bluuebunny/crossref_metadata_2025 huggingface dataset:
Durable Response of Human Epidermal Growth Factor Receptor-2-Positive Gastric Adenosquamous Carcinoma to Trastuzumab-Based Chemotherapy
Authors: Kadowaki Shigenori , Yatabe Yasushi , Nitta Sohei , Ito Yuichi , Muro Kei
Published: March 2014

Here, we report a patient with gastric adenosquamous carcinoma (ASC) with human epidermal growth factor receptor-2 (HER2) overexpression who was successfully treated with trastuzumab-based chemotherapy. The patient was a 66-year-old man preoperatively diagnosed with gastric adenocarcinoma with no evidence of distant metastases. On histopathological examination, the curatively resected tumor was identified as ASC with mixed adenocarcinoma and squamous cell carcinoma components. Multiple liver metastases developed 2.5 months after surgery. Because immunohistochemical staining for HER2 was strong in both components, combination chemotherapy with capecitabine, cisplatin, and trastuzumab was initiated. A partial response was confirmed after 6 treatment cycles and PET and CT scans performed after 13 cycles revealed disease resolution with no uptake in the metastatic lesions. No evidence of disease progression has been observed 16 months after initial chemotherapy. This report suggests the potential utility of trastuzumab-based chemotherapy for HER2-positive gastric ASC.
Circulating Nitrite Contributes to Cardioprotection by Remote Ischemic Preconditioning
Authors: Rassaf Tienush , Totzeck Matthias , Hendgen-Cotta Ulrike B. , Shiva Sruti , Heusch Gerd , Kelm Malte
Published: March 2014

Rationale:

Remote ischemic preconditioning (rIPC) with short episodes of ischemia/reperfusion (I/R) of an organ remote from the heart is a powerful approach to protect against myocardial I/R injury. The signal transduction pathways for the cross talk between the remote site and the heart remain unclear in detail.

Objective:

To elucidate the role of circulating nitrite in cardioprotection by rIPC.

Methods and Results:

Mice were subjected to 4 cycles of no-flow ischemia with subsequent reactive hyperemia within the femoral region and underwent in vivo myocardial I/R (30 minutes/5 minutes or 24 hours). The mouse experiments were conducted using genetic and pharmacological approaches. Shear stress–dependent stimulation of endothelial nitric oxide synthase within the femoral artery during reactive hyperemia yielded substantial release of nitric oxide, subsequently oxidized to nitrite and transferred humorally to the myocardium. Within the heart, reduction of nitrite to nitric oxide by cardiac myoglobin and subsequent
S
-nitrosation of mitochondrial membrane proteins reduced mitochondrial respiration, reactive oxygen species formation, and myocardial infarct size. Pharmacological and genetic inhibition of nitric oxide/nitrite generation by endothelial nitric oxide synthase at the remote site or nitrite bioactivation by myoglobin within the target organ abrogated the cardioprotection by rIPC. Transfer experiments of plasma from healthy volunteers subjected to rIPC of the arm identified plasma nitrite as a cardioprotective agent in isolated Langendorff mouse heart preparations exposed to I/R.

Conclusions:

Circulating nitrite derived from shear stress–dependent stimulation of endothelial nitric oxide synthase at the remote site of rIPC contributes to cardioprotection during I/R.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01259739.
Chelating Intracellularly Accumulated Zinc Decreased Ischemic Brain Injury Through Reducing Neuronal Apoptotic Death
Authors: Zhao Yongmei , Pan Rong , Li Sen , Luo Yumin , Yan Feng , Yin Jie , Qi Zhifeng , Yan Ying , Ji Xunming , Liu Ke Jian
Published: March 2014

Background and Purpose—

Zinc has been reported to possess both neurotoxic and neuroprotective capabilities. The effects of elevated intracellular zinc accumulation following transient focal cerebral ischemia remain to be fully elucidated. Here, we investigated whether removing zinc with the membrane-permeable zinc chelator, N,N,N′,N′-tetrakis(2-pyridylmethyl)ethylenediamine (TPEN), would decrease the intracellular levels of zinc in the ischemic tissue, leading to reduced brain damage and improved neurological outcomes.

Methods—

Rats were pretreated with TPEN or vehicle before or after a 90-minute middle cerebral artery occlusion. Cerebral infarct volume, neurological functions, neuronal apoptosis, poly(ADP-ribose) polymerase activity, and cytosolic labile zinc were assessed after ischemia and reperfusion.

Results—

Cerebral ischemia caused a dramatic cytosolic labile zinc accumulation in the ischemic tissue, which was decreased markedly by TPEN (15 mg/kg) pretreatment. Chelating zinc lead to reduced infarct volume compared with vehicle-treated middle cerebral artery occlusion rats, accompanied by much improved neurological assessment and motor function, which were sustained for 14 days after reperfusion. We also determined that reducing zinc accumulation rescued neurons from ischemia-induced apoptotic death by reducing poly(ADP-ribose) polymerase-1 activation.

