bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of chemical funcionalization of carbon nanoparticles in epoxy matrices
Authors: Bello Roger H , Coelho Luiz AF , Becker Daniela
Published: May 2017

The effects of the silanization of multi-walled carbon nanotubes and graphene nanoplatelets with 3-APTES on thermal, mechanical and electrical properties of epoxy nanocomposites were investigated. Nanocomposites containing pristine, oxidized and silanized nanoparticles of multi-walled carbon nanotubes or graphene nanoplatelets at two different concentrations (0.15 and 0.50 vol.%) were prepared by in situ polymerization without using solvents. The functionalized nanoparticles were characterized by Fourier-transform infrared, X-ray photoelectron spectroscopy, Raman spectroscopy and transmission electron microscope techniques. The oxidation and the silanization on the surface of both nanoparticles were confirmed by Fourier-transform infrared, X-ray photoelectron spectroscopy, Raman and transmission electron microscope analysis. The thermal properties of all studied materials were analyzed by differential scanning calorimetry and the mechanical properties by nanoindentation. The addition of both nanoparticles (pristine and functionalized) into the matrix did not show significant variations on thermal properties, but decreased values for glass transition temperature (Tg) compared to the neat resin. Higher values for modulus of elasticity and hardness of epoxy/nanocomposites were obtained when silanized multi-walled carbon nanotubes or oxidized graphene nanoplatelets were added into the matrix. Adding 0.15 vol.% of silanized multi-walled carbon nanotubes the modulus of elasticity increased in approximately 60%, whereas 0.50 vol.% this increase was greater than 90% compared to the neat resin. While adding 0.15 vol.% of oxidized graphene nanoplatelets, the modulus of elasticity increased approximately 83%, whereas 0.50 vol.% this increase was greater than 88% compared to the neat resin. The formation of percolating networks has been achieved only by pristine multi-walled carbon nanotubes addition at a concentration of 0.50 vol.% and by silanized graphene nanoplatelets at a concentration of 0.15 vol.%. However, for both carbon-based nanoparticles conductivities on the order of 10−7 S/m for frequencies near 100 Hz were observed.
Potential Use of Ayahuasca in Grief Therapy
Authors: González Débora , Carvalho María , Cantillo Jordi , Aixalá Marc , Farré Magí
Published: May 2017

The death of a loved one is ultimately a universal experience. However, conventional interventions employed for people suffering with uncomplicated grief have gathered little empirical support. The present study aimed to explore the potential effects of ayahuasca on grief. We compared 30 people who had taken ayahuasca with 30 people who had attended peer-support groups, measuring level of grief and experiential avoidance. We also examined themes in participant responses to an open-ended question regarding their experiences with ayahuasca. The ayahuasca group presented a lower level of grief in the Present Feelings Scale of Texas Revised Inventory of Grief, showing benefits in some psychological and interpersonal dimensions. Qualitative responses described experiences of emotional release, biographical memories, and experiences of contact with the deceased. Additionally, some benefits were identified regarding the ayahuasca experiences. These results provide preliminary data about the potential of ayahuasca as a therapeutic tool in treatments for grief.
Choosing between Models of Choosing between Sequences: Comments on Shidoji (1993)
Authors: Rosenbaum David A.
Published: May 2017

Previous studies have used a sequence choice procedure to explore the cognitive representations of forthcoming response sequences. Subjects choose as quickly as possible between memorized sequences, and differences in the choice reaction time for a given sequence as a function of the other possible sequence are used to model the structures and processes underlying the choice. In 1993 Shidoji reported experiments to distinguish between two models of choice. One model assumes a hierarchical editing process. The other model assumes that choice time depends only on the total number of responses in the sequences to be distinguished. Shidoji argued that his data supported both models. He also suggested boundary conditions for the applicability of each model. I argue that the hierarchical editor model can account successfully for Shidoji's results.
A Cross-Cultural Perspective on Adolescent Girls' Body Perception
Authors: Smith Delores E. , Cogswell Carolyn
Published: May 2017

The purpose of the study was to examine the body perception of 122 Jamaican adolescent girls. The study is a part of a larger project investigating the psychosocial adjustment of these adolescents. Included in the survey were items asking for demographic information such as height, weight, and age. In addition, subjects were asked to indicate whether they were pregnant and whether they considered themselves under- or overweight. Using the standard system of desirable weight the subjects' perceptions of whether they were under- or overweight were compared with their actual weights. In general, Jamaican adolescent girls had accurate perceptions of their body size and weight.
Perseveration in Healthy Subjects: An Impressive Classroom Demonstration for Educational Purposes
Authors: Brugger Peter , Gardner Martin
Published: May 2017

