bluuebunny/crossref_metadata_2025 huggingface dataset:
Longer Length of First Stay in Intermittent Residential Programmes Is Associated with Larger Weight Loss at 1 and 2 Years
Authors: Martins Catia , Strommen Magnus , Kulseng Bård
Published: June 2013

Objective: To determine if length of first stay impacts on weight loss and cardiovascular fitness, at 1 and 2 years in severely obese patients enrolled in intermittent residential programs. Methods: In a retrospective follow-up study, we assessed weight loss and changes in cardiovascular fitness (VO2 peak) at 1 and 2 years in 179 severely obese adults who participated in two intermittent residential programmes. Both programmes consisted of five stays at the Røros Rehabilitation Centre over a 2-year period, but programme A consisted of a much longer first stay compared with programme B (8 vs. 2 weeks). Results: Of 179 participants (BMI 44 ± 6 kg/m2), 162 completed 1-year and 117 2-year evaluation. Programme A led to significantly larger weight reduction (-20.7 ± 10.8 vs. -13.5 ± 8.1 kg and -16.0 ± 12.7 vs. -7.9 ± 11.2 kg, p < 0.0001) and improvement in VO2 peak (7.8 vs. 3.6 ml/kg/min (p < 0.0001) and 5.6 vs. 2.5 ml/kg/min (p < 0.01)) at both 1 and 2 years, compared with programme B. Intention-to-treat analysis showed similar results. Conclusion: A residential intermittent programme with a longer initial stay is associated with better weight loss and improvement in cardiovascular fitness at both 1 and 2 years. A longer follow-up is needed to clearly establish the sustainability of these programmes.
Taxonomic revision of the genus Bolusiella (Orchidaceae, Angraecinae) with a new species from Cameroon, Burundi and Rwanda
Authors: VERLYNDE SIMON , DUBUISSON JEAN-YVES , STÉVART TARIQ , SIMO-DROISSART MURIELLE , GEERINCK DANIEL , SONKÉ BONAVENTURE , CAWOY VALÉRIE , DESCOURVIÈRES PASCAL , DROISSART VINCENT
Published: June 2013

On basis of morphological analyses and field investigation, a revision of Bolusiella (Angraecinae; Orchidaceae) was undertaken. We examined 302 specimens from several main herbaria, and for each of the six taxa recognized we provide a morphological description, distribution, habitat, phenology and IUCN conservation status assessment. Distribution maps and an identification key are also provided. Detailed examinations of specimens and comparison with nomenclatural types resulted in one novelty, Bolusiella fractiflexa, which is distributed in lowland and montane forests of Cameroon, Burundi and Rwanda. This species is close to Bolusiella maudiae and B. talbotii in general aspect but differs from them in having only a small or absent spur and a basally fractiflex inflorescence. Some taxonomic changes are made: B. alinae is synonymous with B. talbotii, and B. batesii is lectotypified and considered synonymous with B. zenkeri. Two new records are provided: B. maudiae from Nigeria and B. zenkeri from Liberia.
A new species of Mimosa (Mimosoideae, Leguminosae) from the inter-Andean dry valleys
Authors: MORALES MATIAS , FORTUNATO RENEE H.
Published: June 2013

Mimosa arturoana (Mimosoideae, Leguminosae) is described and illustrated for the first time. This species is similar to the recently published M. lamolina and to the allopatric, Mexican M. deamii, but differs by several morphological characters, such as stems armament, secondary venation of leaflets and pubescence of vegetative organs and pods. This species should be included in the Mimosa sect. Mimosa ser. Mimosa subser. Lactifluae by its characteristic habit, armament of stems, and ecology. This finding increments the diversity of Leguminosae in the dry forests of Inter-Andean valleys of Peru, a potentially center of endemism of this family.
A new species of Rhododendron (Ericaceae) from the Gaoligong Mountains, Yunnan, China, supported by morphological and DNA barcoding data
Authors: MA YONGPENG , WU ZHIKUN , XUE RUIJUAN , TIAN XIAOLING , GAO LIANMING , SUN WEIBANG
Published: June 2013

Rhododendron baihuaense sp. nov. is described as a new species endemic to Yunnan, China, that has, to date, only been found in Baihualing on the eastern side of the Gaoligong Mountains. Morphologically, R. baihuaense can be readily distinguished from R. hanceanum and R. genestierianum, by its absent scales on mature leaves, only 2–5 flowers per inflorescence, the funnel-shaped flower and white corolla, and its slender and erect style. A molecular analysis based on the four standard DNA barcodes (rbcL, matK, trnH-psbA and ITS) indicates that R. baihuaense is genetically distinct from R. hanceanum and R. genestierianum, and, together with the morphological differences, is described here as a new species.
A new species of sesarmid crab of the genus Chiromantes (Crustacea: Decapoda: Brachyura) from the Ogasawara Islands, Japan
Authors: KOMAI TOMOYUKI , NG PETER K.L.
Published: June 2013

