bluuebunny/crossref_metadata_2025 huggingface dataset:
Concerns and Issues Faced by Families Headed by a Lesbian Couple
Authors: Hare Jan
Published: August 2018

The author explores the concerns of lesbian mothers and their partners. Twenty-eight lesbian couples who were raising children participated in structured interviews. Results suggested that lesbian parents and co-parents are deeply committed to creating strong families. The primary concern of parents related to worry about potential social difficulties for their children. The diverse ways the women came to motherhood illustrate the trend toward alternative insemination and adoption within the lesbian community. Implications for practice are offered.
Advocacy Practice of Social Workers
Authors: Ezell Mark
Published: August 2018

The author presents empirical information on the extent and nature of advocacy activity among a random sample of social workers. Almost all employed social workers in the sample performed both job-related and volunteer advocacy. They averaged less than five hours per week of on-the-job advocacy and less than one hour per week of volunteer advocacy. Agency goals and functions as well as job characteristics strongly influence the amount of job-related advocacy a social worker does. As a rule, social workers tend to be involved in case advocacy while at work and class advocacy while volunteering. Social workers were case oriented in their advocacy for or with their clients and were inclined to use approaches internal to their agency. An advocacy research agenda is recommended.
Depression, Anxiety, and Self-Esteem in Sexually Abused Children
Authors: Mermen Ferol E. , Meadow Diane
Published: August 2018

The authors report results of research on a sample of 83 sexually abused children. The girls' measures of depression, anxiety, and self-esteem were significantly different from those of standardization samples. These differences indicated higher levels of depression and anxiety and lower self-esteem. The boys' scores did not differ from norms on these measures. The findings' relevance to symptom development in sexual abuse and practice implications are discussed.
Displaced Manufacturing Workers and Their Families: A Research-Based Practice Model
Authors: Vosler Nancy R.
Published: August 2018

The closing of manufacturing plants has affected many workers in the United States throughout the past decade. As a result, social workers and other human service professionals increasingly deal with the impact of displacement on individual workers and their families and participate in designing solutions to problems at multiple social-system levels. Based on findings from the unemployment literature and recent research on plant closings, the author presents a model for understanding dislocated manufacturing workers and their families. The model can be used to guide formulation of interventions in direct practice and empowerment as well as in advocacy, community planning, and policy practice.
Conjoint Marital Therapy: A Practitioner's Approach to Single-System Evaluation
Authors: Collins Pauline M. , Kayser Karen , Platt Sheila
Published: August 2018

Although some practitioners are beginning to use single-system evaluation methods with various client problems and treatment perspectives, many practitioners are still unsure about how to use these methods with more than one individual in a client system. The authors demonstrate the applicability of a practice-driven, single-system evaluation to conjoint therapy. The primary focus of this integration of practice and research methods is to assist the practitioner in making informed treatment decisions based on the couple's progress toward the attainment of measurable treatment goals. A case presentation using a cognitive–dynamic approach in treating marital disaffection illustrates the specific activities involved in an evaluation.
Attention-Deficit Hyperactivity Disorder: A Family and Ecological Systems Perspective
Authors: Bernier James C. , Siegel Deborah H.
Published: August 2018

Little has been written about attention-deficit hyperactive disorder from a family systems perspective. The authors describe the impact of this neurologically based disorder on family functioning and explore the utility of systems theory in addressing families needs. Suggestions for widening the levels of intervention beyond traditional treatment parameters are offered.
Prenatal Care among Low-Income Women
Authors: Schaffer Marjorie A. , Lia-Hoagberg Betty
Published: August 2018

Forty low-income pregnant women were interviewed about the personal, family, and provider rewards and costs they experienced in obtaining prenatal care. The women identified important rewards as the health of their babies, their own health, partner's desire for a healthy baby, monitoring of the pregnancy by qualified healthcare personnel, and the evaluation of problems by health-care providers. The authors suggest strategies to strengthen personal, family, and provider rewards aimed at achieving a high level of prenatal care for low-income women.
Health and Social Issues of Gay, Lesbian, and Bisexual Adolescents
Authors: Dempsey Cleta L.
Published: August 2018

Ten percent of the adolescent population in the United States is gay, lesbian, or bisexual. These teens are difficult to identify and many people are unaware of their existence, problems, and needs. The author reviews current professional and lay literature regarding social and health issues of adolescent homosexuality and presents implications for practitioners in providing comprehensive, culturally appropriate services for these individuals.
Crises that Threaten Out-of-Home Placement of Children with Emotional and Behavioral Disorders
Authors: Petr Christopher G.
Published: August 2018

Children with serious emotional and behavioral disorders present strong challenges to families and professionals who attempt to care for them at home. This longitudinal, exploratory study examines the placement-threatening crises experienced by nine Minnesota families during an 18-month period. The findings encourage critical reevaluation of placement-prevention programs, highlighting the importance of informal support systems, longstanding family supports, attitudes of professionals, and the role of medications.
The Relationship between Feelings of Alienation and Burnout in Social Work
Authors: Powell William E.
Published: August 2018

