bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of gout on patient’s lives: a study of African-American and Caucasian men and women with gout
Authors: Singh Jasvinder A
Published: June 2014

Introduction

The aim of this study was to examine the impact of gout on quality of life (QOL) and study differences by gender and race.

Methods

Ten race- and sex-stratified nominal groups were conducted, oversampling for African-Americans and women with gout. Patients presented, discussed, combined and rank-ordered their concerns.

Results

A total of 62 patients with mean age 65.1 years, 60% men, 64% African-American, participated in 10 nominal groups: African-American men (n = 23; 3 groups); African-American women (n = 18; 3 groups); Caucasian men (n = 15; 3 groups); and Caucasian women (n = 6; 1 group). The most frequently cited high-ranked concerns among the ten nominal groups were: (1) effect of gout flare on daily activities (n = 10 groups); (2) work disability (n = 8 groups); (3) severe pain (n = 8 groups); (4) joint swelling and tenderness (n = 6 groups); (5) food restrictions (n = 6 groups); (6) medication related issues (n = 6 groups); (7) dependency on family and others (n = 5 groups); (8) emotional Impact (n = 5 groups); (9) interference with sexual function (n = 4 groups); (10) difficulty with shoes (n = 4 groups); and (11) sleep disruption (n = 4 groups). Compared with men, women ranked the following concerns high more often: problems with shoes (n = 4 versus n = 0 groups); dependency (n = 3 versus n = 2 groups); and joint/limb deformity (n = 2 versus n = 0 group). Compared with Caucasians, African-Americans ranked the following concerns high more often: dietary restrictions (n = 6 versus n = 0 groups); severe pain (n = 6 versus n = 2 groups); gout bringing the day to a “halt” (n = 2 versus n = 0 group); effect on emotional health (n = 4 versus n = 1 groups); and the need for canes/crutches during flares (n = 2 versus n = 0 group).

Conclusions

Gout has a significant impact on a patient’s QOL. Important differences in the impact of gout by gender and race were noted.
Persistent inflammation and T cell exhaustion in severe sepsis in the elderly
Authors: Inoue Shigeaki , Suzuki Kodai , Komori Yukako , Morishita Yukiko , Suzuki-Utsunomiya Kyoko , Hozumi Katsuto , Inokuchi Sadaki , Sato Takehito
Published: June 2014

Introduction

Sepsis is known as a complex immunological response with hyperinflammation in the acute phase followed by immunosuppression. Although aging is crucial in sepsis, the impact of aging on inflammation and immunosuppression is still unclear. The purpose of this study was to investigate the relationship between inflammation and immunosuppression in aged patients and mice after sepsis.

Methods

Fifty-five patients with severe sepsis and 30 healthy donors were prospectively enrolled, and 90-day survival was compared between elderly (≥65 years) and adult (18–64 years) septic patients with serial measurement of serum interleukin (IL)-6. Within 24 h after diagnosis of severe sepsis, peripheral blood mononuclear cells were stimulated ex vivo to measure expression of the activation maker CD25 in T cells, IL-2 levels in the supernatant, and proliferation. In the mouse study, young (6–8 weeks) and aged (20–22 months) C57/B6 mice were subjected to cecal ligation and puncture (CLP), and survival was compared after 7 days with serial measurement of serum IL-6. Expression of the negative co-stimulatory molecules, CD25, and IL-2 in CD4+ T cells was measured.

Results

The survival rate in elderly sepsis patients and aged septic mice was significantly lower than that in adult patients and young septic mice (60% vs. 93% in septic patients, 0% vs. 63% in septic mice, P < 0.05). Serum IL-6 levels in elderly sepsis patients and aged septic mice were persistently higher than those in adult patients and young septic mice. Expression of negative co-stimulatory molecules in CD4+ T cells in the spleen, lymph nodes, and peripheral blood was significantly higher in aged mice than in young mice (P < 0.01). Ex vivo stimulation decreased CD25 expression, IL-2 production, and proliferation to a greater extent in CD4+ T cells from elderly patients and aged septic mice than in those from adult patients and young septic mice. Elderly patients demonstrated increased detection of gram-negative bacteria at days 14–16 and 28–32 after sepsis (P < 0.05).

Conclusions

Persistent inflammation and T cell exhaustion may be associated with decreased survival in elderly patients and mice after sepsis.
Credit off-take from formal financial institutions in rural India: quantile regression results
Authors: Pal Debdatta , Laha Arnab Kumar
Published: June 2014

Extending financial services to unbanked population in India has remained a central part of the policy thrust of the Indian government for decades. To that effect, a widespread formal credit delivery mechanism has been established to meet the credit requirements of rural communities. However, the Indian government-backed formal financial sector has had limited success in providing resources to poor rural households, which has led to strong criticism of the policy and its implementation. In this study, we use data from 600 rural households spread across six Indian states to examine the changing distribution of credit off-take among borrowers of formal financial institutions. By using quantile regression, we find that even among rural households that could access loans from the formal banking sector, the distribution of credit off-take is skewed towards resource-rich households. We also find that even among borrowers in the upper quantiles of the conditional loan distribution, marginal farmers received substantially less loan amounts than those belonging to the category of medium and large farmers.

