bluuebunny/crossref_metadata_2025 huggingface dataset:
Principals’ Self- and Interpersonal Leadership Amid Work Intensification
Authors: Wang Fei
Published: June 2020

Objectives:

Despite all the attention given in recent years to work intensification among school principals, little research has explored the practices and strategies that principals employ to meet their job expectations and demands and how they adapt to the increasingly uncertain and complex school reality. This qualitative study identifies practices and strategies that principals employ to meet their job expectations and adapt to their intensified work condition in Vancouver, British Columbia, Canada.

Framework:

The study integrates self- and interpersonal leadership into a composite framework to guide the inquiry.

Methods:

Eighteen school principals in Metro Vancouver participated in one-hour semi-structured interviews and shared their comments on the changing nature of their work and strategies they use to go about doing their work amid work intensification.

Results:

The findings capture principals’ skills and competencies that pertain to their personal and social competencies, including self awareness, self direction, social awareness, and relationship management. The findings also identify knowledge and skills that are necessary to prepare principals for their work and highlight strategies they use to gain a sense of being in control at work in a complex and changing work environment.
Effects of Life Skill Training on the School Violence Attitudes and Behavior Among Elementary School Children
Authors: Lee Jae Yeon , Ham Ok Kyung , Oh Hyun Soo , Lee Eun Jin , Ko Young , Kim Bongjeong
Published: June 2020

This study evaluated a life skill training program on school violence given to elementary school children. A quasi-experimental study was conducted, and a 12-week intervention was implemented targeting 70 students aged between 10 and 11 years. The instruments included peer competency, attitudes toward school violence, experience of school violence, and the Self-Control Rating Scale. The data were analyzed using repeated measure analysis of variance. A significant difference was observed between the groups over time on peer competency ( F = 4.17, p = .020), attitudes toward school violence ( F = 6.02, p = .004), and violence experience as a victim ( F = 3.49, p = .036) and as a perpetrator ( F = 3.87, p = .026). In the experimental group, the mean scores for peer competency increased compared to the control group, whereas school violence experience decreased at the posttests. A 12-week program of life skill training offered to children was effective in promoting peer competency and attitudes toward school violence, while decreasing the experience of school violence.
Emergency Medication Access and Administration in Schools: A Focus on Epinephrine, Albuterol Inhalers, and Glucagon
Authors: McCaughey Rebecca A. , McCarthy Ann Marie , Maughan Erin , Hein Maria , Perkhounkova Yelena , Kelly Michael W.
Published: June 2020

Access to emergency medications is a growing concern, particularly regarding the availability, safety, and use of these medications in schools. The purpose of this article is to report results not previously published from a national survey, specifically regarding the emergency use of epinephrine, albuterol inhalers, and glucagon. A nonexperimental, cross-sectional design was utilized for this descriptive study. An online survey was distributed to school nurses in 2015, and data from 6,298 school nurse respondents are presented in the analysis. Findings related to stock and student-specific emergency medication use and storage, epinephrine usage data, and delegation of emergency medication administration to unlicensed assistive personnel are presented in this article. Further development of policies and procedures regarding emergency medication administration in schools is needed. School nurses are a valuable resource for obtaining knowledge in this area and keeping students safe at school.
Command shaping with reduced maneuvering time for crane control
Authors: Khorshid Emad , Al-Fadhli Abdulaziz , Alghanim Khalid , Baroon Jasem
Published: June 2020

This study introduces a modified near-time–optimal rigid-body command that represents the fastest possible command profile based on using the full input capabilities of the system, considering rest-to-rest motion. The control objective is to have the shortest maneuvering time suitable for handling insensitive payloads. The rest-to-rest motion is divided into three stages. The first stage includes a quick response with maximum trolley acceleration. The second stage involves cruising at the maximum trolley velocity. The third stage provides deceleration, where both zero vibration and the zero vibration derivative are applied. The proposed shaper is simulated numerically for testing its performance. The theoretical findings were validated experimentally using a prototype crane. This study’s major finding demonstrates that the new technique succeeded in reducing the maneuvering time with zero vibration at the end of the motion. Moreover, the results show the insensitivity of the proposed shaper to variations in system parameters using a zero vibration derivative shaper.
Preparing Mass Communications Students for an Evolving Industry: The Influence of Emotional Intelligence and Extracurricular Involvement on Career Adaptability
Authors: LaGree Danielle , Tefertiller Alec , Olsen Katie
Published: June 2020

