bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences in unmet healthcare needs between public and private primary care providers: A population-based study
Authors: Lindström Christine , Rosvall Maria , Lindström Martin
Published: March 2018

Aims: To investigate if any differences in unmet healthcare needs between persons registered at public and private primary care providers exist in Skåne (southernmost Sweden). Methods: The 2012 public health survey in Skåne was conducted with a postal questionnaire and included 28,029 respondents aged between 18 and 80 years. The study was cross-sectional. If the responder in the last three months had perceived oneself to be in need of medical care by a physician but did not seek it, this was used as a measure of unmet healthcare needs. Differences in unmet healthcare needs in relation to the primary care provider were investigated while adjusting for socioeconomic status and self-rated health in a logistic regression. Results: Differences in unmet healthcare needs were small and non-significant when comparing public and private healthcare providers. Non-manual workers were to a somewhat higher extent using private providers while manual workers showed a reverse pattern. Unmet healthcare needs had decreased slightly since 2008, but so had the response rate. Conclusions: With the current primary care system, no significant differences in unmet healthcare needs seem to exist when comparing public and private providers. It is likely that the providers are similar in their organizational setup, accessibility and doctor-patient continuity. Still more studies need to be done, preferably in a way so that uncertainty about what type of primary care provider the respondent is listed at can be avoided and perhaps using a longer time interval for unmet needs so that more subjects could be included.
Indoor and outdoor environmental determinants on the perceived housing affordability for senior households
Authors: Kim Suk-Kyung , Lee Jaechoon
Published: March 2018

The primary purpose of this research is to determine influential indoor and outdoor environmental elements that affect senior households’ perceptions of housing affordability. This paper proposes major considerations for indoor and outdoor environmental elements which could make homes for senior households to be affordable and thus support their ageing in place. Our research adopted an empirical approach based on a survey. Relevant research was reviewed to identify potential indoor and outdoor environmental elements that could affect senior residents’ opinions about housing affordability. Sixteen indoor and outdoor environmental elements were selected. The survey targeted senior residents living in the central Michigan area in the United States. The results of this paper were based on descriptive statistics, mean difference tests, correlation coefficients and regression models to explain the relationships between indoor and outdoor environmental elements and senior residents’ perceptions of their housing affordability. Major findings proved statistically significant correlations between interior environmental elements and senior households’ perceived housing affordability. Most housing programmes and policies for housing affordability have focused on financial elements. Findings from this research, however, added several indoor and neighbourhood environmental elements for consideration to improve senior households’ perceived housing affordability and support their ageing in place.
Low-velocity impact on cylindrically curved bilayers
Authors: Bidi A , Liaghat Gh , Rahimi Gh
Published: March 2018

In this study, low-velocity impact response of cylindrically curved bilayer panels is studied. A large number of parameters affect the impact dynamics and many models have been used for solution previously. These models can be classified as energy balance model, spring–mass model, and complete models in which the dynamic behavior of the structure is exactly modeled. In this study, a two degrees of freedom spring–mass model is used to evaluate contact force between the composite panel and impactor. This work uses the modified Hertz contact model which is linearized form of general Hertz contact law. First-order shear deformation theory coupled with Fourier series expansion is used to derive the governing equations of the curved bilayer panel. The effects of panel curvature, impact velocity, and mass of impactor on the panel behavior under low-velocity impact are investigated. The results show that changing the panel radius of curvature will change the impact force, impact duration, and local panel deformation. Finally, analytical solutions have been compared with numerical results.
Identity as a causal power
Authors: Kašperová Eva , Kitching John , Blackburn Robert
Published: March 2018

We propose a critical realist-informed conception of entrepreneurial identity – the personal power to create a new venture. Although most people have the power to become an entrepreneur, not everyone can, or is motivated to, realize that potential. Other countervailing powers – personal, material and social – can constrain, or discourage, action. Utilizing a stratified, emergent ontology, we contextualize entrepreneurial identity within three analytical orders – natural, practical and social. We distinguish personal identity, the set of concerns in the three orders that motivate action, from social identity, the roles we commit to in society. While entrepreneurial identity is a type of social identity, the underlying concerns that motivate commitment to an entrepreneurial role cannot be reduced to social interaction alone. The concept of internal conversation is used to theorize the connection of entrepreneurial motivation, context and behaviour. We draw on qualitative data from three UK-based disabled entrepreneurs to demonstrate the value of our framework.
World Cafés Create Healthier Communities for Rural, Older Adults Living With Diabetes
Authors: Yankeelov Pamela A. , Faul Anna C. , D’Ambrosio Joseph G. , Gordon Barbara A. , McGeeney Teresa J.
Published: March 2018

