bluuebunny/crossref_metadata_2025 huggingface dataset:
A Review of Antibiotic Use in Food Animals: Perspective, Policy, and Potential
Authors: Landers Timothy F. , Cohen Bevin , Wittum Thomas E. , Larson Elaine L.
Published: July 2017

Antibiotic use plays a major role in the emerging public health crisis of antibiotic resistance. Although the majority of antibiotic use occurs in agricultural settings, relatively little attention has been paid to how antibiotic use in farm animals contributes to the overall problem of antibiotic resistance. The aim of this review is to summarize literature on the role of antibiotics in the development of resistance and its risk to human health. We searched multiple databases to identify major lines of argument supporting the role of agricultural antibiotic use in the development of resistance and to summarize existing regulatory and policy documents. Several lines of reasoning support the conclusion that agricultural antibiotics are associated with resistance, yet most public policy is based on expert opinion and consensus. Finally, we propose strategies to address current gaps in knowledge.
Actions to Control High Blood Pressure among Hypertensive Adults in Texas Counties along the Mexico Border: Texas BRFSS, 2007
Authors: Ayala Carma , Fang Jing , Escobedo Luis , Pan Stephen , Balcazar Hector G. , Wang Guijing , Merritt Robert
Published: July 2017

Objectives.

We examined the prevalence of actions taken to control blood pressure as measured by taking antihypertensive medication or making lifestyle modifications among hypertensive adults residing along the Texas/Mexico border.

Methods.

We used self-reported data from the 2007 Texas Behavioral Risk Factor Surveillance System, with oversampling of border counties. We calculated the age-standardized prevalence of actions taken to control hypertension by selected characteristics.

Results.

In analyses that combined ethnicity with predominant language spoken, those least likely to take any action to control their blood pressure—either by taking an antihypertensive medication or by making any of four lifestyle modifications—were Spanish-speaking Hispanic people (83.2% ± 2.7% standard error [SE]), with English-speaking non-Hispanic people (88.9% ± 0.8% SE) having the highest prevalence of taking action to control blood pressure. When analyzed by type of medical category, uninsured Hispanic people (63.8% ± 4.8% SE) had the lowest prevalence of taking action to control their blood pressure compared with uninsured non-Hispanic people (75.4% ± 4.7% SE). Nonborder Texas residents with hypertension were more likely to take antihypertensive medications (78.4% ± 1.0% SE) than border county residents with hypertension (70.7% ± 2.0% SE).

Conclusions.

Public health efforts must be undertaken to improve the control of hypertension among residents of Texas counties along the Mexico border, particularly for uninsured Hispanic people.
The Economic, Institutional, and Political Determinants of Public Health Delivery System Structures
Authors: Ingram Richard C. , Scutchfield F. Douglas , Mays Glen P. , Bhandari Michelyn W.
Published: July 2017

Objectives.

A typology of local public health systems was recently introduced, and a large degree of structural transformation over time was discovered in the systems analyzed. We present a qualitative exploration of the factors that determine variation and change in the seven structural configurations that comprise the local public health delivery system typology.

Methods.

We applied a 10-item semistructured telephone interview protocol to representatives from the local health agency in two randomly selected systems from each configuration—one that had maintained configuration over time and one that had changed configuration over time. We assessed the interviews for patterns of variation between the configurations.

Results.

Four key determinants of structural change emerged: availability of financial resources, interorganizational relationships, public health agency organization, and political relationships. Systems that had changed were more likely to experience strengthened partnerships between public health agencies and other community organizations and enjoy support from policy makers, while stable systems were more likely to be characterized by strong partnerships between public health agencies and other governmental bodies and less supportive relationships with policy makers.

Conclusions.

This research provides information regarding the determinants of system change, and may help public health leaders to better prepare for the impacts of change in the areas discussed. It may also help those who are seeking to implement change to determine the contextual factors that need to be in place before change can happen, or how best to implement change in the face of contextual factors that are beyond their control.
Dental Anxiety and the Use of Oral Health Services among People Attending Two HIV Primary Care Clinics in Miami
Authors: Singer Richard , Cardenas Gabriel , Xavier Jessica , Jeanty Yves , Pereyra Margaret , Rodriguez Allan , Metsch Lisa R.
Published: July 2017

Objectives.

We examined factors associated with dental anxiety among a sample of HIV primary care patients and investigated the independent association of dental anxiety with oral health care.

Methods.

Cross-sectional data were collected in 2010 from 444 patients attending two HIV primary care clinics in Miami-Dade County, Florida. Corah Dental Anxiety Scores and use of oral health-care services were obtained from all HIV-positive patients in the survey.

Results.

The prevalence of moderate to severe dental anxiety in this sample was 37.8%, while 7.9% of the sample was characterized with severe dental anxiety. The adjusted odds of having severe dental anxiety were 3.962 times greater for females than for males (95% confidence interval [CI] 1.688, 9.130). After controlling for age, ethnicity, gender, education, access to dental care, and HIV primary clinic experience, participants with severe dental anxiety had 69.3% lower adjusted odds of using oral health-care services within the past 12 months (vs. longer than 12 months ago) compared with participants with less-than-severe dental anxiety (adjusted odds ratio 5 0.307, 95% CI 0.127, 0.742).

