bluuebunny/crossref_metadata_2025 huggingface dataset:
Poverty and Obesity in Developed Countries
Authors: Meyerhoefer Chad D. , Yang Muzhe
Published: December 2015

This chapter reviews the literature on the relationship between poverty and obesity in developed countries, with a focus on studies that are designed to identity causal relationships. In addition to research measuring the reduced-form impact of poverty on obesity, and vice versa, the authors consider studies on the mechanisms underlying this relationship. Based on the available evidence, the authors conclude that obesity increases the likelihood of poverty mainly through labor market discrimination against women. The reasons why poverty causes obesity are more multifaceted and include poor diet, more limited access to healthy food, and certain maternal characteristics commonly found among poor households.
The Trinity’s Loving Act of Creation
Authors: Weinandy Thomas G.
Published: December 2015

This chapter discusses the Catholic understanding of God as Creator. It begins with an overview of the biblical proclamation as found in the Old and New Testaments and proceeds by citing the writings of Irenaeus as an example of early patristic thought. It then considers the doctrinal and philosophical understandings of God as one and as a Trinity of persons, with particular emphasis on the thought of Thomas Aquinas. It also examines the act of creation and the type of relationship such an act establishes between God and creation. The chapter highlights creation’s eternal purpose: for human beings to become the Father’s children after the manner of his own eternal Son, which would be achieved through the transformative power of the Holy Spirit.
Catholic Personalism up to John Paul II
Authors: Schindler David
Published: December 2015

This chapter charts the history of the Catholic Church’s personalism and its major representatives up to John Paul II. It examines the deep origins of personalism and discusses the theological controversies of the early Church as the ultimate source and the revolutionary philosophy of Immanuel Kant as the proximate source of personalism. It examines movements in European philosophy that prepared the ground for the rise of personalism, including ‘dialogical’ thought and phenomenology, along with the various European schools of personalism. Finally, it outlines the central ideas of personalist philosophy, especially its attempt to think through the various realities of human being, and indeed of reality in general, in light of the radically unique character of personal existence, as well as those aspects of human being linked to personhood ranging from relationality and community to the significance of gender, sexuality, and the mystery of love.
Archaeology, Historical Sciences, and Environmental Conservation
Authors: Ekblom Anneli
Published: December 2015

Environmental conservation has long been orientated towards reconstructing or conserving ‘naturalness’. The historical sciences in combination with new ecological thinking have taught us that landscapes are constantly in flux. We now know that many landscapes that previously were regarded as natural in fact have been shaped and reshaped by people over millennia, and that human disturbance of different kinds may enhance landscape heterogeneity and biodiversity. This chapter presents cases from different parts of Africa that demonstrate how archaeology, palaeoecology, and historical analysis have contributed to reform the traditional outlook of environmental conservation and revise misconstrued landscape histories. It shows that historical studies can offer insights that contribute a better understanding of species conservation, ecosystem function, prediction of ecosystem behaviour, and sound management of cultural landscapes. The long-term historical continuities in the landscape raise awareness of the importance of traditional practices and their benefits for environmental conservation.
Deep Smarts as the Underpinnings of Dynamic Capabilities
Authors: Leonard Dorothy , Barton Michelle
Published: December 2015

Both ordinary and dynamic capabilities depend upon the deep smarts, i.e., business-critical, experience-based knowledge, held in the heads of an organization’s top talent. This chapter examines the links between individual and organizational capabilities and presents the theory and research on deep smarts. The six most universally found characteristics of this particular kind of expertise are: deep domain knowledge; pattern-recognition-based decision making; system perspective; context awareness; diagnostic acuity; and skilled networking. Such deep smarts, as illustrated through extensive examples of entrepreneurs, are operationalized differently in highly volatile environments than in relatively stable ones. Although deep smarts are based on experience, they are skills and abilities rather than static knowledge reservoirs. Therefore, they are particularly essential to dynamic capabilities and to innovation.
Between Cordoba and Nīsābūr
Authors: Thiele Jan
Published: December 2015

This chapter discusses the history of Ashʿarism in the fourth to fifth/tenth to eleventh centuries. Ashʿarism was, besides Māturīdism, the most important school of Sunnikalām. After the decline of Muʿtazilism, it became the predominant theological school, primarily among the adherents of the Shāfiʿite and the Mālikite school of law. There is a wide scholarly consensus that Ashʿarism entered a new phase in the sixth/twelfth century, marked by an increasing influence of Avicennan philosophy, a transition generally associated with the prominent thinker Abū Ḥāmid al-Ghazālī. This chapter focuses on theologians that preceded this methodological shift. It first charts the rise of Ashʿarism, highlighting the contributions of three key figures to the elaboration and broader dissemination of the school’s teachings: Abū Bakr Ibn Fūrak, Abū Isḥāq al-Isfarāʾīnī, and Abū Bakr al-Bāqillānī. It concludes with an assessment of Ashʿarism under the patronage of Niẓām al-Mulk.
Social Influence and Clinical Intervention
Authors: Heesacker Martin
Published: December 2015

