bluuebunny/crossref_metadata_2025 huggingface dataset:
Addressing Illness-Related Chronic Absences
Authors: Arimas-Macalino Cherry , Weismuller Penny C. , McClanahan Rachel
Published: June 2019

School attendance is a predictor of academic achievement. Chronic absenteeism, defined as missing 10% or more school days affects 14% of all students nationwide. District attendance processes, policies, and data were analyzed in a demographically diverse southern California high school. A review of the attendance history of 117 ninth and tenth graders, who missed at least 10% of days in school, showed that 66% of the absences were due to illness. Prior to the project, these students were not referred for nursing intervention. Results of this quality improvement project supported the adoption of a specific code for absences due to illness. A district procedure for illness chronic absence was adopted to allow early nursing intervention for students with chronic absences prior to the development of illness-related academic underperformance. This project demonstrates nursing roles in the quality improvement and care coordination aspects of the NASN’s Framework for 21st Century School Nursing Practice™.
The role of city rankings in local public policy design: Urban competitiveness and economic press
Authors: Carrera Portugal Alberto
Published: June 2019

The objective of this research is to identify the factors that determine the capacity of city rankings published in the economic press—particularly The Economist Intelligence Unit and AméricaEconomía—to not only trigger social dialogue about the ratings different territories attain but also to enrich the public debate on the “competitive city model” and influence the design and implementation of local public policies on the matter. The research method involved interviews with public officials responsible for the design and implementation of urban competitiveness policies in the following Mexican cities: Mexico City, Monterrey, Puebla, and Queretaro, all of which are listed in the rankings of the journals The Economist Intelligence Unit and AméricaEconomía. The field research included an interview with the editor responsible for conceptualizing, preparing, and publishing the first version of “The Best Cities to Do Business in Latin America” ranking of the journal AméricaEconomía. It also included a comparative analysis of city indexes from the theoretic and conceptual perspective of space of flows. The investigation was conducted between March and August 2017.
Water on Fire: The Patients’ Lived Experience of Primary Percutaneous Coronary Intervention
Authors: Javadi-Pashaki Nazila , Salari Arsalan , Emami Sigaroudi Abdolhosein
Published: June 2019

Background:

The success of a coronary angioplasty in the treatment of myocardial infarction is affected by patients’ experiences. However, the experiences of the people with an emergency angioplasty have remained unknown.

Objective:

This study was conducted to explore the patients’ experiences of an emergency angioplasty.

Method:

This study was performed using the qualitative research method and interpretive phenomenological approach. Nine patients under emergency angioplasty were selected using purposeful sampling. A total of 11 deep and semistructured interviews were performed with the patients. The data were analyzed using van Manen method.

Results:

Five subthemes of “diagnosis shock,” “being in an emergency situation,” “trying to self-control,” “the need for reassuring care,” and “stability” formed the structure of the patients’ experiences under the main theme of “water on fire”. Water on fire was the participants’ main perception of the emergency angioplasty. Patient-centered interactions and meeting the care, supportive, and educational needs of the patients in the case of diagnosis shock lead to a pleasant experience of returning to life.

Conclusion:

The findings of this study may have implications for care of patients undergoing emergency cardiovascular interventions.
Consultants as intermediaries: Their perceptions on citizen involvement in urban development
Authors: Stapper EW , Van der Veen M , Janssen-Jansen LB
Published: June 2019

Planning consultants are increasingly hired to organize citizen participation processes for urban development projects. However, the ways in which planning consultants engage in and perceive the involvement of citizens in urban development projects remain relatively understudied. This article opens the black box of consultancy employees’ perceptions toward citizens in urban development processes. Employees from two consultancy firms in the Netherlands were interviewed, and several focus groups were organized. This research shows that consultants have wide-ranging views concerning the ways of incorporating citizens’ interests in urban development projects. With the use of Q-methodology, a typology of how consultants engage with citizens is proposed. Furthermore, we show that the different perceptions of consultants lead to a different approach in identifying the needs and problems of citizens. This finding gives insight into the context in which decisions about urban development are made.
Identifying Project Factors That Affect an Investor’s Escalation of Commitment in Public-Private Partnership Projects
Authors: Liu Jiaqi , Liu Jicai , Gao Ruolan , Gao Huaizhu Oliver , Li Yahui
Published: June 2019

The study comprehensively discusses 18 project factors affecting investors’ escalation of commitment (EOC) in a public-private partnership (PPP) project. Using factor analysis, five factor groupings were addressed: the project information and economic benefit, the reward and punishment mechanisms, project uncertainty, the degree of participation and completeness, and the resources invested in the project. The results revealed that the influence of five grouping factors on investor’s EOC is not independent; after performing the weight analysis, the 18 factors had different influences on EOC. These findings offer effective suggestions and theoretical guidelines for reducing the risk of investor EOC.
Murine platelet production is suppressed by S1P release in the hematopoietic niche, not facilitated by blood S1P sensing
Authors: Niazi Hira , Zoghdani Nesrine , Couty Ludovic , Leuci Alexandre , Nitzsche Anja , Allende Maria L. , Mariko Boubacar , Ishaq Rameez , Aslan Yetki , Becker Pierre Hadrien , Gazit Salomé L. , Poirault-Chassac Sonia , Decouture Benoit , Baudrie Veronique , De Candia Erica , Kono Mari , Benarab Ammar , Gaussem Pascale , Tharaux Pierre-Louis , Chun Jerold , Provot Sylvain , Debili Najet , Therond Patrice , Proia Richard L. , Bachelot-Loza Christilla , Camerer Eric
Published: June 2019

