bluuebunny/crossref_metadata_2025 huggingface dataset:
Artificial intelligence in healthcare: Ethical considerations
Authors: Kluge Eike-Henner W.
Published: July 2019

The term Artificial Intelligence (AI) is systematically ambiguous between electronic expert systems that are used by healthcare professionals in carrying out their tasks and full AIs, which are stand-alone independent electronic entities that function much like human healthcare professionals except that they are electronic and not biological in nature. This discussion sketches the distinct ethical considerations that are relevant to the two kinds of AI while acknowledging that currently there are no full AIs.
#MeToo, Networked Acknowledgment, and Connective Action: How “Empowerment Through Empathy” Launched a Social Movement
Authors: Suk Jiyoun , Abhishek Aman , Zhang Yini , Ahn So Yun , Correa Teresa , Garlough Christine , Shah Dhavan V.
Published: July 2019

How did efforts that prompted the sharing of personal experiences of sexual violence and harassment around #MeToo coalesce into calls for action across a range of institutions and communities? We argue that sharing experiences of trauma in digital spaces created a network of acknowledgment, which supported and sustained nascent #MeToo activism based on the logic of connective action. This article attempts to (a) understand the temporal dynamics of these different discourses within the #MeToo movement on Twitter, (b) reveal the accounts animating these discourses and the most prominent themes within them, and (c) model the overtime relationship between these discourses and their relationship to major news event and #MeToo revelations. To do so, we analyze a 1% sample of tweets from the 5-month period following the revelations about Harvey Weinstein in early October 2017, employing a range of computational approaches, including part-of-speech tagging, dependency analysis, hashtags extraction, and retweet network analysis—to identify key discourses, actors, and themes. We then conduct time series analysis to identify the relationship between the two discourses and predict how the ebbs and flows of each discourse are shaped by news events.
Twitter Activism and Ethical Witnessing: Possibilities and Challenges of Feminist Politics Against Gender-Based Violence
Authors: Puente Sonia Núñez , Maceiras Sergio D’Antonio , Romero Diana Fernández
Published: July 2019

This article examines digital activism on Twitter against gender-based violence with regard to the March 8, 2017, feminist movement in Spain (8M). We explore a sample of 20,000 messages (tweets, retweets, and mentions) of the most commonly utilized hashtags in this context, such as #8M and # NiUnaMenos (Not one less [woman]). We analyze if, in the case of 8M in Spain, digital feminist activism constituted a challenge to the hegemonic frames of representation of gender-based violence. Using the concept of “ethical testimony,”, we demonstrate the opportunity that giving testimony on gender-based violence offers to digital feminist activism to act in an effective, political manner on Twitter, circumventing invisibility. These hashtags do not form strong conversational communities but rather serve to diffuse messages at a mass scale. Within these conversational communities, the term “victim” is rarely utilized, which we interpret as an accomplishment of women as agents capable of resisting their position of vulnerability.
Gender Divisions of Paid and Unpaid Work in Contemporary UK Couples
Authors: McMunn Anne , Bird Lauren , Webb Elizabeth , Sacker Amanda
Published: July 2019

This article uses data from the UK Household Longitudinal Study to describe how contemporary British couples divide a range of work types. Our findings support the hypothesis, suggested by previous authors, that a shared egalitarian ideology is required for gender equality in divisions of work. In response to bargaining theories, the article also hypothesises that differentials in educational attainment within couples are more strongly associated with gender divisions of work when a couple’s gender ideology is in conflict. Interaction analysis does not support this hypothesis.
Cox regression survival analysis with compositional covariates: Application to modelling mortality risk from 24-h physical activity patterns
Authors: McGregor DE , Palarea-Albaladejo J , Dall PM , Hron K , Chastin SFM
Published: July 2019

Survival analysis is commonly conducted in medical and public health research to assess the association of an exposure or intervention with a hard end outcome such as mortality. The Cox (proportional hazards) regression model is probably the most popular statistical tool used in this context. However, when the exposure includes compositional covariables (that is, variables representing a relative makeup such as a nutritional or physical activity behaviour composition), some basic assumptions of the Cox regression model and associated significance tests are violated. Compositional variables involve an intrinsic interplay between one another which precludes results and conclusions based on considering them in isolation as is ordinarily done. In this work, we introduce a formulation of the Cox regression model in terms of log-ratio coordinates which suitably deals with the constraints of compositional covariates, facilitates the use of common statistical inference methods, and allows for scientifically meaningful interpretations. We illustrate its practical application to a public health problem: the estimation of the mortality hazard associated with the composition of daily activity behaviour (physical activity, sitting time and sleep) using data from the U.S. National Health and Nutrition Examination Survey (NHANES).
A Decision-Science Approach to Health-Behavior Change
Authors: Chapman Gretchen B.
Published: July 2019

