bluuebunny/crossref_metadata_2025 huggingface dataset:
The Contemporary U.S. Child Welfare System(s): Overview and Key Challenges
Authors: Berger Lawrence M. , Slack Kristen S.
Published: January 2021

This volume of The ANNALS aims to increase awareness among scholars, policy-makers, and practitioners of the size, scope, and functions of child welfare services in the United States. We aim to promote a wider understanding of the broad impacts of child welfare policies and point to ways in which child welfare services can be better incorporated into cross-cutting social policy debates. The articles in this volume offer concrete recommendations for policies and practices that can reduce child maltreatment, and for systemic approaches—both within the purview of child welfare services and across the broader community and social policy landscape—that can better identify and respond to the needs of children and families in which maltreatment has already occurred or where there is a risk of abuse and neglect. This introduction sets a foundation for understanding the contents of the volume: we provide an overview of child welfare services in the United States and highlight current challenges that the U.S. child welfare systems face.
The Scope, Nature, and Causes of Child Abuse and Neglect
Authors: Font Sarah A. , Maguire-Jack Kathryn
Published: January 2021

Child maltreatment is a complex problem affecting millions of children in the United States every year. This article examines existing knowledge on the scope, nature, and causes of child abuse and neglect. First, we review the discordant definitions and conceptualizations of child maltreatment and consider the implications of broad and narrow definitions for the size and scope of the child welfare system and for child safety. Second, we provide an assessment of the quality and comprehensiveness of existing data for understanding the incidence rates and trends in child abuse and neglect. Third, we review theory and evidence on the causes of child maltreatment, with particular attention to whether and how social policy can reduce its prevalence. Last, we provide recommendations for improving the use of data and scientific evidence in child welfare policy and systems.
Child Welfare Financing: What Do We Fund, How, and What Could Be Improved?
Authors: Haskins Ron
Published: January 2021

Government efforts toward the prevention, detection, and investigation of child abuse and neglect are carried out through the United States’ child welfare system—a complex web of programs that provide family assistance and promote child safety. Most funding for these activities is split among federal, state, and local governments and comprises specific child welfare–related funding (such as Titles IV-E and IV-B of the Social Security Act) and non–child welfare funding that is spent on programs that support poor and disadvantaged families (Medicaid and TANF). I provide an overview of these funding streams that finance the child welfare system, review the federal legislation since 1970 that has led to the current funding structure, and end with a discussion of how the Family First Prevention Services Act of 2018 has the potential to create better outcomes for children and families by promoting prevention activities and program support with strong evidence of success.
The Social Welfare Policy Landscape and Child Protective Services: Opportunities for and Barriers to Creating Systems Synergy
Authors: Feely Megan , Raissian Kerri M. , Schneider William , Bullinger Lindsey Rose
Published: January 2021

Contemporary child welfare policies in the United States are well-suited for prevention of child abuse but fail to account for the relationship between family financial hardship and neglect, that is, the lack of safe and consistent care. We argue that rates of child neglect have been stagnant because of two failures: (1) lack of recognition of financial hardship as a causal mechanism of neglect and (2) federal policy that purposefully omits alleviation of financial hardship as a solution to the occurrence of neglect. Because U.S. antipoverty programs operate independently of one another, our siloed policy structure misses opportunities for the alleviation of child maltreatment and, worse, creates negative and unintended consequences in child welfare. We present a model for change: systems synergy for the promotion of safe and consistent care that makes reduction of child maltreatment the responsibility of every social service program in the United States.
Frequency-Specific Analysis of Hearing Outcomes Associated with Ossiculoplasty Versus Stapedotomy
Authors: Nguyen Denis D. , Judd Ryan T. , Imbery Terence E. , Gluth Michael B.
Published: January 2021

Objective:

Surgery on the ossicular chain may impact its underlying mechanical properties. This study aims to investigate comparative differences in frequency-specific hearing outcomes for ossiculoplasty versus stapedotomy.

Methods:

A retrospective chart review was conducted on subjects who underwent ossiculoplasty with partial ossicular replacement prosthesis (PORP) or laser stapedotomy with self-crimping nitinol/fluoroplastic piston, and achieved closure of postoperative pure tone average air-bone gap (PTA-ABG) ≤ 15 dB. 45 PORP and 38 stapedotomy cases were included, with mean length of follow-up of 7.6 months.

Results:

The mean change in PTA-ABG was similar for the 2 procedures (−17.9 dB vs −18.1 dB, P = .98). Postoperative ABG closure for stapedotomy was superior at 1000 Hz (8.9 dB vs 13.9 dB, P = .0003) and 4000 Hz (11.8 dB vs 18.0 dB, P = .0073). Both procedures also had improved postoperative bone conduction (BC) thresholds at nearly all frequencies, but there was no statistical difference in the change in BC at any particular frequency between the 2 procedures.

