bluuebunny/crossref_metadata_2025 huggingface dataset:
The Most and the Least Performed Self-Care Behaviors Among Patients With Heart Failure in Jordan
Authors: Tawalbeh Loai Issa , Al-Smadi Ahmed Mohammad , AlBashtawy Mohammed , AlJezawi Maen , Jarrah Mohamad , Musa Ahmed S. , Aloush Sami
Published: June 2018

Assessing self-care is important aspects among patients with heart failure. However, few studies were conducted to assess self-care among patients with heart failure in Jordan. Therefore, this study aimed to assess the most and the least performed maintenance self-care behaviors and to examine the relationship between maintenance self-care behaviors and selected sociodemographics. A cross-sectional design utilizing a convenience sample of 226 patients with heart failure was used. The maintenance self-care mean was 53.89 and considered below the clinical target level (≥70). Asking for low salt item and performing physical exercises were the most performed self-care behaviors, while “trying to avoid getting sick” and “checking ankles for swelling” were the least performed self-care behaviors. Limited self-care behaviors indicated the need to implement cardiac education that may improve self-care behaviors. Cardiac education should target mainly patients with low income, low educational level, elderly, living alone, unemployed, and who are using traditional treatment.
Demonstrating the superiority of the FCB Grid as a tool for students to write effective advertising strategy
Authors: Yssel Johan C.
Published: June 2018

This paper demonstrates how strategies written according to the FCB quadrant and sextant grids will be superior to those written per textbook formula. As far as could be determined, this is the first time an attempt to measure strategy has been undertaken. Three different ways for writing strategies, and the instrument for measuring their effectiveness, are discussed before demonstrating that when students use the FCB grid superior strategies result.
Preliminary appraisal of the reliability and validity of the Colorado State University Feline Acute Pain Scale
Authors: Shipley Hilary , Guedes Alonso , Graham Lynelle , Goudie-DeAngelis Elizabeth , Wendt-Hornickle Erin
Published: May 2018

Objectives

The objective of this study was to determine the inter-rater reliability and convergent validity of the Colorado State University Feline Acute Pain Scale (CSU-FAPS) in a preliminary appraisal of its performance in a clinical teaching setting.

Methods

Sixty-eight female cats were assessed for pain after ovariohysterectomy. A cohort of 21 cats was examined independently by four raters (two board-certified anesthesiologists and two anesthesia residents) with the CSU-FAPS, and intra-class correlation coefficient (ICC) was used to determine inter-rater reliability. Weighted Cohen’s kappa was used to determine inter-rater reliability centered on the ‘need to reassess analgesic plan’ (dichotomous scale). A separate cohort of 47 cats was evaluated independently by two raters (one board-certified anesthesiologist and one veterinary small animal rotating intern) using the CSU-FAPS and the Glasgow Composite Measure Pain Scale (CMPS-Feline), and Spearman rank-order correlation was determined to assess convergent validity. Reliability was interpreted using Altman’s classification as very good, good, moderate, fair and poor. Validity was considered adequate if correlation coefficients were between 0.4 and 0.8.

Results

The ICC was 0.61 for anesthesiologists and 0.67 for residents, indicating good reliability. Weighted Cohen’s kappa was 0.79 for anesthesiologists and 0.44 for residents, indicating moderate to good reliability. The Spearman rank correlation indicated a statistically significant ( P = 0.0003) positive correlation (0.31; 95% confidence interval 0.14–0.46) between the CSU-FAPS and the CMPS-Feline.

Conclusions and relevance

The CSU-FAPS showed moderate-to-good inter-rater reliability when used by veterinarians to assess pain level or need to reassess analgesic plan after ovariohysterectomy in cats. The validity fell short of current guidelines for correlation coefficients and further refinement and testing are warranted to improve its performance.
Low temperature mixed-mode debond fracture and fatigue characterisation of foam core sandwich
Authors: Farshidi Arash , Berggreen Christian , Carlsson Leif A
Published: June 2018

This paper experimentally investigates the effects of low temperature on fracture toughness and fatigue debond growth rate in foam core sandwich composites. Mixed-mode bending specimens were statically and cyclically tested inside a climatic chamber at a low temperature (−20°C) and at room temperature (23°C) as a reference. Testing was conducted in mode I (opening) and mixed-mode I/II (opening-sliding) mode mixities. The fatigue tests results are presented according to the modified Paris–Erdogan relation. Results showed substantial fracture toughness reduction due to low temperature. Low temperature furthermore elevated the cyclic crack growth rate.
Global bending analysis of corrugated sandwich panels with integrated piezoelectric layers
Authors: Shaban M , Alibeigloo A
Published: June 2018

