bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence and clinical features of paediatric vasculitis in Eastern China: 14-year retrospective study, 1999–2013
Authors: Mao Youying , Yin Lei , Xia Hui , Huang Hua , Zhou Zhengyu , Chen Tongxin , Zhou Wei
Published: March 2016

Objectives

To determine the incidence and clinical features of paediatric primary vasculitis in patients from one centre in Eastern China.

Methods

Medical records of paediatric patients diagnosed with primary vasculitis between January 1999 and December 2013 were retrospectively reviewed. For Henoch–Schönlein purpura (HSP) and Kawasaki disease (KD), patients included in the analyses had data available for the previous 5 years.

Results

In total, 1896 patients were identified, of whom 1100 had HSP, 760 had KD, 23 had Takayasu arteritis, five had polyarteritis nodosa, four had cutaneous polyarteritis, three had Behçet’s disease and one had microscopic polyangiitis. Of the 615 patients with HSP included in the analyses, 49.8% had HSP nephritis (for 90% of whom it occurred within 1 week of disease onset). Of the 470 patients with KD included in the analyses, 13.8% were diagnosed with incomplete KD and 29.0% had a concurrent coronary artery lesion. For the 23 patients with Takayasu arteritis, the common clinical symptoms were hypertension, asphygmia/weak pulse and heart failure; only one of these patients had been diagnosed at an early disease stage. The five patients with polyarteritis nodosa received immunosuppressant therapy following diagnosis. Other vasculitides were uncommon.

Conclusions

The most common primary vasculitides in this population of children from Eastern China were HSP and KD; other vasculitides were rare. Paediatricians should be suspicious of vasculitis when there is evidence of systemic inflammation and multisystem disease that cannot be explained by one specific disorder.
Invasive pericranial nerve interventions
Authors: Ambrosini Anna , Schoenen Jean
Published: March 2016

Background

In many patients suffering from primary headaches, the available pharmacological and behavioural treatments are not satisfactory. This is a review of (minimally) invasive interventions targeting pericranial nerves that could be effective in refractory patients.

Methods

The interventions we will cover have in common pericranial nerves as targets, but are distinct according to their rationale, modality and invasiveness. They range from nerve blocks/infiltrations to the percutaneous implantation of neurostimulators and surgical decompression procedures. We have critically analysed the published data (PubMed) on their effectiveness and tolerability.

Results and conclusions

There is clear evidence for a preventative effect of suboccipital injections of local anaesthetics and/or steroids in cluster headache, while evidence for such an effect is weak in migraine. Percutaneous occipital nerve stimulation (ONS) provides significant long-term relief in more than half of drug-resistant chronic cluster headache patients, but no sham-controlled trial has tested this. The evidence that ONS has lasting beneficial effects in chronic migraine is at best equivocal. Suboccipital infiltrations are quasi-devoid of side effects, while ONS is endowed with numerous, though reversible, adverse events. Claims that surgical decompression of multiple pericranial nerves is effective in migraine are not substantiated by large, rigorous, randomized and sham-controlled trials.
Determinants of Persistent Anemia in Poor, Urban Pregnant Women of Chandigarh City, North India
Authors: Diamond-Smith Nadia G. , Gupta Madhu , Kaur Manmeet , Kumar Rajesh
Published: March 2016

Background:

Maternal anemia continues to be a public health problem in India, despite existence of multipronged governmental programs to combat it.

Objective:

This study explores the determinants of persistent anemia in poor pregnant women in an urban population in Chandigarh, India.

Methods:

A mixed method approach was used to examine the causes of maternal anemia. Three focus group discussions with pregnant women from different socioeconomic groups and 2 with female health workers were conducted to explore their perceptions and beliefs about maternal anemia and iron folic acid (IFA) tablets in urban settings in 2009. This was followed by interviews of 120 pregnant women about their nutrition knowledge and practices. Food frequency questionnaires were used to estimate daily consumption of nutrients. Finally, a follow-up survey in health clinics explored issues of stock-outs of IFA.

Results:

Sixty-five percent of respondents had hemoglobin less than 11g/dL and were anemic. Only 35% respondents obtained free IFA through public health programs. While 53% of respondents knew that they should eat green leafy vegetables, only 8% reported daily consumption of these vegetables. Focus group discussions highlighted issues around lack of food, especially for slum women, and low decision-making power in the household. Stock-outs of IFA in facilities often pushed women to purchase IFA from chemist shops.

Conclusions:

Clear gaps emerged in pregnant women’s knowledge and practice regarding diet and IFA tablet use. Lack of control over decision-making due to their low status of women was also hindering IFA use and healthy eating.
Suicide in Canada
Authors: Skinner Robin , McFaull Steven , Rhodes Anne E. , Bowes Matthew , Rockett Ian R. H.
Published: March 2016

Objective:

The aim of this study is to compare Canadian suicide rates with other external causes of death to examine potential poisoning misclassifications as a contributor to suicide underreporting.

