bluuebunny/crossref_metadata_2025 huggingface dataset:
School Nurses’ Experiences Working With Students With Mental Health Problems: A Qualitative Study
Authors: Jönsson Julia , Maltestam Malin , Tops Anita Bengtsson , Garmy Pernilla
Published: November 2017

The aim was to describe school nurses’ experiences working with students with mental health problems. In this inductive qualitative study, interviews were conducted with 14 school nurses in Sweden. The content analysis revealed three themes: (1) sense of worriedness about working with students with mental health problems, (2) taking care of students with mental health issues was an opportunity for personal and professional development, and (3) the experience of making a difference for young people with mental health problems. The school nurses working with students who have mental health problems had to cope with their own emotions, worries, and feelings of insufficiency. However, the school nurses also found the work to be meaningful and rewarding because they appreciated the opportunity for personal and professional development while taking care of students with mental health problems. They felt grateful for having a profession that had a huge impact on children’s/adolescents’ lives.
Dietary Supplement Adverse Event Report Data From the FDA Center for Food Safety and Applied Nutrition Adverse Event Reporting System (CAERS), 2004-2013
Authors: Timbo Babgaleh B. , Chirtel Stuart J. , Ihrie John , Oladipo Taiye , Velez-Suarez Loy , Brewer Vickery , Mozersky Robert
Published: November 2017

Background: The Food and Drug Administration (FDA)’s Center for Food Safety and Applied Nutrition (CFSAN) oversees the safety of the nation’s foods, dietary supplements, and cosmetic products. Objective: To present a descriptive analysis of the 2004-2013 dietary supplement adverse event report (AER) data from CAERS and evaluate the 2006 Dietary Supplements and Nonprescription Drug Consumer Protection Act as pertaining to dietary supplements adverse events reporting. Methods: We queried CAERS for data from the 2004-2013 AERs specifying at least 1 suspected dietary supplement product. We extracted the product name(s), the symptom(s) reported, age, sex, and serious adverse event outcomes. We examined time trends for mandatory and voluntary reporting and performed analysis using SAS v9.4 and R v3.3.0 software. Results: Of the total AERs (n = 15 430) received from January 1, 2004, through December 31, 2013, indicating at least 1 suspected dietary supplement product, 66.9% were mandatory, 32.2% were voluntary, and 0.9% were both mandatory and voluntary. Reported serious outcomes included death, life-threatening conditions, hospitalizations, congenital anomalies/birth defects and events requiring interventions to prevent permanent impairments (5.1%). The dietary supplement adverse event reporting rate in the United States was estimated at ~2% based on CAERS data. Conclusions: This study characterizes CAERS dietary supplement adverse event data for the 2004-2013 period and estimates a reporting rate of 2% for dietary supplement adverse events based on CAERS data. The findings show that the 2006 Dietary Supplements and Nonprescription Drug Consumer Protection Act had a substantial impact on the reporting of adverse events.
Effect of pear apple and date fibres incorporation on the physico-chemical, sensory, nutritional characteristics and the acceptability of cereal bars
Authors: Bchir Brahim , Jean-François Thiry , Rabetafika Holy Nadia , Blecker Christophe
Published: November 2017

Cereal bars are nutritious food composed of several ingredients including dry raw and agglutinative ingredients. The objective of this study was to evaluate the effect of pear apple and date fibres, from cooked fruit co-product, addition on the physico-chemical textural and sensory properties of cereal bars. First, five formulations containing an amount of 10% of co-products and commercial fibre, used as a reference, were elaborated and their physico-chemical composition was determined. Second, to determine the acceptability of consumer, apple fibre co-products were added (6, 10 and 14%). Products were evaluated for their texture using a texturometer and sensory characteristics using an acceptance test. Results showed that physico-chemical composition of cereal bars elaborated with co-products was slightly different compared to those elaborated with commercial fibre. All bars have low water activity levels (∼0.470) and interesting energy (300 kcal/100 g bar). External appearance revealed a darker colour (L*:∼42/a*:∼8/b*:∼20). There were no significant differences (P > 0.05) in texture values (hardness: 40.8 N; cohesiveness: 0.34; springiness: 0.60; chewiness: 8.30 N) between cereal bars prepared with pear co-product and wheat bran. Acceptance test confirms the formulation used for cereals bars and showed that incorporation of 10% of co-product produced cereal bars with the highest acceptability. Sensory characteristics revealed that appearance is the limiting factor for consumer acceptability, essentially for cereal bars containing pear co-product. Apple, pear and date co-products could be used successfully as a food ingredient to develop new formulations of cereal bars.
Presentation Matters: Causes of Differences in Preferences for Agricultural Landscapes Displayed via Photographs and Videos
Authors: Svobodova Kamila , Vojar Jiri , Sklenicka Petr , Filova Lucia
Published: November 2017

