bluuebunny/crossref_metadata_2025 huggingface dataset:
Are There Mental Health Differences between Francophone and Non-Francophone Populations in Manitoba?
Authors: Chartier Mariette Jeanne , Finlayson Gregory , Prior Heather , McGowan Kari-Lynne , Chen Hui , Walld Randy , de Rocquigny Janelle
Published: July 2017

Objective:

Francophones may experience poorer health due to social status, cultural differences in lifestyle and attitudes, and language barriers to health care. Our study sought to compare mental health indicators between Francophones and non-Francophones living in the province of Manitoba.

Methods:

Two populations were used: one from administrative datasets housed at the Manitoba Centre for Health Policy and the other from representative survey samples. The administrative datasets contained data from physician billings, hospitalizations, prescription drug use, education, and social services use, and surveys included indicators on language variables and on self-rated health.

Results:

Outside urban areas, Francophones had lower rates of diagnosed substance use disorder (rate ratio [RR] = 0.80; 95% CI 0.68 to 0.95) and of suicide and suicide attempts (RR = 0.59; 95% CI 0.43 to 0.79), compared with non-Francophones, but no differences were found between the groups across the province in rates of diagnosed mood disorders, anxiety disorders, dementia, or any mental disorders after adjusting for age, sex, and geographic area. When surveyed, Francophones were less likely than non-Francophones to report that their mental health was excellent, very good, or good (66.9%, compared with 74.2%).

Conclusions:

The discrepancy in how Francophones view their mental health and their rates of diagnosed mental disorders may be related to health seeking behaviours in the Francophone population. Community and government agencies should try to improve the mental health of this population through mental health promotion and by addressing language and cultural barriers to health services.
Comparative Efficacy of the Generalized Anxiety Disorder 7-Item Scale and the Edinburgh Postnatal Depression Scale as Screening Tools for Generalized Anxiety Disorder in Pregnancy and the Postpartum Period
Authors: Simpson William , Glazer Melanie , Michalski Natalie , Steiner Meir , Frey Benicio N
Published: July 2017

Objective:

About 24.1% of pregnant women suffer from at least 1 anxiety disorder, 8.5% of whom suffer specifically from generalized anxiety disorder (GAD). GAD is often associated with major depressive disorder (MDD). During the perinatal period, the presence of physical and somatic symptoms often makes differentiation between depression and anxiety more challenging. To date, no screening tools have been developed to detect GAD in the perinatal population. We investigated the psychometric properties of the GAD 7-item Scale (GAD-7) as a screening tool for GAD in pregnant and postpartum women.

Methods:

Two hundred and forty perinatal women ( n = 155 pregnant and n = 85 postpartum) referred for psychiatric consultation were enrolled. On the day of initial assessment, all women completed the GAD-7 and the Edinburgh Postnatal Depression Scale (EPDS). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition–based diagnoses were made by experienced psychiatrists. Scores from the GAD-7 and EPDS were compared with the clinical diagnoses to evaluate the psychometric properties of the GAD-7 and EPDS when used as a screening tool for GAD.

Results:

The GAD-7 yielded a sensitivity of 61.3% and specificity of 72.7% at an optimal cut-off score of 13. Compared with the EPDS and the EPDS-3A subscale, the GAD-7 displayed greater accuracy and specificity over a greater range of cut-off scores and more accurately identified GAD in patients with comorbid MDD.

Conclusion:

Our findings suggest that the GAD-7 represents a clinically useful scale for the detection of GAD in perinatal women.
Choosing Psychiatry as a Career: Motivators and Deterrents at a Critical Decision-Making Juncture
Authors: Wiesenfeld Lesley , Abbey Susan , Takahashi Sue Glover , Abrahams Caroline
Published: July 2017

Objective:

To examine factors influencing the choice of psychiatry as a career between residency program application and ranking decision making.

Methods:

Using an online questionnaire, applicants to the largest Canadian psychiatry residency program were surveyed about the impact of various factors on their ultimate decision to enter psychiatry residency training.

Results:

Applicants reported that patient-related stigma was a motivator in considering psychiatry as a career, but that negative comments from colleagues, friends, and family about choosing psychiatry was a deterrent. Training program length, limited treatments, and insufficient clerkship exposure were noted as deterrents to choosing psychiatry, though future job prospects, the growing role of neuroscience, and diagnostic complexity positively influenced choosing psychiatry as a specialty. Research and elective time away opportunities were deemed relatively unimportant to ranking decisions, compared with more highly weighted factors, such as program flexibility, emphasis on psychotherapy, service–training balance, and training program location. Most applicants also reported continuing to fine tune ranking decisions between the application and ranking submission deadline.

