bluuebunny/crossref_metadata_2025 huggingface dataset:
An Exploratory Study on the Viability and Efficacy of a Pet-Facilitated Therapy Project within a Hospice
Authors: Chinner Tracy L , Dalziel Frank R.
Published: April 2019

In this exploratory study an attempt was made to determine what attitudinal, behavioral, and interactive changes were exhibited by terminally ill patients and their caregivers when a miniature poodle was introduced as a resident at a hospice. Pre-test, post-test, and follow-up phases were conducted, where interviews, observations, and videotape were used to collect data. Over the three phases, 14 patients and 15 staff members were sampled. The resident poodle appeared to facilitate staff-patient interactions, ease patient- ’ visitor relations, and improve staff and patient morale on a situational basis. Patients who felt isolated or alone appeared to have no particular affection for the poodle, contrary to current Pet-Facilitated Therapy theory. Also, it appears that the longest and most frequent behaviors exhibited by both dog and human were those that had a relaxing or comforting effect on the human.
Palliative Care — Could Your Patient Have Been Managed at Home?
Authors: Lubin Stan
Published: April 2019

Palliative care, supportive care of the dying, is rapidly changing to better meet the needs of the patients and families. If palliative care is provided in the home rather than in hospital, there is a potential for improvement in the quality of life for patients and their families and a potential for cost reduction in the health care system. Our study was undertaken to determine whether or not palliative care patients admitted to University Hospital could have been cared for at home rather than in the hospital. The hospital charts of 96 palliative care patients were reviewed retrospectively. The results indicated that 61 % of these palliative care patients did not receive any palliative care at home and that 94% died in an acute care hospital setting. Only 18% lived in a setting other than their own home, and 68% had a spouse or other family member living with them at the time of their final admission. Based on the level of support in the place of residence prior to final admission and the reasons for admission, we determined that many of the patients could have been managed at home for at least some of the palliative care period if appropriate support from a home care team had been available.
Lacrima Mortis: The Last Tear
Authors: Lichter Ivan , Hunt Esther
Published: April 2019

A tear, usually at the moment of death, has been observed in 14% of dying patients. No associated factors have been established and the cause of the “last tear” is not known.
Assessing Needs for Palliative Care Education of Primary Care Physicians: Results of a Mail Survey
Authors: Haines Carol S. , Thomas Zachariah
Published: April 2019

The purpose of this study was to determine continuing education needs in the area of palliative care, as defined by family practice physicians. The methodology consisted of an anonymous questionnaire mailed in October, 1991, to all family practitioners in the city of Regina, Saskatchewan having admission privileges at any of the city's three hospitals. Replies were received from 31.1% of that population; the worst-case estimate is that about half of the city's palliative care caseload in 1991 was under the care of these respondents. In a priority-ranking format, physicians rated pain assessment and management as the patients’ greatest need and their greatest continuing education need. Although emotional support and communication were highly ranked among other needs of patients, they were not highly ranked among education needs. Grand rounds was indicated as the educational venue of preference. Longer, more intensive educational formats were not selected. Communication of palliative status, including “Do not resuscitate” status, has reportedly become a routine practice. We have concluded that palliative care education should focus on the felt needs of family practice physicians for technical competence in pain assessment and management, using abbreviated formats. Cautious introduction of content areas and educational methods more likely to address patient needs is warranted. A one- or two-day workshop devoted to bereavement guidance might be a concrete focus for communication-oriented continuing education.
Hospital Response to Psychosocial Needs of AIDS In Patients
Authors: Barnes Rosemary , Barrett Cristina , Weintraub Susan , Holowacz Gabrielle , Chan Meeley , Leblanc Evan
Published: April 2019

Compassionate care for HIV-infected persons requires response to psychosocial needs. With no new external funding, Women's College Hospital, a 270-bed urban teaching hospital, provided effective psychosocial services for HIV-infected in patients by developing a comprehensive policy, educating staff, organizing existing services into a psychosocial support team to provide crisis intervention, and developing liaisons with community AIDS organizations. A retrospective chart review of epide-miologic and psychosocial patient data was carried out for 59 HIV in patients (58 men, 1 woman) admitted during 1987–89. Of the cohort, 91% indicated homosexual contact as the only risk factor. A psychosocial support team contacted 90% of these in patients. One third (36%) of the patients designated as next of kin individuals who were not legally or biologically related. Approximately 25%–30% made active arrangements for impending death, e.g. wills and funeral plans. Thirteen patients, 22%, died in hospital, and three, 5%, on first admission. Experience showed that psychosocial interventions that focus on human dignity and quality of life, normally seen as elements of palliative care, are critically important from the earliest stages of HI V disease and should not be reserved only for those who are terminally ill.
Changes over Time: A Study of Family Bereavement following Childhood Cancer
Authors: Martinson Ida M. , Mcclowry Sandra G. , Davies Betty , Kuhlenkamp E. J.
Published: April 2019