Many articles and books have been written about alienation and burnout. Although the concepts have been conceptually linked, no known empirical studies have demonstrated that relationship. Using data from a survey of social workers practicing in the State of Wisconsin, the author tested the hypothesis that the concepts of burnout and alienation are closely related. The findings support that hypothesis and suggest that some dimensions of alienation may be especially potent predictors of burnout among social workers.
Mutuality in Mother–Daughter Relationships
Authors: Goldberg Joan E.
Published: August 2018

The author explored the concept of mutuality, as perceived by daughters, in the mother-daughter relationship and its impact on the self-esteem and social adjustment of the adolescent daughter. Data were gathered from three schools of higher learning. A sample of 239 respondents, 18–22 years of age, was utilized. Findings supported the study hypothesis that a positive relationship exists between an adolescent daughter's perceived mutuality in the mother–daughter relationship and the daughter's self-esteem and social adjustment. This research represents an important step in the understanding of the mother–daughter relationship and its role in the development of young women and has implications for social work practice.
Emerging Conceptions of Family Development over the Life Course
Authors: Germain Carel B.
Published: August 2018

Life-cycle models assume universal, fixed, sequential stages of individual and family development and thus ignore the diversity of people, social and physical environments, and culture. The author proposes a new, interdisciplinary life-course model of development based on the concept of nonuniform pathways of development. This model incorporates new family forms, human diversity (race, ethnicity, culture, gender, sexual orientation, and physical/mental states), and environmental diversity (economic, political, social). The model includes temporal orientations (historic, individual, and social time) to examine the influence of life transitions, life events, and other life issues on family development and transformations over time. A case example is provided.
Maintaining Attachment Relationships among Children in Foster Care
Authors: Grigsby R. Kevin
Published: August 2018

Frequent, regular parent–child visitation of children in foster care is crucial in maintaining the attachment relationship of the parent and child. Further, the parent–child attachment concept is crucial for permanency planning because it is the rationale behind the goal of providing children with a stable and continuous relationship with the parent or another caretaker, if that child cannot return to the care of the parent. In order to ascertain whether protective services workers recognize and emphasize the importance of maintaining parent–child or other attachment relationships, the author studied closed case records of children who had experienced foster-care placement. Results are discussed in the context of social-attachment theory.
Barriers to Cooperation between Domestic-Violence and Substance-Abuse Programs
Authors: Bennett Larry , Lawson Marie
Published: August 2018

Staff and administrators drawn from a statewide random sample of 74 chemical-dependency and domestic-violence programs completed a questionnaire on linkage, referral, impairments to interagency cooperation, and beliefs about cross-problem incidence. Survey participants estimated that 46% of the male substance abusers currently in their care were batterers, 60% of the female substance abusers were victims, and 42% of the women now in domestic violence programs were substance abusers. Four of five survey participants believed that these clients would benefit from increased cooperation between chemical-dependence and domestic-violence programs. Implications of these findings are discussed.
Psychosocial Issues of AIDS Long-Term Survivors
Authors: Jue Sally
Published: August 2018

The Centers for Disease Control and Prevention's definition of an AIDS long-term survivor is someone who has lived at least three years after an AIDS diagnosis. Data from the late 1980s indicate a three-year survival rate of 15% to 20%, a rate that doubled in less than a decade. Despite the growing number of long-term survivors, little research has focused on how these persons cope with AIDS or on the impact of AIDS over an extended period. The author describes and gives examples of key nonmedical characteristics of AIDS long-term survivors and the special issues they bring to the therapeutic relationship. Suggestions for therapeutic interventions based on a client-empowerment approach are offered.
HIV-Associated Dementia: A Clinician's Guide to Early Detection, Diagnosis, and Intervention
Authors: Buckingham Stephan L. , Van Gorp Wilfred G.
Published: August 2018

HIV-associated dementia is the most common neuropsychiatric problem found among persons infected with HIV. The authors review the research findings on HIV-associated dementia and discuss the pattern of cognitive changes characteristic of this disorder. An overview of the various organic mental disorders found in HIV-infected individuals and how they can be detected and differentiated from other neuropsychiatric illnesses, specifically HIV-associated dementia, is provided. This article provides the clinician with information necessary to detect HIV-associated dementia early, make a correct differential diagnosis, and provide the most effective mental health treatment services for this patient population.
AIDS Prevention for Lesbian, Gay, and Bisexual Adolescents
Authors: Hunter Joyce , Schaecher Robert
Published: August 2018

Knowledge alone is not sufficient to motivate adolescents to adopt safer sex behaviors. Most efforts to address the AIDS crisis among adolescents have focused on providing information about how HIV is transmitted and describing ways to prevent infection. However, recent studies demonstrate that many adolescents lack knowledge and share misconceptions about HIV and do not practice safer sex. The authors present a successful cognitive–behavioral model for HIV prevention. Different modes of clinical intervention are presented within the context of the model.
AIDS and Women of Color
Authors: Land Helen
Published: August 2018

The challenges involved in meeting the service needs of HIV-infected persons have changed dramatically over the past decade. In the past several years, HIV/AIDS has had a particularly devastating impact on women of color of childbearing age, particularly African Americans and Hispanics. The author analyzes differences among women of color infected with HIV and presents implications for delivering culturally sensitive services.
HIV and the Elderly
Authors: Linsk Nathan L.
Published: August 2018