Conclusions:

Stigma, exposure to psychiatry, diagnostic complexity, and an encouraging job market were highlighted as positive influences on the choice to enter psychiatry residency. Interview and information days represent opportunities for continued targeted recruitment activity for psychiatry residency programs.
The Role of Untreated Psychosis in Neurodegeneration: A Review of Hypothesized Mechanisms of Neurotoxicity in First-Episode Psychosis
Authors: Anderson Kelly K , Voineskos Aristotle , Mulsant Benoit H , George Tony P , McKenzie Kwame J
Published: July 2017

For over 20 years, studies have tried to measure the association between the duration of untreated psychosis (DUP) and changes in brain morphology. A hypothesis that untreated psychosis is neurotoxic has been postulated, but the mechanisms of that toxicity have not been described. We re-analyzed papers collected for a systematic review to extract data on the hypotheses that have been generated on the potential mechanisms by which DUP could impact brain morphology in first-episode psychosis. Dopaminergic hyperactivity, prolonged hypothalamic–pituitary–adrenal activation, and persistent activity of catecholamines have been hypothesized as mechanisms to explain these associations. However, the question remains as to whether the observed structural changes are permanent or may be reversed via antipsychotic treatment.
Service Use and Unmet Needs in Youth Suicide: A Study of Trajectories
Authors: Renaud Johanne , Séguin Monique , Lesage Alain D , Marquette Claude , Choo Bettina , Turecki Gustavo
Published: July 2017

Objective:

While 90% of suicide victims have suffered from mental health disorders, less than one-half are in contact with a mental health professional in the year preceding their death. Service use in the last year of life of young suicide victims and control subjects was studied in Quebec. We wanted to determine what kinds of health care services were needed and if they were actually received by suicide victims.

Method:

We recruited 67 consecutive suicide victims and 56 matched living control subjects (aged 25 years and younger). We evaluated subjects' psychopathological profile and determined which services would have been indicated by conducting a needs assessment. We then compared this with what services were actually received.

Results:

Suicide victims were more likely than living control subjects to have a psychiatric diagnosis. They were most in need of services to address substance use disorder, depression, interpersonal distress, and suicide-related problems. There were significant deficits in the domains of coordination and continuity of care, mental health promotion and training, and governance.

Conclusions:

Our results show that we need to urgently take action to address these identified deficits to prevent further loss of life in our young people.
Acute Risk of Suicide and Suicide Attempts Associated with Recent Diagnosis of Mental Disorders: A Population-Based, Propensity Score—Matched Analysis
Authors: Randall Jason R , Walld Randy , Finlayson Greg , Sareen Jitender , Martens Patricia J , Bolton James M
Published: July 2017

Objective:

To determine the degree of risk during the first year after diagnosis with a mental illness.

Methods:

We used propensity scoring to create a matched sample for all identified suicide attempts and suicide deaths in the province of Manitoba from 1996 to 2009. This study identified 2100 suicide deaths and 8641 attempted suicides. Three control subjects were identified for every case and matched on age, sex, income decile, region of residence, and marital status. Five categories of physician-diagnosed mental disorders were tested: schizophrenia, anxiety, depression, dementia, and substance abuse. Logistic regression was used to determine the risk for suicide attempts and suicide deaths overall, and within 3 time periods since initial diagnosis: 1 to 90 days, 91 to 364 days, and 365 or more days.

Results:

All disorders, except dementia, were independently related to death. All disorders were related to suicide attempts. The risk of dying by suicide was particularly high within the first 90 days after initial diagnosis for many disorders, including depression (adjusted odds ratio [AOR] 7.33; 95% CI 4.76 to 11.3), substance use disorders (AOR 4.07; 95% CI 2.43 to 6.82), and schizophrenia (AOR 20.91; 95% CI 2.55 to 172). Depression and anxiety disorders had elevated risk in the first year for suicide attempts.

Conclusions:

These data suggest that several mental disorders independently increase the risk of suicide attempts and death by suicide after controlling for all mental disorders and demographic risk factors. Clinicians should be aware of the heightened risk of suicide and suicidal behaviour within the first 3 months after initial diagnosis.
Repetition of Attempted Suicide among Immigrants in Europe
Authors: Lipsicas Cendrine Bursztein , Mäkinen Ilkka Henrik , Wasserman Danuta , Apter Alan , Kerkhof Ad , Michel Konrad , Renberg Ellinor Salander , van Heeringen Kees , Värnik Airi , Schmidtke Armin
Published: July 2017

Objectives:

To compare frequencies of suicide attempt repetition in immigrants and local European populations, and the timing of repetition in these groups.

Method:

Data from 7 European countries, comprising 10 574 local and 3032 immigrant subjects, were taken from the World Health Organization European Multicentre Study on Suicidal Behaviour and the ensuing Monitoring Suicidal Behaviour in Europe (commonly referred to as MONSUE) project. The relation between immigrant status and repetition of suicide attempt within 12-months following first registered attempt was analyzed with binary logistic regression, controlling for sex, age, and method of attempt. Timing of repetition was controlled for sex, age, and the recommended type of aftercare.

Results:

Lower odds of repeating a suicide attempt were found in Eastern European (OR 0.50; 95% CI 0.41 to 0.61, P < 0.001) and non-European immigrants (OR 0.68; 95% CI 0.51 to 0.90, P < 0.05), compared with the locals. Similar patterns were identified in the sex-specific analysis. Eastern European immigrants tended to repeat their attempt much later than locals (OR 0.58; 95% CI 0.35 to 0.93, P < 0.05). In general, 32% of all repetition occurred within 30 days. Repetition tended to decrease with age and was more likely in females using harder methods in their index attempt (OR 1.29; 95% CI 1.08 to 1.54, P < 0.01). Large variations in the general repetition frequency were identified between the collecting centres, thus influencing the results.

