bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of the refugee crisis in the Balkans: A drift towards security
Authors: Šelo-Šabić Senada
Published: November 2017

During the course of approximately one year - from early 2015 until March 2016 - over 800,000 people crossed four countries on the Western Balkan route: Macedonia, Serbia, Croatia and Slovenia. These countries' ability to organize the refugees' transit in an orderly manner was described as a humanitarian approach. Due to the transit nature of the passage of the refugees, the crisis could have been seen as having little impact on the countries beyond technical issues like registration, accommodation and transportation. This article, however, looks at what happened on the ground as the crisis was developing and in the year following the closure of the refugee route. It claims that the securitization of migration took place as a consequence of the refugee crisis. However, the securitization of migration in the Balkans has certain specifics. What kind of security discourse developed, and which policy measures were adopted? These aspects are analyzed in this article.
Two new species of Chalciporus (Boletaceae) from southern China revealed by morphological characters and molecular data
Authors: ZHANG MING , LI TAI-HUI , SONG BIN
Published: November 2017

Two new species of Chalciporus are described from southern China. Chalciporus citrinoaurantius sp. nov. is characterized by a lemon yellow to grayish orange pileus, light orange to rose pink tubes and elongated basidiospores (9.0)9.5–12.5(13) × 3–4(4.5) μm; C. hainanensis sp. nov. is characterized by small basidiomata with grayish yellow to brownish orange pilei, orange yellow to brownish orange tubes with brownish orange to brownish red pores and elliptic basidiospores 8–10.5(11) × 4–5(5.5) μm. Phylogenetic analysis based on the combined dataset (nrLSU+tef1-α+rpb2) confirmed the affinity of the new species in Chalciporus and indicated their relationships with other species within the genus.
Prodromus of a fern flora for Bolivia. VII. Equisetaceae
Authors: KESSLER MICHAEL , SMITH ALAN R.
Published: November 2017

We provide a synopsis to the family Equisetaceae in Bolivia, including the two species Equisetum bogotense and E. giganteum.
Reestablishment of Mansoa ventricosa (Bignonieae, Bignoniaceae) based on molecular and morphological data
Authors: FRANCISCO JESSICA NAYARA CARVALHO , LOHMANN LÚCIA G.
Published: November 2017

Pachyptera ventricosa is a rare and poorly known species of liana that occurs in wet forests from the state of Pará, in Brazil. This species is characterized by features that are diagnostic of four genera within tribe Bignonieae: Mansoa, Martinella, Pachyptera, and Tanaecium. The currently recognized P. ventricosa was originally described in Mansoa, but subsequently transferred to Pachyptera based on morphological similarities. In this study, we use a combination of molecular and morphological data to evaluate the current placement of P. ventricosa. We conduct a broad scale molecular phylogenetic study based on 114 sequences of ndhF and PepC representing 112 taxa and members of all genera recognized in Bignonieae. In addition, we also conduct detailed morphological studies of selected characters. Our molecular phylogenetic study indicates that the currently recognized Pachyptera ventricosa is more closely related to members of Mansoa than to Pachyptera. New morphological data corroborates the molecular phylogenetic placement indicating that this species is indeed best placed within Mansoa. We here propose the reestablishment of Mansoa ventricosa, and show the detailed description for this species, along with new distribution information, and the first illustration for this taxon.
Taxonomic notes on Spiraea martini Léveillé (Rosaceae)
Authors: XU DONG-XIAN , ZHU XIN-XIN , LIU QUAN-RU
Published: November 2017

Examination of specimens and literature as well as the field survey shows that Spiraea cavalariei Léveillé, S. martini var. pubescens Yu, and S. martini var. tomentosa Yu matches perfectly with Spiraea martini Léveillé, so previous three names are here relegated to the synonymy of Spiraea martini Léveillé.
Discovery of the genus Lebioderus (Coleoptera, Carabidae, Paussinae) from China, with description of two new species
Authors: SONG XIAO-BIN , MARUYAMA MUNETOSHI , PENG ZHONG
Published: November 2017

The rare paussine genus Lebioderus Westwood, 1838 is reported from China for the first time, based on two new species, L. sinicus Song & Maruyama sp. nov. and L. maolanus Song & Maruyama sp. nov. The type series of L. sinicus was collected from nests of Carebara Westwood, 1840 ants, which is also a first host record for Lebioderus.
Contributions to the palaeofauna of Ptinidae (Coleptera) known from Baltic amber
Authors: BUKEJS ANDRIS , ALEKSEEV VITALII I. , COOPER DAVID M.L. , KING GAVIN A. , MCKELLAR RYAN C.
Published: November 2017

