bluuebunny/crossref_metadata_2025 huggingface dataset:
Closed Ankle Fractures in the Diabetic Patient
Authors: Flynn John M. , Rio Felix Rodriguez-del , Pizá Pedro A.
Published: January 2017

Systemic and local manifestations of diabetes mellitus may complicate the treatment of ankle fractures in the diabetic population. We studied 98 patients (73 non-diabetics and 25 diabetics) who were treated for closed ankle fractures by either surgical or non-surgical methods. We found that overall, the risk of infection in the diabetic population (32%) was 4 times higher than in the non-diabetic population (8%). The infection rate in the diabetic group treated surgically more than doubled that in the non-diabetic group. Four out of six diabetic patients treated with cast became infected compared to no infections in the five non-diabetics treated with a cast. Even though the diabetic foot and ankle are well studied, the medical literature is not conclusive regarding the management of ankle fractures in the diabetic patient. Diabetic patients treated conservatively had a tendency to become infected over those treated surgically. Peripherovascular disease, peripheral neuropathy and swelling and/or echymosis increased the risk of infection in the diabetic population. Diabetic patients with poor compliance had a tendency to become infected more than those who were compliant.

We concluded that the diabetic patient who is poorly compliant with evidence of neuropathic disease, peripherovascular disease and severe swelling and echymosis presents the most difficult group to manage. Although these patients are poor surgical candidates, they are also the most difficult to manage and also most prone to infection and complications if treated conservatively. When faced with this difficult scenario a multidisciplinary team approach would probably yield the best possible results by early identification and intervention in these patients.
The MABAL Shoe, an Alternative Method in Contact Casting for the Treatment of Neuropathic Diabetic Foot Ulcers
Authors: Hissink Rutger Jan , Manning Hendrik Anton , van Baal Jeff G.
Published: January 2017

INTRODUCTION: Total Contact Casting (TCC) is considered the gold standard in the treatment of neuropathic diabetic foot ulcers. To overcome some disadvantages of TCC we developed a removable fiberglass combicast shoe - the MABAL shoe.

PATIENTS AND METHODS: The MABAL shoe was used to treat 23 plantar ulcers.

RESULTS: Before treatment the mean surface area was 2.0 cm 2 (0.5–7.1 cm 2 ). Twenty-one of 23 ulcers healed, with a mean healing time of 34 days (7–75 days).

CONCLUSION: The MABAL shoe provides healing of neuropathic diabetic foot ulcers comparable to existing methods of treatment, while offering some potential advantages. The main advantages are mobilization of the ankle, removability of the cast and a less time consuming form of treatment.
The Effect on Ankle Dorsiflexion of Gastrocnemius Recession
Authors: Pinney Stephen J. , Hansen Sigvard T. , Sangeorzan Bruce J.
Published: January 2017

Gastrocnemius equinus contracture has been suggested as an etiologic factor in mechanical diseases of the foot and ankle and in ulcer formation in the foot. The purpose of this study is to assess the correction in ankle dorsiflexion that can be achieved with a gastrocnemius recession. An isolated gastrocnemius release (Strayer procedure) was performed on 26 legs, in 20 consecutive patients, for clinically significant gastrocnemius equinus contracture. Ankle dorsiflexion was assessed using a validated electrogoniometer. Ankle dorsiflexion was recorded with the knee straight and with the knee bent. Measurements were recorded preoperatively, and immediately postoperatively. Measurements at an average of 55.0 days post-surgery (range, 37 to 128 days) were performed on 20 legs (15 patients).

Results: Average preoperative ankle dorsiflexion with the knee straight was 5.1°. Average preoperative ankle dorsiflexion with the knee bent was 22.8°. Immediately following surgery the average ankle dorsiflexion with the knee straight was 23.2°. The average correction was 18.1° and this increase was significant (p < 0.0001.) In the 15 patients (20 legs) available for follow-up, the increase in ankle dorsiflexion with the knee straight was maintained (average: 24.9°).

Patients with gastrocnemius contracture who underwent an isolated gastrocnemius release increased their ankle dorsiflexion (knee straight) by an average of 18.1° with postoperative ankle dorsiflexion (knee straight) being equivalent (23.2 and 22.8°) to preoperative ankle dorsiflexion (knee bent). This correction appears to be maintained (23.2 vs. 24.9°) at short-term follow-up.
The Utilization of Antithrombotic Therapy in Older Patients in Aged Care Facilities With Atrial Fibrillation
Authors: Frain Bridget , Castelino Ronald , Bereznicki Luke R.
Published: January 2017