Our global population is aging at an accelerated pace. While the average life expectancy has seen dramatic increases, chronic disease and disability have also increased, with rural America tending to be older, sicker, and poorer. This article examines the implementation and outcomes associated with the community engagement method of the world café that was instrumental in developing a “culture of health” aimed to reduce diabetes-related inequalities for older adults in rural counties of Kentucky. Older residents and the organizations that serve them participated in world cafés, which resulted in collective action due to the wisdom and capacity that evolve from the core element of the method, conversational sharing via multiple small group interactions. Four world cafés were held to explore the desires of the communities related to healthy eating, exercise, smoking cessation, and diabetes care. The world cafés brought a diverse group of community residents and governmental and business leaders to discuss topics that matter to their community, leading to the development of a strategic plan and a scorecard and, ultimately, community empowerment.
Texting 4 Sexual Health: Improving Attitudes, Intention, and Behavior Among American Indian and Alaska Native Youth
Authors: Yao Patricia , Fu Rongwei , Craig Rushing Stephanie , Stephens David , Ash Joan S. , Eden Karen B.
Published: March 2018

Purpose. To design and test the effectiveness of a text messaging intervention to promote condom use and STI/HIV testing among American Indian and Alaska Native youth. Method. A total of 408 study participants, 15 to 24 years old, were recruited, consented, surveyed, were sent intervention messages, and were incentivized via text message over a 9-month period. Complete pre- and postsurvey data were collected from 192 participants using SMS short codes. A mixed-effects logistic regression model was used to analyze before–after change in responses assessing sexual health knowledge, attitude, self-efficacy, intention, and behavior. Results. Participants’ condom use attitude, condom use behavior, and STI/HIV testing intention improved after the intervention ( p < .05). Frequent condom use increased from 30% to 42% and was retained by participants at least 3 months postintervention, and the intervention improved participants’ intention to get tested for STI/HIV after changing sexual partners, increasing from 46% to 58% postintervention. Conclusions. Given the widespread use of cell phones by youth, text-based interventions may offer a feasible and effective tool to promote condom use and STI/HIV testing.
An Agenda in the Interest of Audiences: Facing the Challenges of Intrusive Media Technologies
Authors: Ytre-Arne Brita , Das Ranjana
Published: March 2018

This article formulates a five-point agenda for audience research, drawing on implications arising out of a systematic foresight analysis exercise on the field of audience research, conducted between 2014 and 2017, by the research network Consortium on Emerging Directions in Audience Research (CEDAR). We formulate this agenda in the context of the rapid datafication of society, amid emerging technologies, including the Internet of Things, and following a transformative decade, which overlapped with the pervasion of social media, proliferation of connected gadgets, and growing interest in and concern about big data. The agenda we formulate includes substantial and intellectual priorities concerning intrusive technologies, critical data literacies, labour, co-option, and resistance, and argues for the need for research on these matters, in the interest of audiences.
Current understanding and future perspectives of the roles of sirtuins in the reprogramming and differentiation of pluripotent stem cells
Authors: Hsu Yi-Chao , Wu Yu-Ting , Tsai Chia-Ling , Wei Yau-Huei
Published: March 2018

In mammalian cells, there are seven members of the sirtuin protein family (SIRT1–7). SIRT1, SIRT6, and SIRT7 catalyze posttranslational modification of proteins in the nucleus, SIRT3, SIRT4, and SIRT5 are in the mitochondria and SIRT2 is in the cytosol. SIRT1 can deacetylate the transcription factor SOX2 and regulate induced pluripotent stem cells (iPSCs) reprogramming through the miR-34a–SIRT1–p53 axis. SIRT2 can regulate the function of pluripotent stem cells through GSK3β. SIRT3 can positively regulate PPAR gamma coactivator 1-alpha (PGC-1α) expression during the differentiation of stem cells. SIRT4 has no direct role in regulating reprogramming but may have the potential to prevent senescence of somatic cells and to facilitate the reprogramming of iPSCs. SIRT5 can deacetylate STAT3, which is an important transcription factor in regulating pluripotency and differentiation of stem cells. SIRT6 can enhance the reprogramming efficiency of iPSCs from aged skin fibroblasts through miR-766 and increase the expression levels of the reprogramming genes including Sox2, Oct4, and Nanog through acetylation of histone H3 lysine 56. SIRT7 plays a regulatory role in the process of mesenchymal-to-epithelial transition (MET), which has been suggested to be a crucial process in the generation of iPSCs from fibroblasts. In this review, we summarize recent findings of the roles of sirtuins in the metabolic reprogramming and differentiation of stem cells and discuss the bidirectional changes in the gene expression and activities of sirtuins in the commitment of differentiation of mesenchymal stem cells (MSCs) and reprogramming of somatic cells to iPSCs, respectively. Thus, understanding the molecular basis of the interplay between different sirtuins and mitochondrial function will provide new insights into the regulation of differentiation of stem cells and iPSCs formation, respectively, and may help design effective stem cell therapies for regenerative medicine.