A new species of sesarmid crab, Chiromantes magnus, is described from the Ogasawara (Bonin) Is., Japan. The new spe-cies was previously confused with C. dehaani (H. Milne Edwards, 1853). The different carapace shape, proportionally longer ambulatory legs, large adult size and the distinct live coloration distinguish the new species from its two closest congeners, C. dehaani and C. neglectus (De Man, 1887). Available information indicates that C. magnus n. sp. is endemic to the Ogasawara Is.; there is no evidence of the occurrence of the true C. dehaani in the Ogasawara Is.
First new species of the Phytoseius horridus group (Acari: Phytoseiidae) described from Brazil, with a key to the Brazilian species of Phytoseius
Authors: DA SILVA GUILHERME LIBERATO , ROCHA MATHEUS DOS SANTOS , FERLA NOELI JUAREZ
Published: June 2013

Phytoseius litoralis n. sp., a member of the horridus species group, is described from the State of Rio Grande do Sul, in southern Brazil, based on specimens collected on Psidium guajava, Solanum concinnum and Cecropia pachystachya. This is the first species of the horridus group described from Brazil. A key to species of Phytoseius reported from Brazil is provided.
Notodonta valeria, a new species (Lepidoptera, Notodontidae) from China, with taxonomic remarks on Notodonta ziczac (Linnaeus, 1758)
Authors: SALDAITIS AIDAS , IVINSKIS POVILAS , RIMSAITE JOLANTA
Published: June 2013

A new species of Notodonta Ochsenheimer, 1810, N. valeria sp. n., from the Chinese Sichuan and Qinghai provinces is described. The new species differs in appearance, genitalia and DNA from its closest known relatives, Notodonta ziczac (Linnaeus) and Notodonta derbendica Daniel, 1965 stat. n. described from Europe and Iran, respectively. The genus Notodonta in the Palearctic is distributed in North Africa, Europe, Middle Asia, Russia (including Siberia), Japan, Korea and China. Three of the known 13 species are found in North America (Schintlmeister 2008). Sampling was conducted using UV lights and DNA barcodes (658 base pairs of Cytochrome Oxidase Subunit I 5' region, COI-5P) were prepared by Hebert's laboratory at the University of Guelph. Male and female genitalia dissections following Lafontaine (2004) were mounted in euparal, and a Wild M3Z microscope and Canon EOS 350D camera were used to prepare images. Taxonomic information and nomenclature follows Daniel 1965, Schintlmeister & Fang 2001, Schintlmeister 2008, Wu & Fang 2001. Acronyms used below: AFM = Alessandro Floriani (Milan, Italy); MNHU = Museum für Naturkunde der Humboldt Universität zu Berlin; MWM/ZSM = Museum Thomas Witt (Munich, Germany) /Zoologische Staatssammlung, Munich (Germany); NRCV = Nature Research Centre (Vilnius, Lithuania); OPB = Oleg Pekarsky (Budapest,Hungary); PMM = Pavel Morozov (Moscow, Russia).
Perioperative use of a beta blocker in coronary artery bypass grafting
Authors: Ogawa Shinji , Okawa Yasuhide , Goto Yoshihiro , Aoki Masakazu , Baba Hiroshi
Published: June 2013

Objectives:

Atrial fibrillation after cardiac surgery is associated with increases in the risk of complications, length of intensive care unit stay, and cost of care. Beta blockers are effective for controlling myocardial ischemia and arrhythmia and suppressing inflammatory cytokines. The purpose of this study was to examine the effect of administrating a short-acting beta-adrenoceptor antagonist, landiolol, on postoperative atrial fibrillation.

Methods:

136 patients undergoing off-pump coronary artery bypass grafting were single-blindly assigned randomly to landiolol ( n = 68) and non-landiolol (control, n = 68) groups. In the landiolol group, the beta blocker was administered from the beginning of the operation until postoperative day 2. The primary endpoint was the incidence of atrial fibrillation until postoperative day 7, and the secondary endpoints were the postoperative levels of troponin I, creatine kinase MB-isoenzyme, and C-reactive protein.

Results:

The incidence of atrial fibrillation was significantly lower in the landiolol group compared to the control group (13/68, 19% vs. 25/68, 37%, p = 0.02, logrank test). Landiolol also significantly reduced the postoperative peak C-reactive protein level compared to the control group (132 ± 55.4 vs. 161 ± 50.9 mgċL−1, p = 0.004).

Conclusion:

Low-dose continuous infusion of landiolol reduced the incidence of postoperative atrial fibrillation, and significantly suppressed inflammation.
Effect of mitral valve replacement on reduction of left atrial size
Authors: Pande Shantanu , Agarwal Surendra K , Mohanty Satyapriya , Bansal Anubhav
Published: June 2013

Introduction:

asymptomatic left atrial enlargement is not uncommon in rheumatic mitral valve disease. We studied the change in size of the left atrium after mitral valve replacement.

Patients and methods:

between January and December 2005, 116 patients underwent isolated mitral valve replacement. Two groups were identified based on left atrial size: group 1 < 60 mm ( n = 79) and group 2 > 60 mm ( n = 37). The patients were followed up for 40.4 ± 19.3 months Clinical assessment, preoperative and last postoperative echocardiograms were considered for analysis.

