bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effectiveness of Six Insulin Management Devices for Blind Diabetic Persons
Authors: Ponchillia S.V. , Richardson K. , Turner-Barry M.M.
Published: July 2020

Insulin measurement is a task all insulin dependent persons with diabetes must undertake one or more times daily. Diabetes is the leading cause of new blindness in the United States and as a result, there are many diabetics who have difficulty accomplishing safe, accurate insulin measurement independently. A variety of adaptive techniques and products are available to assist visually impaired persons with insulin measurement, but there are virtually no data available to support recommendation of any one device over another. A single-subject, alternating-treatment study was conducted with functionally blind diabetic persons to determine safety and accuracy of six leading commercial insulin measurement devices.
Relationship between the Development of Language and Thought in Young Blind Children
Authors: Bigelow A.
Published: July 2020

The relationship between the development of object permanence and early words was studied in three young boys, two totally blind from birth and one severely visually impaired. Auditory and tactile tasks analogous to traditional visual object-permanence tasks were presented to the children at monthly intervals, and their first 50 words and the context in which the words were said were recorded by their mothers and collected monthly. All three boys acquired early words within the age range for sighted children, but their usage of the words was different. The two blind boys but not the visually impaired boy were delayed in their development of object permanence. The relationship between the acquisition of early words and the development of object permanence suggests that the emergence of language is not dependent on a stable understanding of the existence and permanence of objects.
Florida Model Task Force on Diabetic Retinopathy: Development of An Interagency Network
Authors: Groff G. , Barrett B. , Rogers P.
Published: July 2020

This article describes the development of a mechanism to organize a network in Florida for individuals who are at risk for diabetic retinopathy. The Florida Model Task Force on Diabetic Retinopathy, although tailored to meet the needs of Florida, was structured and documented to serve as a national model.
Beliefs about Effective Education among Teachers of Visually Impaired Children
Authors: McLinden D.J.
Published: July 2020

A teacher's personal beliefs about effective education provide a context in which to implement academic subjects, administrative directions, and practical experience in the classroom. To understand the thought processes that influence the delivery of instruction, the author conducted a study in which exemplary teachers provided in-depth information about their beliefs regarding effective education of visually impaired children. Through a combination of qualitative and quantitative research techniques, individual beliefs were organized into higher-order constructs. The results describe the elements of teaching style. The research method used addresses some of the methodological problems of doing research in the field of visual impairments.
The Graphical User Interface: Crisis, Danger, and Opportunity
Authors: Boyd L.H. , Boyd W.L. , Vanderheiden G.C.
Published: July 2020

The graphical user interface is a powerful new interface for mainstream computer users and a source of serious concern for those who cannot see. Fortunately, it will eventually be made as accessible to blind people as character-based forerunners. The systems that evolve will provide blind computer users with new capabilities not possible with character-based computers and access systems. However, the effects of previous inaccessibility, the current limited accessibility, and lingering doubts about the solvability of some of the access problems have slowed efforts to capitalize on the advantages and opportunities of these new systems. This article identifies potential new problems posed by graphic computing environments and describes some programs and strategies that are being developed to provide access to these environments.
The Development of the Descriptive Video Servicesm
Authors: Cronin B.J. , King S.R.
Published: July 2020

Television is an important means of obtaining information and sharing in the culture of this society. Because it is primarily a visual medium, blind and visually impaired people have not had full access to it. In 1990, after five years of research and development, a national service became available over the Public Broadcasting Service that makes television accessible to blind and visually impaired viewers. Developed by WGBH-TV in Boston, Descriptive Video Servicesm provides narrated descriptions of the key visual elements of television programs without interfering with their audio or dialogue.
Optical Character Recognition
Authors: Converso L. , Hocek S.
Published: July 2020

Computer-based optical character recognition (OCR) systems allow blind persons access to a wide variety of printed material. This article describes these systems and how they work and discusses the features that should be considered before one purchases them.
Technological Solutions for Visually Impaired People in Sweden
Authors: Lindström J.I.
Published: July 2020

This article discusses the available technology in Sweden and its applications for visually impaired and deaf-blind people, including systems for stop announcements on buses and trams, queuing systems in shops and banks, and private and information transfer center text-telephones, as well as methods used to make daily newspapers available to visually impaired people and a fourth information channel for deaf-blind people. The involvement of disabled persons in the use of data bases and home terminals is also discussed. Ideas for subtitles for movies, real-time translation of interviews and speeches, and picture communication are also presented.
Microcomputers and Access Technology in Programs for Teachers of Visually Impaired Students
Authors: Mack C.G. , Koenig A.J. , Ashcroft S.C.
Published: July 2020

