bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term Health Consequences of Adverse Labor Market Conditions at Time of Leaving Education: Evidence from West German Panel Data
Authors: Lersch Philipp M. , Jacob Marita , Hank Karsten
Published: January 2018

Using longitudinal survey data from the Socio-Economic Panel Study ( N = 3,003 respondents with 22,165 individual-year observations) and exploiting temporal and regional variation in state-level unemployment rates in West Germany, we explore differences in trajectories of individuals’ self-rated health over a period of up to 23 years after leaving education under different regional labor market conditions. We find evidence for immediate positive effects of contextual unemployment when leaving education on individuals’ health. We find no evidence for generally accelerated or decelerated health deterioration when leaving education in high-unemployment contexts. We find, however, that individual unemployment experience when leaving education is associated with worse health and with more accelerated health deterioration in high-unemployment contexts. The cumulative experience of unemployment after leaving education does not mediate the influence of early labor market experiences for long-term health outcomes. In addition, our analyses indicate no gender differences in these results.
What Is a Clinic? Relationships and the Practice of Organizational Ethnography
Authors: Heimer Carol A.
Published: January 2018

This article examines the practices of ethnographers carrying out research in and, especially, on organizations. Ethnographers studying organizations, like other ethnographers, emphasize close observation and understanding the meaning of actions, words, and artifacts; they differ from other fieldworkers, though, in focusing on the organization itself, not just what happens inside it. Because fieldwork relationships are the core technology of organizational ethnography, this article argues, the challenges of studying organizations differ from the challenges of doing ethnography in other settings or with other analytic purposes precisely because the character of the organization and its activities shape what the researcher can and will study. This article discusses how fieldwork relationships are constrained and shaped as ethnographers submit their projects for ethics review, gain access to research sites, hang out in the organizations they are studying, interview informants, study organizational documents and paperwork, and handle requests to give back to the site.
Constructing Drug Using Victims
Authors: Laguna Sofia
Published: January 2018

Sociologists and political scientists examining the social construction of public anxiety surrounding drug use in the United States have argued that racial minorities are the targets of the harshest drug laws while middle-class whites are shielded. In this article, I provide further evidence that middle-class, white drug users are shielded from harsh punishment by analyzing the process through which U.S. legislators and policy makers decide which drug users need punishment and which deserve protection and treatment. Analyzing transcripts from federal Congressional hearings, I examine the rhetoric of legislators and stakeholder witnesses concerning the use of 3,4-methylenedioxymethamphetamine (MDMA) by middle-class whites. Building on the social construction literature, I use social identity theory to demonstrate how legislators within Congressional hearings create in- and out-groups in order to categorize different drug users and dealers. My analysis of Congressional hearing language concerning white MDMA use demonstrates that Congressional speakers use rhetoric to convince committee members and the wider public that middle-class, white drug users are different from drug users of color and that the appropriate policy response is education and treatment rather than punishment. My findings highlight how middle-class, white drug users are characterized differently from drug users of color, providing further evidence that U.S. drug policy has historically favored middle-class, white drug users.
Bidirectional association between effortful control and intentional self-regulation and their integrative effect on deviant adolescent behaviors
Authors: Liu Yih-Lan , Chang Hui-Tzu
Published: January 2018

Effortful control and intentional self-regulation are two constructs associated with children’s and adolescent self-regulation that have historically been the subject of research in separate fields, where temperament research has primarily focused on effortful control, and positive development research has focused on intentional self-regulation. This study examines the reciprocal relationship between effortful control and intentional self-regulation and discusses how they relate to deviant adolescent behaviors. A total of 599 adolescents from western Taiwan participated in this study, and four waves of data were collected in 2 years. Cross-lagged structural equation models were tested. The results indicate that effortful control has a predominant influence on intentional self-regulation; also, effortful control negatively predicts deviant behavior for boys, whereas intentional self-regulation displays a similar effect for girls.
Comparison of entropic and exergetic methods of quantification of loss of power due to irreversibilities in real processes using the Gouy–Stodola theorem
Authors: Pal Rajinder
Published: January 2018

Thermodynamics offers two methods of quantification of irreversibilities in real processes, namely entropy generation method and exergy destruction method. The engineering students in different disciplines are generally taught only the entropy analysis of processes in their second, advanced level, course in thermodynamics. The exergy analysis of quantification of irreversibilities is rarely covered adequately in the undergraduate courses in thermodynamics, especially when chemical effects are involved where the concept of chemical exergy plays the key role. In this article, the entropy and exergy methods of quantification of irreversibilities are reviewed and are applied to two real processes: steady-state de-mixing of a binary gas mixture into pure components and steady-state combustion of carbon monoxide gas. According to the entropy generation method, the loss of power due to irreversibilities is proportional to the rate of total entropy production (internally and externally). According to the exergy destruction method, the loss of power is equal to the rate of total exergy destruction (internally and externally). Although the calculation procedures involved in the two methods are quite different, the two methods yield the same results in terms of the loss of power due to irreversibilities in the real processes considered in this article. Thus, the detailed calculations carried out in this work confirm that the two methods of quantification of irreversibilities are equivalent. The exergetic method has the advantage that only the knowledge of the exergies of the flowing streams at the inlet and outlet conditions is required in order to calculate the loss of power due to irreversibilities, whereas the entropic method requires a stepwise calculation scheme in going from the inlet conditions to the outlet conditions of the process flow streams. As the material presented in this article involves advanced level concepts in thermodynamics, the appropriate place for the introduction of this material to the engineering students is the second, advanced level, course in thermodynamics.
Tests of the Attachment and Developmental Dynamic Systems Theory of Crime (ADDSTOC): Toward a Differential RDoC Diagnostic and Treatment Approach
Authors: Lindberg Marc A. , Zeid Dana
Published: January 2018

