bluuebunny/crossref_metadata_2025 huggingface dataset:
Rabbit model of cardiopulmonary bypass
Authors: Kim Won Gon , Moon Hyun Jong , Won Tae Hee , Chee Hyun Keun
Published: January 2013

Mainly because of technical problems, the use of rabbits as a cardiopulmonary bypass (CPB) animal model with direct cannulation of the ascending aorta is known to be extremely difficult. The objectives of this study were the establishment of a CPB model in rabbits with direct cannulation of the ascending aorta, and the evaluation of the protective effect of steroid on the development of brain edema during circulatory arrest (CA) in an established rabbit CPB model. Fifteen New Zealand white rabbits were divided into three groups; control CA group, CA with Trendelenberg position, and CA with Trendelenberg position and steroid administration. After anesthetic induction and tracheostomy, median sternotomy was performed. An aortic cannula (3.3 mm) and a venous cannula (14 Fr) were inserted into the ascending aorta and the right atrium, respectively. The CPB circuit consisted of a roller pump and a bubble oxygenator. With 120-150 ml of blood, the priming volume of the circuit was approximately 450 ml, and CPB at a flow rate of 80-85 ml/kg/min was initiated. Blood in the priming solution was obtained from donor rabbits through cardiac puncture. Ten minutes later, CA with cessation of CPB was established for 40 min at 20°C (rectal temperature). After CA, CPB was restarted with a 20 min period of rewarming. Ten minutes after weaning, the animal was sacrificed. Between 1 and 2 g of the brain was removed and the water content was determined and compared between groups. CPB with CA was successfully performed in all cases, with a flow rate of 60-100 ml/kg/min maintained throughout the CPB procedure. At that time, blood gases were reasonably maintained and aortic pressure ranged from 35 to 55 mmHg. After weaning from CPB, all hearts resumed beating spontaneously. Among the three groups, there were no statistically significant differences in the water content of the brain. These results indicate that: (1) if the proper technique is used, CPB in rabbits with direct cannulation of the ascending aorta is a reliable procedure, and (2) the effect of steroid on the prevention of brain edema related to the Trendelenburg position during CA is not established within the scope of this study.
Customized perfusion circuit for the tiny ascending aorta
Authors: Mueller Maryann W , Fraser Charles D
Published: January 2013

Cannulating a pediatric patient with an interrupted aortic arch presents many challenges. Two cannulas are necessary to allow for proper blood flow to the head and to the extremities. This case was made more difficult by the weight of the child and the small size of the ascending aorta. The available pediatric cannulas were too large. The perfusionist adapted two 14-gauge intravenous (i.v.) catheters as arterial cannulas which were incorporated into the 1/4-inch arterial line.

The 14-gauge i.v. catheters worked successfully. While on cardiopulmonary bypass, the patient was both metabolically and hemodynamically stable. The patient survived the procedure and was eventually discharged from hospital.
Assessing heparin neutralization following cardiac surgery: sensitivity of thrombin time-based assays versus protamine titration methods
Authors: LaDuca Frank M , Zucker Marcia L , Walker Charles E
Published: January 2013

Adequate assessment of heparin neutralization following cardiac surgery is critical in reducing the patient’s exposure to protamine. Both excessive protamine and residual heparin have been associated with postoperative bleeding and poor patient recovery. The activated clotting time (ACT) is the preferred intraoperative heparin monitor, while both protamine titration (i.e. a protamine-containing ACT) and thrombin time methods have been used to detect circulating residual heparin after protamine administration.

Following initial protamine dosing using the protamine response test (PRT), postoperative monitoring was employed in the operating room prior to transport of the patient to intensive care. Two point-of-care assays, the thrombin time (TT) and the protamine dose assay (PDA), were evaluated to determine their relative heparin sensitivity and their usefulness to quantitate protamine dose.

The PDA, which is based on the ACT, was shown in laboratory and clinical studies to detect residual heparin above 0.25 units/ml and to quantify additional minidoses of protamine (as low as 25 mg) required to obtain complete heparin neutralization. Differential evaluation of the TT and heparin neutralized thrombin time (HNTT) was shown in laboratory studies to be more sensitive to small amounts of residual heparin than the ACT. Clinical evaluations confirmed that additional protamine is required in approximately 12% of cardiac surgical cases managed using the PRT system. Both the PDA and TT/HNTT provided useful postoperative assessment of the adequacy of heparin neutralization. The TT/HNTT had slightly improved heparin sensitivity even in the presence of significant fibrinogen loss. These point-of-care assays provide the opportunity to optimize heparin and protamine management in the cardiac surgery patient.
Cardiopulmonary bypass on a patient with malaria
Authors: Coley Thomas J , Hart James C
Published: January 2013

