bluuebunny/crossref_metadata_2025 huggingface dataset:
Infarct volume predicts outcome after decompressive hemicraniectomy for malignant hemispheric stroke
Authors: Hecht Nils , Neugebauer Hermann , Fiss Ingo , Pinczolits Alexandra , Vajkoczy Peter , Jüttler Eric , Woitzik Johannes
Published: July 2017

The decision to perform decompressive hemicraniectomy (DHC) by default in malignant hemispheric stroke (MHS) remains controversial. Even under ideal conditions, DHC usually results in moderate to severe disability. The present study for the first time uses neuroimaging to identify independent outcome predictors in a prospective cohort of 96 MHS patients undergoing DHC. The primary outcome was functional status according to the modified Rankin Scale (mRS) at 12 months and categorized as favorable (mRS 0–3) or unfavorable (mRS 4–6). At 12 months, 19 patients (20%) reached favorable and 77 patients (80%) unfavorable outcome. The overall mean infarct volume was 328 ± 114 ml. Multivariable logistic regression identified age per year (OR 1.14, 95% CI 1.04–1.24; p = 0.005), infarct volume per cm3 (OR 1.012, 95% CI 1.003–1.022; p = 0.013), thalamic involvement (OR 8.65, 95% CI 1.04–72.15; p = 0.046) and postoperative pneumonia (OR 5.52, 95% CI 1.03–29.57; p = 0.046) as independent outcome predictors, which was confirmed by multivariable ordinal regression for age ( p = 0.004) and infarct volume ( p = 0.015). The infarct volume threshold for reasonable prediction of unfavorable outcome in our patients was 270 cm3, which in the future may help prognostication and development of clinical trials on DHC and outcome in MHS.
A Discrete Event Simulation Model of Patient Flow in a General Hospital Incorporating Infection Control Policy for Methicillin-Resistant Staphylococcus Aureus (MRSA) and Vancomycin-Resistant Enterococcus (VRE)
Authors: Shenoy Erica S. , Lee Hang , Ryan Erin E. , Hou Taige , Walensky Rochelle P. , Ware Winston , Hooper David C.
Published: July 2017

Background. Hospitalized patients are assigned to available staffed beds based on patient acuity and services required. In hospitals with double-occupancy rooms, patients must be additionally matched by gender. Patients with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) must be bedded in single-occupancy rooms or cohorted with other patients with similar MRSA/VRE flags. Methods. We developed a discrete event simulation (DES) model of patient flow through an acute care hospital. Patients are matched to beds based on acuity, service, gender, and known MRSA/VRE colonization. Outcomes included time to bed arrival, length of stay, patient-bed acuity mismatches, occupancy, idle beds, acuity-related transfers, rooms with discordant MRSA/VRE colonization, and transmission due to discordant colonization. Results. Observed outcomes were well-approximated by model-generated outcomes for time-to-bed arrival (6.7 v. 6.2 to 6.5 h) and length of stay (3.3 v. 2.9 to 3.0 days), with overlapping 90% coverage intervals. Patient-bed acuity mismatches, where patient acuity exceeded bed acuity and where patient acuity was lower than bed acuity, ranged from 0.6 to 0.9 and 8.6 to 11.1 mismatches per h, respectively. Values for observed occupancy, total idle beds, and acuity-related transfers compared favorably to model-predicted values (91% v. 86% to 87% occupancy, 15.1 v. 14.3 to 15.7 total idle beds, and 27.2 v. 22.6 to 23.7 transfers). Rooms with discordant colonization status and transmission due to discordance were modeled without an observed value for comparison. One-way and multi-way sensitivity analyses were performed for idle beds and rooms with discordant colonization. Conclusions. We developed and validated a DES model of patient flow incorporating MRSA/VRE flags. The model allowed for quantification of the substantial impact of MRSA/VRE flags on hospital efficiency and potentially avoidable nosocomial transmission.
No Rest for the Wicked
Authors: Koch Matthias , Orazi Davide Christian
Published: July 2017

Wicked consumption behavior, namely the inflated consumption of unhealthy commodities such as tobacco and soft drinks, constitutes a leading risk for noncommunicable diseases including cancer and diabetes. Despite the fatal impact of wicked consumption on societal welfare, both the social marketing literature and the public policy literature lack a systematic framework capturing the unfolding of the wicked consumption cycle and providing guidance on when and how to intervene upstream. Drawing on historical data on tobacco and soft drink consumption in the U.S., we propose a four-stage epidemic life cycle of wicked consumer behavior. The biological and habitual factors that make different types of wicked consumption appealing to consumers are reinforced by the marketing activities of the manufacturers. To overcome the strong resistance posed by habitual wicked consumption, we articulate a typology of upstream intervention parameters and provide guidance on when and how to intervene depending on the desired long-term equilibrium.
A study measuring the impact of shared decision making in a human-robot team
Authors: Azhar Mohammad Q , Sklar Elizabeth I
Published: July 2017

