bluuebunny/crossref_metadata_2025 huggingface dataset:
“Better pathways of Care”: Suggested Improvements to the Emergency Department management of People with Advanced Cancer
Authors: Jelinek George A. , Boughey Mark , Marck Claudia H. , Phillip Jennifer , Weil Jennifer , Lane Heather , Weiland Tracey J.
Published: December 2018

Objective: It is difficult to provide optimal care to people with advanced cancer presenting to emergency departments (EDs). Recent data suggest that the ED environment, the skills and priorities of treating staff, and the lack of clear communication related to goals of care contribute to the difficulty. By exploring the views of emergency, palliative care (PC), and oncology clinicians on the care of these patients, this study aimed to describe potential solutions. Methods: This qualitative study involved focus groups with clinicians at two major hospitals and two community PC services in Melbourne, Australia, and semi-structured telephone interviews with emergency clinicians from all other Australian states and territories. Discussions were recorded and transcribed verbatim. Thematic analysis identified ways to improve or enhance care. Results: Throughout discussions with 94 clinicians, a number of possible improvements to care were raised; these were broadly grouped into service areas: clinical care, pathways, information access, and education. Conclusion: The provision of care to patients with advanced cancer in the ED occurs across sites, across disciplines, and across teams. To make improvements to care, we must address these complexities. The improvements suggested in this study place the patient (and the patient's family) at the centre of care.
Is Performance Status Associated with Symptom Scores?
Authors: Sutradhar Rinku , Atzema Clare , Seow Hsien , Earle Craig , Porter Joan , Howell Doris , Dudgeon Deborah , Barbera Lisa
Published: December 2018

Background: Symptom scores and performance status are both important measures for patients with cancer. However, since performance status is not often part of routinely collected data, there is interest in exploring whether it can be calculated from symptom scores. Methods: This was a population-based longitudinal study of cancer outpatients in Ontario, Canada in the year following their cancer diagnosis and among the subset of patients during the last year of their lives. Results: In the first year after diagnosis, there was a significant relationship between performance status and fatigue and appetite; fatigue and well-being had a significant association with performance status in the last year of life. In both periods, the associations, although statistically significant, were not large enough to be clinically meaningful. Conclusion: Performance status is an important measurement that cannot be substituted or captured with symptom scores; it is important for healthcare providers to record performance scores on a regular basis.
Cancer cell membrane–coated nanocarriers for homologous target inhibiting the growth of hepatocellular carcinoma
Authors: Xu Lei , Wu Shuo , Wang Jun
Published: December 2018

The cancer cell–specific targeting and controlled drug delivery at the cancer site still remain the main challenges for anticancer therapy. A cancer cell membrane–camouflaged nanoparticle can achieve specific recognition, long circulation time, and immune escaping, owing to the coated special cancer cell membrane structure. Here, using the advantages of cancer cell membrane, we fabricated cancer cell membrane–coated poly(lactide-co-glycolide)–doxorubicin nanoparticles to enhance the antitumor efficiency in vivo. The cancer cell membrane–coated poly(lactide-co-glycolide)–doxorubicin nanoparticles exhibited an obvious core–shell nanostructure consisting of a poly(lactide-co-glycolide)–doxorubicin core and a cancer cell membrane shell with a particle size of about 100 nm and a zeta potential at −29.49 mV. Benefited from the homologous binding adhesion molecules from the cancer cell membrane, the cancer cell membrane–coated poly(lactide-co-glycolide)–doxorubicin nanoparticles significantly enhanced the cellular endocytosis of doxorubicin compared to poly(lactide-co-glycolide)–doxorubicin nanoparticles toward HepG2 cells and exhibited satisfactory antitumor effect in vitro. In the in vivo mice bearing HepG2 xenograft mouse models, the cancer cell membrane–coated poly(lactide-co-glycolide)–doxorubicin nanoparticles achieved satisfactory antitumor effect and depressed system toxicity when compared with free doxorubicin, owing to the prolonged blood circulation, effective immune escape, and enhanced doxorubicin accumulation at the tumor site. The robust cancer cell membrane–coated poly(lactide-co-glycolide)–doxorubicin nanoparticles with homologous properties of the cancer cell membrane provide an effective mimetic therapy for inhibiting the growth of HepG2 cells. With simple compositions and satisfactory therapeutic effects, cancer cell membrane–coated poly(lactide-co-glycolide)–doxorubicin nanoparticles can be a promising nanodelivery system for the future therapy of hepatocellular carcinoma.
Novel Vasopressors in the Treatment of Vasodilatory Shock: A Systematic Review of Angiotensin II, Selepressin, and Terlipressin
Authors: Rodriguez Ryan , Cucci Michaelia , Kane Sean , Fernandez Erica , Benken Scott
Published: December 2018

Study Objective:

Vasodilatory shock is the most common type of shock. Catecholamine vasopressors are the cornerstone of hemodynamic therapy but carry risks. Angiotensin II (AT2) was recently approved, and other novel agents (selepressin and terlipressin) are under investigation and used outside the United States (terlipressin). We performed a systematic review to summarize the efficacy and safety of these novel vasopressors and to offer guidance on their appropriate use.