Conclusions—

Ischemia-induced high accumulation of intracellular zinc significantly contributed to ischemic brain damage through promotion of neuronal apoptotic death. Removing zinc may be an effective and novel approach to reduce ischemic brain injury.
Fecal cortisol content of wild giant pandas (Ailuropoda melanoleuca) to monitor human disturbance level in natural habitats
Authors: Deng Huaiqing , Jin Xuelin , Hu Defu , Liu Dingzhen
Published: March 2014

Wild animals are affected by growing human interference in their habitats and inevitably react internally to such stimuli. This study explores inherent physiological parameters to assess the effect of human interference on giant pandas in their wild habitat. Ninety-one fecal samples were collected within four nature reserves on Qinling Mountain. Fecal cortisol determinations were performed by radioimmunoassay. We categorized the intensity of local human disturbance and tested for correlations between the intensity of human disturbance and fecal cortisol metabolite levels. The results show a significant positive correlation between giant panda fecal cortisol metabolite levels and the degree of disturbance in their habitat. This study is the first to use a non-invasive monitoring method to analyze wild giant panda habitat disturbance, and demonstrates that cortisol metabolite levels in panda dung can objectively reflect the degree of panda habitat disturbance. The results provide a relatively objective means and method with which to evaluate the quality of wild giant panda habitat. This study highlights the need to monitor the effects of human disturbance on wildlife and to implement new policies in the management of nature reserves.
Peacemaking in Intractable Conflict: A Contractualist Approach
Authors: Handelman Sapir , Pearson Frederic S.
Published: March 2014

Abstract

This article presents a contractualist approach to peace and conflict studies that grows out of classical paradigms in the field. The contractualist approach proposes a solution to intractable conflicts through processes such as a public negotiating congress to transform conflicting parties into a large peacemaking community. The vision of an ideal congress is based on the multi-party talks that had operated in South Africa and Northern Ireland during the 1990s. The challenge is to establish a similar peacemaking institution in cases such as the Israeli-Palestinian dispute where ordinary citizens are at the center of the struggle. This article includes theoretical background, analysis of relevant case studies, and lessons from the Minds of Peace Experiment, a small-scale Israeli-Palestinian public negotiating congress that has held sessions in various locations around the world.
International Monetary and Financial Negotiations in Times of Crises: The G20 Pittsburgh Summit 2009
Authors: Kamel Maha S.
Published: March 2014

Abstract

The G20 leaders met for their third summit in Pittsburgh in September 2009. They agreed to institutionalize the G20 as the premier forum for their global economic cooperation, shift 5% of IMF quota shares and 3% of the World Bank’s shares from the overrepresented advanced countries to underrepresented dynamic-markets and developing countries, and continue with their fiscal stimuli and measures to sustain a durable global economic recovery following the global recession of 2008/09. More importantly, they launched negotiations on global imbalances within a newly formed G20 mechanism; theFramework for Strong, Sustainable and Balanced Growth.This article focuses on the financial negotiations that took place in this summit, with the aim of explaining how the aforementioned outcome was reached. It focuses on actors’ negotiating strategies as an intervening variable explaining the outcome, and compares the strategies of three important actors: the United States, China and Germany.
The Armenian Genocide: From Recognition to Reparations
Authors: I Aram
Published: March 2014

For centuries prior to the Armenian Genocide the Armenian Church was the spiritual, cultural, and social center of Armenian life in the Ottoman Empire. The genocide attacked the Church in order to destroy the broader community. The Church suffered greatly in the Genocide. Still of major concern today, is the expropriation and neglect of the Church’s extensive property in modern-day Turkey. The churches, other buildings and the lands on which they sit have tremendous importance to Armenians around the world. They are necessary to the functioning and recovery of the Armenian Church that is central to Armenian life and identity. As part of a reparations process for Armenians, the return of Church properties is crucial and is justified.
Ius Humanitatis and the Right to Reparation for International Crimes in Foreign Domestic Courts
Authors: Brus Marcel
Published: March 2014

This article focuses on the possibilities for victims of international crimes to obtain reparation in a foreign domestic court. The chances of success for such claims are small under traditional international law. The article questions whether the development of human rights and humanitarian ethics as a core element of international law (referred to as ius humanitatis) is having an impact on traditional obstacles to making such claims. Two elements are considered: the relevance of changing societal attitudes to the ‘rights’ of victims of such crimes and their possible effect on the interpretation and application of existing law, and whether in present-day international law humanitarian concerns have led to limiting obstacles that are still based on sovereignty, notably regarding the universality principle, prescription, and state immunity. The general conclusion is that on all these points much remains to be done.
Nigerian-Initiated Pentecostal/Charismatic Churches in the Czech Republic: Active Missionary Force or a Cultural Ghetto?
Authors: Bargár Pavol
Published: March 2014

