bluuebunny/crossref_metadata_2025 huggingface dataset:
Morphology of accessory structures of the humpback whale (Megaptera novaeangliae) eye
Authors: Rodrigues Fernanda M. , Silva Fernanda M. O. , Trompieri‐Silveira Ana C. , Vergara‐Parente Jociery E. , Miglino Maria A. , Guimarães Juliana P.
Published: May 2014

The humpback whale (Megaptera novaeangliae) has a cosmopolitan distribution and inhabits coastal and oceanic habitats, being present in polar and tropical waters. In aquatic mammals, vision has an important role in the perception of photoperiod changes. Due to lack of information on the morphology of Mysticetes, this study aimed to provide a morphological description of the adnexal structures of the humpback whale eye. Three newborn female specimens, stranded on the coast of Sergipe, Brazil, were used. Samples were fixed in a 10% formalin solution, dissected and photographed, and all the structures were collected and analysed using different light microscopy techniques. Eyelids were characterized by a palpebral fissure, a palpebral opening, two grooves (dorsal and ventral) and the presence of mechanoreceptors in the dermis. Some fibres of the four recti muscles had palpebral, scleral and glandular insertions. The Harderian gland filled the area between the orbit wall and the eyeball. Two vascular networks separated the extraocular retractor muscle of the eye and surround the optic nerve. The morphology of the accessory structures of the humpback whale eye was similar to that of other cetaceans, which suggests an adaptation to diving during migration, contributing to the perception of temperature difference in different regions.
Treatment for constipation: New and old pharmacological strategies
Authors: Lacy B. E. , Hussain Z. H. , Mearin F.
Published: May 2014

Background

Constipation is a very common entity. Despite the high prevalence, treatment of constipation remains problematic.

Purpose

Review the current literature on new and existing constipation treatment modalities.
Resource Letter Exo-1: Exoplanets
Authors: Perryman Michael
Published: May 2014

This Resource Letter gives an introduction to the main topics in exoplanet research. It is intended to serve as a guide to the field for upper-division undergraduate and graduate students, both theoretical and experimental, and for workers in other fields of physics and astronomy who wish learn about this new discipline. Topics include historical background, detection methods, host star properties, theories of planet formation and evolution, their interiors and atmospheres, their relationship to the formation and evolution of our own solar system, and issues of life and habitability.
Orbits of massless particles in the Schwarzschild metric: Exact solutions
Authors: Muñoz Gerardo
Published: May 2014

The problem of finding all the orbits of test particles in the exterior Schwarzschild black hole metric has an exact solution in terms of elliptic functions. In this paper, we develop in detail the case of massless particles, including a derivation of an exact formula for the deflection of light. It is shown that the mass of the black hole can be determined from a simple relationship between the angular deflection and the time delay of neighboring light rays.
Molecular simulation of ibuprofen passing across POPC membrane
Authors: Liu Wei , Zhang Shijun , Meng Fancui , Tang Lida
Published: May 2014

Permeability assessment is an important procedure in the drug development process, and drug partitioning in membrane bilayer is related to permeability. To investigate the pH dependence on drug partitioning, the process of different ionization state of ibuprofen passing across POPC bilayer was studied using molecular dynamics simulation. The results show that both atomic charge scheme and ionization state of the drug affect the value and shape of energy profile when passing across the POPC bilayer. The neutral ibuprofen (ibuprofen under acidic condition) has a much lower energy barrier as compared with the anionic ibuprofen (ibuprofen under basic condition). Meantime, hydrogen bond analysis also certifies that it is easy for neutral ibuprofen to pass from bulk water to bilayer center. Our calculation suggests that the ionization state of ibuprofen may be changed between neutral and anionic state when passing across membrane: it may be ionized outside the membrane and neutralized inside the membrane.
PLASMON RESONANCE AND RAMAN MODES IN Pb NANOPARTICLES OBTAINED IN EXTRACT OF OPUNTIA FICUS-INDICA PLANT
Authors: RAMÍREZ-RODRÍGUEZ L. P. , CORTEZ-VALADEZ M. , BOCARANDO-CHACON J.-G. , ARIZPE-CHÁVEZ H. , FLORES-ACOSTA M. , VELUMANI S. , RAMÍREZ-BON R.
Published: May 2014

Colloidal nanoparticles were obtained by green synthesis, embedded in the Opuntia ficus-indica plant extract. Optical measurements allowed us to detect two absorption bands centered in 230 nm and 298 nm. Agglomerates of Pb nanoparticles have size in the range 2–8 nm. The effective absorption cross section of spherical Pb nanoparticles was calculated by applying the Mie theory for colloidal systems and compared to optical absorption measurements of Pb nanoparticles. The Raman spectrum of the samples after the reduction of Pb , shows a band at low wavenumbers centered at 116 cm-1. Similar bands have been assigned to small Pb and Ag clusters in other experimental results. Additionally, we used the density functional theory (DFT) as well as semi-empirical methods to assign this band to radial breathing modes of Pb metal nanoparticles.
STUDY ON PL ENHANCEMENT OF InGaAs/GaAs QUANTUM WELL EMISSION BY GOLD NANOPARTICLE ARRAYS
Authors: GAO HONGWEI , TENG JINGHUA , CHUA SOOJIN , XIANG NING
Published: May 2014

