bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Chitosan on Plasma Lipids and Lipoproteins
Authors: Rizzo Manfredi , Giglio Rosaria Vincenza , Nikolic Dragana , Patti Angelo Maria , Campanella Claudia , Cocchi Massimo , Katsiki Niki , Montalto Giuseppe
Published: June 2013

Chitosan can favorably modulate plasma lipids, but the available data are not conclusive. We evaluated the effect of chitosan on plasma lipids and lipoproteins in 28 patients with plasma triglyceride levels >150 mg/dL (mean age: 63 ± 12 years), not taking other lipid-lowering agents. All patients received a chitosan derived from fungal mycelium (Xantonet, Bromatech, Italy) at a fixed dose of 125 mg/d in addition to their current medications for 4 months. Polyacrylamide gel electrophoresis was used to measure low-density lipoprotein (LDL) subclasses. After treatment, total cholesterol reduced by 8%, LDL cholesterol by 2%, and triglycerides by 19%, with a concomitant 14% increase in high-density lipoprotein cholesterol. We also found a beneficial effect of chitosan on LDL subclasses, with a significant increase in LDL-2 particles (from 37 ± 8% to 47 ± 8%, P = .0001) and a decrease (although not significant) in atherogenic small, dense LDL. Whether these findings may affect cardiovascular risk remains to be established in future studies.
“True fictions”: Subjectivity and intertextuality in the writings of Sylvia Leith-Ross
Authors: Watson Lucy
Published: June 2013

This article examines the writings of the anthropologist Sylvia Leith-Ross, who worked and travelled in Nigeria from the early 1900s to the 1960s. Her key anthropological study, African Women: A Study of the Ibo of Nigeria (1939) has been analysed by anthropologists and scholars of white women’s colonial history. However, no one has yet attempted to investigate her other writings, such as her field memoirs, African Conversation Piece (1944) and Beyond the Niger (1951). Critics who have discussed African Women have tended to compare Leith-Ross’s ethnography to contemporary studies and have criticized her imperialist tone. While I do not dispute that her writings are deeply problematic, this article analyses Leith-Ross’s work from a different perspective; one which attends to the stylistics of her writing. Drawing on previous work on the “literary” aspects of ethnographic writing by Clifford and Marcus et al., I illustrate the ways in which Leith-Ross blurs the boundaries between autobiography, travel writing, and ethnography in an attempt to formulate a more reflexive style of ethnography. By doing so, I argue that she challenged traditional anthropological methods and pushed the boundaries of convention. However, Leith-Ross’s later texts are imbued with a sense of “imperialist nostalgia” as she begins to lament the modernizing effects of colonialism and the move towards independence in Nigeria. The progressive potential of the challenges she makes to traditional anthropological methodologies is blunted by this shift. Nevertheless, this article calls for a reappraisal of Leith-Ross’s writings and suggests that her work reveals much about the developments that were occurring in anthropology in the 1930s and 1940s, as well as the shifting relationship between Nigeria and Britain at a pivotal moment in colonial history.
Introduction: Social value projects in post-liberalisation India
Authors: Nakassis Constantine V. , Searle Llerena Guiu
Published: June 2013

Through a discussion of the articles of this issue, this introduction explores the ways in which the social landscape of post-liberalisation India can be seen through the question of value. We are particularly interested in elucidating how heterogeneous kinds of value—be they economic, ritual, aesthetic, ethical or otherwise—have come to be articulated to and thus constitutive of various forms of cultural practice in contemporary India. We suggest that one way to understand the question of value is through in-depth ethnographic analysis of ‘social value projects’: reflexive and purposive attempts by social actors to produce, negotiate, transform, maintain and sometimes abjure various types of value. We suggest that such value projects can be ethnographically approached through the interactional events that comprise them and that these, in turn, require attention to the emergent and contingent nature of value, its multiplicities and excesses and the ways in which value is articulated to, and through, the performing and ratifying of social identities.
Youth masculinity, ‘style’ and the peer group in Tamil Nadu, India
Authors: Nakassis Constantine V.
Published: June 2013

This article examines young men’s concepts of status in urban Tamil Nadu, India, focussing in particular on their concept of ‘style’. The article shows how young men experience their position in the life cycle as between childhood and adulthood, and how this liminality mediates their concepts of status. In particular, I focus on the construction of the youth peer group as in distinction to, and transgressive of, the forms of adult respectability, propriety and authority from which young men are excluded by virtue of their age. I show how the peer group is marked by a productive tension between transgression and self-differentiation, and reciprocity, intimacy and peer pressure. The article then turns to two kinds of source material for young men’s performances of status: English-Tamil slang and counterfeit global brands. I show how the tension between, and negotiation of, the mandates to status-raise and status-level in the peer group transform and revalourise these signs of status. The article concludes by arguing that while from afar, such youth practice seems to be negotiating globalisation, modernity and tradition, a close analysis of peer-group dynamics shows that youth practice is more centrally concerned with peer-group status negotiations.
Constructing prestige and elaborating the ‘professional’: Elite residential complexes in the National Capital Region, India
Authors: Searle Llerena Guiu
Published: June 2013

