bluuebunny/crossref_metadata_2025 huggingface dataset:
Effective services for improving education and employment outcomes for children and alumni of foster care service: correlates and educational and employment outcomes
Authors: Barnow Burt S. , Buck Amy , O'Brien Kirk , Pecora Peter , Ellis Mei Ling , Steiner Eric
Published: March 2013

Outcomes for youth from foster care have been found to be poor. The education and employment outcomes of youth and alumni of foster care served by transition programmes located in five major US cities were examined. Data were collected by case managers and reported to evaluators quarterly on 1058 youth from foster care for over 2 years. Job preparation, transportation, child care, education support services and life skills were the most common services provided to youth. During the 2‐year study period, 35% of participants obtained employment, 23% obtained a General Education Development or diploma, and 17% enrolled in post‐secondary education. It was found that the longer the youth were enrolled, the more education and employment outcomes they achieved. Further, job preparation and income support services were associated significantly with achieving any positive education or employment outcome. Results indicated that certain services provided over an extended period of time can improve outcomes for youth placed in foster care. For youth to achieve positive outcomes as they transition to adulthood, additional services are necessary. Other implications are discussed.
Vestibular Schwannoma Surgical Treatment
Authors: You Yong‐Ping , Zhang Jun‐Xia , Lu Ai‐Lin , Liu Ning
Published: March 2013

Neurosurgical intervention remains the main step in the effective management of vestibular schwannomas. Extensive studies on vestibular schwannoma treatment have placed emphasis on preserving quality of life and neurological functions, particularly of the facial and vestibulocochlear nerves. Facial nerve preservation and hearing preservation have been achieved by significant advances in skull base microsurgical techniques and intraoperative neuromonitoring. Diffusion tensor imaging is a powerful and accurate method for preoperatively identifying the facial nerve in relation to vestibular schwannomas. Endoscopy offers excellent illumination of the anatomical structures and provides panoramic vision inside the surgical area. In this report, we focused on facial nerve and vestibulocochlear nerve preservation and analyzed the major techniques used for identifying the nerve–tumor relationship.
CEOPay from a Social Norm Perspective: The Infringement and Reestablishment of Fairness Norms
Authors: Rost Katja , Weibel Antoinette
Published: March 2013

Manuscript Type

Empirical

Research Question/Issue

Social norm theory goes beyond economic efficiency arguments and provides a framework that allows for the subjective, judgmental, and socially interactive processes involved in the determination ofCEOremuneration. Building on this theory, we argue that currentCEOpay practices infringe a social norm. This norm states that a firm's wages ought to be fair. Thus, according to the social norm theory view, large inequalities betweenCEOpay and low‐level incomes, as well as inequity concerns ofCEOpay decoupled from performance, become a matter of public distress. If such publicly shared fairness norms become infringed, some amount of norm enforcement becomes likely, particularly when the punishment is of low cost. Norm enforcement also becomes likely if selective incentives and/or intrinsic norm enforcement are present to support punishing actions.

Research Findings/Insights

We test our model using a vignette‐survey study and a representative sample of 800 Swiss citizens. We are able to show that individual differences – more precisely status attributes and moral development – drive perceptions of norm infringement. We demonstrate that the willingness to punish firms with norm‐infringingCEOpay is high if low‐cost punishment opportunities are provided, such as public votes onCEOpay regulation. In addition, the willingness to punish is also driven by feelings of deprivation which fuel intrinsic interest to punish norm infringers even at high individual costs.

Theoretical/Academic Implications

We adapt and contextualize social norm theory for theCEOpay debate. A model that explains how individual differences drive norm infringement perceptions, and how these differences lead to behavioral punishment intentions, is developed and tested empirically.

Practitioner/Policy Implications

The war for talent and the urge to offer incentives toCEOsimpose costs on society, and firms are confronted with those costs. As a consequence, more and more people demandCEOpay regulation, which narrows firms' latitude. For firms, the evidence implies that they would be well advised to consider the climate of public opinion when determining executive pay. They may either reduceCEOpay or should communicate to the public why certain compensation designs may be favorable and in the interests of the enterprise and stakeholders. For politicians, the findings of our study show that there is a demand forCEOpay regulations and that this demand has to be acknowledged in some way in policy‐making.
Improved patient‐centered care with effective use of Integra® in dermatologic reconstructive surgery
Authors: Müller Cornelia Sigrid Lissi , Schiekofer Claudia , Körner Rebecca , Pföhler Claudia , Vogt Thomas
Published: March 2013

Background

The incidence of skin tumors is increasing among elderly patients, and the multi‐morbidities which occur in the elderly are a great challenge for dermatologic surgeons. The currently required safety margins for different types of melanomas and non‐melanoma skin cancers lead to extensive and profound wounds.

Objective

To investigate the usefulness of a dermal substitute (Integra®) for routine use in surgery for dermatologic tumors.

Patients and Methods

In this retrospective study 20 patients underwent sequential surgeries for skin cancer. Wound closures were performed using Integra® (single layer) and immediate split‐thickness skin graft.

Results

Twenty‐two tumors (6 malignant melanomas, 10 squamous cell carcinomas, 2 pleomorphic sarcomas, 1 basal cell carcinoma, 2 Merkel cell carcinomas, and 1 trichoblastic carcinoma) were resected. The mean defect size was 41.4 cm2. All transplants were (65–100 %) vital; however, defects in the midface (cheek and infra‐orbital area) often healed with esthetically disturbing, dense, pillow‐like scars.