Conclusion.

A sizable number of patients living with HIV have anxiety associated with obtaining needed dental care. Routine screening for dental anxiety and counseling to reduce dental anxiety are supported by this study as a means of addressing the impact of dental anxiety on the use of oral health services among HIV-positive individuals.
Mortality Rates and Age at Death from Sickle Cell Disease: U.S., 1979–2005
Authors: Lanzkron Sophie , Carroll C. Patrick , Haywood Carlton
Published: July 2017

Objectives.

Improvements in survival for children with sickle cell disease (SCD) during the last 30 years have been well established. Whether similar improvements for adults with the disease have occurred is unknown. We investigated mortality rates for children and adults with SCD.

Methods.

We used the National Center for Health Statistics multiple-cause-of-death files to examine age at death and calculate mortality rates from 1979 to 2005. We examined trends in mortality rates using negative binomial regression, and we examined age at death using t-tests and linear regression.

Results.

We identified 16,654 sickle cell-related deaths. Mean age at death was significantly different for males (33.4 years, 95% confidence interval [CI] 33.0, 33.7) than for females (36.9 years, 95% CI 36.5, 37.4). In a regression model controlling for gender, the mean age at death increased by 0.36 years for each year of the study. The median age at death in 2005 was 42 years for females and 38 years for males. The overall mortality rate increased 0.7% ( p<0.001) each year during the time period studied. The adult (>19 years of age) mortality rate increased by 1% ( p<0.001) each year during the time period studied. The pediatric mortality rate decreased by 3% ( p<0.001) each year during the time period studied.

Conclusions.

These data confirm prior findings of a significant decrease in mortality for children with SCD The mortality rate for adults appears to have increased during the same time period It seems unlikely that this increase is due merely to an influx of younger patients surviving to adulthood and may reflect a lack of access to high-quality care for adults with SCD.
Geographic and Racial Patterns of Preventable Hospitalizations for Hypertension: Medicare Beneficiaries, 2004–2009
Authors: Will Julie C. , Nwaise Isaac A. , Schieb Linda , Zhong Yuna
Published: July 2017

Objectives.

Hypertension as the primary reason for hospitalization is often used to indicate failure of the outpatient health-care system to prevent and control high blood pressure. Investigators have reported increased rates of these preventable hospitalizations for black people compared with white people; however, none have mapped them nationally by race.

Methods.

We used Medicare Part A data to estimate preventable hypertension hospitalizations from 2004–2009 using technical specifications published by the Agency for Healthcare Research and Quality. Rates per 100,000 beneficiaries were age- and sex-standardized to 2000 U.S. Census data. We mapped county-level rates by race and identified clusters of counties with extreme rates.

Results.

Black people had higher crude rates of these hospitalizations than white people for every year studied, and the test for an increasing linear time trend for the standardized rates was significant for both black and white people; that is, the gap between the races increased over time. For both races, clusters of high-rate counties occurred primarily in parts of Oklahoma, Texas, Southern Alabama, and Louisiana. High rates for white people were also found in parts of Appalachia. Large differences in rates among black and white people were found in a number of large urban areas and in parts of Florida and Alabama.

Conclusions.

Racial disparities in preventable hospitalizations for hypertension persisted through 2009. The gap between black and white people is increasing, and these inequities exist unevenly across the country. Although this study was intended to be purely descriptive, future studies should use multivariate analyses to examine reasons for these unequal distributions.
Urban-Rural Differences in Coronary Heart Disease Mortality in the United States: 1999–2009
Authors: Kulshreshtha Ambar , Goyal Abhinav , Dabhadkar Kaustubh , Veledar Emir , Vaccarino Viola
Published: July 2017

Objective.

Coronary heart disease (CHD) mortality has declined in the past few decades; however, it is unclear whether the reduction in CHD deaths has been similar across urbanization levels and in specific racial groups. We describe the pattern and magnitude of urban-rural variations in CHD mortality in the U.S.

Methods.

Using data from the National Center for Health Statistics, we examined trends in death rates from CHD from 1999 to 2009 among people aged 35–84 years, in each geographic region (Northeast, Midwest, West, and South) and in specific racial-urbanization groups, including black and white people in large and medium metropolitan (urban) areas and in non-metropolitan (rural) areas. We also examined deaths from early-onset CHD in females aged <65 years and males aged <55 years.

Results.

From 1999 to 2009, there was a 40% decline in age-adjusted CHD mortality. The trend was similar in black and white people but was more pronounced in urban than in rural areas, resulting in a crossover in 2007, when rural areas began showing a higher CHD mortality than urban areas. White people in large metropolitan areas had the largest decline (43%). Throughout the study period, CHD mortality remained higher in black people than in white people, and, in the South, it remained higher in rural than in urban areas. For early-onset CHD, the mortality decline was more modest (30%), but overall trends by urbanization and region were similar.

Conclusion.

