bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation on the fabrication of dicing blades with different sintering methods for machining hard-brittle material wafers
Authors: Yuan Zewei , Cheng Kai , Zhang Yiheng , Hu Jintao , Zheng Peng
Published: September 2018

Hard-brittle materials applied in various micro-electromechanical systems should be sliced into miniature and microparts often with complex microstructures. However, it is difficult for bladed dicing to machine those materials without damage because of their hard and brittle properties. This article presents innovative design and fabrication of dicing blades and the associated dicing process optimization, particularly by focusing on the blade wheel fabrication through sintering methods including traditional hot press sintering, vacuum sintering and spark plasma sintering. Four key parameters, namely, the radial wear of the dicing blade, the current of relay, the number of chips larger than 50 μm and the largest chip size, are employed to assess the cutting performance of dicing blades fabricated. The analysis and experimental results indicate that the spark plasma sintering method achieves the lowest number of chips and the smallest chip size due to its rapid spark between metal particles during the sintering process. The spark plasma sintering method can also produce a granular microstructure with sufficient porosities, which results in uniform bonding strength of diamond abrasive grits within the dicing blade. For the dicing process parameters, the back cutting depth has the most obvious influence on the dicing blade tool life, cutting current and slicing damages, while the feed rate is ranked the next. The least influencing parameter is the dicing spindle rotational speed.
Spacecraft attitude control and vibration suppression integration based on single gimbal magnetically suspended control moment gyroscope pyramid configuration
Authors: Chen Xiaocen , Cai Yuanwen , Ren Yuan
Published: September 2018

For the sake of improving the agility and super-static performance of spacecraft, this paper puts forward an idea for using single gimbal magnetically suspended control moment gyroscope pyramid configuration to realize dual control of attitude maneuver and micro-vibration suppression of spacecraft, in which gyro gimbal rotation is used to realize fast attitude maneuver and magnetic suspension rotor deflection is used to realize high-precision micro-vibration suppression of spacecraft; the switching design of spacecraft attitude/vibration controller realizes the coordinated operation of gyro gimbal and magnetic suspension motor, showing the control advantage of dual actuators. This strategy not only speeds up the attitude maneuver process of spacecraft, improving the dynamic response, but also reduces the attitude stabilization adjustment time as well as improves the stabilization precision, ensuring the fast vibration suppression after attitude maneuver. In addition, this method has strong robustness ensuring the smooth implementation of spacecraft attitude control and vibration suppression integration in the case of parameter change. The simulation results show the effectiveness and superiority of this strategy.
Oscillating-wing unit for power generation
Authors: Liu Tianshu , Ramasamy RS Vewen , Radermacher Ryne , Liou William , Salazar David Moussa
Published: September 2018

This paper describes an exploratory study of a nonconventional wind power converter with a pair of oscillating wings, which is called an oscillating-wing unit. The working principles of the oscillating-wing unit are described, including the aerodynamic models, kinematical, and dynamical models. The performance of the oscillating-wing unit is evaluated through computational simulations and the power scaling in comparison with conventional horizontal-axis wind turbines. Then, a model oscillating-wing unit is designed, built, and tested in a wind tunnel to examine the feasibility of the oscillating-wing unit in extraction of the wind energy in comparison with the theoretical analysis. The theoretical analysis and experimental data indicate that the oscillating-wing unit has the power efficiency comparable to the conventional horizontal axis wind turbine and it can operate at low wind speeds.
Transnational Soldiers and Guerrilla Warfare from the Spanish Civil War to the Second World War
Authors: Marco Jorge
Published: September 2018

This article analyses how military institutions incorporated innovations in their tactics using the intermediary role of transnational soldiers in the Spanish Civil War. The Soviet experience of guerrilla warfare during the Russian Civil War was transferred to foreign volunteers during the war in Spain thanks to the collaboration of Soviet experts advising the Spanish Republican Army. After the war, these soldiers’ knowledge and experience of guerrilla warfare were invaluable to the Allied Armies during the Second World War. This article analyses the role of International Brigaders in the OSS in the USA, North Africa, and Europe during the Second World War.
The Golden Age, Revisited: George C. Marshall’s Press Work, 1939–45
Authors: Crosbie Thomas
Published: September 2018

It is often assumed that the Second World War marked a golden age of the US Armed Forces’ control over the mass media. However, few scholars have examined the degree to which press matters occupied the time and attention of the highest levels of military command – if at all. The daily work of Army Chief of Staff George C. Marshall reveals a rather more complex portrait. If the era was indeed a golden age for the army, it was made so in part through persistent effort by both public affairs agencies and at least one top army commander.
Active vibration suppression of elastic blade structure: Using a novel magnetorheological layer patch
Authors: Bolat Fevzi Cakmak , Sivrioglu Selim
Published: September 2018

