bluuebunny/crossref_metadata_2025 huggingface dataset:
Moral and legal prohibitions against pillage in the context of the 1899 Hague Convention and the South African War
Authors: Miller Stephen M. , Miller Jessica
Published: May 2018

This article explores the genesis, scope, and significance of the 1899 Hague Convention’s prohibition against pillage. It analyses how it intersected with the moral contours of pillage as revealed in the actions and attitudes of British soldiers, British commanders, and Boer civilians during the South African War. In doing so, it crosses from ideal moral theory to international law, to shared and disputed moral beliefs among participants in the South African War. Drawing from pillage in the South African War, it concludes that the motives, policing, and moral and political context of pillage are vital to understanding its historical significance.
Concrete–fiber-reinforced polymer interfacial bond monitoring with self-triggering sensors
Authors: Joshi Kunal , Pollard Marquese , Chiari Andrea , Dickens Tarik
Published: May 2018

External bonding with fiber-reinforced polymers is currently one of the most popular technologies for rehabilitation of concrete structures. However, the effectiveness of the technology largely depends on the strength of the bond between the fiber-reinforced polymer laminate and the concrete substrate. This article provides a system to monitor the loss of bond between the fiber-reinforced polymer laminate and the concrete. Fiber optic sensors are broadly accepted as a structural health monitoring device for fiber-reinforced polymer materials by integrating the sensors into the host material. A recent development in fiber optic sensor technology is the mechanoluminescence-based optoelectronic sensors. Concrete beams strengthened with multifunctional fiber-reinforced polymer laminates were tested in shear using these sensors to evaluate the bond strength of the composite system. The sensors showed response to shear stress transfer in the adhesive layer which was observed to be as low as 2 MPa. The inclusion of sensors does not affect the bond strength (3.35 MPa), for both beams with sensors and without sensors. Real-time failure detection of fiber-reinforced polymer–strengthened beams was successfully achieved in this study. In future, the scheme aims at providing a tool to reduce the response time and decision making involved in the maintenance of deficient structures.
Integrating Positive Psychology and Elements of Music Therapy to Alleviate Adolescent Anxiety
Authors: Kwok Sylvia Y. C. L.
Published: May 2018

Purpose:

Incorporating the resource-oriented music therapy framework, the present study aims to examine the effectiveness of a designed protocol, integrating positive psychology, and elements of music therapy, in increasing the sense of hope and enhancing emotional competence, hence decreasing anxiety and increasing subjective happiness of the adolescents with anxiety symptoms.

Method:

Adopting a two-arm randomized controlled trial, 106 Grade 8 to Grade 9 students were recruited from three secondary schools in Hong Kong and randomized into experimental groups and no-treatment control groups.

Results:

Students in the experimental groups had significant increases in scores of hope, emotional competence, subjective happiness, and significant decrease in anxiety symptoms. Changes in hope were a significant mediator in the relationship between the intervention and decrease in anxiety symptoms and increase in subjective happiness.

Discussion:

The study provides evidence that integrating positive psychology and music therapy is effective in alleviating psychopathology and enhancing well-being of adolescents.
Special Education in Kenya
Authors: Kiru Elisheba W.
Published: May 2018

Access to basic education for all students is an essential goal for many countries around the world. Also, as worldwide calls for providing inclusive education continue to intensify, access to basic education for many students with disabilities in Kenya remains a pervasive challenge. Large class sizes, inadequate funding, limited teacher training, cultural perceptions, and lack of disability awareness exacerbate this challenge. In 2009, the Kenyan government put forth a national Special Needs Education policy framework that provides comprehensive strategies and policies to improve services for people with disabilities. Creating advocacy and awareness, revamping the curriculum, incorporating technology, providing teacher training, and improving data collection are some of the recommendations included in the policy framework to enhance special education services and facilitate inclusive practices.
Evaluation of Adherence to Guideline-Directed Antithrombotic Therapy for Atrial Fibrillation at Hospital Discharge
Authors: Dupree Lori , DeLosSantos Marci , Smotherman Carmen
Published: May 2018

Background:

Risk stratification for stroke in patients with atrial fibrillation is a vital step in identifying whether antithrombotic therapy is indicated for stroke prevention in this common arrhythmia.

Purpose:

The aim of this study was to determine adherence to guideline-directed antithrombotic therapy based on Congestive Heart Failure (1 point), Hypertension (1 point), Age (≥75 years old is 2 points and 65-74 is 1 point), Diabetes (1 point), prior Stroke (2 points), Vascular Disease (1 point), and Sex Category (1 point if female; CHA2DS2–VASc) score in patients with atrial fibrillation (AF) on hospital discharge.

Methods:

A total of 293 patients discharged from this academic medical center with a history of atrial fibrillation from June 2014 to June 2016 were enrolled. Demographic data and indicators for antithrombotic therapy based on the CHA2DS2–VASc score were recorded, and factors that affected adherence to guideline-directed therapy, such as bleeding risk, falls, and alcohol abuse, were collected and analyzed.

