bluuebunny/crossref_metadata_2025 huggingface dataset:
Components of palliative care interventions addressing the needs of people with dementia living in long-term care: A systematic review
Authors: Kochovska Slavica , Garcia Maja V , Bunn Frances , Goodman Claire , Luckett Tim , Parker Deborah , Phillips Jane L , Sampson Elizabeth L , van der Steen Jenny T , Agar Meera R
Published: February 2020

Background:

People with dementia requiring palliative care have multiple needs, which are amplified in long-term care settings. The European Association for Palliative Care White Paper offers recommendations for optimal palliative care in dementia integral for this population, providing useful guidance to inform interventions addressing their specific needs.

Aim:

The aim of this study is to describe the components of palliative care interventions for people with dementia in long-term care focusing on shared decision-making and examine their alignment to the European Association for Palliative Care domains of care.

Design:

Systematic review with narrative synthesis (PROSPERO ID: CRD42018095649).

Data sources:

Four databases (MEDLINE, CINAHL, PsycINFO and CENTRAL) were searched (earliest records – July 2019) for peer-reviewed articles and protocols in English, reporting on palliative care interventions for people with dementia in long-term care, addressing European Association for Palliative Care Domains 2 (person-centred) or 3 (setting care goals) and ⩾1 other domain.

Results:

Fifty-one papers were included, reporting on 32 studies. For each domain (1–10), there were interventions found aiming to address its goal, although no single intervention addressed all domains. Domain 7 (symptom management; n = 19), 6 (avoiding overly aggressive treatment; n = 18) and 10 (education; n = 17) were the most commonly addressed; Domain 5 (prognostication; n = 7) and 4 (continuity of care; n = 2) were the least addressed.

Conclusion:

Almost all domains were addressed across all interventions currently offered for this population to various degrees, but not within a singular intervention. Future research optimally needs to be theory driven when developing dementia-specific interventions at the end of life, with the European Association for Palliative Care domains serving as a foundation to inform the best care for this population.
Impact of volume calculation formulae on volume estimation accuracy of different shaped objects: an in vitro ultrasound and CT study
Authors: Kodikara Iroshani , Gamage Dhanusha , Abeysekara Iroshini , Ilayperuma Isurani
Published: February 2020

Background

In image-assisted volume estimation, the volume of the object is calculated with a formula, using linear measurements of the objects. Since the volume estimation accuracy is thought to be influenced by the shape of the object, the volume estimation error would be related to the calculation formula used.

Purpose

To evaluate the volume estimation accuracy of selected volume calculation formulae, for different shaped objects.

Material and Methods

Globular (n = 5), elongated (n = 5), and near-spherical shaped plastic objects (n = 5), filled with water were subjected to ultrasound (US) and computed tomography (CT) in February 2018, to obtain the length, width, depth, and estimated volumes (EV). The volume was calculated manually using prolate, ellipsoid, and Lambert formulae. The actual volume (AV), EV, and calculated volumes were compared.

Results

The AV was in the range of 10–445 mL. The reliability of measurements was high as assessed by the intra-class variability (Cronbach’s alpha = 0.992). The EV has shown a high correlation to AV (US: ρ = 0.914, P < 0.001; CT: ρ = 0.943, P < 0.001; ellipsoid: ρ = 0.876, P < 0.001; prolate: ρ = 0.891, P < 0.001; Lambert: ρ = 0.876, P < 0.001). Regardless of the shape, the highest and lowest estimation accuracies were reported for prolate (bias = −0.7) and Lambert formulae (bias = +23.3), respectively. By any method, the globular objects were estimated with the highest accuracy: (US [bias = −0.31]; CT [bias = −0.14]; ellipsoid [bias = −1.5]; prolate [bias = −0.7]; Lambert [bias = 32.9]); and elongated objects were estimated with the lowest accuracy: (US [bias = −17.5]; CT [bias = −32.6]; ellipsoid [bias = −18.4]; prolate [bias = −0.3]; Lambert [bias = 11.4]).

Conclusion

The shape of the object and the calculation formula used has an impact on the volume estimation accuracy.
Assessment of proposed maximum power point tracking–unity power factor algorithms for optimum operation permanent magnet synchronous generator–based wind turbine
Authors: Nadia Elsonbaty A , Mohamed Enany A , Mahmoud Elymany
Published: February 2020

It is very important to select proper maximum power point tracking algorithm in order to achieve best performance and low cost for wind turbine–generator combination. A permanent magnet synchronous generator steady-state unity power factor analytical model based on a current source—equivalent circuit is provided. Validation of the identified load angle effect in current source as compared with that of the commonly used voltage source permanent magnet synchronous generator is presented. Then three new maximum power point tracking–load angle control algorithms based on current source model are presented. They all apply magnitude and frequency control techniques for Digital Signal Processor control systems. The first one presents maximum power point tracking–unity power factor applying constrained load angle control algorithm. The merits of the next two developed schemes are quickly and precisely tracking the maximum power output of the wind turbine; thus, the second and third algorithms are then characterized with linear control systems. The linearity of the second scenario is between load angle and reference speed while the third one has a load angle–torque linear relationship which shows its optimality. Finally, the controlled characteristics and implementation for the optimum case are presented for both stationary and synchronous reference frames (for vector control purposes). Simulation modeling for optimum case is provided and its results match well with the proposed predictive control algorithm.
Nutrients Essential for Cognitive Function Are Typical Problem Nutrients in the Diets of Myanmar Primary School Children: Findings of a Linear Programming Analysis
Authors: Soe Le Thandar , Fahmida Umi , Seniati Ali Nina Liche , Firmansyah Agus
Published: February 2020

Background:

Good cognitive function is important for school-age children. Although essential fatty acids play a main role in cognitive functions, their intakes are assumed as inadequate among developing countries including Myanmar. However, there is still lack of evidence to show whether they are problem nutrients.