This study shows the importance of landscape scene composition in relation to aesthetic ratings used in preference research where static and dynamic presentation methods substitute landscape onsite evaluation. We aimed to evaluate whether the method of presenting a landscape scene influenced aesthetic ratings and whether these potential differences in ratings were affected by the composition of the static presentation. Using a questionnaire for rating the same scenes of agricultural landscapes presented both in photographs and in videos, it was determined that the presentation method used significantly affected ratings. Respondents ( N = 145, age 20-25 years, students) rated scenes presented in photographs higher than videos. Concerning the effect of composition, well-composed photographs had higher mean ratings than poorly composed photographs. Moreover, the difference in ratings between static and dynamic presentation methods determined for well-composed scenes was larger than that for poorly composed scenes, always in favor of photographs. The results indicate that preference ratings can be influenced both by the medium and by composition. This is a crucial aspect for environmental assessments using a visual preference approach as part of planning and management strategies, and it should always be taken into account.
Optimal design of an annular thrust air bearing using parametric computational fluid dynamics model and genetic algorithms
Authors: Gao Qiang , Lu Lihua , Chen Wanqun , Wang Guanglin
Published: November 2017

The performance of air bearing is highly influenced by the geometrical parameters of its restrictor. This study aims to maximize the load-carrying capacity and stiffness of air bearing, and minimize its volume flow rate by optimizing the geometrical parameters of restrictor. To facilitate the calculation of air bearing performance, a parametric computational fluid dynamics model is developed. Then, it is combined with multiobjective optimization genetic algorithm to search the Pareto optimal solutions. Furthermore, as a case study, the optimal design of an annular thrust air bearing is implemented. The stiffness of air bearing is improved 38.5%, the load-carrying capacity is improved 33.9%, and the volume flow rate is declined 19.6%, which are finally validated by experiments. It proves the reliability of proposed parametric computational fluid dynamics model and genetic optimization algorithm.
When one childhood meets another – maternal childhood trauma and offspring child psychopathology: A systematic review
Authors: Plant Dominic T , Pawlby Susan , Pariante Carmine M , Jones Fergal W
Published: November 2017

Background:

Child maltreatment can have a long-term impact on mental health. Less is known about the consequences of child maltreatment on the next generation’s psychological wellbeing.

Aim:

This systematic review aimed to synthesise the existing empirical literature on the association between a mother’s history of maltreatment in her own childhood and her children’s experiences of psychopathology, and to characterise potential mediating pathways.

Method:

Electronic database and hand searches yielded 12 studies, with a combined sample size of 45,723 mother–child dyads, which met criteria for inclusion in the review.

Results:

There was evidence of an overall positive association between a mother’s history of child maltreatment and her child’s experience of emotional and behavioural difficulties across childhood and adolescence. Maternal psychological distress and poorer parenting practices were found to be key mediating pathways of this association.

Conclusion:

Children of mothers who were exposed to maltreatment in childhood appear to be at an increased risk for psychopathology. Mothers with traumatic childhood experiences should be offered improved access to psychological therapies and parenting programmes to help mitigate the potential impact of child maltreatment on future generations.
A one-year cost–utility analysis of REBOA versus RTACC for non-compressible torso haemorrhage
Authors: Renna Maxwell S , van Zeller Cristiano , Abu-Hijleh Farah , Tong Cherlyn , Gambini Jasmine , Ma Mengyao
Published: November 2017

Introduction

Major trauma is a leading cause of death and disability in young adults, especially from massive non-compressible torso haemorrhage. The standard technique to control distal haemorrhage and maximise central perfusion is resuscitative thoracotomy with aortic cross-clamping (RTACC). More recently, the minimally invasive technique of resuscitative endovascular balloon occlusion of the aorta (REBOA) has been developed to similarly limit distal haemorrhage without the morbidity of thoracotomy; cost–utility studies on this intervention, however, are still lacking. The aim of this study was to perform a one-year cost–utility analysis of REBOA as an intervention for patients with major traumatic non-compressible abdominal haemorrhage, compared to RTACC within the U.K.’s National Health Service.

Methods

A retrospective analysis of the outcomes following REBOA and RTACC was conducted based on the published literature of survival and complication rates after intervention. Utility was obtained from studies that used the EQ-5D index and from self-conducted surveys. Costs were calculated using 2016/2017 National Health Service tariff data and supplemented from further literature. A cost–utility analysis was then conducted.

Results

A total of 12 studies for REBOA and 20 studies for RTACC were included. The mean injury severity scores for RTACC and REBOA were 34 and 39, and mean probability of death was 9.7 and 54%, respectively. The incremental cost-effectiveness ratio of REBOA when compared to RTACC was £44,617.44 per quality-adjusted life year. The incremental cost-effectiveness ratio, by exceeding the National Institute for Health and Clinical Effectiveness’s willingness-to-pay threshold of £30,000/quality-adjusted life year, suggests that this intervention is not cost-effective in comparison to RTACC. However, REBOA yielded a 157% improvement in utility with a comparatively small cost increase of 31.5%.