Conclusions

With the use of Integra®, the duration of hospitalization was decreased, patients with multi‐morbidities were effectively treated, and functionally‐ and esthetically‐satisfactory outcomes were achieved. On the basis of these observations, we discuss points of handling those patients who require rapid and effective surgery and undergo dermatologic surgery using dermal substitutes.
Establishment of a simple predictive scoring system for pancreatic fistula after laparoscopy‐assisted gastrectomy
Authors: Miyai Hirotaka , Hara Masayasu , Hayakawa Tetsushi , Takeyama Hiromitsu
Published: March 2013

Background

The potential severity of postoperative pancreatic fistula (POPF) after laparoscopy‐assisted gastrectomy (LAG) necessitates efforts to identify predictive factors for POPF. The aim of the present study was to identify predictive factors for POPF and to establish a predictive scoring system for POPF after LAG.

Patients and Methods

Between June 2004 and March 2011, 277 gastric cancer patients who underwent curative resection with LAG were enrolled. POPF was defined according to the International Study Group for Pancreatic Fistula grading system. Risk factors for POPF were evaluated using logistic regression analysis, and a scoring system for POPF was established.

Results

In the derivation cohort, multivariate analysis revealed the risk factors for POPF as patient age ≤70 years (5 points), amylase level of postoperative day 1 drainage fluid >454 IU/L(5 points), total number of retrieved lymph nodes >21 (5 points), body mass index >21.45 kg/m2 (4 points), and operating time >337 min (2 points). In the validation cohort, at the cut‐off point for high risk (score ≥15), the model had a negative predictive value of 94.5%, a positive predictive value of 57.4%, a sensitivity of 88.6%, and a specificity of 75.0% (C statistic = 0.857).

Conclusion

This study demonstrated that POPF after LAG is associated with specific preoperative and postoperative factors. With a simple predictive scoring system, patients at high risk for POPF can be accurately identified. This simple predictive scoring system will be useful for many clinicians to assess the risk of POPF after LAG and start treating at‐risk patients earlier.
Preferences for medication attributes among patients with type 2 diabetes mellitus in the UK
Authors: Gelhorn H. L. , Stringer S. M. , Brooks A. , Thompson C. , Monz B. U. , Boye K. S. , Hach T. , Lund S. S. , Palencia R.
Published: March 2013

Aim

To examine preferences for oral medication attributes among participants with early and advanced type 2 diabetes mellitus (T2DM) in the UK using a discrete choice experiment (DCE).

Methods

A web‐based DCE was administered where participants indicated which medication they preferred from two different hypothetical oral anti‐diabetic (OAD) medication profiles, each composed of differing levels of seven attributes (efficacy, hypoglycaemic events, weight change, gastrointestinal/nausea side effects, urinary tract infection and genital infection, blood pressure and cardiovascular risk) for 20 sets of pair‐wise comparisons. A random effects multinomial logit regression model was used to estimate the preference weight (PW) for each of the attribute levels, and the relative importance (RI) of each attribute was calculated. Analyses were conducted for the overall sample and for medication and gender subgroups.

Results

The final sample included 100 participants with a mean age of 62.9 (SD 11.1) years and comparable numbers of participants of each gender (51% male, 49% female). The majority of the participants were White‐British (92%). The total PW and corresponding RI were highest for four of the seven attributes: hypoglycaemic events (PW = 1.98; RI = 24.7%), weight change (PW = 1.65; RI = 20.6%), gastrointestinal/nausea side effects (PW = 1.49; RI = 18.6%) and efficacy (PW = 1.44; RI = 18.0%). The RI values differed for some attributes across gender and number of current T2DM medication subgroups.

Conclusion

The results suggest that hypoglycaemia, weight change, gastrointestinal side effects and efficacy are of primary importance to patients in their OAD preferences in T2DM. These four attributes comprised over 80% of the RI.
Efficacy, safety and dose–response relationship of teneligliptin, a dipeptidyl peptidase‐4 inhibitor, in Japanese patients with type 2 diabetes mellitus
Authors: Kadowaki T. , Kondo K.
Published: March 2013

Aim

To assess the efficacy, safety and dose–response relationship of once‐daily teneligliptin, a novel dipeptidyl peptidase‐4 inhibitor, in Japanese patients with type 2 diabetes mellitus (T2DM) inadequately controlled with diet and exercise.

Methods

In this randomized, double‐blind, placebo‐controlled, parallel‐group study, patients (n = 324) were randomized to receive teneligliptin 10, 20 or 40 mg, or placebo, once daily before breakfast for 12 weeks. The primary endpoint was the change in haemoglobin (Hb)A1c from baseline to week 12.

Results

All teneligliptin‐treated groups showed significantly greater reductions in HbA1c and fasting plasma glucose (FPG) than did the placebo group. The differences between the teneligliptin 10, 20 or 40 mg groups and the placebo group for the change in HbA1c were −0.9 [least‐squares (LS) mean; 95% confidence interval: −1.0, −0.7], −0.9 (−1.1, −0.7) and −1.0 (−1.2, −0.9)%, respectively (all, p < 0.001). The respective LS means for FPG were −17.8 (−23.4, −12.1), −16.9 (−22.6, −11.2) and −20.0 (−25.7, −14.3) mg/dl (all, p < 0.001). There were no significant differences in HbA1c among the three doses of teneligliptin. The incidence of adverse events and adverse drug reactions was similar in each group. The incidence of hypoglycaemia was not significantly different among the four groups.