In this paper, enhancement of photoluminescence (PL) intensity from InGaAs / GaAs quantum well (QW) caused by coupling effect of surface plasmon (SP) resonance generated by Au nanodisk arrays with QW emission is demonstrated experimentally. To increase the coupling efficiency, a thin layer of SiO 2 is introduced between Au nanodisk and GaAs surface. To match SP wavelength with QW emission wavelength (945 nm), Au nanodisk arrays with periodicity of 290 nm, radius of 70 nm, and thickness of 10 nm is fabricated. 2.17-fold enhancement is observed.
Use of Multiple Imputation to Correct for Bias in Lung Cancer Incidence Trends by Histologic Subtype
Authors: Yu Mandi , Feuer Eric J. , Cronin Kathleen A. , Caporaso Neil E.
Published: May 2014

Background: Over the past several decades, advances in lung cancer research and practice have led to refinements of histologic diagnosis of lung cancer. The differential use and subsequent alterations of nonspecific morphology codes, however, may have caused artifactual fluctuations in the incidence rates for histologic subtypes, thus biasing temporal trends.

Methods: We developed a multiple imputation (MI) method to correct lung cancer incidence for nonspecific histology using data from the Surveillance, Epidemiology, and End Results Program during 1975 to 2010.

Results: For adenocarcinoma in men and squamous in both genders, the change to an increasing trend around 2005, after more than 10 years of decreasing incidence, is apparently an artifact of the changes in histopathology practice and coding system. After imputation, the rates remained decreasing for adenocarcinoma and squamous in men, and became constant for squamous in women.

Conclusions: As molecular features of distinct histologies are increasingly identified by new technologies, accurate histologic distinctions are becoming increasingly relevant to more effective “targeted” therapies, and therefore, are important to track in patients. However, without incorporating the coding changes, the incidence trends estimated for histologic subtypes could be misleading.

Impact: The MI approach provides a valuable tool for bridging the different histology definitions, thus permitting meaningful inferences about the long-term trends of lung cancer by histologic subtype. Cancer Epidemiol Biomarkers Prev; 23(8); 1546–58. ©2014 AACR.
S100/Calgranulin-Mediated Inflammation Accelerates Left Ventricular Hypertrophy and Aortic Valve Sclerosis in Chronic Kidney Disease in a Receptor for Advanced Glycation End Products–Dependent Manner
Authors: Yan Ling , Mathew Liby , Chellan Bijoy , Gardner Brandon , Earley Judy , Puri Tipu S. , Hofmann Bowman Marion A.
Published: May 2014

Objective—

S100A12 and fibroblast growth factor 23 are biomarkers of cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD). We tested the hypothesis that human S100/calgranulin would accelerate cardiovascular disease in mice subjected to CKD.

Approach and Results—

A bacterial artificial chromosome of the human S100/calgranulin gene cluster containing the genes and regulatory elements for S100A8, S100A9, and S100A12 was expressed in C57BL/6J mouse (hBAC-S100) to generate a novel humanized mouse model. CKD was induced by ureteral ligation, and hBAC-S100 mice and wild-type mice were studied after 10 weeks of chronic uremia. hBAC-S100 mice with CKD showed increased fibroblast growth factor 23 in the hearts, left ventricular hypertrophy, diastolic dysfunction, focal cartilaginous metaplasia, and calcification of the mitral and aortic valve annulus together with aortic valve sclerosis. This phenotype was not observed in wild-type mice with CKD or in hBAC-S100 mice lacking the receptor for advanced glycation end products with CKD, suggesting that the inflammatory milieu mediated by S100/receptor for advanced glycation end products promotes pathological cardiac hypertrophy in CKD. In vitro, inflammatory stimuli including interleukin-6, tumor necrosis factor-α, lipopolysaccarides, or serum from hBAC-S100 mice upregulated fibroblast growth factor 23 mRNA and protein in primary murine neonatal and adult cardiac fibroblasts.

Conclusions—

Myeloid-derived human S100/calgranulin is associated with the development of cardiac hypertrophy and ectopic cardiac calcification in a receptor for advanced glycation end products–dependent manner in a mouse model of CKD. We speculate that fibroblast growth factor 23 produced by cardiac fibroblasts in response to cytokines may act in a paracrine manner to accelerate left ventricular hypertrophy and diastolic dysfunction in hBAC-S100 mice with CKD.
Rh vs pH: the role of Rhesus glycoproteins in renal ammonia excretion during metabolic acidosis in a freshwater teleost fish
Authors: Wright Patricia A. , Wood Chris M. , Wilson Jonathan M.
Published: May 2014