Smart corrugated sandwich panels are special types of sandwich panels which are well suited in advanced devices to provide not only high resistance capability against mechanical loads but also energy harvesting capacity for low power applications. In this paper, analytical solution for corrugated sandwich panels with embedded piezoelectric layers is presented by using three-dimensional theory of elasticity. Energy method in conjugation with homogenization approach is used to determine effective properties of corrugated cores in thickness direction. Due to extreme orthotropic nature of corrugated cores, this method can give an accurate solution by using state-space method. Accuracy of core properties is verified by comparing numerical results with previous investigations. Furthermore, reliability of presented method is guaranteed by comparing the results with finite element analysis. A comprehensive parametric study including influences of geometrical factors such as pitch, height, sheet thickness and corrugation shape is accomplished.
Dispersion of Home in Contemporary City: A Case Study of Perception and Behavior in Young Tokyoites
Authors: Ikalovic Vedrana , Chiesi Leonardo
Published: May 2018

This article explores the multidimensional concept of home through the relationship of the self and the city. The case study is Tokyo, and sense of home and homelike activities of its young dwellers are explored, analyzed, and discussed within the integrated unity of their spatial, sociocultural, and psychological/temporal properties. Semistructured interviews were conducted in order to grasp the rhythm and the dynamics of the daily lives of the respondents and to recognize significant places in the city where homelike activities happen. As a result, a dispersed model of home is revealed, which is juxtaposed to the existing, more traditional, concept. In this model, home becomes a territory, a collection, or network of (semi)public and (semi)private places connected by routes made by an individual who gives them specific values and meanings. Spatially, home is transposed from the singular space of a house/dwelling to a field of activities and actions, giving the city and its systems significant roles.
Influences of journal with 3D form errors on dynamic coefficients of hydrodynamic bearings yielded to JFO boundary conditions
Authors: Ma Xun , Xu Wubin , Zhang Xueping , Ding Siyi
Published: May 2018

The dynamic characteristics of the journal with form error are analyzed, including normalized stiffness and damping coefficients. A new expression for journal surface with form error is presented, which is capable of formulating any types of form errors on the journal, and the dimensionless Reynolds equation is renewed and solved suffering from the Jakobsson, Floberg, and Olsson boundary conditions. The results show that form errors do have a significant influence on the dynamic performance of journal bearings and that the uncertainty attribute of form error could result in variations of dynamic properties so significantly that the system might operate in an entirely different way. Therefore, it is necessary to take more operating information into account, such as the elaborate state of the journal surface, in order to predict the bearing performance more accurately.
Dividend payouts of travel and leisure companies in Western Europe
Authors: Bahreini Mahboubeh , Adaoglu Cahit
Published: June 2018

This study examines the dividend payout determinants of travel and leisure companies in five Western European countries that are ranked among the world’s top 10 tourist destinations, namely, France, Spain, Italy, Germany, and the United Kingdom. The study analyzes the sector and carries out a comparative analysis of the subsectors. Panel data random-effects Tobit estimation methodology is used during a 10-year period (2005–2015). In addition to the traditional dividend determinants, sector and country-specific determinants such as leverage, asset intangibility, capital intensity (CI), and effective dividend tax rate are used. The estimation results demonstrate that company size, profitability, investment opportunities, and asset intangibility are positive drivers of dividend payout, whereas the leverage ratio and CI deter dividend payout. Additionally, the study provides international empirical evidence for the positive relationship between investment opportunities and dividend payout. This positive relationship, which is regarded as a puzzle, is unique for companies operating in the travel and leisure sector. The identification of unique dividend determinants and the recognition of differences among the subsectors help investors and managers to shape their investment and financial management decisions.
Secondary trauma and compassion fatigue in foster carers
Authors: Hannah Beatrice , Woolgar Matt
Published: May 2018

Background:

With the number of children being placed in the care of local authorities increasing, the need to recruit and retain foster carers is essential. Compassion fatigue is recognised as a negative effect for professionals working with adults and children who have experienced trauma. This study aims to confirm the proof of concept within foster carers and to explore the potential risks associated with intent to continue fostering, overall job satisfaction and psychological factors (avoidant coping) that could be targets for interventions.

Methods:

In total, 131 foster carers completed an online survey including self-report measures of compassion fatigue and associated risk factors.

Results:

Results confirm the existence of compassion fatigue among foster carers with rates in line with previous studies on other professionals working with children. High compassion fatigue was associated with lower intent to continue fostering and lower job satisfaction. Avoidant cognitive styles of psychological inflexibility and thought suppression were associated with compassion fatigue.

