bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex Differences in the Treatment Needs and Outcomes of Problem Gamblers
Authors: Crisp Beth R. , Thomas Shane A. , Jackson Alun C. , Thomason Neil , Smith Serena , Borrell Jennifer , Ho Wei-Ying , Holt Tangerine A.
Published: September 2017

Previous studies have found significant differences between men and women who have sought help for problems associated with their gambling. While this raises the possibility of differing treatment needs, much of the research into treating problem gamblers is based on all-male samples. This article seeks to remedy this situation by reporting on sex differences in the treatment of 1,520 problem gamblers, almost half of whom are female, who sought help in the state of Victoria, Australia, between July 1996 and June 1997. In contrast to the primarily external concerns such as employment and legal matters reported by males, females attending for problem gambling counseling were more likely to report problems with their physical and intrapersonal functioning and were more likely to report resolution of their problems. Male clients were more likely to have their cases closed and be referred to other agencies for assistance.
What Children Learn from Sexual Abuse Prevention Programs: Difficult Concepts and Developmental Issues
Authors: Tutty Leslie M.
Published: September 2017

Objective

Social workers have long been concerned about whether child-directed school-based programs are effective in preventing sexual abuse. Knowing children's prior knowledge of abuse prevention concepts and what changes after intervention would be invaluable to program personnel.

Method

This secondary analysis involved 231 elementary school children who were randomly assigned (matched by age) to participate in the “Who Do You Tell” sexual abuse prevention program (n = 117) or in a wait-list control condition (n = 114). Chi-square analyses compared changes on each item of the Children's Knowledge of Abuse Questionnaire-Revised based on treatment versus control condition and developmental level (ages 5 to 7 compared to ages 8 to 13).

Results

Three items significantly improved for children in the program as compared to those in the control condition across ages.

Conclusions

The results suggest several changes in teaching prevention concepts.
Advanced Group Treatment for Developmentally Disabled Adults with Social Skill Deficits
Authors: Hall James A. , Dineen John P. , Schlesinger David J. , Stanton Roger
Published: September 2017

Objective

This social work research evaluates the effectiveness of an advanced, experimental treatment program for improving social skills with 6 developmentally disabled adults in a vocational training project.

Method

The effectiveness of the group treatment program was evaluated using multiple baseline designs replicated for 6 participants across six social skills. The intervention was developed in a previous study, and the skills were selected using a needs assessment.

Results

Results were mixed, and treatment gains from baseline to treatment phases were inconsistent across skills and participants. A 1-year follow-up assessment revealed that posttreatment skill levels were usually maintained.

Conclusions

These results only partially support the effectiveness of the group treatment program. Possible explanations for this conclusion are given, and clinical implications for social workers are discussed.
Evaluation of a Measure of Engagement for Group Work
Authors: Macgowan Mark J.
Published: September 2017

Objective

This study examines the psychometric properties of a measure of engagement for group work, the Groupwork Engagement Measure (GEM).

Method

The measure's properties were tested at two different points of group development, early and late group. The closed-ended groups were led by 13 graduate social work students and consisted of 86 student peers.

Results

The measure had excellent reliability at both administrations, with coefficient alphas of .97 and low Standard Error of Measurements. The construct- and criterion-related validity analyses were generally favorable.

Conclusions:

The GEM is a promising tool for social group workers interested in monitoring and improving their service.
Distance Education: What Do Our Students Tell Us?
Authors: Petracchi Helen E.
Published: September 2017

Objective

Given the rapid growth of distance education in social work, there is need to evaluate contemporary efforts in schools of social work, including multisite assessments of distance learning. This article reports multisite data addressing the question of how students enrolled in distance learning courses at two urban campuses (one using Interactive TV [ITV] and the other videotape) perceive their learning experiences.

Method

142 students’ responses were received from voluntarily submitted survey questionnaires querying students regarding their experiences with the technology used in their course, their learning environment, the instructor's teaching skills, and perceived resource availability.

Results

Respondents at both sites were pleased with their learning experience, with 100% of ITV students and 75% of the students Who viewed videotaped courses indicating they would enroll in distance learning again.

Conclusions

The opinions of remote student respondents suggest positive learning experiences are had by students in schools of social work, particularly as they experienced these two delivery formats.
A Comparison Study of Live Instruction versus Interactive Television for Teaching MSW Students Critical Thinking Skills
Authors: Huff Marie Thielke
Published: September 2017

Objective

The acquisition of critical thinking skills over one semester by distant and campus social work students enrolled in a graduate-level policy course were compared.

Method

The scores of pretests and posttests of 62 master's of social work students were analyzed using the California Critical Thinking Skills Test.

Results

Both groups significantly increased their critical thinking skills with no significant differences found between the two groups.

Conclusion

Distance education using interactive television was found to be equivalent to face-to-face instruction with regard to acquisition of critical thinking skills.
Delivering Substance Abuse and Child Welfare Content through Interactive Television
Authors: Hollister C. David , McGee Gloria
Published: September 2017

Objective

To evaluate interactive television (ITV) for delivering a graduate course on substance abuse and child welfare to distant sites.