Kelman’s tripartite model organizes advances in research on social influence and clinical outcomes. Recent years have produced important advances in the field’s understanding of compliance, identification, and internalization. In compliance research, normative feedback has, under some conditions, altered clinically relevant behaviors, including drug abuse and gambling. In identification research, the therapeutic alliance has predicted 5–30 percent of the variance in clinical outcomes. Evidence suggests a causal relationship between alliance and outcomes, and that ruptured alliances can be repaired. Internalization theories from basic science have generated little recent clinical application research, but a clinician-developed approach to internalization, motivational interviewing, has generated substantial recent research. Though mixed, enough evidence supports motivational interviewing to warrant additional research.
Descartes, Cartesianism, and Early Modern Theology
Authors: Goudriaan Aza
Published: December 2015

While insisting on the need to separate theology from philosophy, Descartes developed a philosophical theology that was intensely debated in the early modern period. This article asks the question how the receptions of Cartesian philosophy were related to different confessional profiles. Confessional controversies certainly played a role: some feared that Cartesian philosophy was inspired by Jesuits, while others accused it of supporting Calvinism. Descartes’s theory of transubstantiation could never obtain trans-confessional consent. Still, the reactions to Cartesian philosophy reveal significant trans-confessional agreements. Cartesianism, it seems, was only loosely related to confessional specifics. Jansenists and Cocceians apparently had only few specifically theological reasons for espousing Cartesianism. Supporters of Cartesian ideas were found across the confessional spectrum. In a parallel way, critics of Descartes from Roman Catholic, Lutheran, or Reformed backgrounds alike made theological objections against Cartesian notions such as doubt, the dualism of thinking and extension, and an indefinitely extended world.
Markets, Ethics, and Environment
Authors: O'Neill John
Published: December 2015

Is there a relation between the increasing extension of markets and market norms to previously non-market goods, and the growth of environmental problems? This chapter explores two competing answers: market-endorsing positions that argue that a source of environmental problems lies in the absence of markets in environmental goods and that the extension of markets or market modes of valuation to environmental goods offers the most effective way of protecting them; market-skeptical positions that deny that the extension of markets will protect environmental goods or more strongly that markets and increasing marketization are themselves a source of environmental problems. These positions offer distinct perspectives on market mimicking instruments in environmental policy making, such as cost-benefit analysis, and on the development of new markets, for example in emission rights and biodiversity offsets. The issues raised include questions about value commensurability, justice, epistemic limits to planning and markets, and environmental limits to growth.
The Acts of the Apostles, Narrative, and History
Authors: Dupertuis Rubén René
Published: December 2015

The Acts of the Apostles offers a kind of sequel to Gospel of Luke, telling the story of the spread of the Jesus movement through the activities of key leaders, beginning in Jerusalem, moving westward into the Aegean region, and finally to Rome, the imperial center. Narrative approaches have been instrumental in turning attention to how the author tells the story using the tools of narrative—plot, characterization, and so on—as well as to how the author’s use of linguistic and cultural codes would have been heard by ancient readers. This chapter explores the importance of this westward geographical movement in Acts and, through a reading of the story of Paul’s visit to Philippi (Acts 16:11–40), looks at the ways in which the author of Acts adapts narrative conventions to highlight particular moments in the progression.
Bipolar Disorder During Childhood and Adolescence
Authors: Fristad Mary , Nick Elizabeth
Published: December 2015

This chapter reviews bipolar spectrum disorders (bipolar I, bipolar II, bipolar disorder not otherwise specified, and cyclothymic disorder) in childhood and adolescence. The history of the diagnosis in youth, including recent increased public and professional interest, and surrounding controversy is reviewed. Attention is given to prevalence, incidence, similarities and differences in presentation, course, and comorbidities among child, adolescent, and adult bipolar spectrum disorders. Assessment issues are reviewed, including longitudinal and multiinformant perspectives, instruments, strategies, tools, and assessment challenges with youth. Examples of symptom manifestation in youth are provided. Genetic, cognitive, neuroanatomical, psychosocial, and environmental risks for youth bipolar spectrum disorders are discussed. Evidence-based treatments reviewed include commonly prescribed mood stabilizers and atypical antipsychotics, alternative biological treatments, adjunctive psychotherapies, and complementary and alternative treatments. Finally, future directions for the study, assessment, monitoring, and treatment of youth bipolar spectrum disorders are discussed.
Depression and the Desire to Die Near the End of Life
Authors: Fairman Nathan , Irwin Scott A
Published: December 2015

This chapter examines how depression may affect a patient’s ability to make life-shortening decisions within the setting of care near the end of life, as well as a clinician’s willingness to support the patient’s preferences (that is, respecting his autonomy). It considers how the suspicion of depression can make the physician pause even when the obvious choice would be to support the patient’s decision. It also describes some of the defining features of depression, including hopelessness, suicidal ideation, and desire for hastened death. The chapter first reviews depression and similar clinical conditions in the context of end-of-life care before discussing the construct of capacity and the elements of its assessment. It then considers evidence on the relationship between depression and decisional capacity before concluding with suggestions to help guide decision-making.
A Prospective, Randomized, Multicenter, Open-label Clinical Trial Comparing Intradiscal Biacuplasty to Conventional Medical Management for Discogenic Lumbar Back Pain
Authors: Desai Mehul J. , Kapural Leonardo , Petersohn Jeffrey D. , Vallejo Ricardo , Menzies Robert , Creamer Michael , Gofeld Michael
Published: December 2015

Study Design.