This paper presents the results of a user study in which the impact of sharing decision making in a human-robot team was measured. In the experiments outlined here, a human and robot play a game together in which the robot searches an arena for items, with input from the human, and the human-robot team earns points for finding and correctly identifying the items. The user study reported here involved 60 human subjects. Each subject interacted with two different robots. With one robot, the human acted as a supervisor: the human issued commands and the robot obeyed. With the other robot, the human acted as a collaborator: the human and robot shared decisions and were required to reach agreement about the robot’s actions in the arena before any actions were taken, facilitated using computational argumentation. Objective performance metrics were collected and analyzed for both types of human-robot team, as well subjective feedback from human subjects regarding attitudes toward working with a robot. The objective results showed significant improvement in performance metrics with the human-as-collaborator pairs versus the human-as-supervisor pairs. Subjective results demonstrated significant differences across many subjective measures and indicated a distinct preference for the human-as-collaborator mode. The primary contribution of this work lies in the demonstration and evaluation of a computational argumentation approach to human-robot interaction, particularly in proving the efficacy of this approach over a less autonomous mode of interaction.
Making sense of music: Meanings 10- to 18-year-olds attach to experimenter-selected musical materials
Authors: Herbert Ruth , Dibben Nicola
Published: July 2017

What do young people hear when listening to music? Despite substantial literature addressing children and teenagers’ use and experience of music, little research has focused on their holistic (both intra- and extra-musical) understanding. This article reports on the third stage of a mixed-method nationwide UK enquiry concerning young people’s subjective experiences of music. This stage focused on meanings 10- to 18-year-olds attach to music. Participants from varied socio-demographic and music backgrounds ( N = 84) listened to 20 short musical extracts through headphones, to which they gave free written responses. Their reports highlight shared cultural references, and the prevalence of perceived meanings indirectly related to or detached from the original musical source. Individual differences in age and training mediated musical meaning-making: 10- to 12-year-olds were most likely to report induced affect, employ self-reference (including self-in-scenario visualisations), and demonstrate vicarious experience through music. Increases in analytical listening, apparent from c. 15 years of age were primarily training-related. Participants aged 16 and above tended towards evaluative, detached modes of reporting, regardless of musical training level. Findings demonstrate that holistic understanding of music is subject to significant flux across adolescence.
Detroit and the political origins of ‘broken windows’ policing
Authors: Jay Mark , Conklin Philip
Published: July 2017

The authors argue that ‘broken windows’ policing strategies, promoted officially as a means of reducing crime, though criticised by liberals for the potentially discriminatory impact on non-whites, should rather be viewed as an integral component of the state’s attempts to coercively manage the contradictions of capitalism. Taking issue with Wacquant, they stress the need to situate policing strategies in terms of the resistances waged by racialised surplus populations. Examining Detroit, they provide a history, spanning the years between the Great Depression and the aftermath of the Great Rebellion in 1967, which was, at the time, the largest civil uprising in US history, to contextualise the introduction of stop-and-frisk in the mid-1960s. This policy, they argue, was predominantly part of an attempt to contain and repress the political threat emerging from the active and reserve sections of the black working class. They go on to analyse the ‘broken windows’ strategies in contemporary Detroit so as to situate them in relationship to other processes in the now bankrupt Motor City, such as home foreclosures, water shutoffs, and investment and gentrification in the greater downtown area.
Offending, Adjudication, and Outcome Patterns of Solo Male, Solo Female, and Partnered Mass Murderers
Authors: Gurian Elizabeth A.
Published: July 2017

Research on mass murder is limited due to differences in definitions (particularly with respect to victim count), as well as categorizations based on motive. These limitations restrict our understanding of the offending, adjudication, and outcome patterns of these offenders and can obscure potential underlying similarities to comparable types of offenders (e.g., lone actors or terrorists). To address some of these limitations, this research study, which includes an international sample of 434 cases (455 total offenders), uses descriptive and empirical analyses of solo male, solo female, and partnered mass murderers (teams of two or more) to explore offending, adjudication, and outcome patterns among these different types offenders. While the results from this research study support much previous mass murder research, the findings also emphasize the importance of large international sample sizes, objective categorizations, and the use of empirically based analyses to further advance our understanding of these offenders.
Beyond the Apparent
Authors: Guha Ambalika
Published: July 2017

The existing historiography on medicalisation of childbirth in India has overemphasised the role of female doctors in introducing Western medical ideas and practices pertaining to childbirth into the Indian zenana (secluded sections of respectable Indian households inhabited by females) and, hence, has uncritically assumed the absence of male involvement in midwifery as an unquestionable historical fact. Using Bengal as an example, this article will demonstrate that the medicalisation of childbirth was not single-handedly brought about by women doctors but was preceded by the constitution of a medical discourse on midwifery: a process enabled by the inclusion of midwifery in the medical curriculum of Calcutta University in the mid-nineteenth century under the guidance of the medical faculty of the Calcutta Medical College consisting entirely of male doctors, both indigenous and British. This article seeks to analyse the role of male doctors not in terms of the extent of their accessibility to the upper caste purdah women but by highlighting their instrumentality in buttressing the scientific and theoretical foundations of midwifery. It will account for the sustained presence of male physicians in multiple roles of professors, researchers, composers of reproductive tracts and nationalists in the late nineteenth and early twentieth centuries.
The Dutch East India Company through the Local Lens
Authors: Sur Byapti
Published: July 2017