Method:

The study used Statistics Canada mortality data from 2000 to 2011 to calculate sex-and age-specific ratios by external cause of injury codes.

Results:

The overall Canadian suicide rate, as well as the poisoning suicide rate, declined over the study timeframe by an average annual percentage change (AAPC) of 1.0% each year. However, unintentional and undetermined poisonings increased significantly during the timeframe. Unintentional poisoning mortality (primarily narcotics and hallucinogens, including opioids) increased in proportion to suicides for both sexes, although females were consistently higher. The undetermined death to suicide ratio was higher and increasing for females. Poisonings of undetermined intent increased over time to comprise 47% to 80% of the undetermined death category for males and females combined.

Conclusions:

Canadian poisoning suicide rates declined, in contrast to rising unintentional and undetermined poisoning mortality rates. This trend is similar to that of the United States, supporting the hypothesis that misclassification of poisoning deaths may also be an issue in Canada.
Academic Writing Development at the University Level
Authors: Staples Shelley , Egbert Jesse , Biber Douglas , Gray Bethany
Published: March 2016

Using the British Academic Written English corpus, this study focuses on the use of grammatical complexity features in university level texts written by first language (L1) English writers to demonstrate knowledge and perform other specialized tasks required of advanced academic writers. While the primary focus of the analysis is on writing development from first-year undergraduate to graduate students, we also consider interactions with discipline and genre. The study goes beyond most previous work on grammatical complexity in writing by investigating the use of phrasal as well as clausal features. The results show that as academic level increases, the use of phrasal complexity features in writing also increases. On the other hand, the use of clausal complexity features in student writing, particularly finite dependent clauses, decreases as academic level increases. Results further indicate that the extent of the differences across level is mediated by discipline and genre, reflecting patterns observed in research on disciplinary variation in professional academic writing.
Universities, slavery, and the unthought of anti-Blackness
Authors: Stein Sharon
Published: March 2016

Over the past 10 years there has been an increase in institutional recognition of how US universities and their founders directly participated in and benefitted from Black chattel slavery. However, these developments have largely escaped the attention of scholars who take higher education as their object of study. This article offers a conceptual reading of how apology efforts around slavery have unfolded at a single university. Drawing on the intersections of Black Studies and decolonial scholarship, I consider how revised institutional narratives develop through efforts to address and incorporate these violent histories.
Research on a novel flow rate inferential measurement method and its application in hydraulic elevators
Authors: Xu Bing , Dong Pengpeng , Zhang Junhui , Yao Jinjin
Published: March 2016

Measuring and controlling the flow rate is a widely concerned problem in engineering fields. The direct flow rate measurement employing conventional flow meters and the indirect flow rate measurement using speed/position transducers or other particular techniques would result in inevitable pressure drop in hydraulic circuits, more energy consumption for pumping fluid, and higher cost of hydraulic systems. This paper presents a novel flow rate inferential measurement method and its application in hydraulic elevators. Mathematical modeling of the proposed method is deduced. The key component of the hydraulic elevator circuit, a two-stage proportional flow rate valve, is verified by experiments as one of the contributions of this paper. Based on the mathematical modeling and the valve validation test, the feasibility and validity of the proposed method are verified by the experiments performed on a test rig which is designed to imitate work situations of a hydraulic elevator. Moreover, sensitivity analyses of the proposed flow rate inferential measurement method are carried out to find the ways how to improve the accuracy of the proposed method. It is believed that this method can be applied in various engineering devices.
Development of a model for simulation of micro-twin and corresponding asymmetry in high temperature deformation behavior of nickel-based superalloy single crystals using crystal plasticity-based framework
Authors: Samal MK
Published: March 2016

Development of reliable computational models to predict the high temperature deformation behavior of nickel-based superalloys is in the forefront of materials research. These alloys find wide applications in manufacturing of turbine blades and discs of aircraft engines. The microstructure of these alloys consists of the primary γ′-phase, and the secondary and tertiary precipitates (of Ni3Al type) are dispersed as γ′-phases in the gamma matrix. It is computationally expensive to incorporate the explicit finite element model of the γ-γ′ microstructure in a crystal plasticity-based constitutive framework to simulate the response of the polycrystalline microstructure. Existing models in literature do not account for these underlying micro-structural features which are important for simulation of polycrystalline response. The aim of this work is to develop a physically motivated multi-scale approach for simulation of high temperature response of nickel-based superalloys. At the lower length scale, a dislocation density-based crystal plasticity model is developed which simulates the response of various types of microstructures. The microstructures are designed with various shapes and volume fractions of γ′-precipitates. A new model for simulation of the mechanism of anti-phase boundary shearing of the γ′-precipitates, by the matrix dislocations, is developed in this work. The lower scale model is homogenized as a function of various micro-structural parameters, and the homogenized model is used in the next scale of multi-scale simulation. In addition, a new criterion for initiation of micro-twin and a constitutive model for twin strain accumulation are developed. This new micro-twin model along with the homogenized crystal plasticity model has been used to simulate the creep response of a single crystal nickel-based superalloy, and the results have been compared with those of experiment from literature. It was observed that the new model has been able to model the tension–compression asymmetry as observed in single crystal experiments.
Signal separation and correction with multiple Doppler acoustic sources for wayside fault diagnosis of train bearings
Authors: Zhang Shangbin , He Qingbo , Zhang Haibin , Ouyang Kesai , Kong Fanrang
Published: March 2016