Conclusions

Treatment with teneligliptin for 12 weeks provided significant and clinically meaningful reductions in HbA1c and FPG across the dose range studied and was generally well tolerated in Japanese patients with T2DM.
Conserving large carnivores: dollars and fence
Authors: Packer C. , Loveridge A. , Canney S. , Caro T. , Garnett S.T. , Pfeifer M. , Zander K.K. , Swanson A. , MacNulty D. , Balme G. , Bauer H. , Begg C.M. , Begg K.S. , Bhalla S. , Bissett C. , Bodasing T. , Brink H. , Burger A. , Burton A.C. , Clegg B. , Dell S. , Delsink A. , Dickerson T. , Dloniak S.M. , Druce D. , Frank L. , Funston P. , Gichohi N. , Groom R. , Hanekom C. , Heath B. , Hunter L. , DeIongh H.H. , Joubert C.J. , Kasiki S.M. , Kissui B. , Knocker W. , Leathem B. , Lindsey P.A. , Maclennan S.D. , McNutt J.W. , Miller S.M. , Naylor S. , Nel P. , Ng'weno C. , Nicholls K. , Ogutu J.O. , Okot‐Omoya E. , Patterson B.D. , Plumptre A. , Salerno J. , Skinner K. , Slotow R. , Sogbohossou E.A. , Stratford K.J. , Winterbach C. , Winterbach H. , Polasky S.
Published: March 2013

Conservationists often advocate for landscape approaches to wildlife management while others argue for physical separation between protected species and human communities, but direct empirical comparisons of these alternatives are scarce. We relate African lion population densities and population trends to contrasting management practices across 42 sites in 11 countries. Lion populations in fenced reserves are significantly closer to their estimated carrying capacities than unfenced populations. Whereas fenced reserves can maintain lions at 80% of their potential densities on annual management budgets of $500 km−2, unfenced populations require budgets in excess of $2000 km−2 to attain half their potential densities. Lions in fenced reserves are primarily limited by density dependence, but lions in unfenced reserves are highly sensitive to human population densities in surrounding communities, and unfenced populations are frequently subjected to density‐independent factors. Nearly half the unfenced lion populations may decline to near extinction over the next 20–40 years.
Prevalence of neurologic autoantibodies in cohorts of patients with new and established epilepsy
Authors: Brenner Tanja , Sills Graeme J. , Hart Yvonne , Howell Stephen , Waters Patrick , Brodie Martin J. , Vincent Angela , Lang Bethan
Published: March 2013

Purpose

Autoantibodies to specific neurologic proteins are associated with subacute onset encephalopathies, which often present with seizures that are poorly controlled by conventional antiepileptic drugs (AEDs). Previous cross‐sectional studies have found specific neurologic antibodies in a small proportion of people with established epilepsy, but these investigations have seldom included patients with recent diagnosis.

Methods

We screened two large epilepsy cohorts to investigate the prevalence of multiple autoantibodies in adult patients with either established or newly diagnosed, untreated epilepsy.

Key Findings

Eleven percent of patients had antibodies to one or more antigen: voltage‐gated potassium channel (VGKC) complex proteins (5%), glycine receptors (3%), and glutamic acid decarboxylase (GAD) and N‐methyl‐d‐aspartate (NMDA) receptors (1.7% each). There was no difference in the prevalence of antibodies, individually or collectively, between patients with established and newly diagnosed epilepsy or with generalized or focal epilepsy. There was, however, a significantly higher prevalence of positive antibody titers in patients with focal epilepsy of unknown cause than in those with structural/metabolic focal epilepsy (14.8% vs. 6.3%; p < 0.02). Newly diagnosed antibody‐positive patients were less likely to achieve adequate seizure control with initial treatment than antibody‐negative patients, but this difference failed to reach statistical significance.

Significance

The presence of autoantibodies is equally common in newly diagnosed and established epilepsy, it is therefore unlikely to be an epiphenomenon of long‐standing refractory seizures.
Communication between scientists, fishery managers and recreational fishers: lessons learned from a comparative analysis of international case studies
Authors: Dedual M. , Sague Pla O. , Arlinghaus R. , Clarke A. , Ferter K. , Geertz Hansen P. , Gerdeaux D. , Hames F. , Kennelly S. J. , Kleiven A. R. , Meraner A. , Ueberschär B.
Published: March 2013

The management of recreational fisheries benefits from good collaboration between scientists, managers and recreational fishers. However, the level of collaboration largely depends on the levels of effective communication among the different stakeholders. This paper presents the views of scientists, managers and fishers concerning the quality of communication in eleven case studies of recreational fisheries. Case studies were synthesised and common reasons why communication did not always flow as intended were identified. The prevalent barriers to good communication, and therefore collaboration included a lack of rigorous scientific information transfer from scientists to fishers and managers, a fear from fishers that management actions will limit fishing opportunities, pre‐existing antagonism between commercial and recreational fisheries, and fishers' suspicion of science. Overcoming these issues is paramount to improve collaboration and participatory processes that help lead to robust, well‐accepted management actions.
The evolution of viviparity opens opportunities for lizard radiation but drives it into a climatic cul‐de‐sac
Authors: Pincheira‐Donoso Daniel , Tregenza Tom , Witt Matthew J. , Hodgson Dave J.
Published: March 2013

Aim

Evolutionary radiations into novel areas or niches require innovative adaptations. However, rapid subsequent changes in these novel conditions might demand rapid re‐adaptations to secure population persistence and prevent extinction. We propose that reptilian viviparity (live birth) is consistent with such a scenario. Using theLiolaemuslizard radiation, we investigate the hypotheses that historical invasions of cold climates have been permitted by transitions to viviparity, and that this parity mode is irreversible. Then, we investigate whether these combined factors restrict viviparous lizards to cold climates, and hence, whether viviparous species are particularly threatened by climate change.