Behavior change has the potential to radically impact health outcomes. Successfully influencing health behavior requires an understanding of the decision processes underlying health choices and techniques to harness those psychological factors in the service of effective interventions. The way in which information is presented, social consequences of behavior, and methods for guiding behavior without trying to change beliefs and attitudes are examples of using decision science in the service of health.
The impact of knowledge of HPV positivity on cytology triage in primary high-risk HPV screening
Authors: Aitken Clare A , Holtzer-Goor Kim M , Uyterlinde Anne , van den Brule Adriaan JC , van der Linden Hans C , Huijsmans Cornelis J , de Kok Inge MCM , van Kemenade Folkert J
Published: July 2019

Objective

Several studies have shown that there is an upward shift in the classification of cervical cytology when high-risk human papillomavirus (hrHPV) status is known to be positive. The Netherlands implemented primary hrHPV screening with reflex cytology as the primary screening test in 2017. Prior to implementation of the new programme, we investigated whether knowledge of hrHPV status influences cytology rating.

Methods

Using a set of 200 cytology slides that had been previously tested, two pairs of cytotechnicians rated 100 slides per pair twice: first without knowledge of hrHPV status and then, after a wash-out period of two months, with knowledge of hrHPV status.

Results

We found that hrHPV positive slides were more likely to be rated up over the referral threshold (i.e. from negative for intraepithelial lesion or malignancy to atypical squamous cells of undetermined significance+) than hrHPV negative slides at the second review when hrHPV status was known (relative risk = 3.2; 95% confidence interval: 1.3–7.9).

Conclusions

If the same upward shift in ratings were to be observed in the national programme, it may have implications for referrals of women with low-grade lesions.
An Exploratory Study of Challenges Faced by Working Mothers in India and Their Expectations from Organizations
Authors: Sharma Roopali , Dhir Swati
Published: July 2019

Working mothers worldwide find it hard to deal with expectations about their maternal responsibilities and work. The challenges faced by women across nations are perceived to be similar in nature. However, the known diversity in terms of culture, political scenario, educational framework, economic situation, legal policies and employment guidelines are unavoidable factors which may directly impact the challenges faced by women in their respective workplace. This research, therefore, attempts to identify the challenges faced by working mothers in India in their careers including different industrial sectors in the present scenario. A mix of qualitative and quantitative techniques is used for data collection. On the basis of in-depth interviews, grounded theory approach and exploratory factor analysis, three broad categories of challenges faced by working Indian mothers are identified. Post the empirical identification of perceived career barriers for working mothers, organizational interventions to address their concerns are discussed.
The Size of Fiscal Multipliers in India: A State Level Analysis Using Panel Vector Autoregression Model
Authors: Mishra Bibhuti Ranjan
Published: July 2019

This study attempts to measure the fiscal multipliers in India using the state-level panel dataset of 17 non-special category states for the period 2001–2002 to 2013–2014. The study employs the panel vector autoregression (PVAR) approach with a generalized method of moments (GMM) framework and plots the generalized impulse response function to explore shocks and responses of endogenous variables. The article finds that the effects of fiscal variables on income in longer horizon are greater than the immediate impact. Both in the short run and long run, the multiplier effect of capital outlay on income is greater than the multiplier effect of revenue expenditure. The operation of reverse multiplier due to increase in tax is found to be lower than the favourable multiplier effect of expenditure. It provides a rationale for taxation wherein the government should resort to taxation with an objective to spend it on productive investment and thereby raise the economic activity.
The Influence of Safety and Security on Students’ Choice of University in South Africa
Authors: Calitz Andre Paul , Cullen Margaret Diane Munro , Jooste Carlien
Published: July 2019

Higher education institutions (HEIs) are experiencing increased interest and enrolments in study programs by international students. For recruitment and retention purposes it is important that HEI managers understand the factors that influence a student’s choice of HEI. Prior studies have found that these factors may differ from country to country and may include culture, educational needs, campus activities, safety, and security, and socio-economic issues (such as an economic downturn and political or social instability). This article reports specifically on research into the influence of safety and security issues on national and international students’ choice of public university in South Africa. Two surveys conducted at different times were used to collect data from local and international students. The results indicate that safety and security, played a deciding role in both local students’ and international students’ choice of university in South Africa, and that the disruption to campus life associated with the #FeesMustFall student protests in South Africa in 2016 may have made international students more aware of safety and security issues on South African university campuses.
Enhancing the effectiveness of minimum employment standards in New Zealand
Authors: Anderson Gordon , Kenner Lucy
Published: July 2019

Employer breaches of New Zealand’s minimum employer standards and other forms of worker exploitation have been increasingly recognised as a significant problem. This affects migrant workers in particular, and among them those working without documentation or on various types of non-resident visas. Exploitation has become particularly embedded in a number of industries: fishing, hospitality and tourism, and in some sectors of agriculture, particularly those dependent on seasonal labour. Initially, government action to mitigate these problems was slow and reluctant but over the last decade, culminating in the reforms of 2016, there has been a more focussed effort to provide a strong legislative framework to support minimum employment standards. This article describes the background to those reforms, analyses the reforms themselves and goes on to consider whether they are adequate to ensure access to justice by disadvantaged workers.

