bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of intentional abutment disconnection on the micro‐movements of the implant–abutment assembly: a 3D digital image correlation analysis
Authors: Messias Ana , Rocha Salomão , Calha Nuno , Neto Maria Augusta , Nicolau Pedro , Guerra Fernando
Published: May 2015

Background

Implant–abutment assembly stability is critical for the success of implant‐supported rehabilitation. The intentional removal of the prosthetic components may hamper the achievement of the essential stability due to preload reduction in the screw joint and implant–screw mating surface changes.

Objective

To evaluate the effect of intentional abutment disconnection and reconnection in the stability of internal locking hex implants and corresponding abutments using the method of 3D digital image correlation.

Material and Methods

Ten conical shape and internal hexagon connection implants were embedded in acrylic resin and assembled to prosthetic abutments with 30 Ncm torque and assigned to two groups: group 1 – tested for static load‐bearing capacity at 30° off‐axis for two times and group 2 – underwent intentional disconnection and reconnection between tests. Micro‐movements were captured with two high‐speed photographic cameras and analyzed with video correlation system in three spacial axes U, V and W. Screw abutment and internal implant thread morphology was observed with a field‐emission scanning electron microscopy.

Results

After the intentional disconnection of the abutment, group 2 showed generally higher maximum displacements for U and V directions. Under 50N load, mean difference was 24.7 μm (P = 0.008) for U direction and −7.7 μm (P = 0.008) for V direction. No significant differences were found for maximum and minimum displacements in the W direction. Mean displacement of the speckle surface presented was statistically different in the two groups (P = 0.016). SEM revealed non‐homogenous screw surfaces with scoring on group 2 plus striations and debris in the implant threads.

Conclusion

Micro‐movements were higher for the group submitted to intentional disconnection and reconnection of the abutment, particularly under average bite forces.
Illicit drug use in acute care settings
Authors: Grewal Harjot Kaur , Ti Lianping , Hayashi Kanna , Dobrer Sabina , Wood Evan , Kerr Thomas
Published: May 2015

Introduction and Aims

While persons with addiction are often hospitalised, hospitals typically employ abstinence‐based policies specific to illicit drug use. Although illicit drug use is known to occur within hospitals, this problem has not been well characterised. Therefore, we sought to investigate the prevalence of and factors associated with having ever used drugs in hospital among people who use drugs in Vancouver, Canada.

Design and Methods

Data were derived from prospective cohort studies of people who use drugs between December 2012 and May 2013. Multivariable logistic regression was used to identify demographic and behavioural factors associated with having ever used illicit drugs in hospital.

Results

Among 1028 participants who had experienced ≥1 hospitalisation, 43.9% reported having ever used drugs while hospitalised. In multivariable analyses, factors positively associated with having ever used drugs in hospital included daily cocaine injection and daily crack non‐injection (both P < 0.05). Factors negatively associated with the outcome included older age and male gender (both P < 0.05). The most common reasons for drug use in hospital were ‘wanting to use’ and ‘being in withdrawal’. Drugs were most commonly used in patient washrooms.

Discussion and Conclusions

Our findings demonstrate that an abstinence‐based approach to drug use in hospitals may be ineffective at prohibiting drug consumption. High‐risk drug use behaviours arising from ongoing drug use may pose risks for further harm and illness. Efforts to minimise the harms associated with using drugs in hospital are urgently needed. [Grewal HK, Ti L, Hayashi K, Dobrer S, Wood E, Kerr T. Illicit drug use in acute care settings. Drug Alcohol Rev 2015;34:499–502]
Correlates and motives of pre‐drinking with intoxication and harm around licensed venues in two cities
Authors: Miller Peter , Droste Nic , de Groot Florentine , Palmer Darren , Tindall Jennifer , Busija Lucy , Hyder Shannon , Gilham Karen , Wiggers John
Published: May 2015

Introduction and Aims

The study investigates the prevalence of pre‐drinking culture in the night‐time economy (NTE) and its impact upon intoxication and alcohol‐related harm and violence experienced by patrons.

Design and Methods

Cross‐sectional surveys were conducted in and around licensed venues in Newcastle (NSW) and Geelong (Victoria) during peak trading hours (typically 9pm–1am). Participants completed a five minute structured interview which targeted: demographics, past and planned movements on the survey night, safety/experience of harm, and patron intoxication. 3949 people agreed to be interviewed, a response rate of 90.7%. Around half (54.9%) of interviewees were male and mean age was 24.4 years (SD = 5.8).

Results

66.8% of participants reported pre‐drinking prior to attending licensed venues. On a 1–10 scale measuring self‐rated intoxication, pre‐drinkers scored significantly higher compared to non pre‐drinkers (P < 0.001). Compared to non‐pre‐drinkers, patrons who had consumed 6–10 standard pre‐drinks were 1.5 times more likely to be involved in a violent incident in the past 12 months (OR = 1.50, 95%CI 1.03–2.19, P = 0.037) increasing to 1.8 times more likely for patrons who had 11–15 drinks (OR = 1.80, 95%CI 1.04–3.11 P = .036). Pre‐drinking was also associated with both self‐rated and observer‐rated intoxication, as well as increased probability of illicit drug use. Amongst pre‐drinkers, price was the most commonly reported motive for pre‐drinking (51.8%).