A substantial and increasing number of people have developed HIV infections in their later years, most associated with male-to-male sexual contact or blood transfusions, although transmission also occurs through substance users and unsafe heterosexual activity. Human service practitioners need to become sensitive to the needs of elderly people and their families who are affected by HIV/AIDS. Prevention may be incorporated as part of initial engagement and assessment of elderly persons, and service packages may be developed for older persons who are infected or provide care for HIV-infected persons. Issues of confidentiality, social support, family care, and nondiscrimination are critical concerns in serving this population.
Sustaining Informal Caregivers for Persons with AIDS
Authors: Wardlaw Linda A.
Published: August 2018

Friends, partners, and relatives of persons with HIV/AIDS face significant challenges in providing for the emotional, physical, and practical needs of their loved ones. Moreover, the responsibilities of caregiving often disrupt work life, finances, living arrangements, and relationships with family and friends as well as tax the emotional and physical well-being of the caregiver. The author reports on the experiences of 642 informal caregivers to persons with AIDS in order to identify the type of care provided; the physical, emotional, and financial costs of caring for a loved one with AIDS; the resources available to assist caregivers; and the benefits of providing such care.
Adjustment of Children from Maritally Violent Homes
Authors: O'Keefe Maura
Published: August 2018

The author examines various risk and protective factors at multiple system levels that mediate the impact of marital violence on child adjustment. Participants included 185 children and their mothers who were residing at battered women's shelters. Numerous risk and protective factors are identified, and the implications of the findings for clinical intervention are discussed.
Training for Family Preservation Practice with Lesbian Families
Authors: Faria Geraldine
Published: August 2018

To work effectively with lesbian families, family preservation workers must be equipped with additional knowledge and skills beyond those usually provided in family preservation curricula. The author discusses the specific content that should be included in a family preservation curriculum to address the needs of lesbian families and presents three case examples.
Social Work and the Concept of Individualism
Authors: Dean Harvey
Published: August 2018

The author examines current challenges to the concept of individualism as they relate to social work's guiding principle of person-in-environment and to clinical social work practice. Feminist and constructionist thinking help broaden social work's conceptualization of the individual and his or her relationship to the environment. Implications for clinical social work practice are presented.
Filipino American Culture and Family: Guidelines for Practitioners
Authors: Agbayani-Siewert Pauline
Published: August 2018

The author introduces relevant information about Filipino American culture and families in three subcategories: family and extended-family values, marital relations, and children. Guidelines for social work practice with Filipino Americans are offered.
Family Service Executives in a Hostile Environment
Authors: Perlmutter Felice Davidson , Adams Carolyn Teich
Published: August 2018

Dramatic changes in human services funding in the 1980s prompted a redefinition of leadership in family service agencies. In this study of family service executives, attention is focused on changes in the roles executives play within their agencies, the skills they need, and the problems they face in the current environment. Their involvement in advocacy activity is discussed. The authors conclude that the future viability of the voluntary social service sector is tied to the type of leadership provided by agency executives.
Support Networks of Primary Caregivers Receiving Family Preservation Services: An Exploratory Study
Authors: Tracy Elizabeth M. , Whittaker James K. , Pugh Ann , Kapp Stephen N. , Overstreet Edward J.
Published: August 2018

The authors describe network characteristics and support resources from a clinical sample of 40 families. Data were obtained by family workers during the first two weeks of intervention. Case vignettes illustrate the multiple uses to which this information was put. Implications for future research and practice are discussed.
The Use of Culturagrams to Assess and Empower Culturally Diverse Families
Authors: Congress Elaine P.
Published: August 2018

The culturagram was developed in response to the cultural diversity of families and the need for ethnic-sensitive practice. This family-assessment tool assesses (1) reasons for immigration; (2) length of time in community; (3) legal status; (4) age at time of immigration; (5) language spoken at home and in the community; (6) health beliefs; (7) celebrated holidays and special events; (8) impact of crisis events; (9) values regarding family, education, and work; and (10) contact with cultural institutions. With the culturagram, social workers are able to assess the impact of culture on the family, individualize ethnically similar families, become more empathic with regard to cultural differences, and empower culturally diverse clients and their families.
Integrating Systemic and Postsystemic Approaches to Social Work Practice with Refugee Families
Authors: Kelley Patricia
Published: August 2018

The author assesses the potential of integrating systemic and postsystemic theories for therapeutic social work practice with refugee families. These families face problems as they experience rapid transitions. Crucial interventions are examined.
Extinguishing the Fires Within: Treating Juvenile Firesetters
Authors: Raines James C. , Foy Catherine Weigel
Published: August 2018

Children younger than 18 set approximately 60% of the incendiary fires in large cities. The authors review the history of psychological explanations for firesetting and examine the current research regarding this phenomenon. The authors also review treatment approaches for juvenile firesetters, including behavior modification, psychodynamic therapy, family approaches, cognitive therapy, and group work. Critical considerations for effective treat' ment, including bereavement and disfigurement, are presented. Clinical examples are provided throughout the article.
The Zweymüller Cementless Total HIP Prosthesis in Patients Aged 50 Years and Younger
Authors: Vervest T.M.J.S. , Anderson P.G.
Published: August 2018

