bluuebunny/crossref_metadata_2025 huggingface dataset:
Patients' perspectives on how to improve diabetes self-management and medical care: a qualitative study
Authors: Ndjaboue Ruth , Dansokho Selma Chipenda , Dogba Maman Joyce , Boudreault Bianca , Price Roberta , Delgado Pascual , McComber Alex M. , Drescher Olivia , Tremblay Marie-Claude , McGavock Jon , Witteman Holly
Published: October 2018

Background: The experience of living with a chronic disease such as diabetes can provide valuable knowledge about medical care and self-management. Such knowledge may be of use to people seeking to improve diabetes self-management and to health professionals seeking to provide better patient-centered care.Objective: To identify potential areas for improvement in diabetes care from the perspectives of people living with diabetes and their caregivers.Methods: We interviewed 21 people living with diabetes (hereafter called expert patients) who were patient partners in a national Patient-Oriented Research network. Expert patients were men and women from various backgrounds, including Indigenous people and immigrants to Canada. They had significant lived experience of diabetes and were able to offer diverse patient and caregiver perspectives. Three authors independently analyzed videos using inductive framework analysis, identifying themes through discussion and consensus. Results: From expert patients’ perspective, people living with diabetes benefit from acknowledging and accepting the reality of diabetes, receiving support from their family and care team, and not letting diabetes control their lives. To improve diabetes care, health professionals should understand and acknowledge the impact of diabetes on patients and their families, and communicate with patients openly, respectfully, with empathy and cultural competency. Conclusions: From the perspectives of expert patients, there are areas for improvements in diabetes care. These improvements are actionable individually by patients or health professionals and also collectively through collaboration between both groups. Improving the quality of care in diabetes is crucial for improving health outcomes in Canada.
Morphospace expansion paces taxonomic diversification after end Cretaceous mass extinction
Authors: Lowery Christopher , Fraass Andy
Published: October 2018

Highly resolved paleontological records can address a key question about our current climate crisis: How long until the biosphere rebounds from our actions? There are many ways to conceptualize the recovery of the biosphere; here we focus on the global recovery of species diversity. Mass extinction may be expected to be followed by rapid speciation, but the fossil record contains many instances where speciation is delayed, a phenomenon for which we have a poor understanding. A likely explanation for this delay is that extinctions eliminate morphospace as they curtail diversity, and the delay in diversification is a result of the time needed for new innovations to rebuild morphospace which can then be filled out by new species. Here, we test this Morphospace Reconstruction Hypothesis using the morphological complexity of planktic foraminifer tests after the Cretaceous-Paleogene mass extinction. We show that increases in complexity precede changes in diversity, indicating that plankton are colonizing new morphospace and then slowly filling it in. Preliminary diversification is associated with a rapid increase in the complexity of groups refilling relict Cretaceous ecospace. Subsequent jumps in complexity are driven by evolutionary innovations (development of spines and photosymbionts) which opened new niche space. The recovery of diversity was paced by the construction of new morphospace, implying a fundamental speed limit on diversification after an extinction event.
A Diagnostic Evaluation of Tablet Serious Games for the Assessment of Autism Spectrum Disorder in Young Children
Authors: Millar Lindsay , McConnachie Alex , Minnis Helen , Wilson Philip , Thompson Lucy , Azulewicz Anna , Sobota Krystof , Rowe Philip , Gillberg Christopher , Delafield-Butt Jonathan
Published: October 2018

Recent evidence suggests an underlying movement disruption may be a core component of Autism Spectrum Disorder (ASD) and a new, accessible early biomarker. Mobile smart technologies such as iPads contain inertial movement and touch-screen sensors capable of recording sub second movement patterns during gameplay. A previous pilot study employed machine learning analysis of motor patterns recorded from children 3-5 years old. It identified those with ASD from age- and gender-matched controls with 93% accuracy, presenting an attractive assessment method suitable for use in the home, clinic or classroom. This is a Phase III prospective, diagnostic classification study designed according to the Standards for Reporting Diagnostic Accuracy Studies (STARD) guidelines. Three cohorts are investigated: children developing typically (TD); children with a clinical diagnosis of ASD; and children with a diagnosis of another neurodevelopmental disorder (OND) that is not ASD. The study will be completed in Glasgow, U.K., and Gothenburg, Sweden. The recruitment target is 760 children (280 TD, 280 ASD and 200 OND). Children play two games on the iPad then a third party data acquisition and analysis algorithm (Play.Care, Harimata sp. z o.o., Poland) will classify the data as positively or negatively associated with ASD. The results are blind until data collection is complete, when the algorithm’s classification will be compared against medical diagnosis. Furthermore, parents of participants will complete three questionnaires: Strengths and Difficulties Questionnaire; ESSENCE Questionnaire; and the Adaptive Behavioural Assessment System. The primary outcome measure is sensitivity and specificity of Play.Care to detect ASD. Secondary outcomes include the ability of Play.Care to differentiate ASD from OND.
Preschoolers optimize the timing of their conversational turns through flexible coordination of language comprehension and production
Authors: Gambi Chiara
Published: October 2018

Conversation is the natural setting for language learning and use, and a key property of conversation is the smooth taking of turns. In adult conversations, delays between turns are minimal (typically 200ms or less), because listeners display a striking ability to predict what their partner will say, and formulate a response before their partner’s turn ends. Here, we test how this ability to coordinate comprehension and production develops in preschool children. In an interactive paradigm, one-hundred-and-six 3-to-5-year-olds (and forty-eight adults) responded to questions that varied in predictability, but were controlled for linguistic complexity. Using a novel distributional approach to data analysis, we show that when children can predict a question’s ending, they leave shorter gaps before responding, suggesting that they, like adults, can optimize the timing of their conversational turns. In line with a recent ethological theory of turn-taking, this early competency helps explain how conversational contexts support language development.
Mouse-tracking: A practical guide to implementation and analysis
Authors: Kieslich Pascal J. , Henninger Felix , Wulff Dirk U. , Haslbeck Jonas M B , Schulte-Mecklenbeck Michael
Published: October 2018

