bluuebunny/crossref_metadata_2025 huggingface dataset:
Are Hispanic, Asian, Native American, or Language-Minority Children Overrepresented in Special Education?
Authors: Morgan Paul L. , Farkas George , Cook Michael , Strassfeld Natasha M. , Hillemeier Marianne M. , Pun Wik Hung , Wang Yangyang , Schussler Deborah L.
Published: February 2018

We conducted a best-evidence synthesis of 22 studies to examine whether systemic bias explained minority disproportionate overrepresentation in special education. Of the total regression model estimates, only 7/168 (4.2%), 14/208 (6.7%), 2/37 (5.4%), and 6/91 (6.6%) indicated statistically significant overrepresentation for Hispanic, Asian, Native American, and English language learner (ELL) or language-minority children, respectively. Among studies with the strongest internal and external validity, none of the 90 estimates (i.e., 0%) indicated overrepresentation attributable to racial or ethnic bias. Of the 18 estimates for language-minority and ELL children combined, only 3 (16.7%) indicated overrepresentation attributable to language use. Two of the 4 ELL-specific estimates (50%) indicated that children receiving English-as-a-second-language services may be overrepresented in special education. Overall, and replicating findings from a prior best-evidence synthesis, this synthesis indicated that children are underidentified as having disabilities based on their race or ethnicity and language use.
Dosing of Enoxaparin in Morbidly Obese Patients: A Retrospective Cohort
Authors: Czupryn Michael J. , Exline Cristal
Published: February 2018

Purpose: The purpose of this study was to evaluate odds of major bleeding, thrombosis, and ischemic stroke between different enoxaparin dosage strategies in patients weighing ≥120 kg. Methods: Patients weighing ≥120 kg who received therapeutic anticoagulation with enoxaparin for more than 24 hours were selected for retrospective review. Patients without a baseline weight, serum creatinine, a history of heparin-induced thrombocytopenia, or currently pregnant patients were excluded from the study. Patients with a creatinine clearance (CrCL) <30 mL/min were analyzed separately. The incidence of major bleeding was compared between patients receiving <90% and those receiving ≥90% of the Food and Drug Administration (FDA)–approved dose of enoxaparin, as well as between patients weighing ≥150 kg and those weighing <150 kg. Secondary outcomes included incidence of venous thromboembolism (VTE) and ischemic stroke. Results: A total of 462 patients were included in the primary analysis and 25 patients in the subgroup analysis. No difference in major bleeding was observed between different dosage regimens ( P = .12) or weight groups ( P = .36). No difference was observed in rates of VTE or ischemic stroke between different dosage regimens ( P = .52 and P = .60, respectively) or weight groups ( P = .39 and P = .48, respectively). Similar results were observed in the low-CrCL analysis. Results were not altered when patients were propensity matched on baseline characteristics. Conclusion: Reducing the dose of enoxaparin did not reduce the odds of major bleeding or increase the odds of ischemic stroke or VTE.
The Prescription Drug User Fee Act: Cause for Concern?
Authors: Gabay Michael
Published: February 2018

The Prescription Drug User Fee Act (PDUFA) was originally enacted into law in 1992. PDUFA provides the Food and Drug Administration (FDA) with needed revenue in the form of various fees paid by drug and biologic manufacturers. The FDA utilizes this revenue to streamline the review and approval process for medications. Since the enactment of PDUFA, the median approval time for priority new drug applications and biologics license applications has reduced significantly. The FDA views PDUFA as a successful program that provides a consistent revenue stream to the agency, improves access to medications for patients, and allows industry to have a more predictable product review timeline. However, critics of PDUFA cite concerns including the potential for a lack of FDA independence and medication safety issues involving drugs approved after the existence of PDUFA.
Two Years of Retrospective Study on the Incidence of Tuberculosis in Dir Lower Valley, Khyber Pakhtunkhwa, Pakistan
Authors: Uddin Shahab , Khan Faiz Ullah , Ahmad Tariq , Rehman Muhammad Maqsood Ur , Arif Muhammad
Published: February 2018

Background: Pakistan has high tuberculosis (TB) burden with alarming mortality and morbidity, and its rate increases day by day, especially in remote areas where access of quality health is not available. Objective: The objective of the study was to determine the incidence rate of pulmonary TB in the Dir valley among the suspected patients according to age-, gender-, and location-wise prevalence of the disease. Methods: A retrospective descriptive study was designed from January 2015 to December 2016. All the 556 people registered are suspected patients of pulmonary tuberculosis sputum smear (PTB-SS) positive, whereas the remaining cases were diagnosed with extra-pulmonary TB and hence excluded from the study. Results: The ratio of PTB-SS-positive cases was higher in females (50.5%, n = 281) compared with males (49.5%, n = 275). Furthermore, in the age group 1 to 20 years, the percentage of PTB-SS-positive cases was 28.1% (n = 156), in 21 to 40 years 40.3% (n = 224), in 41 to 60 years 18.7% (n = 104), in 61 to 80 years 11.2% (n = 62), and at age group >81 years, it was 1.8% (n = 10). No difference was found in the years 2015 and 2016 regarding PTB-SS-positive cases registration. Age and health care facilities ( P < .000) and treatment outcome ( P < .000) have a strong relationship. No significant relation was found with other demographics variables ( P > 0.05). Conclusion: It was concluded from our finding that TB was considerably increased in the general population of District Dir (Lower), and proper supervision, diagnosis, treatment, and awareness of rapid prophylactic measures are needed to eradicate the issue.
Application of digital signal processing tools for the detection of voltage sag/swell
Authors: Xi Yanhui , Tang Xin , Li Zewen , Zeng Xiangjun
Published: February 2018