Sixty-eight young patients (74 prostheses), mean age 43 years (standard deviation 7. 7) at the time of the index operation, with a Zweymüller cementless total hip prosthesis were evaluated with a mean follow-up time of 75 months (SD 15.7). At follow-up, the mean Harris Hip Score was 94 (SD 8.1). Six stem prostheses had vertical subsidence and nine cups showed signs indicating possible loosening. The Oxford Hip Score averaged 19 points (SD 8.7). Revision surgery was performed for septic loosening (n=3 stem and cup prostheses), for aseptic loosening of the cup (n=2), and for a traumatic periprosthetic fracture (n=1 stem). Worst case survival analysis for aseptic loosening of the cup showed a probability for revision of 3% (Cl95 0 - 7.2%) with a cumulative survival of 96% (Cl95 100 - 90.3%) after 84 months. For the stem prostheses the probability for revision was 1% (Cl95 0 - 4.3%) after 114 months with a cumulative survival of 99% (Cl95 100 - 95.8%) after 72 months. Worst case cumulative survival for any reason of revision was 94.5% (Cl95 99.9 - 89.2%) after 81 months. Promising results of the Zweymüller cementless hip prosthesis for the younger patient were obtained, although longer follow-up will be necessary.
Prospective associations between childhood externalising and internalising problems and adolescent alcohol and drug use
Authors: Heradstveit Ove , Skogen Jens Christoffer , Bøe Tormod , Hetland Jørn , Pedersen Mads Uffe , Hysing Mari
Published: August 2018

Aims:

The literature on associations between internalising problems and subsequent alcohol/drug use and problems shows mixed results, and it is important to consider different aspects of internalising problems along with co-occurring externalising problems.

Methods:

In a longitudinal study ( n = 2438) followed up when the subjects were 7–9, 11–13, and 16–19 years of age, we investigated associations between parent/teacher-reported externalising and internalising problems (Strengths and Difficulties Questionnaire, SDQ) and adolescent self-reported alcohol and illicit drug use and problems. Socioeconomic status (SES), gender, and age were included as potential confounding variables. We also adjusted for the potential confounding effects from externalising problems on the association between internalising problems and alcohol/drug use, and vice versa.

Results:

Externalising problems were positively associated with all measures of alcohol/drug use and problems (adjusted odds ratios [ AORs] ranging from 1.24 to 1.40, all p < .05), while internalising problems were negatively associated with all measures of alcohol/drug use ( AORs ranging 0.83 to 0.88, all p < .05). Full-scale SDQ externalising problems were somewhat stronger and more robust predictors of adolescent alcohol/drug-related problems compared with SDQ externalising subscales, while only full-scale SDQ internalising problems were negatively associated with alcohol/drug-related problems. All estimates were similar across genders.

Conclusions:

Childhood externalising problems are positively associated while internalising problems are negatively associated with alcohol/drug use and problems in late adolescence.
Fan tonal noise from aircraft aeroengines with short intake: A study at approach
Authors: Guérin S , Holewa A
Published: August 2018

This work assesses the risks of increased fan noise for high bypass ratio aeroengines with short intakes. The close proximity between the fan and inlet contributes to the increase in radiation of the rotor-alone tones and reinforces the interaction of the inflow distortion with the fan. Thus, the closer the fan is to the inlet, the higher the risk for noise generation. This article discusses the results of Harmonic Balance simulations performed on a conceptual turbofan operated at the approach condition. The inflow distortion created by the nacelle incidence is dominated by the circumferential component [Formula: see text] = 1. Its presence is visible throughout the nacelle. A thorough analysis of the unsteady pressure and velocity fields shows that the new acoustic source created by the periodic unsteady loading of the rotor cutting the inflow distortion is negligible compared to the rotor–stator interaction. But the amplitude of the rotor–stator interaction tones is affected by the unsteadiness of the rotor wake shape, particularly in the tip region where a pronounced flow separation on the rotor blade is created at a certain range of azimuthal position. The variations of the flow incidence at the rotor leading edge, due to the axial and tangential components of the mean velocity, cannot explain that flow separation. Instead, the origin is attributed to the azimuthal variations of the radial component of the mean flow velocity near the casing which slightly points inward to the spinner, i.e. in the opposite direction of the casing contour line. The flow separation induces a pronounced scattering of the wake azimuthal components mw =  hB into [Formula: see text] in the tip region, whereas the same effect is rather limited on the rest of the blade height. This leads to a moderate increase of the tonal sound power level compared to the case with clean inflow. The azimuthal scattering due to the propagation of the sound waves through the distortion is found to be weak in the bypass duct. However, this effect is very important in the inlet lip vicinity, where the strong asymmetry of the flow modifies the path of the sound waves up to the far field.
Target visibility under mesopic vision using a driving simulator
Authors: Chen Z , Tu Y , Wang Z , Liu L , Wang L , Lou D , Zhu X , Teunissen K
Published: August 2018