Conclusion

Although REBOA has not been found to be cost-effective when compared to RTACC, ultimately, clinical experience and expertise should be the main factor in driving the decision over which intervention to prioritise in the emergency context.
A comparison of fluoroscopic exposure and operative time during treatment of displaced supracondylar elbow fractures in children
Authors: Hand Cameron , Bresnahan James J , Hennrikus William L
Published: November 2017

Background

Intraoperative fluoroscopy can potentially expose the surgeon to levels of radiation beyond the recommended limits. This study aimed to assess the intraoperative differences between the fixation of types 2 and 3 supracondylar fractures for fluoroscopy time, operative time, direction of displacement, and potential cumulative risk of radiation to the surgeon.

Methods

Retrospective chart analysis was used to review 74 consecutive subjects with type 2 or 3 extension supracondylar fractures over a six-year period. Closed reduction and percutaneous pinning with fluoroscopy was used in all cases. Fluoroscopy time and operative time were analyzed based on the fracture type, direction of initial displacement, and the number of K-wires used.

Results

Type 2 supracondylar fractures require less fluoroscopy (mean: 16.8 s) and are shorter operations (mean: 19.2 min) when compared to type 3 (26.2 s and 25.1 min; p<0.05). The direction of displacement (posteromedial vs. posterolateral) did not influence operative (23.8 vs. 26.5 min) or fluoroscopy times (27.6 vs. 24.9 s; p>0.05).

Conclusions

Type 3 supracondylar fractures utilize more fluoroscopy time and operative time than type 2 fractures. The direction of displacement did not affect fluoroscopy time or operative time. Surgeons who perform large numbers of closed reduction and percutaneous pinning may be exposed to excess amounts of radiation.
Implicating teachers in infant–peer relationships: Teacher answerability through alteric acts
Authors: Redder Bridgette , White E Jayne
Published: November 2017

While academic attention is now being paid to infant–peer relationships in early childhood education and care settings and the role of teachers in these interactions, research is inclined to emphasise the importance of shared understanding as a feature in infant–peer relationships. As such, little research attention has been given to the alteric potential of the teacher when she or he engages in infant–peer relationships. This article draws on a dialogic analysis of infants in a New Zealand early childhood education and care setting to argue that infant relationships with their peers can be radically altered by the presence and participation of teachers. The results highlight the pivotal role of the teacher as a connecting figure within and between infant–peer experiences – one that has the potential to significantly impact on the nature of relationships between infants and peers. The study highlights the alteric potential for teachers within infant–peer dialogues, and the significance of these engagements accordingly, and concludes by suggesting that teachers are fully implicated in infant–peer relationships, since the dialogic space posits that there is no alibi!
An intelligent detection method for high-field asymmetric waveform ion mobility spectrometry
Authors: Li Yue , Yu Jianwen , Ruan Zhiming , Chen Chilai , Chen Ran , Wang Han , Liu Youjiang , Wang Xiaozhi , Li Shan
Published: November 2017

In conventional high-field asymmetric waveform ion mobility spectrometry signal acquisition, multi-cycle detection is time consuming and limits somewhat the technique’s scope for rapid field detection. In this study, a novel intelligent detection approach has been developed in which a threshold was set on the relative error of α parameters, which can eliminate unnecessary time spent on detection. In this method, two full-spectrum scans were made in advance to obtain the estimated compensation voltage at different dispersion voltages, resulting in a narrowing down of the whole scan area to just the peak area(s) of interest. This intelligent detection method can reduce the detection time to 5–10% of that of the original full-spectrum scan in a single cycle.
Studies in the efficacy of motion graphics: the relation between expository motion graphics and the presence of naïve realism
Authors: Barnes Spencer R
Published: November 2017

Expository motion graphics are dynamic visual communication devices capable of both informing and entertaining because they provide visual explanations and present narratives to an audience. This article had the goal of exploring how viewers interact with motion graphics that offer exposition and two theories were utilized to frame this inquiry: the theory of naïve realism and cognitive load theory. Each theory describes complementary aspects of the motion graphic viewing experience and a 2 x 2 experiment conducted by the author indicated that visual clutter is detrimental to the viewing experience associated with motion graphics and a viewer’s predilections about motion graphics can be altered after exposure to multiple motion graphics that vary in fidelity or representativeness. These findings have implications for journalistic applications of expository motion graphics within the contexts of online news packages and broadcast news.
Violence Against International Students: A Critical Gap in the Literature
Authors: Bonistall Postel Emily J.
Published: November 2017

