bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Promoting Lifestyle Among Israeli Adult Survivors of Childhood Cancer
Authors: Liebergall-Wischnitzer Michal , Buyum Moriya , DeKeyser Ganz Freda
Published: October 2015

Background: Childhood cancer survivors are at risk for recurrence of their primary cancer as well as other secondary site cancers. The survivors are also at increased risk for long-term effects such as chronic illnesses. Health promoting lifestyles are therefore especially important for childhood cancer survivors. The purpose of the study was to describe the health promoting behaviors of childhood cancer survivors and to determine whether these behaviors are associated with demographic and clinical characteristics. This is a descriptive-comparative study that took place in an oncology follow-up clinic in Israel. Sample: Seventy-seven childhood cancer survivors. Tools: Health Promoting Lifestyle Profile 2, questionnaire (interpersonal relationships, spiritual growth, physical activity, nutrition, health responsibility, and stress management), and smoking and alcohol consumption and a demographic–clinical questionnaire. The mean item score was moderate-high. Survivors scored highest on interpersonal relationships and spiritual growth while the lowest scoring activities were physical activity and nutrition. About 30% of the survivors abstained from smoking and alcohol consumption. Women, as opposed to men, were more likely to have higher scores related to nutrition and interpersonal relationships while singles as opposed to those who were married were found to have higher scores related to spiritual growth. Conclusions: Health behaviors associated with interpersonal relationships and spiritual growth were more likely to be performed compared to physical activity, good nutrition, and decreased smoking and alcohol consumption. Special attention should be placed on promoting physical activity and good nutrition among survivors of childhood cancer.
Acceptability of RPG Simulators for Foreign Language Training in Japanese Higher Education
Authors: Franciosi Stephan J.
Published: October 2015

Background Role-playing game (RPG)/simulators for language and cultural training present an innovative foreign language (FL) instructional approach used in military and governmental contexts in the United States. Currently, developers of such RPGs may be seeking to expand into civilian applications for FL instruction, but the acceptance in potentially worthwhile markets such as Japanese higher education is uncertain.

Purpose The purpose of this acceptability study was to better understand the possible interest in Japan by exploring the perceptions of RPG/simulators among FL faculty in Japanese higher education.

Method The present study was grounded in Everett Rogers’ theory of the Diffusion of Innovation and applied mixed methods to examine the perceived attributes of relative advantage, compatibility, and complexity that FL faculty hold with regard to the new technology.

Results The results indicate that many FL faculty members perceive a beneficial impact on learner motivation, but are also unconvinced that such systems produce real outcomes. Educators also believe that RPG simulators would require an excessive amount of time to implement unless they are used as supplemental material. Finally, FL faculty members with a research interest in Computer-Assisted Language Learning (CALL) are more likely to have positive perspectives of RPG/simulators’ relative advantage and compatibility than instructors with other research interests.
How Do You Lead the Pack? A Resource to Develop Personal Strengths for Students and Practitioners
Authors: Prisant Lesko Ashley
Published: October 2015

Educators and managers that focus on individuals’ strengths can see up to 40× more engagement from those individuals than those that do not. StrengthsFinder 2.0 builds a framework to understand and improve those strengths. This resource review will explain the history of the tool, including its origins in positive and strengths psychology. It will break out the assessment as a tool to be used in the classroom, as well as describe activities to educate on topics such as career development, leadership development, employee engagement, and academic excellence. A comparison to other assessments is presented and an evaluation of the tool’s versatility and ability to self-assess is given. Finally, further information and a list of free resources are provided in use with StrengthsFinder 2.0.
Correlates of Socioeconomic Status and the Health of Older People in the United Kingdom
Authors: Rahman Md. Mijan , Khan Hafiz T. A. , Hafford-Letchfield Trish
Published: October 2015

This article reviews the existing literature on the association between the socioeconomic status (SES) and the health of the ageing population in the United Kingdom. It has been noted that socioeconomic differentials are more marked across the United Kingdom than they are in other developed countries. Social class gradients are significant in health for working-age people (up to age 65), whereas studies on older populations have so far been limited so as to draw any robust conclusions. In this article, we examine the inequalities through selected SES indicators in order to tease out the effects on health outcomes of the older population. We critically review the physical and mental health indicators of older people in the United Kingdom with regard to their SES differentials. The findings reveal that older people with lower SES are more likely to experience poorer health outcomes (e.g., long-standing illness or increased disability) and have shorter life expectancy compared with those of higher SES. We illustrate how education remains the single most important determinant of health inequality in later life. We suggest that educational level or occupational class allied with material deprivation offer the best combined indicators of SES for studying health inequalities among older people. The findings of this article has profound implications for prioritizing policies to improve the health and well-being of elderly people with lower SES and go offer an evidence base of how to understand and to develop interventions that minimize the inequalities in health in later life in the United Kingdom.
Smoking Cessation Failure Among Korean Adolescents
Authors: Kim Sung Reul , Kim Hyun Kyung , Kim Ji Young , Kim Hye Young , Ko Sung Hee , Park Minyoung
Published: October 2015