Results:

the left atrium decreased by 5.84 mm ± 10.5 in group 1 compared to 20.9 mm ± 10.64 in group 2 ( p = 0.0001). This correlated with preoperative mitral valve area ( p = 0.009), preoperative mitral regurgitation ( p = 0.000), and preoperative atrial fibrillation ( p = 0.022). Linear regression analysis revealed atrial fibrillation ( p = 0.001, b1 = 6.006), a high grade of mitral regurgitation ( p = 0.001, b1 = −3.812), and larger size of the left atrium ( p = 0.000, b1 = −0.701) predicted a greater reduction of left atrial size during follow-up. Left atrial size decreased by 28 mm in patients with a preoperative left atrium >60 mm (75% sensitivity and 100% specificity).

Conclusion:

the asymptomatic left atrium reduces in size considerably after mitral valve replacement, and the decrease is greater in patients with a left atrium >60 mm in size.
Successful staged operation for acute type A aortic dissection with paraplegia
Authors: Ando Takashi , Abe Hiroyuki , Nagata Tokuichiro , Makuuchi Haruo
Published: June 2013

A 75-year-old man presented with both paraplegia and acute occlusion of the abdominal aorta at onset. Extraanatomical bypass was performed following spinal drainage. After 3 days, the ascending aorta replaced under cardiopulmonary bypass using the extraanatomical bypass graft for arterial cannulation. The abdominal aorta was replaced after 6 months. A staged operation is one of the options for acute aortic dissection with paraplegia and acute occlusion of the abdominal aorta.
Crosslinked acellular saphenous vein for small-diameter vascular graft
Authors: Ramesh Balasundari , Mathapati Santosh , Galla Satish , Cherian Kotturathu Mammen , Guhathakurta Soma
Published: June 2013

Objective:

Patients with congenital and acquired heart diseases or arteriopathy require small-diameter vascular grafts for arterial reconstruction. Autologous veins are the most suitable graft, but when absent, an alternative is necessary. This work addresses the issue.

Background:

Tissue-engineering efforts to create such grafts by modifications of acellular natural scaffolds are considered a promising area.

Methods:

Homologous saphenous veins harvested from cadavers and organ donors were processed by decellularization with detergent and enzymatic digestion, followed by crosslinking by dye-mediated photooxidation. They were validated for acellularity, mechanical strength, and crosslink stability. In-vitro and in-vivo cytotoxicity and hemocompatibility studies were conducted. Collagen conformity was studied by Fourier transform infrared spectroscopy, and heat stability by differential scanning calorimetry. A limited large animal study was performed.

Results:

The processing method delivered biocompatible, hemocompatible, effectively crosslinked grafts, with high heat stability of 126 ℃, an enthalpy value of 183.5 J·g−1, and collagen conformity close to that of the native vein. The mechanical strength was 250% better than the native vein. The presence of extracellular matrix proteins allowed the acellular vein to become a triple-layered vascular structure in the sheep venous system.

Conclusion:

Crosslinking after decellularization by the dye-mediated photooxidation method could be reproduced in any human vein to obtain a small-diameter vascular grafts.
Methemoglobinemia due to nitric oxide therapy in a child after cardiac surgery
Authors: Syed Aitizaz Uddin , Jelly Ali E Ali , Algebaly Ahmed Azmy , Altoonisi Mustafa M , Shatoory Ahmed El
Published: June 2013

A 5-month-old boy with trisomy 21 had repair of ventricular septal defect, atrial septal defect, and ligation of a patent ductus arteriosus. Due to severe pulmonary hypertension, NO inhalation was instituted postoperatively. Over the course of next few hours, he developed life-threatening methemoglobinemia. The condition once recognized was corrected with exchange blood transfusion. The management strategy is described with a brief review of the literature.
Integrity of mechanical aortic valve prostheses explanted after 27 and 23 years
Authors: Winkler Bernhard , Inderbitzin Devdas T , Ruppert Patrick , Halbeisen Marcel , Grapow Martin TR , Eckstein Friedrich S
Published: June 2013

We describe 2 cases of mechanical aortic valve endocarditis and the influence on clinical outcome and prostheses material integrity. One patient required extensive reconstruction due to active endocarditis leading to a “rocking valve”. The second case was caused by late aortic dissection following endocarditis. Both valve prostheses showed remarkable material quality and performance in functional assessment and high resolution scanning electron microscopic evaluation after 27 and 23 years of service.
Sternal wrapping: developments and results
Authors: Aratari Carlo , Capestro Filippo , Massi Francesco , Magnano Diego , Manché Alexander , Lamarra Mauro
Published: June 2013

Background:

Postoperative sternal wound complications are infrequent events that negatively affect recovery and may have serious consequences. Sternal wrapping, a technique of sternal care, has hemostatic properties without bone wax, and offers mechanical and microbiologic protection.

Methods:

From February 1998 to December 2011, 258 patients in 2 Italian institutions underwent various cardiac surgery procedures with sternal wrapping in place, and were followed up for no less then 6 months.

Results:

Two (0.8%) extremely compromised patients with ischemic sternal osteonecrosis and deep sternal wound infection required a sternal stabilizing procedure. Four (2%) other patients developed sternal wound complications that were treated entirely medically; 3 of them were very trivial, and 1 was an atypical mediastinitis without sternal involvement. Overall, 46.1% of patients (45.3% of isolated coronary artery bypass, 49.3% of isolated on-pump coronary artery bypass, and 18.2% of off-pump coronary artery bypass patients) were transfused. None of the complications was related to sternal wrapping, bleeding from the sternal edge, or sternal wound problems.