This research study proposes a new active control structure to suppress vibrations of a small-scale wind turbine blade with attached magnetorheological fluid patch actuated by an electromagnet. The blade structure is manufactured by an aluminum extrusion machine considering the airfoil data of SH3055 which is designed for use on a small wind turbine. An interaction model between the magnetorheological patch and the electromagnetic actuator is derived and a force characterization is realized. A norm-based multiobjective H2/ H∞ controller is designed using the state-space model of the elastic blade element. The H2/ H∞ controller is experimentally implemented under the steady-state aerodynamic load conditions. The results of experiments show that the magnetorheological layer patch is effective for suppressing vibrations of the blade structure and robust against parametric uncertainty.
“It Changed Our Outlook on How We Want to Live”: Cancer as a Transformative Health Experience for Young Adult Survivors and Their Family Members
Authors: Head Katharine J. , Iannarino Nicholas T.
Published: September 2018

Although young adult cancer survivors (YACSs) and their families face unique psychosocial and health-related challenges related to cancer, little is known about how the illness experience of cancer may positively transform their mental, physical, and social well-being following primary treatment. We conducted individual qualitative interviews with 30 YACSs and 21 of their family members. Participants described positive transformations as (a) perspective shifts on health and risk, (b) behavior changes toward more proactive healthy living, and (c) opportunities for more open communication about wellness. Few participants reported little to no transformation based on a fatalistic view of their diagnosis. Our findings illuminate important implications for health promotion and support in this population, including the role health care providers can play following primary treatment. We also discuss how YACSs can serve as important advocates for others and the need for more work exploring how and why positive illness transformations take place.
Evaluation of Pharmacy-Developed Antibiotic Desensitization Protocols
Authors: Chen Xian Jie Cindy , Fong Karen , Altshuler Diana , Dubrovskaya Yanina , Louie Eddie , Amoroso Nancy , Goldenberg Ronald , Papadopoulos John
Published: September 2018

Background: Parameters within reconstitution, storage, stability, and administration may be optimized according to the unique pharmacokinetics of each antibiotic to ensure a successful desensitization. Objective: The study aims to evaluate the successfulness and safety of antibiotic desensitization protocols developed by the pharmacy department at our institution. Methods: A retrospective study was conducted at an 800-bed, urban, tertiary care, academic medical center. A total of 36 patients 18 years of age or older, admitted to our intensive care units between March 2013 and July 2017, who underwent antibiotic desensitization utilizing our pharmacy developed protocols were included. Results: In 36 patients, 61 desensitization cases were identified and included; 17 (47%) were male, 27 (75%) were Caucasian, and the median age was 55 years (range 19-94). In all, 15 different antibiotics were administered for desensitization, with meropenem (n = 12, 20%), ampicillin (n = 7, 11%), piperacillin/tazobactam (n = 7, 11%), and penicillin (n = 7, 11%) being the most common; 59 (97%) of 61 desensitizations were completed successfully with or without experiencing reactions, and 53 (89%) of the successful desensitization cases were completed without reactions. Two cases were categorized as anaphylaxis, which was severe enough to terminate the desensitization process. Of the 59 cases successfully completed, the 6 (10%) cases that experienced reactions were managed successfully during desensitization with completion of the process. Conclusion and Relevance: The findings suggest that our pharmacy-developed antibiotic desensitization protocols are successful and safe and may be adapted by other institutions.
The Prevalence and Nature of Medication Errors and Adverse Events Related to Preadmission Medications When Patients Are Admitted to an Orthopedic Inpatient Unit: An Observational Study
Authors: Tran Tim , Taylor Simone E. , Hardidge Andrew , Mitri Elise , Aminian Parnaz , George Johnson , Elliott Rohan A.
Published: September 2018

Background: Medication errors commonly occur when patients move from the community into hospital. Whereas medication reconciliation by pharmacists can detect errors, delays in undertaking this can increase the risk that patients receive incorrect admission medication regimens. Orthopedic patients are an at-risk group because they are often elderly and use multiple medications. Objective: To evaluate the prevalence and nature of medication errors when patients are admitted to an orthopedic unit where pharmacists routinely undertake postprescribing medication reconciliation. Methods: A 10-week retrospective observational study was conducted at a major metropolitan hospital in Australia. Medication records of orthopedic inpatients were evaluated to determine the number of prescribing and administration errors associated with patients’ preadmission medications and the number of related adverse events that occurred within 72 hours of admission. Results: Preadmission, 198 patients were taking at least 1 regular medication, of whom 176 (88.9%) experienced at least 1 medication error. The median number of errors per patient was 6 (interquartile range 3-10). Unintended omission of a preadmission medication was the most common prescribing error (87.4%). There were 17 adverse events involving 24 medications in 16 (8.1%) patients that were potentially related to medication errors; 6 events were deemed moderate consequence (moderate injury or harm, increased length of stay, or cancelled/delayed treatment), and the remainder were minor. Conclusion and Relevance: Medication errors were common when orthopedic patients were admitted to hospital, despite postprescribing pharmacist medication reconciliation. Some of these errors led to patient harm. Interventions that ensure that medications are prescribed correctly at admission are required.
Static mechanical response of sandwich panels with bilinear core
Authors: Wei Guangtao , Feng Lijia , Wu Linzhi
Published: September 2018