Abstract

The phenomenon of the Nigerian Pentecostal/charismatic missionaries and communities led by them has been fairly well documented with respect to some Western European countries. However, much less attention has been given to the ministry of Nigerian-initiated Pentecostal/charismatic churches in Central Europe. The present paper seeks to fill this lacuna by exploring the ministry of three Nigerian-initiated churches in Prague, the Czech Republic, namely ‘The Mountain of Fire & Miracles Ministries’, ‘Covenant Parish Prague’ of ‘The Redeemed Christian Church of God’, and ‘The Holy Ghost End Time Ministries Intl.’ The present article analyzes different strategies these churches use to move beyond their ethnic origin. On these particular case studies, it tests a thesis, suggested by the research done by various scholars with respect to the Nigerian Pentecostal immigration in Europe and, especially, Great Britain, which claims that Nigerian-initiated Pentecostal/charismatic churches in Europe fail to appeal to the population of non-Nigerian and non-Pentecostal/charismatic backgrounds. This contribution suggests taking a more complex approach to the phenomenon by considering aspects such as contextual knowledge/experience of the pastor, language politics, worldview, worship style, and outreach policy. It will be proposed that sheer numbers are not to be perceived as the main indicator of whether or not a specific church represents an active missionary force, but rather a multiplicity of factors should be taken into consideration.
A Response to the Review of Matthew Barrett
Authors: Gunter W. Stephen
Published: March 2014

This short methodological rebuttal points out that church history is not an attempt to prove Arminius or any other historical person to be right or wrong, but a scientific effort to represent them without negative bias or prejudice.
UNLOCKING AND ADVANCING THE PROTECTION OF RELIGIOUS BELIEFS IN STRASBOURG: TOWARDS SUB-DIVIDING “THE PUBLIC SPHERE”
Authors: Morijn John
Published: March 2014

Given the increasing religious diversification of European societies, the European Convention on Human Rights (ECHR) and the pertinent Strasbourg jurisprudence are fast becoming a key consideration and reference point for States and their policy-makers. ECHR obligations effectively co-determine how States can and sometimes must protect religious beliefs. Without relying on abstract concepts, this contribution aims first to provide an overview of the approach that the European Court of Human Rights (ECtHR) actually requires from States. It will be suggested that a useful way to make the case law (more) practicable would be for the Strasbourg Court (and those interpreting its work) to clarify when and how ECHR obligations are prescriptive or circumscriptive of States’ policy-making powers. The contribution will then go on to analyse some recent trends in the ECtHR case law, including the 2011 Lautsi ruling. This will lead to a proposal for the ECtHR to refine its case law by distinguishing two different scenarios in which religious beliefs are invoked.
Seventy years of sex education in Health Education Journal: a critical review
Authors: Iyer Padmini , Aggleton Peter
Published: March 2014

This paper examines key debates and perspectives on sex education in Health Education Journal ( HEJ), from the date of the journal’s first publication in March 1943 to the present day. Matters relating to sexuality and sexual health are revealed to be integral to HEJ’s history. First published as Health and Empire (1921 – 1942), a key purpose of the journal since its inception has been to share information on venereal disease and its prevention within the UK and across the former British Empire. From 1943 to the present day, discussions on sex education in the newly-christened HEJ both reflect and respond to evolving socio-cultural attitudes towards sexuality in the UK. Changing definitions of sex education across the decades are examined, from the prevention of venereal disease and moral decline in war-time Britain in the 1940s, to a range of responses to sexual liberation in the 1960s and 1970s; from a focus on preventing sexually-transmitted infections, teenage pregnancy and HIV in the 1980s, to the provision of sexual health services alongside sex education in the 2000s. Over the past 70 years, a shift from prevention of pre-marital sexual activity to the management of its outcomes is apparent; however, while these changes over time are notable, perhaps the most striking findings of this review are the continuities in arguments for and against the discussion of sexual issues. After more than 70 years of debate, it would seem that there is little consensus concerning motivations for and the content of sex education.
Contextual effects on subjective social position: Evidence from European countries
Authors: Lindemann Kristina , Saar Ellu
Published: March 2014

This study investigated subjective social position in 21 European countries using data from the social inequality module of the International Social Survey Programme 2009. Subjective social position shows people’s self-location in a social hierarchy. Most studies on subjective social position have typically involved a few countries and neglected the role of national educational and occupational structures. We hypothesise that these characteristics, together with national-level economic factors, modify the effect of individual-level characteristics on subjective social location. Our expectations are based on extended reference group thesis, the big-fish-little-pond and stigmatisation arguments. The results of multi-level analysis indicated that the extent of educational and income inequalities in society as well as occupational structures influence the importance of individual incomes, education and occupations for estimating social position.
Solidarity, Sustainability, Stewardship: Ethics across Generations
Authors: Moody Harry R. , Achenbaum W. Andrew
Published: March 2014

The religious foundations of environmental concern have rarely been seen as a foundation for environmental ethics: namely, obligations across generations. In this essay, we offer three ethical principles—solidarity, sustainability, and stewardship—whose religious roots illuminate our duties to future generations. “Solidarity” extends both to unborn humans and to nonhuman species; “sustainability” is reflected in connections to generations both past and future; “stewardship” is the imperative of responsibility imposed on today’s generation who understand the global environmental challenge and respond to it with hope instead of despair.
Wisdom and/or Dementia: Is This the Choice American Society Is Mired In?
Authors: Gullette Margaret Morganroth
Published: March 2014