Design:

Systematic review of controlled trials.

Methods:

Numerous databases were searched using terms related to angiotensin II, selepressin, terlipressin, vasopressor, and shock. Twenty-one citations, including 16 prospective comparative trials and 5 post hoc analyses reporting effects of AT2, selepressin, and terlipressin, were reviewed for data on outcomes related to hemodynamic measures, mortality, severity and duration of illness, concomitant vasopressor utilization, and adverse effects. Findings from eligible literature are described qualitatively using Cochrane methods.

Results:

Fourteen controlled trials were assessed after exclusion of 2 dated trials of a distinct AT2 formulation. Trials are limited for AT2 (n = 2) and selepressin (n = 1), while terlipressin was investigated in 11 small trials. Overall, the trials have an unclear risk of bias. Most report mean arterial pressure (MAP) as primary end point, and all indicate novel vasopressors increase MAP compared to placebo and to a similar degree as with catecholamine vasopressors. Mortality findings are preliminary, as they have been limited to specific subgroups in trials of terlipressin and post hoc analyses of one trial of AT2. Trials reported safety concerns for each agent including thromboembolism with AT2 and ischemia with terlipressin/selepressin.

Conclusion:

In this systematic review, controlled trials of novel vasopressors in treatment of vasodilatory shock were limited and of low quality. Angiotensin II, selepressin, and terlipressin appear to significantly increase MAP, but further study is required, particularly for selepressin, to determine their safety, efficacy, and role in treatment of vasodilatory shock.
Sexual Revictimization in College Women: Mediational Analyses Testing Hypothesized Mechanisms for Sexual Coercion and Sexual Assault
Authors: Norris Alyssa L. , Carey Kate B. , Shepardson Robyn L. , Carey Michael P.
Published: December 2018

A precollege history of sexual victimization predicts revictimization during college, making it important to understand the mechanisms underlying the victimization-to-revictimization pathway. The study aimed to test whether heavy episodic drinking and personal and peer hookup norms mediate revictimization for two types of unwanted sexual contact: sexual coercion (attempted and/or completed sexual assault by the use of verbal coercion) and sexual assault (attempted and/or completed sexual assault by the use of force, threats, or incapacitation). At college entry, 483 first-year college women completed self-report measures of their precollege experiences, including history of sexual victimization and health behaviors (i.e., alcohol use, personal and peer hookup norms). At the end of the first and second semesters, they also completed measures assessing incident sexual victimization. Nearly one half of women (48%) reported an experience of attempted or completed sexual coercion or assault prior to entering college; 33% endorsed sexual coercion and 15% endorsed sexual assault in their first year of college. Structural equation models demonstrated that heavy episodic drinking and personal and peer hookup norms partially mediated revictimization for sexual assault, but not for sexual coercion. Sexual coercion was the most common tactic leading to unwanted sexual contact in this sample. Alcohol use and personal and peer hookup norms mediated revictimization by force, threats, or incapacitation. In contrast, the hypothesized mediators did not explain the revictimization pathway for verbally coerced assaults. Given the prevalence of sexual coercion, research needs to identify risk factors for verbal coercion to guide prevention efforts.
Effect of stirring time on the mechanical behavior of friction stir spot weld of Al 6061-T6 lap-shear configuration
Authors: Shahani Amirreza , Farrahi Ali
Published: December 2018

The effect of five different stirring times of friction stir spot welding on lap-shear specimens of Al 6061-T6 alloy has been experimentally analyzed. The welding condition with 2 s of stirring shows the optimum mechanical behavior in comparison to the others. The static strength and fatigue behavior of the joint are justified using the microhardness profiles. The static results prove that the increase of stirring time beyond the 2 s case has little effect on improving the static strength. The fatigue results reveal two different failure modes, which are shear fracture at high load levels and transverse crack growth at low load levels. At medium load levels, although the final failure is similar to high load levels, the transverse growth of the crack outside the welding zone, just like low load levels, is also observed.
Studies on the performance of selective laser melting porous dental implant by finite element model simulation, fatigue testing and in vivo experiments
Authors: Wang Yaling , Chen Xianshuai , Zhang Chunyu , Feng Wei , Zhang Peng , Chen Yang , Huang Jiaming , Luo Yuanxin , Chen Jianyu
Published: December 2018

Biomaterials have been widely used for stomatological reconstructive surgery in recent years. Many studies have demonstrated that the porous structure of an implant promotes bone ingrowth and its stiffness can be controlled via the design of the porosity. Although some researchers have paid attention to investigating the porous structure for dental implants, the biomechanical properties and osseointegration have not been well studied. In this study, finite element analysis and experiments have been used to evaluate the biomechanical performance and osseointegration of dental implants with porous/solid structures fabricated by selective laser melting using commercially pure titanium (CP-Ti, Grade 2). The implants were tested and the fracture surfaces were observed by scanning electron microscope to investigate the failure mechanisms. To reduce bone resorption, the porosity of dental implant was designed to optimize its stiffness. Finally, animal experiments revealed that bone tissue ingrowth was seen into the porous structure. It is believed that the porous dental implants have great potential in future applications.
Uncertainty optimization of dental implant based on finite element method, global sensitivity analysis and support vector regression
Authors: Li Hongyou , Shi Maolin , Liu Xiaomei , Shi Yuying
Published: December 2018

