bluuebunny/crossref_metadata_2025_split huggingface dataset:
Equipping School Health Personnel for Diabetes Care with a Competency Framework and Pilot Education Program
Authors: Berget Cari , Nii Pamela , Wyckoff Leah , Patrick Kathleen , Brooks‐Russell Ashley , Messer Laurel H. 
Published: June 2019

ABSTRACTBACKGROUNDSchools struggle to support health needs of students with diabetes due to limited funding/resources. A competency framework can help individual schools clarify the knowledge and skills required for school‐based diabetes care within their unique context, and inform the development of standardized diabetes education for health staff.METHODSA consensus‐building technique, known as the Delphi method, was used to create a competency framework for diabetes care at school with a panel of 37 stakeholders. A continuing education program based on the resultant framework was developed and pilot‐tested with school nurses. Pretest and post‐test scores on knowledge, perceived competence, and self‐efficacy were compared to evaluate the effectiveness of the program.RESULTSConsensus was obtained for a total of 70 competencies: 22 competencies for health aids, 36 additional competencies for school nurses, and 12 additional competencies for diabetes resource nurses. Thirty school nurses completed the continuing education program and demonstrated significant improvement in diabetes knowledge, self‐efficacy, and competence in pathophysiology and diabetes care tasks (p < .01 for all).CONCLUSIONSDeveloping a consensus framework is an excellent starting place for stakeholders to identify the skills and knowledge required for various school personnel and to ensure that all school health staff members receive adequate diabetes education.
Soft Words for Strident Times
Authors: Clegg Jennifer 
Published: June 2019

AbstractThis commentary considers what the three different issues that the authors combine have in common, what the evidence is for them, and social science research that reveals the complexity of conversations between doctors and patients about serious health conditions. It examines their implicit claim that there are no questions to answer about the quality of life experienced by people with all types of ID and their families, and what labelling these three issues as “eugenics” is likely to achieve.
Pregnancy‐Related Mortality and Severe Maternal Morbidity in Rural Appalachia: Established Risks and the Need to Know More
Authors: Hansen Anna , Moloney Mairead 
Published: June 2019

AbstractPurposeThe Centers for Disease Control and Prevention (CDC) and the American College of Obstetrics and Gynecology have called for researchers to further elucidate medical and social determinants of pregnancy‐related death and severe maternal morbidity. This report begins to answer this call in the context of rural Appalachia.MethodsThis report identifies risk factors exposing women in rural Appalachia to pregnancy‐related death and severe maternal morbidity. We also use CDC WONDER data to illustrate rural‐urban differences in pregnancy‐related death.FindingsRural women nationally die of pregnancy‐related causes at a greater rate than urban women. It is unknown how rurality specifically influences pregnancy‐related death, but rural women more often embody multiple risk factors associated with negative maternal outcomes. Established risk factors, including high rates of chronic illness and substance abuse, place rural women at risk for severe maternal morbidity and pregnancy‐related mortality. These women may also lack the resources to mitigate these risks, including access to high‐risk obstetric care.Next stepsTo address these issues and the concerning lack of data, we propose 4 directions for future study: (1) a determination of the prevalence of pregnancy‐related death and severe maternal morbidity in this population; (2) an examination of how rural women utilize existing pre‐ and perinatal resources; (3) better validation concerning surveillance methods of pregnancy‐related death and severe maternal morbidity in rural areas; and (4) an exploratory qualitative study of rural women and health care providers.
Niche overlap and dietary resource partitioning in an African large carnivore guild
Authors: Vogel John T. , Somers Michael J. , Venter Jan A. 
Published: June 2019

