bluuebunny/crossref_metadata_2025 huggingface dataset:
Thermodynamic Constraints on the Morphology of Simulated Midlatitude Squall Lines
Authors: Alfaro Diego A. , Khairoutdinov Marat
Published: April 2015

This study examines how environmental thermodynamics constrain the morphology of simulated idealized midlatitude squall lines (SLs). The thermodynamic soundings used for simulating various SLs are specified primarily by prescribed vertical profiles of the convective available potential energy (CAPE) and the level of free convection. This framework, which contemplates the latent instability properties of both low- and midtropospheric air, is considered to be convenient for investigating layer-lifting convective phenomena.

Results show that frequently used CAPE indices are unsuitable for diagnosing SL characteristics, while integrated CAPE (ICAPE) discriminates the amplitude of the storm-induced heating for a given value of environmental shear. The skill of ICAPE follows from its relation to the buoyancy attained by low- and midtropospheric parcels as they ascend over the cold pool under layer-lifting convection. Environmental kinematics also affect the storm-induced heating, with stronger low-level shear leading to a greater proportion of inflowing latent unstable air among total storm-relative inflow, thus producing higher temperatures aloft. The precipitable water accounts for much of the precipitation-rate variation for a given value of shear. The precipitation efficiency is lower in environments with weaker shear and dryer midtropospheric conditions.

Cold pool temperatures are slightly affected by environmental variations beneath the layer of minimum moist static energy, with drier midtropospheric conditions and weaker shear leading to warmer cold pools. SLs with a small vertical gradient of cold pool buoyancy propagate less rapidly and produce small surface wind speeds. Cold pool properties could be affected by a descending branch of the front-to-rear flow, which crosses over with the rear inflow jet.
Receipt of Pediatric Weight-Related Counseling and Screening in a National Sample After the Expert Committee Recommendations
Authors: Moyce Sally C. , Bell Janice F.
Published: April 2015

Objective. It is uncertain whether children of all weight classifications receive the recommended screening and counseling and if these affect weight status in the subsequent year. Methods. Data from the 2008-2011 Medical Expenditures Panel Survey were used to examine associations between weight classification and receipt of weight-related screening and counseling from the pediatric provider (n = 9835). Body mass index (BMI) z-score in the subsequent year was modeled as a function of the BMI z-score in year 1. Results. Normal and overweight children have lower odds than obese children of receiving counseling regarding diet (adjusted odds ratio [AOR] = 0.58, 95% confidence interval [CI] = 0.50-0.68; AOR = 0.75, 95% CI = 0.63-0.89, respectively) and exercise (AOR = 0.56, 95% CI = 0.48-0.65; AOR = 0.75, 95% CI = 0.64-0.89, respectively). Counseling was associated with a small increase in BMI z-score in the subsequent year (β = 0.06, 95% CI = 0.01-0.11), as was maternal weight class. Conclusions. Recommendations to focus prevention on the family unit may reduce childhood overweight and obesity.
The Effect of Pressure Glove Tightness on Forearm Muscle Activity and Psychophysical Responses
Authors: Yu Annie , Yick Kit Lun , Ng Sun Pui , Yip Joanne
Published: April 2015

Objective:

The impact of pressure glove tightness on maximum grip force, muscle activity, and psychophysical responses is investigated to facilitate the prescription of a suitable reduction factor (RF) for pressure treatment.

Background:

The wearing of pressure therapy gloves is often considered to hinder hand performance and cause discomfort, resulting in unsatisfactory treatment adherence during burn rehabilitation.

Method:

A wear trial was carried out with 10 participants for three custom-made pressure gloves that consist of different RFs—10%, 15% and 20%—as well as for the bare hand. The surface electromyography of three forearm muscles was measured during tasks that involve moving marbles, buttoning a shirt, and typing. The psychophysical responses were also recorded.

Results:

The use of pressure gloves results in a reduction in the maximum gripping force. Gloves with tighter pressure contribute to lower perceived comfort and ease of hand motion. Increased glove tightness (with RFs of 15% and 20%) decreases muscle activity as compared to the bare-hand condition when buttoning a shirt. In terms of typing, the forearm muscle activity increases with high glove pressure (RF of 20%).

Conclusion:

The forearm muscles are significantly affected by glove tightness in performing different daily tasks that required gripping, pinching, and typing. The increase of RF of pressure gloves causes negative impact on psychophysical response and handgrip strength. Glove tightness in relation to hand performance and comfort is important in prescribing an optimal pressure therapy glove for hypertrophic scar treatment.