Conclusion:

The confirmation of compassion fatigue among foster carers and the potential risks to job retention are important findings for social care. The associations with avoidant cognitive styles have clinical implications for potential interventions. Recommendations for further research and the limitations of this study are also discussed.
Vortex-induced vibration of a truss girder with high vertical stabilizers
Authors: Tang Haojun , Shum KM , Tao Qiyu , Jiang Jinsong
Published: May 2018

To improve the flutter stability of a long-span suspension bridge with steel truss stiffening girder, two vertical stabilizers of which the total height reaches to approximately 2.9 m were planned to install on the deck. As the optimized girder presents the characteristics of a bluff body more, its vortex-induced vibration needs to be studied in detail. In this article, computational fluid dynamics simulations and wind tunnel tests are carried out. The vortex-shedding performance of the optimized girder is analyzed and the corresponding aerodynamic mechanism is discussed. Then, the static aerodynamic coefficients and the dynamic vortex-induced response of the bridge are tested by sectional models. The results show that the vertical stabilizers could make the incoming flow separate and induce strong vortex-shedding behind them, but this effect is weakened by the chord member on the windward side of the lower stabilizer. As the vortex-shedding performance of the optimized girder is mainly affected by truss members whose position relationships change along the bridge span, the vortex shed from the girder can hardly have a uniform frequency so the possibility of vortex-induced vibration of the bridge is low. The data obtained by wind tunnel tests verify the results by computational fluid dynamics simulations.
Framing Ferguson: The interplay of advocacy and journalistic frames in local and national newspaper coverage of Michael Brown
Authors: Mourão Rachel R , Brown Danielle K , Sylvie George
Published: June 2018

The shooting death of Michael Brown by a police officer in August 2014 served as a pivotal case that pushed excessive use of police force against minority groups to the national spotlight. Guided by the scholarship on protest coverage, this article investigates the interplay between advocacy and journalistic framing in the coverage of the Ferguson protests by national and local news. A content analysis of five newspapers during the first cycle of protests identified how journalistic frames of presentation derived from the ‘protest paradigm’ literature related to the content frames pushed forward by the Black Lives Matter movement. Results reveal that initial stories were predominantly episodic and focused on violence to the detriment of demands and grievances. However, episodic stories were also critical of the police response and the use of military-grade weapons to contain the demonstrations. As the weeks progressed, journalists gave space to the ideas of protestors in a more thematic way, especially on issues related to race beyond the topic of police brutality. Taken together, findings suggest small but significant progress as time continued during the first month of demonstrations after Brown’s shooting. Results presented here challenge the paradigmatic nature of protest coverage but reinforce that more space should be given to contextual narratives behind social movements’ actions in addition to coverage that is critical of police and protestor tactics.
Of lads and ear’oles: School, work, and the microsociology of social reproduction
Authors: Voyer Andrea
Published: May 2018

This article draws on structural symbolic interactionism (SSI) to extend Willis’s insights into social reproduction and social mobility. Willis contrasts the lads with the ear’oles – working-class youth who conform to the requirements and ideology of school. If, as Willis argues, working-class youth encounter conflict between the culture of school and the culture of labour, then the ear’oles’ pro-school behaviours may be interpreted as rebellious in their own right. SSI suggests that the ear’oles’ continued attachment to school requires abandoning or delaying adoption of the adult breadwinner role – a working-class role-identity assigned to those who finish required schooling, find jobs, and establish independence. While the lads conform to the behavioural norms and values of their class cultural milieu through their nonconformity at school, the ear’oles opt for school at considerable social cost. As successful ear’oles experience mobility, these class ‘straddlers’ struggle with feelings of inadequacy and guilt.
The unobserved power of context: Can context moderate the effect of expectations on educational achievement?
Authors: Lazarus Amit , Khattab Nabil
Published: May 2018

There is growing evidence that shows that social context is becoming less significant in influencing educational achievements and expectations. Additionally, evidence indicates that expectations are high across the board and becoming of declining significance to educational achievement. In light of this, we reexamine and offer an alternative to the renowned linear models connecting background variables to scholarly achievement via pupils' educational expectation. Analysis of GCSE scores, using three consecutive waves of the Longitudinal Study of Young People in England, reveals that the verity of this classical claim is dependent on occupational class, ethnic origin, and school socio-economic status level. These results thus confirm an unrecognized effect of family and school background variables on achievement—not only to engender expectations but also to moderate their influence. This recognition expands and deepens understanding of inequality in educational achievement and social mobility by treating expectations as a resource and analytically distinguishing between the ability of a social group or a certain school to attain or create high expectations and their ability to capitalize on it and translate these into achievements. We find that in many cases, expectations still possess strong potential to transform into achievement, while in others they are high across the board and rather inconsequential.
Does Adult Sex Ratio Predict Regional Variation in Facial Dominance Perceptions? Evidence From an Analysis of U.S. States
Authors: Torrance Jaimie S. , Kandrik Michal , Lee Anthony J. , DeBruine Lisa M. , Jones Benedict C.
Published: June 2018