AbstractUnderstanding and quantifying a large carnivores’ feeding behaviour is a key component in determining its functional significance in an ecosystem, both in terms of its top‐down influence on prey species, but also its relationships with sympatric carnivores. Dietary overlap is one of the numerous niche dimensions used to characterize resource partitioning and potential competition within a community. We characterize the diet, potential dietary niche overlap and prey preference of a large African carnivore guild on small fenced protected areas. To quantify the potential inter‐ and intraspecific foraging competition, we analysed 5,128 kills, representing 35 prey species made by African wild dogs Lycaon pictus (n = 553), cheetahs Acinonyx jubatus (1,427), lions Panthera leo (2,648) and leopards P. pardus (500). Our results show that large African carnivores in small protected areas are exposed to considerable overlap in dietary resource utilization. At the interspecific level, African wild dogs and cheetahs displayed the greatest vulnerability to potential dietary competition. Lions exhibited marked differences in prey preference, mass and species utilization compared to the other carnivores. African wild dogs and cheetah females with dependent offspring occupied the greatest potential for dietary competition within the large carnivore guild. Using a case study based on the preferred biomass of prey available, we estimate the sustainable density of large carnivores at a small fenced prospective African wild dog reintroduction site. African wild dogs displayed the lowest mean predicted density compared to all sympatric predators with an expected population size of 7 individuals. Our research highlights the need to assess the influence of competitive forces in structuring and restoring large predators to portions of their historical range by identifying species most vulnerable to a potential reintroduction attempt. In the absence of controlled experiments, elucidating the influences of exploitation competition is challenging, and only through manipulating sympatric species presence and densities can these complex interactions be fully understood.
Animal studies and the eighteenth century: The nature of the beast
Authors: Cole Lucinda 
Published: June 2019

AbstractThis essay offers an overview of important historical and theoretical issues in animal studies scholarship on the long eighteenth century, 1660–1750. It draws connections among the theological, social, and ontological debates of the early modern period and discusses how these debates helped to shape current questions in posthumanist and animal studies research. Recent works in animal studies about the eighteenth century explore anthropocentrism and the human–animal divide; sensibility and anti‐cruelty legislation; thing theory and personhood; and literary subjectivity in the broader context of more‐than‐human ecologies.
Reading politics through emotions: ontological ressentiment as the emotional basis of current politics in Turkey
Authors: Tokdoğan Nagehan 
Published: June 2019

AbstractFor almost sixteen years now, politics in Turkey have been analysed with reference to the theme of victimhood. It is true that the political discourse of Turkey's Justice and Development Party (Adalet ve Kalkınma Partisi or AKP) gained its power by the mass response to its victimhood claims. Nevertheless, as this article argues, the legitimacy of the victimhood claim rests mainly on the already‐existing emotions of masses, aroused and triggered by political elites. Thus, Turkish politics during the AKP period cannot be thoroughly understood without taking into consideration the emotions of both political elites and the masses. This article shares insights into the sixteen‐year‐long AKP reign of power based on Recep Tayyip Erdoğan's appeals to such emotions as humiliation, envy, disgust, hatred, anxiety, and anger. It further argues that these emotions reveal a much deeper and stronger emotional trait which we identify as ontological ressentiment.
Establishment and Finite Element Analysis of a Three‐dimensional Dynamic Model of Upper Cervical Spine Instability
Authors: Wang Xiao‐dong , Feng Min‐shan , Hu Yong‐cheng 
Published: June 2019