JEL classifications

C31, Q14
Combining Targeted Therapy With Immunotherapy in BRAF-Mutant Melanoma: Promise and Challenges
Authors: Hu-Lieskovan Siwen , Robert Lidia , Homet Moreno Blanca , Ribas Antoni
Published: June 2014

Recent breakthroughs in the treatment of advanced melanoma are based on scientific advances in understanding oncogenic signaling and the immunobiology of this cancer. Targeted therapy can successfully block oncogenic signaling in BRAFV600-mutant melanoma with high initial clinical responses, but relapse rates are also high. Activation of an immune response by releasing inhibitory check points can induce durable responses in a subset of patients with melanoma. These advances have driven interest in combining both modes of therapy with the goal of achieving high response rates with prolonged duration. Combining BRAF inhibitors and immunotherapy can specifically target the BRAFV600 driver mutation in the tumor cells and potentially sensitize the immune system to target tumors. However, it is becoming evident that the effects of paradoxical mitogen-activated protein kinase pathway activation by BRAF inhibitors in non–BRAF-mutant cells needs to be taken into account, which may be implicated in the problems encountered in the first clinical trial testing a combination of the BRAF inhibitor vemurafenib with ipilimumab (anti-CTLA4), with significant liver toxicities. Here, we present the concept and potential mechanisms of combinatorial activity of targeted therapy and immunotherapy, review the literature for evidence to support the combination, and discuss the potential challenges and future directions for rational conduct of clinical trials.
Abbreviated Breast Magnetic Resonance Imaging (MRI): First Postcontrast Subtracted Images and Maximum-Intensity Projection—A Novel Approach to Breast Cancer Screening With MRI
Authors: Kuhl Christiane K. , Schrading Simone , Strobel Kevin , Schild Hans H. , Hilgers Ralf-Dieter , Bieling Heribert B.
Published: June 2014

Purpose

We investigated whether an abbreviated protocol (AP), consisting of only one pre- and one postcontrast acquisition and their derived images (first postcontrast subtracted [FAST] and maximum-intensity projection [MIP] images), was suitable for breast magnetic resonance imaging (MRI) screening.

Methods

We conducted a prospective observational reader study in 443 women at mildly to moderately increased risk who underwent 606 screening MRIs. Eligible women had normal or benign digital mammograms and, for those with heterogeneously dense or extremely dense breasts (n = 427), normal or benign ultrasounds. Expert radiologists reviewed the MIP image first to search for significant enhancement and then reviewed the complete AP (consisting of MIP and FAST images and optionally their nonsubtracted source images) to characterize enhancement and establish a diagnosis. Only thereafter was the regular full diagnostic protocol (FDP) analyzed.

Results

MRI acquisition time for FDP was 17 minutes, versus 3 minutes for the AP. Average time to read the single MIP and complete AP was 2.8 and 28 seconds, respectively. Eleven breast cancers (four ductal carcinomas in situ and seven invasive cancers; all T1N0 intermediate or high grade) were diagnosed, for an additional cancer yield of 18.2 per 1,000. MIP readings were positive in 10 (90.9%) of 11 cancers and allowed establishment of the absence of breast cancer, with a negative predictive value (NPV) of 99.8% (418 of 419). Interpretation of the complete AP, as with the FDP, allowed diagnosis of all cancers (11 [100%] of 11). Specificity and positive predictive value (PPV) of AP versus FDP were equivalent (94.3% v 93.9% and 24.4% v 23.4%, respectively).

Conclusion

An MRI acquisition time of 3 minutes and an expert radiologist MIP image reading time of 3 seconds are sufficient to establish the absence of breast cancer, with an NPV of 99.8%. With a reading time < 30 seconds for the complete AP, diagnostic accuracy was equivalent to that of the FDP and resulted in an additional cancer yield of 18.2 per 1,000.
Human Papillomavirus and Overall Survival After Progression of Oropharyngeal Squamous Cell Carcinoma
Authors: Fakhry Carole , Zhang Qiang , Nguyen-Tan Phuc Felix , Rosenthal David , El-Naggar Adel , Garden Adam S. , Soulieres Denis , Trotti Andy , Avizonis Vilija , Ridge John Andrew , Harris Jonathan , Le Quynh-Thu , Gillison Maura
Published: June 2014

Purpose

Risk of cancer progression is reduced for patients with human papillomavirus (HPV) –positive oropharynx cancer (OPC) relative to HPV-negative OPC, but it is unknown whether risk of death after progression is similarly reduced.

Patients and Methods

Patients with stage III-IV OPC enrolled onto Radiation Therapy Oncology Group trials 0129 or RTOG 0522 who had known tumor p16 status plus local, regional, and/or distant progression after receiving platinum-based chemoradiotherapy were eligible for a retrospective analysis of the association between tumor p16 status and overall survival (OS) after disease progression. Rates were estimated by Kaplan-Meier method and compared by log-rank; hazard ratios (HRs) were estimated by Cox models. Tests and models were stratified by treatment protocol.

Results

A total of 181 patients with p16-positive (n = 105) or p16-negative (n = 76) OPC were included in the analysis. Patterns of failure and median time to progression (8.2 v 7.3 months; P = .67) were similar for patients with p16-positive and p16-negative tumors. After a median follow-up period of 4.0 years after disease progression, patients with p16-positive OPC had significantly improved survival rates compared with p16-negative patients (2-year OS, 54.6% v 27.6%; median, 2.6 v 0.8 years; P < .001). p16-positive tumor status (HR, 0.48; 95% CI, 0.31 to 0.74) and receipt of salvage surgery (HR, 0.48; 95% CI; 0.27 to 0.84) reduced risk of death after disease progression whereas distant versus locoregional progression (HR, 1.99; 95% CI, 1.28 to 3.09) increased risk, after adjustment for tumor stage and cigarette pack-years at enrollment.