Conclusions:

Sternal wrapping showed a very low incidence and severity of sternal wound complications, with good prevention of sternal osteomyelitis. Hemostatic properties were satisfactory, with transfusion rates within an acceptable range.
Preoperative pulmonary artery pressure and mortality after lung transplantation
Authors: Ohtsuka Takashi , Flaherty Kevin R , Lin Jules , Lama Vibha N , Reddy Rishindra M , Orringer Mark B , Chan Kevin M , Chang Andrew C
Published: June 2013

Background:

The purpose of this study was to determine the influence of changes in pulmonary artery pressure during the waiting period on survival after lung transplantation for pulmonary fibrosis.

Methods:

We identified 65 patients with pulmonary fibrosis who underwent lung transplantation from 2003 to 2010. Pulmonary artery pressure determined at listing was compared with intraoperative pressure. The primary outcome was overall survival. Co-variates included type of transplantation (single or bilateral), ischemic time, recipient and donor age and sex.

Results:

The median age of the 65 patients undergoing transplantation was 58 years, and 27 (43%) underwent bilateral sequential transplantation. Twenty-two (35%) patients presented at transplantation with a mean pulmonary artery pressure increased by at least 10% compared to the initial pressure at the time of listing. Rising pulmonary artery pressure at transplantation was associated with increased mortality ( p = 0.022). Other factors including type of operation, ischemic time, age, and sex, were not significantly associated with mortality. Post-transplantation survival was worse among recipients who had pulmonary artery pressure increased by at least 10% at transplantation ( p = 0.003, logrank).

Conclusions:

Increasing pulmonary artery pressure while awaiting lung transplantation is associated with worse long-term survival following transplantation, and is a sign of progressively worsening disease for which greater urgency of donor organ allocation should be considered.
‘. . . so that by steadfastness and by the encouragement of the scriptures we might have hope’: What does Paul Refer to When He Refers to ‘the Scriptures’?
Authors: Ehrensperger Kathy
Published: June 2013

Paul frequently refers to the traditions of his ancestors as ‘the scriptures’, or with introductory formula such as ‘it is written’. Such references have often been taken as self-explanatory in that it was assumed that these were references to the writings which in Jewish and Christian tradition have acquired the status of canonicity. Since such a perception of the scriptures as canonical is anachronistic for the first century, the question needs to be asked to what does Paul actually refer when he refers to the Scriptures. Which parts of which canon encompassed ‘the holy scriptures’ which Paul refers to e.g. in Rom 1:2? In addition to issues of divergent interpretations of scriptural texts could there also have been issues under debate concerning which written traditions were perceived as ‘scripture’? The issue of the fluidity of the collection as well as of the text deemed ‘holy’ in first-century Judaism has an impact on the question of how the authority of such a collection is perceived, particularly since Paul clearly aims at enculturating gentile Christ-followers into the world of the Scriptures. The mysterious reference in 1 Cor. 2:9 is explored as a test case for Paul’s understanding of the collection and text which he deemed to be ‘scripture’.
Les stratégies de coping des adolescents confrontés à la critique de leurs pairs sur un choix de marque
Authors: Benmoyal-Bouzaglo Sarah , Guiot Denis
Published: June 2013

Résumé

Rares sont les travaux académiques qui portent sur la manière dont les adolescents réagissent aux critiques des pairs sur un choix de marque dans le contexte scolaire. Afin de mieux répondre aux enjeux de cette problématique sociétale et du marketing éducatif qui s’y rattache, ces réactions sont étudiées par le concept de coping mobilisé ici dans le cadre d’une approche mixte processus-style. Trois études quantitatives successives (n1 = 208 ; n2 = 200 ; n3 = 446) ont permis de mettre en évidence cinq stratégies de coping spécifiques : la justification des circonstances de l’achat, la vengeance, le déni du problème, la culpabilisation des critiqueurs et l’auto-attribution du problème. Parmi les déterminants potentiels, trois variables individuelles affectent particulièrement le déploiement de ces stratégies : le genre, la contrôlabilité perçue de la situation et la sensibilité aux marques.
Différences de comportement d’achat entre des magasins laboratoires réels et virtuels
Authors: Desmet Pierre , Bordenave Richard , Traynor John
Published: June 2013

Résumé

Pour tester des initiatives marketing en magasin (packaging, prix, etc.), un magasin laboratoire virtuel (3D) offre une alternative attractive au magasin laboratoire réel sur le plan opérationnel. Par une comparaison sur des échantillons contrôlés, cette recherche montre que les mesures attitudinales sont identiques, mais aussi qu’il existe des différences significatives sur les comportements en magasin et sur l’attention au prix et que celles-ci dépendent de l’achat habituel de la marque.
Spontaneous clearance and treatment of acute hepatitis C infection in HIV-positive men with 48 weeks of interferon-alpha and Ribavirin
Authors: Webster D P , Wojcikiewicz T , Keller M , Castelnovo D , Mistry H , Gilleece Y , Tibbie J , Fisher M
Published: June 2013

