bluuebunny/crossref_metadata_2025 huggingface dataset:
Research and development of a composite with transparent polypropene fiber Part I: a study of combining the Taguchi method with the analytic hierarchy process for masterbatch modification and toughening to enhance characteristics
Authors: Kuo Chung-Feng Jeffrey , Huang Chang-Chiun , Ting Cheng-Hsiang , Dong Min-Yan , Lan Wei Lun
Published: December 2017

Polypropene (PP) has weak mechanical properties; relevant fibrous composite products are likely to bend under stress, becoming unavailable due to creases and folds. In order to maintain the product haze and tensile characteristic, the toughening property is enhanced greatly in this study. Firstly, the PP and enhanced rubber segment-styrene ethylene/butylene styrene (ERS-SEBS) are analyzed, and the two materials’ melting points and cracking points are confirmed. Three proportions of composite are made by single-screw mixing. The cost is reduced and the efficiency is confirmed by the Taguchi experiment. The single quality optimum combination is obtained by analysis of variance (ANOVA) and a factor response table. The optimum process parameters are designed according to the contribution degrees of quality weight and control parameters by using the analytic hierarchy process and ANOVA of the Taguchi method based on the reproducibility of the single quality optimum combination validation experiment. According to practical validation, in the ERS-SEBS modified optimum process of PP, the impact strength is 7.26 kJ/m2, higher than that of regular PP by 142%. The tensile strength is 23.69 MPa, high than that of regular PP by 3%. The haze can be reduced to 5.7%. The developed composite of the PP/styrene triblock copolymer has better mechanical properties and retains its optical performance. It can be used in a fibrous composite to make a composite with transparent fiber to present the fiber line distribution of fabric in the composite.
Adsorption of cationized xylans onto polyethylene terephthalate fabrics for antimicrobial medical textiles
Authors: Velkova Nena , Zemljic Lidija Fras , Saake Bodo , Strnad Simona
Published: December 2017

The main aim of this research was development of thin functional xylan layers on polyethylene terephthalate (PET) fabric surfaces. Xylans, derived from hard wood and oat spelt, were modified chemically in order to introduce cationic functional groups. Cationization of xylans was proved by elemental analysis, total bound nitrogen determination, and Raman techniques, as well as by polyelectrolyte titrations. The antimicrobial activity of xylans was investigated by the determination of Minimal Inhibitory Concentration against bacteria S. aureus and E. coli, and fungi C. albicans. Xylan solutions were then applied onto PET fabric using the spray coating technique. Charging behavior of the treated PET fabric samples was evaluated by potentiometric titration supported by X-ray electron spectroscopy. Hydrophilicity was examined by the water contact angle determination. The morphology of coated fabrics was analyzed using Scanning Electron Microscopy. The results of microbial testing showed that PET fabrics functionalized by cationic xylans act antimicrobially against S. aureus and E. coli. The presented work suggests that cationized xylans, originally derived from hard wood and/or oat spelt, could be applied successfully as a coating material for PET fabrics in order to introduce hydrophilicity and antimicrobial properties.
A 90-year-old man with factious disorder: Separating fact from fiction
Authors: Amladi Anjani K , DePry Dwayne R
Published: December 2017

Objective

Factitious disorders are known to exist in the medical community but are not commonly diagnosed in clinical practice. The majority of the literature on factitious disorder comes from case reports or case series. This particular case is unusual because it describes a patient who initially presented with purely physical complaints, but over time, the symptoms transitioned into predominantly psychiatric concerns. This case describes the patient's unique presentation and is followed by a discussion of the management of factitious disorder.

Methods

The patient was seen during the course of an inpatient psychiatric hospitalization. Electronic chart review was conducted, and information from each prior hospitalization was gathered between the dates of first initial documented presentation available in the electronic record in 1995 to most recent hospitalization in 2017.

Results

The patient still continues to present to the emergency department. Upon each presentation, staff work to objectively assess his complaints to be sure that there is no true underlying medical emergency. There is also a focus on providing non-judgmental, supportive, and compassionate care.

Conclusion

This case highlights the importance of corroborating objective findings with the patient's subjective reports gathered during a history and physical, and to recognize that patients with this disorder can present to any specialty. Thus, the collaboration between specialties is critical in the care of these patients to minimize unnecessary, costly, and sometimes dangerous interventions.
Bringing the Global Home: Students Research Local Areas through Postcolonial Perspectives
Authors: Hammer Ricarda
Published: December 2017

This article describes a class that draws on postcolonial insights to create a global sociological imagination. Postcolonial approaches can make visible how global connections have shaped our local environments even if these relations are not always immediately visible. Specifically, students in this class highlight how global relations, such as the slave trade, settler colonialism, racial formations, or migrations, constitute the local. If we start to reconnect global ties, how do we interpret local inequalities differently? Whose voices do we fail to listen to, and why are these global linkages and histories silenced or forgotten? The article describes the development of the curriculum and local student research projects as the main class assignment. It then discusses how students grapple to understand how global ties are and always have been crucial to our everyday lives and think critically about giving voice to perspectives that have conventionally been marginalized.
From Sociological Interpretation to Political Science
Authors: Barrientos Del Monte Fernando
Published: December 2017