The bioactive lipid mediator sphingosine 1-phosphate (S1P) was recently assigned critical roles in platelet biology: whereas S1P1 receptor-mediated S1P gradient sensing was reported to be essential for directing proplatelet extensions from megakaryocytes (MKs) toward bone marrow sinusoids, MK sphingosine kinase 2 (Sphk2)–derived S1P was reported to further promote platelet shedding through receptor-independent intracellular actions, and platelet aggregation through S1P1. Yet clinical use of S1P pathway modulators including fingolimod has not been associated with risk of bleeding or thrombosis. We therefore revisited the role of S1P in platelet biology in mice. Surprisingly, no reduction in platelet counts was observed when the vascular S1P gradient was ablated by impairing S1P provision to plasma or S1P degradation in interstitial fluids, nor when gradient sensing was impaired by S1pr1 deletion selectively in MKs. Moreover, S1P1 expression and signaling were both undetectable in mature MKs in situ, and MK S1pr1 deletion did not affect platelet aggregation or spreading. When S1pr1 deletion was induced in hematopoietic progenitor cells, platelet counts were instead significantly elevated. Isolated global Sphk2 deficiency was associated with thrombocytopenia, but this was not replicated by MK-restricted Sphk2 deletion and was reversed by compound deletion of either Sphk1 or S1pr2, suggesting that this phenotype arises from increased S1P export and S1P2 activation secondary to redistribution of sphingosine to Sphk1. Consistent with clinical observations, we thus observe no essential role for S1P1 in facilitating platelet production or activation. Instead, S1P restricts megakaryopoiesis through S1P1, and can further suppress thrombopoiesis through S1P2 when aberrantly secreted in the hematopoietic niche.
Truly sustainable or not? An exploratory assessment of sustainability capability of textile and apparel corporations in China from the moral responsibility perspective
Authors: Yang Nannan , Ha-Brookshire Jung E.
Published: June 2019

Within the moral responsibility theory of corporate sustainability (MRCS) framework (Ha-Brookshire in J Bus Ethics, 2015. https://doi.org/10.1007/s10551-015-2847-2), the study examined 86 sustainability reports from top performing textile and apparel companies in China to explore their perceptions and sustainability capability implications. Content analysis of their sustainability reports was conducted to analyze whether each company (a) perceives sustainability as a perfect duty or not, (b) has clear goals toward sustainability or not, and (c) has well-defined structures toward sustainability goals or not. Results show that 66 of the 86 reports described sustainability as a perfect duty to fulfill; 11 described as an imperfect duty, and 9 described no opinions about sustainability. Of the 66 reports, 19 explicitly showed clear goals and the evidence of organizational structures toward such goals, leading us to categorize them as truly sustainable corporations as Ha-Brookshire (2015) described. Of the 66, 43 lacked clear sustainability goals, leading us to categorize them as occasionally sustainable corporations as described by Ha-Brookshire (2015). Other firms were also categorized within the MRCS framework. Findings show a spectrum of Chinese textile and apparel companies’ sustainability capability from the moral responsibility perspective.
Conjugated Estrogens and Bazedoxifene Improve β Cell Function in Obese Menopausal Women
Authors: Lovre Dragana , Peacock Erin , Katalenich Bonnie , Moreau Cynthia , Xu Beibei , Tate Chandra , Utzschneider Kristina M , Gautier Jean-François , Fonseca Vivian , Mauvais-Jarvis Franck
Published: June 2019

Context

Studies suggest that menopausal hormone therapy (MHT) prevents type 2 diabetes (T2D). The combination of conjugated estrogens (CE) with the selective estrogen receptor modulator bazedoxifene (BZA) is an MHT that improves obesity and T2D in preclinical models of menopausal metabolic syndrome. The effect of CE/BZA on adiposity and glucose homeostasis in obese postmenopausal women is unknown.

Objective

To investigate the effect of CE/BZA on body composition, glucose homeostasis, and markers of inflammation in obese postmenopausal women.

Research Design, Intervention, and Participants

Randomized, double-blind, placebo-controlled pilot trial of 12 obese menopausal women assigned to 12-week treatment with CE 0.45 mg/BZA 20 mg (n = 7) or placebo (n = 5). At baseline and after 12 weeks, we assessed body composition (dual-energy X-ray absorptiometry), glucose homeostasis (IV glucose tolerance test), and inflammation biomarkers.

Results

Women treated with CE/BZA exhibited increased β cell function using homeostatic model assessment-B [median (interquartile range) CE/BZA vs placebo: 18.5 (−0.9 to 320.6) μU/mM vs −25.5 (−39.9 to −0.1) μU/mM; P = 0.045], and decreased basal glucose concentrations (Gb) [−5.2 (−9.2 to −1.7) mg/dL vs 2.7 (0.9 to 4.9) mg/dL; P = 0.029]. Insulin sensitivity was higher in the placebo arm [1.35 (1.12 to 1.82) (μU/mL) min−1 vs −0.24 (−1.50 to 0.19) (μU/mL) min−1; P = 0.029]. No changes between treatment groups were observed for the acute insulin response to glucose (AIRg), the disposition index (DI), body composition, and inflammatory biomarkers.