Discussion and Conclusions

‘Pre‐drinking’ was normal behaviour in the current sample and contributes significantly to the burden of harm and intoxication in the NTE. Price disparity between packaged vs. venue liquor is a key motivator for pre‐drinking. [Miller P, Droste N, de Groot F, Palmer D, Tindall J, Busija L, Hyder S, Gilham K, Wiggers J. Correlates and motives of pre‐drinking with intoxication and harm around licensed venues in two cities. Drug Alcohol Rev 2016;35:177–86]
The Pen and the Plough: Balanta Young Men in Guinea‐Bissau
Authors: Temudo Marina , Abrantes Manuel
Published: May 2015

Up until the late 1990s, the Balanta of Guinea‐Bissau constituted what could be described as a ‘deep rural society’, whose central identity was linked with rice production and cattle accumulation. At the same time, it could be argued that even in the early days after Independence in 1974, the social aspirations of Balanta young men matched those of other Guinean youths in their shared desire to get away from the strictures of gerontocracy and of rural life. Surprisingly, however, this study documents the agency of many rural Balanta young men in changing oppressive social rules, and in using agriculture as a means to fund their education, to feed their families and as a route to prosperity. The authors conclude that the persistent political instability in the country (most acutely felt in the capital city) and the national and global economic crises, together with the Balanta agricultural ethos and the softening of gerontocratic power, are at the root of this revaluing of rural livelihoods. This article challenges current dominant narratives about the crisis of young men in contemporary Africa and highlights the need to study the aspirations and achievements of youth in their rural–urban nexus from a historical and holistic perspective.
Involvement of leucocyte/endothelial cell interactions in anorexia nervosa
Authors: Víctor Víctor M. , Rovira‐Llopis Susana , Saiz‐Alarcón Vanessa , Sangüesa Maria C. , Rojo‐Bofill Luis , Bañuls Celia , de Pablo Carmen , Álvarez Ángeles , Rojo Luis , Rocha Milagros , Hernández‐Mijares Antonio
Published: May 2015

Background

Anorexia nervosa is a common psychiatric disorder in adolescence and is related to cardiovascular complications. Our aim was to study the effect of anorexia nervosa on metabolic parameters, leucocyte–endothelium interactions, adhesion molecules and proinflammatory cytokines.

Materials and Methods

This multicentre, cross‐sectional, case–control study employed a population of 24 anorexic female patients and 36 controls. We evaluated anthropometric and metabolic parameters, interactions between leucocytes polymorphonuclear neutrophils (PMN) and human umbilical vein endothelial cells (HUVEC), proinflammatory cytokines such as tumour necrosis factor alpha (TNF‐α) and interleukin‐6 (IL‐6) and soluble cellular adhesion molecules (CAMs) including E‐selectin, vascular cell adhesion molecule‐1 (VCAM‐1) and intercellular adhesion molecule‐1 (ICAM‐1).

Results

Anorexia nervosa was related to a decrease in weight, body mass index, waist circumference, systolic blood pressure, glucose, insulin and HOMA‐IR, and an increase in HDL cholesterol. These effects disappeared after adjusting for BMI. Anorexia nervosa induced a decrease in PMN rolling velocity and an increase in PMN rolling flux and PMN adhesion. Increases in IL‐6 and TNF‐α and adhesion molecule VCAM‐1 were also observed.

Conclusions

This study supports the hypothesis of an association between anorexia nervosa, inflammation and the induction of leucocyte–endothelium interactions. These findings may explain, in part at least, the increased risk of vascular disease among patients with anorexia nervosa.
Patch size, shape and edge distance influence seed predation on a palm species in the Atlantic forest
Authors: Mendes Calebe P. , Ribeiro Milton C. , Galetti Mauro
Published: May 2015

Seed predation is an important ecological process that affects the abundance, diversity and distribution of plant species, and it is known to be influenced by defaunation and forest fragmentation. Most studies on seed predation in human‐modified landscapes do not take into account the different spatial scales in which this process operates. In this study, we evaluated how variables at three distinct spatial scales affected the seed predation of a palm that provides a keystone resource to the frugivore community, the queen palmSyagrus romanzoffiana. Thirteen landscapes that vary in forest cover, number of fragments and patch sizes were sampled in the Brazilian Atlantic forest. We also evaluated the contribution of the three main groups of seed predators: squirrels, terrestrial rodents and invertebrates. Our results indicate that seed predation is more affected by fragment and local variables than by landscape influences. In addition, the size of the fragment, its shape and the distance from the nearest forest edge were the main predictors of the proportion of predated seeds. Moreover, the two main seed predators (squirrels and invertebrates) responded to the same fragment and local variables. Because most of the Atlantic forest consists of small fragments, we expect that the seed predation of this keystone palm should be high in most of its distribution, with potential consequences for the frugivore community.
Pitch processing of dynamic lexical tones in the auditory cortex is influenced by sensory and extrasensory processes
Authors: Krishnan Ananthanarayan , Gandour Jackson T. , Suresh Chandan H.
Published: May 2015