A longitudinal follow-up study which examined changes in 48 families over time (7-9 years) following a death of a child with cancer was conducted. The loss of a child required individual reorganization and adjustments within the family system. Changes in marital status and/or the addition of other children required adjustment in the relationships of family members. Some of the changes were developmental in nature while others, according to the informants, were directly related to the death of the child.
The Paradoxes of Quality of Life and its Phenomenological Approach
Authors: Loew François , Rapin Charles-Henri
Published: April 2019

Although evaluation scales for quality of life (QOL) represent considerable progress in medicine, clinical experience shows striking discrepancies between QOL as evaluated by caregivers and QOL from the patient's point of view. Such paradoxes of QOL are analyzed and discussed. Autonomy is universally advocated but may be denied, especially in the hospital setting, where caregivers, family members, and doctors act as a pressure group. Circumstances that deepen the contradictions in QOL assessment include (a) a high degree of patient dependence, (b) a professional judgement that a patient is incompetent (c) professional values being placed over a patient's values, (d) a multidisciplinary team acting as a pressure group, (e) a lack of effective communication with the patient, and (f) a determination to minimize the symptoms at evaluation. QOL is multidimensional, complex, difficult to measure in clinical practice, and sometimes paradoxical.
The Symptoms of Advanced Cancer: Identification of Clinical and Research Priorities by Assessment of Prevalence and Severity
Authors: Donnelly Sinead , Walsh Declan , Rybicki Lisa
Published: April 2019

In advanced cancer, when cure is impossible, symptoms should be the focus of attention. We report the first prospective, systematic analysis of the severity of 37 symptoms in 1000 patients with advanced cancer, using the Paradox relational database. Pain, easy fatigue, and anorexia were consistently among the 10 most prevalent symptoms associated with cancer at all sites. When pain, anorexia, weakness, anxiety, lack of energy, easy fatigue, early satiety, constipation, and dyspnea were present, 60%-80% of patients rated them as moderate or severe, i.e. of clinical importance. The most common symptoms were also the most severe. In general the same symptoms were clinically important at most primary sites. Clinically important dyspnea, hoarseness, hiccough, and dysphagia were more common in men; anxiety, nausea, vomiting, and early satiety in women. Clinically important dyspepsia, nausea, and vomiting occurred more frequently in gynecological cancers.
A Prospective Longitudinal Investigation of Spousal Bereavement Examining Parkes and Weiss’ Bereavement Risk Index
Authors: Robinson Linda A. , Nuamah Isaac F. , Lev Elise , McCorkle Ruth
Published: April 2019

The purpose of this study was (a) to describe spousal bereavement both prospectively and longitudinally and (b) to examine the validity of the Bereavement Risk Index (BRI) published by Parkes and Weiss (1). Psychological distress was measured in 46 subjects across five time intervals beginning prior to a spousal death from lung cancer and ending 25 months after the death using the Brief Symptom Inventory (BSI) (2). The hypothesis that the BRI discriminates between bereaved spouses at high and low risk for psychological distress was supported by measurements taken within two months of the patient's diagnosis (prior to death), at 6 weeks following the death, and at 6 and 13 months thereafter. These findings support the need for early identification of individuals at high risk for negative bereavement outcomes even prior to the spousal death.
The Sensation of Thirst in Dying Patients Receiving IV Hydration
Authors: Musgrave Catherine F. , Bartal Nira , Opstad Jorunn
Published: April 2019

Cancer patients in the terminal phase of their disease often experience fluid deficits. This is mainly due to their inability to ingest adequate amounts of oral fluids to meet the body's physiological demands. In order to correct this deficit, intravenous (IV) fluid programs are often instituted. This pilot study was conducted on a group of terminal patients hospitalized in an oncology unit who died while receiving IV fluids. It sought to assess the effects of these fluids on their level of thirst. Data were collected on 30 patients in the last 24 hours of life. However, of the 30 patients only 19 were sufficiently alert to be able to verbally evaluate their thirst intensity. Of the 19 patients, six experienced mild thirst, eight moderate thirst, and four severe thirst. This was in spite of IV hydration regimens which ranged from 500 mL to 3000 mL. Little relationship was found between level of thirst and the amount of IV fluids received, blood urea nitrogen (BUN), or sodium blood levels. In addition, although 70% of the patients had fluid retention signs, there was little correlation between these signs and the amount of fluids received. Since the pilot study's sample was small, definitive conclusions could not be drawn. However, our results highlight the need for future research in this area.
A Circular Diagram for Representing Symptom Status in Advanced Cancer Patients
Authors: Mercadante Sebastiano , Salvaggio Leonardo
Published: April 2019

Symptom relief is the major goal of palliative care. Its assessment is essential and several methods have been described. To evaluate immediately the clinical situation, a circular diagram for a visual representation of the physical symptoms is proposed. Particular patterns derived from the given data emerge from the diagrams. Certain critical situations often observed in palliative care, especially in the last weeks of life, show specific patterns that are easily distinguished. Effective treatments may change the appearance of different pictures.
Family Caregivers’ Perspectives on Hospice Nursing Care
Authors: Raudonis Barbara M. , Kirschling Jane Marie
Published: April 2019