Location

SouthAmerica.

Methods

We employ phylogenetic analyses to investigate evolutionary transitions in reproductive modes and their consequences for environmental restrictions in viviparous lizards. We then employ climatic projections to predict the impact of climate change on the future persistence of these organisms.

Results

The oviparity‐to‐viviparity transition is consistently associated with colonization of cold climates, and appears to be irreversible. Since viviparity seems less viable (compared with oviparity) in warm climates, species that evolve viviparity in cold climates are likely to remain adaptively constrained to such environments. Therefore, upward–poleward advances of climate warming will cause severe shifts and contractions of viviparous species ranges, threatening major extinctions over the next half century.

Main conclusions

Viviparity has been largely responsible for the successful radiation ofLiolaemusinto cold climates, but since this adaptation is predominantly viable in these environments and is unlikely to re‐evolve into oviparity, viviparity may prove to be an evolutionary dead‐end for lizards facing rapid climate change.
Predictors of regional establishment success and spread of introduced non‐indigenous vertebrates
Authors: Allen Craig R. , Nemec Kristine T. , Wardwell Donald A. , Hoffman Justin D. , Brust Mathew , Decker Karie L. , Fogell Daniel , Hogue Jennifer , Lotz Aaron , Miller Thaddeus , Pummill Marcy , Ramirez‐Yañez Luis E. , Uden Daniel R.
Published: March 2013

Aim

To provide the first analysis of predictors of both establishment and spread, both within and across taxa, for all vertebrate taxa within a region. We used Florida, USA, as our study system because it has a well‐documented history of introduction and invasion, and is a hotspot for biological invasions.

Location

Florida, USA.

Methods

We analysed non‐indigenous species (NIS) data from peninsular Florida – which included both successful and unsuccessful introductions from all vertebrate classes – to determine the best predictors of both establishment and spread for fish (65 species), herpetofauna (63 species), birds (71 species) and mammals (25 species). We used 10 variables proposed to be associated with the establishment and spread of NIS: body mass, geographic origin, reproductive rate, diet generalism, native‐range size, latitude of native range, number of NIS present at date of introduction, presence of NIS congeners, morphological proximity to other NIS (in terms of body mass) and propagule pressure. A multimodel selection process was used with an information‐theoretic approach to determine the best fit models for predicting establishment and spread of NIS. We selected a priori plausible predictive models for establishment and spread.

Results

Large native‐range size and small body mass best predicted establishment of non‐indigenous herpetofauna. The presence of NIS congeners had the largest positive effect on the establishment of non‐indigenous fish. For mammals, the number of NIS present at the time of introduction best explained establishment. No single model best explained bird establishment. For all taxa but birds, the number of NIS present at time of introduction was included in at least one of the best‐supported models for explaining spread.

Main conclusions

Our analyses suggest that predictors of establishment and spread differ across vertebrate taxa at the scale studied. Most predictive variables can be interpreted as measures of competitive interactions among species.
Endobronchial ultrasound transbronchial needle aspiration in older people
Authors: Okachi Shotaro , Imai Naoyuki , Imaizumi Kazuyoshi , Hase Tetsunari , Shindo Yuichiro , Sakamoto Koji , Aso Hiromichi , Wakahara Keiko , Hashimoto Izumi , Ito Satoru , Hashimoto Naozumi , Sato Mitsuo , Kondo Masashi , Hasegawa Yoshinori
Published: March 2013

Aim

The usefulness and safety of endobronchial ultrasound transbronchial needle aspiration (EBUS‐TBNA) have been established recently, but no study has evaluated whether or not aging increases the risk of the procedure. In the present study, we aimed to assess the usefulness and safety of EBUS‐TBNA in older patients.

Methods

The medical records and database of 109 patients who received EBUS‐TBNA between 2008 and 2011 at Nagoya University Hospital, Nagoya, Japan were reviewed retrospectively. All patients underwent bronchoscopy under light sedation with midazolam. A total of 34 patients were aged 70 years or older (the older group) and 75 were aged 69 years or younger (the younger group). We analyzed patients' characteristics, changes of clinical parameters, usage doses of midazolam and lidocaine, procedure duration, geographic data of biopsied lymph nodes, diagnostic yield, and complications in both groups.

Results

There were more comorbidities in the older group. Four patients (11.8%) in the older group had poor performance status (2–3). Systolic blood pressure at baseline was significantly higher in the older group. There were no statistical differences between the two groups in some clinical parameters (minimum oxygen saturation [SpO2], reduction in SpO2, maximum oxygen supplementation, elevation of systolic blood pressure, increase of heart rate) during the procedure. Diagnostic performance in older patients was similar to that found in younger patients. There was no difference in the frequency of complications between both groups.