Skills in the use of microcomputers and related access technology should become basic competencies required of qualified pre- and in-service teachers of students who are blind or visually impaired. This article presents a framework for incorporating microcomputer technology in teacher preparation programs, including objectives for teacher trainees and in-service teachers and approaches to achieving the objectives. It also provides a list of essential equipment needed in teacher preparation programs and stresses the importance of teacher educators’ positive attitudes toward technology.
Sound Synthesis and Bar-Code Technology to Develop Learning Environments for Blind Children
Authors: Burger D. , Beltrando E. , Sagot J.
Published: July 2020

This article reports on a study of the pedagogical relevance of a computerized sound-based interactive tool as support for educating blind children. It details the concepts and materials that were developed and tested in classrooms and points out that a sound-based approach can be used for teaching in such different domains as sound awareness, logic, language, and technology.
An Analysis of Errors in Braille Writing Samples
Authors: Koenig A.J. , Ashcroft S.C.
Published: July 2020

This study analyzed the spelling and braille orthographic errors found in braille writing samples of students in both residential and local day school programs who were at or near 9, 13, and 17 years old. True spelling errors were most prevalent for all age groups, and errors in braille orthography persisted across age groups. Nevertheless, the results from a larger study (of which this analysis is a part) indicated that subjects who were blind demonstrated skills comparable to their sighted peers in the content and quality of their writing.
Normal Science and Mobility Instruction
Authors: Nyman J.S. , Mettler R.
Published: July 2020

This article contends that the ongoing debate about the necessity of vision in teaching cane travel is misguided. The debate as traditionally framed is dissolved once the focus is shifted from the instructor's teaching to the student's learning. Kuhn's analysis of scientific revolutions and the importance of the cognitive dimension in cane travel are used to propose an alternative model of rehabilitation teaching.
Vap-Cap: A Procedure to Assess the Visual Functioning of Young Visually Impaired Children
Authors: Blanksby D.C. , Langford P.E.
Published: July 2020

This article describes the development of a test for assessing the visual functioning (capacity, processing, and attention) of visually impaired infants and preschool children and its underlying factor structure.
Echolocation: A Study of Auditory Functioning in Blind and Sighted Subjects
Authors: Arias C. , Curet C.A. , Moyano H.F. , Joekes S. , Blanch N.
Published: July 2020

This article describes an assessment of the peripheral and central auditory functioning of eight blind subjects who were good obstacle detectors and eight sighted subjects. An echolocation paradigm in short latency-evoked response was included. The study found that the blind subjects were better (faster) than the sighted subjects in auditory processing and that the echolocation signals may be processed in the superior olivary complex of the midbrain.
A Survey of Blind and Partially Sighted Adults in Britain
Authors: Robinson J.R.
Published: July 2020

This article presents the results of the first nationwide survey on people who are blind or partially sighted in Great Britain to ascertain the challenges they face and to provide better services to them that are based on specific areas of concern.
A Survey of Statewide Self-Help Groups for Older Persons who are Visually Impaired
Authors: Kalafat J. , Dehmer J.
Published: July 2020

This article describes a program funded by the New Jersey Commission for the Blind and Visually Impaired that employs two visually impaired consultants to develop self-help groups for persons who are blind or visually impaired throughout the state. Once established, over half the 23 groups function independently of the consultants. A survey of group members revealed a variety of benefits of the groups, including reduced isolation, as well as barriers to group functioning, such as the lack of transportation.
An Innovative Model for Training Orientation and Mobility Assistants
Authors: Wiener W.R.
Published: July 2020

This article reports on a federally funded short-term project that developed and implemented a model to prepare orientation and mobility (O&M) specialists to train and supervise O&M assistants (OMAs). Curriculum guidelines and training methods were developed, a national workshop to train presenters from seven regions of the United States and Canada was conducted, and the presenters held regional seminars to teach other certified O&M specialists how to train and supervise OMAs.
The Improvement of Vision by Vision Stimulation and Training: A Review of the Literature
Authors: Tavernier G.G.F.
Published: July 2020

A frequently used approach to the rehabilitation of children with severe irreversible visual impairments is to stimulate or train them to “see” better through the programmed presentation of stimuli and instructions. This article reviews the theoretical and research literature on vision stimulation and vision training to determine if it contains useful guidelines for the construction of vision stimulation and training programs.
Quality Management in Residential Schools: A Planning Model for Systems Change
Authors: Howze Y.S.
Published: July 2020

The Quality Circle Model of Planning uses the combined principles and procedures of brainstorming and program evaluation to help the administrator of a school for the blind identify human and monetary resources that can contribute to a positive image of a school's services and assist in evaluating the impact of the plan and changes over time. It encourages the development of a strategic plan for resolving problems associated with programmatic and day-to-day operations and encourages interaction and cooperation among the staff, students, parents, community leaders, and other service providers.
Short-Term Placements: A Crucial Role for Residential Schools
Authors: MacCuspie P.A. , Harmer D. , McConnell J. , Fricker J. , Johnson J.
Published: July 2020