The Attachment and Developmental Dynamic Systems Theory of Crime was tested on 206 male inmates. They completed measures tapping attachments, clinical issues, adverse childhood events, peer crime, and crime addictions. A significant path model was found, going from insecure parental attachments to adverse childhood events, and then on to the behavioral crime addiction and criminal peers scales. Peer crime was also predicted by insecure parent attachments and the crime addiction scale. Finally, the crime addiction, peer crime, and insecure parental attachment scales predicted frequencies of criminal behavior. The model also fit a sample of 239 female inmates. The notions of crime addiction, in this context of adverse events and insecure parental attachments, offered newer and more powerful explanations than previously offered by social learning theories on why some individuals are more likely to associate with peers engaging in criminal behavior, and also how these combine to predict degrees of criminal behavior. By moving beyond main effects models, it was found that a focus on systems of interactions was robust in theory and application. However, profile data from the Attachment and Clinical Issues Questionnaire showed that individual differences in Research Domain Criteria diagnoses are fundamental to treatment settings. Such approaches to reducing rates of recidivism and substance abuse should also enhance outcomes in many domains, including HIV prevention, costs to health care, and at the same time increase overall public safety.
Feelings of Burden in Palliative Care
Authors: Rakic Milenko , Escher Monica , Elger Bernice S. , Eckstein Sandra , Pacurari Nadia , Zwahlen Susanne , Wienand Isabelle
Published: January 2018

Background:

Care for palliative care patients is often provided by unpaid caregivers (eg, family members) who take care of the patient’s daily needs (eg, bathing, dressing). Family members of palliative care patients are involved in numerous ways. These tasks and responsibilities can make them feel burdened and even overburdened.

Aim:

We specifically looked at patients’ medical records to determine what is being reported about burden and overburden and who seems to be mostly affected. Burden was understood as a weight or task that is difficult to accept or carry, whereas overburden indicates that this weight or task cannot be carried anymore.

Methods:

We looked at 300 medical records of palliative care patients written by health-care professionals. Written notes were analyzed using latent content analysis as it helps to analyze large amounts of textual data qualitatively and to understand the underlying concepts of what was said.

Results:

Most (73.5%) patients had a cancer diagnosis. Mean age was 67.6 years (range, 22-98 years). Burden and overburden were identified as main categories and further divided into the following subcategories: for patients and families. According to the written notes, patients often felt burdened by their disease, financial problems, situation at home, and families’ reactions to their disease. By and large, patients felt overburdened by their own disease. Families often felt burdened because of issues related to patients’ medical condition, providing home care, or financial and social aspects. Families mentioned home care and the decision-making process as being overburdening.

Conclusion:

Findings in the palliative care patients’ medical records are inasmuch important, as they point at the health-care staff’s awareness of possible weights and tasks that might be burdensome for patients and their families. Attention should be drawn to the documentation of medical records in order to identify recurrent difficulties and to help discuss these.
Relationships Among Neonatal Mortality, Hospital Volume, Weekday Demand, and Weekend Birth
Authors: Restrepo Elizabeth , Hamilton Patricia , Liu Fuqin , Mancuso Peggy
Published: January 2018

Background

Research findings indicate that hospital volume affects the quality of care, that quality and demand for care on weekends differs from weekdays, and that giving birth on the weekend increases odds of neonatal mortality.

Purpose

To explore relationships among neonatal mortality, hospital volume, weekday demand for services, and weekend birth and risk of neonatal mortality.

Methods

For this retrospective, population-based, cohort study design, data were obtained from 32,140 electronic birth certificate records matched with 92 death certificate records from the Texas Department of State Health Services for 2012. Statistical analyses include descriptive procedures, analysis of variance, bivariate correlation, t-test, logistic regression, and chi-square tests of association.

Results

Higher hospital birth volume and higher concentrations of births during the week were associated with fewer neonatal deaths. Weekend births were associated not only with higher rates of neonatal death but also with lower birth weight and ethnicity of the mother.

