bluuebunny/crossref_metadata_2025 huggingface dataset:
Shared sense-making strategies in curriculum reform: District-level perspective
Authors: Soini Tiina , Pietarinen Janne , Pyhältö Kirsi
Published: December 2017

Curriculum reform that has an effect on the everyday practices in schools always entails translation of new ideas into new educational practices. This takes place primarily through shared sense making. However, our understanding of the different ways in which shared sense making is carried out is still scarce. In Finland, the district level plays an important intermediary role in orchestrating curriculum development work at the municipalities and in translating and mediating reform into school-level development work. The study explores different shared sense-making strategies employed by 12 district-level curriculum reform steering groups around Finland, including participants from 54 municipalities. Three hands-on strategies of shared sense making including comparison, standardisation and transformation were identified. The results indicated that different hands-on strategies have different functions in the process of making sense of the reform objectives. To a certain extent, the strategies can be viewed as hierarchical. Overall, results suggest that district-level actors aim to foster shared sense making; however, a more intentional use of strategies is needed.
Integrating livelihoods approaches with research on development and climate change adaptation
Authors: Clay Nathan
Published: December 2017

This article advances theory and methods for integrating sustainable livelihoods approaches (SLAs) with assessments of adaptive capacity to climate change. The livelihoods concept has been inconsistently applied in research on human dimensions of global environmental change, resulting in limited understanding about how development programmes and policies influence adaptive capacity. Encouraging reflection on the conceptual and methodological overlaps of livelihoods and adaptation, I suggest a process-oriented approach to adaptation that centres on how adaptive capacity is unevenly shaped. Livelihoods analytical frameworks can help visualize complex adaptation pathways, illuminating how households and individuals come to differ in their capacities to adapt to climate change.
Using photovoice to develop critical awareness of tobacco environments for marginalized youth in California
Authors: Lee Juliet P , Pagano Anna , Kirkpatrick Sean , Le Nga , Ercia Angelo , Lipperman-Kreda Sharon
Published: December 2017

Photovoice is used widely for engaging community members in action research aimed at reducing health inequities. Photovoice methodology can help to raise participants’ critical awareness regarding the root causes of community health problems, thereby encouraging them to take action to address these root causes. We report on our experiences using photovoice as part of a tobacco prevention project with multiethnic youths in an underresourced Northern California community. Through an iterative cycle of action and reflection, facilitated by staff from academic and community partner agencies, photovoice activities enabled the youths to connect smoking behaviors they observed at their school with low student morale and student officials’ lack of engagement regarding students’ tobacco use. The photovoice process helped youth participants to develop an action plan, which involved raising critical awareness among their peers and school staff through workshops and strategic meetings. Despite challenges, photovoice was an effective way to engage youths in community-based research and to foster their sense of collective efficacy in addressing structural determinants of inequities.
Case Studies of Community–Academic Partnerships Established Using the Give-Get Grid Model
Authors: Behringer Bruce , Southerland Jodi L. , Plummer Robert M.
Published: December 2017

While partnerships for health delivery and improvement are frequently described by their structure, goals, and plans, less attention is paid to the interactive relationships among partners or for larger stakeholder groups’ coalition memberships. The Give-Get Grid group process tool can be used to assess each stakeholders’ expected benefits (“gets”) and contributions (“gives”) needed to establish and maintain long-term, mutually advantageous community–academic partnerships. This article describes three case study experiences using the Give-Get Grid in real-world context to understand and generate ideas to address contemporary health promotion opportunities among a variety of stakeholders. The case studies address three distinct community health promotion opportunities: prevention of school-based adolescent obesity disparities, higher education health professions training programs in rural community-based settings, and methods for engaging community coalitions in state Comprehensive Cancer Control Programs. The case studies demonstrate the Give-Get Grid’s utility in both planning and evaluating partnerships and documenting key elements for progress in health promotion initiatives built on long-term community–academic relationships. Steps are explained with practical lessons learned in using the Grid.
Improving Linkage, Retention, and Reengagement in HIV Care in 12 Metropolitan Areas
Authors: Neumann Mary Spink , Carey James W. , Flores Stephen A. , Fisher Holly H. , Hoyte Tamika , Pitts Nicole , Carry Monique , Freeman Arin
Published: December 2017

The Centers for Disease Control and Prevention developed the Enhanced Comprehensive HIV Prevention Planning (ECHPP) project to support 12 health departments’ improvement of their HIV prevention and care portfolios in response to new national guidelines. We systematically analyzed 3 years of progress reports to learn how grantees put into practice local intervention strategies intended to link people to, and keep them in, HIV care. All grantees initiated seven activities to support these strategies: (1) improve surveillance data systems, (2) revise staffing duties and infrastructures, (3) update policies and procedures, (4) establish or strengthen partnerships, (5) identify persons not in care, (6) train personnel, and (7) create ways to overcome obstacles to receiving care. Factors supporting ECHPP grantee successes were thorough planning, attention to detail, and strong collaboration among health department units, and between the health department and external stakeholders. Other jurisdictions may consider adopting similar strategies when planning and enhancing HIV linkage, retention, and reengagement efforts in their areas. ECHPP experiences, lessons learned, and best practices may be relevant when applying new public health policies that affect community and health care practices jurisdiction-wide.
Scaling Up and Tailoring the “Putting Public Health in Action” Training Curriculum
Authors: Mainor Avia G. , Decosimo Kasey , Escoffrey Cam , Farris Paige , Shannon Jackilen , Winters-Stone Kerri , Williams Brianah , Leeman Jennifer
Published: December 2017