In this work, an uncertainty optimization approach for dental implant is proposed to reduce the stress at implant–bone interface. Finite element method is utilized to calculate the stress at implant–bone interface, and support vector regression is used to replace finite element method to ease the computational cost. Deterministic optimization based on support vector regression is conducted, which demonstrates that the method using support vector regression replacing finite element method in dental implant optimization is efficient and reliable. Global sensitivity analysis based on support vector regression is used to assign different uncertainties (manufacturing errors) to different design variables to save the manufacturing cost. Two popular uncertainty optimization methods, k-sigma method and interval method, are used for the uncertainty optimization of dental implant. The results indicate that the stress at implant–bone interface is reduced greatly considering the uncertainties in design variables with the manufacturing cost increasing a little. This approach can be promoted to other types of bio-implants.
Clinical, immunological and microbial gingival profile of juvenile systemic lupus erythematosus patients
Authors: Sete M R C , Carlos J C , Lira-Junior R , Boström E A , Sztajnbok F R , Figueredo C M
Published: December 2018

Periodontal disease has been associated with rheumatic diseases; however, few studies have evaluated the association with systemic lupus erythematosus (SLE), and its impact on the local inflammatory and microbial profiles. Therefore, this study evaluated the levels of several cytokines in gingival crevicular fluid (GCF) and serum from juvenile SLE (jSLE) patients with gingival inflammation, compared with controls. In addition, we assessed their subgingival microbial profile. Thirty jSLE patients and 29 systemically healthy individuals were recruited. Participants were rheumatologically and periodontally examined, and GCF, serum and intrasulcular biofilm were collected. Cytokines were analysed by bead-based multiplex assays and the bacterial profile by checkerboard DNA–DNA hybridization. jSLE patients presented higher percentages of dental plaque and bleeding than controls, as well as increased mean probing depth and attachment loss. After adjustment for multiple comparisons, GCF levels of interleukin (IL)-1β, IL-8, granulocyte colony-stimulating factor (G-CSF), interferon-γ and monocyte chemoattractant protein-1 were significantly higher, whereas the levels of granulocyte–macrophage colony-stimulating factor were significantly lower in jSLE patients. In serum, G-CSF levels tended to be higher in jSLE patients (adjusted p-value = 0.06). Intrasulcular counts of Aggregatibacter actinomycetemcomitans were significantly higher in jSLE patients as compared with controls. We conclude that patients with jSLE present a worse periodontal condition associated with altered levels of pro-inflammatory cytokines in GCF and increased counts of A. actinomycetemcomitans in the intrasulcular biofilm.
What Do you Need to Get Started in Your Own Career Counselling Practice?
Authors: Abramson Rachel
Published: December 2018

Picture this. You are sitting in your own office. Perhaps you have an office with a view. The name on the door says: (Your Name) & Associates. Or perhaps it says: (Your Name), Career Counsellor. Either way, you are your own boss. You may even have others working for you. You can determine your own salary — pay yourself what you are really worth. You spend your time seeing the kinds of clients you enjoy seeing. You control how you spend every hour of your working day. No. It is no longer a working day; it is your business day.

A colleague might happen past and notice you are there. With delight, your colleague might say: “Wow! When did you set up your own shop? How did you do it? How did you manage to get there?”

Perhaps on reading the above scenario, you are wondering whether it is at all possible. Perhaps you are wondering whether you even have any entrepreneurial skill or the necessary know-how in running a business. This article is the first of a two-part series designed to help you through the process of establishing and running your own business.
Integrating Internet Technology into A Careers
Authors: Rachinger Diane
Published: December 2018

The challenge for careers services at present is how to incorporate Internet technology into their suite of offerings. Many services are “taking the bull by the horns”, so to speak, resulting in the widely accepted and even commonplace use of the Internet by both students and staff. This case study outlines the experience of the Careers and Employer Liaison Unit at The University of Melbourne.
Student perceptions of Career Development and Employment Services in Tafe
Authors: Anderson Damon
Published: December 2018

Career development and employment services in TAFE perform a vital role in terms of providing students with information to make appropriate course and career choices, opportunities to gain work experience, and access to alternative sources of income. This article analyses the findings of a national study of student perceptions of career development and employment services in TAFE. The survey results show that although students rate career development and employment services among the 12 most important support services in TAFE, there is a high degree of dissatisfaction with the current level and quality of provision. The article argues that a significant improvement is required in the provision of career development and employment services if the vocational needs of TAFE students are to be satisfied and student wastage is to be minimised.
The role of the Market in Career Counselling Delivery
Authors: Watts Anthony G. , Watts Tony
Published: December 2018