JEL Codes: J81, J83, J88
The challenges facing the public mental health sector: implications of the Victorian Psychiatry workforce project
Authors: Newton Richard , Beasley Adele , Bosanac Peter , Castle David , Copolov David , Hopwood Mal , Keks Nick , Paoletti Nick , Tiller John
Published: July 2019

Objectives:

This paper reviews the major findings of the Victorian Psychiatry Attraction, Recruitment and Retention Needs Analysis Project and considers some of the implications for the psychiatrist workforce working in public sector psychiatry.

Conclusions:

The report provides a snapshot of the issues that are impairing the ability of Victorian psychiatrists to comprehensively treat those in our community who have severe mental illness. As the report shows, the issues impacting the profession are multi-faceted and complex, yet surmountable.
Measuring sucrose in blood after oral administration to detect abomasal ulcers in calves
Authors: Hund Alexandra , Schaffer Armin , Dolezal Marlies , Mascher Hermann , Wittek Thomas
Published: July 2019

Abomasal ulcers are common in cattle, especially in calves, and to date, there is no reliable antemortem method for diagnosis, to our knowledge. We assessed if measuring sucrose in blood after oral administration in calves could be used to identify animals with abomasal ulcers. Terminally ill calves ( n = 12; part A) and calves designated for slaughter ( n = 123; part B) were given a sucrose solution per os, and blood samples were taken 15, 30, 60, 90, and 120 min (part A) or 30 and 60 min (part B) after administration. The calves were then euthanized or slaughtered, and their abomasa were examined. Serum samples were analyzed using highperformance liquid chromatography-mass spectrometry, and data were analyzed using general linear mixed models. Calves both with and without affected abomasa had increasing sucrose values over time without significant differences. Also, there was no relationship between the size of the mucosal lesion and sucrose values.
The Role of the Clinical Pharmacist in a Preventive Cardiology Practice
Authors: Warden Bruce A. , Shapiro Michael D. , Fazio Sergio
Published: July 2019

Background: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide. In response, a multidisciplinary team approach, which includes clinical pharmacists, is recommended to improve patient outcomes. The purpose of the study was to describe interventions associated with integration of a clinical pharmacist, with an emphasis on pharmacist-generated patient cost avoidance. Methods: This is a prospective observational study detailing pharmacist-initiated interventions within an academic preventive cardiology service. Interventions targeting pharmacotherapy optimization, side effect management, patient education, medication adherence, and cost avoidance were implemented during shared office visits with providers and/or on provider consultation for remote follow-up. Tabulation of cost avoidance was arranged into 2 formats: clinical interventions implemented by the pharmacist and direct patient out-of-pocket expense reduction. Money saved per clinical intervention was extrapolated from data previously published. Patient out-of-pocket expense prior to and after pharmacist involvement was calculated to assess aggregate yearly patient cost savings. Results: Over 12 months the pharmacist intervened on 974 patients, totaling 3725 interventions. Cost avoidance strategies resulted in yearly savings of $830 748 in aggregate—$149 566 from clinical interventions and $681 182 from patient out-of-pocket expense reduction. Monthly patient out-of-pocket expense was reduced from a median (interquartile range) of $217 ($83.5-$347) before to $5 ($0-$18) after pharmacist intervention. Conclusions: Addition of a clinical pharmacist within an academic preventive cardiology clinic generated substantial pharmacotherapy interventions, resulting in significant cost avoidance for patients. The resulting cost avoidance may result in improved medication adherence and clinical outcomes.
A Focus of Differentiated Myeloid Sarcoma in a Ligation Specimen of the Fallopian Tube: No Evidence of Hematologic Abnormality in 18 Years of Follow-up Despite Absence of Treatment
Authors: Castro Eduardo , Morales Linden , Zreik Riyam , Donner Ludvik R.
Published: July 2019