Perseveration, that is, the inappropriate maintenance of an activity, is not exclusively observed in patients with brain pathology. We present a brief calculation task that requires healthy subjects to add eight numbers sequentially. While the first seven steps of the addition involve the repeated application of a particular rule, this rule does not apply for the last step. However, a high percentage of subjects (approximately 70%) will commit a perseverative error at this last step and hence obtain an incorrect final result. This simple task is a highly informative illustration of the principle of perseverative behavior. When applied in a classroom setting, it is an impressive demonstration of the ease with which perseveration can be evoked in healthy persons.
Re-Examination of Arousing and De-Arousing Effects of Cigarette Smoking
Authors: Hori Tadao , Hayashi Mitsuo , Oka Masami , Agari Ichiro , Kawabe Kunihiko , Takagi Masato
Published: May 2017

An attempt was made to replicate arousing and de-arousing effects of cigarette smoking originally reported by Golding and Mangan. Changes in electrodermal activity, heart rate, and magnitude in the EEG alpha (7.5—11.5 Hz) and beta (13.5—20 Hz) bands were measured under conditions of both mild sensory isolation as well as stress induced by loud white-noise. Under both conditions, real smoking as well as sham smoking an unlit cigarette increased beta activity and the skin potential response. In contrast, only real smoking produced a significant increase in heart rate, decrease in alpha activity, and increase in skin potential. De-arousing effects reported by Golding and Mangan for white-noise stress were not replicated.
Relationship between Cognitive Processing Style and Academic Achievement
Authors: Martinetti Raymond F.
Published: May 2017

3 groups of 36 undergraduate students with low, average, and high grade point averages differed in cognitive style. High achievers scored high on amount and enjoyment of imaginal life and low on suppression. Low achievers exhibited the opposite tendency.
Accident Locus of Control and Risk Taking among Forestry and Construction Workers
Authors: Salminen Simo , Klen Tapio
Published: May 2017

228 forestry and 45 construction workers completed the Accident Locus of Control scale which is a modified version of the Health Locus of Control inventory. The forestry workers scored as having a more external locus of control than the construction workers. In both professional groups the subjects with higher scores on external locus of control tended to take more risks than the subjects with higher scores on internal locus of control. The results support a dual-dimensional view of control rather than a unidimensional view.
Influence of an Added Perceptual Motor Task on Perceived Exertion: A Test of the Dissociation Effect
Authors: Delignières D. , Brisswalter J.
Published: May 2017

This experiment showed that adding a perceptual motor task to an effort session on a cycloergometer for 4 men and 4 women led to an increase in perceived exertion. This effect is opposite to the dissociative effect classically reported in the literature. These contrasting results are analyzed according to the rate of processing imposed by the added task.
Astrological Cuspal Days and Births and Deaths of Suicides
Authors: Lester David
Published: May 2017

Using a sample of 334 famous suicides, evidence was found suggesting a greater incidence of suicidal deaths on astrological cuspal days than would be expected by chance.
Effects of Speaking Speed on Cerebral Lateralization of Speech Assessed by a Dual-Task Interference Paradigm
Authors: Clarici Andrea , Fabbro Franco , Bava Antonio , Darò Valeria
Published: May 2017

Cerebral asymmetry for speech was assessed by means of a verbal-manual interference paradigm in a sample of 16 right-handed men at two different speaking rates. Normal speech rate disrupted the right hand significantly more than the left, whereas increased speech rate showed no differences between right and left hands during verbal-manual interference tasks. This result suggests a role of speaking speed in modifying cerebral motor functions related to speech production.
Injury, Anxiety, and Mood in Competitive Gymnasts
Authors: Kolt Gregory S. , Kirkby Robert J.
Published: May 2017

Psychological factors related to injury were investigated in 115 competitive gymnasts. The subjects were administered the Profile of Mood States-Bipolar Form (POMS-BI) and Competitive State Anxiety Inventory-2 (CSAI-2). Direct discriminant function analysis showed that the best predictors for distinguishing between gymnasts with four or more injuries and those with fewer than four injuries were CSAI-2 Cognitive Anxiety and the POMS-BI Composed-Anxious and Energetic-Tired scores. The more-injured gymnasts were more anxious and tired, and reported higher scores on the CSAI-2 Cognitive Anxiety scale. Males could be differentiated from females by scores on the CSAI-2 Self-confidence and the POMS-BI Composed-Anxious, Confident-Unsure, Energetic-Tired, and Clearheaded-Confused scales. The female gymnasts were more anxious, unsure, tired, and confused, and reported lower levels of CSAI-2 Self-confidence. The findings were interpreted as further evidence of the anxiety-injury link in athletes.
Effect of Visual Complexity in Identification of Tachistoscopic Images
Authors: Geheb Robert , Whitfield Keith E. , Brannon Linda
Published: May 2017