Conclusions:

The lower repetition frequencies in non-Western immigrants, compared with locals, in Europe stands in contrast to their markedly higher tendency to attempt suicide in general, possibly pointing to situational stress factors related to their suicidal crisis that are less persistent over time. Our findings also raise the possibility that suicide attempters and repeaters constitute only partially overlapping populations.
The 6-Month Prevalence of Posttraumatic Stress Syndrome (PTSS) among Older Adults: Validity and Reliability of the PTSS Scale
Authors: Préville Michel , Lamoureux-Lamarche Catherine , Vasiliadis Helen-Maria , Grenier Sébastien , Potvin Olivier , Quesnel Louise , Gontijo-Guerra Samantha , Mechakra-Tahiri Samia Djemaa , Berbiche Djamal
Published: July 2017

Objective:

To document the 6-month prevalence of posttraumatic stress syndrome (PTSS) in the older adult population and the validity of a PTSS Scale in an epidemiologic setting.

Method:

Data came from the Enquête sur la santé des aînés et l'utilisation des services de santé (ESA Services Study) conducted during 2012–2013 using a probability sample of older adults seeking medical services in primary health clinics.

Results:

Results showed that a first-order PTSS measurement model consisting of 3 indicators—the number of lifetime traumatic events, the frequency of reactions and symptoms of distress associated with the traumatic events, and the presence of consequences on the social functioning—was plausible. Reliability of the PTSS was 0.82. According to the PTSS, 11.1% of the older adult patients presented with PTSS, but only 21.7% of them reported an impact of their symptoms on their social functioning. The prevalence of older adults meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for full posttraumatic stress disorder (PTSD) reached 1.8%, and 1.8% of older adults reached criteria for partial PTSD. Our results also showed that women were more at risk to report PTSS than men and that older adults aged 75 years and older were less likely to report these symptoms than those aged between 65 and 74 years.

Conclusions:

PTSS is a common mental health problem among adults aged 65 and older and seeking health services in the general medical sector.
Treatment Patterns, Resource Use, and Economic Outcomes Associated with Atypical Antipsychotic Prescriptions in Children and Adolescents with Attention-Deficit Hyperactivity Disorder in Quebec
Authors: Lachaine Jean , De Gourab , Sikirica Vanja , van Stralen Judy , Hodgkins Paul , Yang Hongbo , Heroux Julie , Amor Leila Ben
Published: July 2017

Objective:

To assess treatment patterns, health care resource utilization (HRU), and costs among previously stimulant-treated children and adolescents with attention-deficit hyperactivity disorder (ADHD) receiving atypical antipsychotic (AAP) prescriptions in Quebec.

Methods:

Health care claims data extracted from Quebec's provincial health plan database between March 2007 and February 2012 were analyzed. Children and adolescents (6 to 17 years) with ADHD who were taking a stimulant and either switched to, or augmented with, an AAP (with the first AAP defined as the index AAP) without a documented diagnosis for which AAPs are Health Canada–approved were included. Discontinuation, augmentation, and switching of the index AAP during the 12-month, follow-up period were estimated using Kaplan–Meier survival analysis. HRU and costs for the 6 months before (baseline period) and after initiation of the index AAP were compared.

Results:

A total of 453 children and adolescents with ADHD, mostly male (74.6%) and aged 6 to 12 years (73.7%), met the inclusion criteria. The 12-month discontinuation, augmentation, and switching rates were 45.5%, 68.2%, and 80.7%, respectively. Patients had, on average, more all-cause prescription fills (22.2, compared with 13.3) and incurred more all-cause pharmacy ($889, compared with $710), total medical ($1096, compared with $644), and total health care ($1985, compared with $1354) costs during the 6-month study period than during the 6-month baseline period (all P < 0.05). Similarly, ADHD-related total health care costs were higher during the study period ($1269, compared with $835; P < 0.05); all-cause and ADHD-related total health care costs increased by 46.6% and 52.0%, respectively.

Conclusion:

Use of an AAP among stimulant-treated children and adolescents with ADHD in Quebec was associated with high rates of therapy changes and increased HRU and costs.
Physical Health and Drug Safety in Individuals with Schizophrenia
Authors: Pringsheim Tamara , Kelly Martina , Urness Doug , Teehan Michael , Ismail Zahinoor , Gardner David
Published: July 2017

Background:

While antipsychotic medications are the mainstay of therapy for individuals with schizophrenia and psychotic disorders, their use is associated with adverse effects on physical health that require the attention and care of prescribers.

Methods:

We used the ADAPTE process to adapt existing guideline recommendations from the National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) guidelines on the dosing of antipsychotics and antipsychotic polypharmacy, screening for adverse effects of antipsychotics, and management of metabolic and extrapyramidal side effects to the Canadian context.