This article examines the production of the internationally familiar landscapes of gated high-rise housing, malls and information technology campuses that have been constructed in the National Capital Region, India since the liberalisation of the economy in the early 1990s. It argues that Indian real estate developers have elaborated on one figure of personhood—the upwardly-mobile, high-earning, internationally-oriented ‘professional’—as part of their efforts to convince both potential international investors and Indian consumers to buy into their high-rise housing projects. The figure of the ‘professional’ must be understood as a discursive construct that industry members use to do various kinds of work, rather than as a straightforward description of actual apartment residents. This article traces the work that developers have done to create social indexical linkages between buildings and figures of personhood by analysing a range of communicative genres through which Indian real estate developers have attempted to create demand for their projects. By delineating the metadiscursive practices through which housing comes to have social indexical value, this article helps to elucidate relationships between new urban landscapes and the production of new class identities in India today.
Toward Publicly Responsive Sociology Curricula
Authors: Greenwood Nancy A.
Published: June 2013

Introductory sociology casts a wide net with regard to its audience and plays an important role in capturing the public eye as well as helping students to make more informed choices in their lives and communities. I ask six questions that help us as sociologists to think about how introductory sociology can better serve our discipline, our students, and their communities. These questions ask us to consider who our students are, how the course fits with university mission and program goals, what we want students to learn in this course and how we can build consensus about that common core, the extent to which there is alignment between learning objectives and our disciplinary standards in sociology, how assessment can be used to improve course design and curriculum in general, and the role that introductory sociology plays in recruitment and retention of students to the university and to the major. Posing such questions will promote further discussion and consensus building among sociology colleagues with the aim of improving curriculum and student learning.
Optionality of finiteness: Evidence for a no-overlap stage in Dutch child language
Authors: Blom Elma , Wijnen Frank
Published: June 2013

This article addresses a child language stage that has figured prominently in the current debate on children’s early linguistic competence: the Optional Infinitive (OI) stage, a relatively extended period during which children freely alternate between finite and nonfinite structures in contexts where adults only use finite forms. The study examines the assumption of previous research that children’s utterances with finite or nonfinite forms are generated by productive morphological rules throughout the OI stage. Analyses of Dutch-speaking children’s utterances indicate that at the onset of the OI stage finite verbs are infrequent and lexically restricted, and that lexical overlap between the verbs used in finite sentences and in children’s nonfinite structures (root infinitives) grows. It is argued that these observations are not due to statistical properties of the corpus, the limited number of finite verbs, or a growing verb lexicon, but signal, instead, the morphological development of finiteness.
Associations among play, gesture and early spoken language acquisition
Authors: Hall Suzanne , Rumney Lisa , Holler Judith , Kidd Evan
Published: June 2013

The present study investigated the developmental interrelationships between play, gesture use and spoken language development in children aged 18–31 months. The children completed two tasks: (i) a structured measure of pretend (or ‘symbolic’) play and (ii) a measure of vocabulary knowledge in which children have been shown to gesture. Additionally, their productive spoken language knowledge was measured via parental report. The results indicated that symbolic play is positively associated with children’s gesture use, which in turn is positively associated with spoken language knowledge over and above the influence of age. The tripartite relationship between gesture, play and language development is discussed with reference to current developmental theory.
An analysis of wind energy potential for micro wind turbine in Hong Kong
Authors: Li DHW , Cheung KL , Chan WWH , Cheng CCK , Wong TCH
Published: June 2013

Renewable energy can play an important role in meeting the ultimate goal of replacing parts of fossil fuels to generate sustainable, inexhaustible, clean and safe energy. One of the promising applications of renewable energy technology is the installation of wind turbine that has been identified as having potential for wide-scale application in Hong Kong. Locally, wind turbines are seldom installed in building developments. The barriers include limited installation space available, the heavily obstructed external environments and noise and vibration problems. The apposite places for the installation would be on the roof/rooftop of low-rise buildings located in low-density zones. Relevant wind data and output power generated on-site, which may be quite site-dependent, are essential for modelling and evaluating the wind energy conversion system. Long-term measured wind data are crucial to the study of wind energy potential. This work studies the wind data and micro-wind turbine used in dense urban terrain and low-density area. Technical data including wind speed and output power were analyzed and reported. To achieve 1% of total building energy consumption generated from wind power, 17 micro-wind turbines are required to be installed in this institutional building located in low-density zone.