Hemicoelus favonii sp. nov. is described and illustrated from Eocene Baltic amber. This new fossil species differs from extant congeners in having 11-segmented antennae; a metathoracic ventrite with large impression in its anterior portion; a pronotum distinctly narrower than the elytral base region; the posterior suture of abdominal ventrite 1 weakly arcuate medially; sharp lateral pronotal margins that are incomplete and distinct in their basal half only; elytral striae that are not grouped in pairs; posterior pronotal angles that are rounded; elytral intestriae 3, 5, 7 and 9 that are distinctly convex; and a comparatively small total body size. The presence of Hemicoelus in Baltic amber suggests that moist, rotting wood was available as a microhabitat in the ancient forest. Beyond the new species description, the systematic placement of Anobium jacquelinae Hawkeswood, Makhan & Turner is discussed. A new fossil record for Microbregma waldwico Bukejs & Alekseev, and the first report of the genus Trichodesma LeConte from Eocene Baltic amber are also presented.
A new species of Hyalella (Crustacea: Amphipoda: Hyalellidae) from Itatiaia National Park, Brazil: an epigean freshwater amphipod with troglobiotic traits at 2,200 meters of altitude
Authors: RODRIGUES STELLA GOMES , SENNA ANDRÉ R. , QUADRA ADRIANA , BUENO ALESSANDRA ANGÉLICA DE PÁDUA
Published: November 2017

A new species of the freshwater amphipod Hyalella Smith, 1874 is described for the plateau of the Itatiaia National Park, located between the states of Minas Gerais and Rio de Janeiro, southeastern Brazil. This is the first Brazilian species of Hyalella found at more than 2,200 meters of altitude. The specimens were found in a small stream, buried under rocks, in the higher area of the Park. The main morphological characteristics that differentiate the new species are the extreme reduction of the size of the uropod 3, absence of apical setae on telson, absence of comb-scales on gnatopods 1 and 2, absence of curved seta on inner ramus of uropod 1 and sternal gills tubular on pereonites 3 to 7. The new species presents similarities with some cave species of the genus, apparently being troglophile and that is the process of adaptation to the hypogean habitat. The importance of creating new protected areas for the conservation of Hyalella in Brazil is discussed.
A new genus of Trichogrammatidae (Hymenoptera: Chalcidoidea) from India
Authors: KHAN MOHD TALIB , ANIS SHOEBA BINTE
Published: November 2017

A new genus and species, Ayaanella globugaster M.T. Khan & Anis gen. nov. and sp. nov. (Hymenoptera: Trichogrammatidae) is described from two females collected in Uttar Pradesh State of India.
Improving Weather Forecast Skill through Reduced-Precision Data Assimilation
Authors: Hatfield Sam , Subramanian Aneesh , Palmer Tim , Düben Peter
Published: November 2017

A new approach for improving the accuracy of data assimilation, by trading numerical precision for ensemble size, is introduced. Data assimilation is inherently uncertain because of the use of noisy observations and imperfect models. Thus, the larger rounding errors incurred from reducing precision may be within the tolerance of the system. Lower-precision arithmetic is cheaper, and so by reducing precision in ensemble data assimilation, computational resources can be redistributed toward, for example, a larger ensemble size. Because larger ensembles provide a better estimate of the underlying distribution and are less reliant on covariance inflation and localization, lowering precision could actually permit an improvement in the accuracy of weather forecasts. Here, this idea is tested on an ensemble data assimilation system comprising the Lorenz ’96 toy atmospheric model and the ensemble square root filter. The system is run at double-, single-, and half-precision (the latter using an emulation tool), and the performance of each precision is measured through mean error statistics and rank histograms. The sensitivity of these results to the observation error and the length of the observation window are addressed. Then, by reinvesting the saved computational resources from reducing precision into the ensemble size, assimilation error can be reduced for (hypothetically) no extra cost. This results in increased forecasting skill, with respect to double-precision assimilation.
A Novel Imaging Method for the Cartilaginous Eustachian Tube Lumen: Computerized Tomography During the Forced Response Test
Authors: Alper Cuneyt M. , Rath Tanya J. , Teixeira Miriam S. , Swarts J. Douglas
Published: November 2017

Objectives:

In vivo imaging of the open cartilaginous Eustachian tube (ET) lumen by computed tomography (CT) scan during ET function (ETF) testing to establish new methodology.

Methods:

Five adults underwent unilateral ETF testing of an ear with a nonintact tympanic membrane using the forced response test (FRT) to measure the opening pressure (PO), steady state pressure (PS), and flow conductance (CS). Then at baseline and during the PS phase of the FRT, a temporal-bone CT scan with continuous 0.625 mm thickness was obtained. Multiplanar oblique reformats along the axis of the ET were created, and point value and region of interest (ROI) Hounsfield unit measurements were recorded from the location of the ET lumen.

Results:

At the FRT flow rate of 11 ml/min, the average PO, PS, and CS were 370.5 daPa, 119.6 daPa, and 0.16 ml/min/daPa, respectively. For flow rates of 23 and 46 ml/min, these values were 236.2, 204.2, 0.12 and 385.5, 321.1, 0.18, respectively. Although areas with lower attenuation were suggestive of air density, a distinct air-filled cartilaginous ET lumen could not be confirmed.