Mouse-tracking – the analysis of mouse movements in computerized experiments – is becoming increasingly popular in psychological research. Mouse movements are taken as an indicator of commitment to or conflict between choice options during the decision process. Using mouse-tracking, researchers have gained insight into the temporal development of cognitive processes across a growing number of psychological domains. In this chapter, we present software that offers users easy and convenient means of recording and analyzing mouse movements in their research. First, we introduce and demonstrate the mousetrap plugin that adds mouse-tracking to OpenSesame, a popular general-purpose experiment builder. It allows for the creation of mouse-tracking studies through a graphical interface, without requiring programming skills. Second, we present the mousetrap library for the statistical programming language R. This library imports mouse-tracking data from a variety of sources. It offers functions for preprocessing, analyzing, clustering, and visualizing mouse movements, and calculates many established measures for curvature, complexity, and velocity. All software is cross-platform, open-source and available free of charge from https://github.com/pascalkieslich/mousetrap-os and http://pascalkieslich.github.io/mousetrap/ .
Efficacy of Possum in Surgical Audit of Patient Undergoing Emergency Surgery at Nepalgunj Medical College
Authors: Bharti S V , Mishra S M , Ranjitkar R R , Chhetri A O
Published: October 2018

Introduction: The Physiological and Operative Severity Score for the en Umeration of Mortality and morbidity (POSSUM) has been proposed as a method for standardizing patient data so that direct comparisons can be made in spite of differing patterns of referral and population.Aims and objectives: To evaluate the efficacy of a scoring system for predicting the incidence of postoperative complications and mortality in patient undergoing Emergency Surgeries based on the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM).Material and Methods: This is a hospital based cross sectional study of all the cases that had undergone Emergency Surgery at Nepalgunj Medical College Teaching Hospital from the period of July 2014 to June 2015. The period of follow up was 30 days following the surgical procedure? A total of 100 emergency surgeries, as defined by the POSSUM scoring system criteria were studied. Predicted mortality and morbidity rates were calculated using the POSSUM equation by exponential analysis method. It was then compared with the actual outcomes. Observed: Expected Ratio (O:E) was calculated and difference detected by chi-square test. The risk factors as scored in the POSSUM criteria were noted.Results: Applying exponential analysis, an observed to expected ratio (O:E) for mortality of 0.44 was obtained, indicating significant 2 difference between the predicted and observed values (x =93.207, df 63, p=0.008). But, an observed to expected ratio (O:E) for 2 morbidity of 1.01 was obtained and there was no significant difference between the predicted and observed values (x =76.295, df 71, p=0.312). It was found to be comparable to other studies. In all the risk factors studied, a positive correlation was found between deaths and post-operative complications with higher POSSUM scores.Conclusion: POSSUM scoring system could accurately predict overall morbidity while it over predicted the overall mortality. POSSUM scoring system serves as a good predictor of post-operative outcome in major general surgical procedures and was applicable even in our setup and be used for comparing various treatment modalities and assessing the quality of care provided. JNGMC Vol. 14 No. 2 December 2016,   page: 2-7
Evaluation of Hypothermia in Sick Neonates as Predictor of Fatality at a Tertiary Care Center of Eastern Nepal
Authors: Kanodia Piush , Bhandari R , Bhatta N , Yadav S
Published: October 2018

Introduction: Hypothermia is a common and frequent problem in newborns. It has larger impact in outcome related to management of sick infants.Objective: To correlate the severity of hypothermia in sick extramural neonates with fatality and physiological derangements.Materials and Methods: This prospective observational study was carried out at Neonatology unit of Pediatric department of B. P. Koirala Institute of Health Sciences (BPKIHS) Dharan. Total 200 extramural hypothermic neonates were transferred to BPKIHS from June 2015 to June 2016. Neonates weighing more than 1000 g, with abdominal skin temperature less than 36.5°C at admission were included in the study.. Clinical features and associated features were recorded at the time of admission. Oxygen saturation was recorded by a pulse oximeter.Results: Fatality was observed to be 39.3% in mildly hypothermic babies, 51.6% in moderately hypothermic babies and 80% in severely hypothermic babies. However, the presence of associated illness (birth asphyxia, neonatal sepsis and respiratory distress), physiological derangements (hypoxia, hypoglycemia and shock) and weight less than 2000 g were associated with more than 50% fatality even in mildly hypothermic babies. When moderate hypothermia was associated with hypoxia or shock, the fatality was 83.3% and 90.9%, respectively. Similarly, mild hypothermia with hypoglycemia was associated with 71.4% fatality.Conclusion: The presence of associated illness (birth asphyxia, neonatal sepsis and respiratory distress), physiological derangements (hypoxia, hypoglycemia and shock) and weight less than 2000 g should be considered adverse factors in hypothermic neonates. Their presence should classify hypothermia in the next higher category of severity in WHO classification. JNGMC Vol. 14 No. 2 December 2016,   page: 8-11
Nasal Polyposis: An Experience in Mid and Far Western Region of Nepal
Authors: Sharma A , Saxena RK , Verma L R
Published: October 2018