When the adult sex ratio of the local population is biased toward women, men face greater costs due to increased direct intrasexual competition. In order to mitigate these costs, men may be more attuned to cues of other men’s physical dominance under these conditions. Consequently, we investigated the relationships between the extent to which people ( N = 3,586) ascribed high dominance to masculinized versus feminized faces and variation in adult sex ratio across U.S. states. Linear mixed models showed that masculinized faces were perceived as more dominant than feminized faces, particularly for judgments of men’s facial dominance. Dominance perceptions were weakly related to adult sex ratio, and this relationship was not moderated by face sex, participant sex, or their interaction. Thus, our results suggest that dominance perceptions are relatively unaffected by broad geographical differences in adult sex ratios.
Grid sensitivity of flow field and noise of high-Reynolds-number jets computed by large-eddy simulation
Authors: Bogey Christophe
Published: May 2018

Three isothermal round jets at a Mach number of 0.9 and a diameter-based Reynolds number of 105 are computed by large-eddy simulation using four different meshes in order to investigate the grid sensitivity of the jet flow field and noise. The jets correspond to two initially fully laminar jets and one initially strongly disturbed jet considered in previous numerical studies. At the exit of a pipe nozzle of radius r0, they exhibit laminar boundary-layer mean-velocity profiles of thickness [Formula: see text] and [Formula: see text], respectively. For the third jet, a peak turbulence intensity close to 9% is also imposed by forcing the boundary layer in the nozzle. The grids contain up to one billion points, and, compared to the grids used in previous simulations, they are finer in the axial direction downstream of the nozzle and in the radial direction on the jet axis and in the outer region of the mixing layers. The main flow field and noise characteristics given by the simulations, including the mixing-layer thickness, the centerline mean velocity, the turbulence intensities on the nozzle lip line and the jet axis, spectra of velocity and far-field pressure obtained from the jet near field by solving the isentropic linearized Euler equations, are presented. With respect to those from previous studies, the results are very similar for the initially laminar jet with thick boundary layers, but they differ significantly for the initially laminar jet with thin boundary layers and for the initially disturbed jet. For the latter two jets, using a finer grid leads to a faster flow development, to higher turbulence intensities in the shear layers and at the end of the potential core, to stronger large-scale structures, and to the generation of more low-frequency noise. Moreover, very small mesh spacings appear to be necessary all along the jet mixing layers, and in particular during their early stages of growth, to properly capture the formation and dynamics of the flow coherent structures and thus obtain results in good agreement with measurements available for high-Reynolds-number jets.
Purity in Early Judaism: Current Issues and Questions
Authors: Rogan Wil
Published: May 2018

The study of purity has become a crucial undertaking in the scholarly quest to understand the social and theological dimensions of early Judaism and the texts that early Jews both formed and were formed by. This article surveys scholarly literature on purity in ancient and early Judaism, in order to identify and address four areas of critical inquiry that ought to be taken into consideration when questions about purity arise in the study of early Jewish writings: (1) the conceptualization of purity as a symbolic system; (2) the distinction between kinds of purity (ritual, moral, and genealogical); (3) the relation of purity to the temple and, more broadly, to space; and (4) the function of purity to construct and maintain social identity. Attention to these critical issues promises to give clarity, direction and depth to scholarship on purity in early Judaism.
Truth-telling to a cancer patient about poor prognosis: A clinical case report in cross-cultural communication
Authors: Razai Mohammad
Published: June 2018

Ethical principles are not mere abstract concepts of academic interest. They have to be applied by care providers in the real world under complex, challenging and often perplexing conditions. This paper discusses, through the case of an ethnic minority patient with metastasis of bowel cancer, the ethical dilemma of truth-telling and withholding information about poor prognosis. It highlights the complexities of applying ethical principles in a different cultural milieu, reflecting on different ethical frameworks and justifications. The paper also discusses some of the wider implications of the practices, issues and controversies of truth-telling about prognosis in cross-cultural communication relevant to clinical practice.
Dilemmas of justice in the post-neoliberal educational policies of Ecuador and Bolivia
Authors: Bastidas Redin María Cristina
Published: June 2018

The election of the first indigenous president in Bolivia, Evo Morales (leader of the Movimiento al Socialismo, MAS), and of Rafael Correa in Ecuador (leader of Alianza País, AP) were important turning points in the social and economic history of these two countries. Both were elected with anti-neoliberal platforms of social movements. Their election promised radical changes in public policy in order to change the historical injustices that had remained unresolved with the rise of democracy. Redistribution, recognition of ethnic differences, and broader participation in the policymaking process were the three bottom-up demands for justice that brought these governments to power. In this article, I discuss how in these two cases the three bottom-up demands for justice – that emerged under the double transition to democracy and neoliberalism – have been incorporated, in different ways, in education policy.
Democratic accountability in the neoliberal era: The politics of teaching and teacher education in mathematics classrooms
Authors: Yeh Cathery
Published: June 2018