From the end of the nineteenth century until well into the 1980s, one spoke of the “political sciences” (in the plural), a concept that included all the disciplines that analyzed political phenomena. “Sociological interpretation” began in the 1960s as a model of social science meant to provide both criticism and direction regarding development policies. Rodolfo Stavenhagen’s 1965 “Seven Erroneous Theses about Latin America” is an example of the role played by the political sciences at the time. Given the development of contemporary political science, which seeks dependent and independent variables and mid-range theories and bases its claims on empirical information, the question arises what Latin American political science can (re) learn from the interpretive model employed 50 years ago.

Desde finales del siglo XIX y todavía en los años ochenta del siglo XX se hablaba de “ciencias políticas” (en plural), concepto en el cual se incluían todas aquellas disciplinas que analizaban los fenómenos políticos. La “interpretación sociológica” se erigió en la década de los años sesenta como un modelo de ciencia social que formulaba críticas pero también orientaba políticas de desarrollo. “Siete tesis equivocadas sobre América Latina” (1965) de Rodolfo Stavenhagen es un ejemplo del ejercicio de las ciencias políticas de la época. A la luz del desarrollo de la ciencia política contemporánea, que busca variables dependientes e independientes y teorías de alcance medio y funda sus afirmaciones a partir de información empírica, se trata de responder a la pregunta qué puede (re)aprender la ciencia política latinoamericana del modelo interpretativo de hace cincuenta años.
A framework for building-related carbon coefficients and primary energy factors for networked electricity supplies
Authors: Hitchin Roger
Published: December 2017

This Technical Note describes a framework for handling the inherent complexities of carbon emission and primary energy factors for networked electricity supply systems within building energy codes and similar policy instruments. The proposed framework reflects the main characteristics of carbon emissions from such networked supplies, while retaining a level of complexity (and simplification) comparable to that of procedures used in existing building energy codes.

The main issues that are addressed are the time-varying nature of factors for networked supply, the impact of variability and curtailment for variable and intermittent renewable sources of electricity and relationship between “marginal” factors and “average” factors. These are important issues as the currently common use of annual system-average factors can result in misleading guidance as to the most effective ways of reducing carbon emissions or primary energy demand.

The note first explains the relationship between building energy performance ratings and networked electric supplies. It then discusses the characteristics of electricity demand and the networked supply systems before proposing and discussing the framework.

Practical application: A framework that can improve the reliability of building energy performance rating based on carbon emissions or primary energy factors.
Opposition instead of recognition
Authors: Abazari Arash
Published: December 2017

Axel Honneth reconstructs Hegel’s social and political philosophy on the basis of the concept of recognition. For Honneth, recognition is a constitutive relation between individuals that is in principle symmetrical. By conceiving recognition through symmetry, Honneth effectively bans the inclusion of power within recognitive relation. He thus regards the relations of power as cases of non-recognition or misrecognition. In this paper, I develop an alternative theory of the constitutive relation between individuals for Hegel, one that is based on the asymmetrical relation of power. To this aim, I focus on the chapter of “determinations of reflection” in the Science of Logic. Through a close analysis of Hegel’s Logic, I argue (a) that the most fundamental form of relation between individuals is the relation of opposition, (b) that individuals are solely constituted in and through the relation of opposition, and (c) that the relation of opposition is essentially asymmetrical. Together, these claims establish that, for Hegel, power is not external to the structure of individuals, but is constitutive of them. Finally, in order to illustrate the social ontology based on Hegel’s conception of opposition, I discuss Catharine MacKinnon, who argues that the male and female genders are solely constituted through the relation of power of the former over the latter.
Choral singing and the acquisition of educational values
Authors: Ferrer Rita , Puiggalí Joan , Tesouro Montse
Published: December 2017

The main objective of this study was to observe the extent to which the practice of collective singing in children’s and youth choirs offers a way of teaching values. The main working tool used was a questionnaire that was completed by the choir conductors and singers of the different choirs surveyed. The purpose of the questionnaire was to assess if choral singing can be a space for working on and developing values, and if these values lead to improvements in the overall education of the person. On the one hand, choir conductors considered respect to be the most important value for a choral group and friendship the most valuable aspect for singers. This view was not shared by the singers, who considered friendship to be less important. On the other hand, they agreed on the influence of respect and communication and that spontaneity is undervalued.
Engagement of patients and the public in NHS sustainability and transformation: An ethnographic study
Authors: Carter Pam , Martin Graham
Published: December 2017

