bluuebunny/crossref_metadata_2025 huggingface dataset:
Re-branding Tasmania: MONA and the altering of local reputation and identity
Authors: Ryan Louise
Published: January 2016

This article investigates the Museum of Old and New Art in Hobart, Tasmania focussing on the relationship between the residents of a place and their principal tourist attraction. Called the ‘Getty of the Antipodes’, the museum mounts a permanent collection, special exhibitions and music/art festivals intended to shock conventional moral sensibilities. Yet, the conservative people of the community embrace their purposefully provocative attraction for having put them on the world map. This article raises a number of questions. Does creating an attraction and the arrival of tourists change local thought and practice in any fundamental ways? Or is it all a masquerade for the golden horde? Is understanding one’s own locality as an attraction-for-others changing the locals’ perception of where and how they live? And of one another? Ultimately, how sustainable are these new cultural ventures in boosting economies, maintaining new cultural identities and engaging visitor interest in the long term?
Introducing an iPad app into literacy instruction for struggling readers: Teacher perceptions and student outcomes
Authors: D’Agostino Jerome V , Rodgers Emily , Harmey Sinéad , Brownfield Katherine
Published: January 2016

There is a critical need, according to national policy statements in the United States, to integrate information and communication technologies into instruction, and yet research about the effect of such integration on the literacy learning of at-risk populations is scant. In addition, barriers exist that prevent teachers from realizing the goal of information and communication technology integration. To address this issue, we conducted a mixed-methods study to investigate the effects of LetterWorks, an iPad app, on the letter learning of 6- to 7-year-old children in an early literacy intervention, Reading Recovery. We present empirical evidence about the effects of the integration of this iPad app into literacy instruction for struggling learners and we describe teachers’ perceptions about the affordances and challenges of integrating this app into their instruction. Despite the positive effects of the iPad app on the letter learning of the children in the treatment group, teachers identified a misfit between their beliefs about literacy teaching and learning and the app as a barrier to their continued use. We suggest that the successful uptake of information and communication technologies into literacy instruction may depend, at least in part, on whether and how well training addresses the coherence between the information and communication technology itself and teachers’ theories about teaching and learning.
Numbers scepticism, equal chances and pluralism
Authors: Lang Gerald , Lawlor Rob
Published: January 2016

The ‘standard interpretation’ of John Taurek’s argument in ‘Should the Numbers Count?’ imputes two theses to him: first, ‘numbers scepticism’, or scepticism about the moral force of an appeal to the mere number of individuals saved in conflict cases; and second, the ‘equal greatest chances’ principle of rescue, which requires that every individual has an equal chance of being rescued. The standard interpretation is criticized here on a number of grounds. First, whilst Taurek clearly believes that equal chances are all-important, he actually argues for a position weaker than the equal greatest chances principle. Second, the argument Taurek gives for the importance of equal chances ought to commit him to being more hospitable to the significance of numbers than he seems to be. Third, and as a result, Taurek should not have dismissed the significance of numbers but embraced a form of pluralism instead. Fourth, this result should be welcomed, because pluralism is more plausible than either the equal greatest chances principle or the saving the greater number principle.
Functional linear mixed models for irregularly or sparsely sampled data
Authors: Cederbaum Jona , Pouplier Marianne , Hoole Phil , Greven Sonja
Published: January 2016

We propose an estimation approach to analyse correlated functional data, which are observed on unequal grids or even sparsely. The model we use is a functional linear mixed model, a functional analogue of the linear mixed model. Estimation is based on dimension reduction via functional principal component analysis and on mixed model methodology. Our procedure allows the decomposition of the variability in the data as well as the estimation of mean effects of interest, and borrows strength across curves. Confidence bands for mean effects can be constructed conditionally on estimated principal components. We provide R -code implementing our approach in an online appendix. The method is motivated by and applied to data from speech production research.
Residents’ and caregivers’ views on spiritual care and their understanding of spiritual needs in persons with dementia: A meta-synthesis
Authors: Ødbehr Liv S , Hauge Solveig , Danbolt Lars J , Kvigne Kari
Published: January 2016

Aims

To synthesize research that investigated how residents and caregivers view spiritual care, come to understand the spiritual needs of people with dementia, and how caregivers provide care congruent with peoples’ needs.

Methods and study design

Meta-synthesis using Noblit and Hare’s meta-ethnography. A synthesis of eight qualitative, empirical, primary studies that explored spiritual care in the context of dementia care was performed.

Findings

Spiritual care for persons with dementia was described in the forms of (i) performing religious rituals that provides a sense of comfort and(ii) coming to know the person, which provides opportunities to understand a person's meaning and purpose, and (iii) attending to basic needs provides an opportunity to appreciate others’ vulnerability and humanness.