In hospice nursing, dying persons and their families are the unit of care and the focus of nursing interventions which are provided within the context of interdisciplinary care. The key component of hospice nursing is the interaction between the nurse, the terminally ill person, and the family. This naturalistic study was designed to describe the family caregiver's relationships between the hospice patient, the nurse, and themselves. The intent was to determine if family caregivers would develop empathic relationships with the hospice nurses. Nine bereaved family caregivers participated in the study. All were bereaved at least six months prior to being interviewed. The major finding of the study was that family caregivers perceived the hospice nurses as part of the family. The hospice nurses were characterized as respectful, kind, caring, clinical experts whose presence and interventions helped meet the needs of the family experiencing death.
Multicentre Study on the Prevalence of Symptoms and Symptomatic Treatment in HIV Infection
Authors: Fantoni Massimo , Ricci Francesco , Del Borgo Cosmo , Izzi Immacolata , Damiano Fernando , Moscati Anna M. , Marasca Giuseppe , Bevilacqua Nazario , Del Forno Antonio ,   The Central Italy PRESINT Group, Narciso P. , Colaiacomo M. , Armignacco O. , Ccrasari G. , Pauluzzi S. , Francisci D. , Tersigni I. , Fabrizi P. , Consorte A. , Parruti G. , Tacconi L. , Vetica A. , Pizzigallo E. , Barberio A. , Caterini A. , Guastini L. , Vullo V. , Santopadre P. , Pompei A.G. , Matarazzo F. , Natalini-Raponi G. , Marani-Toro G. , Tarquini P. , Lauria F.N. , Sciotti M.S. , Mariani A.
Published: April 2019

We investigated the prevalence and intensity of symptoms and the use of drugs for symptom control among all HIV-infected patients reporting to the outpatient clinics or wards of 15 clinical centres in central Italy, recording clinical and epidemiological data on three consecutive days. A total of 1128 patients were observed and tabulated. Their most frequent symptoms were asthenia (55%), anorexia (34%), cough (32%), pain (29%), and fever (29%). Opioid analgesics were used in 3% of these patients and non-opioid analgesics in 13%. A large majority of HIV-infected patients presented with symptoms regardless of the stage of their disease. Pain was present in fewer than one third of patients but nonetheless seemed to be undertreated. Pain was more frequent and more intense among intravenous drug users. Based on our study, a greater effort to control symptoms in HIV patients seems to be warranted.
Development and Evaluation of a Protocol to Manage Fecal Incontinence in the Patient with Cancer
Authors: Beddar Sandra A. Mitchell , Holden-Bennett Lynn , Mccormick Anne Marie
Published: April 2019

Fecal incontinence is an important yet often overlooked clinical problem in the care of patients with cancer. This paper presents a protocol for the assessment and management of this distressing symptom. The objective of the protocol is to regulate bowel motion, thereby minimizing fecal incontinence and improving patients’ physical functioning, self-esteem, dignity, and quality of life. A comprehensive assessment addressing the patient's physical status, previous elimination routines, dietary habits, and medications provides the foundation for successful management. Components of the intervention include dietary modification, Pharmacotherapy with laxatives and suppositories, and attention to routines that capitalize on the normal, involuntary gastrointestinal reflexes. Promotion of normal bowel elimination patterns, positioning, and comprehensive patient teaching and support are also critical components of the intervention. Our experience with this protocol and the outcomes achieved in a small series of patients are discussed.
Provisional Educational Needs of Health Care Providers in Palliative Care in Three Nursing Homes in Ontario
Authors: Patterson Chris , Molloy William , Jubelius Rosalie , Guyatt G.H. , Bédard M.
Published: April 2019

Health care providers in three nursing homes in Ontario were surveyed to determine educational needs, barriers to meeting these needs, and the preferred format for education. Of the 415 health care providers asked to participate, 225 completed the questionnaire. Need was expressed for the majority of the 35 educational topics identified, including the role of the palliative care team, management of physical symptoms, pharmacological and non-pharmacological management of pain, stress management, spiritual needs, culture and death, and counseling. Group discussions and seminars were favored over traditional lectures. The primary factors influencing attendance at a palliative care workshop were loss of pay and time and location of the workshop.
Is there a Relationship between Psychological Well-Being and Patient-Carers Consensus? A Clinical Pilot Study
Authors: Bishara Emad , Loew François , Forest Martyne-Isabel , Fabre Jean , Rapin Charles-Henri
Published: April 2019