This study was a prospective, randomized, crossover, multicenter trial for the evaluation of comparative effectiveness of intradiscal biacuplasty (IDB) versus conventional medical management (CMM) in the treatment of lumbar discogenic pain.

Objective.

The objective was to demonstrate the superiority of IDB over CMM in the treatment of discogenic pain with respect to the primary outcome measure.

Summary of Background Data.

Current therapeutic options for the treatment of chronic low back pain of discogenic origin are limited. CMM is often unsatisfactory with regard to the treatment of discogenic pain. IDB offers a minimally invasive treatment that has been demonstrated to be superior to placebo in the past.

Methods.

A total of 63 subjects with lumbar discogenic pain diagnosed via provocation discography were randomized to IDB + CMM (n = 29) or CMM-alone (n = 34). At 6 months, patients in the CMM-alone group were eligible for crossover if desired. The primary outcome measure was the change in visual analog scale (VAS) from baseline to 6 months. Secondary outcome measures included treatment “responders,” defined as the proportion of subjects with a 2-point or 30% decrease in VAS scores. Other secondary measures included changes from baseline to 6 months in (1) short form (SF) 36-physical functioning, (2) Oswestry Disability Index, (3) Beck Depression Inventory, (4) Patient Global Impression of Change, (5) EQ-5D VAS, and (6) back pain-related medication usage.

Results.

In the IDB cohort, the mean VAS score reduction exceeded that in the CMM cohort (−2.4 vs. −0.56; P = 0.02), and the proportion of treatment responders was substantially greater (50% vs. 18%). Differences in secondary measures favored IDB. No differences in opioid utilization were noted between groups.

Conclusion.

Superior performance of IDB with respect to all study outcomes suggests that it is a more effective treatment for discogenic pain than CMM-alone.

Level of Evidence: 2
Clinical Experience of Use of High‐dose Intravenous Methylprednisolone in Children With Acute Moderate to Severe Colitis
Authors: Vora Rakesh , Finnamore Helen E. , Crook Kay , Baillie Colin , Whittle Emma , Krishnamurthy Balaji , Venkatesh Krishnappa , Auth Marcus K.H.
Published: December 2015

Objectives:

Treatment of acute severe colitis (ASC) has been associated with high morbidity and high colectomy rate in children. In the prebiologics era, our centre used short‐term high‐dose intravenous corticosteroids (IVCS) at 2 to 30 mg · kg−1 · day−1. We conducted a retrospective review to compare efficacy of different dosing regimes of IVCS.

Methods:

Thirty‐four children treated with IVCS for ASC were included over 8 years. Patients were studied as 2 groups with similar pretreatment patient characteristics. Group 1 (standard dose) received IVCS at 2 mg · kg−1 · day−1 and group 2 (high dose) received IVCS at 10 to 30 mg · kg−1 · day−1. Safety, efficacy, and follow‐up of the entire cohort for >1 year were studied. The median IVCS dose in the standard‐ and high‐dose cohort was 1.5 mg · kg−1 · day−1 (maximum 60 mg · kg−1 · day−1) and 24.8 mg · kg−1 · day−1 (maximum 1000 mg · kg−1 · day−1), respectively.

Results:

Pediatric Ulcerative Colitis Activity Index scores at day 5 were significantly lower in high‐dose (15, interquartile range 8.5–20) than in standard‐dose IVCS (30, interquartile range 20–30). IVCS side effects were minor and reversible. Overall, medical salvage therapy was required in 5.8% (2 children) before discharge, and in 17% (6 children) at follow‐up after 1 year. The colectomy rate of the entire cohort was remarkably low with 0% during admission and 11% (4 children) after 1 year, with a trend of less colectomies in high‐dose (4.8%—1 child) than in standard‐dose (23%—3 children).

Conclusions:

Our data show that in paediatric ASC, the short‐term use of high‐dose IVCS is safe and effective. Prospective studies are needed to define the role of IVCS within salvage therapy protocols.
Magnetoencephalographic Infraslow Activity: A Feasibility Study
Authors: Rodin Ernst A. , Taulu Samu J. , Funke Michael E. , Johnson Michael B. , Bornfleth Harald , Constantino Tawnya M.
Published: December 2015

Purpose:

To explore if background infraslow activity (ISA) can be retrieved from archived magnetoencephalographic (MEG) recordings and its potential clinical relevance.

Methods:

Archived recordings of 15 patients with epilepsy and 10 normal subjects were evaluated for MEG/EEG delta (0.5–3 Hz) and ISA (0.01–0.1 Hz). The data were obtained on a Neuromag/Elekta system with 204 planar gradiometers and 102 magnetometer sensors and also 60 EEG channels. To remove artifacts, all MEG files were temporal signal space separation filtered. The data were then analyzed with the BESA Research software.