Using the socially-constructed binary between wisdom and cognitive impairment as its case study, this essay tries to break this binary, first by describing and contextualizing the situation of the author’s mother in her 90s. Dangers to American well-being in general include failures of medical assessment and caregiving, and, not least, problems maintaining the crucial traditional link between old age and wisdom. Hope resides in viewing minds differently, restoring respect to elders, and recognizing wisdom wherever found.
Effects of Age, Sex and Syllable Number on Voice Onset Time: Evidence from Children’s Voiceless Aspirated Stops
Authors: Yu Vickie Y , De Nil Luc F , Pang Elizabeth W
Published: March 2014

Voice onset time (VOT) is a temporal acoustic parameter that reflects motor speech coordination skills. This study investigated the patterns of age and sex differences across development of voice onset time in a group of 70 English-speaking children, ranging in age from 4.1 to 18.4 years, and 12 young adults. The effect of the number of syllables on VOT patterns was also examined. Speech samples were elicited by producing syllables /pa/ and /pataka/. Results supported previous findings showing that younger children produce longer VOT values with higher levels of variability. Markedly higher VOT values and increased variability were found for boys at ages between 8 and 11 years, confirming sex differences in VOT patterns and patterns of variability. In addition, all participants consistently produced shorter VOT with higher variability for multisyllables than monosyllables, indicating an effect of syllable number. Possible explanations for these findings and clinical implications are discussed.
Alcohol calculations and their uncertainty
Authors: Searle John
Published: March 2014

A dilution model is widely used to link blood alcohol concentration and the quantity of alcohol consumed. Whilst some authors use the total body water formulation of that model, others use the Widmark Factor formulation. A paper by Forrest gave a table of example values of the Widmark Factor and Barbour, based on Forrest’s work and using Forrest’s computer program, subsequently presented Forrest’s results by way of a chart. Whilst the results of Forrest and Barbour are often used interchangeably, there is a significant difference between them on the factors for women. This paper examines the source of the unexpected discrepancy. It is essential to quote an error range, in blood alcohol concentration calculations, for the results. The extent of that error range was investigated by Gullberg who also employed the Widmark Factor formulation. Gullberg concluded that when reporting a calculated blood alcohol concentration, a coefficient of variation of ±21% should be applied. Similarly, Gullberg concluded that when calculating the volume of drink, a coefficient of variation of 12½% should be applied. The present paper derives and publishes the formulae for calculating this coefficient of variation. It is then shown that Gullberg’s conclusions are mistaken: the coefficient of variation is not some fixed percentage but must be calculated in each case.
Knowledge and confidence of the mental health act in Scotland: a survey of general practitioners
Authors: Conway Lisa , Mohammed Nabiha , Jardine Charles , Crabb James
Published: March 2014

Aims and method

Front-line clinician general practitioners may be required to assist in the administration of mental health legislation. Limited training has been an issue previously identified. This study aims to ascertain levels of training, knowledge and confidence of general practitioners in Scotland in relation to the mental health act. An anonymous online survey of all general practitioners in one Scottish health board was completed.

Results

Eighty general practitioners in Forth Valley responded to the survey; 55% had never received any previous training in the mental health act. The majority rated knowledge of the act as fair (50%) and confidence in using the act as poor (44%). No relationship was found between previous training and current knowledge or confidence. Previous practical use of the act was associated with better current knowledge ( p = 0.0074) and confidence in using the act ( p = 0.0005). Of the respondents, 99% were keen to pursue further training in the act.

Clinical implications

Further practical training for general practitioners in the use of the mental health act is required to improve knowledge and confidence in this important area.
Coroner consistency – The 10-jurisdiction, 10-year, postcode lottery?
Authors: Mclean Maxwell
Published: March 2014

The investigation and classification of deaths in England and Wales relies upon the application by medical practitioners of diverse reporting standards set locally by coroners and thereafter upon the effectively unconstrained decision process of those same coroners. The author has conducted extensive comparative analysis of Ministry of Justice data on reports to the coroner and their inquest and verdict returns alongside Office of National Statistics data pertaining to the numbers of registered deaths in equivalent local jurisdictions. Here, he analyses 10 jurisdictions characterised by almost identical inquest return numbers in 2011. Substantial variation was found in reporting rates to the coroner and in the profile of inquest verdicts. The range of deaths reported varied from 34% to 62% of all registered deaths. Likewise only 2 of the 10 jurisdictions shared the same ranking of proportions in which the six common verdicts were reached. Individual jurisdictions tended to be consistent over time in their use of verdicts. In all cases, proportionately more male deaths were reported to the coroner. Coroners generally seemed prima facie to be ‘gendered’ in their approach to verdicts; that is, they were consistently more likely to favour a particular verdict when dealing with a death, according to the sex of the deceased. The extent to which coroners seemed gendered varied widely. While similar services such as the criminal courts or the Crown Prosecution Service are subject to extensive national guidance in an attempt to constrain idiosyncratic decision making, there seems no reason why this should apply less to the process of death investigation and classification. Further analysis of coroners’ local practices and their determinants seems necessary.
Involuntary treatment of psychiatric inpatients certified under the Saskatchewan Mental Health Services Act in a secure forensic psychiatric treatment center
Authors: Adelugba Olajide , Mela Mansfield , Haq Inam
Published: March 2014