Electrical engineering education textbooks usually restrict the linking between theory and practical work in power quality problems, such as voltage sag/swell. This paper presents a mathematic model of the power signal and digital signal processing tools, such as Kalman filter and wavelet transform, for analysis and detection of voltage sag/swell. Aiming at education and teaching in electrical power quality courses, M files for Kalman filter and wavelet transform in the Matlab program are introduced to record and track the waveform distortion with harmonics, voltage sag or a pulse, which allow students to simulate the effect of voltage sag and to see immediately the advantages and limitations of these two techniques for power quality problems.
Empowering people: Role for political social work in South Asia
Authors: Nikku Bala Raju , Rafique Zain
Published: February 2018

South Asian governments have initiated political reforms engaging in rhetoric that resonates with the paradigms of good governance and empowerment of people. This article, applying a political social work framework, analyses reform policy in Pakistan and India in South Asia. By doing so, the article investigates the politics of local governance reforms in Pakistan and India within the context of domestic politics, institutional power and dynamics, and bureaucratic traditions and civil society activism. The article argues for renewed South Asian political social work that catalyzes robust local governance through citizen participation, resulting in the empowerment of people.
Resettlement post conflict: Risk and protective factors and resilience among women in northern Uganda
Authors: Corbin Joanne N , Hall J Camille
Published: February 2018

Approximately 1.8 million people were displaced in northern Uganda as a result of the LRA conflict. This paper explores risk and protective factors as well as examples of resilience among women in northern Uganda resettling after armed conflict and internal displacement. The risk and resilience ecological framework is used to identify and understand these factors along the multiple levels of the ecological social system. Risk factors included poor health, loss of instrumental and emotional support networks, and land vulnerability. Protective factors included engagement in livelihood and sociocultural activities with others. Resilience was located in the women’s coping and maintenance of family and social relationships.
External Supporters and Negotiated Settlement: Political Bargaining in Solving Governmental Incompatibility
Authors: Maekawa Wakako
Published: February 2018

External supporters have heterogeneous preferences over civil war outcomes depending on the issues at stake. In this article, the bargaining model and empirical study show that such preferences of external supporters need to be considered not only when analyzing the causes of support but also when analyzing how they affect a conflict. By adding an external supporter to a traditional conflict bargaining model as a strategic actor who receives a payoff from the political division, this article investigates how the preferences of external supporters influence the likelihood of a peace agreement in civil wars over a government. I demonstrate that a peace agreement is more likely to happen when the external supporters of the government side are not satisfied with the current political status quo of the supported state. The empirical analysis of political civil wars from 1976 to 2009 supports the implications of the bargaining model.
Stalin’s terror and the long-term political effects of mass repression
Authors: Zhukov Yuri M , Talibova Roya
Published: February 2018

Repression has a long-term negative effect on political participation. Using millions of arrest records from archival documents, and polling station-level election results, we examine how exposure to Stalin-era repression affects voter turnout in Putin’s Russia. To estimate the effect of repression on voting, we exploit exogenous variation in repression due to the structure of mid-century Soviet railroads, and travel distances to prison camps. We find that communities more heavily repressed under Stalin are less likely to vote today. The electoral legacy of Stalin’s terror – decades after the Soviet collapse, and across multiple election cycles (2003–12) – is systematically lower turnout. To show that our result is not unique to the Putin regime, we replicate our analysis in Ukraine (2004–14), and find similar patterns. These results highlight the negative consequences of repression for political behavior, and challenge the emerging view that exposure to violence increases political engagement. While past research has emphasized the short-term effects of repression over several months or years, we show that these effects may be durable over generations and even changes of political regime. Our findings also demonstrate that repression need not be collective or indiscriminate to have community-level effects.
Music Teacher Dispositions: Self-Appraisals and Values of University Music Students
Authors: Woody Robert H. , Gilbert Danni , Laird Lynda A.
Published: February 2018

For music teachers to be most effective, they must possess the dispositions that best facilitate their students’ learning. In this article, we present and discuss the findings of a study in which we sought to explore music majors’ self-appraisals in and the extent to which they value the disposition areas of reflectivity, empathic caring, musical comprehensiveness, and musical learnability orientation. Evidence from a survey of 110 music majors suggested that music education students possess and value the dispositions of reflectivity, musical comprehensiveness, and musical learnability orientation more highly after they have matured through their college careers. Additionally, based on their responses to music teaching scenarios, it appears that senior music education majors possess greater empathic caring than do their freshman counterparts.
Volumetric and linear measurements of lung tumor burden from non-gated micro-CT imaging correlate with histological analysis in a genetically engineered mouse model of non-small cell lung cancer
Authors: Gallastegui Aitor , Cheung James , Southard Teresa , Hume Kelly R
Published: February 2018