Does communication with terminal cancer patients about their disease influence their psychological well-being? The degree of patient-carer consensus about the disease was compared to psychological well-being related to acceptance of the disease, emotional state, and hope. These were evaluated and scored from 6 (good) to 0 (poor) through a semi-structured interview of 10 open-ended questions. Nineteen palliative care patients were studied, 18 of whom were suffering from advanced cancer. Overall, 57 interviews were conducted with the patients, staff nurses, and medical doctors. The answers of the carers (staff nurses and doctors) were compared to the patients’ answers to determine the degree of consensus in terms of communication about disease, aim of treatment, and ultimate objective of hospitalization. The consensus between patients and carers was scored from 6 (satisfactory) to 0 (unsatisfactory). A significant positive correlation between the scores of consensus and those of psychological well-being ( r=0.90, p<0.001) was found. These results suggest that good and truthful communication may improve patients’ psychological well-being.
The Family's Perspective on Issues of Hydration in Terminal Care
Authors: Parkash Ravi , Burge Frederick
Published: April 2019

We identified issues that are important to family caregivers when deciding whether or not artificial hydration should be provided to patients with advanced cancer. A qualitative study using semi-structured interviews was carried out in the home support and inpatient divisions of a palliative care program in Halifax, Nova Scotia. Participants included children and spouses of terminally ill patients who had dealt with or would soon deal with issues of hydration. Factors influencing caregivers included issues of symptom distress, ethical and emotional considerations, information exchange between health professionals and family, and culture. The perceived benefits of artificial hydration by the caregivers were central to the ethical, emotional, and cultural considerations involved in their decision making. Discussions with caregivers should attempt to (a) discover the patient's wishes and attitudes concerning the procedure; (b) provide as accurate information as is available about advantages and disadvantages; and (c) recognize and explore caregivers’ concerns that may or may not have been expressed.
Community Physicians Describe Management Issues for Patients Expected to Live Less than Twelve Months
Authors: Goodlin Sarah J. , Jette Anne M. , Lynn Joanne , Wasson John H.
Published: April 2019

We examine management issues experienced by community physicians providing care to patients they expect to die within a year. In a case series, 61 physicians in northern New England enrolled 182 consecutive dying patients. Important management issues for these patients were recorded at enrollment and eight months later. The patients’ average age was 74 years; most had cancer (48%) or cardiovascular disease (38%). Almost two-thirds of the patients died within eight months of enrollment. Major management issues for the physicians in care of these patients were deficits in basic self-care, emotional support, pain control, and nutrition. Pain control and family need for support were reported most frequently. Although demand for physician time was seldom a major management issue, when it occurred it correlated with patients’ emotional needs or their desire to extend life (p<0.01). Two barriers to optimum care commonly cited by physicians were (a) the differences in treatment expectations between family members, patients, and physicians and (b) the incurable, progressive nature of the patients’ diseases. Efforts to improve care for patients who have limited life expectancy should further explore the perceptions of community physicians.
The Caregiver Quality of Life Index-Cancer (CQOLC) Scale: Revalidation in a Home Hospice Setting
Authors: Weitzner Michael A. , Mcmillan Susan C.
Published: April 2019

Hospices provide palliative care to persons who are dying and supportive care to their family caregivers. As death approaches, these family caregivers become increasingly responsible for providing the majority of daily care. Although research has documented their distress, little work has evaluated the broader impact of caregiving on quality of life (QOL). This study reevaluates the internal consistency and validity of the Caregiver Quality of Life Index-Cancer (CQOLC). 239 family caregivers of hospice patients with a variety of cancer diagnoses participated. Internal consistency for the instrument was 0.87. There were moderate correlations with overall mental health (r=0.68) and low correlations with overall physical health (r=0.01). Low correlations were observed with patient's performance status (r=0.09). The CQOLC appears to possess adequate validity and internal consistency in this revalidation sample.
Acupuncture for Patients in Hospital-Based Home Care Suffering from Xerostomia
Authors: Rydholm Margareta , Strang Peter
Published: April 2019

A total of 20 patients (17 cancer patients) in late-stage palliative care reporting dryness of mouth and associated problems were treated for 5 weeks with 10 acupuncture treatments. Ten patients were also evaluated for speech problems (articulation) and dysphagia caused by xerostomia. Subjective assessments used Visual Analog Scales (VAS). Acupuncture had a dramatic effect on xerostomia and, subsequently, on dysphagia and articulation, with subjects showing definite improvement after 5 treatments. Release of neuropeptides that stimulate the salivary glands and increased blood flow are possible explanations for the effects.
The role of orthosilicic acid-induced autophagy on promoting differentiation and mineralization of osteoblastic cells
Authors: Chi Hai , Kong Meng , Jiao Guangjun , Wu Wenliang , Zhou Hongming , Chen Lu , Qiao Yini , Wang Hongliang , Ma Wenzheng , Chen Yunzhen
Published: April 2019

