR). We analyzed 74 Indian biomedical journals for the type of information provided in the “instructions to authors” section and adherence to the International Committee of Medical Journal Editors (ICMJE) recommendations. Among the 71 journals that had an “instructions to authors” section, 53 journals adhered to ICMJE recommendations. We discuss sections of the ICMJE recommendations detailed by Indian biomedical journals under the “instructions to authors” section and emphasize components that require greater exposure.
Surfacing a hidden literature
Authors: Hallinger Philip
Published: March 2017

Scholars throughout the world are working to diversify the knowledge base in educational leadership and management (EDLM). In concert with this effort, this article reports the results of a systematic review of research on EDLM in Africa. The goals of the review were to describe trends with respect to the volume of journal publications, national sources, research designs, methods, topics, authors and citation impact. The review database was comprised of 506 journal articles published on EDLM in Africa. A conceptual framework was used to organize the review, consisting of context and personal antecedents, leadership/management, teachers and school, and school outcomes. Systematic methods were employed to identify sources and extract data from the articles. Data analysis relied on quantitative synthesis aimed at identifying trends within Africa as a region, across its composite societies, and in change over time. The review found a surprisingly large literature, 90% of which had been published since 2005. This impression of an ‘emerging literature’ was reinforced by other trends, which bore a striking resemblance to features of the American literature in the 1970s and Asia post-2000. Recommendations are made for topics and methods as well as areas where capacity development is warranted.
Producing communities and commodities: Safaricom and commercial nationalism in Kenya
Authors: Tuwei David , Tully Melissa
Published: March 2017

This research analyses Safaricom, one of the most established mobile operators in Kenya. Alongside the provision of mobile services, Safaricom has closely engaged with the government of Kenya, even getting involved in the nation’s politics. This study examines Safaricom’s advertisements from 2010-2014 to explore its use of national sentiment in its marketing. We argue that the ads reflect a commitment to promoting the country and its products through discourses of ‘commercial nationalism’, which present Safaricom as a driver of economic growth and development in Kenya. These discourses link Kenyan identity and distinctiveness to consumerism, commercial and economic success, profit and upward social mobility.
ERic Acute StrokE Recanalization: A study using predictive analytics to assess a new device for mechanical thrombectomy
Authors: Siemonsen Susanne , Forkert Nils D , Bernhardt Martina , Thomalla Götz , Bendszus Martin , Fiehler Jens
Published: March 2017

Aim and hypothesis

Using a new study design, we investigate whether next-generation mechanical thrombectomy devices improve clinical outcomes in ischemic stroke patients. We hypothesize that this new methodology is superior to intravenous tissue plasminogen activator therapy alone.

Methods and design

ERic Acute StrokE Recanalization is an investigator-initiated prospective single-arm, multicenter, controlled, open label study to compare the safety and effectiveness of a new recanalization device and distal access catheter in acute ischemic stroke patients with symptoms attributable to acute ischemic stroke and vessel occlusion of the internal cerebral artery or middle cerebral artery.

Study outcome

The primary effectiveness endpoint is the volume of saved tissue. Volume of saved tissue is defined as difference of the actual infarct volume and the brain volume that is predicted to develop infarction by using an optimized high-level machine learning model that is trained on data from a historical cohort treated with IV tissue plasminogen activator.

Sample size estimates

Based on own preliminary data, 45 patients fulfilling all inclusion criteria need to complete the study to show an efficacy >38% with a power of 80% and a one-sided alpha error risk of 0.05 (based on a one sample t-test).