Despite the growing trend on college campuses to increase their international student body, this population is largely left out of research due to the complexity they bring to the research process compared to their domestic counterparts. This is particularly true for the existing research on campus sexual violence; thus, there is no research-based indication that international students, let alone international graduate students, would face victimization risks on campus in the same way the extant literature identifies for domestic undergraduates. The existing research on international students indicates that their experiences are different than their domestic counterparts, and the sparse literature on graduate students indicates their experiences are different from their undergraduate counterparts. A specific focus on the intersection of these two identities, international graduate students, is almost completely absent from the literature. This research review highlights key research that provides foundational knowledge for the experience of international students and international graduate students with regard to their vulnerability to sexual violence. The author organizes the extant literature into three major areas that inform the overarching research topic: (1) international student experiences, (2) victimization, and (3) campus culture. Basic findings indicate that there are limitations in extrapolating previous research findings on campus sexual violence to this population, calling for a need to focus specifically and intentionally on this population of students. The objective of this article is to review the current state of knowledge about the risk and vulnerability of international students to sexual violence and victimization and to address the directions for future research.
Nudging Healthier Choices in a Hospital Cafeteria: Results From a Field Study
Authors: Mazza Mary Carol , Dynan Linda , Siegel Robert M. , Tucker Anita L.
Published: November 2017

More than two thirds of adults and one third of children are overweight or obese in the United States. These trends have led to initiatives to provide information that supports informed choices. Traffic light labeling has been shown to increase consumer awareness and encourage healthy selections. This article contributes to the literature on healthy choices by comparing the additional contribution of a number of interventions used in combination with traffic light labeling. We conducted a 21-month field study in a workplace cafeteria. We analyzed cash register receipts, focusing on sales of beverages and chips. We found that the traffic light system was effective. The addition of caloric information to traffic light labeling had a positive effect on the purchase of healthy chips. However, other interventions appeared to produce more harm than good, essentially wiping out the benefits from traffic light labeling. These findings suggest that although it is possible to improve on traffic light labeling with selective interventions, caution is in order as some interventions may trigger compensatory behavior that results in the purchase of unhealthy items.
Evaluating the Implementation of a Farmers’ Market Targeting WIC FMNP Participants
Authors: Ball Lanae , McCauley Amy , Paul Tracey , Gruber Kenneth , Haldeman Lauren , Dharod Jigna
Published: November 2017

The present study planned and implemented a new farmers’ market (FM) at a WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) clinic in North Carolina, of which WIC FM Nutrition Program (FMNP) participants were the main priority population. The purpose of this FM was to provide convenience and improve access to locally grown fresh fruits and vegetables in the community and to increase the FMNP coupon redemption rate. The main objective of this study was to describe the overall process and key strategies involved in implementing a FM at a WIC clinic. A community-based participatory research design using different formative methods documented the process and key inputs in FM implementation. Local farmers, program administrators, and community advocates were involved in documenting the implementation process. Multiple formative methods included direct observation and semistructured interviews with staff and farmers (n = 13). A community partnership was key in implementing the FM. The market operated weekly over the course of 24 weeks, involved 12 WIC-approved farmers, and featured over 50 types of fresh fruits and vegetables. The FMNP coupon redemption rate at the county level increased from 51.3% to 62.9%. The results demonstrate that a FM can be successfully located near a WIC clinic with positive effects of increasing availability to fresh fruits and vegetables for a low-income population and revenue for local farmers.
Gut reactions: How the blood–brain barrier connects the microbiome and the brain
Authors: Logsdon Aric F , Erickson Michelle A , Rhea Elizabeth M , Salameh Therese S , Banks William A
Published: November 2017

A growing body of evidence indicates that the microbiome interacts with the central nervous system (CNS) and can regulate many of its functions. One mechanism for this interaction is at the level of the blood–brain barriers (BBBs). In this minireview, we examine the several ways the microbiome is known to interact with the CNS barriers. Bacteria can directly release factors into the systemic circulation or can translocate into blood. Once in the blood, the microbiome and its factors can alter peripheral immune cells to promote interactions with the BBB and ultimately with other elements of the neurovascular unit. Bacteria and their factors or cytokines and other immune-active substances released from peripheral sites under the influence of the microbiome can cross the BBB, alter BBB integrity, change BBB transport rates, or induce release of neuroimmune substances from the barrier cells. Metabolic products produced by the microbiome, such as short-chain fatty acids, can cross the BBB to affect brain function. Through these and other mechanisms, microbiome–BBB interactions can influence the course of diseases as illustrated by multiple sclerosis.