Silicon, an element, has been reported to possess various osteogenic biological functions. However, the precise cellular action mechanism of silicon in osteogenesis is elusive. Here, we examine whether autophagy is associated with the osteogenic differentiation and mineralization of preosteoblasts stimulated by orthosilicic acid (unique soluble form of silicon). The autophagy induced by silicon was detected via autophagy-related protein expression. The correlation between orthosilicic acid-induced autophagy and the osteogenic process was verified by the autophagy inhibitor 3-methyladenine. We also investigated its applicability in vivo through bone mineral density, collagen staining, hydroxyproline, and immunohistochemistry on osteoporosis rats. Concentrations above 10 µM increased alkaline phosphatase activity, whereas those up to 50 µM decreased alkaline phosphatase activity. Orthosilicic acid at concentrations up to 20 µM increased the osteogenetic indicators, the expression of the autophagy-related factors SQSTM1/p62, and the conversion of microtubule-associated protein 1 light chain 3-II (LC3-II) from microtubule-associated protein 1 light chain 3-I (LC3-I) according to Western Blot analyses. The application of 3-methyladenine decreased the expression of Runt-related transcription factor 2 (RUNX-2), bone morphogenetic protein-2, and collagen I in the Western Blot analysis. Low dose of orthosilicic acid supplemented rats (OVX-1, 2) showed improvements in such parameters as the expression rate of collagenous fiber in bone, bone mineral density, femoral hydroxyproline content, and bone morphogenetic protein-2; while high dose groups (OVX-3, 4) presented no better outcome. The present study showed that orthosilicic acid stimulated the osteogenic differentiation and mineralization of cultured preosteoblasts by inducing autophagy. In addition, it also can enhance bone mineral density of osteoporosis rats.
Elastic buckling of rectangular fiber-metal laminated plates under uniaxial compression
Authors: Bikakis George SE , Kalfountzos Costas D , Theotokoglou Efstathios E
Published: April 2019

In this article, the elastic buckling response of rectangular simply supported and clamped fiber-metal laminates (FMLs) subjected to uniaxial compressive loading is investigated using the finite element method and eigenvalue buckling analysis. Using validated finite element method (FEM) models, the buckling coefficient-aspect ratio diagrams and the mode shapes of nine GLARE grades are obtained and studied along with the diagrams and the mode shapes of three unidirectional glass-epoxy composites and monolithic 2024-T3 aluminum. It is found that the critical average buckling stress and the buckling load of the materials increases for increasing metal volume fraction, when the plate aspect ratio is greater than 1.5. The rule of mixtures is evaluated and found to be a simple method to estimate approximately the average critical buckling stress of the GLARE plates. An approximate formula is derived for the estimation of the critical buckling coefficient of the GLARE plates using the buckling coefficients of their constituents. The applicability of the results to thermoplastic-based FMLs is discussed.
The effects of aramid short fiber and CaCO3 nanoparticles inclusions on the elastic, damping, and thermal behavior of polypropylene composite
Authors: Kalajahi Pouya Faraji , Shahbazi Arman , Shelesh-Nezhad Karim , Arsalani Naser
Published: April 2019

Aramid short fiber (ASF) and calcium carbonate (CaCO3) nanoparticle were incorporated into polypropylene (PP) in an attempt to enhance the elastic, damping, and thermal performances. Different samples were melt mixed by employing a counter rotating twin-screw extruder and then compression molded using hot and cold presses, respectively. Scanning electron microscopy (SEM) studies displayed good dispersion and anchoring effect of the aramid fibers within the PP matrix. Differential scanning calorimetry (DSC) indicated higher crystal nucleating effect for the CaCO3 nanoparticles when compared to that of the aramid fibers. The influences of aramid fiber and CaCO3 nanoparticle on the elastic and damping components and glass transition temperature of composites were studied using a dynamic mechanical thermal analyzer under the fixed oscillation frequency, constant amplitude, temperature sweep, and dual cantilever geometry. The additions of aramid fiber and calcium carbonate (CaCO3) into PP noticeably increased the storage and loss moduli over a wide range of temperature (−50 to 150 °C). However, the effect of ASF was more prominent particularly at high temperatures. The incorporation of aramid fibers into PP enhanced the storage and loss moduli equal to 74% and 67%, respectively, at 100°C. Moreover, flexural tests under quasi-static loading were carried out, and the results indicated a greater capacity for the dynamic mechanical thermal analysis as compared to the simple mechanical tests in evaluating the composites. The anchoring effect of aramid fiber in PP matrix and the presence of CaCO3 nanoparticles in PP-aramid fiber interphase were found to be the key factors in achieving the improved rigidity, damping, and heat performances in PP/ASF/CaCO3 composites.
Loneliness as a Predictor of Work Disability Onset Among Nondisabled, Working Older Adults in 14 Countries
Authors: Morris Zachary A.
Published: April 2019

Objective: The objective of this study is to examine the relationship between loneliness and work disability and whether depression mediates the hypothesized relationship. Method: We draw on data from the 2013 and 2015 waves of the Survey of Health, Aging, and Retirement in Europe. We limited the sample to adults between the ages of 50 and 65 who were working and without work limitations in 2013, which consisted of 10,154 adults from 14 countries. We apply multivariate logistic regression and a binary mediation analysis with logistic regression to examine predictors of the onset of work disability in 2015. Results: Loneliness was predictive of future work disability onset when adjusting for other factors in the disablement process. Depression partly mediated the longitudinal relationship between loneliness and work disability. Discussion: The results indicate that addressing loneliness could mitigate the risk of depression and, in turn, work disability onset.
Ethno-racial Diversity on Nonprofit Boards: A Critical Mass Perspective
Authors: Fredette Christopher , Sessler Bernstein Ruth
Published: April 2019

