bluuebunny/crossref_metadata_2025 huggingface dataset:
Buckling optimization of composite laminates using a hybrid algorithm under Puck failure criterion constraint
Authors: Deveci H Arda , Aydin Levent , Seçil Artem H
Published: May 2016

In this study, an optimization procedure is proposed to find the optimum stacking sequence designs of laminated composite plates in different fiber angle domains for maximum buckling resistance. A hybrid algorithm combining genetic algorithm and trust region reflective algorithm is used in the optimization to obtain higher performance and improve the quality of solutions. As a novelty, Puck fiber and inter-fiber failure criteria are directly implemented to the optimization problems as nonlinear function constraints, which have allowed more consistent and feasible results. The performance of the hybrid algorithm is demonstrated by comparing with the individual performances of genetic and trust region reflective algorithms via test problems from the literature. Also, a study is performed to exhibit the effectiveness of the selected failure criterion as constraint among the other common criteria. The proposed procedure is used to solve many problems including various design considerations. The results indicate that reliable stacking sequence designs can be achieved in specific configurations even for the composite plates subjected to superior buckling loads when Puck physically based (3D) failure theory is considered as a first ply failure constraint in the buckling optimization.
Forecasting of construction and demolition waste in Brazil
Authors: Paz Diogo HF , Lafayette Kalinny PV
Published: May 2016

The objective of this article is to develop a computerised tool (software) that facilitates the analysis of strategies for waste management on construction sites through the use of indicators of construction and demolition waste generation. The development involved the following steps: knowledge acquisition, structuring the system, coding and system evaluation. The step of knowledge acquisition aims to provide subsidies for the representation of them through models. In the step of structuring the system, it was presented the structuring and formalisation of knowledge for the development of the system, and has two stages: the construction of the conceptual model and the subsequent instantiation of the model. The coding system aims to implement (code) the conceptual model developed in a model played by computer (digital). The results showed that the system is very useful and applicable in construction sites, helping to improve the quality of waste management, and creating a database that will support new research.
Protective effect of citicoline against aluminum-induced cognitive impairments in rats
Authors: Abdel-Zaher Ahmed O , Hamdy Mostafa M , Abdel-Rahman Mahran S , Abd El-hamid Doaa H
Published: May 2016

The potential protective effect of citicoline on aluminum chloride-induced cognitive deficits was investigated in rats. In a Morris water maze, administration of aluminum chloride to rats for 90 days resulted in increased escape latency to reach the platform and decreased swimming speed in acquisition trials. Similarly, in probe trials, the time required to reach the hidden platform was increased and the time spent in the target quadrant was reduced. Also, administration of aluminum chloride to rats for 90 days increased the reference and working memory errors and time required to end the task in the radial arm maze. In addition, this treatment decreased the step-through latency in the passive avoidance test. Concurrently, treatment of rats with aluminum chloride for 90 days increased hippocampal glutamate, malondialdehyde, and nitrite levels and decreased intracellular reduced glutathione level. In the citicoline-treated group, aluminum chloride-induced learning and memory impairments as assessed by the Morris water maze, radial arm maze, and passive avoidance tests were inhibited. At the same time, treatment of rats with citicoline prevented the biochemical alterations induced by aluminum chloride in the hippocampus. It can be concluded that elevation of hippocampal glutamate level with consequent oxidative stress and nitric oxide (NO) overproduction may play an important role in aluminum-induced cognitive impairments. Also, our results suggest, for the first time, that citicoline can protect against the development of these cognitive deficits through inhibition of aluminum-induced elevation of glutamate level, oxidative stress, and NO overproduction in the hippocampus.
Temperamental Differences and Classroom Incivility: Exploring the Role of Individual Differences
Authors: Spadafora Natalie , Farrell Ann H. , Provenzano Daniel A. , Marini Zopito A. , Volk Anthony A.
Published: May 2016

Incivility involves rude, discourteous, and disrespectful attitudes and behaviours. The present study examined how various temperament traits were related to beliefs of classroom incivility among adolescents. The sample comprised of 222 adolescents (120 boys) between the ages of 12 and 17 ( Mage = 14.07, SD = 1.54) who were recruited from various extracurricular clubs and sports teams in Southern Ontario. Both intentional and unintentional incivility were examined through separate hierarchical multiple regressions. Lower Effortful Control and lower Frustration significantly predicted unintentional incivility. In addition, lower Affiliation and lower Effortful Control significantly predicted intentional incivility. The results are discussed highlighting practical implications in educational settings, as well as suggestions for future research on incivility, given its potential associations with more negative antisocial behaviours. The results suggest that although there may be shared temperament traits of adolescents who take part in classroom incivility, a disposition for specific subtypes may differ based on the specific temperament characteristics of adolescents.
Can Creatinine Height Index Predict Weaning and Survival Outcomes in Patients on Prolonged Mechanical Ventilation After Critical Illness?
Authors: Datta Debapriya , Foley Raymond , Wu Rong , Grady James , Scalise Paul
Published: May 2016

Objective:

Malnutrition is common in chronic critically ill patients on prolonged mechanical ventilation (PMV) and may affect weaning. The creatinine height index (CHI), which reflects lean muscle mass, is regarded as the most accurate indicator of malnutrition. The objective of this study was to determine the impact of CHI in comparison with other traditional nutritional indices on successful weaning and survival in patients on PMV after critical illness.