Conclusions:

While the current imaging parameters failed to resolve the air-soft tissue interface throughout the open cartilaginous ET, further advances in imaging may obviate this limitation.
Aid for Vote? United Nations General Assembly Voting and American Aid Allocation
Authors: Woo Byungwon , Chung Eunbin
Published: November 2017

How do political factors affect foreign aid allocation? Recognizing that aid can be used as inducement, we argue that the US has incentives to provide aid to countries who oppose it a priori at the United Nations General Assembly when it is the sole country that “buys votes” with aid, in order to maximize the number of favorable votes. When there is a rival country trying to buy votes, as was the case during the Cold War, there are incentives for the US to provide aid even to those who support its position already. We empirically demonstrate that the US provides more aid to countries who hold unfavorable positions to the US only in the post-Cold War era.
Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey
Authors: Cowling Thomas E , Laverty Anthony A , Harris Matthew J , Watt Hilary C , Greaves Felix , Majeed Azeem
Published: November 2017

Objective

To examine associations between the contract and ownership type of general practices and patient experience in England.

Design

Multilevel linear regression analysis of a national cross-sectional patient survey (General Practice Patient Survey).

Setting

All general practices in England in 2013–2014 ( n = 8017).

Participants

903,357 survey respondents aged 18 years or over and registered with a general practice for six months or more (34.3% of 2,631,209 questionnaires sent).

Main outcome measures

Patient reports of experience across five measures: frequency of consulting a preferred doctor; ability to get a convenient appointment; rating of doctor communication skills; ease of contacting the practice by telephone; and overall experience (measured on four- or five-level interval scales from 0 to 100). Models adjusted for demographic and socioeconomic characteristics of respondents and general practice populations and a random intercept for each general practice.

Results

Most practices had a centrally negotiated contract with the UK government (‘General Medical Services’ 54.6%; 4337/7949). Few practices were limited companies with locally negotiated ‘Alternative Provider Medical Services’ contracts (1.2%; 98/7949); these practices provided worse overall experiences than General Medical Services practices (adjusted mean difference −3.04, 95% CI −4.15 to −1.94). Associations were consistent in direction across outcomes and largest in magnitude for frequency of consulting a preferred doctor (−12.78, 95% CI −15.17 to −10.39). Results were similar for practices owned by large organisations (defined as having ≥20 practices) which were uncommon (2.2%; 176/7949).

Conclusions

Patients registered to general practices owned by limited companies, including large organisations, reported worse experiences of their care than other patients in 2013–2014.
Radical ethical naturalism
Authors: Whyman Tom
Published: November 2017

In this article, I identify – and clear up – two problems for contemporary neo-Aristotelian ethical naturalism. The first I call the problem of alienation; the second the problem of conservatism. I argue that these problems will persist, both for ‘hard’ and ‘soft’ forms of ethical naturalism, unless ethical naturalists adopt what I call ‘Practical Realism’ about essential human form. Such a Practical Realism leaves open the possibility of radical social and political criticism – I therefore suggest that contemporary ethical naturalists ought to be more interested in exploring the affinities their view shares with Marxist political thought.
Drinking Water Quality in Indian Water Policies, Laws, and Courtrooms: Understanding the Intersections of Science and Law in Developing Countries
Authors: Sharma Aviram
Published: November 2017

Drinking water quality has drawn enormous attention from scientific communities, the industrial sector, and the common public in several countries during the last couple of decades. The scholarship in science and technology studies somehow overlooked this crucial domain. This article attempts to contribute to this gray area by exploring how drinking water quality is understood in Indian water policies, laws, and courtrooms. The article argues that water policies and laws in India were significantly shaped by international treaties and global environmental stewardship. In the courtrooms, the Indian judiciary employed minimum science-based evidence in decision making in the context of drinking water–related cases; rather they used a rights-based approach and minimally engaged with the issue of drinking water quality/standards. Whatever little science used as valid science by the judges in the decision making was entirely expert-based. The reliance of the judges on the scientific expertise of the experts representing regulatory organizations and public institutions was another unique characteristic of the relationship between science and law in India.
Strengthening Causal Estimates for Links Between Spanking and Children’s Externalizing Behavior Problems
Authors: Gershoff Elizabeth T. , Sattler Kierra M. P. , Ansari Arya
Published: November 2017

Establishing causal links when experiments are not feasible is an important challenge for psychology researchers. The question of whether parents’ spanking causes children’s externalizing behavior problems poses such a challenge because randomized experiments of spanking are unethical, and correlational studies cannot rule out potential selection factors. This study used propensity score matching based on the lifetime prevalence and recent incidence of spanking in a large and nationally representative sample ( N = 12,112) as well as lagged dependent variables to get as close to causal estimates outside an experiment as possible. Whether children were spanked at the age of 5 years predicted increases in externalizing behavior problems by ages 6 and 8, even after the groups based on spanking prevalence or incidence were matched on a range of sociodemographic, family, and cultural characteristics and children’s initial behavior problems. These statistically rigorous methods yield the conclusion that spanking predicts a deterioration of children’s externalizing behavior over time.
Hospital-Based Palliative Care with Medicare Claims: Evidence From Colorado
Authors: Kassner Cordt T. , Bhavsar Nrupen A. , Harker Matthew , Bull Janet , Taylor Donald H.
Published: November 2017

Background:

The prevalence of hospital-based palliative care has been largely anecdotal as an increasing service being provided and there is a need to understand what trends can be analyzed with Medicare data.