Conclusions

A 12-week treatment of obese postmenopausal women with CEs/BZA improves fasting β cell function and glucose concentrations without change in AIRg, HOMA-IR, DI, body composition, or markers of inflammation.
Muscular apoptosis but not oxidative stress increases with old age in a long-lived diver, the Weddell seal
Authors: Allen Kaitlin N. , Vázquez-Medina José Pablo , Lawler John M. , Mellish Jo-Ann E. , Horning Markus , Hindle Allyson G.
Published: June 2019

Seals experience repeated bouts of ischemia-reperfusion while diving, potentially exposing their tissues to increased oxidant generation and thus oxidative damage and accelerated aging. We contrasted markers of oxidative damage with antioxidant profiles across age and sex for propulsive (longissismus dorsi, LD) and maneuvering (pectoralis, P) muscles of Weddell seals to determine whether previously observed morphological senescence is associated with oxidative stress. In LD, old (age 17-26 years) seals exhibited a nearly 2-fold increase in apoptosis over young (age 9-16 years) seals. There was no evidence of age-associated changes in lipid peroxidation or enzymatic antioxidant profiles. In P, 4-hydroxynonenal-Lys (4-HNE-Lys) levels increased 1.5-fold in old versus young seals, but lipid hydroperoxide levels and apoptotic index did not vary with age. Glutathione peroxidase activity was 1.5-fold higher in P of old versus young animals, but no other antioxidants changed with age in this muscle. With respect to sex, no differences in lipid hydroperoxides or apoptosis were observed in either muscle. Males had higher HSP70 expression (1.4-fold) and glutathione peroxidase activity (1.3-fold) than females in LD, though glutathione reductase activity was 1.4-fold higher in females. No antioxidants varied with sex in P. These results show that apoptosis is not associated with oxidative stress in aged Weddell seal muscles. Additionally, the data suggest that adult seals utilize sex-specific antioxidant strategies in LD but not P to protect skeletal muscles from oxidative damage.
The photon menace: kleptoplast protection in the photosynthetic sea slugElysia timida
Authors: Cartaxana Paulo , Morelli Luca , Jesus Bruno , Calado Gonçalo , Calado Ricardo , Cruz Sónia
Published: June 2019

Absorption of excessive light by photosymbiotic organisms leads to the production of reactive oxygen species that can damage both symbiont and host. This is highly relevant in sacoglossan sea slugs that host functional chloroplasts “stolen” from their algal foods (kleptoplasts), due to limited repair capacities resulting from the absence of algal nuclear genes. Here we experimentally demonstrate i) a host-mediated photoprotection mechanism in the photosynthetic sea slug Elysia timida, characterized by the closure of the parapodia under high irradiance and the reduction of kleptoplast light exposure; ii) the activation of a reversible xanthophyll cycle in kleptoplasts, which allows excessive energy to be dissipated. The described mechanisms reduce photoinactivation under high irradiances. We conclude that both host-mediated behavioural and plastid-based physiological photoprotective mechanisms can mitigate oxidative stress induced by high light in E. timida. These mechanisms may play an important role in the establishment of long-term photosynthetic active kleptoplasts.
Molecular mechanisms for intestinal HCO3− secretion and its regulation by guanylin in seawater-acclimated eels
Authors: Takei Yoshio , Wong Marty K. S. , Ando Masaaki
Published: June 2019

The intestine of marine teleosts secretes HCO3− into the lumen and precipitates Ca2+ and Mg2+ in the imbibed seawater as carbonates to decrease luminal fluid osmolality and facilitate water absorption. However, hormonal regulation of HCO3−secretion is largely unknown. Here, mucosally-added guanylin (GN) increased HCO3− secretion, measured by pH-stat, across isolated seawater-acclimated eel intestine bathed in saline at pH 7.4 (5% CO2). The effect of GN on HCO3− secretion was slower than that on the short-circuit current, and the time-course of the GN effect was similar to that of bumetanide. Mucosal bumetanide and serosal 4,4’-dinitrostilbene-2,2’-disulfonic acid (DNDS) inhibited the GN effect, suggesting an involvement of apical Na+-K+-2Cl− cotransporter (NKCC2) and basolateral Cl−/HCO3− exchanger (AE)/Na+-HCO3− cotransporter (NBC) in the GN effect. As mucosal DNDS failed to inhibit the GN effect, apical DNDS-sensitive AE may not be involved. To identify molecular species of transporters involved in the GN effect, we performed RNA-seq analyses followed by quantitative real-time PCR after transfer of eels to seawater. Among the genes upregulated after seawater transfer, AE genes, draa, b, and pat1a, c, on the apical membrane, and NBC genes, nbce1a, n1, n2a, and a AE gene, sat-1, on the basolateral membrane were candidates involved in HCO3− secretion. Judging from the slow effect of GN, we suggest that GN inhibits NKCC2b on the apical membrane and decreases cytosolic Cl− and Na+, which then activates apical DNDS-insensitive DRAs and basolateral DNDS-sensitive NBCs to enhance transcellular HCO3− flux across the intestinal epithelia of seawater-acclimated eels.
Systematic radiological approach to utero-ovarian pathologies
Authors: Nikolic Olivera , Basta Nikolic Marijana , Spasic Aleksandar , Otero-Garcia Mila Milagros , Stojanovic Sanja
Published: June 2019