There are special considerations when performing cardiopulmonary bypass (CPB) on a patient with malaria. A 70-year-old female with a recent history of severe aortic stenosis was scheduled to undergo elective aortic valve replacement. One week prior to surgery, the patient developed shaking chills and fever, with a positive malaria smear. An extensive literature search was undertaken to determine the effect of CPB on a patient with active malaria, but no prior reference was found. One major concern was the lysis of red blood cells while on bypass. The surgery was performed uneventfully, following 2 weeks of treatment with primaquine phosphate.
Mathematical modelling of extracorporeal circulation: simulation of different perfusion regimens
Authors: Bauernschmitt R , Naujokat E , Mehmanesh H , Schulz S , Vahl C F , Hagl S , Lange R
Published: January 2013

Computer- and sensor-aided control of the heart-lung machine is considered a major goal for perfusion sciences for the next few years. At present, control of perfusion is achieved by surgeons, anaesthesiologists and perfusionists making short-term decisions, which leads to variations of the perfusion regimens between different centres and even between different teams in the operating theatre. As the basis for an integrated control of extracorporeal circulation (ECC), we proposed a mathematical model for simulating haemodynamics during pulsatile perfusion. This model was then modified to allow it to simulate the effects of different perfusion regimens on arterial haemodynamics and whole body oxygen consumption.

The model was constructed on a PC using MATLAB/SIMULINK. The human arterial tree was divided into a multibranch structure consisting of 128 segments characterized by their particular physical properties. Peripheral branches were terminated by a resistance term representing smaller vessels like arterioles and capillaries. Flow and pressure were expressed by the intensity of current and voltage in an electrotechnical analogon; inductivity, resistance and capacitance were implemented according to the physical properties of the arterial tree and the rheology of blood. The effects of different perfusion regimens (pulsatility, flow amount, acid-base regulation) were studied.

After introducing an input signal to the model, flow and pressure waves established themselves throughout the simulated arterial tree. During the simulation experiments, marked differences among different perfusion regimens were displayed by the model. Variations in acid-base management mainly influenced the distribution of perfusion: during simulation of low-flow perfusion (1.2 l/min/m2), cerebral blood flow was 6.2 ml/s using an alpha-stat regimen, while it was increased to 9.4 ml/s during pH-stat, caused by an implementation of reduced cerebral resistance. Whole body oxygen consumption was predominantly regulated by the perfusion rate. While central venous oxygen saturation was calculated to be 84.7% during simulation of high-flow perfusion (2.4 l/min/m2), it dropped to 70% during simulation of low-flow perfusion regimens.

The model proved to be useful for a realistic simulation of different perfusion regimens. Therefore it can be considered a continuing step for the derivation of a ‘state’ observer leading to the realization of an automatically controlled heart-lung machine.
Cardioplegia flow dynamics in an in vitro model
Authors: Taft Kimberly J , Stammers Alfred H , Jones Clinton C , Dickes Melinda S , Pierce Michelle L , Beck Daniel J
Published: January 2013

The flow of fluids in extracorporeal circuits does not conform to conventional Poiseuille mechanics which confounds calculating cardioplegia (CP) flow distribution. The purpose of this study was to quantify CP flow dynamics in a model simulating coronary atherosclerosis across varying sized restrictions.

An in vitro preparation was designed to assess hydraulic fluid movement across paired restrictions of 51, 81 and 98% lumen reductions. Volume data were obtained at variable flow, temperature, viscosity and pressure conditions.

CP delivered through 14- and 18-gauge (GA) conduits at 8°C and 100 mmHg infusion pressure revealed that both four to one and crystalloid CP solutions had significantly less total percentage flow through the 14-GA conduit, p < 0.0001 and p < 0.001, respectively. Overall, 4:1 CP exhibited the most favorable fluid dynamics at 8°C in that it delivered the highest percentages of total CP flow through the smaller lumen conduit. At both 8°C and 37°C delivery, blood CP resulted in the least homogeneous fluid distribution at all delivery parameters. The results in relation to blood viscosity indicate that, although the 8°C blood CP had a significantly greater viscosity than 37°C blood CP, it did not produce an effect in fluid distribution.

These data show that increasing the cardioplegic solution hematocrit causes an inhomogeneous fluid distribution regardless of delivery temperature or infusion pressure.
Predictors for heparin resistance in patients undergoing coronary artery bypass grafting
Authors: Ranucci Marco , Isgrò Giuseppe , Cazzaniga Anna , Soro Giorgio , Menicanti Lorenzo , Frigiola Alessandro
Published: January 2013

Heparin resistance (HR) is a common event in cardiac operations. At present, no clear recognition of the risk factors for HR has been reached. The aim of this study was to determine a predictive model for HR, based on the preoperative patient’s profile. Two hundred consecutive patients scheduled for elective coronary artery bypass operations were enrolled in a prospective trial. Demographics, type of preoperative anticoagulation therapy and preoperative coagulation profile were collected and statistically analysed with respect to the evidence of a HR. Heparin resistance was defined as at least one activated clotting time < 400 s after heparinization and/or the need for purified antithrombin III (AT-III) administration. With a multivariate analysis we could identify five predictors for HR: AT-III ≤ 60%; preoperative subcutaneous heparin therapy; intravenous heparin therapy; platelet count ≥ 300 000 cells/mm3; age ≥ 65 years. We conclude that HR is a predictable event. In the presence of all the risk factors, the likelihood of HR is 99%; in the absence of all of them, it is 10%. Predicting HR allows us to apply many possible therapeutic strategies.
Outcome analysis of coronary artery bypass grafting: minimally invasive versus standard techniques
Authors: Dickes Melinda S , Stammers Alfred H , Pierce Michelle L , Alonso Anselmo , Fristoe Lance , Taft Kimberly J , Beck Daniel J , Jones Clinton C
Published: January 2013