Method

Students’ ratings of instructor-student communication are compared across distance and resident sites for the ITV course and with students in the traditional course. Similar comparisons are made for students’ ratings of the amount learned and for instructors’ judgments of student performance. Distance and resident students’ ratings of the ITV course are also compared to traditional courses.

Results

The mean of the instructor-student communication dimensions was the same for distance and traditional students and was slightly more positive for distance students compared to resident students. Student performance and course grades were similar across groups, and the distance and resident students in the ITV course rated it as helpful to their learning as traditional courses.

Conclusions

The results suggest that ITV compromised neither instructor-student communication nor the amount that students learned.
Teaching over the Internet: Results of One Doctoral Course
Authors: Schoech Dick
Published: September 2017

Objective

Although the Internet is new, many educators see it as a future instructional medium that will rival the face-to-face classroom. Currently, we have very little experience teaching a course using only the Internet. The objective of the course evaluated in this article was to test the feasibility and effectiveness of teaching a semester-long social work Ph.D. course on Technology Supported Practice entirely over the Internet. The course was open to master's of social work and Ph.D. students, and continuing education students.

Method

Internet tools used included a Web site, listserv, discussion forum, and chat room.

Results

Findings suggest that the Internet provides ample tools to deliver a course, especially when chat is used. Students report satisfaction and learning similar to a face-to-face classroom.

Conclusion

The Internet provides an environment rich enough to teach at a level of quality consistent with a face-to-face classroom.
Postcourse Evaluations of WebCT (Web Course Tools) Classes by Social Work Students
Authors: Wernet Stephen P. , Olliges Ralph H. , Delicath Timothy A.
Published: September 2017

Objective

Technology-enhanced education is becoming an increasingly important part of higher and professional education. Web-based course management tools such as WebCT (Web Course Tools) are the latest wave of technology-based pedagogical tools. The question is whether certain groups of students, in particular, nontraditional students, are disadvantaged when these tools are used for teaching and learning.

Method

This study reports on a survey of39 social work students’ satisfaction with and perception of impact of WebCT in social work education.

Results

All students found course materials on the course Web site helpful. Graduate and nontraditional students reported greater utility of the course management tools. Nontraditional students were not disadvantaged by, and preferred access to, Web-based courses.

Conclusions

Web-based and Web-enhanced courses hold promise for accommodating the needs of nontraditional students in social work education.
Students’ Use of Computer-Mediated Communication in a Distance Education Course
Authors: Johnson Miriam Mcnown , Huff Marie Thielke
Published: September 2017

Objectives

The authors were interested in how and why students use computer-mediated communication (CMC).

Method

Electronic messages sent by 76 social work students enrolled in a distance education course were examined. Responses to a survey with regard to the usefulness of these technologies were also analyzed.

Results

Students attending at distant sites were more likely than on-campus students to use both e-mail and the course listserv. Students used the technology more often for practical reasons than for academic enrichment. At the end of the term they reported increased competence in using CMC and expressed positive opinions about these technological supports.

Conclusions

CMC presents a partial remedy for the real and perceived isolation of students taking classes at distant sites. It does not, however, automatically augment learning.
Reprofessionalizing Child Welfare Services: An Evaluation of a Title IVE Training Program
Authors: Jones Loring P. , Okamura Amy
Published: September 2017

Objective

Test the effectiveness of a Title IVE training program for preparing practitioners for public child welfare employment.

Method

The sample consisted of all workers (N = 266) hired between June 1994 and June 1997 at a public child welfare agency. Data were collected through self-administered questionnaires, a follow-up phone interview, and a review of personnel records.

Results

Title IV–trained workers scored higher on a test of child welfare knowledge, and they expressed more confidence in their ability to perform basic child welfare tasks than did other workers. Eighty-nine percent of IVE workers were still employed at the study close. Overall, 76% of workers were still employed at that time. Contrary to expectations, IVE workers were not more satisfied with their jobs than other workers.

Conclusion

The retention finding is encouraging because it may mean that the staffing crisis in child welfare may have a solution in programs like IVE. However, IVE-trained workers may not stay unless the unsatisfactory working conditions are corrected.
The Client Satisfaction Inventory: Results of an Initial Validation Study
Authors: Mcmurtry Steven L. , Hudson Walter W.
Published: September 2017

Objective

To obtain initial results with regard to the reliability and validity of the Client Satisfaction Inventory (CSI), a 25-item scale for measuring general satisfaction with services among clients of human service agencies.

Method

The CSI was administered to 329 clients of 11 agencies in six states. Also administered were three other standardized measures and a brief descriptive questionnaire, results from which were used to assess the discriminant validity of the CSI.

Results

Findings indicated that both the full version of the CSI and a 9-item short-form version, the CSI-SF, have good to excellent internal consistency. Item analyses also provided some affirmative evidence with regard to the content validity of both versions, and the presence of hypothesized relationships between client satisfaction scores and those of the other instruments offered indications of good discriminant validity for each version.