Objective:

To compare 2 methods of identifying hospital-based palliative care in the Medicare population in Colorado.

Study Design:

Through Medicare claims data and phone surveys, we ascertained the presence of hospital-based palliative care services, number of patients receiving palliative care, and number of care visits provided during the previous year.

Data Sources/Study Setting:

Data were collected from every Medicare-certified hospital in Colorado during 2008 and 2013.

Measurements:

We measured the presence of hospital-based palliative care teams and their average number of consultations through a phone survey and cross-referenced using a v-code modifier of Medicare claims indicating a palliative care consult visit.

Results:

The number of hospital-based palliative care consultations increased five-fold from 2008-2013, and Medicare claims under-counted the number of these consultations compared to phone surveys.

Conclusion:

The systematic measurement of palliative care nationally is a key priority. More evidence is needed from other states to better understand the usefulness of Medicare claims in this effort.
Validation Study for the Brief Measure of Quality of Life and Quality of Care: A Questionnaire for the National Random Sampling Hospital Survey
Authors: Shimizu Megumi , Fujisawa Daisuke , Kurihara Miho , Sato Kazuki , Morita Tatsuya , Kato Masashi , Miyashita Mitsunori
Published: November 2017

Background:

To monitor quality of life (QOL) for patients with cancer in a large population-based survey, we developed a short QOL and quality-of-care (QOC) questionnaire. To determine the validity and reliability of this new questionnaire for evaluating QOL in patients with cancer.

Methods:

Outpatients and inpatients at National Cancer Center Hospital East were administered a questionnaire, including the following items—the short QOL and QOC questionnaire (physical distress, pain, emotional distress, walk burden, and need for help with self-care; perceived general health status; and satisfaction with medical care and treatment by doctor, communication with doctor, support by health-care staff other than doctor, care for physical symptoms such as pain, and psychological care), the Functional Assessment of Cancer Therapy—General (FACT-G), the Cancer Care Evaluation Scale (CCES) for patients, and demographic and medical data. We then readministered the short QOL and QOC questionnaire.

Results:

In total, 329 outpatients and 239 inpatients completed the survey (response rates: 80% and 90%, respectively). Total Cronbach α for the short QOL and QOC questionnaire was 0.83 for outpatients and 0.82 for inpatients. Items of the questionnaire correlated with cancer-specific measurements, FACT-G, and CCES. Intraclass correlation coefficients for all items of the questionnaire were 0.79 and 0.89 in each setting. Items of QOL and QOC did not correlate with each other.

Conclusion:

The validity and reliability of the short QOL and QOC questionnaire appear sufficient. This questionnaire enables continuous monitoring of patient QOL in large population-based surveys.
Patient Self-Defined Goals: Essentials of Person-Centered Care for Serious Illness
Authors: Schellinger Sandra Ellen , Anderson Eric Worden , Frazer Monica Schmitz , Cain Cindy Lynn
Published: November 2017

This research, a descriptive qualitative analysis of self-defined serious illness goals, expands the knowledge of what goals are important beyond the physical—making existing disease-specific guidelines more holistic. Integration of goals of care discussions and documentation is standard for quality palliative care but not consistently executed into general and specialty practice. Over 14 months, lay health-care workers (care guides) provided monthly supportive visits for 160 patients with advanced heart failure, cancer, and dementia expected to die in 2 to 3 years. Care guides explored what was most important to patients and documented their self-defined goals on a medical record flow sheet. Using definitions of an expanded set of whole-person domains adapted from the National Consensus Project (NCP) Clinical Practice Guidelines for Quality Palliative Care, 999 goals and their associated plans were deductively coded and examined. Four themes were identified—medical, nonmedical, multiple, and global. Forty percent of goals were coded into the medical domain; 40% were coded to nonmedical domains—social (9%), ethical (7%), family (6%), financial/legal (5%), psychological (5%), housing (3%), legacy/bereavement (3%), spiritual (1%), and end-of-life care (1%). Sixteen percent of the goals were complex and reflected a mix of medical and nonmedical domains, “multiple” goals. The remaining goals (4%) were too global to attribute to an NCP domain. Self-defined serious illness goals express experiences beyond physical health and extend into all aspects of whole person. It is feasible to elicit and record serious illness goals. This approach to goals can support meaningful person-centered care, decision-making, and planning that accords with individual preferences of late life.
Managing Bias in Palliative Care: Professional Hazards in Goals of Care Discussions at the End of Life
Authors: Callaghan Katharine A. , Fanning Joseph B.
Published: November 2017

Background:

In the setting of end-of-life care, biases can interfere with patient articulation of goals and hinder provision of patient-centered care. No studies have addressed clinician bias or bias management specific to goals of care discussions at the end of life.

Objectives:

To identify and determine the prevalence of palliative care clinician biases and bias management strategies in end-of-life goals of care discussions.

Design:

A semistructured interview guide with relevant domains was developed to facilitate data collection. Participants were asked directly to identify biases and bias management strategies applicable to this setting. Two researchers developed a codebook to identify themes using a 25% transcript sample through an iterative process based on grounded theory. Inter-rater reliability was evaluated using Cohen κ. It was 0.83, indicating near perfect agreement between coders. The data approach saturation.