Discussion

ERic Acute StrokE Recanalization is the first prospective study in interventional stroke therapy to use predictive analytics as primary and secondary endpoint. Such trial design cannot replace randomized controlled trials with clinical endpoints. However, ERic Acute StrokE Recanalization could serve as an exemplary trial design for evaluating nonpivotal neurovascular interventions.
Antagonizing dabigatran by idarucizumab in cases of ischemic stroke or intracranial hemorrhage in Germany – A national case collection
Authors: Kermer Pawel , Eschenfelder Christoph C , Diener Hans-Christoph , Grond Martin , Abdalla Yasser , Althaus Katharina , Berrouschot Jörg , Cangür Hakan , Daffertshofer Michael , Edelbusch Sebastian , Gröschel Klaus , Haase Claus G , Harloff Andreas , Held Valentin , Kauert Andreas , Kraft Peter , Lenz Arne , Müllges Wolfgang , Obermann Mark , Partowi Someieh , Purrucker Jan , Ringleb Peter A , Röther Joachim , Rossi Raluca , Schäfer Niklas , Schneider Andreas , Schuppner Ramona , Seitz Rüdiger J , Szabo Kristina , Wruck Robert
Published: March 2017

Background

Idarucizumab is a monoclonal antibody fragment with high affinity for dabigatran that reverses its anticoagulant effects within minutes. It may exhibit the potential for patients under dabigatran therapy suffering ischemic stroke to regain eligibility for thrombolysis with rt-PA and may inhibit lesion growth in patients with intracerebral hemorrhage on dabigatran.

Aims

To provide insights into the clinical use of idarucizumab in patients under effective dabigatran anticoagulation presenting with signs of ischemic stroke or intracranial hemorrhage.

Methods

Retrospective data collected from German neurological/neurosurgical departments administering idarucizumab following product launch from January to August 2016 were used.

Results

Thirty-one patients presenting with signs of stroke received idarucizumab in 22 stroke centers. Nineteen patients treated with dabigatran presented with ischemic stroke and 12 patients suffered from intracranial bleeding. In patients receiving rt-PA thrombolysis following idarucizumab, 79% benefitted from i.v. thrombolysis with a median improvement of five points in NIHSS. No bleeding complications occurred. Hematoma growth was observed in 2 out of 12 patients with intracranial hemorrhage. The outcome was favorable with a median NIHSS improvement of 5.5 points and mRS 0–3 in 67%. Overall, mortality was low with 6.5% (one patient in each group).

Conclusion

Administration of rt-PA after reversing dabigatran activity with idarucizumab in case of ischemic stroke is feasible, easy to manage, effective, and appears to be safe. In dabigatran-associated intracranial hemorrhage, idarucizumab has the potential to prevent hematoma growth and improve outcome. Idarucizumab represents a new therapeutic option for patients under dabigatran treatment presenting with ischemic stroke or intracranial hemorrhage.
Trends in the Management of Patients With Kidney Failure in Alberta, Canada (2004-2013)
Authors: Chong Christy C. , Tam-Tham Helen , Hemmelgarn Brenda R. , Weaver Robert G. , Scott-Douglas Nairne , Tonelli Marcello , Quinn Robert R. , Manns Liam , Manns Braden J.
Published: March 2017

Background:

Based on clinical practice guidelines, specific quality indicators are examined to assess the performance of a health care system for patients with end-stage renal disease (ESRD). We examined trends in the proportion of patients with ESRD referred late to nephrology, timing of dialysis initiation in those with chronic kidney disease, and proportion of patients with ESRD treated with pre-emptive kidney transplantation or peritoneal dialysis (PD). Design: This was a retrospective cohort study. Setting: The study was conducted in Alberta, Canada. Patients: Alberta residents aged 18 years or older with incident ESRD requiring renal replacement therapy between 2004 and 2013 were included. Measurements: Descriptive statistics, and log binomial and linear regression models were used for analysis. Methods: We determined the proportion of patients with ESRD who did not see a nephrologist within 90 days prior to starting dialysis (late referrals) and those who were receiving PD 90 days after dialysis initiation. Among those who had been seen by a nephrologist for at least 90 days, we also assessed the proportion who initiated dialysis with estimated glomerular filtration rate (eGFR) higher than or equal to 10.5 mL/min/1.73 m2, and underwent a pre-emptive transplant. Results: Our cohort included 5343 patients (mean age 61.8 years, 61.2% male). Over a 10-year period, there was a decrease in the proportion of late referrals (26.4% to 21.1%, P = .001). We also noted a decrease in the proportion of dialysis initiation with eGFR higher than or equal to 10.5 mL/min/1.73 m2 (21.2% to 14.7%, P < .001), with a significant increase in the proportion of patients initiating dialysis as an inpatient (38.8% to 45.2%, P = .001). There was a non-significant decrease in both the proportion of patients treated with a pre-emptive transplant and PD at 90 days over the 10-year period. Limitations: The use of administrative data restricted the availability of clinical data regarding underlying circumstances of each quality indicator, including patient symptoms, indications for dialysis initiation, and PD eligibility.