Results:

Infraslow activity was present in all files for MEG and EEG. Good concordance between EEG and MEG ISA was seen with delta for laterality and with clinical features. Delta frequencies were always less than 2 Hz. During sleep, an inverse relationship between delta and ISA occurred. With increasing depth of sleep, delta activity increased while ISA decreased and vice versa. Intermittent higher amplitude transients, arising from background, were also seen but their nature is at present unknown. Clinically relevant ictal onset baseline shifts were likewise observed.

Conclusion:

Infraslow activity is a normal segment of the cerebral electromagnetic frequency spectrum. It follows physiologic rules and can be related to areas of pathology. This is in accord with previously published EEG observations and further studies of this segment of the electromagnetic frequency spectrum for its origin and changes in health and disease are indicated.
Consumers’ intention to purchase counterfeit sporting goods in Singapore and Taiwan
Authors: Chiu Weisheng , Leng Ho Keat
Published: December 2015

Purpose

– The purpose of this paper is to compare the purchase intention of counterfeit sporting goods between Singaporean and Taiwanese students using the Theory of Planned Behavior.

Design/methodology/approach

– A quantitative approach was taken, collecting data from Singaporean and Taiwanese students studying in tertiary institutions. In total, 295 valid questionnaires were included in the data analysis.

Findings

– The results showed that consumers’ attitude, subjective norm, and brand consciousness were predictive of purchase intention for both countries, whereas perceived behavioral control had an effect only among Taiwanese students. Further analysis showed that Singapore students had significantly higher positive attitudes toward the purchase of counterfeit sporting goods and higher levels of acceptance from peers in purchasing counterfeits.

Research limitations/implications

– A limitation of this study was that respondents were selected from the undergraduate population and as such were relatively younger than the general population.

Originality/value

– The findings of this study provides a better understanding on how these factors affect purchase intention of counterfeit sporting goods across countries.
The reciprocal effects of country-of-origin on product evaluation
Authors: Katsumata Sotaro , Song Junyi
Published: December 2015

Purpose

– The purpose of this paper is to examine the country-of-origin (COO) effect on product evaluation to determine the different effects of COO in Asian nations.

Design/methodology/approach

– The authors focus on automobiles as the target product category and conduct consumer surveys in three Asian countries – China, Japan, and South Korea – and the USA. Since these four countries are the major global production bases and consumption markets, the authors can examine the reciprocal effects of COO across countries. The authors propose a hierarchical conjoint analysis and estimate parameters. For the attributes of conjoint analysis, the authors incorporate both the COO of products and other functional aspects such as price and fuel consumption to compare their effects on consumer evaluation.

Findings

– The authors find different tendencies in each country’s COO effect. Further, the authors discuss the factors affecting consumer evaluation in each country based on the country’s culture and general product images.

Originality/value

– The authors’ contributions to the literature are as follows. First, in the research design, the authors incorporate COO information as an attribute of automobiles. This enables us to compare the COO effect with the effects of other functional aspects. The authors find that the COO effect is substantially the same as the effect of other functional attributes. Second, the authors assume a hierarchical structure in the conjoint analysis and discuss the different preferences in each country. This hierarchical structure enables to extract the reciprocal effects of COO across countries.
Leadership style and job satisfaction in higher education institutions
Authors: Alonderiene Raimonda , Majauskaite Modesta
Published: December 2015

Purpose

– Although leadership is found to have impact on the followers’ attitudes and performance there is a gap in leadership studies in HEIs, especially having Lithuania in mind. The purpose of this paper is to study the impact of leadership style on job satisfaction of faculty in higher education institutions (HEI).

Design/methodology/approach

– In order to investigate before mentioned problem, the representative quantitative empirical research was conducted in 2013. It includes 72 faculty members and ten supervisors from Lithuanian public and private universities. The survey was conducted to check how leadership styles of supervisors influence faculty job satisfaction and compare the opinion of supervisors and subordinates.

Findings

– The empirical research revealed significant positive impact of leadership style on job satisfaction of faculty where servant leadership style has been found to have the highest positive significant impact on job satisfaction of faculty while controlling autocrat leadership style has the lowest impact.

Research limitations/implications

– There are several implications for further research. It can be expanded whether geographically (e.g. comparative analysis in different countries) or institutionally (e.g. in other educational institutions, such as schools or pre-schools).

Practical implications

– Practical implications reveal that supervisors have the power to increase the levels of job satisfaction of their faculty members, by defining their role as a leader, demonstrating certain leadership behaviors.