A 0.2-cm intramural focus composed predominantly of myelocytes and metamyelocytes, many CD3+, CD43+ T-lymphocytes, scanty CD20+ B-lymphocytes, rare mast cells, but no eosinophils or myeloblasts was incidentally found in a ligation specimen of the left fallopian tube. The myeloid cells were positive for chloroacetate esterase, myeloperoxidase, myeloid marker BM2, and CD43, and they were negative for CD30, CD34, CD117, ERG, and TDT. The findings in the left fallopian tube were consistent with the diagnosis of differentiated myeloid sarcoma. The right fallopian tube was normal. No hematologic abnormalities were found elsewhere in the body. Curiously, the patient remains free of any hematologic abnormality for 18 years despite absence of treatment.
Using the Short Form of the MSBS to Assess State Boredom Among Adolescents: Psychometric Evidence by Applying Item Response Theory
Authors: Donati Maria Anna , Borace Elisa , Franchi Edoardo , Primi Caterina
Published: July 2019

The Multidimensional State Boredom Scale (MSBS) is widely used, but evidence regarding its psychometric properties among adolescents is lacking. In particular, the functioning of the scale across genders is unknown. As a result, we used item response theory (IRT) to investigate gender invariance of the Short Form of the MSBS (MSBS-SF) among adolescents. Four hundred and sixty-six Italian high school students (51% male; M = 16.7, SD = 1.44) were recruited. A confirmatory factor analysis demonstrated the unidimensionality of the scale, and IRT analyses indicated that the scale was sufficiently informative. Differential item functioning (DIF) across genders showed that only one item had DIF that was both nonuniform and small in size. Additionally, relationships with negative/positive urgency and present/future-oriented time perspectives were found. Overall, this study offers evidence that the MSBS-SF is a valuable and useful scale for measuring state boredom among male and female adolescents.
Nursing Advocacy and Long Acting Injectables to Reduce High Readmission Rates: Quality Initiative
Authors: Vonderhaar Bernard , Snyder Marsha
Published: July 2019

INTRODUCTION: Nonadherence to medications for schizophrenia relates to frequent readmissions. Long-acting injectable (LAI) medications are shown to increase adherence and reduce admissions. AIMS: (1) Identify frequent readmissions to psychiatry. (2) Improve nursing advocacy for patients appropriate for LAIs through in-service. METHODS: Chart audits were employed for data collection. Academic detailing and dashboards were used for voluntary nursing education. The chart audit spanned 90 days pre and post in-service. All admissions to psychiatry were screened; patients with readmissions under 30 days (with the same admitting diagnosis), a schizophrenia spectrum diagnosis, and nonadherent with oral antipsychotics were included. Results: Forty-four patients met criteria and amassed 49 frequent readmissions. For inclusion criteria, the admission rate decreased by 53% and LAI prescriptions increased by 9%. Three patients from the first audit group and one from the second were initiated on LAIs. CONCLUSIONS: Attitudes toward LAIs may be improving based on RN advocacy and collaboration.
BDSM as trauma play: An autoethnographic investigation
Authors: Thomas Jeremy N
Published: July 2019

In this article, I introduce the concept of BDSM as trauma play, which is the practice of intentionally engaging in BDSM activities in order to “play” with one’s past trauma or abuse. I begin by offering a fuller definition of trauma play, and I then summarize some of the key scholarly discussions related to the topic, especially the themes of healing, therapy, play, and embodiment. Following this, I take an autoethnographic approach, and I investigate my own trauma play experiences, which I subsequently analyze and use to highlight the need for more systematic research into this understudied topic area that significantly impacts the lives of some BDSM practitioners.
First steps: Parent health behaviours related to children’s foot health
Authors: Hodgson L , Growcott C , Williams AE , Nester CJ , Morrison SC
Published: July 2019

Good foot health throughout childhood is important but remains poorly understood with few studies exploring this topic. The aim of this study was to define parents’ knowledge, practices and health-related perceptions of children’s feet. A qualitative design was adopted. Semi-structured, one-to-one interviews were carried out with parents of children aged five years and under, recruited from South East and North West of England. Interviews explored parents’ views, beliefs and understanding of foot health in infancy and early childhood. Transcripts of the interviews were analysed using thematic analysis. Eighteen interviews were conducted. Seven themes were identified relating to (1) parents belief and knowledge about children’s foot health; (2) how parents use and share foot health information; (3) activities for supporting foot health and development; (4) footwear choices, beliefs and influences; (5) the way they access health professionals; (6) the way they search for foot health information and (7) developing practice(s) to support parents. The study provides the first insight into how parents view foot health in early infancy and childhood. The findings highlight the key foot health beliefs important to parents, how they learn about and what influences their decision-making about caring for children’s feet, the way parents receive and seek information, and how they access support for foot health concerns. The findings highlight the need for accurate, clear and consistent foot health messages, and the important role health professionals have in signposting parents towards reliable and informative sources on foot health.
Suspicious minds: An examination of trust-building in party mergers
Authors: Keith Dan , Sanderson-Nash Emma , Wager Alan
Published: July 2019