Internationally, debates are taking place about sustainable healthcare. In England, guidance on patient and public involvement (PPI) advocates ‘engagement’ and references Arnstein’s ladder of participation, but recent proposals provoked controversy around service closures and the perceived exclusion of patients and the public. This article reports an ethnography of engagement, prior to formal public consultation on plans for major service change. Our analysis uses Cultural Political Economy, linking micro interactions between staff and ‘involvees’ to processes of political economy. We found that co-optation and contestation both occurred. Involvees queried whether the forthcoming consultation was genuine or whether decisions had already been made but the issue of whether NHS services should be delivered by public or private bodies was kept off the agenda. We conclude that engagement in system transformation programmes implicates PPI in a neoliberal agenda that rations state support for healthcare and introduces service models from the USA and elsewhere.
Shedding New Light on the Evaluation of Accented Speakers: Basic Mechanisms Behind Nonnative Listeners’ Evaluations of Nonnative Accented Job Candidates
Authors: Roessel Janin , Schoel Christiane , Zimmermann Renate , Stahlberg Dagmar
Published: December 2017

The present research unites two emergent trends in the area of language attitudes: (a) research on perceptions of nonnative speakers by nonnative listeners and (b) the search for general, basic mechanisms underlying the evaluation of nonnative accented speakers. In three experiments featuring an employment situation, German participants listened to a presentation given in English by a German speaker with a strong versus native-like accent (in Studies 1–3) versus a native speaker of English (in Study 1). They evaluated candidates with a strong accent worse than candidates with a native(-like) pronunciation—even to the degree that the quality of arguments was of no relevance (Study 1). Study 2 introduces an effective intervention to reduce these discriminatory tendencies. Across studies, affect and competence emerged as major mediators of hirability evaluations. Study 3 further revealed sequential indirect influences, which advance our understanding of previous inconsistent findings regarding disfluency and warmth perceptions.
Taking officer time seriously
Authors: DeMichele Matthew , Payne Brian
Published: December 2017

We use a time and motion study to understand how probation officers spend their time. What officers spend their time doing and whom they spend their time with demonstrates a deeper symbolic meaning of how the convicted should be treated, what is believed effective to change behavior, and informs the community about definitions of public safety. Explicitly studying officer time is a neglected area of research. We model a count variable of minutes per task as a function of offender, offense, and task characteristics using zero-truncated negative binomial regressions. Results show that officers spend significantly more time with higher-risk offenders, mixed results regarding domestic violence and sex offenders, and significantly less time with older and black probationers. Our intentions are to delve deeper into how officers spend their time to contribute to the development of an evidence-based model of corrections.
The effect of age and compression strength on venous leg ulcer healing
Authors: Karanikolic Vesna , Binic Ivana , Jovanovic Dragan , Golubovic Masa , Golubovic Ilija , Djindjic Natasa , Petrovic Dejan
Published: December 2017

Objectives

The aim of the study is to compare proportions of venous leg ulcers healed in patients treated with two different sub-bandage pressure values in relation to age.

Methods

The study included 102 outpatients with venous leg ulcers, one group with moderate compression pressure of 35–40 mmHg and the second with high pressure >45 mmHg. Each group was divided into two subgroups according to the age (≥65 vs. <65 years). Computerized planimetry was used to measure the size of the ulcers at 6, 12, 18 and 24 weeks.

Results

Kaplan–Maier analysis showed high pressure leads to higher proportion of healed venous leg ulcers, compared to moderate pressure, in patients aged ≥65 years (57.6% vs. 28%) and in patients <65 years (53.8% vs. 36%) (p < 0.05).

Conclusion

The study showed that higher compression pressure leads to higher proportions of venous leg ulcers healed, independent of age and could be safely preferred in older patients.
Substrain- and sex-dependent differences in stroke vulnerability in C57BL/6 mice
Authors: Zhao Liang , Mulligan Megan K , Nowak Thaddeus S
Published: December 2017

The C57BL/6 mouse strain is represented by distinct substrains, increasingly recognized to differ genetically and phenotypically. The current study compared stroke vulnerability among C57BL/6 J (J), C57BL/6JEiJ (JEiJ), C57BL/6ByJ (ByJ), C57BL/6NCrl (NCrl), C57BL/6NJ (NJ) and C57BL/6NTac (NTac) substrains, using a model of permanent distal middle cerebral artery and common carotid artery occlusion. Mean infarct volume was nearly two-fold smaller in J, JEiJ and ByJ substrains relative to NCrl, NJ and NTac (N-lineage) mice. This identifies a previously unrecognized confound in stroke studies involving genetically modified strain comparisons if control substrain background were not rigorously matched. Mean infarct size was smaller in females of J and ByJ substrains than in the corresponding males, but there was no sex difference for NCrl and NJ mice. A higher proportion of small infarcts in J and ByJ substrains was largely responsible for both substrain- and sex-dependent differences. These could not be straightforwardly explained by variations in posterior communicating artery patency, MCA anatomy or acute penumbral blood flow deficits. Their larger and more homogeneously distributed infarcts, together with their established use as the common background for many genetically modified strains, may make N-lineage C57BL/6 substrains the preferred choice for future studies in experimental stroke.
Preliminary evidence for cerebral capillary shunting in adults with sickle cell anemia
Authors: Juttukonda Meher R , Donahue Manus J , Davis Larry T , Gindville Melissa C , Lee Chelsea A , Patel Niral J , Kassim Adetola A , Pruthi Sumit , Hendrikse Jeroen , Jordan Lori C
Published: December 2017