Conclusions

These findings suggest the need for further study of the ways hospital-level organization of services and resources interact with individual risk factors to play a significant role in raising the neonatal mortality risk associated with weekend birth.
The Use of ECMO for the Treatment of Refractory Cardiac Arrest or Postarrest Cardiogenic Shock Following In-Hospital Cardiac Arrest: A 10-Year Experience
Authors: Chonde Meshe , Sappington Penny , Kormos Robert , Althouse Andrew , Boujoukos Arthur
Published: January 2018

Objectives:

Extracorporeal membrane oxygenation (ECMO) has been increasingly used in the treatment of refractory cardiac arrest (extracorporeal cardiopulmonary resuscitation [ECPR]) and postarrest cardiogenic shock (PACS). Our primary objective was to determine the 1-year survival of patients who were treated with ECMO for PACS or in ECPR.

Methods:

We conducted a retrospective analysis of hospitalized patients in a tertiary care facility who underwent treatment with ECMO for ECPR or PACS. Between January 2004 and December 2013, patients were prospectively entered into an institutional registry. One-year follow-up was assessed by electronic medical record or social security death index if clinical follow-up was unavailable.

Results:

Fifty-one patients were treated with ECMO during the study period. The mean age was 54.0 ± 10.9 years; the majority of patients were men (80.4%). The most common etiology of arrest was acute myocardial infarction (51.0%). Overall, 13 (25.4%) patients survived for at least 1 year. Preexisting coronary artery disease, hypertension, and hyperlipidemia were associated with reduced likelihood of survival. We observed a significant improvement in 1-year mortality in patients treated for PACS when compared to ECPR, 46.7% versus 16.7%, respectively.

Conclusion:

The use of ECMO for treatment of refractory cardiac arrest or cardiogenic shock may be a suitable treatment in a very select cohort of patients. Our results support a significantly higher 1-year survival in patients with PACS compared to refractory cardiac arrest.
A novel method to model the effect of environmental constraint of geometry in the mechanism design
Authors: Guo Wentao , Guo Weizhong , Ge Jeffrey Q , Gao Feng
Published: January 2018

Few studies have considered the effect of environmental constraints throughout the entire design process of mechanical systems. Neglecting such effect might lead to misunderstanding the kinematic performance of the mechanical systems. In our work, an environment-based design concept was proposed by using passive limbs to model and analyze geometrical constraints in each step of the theoretical design process. Redesigning of a thrust system in a shield machine is taken as an example for better demonstration of this design approach. A new equivalent model of the thrust system was synthesized by using passive limbs to express environmental constraints of geometry based on the shield behavior. The uniform kinematic model was developed for the integrated equivalent mechanism of the thrust system. The effectiveness of the passive limbs in expressing environmental constraints was then evaluated by kinematical analysis. A singularity analysis was performed to assess the consistency between the equivalent model and a real thrust system. The reachable angular workspace was also analyzed to demonstrate the influence of the passive limbs as an example of environment-based parameter design. A motion simulation was performed to demonstrate the improvement of the forward kinematics by using the passive limbs to solve the singularity problem. A dexterity performance index based on the proposed model was conducted to demonstrate the kinematical property of the thrust system.
Active disturbance rejection guidance and control scheme for homing missiles with impact angle constraints
Authors: Wang Jian Hua , Cai Yuan Wen , Cheng Long , Li Yan , Jun Xin Chao , Xie Wei Qi , Tang Guo Jian
Published: January 2018

An active disturbance rejection guidance and control scheme for homing missiles with three-dimensional impact angle constraints is proposed. The six-degree-of-freedom dynamical and kinematical models containing model uncertainties and disturbances are established. A strict feedback relative dynamics between the target and homing missile in three-dimensional space are deduced. A reconstructed reduced-order attitude controller design model is proposed. A two-loop control structure with respect to the centroid guidance loop and rotational control loop is conducted to implement the six-degree-of-freedom guidance and control system with the help of second-order sliding mode approach and extended state observers. The tracking loop of the Euler angles of the missile can be elided and the number of six-degree-of-freedom control parameters can be reduced. Finally, the effectiveness and robustness of the newly proposed guidance and control scheme are investigated and verified via six-degree-of-freedom nonlinear simulation studies.
Third-order leader-following consensus protocol of traffic flow formed by cooperative vehicular platoons by considering time delay: constant spacing strategy
Authors: Chehardoli Hossein , Homaeinezhad MR
Published: January 2018

In this article, the problem of third-order consensus of homogeneous traffic flow formed by cooperative vehicular platoons is studied. This article is presented in two main parts. Inter-platoon stability analysis and intra-platoon stability analysis. For inter-platoon stability analysis, due to great length of traffic flow, it is assumed that lead vehicle is not available. Therefore, a new consensus algorithm based on bidirectional virtual leader-following strategy is introduced. Both communication and parasitic delays are involved in control design and stability analysis. By decoupling the closed-loop dynamics of cooperative leaders and employing the cluster treatment characteristic root method, necessary conditions on control parameters and stable regions of time delay satisfying internal stability of leaders’ network are derived. In continuance of this part, inter-platoon string stability is studied. In the second part, it is assumed that the communication topology of each platoon is generic. Therefore, some of the eigenvalues of network matrix are complex which complicates the intra-platoon stability analysis. After decoupling the closed-loop dynamics of each platoon, a new consensus algorithm is presented. It will be shown that by this algorithm, the control parameters are independent of eigenvalues of network matrix which simplifies the controller design and stability analysis. Several simulation results are provided to show the effectiveness of the proposed approaches.
Risk of complications of ultrasound-guided renal biopsy for adult and pediatric patients with systemic lupus erythematosus
Authors: Sun Y S , Sun I T , Wang H K , Yang A H , Tsai C Y , Huang C J , Huang D F , Lai C C
Published: January 2018

Objective

The objective of this paper is to identify the risk of complications of real-time ultrasound-guided renal biopsy in adult and pediatric patients with systemic lupus erythematosus (SLE).