Short-term placements of children with visual impairments in residential schools for the visually impaired are a viable solution to the difficulties these children experience in regular classrooms in their local schools. This article discusses the duration, goals, implementation, and evaluation of these placements, as well as administrative considerations and factors that are critical for their success, and describes the programs at a residential school in Atlantic Canada.
Council of Schools for the Blind
Authors: Tutt L.M.
Published: July 2020

This section—comprised of eight articles written from the perspectives of administrators, practitioners, and researchers—reports on a cross section of contemporary programs.
Residential Schools: An Underutilized Resource
Authors: Stenehjem D.O.
Published: July 2020

Residential schools are often the only places in a state with the expertise to promote the best interests of children who are blind or visually impaired. To be valuable resources and to provide the leadership needed to provide high-quality services throughout a state, they must promote a unified system of effective, cost-efficient services.
Including a Student with Multiple Disabilities and Visual Impairment in Her Neighborhood School
Authors: Bowden J. , Thorburn J.
Published: July 2020

This article begins with a literature review of main-streaming students with multiple disabilities and visual impairment in general schools, stressing the importance of opportunities for peer interaction that are prevalent in regular settings. It then describes a program carried out with a 5-year-old student attending her neighborhood school in Auckland, New Zealand. Comments of the people involved in the program, including the principal, the teachers, the teacher's aide, family members, and fellow pupils, are reported, and the success of the program is discussed.
The Effect of Cultural Beliefs on the Treatment of Native Peoples with Diabetes and Visual Impairment
Authors: Ponchillia S.V.
Published: July 2020

An increase in the incidence of diabetes among Native Americans, Mexican Americans, and Pacific Islanders is leading to a modern epidemic of diabetes and its complications. Traditional cultural beliefs can affect the success of services to native peoples who are experiencing vision loss. This article discusses these cultural beliefs, with illustrations from Native American culture, and the implications for the provision of services.
Training Outreach Workers to Serve American Indian Elders with Visual Impairment and Diabetes
Authors: Orr A.L.
Published: July 2020

American Indians experience diabetes and diabetic retinopathy at a rate considerably higher than the overall U.S. population, and the number and lifespan of American Indian elders is steadily increasing. These demographics, combined with the underrepresentation of American Indians in the rehabilitation system, document the need for an innovative service delivery model for training American Indian elders, both on and off reservations, in independent living skills. This article describes a federally funded rehabilitation project developed and implemented by the American Foundation for the Blind to teach American Indian health care workers about aging and vision loss and independent living skills.
Adaptive Blood Glucose Monitoring and Insulin Measurement Devices for Visually Impaired Persons
Authors: Petzinger R.A.
Published: July 2020

This article describes all the known devices that visually impaired people with diabetes can use to monitor blood glucose levels and measure insulin.
Diabetes Education for Visually Impaired Persons at Cleveland Sight Center
Authors: Williams A.S.
Published: July 2020

This article describes the structure, content, and function of a specialized adaptive diabetes education program in a large, community-based blindness rehabilitation agency.
Rehabilitation Services for People with Diabetes and Visual Impairment in Japan
Authors: Cleary M. , Sawa R.
Published: July 2020

This article describes the major components of rehabilitation services in Japan for people who are visually impaired from diabetes. These components include diabetes education and medical care, social welfare and rehabilitation services, nutrition and exercise, medication, monitoring of blood glucose, glycemic control, and the prevention of further complications.
Two Exercise Programs for People with Diabetes and Visual Impairment
Authors: Dods J.
Published: July 2020

This article describes two programs—one in Australia and one in the United States—that teach people with diabetes and visual impairment to incorporate proper diets and exercise into their daily lives and hence to gain better control of their blood glucose levels. It also presents a basic model of an exercise regimen that clients can perform at home.
Three Classes of Change to Improve the Daily Living Skills of Persons with Visual Impairment
Authors: Richardson J.
Published: July 2020

Individuals who become visually impaired need to adapt in the way they perform tasks. This article describes three classes of change involved in improving the daily living skills of persons with visual impairments: changes in the work, in the workplace, and in the worker's activity. Changes in the work or product are considered the highest level of change and, of necessity, bring about changes in the workplace and in the worker's activities. Case studies illustrate the three levels of changes.
Adapting Standardized Academic Tests in Braille and Large Type
Authors: Duckworth B.J.
Published: July 2020

When a teacher or school system needs to have a commercially available test adapted into large type or braille, certain guidelines must be followed. This article describes the recent adaptation of the Stanford Achievement Test (Series 8) by the American Printing House for the Blind. It presents the steps that are usually pursued in such a process and the guidelines that must be considered in adapting typical standardized tests.
The Effectiveness of Two Strategies for Teaching Students with Blindness and Mental Retardation
Authors: Lane G.M.
Published: July 2020