Background: Nasal polyposis is an unpleasant disease in the developing countries which severely interferes with quality of life but still there is a lack of data on nasal polyposis in Mid and Far Western Region of Nepal.Aim of study: The aim of this hospital based study was to find out the distribution, patterns, presentations and management of nasal polyposis in Mid and Far Western Region of Nepal with a view to improve our understanding of its clinical and epidemiological characteristics.Methods: This prospective descriptive study was conducted from January 2015 to June 2016 in 80 patients diagnosed clinically as nasal polyposis, in the department of otorhinoloryngology, Nepalgunj Medical College Teaching Hospital, Kohalpur. Results: The most common age group affected in the study was comparatively younger ranging from 10-20 yrs. Ethmoidal Polyp were more frequent than antrochoanal polyp (56.25% vs 43.75%). Antrochoanal polyp were more common among the younger age groups 10-20 yrs (30%) where as the ethmoidal polyp were more common among higher age group. All antrochonal polyps (100%) were unilateral while majority of the ethmoidal polyps (89%) were bilateral. The main presenting clinical features were nasal obstruction (100%), nasal discharge (93.75%), sneezing (72.5%) and headache (40%).Conclusion: Nasal polyposis is common in Mid and Far western region of Nepal. Ethmoidal polyps are more common than antrochoanal polyps and are usually bilateral. Antrochoanal polyps are unilateral and mostly present in 10-20 yrs age group patients. Patients usually present late when the polyps are large. NGMC, Vol. 14 No. 2 December 2016, Page: 15-17
Impact of Maternal Obesity on Pregnancy Outcome
Authors: Sinha K , Pandey S , Das C R
Published: October 2018

Background: Maternal obesity increases the risk of complications of pregnancy, labor, and neonate. It has been associated with gestational hypertension, eclampsia, pre-eclampsia, gestational diabetes, cesarean delivery, instrumental delivery, abortion, postpartum haemorrhage, puerperal infection and perinatal outcome like macrosomia, still birth and congenital anomaly, birth asphyxia.Aims: To evaluate the effect of maternal obesity on pregnancy outcome.Methods: The hospital based observational study conducted in the department of Obstetrics & Gynaecology at Nepalgunj Medical College Teaching Hospital Kohalpur between September 2015 to August 2016.Results: Mean age of participant's in the study group was 28 ± 5.77 and youngest participant's age was 19 yrs and oldest participant was 45 yrs. Among the fifty five ladies, 10 were grand multigravida, 30 were multi and 15 were primigravida. 63.6% delivered by cesarean section,1.8% delivered by forceps with episiotomy, 9.1% delivered by svd, 20% by svd with episiotomy and 5.5% by vacuum with episiotomy. Ten participants (18.18%) had hypertensive disorder during pregnancy. The mean BMI was 33±2.4. Under obese class 1 and class 2 were 49.1% and 50.9% respectively. Among the study population 56.36% had complications. Mean BMI was 33 minimum being 30 and maximum was 39.81. Regarding body weight maximum was 90 kgs. and 2 2. minimum was 68 kgs and mean weight being 78 kgs. Regarding maternal height maximum was 2.7 m , minimum was 2.01 m and 2 mean was 2.33 m . Total 7 newborn (13%) were macrosomic. Among 55 cases 27 fall under obesity class 1, 11 ladies with complication and among 28 ladies under obesity class 2, 22 had complications.Conclusion: The obesity has adverse effects on pregnancy outcome both for mother and the foetus.JNGMC, Vol. 14 No. 2 December 2016, Page: 18-22
A Comparative Clinical Evaluation of Efficacy of Midazolam as an Adjuvant to Bupivacaine in Brachial Plexus Block by Supraclavicular Approach for Upper Limb Surgery
Authors: Dhakal Y , Rajbhandari R , Agarwal T N
Published: October 2018

Introduction: Brachial plexus block is useful as a sole regional anesthetic technique for upper limb surgeries. Adjuvants to local anesthesia may enhance quality and duration of analgesia. Our study aimed to evaluate efficacy and safety of midazolam added to brachial plexus block. Methods: 394.50 ±46.874 243 ± 57.545 Addition of midazolam to bupivacaine for brachial plexus block prolongs the duration of analgesia with lower pain scores during post-operative period.  A prospective, randomized, double blind study was conducted on 60 ASA I or II adult patients undergoing upper limb surgeries under single-shot supraclavicular brachial plexus block. Patients were randomly divided into two  groups. Patients in Group B (n = 30) were administered 30 mL of 0.5% bupivacaine and Group BM (n = 30) were given 30 mL of 0.5% bupivacaine with midazolam 2mg. Hemodynamic variables (i.e., heart rate, noninvasive blood pressure), pain scores, onset of motor and sensory block, duration of analgesia and sedation score and were recorded intraoperatively and postoperatively.Results: The duration of analgesia was significantly prolonged (P<0.05) in midazolam group (394.50 ±46.874 ) compared to control group (243 ±57.545). Similarly, pain scores were significantly lower in group BM than in group B (P<0.05). The onset of motor and sensory block, sedation score and hemodynamic variables were comparable between groups. No adverse events were observed during study.Conclusion: Addition of midazolam to bupivacaine for brachial plexus block prolongs the duration of analgesia with lower pain scores during post-operative period. JNGMC, Vol. 14 No. 2 December 2016, Page: 26-29
Single Stages Repair of Hypospadias Using The Snodgrass Technique: A Modern Choice
Authors: Karn Binod , Shrestha N. M.
Published: October 2018