Career paths of entry-level professionals in media fields are more ambiguous and complex than ever before. To make a successful transition into their careers, graduates must possess career management skills; they should be career adaptable. Grounded in a social psychological approach, a survey of college students ( N = 320) examined how emotional intelligence and extracurricular involvement influences career adaptability. Journalism and mass communications students were compared to other majors along these variables to bring insight into how career management training can be implemented. Results indicated a positive relationship between emotional intelligence and career adaptability, which was enhanced by extracurricular participation.
Monitoring of dimple formation in honeycomb sandwich structures using distributed fiber optic sensors
Authors: Siivola Juho T , Minakuchi Shu , Mizutani Tadahito , Kitamoto Kazuya , Takeda Nobuo
Published: June 2020

Dimpling in the composite face sheets of honeycomb sandwich structures due to mismatch in the thermal expansion coefficients of the constituent materials was studied with emphasis on its monitoring and prediction. Strain distributions along optical fibers embedded in the face sheet were monitored during manufacturing. Dimple formation and in-plane strain distributions in the face sheets were studied using finite element analysis, and an analytical model based on the beam theory was constructed to predict the dimple depths from the strain data. A system using twin optical fiber sensors was proposed to accurately measure the dimpling-induced strains. The usability and performance of the system was evaluated using small scale specimens and finally on a more realistic large-scale specimen. The system could measure the strain changes due to dimpling of the face sheets and provided decent prediction of the dimple depth distribution along the sandwich panels.
A Process Evaluation of a Substance Use Brief Intervention for Adolescents in a Psychiatric Inpatient Program
Authors: Johnson Sarah E , Lapomardo Andrea , Thibeau Heather M , Altemus Melanie , Hunt Jeffrey I , Wolff Jennifer C
Published: June 2020

The present study represents a two-phase process evaluation of the implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) on an adolescent psychiatric inpatient unit. The first phase analyzed uptake efforts using chart review data, which revealed that 158 (16.8%) of 942 hospitalized patients ( Mean age = 15.81, SD = 1.24) were eligible to receive the brief intervention; however, only 30 (19%) adolescents received the intervention, 15 (9.5%) declined treatment, and 113 (71.5%) were never offered. The second phase involved directed content analyses of clinical staff and providers’ perceived facilitators and barriers to the implementation. Qualitative findings revealed that providers and staff accepted and agreed with the use of the brief substance use intervention, though perceived time constraints, competing demands, and insufficient staffing interfered with implementation across disciplines. Barriers included patients’ length of stay and competing treatment priorities. Several recommendations emerged including, utilization of non-clinical staff, a clear administration protocol, and the use of computer-based interventions. Findings from the present study shed light on the need to consider alternate or more streamlined substance use treatments such as computerized approaches and focus on ways in which protocol can be modified to fit the needs within an acute, short-term setting.
Current State of the Art in the Adjuvant Systemic Treatment of Premenopausal Patients With Early Breast Cancer
Authors: Parisi Francesca , Razeti Maria Grazia , Blondeaux Eva , Arecco Luca , Perachino Marta , Tagliamento Marco , Levaggi Alessia , Fregatti Piero , Poggio Francesca , Lambertini Matteo
Published: June 2020

Breast cancer is the most frequent malignancy diagnosed in premenopausal women. In this age group, breast tumors tend to be diagnosed at more advanced stages and to harbor more aggressive biological features. In addition, specific age-related issues including genetic counseling, fertility preservation, impact on social and couple relationships, working life, and management of long-term side effects should be considered highly relevant when managing early breast cancer in premenopausal women. Therefore, the care of these patients is particularly complex and a multidisciplinary approach is mandatory. The present review summarizes the current state of art in the adjuvant systemic treatment of premenopausal women with early breast cancer focusing on the optimal chemotherapy, endocrine therapy, and targeted therapy approaches in this specific patient population.
Efficacy of Brodalumab for Moderate to Severe Plaque Psoriasis: A Canadian Network Meta-Analysis
Authors: Xue Weiguang , Saharia Paranjoy , Gray Emma , Khoudigian-Sinani Shoghag , Gaudet Véronique , Barbeau Martin , Papp Kim
Published: June 2020

Background

Several treatments for plaque psoriasis are available, but it remains challenging for physicians to make informed treatment decisions due to a lack of head-to-head trials.

Objectives

This network meta-analysis (NMA) compares the efficacy of brodalumab to other biologic agents in Canada for moderate-to-severe plaque psoriasis.

Methods

A systematic literature review of randomized controlled trials (RCTs) published before October 2017 was conducted to populate the NMA. Comparators included etanercept, infliximab, adalimumab, ustekinumab, secukinumab, ixekizumab, guselkumab, and placebo. The primary outcome was the psoriasis area and severity index (PASI) response at the end of induction phase. A random effects Bayesian multinomial likelihood and probit link model analyzed PASI 75, 90, and 100 responses. Inconsistency and heterogeneity were assessed. Sensitivity analyses were conducted to explore potential effect modifiers like baseline PASI score, age, and weight.