Favorable national trends in CHD mortality conceal persisting disparities for some regions and population subgroups (e.g., rural areas and black people).
How Might Immunization Rates Change if Cost Sharing is Eliminated?
Authors: Shen Angela K. , O'Grady Michael J. , McDevitt Roland D. , Pickreign Jeremy D. , Laudenberger Laura K. , Esber Allahna , Shortridge Emily F.
Published: July 2017

Objectives.

There is a debate regarding the effect of cost sharing on immunization, particularly as the Affordable Care Act will eliminate cost sharing for recommended vaccines. This study estimates changes in immunization rates and spending associated with extending first-dollar coverage to privately insured children for four childhood vaccines.

Methods.

We used the 2008 National Immunization Survey and peer-reviewed literature to generate estimates of immunization status for each vaccine by age group and insurance type. We used the Truven Health Analytics 2006 MarketScan Commercial Claims and Encounters Database of line-item medical claims to estimate changes in immunization rates that would result from eliminating cost sharing, and we used the Kaiser Family Foundation/Health Research and Educational Trust Employer Health Benefits Survey to determine the prevalence of coverage for patients with first-dollar coverage, patients who face office visit cost sharing, and patients who face cost sharing for all vaccine cost components. We assumed that once cost sharing is removed, coverage rates in plans that impose cost sharing will rise to the level of plans that do not.

Results.

We estimate that immunization rates would increase modestly and result in additional direct spending of $26.0 million to insurers/employers. Further, these payers would have an additional $11.0 million in spending associated with eliminating cost sharing for children already receiving immunizations.

Conclusions.

The effects of eliminating cost sharing for vaccines vary by vaccine. Overall, immunization rates will rise modestly given high insurance coverage for vaccinations, and these increases would be more substantial for those currently facing cost sharing. However, in addition to the removal of cost sharing for immunizations, these findings suggest other strategies to consider to further increase immunization rates.
A Tuberculosis Outbreak Fueled by Cross-Border Travel and Illicit Substances: Nevada and Arizona
Authors: Mitruka Kiren , Blake Haley , Ricks Philip , Miramontes Roque , Bamrah Sapna , Chee Carla , Hickstein Laurie
Published: July 2017

Objectives.

From May 2006 to August 2008, the Southern Nevada Health District identified eight tuberculosis (TB) cases in six adults and two children in a Hispanic community. We conducted an outbreak investigation to determine the extent of TB transmission and prevent additional cases.

Methods.

We investigated TB cases in Nevada and Arizona with the outbreak genotype or cases with suspected epidemiologic links to this cluster but without genotyping data. We reviewed medical records and interviewed patients and contacts. Subsequently, genotype surveillance was conducted for approximately four years to monitor additional outbreak-related cases.

Results.

Eight outbreak cases were identified among six adults and two children. All patients were Hispanic and five were U.S.-born. The index patient was diagnosed while detained in Immigration and Customs Enforcement custody but deported before treatment completion. He was lost to follow-up for two years, during which time he served as the source for six secondary TB cases, including his own child. Along with the index patient, five patients reportedly engaged in the sale or use of methamphetamine. Follow-up surveillance in the two states identified eight additional cases with the outbreak genotype; three had epidemiologic links to the index case.

Conclusions.

We found that incomplete TB treatment led to extensive TB transmission. We recommend thorough discharge planning and active measures to ensure continuity of care and TB treatment completion for people in custody at higher risk for loss to follow-up, which likely includes those engaged in the sale or use of illicit substances.
A Public Health Economic Assessment of Hospitals' Cost to Screen Newborns for Critical Congenital Heart Disease
Authors: Peterson Cora , Grosse Scott D. , Glidewell Jill , Garg Lorraine F. , Braun Kim Van Naarden , Knapp Mary M. , Beres Leslie M. , Hinton Cynthia F. , Olney Richard S. , Cassell Cynthia H.
Published: July 2017

Objective.

Critical congenital heart disease (CCHD) was recently added to the U.S. Recommended Uniform Screening Panel for newborns. This evaluation aimed to estimate screening time and hospital cost per newborn screened for CCHD using pulse oximetry as part of a public health economic assessment of CCHD screening.

Methods.

A cost survey and time and motion study were conducted in well-newborn and special/intensive care nurseries in a random sample of seven birthing hospitals in New Jersey, where the state legislature mandated CCHD screening in 2011. The sample was stratified by hospital facility level, hospital birth census, and geographic location. At the time of the evaluation, all hospitals had conducted CCHD screening for at least four months.

Results.

Mean screening time per newborn was 9.1 (standard deviation = 3.4) minutes. Hospitals' total mean estimated cost per newborn screened was $14.19 (in 2011 U.S. dollars), consisting of $7.36 in labor costs and $6.83 in equipment and supply costs.

Conclusions.