Background: Proximal hypospadias with chordee is the most challenging variant of hypospadias to reconstruct. During the last 10 years, the approach to severe hypospadias has been controversial.Materials & Methods: This is a hospital based observational study conducted in the plastic surgery unit of department of surgery at Nepalgunj Medical College and Teaching Hospital Kohalpur from 2012 March to 2016 September. All patients underwent single staged procedures using Snodgrass technique.Results: Thirty three patients were operated. Twenty four patients had no complications. Single fistula was present in 6(18.18%) patients. Two (6.06%) patients had 2 fistulae; one at the original site of the hypospadias and the other was sub-coronal. One (3.03%) patient had moderate meatal stenosis, which was successfully treated by repeated dilatations.Conclusion: Single Staged procedure using the principles of Snodgrass's technique; is a versatile operation that can be used for the proximal hypospadias. It decreases the rate of fistula formation; disruption; stenosis and gives a satisfactory cosmetic appearance. JNGMC,  Vol. 14 No. 2 December 2016, Page: 50-52
Study of Risk Factors of Stroke in Patients Admitted at Kohalpur Teaching Hospital
Authors: Shah Sanjib Kumar , Shah Sunil , Shah Sujeet Kumar , B.K. Shyam
Published: October 2018

Background: Stroke is the major public health burden and the second major cause of death worldwide. This disease is common in old age persons, however the disease can also be seen in young persons. Identifying the modifiable risk factors of stroke may have contribution in prevention.Objective: The retrospective study was done to study risk factors of stroke in adult patients.Method and Material: This is a hospital based retrospective study conducted in Department of Medicine, Nepalgunj Medical College and st th Teaching Hospital, Kohalpur from the period of 1 January 2015 to 30 October 2016. A total of 119 patients were involved in this study. The diagnosis was confirmed using CT scan after taking history and performing clinical examination. Patients were then evaluated for the presence of both non-modifiable as well as modifiable risk factors. The data analysis was done using SPSS 13.0.Results: The mean age of the patient was 59.76±11.22. Among the collected patients, the higher percentage were male in comparison to female. Ischemic Stroke was more common than hemorrhagic stroke in our study. Other conventional risk factors were as follows: Alcohol use75(63%),cigarette smoking 70(58.8%), hypertension 60 (50.4%),diabetes 11(9.2%),previous vascular event 9(7.6%), heart disease 4(3.4%).Conclusions: Ischemic stroke was more common than hemorrhagic stroke; with alcohol use followed by smoking, hypertension and diabetes mellitus being the most common modifiable risk factors. Incidence of stroke increases with the age and the early recognition and management of the risk factors might reduce this major public burden. JNGMC,  Vol. 14 No. 2 December 2016, Page: 53-55
Thyroid Dysfunctions Among Patients at Nepalgunj Medical College: A Hospital Based
Authors: BK Shyam Kumar , Baral Sushil , Bassi S. D. , Joshi S. D. , Gupta Sandeep , Shah Sujit Kr.
Published: October 2018

Introduction: Thyroid disorders are prevalent and their manifestations are determined by the dietary iodine availability which is common in country. Thyroid dysfunction is common clinical finding among the people presenting to the hospital. Its prevalence increases with age. Screening of thyroid disease is advised in high risk population for the early diagnosis and treatment.Objective: Thyroid disfunction is most common clinical problem among male and female in Nepal. To find out thyroid disfunctions among patients at Nepalgunj Medical College.Methodology: This is a retrospective study carried out in the Department of Medicine, Nepalgunj Medical College, Nepal from January 2014 to June 2016 for the period of two years. A total of 200 patients who visited outpatient door with suspected thyroid disorders i.e. hypothyroidism, hyperthyroidism or to rule out thyroid disorders got their thyroid function test. Serum TSH and fT3 /fT4 estimations were carried out by Enzyme linked immune sorbent assay method.Result: Among 200 subjects, the prevalence of thyroid dysfunction was 20%. Females had more thyroid dysfunction than male. Hypothyroidism (15%) had higher prevalence compared to hyperthyroidism (5%). Higher prevalence of thyroid dysfunction was observed in patients between 14 - 45 years.Conclusion: This study revealed that hypothyroidism is predominant then hyperthyroidism. Females patients have more common thyroid dysfunction True population surveillance is difficult and hence, presently it was aimed to carry out hospital based study on the incidence of thyroid disorders. JNGMC,  Vol. 14 No. 2 December 2016, Page: 66-69
BEAUTY AND MYSTERY OF GANDHARA ART
Authors: Rajput Shahid Ahmad
Published: October 2018

This paper is a short history to establish the location, era and the main actors involved in the creation of a civilization what is generally known as Gandhara. It also includes a brief history of the Art and Architecture of Gandhara as the main feature and the beauty and mystery associated therein. Limitation of the length of paper will keep our discussion on three main centers as below. Necessary visual evidence is also included to justify the Beauty and the Mystery attached to the art of Gandhara for which this paper is initiated. Fact of the matter is that hundreds of books are written on Gandhara Civilization but this point “Beauty and Mystery of Gandhara” has hardly been addressed. This paper is therefore an attempt to fill the gap long felt by the author and last but not the least this paper is dedicated to the love and affection to the artwork of the monks who produced the Master Pieces of Gandhara, both in Stone and Stucco. The analysis is made according to the existing literature and author's own experience and interpretation. Researcher: A Research Journal of Culture and Society Vol. 3, No. 3, January 2018, Page: 1-12
SACRAMENT AS A CULTURAL TRAIT IN RAJVAMSHI COMMUNITY OF NEPAL
Authors: Khatiwada Som Prasad
Published: October 2018