Despite access to a growing menu of evidence-based interventions, public health practitioners continue to underuse them, in part because practitioners may require new knowledge, skills, and resources to do so. Numerous foundations, universities, governmental agencies, and consultants are providing trainings to address the gaps in practitioners’ capacity. To most significantly affect population health, these trainings need to reach practitioners who may have limited access to on-site trainings. Despite the number of organizations offering trainings, little is known about how to scale up trainings to efficiently extend their reach or how to tailor trainings to the needs of different intervention. The Cancer Prevention and Control Research Network and its collaborating centers have developed a training curriculum and delivered it in both in-person and distance formats to a range of audiences. The purpose of this article is to describe the training curriculum and findings from the Network’s evaluation of approaches used to scale up delivery of the “Putting Public Health Evidence in Action” curriculum and tailor content for specific evidence-based interventions.
Development of tri-layer knitted fabrics for shuttle badminton players
Authors: Suganthi T , Senthilkumar P
Published: December 2017

Thermo-physiological comfort of the fabric is attained through the ability of managing heat and transmission of sensible and insensible perspiration. An investigation on influence of tri-layer knitted structure on thermal comfort characteristics of layered knitted fabrics was carried out. Three tri-layer knitted structures were developed in which inner layer was made up of micro-fibre polyester and outer layer was made up of modal yarn. The yarn used in the middle layer was changed to either micro-fibre polyester or polyester or acrylic yarn. The thermal comfort characteristics such as thermal conductivity, air permeability, water vapour permeability, wicking, moisture absorbency, drying rate and moisture management properties have been analysed. Wear trial was conducted for shuttle badminton players and they were ranked using thermal environment subjective judgement scale. Tri-layer knitted structure with micro-fibre polyester in the inner and middle layer and modal in the outer layer showed better thermal comfort characteristics both by objective evaluation and wear trial method compared to polyester or acrylic in the middle layer and is preferable for shuttle badminton sportswear.
Extensive Hand Thermal and Blast Injury From Electronic Cigarette Explosion: A Case Report
Authors: Satteson Ellen S. , Walker Nicholas J. , Tuohy Christopher J. , Molnar Joseph A.
Published: December 2017

Background: As the use of electronic cigarettes rises, more reports of injuries related to device explosion are surfacing. Methods: Presented here is the case of a 35-year-old man sustaining extensive thermal and blast injuries to his hand when the device exploded while he was holding it. He required multiple surgeries involving groin flap coverage, tendon transfer, and nerve grafting to optimize his postinjury function. Results: While much of his hand function has been restored, he has continued deficits in range of motion and sensation as a result of the incident. Conclusions: With increasing numbers of such injuries, hand surgeons must be aware of the blast mechanism involved so as to avoid missing deep soft tissue injury or disruption of deep structures, as demonstrated in this case.
What does it take to change practice? Perspectives of pharmacists in Ontario
Authors: Gregory Paul A. M. , Teixeira Beatriz , Austin Zubin
Published: December 2017

Background:

This is a time of rapid change in the profession of pharmacy. Anecdotally, there are concerns that the pace, extent and rate of practice evolution are lagging. There is little evidence documenting the influencers and mechanisms that drive practice changes forward in pharmacy in Canada.

Methods:

An exploratory qualitative method was selected, using both one-on-one interviews with self-categorized typical pharmacists and larger focus groups to provide context and confirmation of themes generated through interviews. Data were analyzed and coded using a constant-comparative iterative method, in order to generate themes related to the factors influencing pharmacists to actually change their practice.

Results:

A total of 46 pharmacists meeting inclusion criteria participated in this study in focus groups, interviews or both. Nine themes were identified: 1) permission, 2) process pointers, 3) practice/rehearsal, 4) positive reinforcement, 5) personalized attention, 6) peer referencing, 7) physician acceptance, 8) patients’ expectations and 9) professional identity supportive of a truly clinical role. One theme that did not emerge was payment, or remuneration, as a specific or isolated motivational factor for change.

Interpretation:

The complexity of practice change in pharmacy and the multiple factors highlighted in this study point to a more deliberate and concerted effort being needed by diverse pharmacy organizations (educators, regulators, employers, professional associations, etc.) to support pharmacists through the change management process.

Conclusions:

The “9 Ps of practice change” identified through this study can provide pharmacists with guidance in terms of how to better support evolution of the profession in a more time-efficient and effective manner.
Incidence of first stroke and ethnic differences in stroke pattern in Bradford, UK: Bradford Stroke Study
Authors: Ramadan Hawraman , Patterson Chris , Maguire Stuart , Melvin Ian , Kain Kirti , Teale Elizabeth , Forster Anne
Published: December 2017

Background

Information on ethnic disparities in stroke between White and Pakistani population in Europe is scarce. Bradford District has the largest proportion of Pakistani people in England; this provides a unique opportunity to study the difference in stroke between the two major ethnic groups.