Results

A total of 43 RCTs were included. Brodalumab 210 mg had significantly better PASI response than etanercept, ustekinumab, adalimumab, secukinumab, and guselkumab and comparable responses to infliximab and ixekizumab. Relative risk of PASI 90 response for brodalumab varied from 2.84 (95% credible interval [CrI]: 2.35-3.52, P < .05) to 0.99 (95% CrI: 0.88-1.11, ns) compared to etanercept and ixekizumab. This was similar across PASI 75 responses, but a larger relative risk between brodalumab and all comparators except ixekizumab was observed for PASI 100. No significant heterogeneity or inconsistencies were identified. The results were consistent across sensitivity analyses, indicating robustness of the results.

Conclusion

Brodalumab 210 mg has efficacy superior to most biologic agents for moderate-to-severe plaque psoriasis in Canada.
An adaptive augmented radial basis function–high-dimensional model representation method for structural engineering optimization
Authors: Wang Qian , Kim Yongwook , Nafash Joseph , Catala Javier
Published: June 2020

A new engineering optimization approach using an adaptive metamodeling method is developed and studied. The adaptive metamodels are based on a high-dimensional model representation framework, and the high-dimensional model representation component functions are created using radial basis functions or augmented radial basis functions. The proposed optimization approach starts with an explicit first-order augmented radial basis function–high-dimensional model representation metamodel, before a numerical optimization algorithm is applied. In each subsequent iteration, an additional sample point is found, and a high-order high-dimensional model representation component function is created and added to the first-order augmented radial basis function–high-dimensional model representation metamodel. The accuracy of the augmented radial basis function–high-dimensional model representation metamodel is improved in an adaptive manner, especially in the neighborhood of the optimal design point. Several numerical examples are solved to demonstrate the method, including a practical three-dimensional reinforced concrete high-rise building structure. The proposed approach works well, and the convergence of the optimal solutions for each of the examples is obtained within a few adaptive iterations.
Characterizing vibration responses of a handheld workpiece and the hand–arm system
Authors: Xu Xueyan S , Welcome Daniel E , McDowell Thomas W , Warren Christopher , Lin Hansheng , Xiao Bin , Chen Qingsong , Dong Ren G
Published: June 2020

The objective of this study is to characterize the vibration responses of a handheld workpiece and the hand–arm system, which is an important step toward identifying and developing effective methods and technologies for controlling the vibration exposures to workers performing the grinding of handheld workpieces. This study established a method for measuring the vibration responses of the entire workpiece–hand–arm system; the vibration exposure of a worker holding and pressing a typical workpiece against a sanding belt or grinding wheel in order to shape the workpiece was simulated. This method was applied to measure the apparent mass and vibration transmissibility of the system under two different feed forces (15 N and 30 N) and six simulated grinding interfaces with different stiffness values. A major resonance was observed in each transmissibility spectrum of the workpiece, which was correlated with the major resonance of the impedance of the entire system. This resonant frequency depended primarily on the workpiece mass and the grinding interface stiffness, but the hand–arm system could substantially affect the resonance magnitude. The feed force also significantly affected the resonance frequency and magnitude. While increasing the feed force increased the overall vibration transmissibility on the hand–arm system, the transmissibility with respect to the workpiece was not significantly affected by the interface conditions. The implications of the results are discussed.
Fake news or true lies? Reflections about problematic contents in marketing
Authors: Di Domenico Giandomenico , Visentin Marco
Published: June 2020

Scholars in different scientific fields and practitioners are analyzing the rise of production and diffusion of fake news and problematic information that is rapidly contaminating the digital world. Although problematic information might seriously affect brands, marketing and consumer behavior research is surprisingly limited. This article aims to provide a research agenda for marketing by analyzing the previous literature and identifying relevant insights suggested by different disciplines. Based on the review of 86 interdisciplinary scientific papers and 5 managerial reports, we speculate on future avenues for consumer behavior, marketing strategy, and marketing ethics research about fake news and problematic information.
‘If you don’t have documents or a legal procedure, you are out!’ Making humanitarian organizations partner in migration control
Authors: Kox Mieke , Staring Richard
Published: June 2020

The paradoxical merger of humanitarian care and securitization imperatives can be seen not only at external and externalized borders, but also at the internal borders in the Netherlands. Here, humanitarian organizations that sprang up to support migrants without a legal status in response to – and given their disagreement with – the state’s exclusionary migration policies have become involved in migration control. During a gradual and subtle responsibilization process, the Dutch authorities have used specific measures and redirected monetary flows in order to incorporate these organizations into its broader migration control policies. This has resulted in a decrease in the number of support organizations for unauthorized migrants, a reduction in their independence and autonomy, and an increased focus on selection and return. Ethnographic fieldwork amongst unauthorized migrants illustrates the consequences of this exclusionary control. These migrants experience exclusion, selection and enforcement by humanitarian organizations and doubt the trustworthiness of these organizations. This development seems to fit in with the broader trend of European states disarming humanitarian organizations for unauthorized migrants by either responsibilizing or criminalizing them. However, these strategies are not without consequences because they run the risk that unauthorized migrants will further withdraw and turn away from this type of assistance altogether. We use both a humanitarian and a pragmatic perspective to argue that it would make sense for states either to allow organizations to continue their – uncompromised and unconditional – support for unauthorized migrants or to adapt their migration policies in such a way that humanitarian support becomes redundant.
Generative systems in the architecture, engineering and construction industry: A systematic review and analysis
Authors: BuHamdan Samer , Alwisy Aladdin , Bouferguene Ahmed
Published: June 2020