The extraction of single train signal is necessary in wayside fault diagnosis because the acoustic signal acquired by a microphone is composed of multiple train bearing signals and noises. However, the Doppler distortion in the signal acquired by a microphone effectively hinders the signal separation and fault diagnosis. To address this issue, we propose a novel method based on the generalized S-transform, morphological filtering, and time–frequency amplitude matching-based resampling time series for multiple-Doppler-acoustic-source signal separation and correction. First, the original time–frequency distribution is constructed by applying generalized S-transform to the raw signal acquired by a microphone. Based on a morphological filter, several time–frequency distributions corresponding to different single source Doppler fault signals are extracted from the original time–frequency distribution. Subsequently, the time–frequency distributions are reverted to time signals by inverse generalized S-transform. Then, a resampling time series is built by time–frequency amplitude matching to obtain the correct signals without Doppler distortion. Finally, the bearing fault is diagnosed by the envelope spectrum of the correction signal. The effectiveness of this method is verified by simulated and practical signals.
Modelling and optimal energy-saving control of automotive air-conditioning and refrigeration systems
Authors: Huang Yanjun , Khajepour Amir , Bagheri Farshid , Bahrami Majid
Published: March 2016

Air-conditioning and refrigeration systems are extensively adopted in homes, industry and vehicles. An important step in achieving a better performance and a higher energy efficiency for air-conditioning and refrigeration systems is a control-based model and a suitable control strategy. As a result, a dynamic model based on the moving-boundary and lumped-parameter method is developed in this paper. Unlike existing models, the proposed model lumps the effects of the fins into two equivalent parameters without adding any complexity and considers the effect produced by the superheated section of the condenser, resulting in a model that is not only simpler but also more accurate than the existing models. In addition, a model predictive controller is designed on the basis of the proposed model to enhance the energy efficiency of the air-conditioning and refrigeration systems. Simulations and experimental results are presented to demonstrate the accuracy of the model. The experiments show that an energy saving of about 8% can be achieved by using the proposed model predictive controller compared with the conventional on–off controller under the examined scenario. The better performance of the proposed controller requires electrification of the automotive air-conditioning and refrigeration systems so as to eliminate the idling caused by running the air-conditioning and refrigeration systems when a vehicle stops.
Constructing multiculturalism at school: Negotiating tensions in talk about ethnic diversity
Authors: Kirkham Sam
Published: March 2016

Recent trends in British education policy have led to an increased focus on promoting ethnic diversity in schools, as well as greater parental involvement in school choice. This combination has led some schools to actively market diversity as a selling point in order to attract more minority ethnic students, as well as attract White middle-class students seeking a more ‘diverse’ educational experience. This article analyses how students attending such a school in England engage with discourses of multiculturalism. I identify three themes that characterise talk about multiculturalism at school: (1) multiculturalism-as-beneficial commodity, (2) claims of ‘reverse racism’ in provision for minority groups, and (3) denial of racism and constructing the school as a tolerant environment where everybody gets along. Through an analysis of discourse strategies and positioning tactics, I demonstrate how students negotiate tensions between the existence of racism and the construction of an inclusive and anti-racist educational environment.
β-Amyrin, a pentacyclic triterpene, exhibits anti-fibrotic, anti-inflammatory, and anti-apoptotic effects on dimethyl nitrosamine–induced hepatic fibrosis in male rats
Authors: Thirupathi A , Silveira PC , Nesi RT , Pinho RA
Published: March 2016

Hepatic fibrosis is a leading cause of morbidity and mortality worldwide. Attenuation of fibrogenic process can significantly lower the mortality rate. However, pharmaceutical intervention at fibrogenesis stage remains a major task in medicine. So there is a need for a natural compound to treat hepatic fibrosis. This study was outlined to investigate the anti-fibrotic effect of β-amyrin in dimethylnitrosamine (DMN)-induced hepatic fibrosis male rats. Serum liver function markers (aspartate transaminase, alanine transaminase, alkaline phosphatase and lactate dehydrogenase), oxidative stress markers (malondialdehyde, superoxide dismutase, catalase, glutathione peroxidase, glutathione reduced content and vitamin C), tissue inflammatory marker (tumor necrosis factor α (TNF-α)), apoptosis marker (caspase 3) and fibrolytic marker (tissue inhibitor of metalloproteinase 1 (TIMP-1)) were evaluated before and after β-amyrin treatment in DMN-induced rat. β-Amyrin treatment attenuated the altered levels of the serum enzyme markers produced by DMN and caused a subsequent recovery toward normalization. Oxidative stress markers and TNF-α levels were reduced significantly ( p < 0.001) as well as proteins’ (caspase-3 and TIMP-1) expression was reduced in β-amyrin –treated DMN rats. By virtue of β-amyrin properties of inhibiting oxidative stress, apoptosis, inflammation, and fibrogenesis, it might act as an ideal anti-inflammatory and anti-fibrogenic agent to halt the progression of liver fibrosis to chronicity.
‘Whoever Has the Stick Guides the Buffalo’
Authors: Suykens Bert , Stein Danielle
Published: March 2016