Results:

At hospital discharge, 63% of patients with AF were on appropriate antithrombotic therapy, 50% with a CHA2DS2–VASc score ≥2. The odds ratio of appropriate therapy in patients with a CHA2DS2–VASc score ≥2 was 1.17 (95% confidence interval [CI]: 0.95-1.30; P = .18). When chart documentation for reasons to withhold anticoagulation was considered as appropriate therapy, 81% of patients with AF were discharged on appropriate antithrombotic therapy with an odds ratio of 1.57 (95% CI: 1.26 -1.96, P < .0001), with bleeding and falls risk as the most common reasons to withhold anticoagulation.

Conclusion:

Based on risk stratification of stroke through the CHA2DS2–VASc score, the majority of patients with AF were discharged from the hospital on appropriate antithrombotic therapy. Withholding anticoagulation due to falls risk should be reconsidered as a result of the known benefits of stroke prevention in atrial fibrillation.
Self-excited Vibration Control of the Flexible Planar Parallel 3-

R

RR Robot
Authors: Qiu Zhi-cheng , Yang Jie , Zhang Xian-min
Published: May 2018

A self-excited vibration active control approach for a 3-RRR flexible planar parallel robot is developed to improve accuracy and stability. The 3-RRR parallel flexible robot experimental setup is constructed. From the motion experiments, it is demonstrated that the residual vibration can be converted to self-excited vibration at a high-speed motion, which will affect the stability and positioning precision of the platform. To suppress the self-excited vibration owing to flexibility, friction, backlash, coupling, and other nonlinear factors, a nonlinear controller and a fuzzy control algorithm are designed to attenuate the self-excited vibration. Experiments are conducted in different positions of the 3-RRR flexible parallel robot. The experimental results demonstrate that the investigated control methods can suppress the self-excited vibration effectively.
Fitting It All In? A Census of Undergraduate Ethics and Leadership Courses in Accredited U.S. Journalism and Mass Communication Programs
Authors: Mills Andrew , Sanders Amy Kristin , Hussain Shakir Shahid
Published: May 2018

As journalism and mass communication programs struggle to help prepare their students for the unknown digital future, many are answering the industry call to inject curricula with the instruction of digital skills. However, this likely comes at the cost of teaching long-standing conceptual courses, including media ethics, or introducing new ones, including media leadership. Although university administrators are likely to say their curricula adequately address these issues, the reality is that they may not. This study analyzed undergraduate degree requirements for all accredited U.S.-based journalism and mass communication degree programs ( N = 119) to evaluate the course offerings in ethics and leadership.
Post Qualitative Inquiry in an Ontology of Immanence
Authors: St. Pierre Elizabeth A.
Published: May 2018

Because post qualitative inquiry uses an ontology of immanence from poststructuralism as well as transcendental empiricism, it cannot be a social science research methodology with preexisting research methods and research practices a researcher can apply. In fact, it is methodology-free and so refuses the demands of “application.” Recommendations for those interested in post qualitative inquiry include putting methodology aside and, instead, reading widely across philosophy, social theories, and the history of science and social science to find concepts that reorient thinking. Post qualitative inquiry encourages concrete, practical experimentation and the creation of the not yet instead of the repetition of what is.
ADHD and the Choice of Small Immediate Over Larger Delayed Rewards: A Comparative Meta-Analysis of Performance on Simple Choice-Delay and Temporal Discounting Paradigms
Authors: Marx Ivo , Hacker Thomas , Yu Xue , Cortese Samuele , Sonuga-Barke Edmund
Published: May 2018

Objective: Impulsive choices can lead to suboptimal decision making, a tendency which is especially marked in individuals with ADHD. We compared two different paradigms assessing impulsive choice: the simple choice paradigm (SCP) and the temporal discounting paradigm (TDP). Method: Random effects meta-analyses on 37 group comparisons (22 SCP; 15 TDP) consisting of 3.763 participants (53% ADHD). Results: Small-to-medium effect sizes emerged for both paradigms, confirming that participants with ADHD choose small immediate over large delayed rewards more frequently than controls. Moderation analyses show that offering real rewards in the SCP almost doubled the odds ratio for participants with ADHD. Conclusion: We suggest that a stronger than normal aversion toward delay interacts with a demotivating effect of hypothetical rewards, both factors promoting impulsive choice in participants with ADHD. Furthermore, we suggest the SCP as the paradigm of choice due to its larger ecological validity, contextual sensitivity, and reliability.
The Male Agency of Arabs in Transition to Adulthood in Israel
Authors: Hadad Haj-Yahya Nasreen , Khattab Nabil , Schnell Izhak
Published: May 2018

Very little is known about the transition to adulthood and particularly the causes of high NEEThood (not in employment, education or training) rates among young Arab men in Israel. This article aims to analyse the main routes of integration into the labour market and postsecondary education among Arab male citizens of Israel. It is argued that given their socioeconomic and political marginalization, they are likely to face extreme situations of NEET behaviour. Using qualitative data obtained through open interviews with 20 young Arab males aged 18–22, the study analyses their past experiences, their present situations and their orientations towards the future. Three types of such orientations emerge from the study: future-oriented, fatalist and desperate. These types differed from each other in their willingness to aspire to career-oriented futures and in their adoption of pugnacity and individualistic future orientations. Those who are less able to demonstrate a pugnacious and individualistic orientation are more likely to either turn to available job opportunities that do not require intensive training and professionalization or often fall into NEET behaviour, thereby perpetuating the vicious cycle of poverty in Arab society.
A new instrument to simplify encircling buckle placement
Authors: Gras Hernán E , Gómez-Resa María , Aguirre Fernando , Corcóstegui Borja
Published: May 2018

Purpose:

The purpose of this study is to describe a new surgical instrument that simplifies 360° silicone band placement, alone or in combination with pars plana vitrectomy, for the treatment of rhegmatogenous retinal detachment.