Aim

To determine the first-ever-stroke incidence and examine the disparities in stroke patterns between Whites and Pakistanis in Bradford.

Methods

Prospective 12 months study consisting of 273,327 adults (≥18 years) residents. Stroke cases were identified by multiple overlapping approaches.

Results

In the study period, 541 first-ever-strokes were recorded. The crude incidence rate was 198 per 100,000 person-years. Age adjusted-standardized rate to the World Health Organization world population of first-ever-stroke is 155 and 101 per 100,000 person-years in Pakistanis and Whites respectively. Four hundred and thirty-eight patients (81%) were Whites, 83 (15.3%) were Pakistanis, 11 (2%) were Indian and Bangladeshis, and 9 (1.7%) were of other ethnic origin. Pakistanis were significantly younger and had more obesity ( p = 0.049), and diabetes mellitus (DM) ( p = <0.001). They were less likely to suffer from atrial fibrillation ( p = <0.001), be ex- or current smokers ( p = <0.001), and drink alcohol above the recommended level ( p = 0.007) compared with Whites. In comparison with Whites, higher rates of age-adjusted stroke (1.5-fold), lacunar infarction (threefold), and ischemic infarction due to large artery disease (twofold) were found in the Pakistanis.

Conclusions

The incidence of first-ever-stroke is higher in the Pakistanis compared with the Whites in Bradford, UK. Etiology and vascular risk factors vary between the ethnic groups. This information should be considered when investigating stroke etiology, and when planning prevention and care provision to improve outcomes after stroke.
A visual uprising: Framing the online activism of Bahrain’s Shiʿi opposition
Authors: Moore-Gilbert Kylie
Published: December 2017

Drawing on content analysis and framing theory, this article examines the use of images in the social media activism of three Bahraini Shiʿi opposition groups throughout 2015: Al-Wefaq, a moderate political society in favour of constitutional monarchy; Haqq, an underground pro-republic political society; and the February 14 Coalition, a decentralized umbrella group of youth activists dedicated to overthrowing Bahrain’s Al Khalifa monarchy. The differing ideologies, objectives and approaches to activism within Bahrain’s Shiʿi opposition are investigated through an analysis of each group’s framing of themes including religion, violence, nationalism and sectarianism. The first empirical study of social media image activism in post-Arab Spring Bahrain, this article reveals the increasing fragmentation of the Shiʿi opposition following the 2011 uprising, and makes a valuable contribution to the broader debate surrounding the changing nature of activism in an increasingly visual digital age.
Reduction of the head-up pitching moment of small quad-rotor unmanned aerial vehicles in uniform flow
Authors: Otsuka Hikaru , Sasaki Daisuke , Nagatani Keiji
Published: December 2017

Multi-rotor unmanned aerial vehicles are unstable in headwind because of nose-up pitching moment generation and thrust degradation. Reducing the pitching moment generation could enhance the tolerance of the unmanned aerial vehicles to wind and improve cruise flight speed. In this study, a canted rotor configuration was proposed to reduce the moment in uniform flow and examined. The objective of the study is to evaluate the effect of moment reduction by canted rotors. First, flow interactions between rotors of the quad-rotor were visualized using a smoke wire method. Second, the moment reduction by canted rotors was estimated based on isolated rotor performance. Third, the moment of the quad-rotor varying the body pitching angle was examined using a wind tunnel. At an 8 m/s wind, when the body pitching angle is horizontal, slanting the rotor by 20° to outside the body degraded the moment by 26% compared with the parallel rotor configuration.
Assessing the performance of microfinance lending process using AHP-fuzzy comprehensive evaluation method
Authors: Alaoui Youssef Lamrani , Tkiouat Mohamed
Published: December 2017

Many studies focus on microfinance institutions (MFIs) profitability, client retention, and default rate. Yet, they do not pay much attention to the way in which microfinance (MF) can improve the living conditions of the poor and satisfy their needs. This article presents a new way to assess the performance of MF lending process based on analytic hierarchy process (AHP)-fuzzy comprehensive evaluation method. The aim is to suggest some solutions to improve the performance of processes that create and support MF products and services. Not only should this study contribute to the research literature but it can also help the MFIs to control the risk derived from their operations and increase client satisfaction. Thus, MFIs can enhance their performance and their role in reducing poverty.
Comparison of European guidelines on paediatric urology against current British best practice
Authors: Gill Nicholas W , Jones Paul
Published: December 2017

A comparison of European Association of Urology paediatric urology guidelines with British guidelines and best practice.

Level of evidence: Not applicable for this multicentre audit.
Orthopaedic Sports Medicine Fellowship Interviews: Structure and Organization of the Interview Day
Authors: Haislup Brett D. , Kraeutler Matthew J. , Baweja Rishi , McCarty Eric C. , Mulcahey Mary K.
Published: December 2017

Background:

Over the past few decades, there has been a trend toward an increasing subspecialization in orthopaedic surgery, with orthopaedic sports medicine being one of the most competitive subspecialties. Information regarding the application and interview process for sports medicine fellowships is currently lacking.

