bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effects of Various Design Alternatives on Moving-Base Driving Simulator Discomfort
Authors: Casali John G. , Wierwille Walter W. 
Published: July 2017

The effects of three independent variables on eight measures of driving simulator discomfort were investigated using a high-fidelity, moving-base driving simulator. The between-subjects simulator variables were: (1) simulation of lateral acceleration (LAT)—by lateral translation (standard method) versus by angular rotation; (2) presence or absence of delay in the visual and motion systems (DEL)—nondelayed (normal) versus delayed; and (3) simulator platform (CAB)—open (normal) versus enclosed. Sixty-four subjects were divided into eight groups, each group having equally distributed scores on a test of field independence-dependence. Each group was then assigned to one of the eight simulator conditions. After subjects drove the simulator, a multivariate analysis of variance was performed on the data and resulted in significance for each main effect and the LAT x DEL interaction. Subsequent analyses demonstrated that dependent measures of pallor, skin resistance, respiration rate, yaw deviation, and steering reversals were each reliably sensitive to at least one of the simulator independent variables. It is concluded that future simulator designs should avoid: rotation of the platform to simulate translation, delay in the system dynamics, and complete enclosure of subjects.
Volitional Postures during Maximal Push/Pull Exertions in the Sagittal Plane
Authors: Chaffin Don B. , Andres Robert O. , Garg Arun 
Published: July 2017

A set of push/pull experiments was performed by six men and women of varying anthropometry who were asked to exert maximal one-handed and two-handed push and pull forces on a load cell set at three different heights (67, 109, and 152 cm). They were each permitted to experiment with their postures to determine that which they sensed would permit the largest push or pull force, though no direct feedback was given as to their actual performance. Once they achieved what they believed to be their optimal posture, sagittal-plane photographs were taken. The angles of major body joints were then recorded along with the isometric force produced. It is shown that foot placement, handle height, and body postures affect push and pull force capability in a manner that is reasonably logical, using biomechanical concepts. It is proposed that future biomechanical models of push an pull strengths and workplace layouts must be carefully assessed with reference to the postural variations reported.
The emergence of post-NPM initiatives: Integrated Impact Assessment as a hybrid decision-making tool
Authors: Marchand Jean-Sebastien , Brunet Maude 
Published: July 2017

Despite the criticism levelled at it, New Public Management (NPM) seems to be enduring. Post-NPM initiatives remain relatively theoretical and are slow to take root at the heart of the governmental apparatus. Integrated Impact Assessment (IIA), a tool for decision-making at national level, seems to be providing new answers. IIA has developed from NPM regulatory relief initiatives, but its objectives and effects are more in line with post-NPM principles. This article aims to explore the concept of IIA, its development and the implications of its institutionalization. A comparative analysis of IIA practice is carried out for four approaches: three at the national level (France, United Kingdom and Switzerland) and one at the supranational level (European Commission). IIA appears as a hybrid NPM and post-NPM tool, the use of which allows the implementation of certain post-NPM principles. The article concludes on future avenues for research. Points for practitioners Administrations often have to deal with issues related to evidence-based decision-making, transparency and the proliferation of statutory sectoral impact assessments. In a context of limited resources, Integrated Impact Assessment (IIA) can be an attractive solution. However, a careful analysis of its development makes it possible to better understand what its institutionalization actually implies. The practice of IIA makes it possible to systematize consultation with stakeholders, but varies according to the methods used and the administrative structures in place. IIA could serve as a decision-making tool that adds a public interest component and better reflect public values in a decision-making situation.
Diabetes prevalence, process of care and outcomes in relation to practice size, caseload and deprivation: national cross-sectional study in primary care
Authors: Millett Christopher , Car Josip , Eldred Darren , Khunti Kamlesh , Mainous Arch G , Majeed Azeem 
Published: July 2017