The Dutch East India Company (VOC) shared a history of two hundred years of coexistence with the locals in Bengal. And yet their official reports had little to say about this relation, except frequent complaints against the locals and the accompanying, inherent distrust. There has been, however, a significant amount of historiography that has developed in the recent decades on Indo-Dutch contacts based on the information available in the sources. This article aims to add more nuances to these dynamics, by showing how the Company and its officials were seen by the locals in Bengal. It argues that the local–Dutch relation had not just been about static characterisations of ‘partnership’, ‘cooperation’ or ‘conflict’, but was rather dependant on personal networks and profit motives backed by diverse social positions. The Dutch in the perception of the locals had different meanings, images and implications. Through the study of three objects—local texts, a Dutch painting and a legal case—this article aims to capture precisely these very perceptions in contributing towards the complex of Indo-Dutch interactions in seventeenth century Bengal.
Elephant and ant: The social and cognitive organization of computer simulation
Authors: Lenhard Johannes
Published: July 2017

The text comprises two main parts. The first part reflects on the status of simulation as scientific instrument and clarifies the relationship between modeling and instrumentation. The second part aims at investigating how simulation is organized. My main claim is that a turning point for simulation occurred around 1990 that signals a new quality of simulation in terms of its social and cognitive organization. Computational chemistry will serve as primary example. So-called density functional theory (DFT) has not yet received much attention from the side of science studies, whereas the 1990s turn propelled it into the arguably most widely used theory in all of chemistry and physics. This success, I argue, is based on networked and cheaply accessible computers as well as on how DFT is socially and cognitively organized, much like the power of ants depends on their organization.
The Equation of Exchange: A Derivation
Authors: Hunte C. Kenrick
Published: July 2017

This paper provides a theoretically plausible model to explain the equation of exchange, deriving it from an agent's utility maximization problem and the profit maximizing behavior of a competitive firm. It shows that the marginal propensity to consume is constant, while the average propensity to consume is decreasing as income increases. Supporting the notion that consumption growth is positively related to income growth, it confirms that the marginal propensity to consume has a theoretical basis for modifying velocity, money demand and consumption, given that money demand is inversely related to the interest rate and positively related to income.
An Investigation of Underwriting Fees for Asset-Backed Securities
Authors: Puskar David , Gottesman Aron A.
Published: July 2017

This paper uses a proprietary database of asset-backed securities (ABS) to make two contributions to the literature: A detailed descriptive analysis of the ABS market and an investigation of the factors that influence underwriting fees in the ABS market. Using methodology similar to that used in Livingston and Miller (2000), evidence is provided that that the relation between underwriter prestige and underwriter fees is positive. Further, evidence is provided that the relation between underwriter fees and loyalty is positive, indicating that the more an issuer uses the same underwriter, the higher the fees that the issuer is charged.
Optimal Pricing for Voice Mail Services: A Comment
Authors: Boyd David W.
Published: July 2017

The presence of voice mail services not only increases the likelihood of a successful communication between two callers, it also creates additional calls, which can increase telecommunications company revenue. If voice mail is available to both parties, a voice mail message spawns return calls, some of which may also be diverted to voice mail. These back-and-forth calls are a multiple of the number of initial calls placed by the initiating party. Because voice mail increases the number of calls made, it may be possible that the telecommunications company increases its profits by making voice mail available to its customers.
Design of Knitted Fabric Reinforced Composites
Authors: Wu Wei Liang , Hamada Hiroyuki , Koraki Masaya , Maekawa Zenichiro
Published: July 2017

The authors focused on designing the mechanical properties of knitted fabrics as reinforcement and knitted structural composites, including warp knit and weft knit. Tlwo parts are described in this paper: one is the design of the deformed state of knitted fabric as the reinforcement in knitted structural composites; the other is the concept of design of parameters which influence the mechanical properties of knitted structural composites.
Laminate Temperature Distributions and Filling Tine Prediction during Non-Isothermal Impregnation of Fibre Preforms
Authors: Lebrun G. , Rudd C. D. , Gauvin R.
Published: July 2017

The resin temperature distributions in a heated mould during the impregnation stage of resin transfer moulding have been investigated in this work. Effects such as the fibre content, the filling time and the mould and preform temperatures have been evaluated. It was shown that the fibre content and the filling time effects on the resin temperature distributions are less significant than the mould and preform temperatures. It was also shown that approximately 70% of the resin temperature increase is obtained within a flow path length of 12.5 cm. These trends led to the development of an empirical relation used to evaluate the influence on fill times of non-isothermal effects during filling.
Energy Absorption Characteristics of Knitted Fabric Reinforced Epoxy Composite Tubes
Authors: Ramakrishna S.
Published: July 2017