Conclusion:

Both procedures achieved a similar mean change in PTA-ABG. Stapedotomy was superior to PORP at ABG closure at 1000 Hz and at 4000 Hz, with 1000 Hz the most discrepant. The exact mechanism responsible for these changes is unclear, but the specific frequencies affected suggest that differences in each procedure’s respective impact on the native resonant frequency and mass load of the system could be implicated.
Multimorbidity and vulnerability among those living with psychosis in Indigenous populations in Cape York and the Torres Strait
Authors: Charlson Fiona , Gynther Bruce , Obrecht Karin , Waller Michael , Hunter Ernest
Published: January 2021

Objective:

Previous research has found an alarmingly high rate of psychosis in Indigenous1 patients from remote communities of Cape York and the Torres Strait with the treated prevalence of psychosis four times higher than that found for the Australian population. This study assesses comorbid illness and risk factors among this same cohort of psychosis patients.

Methods:

Data were collated from a clinical database that contains complete psychiatric records from 1992 to 2015, extracted for all Indigenous patients who received treatment for a psychotic disorder from the Remote Area Mental Health Service. Descriptive analysis and logistic regression models explored differences across subgroups of ethnicity and sex, and relationships between co-morbid disorders and risk factors. All multivariate models included variables of age, year of birth, sex and ethnicity.

Results:

Sixty per cent of participants ( n = 256) experienced a comorbid mental or substance use disorder. Forty-five per cent ( n = 192) of participants experienced a physical comorbidity. The most frequent physical health outcomes were injury (29%, n = 93), diabetes (18%, n = 58) and cardiovascular disease (21%, n = 68). Risk factors considered to play a potential biological or neurodevelopmental role in the development of psychosis were approximately three times more likely in Aboriginal (odds ratio = 3.2; 95% confidence interval = [2.0, 4.9]) versus Torres Strait Islander patients, and those born after 1980 (odds ratio = 2.5; 95% confidence interval = [1.6, 3.9]) versus those born prior to 1980. Environmental or contextual factors were associated with significantly greater risk among Aboriginal (odds ratio = 3.8; 95% confidence interval = [2.4, 6.0]) compared with Torres Strait Islander patients.

Conclusion:

Our data expose the perinatal and early environment of Indigenous children who later developed a psychotic disorder. As risk factors for schizophrenia may be cumulative and interactive, both with each other and with critical periods of neurodevelopmental vulnerability, our results suggest possible causes for the increasing prevalence of psychotic disorders between 1992 and 2015.
The visual international politics of the European refugee crisis: Tragedy, humanitarianism, borders
Authors: Hansen Lene , Adler-Nissen Rebecca , Andersen Katrine Emilie
Published: January 2021

The European refugee crisis has been communicated visually through images such as those of Alan Kurdi lying dead on the beach, by body bags on the harbor front of Lampedusa, by people walking through Europe and by border guards and fences. This article examines the broader visual environment within which EU policy-making took place from October 2013 to October 2015. It identifies ‘tragedy’ as the key term used by the EU to explain its actions and decisions and points out that discourses of humanitarianism and border control were both in place. The article provides a theoretical account of how humanitarianism and border control might be visualized by news photography. Adopting a multi-method design and analyzing a dataset of more than 1000 photos, the article presents a visual discourse analysis of five generic iconic motifs and a quantitative visual content analysis of shifts and continuity across four moments in time. The article connects these visual analyses to the policies and discourses of the EU holding that the ambiguity of the EU’s discourse was mirrored by the wider visual environment.
Global Justice and the Role of Stakeholding
Authors: Brooks Thom
Published: January 2021

Most research in global justice considers international distributive justice from a perspective of what duties, if any, affluent states have towards people in severe poverty. The debate usually focuses on whether positive or negative duties are most relevant and how they should be applied. This article challenges this orthodoxy by defending stakeholder theory as a promising new approach overcoming limitations in current debates through promotion of the virtue of stakeholders having a say where they have a stake.
Mechanical characteristics of composites based on oil palm empty fruit bunch, modified oca starch and polyvinyl alcohol
Authors: Valle Vladimir , Baquero Paulina , Rico Paola , Kreiker Jerónimo , Raggiotti Belén , Cadena Francisco
Published: January 2021

Tensile behavior of empty fruit bunch (EFB) reinforced modified-starch/polyvinyl alcohol (PVA) composites was studied. Initially, oca starch was chemically modified and characterized by nitrogen content. Afterward, a modified-starch/PVA blend was prepared. Spectrophotometric assessment of blend was carried out by Fourier transform infrared spectroscopy (FTIR). Besides, blend and EFB were evaluated through thermogravimetric analysis (TGA). Composite formulation was performed considering EFB loading (10 and 20 wt. %), EFB particle size (0.425 and 0.600 mm), and processing temperature (80 and 100 °C). FTIR and nitrogen content results confirmed the presence of starch carbamates as a product of chemical modification. TGA evidenced three and four decomposition stages for EFB and blend, respectively. On the other hand, the statistical evaluation showed that EFB content and particle size-processing temperature correlation were the main influence on tensile characteristics. Overall, tensile modulus raised as EFB loading increased, whereas tensile strength decreased slightly with EFB increment. Elongation at break fell by the addition of EFB. Notwithstanding the wide dispersion of tensile properties, results showed similarities to other analogous studies. Therefore, green composites based on oca starch carbamates and EFB have the potential to be duly enhanced by the optimization of fiber-matrix interaction.
Experiences of Maternity Healthcare Professionals Returning to Work Following a Personal Perinatal Loss: A Scoping Review of the Literature
Authors: Musodza Wimbayi , Sheehan Athena , Nicholls Daniel , Dahlen Hannah
Published: January 2021