In vivo micro-computed tomography (CT) imaging allows longitudinal studies of pulmonary neoplasms in genetically engineered mouse models. Respiratory gating increases the accuracy of lung tumor measurements but lengthens anesthesia time in animals that may be at increased risk for complications. We hypothesized that semiautomated, volumetric, and linear tumor measurements performed in micro-CT images from non-gated scans would have correlation with histological findings. Primary lung tumors were induced in eight FVB mice with two transgenes (FVB/N-Tg(tetO-Kras2)12Hev/J; FVB.Cg-Tg(Scgb1a1-rtTA)1Jaw/J). Non-gated micro-CT scans were performed and the lungs were subsequently harvested. In the acquired micro-CT scans, measurements of all identified tumors were determined using the following methods: semiautomated three-dimensional (3D) volume, ellipsoid volume, Response Evaluation Criteria in Solid Tumors (RECIST; sum of largest axial (i.e., transverse) diameter from five tumors), sum of largest axial diameters from all tumors (modified RECIST), and average axial diameter. For histological analysis, all five lung lobes were analyzed and the tumor area was summed from measurements made on five histological sections that were 300 µm apart from each other (covering a total depth of 1200 µm). All micro-CT measurement methods had very strong correlation with histological tumor burden (Pearson’s correlation coefficient, 0.87 ( p = 0.0053) −0.98 ( p < 0.0001)). The only methods found to have different correlations were the semiautomated 3D method and the RECIST method (Williams’ test for dependent overlapping correlations, p = 0.013). Our results suggest quantification of lung tumor burden from non-gated micro-CT imaging will reflect histological differences between mice and can therefore be used for between-group comparisons or when concerns about systemic health of research animals may limit lengthy anesthetic procedures.
Energy absorption and Poisson's ratio of warp-knitted spacer fabrics under uniaxial tension
Authors: Chang Yuping , Ma Pibo
Published: February 2018

This paper presents five different auxetic warp-knitted spacer fabrics and discusses their energy absorption under uniaxial tension through integrals of stress on strain. Structures of auxetic fabrics are designed based on rotating hexagonal models and knitted for experimental tests, including Poisson's ratio tests and tensile tests. Results show that energy absorption of auxetic warp-knitted spacer fabric is mainly determined by its structural deformation capacity and yarn loading capacity, between which the yarn loading capacity of fabrics plays the dominant part in energy absorption, while the structural deformation capacity, which is affected by Poisson's ratio, has relatively little influence. With equivalent yarn loading capacity, the energy absorption of fabrics with negative Poisson's ratios are relatively better.
Roadmaps to utopia: Tales of the smart city
Authors: Valdez Alan-Miguel , Cook Matthew , Potter Stephen
Published: February 2018

Notions of the smart city are pervasive in urban development discourses. Various frameworks for the development of smart cities, often conceptualised as roadmaps, make a number of implicit claims about how smart city projects proceed but the legitimacy of those claims is unclear. This paper begins to address this gap in knowledge. We explore the development of a smart transport application, MotionMap, in the context of a £16M smart city programme taking place in Milton Keynes, UK. We examine how the idealised smart city narrative was locally inflected, and discuss the differences between the narrative and the processes and outcomes observed in Milton Keynes. The research shows that the vision of data-driven efficiency outlined in the roadmaps is not universally compelling, and that different approaches to the sensing and optimisation of urban flows have potential for empowering or disempowering different actors. Roadmaps tend to emphasise the importance of delivering quick practical results. However, the benefits observed in Milton Keynes did not come from quick technical fixes but from a smart city narrative that reinforced existing city branding, mobilising a growing network of actors towards the development of a smart region. Further research is needed to investigate this and other smart city developments, the significance of different smart city narratives, and how power relationships are reinforced and constructed through them.
Tourism Stocks in Times of Crisis: An Econometric Investigation of Unexpected Nonmacroeconomic Factors
Authors: Zopiatis Anastasios , Savva Christos S. , Lambertides Neophytos , McAleer Michael
Published: February 2018

The relationship between the tourism industry and unexpected nonmacro incidents has received limited academic coverage. As a result, the quantifiable impact of such events on tourism-specific stock values, both in terms of returns and volatility, remains grossly underexamined. Motivated by the reasoning that the well-established features inherent to the tourism industry may trigger a different pattern of stock price movement compared with other industries, and by using econometric methodology, this article investigates the reaction of five hospitality/tourism stock indices to 150 incidents, depicting major Acts of Terrorism, natural catastrophes, and War conflicts that have taken place since the year 2000. Empirical findings underscore the effect of such incidents on stock indices, with distinctive differences among the types and specificities of each event under investigation. This article contributes to the extant literature and enhances our conceptual capital pertaining to the tourism industry’s current financial practices related to stock performance and behavior.
Adult Children Living With Aging Parents: The Association Between Income and Parental Affect
Authors: Gerber Andrew , Heid Allison R. , Pruchno Rachel
Published: February 2018