Conclusions

Spiritual care intended to help persons with dementia to express their faith and religious beliefs, and help persons with dementia experience meaning in life, connectedness to self, God/deity and other persons.
Fire safety regulations and performance of fibre-reinforced polymer composite ship structures
Authors: Evegren Franz , Hertzberg Tommy
Published: January 2016

This article presents a procedure for how to relate fire performance of fibre-reinforced polymer composite structures to the fire safety regulations in Safety of Life at Sea II-2. It can be used as basis when performing a fire risk assessment to demonstrate that the degree of safety is at least equivalent to that provided by prescriptive requirements. A key issue is that requirements and test methods are based on the use of steel structures, which requires seeking the safety level implied by the regulations. This was demonstrated for the regulations and introduced hazards affecting the growth stage of a fire. The safety implied by regulations was related to fire performance of fibre-reinforced polymer composite by reference to fire tests involving typical materials and some relevant safety measures. Ignition was described as uncritical, while the fire growth on a fibre-reinforced polymer composite surface can be rapid. Flammability requirements are generally not achieved by an untreated panel but different means can be used for protection. A fire protective coating can be used to prevent ignition, and sprinkler is effective for both fire prevention and extinguishment on interior and external surfaces. For interior spaces, it can be relevant with a coating or thermal insulation also to hinder increased generation of smoke and toxic gases during fire evacuation. In all, it is shown that fire hazards during the fire growth stage are manageable, and a foundation is lain out for a well-structured fire risk assessment.
Following fashion: Visible progressiveness and the social construction of firm value
Authors: Nijholt Jurriaan J. , Bezemer Pieter-Jan , Reinmoeller Patrick
Published: January 2016

A central tenet underlying studies on management fashions is that the diffusion of novel forms, models and techniques is driven by an institutional norm of progress, which is the societal expectation that managers will continuously use ‘new and improved’ management practices. We add to the literature on management fashions by arguing that, if the display of progressiveness in the manner of managing and organizing is expected of organizations, firms that are visibly progressive would be evaluated more positively by organizational audiences following this institutional prescription. Using article counts of co-occurrences of firms and various fashionable management practices in Wall Street Journal, we hypothesize positive effects of such associations on security analysts’ evaluations of these firms. Results support this hypothesis. Our study enriches the management fashion literature by highlighting the consequential relevance of organizational adherence to the norm of progress.
Crime among young Moroccan men in the Netherlands: Does their regional origin matter?
Authors: Bovenkerk Frank , Fokkema Tineke
Published: January 2016

High crime rates among second-generation immigrants are usually attributed to the ethnic group’s weak socioeconomic position in the host society. The causes of crime can, however, also be sought in their native countries or regions. Owing to a lack of empirical data, this has rarely been tested. The Netherlands is an exception: small-scale ethnographic case studies among young Moroccan men in Dutch cities suggest that their regional background and culture, particularly if they are from the less developed Rif Mountains area, may explain their high crime rates. In this article we examine whether this applies to the results of a quantitative study on all the Moroccan male juveniles in the Netherlands. At the individual level, our unique dataset is a combination of their native regions, criminal records (ever suspected of a crime) and demographic and socioeconomic characteristics. Logistic regression analysis shows that current socioeconomic position is a strong predictor of ever having been suspected of a criminal offence, and the impact of geographical descent, directly or indirectly via socioeconomic position in the Netherlands, is negligible. Accordingly, our findings on Moroccans in the Netherlands do not warrant our questioning the common explanation of the immigrant–crime connection in criminology and suggest further research to determine the specific host society’s features that explain the overrepresentation of ethnic groups in crime statistics.
The interaction between self-control and morality in crime causation among older adults
Authors: Hirtenlehner Helmut , Kunz Franziska
Published: January 2016

Situational Action Theory (SAT), a recently developed explanation of criminal conduct, is becoming increasingly studied. Hitherto, however, nearly all tests of the theory and its hypotheses have been based on samples of adolescents or young adults. Studies drawing on the older population have been missing so far. This work addresses the interplay of moral beliefs and the ability to exercise self-control in crime causation among respondents aged 50 years and over. In line with SAT and the results obtained previously for young people, our analyses show that self-control ability affects offending among older adults too, particularly when personal morality is weak.
The Italian mafias in the world: A systematic assessment of the mobility of criminal groups
Authors: Calderoni Francesco , Berlusconi Giulia , Garofalo Lorella , Giommoni Luca , Sarno Federica
Published: January 2016

This study complements existing literature on the mobility of criminal groups (mainly based on country case studies) with the first systematic assessment of the worldwide activities of the four main types of Italian mafias (Cosa Nostra, Camorra, ’Ndrangheta and Apulian mafias) from 2000 to 2012. Drawing from publicly available reports, a specific multiple correspondence analysis identifies the most important associations among mafias, activities, and countries. The results show that the mafias concentrate in a few countries; drug trafficking is the most frequent activity, whereas money laundering appears less important than expected; a stable mafia presence is reported in a few developed countries (mainly Germany, Canada, Australia, and the United States). The mafias show significant differences: the ’Ndrangheta tends to establish structured groups abroad, whereas the other mafias mainly participate in illicit trades.
Forum Play as a method for learning ethical practice: A qualitative study among Swedish health-care staff
Authors: Zbikowski Anke , Zeiler Kristin , Swahnberg Katarina
Published: January 2016

Background

In Scandinavia 13–28% of gynecology patients have experienced abuse in health care in their life time, which contradicts the ethical obligations not to harm the patient and to protect the patient's dignity. Concerning learning to act ethically, scholars have emphasized the importance of combining theoretical and practical dimensions. This article explores Forum Play as a way of learning to act ethically in abusive situations in health care.