Purpose:

To survey orthopaedic sports medicine fellowship program directors (PDs) to better define the structure of the sports medicine fellowship interview and to highlight important factors that PDs consider in selecting fellows.

Study Design:

Cross-sectional study.

Methods:

A complete list of accredited programs was obtained from the American Orthopaedic Society for Sports Medicine (AOSSM) website. An anonymous survey was distributed to fellowship PDs of all Accreditation Council for Graduate Medical Education (ACGME)–accredited orthopaedic sports medicine fellowships in the United States. The survey included 12 questions about the fellowship interview and selection process.

Results:

Of the 95 orthopaedic sports medicine fellowship PDs surveyed, 38 (40%) responded. Of these, 16 (42.1%) indicated that they interview between 21 and 30 applicants per year. Eleven of the 38 fellowship programs (28.9%) have only 1 fellow per year at their respective program. Most programs (27/37, 73%) reported that between 0 and 5 faculty members interview applicants, and 29 of the 38 programs (76.3%) arrange for applicants to have ≥4 interviews during their interview day. Large group interviews are conducted at 36 of 38 (94.7%) sports medicine fellowship programs, and most programs (24/38, 63.2%) hold individual interviews that last between 5 and 15 minutes. The most important applicant criterion taken into account by PDs was the quality of the interview, with an average score of 8.68 of 10.

Conclusion:

The most significant factor taken into account by PDs when deciding how to rank applicants was the quality of the interview. Many orthopaedic sports medicine fellowship programs interview between 21 and 30 applicants per year, with each applicant participating in an average of 2 to 4 individual interviews per interview day and interviews commonly lasting between 5 and 15 minutes.
Parental and Pediatricians’ Perception of Need for Subspecialty Training in Pediatric Emergency Medicine for Delivering Emergency Care to Pediatric Patients
Authors: Leva Ernest G. , Bunn Vanarsdale Diane , Miele Niel F. , Petrova Anna
Published: December 2017

The quality of pediatric emergency care may depend on the competence of the emergency department physicians. It is important to know whether parents and general pediatricians associate the quality of pediatric emergency care with the pediatric emergency medicine (PEM) training of the emergency department physicians. We designed the study to determine parental and pediatricians’ opinion and expectation in regard to this question. Most of the surveyed parents’ and pediatricians’ recognize the importance of PEM training and believed that physicians trained in PEM can provide better emergency care for children. However, 53.8% of parents, especially Spanish speaking and with Medicaid/no insurance coverage, believe that the emergency care provided for their children by general pediatricians and PEM physicians is equivalent. The results of our study could be utilized by accredited PEM planners in the creation of strategies to ensure the quality of emergency care for children population.
Circadian mood variations in Twitter content
Authors: Dzogang Fabon , Lightman Stafford , Cristianini Nello
Published: December 2017

Background:

Circadian regulation of sleep, cognition, and metabolic state is driven by a central clock, which is in turn entrained by environmental signals. Understanding the circadian regulation of mood, which is vital for coping with day-to-day needs, requires large datasets and has classically utilised subjective reporting.

Methods:

In this study, we use a massive dataset of over 800 million Twitter messages collected over 4 years in the United Kingdom. We extract robust signals of the changes that happened during the course of the day in the collective expression of emotions and fatigue. We use methods of statistical analysis and Fourier analysis to identify periodic structures, extrema, change-points, and compare the stability of these events across seasons and weekends.

Results:

We reveal strong, but different, circadian patterns for positive and negative moods. The cycles of fatigue and anger appear remarkably stable across seasons and weekend/weekday boundaries. Positive mood and sadness interact more in response to these changing conditions. Anger and, to a lower extent, fatigue show a pattern that inversely mirrors the known circadian variation of plasma cortisol concentrations. Most quantities show a strong inflexion in the morning.

Conclusion:

Since circadian rhythm and sleep disorders have been reported across the whole spectrum of mood disorders, we suggest that analysis of social media could provide a valuable resource to the understanding of mental disorder.
Evaluation of Lipid Profile and Residual Cardiovascular Risk in Patients Prior to Initiation of Niaspan Therapy
Authors: Islam Syed , Danwada Raghava , Ganguli Minoti , Espaillat Ramon , Jarvis Michael , Bacher H. Peter
Published: December 2017