This study examined the moderating effect of parental income on the association between parent–child coresidence and parental affect. Secondary analysis was conducted with data from the ORANJ BOWL panel, a representative sample of adults in New Jersey, aged 50 to 74 years ( N = 5,688). Results indicated that income had a significant moderating effect on the association between the adult child’s residential status and parents’ positive and negative affect. Among parents with coresident adult children, an observed decline in positive affect and rise in negative affect were amplified as parental income level increased, suggesting differential strains on parental well-being across income levels.
What is an open mind?
Authors: Sandel Adam Adatto
Published: February 2018

In this article, I suggest that an open mind wholly unburdened by preconceptions and prejudgments is a mistaken ideal. Not only is it unrealistic; it deprives us of context and background knowledge relevant to judging well. I begin with two cases that show how the ideal of the “prejudice-free” mind, though appealing, may end up thwarting good judgment: blind assessment and “blank-slate” jury selection (the ideal of empaneling jurors without prejudgments). I then trace the prejudice-free ideal to the Enlightenment, exposing its roots in the subject-object worldview. Drawing on Heidegger, I suggest that the subject-object worldview is misguided and that all judgment involves a prior understanding of the matter we judge. To have an open mind, paradoxically, is to have a stake in defending a prior understanding, to be possessed of an understanding of the good that one wishes (at least provisionally) to promote. I then draw out the implications of this view for how we might make sense of cultural differences, examining the difference between the practice of marriage based on a romantic conception of love, and that of arranged marriage. By thinking through these two practices, seemingly opposed, we can arrive at a conception of marriage and love that preserves both.
Which Assessment Method of Malnutrition in Head and Neck Cancer?
Authors: Saroul Nicolas , Pastourel Rémy , Mulliez Aurélien , Farigon Nicolas , Dupuch Vincent , Mom Thierry , Boirie Yves , Gilain Laurent
Published: February 2018

Objective

To assess the value of several diagnostic methods of nutritional status during the initial management of a head and neck cancer.

Study Design

Single‐center prospective study.

Setting

Tertiary referral center.

Subjects and Methods

Ninety patients with head and neck cancer participated in the study. Assessment of their nutritional status was made with anthropometric, biological, body, and muscle measurements (the last by computed tomography: L3 muscle mass index [L3MMI]). Assessment of muscle performance (functional reflection of nutritional status) was made via the Short Physical Performance Battery test. The malnutrition thresholds were set according to the literature.

Results

Mean body mass index (BMI) was 24.6 ± 5.4 kg/m2. Mean weight loss and albumin levels were –4.5 ± 10.5 kg and 37.1 ± 5.2 g/L, respectively. Fourteen percent of patients were diagnosed as malnourished on the basis of BMI, 54% according to the Nutritional Risk Index (NRI), and 58% by L3MMI. There was 64% agreement between NRI and L3MMI (P <. 001). All patients identified as malnourished by BMI were considered as such by the other assessment methods; however, many malnourished patients had normal or high BMI. The Short Physical Performance Battery score was low particularly among patients considered to be the most undernourished by the other methods.

Conclusion

NRI and L3MMI are the best methods to identify patients as being malnourished. Functional muscle assessment can determine the severity of malnutrition.
Patient Decision Making in Vestibular Schwannoma: A Survey of the Acoustic Neuroma Association
Authors: Moshtaghi Omid , Goshtasbi Khodayar , Sahyouni Ronald , Lin Harrison W. , Djalilian Hamid R.
Published: February 2018

Objective

To assess the decision‐making process of patients with vestibular schwannoma (VS).

Study Design

Patients with VS completed a voluntary survey over a 3‐month period.

Setting

Surveys were distributed online through email, Facebook, and member website.

Subjects and Methods

All patients had a diagnosis of VS and were members of the Acoustic Neuroma Association (ANA). A total of 789 patients completed the online survey.

Results

Of the 789 participants, 474 (60%) cited physician recommendation as a significant influential factor in deciding treatment. In our sample, 629 (80%) saw multiple VS specialists and 410 (52%) sought second opinions within the same specialty. Of those who received multiple consults, 242 (59%) of patients reported receiving different opinions regarding treatment. Those undergoing observation spent significantly less time with the physician (41 minutes) compared to surgery (68 minutes) and radiation (60 minutes) patients (P<. 001). A total of 32 (4%) patients stated the physician alone made the decision for treatment, and 29 (4%) felt they did not understand all possible treatment options before final decision was made. Of the 414 patients who underwent surgery, 66 (16%) felt they were pressured by the surgeon to choose surgical treatment.