Objective To examine the association between practice list size, deprivation and the quality of care of patients with diabetes. Design Population-based cross-sectional study using Quality and Outcomes Framework data. Setting England and Scotland. Participants 55 522 778 patients and 8970 general practices with 1 852 762 people with diabetes. Interventions None. Main outcome measures Seventeen process and surrogate outcome measures of diabetes care. Results The prevalence of diabetes was 3.3%. Prevalence differed with practice list size and deprivation: smaller and more deprived practices had a higher mean prevalence than larger and more affluent practices (3.8% versus 2.8%). Practices with large patient list sizes had the highest quality of care scores, even after stratifying for deprivation. However, with the exception of retinal screening, peripheral pulses and neuropathy testing, differences in achievement between small and large practices were modest (<5%). Small practices performed nearly as well as the largest practices in achievement of intermediate outcome targets for HbA1c, blood pressure and cholesterol (smallest versus largest practices: 57.4% versus 58.7%; 70.7% versus 70.7%; and 69.5% versus 72.7%, respectively). Deprivation had a negative effect on the achieved scores and this was more pronounced for smaller practices. Conclusion Our study provides some evidence of a volume-outcome association in the management of diabetes in primary care; this appears most pronounced in deprived areas.
Antioxidative mechanism in the course of varicose veins
Authors: Horecka Anna , Biernacka Jadwiga , Hordyjewska Anna , Dąbrowski Wojciech , Terlecki Piotr , Zubilewicz Tomasz , Musik Irena , Kurzepa Jacek 
Published: July 2017

Objective Our objective was to evaluate the state of oxidative stress in the great saphenous varicose vein wall and blood of varicose vein patients taken from the antecubital vein. Methods The superoxide dismutase, reduced glutathione (GSH) and total antioxidant status were measured with commercially available colorimetric kits in erythrocytes, plasma and varicose vein wall of 65 patients (second degree of clinical state classification, etiology, anatomy and pathophysiology) aged 22–70 (49 women, 16 men) in comparison to normal great saphenous vein walls collected from 10 patients who underwent coronary artery bypass graft and blood collected from 20 healthy individuals. Results A statistically significant decrease (p < 0.001) in superoxide dismutase activity in erythrocytes and the increase (p < 0.05) in superoxide dismutase activity in varicose vein has been observed. There have been no significant changes in the concentration of GSH in plasma and in varicose vein. The decreased concentration of total antioxidant status in plasma (p < 0.001) and in varicose vein wall (p < 0.05) in comparison to the control has been noticed. Conclusion The varicose vein patients are affected by oxidative stress. Our results indicate impaired antioxidant defense mechanism in the blood of varicose vein patients. In contrast to the blood, an increased process of antioxidant defense in the varicose vein wall was noticed.
A randomized controlled trial of a combined self-management and exercise intervention for elderly people with osteoarthritis of the knee: the PLE2NO program
Authors: Marconcin Priscila , Espanha Margarida , Teles Júlia , Bento Paulo , Campos Pedro , André Rui , Yázigi Flávia 
Published: July 2017

Objective: To assess the effectiveness of a 12-week self-management and exercise intervention (the PLE2NO program) in elderly individuals with knee osteoarthritis. Design: Randomized controlled trial. Setting: Four different community settings. Subjects: Eighty individuals aged 60 years or older with clinical and radiographic knee osteoarthritis enrolled in the study. Intervention: A combined self-management and exercise intervention (treatment group) and an educational intervention (control group). Main measures: The primary outcomes were pain and other knee osteoarthritis symptoms (swelling, crackling, limitation on movement, and stiffness), self-management behaviors (communication with physician and cognitive symptom management), and functional lower limb strength. Secondary outcomes were knee osteoarthritis–specific health-related quality of life, self-perceived health, aerobic capacity, lower and upper limb flexibility, and handgrip strength. Results: In all, 67 participants, mean age 69.1 ± 5.8 years, completed the study: 32 in the Educational Group and 35 in the Self-Management and Exercise Group. A significant group effect favorable to the Self-Management and Exercise Group was observed in the following variables: communication with the physicians ( P = .048), aerobic capacity ( P = .035), and functional lower limb strength ( P = .015). Although no significant group effect was detected, clinical improvements in pain (31%) and knee osteoarthritis symptoms (29%) were observed in the experimental group. No improvements regarding cognitive symptom management, self-perceived health, lower limb flexibility, and handgrip strength were found. Conclusion: This study supports the importance of a combined self-management and exercise intervention to improve functional lower limb strength and aerobic capacity in a Portuguese sample. Additionally, pain and other symptoms have improved clinically.
Comparison of patient outcomes with and without stenting tube in pancreaticoduodenectomy
Authors: Bin Xiong , Lian Bai , Jianping Gong , Bin Tu 
Published: July 2017

