bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiphasic acute disseminated encephalomyelitis associated with atypical rubella virus infection
Authors: Shinoda Koji , Asahara Hideaki , Uehara Taira , Miyoshi Katsue , Suzuki Satoshi O , Iwaki Toru , Kira Jun-ichi
Published: May 2014

We report the first case of an occurrence of multiphasic acute disseminated encephalomyelitis (ADEM) associated with atypical rubella virus infection with no rash and long-term increased titers of serum anti-rubella IgM in a 17-year-old male who had no history of rubella vaccination. He suffered from at least six clinical exacerbations with disseminated hyperintense lesions on FLAIR MR images during the course of 18 months. Repeated methylprednisolone pulse therapy and intravenous immunoglobulin therapy resolved the exacerbations. In patients with multiphasic ADEM of unknown etiology, clinicians should also consider the possibility of preceding infection with rubella virus.
Extensive cerebral white matter involvement in a patient with NMO spectrum disorder
Authors: Ayrignac Xavier , Dalière Clarisse Carra , Nerrant Elodie , Vincent Thierry , De Seze Jérôme , Labauge Pierre
Published: May 2014

Abnormal brain MRI has been described in up to 60% of patients with NMO patients. However, white matter T2 hyperintensities have been rarely observed. We report the case of a 49-year-old woman with long-lasting neuromyelitis optica (NMO) spectrum disorder and diffuse cerebral white matter T2-weighted hyperintensities. Our case suggests that some NMO patients can progressively develop l extensive cerebral involvement.
Does relative age influence motor test performance of fourth grade pupils?
Authors: Wattie Nick , Tietjens Maike , Schorer Jörg , Ghanbari Marie-Christine , Strauss Bernd , Seidel Ilka , Baker Joseph
Published: May 2014

The aim of the current study was to explore relative age’s influence on physical and motor tests among fourth grade children (9 to 10 years) from Germany. Data from 1218 children (49% female) who had performed the German Motor Ability Test (Bös et al., 2009) were analysed. The test battery, which was comprised of physical and motor tests, included 20 m sprint, balance backwards, jumping sideways, stand and reach, push-ups, sit-ups, standing broad jump, and six-minute run. Analyses of variance only revealed statistically significant effects for height, weight, and 20 m sprint time ( p < .01) among boys, with relatively older boys performing better than relatively younger boys. For the girls, the only significant difference between quartiles was for height ( p < .01), with the oldest quartiles being taller than the younger quartiles. These results may have implications for statistical vs. practical significance, sampling, and how youth are evaluated in physical education classes.
Being a competent athlete or a competent teacher? Aesthetic experiences in physical education teacher education
Authors: Maivorsdotter Ninitha , Lundvall Suzanne , Quennerstedt Mikael
Published: May 2014

The aim of this study was to explore physical education teacher education students’ meaning-making of participating in lessons – in this case gymnastics and basketball – based on their aesthetic judgements, expressed in written stories. A transactional approach, drawing on the work of John Dewey, was used in the study and the empirical data was generated through observations and collection of students’ written stories. A practical epistemology analysis was used in order to explore the students’ meaning-making in-depth. The purposes that the students ascribed to participating in the lessons were to develop both as athletes and as teachers. When analysing the stories, the importance of being a competent athlete emerged as the main purpose of participating in the lessons, and the majority of the students never included the purpose of developing as a teacher in their stories at all. By making the competent athlete the centre of their participation, other positions of participation were excluded or marginalized. However, even if all the students’ stories contribute to the collective appropriation of the type, the majority did not include the projected, ideal type in all respects. In their stories, it was clear that many of the students expressed a tension between doing gymnastics or basketball within the context of competitive sport and doing the same activities within the context of physical education teacher education. Even if the students did not fulfil this awareness of contrasting ideals by undoing ‘the competent athlete’ completely, many of them did highlight the conflict.
Psychosocial predictors of body mass index at late childhood: A longitudinal investigation
Authors: Holm-Denoma Jill M , Smith April , Lewinsohn Peter M , Pettit Jeremy W
Published: May 2014

Little is known about the psychosocial circumstances under which children develop excessive body mass. A community sample was followed up from age 2–10 years to determine which early problems were predictive of increased body mass index. Hypothesized mediators (i.e. eating habits, physical activity, and “screen time”) were also examined. After controlling for parental psychopathology, family income, child’s gender, and child’s body mass index, externalizing behaviors, aggressive behaviors, and anger predicted a relatively high body mass index. Exploratory analyses did not support hypothesized mediators, although low power was an issue.
Lay beliefs about autism spectrum disorder among the general public and childcare providers
Authors: Mitchell Gwen E , Locke Kenneth D
Published: May 2014