This article examines the relationship between the concept of neutrality in community mediation and partisan party politics in Nepal. Focusing on one donor-sponsored, US model-based community mediation programme in the Terai, this article contributes to a growing literature on authority formation and the role of party politicians in post-conflict Nepal. It argues that both neutrality and bias in dispute settlement are constitutive of building (Weberian) authority, allowing for the legitimate exercise of power by politicians. Neutrality is not only highly valued in mediation ideology, but is also a crucial legitimizing register in dispute settlement in Nepal. Although resolving disputes neutrally enhances the local legitimacy of (political) mediators, our research finds that there are cases when showing political favouritism also helps maintain power. We find that these contradictory incentives and the need to balance them guide the arena in which politicians choose to resolve disputes and how they choose to resolve them. These strategic decisions made by politicians in order to balance neutrality and bias thus guide outcomes of dispute settlement, and mediation in particular. This raises questions about the proclaimed ability of community mediation to overcome power imbalances and provide justice to disadvantaged communities.
From a Politics of Dilemmas to a Politics of Paradoxes
Authors: Kark Ronit , Preser Ruth , Zion-Waldoks Tanya
Published: March 2016

Transformational learning is a process resulting in deep and significant change in habitual patterns of identity, thought, emotion, and action, enabling new approaches to role enactment. This article explores how moving from a framework of dilemmas, which require solutions and one-sided choices, to a framework of paradoxes that embraces tensions and contradictions can contribute to meaningful transformational learning in the context of women’s leadership development. Drawing on recent theories of paradoxes and on critical feminist theory, we propose a critical feminist pedagogy of paradoxes for developing women’s leadership of social change enterprises. This perspective is put forth based on our analysis of an experiential course in a graduate gender studies program wherein participants take on leadership roles and interrogate them, by integrating theoretical discussions, reflection, and practical engagement in social activism. We use case studies from our students’ experiences in the field and in the classroom to demonstrate and explore the use of paradoxical thinking for teaching complex modes of leadership. We then show how fundamental, unresolvable paradoxes can be generative of novel ways of enacting social change leadership. We suggest several advantages and implications that this critical feminist pedagogy of paradoxes can have on the development of women’s leadership.
What Comes to a Manager’s Mind
Authors: Houdek Petr
Published: March 2016

This article develops a model of local thinking in managerial decision making. According to the concept, attention is drawn by selectively salient factors or recalls in specific decision-making contexts. Although decision makers are aware of the changing conditions, they do not make a sufficient mental correction for the fact that the relevance of these factors is not generalized. They overestimate the importance of an option that “easily comes to one’s mind”: They excessively extrapolate from their experiences and extreme news, succumb to reference points and imprinting. The usefulness of the concept of local thinking in explaining decisions taken by managers is demonstrated by a short conceptual review of several empirical studies on local economic and natural shocks, negotiation of bank loans, expert forecasts, workers’ compensations, and gender equality. The conclusion brings speculations about further implications of the theory for organizational research.
Linking Job Design to Subjective Career Success
Authors: Dahling Jason J. , Lauricella Taylor K.
Published: March 2016

We tested a predictive model based on self-determination theory (SDT) to demonstrate how job design choices contribute to subjective career success. Data collected at Time 1 demonstrated that the job characteristics of autonomy support and competence support had direct and interactive effects on employees’ need satisfaction. Need satisfaction at Time 1 mediated the relationship between autonomy support and self-determined work motivation at Time 2. Work motivation, in turn, mediated the relationships between need fulfillment and career attitudes that characterize subjective career success. These findings are theoretically important because they demonstrate that SDT can bridge job design theory and career theory, pointing to new ways that job and career experiences are interrelated. From a practical standpoint, the results are valuable because they show that job enrichment efforts guided by SDT have important implications for promoting career success perceptions and vocational retention among experienced workers.
An Exploration of Gender and Career Stage Differences on a Multidimensional Measure of Work Meaningfulness
Authors: Lopez Frederick G. , Ramos Katherine
Published: March 2016