Materials and methods

This retrospective study examined outcomes of 296 renal biopsy procedures in 275 SLE patients. Imaging-confirmed symptomatic hematoma was regarded as a major complication when intervention (blood transfusion, angiographic embolization, or surgery) was required or as a minor complication otherwise. Clinical and laboratory data were compared between groups with or without complications after initial or subsequent renal biopsy. Binary logistic regressions were used to evaluate complication risk of initial renal biopsy.

Results

Overall complication rate of initial renal biopsy was 8.7% (major: 2.9%, minor: 5.8%). Three patients expired from pulmonary hemorrhage, thrombotic microangiopathy, and pneumonia. Pediatric SLE patients tended to have a higher rate of major complications (12.5%) than adult patients (2.3%). According to multivariable analysis results, elevated serum creatinine (SCr) level (OR 1.45; 95% CI 1.17–1.81 per mg/dl), prolonged prothrombin time (PT) (OR 2.2; 95% CI 1.05–4.62 per second), and thrombocytopenia (OR 4.3; 95% CI 1.56–11.9) increased overall complication risk of initial renal biopsy. Age < 18 years (OR 8.43; 95% CI 1.21–58.8), thrombocytopenia (OR 16.4; 95% CI 2.44–110.5), and elevated SCr level (OR 1.97; 95% CI 1.36–2.86 per md/dl) increased risk of major complications. Thrombocytopenia, prolonged PT, and elevated SCr level were associated with complications after subsequent renal biopsy (all p = 0.01).

Conclusions

SLE patients, particularly patients under 18 years old or with elevated SCr level, prolonged PT, or thrombocytopenia, have an increased risk of complications after initial or subsequent renal biopsy.
Blood pressure control over time in childhood-onset systemic lupus erythematous
Authors: Avar Aydin P O , Shan J , Brunner H I , Mitsnefes M M
Published: January 2018

Introduction

Hypertension (HTN) is prevalent in patients with systemic lupus erythematosus (SLE) and causes early cardiovascular aging and progression of renal and cardiac disease. The aim of this longitudinal retrospective study was to evaluate the prevalence of HTN, the follow-up blood pressure trends, and risk factors for HTN in a population-based cohort with childhood-onset SLE (cSLE).

Methods

Demographic and clinical data of consecutive visits from the baseline to the last visit were extracted from electronic medical records of patients with cSLE.

Results

A total of 110 patients with cSLE were identified with a median follow-up duration of 29.5 months; 19% had lupus nephritis (LN) at diagnosis. Further, 29% and 23% had HTN and preHTN at the baseline visit. Compared to those without HTN, patients with HTN had higher disease activity, obesity, more frequent LN, and lower eGFR. In multivariate analysis, the presence of LN, obesity, and high extra-renal disease activity were independent predictors of HTN at baseline.

Conclusions

While HTN is a known feature of LN, HTN is common and persistent in cSLE without LN, with about one-third of patients having uncontrolled elevated blood pressure almost three years after the onset of lupus. In addition to LN, obesity and high overall disease activity were independent predictors of HTN.
Factors associated with health-related quality of life in Peruvian patients with systemic lupus erythematosus
Authors: Elera-Fitzcarrald Claudia , Alva Magaly , Gamboa-Cardenas Rocío , Mora-Trujillo Claudia S , Zevallos Francisco , García-Poma Augusto , Medina Mariela , Rodriguez-Bellido Zoila , Perich-Campos Risto A , Pastor-Asurza César A , Segami María I , Ugarte-Gil Manuel F
Published: January 2018

Objective

In this paper, we aim to define factors associated with health-related quality of life (HRQoL) in Mestizo patients with systemic lupus erythematosus (SLE).

Methods

We evaluated patients with SLE from Peru’s two largest hospitals between October 2012 and July 2015 to ascertain HRQoL. Using a standard protocol, we incorporated demographic characteristics, clinical manifestations and treatment in our analysis. HRQoL was measured with the LupusQoL, disease activity was ascertained with the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and damage was appraised with the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) damage index (SDI). The associations between the LupusQoL and these variables were examined using linear regression models. Model selection was based on backward elimination.