Results:

Prescribers are encouraged to use the lowest effective dose and to avoid the routine use of multiple antipsychotics. Scheduled monitoring of body mass index, waist circumference, blood pressure, glucose, lipids, prolactin, electrocardiograms, and extrapyramidal symptoms is recommended. Lifestyle interventions are recommended to mitigate antipsychotic-induced weight gain. Prescribers should follow Canadian guidelines on the treatment of obesity, dyslipidemia, and diabetes. Recommendations on antipsychotic drug choice are made for users particularly concerned about extrapyramidal symptoms.

Conclusion:

Careful monitoring and attention by prescribers may mitigate adverse effects associated with antipsychotic medications.
The Association of Socioeconomic Conditions and Readiness to Learn New Ways of Performing Daily Activities in Older Adults With Functional Difficulties
Authors: Gleason Kelly T. , Gitlin Laura N. , Szanton Sarah L.
Published: July 2017

Behavioral interventions for older adults can reduce difficulties in performing daily activities, hospitalizations, and mortality risk. The success of behavior change interventions, however, can be affected by a participant’s readiness to adopt changes. This study evaluates whether socioeconomic conditions, particularly financial strain affording food, are associated with readiness to change. We conducted a cross-sectional, descriptive study of baseline data from disabled older adults ( N = 147) participating in an intervention to reduce physical disability. Readiness to change score was rated at the start of the intervention by interventionists as either pre-action (precontemplation = 1, contemplation = 2, preparation = 3) or action (=4). Participants reporting high financial strain affording food were more likely to have high readiness at the start of intervention; the association of this specific socioeconomic condition with readiness may be an important consideration in implementing interventions to reduce disability.
On Using Simulations to Inform Decision Making During Instrument Development
Authors: Morgan Grant B. , Moore Courtney A. , Floyd Harlee S.
Published: July 2017

Although content validity—how well each item of an instrument represents the construct being measured—is foundational in the development of an instrument, statistical validity is also important to the decisions that are made based on the instrument. The primary purpose of this study is to demonstrate how simulation studies can be used to assist the decision making of researchers who are developing or updating instruments. A hypothetical research study is presented in which the researcher needs to make choices that will guide his or her development of a universal behavior screener. In the study, he or she wishes to make choices regarding the number of items to include, the pilot sample size, average difficulty of the items, and the amount of information provided by the instrument at different cut scores. Simulation is then used to create data sets with varying levels of each of these aspects, and decisions are subsequently made regarding the levels that should be applied in the actual study. Rationale for these decisions as well as implications for practice are included.
Blue blood or true blood: Why are levels of intrastate armed conflict so low in Middle Eastern monarchies?
Authors: Møller Fenja Søndergaard
Published: July 2017

In the aftermath of the Arab uprisings, the difference between monarchies and republics appears more profound than ever. Aside from Bahrain, all of the Middle Eastern monarchies avoided major anti-governmental protests, and no armed conflict has occurred in any of them since 1979. Inspired by Middle Eastern case studies, this article argues that traditional legitimacy contributes to peace in Middle Eastern monarchies. The article explores the argument with time-series cross-sectional data covering 19 Middle Eastern countries from 1947 (or independence) to 2009. Traditional legitimacy is not measured directly but assumed to be embedded in the monarchical regime type, and the results show that alternative covariates are unable to fully explain the monarchical peace. Moreover, the study finds that horizontal discrimination increases the risk of intrastate conflict in authoritarian republics but that discrimination has no effect in monarchies. Future conflict studies should therefore consider legitimacy connected to authoritarian regime types.
War experiences, economic grievances, and political participation in postwar societies: An empirical analysis of Kosovo
Authors: Freitag Markus , Kijewski Sara , Oppold Malvin
Published: July 2017

This article contributes to the debate evolving around the political legacy of armed conflict. We evaluate the effect of war experiences during the 1998–1999 civil war in Kosovo on various modes of political participation. We find that war victims are on average more likely to participate in non-institutionalized forms of participation such as signing petitions and to participate in protests in the postwar era. In addition, we show that the impact of war experiences on political protest is contingent upon the postwar situation. War experiences are linked to protest behavior when a survivor is economically disadvantaged after the war. However, war experiences lose their impact on protest behavior when people do not encounter economic grievances in the postwar environment. In this vein, exploring the postwar context enriches our understanding of the political legacy of war victimization.
Text Remains Most Useful Format for Online News Sites
Authors: Wojdynski Bartosz W.
Published: July 2017

A survey of the most-trafficked U.S. news sites asked about the perceived usefulness of story platforms. All respondents use text stories daily, with 26 percent saying they publish video stories every day.
Feature Reporting Improves after Midcareer Training
Authors: Beam Randal A. , Spratt Meg , John Sue Lockett
Published: July 2017

After a week long fellowship program at the Dart Center for Journalism and Trauma, journalists were more likely to use victims and survivors of tragic events as sources in their feature articles and to humanize the experiences of people exposed to trauma.
The Impact of Sexual Orientation on the Racial Dating Patterns of Hispanic Males
Authors: Tarrence Jake A.
Published: July 2017