Conclusion

Accountability demands, including pressures associated with managed care, have created a need in many agencies for brief, accurate, and norm-referenced measures of client satisfaction. Although further research is needed, initial results suggest that the CSI and CSI-SF may be useful tools for meeting this need.
Size-dependent free vibration analysis of a three-layered exponentially graded nano-/micro-plate with piezomagnetic face sheets resting on Pasternak’s foundation via MCST
Authors: Arefi Mohammad , Kiani Masoud , Zenkour Ashraf M
Published: September 2017

The present work is devoted to the free vibration analysis of elastic three-layered nano-/micro-plate with exponentially graded core and piezomagnetic face-sheets using the modified couple stress theory. To capture size-dependency for a nano-/micro-sized rectangular plate, the couple stress theory is used as a non-classical continuum theory. The rectangular elastic three-layered nano-/micro-plate is resting on Pasternak’s foundation. The present model contains one material length scale parameter and can capture the size effect. Material properties of the core are supposed to vary along the thickness direction based on the exponential function. The governing equations of motion are derived from Hamilton’s principle based on the modified couple stress theory and first-order shear deformation theory. The analytical solution is presented to solve seven governing equations of motion using Navier’s solution. Eventually the natural frequency is scrutinized for different side length ratio, thickness ratio, inhomogeneity parameter, material length scale, and parameters of foundation numerically.
Commentary: Rehabilitation for Rural and Remote Residents Following a Traumatic Hand Injury
Authors: Kingston Gail A
Published: September 2017

A traumatic hand injury can involve damage to a number of structures including skin, nerves, tendons, muscle bone, and soft tissue. Impairments such as pain or stiffness and loss of range of motion can last for many years and result in a moderate to extreme impact on a person’s day-to-day life. Work, leisure, financial security, and emotional well-being often most affected. This commentary provides an analysis of those factors that inhibit (barriers) and support (enablers) the provision of hand therapy rehabilitation in rural and remote areas. Providing a collaborative and flexible rehabilitation programme to rural and remote residents following a traumatic hand injury can be seen as a challenge due to issues such as a limited access to health care services. Established protocols that work in regional or metropolitan locations are unlikely to be effective and innovative and pragmatic strategies are required. The provision of a collaborative and flexible rehabilitation programme regardless of residential location is an important part of the therapist’s intervention plan.
Diffusion in Tube Dialyzer
Authors: Nigatie Yohannes
Published: September 2017

Nowadays, kidney failure is a problem of many peoples in the world. We know that the main function of kidney is maintaining the chemical quality of blood particularly removing urea through urine. But when they malfunction, the pathologic state known as uremia results in a condition in which the urea is retained in the body. Failure of the kidney results in building up of harmful wastes and excess fluids in the body. Kidney diseases (failures) can be due to infections, high blood pressure (hypertension), diabetes, and/or extensive use of medication. The best form of treatment is the implantation of a healthy kidney from a donor. However, this is often not possible due to the limited availability of human organs. Chronic kidney failure requires the treatment using a tube dialyzer called dialysis. Blood is taken out of the body and passes through a special membrane that removes waste and extra fluids. The clean blood is then returned to the body. The process is controlled by a dialysis machine (tube dialyzer) which is equipped with a blood pump and monitoring systems to ensure safety. So this article investigates the real application of mathematics (diffusion) in medical science, and it also contains the mathematical formulation and interpretation of tube dialyzer in relation to diffusion.
Leadership in organisational change: A post-structuralist research agenda
Authors: MacKillop Eleanor
Published: September 2017

The organisational change literature remains dominated by macro- and microexplanatory models which tend to exclude conflict, mess and power in favour of enumerating universalistic steps or, as is the subject of this article, leadership definitions and factors for successful change. In this article, I review and question some of the mainstream literature on leadership in organisational change, drawing on Laclau and Mouffe’s political discourse theory and its mobilisation by critical leadership studies of organisational change. This article problematises change leadership as a set of multiple and changing practices, pragmatically deployed by organisational players. In exploring those avenues, I deploy a five-step ‘logics of critical explanation’ approach – specifically designed by Laclauian discourse theorists – characterising organisational change practices according to social (rules and norms), political (inclusions and exclusions) and fantasmatic (fears and hopes) logics. Rather than a set of factors or top–down causes and effects, I offer a situated and critical explanation of leadership in organisational change. This research contributes to critical explanations of organisational change politics by considering leadership as a set of changing discursive practices and by developing four situated dimensions of leadership, which build on concepts of empty and floating signifiers, to add to discussions of the role of individuals in organisational politics.
Systematic review of lessons learned from delivering tele-therapy to veterans with post-traumatic stress disorder
Authors: Turgoose David , Ashwick Rachel , Murphy Dominic
Published: September 2017

Introduction

Despite increases in the number of ex-service personnel seeking treatment for post-traumatic stress disorder (PTSD), there remain a number of barriers to help-seeking which prevents many veterans from accessing psychological therapies. Tele-therapy provides one potential method of increasing the number of veterans accessing support. This review aimed to systematically review the literature in order to summarise what lessons have been learned so far from providing trauma-focused tele-therapies to veterans with PTSD.