Impact statement

This is an extensive review of the recent advances in our understanding of the roles of some members of the sirtuins family, such as SIRT1, SIRT2, SIRT3, and SIRT6, in the regulation of intermediary metabolism during stem cell differentiation and in the reprogramming of somatic cells to form induced pluripotent stem cells (iPSCs). This article provides an updated integrated view on the mechanisms by which sirtuins-mediated posttranslational protein modifications regulate mitochondrial biogenesis, bioenergetics, and antioxidant defense in the maintenance and differentiation of stem cells and in iPSCs formation, respectively.
Spectrin and its interacting partners in nuclear structure and function
Authors: Lambert Muriel W
Published: March 2018

Nonerythroid αII-spectrin is a structural protein whose roles in the nucleus have just begun to be explored. αII-spectrin is an important component of the nucleoskelelton and has both structural and non-structural functions. Its best known role is in repair of DNA ICLs both in genomic and telomeric DNA. αII-spectrin aids in the recruitment of repair proteins to sites of damage and a proposed mechanism of action is presented. It interacts with a number of different groups of proteins in the nucleus, indicating it has roles in additional cellular functions. αII-spectrin, in its structural role, associates/co-purifies with proteins important in maintaining the architecture and mechanical properties of the nucleus such as lamin, emerin, actin, protein 4.1, nuclear myosin, and SUN proteins. It is important for the resilience and elasticity of the nucleus. Thus, αII-spectrin’s role in cellular functions is complex due to its structural as well as non-structural roles and understanding the consequences of a loss or deficiency of αII-spectrin in the nucleus is a significant challenge. In the bone marrow failure disorder, Fanconi anemia, there is a deficiency in αII-spectrin and, among other characteristics, there is defective DNA repair, chromosome instability, and congenital abnormalities. One may speculate that a deficiency in αII-spectrin plays an important role not only in the DNA repair defect but also in the congenital anomalies observed in Fanconi anemia , particularly since αII-spectrin has been shown to be important in embryonic development in a mouse model. The dual roles of αII-spectrin in the nucleus in both structural and non-structural functions make this an extremely important protein which needs to be investigated further. Such investigations should help unravel the complexities of αII-spectrin’s interactions with other nuclear proteins and enhance our understanding of the pathogenesis of disorders, such as Fanconi anemia , in which there is a deficiency in αII-spectrin.

Impact statement

The nucleoskeleton is critical for maintaining the architecture and functional integrity of the nucleus. Nonerythroid α-spectrin (αIISp) is an essential nucleoskeletal protein; however, its interactions with other structural and non-structural nuclear proteins and its functional importance in the nucleus have only begun to be explored. This review addresses these issues. It describes αIISp’s association with DNA repair proteins and at least one proposed mechanism of action for its role in DNA repair. Specific interactions of αIISp with other nucleoskeletal proteins as well as its important role in the biomechanical properties of the nucleus are reviewed. The consequences of loss of αIISp, in disorders such as Fanconi anemia, are examined, providing insights into the profound impact of this loss on critical processes known to be abnormal in FA, such as development, carcinogenesis, cancer progression and cellular functions dependent upon αIISp’s interactions with other nucleoskeletal proteins.
Laser Fenestration for Treatment of a Complicated Chronic Type B Aortic Dissection
Authors: Talaie Tara , Werter Christopher , Drucker Charles , Aicher Brittany O. , Crawford Robert , Toursavadkohi Shahab
Published: March 2018

We report a case of a complex chronic type B aortic dissection treated by thoracic endovascular aortic repair and laser fenestration of the false septum to preserve flow to branch vessels originating from both the true and false lumen. Dissections complicated by thoracoabdominal aneurysmal degeneration with critical organs being perfused by branches arising from both true and false lumens are rare and leave limited options for repair. Despite advancements in endovascular techniques, fenestration remains one of the only means of preserving flow to both the true and false lumens and thus was necessary in the management of our patient. This novel procedure allows complex aortic dissections to be addressed endovascularly, which increases the flexibility and management of this challenging problem that previously required an open repair with significant morbidity.
Racial and Socioeconomic Disparities After Carotid Procedures
Authors: Vogel Todd R. , Kruse Robin L. , Kim Ryan J. , Dombrovskiy Viktor Y.
Published: March 2018

Background:

Race has been associated with inferior outcomes after multiple procedures, but the association of socioeconomic status with procedures for cerebrovascular disease is not well established.

Materials and Methods:

Elective carotid artery stenting (CAS) and carotid endarterectomy (CEA) procedures were identified in the National Inpatient Sample, 2012 to 2014. Median household income was estimated from patient ZIP codes. Chi-square and multivariable logistic regression analysis evaluated outcomes, accounting for age, race, gender, comorbidities, procedure, income, insurance, and hospital characteristics.

Results:

We identified 234 825 carotid procedures (205 835 CEA and 28 990 CAS). Blacks and Hispanics were more likely to be among the lowest quartile income patients (LQIPs) compared to whites (53.5% and 38.7% vs 27.0%, respectively; P < .0002). Compared to highest income quartile patients, LQIP had lower rates of private insurance (16.3% vs 22.0%) and higher Medicaid use (4.7% vs 2.0%; all P < .0002). Lowest quartile income patients were more likely to receive CAS (odds ratio [OR] = 1.32, 95% confidence interval [CI]: 1.27-1.37), as were blacks and Hispanics (OR = 1.09, 95% CI: 1.02-1.26; OR = 1.31, 95% CI: 1.24-1.40, respectively). In multivariable regression, postoperative stroke was associated with LQIP, black race, and Hispanic ethnicity (OR = 1.16, 95% CI: 1.06-1.28; OR = 1.52, 95% CI: 1.33-1.73; OR = 1.43, 95% CI: 1.24-1.64, respectively). Subgroup analysis demonstrated that whites also had higher odds of stroke in the lower income quartile (OR = 1.2, 95% CI: 1.1-1.4). Mortality was associated with LQIP (OR = 1.6, 95% CI: 1.2-2.1), black race (OR = 1.8, 95% CI: 1.4-2.5), and CAS (OR = 1.3, 95% CI: 1.1-1.6). Length of stay in the lowest income quartile was longer than in patients with the highest income ( P < .0001).