Method

Ten health-care workers participating in a Forum Play course took part in this study. To explore participants' experiences of Forum Play, semi-structured interviews were conducted and processed by using the grounded theory analysis techniques of coding and constant comparison.

Results

The analysis resulted in the core category “developing response–ability.” It encompasses the processes bringing about the ability to respond adequately to situations where abuse occurs and the conditions for these processes, as well as the participants' achieved understanding of the third person's potential to act in a situation with a power imbalance. Forum Play allows participants to reflect on both verbal and body language, and gives them time to enact and think through issues of moral agency.

Conclusion

The simulated reality of Forum Play offers a platform where learning to act ethically in abusive situations in health care is facilitated by providing a safe space, suspending constricting structural conditions such as hierarchies and lack of time, fostering moral imagination, allowing creativity in developing and trying out a variety of acting alternatives, and reflecting upon the observed and experienced situation.
Distributive decisions in education: Goals, trade-offs, and feasibility constraints
Authors: Shores Kenneth , Loeb Susanna
Published: January 2016

Educators, policymakers, and citizens face questions of how to allocate scarce resources in the pursuit of competing goals for children and youth. Our goal in this article is to provide decision-makers with a framework for considering allocative problems in education, explicitly highlighting the implications of relevant feasibility constraints. We assume that the decision-maker cares about children’s present and future welfare and that she gives priority to children whose welfare is lower. We highlight four especially relevant constraints: scarcity of resources, buy-in from community members, high-stakes consequences of skill development, and measurement of desired outcomes. Using four cases to illustrate common situations decision-makers face, we show that the framework provides both some understanding of the distributive decisions that are made in practice and some structure for thinking about how to optimize decisions in non-ideal settings.
Non-haemodynamic anti-anginal agents in the management of patients with stable coronary artery disease and diabetes: A review of the evidence
Authors: Ambrosio Giuseppe , Tamargo Juan , Grant Peter J
Published: January 2016

Patients with coronary artery disease and concomitant diabetes mellitus tend to have more extensive vessel disease than non-diabetes mellitus coronary artery disease patients, are at high risk of adverse cardiovascular events and suffer from a great anginal burden. Very few trials have specifically addressed the issue of optimal anti-anginal therapy in coronary artery disease patients who also have diabetes mellitus. Among ‘classical’ anti-anginal agents, recent guidelines do not specifically recommend any molecule over others; however, European Society of Cardiology guidelines acknowledge that favourable data in patients with concomitant diabetes mellitus and coronary artery disease are available for trimetazidine and ranolazine, two anti-anginal agents with a non-haemodynamic mechanism of action. The aim of this article is to review available evidence supporting the anti-anginal efficacy of these two drugs in the difficult-to-treat population of diabetes mellitus patients, including their effects on glycated haemoglobin (HbA1c), a measure of medium-term glycaemic control. Although direct head-to-head comparisons have not been performed, available evidence favours ranolazine as an effective anti-anginal agent over trimetazidine in this population. In addition, ranolazine lowers HbA1c, indicating that it may improve glycaemic control in patients with diabetes mellitus. Conversely, scanty data are available on the metabolic effects of trimetazidine in this cohort of patients. Thus, ranolazine may represent a valuable therapeutic option in stable coronary artery disease patients with diabetes mellitus.
Empagliflozin reduces body weight and indices of adipose distribution in patients with type 2 diabetes mellitus
Authors: Neeland Ian J , McGuire Darren K , Chilton Robert , Crowe Susanne , Lund Søren S , Woerle Hans J , Broedl Uli C , Johansen Odd Erik
Published: January 2016

Aims:

To determine the effects of empagliflozin on adiposity indices among patients with type 2 diabetes mellitus.

Methods:

Changes in weight, waist circumference, estimated total body fat, index of central obesity and visceral adiposity index were assessed using analysis of covariance and testing of treatment by strata for age, sex and baseline waist circumference in patients with type 2 diabetes mellitus randomized to blinded treatment with empagliflozin versus placebo in clinical trials of 12 weeks (cohort 1) or 24 weeks (cohort 2) duration.