Practical application: Wind turbine is one of the typical applications of renewable energy technology. However, micro-turbines are not popularly installed in building developments. This work analyses the measured wind data and the energy performance of micro-wind turbines installed in an institutional building. The findings provide the on-site measured data for design and assessment of micro-wind turbines installed in building blocks.
Barriers to Physical Activity in People With Type 2 Diabetes Enrolled in a Worksite Diabetes Disease Management Program
Authors: Erickson Deborah
Published: June 2013

Purpose

The purpose of this study was to explore the level of physical activity, barriers to physical activity, and strategies used to meet physical activity goals in people with type 2 diabetes (T2DM).

Methods

A descriptive, cross-sectional design was used in a sample of 75 adults with T2DM enrolled in a worksite diabetes disease management program (WDDMP). Participants self-reported the length of time they engaged in moderate-intensity physical activity, the frequency of general and specific physical activity, and barriers to participating in physical activity.

Results

Participants who chose to work on physical activity as part of their diabetes self-management had a higher stage of change for physical activity and participated in more general and specific physical activity than did those participants who did not choose to work on physical activity. Participants who were active reported fewer barriers to physical activity and chose to work on more self-care areas to control their diabetes than did those participants who were inactive.

Conclusions

Participants who chose to work on physical activity participated in more general and specific physical activity and had a higher stage of change for physical activity. Stage of change affects physical activity. While results provide support for the stages of change construct of the transtheoretical model of change, the results do not support that the WDDMP assisted participants in achieving their physical activity goals.
Who Can Provide Diabetes Self-Management Support in Primary Care?
Authors: Siminerio Linda , Ruppert Kristine M. , Gabbay Robert A.
Published: June 2013

Purpose

The purpose of this comparative effectiveness study is to compare diabetes self-management support (DSMS) approaches and determine who can be most effective in helping patients maintain/improve clinical outcomes, self-care behaviors, distress, and satisfaction following diabetes self-management education (DSME) delivered in primary care.

Methods

After receiving DSME, 141 participants were randomized to receive DSMS delivered by a trained supporter: educator, peer, practice staff, or usual education during a 6-month follow-up period. DSMS groups were compared to determine which supporter helped participants to maintain/improve A1C, blood pressure, lipids, weight, self-care, and distress. DSMS satisfaction was also examined.

Results

There was a significant improvement in A1C, empowerment, aspects of self-care, and distress following DSME at 6 weeks. Those in the educator DSMS group best sustained improved A1C while those in the other DSMS groups maintained glycemic improvements but began to show trends toward worsening. No significant differences or clear trends were seen in other clinical, behavioral, or psychosocial outcomes. The Program Reinforcement Impacts Self-Management (PRISM) study demonstrates that following DSME, participants maintained improved glycemia, lipid, weight, and self-care behaviors and reductions in distress throughout the delivery of DSMS interventions regardless of DSMS supporter. All of the participants reported satisfaction with DSMS.

Conclusions

These findings reaffirm the critical role of educators but suggest that others may serve as DSMS supporters. Results suggest that DSME delivered in primary care is effective and multiple DSMS agents are reasonable. As patient-centered self-management approaches are being explored in primary care, delivery of DSME and DSMS becomes paramount.
Attractiveness of reformulated OxyContin® tablets: assessing comparative preferences and tampering potential
Authors: Sellers Edward M , Perrino Peter J , Colucci Salvatore V , Harris Stephen C
Published: June 2013

Reformulated OxyContin® (oxycodone HCl controlled-release or ORF) was developed as a tamper and abuse-deterrent product, to reduce the risk of product abuse, misuse and their consequences. This noninterventional single-session study asked participants who were medically-healthy recreational opioid users, aged 18 years and older, to consider how they would use commonly available supplies to tamper with placebo ORF and placebo original OxyContin (OC) tablets, and how they would assess the attractiveness of tampering and abusing ORF tablets, as compared with other opioid formulations. Participants provided information on past opioid use, and they assessed the properties of five nonhypothetical oxycodone products and two hypothetical oxycodone products. Participants provided feedback on tampering preferences, preferred tamper methods for each product, overall tampering potential and product preferences. We had 30 participants (27 males and 3 females; mean age 35 years, range 18–51) complete both the interview and tampering sessions. Participants judged OC as the most attractive, valuable, desirable and most likely to be tampered with, from among all opioid products studied. By contrast, they rated ORF as the least attractive, least valuable, least desirable, and least likely to be tampered with among all the nonhypothetical opioid products studied. These results suggested that recreational drug abusers view ORF tablets as tamper-deterrent products.
Lamotrigine for attention deficit-hyperactivity disorder comorbid with mood disorders: a case series
Authors: Öncü Bedriye , Er Okan , Çolak Burçin , Nutt David J
Published: June 2013