Oral anticoagulants are essential drugs for the prevention of thromboembolic events in patients with atrial fibrillation (AF). Anticoagulants are, however, commonly withheld in older people due to the risk and fear of hemorrhage. Although the underutilization of anticoagulants in patients with AF has been demonstrated internationally, few studies have been conducted among aged care residents. The aim of this study was to determine the utilization of anticoagulants among people with AF residing in aged care facilities. We performed a non-experimental, retrospective analysis designed to evaluate antithrombotic usage in patients with AF in Australia residing in aged care facilities, using data collected by pharmacists while performing Residential Medication Management Reviews (RMMRs). The utilization of antithrombotic therapy and the appropriateness of therapy were determined based on the CHADS2, CHA2DS2-VASc, and HAS-BLED risk stratification schemes in consideration of documented contraindications to treatment. Predictors of anticoagulant use were determined using multivariate logistic regression. A total of 1952 RMMR patients with AF were identified. Only 35.6% of eligible patients (CHADS2 score ≥2 and no contraindications to anticoagulants) received an anticoagulant. As age increased, the likelihood of receiving an anticoagulant decreased and the likelihood of receiving an antiplatelet or no therapy increased. In patients at high risk of stroke (CHADS score ≥2), utilization of anticoagulants dropped by 19.7% when the HAS-BLED score increased from 2 to 3, suggesting that physicians placed a heavier weighting on bleeding risk rather than stroke risk. Prescribing of anticoagulants was influenced to a greater extent by bleeding risk than it was by the risk of stroke. Further research investigating whether the growing availability of direct oral anticoagulants influences practice in this patient population is needed.
Teaching Creativity Through Inquiry Science
Authors: Thompson Taylor
Published: January 2017

The experience that students gain through creative thinking contributes to their readiness for the 21st century. For this and other reasons, educators have always considered creative thinking as a desirable part of any curriculum. The focus of this article is on teaching creative thinking in K-12 science as a way to serve all students and, especially, creatively gifted students. The premise is that teaching creativity through science is a good learning motivator and can lead to more meaningful science learning. Included is a model for teaching creative thinking through science with examples that show how a teacher can, at a minimum, start with an established series of inquiry lessons and incorporate more creative thinking. It is hoped that teachers with this experience can begin to include more creative aspects in the curriculum at the initial planning stages.
Bridging the Gap 10 Years Later
Authors: Beasley Jennifer G. , Briggs Christine , Pennington Leighann
Published: January 2017

The need for a shared vision concerning exemplary curricula for academically advanced learners must be a priority in the field of education. With the advent of the Common Core State Standards adoption in many states, a new conversation has been ignited over meeting the needs of students with gifts and talents for whom the “standard” curriculum is not a good fit. The purpose for this article is to highlight the current need for high-quality curriculum, discuss how the National Association for Gifted Children (NAGC) Curriculum Awards rubric has been updated to reflect the research in the field, and look at additional ways to use the NAGC Curriculum rubric as a tool to support the development of quality curriculum and to select and award exemplary curricula for addressing advanced academic needs of students with gifts and talents.
The Influence of Pre-existing Audience Mood and Message Relevance on the Effectiveness of Health PSAs: Differential Effects by Message Type
Authors: Anghelcev George , Sar Sela
Published: January 2017

Most health communication research is grounded in theories of rational human behavior, which emphasize the role of cognition in health-related decision making. The role of affect—particularly pre-exposure mood—as a determinant of responses to health campaigns is underexplored. Using experimental data, the present study describes variations in attitudinal and behavioral responses to health communication as a function of preexisting mood (positive/negative), message relevance (high/low), and health message type (prevention/detection). Data show that message relevance moderated the effects of health message type under positive, but not under negative, mood.
Effects of Visual Framing on Emotional Responses and Evaluations of News Stories about the Gaza Conflict 2009
Authors: Brantner Cornelia , Lobinger Katharina , Wetzstein Irmgard
Published: January 2017

The experiment investigates visual framing effects of news stories on readers'(1) emotional response, (2) evaluation of communicative quality, (3) journalistic credibility and (4) objectivity, and (5) perception of actor representation. Three versions of a news report about the Gaza conflict were used. While the text remained the same, different images were added representing visual human-interest framing, visual political framing, and no visual framing. Visual human-interest framing elicited stronger emotional responses, higher values concerning the communicative quality, and had an impact on the perceived actor representation. No differences in objectivity and credibility were found among the three stimuli.
Who's to Blame When a Business Fails? How Journalistic Death Metaphors Influence Responsibility Attributions
Authors: Williams Ann E. , Davidson Roei , Yochim Emily Chivers
Published: January 2017

This study unites a textual analysis and an experimental audience study to document the use of death metaphor in business news and to assess the impact that death metaphor has on audiences' attributions of responsibility for corporate failure. The findings show that death metaphors are frequently used in financial press coverage and that the use of death metaphor influences audience members' responsibility attributions by intensifying overall levels of blame, while simultaneously deflecting blame away from the executives responsible for managing the firm and diffusing it to other factors, including the state of the economy, the government, and individual consumers.
The Value of Public Relations in Investor Relations: Individual Investors' Preferred Information Types, Qualities, and Sources
Authors: Penning Timothy
Published: January 2017

A survey targeting individual investors addressed the types, qualities, and sources of information this specific public seeks and values. In keeping with uses and gratifications theory and situational theory of problem solving, results identify specific conditions associated with investors seeking and selecting sources of information that would be considered public relations content, validating public relations and investor relations communication as having value to a specific set of individual investors. This study provides evidence that public relations communications content has as much or more value than information from the news media or other sources in an investor relations context.
Erythropoietic Protoporphyria: Spectrum of Three Cases
Authors: Bertrand Janie , Clarke Joe T.R. , Hanna Dominique
Published: January 2017

Background:

Erythropoietic protoporphyria is a rare photodermatosis of childhood, and the diagnosis can be delayed. A deficient ferrochelatase enzyme leads to accumulation of protoporphyrins in the dermis, causing phototoxic burning.