Conclusion

Safety and usefulness of EBUS‐TBNA in older people were comparable with those in younger people. Geriatr Gerontol Int 2013; 13: 986–992.
Corticosteroids injection in rotator cuff tears in elderly patient: Pain outcome prediction
Authors: Gialanella Bernardo , Bertolinelli Maurizio
Published: March 2013

Aim

The aim of this prospective study was to evaluate the effect of corticosteroids intra‐articular injections on pain in patients with rotator cuff tear (RCT), and to identify predictors for pain outcomes.

Methods

A total of 60 patients with RCT were enrolled. All patients underwent rehabilitation; 20 patients received a single intra‐articular injection of 40 mg triamcinolone acetonide and 20 patients had a repeat injection at a 21‐day interval. Backward stepwise regression analysis was used to predict effectiveness and improvement of pain. The independent variables were age, sex, symptom duration, tear size, passive range of motion (ROM), active ROM, non‐steroidal anti‐inflammatory drugs request, pain at rest, number of triamcinolone injections and severity of osteoarthritis at admission.

Results

At 3 and 6 months, patients who received triamcinolone had higher effectiveness and improvement in pain during activities and pain at night than those of control group. At the 3‐month interval post‐therapy, active ROM was the only predictor for effectiveness in pain during activity, effectiveness in pain at night and improvement in pain at night. Six months after therapy, active ROM was a predictor for improvement in pain at night. Age was a predictor for effectiveness in pain at night, whereas tear size of RCT was a predictor for effectiveness and improvement in pain during activity.

Conclusions

Corticosteroids can relieve pain in RCT. Active ROM is the most important predictor of pain outcomes. This finding can be useful to physicians when deciding on the type of patients who might best benefit from intra‐articular injections of corticosteroids. Geriatr Gerontol Int 2013; 13: 993–1001.
Quality of water in hemodialysis centers in Baghdad, Iraq
Authors: Al‐Naseri Saadi K. , Mahdi Zinah Mohammed , Hashim Mohammed Fawzi
Published: March 2013

Dialysis water quality is one of the important parameters all over the world because of its direct influence on the health of kidney patients. In Iraq, there are more than 20 dialysis centers; most of them contain identical units for the production of dialysis water. In this work, the quality of water used for dialysis in six dialysis centers located within Baghdad hospitals was evaluated. Samples of product water from each of the six dialysis centers were examined for total heterotrophic bacteria, endotoxin, and chemical contaminants. Endotoxin was measured on‐site using a portable instrument. Bacteriological and chemical examinations were done in the laboratory after collecting samples from each dialysis center. The results showed a fluctuation in the produced water quality that makes the produced water unaccepted when compared with international standards. Bacterial counts for 60% of the analyzed samples were above the action level (50 colony‐forming units[CFU]/mL), while five out of the six dialysis centers showed values higher than the maximum value (100 CFU/mL). Chemical analysis showed that the dialysis water quality suffers from elevated aluminum concentration for all dialysis centers. All hemodialysis centers need thorough monitoring and preventive maintenance to ensure good water quality. In addition, it is important to revise the design of the water treatment units according to the feed and product water quality.
A multidisciplinary quality improvement educational initiative to improve the rate of deep-vein thrombosis prophylaxis
Authors: Vyas Deepti , Bearelly Dilip , Boshard Barbara
Published: March 2013

Purpose

To describe a quality improvement initiative to improve deep-vein thrombosis (DVT) prophylaxis rates among hospitalized medicine patients.

Methods

A standardized admission order-set with an embedded risk-assessment tool and DVT prophylaxis orders was developed.

Results

An audit 2 months after the intervention showed the use of optimal DVT prophylaxis was 91%, an increase from 75%. Chart review 1 year after the implementation of the order-set revealed that the increase in DVT prophylaxis was sustained at 95%.

Conclusion

The use of formalized quality improvement methods to implement an intervention is effective in changing physician behaviour.
Prevalence of depression in patients referred with snoring and obstructive sleep apnoea
Authors: Douglas N. , Young A. , Roebuck T. , Ho S. , Miller B. R. , Kee K. , Dabscheck E. J. , Naughton M. T.
Published: March 2013

Background and Aims

Depression and obstructive sleep apnoea are two common entities, with common symptoms that make identification of either condition difficult. Our aim was to examine, within a group of patients referred with snoring and obstructive sleep apnoea, (i) the prevalence of depression with the 14‐question Hospital Anxiety and Depression Scale (HADS), (ii) the correlation between the two lead depression symptoms from the Mini‐International Neuropsychiatric Interview (MINI) and HADS, and (iii) the relationship between depression symptoms with physiological markers of OSA.

Methods

An observational study of depression questionnaires in patients referred because of snoring to a sleep clinic within university‐affiliated public teaching hospital.

Results

Ninety‐seven per cent of 240 patients approached responded, and 32% had a positive HADS (score >16/42). The HADS and MINI significantly correlated (r = 0.736, P < 0.001). Fifty‐three per cent had either doctor‐diagnosed depression (28%) and/or a positive HADS or MINI (25%). HADS correlated with the degree of sleepiness (r = 0.252, P < 0.0001) and inversely with hypoxaemia (r=‐0.231, P < 0.0003) but not with the frequency of apnoeas and hypopnoeas (r = 0.116, P > 0.05).