The aim is to evaluate how language experience (Chinese, English) shapes processing of pitch contours as reflected in the amplitude of cortical pitch response components. Responses were elicited from three dynamic curvilinear nonspeech stimuli varying in pitch direction and location of peak acceleration: Mandarin lexical Tone 2 (rising) and Tone 4 (falling), and a flipped variant of Tone 2, Tone 2′ (nonnative). At temporal sites (T7/T8), Chinese listeners’ Na–Pb response amplitudes to Tones 2 and 4 were greater than those of English listeners in the right hemisphere only; a rightward asymmetry for Tones 2 and 4 was restricted to the Chinese group. In common to both Fz‐to‐linked T7/T8 and T7/T8 electrode sites, the stimulus pattern (Tones 2 and 4 > Tone 2′) was found in the Chinese group only. As reflected by Pb–Nb at Fz, Chinese subjects’ amplitudes were larger than those of English subjects in response to Tones 2 and 4, and Tones 2 and 4 were larger than Tone 2′, whereas for English subjects, Tone 2 was larger than Tone 2′ and Tone 4. At frontal electrode sites (F3/F4), regardless of component or hemisphere, Chinese subjects’ responses were larger in amplitude than those of English subjects across stimuli. For either group, responses to Tones 2 and 4 were larger than Tone 2′. No hemispheric asymmetry was observed at the frontal electrode sites. These findings demonstrate that cortical pitch response components are differentially modulated by experience‐dependent, temporally distinct but functionally overlapping, weighting of sensory and extrasensory effects on pitch processing of lexical tones in the right temporal lobe and, more broadly, are consistent with a distributed hierarchical predictive coding process.
Non‐Mammalian Infants Requiring Parental Care Elicit Greater Human Caregiving Reactions Than Superprecocial Infants Do
Authors: Kruger Daniel J.
Published: May 2015

Ethologists proposed the coevolution of pedomorphic characteristics in infants and caregiving responses to these features in parents. Human infants higher in pedomorphic characteristics are more likely to receive baby talk from adults and elicit stronger motivations for caretaking. Neotenous facial characteristics in human adults cue social approach and elicit helping. This study demonstrates generally strong differences in reactions to infants from non‐mammalian species requiring parental care (semiprecocial) and superprecocial species within the same class. People perceive semiprecocial infants as more neotenous (cute, immature, and helpless), had greater desires to hold or pet them, thought they would have a greater appreciation of being held or pet, thought they would be less likely to survive on their own, and anticipated being more likely to adopt them compared to superprecocial infants. Both avian and reptilian infants elicited these patterns. There was a moderate degree of sex differences in ratings, women saw the infants as more neotenous and were more willing to adopt them than men.
Travel and Activity Choices for Transit Travelers at Terminals with Dynamic Information Provision
Authors: Hsu Chaug‐Ing , Li Chia‐Wen
Published: May 2015

This study explores the impacts of providing dynamic information on travelers' behavior and the induced demand for terminal‐surrounding activities. A nested logit model was used to identify the important factors, and a questionnaire was designed to explore the preference of travelers regarding activities and travel choices. Adopting dynamic information was found to have a significant influence on travel decisions. The results show that an increased duration of activity participation may accompany an alteration of departure time or mode choice. The results also show that the use of dynamic information for travelers is related to induced activity participation and travelers' socioeconomic characteristics. The content of the dynamic information should be designed in accordance with the preference of travelers to encourage travelers participating in terminal‐surrounding activities.
Urban Growth Boundaries and Betterment: Rent‐Seeking by Landowners on Melbourne's Expanding Urban Fringe
Authors: Taylor Elizabeth Jean
Published: May 2015

Melbourne's Urban Growth Boundary (UGB) was legislated in 2002 and expanded substantially in 2010. Although based on strategic planning goals, UGBs have the capacity to influence land and housing markets. Landowners on the rural–urban fringe are a stakeholder group directly impacted by UGB policy, with multiple interests in containment policies and any land‐value effects. Following the 2010 expansion, substantial windfall profits to “instant millionaire” Melbourne landowners were openly reported. This paper critically interprets claims made by landowners in 264 public submissions responding to the proposed UGB expansion, and to an accompanying new policy instrument, the Growth Areas Infrastructure Contribution (GAIC). The GAIC was, in effect, a hypothecated tax on betterment expected to result from the UGB shift. Landowners commonly expressed fears that the UGB shift would not result in claimed value increases. On this basis, the GAIC was revised such that it is—at least in intention—a system wherein the tax is to be paid by housing developers and passed forward to homebuyers. The paper argues that the series of changes to the UGB and GAIC, including the modified “purchaser pays” system, may be understood as a response to rent‐seeking policy pressures from existing landowners as “insiders.” Although the unpopularity of the GAIC with landowners might have been anticipated, the outcome appears to legitimise their misinterpretation of the premise of development gain. A broader implication is that rent‐seeking behaviour by existing property owners can determine whether and how strategic planning policies are implemented.
Professional development through attending conferences: reflections of a health librarian
Authors: Jenkins Ruth
Published: May 2015

In this article, guest writer Ruth Jenkins from Berkshire Heathcare Foundation Trust reflects on two conferences she attended in 2014, LILAC and SLA. Through the process of reflection, she considers the benefits that attending conferences can have to library and information professionals in the health sector. In particular, she discusses the opportunities and areas for learning and professional development that conferences can offer including evidence‐based practice and current awareness, gaining new knowledge and objectivity, and networking and the unexpected benefits of conferences. Ruth also offers some practical hints and tips on ways to facilitate your attendance at conferences, including through awards and funding.