The aim of this study was to identify smoking cessation failure subgroups among Korean adolescents. Participants were 379 smoking adolescents who joined a smoking cessation program. A questionnaire and a cotinine urine test were administered before the program began. Three months after the program ended, the cotinine urine test was repeated. A decision-tree model identified seven subgroups with low or high smoking cessation rates. The predictors of smoking cessation were intention to stop smoking, initiation of smoking, amount of cigarette use, self-efficacy, and paternal smoking status. The subgroup with the lowest smoking cessation rate included adolescents who did not have any intention to stop smoking and who had started smoking after eighth grade, and none of the participants in this group stopped smoking. The results of this study provide crucial information for tailored smoking cessation programs.
Understanding Cross-National Differences in Risk Through a Localized Cultural Perspective
Authors: Park Junsu , Kim Do-Yeong , Zhang Chong
Published: October 2015

We examine cross-national differences in attitudes and decisions toward risk by comparing Chinese (collectivists), South Korean (collectivists, but with distinctive localized cultural norms), and Australian (individualists) undergraduate student samples from a balanced cross-cultural perspective. Individual evaluation revealed that risk was least favored by the Chinese students in their attitudes and choices, followed by the South Korean and Australian students. Unlike previous results from South Korean and Australian student samples that exhibited unique shifts toward risky choices indicative of group polarization, the Chinese students did not tend to take greater risks when making group versus individual decisions (i.e., risky shift). This was regardless of the group’s gender composition, although the pattern did vary according to financially oriented risk domains. The implications of these results are discussed in terms of each country’s indigenous sociocultural norms.
The Measurement of Journalistic Role Enactments
Authors: Carpenter Serena , Boehmer Jan , Fico Frederick
Published: October 2015

Media scholars have primarily assessed journalistic role perceptions through the survey method. We propose conceptual and operational definitions for four role enactments observable through content analysis: dissemination, interpretative, adversarial, and mobilization. We also examined how journalistic role enactments in stories related to organization type (nonprofit and for-profit) and reporter workload. Results show that nonprofit journalists were more likely to include interpretation in stories, whereas for-profit journalists were more likely to enact the dissemination and mobilization roles. In addition, as reporter story number increases, it significantly predicted enacting the dissemination role, while suppressing the interpretative role, and especially the adversarial role enactment.
Leg Length Versus Torso Length in Pedophilia: Further Evidence of Atypical Physical Development Early in Life
Authors: Fazio Rachel L. , Dyshniku Fiona , Lykins Amy D. , Cantor James M.
Published: October 2015

Adult men’s height results from an interaction among positive and negative influences, including genetic predisposition, conditions in utero, and influences during early development such as nutritional quality, pathogen exposure, and socioeconomic status. Decreased height, reflected specifically as a decreased leg length, is strongly associated with increased risk of poorer health outcomes. Although prior research has repeatedly shown that pedophiles are shorter than nonpedophiles, the largest study to date relied on self-reported height. In the present study, pedophiles demonstrated reduced measured height and reduced leg length as compared with teleiophiles. Given the prenatal and early childhood origins of height, these findings contribute additional evidence to a biological, developmental origin of pedophilia. In addition, the magnitude of this height difference was substantially larger than that found in children exposed to a variety of early environmental stressors, but similar to that seen in other biologically based neurodevelopmental disorders.
Faecal consistency and risk factors for diarrhoea and constipation in cats in UK rehoming shelters
Authors: German Allison C , Cunliffe Nigel A , Morgan Kenton L
Published: October 2015

Objectives

The aim of the study was to describe faecal consistency, prevalence and risk factors for diarrhoea and constipation in a rescue cat population.

Methods

Faecal samples in litter trays from a stratified random sample of cats in pens at 25 UK rehoming centres were scored for consistency in two discrete time periods, summer and winter. A six-point scale was used, with diarrhoea ⩽3, severe diarrhoea ⩽2 and constipation as 6. The effect on faecal consistency of age, number of cats per pen and season was investigated using multivariable hierarchical logistic regression with centre and pen as random effects. Intraclass correlation coefficients were used to estimate the effect of pen and centre.

Results

Overall, 11.9% (95% confidence interval [CI]:10.4–13.7) of cats had diarrhoea, 2.4% (95% CI 1.6–3.7) had severe diarrhoea and 5.6% (95% CI 4.2–7.5) were constipated. The prevalence of diarrhoea (median 11.0%, interquartile range [IQR] 5.0–14.5%) and constipation (median 4.2%, IQR 1.8–5.9) varied at the centre level. Diarrhoea was associated with being a kitten (odds ratio [OR] 2.54, 95% CI 1.45–4.46; P = 0.001) and being in a multi-cat pen (OR 1.24, 95% CI 1.04–1.48; P = 0.02) but not with season (OR 0.99, 95% CI 0.55–1.77; P = 0.96). Severe diarrhoea was associated with senior cats (OR 4.66, 95% CI 1.25–17.44; P = 0.02). Constipation was associated with increasing age (OR 1.01; 95% CI 1.00–1.01; P = 0.02) and winter (OR 0.43, 95% CI 0.21–0.89; P = 0.02). Both diarrhoea and constipation showed moderate correlation with pens within a centre.