Attention deﬁcit-hyperactivity disorder (ADHD) is frequently comorbid with mood disorders in both children and adults. Comorbidity is shown to have negative consequences and it needs to be treated effectively. Lamotrigine, an anticonvulsant indicated for the maintenance treatment of bipolar depression is reported to be effective in adult ADHD comorbid with bipolar II disorder. We conducted a retrospective chart review to identify patients with adult ADHD and comorbid mood disorders on lamotrigine, along with ADHD medications, and/or antidepressants and antipsychotics. We identified 40 patients (17 women, 42.5%; age range 16 – 55 yrs), 50% with bipolar II and 50% with recurrent depression. Their treatment response was evaluated by Clinical Global Impression scales. We found that 31 patients (77.5%) improved with lamotrigine, there was no change in 7 patients (17.5%) and 2 patients got worse, with a mean lamotrigine dose of 125.6 ± 47.8 mg (25 – 250 mg). To our knowledge, this is the first study to report that lamotrigine might be a safe and effective treatment option for adult ADHD comorbid with bipolar and recurrent depression.
Think Tanks and the Media
Authors: McDonald Lauren
Published: June 2013

This research examines how the conservative movement has used both conservative think tanks and the media to gain entry into the field of education policy. The study examines how the conservative movement has attempted to use think tanks as legitimating organizations to enter the education policy arena by (a) measuring the historical growth in the number of conservative think tanks focused on education policy, (b) situating that growth within the larger context of efforts on the part of the conservative movement to bring free market ideas to education, and (c) analyzing and comparing conservative think tank media presence to that of centrist and progressive think tanks and university-based education-policy centers. Findings indicate that conservative think tanks produced the largest number of education media citations, followed by centrist think tanks. Liberal/progressive think tanks and university-based education-policy centers had little to no media presence.
Nurse–Patient Interaction
Authors: Haugan Gørill , Moksnes Unni Karin , Espnes Geir Arild
Published: June 2013

Background: Nursing home care increasingly targets those elderly with the greatest needs in terms of personal daily activities, whereas services supporting spiritual needs such as hope tend to be ignored. Hope is seen to be a dynamic life force vital to well-being. Nursing home patients are frail, vulnerable, and dependent, which may lead to their hope being intimately related to the nurse–patient interaction. Purpose: The purpose of this study was to investigate the relationship between nurse–patient interaction and hope among cognitively intact nursing home patients. Design and method: Cross-sectional data were obtained by means of one-on-one interviews; 202 cognitively intact nursinghome patients representing 44 Norwegian nursing homes responded to the Herth Hope Index and the Nurse–Patient Interaction Scale. The hypothesized relationships between a two-factor construct of hope and nurse–patient interaction were assessed by means of structural equation modelling. Results: The structural equation model revealed a good fit to the data, showing significant influence of nurse–patient interaction on nursing home patients’ level of hope. Conclusion and implications: Nurse–patient interaction significantly influences hope in cognitively intact nursing home patients. Offering connectedness should be a central and integral aspect of holistic nursing home care. Providing continuing educational programs for caregivers focusing on how to interact with patients in a health-promoting and hopeful manner seems essential.
Highly cross-linked thermosetting benzocyclobutene-modified bis-benzoxazine resins from 4-hydroxybenzocyclobutene
Authors: Cheng Yuanrong , Kong Lingqiang , Ren Zhidong , Qi Tianke
Published: June 2013

In the present study, benzocyclobutene (BCB) was incorporated into the benzoxazine (BOZ) monomers. BCB-functionalized BOZ monomers were synthesized by the reaction of 4-hydroxybenzocyclobutene, aromatic diamine, and paraformaldehyde in dioxane under reflux. The structure of the monomers was characterized by Fourier transform infrared spectroscopy (FTIR) and proton and carbon nuclear magnetic resonance spectroscopies. The monomers possess two kinds of ring-opening polymerizable functional groups, BCB and BOZ. Differential scanning calorimetry and FTIR were used to study the polymerization behavior of the monomers. Dynamic mechanical analysis demonstrates that the related polymers show high storage moduli maintained in a wide range of temperature up to 300°C and high glass transition temperature at about 330°C. The incorporation of BCB improved the thermal stability and mechanical property of the monomer.
L.E.A.D.
Authors: Chatterji Madhabi , Green Lawrence W. , Kumanyika Shiriki
Published: June 2013

This article summarizes a comprehensive, systems-oriented framework designed to improve the use of a wide variety of evidence sources to address population-wide obesity problems. The L.E.A.D. framework (for Locate the evidence, Evaluate the evidence, Assemble the evidence, and inform Decisions), developed by an expert consensus committee convened by the Institute of Medicine, is broadly applicable to complex, community-wide health problems. The article explains how to use the framework, presenting an evidence typology that helps specify relevant research questions and includes examples of how particular research methodologies and sources of evidence relate to questions that stem from decision-maker needs. The utility of a range of quantitative, qualitative, and mixed method designs and data sources for assembling a broad and credible evidence base is discussed, with a call for ongoing “evidence generation” to fill information gaps using the recommended systems perspective.
A case of valence competition in elections
Authors: Curini Luigi , Martelli Paolo
Published: June 2013