The effects of neoliberal policies have increased inequalities globally and nationally, diminishing democratic accountability. They have also tainted the goals, motivations, methods, and standards of excellence with regard to teacher preparation. Although various programs of research have examined teacher preparation in terms of diversity and equity, fewer studies have raised questions about institutional constructs of power and privilege: what counts as knowledge?; whose experiences frame curricular and instructional design?; and why and how are systems of inequality perpetuated within and after university-based teacher preparation? In response, this article uses critical pedagogy as a lens through which to view teacher preparation programs as institutions that support neoliberalism by giving unconditional support to a Western episteme that eradicates the knowledge systems of students and teachers of color, including their languages and experiences of the world. The article describes the experiences of four bilingual teachers and teachers of color and their attempts to make mandated mathematics programs more responsive to the needs of their bilingual students. The study follows the four teachers for three years—from their year in teacher preparation to their first two years of classroom teaching—to examine the relation between their experiences as classrooms teachers and their exclusion in the teacher preparation phase. The article then argues that teacher preparation programs should move away from narrow definitions of what counts as knowledge to representing, valuing, and legitimizing teachers and students whose knowledge spans multiple cultural and political frames.
Qualitative Analysis of Partnerships’ Effect on Implementation of a Nationally Led Community-Based Initiative
Authors: Garcia Kristen M. , Martin Emily , Garney Whitney R. , Primm Kristin M.
Published: May 2018

Introduction. The American Heart Association (AHA) was funded to implement a nationally led initiative to implement policy, systems, and environment (PSE) interventions in communities across the United States. In Cohort 1, 15 communities were tasked with working with local community partners to plan and implement initiatives. Method. Engaged as the evaluators, Texas A&M researchers conducted telephone interviews with project managers (employed by AHA) and community partners representing the 15 communities. Interviewees were asked questions pertaining to partnership planning and involvement in initiatives and overall perceptions of the impact of the program. Interviews were analyzed qualitatively using the Consolidated Framework for Implementation Research as the guiding framework. Results. Thematic analysis revealed that partners were used in planning and implementing initiatives and felt that initiatives were successful in building community engagement. Some noted success in PSE changes, although this was not a major focus of respondents, regardless of it being a main indicator for the funder. Discussion. Themes reveal several recommendations for those embarking on community-level work. Those recommendations include (1) build on existing priorities, (2) focus on incremental steps that build toward the bigger goal, (3) use national organizations to move more quickly, and (4) leverage resources through collaborative efforts.
Dural arteriovenous fistula in the sphenoid bone lesser wing region: Endovascular adjuvant techniques of treatment and literature review
Authors: Kandyba Dmitriy V , Babichev Konstantin N , Stanishevskiy Artem V , Abramyan Arevik A , Svistov Dmytriy V
Published: May 2018

This article describes the successful endovascular treatment of a dural arteriovenous fistula of a rare localization (the area of sphenoid bone lesser region). We examine one report of an unusually located dural arteriovenous fistula successfully treated with Onyx (ev3, Irvine, USA) using a combination of endovascular adjuvant techniques: pressure cooker and remodeling balloon protection of cerebral artery. The article includes previously published observations of such fistulas and discusses anatomic features and venous drainage of dural arteriovenous fistulas in the given location.
Reliability and differences in quadriceps femoris muscle morphology using ultrasonography: The effects of body position and rest time
Authors: Tomko Patrick M , Muddle Tyler WD , Magrini Mitchel A , Colquhoun Ryan J , Luera Micheal J , Jenkins Nathaniel DM
Published: May 2018

Introduction

The purpose of this investigation was to: (1) to determine the reliability of rectus femoris muscle cross-sectional area and echo intensity obtained using panoramic ultrasound imaging during seated and supine lying positions before and after a 5-minute rest period and (2) to determine the influence of body position and rest period on the magnitude of rectus femoris muscle cross-sectional area and echo intensity measurements.

Methods

A total of 23 males and females (age = 21.5 ± 1.9 years) visited the laboratory on two separate occasions. During each visit, panoramic ultrasound images of the rectus femoris were obtained in both a seated and a supine position before (T1) and after a 5-minute (T2) rest period to quantify any potential changes in either muscle cross-sectional area and/or echo intensity.

Results

None of the muscle cross-sectional area or echo intensity measurements exhibited systematic variability, and the ICCs were 0.98–0.99 and 0.88–0.91, and the coefficients of variation were ≤ 3.9% and ≤ 8.2% for muscle cross-sectional area and echo intensity, respectively. Our results indicated that muscle cross-sectional area was greater in the seated than supine position, whereas echo intensity was greater in the supine position. Further, echo intensity increased in the seated position from T1 to T2.