A psychiatric patient prisoner is certified and treated involuntarily under the Saskatchewan Mental Health Services Act at the Regional Psychiatric Center if he/she is mentally ill, incapable of making treatment decision and is likely to cause harm to self or others. This retrospective study examined the treatment of certified patients during a 12-year period (1996 to 2007). A total of 112 patients were treated using 263 certifications during 163 separate hospital admissions. Fifty of all the certified patients (44.6%) required more than one certification, and out of these, 72% required another certification within three months of the first certification. Among those certified, schizophrenia and related psychosis (65.2%, n = 73), substance use disorder (50%, n = 56) and antisocial personality disorder (58%, n = 65) were the most common discharge diagnoses and antipsychotics, the most frequent discharge medications. Global Assessment of Functioning score of patients improved significantly ( p < .05) from 43.6 at admission to 50.4 at discharge. This functional improvement may suggest a beneficial use of certification by keeping patients in treatment. This benefit may be enhanced if the statutory duration of certification can be increased to account for the length of time required for the adequate resolution of symptoms and to reduce the need for repeat certification.
A survey of some pre-analytical errors identified from the Biochemistry Department of a Scottish hospital
Authors: Davidson D Fraser
Published: March 2014

Background

It is estimated that 70% of all health care decisions affecting diagnosis or treatment involve laboratory testing. The pre-analytical phase of the testing process shows the highest prevalence of errors accounting for 70% of all mistakes in laboratory diagnostics. It is recommended that laboratories collect statistics on pre-analytical error rates. This survey examined some mistakes in blood collection, i.e. specimen haemolysis, and EDTA contamination.

Methods

Survey was from June 2011 to May 2012. Haemolysis was detected by analysers’ automated haemolysis index function. Plasma EDTA was measured by an automated system. Data were captured from our laboratory information management system.

Results

For a total workload of 763,577 blood specimens, the overall haemolysis rate was 3.2%. Much higher rates of both specimen haemolysis and EDTA contamination were observed when blood was not collected by trained phlebotomists.

Conclusions

Better training in blood collection, achieving the standard of professional phlebotomists, will improve validity of diagnostic information; reduce risks of dangerous misinterpretation of results, unwanted anaemia and needlestick injury and decrease laboratory supplies costs. This type of audit could be replicated in other Scottish Health Boards with some benefit and thereby better target future training needs.
Research ethics policies and practices in health research institutions in sub-Saharan African countries: results of a questionnaire-based survey
Authors: Zielinski Chris , Kebede Derege , Mbondji Peter Ebongue , Sanou Issa , Kouvividila Wenceslas , Lusamba-Dikassa Paul-Samson
Published: March 2014

Objective

To describe the state of research ethics policies and practices in health research institutions in sub-Saharan African countries.

Design

A structured questionnaire was used to solicit information on research ethics from health research institutions.

Setting

Forty-two sub-Saharan African countries.

Participants

Key informants from the health research institutions.

Main outcome measures

Existence of institutional ethics review policies and mechanisms.

Results

About half (51%) of respondent institutions reported having policies on research ethics and 58% had written policies requiring that researchers obtain informed consent of research participants. About one-third of respondent institutions (34%) had established ethics review committees, 42% required that studies went through ethics review committees and 46% had linkages with national or regional ethics organisations. Regarding operating procedures for ethics review committees, 53% had adopted standard operating procedures. Less than one-quarter of respondent institutions reported having policies in place to monitor ongoing research. Of the institutions that monitored ongoing research, 34% did an annual ethical review and 74% required a periodic written report. Only 36% provided any type of ethics training for staff, including those conducting health research and those who were not members of the ethics review committee.

Conclusions

There are substantial gaps in the capacity of health research institutions in the WHO African Region to undertake ethical review of studies before, during and after studies conducted. There is a need to strengthen such capacity in order to ensure the wellbeing of individuals enrolled in studies and that of communities that host these studies.
Knowledge systems in health in sub-Saharan Africa: results of a questionnaire-based survey
Authors: Zielinski Chris , Kebede Derege , Mbondji Peter Ebongue , Sanou Issa , Kouvividila Wenceslas , Lusamba-Dikassa Paul-Samson
Published: March 2014

Objective

To describe the mechanisms and systems of knowledge acquisition, creation, diffusion, application and improvement of knowledge in two layers of the health system: health policy formulation and the provision of clinical services.

Design

A questionnaire-based survey.

Setting

Health research institutions in 46 countries of the World Health Organization (WHO) African Region.

Participants

Key informants in ministries of health and health care institutions in 39 countries of the Region.

Main outcome measures

Existence of knowledge management infrastructure or components of infrastructure in the countries of the Region.