Minimally invasive coronary artery bypass grafting (MIDCAB) procedures are purported to result in improvements in patient management over standard techniques. A comparative study was performed on risk-stratified patients treated with either technique. Following institutional review board approval, a retrospective random chart review was conducted on 27 MIDCAB and 37 standard coronary artery bypass grafting (CABG) patients who were operated on over a 12-month period at the University of Nebraska Medical Center. Risk stratification was accomplished by dividing the two patient populations, MIDCAB and ‘standard’, into one of four subgroups based on a preoperative risk score. Risk stratification was achieved by dividing the patient populations into one of four subgroups: good, fair, poor and high risk. Both groups received similar operations and surgical interventions, except for the inclusion of cardiopulmonary bypass (CPB). Approximately 200 parameters were collected and analyzed in the following categories: anthropometric, operative and postoperative outcomes.

The MIDCAB group had a significantly lower number of vessels bypassed (2.0 ± 0.7 vs 3.4 ± 0.9, p < 0.0001). Total postoperative blood product transfusions trended higher in the standard group (6.1 ± 12.6 U) when compared to the MIDCAB patients (2.3 ± 5.5 U, p < 0.15), although not statistically significant. Postoperative inotrope use was significantly less in the MIDCAB group (19% vs 59%, p < 0.002). Ventilator time in the MIDCAB group was 10.5 ± 5.4 h vs 15.0 ± 12.3 h in the standard group ( p < 0.07). The MIDCAB group had an overall greater length of stay, but was only statistically different within the poor-risk subgroup (12.2 ± 10.7 vs 7.5 ± 3.9, p < 0.04).

The results of this study show that when CPB is not utilized in treating patients undergoing CABG procedures, the benefits in regards to patient outcomes are unclear. This necessitates the need for further work when comparing outcomes for risk-stratified patients.
Effect of Trillium™ Biopassive Surface coating of the oxygenator on platelet count drop during cardiopulmonary bypass
Authors: Palanzo David A , Zarro Debra L , Montesano Ralph M , Manley Norman J , Quinn Michael , Elmore Barbara-Anne , Gustafson Patricia A , Castagna Joseph M
Published: January 2013

The new Trillium™ Biopassive Surface is a coating designed to minimize the adsorption of protein and the attachment of cells. In previous studies, we were able to demonstrate that, by coating the bypass circuit with small amounts of albumin, the drop in circulating platelet count seen with the newer low-prime hollow-fiber membrane oxygenators is eliminated.

A study was undertaken to compare the Avecor Affinity™ oxygenator with albumin in the prime with the Trillium-coated Affinity. Fifty-six patients undergoing nonemergency open-heart surgery were randomly divided into two groups. One group (Albumin) received the Affinity oxygenator with 10 ml of 25% albumin added to the pump prime. The other group (Trillium) received the Trillium-coated Affinity oxygenator. To normalize the data for the effects of hemodilution, the mean net platelet count drop on bypass was calculated for each group. The Albumin group had a net platelet count drop of 0.81 ± 9.78%, while the Trillium group had a drop of 1.58 ± 13.0%. There was no significant statistical difference between the two groups.

From our investigation, we concluded that Trillium Biopassive Surface coating affords the Affinity oxygenator the same protective effects on circulating platelet counts as adding albumin to the prime.
Case report of severe bradycardia due to transdermal fentanyl
Authors: Hawley Pippa
Published: January 2013

Background:

This case report describes a patient who developed severe bradycardia due to transdermal fentanyl. There have been no prior case reports of this occurring in palliative care, but the frequency of association of fentanyl with bradycardia in the anesthesia setting suggests it may be more common than realized. Palliative care settings often have a policy of not routinely checking vital signs, and symptoms of bradycardia could be misinterpreted as the dying process.

Case presentation:

A patient with recurrent ovarian cancer was admitted with nausea and abdominal pain due to bowel obstruction and fever from a urinary tract infection. A switch from injectable hydromorphone to transdermal fentanyl resulted in symptomatic severe bradycardia within 36 h, without any other signs of opioid toxicity and with good analgesic effect.

Case management:

The fentanyl patch was removed. Atropine was not required.

Case outcome:

The patient made an uneventful recovery. Transdermal buprenorphine was subsequently used satisfactorily for long-term background pain control, with additional hydromorphone when needed.