Results:

This study comprised 3300 patients (cohort 1, N = 823; cohort 2, N = 2477). Empagliflozin reduced weight, waist circumference and adiposity indices versus placebo in both cohorts. Adjusted mean (95% confidence interval) change from baseline in empagliflozin versus placebo was −1.7 kg (−2.1 to −1.4 kg) and −1.9 kg (−2.1 to −1.7 kg) for body weight ( p < 0.001); −1.3 cm (−1.8 to −0.7 cm) and −1.3 cm (−1.7 to −1.0 cm) for waist circumference ( p < 0.001); −0.2% (−0.7% to 0.3%; p = 0.45) and −0.3% (−0.7% to 0.0%; p = 0.08) for estimated total body fat; −0.007 (−0.011 to −0.004) and −0.008 (−0.010 to −0.006) for index of central obesity ( p < 0.001); and −0.3 (−0.5 to 0.0; p = 0.07) and −0.4 (−0.7 to −0.1; p = 0.003) for visceral adiposity index in cohorts 1 and 2, respectively. Adipose reductions were seen across most age, sex and waist circumference subgroups.

Conclusion:

Empagliflozin significantly reduced weight and adiposity indices with the potential to improve cardiometabolic risk among patients with type 2 diabetes mellitus.
Patterns of sedentary behaviour and physical activity in people following curative intent treatment for non-small cell lung cancer
Authors: Cavalheri Vinicius , Jenkins Sue , Cecins Nola , Phillips Martin , Sanders Lucas H , Hill Kylie
Published: January 2016

This study aimed to compare patterns of sedentary behaviour (SB) and physical activity (PA) in people following curative intent treatment for non-small cell lung cancer (NSCLC) with healthy controls. Participants 6–10 weeks following lobectomy for NSCLC and healthy controls wore two activity monitors for 7 days. Waking hours were divided into time spent in SB (<1.5 metabolic equivalent of tasks (METs)), light intensity PA (LIPA ≥ 1.5 to <3.0METs) and moderate-to-vigorous intensity PA (≥3.0METs). Daily steps were also recorded. Data were available in 20 participants with NSCLC (13 females; 68 ± 10 years) and 20 healthy controls (13 females; 69 ± 5 years). The NSCLC group accumulated a greater percentage of time in SB in uninterrupted bouts ≥30 minutes (49% vs. 42%; p = 0.048). Further, the NSCLC group spent a lower percentage of waking hours in LIPA (21 ± 9% vs. 26 ± 8%; p = 0.04) and accumulated a lower percentage of time in this domain in uninterrupted bouts ≥10 minutes (13% vs. 19%; p = 0.025). The NSCLC group also had a lower daily step count (8863 ± 3737 vs. 11,856 ± 3024 steps/day; p = 0.009). Time spent in moderate-to-vigorous intensity PA was similar in both groups ( p = 0.92). People following curative intent treatment for NSCLC spend more time in prolonged bouts of SB at the expense of LIPA.
A Systematic Review of Longitudinal Risk and Protective Factors and Correlates for Posttraumatic Stress and Its Natural History in Forcibly Displaced Children
Authors: Tam Stephanie Y. , Houlihan Shea , Melendez-Torres G. J.
Published: January 2016

Background:

Posttraumatic stress (PTS) results in significant distress or functional impairment. Prevalence studies report higher rates of PTS in forcibly displaced children (FDC). Current evidence deriving mainly from cross-sectional studies is unable to make causal attributions. Given rising rates of forcible displacement reported by the United Nations High Commissioner for Refugees (UNHCR) in 2014, there is increasing need to determine the best policies and practice for engaging mental health needs of FDC.

Methods:

This systematic review identifies (1) longitudinal risk and protective factors and correlates for PTS and (2) its natural history in FDC, contributing to research identifying vulnerable subgroups and malleable factors for PTS and understanding its natural history. No meta-analysis was conducted due to heterogeneity; results were analyzed through narrative synthesis.

Results:

Eleven longitudinal studies were identified. All but one were prospective cohort designs. They identified prevalence rates between 20% and 48.7% at baseline, 10% and 48.3% at 1 year ( k = 7), 18% and 48% at 2–3 years ( k = 2), 8% and 38% at 6 years ( k = 2), and 35% at 12 years using nine measurement methods in seven independent samples. Evidence from multiple associations supported the following risk factors: exposure to traumatic stressors or other stress, older age, and prior psychopathology. Evidence predominantly supported the stability of PTS with some decline.