We conducted a survey of beliefs about autism among the general public in the United States and Canada ( n = 823) and among individuals working in childcare facilities in the state of Idaho ( n = 176). Results included the following. Almost all respondents correctly believed that autism’s primary causes are genetic and neurological (not parenting, drugs, or current diet), that it can be identified in early childhood, and that helpful interventions exist. Respondents generally distinguished diagnostic from non-diagnostic traits, but approximately half incorrectly labeled constant squirming as diagnostic and difficulties in making friends as non-diagnostic. College graduates and childcare workers were more likely to have learned about autism in professional/academic settings and to correctly recognize diagnostic traits. Of concern, 10% of respondents considered vaccinations to be among the two main causes of autism. Accurate public understanding of autism spectrum disorders can facilitate early identification and effective intervention; our results suggest that efficient channels for conveying accurate information include broadcast and online media (from which the general public, especially members of ethnic minority groups, were most likely to learn about autism), and professional development courses for childcare providers.
“I'm just trying to be tough, okay”: Masculine performances of everyday practices
Authors: Collier Diane R.
Published: May 2014

Everyday cultural resources that originate outside school offer possibilities for multimodal creativity and identity play, as children consume, transform and produce multimodal texts. In this study, Kyle, a boy in elementary school, fluidly performed social identities and engaged in playful and parodic rescripting of identities and resources from everyday culture, such as professional wrestling and rap music. In this paper, I posit that (1) Kyle and his family understood and experienced professional wrestling in contradictory ways as both taboo and appealing, (2) Kyle’s deep knowledge of the genre of professional wrestling as performative text allowed him to use it in playful and parodic ways, (3) this playful approach to wrestling and other masculine identities, made available through Kyle’s culture, constitutes a form of improvisation and can be explained as a form of masculine melodrama and (4) the role of audiences is key in the reflexive performance of masculine identities.
A new perspective on market dynamics
Authors: Nenonen Suvi , Kjellberg Hans , Pels Jaqueline , Cheung Lilliemay , Lindeman Sara , Mele Cristina , Sajtos Laszlo , Storbacka Kaj
Published: May 2014

Several researchers have pointed out that if marketing is to develop as a discipline and contribute to solving complex business and societal challenges, it should question the neoclassical view of markets and develop its own theory of markets. Efforts in this direction indicate an emerging view of markets as dynamic, subjective, and subject to multiple change efforts. However, the neoclassical view of objective, detached, and deterministic market still influences the dominant models used to describe market change. We argue that in order to better understand market dynamics, both academics and practitioners need new concepts and constructs that go beyond existing linear process and development stage models. We seek to contribute to improved understanding of markets by studying a special characteristic of markets that enables market dynamics. Borrowing a term used by Alderson (1957: 277), we propose that markets are characterized by plasticity, that is, a “potentiality for being remolded and responding in a different way thereafter.” Even though the plasticity concept was introduced into the marketing literature nearly 60 years ago, the plastic character of markets remains underresearched. This article investigates the meaning and manifestations of market plasticity, drawing analogies from the physical, natural, and social sciences. We define market plasticity as the market’s capacity to take and retain form and propose that the dialectic between market stability and market fluidity lies at the heart of market change.
Effect of processing parameters on free surface electrospinning from a stepped pyramid stage
Authors: Jiang Guojun , Zhang Sai , Qin Xiaohong
Published: May 2014

In this study, an improved free surface electrospinning was applied to large-scale production of polyvinyl alcohol nanofibers by utilizing a stepped pyramid stage. Multiple polymer jets were observed to form on the edges of the stepped pyramid stage. The influences of operating parameters (e.g. polymer solution concentration, applied voltage and collecting distance) on fiber diameter as well as productivity were experimentally investigated. Response surface methodology was utilized to obtain a quantitative relationship between selected electrospinning parameters and the average fiber diameters as well as the productivity, and the analysis of variance has been used to the statistical validation of regression models. Adjusted R-squared was found to be 98.79% and 98.55% for the fiber diameter and productivity, respectively. The results indicated that the solution concentration had a statistically significant effect on the fiber diameter and the applied potential influence, largely on the productivity.
Theoretical analysis and 2D simulation of clean oil flowing through nonwoven
Authors: Feng Jianyong , Zhang Jianchun
Published: May 2014

A green and biodegradable hemp/cotton spunlaced nonwoven was developed to research oil flowing property and practical application. The filtration area of nonwoven and flux of experimental oil have great influence on pressure drop. Filtration area, thickness, mean pore diameter, porosity, and fiber diameter of hemp/cotton spunlaced nonwoven, flux, and density of experimental oil are used to verify previous pressure drop theories and permeability coefficients. The results demonstrate that Reynolds number of hemp/cotton spunlaced nonwoven at different fluxes is small (Re <1) at the state of laminar flow. Through 2D simulation of oil flowing through porosities of hemp/cotton spunlaced nonwoven on the basis of uniformly and disorderly arrangement fiber model, the results indicate that streamline of oil is curve in porosities in the case of fiber disorderly arrangement model. This paper mainly focuses on combining with practical application and theoretical simulation for better understanding the streamline shape and pressure drop distribution in the pores of material as clean oil flowing through porous nonwoven.
Needs Assessments of Memory Disorder Patients
Authors: Bowen Kate J. , Gonzalez Elizabeth W. , Edwards Carolyn Y. , Lippa Carol F.
Published: May 2014