Application:

The findings give insight into the impacts of pressure glove tightness on muscle activity, thus providing a reference for glove development.
Relationship of sharp force injuries to motivation
Authors: Kitulwatte IDG , Edirisinghe PAS
Published: April 2015

Forensic pathologists are often expected to provide an opinion on the intention of the assailant in sharp force fatalities. A retrospective study was carried out on reports of post-mortems of victims of sharp force trauma over five years. The position and type of injuries were recorded and related to the known motivation for murder. Victims of different motives of killing had an almost similar injury pattern. There is no significant association of the pathology of sharp force injuries with the motive of killing.
Financialisation, the valuation of investment property and the urban built environment in the UK
Authors: Crosby Neil , Henneberry John
Published: April 2015

The financialisation literature has been criticised for its limited empirical base and its failure adequately to link the everyday world with that of high finance. The paper addresses these shortcomings by examining the calculative practice of property valuation. The way that valuations are performed affects their results and, therefore, the operation of the property market. The paper traces the evolving influence of finance capital on the valuation of commercial property in the UK by constructing a historiography of investment valuation since 1960. Traditional approaches to valuation have been increasingly challenged by those derived from financial economics. However, the former remains the dominant method for undertaking market valuation. Its grounding in comparison – a centring and standardising process – offers an explanation for some of the changes in the urban built environment that are ascribed to financialisation. This suggests that a more detailed and historically sensitive interpretation of financialisation is required.
Post-Neoliberalism’s Difficult Hegemonic Consolidation
Authors: Errejón Íñigo , Guijarro Juan
Published: April 2015

The current governments of Ecuador and Bolivia came to power after across-the-board crises of the political system. One of their immediate challenges is to consolidate the hegemony forged in the struggles against the neoliberal state. However, the allegiances created through the conflict are hard to transfer to an institutionalization of the new correlation of forces, and some groups have experienced disenchantment with the progressive governments. A comparative analysis of the hegemonic transition in the two cases suggests that, in contrast to that of Bolivia’s Movimiento al Socialismo, the hegemonic capacity of Ecuador’s electoral alliance, weakly organized and centered around the charismatic leadership of an “outsider,” depends more on its ability to dismantle possible opponents than on the appeal of its official identity, forcing it into constant reaffirmation of political boundaries.

Los actuales gobiernos de Ecuador y Bolivia llegaron al poder después de las crisis exhaustivas del sistema político. Uno de sus desafíos inmediatos es consolidar la hegemonía forjada en las luchas contra el Estado neoliberal. Sin embargo, las alianzas creadas por el conflicto son difíciles de transferir a una institucionalización de la nueva correlación de fuerzas, y algunos grupos han experimentado el desencanto con los gobiernos progresistas. Un análisis comparativo de la transición hegemónica en los dos casos sugiere que, en contraste con la capacidad hegemónica del Movimiento al Socialismo de Bolivia, lo de la alianza electoral de Ecuador, débilmente organizada y centrada en el liderazgo carismático de un “desconocido,” depende más de su capacidad para desmantelar posibles adversarios que de la apelación de su identidad oficial, lo que obligó a la reafirmación constante de las fronteras políticas.
Establishing a course in how to facilitate journal clubs: Opportunities and barriers
Authors: Faebo Larsen Rikke , Moesgård Ravnholt Mette , Hølge-Hazelton Bibi
Published: April 2015

Aim

To discuss the potentials and barriers of establishing a course in facilitating journal clubs among non-medical health professionals (NMHP).

Background

NMHPs and managers had a wish to offer journal clubs. To accomplish this, there was a need of enhancing competences among NMHPs with developmental responsibility, both by education and practice in order to establish journal club in their own department.

Methods

A journal club facilitation course was offered to hospital employed NMHPs. Participants were asked to fill out questionnaires prior to, at midterm, 4 months, and 18 months after, course participation. At the 18-month follow-up, their managers were asked to fill out questionnaires. Results are discussed in an analytic framework inspired from research on conducting journal clubs and learning transfer.

Findings

After 18 months, only three journal clubs were established. Participants and managers mentioned barriers such as time, resources and interest from colleagues. Participants also disputed the management approval. Among the three established journal clubs, the participants stated good management approval, but also a challenge in establishing, preparing and conducting journal clubs.

Conclusion

Facilitation journal club courses have the potential to increase knowledge and skills. To secure implementation, further transfer strategies need to be considered as part of the course.
Pårørendes rolle som ressurs og samarbeidspartner: En studie med fokus på pårørende til pasienter med demenssykdom i sykehjem
Authors: Rognstad May-Karin , Sagbakken Mette , Nåden Dagfinn
Published: April 2015

Aim

To bring knowledge about how relatives can serve as a resource and cooperate with nursing home staff in giving care to patients with dementia and behavioural symptoms.

Background

Studies suggests that family members want to retain the role of caregivers also after institutionalization of a family member with dementia. We have little knowledge about how family caregivers and nursing home staff develop a collaborative relationship.

Methods

The study has a descriptive and explorative design. Data were collected via 11 semi-structured, audiotaped interviews with family members. The analysis is based on Kvale and Brinkman’s three levels of interpretation.

Findings

Relatives were to a little degree included as a resource for nursing home staff, and they missed a continuous dialog with health personnel in charge of the care. The transition from the role of being an active, responsible caregiver to someone that was not involved and familiar with the daily needs of their family member was perceived as difficult.