Results

A total of 277 patients fit the inclusion criterion. Of these, 254 (91.7%) were female, the median (interquartile range, IQR) age at diagnosis was 41.5 (33.8–51.8) years, disease duration was 6.5 (2.7–11.3) years. The HRQoL domains most affected were the following: burden to others, fatigue, and intimate relationships. Through multivariate analysis, we determined that older age at diagnosis, higher disease activity, damage, and immunosuppressive drug use were negatively associated with HRQoL. Further, we found that higher socioeconomic status, disease duration, and antimalarial use were positively associated with HRQoL.

Conclusion

Age at diagnosis, disease activity, damage, and use of immunosuppressive drugs were negatively associated with HRQoL; high socioeconomic status, disease duration, and use of antimalarials were positively associated with HRQoL.
Frequency of psychological alterations in primary antiphospholipid syndrome: preliminary study
Authors: Sadetski M , Tourinho Moretto M L , Correia de Araujo R P , de Carvalho J F
Published: January 2018

Objectives

To detect the frequency of psychological alterations in primary antiphospholipid syndrome patients.

Methods

Thirty-six primary antiphospholipid syndrome patients were analyzed by a psychological interview using a standard protocol and review of medical charts. Clinical manifestations, associated comorbidities, antiphospholipid antibodies, and treatment were also evaluated.

Results

The mean age was 44.2 ± 10.8 years, 29 (80%) were women and 29 (80%) were of Caucasian race. The mean duration of disease was 7.3 ± 5.2 years. The frequency of the presence of psychological alterations was 97.1%. Family dependence was observed in 14 (40%), memory loss in 12 (34.3%), social losses in 12 (34.3%), sexual limitations in seven (20%), sadness in six (17.1%), severe speech limitation in four (11.4%), anxiety in three (8.6%), learning difficulty in two (5.7%), generalized phobia in two (5.7%), suicide ideation in one (2.6%), agoraphobia in one (2.6%), and obsessive-compulsive disorder in one (2.6%).

Conclusion

This study demonstrated that almost all primary antiphospholipid syndrome patients have psychological alterations. These data reinforce the need for psychological evaluation in primary antiphospholipid syndrome patients.
Art in Social Work: Do We Really Need It?
Authors: Huss Ephrat , Sela-Amit Michal
Published: January 2018

The arts have been used in social work practice with individuals and communities since the beginning of the profession, and yet an articulation of a rationale for their use is missing. An exploration of how the arts fit within the profession’s mission is also lacking. The lack of a theoretical foundation for the arts in social work has thus resulted in the marginalization of arts practice in the field. This article examines fundamental questions regarding the use of the arts in social work: the relevance of the arts to clients, to social workers, and whether the arts can provide evidence to promote professional work. Addressing these concerns will clarify the relevance of the arts to social work theory and practice and explore their advantages and limitations, thus helping to create more nuanced collaborations between social work and the humanities, arts therapy, and the arts in general.
Palatal and Alveolar Tissue Deficiency in Infants With Complete Unilateral Cleft Lip and Palate
Authors: Bednar Katy A. , Briss David S. , Bamashmous Mohamed S. , Grayson Barry H. , Shetye Pradip R.
Published: January 2018

Objective:

To investigate intrinsic palatal and alveolar tissue deficiency in patients with unilateral cleft lip and palate (UCLP) as compared to age-matched individuals without UCLP using surface area measurements on 3D scans of plaster casts.

Methods:

22 maxillary casts of infants with UCLP from the Wyss Department of Plastic Surgery of NYU Langone Medical Center and 37 maxillary casts from infants without clefts from Sillman’s longitudinal study were scanned by Ortho Insight 3D by Motion View Software, LLC (Chattanooga, TN) and measured using Checkpoint software (Stratovan, Davis, CA). The palatal and alveolar surface areas of each cast were measured. The most superior point of the alveolar ridge in front of the incisive papilla and the most superior point of each maxillary tuberosity were connected by a line that ran along the highest part of the alveolar ridge. This line was used to set boundaries for the palatal surface area measurements. The surface areas of greater and lesser segments were measured independently on UCLP casts. A total palatal surface area for the UCLP sample including width of the cleft gap was also measured.

Results:

There was a statistically significant difference in surface area ( P > .001) when we compared the UCLP area of the cleft segments alone with the non-cleft sample. There was a positive correlation (determine the statistical significance) between the surface area of the cleft segments and cleft gap. In addition, there was a statistically significant difference between UCLP plus cleft area and the non-cleft samples in surface area ( P < .0001).

Conclusion:

An intrinsic palatal and alveolar tissue deficiency exists in patients born with UCLP. The amount of tissue deficiency for a patient with UCLP should be considered when developing and executing a patient-specific treatment plan.
Comparing Methodologies in a Series of Speech Outcome Studies
Authors: Ahl Rebecka , Harding-Bell Anne
Published: January 2018

Background:

Development of the speech audit tool Cleft Audit Protocol for Speech Augmented (CAPS-A) facilitated intercenter comparison of speech outcomes following cleft palate repair. The CAPS-A protocol recommends consensus listening by 3 speech and language therapists, 2 of whom must be CAPS-A trained. Allowing 15 minutes per sample, 15 to 20 samples can be assessed each day. Centers typically have resources to audit 15 to 75 samples per year but not to report speech outcomes of larger data sets for research. This 3-phased outcome study examines how the implementation of the CAPS-A protocol might be modified without compromising reliability.