Conclusion

Both rectus femoris muscle cross-sectional area and echo intensity may be reliably measured in either a seated or supine lying position before or after a 5-minute rest period. Aside from echo intensity in the seated position, rest period had no influence on the magnitude of muscle cross-sectional area or echo intensity. Comparison of muscle cross-sectional area values that are obtained in different body positions is ill-advised.
Jury Nullification: Features, Bugs, and the Possibility of Granular Law
Authors: Dane Perry
Published: June 2018

Jury nullification is the ability of juries to acquit criminal defendants even against the apparent weight of the law and the facts. This commentary asks whether jury nullification is a “bug” or a “feature” of the American criminal trial, a question separate, for example, from whether it is good or bad. The commentary concludes, tentatively, that jury nullification, on one understanding, might be a “feature.” In that understanding, jury nullification reflects the jury’s authority, in exceptional cases, to particularize the applicable law by way of its existential engagement with a live defendant and the unique circumstances of a case. The possibility of jury nullification might therefore represent the legal system’s implicit recognition that law can have a granular as well as a global quality. This power, if it exists, is necessarily controversial, though it has analogues in religious normative systems. Its embrace would require a more complex theory of law.
In search of care strategies for distressed people with communication difficulties and a learning disability in palliative care settings: the lived experiences of registered learning disability nurses and palliative care professionals
Authors: Arrey Sally K , Kirshbaum Marilynne N , Finn Vincent
Published: May 2018

Aims

The aim of this study was to gain an in-depth phenomenological understanding of the care strategies used by registered learning disability nurses (RNLDs) and palliative care professionals (PCPs) to identify and respond to the distress of people with communication difficulties and a learning disability (PCDLD) in palliative care settings. The objective was to critically explore the lived experiences of RNLDs and PCPs who care for distressed PCDLD in palliative care settings.

Methods

A single-phase hermeneutic phenomenological study following Van Manen provided the framework for the synthesis and structuring of the hermeneutic phenomenological text. Participants were drawn from learning disability nursing homes, community learning disabilities teams and hospices. Purposive sampling was used, and 13 participants comprising eight RNLDs and five PCPs were interviewed. Data were collected by semi-structured, audio-recorded interviews, field notes and a demographic questionnaire. Hermeneutic data analysis was used. Ethical approval was gained from the University Research Ethics Panel and from individual research locations.

Results

The primary strategies used by the participants to identify and respond to the distress of PCDLD were encapsulated by seven main themes: knowing by building relationships; positivity in successful caring outcomes; humane care; moral duty of care; time to care; comfortable care environment; and future perspectives.

Conclusions

Effective care strategies based on the above-mentioned findings can reduce the dilemma professionals encounter in addressing the distress of PCDLD and enhance their confidence to care.
Helping hospital professionals to implement Advance Care Planning in daily practice: a European Delphi study from field experts
Authors: Vanderhaeghen Birgit , Bossuyt Inge , Menten Johan , Rober Peter
Published: May 2018

Background

Advance Care Planning (ACP) communication is difficult to implement in hospital. Possibly this has to do with the fact that the concept is not well tuned to the needs of hospital professionals or that they experience implementation barriers in practice.

Aims

The aim of this study was to investigate what is valued in having ACP conversations by hospital professionals (physicians, nurses, psychologists and social workers) and what they experience as barriers and facilitating factors for having ACP conversations with patients.

Methods

A Delphi study consisting of two rounds with respectively 21 and 19 multidisciplinary experts from seven European countries was organised. Data were analysed using content analysis and descriptive statistics.

Results

Participants agreed that ACP is valued mostly because it is seen to improve transmural continuation of care, emotional processing of the loss of a patient, and serenity at the end of life. Reported barriers are patient characteristics blocking patient-centred communication and a lack of knowledge to have these conversations. An important facilitator is multidisciplinary cooperation.

Conclusions

There is consensus by experts from different settings and countries suggesting that these results can theoretically be applied to hospital settings in Europe. This study reveals that hospital professionals value ACP in hospital practice, but that they encounter several barriers to its implementation.
Sustainable Development in Health
Authors: Bellamy Carol
Published: May 2018

«UNICEF values its longstanding partnership with the IUHPE and we hope to continue working closely in the future. The IUHPE triennial conferences are important gatherings of «movers and shakers» who make a real difference for health promotion and education worldwide.»
Carbon nanotube-reinforced smart composites for sensing freezing temperature and deicing by self-heating
Authors: Jang Sung-Hwan , Park Yong-Lae
Published: May 2018