Elevated flow velocities in adults with sickle cell anemia (SCA) may cause rapid erythrocyte transit through capillaries. This phenomenon could present as dural venous sinus hyperintensity on arterial spin labeling (ASL)-MRI and could be indicative of capillary shunting. Here, the prevalence of ASL venous hyperintensities and association with relevant physiology in adults with SCA was investigated. SCA ( n = 46) and age-matched control ( n = 16) volunteers were recruited for 3.0 T MRI. Pseudo-continuous ASL-MRI was acquired for cerebral blood flow (CBF) calculation and venous hyperintensity determination; venous signal intensity and a categorical venous score (three raters; 0 = no hyperintensity, 1 = focal hyperintensity, and 2 = diffuse hyperintensity) were recorded. Flow velocity in cervical internal carotid artery segments was determined from phase contrast data (venc = 40 cm/s) and whole-brain oxygen extraction fraction (OEF) was determined from T2-relaxation-under-spin-tagging MRI. Cerebral metabolic rate of oxygen was calculated as the product of OEF, CBF, and blood oxygen content. ASL venous hyperintensities were significantly ( p < 0.001) more prevalent in SCA (65%) relative to control (6%) participants and were associated with elevated flow velocities ( p = 0.03). CBF ( p < 0.001), but not OEF, increased with increasing hyperintensity score. Prospective trials that evaluate this construct as a possible marker of impaired oxygen delivery and stroke risk may be warranted.
Fetal brain sparing in a mouse model of chronic maternal hypoxia
Authors: Cahill Lindsay S , Hoggarth Johnathan , Lerch Jason P , Seed Mike , Macgowan Christopher K , Sled John G
Published: December 2017

Hypoxic stress is a common occurrence during human pregnancy, yet little is known about its effects on the fetal brain. This study examined the fetal hemodynamic responses to chronic hypoxia in an experimental mouse model of chronic maternal hypoxia (11% O2 from E14.5 to E17.5). Using high-frequency Doppler ultrasound, we found fetal cerebral and ductus venosus blood flow were both elevated by 69% and pulmonary blood flow was decreased by 62% in the fetuses exposed to chronic hypoxia compared to controls. This demonstrates that brain sparing persists during chronic fetal hypoxia and is mediated by “streaming,” where highly oxygenated blood preferentially flows through the ductus venosus towards the cerebral circulation, bypassing the liver and the lungs. Consistent with these changes in blood flow, the fetal brain volume measured by MRI is preserved, while the liver and lung volumes decreased compared to controls. However, hypoxia exposed fetuses were rendered vulnerable to an acute hypoxic challenge (8% O2 for 3 min), demonstrating global blood flow decreases consistent with imminent fetal demise rather than elevated cerebral blood flow. Despite this vulnerability, there were no differences in adult brain morphology in the mice exposed to chronic maternal hypoxia compared to controls.
Antenatal HIV Testing in Sub-Saharan Africa During the Implementation of the Millennium Development Goals: A Systematic Review Using the PEN-3 Cultural Model
Authors: Blackstone Sarah R. , Nwaozuru Ucheoma , Iwelunmor Juliet
Published: December 2017

This study systematically explored the barriers and facilitators to routine antenatal HIV testing from the perspective of pregnant women in sub-Saharan Africa during the implementation period of the Millennium Development Goals. Articles published between 2000 and 2015 were selected after reviewing the title, abstract, and references. Twenty-seven studies published in 11 African countries were eligible for the current study and reviewed. The most common barriers identified include communication with male partners, patient convenience and accessibility, health system and health-care provider issues, fear of disclosure, HIV-related stigma, the burden of other responsibilities at home, and the perception of antenatal care as a “woman's job.” Routine testing among pregnant women is crucial for the eradication of infant and child HIV infections. Further understanding the interplay of social and cultural factors, particularly the role of women in intimate relationships and the influence of men on antenatal care seeking behaviors, is necessary to continue the work of the Millennium Development Goals.
Tactical Moments of Creative Destruction for Affordable Housing
Authors: Ozanne Lucie K. , Ozanne Julie L. , Phipps Marcus
Published: December 2017

The formation of a marketing system often reflects historical legacies that seek to protect and preserve longstanding community interests. These legacies encourage some patterns of adaptive growth, but they may also limit other avenues of productive change. In this essay, we focus on the United States housing system as an illustration of a marketing system with significant legacy structures. Historically, this marketplace system arose to provide safe shelter for citizens and was enacted through building codes. These codes arose for historically important reasons, many of which are still pertinent today. Other legacies, however, inhibit market innovations, such as the significant barriers that exist for developing affordable housing. We argue that change in legacy market systems may require tactical moments of creative destruction. We examine a multi-stakeholder approach across the macro, meso, and micro levels of the marketplace to enable novel solutions for systemic change.
Quantification of pancreatic fat with dual-echo imaging at 3.0-T MR in clinical application: how do the corrections for T1 and T2* relaxation effect work and simplified correction strategy
Authors: Yuan Fang , Song Bin , Huang Zixing , Xia Chunchao , Liu Xijiao
Published: December 2017

Background

Dual-echo imaging is a routine clinical magnetic resonance (MR) sequence affected by T1 and T2* relaxation effect in fat quantification. The separate impacts of T1 and T2* relaxation effect in pancreatic fat quantification using dual-echo imaging at 3.0-T MR have not been reported in detail.