The present study of gender differences in hemispheric processing involved identification of tachistoscopically presented images of varying complexity. A computerized tachistoscopic program was administered to 24 men and 34 women. Time to identify contour and detailed pictures presented to the left or right cerebral hemisphere was recorded. Mean reaction time for contour pictures was significantly faster than for detailed pictures, and mean reaction time to the right hemisphere was significantly faster than that to the left hemisphere. The mean reaction time for men to identify pictures exposed to the left hemisphere was significantly slower than that for exposure to the right hemisphere for women. The mean reaction time for both men and women to identify contour pictures exposed to the right hemisphere was significantly faster than the mean time to identify detailed pictures presented to the left hemisphere. The interaction of gender, hemisphere, and complexity was also significant in that mean reaction times for men to identify detailed pictures presented to the left hemisphere were slower than the times for women to identify contour pictures presented to the right hemisphere. The results are discussed in relation to theories about hemispheres, gender, and differences in picture features.
Selected Motor Skills of Mentally Retarded and Nonretarded Individuals
Authors: Kioumourtzoglou Efthimis , Batsiou Sofia , Theodorakis Yannis , Mauromatis Giorgos
Published: May 2017

The aim of this study was to examine whether mentally retarded individuals show a specific motor performance deficit on measures of reaction time, aiming, and dexterity. 23 mentally retarded adolescents and two control groups of 22 non-retarded persons of the same mental age and 20 nonretarded persons of the same chronological age were tested. Motor performance measures for retarded persons were considerably longer than those of nonretarded persons of the same chronological age and of the same mental age. Only time of finger dexterity with short pins was longer for the retarded than for the nonretarded adolescents of the same mental age. Reaction times across groups were faster for the sound than for the light signal. No difference in RT for fine movement was observed. Differences among the various motor performance measures for retarded and nonretarded subjects are confirmed.
Analysis of Data from Reichler's (1979) the Baseball Encyclopedia: Right-Handed Pitchers are Taller and Heavier than Left-Handed Pitchers
Authors: Fudin Robert , Renninger Lesley , Hirshon Jordon
Published: May 2017

In 1989 Coren concluded right-handed Major League pitchers whose careers began up to 1975 are significantly taller and heavier than left-handed pitchers. His source of data, Reichler's 1979 edition of The Baseball Encyclopedia, however, lists heights and weights for pitchers whose careers began through 1978 and for individuals who pitched but who almost always appeared at a different position or positions. Coren did not indicate why he did not analyze all of the relevant data in Reichler nor did he explain how he decided that an individual's usual position was that of pitcher. Further, there is evidence from Topp which suggests that the era during which the pitchers began their careers should be considered when comparing their heights and weights because relatively recent rookies (from 1980 through 1986) are taller and heavier than rookies who began their careers 50 and 100 years prior to that era. Classifying an individual as a pitcher if he pitched in at least 50% of the games in which he played at a position, using all relevant data in Reichler, and considering the era during which dextral and sinistral pitchers began their careers, we found strong corroborative evidence for Coren's 1989 findings.
The importance of “place” in Book Five of the Psalter
Authors: deClaissé-Walford Nancy
Published: May 2017

In August of 2016, the Faculty of Theology at the University of Pretoria in South Africa held a joint conference with the University’s Faculty of Law on the topic of “Land and Land Rights in South Africa.” Restitution of land to those displaced by the settlement of non-Africans in South Africa became a topic at the end of apartheid, and it is still an issue today. The conference in Pretoria was very enlightening and highlighted the difficult issues, legal, ethical, financial, and so forth, surrounding the topic. As a student of the book of Psalms, I offered an examination of the concept of land in Book Five of the Psalter. Herewith, I offer what I presented at that conference, an alternative way to consider “land ownership” in today’s society. I pray that it will in some way resonate with various issues that face our world today.
Preaching incarnation, incarnational preaching: The witness of limitation
Authors: Sayles Guy
Published: May 2017

Preaching the incarnation entails acknowledging and exploring the implications of bodily existence. Such preaching affirms that embodied life calls for ethical concern and reflection. The body is not, for Christian faith, merely a container for a “soul”; instead, the body is essential to, and constitutive of, human personhood. The doctrine of incarnation says that divinity became known in humanity, including the singular and limited bodily life of Jesus. Incarnational preaching is confident that human limitations are a crucible of revelation.
What is truth? The complicated characterization of Pontius Pilate in the Fourth Gospel
Authors: Wright Arthur M.
Published: May 2017

Scholars have long discussed the characterization of the Roman governor, Pontius Pilate, in the Fourth Gospel. Historically, a majority of scholars have labeled him a “weak” governor, who ultimately bends to the wishes of the Jewish authorities. In recent years, some scholars have made compelling arguments that Pilate is actually a strong figure who gets what he wants while antagonizing the Jewish authorities in the process. The Roman governor is indeed a complex character in the Johannine narrative. Pilate is presented with significant strength, but is not without significant vulnerabilities. Yet the Johannine evangelist also employs the literary device of irony against the Roman governor, undercutting the presentation of a strong Pilate and subverting Roman imperial claims to authority and dominion.
Cut from the same cloth: A study of female patrons in Luke–Acts and the Roman Empire
Authors: Miller Amanda C.
Published: May 2017