Increased renal ammonia excretion in response to metabolic acidosis is thought to be a conserved response in vertebrates. We tested the hypothesis that Rhesus (Rh) glycoproteins in the kidney of the freshwater common carp Cyprinus carpio play a critical role in regulating renal ammonia excretion during chronic metabolic acidosis. Exposure to water pH 4.0 (72 h) resulted in a classic metabolic acidosis with reduced plasma pHa, [HCO3-], no change in PCO2, and large changes in renal function. Urine [NH4+] as well as [titratable acidity–HCO3-] rose significantly over the acid exposure, but the profound reduction (5-fold) in urine flow rates eliminated the expected elevations in renal ammonia excretion. Low urine flow rates may be a primary strategy to conserve ions, as urinary excretion of Na+, Cl- and Ca2+ were significantly lower during the acid exposure relative to the control period. Interestingly, renal Rhcg1 mRNA and protein levels were elevated in acid relative to control groups, along with mRNA levels of several ion transporters, including the Na+/H+ exchanger (NHE3), H+ATPase and Na+/K+ATPase (NKA). Immunofluorescence microscopy showed a strong apical Rhcg1 signal in distal tubules. Taken together, these data show that renal Rh glycoproteins and associated ion transporters are responsive to metabolic acidosis, but conservation of ions through reduced urine flow rates takes primacy over renal acid-base regulation in the freshwater C. carpio. We propose that an “acid/base-ion balance” compromise explains the variable renal responses to metabolic acidosis in freshwater teleosts.
Transition from wing to leg forces during landing in birds
Authors: Provini Pauline , Tobalske Bret W. , Crandell Kristen E. , Abourachid Anick
Published: May 2014

Transitions to and from the air are critical for aerial locomotion and likely shaped the evolution of flying animals. Research on take-off demonstrates that legs generate greater body accelerations compared to wings, and thereby contribute more to initial flight velocity. Here, we explore coordination between wings and legs in two species with different wingbeat styles, and quantified force production of these modules during the final phase of landing. The same birds we studied during take-off were used: zebra finch (Taeniopygia guttata, n=4) and diamond dove (Geopelia cuneata, n=3). We measured kinematics using high-speed video, aerodynamics using particle image velocimetry, and ground-reaction forces using a perch mounted on a force-plate. In contrast with the first three wingbeats of take-off, the final four wingbeats during landing featured ~2 times greater force production. Thus, wings contribute proportionally more to changes in velocity during the last phase of landing compared with the initial phase of take-off. Both species touched down at the same velocity (~1 m/s), but they exhibited significant differences in timing of their final wingbeat relative to touchdown. The ratio of average wing force to peak leg force was greater in doves than finches. Peak ground reaction forces during landing were ~50% of those during take-off, consistent with the birds being motivated to control landing. Likewise, estimations of mechanical energy flux for both species indicate wings produce 3-10 times more mechanical work within the final wingbeats of flight compared with the kinetic energy of the body absorbed by legs during ground contact.
Strengthening a research based profession
Authors: Maimbolwa Margaret
Published: May 2014

The major aim of the African Journal of Midwifery and Women's Health is to enhance networking and communication and provide for sharing scientific evidence and professional experiences in midwifery and women's health. To enhance networking and communication, midwives in Africa established the Africa Midwives Research Network (AMRN) in 1992. The AMRN has grown steadily I would like to congratulate all network members for the hard work they put in to make the sixth biennial conference in November 2007 such a success. The conference attracted more than 350 participants from both Africa and Europe. The participants shared various research findings in areas which should bring about a positive effect in improving the health status of women and children.
A new journal for African midwives and nurses
Authors: Clift-Matthews Victoria
Published: May 2014

The launch of the AJM took place during the official opening of the Africa Midwives'Research Network conference, where the speeches highlighted just how important it is for knowledge to be shared.
Adherence to intermittent preventive treatment for malaria in pregnancy
Authors: Nankwanga Hasahya Alice Agnes , Gorette Nalwadda
Published: May 2014

Malaria during pregnancy is a serious health risk for pregnant women; it is associated with maternal and infant morbidity and mortality. In Uganda, Intermittent Preventive Treatment (IPT) for prevention of Malaria in pregnancy, coverage one and two are still low standing at 61%, 38% respectively.

To identify client-related, health worker-related and health-related factors affecting adherence to IPT.

A descriptive cross-sectional study involving 222 pregnant women and 15 health workers was undertaken in Kampala City Council (KCC) health centre IV (Kawempe, Naguru and Kiruddu), Data was collected using interview guided and self-administered questionnaires and checklist.