Researchers have been extensively exploring the employment of generative systems to support design practices in the architecture, engineering and construction industry since the 1970s. More than half a century passed since the first architecture, engineering and construction industry’s generative systems were developed; researchers have achieved remarkable leaps backed by advances in computing power and algorithms’ capacity. In this article, we present a systematic analysis of the literature published between 2009 and 2019 on the utilization of generative systems in the design practices of the architecture, engineering and construction industry. The present research studies present trends, collaborations and applications of generative systems in the architecture, engineering and construction industry in order to identify existing shortcomings and potential advancements that balance the need for theory development and practical application. It provides insightful observations that are translated into meaningful recommendations for future research necessary to progress the incorporation of generative systems into the design practices of the architecture, engineering and construction industry.
The Prevalence of Sex Trafficking of Children and Adolescents in the United States: A Scoping Review
Authors: Franchino-Olsen Hannabeth , Chesworth Brittney R. , Boyle Colleen , Rizo Cynthia Fraga , Martin Sandra L. , Jordan Brooke , Macy Rebecca J. , Stevens Lily
Published: June 2020

Topic:

This scoping review investigated research regarding the magnitude of minor sex trafficking (domestic minor sex trafficking and/or commercial sexual exploitation of children) in the United States, summarizing estimates, methodologies, and strengths and weaknesses of the studies.

Method:

Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, peer-reviewed articles and the gray literature were accessed via databases searches, reference harvesting, and expert advice. Articles were included if they provided a count or prevalence proportion estimate of trafficked or at-risk minors across or within a region of the United States. Six empirical studies, published from 1999 to 2017, were included in the review.

Results:

Included studies produced count estimates ( n = 3) or prevalence proportion estimates ( n = 3) for youth at risk of minor sex trafficking ( n = 2) or reporting victimization ( n = 5). Studies examined sex trafficking risk and victimization in different geographical areas, including across the United States ( n = 2), in New York City ( n = 1), and in Ohio ( n = 1). Further, several studies focused on particular populations, such as street and shelter youths ( n = 1) and adjudicated males ( n = 1). Sampling methodologies of reviewed estimates included traditional random sampling ( n = 1), nationally representative sampling ( n = 2), convenience sampling ( n = 1), respondent-driven sampling ( n = 1), purposive sampling ( n = 1), and use of census data ( n = 2).

Conclusion:

Little research has estimated the prevalence of minor sex trafficking in the United States. The existing studies examine different areas and populations and use different categories to estimate the problem. The estimates reviewed here should be cited cautiously. Future research is needed on this important topic, including methodologies to produce more representative estimates of this hard-to-reach population.
An Application of a Negative-Pressure Wound Dressing for Partial- or Full-Thickness Burn Wounds
Authors: Cheng Yulong , Zhou Zengding , Hu Huan , Li Wenbo , Liu Yi , Xia Zihuan , Deng Chenliang , Mao Guangyu , Yi Lei , Liu Xiangdong , Yang Songlin , Zheng Jianghong , Guo Feng
Published: June 2020

Negative-pressure wound therapy is widely used in burn populations. Traditionally, negative-pressure devices use persistent vacuum suction, requiring a longer hospital stay. In this study, we applied a novel negative-pressure wound dressing for burn wounds, which eliminates the hospital stay. The medical records of 39 patients with partial-/full-thickness burns treated by negative-pressure wound dressing were retrospectively analyzed. The average burn area, burn degree, healing duration, cost, and incidents during treatment were determined and compared with previous data for conventional therapies. In conclusion, for patients diagnosed with partial-thickness or full-thickness burns and a burn area <34.6 ± 2.21 cm2, the negative-pressure wound dressing is a reliable option, especially for burnt children. Moreover, the negative-pressure wound dressing treatment was not only much cheaper than conventional therapies, but also eliminated hospital stay in patients with small-area deep burn wounds.
A Primary Care Answer to a Pandemic: Keeping a Population of Patients Safe at Home through Chronic Care Management and Remote Patient Monitoring
Authors: Donohue David
Published: June 2020