The need for greater diversity among organizational leaders and directors remains a challenge for organizations within the third sector, and beyond. This study examines diversity through a critical mass lens; that is, we examine an alternative approach to understanding the relationship between the ethno-racial composition of boards of directors and their perceived ability to engage stakeholders, improve organizational responsiveness, and effectively manage fiduciary responsibilities. Our study, drawing on a survey of 247 boards, clarifies the need for a critical mass approach to leadership diversity by highlighting the uneven impact of diversity on performance demonstrated by periods of accelerating and decelerating effect. We find that boards achieving a critical mass of ethno-racial diversity improved board performance among three governance activities—fiduciary performance, stakeholder engagement, and organizational responsiveness—with our critical mass approach illustrating the uneven impact of diversity on performance for each governance activity.
Potential Roles of NIX/BNIP3L Pathway in Rat Traumatic Brain Injury
Authors: Ma Jialing , Ni Haibo , Rui Qin , Liu Huixiang , Jiang Feng , Gao Rong , Gao Yanping , Li Di , Chen Gang
Published: April 2019

NIX/BNIP3L is known as a proapoptotic protein that is also related to mitophagy. Previous reports have shown that NIX could be involved in neuronal apoptosis after intracerebral hemorrhage, but it also plays a protective role in mitophagy in ischemic brain injury. How NIX works in traumatic brain injury (TBI) is unclear. Thus, this study was designed to observe the expression of NIX and perform a preliminary exploration of the possible effects of NIX in a rat TBI model. The results showed that NIX expression decreased after damage, and colocalized with neuronal cells in cortical areas. Moreover, when we induced upregulation of NIX, autophagy was increased, while neuronal apoptosis and brain water content decreased along with neurological deficits. These findings remind us that NIX probably plays a neuroprotective role in TBI through autophagy and apoptosis pathways.
Interlinkages Between USD–INR, EUR–INR, GBP–INR and JPY–INR Exchange Rate Markets and the Impact of RBI Intervention
Authors: Dua Pami , Suri Ritu
Published: April 2019

This article examines interlinkages between four major exchange rates, namely, USD–INR, EUR–INR, GBP–INR and JPY–INR in terms of returns and volatility spillovers using a vector autoregressive-multivariate GARCH–BEKK framework. In addition, we analyse the impact of RBI intervention on the returns, volatility and covariance of these exchange rates. The study finds significant bidirectional causality-in-mean and causality-in-variance between all four exchange rates. The estimation results suggest that RBI intervention in the form of net purchase of dollars leads to depreciation of INR vis-à-vis USD, EUR, GBP and JPY. Furthermore, we find that RBI intervention not only significantly affects the volatility of INR vis-à-vis USD, EUR and GBP but also explains significant amount of covariance between USD–INR and the other three exchange rates.

JEL Classification: C32, G15, E58, F31
Out-of-Pocket Health Expenditures Among Insured and Uninsured Patients in Vietnam
Authors: Thanh Nguyen Duc , Anh Bui Thi My , Xiem Chu Huyen , Van Minh Hoang
Published: April 2019

Out-of-pocket expenditure/payment (OOP) is one of the indicators measuring the achievement of Universal Health Coverage. This article aimed to compare OOP among the insured and uninsured for their outpatient and inpatient health care services. The data of 6710 individuals using outpatient care and 924 individuals using inpatient care at 78 district hospitals and 246 commune health centers in 6 provinces from the World Bank survey, “The 2015 Vietnam District and Commune Health Facility,” were used for analysis. In the ordinary least square model, the estimated coefficient of the insurance status variable suggested that insurance reduced OOP by 31.1% for outpatient care and 31.5% for inpatient care of the insured as compared with the uninsured ( P <0.001). For outpatient care, insurance reduced OOP more for those enrollees using commune health centers than those using district health facilities, 42.3% and 20.2%, respectively. For inpatient care at district health facilities, insurance reduced OOP by 34.9% as compared with the uninsured ( P <0.001). The study suggested that more active solutions should be created to promote the universal health insurance in Vietnam.
Toward a More-Than-Human Analysis of Digital Health: Inspirations From Feminist New Materialism
Authors: Lupton Deborah
Published: April 2019

New feminist materialism theories potentially offer a foundation for innovative ways to research health-related experiences from a more-than-human perspective. Thus far, however, few researchers have taken up this more-than-human and post-qualitative approach to investigate health topics. In this article, I outline some approaches I have developed. I begin with a brief overview of the central tenets of new feminist materialism scholarship and a discussion of some empirical studies where these perspectives have been employed to address health topics. I then list some key propositions, research questions, and things to think with from the feminist materialism literature that I have put to work as a basis for conducting empirical research and analyzing data. Then follows four examples drawn from my research on digital health, providing instances of how qualitative researchers can take up this approach and what insights can be generated from entering into this kind of “research assemblage.”
Clinical outcomes and toxicities of pazopanib administered orally in crushed form: Case reports and review of the literature
Authors: Stein Jill , Milhem Mohammed , Vaena Daniel
Published: April 2019