Conclusion

Tumor HPV status is a strong and independent predictor of OS after disease progression and should be a stratification factor for clinical trials for patients with recurrent or metastatic OPC.
Calcium, Vitamin D, Dairy Products, and Mortality Among Colorectal Cancer Survivors: The Cancer Prevention Study-II Nutrition Cohort
Authors: Yang Baiyu , McCullough Marjorie L. , Gapstur Susan M. , Jacobs Eric J. , Bostick Roberd M. , Fedirko Veronika , Flanders W. Dana , Campbell Peter T.
Published: June 2014

Purpose

Higher calcium, vitamin D, and dairy product intakes are associated with lower colorectal cancer incidence, but their impacts on colorectal cancer survival are unclear. We evaluated associations of calcium, vitamin D, and dairy product intakes before and after colorectal cancer diagnosis with all-cause and colorectal cancer-specific mortality among colorectal cancer patients.

Patients and Methods

This analysis included 2,284 participants in a prospective cohort who were diagnosed with invasive, nonmetastatic colorectal cancer after baseline (1992 or 1993) and up to 2009. Mortality follow-up was through 2010. Prediagnosis risk factor information was collected on the baseline questionnaire. Postdiagnosis information was collected via questionnaires in 1999 and 2003 and was available for 1,111 patients.

Results

A total of 949 participants with colorectal cancer died during follow-up, including 408 from colorectal cancer. In multivariable-adjusted Cox proportional hazards regression models, postdiagnosis total calcium intake was inversely associated with all-cause mortality (relative risk [RR] for those in the highest relative to the lowest quartiles, 0.72; 95% CI, 0.53-0.98; Ptrend = .02) and associated with marginally statistically significant reduced colorectal cancer-specific mortality (RR, 0.59; 95% CI, 0.33 to 1.05; Ptrend = .01). An inverse association with all-cause mortality was also observed for postdiagnosis milk intake (RR, 0.72; 95% CI, 0.55 to 0.94; Ptrend = .02), but not vitamin D intake. Prediagnosis calcium, vitamin D, and dairy product intakes were not associated with any mortality outcomes.

Conclusion

Higher postdiagnosis intakes of total calcium and milk may be associated with lower risk of death among patients with nonmetastatic colorectal cancer.
Macrophages modulate adult zebrafish tail fin regeneration
Authors: Petrie Timothy A. , Strand Nicholas S. , Tsung-Yang Chao , Rabinowitz Jeremy S. , Moon Randall T.
Published: June 2014

Neutrophils and macrophages, as key mediators of inflammation, have defined functionally important roles in mammalian tissue repair. Although recent evidence suggests that similar cells exist in zebrafish and also migrate to sites of injury in larvae, whether these cells are functionally important for wound healing or regeneration in adult zebrafish is unknown. To begin to address these questions, we first tracked neutrophils (lyzC+, mpo+) and macrophages (mpeg1+) in adult zebrafish following amputation of the tail fin, and detailed a migratory timecourse that revealed conserved elements of the inflammatory cell response with mammals. Next, we used transgenic zebrafish in which we could selectively ablate macrophages, which allowed us to investigate whether macrophages were required for tail fin regeneration. We identified stage-dependent functional roles of macrophages in mediating fin tissue outgrowth and bony ray patterning, in part through modulating levels of blastema proliferation. Moreover, we also sought to detail molecular regulators of inflammation in adult zebrafish and identified Wnt/β-catenin as a signaling pathway that regulates the injury microenvironment, inflammatory cell migration and macrophage phenotype. These results provide a cellular and molecular link between components of the inflammation response and regeneration in adult zebrafish.
Heterogeneity and plasticity of epidermal stem cells
Authors: Schepeler Troels , Page Mahalia E. , Jensen Kim B.
Published: June 2014

The epidermis is an integral part of our largest organ, the skin, and protects us against the hostile environment. It is a highly dynamic tissue that, during normal steady-state conditions, undergoes constant turnover. Multiple stem cell populations residing in autonomously maintained compartments facilitate this task. In this Review, we discuss stem cell behaviour during normal tissue homeostasis, regeneration and disease within the pilosebaceous unit, an integral structure of the epidermis that is responsible for hair growth and lubrication of the epithelium. We provide an up-to-date view of the pilosebaceous unit, encompassing the heterogeneity and plasticity of multiple discrete stem cell populations that are strongly influenced by external cues to maintain their identity and function.
Gene expression profiling identifies the zinc-finger protein Charlatan as a regulator of intestinal stem cells in Drosophila
Authors: Amcheslavsky Alla , Nie Yingchao , Li Qi , He Feng , Tsuda Leo , Markstein Michele , Ip Y. Tony
Published: June 2014