This article discusses how women acted as patrons and benefactors in the social hierarchy of the Roman Empire, and how that sociohistorical context enlightens our understanding of women portrayed as patrons in the Gospel of Luke and Acts of the Apostles. Specifically in view are Mary Magdalene, Joanna, Susanna, and other unnamed women in Luke 8:1–3, and the businesswoman Lydia in Acts 16. Miller argues that Luke’s reading communities would have understood these women as important and influential members of the early Jesus movement, and that Luke blurs the lines between patron and client as part of his challenge to the Empire’s sociocultural boundaries.
Queer/Love/Bird Extinction: Rachel Carson’s Silent Spring as a Work of Love
Authors: Maxwell Lida
Published: May 2017

This essay argues for reading Rachel Carson’s Silent Spring as a work of love that calls for an environmental politics of desire rather than self-preservation narrowly construed. I make this argument by reading Silent Spring in conjunction with the extant love letters of Carson and Dorothy Freeman, where they depict their love as a wondrous multispecies achievement constituted through encounters with birds. I argue that their example reveals that love need be neither worldless nor heteronormative, but may be a world-disclosing practice that leads individuals to live, and desire to live, differently. Reading Silent Spring through the lens of these letters, I argue that it calls us to see the threat insecticides pose not only to “mere life” (Honig) but also to pleasurable lives of wonder and love. I build on Silent Spring to argue for an alternative politics of survival in the face of climate change: one that foregrounds the connections between inter-human affects and a vibrant multispecies world, between intimate and public feelings, and calls for preservation of a multispecies world through and on behalf of human pleasure.
Custer’s Sins: Vine Deloria Jr. and the Settler-Colonial Politics of Civic Inclusion
Authors: Temin David Myer
Published: May 2017

While “inclusion” has been seen as a central mode of redressing ongoing injustices against communities of color in the US, Indigenous political experiences feature more complex legacies of contesting US citizenship. Turning to an important episode of contestation, this essay examines the relation between inclusion and the politics of eliminating Indigenous nations that was part of a shared policy shift toward “Termination” in the Anglo-settler world of the 1950s and 1960s. Through a reading of Indigenous activist-intellectual Vine Deloria Jr.’s Custer Died for Your Sins: An Indian Manifesto (1969), it demonstrates how the construction of what I call the “civic inclusion narrative” in post–World War II American political discourse disavowed practices of empire-formation. Widely considered a foundational text of the Indigenous Sovereignty Movement, the work repositioned Indigenous peoples not as passive recipients of civil rights and incorporation into the nation-state but as colonized peoples actively demanding decolonization. Deloria’s work provides an exemplary counterpoint to the enduring thread of civic inclusion in American political thought and an alternative tradition of decolonization—an imperative that continues to resonate in today’s North American and global Indigenous struggles over land, jurisdiction, and sovereignty.
Development of a Research Methods and Statistics Concept Inventory
Authors: Veilleux Jennifer C. , Chapman Kate M.
Published: May 2017

Research methods and statistics are core courses in the undergraduate psychology major. To assess learning outcomes, it would be useful to have a measure that assesses research methods and statistical literacy beyond course grades. In two studies, we developed and provided initial validation results for a research methods and statistical knowledge concept inventory for eventual use in further scholarship of teaching and learning. In Study 1, we created vignettes and administered open-ended questions to psychology subject pool students. In Study 2, we refined the vignettes and created multiple-choice items using participant responses from Study 1. After administering the measure to psychology subject pool students and a community-based sample of Amazon Mechanical Turk workers, we used item response theory to select 20 items to compose the final Psychological Research Inventory of Concepts.
Haemoglobin concentration and erythrocyte sedimentation rate in primary care patients
Authors: Kanfer E J , Nicol B A
Published: May 2017

The erythrocyte sedimentation rate (ESR) remains a commonly measured indicator of disease, but is subject to several non-disease influences. The haemoglobin concentration (Hb) and ESR were measured in 1249 consecutive patients (492 men, 757 women) from primary care practices.

An inverse correlation was found between Hb and ESR throughout the range of measured Hb, and in particular there was a significant difference in the median ESR of patients in the highest and lowest quartile for non-anaemic Hb (P<0.001).

These results indicate that correct clinical analysis of an ESR result should take into account the Hb, both in anaemic and in non-anaemic patients. Interpretative difficulties due to external influences on the measured ESR could be resolved by replacement of this test with plasma viscosity estimation.
Double-Blind, Placebo-Controlled, Randomized Clinical Trial of Homoeopathic Arnica C30 for Pain and Infection after Total Abdominal Hysterectomy
Authors: Hart Oliver , Mullee Mark A , Lewith George , Miller John
Published: May 2017

Homoeopathic potencies of arnica have been used for many years to aid postoperative recovery. The effects of arnica C30 on pain and postoperative recovery after total abdominal hysterectomy were evaluated in a double-blind, randomized, controlled study.

