bluuebunny/crossref_metadata_2025 huggingface dataset:
Improved water resistance, thermal stability, and mechanical properties of waterborne polyurethane nanohybrids reinforced by fumed silica via in situ polymerization
Authors: Han Yanting , Chen Zheng , Dong Wei , Xin Zhongyin
Published: December 2014

In this study, a series of waterborne polyurethane/fumed silica (WPU/S) hybrids were prepared by an optimized in situ polymerization through a grafting process. Fourier transform infrared spectrum and X-ray diffraction confirmed the enhanced interfacial interactions between fumed silica particles and polyurethane (PU) segments. Atomic force microscopy demonstrated well dispersion of fumed silica in PU matrix and the rough surface of WPU/S hybrid films, which contributed to improved water resistance. The thermal stability of WPU was also improved by the incorporation of fumed silica, and the glass transition temperature of WPU/S increased compared with pure WPU. Moreover, as the content of fumed silica increased from 0% to 4%, the tensile strength of WPU/S increased from 29.0 MPa to 37.6 MPa without losing high elongation at break.
High-order non-singular terminal sliding mode control for dual-stage hard disk drive head positioning systems
Authors: Huang Jin , Liu Mingjun , Zhang Jie
Published: December 2014

A dual-stage actuator system in a hard disk drive will be expected to meet more stringent servo bandwidth requirements for higher recording density in the near future. To simplify the control design, most of the work on the dual-stage actuator track-seeking control is based on the rigid model. However, light-weight materials are used in practice; because of the existence of flexible modes in the system, the challenges involved in designing a reasonable controller need to be addressed. This article proposes a high-order non-singular terminal sliding mode control scheme to suppress undesirable flexural vibrations, while improving the head positioning speed and accuracy. Initially, a model of the system is built and then the flexible dual-stage actuator system is decomposed into input–output and internal sub-systems, to design the high-order non-singular terminal sliding mode controller. Simulation results show that the settling time in track-seeking is reduced and the tracking precision is improved with the proposed method.
An intuitive approach for quadruped robot trotting based on virtual model control
Authors: Xie Huixiang , Ahmadi Mojtaba , Shang Jianzhong , Luo Zirong
Published: December 2014

This article presents an intuitive approach based on virtual model control for quadrupedal dynamic locomotion, aiming at simple and robust trotting control. The controller consists of two main modules: stance phase virtual model control for full control of the robot body and swing phase virtual model control for control of swing legs. We combine the decomposed virtual model control with Raibert’s method to intuitively regulate the height, speeds and attitude of the body during stance phase, with special attention to the rotation about the body diagonal line. To unify the control law and further simplify the controller, virtual model control is also implemented for swing legs to follow the planned swing foot trajectories that are self-adapting depending on the speeds of the robot. Simulations including forward trotting, lateral push recover, and lateral travel are presented to demonstrate the effectiveness and robustness of our controller.
Poisson and negative binomial item count techniques for surveys with sensitive question
Authors: Tian Guo-Liang , Tang Man-Lai , Wu Qin , Liu Yin
Published: December 2014

Although the item count technique is useful in surveys with sensitive questions, privacy of those respondents who possess the sensitive characteristic of interest may not be well protected due to a defect in its original design. In this article, we propose two new survey designs (namely the Poisson item count technique and negative binomial item count technique) which replace several independent Bernoulli random variables required by the original item count technique with a single Poisson or negative binomial random variable, respectively. The proposed models not only provide closed form variance estimate and confidence interval within [0, 1] for the sensitive proportion, but also simplify the survey design of the original item count technique. Most importantly, the new designs do not leak respondents’ privacy. Empirical results show that the proposed techniques perform satisfactorily in the sense that it yields accurate parameter estimate and confidence interval.
Doubly robust estimation of attributable fractions in survival analysis
Authors: Sjölander Arvid , Vansteelandt Stijn
Published: December 2014

The attributable fraction is a commonly used measure that quantifies the public health impact of an exposure on an outcome. It was originally defined for binary outcomes, but an extension has recently been proposed for right-censored survival time outcomes; the so-called attributable fraction function. A maximum likelihood estimator of the attributable fraction function has been developed, which requires a model for the outcome. In this paper, we derive a doubly robust estimator of the attributable fraction function. This estimator requires one model for the outcome, and one joint model for the exposure and censoring. The estimator is consistent if either model is correct, not necessarily both.
William Orange CB, MD, FRCP, LSA: A Broadmoor pioneer
Authors: Lansdown Richard
Published: December 2014

William Orange was the second Medical Superintendent of Broadmoor and in the 23 years he spent there created a management style that was greatly admired. Among his patients were the painter Richard Dadd, the Surgeon of Crowthorne and the Brighton poisoner. As advisor to the Home Office he also made a significant contribution to the interface between medicine and the law.
On the Dynamic Transmission of Mean and Volatility across the Arab Stock Markets
Authors: Bouri Elie , Azzi Georges
Published: December 2014

This article applies a multivariate model to uncover the dynamic mean and volatility interdependence across the markets of Morocco, Tunisia, Egypt, Lebanon, Jordan, Kuwait, Bahrain, Qatar, United Arabic Emirates (UAE), Saudi Arabia and Oman from June 2005 to January 2012. Results show that the Arab Middle East and North African equity markets are interconnected by their volatilities and not by their returns, which makes risk reduction possible. Volatility persistence and innovations in one market enclose figures that are valuable to investors and risk managers seeking to predict volatility in other markets. Surprisingly, we find evidence of significant volatility spillover from small to larger markets.