Conclusion

Depending on classification, 32–53% of patients with snoring had depressive symptoms or were on treatment, which is significantly greater than the Australian average of 21%. A simplified depression questionnaire was validated. Severity of depression correlated with sleepiness and hypoxaemia but not with severity of sleep apnoea.
Mapping Prefrontal Cortex Functions in Human Infancy
Authors: Grossmann Tobias
Published: March 2013

It has long been thought that the prefrontal cortex, as the seat of most higher brain functions, is functionally silent during most of infancy. This review highlights recent work concerned with the precise mapping (localization) of brain activation in human infants, providing evidence that prefrontal cortex exhibits functional activation much earlier than previously thought. A systematic evaluation of the activation patterns in these neuroimaging studies mainly based on functional near‐infrared spectroscopy reveals that prefrontal cortex function can be broadly divided into two distinct anatomical clusters with different functional properties. One cluster of activations falls within the region of the medial prefrontal cortex and is mainly involved in affective processes; another cluster is located in lateral aspects of the prefrontal cortex and shows sensitivity to cognitive processes such as memory and attention. This distinction is in line with adult data and evolutionary models and may represent a developmentally continuous organization principle of prefrontal cortex function. All in all, this review is aimed at providing a synthesis of new findings that are emerging from the use of neuroimaging techniques with infants as well as at encouraging further theory‐driven research to understand the developmental origins of prefrontal cortex function.
Implementing Extended Producer Responsibility Legislation
Authors: Gui Luyi , Atasu Atalay , Ergun Özlem , Toktay L. Beril
Published: March 2013

The goal of this article is to contribute to the understanding of how the multiple, and sometimes conflicting, stakeholder perspectives and prevailing conditions (economic, geographic, etc.) in the implementation locality shape extended producer responsibility (EPR) “on the ground.” We provide an in‐depth examination of the implementation dimension of EPR in a specific case study by examining concrete activities at the operational front of the collection and recycling system, and probing the varying stakeholder preferences that have driven a specific system to its status quo. To this end, we conduct a detailed case study of the Washington State EPR implementation for electronic waste. We provide an overview of various stakeholder perspectives and their implications for the attainment of EPR policy objectives in practice. These findings shed light on the intrinsic complexity of EPR implementation. We conclude with recommendations on how to achieve effective and efficient EPR implementation, including improving design incentives, incorporating reuse and refurbishing, expanding product scope, managing downstream material flows, and promoting operational efficiency via fair cost allocation design.
Bufonia yildirimhanii sp. nov. (Caryophyllaceae) from Turkey
Authors: İlçim Ahmet , Behçet Lütfi
Published: March 2013

Bufonia yildirimhaniiİlçim & Behçet sp. nov. (Caryophyllaceae) is described and illustrated from Turkey. This new species is confined to C7 Sanlıurfa‐Birecik where it grows on calcarous slopes. The species is compared with the closely related Bufonia calyculata and B. kotschyana subsp. kotschyana. Notes on its ecology and conservation status are provided. A distribution map of the new and related species is also included.
The development of a framework for evaluating the impact of nurse consultant roles in the UK
Authors: Gerrish Kate , McDonnell Ann , Kennedy Fiona
Published: March 2013

Aim

To develop a framework to evaluate the impact of nurse consultants on patient, professional and organizational outcomes and identify associated indicators of impact.

Background

Since nurse consultants were introduced into the UK in 2000, there has been growing interest in demonstrating their impact, although robust evidence of impact is lacking. Existing frameworks for evaluating the impact of advanced practice roles do not cover the four dimensions of the nurse consultant role sufficiently.

Design

Multiple case study.

Method

Individual case studies of six nurse consultants in England were undertaken between December 2009–October 2010. Each case study involved interviews with the nurse consultant, healthcare staff, managers, patients and carers. Interviews explored participants' perceptions of the impact of the nurse consultant and indicators of actual and/or potential impact. Data were analysed using framework approach.

Findings

Three domains of impact of nurse consultant roles were identified: clinical significance, professional significance and organizational significance. Each domain included three to four indicators of impact. All nurse consultants showed some evidence of impact in all three domains although the primary focus varied across the different nurse consultants. Due to the wide diversity in nurse consultant roles there was little commonality in the specific indicators of impact across all nurse consultants.

Conclusion

The framework for capturing the impact of nurse consultants could be used by researchers and by nurse consultants to demonstrate their impact. Further research is required to assess the suitability of the framework for capturing the impact of other advanced practice roles.
A concept analysis of nursing overtime
Authors: Lobo Vanessa M. , Fisher Anita , Ploeg Jenny , Peachey Gladys , Akhtar‐Danesh Noori
Published: March 2013

Aim

To report a concept analysis of nursing overtime.

Background

Economic constraints have resulted in hospital restructuring with the aim of reducing costs. These processes often target nurse staffing (the largest organizational expense) by increasing usage of alternative staffing strategies including overtime hours. Overtime is a multifaceted, poorly defined, and indiscriminately used concept. Analysis of nursing overtime is an important step towards development and propagation of appropriate staffing strategies and rigorous research.

Design

Concept analysis.

Data sources

The search of electronic literature included indexes, grey literature, dictionaries, policy statements, contracts, glossaries and ancestry searching. Sources included were published between 1993–2012; dates were chosen in relation to increases in overtime hours used as a result of the healthcare structuring in the early 1990s. Approximately 65 documents met the inclusion criteria.

Review methods

Walker and Avant's methodology guided the analysis.