Intestinal stem cells (ISCs) in the adult Drosophila midgut can respond to tissue damage and support repair. We used genetic manipulation to increase the number of ISC-like cells in the adult midgut and performed gene expression profiling to identify potential ISC regulators. A detailed analysis of one of these potential regulators, the zinc-finger protein Charlatan, was carried out. MARCM clonal analysis and RNAi in precursor cells showed that loss of Chn function caused severe ISC division defects, including loss of EdU incorporation, phosphorylated histone 3 staining and expression of the mitotic protein Cdc2. Loss of Charlatan also led to a much reduced histone acetylation staining in precursor cells. Both the histone acetylation and ISC division defects could be rescued by the simultaneous decrease of the Histone Deacetylase 2. The overexpression of Charlatan blocked differentiation reversibly, but loss of Charlatan did not lead to automatic differentiation. The results together suggest that Charlatan does not simply act as an anti-differentiation factor but instead functions to maintain a chromatin structure that is compatible with stem cell properties, including proliferation.
Amyloid precursor protein and neural development
Authors: Nicolas Maya , Hassan Bassem A.
Published: June 2014

Interest in the amyloid precursor protein (APP) has increased in recent years due to its involvement in Alzheimer's disease. Since its molecular cloning, significant genetic and biochemical work has focused on the role of APP in the pathogenesis of this disease. Thus far, however, these studies have failed to deliver successful therapies. This suggests that understanding the basic biology of APP and its physiological role during development might be a crucial missing link for a better comprehension of Alzheimer's disease. Here, we present an overview of some of the key studies performed in various model organisms that have revealed roles for APP at different stages of neuronal development.
The DEP domain-containing protein TOE-2 promotes apoptosis in the Q lineage of C. elegans through two distinct mechanisms
Authors: Gurling Mark , Talavera Karla , Garriga Gian
Published: June 2014

Neuroblast divisions in the nematode Caenorhabditis elegans often give rise to a larger neuron and a smaller cell that dies. We have previously identified genes that, when mutated, result in neuroblast divisions that generate daughter cells that are more equivalent in size. This effect correlates with the survival of daughter cells that would normally die. We now describe a role for the DEP domain-containing protein TOE-2 in promoting the apoptotic fate in the Q lineage. TOE-2 localized at the plasma membrane and accumulated in the cleavage furrow of the Q.a and Q.p neuroblasts, suggesting that TOE-2 might position the cleavage furrow asymmetrically to generate daughter cells of different sizes. This appears to be the case for Q.a divisions where loss of TOE-2 led to a more symmetric division and to survival of the smaller Q.a daughter. Localization of TOE-2 to the membrane is required for this asymmetry, but, surprisingly, the DEP domain is dispensable. By contrast, loss of TOE-2 led to loss of the apoptotic fate in the smaller Q.p daughter but did not affect the size asymmetry of the Q.p daughters. This function of TOE-2 required the DEP domain but not localization to the membrane. We propose that TOE-2 ensures an apoptotic fate for the small Q.a daughter by promoting asymmetry in the daughter cell sizes of the Q.a neuroblast division but by a mechanism that is independent of cell size in the Q.p division.
Structural and functional condition of the left departments of heart in the patients with bronchial asthma
Authors: Ищенко  , Ishchenko O. , Демко  , Demko I. , Рязанова  , Ryazanova N. , Крапошина  , Kraposhina A. , Собко  , Sobko E. , Соловьева  , Solovyeva Inna , Хендогина  , Khendogina V.
Published: June 2014

The purpose of the research was studying of clinical and diagnostic value of bronchial obstruction, hypoxemia, as well structural and functional condition of the left departments of heart in the patients with middle and severe degree of bronchial asthma. This research had prospective open design. Assessment of cardiac remodeling was carried out by means of the echocardiography with color Doppler mapping in period of exacerbation and after 12 months. Indicators of function of external respiration were estimated by means of the spirography and the bodyplethismography at the same periods. According to research data, it was revealed that with the severity of asthma is increasing the size of the left atrium and a decrease in the ratio of the AO/LA. The importance of early identification of a hypertrophy of a left ventricle in the patients with severe bronchial asthma is bound to the fre-quency of accompanying cardiac pathology and the correlation between hypertrophy of a left ventricle and the subsequent adverse clinical course of cardiovascular diseases. In patients with bronchial asthma parallel to the severity of the disease are formed changes of structural and functional state of myocardium of the left ventricle, causing diastolic dysfunction. The most significant risk factors in the formation of diastolic dysfunction of the left ventricle in patients with bronchial asthma are bronchial obstruction and hypoxemia.
Regional of medico-demographic processes in the Tver region
Authors: Степанова  , Stepanova Yu. , Петров  , Petrov V. , Рыбакова  , Rybakova M. , Королюк  , Korolyuk Ekaterina , Жуков  , Zhukov Sergey , Зайцева  , Zaytseva A.
Published: June 2014

To prevent the depopulation of indigenous people in the Tver region the dynamics of demographic processes from 1986 for 2012 was studied. Official data of Ministry of Health of the Tver region were used. The slowdown in the decrease of the population in Tver compared with the Tver region was identified. This is due to the replacement of labour migration. The region is characterized by the low level of birth and a high level of mortality including children´s and infantile. At the same time the tendency of approximation of medico-demographic indicators for national values is observed. In recent years, reducing child mortality from preventable causes is noted. According to revealed negative tendencies, the authors have developed and implemented interdepartmental medical-social model of prevention of reduction of the level of health in children in conditions of chronic social stress. To realize this model, the correctional and improving program for prophylaxis of risk of decreasing of health level in the children is offered. The program consists of two blocks: medical block is aimed at achieving the optimal level of the energy metabolism of the child; socio-psychological block - at improving the social adaptation of the child. The program is designed for physicians in primary care.
Comparative characteristics of microflora root dentine at the use of different variants of medicamentous treatment of root canals
Authors: Беленова  , Belenova I. , Красичкова  , Krasichkova Olga
Published: June 2014