Conclusions and relevance

From IQRs, we suggest acceptable levels for diarrhoea and constipation of 11% and 4%, respectively, targets of 5% and 2%, and intervention at 15% and 6%. Increasing age was associated with decreased risk of diarrhoea and increased risk of constipation. However, severe diarrhoea was associated with being a senior cat. Season (winter) was a risk factor for constipation; multi-cat pens were a risk factor for diarrhoea. Describing the prevalence and risk factors for diarrhoea and constipation in cats will assist their management in this population. Understanding and managing constipation may be more important than interventions to reduce severe diarrhoea.
The Relationship Between the Serum Level of Vitamin D and Vitiligo
Authors: Khurrum Huma , AlGhamdi Khalid M.
Published: October 2015

Background:

Low vitamin D levels have been associated with several autoimmune diseases. Vitiligo could be associated with low vitamin D levels.

Objective:

To determine the level of serum vitamin D in vitiligo patients compared to controls and reveal the possible association of vitamin levels with the pathogenesis of vitiligo.

Patients and Methods:

A case-controlled study was conducted. After excluding factors that may affect serum vitamin D levels, blood samples were taken from vitiligo patients and controls. The association between vitamin D levels and various vitiligo subgroups (duration of vitiligo, site of onset, age, etc) was measured and correlated.

Results:

A total of 150 vitiligo patients, 90 (60%) males with a mean age of 30.6 ± 11.4 years, were recruited. The study also had 150 age- and gender-matched vitiligo-free control subjects. There was no significant difference in median serum vitamin D levels between the cases and the controls ( P = .25). The serum levels of vitamin D of the vitiligo patients were found to be lower in males ( P = .01), the younger age group ( P = .01), and patients not treated with ultraviolet (UV) treatment ( P = .01).

Conclusion:

There is no difference between the vitamin D levels of the vitiligo patients and the control subjects. However, deficiency of 25(OH)D levels within the vitiligo subgroups may be linked to younger age, male gender, short duration of vitiligo, and non-use of phototherapy.
Trends in Non-Melanoma Skin Cancer (Basal Cell Carcinoma and Squamous Cell Carcinoma) in Canada
Authors: Abbas Mariam , Kalia Sunil
Published: October 2015

Background:

Despite its increased incidence and status as the most prevalent cancer in Canada, there is a paucity of epidemiological data on non-melanoma skin cancer (NMSC).

Objective:

To assess trends of keratinocyte carcinomas (KC) in Canada over 5 decades.

Methods:

Articles published from 1960 to 2015 on NMSC in Canada were identified through MEDLINE. Six articles met our search criteria.

Results:

Overall, KC has increased. However, the rate of increase in the past decade has slowed down and decreased in younger age cohorts. Men had higher incidences of KC. In both sexes, the basal cell carcinoma and squamous cell carcinoma ratio was ≥2.5:1. Keratinocyte carcinomas were most commonly located on the head and neck, and increasing rates are occurring on the trunk.

Limitations:

The methods of registering skin cancer cases vary among different provinces.

Conclusion:

Keratinocyte carcinomas incidence is overall increasing; however, there may be evidence that the incidence is leveling off and decreasing in younger age cohorts.
Informal music education: The nature of a young child’s engagement in an individual piano lesson setting
Authors: Kooistra Lauren
Published: October 2015

The purpose of this study was to gain insight into the nature of a young child’s engagement in an individual music lesson setting based on principles of informal learning. The informal educational space allowed the child to observe, explore, and interact with a musical environment as a process of enculturation and development (Gordon, 2013; McCloskey, 2012). The setting incorporated the piano, and was considered a readiness experience for later formal piano training. Data collection occurred via video recording, with 24 episodes isolated for close analysis. Richly descriptive narratives of each episode were analyzed by line-by-line transformation regarding the nature of the child’s engagement (Van Manen, 1990). The child’s engagement in the setting was viewed through lenses of lived space, lived body, lived time, lived other (Van Manen, 1990), and lived musicality (Kooistra, 2013). Results include that the child engaged in the setting by expanding the boundaries of the room, using the full range of the room, using his body in rhythmic response, directing the time, including the parent in the lesson, creating pretend contexts, making music (singing, chanting, moving, playing the piano and other instruments), embedding music in his activities, and believing in his musicianship.
Relevance of asymptomatic spinal MRI lesions in patients with multiple sclerosis
Authors: Zecca C , Disanto G , Sormani MP , Riccitelli GC , Cianfoni A , Del Grande F , Pravatà E , Gobbi C
Published: October 2015

Background:

The impact of new asymptomatic spinal cord lesions (a-SL) in multiple sclerosis (MS) course is poorly characterized.

Objective:

The objective of this research paper is to assess the prognostic value of a-SL in predicting MS course.

Methods:

Relapsing–remitting MS patients who received serial MRI (brain and spinal) at baseline (t1) and within 12 to 36 months (t2) during clinical stability, and had a follow-up (t2–t3) ⩾24 months were included. Relapses and disability progression were evaluated between t2 and t3.