H.S.
International Trends in Health Science Librarianship Part 14: East Africa (Kenya, Uganda, Rwanda)
Authors: Gathoni Nasra , Kamau Nancy , Nannozi Judith , Singirankabo Marcel
Published: May 2015

This is the 14th in a series of articles exploring international trends in health science librarianship in the 21st century. This is the second of four articles pertaining to different regions in the African continent. The present issue focuses on countries in East Africa (Kenya, Uganda and Rwanda). The next feature column will investigate trends in West Africa.

JM
The health information seeking behaviour and needs of community health workers in Chandigarh in Northern India
Authors: Raj Sonika , Sharma Vijay Lakshmi , Singh Amarjeet , Goel Sonu
Published: May 2015

This article represents two‐firsts for the feature – it is the first to report on a study outside the UK and the first to examine the health information needs of community health workers. Sonika Raj is pursuing PhD at the Centre for Public Health, Panjab University, Chandigarh, in India and she conducted her research in Chandigarh. The article outlines the important role that health workers at community level play in determining health outcomes in the developing world, including Chandigarh. It demonstrates that while those workers recognise their information needs, there are many issues affecting their ability to access health information effectively, not least their limited access to appropriate technology and training.

AM
Reporting statistical analyses in peer review journal articles
Authors: Stephens Richard , Grant Maria J.
Published: May 2015

As a regular referee for the Health Information and Libraries Journal, Richard Stephens – Winner of the 2014 Wellcome Trust Science Writing Prize – has been impressed by the science on offer in the Health Information and Libraries Journal. But he has also been struck by how often similar problems with statistical analysis reporting come up during the review process. Acknowledging that statistics can be scary, he advocates that they should be simply viewed as a means of communicating ideas. In this editorial, he provides some straightforward guidelines on reporting statistical analyses in peer review journal articles, highlights pitfalls to avoid and illustrates best practice to aim for.
Soluble biomarkers of immune activation and inflammation in HIV infection: impact of 2 years of effective first‐line combination antiretroviral therapy
Authors: Hattab S , Guiguet M , Carcelain G , Fourati S , Guihot A , Autran B , Caby F , Marcelin A‐G , Costagliola D , Katlama C
Published: May 2015

Objectives

The aim of the study was to assess the impact of rapid and sustained viral control produced by combination antiretroviral therapy (cART) on HIV‐associated immune activation and inflammation.

Methods

In this longitudinal observational study, we examined changes in interleukin‐6 (IL‐6), interferon‐γ‐inducible protein‐10 (IP‐10), monokine induced by interferon‐γ (MIG) and soluble CD14 (sCD14) levels during 2 years of effective first‐line cART. Biomarker levels before and after cART were compared with those observed in healthy subjects, using the Wilcoxon signed rank test. Elevated biomarker levels were defined with respect to values for healthy subject (mean + 2 standard deviations). Factors associated with persistently elevated biomarker levels after 2 years of cART were identified by logistic regression.

Results

We included in the study 139 patients with a median HIV‐1 RNA level of 4.8 log10 HIV‐1 RNA copies/mL and a median CD4 cell count of 294 cells/μL at cART initiation [day 0 (D0)]. At D0, all biomarker levels were higher than in healthy subjects (P < 0.05). After 2 years of cART, IL‐6, IP‐10 and MIG levels fell significantly, by a median of 0.54, 420 and 1107 pg/mL, respectively (all P < 0.001), and were no longer elevated in > 75% of patients. In contrast, sCD14 levels did not change significantly (0.18 × 106 pg/mL; P = 0.102) and remained elevated. Older age was associated with elevated levels of IP‐10 [odds ratio (OR) 1.60 per 10 years older; P = 0.047] and MIG (OR 1.92 per 10 years older; P = 0.007) after 2 years of cART.

Conclusions

The rapid and sustained viral suppression produced by first‐line cART reduced IL‐6, IP‐10 and MIG to normal levels, while sCD14, a marker of monocyte activation, remained elevated. High levels of IP‐10 and MIG tended to persist in older patients.
Assessment of radiological vertebral fractures in HIV‐infected patients: clinical implications and predictive factors
Authors: Gazzola L , Savoldi A , Bai F , Magenta A , Dziubak M , Pietrogrande L , Tagliabue L , Del Sole A , Bini T , Marchetti G , d'Arminio Monforte A
Published: May 2015

Objectives

The aim of this study was to evaluate the clinical impact of including lateral spine X‐ray in the screening of bone diseases in HIV‐positive patients.

Methods

A total of 194 HIV‐positive patients underwent dual‐energy X‐ray absorptiometry (DEXA), lateral spine X‐ray and bone biochemical analysis. Vertebral fractures were identified using a morphometric analysis of X‐rays and classified using the semiquantitative scoring system of Genant et al. For each patient, a spine deformity index (SDI) score was calculated by summing the grades of vertebral deformities. Reductions in vertebral body height of > 25% were considered vertebral fractures, and those < 25% were considered vertebral deformities. Risk factors associated with vertebral fractures were evaluated by univariate and multivariate analysis.