Methods

A systematic literature review was conducted from which 41 papers were reviewed. Studies were included if they involved the use of trauma-focused therapies carried out using tele-therapy technologies. Only studies using tele-therapy interventions via video or telephone with populations of ex-military personnel with PTSD were included.

Results

In the majority of cases tele-therapy was found to be as effective in reducing PTSD symptoms as in-person interventions. Similarly, there were few differences in most process outcomes such as dropout rates, with tele-therapy helping to increase uptake in some cases. Veterans using tele-therapy reported high levels of acceptability and satisfaction. Some challenges were reported in terms of therapeutic alliance, with some studies suggesting that veterans felt less comfortable in using tele-therapy. Several studies suggested it was harder for clinicians to read non-verbal communication in tele-therapy, but this did not affect their ability to build rapport. Technological issues were encountered, but these were not found to impede therapy processes or outcomes.

Discussion

Tele-therapy provides a viable alternative to in-person therapies and has the potential to increase access to therapy for veterans. Tele-therapy should continue to be evaluated and scrutinised in order to establish the most effective methods of delivery.
Effectiveness of remote feedback on physical activity in persons with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials
Authors: Kongstad Malte Bue , Valentiner Laura Staun , Ried-Larsen Mathias , Walker Karen Christina , Juhl Carsten Bogh , Langberg Henning
Published: September 2017

Objectives

The objective of this systematic review and meta-analysis was to examine the effectiveness of remote feedback intervention compared with standardized treatment on physical activity levels in persons with type 2 diabetes. Further, to investigate the influence of the length of intervention, number of contacts, study size, delivery of feedback, and preliminary face-to-face sessions.

Methods

A systematic literature search was conducted in May 2017, with a priori defined eligibility criteria: randomized controlled trials investigating remote feedback interventions in adult persons with type 2 diabetes, using physical activity as outcome. The effect size was calculated as standardized mean difference (SMD) and was pooled in a meta-analysis using a random-effects model. Meta-regression analyses were performed to examine if the observed effect size could be attributed to study- or intervention characteristics using these as covariates.

Results

The literature search identified 4455 articles of which 27 met the eligibility criteria. The meta-analysis including a total of 4215 participants found an overall effect size in favour of remote feedback interventions compared to standardized treatment, SMD = 0.33 (95% CI: 0.17 to 0.49), I2 = 81.7%). Analyses on study characteristics found that the effect on physical activity was only influenced by study size, with a larger effect in small studies.

Conclusion

Adding remote feedback to standardized treatments aimed at increasing physical activity in persons with type 2 diabetes showed a small to moderate additional increase in physical activity levels. Systematic review registration: PROSPERO CRD42016033479.
Feeling your data: Touch and making sense of personal digital data
Authors: Lupton Deborah
Published: September 2017

People’s encounters and entanglements with the personal digital data that they generate is a new and compelling area of research interest in this age of the ascendancy of digital data. Masses of personal information are constantly generated via people’s use of digital technologies and used for a variety of purposes by a range of actors. People are faced with the conundrum of how to interpret, control and make sense of their lively data. In this article, I explore the topic of how personal digital data and their circulations can be made more perceptible and therefore interpretable to people with the use of three-dimensional materialisations. These materialisations invite users to ‘feel your data’. As I show, ‘feeling your data’ has two meanings: the sensations of touching these three-dimensional objects and the visceral responses that are generated from these and other sensory encounters with data.
A physical-based approach for modeling cycle-to-cycle variations within a zero-dimensional/one-dimensional simulation environment
Authors: Krost Philipp , Hübner Walter , Hasse Christian
Published: September 2017

In the spark-ignition engine development and optimization process, the cyclic variability of combustion is an essential and current issue. Cycle-to-cycle variations are extensively investigated by means of quasi-dimensional (zero-dimensional/one-dimensional) simulation modeling. To date, these model approaches have been limited either because they neglected particularly significant physical causes and factors influencing cyclic combustion variations or because of their solely empirical combustion modeling basis. However, in order to ensure the high validity of simulation results, quasi-dimensional model approaches have to accurately describe the physical background of engine combustion. Therefore, a new cyclic combustion variation model is introduced in this study. This cycle-to-cycle variation model is based on previously developed, highly sophisticated physical turbulence, ignition and combustion models, thus for the first time enabling the physical description of cycle-to-cycle variation. The model integrates the most significant physical causes of combustion variations and the factors which influence them, obtained from a literature study. Hence, the derived cycle-to-cycle variation model can physically react to changes in engine parameters such as the engine speed, load, spark timing, valve lift and timing as well as the air–fuel equivalence ratio [Formula: see text]. For validation, the new cycle-to-cycle variation model is compared to a state-of-the-art cycle-to-cycle variation model and analyzed by means of engines with different combustion processes. This new cycle-to-cycle variation model uniquely features the physical background of the underlying combustion model and the integration of more influencing factors than in previous approaches. Another unique feature is its basis on extensive experimental data, gained by changing various engine parameters for homogeneous charge spark-ignition engines with different combustion/engine concepts. These include engines with high turbulence generation or a long expansion stroke via crank and valve train.
Transvenous retrograde AVM embolization: Indications, techniques, complications and outcomes
Authors: Lv Xianli , Song Cao , He Hongwei , Jiang Chuhan , Li Youxiang
Published: September 2017