This federal agency-state health department collaborative assessment is the first state-level analysis of time and hospital costs for CCHD screening using pulse oximetry conducted in the U.S. Hospitals' cost per newborn screened for CCHD with pulse oximetry is comparable with cost estimates of existing newborn screening tests. Hospitals' equipment costs varied substantially based on the pulse oximetry technology employed, with lower costs among hospitals that used reusable screening sensors. In combination with estimates of screening accuracy, effectiveness, and avoided costs, information from this evaluation suggests that CCHD screening is cost-effective.
Effect of Rapid Influenza Diagnostic Testing on Antiviral Treatment Decisions for Patients with Influenza-like Illness: Southwestern U.S., May–December 2009
Authors: Suryaprasad Anil , Redd John T. , Ricks Philip M. , Podewils Laura Jean , Brett Meghan , Oski Jane , Minenna Wanda , Armao Frank , Vize Barbara J. , Cheek James E.
Published: July 2017

Rapid influenza diagnostic tests (RIDTs) had low test sensitivity for detecting 2009 pandemic influenza A (H1N1pdm09) infection, causing public health authorities to recommend that treatment decisions be based primarily upon risk for influenza complications. We used multivariate Poisson regression analysis to estimate the contribution of RIDT results and risk for H1N1pdm09 complications to receipt of early antiviral (AV) treatment among 290 people with influenza-like illness (ILI) who received an RIDT ≤48 hours after symptom onset from May to December 2009 at four southwestern U.S. facilities. RIDT results had a stronger association with receipt of early AVs (rate ratio [RR] = 3.3, 95% confidence interval [CI] 2.4, 4.6) than did the presence of risk factors for H1N1pdm09 complications (age <5 years or high-risk medical conditions) (RR=1.9, 95% CI 1.3, 2.7). Few at-risk people (28/126, 22%) who had a negative RIDT received early AVs, suggesting the need for sustained efforts by public health to influence clinician practices.
Duplicate Hepatitis C Antibody Testing in New York City, 2006–2010
Authors: Tsai Victoria , Bornschlegel Katherine , McGibbon Emily , Arpadi Stephen
Published: July 2017

Repeating a hepatitis C virus antibody test for a person who previously tested positive provides no new information, wastes resources, and may reflect poor coordination of medical care. Using public health surveillance data collected by the New York City Department of Health and Mental Hygiene, we evaluated the magnitude of duplicate antibody testing and assessed patient-level and facility-level risk factors for duplicate testing. From 2006 to 2010, 70,257 duplicate tests were performed for 58,886 individuals in New York City, costing an estimated $1.4 million. Analyses using a polytomous logistic regression model indicated that individuals in correctional and substance abuse treatment facilities were more likely to undergo duplicate testing. Future efforts should focus on coordinating medical information and care for hepatitis C antibody-positive individuals to ensure that the recommended diagnostic follow-up and treatment services are provided.
The Concept of Life Cycle: An Application to the Tourist Product
Authors: da Conceição Gonçalves Vitor Fernando , Águas Paulo Manuel Roque
Published: July 2017

The concept of life cycle is widely discussed, both in the marketing and the strategic management fields. Nevertheless, operational problems make this concept difficult to put into practice. This article clarifies the life cycle concept and its effective use, especially as it applies to the tourist product. First, the object, the tourist product, is defined, then the life cycle concept is presented and developed by explaining its different stages and their respective strategic implications. Finally, following this conceptual framework, a case study of the Algarve (a province of Portugal) is presented to illustrate the proposed methods for identifying each life cycle stage.
The Influence of Weather Context on Winter Resort Evaluations by Visitors
Authors: Williams Peter W. , Dossa Karim B. , Hunt John D.
Published: July 2017

Many of the criticisms of on-site surveys relate to contextual concerns. This is particularly the case for outdoor on-site surveys where the contextual effects of weather conditions are so intuitively apparent. In such circumstances, research is needed to suggest a priori which contextual weather factors have positive outcomes and which have negative effects. It was thought that some of the differences in reported satisfaction levels at winter resorts might be caused specifically by contextual weather conditions at the time of the assessment. To probe this perspective, this study compared the attribute satisfaction ratings of participants at Canadian winter resorts with prevailing weather conditions on the day of the survey. This article suggests that on-site weather conditions may be associated with the overall attribute evaluation scores reported by participants at Canadian winter resort destinations. This relationship appears to be particularly clear with respect to low attribute ratings occurring during windy weather conditions.
Hotel Complaint Behavior and Resolution: A Content Analysis
Authors: Manickas Peter A. , Shea Linda J.
Published: July 2017

This article represents a case study of a luxury hotel located in New York City. A content analysis of 220 complaints recorded in a logbook used by front desk agents during 1994 was conducted. The data were classified by guests' gender and place of residence, time of complaint, the type of complaint, the solutions to the complaints, and guests' responses to the solutions. This method provided insights into the hotel's operation and customer base, and suggested areas for future attention.
V. A Rationalist Malgré Lui: The Perplexities of Being Michael Oakeshott
Authors: Spitz David
Published: July 2017

APART FROM HIS WORK AS AN INTERPRETER of Hobbes, Oakeshott's significance as a political philosopher prior to the publication of On Human Conduct1 may fairly be said to be encompassed in, and derive from, his essay “Political Education.”2 To be sure, he has written a good deal before and after that essay, but the bulk of those writings—not least the papers collected in his Rationalism in Politics-are in one way or another glosses on the central theme articulated in that inaugural lecture.