Purpose

To demonstrate the separate T1 and T2* relaxation effect on pancreatic fat quantification by dual-echo imaging at 3.0-T MR and the simplified correction strategy is discussed for convenient clinical application.

Material and Methods

Twenty-one non-alcoholic fatty liver disease (NAFLD) participants with high risk of pancreatic steatosis were included. Pancreatic fat fractions (FF) by dual-echo imaging with different corrections were compared to that of proton magnetic resonance spectroscopy (1H-MRS). Correlation analysis and Bland–Altman analysis were applied.

Results

The FF by 1H-MRS was 5.9 ± 1.7%. Significant positive correlation (all P < 0.01) was found between FF by 1H-MRS and each dual-echo imaging, in which T1 and T2* correction showed the best correlation (r = 0.95, FF = 6.2 ± 1.7%) and no correction showed the worst correlation (r = 0.86, FF = 5.2 ± 2.0%), and the simplified T1 and T2* correction manifested as r = 0.93 and FF = 6.3 ± 1.8%. FF by T1 and T2* correction showed the best agreement, while T1 correction showed the worst agreement as compared to that of 1H-MRS.

Conclusion

T1 and T2* correction shows the best performance while no correction dual-echo imaging remains clinical available which may benefit from prior OP echo. Simplified correction using single T2* (32.6 ms) of water and fat is recommended for convenient clinical application in absence of obvious pancreatic iron overload.
Geographies of migration II: The racial-spatial politics of immigration
Authors: Ehrkamp Patricia
Published: December 2017

This second report on geographies of migration examines scholarship on the racial-spatial politics of immigration in the Global North, which have emerged as important issues in the context of rising nativism, the criminalization of immigrants, and the racist exclusion of immigrants from polities. The report first highlights research that has revealed the entanglements of race, immigration law, and citizenship before turning to ‘new immigrant destinations’ as central contemporary sites where race and belonging are hashed out. The following section examines the effects of anti-immigrant policing and racist politics on the health and well-being of immigrants. Activism and immigrant youth mobilization that challenge anti-immigrant politics and racist exclusions from citizenship are at the center of the arguments I discuss in the penultimate section. I conclude by calling for more geographic analysis of the racial-spatial politics of immigration, as well as of the activism that challenges such politics.
Geographies of outer space: Progress and new opportunities
Authors: Dunnett Oliver , Maclaren Andrew S. , Klinger Julie , Lane K. Maria D. , Sage Daniel
Published: December 2017

Research into outer space has burgeoned in recent years, through the work of scholars in the social sciences, arts and humanities. Geographers have made a series of useful contributions to this emergent work, but scholarship remains fairly limited in comparison to other disciplinary fields. This forum explains the scholarly roots of these new geographies of outer space, considering why and how geographies of outer space could make further important contributions. The forum invites reflections from political, environmental, historical and cultural geographers to show how human geography can present future avenues to continued scholarship into outer space.
Determinants of glucose metabolism and the role of NPY in the progression of insulin resistance in chronic migraine
Authors: Siva Zeynep Oşar , Uluduz Derya , Keskin Fatma Ela , Erenler Feyza , Balcı Huriye , Uygunoğlu Uğur , Saip Sabahattin , Göksan Baki , Siva Aksel
Published: December 2017

Background

Chronic migraine has a well-documented association with increased insulin resistance and metabolic syndrome. The hypothalamus may play a role in the progression of insulin resistance in chronic migraine through the regulation of orexigenic peptides such as neuropeptide Y. Insulin resistance may lead to increased risk of future type 2 diabetes mellitus in patients with chronic migraine, which is more likely to occur if other pathogenetic defects of type 2 diabetes mellitus, such as impaired pancreatic β-cell functions and defects in intestinal glucagon-like peptide-1 secretion after meals. We studied the relationship of fasting neuropeptide Y with insulin resistance, β-cell function, and glucagon-like peptide-1 secretion in non-obese female chronic migraine patients. We also aimed to investigate glucose-stimulated insulin and glucagon-like peptide-1 secretions as early pathogenetic mechanisms responsible for the development of carbohydrate intolerance.

Methods

In this cross-sectional controlled study, 83 non-obese female migraine patients of reproductive age categorized as having episodic migraine or chronic migraine were included. The control group consisted of 36 healthy females. We studied glucose-stimulated insulin and glucagon-like peptide-1 secretion during a 75 g oral glucose tolerance test. We investigated the relationship of neuropeptide Y levels with insulin resistance and β-cell insulin secretion functions.