ObjectivesTo establish a dynamic three‐dimensional (3D) model of upper cervical spine instability and to analyze its biomechanical characteristics.MethodsA 3D geometrical model was established after CT scanning of the upper cervical spine specimen. The ligament of the specimen was fatigued to establish the upper cervical spine‐instability model. A 100‐N preloaded stress was applied to the upper surface of the occipital bone, and then a 1.5‐Nm moment was applied in the occipital‐sagittal direction to simulate upper cervical spine flexion and extension. Subsequently, the 3D dynamic model was established based on trajectory data that were measured using a motion‐capture system. The stress on the main ligament and the relative motion angle of the joint were analyzed.ResultsThe shape of the model grid was regular and the total number of its units was 627 000. After finite‐element analysis was conducted, results of the ligament stress and relative movement angle were obtained. After the upper cervical spine instability, the pressure of the alar ligament during the upper cervical spine extension was increased from 2.85 to 8.12 MPa. The pressure of the flavum ligament was increased during the upper‐cervical spine flexion, from 0.90 to 1.21 MPa. The pressure of the odontoid ligament was reduced during the upper cervical spine flexion and extension, from 10.46 to 6.67 MPa and 25.66 to 16.35 MPa, respectively. The pressure of the anterior longitudinal ligament and cruciate ligament was increased to a certain degree during upper cervical spine flexion and extension. The pressure of the anterior longitudinal ligament was increased during flexion and extension, from 7.70 to 10.10 MPa and 10.45 to 13.75 MPa, respectively. The pressure of the cruciate ligament was increased during flexion and extension, from 2.29 to 4.34 MPa and 2.32 to 4.40 MPa, respectively. In addition, after upper cervical spine instability, the articular‐surface relative‐movement angle of the atlanto‐occipital joint and atlanto‐axial joint had also changed. During upper cervical spine flexion, the angle of the atlanto‐occipital joint was increased from 3.49° to 5.51°, and the angle of the atlanto‐axial joint was increased from 8.84° to 13.70°. During upper cervical spine extension, the angle of the atlanto‐occipital joint was increased from 11.16° to 12.96°, and the angle of the atlanto‐axial joint was increased from 14.20° to 17.20°. Therefore, the movement angle of the atlanto‐axial joint was most obvious after induction of instability.ConclusionThe 3D dynamic finite‐element model of the upper cervical spine can be used to analyze and summarize the relationship between the change of ligament stress and the degree of instability in cervical instability. Frequent or prolonged flexion activities are more likely to lead to instability of the upper cervical spine.
Midterm Clinical Outcome of Combined Posterior Cruciate Ligament Reconstruction and Posterolateral Corner Surgery Using Second‐Look Arthroscopic “Lateral Gutter Drive‐Through” Test as an Adjunctive Evaluation
Authors: Li Yue , Hong Lei , Wang Xue‐song , Zhang Hui , Li Xu , Zheng Tong , Feng Hua 
Published: June 2019

ObjectivesThe arthroscopic “lateral gutter drive‐through” (LGDT) sign is reported to diagnose popliteus tendon (PT) injury with high sensitivity and specificity. However, no study has provided a postoperative evaluation of combined posterior cruciate ligament (PCL) and posterolateral corner (PLC) injuries using the LGDT test.MethodsFrom January 2012 to January 2015, a total of 80 consecutive patients who underwent combined PCL reconstruction and PLC surgeries were identified. Fifty eligible patients were included in this study for evaluation with subjective scoring systems, physical examinations, posterior and varus stress radiographs, and second‐look arthroscopic surgeries during hardware removal operation.ResultsForty‐nine patients were available for a mean of 31.5 ± 9.3 months follow‐up (range, 24.0–81.0 months). In terms of PLC injury pattern, there were 27 type A, 10 type B, and 12 type C patients, with 21 acute cases and 28 chronic cases. At the final follow‐up, subjective scores were all significantly improved. The side‐to‐side difference (SSD) of posterior tibial translation (PTT) improved from 18.4 ± 9.2 mm (range, 12.9–25.6 mm) to 5.2 ± 5.0 mm (range, −5.0−18.5 mm, P < 0.001), and the SSD of tibial external rotation by dial test (ER) decreased from 18.0° ± 14.4° (range, 13.0°–22.0°) to 1.2° ± 7.5° (range, −9.0°–22.0°, P < 0.001). In patients with type C injury, the SSD of the lateral opening decreased from 14.2 ± 6.6 mm (range, 22–10.2 mm) to 0.9 ± 3.1 mm (range, −4.4‐6 mm, P < 0.001). In a comparison between patients with positive and negative LGDT signs, the LGDT‐negative patients had significant superiority in subjective scores, SSD of PTT, and SSD of ER. The sensitivity and specificity of the LGDT test in detecting postoperative posterolateral rotational instability (PLRI) were calculated as 100% and 88.4%, respectively.ConclusionsIn the series of surgically treated patients with PCL and PLC injury: (i) patients had improved subjective and objective clinical outcome after combined PCL reconstruction and PLC surgery at a minimum of 24‐months follow‐up; and (ii) second arthroscopic LGDT sign testing had high sensitivity and specificity in detecting postoperative PLRI, and a positive LGDT sign was related with inferior subjective and objective results.
Clinical efficacy of a combined acceptance and commitment therapy, dialectical behavioural therapy, and functional analytic psychotherapy intervention in patients with borderline personality disorder
Authors: Reyes‐Ortega Michel A. , Miranda Edgar M. , Fresán Ana , Vargas Angélica N. , Barragán Sandra C. , Robles García Rebeca , Arango Iván 
Published: June 2019