Conclusions:

The delayed absorption of fentanyl via the transdermal route makes early identification of fentanyl-induced bradycardia key to prompt reversal. Patients with resting or relative bradycardia may be at higher than average risk.
One Hundred Two Tumors in 100 Goats (1987–2011)
Authors: Löhr C. V.
Published: January 2013

Of 1146 caprine necropsy or biopsy specimens submitted from 1987 through 2011 to the Veterinary Diagnostic Laboratory at Oregon State University, 100 goats (8.7%) had 102 tumors. Detailed records were available for 89 cases. Fifty-five goats were female, 17 were castrated males, and 12 were intact males. Breeds included 21 Nubian, 16 Pygmy, 10 Pygora, 8 Alpine, 4 Angora, 4 Saanen, 2 Toggenburg, and 9 crossbred goats. Dwarf, Nubian, and Saanen goats were overrepresented and Alpine and Boer goats underrepresented among cases with neoplastic disease in comparison to submissions overall. Age ranged from 7 months to 19 years (median, 7 years). Histopathology was performed on 97 tumors. Lymphoma (n = 17) was the most common tumor, followed by cutaneous squamous cell carcinoma (n = 10) and thymoma (n = 9). Most lymphomas were multicentric. All 7 mammary neoplasms were adenocarcinomas. Five of 7 vascular proliferations were hemangiosarcomas. All 4 melanocytic tumors were classified as (malignant) melanoma. Rarely reported caprine tumors included a choroid plexus carcinoma, 2 rhabdomyosarcomas, and 3 pheochromocytomas. Cutaneous round cell tumors were provisionally diagnosed as 2 histiocytomas and 5 mast cell tumors. Single cases of previously unreported caprine tumors included amyloid-producing odontogenic tumor, myxosarcoma, sebaceous carcinoma, apocrine sweat gland adenoma, and thyroid carcinoma. Nonneoplastic entities included 2 cases of mammary fibroadenomatous hyperplasia and single cases of vascular hamartoma, cervical adenomatous hyperplasia, and cervical leiomyofibromatosis. The results of this 25-year retrospective study indicate that lymphoma in particular and tumors in general are common in goats.
Sanctuary
Authors: Bagelman Jennifer
Published: January 2013

Over the last decade, sanctuary has been evoked as an alternative to the problems associated with an exclusionary statist asylum regime. In Canada, the United States, and Europe, a “cities of sanctuary” movement has emerged, articulated through various political vocabularies. This movement conceives of sanctuary not simply as a church-based site where asylum seekers may be secured but offers a host of welcoming practices within and beyond cities. This article specifically explores the UK-based City of Sanctuary movement, with a focus on the case of Glasgow, which has widely been read as exemplifying hospitality toward an empowerment of asylum seekers. It has been argued that while a statist discourse of fear—a “politics of unease”—posits migrants as a threat to be policed, the City of Sanctuary stimulates a softer approach. Yet, this article illustrates how the City of Sanctuary is also mobilizing a deeply troubling “politics of ease.” Based on an ethnographic investigation, I show how a politics of ease renders intractable the serious problem of protracted waiting that many controls many asylum seekers. In doing so, I demonstrate how the seemingly hospitable City of Sanctuary in fact contributes to a hostile asylum regime by indefinitely deferring and even extending a temporality of waiting.
Love, Sex, Money, and Meaning
Authors: Daigle Megan
Published: January 2013

Since the disintegration of the Soviet Union and subsequent collapse of Cuba’s centralized economy, pursuing relationships with foreign visitors to the island has emerged as a viable means of accessing hard currency, consumer goods, travel, and emigration—of gaining admittance to a perceived better life. In the mid of escalating state repression, a discursive struggle has materialized, assigning meanings to new sexual identities, problematizing these sexual relations, and creating new objects of disciplinary power. Far from simple semantics, defining and naming allows actors within the field of relations—government, police, journalists, mass organizations, individuals—to situate young Cubans within various binaries including good/bad, right/wrong, virtue/vice. Specific labels ranging from crass ( puta or prostituta) to enigmatic ( candelero or luchadora) have ebbed and flowed in popular parlance, each loaded with different raced and gendered implications and political commitments. As state governance of bodies and sexualities evolves, this ethnographic study demonstrates that many young Cubans have begun to use bodily and sexual practices as tools to circumvent poverty, resist state dictates on morality and austerity, and create new subjectivities. Language, for its part, has become a major weapon, alternately disciplinary and liberatory, in the struggle for (self-)definition.
Simple Method of Glenoid Bone Loss Calculation Using Ipsilateral Magnetic Resonance Imaging
Authors: Owens Brett D. , Burns Travis C. , Campbell Scot E. , Svoboda Steven J. , Cameron Kenneth L.
Published: January 2013

Background:

Current methods for estimating glenoid bone loss in patients with chronic shoulder instability include computed tomography imaging with 3-dimensional reconstruction, specialized computer software, and imaging of the contralateral shoulder. An ideal method of glenoid measurement would require only magnetic resonance imaging (MRI) of the injured shoulder.

Purpose:

To determine whether MRI measurement of glenoid height, as well as sex, could be used to estimate glenoid width in healthy subjects with no history of shoulder instability.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Bilateral shoulder MRIs were obtained in a healthy cohort of young athletes as part of the baseline assessment in a prospective cohort study. A musculoskeletal radiologist measured glenoid height and width using the sagittal MRI cuts. Univariate and multivariate regression analyses were performed to determine whether demographic and MRI measurements of the glenoid could be used to estimate glenoid width.