Background: Despite significant impact of statins, there are a number of patients with residual risk of cardio vascular disease who have optimally controlled low-density lipoprotein cholesterol (LDL-C). Niaspan (extended-release nicotinic acid or niacin-ER) is indicated for its use as monotherapy for the treatment of very high triglyceride (TG) levels and for the raising of high-density lipoprotein cholesterol (HDL-C) representing those residual risk populations. The patient characteristics and lipid profile, prior to initiation of therapy, in the real-world clinical setting has not been well documented. Objectives: This study evaluated lipid levels among patients initiating Niaspan in real-world clinical practice. Methods: Patients with a first prescription of Niaspan were identified using electronic medical record data from GE. Lipid values were categorized into optimal and nonoptimal TG or HDL-C levels. Results: There were 89 091 new users. Most patients had nonoptimal TG, HDL-C, TG/HDL-C ratio, LDL-C, and non-HDL-C levels. Among those with nonoptimal TG and HDL, the ratio of TG to HDL-C was higher among younger age groups (mean ratio 12.0 in males; 10.58 in females aged 18 to <40 years). TG was significantly correlated with non-HDL-C (0.41, P < .001) but not with LDL-C. Among those with LDL-C <100 mg/dL, 64.3% had nonoptimal TG/HDL-C ratio and approximately 70% had non-HDL-C ≥130 mg/dL. More than a third of the patients had diagnosis of coronary heart disease or coronary heart disease risk equivalent. Conclusion: Majority of Niaspan users had nonoptimal TG and/or HDL-C. The correlation of nonoptimal TG levels with non-HDL-C levels further support that Niaspan was targeted to population with residual risk for cardiovascular disease.
DNA and factor VII–activating protease protect against the cytotoxicity of histones
Authors: Marsman Gerben , von Richthofen Helen , Bulder Ingrid , Lupu Florea , Hazelzet Jan , Luken Brenda M. , Zeerleder Sacha
Published: December 2017

Key Points

Free histones, not nucleosomes, are cytotoxic and are degraded by FSAP in serum to protect against cytotoxicity. Free histone H3 was not detectable in sera of septic baboons and patients with meningococcal sepsis.
Severe COPD and the transition to a palliative approach
Authors: Landers Amanda , Wiseman Rachel , Pitama Suzanne , Beckert Lutz
Published: December 2017

Patients with severe chronic obstructive pulmonary disease (COPD) have a chaotic trajectory towards death. Research has focused on identifying a “transition point” that would allow identification of those patients who may benefit from a palliative approach to their care, or referral to a specialist palliative care service. This article aims to outline difficulties in identifying this transition point, summarise current literature on this topic and suggests a model based on clinical milestones.

Educational aims

To outline the difficulties associated with identifying patients with severe COPD who are at risk of dying.

To summarise current research on this topic.

Key points

A specific transition point is difficult to identify in severe COPD.

Tools are available that may assist the physician in identifying those at risk of dying.

It is essential that the patient voice is heard, patients can describe specific events that may be used as a “trigger” for a palliative approach.

Specialist palliative care services may only be required for a subgroup of patients whose needs cannot be managed by the primary care team.
A Model for Postdoctoral Education That Promotes Minority and Majority Success in the Biomedical Sciences
Authors: Eisen Arri , Eaton Douglas C.
Published: December 2017

How does the United States maintain the highest-quality research and teaching in its professional science workforce and ensure that those in this workforce are effectively trained and representative of national demographics? In the pathway to science careers, the postdoctoral stage is formative, providing the experiences that define the independent work of one’s first faculty position. It is also a stage in which underrepresented minorities (URMs) disproportionately lose interest in pursuing academic careers in science and, models suggest, a point at which interventions to increase proportions of URMs in such careers could be most effective. We present a mixed-methods, case study analysis from 17 years of the Fellowships in Research and Science Teaching (FIRST) postdoctoral program, to our knowledge the largest and longest continuously running science postdoctoral program in the United States. We demonstrate that FIRST fellows, in sharp contrast to postdocs overall, are inclusive of URMs (50% African American; 70% women) and as or more successful in their fellowships and beyond as a comparison group (measured by publication rate, attainment of employment in academic science careers, and eventual research grant support). Analysis of alumni surveys and focus group discussions reveals that FIRST fellows place highest value on the cohort-driven community and the developmental teaching and research training the program provides.
Prison mental health in-reach teams in England: the care programme approach and sexual abuse/violence
Authors: Brooker Charles G. D. , Forrester Andrew
Published: December 2017

Prison mental health in-reach teams have doubled in size over the past decade and case-loads have reduced. Since 2010 it has been mandatory for keyworkers to ask whether prisoners with serious mental illness being treated under the care programme approach have experienced sexual or physical abuse. This is known as routine enquiry and should take place for these prisoners but NHS England, the commissioners, do not audit this activity. It is time to review current interventions and their associated outcomes.
Weekend new patient reviews in psychiatry: evaluation of activity over 3 months
Authors: Rutherford Michael , Potter Mark
Published: December 2017

Aims and method

South West London and St George's Mental Health NHS Trust developed a system of weekend new patient reviews by higher trainees to provide senior medical input 7 days a week. To evaluate the effectiveness of these reviews, the notes for all patients admitted over 3 months were examined. The mean length of stay for patients before and after the introduction of the weekend new patient reviews were compared via unpaired t-test.

Results

A total of 88 patients were seen: 84.4% of patients were seen within 24 h of admission. Higher trainees instituted some changes in 78.9% of patients. The most frequent action was to modify medication, in 47.8%. The average length of stay after the introduction of weekend reviews was not significantly different.