Impact statement

The connection between the gut microbiome and central nervous system (CNS) disease is not fully understood. Host immune systems are influenced by changes to the microbiota and offers new treatment strategies for CNS disease. Preclinical studies provide evidence of changes to the blood–brain barrier when animals are subject to experimental gut infection or when the animals lack a normal gut microbiome. The intestine also contains a barrier, and bacterial factors can translocate to the blood and interact with host immune cells. These metastatic bacterial factors can signal T-cells to become more CNS penetrant, thus providing a novel intervention for treating CNS disease. Studies in humans show the therapeutic effects of T-cell engineering for the treatment of leukemia, so perhaps a similar approach for CNS disease could prove effective. Future research should begin to define the bacterial species that can cause immune cells to differentiate and how these interactions vary amongst CNS disease models.
Stakeholders’ Home and Community Based Services Settings Rule Knowledge
Authors: Friedman Carli
Published: November 2017

Medicaid Home and Community Based Services (HCBS) waiver programs provide the majority of long-term services and supports for people with intellectual and developmental disabilities (IDD). Relatively new (2014) HCBS rules (CMS 2249-F/2296-F) governing these programs require meaningful community integration of people with disabilities who receive services under this Medicaid program. States are required to develop and submit transition plans, which document how their programs will meet the so-called settings rules. Public comment periods provide advocates the opportunity to impact states’ rules by ensuring that plans are truly community based. Yet the lengthy and technical description of the rules may be inaccessible for people with disabilities and their allies. Because knowledge of the HCBS settings rules can be crucial for people with IDD to enable them to access their rights, the aim of this study was to explore HCBS settings rules knowledge of people with IDD and key stakeholders. Our findings confirmed that there is a need to make the HCBS settings rules more accessible to those most affected by the changes—people with IDD and family members of people with IDD. Doing so is a necessary first step to promote advocacy regarding its implementation.
Utilization of stent grafts in the management of arteriovenous access pseudoaneurysms
Authors: Aurshina Afsha , Hingorani Anil , Marks Natalie , Ascher Enrico
Published: November 2017

Objective

Endovascular stent graft repair for exclusion of pseudoaneurysm is currently being explored to replace open surgical repair as current management. The objective of the study was to evaluate the clinical safety and efficacy of endovascular stent graft intervention in pseudoaneurysms complicating arteriovenous reconstructions in patients on chronic hemodialysis.

Methods

A retrospective analysis of all pseudoaneurysms treated with stent grafts at our institution over a period of five years was performed. The indications for endovascular intervention included bleeding from the pseudoaneurysm, infection, and significant skin compromise overlying the pseudoaneurysm or combination of the above. The rates of technical success, complication, and primary patency were measured at one-week, one-month, and six-month follow-up.

Results

A total of 33 endovascular stent graft interventions in 29 patients were performed for the treatment of pseudoaneurysms. The average age of patients was 68 years (range 31–90 years), with 13 female. Diabetes and hypertension were present in 15 and 22 patients, respectively. In eight patients, there was evidence of active infection at the fistula site. The choice of stent grafts include Viabahn ( n = 31), Wallgraft ( n = 1), and i-Cast ( n = 1). The initial technical success rate was 94%. The two failed interventions included occlusion of inflow artery with immediate conversion to open procedure ( n = 1) and incomplete pseudoaneurysm exclusion ( n = 1). Primary patency at one month and six months was 83 and 60%, respectively. An additional balloon angioplasty of outflow tract or central stenosis was performed in 18 cases (54%). The explanation of stent grafts due to persistent or recurrent bacteremia/site infection was required in four out of eight patients. The average time to explanation was 93 days (range 6–204 days).

Conclusion

The stent graft implantation is a safe, minimally invasive and efficient way to control and manage arteriovenous accesses with pseudoaneurysms. In the presence of infection, this approach may be less durable.
Arterio-biliary fistulas: What to choose as endovascular treatment?
Authors: Stefańczyk Ludomir , Polguj Michał , Szubert Wojciech , Chrząstek Jarosław , Jurałowicz Piotr , Garcarek Jerzy
Published: November 2017

Objectives

Endovascular procedures are the treatment of choice in cases of intrahepatic fistulas. Arterio-biliary fistulas are the rarest and most difficult to treat, due to high risk of infection.

Methods

Eight cases of persistent hemobilia that developed as a result of arterio-biliary fistulas are presented. Five cases developed as a result of iatrogenic injury, two cases as a result of chronic infection, one case as a consequence of trauma.

Results

Patients were treated using endovascular embolization or combined endovascular and endoscopic biliary tract revision. The results were monitored after six to seven days and one month after embolization. The embolizations were considered effective in all cases. One patient had four asynchronous fistulas requiring separate treatments sessions. Four patients required a revision of their biliary ducts after embolization and restoration of patency. In one patient, a migration of the coil to biliary ducts occurred.