Only 21% of pregnant women were told about the use of drugs to prevent malaria; 31.5% knew the recommended drug used in prevention of malaria in pregnancy; while 4.5% knew the fansidar recommended doses taken. Over 95% of pregnant women reported no health education was given to them concerning IPT. Surprisingly only 34.4% took fansidar under observation by a health worker. Guidelines on malaria in pregnancy were not referred to and only 1.6% of health workers were trained in the last six months. Generally all the three heath units lacked cups, kettles, posters on prevention of malaria in pregnancy and IPT. Awareness and use of IPT among pregnant women in KCC health units was very low. Health workers knew the importance of IPT but practice as directly observed therapy was poor. KCC should strengthen campaigns for IPT, support training and supervise health workers.
Are we moving in the right direction?
Authors: Lugina Helen
Published: May 2014

Historical research and writings suggest that the original paradigm of midwifery allowed midwives to be considered as powerful, strong, with status and respected. Across many cultures the name midwife is associated with terms such as mother, earth, bringer of light, wise woman, and the like. For example, in the Swahili language spoken in some eastern, central and southern African countries the midwife is called mkunga. Most of the Swahili words have origins in English, German, Arabic, Hindu, Turkish and Bantu languages. The word mkunga originates from Bantu languages and the verb kunga meaning confidential and private matters that are unfit for open mentioning, such as sexual and related matters. Also kunga as a noun means secret or private refelections. It is a priviledge to be involved in confidential individual and social matters and there is inherent power and recognition in the origin of this word for midwife in Swahili.
Strategies to confront intimate partner violence in Kenya
Authors: Maina Geoffrey M. , Banda Mary K.
Published: May 2014

Intimate partner violence causes physical, psychological, sexual and emotional damage to the victim. In Kenya partner violence results from social, cultural and economic factors and has been found to be a prevalent social problem. The purpose of the study was to identify appropriate and applicable strategies to deal with partner violence in Kenya. In the study, eleven health professionals were engaged in individual, in-depth interviews. Several approaches to address partner violence were identified ranging from personal, community level and professional involvement.
Mothers with HIV: attitudes to exclusive breastfeeding
Authors: Kashaija Denis K.
Published: May 2014

The was a cross-sectional study in Muleba District, Kagera Tanzania to determine knowledge and attitudes of lactating women with HIV towards exclusive breastfeeding. Just over half of the population under study had a good attitude towards exclusive breastfeeding and although there was good knowlege in areas such as mother to child transmission, not all of it was thorough. Working mothers also had difficulty exclusively breastfeeding for six months. There is a need to raise awareness among men and decision makers so that HIV-positive women who choose to breastfeed exclusively are supported.
Managing postnatal depression in young mothers
Authors: Danda Grace , Mudokwenyu-Rawdon Christine , Mapanga KG
Published: May 2014

The purpose of this study was to determine knowledge of stress management techniques and their affect on postnatal depression in young mothers.

A descriptive design was used; 75 young mothers (17–25 years) were sampled at two and six weeks postnatally using systematic random sampling. The instruments used for postnatal depression were the Mills depression scale and the Edinburgh postnatal depression scale and for assessing stress management a knowledge questionnaire was used.

Most common responses given were appetite change (54.7%), feeling depressed (48%), feeling irritable (49.3%), loss of libido (52%), self-blame (54.7%), worried and anxious (50.7%) and sadness or miserable (42.7%). Both instruments combined defined 32% (n=24) subjects with postnatal depression.

The Mills scale indicated 48% with depressed feelings, which suggests the need for early diagnosis as well as educating mothers on stress management as evidenced by the stress management knowledge questionnaire with 35.9% showing below average knowledge.
Randomized controlled trial: the most powerful tool in clinical research
Authors: Okeh UM , Ugwu AC
Published: May 2014

The randomized controlled trial (RCT) is one of the simplest but most powerful tools of research. It is the most rigorous way of determining whether a cause–effect relationship exists between treatment and outcome and for assessing the cost-effectiveness of a treatment. Through the randomization bias will be avoided by distributing the characteristics of patients that may influence outcome randomly between treatment groups so that any difference in outcome can be explained only by treatment. These characteristics might be demographic in nature in the form of age or prognostic factors such as clinical history or disease severity. For instance, menopausal status may influence outcome of treatment for breast cancer. This article is aimed at reviewing the general principles, importance of the RCT and the reason for its use in clinical research.
Strengthening health systems
Authors: Lavender Tina , Richens Yana
Published: May 2014

On the 30th November 2009, we had the privilege of attending the 7th Biennial Scientific Conference of the Africa Midwives Research Network (AMRN). The theme of the conference was strengthening health systems to reduce maternal, neonatal and child morbidity and mortality. The conference is one of the many activities used by AMRN to share information on evidence-based practice. Dr Christina Rawdon, acting AMRN Regional Chairperson, gave a brief overview of AMRN activities, which included evidence-based practice workshops, information technology, writing workshops and conferences; all aimed at sharing information. During her welcome speech, she reiterated the importance of ‘knowledge translation from data to impact’. She concluded by thanking the audience for contributing to AMRN's activities ‘for the love of women and children’.
A responsibility for evidence-based practice
Authors: Mudokwenyu-Rawdon Christina
Published: May 2014

Research and evidence-based practice are ‘buzz words’ in midwifery today. While credible research builds on a body of scientific knowledge that promotes midwifery as a profession, best practice is based on evidence from studies, particularly those that are action-oriented. This means that any aspects of midwifery (i.e. education, leadership and management, clinical practice) that rely heavily on research evidence to potentially enhance quality performance is a professional responsibility.
Preventing gender-based violence
Authors: Omoni Grace Moraa
Published: May 2014