The present study investigates the racial dating preferences of homosexual and heterosexual Hispanic males. Data used to conduct this study were collected from a popular online dating website ( N = 2,416). Logistic regression is utilized to determine the odds of a Hispanic male stating a preference for dating someone who is White, Black, Asian, and Hispanic. Findings suggest that gay Hispanic males, when compared with straight Hispanic males, are less likely to state a preference for dating an Asian person, a Hispanic person, and a Black person. Results also show that racial dating preferences of Hispanic males are shaped by educational attainment, political orientation, age, and religious orientation. These findings are discussed in relation to how racial ideology creates and perpetuates racial disparities in mate selection.
Autologous Fat Grafts by Injection-Ten Years' Experience
Authors: Johnson Gerald
Published: July 2017

The use of surgically excised/mechanically fragmented dermal fat grafts by injection led to the use of suction-aspirated fat for autologous grafts by injection. Efforts to scientifically evaluate the fat survival began with a microscopic evaluation of the integrity of the aspirated fat in a series of patients. The next study consisted of injection of dye-stained fat into the abdominal skin/fat followed by removal and microscopic evaluation of the grafts from 3 months to 1 year later. Also, different sized cannulas for removal and different sized needles for injection of fat were used, with the abdominal skin/fat used as the recipient site. Studies were also done to compare washing versus nonwashing of the fat. These studies and 10 years of clinical evaluation and follow-up has led us to conclude that fat, properly aspirated, properly prepared, and properly injected, is an excellent and permanent substance for soft tissue augmentation.
A Novel Method of Liposuction Using an Ultrasonic Cannula: Ultrasonic Liposuction
Authors: Takasu Katsuya , Takasu Shizu , Kure Katsuhiro
Published: July 2017

Despite improvement in the methods of liposuction in the last decade, the basic concept of liposuction has not changed very much. There are still several unsolved problems with the conventional methods, including strenuous labor, accuracy, tissue destruction, and bleeding. In this paper, we introduce a new liposuction method that may solve these problems. This new method, “Ultrasonic Liposuction,” employs ultrasonic power directly released from a specially designed cannula. With this cannula, the surrounding adipose tissue is easily emulsified and aspirated through the cannula without significant complications. Although still in the experimental stage, an application of ultrasonic power to a cannula may be advantageous over the conventional methods.
Bi-Level Lipoinjection for Facial Wrinkles
Authors: Hernàndez-Pèrez Enrique
Published: July 2017

The survival of injected fat has long been a matter of concern. With the aim of obtaining more even and longer lasting results, during the last 3 years, we have injected fat using the following personal technique.

1. Deposit of fat is made in a deep supra-fascial level.

2. Injection is performed in a superficial, subdermal level.

3. Procedure ends with the injection of silicone in the dermis.
Medications Potentially Causing Lidocaine Toxicity
Authors: Shiffman Melvin A.
Published: July 2017

This article presents a first warning to surgeons using tumescent solutions for liposuction that inhibitors of cytochrome P450 3A4 (CYP34A) compete with lidocaine as substrates for this enzyme and, therefore, may diminish lidocaine metabolism, leading to a rise in lidocaine blood levels following tumescent infiltration. A table of medications that may cause adverse drug interactions is presented.
Double Skin Technique with Polyglactine or Mixed Mesh in Mastopexy and Breast Reduction
Authors: Di Giuseppe Alberto
Published: July 2017

Introduction:

The periareolar approach to breast reduction results in a circumareolar scar without vertical and horizontal components. The problems of this technique are widening of the periareolar scar, difficulty in obtaining proper breast shape, and early appearance of breast ptosis. The double skin technique using polyglactine or mixed mesh through a periareolar approach was utilized to see if the problems of the periareolar approach could be reduced.

Materials and Methods:

Since 1994, 100 patients have had a periareolar approach utilizing the double skin technique with polyglactine or mixed mesh. Age range was 19 to 49 years. There were 44 cases of mastopexy (breast lift) and 66 cases of breast reduction. The double skin technique is a periareolar pexy that utilizes a central large dermo-glandular pedicle, which is lifted (and eventually reduced) up to the desired new position and fixed at the costal margin. A second layer, represented by a large dermal flap, is utilized for the internal lining. A 910 polyglactine mixed mesh harvests the new breast cone to reinforce the new shaped breast. A round-block continuous nonabsorbable suture contributes to pull and distributes the tension of the internal cutaneous lining, while the areolar skin is sutured with a long-term absorbable continuous suture, in a double layer, leaving two independent elements sutured without tension. Conclusions: The experience of the author with the Goes technique includes a large series of patients with mild to medium ptosis and mild to medium hypertrophies. Having performed breast pexy and reductions with other periareolar techniques, experience shows that the present choice exactly fulfills all the requirements of the operation. Shape, projection of the breast, quality of the areolar scar, and long-term results are all improved in comparison with the techniques utilized in the past.
Effects of Combination Chemical Peel on Facial Photodamaged Skin
Authors: El Samahy May H. , Ghoz Mohamed M. , Ramzy Naglaa
Published: July 2017

Introduction:

Chemical peeling involves the topical application of a wounding agent with the goal of effecting an organized regeneration of the skin. The histologic and ultrastructural features of actinic and age-related damage include structural abnormalities that disrupt normal epidermal and dermal architecture. The purpose of the present study is to evaluate the clinical and histologic effects of an enhanced medium-depth peel on photodamaged skin. We aimed to correlate the clinical and histologic findings with the ultrastructural changes occurring after the peel. These ultrastructural features are supposed to be more precise and informative than the clinical or histological response. They may also be employed as markers of peel response.