Conclusions:

We noted improvement in late referrals and early dialysis initiation over time. However, we also noted low and stable use of pre-emptive kidney transplantation and PD at 90 days, which warrants further exploration. These findings support the need for quality improvement initiatives designed to address these gaps in care and improve outcomes for patients with kidney failure.
Contracting, performance management, and accountability
Authors: Fine Janice , Mareschal Patrice , Hersh David , Leach Kirk
Published: March 2017

As state governments expand the use of private contractors to provide public services, they create challenges to performance management and accountability. Using the framework of accountability as a social relationship, we evaluate New Jersey’s oversight practices. We combine data from interviews and observation with a comprehensive analysis of the institutional framework. We raise two key questions. First, what causes New Jersey to neglect its performance management responsibilities? Second, how can New Jersey and other states strengthen their performance management and accountability practices? We posit that the state must retain some level of internal monitoring capacity as a core element of government. Effective oversight requires rebuilding administrative capacity and implementing ongoing, flexible, relational contract management that involves key stakeholders and does not put the entire burden of performance measurement on direct service providers. In this way, performance management and accountability can be linked together as tools for reflection and learning.
Differential Influences of Depression and Personality Traits on the Use of Facebook
Authors: Scherr Sebastian , Brunet Antonia
Published: March 2017

Depressive symptoms are highly prevalent among younger populations and have been clearly associated with lowered activity in general. Focusing on Facebook use as an extremely popular leisure activity, this study examines the influence of depressive tendencies on the intensity of using Facebook by considering the moderating effects of relevant personality traits and different motivations associated with social network site (SNS) use. Based on an online survey among 510 young Facebook users, this study shows that increasing depressive tendencies are associated with an increased frequency of posting status updates—most likely for negative reasons. Moderated mediation models show that the personality traits of neuroticism and extraversion only influence the motivations behind using Facebook and not the time spent on the SNS. Findings are also discussed with regard to novel digital help offers for Facebook users with depressive tendencies.
Model-Based Comparison of the Normal and Fontan Circulatory Systems—Part III
Authors: Watrous Raymond L. , Chin Alvin J.
Published: March 2017

Background:

For patients with the Fontan circulatory arrangement, angiotensin-converting enzyme inhibition, guanylate cyclase activation, phosphodiesterase 5 inhibition, and endothelin receptor antagonism have so far resulted in little or no improvement in [Formula: see text] or peak cardiac index (CI), suggesting that our understanding of the factors that most impact the exercise hemodynamics is incomplete.

Methods:

To facilitate comparisons with clinical reports of the exercise performance of preadolescent Fontan patients, we rescaled our previously reported computational models of a two-year-old normal child and similarly aged Fontan patient, extended our Fontan model to capture the nonlinear relationship between flow and resistance quantified from previous computational fluid dynamic analyses of the total cavopulmonary connection (TCPC), and added respiration as well as skeletal muscle contraction.

Results:

(1) Without respiration, the computational model for both the normal and the Fontan cannot attain the values for CI at peak exercise reported in the clinical literature, (2) because flow through the TCPC is much greater during inspiration than during expiration, the effect on the CI of the dynamic (flow-related) TCPC resistance is much more dramatic during exercise than it is in breath-hold mode at rest, and (3) coupling breathing with skeletal muscle contraction leads to the highest augmentation of cardiac output, that is, the skeletal muscle pump is most effective when the intrathoracic pressure is at a minimum—at peak inspiration.