That theme has both a philosophical and a doctrinal importance. At the philosophical level, it offers a serious challenge to conventional conceptions of political theory. At the doctrinal level, it sets forth an alternative to conventional conservatism—but not, as some American conservatives like to think, a compatible or complementary alternative.
Evaluation of Unaccountable Phlebitis with the Long Arm Silastic Catheter
Authors: Geiss Alan C. , Friedman Andrew C.
Published: July 2017

This study was initiated to identify the causal factor responsible for the development of “unaccountable phlebitis” when using the long arm silastic catheter. Use of computerized axial tomography has provided a means of analyzing veins containing indwelling silastic catheters of the upper arm. Physical data of diameters of the veins are limited to inaccuracies of the machine and must only be regarded as relative. We have been able to detect a great variability of cross‐sectional vein diameter and area within any one patient. This narrowing tends to occur in the mid‐upper arm region and may explain the occurrence of “unaccountable” phlebitis in this area. It appears that laminar blood flow and flotation of the catheter in the vein is inhibited in these areas of narrowing.
Götterdämmerung or a Brave New World
Authors: Pavlik Claire Ellen
Published: July 2017

In semi-darkness, a group stands clustered around a form. Some try to check vital signs—respiration, circulation, status of vital organs—and discuss the situation in hushed voices tinged with anguish. Others nearby are apparently unconcerned. “Breathing seems to be weak,” comes the first report, “and it's getting shallower and more uneven.” “Pulse! The pulse ... I can't find it.” The second voice is anxious, almost frantic. “What are you so wound up about? There's nothing wrong,” a third disdainfully remarks. “What makes you think it's supposed to have one?”
An Implementation Evaluation of Community Corrections
Authors: Rog Debra J. , Henry Gary T.
Published: July 2017

This article describes an evaluation of the implementation of a community diversion program for nonviolent offenders in Virginia. The evaluation used a unique application of logit analysis to focus on the extent to which the program was serving the intended population, in this case, offenders who would have otherwise been incarcerated. Results indicate that at least 46% of the divertees would have been incarcerated if the program had not been available. Usefulness of a statistical technique for evaluating implementation and providing concrete results to policymakers is discussed.
Retrospective and Prospective Analysis: Linking Program Evaluation and Forecasting
Authors: Chelimsky Eleanor
Published: July 2017

This article raises some questions about the relationship between program evaluation and forecasting. Contrasting the two fields in terms of mind-set, purpose, problems, advantages, and use shows that although their modes of inquiry are indeed very different in many ways, there is also interdependence between the two in several areas. It is argued that each can be greatly strengthened by better understanding and use of the other's techniques.
Using Group Mean Centering for Computing Adjusted Means by Site in a Randomized Experimental Design
Authors: Lewin Alisa C. , Mitchell Michael N.
Published: July 2017

When analyzing data from a randomized experiment that is replicated across multiple sites and includes covariates, the covariates can adjust for differences from either the grand mean or the group (site) mean. The analysis strategy determines the reference point. Pooling the sites and using a standard analysis of covariance (ANCOVA) adjusts for differences around the grand mean, whereas analyzing each site separately adjusts for differences around each group (site) mean. This article demonstrates that group mean centering permits pooling data from multiple sites into a single analysis while still using the group mean as a reference point for evaluating the covariate.
An examination of the pattern of preschool referrals to speech and language therapy
Authors: Anderson Carolyn A. , van der Gaag Anna
Published: July 2017

This evaluation was undertaken as part of a UK-wide multidisciplinary audit of services to preschool children with speech and language difficulties. Information was collected via questionnaire from parents, health visitors and general practitioners from six districts in Britain. The results showed a discrepancy between the average age at which parents first noticed speech and language problems in their children (2;3) and the average age at which health visitors referred children to speech and language therapy (3;3). This is interesting in the light of new research on early communication that suggests that it should be possible to screen for communication difficulties as early as 12 months and that many language difficulties will be apparent by 2 years. The study also found that health visitor training by speech and language therapists was provided on an ad hoc basis. The paper recommends that more training should be available and it should support professionals in providing good practice based on current evidence.
Second language data and constraints on Manner: explaining substitutions for the English interdentals
Authors: Lombardi Linda
Published: July 2017

Substitutions for English interdentals tend to be consistent based on first language (L1): eg. [t] for speakers of Russian, [s] for speakers of Japanese. While the facts suggest that some type of L1 transfer must be involved, a rule affecting a sound that does not occur in L1 is unlearnable. Optimality Theory (OT) allows a solution to this conundrum because the grammars contain independently necessary constraint rankings that also have an effect on the interdentals. [t] substitution results from high ranked markedness. This can be seen as an effect of universals because this grammar retains the original ranking that the L1 learners begins with. [s] substitution results from high ranked Faithfulness. In this case, some L1 phonology has forced reranking, making this an effect of L1 transfer.
Psychometric properties of the Fear-Avoidance Beliefs Questionnaire in patients with neck pain
Authors: Lee Kwok-Chung , Chiu Thomas TW , Lam Tai-Hing
Published: July 2017

Objectives: To translate the Fear-Avoidance Beliefs Questionnaire and investigate the validity and reliability of the Chinese version of the questionnaire in patients with neck pain.