Here, we examine the understudied merger of the Social Democratic Party and the Liberal Party. This systematic study of the process which created the Liberal Democrats in 1988 adds to our understanding of what was a rare but important event in British politics. We demonstrate that it deviated from theoretical accounts of such mergers that stress the need for trust at the elite level. We recognise that inter-party trust can instead develop across the three faces of party organisation. We contribute a new typology for understanding these processes, and argue that existing studies are right to highlight that trust between the party in public office is important but wrong to conclude that its absence precludes mergers from occurring. Instead, we find that a lack of trust between parties in public office restricts the degree of delegation and increases the level of monitoring and formalisation, which can have damaging effects on the parties that emerge.
Cotinine Test in Evaluating Smoking Cessation at the Day of Bariatric Surgery
Authors: Gormsen J. , Hjørne F. , Helgstrand F.
Published: July 2019

Background and Aims:

Smoking increases the risk of postoperative complications after bariatric surgery. Therefore, preoperative smoking cessation is mandatory according to Danish guidelines before elective bariatric surgery. The aim of this study was to investigate if patients scheduled for bariatric surgery continue to smoke on the day of their operation despite recommendations.

Materials and Methods:

A prospective single-center study including all patients scheduled for bariatric surgery from June to December 2017 at Zealand University Hospital in Denmark. Urine samples were collected on the day of surgery to test for cotinine. During the minimum preoperative period of 3 months, patients were repeatedly informed of the increased risk of complications, that smoking cessation was mandatory, that rescheduling of the surgery was possible if more time to achieve smoking cessation was necessary, and if tested positive on the day of surgery, the operation would be canceled.

Results:

Of the 71 patients included, 9 patients (13%) were tested positive. After confrontation with the test result, all but 1 patient confessed to smoking. Overall, 6 out of 12 patients (50%) who were actively smoking at the time of referral tested positive, and 2 out of 25 patients (8%) who claimed to have smoked previously tested positive. No patients claiming no smoking history tested positive.

Conclusion:

Despite information that smoking cessation was mandatory, and the scheduled bariatric operation would be canceled in case of smoking, up to 50% of patients with a history of smoking still smoked on the day of surgery.
Numerical simulation of ductile fracture in polyethylene pipe with continuum damage mechanics and Gurson-Tvergaard-Needleman damage models
Authors: Zhang Yi , Jar P-Y Ben , Xue Shifeng , Li Lin
Published: July 2019

A phenomenon-based hybrid approach of experimental testing and finite element simulations is used to describe the fracture behavior of pipe-grade polyethylene. The experimental testing adopts a modified D-split test method to stretch the pipe ring (notched pipe ring) specimens that have symmetric, double-edged flat notches along the pipe direction. Two series of experimental testing were conducted: (1) monotonic loading till fracture and (2) monotonic loading to a predefined strain level, keeping constant displacement for a period of time, and then unloaded. Crosshead speeds of 0.01, 1, and 100 mm/min were used in both series of tests. Likewise, two series of finite element simulation were conducted to establish the constitutive equations, either with or without considering damage evolution during the deformation process. The constitutive equation without the consideration of damage was established using results from the first series of experimental testing, and that with damage was inspired from the second series which showed the decrease in unloading modulus with the increase of crosshead speed or the predefined strain level. The results show that with the consideration of damage evolution, the constitutive equations enable the finite element simulation to determine the whole stress–strain relationship during both necking and fracture processes.
Votes, money can buy. The conditional effect of EU Structural Funds on government MPs’ electoral performance
Authors: Papp Zsófia
Published: July 2019

Members of Parliament are often thought to attract funding into their constituencies to increase their local support, and eventually, secure re-election. Nevertheless, there is only limited research focusing on the question whether or not government funding indeed affects the MPs’ electoral performances. I focus on pork barrel politics in a single country, namely Hungary, and use town-level European Union Structural Funds data between 2007 and 2010 to explain the electoral performance of single-member district MPs at the 2010 general elections. I find that increasing funding improves government MPs’ electoral performances and that the size of the effect is conditional upon the mayors’ party affiliations. In towns with government mayors, government MPs perform significantly better than in towns with opposition mayors. The results have consequences in the fields of the distribution of Structural Funds, the electoral connection between legislators and voters and the European Union’s contribution to regime legitimation.
Assessment on the consequences of injection strategies on combustion process and particle size distributions in Euro VI medium-duty diesel engine
Authors: Bermúdez Vicente , García Antonio , Villalta David , Soto Lian
Published: July 2019