Clinical implications

Weekend reviews of newly admitted patients by higher trainees is a feasible method for providing senior input to patients admitted out of hours.
Racial Disparities in Clinically Significant Prostate Cancer Treatment: The Potential Health Information Technology Offers
Authors: Bickell Nina A. , Lin Jenny J. , Abramson Sarah R. , Hoke Gerald P. , Oh William , Hall Simon J. , Stock Richard , Fei Kezhen , McAlearney Ann Scheck
Published: December 2017

Purpose:

Black men are more likely to die as a result of prostate cancer than white men, despite effective treatments that improve survival for clinically significant prostate cancer. We undertook this study to identify gaps in prostate cancer care quality, racial disparities in care, and underlying reasons for poorer quality care.

Methods:

We identified all black men and random age-matched white men with Gleason scores ≥ 7 diagnosed between 2006 and 2013 at two urban hospitals to determine rates of treatment underuse. Underuse was defined as not receiving primary surgery, cryotherapy, or radiotherapy. We then interviewed treating physicians about the reasons for underuse.

Results:

Of 359 black and 282 white men, only 25 (4%) experienced treatment underuse, and 23 (92%) of these were black. Most (78%) cases of underuse were due to system failures, where treatment was recommended but not received; 38% of these men continued receiving care at the hospitals. All men with treatment underuse due to system failures were black.

Conclusion:

Treatment rates of prostate cancer are high. Yet, racial disparities in rates and causes of underuse remain. Only black men experienced system failures, a type of underuse amenable to health information technology–based solutions. Institutions are missing opportunities to use their health information technology capabilities to reduce disparities in cancer care.
High Serum TSH Level Is Associated With Progression of Papillary Thyroid Microcarcinoma During Active Surveillance
Authors: Kim Hye In , Jang Hye Won , Ahn Hyeon Seon , Ahn Soohyun , Park So Young , Oh Young Lyun , Hahn Soo Yeon , Shin Jung Hee , Kim Jung-Han , Kim Jee Soo , Chung Jae Hoon , Kim Tae Hyuk , Kim Sun Wook
Published: December 2017

Objective

Thyroid-stimulating hormone (TSH) is a growth factor affecting initiation or progression of papillary thyroid cancer (PTC), which supports TSH suppressive therapy in patients with PTC. In patients with papillary thyroid microcarcinoma (PTMC) during active surveillance, however, the association between serum TSH level and growth of PTMC has not been demonstrated.

Patients

We analyzed 127 PTMCs in 126 patients under active surveillance with serial serum TSH measurement and ultrasonography.

Design

The patients were categorized into groups with the highest, middle, and lowest time-weighted average of TSH (TW-TSH). PTMC progression was defined as a volume increase of ≥50% compared with baseline. Kaplan-Meier survival analysis according to TW-TSH groups and Cox proportional hazard modeling was performed. We identified the cutoff point for TSH level by using maximally selected log-rank statistics.

Results

During a median follow-up of 26 months, PTMC progression was detected in 28 (19.8%) patients. Compared with the lowest TW-TSH group, the adjusted hazard ratio (HR) for PTMC progression in the highest TW-TSH group was significantly higher [HR 3.55; 95% confidence interval (CI), 1.22 to 10.28; P = 0.020], but that in the middle TW-TSH group was not (HR 1.52; 95% CI, 0.46 to 5.08; P = 0.489). The cutoff point for the serum TSH level for PTMC progression was 2.50 mU/L.

Conclusions

Sustained elevation of serum TSH levels during active surveillance is associated with PTMC progression. Maintaining a low-normal TSH range with levothyroxine treatment during active surveillance of PTMC might be considered in future studies.
Respiratory Gas Analysis—Technical Aspects
Authors: Jaffe Michael B.
Published: December 2017

A technology-focused review of respiratory gas analysis, with an emphasis on carbon dioxide analysis, is presented. The measurement technologies deployed commercially are highlighted, and the basic principles and technical concerns of infrared spectroscopy and mainstream versus sidestream gas sampling are discussed. The specifications of particular interest to the clinician, accuracy and response time, and the related standard, with typical values for a capnometer, are presented. Representative time and volumetric capnograms are shown with the clinically relevant parameters described. Aspects of the terminology in present-day use and the need for clarity in defining what is a breath and an end-tidal value are reviewed. The applications of capnography of particular interest to the anesthesiologist are noted, and key references are provided. Ongoing developments with respect to respiratory gas analysis, and those that will impact it, are noted.
Perioperative Management of the Patient With a Left Ventricular Assist Device for Noncardiac Surgery
Authors: Chung Mabel
Published: December 2017

The pandemic of heart failure and the limited options for treatment of end-stage disease have resulted in an increase in the utilization of left ventricular assist devices (LVADs). Improvements in device technology and patient survival have led to an expanding population of patients requiring noncardiac surgery while on LVAD therapy, thus leading to a growing need for familiarity with the physiology of these patients. This review describes the functional mechanics of the most prevalent continuous-flow LVAD, the HeartMate II, and focuses on perioperative anesthetic concerns.
Consensus Statement on Perioperative Use of Neuromuscular Monitoring
Authors: Naguib Mohamed , Brull Sorin J. , Kopman Aaron F. , Hunter Jennifer M. , Fülesdi Béla , Arkes Hal R. , Elstein Arthur , Todd Michael M. , Johnson Ken B.
Published: December 2017