Application of ultrasonic treatment combined with conventional methods of endodontic treatment contributes to reduce the cases of relapses and the time of treatment, and causes the highest economic effect. The proposed method allows to successfully treating chronic granulating periodontitis and to save the need for prosthetics abutment teeth. The purpose of this study is to increase the effectiveness of treatment of granulating periodontitis by optimizing antiseptic treatment of root canals by means of ultrasound. In a series of studies the material of the examination and treatment of patients in the therapeutic department «Lipetsk municipal dental polyclinic №2» was examined. The basis for receiving scientific data – contingent of 127 patients from 26 to 51 years with granulating form of chronic periodontitis, of these were 83 women and 44 men. Depending on the tactics of the treatment the patients were divided into two groups: the 1st group – 43 patients who were treated by the traditional method of treatment of periodontitis; the 2nd group – 84 persons were treated by means of ultrasound. Clinical examination of patients included visual diagnostics, sensing, thermometry, percussion, determination of conductivity of the tooth pulp, radiovisiographic and x-ray study. It is established, that after use of a 3% solution of sodium hypochlorite the changes are observed not qualitative composition of the microflora, but quantitative. The methods of ultrasonic treatment of chronic granulating periodontitis are developed. The ultrasound effect on the microflora of each root channel is conducted during 30 seconds with the frequency of 30 kHz. The structure of the dentin of the root canal with the help of scanning electronic microscopy, before and after the influence of ultrasound is studied and described. After exposure to 3% of sodium hypochlorite, activated by ultrasound, on the wall of the root canal by granulating periodontitis the growth of microorganisms didn’t revealed in 94,8% of cases.
Computer technologies for the analysis of errors and complications of dental implant
Authors: Петров  , Petrov A. , Петров  , Petrov Igor , Ипполитов  , Ippolitov Yuriy , Бут  , But L.
Published: June 2014

The article is devoted to the problems of errors and complications during dental implantation, which is widespread in the last decade. The need for dental implantation is constantly growing, it requires improvement of this type of specialized treatment. However, today there is an incorrect view of the simplicity and availability of dental operations for a wide range of dentists. It is the cause of different conflicts between doctor and patient due to various stages of treatment of complications. One of the ways of problem solution is detailed and objective study of the errors of complications and failures of dental implantation. In this regard, the authors have developed a computer database, which allows to collect information about various errors and complications of implant treatment for detailed and objective of their study and discussion with students and physicians-participants of the courses of additional professional education. The algorithm and computer subprogram for analysis of errors and complications of dental implantation is based on modern classification, which includes a section of intraoperative complications, early postoperative and late postoperative complications and complications associated with prosthetics and complications that may arise during the functioning of the implants.
Pragmatism, Practice, and the Boundaries of Organization
Authors: Whitford Josh , Zirpoli Francesco
Published: June 2014

This article uses a longitudinal qualitative analysis of key transitions in the relationship between Fiat Group Automobiles and a major supplier to integrate a pragmatist model of action into the contemporary “practice” approach to the study of organizations. It builds on an affinity between pragmatist and practice approaches that has been widely recognized but has not yet been fully developed with reference to an empirical case. It argues that an analytic reliance on a pragmatist conception of agency improves on the more general reliance in studies of organizational practice on a conception of the agent imported from Giddens’ structuration theory [Giddens A (1984) The Constitution of Society: Outline of the Theory of Structuration (Polity Press, Cambridge, UK)]. The argument is developed with reference to a long-standing debate in organization theory—the debate over the determinants of organizational boundaries—that has grown in importance as companies have responded to market and technological volatility by involving suppliers not just in the production but also in the conceptualization and design of the products they sell. It provides a theoretical framework that can help analyze the place of managerial agency in organizational strategy making and explain why organizational boundaries in many industries today are so unsettled and contested and are likely to remain so in the future.
Inadvertent peri-operative hypothermia: guidance and protecting patients
Authors: John Martin , Harper Mark
Published: June 2014

Inadvertent peri-operative hypothermia is a complication of surgery which is associated with significant patient morbidity, with indirect consequences to hospital efficiency and resource burden. Despite increased awareness and the expansion of new warming equipment, peri-operative hypothermia remains a persistent problem. This review aims to provide a brief overview of the mechanisms and consequences of inadvertent peri-operative hypothermia as well as the salient features of recent guidelines that aim to protect patients.
Efficiency and perceptions of cost in healthcare
Authors: Dickson John K , Bulley Simon , Oliver David
Published: June 2014

Are patients and healthcare professionals able to estimate the costs involved in delivering healthcare? Could a better awareness help to improve efficiency and effectiveness? This questionnaire-based study assessed whether those who deliver and those who receive healthcare are able to estimate the costs involved. The questionnaire asked the participants to estimate the costs for various items of healthcare. Of the 200 questionnaires distributed 122 were returned. An estimate that was either 5% above or below the actual price was accepted as being correct. Overall, 65% of responses were underestimates, 30% of responses were overestimates and 5% were correct. Overall, there was a highly significant trend towards underestimating costs. The proportion of over and under-estimates was similar between the different groups (doctors, nurses, other healthcare professionals and patients).
DNA rates in outpatient physiotherapy
Authors: Smith Benjamin E , Bateman Marcus
Published: June 2014