This paper describes the energy absorption behaviors of knitted glass fiber fabric/epoxy and knitted carbon fiber fabric/epoxy composite tubes. The effects of fiber content, fiber orientation and testing speed on the crush zone morphology and specific energy absorption capability are discussed. Attempts have been made to relate the energy absorption capability to the crush zone morphology.
Local Buckling of Pultruded FRP Beams-Analysis and Design
Authors: Bank Lawrence C. , Gentry T. Russell , Nadipelli Murali
Published: July 2017

An investigation of the local compression flange buckling and failure of pultruded fiber-reinforced plastic (FRP) beams is described in this paper. Results of tests on commercially produced pultruded E-glass/polyester and E-glass/vinylester composite material wide-flange I-beams are described. The beams were tested in a four-point bending configuration in a specially designed fixture which was designed to cause local buckling and ultimate failure of the compression flange of the beams and to avoid global lateraltorsional buckling and local web failure. All beams were monitored with strain gages and LVDTs. Buckling loads, failure loads, buckling stresses, deflections and failure modes are reported. Standard and "customized" pultruded beams in the 8 inch (203 mm) series were tested. Based on an analysis of the performance of the standard 8 x 8 x 3/8 in. (203 x 203 x 9.5 mm) beams, two 8 x 8 x 3/8 in. (203 x 203 x 9.5 mm) beams were "customized." In these "customized" beams the fillet region at the flange and web intersection was altered in order to increase its strength and the rotational stiffness. Analysis of the test results of the customized beams indicated that significant increases in load carrying capacity of pultruded beams can be achieved with minor geometry and fiber architecture modifications to the standard beams. A discussion of the differences in buckling and failure characteristics of the beams based on their resins, sizes, and custom modifications is provided.
Application of Piezoelectric Paints to Damage Detection in Structural Materials
Authors: Egusa Shigenori , Iwasawa Naozumi
Published: July 2017

Piezoelectric paints were prepared using lead zirconate titanate (PZT) ceramic powder as a pigment and epoxy resin as a binder. The obtained paints were coated on aluminum plates and were cured at room temperature, thus forming the paint films having thicknesses of 25 to 300 /tm and a PZT volume fraction of 53%. These films were then poled at room temperature, and were evaluated with regard to the sensitivity as an acoustic emission sensor in the frequency range of 0-1.2 MHz. The paint film sensitivity obtained at a given poling field depends on the film thickness, even after being normalized by dividing by the film thickness. The current-voltage characteristic of the paint film reveals that the film-thickness dependence of the normalized sensitivity is interpreted in terms of the space-charge buildup at the PZT/epoxy interface during the poling process of the paint film.
On the Stress Concentration in the Matrix Around the Fibers in Laminae
Authors: Upadhyay P. C. , Lyons D. W.
Published: July 2017

This paper is concerned with reporting of the effect of fiber volume fraction on the results of stress concentration in the matrix at the fiber-matrix interface in laminae. It adds to the results published in Reference [1] which may be considered reasonable only for very low fiber volume fractions. Four different types of fibers in epoxy matrix are considered to examine the effect of variation of the ratio of modulus of elasticity of the fiber in epoxy.
Micromechanical Analysis of Hybrid Composites
Authors: Ross G. R. , Ochoa O. O.
Published: July 2017

The response of hybrid composites to tensile and transverse loads is studied using a micromechanical analysis. Of particular interest are the effects of matrix viscoelasticity and the properties of the interphase region on the material properties and failure initiation. The tensile response of hybrid composites is studied using a statistical model in which the fiber failure strains are represented with Weibull distributions. A shear lag formulation is used to include the contribution of load transfer to broken fibers to the longitudinal modulus. The transverse tensile response is studied using the rule-ofmixtures. Linear viscoelastic matrix properties are incorporated in both analyses.

Results from the analysis indicate that the interphase properties have a negligible effect on the longitudinal failure strain and that the effect of matrix viscoelasticity on the longitudinal tensile response is negligible. The longitudinal failure strains decreased with increasing composite length and carbon to glass volume ratios. For transverse tensile loading, the stress rises more rapidly on the stress strain curve when the strain rate is increased and when the interphase moduli are higher.
On the Use of Dent Depth as an Impact Damage Metric for Thin Composite Structures
Authors: Wardle Brian L. , Lagace Paul A.
Published: July 2017