Results:

Of the 1264 shoulder MRIs evaluated, the mean glenoid width was 26.67 mm (±2.49 mm), and the mean glenoid height was 42.15 mm (±3.00 mm). There were significant differences between the 129 female glenoids and the 1035 male glenoids for both width (23.1 mm, 27.1 mm, respectively, P < .0001) and height (37.9 mm, 42.7 mm, respectively, P < .0001); however, the relationship between glenoid height and width was similar for both men and women. The glenoid width was found to correlate with the height measurement ( r = 0.56) for the entire cohort. Based on the results of linear regression analysis, controlling for the influence of sex, a formula was created that represents the relationship between these variables for male subjects: Glenoid Width = (1/3 Height) + 15 mm. Female patients are estimated with a formula that represents the same slope but a different intercept: W = 1/3 H + 13 mm.

Conclusion:

Significant differences in glenoid height and width were found by sex; however, the relationship between height and width was similar. These variables are correlated, and the resultant formula can be used to estimate the expected glenoid width in a patient with bone loss. This formula allows for easy calculation of the amount of glenoid bone loss with only a ruler and an MRI of the injured shoulder.
Predictors of Recurrent Instability After Acute Patellofemoral Dislocation in Pediatric and Adolescent Patients
Authors: Lewallen Laura W. , McIntosh Amy L. , Dahm Diane L.
Published: January 2013

Background:

Patellofemoral instability is common in the pediatric and adolescent population, yet prognosis after the first dislocation has been difficult to determine.

Purpose:

To describe the demographics of pediatric and adolescent patients with a first-time patellofemoral dislocation and to determine predictors of recurrent instability.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A search of the Mayo Medical Index database between 1998 to 2010 was performed, and 2039 patients were identified. Inclusion criteria were (1) age 18 years or younger, (2) no history of patellofemoral subluxation/dislocation of the affected knee, (3) radiographs within 4 weeks of the initial instability episode, and (4) a dislocated patella requiring reduction or convincing history/findings suggestive of acute patellar dislocation (effusion/hemarthrosis, tenderness along medial parapatellar structures, and apprehension with lateral patellar translation). Radiographs were evaluated for trochlear dysplasia (Dejour classification) and patella alta (Caton-Deschamps and Insall-Salvati indices). Skeletal maturity was graded based on the distal femoral and proximal tibial physes (open, closing, or closed).

Results:

A total of 222 knees (120 male [54.1%] and 102 female [45.9%]) in 210 patients with an average age of 14.9 years (range, 9-18 years), met the inclusion criteria. Twenty-four patients (10.8%) underwent early surgery. All others were initially treated nonoperatively. Of the 198 patients in this group, 76 (38.4%) had recurrent instability, and 39 (51.3%) of these required surgical treatment. Recurrent instability was associated with trochlear dysplasia ( P < .01). Patients with both immature physes and trochlear dysplasia had a recurrence rate of 69% (33/48), with a hazard ratio of 3.3. Age, sex, body mass index, and patella alta were not statistically associated with recurrent instability.

Conclusion:

Nonoperative treatment for first-time patellofemoral dislocation resulted in a 62% success rate. However, skeletally immature patients with trochlear dysplasia had only a 31% success rate with nonoperative management. Nearly half of patients with recurrent instability required surgical intervention to gain stability.
Doing the “Talk”
Authors: Shevell Allison Haley , Shevell Michael
Published: January 2013

The disclosure to a family of a child’s cerebral palsy is an important transformative event that has potential lasting implications. This article highlights specific challenges, the results of research into the disclosure process and what attributes should be sought for in this encounter by health care providers. Illustrative case vignettes are presented to concretely demonstrate the “dos and don’ts” of the disclosure. Suggestions will also be provided to improve the disclosure process.
Childhood Disintegrative Disorder
Authors: Rosman N. Paul , Bergia Berta M.
Published: January 2013

Childhood disintegrative disorder, a rare, relentlessly progressive neurologic disorder, first described by Heller in 1908, remains a condition of great interest. It has long been debated whether it is a discrete disorder or simply a late-onset variant of childhood autism. We have studied 6 cases of childhood disintegrative disorder, collected over 8 years, and followed for 2.5 to 22 years (mean 8.6 years). Childhood disintegrative disorder begins later in life than autism, and following a period of entirely normal development; the regression is more global and more severe than in autism; seizures are more frequent than in autism, yet demonstrable organicity in childhood disintegrative disorder is decidedly rare. Lastly, the prognosis is usually much worse than in autism, but in those cases with neither seizures nor epileptiform activity on electroencephalography (EEG), the outcome may be more favorable. Childhood disintegrative disorder should be viewed as a condition distinct from childhood autism.
Objects Don’t Object
Authors: Calogero Rachel M.
Published: January 2013