To investigate the crossmodal transfer effects of verbal information to the performance of manual tasks, this study compared the effectiveness of two strategies—manual guidance only and manual guidance plus verbal prompts—with students whose multiple disabilities included total blindness and severe mental retardation. Within the framework of an alternating treatments design, the two strategies were differentially applied to two tasks. The results suggest that prompting methods that require shifting verbal information to the performance of a manual task may interfere with the learning of students with such multiple disabilities.
The Relationship of Personality Traits to the Employment Status of Persons who are Blind
Authors: Hagemoser S.D.
Published: July 2020

Two levels of education (high school or less and training beyond high school) and nine content scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were used to predict employment-related outcomes among a sample of 109 blind adults. It was found that education, anger, cynicism, obsessiveness, and family problems were significant predictors of employability. Furthermore, 80 percent of the employed subjects and 71.4 percent of the unemployed subjects were classified by low self-esteem, education, and cynicism and the underemployed had higher mean scores than the nonunderemployed on cynicism and Type A behavior.
Teachers’ Voices: Comments on Braille and Literacy from the Field
Authors: Wittenstein S.H. , Pardee M.L.
Published: July 2020

This article presents the selected comments of a nationwide sample of teachers of students who are blind or visually impaired. The teachers responded to a survey that asked them to express their attitudes about braille literacy for them and for their students. Their comments, gathered incidentally to the quantitative data, reveal that teachers hold strong opinions and care deeply about the literacy skills of their students.
Braille Reading Rates as a Function of Reading Tasks
Authors: Knowlton M. , Wetzel R.
Published: July 2020

This study of the cognitive processes of braille reading compared the reading of 23 adult braille readers in four different reading conditions: oral reading, silent reading, studying, and scanning. The findings provide support for the idea that braille reading is process driven and that reading rates vary, depending on the purpose of the reading task.
Reading Competence of Visually Impaired Pupils in Sweden
Authors: Fellenius K.
Published: July 2020

This article reports on a study of the reading competence of 25 visually impaired pupils in Sweden, who were followed from 1988 to 1991. Neither visual acuity, reading media, optical aids, nor reading distance were clearly related to reading competence. Rather, good readers were pupils who scored higher on verbal cognitive tests and had a greater interest in reading as a leisure activity.
Satisfaction of Direct-Labor Workers who are Blind and Employed in Industries for the Blind
Authors: Crudden A. , Moore J.E. , Giesen J.M.
Published: July 2020

This article reports on a 1994 survey of the levels of satisfaction of 502 direct-labor workers who were employed in industries affiliated with National Industries for the Blind. The survey found that the majority (61%) reported they were satisfied or very satisfied with their current placements. Levels of satisfaction were lower for those with higher levels of education and those employed more than five years.
The Ability of Visually Impaired Children to Locate Themselves on a Tactile Map
Authors: Ungar S. , Blades M. , Spencer C.
Published: July 2020

This experiment investigated self-location by 26 visually impaired children using a large layout of landmarks, through which the children walked each of a number of routes holding a tactile map that was aligned or rotated relative to the layout. The children pointed to their position on the map as they walked along a route. On the majority of trials, the children correctly traced the route they walked and worked out their position on the map. Although the type of route (those with unique, clear landmarks versus those with nonunique, ambiguous landmarks) and the use of a strategy affected performance, the alignment of maps did not.
Essential Experiences to Undergird the Early Development of Literacy
Authors: Koenig A.J. , Farrenkopf C.
Published: July 2020

This study identified a repertoire of essential early life experiences to which young children with visual impairments need to be exposed to undergird their development of literacy. The authors analyzed 254 stories from three published basal literacy series to identify the experiences necessary to bring meaning to each story. Through analysis and categorization of the data, they then identified 22 global areas of experience as essential. Guidelines for providing these experiences are suggested, including ways to link experiences to early literacy events.
Efficacy of the Touch Technique for Surface and Foot-Placement Preview
Authors: LaGrow S.J. , Blasch B.B. , De L'Aune W.
Published: July 2020

Seven orientation and mobility specialists were videotaped simultaneously on three stationary cameras while traveling with long canes. The cameras were calibrated to allow for the exact determination of the relative position of the various body and cane parts as the travelers passed through the coordinated focal point. Input from the videotapes was digitized and entered on a computer to provide continuous traces of movement. A visual analysis of the traces indicated that the cane tip consistently touched outside the foot (and therefore did not provide foot-placement preview) and that surface preview was inconsistent.
Conceptual and Methodological Issues in Rehabilitation Outcomes for Adults who are Visually Impaired
Authors: Crews J.E. , Long R.G.
Published: July 2020