Methodology:

In phase 1, 2 external listeners independently rated 42 speech samples; in phase 2, 2 external listeners consensus listened 25% of 140 samples before 1 listener independently rated the remainder; phase 3 compared 124 Great Ormond Street Speech Assessment (GOS.SP.ASS’98) records from live assessments with CAPS-A-rated video samples.

Results:

Hypernasality, nasal airflow, and passive cleft speech characteristics were rated to identify signs of velopharyngeal dysfunction across all phases. Phase 1 demonstrated suboptimal correlation, intraclass correlation coefficient (ICC) ranging between 0.39 and 0.72. However, the “modified” CAPS-A consensus listening process in phase 2 achieved a mean ICC of 0.91. Phase 3 revealed only moderate agreement between GOS.SP.ASS’98 and CAPS-A.

Conclusion:

A large data set of speech samples was successfully managed by establishing good interrater reliability on 25% of the data, which calibrated the listeners and validated a decision for only 1 of 2 listeners to rate the remaining speech samples. The recommended implementation of the CAPS-A protocol can therefore be modified for more efficient speech outcome reporting.
Assessment of Orthodontic Burden of Care in Patients With Unilateral Complete Cleft Lip and Palate
Authors: Alberconi Thamara Frascarelli , Siqueira Gabriela Leticia Clavisio , Sathler Renata , Kelly Katherine A. , Garib Daniela G.
Published: January 2018

Objective:

To assess the orthodontic burden of care of patients from a Brazilian rehabilitation center (Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo [HRAC-USP]).

Design:

Retrospective.

Setting:

Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo.

Interventions:

One hundred files of unilateral complete cleft lip and palate patients who had consecutively finished orthodontic rehabilitation at HRAC-USP were evaluated from January 2011 to January 2013. The duration of orthodontic treatment, number of visits, kilometers traveled, number of appliances and surgical procedures performed were recorded. The sample was divided into 2 subgroups according to severity the interarch relation (Goslon Yardstick score) at the beginning of orthodontic treatment. Mann-Whitney test was applied for intergroup comparison ( P < .05).

Results:

For the total sample (n = 100), the mean time of orthodontic treatment was 140.2 months, the mean number of orthodontic appointments was 61.8, the mean number of appliances was 10, the mean number of surgical procedures was 6.2, and the mean distance traveled to attend the center for orthodontic appointments was 38,978.5 km. The subgroup with the most severe malocclusion (Goslon yardsticks scores 4 and 5) showed a longer orthodontic treatment length, greater number of surgical procedures, and longer distance traveled than those presenting Goslon yardstick scores 1, 2, and 3.

Conclusion:

Patients with greater severity of the initial malocclusion experienced a higher burden of care than patients with less severity of the initial malocclusion. To reduce the burden of care, research and efforts should focus on minimizing maxillary growth deficiency related to primary surgery.
Cleft-Related Infanticide and Abandonment: A Systematic Review of the Academic and Lay Literature
Authors: Stewart Barclay T. , Hatcher Kristin Ward , Sengupta Abhishek , Burg Richard Vander
Published: January 2018

Objective:

We aimed to describe the scope of cleft-related infanticide and identify issues that might inform prevention strategies.

Design:

Systematic reviews of both academic (eg, PubMed, EBSCOhost) and lay literature (eg, LexisNexis Academic, Google) databases were performed to identify all primary reports of cleft-related infanticide. All languages were included. Records before 1985 were excluded. Reference lists of all included reports were screened for potentially relevant records.

Main Outcome Measures:

Country of origin and excerpts that pertained to the concepts surrounding cleft-related infanticide were extracted. Extracted excerpts were examined using a content analysis framework.

Results:

Of the 1,151 records retrieved, 70 reports documented cleft-related infanticide from 27 countries. The largest number of reports was from China (14 reports; 48% of reports), followed by India (4; 14%) and Nigeria (4; 14%). However, 2 countries had 3 reports, 5 countries had 2 reports, and 17 countries had 1 report. Themes that emerged from excerpt analysis included stigma, lack of affordable cleft care, abandonment, orphanage overcrowding, and abuse and slavery.