Setting/Participants:

A purposive sampling of 20 palliative care clinicians in Middle Tennessee participated in interviews.

Results:

The 20 clinicians interviewed identified 16 biases and 11 bias management strategies. The most frequently mentioned bias was a bias against aggressive treatment (n = 9), described as a clinician’s assumption that most interventions at the end of life are not beneficial. The most frequently mentioned bias management strategy was self-recognition of bias (n = 17), described as acknowledging that bias is present.

Conclusion:

This is the first study identifying palliative care clinicians’ biases and bias management strategies in end-of-life goals of care discussions.
The Impact of Teaching Prognostication at the End of Life: A Pre–Post Interventional Study
Authors: Bear Alexandria , Keuter Tucker , Patel Jayshil J.
Published: November 2017

Background:

Providing accurate and valid prognostic information significantly influences end-of-life care. Disclosing a poor prognosis can be among the most difficult of physician responsibilities, thus having appropriate knowledge during training is crucial for appropriate prognostication.

Objective:

To provide internal medicine (IM) house staff with a pre- and posteducational survey to determine their ability to accurately prognosticate 5 common end-stage diseases.

Design:

We conducted a pre- and posteducational intervention survey-based study. A preintervention survey was administered to IM postgraduate year 1 (PGY-1) and PGY-2-4 house staff. The survey consisted of case scenarios for 5 common end-stage diseases, containing 1 question on comfort level and 2 on prognostication (totaling 10 points). A 30-minute educational intervention was presented immediately after the initial survey. The same survey was readministered 4 weeks thereafter. An identical survey was administered once to palliative care faculty.

Results:

Forty house staff completed pre- and posteducational surveys. Eight palliative care faculty completed the survey. No difference was found between all house staff pre- and postscores (mean 2.70 [1.45] vs 2.78 [1.59], P = .141). There was no significant difference between PGY-1 and PGY-2-4 pretest scores (mean 2.63 [1.71] vs 2.81 [1.42], P = .72). The PGY-2-4 posttest score was significantly greater than PGY-1 posttest score (3.38 [1.58] vs 2.38 [1.58], P = .05). Total house staff posttest score was significantly lower than gold standard palliative care faculty (mean 4.71 [1.98] vs 2.78 [1.59], P = .006).

Conclusions:

Our pre–post intervention survey-based study demonstrates no significant increases in all house staff scores. The PGY-2-4 postintervention scores improved significantly. We speculate the optimal time for prognostication education may be after the PGY-1 year when house staff have had sufficient exposure to common conditions.
Fear, Pain, Denial, and Spiritual Experiences in Dying Processes
Authors: Renz M. , Reichmuth O. , Bueche D. , Traichel B. , Mao M. Schuett , Cerny T. , Strasser F.
Published: November 2017

Purpose:

Approaching death seems to be associated with physiological/spiritual changes. Trajectories including the physical–psychological–social–spiritual dimension have indicated a terminal drop. Existential suffering or deathbed visions describe complex phenomena. However, interrelationships between different constituent factors (e.g., fear and pain, spiritual experiences and altered consciousness) are largely unknown. We lack deeper understanding of patients’ inner processes to which care should respond. In this study, we hypothesized that fear/pain/denial would happen simultaneously and be associated with a transformation of perception from ego-based (pre-transition) to ego-distant perception/consciousness (post-transition) and that spiritual (transcendental) experiences would primarily occur in periods of calmness and post-transition. Parameters for observing transformation of perception (pre-transition, transition itself, and post-transition) were patients’ altered awareness of time/space/body and patients’ altered social connectedness.

Method:

Two interdisciplinary teams observed 80 dying patients with cancer in palliative units at 2 Swiss cantonal hospitals. We applied participant observation based on semistructured observation protocols, supplemented by the list of analgesic and psychotropic medication. Descriptive statistical analysis and Interpretative Phenomenological Analysis (IPA) were combined. International interdisciplinary experts supported the analysis.

Results:

Most patients showed at least fear and pain once. Many seemed to have spiritual experiences and to undergo a transformation of perception only partly depending on medication. Line graphs representatively illustrate associations between fear/pain/denial/spiritual experiences and a transformation of perception. No trajectory displayed uninterrupted distress. Many patients seemed to die in peace. Previous near-death or spiritual/mystical experiences may facilitate the dying process.

Conclusion:

Approaching death seems not only characterized by periods of distress but even more by states beyond fear/pain/denial.
Clinical Factors Associated With Adherence to the Premedication Protocol for Withdrawal of Mechanical Ventilation in Terminally Ill Patients: A 4-Year Experience at a Single Medical Center in Asia
Authors: Wang Chao-Hui , Huang Pei-Wei , Hung Chia-Yen , Lee Shu-Hui , Kao Chen-Yi , Wang Hung-Ming , Hung Yu-Shin , Su Po-Jung , Kuo Yung-Chia , Hsieh Chia-Hsun , Chou Wen-Chi
Published: November 2017

Purpose:

Data on end-of-life care practices in Asia are scarce. This study aimed to analyze the clinical factors associated with the recommended premedication protocol for mechanical ventilation withdrawal, in Taiwan.