This article defines some of the conceptual and methodological issues in creating outcome measures in vision rehabilitation. It proposes a model to describe rehabilitation outcomes in the context of organizational activities and discusses such methodological problems as the clarification and measurement of goals, aggregation of data, self-report and observational data, scaling, frequency of measurements, and causal events.
Research to Improve Vocational Rehabilitation: Employment Barriers and Strategies for Clients who are Blind Or Visually Impaired
Authors: Kirchner C. , Johnson G. , Harkins D.
Published: July 2020

This study identified factors that lead to or impede competitive job placements for clients of a state blindness rehabilitation agency. The authors conducted focus groups with the agency's service providers and administered surveys to adults who are blind or visually impaired and to employers. The survey data analysis compared persons who were employed with persons who were not employed but were interested in working and with persons who were not working and were not interested in working. Also identified were services that employers felt would assist them in hiring or retaining blind or visually impaired workers. Five themes, stated in terms of needs for the agency to address, are presented to summarize the findings.
A Comparative Study of Spelling Performance of Sighted and Blind Students in Senior High School
Authors: Grenier D. , Giroux N.
Published: July 2020

This study compared the spelling competency of 7 functonally blind braille-reading students with that of 180 sighted students using conventional print. The students were all attending regular high school classes, grades 9 to 11, within the province of Quebec, Canada. A 100-word dictation was given to these students and then analyzed for mistakes in both grammar and usage. The results indicated a significant gap in the spelling competency between the two groups. The functionally blind students were significantly ahead of their sighted peers. These students made less than half the number of usage mistakes than did their sighted peers. The most important gap involves grammatical spelling, again in the favor of the functionally blind students.
Mothers’ Interpretations of the Behavior of Their Infants with Visual and Other Impairments during Interactions
Authors: Baird S.M. , Mayfield P. , Baker P.
Published: July 2020

In this study, seven mothers of infants with visual and other impairments identified behaviors that they considered meaningful and interpreted these behaviors. The mothers identified 14 of 22 subcategories of behaviors that a previous study of mothers with sighted infants had identified. Not only was the range of behaviors they interpreted limited, but over 65 percent of their interpretations fell into only two of the 16 subcategories previously identified (attention preference and intentional behavior: desire). The implications for early intervention and future research are discussed.
Standardized Ability Testing for Vocational Rehabilitation in Visually Impaired Adults: A Literature Review
Authors: Reid J.M.V.
Published: July 2020

This article reviews the past research on ability testing for adults who are visually impaired. The verbal scales of the Wechsler Adult Intelligence Scale-Revised were found to be widely accepted as measures of verbal ability with these clients. However, relying solely on verbal assessment has its limitations, both theoretically and practically. Many attempts have been made to develop and adapt nonverbal tests for visually impaired adults. To date, none of the tests reviewed are established as reliable and valid, indicating an ongoing need for further research.
Veno-venous extracorporeal membrane oxygenation for COVID-19-associated pediatric acute respiratory distress syndrome
Authors: Lewis Deirdre , Fisler Grace , Schneider James , Sweberg Todd , Murphy Kristina , Sathya Chethan , Silver Peter , Taylor Matthew D
Published: July 2020

Background:

The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) coronavirus has emerged as a highly contagious respiratory pathogen causing severe acute lung injury. Extracorporeal membrane oxygenation is a standard tool for the management of life-threatening acute respiratory distress syndrome, but the use of this resource-intensive therapy has come into question due to strained medical systems and limited proven treatments for COVID-19.

Case summary:

A 16-year-old female with obesity presented with fever, myalgias, cough, and tachypnea and was diagnosed with COVID-19. She progressed to severe pediatric acute respiratory distress syndrome requiring intubation on hospital day 4 and cannulation to veno-venous extracorporeal membrane oxygenation on hospital day 6. The patient received remdesivir, steroids, and anakinra. The patient was successfully decannulated on hospital day 12 and was discharged home on hospital day 21.

Conclusion:

We report the use of veno-venous extracorporeal membrane oxygenation as a bridge to lung recovery in a pediatric patient with severe pediatric acute respiratory distress syndrome due to COVID-19.
Municipal Utilities and COVID-19: Challenges, Responses, and Collaboration
Authors: Switzer David , Wang Weijie , Hirschvogel Lacey
Published: July 2020

The COVID-19 pandemic has put pressure on essential public services. While much of the economy has been shut down, essential public services have continued. Using professional experience, publicly available information, and interviews with two municipal utility managers, we evaluate the challenges presented to municipal utility services by the COVID-19 pandemic and explore some of the responses by utilities to the pandemic. Specifically, we focus on the strategies utilities have used to keep employees safe from the virus and plans for workforce shortages. One important strategy we identify is reliance on mutual aid agreements, where utilities agree to send staff and equipment to other utilities in times of crisis. We also explore the role of a municipal utility association in coordinating response. The case of utility response to COVID-19 carries important potential implications for both public administration practice and research.
Diagnostic reference levels for fluoroscopically guided procedures in a South African tertiary hospital
Authors: Malan Leon , Pitcher Richard D , da Silva Michelle , Breuninger Sharlene , Groenewald Wilhelm
Published: July 2020

Background

The burgeoning usage and complexity of fluoroscopically guided procedures (FGPs) contribute to extended examination times and increased risk of adverse radiation effects. Diagnostic reference levels (DRLs) play a pivotal role in dose optimization. There are limited DRL data for FGPs in low- and middle-income countries (LMICs).