Objective:

To report three cases with great variability in severity of symptoms and age at diagnosis. We discuss clinical and biochemical findings, mutation analysis, and therapeutic options.

Methods:

We report three cases with different degrees of photosensitivity, laboratory results, psychosocial impact, and preventive and therapeutic treatments.

Results:

The diagnosis of erythropoietic protoporphyria was confirmed by both typical elevation of plasma porphyrins and the discovery of a mutated FECH gene.

Conclusion:

Erythropoietic protoporphyria should be suspected in any cases of childhood photosensitivity. Systemic complications are unusual. Mutation analysis confirms the diagnosis. Photoprotection is the cornerstone of treatment.

Renseignements de base:

La protoporphyrie érythropoïétique est une photodermatose infantile rare, et le diagnostic peut être retardé. Une déficience de l'enzyme ferrochélatase produit une accumulation de protoporphyrines dans le derme ce qui provoque une réaction phototoxique.

Objectif:

Présenter trois cas qui illustrent une grande variabilité de la gravité des symptômes et de l'âge au moment du diagnostic. Nous discutons des résultats cliniques et biochimiques, de l'analyse des mutations, et des options thérapeutiques.

Méthodes:

Nous exposons trois cas qui présentent différents degrés de photosensibilité, les résultats d'examen de laboratoire, l'impact psychosocial, et les traitements préventifs et thérapeutiques.

Résultats:

Le diagnostic de la protoporphyrie érythropoïétique a été confirmé à la fois par l'élévation caractéristique des porphyrines plasmatiques et par la mise en évidence d'une mutation du gène FECH.

Conclusion:

La protoporphyrie érythropoïétique doit être soupçonnée dans tous les cas de photosensibilité infantile. Les complications systémiques sont inhabituelles. L'analyse des mutations confirme le diagnostic. La photoprotection est la pierre angulaire du traitement.
Resistance to mainstreaming gender into the higher education curriculum
Authors: Verge Tània , Ferrer-Fons Mariona , González M José
Published: January 2017

Disregard of gender and of women’s contributions in the higher education curriculum is still a widespread phenomenon. Building on feminist institutionalism, this article explores the forms and types of resistance that efforts to engender the higher education curriculum must contend with and discusses the ways in which resistance to curricular reform is entrenched in a web of both gender-specific and apparently gender-neutral academic informal (non-written) rules. In doing so, the authors use empirical evidence collected by an action-research project undertaken at a faculty of political and social sciences in a Catalan public university (Spain). The Spanish case is intriguing because mainstreaming gender in higher education has been prescribed by various national and regional laws that are nonetheless poorly implemented. The article also reflects on the positive feedback loop action-research projects can facilitate within gendered institutions such as universities and pinpoints the role of feminist agency in counteracting resistance to institutional change.
In the Queue for Coronary Artery Bypass Grafting: Patients' Perceptions of Risk and ‘Maximal Acceptable Waiting Time’
Authors: Llewellyn-Thomas Hilary , Thiel Elaine , Paterson Michael , Naylor David
Published: January 2017

Objectives:

To elicit patients' maximal acceptable waiting times (MAWT) for non-urgent coronary artery bypass grafting (CABG), and to determine if MAWT is related to prior expectations of waiting times, symptom burden, expected relief, or perceived risks of myocardial infarction while waiting.

Methods:

Seventy-two patients on an elective CABG waiting list chose between two hypothetical but plausible options: a 1-month wait with 2% risk of surgical mortality, and a 6-month wait with 1% risk of surgical mortality. Waiting time in the 6-month option was varied up if respondents chose the 6-month/lower risk option, and down if they chose the 1-month/higher risk option, until the MAWT switch point was reached. Patients also reported their expected waiting time, perceived risks of myocardial infarction while waiting, current function, expected functional improvement and the value of that improvement.

Results:

Only 17 (24%) patients chose the 6-month/1% risk option, while 55 (76%) chose the 1-month/2% risk option. The median MAWT was 2 months; scores ranged from 1 to 12 months (with two outliers). Many perceived high cumulative risks of myocardial infarction if waiting for 1 (upper quartile, ≥ 1.45%) or 6 (upper quartile, ≥ 10%) months. However, MAWT scores were related only to expected waiting time ( r= 0.47; P < 0.0001).