Originality/value

– This survey covers the area which lacks academic research, namely, the impact of leadership on HEI faculty. Previous leadership studies in HEI focus on particular leadership style demonstrated (van Ameijde, 2009), the impact of leadership on culture (Asmawi et al., 2013), organizational effectiveness (Siddique et al., 2011) and other factors. However, very few of them (one of the examples is the study of Webb, 2009 in USA) investigate the direct managers’ leadership style and faculty job satisfaction. Besides, the previous surveys have not covered as many leadership styles as this one does.
On the relationship between implied volatility index and equity index returns
Authors: Shaikh Imlak , Padhi Puja
Published: December 2015

Purpose

– The purpose of this paper is to analyze the asymmetric contemporaneous relationship between implied volatility index (India VIX) and Equity Index (S
&
P CNX Nifty Index). In addition, the study also analyzes the seasonality of implied volatility index in the form of day-of-the-week effects and option expiration cycle.

Design/methodology/approach

– This study employs simple OLS estimation to analyze the contemporaneous relationship among the volatility index and stock index. In order to obtain robust results, the analysis has been presented for the calendar years and sub-periods. Moreover, the international evidenced presented for other Asian markets (Japan and China).

Findings

– The empirical evidences reveal a strong persistence of asymmetry among the India VIX and Nifty stock index, at the same time the magnitude of asymmetry is not identical. The results show that the changes in India VIX occur bigger for the negative return shocks than the positive returns shocks. The similar kinds of results are recorded for the Japan and China volatility index. Particularly, the analysis also supports that India VIX holds seasonality, on the market opening VIX observed to be at its high level, and on the subsequent days it remains low. The results on the options expiration unfold the facts that India VIX remains more normal on the day of expiration.

Practical implications

– The asymmetric relation and seasonal patterns are quite useful to the volatility traders to price the financial assets when market trades in the high- and low-volatility periods.

Originality/value

– There is a lack of studies of this kind in the context of emerging markets like India; hence, this is an attempt in this direction. The study provides an insight to the NSE to launch some derivative products (i.e. F
&
Os) on India VIX that can generate more liquidity in the market for the volatility traders.
Geographies of adult multigenerational family households in metropolitan Sydney
Authors: Burnley Ian , Liu Edgar , Easthope Hazel
Published: December 2015

This paper investigates spatial trends of multigenerational adult families in metropolitan Sydney. Australia's immigrant gateway city, Sydney has high housing costs and infrastructure pressures, and planning policies support higher residential densities. In this context, the accommodation of persons living in multigenerational families is examined, by major region of origin, their geographies in Sydney, and by housing costs and constraints. Results highlight that cultural origins were influential in multigenerational household formations, and such formation is higher in areas of first and second ethnic community formation areas. Multigenerational living is also more common in middle ring and outer areas of cheaper housing. Implications are drawn for more nuanced housing policies in Sydney and comparable cities, given that detached and semi‐detached houses were favoured by these households, whereas two‐fifths of new housing constructed in Sydney in 2011 consists of two or less bedroom apartments.
A draft fur seal genome provides insights into factors affecting SNP validation and how to mitigate them
Authors: Humble E. , Martinez‐Barrio A. , Forcada J. , Trathan P. N. , Thorne M. A. S. , Hoffmann M. , Wolf J. B. W. , Hoffman J. I.
Published: December 2015

Custom genotyping arrays provide a flexible and accurate means of genotyping single nucleotide polymorphisms (SNPs) in a large number of individuals of essentially any organism. However, validation rates, defined as the proportion of putative SNPs that are verified to be polymorphic in a population, are often very low. A number of potential causes of assay failure have been identified, but none have been explored systematically. In particular, as SNPs are often developed from transcriptomes, parameters relating to the genomic context are rarely taken into account. Here, we assembled a draft Antarctic fur seal (Arctocephalus gazella) genome (assembly size: 2.41 Gb; scaffold/contig N50: 3.1 Mb/27.5 kb). We then used this resource to map the probe sequences of 144 putative SNPs genotyped in 480 individuals. The number of probe‐to‐genome mappings and alignment length together explained almost a third of the variation in validation success, indicating that sequence uniqueness and proximity to intron–exon boundaries play an important role. The same pattern was found after mapping the probe sequences to the Walrus and Weddell seal genomes, suggesting that the genomes of species divergent by as much as 23 million years can hold information relevant to SNP validation outcomes. Additionally, reanalysis of genotyping data from seven previous studies found the same two variables to be significantly associated with SNP validation success across a variety of taxa. Finally, our study reveals considerable scope for validation rates to be improved, either by simply filtering for SNPs whose flanking sequences align uniquely and completely to a reference genome, or through predictive modelling.
Helicopter‐based emergency medical services for a sparsely populated region: A study of 42,500 dispatches
Authors: Østerås Ø. , Brattebø G. , Heltne J.‐K.
Published: December 2015

Background

The Helicopter Emergency Medical Service (HEMS) in Norway is operated day and night, despite challenging geography and weather. In Western Norway, three ambulance helicopters, with a rapid response car as an alternative, cover close to 1 million inhabitants in an area of 45,000 km2. Our objective was to assess patterns of emergency medical problems and treatments in HEMS in a geographically large, but sparsely populated region.

Methods

Data from all HEMS dispatches during 2004–2013 were assessed retrospectively. Information was analyzed with respect to patient treatment and characteristics, in addition to variations in services use during the day, week, and seasons.