Conclusions:

Race was associated with increased hospital mortality, postoperative stroke, and overall complications after carotid procedures. Lower income was significantly associated with increased stroke and mortality irrespective of race. Disparate utilization and outcomes for carotid procedures are multifactorial. Efforts to reduce disparities will need to focus on race and other socioeconomic factors.
Combined Radial and Femoral Access Strategy and Radial-Femoral Rendezvous in Patients With Long and Complex Iliac Occlusions
Authors: Hanna Elias B. , Mogabgab Owen N. , Baydoun Hassan
Published: March 2018

We present cases of complex, calcified iliac occlusive disease revascularized via a combined radial-femoral access strategy. Through a 6-French, 125-cm transradial guiding catheter, antegrade guidewires and catheters are advanced into the iliac occlusion, while retrograde devices are advanced transfemorally. The transradial and transfemoral channels communicate, allowing the devices to cross the occlusion into the true lumen (radial-femoral antegrade–retrograde rendezvous).
Accelerating Stroke Recovery: Body Structures and Functions, Activities, Participation, and Quality of Life Outcomes From a Large Rehabilitation Trial
Authors: Lewthwaite Rebecca , Winstein Carolee J. , Lane Christianne J. , Blanton Sarah , Wagenheim Burl R. , Nelsen Monica A. , Dromerick Alexander W. , Wolf Steven L.
Published: March 2018

Background. Task-oriented therapies have been developed to address significant upper extremity disability that persists after stroke. Yet, the extent of and approach to rehabilitation and recovery remains unsatisfactory to many. Objective. To compare a skill-directed investigational intervention with usual care treatment for body functions and structures, activities, participation, and quality of life outcomes. Methods. On average, 46 days poststroke, 361 patients were randomized to 1 of 3 outpatient therapy groups: a patient-centered Accelerated Skill Acquisition Program (ASAP), dose-equivalent usual occupational therapy (DEUCC), or usual therapy (UCC). Outcomes were taken at baseline, posttreatment, 6 months, and 1 year after randomization. Longitudinal mixed effect models compared group differences in poststroke improvement during treatment and follow-up phases. Results. Across all groups, most improvement occurred during the treatment phase, followed by change more slowly during follow-up. Compared with DEUCC and UCC, ASAP group gains were greater during treatment for Stroke Impact Scale Hand, Strength, Mobility, Physical Function, and Participation scores, self-efficacy, perceived health, reintegration, patient-centeredness, and quality of life outcomes. ASAP participants reported higher Motor Activity Log–28 Quality of Movement than UCC posttreatment and perceived greater study-related improvements in quality of life. By end of study, all groups reached similar levels with only limited group differences. Conclusions. Customized task-oriented training can be implemented to accelerate gains across a full spectrum of patient-reported outcomes. While group differences for most outcomes disappeared at 1 year, ASAP participants achieved these outcomes on average 8 months earlier (ClinicalTrials.gov: Interdisciplinary Comprehensive Arm Rehabilitation Evaluation [ICARE] Stroke Initiative, at www.ClinicalTrials.gov/ClinicalTrials.gov . Identifier: NCT00871715).
Sensorimotor and Physiological Indicators of Impairment in Mild Traumatic Brain Injury: A Meta-Analysis
Authors: Galea Olivia A. , Cottrell Michelle A. , Treleaven Julia M. , O’Leary Shaun P.
Published: March 2018

Objective. To systematically review the literature with meta-analysis to determine whether persistence of sensorimotor or physiological impairment exists between 4 weeks to 6 months post mild traumatic brain injury (mTBI), and assign level of evidence to findings. Method. The databases PubMed, pscyINFO, SPORTdiscus, Medline, CINAHL and Embase were searched from inception to November 2016 using a priori inclusion criteria. Critical appraisal was performed, and an evidence matrix established level of evidence. Meta-analysis of pooled results identified standardized mean difference (SMD) and 95% confidence intervals (95% CI) between mTBI and healthy controls for a variety of physiological and sensorimotor indicators. Results. Eighteen eligible articles, with a mean quality score of 15.67 (SD = 2.33) were included in the final review. Meta-analysis of center of motion variable; maximal mediolateral center of motion/center of pressure separation distance SMD [95% CI] approached significance at (−0.42 [−0.84, −0.00], I2 = 0%) for dual task, level walking indicating a potential reduction in maximal mediolateral excursion during gait in the mTBI group compared to healthy controls. Significantly reduced variability in the standard deviation of heart beat intervals was observed in the mTBI group (−0.51 [−0.74, −0.28], I2 = 0%). Overall, significant group differences in 36 sensorimotor and physiological variables (eg, balance, gait velocity and motion analysis outcomes, various oculomotor tasks, as well as heart rate variability frequency domains) were identified. Conclusion. Findings demonstrate that persistence of sensorimotor and physiological changes beyond expected recovery times following subacute mTBI in an adult population is possible. These findings have implications for post-injury assessment and management.
The Impact of Dual-Tasking on Postural Stability in People With Parkinson’s Disease With and Without Freezing of Gait
Authors: Bekkers Esther M. J. , Dockx Kim , Devan Surendar , Van Rossom Sam , Verschueren Sabine M. P. , Bloem Bastiaan R. , Nieuwboer Alice
Published: March 2018