Acute hepatitis C infection in the context of HIV is an emerging problem in men who have sex with men (MSM). We conducted a retrospective cohort study of MSM diagnosed with and treated for acute hepatitis C infection over 10 years. Genotype 1 was the commonest type representing 69% of cases; the spontaneous clearance rate was 20%. The overall sustained virological response (SVR) rate on an intention-to-treat basis was 83%; SVR and was 92% for those completing 48 weeks of treatment. The presence of detectable RNA at week 12 had a 100% negative predictive value for SVR. This is the largest single cohort treated with 48 weeks of interferon and ribavirin and the treatment SVR is one of the highest reported. We propose that a 48-week treatment regimen may be superior to shorter (24-week) regimens though we acknowledge the need for a randomized controlled trial.
Estimating the positive predictive value of opportunistic population testing for gonorrhoea as part of the English Chlamydia Screening Programme
Authors: Fowler T , Edeghere O , Inglis N , Bradshaw S
Published: June 2013

Advances in technology have raised the possibility of including gonorrhoea testing as part of chlamydia screening. In England this is recommended only where the positive predictive value (PPV) of the test is >90%. This study assessed the PPV for gonorrhoea testing using routine testing data. Routine data (including gonorrhoea testing) from the Greater Manchester Chlamydia Screening Programme (GMCSP) in 2009/2010, were used to estimate the PPV for gonorrhoea testing. Of those screened, 0.3% (59/18044) of men and 0.4% (174/41873) of women tested positive for gonorrhoea. The PPV was 82.3% in women and 73.6% in men, in those who also tested positive for chlamydia. For women and men testing negative for chlamydia the PPV for a positive gonorrhoea test was incalculable. The low PPV observed in most groups suggests that where population testing for gonorrhoea occurs there is a need for further confirmatory testing of positive results before treatment decisions are made. Clinicians should be aware of screening test result limitations in this context.
A comparison of condom use perceptions and behaviours between circumcised and intact men attending sexually transmitted disease clinics in the United States
Authors: Crosby R , Charnigo R J
Published: June 2013

This investigation compared circumcised and intact (uncircumcised) men attending sexually transmitted infection (STI) clinics on condom perceptions and frequencies of use. Men ( N = 316) were recruited from public clinics in two US states. Circumcision status was self-reported through the aid of diagrams. Intact men were less likely to report unprotected vaginal sex ( P < 0.001), infrequent condom use ( P = 0.02) or lack of confidence to use condoms ( P = 0.049). The bivariate association between circumcision status and unprotected sex was moderated by age ( P < 0.001), recent STD acquisition ( P < 0.001) and by confidence level for condom use ( P < 0.001). The bivariate association between circumcision status and infrequent condom use was also moderated by age ( P = 0.002), recent STI acquisition ( P = 0.02) and confidence level ( P = 0.01). Multivariate findings supported the conclusion that intact men may use condoms more frequently and that confidence predicts use, suggesting that intervention programmes should focus on building men's confidence to use condoms, especially for circumcised men.
Multiple human papillomavirus infections and HIV seropositivity as risk factors for abnormal cervical cytology among female sex workers in Nairobi
Authors: Patel S J , Mugo N R , Cohen C R , Ting J , Nguti R , Kwatampora J , Waweru W , Patnaik P , Donders G G , Kimani J , Kenney D L , Kiviat N B , Smith J S
Published: June 2013

We estimated type-specific prevalence of human papillomavirus (HPV) and examined risk factors for abnormal cervical cytology among 296 female sex workers from Nairobi, Kenya. Over half (54%) were infected with a high-risk (HR) HPV type, of which HPV16 and 52 were the most common types. HIV-1 prevalence was 23% and HIV-1 sero-positivity was associated with high-grade cervical lesions, particularly among women with CD4 count less than 500 cells/mm3 (odds ratio [OR] = 6.9; 95% confidence interval [CI]: 1.7–24.9). Among women who had normal cytology at the time of entry into the study, the risk of having an abnormal Pap smear within one year was significantly elevated for women with multiple HPV types at study entry (adjusted odds ratio [aOR] = 6.0; 95% CI: 2.3–15.7) and with a subset of HR HPV types (aOR = 4.2; 95% CI: 1.6–11.2). Detection of multiple concurrent HPV infections may be a useful marker to identify women at risk of developing precancerous lesions in populations of high HPV prevalence.
Development of a validated patient satisfaction survey for HIV clinic attendees
Authors: Land L , Sizmur S , Harding J , Ross JDC
Published: June 2013

Patients are becoming more actively involved in decisions about their care and have greater influence to change and improve the quality of services by reporting their experiences. A recent systematic review failed to reveal a method of measuring HIV patient satisfaction that reflects their experience of contemporary treatment and care. The aim of this study was to design a specific HIV patient satisfaction questionnaire that can be used as a patient reported outcome measure. Key themes in the systematic review were identified and used as a topic guide for focus group discussion to confirm their relevance and importance. HIV patients were also interviewed about their motivation to complete a questionnaire. The data from the focus groups and interviews were used to develop an initial questionnaire and cognitive testing was used to provide face validity for the questionnaire design, layout and wording. A revised version was used in a pilot study of 80 respondents, which demonstrated that the questionnaire's completion rate and content validity were high.
Immunization against pneumococcal disease in HIV-infected patients: conjugate versus polysaccharide vaccine before or after reconstitution of the immune system (CTN-147)
Authors: Slayter K L Bsc , Singer J , Lee T C K , Kayhty H , Schlech W F
Published: June 2013