Methods:

A total of 135 terminally ill patients who had mechanical ventilation withdrawn between 2013 and 2016 from a single medical center in Taiwan were enrolled. A premedication protocol of morphine and midazolam intravenous bolus was routinely recommended for the patients before mechanical ventilation withdrawal. Receipt of opioids and/or benzodiazepines during the withdrawal process was defined as full (both), partial (1 drug), and no (none) adherence. The clinical factors relevant to the adherence of recommended premedication protocol for mechanical ventilation withdrawal were analyzed.

Results:

Overall, 126 (93.3%) patients died, 8 (5.9%) patients were transferred to other institutions for further care, and 1 (0.7%) patient was discharged to home after mechanical ventilation withdrawal. The median survival time was 45 minutes, and 102 (75.6%) patients died within 1 day after the withdrawal process. The full, partial, and no adherence rates for premedication guideline were 17.8%, 40.0%, and 42.2%, respectively. The main diagnosis of cancer, receipt of hospice care, and preservation of spontaneous respiration were independent variables associated with the partial or full adherence to the premedication protocol.

Conclusion:

Our data show that adherence to the premedication protocol for mechanical ventilation withdrawal in terminally ill patients was inadequate in Taiwan. Promoting hospice care and educating medical personnel in the compassionate withdrawal of mechanical ventilation, especially in patients with noncancer disease, are warranted.
Cyberbullying and Social Media: Information and Interventions for School Nurses Working With Victims, Students, and Families
Authors: Byrne Elizabeth , Vessey Judith A. , Pfeifer Lauren
Published: November 2017

Social media has become an increasingly prevalent fixture in youths’ lives, with over 90% of teenagers reporting daily usage. These online sites and applications have provided many positive opportunities for youths to connect and share ideas with others; however, social media has also become a major platform for cyberbullying. Victims often experience negative health outcomes directly related to cyberbullying. For this reason, it is critical that third parties, such as school nurses, are well versed in social media and the warning signs of those being victimized by cyberbullying. Therefore, this integrative review examines school nurses’ knowledge of cyberbullying and social media and identifies the implications for school nursing practice regarding prevention and intervention processes.
Systematic reuse and platforming: Application examples for enhancing reuse with model-based systems engineering methods in space systems development
Authors: Lange Caroline , Grundmann Jan Thimo , Kretzenbacher Michael , Fischer Philipp Martin
Published: November 2017

Despite popular belief, space missions are not always one-of-a-kind, but are frequently benefiting from explicit or implicit reuse of different types. The Venus Express mission is one example of cost savings by reusing existing hardware in a new mission context. Other examples are based on the platform approach, popular, for example, in geostationary telecommunication satellites, which benefits from a pre-planned reuse and its application to a family of missions with commonality. While the latter is handled more strategically, promising more gain in its execution, the Venus Express example is more of an ad hoc nature. Given the increasing importance of design reuse, the practical question to be answered in this article is how to promote it using effective engineering methods and processes. Model-based systems engineering often advertises itself as especially beneficial to reuse projects and we provide a systematic review of the respective capabilities in this article. Furthermore, we describe two reuse application examples: an asteroid nanolander based on the Mobile Asteroid Surface Scout lander currently flying onboard Hayabusa2 and a Small Satellite Platform for Earth science missions. With Mobile Asteroid Surface Scout’s heritage generating strong interest for future small body missions, this creates a case for what we call ad hoc reuse. Conversely, the Small Satellite Technology Platform, which is currently in its definition phase, can be classified as systematic reuse case with the aim of developing a commonality-based small satellite family, suitable for a set of rapidly recurring missions in low Earth orbit. Our study of the Mobile Asteroid Surface Scout-2 reuse case has provided insights into reuse requirements, which are mapped to typical model-based systems engineering features that create value beyond those offered by classical approaches. The article identifies key areas where model-based systems engineering provides benefits in reuse cases: requirements reuse, system context analysis as well as interface compatibility checking. It further outlines an overall approach regarding tools and development processes.
Preliminary study on launch vehicle design: Applications of multidisciplinary design optimization methodologies
Authors: Brevault Loïc , Balesdent Mathieu , Defoort Sébastien
Published: November 2017

The design of complex systems such as launch vehicles involves different fields of expertise that are interconnected. To perform multidisciplinary studies, concurrent engineering aims at providing a collaborative environment which often relies on data set exchange. In order to efficiently achieve system-level analyses (uncertainty propagation, sensitivity analysis, optimization, etc.), it is necessary to go beyond data set exchange which limits the capabilities of performance assessments. Multidisciplinary design optimization methodologies is a collection of engineering methodologies to optimize systems modelled as a set of coupled disciplinary analyses and is a key enabler to extend concurrent engineering capabilities. This article is focused on several examples of recent developments of multidisciplinary design optimization methodologies (e.g. multidisciplinary design optimization with transversal decomposition of the design process, multidisciplinary design optimization under uncertainty) with applications to launch vehicle design to illustrate the benefices of taking into account the coupling effects between the different physics all along the design process. These methods enable to manage the complexity of the involved physical phenomena and their interactions in order to generate innovative concepts such as reusable launch vehicles beyond existing solutions.
The Development of Gratitude in Seven Societies: Cross-Cultural Highlights
Authors: Mendonça Sara Etz , Merçon-Vargas Elisa A. , Payir Ayse , Tudge Jonathan R. H.
Published: November 2017