The pandemic caused by the coronavirus disease of 2019 (COVID-19) challenged primary care providers (PCPs) to continue to deliver care for their patients, while also remaining financially stable. Most practices have experienced declining revenue due to fewer in-person patient visits. To help offset this and to continue to provide safe patient care, practices have shifted toward using remote options. Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) are benefits available to Medicare fee-for-service patients, which allow a medical practice to deliver expanded care and generate much-needed revenue. These services can be delivered by clinical staff called care managers. A top health priority for most seniors is to effectively self-isolate to reduce risk of COVID-19, while maintaining mental and physical health. We developed a Safe at Home program, designed to be run by care managers through CCM and RPM, with the use of a remote monitoring technology. Safe at Home tracks signs and symptoms of COVID-19, mental and physical health, and lifestyle behaviors that can affect immune function. We project that this service can complement regular telehealth PCP visits and deliver population health monitoring services, while generating substantial revenue for the practice.
State feedback-based impedance control for legged robot hydraulic drive unit via full-dimensional state observer
Authors: Zhu Qixin , Yu Bin , Huang Zhipeng , Kang Yan , Kong Xiangdong , Ba Kaixian
Published: June 2020

In this article, the hydraulic drive unit that drives the movement of the joint of a legged robot was researched, aiming at improving the control accuracy of the position-based impedance control system with dual input and single output. The state feedback control containing more state information of the system was adopted to replace the traditional output feedback and proportional-integral-derivative (PID) control, through the real-time calculation of the time-varying parameters of the servo valve flow, the nonlinear state space expression of the system was derived, the state feedback matrix and the input transformation amplifier were obtained and the full-dimensional state observer was designed. The experimental results show that the designed full-dimensional state observer can track the state variables of the actual system better. Compared with the traditional output feedback and PID control, state feedback control performs better in aspects of accuracy and system dynamics for the position-based impedance control system, which can further improve the compliance performance of the robot.
Meditation and the Wandering Mind: A Theoretical Framework of Underlying Neurocognitive Mechanisms
Authors: Brandmeyer Tracy , Delorme Arnaud
Published: June 2020

During the practice of meditation, the tendency of the mind to wander away from the object of focus is ubiquitous. The occurrence of mind wandering in the context of meditation provides individuals a unique and intimate opportunity to closely examine the nature of the wandering mind by cultivating an awareness of ongoing thought patterns, while simultaneously aiming to cultivate equanimity (evenness of temper or disposition) and compassion toward the content of thoughts, interpretations, and bodily sensations. In this article we provide a theoretical framework that highlights the neurocognitive mechanisms by which contemplative practices influence the neural and phenomenological processes underlying spontaneous thought. Our theoretical model focuses on several converging mechanisms: the role of meta-awareness in facilitating an increased moment-to-moment awareness of spontaneous thought processes, the effects of meditation practice on key structures underlying both the top-down cognitive processes and bottom-up sensory processes implicated in attention and emotion regulation, and the influence of contemplative practice on the neural substrates underlying perception and perceptual decoupling.
Employers’ perspectives of how well prepared early childhood teacher graduates are to work in early childhood education and care services
Authors: Boyd Wendy , Wong Sandie , Fenech Marianne , Mahony Linda , Warren Jane , Lee I-Fang , Cheeseman Sandra
Published: June 2020

With an unprecedented number of children in early childhood education and care in Australia, demand for early childhood teachers is increasing. This demand is in the context of recognition of the importance of the early years and increasing requirements for more highly qualified early childhood teachers under the National Quality Framework. Increasingly, evidence shows the value-added difference of university-qualified teachers to child outcomes. Within Australia there are multiple ways to become an early childhood teacher. Three common approaches are a 4-year teaching degree to teach children aged birth to 5 years, children aged birth to 8 years, or children aged birth to 12 years. There is, however, no evidence of how effective these degree programmes are. This paper presents the perspectives of 19 employers of early childhood teachers in New South Wales regarding how well prepared early childhood teacher graduates are to work in the early childhood sector in Australia. Although participants noted the strengths of new graduate early childhood teachers, they also identified several areas in which they were less well prepared to teach in the early years.
Comparison of Current Staging Systems for Sinonasal Inverted Papilloma
Authors: Nakayama Tsuguhisa , Tsunemi Yasuhiro , Kashiwagi Takashi , Kuboki Akihito , Yamakawa Shuchi , Konno Wataru , Mori Aya , Iimura Jiro , Tsukidate Toshiharu , Tanaka Yasuhiro , Haruna Shin-ichi
Published: June 2020

Background

A staging system is essential for determining the optimal surgical approach and predicting postoperative outcomes for inverted papilloma (IP). Although staging systems based on the extent to which the location is occupied by an IP have been widely used, an origin site-based classification of IP using unsupervised machine learning algorithms has recently been reported.