Objective To evaluate the clinical effect of different pancreaticojejunostomy techniques in the treatment of pancreaticoduodenectomy and investigate the applicability of pancreaticojejunostomy without pancreatic duct stenting. Methods From January 2012 to December 2015, 87 patients who underwent pancreaticoduodenectomy were randomly assigned to either Group A (duct-to-mucosa anastomosis with pancreatic duct stenting, n = 43) or Group B (pancreas–jejunum end-to-side anastomosis without stenting (n = 44). The operative duration of pancreaticojejunostomy, postoperative hospital stay, and incidence of postoperative complications were compared between the two methods. Results The operative duration of pancreaticojejunostomy without use of the pancreatic duct stent was significantly shorter in Group B than in Group A (t = 7.137). The postoperative hospital stay was significantly shorter in Group B than in Group A (t = 2.408). The differences in the incidence of postoperative complications such as pancreatic fistula, abdominal bleeding, abdominal infection and delayed gastric emptying were not significantly different between the two groups (χ2 = 0.181, 0.322, 0.603, and 0.001, respectively). Conclusion Pancreaticoduodenectomy without pancreatic duct stenting is safe and reliable and can reduce the operative time and hospital stay. No significant differences were observed in the incidence of postoperative complications.
Tumor-induced disorder of iron metabolism in major organs: a new insight from chemical speciation of iron
Authors: Chen Rujie , Chen Guangcun 
Published: July 2017

Objective To investigate the evolution of iron speciation in major organs of tumor-bearing mice and its role in cancer formation and cancer-associated complications. Methods The concentration and chemical speciation of iron in the spleen, liver, lung, kidney, heart, blood, muscle, and tumor tissue of healthy mice and tumor-bearing mice were studied by synchrotron radiation-based total reflection X-ray fluorescence spectrometry (SR-TXRF) coupled with X-ray absorption spectroscopy (XAS). Results The TXRF and XAS results showed that the iron content, especially the ferritin content, significantly decreased in the blood and spleen but significantly increased in the liver, lung, and muscle of mice after tumor implantation. The chemical speciation of iron in the tumor mainly comprised ferrous-sulfide-like iron and ferritin. Conclusion The tumors disturbed the iron metabolism in major organs, and the evolution of iron may be involved in iron deficiency anemia, cancer growth, and immunity. Additionally, iron speciation-based markers may be further developed as clinical indicators for cancer and cancer-associated complications.
Manual tracking impairs postural stability in older adults
Authors: Rossiter Anna , Allsop Matthew J , Raw Rachael K , Howard Lindsay , Holt Raymond J , Wilkie Richard M , Mon-Williams Mark 
Published: July 2017

Introduction Older adults show increased postural sway and a greater risk of falls when completing activities with high cognitive demands. While dual-task approaches have clarified an association between cognitive processes and postural control, it is unclear how manual ability, which is also required for the successful completion of cognitively demanding tasks (such as putting a key into a lock), affects this relationship. Method Kinematic technology was used to explore the relationship between postural sway and manual control in healthy younger and older adults. Participants ( n = 82) remained standing to complete a visual-motor tracking task on a tablet computer. Root mean square tracking error measured manual performance, and a balance board measured deviations in centre of pressure as a marker of postural sway. Results Older adults displayed poorer manual accuracy and increased postural sway across all testing conditions. Conclusions Cognitive capacity can interact with multiple task demands, and in turn affect postural sway in older adults. Improving our understanding of factors that influence postural control will assist falls-prevention efforts and inform clinical practice.
Governing Foreign Direct Investment: Post-Enron Initiatives in India
Authors: Ahmed Waquar 
Published: July 2017