A new theoretical model based on the extended high order sandwich panel theory is established to predict the mechanical response of sandwich panels under static loads with the bilinear constitutive stress–strain relation in the core. The constitutive relations of normal stresses related to the longitudinal and vertical normal strains in the bilinear isotropic hardening core are first formulated. The influence of the in-plane rigidity on the elastoplastic response of sandwich structures is analyzed. An in-plane loaded sandwich structure with the bilinear core is first studied based on extended high order sandwich panel theory, and the effect of the bilinear ratio on the mechanical response is evaluated. The governing equations are derived from the principle of minimum potential energy, and a Ritz-based half-analytical method is applied to get the solutions. The plastic response is acquired by an iterative procedure along with the convergence criteria. The results reveal that the local effect can be captured when the axial rigidity of the core is considered. The bilinear characteristic of the core decreases the maximum normal stress with an increase of the average value. The equivalent plastic region extends with the increase of the bilinear ratio when the sandwich structure is loaded in plane. By comparison with open literatures and finite element results, the present theoretical model is proved to be effective and efficient.
Retinal Vascular Imaging in Vascular Cognitive Impairment: Current and Future Perspectives
Authors: Dumitrascu Oana M , Qureshi Touseef A
Published: September 2018

Vascular cognitive disorders are heterogeneous and increasingly recognized entities with intricate correlation to neurodegenerative conditions. Retinal vascular analysis is a noninvasive approach to study cerebrovascular pathology, with promise to assist particularly during early disease phases. In this article, we have systematically summarized the current understanding, potential applications, and inevitable limitations of retinal vascular imaging in patients with vascular cognitive impairment. In addition, future directions in the field with support from automated technology using deep learning methods and their existing challenges are emphasized.
Reinstating the artist’s voice: Artists’ perspectives on participatory projects
Authors: Johanson Katya , Glow Hilary
Published: September 2018

Claire Bishop argued that the ethical lens applied to socially engaged arts practice encourages ‘authorial renunciation’ in favour of collaboration and limits the opportunity to expose such practice to critical reception. This article responds to Bishop’s implicit call to envision an artist-centred framework for participatory arts by identifying the motivations and beneficial discoveries that artists make when they seek out the creative involvement of others. Based on interviews with Australian performing artists who have established socially engaged practices, the article aims to bring about a form of ‘authorial reinstatement’ into the value system around participatory arts practice. It identifies a range of motivations for artists who establish socially engaged or participatory practice, from self-developmental to altruistic; and from arts-focused to community- and society-focused. The article argues that using these motivations to inform indicators of achievement for participatory practice provides new opportunities for critical interrogation of those practices.
Does part-time employment status really reduce time pressure?
Authors: Rose Judy , Hewitt Belinda
Published: September 2018

Part-time employment rates are increasing in Australia, for both women and men. However, gendered patterns in part-time employment status are typically associated with mothers’, rather than fathers’, transition to parenthood. This study uses data from the 2006 Negotiating the Life Course survey to investigate whether part-time employment reduces time pressure for women compared to men, when temporal job quality is considered. Our results show that women employed in shorter part-time hours had better time pressure outcomes, overall and at work, than women employed in longer part-time hours. Yet findings show that a lack of access to temporal flexibility and irregular work schedules negatively impact time pressure outcomes for both men and women. We conclude that time pressure benefits gained from being employed part-time, may be diminished when there is poor temporal job quality.
The role of self-reports in the study of news production
Authors: Ryfe David M
Published: September 2018

For decades, scholars have known that much of journalistic practice is motivated by habits that lie beyond the conscious reflection of journalists. Yet, when studying news production, scholars often rely on methods, like interviewing, which elicit consciously articulated self-reports from journalists. Doing so leaves unexplored the comparatively vast terrain of news production driven by pre-reflective motivations. Borrowing from the dual-processing theory of human cognition, this article explores what methods like interviewing can and cannot explain about news production. It also discusses alternative methods specifically designed to investigate the role of ‘practical consciousness’ in behavior. The benefits of this exercise are several, including greater clarity about the sorts of claims that can be made on the basis of self-reported data, better alignment between theories and methods in the study of news production, and consideration of alternative methods for accessing the parts of journalistic practice that work in implicit and unconscious ways.
Meaningful tourist transformations with Country at Bawaka, North East Arnhem Land, northern Australia
Authors: Country Bawaka , Wright Sarah , Lloyd Kate , Suchet-Pearson Sandie , Burarrwanga Laklak , Ganambarr Ritjilili , Ganambarr Merrkiyawuy , Ganambarr Banbapuy , Maymuru Djawundil , Tofa Matalena
Published: September 2018