Purpose

To determine local DRLs (LDRLs) for common FGPs in the South African (SA) context and compare these with published international data.

Material and Methods

A three-year, retrospective study of the 15 most frequently performed FGPs at a SA institution. For each procedure, the 50th and 75th percentiles of kerma area product (KAP), reference point air kerma (Ka,r), and fluoroscopy time data were derived. Published international FGP DRL data were collated and compared with the 75th percentiles of local institutional dosage parameters.

Results

The commonest FGPs were aorto-bifemoral diagnostic angiography (n = 590), aorto-bifemoral interventional angiography (n = 287), nephrostomy (n = 265), and bronchial arterial embolization (BAE) (n = 208). Selective abdominal vessel interventional angiography (KAP = 170 Gy . cm2; Ka,r = 877 mGy) recorded the highest LDRL dosages; BAE was the longest procedure (LDRL = 38 min). Nephrostomies achieved the lowest LDRLs across all parameters (KAP = 10 Gy . cm2; Ka,r = 63 mGy, fluoroscopy time = 4.3 min). All Tygerberg Hospital LDRLs with comprehensive comparable data were within or below published ranges.

Conclusion

This study advances international radiation protection initiatives, addresses the paucity of LMIC DRL data, demonstrates broad alignment of Tygerberg Hospital FGP practice with international norms and highlights areas for optimization of institutional practice.
An unusual diagnosis of paravertebral lesions: mediastinal myelolipoma
Authors: Qin De-an , Ren Xiao-qiang , Zheng Shuai , Bi Hong
Published: July 2020

Background

Mediastinal myelolipoma is extremely rare. It is a benign nonfunctioning tumor composed of hematopoietic tissue and mature fatty tissue. Although computed tomography and magnetic resonance imaging are effective in diagnosing mediastinal myelolipoma, a definitive diagnosis is difficult to establish for rare extra-adrenal myelolipomas by imaging alone. Such tumors are often misdiagnosed as malignant retropleural liposarcoma, denoting a poor prognosis. Case presentation: We herein describe a 72-year-old man with multiple bilateral paravertebral mediastinal myelolipomas and discuss the imaging findings and differential diagnoses. We used a computed tomography-guided core biopsy to attain a preoperative diagnosis. Using this technique, we avoided an unnecessary surgical procedure for the patient’s asymptomatic and relatively small lesions.

Conclusions

Instead of biopsy by lesion excision, we advocate conducting a precisely targeted, minimally invasive computed tomography-guided core biopsy to obtain a definitive preoperative diagnosis and thus avoid unnecessary surgery for mediastinal myelolipoma, a benign nonfunctioning tumor.
Experiences of current and former members of self-managed superannuation funds
Authors: Thorp Susan , Bird Ron , Foster F Douglas , Gray Jack , Raftery Adrian , Yeung Danny CS
Published: July 2020

We surveyed 854 current and 147 former members of self-managed superannuation funds (SMSFs) in 2016. The results of our survey document their aspirations, operational practices and experiences. Both current and former members expressed high general interest in superannuation, but ‘detractors’ of SMSFs outnumbered ‘promoters’. SMSF members said they enjoy ‘control’ of investment, but a majority delegated tasks to financial professionals. Three times as many members rated the performance of their fund as above the SMSF average as below, although most did not measure the performance of their fund adequately. The probability of closing a SMSF is significantly higher if members use net returns, rather than other indicators such as account balance, to judge performance.

JEL Classification: H55, H75, J32
The Inside and Outside Game of Growth Management: Tracking Sprawl of Canada’s Largest Metropolitan Areas
Authors: Han Albert T. , Graham Rylan , Tsenkova Sasha
Published: July 2020

This study explores the changes in the regional growth patterns in the nine largest Canadian Census Metropolitan Areas (CMAs) between 1990 and 2010. We analyzed whether the metropolitan areas matched the Inside Game (i.e., intensification) with a strong Outside Game (i.e., regional planning) of growth management as represented by physical growth patterns. Overall, Toronto, Vancouver, and London CMAs matched the Inside Game with a strong Outside Game. Conversely, the CMAs of Ottawa, Montreal, Quebec, Calgary, Edmonton, and Winnipeg, where regional governance is fragmented or absent, exhibited signs of regional sprawl. All studied CMAs but Quebec City exhibited signs of intensification.
Influence of organically modified nanoclay and TiO2 nanopowder on the properties of Azadirachta indica wood flour-reinforced high-density polyethylene, low-density polyethylene, polypropylene, and polyvinyl chloride nanocomposite
Authors: Rathnam Vamsi , Kichu Arenjungla , Dutta Nipu , Maji Tarun K , Devi Nirmala
Published: July 2020