Since the initiation of the New Economic Policy in 1991, India’s power policy illustrates the crystallization of a form of situated rationality that relies on capitalist competitiveness and foreign investment for growth and development. This paper, using critical discourse analysis, examines the resettlement of the Enron/Dabhol Power Project to highlight how this situated rationality represents power/knowledge that “legitimizes” prioritization of international capital, erosion of national sovereignty, and facilitates capitalist exploitation. JEL Classification: F65
Obsessive—Compulsive Disorder and Psychosis
Authors: Ganesan Venkatasubramanian , Kumar TC Ramesh , Khanna Sumant 
Published: July 2017

Objective: To study the phenomenology, treatment, course, and outcome of patients with comorbid obsessive–compulsive disorder (OCD) and psychotic features. Method: A retrospective chart analysis was conducted on 15 patients with OCD with psychotic features. Data were collected regarding patient demographics, psychiatric diagnosis, duration of illness, treatment details, and clinically determined outcome over time. Results: Obsessive doubts, washing, and checking compulsions were the most commonly seen obsessive–compulsive (OC) symptoms. Of the patients, 53% had first-rank symptoms, and 77% showed significant improvement on treatment with a combination of antipsychotic and antiobsessional drugs. Conclusions: The observed improvement on treatment with a combination of antiobsessional and antipsychotic drugs supports the use of combination treatment in patients who have both OC and psychotic symptoms.
Validation de la version française du Health of the Nation Outcome Scales (HoNOS-F)
Authors: Lauzon Sylvie , Corbière Marc , Bonin Jean-Pierre , Bonsack Charles , Lesage Alain D , Ricard Nicole 
Published: July 2017

Objectif: L'objectif de l'étude consiste à valider la version française du questionnaire « Health of the Nation Outcome Scales-HoNOS » (HoNOS-F), instrument servant à évaluer la santé et le fonctionnement social de personnes souffrant de troubles mentaux. Méthode: La compréhension de chacun des énoncés de la version française a été vérifiée, puis le questionnaire a été administré à 3 échantillons de personnes aux prises avec des troubles mentaux graves, pour en évaluer la fidélité et la validité. Plus précisément, nous avons estimé la fiabilité sous l'angle de la cohérence interne, de la stabilité et de l'accord inter-juges, tandis que nous avons procédé à des analyses factorielles confirmatives et à la différence de moyennes selon le sexe, l'âge et le diagnostic pour vérifier respectivement la validité de construit et la validité de critères. Résultats: Les différents indices obtenus montrent que seul le score global du questionnaire lui confère une fidélité acceptable. Quant aux résultats d'analyses factorielles confirmatives, ils indiquent un non-ajustement des données empiriques aux 2 modèles proposés, soit un modèle à une dimension et un autre à 4 dimensions. La validité de critères est toutefois satisfaisante. Conclusions: Les résultats obtenus dans la présente étude de validation concordent avec ceux de la version originale anglaise qui est largement utilisée. Ainsi, sur le plan clinique, nous suggérons d'utiliser chaque énoncé du questionnaire de façon distincte sans omettre certaines caractéristiques de la personne ayant des problèmes graves de santé mentale, notamment l'âge, le sexe et le diagnostic. Dans le domaine de la recherche, nous proposons d'utiliser le score global pour l'évaluation de la santé et du fonctionnement social de la personne souffrant de troubles mentaux graves. Toutefois, nous insistons sur l'importance de rester très vigilants quant à l'interprétation du score global auprès d'une population francophone.
Serum Cholesterol Level Comparison: Control Subjects, Anxiety Disorder Patients, and Obsessive-Compulsive Disorder Patients
Authors: Peter Helmut , Hand Iver , Hohagen Fritz , Koenig Anne , Mindermann Olaf , Oeder Frank , Wittich Markus 
Published: July 2017