Conclusion:

While results should be interpreted with caution given small or unrepresentative samples, they suggest regular mental health screenings should be conducted for FDC, who are a vulnerable subgroup with variable onset and remission. Risk associations with prior psychopathology also suggest that screening upon arrival may be advisable for early intervention and prevention.
Nonfatal Strangulation as Part of Domestic Violence: A Review of Research
Authors: Pritchard Adam J. , Reckdenwald Amy , Nordham Chelsea
Published: January 2016

This article reviews recent scholarship around the issue of nonfatal strangulation in cases of domestic violence. In the mid-1990s, the San Diego City Attorney’s Office began a systematic study of attempted strangulation among 300 domestic violence cases, becoming one of the first systematic research studies to specifically examine the prevalence of attempted strangulation as a form of injury associated with ongoing domestic violence. Prior to this time, most of the research into strangulation was conducted postmortem, and little was known about the injuries and signs of attempted strangulation among surviving victims. This article reviews the research that has since been conducted around strangulation in domestic violence cases, highlighting topics that are more or less developed in the areas of criminology, forensic science, law, and medicine, and makes recommendations for future research and practice.
Smart Choice Health Insurance©
Authors: Brown Virginia , Russell Mia , Ginter Amanda , Braun Bonnie , Little Lynn , Pippidis Maria , McCoy Teresa
Published: January 2016

Smart Choice Health Insurance© is a consumer education program based on the definition and emerging measurement of health insurance literacy and a review of literature and appropriate theoretical frameworks. An interdisciplinary team of financial and health educators was formed to develop and pilot the program, with the goal of reducing confusion and increasing confidence in the consumer’s ability to make a smart health insurance decision. Educators in seven states, certified to teach the program, conducted workshops for 994 consumers. Results show statistically significant evidence of increased health insurance literacy, confidence, and capacity to make a smart choice health insurance choice. Discussion centers on the impact the program had on specific groups, next steps to reach a larger audience, and implications for educators, consumers, and policymakers nationwide.
Complementary and Alternative Medicine in Palliative Care
Authors: Muecke Ralph , Paul Magdalena , Conrad Christina , Stoll Christoph , Muenstedt Karsten , Micke Oliver , Prott Franz J. , Buentzel Jens , Huebner Jutta ,   On Behalf of PRIO (Working Group Prevention and Integrative Oncology of the German Cancer Society)
Published: January 2016

Purpose. Many cancer patients use complementary and alternative medicine (CAM) during or after their therapy. Because little is known about CAM in palliative care, we conducted 2 surveys among patients and professionals in the palliative setting. Participants and methods. Patients of a German Comprehensive Cancer Center were interviewed, and an independent online survey was conducted among members of the German Society for Palliative Care (DGP). Results. In all, 25 patients and 365 professional members of the DGP completed the survey (9.8% of all members); 40% of the patients, 85% of the physicians, and 99% of the nurses claimed to be interested in CAM. The most important source of information for professionals is education, whereas for patients it is radio, TV, and family and friends. Most patients are interested in biological-based methods, yet professionals prefer mind-body-based methods. Patients more often confirm scientific evidence to be important for CAM than professionals. Conclusions. To improve communication, physicians should be trained in evidence for those CAM methods in which patients are interested.
Contribution of Paretic and Nonparetic Limb Peak Propulsive Forces to Changes in Walking Speed in Individuals Poststroke
Authors: Hsiao HaoYuan , Awad Louis N. , Palmer Jacqueline A. , Higginson Jill S. , Binder-Macleod Stuart A.
Published: January 2016

Background. Recent rehabilitation efforts after stroke often focus on increasing walking speed because it is associated with quality of life. For individuals poststroke, propulsive force generated from the paretic limb has been shown to be correlated to walking speed. However, little is known about the relative contribution of the paretic versus the nonparetic propulsive forces to changes in walking speed. Objective. The primary purpose of this study was to determine the contribution of propulsive force generated from each limb to changes in walking speed during speed modulation within a session and as a result of a 12-week training program. Methods. Gait analysis was performed as participants (N = 38) with chronic poststroke hemiparesis walked at their self-selected and faster walking speeds on a treadmill before and after a 12-week gait retraining program. Results. Prior to training, stroke survivors increased nonparetic propulsive forces as the primary mechanism to change walking speed during speed modulation within a session. Following gait training, the paretic limb played a larger role during speed modulation within a session. In addition, the increases in paretic propulsive forces observed following gait training contributed to the increases in the self-selected walking speeds seen following training. Conclusions. Gait retraining in the chronic phase of stroke recovery facilitates paretic limb neuromotor recovery and reduces the reliance on the nonparetic limb’s generation of propulsive force to increase walking speed. These findings support gait rehabilitation efforts directed toward improving the paretic limb’s ability to generate propulsive force.
Paradoxical Motor Recovery From a First Stroke After Induction of a Second Stroke
Authors: Zeiler Steven R. , Hubbard Robert , Gibson Ellen M. , Zheng Tony , Ng Kwan , O’Brien Richard , Krakauer John W.
Published: January 2016