Conclusion

Endovascular treatment of arterio-biliary fistulas is safe and effective. The use of embolization with soft and biodegradable materials like histoacrylic glue or thrombin may be the optimal method of treatment in comparison with coils which have a risk of migration or chronic infection.
Explaining Gender Gaps in English Composition and College Algebra in College: The Mediating Role of Psychosocial Factors
Authors: Ndum Edwin , Allen Jeff , Way Jason , Casillas Alex
Published: November 2017

We examined the role of six psychosocial factors (PSFs) in explaining gender gaps in English Composition ( n = 8,633) and College Algebra ( n = 2,261) using data of first-year female (55%) and male students from 42 colleges. Using a multilevel model and controlling for prior achievement, we found that PSFs mediated between 3% and 41% of the gender gap in English Composition, but only one PSF ( Academic Discipline), helped explain the gender gap in College Algebra. Gender gaps significantly narrowed when students were more motivated to turn in homework assignments in a timely and consistent manner, meet deadlines, and obtain satisfactory academic achievement. These findings may help stakeholders prepare students for success in these foundational college courses.
Time Savings Using a Standardized Glucose Reporting System and Ambulatory Glucose Profile
Authors: Mullen Deborah M. , Bergenstal Richard , Criego Amy , Arnold Kathleen Cecilia , Goland Robin , Richter Sara
Published: November 2017

Background:

Diabetes care is predominately done at home by the patient. When clinics do not have a reliable, easy process for obtaining this patient data, clinical decisions must be made with incomplete verbal recall reports. Unused or inaccessible glucose data represent a large information gap affecting clinical decision making. This study’s purpose was to design an optimized glucose device download system with a standardized report and to evaluate its efficiency.

Methods:

Observations and evaluations of glucose data retrieval occurred at two clinics; an additional clinic utilized the optimized process doing only post process timings. Patients/families and clinicians were surveyed about their experiences with the system and the standardized report (AGP). The study was approved by all the sites’ IRBs.

Results:

Optimized systems saved staff at least 3 min per patient. Standardized AGP reports and an optimized data system made the work flow of glucose data easier to complete. The AGP report was preferred by patients, families, and clinicians.

Conclusions:

An optimized system takes advantage of patient lobby downtime to download glucose devices and ensures that diabetes clinical decisions are made utilizing all available data. Staff and patients liked the software lobby system and found it a valuable time-saving tool.
ADC quantification in basilar artery occlusion as an indicator of clinical outcome after endovascular treatment
Authors: Pereira Daniela , Fragata Isabel , Amorim José , Reis João
Published: November 2017

Background

Acute ischemic stroke due to basilar artery occlusion (BAO) is associated with a dismal prognosis and, even though endovascular treatment (EVT) contributed to an improvement in clinical outcomes, patient selection is difficult and frequently results in futile recanalization. We investigated the prognostic value of baseline ADC quantification in patients with BAO undergoing EVT.

Methods

We retrospectively evaluated MRI at admission in 11 patients with BAO undergoing EVT. Ischemic lesions were defined on baseline DWI and minimum ADC (minADC), ADC ratio and total area were quantified. Final infarction area was determined on follow-up T2WI/CT. We assessed the correlation between imaging parameters, recanalization grade and clinical scores (NIHSS at admission, NIHSS and mRS at discharge and mRS at three months) using Spearman rank correlation coefficient and correcting for multiple comparisons with the false discovery rate (FDR).

Results

Lower values of minADC at admission MRI are strongly correlated with higher scores in NIHSS (rs = −0.845, p = 0.001) and mRS at discharge (rs = −0.743, p = 0.009). We also found a negative correlation between minADC and NIHSS at admission (rs = −0.67, p = 0.02), mRS at three months and difference between pre- and post-treatment ischemic area (rs = −0.664, p = 0.026) that lost significance with FDR correction. Ischemic area and TICI grade were not significantly associated with clinical results.

Conclusions

ADC quantification of ischemic lesions at baseline MRI seems to predict clinical outcome in patients with BAO undergoing EVT, more importantly than ischemic area or TICI grade.
Comparison of normal facial nerve enhancement at 3T MRI using gadobutrol and gadopentetate dimeglumine
Authors: Radhakrishnan Rupa , Ahmed Shamima , Tilden Joshua Cole , Morales Humberto
Published: November 2017

Background and purpose

The facial nerve is unique among cranial nerves in demonstrating normal enhancement of particular segments. The effect of varying T1 relaxivities of gadolinium-based contrast agents on facial nerve enhancement is unclear. In this study, we assess differences in normal facial nerve enhancement with two different gadolinium-based contrast agents, gadobutrol and gadopentetate dimeglumine. In addition, we evaluate differences in facial nerve enhancement with spin-echo (SE) T1 versus 3D inversion recovery prepared fast spoiled gradient-echo (FSPGR) post-contrast sequences.

Methods

A total of 140 facial nerves in 70 individuals were evaluated (70 with gadobutrol and 70 with gadopentetate dimeglumine) by two blinded reviewers. Differences in enhancement of facial nerve segments between the two agents were analyzed. Differences in enhancement between SE T1 and FSPGR imaging were also evaluated.

Results

There was no significant difference in facial nerve enhancement between gadobutrol and gadopentetate dimeglumine. Enhancement was commonly observed in the geniculate, tympanic and mastoid segments (98%–100%) with either contrast agent; enhancement was less common in the labyrinthine segments (9%–14%) and lateral canalicular segment (2%–5%). There was a smaller enhancing proportion of labyrinthine and tympanic segments with FSPGR as compared to SE T1 images with gadobutrol.