Background:

Previous research shows that informal caregivers of individuals with a memory disorder experience financial strain, declining physical health, and psychological distress. Various resources and services have been developed to address and/or prevent these potential outcomes, yet caregivers continue to be negatively affected by the demands of caregiving. We hypothesize that better identification and clarification of concrete patient and caregiver needs will aid in the modification and improvement of the available resources. The purpose of this study is to determine the psychosocial needs of the cognitively impaired population and their caregivers.

Methods:

A one-page Needs Assessment was created to address areas of potential concern for the individual with a memory disorder and the caregiver. This assessment was administered during visits to an outpatient clinic in Philadelphia.

Results:

A total of 204 Needs Assessments were collected. The significant needs found in our study cohort include sleep, exercise, clinical trials, education, and assistance with ADLs and IADLs.

Conclusions:

This study satisfied the initial identification of caregiver and patient needs; now each must be explored further to determine how to successfully meet such needs. If the primary needs of the patient can be met by a focused service, the caregiver will no longer be the sole provider of meeting the specific need. This will decrease the involved role of the caregiver, maximize patient homecare, minimize caregiver stress, and increase the quality of life for both the patient and caregiver.
The Role of Relapse Prevention and Goal Setting in Training Transfer Enhancement
Authors: Rahyuda Agoes , Syed Jawad , Soltani Ebrahim
Published: May 2014

This article reviews the effect of two post-training transfer interventions (relapse prevention [RP] and goal setting [GS]) on trainees’ ability to apply skills gained in a training context to the workplace. Through a review of post-training transfer interventions literature, the article identifies a number of key issues that remain unresolved or underexplored, for example, the inconsistent results on the impact of RP on transfer of training, the lack of agreement on which GS types are more efficient to improve transfer performance, the lack of clarity about the distinction between RP and GS, and the underlying process through which these two post-training transfer interventions influence transfer of training. We offer some recommendations to overcome these problems and also provide guidance for future research on transfer of training.
Hookah Smoking in High School Students and Its Determinants in Iran
Authors: Fakhari Ali , Mohammadpoorasl Asghar , Nedjat Saharnaz , Sharif Hosseini Mohammad , Fotouhi Akbar
Published: May 2014

Hookah smoking has increased worldwide, especially among youth, and has been identified as an emerging threat to public health. The aim of the present study was to estimate the prevalence and transition rates in hookah smoking statuses and predictors of transitions among a representative sample of Iranian high school students. In this longitudinal study, a representative sample ( n = 5197) of students in the northwest of Iran was assessed thrice with a 6-month interval in 2010 and 2011. A self-administered questionnaire was used to measure hookah smoking, demographic characteristics, and personal and environmental factors. In total, the prevalence of hookah use (at least once a month) in this study was 6.0% (95% confidence interval [CI] = 5.1, 6.9). Results indicated that 44.9% (95% CI = 43.0, 46.7) of the students in the sample at least tried hookah smoking. During 1 year, 18.5% and 1.5% of students who have never used hookah before had transitioned to experimenter and regular hookah smoking, respectively, and notably, 7.8% of experimenters had transitioned to regular hookah smoking. Adjusted for other factors, being male, regular cigarette smoking, and positive attitude toward smoking were factors associated with students’ transition to hookah smoking status. The incidence rate of hookah smoking in adolescents is notable. The findings identified the co-occurrence of risky behaviors that support programs aimed at reducing or preventing high-risk behaviors simultaneously.
Wacky races: Miller, Pogge and Rawls, and conceptions of development in the global justice debate
Authors: Williams Huw L
Published: May 2014

David Miller criticises Thomas Pogge for placing excessive emphasis on the global environment in identifying the sources of global poverty. Miller argues that despite some structural obstacles, ‘careful drivers’ are able to negotiate their way along the road to development and it is wrong to place responsibility solely on those who have constructed the route. This article questions the analogy. It is argued that the complexities of global poverty make any attempt to identify straightforward outcome responsibility problematic, and that both Miller and Pogge’s interpretations of its causes may be regarded as partial. Furthermore, the analogy deployed by Miller reflects a reified notion of development, either explicit or assumed in arguments on global justice. An analogy of development as an anarchic car race is presented to initiate these criticisms, and as a premise for articulating John Rawls’ duty of assistance as a promising alternative – one that avoids the question of outcome responsibility, while being less prone to the accusation of ‘parochialism’.
Brown’s Paradox: Speed, ressentiment and global politics
Authors: Glezos Simon
Published: May 2014