In this article, we discuss how human and more-than-human agencies, experienced and interpreted through emotions and sensory experiences, actively shape and enable transformative learning for tourists. We examine the narratives of two visitors to Bawaka Cultural Enterprises, an Indigenous-run tourism venture in North East Arnhem Land, northern Australia. We attend particularly to the more-than-human place of Bawaka and the ways the visitors are drawn into what is known as Bawaka Country. Indeed, transformation occurs as the visitors co-become with Country, become part of its ongoing co-constitution. We also examine the limits to transformations forged through such immersive tourism experiences. Ultimately, we suggest that for these visitors, more-than-human agencies create transformative learning experiences which build emotional and affective connections with people, places and causes. We argue that even though these connections may become diluted over time and distance, embodied and remembered experiences remain meaningful, having the potential to unsettle, connect and transform.
Economics of dementia: A review of methods
Authors: Connolly Sheelah
Published: September 2018

Given the expected increase in the number of people with dementia in the coming years, it is anticipated that the resources necessary to support those with dementia will significantly increase. There will therefore likely be increased emphasis on how best to use limited resources across a number of domains including prevention, diagnosis, treatment and supporting informal caregivers. There has been increasing use of economic methods in dementia in the past number of years, in particular, cost-of-illness analysis and economic evaluation. This paper reviews the aforementioned methods and identities a number of methodological issues that require development. Addressing these methodological issues will enhance the quality of economic analysis in dementia and provide some useful insights about the best use of limited resources for dementia.
“I haven't read it, I've lived it!” The benefits and challenges of peer research with young people leaving care
Authors: Kelly Berni , Friel Seana , McShane Theresa , Pinkerton John , Gilligan Eithne
Published: September 2018

Peer research is increasingly being used in research with children and young people. As a result, there is a growing understanding of both the benefits and challenges of involving young peer researchers in qualitative research. This article aims to add to that understanding by providing a detailed account and reflection of the involvement of care leavers as peer researchers in the qualitative case study phase of a three-year, mixed method study of the transitions of young people leaving care in Northern Ireland. It is one of only a few studies on leaving care in which peer research is central to the design. Particular attention is given to the benefits and challenges for all of the stakeholders involved in the research study: the participants, peer researchers, academic researchers and supporting partner organisation. Key learning points are identified and it is concluded that, despite the considerable challenges, peer research should become a routine consideration as a fruitful means of co-production in the design of care leaver research.
Life History, Fertility, and Short-Term Mating Motivation
Authors: Kim Aekyoung , Bradshaw Hannah , Durante Kristina M. , Hill Sarah E.
Published: September 2018

The current research examines the impact of women’s early-life socioeconomic status (SES; used as a proxy measure of life history strategy), relationship status, and ovulatory cycle phase on their desire for short-term mating. Results revealed that during the periovulatory phase (i.e., the high-fertility phase of the monthly ovulatory cycle), single women from low SES environments expressed an increased desire for short-term mating, whereas the opposite was found for single women from high SES environments. No such pattern was found for partnered women. These results suggest that one’s early-life environment and relationship status may play a key role in how women respond to internal fertility cues, providing important new insights into factors that may moderate ovulatory shifts in mating behavior. Results provide some of the first evidence that one’s developmental history may alter the expression of ovulatory cycle adaptations.
Development and application of a deep learning–based sparse autoencoder framework for structural damage identification
Authors: Pathirage Chathurdara Sri Nadith , Li Jun , Li Ling , Hao Hong , Liu Wanquan , Wang Ruhua
Published: September 2018

This article proposes a deep sparse autoencoder framework for structural damage identification. This framework can be employed to obtain the optimal solutions for some pattern recognition problems with highly nonlinear nature, such as learning a mapping between the vibration characteristics and structural damage. Three main components are defined in the proposed framework, namely, the pre-processing component with a data whitening process, the sparse dimensionality reduction component where the dimensionality of the original input vector is reduced while preserving the required necessary information, and the relationship learning component where the mapping between the compressed dimensional feature and the stiffness reduction parameters of the structure is built. The proposed framework utilizes the sparse autoencoders based deep neural network structure to enhance the capability and performance of the dimensionality reduction and relationship learning components with a pre-training scheme. In the final stage of training, both components are jointly optimized to fine-tune the network towards achieving a better accuracy in structural damage identification. Since structural damages usually occur only at a small number of elements that exhibit stiffness reduction out of the large total number of elements in the entire structure, sparse regularization is adopted in this framework. Numerical studies on a steel frame structure are conducted to investigate the accuracy and robustness of the proposed framework in structural damage identification, taking into consideration the effects of noise in the measurement data and uncertainties in the finite element modelling. Experimental studies on a prestressed concrete bridge in the laboratory are conducted to further validate the performance of using the proposed framework for structural damage identification.
Deep Femoral Vein Reconstruction of the Abdominal Aorta and Adaptation of the Neo-Aortoiliac System Bypass Technique in an Endovascular Era
Authors: Nordanstig Joakim , Törngren Kristina , Smidfelt Kristian , Roos Håkan , Langenskiöld Marcus
Published: September 2018

Background:

Primary infection of the abdominal aorta is a rare pathology that may threaten the integrity of the aortic wall, while secondary aortic prosthesis infection represents a devastating complication to open surgical and endovascular aortic surgery. Curative treatment is achievable by removal of all infected prosthetic material followed by a vascular reconstruction.