Conclusions:

Novel insights emerge when a Fontan model incorporating dynamic TCPC resistance, full respiration, and skeletal muscle contraction can be compared to the model of the normal.
Nineteen Years of Adult Congenital Heart Surgery in a Single Center
Authors: Perinpanayagam Madurra , Larsen Signe H. , Emmertsen Kristian , Møller Marianne B. , Hjortdal Vibeke E.
Published: March 2017

Background:

Adults with congenital heart disease are a growing population. We describe surgical interventions, short- and long-term mortality and morbidity, and risk factors for adverse events in a population-based cohort.

Methods:

Patients over or equal to 18 years with congenital heart disease who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System.

Results:

Four hundred seventy-four surgeries were performed in 445 adults (50% men). The median age was 39 years (range 18-83). Thirty-nine percent had previous surgical or catheter-based interventions. Thirty-day and in-hospital mortality were 1.1%. Postoperative complications occurred in 50% of cases, most were minor such as temporary arrhythmias and pneumonia. Major complications included postoperative bleeding necessitating intervention (6%), stroke (2%), and acute temporary renal failure (1%). Multivariate analysis identified RACHS-1 categories over or equal to 3 compared to category 1 (odds ratio (OR) = 2.3; 95% confidence interval (CI): 1.5-3.7), New York Heart Association functional class III and IV compared to class I (OR = 2.2; 95% CI: 1.3-3.7) and age at surgery (OR = 1.03, 95% CI: 1.01-1.04), as risk factors for adverse events. Survival during a median follow-up of 7.8 years (range 0 days-21.4 years) was 85% (95% CI: 80%-89%).

Conclusion:

Adults with congenital heart disease constitute a growing population with the need for cardiac surgery. Postoperative complications are frequent but early and late mortality are low.
Segregated Data of Urban Poor for Inclusive Urban Planning in India
Authors: Srivastava Ambey Kumar
Published: March 2017

The population of urban poor in India is posing enormous challenges to urban planning as there is a huge scarcity of segregated data. The five-year plans give an overview of how urban poor population has been estimated for planning and how the data deficiency in planning for them has been realized. Areas populated by the urban poor have a constellation of issues, but without data a comprehensive understanding of their vulnerabilities is lacking. Segregated data are needed for evidence-based planning. Undoubtedly, there are challenges in collecting these data. However, these challenges need to be addressed as planning so far is based on an average situation of the urban poor population, while all urban poor and the slums cannot be said equally vulnerable. Segregated data of urban poor are essential for inclusive planning and to build sustainable cities.
Traditional Wisdom on Sustainable Learning
Authors: Huda Miftachul , Jasmi Kamarul Azmi , Mustari Ismail , Basiron Bushrah , Sabani Noraisikin
Published: March 2017

Providing guidelines to the students is central for them to optimize their learning, so as to enhance the effectiveness of their learning. However, one of the contemporary issues debated within the dynamics of learning indicates the decline of instructional strategies, one of which occurs due to the ruling out of ethical consideration in learning. Traditional wisdom plays a role in strengthening ethical considerations needed in the learning process. This article aims to shed light on strategies utilized in dynamics of learning through addressing moral ethics. A critical review of peer-reviewed journals, articles, and books was conducted with special reference to al-Zarnūjī’s concept in Ta‘lim al-Muta‘allim. This concept contains several significant guidelines for teaching and learning instructions. The findings revealed that the dynamics of learning requires mechanical aids and rules with ethical consideration on the moral purpose to promote sustainable learning. Learning with holistic approach comprises rightful intention and comprehensive perseverance, which plays a significant role to strengthen ethical engagement in sustainable learning among the students. Finally, this study is expected to contribute to the conceptual framework on the Islamic literature, specifically in relation to sustainable learning by strengthening traditional wisdom.
Teaching Learners With Diverse Needs in the Foundation Phase in Gauteng Province, South Africa
Authors: Mahlo Dikeledi
Published: March 2017