Methods:

The instrument has a straight shank and a curved component in the form of a partial helix, whose purpose is to encircle the perimeter of the eye globe below the rectus muscles. The distal tip of the helix is inserted through a small conjunctival incision in the superior temporal quadrant, and the shank is rotated 360° on its axis until the tip emerges from the insertion point. One end of the silicone band is sutured to the tip, and the instrument is rotated in the opposite direction until both ends of the band are positioned in the same scleral quadrant. The band is sutured to the sclera and the conjunctival incision is closed. Pars plana vitrectomy can then be performed using transconjunctival microincision techniques through the intact conjunctiva.

Results:

Our experience using the instrument in more than 100 procedures has shown that the new technique considerably reduces surgical trauma: wide opening of the conjunctiva is obviated, there is little manipulation of the extraocular musculature, and only a few sutures are needed. The duration of the procedure is considerably shorter because of the smaller number of surgical maneuvers.

Conclusion:

We describe a new scleral technique facilitated by this surgical instrument, whose objective is safe and effective placement of an encircling silicone band with minimum trauma and a reduction in operating time.
Accuracy of implementing principles of fusion imaging in the follow up and surveillance of complex aneurysm repair
Authors: Martin-Gonzalez Teresa , Penney Graeme , Chong Debra , Davis Meryl , Mastracci Tara M
Published: May 2018

Fusion imaging is standard for the endovascular treatment of complex aortic aneurysms, but its role in follow up has not been explored. A critical issue is renal function deterioration over time. Renal volume has been used as a marker of renal impairment; however, it is not reproducible and remains a complex and resource-intensive procedure. The aim of this study is to determine the accuracy of a fusion-based software to automatically calculate the renal volume changes during follow up. In this study, computerized tomography (CT) scans of 16 patients who underwent complex aortic endovascular repair were analysed. Preoperative, 1-month and 1-year follow-up CT scans have been analysed using a conventional approach of semi-automatic segmentation, and a second approach with automatic segmentation. For each kidney and at each time point the percentage of change in renal volume was calculated using both techniques. After review, volume assessment was feasible for all CT scans. For the left kidney, the intraclass correlation coefficient (ICC) was 0.794 and 0.877 at 1 month and 1 year, respectively. For the right side, the ICC was 0.817 at 1 month and 0.966 at 1 year. The automated technique reliably detected a decrease in renal volume for the eight patients with occluded renal arteries during follow up. This is the first report of a fusion-based algorithm to detect changes in renal volume during postoperative surveillance using an automated process. Using this technique, the standardized assessment of renal volume could be implemented with greater ease and reproducibility and serve as a warning of potential renal impairment.
Evaluating a telehealth intervention for urinalysis monitoring in children with neurogenic bladder
Authors: Carter Bernie , Whittaker Karen , Sanders Caroline
Published: May 2018

Telehealth as a community-monitoring project within children’s urology care is an innovative development. There is limited evidence of the inclusion of staff and parents in the early-stage development and later adoption of telehealth initiatives within routine urological nursing care or families’ management of their child’s bladder. The aim was to explore the experiences of key stakeholders (parents, clinicians, and technical experts) of the proof of concept telehealth intervention in terms of remote community-based urinalysis monitoring by parents of their child’s urine. A concurrent mixed-methods research design used soft systems methodology tools to inform data collection and analysis following interviews, observation, and e-surveys with stakeholders. Findings showed that the parents adopted aspects of the telehealth intervention (urinalysis) but were less engaged with the voiding diary and weighing. The parents gained confidence in decision-making and identified that the intervention reduced delays in their child receiving appropriate treatment, decreased the time burden, and improved engagement with general practitioners. Managing the additional workload was a challenge for the clinical team. Parental empowerment and self-efficacy were clear outcomes from the intervention. Parents exercised their confidence and control and were selective about which aspects of the intervention they perceived as having credibility and which they valued.
Leaders’ limitations and approaches to creating conditions for interaction and communication in parental groups: A qualitative study
Authors: Frykedal Karin Forslund , Rosander Michael , Barimani Mia , Berlin Anita
Published: May 2018