Objective

To determine the most appropriate of five staging systems for sinonasal IP by comparing recurrence rates for each stage according to each of those systems.

Methods

Eighty-seven patients with sinonasal IP were enrolled in the study. Their tumors were retrospectively categorized according to the Krouse, Oikawa, Cannady, and Han staging systems, which are based on the extent of IP, and the Meng system, which is based on the site of origin. The rates of recurrence for each stage of the five systems were compared.

Results

Seven of the 87 patients (8.0%) had recurrences during an average 45.5 months (12–138 months) of follow-up. There were significant differences in disease-free survival between the stages specified by Han and Meng (p = 0.027 and p < 0.001, respectively), but not between the stages specified by Krouse, Oikawa, and Cannady (p = 0.236, 0.062, and 0.130, respectively). Cox proportional hazard models revealed that Meng system (adjusted hazard ratio [aHR] 4.32, 95% confidence interval [CI] 1.10–17.04) and presence of dysplasia (aHR 7.42, 95% CI 1.15–47.85) were significantly associated with recurrence.

Conclusion

The staging systems proposed by Han and Meng were found to be accurate in terms of tumor recurrence. We recommend use of the Han staging system before surgery and the Meng system after intraoperative identification of the origin of the tumor.
Using audience response system in a third world country: The good, bad and ugly
Authors: Ayebi-Arthur Kofi , Acheaw Owusu Kofi
Published: June 2020

An effective classroom is where there are various forms of interactions: student-student and teacher-student. Unfortunately, most of the interactions that go on in our lecture theatres are minimal. This paper reports an innovative method of engaging students through the use of an Audience Response System (ARS) in a university course. The ARS was used to explore the possibility of improving the interactions in the lecture theatres. The overarching research question was: How best does ARS support lecturer-student interactions in the lecture theatre? A questionnaire and interview were used to elicit students’ views on the use of ARS as an instructional tool. Students reported that they enjoyed using ARS as it facilitated class interaction and collaboration. Internet onnectivity and incompatibility issues on some devices made teaching with the ARS a bit challenging. It is therefore recommended that lecturers can make use of ARS to improve interactions in their lecture rooms.
Evaluation of mobile games in the context of content: What do children face when playing mobile games?
Authors: Göksu İdris , Aslan Alper , Turgut Yiğit Emrah
Published: June 2020

The aim of this study is to examine mobile games in the context of their content and to evaluate the situations faced by children through document analysis in terms of age-rating, game score, access permissions, the inclusion of advertisements, in-game purchases, encouraging consumerism, the inclusion of violence, bad habits, and educational value. The review and rating data of the games which can be found in Common Sense Media and Google Play Store were included in the study. These data were analyzed by descriptive content analysis using frequency (f) and percentage(%) values. According to our findings, it was revealed that 92% of the games involved in the study included in-game purchases and 75% of them included advertising. As a result of the investigations, it was also found that mobile games requested a lot of access permissions during installation. In addition, it was concluded that 90% of mobile games encouraged consumerism and 50% contained violence and fear elements. We think that the results are important in the way that they reveal the possible risks encountered by young people while they are playing mobile games and also in terms of increasing the awareness on the subject for both the users and their parents.
A review of big data and medical research
Authors: Mallappallil Mary , Sabu Jacob , Gruessner Angelika , Salifu Moro
Published: June 2020

Universally, the volume of data has increased, with the collection rate doubling every 40 months, since the 1980s. “Big data” is a term that was introduced in the 1990s to include data sets too large to be used with common software. Medicine is a major field predicted to increase the use of big data in 2025. Big data in medicine may be used by commercial, academic, government, and public sectors. It includes biologic, biometric, and electronic health data. Examples of biologic data include biobanks; biometric data may have individual wellness data from devices; electronic health data include the medical record; and other data demographics and images. Big data has also contributed to the changes in the research methodology. Changes in the clinical research paradigm has been fueled by large-scale biological data harvesting (biobanks), which is developed, analyzed, and managed by cheaper computing technology (big data), supported by greater flexibility in study design (real-world data) and the relationships between industry, government regulators, and academics. Cultural changes along with easy access to information via the Internet facilitate ease of participation by more people. Current needs demand quick answers which may be supplied by big data, biobanks, and changes in flexibility in study design. Big data can reveal health patterns, and promises to provide solutions that have previously been out of society’s grasp; however, the murkiness of international laws, questions of data ownership, public ignorance, and privacy and security concerns are slowing down the progress that could otherwise be achieved by the use of big data. The goal of this descriptive review is to create awareness of the ramifications for big data and to encourage readers that this trend is positive and will likely lead to better clinical solutions, but, caution must be exercised to reduce harm.
Doxazosin for the treatment of nightmare disorder: A diary-based case study
Authors: Pallesen Ståle , Hamre Hilde Sofie , Lang Nina , Bjorvatn Bjørn
Published: June 2020