Background and objective. Prior studies have suggested that after stroke there is a time-limited period of increased responsiveness to training as a result of heightened plasticity—a sensitive period thought to be induced by ischemia itself. Using a mouse model, we have previously shown that most training-associated recovery after a caudal forelimb area (CFA) stroke occurs in the first week and is attributable to reorganization in a medial premotor area (AGm). The existence of a stroke-induced sensitive period leads to the counterintuitive prediction that a second stroke should reopen this window and promote full recovery from the first stroke. To test this prediction, we induced a second stroke in the AGm of mice with incomplete recovery after a first stroke in CFA. Methods. Mice were trained to perform a skilled prehension (reach-to-grasp) task to an asymptotic level of performance, after which they underwent photocoagulation-induced stroke in CFA. After a 7-day poststroke delay, the mice were then retrained to asymptote. We then induced a second stroke in the AGm, and after only a 1-day delay, retrained the mice. Results. Recovery of prehension was incomplete when training was started after a 7-day poststroke delay and continued for 19 days. However, a second focal stroke in the AGm led to a dramatic response to 9 days of training, with full recovery to normal levels of performance. Conclusions. New ischemia can reopen a sensitive period of heightened responsiveness to training and mediate full recovery from a previous stroke.
Laparoscopy Versus Robotic Surgery for Colorectal Cancer
Authors: Ferrara Francesco , Piagnerelli Riccardo , Scheiterle Maximilian , Di Mare Giulio , Gnoni Pasquale , Marrelli Daniele , Roviello Franco
Published: January 2016

Background. Minimally invasive approach has gained interest in the treatment of patients with colorectal cancer. The purpose of this study is to analyze the differences between laparoscopy and robotics for colorectal cancer in terms of oncologic and clinical outcomes in an initial experience of a single center. Materials and Methods. Clinico-pathological data of 100 patients surgically treated for colorectal cancer from March 2008 to April 2014 with laparoscopy and robotics were analyzed. The procedures were right colonic, left colonic, and rectal resections. A comparison between the laparoscopic and robotic resections was made and an analysis of the first and the last procedures in the 2 groups was performed. Results. Forty-two patients underwent robotic resection and 58 underwent laparoscopic resection. The postoperative mortality was 1%. The number of harvested lymph nodes was higher in robotics. The conversion rate was 7.1% for robotics and 3.4% for laparoscopy. The operative time was lower in laparoscopy for all the procedures. No differences were found between the first and the last procedures in the 2 groups. Conclusions. This initial experience has shown that robotic surgery for the treatment of colorectal adenocarcinoma is a feasible and safe procedure in terms of oncologic and clinical outcomes, although an appropriate learning curve is necessary. Further investigation is needed to demonstrate real advantages of robotics over laparoscopy.
Writing “Gamers”
Authors: Cote Amanda C.
Published: January 2016

In the mid-1990s, a small group of video game designers attempted to lessen gaming’s gender gap by creating software targeting girls. By 1999, however, these attempts collapsed, and video games remained a masculinized technology. To help understand why this movement failed, this article addresses the unexplored role of consumer press in defining “gamers” as male. A detailed content analysis of Nintendo Power issues published from 1994 to 1999 shows that mainstream companies largely ignored the girls’ games movement, instead targeting male audiences through player representations, sexualized female characters, magazine covers featuring men, and predominantly male authors. Given the mutually constitutive nature of representation and reality, the lack of women in consumer press then affected girls’ ability to identify as gamers and enter the gaming community. This shows that, even as gaming audiences diversify, inclusive representations are also needed to redefine gamer as more than just “male.”
Gendered Manifestations of Depression and Help Seeking Among Men
Authors: Call Jarrod B. , Shafer Kevin
Published: January 2016

Men who do not seek help for mental health problems may experience unnecessary suffering which ultimately affects the well-being of themselves and others. Gendered manifestations of depressive symptoms may play an important role in why some men do not seek help for mental health issues. Using data from 2,382 male respondents in the National Comorbidity Survey Replication, the authors examined the relationship that both traditional and male-typical symptoms of depression had on the help-seeking behaviors of men. Traditional symptoms increased the odds of seeking help for depression for all men. Male-typical symptoms, however, did not increase the odds of seeking help for depression or another mental health concern. Both traditional and male-typical symptoms increased the odds of initially seeking help from a medical provider, and men with male-typical symptoms had an overall higher likelihood of seeking help from a medical provider. Consequently, it is important that medical professionals assess for depression even when it is not a presenting concern.
How the generic and biosimilar medicines industry could take advantage of trade opportunities
Authors: Jauch David , Napolitano Sergio
Published: January 2016

International trade policy initiatives, including trade negotiations and regulatory dialogues, have a rather significant impact on the industry. This is particularly the case for the pharmaceutical sector, which is a highly regulated sector. Non-tariff barriers (NTBs) to trade have a negative effect on generic and biosimilar medicine exporters as they often create an advantage for local companies. To aim at their removal, several actions can be taken by governments both at bilateral level or with the World Trade Organization in the context of its dispute resolution procedures. NTBs can also be addressed in the context of trade agreements or bilateral and plurilateral regulatory dialogues. Regulatory cooperation in trade agreements can produce very positive results for patients, industry and regulators, as the Transatlantic Trade and Investment Partnership Agreement (TTIP) demonstrate.
People with intellectual disability and their families’ perspectives of Special Olympics Ireland
Authors: Bowers Kirsty , Corby Deidre , Lambert Veronica , Staines Anthony , McVeigh Treasa , McKeon Michael , Hoey Edel , Belton Sarahjane , Meegan Sarah , Walsh Denise , Trépel Dominic , Griffin Peter , Sweeney Mary Rose
Published: January 2016