JEL Classification: G1, G15, G17, C22, C32
Psychosocial short stature with psychosis: a case report
Authors: Wattchow Naomi , Lee Hsu-en , Brock Philip
Published: December 2014

Objective:

Our objective was to report and describe a case of psychosocial short stature in an adolescent girl with psychotic features. Psychosocial short stature is a rare condition in which emotional stress or deprivation in childhood profoundly reduces growth, leading to persistent short stature. This disorder is variably known as psychosocial dwarfism, hyperphagic short stature or maternal deprivation dwarfism. In the literature, psychosocial short stature has not been associated previously with psychosis.

Conclusions:

We formulate that our patient’s short stature, developmental regression and psychotic features were culminations of insecure mother–child attachment, personal traumatic experiences, immigrant status, high family expressed emotions and social isolation. Neuropsychiatric influences were critically regarded due to our patient’s fluctuations in behaviour and affect, in the setting of cortical volume loss on brain MRI. Diagnostic hypotheses included childhood disintegrative disorder or childhood-onset schizophrenia. The management plan involved inpatient family psychoeducation, a pharmacological trial with an atypical antipsychotic and community mental health service follow-up for family therapy and psychotherapy.
The structure and reliability of the Health of the Nation Outcome Scales
Authors: Speak Barry , Muncer Steven
Published: December 2014

Objective:

The Health of the Nation Outcome Scales (HoNOS) has been suggested as an outcome measure for the evaluation of mental health services in several countries; however, the scoring, reliability and structure of HoNOS are all ambiguous.

Methods:

A total of 80,161 completed HoNOS forms were checked for internal reliability and structural integrity. Parallel analysis was used to investigate the likelihood that HoNOS consists of 12 independent scales. The reliability of the scale was investigated using ordinal reliability analysis. Confirmatory factor analysis was used to investigate the factor structure.

Results:

Parallel analysis suggested that HoNOS had three underlying factors and could not be considered as 12 independent scales. The 12-item scale had good reliability. Confirmatory factor analysis found that a one factor, four-item scale produced the most acceptable fit.

Conclusions:

HoNOS should not be considered as 12 independent scales. Although the four-item scale is acceptable psychometrically, it has practical problems, as it focuses only on the social aspects of outcome measurement. It is possible that there are other factor structures that would encompass more items, but any study of these should test for invariance between groups of service users.
Bug-in-Ear Coaching
Authors: Ottley Jennifer Riggie , Hanline Mary Frances
Published: December 2014

Many early childhood educators struggle to meet the communication needs of children with delays and disabilities. The purpose of this study was to examine the functional relation between bug-in-ear coaching and the frequency of educators’ correct use of targeted communication strategies, as well as associations with children’s expressive communication. Four multiple-baseline single-case intervention design experiments were completed. Dependent variables were educators’ use of communication strategies and the expressive communication of children with delays or disabilities. Bug-in-ear improved educators’ implementation of at least one communication strategy for each educator. Effect sizes were large for three educators and moderate for one. Each behavior successfully implemented during intervention was maintained at moderate levels or better, while behaviors implemented with greater variability during intervention were not maintained. Associations with children’s expressive communication were questionable/small during both intervention and maintenance. Outcomes suggest that bug-in-ear is a socially valid practice that shows promise of effectiveness in inclusive early childhood environments. Implications and future directions are provided.
Communicating With School Nurses About Sexual Orientation and Sexual Health
Authors: Rasberry Catherine N. , Morris Elana , Lesesne Catherine A. , Kroupa Elizabeth , Topete Pablo , Carver Lisa H. , Robin Leah
Published: December 2014

Black and Latino young men who have sex with men (YMSM) are at disproportionate risk for sexually transmitted diseases (STDs), including HIV. This study informs school-centered strategies for connecting YMSM to health services by describing their willingness, perceived safety, and experiences in talking to school staff about sexual health. Cross-sectional data were collected from Black and Latino YMSM aged 13–19 through web-based questionnaires ( N = 415) and interviews ( N = 32). School nurses were the staff members youth most often reported willingness to talk to about HIV testing (37.8%), STD testing (37.1%), or condoms (37.3%), but least often reported as safe to talk to about attraction to other guys (11.4%). Interviews revealed youth reluctance to talk with school staff including nurses when uncertain of staff members’ perceptions of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) people or perceiving staff to lack knowledge of LGBTQ issues, communities, or resources. Nurses may need additional training to effectively reach Black and Latino YMSM.
The “Doctors” Will See You Now
Authors: Jennings Douglas L.
Published: December 2014