Methods:

Records of 167 patients on PMV following critical illness, admitted for weaning, were reviewed. Parameters studied included age, gender, body mass index (BMI), percentage ideal body weight (%IBW), total protein, albumin, prealbumin, hemoglobin (Hb), and cause of respiratory failure. Number successfully weaned and number discharged alive and time to wean and time to discharge alive were determined from records. The CHI was calculated from 24-hour urine creatinine using a standard formula. Unpaired 2-sample t test was performed to determine the association between the studied nutritional parameters and outcomes. Predictive value of studied parameters for successful weaning and survival was determined by multivariate logistic regression analysis to model dichotomous outcome of successful weaning and survival.

Results:

Mean age was 68 ± 14 years, 49% were males, 64% were successfully weaned, and 65.8% survived. Total protein, Hb, and CHI had a significant impact on successful weaning. Weight, %IBW, BMI, and CHI had a significant effect on survival. Of all parameters, CHI was most strongly predictive of successful weaning and survival.

Conclusions:

The CHI is a strong predictor of successful weaning and survival in patients on PMV.
In-Hospital Management and Follow-Up Treatment of Venous Thromboembolism: Focus on New and Emerging Treatments
Authors: Lenchus Joshua D. , Biehl Michelle , Cabrera Jorge , Moraes Alice Gallo de , Dezfulian Cameron
Published: May 2016

Venous thromboembolism (VTE), encompassing pulmonary embolism (PE) and deep venous thrombosis (DVT), is a major cause of morbidity and mortality of particular relevance for intensivists and hospitalists. Acute VTE is usually managed with parenteral unfractionated heparin or low-molecular-weight heparin, followed by an oral vitamin K antagonist. Data are lacking for optimal treatment of less common occurrences, such as upper extremity DVT, and for approaches such as thrombolysis for PE associated with early signs of hemodynamic compromise or inferior vena cava filters when anticoagulation is contraindicated. Direct oral anticoagulants (DOACs) including apixaban, dabigatran, edoxaban, and rivaroxaban are now added to the armamentarium of agents available for acute management of VTE and/or reducing the risk of recurrence. This review outlines an algorithmic approach to acute VTE treatment: from aggressive therapies when anticoagulation may be inadequate, to alternative choices when anticoagulation is contraindicated, to anticoagulant options in the majority of patients in whom anticoagulation is appropriate. Evidence-based guidelines and the most recent DOAC clinical trial data are discussed in the context of the standard of care. Situations and treatment approaches for which data are unavailable or insufficient are identified. VTE therapy in care transitions is discussed, as are choices for secondary prevention.
Effect of isocyanate chain extender on the structure and properties of the blends of poly(butylene terephthalate) and thermoplastic polyester elastomer
Authors: Pesetskii SS , Shevchenko VV , Koval VN
Published: May 2016

The effect of diisocyanate chain extender (CE) additives on the change of molecular structural characteristics, rheological, and mechanical properties of the blends comprising of poly(butylene terephthalate) (PBT) and thermoplastic polyester elastomer (TPEE) obtained by reactive compounding in the melt and having different phase structure is studied. It is shown that addition of CE in the amount of 0.2 wt% to 1.25 wt% causes an increase in viscosity of polyester melts and solutions owing to the chain extension reactions and intermolecular cross-linking of macro-chains which occur in the melt. CE has a strong effect on the character of deformation curves at straining of both polyesters in primary form and their blends irrespective of the ratio of components in them (phase structure of materials). At the increase of its concentration, values of high and low flow limits increase and the difference in values of these parameters decreases, that is, a sharp yield point is gradually degenerating. At the same time, increase in Charpy impact strength on notched specimens is observed, including the subzero temperatures range (−40°C). Besides, CE has an effect on crystallizability of both individual polyester components and their blends. The general trend (irrespective of the polyester type and phase structure of the blend) is the decrease in crystallization temperature. This fact is explained by limitation of molecular mobility due to an increase in the molecular weight of polyester and intensification of interchain interactions.
Coping With Chronic Stress by Unhealthy Behaviors: A Re-Evaluation Among Older Adults by Race/Ethnicity
Authors: Rodriquez Erik J. , Gregorich Steven E. , Livaudais-Toman Jennifer , Pérez-Stable Eliseo J.
Published: May 2016