The nanocomposites of high-density polyethylene, low-density polyethylene, polypropylene, and poly(vinyl chloride) reinforced with Azadirachta indica wood flour (WF) and different amounts of the organomodified nanoclay and titanium dioxide (TiO2) nanopowder were produced by melt-blending process followed by compression molding. Polyethylene- co-glycidyl methacrylate (PE- co-GMA) was used as a compatibilizer. TiO2 nanopowder was synthesized by sol–gel method and characterized using transmission electron microscopy (TEM). The average size of the synthesized nano-TiO2 was 17.5 nm, which was confirmed both by TEM and X-ray diffraction (XRD) study. The distribution of nanoparticles in the nanocomposites was also examined by the XRD study. The surface modification of the TiO2 nanoparticles by organic surfactant cetyl trimethyl ammonium bromide and their interaction with the wood and the polymer were studied by Fourier transform infrared spectroscopy. Incorporation of compatibilizer PE- co-GMA, nanoclay, and nano-TiO2 significantly influenced the mechanical and thermal properties of the WF-reinforced composites. Wood polymer composites (WPC) reinforced with nanoclay and nano-TiO2 showed improved tensile strength, tensile modulus, flexural strength, flexural modulus, and hardness. Maximum improvement in mechanical properties was shown by WPC loaded with 40 phr WF, 2 phr nanoclay, and 2 phr of nano-TiO2. On inclusion of organically modified nanoclay and nano-TiO2, the WPC samples showed lower water uptake and higher chemical resistance. The nanocomposites were further examined by TEM study and thermogravimetric analyzer.
Documentation of Indications: Agreement Between Order Entry and Clinical Notes and Effect on Time to Antibiotic Administration
Authors: Scardina Tonya , Stach Leslie , Sun Shan , Kociolek Larry K. , Reuter Caroline , Vogt Michael , Patel Sameer
Published: July 2020

Background/Objectives:

Antibiotic indication documentation at the time of order entry is mandated by the Joint Commission. Inclusion of indication at order entry may have an impact on the time to administration. Our primary objective was to evaluate agreement between indication selected during order entry and clinical notes. Our secondary objective was to observe if there was a change in time to administration after indications were required during order entry.

Methods:

Patients ≤18 years old who received ≥1 dose of vancomycin or ceftriaxone during a preintervention period and 3 postintervention periods were included. Indication for use, agreement between order and clinical note, and timing of antibiotic administration were collected.

Results:

Most common indication for vancomycin (total: 789) was sepsis (26%, n = 204). Common indications for ceftriaxone (total: 1071) were sepsis (12%, n = 127), perforated appendicitis (12%, n = 125), and urinary tract infection (10%, n = 107). Postintervention, agreement between the indication selected during order entry and indication documented in clinical note for ceftriaxone and vancomycin orders were 41% and 46%, respectively. Median time to administration decreased among patients who received ceftriaxone ( P < .01) but had no significant impact on time to administration of vancomycin ( P = .49).

Conclusions:

Indication for ceftriaxone and vancomycin selected during order entry and reported in clinical notes inconsistently matched. Inclusion of antibiotic indication may impact time to administration.
Climate and social change at the start of the Late Antique Little Ice Age
Authors: Peregrine Peter N
Published: July 2020

The Late Antique Little Ice Age, spanning the period from 536 CE to roughly 560 CE, saw temperatures in the Northern Hemisphere drop by a degree C in less than a decade. This rapid cooling is thought to have caused widespread famine, epidemic disease, and social disruption. The relationship between cooling and social disruption is examined here using a set of high-resolution climate and historical data. A significant link between cooling and social disruption is demonstrated, but it is also demonstrated that the link is highly variable, with some societies experiencing dramatic cooling changing very little, and others experiencing only slight cooling changing dramatically. This points to variation in vulnerability, and serves to establish the Late Antique Little Ice Age as a context within which naturalistic quasi-experiments on vulnerability to climate change might be conducted.
Severe refractory thrombocytopenia in a woman positive for coronavirus disease 2019 with lupus and antiphospholipid syndrome
Authors: Hayden Alina , Vyas-Lahar Aishwarya , Rella Vincent , Rudinskaya Alla
Published: July 2020