Design and Methods:

Twelve consecutive patients treated with the neo-aortoiliac system bypass (NAIS) procedure were reviewed. Nine were treated for a secondary aortic prosthesis infection (tube graft n = 3, bifurcated graft n = 4, endovascular aortic repair (EVAR) stent graft n = 1, and fenestrated EVAR [FEVAR] stent graft n = 1), while 3 patients underwent NAIS repair due to an emergent primary mycotic aortoiliac aneurysm.

Primary Results:

Ten of 12 patients survived 30 days. Three patients were operated on acutely, and 9 patients had elective or subacute NAIS surgery. Two of 3 patients operated acutely died within 30 days, whereas no 30-day or 1-year mortality was observed in patients undergoing elective or subacute surgery. The median time from primary reconstruction to the NAIS procedure was 11 months (range: 0-201 months). Stent grafts (n = 5 of 12) were in 4 cases explanted using endovascular balloon clamping. Of the explanted endografts, 2 patients presented with a secondary graft infection after EVAR/FEVAR, while 3 patients had been emergently treated with endovascular cuffs as a “bridge-to-surgery” procedure due to aortoenteric fistula (AEF). Patients who received a “bridge-to-surgery” regimen were treated with the NAIS procedure within 8 weeks (median 27 days, range: 27-60) after receiving emergency stent grafting.

Principal Conclusions:

Aortic balloon-clamping during explantation of infected aortic prosthetic endografts is feasible and facilitates complete endograft removal. Endovascular bridging procedures could be beneficiary in the treatment of AEF or anastomotic dehiscence due to graft infection, offering a possibility to convert the acute setting to an elective definitive reconstructive procedure with a higher overall success rate.
Assumptions about Frailty and the Tenacity of Ageism among Care Professionals
Authors: Kane Michael N. , Jacobs Robin J.
Published: September 2018

Health, mental health, and pastoral care professionals encourage individuals to care for themselves in order to age successfully. Younger persons who live with long-term physical or mental health challenges are perceived as disabled or health-challenged. When older persons possess long-term physical or psychiatric challenges the older individual is perceived as frail or with deficits. Implications for clinical and pastoral care are considered as a result of perceptions of frailty in an ageist culture.
Ministry to Transgender Teenagers (Part One): Pursuing Awareness and Understanding about Trans Youth
Authors: Canales Arthur D.
Published: September 2018

Several significant aspects are addressed in this article to gain clarity and to pursue awareness regarding transgender teenagers. It begins by offering a brief introduction and then moves towards a common understanding of the language and landscape surrounding transgender teenagers. Next the paper centers on maligned, marginalized, and misunderstood transgender teenagers and the experiences they encounter. Hopefully, the information gleaned in this article will empower pastoral care givers to minister directly to this particular underserved sexual minority group.
Need for Perspective
Authors: Mäyrä Frans , Sotamaa Olli
Published: September 2018

This special issue of Games and Culture aims to engage in dialogue between different traditions of doing games research and to stimulate reflective responses about the overall state of the field.
Embolization of a peripheral cerebral aneurysm associated with intracranial major artery occlusion through a transdural anastomotic artery: Case report
Authors: Fukuda Norito , Kanemaru Kazuya , Hashimoto Koji , Yoshioka Hideyuki , Senbokuya Nobuo , Yagi Takashi , Kinouchi Hiroyuki
Published: September 2018

A peripheral cerebral aneurysm is known to develop at collateral vessels as a result of hemodynamic stress by the occlusion of the intracranial major arteries. We report a case of successful embolization of a ruptured aneurysm through a transdural anastomotic artery. The aneurysm formed at the developed collateral vessel from the meningeal branch of the occipital artery (OA) to the posterior pericallosal artery. A 59-year-old man presented with acute-onset headache, and computed tomography revealed subarachnoid hemorrhage and intracerebral hemorrhage at the splenium of the corpus callosum with intraventricular hemorrhage. Digital subtraction angiography demonstrated a ruptured aneurysm located at a transdural anastomotic artery from the right OA to the posterior pericallosal artery. The patient underwent endovascular treatment for the aneurysm through the transdural anastomotic artery with a coil and n-butyl-2-cyanoacrylate. Because it was impossible to navigate a microcatheter to the aneurysm through the right anterior cerebral artery because of the occlusion of its proximal portion, it was advanced through the transdural anastomosis from the right OA. The aneurysm was completely occluded without complications. Endovascular embolization is a useful treatment option for a peripheral cerebral aneurysm developed at a collateral vessel with intracranial major artery occlusion.
Social justice in a tertiary education context: Do we practice what we preach?
Authors: Gair Susan , Baglow Len
Published: September 2018