Conclusion

There is no significant difference in overall enhancement of the facial nerve between gadobutrol and gadopentetate dimeglumine. Mild enhancement of the lateral canalicular portion of the facial nerve may be a normal finding. With FSPGR sequence, there is lesser perceived enhancement of the labyrinthine and tympanic segments of the facial nerve with gadobutrol.
Can diplomatic assurances, in their practical application, provide effective protection against the risk of torture and ill treatment? A focus on the evolution of the pragmatic approach of the European Court of Human Rights in removal cases of suspected terrorists
Authors: Salerno Martina Elvira
Published: November 2017

In order to implement counterterrorism measures, governments have frequently resorted to the use of diplomatic assurances. This practice aims to facilitate and legitimize the removal of non-nationals to third states with dubious human rights records, contrary to the obligation not to refoule set out under international law. This article raises the question of whether such assurances provide, in practical terms, effective protection against the risk that the transferred person may be subjected to torture and ill treatment upon return. With the purpose of addressing this issue, it is essential to evaluate whether diplomatic assurances can be deemed adequate and reliable guarantees of safety against ill treatment. In this regard, the position taken by international and regional human rights bodies is of profound importance. For this reason, this article considers and comparatively analyses the existing jurisprudence on non-refoulement and diplomatic assurances of such bodies. In particular, it closely examines the pragmatic approach of the European Court of Human Rights, by focusing on the abundant case law on the removal of suspected terrorists.
Fitness attenuates the prevalence of increased coronary artery calcium in individuals with metabolic syndrome
Authors: Ekblom-Bak Elin , Ekblom Örjan , Fagman Erika , Angerås Oskar , Schmidt Caroline , Rosengren Annika , Börjesson Mats , Bergström Göran
Published: November 2017

Background

The association between cardiorespiratory fitness, physical activity and coronary artery calcium (CAC) is unclear, and whether higher levels of fitness attenuate CAC prevalence in subjects with metabolic syndrome is not fully elucidated. The present study aims to: a) investigate the independent association of fitness on the prevalence of CAC, after adjustment for moderate-to-vigorous physical activity and sedentary time, and b) study the possible attenuation of increased CAC by higher fitness, in participants with metabolic syndrome.

Design

Cross-sectional.

Methods

In total 678 participants (52% women), 50–65 years old, from the SCAPIS pilot study were included. Fitness (VO2max) was estimated by submaximal cycle ergometer test and moderate-to-vigorous physical activity and sedentary time were assessed using hip-worn accelerometers. CAC score (CACS) was quantified using the Agatston score.

Results

The odds of having a significant CACS (≥100) was half in participants with moderate/high fitness compared with their low fitness counterparts. Further consideration of moderate-to-vigorous physical activity, sedentary time and number of components of the metabolic syndrome did only slightly alter the effect size. Those with metabolic syndrome had 47% higher odds for significant CAC compared with those without metabolic syndrome. However, moderate/high fitness seems to partially attenuate this risk, as further joint analysis indicated an increased odds for having significant CAC only in the unfit metabolic syndrome participants.

Conclusions

Being fit is associated with a reduced risk of having significant CAC in individuals with metabolic syndrome. While still very much underutilized, fitness should be taken into consideration in everyday clinical risk prediction in addition to the traditional risk factors of the metabolic syndrome.
Perceptions of College Among Latina/o Elementary Students
Authors: Núñez Amy J. , Meráz García Martín
Published: November 2017

This study uses empirical data from a version of the Clark doll experiment and Latina/o Critical Race Theory (LatCrit) to determine the factors that shape the perceptions of college among 35 randomly selected Latina/o children in Grades 2nd to 5th. The findings of this study lead to two conclusions: (a) that Latina/o children hold their race/ethnicity in lower regard when compared to Whites, exhibit an ambivalence regarding identity that negatively affects their self-esteem and their perceptions of college as an attainable goal; and (b) that Latinas perceived themselves more favorably than Latinos in all categories, which positively affects their perceptions of a college education.
Recurrent Lactobacillus Bacteremia in a Patient With Leukemia
Authors: Ambesh Paurush , Stroud Sarah , Franzova Eva , Gotesman Joseph , Sharma Kavita , Wolf Lawrence , Kamholz Stephan
Published: November 2017

Lactobacillus species are a commensal flora of the human gastrointestinal and the female genitourinary tract. Lactobacilli especially the rhamnosus species, are common components of commercial probiotics. They are rarely associated with pathology in immunocompetent people, but they have been known to cause dental caries, bacteremia, and endocarditis in patients with suppressed immune function. Cases of Lactobacillus bacteremia have been reported in patients with acute myeloid leukemia, large granular lymphocytic leukemia, and in transplant recipients. In this article, we report a strange case of recurrent Lactobacillus bacteremia causing multiple episodes of fever of unknown origin in a patient with leukemia. This report is unique as Lactobacillus is not recognized as a common source of bacteremia. Moreover, the source of the bacillus continued to elude us even after extensive investigation.
Employing a Qualitative Description Approach in Health Care Research
Authors: Bradshaw Carmel , Atkinson Sandra , Doody Owen
Published: November 2017