Conclusion

Relatives may be an important resource in the planning of long-term care for their family members. Conscious inclusion and collaboration with relatives can help them remain in their role as caregivers and prevent them from feeling disclosed.
Occupational health and safety of temporary and agency workers
Authors: Hopkins Benjamin
Published: April 2015

Previous quantitative studies have established a link between precarious work and occupational health and safety (OHS). Using an ethnographically informed qualitative approach, this article investigates the workplace experiences of different types of precarious workers, in particular those who are directly-employed temporary workers and those who are engaged through an agency. Drawing on the work of Andrew Hopkins, the article finds cultural practices that lead to worsened OHS experiences for those who are engaged through an agency. These experiences include inadequate safety training, poor quality personal protective equipment and a lack of clarity of supervisory roles.
Adequate Nutrition May Get You Home
Authors: Yeh D. Dante , Fuentes Eva , Quraishi Sadeq A. , Cropano Catrina , Kaafarani Haytham , Lee Jarone , King David R. , DeMoya Marc , Fagenholz Peter , Butler Kathryn , Chang Yuchiao , Velmahos George
Published: April 2015

Background: Macronutrient deficit in the surgical intensive care unit (ICU) is associated with worse in‐hospital outcomes. We hypothesized that increased caloric and protein deficit is also associated with a lower likelihood of discharge to home vs transfer to a rehabilitation or skilled nursing facility. Materials and Methods: Adult surgical ICU patients receiving >72 hours of enteral nutrition (EN) between March 2012 and May 2014 were included. Patients with absolute contraindications to EN, <72‐hour ICU stay, moribund state, EN prior to surgical ICU admission, or previous ICU admission within the same hospital stay were excluded. Subjects were dichotomized by cumulative caloric (<6000 vs ≥6000 kcal) and protein deficit (<300 vs ≥300 g). Baseline characteristics and outcomes were compared using Wilcoxon rank and χ2 tests. To test the association of macronutrient deficit with discharge destination (home vs other), we performed a logistic regression analysis, controlling for plausible confounders. Results: In total, 213 individuals were included. Nineteen percent in the low‐caloric deficit group were discharged home compared with 6% in the high‐caloric deficit group (P = .02). Age, body mass index (BMI), Acute Physiology and Chronic Health Evaluation II (APACHE II), and initiation of EN were not significantly different between groups. On logistic regression, adjusting for BMI and APACHE II score, the high‐caloric and protein‐deficit groups were less likely to be discharged home (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.08–0.96; P = .04 and OR, 0.29; 95% CI, 0.0–0.89, P = .03, respectively). Conclusions: In surgical ICU patients, inadequate macronutrient delivery is associated with lower rates of discharge to home. Improved nutrition delivery may lead to better clinical outcomes after critical illness.
“It’s Good for the Kids”: Fathers Consider Risk and Protection in Their Own and Their Children’s Lives
Authors: Creighton Genevieve , Brussoni Mariana , Oliffe John , Olsen Lise
Published: April 2015

We conducted a qualitative inquiry to better understand how fathers of young children consider risk in their own life and in the lives of their 2- to 7-year-olds. Interview data were collected from 64 fathers from rural and urban Canada. Fathers’ discourse was considered in the context of masculine identities as well as the implications for father-focused health promotion and safety education. We found that most fathers considered risk taking to be an essential component of their own and their fathering identities. Some fathers held negative views about risk taking in their own and their children’s lives or were inconsistent in risk considerations for themselves compared to their children. For these fathers, identity construction was a somewhat fluid and contradictory process. Overall, we conclude that health promotion programs should support and bolster fathering identities and practices that involve engaging children in physical risk taking while employing appropriate safety strategies.
Students’ Perceptions and Experiences of Social Media in Higher Education
Authors: Neier Stacy , Zayer Linda Tuncay
Published: April 2015

Recent research has discussed the opportunities associated with the use of social media tools in the classroom, but has not examined the perceptions students themselves hold about its usefulness in enhancing their educational experience. This research explores students’ perceptions of social media as an effective pedagogical tool. Undergraduate students in a midsized, private university taking a marketing course were surveyed about their social media usage and preferences as well as their perceptions regarding the use of social media in higher education. Additional qualitative data collection with students probed into motivations for social media use in education as well as instructor and university perceptions. Findings reveal openness to using social media in education, uncover interactive and information motives for its use, and offer theoretical and pedagogical implications. Importantly, we offer insights into how educators can strategically incorporate social media tools into the classroom as well as how the use of social media can potentially affect students’ views of the instructor and the university.
Agency costs, executive incentives and corporate financial decisions
Authors: Agha Mahmoud
Published: April 2015