Cancer treatment has changed dramatically with the development of oral targeted therapies. Pazopanib, an oral VEGF tyrosine kinase inhibitor, is currently approved for advanced renal cell carcinoma, advanced soft tissue sarcoma, and is being studied for various tumor types. Due to the potential of increased exposure to pazopanib when crushed, pazopanib should be given as an intact whole tablet. Thus, in patients with difficulty swallowing medications or feeding tubes, pazopanib is usually not considered to be an option. Here, we describe two cases which show the administration of crushed pazopanib was feasible and had apparent clinical activity.
The inverse doubly periodic problem of fracture mechanics for a composite reinforced with unidirectional fibres
Authors: Mirsalimov Vagif
Published: April 2019

A theoretical analysis is made of the optimal interference for fitting elastic fibres into the two-periodic system of holes of an isotropic elastic binder. The principles of equal strength and the minimization of stress intensity factors are used. The binder of the composite is weakened by a doubly periodic system of rectilinear cracks. A criterion and methods for solving the problem of the prevention of fracture of a composite reinforced with unidirectional fibres are suggested. A closed system of algebraic equations that allows one to obtain the solution of the problem of the optimal design of a composite body depending on the mechanical and geometrical characteristics of a binder and fibre is constructed. The found interference provides an increase of the load-bearing capacity of the composite. The results of the considered theoretical work open new possibilities for the optimal design of the composite bodies (composites) at the expense of the choice of interference of the binder and fibre joint.
The Haptic Space of Disaster
Authors: Linnell Mikael
Published: April 2019

The overall aim of this article is to contribute to discussions on the spatialization of future events and, in particular, on enactment as the primary contemporary response to uncertain futures. Realistically simulated disasters is an emerging feature in contemporary public preparedness exercises. The purpose of such simulations is to foster public vigilance and initiative by way of immersive experiences of future disasters. This new mode of experiential learning calls for new analytical concepts that take into account the dynamic relationship between the materiality of experience and the experiencing subject. Therefore, in this article, I propose an analytical vocabulary derived from recent interjections in visual and cultural studies, human geography, and sociology. More specifically I make use of, and extend, the notions of “haptic space” and “haptic sense” as elaborated by Bruno (2014), Fisher (2012), and Marks (2015). I apply these concepts to make sense of my empirical encounter with public simulation centers in Japan and Turkey. Finally, I discuss some implications of the haptic perspective in this context.
Gambling among Swedish youth: Predictors and prevalence among 15- and 17-year-old students
Authors: Svensson Johan , Sundqvist Kristina
Published: April 2019

Background:

Gambling among adolescents is a growing public health concern in Sweden as in many other countries. Excessive gambling has been found to be associated with a wide range of negative consequences such as financial problems, strained relationships, criminal behaviour, depression, and an elevated risk for suicide. Research suggests a link between alcohol consumption and gambling, particularly among male gamblers. There are nevertheless gaps in the available knowledge pertaining to school-aged students in Sweden.

Aim:

The purpose of this study is to investigate predictors of gambling and frequent gambling among Swedish students in Grade 9 and Grade 11 (ages 15 and 17 years).

Data and method:

Data on gambling and alcohol consumption were obtained from the Swedish Council on Information and Other Drugs yearly school surveys ( n = 4763) in Grade 9 and Grade 11 ( n = 3720). Poisson regression models have been applied to estimate the association between less frequent and frequent gambling with the predictors of gender, family and school satisfaction, school situation, and alcohol and drug use.

Results:

Gambling among Swedish students is a highly gendered activity: boys gamble more and more frequently than girls. Having consumed alcohol was associated with both less frequent and more frequent gambling among Grade 9 students while controlling for other variables. In Grade 9, heavy episodic drinking was only associated with less frequent gambling, not with frequent gambling. Among Grade 11 students, both alcohol consumption and heavy episodic drinking was associated with less frequent gambling but heavy episodic drinking was only associated with frequent gambling. Moreover, drug use was associated with less frequent gambling in Grade 11. Skipping classes was the only school factor that was found to be associated with less frequent gambling (Grade 11). Such factors as family satisfaction and two measurements of economic situation were not associated with gambling at all.
Social enterprise: Bridging the gap between the statutory and third sector
Authors: Heyworth-Thomas Elizabeth Mary , Jones Rosalind
Published: April 2019