Despite a growing interest in investigating the causes of political corruption, far less attention has been devoted to analysing the conditions under which political actors have an incentive to highlight corruption in electoral competition. Do parties talk about corruption just as a reaction to exogenous factors (i.e. scandals reported in the press)? Or are there systematic patterns in the way parties emphasize this issue during campaigns? Assuming that corruption is a valence issue (i.e. an issue universally supported/disclaimed by electors), we put our investigation in the framework of a one-dimensional model and hypothesize that spatial considerations can affect parties’ incentives to emphasize corruption issues. Empirical analysis based on CMP data shows that such an incentive exists for both cabinet and non-cabinet parties, and increases with proximity on the ideological scale.
Attention-deficit hyperactivity disorder (ADHD) in the early years: Diagnostic issues and educational relevance
Authors: Schmiedeler Sandra , Schneider Wolfgang
Published: June 2013

In this study we discuss implications of the dimensional versus categorical approach in the diagnosis of attention-deficit hyperactivity disorder (ADHD) and focus on the educational relevance of an early assessment. In a longitudinal study in a German community sample we investigated the development of ADHD symptoms from kindergarten until the end of Grade 1 as well as the association to pre-academic skills and later academic performance. At three time points in kindergarten, children (original sample N = 793; Mn age 4 years 10 months) were assessed in regard to school-relevant precursors of reading, spelling and mathematical abilities; ADHD symptoms were rated by parents and preschool teachers. In elementary school academic performance in reading, spelling, and mathematics was measured with standardized tests. Results show that stability of ADHD symptoms during preschool was high considering the dimensional approach, whereas in regard to the categorical classification many children crossing the cut-off point at one measurement point did not do so at the next assessment. Furthermore, preschool ADHD symptoms were negatively correlated with all school-relevant precursors. This was more pronounced for symptoms of inattention than for hyperactivity/impulsivity. Observing later development, preschool ADHD symptoms predicted academic achievement in mathematics and reading at the end of Grade 1 even after individual differences in nonverbal intelligence and specific precursors had been statistically controlled for.
Cultural activism as a counter-discourse to the European Capital of Culture programme: The case of Turku 2011
Authors: Lähdesmäki Tuuli
Published: June 2013

Each year the European Union designates one or more cities with the competed-for city brand of European Capital of Culture (ECOC). In several recent ECOCs, such as in Turku, Finland, the management and organisation of the events have caused tension among the citizens regarding decision-making, financing and power over use of the urban space. The focus of the article is on analysis of the discursive dynamics of local activists and their project ‘Turku – European Capital of Subculture 2011’. By emphasising the cultural analysis of activism, the article indicates how the counter-discourse of the activists was produced through cultural production. The project produced a strong movement culture with common practices, anti-neoliberal values and world views. Through cultural production and movement culture, the project participated in the creation of subculture as a fluid and flexible cultural category expressed through stylistic and lifestyle choices.
When old and new media collide: The case of WikiLeaks
Authors: Hindman Elizabeth Blanks , Thomas Ryan J
Published: June 2013

In November 2010, WikiLeaks released over a quarter of a million US State Department diplomatic cables to the world’s media, exposing private communications between diplomatic officials at US embassies across the globe and the State Department at Washington, DC. This study analyzes the WikiLeaks controversy through institutional views of the US news media. Our analysis of 83 newspaper editorials found four prominent themes in US newspaper discourse: (1) The contrast between the “discretion and maturity” of traditional journalism and the rash actions of WikiLeaks; (2) The need for “old media” in a new media landscape; (3) The tension between the public’s right to know and national security; and (4) The invocation of the Pentagon Papers as a way of drawing clear lines of difference between journalism’s past and its possible future. Our findings indicate ongoing tension between “old” and “new” media at a time when definitions of journalism are increasingly diffuse.
“Their Depression Is Something Different . . . It Would Have to Be”
Authors: Watkins Daphne C. , Abelson Jamie M. , Jefferson S. Olivia
Published: June 2013

This study reports findings from the Black Women’s Perceptions of Black Men’s Depression (BWP) study, which included eight focus groups with Black women ( N = 46) from southeastern Michigan. Four themes illustrated the impressions of Black women from different socioeconomic backgrounds: Black men’s depression is a cultured and gendered phenomenon, the role of Black women in Black men’s depression, intergenerational differences with how depression is handled by Black men, and the need (and ways) to reach Black men with depression resources. Results underscore not only the importance of understanding the kind of depression in Black men that meets criteria described by the Diagnostic and Statistical Manual of Mental Disorders ( DSM) but also the psychological distress that may coexist with (or be separate from) DSM depression. Implications for interventions that educate, diagnose, and treat depression in Black men are discussed.
Pharmacist and physician views on collaborative practice
Authors: Kelly Deborah V. , Bishop Lisa , Young Stephanie , Hawboldt John , Phillips Leslie , Keough T. Montgomery
Published: June 2013

Background:

Strong working relationships between pharmacists and physicians are needed to optimize patient care. Understanding attitudes and barriers to collaboration between pharmacists and physicians may help with delivery of primary health care services. The objective of this study was to capture the opinions of family physicians and community pharmacists in Newfoundland and Labrador (NL) regarding collaborative practice.