This paper investigates the roles of executive incentive structures in creating and mitigating investment-related agency costs. A model is developed which shows that underinvestment and overpayment of dividends are always expected to prevail when managers are offered short-term incentives, while overinvestment and underpayment of dividends are likely to exist when managers are offered long-term incentives. Using a large sample of non-financial US-listed firms over the period 1992–2009, it is found that managers underinvest and overpay dividends when offered vested stocks, but overinvest and underpay dividends when offered option incentives. An increase in these incentives, however, mitigates these problems. The results also suggest that, if properly constructed, long-term incentives might be superior to short-term incentives, and should be used alone in designing the optimal incentive package under certain conditions.
Thermosensitive tribrachia star-shaped s-P(NIPAM-co-DMAM) random copolymer micelle aggregates: Preparation, characterization, and drug release applications
Authors: Luo Yan-Ling , Wang Yuan , Wang Xuan , Xu Feng , Chen Ya-Shao
Published: April 2015

Tribrachia star-shaped random copolymers with tunable thermosensitive phase transition temperature were designed and synthesized via a simple one-pot ammonolysis reaction approach with trimesic acid as cores. The self-assembly micellization behavior of the copolymers in aqueous solution was examined by surface tension, UV–vis transmittance, transmission electron microscope, and dynamic light scattering measurements, etc. The results indicated that the resultant copolymers formed thermosensitive micelle aggregates through hydrophobic interactions among the isopropyl groups of poly(N-isopropylacrylamide) PNIPAM chains and inter-star association at a polymer concentration above critical aggregation concentrations from 4.06 to 6.55 mg L−1, with a cloud point range from 36.6℃ to 52.1℃, and homogeneously distributed micelle size below 200 nm. The arm length and the compositional ratios of the two comonomers had effect on physicochemical properties of the polymer micelle aggregates. Particularly, the cloud point values were enhanced as the (N,N-dimethylacrylamide) DMAM monomer was introduced and reached to 36.6℃ and 41.0℃–44.7℃ when the mass ratio of NIPAM to DMAM was 90:10 and 80:20, respectively. The thermo-triggered drug release and cytotoxicity were evaluated to confirm the applicability of the random copolymer micelle aggregates as novel drug targeted release carriers.
‘Why has my world become more confusing than it used to be?’ Professional doctoral students reflect on the development of their identity
Authors: Rayner Stephen , Lord Janet , Parr Elizabeth , Sharkey Rachel
Published: April 2015

This article reports on research into the experience of professional doctoral students and is written by the students themselves. We, the authors, are currently studying for the Doctorate in Education at the University of Manchester, UK. We place our work in the context of recent empirical research into the development of doctoral student identity, noting that these literatures are usually authored by programme directors and supervisors. Using a theoretical approach based on the work of Etienne Wenger, we examine how the aims and curriculum of our programme interplay with our professional learning. In interviews with our cohort of students, we explore the complexity and non-linearity of learning. We do not find a simple progression from practitioner to researcher; rather, we find a fluid and complex relationship between those two identities. We consider the extent to which Wenger’s modes of identification are a useful conceptual tool for understanding this interplay and for theorising about our findings. We conclude that there is further scope for the development of our theoretical framework by drawing on other scholarly work on identity development and reflexivity.
Personalized knowledge push system based on design intent and user interest
Authors: Wang Zhan-Song , Tian Ling , Wu Yuan-Hao , Liu Bei-Bei
Published: April 2015

Existing knowledge provides important reference for designers in mechanical design activities. However, current knowledge acquisition methods based on information retrieval have the problem of inefficiency and low precision, which mainly meet the requirement for knowledge coverage. To improve the efficiency of knowledge acquisition and ensure the availability of design knowledge, this paper proposes a knowledge push service method based on design intent and user interest. First, the design intent model, which is mainly the formal expression of the target function of conceptual design, is built. Second, the user interest model that consists of domain themes and operation logs is built, and an automatic updating method of user interest is proposed. Third, a matching method of design knowledge based on design intent, and a sorting algorithm of knowledge candidates based on user interest are proposed to realize personalized knowledge active push service. Finally, a prototype system called Personalized Knowledge Push System for Mechanical Conceptual Design (MCD-PKPS) is implemented. An illustrative case demonstrates that the proposed method can successfully improve the efficiency and availability of knowledge acquisition.
Modality and Morphology
Authors: Rapp Brenda , Fischer-Baum Simon , Miozzo Michele
Published: April 2015

Written language is an evolutionarily recent human invention; consequently, its neural substrates cannot be determined by the genetic code. How, then, does the brain incorporate skills of this type? One possibility is that written language is dependent on evolutionarily older skills, such as spoken language; another is that dedicated substrates develop with expertise. If written language does depend on spoken language, then acquired deficits of spoken and written language should necessarily co-occur. Alternatively, if at least some substrates are dedicated to written language, such deficits may doubly dissociate. We report on 5 individuals with aphasia, documenting a double dissociation in which the production of affixes (e.g., the -ing in jumping) is disrupted in writing but not speaking or vice versa. The findings reveal that written- and spoken-language systems are considerably independent from the standpoint of morpho-orthographic operations. Understanding this independence of the orthographic system in adults has implications for the education and rehabilitation of people with written-language deficits.
Acting in different worlds. Challenges to transnational trade union cooperation in the eurozone crisis
Authors: Lehndorff Steffen
Published: April 2015