Results

Fasting glucose levels were significantly higher in migraine patients. Plasma glucose and insulin levels during the oral glucose tolerance test were otherwise similar in chronic migraine, episodic migraine and controls. Patients with chronic migraine were more insulin resistant than episodic migraine or controls ( p = 0.048). Glucagon-like peptide-1 levels both at fasting and two hours after glucose intake were similar in chronic migraine, episodic migraine, and controls. Neuropeptide Y levels were higher in migraineurs. In chronic migraine, neuropeptide Y was positively correlated with fasting glucagon-like peptide-1 levels (r = 0.57, p = 0.04), but there was no correlation with insulin resistance (r = 0.49, p = 0.09) or β-cell function (r = 0.50, p = 0.07).

Discussion

Non-obese premenopausal female patients with chronic migraine have higher insulin resistance, but normal β-cell function is to compensate for the increased insulin demand during fasting and after glucose intake. Increased fasting neuropeptide Y levels in migraine may be a factor leading to increased insulin resistance by specific alterations in energy intake and activation of the sympathoadrenal system.
Falls Prevention Process in Assisted Living Communities
Authors: Coughlin DaRae , Nordman-Oliveira Susan E. , Schlaak Mary , Ford James H.
Published: December 2017

Falls are a significant issue for older adults, and many older adults who once received care in nursing homes now reside in assisted living communities (ALCs). ALC staff needs to address resident falls prevention; however, federal or state requirements or oversight are limited. This research explores falls prevention in Wisconsin ALCs in the context of the Kotter Change Model to identify strategies and inform efforts to establish a more consistent, proactive falls prevention process for ALCs. A mixed methods approach demonstrated inconsistency and variability in the use of falls risk assessments and prevention programs, which led to the development of standardized, proactive falls prevention process flowcharts. This process, as delineated, provides ALCs with an approach to organize a comprehensive falls reduction strategy. Findings highlight the importance of educating staff regarding assessments, resident motivation, falls prevention programs, and feedback, all key components of the falls prevention process.
Documentation of Crucial Information Relating to Critically Ill Patients
Authors: Bear Alexandria , Thiel Elizabeth
Published: December 2017

Background:

Medical decision-making has evolved to the modern model of shared decision-making among patients, surrogate decision-makers, and medical providers. As such, informed consent discussions with critically ill patients often should include larger discussions relating to values and goals of care. Documentation of care options and prognosis serves as an important component of electronic communication relating to patient preferences among care providers.

Objective:

This retrospective chart review study sought to evaluate the prevalence of documentation of critical data, care options, prognosis, and medical plan, within primary team and palliative care consult team documentation.

Results:

Three hundred two electronic medical records were reviewed. There was a significant difference in documentation between palliative care and primary teams for prognosis (83% vs 32%, P < .001), care options (82% vs 50%, P < .001), and care plan (82% vs 46%, P < .001).

Conclusions:

Our retrospective chart review study demonstrated a significant difference in documentation between primary and palliative care teams. We acknowledge that review of documentation cannot be extrapolated to the presence or absence of conversations between providers and patients and/or surrogates. Additional studies to evaluate this connection would be advantageous.
Lessons learned from the Canadian cancer registry experience
Authors: MacIntyre Maureen , MacKay Cathy
Published: December 2017

Health leaders and caregivers are focused on evidence-based data to drive care delivery and practice. Ensuring the health system is functioning effectively and efficiently and that patient outcomes are reaching expected targets are topics that permeate conversations at the local, provincial, and national levels. However, as many leaders have come to understand in recent years, healthcare data collection and producing meaningful, high-quality metrics is a complex set of tasks, requiring its own level of attention and dedicated resources. In the healthcare data realm, there are opportunities to learn from experience. One of these opportunities is the population-based cancer registry, which is one of the oldest examples of standardized data collection in the Canadian health system.
Impact of Urgent Chemotherapy in Critically Ill Patients
Authors: de Oliveira Maria Cristina Franca , Ferreira Juliana Carvalho , Nassar Junior Antonio Paulo , Dettino Aldo Lourenço Abbade , Caruso Pedro
Published: December 2017

Objective:

Compare the mortality between critically ill patients who received urgent chemotherapy for a cancer-related life-threatening complication with matched patients (controls) who did not received it.

Design:

Propensity score-matched retrospective study.

Setting:

Adult intensive care unit in an oncological hospital.

Participants:

All adults with solid tumor or hematological malignancies who received at least 1 day of urgent intravenous chemotherapy for a cancer-related life-threatening complication. Using the propensity score method adjusted for 10 variables, patients who received urgent chemotherapy were matched to patients who did not.

Interventions:

None.

Main Outcomes Measures:

Intensive care unit and hospital mortality.

Results:

Forty-seven patients (57% with solid tumors and 43% with hematological malignancies) who received urgent chemotherapy were matched to 94 controls. At intensive care unit admission, patients were similar except that those who received urgent chemotherapy were less likely to have received chemotherapy previously (36% vs 85%; P < .01). The intensive care unit (48.9% vs 23.4%; P < .01) and hospital (76.6% vs 46.8%; P < .01) mortality of the patients who received urgent chemotherapy was higher than the controls. The subgroup analysis showed that the higher mortality was limited to patients with solid tumor.