Methods:

Two parallel surveys were offered to all community pharmacists and family physicians in NL. Surveys assessed the following: attitudes and experience with collaborative practice, preferred communication methods, perceived role of pharmacists, areas for more collaboration and barriers to collaborative practice. Results for both groups were analyzed separately, with comparisons between groups to compare responses with similar questions.

Results:

Survey response rates were 78.6% and 7.1% for pharmacists and physicians, respectively. Both groups overwhelmingly agreed that collaborative practice could result in improved patient outcomes and agreed that major barriers were lack of time and compensation and the need to deal with multiple pharmacists/physicians. Physicians indicated they would like more collaboration for insurance approvals and patient counselling, while pharmacists want to assist with identifying and managing patients’ drug-related problems. Both groups want more collaboration to improve patient adherence.

Conclusion:

Both groups agree that collaborative practice can positively affect patient outcomes and would like more collaboration opportunities. However, physicians and pharmacists disagree about the areas where they would like to collaborate to deliver care. Changes to reimbursement models and infrastructure are needed to facilitate enhanced collaboration between pharmacists and physicians in the community setting.
Labour market outcomes of public health graduates: evidence from Australia
Authors: Li Ian W , Awofeso Niyi
Published: June 2013

Little information is available on the public health workforce. This study contributes to the gap in the literature and examines the demographic characteristics, career destinations and earnings of Masters in Public Health (MPH) graduates in Australia, using data from the 1999–2009 waves of the Graduate Destination Survey. It was found that public health graduates had a high amount of female representation and very low proportions of indigenous representation. Public health graduates experienced a relatively low unemployment rate and 85% were employed within 120 days of graduation. However, close to half of the graduates did not work in the health industry or in health-related roles. The mean salaries of public health graduates working in public health roles were relatively low compared to those in other occupations, but they had a range comparable to that observed for public health professionals in the USA and were higher than those of other Masters graduates in some other health fields. The results indicate strong demand and positive employment prospects for public health graduates in Australia. Strategies to target recruitment and/or retention of female or indigenous graduates in the public health workforce should be a priority. Mapping of public health graduate destinations and employment prospects should might be prioritised, given its strong potential to facilitate workforce planning and provide potential public health workers with more comprehensive career trajectories.
Personality, Psychopathology, and the Neurotransmitter Attributes Questionnaire (NAQ)
Authors: O’Connor Lynn E. , Berry Jack W. , Lewis Thomas , Rangan Rachna K. , Poursohrab Natalie
Published: June 2013

In this study, 901 participants completed an anonymous Internet-based survey, including a new instrument, the Neurotransmitter Attributes Questionnaire (NAQ), indicating possible dysfunction of the serotonergic or dopaminergic circuits. NAQ items were derived from questions prescribing professionals commonly ask new patients whose symptoms call for psychopharmacological treatments, sometimes in combination with psychosocial interventions. Rasch modeling was used to establish item quality, subscale reliability, and unidimensionality. In addition, the items in each subscale were found reliable when judged by three blind raters who were experienced psychopharmacologists. Standard measures of mental disorders and self-reported diagnoses were used to validate the NAQ subscales. These questions that form the subscales on the NAQ may be helpful when determining the class of medication likely to be most effective. Variations in mood and anxiety-disordered patients call for a case-specific approach to pharmacological treatment. Some patients are best helped by serotonergic agonists, others have a better outcome from treatment with dopaminergic agonists, and some patients seem to be best served by a combination of both. The NAQ was designed to aid decision-making early in treatment, potentially leading to greater compliance and better outcome. The NAQ may be used to standardize protocols in outcome research, and in addition, it may provide a new perspective on personality studies.
Malaria Policy Advisory Committee to the WHO: conclusions and recommendations of March 2013 meeting
Authors:   WHO Malaria Policy Advisory Committee and Secretariat
Published: June 2013

The Malaria Policy Advisory Committee to the World Health Organization met in Geneva, Switzerland from 13 to 15 March, 2013. This article provides a summary of the discussions, conclusions and recommendations from that meeting.