Conclusions:

Most patients reject waiting 6 months for elective CABG, even if offered along with a halving in surgical mortality (from 2% to 1%). Intolerance for further delay seems to be determined primarily by patients' attachment to their scheduled surgical dates. Many also have severely inflated perceptions of their risk of myocardial infarction in the queue. These results suggest a need for interventions to modify patients' inaccurate risk perceptions, particularly if a scheduled surgical date must be deferred.
Open Heart Surgery in Public and Private Practice
Authors: Pons Joan , Moreno Victor , Borras Josep , Espinas Josep , Almazan Caritat , Granados Alicia
Published: January 2017

Objectives:

To compare open heart surgery services provided by public and private hospitals in Catalonia (Spain) according to case mix, procedures undergone and surgical mortality.

Methods:

Data on all adult patients undergoing open heart surgery procedures were collected prospectively in a sample of public and privately owned centres for a 6.5-month period in 1994. Sociodemographic, clinical and procedural variables were collected. A predictive model stratifying patients according to their surgical mortality risk was used to adjust for differences in case mix between providers.

Results:

Included were 1287 open heart surgery procedures. Public and private patients differed significantly in terms of gender, clinical history (e.g. hypertension, pulmonary disease, recent infarction) and procedural variables (e.g. reoperation, type of intervention). There were also statistically significant differences related to educational level, with better educated patients more likely to be treated in private centres. Crude surgical mortality rates differed between providers, although public centres operated on higher-risk patients. After adjusting for differences in case mix, the association between the type of provider and surgical mortality was not statistically significant (odds ratio 1.68; 95% CI from 0.94 to 3.0).

Conclusions:

Although crude mortality rates differ between public and private providers, there is a significant trend towards higher surgical risk in public centres. After adjusting for surgical risk, differences between types of provider decreased and were no longer statistically significant. The importance of other social and health-related factors, such as educational level, may explain differences between providers in their patients' surgical risk and in their performance in open heart surgery.
A service failure framework of hotels in Taiwan
Authors: Loo Poh Theng , Leung Rosanna
Published: January 2017

This study aims to identify and categorize service failures from luxury hotels in Taiwan. A theoretical framework is proposed by adapting marketing mix elements. A total of 411 negative comments were found and extracted from four popular online review websites from 20 luxury hotels in Taipei. The content analysis method was employed for data analysis. The study results show that majority of luxury hotels in Taiwan encounter critical product issues, especially concerning the condition of facilities and equipment offered in the guest rooms. Furthermore, cleanliness of the hotel rooms requires greater attention, especially the cleanliness of room carpets, which could affect the hotel guests’ comfort during their stay. The findings and recommendations can provide luxury hotel practitioners in Taiwan a clearer picture about the service problems faced and enable them to conduct further investigations for further improvements. So far, existing studies are lacking of a systematic framework in demonstrating the service failures from online reviews. This research attempts to fill this gap.
A Survey of Telepsychiatry in the USA
Authors: Brown Frank W
Published: January 2017

Active telepsychiatry services in the United States were surveyed. Telepsychiatry was being used in four broad areas: educational, administrative, research, and clinical. Of the five telepsychiatry sites with accurate patient contact data, there was a mean of 1.35 patient contacts per week. The majority of telepsychiatry usage involved direct physician-patient contact. No adverse outcomes to patients were reported.
Telemedicine for Patient Consultation: Factors affecting Use by Rural Primary-Care Physicians in Kansas
Authors: Whitten P , Franken E A
Published: January 2017

The purpose of our study was to investigate knowledge of, attitudes to, and use of interactive telemedicine for specialist consultation among rural practitioners in Kansas. We interviewed 28 rural primary-care practitioners at seven remote health-care facilities in six locations. Content analyses of the interviews showed universal but superficial knowledge of telemedicine, appreciation of the value of the technology, but relatively low usage of the telemedicine service available (32% of subjects). Physicians did not appear to be afraid of change. Telemedicine usage was not related to the professional characteristics of the physicians. Our findings suggest that further growth in the use of telemedicine will depend on efforts directed towards physicians which are aimed at creating a more user-friendly environment and at accommodating the referral practices of potential users.
Improved Methods for Assessing Information Technology in Primary Health Care and an Example from Telemedicine
Authors: Burghgraeve P , De Maeseneer J
Published: January 2017

A change in evaluation methodology, from a strictly technical approach to a more comprehensive one, would result in better and less biased decision making in connection with the introduction of information technology in health care. To reach this goal, guidelines are required for building and refining contextual frames, taking qualitative considerations into account. We used primary health care as an example. A literature search produced over 200 relevant articles, from which 76 were selected which explicitly referred to evaluation in connection with health-care information systems. Text analysis allowed us to classify them into three groups. This allowed the development of a contextual frame and emphasized the human dimension as a possible problem area when using medical information systems.
Introducing an Asymmetric Cleft Lift Technique as a Uniform Procedure for Pilonidal Sinus Surgery
Authors: Rushfeldt C. , Bernstein A. , Norderval S. , Revhaug A.
Published: January 2017

Background and Aims:

Asymmetric techniques for surgery in pilonidal sinus disease (PSD) have been reported to provide better results than simple excision and closure in the midline. The aim of this retrospective study was to evaluate the results after introducing the Bascom asymmetric cleft lift procedure in our hospital on a day care basis.