This study aimed to examine children’s expression of gratitude in Brazil, China, Guatemala, Russia, South Korea, Turkey, and the United States. Participants ( N = 2,265) consisted of 7- to 14-year-olds ( M = 10.56, SD = 2.09; 54.4% girls). Using hierarchical cluster analysis, we found four clusters of gratitude expression: (a) Russia and Turkey (moderate–high expression of connective, low concrete, and moderate verbal gratitude), (b) Brazil and the United States (low connective, higher rates of concrete, and moderate–high rates of verbal gratitude), (c) China and South Korea (higher rates of connective, lower concrete, and lower–moderate verbal gratitude), and (d) Guatemala (lower rates of concrete and connective gratitude, and higher rates of verbal gratitude). In addition, we found common trends in age-related differences for verbal and concrete gratitude among most societies. These findings support the argument for diligence in avoiding implicit generalizations based on research conducted mostly in Western Educated Industrialized Rich Democratic (WEIRD) societies.
The First Pint of Science Festival in Asia
Authors: Robinson Matthew T. , Jatupornpimol Nattapat , Sachaphimukh Sandy , Lönnkvist Maria , Ruecker Andrea , Cheah Phaik Yeong
Published: November 2017

The Pint of Science Festival is the largest annual international science festival. So far the event has been held simultaneously in Europe, North America, South America, Africa, and Australia but not in Asia. Pint of Science Thailand was held for the first time this year, in Thailand’s capital, Bangkok. This article briefly discusses some of the successes, challenges, and lessons learnt associated with running the first Pint of Science event in Asia, a culture very different to the Western Hemisphere cities that have currently hosted Pint of Science events.
Patient Numeracy? Don’t Count on It
Authors: Suter William N. , Suter Paula M.
Published: November 2017

Low levels of patient numeracy are pervasive, yet patients are expected to use basic math skills to maintain health, avoid ill health, and make important health decisions. This article summarizes what we know about best practices when communicating numeracy-based information to patients. We offer advice to home health nurses faced with challenges of caring for patients with low numeracy and who are responsible for their health and safety that require quantitative reasoning. Comprehending statistical data is difficult and counterintuitive for many people (and experts), and we offer examples of widely misunderstood formats of quantitative information but clarify them in ways that will benefit the practicing home health nurse. We conclude that patients need help understanding and using numbers while nurses need help explaining them.
Combination Therapy with Budesonide and Formoterol in Single Inhaler of Asthma
Authors: Hamzavi Mohammad
Published: November 2017

Inhaled corticosteroids are the mainstay of asthma therapy, but there is now compelling evidence that addition of a long-acting inhaled β2-agonist, such as formoterol, gives better control in terms of reduced symptoms, improved lung function and reduced exacerbations in patients with mild to severe persistent asthma than increasing the dose of corticosteroids in patients not fully in control by low dose. This has led to development of fixed dose combination inhalers such as budesonide/formoterol.

Budesonide/formoterol combination in a single inhaler represents a safe, effective and convenient treatment option for management of patients with unstable asthma than inhaled steroid alone. This combination has shown effectiveness for both maintenance and rescue therapy. Clinical results show that the budesonide/formoterol by SMART approach prolongs the time to first severe asthma exacerbation, reduces frequency of exacerbation and maintains day to day asthma control at a reduced corticosteroid load and cost when compared with higher fixed maintenance dose of combination inhalers. With regular maintenance therapy by this approach it is more likely to improve patient compliance.

Budesonide/formoterol combination inhaler has shown to have a faster bronchodialatory effect compared with other combination inhalers, a quality highly in demand during exacerbation episodes. Due to this rapid onset of action, budsonide/formoterol in a single inhaler lends itself to be used as a rescue medication, as well.
The presence of co-morbid mental health problems in a cohort of adolescents with chronic fatigue syndrome
Authors: Loades Maria Elizabeth , Rimes Katharine A , Ali Sheila , Lievesley Kate , Chalder Trudie
Published: November 2017

Objective:

To report on the prevalence of mental health disorders in adolescents with chronic fatigue syndrome (CFS) and to compare the diagnoses identified by a brief clinician-administered psychiatric interview with self-report screening questionnaires.

Design:

Cross-sectional study.

Setting:

Consecutive attenders to specialist CFS clinics in the United Kingdom.

Patients:

N = 52 adolescents, age 12–18 years with CFS.

Measures:

Self-report questionnaires and a brief structured psychiatric diagnostic interview, administered by a researcher.

Results:

On the psychiatric interview, 34.6% met a diagnosis of major depressive disorder and 28.8% had an anxiety disorder. Of these, 15% had co-morbid anxiety and depression. Those with a depression diagnosis reported significantly greater interference on the school and social adjustment scale. They also scored significantly higher on trait anxiety, but not on state anxiety. There were no differences between those who had an anxiety disorder and those who did not on fatigue, disability or depressive symptoms. Children’s Depression Inventory (CDI) score was associated with a depression diagnosis on the psychiatric interview. However, neither the state nor the trait subscale of the State-Trait Anxiety Inventory (STAI) was associated with an anxiety diagnosis.