Although there are already several works where the influence of injection parameters on exhaust emissions, and specifically on particulate matter emissions, in diesel engines has been evaluated, the diversity in the results that can be found in the literature indicates the need to carry out new experiments that can provide more information about the influence of these parameters on modern diesel engines. This study intends to be placed within this scientific framework, hence a parametric study was carried out based on the independent modification of the main injection timing and the injection pressure with respect to the nominal conditions of a new Euro VI direct injection diesel engine. Four steady-state operation points of the engine map were chosen: 25% load and 950 r/min, 50% load and 1500 r/min, 75% load and 2000 r/min and 100% load and 2200 r/min, where in each of these operation points, the variations of the injection parameters in the study on the combustion process and its consequent impact on the particle size distribution, including an analysis of the geometric mean diameter values, were evaluated. The results showed that the different injection strategies adopted, despite not significantly affecting the engine efficiency, did cause a significant impact on particle number emissions. At the low load operation, the size distribution showed a bimodal structure, and as the main injection timing was delayed and the injection pressure was decreased, the nucleation-mode particle concentration decreased, while the accumulation-mode particle concentration increased. In addition, at medium load, the nucleation-mode particle emission decreased considerably while the accumulation-mode particle emission increased, and this increase was much greater with the main injection timing delay and the injection pressure reduction. Similar behavior was observed at high load, but with a much more prominent pattern.
Combination of oxymatrine and diammonium glycyrrhizinate significantly mitigates mice allergic contact dermatitis induced by dinitrofluorobenzene
Authors: Shi Hui-juan , Song Hong-bin , Gao Qiong , Si Jia-wei , Zou Qian
Published: July 2019

This study investigated the safety and effect of oxymatrine (OMT) and/or diammonium glycyrrhizinate (DG) on allergic contact dermatitis (ACD) induced by 1-fluoro-2,4-dinitrofluorobenzene (DNFB) in ICR mice. Mice were topically smeared with vehicle (control) or DNFB on their ear and skin to induce ACD. The mice were randomized and injected with saline as the model, treated intraperitoneally with dexamethasone (DEX), 45 or 90 mg·kg−1 OMT and/or DG daily beginning one day post the first smearing for two weeks. The body weights, the severity of ear and skin inflammation, the levels of serum IgE, IL-4, and IFNγ, creatinine and urea as well as plasma sodium and potassium in individual mice were measured. In comparison with the control group, the model group did not change the body weights, but developed severe skin and ear inflammation with increased ear thickness, accompanied by many inflammatory infiltrates in the lesions and high levels of serum IgE, IL-4, and IFNγ. Combination of OMT and DG prevented the OMT- or DG-altered body weights in mice. While treatment with either OMT or DG moderately reduced the skin and ear inflammation, their thickness and inflammatory infiltrates, combination of OMT and DG further significantly increased their anti-inflammatory effects in mice. A similar pattern of inhibitory effect on the levels of serum IgE, IL-4, and IFNγ was observed in the different groups of mice. Combination of OMT and DG also prevented the OMT-, DG-, or DEX-altered plasma sodium or potassium levels in mice. Therefore, combination of OMT and DG significantly increased anti-inflammatory effects on ACD induced by DNFB in mice and attenuated DG- or OMT-related adverse effects.

Impact statement

Diammonium glycyrrhizinate (DG) and oxymatrine (OMT) have similar anti-inflammatory, anti-allergic, anti-tumor, immunomodulatory, and other pharmacological properties. Our previous study has shown that when DG and OMT are combined, DG can attenuate both high-dose (347.44 mg·kg−1) and regular-dose (90 mg·kg−1) OMT-induced mortality and adverse effects (such as body weight loss and hyponatremia). Furthermore, OMT can similarly attenuate the adverse effects (such as body weight gain, hypernatremia, and hypokalemia) induced by regular dose (90 mg·kg−1) of DG. Accordingly, we tested whether combination of OMT and DG would increase anti-inflammatory activities and reduce their adverse effect in a mouse model of allergic contact dermatitis (ACD) induced by 1-fluoro-2,4-dinitrofluorobenzene (DNFB). Our findings indicated that combination of OMT and DG significantly increased anti-inflammatory effects on ACD induced by DNFB in ICR mice and attenuated adverse effects of DG or OMT alone.
Scoping Review of Self-Advocacy Education Interventions to Improve Care
Authors: Schmidt Elizabeth K. , Faieta Julie , Tanner Kelly
Published: July 2019