Material and Methods:

From a total of 33 patients operated from April 2002 to September 2004 with the Bascom asymmetric cleft lift technique, we were able to contact 29 who were invited to a follow up study. Eighteen (62%) of these patients accepted a consultation in the outpatient clinic while 11 (38%) were interviewed by phone.

Results:

At follow up mean 17 (range 10–27) months after the operation 24 (83%) of the wounds were healed while recurrences were present in 5 (17%) of the patients. In two of the patients with recurrences errors in the procedures were identified. Further results related to pre-, per- and postoperative conditions are discussed in this paper.

Conclusion:

Early results after surgery for PSD with the Bascom asymmetric cleft-lift technique are promising. The technique has now become our standard procedure for treating chronic, symptomatic PSD.
Arthroscopic Subacromial Decompression: Outcome Comparison between Outpatient and Hospitalized Patients with 2- to 5-Year Follow-up
Authors: Järvelä S. , Järvelä T. , Aho H. , Kiviranta I.
Published: January 2017

Backround and Aims:

The purpose of this study was to evaluate the mid-term result of the arthroscopic subacromial decompression after failed conservative treatment of shoulder pain caused by subacromial impingement, when the patients were treated as an outpatient way or by staying overnight in hospital after surgery (hospitalized patients). Our hypothesis was that the results would be equal in both groups.

Material and Methods:

Arthroscopic subacromial decompression was performed in 80 consecutive patients, of which 40 patients were treated as an outpatient way (Outpatient Group), and 40 patients as a hospitalized way (Hospitalized Group). A prospective, comparative 2- to 5-year follow-up study including clinical examination, radiographic evaluation, isometric elevation strength measurements, as well as the University of California, Los Angeles (UCLA) and Constant shoulder scores was performed in 74 patients (93%).

Results:

Preoperatively, the mean UCLA score was 19 (SD 3) in the Outpatient Group, and 19 (SD 3) in the Hospitalized Group. Respectively, the mean Constant scores were 62 (SD 10) and 60 (SD 11). At the follow-up, the mean UCLA score was 32 (SD 4) in the Outpatient Group, and 32 (SD 3) in the Hospitalized Group, which both indicated good clinical outcome. Respectively, the mean Constant scores were 95 (SD 7) and 92 (SD 11), which both indicated excellent clinical outcome. At the follow-up, the UCLA and the Constant shoulder scores were significantly better than preoperatively in both groups (p < 0.01, p < 0.01), although no differences were found between the groups. The duration of the sick leaves and ability to return to work were similar in both groups. Also, the isometric elevation strengths of the operated shoulders were equally good in both groups.

Conclusions:

According to this study, the results of arthroscopic subacromial decompression were equally good whether the patient was treated as an outpatient way or by staying overnight in hospital after surgery. The results were significantly better at follow-up than preoperatively in both groups.
Laparoscopic Repair of Perforated Ulcer in Western Denmark — A Retrospective Study
Authors: Sommer T. , Elbroend H. , Friis-Andersen H.
Published: January 2017

Objective:

To report the distribution and results of laparoscopic repair of perforated ulcer surgery in surgical departments in a major region in Denmark and compare it with the results from the national database regarding mortality and morbidity.

Method:

Case charts from all patients who underwent laparoscopic repair of perforated ulcer in Western Denmark in the period 1 January 2003–1 July 2007 were collected. Demographical data, surgical details, morbidity, 30-day mortality, and length of stay were recorded. For comparison, data from the National Health Registry (NIP) describing all patients who had an operation due to perforated ulcer in this period was obtained.

Results:

No more than 51 out of 818 patients undergoing operation for perforated ulcer in the region had a laparoscopic operation. Mortality in the laparoscopic group was 4% compared to 26% reported from the national database (NIP). The laparoscopic group had a higher reperforation rate but length of stay was equal. No formal criteria concerning surgeon or patients selection for laparoscopic surgery were met.

Conclusion:

Laparoscopic repair of perforated ulcer was done without any selection criteria in few surgical departments in Western Denmark and was associated with a low mortality but a higher risk of reperforation.
The Outcome of Reduction Mammaplasty is Affected More by Psychosocial Factors Than by Changes in Breast Dimensions
Authors: Saariniemi K. , Luukkaala T. , Kuokkanen H.
Published: January 2017

Background and Aims:

Several randomised studies have proved the effects of breast reduction surgery. However, search for predictive factors has not been successful. Therefore we decided to analyse breast dimension changes and to see whether these, or patient characteristics or individual psychosocial factors have an effect on the outcome.

Material and Methods:

Twenty-nine patients were assessed at baseline and at six months follow-up. Outcome measures used were two health-related quality of life questionnaires, a breast-associated symptoms questionnaire, a pain-rating questionnaire, and a mood questionnaire. Detailed breast dimensions were recorded. Forward stepwise linear regression was applied to detect possible associations between outcome measure changes and breast dimensions or patient-related factors.