Conclusion

Deciding on a proper VS treatment for patients can be complicated and dependent on numerous clinical and individual factors. It is clear that many patients find it important to seek second opinions from other specialties. Moreover, second opinions within the same specialty are common, and the number of neurotologists consulted correlated with higher decision satisfaction.
Universal Sellar Anatomical Reconstruction Using the Sellar Floor Flap after Endoscopic Pituitary Adenoma Surgery
Authors: Cong Zixiang , Liu Kaidong , Wen Guodao , Qiao Liang , Wang Handong , Ma Chiyuan
Published: February 2018

Postoperative cerebrospinal fluid (CSF) leaks still occur in patients without intraoperative CSF leaks after endoscopic endonasal pituitary adenoma surgery. We propose a reconstructive technique, the sellar floor flap (SFF), for universal sellar anatomical reconstruction. A total of 113 patients without intraoperative CSF leaks after endoscopic endonasal pituitary adenoma surgery from July 2013 to June 2016 were reviewed: 43 underwent sellar reconstruction with the SFF (the SFF group) and 70 underwent sellar packing only (the nonreconstruction group). No case of postoperative CSF leak was reported in the SFF group, whereas 7 cases were reported in the nonreconstruction group (P <. 05). The SFF is suitable for universal reconstruction after endoscopic endonasal pituitary adenoma surgery and may decrease postoperative CSF leak.
Predictors of Readmission and Reoperation in Patients Undergoing Parathyroidectomy for Primary Hyperparathyroidism
Authors: Roche Ansley M. , Brant Jason A. , Chai Raymond L.
Published: February 2018

Objective

Identify risk factors for 30‐day reoperation and readmission after parathyroidectomy for primary hyperparathyroidism.

Study Design

Retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2012 through 2014.

Subjects and Methods

Patients undergoing parathyroidectomy and parathyroid reexploration for primary hyperparathyroidism. Univariate and multivariate analyses were conducted to determine risk factors for reoperation and readmission.

Results

Of the 9439 patients who underwent parathyroidectomy, 72 patients underwent 1 reoperation in the first 30 days after surgery, and 8 patients underwent 2 reoperations. The most common reasons were hematoma (25%) and persistent hyperparathyroidism (15.9%). Risk factors included smoking (odds ratio [OR], 1.86; 95% confidence interval [CI], 0.97‐3.31), insulin‐dependent diabetes (OR, 2.38; 95% CI, 1.02‐4.86), and history of bleeding disorder (OR, 3.95; 95% CI, 1.48‐8.79). In total, 182 (1.9%) patients were readmitted within 30 days of surgery; the most common cause was hypocalcemia (17.0%). Risk factors included operative time (hours) (OR, 1.3; 95% CI, 1.1‐1.5), insulin‐dependent diabetes mellitus (OR, 2.01; 95% CI, 1.2‐3.3), dyspnea with moderate exertion (OR, 5.77; 95% CI, 0.86‐14.67), and age (decade) (OR, 1.16; 95% CI, 1.02‐1.32). Patients undergoing outpatient surgery were less likely to be readmitted (OR, 0.49; 95% CI, 0.35‐0.69) or undergo reoperation (OR, 0.44; 95% CI, 0.27‐0.73).

Conclusions

Thirty‐day reoperation rate after parathyroidectomy was low and most commonly occurred due to hematoma. Risk factors for readmission were multifactorial and associated with perioperative factors, patient factors, and medical comorbidities. Preoperative counseling for patients at increased risk of readmission and reoperation may decrease these rates.
Professional Disappointment as a Cause of Burnout
Authors: Judge Paul D. , Haynes David S. , Tawfik Kareem O.
Published: February 2018

Burnout is common among physicians. Chronic sources of burnout have been previously examined, but little is known about the impact of acute stressors on physician burnout. Otolaryngology residents applying for competitive fellowships provide a good example for how professional disappointment may cause burnout. As otolaryngology comprises highly successful, highly competitive individuals, a long history of success may leave otolaryngologists ill‐equipped to cope with such failures. Otolaryngologists should be aware of such pitfalls, preparing appropriate coping mechanisms in cases of professional disappointment.
Domestic Workplace: Critical Crossroads of Unorganized Labour and Management
Authors: Poddar Debasis
Published: February 2018

In the world of work at large, domestic workplace constitutes an altogether different space for hitherto labour jurisprudence and more so in the given age of liberalization-privatization-globalization worldwide. The way workforce used to get together at workplace and thereby unionized to form trade union in factory, mine, plantation and other establishments cannot take place anyway in case of domestic workplace. No wonder that the same attracts attention of relevant stakeholders on several counts, for example, labour on the one side and management on the other side.