Results

A total of 42,456 dispatches were analyzed. One third of the patients encountered were severely ill or injured, and two thirds of these received advanced treatment. Median activation time and on‐scene time in primary helicopter missions were 5 and 11 min, respectively. Most patients (95%) were reached within 45 min by helicopter or rapid response car. Patterns of use did not change. More than one third of all dispatches were declined or aborted, mostly due to no longer medical indication, bad weather conditions, or competing missions.

Conclusion

One third of the patients encountered were severely ill or injured, and more than two thirds of these received advanced treatment. HEMS use did not change over the 10‐year period, however HEMS use peaked during daytime, weekends, and the summer. More than one third of all dispatches were declined or aborted.
Unmet Needs at the Time of Emergency Department Discharge
Authors: Samuels‐Kalow Margaret , Rhodes Karin , Uspal Julie , Reyes Smith Alyssa , Hardy Emily , Mollen Cynthia
Published: December 2015

Objectives

Emergency department (ED) discharge requires conveying critical information in a time‐limited and distracting setting. Limited health literacy may put patients at risk of incomplete comprehension, but the relationship between discharge communication needs and health literacy has not been well defined. The goal of this study was to characterize the variation in needs and preferences regarding the ED discharge process by health literacy and identify novel ideas for process improvement from parents and patients.

Methods

This was an in‐depth qualitative interview study in two EDs using asthma as a model system for health communication. Adult patients and parents of pediatric patients with an asthma exacerbation and planned discharge were enrolled using purposive sampling to balance across literacy groups at each site. Interviews were audiotaped, transcribed, coded independently by two team members, and analyzed using a modified grounded theory approach. Interviews were conducted until thematic saturation was reached in both literacy groups at each site.

Results

In‐depth interviews were completed with 51 participants: 20 adult patients and 31 pediatric parents. The majority of participants identified barriers related to ED providers, such as use of medical terminology, and systems of care, such as absence of protected time for discharge communication. Patients with limited health literacy, but not those with adequate literacy, identified conflicting information between health care sources as a barrier to successful ED discharge.

Conclusions

Participants across literacy groups and settings identified multiple actionable areas for improvement in the ED discharge process. These included the use of simplified/lay language, increased visual learning and demonstration, and the desire for complete information. Individuals with limited literacy may particularly benefit from increased attention to consistency.
Reduced Social Network Drinking is Associated with Improved Response Inhibition in Women During Early Recovery from Alcohol Use Disorders: A Pilot Study
Authors: McCutcheon Vivia V. , Luke Douglas A. , Lessov‐Schlaggar Christina N.
Published: December 2015

Background

Social support for recovery from alcohol use disorders (AUDs) is associated with improvements in self‐reported impulsive behavior in individuals treated for AUDs. We build on these findings using a behavioral task‐based measure of response inhibition, a well‐defined component of impulsivity, to examine the association of disinhibition with alcohol‐specific social network characteristics during early recovery.

Methods

Women (n = 28) were recruited from treatment for AUD within 3 to 4 weeks of their last drink and were assessed at baseline and again 3 months later. Outcome measures were level of disinhibition at baseline and change in disinhibition from baseline to follow‐up, measured using a computer‐based continuous performance test. The primary independent variables were level of drinking in the social network at baseline and change in network drinking from baseline to follow‐up.

Results

The sample [50% black, age M (SD) = 42.3 (9.5)] reported high rates of physical and sexual abuse before age 13 (43%), psychiatric disorder (71%), drug use disorder (78%), and previous treatment (71%). More drinking in participants' social networks was associated with greater disinhibition at baseline (β = 12.5, 95% CI = 6.3, 18.7). A reduction in network drinking from baseline to follow‐up was associated with reduced disinhibition (β = −6.0, 95% CI = −11.3, −0.78) independent of IQ, recent alcohol consumption, and self‐reported negative urgency.

Conclusions

This study extends previous findings of an association between social networks and self‐reported impulsivity to a neurobehavioral phenotype, response inhibition, suggesting that abstinence‐supporting social networks may play a role in cognitive change during early recovery from AUDs.
The market premium for the option to close: evidence from Australian gold mining firms
Authors: Kelly Simone
Published: December 2015

This study shows the market value of gold mining firms contains a premium for the option to close. The sample uses 41 gold mining producers listed on the Australian Stock Exchange from 1987 to 2013. The premium of the market price over the present value of cash flows is isolated and a pooled cross‐sectional regression tests the degree of association between that premium and theoretical option premiums. The results show market prices incorporate a premium reflecting the option to temporarily close operations. The magnitude of the option premium to close depends on whether firms are out or in the money options.
Behaviours of phoretic mites (Acari) associated with Ips pini and Ips grandicollis (Coleoptera: Curculionidae) during host‐tree colonization
Authors: Pfammatter Jesse A. , Malas Kareem M. , Raffa Kenneth F.
Published: December 2015

Studies on interactions between bark beetles and phoretic mites have focused largely on dispersal life stages. However, many of these interactions occur within trees, where beetles and mites develop. Within‐tree interactions are potentially important to beetle and mite reproduction, as well as beetle–mite phoretic pairings.