Background. Postural instability and freezing of gait (FOG) are major problems in patients with Parkinson’s disease (PD), and both contribute to falls. However, the interrelationship between these 2 deficits is still unclear. Objective. This study investigated whether dual-tasking influenced postural control differently in freezers (FOG+) and nonfreezers (FOG−). Methods. Thirty-three patients with PD (19 FOG+, 14 FOG−, well-matched) and 28 healthy controls underwent 4 postural control tasks, consisting of standing on either stable or unstable surfaces with eyes open or closed. Each condition was performed with and without a cognitive dual-task (DT). Center of pressure and center of mass variables and cognitive DT performance outcomes were investigated. Results. Postural stability decreased to a larger extent in FOG+ under DT conditions compared with the other groups, although overall most differences were found between FOG+ and controls. FOG+ exhibited worse postural control compared with FOG− under stable surface DT conditions, shown by higher medial-lateral sway measures (group × surface × task, P < .05). Also, postural DT cost (%) was higher in FOG+ than in FOG− in unstable surface conditions without vision. Controls performed better on the cognitive DT when balancing compared with sitting, whereas this improvement was absent in both PD subgroups and more so in FOG+. Conclusions. Postural stability in FOG+ deteriorated more than in FOG− and controls upon cognitive load. Our results extend earlier findings on gait that the compensatory mechanisms to cope with DT stance are insufficient in FOG+. The findings highlight the need for adapted rehabilitation programs for this subgroup, comprising motor-cognitive balance training.
Received signal strength difference–based tracking estimation method for arbitrarily moving target in wireless sensor networks
Authors: Jia Zixi , Guan Bo
Published: March 2018

The surveillance system, which is mainly used for detecting and tracking moving targets, is one of the most significant applications of wireless sensor networks. Up to present, received signal strength indicator is the most common measuring mean for estimating the distance in sensor networks. However, in the presence of noise, it is impossible to gain the accurate distance based on received signal strength indicator. In this article, we propose a new tracking scheme based on received signal strength difference, which is the difference value of received signal strength indicators between two neighboring sampling steps. Supposing the noise has a certain degree of correlation in a certain time interval, received signal strength difference can effectively reduce the negative impact from noise. The tracking algorithm based on received signal strength difference is built: The sensor nodes collectively estimate a possible zone of the target via the signs of received signal strength difference. Next, the possible zone is further immensely shrunk to the refined zone via the absolute values of received signal strength difference. Finally, we determine the target’s final location by choosing the reference dot with the minimum norm in the refined zone. The simulation results demonstrate that the proposed tracking method achieves higher localization accuracy than the typical received signal strength indicator–based scheme. The received signal strength difference–based method also has good generality and robustness with respect to the noises with different deviation values and the target following arbitrarily state model.
New Body Scales Reveal Body Dissatisfaction, Thin-Ideal, and Muscularity-Ideal in Males
Authors: Ralph-Nearman Christina , Filik Ruth
Published: March 2018

The aim of the current study was to develop, test, and retest two new male body dissatisfaction scales: The Male Body Scale (MBS; consisting of emaciated to obese figures) and the Male Fit Body Scale (MFBS; consisting of emaciated to muscular figures). These scales were compared to the two most commonly used visually based indices of body dissatisfaction (Stunkard Figure Rating Scale, SFRS; and Somatomorphic Matrix, SM). Male participants rated which body figure on each scale most represented their current figure, then their ideal figure, and then rated which one of the three scales (MBS, MFBS, and SFRS) best represented their current and ideal body overall. Finally, they completed the Drive for Muscularity Scale (DMS), the Eating Disorder Examination Questionnaire (EDE-Q 6.0), and their actual body composition was calculated. This was followed by a retest and manipulation check 2 to 6 weeks later. Participants’ actual body mass index, fat- and muscularity-percentage were all highly related to their current body figure choice, and both new scales were consistently valid and more reliable between test and retest than the SFRS and SM body dissatisfaction scores. Importantly, each scale was sensitive to different types of body dissatisfaction within males. Specifically, the MBS revealed that males’ desire for the thin-ideal significantly corresponded to higher eating disorder tendencies as identified by EDE-Q 6.0 scores, while the MFBS revealed much higher body dissatisfaction toward the larger, muscularity-ideal, predicting higher drive for muscularity as identified by DMS scores. Results validated the new scales, and inform male-focused eating disorder research.
Physical Activity Interventions With African American or Latino Men: A Systematic Review
Authors: Griffith Derek M. , Bergner Erin M. , Cornish Emily K. , McQueen Chelsea M.
Published: March 2018