This qualitative study draws from Bronfenbrenner’s ecological theory, which emphasizes interaction between the systems of education. The study argues that if teachers are able to cater for diversity in their classes, the vision of inclusive education will be realized. Inclusive education requires all learners with the diverse needs to be able to access education and succeed in their schooling careers. Ten teachers who are teaching in the Foundation Phase were purposively selected to form part of the study; data were collected through interviews, observations, and document analysis. Teachers indicated that large classes, lack of parental support, training for teachers, and social problems of the learners were making the teaching of learners with diverse needs challenging. This article focussed on the factors that are considered by teachers in the study as barriers to catering of learners with diverse needs, concluding that if teachers are provided with support, more learners will be able to sail through the system of education.
Power, Apathy, and Failure of Participation
Authors: Chen Sibo
Published: March 2017

Public participation is widely regarded as a vital component for making environmental decisions more democratic, legitimate, and effective. Yet, research on this subject has largely focused on rights and principles instead of context and process, especially in non-Western settings. To address this gap, this article explores how local voices on environmental issues were muted in a Chinese rural context. It describes controversies surrounding a cultural and ecological tourism development in Heyang, a transforming village in the east coastal region of China. Based on semistructured group interviews, the article reveals that although many issues found in the Heyang case resonated with similar cases in Western settings, such as the lack of access to information and the problematic solicitation of public input, fundamentally, the local voices were muted by the village council’s blind adoption of an urban-centric ecological modernization agenda and its neglect of local villagers’ emotional attachment to their land properties. The above findings not only draw our attention to how participatory communication can be compromised by contextual factors but also invite us to reconsider how China’s existing urban–rural division fundamentally influences its ecological civilization.
Development and Implementation of the Health Education and Promotion Module for Incarcerated Mothers
Authors: Shoemaker Joy
Published: March 2017

To discuss the knowledge gained and future implications for incarcerated parents and community members through the development and implementation of a standardized health education and promotion module for incarcerated mothers. A descriptive pilot study with a convenience sample of incarcerated mothers enrolled in a prison nursery program. A Midwestern women’s nursery program. The health education and promotion module was presented in a series of four group sessions. A posttest format was utilized to examine if knowledge acquisition perceived coping strategies and satisfaction with the health education and promotion module. The incarcerated mothers did acquire knowledge and were able to list coping strategies that would help them individually reduce stress while incarcerated. Also, the participants expressed interest in other health education topics.
What’s Dignity Got To Do With It? Patient Experience of the Dignity Care Intervention
Authors: Johnston Bridget , Papadopoulou Constantina , Östlund Ulrika , Hunter Katrina , Andrew Jane , Buchanan Deans
Published: March 2017

The delivery of palliative care in the community setting has been recognized as a valued and challenging aspect of nursing care. To this end, care pathways have been shown to support nurses in a variety of settings to deliver individualized patient care. This study provides a qualitative evaluation of an end-of-life intervention known as the Dignity Care Intervention (DCI) based on patients’ perspectives. The DCI consists of four sections: a manual, the Patient Dignity Inventory, reflective questions, and evidence-based care actions. A qualitative design underpinned by the philosophy of Merlau-Ponty was employed for the evaluation of the DCI. Data collection included individual interviews with participants ( n = 25). Interview data were analyzed using framework thematic analysis. Four theme categories were identified: “experience of DCI,” “responding to my illness concerns,” “how illness affects me as a person,” and “how illness concerns affect my relationships.” The DCI was found to enable patients to discuss openly important issues with community nurses that they might not otherwise have raised. Participants conveyed satisfaction with the support they received through the DCI. The use of care pathways detailing interventions to manage clinical problems and ensure systematic integration of the best available evidence into care delivery can improve end-of-life care.
Short- and Long-Term Outcomes of Vitreoretinal Surgeries With Deferred First Postoperative Visits at Day 3 or Later
Authors: Ho Vincent Y. , Shah Gaurav K.
Published: March 2017

Background and Objective:

Postoperative (PO) day 1 visits can be challenging for certain patients (eg, satellite office patients). This study analyzes the proportion of eyes requiring changes in management on the first PO visit day ≥3 following vitreoretinal surgery.