We performed experiments aiming to characterize the behaviours of mites associated with Ips pini (Say) and Ips grandicollis (Eichoff) during nondispersal life stages.

Mites are highly specific in the location on which they attach to beetles.

Detachment from beetles is elicited by cues associated with both beetle vectors and tree hosts. Beetle condition can trigger rapid mite departure and Iponemus confusus Lindquist detach more rapidly from beetles colonizing tissue amended with the host tree secondary compound α‐pinene than in un‐amended tissue.

Within‐plant movement by detached mites is elicited by host plant volatiles. In olfactometer assays, Dendrolaelaps quadrisetus (Berlese) preferred volatiles from beetle‐infested phloem over fresh phloem and blank controls.

Within host plant tissue, fungal symbionts of beetles provide a resource for mites. Histiogaster arborsignis Berlese fed and reproduced more successfully on Pinus resinosa (Ait) phloem inoculated with the symbiotic fungus Ophiostoma ips (Rumbold) than on phloem with the opportunistic fungus Aspergillus fumigatus or blank controls.
Aged‐care nurses in rural Tasmanian clinical settings more likely to think hypothetical medication error would be reported and disclosed compared to hospital and community nurses
Authors: Carnes Debra , Kilpatrick Sue , Iedema Rick
Published: December 2015

Objective

This study aims to determine the likelihood that rural nurses perceive a hypothetical medication error would be reported in their workplace.

Design

This employs cross‐sectional survey using hypothetical error scenario with varying levels of harm.

Setting

Clinical settings in rural Tasmania.

Participants

Participants were 116 eligible surveys received from registered and enrolled nurses.

Main outcome measures

Frequency of responses indicating the likelihood that severe, moderate and near miss (no harm) scenario would ‘always’ be reported or disclosed.

Results

Eighty per cent of nurses viewed a severe error would ‘always’ be reported, 64.8% a moderate error and 45.7% a near‐miss error. In regards to disclosure, 54.7% felt this was ‘always’ likely to occur for a severe error, 44.8% for a moderate error and 26.4% for a near miss. Across all levels of severity, aged‐care nurses were more likely than nurses in other settings to view error to ‘always’ be reported (ranging from 72–96%, P = 0.010 to 0.042,) and disclosed (68–88%, P = 0.000). Those in a management role were more likely to view error to ‘always’ be disclosed compared to those in a clinical role (50–77.3%, P = 0.008–0.024).

Conclusion

Further research in rural clinical settings is needed to improve the understanding of error management and disclosure.
Promoting women's health in remote Aboriginal settings: Midwifery students' insights for practice
Authors: Thackrah Rosalie D. , Thompson Sandra C. , Durey Angela
Published: December 2015

Objective

To describe midwifery students' insights on promoting health to Aboriginal women in remote Australia following a supervised clinical placement.

Design

Semistructured, in‐depth interviews were conducted with all midwifery students who undertook the placement between 2010 and 2013.

Setting

Aboriginal communities on the Ngaanyatjarra Lands, Western Australia.

Participants

Undergraduate and postgraduate midwifery students from a Western Australian university.

Interventions

Remote cultural immersion clinical placement.

Main outcome measures

Student learning related to culturally respectful health care delivery and promotion of health.

Results

Students observed that, despite vast distances, high rates of participation in a breast screening program were achieved due to the informal provision of culturally relevant information and support. Opportunistic encounters in communities also enabled sexual health messages to be delivered more widely and in less formal settings. The role played by Aboriginal Health Workers and female family members was vital. The importance of culturally respectful approaches to sensitive women's business, including discretion, the use of local language and pictorial representations of information, was recognised as was the socio‐cultural context and its impact on the health and well‐being of the community.

Conclusions

Although short in duration, the Ngaanyatjarra Lands clinical placement provided midwifery students with a rare opportunity to observe the importance of local contexts and cultural protocols in Aboriginal communities, and to adapt health promotion strategies to meet local needs and ways of doing things. These strategies embraced the strengths, assets and capacities of communities, yet students also witnessed challenges associated with access, delivery and acceptance of health care in remote settings.
The prevalence of and risk factors for prostatitis‐like symptoms and its relation to erectile dysfunction in Chinese men
Authors: Zhang Z. , Li Z. , Yu Q. , Wu C. , Lu Z. , Zhu F. , Zhang H. , Liao M. , Li T. , Chen W. , Xian X. , Tan A. , Mo Z.
Published: December 2015