Concepts of social justice have strong historical roots, while more contemporary notions of social justice coincide with human rights, equity, fairness and facilitation of social change with lasting impact. In higher education, evident examples of social justice include widened university access facilitating a diverse student body and graduate workforce who can, in turn, contribute to a more just society. University student identity in past eras has been synonymous with social activism. Equally, social work has a mandate to uphold social justice. Yet tertiary students’ own growing material hardships appear to constitute an unacknowledged injustice. While it is understood that tertiary study may mean short-lived poverty, more recent literature suggests that many university students are suffering mounting debt, increased mental health stress and vulnerability to withdrawal. In this article, the authors ponder social justice education by calling on specific results of a 2015 survey of 2320 Australian social work students. Findings revealed that for many students a juggling act of core study requirements, paid work, family commitments and affording necessities impacted their health, wellbeing and study success. Some astute students identified a disconnect between social work’s staunch social justice agenda and its lack of acknowledgement, empathy or action regarding student hardship. The findings have implications for curricula, universities, accrediting bodies and educators who want to facilitate social justice education.
Photographing prisoners: The unworthy, unpleasant and unchanging criminal body
Authors: Miranda Diana , Machado Helena
Published: September 2018

The use of photography in representing the criminal body has long been a focus of interest in the social sciences, especially so when exploring the historical evolution of criminal identification practices. By contributing to the emerging field of visual criminology, this article explores current practices around photography of prisoners in the everyday contexts of the prison space. Drawing on a qualitative study conducted with prisoners, prison guards and probation officers in three Portuguese prisons, we analyse how different social actors construct the criminal body. This construction is explored through the meanings attributed to prisoners’ photographic portraits used for their identification. In particular, we discuss how their photographic documentation acts as a classification device and a visual representation of the criminal. We argue that this representation, by portraying elements of unworthiness, unpleasantness and immutability, plays a significant role in the parole board’s decisions and produce an embodied sense of identity and perpetuation of stigma.
Mixed connective tissue disease in pregnancy: A case series and systematic literature review
Authors: Tardif Marie-Lou , Mahone Michèle
Published: September 2018

Objective

To investigate the impact of medical and obstetric complications associated with mixed connective tissue disease (MCTD) in pregnancy.

Method

We analyzed 68 pregnancies from a systematic literature review and 12 pregnancies affected by MCTD at our centre between 1986 and 2015 for medical and obstetric complications.

Results

During pregnancy 37.1% had active MCTD and 26.7% had relapsed. Maternal complications included caesarean section (31.1%, n = 19), preeclampsia (17.6%, n = 13), thromboembolism events, and death (2.5%, n = 2 for each). Fetal complications included prematurity (48.1%, n = 25), intrauterine growth restriction (38.3%, n = 19), and neonatal lupus (28.6%, n = 18, including chondrodysplasia punctata). More than half ( n = 10) of the neonatal lupus cases were explained by anti-U1RNP only. The perinatal mortality rate was 17.7% ( n = 14). Pregnant women with active disease had higher rates of prematurity (OR = 7.60; 95%CI [1.93; 29.95]) and perinatal death (OR = 16.83; 95%CI [1.90; 147.70]).

Conclusion

MCTD in pregnancy puts women at risk of medical and obstetric complications, and disease activity probably increases this risk.
Long-term outcome of elderly out-of-hospital cardiac arrest survivors as compared with their younger counterparts and the general population
Authors: Hiemstra Bart , Bergman Remco , Absalom Anthony R. , van der Naalt Joukje , van der Harst Pim , de Vos Ronald , Nieuwland Wybe , Nijsten Maarten W. , van der Horst Iwan C. C.
Published: September 2018

Background:

Over the past decade, prehospital and in-hospital treatment for out-of-hospital cardiac arrest (OHCA) has improved considerably. There are sparse data on the long-term outcome, especially in elderly patients. We studied whether elderly patients benefit to the same extent compared with younger patients and at long-term follow up as compared with the general population.

Methods:

Between 2001 and 2010, data from all patients presented to our hospital after OHCA were recorded. Elderly patients (⩾75 years) were compared with younger patients. Neurological outcome was classified as cerebral performance category (CPC) at hospital discharge and long-term survival was compared with younger patients and predicted survival rates of the general population.

Results:

Of the 810 patients admitted after OHCA, a total of 551 patients (68%) achieved return of spontaneous circulation, including 125 (23%) elderly patients with a mean age of 81 ± 5 years. In-hospital survival was lower in elderly patients compared with younger patients with rates of 33% versus 57% ( p < 0.001). A CPC of 1 was present in 73% of the elderly patients versus 86% of the younger patients ( p = 0.031). In 7.3% of the elderly patients, a CPC >2 was observed versus 2.5% of their younger counterparts ( p = 0.103). Elderly patients had a median survival of 6.5 [95% confidence interval (CI) 2.0–7.9] years compared with 7.7 (95% CI 7.5–7.9) years of the general population ( p = 0.019).