Study Design/Materials and Methods:

A retrospective, consecutive case series of 1 vitreoretinal surgeon was conducted on 246 surgeries of 231 patients with the first PO examination day ≥3 from January 1, 2008 to December 31, 2013. Clinical parameters were statistically analyzed to identify eyes with pressure issues or early interventions. Short- and long-term outcomes were assessed at PO weeks 1 to 4 and months 3 to 8.

Results:

At the first PO visit ≥3 (mean 4.5) days, 3.3% eyes had intraocular pressure (IOP) ≤5, 3.3% IOP ≥30, 0.8% choroidal detachments, 0.4% vitreous hemorrhage, and 0% endophthalmitis. About 2.0% of eyes required intervention (IOP medications). Surgical indications, procedure, and tamponade were not predictive of pressure issues or early intervention ( P > .05). At weeks 1 to 4 and month 3 to 8, 4% to 6% of eyes required additional intervention or surgery.

Conclusion:

The first PO visit day ≥3 after vitreoretinal surgeries had low intervention rates. Few complications or additional surgeries occurred throughout the study period.
Intravitreal Anti-VEGF Treatment of Myopic Choroidal Neovascularization
Authors: Moroz Daniel R. , Munro Monique , Fielden Michael P.
Published: March 2017

Purpose:

To determine whether the presenting clinical features of active myopic choroidal neovascularization (CNV), including the presence of fibrosis or atrophy, limit the ultimate visual acuity gains from intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy.

Methods:

A retrospective analysis of 42 eyes with new-onset subfoveal CNV was performed. Only patients without concurrent age-related macular degeneration and with a spherical equivalent of at least −6.0 diopters were included in the study. All eyes received either intravitreal ranibizumab or bevacizumab injections as the primary treatment on a pro re nata basis for 1 year. Changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were recorded.

Results:

The mean number of ranibizumab (18 eyes) or bevacizumab (24 eyes) injections was 4.7 ± 0.5 over a mean follow-up time of 12 ± 0.4 months. The mean age of the patients was 62 ± 2.0 years. Based on optical coherence tomography staging at the initiation of treatment for active CNV, 30 had no fibrosis or atrophy (group 1), 5 had fibrotic stage, and 7 had atrophic stage CNV (the latter combined to form group 2). The BCVA for group 1 improved significantly ( P < .02) but worsened for group 2 ( P < .38), a statistically significant difference ( P < .05). The CRT for group 1 also declined significantly more than for group 2 ( P < .014).

Conclusion:

The presence of fibrosis or atrophy in eyes with active myopic CNV at the initiation of anti-VEGF therapy was associated with limited anatomic outcomes and visual gain.
Outcomes of Pars Plana Vitrectomy in Combination With Penetrating Keratoplasty
Authors: Watson Randee Miller , Dawood Sherif , Cao Dingcai , Mieler William F. , Leiderman Yannek I.
Published: March 2017

Purpose:

To report indications and outcomes of combined pars plana vitrectomy and penetrating keratoplasty (PPV-PKP).

Methods:

A review of all patients who underwent PPV-PKP at the Illinois Eye and Ear Infirmary from January 1, 2001 to May 31, 2013, was performed. Ninety eyes of 90 patients were identified. Survival analysis was utilized to assess differences in retinal detachment (RD) and corneal graft failure rates among groups based on clinical and surgical variables.

Results:

Seventy-nine eyes met the inclusion criteria. Most common indications for vitrectomy and corneal transplantation were RD (65%) and corneal decompensation (43%), respectively. The preoperative and final visual acuity (VA) logarithm of the minimum angle of resolution values were 2.7 (0.31) and 2.5 (0.67) (hand motions; mean [SD]; P = .02); 15% of eyes were ≥20/400 and 15% gained ≥2 lines of vision following surgery. Corneal graft failure occurred in 51% (40 eyes), recurrent RD in 28% (22 eyes), and hypotony in 25% (20 eyes). Silicone oil endotamponade was associated with postoperative RD ( P = .045), and previous ocular trauma was associated with postoperative corneal graft failure ( P = .023).