Design: Observational cross-sectional and prospective study.

Setting: Physiotherapy outpatient departments.

Subjects: Four samples with 476 consecutive adult patients with neck pain from four physiotherapy centres.

Methods: The original questionnaire was translated into Chinese by forward and backward translation and reviewed by a panel of experts. The subjects completed the Chinese version of the fear-avoidance questionnaire, Northwick Park Neck Pain Questionnaire, Medical Outcomes 36-Item Short-Form Health Survey and their pain intensity was measured using an 11-point pain numerical rating scale. They were observed and measured at the beginning of physiotherapy, at week 3 and at week 6 after treatment began.

Results: The questionnaire had very good content validity and test-retest reliability with an intraclass correlation coefficient of 0.81 and Cronbach’s alpha coefficient of 0.90. Spearman’s correlation coefficients between fear-avoidance and the neck pain questionnaire, the health survey (physical), health survey (mental) and pain scale were 0.56, 0.45, 0.36 and 0.34, respectively. The standard response mean and effect size at week 6 were 0.38 and 0.32, respectively. Factor analysis yielded three factors which accounted for 61.6% of the total variance of the questionnaire.

Conclusion: The Fear-Avoidance Beliefs Questionnaire is a valid and reliable tool for patients with neck pain. It has been shown to demonstrate very good content validity, a high degree of test-retest reliability and internal consistency, good construct validity and medium responsiveness.
Task-oriented progressive resistance strength training improves muscle strength and functional performance in individuals with stroke
Authors: Yang Yea-Ru , Wang Ray-Yau , Lin Kuei-Han , Chu Mou-Yu , Chan Rai-Chi
Published: July 2017

Objective: To examine the effectiveness of task-oriented progressive resistance strength training on lower extremity strength and functional performance in chronic stroke subjects.

Design: Single-blind, randomized controlled trial.

Setting: Medical centre and district hospital.

Subjects: Forty-eight subjects at least one year post stroke.

Interventions: Participants randomly allocated to two groups, control (n-/24) and experimental (n-/24). Subjects in the control group did not receive any rehabilitation training. Subjects in the experimental group were put on a four-week task-oriented progressive resistance strength training.

Main measures: Lower extremity muscle strength, gait velocity, cadence, stride length, six-minute walk test, step test, and timed up and go test.

Results: Muscle strength significantly improved in the experimental group for strong side muscle groups (ranged from 23.9% to 36.5%) and paretic side muscle groups (ranged from 10.1% to 77.9%). In the control group muscle strength changes ranged from 6.7% gain to 11.2% decline. The experimental group showed significant improvement in all selected measures of functional performance except for the step test. In the control group, the number of repetitions of the step test significantly decreased (-20.3%) with no change in other functional tests. There was a significant difference between groups for muscle strength and all functional measures. The strength gain was significantly associated with gain in the functional tests.

Conclusions: The task-oriented progressive resistance strength training programme could improve lower extremity muscle strength in individuals with chronic stroke and could carry over into improvement in functional abilities.
Hand function in Charcot Marie Tooth: test retest reliability of some measurements
Authors: Svensson Elisabeth , Häger-Ross Charlotte
Published: July 2017

Objective: To evaluate the reliability of some measurements of hand function in people with Charcot Marie Tooth disease.

Design: Test retest study.

Setting: University, hospitals/clinics in northern Sweden.

Subjects: Twenty people with Charcot Marie Tooth disease.

Main outcome measures: Measures of (1) dexterity; Box and Block Test and Nine-Hole Peg Test, (2) strength; Grippit instrument (grip and pinch), (3) tactile sensation; Shape Texture Identification Test. Statistics used: intraclass correlation (ICC 2.1), limits of agreement, coefficient of repeatability, coefficient of variation, and linear weighted kappa.

Results: The ICC for the Box and Block Test was very high (0.95). The limits of agreement, coefficient of repeatability (CR) (11.5 blocks/min) and coefficient of variation (CV) (8.4%) were acceptable. There was bias towards a better result on the second occasion. For the Nine-Hole Peg Test, the reliability was good if performance was within 2 min (ICC =0.99, CR = 4.3 s, CV = 3.9%). Grip strength proved to be reliable (ICC = 0.99, CR = 26.7 N, CV = 6.6%), while pinch strength was less reliable. The kappa value of the Shape Texture Identification Test was 0.87, which was considered very good although the test has limitations in terms of how well it can describe patients either performing very well or very poorly.