In response to this growing movement of allied health “doctors,” the American Medical Association (AMA) launched its “Truth in Advertising” campaign in 2011, which aims to pass legislation regarding use of the “doctor” title. As a result of this initiative, several states have enacted laws that require any nonphysician practitioners who evoke the “doctor” salutation with patients to immediately identify their profession. Although designed to prevent confusion among patients, this initiative is misguided, and we as pharmacists need to use our professional organizations to open a dialog with the AMA and address this issue.
Xp11 Translocation Renal Cell Carcinoma Morphologically Mimicking Clear Cell–Papillary Renal Cell Carcinoma in an Adult Patient
Authors: Parihar Asmita , Tickoo Satish K. , Kumar Sunil , Arora Vinod Kumar
Published: December 2014

Xp11 translocation renal cell carcinoma (RCC) is a relatively rare tumor mainly affecting children and adolescents. It shows significant morphological overlap with the 2 most common adult renal tumors, which are the clear cell (conventional) RCC and papillary RCC. We describe case of a young adult female who presented with right flank pain and abdominal mass. Radiological investigations showed features suggestive of renal cell carcinoma in the right kidney. Histopathological findings while suggestive of Xp11 carcinoma, showed significant overlap with the recently described entity clear cell papillary RCC. TFE3 immunohistochemistry confirmed the tumor to be Xp11 translocation RCC. The patient had an aggressive course with lymph node metastasis. In this report, we discuss differential diagnosis and the diagnostic challenges of Xp11 translocation RCC in adults.
Strange patterns in one ring of Chen oscillators coupled to a ‘buffer’ cell
Authors: Pinto Carla MA , Carvalho Ana RM
Published: December 2014

We study curious dynamical patterns appearing in networks of one ring of cells coupled to a ‘buffer’ cell. Depending on how the cells in the ring are coupled to the ‘buffer’ cell, the full network may have a nontrivial group of symmetries or a nontrivial group of ‘interior’ symmetries. This group is Z3 in the unidirectional case and D3 in the bidirectional case. We simulate the coupled cell systems associated with the networks and obtain steady states, rotating waves, quasiperiodic behavior, and chaos. The different patterns seem to arise through a sequence of Hopf, period-doubling, and period-halving bifurcations. The behavior of the systems with exact symmetry are similar to the ones with ‘interior’ symmetry. The network architecture appears to explain some features, whereas the properties of the Chen oscillator, used to model cells’ internal dynamics, may explain others. We use XPPAUT and MATLAB to numerically compute the relevant states.
Dynamic response of a viscoelastic plate impacted by an elastic rod
Authors: Rossikhin Yu A , Shitikova MV
Published: December 2014

The problem on low-velocity impact of a long thin elastic rod upon an infinite plate, the viscoelastic features of which are exhibited only within the contact domain and are governed by the fractional derivative standard linear solid model. The part of the plate being out of the contact region is considered to be elastic, and its behavior is described by a set of equations taking the rotary inertia and transverse shear deformation into account. At the moment of impact, shock waves are generated both in the impactor and target, the influence of which on the contact domain is considered via the theory of discontinuities. The contact zone moves like a rigid whole under the action of the contact force and transverse forces applied to the boundary of the contact region, which are obtained on the basis of one-term ray expansions. As this takes place, two cases are considered, namely: (1) the rod with a flat end; and (2) the rod with a rounded end. In the first case, the problem of defining the contact force is a linear one, and the Laplace transform technique is used for its solution. In the second case, the contact force is determined via the Hertz contact theory, and the operators entering in the contact force are decoded with help of the algebra of Rabotnov fractional operators. As a result, a nonlinear integrodifferential equation is obtained in terms of the value of the local bearing of plate and rod's materials, which could be solved numerically. The time-dependence of the contact domain is obtained numerically at different magnitudes of the fractional parameter which defines the order of fractional derivatives.
Non-negative least squares deconvolution method for mirror-ground beamforming
Authors: Zhigang Chu , Linbang Shen , Yang Yang , Guangjian Wang
Published: December 2014

In order to improve the acoustic source identification performance of beamforming when ground reflection exists, an array point spread function was derived and a corresponding non-negative least squares deconvolution method was given for a mirror-ground beamforming method. Simulations of a known acoustic source indicate that the given method is correct, and it could not only clear the acoustic source identification results effectively by improving the spatial resolution and attenuating the sidelobe interference, but it could also be superior to the conventional beamforming deconvolution method. On this basis, experiments were conducted to validate the correctness of the simulations and the effectiveness of the mirror-ground beamforming deconvolution method in practical application.
Transverse vibrations of moving skew plates made of functionally graded material
Authors: Ruan Miao , Wang Zhong-Min
Published: December 2014