The α1-adrenergic antagonist prazosin has showed good effect against posttraumatic stress disorder–related nightmares in several randomized controlled trials. The α1-adrenergic antagonist doxazosin, which has a longer half-live than prazosin, has received far less attention in the treatment of such nightmares. Here, we report a case of a patient suffering from severe nightmares following an erroneous medical administration of adrenaline (causing severe physiological hyper-activation) who was treated with doxazosin. Over a period of 280 days, the patient kept a nightmare diary and took 0, 4, or 8 mg doxazosin. The analyses showed that 8 mg doxazosin (55.2% nightmare-free nights) worked better (odds ratio = 28.2; 95% confidence interval = 3.7–213.9) compared to nights without doxazosin (4.3% nightmare-free nights). Except dizziness, which was not regarded as particularly bothersome by the patient, doxazosin was well tolerated. It is concluded that doxazosin may be indicated as a pharmacological treatment for patients suffering from posttraumatic stress disorder–related nightmares.
Comparative efficacy and safety of lactulose plus paraffin vs polyethylene glycol in functional constipation: a randomised clinical study
Authors: Piche T , Dapoigny M
Published: June 2020

Background

Few head‐to‐head comparisons of the different classes of laxatives have been conducted.

Objective

The objective of this work is to compare the efficacy of lactulose plus paraffin vs polyethylene glycol in the treatment of functional constipation (non‐inferiority study).

Methods

This randomised, parallel‐group, multicentre phase 4 study recruited patients with functional constipation diagnosed according to Rome III criteria. Patients received lactulose plus paraffin or polyethylene glycol for 28 days. The primary end point was the change from baseline in the Patient Assessment of Constipation–Symptoms (PAC‐SYM) score.

Results

A total of 363 patients were randomised to lactulose plus paraffin (n  = 179) or polyethylene glycol (n  = 184). On day 28, the mean PAC‐SYM score decreased significantly vs baseline with both treatments (p  < 0.001). The lower boundary of the 95% CI exceeded the pre‐specified limit of −0.25, therefore establishing non‐inferiority of lactulose plus paraffin vs polyethylene glycol. At least one adverse event occurred in 20 patients (11.2%) in the lactulose plus paraffin group and in 26 patients (14.2%) in the polyethylene glycol group, most of which were of mild or moderate severity and unrelated to study drugs.

Conclusion

Lactulose plus paraffin may be used interchangeably with polyethylene glycol for the pharmacological treatment of functional constipation.

Trial registration: EudraCT number 2015‐003021‐34
Assessment of the practicability of implementing the EULAR recommendations for the role of nurses in the management of chronic inflammatory arthritis in China
Authors: Ma Ling , Liang Yan , Yu Sheng-nan , Wang Ying , Oliver Susan M , Chen Yan-ling , Zhao Yi , Cao Yu-qiong , Liu Xue-mei , Zhang Zi-yun , Chen Li-hong , Liu Yi
Published: June 2020

Chronic inflammatory arthritis (CIA) severely impacts quality of life in over 100 million people in China. In 2011, the European League Against Rheumatism (EULAR) developed recommendations for the role of nurses in the management of CIA. However, it remains unknown whether these recommendations could be fully implemented in China. Therefore, we aimed to solve the problem in this study. We conducted a nationwide cross-sectional study among 485 nurses in rheumatology and immunology departments based on an online questionnaire. The agreement of the recommendations by the subjects and the feasibility of the recommendations they believe were assessed by visual analogue scale (VAS). Our results showed that over 80% of the subjects agreed with each recommendation (VAS 5–10), and over 80% of the subjects considered the recommendations feasible (VAS 5–10). This study indicates that the EULAR recommendations can also be well implemented in China.
The use of botulinum toxin in keloid scar management: a literature review
Authors: Sohrabi Catrin , Goutos Ioannis
Published: June 2020

Introduction:

Administration of botulinum toxin is an increasingly popular procedure in the medical and aesthetic field. There is emerging evidence that it can influence fibroblast activity and minimise tension around the scar by virtue of muscular chemoimmobilisation. This review aims to explore the current evidence base behind the treatment of keloid scars with botulinum toxin. [Formula: see text]

Methods:

A detailed literature review was conducted using PubMed Medline, Embase and Web of Science databases. Manuscripts were appraised and classified in accordance with the Joanna Briggs Institute Levels of Evidence by an independent consultant in evidence synthesis. The results of this search are presented in descending order of evidence for botulinum toxin as a primary management agent as well as a secondary adjunct following extralesional keloid excision.

Discussion:

On the basis of level 1 evidence, botulinum toxin appears to be equivalent to triamcinolone in producing a short-term reduction in keloidal volume, height and vascularity. A number of level 1 and 2 studies also suggest that botulinum toxin may be particularly helpful in alleviating symptoms of keloid associated pain and itch. There are currently limited studies appraising the value of botulinum toxin in the postoperative management of keloid scars.