Objective: To determine whether panic disorder is associated with elevated serum cholesterol levels. Serum cholesterol levels of panic disorder patients are reported to be elevated. This could explain the higher-than-expected cardiovascular mortality in this population. Some evidence exists wherein cholesterol levels are also increased in patients with general anxiety disorder and phobias. To date, there are only 2 reports on cholesterol levels of obsessive-compulsive disorder (OCD) patients, giving controversial results. Method: We compared serum cholesterol levels of anxiety disorder patients, OCD patients, and normal control subjects with each other ( n = 60 in each group). Serum cholesterol was measured in each subject before treatment. Subjects of the 3 groups were matched by age and sex. Results: Patients with anxiety disorders and OCD had elevated cholesterol levels, compared with normal control subjects. Cholesterol levels in OCD patients were comparable with those in patients with phobia. Conclusions: Our data support the assumption that elevation in cholesterol level is not a specific feature of panic disorder (as most assumed), but more generally associated with anxiety disorders. Increased cholesterol levels in patients with anxiety disorders and OCD may be of clinical relevance.
Perceptions of Intimidation in the Psychiatric Educational Environment in Edmonton, Alberta
Authors: Tibbo Phil , de Gara CJ , Blake Treena M , Steinberg Carolyn , Stonehocker Brian 
Published: July 2017

Objective: To examine the perceptions of intimidation in the psychiatric educational environment in Edmonton, Alberta. Methods: We distributed a 7-point modified Likert scale questionnaire that included questions with respect to intimidation perceptions and experience in psychiatry during a 1-week period to all student interns on psychiatry rotations, residents, and teaching faculty in the 5 teaching hospitals in Edmonton. Results: A total of 92 individuals responded, with response rates of 81% for faculty, 82% for residents, and 84% for students. Response rates did not differ among sites. While there were differences between site and group with respect to comparing the perceived intimidation in psychiatry with other specialties, respondents did not view psychiatry as worse than other specialties. Although, overall, women perceived intimidation as more prevalent at their sites than did men, the overall means reflect sites that are relatively free from intimidation. Faculty and student interns within sites, except for the university hospital, tended to disagree on management's approach to perceived intimidation. All groups, however, reported little personal experience and felt their sites had little tolerance for intimidators. Conclusions: Reported perceptions and personal experiences of intimidation within the psychiatric learning environment in Edmonton are low.
Rehabilitation in the United Kingdom: Research, Policy, and Practice
Authors: Holloway Frank , Carson Jerome , Davis Sarah 
Published: July 2017

Objective: To review research, policy, and practice in psychiatric rehabilitation in the UK. Method: We undertook a literature review and review of government policy documents. Findings: Most individuals with severe, disabling mental illnesses are cared for by generic community mental health services under the Care Programme Approach (CPA). Current government policy requires the introduction of assertive outreach and early psychosis services and is highly consistent with the adoption of the recovery paradigm within UK mental health services. Research and development activities have demonstrated the success of the UK hospital-closure program and have contributed to the worldwide resurgence of interest in psychosocial interventions in psychosis. Conclusions: A need remains to focus research and practice on those who are most disabled by their illnesses and to improve the skills of the workforce in psychosocial interventions.
Mental Health Reform and Evolution of General Psychiatry in Ontario
Authors: Swenson John Robert , Bradwejn Jacques 
Published: July 2017

Objectives: To discuss developments in Ontario mental health reform, describe general psychiatric services in contrast to tertiary services, describe guidelines for the training of general psychiatrists, and suggest what changes may be required to develop an integrated mental health system (IMHS). Method: We review the Ontario government's recent blueprint for mental health reform and the Canadian federal government's document on best practices in psychiatry, in the context of defining general psychiatric services and their relation to tertiary services. From this, we consider the education of general psychiatrists and make suggestions for their training. Results: General psychiatric services correspond to first-line and intensive psychiatric services delivered by community mental health agencies, community psychiatrists, and general hospitals for patients with moderate or serious mental illness. Many suggest that psychiatrists are not being trained to meet the needs of a reformed mental health system. An education program for general psychiatrists should include training in a wide range of community and general hospital settings, work within a multidisciplinary mental health team, and experience working in a shared care model with family physicians. Conclusions: Along with training general psychiatrists better, we must also develop recruitment and payment incentives, which would allow general psychiatrists who are based in the community and general hospitals to work within an IMHS.