The author explores peculiarity of such workplace, issues involved therein along with means and methods to address major hurdles for management and labour studies to grapple with one among the least explored workplaces of the world. The forthcoming paragraphs are meant to grapple with relative (read comparative) vulnerability for members of the workforce inside a space otherwise meant for private individual use, albeit with the potential for abuse to gross detriment of the workforce and, at times, of the management as well. With recent focus of the International Labour Organization (ILO), the labour wing of the UN administration and one among the oldest institutions meant for global governance since the League of Nations regime, a unique trajectory of labour jurisprudence is on its wise to save stakeholders of the workplace from drudgery, if not vagary, of injustice with impunity. The hitherto private space is thereby increasingly converted to public space during its working hours in technical sense of the term and thereby subjected to the rule of law genre available elsewhere outside.
Antecedents and consequences of parental psychological control and autonomy support: The role of psychological basic needs
Authors: Costa Sebastiano , Gugliandolo Maria C. , Barberis Nadia , Cuzzocrea Francesca , Liga Francesca
Published: February 2018

Research suggests that psychologically controlling and autonomy-supportive parenting can be described within the Self-Determination Theory’s (SDT) framework. Two studies were conducted to examine (a) the role of parental need frustration as a predictor of parental psychological control, (b) the role of parental need satisfaction as a predictor of parental autonomy support, and (c) the role of parents’ psychological control and autonomy support in the intergenerational transmission of satisfaction and frustration of the psychological basic needs. Study 1 provided evidence, in a sample of 203 Italian coupled parents, that needs frustration and needs satisfaction represent distinct antecedents of psychological control and autonomy support. Study 2, showed that in 135 families, the intergenerational association between parents’ and adolescents’ need frustration was partially mediated by psychological control and autonomy support. Results clearly showed that parents who experienced high level of psychological needs frustration are more likely to use psychological control and in turn to promote a feeling of need frustration in their adolescents; differently, parents who experienced high levels of psychological needs satisfaction tend to exert more autonomy support in their relationship with their children and in turn adolescents tend to perceive higher level of needs satisfaction. These findings are discussed in light of SDT and underline the importance of needs in the parenting context and have implications for interventions.
Integrated palliative care is about professional networking rather than standardisation of care: A qualitative study with healthcare professionals in 19 integrated palliative care initiatives in five European countries
Authors: den Herder-van der Eerden Marlieke , van Wijngaarden Jeroen , Payne Sheila , Preston Nancy , Linge-Dahl Lisa , Radbruch Lukas , Van Beek Karen , Menten Johan , Busa Csilla , Csikos Agnes , Vissers Kris , van Gurp Jelle , Hasselaar Jeroen
Published: February 2018

Background:

Integrated palliative care aims at improving coordination of palliative care services around patients’ anticipated needs. However, international comparisons of how integrated palliative care is implemented across four key domains of integrated care (content of care, patient flow, information logistics and availability of (human) resources and material) are lacking.

Aim:

To examine how integrated palliative care takes shape in practice across abovementioned key domains within several integrated palliative care initiatives in Europe.

Design:

Qualitative group interview design.

Setting/participants:

A total of 19 group interviews were conducted (2 in Belgium, 4 in the Netherlands, 4 in the United Kingdom, 4 in Germany and 5 in Hungary) with 142 healthcare professionals from several integrated palliative care initiatives in five European countries. The majority were nurses ( n = 66; 46%) and physicians ( n = 50; 35%).

Results:

The dominant strategy for fostering integrated palliative care is building core teams of palliative care specialists and extended professional networks based on personal relationships, shared norms, values and mutual trust, rather than developing standardised information exchange and referral pathways. Providing integrated palliative care with healthcare professionals in the wider professional community appears difficult, as a shared proactive multidisciplinary palliative care approach is lacking, and healthcare professionals often do not know palliative care professionals or services.

Conclusion:

Achieving better palliative care integration into regular healthcare and convincing the wider professional community is a difficult task that will take time and effort. Enhancing standardisation of palliative care into education, referral pathways and guidelines and standardised information exchange may be necessary. External authority (policy makers, insurance companies and professional bodies) may be needed to support integrated palliative care practices across settings.
Buprenorphine alone or with naloxone: Which is safer?
Authors: Kelty Erin , Cumming Craig , Troeung Lakhhina , Hulse Gary
Published: February 2018

To address concerns regarding the intravenous diversion of buprenorphine, a combined buprenorphine-naloxone (BUP-NLX) preparation was developed. The aim of this study is to compare health outcomes in opioid dependent patients treated with BUP and BUP-NLX. All patients treated with BUP and/or BUP-NLX in Western Australia between 2001 and 2010 were included in the study ( N = 3455). Patients were identified via State prescribing records and matched against the State mortality, hospital, and emergency department records. Rates of health events were examined and compared using Cox Proportional Hazard Models and Generalized Estimating Equations. While on treatment there was no significant difference between mortality rates in the two groups, mortality rates following the cessation of treatment were significantly higher in patients treated with BUP-NLX (adjusted hazard ratio: 1.59). Rates of hospitalization were significantly elevated in BUP-NLX patients (adjusted odds ratio: 1.17) compared with BUP treated patients; however, rates of hospitalization with a skin/subcutaneous diagnosis were significantly lower in BUP-NLX treated patients (adjusted odds ratio: 0.65). Off-treatment rates of both all-cause hospital admissions (adjusted odds ratio: 1.53) and hospital admissions with an opioid poisoning diagnosis (adjusted odds ratio: 1.59) were significantly elevated in BUP-NLX treated patients compared with BUP treated patients. The addition of naloxone does not appear to improve the safety profile of buprenorphine.
Cerebral perfusion and compensatory blood supply in patients with recent small subcortical infarcts
Authors: Rudilosso Salvatore , Laredo Carlos , Mancosu Marco , Moya-Planas Nuria , Zhao Yashu , Chirife Oscar , Chamorro Ángel , Urra Xabier
Published: February 2018