Conclusion:

The use of urgent chemotherapy is associated with an increase in the intensive care unit and hospital mortality of unselected critically ill patients with solid tumors but not in patients with hematological malignancies.
Outcomes of ICU Admission of Patients With Progressive Metastatic Gastrointestinal Cancer
Authors: Epstein Andrew S. , Yang Andrew , Colbert Lauren E. , Voigt Louis P. , Meadows Jason , Goldberg Jessica I. , Saltz Leonard B.
Published: December 2017

Background:

Data on the outcomes of intensive care unit (ICU) admissions for patients with advanced incurable chemoresistant solid tumor malignancies, and the benefits of subsequent/post-ICU anticancer treatments are limited but have end-of-life and ethical implications.

Methods:

An institutional database was queried to identify patients of the gastrointestinal (GI) medical oncology service of Memorial Sloan Kettering Cancer Center with ≥1 ICU admission during 2014. Records were reviewed for evidence of cancer control from cancer treatment after the ICU admission.

Results:

Twenty-eight patients who had progressed beyond at least first-line chemotherapy for metastatic GI adenocarcinoma were admitted to the ICU for sequelae of progressive clinical deterioration. The most frequent reasons for ICU admission were sepsis (39%) and acute respiratory failure (29%). Ten patients died in the ICU, 3 died during the same hospitalization after ICU discharge, and 15 were discharged from the hospital. Of these 15, the median survival from hospital discharge was 2.2 months and 6 received further chemotherapy but with no evidence of clinical benefit. Of these 6, 3 lived over 5 months but the treatment of 5 entailed recycling of previously ineffective chemotherapy agents (3) or those originally used in the adjuvant setting (2). Two of these patients received liver-directed therapy without benefit.

Conclusions:

Admissions to the ICU in this cancer population were associated with high morbidity and mortality and did not result in benefit from subsequent cancer treatment. These data can be used to help establish realistic expectations and care goals in previously treated patients having metastatic GI cancer with clinical deterioration.
Adverse Consequences to Assisting Victims of Campus Violence: Initial Investigations Among College Students
Authors: Krauss Alison , Jouriles Ernest N. , Yule Kristen , Grych John H. , Sargent Kelli S. , Banyard Victoria L.
Published: December 2017

Despite growing interest in the use of bystander education programs to address the problems of sexual and relationship violence on college campuses, little knowledge exists on adverse consequences experienced by students intervening as a bystander. The current study examined the prevalence and correlates of adverse consequences of bystander intervention in two samples of first-year college students. In Study 1, 281 students completed a measure of negative consequences experienced when acting as a bystander to help someone at risk of sexual assault, relationship abuse, or stalking. Efficacy for bystander behavior was also assessed. Approximately one third of the students (97/281) reported having tried to help someone who had been at risk of violence during the previous academic year. Of these, approximately 17% (16/97) reported experiencing a negative consequence from having tried to help. Experiencing negative consequences was associated with lower levels of bystander efficacy. In Study 2, conducted at a different university, 299 students completed measures of negative consequences resulting from intervening as a bystander and efficacy for bystander behavior. Students also participated in virtual-reality simulations that provided opportunities to intervene as a bystander. Again, approximately one third of the students (99/299) reported having tried to help someone at risk of violence. Of these, 20% (20/99) reported experiencing a negative consequence. Two of the adverse consequences (physically hurt, got into trouble) were negatively associated with bystander efficacy and observed effectiveness of bystander behavior in the virtual simulations. Results of exploratory analyses suggest that training in bystander intervention might reduce the likelihood of experiencing adverse consequences.
Development and Psychometrics of Instruments to Assess School Personnel’s Bystander Action in Situations of Teen Relationship Abuse and Sexual Assault
Authors: Edwards Katie M. , Sessarego Stephanie N. , Stanley Linda R. , Mitchell Kimberly J. , Eckstein Robert P. , Rodenhizer Kara Anne E. , Leyva P. Caroline , Banyard Victoria L.
Published: December 2017

This article describes recently developed instruments that assess school personnel’s bystander barriers and intentions in situations of teen relationship abuse, sexual assault, and sexual harassment, as well as perceptions of school readiness specific to relationship abuse, sexual assault, and sexual harassment prevention and response. Participants were 1,150 high school personnel from 25 schools in New Hampshire, Massachusetts, and Maine. Specific instruments focused on bystander intentions, bystander action, barriers to bystander action, and perceptions of school readiness. Participants were randomly divided into two groups for analysis—the exploratory sample (ES; n = 575) and the confirmatory sample (CS; n = 575). Overall, the measures demonstrated acceptable fit indices. Results suggested that most measures and subscales had adequate reliability, but a few subscales had less than ideal internal consistency, which can likely be attributed to the small number of items. More work is needed, but these measures act as a starting point by which the role of school personnel in prevention initiatives and bystander intervention can be evaluated.
Relationships Between Youth Sports Participation and Mental Health in Young Adulthood Among Finnish Males
Authors: Appelqvist-Schmidlechner Kaija , Vaara Jani , Häkkinen Arja , Vasankari Tommi , Mäkinen Juha , Mäntysaari Matti , Kyröläinen Heikki
Published: December 2017

Purpose:

To examine whether retrospectively assessed sports participation (SP) and competitive sports (CS) at the age of 12 years is associated with mental health and health behavior in young adulthood among males.