This article contributes to research of vulnerable communities and investigates the role of social enterprise created or saved from closure by social entrepreneurs affected personally by a life-changing event, in the context of stroke survival. Qualitative research is deployed to investigate the ways in which social enterprise supports survivors of stroke and their caregivers. Research analysis identifies start-up motives and challenges faced by social entrepreneurs and highlights how social enterprise can bridge the gap in support provision provided by the statutory and third sectors. Involvement in stroke clubs was found to be a key positive contributor to participants’ life after stroke. This study has found that those who become social entrepreneurs after a life-changing event exhibit altruistic behaviours, while engagement between these social enterprises and this vulnerable group created specific benefits for vulnerable individuals and their caregivers, highlighting the potential for social enterprise to bridge the gap between statutory and third sectors which is currently overlooked in existing policy provision. The article concludes by making detailed recommendations for future research in this context and for governments and policymakers.
Open innovation in (young) SMEs
Authors: Kraus Sascha , Kailer Norbert , Dorfer Julia , Jones Paul
Published: April 2019

The purpose of this article is to identify the role start-ups play in the open innovation (OI) context by reviewing the existing body of research. Since the OI literature on young ventures is nascent, a stepwise review approach is applied, using the already more evolved findings of small- and medium-sized enterprises (SMEs) in order to derive similarities or differences. The findings indicate that if empirical studies with a similar research focus are conducted, similar results are likely to be obtained in both SMEs and young ventures. Generally, young ventures have a higher application of OI activities compared to large firms as it boosts their innovation performance enabling them to overcome the liability of smallness and newness. Because of this importance, combined with the limited number of quantitative studies available, ongoing research is required to further understand young ventures role in the OI context.
Tensile and interfacial properties of dry-jet wet-spun and wet-spun polyacrylonitrile-based carbon fibers at cryogenic condition
Authors: Liu Wei , Gao Yang , Liu Xiaoyun , Qiu Yiping , Xu Fujun
Published: April 2019

For carbon fiber–reinforced polymer composites applied in aerospace industry, the mechanical performance of carbon fiber in extreme temperature environment is of great importance. In this study, carbon fiber produced by dry-jet wet spinning and wet spinning approaches were cryogenically conditioned at different cooling rates. After cryogenically conditioned at sharp cooling rate, both fibers have around 10% decreases in tensile strength due to the huge hoop stress induced by the quenching process. However, after cryogenically conditioned at slow cooling rate, the interfacial shear strength between the two kinds of carbon fibers and epoxy resin was significantly enhanced. Furthermore, scanning electron microscopy, atomic force microscopy, and the Raman spectroscopy were conducted to detect the micro-structures and surface morphologies of the cryogenically conditioned carbon fibers. This study provided fundamental data for the material design and application of the carbon fiber at extreme temperature environments such as aerospace or other industrial fields.
The selection of key temperature measurement points for thermal error modeling of heavy-duty computer numerical control machine tools with density peaks clustering
Authors: Zhou Zude , Hu Jianmin , Liu Quan , Lou Ping , Yan Junwei , Hu Jiwei , Gui Lin
Published: April 2019

Having great impacts on machining precision, thermal error is one of the main error sources for heavy-duty computer numerical control machine tools. Thermal error compensation using prediction models with temperature field is an effective way to improve machining precision of computer numerical control machine tools. The accuracy and robustness of thermal error prediction models depend considerably on the selection of temperature measurement points. Too many temperature measurement points will increase the complexity of thermal error prediction models and incur over-fitting problems. To improve the complexity and performances of prediction models, a selection method of key temperature measurement points based on density peaks clustering is presented in this article. This method is able to cluster massive temperature measurement points quickly and select the key temperature measurement point which characterizes the common feature of each cluster automatically. It is verified on the ZK5540A heavy-duty computer numerical control gantry drilling machine tool. Six key temperature measurement points are selected from the total 222 temperature measurement points with this method. Then, the back propagation neural network optimized by genetic algorithm thermal error model with the six key temperature measurement points is built and the accuracy and robustness of the model are analyzed. The results show that the model has high prediction accuracy and strong robustness.
Reliability-based parameter design for FlexRay network in vehicles
Authors: Wang Yuefei , Liu Hongjun , Huang Bin , Zhang Nan , Wu Yuan
Published: April 2019

FlexRay has been extensively applied to safety-critical systems, such as powertrain, chassis, and X-by-wire system in vehicles. Its transmission reliability considerably influences vehicle safety. In this study, frame coding and media access control in the FlexRay protocol are analyzed, and calculation equations are deduced for the length of time slot and coded frame of FlexRay. Redundant transmission of FlexRay static frame is introduced to solve the transmission failure caused by the bit error in the physical layer, and the transmission reliability of a static segment is defined for the mechanism. Considering the demands on transmission reliability and network schedulability, the configuration of FlexRay parameters, including communication cycle, time slot allocation, and segment length, is formulated as a generalized optimization problem with constraints on predefined transmission reliability and response time of messages. A Reliability-Based Parameter Optimization algorithm and its sub-algorithms, Response Time of Dynamic Segment and Slot Allocation for the Predefined Reliability, are presented to approximately solve the optimization model. Experiment results validate the proposed method, which can efficiently improve the transmission reliability and guarantee the real-time performance of the FlexRay network.