In recent years, the constructs of work meaning and work meaningfulness have been differentiated, and multidimensional measures of the latter have been developed. In the present study, we administered one such measure—the Comprehensive Meaningful Work Scale (CMWS)—to a gender-balanced and age-diverse sample of managers and conducted a multivariate analysis of CMWS scores that explored the contributions of participants’ gender and their adult career stage. As hypothesized, the CMWS subscale scores were negatively correlated with participants’ scores on an independent measure of work stress. Results also revealed a significant multivariate effect associated with their career stage that was limited to one CMWS subscale (i.e., “balancing tensions”), with managers in their “prime work years” (i.e., 40–54) evidencing less favorable scores than those in either the “settling in” (i.e., 25–39) or “approaching retirement” (i.e., 55–65) stages. The implications of these findings for future research on work meaningfulness are discussed.
Protecting Oneself Online
Authors: Chen Hongliang , Beaudoin Christopher E. , Hong Traci
Published: March 2016

With a general basis in protection motivation theory, this study builds a three-stage model from online negative privacy experiences to online privacy protection motivation to online privacy protection behaviors. With 2013 survey data ( N = 528), a well-fitting structural equation model was tested, indicating general support for the model’s progression. There was support in only one instance, however, for the mediation role of online privacy protection motivation. In that case, awareness of online information disclosure mediated the effects of information stolen on contact management. The other protection motivation—online privacy concerns—had stronger effects on the four online privacy protection behaviors.
Pharmacogenetic Testing
Authors: Burke Elizabeth , Love Rene , Jones Pam , Fife Taylor
Published: March 2016

BACKGROUND: Despite extensive scholastic and professional training, medication management in psychiatry is often relegated to trial-and-error prescribing. Pharmacogenetic testing (PGT) may expedite identification of medications with maximal efficacy and minimal side effects by recognizing individual genetic variability in drug response. OBJECTIVES: This article outlines the background of PGT, explains drug metabolism, and evaluates the impact of PGT. DESIGN: A review of the literature since 2010 found 42 articles regarding PGT in clinical nursing settings on PubMed and ProQuest. RESULTS: Despite continuing rises in health care costs, new biotechnology has led to a decrease in the cost of genetic sequencing and application of PGT to practice. CONCLUSION: As PGT becomes increasingly prevalent, nurses should be knowledgeable of its purpose, possibilities, and potential limitations to provide accurate and up-to-date patient information.
How Country Image Affects Tourists’ Destination Evaluations: A Moderated Mediation Approach
Authors: Zhang Jingru , Wu Bihu , Morrison Alastair M. , Tseng Chi , Chen Ying-chen
Published: March 2016

Limited tourism research has as yet drawn attention to the differences and interactions between country image and destination image. Therefore, this research explored the relationships among country image, destination image, familiarity, and destination evaluation. Based on an empirical study of international tourists in Beijing, China, a model was proposed covering these four variables. Country image mainly affected international tourists’ evaluations of China as a destination in a conditional indirect way, mediated by destination image and especially by psychological image, and moderated by familiarity. Moreover, familiarity directly and positively influenced functional destination image and negatively moderated the relationship between country and psychological destination images.
Identifying the participants: reference in television news
Authors: Feng Debing
Published: March 2016

This article presents a generalized model of reference relations in the discourse of television news based on Montgomery’s principles of intelligibility, Halliday and Hasan’s reference cohesion, Martin’s identification system, Tseng’s cohesive reference and some intersemiotic models. Reference in television news involves reference patterns from the verbal track (verbal reference), the visual track (visual reference) and across the two tracks (visual–verbal reference). Based on the categorization of verbal reference, this study classifies visual reference as personals (such as visual reappearance), demonstratives (such as proximity and direction) and comparatives (such as similarity and difference). Reference across visual and verbal tracks includes three general types of visual–verbal reference, i.e. complementary, visual-as-bridge and parallel, among others. Through these patterns of reference and their reference chains, participants in television news can be tracked and identified. This model is applied to a comparative analysis of two news items broadcast separately by BBC’s News at Ten and CCTV’s News Simulcast. Differences and their implications are presented and discussed.
Mastering musical meaning: images as interpretive resources in multimodal music texts
Authors: Weekes Trish
Published: March 2016

In a Music listening examination in the final year of secondary schooling in New South Wales, Australia, successful students use a range of images – graphic notation, diagrams, tables and graphs – as well as language, to build meaning about the concepts of music. Little is known about the ways in which language and image can be deployed as interpretive resources to construct musical knowledge in this high stakes examination. To address this gap, theories of Systemic Functional Linguistics and Systemic Functional Multimodal Discourse Analysis are utilised to make the disciplinary and semiotic requirements of this examination clearer. In this article, five types of images are described and classified, analysing ways in which images can construct disciplinary meanings about concepts of music, principles of composition, and providing a range of perspectives on musical time. Analysis of affordances of images and language, as well as intersemiosis, provides some insights into the hidden curriculum of Music as well as the value of images as a significant interpretive resource.
The communicology of Roland Barthes’ Camera Lucida: reflections on the sign–body experience of visual communication
Authors: Butchart Garnet C
Published: March 2016