Carbon nanotube-reinforced polymer composites were fabricated by high shear mixing. The microstructure and the electrical properties of the carbon nanotube–polymer composites were investigated by scanning electron microscopy and electrical resistance measurement. We found that the carbon nanotube composites showed high electrical conductivity (1.5 S m−1) at 7.0 wt% of carbon nanotubes, and the increase in thickness enhanced the electrical conductivity of the composites. The multifunctional properties of the carbon nanotube composites were also investigated for use in sensing the freezing temperature and also in deicing by self-heating. The results showed that the carbon nanotube–polymer composites had high temperature sensitivity in the freezing temperature range from −5 to 5 C and an excellent heating performance due to the Joule heating effect. The carbon nanotube composites are promising to be used as smart coating materials for deicing by self-heating as well as by detection of the freezing temperature.
The Effect of Franchising on Establishment Performance in the U.S. Restaurant Industry
Authors: Sveum Matthew , Sykuta Michael
Published: June 2018

A central theme in much of the franchising literature is that franchising mitigates the Principle–agent problems between the owner of the franchise company and the operator of the local establishment by making the operator the owner-franchisee of the establishment. Despite the centrality of that assumption in the literature, there is little empirical evidence to support it. We use Census of Retail Trade data for essentially all full- and limited-service restaurants in the United States to test whether franchisee-ownership affects performance at the establishment level. We find a strong and robust franchise effect for full-service restaurants but little effect among limited-service restaurants. We argue this difference is consistent with agency costs given differences in work processes and the importance of managerial discretion.
Pertussis Resurgence: School Nurses as a Safety Net for Children
Authors: Barnby Elizabeth , Reynolds Mark
Published: June 2018

After a decade of decreases in the incidence of vaccine-preventable diseases, in the late 1980s the incidence began to increase. Four vaccine preventable diseases, including pertussis, caused major epidemics, and children were the most vulnerable during these outbreaks. Due to waning immunity, genomic changes, and inadequate herd immunity in adults, infants and children are at risk for contracting pertussis. Pertussis is a vaccine-preventable disease. Pertussis is difficult to diagnose early because the presentation is similar to common problems such as bronchitis or upper respiratory infections. School nurses should be able to identify signs and symptoms in the earliest stage possible to prevent transmission and refer for treatment early. The purpose of this article is to provide school nurses with information to understand the disease and identify individuals infected with pertussis.
Condom Access for High School Students: The Journey From Data to Policy
Authors: Hogan Janis
Published: June 2018

Nationally, many adolescents remain at risk for unintended pregnancies and sexually transmitted infections. School nurses can be leaders and change agents in their schools. This article shares the journey of a school nurse in Maine, who used evidence-based data to develop support from administration and key stakeholders to successfully advocate for a needed policy change. That support and advocacy led to a new “Safer Sex” policy.
Introducing Futures Concepts to Experts in Public Services in Developing Countries
Authors: Ono Ryota
Published: June 2018

This article describes my teaching of futures to experts in public services such as water supply, power supply, and waste treatment in developing countries. These experts come to Japan to participate in the training course of their field of service, which is offered by a state-run organization in Japan. At the end of the course, they prepare an action plan, which is to be implemented after they return to their countries. In the course, I give them three lectures on futures to help them make their action plans more future-oriented. Experts are quite different from university students in that they carry the burden and responsibility to make services better and more effective in the future. Most of them assume, in their planning, that data and information in the past and present form the foundation on which they project the future of their services. As a result, their plans are always based on a probable future and not on possible futures. I teach them futures to point out the risks of such planning approach, and to open their eyes to an alternative one, which I call “Futures planning.” By following the three lectures in chronological order, this article clarifies characteristics of my futures teaching and its impact on the experts from developing countries.
Effect of Asian BMI on risk of chronic disease progression: A Singapore perspective
Authors: Kaur Palvinder , Saxena Nakul , Zhu Zhecheng
Published: May 2018

Objectives:

High body mass index (BMI) has been associated with increased mortality, healthcare utilization and costs. This study investigates the one-year chronic disease progression and risk of developing diabetes with varying cardiovascular disease (CVD) risks based on the Asian BMI categories.

Methods:

Patients with BMI information from 2008 to 2014 were included in the analysis ( N=23,508). Patients were stratified into low, moderate, high and very high CVD risk categories. To study disease progression for patients with varying CVD risks, patients were further segmented into seven mutually exclusive disease states based on prevalence of chronic diseases and their complications. The categories were no known chronic disease, at-risk of developing chronic disease, one chronic condition, more than two chronic conditions, chronic conditions with complications, patients with cancer and death. Logistic regression was used to determine the association of CVD risk categories and risk of having diabetes.

Results:

High CVD risk patients had more chronic diseases in the following year as compared with low CVD risk patients. With reference to low CVD risk patients, patients in the moderate, high and very high risk categories had an odds ratio of 1.78 (95% confidence interval (CI): 1.60 to 1.98), 2.84 (95% CI: 2.51 to 3.21) and 3.99 (95% CI: 3.30 to 4.82) for having diabetes after adjusting for age, gender and ethnicity.