This article explores the roles of public policy in career guidance delivery. Traditionally, most career guidance services have been structured towards the provision of social welfare to the public sector. The New Right critique of this has led to attempts to apply market principles to guidance delivery. This can take the form of a market or quasi-market in guidance. However, guidance can also be viewed as a market-maker: a means of making the labour market and education and training markets work more effectively. Some experiments in applying these principles in the UK and elsewhere are analysed.
Assessing Disease Knowledge and Self-Management in Youth With Sickle Cell Disease Prior to Transition
Authors: Speller-Brown Barbara , Varty Maureen , Thaniel Lisa , Jacobs Marni B.
Published: December 2018

Introduction: Transition of medical care from pediatrics to adult can be challenging and difficult. Until the 1970s, only half of patients diagnosed with sickle cell disease (SCD) reached adulthood. As a result of patients living longer, there is a growing need to understand factors that influence readiness to transition. This descriptive study examined age-specific SCD knowledge, self-management skills of patients, and education goals in a convenience sample of patients and their parents. Method: One hundred eighty-three transition surveys were distributed during scheduled hematology clinic visits. Surveys were analyzed with descriptive statistics to determine differences of knowledge between age groups, self-care skills, vocational supports, and educational goals. The parent group consists of children aged 0 to 4 years (32), 5 to 8 years (52), 9 to 11 years (12); the child group consists of children aged 9 to 11 years (24) and 12 to 15 years (31); and adolescent and young adult (AYA) group consists of children aged 16 to 21 years (32). Results: Indeed, 50% of parents of the 0 to 4 years age group and 33% of 5 to 8 years age group knew their child’s baseline hemoglobin. Only 38% of patients aged 16 to 21 years knew their baseline hemoglobin. However, 79% of patients aged 9 to 11 years, 74% of patient aged 12 to 15 years, and 78% of AYAs could name their hematology provider. Only 66% of patients aged 16 to 21 years knew what symptoms required medical attention. Discussion: Most patients and parents had adequate basic knowledge regarding SCD. AYAs lack the disease knowledge necessary to transition care away from parents to become more independent. An assessment for transition readiness should be ongoing to include disease-specific knowledge and self-management skills.
Psychological Predictors of Pain in Children and Adolescents With Sickle Cell Disease: A Scoping Review
Authors: Donohoe Clare , Smith Ellen Lavoie
Published: December 2018

Objective: Sickle cell disease (SCD) is a common red blood cell disorder that disrupts the lives of many African Americans and those of Middle Eastern heritage within the United States due to frequent pain. There is limited research quantifying biopsychosocial factors, specifically psychological characteristics, that influence pain in children and adolescents with SCD. The aim of this literature review was to identify psychological characteristics that are predictive or associated with pain in children and adolescents with SCD. Method: This review was conducted using PRISMA guidelines. Four databases, PubMed, CINAHL, PsycINFO, and Scopus, were searched using specific terms to address the aim of the review (SCD, pain, pediatrics and adolescents, and psychological characteristics). Results: The review identified a lack of consensus regarding the definitions and measurement of pain frequency and intensity. A variety of psychological characteristics were associated with pain including coping strategies, anxiety, depressive symptoms, catastrophizing, and stress. Overall, the study designs restricted the ability to fully identify psychological characteristics that predict pain. Conclusions: Health science researchers must strive for a deeper understanding about the presentation of SCD pain and psychological risk factors associated with increased pain to provide targeted screening and treatment.
The Lived Experience of Korean Female Military Nursing Officers During the Vietnam War
Authors: Han Jung-jin
Published: December 2018

Introduction: Between 1964 and 1973, more than 550 Korean female nursing officers were deployed to the Vietnam War as part of the Korean military. Their achievements were overshadowed by the male combat troops. The purpose of this study was to explore the essence of their lived experiences. Method: Using the hermeneutic phenomenological approach, the data were collected through in-depth interviews with 14 Korean female nursing officers who were deployed to the Vietnam War. Results: Seven essential themes were derived: Enduring confusion, Being devoted to duty, Establishing deep comradeship, Realizing the dark side of war, Being discriminated against as female, Achieving and being rewarded, and Growing as leaders. Conclusion: This study acquired valuable data on nursing history and useful information on the psychological, physical, and environmental difficulties that could be faced by female nurses working in conflicts, wars, and disaster situations.
Pitfalls of Frozen Section in Gynecological Pathology: A Case of Ovarian Serous Surface Papillary Adenofibroma Imitating Malignancy
Authors: Jones Anja M. K. , Yue Wei Ying , Marcus Jenna , Heller Debra S.
Published: December 2018

Serous cystadenofibromas are uncommon benign ovarian lesions, consisting of both fibrous and epithelial components, that are usually cystic but may contain solid or papillary architecture that can be confused with a malignancy on imaging. Papillary architecture seen on frozen section may also falsely steer the pathologist in the direction of a diagnosis of a borderline serous tumor. Overcalling the lesion may lead to more aggressive surgery than necessary, so extensive tissue sampling and consideration of this entity is important in possibly avoiding this mistake.
Microvasculature of the Plantar Plate Using Nano–Computed Tomography
Authors: Finney Fred T. , McPheters Aaron , Singer Natalie V. , Scott Jaron C. , Jepsen Karl J. , Holmes James R. , Talusan Paul G.
Published: December 2018

Background:

Lesser toe plantar plate attenuation or disruption is being increasingly implicated in a variety of common clinical conditions. A multitude of surgical techniques and devices have been recently developed to facilitate surgical repair of the plantar plate. However, the microvascular anatomy, and therefore the healing potential in large part, has not been defined. We investigated the microvasculature of the plantar plate by employing a novel technique involving microvascular perfusion and nano–computed tomography (nano-CT) imaging.