Results:

Of 413 consecutive screened MS patients, 103 patients (65 females, median age 43 years) were included. After a median t1–t2 interval of 17 (IQR 13–26) months, 25.2% and 43.7% patients had ⩾1 new a-SL (a-SL+) and asymptomatic brain lesions (a-BL+), respectively. Relapse risk between t2 and t3 (median interval: 42 (IQR 32–57.5) months) was significantly increased in a-SL+ and/or a-BL+ vs a-BL– and a-SL– (HR = 2.31, 95% CI = 1.13–4.72, p = 0.02). No differences in the risk of disability progression were found in a-SL+ and/or a-BL+ vs a-SL- and a-BL–.

Conclusion:

a-SL occur in one-quarter of clinically stable RRMS, and combined with a-BL contribute significantly in predicting future disease course.
Dimethyl fumarate selectively reduces memory T cells in multiple sclerosis patients
Authors: Longbrake Erin E , Ramsbottom Michael J , Cantoni Claudia , Ghezzi Laura , Cross Anne H , Piccio Laura
Published: October 2015

Background:

Dimethyl fumarate (DMF) alters the phenotype of circulating immune cells and causes lymphopenia in a subpopulation of treated multiple sclerosis (MS) patients.

Objective:

To phenotypically characterize circulating leukocytes in DMF-treated MS patients.

Methods:

Cross-sectional observational comparisons of peripheral blood from DMF-treated MS patients ( n = 17 lymphopenic and n = 24 non-lymphopenic), untreated MS patients ( n = 17) and healthy controls ( n = 23); immunophenotyped using flow cytometry. Longitudinal samples were analyzed for 13 DMF-treated patients.

Results:

Lymphopenic DMF-treated patients had significantly fewer circulating CD8+ and CD4+ T cells, CD56dim natural killer (NK) cells, CD19+ B cells and plasmacytoid dendritic cells when compared to controls. CXCR3+ and CCR6+ expression was disproportionately reduced among CD4+ T cells, while the proportion of T-regulatory (T-reg) cells was unchanged. DMF did not affect circulating CD56hi NKcells, monocytes or myeloid dendritic cells. Whether lymphopenic or not, DMF-treated patients had a lower proportion of circulating central and effector memory T cells and concomitant expansion of naïve T cells compared to the controls.

Conclusions:

DMF shifts the immunophenotypes of circulating T cells, causing a reduction of memory cells and a relative expansion of naïve cells, regardless of the absolute lymphocyte count. This may represent one mechanism of action of the drug. Lymphopenic patients had a disproportionate loss of CD8+ T-cells, which may affect their immunocompetence.
Passion and reason: Notes on a contested relationship
Authors: Corner John
Published: October 2015

This note of commentary examines aspects of the relationship between passion and reason. It looks at how forms of interaction between the two have been conceptualised within different theories and at how attempts at correcting the under-recognition of emotion in deliberative activity have been a goal of recent studies. It suggests that ideas of mutuality as well as of tension with forms of rationality will continue to guide cultural analysis into the variety of passionate experience across a diversity of practices and contexts of power. This article is part of a themed issue entitled ‘Passion’.
Application of process mining to assess the data quality of routinely collected time-based performance data sourced from electronic health records by validating process conformance
Authors: Perimal-Lewis Lua , Teubner David , Hakendorf Paul , Horwood Chris
Published: October 2015

Effective and accurate use of routinely collected health data to produce Key Performance Indicator reporting is dependent on the underlying data quality. In this research, Process Mining methodology and tools were leveraged to assess the data quality of time-based Emergency Department data sourced from electronic health records. This research was done working closely with the domain experts to validate the process models. The hospital patient journey model was used to assess flow abnormalities which resulted from incorrect timestamp data used in time-based performance metrics. The research demonstrated process mining as a feasible methodology to assess data quality of time-based hospital performance metrics. The insight gained from this research enabled appropriate corrective actions to be put in place to address the data quality issues.
How do carers of people with multiple sclerosis engage with websites containing the personal experiences of other carers and patients?
Authors: Sillence Elizabeth , Hardy Claire , Briggs Pam , Harris Peter R
Published: October 2015

The Internet supports the peer-to-peer healthcare and the promotion of shared patient narratives. Websites incorporating these narratives or personal accounts are known to offer support to carers of people with multiple sclerosis, but little is known about how carers make choices about what websites to visit and why. In total, 20 carers viewed a range of websites and online personal accounts about multiple sclerosis and subsequently took part in either a group discussion or an individual interview, followed by 2 weeks and 12 months and later by a telephone interview. Data were subjected to thematic analysis with the aim of understanding more about what drives engagement with the stories of others. We found that carers’ interpersonal and coping needs shaped their selection of online narratives, and that they were most likely to engage with online personal accounts that provided a good match in terms of experience and perspective.
Effects of Humor Production, Humor Receptivity, and Physical Attractiveness on Partner Desirability
Authors: Tornquist Michelle , Chiappe Dan
Published: October 2015