Objective

Transvenous retrograde arteriovenous malformation (AVM) embolization (TRAE) has been proposed. The present study was to review the techniques, their conjunctions and effectiveness.

Methods

Eligible related articles were identified by searching the PubMed and Web of Science databases using “transvenous” and “arteriovenous malformation.”

Results

A total of 16 eligible studies, with 60 cases of AVM treated with TRAE, were analyzed. Prior to TRAE procedure, transarterial Onyx 18 was performed in 23 (38.3%), cyanoacrylate in three (5%) and coiling in two (3.3%), neurosurgery in one (1.7%) and radiosurgery in three (5%). These prior treatments were used to reduce the size of the nidus to <3 cm and TRAE was performed. One anterior choroidal artery aneurysm was coiled before TRAE. Systemic hypotension (blood pressure<100 mmHg) occurred in six (10%) patients and local hypotension (proximal arterial temporary balloon protection) in five (8.3%) patients. Complete obliteration was achieved in 56 (93.3%) AVMs, four (6.7%) with residual, of which one was supplemented with radiosurgery. During mean one-year follow-up (1 month to 3.2 years), there were five cases (8.3%) of permanent disability and one (1.7%) mortality resulting from initial hemorrhage. Fifty-four (90%) patients were independent (mRS ≤ 2) at follow-up. Ruptured AVMs and Spetzler-Martin I–III were associated with a high cure rate.

Conclusion

According to previous reports, selected AVMs could undergo TRAE. TRAE is safe and curative with Onyx after the nidus size is reduced sufficiently by transarterial embolization, neurosurgery or radiosurgery, with or without the aid of proximal arterial temporary balloon protection.
Testing a new surfactant in a widely-used blood mimic for ultrasound flow imaging
Authors: Zhou Xiaowei , Hoskins Peter R.
Published: September 2017

Background

A blood-mimicking fluid developed by Ramnarine et al. has been widely used in flow phantoms for ultrasound flow imaging research, and it has also been cited by IEC 61685 as a reference for making blood-mimicking fluid.However, the surfactant material Synperonic N in this blood-mimicking fluid recipe is phased out from the European market due to environmental issues. The aim of this study is to test whether Synperonic N can be substituted by biodegradable Synperonic A7 in making blood-mimicking fluid for ultrasound flow imaging research.

Methods and materials

A flow phantom was fabricated to test the blood-mimicking fluid with Synperonic N and Synperonic A7 as surfactants separately. Doppler images and velocity data were collected using a clinical ultrasound scanner under constant and pulsatile flows; and images and measured velocities were compared.

Results

It was found that both blood mimics can provide exactly the same images under spectral Doppler ultrasound and colour Doppler ultrasound in terms of their image qualities. The maximum velocities under constant flow were measured by the spectral Doppler ultrasound as 0.4714 ± 0.001 m.s−1 and 0.4644 ± 0.001 m.s−1 for blood-mimicking fluid with Synperonic N and blood-mimicking fluid with Synperonic A7, respectively. Measured velocities using the two different blood-mimicking fluids were statistically different ( p < 0.001), but this difference was less than 2%. The Synperonic A7 can be used as a substitute for Synperonic N as a surfactant material in making the blood-mimicking fluid for ultrasound flow imaging research.
TLR4 receptor expression and function in F11 dorsal root ganglion × neuroblastoma hybrid cells
Authors: Hashemian Sanaz , Alhouayek Mireille , Fowler Christopher J
Published: September 2017

TLR4 respond to bacterial LPS to produce inflammatory cytokines. TLR4 are expressed in dorsal root ganglia and play a role in pain. F11 dorsal root ganglia × mouse neuroblastoma cells possess many of the properties seen in nociceptive dorsal root ganglia neuronal cells. Here, we investigated the effect of 2 h and 6 h treatment with LPS upon the expression of inflammatory proteins in undifferentiated and differentiated F11 cells. The cells expressed mRNA for TRL4 (mouse, not rat) and proteins involved in TLR4 signaling. TLR4 expression was confirmed using immunohistochemistry. LPS produced modest increases in mouse and rat IL-6 and in mouse cyclooxygenase-2 levels in undifferentiated cells, but did not significantly affect mouse TNF-α expression. This contrasts with the robust effects of LPS upon cyclooxygenase-2 expression in cultured dorsal root ganglia neurons. F11 cells expressed the endocannabinoid metabolizing enzymes fatty acid amide hydrolase and N-acylethanolamine acid amidase (both murine), which were functionally active. These data suggest that F11 cells are not a useful model for the study of LPS-mediated effects but may be useful for the study of endocannabinoid catabolism.
Treatment of ulcerative compared to non-ulcerative interstitial cystitis with hyperbaric oxygen: a pilot study
Authors: Wenzler David L. , Gulli Farris , Cooney Maureen , Chancellor Michael B. , Gilleran Jason , Peters Kenneth M.
Published: September 2017