The present paper investigates the transverse vibrations and stability of a moving skew thin plate made of functionally graded ceramic–metallic material. The material properties are assumed to vary continuously through the thickness according to a power-law distribution of the volume fractions of the constituents. The Voigt's rule is used to estimate the effective material properties from the volume fractions and the properties of the constituent materials. By the coordinate transformation, the differential equations of motion of the moving functionally graded material (FGM) skew plate are obtained in oblique coordinate system. The boundary conditions with simply supported and clamped edges are obtained in oblique coordinate system. The vibration frequencies are obtained from the solution of a generalized eigenvalue problem. The entire computational work is carried out in a normalized square domain obtained through an appropriate domain mapping technique. Results of the reduced problem revealed excellent agreement with other studies. The dimensionless complex frequencies of the moving FGM skew plate are calculated by the differential quadrature method. The effects of gradient index, aspect ratio, and dimensionless moving speed on the transverse vibration and stability of the moving FGM skew plate are analyzed. Results are furnished in dimensionless amplitude–frequency curves for different dimensionless moving speed and representations of some vibration mode shapes are shown.
Social Support, Collective Efficacy, and Child Physical Abuse
Authors: Price-Wolf Jennifer
Published: December 2014

Social support and collective efficacy are related to child physical abuse. However, little is known about whether these relationships differ by gender, although mothers and fathers differ in the quantity and quality of time spent with children. This study examined whether the relationship between social support, collective efficacy, and physical abuse is stronger for mothers than fathers. Telephone interviews were conducted with parent respondents in 50 California cities ( N = 3,023). Data were analyzed via overdispersed multi-level Poisson models. Results suggest that high levels of emotional support were inversely associated with physical abuse for women and men, although this effect was stronger for women. High levels of companionship support were positively associated with physical abuse for women; however, the opposite was true for men. There were no significant interactions between collective efficacy variables and gender. The relationships between some types of social support and physical abuse appear to vary for men and women suggesting possibilities for more targeted intervention.
Executive Dysfunction and Functional Impairment Associated With Sluggish Cognitive Tempo in Emerging Adulthood
Authors: Wood Whitney L. M. , Lewandowski Lawrence J. , Lovett Benjamin J. , Antshel Kevin M.
Published: December 2014

Objective: Research has identified a relationship between sluggish cognitive tempo (SCT) symptoms and symptoms of ADHD, anxiety, and depression; however, no study has controlled for symptoms of ADHD, anxiety, and depression when examining impairment related to SCT symptoms. This study aimed to examine (a) the extent to which functional impairment and executive function (EF) problems were accounted for by SCT symptoms when controlling for ADHD, anxiety, and depression symptoms, and (b) which type of symptoms were associated with the greatest amount of impairment. Method: College students ( N = 458) completed self-report scales of ADHD, SCT, anxiety, and depression symptoms, as well as functional impairment and EF problems. Results: Thirteen percent of the sample was found to have high levels of SCT symptoms. SCT symptoms showed a moderate to strong correlation with the other symptom sets; however, high levels of SCT symptoms often occurred separate from high levels of ADHD, anxiety, or depression symptoms. SCT symptoms accounted for the most unique variance for both EF problems and functional impairment. Students with high levels of SCT symptoms, with or without high levels of ADHD symptoms, exhibited more impairment and EF problems than the controls. Conclusion: SCT is a clinical construct worthy of additional study, particularly among college students.
Simplified methods for estimating glomerular filtration rate in cats and for detection of cats with low or borderline glomerular filtration rate
Authors: Paepe Dominique , Lefebvre Hervé P , Concordet Didier , van Hoek Ingrid , Croubels Siska , Daminet Sylvie
Published: December 2014

Objectives

Diagnosis of early feline chronic kidney disease (CKD) is challenging. Glomerular filtration rate (GFR) is the best overall indicator of kidney function, but multisample plasma clearance methods to determine GFR are labour intensive, time consuming and stressful for feline patients. This study aimed to develop simplified methods to detect decreased GFR in cats.

Methods

Data from a nine-sample combined plasma exogenous creatinine–iohexol clearance test of 73 cats were used. Limited sampling strategies were developed by comparing all sampling time combinations with the complete nine sampling times set and selecting the best sampling time combinations based on maximum relative error. By regression analysis, the ability of routine blood (serum creatinine, serum urea) and urine (urine specific gravity, urinary protein:creatinine ratio) variables to predict GFR or identify cats with low or borderline GFR was examined. Cut-off clearance marker concentrations to predict low or borderline GFR was determined at three time points after marker injection. All procedures were analysed for three clearance markers (exo-iohexol, creatinine, endo-iohexol).

Results

For reliable estimation of GFR, at least three blood samples for clinical purposes and five blood samples for research purposes are required. Regression formulae based on routine variables did not reliably predict GFR, but accurately identified cats with low (sensitivity 96.5–98.2%; specificity 60–91.3%) or borderline (sensitivity 91.1–96%; specificity 76.5–81.8%) GFR. Clearance marker concentrations exceeding given marker cut-off concentrations also identified cats with low or borderline GFR with high sensitivities and specificities.