Results

Central national bodies are always cited as having a major role in policy-setting. Non-national bodies most frequently provide advice and act in monitoring and evaluation, while decentralised entities are strongly involved in dissemination, implementation, and monitoring and evaluation. In general, ministries tend not to have an explicit knowledge management framework and do not map knowledge sources and flows for policy-making. The main sources of evidence are guidelines or recommendations from international or national agencies, although systematic reviews are rarely used. Routine monitoring and evaluation of quality and effectiveness of the process of policy development and its implementation was reported in 19 of the 39 respondent countries. In most respondent countries, electronic medical records were rarely used.

Conclusions

As systematic reviews are rarely utilised as a source of evidence in policy development and few mechanisms exist to assess the performance of the policies, there are significant opportunities for improving policy development.
‘Don’t blame the middle man’: an exploratory qualitative study to explore the experiences of translators breaking bad news
Authors: Prentice Joanna , Nelson Annmarie , Baillie Jessica , Osborn Hannah , Noble Simon
Published: March 2014

Background:

Healthcare professionals find breaking bad news difficult and upsetting. Increasing cultural diversity has led to a greater number of patients whose first language differs to that of the healthcare provider, with more patients requiring a translator to facilitate communication. Hospitals often ask non-clinical translators to facilitate breaking bad news. We sought to explore the experiences of translators within a specialist oncology centre.

Methods:

Following ethical and governance approvals, semi-structured interviews were undertaken with five translators recruited from the specialist oncology centre. Interviews were audiotaped and transcribed verbatim. The data were analysed thematically, with major themes and subthemes identified.

Setting:

Outpatient setting of a regional cancer centre.

Participants:

Translators serving a regional cancer centre.

Main outcome measures:

Qualitative data identified through thematic analysis.

Results:

Major themes included the significant emotional impact of translating distressing information, the challenges of accurately conveying information in a culturally congruent format and the need for formal briefing, debriefing and support. Subthemes included feeling guilty for divulging distressing news, being the focus of patients’ distress or anger, and feeling in conflict with the patient or family and issues surrounding confidentiality. Translators also felt a strong sense of advocacy for the patients and found encounters with death and dying emotionally challenging.

Conclusions:

The increasing use of translators in the care of patients with advanced cancer is increasingly resulting in lay people being subject to similar emotional pressures faced by clinical staff, yet without the necessary formal training or support mechanisms that are recommended for clinicians. This exploratory study highlights the training and support needs of non-clinical staff as identifying a unique set of communication challenges faced by translators.
The Concept of Algorithm as an Interpretative Key of Modern Rationality
Authors: Totaro Paolo , Ninno Domenico
Published: March 2014

According to Ernst Cassirer, the transition from the concept of substance to that of mathematical function as a guide of knowledge coincided with the end of ancient and the beginning of modern theoretical thought. In the first part of this article we argue that a similar transition has also taken place in the practical sphere, where mathematical function occurs in one of its specific forms, which is that of the algorithm concept. In the second part we argue that with the rise of modernity the idea of substance and the related concepts of category and classification, which are deeply embedded in western culture, have not been totally supplanted by that of function. The intertwining of the concepts of substance and function has generated contradictory hybrids. These hybrids are used as a key for the understanding of the different repercussions of algorithmic logic on society in terms of social integration.
Security enhancement, self-esteem threat, and mental depletion affect provision of a safe haven and secure base to a romantic partner
Authors: Mikulincer Mario , Shaver Phillip R. , Bar-On Naama , Sahdra Baljinder K.
Published: March 2014

We recently showed that security priming facilitates safe haven support and overrides the detrimental effects of mental depletion (Mikulincer, Shaver, Sahdra, & Bar-On, 2013, Can security-enhancing interventions overcome psychological barriers to responsiveness in couple relationships? Attachment & Human Development, 15, 246–260.). Here, we extend these findings by examining another contextual barrier to caregiving (self-worth threat) and the effects of security priming on secure base support. In Study 1, participants were randomly assigned to one of four conditions based on self-worth threat (yes, no) and security priming (yes, no) manipulations, and their behaviors were video recorded while they interacted with their romantic partner who was disclosing a personal problem. In Study 2, participants were randomly assigned to one of four conditions based on depletion (yes, no) and security priming (yes, no) manipulations, and their behaviors were videotaped while they interacted with their romantic partner who was exploring personal goals. In both studies, independent judges rated participants’ responsiveness to their partner’s needs during the videotaped interaction. Self-esteem threat and mental depletion adversely affected responsiveness to a partner’s disclosures. Security priming facilitated responsiveness in both studies and overrode the detrimental effects of mental depletion on secure base support.
Cerebral venous sinus thrombosis
Authors: Hartel Marcin , Kluczewska Ewa , Gancarczyk-Urlik Eliza , Pierzchała Krystyna , Bień Karolina , Zastawnik Anna
Published: March 2014