Small target visibility is widely used to evaluate the quality of road lighting. It provides a link between lighting design and driving performance. However, it is based on a strong simplification of the driving task using psychophysical data from laboratory conditions. Using a driving simulator to mimic the real driving environment, the impact of driving workload on target detection performance in mesopic vision conditions has been evaluated. The target visibility level is studied with and without driving workload together with different luminance contrasts and target positions, with reference to the small target visibility scenario. The results show that the driving workload significantly reduces the target detection performance. Consequently, the visibility level value for driving conditions should be much higher (visibility level ≥21) than some currently recommended ones (visibility level = 7) to achieve the same detection rates. Effects of target position and contrast are found in a way consistent with the literature. In addition, results indicate that the small target visibility model used for road lighting is limited and needs to be improved for a reliable prediction of visual performance with driving workload.
A solution method for one-dimensional shallow water equations using flux limiter centered scheme for open Venturi channels
Authors: Welahettige Prasanna , Vaagsaether Knut , Lie Bernt
Published: August 2018

The one-dimensional shallow water equations were modified for a Venturi contraction and expansion in a rectangular open channel to achieve more accurate results than with the conventional one-dimensional shallow water equations. The wall-reflection pressure–force coming from the contraction and the expansion walls was added as a new term into the conventional shallow water equations. In the contraction region, the wall-reflection pressure–force acts opposite to the flow direction; in the expansion region, it acts with the flow direction. The total variation diminishing scheme and the explicit Runge–Kutta fourth-order method were used for solving the modified shallow water equations. The wall-reflection pressure–force effect was counted in the pure advection term, and it was considered for the calculations in each discretized cell face. The conventional shallow water equations produced an artificial flux due to the bottom width variation in the contraction and expansion regions. The modified shallow water equations can be used for both prismatic and nonprismatic channels. When applied to a prismatic channel, the equations become the conventional shallow water equations. The other advantage of the modified shallow water equations is their simplicity. The simulated results were validated with experimental results and three-dimensional computational fluid dynamics result. The modified shallow water equations well matched the experimental results in both unsteady and steady state.
Evaluation of open reduction and internal fixation of proximal humerus fractures using a locking plate with smooth pegs – A retrospective study
Authors: Hansson Frida , Riddar Magdalena , Ekelund Anders
Published: August 2018

Background

Optimal treatment of displaced proximal humeral fractures is controversial. This retrospective study aims to identify complications and clinical outcomes using a locking plate with smooth pegs instead of screws (S3 plate).

Method

Eighty-two patients with displaced proximal humeral fracture classified with 2–4 fragments (Neer’s classification) treated with open reduction and internal fixation (ORIF) with S3 plate were studied retrospectively. Clinical outcome according to constant score; Single Shoulder Value; Disabilities of Arm, Shoulder and Hand; and European Quality of life-5 dimensions and complication rate defined radiologically including peg penetration, avascular necrosis, and loss of reduction was assessed minimum 2.5 years after surgery.

Results

A total of 11 peg penetrations were identified (13.6%). Avascular necrosis was seen in 8.5% (n = 7). Mean constant score at follow-up was 64.4 with a relative constant score of 87% (standard deviation 18%) compared to the contralateral uninjured side. The mean Disabilities of Arm, Shoulder and Hand score was 12.7 and mean European Quality of life-5 dimensions score 0.83. The mean Single Shoulder Value was 78.3. No cases of deep infection were seen.

Conclusions

Fixation with S3 plate shows a proper osteosynthesis and the functional outcome is good. Symptomatic peg penetrations are rare and the incidence is lower compared to what has been reported with locked screws.
Do Status-Legitimizing Beliefs Moderate Effects of Racial Progress on Perceptions of Anti-White Bias? A Replication of Wilkins and Kaiser (2014)
Authors: Crawford Jarret T. , Vodapalli Shreya , Stingel Ryan E. , Ruscio John
Published: August 2018

In three studies, Wilkins and Kaiser found that both chronic and experimental salience of racial progress in the United States increased the perceptions of anti-White bias only among people high in status-legitimizing beliefs (SLBs). We conducted four preregistered high-powered replications of this research. Studies 1, 2, and 3a were close replications of studies 1–3, respectively. Study 3b was a close replication that included an additional experimental condition. Contrary to the original findings, none of the four expected interaction effects tested were statistically significant in the predicted direction, and only one of the four survived a “small telescopes” analysis. We provide additional tests addressing whether changing social contexts explain our failures to replicate, with mixed conclusions. Whereas it is possible that changing social contexts may have eliminated a once true effect, it is also possible that the original results were false positives.
Amodal Presence and the Bounce/Stream Illusion
Authors: Anstis Stuart
Published: August 2018