Of 93 women entered into the study, 20 did not complete protocol treatment: nine were excluded because they failed to comply with the protocol, nine had their operations cancelled or changed within 24 h and two had to be withdrawn because of the recurrence of previously chronic painful conditions. Those who did not complete protocol treatment were equally divided between the arnica (nine patients) and placebo groups (11 patients). 73 patients completed the study, of whom 35 received placebo and 38 received arnica C30. The placebo group had a greater median age and the arnica group had slightly longer operations; nevertheless, no significant difference between the two groups could be demonstrated.

We conclude that arnica in homoeopathic potency had no effect on postoperative recovery in the context of our study.
Does the National Health Service want Hospital-at-Home?
Authors: Fulop Naomi J , Hood Sonja , Parsons Sharon
Published: May 2017

There has been increasing interest in the development of hospital-at-home within the National Health Service (NHS) as a way of shifting resources from secondary to primary care. We describe the development of hospital-at-home schemes in London and draw on data from an evaluation of five such schemes to discuss support for hospital-at-home within the NHS. The study has identified a small but important group of patients who do not want hospital-at-home, as well as resistance to it from some health care professionals and managers, particularly in hospitals. These organizational issues must be taken into account in any evaluation of hospital-at-home, along with issues of quality, outcome and cost. Feasibility studies are needed to identify possible organizational barriers to hospital-at-home and the development work that is required. This service innovation should not be considered in isolation from other services, but rather within the context of a wider debate about the pattern of acute care.
Carpal Tunnel Syndrome as a Herald of Autoimmune Rheumatic Disorders
Authors: Pal Badal
Published: May 2017

In six patients aged 59–71 years carpal tunnel syndrome, seemingly idiopathic, was followed by connective tissue disorders, in most cases autoimmune in nature. Patients with idiopathic carpal tunnel syndrome may therefore require long-term follow-up, if inflammatory rheumatic conditions are not to be missed.
Psychiatric Dilemmas—Surgery and the Mental Health Act (1983)
Authors: Porter Suzi , Williams Chris
Published: May 2017

Clinicians commonly face an ethical conundrum when the patient declines a treatment they believe to be necessary. The decision, whether to give or to withhold treatment, may also have legal repercussions. Two illustrative cases are presented. Although the Mental Health Act (1983) is concerned with treatment of mental disorder, treatments for physical disorders may be given in certain circumstances if the patient is deemed to lack the competence to understand the issues involved in the decision, and treatment is deemed to be in their best interests.
Tracheal Microaspiration in Adult Cystic Fibrosis
Authors: Ledson M J , Wilson G E , Tran J , Walshaw M J
Published: May 2017

Gastro-oesophageal reflux (GOR) has been implicated in the aetiology of lung disease. Cystic fibrosis (CF) patients have a high incidence of GOR symptoms with demonstrable episodes of oesophageal acidification. We studied 24-hour ambulatory tracheal and oesophageal pH in 11 CF patients with GOR symptoms to identify any episodes of tracheal acidification and define their temporal relation to oesophageal reflux and respiratory symptoms.

8 patients had evidence of significant GOR (DeMeester score mean 58; range 17–107) and in 6 it was gross (DeMeester score >30). 4 patients had tracheal acidification (defined as tracheal pH <5.5): all had greatly raised DeMeester scores. Two patterns of lowered tracheal pH were seen: a gradual drift downwards of tracheal pH to <5.5 which recovered slowly, and an acute fall in tracheal pH to <5.5 with rapid recovery. Only one patient had a fall in peak expiratory flow in conjunction with a decline in tracheal pH, and no association was found between the presence of tracheal microaspiration and pulmonary function.

We conclude that tracheal acidification occurs in adult CF patients with GOR.
An Audit of the Investigation and Treatment of Folic Acid Deficiency
Authors: Haslam Neil , Probert Christopher S
Published: May 2017

On the suspicion that folate deficiency was not being thoroughly investigated we conducted a retrospective study of management in a teaching hospital. Notes from 84 consecutive patients with low red cell folates (mean age 69.5 years, range 21–95, M:F 33:51) were reviewed for haemoglobin, mean cell volume, dietary history, alcohol consumption, drug history, relevant medical history, relevant investigations, treatment, repeat measurement of red cell folate and diagnosis of deficiency.

In 52 (61.9%, mean age 72.9 years, range 33–95, M:F 21:51) no diagnosis was reached. In only 32 (38.1 %, mean age 63.9 years, range 21–89, M:F 12:20) was a definitive diagnosis established: 5 had coeliac disease, 1 had Crohn's disease, 9 had drug-associated deficiency (4 methotrexate, 3 phenytoin, 1 trimethoprim and 1 valproate), 1 had combined variable immunodeficiency and 16 had dietary deficiency.

In most cases of folic acid deficiency no attempt was made to establish aetiology. We recommend that younger patients without an obvious cause are investigated initially by dietary assessment and measurement of anti-endomysial antibody and by duodenal biopsy with small-bowel follow-through if clinically indicated.
Psychological stress and burnout in medical students: a five-year prospective longitudinal study
Authors: Guthrie E , Black D , Bagalkote H , Shaw C , Campbell M , Creed F
Published: May 2017

The aim of this study was to assess psychological morbidity and symptoms of burnout in medical students during their undergraduate training, and to identify baseline factors that predict psychological morbidity in students in the final year of the course. It was a 5-year prospective longitudinal cohort study. Students were assessed in years 1, 4 and 5 of their medical undergraduate training by means of the GHQ-12 and the Maslach Burnout Inventory.