Results

Vertebral fractures were detected in 24 patients (12.4%) and vertebral deformities in 17 patients (8.7%); 153 patients (78.9%) did not show any vertebral deformity. Among patients with fractures, only two with SDI > 10 reported lumbar pain; the remaining were asymptomatic. Patients over 50 years old showed a higher prevalence of vertebral fracture [24.4% versus 11.8% in patients 41–50 years old (P = 0.05) and 1.9% in patients ≤ 40 years old (P = 0.04)]. No significant increase in the prevalence according to bone mineral density (BMD) reduction was observed, and 70% of fractures were diagnosed in nonosteoporotic patients. Older age [adjusted odds ratio 1.09; 95% confidence interval (CI) 1.03–1.13; P = 0.001] and steroid use (adjusted odds ratio 3.64; 95% CI 1.29–10.3; P = 0.01) were independently associated with vertebral fracture; no association was found with HIV‐ or highly active antiretroviral therapy (HAART)‐related variables.

Conclusions

A prevalence of vertebral fractures of 12.4% was observed in our HIV‐positive cohort. Given that two‐thirds of fractures occurred in nonosteoporotic patients, spine X‐ray may be considered in patients at increased risk, irrespective of BMD; that is, in elderly patients and/or patients using steroids.
Antimicrobial 2‐hydroxyisocaproic acid and chlorhexidine resist inactivation by dentine
Authors: Sakko M. , Tjäderhane L. , Sorsa T. , Hietala P. , Rautemaa R.
Published: May 2015

Aim

To compare the antibacterial activity of 2‐hydroxyisocaproic acid (HICA) with currently used root canal medicaments and to examine their interactions with potential inhibitors in nutrient‐deficient and nutrient‐rich conditions.

Methodology

First, the antibacterial activity of single concentrations of HICA, calcium hydroxide solution or slurry, chlorhexidine digluconate or acetate was tested against Enterococcus faecalis with and without potential inhibitors: dentine powder (DP), hydroxyapatite or bovine serum albumin, in a low concentration of peptone water. Relative viable counts were determined by culture at 1, 24 and 48 h. In the second set of experiments, the activity of three concentrations of HICA was evaluated against two isolates of E. faecalis with and without potential inhibitors in nutrient‐rich thioglycollate broth using a modification of a standard microdilution method. The minimum bactericidal concentration was determined by culture at 1, 24 and 48 h.

Results

Concentrations of ≥33 mg mL−1 of HICA were found to be bactericidal against E. faecalis in both nutrient‐deficient and nutrient‐rich environments at 24‐ to 48‐h incubation, whereas the initial activity of Ca(OH)2 slurry was lost at 48‐h incubation. HICA tolerated well all tested potential inhibitors up to 19 mg mL−1. DP concentrations higher than this inhibited its activity in a dose‐dependent manner in both environments. DP demonstrated moderate antibacterial activity, and it enhanced the otherwise limited activity of Ca(OH)2 slurry and solution. DP did not impact on the activity of chlorhexidine.

Conclusions

These results support the long‐term antibacterial activity of HICA and indicate its tolerance to clinically relevant concentrations of dentine and other inhibitors commonly present in the root canal system. Therefore, HICA may have potential as an interappointment medication in the treatment of root canal infections.
Evaluation of Mindray BC‐5000 hematology analyzer: a new miniature 5‐part WBC differential instrument
Authors: Xiang D. , Yue J. , Lan Y. , Sha C. , Ren S. , Li Y. , Li M. , Wang C.
Published: May 2015

Introduction

The Mindray BC‐5000 automated hematology analyzer is a miniature, automated hematology analyzer, and 5‐part leukocyte differential counter for in vitro diagnostic use in clinical laboratories.

Methods

Precision, linearity, carryover, and method comparison were carried out. The analyzer was evaluated and compared with the Sysmex XE‐2100 hematology analyzer and manual microscopic in the hematology laboratory of a tertiary hospital in Chinese.

Results

There were minimal carryover (<0.25%), and excellent linearity for white blood cell, and platelet counts (r > 0.99). Within‐run precision was good at all levels for the routine cell blood count parameters (CV < 3.5%). Between‐run precision was acceptable at all levels for the analysis parameters (CV < 5%) except for eosinophil and basophil (CV% >10%). BC‐5000 displayed very good correlation (r > 0.94) with the XE‐2100 for cell blood count and cell differential parameters except for basophil (r = 0.72). The comparison of 258 leukocyte differential count results analyzed in parallel with manual microscopy, BC‐5000 analyzer showed perfect specificity (93%) and negative predictive value (90%) on abnormal blood samples.

Conclusion

It is concluded that the overall performance of the BC‐5000 is acceptable. The miniature analyzer is suitable for use in small‐ to medium‐size laboratories.
Social support and stress of kin caregivers of orphaned children in Addis Ababa, Ethiopia: Implications for practice and policy
Authors: Kassahun Meseret
Published: May 2015

Using a mixed methods research design, this study analysed available social supports and stressors among 127 kin caregivers who were caring for HIV‐ and AIDS‐affected orphans and vulnerable children in Addis Ababa, Ethiopia. The conceptual framework of the study was social support viewed as a buffer. Kin caregivers’ scores indicate a low level of social support and a high level of stress. The amount of support caregivers received from formal sources is considered inadequate, irregular and inconsistent. Kin caregivers’ stress is situational and largely related to poverty, especially food insecurity. Social service providers should consider programmes that strengthen support to help kin caregivers deal with major stressors. Policy makers should ensure that both specific child and caregiver supportive policies and related programmes respond to the overwhelming numbers of orphans and vulnerable children in Ethiopia through explicitly acknowledging the significant role of kinship care.
Unemployment and conditional welfare: Exclusion and belonging in immigrant women's discourse on being long‐term dependent on social assistance
Authors: Bergnehr Disa
Published: May 2015