The aim of this study was to describe and understand parental group (PG) leaders’ experiences of creating conditions for interaction and communication. The data consisted of 10 interviews with 14 leaders. The transcribed interviews were analysed using thematic analysis. The results showed that the leaders’ ambition was to create a parent-centred learning environment by establishing conditions for interaction and communication between the parents in the PGs. However, the leaders’ experience was that their professional competencies were insufficient and that they lacked pedagogical tools to create constructive group discussions. Nevertheless, they found other ways to facilitate interactive processes. Based on their experience in the PG, the leaders constructed informal socio-emotional roles for themselves (e.g. caring role and personal role) and let their more formal task roles (e.g. professional role, group leader and consulting role) recede into the background, so as to remove the imbalance of power between the leaders and the parents. They believed this would make the parents feel more confident and make it easier for them to start communicating and interacting. This personal approach places them in a vulnerable position in the PG, in which it is easy for them to feel offended by parents’ criticism, questioning or silence.
Micro particle image velocimetry investigation of near-wall behaviors of tumble enhanced flow in an internal combustion engine
Authors: Shimura Masayasu , Yoshida Shingo , Osawa Kosuke , Minamoto Yuki , Yokomori Takeshi , Iwamoto Kaoru , Tanahashi Mamoru , Kosaka Hidenori
Published: May 2018

A micro particle image velocimetry has been performed to investigate tumble enhanced flow characteristics near piston top surface of a motored internal combustion engine for three inlet valve open timing (−30, −15, 0 crank angle degrees). Particle image velocimetry was conducted at 340, 350 and 360 crank angle degrees of the end of the compression stroke at the constant motored speed of 2000 r/min. The measurement region was 3.2 mm × 1.5 mm on the piston top including central axis of the cylinder. The spatial resolution of particle image velocimetry in the wall-normal direction was 75 µm and the vector spacing was 37.5 µm. The first velocity vector is located about 60 µm from the piston top surface. The micro particle image velocimetry measurements revealed that the ensemble-averaged flow near the piston top is not close to the turbulent boundary layer and rather has tendency of the Blasius theorem, whereas fluctuation root-mean-square velocity near the wall is not low. This result shows that revision of a wall heat transfer model based on an assumption of the proper characteristics of flow field near the piston top is required for more accurate prediction of heat flux in gasoline engines.
Modern infinitesimals and the entropy jump across an inviscid shock wave
Authors: Baty Roy S , Margolin Len G
Published: May 2018

This article applies nonstandard analysis to study the generalized solutions of entropy and energy across one-dimensional shock waves in a compressible, inviscid, perfect gas. Nonstandard analysis is an area of modern mathematics that studies number systems that contain both infinitely large and infinitely small numbers. For an inviscid shock wave, it is assumed that the shock thickness occurs on an infinitesimal interval and that the jump functions for the field variables are smoothly defined on this interval. A weak converse to the existence of the entropy peak is derived and discussed. Generalized solutions of the Euler equations for entropy and energy are then derived for both theoretical and realistic normalized velocity profiles.
Inclusive Higher Education in Spain: Students With Disabilities Speak Out
Authors: Moriña Anabel , Perera Victor H.
Published: May 2018

This study examined the barriers and supports to inclusive education identified by university students with disabilities in Spain. A qualitative methodology is used. Students identified several organizational and architectural barriers and supports in completing their degrees. The conclusions go back to the main ideas analyzed to discuss previous works; likewise, proposals for improvements are provided, such as the need to train faculty in inclusive education and universal design for learning and the importance of redesigning learning environments to make them more accessible.
Situational Strength as a Moderator of the Relationship Between Organizational Identification and Work Outcomes
Authors: Collins Brian J. , Galvin Benjamin M. , Meyer Rustin D.
Published: May 2018

Organizational identification theory suggests that the extent to which employees perceive a sense of oneness with their employer positively influences their workplace attitudes and behavior. We investigated situational strength as a potential moderator by exploring the extent to which the relationship between organizational identification and employee outcomes is attenuated when employee discretion is restricted. In particular, we examined whether the workplace cues that signal appropriate conduct in strong situations would mitigate the potentially positive effects of organizational identification on job satisfaction and performance. Consistent with this perspective, results from a field study point to the notion that organizational identification has a more pronounced, positive influence on employee job satisfaction and performance when employees experience behavioral discretion (i.e., in weak situations) compared with situations wherein behavior is more externally controlled (i.e., strong situations). We discuss theoretical and practical implications, as well as suggest avenues for future research.
Leader Role Crafting and the Functions of Leader Role Identities
Authors: Gjerde Susann , Ladegård Gro
Published: May 2018

This article explores how experienced leaders address an inherent tension between leader role expectations and leader role identities when they enter a new position. Building on analysis of interviews with leaders in intrarole transition, role, and identity theories, we suggest they engage in a process of leader role crafting. We present four sets of role-crafting strategies which aim to influence the development of leader roles, and show how leader role identities both facilitate and impede the use of these. The article contributes to the leadership literature by extending contemporary perspectives on dynamic roles and role identities, while shedding light on an important challenge for today’s leaders who are faced with a particularly ambiguous and demanding role that is always in the making. The study also adds to practice by suggesting ways that leaders can engage in leader role crafting in a more reflexive manner.
Adolescent and Parental Attitudes About Return of Genomic Research Results: Focus Group Findings Regarding Decisional Preferences
Authors: McGowan Michelle L. , Prows Cynthia A. , DeJonckheere Melissa , Brinkman William B. , Vaughn Lisa , Myers Melanie F.
Published: May 2018