Methods:

Twelve human adult cadaveric lower extremities were amputated distal to the knee. The anterior and posterior tibial arteries were perfused with a barium solution. The soft tissues of each foot were then counterstained with phosphomolybdic acid (PMA). The second through fourth toe metatarsophalangeal (MTP) joints of 12 feet were imaged with nano-CT at 14-micron resolution. Images were then reconstructed for analysis of the plantar plate microvasculature and calculation of the vascular density along the length of the plantar plate.

Results:

A microvascular network extends from the surrounding soft tissues at the attachments of the plantar plate on both the metatarsal and proximal phalanx. The midsubstance of the plantar plate appears to be relatively hypovascular. Analysis of the vascular density along the length of the plantar plate demonstrated a consistent trend with increased vascular density at approximately the proximal 29% and distal 22% of the plantar plate.

Conclusion:

There is a vascular network extending from the surrounding soft tissues into the proximal and distal attachments of the plantar plate.

Clinical relevance:

The hypovascular midportion of the plantar plate may play an important role in the underlying pathoanatomy and pathophysiology of this area. These findings may have significant clinical implications for the reparative potential of this region and the surgical procedures currently described to accomplish anatomic plantar plate repair.
Investigation on a two-stage platform of large stroke for broadband vertical vibration isolation
Authors: Xie Xiling , Ren Mingke , Zheng Hongbo , Zhang Zhiyi
Published: December 2018

For the purpose of preventing vibration-sensitive optical switches from malfunction caused by broadband vertical vibration, a novel two-stage vibration isolation platform is proposed. The primary stage is a bellows-type isolator of large stroke and low isolation frequency, and the secondary stage is a small-stroke hybrid isolator composed of bellows and voice-coil actuators. In the primary stage, two pre-compressed horizontal bellows and one vertical bellows are used to counter the weight of the switch and to reduce the total height of the isolator. The static properties of the primary stage are analyzed, and the vibration isolation of the platform is investigated. Numerical results indicate that the two-stage platform is effective in isolating vertical vibration. Experiments are also conducted to verify the performance of the platform. It is exhibited that the transmissibility is less than 0 dB over 2 Hz, and the attenuation rate reaches −35 dB/dec at high frequencies. The frequency range of test is 2–200 Hz, and the maximum displacement is 10 mm at 2 Hz. In the secondary stage, the actuators can substantially suppress the resonance peak, and promote isolation performance at low frequencies.
Eyes Wide Shut: Failures to Teach Student Journalists About Eyewitness Error
Authors: Blom Robin
Published: December 2018

Every news story depends on human memory one way or the other; in particular, eyewitness accounts. However, the amount of scholarly research on eyewitness misidentification in the fields of journalism and mass communication is minimal, whereas a plethora of studies is available in other disciplines. Journalism textbooks could fill that void by presenting information about eyewitness issues to student journalists. However, widely adopted journalism textbooks lack in-depth modules, if anything at all, that warn journalism students that they should not take all eyewitness accounts for granted. This essay is a call to increase research in an underdeveloped aspect of journalism education.
MRI in 30 cats with traumatic brain injury
Authors: Caine Abby , Brash Robert , De Risio Luisa , Van Dijk Jan , Cherubini Giunio Bruto , Dennis Ruth
Published: December 2018

Objectives

The aim of this study was to evaluate the MRI findings in cats following traumatic brain injury (TBI), and establish which features identified might correlate with prognosis.

Methods

The magnetic resonance images of 30 cats with clinical signs attributed to the brain following TBI were retrospectively reviewed to assess the imaging features seen and their correlation with outcome.

Results

Twenty-one of 30 cats had a good outcome (full recovery or minor ongoing neurological deficits); the other nine either died or had ongoing neurological deficits that significantly affected quality of life. There was evidence of parenchymal injury in only 20/30 cats, including 8/9 that had a poor outcome. The frequency of bilateral or multifocal parenchymal lesions on T2-weighted imaging, and mass effect, particularly caudal transtentorial herniation, was statistically significantly higher in patients with a poorer outcome. Extra-axial haemorrhage was not identified. Concurrent soft tissue injury was noted in all cats, with a poorer prognosis statistically associated with a peripharyngeal pattern of injury and orbital trauma.