This study examined women’s and men’s preferences for humor production and humor receptivity in long-term and short-term relationships, and how these factors interact with physical attractiveness to influence desirability. Undergraduates viewed photographs of the opposite sex individuals who were high or low in physical attractiveness, along with vignettes varying in humor production and receptivity. Participants rated physical attractiveness and desirability for long-term and short-term relationships. The main findings were that individuals desired partners who were high in humor production and receptivity, though the effects were particularly pronounced for women judging long-term relationships. Moreover, humor production was more important than receptivity for women’s ratings of male desirability. Notably, we also found that ratings of physical attractiveness were influenced by the humor conditions. These results are discussed in terms of the fitness indicator, interest indicator, and encryption hypotheses of the evolutionary functions of humor.
Correlates of bullying in Switzerland
Authors: Lucia Sonia
Published: October 2015

This article addresses the strongest variables related to bullying, taking into account personal background, personality characteristics and social context. A survey of self-reported juvenile delinquency among more than 4500 pupils in the 8th and 9th grades was conducted in a French-speaking part of Switzerland. Offenders are more often boys, and boys score higher than girls for all the considered behaviours. The multivariate analyses showed that youths with a low level of self-control are more likely to bully others. Moreover, adopting a positive attitude towards violence and spending time with peers also increase the risk of bullying. The importance of environmental variables was also shown; youths are less likely to bully with increased supervision and monitoring by adults, and when schools participate in social control by impartially intervening to increase respect for the rules. Furthermore, when the school climate is considered in a positive light by the pupils, then their risk of committing bullying decreases. Finally, it appears that school absenteeism is a good indicator for detecting at-risk youths. The identification of these risk factors can be used to define appropriate intervention strategies.
Creating frugal citizens: The liberal egalitarian case for teaching frugality
Authors: Zwarthoed Danielle
Published: October 2015

According to Agenda 21, the United Nation’s action plan for sustainable development, ‘Governments and private sector organisations should promote more positive attitudes towards sustainable consumption through education, public awareness programmes and other means’. But some could wonder whether the cultivation of frugal consumption habits in schools is compatible with basic liberal principles. This article argues that, in societies like ours, liberal egalitarian theories of justice should permit and even advocate teaching frugality in educational institutions. Liberal egalitarianism expects educational institutions to equip children with the abilities and virtues needed to live well by their own judgment and in compliance with just institutions. The article examines how frugality could be one of these virtues. First, frugality is conducive to better compliance with our distributive obligations towards the current poor and future generations. Second, frugality enables prospective adults to live well with their fair share of scarce resources, and even with less. Third, frugality increases autonomy and facilitates its exercise. The article thus concludes that liberal egalitarian institutions should encourage schools to teach frugality.
The Dimensionality of Congressional Voting Reconsidered
Authors: Roberts Jason M. , Smith Steven S. , Haptonstahl Stephen R.
Published: October 2015

This article reports findings for a decomposition of the roll-call voting record of the U.S. Congress to determine the effect of the level of aggregation on the observed dimensionality of the policy space. In doing so, we identify some but certainly not all of the ways in which the aggregation of the voting record affects the observed dimensionality of the policy space. For the 1955 to 2008 period (84th-110th Congresses), we apply optimal classification (OC) to votes aggregated to the level of the individual bill and policy area to measure dimensionality. We examine the marginal proportional reduction in error (MPRE) across dimensions. Our results demonstrate that complexity in voting patterns of individual bill episodes is the norm, that aggregating to higher levels reduces the observed dimensionality, and that the liberal–conservative dimension appears more dominant in more highly aggregated analyses. These results call into question many of the conclusions from the theoretical and empirical literature on the U.S. Congress that uses a unidimensional model.
On Strengthening Compassionate Care for Muslim Patients
Authors: Zaidi Danish
Published: October 2015

In this piece, I contribute to an ongoing conversation on compassionate care for Muslim patients. I address the various barriers hindering such care and ways in which to work around them. In providing an introductory understanding of general Islamic beliefs on the definition of life, the use of palliative care, etc., I hope this reflection can offer insight into the general background of Muslim patients and spark interest in further reading and research.
Voices from the Margins: Reflections of an Oncology Chaplain
Authors: Eselun, BCC Michael
Published: October 2015

Michael Eselun, BCC, who serves as the oncology chaplain for the Simms-Mann/UCLA Center for Integrative Oncology, recently gave a lecture as part of the Insights Into Cancer lecture series at UCLA called ‘Cancer: “It Could Be Worse” – A Spiritual Ponzi Scheme?’. Michael has written a personal reflection to provide a fuller context for his chaplaincy, as he views it, and to provide some background to the lecture. A link to a video of the lecture is included.
Does the work role of Catholic clergy in Ireland contribute to the disenfranchisement of their grief?
Authors: Mooney Dearbhla
Published: October 2015

While bereavement-related compassion fatigue and burnout have been studied in many helping professions, this researcher has found no peer-reviewed articles based specifically on bereavement experiences of Roman Catholic (RC) clergy in Ireland and only a handful on experiences of other religious ministers worldwide. There is a clear gap in research with regard to clergy experiences of personal or professional grief, the possible effects this may have on them, or the supports they use to help them cope. Peer support, some form of mentoring/supervision, and debriefing may help clergy to recognize their own grief, have it acknowledged by others, and recognize their personal strengths and limitations. While prevention of burnout is important to individual clergy, it is also vital for the health of the wider Church and formal support structures may be necessary as part of the Church’s duty of care towards its clergy.
The Spiritual and Theological Issues Raised by Stillbirth for Healthcare Chaplains
Authors: Nuzum Daniel , Meaney Sarah , O’Donoghue Keelin , Morris Heather
Published: October 2015