Objective: To assess the role of unhealthy behaviors in the relationship between chronic stress and significant depressive symptoms by race/ethnicity among older adults. Method: Participant data from the 2006 to 2008 Health and Retirement Study were analyzed. Unhealthy behaviors included current smoking, excessive/binge drinking, and obesity. Chronic stress was defined by nine previously used factors. The eight-item Center for Epidemiologic Studies Depression (CES-D) Scale measured depressive symptoms, where ≥4 symptoms defined significant. Multivariable logistic regression assessed the effects of chronic stress and unhealthy behaviors in 2006 on depressive symptoms in 2008. Results: A higher chronic stress index score predicted depressive symptoms in 2008 among African Americans, Latinos, and Whites (adjusted odds ratio [aOR] = 1.78, 95% confidence interval [CI] = [1.48, 2.15]; aOR = 1.54, 95% CI = [1.15, 2.05]; and aOR = 1.40, 95% CI = [1.26, 1.56], respectively). Unhealthy behaviors moderated this relationship among Latinos (aOR = 1.54, 95% CI = [1.02, 2.33]). Discussion: Unhealthy behaviors were not effective coping mechanisms for chronic stress in terms of preventing significant depressive symptoms. Instead, they strengthened the relationship between chronic stress and significant depressive symptoms among Latinos.
Fault diagnosis of gearbox using multi-time-delayed feedback stochastic resonance
Authors: Hu Bingbing , Li Bing
Published: May 2016

Gearbox vibration signals with defects often show some important characteristic information. However, the feature information is difficult to extract since it is often flooded in the noise. To solve this problem, we present a novel detection approach for weak signals based on the multi-time-delayed feedback stochastic resonance model (MTFSR). Because the shape of the bistable potential well can be changed by the number of time-delayed terms, the MTFSR method can use historical information which is formed by the superposition of multiple time-delayed feedback items to enhance signal periodicity and obtain better output waveform and higher signal-to-noise ratio (SNR). Moreover, the presented method is also insensitive to the noise, and can detect the weak signals with different noise levels. Additionally, by selecting the proper calculation step, the approach has the ability to detect weak signals with different driving frequencies. With these properties, the proposed MTFSR is considered to be very suitable for gearbox fault diagnosis. Both simulation study and practical application confirm that the proposed strategy is feasible and superior in comparison with some traditional methods.
A model-scale study to assess the influence of ground geometries on aerodynamic flow development around a train
Authors: Soper David , Gallagher Martin , Baker Chris , Quinn Andrew
Published: May 2016

The need for interoperability for rail operators across Europe has resulted in the development of the technical specifications for interoperability: requirements and regulations which include safety limits for train aerodynamics. Safety limits are calculated within guidelines, including environmental conditions, train speeds and ballast shoulder height. However, there are many cases on the European rail network which fall outside ballast shoulder height limits, raising questions about the suitability of the technical specifications for interoperability limits, where European homologation is a requirement. Ballast is a layer of crushed stone onto which the railway track is laid; a ballast shoulder is defined from the top of the ballast layer to the base of the track foundation or ground. This paper describes the detailed model-scale experiments carried out at the University of Birmingham’s moving model TRAIN rig facility to assess the influence of ground geometries on aerodynamic flow development around a train. The technical specifications for interoperability methodology was questioned in relation to whether modest changes to include a wider cross-section of ballast shoulder heights, more appropriate to actual operating conditions, would affect limit values in relation to safety. The influence of ballast shoulder height was investigated for three typical train types. The results showed a similar static pressure development for all the ballast shoulder heights tested. Passenger train results indicated that shallow ballast shoulders confine the aerodynamic flow within a smaller area, increasing the magnitude of slipstream velocities in respect to larger ballast shoulders. The largest slipstream velocities were found for the ground configuration with no ballast shoulder modelled. Measurements within the technical specifications for interoperability-specified range of ballast shoulder heights exhibited little difference in flow development. Analysis of maximum 1 s gusts, calculated using the current technical specifications for interoperability methodology, found values lie close to, but do not break, the existing limits. Increasing ballast shoulder height was shown to decrease values away from technical specifications for interoperability limits.
Anorectal pathology amongst HIV infected patients attending the Douala General Hospital: a cross-sectional study
Authors: Luma Henry Namme , Eloumou Servais Albert Fiacre Bagnaka , Fualefeh-Morfaw Ellis Atemlefeh , Malongue Agnes , Temfack Elvis , Lekpa Fernando Kemta , Donfack-Sontsa Olivier , Ndip Lucy , Ditah Ivo Che
Published: May 2016