Ambiguous bounce/stream collision points were hidden behind an occluder so that observers had to complete them amodally. In Movie 1, straight or curved static lines were painted on the occluder. In Movie 2, dotted textures flowed in straight or curved lines across the front of the occluder. In Movie 3, moving eyes, painted on the occluder, either moved in straight lines, as if tracking streaming spots, or else followed curved paths, as if tracking bouncing spots. The straight (or curved) lines, texture flow or eye movements led to judgments of streaming (or bouncing). These effects demonstrate the role of attention and expectations in disambiguating bounce/stream stimuli.
Neoadjuvant Chemoradiotherapy Followed by Surgery Versus Surgery Alone for Locally Advanced Squamous Cell Carcinoma of the Esophagus (NEOCRTEC5010): A Phase III Multicenter, Randomized, Open-Label Clinical Trial
Authors: Yang Hong , Liu Hui , Chen Yuping , Zhu Chengchu , Fang Wentao , Yu Zhentao , Mao Weimin , Xiang Jiaqing , Han Yongtao , Chen Zhijian , Yang Haihua , Wang Jiaming , Pang Qingsong , Zheng Xiao , Yang Huanjun , Li Tao , Lordick Florian , D’Journo Xavier Benoit , Cerfolio Robert J. , Korst Robert J. , Novoa Nuria M. , Swanson Scott J. , Brunelli Alessandro , Ismail Mahmoud , Fernando Hiran C. , Zhang Xu , Li Qun , Wang Geng , Chen Baofu , Mao Teng , Kong Min , Guo Xufeng , Lin Ting , Liu Mengzhong , Fu Jianhua ,   on behalf of the AME Thoracic Surgery Collaborative Group
Published: August 2018

Purpose

The efficacy of neoadjuvant chemoradiotherapy (NCRT) plus surgery for locally advanced esophageal squamous cell carcinoma (ESCC) remains controversial. In this trial, we compared the survival and safety of NCRT plus surgery with surgery alone in patients with locally advanced ESCC.

Patients and Methods

From June 2007 to December 2014, 451 patients with potentially resectable thoracic ESCC, clinically staged as T1-4N1M0/T4N0M0, were randomly allocated to NCRT plus surgery (group CRT; n = 224) and surgery alone (group S; n = 227). In group CRT, patients received vinorelbine 25 mg/m2 intravenously (IV) on days 1 and 8 and cisplatin 75 mg/m2 IV day 1, or 25 mg/m2 IV on days 1 to 4 every 3 weeks for two cycles, with a total concurrent radiation dose of 40.0 Gy administered in 20 fractions of 2.0 Gy on 5 days per week. In both groups, patients underwent McKeown or Ivor Lewis esophagectomy. The primary end point was overall survival.

Results

The pathologic complete response rate was 43.2% in group CRT. Compared with group S, group CRT had a higher R0 resection rate (98.4% v 91.2%; P = .002), a better median overall survival (100.1 months v 66.5 months; hazard ratio, 0.71; 95% CI, 0.53 to 0.96; P = .025), and a prolonged disease-free survival (100.1 months v 41.7 months; hazard ratio, 0.58; 95% CI, 0.43 to 0.78; P < .001). Leukopenia (48.9%) and neutropenia (45.7%) were the most common grade 3 or 4 adverse events during chemoradiotherapy. Incidences of postoperative complications were similar between groups, with the exception of arrhythmia (group CRT: 13% v group S: 4.0%; P = .001). Peritreatment mortality was 2.2% in group CRT versus 0.4% in group S ( P = .212).

Conclusion

This trial shows that NCRT plus surgery improves survival over surgery alone among patients with locally advanced ESCC, with acceptable and manageable adverse events.
Genomic Landscape of Appendiceal Neoplasms
Authors: Ang Celina S.-P. , Shen John Paul , Hardy-Abeloos Camille J. , Huang Justin K. , Ross Jeffrey S. , Miller Vincent A. , Jacobs Miriam T. , Chen Ingrid L. , Xu David , Ali Siraj M. , Baumgartner Joel , Lowy Andrew , Fanta Paul , Ideker Trey , Millis Sherri Z. , Harismendy Olivier
Published: August 2018

Purpose

Appendiceal neoplasms are heterogeneous and are often treated with chemotherapy similarly to colorectal cancer (CRC). Genomic profiling was performed on 703 appendiceal cancer specimens to compare the mutation profiles of appendiceal subtypes to CRC and other cancers, with the ultimate aim to identify potential biomarkers and novel therapeutic targets.

Methods

Tumor specimens were submitted to a Clinical Laboratory Improvement Amendments–certified laboratory (Foundation Medicine, Cambridge, MA) for hybrid-capture–based sequencing of 3,769 exons from 315 cancer-related genes and 47 introns of 28 genes commonly rearranged in cancer. Interactions between genotype, histologic subtype, treatment, and overall survival (OS) were analyzed in a clinically annotated subset of 76 cases.

Results

There were five major histopathologic subtypes: mucinous adenocarcinomas (46%), adenocarcinomas (30%), goblet cell carcinoids (12%), pseudomyxoma peritonei (7.7%), and signet ring cell carcinomas (5.2%). KRAS (35% to 81%) and GNAS (8% to 72%) were the most frequent alterations in epithelial cancers; APC and TP53 mutations were significantly less frequent in appendiceal cancers relative to CRC. Low-grade and high-grade tumors were enriched for GNAS and TP53 mutations, respectively (both χ2 P < .001). GNAS and TP53 were mutually exclusive (Bonferroni corrected P < .001). Tumor grade and TP53 mutation status independently predicted OS. The mutation status of GNAS and TP53 strongly predicted OS (median, 37.1 months for TP53 mutant v 75.8 GNAS- TP53 wild type v 115.5 GNAS mutant; log-rank P = .0031) and performed as well as grade in risk stratifying patients.