The death of a baby is one of the most challenging bereavements for parents and healthcare professionals. This study explores the spiritual and theological issues raised for healthcare chaplains as they minister with parents following perinatal bereavement. Chaplains from 85% of maternity units in the Republic of Ireland participated in this study. Suffering, doubt and presence were the main theological themes raised for chaplains following perinatal death. The process of theological reflection is recommended as a sustaining and necessary tool in perinatal healthcare ministry.
Molecular Mechanisms of Action of BPA
Authors: Acconcia Filippo , Pallottini Valentina , Marino Maria
Published: October 2015

Bisphenol A (BPA) exposure has been associated with serious endocrine-disrupting effects in humans and wildlife. Toxicological and epidemiological studies evidenced that BPA increases body mass index and disrupts normal cardiovascular physiology by interfering with endogenous hormones in rodents, nonhuman primates, and cell culture test systems. The BPA concentration derived from these experiments were used by government regulatory agencies to determine the safe exposure levels of BPA in humans. However, accumulating literature in vivo and in vitro indicate that at concentrations lower than that reported in toxicological studies, BPA could elicit a different endocrine-disrupting capacity. To further complicate this picture, BPA effects rely on several and diverse mechanisms that converge upon endocrine and reproductive systems. If all or just few of these mechanisms concur to the endocrine-disrupting potential of low doses of BPA is at present still unclear. Thus, taking into account that the incidence and/or prevalence of health problems associated with endocrine disruption have increased worldwide, the goal of the present review is to give an overview of the many mechanisms of BPA action in order to decipher whether different mechanisms are at the root of the effect of low dose of BPA on endocrine system.
Developing social responsibility and political engagement: Assessing the aggregate impacts of university civic engagement on associated attitudes and behaviors
Authors: Whitley Cameron T , Yoder Scot D
Published: October 2015

Universities have become increasingly interested in incorporating civic engagement into undergraduate education with the goal of enhancing leadership skills and creating socially responsible global citizens. What is unclear is which educational experiences are most effective in achieving this goal. In this study, we seek to determine the impact of three types of educational experiences—curricular civic engagement, extra-curricular civic engagement, and participation in a living-learning community on social responsibility and political engagement (two components of civic engagement) attitudes and behaviors. Using a survey of 1240 undergraduates, our findings indicate that while all three types of experiences are positively related to civic engagement attitudes and behaviors, extra-curricular civic engagement has the most impact. Furthermore, student civic engagement attitudes are already relatively high; so instructors should focus on behaviors. The greatest potential for growth is in political engagement behaviors. We identify what this means for higher education and how implementations in the university can lead to increases in aggregate student development.
Bayesian Evidence Synthesis and the quantification of uncertainty in a Monte Carlo simulation
Authors: Sahlin Ullrika , Jiang Yf
Published: October 2015

Monte Carlo simulation is a useful technique to propagate uncertainty through a quantitative model, but that is all. When the quantitative modelling is used to support decision-making, a Monte Carlo simulation must be complemented by a conceptual framework that assigns a meaningful interpretation of uncertainty in output. Depending on how the assessor or decision maker choose to perceive risk, the interpretation of uncertainty and the way uncertainty ought to be treated and assigned to input variables in a Monte Carlo simulation will differ. Bayesian Evidence Synthesis is a framework for model calibration and quantitative modelling which has originated from complex meta-analysis in medical decision-making that conceptually can frame a Monte Carlo simulation. We ask under what perspectives on risk that Bayesian Evidence Synthesis is a suitable framework. The discussion is illustrated by Bayesian Evidence Synthesis applied on a population viability analysis used in ecological risk assessment and a reliability analysis of a repairable system informed by multiple sources of evidence. We conclude that Bayesian Evidence Synthesis can conceptually frame a Monte Carlo simulation under a Bayesian perspective on risk. It can also frame an assessment under a general perspective of risk since Bayesian Evidence Synthesis provide principles of predictive inference that constitute an unbroken link between evidence and assessment output that open up for uncertainty quantified taking qualitative aspects of knowledge into account.
Health-and-usage-based maintenance policies for a partially observable deteriorating system
Authors: Deloux Estelle , Fouladirad Mitra , Bérenguer Christophe
Published: October 2015

The aim of this paper is to discuss the modelling and optimisation of condition-based maintenance policies for systems submitted to usage profile changes. The considered system undergoes a monotone deterioration (gamma process) and is impacted by the usage conditions (covariates) via the proportional hazards model. Four different policies are proposed and the optimal maintenance parameters minimising the long-run average maintenance cost are derived. The different maintenance policies are numerically compared using Monte Carlo simulations.
Motivations of women who organized others for prostitution: Evidence from a female prison in China
Authors: Shen Anqi
Published: October 2015