The damage resistance of thin composite structures was investigated experimentally. Specifically, surface damage in the form of dent-depth measurements are compared with internal damage states obtained by the X-radiography technique to better understand the implications of "barely visible impact damage" (BVID). Impact and quasistatic tests were conducted on plate and shell graphite/epoxy specimens between 0.804 mm and 2.412 mm thick in a [45n/10n], layup configuration. Damage was measured via visual, transducer, and X-ray methodologies. No correlation was found between internal (nonvisible) damage from the X-ray data and measured characteristics of the surface damage, specifically the depth of the dent. The results indicate that the use of dent depth as a metric can be misleading, particularly in that no dent depth can be found in some cases where substantial subsurface damage exists. Other examples are given wherein substantial (relative to other specimens) dent depths are measured with no corresponding internal damage. In previous work, peak force was found to correlate the resulting internal damage for both shell and plate specimens. However, dent depth shows no such general trend or correlation with peak force. This, coupled with previous damage tolerance work, places into question the use of dent-depth for thin (less than 2.4 mm, or 0.10") composite plate and shell structures in current damage tolerance methodologies.
Measurement of Micro-Residual Stresses in Fiber-Prestressed Composites
Authors: Motahhari Siamak , Cameron John
Published: July 2017

In the present work, micro-residual stresses are measured in fiber prestressed composites. This is carried out by evaluation of residual strains in the fibers subsequent to the curing process. The force-strain curve for the glass fiber before, during and after setting of the epoxy resin shows that some part of the fibers' strain, caused by pretension, is not recovered when the tension is removed at the end of the curing process. The unrecovered strain in the fibers is used to assess the micro-residual stresses in the composite. Experimental results indicate that the micro-residual stresses in the fibers are linear functions of the applied pretension on the fibers during cure.
Failure Analysis of Polymer Composite Stiffened Laminates Using the Finite Element Method
Authors: Goswami Sanjib
Published: July 2017

A finite element method is adopted to study the initiation of damage (ply failure) of polymer composite stiffened laminates under static loading. Lightweight and high strength advanced composite materials are nowadays extensively used in aircraft and automobile industry. These structures on various occasions are subjected to point load or uniformly distributed load. Under these loads the stress level at a point may be high enough to initiate a local failure and a reduction in strength. So, a first-ply failure analysis (initiation of damage) of plated structures are often necessary. The procedure adopted here is based on the first-order shear deformation theory and a tensor polynomial failure criteria. As a special case, Tsai-Wu failure criteria is incorporated in the computer code. A number of problems for which experimental and theoretical results are available, have been analysed in the present investigation to check the code developed, and finally, analysis of stiffened composite plate problems with various laminae orientation, stiffener eccentricity etc. have been put forward for first ply failure load as new results for future reference. The results can be compared to find the best possible ply group against failure under transverse loading. According to author's knowledge, this is perhaps the first attempt to apply first ply-failure analysis in any stiffened configuration.
Modeling and Simulation of the Solids Conveying and Unfilled Regions in Polymer Extrusion
Authors: Jaluria Yogesh , Liu Yan , Chiruvella R. V.
Published: July 2017

This paper considers the important aspects of solids conveying and unfilled channels in a single screw extruder. An analytical and numerical study is carried out to obtain the compaction of powdery material as it is conveyed downstream. The associated temperature and pressure rise are also determined. The effects of operating conditions, extruder geometry and friction factors at the surface are studied. For unfilled regions, experimental data are used to obtain an expression for the filled channel length. The flow in the filled region of the extruder is simulated to obtain the pressure and temperature rise, along with other quantities. Comparisons with experimental results on both of these aspects show good agreement. The results obtained will be useful in the simulation of the entire extrusion process.
Experimental Examination of Temperature Variations in a Hot Runner System
Authors: Buchardt Carsten , Jensen Jan Helleskov , Lauridsen Carsten L.
Published: July 2017

This paper deals with the temperature variations in a hot runner system. By use of FEM-simulations and experiments an investigation is made of the effects of different thermal conductivity's at the supported areas. This effect is analyzed by measuring the temperature and pressure in a hot runner mold.

The pressure development is measured in a specially designed 2-cavity hot runner system where temperature differences can be introduced in the two sections. The weight of the products is also measured.
Reduction of Tensile Strength in Angle-Ply Composite Laminates Due to Low-Velocity Impact
Authors: Scarponi C. , Briotti G. , Barboni R. , Marcone A.
Published: July 2017

The purpose of the present paper is to evaluate the tensile strength reduction of angle-ply composite laminates due to low-velocity impact. Three angle ply lay-up were chosen: [+30',-300]2s, [+45',-45oI2s and +60',[-60]2s. Impact tests were performed at different impact energy level and then an ultrasonic scan NDI was performed, to evaluate the internal damage. The impacted specimens were subjected to tensile load until failure occurs and the ultimate tension strength after impact was compared with the corresponding value for undamaged specimens.

Moreover, for a better understanding of the failure phenomenon, some tension tests for damaged specimens were interrupted at different load levels (respectively at 30%, 60%, 85% and 90% of the corresponding failure load) and ultrasonic scans at any step were performed to evaluate the delamination growth due to tensile load. A correlation between the amount of delamination areas and the impact energy has been determined.
The Variation of G1c and δ1c with Crack Growth Rate in Polyethylene
Authors: Bradley Walter L. , Self Robert A. , Register David , Lamborn Mark
Published: July 2017

The crack growth rate in HMN 5202 polyethylene has been studied as a function of stress intensity using deeply notched three-point bend specimens. The load-line displacement in response to a static applied load has been measured, with the material compliance as a function of time determined from the specimen compliance prior to the initiation of crack growth. Measured specimen compliance as a function of time after crack growth begins is used to determine crack growth rate as a function of stress intensity.