While gastrointestinal disease is common among HIV infected individuals, the prevalence and distribution of ano-rectal pathology has not been well studied in our setting. The objective of this study therefore was to determine the prevalence and determinants of ano-rectal pathology in HIV infected patients attending the Douala General Hospital HIV treatment centre. A hospital-based cross-sectional study was undertaken. We collected socio-demographic, clinical and laboratory data using a structured questionnaire and patients’ files. Each study participant had a full physical and ano-rectal examination. We further studied factors associated with having at least one ano-rectal lesion by logistic regression reporting odds ratios (ORs) and their 95% confidence intervals (CI). We included 390 HIV infected patients. The mean age was 41 (SD: 8) years and 48% were men. Median duration since HIV diagnosis was 3 (interquartile range: 2–5) years and median CD4 cell count was 411 (interquartile range: 234–601) cells/mm3. Prevalence of ano-rectal pathology was 22.8% (95% CI: 18.7–27.3). Hemorrhoids and proctitis were most common lesions found; each in 10% of patients. From multivariate logistic regression, factors associated with ano-rectal pathology were CD4 < 350 cells/ml (OR: 2.1, 95% CI: 1.1–4.2), not on highly active antiretroviral therapy (OR: 2.2, 95% CI: 1.1–4.6), inpatient (OR: 2.3, 95% CI: 1.2–4.3), ano-rectal intercourse (OR: 5.0, 95% CI: 1.7–15.1), and more than one sexual partner (OR: 2.4, 95% CI: 1.3–4.2). Ano-rectal pathology is common amongst HIV infected patients. Care givers should actively investigate and treat them as this will improve the quality of life of people living with HIV/AIDS.
Effect of suction side blade profile on the performance of a side channel pump
Authors: Zhang Fan , Fleder Annika , Böhle Martin , Yuan Shouqi
Published: May 2016

Due to the centrifugal effect of the radial impeller, side channel pumps are a kind of regenerative pumps that provide high head at low flow rate. The geometry of the impeller affects flow patterns and energy conversion directly, greatly influencing the performance of side channel pumps. To investigate the effect of blade profile for suction side on the performance of a side channel pump, three different base angles of 10°, 20°, and 30°, respectively, on the blade suction side were discussed and analyzed both with numerical and experimental methods. The hydraulic performance, exchange mass flow, and velocity vectors were discussed in detail. The numerical work was validated by the comparison between the simulated result and tested result. The results show that the hydraulic performance of the impeller with 30° angle is the best one of the three impellers, especially for head performance. The evaluation method based on exchanged mass flow also confirms that the performance of the side channel pump can be improved by increasing the angle on the suction side of the blade. In addition, the radial vortex on the impeller flow passage has negative effect on the performance of the side channel pump. However, the axial vortex among the impeller and side channel directly affects the energy conversion and has a beneficial effect on the performance of the pump. The results could be used to modify the design models and conclude the effect of blade shapes on the performance of a side channel pump.
Palaeoenvironmental history of the last six centuries in the Nettilling Lake area (Baffin Island, Canada): A multi-proxy analysis
Authors: Beaudoin Anne , Pienitz Reinhard , Francus Pierre , Zdanowicz Christian , St-Onge Guillaume
Published: May 2016

The Baffin Island region in the eastern Canadian Arctic has recently experienced a rapid warming, possibly unprecedented in millennia. To investigate the response of freshwater environments to this warming and place it in a secular perspective, we analyzed a 90-cm-long sediment core from Nettilling Lake, the largest lake of the Canadian Arctic Archipelago. The core was taken from a part of the lake basin that receives meltwater and sediment inputs from the nearby Penny Ice Cap. The core time scale, established using 137Cs and palaeomagnetic techniques, spans an estimated 600 years. A multi-proxy approach was used to document changes in the physical, chemical, and biological properties of the sediments. We found evidence for a relatively warm period (mid/late 15th century to mid/late 16th century) during the early part of the ‘Little Ice Age’ (LIA), characterized by high sedimentation rates and laminations. This was followed by colder, drier, and windier conditions corresponding to the coldest phase of LIA and coinciding with the latest and most extensive period of regional ice cap expansion (early 16th to late 19th centuries). A rapid warming occurred at the beginning of the 20th century. Variations in titanium (Ti) content in the core, a proxy for detrital sediment inputs, showed good agreement with reconstructed secular variations in summer melt rates on Penny Ice Cap between the mid-14th century and the present-day, providing supporting evidence for a climatic–hydrological connection between the ice cap and Nettilling Lake.
Millet grain morphometry as a tool for social inference: A case study from the Yiluo basin, China
Authors: Walsh Rory , Lee Gyoung-Ah , Liu Li , Chen Xingcan
Published: May 2016

Morphological analysis of plant remains from archaeological sites provides evidence regarding the domestication process of crop species, and the changing economic behaviors of humans during the foundation and intensification of agriculture. In contexts from the Neolithic and early state periods of Henan, China, morphometry of genus Setaria millet seeds is shown to provide data on production versus consumption contexts of archaeological deposits, in connection with site function and settlement hierarchy. Comparative morphometry of modern Setaria seeds sheds light on larger archaeobotanical issues, including problematizing the distinction between domesticated and wild/weedy seeds. Statistical analysis suggests that subdivision of archaeological millets below the genus level is less useful in some cases than consideration and comparison of genus-level populations.
Geochemical records of anoxic water mass expansion in an oligotrophic alpine lake (Yunnan Province, SW China) in response to climate warming since the 1980s
Authors: Zhang Yongdong , Su Yaling , Liu Zhengwen , Jeppesen Erik , Yu Jinlei , Jin Miao
Published: May 2016