Conclusion:

Clinicians should assess for the presence of anxiety and depressive disorders in adolescents with CFS using a validated psychiatric interview. Treatment should be flexible enough to accommodate fatigue, depression and anxiety. Transdiagnostic approaches may suit this purpose. Goals should include pleasurable activities particularly for those who are depressed.
Effect of tungsten carbide on mechanical and tribological properties of jute/sisal/E-glass fabrics reinforced natural rubber/epoxy composites
Authors: Athith D , Sanjay MR , Yashas Gowda TG , Madhu P , Arpitha GR , Yogesha B , Omri Med Amin
Published: November 2017

Natural fiber polymer composites have been largely used in applications like aerospace, automotive, marine, and other civil structures, where mechanical and tribological properties are of prime consideration. The performance of hybrid composites can be improved by using different natural fibers and adding particulate fillers to them. In this study, mechanical and tribological properties of jute/sisal/E-glass fabrics reinforcing matrix such as natural rubber and epoxy filled with different proportion of tungsten carbide (WC) powder were studied. Mechanical properties like tensile strength, flexural strength, impact strength, and also tribological behavior like two-body abrasive wear of composite were studied. Taguchi technique was employed for wear analysis. Results revealed that there is a significant change in the mechanical properties and enhancement of wear behavior was noticed due to the incorporation of filler (WC) particles.
Team identity in youth soccer: The role of coaches' feedback patterns and use of humour
Authors: Høigaard Rune , Haugen Tommy , Johansen Bjørn T , Giske Rune
Published: November 2017

The purpose of this study was to empirically examine the relationship between coaches' communication patterns (feedback and use of humour) and team identity in youth soccer. A cross-sectional design was used and participants were 532 soccer players, aged from 13 to 20 years, taking part in a youth soccer tournament, the Sør Cup. Structural Equation Modelling based multiple regression analysis was conducted, and the findings revealed that positive/instructive feedback and coaches' use of humour were positive significant predictors of team identity. Contrary to our expectations, negative/punishment feedback was not significantly related to team identity. The findings are discussed within a social identity framework. It is concluded that positive/instructive feedback and the use of humour are elements that coaches may use to develop the team identity. However, future work is needed to further validate the scales used in this study, and to examine how the use of humour may influence the athlete and the team.
Radial styloidectomy for scaphoid nonunion advanced collapse – relevance of nonunion location
Authors: Vutescu Emil S. , Jethanandani Rishabh , Sneag Darryl B. , Wolfe Scott W. , Lee Steve K.
Published: November 2017

Radial styloidectomy along with scaphoid nonunion reconstructive surgery is considered an acceptable surgical treatment for stage 1 scaphoid nonunion advanced collapse. The extent of radioscaphoid joint wear that defines scaphoid nonunion advanced collapse stage 1 is unclear. An appropriate radial styloidectomy is limited to 6 mm styloid removal to prevent carpal instability. The aim of this study was to determine whether nonunion fracture location can be a guiding factor in determining whether the scaphoid bone can be retained with scaphoid nonunion reconstructive surgery and radial styloidectomy. We reviewed wrist radiographs and magnetic resonance imaging studies of 21 patients with a diagnosis of scaphoid nonunion advanced collapse stage 1, and quantified chondral wear as the length of a line (in mm) along the radioscaphoid joint traced from the tip of the radial styloid to the most ulnar position along the radioscaphoid joint. We concluded that scaphoid nonunion reconstructive surgery with radial styloidectomy is only appropriate for nonunions in the distal or middle third of the scaphoid.

Level of evidence: III
The impact of structured physical activity on glycaemic control in diabetes prevention programmes: A systematic review
Authors: Edwards Joseph , Hosseinzadeh Hassan
Published: November 2017

Background:

Seven landmark randomised controlled trials, with some that began as early as the 1990s, observed the prediabetic state, namely, impaired glucose tolerance and impaired fasting glucose conditions, against the impact of lifestyle interventions such as physical activity, to prevent or delay the onset of type 2 diabetes mellitus. In addition to the landmark trials, this systematic review examines 14 studies that retained a focus on prediabetic individuals and measured the efficacy of physical activity on improving glucose tolerance.

Results:

Type, duration and intensity of structured physical activity can have unique benefits to prediabetic individuals. It is posited that diabetes prevention programmes must target prediabetic individuals as belonging to a high-risk group, separate and distinct from those identified with overall risk factors. While the transition from prediabetes to type 2 diabetes mellitus is not completely deterministic, the conversion rate is phenomenally higher among those with impaired glucose tolerance than those with normal glucose levels.

Conclusion:

Tenets of health behaviour models do support inferences that prediabetic individuals are potentially more inclined to weighing the risks and benefits of progressive illnesses and would therefore be more receptive to active participation in interventions. More research is required to develop evidence-based diabetes prevention programmes linked to structured physical activity intervention.