The coronavirus disease 2019 (COVID-19) pandemic has created new challenges that necessitate prompt responses in unexpected clinical situations. Multiple extrapulmonary manifestations and complications of COVID-19 have already been described, but only scattered data are present on immunologic manifestations. We present a case of severe refractory thrombocytopenia in a 51-year-old woman with a history of long-standing systemic lupus erythematosus and antiphospholipid syndrome who presented with hemoptysis in the setting of COVID-19 infection. The patient failed to respond to initial treatment with intravenous immunoglobulin, high-dose steroids, and platelet transfusion, but responded to eltrombopag, with prompt improvement of a platelet count. The current case report provides clinical data of relevance to the largely unexplored question of the immunologic complications of COVID-19 in patients with a pre-existing inflammatory state.
Semiparametric regression of the illness-death model with interval censored disease incidence time: An application to the ACLS data
Authors: Zhou Jie , Zhang Jiajia , McLain Alexander C , Lu Wenbin , Sui Xuemei , Hardin James W
Published: July 2020

To investigate the effect of fitness on cardiovascular disease and all-cause mortality using the Aerobics Center Longitudinal Study, we develop a semiparametric illness-death model account for intermittent observations of the cardiovascular disease incidence time and the right censored data of all-cause mortality. The main challenge in estimation is to handle the intermittent observations (interval censoring) of cardiovascular disease incidence time and we develop a semiparametric estimation method based on the expectation-maximization algorithm for a Markov illness-death regression model. The variance of the parameters is estimated using profile likelihood methods. The proposed method is evaluated using extensive simulation studies and illustrated with an application to the Aerobics Center Longitudinal Study data.
Technological Change and Innovations in Microfinance Institutions: What Matters?
Authors: Mia Md Aslam
Published: July 2020

Usage of technology that serves to improve organizational efficiency among financial service providers has substantially increased during the past decade. Similarly, a large number of microfinance institutions (MFIs) have incorporated technological innovation in their operations to provide clients with better financial services. To understand the determinants of technological change in MFIs, this study investigated various factors, including sources of funds, institutional characteristics (IC) and macroeconomic factors. Using longitudinal data (2009–2014) from the microfinance industry in Bangladesh, this study estimated the Malmquist Productivity Index (non-parametric) to decompose the technological change at the first stage. This index was then used as a dependent variable in the second stage to regress against certain independent variables. Overall, it was found that the microfinance industry in Bangladesh observed regression in technological change; however, technological change could be improved by promoting peer borrowing among MFIs. Apart from that, greater autonomy through decentralization of MFI branches could also stimulate technological progress. Interestingly, MFIs located in Dhaka have experienced better technological progress than MFIs located in other parts of the country, which signifies the importance of location. Additionally, the findings also revealed a gap in transfer of technological knowledge from commercial banks to the MFIs that they fund.
Measuring entertainment production at the Canadian Television Fund
Authors: Maier Esther R
Published: July 2020

In 1983, the Canadian government established a television fund to facilitate the development of a vibrant independent production sector by investing the production of domestic entertainment in four key genres. Over the next three decades, the annual budget of the Canadian Television Fund grew from C$35 million to over C$325 million1. In taking a stakeholder approach to explore the evolution evaluative practices at the Fund from 1983 to 2010, this study contributes to our understanding of performance measures as a networked practice. It also highlights the centrality of performance measures to multiple accountings of performance in the entertainment industry.
Enlightenment value theories and the three levels in fair value accounting
Authors: Cardao-Pito Tiago
Published: July 2020

I cannot endorse Donleavy’s conclusion that “ fair value” accounting is derived from the eighteen-century economic thinkers: Anne Robert Turgot; Richard Cantillon; and Adam Smith. In his well-written study, Donleavy seems to misperceive fair value accounting as the reporting of accounting items by their market values. However, fair value accounting also advocates a theoretical explanation of how market prices would be formed and why they would be fair values. It is important to clarify this point, because it leads to two subsequent conclusions. First, that the price/value theory in fair value accounting is quite distinct from Turgot, Cantillon and Smith’s theories on the same matter. For instance, Cantillon and Smith suggested cost-based theories of value, where labor was the key element. Second, it is possible to distinguish fair value accounting from periods where the case for reporting accounting rubrics by market values was promoted based on other theoretical motivations.
Ergonomic clusters and displaced affordances in early lithic technology
Authors: Wynn Thomas
Published: July 2020

Traditional typological, technical, and cognitive approaches to early stone tools have taken an implicit Cartesian stance concerning the nature of mind. In many cases, this has led to interpretations of early technology that overemphasize its human-like features. By eschewing an epistemic mediator, 4E approaches to cognition (embodied, embedded, enactive, and extended) are in a better position to make appropriate evaluations of early hominin technical cognition that emphasize its continuity with non-human primates and ground a description of the evolution of hominin technology. This essay takes some initial steps in that direction by shifting focus away from tool types and knapping patterns toward a description based on ergonomics and Gibsonian affordances. The analysis points to the evolutionary importance of two hitherto underappreciated aspects of hominin technical systems—the emergence of ergonomic clusters instantiated in artifact form and the development of displaced affordances.