In order to elucidate the effect of recent warming, we studied lipid biomarkers and trace elements in a dated sediment core from Lake Heihai, a small, deep, and ultraoligotrophic alpine lake in Yunnan Province (SW China), being only marginally affected by anthropogenic activities. The variation in lipid biomarkers (such as 10-methyl-C16:0 fatty acid (FA), iso-branched C15 ( i-C15) and anteiso-branched C15 ( ai-C15) FA, and tetrahymanol) suggests a rapid productivity increase in sulfate reducing bacteria and ciliates since 1980, likely reflecting expansion of the hypolimnion anoxia and a prolonged duration of an oxic–anoxic chemocline in the water column. The concentrations of element molybdenum (Mo) in pre-1980 sediments approach the values in average crust. After 1980, the concentration increased, reaching levels approximately sixfold higher than the initial abundances. This likely reflects a high authigenic Mo deposition when the bottom water was more anoxic and enrichment in H2S. The suggested spatial and temporal expansion of the anoxic bottom water since 1980 was probably a response to the regional climate warming, resulting in stronger water column stratification and terrestrial grass inputs to the lake, and thus higher dissolved oxygen (DO) loss in hypolimnion.
Rock art imagery as a proxy for Holocene environmental change: A view from Shuwaymis, NW Saudi Arabia
Authors: Guagnin Maria , Jennings Richard , Eager Heidi , Parton Ash , Stimpson Christopher , Stepanek Christian , Pfeiffer Madlene , Groucutt Huw S. , Drake Nick A. , Alsharekh Abdullah , Petraglia Michael D.
Published: May 2016

The animal species depicted in the rock art of Shuwaymis, Saudi Arabia, provide a record of Holocene climatic changes, as seen by the engravers. Of 1903 animal engravings, 1514 contained sufficient detail to allow identification with confidence. In addition, the stratigraphy of the engravings and the depiction of domesticates provide a broad chronological framework that allows a division into images created during the Holocene humid phase and animals represented after the onset of desert conditions. Despite the large sample size, only 16 animal species could be identified, which represents an extraordinarily narrow species spectrum. Comparison with the scarce faunal record of the Arabian Peninsula shows that all larger animals that are thought to have been present in the area were also depicted in the rock art. The contemporaneous presence of at least four large carnivores during the Holocene humid phase suggests that prey animals were abundant, and that the landscape consisted of a mosaic of habitats, potentially with thicker vegetation along the water courses of the wadis and more open vegetation in the landscape around them. Community Earth System Models (COSMOS) climate simulations show that Shuwaymis was at the northern edge of the African Summer Monsoon rainfall regime. It is therefore possible that Shuwaymis was ecologically connected with southwestern Arabia, and that an arid barrier remained in place to the north, restricting the dispersal of Levantine species into Arabia.
Progressive outer retinal necrosis syndrome in the course of systemic lupus erythematosus
Authors: Turno-Kręcicka A , Tomczyk-Socha M , Zimny A
Published: May 2016

Progressive outer retinal necrosis syndrome (PORN) is a severe clinical variant of necrotizing herpetic chorioretinitis, which occurs almost exclusively in patients with advanced acquired immunodeficiency syndrome (AIDS). To date, only a few cases of PORN have been reported in patients, mostly among those who were immunocompromised. To our knowledge, only one case of PORN in a patient with systemic lupus erythematosus (SLE) has been described. We report the case of a 44-year old HIV-negative patient with lupus nephritis, whom was being treated by mycophenolate mophetil (MMF), arechin and prednisone. After 14 months of MMF therapy, the patient revealed PORN symptoms; and several months later, the patient developed Type B primary central nervous system lymphoma (PCNSL). PORN is usually compared to acute retinal necrosis (ARN) syndrome, because of having the same causative agent: varicella zoster virus (VZV). There are also some similarities in clinical findings. Our observation supports the hypothesis that PORN symptoms in HIV-negative patients can be an intermediate form between ARN and PORN, and can vary according to the patient’s immune status.
A Bayesian approach for estimating under-reported dengue incidence with a focus on non-linear associations between climate and dengue in Dhaka, Bangladesh
Authors: Sharmin Sifat , Glass Kathryn , Viennet Elvina , Harley David
Published: May 2016

Determining the relation between climate and dengue incidence is challenging due to under-reporting of disease and consequent biased incidence estimates. Non-linear associations between climate and incidence compound this. Here, we introduce a modelling framework to estimate dengue incidence from passive surveillance data while incorporating non-linear climate effects. We estimated the true number of cases per month using a Bayesian generalised linear model, developed in stages to adjust for under-reporting. A semi-parametric thin-plate spline approach was used to quantify non-linear climate effects. The approach was applied to data collected from the national dengue surveillance system of Bangladesh. The model estimated that only 2.8% (95% credible interval 2.7–2.8) of all cases in the capital Dhaka were reported through passive case reporting. The optimal mean monthly temperature for dengue transmission is 29℃ and average monthly rainfall above 15 mm decreases transmission. Our approach provides an estimate of true incidence and an understanding of the effects of temperature and rainfall on dengue transmission in Dhaka, Bangladesh.
Variability and Overcrowding Management
Authors: Aguado-Correa Francisco , Herrera-Carranza Manuel , Padilla-Garrido Nuria
Published: May 2016

Emergency department (ED) overcrowding has become a common situation with significant negative effects on the quality of care. The aim of this study is to detail the flow of patients and their variability and determine the existence of stable patterns that allow better planning of resources.