172 (84.3%), 157 (77.0%) and 155 (75.9%) students out of an original group of 204 completed assessments in years 1, 4 and 5, respectively. 18 students were above threshold on the GHQ-12 on all three occasions, 25 on two occasions and 43 on one occasion; 69 students were never a ‘case’. Students who were cases on two or more occasions were more likely to find the medical course stressful during the first year, but not subsequent years. There was no significant difference between the percentages of men and women who scored as cases on the GHQ-12 in any of the years. The best predictor of psychological morbidity in the final year of the course was the GHQ-12 score in year 1.

This study suggests that a small group of students repeatedly experience psychological distress during their medical training.
Access to complementary medicine in general practice: survey in one UK health authority
Authors: Wearn A M , Greenfield S M
Published: May 2017

Complementary therapy (CT) has become increasingly popular with the general public and interest from the health professions has been rising. There has been no study focusing on the pattern of availability of CT within urban and inner-city general practice. We aimed to describe the prevalence and pattern of access to complementary therapy in this setting, identifying the characteristics of practices offering CT and the perceived barriers to service provision. We sent a postal questionnaire to all 254 general practices on the Birmingham Family Health Services Authority list. Practices were asked whether they offered any access to CTs, how services were organized and which therapies were available and to identify any barriers to provision.

175 practices (68.9%) responded. Half of the practices offered access to CT. Of these, half offered an in-house service, usually provided by the doctor (81.8%). Of GPs practising therapies themselves, 58% began in or after 1990. Seventeen separate therapies were offered, most commonly acupuncture, osteopathy, chiropractic, hypnotherapy and homoeopathy. Practices significantly more likely to offer access to CT were of larger list size and training or teaching practices. They were equally likely to be fundholders or non-fundholders. Practices offering an in-house service tended to be fundholding, training and of larger list size. Finance was perceived as the major barrier.

In the area studied, many patients now have some access to CT within primary care, often within their own practice. In the main, therapies offered are the ‘medically acceptable face' of complementary medicine.
Management and outcome of patients undergoing surgery after acute upper gastrointestinal haemorrhage
Authors: Rockall T A
Published: May 2017

Most patients with acute upper gastrointestinal haemorrhage are managed conservatively or with endoscopic intervention but some ultimately require surgery to arrest the haemorrhage. We have conducted a population-based multicentre prospective observational study of management and outcomes. This paper concerns the subgroup of 307 patients who had an operation because of continued or recurrent haemorrhage or high risk of further bleeding.

The principal diagnostic group was those with peptic ulcer. Of 2071 patients with peptic ulcer presenting with acute haemorrhage, 251 (12%) had an operative intervention with a mortality of 24%. In the non-operative group mortality was 10%. The operative intervention rate increased with risk score, ranging from 0% in the lowest risk categories to 38% in the highest. Much of the discrepancy between operative and non-operative mortality was explainable by case mix; however, for high-risk cases mortality was significantly higher in the operated group. In 78% of patients who underwent an operation for bleeding peptic ulcer there had been no previous attempt at endoscopic haemostasis. For patients admitted to surgical units, the operative intervention rate was about four times higher than for those admitted under medical teams.

In patients with acute upper gastrointestinal haemorrhage operative intervention is infrequent and largely confined to the highest-risk patients. The continuing high mortality in surgically treated patients is therefore to be expected. The reasons for the low use of endoscopic treatment before surgery are not revealed by this study, but wider use of such treatments might further reduce the operative intervention rate. Physicians and surgeons have not yet reached consensus on who needs surgery and when.
Promoting physical activity in general practice: should prescribed exercise be free?
Authors: Tai Sharon See , Gould Mairi , Smith Paul , Iliffe Steve
Published: May 2017

In the UK there are numerous schemes whereby general practitioners can prescribe exercise programmes, usually based in leisure centres. Of the factors that discourage adherence to such programmes in the USA, cost has proved important. We collected demographic and questionnaire data from 152 inner-London patients (108 women, 44 men) before they started an exercise programme on a National Health Service prescription, and analysed the results according to whether they dropped out of the programme (78%) or not.

Use of logistic regression revealed only one previous barrier to exercise, ‘not knowing about local exercise facilities’, as a significant positive determinant of adherence (adjusted odds ratio 3.51,95% confidence interval, 1.04 to 11.86). For ‘lack of money' patients were more likely to drop out of the programme (adjusted odds ratio 0.25, 95% CI 0.07–0.85).