Conclusions and relevance

The number of cases with MRI-identified brain pathology, the patterns of injuries identified and the specific imaging features that appear to have effects on prognosis differ in this series of cats from those published in similar case series of dogs. Further work is needed to establish if cat-specific guidelines are needed to assess brain MRI following trauma.
Trafficked women’s presentation of self before the German courts
Authors: FitzGerald Sharron A
Published: December 2018

The analysis in this article provides an alternative interpretation of trafficked women’s self-presentation before the courts. I use complete observations of German judges deposing women in camera who are witnesses in criminal proceedings against their traffickers. My objective is to develop and inform a different account of the women’s self-presentation by prioritising the narrative accounts of their ‘lived’ experiences of trafficking. Invoking Judith Butler’s analysis of the complex transactions between subjectification and subversive agency and emerging debates in the health arena in psychosocial theory on resilience, I ask: How is trafficked women’s self-presentation in criminal proceedings an expression of their agency and resilience?
Guidelines for designing middle-school transition using universal design for learning principles
Authors: Chambers Dianne , Coffey Anne
Published: December 2018

Transition from primary (elementary) to secondary school can be both an exciting and a daunting prospect for young adolescents. Ensuring that students quickly settle into their new secondary school environment is the goal of transition programmes employed by schools. These programmes typically comprise a number of discrete and interrelated initiatives that often commence in the year prior to the move and continue during the initial months in the new school. These activities generally include specific initiatives for both the students and their parents. The needs of both groups are many and varied. It is critical that whatever transition events and strategies are planned, the needs of all students and parents are catered for. In this article the authors propose that the principles of Universal Design for Learning (UDL) may provide a useful basis for the development of transition programmes that address the needs of all participants. UDL is based on three principles which are: multiple means of engagement, multiple means of representation, and multiple means of action and expression. Examples outlining how these principles can be applied before, during and after transition are provided. The authors conclude with the proposition that research be conducted in a variety of cultural contexts and across countries to investigate whether transition programmes based on UDL principles better enable schools to meet the needs of all transitioning students and their parents.
Parastomal Hernia Repair; Seldom Performed and Seldom Reported: Results From a Nationwide Survey
Authors: Odensten C. , Strigård K. , Dahlberg M. , Gunnarsson U. , Näsvall P.
Published: December 2018

Background:

Parastomal hernia is common, but there are few population-based studies showing the frequency and outcome of parastomal hernia repair in routine surgical practice. The aim of this study was to identify patients undergoing surgery for parastomal hernia in Sweden and to define risk factors for complication and recurrence.

Methods:

A broad search of the Swedish National Patient Register 1998–2007 for all possible parastomal hernia repairs using surgical procedure codes. Records of all patients identified were reviewed and those with a definite parastomal hernia procedure were included and analyzed.

Results:

A total of 71 patients were identified after review of the records. The most common reason for surgery was cosmetic and the most frequent method was relocation of the stoma. Parastomal hernia recurrence rate was 18% during follow-up of a minimum 2 years. Overall, a surgical complication occurred in 32%. Possible risk factors were analyzed including emergency surgery versus planned, gender, age, indication for surgery, and method of surgery; none of which was significant.

Conclusion:

The frequency of parastomal hernia procedures was much lower than suggested by previous studies. The number of procedures per surgeon was even lower than expected. No specific risk factor could be identified. Parastomal hernia auditing in the form of a nationwide quality register should be mandatory. Centralization should be considered.
UK Helicopter Emergency Medical Services’ use of circulatory access devices, blood product transfusion and fluid warmers – a cross-sectional survey
Authors: Morris Jonathan , Hughes Simon
Published: December 2018

Introduction

The pre-hospital environment provides significant challenges to clinicians who wish to rapidly administer warmed blood products and fluids to patients with haemorrhagic shock. Large-bore circulatory access is required with the use of devices that will successfully warm cold blood with minimal impact on flow rates. Until now, no information has been available that defines UK Helicopter Emergency Medical Services’ (HEMS) use of circulatory access and fluid warming devices, nor the recent adoption of pre-hospital blood product transfusion.

Methods

A survey was sent to all 22 UK HEMS asking which circulatory access devices crews have available, whether blood products are being transfused and if fluid warming devices are used as part of their resuscitations.

Results

All services responded. All UK HEMS use peripheral intravenous cannulae and intraosseous access. In addition, seven use central venous catheters and three use large-bore peripheral access (the Arrow Rapid Infusion Catheter®). Three services use landmark technique alone to gain central venous access, whereas four use a combination of landmark and ultrasound-guided techniques. Different sites for central venous access are used: subclavian (seven services), internal jugular (four) and femoral (four). Fourteen services carry pre-hospital blood products of which six transfuse packed red blood cells; four transfuse packed red blood cells and fresh frozen plasma; four transfuse packed red blood cells and lyophilised plasma. Eight services carry no pre-hospital blood products. Seventeen HEMS use fluid warmers; 13 use the Belmont® buddy lite™ and four use the QinFlow Warrior.