Gender-based violence is an umbrella term for any harmful act that is perpetrated against a woman's will. It is estimated that one in three women will experience violence in their lifetime and that violence by an intimate partner is one of the most common forms of violence against women (Ashford, 1997). History presents divergent views and ways in which societies ascribe different gender roles between males and females. Although it is generally recognized that sexual violence is prevalent worldwide, it is rarely addressed in international security forums.
Assessment of the effectiveness of childbirth education in Malawi
Authors: Malata Address , Chirwa Ellen
Published: May 2014

A previous study has indicated that mothers are not satisfied with the amount of labour and childbirth information given in the hospital setting ( Malata, 2000 ). This has implications for how these information needs can be addressed through a childbirth education programme. These needs can be divided into three domains: antenatal; labour and birth; and postnatal needs. A sequential quasi-experimental design was used to assess the structured childbirth education programme that was subsequently launched. Healthy pregnant women of at least 30 weeks gestation were recruited and the final sample sizes were 104 and 105 for the control and intervention groups. The control group attended the normal antenatal clinic and the intervention group enrolled in a childbirth education programme in addition to the antenatal clinic education. Using a semi-structured questionnaire, the mean pre-test and post-test scores for the control group across the three domains were not significantly different from each other (P > 0.05). For the intervention group there were significant differences (P < 0.05) in the mean pre-test and post-test scores across the three domains. The results show that the childbirth education programme imparted knowledge to the intervention group who received more effective childbirth education.
Students’ experiences of using the partograph in Kenyan labour wards
Authors: Lavender Tina , Omoni Grace , Lee Karen , Wakasiaka Sabina , Watiti James , Mathai Matthews
Published: May 2014

Background: Previous research has demonstrated the likely benefits of partograph use in low-resourced settings. However, the challenges of completing a partograph are also reported. The objective of this study was to examine students’ views and experiences of partograph use to gain understanding of the realities of using this tool in the labour ward. Methods: In a qualitative study, 51 student nurses, undertaking their maternity placement at a university in Nairobi, Kenya, participated in five focus group discussions. Data were audio recorded, transcribed verbatim and analysed thematically. Results: Four main themes emerged from the analyses: challenges to ‘doing the right thing’; theory-practice disconnectedness; negative role models; and retrospective recording. Conclusions: The results provide insight into the challenges faced by students when practising in the labour ward environment. A more effective approach to partograph training and implementation should be adopted to support students. However, student midwife training is unlikely to be implemented into practice unless the qualified team supports their learning. Given that the partograph had little status in the labour ward, change may only happen when senior health professionals (midwives and obstetricians) lead by example. Further research is required to explore the views of obstetricians and qualified midwives on partograph use. Appropriate implementation strategies also warrant further investigation.
Traumatic fistula resulting from sexual violence: A case study in Kenya
Authors: Khisa Weston , Kamau Reuben
Published: May 2014

Gender-based violence is any violence that exploits distinctions between individuals of different sexes. Sexual violence in the form of rape or mass rape is traumatic for the victim but can have significant physical consequences, such as traumatic fistula which can render the victim incontinent of urine and/or faeces. The physical consequences are compounded by psychological trauma and stigma. This article presents a case study of a 16-year-old girl affected by traumatic fistula. It explains the implications of such a condition and provides a brief explanation of surgery, giving health professionals a greater understanding of the context and surgical treatment.
Evaluation of the use of herbal drugs by pregnant women in Nigeria
Authors: Achema G. , Emmanuel A. , Oguche M.
Published: May 2014

Women are increasingly recognized as the main users of alternative medicine, although data is limited on the extent of women's use of herbal medicine during pregnancy to help with the discomforts of pregnancy and labour. However, questions remain about the safety of many herbal drugs, especially within the first and second trimester. For this reason, this study aimed to ascertain patterns of use of herbal medicinal products by pregnant women in selected health care centers in Enugu South Local Government Area of Enugu State, Nigeria. The study utilized a descriptive survey/research design using a structured questionnaire for data collection. Data were collected from 60 respondents. The findings from the study showed that a greater percentage of the women (58.3%) (n = 35) used herbal drugs in pregnancy-free periods while 41.7% (n = 25) used them in the current pregnancy. The pattern of herbal drug use in pregnancy was irregular, although the first trimester showed the highest percentage (23.3%) (n = 14). When asked for their reasons for using the products, a good number of the pregnant women (n = 27; 45%) asserted it is safer and the majority (n = 33; 55%) said it works better than orthodox medicine. However, half of the women (n = 30; 50%) considered herbal products to be harmful to the baby during pregnancy, and yet 25 of the women (41.7%) were still taking it in their current pregnancy. From the findings of this study, it is recommended that a comprehensive coordinated health approach is needed to provide information about medication in pregnancy and this should be made available and translated into safe and effective use. Proper history taking on drug use (including herbal drugs) should be included in antenatal care sessions in order to exclude the possibility of drug interactions and consequent effects on pregnancy.
Home management of febrile conditions in children
Authors: Ehiemere Ijeoma O , Ihudiebube-Splendor Chikaodili Ndidiamaka , Chinweuba Anthonia U , Akosile Christopher O
Published: May 2014