The very low cost of participation in this scheme, did not encourage adherence, particularly by those who had cited ‘lack of money' as a previous barrier. The case of making prescribed exercise free or even low-cost remains unproven.
Two-surgeon approach to thoracic outlet syndrome: long-term outcome
Authors: Sharan D , Moulton A , Greatrex G H , Das S K , Whiteley A M , Srivastava V M Ms
Published: May 2017

An orthopaedic surgeon and a vascular surgeon jointly conducted 30 operations for thoracic outlet syndrome in 27 patients, having done the preoperative assessments in conjunction with a neurologist. Anterior scalenectomy was performed by the supraclavicular route except in one case where the infraclavicular route was used. The further surgical procedure was tailored to the abnormalities identified—i.e. resection of cervical rib or band, or medial scalenectomy. The first rib was spared. At median follow-up of 37 months (range 3–228) results were judged excellent or good on 26/30 sides (87%); on the three occasions when scalenectomy alone was performed, the results were only fair or poor. There were no major complications and no patient required reoperation. The long-term outcome in this series suggests that, with multidisciplinary assessment and two-surgeon operative treatment, good results can be obtained by the supraclavicular route without resection of the first rib.
The limits of pressure sore prevention
Authors: Hagisawa Satsue , Barbenel Joseph
Published: May 2017

Pressure sore prevalence and incidence were assessed in 275 patients who were admitted to a well-staffed internal medicine ward during a 12-month study period or who were present on day 1. Pressure sore risk was assessed by use of the Braden scale and patients scoring 16 or less were provided with intensive preventive care.

During the study period 5.1% (95% confidence interval 2.7–7.8) of 275 patients had pressure sores (prevalence) and 4.4% (1.9–6.9) developed sores (incidence). None of the 239 patients who were assessed as not being at risk developed a sore. 36 patients were assessed as being at risk at some time during the study and 12 of these developed sores despite receiving high-quality preventive care.

The results suggest that not all pressure sores can be prevented in severely ill patients. We believe that the 4.4% incidence of sores in this study approaches the current limit of prevention.
Scaled consensus for multi-agent systems with communication time delays
Authors: Xing Mali , Deng Feiqi
Published: May 2017

This paper aims to solve the scaled consensus problem of general linear multi-agent systems with non-uniform time-varying communication time-delay. The proposed consensus protocol is based on the low gain solution of a parametric algebraic Riccati equation. Based on the proposed consensus protocol, we obtain the sufficient condition for scaled consensus of multi-agent systems with communication time-delay. The results reveal that the upper bound of time-delay can be arbitrarily large if all poles of the system are zero. For the case of non-zero poles on the imaginary axis, the maximal admissible upper bound of the time-varying delay is provided. Simulation results are performed to demonstrate the scaled consensus performance of multi-agent systems.
A simple portable low-pressure healant-injection device for repairing damaged composite laminates
Authors: Lai WL , Cheah AYH , Ruiz RCO , Lo NGW , Kuah KQJ , Saeedipour H , Goh KL
Published: May 2017

This article presents the outcomes of an undergraduate design-for-industry team-driven project to develop a portable low-pressure healant-injection device. The developed healant-injection device is intended to use for teaching purpose. The students practice some of the techniques of repairing damaged composite laminates, as part of an engineering composite-related course, which mainly covers the fundamentals and applications of composite laminates. The healant-injection device works by introducing resin into damaged site that can assist the healant to flow through the network of micro-cracks in a low-pressure environment. The device comprises three components: a chamber featuring a (rectangular box) cover made from acrylic that is intended to cover a damaged surface in a low-pressure environment, an injection unit and a vacuum pump unit. Only the vacuum chamber was designed from scratch by the team; the other components were sourced commercially. The repair of composite laminates can be performed using a low viscosity resin, which is made to flow through a hole on the roof of the chamber, assisted by the injection unit (fluid dispenser), from which the resin flows into the damaged (micro-cracks) site; the very low pressure environment (25–29 inHg) in the chamber facilitates the removal of air pockets in the cracks. The composite laminates featured in this project are carbon fibre reinforced composite laminates, which are of great interest to the aerospace industry. Testing and evaluation were carried out by the team to assess the performance of the healant-injection device using impacted carbon fibre reinforced composites. To assist the team to study the effectiveness of the repair, (a) an ultrasonic C-scan equipment for non-destructive testing was used to assess the extent of the healant flow into the crack regions within the damaged carbon fibre reinforced composites and (b) a compression after impact test was carried out to assess the recovery of the compressive strength of the repaired carbon fibre reinforced composites compare to the pristine and damaged samples in different number of carbon-fibre plies (10, 16, 24 and 32).
Long-term improvement in activities of daily living in women with systemic sclerosis attending occupational therapy
Authors: Zanatta Elisabetta , Rodeghiero Francesca , Pigatto Erika , Galozzi Paola , Polito Pamela , Favaro Maria , Punzi Leonardo , Cozzi Franco
Published: May 2017

Introduction

Systemic sclerosis often affects hand function, leading to severe disability in many subjects. There is little data available on the effects of occupational therapy in systemic sclerosis in current literature. The aim of our study was therefore to evaluate the effects of a cycle of occupational therapy on performing activities of daily living in a group of women with systemic sclerosis.