Results:

Preoperatively anxious patients had more improvement in the quality of life index scores, but less improvement in the mental health scores when compared to patients not anxious. Patients with physically demanding work had more improvement in the quality of life index scores and a trend to less improvement in the mental health scores when compared to patients with physically less stressful work. Patients with no overweight had a trend to better improvement in self-esteem.

Conclusions:

The outcome of reduction mammaplasty is affected more by psychosocial factors than by changes in breast dimensions.
In-Hospital Treated Pediatric Injuries are Increasing in Finland — A Population Based Study between 1997 AND 2006
Authors: Suominen J. S. , Pakarinen M. P. , Kääriäinen S. , Impinen A. , Vartiainen E. , Helenius I.
Published: January 2017

Background and Aims:

Injuries are an important public health problem as well as the leading cause of death and disability among children. Our aim was to longitudinally explore the incidence of in-hospital treated traumas, their operative treatment and related mortality among pediatric patients in Finland.

Methods:

The National Hospital Discharge Register and the Official Cause-of-Death Statistics data of in-hospital treated pediatric trauma patients between 1997 and 2006 in Finland were evaluated for hospitalizations, treatment modality and mortality.

Results:

Fractures (69%) and head injuries (28%) were the most common in-hospital treated traumas (477/100 000 persons/year). These were followed by injuries of intra-abdominal (1.4%), thoracic (1.2%) and urological organs (0.6%). Head traumas constituted 67% of injury-related deaths. During the ten-year follow-up period, the annual incidence (per 100 000 persons) of head injuries decreased by 13.6% (152 in 1997 vs. 131 in 2006, p < 0.0001) mainly contributing to a 30% decrease in overall injury-related mortality incidence (from 5.7 in 1997 to 4.0 in 2006, p = 0.0519). The overall trauma incidence, and incidence of fractures and abdominal injuries significantly increased by 5.0% (p < 0.0001), 13.5% (p < 0.0001) and 37% (p < 0.05), respectively, while the incidence of thoracic and urological injuries remained unchanged. Up to 15% of spleen injuries lead to splenectomy.

Conclusions:

Although overall and head trauma-related mortality is decreasing, the increasing incidence of fractures and abdominal injuries has amplified the overall incidence of severe injuries among children in Finland. A significant number of unnecessary splenectomies are still performed among children.
Mechanism of death after early decompressive craniectomy in traumatic brain injury
Authors: Zeiler FA , Trickey K , Hornby L , Shemie SD , Lo BWY , Teitelbaum J
Published: January 2017

Background

Decompressive craniectomy in devastating traumatic brain injury is controversial. The impact of decompressive craniectomy on mechanism of death is unclear in the literature to date. Our goal was to determine the mechanism of death between those receiving early decompressive craniectomy and those managed medically.

Methods

We performed an institutional retrospective review, from June 2003 to June 2013, of adult patients with devastating blunt traumatic brain injury undergoing early decompressive craniectomy who subsequently died. We compared this group to a retrospectively matched group based on: age, pre-hospital KPS, Marshall diffuse computed tomography grades, Injury Severity Scores, and admission laboratory values.

Results

Forty patients were analyzed; 20 with decompressive craniectomy and 20 without. The two groups were similar based on admission demographics, with the only statistically significant difference being platelet levels. Upon analysis, through both univariate and multivariate regression analysis, the mechanism of death was significantly different (p = 0.003; OR: 0.07 (0.01–0.41) and p = 0.04; OR: 0.08 (0.01–0.87)) with the decompressive craniectomy and non-decompressive craniectomy groups displaying neurological death rates of 10.0% versus 60.0%, respectively, with all other patients in both groups dying secondary to circulatory arrest after withdrawal of life-sustaining therapy. Time to death was significantly longer in the decompressive craniectomy group (2.83 vs. 9.21 days, respectively) (p = 0.01; OR: 0.65 (0.46–0.91).

Conclusions

Progression to neurological death appears to be more common in those devastating blunt traumatic brain injury patients treated medically compared to those undergoing early decompressive craniectomy. Given the implications of end-of-life care and societal implications, the mechanism of death determination and organ donation should be reported as relevant outcomes in devastating traumatic brain injury studies.
Under-cover: The influence of event- and context-traits on the visibility of armed conflicts in German newspaper coverage (1992–2013)
Authors: Zerback Thomas , Holzleitner Johannes
Published: January 2017

Although armed conflicts are an intensively researched domain in communication science, not much is known about the factors influencing their visibility in the news media. Based on research on the international flow of news, we identify traits of conflicts and the nations involved that potentially determine visibility. In our study, we combine data on 119 armed conflicts between 1992 and 2013 and an analysis of German newspaper coverage. We can show that several event- and context-oriented factors exert an influence on how much attention the media devote to a conflict. Conflict visibility was determined by the geographical distance between the reporting country and the conflict, the involvement of nuclear weapons, a military involvement of the reporting country, political sanctions imposed by supranational organizations, and (to a lesser extent) the number of fatalities.
Social engagement during game play in persons with Alzheimer’s: Innovative practice
Authors: Miltiades Helen B , Thatcher WG
Published: January 2017