Conclusions: The tested instruments can all be used to evaluate hand function in people with Charcot Marie Tooth. Certain factors, however, like limited time aspects for the Nine-Hole Peg Test and the number of trials used, should be taken into consideration. Pinch strength evaluation should be interpreted with caution.
Hereditary Multifocal Renal Cystadenocarcinomas and Nodular Dermatofibrosis in the German Shepherd Dog: Macroscopic and Histopathologic Changes
Authors: Lium B. , Moe L.
Published: July 2017

A syndrome characterized by bilateral, multifocal renal cystadenocarcinomas and nodular dermatofibrosis was found in 43 German shepherd dogs. Affected kidneys varied in weight from normal to 2950 g. The cut surface revealed multiple solid and cystic tumors that varied in size from barely visible to 27 cm in diameter. Metastases were found in ten of the 23 dogs examined since 1979. All 23 dogs had numerous firm nodules in the skin and subcutis, and ten of 11 bitches had multiple uterine leiomyomas. Histological examination of the renal cortex showed multifocal hyperplastic to highly malignant epithelial proliferations. Skin lesions consisted of dense collagen fibers, and the uterine tumors consisted of interlacing bundles of smooth muscle cells. Pedigree analysis strongly indicates that the syndrome is hereditary, probably in an autosomal dominant pattern.

This seems to be the first description of such a syndrome in domestic animals. Comparable syndromes in man are discussed.
Ultrastructural Ocular Lesions of 6-Aminonicotinamide Toxicosis in Rabbits
Authors: Render J. A. , Turek J. J. , Hinsman E. J. , Carlton W. W.
Published: July 2017

6-Aminonicotinamide, given by intraperitoneal injection to male and female Dutch belted rabbits, produced swelling and vacuolation of ciliary and iridal epithelium plus vacuolation of the retinal pigment epithelial and outer plexiform layers of the retina. By transmission electron microscopy, inner and outer ciliary epithelial cells and inner iridal epithelial cells contained numerous coalescing, membrane-bound vacuoles of the cytocavitary network. These vacuoles were viewed as numerous interconnecting, intracytoplasmic cavities in scanning electron micrographs. Swelling of vacuolated epithelial cells and the presence of fibrin and proteinaceous fluid in the ciliary stroma resulted in thickening of the anterior ciliary processes with the formation of surface alterations detectable by scanning electron microscopy. In transmission electron micrographs the vacuoles in the retinal pigment epithelium were large, electron-lucent spaces and the vacuoles in the outer plexiform layer of the retina appeared to be intracytoplasmic spaces in axons of photoreceptor cells. Distention of cytocavitary structures has been reported in glial cells of animals given 6-aminonicotinamide and this change was apparently due to alterations in ion and water movement across cellular membranes that resulted in intracellular edema.
Gold-induced Immune Thrombocytopenia in the Dog
Authors: Bloom J. C. , Blackmer S. A. , Bugelski P. J. , Sowinski J. M. , Saunders L. Z.
Published: July 2017

In two seven-year studies with gold compounds in dogs of both sexes, thrombocytopenia was observed after 45 to 72 months of dosing in three of 14 and two of 14 dogs in high-dose groups that received 2.4 to 3.6 mg/kg of auranofin per day orally or 0.5 to 2.0 mg/kg of gold sodium thiomalate intramuscularly once every three days, respectively. An immune basis for the disorder was suggested by the apparent consumptive nature of the thrombocytopenia (increased bone marrow megakaryocytes and large peripheral blood platelets), the response to corticosteroid therapy and the demonstration of increased platelet-associated immunoglobulin. The latter was demonstrated with a solid phase radioimmunoassay and by electron microscopy using a staphylococcal protein A-colloidal gold conjugate. Platelet-associated immunoglobulin decreased as the platelet counts rose, and in one dog monitored over periods of steroid-induced remissions and subsequent relapses, the amount of platelet-associated immunoglobulin G correlated inversely with the platelet count (r = 0.82). These findings suggest that the long-term administration of gold compounds in dogs is associated with a dose-dependent incidence of thrombocytopenia, which is immune-mediated and similar to that associated with parenteral chrysotherapy in man. The application of tests for platelet-associated immunoglobulin to canine patients with immune thrombocytopenia should be useful in the diagnosis of the disorder in clinical practice.
Judges 18 as an Anti-Spy Story in the Context of an Anti-Conquest Story: The Creative Usage of Literary Genres
Authors: Bauer Uwe F.W.
Published: July 2017

Using the example of Judges 18, this paper aims to show how an existing literary genre could be transformed into an anti-story. Six typical elements of the spy story genre are identified, of which three are used atypically in Judges 18. The spy story genre is classified as a subcategory of the Yhwh-war story genre, which in turn is a subcategory of the conquest story genre. Judges 18 uses some typical elements of the Yhwh-war story atypically. In the light of this, Malamat's thesis that Judges 18 represents a microcosm of a settlement campaign falls short, because he (differently from Pennant) fails to notice the anti-story effects.
Online Homework Management Systems: Should we Allow Multiple Attempts?
Authors: Rhodes M. Taylor , Sarbaum Jeffrey K.
Published: July 2017