Previous research has highlighted that while involvement in Special Olympics can have benefits for athletes and their families, there can also be many barriers to participation. This qualitative study, which was part of a large mixed-method study, examined the experiences and perspectives of people with intellectual disability, their families and staff who work with them, about Special Olympics Ireland (SOI). A total of 47 participants (15 athletes, 6 non-athletes, 18 family members and 8 staff members) participated in focus group and individual interviews. Supplemental data, gathered as part of the larger study extracted from open-ended survey questions completed by 97 family members also informed this element. Findings revealed four main themes: impact of participation on athletes, impact of involvement on families, barriers to participation and how to enhance participation rates. Involvement in Special Olympics impacted positively on the quality of life of athletes and families. Enhanced availability of user-friendly information and service accessibility were important drivers identified for enhancing participation rates in Special Olympics.
The concept of sporadic cerebral small vessel disease: A road map on key definitions and current concepts
Authors: Charidimou Andreas , Pantoni Leonardo , Love Seth
Published: January 2016

Sporadic cerebral small vessel disease is considered to be among the most common known neuropathological processes and has an important role in stroke, cognitive impairment, and functional loss in elderly persons. The term is now commonly used to describe a range of neuroimaging, neuropathological, and associated clinical features, the pathogenesis of which is largely unclear but that are thought to arise from disease affecting the perforating cerebral arterioles, capillaries, and venules. Modern neuroimaging has revolutionized our understanding of the consequences of small vessels disease on the brain parenchyma, even though small arteries, arterioles, capillaries, and venules are difficult to be directly visualized with current techniques used in clinical practice. In this short review, we focus on histopathological and neuroimaging perspectives, basic definitions, and recent advances in the field.
Magnetic resonance imaging-based endovascular versus medical stroke treatment for symptom onset up to 12 h
Authors: Wouters Anke , Lemmens Robin , Christensen Soren , Wilms Guido , Dupont Patrick , Mlynash Michael , Schneider Armin , Laage Rico , Cereda Carlo W , Lansberg Maarten G , Albers Gregory W , Thijs Vincent ,   on behalf of the AXIS 2 and DEFUSE 2 study investigators
Published: January 2016

Background

Recent trials have shown a clear benefit of endovascular therapy for stroke patients presenting within 6 h after stroke onset. Imaging-based selection may identify a cohort with a favorable response to endovascular therapy, in an even later time window.

Aims

We performed an indirect comparison between outcomes seen in DEFUSE 2, a prospective cohort study of patients who received a baseline MRI before endovascular therapy, and a control group from AXIS 2 receiving standard medical care up to 12 h after symptom onset.

Methods

Patients from AXIS 2 with a confirmed large vessel occlusion were selected as a control group for DEFUSE 2-patients. The primary endpoint was good functional outcome at day 90 (Modified Rankin Score 0–2). We performed a stratified analysis based on the presence of the target mismatch for both studies and reperfusion status in DEFUSE 2.

Results

We compared good functional outcome in 108 patients from AXIS 2 and 99 patients from DEFUSE 2. In DEFUSE 2-patients with the target mismatch profile in whom reperfusion was achieved, the rate of good functional outcome was increased compared to target mismatch patients in AXIS 2, 54% versus 29% (OR 3.2, 95% CI 1.1–9.4). In target mismatch patients treated between 6 and 12 h after stroke onset, this association between study and good functional outcome remained present (OR 9.0, 95% CI 1.1–75.8).

Conclusions

This indirect comparison suggests that endovascular treatment resulting in substantial reperfusion is associated with improved outcome in target mismatch patients even beyond 6 h after stroke onset. Confirmation is needed from future clinical trials that randomize patients beyond the 6 h time window.
Statistical analysis plan for the Sleep Apnea cardioVascular Endpoints study: An international randomised controlled trial to determine whether continuous positive airways pressure treatment for obstructive sleep apnea in patients with CV disease prevents secondary cardiovascular events
Authors: Heeley Emma , Billot Laurent , Anderson Craig S , Antic Nick A , Neal Bruce , McEvoy R Doug ,   for the SAVE investigators
Published: January 2016

Rationale

Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular disease. Continuous positive airway pressure (CPAP) delivered via a nasal mask during sleep immediately alleviates obstructive apneas and improves sleep quality and daytime somnolence. However, there is uncertainty as to whether such treatment can modify CV risk and disease.

Aims

The Sleep Apnea Cardiovascular Endpoints (SAVE) study aims to determine whether CPAP on top of best medical care compared to best medical care alone can reduce the risk of serious CV events in patients with co-morbid OSA and established CV disease.