Meeting sessions included: a review of the efficacy of artemisinin-based combination therapy in Guyana and Suriname; the outcomes from a consultation on non-malaria febrile illness; the outcomes from the second meeting of the Evidence Review Group on malaria burden estimation; an update on the review of the WHO Guidelines for the Treatment of Malaria; an update regarding progress on the constitution of the vector control Technical Expert Group; updates on the RTS, S/AS01 vaccine and the malaria vaccine technology roadmap; financing and resource allocation for malaria control; malaria surveillance and the need for a surveillance, monitoring and evaluation Technical Expert Group; criteria and classification related to malaria elimination; the next meeting of the Evidence Review Group on Intermittent Preventive Treatment in pregnancy; an update on the soon-to-be launched Elimination Scenario Planning Tool; and an update on the process for the Global Technical Strategy for Malaria Control and Elimination (2016–2025).

Policy statements, position statements, and guidelines that arise from the MPAC meeting conclusions and recommendations will be formally issued and disseminated to World Health Organization Member States by the World Health Organization Global Malaria Programme.
Pathways of neighbourhood-level socio-economic determinants of adverse birth outcomes
Authors: Meng Gang , Thompson Mary E , Hall G Brent
Published: June 2013

Background

Although socio-economic factors have been identified as one of the most important groups of neighbourhood-level risks affecting birth outcomes, uncertainties still exist concerning the pathways through which they are transferred to individual risk factors. This poses a challenge for setting priorities and developing appropriate community-oriented public health interventions and planning guidelines to reduce the level of adverse birth outcomes.

Method

This study examines potential direct and mediated pathways through which neighbourhood-level socio-economic determinants exert their impacts on adverse birth outcomes. Two hypothesized models, namely the materialist and psycho-social models, and their corresponding pathways are tested using a binary-outcome multilevel mediation analysis. Live birth data, including adverse birth outcomes and person-level exposure variables, were obtained from three public health units in the province of Ontario, Canada. Corresponding neighbourhood-level socio-economic, psycho-social and living condition variables were extracted or constructed from the 2001 Canadian Census and the first three cycles (2001, 2003, and 2005) of the Canadian Community Health Surveys.

Results

Neighbourhood-level socio-economic-related risks are found to have direct effects on low birth weight and preterm birth. In addition, 20-30% of the total effects are contributed by indirect effects mediated through person-level risks. There is evidence of four person-level pathways, namely through individual socio-economic status, psycho-social stress, maternal health, and health behaviours, with all being simultaneously at work. Psycho-social pathways and buffering social capital-related variables are found to have more impact on low birth weight than on preterm birth.

Conclusion

The evidence supports both the materialist and psycho-social conceptualizations and the pathways that describe them, although the magnitude of the former is greater than the latter.
Improving Si solar cell performance using Mn:ZnSe quantum dot-doped PLMA thin film
Authors: Cheng Dan-Chen , Hao Hong-Chen , Zhang Miao , Shi Wei , Lu Ming
Published: June 2013

Poly(lauryl methacrylate) (PLMA) thin film doped with Mn:ZnSe quantum dots (QDs) was spin-deposited on the front surface of Si solar cell for enhancing the solar cell efficiency via photoluminescence (PL) conversion. Significant solar cell efficiency enhancements (approximately 5% to 10%) under all-solar-spectrum (AM0) condition were observed after QD-doped PLMA coatings. Furthermore, the real contribution of the PL conversion was precisely assessed by investigating the photovoltaic responses of the QD-doped PLMA to monochromatic and AM0 light sources as functions of QD concentration, combined with reflectance and external quantum efficiency measurements. At a QD concentration of 1.6 mg/ml for example, among the efficiency enhancement of 5.96%, about 1.04% was due to the PL conversion, and the rest came from antireflection. Our work indicates that for the practical use of PL conversion in solar cell performance improvement, cautions are to be taken, as the achieved efficiency enhancement might not be wholly due to the PL conversion.
A 68-year-old Caucasian man presenting with urinary bladder lymphoepithelioma: a case report
Authors: Spinelli Gian Paolo , Lo Russo Giuseppe , Pacchiarotti Alberto , Stati Valeria , Prete Alessandra Anna , Tomao Federica , Sciarretta Cinzia , Arduin Mara , Basso Enrico , Chiotti Stefania , Sinjari Marsela , Venezia Martina , Zoccoli Giada , Tomao Silverio
Published: June 2013

Introduction

Lymphoepithelioma is a very rare form of malignant tumor originating from epithelial line cells. Its occurrence has potential clinical, therapeutic and prognostic implications. In the present report we describe an unusual case of bladder cancer with two different histological varieties: transition cell carcinoma and lymphoepithelioma-like carcinoma. Lymphoepithelioma-like carcinoma of the bladder has only been rarely reported in the literature to date.