Ultrasound is the first-line imaging modality for the evaluation of suspected adnexal masses, endometriosis and uterine tumors, whereas MRI is used as a secondary diagnostic tool to better characterize these lesions. The aim of this review is to summarize the latest advances in the imaging of these utero-ovarian pathologies.
Case Report: Resolution of chronic urticaria following treatment of odontogenic infection
Authors: Tadros Susan , Bahal Sameer , Nagendran Vasantha
Published: June 2019

Background: Chronic spontaneous urticaria (CSU) is a condition characterised by the presence of hives with/without angioedema, that affects individuals on more days than not for 6 weeks or more. The role of infection as a potential trigger for CSU is well described, but the current clinical guidelines do not recommend routine screening for underlying infections.

Main observations: We report a case of severe prolonged chronic spontaneous urticaria in a 19-year-old, that went into rapid remission following the treatment of dental infection.

Conclusions: Clinicians should recognise the potential role that infection can have in causing chronic urticaria. There should be a low threshold to treat infection in such circumstances.
Recent advances in laryngoscopy in adults
Authors: Parotto Matteo , Cooper Richard
Published: June 2019

Recent advances in technology have made laryngoscopy less dependent upon a direct line of sight to achieve tracheal intubation. Whether these new devices are useful tools capable of increasing patient safety depends upon when and how they are used. We briefly consider the challenges in reviewing the emerging literature given the variety of devices, “experience” of the care providers, the clinical settings, and the definitions of outcome. We examine some of the limitations of conventional direct laryngoscopy, question the definitions we have used to define success, discuss the benefits of indirect (video) techniques, and review evidence pertaining to their use in the patients in the operating room, emergency department, and intensive care unit.
Exploring the perspectives of stroke survivors and healthcare professionals on the use of mobile health to promote physical activity: A qualitative study protocol
Authors: Carter Daniel D. , Robinson Katie , Forbes John , Walsh Jane C. , Hayes Sara
Published: June 2019

Background: Physical inactivity is both the second-highest population attributable risk factor for and a common consequence of stroke. Despite well-documented health benefits associated with physical activity, its levels typically remain below recommended guidelines in stroke survivors. Consequently, calls have been made for novel interventions targeting the promotion of physical activity in stroke survivors. Mobile health is an emerging field which can offer personalised health interventions through mobile and wireless technology. However, a paucity of research has focused on mobile health to promote physical activity in stroke survivors and, more broadly, this field has been criticised for not incorporating the views of stakeholders. This study aims to explore the perspectives of stroke survivors and healthcare professionals on the development of a mobile health intervention for the promotion of physical activity.

Methods: The current study will employ a qualitative descriptive approach using separate, semi-structured focus groups for two key stakeholder groups. Community-dwelling stroke survivors will be recruited through an early supported discharge service for acute stroke and stroke support groups. Healthcare professionals will be recruited through the same early supported discharge service, relevant professional bodies and Twitter. The final number of focus groups will depend on data saturation. Thematic analysis will be conducted using NVivo 12 and findings will be reported in accordance with the Consolidated Criteria for Reporting Qualitative Studies.

Conclusion: This study was granted ethical approval from the HSE Mid-Western Regional Hospital Research Ethics Committee and the Faculty of Education and Health Sciences Research Ethics Committee at the University of Limerick. Output will consist of recommendations for the development of a mobile health intervention aimed at the promotion of physical activity in stroke survivors. Findings will be disseminated locally through presentations at stroke support groups, as well as internationally through academic conferences and peer-reviewed journals.
ZMYM2 inhibits NANOG-mediated reprogramming
Authors: Lawrence Moyra , Theunissen Thorold W. , Lombard Patrick , Adams David J. , Silva José C. R.
Published: June 2019

Background: NANOG is a homeodomain-containing transcription factor which forms one of the hubs in the pluripotency network and plays a key role in the reprogramming of somatic cells and epiblast stem cells to naïve pluripotency.  Studies have found that NANOG has many interacting partners and some of these were shown to play a role in its ability to mediate reprogramming. In this study, we set out to analyse the effect of NANOG interactors on the reprogramming process.

Methods: Epiblast stem cells and somatic cells were reprogrammed to naïve pluripotency using MEK/ERK inhibitor PD0325901, GSK3β inhibitor CHIR99021 and Leukaemia Inhibitory Factor (together termed 2i Plus LIF). Zmym2 was knocked out using the CRISPR/Cas9 system or overexpressed using the PiggyBac system. Reprogramming was quantified after ZMYM2 deletion or overexpression, in diverse reprogramming systems. In addition, embryonic stem cell self renewal was quantified in differentiation assays after ZMYM2 removal or overexpression.

Results: In this work, we identified ZMYM2/ZFP198, which physically associates with NANOG as a key negative regulator of NANOG-mediated reprogramming of both epiblast stem cells and somatic cells. In addition, ZMYM2 impairs the self renewal of embryonic stem cells and its overexpression promotes differentiation.