Background

In Australia, midwives care closely for women during pregnancy and birth and the immediate postnatal period. This scoping review aimed to explore the experiences of female maternity healthcare professionals when they return to work following a personal pregnancy loss or neonatal death. Methodology: A scoping review was carried out on published and unpublished research and grey literature looking at how maternity healthcare professionals who have had a personal perinatal loss experience working in a maternity setting following the loss. A search of the literature was performed between October and December 2018, with no set limitations. A search for relevant references from included papers was also carried out. The literature was analysed thematically. The types of perinatal loss were defined as per Australian guidelines.

Results

10 articles were included in this scoping review. Four themes emerged from the literature and these were: 1) Impact of being asked, “have you got children?”; 2) Impact on professional practice; 3) Impact of pre-existing professional knowledge; 4) Importance of collegial support on return to work.

Conclusions

Return to work in a maternity setting following a personal perinatal loss is emotionally challenging and requires a range of supports. Further research is needed in this area.
Sex Does Not Sell: Effects of Sexual Advertising Parameters on Women Viewers’ Implicit and Explicit Recall of Ads and Brands
Authors: Lawrence Helena , Furnham Adrian , McClelland Alastair
Published: January 2021

This study investigated implicit and explicit memory effects of sexual and non-sexual advertisements embedded in either a sexual or non-sexual program among women viewers. We predicted that sexual appeals would facilitate implicit memory for the brand, and we explored whether program-type (sexual or non-sexual) and its associated congruity would impact or moderate recall of the surrounding advertisement among a small sample (n = 52) of exclusively women advertisement viewers. Sexual (versus non-sexual) advertising led to significantly worse implicit memory for the brand logo but better explicit recall for the advertisement scene itself. There was no effect of sexual appeals on explicit brand name recall, and no significant effect on advertisement recall of the program type. There was a significant interaction effect for program type and advertisement type for explicit recall of the advertisement scene, in which program-type moderated sexual advertisement recall. These results suggest that sexual advertising may increase memory for the advertisement at the expense of recalling the brand advertised. Limitations and implications of this study are discussed.
Book review: Hilal Ahmed, Siyasi Muslims: A Story of Political Islams in India
Authors: Kapoor Aditya Ranjan
Published: January 2021

Hilal Ahmed, Siyasi Muslims: A Story of Political Islams in India. New Delhi: Penguin Viking, 2019, 240 pp., ₹599 (Hardback). ISBN: 978-0-670-09140-9.
Organising care and community in the era of the ‘gay disease’: Gay community responses to HIV/AIDS and the production of differentiated care geographies in Vancouver
Authors: Catungal John Paul , Klassen Benjamin , Ablenas Robert , Lambert Sandy , Chown Sarah , Lachowsky Nathan
Published: January 2021

Scholarship on the place of the HIV/AIDS crisis in urban geographies of sexual minority activism has powerfully insisted on the importance of community organising as a response to state and societal failures and to their homophobic, AIDS phobic and morally conservative underpinnings. This paper extends this scholarship by examining the urban social geographies of exclusion produced by such community organising efforts. It draws on the perspectives of long-term survivors of HIV/AIDS (LTS) in Vancouver to highlight the differentiated care geographies of HIV/AIDS that resulted from the racialised, classed and gendered politics and urban imaginations enacted by gay and allied HIV/AIDS organising. Though LTS networks, spaces and politics of care and community were more extended than Vancouver’s gay community during the 1980s and 1990s, the centring of the West End gay village in many community-led responses to HIV/AIDS resulted in LTS geographies outside the West End being excluded from important systems of care and community. LTS narratives of the city at the time of the ‘gay disease’ thus tell an urban politics of sexual and health activisms as shaped not only by processes of heteronormativity and homophobia but also of racially, colonially and class-inflected homonormative urban imaginaries.
A Transformational Approach to Developing Cultural Humility in the Classroom
Authors: Farrelly Denise , Kaplin Daniel , Hernandez Delia
Published: January 2021

Introduction:

Undergraduate psychology programs offer opportunities for the development of knowledge and specialized skills in order to equip students to work with diverse populations.

Statement of the Problem:

It is crucial for psychology clinicians and other human service providers to understand and be responsive to the scope of cultural diversity. To be effective, they must demonstrate cultural humility through an anti-bias approach.

Literature Review:

We review research pertaining to cultural diversity, cultural humility, and the social and pedagogical implications associated with these constructs.

Teaching Implications:

We offer one approach for fostering the development of cultural humility through a 6-week Cultural Humility Learning Module that capitalizes on the principles of diversity, privilege and bias, cultural humility, fairness, and social justice.