Conclusions and relevance

These simplified methods will facilitate the detection of early kidney dysfunction in cats. Early diagnosis allows timely therapeutic intervention, and future studies must reveal whether this improves the long-term outcome of cats with CKD.
The relation of red blood cell fatty acids with vascular stiffness, cardiac structure and left ventricular function: The Framingham Heart Study
Authors: Kaess Bernhard M , Harris William S , Lacey Sean , Larson Martin G , Hamburg Naomi M , Vita Joseph A , Robins Sander J , Benjamin Emelia J , Mitchell Gary F , Vasan Ramachandran S
Published: December 2014

Polyunsaturated fatty acids have been associated with beneficial influences on cardiovascular health. However, the underlying mechanisms are not clear, and data on the relations of polyunsaturated fatty acids to subclinical disease measures such as vascular stiffness and cardiac function are sparse and inconclusive. In a large community-based cohort, we examined the relations of omega-3 and other fatty acids to a comprehensive panel of vascular function measures (assessing microvascular function and large artery stiffness), cardiac structure and left ventricular function. Red blood cell (RBC) membrane fatty acid composition, a measure of long-term fatty acid intake, was assessed in participants of the Framingham Offspring Study and Omni cohorts and related to tonometry-derived measures of vascular stiffness and to a panel of echocardiographic traits using partial correlations. Up to n=3055 individuals (56% women, mean age 66 years) were available for analyses. In age- and sex-adjusted models, higher RBC omega-3 content was moderately associated ( p≤0.002) with several measures of vascular stiffness and function in a protective direction. However, after multivariable adjustment, only an association of higher RBC omega-3 content with lower carotid-femoral pulse wave velocity (a measure of aortic stiffness) remained significant ( r = −0.06, p=0.002). In secondary analyses, higher linoleic acid, the major nutritional omega-6 fatty acid, was associated with smaller left atrial size, even after multivariable adjustment ( r = −0.064, p<0.001). In conclusion, in our cross-sectional community-based study, we found several associations consistent with the notion of protective effects of omega-3 and linoleic acid. The clinical significance of these modest associations remains to be elucidated.
The first 10 years of the American Board of Vascular Medicine
Authors: Gray Bruce H , Jaff Michael R , Slovut David Paul , Bacharach J Michael , Carman Terry , Creager Mark , Halperin Jonathon , von Mering Gregory , Kinlay Scott
Published: December 2014

The American Board of Vascular Medicine (ABVM) was conceived through the Society for Vascular Medicine and this year will complete 10 years of certifying physicians who practice vascular medicine and endovascular medicine. The value of certification to our physicians, patients, and field cannot be understated. This paper reviews the highlights of the test development process, quality assurance measures, and management of these high stakes examinations.
Bobbles and values: An ethnography of de-bobbling garments in postsocialist urban Romania
Authors: Crăciun Magdalena
Published: December 2014

Based on research on clothing consumption in a provincial Romanian town, this article focuses on bobbling (pilling) and on reflections on its appearances and progression. Bobbling is considered an index of a faulty or decaying materiality, and an index of usage and, possibly, carelessness and hardship. It limits an individual’s ability to project a desired self. It hints at an individual’s inability to present a renewed self. It not only disrupts a common process of value creation through the act of dressing, but also exposes a disputed process of value creation through the consumption of certain objects. It foregrounds a predisposition to equate the value of objects with the value of people. It affects a sense of self-worth. The author demonstrates that a preoccupation with bobbling reflects deeper concerns and frequent deliberations over value in postsocialist Romania.
Multiculturalism and contextualism: How is context relevant for political theory?
Authors: Lægaard Sune
Published: December 2014

Many political theorists of multiculturalism (e.g. Joseph Carens, Bhikhu Parekh, James Tully) describe their theories as “contextualist.” But it is unclear what “contextualism” means and what difference it makes for political theory. I use a specific prominent example of a multiculturalist discussion, namely Tariq Modood’s argument about “moderate secularism,” as a test case and distinguish between different senses of contextualism. I discuss whether the claim that political theory is contextual in each sense is novel and interesting, and whether contextualism is a distinct feature of political theory of multiculturalism. I argue that the forms of contextualism which concern the scope and methodology of political theory are sensible, but not novel or distinctive of multiculturalism. I then discuss the more controversial forms of contextualism, which I call political and theoretical contextualism. Finally, I apply the distinctions to Modood’s argument. I argue that it is not a form of theoretical contextualism and that theoretical contextualism would in fact undermine arguments for multiculturalist policies of accommodation.
Philosophical anarchism and the paradox of politics
Authors: Arnold Jeremy
Published: December 2014