Relatively little is known about what helps increase physical activity in African American men, and even less is known about promoting physical activity among Latino men. This systematic review aimed to address the key questions: (a) what is the state of the evidence on health-related behavior change interventions targeting physical activity among African American or Latino men? and (b) What factors facilitate physical activity for these men? For this review, nine electronic databases were searched to identify peer-reviewed articles published between 2011–2017 that reported interventions to promote physical activity among African American or Latino men. Following PRISMA guidelines, nine articles representing seven studies that met our criteria were identified: six published studies that provided data for African American men, and one published study provided data for Latino men. Consistent with previous reviews, more research is needed to better understand how gender can be incorporated in physical activity interventions for African American and Latino men. Future interventions should explore how being an adult male and a man of color shapes motivations, attitudes, and preferences to be physically active. Studies should consider how race and ethnicity intersect with notions of masculinity, manhood and Machismo to enhance the effectiveness of physical activity interventions for these populations. Despite the health benefits of physical activity, rates of these behaviors remain low among African American and Latino men. It is essential to determine how best to increase the motivation and salience for these men to overcome the obesogenic environments and contexts in which they often live.
Comparison of Radiographic and Intraoperative Visual Assessment of Scaphotrapezoid Joint Arthritis in Patients With End-Stage Carpometacarpal Arthritis of the Thumb Base
Authors: Akoon Anil , Grandizio Louis C. , Mookerjee Gaurav G. , Graham Jove , Klena Joel C.
Published: March 2018

Background: The purpose of this investigation is to compare the radiographic and intraoperative assessment of scaphotrapezoid (ST) joint arthritis in patients with end-stage carpometacarpal (CMC) arthritis of the thumb base. We aim to define the incidence of ST arthritis in this population and determine whether radiographic features such as lunate morphology, dorsal intercalated segment instability (DISI), and scapholunate (SL) diastasis are associated with the incidence of ST arthritis. Methods: We retrospectively reviewed consecutive patients with end-stage CMC arthritis of the thumb treated operatively with trapeziectomy. Preoperative wrist radiographs were reviewed, and the presence of ST arthritis was determined using the Sodha classification. Lunate morphology, DISI, and SL diastasis were noted. Intraoperative grading of ST arthritis was assessed using a modified Brown classification. The specificity and sensitivity of radiographic assessment was compared with the gold standard of intraoperative direct visualization. Results: In total, 302 thumbs met inclusion criteria. End-stage ST joint arthritis determined by intraoperative visual inspection was noted in 31% of cases. No radiographic or demographic variables were found to be risk factors for ST arthritis. Plain radiographs were 47% sensitive and 94% specific in their ability to detect end-stage ST joint arthritis. Conclusions: We report a 31% incidence of end-stage ST joint arthritis in surgically treated patients with CMC arthritis based on visual inspection which is lower than previous literature. Wrist radiographs demonstrate a 47% sensitivity and 94% specificity in predicting end-stage ST joint arthritis. It is imperative to directly visualize the ST joint after trapeziectomy, as radiographs demonstrate poor sensitivity.
“That Curious Privilege of Immunity”
Authors: Sitze Adam
Published: March 2018

This article offers a close reading of Nasser Hussain’s 1989 essay on Salman Rushdie’s 1983 novel Shame in order to propose some thoughts on the basic problematic guiding Hussain’s inquiries into post-colonial law.
Simulation-based uncertainty correlation modeling in reliability analysis
Authors: Khosravi Faramarz , Müller Malte , Glaß Michael , Teich Jürgen
Published: March 2018

Due to destructive effects like temperature and radiation, today’s embedded systems have to deal with unreliable components. The intensity of these effects depends on uncertain aspects like environmental or usage conditions such that highly safety-critical systems are pessimistically designed for worst-case mission profiles. These uncertain aspects may affect several components simultaneously, implying correlation across uncertainties in their reliability. This paper enables a state-of-the-art uncertainty-aware reliability analysis technique to consider multiple arbitrary correlations; in other words, components’ reliability is affected by several uncertain aspects to different degrees. This analysis technique combines reliability models such as binary decision diagrams with a Monte Carlo simulation, and derives the uncertainty distribution of the system’s reliability with insights on the mean, quantile intervals, and so on. The proposed correlation method aims at generating correlated samples from the uncertainty distribution of components’ reliability such that the shape and statistical properties of each individual distribution remain unchanged. Experimental results confirm that the proposed correlation model enables the employed uncertainty-aware analysis to accurately calculate uncertainty at system level.
Putting Feelings Into Words: Affect Labeling as Implicit Emotion Regulation
Authors: Torre Jared B. , Lieberman Matthew D.
Published: March 2018