Objective:

This study aimed to determine the problem nutrients in the diets of Myanmar primary schoolchildren and to formulate food-based recommendations (FBR) to optimize the intake of these micronutrients.

Methods:

A cross-sectional study was conducted at 3 primary schools in Nyaungdon Township of Myanmar. A 1-week dietary intake assessment was done on 7- to 9-year-old (n = 100) primary schoolchildren. A linear programming approach using the World Health Organization Optifood software was used to assess the nutrient intake and develop FBRs.

Results:

The prevalence of stunted growth, wasting, and being underweight in the students were 28%, 18%, and 28%, respectively. The intake of calcium, vitamin B1, folate, iron, omega-3 fatty acids, eicosapentaenoic acid, and docosahexaenoic acid was insufficient. Locally available nutrient-dense foods that include water spinach, carp fish, duck egg, garden pea, and shrimp were selected to develop FBR to increase the intake of problem nutrients.

Conclusion:

The linear programming analysis showed that the primary schoolchildren have difficulty meeting nutrient recommendations given locally available foods, especially iron and essential fatty acids which are important for cognitive performance of schoolchildren.
Evaluation of intradialytic sodium shifts during sodium controlled hemodialysis
Authors: Ponce Pedro , Pinto Bruno , Wojke Ralf , Maierhofer Andreas P , Gauly Adelheid
Published: February 2020

Plasma sodium shifts during hemodialysis treatments can be minimized by application of a sodium control algorithm. The present randomized cross-over trial was designed to apply this option on a large patient cohort and to observe the time course of plasma sodium over the treatment. In one study phase, patients received post-dilution online hemodiafiltration treatments with sodium control over the entire treatment. In the other study phase, patients received isolated ultrafiltration during the first 90 min followed by post-dilution online hemodiafiltration with sodium control for the remainder of the session, with the purpose to follow a possible initial equilibration process without the influence of a diffusive solute transfer. Each phase included six treatments and was delivered in randomized order. Eighty-one patients were enrolled, 77 patients could be analyzed as intention-to-treat population. The difference of the mean plasma sodium concentration between start and end of the treatment was −0.60 mmol/L (confidence interval −0.88 to −0.32) and −0.15 mmol/L (confidence interval −0.43 to 0.13), for sodium control and isolated ultrafiltration during the first 90 min followed by post-dilution online hemodiafiltration with sodium control, respectively. The functionality of the sodium control option could be confirmed and further reproduced in a bigger population of dialysis patients, providing the basis to investigate the clinical benefit of individually adjusting dialysate sodium in further clinical studies.
Development of a circulatory mock loop for biventricular device testing with various heart conditions
Authors: Kado Yuichiro , Miyamoto Takuma , Horvath David J , Gao Shengqiang , Fukamachi Kiyotaka , Karimov Jamshid H
Published: February 2020

This study aimed to evaluate a newly designed circulatory mock loop intended to model cardiac and circulatory hemodynamics for mechanical circulatory support device testing. The mock loop was built with dedicated ports suitable for attaching assist devices in various configurations. This biventricular mock loop uses two pneumatic pumps (Abiomed AB5000™, Danvers, MA, USA) driven by a dual-output driver (Thoratec Model 2600, Pleasanton, CA, USA). The drive pressures can be individually modified to simulate a healthy heart and left and/or right heart failure conditions, and variable compliance and fluid volume allow for additional customization. The loop output for a healthy heart was tested at 4.2 L/min with left and right atrial pressures of 1 and 5 mm Hg, respectively; a mean aortic pressure of 93 mm Hg; and pulmonary artery pressure of 17 mm Hg. Under conditions of left heart failure, these values were reduced to 2.1 L/min output, left atrial pressure = 28 mm Hg, right atrial pressure = 3 mm Hg, aortic pressure = 58 mm Hg, and pulmonary artery pressure = 35 mm Hg. Right heart failure resulted in the reverse balance: left atrial pressure = 0 mm Hg, right atrial pressure = 30 mm Hg, aortic pressure = 100 mm Hg, and pulmonary artery pressure = 13 mm Hg with a flow of 3.9 L/min. For biventricular heart failure, flow was decreased to 1.6 L/min, left atrial pressure = 13 mm Hg, right atrial pressure = 13 mm Hg, aortic pressure = 52 mm Hg, and pulmonary artery pressure = 18 mm Hg. This mock loop could become a reliable bench tool to simulate a range of heart failure conditions.
Bone inductivity comparison of control versus non-control released rhBMP2 coatings in 3D printed hydroxyapatite scaffold
Authors: Wu Gui , Huang Fei , Huang Yunpeng , Chen Yaoqing , Zheng Lifeng , Wang Hai , Xie Yun
Published: February 2020