Background

The etiology of interstitial cystitis (IC) is often idiopathic but can be due to Hunner’s ulcers. Hyperbaric oxygen (HBO) is used to treat ulcerative disease of the superficial skin. We hypothesized that HBO can treat ulcerative IC (UIC) but would be less efficacious for non-ulcerative IC (NIC).

Methods

Patients with NIC and UIC enrolled in this study. Following informed consent, demographic information was collected. A visual analog pain scale and validated questionnaires were collected; each patient underwent cystoscopy prior to treatment. Each subject met with a hyperbaric specialist and after clearance underwent 30 treatments over 6 weeks. Adverse events were monitored. Patients repeated questionnaires, visual analog pain scale and global response assessment (GRA) immediately, 2 weeks, 3, 6 and 12 months after treatment. Patients also underwent cystoscopy 6 months after treatment. Differences before and after treatment were compared.

Results

Nine patients were recruited to this study. One was unable to participate, leaving two subjects with NIC and six with UIC. All patients completed HBO without adverse events. Three patients completed HBO but pursued other therapies 7, 8.5 and 11 months after treatment. On GRA, 83% of patients with UIC were improved. This treatment effect persisted, as 66% of UIC patients remained better at 6 months. In contrast, only one patient in the NIC group improved. Questionnaire scores improved in both groups. Pain scores improved by 2 points in the UIC group but worsened by 1.5 points in the NIC group. Two patients with ulcers resolved at 6-month cystoscopy.

Conclusion

HBO appeared beneficial for both UIC and NIC. Data shows slightly better benefit in patients with UIC compared to NIC; both groups showed improvement. Given the small sample size, it is difficult to draw definitive conclusions from these data. Larger studies with randomization would be beneficial to show treatment effect.
Innovation activity among nurses: The translation and preliminary validation of the Bricolage Measure – a mixed-method study
Authors: Krontoft Anna , Fuglsang Lars , Kronborg Hanne
Published: September 2017

Qualitatively, research has demonstrated the existence of bricolage among healthcare staff, i.e. solving problems on the spot by resources at hand, and its potential to lead to innovation. However, we know little about the spread of bricolage activity and its potential role for innovation in healthcare. The aim of this study was therefore to provide an instrument for measuring bricolage activity among nurses, to test the measure and learn about the spread of bricolage in nursing in Denmark. We used a mixed-method design including a translation–back translation, a pre-test and a pilot test. Primary data were collected during 2015 via interviews and a survey, including 248 nurses. The analysis revealed that the majority of nurses rated themselves and colleagues as having a high level of bricolage activity. This study’s preliminary validations (content and face validation), of the translated Bricolage Measure, confirmed the usability of the instrument to examine bricolage activity in nursing in Denmark.
Recasting Language of Work: Beedi Industry in Post-colonial Central India
Authors: Sharma Megha
Published: September 2017

The complexities of studying informal sector labour can be dealt with bringing a wide range of identities and ideas used by the workers, which encompass beyond the socio-economic and political identities. 2 2   This article is based on my MPhil dissertation, ‘Conditions of Informality: Beedi Industry in Colonial and Post 1947 Central India’, submitted to the Centre for Historical Studies, Jawaharlal Nehru University in 2015. This article attempts to capture the diversified identities among the home-based beedi-making women workers and their settlement in Madhya Pradesh based on their oral interviews. Further, it captures how the division of work is sustained and perpetuated through the gendered allocation of work over the years. It also recounts how the state has perpetuated this division as the natural allocation of work in official discourse. Precisely, the article argues that how the worker’s narratives are an essential source to question the way work is explained in official language and the inequalities justified by the state.
Takotsubo Cardiomyopathy With a Rapidly Resolved Left Ventricular Thrombus
Authors: Anabtawi Abdel , Roldan Paola C. , Roldan Carlos A.
Published: September 2017