Hypoperfusion is the typical perfusion pattern associated with recent small subcortical infarcts of the brain, but other perfusion patterns may be present in patients with these infarcts. Using CT perfusion, we studied 67 consecutive patients who had a small subcortical infarct at a follow-up MRI study to investigate the correlation between the perfusion pattern and the clinical and radiological course. On CT perfusion map analysis, 51 patients (76%) had focal hypoperfusion, 4 patients (6%) had hyperperfusion and the remaining 12 patients (18%) showed no abnormalities. On dynamic sequential imaging analysis obtained from the source perfusion images, 32 patients (48%) had a sustained hypoperfusion pattern, 11 patients (16%) had a reperfusion pattern, and 18 patients (27%) had a delayed compensation pattern. Systolic blood pressure was higher in patients with sustained hypoperfusion although the perfusion pattern was independent of the final volume of infarction. These results reinforce the notion that mechanisms other than hypoperfusion are at play in patients with small subcortical infarcts including the intervention of compensatory sources of blood flow. The ultimate clinical significance of these perfusion patterns remains to be determined in larger series of patients assessed longitudinally.
Development and Validation of the Consumer Health Activation Index
Authors: Wolf Michael S. , Smith Samuel G. , Pandit Anjali U. , Condon David M. , Curtis Laura M. , Griffith James , O’Conor Rachel , Rush Steven , Bailey Stacy C. , Kaplan Gordon , Haufle Vincent , Martin David
Published: February 2018

Background. Although there has been increasing interest in patient engagement, few measures are publicly available and suitable for patients with limited health literacy. Objective. We sought to develop a Consumer Health Activation Index (CHAI) for use among diverse patients. Methods. Expert opinion, a systematic literature review, focus groups, and cognitive interviews with patients were used to create and revise a potential set of items. Psychometric testing guided by item response theory was then conducted among 301 English-speaking, community-dwelling adults. This included differential item functioning analyses to evaluate item performance across participant health literacy levels. To determine construct validity, CHAI scores were compared to scales measuring similar personality constructs. Associations between the CHAI and physical and mental health established predictive validity. A second study among 9,478 adults was used to confirm CHAI associations with health outcomes. Results. Exploratory factor analyses revealed a single-factor solution with a 10-item scale. The CHAI showed good internal consistency (alpha = 0.81) and moderate test–retest reliability (ICC = 0.53). Reading grade level was found to be at the 6th grade. Moderate to strong correlations were found with similar constructs (Multidimensional Health Locus of Control, r = 0.38, P < 0.001; Conscientiousness, r = 0.41, P < 0.001). Predictive validity was demonstrated through associations with functional health status measures (depression, r = −0.28, P < 0.001; anxiety, r = −0.22, P < 0.001; and physical functioning, r = 0.22, P < 0.001). In the validation sample, the CHAI was significantly associated with self-reported physical and mental health ( r = 0.31 and 0.32 respectively; both P < 0.001). Conclusions. The CHAI appears to be a valid, reliable, and easily administered tool that can be used to assess health activation among adults, including those with limited health literacy. Future studies should test the tool in actual use and explore further applications.
Predicting Facets of Adult Paranormality From Childhood Exposure to Inappropriate Styles of Parenting
Authors: Rogers Paul , Lowrie Emma L.
Published: February 2018

This study examines the extent to which recalled childhood exposure to three different styles of parental caregiving (rejecting, unresponsive, and overprotective parenting) predict four facets of adult paranormality (self-reported anomalous experiences, beliefs, ability, and fears). Path analysis controlling for respondents’ age and qualifications revealed that more anomalous experiences were a direct predictor of stronger anomalous beliefs which in turn predicted more self-proclaimed anomalous ability, with the latter then predicting, somewhat surprisingly, more anomalous fears. Of the three child-rearing styles, rejecting parenting directly predicted more anomalous experiences as did overprotective parenting (marginally). Also surprisingly, unresponsive parenting directly predicted more anomalous fears. Subsequent indirect (mediating) effects through more anomalous fears, ability, and beliefs also emerged. Findings are discussed in relation to claims that adoption of a paranormal worldview serves as a psychological mechanism for coping with an unhappy or insecure childhood. Methodological limitations and ideas for future research are also considered.
Association of cardiovascular risk factors on myocardial perfusion and fibrosis in asymptomatic individuals: cardiac magnetic resonance study
Authors: Cha Min Jae , Kim Sung Mok , Kim Hyun Su , Kim Yiseul , Choe Yeon Hyeon
Published: February 2018

Background

Myocardial perfusion reserve index (MPRI) and extracellular volume fraction (ECV) on cardiac magnetic resonance (CMR) are known to quantify coronary microvascular dysfunction and myocardial fibrosis, respectively.