Diagnostic imaging in cerebral venous sinus thrombosis poses difficulties due to the relatively rare incidence of this pathology and its usually inconclusive clinical and radiological symptoms. The preliminary examination is usually performed using computed tomography, whereas magnetic resonance imaging (MRI) provides better visualisation of the lesion. Computed tomography and magnetic resonance imaging angiography enable the characterisation of the blood flow in the pathologically affected vessels in more detail. Familiarity with the anatomic variations of the venous system and with the advantages and limitations of computed tomography/magnetic resonance imaging enables faster diagnosis of the pathology. This is significant for treatment, which, in many cases, can be efficient only if introduced at a sufficiently early stage.
End-of-life care in general practice: A cross-sectional, retrospective survey of ‘cancer’, ‘organ failure’ and ‘old-age/dementia’ patients
Authors: Evans Natalie , Pasman H Roeline W , Donker Gé A , Deliens Luc , Van den Block Lieve , Onwuteaka-Philipsen Bregje ,   on behalf of EUROIMPACT, Van den Block Lieve , De Groote Zeger , Brearley Sarah , Caraceni Augusto , Cohen Joachim , Francke Anneke , Harding Richard , Higginson Irene J , Kaasa Stein , Linden Karen , Miccinesi Guido , Onwuteaka-Philipsen Bregje , Pardon Koen , Pasman Roeline , Pautex Sophie , Payne Sheila , Luc Deliens
Published: March 2014

Background:

End-of-life care is often provided in primary care settings.

Aim:

To describe and compare general-practitioner end-of-life care for Dutch patients who died from ‘cancer’, ‘organ failure’ and ‘old-age or dementia’.

Design:

A cross-sectional, retrospective survey was conducted within a sentinel network of general practitioners. General practitioners recorded the end-of-life care of all patients who died (1 January 2009 to 31 December 2011). Differences in care between patient groups were analysed using multivariate logistic regressions performed with generalised linear mixed models.

Setting/participants:

Up to 63 general practitioners, covering 0.8% of the population, recorded the care of 1491 patients.

Results:

General practitioners personally provided palliative care for 75% of cancer, 38% of organ failure and 64% of old-age/dementia patients (adjusted odds ratio (confidence interval): cancer (reference category); organ failure: 0.28 (0.17, 0.47); old-age/dementia: 0.31 (0.15, 0.63)). In the week before death, 89% of cancer, 77% of organ failure and 86% of old-age/dementia patients received palliative treatments: (adjusted odds ratio (confidence interval): cancer (reference category); old-age/dementia: 0.54 (0.29, 1.00); organ failure: 0.38 (0.16, 0.92)). Options for palliative care were discussed with 81% of cancer, 44% of organ failure and 39% of old-age/dementia patients (adjusted odds ratio (confidence interval): cancer (reference category); old-age/dementia: 0.34 (0.21, 0.57); organ failure: 0.17 (0.08, 0.36)).

Conclusion:

The results highlight the need to integrate palliative care with optimal disease management in primary practice and to initiate advance care planning early in the chronic disease trajectory to enable all patients to live as well as possible with progressive illness and die with dignity and comfort.
A Bayesian Approach to Measurement Bias in Networking Studies
Authors: Zhu Ling , Robinson Scott E. , Torenvlied René
Published: March 2014

The study of managerial networking has been growing in the field of public administration; a field that analyzes how managers in open system organizations interact with different external actors and organizations. Coincident with this interest in managerial networking is the use of self-reported survey data to measure managerial behavior in building and maintaining networks. One predominant approach is to generate factor indices of networking activity from ordinal scales. However, when public managers answer survey questions with ordinal scales to describe their networking activities, the answers may be subject to various response biases. Consequently, the use of factor indices may lead to biased measurements that misrepresent managerial networking. As an alternative, we build on studies that apply the item response theory (IRT) as a measurement strategy and propose a Bayesian alternative. To tap managers’ latent effort put in networking activity, the Bayesian Generalized Partial Credit Model allows us to select a one-dimensional networking scale from multiple ordinal survey items. Using 12 such items in a mail survey of nearly 1,000 American hospital managers, we demonstrate the advantage of using the Bayesian IRT model over factor-analytic models in a substantive test of how managerial networking affects organizational performance.
A coupled structural and flow approach for numerical simulation of the light resin transfer moulding process. II: Fabric permeability and compaction characterisation, model results and a 6-kW wind turbine blade case study
Authors: Hutchinson JR , Schubel PJ
Published: March 2014

This is the second paper in a two-part study into the numerical simulation of the light resin transfer moulding (LRTM) process. It focuses on the development of empirically derived models for the permeability and compaction behaviour of Unifilo during light resin transfer moulding. A detailed review of relevant literature allowed identification of important material parameters, and appropriate testing procedures were devised accordingly. Previously published approaches were used to construct light resin transfer moulding specific permeability and compaction models. A material response for each stage of the process was quantified and then inputted into the light resin transfer moulding simulation developed in the Part I of this study. Results were verified using data from an empirical testbed, and the completed light resin transfer moulding model was then applied to a 6-kW wind turbine blade case study to evaluate different infusion strategies and minimise fill time. Finally, it was used to compare the light resin transfer moulding, resin transfer moulding and liquid resin infusion processes for the manufacture of this part.
Effects of pyrolysis temperature on the physicochemical properties of empty fruit bunch and rice husk biochars
Authors: Claoston N , Samsuri AW , Ahmad Husni MH , Mohd Amran MS
Published: March 2014