A qualitative description design is particularly relevant where information is required directly from those experiencing the phenomenon under investigation and where time and resources are limited. Nurses and midwives often have clinical questions suitable to a qualitative approach but little time to develop an exhaustive comprehension of qualitative methodological approaches. Qualitative description research is sometimes considered a less sophisticated approach for epistemological reasons. Another challenge when considering qualitative description design is differentiating qualitative description from other qualitative approaches. This article provides a systematic and robust journey through the philosophical, ontological, and epistemological perspectives, which evidences the purpose of qualitative description research. Methods and rigor issues underpinning qualitative description research are also appraised to provide the researcher with a systematic approach to conduct research utilizing this approach. The key attributes and value of qualitative description research in the health care professions will be highlighted with the aim of extending its usage.
Hypertension in Low-Income Adolescents
Authors: Ewald D. Rose , Bond Sarah Howle , Haldeman Lauren A.
Published: November 2017

Disadvantaged adolescents are at higher risk for undiagnosed and untreated obesity and hypertension. Using nurse-measured weight, height, and blood pressure (BP) as well as self-reported age and activity/lifestyle behaviors, we assessed the prevalence of obesity and hypertension in 573 adolescent patients aged 13.0 to 17.9 years (females: n = 267, 46.6%; males: n = 306, 53.4%) from a clinic serving low-income, ethnically diverse pediatric patients. Body mass index distribution was as follows: 11, underweight (1.9%); 330, healthy weight (57.6%); 105, overweight (18.3%); and 127, obese (22.2%). The age-adjusted height percentile was normally distributed, but distribution by BP category was 326 normotensive (56.9%), 147 prehypertensive (25.7%), 60 with stage 1 hypertension (10.5%), and 40 with stage 2 hypertension (7.0%). Activity and lifestyle behaviors did not adequately explain obesity and hypertension rates. Efforts to prevent/reduce childhood overweight, obesity, and hypertension in underserved populations need to include dietary education, weight control interventions, and physical activity programs specifically tailored to overweight/obese youth and parents.
Mitigating Burden Associated With Informal Caregiving
Authors: Frederick Dorothea
Published: November 2017

Informal caregiving is the most common form of long-term care provided in the United States, and with the projected rapid growth of older adults, informal caregiving will be even more critical in the foreseeable future. In the United States, slightly more than 20% of informal caregivers provide care for more than one care recipient, and 10% provide care for three or more care recipients. Caring for a dependent, older adult patient may have negative effects on physical, psychological, psychosocial, social and financial health of caregivers. Careful assessment of the impact of informal caregiving on the caregiver’s functioning is imperative, and will enable a practitioner to not only find ways to help caregivers shoulder the effects of caregiving, but also to measure the effectiveness of interventions that seek to mitigate the effects of caregiving.
Cardiovascular Ultrasound Combined With Non-invasive Screening for the Detection of Undiagnosed Cardiovascular Disease: A Literature Review
Authors: Bierig S. Michelle , Arnold Anita , Einbinder Lynne C. , Armbrecht Eric , Burroughs Thomas
Published: November 2017

Non-invasive screenings have been widely utilized in the United States and worldwide to provide early identification of cardiovascular disease, allowing for earlier diagnosis and treatment. Screening sonography detects valve disease, cardiac dysfunction, and carotid disease in 5% to 20% of the population. This review discusses the current data regarding cardiovascular screening, the methodologies, and the resources required for performance of screenings. Cardiac and carotid sonography is highly accurate and discovers cardiovascular diseases that impact quality of life and risk of future events. Screenings are performed in a variety of settings and accuracy depends on the quality of personnel performing the non-invasive testing, the equipment utilized, and the personnel interpreting the studies. Despite the potential benefit for disease detection, population screening to detect cardiovascular disease is not widely supported by national organizations due to the theoretical cost of further testing and lack of cost versus benefit data. Additional studies are necessary to compare costs and benefits of non-invasive cardiovascular screening in the community setting.
Prenatal Findings in Left Atrial Isomerism and an Overview of Heterotaxy Syndrome
Authors: Thomas Claudine , Callis Samantha N.
Published: November 2017

Heterotaxy syndrome is a rare, complex disorder involving structural cardiac defects in combination with symmetrical development of abdominal viscera that are normally asymmetrical organs. The vast assortment of cardiac manifestations with accompanying abdominal visceral variations determines the prognosis of heterotaxy syndrome. This case study provides an example of the management of this disease, which is unique to the patient. This is a case report of heterotaxy syndrome diagnosed in utero at 29 weeks and 4 days.