Rajvamshi is a local ethnic cultural group of eastern low land Nepal. Their traditional villages are scattered mainly in Morang and Jhapa districts. However, they reside in different provinces of West Bengal India also. They are said Rajvamshis as the children of royal family. Their ancestors used to rule in this region centering Kuchvihar of West Bengal in medieval period. They follow Hinduism. Therefore, their sacraments are related with Hindu social organization. They perform different kinds of sacraments. However, they practice more in three cycle of the life. They are naming, marriage and death ceremony. Naming sacrament is done at the sixth day of a child birth. In the same way marriage is another sacrament, which is done after the age of 14. Child marriage, widow marriage and remarriage are also accepted in the society. They perform death ceremony after the death of a person. This ceremony is also performed in the basis of Hindu system. Bengali Brahmin becomes the priests to perform death sacraments. Shradha and Tarpana is also done in the name of dead person in this community.Researcher: A Research Journal of Culture and SocietyVol. 3, No. 3, January 2018, Page: 13-32
RECENT TREND OF CHANGE OF FERTILITY IN NEPAL
Authors: Raya Hikmat Bahadur
Published: October 2018

Fertility is one of the most predominant demographic factors of population dynamics. This article tries to analyze the trend of fertility of Nepal comparing with Global trend and the trends of other SAARC countries. This paper follows the quantitative analysis. The entire scope of discussion in this study is based on secondary sources of data. The results show that both ASFR and TFR have been continuously decreasing since 1990s. The decreasing rate is seen more in between 1998-2005s. Now the TFR is 2.3, so Nepal is in nearer to the replacement level of fertility rate. The marriage in early age is not still reduced remarkably that's why the fertility rate of this age group is not decreased as comparison to other age groups in Nepal. In the beginning, the TFRs of all SAARC countries were more than that of world. But in between past sixty decades, the TFR of this region is remarkably reduced and now it is similar to the world's figure except the Pakistan's. The TFR of Pakistan is still high in comparison to its neighbors. Fertility decline in Nepal has been occurring for several decades to till now. The reduction of fertility is beneficial in many domains, as it opens up completely for new employment and educational prospects for young women. It also creates new manpower for job market which helps to boost the economic growth. But continuous declination of fertility rate below the replacement level is not a good scenario in demography because it causes the negative growth rate of population and increase the dependency ratio.Researcher: A Research Journal of Culture and SocietyVol. 3, No. 3, January 2018, Page: 72-80
Coordination Mechanisms and Network Performance
Authors: Gil Olga
Published: October 2018

This paper analyses the Spanish Network of Smart Cities (RECI) from the point of view of coordination mechanisms and network performance, focusing in particular on policy learning capabilities and efficiency-based policies. The paper seeks to analyse the extent to which the RECI network has the capacity to bring about successful outcomes in smart city public policies in Spain. The selection of this
particular case is based on an interest in understanding changes in public policy management at the local level in contemporary Spain, and it is also motivated by the fact that city governance networks arise in other geographical settings. Thus there is a challenge and a need to sharpen analytical tools in order to understand the features, impact, and success of these networks on a global scale.
Dekoncentrirana državna uprava u Francuskoj
Authors: Lopižić Iva
Published: October 2018

Francuski model organizacije obavljanja javnih poslova na teritoriju tradicionalno počiva na dodjeljivanju poslova gustoj mreži teritorijalnih državnih organa i funkcionara koji formiraju dekoncentriranu državnu upravu, a u manjoj mjeri organima lokalne samouprave. U radu je prikazan povijesni razvoj dekoncentrirane državne uprave u Francuskoj s ciljem da se na temelju uočenih razvojnih trendova utvrdi je li i na koji način jačanje lokalne samouprave prouzročilo modifikaciju tradicionalnog francuskog modela, a onda i generiranje hipoteze o međuodnosu dekoncentracije
i decentralizacije. Pregled je podijeljen na razdoblje prije i poslije decentralizacijskih reformi 1982. koje su značile davanje veće uloge lokalnoj samoupravi u sustavu vlasti. S obzirom na jaku francusku upravnu tradiciju, kao interpretativni okvir uzima se teorijski pravac historijski institucionalizam, a uočeni razvojni trendovi kategoriziraju se u modele institucionalne promjene koje su razvili predstavnici ovog pravca. Na temelju francuskog iskustva daju se preporuke za unapređenje dekoncentrirane državne uprave u Hrvatskoj.
Primjena Europske konvencije za zaštitu ljudskih prava i temeljnih sloboda u praksi Ustavnog suda Republike Hrvatske
Authors: Held Mateja
Published: October 2018

U radu se analiziraju odluke koje se odnose na upravnu materiju u kojima je odlučivao Ustavni sud Republike Hrvatske od 1999. do rujna 2015. Ta je analiza relevantna jer pokazuje u kojoj mjeri javnopravna tijela te Ustavni sud u Republici Hrvatskoj vrednuju Europsku konvenciju za zaštitu ljudskih prava i temeljnih sloboda. Drugim riječima, ispituju se modeli primjene Europske konvencije za zaštitu ljudskih prava i temeljnih sloboda od Ustavnog suda u upravnim područjima te se pokušava odgovoriti na pitanje može li se govoriti o primjeni Europske konvencije za zaštitu ljudskih prava i temeljnih sloboda u pravom smislu riječi ili je prisutno tek puko pozivanje na pojedine njezine odredbe bez ulaska u dubinu i prijeko potrebnu analizu prakse ESLJP-a.
Europsko državljanstvo
Authors: Marković Milan , Vukašinović Aleksandra
Published: October 2018