In this paper, I compare two prominent positions within contemporary “Analytic” and “Continental” political philosophy: philosophical anarchism and the paradox of politics. I compare each through an analysis of their respective criticisms of state legitimacy and the internal difficulties each position has in accounting for the legitimacy of state violence. I argue that these internal difficulties force each position to ask questions and criticize assumptions commonly found in the other position. I hope to show through this comparison that work across the analytic/continental divide can tell us a great deal about a range of intractable political phenomena.
Childcare providers: Work stress and personal well-being
Authors: Faulkner Monica , Gerstenblatt Paula , Lee Ahyoung , Vallejo Viana , Travis Dnika
Published: December 2014

Childcare providers face multiple work-related stressors. Small studies of childcare providers have suggested that providers have high levels of depression compared to the general population. However, unlike other caregiving professions, the research examining childcare providers is sparse, and there is little information to inform practices and policies to support childcare providers. This study identifies specific work-related stressors for childcare providers and examines the impact of those work-related stressors on their personal well-being. A total of 26 home-based and centre-based providers participated in seven focus groups in Central Texas. Themes from the focus groups identify parental interaction as the most prominent stressor for providers followed by the public perception of providers as “babysitters.” Providers also discussed the impact of stress on their personal well-being manifesting through exhaustion, sleep disturbances, and physical health problems.
Mind–Body Interventions
Authors: Kotecki Jerome , Khubchandani Jagdish , Simmons Rob , Sharma Manoj
Published: December 2014

Mind–body interventions (MBIs) have become increasingly popular. In the current article, we examine the potential role of MBIs for improving health and promoting wellness. We first describe typologies of MBIs and prevalence of their use. We also examine the efficacy evidence about how MBIs offer many psychological and physiological benefits, including reductions in disease symptoms and improvements in coping, behavior regulations, quality of life, and well-being. We further discuss how the health education discipline has long supported the inherent holism of the human being, the importance of healing potential of the mind on one’s health, and values capacity for self-regulation and describe the potential opportunities for health educators as it relates to MBIs. Finally, we discuss implications for the profession of health education and promotion.
The investigation of barrier and comfort properties of multifunctional coated conductive knitted fabrics
Authors: Varnaitė-Žuravliova Sandra , Sankauskaitė Audronė , Stygienė Laimutė , Krauledas Sigitas , Bekampienė Paulė , Milčienė Irena
Published: December 2014

The aim of this work was to investigate the barrier and comfort properties of protective uncoated and coated-impregnated three-layered knitted fabrics with different arrangements of special yarns, such as conductive yarns and yarns with different filament cross sections. Depending on content (7.5–30%) of conductive PES yarns with carbon core filaments and PES/stainless steel spun yarns, fabrics were grouped into A and B. In order to achieve multifunctional barrier and comfort properties, high porosity polyurethane and fluorocarbon resin coatings were applied. At the beginning of the research, the fabrics of groups A and B were coated with commercially available micro-porous polyurethane foam Tubicoat® MB according to the crushed foams method and impregnated with fluorocarbon water-repellent agent Tubiguard® 270. The achieved functional, barrier (water and oil repellency, resistance to water penetration, and electrostatic shielding), and comfort (air permeability, water vapor permeability, water retentivity, and drying intensiveness) properties were determined.
Computer-Aided Diagnosis for Distinguishing Pancreatic Mucinous Cystic Neoplasms From Serous Oligocystic Adenomas in Spectral CT Images
Authors: Li Chao , Lin Xiaozhu , Hui Chun , Lam Kin Man , Zhang Su
Published: December 2014

Objective:

This preliminary study aims to verify the effectiveness of the additional information provided by spectral computed tomography (CT) with the proposed computer-aided diagnosis (CAD) scheme to differentiate pancreatic serous oligocystic adenomas (SOAs) from mucinous cystic neoplasms of pancreas cystic lesions.

Materials and Methods:

This study was conducted from January 2010 to October 2013. Twenty-three patients (5 men and 18 women; mean age, 43.96 years old) with SOA and 19 patients (3 men and 16 women; mean age, 41.74 years old) with MCN were included in this retrospective study. Two types of features were collected by dual-energy spectral CT imaging as follows: conventional and additional quantitative spectral CT features. Classification results of the CAD scheme were compared using the conventional features and full feature data set. Important features were selected using support vector machine classification method combined with feature-selection technique. The optimal cutoff values of selected features were determined through receiver–operating characteristic curve analyses.

Results:

Combining conventional features with additional spectral CT features improved the overall accuracy from 88.37% to 93.02%. The selected features of the proposed CAD scheme were tumor size, contour, location, and low-energy CT values (43 keV). Iodine–water basis material pair densities in both arterial phase (AP) and portal venous phase (PP) were important factors for differential diagnosis of SOA and MCN. The optimal cutoff values of long axis, short axis, 40 keV monochromatic CT value in AP, iodine (water) density in AP, 43 keV monochromatic CT value in PP, and iodine (water) density in PP were 3.4 mm, 3.1 mm, 35.7 Hu, 0.32533 mg/mL, 39.4 Hu, and 0.348 mg/mL, respectively.