To investigate whether patients should be immunized immediately or delay immunization until after reconstitution of the immune system and whether a conjugate or polysaccharide vaccine results in a better immunologic response. Seventy-nine patients were randomly assigned, utilizing a two by two factorial design to receive immediate immunization or delay immunization. Baseline characteristics were similar for the four arms: 78% men, median age 41 years, median time since HIV diagnosis 0.3 years, median CD4 60 cells/mm3 and median HIV viral load 5.02 log copies/mL. Results in favour of delayed immunization were observed for those serotypes showing a response. The proportional odds ratios for delayed versus immediate immunization were 0.341 ( P = 0.04) and 0.204 ( P = 0.004) at months 6 and 12, respectively. No differences in immunological response were observed between the two individual vaccines for the shared serotypes studied. HIV-infected adults produced a higher immunological response to pneumococcal vaccine after reconstitution of the immune system.
Routine detection and management of neurocognitive impairment in HIV-positive patients in a UK centre
Authors: Haddow L J , Cpsychoil A Accoroni , Cartledge J D , Manji H , Benn P , Gilson R J C
Published: June 2013

We estimated the burden of HIV-associated neurocognitive disorders (HAND) in a UK clinic. From a random sample, and referrals to specialist services over one year (neurology, clinical psychology, hospital admissions), we determined whether patients were diagnosed with HIV-associated dementia (HAD) and whether they reported symptoms suggesting neurocognitive impairment (NCI). In the first sample, 2/150 (prevalence 1.3%; 95% confidence interval [CI] 0.2–4.7%) had documented HAD. Eleven patients (7.3%; CI 3.7–12.7%) reported recent symptoms suggesting NCI; most of these individuals were diagnosed with a psychiatric or substance-use disorder. Among specialist referrals with symptoms suggesting NCI, 11 were diagnosed with HAD from a clinic population of 3129 individuals (annual incidence 0.4%; CI 0.2–0.6%). No patients with mildly symptomatic or asymptomatic HAND were identified in either sample, suggesting that such patients remain undetected in current clinical practice. Evidence-based screening for HAND in HIV clinics may be needed.
Language, interactivity and solution probing: repetition without repetition
Authors: Cowley Stephen , Nash Luarina
Published: June 2013

Recognition of the importance of autopoiesis to biological systems was crucial in building an alternative to the classic view of cognitive science. However, concepts like structural coupling and autonomy are not strong enough to throw light on language and human problem solving. The argument is presented though a case study where a person solves a problem and, in so doing relies on non-local aspects of the ecology as well as his observer’s mental domain. Like Anthony Chemero we make links with ecological psychology to emphasize how embodiment draws on cultural resources as people concert thinking, action and perception. We trace this to human interactivity or sense-saturated coordination that renders possible language and human forms of cognition: it links human sense-making to historical experience. People play roles with natural and cultural artifacts as they act, animate groups and live through relationships drawing on language that is, at once, artificial and natural. Thus, while constrained by wordings, interactivity is able to fine-tune what we do with action-perception loops. Neither language nor human problem solving reduce to biological sense-making.
Metformin's performance in in vitro and in vivo genetic toxicology studies
Authors: Sant'Anna Juliane R , Yajima Joana Paula RS , Rosada Lúcia J , Franco Claudinéia CS , Prioli Alberto J , Della-Rosa Valter A , Mathias Paulo Cezar F , Castro-Prado Marialba AA
Published: June 2013

Metformin is a hypoglycemiant drug prescribed for the treatment and control of the type 2 diabetes mellitus. Recently, the potential efficacy of this antidiabetic drug as an anticancer agent has been demonstrated in various mammalian cancer cells. This report evaluates the mutagenic as well as the recombinogenic potentials of the metformin drug in therapeutically relevant plasma concentrations (12.5 µM, 25.0 µM or 50.0 µM). Since the loss of heterozygosity is a process associated with carcinogenesis, the recombinogenic potential of such a drug was evaluated by the homozygotization assay using a heterozygous diploid strain of Aspergillus nidulans. The homozigotization indices (HI) for the genetic markers from the metformin-treated diploids were not statistically different from the negative control (non-treated diploids). For the first time, this indicated a lack of recombinogenic activity of the antidiabetic drug. The mutagenic potential of the metformin drug was evaluated by the chromosome aberrations and the micronuclei tests in human lymphocytes cultures. The metformin drug did not show any significant increase either in the numerical or in the structural chromosome aberrations and did not affect significantly the mitotic index when compared to the negative control. In the in vitro micronucleus test, the drug did not increase the number of micronuclei or nuclear buds when compared with the negative control. The data in this study suggest that the metformin drug is not a secondary cancer inducer, since it has neither showed recombinogenic nor mutagenic activities when used in pharmacological concentrations.
An inter-professional ‘advocacy and activism in global health’: module for the training of physician-advocates
Authors: Peluso Michael J. , Seavey Brian , Gonsalves Gregg , Friedland Gerald
Published: June 2013