Rad analizira koncept europskog državljanstva, njegove najvažnije aspekte i prava i slobode koje taj koncept podrazumijeva. Proučavaju se najvažniji pravni izvori europskog državljanstva: osnivački ugovori Europske unije, njene regulative i direktive, kao i dugogodišnja sudska praksa koja je imala ključnu ulogu u razvoju ovog koncepta u Europskoj uniji. Posebno se analiziraju prava i slobode europskog državljanjstva, poput prava na slobodu kretanja i prebivališta. Posebno mjesto u ovom radu zauzimaju i sudski precedenti i predmeti pred Europskim sudom pravde koji su oblikovali primjenu prava o europskom državljanstvu, i njihovom analizom ilustruje se povijesni razvoj i pravna transformacija ovog koncepta. U radu se prikazuje i ideološki aspekt europskog državljanstva: ideju europskog identiteta, njen odnos i utjecaj na koncept europskog državljanstva.
New Governance of Urban Areas in France
Authors: Breuillard Michæle
Published: October 2018

The paper analyses urban governance and decentralisation in France. It explains the “quiet revolution” that wants to set the legal base of French local government back to the drawing board with special focus on the reform of local government in urban areas. The context of the too many too small communes – at the heart of the reform programme – is described since it is a typically French evil (part 2). In the absence of any successful top-down policy of amalgamating
communes, new communes are deemed to be the effective solution along with a new mapping of intercommunal joint bodies (part 3). Finally, the paper describes what the metropolis “à la française” consists of (part 4) with a special focus on Lyon – the perfect model for the whole country – and Paris and Aix-Marseille as the worst pupils in transition. France stands out as an important case where new powers bestowed upon metropolitan governments have curbed the jurisdictions of regional governments. The ambiguity over the powers
and functions of local governments triggers obdurate turf wars between the two levels of government, which clearly indicates that the governance of any modern society needs to be simplified. If left unaddressed, competition – not coordination or cooperation – between regionalization and metropolitanisation, regionalization
and local governments, governability and multilevel governance is likely to become the norm. The author concludes that France desperately needs an in-depth reform of its institutional architecture, which is regularly postponed. What is required is a simplification of governmental machinery: more efficiency in local policies, a clearer allocation of responsibilities, reduced expenses, and governance closer to citizens.
Critical Events and the Funding of Indigenous Organizations
Authors: Ramos Howard , Young Janelle
Published: October 2018

Many Canadian advocacy organizations were founded with federal government funding. However, in recent years, with federal budget cuts that funding has come into question. In this article, we analyze the funding of Indigenous organizations in Nova Scotia between 1960 and 2014 in order to examine whether or not the province filled gaps created by a changing political and economic context at the federal level. We analyze how the amount of funding and number of organizations funded changed during this period and consider how national and provincial critical events, federal Supreme Court decisions, changes in governments, and the founding of key organizations affect those shifts. Overall, we find that the province did make up shortfalls in funding during the 1990s and the first decade of the twenty-first century, offering more funds and to a wider number of organizations, but at the same time we see less funding per organization over time and ultimately cutbacks at the provincial level mirroring broader national trends toward austerity and neo-liberalism.
Synthesis of Ni/YSZ based anode and investigation of effect of PVA as pore-former upon porosity, microstructure and thermal behavior for potential use in solid oxide fuel cells (SOFCs)
Authors: Batool Mariah , Sattar Maria , Barki Ussama K. , Khan Zuhair S.
Published: October 2018

This study focuses on development of Nickel–Yttira Stabilized Zirconia (Ni/YSZ) based anode material by solid-state synthesis using polyvinyl alcohol (PVA) in varying weight concentrations (3 wt.% and 6 wt.%) both as a binder and as a pore-former. Scanning electron microscopy and X-ray diffraction based structural and morphological analyses were performed and the synthesis of a homogeneous NiO/YSZ phase was confirmed after sintering at 1 000 °C. Microscopic study investigating effects of PVA concentration upon pore density in pellets pressed under the same conditions was conducted. Thermo-gravimetric/differential thermal analysis of the powders pre-dried at around 120 °C was carried out up to 1 000 °C to investigate the phase change and the thermal decomposition behavior. Findings on reduction of NiO/YSZ in a mixed atmosphere of H2/Ar at 550 °C are also discussed in detail. The results demonstrated that areal porosity of 12 % and 24 % was achieved with 3 wt.% and 6 wt.% of PVA, respectively.
Effect of B4C in Ti-6Al-4V matrix on workability behavior of powder metallurgy composites during cold upsetting
Authors: Thulasiram Ramkumar , Mani Selvakumar , Pandiarajan Narayanasamy , Pandiarajan Balasundar
Published: October 2018

The present research evaluates different weight percentages of nano-B4C incorporated into Ti-6Al-4V through a powder metallurgy technique. Nano-B4C weight percentage was set at 0 %, 5 %, and 10 % with a particle size of ≤100 nm. Cylindrical preforms with different initial preform densities were prepared using a suitable die and punch assembly. Further, the preforms were sintered in a muffle furnace with argon atmosphere at a temperature of 1 100 °C for a holding period of 1 hr. Cold deformation experiments were carried out using a 1 000 kN hydraulic press; incremental loading steps of 5 kN were applied on the preform until the first visible cracks appeared on the free surfaces. The experimental results have shown that the powder metallurgy composite with 10 % nano-B4C demonstrates higher densification properties such as axial stress, axial strain, hoop stress, hydrostatic stress, and Poisson's ratio.
Küçük ve Orta Büyüklükteki İşletmelerde İnovasyona Yönelik Tutumlar ve İnovasyon Engelleri: Çanakkale İlinde KOBİ’ler Üzerine Bir Araştırma
Authors: ŞAHBAZ Ahmet , TANYERİ Mustafa
Published: October 2018