Opportunities to participate in genomic sequencing studies, as well as recommendations to screen for variants in 59 medically actionable genes anytime clinical genomic sequencing is performed, indicate adolescents will increasingly be involved in decisions about learning secondary findings from genome sequencing. However, how adolescents want to be involved in such decisions is unknown. We conducted five focus groups with adolescents (2) and parents (3) to learn their decisional preferences about return of genomic research results to adolescents. Discussions about decisional preferences centered around three themes: feelings about receiving genomic risk information, adolescent involvement and capacity to participate in decision-making, and recommendations for parental versus collaborative decision-making. We address the contested space between parental duties to act in their children’s best interests when choosing which results to return and adolescents’ desires to make autonomous decisions. A collaborative decision-making approach is recommended for obtaining consent from adolescents and their parents for genome sequencing research.
On some characteristics of quality for systems operating in a random environment
Authors: Cha Ji Hwan , Finkelstein Maxim
Published: May 2018

We consider systems that are operating in a random environment modeled by an external shock process. Performance of a system is characterized by a quality (output) function that is decreasing (due to degradation) in the absence of shocks. The important feature of our model is that shocks affect the failure rate of a system directly, and at the same time, each shock contributes to the additional decrease in the quality function forming the corresponding stochastic process. Expectations (unconditional and conditional on survival) and variability of this process are analyzed. Some monotonicity properties of the conditional quality function are discussed and expressions for the future values of this function are derived.
The theater of memory: Direct speech in Palestinian oral history
Authors: Peled Kobi
Published: May 2018

A striking feature of Palestinian oral history projects is the extensive use that interviewees make of direct speech to communicate their memories—especially those born before the 1948 Arab–Israeli war. They do so irrespective of whether or not they participated in or actually heard the dialogues they wish to convey. This article seeks to characterize and explain this phenomenon. In the interviews conducted by the author—an Arabic-speaking Jew—as well as in other projects, this mode of speech is marked by ease of transition from character to character and between different points in time. It clearly gives pleasure to those engaged in the act of remembering, and it grades readily into a theatrical performance in which tone of speech and the quality of the acting become the main thing. This form of discourse sprang up from the soil of a rural oral culture and still flourishes as a prop for supporting memory, a vessel for collecting and disseminating stories, and a technique for expressing identification with significant figures from the past.
Tryptophan immunoadsorption during pregnancy and breastfeeding in patients with acute relapse of multiple sclerosis and neuromyelitis optica
Authors: Hoffmann Frank , Kraft Andrea , Heigl Franz , Mauch Erich , Koehler Jürgen , Harms Lutz , Kümpfel Tania , Köhler Wolfgang , Ehrlich Sven , Bayas Antonios , Weinmann-Menke Julia , Beuker Carolin , Henn Karl-Heinz , Ayzenberg Ilya , Ellrichmann Gisa , Hellwig Kerstin , Klingel Reinhard , Fassbender Cordula Marie , Fritz Harald , Slowinski Torsten , Weihprecht Horst , Brand Marcus , Stiegler Thomas , Galle Jan , Schimrigk Sebastian
Published: May 2018

Background:

Up to every fourth woman with multiple sclerosis (MS) or neuromyelitis optica spectrum disorder (NMOSD) suffers a clinically relevant relapse during pregnancy. High doses of steroids bear some serious risks, especially within the first trimester of pregnancy. Immunoadsorption (IA) is an effective and more selective treatment option in disabling MS relapse than plasma exchange. Data on the use of IA during pregnancy and breastfeeding are scarce.

Methods:

In this retrospective multicenter study, we analyzed the safety and efficacy of IA treatment in acute relapses during pregnancy or breastfeeding. The primary outcome parameter - change of acute relapse-related disability after IA - was assessed using Expanded Disability Status Scale (EDSS) and visual acuity (VA) measurements for patients with optic neuritis (ON).

Results:

A total of 24 patients were analyzed, 23 with relapsing–remitting MS, and 1 with NMOSD. Twenty patients were treated with IA during pregnancy. Four patients received IA postnatally during the breastfeeding period. Treatment was started at a mean 22.5 [standard deviation (SD) 13.9] days after onset of relapse. Patients were treated with a series of 5.8 (mean, SD 0.7) IA treatments within 7–10 days. Sixteen patients received IA because of steroid-refractory relapse, eight were treated without preceding steroid pulse therapy. EDSS improved clinically relevant from 3.5 [median, interquartile range (IQR) 2] before IA to 2.5 (median, IQR 1.1) after IA, p < 0.001. In patients with ON, VA improved in four out of five patients. Altogether, in 83% of patients, a rapid and marked improvement of relapse-related symptoms was observed after IA with either a decrease of ⩾1 EDSS grade or improvement in VA ⩾20%. No clinically relevant side effect was reported in 138 IA treatments.