Investigating the effects of rhBMP2 (recombined human bone morphogenetic protein-2) release kinetics on bone formation is important to optimize the use of rhBMP2 in tissue-engineered bone. However, there is still no direct evidence regarding how the release kinetic of rhBMP2 has effects on mesenchymal stem cells homing and differentiation during bone regeneration. In this study, we construct control and non-control released rhBMP2 coatings within the pores of 3D printed hydroxyapatite scaffold, and investigate how the release kinetic of rhBMP2 affects bone inductivity of tissue-engineered bone. We show that control released rhBMP2 has better effects on enhancing mesenchymal stem cells proliferation and migration than non-control released rhBMP2. Control released rhBMP2 promotes mesenchymal stem cells differentiation to a better extent than non-control released rhBMP2. Those findings are in consistent with the results of quantitative rhBMP2 stimulation for mesenchymal stem cells proliferation, migration and differentiation. The histological results after in vivo implantation also reveal that control released rhBMP2 coating can induce more bone formation than non-control released rhBMP2. Our data provide a basis for optimizing the rhBMP2 delivery modes in tissue-engineered bone and improving the bone inductivity of rhBMP2.
Detrimental Effects of Color-Blind Racial Attitudes in Preparing a Culturally Responsive Teaching Workforce for Immigrants
Authors: Cadenas Germán A. , Cisneros Jesus , Spanierman Lisa B. , Yi Jacqueline , Todd Nathan R.
Published: February 2020

Demands on the teacher workforce are changing as one quarter of children in U.S. schools live in immigrant families and about half of students are racial/ethnic minorities. Simultaneously, diminishing teacher support and teacher shortages cause reliance on alternative certification programs (e.g., Teach for America). In response, we studied the links between color-blind racial attitudes and culturally responsive teaching self-efficacy and outcome expectations with immigrant students among 323 teachers completing an alternative program. Results from a moderated mediation model based on social cognitive career theory demonstrated that color-blind racial attitudes were significantly negatively associated with teaching outcome expectations with immigrants. In addition, the link between color-blind attitudes and self-efficacy was positive and significant only for Asian/Asian American teachers, and the link between self-efficacy and outcome expectations was significant for Latinx and Asian/Asian American teachers, and White teachers. We discuss implications for supporting teachers’ career development in schools serving immigrants of color.
Neck growth kinetics during ultrasonic-assisted sintering of copper powder
Authors: Singh Gurminder , Pandey Pulak M
Published: February 2020

The present paper presents an investigation of the neck growth kinetics during ultrasonic-assisted sintering of the loose spherical copper particles. The study was performed to identify the sintering mechanism during the initial stage sintering of the copper powder. The classical sphere-to-sphere approach was used to determine the neck growth between the particles at four different sintering temperatures 700, 800, 900 and 950 ℃ at different soaking time of 60, 180, 300, 600, and 900 s. The neck growth exponent was found to be 6.21, 4.92, 5.26 and 5.13 for different sintering temperatures, respectively, which signified the involvement of surface and volume diffusion mechanism during the initial stage sintering of copper particles with ultrasonic vibration assistance. The neck growth calculation was attempted to compare with conventional sintering. The evidence of the local heating between the particles was evolved from the activation energy calculations, which was found to be lower than the conventional sintering. An attempt was made to develop a numerical model for the prediction of neck growth by considering the rise in temperature due to friction between the particles owing to ultrasonic vibrations at different sintering temperature and soaking time. The model was obtained to be in-line with the trend of the experimental results.
Adult macrophage activation syndrome–haemophagocytic lymphohistiocytosis: ‘of plasma exchange and immunosuppressive escalation strategies’ – a single centre reflection
Authors: Lorenz G , Schul L , Schraml F , Riedhammer K M , Einwächter H , Verbeek M , Slotta-Huspenina J , Schmaderer C , Küchle C , Heemann U , Moog P
Published: February 2020

Objective

In the context of systemic autoimmunity, that is systemic lupus erythematosus (SLE) or adult-onset Still’s disease (AOSD), secondary haemophagocytic lymphohistiocytosis (HLH; also referred to as macrophage activation syndrome (MAS) or more recently MAS-HLH) is a rare and potentially life-threatening complication. Pathophysiological hallmarks are aberrant macrophage and T cell hyperactivation and a systemic cytokine flare, which generate a sepsis-like, tissue-damaging, cytopenic phenotype. Unfortunately, for adult MAS-HLH we lack standardized treatment protocols that go beyond high-dose corticosteroids. Consequently, outcome data are scarce on steroid refractory cases. Aside from protocols based on treatment with calcineurin inhibitors, etoposide, cyclophosphamide and anti-IL-1, favourable outcomes have been reported with the use of intravenous immunoglobulin (IvIG) and plasma exchange (PE).