Homework is increasingly being auto-administered online with systems that offer numerous assignment settings. This paper discusses the results of a quasi-experiment designed to evaluate student behavior under single and multiple attempt homework settings using an online homework management system. We explore whether or not multiple attempts lead to more effort and improved performance, and evaluate alternative, less desirable, behaviors that are potentially incentivized. We find that multiple attempts lead to “guessing” behavior and in turn grade inflation, hence improving scores without improving learning outcomes.
Criteria for Ranking of Nation-States through Regional Knowledge Evaluation
Authors: Fan Y. H.
Published: July 2017

This study creates a new model using a knowledge management approach to rank nation-states. The goal of it is to create a more accurate ranking that takes into account a broad and balanced spectrum of attributes of the nation-states including both subsistent and super knowledge. A regional knowledge distribution curve has subsistent regional knowledge on the horizontal axis and super regional knowledge on the vertical axis. The paper then uses a four-essence regional knowledge model to choose four elements that are used to construct the factors for ranking. The study provides a ranking table that uses this new ranking system.
Analysis of the Consolidation in Flexible Bladder Process for Thin Composite Parts by Finite Element Method
Authors: Pham Xuan-Tan , Trochu Francois
Published: July 2017

The consolidation of a saturated preform under pressure by means of a flexible bladder is studied in this paper. This phenomenon occurs in several composite manufacturing processes such as compression resin transfer molding (CRTM) for example. The resin flow in the fiber bed is governed by Darcy's law. The consolidation of the saturated preform is described by the total mass conservation. Mechanical behavior of the fiber network is analyzed. A two-dimensional numerical model is developed based on the finite element method. The numerical model allows the calculation of the resin pressure distribution in the preform, the reaction force of the preform and the prediction of the evolution of the preform thickness as a function of time and space.
Thermo-Viscoelastic Constitutive Modeling of Polymer Composites Subjected to Space Irradiation
Authors: Chao Chen-Ping , Chaturvedi Shive K.
Published: July 2017

In this paper, a general linear constitutive theory of thermo-viscoelasticity for irradiated polymer composites is presented. The model is based upon thermodynamic considerations involving Helmholtz and Gibbs free energies, Clausius and Duhem inequality and micro-mechanical strain, and stress fields associated with the fiber and matrix materials. The results show that the transverse and shear creep compliances for a T300/934 graphite-epoxy composite increase as the volume fraction of matrix increases and/or the fiber-matrix interfacial debonding increases. The results, when compared with the available limited experimental data, exhibit good correlation.
Instability of Multiple Penny-Shape Delaminations in Composite Laminates Subjected to Quasi-Static Transverse Loading
Authors: Suemasu H. , Majima O. , Aoki Y.
Published: July 2017

Instability and propagation process of multiple penny-shape interlaminar delaminations in circular axi-symmetric plates subjected to a quasi static transverse load, which is an idealized problem of damage accumulation in composite laminates due to low velocity impact loading, is numerically studied through a finite element analysis. A special fracture element is proposed in order to simulate the crack propagation. Both failures due to maximum stress and fracture mechanical instability are possible to be considered by using the element when the failed surface is presumed beforehand. The convergence of the solution is discussed by studying the distribution of the expansion of the element ahead of crack tip. First, the element is applied to the problem of propagation of a penny shape crack in infinite body. The results agree well with the theoretically predicted results. Then, the element is used to simulate the propagation of multiple delaminations in a laminate. The finite element results are consistent with the failure process inferred from the energy release rate distribution theoretically and numerically obtained.
Delamination Modeling and Detection in Smart Composite Plates
Authors: Chattopadhyay Aditi , Nam Changho , Dragomir-Daescu Dan
Published: July 2017

A refined model for smart composite plates with delamination is developed. The modeling is based on a third order refined displacement field, which satisfies the stress free boundary conditions at all free surfaces including delamination interfaces. The displacement field also accounts for the presence of distributed piezoelectric actuators. The mathematical model is implemented using the finite element method. The dynamic strain is analyzed for smart composites with and without delamination. Next, a new approach is investigated for the detection of delamination in smart composites based on the Root-Mean Square (RMS) values of the plate response subject to disturbances. Numerical results presented show accurate location of the delamination and its size.
Evaluation of Engineering Polymeric Composites for Abrasive Wear Performance
Authors: Bijwe Jayashree , Indumathi J. , Ghosh A. K.
Published: July 2017

The paper pertains to the studies of influence of short glass fibre reinforcement on abrasive wear behaviour of high performance polyetherimide (PEI) composites. A series of composites of PEI and its copolymer reinforced with short glass fibres (GF) in the range of 0-40% were selected. Abrasive wear studies were conducted under various testing conditions such as load, abrasive grit size, fibre orientation, etc. Based on these investigations, it was observed that short fibre reinforcement in optimum proportion showed better performance than the parent polymer. Wear versus fibre concentration curve showed minima at 30% GF loading and maxima at 10% and 20% GF loadings depending on the counterface selected indicating wear performance was maximum at 30% fibre concentration which deteriorated with further reinforcement. Various parametres such as hardness, ultimate tensile strength, elongation to break were critically analysed for investigating wear property correlations. SEM was used for examining worn surface topography.