Biochar has received great attention recently due to its potential to improve soil fertility and immobilize contaminants as well as serving as a way of carbon sequestration and therefore a possible carbon sink. In this work, a series of biochars were produced from empty fruit bunch (EFB) and rice husk (RH) by slow pyrolysis at different temperatures (350, 500, and 650°C) and their physicochemical properties were analysed. The results indicate that porosity, ash content, electrical conductivity (EC), and pH value of both EFB and RH biochars were increased with temperature; however, yield, cation exchange capacity (CEC), and H, C, and N content were decreased with increasing pyrolysis temperature. The Fourier transform IR spectra were similar for both RH and EFB biochars but the functional groups were more distinct in the EFB biochar spectra. There were reductions in the amount of functional groups as pyrolysis temperature increased especially for the EFB biochar. However, total acidity of the functional groups increased with pyrolysis temperature for both biochars.
Long-Term English Language Learners’ Perceptions of Their Language and Academic Learning Experiences
Authors: Kim Won Gyoung , García Shernaz B.
Published: March 2014

Long-term, adolescent English language learners (ELLs) experience persistent academic underachievement in spite of several years of schooling; yet, the research on this topic is scant. To increase our understanding of these students’ educational experiences, we explored perceptions of 13 long-term ELLs about their schooling in the context of their school history, including program placements, special education referral, and academic outcomes. Data from semistructured interviews and documents were analyzed using a grounded theory approach. Participants viewed themselves as English-proficient, motivated learners, and described their school experience as positive but challenging. The findings revealed a gap between their postsecondary aspirations and the reality of their academic performance, which raises questions about the adequacy of educational programs and identification of ELLs with disabilities.
The Modern Cult of Efficiency
Authors: Trujillo Tina
Published: March 2014

This article analyzes one intermediary organization. It draws on critical policy studies to frame the agency’s behaviors amid a discourse of managerialism in the public sector, and critical studies of education markets to explain the relationships between its reforms and education policy. Findings illustrate how the intermediary enacted managerial data monitoring systems as the core drivers of its reforms; how it framed leadership and teaching as reductive, managerialist pursuits; and why its reliance on business-inspired logics, roles, and language enabled it to compete in a marketplace and preserve its industry niche. In this way, its behaviors resembled those of the “efficiency experts” during the industrial revolution. The result was an intermediary that erroneously equated data with professional judgment, and that guided decisions based not on a century’s worth of evidence about the limitations of purely managerial reforms, but on an enduring ideological faith in technocratic solutions to complex social problems.
Mass Incarceration: Examining and Moving Beyond the New Jim Crow
Authors: Kilgore James
Published: March 2014

Michelle Alexander’s critical analysis of the US criminal justice system contained in The New Jim Crow: Mass Incarceration in the Age of Colorblindness has received extraordinary critical and popular acclaim. Her main thesis, that mass incarceration constitutes a new system of racial oppression akin to slavery and the original Jim Crow, has had a profound impact on mainstream and academic framing of criminal justice issues. This article outlines her main thesis, then builds on and critiques her work by interrogating her notion of ‘racial caste’, updating her statistical breakdown of the racial demographics of the incarcerated population, and outlining the constituencies and organizations which are essential to the building of a social movement to reverse the mass incarceration process.
Characteristics and Behaviors of Older Male Anabolic Steroid Users
Authors: Ip Eric J. , Trinh Karen , Tenerowicz Michael J. , Pal Jai , Lindfelt Tristan A. , Perry Paul J.
Published: March 2014

Objective:

To compare and contrast the characteristics of 2 groups of men ≥40 years old: reported anabolic–androgenic steroid (AAS) users and nonusers.

Design:

Cross-sectional survey.

Setting:

Thirty-eight online fitness, weight lifting, bodybuilding, and steroid Web sites.

Participants:

A total of 67 male AAS users and 76 male nonusers ≥40 years old.

Main Outcomes Measured:

Demographics, utilization of AAS and other performance-enhancing agents (PEAs), exercise patterns, history of illicit drugs and alcohol use, and psychiatric traits/diagnoses.

Results:

The majority of AAS users ≥40 years old were caucasian (92.5%), heterosexual (97.0%), and classified themselves as recreational exercisers (79.1%). AAS users took more PEAs (11.5 ± 5.6 vs 4.6 ± 2.7; P < .001), were more likely to binge drink (47.8% vs 29.0%; P = .025), report heavy alcohol use (21.0% vs 7.9%; P = .031), meet criteria for substance dependence disorder (27.4% vs 4.0%; P < .001), and report an anxiety disorder diagnosis (12.0% vs 2.6%; P = .046) than nonusers.

Conclusions:

AAS misuse is prevalent among older men and is associated with polypharmacy, more aggressive alcohol use, and a higher incidence of substance dependence and anxiety disorders compared to nonusers. This information may help clinicians and researchers identify and develop appropriate intervention strategies for AAS abuse among older men.