Conclusion

The use of a variety of policies and range of equipment has evolved across UK HEMS, demonstrating a lack of consensus on best practice. This is the first study to record a complete picture of current UK HEMS practice with regard to the use of circulatory access devices, fluid warmers and blood product administration.
Researching far right groups on Twitter: Methodological challenges 2.0
Authors: Crosset Valentine , Tanner Samuel , Campana Aurélie
Published: December 2018

The Internet poses a number of challenges for academics. Internet specificities such as anonymity, the decontextualisation of discourse, the misuse or non-use of references raise methodological questions about the quality and the authenticity of the data available online. This is particularly true when dealing with extremist groups and grass-root militants that cultivate secrecy. Based on a study of the far-right on Twitter, this article explores these methodological issues. It discusses the qualitative indicators we have developed to determine whether a given Twitter account should be included in the sample or not. By using digital traces drawn from profiles, interactions, content and through other visual information, we recontextualize user’s profile and analyze how digital traces participate in providing far right ideas with a wider representation.
Use of an Online Platform to Facilitate and Investigate Data-Driven Instructional Coaching
Authors: Glover Todd A. , Reddy Linda A. , Kurz Alexander , Elliott Stephen N.
Published: December 2018

This article presents theoretical and empirical support for a data-driven instructional coaching approach and emerging evidence for the contributions of an online platform in operationalizing, assessing, and facilitating the implementation of key coaching actions for both research and practice. The contributions of an online platform in guiding the implementation and investigation of key coaching actions (i.e., modeling, facilitation of practice, and feedback) throughout a five-phase coaching sequence are presented. The article outlines initial research to demonstrate the utility of the online platform for advancing an understanding of how coaching actions predict teacher and student outcomes. This research suggests that there are predictive relationships between coaching actions and the fidelity of implementation of teacher interventions, reductions in instructional gaps, and student achievement. The implications of this work for advancing coaching practices and future empirical investigations are described.
Disability Studies: What is it and what Difference does it Make?
Authors: Ferguson Philip M. , Nusbaum Emily
Published: December 2018

The academic field of disability studies has expanded rapidly over the last two decades or so. With that expansion has also come some growing ambiguity about exactly what is meant by the term “disability studies.” This article reviews the history and evolution of disability studies as an interdisciplinary approach to research and scholarship. While acknowledging the broad range of interests and approaches that can fall under the umbrella of the “disability studies” label, we argue that it may be useful to present a set of core themes or beliefs that seem central to disability studies as a field if it is to fulfill its promise as a truly different way of exploring the meanings of disability in society. Finally, we argue that disability studies should be of special interest to members of TASH and others with particular interest in the lives of people with significant intellectual and developmental disabilities.
Mycotic Superior Mesenteric Artery Aneurysm: Case Report and Literature Review
Authors: Xu Xuedong , Eubanks Alicia L. , Wladis Alan , Veldhuis Paula , Eubanks Steve
Published: December 2018

Superior mesenteric artery (SMA) aneurysm is the third most common splanchnic artery aneurysm. A 73-year-old woman presented with a minimally symptomatic SMA aneurysm, which was resected by laparoscopic surgical technique. The patient recovered quickly and remained well after 8 months of follow-up. This case report and literature review presents a rare mycotic aneurysm that developed in the SMA. Laparoscopic surgery can be a useful technique for the treatment of mycotic SMA aneurysms.
Recognition and transformation: Beyond media discourses on the BRICS
Authors: Dwyer Tom , Arifon Olivier
Published: December 2018

Based on literature review and interviews with journalists, we argue that the BRICS countries are constructing a collective vision, guided by logics of recognition and of transformation. The production of discourse reaches its high point during the BRICS leaders’ summits. To go beyond analysis of the discourse revealed in the media, this article examines projects, thereby aiming to qualify and label the justificatory discourses, in order to develop an understanding of intentions. The BRICS countries have become a reference point as the press increasingly makes comparisons between these countries. The notion of recognition, present in the political elites, also appears as a part of the public imagination and in the press. The leaders too seek transformation. The first official multilateral institution founded by the BRICS countries was the New Development Bank. Current efforts indicate the development of common scientific and technological research initiatives and official support for the establishment of an innovative BRICS Network University. Initiatives will appear as these countries try to consolidate their position.
An examination of the effects on crime of switching off street lighting
Authors: Davies Matthew W , Farrington David P
Published: December 2018

Prior reviews suggest that improving street lighting leads to a decrease in offending, but little is known about the effects of switching off street lighting. The present research investigates the effects of switching off street lighting in Maldon, Essex, by comparing police-recorded crime rates before and after, in Maldon and in the adjacent area of Braintree, Essex. After street lighting was switched off, burglary and vehicle crime increased relatively in Maldon, but criminal damage did not change, and violence decreased relatively in Maldon. Since violence is a costly crime, switching off street lighting in Maldon was not followed by an increase in the costs of crime. Possible explanations of these findings are discussed, including the fact that switching off street lighting in Maldon might have deterred people from going out at night.
Creating Safety II in the operating theatre: The Durable Dozen!
Authors: Carthey Jane
Published: December 2018