This article discusses women’s involvement in sex work management – an offence defined under section 358 of the 1997 Chinese Criminal Law and one of the re-emerged areas of illegality following the economic reforms since 1978. It first provides the historical context, legislative background and relevant sections of the Chinese vice laws so as to help make sense of the data obtained. Then it discusses the methodological issues before presenting the empirical findings to explore the socio-demographic profile of the incarcerated female sex work organizers who participated in this study and their motivations for organizing others for prostitution. Based on empirical data, this article explores the impact of social conditions on female offenders in China’s reform era and also the effects of the anti-prostitution policy in the country. Moreover, through a Chinese case study, it makes contributions to broader scholarship on the sex trade regulation. It concludes with a couple of implications for policy and practice.
Intermediate and Long-Term Outcomes of the Modified Brostrom-Evans Procedure for Lateral Ankle Ligament Reconstruction
Authors: Hsu Andrew R. , Ardoin G. Troy , Davis W. Hodges , Anderson Robert B.
Published: October 2015

Background. This case series evaluated the clinical and functional outcomes of patients with lateral ankle instability treated with a primary modified Brostrom-Evans. Methods. Nineteen patients who underwent the modified Brostrom-Evans procedure for lateral ankle instability with a minimum follow-up of 5 years were reviewed. Physical exams were performed and weight-bearing ankle radiographs taken at final follow-up. Clinical outcomes were evaluated using Short Form Health Survey (SF-36), Foot Function Index (FFI), and Visual Analog Scale (VAS) scores. Functional outcomes were assessed using a goniometer for ankle range of motion (ROM) and dynamometer for ankle strength compared to the non-operative extremity. Results. Average age at time of surgery was 34 ± 11 years (range 17-58 years) and average follow-up was 8.7 ± 2.8 years (range 5.1-15.4 years). At final follow-up, average total SF-36 and FFI scores were 83 ± 18 and 11% ± 18%, respectively. Average VAS at rest was 1 ± 1 and during activities 2 ± 2. There were no significant differences in ankle eversion ROM or strength between operative and non-operative extremities. Ankle eversion strength in operative extremities was 91 ± 12% of non-operative ankles. Ankle ROM was similar in all planes except for a 41% decrease in ankle inversion in surgically treated extremities compared to the contralateral side (p = .01). Conclusions. Patients treated with the modified Brostrom-Evans procedure for lateral ankle ligament reconstruction have minimal loss of peroneal strength, decreased inversion ROM, and no recurrent instability or progressive symptomatic subtalar arthritis requiring re-operation at long-term follow-up.

Levels of Evidence: Level IV: Retrospective case series
Achilles Tendon Repair in Obese Patients Is Associated With Increased Complication Rates
Authors: Burrus M. Tyrrell , Werner Brian C. , Park Joseph S. , Perumal Venkat , Cooper M. Truit
Published: October 2015

Objective. The objective of the present study is to utilize a national database to examine the association between obesity and postoperative complications after primary Achilles tendon repair. Methods. The PearlDiver database was queried for patients undergoing primary Achilles repair using CPT 27650. Excision of a Haglund’s deformity or tendon transfer were exclusion criteria. Patients were then divided into obese (body mass index [BMI] > 30 kg/m2) and nonobese (BMI < 30 kg/m2) cohorts using ICD-9 codes. Complications within 90 days postoperatively were assessed using ICD-9 and CPT codes. Results. In all, 18 948 patients who underwent primary Achilles tendon repair were identified from 2005 to 2012. Overall, 2962 patients (15.6%) were coded as obese or morbidly obese. Obese patients had significantly higher rates of postoperative wound complications (odds ratio [OR] = 2.1; P < .0001), infection (OR = 1.8; P < .0001), venous thromboembolism (VTE; OR = 1.8; P = .001), and medical complications (OR = 3.9; P < .0001) compared with nonobese patients after primary Achilles tendon repair. Additionally, obese patients had a significantly lower rate of ankle stiffnesassociated with a significantly higher risk of s (OR = 0.4; P < .0001) compared with nonobese patients. Conclusion. Obesity is associated with a significantly higher risk of wound complications, infection, VTE, and medical complications after primary Achilles tendon repair.

Levels of Evidence: Prognostic, Level II: Retrospective study
Bone Marrow Edema Syndrome of the Foot and Ankle
Authors: Singh Dishan , Ferrero Andrea , Rose Barry , Goldberg Andrew , Cullen Nicholas
Published: October 2015