Methods

Here we report a retrospective series of steroid refractory MAS-HLH, the associated therapeutic regimes and outcomes.

Results

In this single-centre experience, 6/8 steroid refractory patients survived (median follow-up: 54.4 (interquartile range: 23.3–113.3) weeks). All were initially treated with PE, which induced partial response in 5/8 patients. Yet, all patients required escalation of immunosuppressive therapies. One case of MAS-HLH in new-onset AOSD had to be escalated to etoposide, whereas most SLE-associated MAS-HLH patients responded well to cyclophosphamide. Relapses occurred in 2/8 cases.

Conclusion

Together, early use of PE is at most a supportive measure, not a promising monotherapy of adult MAS-HLH. In refractory cases, conventional cytoreductive therapies (i.e. cyclophosphamide and etoposide) constitute potent and reliable rescue approaches, whereas IvIG, anti-thymoglobulin, and biologic agents appear to be less effective.
Prediction of water content in biscuits using near infrared hyperspectral imaging spectroscopy and chemometrics
Authors: Lancelot Eloïse , Courcoux Philippe , Chevallier Sylvie , Le-Bail Alain , Jaillais Benoît
Published: February 2020

The possibility of using near infrared hyperspectral imaging spectroscopy to quantify the water content in commercial biscuits was investigated. Principal component analysis was successfully applied to hyperspectral images of commercial biscuits to monitor their water contents. Variables were selected and water contents quantified using analysis of variance, followed by multiple linear regression, and the results were compared with those obtained with variable importance in projection partial least squares. Initially equal to 212, the number of variables after application of analysis of variance was equal to 10. Analysis of variance–multiple linear regression gave better results: the coefficient of determination (R2) was higher than 0.92 and the root mean square error of validation was less than 0.015. The “prediction images” obtained were very relevant and can be used to study biscuit defects. The methodology developed could be implemented at the industrial level for biscuit quality control and for online monitoring of the uniform distribution of water in the superficial layer of biscuits.
Immigrant Mothers’ Perspectives of Barriers and Facilitators in Accessing Mental Health Care for Their Children
Authors: Tulli Mia , Salami Bukola , Begashaw Lule , Meherali Salima , Yohani Sophie , Hegadoren Kathleen
Published: February 2020

Introduction: Data on immigrant and refugees’ access to services in Canada typically focus on adult populations generally but not children specifically. To fill this gap, this study explored immigrant and refugee mothers’ perceptions of barriers and facilitators for mental health care for their children in Edmonton, Alberta, Canada. Method: In this qualitative descriptive study, researchers conducted 18 semistructured interviews with immigrant and refugee mothers who live in Edmonton, self-identify as women, and have children living in Canada. Results: Barriers included financial strain, lack of information, racism/discrimination, language barriers, stigma, feeling isolated, and feeling unheard by service providers. Facilitators included schools offering services, personal levels of higher education, and free services. Discussion: Nurses can improve access to mental health services by addressing issues related to racism within the health system, by creating awareness related to mental health, and by providing trained interpreters to help bridge barriers in communications.
Partial Suture Fusion in Nonsyndromic Single-Suture Craniosynostosis
Authors: Boyajian Michael K. , Al-Samkari Hanny , Nguyen Dennis C. , Naidoo Sybill , Woo Albert S.
Published: February 2020

Introduction:

Partial synostosis of cranial sutures has been shown to have clinical and diagnostic significance. However, there is limited published information about how suture fusion progresses over time. In this study, we evaluate patients with nonsyndromic single-suture synostosis. We aim to define the incidence of partial versus complete suture fusion and whether a correlation exists between the degree of suture fusion and age.

Methods:

Two hundred fifty-four patients with nonsyndromic single-suture synostosis were evaluated. Preoperative computed tomography (CT) scans were rendered in 3-dimensions, all sutures were visualized and assessed for patency or fusion, and length of fusion was measured. Findings were grouped according to suture type (sagittal, coronal, metopic, or lambdoid), the degree of fusion (full, >50%, or <50%), and patient age at time of CT scan (0-90, 91-180, 181-360, or >360 days). Data were analyzed to correlate patient age versus the degree of suture fusion.

Results:

For all patients, 72% had complete and 28% had partial synostosis. Ratios of full to partial fusion for each suture type were as follows: sagittal 97:36, coronal 35:22, metopic 46:4, and lambdoid 4:10. The sagittal, coronal, and metopic groups demonstrated greater probabilities of complete suture fusion as patient age increases ( P = .021, P < .001, P = .001, respectively). This trend was also noted when all sutures were considered together by age-group ( P < .001).

Conclusion:

We note a partial suture fusion rate of 28.3%. Our analysis shows a correlation between the extent of suture synostosis and patient age. Finally, we demonstrate that different sutures display different patterns of partial and complete fusion.
Improved Injection Technique of Ethanol for Morton’s Neuroma
Authors: Pabinger Christof , Malaj Isabella , Lothaller Harald , Samaila Elena , Magnan Bruno
Published: February 2020

Background:

Morton’s neuroma is a common cause of forefoot pain. Various conservative methods (injections of various pharmacologic agents) have been published with an outcome of 6%-75% success rate (free of pain in daily life) per injection. The aim of the present study was to assess the outcome of an improved localization technique, a higher dosage, and a higher percentage of ethanol.