Conclusion:

Botulinum toxin may represent a promising agent in the management of keloid scars. However, further research involving large-scale studies with comparative designs and long-term follow-up is warranted to delineate the value of this therapeutic modality in scar management protocols.
Similar early functional recovery after total knee replacement comparing single shot versus continuous saphenous nerve block: A randomised, double-blind trial
Authors: Lam Ho Yee Joyce , Tang Yan Ho Bruce , Wong Hok Leung , Yang Isaac Bruce
Published: June 2020

Purpose:

Total knee replacement (TKR) is associated with post-operative pain. Femoral nerve block can relieve the pain but also affects the post-operative mobility. Saphenous nerve block (SNB) can improve analgesia without interfering mobilisation. However, there is no consensus on the ideal mode of administration of SNB. We aim to compare the effects of single shot versus continuous SNB on patients undergoing TKR.

Methods:

Patients were randomised into two groups: single shot and continuous SNB groups. Post-operative rehabilitation and mobilisation were assessed by blinded physiotherapists, and preoperative and post-operative American knee scores were recorded by blinded specialised nurse. Post-operative analgesics usage was recorded by blinded pain nurses and anaesthetists.

Results:

Sixty-four patients were recruited; 6 patients withdrew with 29 patients in each group. There is no significant difference in early mobilisation and rehabilitation comparing both groups. The mean of the range gained on day 2 when compared to day 1 in single-shot SNB group was 17.41 ± 19.67° versus continuous SNB group was 23.45 ± 19.18° ( p = 0.149). The mean of the range gained on day 3 when compared to day 1 in single-shot group was 27.24 ± 22.66° versus continuous SNB group was 29.31 ± 21.57° ( p = 0.6). The mean of maximum flexion achieved by day 3 in single-shot SNB group was 92.41 ± 9.6° versus continuous SNB was 91.90 ± 7.95° ( p = 0.84). The day of reaching maximum flexion and the goal of 40 m showed no significant difference. Length of stay (LOS), difference in post-operative American Knee Society knee score at 3 months and analgesics usage showed no significant difference.

Conclusion:

There is no significant difference in comparing the effect on mobilisation, LOS, early clinical outcome, analgesics usage in the single-shot group and the continuous SNB group.
Training Exposure and Self-Rated Competence among HIV Care Providers Working with Adolescents in Kenya
Authors: Karman Elizabeth , Wilson Kate S. , Mugo Cyrus , Slyker Jennifer A. , Guthrie Brandon L. , Bukusi David , Inwani Irene , John-Stewart Grace C. , Wamalwa Dalton , Kohler Pamela K.
Published: June 2020

Lack of health care worker (HCW) training is a barrier to implementing youth-friendly services. We examined training coverage and self-reported competence, defined as knowledge, abilities, and attitudes, of HCWs caring for adolescents living with HIV (ALWH) in Kenya. Surveys were conducted with 24 managers and 142 HCWs. Competence measures were guided by expert input and Kalamazoo II Consensus items. Health care workers had a median of 3 (interquartile range [IQR]: 1-6) years of experience working with ALWH, and 40.1% reported exposure to any ALWH training. Median overall competence was 78.1% (IQR: 68.8-84.4). In multivariable linear regression analyses, more years caring for ALWH and any prior training in adolescent HIV care were associated with significantly higher self-rated competence. Training coverage for adolescent HIV care remains suboptimal. Targeting HCWs with less work experience and training exposure may be a useful and efficient approach to improve quality of youth-friendly HIV services.
Clinician Barriers and Facilitators to Routine HIV Testing: A Systematic Review of the Literature
Authors: Bagchi Ann Dalton , Davis Tracy
Published: June 2020

Background:

Routine HIV screening rates are suboptimal.

Objectives:

This systematic review identified barriers to/facilitators of routine HIV testing, categorized them using the socioecological model (SEM), and provided recommendations for interventions to increase screening.

Data Sources:

Included articles were indexed in PubMed, EBSCO CINAHL, Scopus, Web of Science, and the Cochrane Library between 2006 and October 2018.

Eligibility Criteria:

Included studies were published in English or Spanish and directly assessed providers’ barriers/facilitators to routine screening.

Data Extraction:

We used a standardized Excel template to extract barriers/facilitators and identify levels in the SEM.

Data Synthesis:

Intrapersonal factors predominated as barriers, while facilitators were directed at the institutional level.

Limitations:

Policy barriers are not universal across countries. Meta-analysis was not possible. We could not quantify frequency of any given barrier/facilitator.

Conclusions:

Increasing reimbursement and adding screening as a quality measure may incentivize HIV testing; however, many interventions would require little resource investment.