Conclusions: We propose that ZMYM2 curtails NANOG’s actions during the reprogramming of both somatic cells and epiblast stem cells and impedes embryonic stem cell self renewal, promoting differentiation.
Basics of enterprise information security
Authors: Гришина Наталия , Grishina Nataliya
Published: June 2019

The textbook discusses the basic concepts, definitions, provisions and methodological approaches to the organization of an integrated information security system. Special attention is paid to the problem of the human factor.
Complies with the requirements of the Federal State Educational Standard of Higher Education of the last generation in the bachelor program 10.03.01 “Information Security”.
The manual is intended for students, graduate students, teachers of higher educational institutions engaged in the protection of information.
The changing face of patient care
Authors: Bridger Laura
Published: June 2019

Dental nurse and practice manager, Laura Bridger, considers the impact of an UK's ageing population on dentistry
How to become a locum
Authors: Anastasi Emma
Published: June 2019

Diamond Dental Staff's Emma Anastasi offers insight into how to succeed as a locum dental nurse
‘I feel like I'm home’
Authors: El Mgharbel Rola
Published: June 2019

Syrian refugee Rola El Mgharbel recalls her journey – from war-torn Damascus to dental nursing in Durham
Dentistry on the move
Authors: Cowdin Anna
Published: June 2019

Anna Cowdin is co-owner and dentist at Nomad Dental, a forward-thinking company that involves transporting a mobile dental practice between multiple locations to provide accessible care
Gravity-induced exercise intervention in an individual with chronic fatigue syndrome/myalgic encephalomyeltis and postural tachycardia syndrome: a case report
Authors: Ballantine Robert , Strassheim Victoria , Newton Julia
Published: June 2019

Background/Aims

Chronic fatigue syndrome/myalgic encephalomyeltis is a condition of complex nature, characterised by unexplained disabling fatigue and a combination of non-specific accompanying symptoms. Individuals with chronic fatigue syndrome/myalgic encephalomyeltis frequently present with debilitating orthostatic symptoms, which may fall under the umbrella of postural tachycardia syndrome. Postural tachycardia syndrome is underpinned by autonomic nervous system dysfunction. The gravitational deconditioning that occurs in those severely affected by chronic fatigue syndrome/myalgic encephalomyeltis alongside postural tachycardia syndrome has been suggested as a key focus for interventions in this group. This case report documents the evaluation and rationale behind a novel gravity-induced exercise intervention to improve the symptoms of a 44-year-old female severely affected by chronic fatigue syndrome/myalgic encephalomyeltis and postural tachycardia syndrome, who had been bedbound for 10–15 years.

Methods

An exercise intervention was designed to challenge and therefore improve key areas of autonomic nervous system regulation in the presence of gravity. It contained seven different exercises conducted once a month in a class over a 6-month period.

Results

Fatigue impact score, activity levels and heart rate upon standing, as detected by an active stand test, improved during the exercise intervention and at follow up.

Conclusions

Gravity-induced exercise intervention can have a positive effect on an individual severely affected by Chronic fatigue syndrome/myalgic encephalomyeltis alongside postural tachycardia syndrome.
The décolletage: the forgotten area of anti-ageing enhancement
Authors: Glancey Lucy
Published: June 2019

The past few years has seen a shift in aesthetic practice from filling individual lines to a more holistic and comprehensive view of treatment. However, some areas of the body are still neglected. In this article, Lucy Glancey discusses one of these forgotten areas—the décolletage—and provides an overview of some of the available approaches to treating this area
Responsibilities and qualities of an ethical trainer
Authors: Senior Yvonne
Published: June 2019

As part of our Ethics in Aesthetics campaign, we have been exploring the issue of training in aesthetics, and the impact that this has on patient safety. In this article, Yvonne Senior discusses the responsibilities and qualities of an ethical trainer
How to use the knowledge of your unique selling points
Authors: Dickons Gilly
Published: June 2019

In last month's issue, Gilly Dickons gave some guidance as to how to identify your clinic's unique selling points (USPs). However, identifying your clinic's USPs is futile if you don't then put this information to good use. In this article, Dickons explores how you can do this
Recognising and treating arrhythmias in primary care
Authors: Richley Dave
Published: June 2019

As more and more people in the UK are being affected by cardiovascular conditions, it is increasingly necessary for practice nurses to keep up-to-date with the latest developments. Dave Richley explains common ECG readings that may be seen in primary care

Cardiac arrhythmias may be asymptomatic or they may be responsible for a range of symptoms including palpitations, dizziness, chest pain and loss of consciousness. Accurate diagnosis, and therefore appropriate management, depends on careful interpretation of an electrocardiogram (ECG) recording of the arrhythmia, and this is often achievable in primary care. This article presents the arrhythmias most commonly encountered in primary care, as well as those seen rarely, and describes and illustrates their defining features. It will also discuss some of the pitfalls that can lead to erroneous diagnosis. While some arrhythmias can be managed appropriately in primary care, guidance is provided in regarding referral or admission to hospital for arrhythmias that may warrant further investigation or specialist care.
Public health approaches to tackling obesity in the UK
Authors: Mulrooney Hilda
Published: June 2019

Being obese and overweight affects an increasing number of adults and children in the UK. Hilda Mulrooney presents an overview of the population-based approaches to improving public health and enabling more people to lose weight