This article presents the case of a 53-year-old man who presented with acute right superficial femoral and popliteal arterial thrombosis for which he underwent an emergent uncomplicated thrombectomy. He denied preceding cardiovascular or neurologic symptomatology and had no history of coronary or peripheral arterial disease, trauma, hypercoagulability, or malignancy. However, he reported having several days of intense emotional stress prior to presentation. His cardiac exam was normal, his electrocardiogram showed normal sinus rhythm and nonspecific ST-T wave abnormalities, and his troponin levels were normal. Transthoracic echocardiography (TTE) revealed a large (2.4 × 2 cm) apical left ventricle (LV) thrombus, LV apical akinesis, and LV ejection fraction of 40% to 45%. Coronary angiography revealed only luminal irregularities. A repeat TTE performed 3 days after initiating unfractionated heparin revealed complete resolution of the LV thrombus. The patient had an uneventful clinical course and was discharged home in stable condition on oral anticoagulants. The lower incidence of LV thrombus in takotsubo cardiomyopathy (TC) of 1.3% in comparison to 4% to 8% in acute myocardial infarction due to coronary artery disease in the current era of early reperfusion may be explained by the lower extent of ischemic myocardial necrosis associated with TC. This case suggests that the lower extent of myocardial necrosis in TC may also lead to faster resolution of LV thrombus. Therefore, earlier follow-up with TTE (within 2 weeks) and shorter duration of anticoagulation (<3 months) may be considered in patients with TC complicated by LV thrombus formation with or without systemic embolism.
Climate governance entrepreneurship: Emerging findings and a new research agenda
Authors: Boasson Elin Lerum , Huitema Dave
Published: September 2017

This is an introductory paper to a special issue on climate governance entrepreneurship, where entrepreneurship is understood as acts performed by actors seeking to ‘punch above their weight’. By contrast, actors who are merely doing their job are not ‘entrepreneurs’. In order to understand climate policy and governance, we need to learn more about the factors that condition variance in entrepreneurial activity, strategies and success. In this introduction, we present a comprehensive review of the literature on entrepreneurs and entrepreneurship in policy in governance, with special attention to the recent upsurge in studies of climate governance entrepreneurship. We distinguish two types of entrepreneurship: (1) acts aimed at enhancing governance influence by altering the distribution of authority and information; and (2) acts aimed at altering or diffusing norms and cognitive frameworks, worldviews or institutional logics. The contributions in this special issue offer valuable insights into how personal motivations, policy windows, international trends, cultural-institutional traditions and the distribution of structural power influence entrepreneurship. However, more work is needed – not least as regards whether actors that seek change are more active and/or more successful as entrepreneurs compared to those that defend the status quo, and whether there is more successful entrepreneurship in public or in private arenas of governance.
Regional governance and public accountability in planning for new housing: A new approach in South Holland, the Netherlands
Authors: Kang Vitnarae , Groetelaers Daniëlle A
Published: September 2017

Regional governance is coming to play an increasingly pivotal role in the planning of housing development. It has been argued that an absence of formal accountability lines in regional governance is beneficial because it makes inter-municipal coordination more flexible, without the need for territorial adjustments in local authorities. However, this view is based on a narrow interpretation of public accountability. In fact, regional governance becomes effective when hierarchical accountability arrangements are structured to reinforce horizontal accountability that strengthens self-organising capacity. This paper is based on a study of regional housing planning in the province of South Holland, the Netherlands, and analyses three types of governance modes (hierarchical, horizontal and market-oriented) and public accountability relationships. The measures undertaken in the case under review to ensure effective regional housing planning under changing market circumstances highlight the need to modify accountability arrangements when policy-makers choose a new set of governance modes in order to shape relational dynamics appropriately.
Anxiety, irritability, and agitation as indicators of bipolar mania with depressive symptoms: a post hoc analysis of two clinical trials
Authors: Suppes Trisha , Eberhard Jonas , Lemming Ole , Young Allan H. , McIntyre Roger S.
Published: September 2017

Background

Symptoms of anxiety, irritability, and agitation (AIA) are prevalent among patients with bipolar I disorder (BD-I) mania with depressive symptoms, and could potentially be used to aid physicians in the identification of this more severe form of BD-I. Using data from two clinical trials, the aims of this post hoc analysis were to describe the phenomenology of bipolar mania in terms of AIA and depressive symptoms, and to evaluate the influence of these symptoms on the likelihood of remission during treatment.

Methods

Patients with a BD-I manic or mixed episode (Diagnostic and Statistical Manual of Mental Disorders IV criteria) were randomised to 3 weeks of double-blind treatment with asenapine, placebo, or olanzapine (active comparator). Anxiety was defined as a score of ≥3 on the Positive and Negative Syndrome Scale ‘anxiety’ item, irritability as a score of ≥4 on the Young Mania Rating Scale (YMRS) ‘irritability’ item, and agitation as a score of ≥3 on the YMRS ‘increased motor activity–energy’ item. Depressive symptoms were defined as a score of ≥1 on three or more individual Montgomery–Åsberg Depression Rating Scale (MADRS) items, or a MADRS Total score of ≥20.

Results

A total of 960 patients with BD-I were analysed, 665 with a manic episode and 295 with a mixed episode. At baseline, 61.4% had anxiety, 62.4% had irritability, 76.4% had agitation, and 34.0% had all three AIA symptoms (‘severe AIA’); 47.3% had three or more depressive symptoms, and 13.5% had a MADRS total score of ≥20. Anxiety, irritability, and severe AIA (but not agitation) were statistically significantly more common in patients with depressive symptoms. Patients with anxiety or severe AIA at baseline were statistically significantly less likely to achieve remission (YMRS total <12). In general, remission rates were higher with asenapine and olanzapine than with placebo, irrespective of baseline AIA or depressive symptoms.