İşletmelerin rekabet gücünün ve verimliliklerinin artırılmasında, inovasyon çok önemli bir araçtır. İnovasyon sayesinde maliyetlerini düşürebilen işletmeler; fiyat avantajı, rakipleri karşısında farkındalık ve üstün kalite gibi avantajlar elde edebilmektedir. Büyük ölçekli işletmelerin rakibi durumunda olan KOBİ’ler; ürünlerinde, süreçlerinde, pazarlama yöntem ve tekniklerinde, organizasyon yapılarında inovasyondan faydalanmak durumundadırlar.Çalışmanın amacı; KOBİ’lerin inovasyona yönelik tutumlarının belirlenmesi, inovasyon uygulamalarını engelleyen işletme içi ve dışı faktörlerin tespit edilmesine yöneliktir. Belirtilen bu faktörler arasındaki ilişki ve ilişki boyutları incelenmeye çalışılmıştır. Bu amaçla Çanakkale ili ve çevresinde faaliyet gösteren 132 KOBİ’nin sahipleri ve çeşitli kademelerdeki yöneticilerinin görüşleri anket uygulaması yöntemiyle alınmış ve analiz edilmiştir.
Antony Flew’ün Ateizmden Tanrı İnancına Yolculuğunda Kanıtların Rolü: Eleştirel Bir Yaklaşım
Authors: ÖZKAN Mehmet Şükrü
Published: October 2018

Bu çalışma Antony Flew’ün ateizmden Tanrı inancına dönüş serüvenini incelemektedir. Bu açıdan bakıldığında onun entelektüel hayatını iki döneme ayırmak mümkündür. Ateist olarak geçirdiği ilk dönem ve Tanrı inancına sahip olduğu ikinci dönem. Flew ateist olduğu dönemde belli argümanlardan yola çıkarak Tanrı’nın varlığının imkânsızlığını savunmuştur. Tanrı inancına sahip olduğu dönemde ise bu argümanlarda işaret edilen problemlere cevap bulduğunu ve yeni kanıtlarla birlikte Tanrı’nın varlığını kabul ettiğini ifade etmiştir. Dolayısıyla bu çalışmanın temel gayesi bu dönüşümdeki gerekçelerin tutarlı olup olmadığını sorgulamak, varılan noktada Flew’ün sahip olduğu Tanrı inancının dini açıdan yansımalarını tartışmaktır. 
KINERJA PEMBANGUNAN KEPARIWISATAAN DI DESA KEBUN DURIAN KECAMATAN GUNUNG SAHILAN KABUPATEN KAMPAR
Authors: Dailiati Surya , Sudaryanto Sudaryanto
Published: October 2018

President of the Republic of Indonesia Joko Widodo has targeted a number of foreign tourists in 2016reached 20 million to Indonesia. Various programs are being introduced to make it happen. This needs to besupported by local governments, including the Government of Kampar regency. Because in this district are one ofthe leading tourist attraction that is not managed well, but already well-known. Call it Durian Gardens, located inDistrict of Mount Sahilan Kampar, Riau. The purpose of this study is the first activity; to analyze the performanceof the tourism development Durian Gardens in Kampar regency. Second, to identify and analyze the barriers to thedevelopment of tourism in Kampar Regency Gardens Durian. The study was conducted in Desa Kebun Durian District of Mount Sahilan Kampar regency. Thepopulation in this study is the Government apparatus and related parties. Serve as the Village Head KeyInformance. The sampling technique used is the census for the government apparatus and techniques for publicaccidental. Sources and types of data in this study are primary and secondary. Data have been collected based onthe type and form of data, for subsequent qualitative data is analyzed descriptively.With the enactment of Law no.10/2009 About Tourism, the Tourism Development today Riau Indonesia in general and in particular shall refer tothe provisions of the Act. Tourism operations carried out by the principles as set out in Article 5 of the Law. DurianGardens development of tourism performance in Kampar regency unfavorable. Generally the respondentsanswered less well (14.75) and was quite good (14.25) while either (0).
KAHRAMANMARAŞ ŞEHRİNİN BUGÜNKÜ VE GEÇMİŞTEKİ MEŞE (Quercus L.) VARLIĞI ÜZERİNE BİR DEĞERLENDİRME
Authors: AVŞAR Mahmut D. , OK Tolga
Published: October 2018

Meşeler (Quercus
spp.), ülkemizde hak ettiği kıymeti pek görememiş; bununla birlikte, orman ve
şehir ekosistemleri için çok kıymetli odunsu bitkilerdir. Kahramanmaraş
şehrinde hâlen 5 adet meşe taksonunun tabiî olarak bulunduğu belirlenmiştir.
Şehirde meşe varlığı çok sınırlı olup, kermes meşesinin (Quercus coccifera) varlığı diğer taksonlara göre nispeten daha
fazladır. Kahramanmaraş şehrinin geçmişte sahip olduğu ormanlarda meşelerin
özellikle de kermes meşesi, mazı meşesi (Quercus
infectoria subsp. veneris) ve İran palamut meşesinin (Quercus brantii) önemli bir yeri olduğu
tahmin edilmektedir. Meşelerin insan yerleşimleri ve şehirleşmeye bağlı olarak
geniş ölçüde faydalanma ve tahribata tâbi tutulduğu; böylece, şehirdeki meşe
varlığının tarihi süreç içerisinde çok azaltıldığı düşünülmektedir. Şehirdeki
mevcut meşe bakiyeleri imkânlar ölçüsünde korunmalı ve Kahramanmaraş’taki şehir
içi ağaçlandırmalarda meşe taksonlarına da yer verilmelidir.
Psychometric Properties of Apathy Scales in Dementia: A Systematic Review
Authors: Mohammad Dana , Ellis Courtney , Rau Allison , Rosenberg Paul B. , Mintzer Jacobo , Ruthirakuhan Myuri , Herrmann Nathan , Lanctôt Krista L.
Published: November 2018