ObjectiveBorderline personality disorder (BPD) consists of a persistent pattern of instability in affective regulation, impulse control, interpersonal relationships, and self‐image. Although certain forms of psychotherapy are effective, their effects are small to moderate. One of the strategies that have been proposed to improve interventions involves integrating the therapeutic elements of different psychotherapy modalities from a contextual behavioural perspective (ACT, DBT, and FAP).MethodsPatients (n = 65) attending the BPD Clinic of the Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz in Mexico City who agreed to participate in the study were assigned to an ACT group (n = 22), a DBT group (n = 20), or a combined ACT + DBT + FAP therapy group (n = 23). Patients were assessed at baseline and after therapeutic trial on measures of BPD symptom severity, emotion dysregulation, experiential avoidance, attachment, control over experiences, and awareness of stimuli.ResultsANOVA analyses showed no differences between the three therapeutic groups in baseline measures. Results of the MANOVA model showed significant differences in most dependent measures over time but not between therapeutic groups.ConclusionsThree modalities of brief, contextual behavioural therapy proved to be useful in decreasing BPD symptom severity and emotional dysregulation, as well as negative interpersonal attachment. These changes were related to the reduction of experiential avoidance and the acquisition of mindfulness skills in all treatment groups, which may explain why no differences between the three different intervention modalities were observed.Practitioner points

Brief adaptations of acceptance and commitment therapy and dialectical behavioural therapy are effective interventions for BPD patients, in combined or isolated modalities, and with or without the inclusion of functional analytic psychotherapy.

The reduction of experiential avoidance and the acquisition of mindfulness skills are related with the diminution of BPD symptoms severity, including emotional dysregulation and negative interpersonal attachment.
End‐of‐life care in the pediatric intensive care unit: Survey in Japan
Authors: Seino Yusuke , Kurosawa Hiroshi , Shiima Yuko , Niitsu Takehiro 
Published: June 2019

AbstractBackgroundEnd‐of‐life (EOL) care is an important topic in critical care medicine, but EOL discussions with families can be difficult and stressful for intensivists. The aim of this study was to clarify the current practices and barriers facing pediatric intensive care unit (PICU) EOL care and to identify the requisites for excellent PICU EOL care in Japan.MethodsA survey was conducted in 29 facilities across Japan in 2016. The questionnaire consisted of 19 multiple‐choice questions and one open‐ended question.ResultsTwenty‐seven facilities responded to the survey. Only 19% had educational programs on EOL care for fellows or residents. Although 21 hospitals (78%) had a multidisciplinary palliative care team, only eight of these teams were involved in EOL care in PICUs. Mental health care for health‐care providers provided by a psychiatrist was rare (4%). The free comments were categorized as individual, team, environment, legal/ethics, or culture. Commonly raised individual issues included “lack of experience and knowledge about EOL care”, “fear of making the decision to end care”, and “reluctance to be involved in EOL care because of its complex process”. Team issues included “insufficient frequency of conferences” and “non‐multidisciplinary approach”. Legal and ethics issues were “lack of legal support” and “fear of lawsuits”.ConclusionsThis study is the first to investigate the current conditions and barriers in PICU EOL care in Japan. Most of the facilities involved were not satisfied with current practices. A need was identified for relevant educational programs, as well as the importance of multidisciplinary and legal support.
Effects of feedback delay and agency on feedback‐locked beta and theta power during reinforcement learning
Authors: Weismüller Benjamin , Kullmann Janna , Hoenen Matthias , Bellebaum Christian 
Published: June 2019