Discussion

Nursing overtime can be defined by four attributes: perception of choice or control over overtime hours worked; rewards or lack thereof; time off duty counts equally as much as time on duty; and disruption due to a lack of preparation. Antecedents of overtime arise from societal, organizational, and individual levels. The consequences of nursing overtime can be positive and negative, affecting organizations, nurses, and the patients they care for.

Conclusion

This concept analysis clarifies the intricacies surrounding nursing overtime with recommendations to advance nursing research, practice, and policies. A nursing‐specific middle‐range theory was proposed to guide the understanding and study of nursing overtime.
Genome‐wide Analysis of Plant‐specific Dof Transcription Factor Family in Tomato
Authors: Cai Xiaofeng , Zhang Yuyang , Zhang Chanjuan , Zhang Tingyan , Hu Tixu , Ye Jie , Zhang Junhong , Wang Taotao , Li Hanxia , Ye Zhibiao
Published: March 2013

The Dof (DNA binding with One Finger) family encoding single zinc finger proteins has been known as a family of plant‐specific transcription factors. These transcription factors are involved in a variety of functions of importance for different biological processes in plants. In the current study, we identified 34 Dof family genes in tomato, distributed on 11 chromosomes. A complete overview of SlDof genes in tomato is presented, including the gene structures, chromosome locations, phylogeny, protein motifs and evolution pattern. Phylogenetic analysis of 34 SlDof proteins resulted in four classes constituting six clusters. In addition, a comparative analysis between these genes in tomato, Arabidopsis and rice was also performed. The tomato Dof family expansion has been dated to recent duplication events, and segmental duplication is predominant for the SlDof genes. Furthermore, the SlDof genes displayed differential expression either in their transcript abundance or in their expression patterns under normal growth conditions. This is the first step towards genome‐wide analyses of the Dof genes in tomato. Our study provides a very useful reference for cloning and functional analysis of the members of this gene family in tomato and other species.
Quality of life and mental health among parents of children with cerebral palsy: the influence of self‐efficacy and coping strategies
Authors: Guillamón Noemí , Nieto Ruben , Pousada Modesta , Redolar Diego , Muñoz Elena , Hernández Eulàlia , Boixadós Mercè , Gómez‐Zúñiga Benigna
Published: March 2013

Aims and objectives

To explore the quality of life and mental health of caregivers of children with cerebral palsy and to examine the impact of self‐efficacy and coping strategies on these outcomes.

Background

Few studies analyse the impact of caring for a child with cerebral palsy on the caregivers' quality of life besides mental health. Also, less attention has been paid to the influence of caregiver's personal resources like self‐efficacy or coping strategies on how they adjust to the child's illness and the care situation.

Design

Cross‐section correlational design.

Methods

Sixty two parents of children with cerebral palsy completed measures to assess the quality of life (i.e. physical, environmental and social relationships), mental health (i.e. general mental health, depression and anxiety), self‐efficacy and coping strategies.

Results

Parents of children with cerebral palsy had, in general terms, low levels of quality of life and mental health. Self‐efficacy was related to most of the outcomes, whereas any of the coping strategies assessed was significantly related to the outcomes.

Conclusions

Quality of life and mental health can be affected in caregivers of children with CP. Personal resources like self‐efficacy also need attention as they can help in the understanding of the differences in these outcomes and the design of effective interventions.

Relevance of clinical practice

Self‐efficacy should be a key element in interventions addressed to parents of children with CP to elicit a process of empowerment that can improve the well‐being of the family as a whole.
META‐ANALYSIS OF ECONOMICS RESEARCH REPORTING GUIDELINES
Authors: Stanley T.D. , Doucouliagos Hristos , Giles Margaret , Heckemeyer Jost H. , Johnston Robert J. , Laroche Patrice , Nelson Jon P. , Paldam Martin , Poot Jacques , Pugh Geoff , Rosenberger Randall S. , Rost Katja
Published: March 2013

Meta‐regression analysis (MRA) can provide objective and comprehensive summaries of economics research. Their use has grown rapidly over the last few decades. To improve transparency and to raise the quality of MRA, the meta‐analysis of economics research‐network (MAER‐Net) has created the below reporting guidelines. Future meta‐analyses in economics will be expected to follow these guidelines or give valid reasons why a meta‐analysis must deviate from them.
Medication Adherence and Treatment Patterns for Hypogonadal Patients Treated with Topical Testosterone Therapy: A Retrospective Medical Claims Analysis
Authors: Schoenfeld Michael Jay , Shortridge Emily , Cui Zhanglin , Muram David
Published: March 2013

Introduction

There is limited information on adherence to topical testosterone replacement therapy (TRT) among hypogonadal men.

Aim

To determine adherence rates among men treated with topical testosterone gels and to examine factors that may influence adherence, including age, presence of a specific diagnosis, and index dose.

Methods

Included were 15,435 hypogonadal men, from the Thomson Reuters MarketScan® Database, who had an initial topical testosterone prescription in 2009 and who were followed for 12 months.

Main Outcome Measures

Adherence to testosterone was measured by medication possession ratio (MPR), with high adherence defined as ≥0.8. Persistence was defined as the duration of therapy from the index date to the earliest of the following events: end date of the last prescription, date of the first gap of >30 days between prescriptions, or end of the study period (12 months).