Missed hospital appointments (DNA: did not attend) are a large problem for the NHS, costing up to £745 million a year. The national rate is 9.1% and the aim of this audit was to compare traditional appointment booking methods in a physiotherapy outpatient setting with two new methods. DNAs were analysed over a six-month period using traditional methods vs choice booking for follow-up appointments, and vs choose and book for new appointments.
Providing care services to people affected by Huntington's disease: an overview of the challenges
Authors: Wilson Eleanor , Pollock Kristian , Aubeeluck Aimee
Published: June 2014

Huntington's disease (HD) is a complex neurodegenerative genetic condition that affects motor, cognitive and behavioural functioning ( Quarrell, 1999 ; Walker, 2007 ). Caring for people affected by HD is challenging, complex and requires multidisciplinary as well as patient and family input. In the UK the initial focus on neurology brought about by the introduction of the National Service Framework for Long-term Conditions ( Department of Health (DH), 2005 ) has been renewed by concerns that the framework has not been adequately implemented. In addition, there remains insufficient data to assess the effectiveness of services or provide evidence of best practice for people with neurological conditions. However, current research in this area can provide insight into care provision.
Research Roundup
Authors: Eberhardie Christine
Published: June 2014

Christine Eberhardie provides a synopsis and brief review of a selection of recently published research articles of interest to neuroscience nurses, highlighting the key points to keep you up to date. A full reference is provided for those who wish to read the research in more detail.
Practical tips for promoting continence in the care home
Authors: Vickerman Julie
Published: June 2014

It is not inevitable that incontinence occurs with old age, however, older people are more likely to experience problems that affect toileting, such as impaired mobility. Julie Vickerman explains how staff can encourage residents to void independently
The role of animal models in tendon research
Authors: Hast M. W. , Zuskov A. , Soslowsky L. J.
Published: June 2014

Tendinopathy is a debilitating musculoskeletal condition which can cause significant pain and lead to complete rupture of the tendon, which often requires surgical repair. Due in part to the large spectrum of tendon pathologies, these disorders continue to be a clinical challenge. Animal models are often used in this field of research as they offer an attractive framework to examine the cascade of processes that occur throughout both tendon pathology and repair. This review discusses the structural, mechanical, and biological changes that occur throughout tendon pathology in animal models, as well as strategies for the improvement of tendon healing.

Cite this article: Bone Joint Res 2014;3:193–202.
‘Dieu et le sexe. Le pur et l’impur’: Concilier l’Islam et l’homosexualité chez Rachid O. et Abdellah Taïa
Authors: Ncube Gibson
Published: June 2014

Although homosexuality is palpably present in Arab-Muslim societies of the Maghreb, there is nonetheless intolerance of their open discussion. Even on a purely discursive level, taboo remains an insurmountable hurdle. The present study attempts to contribute to growing debate and interest in various aspects and potential common points between literary production and ‘marginal’ sexuality in Francophone North Africa. This article problematizes homosexuality in Arab-Muslim societies before examining its depiction in the autofictional novels of two openly gay Moroccan writers: Rachid O. and Abdellah Taïa. Of particular interest in this literary analysis is the manner in which the protagonists of the two novelists grapple in reconciling their (homo)sexuality and their religious beliefs. This article concludes by scrutinizing the transgressiveness of these pioneering contemporary novels in their candid and open representation homosexuality.

Bien que l’homosexualité soit manifestement présente dans les sociétés arabo-musulmanes du Maghreb, sa discussion ouverte demeure intolérable. Même sur un plan purement discursif, le tabou reste un obstacle insurmontable. La présente étude vise à contribuer au débat et à l’intérêt croissants par rapport aux divers aspects et aux points communs potentiels entre la production littéraire et la sexualité ‘marginale’ dans les milieux francophones de l’Afrique du Nord. Cet article problématise initialement l’homosexualité dans les sociétés arabo-musulmanes avant d’examiner sa représentation dans les romans autofictionnels de deux écrivains marocains qui sont ouvertement gay: Rachid O. et Abdellah Taïa. L’intérêt particulier de cette analyse littéraire sera la manière dont les protagonistes des deux romanciers se négocient la difficulté de concilier leur (homo)sexualité et leurs croyances religieuses. Cet article examine, en guise de conclusion, la nature transgressive de ces romans contemporains pionniers dans leur représentation franche et ouverte de l’homosexualité.
Review Article
Authors: Arnold Markus
Published: June 2014

Géo/Graphies postcoloniales. La Poétique de l’espace dans le roman mauricien et sénégalais, Antje Ziethen (2013) Trier: WVT Wissenschaftlicher Verlag Trier, 172 pp., ISBN: 9783868214260, 25€
Bem-Estar e Educação pela Arte
Authors: Pereira Rui Penha
Published: June 2014