This article is an engagement with the effects of speed in global politics through the lens of what it terms “Brown’s Paradox,” Wendy Brown’s insight that, in a radically accelerating world we “feel a greater political impotence than humans may have felt before, even as we occupy a global order more saturated by human power than ever before.” It begins by discussing the two dominant responses to Brown’s Paradox: the first, the neoliberal embrace and valorization of the uncertainty of an accelerating world, and the second, the reactionary attempt to aggressively (re)secure the foundations of politics and society (in this latter discussion, the article engages with the specific case study of the treatment of Tamil refugees in Canada). The discussion of this latter approach will lead us to the central concept of this article, the idea of a ressentiment against speed. The article will discuss how this ressentiment inhibits our ability to productively respond to the challenges of an accelerating world, while at the same time frequently authorizing policies of violence, marginalization, and exploitation against those constituencies which are already most subject to the conditions of accelerating globalization. Conversely, this understanding of ressentiment against speed will be used to point the way to a politics which, while not resolving the contradiction inherent in Brown’s Paradox, might teach us to live with it—and within it—in a productive and ethical manner.
Iron-deficiency anaemia
Authors: Hussain Nazia
Published: May 2014

Iron-deficiency anaemia is the most common nutritional deficiency around the world. This article looks at the presentation, causes and management of a common and potentially serious condition in general practice.
Global Brain and the Future of Human Society
Authors: Last Cadell
Published: May 2014

The Global Brain is a leading hypothesis explaining the current evolution of the human system. Recent multidisciplinary research at the Global Brain Institute has laid a potential framework for thinking about the future of human society within the context of the emergence of a global brain this century. In this article, I outline the theory of challenge propagation and explain how this theory can help us formulate an empirical understanding of the future of individual and collective human experience with a global brain. This includes a prescriptive and predictive analysis of the future of governance and religion. The article invites discussion as well as critical and constructive feedback as its sole purpose is to stimulate a decentralized discussion that will help us all better understand the future of human organization in the twenty-first century.
Stent thrombosis in a patient with high on-treatment platelet reactivity despite ticagrelor treatment
Authors: Musallam Anees , Lev Eli I , Roguin Ariel
Published: May 2014

We describe, to the best of our knowledge, the first incidence of stent thrombosis in a patient treated with ticagrelor, who exhibited high on-treatment platelet reactivity (HTPR) according to platelet reactivity testing. He was on clopidrogel and tested for platelet reactivity using the VerifyNow P2Y12 assay. The test showed a PRU of 249 and only 12% platelet inhibition. The patient was then switched to ticagrelor, with a loading dose of 180 mg given. The patient had stent thrombosis three weeks later with an acute myocardial infarction (MI). The patient had good platelet inhibition when started on Ticagrelor treatment (PRU=33), but had HTPR when the stent thrombosis occurred three weeks later (PRU=339).
A note on recent fixed point results involving g-quasicontractive type mappings in partially ordered metric spaces
Authors: Karapınar Erdal , Samet Bessem
Published: May 2014

In this note, we establish the equivalence between recent fixed point theorems involving quasicontractive type mappings in metric spaces endowed with a partial order.

MSC:47H10.
The effect of foot orthoses and in‐shoe wedges during cycling: a systematic review
Authors: Yeo Boon K , Bonanno Daniel R
Published: May 2014

Background

The use of foot orthoses and in‐shoe wedges in cycling are largely based on theoretical benefits and anecdotal evidence. This review aimed to systematically collect all published research on this topic, critically evaluate the methods and summarise the findings.

Methods

Study inclusion criteria were: all empirical studies that evaluated the effects of foot orthoses or in‐shoe wedges on cycling; outcome measures that investigated physiological parameters, kinematics and kinetics of the lower limb, and power; and, published in English. Studies were located by data‐base searching (Medline, CINAHL, Embase and SPORTDiscus) and hand‐searching in February 2014. Selected studies were assessed for methodological quality using a modified Quality Index. Data were synthesised descriptively. Meta‐analysis was not performed as the included studies were not sufficiently homogeneous to provide a meaningful summary.

Results

Six studies were identified as meeting the eligibility criteria. All studies were laboratory‐based and used a repeated measures design. The quality of the studies varied, with Quality Index scores ranging from 7 to 10 out of 14. Five studies investigated foot orthoses and one studied in‐shoe wedges. Foot orthoses were found to increase contact area in the midfoot, peak pressures under the hallux and were perceived to provide better arch support, compared to a control. With respect to physiological parameters, contrasting findings have been reported regarding the effect foot orthoses have on oxygen consumption. Further, foot orthoses have been shown to not provide effects on lower limb kinematics and perceived comfort. Both foot orthoses and in‐shoe wedges have been shown to provide no effect on power.