Results

Adherence to topical TRT was low. By 6 months, only 34.7% of patients had continued on medication; at 12 months, only 15.4%. Adherence rates were numerically similar among men who received AndroGel® or Testim® topical gels and did not differ among men of different age groups. Approximately 80% of patients initiated at the recommended dose of 50 mg/day. Over time, an increased proportion of men used a higher dose. This change was the result of dose escalation, rather than of greater adherence among men initiating therapy at a high dose. Dose escalation was seen as early as 1 month into therapy. Approximately 50% of men who discontinued treatment resumed therapy; most men used the same medication and dose.

Conclusions

Discontinuation rates are high among hypogonadal men treated with testosterone gels, irrespective of their age, diagnosis, and index dose. Further study, evaluating other measurable factors associated with low adherence among patients receiving topical TRT, may lead to interventions designed to improve adherence with therapy.
Antiretroviral therapy: effects on orofacial health and health care
Authors: Diz Dios P , Scully C
Published: March 2013

This study summarizes the adverse effects of antiretroviral therapy (ART) agents against HIV on orofacial health and health care. Current antiretroviral agents fall mainly into three major classes: nucleoside reverse‐transcriptase inhibitors (NRTIs), non‐nucleoside reverse‐transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs) – now with the new classes of fusion inhibitors, entry inhibitors ‐CCR5 co‐receptor antagonists and HIV integrase strand transfer inhibitors. Many of the ART agents can have adverse orofacial effects, or can give rise to allergies or drug interactions – the optimum anti‐HIV drug has yet to be found. There are few orofacial adverse effects that characterize a particular ART class, but erythema multiforme (EM), ulcers and xerostomia may be associated with reverse‐transcriptase inhibitors (RTI); parotid lipomatosis, taste disturbance, xerostomia and perioral paraesthesia mainly related to PIs. Facial lipoatrophy is a common adverse effect of NRTIs; EM is more frequently associated with NNRTIs. Thus, although most of the more recent ART drugs and combinations of them show improved safety profiles, some may give rise to orofacial adverse effects, and may affect oral health care.
Potential pathogenetic role of Th17, Th0, and Th2 cells in erosive and reticular oral lichen planus
Authors: Piccinni M‐P , Lombardelli L , Logiodice F , Tesi D , Kullolli O , Biagiotti R , Giudizi MG , Romagnani S , Maggi E , Ficarra G
Published: March 2013

Objectives

The role of Th17 cells and associated cytokines was investigated in oral lichen planus.

Material and methods

14 consecutive patients with oral lichen planus were investigated. For biological studies, tissues were taken from reticular or erosive lesions and from normal oral mucosa (controls) of the same patient. mRNA expression for IL‐17F, IL‐17A, MCP‐1, IL‐13, IL‐2, IL‐10, IL‐1β, RANTES, IL‐4, IL‐12B, IL‐8, IFN‐γ, TNF‐α, IL‐1α, IL‐18, TGF‐β1, IL‐23R, IL‐7, IL‐15, IL‐6, MIG, IP‐10, LTB, VEGF, IL‐5, IL‐27, IL‐23A, GAPDH, PPIB, Foxp3, GATA3, and RORC was measured using the QuantiGene 2.0.

Results

Results showed that Th17‐type and Th0‐type molecules' mRNAs, when compared with results obtained from tissue controls, were increased in biopsies of erosive lesions, whereas Th2‐type molecules' mRNAs were increased in reticular lesions. When the CD4+ T‐cell clones, derived from oral lichen planus tissues and tissue controls, were analyzed, a higher prevalence of Th17 (confirmed by an increased CD161 expression) and Th0 CD4+ T clones was found in erosive lesions, whereas a prevalence of Th2 clones was observed in reticular lesions.

Conclusions

Our data suggest that Th17, Th0, and Th2 cells, respectively, may have a role in the pathogenesis of erosive and reticular oral lichen planus.
The Costs and Consequences of Adequately Managed Chronic Non‐Cancer Pain and Chronic Neuropathic Pain
Authors: Andrew R. , Derry Sheena , Taylor Rod S. , Straube Sebastian , Phillips Ceri J.
Published: March 2013

Background

Chronic pain is distressing for patients and a burden on healthcare systems and society. Recent research demonstrates different aspects of the negative impact of chronic pain and the positive impact of successful treatment, making an overview of the costs and consequences of chronic pain appropriate.

Objective

To examine recent literature on chronic noncancer and neuropathic pain prevalence, impact on quality and quantity of life, societal and healthcare costs, and impact of successful therapy.

Methods

Systematic reviews (1999 to February 2012) following PRISMA guidelines were conducted to identify studies reporting appropriate outcomes.

Results

Chronic pain has a weighted average prevalence in adults of 20%; 7% have neuropathic pain, and 7% have severe pain. Chronic pain impeded activities of daily living, work and work efficiency, and reduced quality and quantity of life. Effective pain therapy (pain intensity reduction of at least 50%) resulted in consistent improvements in fatigue, sleep, depression, quality of life, and work.

Conclusion

Strenuous efforts should be put into obtaining good levels of pain relief for people in chronic pain, including the opportunity for multiple drug switching, using reliable, validated, and relatively easily applied patient‐centered outcomes. Detailed, thoughtful and informed decision analytic policy modeling would help understand the key elements in organizational change or service reengineering to plan the optimum pain management strategy to maximize pain relief and its stream of benefits against budgetary and other constraints. This paper contains the information on which such models can be based.