This study examined social engagement during game play among persons with Alzheimer’s. In addition to being engaged with the game, engagement with players was noticed. Players would congratulate each other when they won, and they encouraged each other to do well. Natural conversation occurred as a result of playing the game. The researchers observed that as placement accuracy increased, the players developed a friendly competition. They played to win and experienced a sense of accomplishment when they correctly matched tile pieces. Interestingly, the game provided the players an opportunity to help each other. When a player was unable to figure out where to place a tile, oftentimes the other players would remind them of the rules and assist in tile placement. The ability to help and share knowledge is an opportunity often denied to persons with Alzheimer’s.
Young people and young adults’ experiences with child abuse and maltreatment: Meaning making, conceptualizations, and dealing with violence
Authors: Aadnanes Margrete , Gulbrandsen Liv Mette
Published: January 2017

Exploring children and young people’s own understanding of experiences with abuse and maltreatment is an important part of taking their right to participation seriously. By applying a narrative theoretical framework, this paper explores and analyzes young people’s and young adults’ stories of being the target of violence and abuse as children, and their meaning making and definition of such experiences, then and now. The overall findings show the participants’ varied and nuanced perceptions of what constitutes violence were much dependent on contextual, relational, and temporal aspects. Furthermore, many participants reported psychological and emotional abuse and neglect to be the most hurtful of their experiences of maltreatment. Finally, the analysis sheds light on how responses to abuse and maltreatment change and depend on the children and young people’s definition of their situation through time and context. The paper contributes with qualitative knowledge to the social work research and practice field, on how abuse and maltreatment unfold in and affect children and young people’s lives seen from their own points of view.
Tuning history
Authors: Booth Alan , Ludvigsson David
Published: January 2017

The Tuning educational project for history has its supporters and its detractors. This overview of the articles contained in this special issue of the journal reflects on some of the complexities of implementing such an ambitious global project and the local and national priorities that have made the process both stimulating and challenging for those involved. And it argues that while lists of competences constitute valuable reference points for discussion of the arts and humanities curriculum in an international context, they should be seen as the starting point for a more detailed and broad-ranging set of global conversations about how we (should) teach our subjects and why this matters for students in today’s world.
Deciding about Lung Transplantation: Informational Needs of Patients and Support Persons
Authors: Moloney Sharon , Cicutto Lisa , Hutcheon Michael , Singer Lianne
Published: January 2017

Context

Information is essential for informed decision making. To date, the informational needs of patients and support persons making the lung transplant decision are unexplored; in addition, the role of support persons in the transplant decision is unknown.

Objective

To identify the informational needs of patients and support persons attending a transplant clinic for consultation on lung transplantation, and to identify the involvement of support persons in the decision.

Design

A qualitative descriptive study and qualitative content analysis. Setting—Participants were recruited from the Toronto General Hospital Lung Transplant Program.

Participants

Twenty-two patients (8 candidates, 14 recipients) and 16 support persons.

Results

Most patients made the lung transplant decision in collaboration with their support person and reported receiving adequate information to make an informed decision. Diverse learning needs were identified among and between patients and support persons. Many participants identified the need for more information on practical issues, life after transplantation, and the experiences of transplant recipients.

Conclusion

Most patients attending a transplant clinic for consultation on lung transplantation felt they made an informed decision; however, modifications to the content, timing, and ways of providing information could enhance the decision-making process for patients and support persons. Specifically, the transplant team can provide information on core lung transplant topics with access to supplementary information to meet specific needs and use materials that vary in source, formats, and time points during the decision-making period.
Transplant Professionals' Attitudes toward Facial Transplantation in the United Kingdom
Authors: Clarke Alex , Murphy Fidelma , White Paul , Brough Veronica , Renshaw Anthony , Butler Peter E. M.
Published: January 2017

Background

In November 2005, the world's first partial facial transplantation positioned this treatment at the forefront in the development of facial reconstructive techniques.

Objective

Because the procedure is dependent on donation of facial tissue, we sought to understand the attitudes and beliefs of the general public and transplant professionals toward this treatment.

Methods

This research reports the results of a survey of 170 transplant professionals sampled by means of a questionnaire generated by a focus group of transplant coordinators.

Results

We found a high level of support for facial transplantation, with 76% of respondents in favor and none opposed to the procedure in principle. There was a significant association between knowing someone with a disfiguring condition and being in favor of facial transplantation. Areas of concern to this group can be summarized as factors that affect organ retrieval and the impact on the retrieval team and the donor family.