Medical students typically learn about the role of physicians as health advocates through a component of the health professionalism curriculum. Recently, there has been a call for increased exposure to health advocacy in undergraduate medical education so that students can develop the interest, knowledge, skills, and attitudes that they will utilize throughout their careers as physician-advocates. We developed a four-session Advocacy and Activism training module that consisted of formal didactic teaching, training in basic skills, debate and discussion, and the development and presentation of advocacy projects. There were several uniquely innovative aspects of this module, including its structure, content, and inter-professional approach that included students of medicine, nursing, and public health. However, this approach also resulted in some important and unexpected limitations. We were encouraged by the quality of student participation during the module, as well as specific feedback regarding the format and content. The module was a low-cost, easy-to-implement, and academically rigorous model that can be implemented by interested students and faculty at other schools. We plan to continue to develop this program in the future, and we believe that other medical institutions should consider a similar model for introducing students to their future role as health advocates.
Everyday life and health concepts among blue-collar female workers in Denmark: implications for health promotion aiming at reducing health inequalities
Authors: Jensen Jeanette Magne
Published: June 2013

This article introduces a perspective on the health of women with low levels of education in terms of organisation of their everyday life. The aim is to demonstrate the ways in which the women’s concept of health is contingent on the conditions encountered in everyday life. A qualitative study based on interviews with the women forms the basis for the discussion. The analysis shows that the women find it difficult to adopt the official discourse on health and its foundation in a biomedical tradition. The article argues that it is necessary to move away from the educational approach focusing on risk and lifestyle with the goal of regulating individual behaviour. Instead, an approach is suggested which can provide the women with the opportunity to gain control of the everyday health determinants which are normally beyond their immediate reach. This is based on the argument that it is necessary to work with a health promotion and education strategy capable of operating within the various interactive patterns between ‘environment’ and ‘individual’ which form the foundation for health.
The call to action: health promotion in The Gambia – closing the implementation gap?
Authors: Dixey Rachael , Njai Modou
Published: June 2013

This paper discusses the difficulties facing the development of health promotion in The Gambia, and in ‘closing the implementation gap’ noted by the WHO 7th Global Conference on Health Promotion (2009, Nairobi). The Gambia has achieved a great deal so far, but health promotion as a discipline has not really informed the development of its approach to health. There is not a central concern with determinants of health and tackling health inequalities and there is no well-developed health promotion infrastructure. The difficulties facing sub-Saharan Africa generally can be extrapolated from the paper, with the conclusion that sub-Saharan Africa faces many disease and health challenges not experienced by richer countries and thus not only does the discourse of health promotion need to take this into account, but also the basic needs of Africa need to be placed at the forefront.
The importance of context in the evolution of health promotion
Authors: Sparks Michael
Published: June 2013

The world has changed dramatically since the Ottawa Charter was developed in 1986. Contemporary health promotion responses continue to evolve and become more sophisticated in response to the multiple challenges created by an ever-changing world. This commentary discusses some of the challenges facing health promotion professionals today and some of the responses that are being developed to address them. The importance of contextual considerations for both the worker and the work of health promotion are emphasised. The author then suggests ways that organisations and individuals can meet modern-day health promotion challenges through specific courses of action.
The salutogenic model of health in health promotion research
Authors: Mittelmark Maurice B. , Bull Torill
Published: June 2013

Despite health promotion’s enthusiasm for the salutogenic model of health, researchers have paid little attention to Antonovsky’s central ideas about the ease/dis-ease continuum, defined in terms of ‘breakdown’ (the severity of pain and functional limitations, and the degree medical care is called for, irrespective of specific diseases). Rather, salutogenesis research has a strong focus on how sense of coherence relates to a wide range of specific diseases and illness endpoints. We address two questions: Why has Antonovsky’s health concept failed to stimulate research on breakdown, and how can the present emphasis on disease be complemented by an emphasis on positive well-being in the salutogenic model? We show that (i) the breakdown concept of health as specified by Antonovsky is circular in definition, (ii) it is not measured on the ‘required’ ease/dis-ease continuum, (iii) it is not measureable by any validated or reliability-tested assessment tool, and (iv) it has not so much been rejected by health promotion, as it has not been considered at all. We show that Antonovsky came to view breakdown as but one aspect of well-being. He was open to the idea of well-being as something more positive than the absence of pain, suffering and need for medical care. We suggest ways to move salutogenesis research in the direction of well-being in its positive sense.
Reducing social inequities in health through settings-related interventions — a conceptual framework
Authors: Shareck Martine , Frohlich Katherine L. , Poland Blake
Published: June 2013

Introduction: The creation of supportive environments for health is a basic action principle of health promotion, and equity is a core value. A settings approach offers an opportunity to bridge these two, with its focus on the interplay between individual, environmental and social determinants of health. Methods: We conducted a scoping review of the literature on theoretical bases and practical applications of the settings approach. Interventions targeting social inequities in health through action on various settings were analyzed to establish what is done in health equity research and action as it relates to settings. Results: Four elements emerged as central to an equity-focused settings approach: a focus on social determinants of health, addressing the needs of marginalized groups, effecting change in a setting’s structure, and involving stakeholders. Each came with related challenges. To offer potential solutions to these challenges we developed a conceptual framework that integrates theoretical and methodological approaches, along with six core guiding principles, into a ‘settings praxis’. Conclusions: Reducing social inequities in health through the creation of supportive environments requires the application of the settings approach in an innovative way. The proposed conceptual framework can serve as a guide to do so, and help develop, implement and evaluate equity-focused settings-related interventions. (Global Health Promotion, 2013; 20(2): 39–52).
Protective effect of Erythropoietin on renal injury induced in rats by four weeks of exhaustive exercise
Authors: Lin Xixiu , Jiang Chonghe , Luo Ziqiang , Qu Shulin
Published: June 2013