Conclusion:

The combination of conventional features and additional information provided by dual-energy spectral CT shows a high accuracy in the CAD scheme. The quantitative information of spectral CT may prove useful in the diagnosis and classification of SOAs and MCNs with machine learning algorithms.
Evaluation of Dose Uncertainty to the Target Associated With Real-Time Tracking Intensity-Modulated Radiation Therapy Using the CyberKnife Synchrony System
Authors: Iwata Hiromitsu , Inoue Mitsuhiro , Shiomi Hiroya , Murai Taro , Tatewaki Koshi , Ohta Seiji , Okawa Kohei , Yokota Naoki , Shibamoto Yuta
Published: December 2014

We investigated the dose uncertainty caused by errors in real-time tracking intensity-modulated radiation therapy (IMRT) using the CyberKnife Synchrony Respiratory Tracking System (SRTS). Twenty lung tumors that had been treated with non-IMRT real-time tracking using CyberKnife SRTS were used for this study. After validating the tracking error in each case, we did 40 IMRT planning using 8 different collimator sizes for the 20 patients. The collimator size was determined for each planning target volume (PTV); smaller ones were one-half, and larger ones three-quarters, of the PTV diameter. The planned dose was 45 Gy in 4 fractions prescribed at 95% volume border of the PTV. Thereafter, the tracking error in each case was substituted into calculation software developed in house and randomly added in the setting of each beam. The IMRT planning incorporating tracking errors was simulated 1000 times, and various dose data on the clinical target volume (CTV) were compared with the original data. The same simulation was carried out by changing the fraction number from 1 to 6 in each IMRT plan. Finally, a total of 240 000 plans were analyzed. With 4 fractions, the change in the CTV maximum and minimum doses was within 3.0% (median) for each collimator. The change in D99 and D95 was within 2.0%. With decreases in the fraction number, the CTV coverage rate and the minimum dose decreased and varied greatly. The accuracy of real-time tracking IMRT delivered in 4 fractions using CyberKnife SRTS was considered to be clinically acceptable.
Penny for Your Thoughts? The Protective Effect of Youths’ Attitudes Against Drug Use in High-Risk Communities
Authors: Wright Emily M. , Fagan Abigail A. , Pinchevsky Gillian M.
Published: December 2014

Individual-level attitudes about drugs are strong predictors of substance use among adolescents, and aggregate-level community norms regarding deviancy and drug use may influence youth attitudes as well as their drug use. This study examined the direct effects of neighborhood norms about deviance, disadvantage, immigrant concentration, and residential stability on youths’ attitudes about drug harmfulness as well as their variety of past month substance use. The moderating effect of community norms on the relationship between youth attitudes and drug use was also examined. Results suggest that community norms favorable to deviance and drug use reduced youth’s attitudes that drugs were harmful. Further, youth’s perceptions of drug harmfulness significantly reduced their substance use in the past month. Neighborhood concentrated immigration also significantly reduced substance use. Finally, living in areas where norms were favorable to deviance enhanced the protective effect of youths’ perceptions. Implications for research and substance use prevention strategies are discussed.
Contrasting Views of Risk Perception and Influence of Financial Compensation Between Adolescent Research Participants and Their Parents
Authors: Wiener Lori , Viola Adrienne , Wilfond Benjamin S. , Wendler David , Grady Christine
Published: December 2014

U.S. regulations governing pediatric research do not specify the assent process. To identify best practices, it is important to examine parents’ and adolescents’ views. The present study focuses on parents’ and adolescents’ views regarding possible research risks and the influence of financial compensation on their willingness to accept research procedures. Interviews were conducted with 177 adolescents participating in clinical research for a medical or psychiatric illness, or as healthy volunteers, and a parent. Significant discordance was found between how bothered the teen would feel from research-related side effects and procedures compared with parental report. Most teens were willing to accept non-beneficial procedures without compensation. Payment had significantly greater influence on healthy volunteers and their parents compared with those with a medical or psychiatric illness. Discordance between adolescent and parental views about risks recommends obtaining direct input from adolescents during the assent process. Modest payments should not raise concerns of undue inducement, especially in teens with pre-existing conditions.
Initial uptake of the Ontario Pharmacy Smoking Cessation Program
Authors: Wong Lindsay , Burden Andrea M. , Liu Yan Yun , Tadrous Mina , Pojskic Nedzad , Dolovich Lisa , Calzavara Andrew , Cadarette Suzanne M.
Published: December 2014

Background:

Smoking is a significant public health concern. The Ontario Pharmacy Smoking Cessation Program was launched in September 2011 to leverage community pharmacists and expand access to smoking cessation services for public drug plan beneficiaries.

Methods:

We examined health care utilization data in Ontario to describe public drug plan beneficiaries receiving, and pharmacies providing, smoking cessation services between September 2011 and September 2013. Patient characteristics were summarized, stratified by drug plan group: seniors (age ≥65 years) or social assistance. Trends over time were examined by plotting the number of services, unique patients and unique pharmacies by month. We then examined use of follow-up services and prescription smoking cessation medications.