Conclusions

Assessment of AIA symptoms in bipolar mania could enable physicians to identify patients with more severe depressive symptoms, allowing for appropriate intervention. Assessment and monitoring of AIA may help physicians to predict which patients may be harder to treat and at risk for self-harm.

Trial registration ClinicalTrials.gov NCT00159744, NCT00159796. Registered 8 September 2005 (retrospectively registered)
Estrogen Metabolism in Abdominal Subcutaneous and Visceral Adipose Tissue in Postmenopausal Women
Authors: Hetemäki Natalia , Savolainen-Peltonen Hanna , Tikkanen Matti J , Wang Feng , Paatela Hanna , Hämäläinen Esa , Turpeinen Ursula , Haanpää Mikko , Vihma Veera , Mikkola Tomi S
Published: September 2017

Context

In postmenopausal women, adipose tissue (AT) levels of estrogens exceed circulating concentrations. Although increased visceral AT after menopause is related to metabolic diseases, little is known about differences in estrogen metabolism between different AT depots.

Objective

We compared concentrations of and metabolic pathways producing estrone and estradiol in abdominal subcutaneous and visceral AT in postmenopausal women.

Design, Setting, Patients, and Interventions

AT and serum samples were obtained from 37 postmenopausal women undergoing surgery for nonmalignant gynecological reasons. Serum and AT estrone, estradiol, and serum estrone sulfate (E1S) concentrations were quantitated using liquid chromatography-tandem mass spectrometry. Activity of steroid sulfatase and reductive 17β-hydroxysteroid dehydrogenase enzymes was measured using radiolabeled precursors. Messenger RNA (mRNA) expression of estrogen-converting enzymes was analyzed by real-time reverse transcription quantitative polymerase chain reaction.

Results

Estrone concentration was higher in visceral than subcutaneous AT (median, 928 vs 706 pmol/kg; P = 0.002) and correlated positively with body mass index (r = 0.46; P = 0.011). Both AT depots hydrolyzed E1S to estrone, and visceral AT estrone and estradiol concentrations correlated positively with serum E1S. Compared with visceral AT, subcutaneous AT produced more estradiol from estrone (median rate of estradiol production, 1.02 vs 0.57 nmol/kg AT/h; P = 0.004). In visceral AT, the conversion of estrone to estradiol increased with waist circumference (r = 0.65; P = 0.022), and estradiol concentration correlated positively with mRNA expression of HSD17B7 (r = 0.76; P = 0.005).

Conclusions

Both estrone and estradiol production in visceral AT increased with adiposity, but estradiol was produced more effectively in subcutaneous fat. Both AT depots produced estrone from E1S. Increasing visceral adiposity could increase overall estrogen exposure in postmenopausal women.
The Implication of Diagnostic Errors
Authors: Govindarajan Raghav
Published: September 2017

Diagnostic errors are mistakes in the diagnostic process that lead to a misdiagnosis, a missed diagnosis, or a delayed diagnosis. While the past decade’s impetus to improve patient safety has focused on medication errors, health care–associated infections, and postsurgical complications, diagnostic errors have received comparatively less attention. Diagnostic errors will continue to play a major role in the patient safety and quality improvement movement because of their burden on care and their financial burden. Developing a patient-partnered diagnostic approach with self-reflection and awareness of cognitive biases is the key to minimizing the impact of diagnostic errors.
Charcot-Marie-Tooth Disease and Other Genetic Polyneuropathies
Authors: Ramchandren Sindhu
Published: September 2017

Purpose of Review:Genetic polyneuropathies are rare and clinically heterogeneous. This article provides an overview of the clinical features, neurologic and electrodiagnostic findings, and management strategies for Charcot-Marie-Tooth disease and other genetic polyneuropathies as well as an algorithm for genetic testing.

Recent Findings:In the past 10 years, many of the mutations causing genetic polyneuropathies have been identified. International collaborations have led to the development of consortiums that are undertaking careful genotype-phenotype correlations to facilitate the development of targeted therapies and validation of outcome measures for future clinical trials. Clinical trials are currently under way for some genetic polyneuropathies.

Summary:Readers are provided a framework to recognize common presentations of various genetic polyneuropathies and a rationale for current diagnostic testing and management strategies in genetic polyneuropathies.
The Suicide State
Authors: Anidjar Gil
Published: September 2017

When he refers to civil war as “self-laceration,” Carl Schmitt evokes a strange figure, whereby the state could be bound for self-destruction. In this essay, I am less interested in civil war than in the conception of a state as suicidal. What could that even mean? What could be gained by asking whether there are, among states, suicide states? What kind of destruction, what kind of politics, are thereby made manifest? My concerns ultimately align, I hope, with the knowledge of militarization.