This article contributes both to the conversation about visual communication opened by Roland Barthes’ classic book, Camera Lucida: Reflections on Photography and current research in communicology (semiotic phenomenology). The article offers an interpretation (third step) to the reduction (second step) of the description (first step) of Barthes’ semiotic phenomenology of communication. Attention is paid to time consciousness, the concept of the punctum, and the interplay between presence and absence opened by it. The interpretation draws on Jean Luc Nancy’s philosophy of visual images in order to expand the discussion of three emergent themes in Camera Lucida: the unseen, exposure, and death. Discussion of these themes from a communicology perspective deepens our understanding of visual communication as a sign–body experience.
Finding One’s Way on the Roads to Social Change
Authors: Kammer Adrian , Niessen Sebastian , Schmid Lukas , Schwendener Norina
Published: March 2016

Many theories and models attempt to explain the mechanisms underlying human behavior. In order to maintain an overview of the many aspects involved in communication campaigns, social marketing, and behavior change, the Swiss Federal Office for Public Health has created a metamodel of the impact of its campaigns. This metamodel does not claim to contribute any new findings to behavioral research. Its purpose is primarily to summarize the current state of research in the field in a comprehensive and comprehensible way, with reference to a range of relevant communications, social marketing, and behavior change theories. Dimensions addressed include strategy, processes, and impact, with the final dimension demonstrating the possible ranges of impact from individual to societal and from information to behavior. Social marketers and campaign planners may find this model useful as a planning and evaluation tool for campaigns, programs, or interventions that seek to increase awareness or change behavior. Its focus lies on communication campaigns, while also indicating the limits of campaign efficacy. It makes it clear that campaigns are most effective at the early stages of the behavioral change process, such as capturing attention, while other interventions are more effective at later stages.
Chronic Ulcer by Cutaneous GvHD After Bone Marrow Transplantation Treated With Skin Allograft From HLA-Identical Donor
Authors: Amendola Francesco , Gazzola Riccardo , Lombardo Michele , Caminiti Rocco , Dagna Lorenzo , Baruffaldi-Preis Franz Wilhelm
Published: March 2016

We present a successful split-thickness skin allograft for a chronic cutaneous graft-versus-host disease of the thigh in an immunosuppressed patient, treated for acute myeloid leukemia with allogenic bone marrow stem cells transplant.
Depth Perception of Surgeons in Minimally Invasive Surgery
Authors: Bogdanova Rositsa , Boulanger Pierre , Zheng Bin
Published: March 2016

Minimally invasive surgery (MIS) poses visual challenges to the surgeons. In MIS, binocular disparity is not freely available for surgeons, who are required to mentally rebuild the 3-dimensional (3D) patient anatomy from a limited number of monoscopic visual cues. The insufficient depth cues from the MIS environment could cause surgeons to misjudge spatial depth, which could lead to performance errors thus jeopardizing patient safety. In this article, we will first discuss the natural human depth perception by exploring the main depth cues available for surgeons in open procedures. Subsequently, we will reveal what depth cues are lost in MIS and how surgeons compensate for the incomplete depth presentation. Next, we will further expand our knowledge by exploring some of the available solutions for improving depth presentation to surgeons. Here we will review the innovative approaches (multiple 2D camera assembly, shadow introduction) and devices (3D monitors, head-mounted devices, and auto-stereoscopic monitors) for 3D image presentation from the past few years.
A Prospective Study Comparing the Efficacy and Surgical Outcomes of Harmonic Focus Scalpel Versus LigaSure Small Jaw in Thyroid and Parathyroid Surgery
Authors: Hammad Abdulrahman Y. , Deniwar Ahmed , Al-Qurayshi Zaid , Mohamed Hossam Eldin , Rizwan Aslam , Kandil Emad
Published: March 2016

Background. The use of sealing devices has been established in thyroid surgeries. Recently, LigaSure Small Jaw (LS), a new device that utilizes bipolar energy, was approved by the Food and Drug Administration for use in different head and neck procedures. The purpose of this study is to assess the efficiency and safety of LS use in thyroid surgery compared to Harmonic Focus Scalpel (HS), a well-established device. Methods. A prospective study was conducted to compare the efficacy of LS versus the HS. We evaluated 301 patients who underwent surgery at a North American academic institution. Patients were allocated into two groups according to LS or HS use. All patients underwent vocal cord assessment using direct laryngoscopy preoperatively and postoperatively. Analyses were performed to examine the difference in perioperative outcomes resulting from the utilization of either device. Results. No difference was seen in operative time between both groups (124.20 ± 68.44 minutes in HS vs 125.20 ± 72.13 minutes in LS, P = .99). Overall complications were similar between both groups (22.86% in HS vs 13.84% in LS, P = .05). However, LS use was also associated with a lower incidence of postoperative transient hypocalcemia as compared to the HS ( P = .025). No significant difference was found between both groups regarding the incidence of recurrent laryngeal nerve injury ( P = .52). Conclusion. The use of the LS is safe, feasible, and is associated with comparable outcomes to HS. Both intraoperative and postoperative variables were similar between both devices. Future larger studies are warranted to further investigate the effect on postoperative transient hypocalcemia.
The Influence of Age, Health Literacy, and Affluence on Adolescents’ Capacity to Consent to Research
Authors: Nelson Lance R. , Stupiansky Nathan W. , Ott Mary A.
Published: March 2016