A panel of clinician scientists with expertise in neuromuscular blockade (NMB) monitoring was convened with a charge to prepare a consensus statement on indications for and proper use of such monitors. The aims of this article are to: (a) provide the rationale and scientific basis for the use of quantitative NMB monitoring; (b) offer a set of recommendations for quantitative NMB monitoring standards; (c) specify educational goals; and (d) propose training recommendations to ensure proper neuromuscular monitoring and management. The panel believes that whenever a neuromuscular blocker is administered, neuromuscular function must be monitored by observing the evoked muscular response to peripheral nerve stimulation. Ideally, this should be done at the hand muscles (not the facial muscles) with a quantitative (objective) monitor. Objective monitoring (documentation of train-of-four ratio ≥0.90) is the only method of assuring that satisfactory recovery of neuromuscular function has taken place. The panel also recommends that subjective evaluation of the responses to train-of-four stimulation (when using a peripheral nerve stimulator) or clinical tests of recovery from NMB (such as the 5-second head lift) should be abandoned in favor of objective monitoring. During an interim period for establishing these recommendations, if only a peripheral nerve stimulator is available, its use should be mandatory in any patient receiving a neuromuscular blocking drug. The panel acknowledges that publishing this statement per se will not result in its spontaneous acceptance, adherence to its recommendations, or change in routine practice. Implementation of objective monitoring will likely require professional societies and anesthesia department leadership to champion its use to change anesthesia practitioner behavior.
Informed Consent and Cognitive Dysfunction After Noncardiac Surgery in the Elderly
Authors: Hogan Kirk J. , Bratzke Lisa C. , Hogan Kendra L.
Published: December 2017

Cognitive dysfunction 3 months after noncardiac surgery in the elderly satisfies informed consent thresholds of foreseeability in 10%–15% of patients, and materiality with new deficits observed in memory and executive function in patients with normal test performance beforehand. At present, the only safety step to avoid cognitive dysfunction after surgery is to forego surgery, thereby precluding the benefits of surgery with removal of pain and inflammation, and resumption of normal nutrition, physical activity, and sleep. To assure that consent for surgery is properly informed, risks of both cognitive dysfunction and alternative management strategies must be discussed with patients by the surgery team before a procedure is scheduled.
Dynein and EFF-1 control dendrite morphology by regulating the localization pattern of SAX-7 in epidermal cells
Authors: Zhu Ting , Liang Xing , Wang Xiang-Ming , Shen Kang
Published: December 2017

Our previous work showed that the cell adhesion molecule SAX-7 forms an elaborate pattern in Caenorhabditis elegans epidermal cells, which instructs PVD dendrite branching. However, the molecular mechanism forming the SAX-7 pattern in the epidermis is not fully understood. Here, we report that the dynein light intermediate chain DLI-1 and the fusogen EFF-1 are required in epidermal cells to pattern SAX-7. While previous reports suggest that these two molecules act cell-autonomously in the PVD, our results show that the disorganized PVD dendritic arbors in these mutants are due to the abnormal SAX-7 localization patterns in epidermal cells. Three lines of evidence support this notion. First, the epidermal SAX-7 pattern was severely affected in dli-1 and eff-1 mutants. Second, the abnormal SAX-7 pattern was predictive of the ectopic PVD dendrites. Third, expression of DLI-1 or EFF-1 in the epidermis rescued both the SAX-7 pattern and the disorganized PVD dendrite phenotypes, whereas expression of these molecules in the PVD did not. We also show that DLI-1 functions cell-autonomously in the PVD to promote distal branch formation. These results demonstrate the unexpected roles of DLI-1 and EFF-1 in the epidermis in the control of PVD dendrite morphogenesis.
Ontogeny and morphometrics of the gill and swim bladder of air-breathing striped catfishPangasianodon hypophthalmus
Authors: Phuong Le My , Huong Do Thi Thanh , Malte Hans , Nyengaard Jens Randel , Bayley Mark
Published: December 2017

The air-breathing fish Pangasianodon hypophthalmus has been shown to have highly plastic branchial surfaces whose area (SA) increases with temperature and aquatic hypoxia. This modulation occurs through development of inter-lamellar cell mass (ILCM). Paradoxically, in conditions where this fish has been shown capable of covering its entire aerobic scope from the water phase, it has been shown to have a very small branchial SA. To address this paradox, we measured the SA, harmonic mean diffusion (τh) and calculated the anatomic diffusion factor (ADF) of the branchial and swim bladder surfaces in fish ranging from 3 to 1900 g at 27ᵒC in normoxia. Since the lamellae were distinguishable from the ILCM, we measured the actual SA as well as the potential SA if ILCM were lost. As a result of low τh, P. hypophthalmus has a high capacity for branchial oxygen uptake with or without ILCM. The actual and potential gill ADF being 361 and 1002 cm2µm−1kg−1 respectively for 100g fish. The ADF of the swim bladder was similarly 308 cm2µm−1kg−1. By swimming the fish to exhaustion at different temperatures we showed that modulation of this SA is rapid, indicating that the apparent paradox between previous studies is eliminated. Regression analysis of log-log plots of respiratory SA in relation to body mass show that the gills scale with mass similarly to active water breathing fish, whereas the swim bladder SA scales similarly to the mammalian lung. This fish presents a combination of respiratory surfaces not previously seen in air-breathing fish.
Οι τάσεις αποδόμησης/μετασχηματισμού του μεταπολιτευτικού κομματικού συστήματος
Authors: Μαυρής Γιάννης
Published: December 2017