Conclusions

Consistency in ranking of item importance provides the basis for development of relevant education materials, team liaison, and care pathways. These findings also validate the use of focus groups in sampling issues of concern to relevant groups as facial transplantation takes its place as a reconstructive option.
Comparison of New Tau PET-Tracer Candidates With [18F]T808 and [18F]T807
Authors: Declercq Lieven , Celen Sofie , Lecina Joan , Ahamed Muneer , Tousseyn Thomas , Moechars Diederik , Alcazar Jesus , Ariza Manuela , Fierens Katleen , Bottelbergs Astrid , Mariën Jonas , Vandenberghe Rik , Andres Ignacio Jose , Van Laere Koen , Verbruggen Alfons , Bormans Guy
Published: January 2017

Early clinical results of two tau tracers, [18F]T808 and [18F]T807, have recently been reported. In the present study, the biodistribution, radiometabolite quantification, and competition-binding studies were performed in order to acquire comparative preclinical data as well as to establish the value of T808 and T807 as benchmark compounds for assessment of binding affinities of eight new/other tau tracers. Biodistribution studies in mice showed high brain uptake and fast washout. In vivo radiometabolite analysis using high-performance liquid chromatography showed the presence of polar radiometabolites in plasma and brain. No specific binding of [18F]T808 was found in transgenic mice expressing mutant human P301L tau. In semiquantitative autoradiography studies on human Alzheimer disease slices, we observed more than 50% tau selective blocking of [18F]T808 in the presence of 1 µmol/L of the novel ligands. This study provides a straightforward comparison of the binding affinity and selectivity for tau of the reported radiolabeled tracers BF-158, BF-170, THK5105, lansoprazole, astemizole, and novel tau positron emission tomography ligands against T807 and T808. Therefore, these data are helpful to identify structural requirements for selective interaction with tau and to compare the performance of new highly selective and specific radiolabeled tau tracers.
The Validation of the Hong Kong Chinese Version of the Lawton Instrumental Activities of Daily Living Scale for Institutionalized Elderly Persons
Authors: Tong Angela Y.C. , Man David W.K.
Published: January 2017

The Lawton Instrumental Activities of Daily Living (IADL) scale is the assessment tool most commonly used by occupational therapists in Hong Kong. However, there has been no cross-cultural validation study of the Lawton IADL-Chinese Version (IADL-CV) scale as applied to Hong Kong's older adults. This was the first study of content validity, construct validity, and reliability of the Lawton IADL-CV. A total of 155 institutionalized older adults were recruited from three different hostels and one care-and-attention home by using a convenience sampling method. Expert panel review and pilot testing on the subjects established the linguistic and content validity of the Hong Kong Chinese version. The content of the scale, the scoring criteria, translation, and level of rating scale were examined. It was shown that all nine IADL items apart from “handyman work” were culturally relevant (more than 78% agreement). Nine items altogether had good representation in assessing the IADL ability of Hong Kong older adults (73% agreement). The scoring criteria were refined with reference to the local culture. Both panel review and the related psychometric properties supported the change of the level of rating scale from a three-point to a four-point scale. The inter-rater and test-retest reliability estimated by intraclass correlation coefficient (ICC) gave a value of 0.99 and 0.90, respectively. The Cronbach's alpha estimating the internal consistency was 0.86. In the study of the construct validity, the factor analysis and known-groups methods were used. The construct validity was examined by factor analysis of the Lawton IADL scores of 111 hostel subjects. The result showed that one factor was extracted from the nine items of the Lawton IADL-CV scale. The known-groups method was performed using the Lawton IADL-CV to separate 146 institutionalized subjects into their corresponding living institutions: hostel or care-and-attention home. An overall prediction ability of 78% was achieved so as to correctly discriminate between residents in the hostel and care-and-attention home. In conclusion, the Lawton IADL-CV scale is a valid and reliable instrument to assess the older adults' IADL ability to live independently in the community.
A new approach of anomaly detection in wireless sensor networks using support vector data description
Authors: Feng Zhen , Fu Jingqi , Du Dajun , Li Fuqiang , Sun Sizhou
Published: January 2017

Anomaly detection is an important challenge in wireless sensor networks for some applications, which require efficient, accurate, and timely data analysis to facilitate critical decision making and situation awareness. Support vector data description is well applied to anomaly detection using a very attractive kernel method. However, it has a high computational complexity since the standard version of support vector data description needs to solve quadratic programming problem. In this article, an improved method on the basis of support vector data description is proposed, which reduces the computational complexity and is used for anomaly detection in energy-constraint wireless sensor networks. The main idea is to improve the computational complexity from the training stage and the decision-making stage. First, the strategy of training sample reduction is used to cut back the number of samples and then the sequential minimal optimization algorithm based on the second-order approximation is implemented on the sample set to achieve the goal of reducing the training time. Second, through the analysis of the decision function, the pre-image in the original space corresponding to the center of hyper-sphere in kernel feature space can be obtained. The decision complexity is reduced from O( l) to O(1) using the pre-image. Eventually, the experimental results on several benchmark datasets and real wireless sensor networks datasets demonstrate that the proposed method can not only guarantee detection accuracy but also reduce time complexity.