Conclusions:

The survival rate after OHCA in elderly patients is approximately half that of younger patients. Elderly patients who survive to discharge frequently have favorable neurological outcomes and a long-term survival that approximates that of the general population.
Effects of Emergency Department Physical Design Elements on Security, Wayfinding, Visibility, Privacy, and Efficiency and Its Implications on Staff Satisfaction and Performance
Authors: Zamani Zahra
Published: September 2018

Objective:

The purpose of this study was to identify the role of emergency department (ED) design on ED staff satisfaction and performance.

Background:

High patient volume, surging workloads, and violent behaviors are expected pressures for ED staff. Literature suggests the substantial role of the physical environment in the delivery of care and its role in staff and patient experiences. Nevertheless, limited studies have explored simultaneous interactions between ED physical design elements, attributes (security, wayfinding, visibility, privacy, and efficiency), and staff satisfaction or performance.

Method:

Interviews, surveys, visibility graph analysis, and agent simulations were employed to understand the connection between ED physical design, attributes, performance, and staff satisfaction.

Results:

Enhanced security, effective wayfinding, team visibility, noise reduction, adequate privacy, and accessible supplies and equipment were significant predictors of staff satisfaction and performance. Unobstructed views in waiting and triage and controlled entrances were critical for improving security. To improve wayfinding, eye-level signage, reducing surveillance obstacles, and creating direct public routes were recommended. Rectangular units with multiple perpendicularly connected corridors and linear pod arrangements enhanced movement. Including team rooms and enclosed ERs were recommended for privacy improvements. Visibility was critical for team communication and improved by including short-distanced perpendicular corridors and eliminating columns. Enhancing access to supplies or equipment and reducing noise levels improved the perception of staff efficiency.

Conclusion:

The findings contribute to the general body of knowledge on the impact of ED physical design on attributes that potentially improve staff satisfaction and work performance.
Association between musculoskeletal pain with social isolation and loneliness: analysis of the English Longitudinal Study of Ageing
Authors: Smith Toby O , Dainty Jack R , Williamson Esther , Martin Kathryn R
Published: September 2018

Introduction:

Musculoskeletal pain is a prevalent health challenge for all age groups worldwide, but most notably in older adults. Social isolation is the consequence of a decrease in social network size with a reduction in the number of social contacts. Loneliness is the psychological embodiment of social isolation and represents an individual’s perception of dissatisfaction in the quality or quantity of their social contacts. This study aims to determine whether a relationship exists between musculoskeletal pain and social isolation and loneliness.

Methods:

A cross-sectional analysis of the English Longitudinal Study of Ageing (ELSA) cohort was undertaken. ELSA is a nationally representative sample of the non-institutionalised population of individuals aged 50 years and over based in England. Data were gathered on social isolation through the ELSA Social Isolation Index, loneliness through the University of California, Los Angeles (UCLA) Loneliness Scale and musculoskeletal pain. Data for covariates included physical activity, depression score, socioeconomic status, access to transport and demographic characteristics. Logistic regression analyses were undertaken to determine the relationship between social isolation and loneliness with pain and the additional covariates.

Results:

A total of 9299 participants were included in the analysis. This included 4125 (44.4%) males, with a mean age of 65.8 years. There was a significant association where social isolation was lower for those in pain (odd ratio (OR): 0.87; 95% confidence intervals (CI): 0.75 to 0.99), whereas the converse occurred for loneliness where this was higher for those in pain (OR: 1.15; 95% CI: 1.01 to 1.31). Age, occupation, physical activity and depression were all associated with increased social isolation and loneliness.

Conclusion:

People who experience chronic musculoskeletal pain are at greater risk of being lonely, but at less risk of being socially isolated. Health professionals should consider the wider implications of musculoskeletal pain on individuals, to reduce the risk of negative health implications associated with loneliness from impacting on individual’s health and well-being.
Glomus cell tumour on the head of a cat
Authors: Conte Alessandro , Scurrell Emma , Baines Stephen J
Published: September 2018

Case summary

A solitary, sessile, non-ulcerated, freely mobile cutaneous mass approximately 1 cm in diameter on the left temporal region of a 7-year-old neutered female cat was examined. A fine-needle aspirate and wedge biopsy were performed by the referring veterinary surgeon and indicated a neoplasm of uncertain cell lineage. On histopathological examination, the deep dermis contained a discrete, non-encapsulated and vascular neoplasm with morphological and immunophenotypical features typical of a glomus cell tumour. Neoplastic cells were immunopositive for vimentin, muscle actin and smooth muscle actin, and immunonegative for cytokeratin, S100, desmin and von Willebrand factor (factor VIII-related antigen).