Integrating system-justification and objectification theories, the research reported here broadens the scope of prior work on women’s self-objectification to examine its system-justifying function. I investigated the relation of trait and state self-objectification to support for the gender status quo and engagement in gender-based social activism among U.S. college women. Study 1 established that greater trait self-objectification was related to more gender-specific system justification and less engagement in gender-based social activism. The data supported a mediational model in which gender-specific system justification mediated the link between trait self-objectification and social activism. Results from Study 2, in which self-objectification was situationally activated, confirmed the same mediational model. These findings suggest that trait and state self-objectification may be part of a wider pattern of system-justifying behavior that maintains gender inequality and thwarts women’s pursuit of social justice.
The endangered middle class? A comparative analysis of the role played by income redistribution
Authors: Dallinger Ursula
Published: January 2013

Contributing to the debate on the decline of the middle class, this article provides a comparative and longitudinal analysis of changes to the relative position of middle income groups in 19 (post)industrial countries between 1985 and 2005. How much did the income position of the middle worsen compared with more vulnerable groups? To what extent did public policies mitigate the market position of different income groups? The analysis is based on microdata of the Luxembourg Income Study. It divides the broad category of ‘middle class’ into three groups. Results suggest little change in the income position of the middle classes with respect to both market and disposable incomes. In most countries market incomes in the top quintile increased remarkably while the bottom quintile group lost out. The scale of government income redistribution has improved the position of the lowest income group, while burdening the highest income group. But it failed to fully compensate for the growing gap between the top and bottom income groups. The distance between the middle and the top incomes grew significantly, which might be one reason for the current public debate about an endangered middle class.
The social stratification of social risks: The relevance of class for social investment strategies
Authors: Pintelon Olivier , Cantillon Bea , Van den Bosch Karel , Whelan Christopher T.
Published: January 2013

Over the course of the past 20 years, welfare states are said to have evolved towards a ‘social investment’ model of welfare – characterized by a focus on equality of opportunity and upward social mobility along with a greater emphasis on individual responsibility. In view of these policy changes, it is necessary to assess whether traditional stratification cleavages (still) affect the occurrence of ‘social risks’. Using data from the 2005 EU-SILC intergenerational module, we consider the impact of social class (of origin) on a relevant selection of risks: unemployment, ill-health, living in a jobless household, single parenthood and low-paid employment. The results provide clear evidence of a substantial influence of social class. On this basis, we argue that social investment strategies need to take stock of the persistence of traditional stratification cleavages. Otherwise, a one-sided approach may create new forms of exclusion and give way to ‘Matthew effects’.
A toothless bite? The effectiveness of the European Employment Strategy as a governance tool
Authors: Copeland Paul , ter Haar Beryl
Published: January 2013

This article concerns the effectiveness of the European Employment Strategy (EES) as a governance tool. It analyses the policy measures of the Member States with regard to the commonly agreed guidelines and the country-specific recommendations of the Council. To analyse the policy measures the paper introduces a new quantitative method, which is applied to ten EU Member States during 2005–2009. After presenting the results, the paper subsequently analyses the level of follow-up with regard to future intended reforms within the Member States and their level of responses to the country-specific recommendations. Although it is difficult to attribute the reforms within the Member States to the EES, the analysis reveals that it is hard to get Member States to move beyond their national priorities, resulting in the EES being a weak governance tool.
Confusion and divergence: Origins and meanings of the term ‘welfare state’ in Germany and Britain, 1840–1940
Authors: Petersen Klaus , Petersen Jørn Henrik
Published: January 2013

It is often stated that there is no standard definition of a ‘welfare state’. A survey of the standard textbooks supports this claim. It is also often the case that academic works on welfare state and social policy history earmark lines or even pages to discussing the origins of the term welfare state. However, these brief accounts are often wrong in the details and are missing important aspects. In our article we offer the first detailed study of the origin of the term ‘welfare state’ tracing it back to the mid-19th century Germany and following its diverse and changing definitions in the German and British context until the 1940s. The study adds decades to the conventional understanding of this history and offers a more nuanced understanding of the different definitions attributed to the term before its political breakthrough in the late 1940s. Projecting this post-war understanding backwards in time – what the literature generally does – is too simple and anachronistic. Both in Germany and Britain the dominating understandings differ from our present day understanding of the ‘welfare state’ as a social security system.
People’s Perception Towards Health Providers in Rural Punjab
Authors: Mehra Anjali , Nanda Richika
Published: January 2013

Accessibility to quality health care becomes a significant factor in improving the quality of life especially in developing countries. In spite of having a good health care infrastructure, the efficiency, quality and heavy cost of health care services is very weak in rural India. In such a scenario, the study attempts to analyze the availability, reach and spread of health infrastructure in rural areas of Punjab by examining the people’s choice and the factors governing their choice in health providers. The study is based on a random sample survey done in Ramdas sub-tehsil of Amritsar district and the results indicate that in the border district of Punjab more than 76 per cent of respondents preferred private providers, even quacks due to factors like easy availability of health providers, fee charged by them, free medicines dispersed, monthly income of respondents etc. while only the very poor went to public providers.
HIV Insurability in India: Early History and Current Status
Authors: Trivedi Mayur , Gupta Indrani
Published: January 2013