Conclusion:

Through piloting and refining the learning module in our own classrooms, we believe that this approach shows promise of transformational learning. We offer the reader potential ways to assess the effectiveness of the module.
Study of B-spline collocation method for solving fractional optimal control problems
Authors: Edrisi-Tabriz Yousef , Lakestani Mehrdad , Razzaghi Mohsen
Published: January 2021

In this article, a class of fractional optimal control problems (FOCPs) are solved using a direct method. We present a new operational matrix of the fractional derivative in the sense of Caputo based on the B-spline functions. Then we reduce the solution of fractional optimal control problem to a nonlinear programming (NLP) one, where some existing well-developed algorithms may be applied. Numerical results demonstrate the efficiency of the presented technique.
Improving Social Performance Through Video-feedback with Cognitive Preparation in Children with Emotional Problems
Authors: Melero Silvia , Morales Alexandra , Espada José Pedro , Orgilés Mireia
Published: January 2021

Anxious children report a more negative perception of their social performance and increased nervous behaviors. The video-feedback with cognitive preparation allows children to contrast and modify their negative social self-image, increasing their self-confidence and decreasing anxiety behaviors. This study aimed to examine the effectiveness of the Super Skills for Life (SSL) program in improving social performance in a sample of children with emotional symptoms. Results indicated that both objective and subjective evaluation showed positive effects of the SSL program on the children’s social performance, enhancing their social skills and reducing anxiety behaviors in social situations, both during the program and in the last session. Girls felt more comfortable and showed better speech and social performance than boys. Our findings increase the evidence about the short-term effects of the video-feedback with cognitive preparation of the SSL program and provide a useful transdiagnostic protocol for application in the clinical setting.
Comparison of the Cerumenolytic Activities of New and Currently Used Agents
Authors: Anh Nguyen Quynh , Numthavaj Pawin , Bhongmakapat Thongchai
Published: January 2021

Objectives:

This study compared the cerumen dissolution activities of 7.5% sodium bicarbonate, 5% potassium hydroxide, 10% lactic acid, 3% salicylic acid, 10% glycolic acid, and distilled water.

Methods:

An in vitro study was conducted with 36 cerumen samples. The cerumenolytic activities of the 6 agents were assessed by recording the degree of cerumen disintegration using digital photography at 15 minutes, 30 minutes, 1 hour, 2 hours, and 12 hours. The undissolved cerumen that remained after 12 hours was removed from the solutions and weighed after drying.

Results:

Potassium hydroxide showed the fastest cerumenolytic activity, dissolving a moderate amount of cerumen at 30 minutes, while glycolic acid and salicylic acid caused no visible changes in the cerumen samples. Samples treated with potassium hydroxide and sodium bicarbonate exhibited higher degrees of disintegration compared to samples treated with distilled water (odds ratio and 95% CI: 273.237 [0.203-367 470.4] and 1.129 [0.002-850.341], respectively). The greatest reduction in cerumen weight was associated with the use of sodium bicarbonate; however, this result did not reach statistical significance.

Conclusions:

Among the solutions tested, 5% potassium hydroxide showed the fastest dissolution activity, yielding moderate disintegration within only 30 minutes. In terms of residual cerumen weight within 12 hours, all solutions exhibited equivalent effectiveness in the disintegration of cerumen.
The expertocratic shortcut
Authors: Gabriëls René
Published: January 2021

Lafont rightly criticizes the expertocratic shortcut, i.e. the expectation that citizens blindly defer to experts. This shortcut is based on the assumptions that citizens are generally politically ignorant. I will argue that it is necessary to address not only the political ignorance of citizens, but also that of politicians, scientific experts and entrepreneurs. Just like politicians, scientific experts often show political ignorance towards citizens. This is the case if they do not consider the perspective of citizens in politically charged research. Unlike Lafont, I believe that if citizens are expected to blindly defer to politicians, there is no expertocratic shortcut, but a form of authoritarianism that fosters populism. Lafont overlooks an expertocratic shortcut: scientific experts who expect politicians to blindly defer to them, i.e. to accept the agenda they set. It is noteworthy that neither Lafont nor her opponents defending an expertocratic shortcut explicitly discuss the tension between capitalism and democracy. They should do so in order to explain which citizens are ignorant and bypassed, and which are not. The socio-economic inequalities inherent in capitalism correspond to the degree of political interest and participation of citizens. Entrepreneurs are often not only politically ignorant towards citizens, but also towards politicians and scientific experts. Their political ignorance is due to the fact that they are most often in a dominant position where politicians, scientific experts and citizens depend on them. This can be traced back to what I call the neoliberal shortcut: the expectation that actors blindly defer to the markets.
Democratic deliberation and economic democracy
Authors: Wesche Tilo
Published: January 2021

In Democracy without Shortcuts, Cristina Lafont elaborates the view that participatory deliberation is at the heart of every democracy and that both truth-tracking and mutual justification are the aims of democratic deliberation. What remains unconsidered in her approach is the economic framework in which democratic deliberation takes place. In my comment, I will take the following view: no political democracy without a democratisation of the economy. I will elaborate on this relationship as a concept of economic democracy. I will argue for that there is no political democracy without an economic democracy.
The Impact of Compulsory Schooling on Hourly Wage: Evidence From the 1999 Education Reform in Poland
Authors: Liwiński Jacek
Published: January 2021

Background:

In 1999, an education reform was implemented in Poland, which added 1 year to the shortest available educational path—that of basic vocational education. Under the new system, students choosing this path receive one additional year of general education. According to the authors of the reform, this should improve the students’ position in the labor market, as a shortage of general skills was identified as the main deficit of basic vocational school leavers prior to the reform.