Background

The protective effect of Erythropoietin (EPO) analogue rHuEPO on acute renal injury induced by exhaustive exercise had been reported. The purpose of this study is to probe into the protective effect of EPO on chronic renal injury induced by repeated exhaustive exercise for four weeks.

Methods

Eighty adult male Sprague–Dawley rats were used in this experiment. The animals were randomly allocated to one of four groups: control (C), exhaustive exercise test (ET), ET plus EPO pre-treatement (ET+EPO) and ET+EPO plus LY294002 pretreatment (ET+EPO+LY).

Results

Compared with the rats in control group, there was considerable damage in kidney cells in rats of ET group as revealed by histological and ultrastructural examinations. However, treatment with EPO during the training, the exhaustive running distance was significant increased (P < 0.01), and the pathological changes of kidney cell were much less compared with those of rats without EPO intervention. When LY294002, a specific inhibitor of phospholipids phthalocyanine inositol 3-kinase, was added to the EPO treated rats, the injury changes of renal cell were becoming more pronounced.

Conclusions

The protective effect of EPO on chronic renal injury induced by repeated exhaustive exercise was demonstrated in the present study. We proposed that the effect could be due to inhibiting the cell apoptosis and blocking the formation of interstitial fibrosis via activation of the PI3K/Akt pathway, thus plays role in the endogenous protection of the kidney injury.
Correlates of preferences for home or hospital confinement in Pakistan: evidence from a national survey
Authors: Javed Sajid Amin , Anjum Muhammad Danish , Imran Waqas , Haider Azad , Shiraz Ayesha , Shaheen Farzana , Iftikhar ul Husnain Muhammad
Published: June 2013

Background

Despite the pregnancy complications related to home births, homes remain yet major place of delivery in Pakistan and 65 percent of totals births take place at home. This work analyses the determinants of place of delivery in Pakistan.

Methods

Multivariate Logistic regression is used for analysis. Data are extracted from Pakistan Demographic and Health Survey (2006–07). Based on information on last birth preceding 5 years of survey, we construct dichotomous dependent variable i.e. whether women deliver at home (Coded=1) or at health facility (coded=2).

Results

Bivariate analysis shows that 72% (p≤0.000) women from rural area and 81% women residing in Baluchistan delivered babies at home. Furthermore 75% women with no formal education, 81% (p≤0.000) women working in agricultural sector, 75% (p≤0.000) of Women who have 5 and more children and almost 77% (p≤0.000) who do not discussed pregnancy related issues with their husbands are found delivering babies at home. Multivariate analysis documents that mothers having lower levels of education, economic status and empowerment, belonging to rural area, residing in provinces other than Punjab, working in agriculture sector and mothers who are young are more likely to give births at home.

Conclusion

A trend for home births, among Pakistani women, can be traced in lower levels of education, lower autonomy, poverty driven working in agriculture sector, higher costs of using health facilities and regional backwardness.
Hospital survey on patient safety culture in China
Authors: Nie Yanli , Mao Xuanyue , Cui Hao , He Shenghong , Li Jing , Zhang Mingming
Published: June 2013

Background

Patient safety culture is an important measure in assessing the quality of health care. There is a growing recognition of the need to establish a culture of hospital focused on patient safety. This study explores the attitudes and perceptions of patient safety culture for health care workers in China by using a Hospital Survey on Patient Safety Culture (HSPSC) questionnaire and comparing it with the psychometric properties of an adapted translation of the HSPSC in Chinese hospitals with that of the US.

Method

We used the modified HSPSC questionnaire to measure 10 dimensions of patient safety culture from 32 hospitals in 15 cities all across China. The questionnaire included 1160 Chinese health-care workers who consisted of predominately internal physicians and nurses. We used SPSS 17.0 and Microsoft Excel 2007 to conduct the statistical analysis on survey data including descriptive statistics and validity and reliability of survey. All data was input and checked by two investigators independently.

Result

A total of 1500 questionnaires were distributed of which 1160 were responded validly (response rate 77%). The positive response rate for each item ranged from 36% to 89%. The positive response rate on 5 dimensions (Teamwork Within Units, Organization Learning-Continuous Improvement, Communication Openness, Non-punitive Response and Teamwork Across Units) was higher than that of AHRQ data (P < 0.05). There was a statistical difference on the perception of patient safety culture in groups of different work units, positions and qualification levels. The internal consistency of the total survey was comparatively satisfied (Cronbach’s α = 0.84).

Conclusion

The results show that amongst the health care workers surveyed in China there was a positive attitude towards the patient safety culture within their organizations. The differences between China and the US in patient safety culture suggests that cultural uniqueness should be taken into consideration whenever safety culture measurement tools are applied in different culture settings.