Apathy is a prevalent and problematic neuropsychiatric symptom in those with dementia that is emerging as a treatment target, necessitating accurate assessment. While many apathy scales are available, not all have been developed for use exclusively in dementia, and psychometric properties may vary across different populations. This systematic review aimed to provide an overview of the psychometric properties of apathy scales used in Alzheimer’s disease (AD) and related dementias, as well as rate the methodological quality of supporting studies. In addition, for those scales identified, performance in clinical trials was reviewed. A search was conducted through Medline, Psychinfo, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. Articles that reported psychometric properties of an apathy scale in an AD or mixed dementia population were included. Of 15 articles, the methodological quality ratings of the studies ranged from adequate to excellent. Three clinical trials and two pooled analyses of clinical trials were included that used apathy scales evaluated in this review. Three scales emerged. The Neuropsychiatric Inventory apathy subscale (NPI-apathy) and the Apathy Evaluation Scale (AES) had the greatest number of studies evaluating psychometric properties and were also used in the clinical trials and have shown sensitivity to change. The Dementia Apathy Interview and Rating demonstrated excellent values of internal consistency, validity, and reliability for use in an AD population. Future research should address comparative scale performance and assess ability to distinguish subtypes of apathy. Validation may include evaluation of performance against specific imaging defined deficits.
Impact of Untimely Access to Formal Care on Costs and Quality of Life in Community Dwelling People with Dementia
Authors: Janssen Niels , Handels Ron L. , Sköldunger Anders , Woods Bob , Jelley Hannah , Edwards Rhiannon Tudor , Orrell Martin , Selbæk Geir , Røsvik Janne , Gonçalves-Pereira Manuel , Marques Maria J. , Zanetti Orazio , Portolani Elisa , Irving Kate , Hopper Louise , Meyer Gabriele , Bieber Anja , Stephan Astrid , Kerpershoek Liselot , Wolfs Claire A.G. , de Vugt Marjolein E. , Verhey Frans R.J. , Wimo Anders ,   Consortium Actifcare
Published: November 2018

Background:

Access to formal care is not always timely and a better understanding on the impact of untimely access is needed.

Objective:

To examine, from a societal perspective, the impact of untimely access to formal care in terms of total costs and quality of life over one year in community dwelling people with dementia.

Methods:

Within the Actifcare study, needs, resource use, and quality of life were observed for one year in a cohort of 451 community dwelling people with dementia in 8 European countries. Untimely access to care was operationalized as having at least one unmet need for care identified by the Camberwell Assessment of Need for the Elderly (CANE) instrument. Two regression models were built for both total costs and quality of life measured by the EQ-5D-5L, one using sum of unmet needs and one using a predefined selection of need items.

Results:

Unmet needs were not associated with higher total costs but they were associated with a lower quality of life of people with dementia. Of all CANE items, only an unmet need for “company” was significantly related to lower total costs.

Conclusion:

Total costs did not seem to differ between participants with unmet and met needs. Only few associations between specific unmet needs and costs and quality of life were found. Furthermore, quality of life of people with dementia decreases when multiple unmet needs are experienced, indicating that assessing and meeting needs is important to improve quality of life.
Distinct White Matter Changes Associated with Cerebrospinal Fluid Amyloid-β1-42 and Hypertension
Authors: Al-Janabi Omar M. , Brown Christopher A. , Bahrani Ahmed A. , Abner Erin L. , Barber Justin M. , Gold Brian T. , Goldstein Larry B. , Murphy Ronan R. , Nelson Peter T. , Johnson Nathan F. , Shaw Leslie M. , Smith Charles D. , Trojanowski John Q. , Wilcock Donna M. , Jicha Gregory A.
Published: November 2018

Background:

Alzheimer’s disease (AD) pathology and hypertension (HTN) are risk factors for development of white matter (WM) alterations and might be independently associated with these alterations in older adults.

Objective:

To evaluate the independent and synergistic effects of HTN and AD pathology on WM alterations.

Methods:

Clinical measures of cerebrovascular disease risk were collected from 62 participants in University of Kentucky Alzheimer’s Disease Center studies who also had cerebrospinal fluid (CSF) sampling and MRI brain scans. CSF Aβ1-42 levels were measured as a marker of AD, and fluid-attenuated inversion recovery imaging and diffusion tensor imaging were obtained to assess WM macro- and microstructural properties. Linear regression analyses were used to assess the relationships among WM alterations, cerebrovascular disease risk, and AD pathology. Voxelwise analyses were performed to examine spatial patterns of WM alteration associated with each pathology.

Results:

HTN and CSF Aβ1-42 levels were each associated with white matter hyperintensities (WMH). Also, CSF Aβ1-42 levels were associated with alterations in normal appearing white matter fractional anisotropy (NAWM-FA), whereas HTN was marginally associated with alterations in NAWM-FA. Linear regression analyses demonstrated significant main effects of HTN and CSF Aβ1-42 on WMH volume, but no significant HTN×CSF Aβ1-42 interaction. Furthermore, voxelwise analyses showed unique patterns of WM alteration associated with hypertension and CSF Aβ1-42.

Conclusion:

Associations of HTN and lower CSF Aβ1-42 with WM alteration were statistically and spatially distinct, suggesting independent rather than synergistic effects. Considering such spatial distributions may improve diagnostic accuracy to address each underlying pathology.