We performed a retrospective descriptive observational study of emergencies attended from 2008 to 2010 in the ‘Juan Ramón Jiménez’ General Hospital (Huelva, Spain), with a sample of 343,233 visits. The time between consecutive arrivals of patients and the arrival patterns according to severity and clinical area was calculated using Microsoft Excel and Stat::Fit. Quarterly differences were determined using the Kruskal–Wallis test.

The mean value of the inter-arrival time, independent of the quarter ( p < 0.05), was 2–4 minutes from 10:00 am to 10:00 pm and 15–20 minutes from midnight to 8:00 am. The Priority (P) I Patients arrived every 119.05 ± 136.71 minutes, the PII patients every 75.96 ± 97.58 minutes, the PIII patients every 22.62 ± 33.47 minutes and the PIV patients every 6.37 ± 10.53 minutes. PIV had a fluctuating pattern. The arrival rate peaks at 1:00 pm on Monday in the medical–surgical area, at 10:00 pm on Monday for the trauma area, and at 1:00 pm on Sunday for the paediatric area.

The study shows that inter-arrival times and average arrival rates of patients have a defined and reproducible pattern for each level of severity and clinical area, which forces us to rethink the fixed capacity model and oriented towards flexibility of resources to reduce the overcrowding.
Diabetic Care through Public–Private Partnership in Rural Set-up
Authors: Trivedi Mayur , Gaurav Kumar , Saxena Deepak
Published: May 2016

Introduction

Prevalence of diabetes is increasing rapidly in across the world and India is no exception. In the year 2000, the World Health Organization (WHO) estimated that India had 32 million diabetic. One of the proven strategies to improve access to healthcare, especially in the areas that are underserved or un-served through public healthcare services, is Public–Private Partnerships (PPPs).

Methodology

The case study is based on the observation of the facilities and service delivery, desk review of service delivery statistics of the PHC, in-depth interviews with stakeholders.

Findings

It was observed that the Valam Primary health Centre (PHC) is an excellent example of locally-initiated, village-level PPP model to cater to rural population. It was quite evident from the available records that PHC is having adequate supply of strips and glucometer to perform the investigation to monitor the blood sugar level of diabetic or suspected cases, which was not available even in other PHCs of the same block. Round the clock availability of the diagnostic equipment reflects the commitment of the NGO for providing the optimal diabetes investigation care to the residents in and around Valam PHC level.

Recommendation

The Valam Diabetic Care Model is an excellent example of locally-initiated PPP model and this kind of model should be encouraged in resource constrain areas.
Book Review: Nitin Govil, Orienting Hollywood: A Century of Film Culture between Los Angeles and Bombay
Authors: Rajadhyaksha Ashish
Published: May 2016

Nitin Govil, Orienting Hollywood: A Century of Film Culture between Los Angeles and Bombay. New York and London: New York University Press, 2015, 272 pp., US$ 27, ISBN 978-0-8147-8934-6
Illness Experiences, Collective Decisions, and the Therapeutic Encounter in Indian Oncology
Authors: Broom Alex , Chittem Mahati , Bowden Vanessa , Muppavaram Nagesh , Rajappa Senthil
Published: May 2016

Social science scholarship on cancer has been almost exclusively focused on Organization for Economic Cooperation and Development (OECD) countries, despite a significant epidemiological transition taking place in many non-OECD contexts, with cancer emerging as a prominent, and strongly feared, illness experience. With cancer gaining an increasingly high profile in India, there is an urgent need to explore how experiences of cancer may be socially and culturally embedded, and in turn, how localized practices may shape the therapeutic encounter. Here, drawing on interviews with 40 people living with cancer in Hyderabad, India, we focus on some specific components of their therapeutic journeys, including diagnostic and prognostic disclosure, collective versus individual decision making, the dynamics of medical authority, and the reception of cancer within their social milieu. These participants’ accounts provide insight into a range of cultural sensibilities around illness and care, and reinforce the importance of understanding the cultural inflections of communication, decisions, and illness experiences.
Seeking Help From Everyone and No-One
Authors: Best Paul , Gil-Rodriguez Elena , Manktelow Roger , Taylor Brian J.
Published: May 2016

Online help-seeking is an emerging trend within the 21st century. Yet, despite some movement toward developing online services, little is known about how young people locate, access, and receive support online. This study aims to conceptualize the process of online help-seeking among adolescent males. Modified photo-elicitation techniques were employed within eight semi-structured focus group sessions with adolescent males aged 14 to 15 years ( n = 56) across seven schools in Northern Ireland. Thematic analyses were conducted within an ontological framework of critical realism and an epistemological framework of contextualism. Informal online help-seeking pathways increased opportunity for social support and reduced stigma but also included loss of control and reduced anonymity. Formal pathways offered increased anonymity but concerns were raised regarding participants’ ability to locate and appraise the quality of information online. A conceptual model of online help-seeking has been developed to highlight the key help-seeking pathways taken by adolescent males.
Inequalities in a National Health Care System From the Perspective of Social Workers in Israel
Authors: Baum Nehami , Kum Yishay , Shalit Hani , Tal Malka
Published: May 2016