This study examined the home management of febrile conditions in 131 children by caregivers who attended Children Emergency (CHER) clinics of selected health facilities in Anambra South-East Nigeria. A cross-sectional survey design was employed for the study and all caregivers gave their informed consent before the study. The children were aged between 1 day and 5 years old, and had fever as one of the presenting symptoms. A self-developed questionnaire and observation guide were used for data collection and descriptive and inferential statistics were used to analyse the data. Results of the study revealed that 123 (93.9%) of the caregivers first treated their febrile children at home before reporting to the health facility. The immediate actions taken by 99 of the 131 respondents (75.5%) were: the removal of clothing and exposing the child to air, and administering syrup paracetamol and antibiotics, respectively. The most common home remedies used by caregivers were herbal preparations. However, the proportion of caregivers that used home preparations (name—unknown) as home remedies (n=84; 75.7%) was not statistically significant (Zcal1.85Ztab1.96; P=0.02) of caregivers (120, 91.6%) specified ‘first aid’ as their reason for treatment at home. The proportion of cases that survived when brought to the health facility for management was also statistically significant (Zcal7.279>Ztab1.96; P=0.03). Thus, the study suggests that treatment practices at home by caregivers constitute major determinants of the outcome of management of febrile conditions at health facility.
Prevention of mother to child transmission of HIV services in Malawi
Authors: Muheriwa Sadandaula , Chimwaza Angela , Maluwa Alfred , Kamanga Martha
Published: May 2014

This study aimed to determine the factors that influence the use of prevention of mother to child transmission of HIV (PMTCT) services among young HIV-positive adults in the Balaka district of Malawi. A questionnaire was given to 184 HIV-positive young mothers aged 15–24 years who met the inclusion criteria and who consented to the study. The participants were selected from six health centres in the Balaka district during their visits to the under 5 clinic, HIV and AIDS support groups and HIV follow up clinic. Results showed that the participants’ knowledge of mandatory HIV testing, stigma and discrimination, and poverty influenced their use of PMTCT services. There is a need to mobilise the communities to promote PMTCT awareness and reduce stigma and discrimination towards HIV-positive mothers. Monitoring and evaluation activities and in-service education for health workers is also recommended to promote utilisation of PMTCT services in the district.
Factors affecting partner notification of HIV status
Authors: Makoleka Maureen Masumo
Published: May 2014

Mother to child transmission is the major cause of HIV infection in children. This quantitative study was aimed at identifying the factors that influence mothers notifying their partners of their HIV status after undergoing routine HIV testing at antenatal clinics in Kalomo district, Zambia. A total of 120 antenatal mothers were interviewed. The study revealed that participants who had positive cultural practices, were married, in the same relationship for more than 5 years, had prior discussion with the partner about testing, and knew their partner's HIV status were more likely to notify their partners about their HIV status. Midwives will be able to use these factors to increase the women's HIV status notification rate and participation in preventive programmes by identifying women who are unlikely to notify their partners and help them to do so.
Reducing maternal and neonatal mortality in East, Central and Southern Africa with midwifery educator training
Authors: Kamdonyo Joyce , Matinhure Sheillah
Published: May 2014

The East, Central and Southern Africa (ECSA) region faces a critical shortage of skilled birth attendants despite high levels of maternal and neonatal mortality. This situation could be improved by training more midwives, but in order to achieve this there is a need for more trainers. However, most countries in the region have no midwifery educators’ programmes to produce people to train the required midwives. To address this gap, the East, Central and Southern Africa College of Nursing (ECSACON), in collaboration with the Commonwealth Secretariat, is implementing a 5-year project aimed at increasing the number of midwifery educators and midwives to contribute to the reduction of maternal and neonatal mortality in the ECSA region. A midwifery master’s prototype curriculum, compliant with regional and international standards for midwifery educators, was developed by regional and international stakeholders which higher education institutions in the region are encouraged to adapt according to country needs. The paper describes promising progress and achievements in the ongoing implementation of this project. Kamuzu College of Nursing (KCN) in Malawi and the University of Central Lancashire (UCLAN) in the UK both adapted the midwifery prototype curriculum and started the programme in 2008 as full time and distance learning, respectively. The University of Makerere in Uganda commenced the programme in August 2011; and the following universities are planning to commence the programme in late 2013: Muhimbili and Tumaini in Tanzania, Zambia, Swaziland, and the National University of Science and Technology in Zimbabwe. Uganda Christian University in Mukono intends to start the programme in 2014.
Full-term abdominal pregnancy with delivery of a normal living child: Diagnostic and management challenges in resource-limited settings
Authors: Mwampagatwa Ipyana
Published: May 2014