Conclusions:

Tryptophan-IA was found to be effective and well tolerated in MS/NMOSD relapses, both as an escalation option after insufficient response to steroid pulse therapy and as first-line relapse treatment during pregnancy and breastfeeding.
Establishing catheter-related bloodstream infection surveillance to drive improvement
Authors: Hallam Carole , Jackson Tim , Rajgopal Anu , Russell Belinda
Published: May 2018

Background:

Catheter-related blood stream infections (CRBSI) are an important complication of central venous access devices but are often poorly measured. This article describes the journey of one hospital trust to set up a surveillance process for CRBSI across all specialties of the trust and to reduce CRBSI.

Method:

Using a locally adapted CRBSI criteria and root cause analysis (RCA) for investigation we identified a number of opportunities for a quality improvement programme.

Findings:

Over a 5-year period we saw a significant and sustained reduction in the rate of CRBSI from 5 per 1000 catheter days to 0.23 per 1000 catheter days.

Conclusions:

The surveillance enabled rates of CRBSI to be monitored across the trust and the success of our improvements to be measured.
Familiarity affects the same event-related brain potential components in note readers and non-note readers
Authors: Becker Linda
Published: May 2018

Musical expertise can lead to neural plasticity in specific cognitive domains (e.g., in auditory music perception). However, not much is known about whether the visual perception of simple musical symbols (e.g., notes) already differs between musicians and non-musicians. This was the aim of the present study. Therefore, the Familiarity Effect (FE) – an effect which occurs quite early during visual processing and which is based on prior knowledge or expertise – was investigated. The FE describes the phenomenon that it is easier to find an unfamiliar element (e.g., a mirrored eighth note) in familiar elements (e.g., normally oriented eighth notes) than to find a familiar element in a background of unfamiliar elements. It was examined whether the strength of the FE for eighth notes differs between note readers and non-note readers. Furthermore, it was investigated at which component of the event-related brain potential (ERP) the FE occurs. Stimuli that consisted of either eighth notes or vertically mirrored eighth notes were presented to the participants (28 note readers, 19 non-note readers). A target element was embedded in half of the trials. Reaction times, sensitivity, and three ERP components (the N1, N2p, and P3) were recorded. For both the note readers and the non-note readers, strong FEs were found in the behavioral data. However, no differences in the strength of the FE between groups were found. Furthermore, for both groups, the FE was found for the same ERP components (target-absent trials – N1 latency; target-present trials – N2p latency, N2p amplitude, P3 amplitude). It is concluded that the early visual perception of eighth note symbols does not differ between note readers and non-note readers. However, future research is needed to verify this for more complex musical stimuli and for professional musicians.
Establishing School Counselors as Leaders in Bullying Curriculum Delivery
Authors: Midgett Aida , Doumas Diana M. , Johnston April D.
Published: May 2018

The authors evaluated a brief, school-wide, bystander bullying intervention (STAC) designed to establish school counselors as leaders in curriculum delivery. Elementary school students trained in the program reported an increase in perceived knowledge and confidence to act as “defenders,” utilizing the STAC strategies when they observed bullying, and a decrease in bullying victimization and perpetration at a 4-month follow-up. We discuss implications for school counselors.
What Do African American Ninth Graders Discuss During Individual School Counseling Sessions? A National Study
Authors: Shi Qi , Goings Ramon
Published: May 2018

To investigate the topics that African American ninth graders discuss during individual counseling sessions, we used the High School Longitudinal Study of 2009. Results showed that ninth-grade African American students most frequently talked with school counselors about going to college, math courses, and other courses. African American male students were more likely than female students to talk to school counselors about science courses. Socioeconomic status and school belonging had significant impact on the topics African American students raised in individual counseling sessions. We provide discussion and implications for school counselors.
The association between endometriosis and the risk of LBW: A meta-analysis
Authors: Jenabi Ensiyeh , Fereidooni Bita
Published: May 2018

Background:

Many observational services have been conducted to evaluate the risk factors of low birth weight, but the results showed no consistency. Therefore, we conducted this meta-analysis to investigate the association between endometriosis (body mass index) and the risk of low birth weight.

Methods:

Relevant works that were published in major international electronic databases such as PubMed, Scopus, Web of Science, LILACS, SciELO, and Cochrane were systematically searched until February 2018. Begg’s and Egger’s tests were used to determine publication bias in included studies. The random-effects model was carried out to determine the odds ratio.