Conclusion

In general, there is limited high‐quality research on the effects foot orthoses and in‐shoe wedges provide during cycling. At present, there is some evidence that during cycling foot orthoses: increase contact area under the foot and increase plantar pressures under the hallux, but provide no gains in power. Based on available evidence, no definitive conclusions can be made about the effects foot orthoses have on lower limb kinematics and oxygen consumption, and the effect in‐shoe wedges have on power during cycling. Future well‐designed studies on this topic are warranted.
Mathematical analysis of the sodium sensitivity of the human histamine H3 receptor
Authors: Wittmann Hans-Joachim , Seifert Roland , Strasser Andrea
Published: May 2014

Purpose

It was shown by several experimental studies that some G protein coupled receptors (GPCR) are sensitive to sodium ions. Furthermore, mutagenesis studies or the determination of crystal structures of the adenosine A2A or δ-opioid receptor revealed an allosteric Na+ binding pocket near to the highly conserved Asp2.50. Within a previous study, the influence of NaCl concentration onto the steady-state GTPase activity at the human histamine H3 receptor (hH3R) in presence of the endogenous histamine or the inverse agonist thioperamide was analyzed. The purpose of the present study was to examine and quantify the Na+-sensitivity of hH3R on a molecular level.

Methods

To achieve this, we developed a set of equations, describing constitutive activity and the different ligand-receptor equilibria in absence or presence of sodium ions. Furthermore, in order to gain a better understanding of the ligand- and Na+-binding to hH3R on molecular level, we performed molecular dynamic (MD) simulations.

Results

The analysis of the previously determined experimental steady-state GTPase data with the set of equations presented within this study, reveals that thioperamide binds into the orthosteric binding pocket of the hH3R in absence or presence of a Na+ in its allosteric binding site. However, the data suggest that thioperamide binds preferentially into the hH3R in absence of a sodium ion in its allosteric site. These experimental results were supported by MD simulations of thioperamide in the binding pocket of the inactive hH3R. Furthermore, the MD simulations revealed two different binding modes for thioperamide in presence or absence of a Na+ in its allosteric site.

Conclusion

The mathematical model presented within this study describes the experimental data regarding the Na+-sensitivity of hH3R in an excellent manner. Although the present study is focused onto the Na+-sensitivity of the hH3R, the resulting equations, describing Na+- and ligand-binding to a GPCR, can be used for all other ion-sensitive GPCRs.
Fixin’ To: THE EMERGENCE OF AN AMERICAN Quasi-Modal
Authors: Myers Jay L.
Published: May 2014

The Southern American English expression fixin’ to has its roots in the lexical verb to fix. The expression has developed in English for over six centuries, from a concrete transitive verb of Latin origin, through intransitive phases that included complements of either for + gerund or nonfinite verb phrases, and eventually to a quasi-modal with both deontic and epistemic senses of assessment, acknowledgement, and response to compelling or obligating circumstances. Syntactic and semantic tests are offered to argue that fixin’ to clearly belongs in the family of American English quasi-modals, which also includes be bound to, be going to, and be supposed to. It is hypothesized that the expression bears a special semantic value implying that the speaker (1) is aware of and has evaluated a situation; (2) acknowledges a resulting pressing obligation or compulsion—typically, but not always, in the first person—to act/to happen; and (3) is preparing to address the situation forthwith. Finally, it is claimed that this special semantic value of fixin’ to is why the expression has withstood the pressures of stigmatization and remains in the everyday lexicon of Southern American English Speakers.
The mechanics and behavior of Cliff Swallows during tandem flights
Authors: Shelton Ryan M. , Jackson Brandon E. , Hedrick Tyson L.
Published: May 2014

Cliff Swallows (Petrochelidon pyrrhonota) are highly maneuverable social birds that often forage and fly in large open spaces. Here we used multi-camera videography to measure the three dimensional kinematics of their natural flight maneuvers in the field. Specifically, we collected data on tandem flights, defined as two birds maneuvering together. These data permit us to evaluate several hypotheses on the high-speed maneuvering flight performance of birds. We found that high speed turns are roll-based, but that the magnitude of the centripetal force created in typical maneuvers varied only slightly with flight speed, typically reaching a peak of ~2 body weights. Turning maneuvers typically involved active flapping rather than gliding. In tandem flights the following bird copied the flight path and wingbeat frequency (~12.3 Hz) of the lead bird while maintaining position slightly above the leader. The lead bird turned in a direction away from the lateral position of the following bird 65% of the time on average. Tandem flights vary widely in instantaneous speed (1.0 to 15.6 m s-1) and duration (0.72 to 4.71 s), and no single tracking strategy appeared to explain the course taken by the following bird.
Challenges in Designing Pre-School Education Standard
Authors: �����  , Mayer Aleksey , ���������  , Timofeeva Liliya
Published: May 2014

The positions of system approach in the development of preschool educational standard are represented due to the contest of social, economic, demographic,

psychological, pedagogical and law changes. It is considered that family dysfunctions, the long-time strategy absence and neglect of the

preschool progressive practice are determining the actual situation of the childhood development.