Methods:

Using fluoroscopic and electroneurographic guidance, 2.5 mL of 70% ethanol were injected into 33 feet with a magnetic resonance imaging (MRI)–verified neuroma. We evaluated patients at up to 5-year follow-up.

Results:

A “success rate” of more than 82% per single injection (defined as free of pain in daily life) was achieved and no recurrence was seen over 5 years. All scores (visual analog scale; Short Form–36 subscales, American Orthopaedic Foot & Ankle Society ankle-hindfoot score) showed significant improvement ( P < .0001). Mean 1.2 injections were necessary. No significant side effects were seen. However, some mild pain persisted in some patients who participated in sports.

Conclusion:

The injection of 2.5 mL of 70% ethanol under fluoroscopic and electroneurographic guidance was a safe method for the treatment of MRI-verified Morton’s neuromas. Combining the effect of a higher percentage of alcohol and a higher dosage and an improved localization technique resulted in a high rate of patients without pain.

Level of Evidence:

Level IV, cases series, prospective.
Are Men Who Pay for Sex Sexist? Masculinity and Client Attitudes Toward Gender Role Equality in Different Prostitution Markets
Authors: Brents Barbara G. , Yamashita Takashi , Spivak Andrew L. , Venger Olesya , Parreira Christina , Lanti Alessandra
Published: February 2020

Prostitution clients’ attitudes toward gender equality are important indicators of how masculinity relates to the demand for commercial sexual services. Research on male client misogyny has been inconclusive, and few studies compare men in different markets. Using an online survey of 519 clients of sexual services, we examine whether male client attitudes toward gender role equality are related to the main methods customers used to access prostitution services (i.e., through print or online media vs. in-person contact). We found no differences among men in these markets in attitudes toward gender role equality in the workplace and home. This is in a context where all clients had more egalitarian attitudes toward women’s roles than the U.S. male population in the General Social Survey (GSS). However, clients in in-person markets were less supportive of affirmative action than in online markets in a context where all clients were less supportive compared to the national average. These findings point to need to rethink how masculinity and gender role attitudes affect patterns of male demand for paid sex.
Not Your Average Joe: Pluralistic Ignorance, Status, and Modern Sexism
Authors: Sobotka Tagart Cain
Published: February 2020

A growing body of research has highlighted that men’s gender-related behaviors and choices are strongly influenced by the gendered beliefs they believe other men hold. However, limited research has sought to identify how men come to form opinions about what other men believe. Drawing from research on pluralistic ignorance, status, and masculinity, this study examines the role that high and low status men’s sexist behaviors have on the discrepancy between men’s own sexist beliefs and those they believe are held by most other men. Results from a series of online experiments show that men believe that “most men” are more sexist than themselves. Moreover, while the sexist acts of a low status man decrease men’s personal endorsement of sexist beliefs, the same acts by a high status man increased men’s personal endorsement of sexist beliefs. While personal beliefs were malleable, neither high nor low status men’s behaviors affected men’s perception of how sexist other men are. Together, these findings provide insight into the ways in which pluralistic ignorance and the sexist actions of high status men may contribute to systems of gender inequality.
Ragnar Rommetveit: A full life
Authors: Hagtvet Bente Eriksen , Linell Per , Wertsch James V , Wold Astri Heen
Published: February 2020

Over a long professional lifetime, Ragnar Rommetveit contributed to numerous disciplines in the social sciences and humanities, reflecting discussions in global social science and his own unending quest to understand social and individual life. His remarkable career and impact can be outlined in terms of four main phases. The first involved general social psychology in the 1950s and was reflected in Social Norms and Roles (1953/1955). In the second phase during the 1960s and 1970s, he focused on language-related psycholinguistic research leading to publications such as his 1968 volume Words, Meanings and Messages. The third phase came in the 1970s and 1980s and was motivated by his critique of formal linguistics and resulted in his short, magisterial 1974 volume On Message Structure. The fourth phase between 1980 and 2010 focused on “dialogism,” giving rise to works such as his 1992 article “Outlines of a dialogically based social-cognitive approach to human cognition and communication.” Along with his intellectual accomplishments, Rommetveit’s brilliance and generosity inspired students and colleagues at the University of Oslo, as well as from around the world. His capacity to engage with others in unending mediations on communication and mental life ranks among his most important legacies.
Consequences of ‘conversations not had’: insights into failures in communication affecting delays in hospital discharge for older people living with frailty
Authors: Redwood Sabi , Simmonds Bethany , Fox Fiona , Shaw Alison , Neubauer Kyra , Purdy Sarah , Baxter Helen
Published: February 2020

Objectives

Older people living with frailty (OPLWF) are often unable to leave hospital even if they no longer need acute care. The aim of this study was to elicit the views of health care professionals in England on the barriers to effective discharge of OPLWF.

Methods

We conducted semi-structured interviews with hospital-based doctors and nurses with responsibility for discharging OPLWF from one large urban acute care hospital in England. The data were analysed using the constant comparative method.