Design:

A cross-sectional study using self-administered questionnaires.

Setting:

Conducted prior to compulsory military refresher training course in Finland allowing geographically representative sample of Finnish young men.

Participants:

Six hundred eighty males aged between 20 and 35 years.

Measures:

Mental well-being was measured with the short version of Warwick-Edinburgh Mental Well-Being Scale and mental distress with 5 items of The Short Form Helalth Survey (SF-36) scale.

Analysis:

Binary logistic regression models.

Results:

Sports participation at the age of 12 was associated with better mental health in young adulthood, with both mental well-being (odds ratio [OR] = 1.86, 95% confidence interval 1.11-3.11) and mental distress (OR = 0.61, 0.41-0.90). Age, years of education, and current physical activity were controlled. Higher level of intensity of SP and the level of CS in childhood were associated with lower level of mental distress in adulthood. No association was found between the level of CS in childhood and mental well-being in adulthood. Further, youth SP seemed to be a risk factor for increased alcohol consumption and use of snuff in adulthood.

Conclusions:

Despite negative outcomes related to health behavior, the findings provide support for the association between youth SP and positive mental health outcomes in adulthood among males.
The Voices That Influence HIV-Positive Mothers’ Breastfeeding Practices in an Urban, Ghanaian Society
Authors: Acheampong Angela Kwartemaa , Naab Florence , Kwashie Adzo
Published: December 2017

Background:

The World Health Organization recommends that HIV-positive mothers should breastfeed for at least 1 year. There are people in the lives of these mothers who influence their decisions.

Research aim:

The aim was to explore the role of social persuasion in the decision-making processes of HIV-positive breastfeeding mothers.

Methods:

A qualitative, exploratory research design was employed ( N = 13). Participants were recruited from a public hospital in the Greater Accra Region of Ghana. One-on-one interviews were recorded and transcribed verbatim, and the contents of the transcripts were analyzed for emerging themes.

Results:

The perspectives of spouses, health workers, counselors, and siblings about breastfeeding affect the breastfeeding practices of mothers living with HIV in Ghana. Most of the women had negative experiences with their midwives. Because of complex social and cultural influences, the opinions of spouses, health professionals, siblings, and members of the communities in which breastfeeding mothers with HIV live influence breastfeeding practices.

Conclusion:

This study described HIV-positive, breastfeeding mothers’ perceptions of the role played by spouses, health professionals, siblings, and the community in breastfeeding decisions and practices. Influential people in the lives of breastfeeding mothers with HIV should be involved during interventions by HIV counselors to promote breastfeeding practices.
The Effect of Online and Mixed-Mode Measurement of Cognitive Ability
Authors: Al Baghal Tarek
Published: December 2017

A number of studies, particularly longitudinal surveys, are collecting direct measures of cognitive ability, given its importance as a measure in social science research. As longitudinal studies increasingly switch to mixed-mode data collection, frequently including a web component, differences in survey outcomes including cognitive ability may result from mode effects. Differences may arise due to respondent self-selection into mode or due to the mode causing differential measurement. Using a longitudinal survey that measured cognitive ability after introducing a mixed-mode design with a web component, this research explores if and how mode affects cognitive ability outcomes. This survey allows for control of several possible selection mechanisms, including a limited set of direct cognitive ability measures collected in a single mode in an earlier wave. Findings presented here show clearly that web respondents do better on a number of cognitive ability indicators. However, it does not appear that this is wholly explainable by respondents of different ability self-selecting into particular modes. Rather, it appears that measurement of cognitive ability may differ across modes. This result is potentially problematic as comparability is a key component of using cognitive ability in further research.
Organized Social Activity, Physical Exercise, and the Risk of Insomnia Symptoms Among Community-Dwelling Older Adults
Authors: Endeshaw Yohannes W. , Yoo Wonsuk
Published: December 2017

Objectives: To compare the risk of insomnia symptoms among community-dwelling older adults who participated and did not participate in organized social activity and physical exercise. Design: Secondary data analysis of a prospective cohort study. Material and Methods: Community-dwelling older adults ≥65 years of age with no insomnia symptoms at baseline were included in the study. Participants were followed up yearly for 3 years. Insomnia symptoms, social activity, and physical exercise status of study participants were assessed at baseline and during follow-up. Results: Study participants who reported engaging in organized social activity and low-intensity physical exercise and organized social activity and high-intensity physical exercise were less likely to report insomnia symptoms during follow-up compared with those who did not engage in any activity. Conclusion: These results suggest beneficial effect of organized social activity and physical exercise in maintaining sleep quality in old age.