Putting feelings into words, or “affect labeling,” can attenuate our emotional experiences. However, unlike explicit emotion regulation techniques, affect labeling may not even feel like a regulatory process as it occurs. Nevertheless, research investigating affect labeling has found it produces a pattern of effects like those seen during explicit emotion regulation, suggesting affect labeling is a form of implicit emotion regulation. In this review, we will outline research on affect labeling, comparing it to reappraisal, a form of explicit emotion regulation, along four major domains of effects—experiential, autonomic, neural, and behavioral—that establish it as a form of implicit emotion regulation. This review will then speculate on possible mechanisms driving affect labeling effects and other remaining unanswered questions.
Pharmacotherapy of type1 diabetes in children and adolescents: more than insulin?
Authors: Biester Torben , Kordonouri Olga , Danne Thomas
Published: March 2018

For paediatric patients with type 1 diabetes, intensified insulin therapy with either multiple daily injection or insulin pump therapy is currently the only method of treatment. To optimize this therapy, insulin analogues are fixed parts of all therapy regimens. New ultra-rapid insulins seem to be beneficial not only in adults but also in this age group. New developments in long-acting analogues have demonstrated safety and will be regular in paediatrics, we hope, soon. Furthermore, the psychosocial approach for consideration of real-life aspects becomes more the focus of therapeutic regimens and is implemented into international guidelines. Technical improvements, such as continuous glucose monitoring, particularly in combination with pump therapy, support the great success of rapid-acting analogues by reducing hypoglycaemias. Non-insulin agents such as SGLT2-inhibitors show beneficial aspects in people with type 1 diabetes. For outpatient care with these currently off-label-used drugs, special training for measurement of ketones should be imperative.
The impact of relocation of chronic pain service from hospital setting to community centre on patient experience: a single-centre audit
Authors: Tsui Jonathan Jenkin , Davey Veronica , Colvin Lesley
Published: March 2018

Background and aims:

The Lothian Chronic Pain Service relocated from a university teaching hospital (Western General Hospital (WGH)) to a community centre (Leith Community Treatment Centre (LCTC)) in 2015. Transportation and geographical location were noted by staff to be potential challenges that could negatively impact on the patient experience. The objective of this study is to evaluate how relocating pain clinic from an urban-based hospital to a peripheral community centre on patient experience.

Methods:

An assessment and audit of the impact of the relocation on the Patient-Reported Experience Measure (PREM) of pain services was conducted. Using a nationally developed questionnaire, the patient-reported experience from LCTC was prospectively collected in 2016 and was compared to historical data obtained from WGH in 2014 by National Health Service (NHS) Scotland. All patients attending Lothian Chronic Pain Service clinics were deemed eligible for the audit. Patient demographics were compared between the two data sets. The impact of patient deprivation on patient experience was investigated using the Scottish Index of Multiple Deprivation (SIMD16).

Results:

Data from 111 patients from LCTC were compared to 206 patients from WGH. Percentage of patients rating care as ‘excellent’ was found to be significantly greater at LCTC than WGH (0.0049). However, overall patient rating of care from LCTC was not significantly different from WGH data and ratings were higher at LCTC. No correlation was found between patient deprivation and PREM.

Conclusion:

There is no clear evidence that PREM was negatively affected by the move from a university teaching hospital to a community setting. As this only reported experiences of patients who attended the service, further studies may be warranted to investigate the impact of patient nonattendance.
The BC Glomerulonephritis Network: Improving Access and Reducing the Cost of Immunosuppressive Treatments for Glomerular Diseases
Authors: Barbour Sean , Lo Clifford , Espino-Hernandez Gabriela , Gill Jagbir , Levin Adeera
Published: March 2018

Glomerulonephritis (GN) is a common cause of end-stage renal disease in Canada and worldwide, and results in significant health care resource utilization and patient morbidity. However, GN has not been a traditional priority of provincial renal health care organizations, despite the known benefits to health services delivery and patient outcomes from integrated provincial care in other types of chronic kidney disease. To address this deficiency, the British Columbia (BC) Provincial Renal Agency created the BC GN Network in 2013 to coordinate provincial GN health services delivery informed by robust population-level data capture on all GN patients in the province via the BC GN Registry. This report describes the use of the BC GN Network infrastructure to systematically develop and evaluate a provincial GN drug formulary to improve patient and physician access to evidence-based immunosuppressive treatments for GN in a cost-efficient manner that successfully halted historical trends of increasing medication costs. An example is provided of using the provincial infrastructure to implement and subsequently evaluate an evidence-informed health policy of converting brand to generic tacrolimus for the treatment of GN. The BC GN Network, including the provincial drug formulary and data infrastructure, is an example of the benefits of expanding the mandate of provincial renal health administrative organizations to include the care of patients with GN, and constitutes a viable health delivery model that can be implemented in other Canadian provinces to achieve similar goals.
Quantifying performance metrics of cervical spine mobilization for improved education and clinical outcomes: Early experience with a novel wearable device
Authors: Kope Ryan , O’Brien Jordan , Sadi Jackie , Walton David M. , Ferreira Louis M
Published: March 2018

Introduction

Evaluation of manual skills training for spinal rehabilitation has been stagnant for 40 years. Observation and mimicry are coupled with feedback from “expert” observers to train and evaluate learners, relying on rater experience to discern speed and force. Spinal manipulation is a controlled act under the Regulated Health Professions Act (1991) as it is not without risk. The discordance between current methods for evaluating proficiency and the potential risks of inadequate application is a critical gap.