Method

Twenty women with systemic sclerosis were included in the study: 10 followed a cycle of occupational therapy; 10 were enrolled as controls. An occupational therapy cycle consisted of six meetings of 90 minutes each over a 3-week period. All women were evaluated by the Health Assessment Questionnaire and Evaluation of Daily Activity Questionnaire at baseline and after 24 weeks. The use of devices and alternative strategies was also assessed.

Results

We observed a significant reduction in the Health Assessment Questionnaire and Evaluation of Daily Activity Questionnaire scores in occupational therapy subjects after 6 months compared to controls. There was also evidence of significant improvement in four dimensions of the Evaluation of Daily Activity Questionnaire: eating; indoor mobility; outdoor mobility; and communication. The number of devices in the occupational therapy group increased significantly.

Conclusion

Our findings suggest a relevant role for occupational therapy in improving activities of daily living in women with systemic sclerosis. The use of strategies learned during occupational therapy sessions allows for long-lasting beneficial effects.
Digital inequality in provincial China
Authors: Liu Haimeng , Fang Chuanglin , Sun Siao
Published: May 2017

The rapid spread of information and communications technologies is accelerating the development of our economy and society. While information and communications technologies have become an important development tool that reshapes many aspects of the world’s activities, digital inequality emerges on a worldwide scale due to difference in access to and use of information and communications technologies. Digital inequality, which is a new phenomenon in the current information era, will widen the gap between developed and developing countries/regions. China has witnessed rapid informationization along with its booming economic growth over the past decade. However, digital inequality, as an important aspect of social inequalities in China, has received only scant attention currently. Based on the technique of cartogram, Figures display provincial information and communications technologies development index (IDI) values in 2010 and 2015 in China, exhibiting high inequality. Regions of the highest information and communications technologies levels are distributed along China's eastern coast. On the contrary, the provinces in the west present very low information and communications technologies levels. The coefficient of variation of IDI values dropped from 0.30 to 0.18, indicating declining digital inequality in China. A causal bidirectional relation probably exists between the economic development and information and communications technologies levels.
Modification of Condyle Anatomy following a Monolateral Bite Rise: A Histological Study in Rat
Authors: D'attilio M. , Scarano A. , Quaranta A. , Festa F. , Caputi S. , Piattelli A.
Published: May 2017

The aim of this study is to evaluate the histologic modifications of rat articular capsules, after compression and strain. Fifty adults Sprague Dawley rats were used in this study. The rats were divided into 3 groups: a dysfunction group, treatment group and a Control group. In the rats in the first two groups an occlusion hump, made of composite and less than 0,5 mm high, was applied to the upper right molar. The rats were anesthetized with an intraperitoneal injection of benzodiazepine (0.5-1mg for 100 g. of body weight). The composite used consisted of a hollow, plastic cylinder 0.5 mm high, spread over the whole occlusal surface of the right upper molar. The dysfunction group therapy wore the occlusion hump for a week, at the end of which the animals in this group were killed and their temporomandibular joint removed. In the treatment group a second occlusion hump was applied to the left upper molar, in order to obtain a distraction of the previously compressed temporomandibular joint. The rats of the second group wore the second occlusion hump for one week. The rats were then killed with an intraperitoneal injection of Tanax, and the block sections, containing the temporo-mandibolar joint, were retrieved with a diamond disk, and surrounding tissues were washed in saline solution and immediately fixed in 4% formalin for 4 days. In the control group, no treatment was applied. In the first group, bone resorption was observed in the left temporomandibular joint; no osteoclast were, however, present. No other tissue alterations were present. Newly formed bone undergoing remodelling was intensely stained with acid fuchsin. In the second and third groups, no bone remodelling areas were observed. In conclusion, the compression of the temporomandibular joint determined a remodelling of the bone structure of the condyle.
Health Variables Are Informative in Screening for Mild Cognitive Impairment Among Elderly African Americans
Authors: Tsang Siny , Sperling Scott A. , Park Moon-Ho , Helenius Ira M. , Williams Ishan C. , Manning Carol
Published: May 2017

To aid primary care providers in identifying people at increased risk for cognitive decline, we explored the relative importance of health and demographic variables in detecting potential cognitive impairment using the Mini-Mental State Examination (MMSE). Participants were 94 older African Americans coming to see their primary care physicians for reasons other than cognitive complaints. Education was strongly associated with cognitive functioning. Among those with at least 9 years of education, patients with more vascular risk factors were at greater risk for mild cognitive impairment. For patients with fewer than 9 years of education, those with fewer prescribed medications were at increased risk for dementia. These results suggest that in addition to the MMSE, primary care physicians can make use of patients’ health information to improve identification of patients at increased risk for cognitive impairment. With improved identification, physicians can implement strategies to mitigate the progression and impact of cognitive difficulties.