Results:

A meta-analysis of the 12 studies proposed a significant association between endometriosis and the risk of low birth weight (odds ratio = 1.34, 95% confidence interval = 1.08–1.60). The subgroup analysis was carried out based on the design, adjusted form, and use of assisted reproductive technology in studies. The pooled results based on subgroup analysis in case–control and cohort studies were 1.46 (0.79–2.12) and 1.32 (1.02–1.62), respectively. There was significant correlation between endometriosis and low birth weight in cohort studies. Also, heterogeneity was not reported among studies in the subgroup based on adjusted form. There was no significant correlation between endometriosis and low birth weight in studies using assisted reproductive technology methods

Conclusion:

The systematic review and meta-analysis showed that endometriosis increases the risk of low birth weight. Therefore, it is a risk factor for low birth weight.
Systemic sclerosis phase III clinical trials: Hope on the horizon?
Authors: Aringer Martin , Denton Christopher P
Published: May 2018

While significant progress has been made in treating systemic sclerosis, many patients still have an outcome that is far from satisfactory. For the first time in history, several drugs are now in phase III randomized controlled trials. Approaches tested include the anti-B cell antibody rituximab, the anti-interleukin-6 receptor antibody tocilizumab, the antifibrotic drugs nintedanib and pirfenidone, and the cannabinoid receptor mimetic lenabasum. That all these drugs are in advanced clinical trials despite the relatively low incidence of the disease therefore is good news. Not only is there realistic hope that at least some of the approaches will work, this also indicates growing industry interest, for most of the trials are company-sponsored. This review attempts to delineate the ongoing trials and to summarize the underlying evidence of these candidate systemic sclerosis drugs.
Opioid Prescribing: A Retrospective Analysis of Opioid Prescription Requests in a Large, Multicenter Ambulatory Care Organization
Authors: Durrani Semie , Zaiken Kathy
Published: May 2018

Background: To date, Atrius Health has not assessed how often patients request additional pain medication after receiving an initial opioid for acute pain management. This assessment was requested to help justify prescribing patterns for opioids in the primary care setting. Objective: To assess the amount of requests for additional opioid prescriptions in patients who received a short-acting opioid for acute pain management. Methods: This was a retrospective chart review of a multicenter large ambulatory care organization in the Greater Boston Area. Atrius Health patients who received an initial prescription for a short-acting oral opioid indicated for acute pain management between May 1, 2016, and October 1, 2016, were included in the study. Results: The overall percentage of patients requesting additional medication for acute pain management was 13% (46/350). Of the 46 patients who requested additional medication, 15 patients received a second opioid prescription (33%, 15/46). For those patients who requested additional pain medication, there were no trends between the day supply that was prescribed and a patient receiving a second opioid prescription from a health care provider. Patients who received a 4- to 5-day supply of opioids were not more likely to call back requesting additional pain medication than patients who received a 1- to 3-day supply of opioids (odd ratio = 0.41; 95% confidence interval = 0.17-1.00). Conclusion: At Atrius Health, roughly 13% of patients are requesting additional pain medications after being prescribed a short-acting opioid for acute pain management. Other primary care and urgent care health systems may consider reducing the day supply of opioids prescribed for acute pain management.
The contributions and future direction of Program Science in HIV/STI prevention
Authors: Becker Marissa , Mishra Sharmistha , Aral Sevgi , Bhattacharjee Parinita , Lorway Rob , Green Kalada , Anthony John , Isac Shajy , Emmanuel Faran , Musyoki Helgar , Lazarus Lisa , Thompson Laura H. , Cheuk Eve , Blanchard James F.
Published: May 2018

Background

Program Science is an iterative, multi-phase research and program framework where programs drive the scientific inquiry, and both program and science are aligned towards a collective goal of improving population health.

Discussion

To achieve this, Program Science involves the systematic application of theoretical and empirical knowledge to optimize the scale, quality and impact of public health programs. Program Science tools and approaches developed for strategic planning, program implementation, and program management and evaluation have been incorporated into HIV and sexually transmitted infection prevention programs in Kenya, Nigeria, India, and the United States.

Conclusion

In this paper, we highlight key scientific contributions that emerged from the growing application of Program Science in the field of HIV and STI prevention, and conclude by proposing future directions for Program Science.
The effect of non-contributory pensions on labour supply and private income transfers: evidence from Singapore
Authors: Chen Yanying , Tan Yi Jin
Published: May 2018

Non-contributory pensions are becoming increasingly prevalent worldwide. As their effects are likely to be context-dependent, evaluating their effects in a wide range of settings is important for establishing the external validity of the non-contributory pension literature. We use a new monthly panel dataset and a difference-in-differences strategy to study the effect of a new non-contributory pension in Singapore (the Silver Support Scheme or SSS) on labour supply, work expectations, private cash transfers, and expenditure, 1 year after its implementation. We find no evidence that receiving SSS payouts led to a fall in labour supply, work expectations, or the receipt of private cash transfers in the first year after SSS implementation—our estimated effects for these outcomes are statistically insignificant and are either negative but close to zero or positive. Our point estimates of the effects of receiving SSS payouts on expenditure are positive but too imprecise to allow us to make any definitive conclusions. Lastly, we do not find evidence of anticipatory effects among younger individuals who are not age-eligible for payouts yet. These results, when coupled with our finding in a companion paper that the SSS improved recipients’ subjective well-being, suggest that the SSS was successful in improving recipients’ welfare without substantial crowding out of private transfers or changes in labour market behaviour of current and future SSS beneficiaries.
Longitudinal Trajectories of Gestational Thyroid Function: A New Approach to Better Understand Changes in Thyroid Function
Authors: Pop Victor , Broeren Maarten , Wijnen Hennie , Endendijk Joyce , van Baar Anneloes , Wiersinga Wilmar , Williams Graham R
Published: May 2018

Context

Most studies of thyroid function changes during pregnancy use a cross-sectional design comparing means between groups rather than similarities within groups.