Bone marrow edema syndrome (BMES) is a condition characterized by pain and an increase interstitial fluid within the bone marrow in the absence of a definable cause. The purpose of this study was to assess the changes in the pattern of bone edema and quality of pain over time. In patients diagnosed with BMES of the foot and ankle, we investigated the benefit of treatment with bisphosphonates and immobilization in a pneumatic walking boot compared with immobilization in a boot alone. This study is a retrospective review of 18 consecutive patients (mean age 54 years) diagnosed with foot and ankle BMES. Twelve (67%) patients were female and 6 were male with a mean age of 60.1 and 43.0 years, respectively (P < .05). The minimum follow-up was 2 years (range 2-11 years, mean 5.75 years). Five females and no males were found to suffer from generalized osteoporosis. The average duration of symptoms prior to presentation was 22 weeks and the most common bone affected was the talus (56%). More than one bone was affected in 8 (44%) patients. All patients were given a walking boot at first attendance for 8 weeks. The mean time to resolution of pain in patients treated with a pneumatic walker alone (7 patients) was 25.6 weeks (range 8-36 weeks). In the 11 patients whose pain had not improved at their first follow-up, treatment with bisphosphonates led to a more rapid resolution of pain in 13.8 weeks if given intravenously, and 24.0 weeks if given orally. Statistical analysis demonstrated a significant advantage in using a bisphosphonate versus a protected weightbearing alone (P < .01). Recurrence within the same foot and ankle occurred in 44% of patients at a mean interval of 15.6 months and migration to a different site occurred in 6% of patients.

Levels of Evidence: Therapeutic, Level III: Retrospective, comparative trial
Spondylodiscitis associated with button battery ingestion: prompt evaluation with MRI
Authors: Young Allen , Tekes Aylin , Huisman Thierry AGM , Bosemani Thangamadhan
Published: October 2015

Spondylodiscitis is a rare complication of unwitnessed button battery ingestion in children. We report a case of a 20-month-old girl who presented to the emergency room 2 weeks after endoscopic removal of unwitnessed, impacted esophageal battery. Delayed presentation of spondylodiscitis after foreign body removal is related to local injury, pressure necrosis, and perforation. The bilaminar shape of an unknown ingested foreign body should alert the treating physician that it might be a battery rather than a coin. Prompt evaluation with magnetic resonance imaging is essential to prevent neurological deficit and/or spinal deformities.
Osteitis fibrosa cystica in a domestic young cat
Authors: Leite-Filho Ronaldo V , Bandinelli Marcele B , Fredo Gabriela , Bianchi Matheus V , van der lan Fonini Alessandra , Alievi Marcelo M , Driemeier David , Pavarini Saulo P , Sonne Luciana
Published: October 2015

Case summary

A 4-month-old cat had bilateral swellings of the mandible, maxilla, humerus and femur, and angular deviations in the axial and appendicular skeleton. The biochemical profile indicated hypercalcemia, hyperphosphatemia and increased parathyroid hormone levels. Because of the poor prognosis, the cat was euthanized. At necropsy, malleable and fragile bones, associated with numerous cystic areas containing yellowish and translucent liquid, were observed. Histologically, the bones showed marked diffuse proliferation of fibrous connective tissue, and large numbers of osteoclasts surrounding numerous cystic structures were also observed within fibrotic areas at the periphery of the trabecular bone. In addition, enlargement of the parathyroid glands, which was associated with increased serum concentrations of calcium, phosphorus and parathyroid hormone, was detected.

Relevance and novel information

The changes observed in this cat are consistent with hyperparathyroidism-associated osteitis fibrosa cystica, which is an unusual presentation in the cat. Hyperparathyroidism, either primary (neoplastic) or secondary (nutritional or renal), is the primary cause of this condition.
Extrahepatic biliary duct obstruction as a result of involuntary transcavitary implantation of hair in a cat
Authors: Linton Michael , Buffa Eugene , Simon Adrian , Ashton Julie , McGregor Ross , Foster Darren J
Published: October 2015

Case summary

A 4-year-old male neutered domestic shorthair cat was referred for investigation of jaundice. The cat had a recent history of a skin laceration repair following trauma. Sequential serum biochemistry demonstrated increasing plasma bilirubin concentrations; abdominal ultrasonography revealed ongoing pancreatitis and apparent extrahepatic obstruction of the common bile duct. Exploratory laparotomy identified constriction of the common bile duct with foreign material (cat hair). The constricting band of hair was removed surgically; cholecystoduodenostomy was performed. Postsurgical quality of life is excellent with chronic treatment of tylosin, omeprazole and ursodeoxycholic acid.

Relevance and novel information

To our knowledge, this is the first reported case of extrahepatic biliary duct obstruction resulting from the intra-abdominal migration of a foreign body, in this case, hair shafts. The mechanism by which this occurred was likely a combination of physical constriction by the hair shafts and subsequent foreign body reaction surrounding this. This should be included in the differential diagnosis of a cat with jaundice.
From being bullied to being accepted: The lived experiences of a student with Asperger’s enrolled in a Christian university
Authors: Reid Denise P
Published: October 2015

Thirteen participants from two private universities located in the western region of the United States shared their lived experiences of being a college student who does not request accommodations. In one’s educational pursuit, bullying is often experienced. While the rates of bullying have increased, students with disabilities are more likely to be bullied. This article chronicles key incidents through the educational journey of a college student with Asperger’s syndrome enrolled in a Christian university. Incidents of bullying, aggression, retaliation, and forgiveness underlie this article. Recursive analysis was used to analyze qualitative data from semi-structured interviews. Initial codes were combined to create interconnected families of codes. A second level of analysis resulted in seven spaces in which participants describe their lived experiences. Findings suggest participants experience various tensions, ranging from incompatible options to competing perspectives, as they negotiate their identity. Implications for effective school-home collaboration are addressed.