Conclusion

Epithelial appendiceal cancers and goblet cell carcinoids show differences in KRAS and GNAS mutation frequencies and have mutation profiles distinct from CRC. This study highlights the benefit of performing molecular profiling on rare tumors to identify prognostic and predictive biomarkers and new therapeutic targets.
Precision Medicine for Relapsed Multiple Myeloma on the Basis of an Integrative Multiomics Approach
Authors: Laganà Alessandro , Beno Itai , Melnekoff David , Leshchenko Violetta , Madduri Deepu , Ramdas Dennis , Sanchez Larysa , Niglio Scot , Perumal Deepak , Kidd Brian A. , Miotto Riccardo , Houldsworth Jane , Shaknovich Rita , Chari Ajai , Cho Hearn Jay , Barlogie Bart , Jagannath Sundar , Dudley Joel T. , Parekh Samir
Published: August 2018

Purpose

Multiple myeloma (MM) is a malignancy of plasma cells, with a median survival of 6 years. Despite recent therapeutic advancements, relapse remains mostly inevitable, and the disease is fatal in the majority of patients. A major challenge in the treatment of patients with relapsed MM is the timely identification of treatment options in a personalized manner. Current approaches in precision oncology aim at matching specific DNA mutations to drugs, but incorporation of genome-wide RNA profiles has not yet been clinically assessed.

Methods

We have developed a novel computational platform for precision medicine of relapsed and/or refractory MM on the basis of DNA and RNA sequencing. Our approach expands on the traditional DNA-based approaches by integrating somatic mutations and copy number alterations with RNA-based drug repurposing and pathway analysis. We tested our approach in a pilot precision medicine clinical trial with 64 patients with relapsed and/or refractory MM.

Results

We generated treatment recommendations in 63 of 64 patients. Twenty-six patients had treatment implemented, and 21 were assessable. Of these, 11 received a drug that was based on RNA findings, eight received a drug that was based on DNA, and two received a drug that was based on both RNA and DNA. Sixteen of the 21 evaluable patients had a clinical response (ie, reduction of disease marker ≥ 25%), giving a clinical benefit rate of 76% and an overall response rate of 66%, with five patients having ongoing responses at the end of the trial. The median duration of response was 131 days.

Conclusion

Our results show that a comprehensive sequencing approach can identify viable options in patients with relapsed and/or refractory myeloma, and they represent proof of principle of how RNA sequencing can contribute beyond DNA mutation analysis to the development of a reliable drug recommendation tool.
Normobaric Hypoxia Reduces V˙O2 at Different Intensities in Highly Trained Runners
Authors: SHARMA AVISH P. , SAUNDERS PHILO U. , GARVICAN-LEWIS LAURA A. , CLARK BRAD , GORE CHRISTOPHER J. , THOMPSON KEVIN G. , PÉRIARD JULIEN D.
Published: August 2018

Introduction

We sought to determine the effect of low and moderate normobaric hypoxia on oxygen consumption and anaerobic contribution during interval running at different exercise intensities.

Methods

Eight runners (age, 25 ± 7 yr, V˙O2max: 72.1 ± 5.6 mL·kg−1·min−1) completed three separate interval sessions at threshold (4 × 5 min, 2-min recovery), V˙O2max (8 × 90 s, 90-s recovery), and race pace (10 × 45 s, 1 min 45 s recovery) in each of; normoxia (elevation: 580 m, FiO2: 0.21), low (1400 m, 0.195) or moderate (2100 m, 0.18) normobaric hypoxia. The absolute running speed for each intensity was kept the same at each altitude to evaluate the effect of FiO2 on physiological responses. Expired gas was collected throughout each session, with total V˙O2 and accumulated oxygen deficit calculated. Data were compared using repeated-measures ANOVA.

Results

There were significant differences between training sessions for peak and total V˙O2, and anaerobic contribution (P < 0.001, P = 0.01 respectively), with race pace sessions eliciting the lowest and highest responses respectively. Compared to 580 m, total V˙O2 at 2100 m was significantly lower (P < 0.05), and anaerobic contribution significantly higher (P < 0.05) during both threshold and V˙O2max sessions. No significant differences were observed between altitudes for race pace sessions.