Obesity is a serious condition that is highly prevalent in UK adults and children. A number of population-based approaches to improve the ‘obesogenic’ environment have been put into place while more are being proposed. Many of these approaches have the advantage of potentially altering dietary intakes without individual behaviour change, and they are taking place in a wider context that encourages physical activity and partnership working. Approaches to obesity and progress made towards targets will be discussed.
Research Roundup
Authors: Winter George
Published: June 2019

George Winter provides an overview of recently published articles that may be of interest to practice nurses. Should you wish to look at any of the papers in more detail, a full reference is provided.
Victimhood as victory: The role of memory politics in the process of de-Europeanisation in East-Central Europe
Authors: Vermeersch Peter
Published: June 2019

To a large extent, the traditional narrative of EU integration has revolved around reconciliation and peace-building after the Second World War. This article examines how current memory work in nationalist movements in East-Central Europe subverts this moral story and uses it as the basis for a politics of backlash against the EU. Recent developments in national commemoration and remembrance practices in the region have enabled not only the glorification of the national past but also the suppression of ‘heretical’ interpretations of specific traumatic historical episodes. The fault lines of national belonging are now often used to eclipse stories of post-war state reconciliation in Europe and focus directly on the victimised population. As a result, commemorations carry strong normative and moral overtones related to justice and culpability. Nationalism in this context has received moral connotation and, vice versa, questions of morality become questions of nationhood. The ‘we’ of this distinguishing work embodies a subject of immaculate historical innocence and victimhood; by extension, the ‘others’ always bear responsibility and guilt. This nationalist moral classification work changes and reframes the moral underpinnings of the EU enlargement. The victim theme has adhered a strong potential to garner solidarity among various social groups in East-Central Europe against the EU. The role of victimiser is easily projected onto both the abstract notion of the ‘European elites’ and the supposed allies of those elites: the internal ‘others’.
O “NOVO REGIME FISCAL” E A VIOLAÇÃO DA PROGRESSIVIDADE E DA PROIBIÇÃO DE RETROCESSO EM MATÉRIA DE DIREITO À SAÚDE
Authors: Soares Hector Cury , Costa José Ricardo Caetano
Published: June 2019

A pesquisa analisa a violação da progressividade e da proibiçãode retrocesso em matéria de direito à saúde face ao “Novo Regime Fiscal”, instituído pela Emenda à Constituição nº 95/2016. Para tanto, comprova que os direitos fundamentais sociais geram custos e, assim, impactam no Orçamento Público; demonstra que a mudança do indexador dos gastos públicos em saúde gerará um impacto negativo no Orçamento; e, por fim, demonstra que o “Novo Regime Fiscal” impõe uma situação normativa mais prejudicial à efetivação do direito à saúde, com base na doutrina e na dogmática constitucional. Utiliza-se uma abordagem metodológica descritiva, coletando as informações e os principais conceitos utilizados por meio de revisão bibliográfica, pesquisa documental e análise de jurisprudência. Ao final, resta demonstrado que o art. 110, II do Ato das Disposições Constitucionais Transitórias (ADCT), do Novo Regime Fiscal, viola a Constituição da República no que concerne à progressividade do direito à saúde.
A MEDIAÇÃO COMO FORMA DE RESOLUÇÃO DE CONFLITOS: UMA ABORDAGEM APLICADA DO PENSAMENTO DE HANNAH ARENDT
Authors: Bordoni Jovina d’Avila , Siqueira Natercia Sampaio
Published: June 2019

O estudo aborda a mediação como instrumento de resolução dos con-flitos. Busca-se repensar a relação entre os indivíduos e a forma de solução dos seus conflitos, por meio da mediação, com base nos conceitos e nas discussões de Hannah Arendt sobre política, cidadania e amizade. Ao assim proceder, arguise que a prática dialógica é condição para que se seja pessoa com igual dignidade a qualquer outra, para, em momento posterior, se ponderar que a tecnologia do diálogo, em vez da descoberta da verdade, é a prática epistemológica mais adequada à democracia. Conclui-se, ao final, que a mediação se constitui em prática capaz de proporcionar a emancipação das pessoas dentro da sociedade, pois garante a voluntariedade e resgata a comunicação entre os conflitantes, configurando-se como prática democrática capaz de restabelecer o equilíbrio e a paz social. A metodologia utilizada no estudo é descritiva e analítica, desenvolvida por meio de pesquisa bibliográfica.
TRIBUTAÇÃO AMBIENTAL COMO MECANISMO INDUTOR DO DIREITO HUMANO AO DESENVOLVIENTO SUSTENTÁVEL
Authors: Paiva Francisco Cleiton da Silva
Published: June 2019

Este trabalho tem por objetivo mostrar a tributação ambiental como instrumento indutor da proteção ao meio ambiente e alcance do direito humano ao desenvolvimento sustentável. Como agente responsável pela promoção do desenvolvimento sustentável, o Poder Público tem a prerrogativa de contribuir positivamente para um meio ambiente ecologicamente equilibrado, via instituição de tributos. O direito ao meio ambiente é parte fundamental para a qualidade de vida e dignidade da pessoa humana, sendo este um direito transindividual. A pesquisa corresponde a um estudo bibliográfico, de natureza qualitativa e objetivo descritivo. Com ela verificou-se que a proteção ambiental é fator decisivo para a consolidação do direito humano ao desenvolvimento sustentável, visto que o indivíduo precisa da natureza para se desenvolver plenamente em sua condição de vida, tendo a tributação ecológica um papel fundamental na promoção desse direito, tão importante para as atuais e futuras gerações.
DIREITO DA SUSTENTABILIDADE: REFLEXÕES ACERCA DA CRISE ECOLÓGICA MARCADA PELA FLEXIBILIZAÇÃO DAS NORMAS AMBIENTAIS E A EFETIVAÇÃO DOS DIREITOS HUMANOS SOCIOAMBIENTAIS
Authors: Vieira Ricardo Stanziola , Tavares Elisa Goulart
Published: June 2019