Long‐term unemployment with dependency on social assistance in Sweden has increased and is particularly high among foreign‐born persons. The present study explored immigrant recipients' experiences of being welfare reliant. Swedish‐Iraqi women's construction of exclusion and belonging in relation to policies and welfare regulations was scrutinised. The women referred to unemployment with frustration, expressing that it renders dependence on social welfare and enforces adherence to the stipulations of the social services. The individual's mobility and agency are restricted and concerted efforts to obtain employment are futile, which increase the sense of exclusion. However, the entitlement to social assistance also engenders feelings of belonging, of being connected to and cared for by the new country. More research is needed to examine the role that social assistance regulations play in forming feelings of belonging and exclusion. It appears essential that political initiatives be taken to reverse the trend of high unemployment among foreign‐born persons.
Measures of acute physiology, comorbidity and functional status to differentiate illness severity and length of stay among acute general medical admissions: a prospective cohort study
Authors: Huggan P. J. , Akram F. , Er B. H. D. , Christen L. S. J. , Weixian L. , Lim V. , Huang Y. , Merchant R. A.
Published: May 2015

Background

Simple measures of acute physiologic compromise, functional status and comorbidity may help clinicians to make decisions relating to clinical care and resource utilisation.

Aims

To explore the usefulness of common assessment tools in predicting outcomes of (i) death or intensive care unit (ICU) admission and (ii) length of hospital stay at a busy tertiary hospital in Singapore.

Methods

Three hundred and ninety‐eight consecutive admissions to two general medicine teams were prospectively assessed during 2 months in 2011. Patients were followed until discharge or transfer to ICU/high dependency unit (HDU). Data collected included routine demographic data, final diagnosis, comorbid conditions including a weighted prognostic comorbidity index (the updated Charlson index) and the modified Early Warning Score (MEWS) at presentation to the emergency department. The admission modified Barthel Index was recorded for patients aged 65 and over. Death and total length of hospital stay were recorded in all cases.

Results

Of 398 patients, 16 (4 %) died or were transferred to ICU and 99 (25%) stayed for more than 7 days. Medical early warning (MEW) scores of ≥5 were significantly associated with death or ICU admission (hazard ratio 5.50, 95% confidence interval 1.77–17.07, P = 0.003). There was no independent association between this outcome and the Charlson score or admission Barthel Index. Excess length of stay was associated with a modified Barthel Index ≤17 and altered mental status at presentation.

Conclusion

Among unselected general medical patients, MEW scores of ≥5 were significantly associated with death or ICU admissions and only functional status and altered mental status were independent predictors of excess length of stay.
Icatibant in angiotensin‐converting enzyme (ACE) inhibitor‐associated angioedema
Authors: Fok J. S. , Katelaris C. H. , Brown A. F. , Smith W. B.
Published: May 2015

Background

Angioedema occurs in up to 2% of those taking angiotensin‐converting enzyme (ACE) inhibitors. Upper airway angioedema may potentially require endotracheal intubation or cricothyrotomy, and is usually unresponsive to adrenaline. The bradykinin receptor antagonist icatibant is proven to be effective in the treatment of acute attacks of hereditary angioedema, and has also been reported effective in the treatment of angioedema associated with ACE inhibitors.

Aim

To describe the use of icatibant for ACE inhibitor‐associated airway angioedema.

Methods

We treated 13 consecutive emergency department (ED) patients, who had not improved with adrenaline and/or corticosteroids, with icatibant 30 mg subcutaneously for ACE inhibitor‐associated upper respiratory tract angioedema according to an agreed protocol.

Results

Four patients were intubated in the ED either before or after receiving icatibant; three of these were extubated within 24 h of treatment. Eight patients received early icatibant and did not require intubation. The time from onset of airway angioedema to ED presentation ranged from 1 h to 3 days (median 4 h); from ED presentation to receiving icatibant, from 30 minutes to 3 days (median 3 h); and to onset of symptom improvement after icatibant, 15 minutes to 7 h (median 2 h). One patient received a second dose of icatibant.

Conclusion

All patients improved after receiving icatibant, consistent with its bradykinin receptor blocking mechanism. Icatibant rapidly reversed symptoms, and appeared to avert the need for intubation or expedite extubation. Timely use of icatibant in ACE inhibitor‐associated angioedema may avert the need for invasive airway procedures and intensive care unit admission.
Biochemical composition of the saliva and dental biofilm of children with Down syndrome
Authors: Schwertner Carolina , Moreira Maurício José Santos , Faccini Lavinia Schuler , Hashizume Lina Naomi
Published: May 2015

Background

The biochemical composition of the saliva and biofilm of children with Down syndrome (DS) may be associated with the incidence of caries in this population.

Aim

To evaluate the biochemical composition of the saliva and dental biofilm of children with DS in the city of Porto Alegre, RS.

Design

The sample comprised 144 children between 6 and 14 years of age, of whom 61 had DS and 83 did not. Stimulated saliva samples were collected from all participants, as were samples of 48‐h biofilm. Fluoride (F), calcium (Ca), and phosphorus (Pi) concentrations in saliva and biofilm were determined by colorimetric method (Ca and Pi) or selective electrode (F). The level of insoluble extracellular polysaccharide (EPS) in dental biofilm was measured using sulphuric acid method.