Conclusions:

Cleft-related infanticide is a global problem. Initiatives to sensitize communities to cleft lip and/or cleft palate, provide timely and affordable cleft care, and build support systems for affected families may prove beneficial. Cleft care organizations have the opportunity to advocate for these initiatives, reduce the incidence of infanticide by providing or supporting timely and affordable cleft care, and demonstrate that children with successful cleft repairs reassimilate well into their communities.
Relevance of the Updated Food and Drug Administration Alteplase Label for Acute Ischemic Stroke: The Estimated Impact and Current Guidelines
Authors: Shiue Harn J. , Albright Karen C. , Sands Kara A.
Published: January 2018

In 2015, the Food and Drug Administration updated the contraindications for the use of alteplase in acute ischemic stroke (AIS), potentially creating a greater impact on treatment. A history of intracranial hemorrhage and recent stroke within 3 months were removed as contraindications, increasing the number of patients eligible for alteplase. The aim of this commentary is to call attention to the updates and discuss them relative to current American Heart Association/American Stroke Association guidelines. Additionally, we estimate the clinical impact of the updates by analyzing AIS admissions to a large-volume Comprehensive Stroke Center.
Cognitive reserve, cognition, and regional brain damage in MS: A 2 -year longitudinal study
Authors: Rocca Maria Assunta , Riccitelli Gianna C , Meani Alessandro , Pagani Elisabetta , Del Sette Paola , Martinelli Vittorio , Comi Giancarlo , Falini Andrea , Filippi Massimo
Published: January 2018

Background:

According to the cognitive reserve (CR) theory, enriching experiences protect against cognitive decline.

Objectives:

To investigate the dynamic interaction between CR and global/regional measures of brain white matter (WM) and gray matter (GM) damage and their effect on cognitive performance in multiple sclerosis (MS).

Methods:

Baseline and 2 -year three-dimensional (3D) T1-weighted scans were obtained from 54 MS patients and 20 healthy controls. Patients’ cognitive functions were tested and a cognitive reserve index (CRI) was calculated. Baseline regional atrophy and longitudinal volume changes were investigated using voxel-wise methods. Structural damage and CRI effects on cognitive performance were explored with linear models.

Results:

At baseline, MS patients showed atrophy of the deep GM nuclei, GM/WM frontal–temporal–parietal–occipital regions, and left cerebellum. Controlling for atrophy, higher CRI explained significant portions of variance in verbal memory and verbal fluency (∆ R2 = 0.07–0.16; p < 0.03). The interaction between thalamic volume and CRI was significant (∆ R2 = 0.05; p = 0.03). Longitudinal changes in memory and attention performance were associated with local/global variations of GM/WM and T2 lesions. CRI had no effect on longitudinal cognitive changes.

Conclusion:

In MS, CR may have a protective role in preserving cognitive functions, moderating the effect of structural damage on cognitive performance. This protective role may diminish with disease progression.
Online youth political engagement and bureaucratization: The Australian Youth Forum
Authors: Pillay Prashanth
Published: January 2018

Through in-depth interviews with all 10 youth representatives who worked in the Australian Youth Forum (AYF), Australia’s first online government youth forum, this article explains how online engagement was experienced and understood by those who managed its day-to-day operation. While the AYF was decommissioned in 2014, it was the first, and, till date, only online federal initiative that invited young people to run a government-funded youth public forum. Despite its relatively short existence, the AYF provokes questions about the influence of historically entrenched political values on online youth political participation and policy. Findings from this article have uncovered a series of challenges faced by youth in adjusting to government efforts to regulate consultation within the AYF. Building on Collin’s (2015, Young Citizens and Political Participation in a Digital Society: Addressing the Democratic Disconnect. London: Palgrave Macmillan.) observation of a ‘democratic disconnect’ in Australian youth policy, an incompatibility between government expectations of youth political involvement and how young people value participation, this article suggests that the AYF provided key insights into the centralized bureaucratic arrangements that have historically defined Australian youth participation and how they influence youth participatory experiences in online government initiatives.
Contesting market rationality: Discursive struggles over prison privatization
Authors: Burkhardt Brett
Published: January 2018

Market rationality suffuses many areas of modern criminal justice. Prison privatization is one area in which market rationality is particularly salient. This paper presents a case study of how market rationality was deployed in public discourse on prison privatization. It answers four questions: (1) Who shaped public discourse on prison privatization? (2) How frequently were market-rational themes invoked in the public discourse?, (3) Who employed (and who avoided) market-rational themes in the discourse?, and (4) Why did rates of market-rational discourse change over time? To answer these questions, the paper analyzes public discourse in four major American newspapers from 1985 to 2008. It employs a series of descriptive statistics and regression analyses, as well as an underutilized method—formal decomposition analysis. The research contributes to historical knowledge of the development of prison privatization, methodological techniques for analyzing textual data, and theoretical understanding of how public actors engage in discursive struggles over the meaning of criminal justice policies.
Intercountry Consensus Building: Lessons From Developing a Chronic-Conditions Self-Management Support Framework
Authors: Mills Susan L. , Ziabakhsh Shabnam , Brady Teresa J. , Jayanthan Janaki , Sargious Peter M.
Published: January 2018