The key directions and risks of preschool educational standard introduction are analyzed. The preschool education had been analyzed due to basic

features � object, content, technology and result. It determined the data in the projection of the standard in preschool education. It was shown that

underestimation of the basic process in preschool education represented a real threat to the quality of standard.

The actual problems in standardization are detected. It can help to determine the optimal directions in the realization of federal educational standard of

preschool education according to the practice of educational organizations.
GRADUATION DETERMINANTS OF PRODUCTIVE SAFETY NET PROGRAM BENEFICIARY HOUSEHOLDS: A LOGISTIC ANALYSIS, TIGRAI-ETHIOPIA
Authors: Gebresilassie Yibrah Hagos
Published: May 2014

Household food security issues have become the concern of international communities as well as national government of Ethiopia. Social safety nets (like Productive Safety Net Program in Ethiopia) are programs that offer protection to poor rural people by providing income through transfer programs and employment opportunities. The main objective of this study was to identify the major graduation determinants of Productive safety Net Program beneficiary rural households using a logistic regression technique from a total of 400 sample respondents using Eastern zone of Tigrai regional national state, northern Ethiopia, as case study site. The researcher was initially identified about sixteen predicting factors of which just ten of them were found to be statistically significant, and all exhibited the expected signs. Regression results revealed thatan introduction to integrated agricultural package make use of, male-headed household, age squared of the household head, educational status of the household head, saving culture, male adults, non-government organizations follow-up, access to credit, access to petty trading and irrigation have led productive safety net program beneficiary households to have more probability of graduation. Finally, it is recommended that assisting farming rural households to diversify and expand their sources of income in order to be able to meet their minimum food requirement and graduate soon through the provision of integrated agricultural packages. Besides, program participants should be followed up by non-government organizations and highly engaged in petty trading to graduate sooner, boost their income and food secure.
The morphological peculiarities of the cerebrum arteries under the hemorrhagic and ischemic stroke in the patients with the metabolic syndrome
Authors: Chuiko Natalia
Published: May 2014

In this article, the results of the morphological study of the cerebral arteries in the patients with the hemorrhagic ischemic stroke on the background of metabolic syndrome were submitted. We established that under hemorrhagic stroke on the background of metabolic syndrome one could observe the atherosclerotic damages in the form of plaques, hyalinosis of vessels walls, destructive and necrotic changes of the middle coat of vessel wall, which are, in our opinion, the main reason in morphogenesis of hemorrhagic stroke. The atherosclerotic affection of the cerebral vessels with the lipidosis and fibrotic plaques in the vessel wall, which caused in disorganization of the vessel wall in the form intimae proliferation, structural reconstruction of the internal elastic membrane which resulted in narrowing of the vessel lumen and development of ischemia is the morphological basis for the ischemic stroke with the metabolic syndrome.     Also diabetic microangiopathy with the development of the hyalinosis, vessels walls sclerosis, which provoked the microcirculatory and metabolism processes injury in the cerebral substance that complicate the disease course is the important factor of cerebral blood circulation damage.
Comparing standard primigravidae and low parity women in Tanzania
Authors: Kidanto HL , Fadhlun MA , Projestin M
Published: May 2014

The concept of standard primigravidae is relatively new and has only been used in the past twenty years. It is a tool to assess performance of different obstetric units taking into account the similarities. This study was conducted to determine the proportion of standard primigravid women and compare their pregnancy outcome with women of low parity delivering at Muhimbili National Hospital, Dar es salaam, Tanzania. This is a cross-sectional study carried out from July to December 2007. A total of 775 women were analysed; 296 were standard primigravidae and 479 were women of low parity.

The standard primigravid group had a higher emergency caesarean section rate compared to women of low parity. Augmentation of labour and episiotomies were more often given to standard primigravid compared to the low parity group. There were higher rates of prolonged labour and fetal distress than the low parity women. There were lower Apgar scores (LAS) in the primigravid group than in the low parity group. Neonatal unit admissions were more compared to low parity women and the proportion of birth asphyxiated neonates was higher in the standard primigravidae.