Results

We conducted interviews with 17 doctors (12 senior doctors or consultants and 5 doctors in training) and six senior nurses. Some of our findings reflect well-known barriers to hospital discharge including service fragmentation, requiring skilled coordination that was often not available due to high volumes of work, and poor communication between staff from different organizations. Participants’ accounts also referred to less frequently documented factors that affect decision making and the organization of patient discharges. These raised uncomfortable emotions and tensions that were often ignored or avoided. One participant referred to ‘conversations not had’, or failures in communication, because difficult topics about resuscitation, escalation of treatment and end-of-life care for OPLWF were not addressed.

Conclusions

The consequences of not initiating important conversations about decisions relating to the end of life are potentially far reaching not only regarding reduced efficiency due to delayed discharges but also for patients’ quality of life and care. As the population of older people is rising, this becomes a key priority for all practitioners in health and social care. Evidence to support practitioners, OPLWF and their families is needed to ensure that these vital conversations take place so that care at the end of life is humane and compassionate.
Seeing and treating the out-group like family: Transference effects in an ethnic context
Authors: Wolf Lukas J. , Karremans Johan , Maio Gregory R.
Published: February 2020

Transference effects occur when our impressions are guided by our mental representations of significant others. For instance, if a target resembles an individual’s significant other, then that person’s feelings toward their significant other will be transferred onto the target. The present research examines whether transference effects emerge even when the target belongs to an ethnic out-group. In two experiments, participants received descriptions of in-group and out-group targets who partly resembled their own (or another’s) positive significant other. The findings showed that resemblance to one’s own significant other improves attitudes and behavior toward both in-group and ethnic out-group targets, as found across 2 nations and 3 different ethnic out-groups. The present research hence provides evidence of robust transference effects across ethnic group boundaries.
Air-appropriation: The imperial origins and legacies of the Anthropocene
Authors: Folkers Andreas
Published: February 2020

This article elucidates the spatial order that underpins the politics of the Anthropocene – the ecological nomos of the earth – and criticizes its imperial origins and legacies. It provides a critical reading of Carl Schmitt’s spatial thought to not only illuminate the spatio-political ontology but also the violence and usurpations that characterize the Anthropocene condition. The article first shows how with the emergence of the ecological nomos seemingly ‘natural’ spaces like the biosphere and the atmosphere became politically charged. This challenges the modernist separation between natural facts and political norms. It then underlines the imperial origins of this nomos by introducing the concept of air-appropriation understood as the colonization of atmospheric space by CO2 emissions. Instead of assuming that the ecological nomos represents a transition from a colonial to an ecological and cosmopolitan world order, focusing on air-appropriation highlights forms of ecological imperialism that go along with the new nomos. Accordingly, the article calls for a just redistribution of ecospace that takes into account the imperial legacies and ongoing effects of air-appropriation.
What happens before, during and after crisis for someone with dementia living at home: A systematic review
Authors: Hopkinson Jane B , King Amanda , Mullins Jane , Young Lucy , Kumar Sugandha , Hydon Kate , Muthukrishnan Sabarigirivasan , Elliott Fiona , Hopkinson Martin
Published: February 2020

Background

People living with dementia often experience crisis. Home treatment of crisis is an alternative to hospital admission that can have better outcomes. This systematic review is about people with dementia living at home and in crisis. It identifies modifiable factors in the crisis process that may facilitate crisis resolution.

Methods

The protocol is registered on PROSPERO. A systematic search of MEDLINE, EMBASE, CINAHL, AHMED, PsycINFO, Cochrane Library and references of retrieved publications, identified empirical research in English language and date range January 2000 to February 2019. Two researchers independently screened abstracts, selected publications and extracted data using a framework based on published guidelines. This is a report of the analysis and narrative synthesis.

Results

The search identified 2755 titles and abstracts, 76 were selected for full-text examination and 13 agreed for inclusion. The included studies evidence that: for a person with dementia, crisis is a process that begins with a problem judged to put them or others at risk of harm. It leads to decision and action to treat this risk, thus resolve the crisis. Such crisis can be predicted or unpredicted and progress quickly or slowly. Medical treatment, community resources and psychosocial support of personal resources, decision making, relationships and social networks, are all modifiable factors that can treat the risk of harm during crisis. Carers’ and professionals’ knowledge and skills in dementia care are likely to play a key role in crisis resolution in the home.

Conclusion

There has been limited investigation of the process and management of crisis at home for people living with dementia. The results of this review provide a foundation for future research. There is no consensus on critical components of home treatment to facilitate crisis resolution. However, education in dementia care for carers and professionals is likely to prove essential to successful home treatment.
Binary structured polypropylene-/propylene-based elastomer fibrous membranes with enhanced flexibility
Authors: Zhang Heng , Zhen Qi , Liu Yong , Wang Liang , Guan Xiaoyu , Zhang Yifeng
Published: February 2020