This study explores social workers’ perceptions of inequalities in Israel’s national health care system. Unlike previous studies, which relied on patients’ and practitioners’ reports, it is based on interviews with 60 social workers in hospitals and ambulatory clinics. The findings show that although Israeli law provides for (almost) free, universal medical care, the treatment of persons lacking in money, education, and social affiliation may be compromised by difficulties in paying for medications, treatments, and travel to and from hospital; by difficulties in understanding doctors’ instructions; and by reluctance to ask questions. Most doctors tend to focus exclusively on patients’ medical needs, seem to lack sympathy with less educated patients, have little understanding of the life circumstances that impinge on their compliance, and make little effort to speak to them in the language they can understand. Practical suggestions are made with regard to the need to turn doctors’ attention to their patients’ non-medical needs.
“What Do They Really Mean by Partnerships?” Questioning the Unquestionable Good in Ethics Guidelines Promoting Community Engagement in Indigenous Health Research
Authors: Brunger F. , Wall D.
Published: May 2016

Academics and community members collaborated in research to examine how best to apply ethics guidelines for research involving Indigenous communities in a community with complex and multiple political and cultural jurisdictions. We examined issues of NunatuKavut (Southern Inuit) authority and representation in relation to governance of research in a context where community identity is complex and shifting, and new provincial legislation mandates centralized ethics review. We scrutinize the taken-for-granted assumption of research ethics that community engagement is an unquestionable “good.” We examine the question of whether and how research ethics guidelines and associated assumptions about the value of community engagement may be grounded in, and inadvertently reinforce, ongoing colonialist relations of power. We present findings that community engagement—if done uncritically and in service to ethics guidelines rather than in service to ethical research—can itself cause harm by leading to community fatigue, undermining the community’s ability to be effectively involved in the research, and restricting the community’s ability to have oversight and control over research. We conclude by suggesting that the laudable goal of engaging communities in research requires careful reflection on the appropriate use of resources to operationalize meaningful collaboration.
Early Intervention for Children With Behavior Problems in Summer Settings
Authors: Hart Katie C. , Graziano Paulo A. , Kent Kristine M. , Kuriyan Aparajita , Garcia Alexis , Rodriguez Madison , Pelham William E.
Published: May 2016

The objective of this study was to evaluate two early intervention packages to promote successful transitions to kindergarten for preschoolers with behavior problems recruited from Head Start preschools. Fifty children ( Mage = 61 months; 76% male; 98% minority) referred by teachers due to early externalizing behavior problems were randomly assigned to one of the two groups. Group 1 (high intensity; HI) received a 4-week intensive summer program before the start of kindergarten, weekly parent workshops, and monthly school consultation and parent workshops throughout kindergarten. Group 2 (low intensity; LI) received only parent workshops. Program feasibility, child improvement, and parental satisfaction data were collected along with parent and teacher reports and measures of school readiness. Children in the HI group demonstrated fewer problem behaviors and less student–teacher conflict as reported by teachers. Early intensive summer interventions prior to kindergarten were found to be a promising avenue to promote successful transitions to school for children from Head Start preschools with behavior problems.
Walking Beliefs in Women With Fibromyalgia: Clinical Profile and Impact on Walking Behavior
Authors: Peñacoba Cecilia , Pastor María-Ángeles , López-Roig Sofía , Velasco Lilian , Lledo Ana
Published: May 2016

Although exercise is essential for the treatment of fibromyalgia, adherence is low. Walking, as a form of physical exercise, has significant advantages. The aim of this article is to describe, in 920 women with fibromyalgia, the prevalence of certain walking beliefs and analyze their effects both on the walking behavior itself and on the associated symptoms when patients walk according to a clinically recommended way. The results highlight the high prevalence of beliefs related to pain and fatigue as walking-inhibitors. In the whole sample, beliefs are associated with an increased perception that comorbidity prevents walking, and with higher levels of pain and fatigue. In patients who walk regularly, beliefs are only associated with the perception that comorbidity prevents them from walking. It is necessary to promote walking according to the established way (including breaks to prevent fatigue) and to implement interventions on the most prevalent beliefs that inhibit walking.
“Bursting” to Go and Other Experiences
Authors: Tatlow-Golden Mimi , O’Farrelly Christine , Booth Ailbhe , Doyle Orla
Published: May 2016