The experimentally determined crack growth rate as a function of stress intensity has been compared to theoretical predictions by Williams and Schapery. This comparison implies that both critical crack tip opening displacement, 61c, and critical energy release rate, GIn, increase with increasing crack growth rate. The results also show that the crack growth rate is significantly reduced by plane stress conditions at the surface of the specimen.
Successful Aging as a Predictor of Long-Term Care Among Oldest Old: The Vitality 90+ Study
Authors: Nosraty Lily , Pulkki Jutta , Raitanen Jani , Enroth Linda , Jylhä Marja
Published: July 2017

Aim: The aim of the study was to investigate whether successful aging (SA) predicts entering long-term care (LTC) among nonagenarians. Methods: Data originated from the linkage of the Vitality 90+ Study surveys with register data from Finnish Population Register and Care Registers. Altogether 1,966 community-dwelling individuals were followed for 2 years and 1,354 individuals for 5 years. Four models of SA were constructed by varying combinations of physical, psychological, and social components. Competing risk regression analysis was used. Findings: The incidence rate for entering LTC was lower for successful agers. Three models of SA presented a significantly decreased risk for entering LTC in the whole group and in women. The impact of SA was attenuated when living alone, needing help, and the year of participation were adjusted for, but was still significant for Model 3. Conclusion: Nonagenarians who meet the multidimensional criteria of SA are less likely to enter LTC than those aging less successfully.
Conceptions of Teaching
Authors: Pratt Daniel D.
Published: July 2017

From interviews of 253 adults and teachers of adults in Canada, the People's Republic of China, Hong Kong, Singapore, and the United States, five conceptions of teaching emerged: Engineering–Delivering Content; Apprenticeship–Modeling Ways of Being; Developmental–Cultivating the Intellect; Nurturing–Facilitating Personal Agency; and, Social Reform–Seeking a Better Society. Variation amongst conceptions was examined in relation to three interdependent aspects of each conception: actions, intentions, and beliefs related to one or more of five elements and the relationship amongst those elements: teacher, learner, content, context, and/or an ideal vision for society. Findings have implications for cross-cultural work, the evaluation of teaching, and the development of teachers.
Rites of Passage Among Women Reentering Higher Education
Authors: Redding Nancy P. , Dowling William D.
Published: July 2017

The purpose of this article is to review the rites of passage concept; to describe the rites developing among reentry women in both university and home environments; and, finally, to discuss the purposes of and necessity for such rites. Nineteen adult women students were interviewed in depth on the campus of a major midwestern university. Analysis of the data indicates that reentry women and their families are fashioning rites of passage peculiar to their return to higher education in quest of a degree. These rituals facilitate the transition, offer approval, and mark progress during the passage from non-degreed to degreed status. Spontaneous development of ceremonies suggests there are some needs specific to women who are simultaneously student, wife, and mother that are not being met by traditional university rituals and familial practices.
Transformation Theory: Critique and Confusion
Authors: Mezirow Jack
Published: July 2017

In the Spring, 1992 issue of AEQ, Phyllis Cunningham reviews, inter alia, my recent book, Transformative Dimensions of Adult Learning (Jossey-Bass, 1991). This book presents a comprehensive learning theory and analyzes the dynamics of how adults learn. Cunningham makes several erroneous inferences to which she takes exception. In doing so, she seriously misrepresents my meaning. In this article I clarify my position and take issue with her approach and conclusions.
Engagement of Primary Care Physicians in Home Palliative Care
Authors: Malik Shiraz , Goldman Russell , Kevork Nanor , Wentlandt Kirsten , Husain Amna , Merrow Nancy , Le Lisa W. , Zimmermann Camilla
Published: July 2017

Purpose:

To describe prevalence and characteristics associated with family physician and general practitioner (FP/GP) provision of home palliative care (HPC).

Methods:

We surveyed FP/GPs in an urban health region of Ontario, Canada, to determine their current involvement in HPC, the nature of services provided, and perceived barriers and enablers.

Results:

A total of 1439 surveys were mailed. Of the 302 FP/GP respondents, 295 provided replies regarding engagement in HPC: 101 of 295 (33%) provided HPC, 76 (26%) were engageable with further support, and 118 (40%) were not engageable regardless of support. The most substantial barrier was time to provide home visits (81%). Engaged FP/GPs were most likely to be working with another physician providing HPC ( P < .0001). Engageable FP/GPs were younger ( P = .007) and placed greater value on improved remuneration ( P < .001) than the other groups. Nonengageable physicians were most likely to view time as a barrier ( P < .0001) and to lack interest in PC ( P = .03).