Materials and Methods:

In the present study, five patients with actinically damaged skin underwent enhanced medium-depth peels using 70% glycolic acid and 35% trichloracetic acid. Biopsy specimens were taken before the peel and 3 months after the peel for histologic and electron microscopic examination.

Results:

Clinical resolution of actinic damage corresponded with restoration of epidermal polarity. Characteristic histologic and ultrastructural features of the skin after peeling include markedly decreased epidermal intracytoplasmic vacuoles, decreased elastic fibers, increased activated fibroblasts, and organized parallel arrays of collagen fibrils. The diameters of individual fibrils are consistent with recent production of collagen by activated fibroblasts.

Conclusion:

Glycolic acid—tricholoro-acetic acid (GA-TCA) is an effective combination for a medium-depth peel in photodamaged skin both clinically and histologically. Electron microscopic studies following medium-depth peels reveal changes more profound than those seen histologically. The characteristic changes occurring in the keratinocytes, collagen, and elastic fibrils may be considered as guidelines or markers of the peel response.
Production and hemocompatibility assessment of novel electrospun polyurethane nanofibers loaded with dietary virgin coconut oil for vascular graft applications
Authors: Jaganathan Saravana Kumar , M Mohan Prasath , Fauzi Ismail Ahmad , A Manikandan , N Gomathi
Published: July 2017

To develop biodegradable polymer scaffolds suitable for vascular tissue engineering applications, the bioengineering community has invested an extensive effort. The most common cause for the failure of vascular graft scaffolds is thrombosis. In this work, the scaffold based on polyurethane and virgin coconut oil was produced by electrospinning process for vascular tissue engineering applications with improved antithrombogenicity. The diameter of this electrospun polyurethane/virgin coconut oil composite was found to be reduced in the range of 886 ± 207 nm compared to pristine polyurethane which was in the range of 969 ± 217 nm. The Fourier transform infrared spectroscopy analysis revealed the interaction between polyurethane and virgin coconut oil as indicated by phase shifting of CH bond along with the formation of hydrogen bond. The contact angle measurement of fabricated composites was found to be increased owing to hydrophobic nature and also exhibited enhanced thermal stability as noted in thermogravimetric analysis. The atomic force microscopy analysis insinuated the increased surface roughness of the composite in comparison with the pure polyurethane. Developed scaffold resulted in delayed blood clotting as revealed by activated partial thromboplastin time and partial thromboplastin time assay. The hemolytic index of fabricated composites was found to be low indicating the enhanced safety of red blood cells. Hence, the newly developed nanofibrous composite scaffold could open the door for a suitable alternative for vascular graft applications.
Height Prediction From Ulna Length of Critically Ill Patients
Authors: Tarnowski Micheli S. , Rabito Estela I. , Fernandes Daieni , Rosa Mariane , Oliveira Manoela L. , Hirakata Vânia N. , Marcadenti Aline
Published: July 2017

Background: Ulna length (UL) has been used in mathematical formulas to predict the body height of healthy and sick individuals. However, the evaluation of its use with patients admitted to intensive care units (ICU) is scarce. The objective of this study was to develop a mathematical equation to estimate critically ill patients’ height using the UL measure and to evaluate its agreement with measured standing height. Methods: This cross‐sectional study was performed at the ICU of a tertiary hospital in Brazil. A total of 100 patients aged ≥18 years who had their body height measured before ICU admission were enrolled. The equation was developed through multiple linear regression, and its agreement was assessed through paired Student’s t test and Bland‐Altman plot. Results: The following formula was obtained: height in cm = 153.492 – (7.97 × sex [sex: male = 1, female = 2]) + (0.974 × UL [in cm]). The difference between means of measured height (MH) and height estimated from UL was not significant (166.26 ± 8.75 cm and 166.30 ± 5.29 cm, respectively, P = .96), and a significant correlation (r = 0.624, P < .001) was detected. In the Bland‐Altman analysis, UL was in agreement with MH; however, there was a significant bias (P < .001) suggesting that it may be disproportional and dependent on the average’s height value. Conclusion: The mathematical equation for height estimation using UL developed in this study matched the MH of critically ill patients. However, we suggest more studies for its validation.
Lipid Injectable Emulsion Survey With Gap Analysis
Authors: Christensen Michael L. , Ayers Phil , Boullata Joseph I. , Guenter Peggi , Gura Kathleen M. , Holcombe Beverly , Seres David S. , Sacks Gordon S. ,   for the ASPEN PN Safety Committee
Published: July 2017