Self-management support initiatives that aim to improve the self-care of chronic conditions are considered a key part of a health promotion strategy for addressing the impacts of long-term illness. Given the growth of these activities and still evolving evidence base, thoughtful intercountry collaborations with subject matter experts can be an effective way to expedite building self-management support capacity, promoting the advancement of evidence, and developing effective policies and programs. The challenge is to find an effective consensus building process that promotes linkages between researchers and health promotion decisions makers across vast geographical boundaries and limited resources. This paper describes the international, multistage, face-to-face, and online process that was used for developing an international framework for self-management support by researchers, educators, health care providers, policy makers, program managers/directors, program planners, consultants, patient group representatives, and consumers in 16 countries. We reflect on key lessons from this international initiative and discuss how this type of process may be useful for other health promotion groups trying to exchange knowledge and build consensus on how to move a field of research, policy, and/or practice forward, and advance the evidence-base of practice and the relevance of research.
Helping Dementia Caregivers Manage Medical Problems: Benefits of an Educational Resource
Authors: Zimmerman Sheryl , Sloane Philip D. , Ward Kimberly , Beeber Anna , Reed David , Lathren Christine , Matchar Bobbi , Gwyther Lisa
Published: January 2018

Background/Rationale:

Family caregivers of people with dementia must attend to medical care needs of their relative, yet few available resources address comorbidities in dementia. Consequently, caregivers feel ill-equipped when medical concerns arise. In response, an educational resource—Alzheimer’s Medical Advisor ( AlzMed)—was developed in 2 forms (website and book) and evaluated.

Methods:

Family caregivers (143 website and 51 book) used an educational resource that provides information on medical problems, vital signs, pain, dehydration, and the healthcare system. Data were collected at baseline, 3 months, and 6 months regarding confidence in sign/symptom management, burden, depression, and anxiety.

Results:

Caregivers reported significantly improved confidence and (for website users) decreased role strain. Anxiety and depression also decreased, although not significantly. Improved confidence related to a reduction in role strain and anxiety, and care recipients did not experience adverse events.

Conclusion:

An educational resource focusing on care of comorbid illness may benefit caregiver outcomes.
The Relationship Between Hand Function and Overlapping Motor Representations of the Hands in the Contralesional Hemisphere in Unilateral Spastic Cerebral Palsy
Authors: Marneweck Michelle , Kuo Hsing-Ching , Smorenburg Ana R. P. , Ferre Claudio L. , Flamand Veronique H. , Gupta Disha , Carmel Jason B. , Bleyenheuft Yannick , Gordon Andrew M. , Friel Kathleen M.
Published: January 2018

Background. In many children with unilateral spastic cerebral palsy (USCP), the corticospinal tract to the affected hand atypically originates in the hemisphere ipsilateral to the affected hand. Such ipsilateral connectivity is on average a predictor of poor hand function. However, there is high variability in hand function in these children, which might be explained by the complexity of motor representations of both hands in the contralesional hemisphere. Objective. To measure the link between hand function and the size and excitability of motor representations of both hands, and their overlap, in the contralesional hemisphere of children with USCP. Methods. We used single-pulse transcranial magnetic stimulation to measure the size and excitability of motor representations of both hands, and their overlap, in the contralesional hemisphere of 50 children with USCP. We correlated these measures with manual dexterity of the affected hand, bimanual performance, and mirror movement strength. Results. The main and novel findings were (1) the large overlap in contralesional motor representations of the 2 hands and (2) the moderate positive associations of the size and excitability of such shared-site representations with hand function. Such functional associations were not present for overall size and excitability of representations of the affected hand. Conclusions. Greater relative overlap of the affected hand representation with the less-affected hand representation within the contralesional hemisphere was associated with better hand function. This association suggests that overlapping representations might be adaptively “yoked,” such that cortical control of the child’s less-affected hand supports that of the affected hand.
Clinical Research of Combined Intravenous Administration and Topical Application of Tranexamic Acid to a Surgical Wound During Posterior Lumbar Fusion
Authors: Ou Yufu , Wei Jianxun , Li Rongzhu , Liang Bin , Qiu Dezan , Wei Minke , Mu Xiaoping , Li Zhuhai
Published: January 2018

Background. The safety and effectiveness of combined intravenous and topical administration of tranexamic acid (TXA) on the reduction of blood loss in patients undergoing posterior lumbar fusion are not yet clear. The study aimed to investigate the safety and effectiveness of the combined intravenous and topical administration of TXA on the reduction of blood loss in patients undergoing posterior lumbar fusion. Method. One hundred and eighteen patients who underwent double-segment posterior lumbar decompression and fusion from February 2014 to May 2016 in our hospital were retrospectively reviewed. Patients were divided into two groups, the experimental group and the control group. Preoperative demographics, operative parameters, and adverse effect were recorded and compared. Results. Intraoperative blood loss, postoperative 24-hour drainage volume, and blood transfusion ratio and volume were significantly lower in the experimental group than in the control group (P < .01); on postoperative 24 hours and 48 hours, hemoglobin and hematocrit levels were significantly higher in the experimental group than in the control group (P < .01). Prothrombin time and fibrinogen content were not significantly different between the 2 groups. The postoperative length of hospital stay was shorter in the experimental group than in the control group (P < .01). No postoperative thrombotic events were reported in either group. Conclusions. Combined intravenous and topical administration of TXA seems to be effective and safe in reducing allogenic blood transfusion and blood loss in double-segment posterior lumbar decompression and fusion surgery.