Polypropylene (PP) fibrous membranes are widely used in medical and healthcare due to its sustainability. However, pristine PP fibrous membranes show poor flexibility, which limits their advanced functional application in medical and healthcare. Therefore, to improve the flexibility of PP fibrous membranes, propylene-based elastomer (PBE), a copolymer compatible with PP, was introduced by using the melt blowing technique in this study. The SEM images show that the PP/PBE fibrous membrane samples expressed a binary structured network morphology consisting of fibers with a diameter distribution ranging from 0.4 to 15 µm. With an increase in PBE mass ratio from 15 to 80 wt%, the frequency of fibers with a diameter <3 µm increased from 48.6 to 61.2%, thus making the elastic recovery rate in the machine direction (MD) increase from 62.9 to 80.3% and softness values increase from 15.88 to 54.31. Meanwhile, air permeability increased from 856 to 2257 m3/m2 · h as the mass per unit area of the samples decreased from 129.9 to 40.1 g/m2. This work provides an alternate method for producing flexible fibrous membranes that have potential for application in items such as surgical gown cuffs, bandages, and face mask ear loops.
What do we know about novice school principals? A systematic review of existing international literature
Authors: Kılınç Ali Çağatay , Gümüş Sedat
Published: February 2020

For much of the past half-century, scholars from various parts of the world have studied the early stages of school principals’ careers. This article presents the results of a review of research on novice principals (NPs) regarding its current status, intellectual structure and conceptual structure. The review conducted bibliometric and content analysis of relevant articles accessed through Scopus. The findings primarily concerned patterns in the knowledge production related to novice school principals. Our findings indicate that this line of research is still in its infancy, but has been growing rapidly in recent years. Related studies have mostly focused on three broad areas: preparation and development of NPs; NPs’ socialization process and the challenges they face; and NPs’ role in school improvement. Most of the related studies are found to be lacking in terms of a solid theoretical grounding. The implications of the results for the related literature are discussed.
Trigeminal neuralgia causes neurodegeneration in rats associated with upregulation of the CD95/CD95L pathway
Authors: Wang Lu , Long Menghong , Wang Maohua , Peng Shuangchun , Chen Guangxiang , Zhou Jun , Ou Cehua
Published: February 2020

Objectives

To explore the effects of trigeminal neuralgia on neurodegeneration in rats and the underlining mechanism.

Methods

Sixty adult male Sprague Dawley rats were divided randomly into Chronic Constriction Injury of the Rat’s Infraorbital Nerve (ION-CCI) group and sham group ( n = 30). Right suborbital nerve was ligated in ION-CCI group to establish a trigeminal neuralgia model. In sham group, suborbital nerve was exposed without ligation. Pain thresholds were measured before surgery and 1, 7, 15, and 30 days after surgery ( n = 10). Morris water maze tests ( n = 10) were conducted at 1, 15, and 30 days after surgery to evaluate the changes in learning and memory ability of rats. At 5, 19, and 34 days after surgery, serum S100β protein concentration and hippocampal Aβ1-42 protein expression were detected by enzyme-linked immunosorbent assay; total tau protein expression was detected by Western blotting; changes of neurons in hippocampus were observed by Nissl staining; and the expression of ser404p-tau, cluster of differentiation (CD)95, CD95L, and cleaved caspase-3 proteins was detected by immunofluorescence and Western blotting.

Results

Hyperalgesia occurred in ION-CCI group, and mechanical pain threshold decreased significantly ( P < 0.05). On the 15th and 30th days after surgery, ION-CCI group showed lower learning and memory ability than sham group ( P < 0.05). Serum S100β protein concentration, hippocampal A β1-42, and ser404p-tau protein expression increased in the ION-CCI group 19 and 34 days after surgery ( P < 0.05), hippocampal CD95 expression increased in the ION-CCI group after surgery ( P < 0.05), hippocampal CD95L expression increased at 19 and 34 days after surgery ( P < 0.05), and cleaved caspase-3 expression increased at 5 and 19 days after surgery ( P < 0.05). Nissl bodies in ION-CCI group decreased significantly at 15 days after surgery. The expression of cleaved caspase-3 protein in ION-CCI group was positively correlated with the expression of CD95 and CD95L ( P < 0.05).

Conclusions

Trigeminal neuralgia may lead to neuronal inflammation and neuronal apoptosis associated with upregulation of CD95/CD95L expression, thus causing neurodegeneration.
The 7th World Congress of Nurse Anaesthetists 8-12 June 2002 Helsinki Finland
Authors: Allan Christine
Published: February 2020

Melanie van Limborgh and I were privileged to attend this flagship event of the International Federation of Nurse Anaesthetists (IFNA), representing NATN as UK delegates, to ensure that the sharing of knowledge and expertise strengthens nurse anaesthetist relationships and promotes an international culture of development within this nursing speciality.
Endoplasmic reticulum stress and pulmonary hypertension
Authors: Hu Yanan , Yang Wenhao , Xie Liang , Liu Tao , Liu Hanmin , Liu Bin
Published: February 2020