Partindo-se da percepção de que a natureza é também um produto humano, o cenário de crise (degradação ecológica) originou-se com a Revolução Industrial, que de maneira desordenada culminou numa crise ambiental global a partir de um modelo de civilização que mantém uma relação insustentável com os recursos naturais existentes no Planeta Terra. Dado o enfoque ao colapso ambiental ameaçador da geração presente e futura, tem-se a necessidade de adoção de mecanismos emergenciais, para além das normas jurídicas, com o escopo prioritário de se efetivar o Estado Socioambiental de Direito contemporâneo, perspectiva de transformação da sociedade atual que altera a sua relação paradigmática com a natureza. Dessa forma, busca-se tecer algumas considerações acerca do modo como se apresenta os valores da sociedade capitalista neste contexto, em que o mito do desenvolvimento a qualquer custo reduzido a mero crescimento econômico não pode mais prosperar.
Influence of Coir Fiber Diameter and Length on Mechanical Behavior of Coconut Shell Powder–Based Polyester Resin Composites
Authors: Vignesh K. , Natarajan U. , Arockia Jaswin M. , Antony Arul Prakash M. D.
Published: June 2019

Coir fiber is available in abundance in nature. Coconut shell is a food waste material. Both are procured from the coconut. Coir fiber–reinforced coconut shell powder–based polyester resin composite is fabricated by using the hand lay-up technique. Here, coir fiber acts as a reinforcing agent. Coconut shell powder acts as a filler material. Polyester resin acts as a binding material. Composites are fabricated as per ASTM standards. Tests of mechanical behaviors such as tensile strength and compressive strength are carried out, and the results are analyzed based on the influence of coir fiber diameter and length.
Investigation of Wave Propagation Behavior of Partially Two-Layered Plates
Authors: Mostafapour Amir , Davoodi Saman , Ghareaghaji Mohammad
Published: June 2019

In this study, the acoustic emission characteristics of a rectangular plate with a partially covered free damping viscoelastic layer excited by an acoustic source (Hsu-Nielsen) has been investigated. A partially covered plate configuration consisting of a base plate (aluminum) and free damping layer (polyethylene) is considered. An acoustic emission source generated different acoustic modes, which caused the plate to have in-plane and out-plane displacements. These plate displacements will be captured by acoustic sensors. To obtain the general form of plate displacements theoretically, Von Karman theory and a Kelvin-Voigt model were used and the equations of motion were derived using Galerkin’s method. The effects of nonlinear terms of the strain-displacement relation on wave propagation characteristics of plates were investigated. The main frequency ranges of signals and the propagation speed of acoustic modes and their attenuation are very important for source locating. These parameters depend on the acoustic source and transmitted medium. So, theoretically predicting the main frequency range of signals because of the acoustic source and propagation characteristics of different acoustic modes has an important role in an acoustic source–locating algorithm. For this purpose, acoustic emission experiments were carried out using two R15α sensors. Frequency domains of theoretical and experimental results were analyzed. A comparison of the obtained results showed good agreement between the experimental and theoretical Lamb velocities and main frequency ranges.
Study on Photo Aging Differential among Inner, Outer, and Middle Layers of Moso Bamboo (Phyllostachys pubescens Mazel)
Authors: Yu Hai-xia , Pan Xin , Wang Zeng , Zhang Wenfu , Zhuang Xiao-wei , Jiang Yingti
Published: June 2019

To better understand the photo weathering characteristics of different parts of bamboo culms, Moso bamboo (Phyllostachys pubescens Mazel) was divided into three layers from the outmost side to the inside along the radial direction and then radiated by ultraviolet (UV) light for 56 days. The lignin content on top surface was accurately measured by the acetyl bromide method and degree of crystallinity was analyzed by X-ray Photoelectron Spectroscopy (XPS) before and after UV aging. Results showed that after UV radiation, the surface color of the outer layer changed the most and turned to dark brown, however, the inner layer and middle layer became more yellowish; the lignin content of each layer all decreased, and the crystalline region increased. The lignin content of the outer layer decreased the least because of its relative high density and less light penetration. The degree of crystallinity of the outer layer bamboo increased the most, and the inner layer was the least. The photo oxidation reaction may occur only in the amorphous region, and it was very difficult for light to break the crystalline region. The crystal lattice structure kept unchanged.
Influence of Boundary Insulation on the Growth of Frozen Soils during AGF Modeling
Authors: Huang Ren-Chung , Wu Po-Kai , Chang Muhsiung
Published: June 2019