Purpose:

The study assesses the impact of the 1999 reform on the hourly wage of individuals who completed formal education after obtaining a basic vocational school certificate.

Methods:

The analysis is based on individual data from the Polish Labor Force Survey for the years 2001–2016. As the education reform was implemented simultaneously across the country, a regression discontinuity design is used to assess its impact.

Results and Conclusions:

The study finds that one additional year of general education has led to a 13% increase in the hourly wages of individuals who completed basic vocational schools. This effect is higher than those reported in studies for other countries where the wage premium is typically found to be under 10%. This may be because the extension of compulsory schooling in Poland affected individuals with relatively low general skills and abilities.
Preservice music teachers’ self-efficacy and concerns before and during student teaching
Authors: Regier Bradley J
Published: January 2021

The purpose of this study was to investigate the experiences and contextual factors that influenced preservice music teachers’ self-efficacy and concerns from pre-student teaching to student teaching. Data were collected for this case study through an open-response questionnaire about participants’ ( N = 4) efficacious teaching experiences, 10 weekly e-journal reflections written during pre-student teaching ( n = 5 weeks) and student teaching placements ( n = 5 weeks at 1 placement), interviews ( n = 4), and my own researcher journal ( n = 31 entries). Preservice teachers’ self-efficacy and concerns were most impacted by teaching experiences in familiar settings. Results indicated that participants made more comments about student-impact and self-survival concerns during student teaching than pre-student teaching. Further investigation revealed that participants consistently expressed concerns for classroom management during pre-student teaching and student teaching placements. Finding ways to expedite the developmental process could reduce the amount of time that preservice teachers focus on early contextual factors and instead identify ways to improve students’ music and academic performance.
A Theory of Relativity of Cultures, Incomes and Happiness
Authors: Rötheli Tobias F.
Published: January 2021

The concepts of cultural relativism (introduced by Franz Boas) and hedonic relativism (introduced by Richard Easterlin) are reference points of a theory that addresses international differences in per capita incomes and variations in the contribution of income to happiness. The pivotal concept in this study is diligence. Painstaking effort, that is, diligence, is needed to produce high quality goods and services. The downside of such efforts lies in the psychological burden that comes with the necessary high level of self-control of the individual worker and the required organisational feedback mechanisms in firms. We present two competing views concerning the determination of diligence. The first, anthropologically inspired, hypothesis states that a society’s cultural forces such as cognitive styles, organisational traditions and religion determine the level of diligence. One implication of this perspective is that societies can have income levels that are either too high or too low relative to the welfare optimum. The second view holds that diligence is determined in a maximising way, balancing the gains and pains of diligence in the economic realm. Cross-country data are studied in order to assess the two competing views. The econometric evidence indicates that it is the maximising view that can explain key aspects of the data.

JEL: D63, P5, Z1
AIR-Act2Act: Human–human interaction dataset for teaching non-verbal social behaviors to robots
Authors: Ko Woo-Ri , Jang Minsu , Lee Jaeyeon , Kim Jaehong
Published: January 2021

To better interact with users, a social robot should understand the users’ behavior, infer the intention, and respond appropriately. Machine learning is one way of implementing robot intelligence. It provides the ability to automatically learn and improve from experience instead of explicitly telling the robot what to do. Social skills can also be learned through watching human–human interaction videos. However, human–human interaction datasets are relatively scarce to learn interactions that occur in various situations. Moreover, we aim to use service robots in the elderly care domain; however, there has been no interaction dataset collected for this domain. For this reason, we introduce a human–human interaction dataset for teaching non-verbal social behaviors to robots. It is the only interaction dataset that elderly people have participated in as performers. We recruited 100 elderly people and 2 college students to perform 10 interactions in an indoor environment. The entire dataset has 5,000 interaction samples, each of which contains depth maps, body indexes, and 3D skeletal data that are captured with three Microsoft Kinect v2 sensors. In addition, we provide the joint angles of a humanoid NAO robot which are converted from the human behavior that robots need to learn. The dataset and useful Python scripts are available for download at https://github.com/ai4r/AIR-Act2Act . It can be used to not only teach social skills to robots but also benchmark action recognition algorithms.
Usefulness of computed tomography in the diagnosis of acute pyelonephritis in older patients suspected of infection with unknown focus
Authors: Yano Tetsuhiro , Takada Toshihiko , Fujiishi Ryuto , Fujii Kotaro , Honjo Hiroshi , Miyajima Masayuki , Takeshima Taro , Hayashi Michio , Miyashita Jun , Azuma Teruhisa , Fukuhara Shunichi
Published: January 2021

Background

In older adults, the diagnosis of acute pyelonephritis is challenging because of non-specific symptoms and false-positive urine test results. Few studies have investigated the diagnostic performance of computed tomography (CT) signs.