De 6 a 9 de Março de 2006, teve lugar em Lisboa a Conferência Mundial sobre Educação Artística, sob os auspícios da UNESCO. Aproveitando este evento e com o fim de lançar um importante contributo para a discussão das bases da educação artística em Portugal, seguiu-se-lhe a Conferência Nacional de Educação Artística que decorreu de 29 a 31 de Outubro de 2007, no Porto, numa promoção conjunta dos Ministérios da Educação e da Cultura. De alguns documentos destas conferências ressalta a ênfase dada à criatividade artística, como elemento justificador da educação pela arte. No entanto, argumento aqui que a criatividade talvez não seja o conceito merecedor da maior centralidade, mesmo na educação pela arte, contrapondo-lhe o conceito de bem-estar. Aponto também como desenvolvimento natural do bem-estar no processo educativo, o “desinteresse” tal como interpretado na filosofia de Emmanuel Levinas. Argumento ainda que a arte parece ter de facto particularidades que podem facilitar um ambiente ético permeado por este “desinteresse” Levinasiano, não obstante o facto de tal ser igualmente possível no ensino de qualquer outro tópico. Tal deve-se ao facto de pugnar aqui pela centralidade do “processo” na educação, apontando-se o “produto” como do interesse do mais simples e restrito processo instrutivo. Finalmente, como exemplo paradigmático de uma rede de instrução pela arte onde é possível contrastar os elementos acima debatidos, refiro-me às mais de setecentas Associações Filarmónicas portuguesas, espalhadas pelo continente e ilhas.
O consumo de cannabis na adolescência: dados de um estudo português
Authors: Fonseca A. C.
Published: June 2014

O objectivo deste artigo é proceder a uma caracterização do consumo de cannabis durante a adolescência, bem como das suas consequências a médio prazo, na vida dos indivíduos. Utilizaram-se, para tal, dados de um estudo longitudinal, em que várias centenas de alunos portugueses do ensino básico foram seguidas, desde a infância até aos últimos anos da adolescência, e avaliadas em vários domínios do seu funcionamento. No geral, os resultados mostraram que o consumo de cannabis é uma prática rara, no fim da infância e início da adolescência; vai aumentando regularmente com a idade; apresenta uma estabilidade temporal fraca ou moderada; e aparece associado a outras formas de consumo de droga lícita. Todavia, este tipo de conduta não parece comprometer seriamente o desempenho escolar, nem aumentar o risco de futuros problemas de saúde mental, no fim da adolescência. O único domínio em que os consumidores de cannabis apresentavam, posteriormente, mais problemas era o dos comportamentos anti-sociais e do consumo de outras drogas. Finalmente, não se encontrou qualquer diferença significativa entre o consumo de início precoce e o consumo de início tardio. Estes resultados são discutidos à luz dos últimos desenvolvimentos na investigação do consumo de cannabis durante a adolescência.
Função de Acompanhamento da Inspecção-Geral da Educação: Percepções de Educadores de Infância
Authors: Fonseca Ana Rita , Damião Maria Helena , Nascimento Maria Augusta
Published: June 2014

Apresenta-se um estudo que incide na Inspecção no âmbito da Educação Pré-Escolar, e como qual se procurou conhecer as percepções que os educadores de infância têm da função e da actuação desta entidade, mais concretamente ao nível da actividade Gestão Curricular e Integração de Alunos da Educação Pré-Escolar e do 1º. Ciclo. Tal estudo, que recorreu predominantemente a uma abordagem quantitativa, apoiou-se num questionário construído para o efeito e envolveu 105 educadores de infância, de 15 Agrupamentos de Escolas intervencionados pela Inspecção. Os resultados obtidos revelam que, globalmente, estes docentes caracterizam a actuação da Inspecção como sendo predominantemente de Acompanhamento, valorizando, na actuação desta entidade, a atenção prestada aos documentos de Planificação da Acção Educativa e aos aspectos relativos à Gestão do Currículo. Contudo, denotam reservas relativamente à utilidade da informação disponibilizada no Relatório Síntese da Inspecção, no sentido da melhoria dos aspectos referidos.
Competências do século XXI, transição para o Ensino Superior e sucesso académico: Estudo do nível de proficiência linguística em Inglês e Português dos estudantes do 1º ano da Universidade de Coimbra
Authors: Soares Andreia Martins , Pereira Marco Daniel de Almeida , Canavarro José Manuel Albuquerque Portocarrero
Published: June 2014

Entre as “competências do século XXI”, um dos termos mais ubíquos dos debates internacionais sobre Educação, o domínio das línguas materna e estrangeiras, particularmente do Inglês, é apontado como indispensável para uma comunicação perspícua numa aldeia-global (a sociedade sem fronteiras e interdependente deste século). Estudos realizados com alunos do Ensino Superior português têm demonstrado lacunas nas competências linguístico-comunicativas, na sua língua materna e no Inglês, situação que limita o acesso e a produção de conhecimento e a mobilidade e compromete o sucesso académico e profissional. O presente artigo visa a divulgação e a reflexão sobre os dados obtidos na aferição da proficiência em Inglês e em Português dos alunos do primeiro ano da Universidade de Coimbra do ano lectivo 2007/2008, a fim de conhecer a proficiência linguística da amostra, a variabilidade desta variável em função de algumas características sociodemográficas e relativas ao perfil do estudante, bem como a relação entre os dois níveis de proficiência linguística medidos.
Sobre o ethos na educação: dialogando com Kohlberg, Habermas e Boaventura de Sousa Santos
Authors: Teixeira Leônia Cavalcante , Ramos Natália
Published: June 2014