In the ongoing crisis in, and of, the eurozone, the fates of trade unions in different countries are more than ever linked to each other, while the respective national areas of conflict are drifting apart. Most notably, the damage caused by the widely hailed German labour market ‘reforms’ before the crisis, which have resulted in a substantial decline in the impact of trade union policy in Germany, has in the course of the eurozone crisis become a threat for unions at the ‘periphery’. This article argues that, while unions in individual countries will necessarily continue to fight the dominant EU crisis management policies primarily at national level, their prospects of success will increasingly depend on their transnational cooperation. The argument is developed through a comparison between the problems faced by trade unions in Greece and Spain on the one hand, and in Germany on the other.
Explaining ‘varieties of solidarity’: labour mobility and trade unions in an enlarged Europe
Authors: Hardy Jane
Published: April 2015

The enlargement of the European Union in 2004 and 2007 simultaneously extended the freedom of movement to workers from new Member States and sharpened existing economic inequalities within the EU. Drawing on the data of three projects, this article examines the conditions under which, and in what ways, real (as opposed to rhetorical) solidarity is forged by trade unions within and across boundaries in relation to migrant workers. Sectoral dynamics provide important insights into cross-country commonalities. In particular, the data demonstrate the importance of the strategies of individual unions and the agency of individuals within them in explaining ‘varieties of solidarity’ and their varying success. The article concludes by arguing that the growth of right-wing xenophobic parties and the failure of social democratic parties to offer an alternative narrative mean that trade union strategies are being formulated and executed in an increasingly hostile political climate.
A new proletariat in the making? Reflections on the 14 November 2012 strike and the movements of 1968 and 1995
Authors: Helle Idar
Published: April 2015

On 14 November 2012, southern Europe witnessed its first transnational one-day general strike wave. This article compares the 14 November experience with the previous western European mobilizations of 1968 and 1995, assessing (i) their transnational dimension, (ii) their links to the European economic integration process, (iii) their historical specificities and action repertoires, and finally (iv) their impact on social class formation and labour movement organization. In conclusion, this historical comparison contends that the 14 November movement not only indicates a certain transnationalization of the social class struggle, but also a substantial recomposition of western Europe’s working classes with potentially far-reaching implications for the traditional labour movement.
The Cultural and Linguistic Adaptation to Brazilian Portuguese and Content Validity of the Patient Expectations and Satisfaction With Prenatal Care Instrument
Authors: Santos Prudêncio Patrícia , Hilfinger Messias DeAnne K. , Villela Mamede Fabiana , Spadoti Dantas Rosana Aparecida , de Souza Luiz , Villela Mamede Marli
Published: April 2015

Background: Patient satisfaction reflects how an individual’s expectations, goals, and preferences are met by health care providers or services. Most research on patient expectations and satisfaction has been conducted in developed countries; there was no Portuguese language instrument to measure pregnant women’s expectations and satisfaction with prenatal care. Purpose: To adapt and test the Patient Expectations and Satisfaction with Prenatal Care (PESPC) instrument for use in Brazil. Design: We conducted a systematic cultural and linguistic adaptation of the PESPC into Brazilian Portuguese and tested the validity of the adapted instrument. Results: Implementation of this rigorous methodological process resulted in a valid, reliable, culturally, and linguistically appropriate instrument. Implications for Practice: We recommend further assessment of the Brazilian Portuguese PESPC with more diverse samples of Portuguese-speaking pregnant women in Brazil and other countries. Application of this structured approach to cultural and linguistic instrument adaptation is one way to further transcultural nursing research.
The Role of Ivabradine in Cardiac Rehabilitation in Patients With Recent Coronary Artery Bypass Graft
Authors: Marazia Stefania , Urso Lucia , Contini Marco , Pano Marco , Zaccaria Salvatore , Lenti Vincenzo , Sarullo Filippo M. , Di Mauro Michele
Published: April 2015

Background:

Little is known about ivabradine in cardiac rehabilitation in patients with coronary artery bypass graft (CABG).

Methods:

In this prospective, randomized study, suitable patients admitted for cardiac rehabilitation after recent CABG were randomized to ivabradine 5 mg twice a day + standard medical therapy including bisoprolol 1.25 mg once daily (group I-BB, n = 38) or standard medical therapy including bisoprolol 2.5 to 3.75 mg once daily (group BB, n = 43). Patients were evaluated at admission, discharge, and 3 months. The primary end point was improvement in functional status, and other end points were improvement in diastolic function and recovery of systolic function. End points were assessed by distance covered in 6-minute walking test (6MWT), percentage with normal diastolic function, and percentage increase in left ventricular ejection fraction (LVEF).

Results:

Cardiac rehabilitation improved functional capacity in both groups. In group BB, distances covered in the 6MWT at admission, discharge, and 3 months were 215 ± 53, 314 ± 32, and 347 ± 42 m, respectively. Corresponding distances in group I-BB were 180 ± 91, 311 ± 58, and 370 ± 55 m. Normal diastolic function was restored in I-BB patients, increasing from 24% at admission to 50% and 79% at discharge and 3 months; in BB patients, it decreased from 23% to 19% and 16%. The LVEF improved in I-BB patients, from 57% ± 3% at admission to 62% ± 4% at discharge and 66% ± 3% at 3 months, while remaining unchanged in BB patients (57% ± 3%, 59% ± 4%, and 59% ± 3%).