Purpose

To evaluate the diagnostic performance of CT signs for acute pyelonephritis in older patients suspected of infection with unknown focus.

Material and Methods

This cross-sectional study was conducted between 2015 and 2018. Patients aged ≥65 years who underwent blood cultures, urine culture, and non-contrast or contrast-enhanced CT on admission were included. Cases with clinically presumable infection focus before CT were excluded. Two radiologists blinded to clinical information independently reviewed five CT signs: perirenal fat stranding; pelvicalyceal wall thickening and enhancement; renal enlargement; thickening of Gerota’s fascia; and area(s) of decreased attenuation. The final diagnoses were made by a clinical expert panel.

Results

Among 473 eligible patients, 61 were diagnosed with acute pyelonephritis. When the laterality of findings between the left and right kidneys were considered, the positive and negative likelihood ratios of perirenal fat stranding were 4.0 (95% confidence interval [CI] = 2.3–7.0) and 0.8 (95% CI = 0.7–0.9) in non-contrast CT, respectively. The other signs in non-contrast CT showed similar diagnostic performance with positive and negative likelihood ratios of 3.5–11.3 and 0.8–0.9, respectively.

Conclusion

CT signs can help physicians diagnose acute pyelonephritis in older patients suspected of infection with unknown focus.
Nonstructural bone graft for single-segment lumbar tuberculosis: surgical indications, clinical efficacy, and preliminary experiences in 34 patients
Authors: Du Xing , Ou Yunsheng , Jiang Guanyin , Zhu Yong , Luo Wei , Jiang Dianming
Published: January 2021

Objective

This study was performed to evaluate the surgical indications, clinical efficacy, and preliminary experiences of nonstructural bone grafts for lumbar tuberculosis (TB).

Methods

Thirty-four patients with lumbar TB who were treated with nonstructural bone grafts were retrospectively assessed. The operative time, operative blood loss, hospital stay, bone graft fusion time, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) concentration, visual analog scale (VAS) score, Oswestry Disability Index (ODI), American Spinal Injury Association (ASIA) impairment grade, and Cobb angle were recorded and analyzed.

Results

The mean operative time, operative blood loss, hospital stay, Cobb angle correction, and Cobb angle loss were 192.59 ± 42.16 minutes, 385.29 ± 251.82 mL, 14.91 ± 5.06 days, 9.02° ± 3.16°, and 5.54° ± 1.09°, respectively. During the mean follow-up of 27.53 ± 8.90 months, significant improvements were observed in the ESR, CRP concentration, VAS score, ODI, and ASIA grade. The mean bone graft fusion time was 5.15 ± 1.13 months. Three complications occurred, and all were cured after active treatment.

Conclusions

Nonstructural bone grafts may achieve satisfactory clinical efficacy for appropriately selected patients with lumbar TB.
Adolescents with cancer on privacy: Fact-finding survey on the need for confidentiality and space
Authors: Silva Matteo , Barretta Francesco , Luksch Roberto , Terenziani Monica , Casanova Michela , Spreafico Filippo , Meazza Cristina , Podda Marta , Biassoni Veronica , Schiavello Elisabetta , Chiaravalli Stefano , Puma Nadia , Bergamaschi Luca , Gattuso Giovanna , Sironi Giovanna , Adduci Annarita , Grampa Paolo , Massimino Maura , Ferrari Andrea
Published: January 2021

Background:

Cancer diagnosis and related treatment can limit young patients’ privacy. Their need for private physical and psychological spaces can be impeded by limited freedom, e.g., sharing hospital rooms with others and exposing their body to their parents and doctors.

Methods:

We conducted a survey among young patients of our center to investigate how their perception of privacy changed after being diagnosed with cancer and their need for hospital dedicated physical spaces and time for patients to enjoy their privacy. A questionnaire with 16 items was developed by the staff involving psychologists and physicians. The relevance of changes before and after the cancer diagnosis was assessed by calculating two scores indicating the situation before and after diagnosis for each answer, as well as a delta score.

Results:

Between May and June 2020, the questionnaire was completed by 60 patients aged 16–24 years. The median delta scores describing the changes before and after diagnosis were −8 points for perception of privacy, indicating a significant decrement of the level of privacy perceived. A major issue was the constant presence of parents being perceived as intrusive. Concerning hospital dedicated physical spaces and time for patients to enjoy their privacy, respondents requested dedicated spaces (50% of patients) and opportunities to have private interviews with medical personnel (88%).