The aim of this study was to describe the prevalence of and risk factors for prostatitis‐like symptoms and its relation to erectile dysfunction (ED) among southern Chinese men. Data were collected from 2790 men attending the Fangchenggang Area Male Healthy and Examination Survey from September 2009 to December 2009. The prostatitis‐like symptoms were assessed by the NIH Chronic Prostatitis Symptom Index and ED was assessed using the 5‐item International Index of Erectile Function. Lifestyle and demographic characteristics were obtained through a questionnaire. Prevalence of prostatitis‐like symptoms was 12.4% among 2790 Chinese men aged 20–84 years. In smokers who smoked ≥20 cigarettes per day (age‐adjusted OR = 1.29; 95% CI = 1.00–1.66; p = 0.04), physical inactivity (age‐adjusted OR = 1.31; 95% CI = 1.03–1.66; p = 0.02) was a significant risk factor for prostatitis‐like symptoms. Alcohol consumption (daily drinking) also was a risk factor for prostatitis‐like symptoms, although the differences were not statistically significant (age‐adjusted OR = 1.36; 95% CI = 0.96–1.92; p = 0.07). Those with diabetes may also be at higher risk for prostatitis‐like symptoms (age‐adjusted OR = 1.37; 95% CI = 0.85–2.21; p = 0.19). In addition, men with ED were more likely to have had prostatitis‐like symptoms (age‐adjusted OR = 1.86; 95% CI = 0.47–2.36; p < 0.0001), and the ORs increased with increasing severity of ED status (mild ED, mild to moderate ED, and moderate to severe ED were 1.57, 2.62, and 3.24, respectively. Test for trend, p = 0.0001). Our results show that prostatitis‐like symptoms are prevalent in Southern China affecting men of all ages. Smoking, drinking, lack of physical activity, and elevated plasma glucose level were associated with an increased risk of prostatitis‐like symptoms. In addition, our results reveal that ED accounted for a large proportion (61.5%) among men with prostatitis‐like symptoms; we also confirm the magnitude of ED associated with prostatitis‐like symptoms. Thus, interventions to evaluate and improve ED might help ameliorate prostatitis‐like symptoms and vice versa.
Extracorporeal Life Support in Out‐of‐Hospital Refractory Cardiac Arrest
Authors: Rousse Natacha , Robin Emmanuel , Juthier Francis , Hysi Ilir , Banfi Carlo , Al Ibrahim Merie , Coadou Herve , Goldstein Patrick , Wiel Eric , Vincentelli Andre
Published: December 2015

Out‐of‐Hospital refractory Cardiac Arrest (OHrCA) has a mortality rate between 90 and 95%. Since 2009, French medical academic societies have recommended the use of extracorporeal life support (ECLS) for OHrCA. According to these guidelines, patients were eligible for ECLS support if vital signs were still present during cardiopulmonary resuscitation (CPR), or if cardiac arrest was secondary to intoxication or hypothermia (≤32°C). Otherwise, patients would receive ECLS if (i) no‐flow duration was less than 5 min; (ii) time delays from CPR to ECLS start (low flow) were less than 100 min; and (iii) expiratory end tidal CO2 (ETCO2) was more than 10 mm Hg 20 min after initiating CPR. We have reported here our experience with ECLS in OHrCA according to the previous guidelines. We retrospectively analyzed mortality rates of patients supported with ECLS in case of OHrCA. From December 2009 to December 2013, 183 patients were assisted with ECLS, among which 32 cases were of OHrCA. Mean age for the OHrCA patients was 43.6 years. Over two‐thirds were male (71.9%). Causes of OHrCA included intoxication, isolated hypothermia <32°C, acute coronary syndrome, pulmonary edema, and other cardiac pathology. Despite adherence to protocols, only two patients (6.2%) with hypothermia and acute myocardium ischemia, respectively, could be discharged from hospital after cardiac recovery. Causes of death were brain death and multiple organ failure. Despite ECLS support setting in accordance with French guidelines in case of refractory OHrCA, mortality rates remained high. French ECLS support recommendations for OHrCA due to presumed cardiac cause should be re‐examined through new studies. Low flow duration should be improved by a shorter time of CPR before hospital transfer.
Intravenous isotonic fluids induced a positive trend in natraemia in children admitted to a general paediatric ward
Authors: Toledo Juan Diego , Morell Carlos , Vento Maximo
Published: December 2015

Aim

Using hypotonic intravenous solutions for baseline fluid needs in paediatric patients on a nil by mouth diet may cause serious complications, including hyponatraemia, cerebral oedema and even death. We analysed the evolution of natraemia and explored any adverse effects on children treated with intravenous isotonic fluids.

Methods

This was a prospective study of 50 patients consecutively admitted to a general paediatric ward who were treated with isotonic intravenous fluids and on a nil by mouth diet.

Results

The most prevalent diagnosis was acute gastroenteritis (64%). Hyponatraemia, defined as sodium in plasma of <135 mEq/L, affected 22% of the subjects, but none displayed this during the first postadmission analysis at a median of eight hours. Sodium levels changed by an average of +0.64 mEq/L/hour. The subgroup analysis (0.91 versus 0.56 mEq/L/hour, p = 0.02) and multiple linear regression (R2 = 0.756) showed a greater increase in sodium when patients had hyponatraemia on admission. Iatrogenic hyponatraemia was not detected, but two patients showed mild hypernatraemia and 35% developed clinically insignificant hyperchloraemia.

Conclusion

Using intravenous isotonic fluids induced a positive trend in natraemia on a general paediatric ward, particularly if patients were hyponatraemic when admitted, and did not induce clinically relevant adverse effects.