HIV and AIDS have been long recognized as developmental concerns that require a comprehensive approach in prevention, treatment and impact alleviation. In India, HIV has been recognized as one of the most important public health issues. Despite a free antiretroviral therapy (ART) programme, treatment costs due to hospitalization continue to be a source of economic strain on household affected by HIV/AIDS. This article traces the various initiatives taken in India to provide financial protection to individuals with HIV/AIDS, before and after the free ART programme, to put into perspective current efforts to mainstream HIV into existing health insurance programmes.
Occupational Stress and Coping among Nurses in a Super Specialty Hospital
Authors: P.N. Roopalekha Jathanna , K.S. Latha , Prabhu Swetha
Published: January 2013

Nursing is a demanding occupation characterized by high work demands, the need to learn new technologies, to work to increasingly intensified schedules, and to respond to emergencies. In addition to excessive working hours, shift work with its changing routine worsens stress. Poor management and supervisory practices also contributes to stress outcomes. This article examines stress among nurses working in different units and their coping abilities in a super specialty hospital in Kerala. Willing respondents of the study include 339 nurses of either sex. Expanded Nursing Stress Scale (ENSS) (French et al. 2000) and Brief Cope (Carver 1997) were administered in small groups of two to twelve participants over a four-month period. Results showed majority were females, single and less than 30 years of age. Of the 13 domains of stress the nurses who had less than one year of work perceived as ‘stressful’ issues related to workload, failure to carry out nursing responsibilities because of demands by patient and patient’s carers. Nurses working in OTs and emergency unit rated ‘conflict with supervisors’ as extreme stressors whereas ICU nurses rated ‘inadequate emotional preparation’ as extreme stressor. The primary coping mode included praying or meditating and looking for something good in the situation. Many had resorted to healthier modes of coping like resorting to humour, seeking social support, positive appraisal and abstaining from using substances/drugs.
Effect of Role Ambiguity, Conflict and Overload in Private Hospitals’ Nurses’ Burnout and Mediation Through Self Efficacy
Authors: Dasgupta Prasanjit
Published: January 2013

Background

The motivation of this study was to investigate how role overload, role conflict and role ambiguity of nurses relate to burnout and the relationship of nurses’ efficacy to these three stressors and burnout in private hospitals. Patients in private hospitals incur higher expenditure with expectations for better care. Stressors serve as impediments in nursing care and burnout has deleterious effect, high self efficacy can mediate in the effects of stressors and burnout.

Methods:

Study has been carried out on nurses in three large private hospitals of Kolkata through set of instruments-Organizational Role Stress (Udai Pareek) to assess role conflict, overload and ambiguity, Oldenburg Burnout Inventory to assess the disengagement and exhaustion and Nursing Role Efficacy Scale (Udai Pareek) to assess role efficacy. Data have been analyzed through correlation and regression analysis.

Results:

According to the nurses’ view, the findings are as follows: Increase in role overload, role conflict, role ambiguity leads to an enhancement in disengagement, exhaustion. Enhancement in self efficacy leads to a reduction in role overload, role conflict, role ambiguity, and disengagement, exhaustion.

Conclusion:

For better patient care Health care Managers may try to reduce the stressors and enhance efficacy of the nurses, some practical suggestions have been made in these regard.
The Public Attitudes and Images of the European Union in India
Authors: Jain Rajendra Kumar , Pandey Shreya
Published: January 2013

This article seeks to fill a major gap in existing studies on how Asians perceive the European Union. It discusses the Union’s efforts to promote its visibility in India since the mid-1990s and provides an overview of the Indian literati’s perceptions of contemporary Europe. This article examines the perception, representation and visibility of the EU in the Indian media, among business, civil society and media ‘elite’ and in public opinion. It explores whether the Union’s self-proclaimed representation as a global actor, a normative power and a leader in environmental negotiations conforms to how it is actually perceived in Third World countries. It evaluates whether more than a decade of summitry has led to greater visibility of the EU in the Indian media. The article concludes by making a comparison of EU imagery in media, elite and public opinion discourses, and makes several recommendations on how EU can possibly improve its visibility in future.
Brief Synopsis of the Brazilian Freight Transport and Future Development
Authors: Massara Vanessa Meloni
Published: January 2013

This article aims to present a brief profile about the array of freight transportation in Brazil with emphasis on road, rail and water transport; its current condition, use and future perspectives; relating them to the grid and more specifically, the consumption of various fuels. Done in parallel, it fits the concept of modal combination based on maintenance costs, service level and particularly, in mitigating emissions of greenhouse gases (GHGs). In conclusion, we present medium-term projects that should contribute to that inter-modality is effectively used in the country, helping to boost the infrastructure of transport and the distribution of products on the rise in the Brazilian economic activity, such as soybeans, minerals and fuels, and at the same time, encourage the reduction targets of GHG emissions based on energy-efficient fuel use, with an emphasis on water transport, using the immense potential of navigable rivers and the coastline of Brazil.
Does Governance Matter for Infrastructure Development? Empirical Evidence from Asia
Authors: De Prabir
Published: January 2013