Conclusion:

One-third of FP/GPs provide HPC. A cohort of younger physicians could be engageable with adequate support. Integrated practices including collaboration with specialist PC colleagues should be encouraged and supported.
Expert Discussion on Taking a Spiritual History
Authors: Paal Piret , Frick Eckhard , Roser Traugott , Jobin Guy
Published: July 2017

This article elaborates on the hazards of spiritual history taking. It provides expert insights to consider before entering the field. In summer 2012, a group of spiritual care experts were invited to discuss the complexity of taking spiritual histories in a manner of hermeneutic circle. Thematic analysis was applied to define the emerging themes. The results demonstrate that taking a spiritual history is a complex and challenging task, requiring a number of personal qualities of the interviewer, such as ‘being present’, ‘not only hearing, but listening’, ‘understanding the message beyond the words uttered’, and ‘picking up the words to respond’. To ‘establish a link of sharing’, the interviewer is expected ‘to go beyond the ethical stance of neutrality’. The latter may cause several dilemmas, such as ‘fear of causing more problems’, ‘not daring to take it further’, and above all, ‘being ambivalent about one’s role’. Interviewer has to be careful in terms of the ‘patient’s vulnerability’. To avoid causing harm, it is essential to propose ‘a follow-up contract’ that allows responding to ‘patient’s yearning for genuine care’. These findings combined with available literature suggest that the quality of spiritual history taking will remain poor unless the health-care professionals revise the meaning of spirituality and the art of caring on individual level.
Continuous Palliative Sedation for Existential Distress? A Survey of Canadian Palliative Care Physicians’ Views
Authors: Voeuk Anna , Nekolaichuk Cheryl , Fainsinger Robin , Huot Ann
Published: July 2017

Background:

Palliative sedation can be used for refractory symptoms during end-of-life care. However, continuous palliative sedation (CPS) for existential distress remains controversial due to difficulty determining when this distress is refractory.

Objectives:

The aim was to determine the opinions and practices of Canadian palliative care physicians regarding CPS for existential distress.

Methods:

A survey focusing on experience and views regarding CPS for existential distress was sent to 322 members of the Canadian Society of Palliative Care Physicians.

Results:

Eighty-one surveys returned (accessible target, 314), resulting in a response rate of 26%. One third (31%) of the respondents reported providing CPS for existential distress. On a 5-point Likert-type scale, 40% of participants disagreed, while 43% agreed that CPS could be used for existential distress alone.

Conclusion:

Differing opinions exist regarding this complex and potentially controversial issue, necessitating the education of health-care professionals and increased awareness within the general public.
Interference Between Family Caregivers’ Mental Disorders and Their Estimates of Quality of Dying and Death (QODD) of Their Loved Ones
Authors: Heckel Maria , Bussmann Sonja , Weber Martin , Ostgathe Christoph , Stiel Stephanie
Published: July 2017

Background:

In studies enrolling informal caregivers of patients in palliative care, it is necessary to ensure that findings are not influenced by factors such as mental disorders.

Aim:

This study aims to describe the influence of anxiety and depression on bereaved informal caregivers’ retrospective ratings of the quality of dying and death (QoDD) of their loved ones.

Design:

Informal caregivers of deceased patients from 2 German palliative care (PC) units took part in a validation study of the German version of the original QoDD-Deutsch-Angehörige (QoDD-D-Ang) during the fourth week following the patient’s death at the earliest. Depressive and panic disorders were assessed via the Patient Health Questionnaire (PHQ). Group comparisons (χ2, t test; significance level P < .05) analyzed whether informal caregivers with depression or panic disorders and those without such disorders differ in their estimates.

Results:

A total of 226 informal caregivers participated between August 2012 and December 2013. The mean age of participants was 55.5 years; 61.1% were female. The PHQ of 221 participants resulted in 8.6% with major disorders, 13.6% with other depressive syndromes, and 77.8% without depressive disorders. In this secondary data analysis here, there was no difference between female and male participants concerning the incidence of depression ( P = .519, χ2). Two participants screened positive for both panic and major depressive disorders. Both groups presented no significant differences in the mean total QoDD-D-Ang scores ( P = .343).

Conclusion:

Informal caregivers’ estimates on the QoDD-D-Ang of their significant others do not interfere with mental disorders. Therefore, bereaved informal caregivers are able to participate in the PC research after a few weeks following the loss of a loved one.
Parenteral Nutrition Errors and Potential Errors Reported Over the Past 10 Years
Authors: Guenter Peggi , Ayers Phil , Boullata Joseph I. , Gura Kathleen M. , Holcombe Beverly , Sacks Gordon S.
Published: July 2017