O momento civilizatório actual define-se como de crise epistêmica, antropológica, ontológica e ética. Ratificando o espaço educacional como locus privilegiado de constituição de subjetividades, o acento deste estudo recai sobre as concepções de Kohlberg, Habermas e Boaventura de Sousa Santos. As articulações entre filosofia, sociologia e educação iluminam a escola como território de construção subjetiva pela via da interdisciplinaridade. Habermas, em diálogo com a teoria kohlberguiana do julgamento moral,
questiona o tecnicismo ao retomar uma ética iluminista cosmopolita emancipatória. Baseando-se na consideração da actualidade como momento de transição paradigmática, Santos posiciona-se contra as perspectivas iluministas antropológica, epistêmica e ética, propondo cartografias da experiência subjectiva que visem à emancipação por um ethos que se norteie pelo senso comum solidário. A discussão entre os autores dar-se-á considerando as relações entre ética e subjectividade no campo da educação, privilegiando os lugares do ensino-aprendizagem e do educador na instituição escolar.
Da Escola em Crise: Posição do Problema
Authors: Urbano Pedro
Published: June 2014

Reflexão crítica sobre a crise da Escola nas sociedades da abundância, numa perspectiva histórica desde a Escola dos Escribas até à actualidade. Apontamentos introdutórios.
Faculty perceptions of webcasting in health sciences education
Authors: Gushrowski Barbara Ann , Romito Laura M.
Published: June 2014

Pre-recorded lectures (podcasts) and recordings of live lectures (lecture-capture) are now everyday occurrences on many college campuses. Student use and opinions of these technologies have been frequently studied. However, there has been little reported on how faculty perceive these technologies. This article reports the results from a 2010 survey of dental, medical, and nursing faculty about their experiences with podcast/lecture capture technologies as teaching tools. A 46-item survey was distributed electronically to full-time faculty at the schools of Dentistry, Medicine, and Nursing on the campus of Indiana University-Purdue University Indianapolis (IUPUI) in Fall 2010 to determine their experiences and perceptions of podcast/lecture capture technologies as teaching tools. Of the 398 respondents, 32% employed lecture capture while only 2% used podcasting. Of those faculty not currently recording materials, 83 (68%) stated that they plan to do so in the next 2 years. Lack of time, 26 (24%) and training, (22%) are major reasons stated for not recording course content. Although a large number of faculty believe student learning has improved through the use of these technologies (74%, n=86), few stated that test scores have improved following implementation of electronic delivery of course materials (29%, n=34). There was no correlation between the use of podcast/lecture capture technologies and faculty gender, school, or years of teaching. A wide array of technologies to record lectures and present additional course materials electronically are in use at the health sciences programs on the IUPUI campus. Overall, faculty view these technologies in a favorable light.
Databases and the silification of health
Authors: Zobel Justin
Published: June 2014

Developments in databases and computing are helping to create a revolution in health and in biomedical research. Many aspects of medicine are increasingly data-centric, from basics such as record-keeping to diagnosis and biological discovery. Drivers of change include massive curated biological data sets, consolidations of medical knowledge into systematised online repositories, innovations in data linkage, change of practice in hospitals, and new diagnostic technologies. However, the volumes of data means that new database and computational innovations are required if the data's value is to be fully exploited. This talk reviews the biomedical mechanisms that are creating data and explores achievements and challenges for database researchers in future health.
Constrained physical design tuning
Authors: Bruno Nicolas , Chaudhuri Surajit
Published: June 2014

Existing solutions to the automated physical design problem in database systems attempt to minimize execution costs of input workloads for a given a storage constraint. In this paper, we argue that this model is not flexible enough to address several real-world situations. To overcome this limitation, we introduce a constraint language that is simple yet powerful enough to express many important scenarios. We build upon an existing transformation-based framework to effectively incorporate constraints in the search space. We then show experimentally that we are able to handle a rich class of constraints and that our proposed technique scales gracefully.
Performance profiling with EndoScope, an acquisitional software monitoring framework
Authors: Cheung Alvin , Madden Samuel
Published: June 2014

We propose EndoScope, a software monitoring framework that allows users to pose declarative queries that monitor the state and performance of running programs. Unlike most existing monitoring tools, EndoScope is
acquisitional
, meaning that it only instruments the portions of the program that need to be monitored to answer queries. The use of a high level declarative language allows EndoScope to search for efficient physical instantiations of queries by applying a suite of optimizations, including control flow graph analysis, and traditional database query optimization techniques, such as predicate pushdown and join optimization, to minimize the number of program instrumentation points and overhead to the monitored program. Furthermore, a flexible, high level language and the ability to attach to running programs enable developers to build various program analysis and monitoring applications beyond traditional software profilers with EndoScope. We describe a prototype implementation of the EndoScope framework and a simple profiler for Java programs implemented with EndoScope. We show results from using our profiler on a collection of real-world programs, including a TPC-C implementation using the Derby database and the petstore application running on top of Tomcat application server. Our results show the benefit of our optimization framework and demonstrate that our declarative, acquisitional approach can yield program instrumentation overheads that are dramatically lower than conventional profiling tools (for example, when profiling the Derby Database running TPC-C, our system's overhead ranges from 1% to about 25%, whereas the fastest existing profiler we measured imposes a minimum overhead of about 30%.)