Design

SAVE is an investigator initiated and conducted, international, multicenter, open, blinded endpoint, randomized controlled trial. Participants were randomised to either CPAP or usual care between 2008 and 2013 and will be followed up for an average of approximately 4 years.

Study outcome

The primary endpoint is a composite of CV death, myocardial infarction (MI, including silent MI), stroke, hospitalisation for heart failure, hospitalisation for an acute ischemic cardiac event (unstable angina) or cerebral event (transient ischemic event [TIA]).

Discussion

The pre-specified statistical analysis plan (SAP) for the main analyses is presented. This SAP was finalised before patient follow-up was completed and before any unblinding of the data. The SAP outlines details of the primary, secondary and tertiary outcomes, together with planned subgroup and exploratory analyses.
Inter-rater agreement analysis of the Precise Diagnostic Score for suspected transient ischemic attack
Authors: Cereda Carlo W , George Paul M , Inoue Manabu , Vora Nirali , Olivot Jean-Marc , Schwartz Neil , Lansberg Maarten G , Kemp Stephanie , Mlynash Michael , Albers Gregory W
Published: January 2016

Background

No definitive criteria are available to confirm the diagnosis of transient ischemic attack. Inter-rater agreement between physicians regarding the diagnosis of transient ischemic attack is low, even among vascular neurologists. We developed the Precise Diagnostic Score, a diagnostic score that consists of discrete and well-defined clinical and imaging parameters, and investigated inter-rater agreement in patients with suspected transient ischemic attack.

Methods

Fellowship-trained vascular neurologists, blinded to final diagnosis, independently reviewed retrospectively identical history, physical examination, routine diagnostic studies, and brain magnetic resonance imaging (diffusion and perfusion images) from consecutive patients with suspected transient ischemic attack. Each patient was rated using the 8-point Precise Diagnostic Score score, composed of a clinical score (0–4 points) and an imaging score (0–4 points). The composite Precise Diagnostic Score determines a Precise Diagnostic Score Likelihood of Brain Ischemia Scale: 0–1 = unlikely, 2 = possible, 3 = probable, 4–8 = very likely.

Results

Three raters reviewed data from 114 patients. Using Precise Diagnostic Score, all three raters scored a similar percentage of the clinical events as being “probable” or “very likely” caused by brain ischemia: 57, 55, and 58%. Agreement was high for both total Precise Diagnostic Score (intraclass correlation coefficient of 0.94) and for the Likelihood of Brain Ischemia Scale (agreement coefficient of 0.84).

Conclusions

Compared with prior studies, inter-rater agreement for the diagnosis of transient brain ischemia appears substantially improved with the Precise Diagnostic Score scoring system. This score is the first to include specific criteria to assess the clinical relevance of diffusion-weighted imaging and perfusion lesions and supports the added value of magnetic resonance imaging for assessing patients with suspected transient ischemic attack.
Vitamin D deficiency and incident stroke risk in community-living black and white adults
Authors: Judd Suzanne E , Morgan Charity J , Panwar Bhupesh , Howard Virginia J , Wadley Virginia G , Jenny Nancy S , Kissela Brett M , Gutiérrez Orlando M
Published: January 2016

Background

Black individuals are at greater risk of stroke and vitamin D deficiency than white individuals. Epidemiologic studies have shown that low 25-hydroxyvitamin D concentrations are associated with increased risk of stroke, but these studies had limited representation of black individuals.

Methods

We examined the association of 25-hydroxyvitamin D with incident stroke in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a cohort of black and white adults ≥45 years of age. Using a case–cohort study design, plasma 25-hydroxyvitamin D was measured in 610 participants who developed incident stroke (cases) and in 937 stroke-free individuals from a stratified cohort random sample of REGARDS participants (comparison cohort).

Results

In multivariable models adjusted for socio-demographic factors, co-morbidities and laboratory values including parathyroid hormone, lower 25-hydroxyvitamin D concentrations were associated with higher risk of stroke (25-hydroxyvitamin D >30 ng/mL reference; 25-hydroxyvitamin D concentrations 20–30 ng/mL, hazard ratio 1.33, 95% confidence interval (95% CI) 0.89,1.96; 25-hydroxyvitamin D <20 ng/mL, hazard ratio 1.85, 95% CI 1.17, 2.93). There were no statistically significant differences in the association of lower 25-hydroxyvitamin D with higher risk of stroke in black vs. white participants in fully adjusted models (hazard ratio comparing lowest vs. highest 25-hydroxyvitamin D category 2.62, 95% CI 1.18, 5.83 in blacks vs. 1.64, 95% CI 0.83, 3.24 in whites, Pinteraction = 0.82). The associations were qualitatively unchanged when restricted to ischemic or hemorrhagic stroke subtypes or when using race-specific cut-offs for 25-hydroxyvitamin D categories.

Conclusions

Vitamin D deficiency is a risk factor for incident stroke and the strength of this association does not appear to differ by race.