Results

Salivary concentration of F, Ca, and Pi did not differ between children with and without DS. The dental biofilm of children with DS, however, showed higher Pi and EPS levels than that of children without the syndrome (P < 0.05).

Conclusions

The present results suggest that despite the salivary composition being similar between groups, the dental biofilm of children with DS has higher cariogenic potential than that of children without this condition.
Organising migrant workers: the living wage campaign at the University of East London
Authors: Lopes Ana , Hall Timothy
Published: May 2015

This critical case study looks at the campaign led by Citizens UK and Unison to get the University of East London (UEL) to sign up to the London living wage (LLW). UEL agreed to pay the LLW after a brief campaign in November 2010 and it was subsequently implemented in August 2011. The study charts the course of the campaign and draws on mobilisation theory and new primary research to account for its success. What our findings suggest is that community organisers and union activists were able to organise and mobilise a largely apolitical group of migrant workers. This, we suggest, can be explained by the successful mobilisation of the community and augurs well for future broad‐based campaigns.
State Aid Policy in the European Union
Authors: Tunali Çiğdem Börke , Fidrmuc Jan
Published: May 2015

Industrial policy is an important tool of economic policy‐making, and this has been the case especially since the onset of the current global financial crisis in 2008. However, only relatively few empirical studies consider the macroeconomic effects of industrial policy, especially for European Union countries. In this study we investigate the effect of state aid policy on economic growth and investment, using a panel data set which covers 27 European Union countries over the period 1992–2011. Our results suggest that state aid policy is not an effective tool to achieve higher economic growth and investment rates.
Germany's Institutional Power and the EMU Regime after the Crisis: Towards a Germanized Euro Area?
Authors: Steinberg Federico , Vermeiren Mattias
Published: May 2015

In this article we examine the constraints on Germany's influence over reforms of the Economic and Monetary Union's (EMU) macroeconomic governance regime. Drawing on the insights of historical institutionalism, we show that the German government's control over the process is constrained by the increased sunk costs of European monetary integration and the unintended negative spillovers from its management of the eurozone crisis. While the German government attempted to promote the domestic societal interests underpinning its creditor preferences by deflecting the burden of macroeconomic and institutional adjustment onto the debtor countries, negative feedback loops linked to the pursuit of these preferences induced it to accept a less orthodox and increasingly accommodative central bank to make the EMU sustainable.
Mobility Device Use in Older Adults and Incidence of Falls and Worry About Falling: Findings from the 2011–2012 National Health and Aging Trends Study
Authors: Gell Nancy M. , Wallace Robert B. , LaCroix Andrea Z. , Mroz Tracy M. , Patel Kushang V.
Published: May 2015

Objectives

To examine the prevalence of mobility device use in community‐dwelling older adults in the United States and to investigate the incidence of falls and worry about falling according to type and number of mobility devices used.

Design

Analysis of cross‐sectional and longitudinal data from the 2011–12 National Health and Aging Trends Study.

Setting

In‐person interviews in the homes of study participants.

Participants

Nationally representative sample of Medicare beneficiaries (n = 7,609).

Measurements

Participants were asked about mobility device use (e.g., canes, walkers, wheelchairs and scooters) in the last month, 1‐year fall history and worry about falling.

Results

Twenty‐four percent of adults aged 65 and older reported mobility device use in 2011, and 9.3% reported using multiple devices within the last month. Mobility device use increased with advancing age and was associated with nonwhite race and ethnicity, female sex, lower education level, greater multimorbidity, and obesity (all P < .001). Adjusting for demographic and health characteristics and physical function, the incidence of falls and recurrent falls was not associated with the use of multiple devices or any particular type of mobility device. Activity‐limiting worry about falling was significantly higher in cane‐only users than in nonusers.

Conclusion

The percentage of older adults reporting mobility device use is higher than results from previous national surveys, and multiple device use is common in those who use any device. Mobility device use is not associated with greater incidence of falls. Cane‐only users may compensate for worry about falling by limiting activity.
Comparative Efficacy and Safety of Selective Serotonin Reuptake Inhibitors and Serotonin‐Norepinephrine Reuptake Inhibitors in Older Adults: A Network Meta‐Analysis
Authors: Thorlund Kristian , Druyts Eric , Wu Ping , Balijepalli Chakrapani , Keohane Denis , Mills Edward
Published: May 2015

Objectives

To establish the comparative efficacy and safety of selective serotonin reuptake inhibitors and serotonin‐norepinephrine reuptake inhibitors in older adults using the network meta‐analysis approach.

Design

Systematic review and network meta‐analysis.

Participants

Individuals aged 60 and older.

Measurements

Data on partial response (defined as at least 50% reduction in depression score from baseline) and safety (dizziness, vertigo, syncope, falls, loss of consciousness) were extracted. A Bayesian network meta‐analysis was performed on the efficacy and safety outcomes, and relative risks (RRs) with 95% credible intervals (CrIs) were produced.

Results

Fifteen randomized controlled trials were eligible for inclusion in the analysis. Citalopram, escitalopram, paroxetine, duloxetine, venlafaxine, fluoxetine, and sertraline were represented. Reporting on partial response and dizziness was sufficient to conduct a network meta‐analysis. Reporting on other outcomes was sparse. For partial response, sertraline (RR = 1.28), paroxetine (RR = 1.48), and duloxetine (RR = 1.62) were significantly better than placebo. The remaining interventions yielded RRs lower than 1.20. For dizziness, duloxetine (RR = 3.18) and venlafaxine (RR = 2.94) were statistically significantly worse than placebo. Compared with placebo, sertraline had the lowest RR for dizziness (1.14) and fluoxetine the second lowest (1.31). Citalopram, escitalopram, and paroxetine all had RRs between 1.4 and 1.7.