Results:

We identified 7767 residents receiving pharmacy smoking cessation services: 28% seniors (mean age = 69.9, SD = 4.8; 53% male) and 72% social assistance (mean age = 44.4 years, SD = 11.8; 48% male). Cumulative patient enrollment increased over time with an average of 311 (SD = 61) new patients per month, and one-third ( n = 1253) of pharmacies participated by the end of September 2013. Regions with the highest number of patients were Erie St. Clair ( n = 1328) and Hamilton Niagara Haldimand Brant ( n = 1312). Sixteen percent of all patients received another pharmacy service (e.g., MedsCheck) on the same day as smoking cessation program enrollment. Among patients with follow-up data, 56% received follow-up smoking cessation services (60% seniors, 55% social assistance) and 74% received a prescription smoking cessation medication. One-year quit status was reported for 12%, with a 29% success rate.

Conclusions:

Program enrollment has increased steadily since its launch, yet only a third of pharmacies participated and 56% of patients received follow-up services.
Carbohydrate-to-Insulin Ratio in a Mediterranean Population of Type 1 Diabetic Patients on Continuous Subcutaneous Insulin Infusion Therapy
Authors: Alcántara-Aragón Valeria , Gonzalez Cintia , Corcoy Rosa , Ubeda Justa , Chico Ana
Published: December 2014

Background: The carbohydrate-to-insulin ratio (CIR) is initially calculated from the total daily insulin dose (TDID). However, CIR likely presents variations owing to different population characteristics and intraday variations not being taken into account by most formulas. No information is available concerning the Mediterranean population. We investigated the CIR used by patients with type 1 diabetes (T1DM) using continuous subcutaneous insulin infusion (CSII) therapy in a Mediterranean area, to identify possible intraday variations and establish an adequate formula to calculate CIR. Methods: Data from 170 T1DM patients from Barcelona were obtained retrospectively from the Spanish National Registry of CSII Therapy (SNR-CSII). Theoretical CIR was calculated using the formula: 500 divided by TDID. This theoretical CIR was compared to the real CIR. Results: The real CIR was also compared between main meals. Patients with HbA1c < 7% (n = 44) were considered a reference group for accurate bolus calculation and were analyzed as a subgroup. The real CIR used was 11.5 g/UI for breakfast, 12 g/UI for lunch, and 13.3 g/UI for dinner. CIR obtained by the 500/TDID formula for all meals was 15.5 g/UI. We obtained similar results for the group with HbA1c < 7%. The real CIR differed significantly from the theoretical CIR values and between breakfast and the other main meals ( P < .005). Conclusions: CIR in our population was significantly lower for breakfast than for other meals. CIR using the 500/TDID formula underestimated prandial insulin requirements. A calculation of 350/TDID for breakfast and 400/TDID for lunch and dinner would be more appropriate for this population.
Tides of Change
Authors: Mulla Christopher M. , Lieb David C. , McFarland Raymie , Aloi Joseph A.
Published: December 2014

Background: This study explores the relationship between education for inpatient diabetes providers and the utilization of insulin order sets, inpatient glucometrics, and length of stay in a large health care system. Methods: The study included patients with and without the diagnosis of diabetes. An education campaign included provider-directed diabetes education administered via online learning modules and in-person presentations by trained individuals. Relationships among provider-attended diabetes education, order set usage, and inpatient glucometrics (hypo- and hyperglycemia) were analyzed, as well as length of stay. Results: Insulin use knowledge scores for all providers averaged 52%, and improved significantly to 93% ( P < .001) by the end of the education intervention period. Likewise utilization of electronic basal-bolus order sets increased from a baseline of 20% for patients receiving insulin to 86% within 6 weeks ( P < .01) of introduction of order sets. During the study, the incidence of hypoglycemia and hyperglycemia declined from 1.47% to 1.27% and from 23.21% to 17.80%, respectively. However, these improvements were not sustained beyond the completion of the education campaign. Conclusions: Education of diabetes health care providers was provided in a large, multihospital system through the use of online learning modules. Adoption of standardized insulin order sets was associated with an improvement in glucometrics. This educational and quality initiative resulted in overall improvements in insulin knowledge, adherence to recommended order sets, inpatient glucometrics, and patient length of stay. These improvements were not sustained, reinforcing the need for repeated educational interventions for those involved in providing inpatient diabetes care.
Evaluating Principal-Preparation Programs Based on Placement Rates
Authors: Fuller Edward J. , Hollingworth Liz
Published: December 2014

Recent calls to hold preparation programs accountable for outcomes have led states to develop and adopt preparation program accountability systems. A primary feature of these systems is a focus on outcomes such as placement rates, retention rates, and graduates’ effectiveness in improving K-12 student achievement. Yet, little research has examined the feasibility of employing such outcome measures, let alone the validity and reliability of the inherent judgments. This conceptual study reviews and makes conclusions about the appropriateness of using placement rates to evaluate principal-preparation programs based on theoretical analyses and empirical analysis of statewide placement data from Texas.