This study found that standard primigravidae have a slightly higher risk of poor pregnancy outcome compared to low parity women. There is a need for a more aggressive intrapartum monitoring system in this group.
Emergency referral transport needs of pregnant women in rural Tanzania
Authors: Mlay Rose , Chuwa Mary , Smith Helen
Published: May 2014

For pregnant women in rural Africa, delays in reaching a health facility are inevitable. When complications occur, unless transport is found quickly to reach a facility providing essential obstetric care promptly, morbidity and mortality are common outcomes. The study aimed to explore the emergency transport needs of rural pregnant women in Erri village, Babati District, Tanzania. Communities were selected purposefully. A crosssectional design was used, 250 women of childbearing age were interviewed, 12 men and 12 women participated in focus group discussions (FGD), and 7 women were interviewed using the critical incidence technique. Information on community awareness of women's needs for locally available and functional transport for emergency obstetrics referrals was obtained using a structured questionnaire, FGD and critical incident interviews. The questionnaire revealed that 75% of women with 7 years of school in this study, were more likely to seek help from the district hospital than women with 5 or fewer years of schooling. Women who lived nearer to emergency obstetric facilitates were more likely to use these facilitates than those living far away. Having a bicycle in a household did not influence the woman's decision about where to seek help during an emergency. Seventy percent of respondents (43/61) who used a bicycle revealed that when women encounter emergencies it takes more than half a day to reach the district hospital. Almost every participant declared the hardship in accessing emergency obstetric care related to lack of funds and unavailability of the transport. During FGD women shared stories of mothers and newborns who had died on their way to emergency obstetric care. The study provides a small insight into the referral transport needs of pregnant women living in rural communities in Manyara region. Further participatory research is necessary to identify reliable and affordable transport options acceptable to pregnant women and their families; and evaluation is required to estimate the impact of emergency referral programmes on referral times and operational feasibility.
Framework analysis: a method for analysing qualitative data
Authors: Furber Christine
Published: May 2014

Framework analysis is now an established method of data analysis used by many qualitative researchers. The method was developed by specialist researchers exploring important aspects of society in order to influence social policy in the UK. The method has five distinct phases that are interlinked and form a methodical and rigorous framework. These phases enable researchers to understand and interpret data, and move from descriptive accounts to a conceptual explanation of what is happening from the data of participants in the study. The method is transparent and enables teams of researchers to work together. In this article, the phases of framework analysis are explained. The author uses examples of a qualitative research study where data were analysed using the framework method to illustrate the phases.
Question box: a tool for gathering information about HIV and AIDS
Authors: Kazembe Abigail
Published: May 2014

Previous studies on knowledge of HIV transmission and prevention have used surveys. This study used the question box method to create a safe environment for collecting information on knowledge of HIV transmission and prevention. The aim was to encourage young people to ask questions about HIV, which they would otherwise not ask because of fear of being judged negatively, ridiculed, punished or stigmatized. Seven question boxes were placed at each community secondary school in Lilongwe Rural West District of Malawi. In total participants asked 394 questions. Six categories of questions emerged and included: general questions about HIV, sexual practices, perinatal transmission, other modes of transmission, contact/sharing items and prevention and condom use. The question box method created a safe environment for asking sensitive questions anonymously about HIV and AIDS.
Partograph use among midwives in the Gambia
Authors: Badjie Burama , Kao Chien-Huei , Gua Meei-ling , Lin Kuan-Chia
Published: May 2014

The purpose of this study was to determine factors related to utilisation of the partograph in three health regions of the Gambia. The study consisted of 120 participants who completed a self-administered semi-structured questionnaire, which demonstrated a statistically significant difference in knowledge levels among registered, state-enrolled and community health midwives. The results also showed significant differences within the workplace of midwives regarding knowledge and utilisation of the partograph. Overall, the knowledge level of the midwives about the utilisation of the partograph was good (80%), and on average 78% of the midwives were utilising the tool to monitor women in labour. These findings may help the Ministry of Health and Social Welfare address the gaps identified in midwives’ knowledge and use of the partograph.
Knowledge, views and practices of mothers regarding postnatal care at Zomba Central Hospital, Malawi
Authors: Sakala Betty
Published: May 2014

Background:

Two thirds of all women who deliver in an urban hospital in Malawi do not return for postnatal care at 1 and 6 weeks after labour. Factors that influence their postnatal visit are not well established.

Aim:

This study investigates factors influencing the attendance at postnatal visits at 1 and 6 weeks among mothers at Zomba Central Hospital in Malawi. Specifically, the study assessed mothers' knowledge about postnatal care at 1 week and 6 weeks, and determined the characteristics of mothers who did or did not attend postnatal appointments on these dates.

Method:

A descriptive quantitative, cross-sectional study was conducted to assess mothers' knowledge. Data were collected using a structured interview. A convenient sample of 154 mothers participated in the study. Ethical approval was obtained from the Malawi College of Medicine Ethical Review Board. Data were analysed using SPSS.