Conclusion:

Combined PPV-PKP surgery was likely to achieve stabilization of VA, with a minority of eyes achieving modest gains in VA.
Platelet CD36 promotes thrombosis by activating redox sensor ERK5 in hyperlipidemic conditions
Authors: Yang Moua , Cooley Brian C. , Li Wei , Chen Yiliang , Vasquez-Vivar Jeannette , Scoggins Na’il O. , Cameron Scott J. , Morrell Craig N. , Silverstein Roy L.
Published: March 2017

Key Points

Atherogenic conditions promote platelet CD36 signaling by generating specific reactive oxygen species. Redox sensor ERK5 MAP kinase activation by reactive oxygen species potentiates thrombus formation in hyperlipidemic conditions.
Lessons from the swamp: developing small molecules that confer salamander muscle cellularization in mammals
Authors: Um JungIn , Jung Da‐Woon , Williams Darren Reece
Published: March 2017

The ability of salamanders, such as newts, to regenerate damaged tissues has been studied for centuries. A prominent example of this regenerative power is the ability to re‐grow entire amputated limbs. One important step in this regeneration process is skeletal muscle cellularization, in which the muscle fibers break down into dedifferentiated, mononuclear cells that proliferate and form new muscle in the replacement limb. In contrast, mammalian skeletal muscle does not undergo cellularization after injury. A significant proportion of research about tissue regeneration in salamanders aims to characterize regulatory genes that may have mammalian homologs. A less mainstream approach is to develop small molecule compounds that induce regeneration‐related mechanisms in mammals. In this commentary, we discuss progress in discovering small molecules that induce cellularization in mammalian muscle. New research findings using these compounds has also shed light on cellular processes that regulate cellularization, such as apoptotic signaling. Although formidable technical hurdles remain, this progress increases our understanding of tissue regeneration and provide opportunities for developing small molecules that may enhance tissue repair in humans.
Pembrolizumab for Platinum- and Cetuximab-Refractory Head and Neck Cancer: Results From a Single-Arm, Phase II Study
Authors: Bauml Joshua , Seiwert Tanguy Y. , Pfister David G. , Worden Francis , Liu Stephen V. , Gilbert Jill , Saba Nabil F. , Weiss Jared , Wirth Lori , Sukari Ammar , Kang Hyunseok , Gibson Michael K. , Massarelli Erminia , Powell Steven , Meister Amy , Shu Xinxin , Cheng Jonathan D. , Haddad Robert
Published: March 2017

Purpose

There are no approved treatments for recurrent/metastatic head and neck squamous cell carcinoma refractory to platinum and cetuximab. In the single-arm, phase II KEYNOTE-055 study, we evaluated pembrolizumab, an anti–programmed death 1 receptor antibody, in this platinum- and cetuximab-pretreated population with poor prognosis.

Methods

Eligibility stipulated disease progression within 6 months of platinum and cetuximab treatment. Patients received pembrolizumab 200 mg every 3 weeks. Imaging was performed every 6 to 9 weeks. Primary end points: overall response rate (Response Evaluation Criteria in Solid Tumors v1.1, central review) and safety. Efficacy was assessed in all dosed patients and in subgroups on the basis of programmed death ligand 1 (PD-L1) expression and human papillomavirus (HPV) status.

Results

Among 171 patients treated, 75% received two or more prior lines of therapy for metastatic disease, 82% were PD-L1 positive, and 22% were HPV positive. At the time of analysis, 109 patients (64%) experienced a treatment-related adverse event; 26 patients (15%) experienced a grade ≥ 3 event. Seven patients (4%) discontinued treatment, and one died of treatment-related adverse events. Overall response rate was 16% (95% CI, 11% to 23%), with a median duration of response of 8 months (range, 2+ to 12+ months); 75% of responses were ongoing at the time of analysis. Response rates were similar in all HPV and PD-L1 subgroups. Median progression-free survival was 2.1 months, and median overall survival was 8 months.