Conclusion:

Adding ivabradine to low-dose bisoprolol during cardiac rehabilitation in patients with CABG improved functional capacity, enhanced recovery of systolic function, and reduced diastolic dysfunction.
An analytical method for vibration analysis of cylindrical shells coupled with annular plate under general elastic boundary and coupling conditions
Authors: Ma Xianglong , Jin Guoyong , Shi Shuangxia , Ye Tiangui , Liu Zhigang
Published: April 2015

A unified solution for coupled cylindrical shell and annular plate systems with general boundary and coupling conditions is presented in the study by using a modified Fourier-Ritz method. Under the framework, regardless of the boundary and continuity conditions, each displacement for the cylindrical shell and the annular plate is invariantly expressed as the modified Fourier series composed of the standard Fourier series and auxiliary functions. The introduction of the auxiliary functions can not only remove the potential discontinuities at the junction and the extremes of the combination but also accelerate the convergence of the series expansion. All the expansion coefficients are determined by the Rayleigh-Ritz method as the generalized coordinates. The arbitrary axial position of the annular plate coupling with the cylindrical shell considered in the theoretical formulation makes the present method more general. The theoretical model established by present method can be conveniently applied to cylindrical shell-circular plate combinations just by varying the inner radius of the annular plate. The convergence and accuracy of present method are tested and validated by a number of numerical examples for coupled annular plate-cylindrical shell structures with various boundary restraints and general elastic coupling conditions. The effects of the axial position of the annular plate and elastic coupling conditions on the vibration behavior of the coupled system are also investigated. The power of present method compared to conventional finite element method is demonstrated with less computation cost. Some new results are presented to provide useful information for future researchers.
Two parameters affecting the dynamics characteristics of a uniform-conical assembled pipe conveying fluid
Authors: Zijun Zhang , Yongshou Liu , Tao Han
Published: April 2015

A modified Galerkin approach is employed to calculate the dynamic characteristics of a complex non-uniform fluid-conveying pipe assembled by a uniform and a conical segment. The effects of two geometric parameters (length ratio of the uniform part and conical truncation factor) on the dynamic stability are studied. Results prove that for the assembled fluid-conveying pipe 1) when fluid enters the pipe from the thinner end, the natural frequencies are higher than those when it enters from the wider end; 2) the critical flow velocity increases linearly with the increase of the uniform part ratio, while it decreases squarely with the increase of the conical truncation factor in a limited range and 3) the clamp-pined non-uniform pipe has a higher dimensionless critical velocity than the pin-clamped pipe when fluid enters from the wider end.
Academic Skills Groups for Middle School Children With ADHD in the Outpatient Mental Health Setting: An Open Trial
Authors: Ciesielski Heather A. , Tamm Leanne , Vaughn Aaron J. , Cyran Jessica E. M. , Epstein Jeffery N.
Published: April 2015

Objective: To conduct an open trial assessing the initial efficacy of an intervention focusing on increasing skills related to academic performance (planning, organization, studying, and homework behaviors) for middle school children diagnosed with ADHD. The intervention is modeled on evidence-based interventions but designed for administration in the outpatient setting. Method: Parents and their children diagnosed with ADHD attended seven weekly group sessions targeting academic, organizational, and homework skills. Parents completed the Homework Problem Checklist and Impairment Rating Scale pre- and post-treatment. Results: Following intervention, significant improvements in homework completion and management, as well as reductions in academic impairment and improvements in parent confidence and family relations, were reported. Conclusion: Despite limitations including small sample size and lack of a control group, our results demonstrate initial efficacy of an academic skills intervention designed for use in the outpatient setting with middle school children diagnosed with ADHD on clinically relevant outcome measures.
Full-wave nonlinear ultrasound simulation on distributed clusters with applications in high-intensity focused ultrasound
Authors: Jaros Jiri , Rendell Alistair P , Treeby Bradley E
Published: April 2015

Model-based treatment planning and exposimetry for high-intensity focused ultrasound requires the numerical simulation of nonlinear ultrasound propagation through heterogeneous and absorbing media. This is a computationally demanding problem due to the large distances travelled by the ultrasound waves relative to the wavelength of the highest frequency harmonic. Here, the k-space pseudospectral method is used to solve a set of coupled partial differential equations equivalent to a generalised Westervelt equation. The model is implemented in C++ and parallelised using the message passing interface (MPI) for solving large-scale problems on distributed clusters. The domain is partitioned using a 1D slab decomposition, and global communication is performed using a sparse communication pattern. Operations in the spatial frequency domain are performed in transposed space to reduce the communication burden imposed by the 3D fast Fourier transform. The performance of the model is evaluated using grid sizes up to 4096×2048×2048 grid points, distributed over a cluster using up to 1024 compute cores. Given the global nature of the gradient calculation, the model shows good strong scaling behaviour, with a speed-up of 1.7x whenever the number of cores is doubled. This means large-scale simulations can be distributed across high numbers of cores on a cluster to minimise execution times with a relatively small overhead. The efficacy of the model is demonstrated by simulating the ultrasound beam pattern for a high-intensity focused ultrasound sonication of the kidney.
Non-melanoma Skin Cancer in Canada Chapter 3: Management of Actinic Keratoses
Authors: Poulin Yves , Lynde Charles W. , Barber Kirk , Vender Ronald , Claveau Joël , Bourcier Marc , Ashkenas John
Published: April 2015