While adults are assumed to have the capacity to consent to medical research, and young children to have no capacity, adolescents’ capacity to consent is not well described. Adapting the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), we describe adolescents’ capacity to consent to medical research and factors influencing that capacity. Our pilot study included a community-based sample of 30 adolescents, 14 to 21 years of age, who completed the MacCAT-CR after undergoing a simulated informed consent process. We found that adolescents’ capacity to consent to research was associated with age, health literacy, and family affluence. These findings suggest that investigators and institutional review boards should be aware that factors other than age may influence capacity to consent, and, for modifiable factors, such as health literacy, consent processes for medical research with adolescents can be modified.
Assessing the Oral Health Needs of African American Men in Low-Income, Urban Communities
Authors: Akintobi Tabia Henry , Hoffman LaShawn M. , McAllister Calvin , Goodin Lisa , Hernandez Natalie D. , Rollins Latrice , Miller Assia
Published: March 2016

Despite improvements in oral health status in the United States, pronounced racial/ethnic disparities exist. Black men are less likely to visit the dentist, are twice as likely to experience tooth decay, and have a significantly lower 5-year oral cancer survival rate when compared to White men. The Minority Men’s Oral Health Dental Access Program employed a community-based participatory research approach to examine the oral health barriers and opportunities for intervention among Black men in a low-income, urban neighborhood. A cross-sectional study design was implemented through a self-administered survey completed among 154 Black males. The majority reported not having dental insurance (68.8%). Most frequently cited oral health care barriers were lack of dental insurance and not being able to afford dental care. Attitudes related to the significance of dental care centered on cancer prevention and feeling comfortable with one’s smile. The impact of oral health on daily life centered on social interaction, with men citing insecurities associated with eating, talking, and smiling due to embarrassment with how their teeth/mouth looked to others. Multivariate logistic regression revealed that those who had difficulty finding dental care were 4.81 times (odds ratio = 4.65, 95% confidence interval [1.80, 12.85]) more likely to report no dental insurance, and 2.73 times (odds ratio = 3.72; 95% confidence interval [1.12, 6.70]) more likely to report poor oral health. Community-based participatory approaches include assessment of neighborhood residents affected by the health issue to frame interventions that resonate and are more effective. Social, physical, and infrastructural factors may emerge, requiring a multilevel approach.
Why We Don’t “Just Do It”
Authors: Faries Mark D.
Published: March 2016

Intention can be a poor predictor of actual health behavior change—now termed the intention-behavior gap. In other words, although patients intend to change and maintain their behavior, the data suggest that many will not follow through with their intention. This review introduces 5 factors that could help the practitioner understand the patient intention-behavior gap: (1) the motivation, (2) the trigger, (3) the response, (4) the capacity, and (4) the process. These key factors allow the lifestyle medicine practitioner to (1) understand the difficulties in changing patient behavior and (2) apply strategies to encourage successful change and maintenance of healthy lifestyle behavior in their patients.
A new method for high speed and smooth transfer of robot motion trajectory
Authors: Shen Haikuo , Jiang Liangwei , Zhang Qinjian , Tao Yong , Cao Yunan
Published: March 2016

In the process of the robot practical working, the change of motion direction of trajectory is inevitable. When the direction changes dramatically, the sharp angle between adjacent trajectories, which can generate the vibration of robot, affects the service life of the robot. In order to deal with the sharp angle between adjacent trajectories, we propose a method which can deal with the sharp angle transferring by inserting transition arc, which is called position level, to solve the trajectory speed control problem. We analyze three basic analytic trajectories—space line, space arc, and space parabola—and present the formula for calculating the parameters of circular-arc-related parameters and propose the implementation process of algorithm of robot system. Through the simulation and experiment, this method can solve the sharp angle trajectory transfer problem effectively, increase the transfer speed dramatically, and reduce the vibration of robot’s mechanical structure.
Knowledge Workers and Virtues in Peter Drucker’s Management Theory
Authors: Turriago-Hoyos Alvaro , Thoene Ulf , Arjoon Surendra
Published: March 2016

The fallout of the 2008 global financial crisis and frequent disregard for labor, environmental, and social standards have instilled new vigor into the study of ethics and virtues. In the contemporary knowledge society, the issue of which virtues the modern day workforce needs to possess is of crucial significance. This study specifies the virtues laid out in the management theory of Peter Drucker (1909-2005), focusing upon the conceptual category of the knowledge worker as the primary unit of the contemporary information and innovation-based knowledge society. The idea and role of intellectual virtues are not yet fully developed in the literature, especially as those identified in this article are the source of critical and creative thinking. This intervention, therefore, identifies prudence, effectiveness, excellence, integrity, and truthfulness as the knowledge worker’s intellectual virtues, whereas practical wisdom, responsibility, cooperation, and courage are seen to constitute the knowledge worker’s moral character.
Resilience, Violence, and Early Pregnancy
Authors: Lévesque Sylvie , Chamberland Claire
Published: March 2016