Case presentation

We present the case of a 68-year-old Caucasian man who, after occurrence of hematuria, underwent transurethral resection of a bladder tumor. The results of a histological examination confirmed a high-grade non-muscle-invasive pT1 lymphoepithelioma-like carcinoma of the urinary bladder, associated with a concurrent high-grade transition cell carcinoma. After analyzing the histological features, our patient was subjected to treatment with intra-vesical instillations of bacillus Calmette-Guérin. Our work stresses that diagnosis and therapeutic approaches can be difficult and controversial, especially in the early stages of this rare carcinoma.

Conclusions

This report emphasizes the importance of extending our knowledge and experiences regarding this uncommon carcinoma. Further studies are needed to better understand this rare disease and define more accurate diagnostic and therapeutic strategies.
Procalcitonin decrease over 72 hours in US critical care units predicts fatal outcome in sepsis patients
Authors: Schuetz Philipp , Maurer Paula , Punjabi Vikas , Desai Ami , Amin Devendra N , Gluck Eric
Published: June 2013

Introduction

Close monitoring and repeated risk assessment of sepsis patients in the intensive care unit (ICU) is important for decisions regarding care intensification or early discharge to the ward. We studied whether considering plasma kinetics of procalcitonin, a biomarker of systemic bacterial infection, over the first 72 critical care hours improved mortality prognostication of septic patients from two US settings.

Methods

This retrospective analysis included consecutively treated eligible adults with a diagnosis of sepsis from critical care units in two independent institutions in Clearwater, FL and Chicago, IL. Cohorts were used for derivation or validation to study the association between procalcitonin change over the first 72 critical care hours and mortality.

Results

ICU/in-hospital mortality rates were 29.2%/31.8% in the derivation cohort (n = 154) and 17.6%/29.4% in the validation cohort (n = 102). In logistic regression analysis of both cohorts, procalcitonin change was strongly associated with ICU and in-hospital mortality independent of clinical risk scores (Acute Physiology, Age and Chronic Health Evaluation IV or Simplified Acute Physiology Score II), with area under the curve (AUC) from 0.67 to 0.71. When procalcitonin decreased by at least 80%, the negative predictive value for ICU/in-hospital mortality was 90%/90% in the derivation cohort, and 91%/79% in the validation cohort. When procalcitonin showed no decrease or increased, the respective positive predictive values were 48%/48% and 36%/52%.

Discussion

In septic patients, procalcitonin kinetics over the first 72 critical care hours provide prognostic information beyond that available from clinical risk scores. If these observations are confirmed, procalcitonin monitoring may assist physician decision-making regarding care intensification or early transfer from the ICU to the floor.
Hemodynamic assessment of critically ill patients using a miniaturized transesophageal echocardiography probe
Authors: Cioccari Luca , Baur Hans-Rudolf , Berger David , Wiegand Jan , Takala Jukka , Merz Tobias M
Published: June 2013

Introduction

Hemodynamic management in intensive care patients guided by blood pressure and flow measurements often do not sufficiently reveal common hemodynamic problems. Trans-esophageal echocardiography (TEE) allows for direct measurement of cardiac volumes and function. A new miniaturized probe for TEE (mTEE) potentially provides a rapid and simplified approach to monitor cardiac function. The aim of the study was to assess the feasibility of hemodynamic monitoring using mTEE in critically ill patients after a brief operator training period.

Methods

In the context of the introduction of mTEE in a large ICU, 14 ICU staff specialists with no previous TEE experience received six hours of training as mTEE operators. The feasibility of mTEE and the quality of the obtained hemodynamic information were assessed. Three standard views were acquired in hemodynamically unstable patients: 1) for assessment of left ventricular function (LV) fractional area change (FAC) was obtained from a trans-gastric mid-esophageal short axis view, 2) right ventricular (RV) size was obtained from mid-esophageal four chamber view, and 3) superior vena cava collapsibility for detection of hypovolemia was assessed from mid-esophageal ascending aortic short axis view. Off-line blinded assessment by an expert cardiologist was considered as a reference. Inter-rater agreement was assessed using Chi-square tests or correlation analysis as appropriate.

Results

In 55 patients, 148 mTEE examinations were performed. Acquisition of loops in sufficient quality was possible in 110 examinations for trans-gastric mid-esophageal short axis, 118 examinations for mid-esophageal four chamber and 125 examinations for mid-esophageal ascending aortic short axis view. Inter-rater agreement (Kappa) between ICU mTEE operators and the reference was 0.62 for estimates of LV function, 0.65 for RV dilatation, 0.76 for hypovolemia and 0.77 for occurrence of pericardial effusion (all P < 0.0001). There was a significant correlation between the FAC measured by ICU operators and the reference (r = 0.794, P (one-tailed) < 0.0001).

Conclusions

Echocardiographic examinations using mTEE after brief bed-side training were feasible and of sufficient quality in a majority of examined ICU patients with good inter-rater reliability between mTEE operators and an expert cardiologist. Further studies are required to assess the impact of hemodynamic monitoring by mTEE on relevant patient outcomes.