Methods

This work reports a novel wearable device that measures finger forces via microstrain bending of the physiotherapist’s nail. The device leaves the tactile finger pad unobstructed and does not interfere with treatment application. Five expert-level physiotherapists performed a standard postero-anteriorly directed spinal segmental mobilization treatment for 1 min at 1–1.5 Hz rhythm.

Results

The device successfully measured all treatment forces (0.2–27.3 N). Physiotherapists applied a maximum force rate of 0.03 ± 0.01 N/s with a rhythm of 1.76 ± 0.38 Hz. In 15 trials, there were no device failures. The device was easily applied and removed, and physiotherapists were able to walk about and interact normally with patients.

Conclusions

These results indicate that this technology can be integrated into a skills training program to provide quantitative feedback for objective assessments.
Trust in the Age of Social Media: Populist Politicians Seem More Authentic
Authors: Enli Gunn , Rosenberg Linda Therese
Published: March 2018

The current debate about declining media trust is related not only to the disruptive changes in the media but also to the general decline of trust in institutions and politicians. This article combines the perspectives of media trust and political trust, by examining to what degree voters perceive politicians as “honest” in the contexts of various media and communication forms. Comparing the voters’ evaluation of politicians’ trustworthiness in talk shows, news interviews, speeches, flyers, social media, and opinion pieces makes it possible to measure the impact of media contexts on the level of trust. A key finding is that voters deem politicians as more honest in social media and opinion pieces, compared to talk shows and news interviews. Second, voters tend to evaluate politicians as more honest in the media formats they most often consume; a finding that confirms the virtuous circle theory; young people typically found politicians to be more dishonest in mainstream media compared to social media A third finding is that the voters tend to evaluate populist politicians as more authentic than traditional politicians and that female politicians were regarded as more authentic compared to male politicians. These findings have implications both for journalistic ideals for coverage of politics in and for political strategic communication.
Role of Rotational Kinematics in Minimizing Elbow Varus Torques for Professional Versus High School Pitchers
Authors: Luera Micheal J. , Dowling Brittany , Magrini Mitchel A. , Muddle Tyler W.D. , Colquhoun Ryan J. , Jenkins Nathaniel D.M.
Published: March 2018

Background:

Elbow injury rates among baseball pitchers are rapidly rising. However, this increase has been most dramatic among high school (HS) pitchers.

Purpose:

To examine pitch velocity and the kinetic and kinematic characteristics of HS versus professional (PRO) pitchers to identify potential differences that may play a role in the increased risk of ulnar collateral ligament injury in youth pitchers.

Study Design:

Controlled laboratory study.

Methods:

A total of 37 HS (mean ± SD: age, 16 ± 1 years) and 40 PRO (age, 21 ± 2 years) baseball pitchers completed maximal-effort baseball pitches during a single testing session, from which pitch velocity (PV), absolute and normalized elbow varus torque (EVTA and EVTN, respectively) during arm cocking and at maximum shoulder external rotation (MER), and 8 other elbow and shoulder torques or forces and rotational kinematics of the pelvis and trunk were analyzed, recorded, and compared.

Results:

PV was greater in PRO than HS athletes; EVTA was greater in PRO than HS athletes during arm cocking and at MER; but EVTN was similar during arm cocking and greater in HS than PRO athletes at MER. In PRO athletes, PV was not related to EVTA during arm cocking or MER ( r = 0.01-0.05). Furthermore, in PRO athletes, EVTA during arm cocking and at MER were inversely related to upper trunk rotation at hand separation and foot contact and to pelvis rotation at elbow extension ( r = –0.30 to –0.33). In contrast, in HS athletes, PV was strongly related to EVTA during arm cocking and MER ( r = 0.76-0.77). Furthermore, in HS athletes, PV and EVTA during arm cocking and at MER were moderately or strongly related to the other elbow and shoulder torques and forces ( r = 0.424-0.991), and EVTA was not related to upper trunk rotation or pelvis rotation throughout the throwing motion ( r = –0.16 to 0.15).

Conclusion:

The kinetic and rotational kinematic differences observed between PRO and HS pitchers in this study may help explain the greater performance of PRO pitchers while allowing them to minimize EVT during pitching. HS pitchers, however, do not appear to be as capable of utilizing the forces generated by rotation of their trunk and pelvis to aid in pitching, and those who throw the hardest generate the greatest forces at the shoulder and elbow. As a result, they experience higher EVTs relative to their body size, which may place them at an increased risk of injury.

Clinical Relevance:

HS pitchers throw harder primarily by generating larger forces in the arm and shoulder. Thus, owing to the relative physical immaturity of HS versus PRO pitchers, these factors may place them at an increased risk of injury. Coaches may first wish to focus on improving the rotational kinematics of HS pitchers rather than first focusing on achieving greater pitch velocities.