Conclusions:

Higher BMI is associated with greater chronic disease progression in the following year. Diet control and lifestyle modifications should be encouraged to prevent people from shifting to higher BMI strata as this can be detrimental in the long run.
The right to collective action under European law and Turkish law
Authors: Uncular Selen
Published: June 2018

Apart from many other important and urgent problems in labour law, the right to collective action is increasingly the most violated and ignored labour right in this continuing period of economic, political and social crises around the world due to the very fact that it constitutes the most effective and progressive power of workers. Therefore, it is essential and urgent that fundamental hindrances are identified and substantial solutions are put in place to ensure efficient protection and exercise of the right. In this respect, I aim to evaluate the right to collective action of private sector workers under the instruments of the Council of Europe, the European Union and Turkey, and to examine selected fundamental impediments to its effective protection and enforcement under European law and Turkish law, which essentially arise from sovereignty and exceptionalist concerns as well as the subordination of social rights to economic interests. Lastly, I will propose some solutions for a more progressive protection and implementation of the right to collective action whose evolution requires a lot of effort, dedication and struggle during a long yet hopeful process.
Prognostic values of fasting hyperglycaemia in non-diabetic patients with acute coronary syndrome: A prospective cohort study
Authors: Gencer Baris , Rigamonti Fabio , Nanchen David , Klingenberg Roland , Räber Lorenz , Moutzouri Elisavet , Auer Reto , Carballo David , Heg Dik , Windecker Stephan , Lüscher Thomas Felix , Matter Christian M , Rodondi Nicolas , Mach François , Roffi Marco
Published: June 2018

Background:

Controversy remains regarding the prevalence of hyperglycaemia in non-diabetic patients hospitalised with acute coronary syndrome and its prognostic value for long-term outcomes.

Methods and results:

We evaluated the prevalence of hyperglycaemia (defined as fasting glycaemia ⩾10 mmol/l) among patients with no known diabetes at the time of enrolment in the prospective Special Program University Medicine-Acute Coronary Syndromes cohort, as well as its impact on all-cause death, myocardial infarction, stroke and incidence of diabetes at one year. Among 3858 acute coronary syndrome patients enrolled between December 2009–December 2014, 709 (18.4%) had known diabetes, while 112 (3.6%) of non-diabetic patients had hyperglycaemia at admission. Compared with non-hyperglycaemic patients, hyperglycaemic individuals were more likely to present with ST-elevation myocardial infarction and acute heart failure. At discharge, hyperglycaemic patients were more frequently treated with glucose-lowering agents (8.9% vs 0.66%, p<0.001). At one-year, adjudicated all-cause death was significantly higher in non-diabetic patients presenting with hyperglycaemia compared with patients with no hyperglycaemia (5.4% vs 2.2%, p=0.041) and hyperglycaemia was a significant predictor of one-year mortality (adjusted hazard ratio 2.39, 95% confidence interval 1.03–5.56). Among patients with hyperglycaemia, 9.8% had developed diabetes at one-year, while the corresponding proportion among patients without hyperglycaemia was 1.8% (p<0.001). In multivariate analysis, hyperglycaemia at presentation predicted the onset of treated diabetes at one-year (odds ratio 4.15, 95% confidence interval 1.59–10.86; p=0.004).

Conclusion:

Among non-diabetic patients hospitalised with acute coronary syndrome, a fasting hyperglycaemia of ⩾10 mmol/l predicted one-year mortality and was associated with a four-fold increased risk of developing diabetes at one year.
Eosinophils in the skin—a red herring masking lymphoma: a case series
Authors: Jaque Alejandra , Mereniuk Alexandra , Sade Shachar , Lansang Perla , Imrie Kevin , Shear Neil H
Published: May 2018

Eosinophilia, both peripheral and in cutaneous tissue, is not a typical finding in mycosis fungoides; in fact, when faced with a lymphoeosinophilic infiltrate, mycosis fungoides is often not part of initial differential considerations. However, eosinophilia has been described in certain subtypes of mycosis fungoides, namely, in folliculotropic mycosis fungoides. We describe three challenging cases of folliculotropic mycosis fungoides presenting with varied clinical morphologies and a dense lymphoeosinophilic infiltrate and/or severe hypereosinophilia that obscured the final diagnosis for years. Only after treatment of the eosinophilia were the underlying atypical lymphocytes more apparent on histology and a correct diagnosis made. Thus, when characteristic features of mycosis fungoides are subtle, eosinophils can act as a red herring in terms of clinico-pathologic correlation and may prevent early and accurate diagnosis of mycosis fungoides. We suggest that further studies are needed to evaluate whether treatments to reduce eosinophilia, once other causes have been excluded, may help clear the confounding reactive inflammatory infiltrate and facilitate the diagnosis of mycosis fungoides.