Findings:

A sample of 154 mothers participated in the study who were all attendees at an under-fives clinic and had infants who were between 8 weeks and 12 months old. More than 75% of participants were aged between 20 and 30 years old. The main factor that hindered attendance was lack of advice given by midwives to return for postnatal care. Awareness of postnatal services, mothers' educational level and growth monitoring all promoted utilisation of postnatal care at 1 and 6 weeks. These findings have implications for training and practice: training institutions should emphasise the importance of postnatal care at 1 and 6 weeks; and, with reference to practice, supervisors of midwives should ensure that mothers are booked for postnatal care at 1 week and 6 weeks.
Depression during pregnancy may affect babies development
Authors: Bainbridge Jane
Published: May 2014

Research in Singapore has found that children born to women who suffer from depression during pregnancy are likely to develop depression also
Rewards and opportunities in rapid-access chest-pain clinics
Authors: Keenan Jan
Published: May 2014

Rapid-access chest-pain clinics have existed in some areas for several years, but the introduction of the National Service Framework for Coronary Heart Disease (DH, 2000) made a ‘rapid-access’ approach to assessment and management of new-onset stable angina the gold standard. However, little has been written about the development of these clinics and there is little research evidence that they are a cost-effective approach to the organization of patient care. This paper offers an insight into the development of chest-pain clinics and describes one model of a nurse-led service.
Measuring cardiac output using the PiCCO system
Authors: King Deborah , Price Ann M
Published: May 2014

Deborah King and Ann M Price discuss how the system works and provide practical advice on appropriate use
Letters
Authors: Riley Jillian
Published: May 2014

I read with interest your report of the recent annual meeting of BANCC published in your August edition (British Journal of Cardiac Nursing vol. 3 no 8, p368). However I wish to make a few comments upon your reporting of the Home- HF study.
Developing a culturally appropriate cardiac rehabilitation programme for Bengali speakers
Authors: Colley Judith , Whitfield Debbie , Grayer Justin
Published: May 2014

South Asian people living in the United Kingdom have an increased risk of coronary heart disease compared with Caucasians. However, the South Asian community is under-represented in phase III cardiac rehabilitation (CR) attendance. This article describes the development and content of a community-based phase III CR programme for a local Bengali-speaking population in East London. Adaptations to a standard CR programme—such as single-sex groups; shorter, more frequent sessions; avoiding important religious times; and sufficient advocacy provision—are discussed. Facilitating factors and barriers to the development of the CR programme are considered as well as areas for future development.
Updated NICE guidance on chronic heart failure
Authors: Riley Jillian P
Published: May 2014

Jillian Riley presents an overview of the recently updated guidance from the National Institute for Health and Clinical Excellence on the diagnosis and management of chronic heart failure
Exercise-based rehabilitation for heart failure
Authors: Linden Belinda
Published: May 2014

As part of our series keeping you up-to-date with developments in evidence-based practice,Belinda Linden presents a summary of the Cochrane Collaboration systematic review of studies relating to exercise-based cardiac rehabilitation in patients with heart failure
Will High Impact Actions help in HF?
Authors: Tagney Jenny
Published: May 2014

The changes are coming thick and fast from the new government. The latest was launched in the North of England as this issue went to press: a new, 3 digit ‘non-emergency’ number for people to call for health information and advice (111). It appears the phones will be staffed by non-clinical personnel ‘supported’ by nurses. We await evaluation with interest—or will it just be rolled out anyway?
ECG of the month
Authors: Regan Claire
Published: May 2014

Clare Regan presents an ECG for you to analyse. The answer is given on page 431
Joined-up working for nurses and physiologists: Does it work?
Authors: Cole Jennifer , Meldrum Nicola
Published: May 2014

Jennifer Cole and Nicola Meldrum discuss their team's experience of a highly collaborative approach to cardiac rhythm management, with specialist nurses taking on some of the role of cardiac physiologists
Cardiac rehabilitation: motivation and commitment
Authors: Sage Shelley
Published: May 2014

Cardiac rehabilitation reduces morbidity and mortality following cardiac events and interventions. It is a cost-effective but under-used treatment. Many patients who are invited to attend do not engage with or complete these programmes, therefore missing out on the resources available from multidisciplinary teams to improve their health and reduce their risk of further heart disease. Delivering cardiac rehabilitation in ways that are sensitive to the needs of people, irrespective of their age, gender, comorbidities, ethnicity or economic status, is essential. By building collaborative relationships with patients, respecting their autonomy and supporting their ability to make changes, it is possible to ensure that more patients are committed to achieving their cardiac rehabilitation goals by completing the programme.
Description of a module on the theory and practice of reflection
Authors: Rafferty Michael , Lewis David , Mabbett Gaynor , Vine Janet
Published: May 2014

This paper is a description of a module to prepare community studies students for reflective practice skills, and which provides a model of collaboration between service and educational practitioners. Details are given of the taught, experiential and organisational elements of the programme and the practice issues examined are also identified.

Group process issues indicate that formal reflective practice may create uncertainty and anxiety due to the need to share practice thinking and actions. Strategies and interventions are identified to contain such inevitable reactions, which centre upon informed consent, consideration of feelings and the establishment of the conditions necessary for trust. Student evaluations of the module indicate both scepticism about, and hope for, formal reflection upon practice.

The issues arising from this module have relevance to all practitioners engaged in reflective practice and clinical supervision.