Conclusion

Pembrolizumab exhibited clinically meaningful antitumor activity and an acceptable safety profile in recurrent/metastatic head and neck squamous cell carcinoma previously treated with platinum and cetuximab.
Thank You
Authors: Joudah Fady
Published: March 2017

Medical anthropology poem.
Dimensões da constitucionalização das políticas públicas
Authors: Dimoulis Dimitri , Lunardi Soraya Gasparetto
Published: March 2017

As políticas públicas que visam implementar direitos sociais apresentam peculiaridades nos sistemas jurídicos que constitucionalizam direitos e programas de ação social. A constitucionalização modifica o desenho institucional da separação dos Poderes, pois o Judiciário passa a ter papel ativo na execução de políticas públicas. O presente trabalho examina a definição e as formas de avaliação de políticas públicas e analisa criticamente a bibliografia sobre a judicialização dessas políticas. Examinase o papel de cada Poder na execução de políticas públicas, apresentando experiências de vários países e indicando as diferenças na atuação dos Poderes em razão de suas especificidades funcionais. Public policies aiming to implement social rights have peculiarities in legal systems that constitutionalize social rights and action programs. The constitutionalization modifies the institutional design of the separation of powers and the Judiciary assumes an active role in the implementation of public policies. This paper analyzes the methods for elaboration and evaluation methods of public policies and critically reviews the literature about the judicialization of such policies. We describe the role of each Branch in the implementation of public policies, relating experiences from various countries and indicating the differences in the performance of the state powers due to its functional characteristics.
Responsabilidade civil e penal de agente público nos casos de delegação do ato de ordenação de despesas
Authors: Oliveira Luciano Moreira de
Published: March 2017

A execução da despesa pública é um procedimento de grande importância para o desempenho da função administrativa e que merece especial atenção, pois implica o desembolso de recursos do erário. Com a crescente complexidade da atividade administrativa, a ordenação da despesa pública tem sido alvo de delegação de competência no serviço público. Assim, identificada a prática de ato ilícito decorrente da ordenação de despesas por agente público no exercício de competência delegada, faz-se necessário analisar os casos e os requisitos para a caracterização da responsabilidade civil e penal do agente público delegante. O presente artigo relata uma análise dogmática sobre o tema. The implementation of public expenditure is an important procedure for the performance of administrative functions and it deserves special attention because it involves the disbursement of treasury resources. With the increasing complexity of administrative activity, the expenses commanding act has been delegated in the public service. Thus, identified the practice of tort or crime arising from the ordination of expenditure by public official in the delegated powers of exercise, it is necessary to examine the cases and requirements for the characterization of civil and criminal liability of the public official who delegator. This article reports a dogmatic analysis of the topic.
Prazo decadencial para benefícios previdenciários
Authors: Barroso Ministro Luís Roberto
Published: March 2017

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Recent advances in understanding spondyloarthritis
Authors: Gaston J.S.H.
Published: March 2017

This review is concerned with a number of recent publications that contribute to current thinking on the pathogenesis of spondyloarthritis. The areas covered include the lymphocyte population in the enthesis, which is thought to drive enthesitis, and hence clinical manifestations. The debate on how HLA-B27 is implicated in inflammation is also considered, together with recent and contradictory evidence on the effects of the peptide-trimming enzyme ERAP1 on B27 expression and hence susceptibility to spondylitis. Lastly, a recent report on the role of the gut microbiome in an important model of spondyloarthritis is considered.
Saateks / Foreword
Authors: Praakli Kristiina
Published: March 2017

Saateks / Foreword
Birute Klaas-Lang 60
Authors: Praakli Kristiina , Tender Tõnu
Published: March 2017

Birute Klaas-Lang 60