The aviation industry calls the most frequently recurring factors that lead to incidents ‘the Dirty Dozen.’ The ‘Dirty Dozen’ includes, for example, stress, distractions and interruptions, team norms etc. The article adapts the concept of the Dirty Dozen from aviation to explore resilience in operating theatres. Taking a Safety II perspective, the article introduces the ‘Durable Dozen’: 12 regulatory, organisational, team and individual behaviours that enable theatre teams to resolve safety threats.
Funding in primary care
Authors: Burch Patrick
Published: December 2018

The mechanisms for funding primary care are complex, due to the historical legacy of the many changes in UK general practice, and can be difficult to understand. This article gives a basic outline of how primary care is funded and where individual practices earn income. It explains several of the financial and contractual terms for GPs and discusses some of the current issues in funding. Although much is similar, mechanisms underlying GP funding differ between the four home nations. This article focuses on primary care funding in England.
Gynaecological emergencies
Authors: Gray Thomas , McQueen Victoria , Farkas Andrew
Published: December 2018

Gynaecological problems in primary care are common. Some gynaecological conditions present as emergencies, requiring rapid referral to secondary care for review and treatment. GPs are likely to see such patients more often in out-of-hours sessions. This article will consider common gynaecological emergencies including pelvic inflammatory disease, bleeding and pain in early pregnancy, vulval abscess, Bartholin’s cyst abscess and ovarian cyst accidents. The article aims to guide assessment of patients in primary care including information on aetiology, risk factors, clinical features, initial investigations, management and referral.
Preconception counselling
Authors: Garthwaite Heather , Wilkes Scott
Published: December 2018

A woman’s health in the preconception period is important to ensure a healthy pregnancy and to support the wellbeing of her child. Encouraging positive behaviour change can help to establish a balanced lifestyle for a woman and her family. The first half of this article will cover the initial assessment and general advice that applies to all women who are planning a pregnancy. The second half will explore the preconceptual management of long-term health conditions, and will describe the relevance of genetic risk assessment in pre-pregnancy counselling.
Validation of ICD-10 codes shows intracranial venous thrombosis incidence to be higher than previously reported
Authors: Handley Joel D , Emsley Hedley CA
Published: December 2018

Background:

Intracranial venous thrombosis (ICVT) accounts for around 0.5% of all stroke cases. There have been no previously published studies of the International Classification of Diseases, Tenth Edition (ICD-10) validation for the identification of ICVT admissions in adults.

Objective:

The aims of this study were to validate and quantify the performance of the ICD-10 coding system for identifying cases of ICVT in adults and to derive an estimate of incidence.

Method:

Administrative data were collected for all patients admitted to a regional neurosciences centre over a 5-year period. We searched for the following ICD-10 codes at any position: G08.X (intracranial and intraspinal phlebitis and thrombophlebitis), I67.6 (non-pyogenic thrombosis of intracranial venous system), I63.6 (cerebral infarction due to cerebral venous thrombosis, non-pyogenic), O22.5 (cerebral venous thrombosis in pregnancy) and O87.3 (cerebral venous thrombosis in the puerperium).

Results:

Sixty-five admissions were identified by at least one of the relevant ICD-10 codes. The overall positive predictive value (PPV) for confirmed ICVT from all of the admissions combined was 92.3% (60 out of 65) with the results for each code as follows: G08.X 91.5% (54 of 59), O22.5 100% (4 of 4), I67.6 100% (1 of 1), I63.6 100% (1 of 1) and O87.3 100% (1 of 1). There were 40 unique cases of ICVT over a 5-year period giving an annual incidence of ICVT of 5 per million.

Conclusions:

All codes gave a high PPV.

Implications for practice:

As demonstrated in previous studies, the incidence of ICVT may be higher than previously thought.
Investigating Mechanisms of Stillbirth in the Setting of Prenatal Substance Use
Authors: Miller Corrie B. , Wright Tricia
Published: December 2018

Introduction:

Intrauterine fetal demise affects between 0.4-0.8% of pregnancies worldwide. This significant adverse pregnancy outcome continues to be poorly understood. In utero exposure to substances increases the risk of stillbirth to varying degrees according to the type of substance and degree of exposure. The aim of this qualitative narrative review is to investigate common biologic relationships between stillbirth and maternal substance use.

Methods:

A PubMed literature search was conducted to query the most commonly used substances and biologic mechanisms of stillbirth. Search terms included “stillbirth,” “intrauterine fetal demise,” “placenta,” “cocaine,” “tobacco,” “alcohol,” “methamphetamines,” “opioids/ opiates,” and “cannabis.”

Results:

There are very few studies identifying a direct link between substance use and stillbirth. Several studies demonstrate associations with placental lesions of insufficiency including poor invasion, vasoconstriction, and sequestration of toxic substances that inhibit nutrient transport. Restricted fetal growth is the most common finding in pregnancies complicated by all types of substance use.

Discussion:

More research is needed to understand the biologic mechanisms of stillbirth. Such knowledge will be foundational to understanding how to prevent and treat the adverse effects of substances during pregnancy.