AbstractFeedback‐based learning initiated by dopamine (DA) cell firing is crucial for adaptive behavior. The nature and context of feedback can vary, however, affecting how feedback is processed. For example, the feedback‐related negativity (FRN) in the ERP in humans, which has been linked to the DA system, is reduced for delayed feedback and for observational compared to active learning. Recent research suggested that oscillations in the theta and beta band over the medio‐frontal cortex reflect distinct feedback processing mechanisms. In this study, we hypothesized that the power in both frequency bands is affected by feedback delay and agency. We thus investigated effects of feedback delay (1 s vs. 7 s) on induced theta and beta band power and the FRN in a probabilistic feedback learning task in two participant groups, one learning actively and one by observation. For theta and beta, a larger power difference between negative and positive feedback for immediate than delayed feedback was found, driven by positive feedback for beta and by negative feedback for theta, while no differential modulation by agency was seen for theta or beta power following positive and negative feedback. These results indicate that feedback‐locked beta and theta both reflect neural processes that are specific for the integration of feedback and recently preceding events, possibly linked to cognitive control and memory. With respect to the FRN amplitude, we could replicate previous findings of both delay and agency modulations, suggesting that the neural processes underlying feedback‐locked ERPs and theta and beta power modulations differ.
A review of approaches for analysing obstructive sleep apnoea‐related patterns in pulse oximetry data
Authors: Terrill Philip I. 
Published: June 2019

ABSTRACTOvernight pulse oximetry allows the relatively non‐invasive estimation of peripheral blood haemoglobin oxygen saturations (SpO2), and forms part of the typical polysomnogram (PSG) for investigation of obstructive sleep apnoea (OSA). While the raw SpO2 signal can provide detailed information about OSA‐related pathophysiology, this information is typically summarized with simple statistics such as the oxygen desaturation index (ODI, number of desaturations per hour). As such, this study reviews the technical methods for quantifying OSA‐related patterns in oximetry data. The technical methods described in literature can be broadly grouped into four categories: (i) Describing the detailed characteristics of desaturations events; (ii) Time series statistics; (iii) Analysis of power spectral distribution (i.e. frequency domain analysis); and (d) Non‐linear analysis. These are described and illustrated with examples of oximetry traces. The utilization of these techniques is then described in two applications. First, the application of detailed oximetry analysis allows the accurate automated classification of PSG‐defined OSA. Second, quantifications which better characterize the severity of desaturation events are better predictors of OSA‐related epidemiological outcomes than standard clinical metrics. Finally, methodological considerations and further applications and opportunities are considered.
China in Laos: Enclave spaces and the transformation of borders in the Mekong Region
Authors: Laungaramsri Pinkaew 
Published: June 2019

Where China Meets Southeast Asia: Social and Cultural Change in the Border Regionsedited by Grant Evanset al., is among the few works that take borderlands between China and mainland Southeast Asia seriously. A major contribution of this collection of border studies is its attempt to understand how border experiences and the process of bordering have changed since the early 1990s. Various Chinese–local interactions are explored in this book, with an emphasis on complex local responses to border transformations and diverse forms of mobility and network building. This article further examines the role of China and the Lao state, and the new wave of Chinese movement at the border. In establishing an economic integration that spills across the region, the penetration of Chinese power has been effective. The consequent retreat of the Lao state at the border has not only put an end to the old frontier but turned various borderlands into an estranged space of neoliberal enclave.