To clarify the influence of boundary insulation on the development of frozen soils, seven artificial ground freezing (AGF) models of Ottawa sand were performed with different thermal impedance Z-values of the boundary insulation system. Results of testing show that the greater the Z-values, the larger the frozen soil areas for a given time of freezing. When the Z-value is more than 2.27 m2 K/W, however, the extent of frozen soils appears to be stabilized for the AGF model with dimensions of 100 cm (L) by 100 cm (W) by 15 cm (H). Two-dimensional finite element analyses were also conducted to verify the performance of boundary insulation systems of the physical model. Numerical simulations show the development of frozen soils is significantly affected by the ambient temperature if no insulation is covered on the boundary of the AGF model, and the growth of frozen soils would cease at a freezing time of less than 6 h. However, when the Z-value of the boundary insulation system is more than 2.27 m2 K/W, the pattern of the temperature field and the size of frozen soils in the model resemble those for a system with a perfectly insulated boundary with an elapsed time of freezing up to 24 h. Hence, it can be concluded that the thermal impedance Z-value should be at least 2.27 m2 K/W for the boundary insulation system of the current AGF model to be free from the influence of an ambient environment and have a similar temperature response as the perfectly insulated model for a test time up to 24 h.
Reliability-Based Specification for Asphalt Concrete Pavements
Authors: Dinegdae Yared , Onifade Ibrahim , Birgisson Bjorn
Published: June 2019

The use of volumetric-based specifications that utilize air void and asphalt content for the quality control of asphalt pavements is a major concern as there is a lack of fundamental correlation between these mixture properties and long-term pavement performance. In addition to that, the input variabilities’ influence on target reliability and pavement performance is not addressed in these volumetric-based specifications. The aim of this article is to introduce a reliability-based specification for the quality control of top-down cracking in asphalt concrete pavements. The reliability-based specification criteria are developed for two traffic level categories and using design inputs such as hourly equivalent single axle load traffic, asphalt layer thickness, base modulus, and dissipated creep strain energy limit. For the development of the reliability-based specification, several field pavement sections with well-documented performance history and high-quality laboratory and field data were analyzed using the mechanics-based design framework for variability conditions that are representative of actual field conditions. Variation in dissipated creep strain energy limit and asphalt concreter layer thickness has been observed to influence target reliability and overall pavement performance significantly, in comparison with base modulus and hourly equivalent single axle load traffic. The proposed reliability-based specification can complement existing performance-based specifications for the quality control of top-down cracking in asphalt concrete pavements.
Adrenal venous sampling: cosyntropin stimulation or not?
Authors: Deinum Jaap , Groenewoud Hans , van der Wilt Gert Jan , Lenzini Livia , Rossi Gian Paolo
Published: June 2019

Notwithstanding the high prevalence of primary aldosteronism (PA), probably the most common form of secondary hypertension, the diagnosis of PA is often neglected or delayed, thus precluding target treatment, which is curative in many cases. For selection of the most appropriate treatment, a fundamental step is the distinction between a lateralized form, mainly aldosterone-producing adenoma (APA), and bilateral adrenocortical hyperplasia (BAH), also known as idiopathic hyperaldosteronism (IHA). To this aim all current guidelines recommend adrenal vein sampling (AVS), a technically challenging procedure that often fails, particularly in non-experienced hands. Cosyntropin (synthetic ACTH) is administered in the attempt to maximize adrenal cortisol secretion and avoid pulsatile adrenocortical hormone secretion in about 40% of the referral centres around the world. However, the Endocrine Society guidelines do not advise about the use or not of cosyntropin as stimulus during AVS, as there are arguments in favour and against its use. These arguments are presented in this debate article reflecting the views of groups that currently use and do not use cosyntropin.
Lean non-alcoholic fatty liver disease and development of diabetes: a cohort study
Authors: Sinn Dong Hyun , Kang Danbee , Cho Soo Jin , Paik Seung Woon , Guallar Eliseo , Cho Juhee , Gwak Geum-Youn
Published: June 2019

Objective

Non-alcoholic fatty liver disease (NAFLD), a condition associated with multiple metabolic abnormalities, is frequently observed in normal weight individuals (lean NAFLD). The metabolic consequences of lean NAFLD, however, are not well characterized. Thus, this study aimed to evaluate the risk of incident diabetes in lean NAFLD.

Methods

This is a cohort study of 51,463 adults without diabetes, history of liver disease or cancer at baseline who participated in a regular health screening exam. Fatty liver was diagnosed by ultrasonography. The study outcome was the development of diabetes during follow-up.

Results

During 236,446.6 person-years of follow-up (median follow-up of 4.0 years), 5370 participants developed diabetes. In fully adjusted models, the hazard ratios (HRs) for incident diabetes comparing lean participants with NAFLD, overweight/obese participants without NAFLD and overweight/obese participants with NAFLD to lean participants without NAFLD, were 1.18 (95% CI: 1.03–1.35), 1.06 (0.98–1.14) and 1.45 (1.34–1.57), respectively. The fully adjusted HR for incident diabetes for lean NAFLD participants with low NAFLD fibrosis score (NFS) (<−1.455) and with intermediate-to-high NFS (≥−1.455) compared to lean participants without NAFLD were 1.32 (1.14–1.53) and 2.73 (2.10–3.55), respectively.

Conclusions

In this large cohort study, the presence and severity of NAFLD in normal weight adults was associated with an increased incidence of diabetes independently of established risk factors. Indeed, isolated lean NAFLD was a stronger risk factor for incident diabetes than the presence of overweight/obesity without NAFLD. Subjects with lean NAFLD require careful monitoring for the development of metabolic abnormalities.