Objective

Latent class growth analysis (LCGA) is a novel approach to investigate longitudinal changes that provide dynamic understanding of the relationship between thyroid status and advancing pregnancy.

Design

Prospective observational study with repeated assessments.

Setting

General community.

Patients

Eleven hundred healthy women were included at 12 weeks’ gestation.

Main Outcome Measures

The existence of both free T4 (fT4) and TSH trajectories throughout pregnancy determined by LCGA.

Results

LCGA revealed three trajectory classes. Class 1 (n = 1019; 92.4%), a low increasing TSH reference group, had a gradual increase in TSH throughout gestation (from 1.1 to 1.3 IU/L). Class 2 (n = 30; 2.8%), a high increasing TSH group, displayed the largest increase in TSH (from 1.9 to 3.3 IU/L). Class 3 (n = 51; 4.6%), a decreasing TSH group, had the largest fall in TSH (from 3.2 to 2.4 IU/L). Subclinical hypothyroidism at 12 weeks occurred in up to 60% of class 3 women and was accompanied by elevated thyroid peroxidase antibodies (TPO-Ab) titers (50%) and a parental history of thyroid dysfunction (23%). In class 2, 70% of women were nulliparous compared with 46% in class 1 and 49% in class 3.

Conclusions

LCGA revealed distinct trajectories of longitudinal changes in fT4 and TSH levels during pregnancy in 7.4% of women. These trajectories were correlated with parity and TPO-Ab status and followed patterns that might reflect differences in pregnancy-specific immune tolerance between nulliparous and multiparous women.
Epidemiology of Childhood Hyperthyroidism in France: A Nationwide Population-Based Study
Authors: Simon Marie , Rigou Annabel , Le Moal Joëlle , Zeghnoun Abdelkrim , Le Tertre Alain , De Crouy-Chanel Perrine , Kaguelidou Florentia , Leger Juliane
Published: May 2018

Context

Hyperthyroidism affects all age groups, but epidemiological data for children are scarce.

Objective

To perform a nationwide epidemiological survey of hyperthyroidism in children and adolescents.

Design

A cross-sectional descriptive study.

Setting

Identification of entries corresponding to reimbursements for antithyroid drugs in the French national insurance database.

Participants

All cases of childhood hyperthyroidism (6 months to 17 years of age) in 2015.

Main Outcome Measures

National incidence rate estimated with a nonlinear Poisson model and spatial distribution of cases.

Results

A total of 670 cases of childhood hyperthyroidism were identified. Twenty patients (3%) had associated autoimmune or genetic disease, with type 1 diabetes and Down syndrome the most frequent. The annual incidence for 2015 was 4.58/100,000 person-years (95% CI 3.00 to 6.99/100,000). Incidence increased with age, in both sexes. This increase accelerated after the age of 8 in girls and 10 in boys and was stronger in girls. About 10% of patients were affected before the age of 5 years (sex ratio 1.43). There was an interaction between age and sex, the effect of being female increasing with age: girls were 3.2 times more likely to be affected than boys in the 10 to 14 years age group and 5.7 times more likely to be affected in the 15 to 17 years age group. No conclusions about spatial pattern emerged.

Conclusion

These findings shed light on the incidence of hyperthyroidism and the impact of sex on this incidence during childhood and adolescence. The observed incidence was higher than expected from the results published for earlier studies in Northern European countries.
INTEGRATION OF THE POTENTIALITIES PRESENTED IN MUSIC LESSON OF A GENERAL EDUCATION SCHOOL INTO CHORAL CLASSES WITH ADULTS
Authors: ННовоселов Вячеслав , Novoselov Vyacheslav
Published: May 2018

The article reveals the role of a lesson as the main form of education. The potentialities of integration of music lessons in a general education school into choral classes with the labour veterans choir are determined.
Becoming a reflective practitioner
Authors: Fontaine Samantha J
Published: May 2018

Reflective practice (RP) can be defined as the process of considering an event or a situation in order to examine the factors that influenced it so that one can determine what could have been done differently, or to identify what learning occurred. RP has many potential benefits to professional practice including developing critically thoughtful approaches to patient care, influencing professional decision-making, developing emotional intelligence, and stimulating personal and professional growth. Specific skills must be developed to successfully undertake RP including self-awareness, description, critical analysis, synthesis and evaluation. These skills can be developed using a model of reflection. Models encourage a structured and guided approach to RP and encourage individuals to achieve a deeper level of understanding of the event. To make effective use of a model of reflection, a written account is preferred. This can easily be achieved through the use of a journal, which is a personal collection of notes, thoughts, observations and experiences. Journals can enhance learning through the action of writing and critically exploring experiences. Group reflection is another method of RP, and allows participants to learn from the perspectives of others, and to receive feedback on their practice. There are barriers to RP including lack of time and power to implement changes, as such there is a need for organisations to recognise the importance of RP and to allocate appropriate resources to help support its action.