Background: Lipid injectable emulsion (ILE) is an integral part of parenteral nutrition (PN), providing energy and essential fatty acids. With recent consensus recommendations for PN, clinical guidelines for ordering and preparation of PN, the U.S. Food and Drug Administration approval of new ILE products, and revised ILE labeling to include a 1.2‐micron filter, a gap in current practice knowledge was apparent. Materials and Methods: The American Society for Parenteral and Enteral Nutrition PN Safety Committee surveyed clinicians on how ILE products are prescribed, prepared, and administered to patients from neonates to adults. Results: The results of this survey conducted in late 2016 found a wide variation in practice, particularly across patient age groups. Conclusion: These findings demonstrate the need for ongoing dissemination and education on standardized safe practices for ILE use.
From Movement to Mainstream
Authors: Fleck-Henderson Ann
Published: July 2017

This is a case study of Transition House in Cambridge, MA, a pioneering feminist agency founded in 1976. Transition House has survived and is, today, a thriving agency. Based on interviews with and papers collected from those involved in founding and running it, as well as a few guests/clients, I argue that Transition House’s evolution was impelled by three major forces shared with other early domestic violence agencies: changes in the culture due in part to successes of the battered women’s movement in the early years, changes in the larger political–economic context due to national policies and economic trends, which make getting out of poverty in 2017 more difficult than it was in the 1970s, and learning from survivors and from evolving research on domestic violence. In 1976, the immediate focus was on women “battered” by their partners, and the agency was strongly identified with the women’s movement. In 2017, the focus is on women who are battered by economic and social conditions as much as by their partners, and the agency is seen as a partner with the city and with other nonprofit agencies.
Campus Sexual Violence Prevention Educators’ Use of Gender in Their Work: A Critical Exploration
Authors: Marine Susan B. , Nicolazzo Z
Published: July 2017

Recent studies indicate that sexual violence affects college students who identify as trans* or gender nonconforming (TGNC) at higher proportions than cisgender students with a full 29% reporting an experience with violence in a recent large-scale study. College sexual violence prevention educators (SVPEs) are critical actors in the effort to reduce the incidence of sexual violence, yet little is known about the practices they engage in to support the learning of students of diverse genders, and to educate students about the role of gender in sexual violence. This study explores the practices of SVPEs with respect to gender diversity, and the challenges and strategies they use to be gender inclusive in their work. Using an exploratory qualitative lens, 16 SVPEs were interviewed to better understand how they think about gender in their work, talk about gender as it relates to sexual violence, and deploy teaching and learning strategies regarding gender in their work with undergraduate students. Findings suggest that SVPEs face significant pressures related to compliance with Title IX, and that in terms of their practices related to gender, they occupy a continuum typified by gender defensiveness and unawareness, gender awareness, gender inclusion, and/or gender transformation. Recommendations include advancing opportunities for enhanced gender diversity education and professional development for SVPEs and the need for additional research on cisgender men’s and trans* survivors’ experiences with campus sexual violence.
Domestic Violence Against Women Working in Four Educational Hospitals in Iran
Authors: Sheikhbardsiri Hojat , Raeisi Ahmadreza , Khademipour Gholamreza
Published: July 2017

Domestic violence is a serious threat to the health of women in the world and derives from several factors. Therefore, due to the importance of this issue, this study aimed to determine domestic violence against women in four educational hospitals in Iran as a Muslim country. The study employed a cross-sectional design and was conducted in four educational hospitals supervised by the Kerman University of Medical Sciences in 2016. Using a researcher-made questionnaire, we assessed factors associated with domestic violence in female employees using a census method ( N = 400). Data were analyzed using descriptive statistics including mean and SD and analytic statistics such as Kolmogorov–Smirnov, ANOVA, t test, and Pearson and multivariate regression tests using SPSS 16 and p ≤ .05. This study showed that most common types of violence against women are psychological/verbal (58%), physical (29.25%), and sexual (10%), respectively. There was a significant relationship between couples’ age gap, forced marriage, husband addiction, income, and history of violence experienced by the husband with domestic violence against women. This study examines the basic prevalence of partner violence victimization among Iranian women who work in hospitals in southeast Iran. Findings suggest that national and local policies in Iran may need to examine factors that contribute to violence against women as well as focusing on how to reduce partner violence.
The Emergence of Local Practices in a Devolved Workforce Investment System: Barriers and Possibilities for Enhancing Degree Completion
Authors: Nisbet Elizabeth , McKay Heather A. , Haviland Sara
Published: July 2017

Former President Obama’s 2020 Goal for the United States to have the highest proportion of college graduates in the world required that both new and disengaged college students attain degrees. The workforce development system could assist the latter by supporting credit-bearing education as training. Its ability to address this need depends on the controlled devolved structure established by the Workforce Investment Act of 1998, which allows states and local workforce investment areas to set priorities and make a range of choices bounded by federal constraints. Analyzing interview data with frontline staff, case managers, and leadership in workforce systems in four states, the authors identify obstacles and opportunities for supporting degree completion. Three federal Workforce Investment Act mandates are particularly influential: individual training accounts, eligible training provider lists, and emphasis on demand occupations. The authors also model factors such as local partnerships and staff knowledge that can mediate how policy and practice shape local workforce investment area support for college.
The Effect of Measures Taken by Craigslist to Screen Online Ads for Commercial Sex
Authors: Judge Shana M.
Published: July 2017