Parenteral nutrition (PN) is a complex, high‐alert medication, and errors associated with the use of this therapy may lead to significant harm to patients. This document reviews error reports from the Institute for Safe Medication Practices’ Medication Errors Reporting Program that are associated with the PN use process over the past 10 years. Actual PN‐related errors are outlined, with most occurring in the PN‐compounding/dispensing and PN administration steps. Clinicians involved in any phase of the PN use process should review their institutional or homecare company's processes for reporting of PN errors and collaborate with their medical safety officer and/or committees involved with medication error reporting.
Patients With Vasculitides Admitted to the Intensive Care Unit: Implications From a Single-Center Retrospective Study
Authors: Haviv Yael , Shovman Ora , Bragazzi Nicola Luigi , Sharif Kassem , Yavne Yarden , Shoenfeld Yehuda , Amital Howard , Watad Abdulla
Published: July 2017

Background:

Vasculitides are a group of disorders characterized by inflammation of vessels. Vasculitides may have life-threatening complications with significant morbidity and mortality; however, information regarding the outcome and prognosis of patients with vasculitides requiring intensive care unit (ICU) is scarce.

Methods:

Data of patients with vasculitides admitted to the ICU of the Sheba Medical Center between the years 2000 and 2014 were retrieved retrospectively. Continuous variables were computed as mean (standard deviation), whereas categorical variables were recorded as percentages. In order to investigate the impact of clinical variables on mortality, Student t test and χ2 analyses were performed.

Results:

Twenty-five patients with vasculitides were admitted to the ICU during the study period with mean age of 52 ± 14 years and sex ratio of male/female: 12/13. The mortality rate among these patients was 48%. Leading causes for ICU admission were infection (64%), disease exacerbation (34%), and hemorrhage (16%), while respiratory or cardiovascular involvement accounted for the majority of mortality during admission. An elevated Sequential Organ Failure Assessment (SOFA) score was significantly associated with mortality ( P = .041).

Conclusion:

Our study confirms the high mortality rate among patients with vasculitides who require ICU care as well as the roles of infection and disease flare-up as causes for admission. An elevated SOFA score was found to be predictive of mortality.
Hair growth promoting activity of discarded biocomposite keratin extract
Authors: Akanda Md Rashedunnabi , Kim Hak-Yong , Park Mira , Kim In-Shik , Ahn Dongchoon , Tae Hyun-Jin , Park Byung-Yong
Published: July 2017

Keratin biomaterial has been used in regenerative medicine owing to its in-vivo and in-vitro biocompatibility. The present study was aimed to investigate the hair growth promoting activity of keratin extract and its mechanism of action. Keratin extract was topically applied on the synchronized depilated dorsal skin of telogenic C57BL/6 mice and promoted hair growth by inducing the anagen phase. The histomorphometric observation indicated significantly increases the number, shaft of hair follicles and deep subcutis area in the keratin extract treated group in contrast to the control group, which was considered an indication of anagen phase induction. Subsequently, the quantitative real-time polymerase chain reaction analysis revealed that fibroblast growth factor-10, vascular endothelial growth factor, insulin-like growth factor-1, β-catenin, and Shh were expressed earlier in the keratin extract-treated group than in the control group. Besides, keratin extract has been observed to be biocompatible when analyzed with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and 4’,6-diamidino-2-phenylindole staining using immortalized human keratinocyte cells, showing more than 90% cell viability. Our study demonstrated that keratin extract stimulating hair follicle growth by inducing the growth phase; anagen in telogenic C57BL/6 mice and thus the topical application of keratin extract may represent a promising biomaterial for the management and applications of hair follicle disorder.
Discursive Positioning and Collective Resistance: How Managers Can Unwittingly Co-Create Team Resistance
Authors: Zanin Alaina C. , Bisel Ryan S.
Published: July 2017

This ethnographic study describes how authority figures may unwittingly invite and co-create a team’s collective resistance in response to their actions. The study documents two pivotal organizational communication episodes experienced by two separate teams within a Collegiate Division I Athletic Department. A positioning analysis of the episodes revealed how a specific speech act (what we label “ managerial inquisition”) partially facilitated athletes’ collective resistance to coaching staff. Our analysis suggested that coaches’ directives implicated team members’ identity needs and moral obligations to one another, which either encouraged or discouraged collective resistance to emerge within the unfolding discourse. This essay contributes to the team and organizational resistance literature by documenting how resistance can be co-created by management during control attempts.
Source–Target Relationship and Information Specificity
Authors: Rui Jian Raymond
Published: July 2017

Other-generated information about specific targets available online reduces third parties’ uncertainty of strangers. Yet only information perceived as credible can shape their impressions. This study examines how impressions form after exposure to online recommendations, a type of other-generated information via LinkedIn, through credibility assessment of these recommendations. The source–target relationship and recommendation specificity were manipulated in a 2 × 2 between-subjects experiment ( N = 213). Main effects for both independent variables were found. Perceived manipulation likelihood and perceived credibility of recommendation mediated the impact of the source–target relationship on impressions. Additionally, perceived familiarity with the target and perceived credibility of recommendation mediated the impact of recommendation specificity on impressions. This study extends warranting theory and highlights the impact of new communication technology on credibility assessment of online information and impression formation.