Relevance and novel information

Glomus cell tumours arise from modified smooth muscle cells and are rare in animals, particularly cats. Specific immunohistochemistry is of fundamental importance in the correct diagnosis of these tumours and should be considered for masses when cytology and histology results are inconclusive or uncertain.
Patients’ Use and Perception of Internet-Based Orthopaedic Sports Medicine Resources
Authors: Koenig Scott , Nadarajah Vidushan , Smuda Michael P. , Meredith Sean , Packer Jonathan D. , Henn R. Frank
Published: September 2018

Background:

Current research is sparse regarding how patients with orthopaedic injuries perceive and use internet-based information resources.

Hypothesis:

The majority of patients use the internet to research their orthopaedic condition and are receptive to guidance from their provider.

Study Design:

Cross-sectional study.

Methods:

A total of 213 patients attending a sports medicine clinic on the East Coast of the United States were asked to complete a questionnaire regarding their use of internet-based information. Data from 185 patients were available for analysis. Bivariate and multivariate statistical analyses were used to determine the significance of identified associations.

Results:

Overall, 54% of patients used the internet to find information about their orthopaedic condition prior to their consultation. A higher percentage of internet users were women ( P = .01), were white ( P = .03), and had internet access at home ( P = .02). Multivariable analysis found home internet access to be the only significant independent factor predictive of patients using internet-based information sources ( P < .01). The majority of patients (61%) were neutral toward orthopaedic information found online, and only 32% of patients trusted the orthopaedic information they found online. The majority of patients (83%) reported they would be receptive to providers’ guidance on which internet resources to use.

Conclusion:

Only half of patients use the internet to research their orthopaedic condition. Most patients were either neutral toward or did not trust the internet-based information that they found and may forgo internet sources altogether. To help patients avoid misleading information, sports medicine providers should understand how patients are using the internet and guide patients in selecting high-quality, peer-reviewed sources of information. Doing so allows physicians to proactively educate their patients even after the clinic visit.
Surgical Decision Making for Acetabular Labral Tears: An International Perspective
Authors: Herickhoff Paul Kenneth , Safran Marc Raymond
Published: September 2018

Background:

Studies comparing acetabular labral repair with debridement have generally demonstrated better clinical outcomes with repair. However, it is not clear whether hip arthroscopic surgeons agree on the indications for labral repair and debridement, bringing the generalizability of these (and future) studies into question.

Purpose:

To investigate surgical decision making for acetabular labral tears, with a specific focus on indications for repair or debridement, by performing an international survey of hip arthroscopic surgeons.

Study Design:

Cross-sectional study.

Methods:

A total of 35 hip arthroscopic surgeons from around the world were invited to participate in this survey study. Surgeons selected the factors that they consider when deciding to repair or debride acetabular labral tears. For each variable selected, computerized adaptive logic prompted additional questions to better define how that variable affects decision making. Six deidentified intraoperative videos of a variety of labral tears were included to determine the level of agreement between the experts on which labral tears are repairable.

Results:

The survey response rate was 86%. A majority (77%) of hip arthroscopic surgeons selected the intraoperative appearance of the labrum as the most important factor affecting their decision making. Specific factors affecting surgical decision making included pattern of the labral tear (73% of surgeons), ossification of the labrum (70%), magnetic resonance imaging findings (70%), patient age (63%), activity level (57%), radiographic findings (53%), calcification of the labrum (50%), and thickness of the labrum (47%). Three intraoperative videos had ≥90% agreement for labral repair, while the other 3 had ≤76% agreement.

Conclusion:

The intraoperative appearance of the labrum is the most important factor affecting surgical decision making. However, different surgeons viewing the same tear arthroscopically may select different treatments. The indications to repair a torn acetabular labrum are highly variable among hip arthroscopic surgeons.
Light Privilege? Skin Tone Stratification in Health among African Americans
Authors: Hargrove Taylor W.
Published: September 2018

Skin tone is a status characteristic used in society to evaluate and rank the social position of minorities. Although skin color represents a particularly salient dimension of race, its consequences for health remains unclear. The author uses four waves of panel data from the Coronary Artery Risk Development in Young Adults study and random-intercept multilevel models to address three research questions critical to understanding the skin color–health relationship among African American adults ( n = 1,680): What is the relationship between skin color and two global measures of health (cumulative biological risk and self-rated health)? To what extent are these relationships gendered? Do socioeconomic characteristics, stressors, and discrimination help explain the skin color–health relationship? The findings indicate that dark-skinned women experience more physiological deterioration and self-report worse health than lighter skinned women. These associations are not evident among men, and socioeconomic factors, stressors, and discrimination do not explain the dark-light disparity in physiological deterioration among women. Differences in self-ratings of health among women, however, are generally explained by education and income. The results of this study highlight heterogeneity in determinants of health among African Americans. They also provide a more nuanced understanding of health inequality by identifying particularly disadvantaged members of racial groups that are often assumed to have monolithic experiences.