Self-advocacy is a client’s ability to represent one’s interests when managing disease or disability. Self-advocacy may increase one’s ability to seek, evaluate, and use information to promote health, yet little is known about the role of occupational therapy in promoting self-advocacy. This scoping review aims to identify interventions within occupational therapists’ scope of practice to improve self-advocacy. A literature search was conducted through Academic Search Complete to identify interventions within the scope of occupational therapy that promote self-advocacy. All levels of evidence were included, and articles were reviewed for inclusion by two authors. Included articles were charted for level of evidence, objectives, participants, and results. Fourteen articles met the criteria. Interventions included interactive multimedia interventions, peer-led educational groups, writing interventions, job counseling and advocacy, and disease-specific advocacy programs. Occupational therapists are well-equipped to intervene and promote self-advocacy through workplace modification, utilizing assistive technologies, and facilitating peer-led educational groups.
Interviewers as Intruders? Ethical Explorations of Joint Family Interviews
Authors: Herzog Madeleine , Jürgensen Martina , Rehmann-Sutter Christoph , Schües Christina
Published: July 2019

This paper discusses a case vignette that captures an ethically challenging situation in qualitative research. The study was about families who had experienced a life-saving bone marrow transplantation between siblings, who were children at the time of transplantation. A difficult situation emerged during a joint family interview that took place a few years after the transplantation. Parents, donor and the recipient were present, both still children. This interview technique produced unique, rich, and nuanced data about the family dynamics, about how the family constructed relationships and identity (“doing family”). The difficulties included a confrontation of the 10-year old donor child with accusations and pejorative statements from the other family members and his sidelining from the conversation. The interviewers have been acutely aware that their presence in this situation in this moment was an intrusion into family dynamics. In his commentary, Simon Woods emphasizes a model of ethical reflexivity, which shows how reflexive researchers can incorporate moral reflection at the different stages of the research process. Tim Henning argues for a morally engaged interviewer: the researcher should not stay uninvolved and should show willingness to actually engage in a moral discourse with the participants. Since the actual harms were caused not during the interviews but long before, it may be beneficial to bring them out in the open, as a matter for discussion, painful though it may be. The authors of the vignette (Madeleine Herzog, Martina Jürgensen, Christoph Rehmann-Sutter and Christina Schües) respond to the commentaries by endorsing the model of the reflexive researcher while rejecting (for methodological and moral reasons) the model of the morally engaged researcher.
Hybrid Operating Room: One-Stop-Shop for Diagnosis, Staging, and Treatment
Authors: Drevets Peter , Chung Jane M. , Schampaert Stephanie , Schroeder Carsten
Published: July 2019

The Hybrid Operating Room allows the thoracic surgeon to image, biopsy, diagnose, and operate in the same setting. With this streamlined model, time from referral to diagnosis to treatment is reduced. Increased efficiency allows for diagnosis and definitive surgical therapy sooner, thereby improving patient outcomes. A team-based approach is required for this one-stop-shop model of thoracic surgical practice to succeed. We present a series of prospective registry chart reviews demonstrating the utility of same-day diagnosis for thoracic oncology patient outcomes. Of the 21 patients presented, we were able to successfully obtain a diagnosis in 20 patients, resulting in a >95% single-session diagnostic rate.
Are schools educating toward active citizenship? The internal school struggle between contradictory citizenship models
Authors: Wahrman Hillel , Hartaf Hagit
Published: July 2019

This article investigates the phenomenology of Social Education Coordinators in Israeli high schools regarding school’s civic education. Twenty-one semi-structured interviews were conducted, followed by a two-stage coding process. The Social Education Coordinators indicate that their schools seem to be unified behind the goal of maximal citizenship. However, their unique position as agents of non-formal pedagogies gains them insight into the role of pedagogy in advancing various citizenship models and the struggle in schools between opposing pedagogies and citizenship models. Formal pedagogies are understood to be incoherent; they speak of maximal citizenship, however, habituate minimal citizenship. Informal pedagogies are understood to be coherent, to both speak and habituate maximal citizenship. From the Social Education Coordinators’ perspective, their attempt to insert meaningful informal pedagogies and true maximal citizenship is subversive and a show of agency. They perceive themselves as still weak but significant players in providing students with ‘voice’ in the public sphere. This analysis may advance our understanding of schools as arenas of incoherency and contradictions, of simultaneously pushing toward contradictory civic education ideals; it may highlight the civic significance of pedagogy choice and raise the issue of cultivating informal civic education pedagogies as a basic student right, a democratic right to cultivate ‘voice’.
Safeguarding the posted worker. A private international law perspective
Authors: Piir Ragne
Published: July 2019

This article examines the protection measures and the law applicable to posted workers. As a general rule, the Rome I Regulation designates the law to be applied to transnational individual employment contracts. In the context of postings, however, this is supplemented by certain safeguards foreseen in the Posting of Workers Directive. This paper analyses the interrelationship between the core set of employment terms as regulated in the Directive and the conflict-of-law rules for employment contracts in the Rome I Regulation. The article takes a critical look at the key problems in the legal regime applicable to posted workers under the Directive and its 2018 amendment. Special attention is first given to the question of determining the habitual workplace of a posted worker, then to the temporary nature of postings, and subsequently to the question of remuneration guaranteed to posted workers. The legal nature of national transposing measures of the Directive and national provisions entailing the core set of employment terms will also be analysed in order to explicate the interface of the two instruments. The paper will subsequently examine the application of the preferential approach.
Management of diabetes complications in youth
Authors: Graves Lara E. , Donaghue Kim C.
Published: July 2019