Abdominal pregnancy is a rare type of ectopic pregnancy where the fetus is implanted within the peritoneal cavity. The condition is extremely rare accounting for about 1% of all ectopic pregnancies. It presents a great threat to the life of the mother and, in most cases, the fetus does not survive. Full-term abdominal pregnancies are even rarer, particularly when a live baby is delivered. It Is this rarity that justifies it being of medical curiosity. This article presents the case of a 30-year-old woman who was referred to Dodoma Regional and Teaching Hospital with a history of ‘labour-like abdominal pains’ for 3 days associated with vaginal spotting. After examination, the tentative diagnosis of early abruption placenta with a live fetus was reached and a decision to deliver by caesarean section was made. After opening the abdomen the amniotic sac was identified within the peritoneal cavity and it was ruptured to deliver a live 2.650 kilogram female baby with an Apgar score of 7–10 at 1 and 5 minutes respectively. The mother recovered uneventfully and was discharged home with her healthy baby 1 week later.
OSCE assessment for emergency scenarios in midwifery education: A reflection and evaluation
Authors: Einion Alys
Published: May 2014

The Objective Structured Clinical Examination (OSCE) in Swansea University's midwifery course began life as a clinical skills/obstetric emergencies assessment with a pass/fail outcome, and segued into a graded, summative assessment as part of the redevelopment and revalidation of the undergraduate curriculum. An evaluation of the first iteration of the OSCE identified key learning points around preparation, learning, resources, lecturer input and skills practice, which were then used to improve the second iteration of the module/assessment. The need to provide ample opportunities for practice, the value of simulation as a ‘safe’ place to learn critical clinical skills and the stress associated with this kind of examination were identified as issues. The provision of immediate peer and lecturer feedback during practice sessions was highly valued. Future work on the OSCE needs to consider the need to tailor learning experiences to the context and to the learner.
Psychosocial problems of sickle cell disease as experienced by primary paediatric carers in southwest Nigeria
Authors: Olagunju Oluwayemisi , Olaogun Adenike , Afolabi Esther , Adereti Stella
Published: May 2014

Primary carers of children with haemoglobin SS (HbSS) experience psychosocial problems which may not be addressed by the medical team in their effort to provide adequate care for the child. Identifying these psychosocial problems early and providing help will not only ensure the paediatric patients experience a higher-quality lifestyle but will also reduce their frequency of crises. This study explored the psychosocial problems encountered by primary paediatric caregivers, as well as the coping mechanisms used by them, with a view to determine whether there was support network that influences their coping in southwest Nigeria. Methods: The study employed a descriptive design. Thirty-seven primary paediatric carers were purposively selected from the haematology clinic of Obafemi Awolowo University Teaching Hospitals Complex to participate in the study. The instrument used was an interview guide that explored the psychosocial problems and coping mechanisms of the primary paediatric carers. Results: A majority (89.2%) of the primary caregivers were mothers and 40% of the caregivers were aged 30–34 years old (36.2+7.9 mean, standard deviation). Reports from the interview of the primary caregivers revealed emotional distress and burden of time investment among other psychosocial problems. The coping mechanism mostly used, as reported by participants, was seeking instrumental social support, which in this study is explained as seeking assistance, support, information or advice about what to do. Conclusion: The study concluded that the primary paediatric carers experience some psychosocial problems and made efforts to utilise the support available to them in the context of the community they live in.
Factors determining diagnosis and admission of Bangladeshis with coronary symptoms
Authors: Gibson Tracey
Published: May 2014

Epidemiological studies show that South Asian immigrants, irrespective of any regional, cultural and religious differences, have significantly higher coronary heart disease mortality than the native white population in the UK. Evidence suggests Bangladeshi patients with acute myocardial infarction often present with atypical symptoms, which may lead to slower triage and delayed treatment. The aim of this pilot study of 18 patients is to answer the question: Does symptomatology impair the successful diagnosis and hospital admission route of Bangladeshis with coronary heart disease? This study found that Bangladeshis presenting with chest pain were less likely than white patients to offer a classical description of the pain such as ‘heaviness’ or ‘band-like’ pain.
The potential problems of peripheral oedema associated with heart failure
Authors: O'Grady Elleen
Published: May 2014

Increasing numbers of patients are being diagnosed with heart failure because of the ageing population and improved survival rates following myocardial infarction. This article examines how one symptom of heart failure (peripheral oedema) can have an adverse impact on a patient's lifestyle. It discusses how peripheral oedema develops as a result of heart failure, the problems associated with peripheral oedema, how a good skin care routine can minimize these problems and the importance of self-monitoring and other steps that a patient can undertake to prevent acute heart failure.
From bones to books: The career pathway of a professor
Authors: Quinn Tom
Published: May 2014

Starting out as an orthopaedic staff nurse, Tom Quinn temporarily veered off the pathway onto a course in law. He found his way again though and now he is Professor of Cardiac Nursing. Tom Quinn spoke with Lucy Jolin.
Chapter 8 brings hope but lacks outcome measures
Authors: Lobban Trudie
Published: May 2014