Children’s use of the toilet at school, although rarely explored, is an important facet of school experience with consequences for physical and psychological health. A mixed methods study investigated views of 25 children (4–5 years) regarding potential stressors in the first school year, including views of toileting, in Dublin, Ireland. Despite very positive responses to school, most responses to toileting (15 of 25) were mixed or negative. Although some liked to go, or noted the toilets were clean, most indicated delayed toilet use (“bursting” to go) and ambivalent or negative experiences such as fear of not identifying the right toilet, fear of being alone, lack of privacy, and potential bullying. Many children did not expect to receive help from the teacher. As delaying toilet use can have lasting health consequences, teacher–nurse collaboration could be used to develop whole-school policies to support children’s early adjustment in this sensitive area of functioning.
More Than Just a Lack of Uniformity: Exploring the Evolution of Public Relations Master’s Programs
Authors: Briones Rowena L. , Shen Hongmei , Parrish Candace , Toth Elizabeth L. , Russell Maria
Published: May 2016

Public relations is well known for its adaptability through continual change, and as a result, public relations master’s programs have been re-conceptualized to remain rigorous and competitive. To further assess both the state and changes of these programs, 20 in-depth interviews were conducted with administrators of public relations master’s programs. Findings highlighted that although many programs have evolved their curricula to meet industry demands toward a more interdisciplinary identity, there are still programs that still model recommendations from the Commission on Public Relations Education (CPRE). These findings could be used to better ground the discipline by ensuring a stronger cohesiveness within public relations master’s education.
Mass Communications Students’ Motivations
Authors: Alkazemi Mariam F. , Al Nashmi Eisa , Wanta Wayne
Published: May 2016

Kuwaiti students intending to major in mass communication face a long process that begins in high school. A survey of students at Kuwait University examined whether the process led to disillusionment of the mass communication field and/or mass communication education. Findings show that all respondents viewed the field of journalism positively. Respondents also viewed journalism education in a positive light. Students majoring or minoring in journalism differed from majors in other disciplines in several ways: They were more likely to be female and younger, and were more likely to agree with statements that mass communication is a good field for women, journalists make a good living, the field is highly respected, and friends would support their decision to major in mass communication. This is a significant finding because it demonstrates that mass communications is considered a safe industry for women even when the role of women in the public sphere does not have many decades of precedent. The results also suggest that the more active the students were in selecting a major, the more positive they felt about mass communications education. Students who had published works or internship experience were more likely to declare a major in mass communications. All students agreed that their education increased their appreciation for the field of mass communications. These findings demonstrate that journalism education can be beneficial even in nations where the media system is not completely free.
The Abuse of Technology in Domestic Violence and Stalking
Authors: Woodlock Delanie
Published: May 2016

We focus on an emerging trend in the context of domestic violence—the use of technology to facilitate stalking and other forms of abuse. Surveys with 152 domestic violence advocates and 46 victims show that technology—including phones, tablets, computers, and social networking websites—is commonly used in intimate partner stalking. Technology was used to create a sense of the perpetrator’s omnipresence, and to isolate, punish, and humiliate domestic violence victims. Perpetrators also threatened to share sexualized content online to humiliate victims. Technology-facilitated stalking needs to be treated as a serious offense, and effective practice, policy, and legal responses must be developed.
The Politics of Urban Climate Change Policy
Authors: Hughes Sara
Published: May 2016

Urban politics research has not kept pace—empirically or theoretically—with city governments’ engagement with climate change policy. Thousands of cities globally have made commitments to reduce their greenhouse gas emissions and are taking steps toward these goals. In the United States, research has examined the motivations for such actions and has described some of the implementation challenges cities are encountering, but we lack a theoretically informed understanding of how these actions intersect politically with existing interests, institutions, and fiscal realities in cities. This article identifies five political entry points that are specific to urban climate change policy and can provide a foundation for empirically and theoretically valuable research. The pursuit of such an interdisciplinary urban research agenda for climate change would enhance our understanding of when and how cities are successful in addressing climate change and would provide new answers to long-standing questions in urban politics.
A Randomized Controlled Trial of an Integrated Brain, Body, and Social Intervention for Children With ADHD
Authors: Smith Stephanie D. , Vitulano Lawrence A. , Katsovich Liliya , Li Shuaixing , Moore Christina , Li Fenghua , Grantz Heidi , Zheng Xixi , Eicher Virginia , Aktan Guloksuz Selin , Zheng Yi , Dong Jinxia , Sukhodolsky Denis G. , Leckman James F.
Published: May 2016

Objective: This study evaluated the efficacy of an Integrated Brain, Body, and Social (IBBS) intervention for children with ADHD. Treatment consisted of computerized cognitive remediation training, physical exercises, and a behavior management strategy. Method: Ninety-two children aged 5 to 9 years with ADHD were randomly assigned to 15 weeks of IBBS or to treatment-as-usual. Primary outcome measures included blinded clinician ratings of ADHD symptoms and global clinical functioning. Secondary outcome measures consisted of parent and teacher ratings of ADHD and neurocognitive tests. Results: No significant treatment effects were found on any of our primary outcome measures. In terms of secondary outcome measures, the IBBS group showed significant improvement on a verbal working memory task; however, this result did not survive correction for multiple group comparisons. Conclusion: These results suggest that expanding cognitive training to multiple domains by means of two training modalities does not lead to generalized improvement of ADHD symptomatology.