Purpose

To demonstrate that cardiovascular risk factors such as hypertension, diabetes, hyperlipidemia, and smoking are correlated with MPRI and ECV on CMR in asymptomatic individuals.

Material and Methods

Between October 2013 and July 2014, 196 individuals underwent CMR. After excluding those with chest pain, arrhythmia, and obstructive coronary artery disease, participants were divided into five groups: those without risk factor (n = 26) and those with one (n = 43), two (n = 35), three (n = 24), or four (n = 6) risk factors. MPRI and ECV were obtained on perfusion CMR and pre- and post-T1 mapping, respectively.

Results

A total of 134 asymptomatic individuals (109 men, 25 women; mean age = 54.4 ± 7.08 years; body mass index [BMI] = 24.96 ± 2.76 kg/m2; Framingham risk score [FRS] = 7.71 ± 5.21) were included. The Jonckheere-Terpstra test demonstrated trends of increasing BMI, FRS, and left ventricular mass index (all P values < 0.001), but decreasing MPRI ( P = 0.001) with increasing numbers of risk factors. Stepwise multiple linear regression demonstrated that an increasing number of cardiovascular risk factors was an independent predictor of MPRI ( P = 0.001). However, there was no significant association between the number of risk factors and ECV ( P = 0.99).

Conclusion

We demonstrated that an increasing number of cardiovascular risk factors is significantly associated with reduced MPRI, but not with ECV on CMR.
Vitamin A intake of Brazilian mothers and retinol concentrations in maternal blood, human milk, and the umbilical cord
Authors: Deminice Thalia Manfrin Martins , Ferraz Ivan Savioli , Monteiro Jacqueline Pontes , Jordão Alceu Afonso , Ambrósio Lívia Maria Cordeiro Simões , Nogueira-de-Almeida Carlos Alberto
Published: February 2018

Objectives

To analyse intake of vitamin A (VA) and retinol concentrations in maternal blood, breast milk (BM), and the umbilical cord (UC) of newborns, and to determine the associations among these variables.

Methods

We performed a cross-sectional, epidemiological study of 180 mother–newborn dyads. Maternal and UC blood samples and BM were collected. VA intake by the mother over 30 days was assessed using a questionnaire.

Results

Mean retinol concentrations in maternal serum, the UC, and BM were 0.65 ± 0.27, 0.36 ± 0.18, and 2.95 ± 2.70 µmol/L, respectively. Retinol concentrations <0.70 µmol/L were found in 57.2% of maternal blood samples and in 94.9% of UC samples. A total of 27.9% of BM samples showed retinol concentrations <1.05 µmol/L. Mean VA intake by the mothers was 1041.33 ± 1187.86 µg retinol activity equivalents/day and was inadequate (<550 µg retinol activity equivalents/day) in 44.7%.

Conclusions

High proportions of insufficient retinol concentrations were observed in the UC, maternal blood, and BM. A high percentage of pregnant women had inadequate VA intake. Mothers with insufficient serum retinol concentrations had newborns with lower retinol concentrations in the UC. Higher retinol concentrations were observed in maternal blood and the UC with a higher VA intake.
Medical Humanitarianism of Turkey’s NGOS
Authors: Aras Bülent
Published: February 2018

This article investigates to what extent Turkish humanitarian nongovernmental organizations (NGOs) are able to alleviate human suffering as the ultimate goal of medical humanitarianism. To answer this question, the study investigates the efficiency of Turkish humanitarian NGOs in general with a specific focus on Uganda. It explores how their aid surfaces on the ground, to what extent it is aligned with country needs and priorities, the extent to which these initiatives help to strengthen or improve existing health systems, Turkish NGOs’ criteria for aid, and the challenges they face. Turkish NGOs’ distribution of medical aid is aligned with country needs and priorities, and their initiatives help strengthen and improve existing health systems. However, their sustainability is threatened by challenges of overreliance on voluntarism and lack of sufficient expertise, capacity, and funding.
The unmaking of a commodity: Intermediation and the entanglement of power cables in Nigeria
Authors: Østbø Haugen Heidi
Published: February 2018

Nigerians once trusted power cables to be safe and compliant with international standards. Today, however, the Nigerian market is rife with substandard cables, which may overheat, shoot out sparks, and cause fires. Power cables have been transformed from commodities with stable and precisely defined properties into entangled objects that can only be known through the actors accompanying them. Marketization scholarship has conventionally focused on efforts and investments to disentangle things from their networks of connections, affording less attention to the specifics of how entanglements are produced. This article examines the role of intermediation in creating entanglements and undermining market orders. The analysis first identifies intermediaries that endeavor to translate the market logic into concrete realities in Nigeria. The second and main part of the analysis draws upon data from ethnographic fieldwork in Nigeria and China to assess how intermediaries destabilized the commodity of cables by forging new connections between traders and producers and by enabling inferior products to enter the market. The article proposes intermediation as a meso-level concept for connecting concrete and empirically observable events to theories of marketization. The approach moves marketization scholarship forward and away from its oft-vague operationalizations, while also suggesting new avenues for research on intermediation beyond the study of markets.