Giving birth at a young age and being a victim of intimate partner violence are adversities that affect the life course of women. However, some young mothers overcome these adversities and cope well, showing a dynamic resilience pathway. In this qualitative exploratory study, we examined a purposive sample of 10 resilient mothers who gave birth as adolescents in a situation of intimate partner violence. Their stories were gathered from individual in-depth interviews and on-site participatory observations. Data were collected and analyzed simultaneously, according to grounded theory. Inspired by Masten and Monn’s integrated framework of resilience, the resilience pathway of the participating mothers began with the occurrence of the adversities addressed in this study, namely, early pregnancy combined with intimate partner violence. To overcome these adversities, the participants deployed several protective processes: (a) establishing their maternal identity and the creation of a bond with the child as a turning point, (b) taking an active stance to respond to victimization, and (c) acting proactively and adjusting to motherhood. Promotive processes, positive adaptation indicators, and risks to positive adaptation complete the proposed resilience pathway. The results lead to the conclusion that increased recognition of the challenges that these young mothers face and greater emphasis on the importance of their social surroundings to support these protective processes would support them in their transition to motherhood and promote their well-being and that of their children.
Diagnostic Dilemma in the Treatment of a Fatal Case of Bloody Diarrhea
Authors: Mahapatra Sidharth , Michie Sara A. , Sylvester Karl , Cornfield David
Published: March 2016

Although diarrhea is the most commonly reported pediatric illness in the United States, mortality is usually a rare and unexpected event. We report the case of a healthy 13-month-old male that succumbed to a diarrheal illness of unclear etiology. Presenting signs included frequent nonbloody stools that progressed to frankly bloody stools over 72 hours. Associated symptoms included fever, tenesmus, relief with stool passage, and significant fatigue. On examination, the patient appeared tired and lay with legs curled toward his chest. The abdominal exam was remarkable for hypoactive bowel sounds, diffuse tenderness to palpation without guarding or rebound pain, and intermittent prolapse of rectal tissue. Abdominal plain films demonstrated a paucity of bowel gas, especially in the rectum; and ultrasound revealed thickening of bowel loops in the left lower quadrant. Abdominal computed tomography scan showed decreased enhancement of the mucosa of the rectosigmoid colon. The patient deteriorated rapidly with cardiorespiratory arrest occurring 48 hours after admission. Despite a protracted effort at cardiopulmonary resuscitation, perfusing heart rate or rhythm could not be reestablished. Autopsy revealed infarction and necrosis of the rectosigmoid colon with invasive gram-negative bacilli. Here we present his perplexing case, diagnostic evaluations, and suggest a unifying diagnosis.
Perspectives of Nurses on Patients With Limited English Proficiency and Their Call Light Use
Authors: Galinato Jose , Montie Mary , Shuman Clayton , Patak Lance , Titler Marita
Published: March 2016

Patients use call light systems to initiate communication with their health care team. Little is known how this process is affected when language barriers exist between an English-speaking nurse and a patient with limited English proficiency (LEP). The aims of this study are to describe (a) the perceptions of nurses regarding their communication with patients with LEP, (b) how call lights affect their communication with patients with LEP, and (c) the perceptions of nurses on the impact of advancement in call light technology on patients with LEP. Using focus groups, nurses were asked about their interactions with patients with LEP. The following themes emerged: barriers to communication, formal tools for communication, gestures and charades, reliance on family, creating a better call light system, and acceptability of Eloquence™. This results show that call lights affect the interaction of nurses with patients with LEP and complex issues arise in the subsequent communication that is initiated by the call light.
Maintaining a Distinction Between Possible and Impossible Topics of Conversation in the Outpatient Respiratory Medical Clinic
Authors: Jensen Lone Birgitte Skov , Larsen Kristian , Konradsen Hanne
Published: March 2016

The aim of this study is to generate a grounded theory explaining patterns of behavior among health care professionals (HCPs) during interactions with patients in outpatient respiratory medical clinics. The findings suggest that the HCPs managed contradictory expectations to the interaction by maintaining a distinction between possible and impossible topics to counseling. Three subcategories explaining the effort that maintain the impossible and possible topics separated were identified: (a) an effort to maintain the diseased lungs as the main task in counseling, (b) navigating interactions to avoid strong emotions of suffering in patients to reveal, (c) avoiding the appearance of the non-alterable life circumstances of the patients. The HCPs’ attitudes toward what patients could be offered generated a distance and a difficulty during counseling and created further suffering in the patients but likewise a discomfort and frustration among the HCPs.