Conclusions:

Our study offers a snapshot of how young people with cancer perceive the impact of the disease and its treatment on their privacy with the restrictions imposed on their individual freedom. Patients’ personal needs must be taken into consideration to adopt appropriate measures and better organize wards.
Transit Accessibility Measurement Considering Behavioral Adaptations to Reliability
Authors: Bills Tierra S. , Carrel Andre L.
Published: January 2021

Accessibility measures are necessary for evaluating the benefits of proposed transportation improvements. However, they often do not account for travel time unreliability, but instead incorporate deterministic and time-invariant travel times. This approach risks mischaracterizing the accessibility experienced by travelers. In this paper, we review recent literature on accessibility and travel time reliability with a focus on transit and introduce an approach to joint accessibility-reliability measurement that relies on a behavioral perspective. Using this behavioral perspective, we propose that existing accessibility measures be implemented using travelers’ total travel time budget as a measure of travel time, and that varying departure time strategies depending on service characteristics be considered. The total travel time budget can reasonably be quantified with a high percentile of the total travel time distribution. However, we note that different percentiles may be more appropriate for different traveler types, as these percentiles correspond to varying tolerances for late arrivals. This behavioral perspective can be operationalized with commonly used accessibility measures, such as the cumulative opportunity measure, and with real-time vehicle location data. We include a demonstration of the potential changes in accessibility estimates when accounting for travel time unreliability, with a simplified case study of a transit route in San Francisco. The results show a considerable reduction of the number of opportunities available to travelers when the calculation is based on the latter—between 5.9% and 37.9% less, depending on various factors. Such differences have the potential to significantly affect the accessibility benefits of transit capital investments.
Measuring Benefits of Rural and Small Urban Transit in Greater Minnesota
Authors: Mattson Jeremy , Peterson Del
Published: January 2021

The objective of this research was to measure the benefits of rural and small urban transit services in Minnesota. The study accomplished this by first identifying, describing, and classifying the potential benefits of transit. Second, a method was developed to measure these benefits. Where possible, benefits were quantified in dollar values. Other benefits that could not be quantified in monetary terms were either quantified in another way or described qualitatively. The study included an analysis of societal benefits and economic impacts within local communities. Third, the developed method was applied to a series of six case studies across Greater Minnesota. Data were collected through onboard rider surveys for each of the six transit agencies. Total benefits and benefit-cost ratios were estimated for the six transit agencies—all showed benefits that exceeded costs—and results were generalized to Greater Minnesota. Economic impacts were also estimated showing the effect on jobs, labor income, and value added. This research provides information to assess the benefits of public spending on transit, which gives decision makers the data needed to inform investment decisions.
Development of High Friction Surface Treatment Prescreening Protocols and an Alternative Friction Application
Authors: Bennert Thomas , Blight Robert , Ganji Vahid , Tulanowski Drew , Gresavage Susan
Published: January 2021

The use of high friction surface treatments (HFST) has become increasingly popular to help improve roadway friction properties and reduce the number of lane-departure and breaking-related accidents. Conventional HFST installation consists of applying an epoxy-resin material to an existing roadway surface and “gluing” a hard, highly angular fine aggregate to the roadway surface. When constructed correctly, skid resistance values (SN40) are often measured in the upper 60s and 70s. However, this functional overlay does not come without potential issues. Performance and service life is strongly dependent on the quality of the construction process, as well the quality of the substrate, which is often difficult to assess in situ. The paper summarizes the forensic testing of three HFST installations in New Jersey—one performing well and two showing premature failure. Testing procedures and preliminary criteria for existing asphalt pavement surfaces were developed to address whether or not epoxy-resin HFST is a viable option. Additionally, the paper summarizes the development and forensic testing of a potential alternative to the epoxy-resin based HFST application. This alternative surface, called a high friction chip seal (HFCS), incorporates the same hard, highly angular fine aggregate but using asphalt binder as the “gluing” medium within the chip seal application process. Three different aggregate sources were evaluated using the HFCS application on Rt 68 in New Jersey. Laboratory testing of the aggregates, as well as field measurements of the test sections, were conducted. It was found that HFCS could be a potential alternative for areas where premature HFST failure is a concern.
Democracy vs. demography: Rethinking politics and the people as debate
Authors: Palonen Emilia
Published: January 2021

Rise of populist politics in the 21s century calls scholars and politicians alike to reflect upon the question of how politics and democracy have been understood. Drawing on the theory of hegemony, this article establishes a distinction between democracy and ‘demography’ as a key line of conceptualization in politics. It highlights a central misunderstanding at the core of the demonization of populism: For radical democratic theory, ‘the people’ is not a demographic, socio-economic, or historically sedimented category tied to some characteristics, but a performative process of ‘being’ and ‘becoming’ ‘the people’ as a self-consciously enacted polity. This statement challenges the taken-for-granted status of subjectivities of political struggle and links this approach to other contemporary discussions of politics, democracy, and populism. After discussing how anti, neo and post-foundational theoretical accounts on populism reveal a dimension of politics and representation, this article emphasizes action and performativity over static categories and models characteristic of political realism and political system approaches.
Sexual and Reproductive Health Outcomes among Incarcerated Women in Canada: A Scoping Review
Authors: Paynter Martha , Heggie Clare , McKibbon Shelley , Martin-Misener Ruth , Iftene Adelina , Murphy Gail Tomblin
Published: January 2021

Background

Women are the fastest growing population in Canadian prisons. Incarceration can limit access to essential health services, increase health risks and disrupt treatment and supports. Despite legal requirements to provide care at professionally accepted standards, evidence suggests imprisonment undermines sexual and reproductive health. This scoping review asks, “What is known about the sexual and reproductive health of people incarcerated in prisons for women in Canada?”