Background

Actinic keratosis (AK) and cheilitis (AC) are lesions that develop on photodamaged skin and may progress to form invasive squamous cell carcinomas (SCCs).

Objective

To provide guidance to Canadian health care practitioners regarding management of AKs and ACs.

Methods

Literature searches and development of graded recommendations were carried out as discussed in the accompanying introduction (chapter 1 of the NMSC guidelines).

Results

Treatment of AKs allows for secondary prevention of skin cancer in sun-damaged skin. Because it is impossible to predict whether a given AK will regress, persist, or progress, AKs should ideally be treated. This chapter discusses options for the management of AKs and ACs.

Conclusions

Treatment options include surgical removal, topical treatment, and photodynamic therapy. Combined modalities may be used in case of inadequate response. AKs are particularly common following the longterm immunosuppression in organ transplant patients, who should be monitored frequently to identify emerging lesions that require surgery.
Impaired aortic elastic properties in primary osteoarthritis
Authors: Belen Erdal , Karaman Ozgur , Caliskan Gurkan , Atamaner Oya , Aslan Omer
Published: April 2015

Osteoarthritis is one of the most common chronic diseases and associated with increased cardiovascular comorbidity and deaths. Elastic properties of aorta are closely associated with cardiovascular mortality and morbidity. In our study, we aimed to evaluate aortic stiffness in primary osteoarthritis patients. A total of 160 patients including 80 patients with primary knee osteoarthritis and 80 controls without osteoarthritis were included in the study. Additionally, osteoarthritis patients were divided into four subgroups according to the severity of the disease. Aortic parameters were evaluated by using transthoracic echocardiography method. While measurements of aortic stiffness of osteoarthritis group were higher compared to the control group ( p < 0.01), aortic strain and aortic distensibility measurements of osteoarthritis group are lower than the control group ( p < 0.01). Additionally, it was determined that as the severity of osteoarthritis increased also aortic stiffness increased highly significantly ( p = 0.001). Presence and severity of osteoarthritis are closely associated with elastic properties of aorta, which are correlated with cardiovascular mortality and morbidity.
Emergent conversion of the Ovation Stent Graft System to aortouniiliac modification via occlusion of a unilateral internal iliac artery with a stentgraft as a bailout solution
Authors: Georgakarakos Efstratios , Schoretsanitis Nikolaos , Souftas Vasileios D , Argyriou Chris , Moustafa Erchan , Georgiadis George S , Lazarides Miltos K
Published: April 2015

Purpose

To present a case of inadvertent collapse of the contralateral limb gate caused by misorientation during the deployment of the Ovation Abdominal Stent Graft System in a narrow aortic lumen and the bailout conversion to aortouniiliac modification, using a covered stent to exclude the orifice of the internal iliac artery (IIA).

Technique description

Despite the repeated efforts from the femoral and brachial site, the collapsed/occluded contralateral limb gate could not be catheterized. In order to exclude successfully the orifice of the IIA, an oversized stentgraft was placed immediately at the common-to-external iliac artery (CIA-EIA) transition followed by peripheral ligation of the latter. The procedure was completed with crossover femorofemoral bypass.

Conclusion

Occlusion the IIA orifice with an oversized stentgraft in the CIA-EIA transition can be considered as a safe, simple, fast, and efficient bailout maneuver, followed by EIA ligation and crossover bypass.
The perceived influence of school leadership on learner behaviour in a Namibian secondary school
Authors: Smith Clive , Amushigamo Angelina
Published: April 2015

Despite the deeply entrenched belief in and practice of corporal punishment to maintain learner control in schools, a secondary school in Namibia has for a number of years proven to be an exception to this practice. This is an interpretive account of the teachers’ and learners’ experiences and perceptions of the influence of their school principal’s leadership on learner behaviour. In-depth individual and group interviews were held with teachers and learners. Onsite observation was conducted for 14 consecutive school days and school documents were analysed. The data reveal an engaged school leadership that has created a school culture characterized by respect, care, trust, edifying relationships, a sense of belonging, praise, acknowledgement and recognition, and collaboration. By creating a collaborative school culture the school’s leadership is not located in the principal alone but in a ‘web of relationships’. In the view of both teachers and learners these features of the school’s leadership and culture are largely responsible for the positive learner behaviour in the school. This research reaffirms the central role played by school principals in establishing and maintaining their school’s culture. It also illustrates the mediating role of school culture in learner behaviour. It is significant that this occurs in a socio-economically deprived context in a developing nation.
The intercultural and non-formal learning processes of children in primary school exchange programmes in France and Germany
Authors: Melin Valérie , Wagner Bernd
Published: April 2015