Conclusions

To maintain oxygen flux, completing acute exercise at threshold and V˙O2max intensity at 1400 m simulated altitude appears more beneficial compared with 2100 m. However, remaining at moderate altitude is a suitable when increasing the anaerobic contribution to exercise is a targeted response to training.
Current status and advances in ram semen cryopreservation
Authors: NTEMKA A. , TSAKMAKIDIS I. A. , KIOSSIS E. , MILOVANOVIĆ A. , BOSCOS C. M.
Published: August 2018

Ram semen cryopreservation contributes to genetic improvement through artificial insemination, eliminates geographical barriers in artificial insemination application and supports the preservation of endangered breeds thus the conservation of biodiversity. Sperm freezing process induces ultrastructural, biochemical and functional changes of spermatozoa. Especially, spermatozoa’s membranes and chromatin can be damaged, sperm membranes’ permeability is increased, hyper oxidation and formation of reactive oxygen species takes place, affecting fertilizing ability and subsequent early embryonic development. Aiming to improve ram frozen-thawed semen’s fertilizing capacity, many scientific investigations took place. Among them the composition of semen extenders, was a main point of interest. Semen preservation extenders regulate and support an environment of adequate pH and buffering capacity to protect spermatozoa from osmotic and cryogenic stress. Therefore, permeating (glycerol, dimethyl sulfoxide) and non-permeat ing (egg yolk, skimmed milk) cryoprotectants, sugars (glucose, lactose, trehalose, raffinose), salts (sodium citrate, citric acid) and antioxidants (amino acids, vitamins, enzymes) have been added and tested. Moreover, semen dilution rate, storage temperature, cooling rate and thawing protocol, are also some key factors that have been studied. The research results of this scientific topic are encouraging, not only about the freezing and thawing procedures, but also about the improvement of the additives’ properties. However, further research is needed to enhance the fertilizing ability of ram frozen-thawed semen, making its use practical in sheep reproductive management by the application of cervical artificial insemination.
Effects of testosterone administration and feeding level on reproductive activity in sexually inactive goat bucks
Authors: DE SANTIAGO A. , ALVARADO J. F. , LÓPEZ A. G. , TRUJILLO G. , ÁLVAREZ M. M. , MELLADO M.
Published: August 2018

The aim of this study was to investigate the effect of the administration of testosterone to a well-fed or underfed sexually inactive goat bucks on their sexual behavior and semen characteristics. Twenty sexually experienced mixed-breed goat bucks (1.5 years of age) were randomly assigned to one of four treatments for a period of 71 days. Treatments consisted of diets with amount of nutrients to meet 1.0 times the nutrient maintenance requirements with the application of 25 mg testosterone every third day during 21 d (treatment 1T) or saline (treatment 1C). A third and fourth treatments received a diet 1/2 times the nutrient maintenance requirements with testosterone (1/2T) or saline (1/2C). Bucks on 1T and 1C had higher body weight, body condition score and scrotal circumference compared to 1/2T and 1/2C (P<0.05). Also, bucks on 1T and 1/2T had higher sexual odor compared to 1C and 1/2C (P<0.05). Mean serum testosterone concentrations were highest in 1T (4.78 ± 6.78 ng/ml) and lowest in 1/2C (0.56 ± 0.96 ng/ml; P<0.01). Semen volume, sperm concentration, and mass motility were not affected by treatments, but sperm progressive motility was lower (P<0.05) in 1/2C (46%) than the other treatments (52 to 57%). Courtship traits and mounts were more frequent (P<0.05) in 1T compared with the other treatments. Likewise, bucks in the 1T group had the shortest latency to first mount (82 seconds) compared to other treatments (110 to 164 seconds). These results indicate that testosterone administration to well-fed sexually inactive bucks provokes clearly defined sexual activity during the non-breeding season. However, these benefits are overridden by underfeeding goat bucks.
Continence care education: views of students and registered nurses
Authors: Ferdinand Sarah
Published: August 2018

Background:

this article reports on a study of continence education and training for students and qualified nurses.

Aims:

to understand how nurses and nursing students gain their knowledge in continence education and training, to examine nurses' understanding of bladder and bowel care and to discover to what degree nurses are confident in their knowledge of bladder and bowel care.

Methods:

this was a qualitative enquiry and a case study methodology was used to frame the research. The data were captured through a questionnaire and group discussions.

Findings:

continence education comprised support through self-learning, classroom instruction, skills laboratory sessions and on the wards. Feedback from participants indicated that, although continence education enhanced learning, they thought continence education sessions were either too short or did not go into enough detail. Two key factors that limited learning in the workplace were time and work priorities.

Conclusion:

it is recommended that a combination of learning strategies is useful and valuable in developing the nurse's skills and knowledge of continence care, if time and funding are available.
Between Text and Discourse: Re-Theorizing Islamic Orthodoxy
Authors: Mohammed Sulaiman
Published: August 2018

This article will examine the concept of orthodoxy as it appears in the work of Talal Asad and two of his interlocutors, namely Ovamir Anjum and Shahab Ahmed. In response to Ahmed’s critique of Asad which attempts to dislocate orthodoxy as constitutive of Islam, this article employs the distinction Anjum draws between local and universal orthodoxy and theorizes it from a discourse-theoretical perspective. Hence, it will be argued that universal orthodoxy is central to Islamic discursive tradition because it is the limit which preserves Islam’s singularity and allows it to exist as a unified universe of meaning. Furthermore, against Ahmed’s contention that orthodoxy cannot account for Islamic philosophy1 and Sufism as Islamic discourses because it is an inherently exclusionary concept, I will demonstrate that exclusionary limits are necessary for the formation of all discourses including Sufism and Islamic philosophy. Displacing orthodoxy effectively amounts to subverting the singularity of Islam and reproduces the pitfalls of anti-essentialist approaches.