[Δεν διατίθεται περίληψη / no abstract available]
Πρόλογος: Κοινωνικά κινήματα και Κοινωνικές Επιστήμες
Authors: Παντελίδου-Μαλουτα Μάρω
Published: December 2017

[Δεν διατίθεται περίληψη / no abstract available]
Feminist movement, feminist theory and citizenship
Authors: Παντελίδου-Μαλουτα Μάρω
Published: December 2017

Δεν διατίθεται περίληψη στα ελληνικά
Analyses of the experimental learning results of teaching fiction translation among students of a linguistic university in the light of social-cultural approach
Authors: Исаева Сабина , Isaeva Sabina
Published: December 2017

Modern workbooks on teaching fiction translation do not fully embrace the social-cultural component of educational content, despite the state standard strict demand on seeing students mainly as an object of cultural dialog. According to this, a row of competence, possessing demands of preparing students that can use foreign language as an instrument of social-cultural communication, may be insufficient for forming skills in fiction translation. Due to this fact we have worked out and tested the model of forming skills in fiction translation using social-cultural approach among students of a linguistic university. The forming of translational social-cultural competence, which the totality of social and political, cultural and historical, demographic and everyday knowledge about the country of the language during the creation of identical translation version in accordance with cross-cultural equivalence level and the way of translation of social-cultural realias, is the result of education. The author has created two diagrams to demonstrate social-cultural changes on different levels of translational equivalence: one illustrates ways of translation of social-cultural realias typical for the proper level, the other shows how different groups of realias split on different levels of cross-cultural equivalence. Suggested model of education is based on teaching students fiction translation according to these diagrams; according to this model the process of education is real- ized according to the principle from simple to complicated, i.e. from formal equivalence level to descriptive. Taking into account the statistic analyses of experimental teaching results, it demonstrates the effectiveness of the proposed teaching model, we can conclude that using this model on teaching fiction translation process in linguistic university will help students to broaden their social-cultural database and embrace some skills in fiction translation.
Urban sculpture and cultural code of Volgograd in the context of branding the territory
Authors: Шипицин Антон , Shipitsin Anton
Published: December 2017

The sculpture and monuments of Volgograd are discussed in the article as cultural and symbolic objects expressing the local identity and the defining image of the city, and also as resources for branding areas. Field studies and analysis of publications in print and electronic media showed that in the period from 2006 to 2016. in Volgograd, it was installed about 50 different sculptural forms and art objects – sculptures, memorials, monuments, small architectural forms. The author carried out a content analysis of the sculptural text and made the classification of monuments installed over the last 10 years. There were identified dominant themes and motifs, proving the irreducibility of the identity of Volgograd to a common denominator with a predominance of heroic discourse of the Soviet past. Specific examples show that the development of object environment of Volgograd clarifies three main trends: the assertion of the identity of the city-hero, stream professional-corporate symbols, representation of the images of the pre-Soviet past, first of all, an appeal to the history and culture of Tsaritsyn. The empirical material of Volgograd highlights the key functions of modern urban sculptures and monuments: monumental, memorial, axiological, aesthetic, social, advertising, entertainment, cultural and educational. It’s stated that creation and promotion of a positive image of Volgograd as a modern city of cultural innovations is difficult in the absence of a developed strategy of cultural policy aimed at the use of intelligent, creative, real assets and the search for alterna- tive symbolic models.
Visas for international students: a comparative analysis of the legislation and the issuing of student visas in the United States and Germany Jacob Schoofs
Authors: Шуфс Якоб , Schoofs Jacob
Published: December 2017

The field of higher education has seen great increases in the mobility of international students over the last decades. Due to this trend, not only has global educational programming become increasingly important, but also, the development of appropriate visa regulations and schemes to support international students has come into debate. The F-1 visa in the United States and the Aufenthaltstitel for students in Germany are two cases, which are similar in many ways but different in others. Due to Germany’s status as a member state of the European Union, directives created at Union level, also have a significant impact on Germany's legislation. To be able to understand the procedure and benefits and/or disadvantages attained by the students themselves in each scheme, it is important to analysis the many aspects of the visa schemes. It's not better or worse, it’s just different’ is a phrase which, in the case of visa regulations, holds true. Important for both schemes however, is their ability to further the ideals of globalization through allowing student academic mobility.
Study of Local Lore, History, and Economy at Profession-Oriented School
Authors: Баринова И. , Barinova I. , Архипов Е. , Arhipov E.
Published: December 2017

In this paper the authors describe the role of local lore materials in practical studies at profession-oriented school for building students’ professional competences. They provide detailed examples of local lore practical studies within specialized educational programs with regard to particular social and economic characteristics of Russian cities.