Methods

We use the Joanna Briggs Institute methodology for systematic scoping reviews. Databases searched include MEDLINE, CINAHL, PsycINFO, Gender Studies Abstracts, Google Scholar and Proquest Dissertations and grey literature. The search yielded 1424 titles and abstracts of which 15 met the criteria for inclusion.

Results

Conducted from 1994–2020, in provincial facilities in Ontario, British Columbia, Alberta and Quebec as well as federal prisons, the 15 studies included qualitative, quantitative and mixed methods. The most common outcomes of interest were related to HIV. Other outcomes studied included Papanicolaou (Pap) and sexually transmitted infection (STI) testing, contraception, pregnancy, birth/neonatal outcomes, and sexual assault.

Conclusion

Incarceration results in lack of access to basic services including contraception and prenatal care. Legal obligations to provide sexual and reproductive health services at professionally acceptable standards appear unmet. Incarceration impedes rights of incarcerated people to sexual and reproductive health.
Enhanced mesenchymal stem cells growth on antibacterial microgrooved electrospun zinc chloride/polycaprolactone conduits for peripheral nerve regeneration
Authors: Ekram Basma , Abd El-Hady Bothaina M , El-Kady Abeer M , Fouad Mohamed T , Sadek Zeinab I , Amr Sherif M , Gabr Hala , Waly Ahmed I , Guirguis Osiris W
Published: January 2021

In this study, we have investigated the effect of adding zinc chloride (ZnCl2) on polycaprolactone (PCL) before and after electrospinning. The rheological properties and conductivity of ZnCl2/PCL solutions were measured prior to the electrospinning process. The resultant electrospun mats were characterized by SEM, contact angle, FTIR, XRD, mechanical properties, as well as its antibacterial and stem cell proliferation assessment were tested. It was found that the fibers became finer by increasing the zinc salt content. Moreover, stability increased slightly up to 5% Zn-PCL and also the hydrophilicity has been enhanced by 52%. By adding ZnCl2, the degradation rate and mechanical properties were significantly increased. Also, the resultant mats have shown antibacterial properties against S. aureus than E. coli. From the stem cells proliferation study, it can be observed that by increasing ZnCl2, the stem cells proliferation was significantly increased. Grooved multichannel nerve conduits were successfully fabricated by rolling the electrospun mats produced on corn husks which has shown better cell alignment and attachment. Hence, adding zinc chloride is a facile biocompatible enhancement to polycaprolactone nanofibers to be used in nerve regeneration.
Effect of Nurse-Led Goal-Directed Lung Physical Therapy on the Prognosis of Pneumonia in Sepsis Patients in the ICU: A Prospective Cohort Study
Authors: Sun Jianhua , Han Wen , Cui Na , Li Qi , Wang Hao , Li Zunzhu , Luo Hongbo , Liu Jinbang
Published: January 2021

Background:

Pneumonia poses a significant burden on healthcare systems. However, few studies have focused on nurse-led goal-directed lung physical therapy (GDLPT) for pneumonia in sepsis patients in the intensive care unit (ICU).

Objectives:

This study aimed to investigate the effects of nurse-led GDLPT on the prognosis of pneumonia in sepsis patients in the ICU.

Methods:

We performed a prospective 2-phase (before-and-after) study over 3 years. After an observational phase (phase 1, n = 188), we designed, implemented, and evaluated a nurse-led GDLPT protocol (phase 2, n = 359) for pneumonia in sepsis patients in the ICU. The primary outcome was 28-day mortality.

Results:

We evaluated 742 critically ill patients with sepsis from January 2017 to January 2020. Among the 742 sepsis patients, 609 were diagnosed with pneumonia and 547 who met the inclusion criteria were enrolled in the study. Compared with patients in phase 1, patients in phase 2 had significantly shorter mechanical ventilation duration (5 [4, 6] days vs. 5 [4, 8] days, p = 0.037), shorter ICU stay (9 [4, 16] days vs. 9 [6, 20] days, p = 0.010), lower ICU mortality (15.0% [54/359] vs. 25.5% [48/188], p = 0.003), and lower 28-day mortality (16.7% [60/359] vs. 27.1% ([51/188], p = 0.004). Multivariate logistic regression analysis revealed that nurse-led GDLPT (odds ratio 0.540, 95% confidence interval 0.345–0.846, p = 0.007), clinical pulmonary infection score (odds ratio 1.111, 95% confidence interval 1.012–1.221, p = 0.028), and ventilation day (OR 1.160, 95% CI, 1.058–1.240, p<0.001)were independent predictors of 28-day mortality for pneumonia in sepsis patients, and that nurse-led GDLPT was a protective factor.

Conclusions:

Nurse-led GDLPT improved the outcomes of pneumonia in sepsis patients, and was particularly associated with shortened mechanical ventilation duration and ICU stay, and reduced ICU mortality and 28-day mortality.