Pulmonary hypertension is a fatal disease of which pulmonary vasculopathy is the main pathological feature resulting in the mean pulmonary arterial pressure higher than 25 mmHg. Moreover, pulmonary hypertension remains a tough problem with unclear molecular mechanisms. There have been dozens of studies about endoplasmic reticulum stress during the onset of pulmonary hypertension in patients, suggesting that endoplasmic reticulum stress may have a critical effect on the pathogenesis of pulmonary hypertension. The review aims to summarize the rationale to elucidate the role of endoplasmic reticulum stress in pulmonary hypertension. Started by reviewing the mechanisms responsible for the unfolded protein response following endoplasmic reticulum stress, the potential link between endoplasmic reticulum stress and pulmonary hypertension were introduced, and the contributions of endoplasmic reticulum stress to different vascular cells, mitochondria, and inflammation were described, and finally the potential therapies of attenuating endoplasmic reticulum stress for pulmonary hypertension were discussed.
Exploring the determinants of the cardiac changes after ultra-long duration exercise: The echocardiographic Spartathlon study
Authors: Christou Georgios A , Pagourelias Efstathios D , Anifanti Maria A , Sotiriou Panagiota G , Koutlianos Nikolaos A , Tsironi Maria P , Andriopoulos Panagiotis I , Christou Konstantinos A , Kouidi Evangelia J , Deligiannis Asterios P
Published: February 2020

Aim

The investigation of the pathophysiological determinants of cardiac changes following ultra-long duration exercise.

Methods

Twenty-seven runners who finished a 246 km running race were examined both before and after the finish of the race. Examinations included echocardiography and measurement of body weight and blood biochemical parameters.

Results

Exercise increased left ventricular end-diastolic interventricular septum thickness (LVIVSd) ( p < 0.001) and posterior wall thickness (LVPWTd) ( p = 0.001) and right ventricular end-diastolic area ( p = 0.005), while reduced tricuspid annular plane systolic excursion (TAPSE) ( p = 0.004). A minor decrease in the peak absolute values of both left ventricular (from −20.9 ± 2.3% to −18.8 ± 2.0%, p = 0.009) and right ventricular (from −22.9 ± 3.6% to −21.2 ± 3.0%, p = 0.040) global longitudinal strains occurred. There was decrease in body weight ( p < 0.001) and increase in both circulating high-sensitivity troponin I ( p = 0.028) and amino-terminal pro-B type natriuretic peptide (NT-proBNP) ( p = 0.018). The change in the sum of LVIVSd and LVPWTd correlated negatively with percentage change of body weight ( r = −0.416, p = 0.049). The only independent determinant of post-exercise NT-proBNP was pulmonary artery systolic pressure ( r = 0.797, p = 0.002). Post-exercise NT-proBNP correlated positively with percentage changes of basal (RVbas) ( r = 0.582, p = 0.037) and mid-cavity (RVmid) ( r = 0.618, p = 0.043) right ventricular diameters and negatively with percentage change of TAPSE ( r = −0.720, p = 0.008). Similar correlations with RVbas, RVmid and TAPSE were found for pulmonary artery systolic pressure. Post-exercise high-sensitivity troponin I correlated negatively with percentage change of body weight ( r = −0.601, p = 0.039), but was not associated with any cardiac parameter.

Conclusion

The main cardiac effects of ultra-long duration exercise were the decrease in left ventricular end-diastolic dimensions and increase in left ventricular wall thickness, as well as minimal dilatation and alteration in systolic function of right ventricle, possibly due to the altered exercise-related right ventricular afterload.
A survey of syphilis knowledge among medical providers and students in Rhode Island
Authors: Bonnewell John , Magaziner Sarah , Fava Joseph L , Montgomery Madeline C , Almonte Alexi , Carey Michael , Chan Philip A
Published: February 2020

Background:

In the United States, syphilis cases have increased dramatically over the last decade. Recognition and timely diagnosis by medical providers are essential to treating syphilis and preventing further transmission.

Methods:

From 2016 to 2017, a cross-sectional survey was performed among medical students, residents, fellows, and attending physicians in Rhode Island. Topics included demographics, level of medical training, experience diagnosing and treating syphilis, and familiarity with the reverse testing algorithm. Participants were asked 25 true/false questions to assess basic knowledge of syphilis, which covered five domains: epidemiology, transmission, clinical signs and symptoms, diagnosis, and treatment. Univariate and bivariate analyses were performed to determine knowledge levels across provider characteristics. Significance was defined as p < 0.05.

Results:

Of the 231 participants, 45% were medical students, 34% were residents or fellows, 11% were medicine attendings (non-infectious diseases), and 10% were infectious diseases attendings. The overall mean score was 9.79 (out of 25; range = 0–23, p ⩽ 0.001). Mean scores differed significantly ( p < 0.001) across groups, including 7.68 for students (range = 0–16), 10.61 for residents/fellows (range = 3–17), 10.41 for non-infectious diseases attendings (range = 4–18), and 16.38 for infectious diseases attendings (range = 6–23). Familiarity with the reverse sequence algorithm was low with only 22% having heard of it. Infectious diseases attendings were significantly more knowledgeable compared to other groups. Overall and across domains, infectious diseases attendings had significantly higher scores except when compared to non-infectious diseases attendings in the epidemiology domain and residents/fellows in the transmission domain.

Conclusion:

Overall syphilis knowledge among non-infectious diseases medical providers was low. Improved education and clinical training are needed to promote early diagnosis, treatment, and prevention efforts.