This paper is based on educational anthropology, and presents the initial findings of a three-year international comparative study of primary school children’s learning-processes during travel and cross-cultural encounters. A French-German research team investigated and here reports on primary school exchange programmes. Open coding of the ethnographic video material is evaluated in reference to intercultural education, as addressed in French and German primary school lessons in the social sciences.
Intercostal chest drains: Are you confident going on the pull? If not use the I-T-U approach
Authors: Chadwick AJ , Halfyard R , Ali M
Published: April 2015

Chest drains are common on intensive care units for a wide variety of clinical conditions. Despite this, there are no published data on their use within the intensive care unit and minimal published literature to guide decision making regarding the timing of their removal. Therefore, we undertook an audit to review our experience over one year, as to the degree of variability in when chest drains were removed. Using our electronic observation records, we assessed the length of stay of our chest drains against their functionality by whether they remained swinging (i.e. in connection with the pleural space) and whether they had a pathological fluid output (>150 mL/24 h). We found that our drains had a mean duration of 5.89 days, and that one-quarter remained in place for three days despite being non-functional. To conclude, we have devised a three-stage assessment (using the acronym I-T-U), to help guide an intensivist in the safe and timely removal of a chest drain.
Haemophagocytic syndrome in intensive care: The great pretender
Authors: de Asua Ignacio , Ciliberti Esteban
Published: April 2015

The haemophagocytic syndrome is a unique disease process in which the dysregulation of the patient’s immune system leads to an inflammatory storm which rapidly ravages through multiple organ systems, generating life-threatening end-organ dysfunction. Since it usually mimics other conditions frequently encountered in the critical care population – most notably septic shock – its diagnosis is elusive and the condition remains under-recognized and under-reported. We present a concise review of the pathophysiology and clinical features of the heamophagocytic syndrome and discuss the main diagnostic and therapeutic issues relevant to the management of this condition in the critically ill patient. Increasing awareness about the haemophagocytic syndrome amongst intensive care physicians will facilitate earlier recognition and timely management.
Identifying Elements of the Health Care Environment That Contribute to Wayfinding
Authors: Pati Debajyoti , Harvey Thomas E. , Willis Douglas A. , Pati Sipra
Published: April 2015

Objectives:

Identify aspects of the physical environment that inform wayfinding for visitors. Compare and contrast the identified elements in frequency of use. Gain an understanding of the role the different elements and attributes play in the wayfinding process.

Background:

Wayfinding by patients and visitors is a documented problem in healthcare facilities. The few studies that have been conducted have identified some of the environmental elements that influence wayfinding. Moreover, literatures comparing different design strategies are absent. Currently there is limited knowledge to inform prioritization of strategies to optimize wayfinding within capital budget.

Methods:

A multi-method, non-experimental, qualitative, exploratory study design was adopted. The study was conducted in a large, acute care facility in Texas. Ten healthy adults in five age groups, representing both sexes, participated in the study as simulated visitors. Data collection included (a) verbal protocols during navigation; (b) questionnaire; and (c) verbal directions from hospital employees. Data were collected during Fall 2013.

Results:

Physical design elements contributing to wayfinding include signs, architectural features, maps, interior elements (artwork, display boards, information counters, etc.), functional clusters, interior elements pairing, structural elements, and furniture. The information is used in different ways - some for primary navigational information, some for supporting navigational information, and some as familiarity markers.

Conclusions:

The physical environment has a critical role in aiding navigation in healthcare facilities. Architectural feature is the top contributor in the domain of architecture. Artwork (painting, sculpture, etc.) is the top contributor in the domain of interior design.
Reinventing Emergency Department Flow via Healthcare Delivery Science
Authors: DeFlitch Christopher , Geeting Glenn , Paz Harold L.
Published: April 2015

Healthcare system flow resulting in emergency departments (EDs) crowding is a quality and access problem. This case study examines an overcrowded academic health center ED with increasing patient volumes and limited physical space for expansion. ED capacity and efficiency improved via engineering principles application, addressing patient and staffing flows, and reinventing the delivery model. Using operational data and staff input, patient and staff flow models were created, identifying bottlenecks (points of inefficiency). A new flow model of emergency care delivery, physician-directed queuing, was developed. Expanding upon physicians in triage, providers passively evaluate all patients upon arrival, actively manage patients requiring fewer resources, and direct patients requiring complex resources to further evaluation in ED areas. Sustained over time, ED efficiency improved as measured by near elimination of “left without being seen” patients and waiting times with improvement in door to doctor, patient satisfaction, and total length of stay. All improvements were in the setting on increased patient volume and no increase in physician staffing. Our experience suggests that practical application of healthcare delivery science can be used to improve ED efficiency.