Trudie Lobban welcomes Chapter 8 but argues outcome measures need to be defined so that its objectives can be implemented. She calls on cardiac nurses for help
ECG of the month: 1
Authors: Whitbread Mark
Published: May 2014

Mark Whitbread presents an ECG for you to analyse. The answer and management plan will be published next month
Arterial blood pressure monitoring
Authors: Sargent Andrew
Published: May 2014

Andrew Sargent discusses the benefits and mangement of invasive arterial monitoring.
New chapters added
Authors: Gibson Tracey
Published: May 2014

If you have not yet had the opportunity to browse previous editions of Cardiac Nursing, then this latest edition is definitely worth a look. If you have, then there have been many revisions, as well as the addition of several new chapters to reflect current evidence-based practice.
Beta blockers: Types and clinical implications
Authors: Khan Ehsan
Published: May 2014

After approximately 50 years of development and refinement, there are a significant number of beta blockers available to the clinician today. These medications differ in clinical effect and clearance from the body. This review presents the nurse with the main features of the different types of beta blocker and explains the factors that guide the choice of drug in particular pathologies. This information will give the practitioner an evidence-based understanding of the potential uses and adverse effects which are associated with this class of drugs.
The ‘expert patient’ in cardiac nursing: Toward empowerment
Authors: Margereson Carl
Published: May 2014

Given appropriate knowledge and skills, patients with chronic illnesses can become expert in managing their own lives, including their illnesses. But there is more to effective self management than just knowledge and skills. This article gives an over view of policy initiatives in chronic disease management, including the Expert Patient Programme. It explores the principles of self management, suggesting that cardiac nurses in a variety of different settings can incorporate these into their work with patients who have long-term cardiac disorders.
Adopting a fast-track approach to cardiac surgery
Authors: Aps Chris
Published: May 2014

In the UK fast-tracking is a clinical practice that reduces the need For or duration of, postoperative critical care support, thus allowing Patients to be admitted to clinical areas other than the intensive care Unit (ICU) after surgery. In some other countries, notably the USA, this Practice is used to reduce ICU length of stay and hence costs.

Implicit in successful fast-tracking is the improved clinical condition Of patients (a quality issue), which reduces time to extubation and Facilitates same-day discharge to lower dependency beds. This Relieves the pressure on over-stretched critical care resources, Impacts beneficially on operative cancellation rates and frees up ICU Beds for emergency admissions.
Hearts and minds: Developing and expanding the role of the paediatric cardiac liaison nurse
Authors: Killey Mona , Flynn Maria
Published: May 2014

The needs and care of children with congenital hear t disease have recently assumed political prominence, and the role of the paediatric cardiac liaison nurse has been highlighted as an example of good practice in this area of nursing. However, there are issues associated with further development of the role. These issues include resources, professional background, training, and models of ser vice provision, and they are discussed in this article in the context of currently available evidence. We conclude that the paediatric cardiac liaison nurse, along with other emerging cardiac nurse specialists, has a vital par t to play in cardiac ser vice provision, but that the development and impact of this role must be evaluated reliably.
Does optimal drug treatment of acute coronary syndromes depend on management area?
Authors: Waterall Jamie
Published: May 2014

Audit showed that there were differences in the drug treatments prescribed at discharge to patients with acute coronary syndromes in relation to the area of management. Altogether 97% of patients managed on a cardiology ward were prescribed statin treatment compared with only 65% of those managed on a general medical ward, while proportions prescribed β-blockers were 80% for patients on a cardiology ward and 53% for those on a general medical ward. Differences could not be explained by different rates of contraindications to drug therapy. A cardiac outreach team has now been established to resolve any possible inequalities in the management of these patients.
Tackling inactivity
Authors: Johnson Kate
Published: May 2014

The eagle-eyed readers among you will have spotted that we have changed the aim on the cover to ‘promoting excellence in cardiovascular care’ in recognition of the fact that many vascular and cardiac conditions have the same risk factors (hypertension, smoking and diabetes). It also reflects a growing trend towards encompassing all types of circulatory disease within our thinking. We were influenced, in part, by the British Association for Nursing in Cardiac Care (BANCC) who have changed their name to the British Association for Nursing in Cardiovascular Care as discussed last month.
Statin therapy in cardiovascular disease
Authors: Walthall Helen
Published: May 2014

It is now established practice to administer statin therapy to patients with known coronary heart disease (CHD). This pharmacological prevention is based of the findings of a number of randomized controlled trials that have set out to establish the role statin therapy plays in the management of blood cholesterol levels. As a nurse caring for patients with CHD, or a nurse who is assessing patients who may be at risk of developing CHD, it is essential to understand the physiology behind blood cholesterol and to understand how these processes alter to develop cardiovascular disease. The following paper will outline these processes and examine the role statin therapy plays in the reduction of blood cholesterol levels. It will also highlight the information required to care for patients who are prescribed statins.
Every hospital does not need to offer a specialist service
Authors: Cumper Michael
Published: May 2014

Michael Cumper discusses the impact of the new Grown Up Congenital Heart Guide and the services which are required by patients with congenital heart conditions.