A 2017 U.S. Senate subcommittee report charging employees at backpage.com with editing the website’s online ads for prostitution has revived debate over the willingness and ability of such websites to screen ads for unlawful commercial sex activity. This study sheds light on the controversy by revisiting the dispute surrounding similar advertising on craigslist.com . Using an observational pre–post research design, I examined unique data collected from commercial sex ads on a North Carolina Craigslist site to assess the impact of enhanced ad screening measures that Craigslist implemented to address misuse of its ad hosting services. Results indicate that Craigslist’s switch to a manual review of ads led to significant decreases in illicit ad content, temporarily inhibiting online marketing of commercial sex by regional advertisers.
The Absence and Influence of Genesis 48 (the Blessing of Ephraim and Manasseh) in the Book of Jubilees
Authors: Buisch Pauline P.
Published: July 2017

While scholars have acknowledged the literary dependence of Jubilees 31 (the blessing of Levi and Judah) on Genesis 48 (the blessing of Ephraim and Manasseh), little work has been done to understand the purpose of this intentional intertextuality. This article examines the literary influence of Genesis 48, the effect of its absence, and the altered roles of Levi, Judah, and Joseph in Jubilees in order to determine why the author made the literary decision to pattern one scene of blessing after the other. This article suggests that the author's decision to omit Genesis 48 and to present not one but two similar scenes of blessing in its place is part of a larger strategy to negotiate the interpretive problem of the prominent status given to Joseph's sons in Genesis 48. By replacing Ephraim and Manasseh with Levi and Judah, but allowing Joseph to receive the double portion of land, the author of Jubilees reflects an interpretive tradition, also found in the Targums, Genesis Rabbah, and the Testaments of the Patriarchs, that understands the inheritance of Jacob to be threefold and distributed three ways—the birthright to Joseph, the priesthood to Levi, and the kingship to Judah.
High efficiency blasting erosion arc machining of 50 vol.% SiC/Al matrix composites
Authors: Chen Jipeng , Gu Lin , Zhu Yingmou , Zhao Wansheng
Published: July 2017

Blasting erosion arc machining (BEAM) is adopted to improve the machining efficiency of high fraction (50 vol.%) SiC/Al matrix composites. Results of the fractional factorial experiments and full factorial experiments indicate that the electrical parameters (peak current, pulse duration and pulse interval) are the main impact factors of the machining efficiency, and when the peak current is 500 A, the pulse duration is 8 ms and the pulse interval is 2 ms, the material removal rate reaches to 6000 [Formula: see text]/min. Furthermore, the material removal rate was optimized and could be as high as 7500 [Formula: see text]/min with the tool wear ratio about 10%. Simulation of the single discharge heat transfer illustrates that the SiC particles have negative influence on the machining performance due to their temperature dependent characteristics. The polarity effect was also studied and it is disclosed that different machining polarities have different influences on the machining performance, surface integrity and even the formation of SiC particles. Finally, a 50 vol.% SiC/Al workpiece was machined with blasting erosion arc machining.
Manufacturing helical gears with double-crowning and twist-free tooth flanks using a variable pressure angle shaving cutter
Authors: Hsu Ruei-Hung , Wu Yu-Ren , Tran Van-The
Published: July 2017

For a parallel gear shaving process, the tooth flanks of a shaved work gear surface are longitudinally crowned using an auxiliary crowning mechanism. However, the flanks are only crowned in the longitudinal direction and not in the cross-profile direction so there is a natural twist on the shaved work gear surfaces. A new shaving method for double-crowning that has no natural twist in the tooth flanks on the work gear surfaces is proposed, which uses a variable pressure angle shaving cutter in a parallel gear shaving process. Three numerical examples are presented to verify the merits of the proposed shaving method. The tooth flanks are crowned in both the cross-profile and the longitudinal directions, and natural twists in the shaved tooth flanks are reduced significantly.
Elastic analytical solutions and angular distributions near spot weld nugget in lap-shear specimens
Authors: Xu Fengxiang , Yan Fei , Wang Chao , Li Yuqiang
Published: July 2017

Spot welding has been a remarkably important joint method for automotive body engineering. Based on a simplified two-dimensional analytical model in a lap-shear specimen, the elastic analytical solutions near spot weld nugget are theoretically derived to analyze stress distributions. A Cartesian coordinate system is centered at the center of the nugget, and the shear or resultant force acting on the nugget is marked as the positive x-direction. The results show that the normalized radial and hoop stresses are negative at the angle intervals between [66.25°, 113.75°] and [246.25°, 293.74°], while the normalized shear stress is negative at the angle intervals between [0°, 90°] and [180°, 270°]. It can be observed that the locations with the initial yielding failure change gradually from the normalized radial distance of 1.34 to the circumference of the spot weld nugget, and finally to the infinity as the angle increases. The normalized effective stress could approach to 1.84 as the normalized radial distance goes to infinity. In addition, the obtained analytical solutions are validated in the comparison with numerical results. The locations with peak Von Mises stresses along the circumference of the spot weld nugget have a good agreement with the analytical solutions. It indicates that the initial yielding locations would likely occur at the four special angles of the spot weld nugget. Therefore, the derived stress distributions in this study are beneficial for analyzing yielding failure behavior or evaluating damage evolution on engineering structures jointed with spot welds.