Conclusion

There was clear evidence of the effectiveness of sertraline, paroxetine, and duloxetine. There also appears to be a hierarchy of safety associated with the different antidepressants, although there appears to be a dearth of reporting of safety outcomes.
Enhancing the Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department (EQUiPPED): Preliminary Results from Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department, a Novel Multicomponent Interdisciplinary Quality Improvement Initiative
Authors: Stevens Melissa B. , Hastings Susan Nicole , Powers James , Vandenberg Ann E. , Echt Katharina V. , Bryan William E. , Peggs Kiffany , Markland Alayne D. , Hwang Ula , Hung William W. , Schmidt Anita J. , McGwin Gerald , Ikpe‐Ekpo Edidiong , Clevenger Carolyn , Johnson Theodore M. , Vaughan Camille P.
Published: May 2015

Suboptimal medication prescribing for older adults has been described in a number of emergency department (ED) studies. Despite this, few studies have examined ED‐targeted interventions aimed at reducing the use of potentially inappropriate medications (PIMs). Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the ED (EQUiPPED) is an ongoing multicomponent, interdisciplinary quality improvement initiative in eight Department of Veterans Affairs EDs. The project aims to decrease the use of PIMs, as identified by the Beers criteria, prescribed to veterans aged 65 and older at the time of ED discharge. Interventions include provider education; informatics‐based clinical decision support with electronic medical record–embedded geriatric pharmacy order sets and links to online geriatric content; and individual provider education including academic detailing, audit and feedback, and peer benchmarking. Poisson regression was used to compare the number of PIMs that staff providers prescribed to veterans aged 65 and older discharged from the ED before and after the initiation of the EQUiPPED intervention. Initial data from the first implementation site show that the average monthly proportion of PIMs that staff providers prescribed was 9.4 ± 1.5% before the intervention and 4.6 ± 1.0% after the initiation of EQUiPPED (relative risk = 0.48, 95% confidence interval = 0.40–0.59, P < .001). Preliminary evaluation demonstrated a significant and sustained reduction of ED‐prescribed PIMs in older veterans after implementation of EQUiPPED. Longer follow‐up and replication at collaborating sites would allow for an assessment of the effect on health outcomes and costs.
Dimensional accuracy of different techniques used for complete‐arch multi‐implant impressions
Authors: Ghanem Rabab A. , Nassani Mohammad Z. , Baroudi Kusai , Abdel Fattah Amany
Published: May 2015

Objective

The aim of this study was to compare the linear horizontal dimensional accuracy of the stone casts obtained from four different direct transfer implant impression techniques compared with an acrylic master model.

Methods

An acrylic resin master model with four implants was fabricated. Four impression techniques were used with squared transfer impression copings. These were nonsplinted transfer copings, splinted transfer copings, airborne particle‐abraded transfer copings coated with impression adhesive, and transfer copings with unilateral acrylic extension. Dimensional accuracy of the resultant casts was assessed with a traveling microscope by recording the linear horizontal distances between the most anterior implants and between the most posterior implants. Paired t‐test and one‐way anova followed by Tukey's post hoc test were used for the statistical analysis.

Results

The results showed a significantly greater anterior and posterior horizontal distance in the direct nonsplinted transfer copings technique compared with the master model (P < 0.05). When the horizontal variations were compared between the four impression techniques, the direct nonsplinted transfer copings technique had significantly the greatest anterior and posterior horizontal distance in comparison with the other impression techniques (P < 0.05).

Conclusion

Casts obtained from the direct nonsplinted transfer impression technique were significantly less accurate than those obtained from the other impression techniques used in this study.
Estimating the frequency of Candida in oral squamous cell carcinoma using Calcofluor White fluorescent stain
Authors: Sanketh D. S. , Patil Shankargouda , Rao Roopa S.
Published: May 2015

Objective

To determine the frequency of Candida in oral squamous cell carcinoma (OSCC) using Calcofluor White (CFW) fluorescent stain and to evaluate the association of the same in different grades of OSCC.

Methods

One hundred archival formalin fixed paraffin embedded tissues of diagnosed cases of OSCC were retrieved. The samples comprised of 81, 18 and 1 case of well, moderately, and poorly differentiated squamous cell carcinomas (WSCC, MSCC, PSCC) respectively. Each section was subjected to staining with CFW fluorescent stain for the detection of frequency of candidal hyphae. A chi square test was used to compare the proportion of occurrence of candidal hyphae between different grades of OSCC.

Results

Ten of the 100 cases of OSCCs stained positive for Candida with CFW. Positive staining for Candida was seen in six out of 81 and four out of 18 cases of WSCCs and MSCCs respectively. The chi square test used for comparison of the proportion of occurrence of candidal hyphae between WSCC and MSCC (P = 0.059) and all grades of OSCC (P = 0.157) did not yield any statistically significant value.

Conclusion

The presence of Candida in OSCC solely does not justify its role in carcinogenesis. Further appraisal to evaluate a direct causal role of the micro‐organism in potentially malignant disorders and OSCC is required.