Type 1 and type 2 diabetes are increasing in prevalence and diabetes complications are common. Diabetes complications are rarely studied in youth, despite the potential onset in childhood. Microvascular complications of diabetes include retinopathy, diabetic kidney disease or nephropathy, and neuropathy that may be somatic or autonomic. Macrovascular disease is the leading cause of death in patients with type 1 diabetes. Strict glycaemic control will reduce microvascular and macrovascular complications; however, they may still manifest in youth. This article discusses the diagnosis and treatment of complications that arise from type 1 and type 2 diabetes mellitus in youth. Screening for complications is paramount as early intervention improves outcome. Screening should commence from 11 years of age depending on the duration of type 1 diabetes or at diagnosis for patients with type 2 diabetes. Diabetic retinopathy may require invasive treatment such as laser therapy or intravitreal antivascular endothelial growth factor therapy to prevent future blindness. Hypertension and albuminuria may herald diabetic nephropathy and require management with angiotensin converting enzyme (ACE) inhibition. In addition to hypertension, dyslipidaemia must be treated to reduce macrovascular complications. Interventional trials aimed at examining the treatment of diabetes complications in youth are few. Statins, ACE inhibitors and metformin have been successfully trialled in adolescents with type 1 diabetes with positive effects on lipid profile, microalbuminuria and measures of vascular health. Although relatively rare, complications do occur in youth and further research into effective treatment for diabetes complications, particularly therapeutics in children in addition to prevention strategies is required.
The road from intermittently scanned glucose monitoring to hybrid closed-loop systems: Part A. Keys to success: subject profiles, choice of systems, education
Authors: De Ridder Francesca , den Brinker Marieke , De Block Christophe
Published: July 2019

Managing type 1 diabetes (T1DM) is challenging and requires intensive glucose monitoring and titration of insulin in order to reduce the risk of complications. The use of continuous glucose monitoring (CGM) systems, either flash or intermittently scanned glucose monitoring (isCGM) or real-time (RT) CGM, has positively affected the management of type 1 diabetes with the potential to lower HbA1c, enhance time spent in range, reduce frequency and time spent in hypoglycemia and hyperglycemia, lower glycemic variability, and improve quality of life. In recent years, both CGM and pump technology have advanced, with improved functional features and integration, including low glucose suspend (LGS), predictive low glucose suspend (PLGS), and hybrid closed-loop (HCL) systems. In this review, we highlight the benefits and limitations of use of isCGM/RT-CGM for open-loop control and recent progress in closed-loop control systems. We also discuss different subject profiles for the different systems, and focus on educational aspects that are key to successful use of the systems.
How the study of historical educators in higher education can strengthen virtuous professionality of schoolteachers
Authors: De Muynck Bram
Published: July 2019

Reading texts of historical educators and being informed about their works and lives can be inspiring and exemplary for future teachers. In this article, I explore the learning processes that occur when student teachers study the classics, using frameworks from different disciplines, including social learning theory, drama theory, Aristotelian ethics, cognitive dissonance theory, and a theory of historical imagination. The results show that the study of educators from the past can have a beneficial impact on professional virtues when the encounter is in depth and when the student can actively choose an educator who captures his or her imagination.
Two-level game analysis of Japan in the TPP negotiations
Authors: Shinoda Tomohito
Published: July 2019

Starting his second term as Japanese prime minister in late 2012, Shinzo Abe regarded Japan’s participation in TPP negotiations as one of the top priority foreign policy issues. Abe successfully acquired a concession from President Barack Obama in order to enter the TPP negotiations without prior commitment to the total elimination of tariffs. After entry into the negotiations, Japan found a way to offer a tariff elimination on the politically sensitive agricultural products. Although the Japanese negotiation team was a latecomer in the TPP negotiation, its members played an instrumental role in reaching an agreement by helping other negotiating partners in the process. In addition, other factors including Japan-Australia FTA, the break-up of the Japan-US cabinet level meeting, and the Chinese initiative in AIIB motivated the American negotiators to reach an agreement. Japan’s role became even more important with the US withdrawal from the agreement, eventually contributing to a successful conclusion of the TPP agreement among 11 countries. Employing a two-level game framework, this study examines how Japan reached an important agreement with the United States in the original TPP negotiations, and then, after the American withdrawal, with other countries in the TPP 11 negotiations.