Governance is an important determinant for both national and regional infrastructure development for many parts of Asia. This study shows that institutional governance is an important determinant for national and regional infrastructure development. Improved national governance is a necessary condition for enhancing regional governance for effective regional infrastructure development. However, strong and formal regional institutions need to be developed for achieving effective regional connectivity in Asia. This article concludes that the soft infrastructure such as the quality of governance is crucial to make hard infrastructure work efficiently.
Public Environmental Awareness and Performance in Kuala Lumpur City, Malaysia
Authors: Afroz Rafia , Masud Muhammad Mehedi , Akhtar Rulia , Duasa Jarita Bt
Published: January 2013

The aim of this article is to estimate the perception, knowledge and attitude of the respondents towards electrical and electronic equipment waste (e-waste) management. It also tried to identify current e-waste management practiced by households in Kuala Lumpur. In order to ensure a higher response rate, face-to-face survey was employed. In this study, it has been found that 69 per cent of the respondents were satisfied with Kuala Lumpur’s environmental quality, while 31 per cent were not satisfied. More than one third of the respondents informed that they send their electric and electronic equipment (EEE) to charity or transfer the EEE to relatives if they cannot repair them. Only a small fraction of the used EEE finds its way to recycling facilities and manufacturer as there is no efficient take back scheme for consumers. It has also been found in this study that more than 81 per cent of the respondents are unenthusiastic to pay for the recycling of their e-waste. It is interesting to find that much of the EEE was updated within two thirds of their designed lifetime.
Carbon Finance and Decentralized Composting in Asia
Authors: Yenneti Komalirani , Gamaralalage Premakumara Jagath Dickella
Published: January 2013

The solid waste sector is a significant contributor to methane (CH4) emissions with a global warming potential (GWP) of 21 times more than that of CO2 bringing the need for preventive actions from this sector. In the recent years, composting projects both centralized and decentralized have proved to be addressing this issue. However, much of the decentralized composting projects failed due to their financial and other operational constraints that arise during the course of the implementation. On this regard, the current article reviews the potential of carbon finance as an opportunity for funding decentralized composting projects through demonstrating the application through emission calculation of four cities in Asia. On assessing the emissions, it also identifies the benefits associated with the emissions reduction from the composting projects which might not be available in the absence of the projects. The article also discusses the various carbon financing strategies available in the present market to identify the potential market for inclusion of decentralized composting projects. In the process, the article identifies the issues in the implementation of decentralized composting projects under Clean Development Mechanism (CDM) and other carbon markets in general.
Ball or aerosol? Sin, soap and the pharmaceutical industry
Authors: Ratcliff Eric
Published: January 2013

Objective:

The purpose of this paper is to provoke careful and continuing reconsideration of the relationship between psychiatrists and the pharmaceutical industry through historical analysis of trends in the promotion of psychotropic drugs.

Conclusions:

Psychiatrists remain concerned about the relationship of the profession with the pharmaceutical industry. From examination of my own extended experience of that relationship (including as a former Royal Australian and New Zealand College of Psychiatrists General Councilor and chair of the Clinical Practice Advisory and Ethical Practice Committees), attention is drawn to the influence of the industry on the categorization and naming of drugs, attempts to propose target disorders and the obsolescence of established agents. Caution in accepting the role of ‘opinion leader’ is recommended but it remains important for psychiatrists to continue to ethically engage with the industry.
William Siegfried Dawson: a pioneering Australasian psychiatrist
Authors: Roxanas Milton
Published: January 2013

Objective:

The purpose of this paper was to consider the life and contribution of Professor William Siegfried Dawson (1891–1975) by examination of school, university and hospital reports and journal articles.

Conclusions:

Professor Dawson made a major contribution, through his academic and professional roles and leadership, to the firm establishment of psychiatry, psychiatric scholarship and psychiatric organisations in Australia.
Intracoelomic anaplastic sarcoma in an intersex Madagascar tree boa (Sanzinia madagascariensis)
Authors: Sharpe Sam , Lamm Catherine G. , Killick Rowena
Published: January 2013

An adult Madagascar tree boa ( Sanzinia madagascariensis) underwent coeliotomy for investigation of a coelomic mass. At surgery, a large mass originating from the peri-pancreatic adipose tissue and involving the gall bladder was removed. The snake did not recover from general anesthesia. A complete postmortem was performed, and samples were submitted to the University of Glasgow for histopathology. On histological examination, the mass was composed of adipose tissue infiltrated with a poorly demarcated spindle cell neoplasm. The neoplastic cells were highly pleomorphic with abundant cytoplasm and frequent clear cytoplasmic vacuoles, suggestive of adipocyte origin. Immunohistochemical characterization of the mass was inconclusive. Metastatic neoplastic cells were present within vessels in the liver, lungs, and brain. As an incidental finding, the gonads contained both maturing ovarian follicles and seminiferous tubules with intact germinal epithelium and evidence of spermatogenesis, along with other features of male and female gonad anatomy. The current report describes a rare neoplasm in snakes within an intersex Madagascar tree boa.