bluuebunny/crossref_metadata_2025 huggingface dataset:
‘You Can See Your Face in My Floor’: Examining the Function of Cleanliness in an Adult Male Prison
Authors: Sloan Jennifer
Published: August 2012

In this article, consideration is given to the concept of cleanliness and tidiness from the perspective of the masculine prisoner. Themes related to processes of maintaining, and perceptions of, cleanliness emerged, related to the self, personal space, and the cleanliness of others. Running through these were overarching elements of control, differentiation and processes of normalisation, which can be seen to relate concepts of cleanliness directly to the negotiation of the adult male prisoner's gendered identity, implying that keeping clean and tidy relates directly to individuals’ senses of masculine self and perceptions of others.
Emollients are more than sensory ingredients: the case of Isostearyl Isostearate
Authors: Dederen J. C. , Chavan B. , Rawlings A. V.
Published: August 2012

Synopsis

In order to understand the skin benefits of emollient oil ingredients in topical skin moisturizers, one single highly popular in vivo method (corneometry), even when executed to perfection, does not suffice. A systematical exploration using a combination of bioengineering techniques shows how a previously unaccounted for mechanism of moisturization by internal occlusion was discovered. As a result, Isostearyl Isostearate turns out to be a highly functional moisturizer when several methodologies are used.
The use of the Solihull Approach with children with complex neurodevelopmental difficulties and sleep problems: a case study
Authors: Williams Laura , Newell Reetta
Published: August 2012

Accessible summary

A lot of children have trouble sleeping, especially children with disabilities.

Sometimes sleeping does not get better with advice about behaviour or medicine alone.

We helped a mother, who has a little girl with problems sleeping, to think about her worries and their relationship, before offering advice.

People can use the same steps to help other children who are not sleeping well. We think it might even work for problems like not eating and not doing as you are told.

The following article introduces the Solihull Approach, a structured framework for intervention work with families (Douglas, Solihull resource pack; the first five years. Cambridge: Jill Rogers Associates, 2001) and aims to demonstrate the usefulness of this approach in working with school‐age children with complex neurodevelopmental difficulties in a community Child and Adolescent Mental Health Service (CAMHS) setting. More specifically, it aims to show the efficacy of this approach in intervening with sleep problems, which are prevalent amongst children with learning disabilities. The authors hope to achieve these aims through the use of the qualitative case study method, which allows for a rich account of the intervention and therefore facilitates a detailed understanding of the psychological phenomena and processes involved in the approach (Dallos & Smith, Clin Psychol Forum 2008; 182, 18). The three theoretical concepts central to the Solihull Approach – containment, reciprocity and behaviour management – are used to describe the intervention, which resulted in a positive outcome. Implications for clinical practice and future research directions are discussed.
Examining students' future time perspective: Pathways to knowledge building1
Authors: HILPERT JONATHAN C. , HUSMAN JENEFER , STUMP GLENDA S. , KIM WONSIK , CHUNG WEN‐TING , DUGGAN MARY ANNE
Published: August 2012

The purpose of this study was to provide evidence for the internal structure of the domain‐general and context‐specific components of future time perspective (FTP) and to provide support for a top‐down structure of FTP theory. The participants included 546 engineering students from a large university in the southwest of the USA. The students responded to the Future Time Perspective Scale, the Perceptions of Instrumentality Scale, and the Student Perceptions of Classroom Knowledge‐building Scale. Analyses present evidence for: (a) the structural fidelity of student responses to the respective theoretical constructs, and (b) the top down, domain‐general to context‐sensitive relation between FTP variables and student learning behavior. The results also indicate that students' use of knowledge building strategies may be influenced by both domain‐general aspects of FTP and the perceived endogenous instrumentality of coursework. Implications include support for use of valid FTP measures and the recognition of the relation between FTP and value of present school activities.
Excellent outcomes after extratemporal epilepsy surgery in children
Authors: MOSELEY BRIAN D
Published: August 2012

This commentary is on the original article by D’Argenzio et al. on pages 995‐1000 of this issue.
Psychiatric and cognitive phenotype of childhood myotonic dystrophy type 1
Authors: DOUNIOL MARIE , JACQUETTE AURÉLIA , COHEN DAVID , BODEAU NICOLAS , RACHIDI LINDA , ANGEARD NATHALIE , CUISSET JEAN‐MARIE , VALLÉE LOUIS , EYMARD BRUNO , PLAZA MONIQUE , HÉRON DELPHINE , GUILÉ JEAN‐MARC
Published: August 2012

Aim  To investigate the psychiatric and cognitive phenotype in young individuals with the childhood form of myotonic dystrophy type 1 (DM1).

Method  Twenty‐eight individuals (15 females, 13 males) with childhood DM1 (mean age 17y, SD 4.6, range 7–24y) were assessed using standardized instruments and cognitive testing of general intelligence, visual attention, and visual–spatial construction abilities.

Results  Nineteen patients had repeated a school grade. The mean (SD) Full‐scale IQ was 73.6 (17.5) and mean Verbal IQ was significantly higher than the mean Performance IQ: 80.2 (19.22) versus 72.95 (15.58), p=0.01. Fifteen patients had one or more diagnoses on the DSM‐IV axis 1, including internalizing disorders (phobia, n=7; mood disorder, n=6; other anxiety disorders, n=5) and attention‐deficit–hyperactivity disorder, inattentive subtype (n=8). Twelve out of 22 patients had alexithymia (inability to express feelings with words and to recognize and share emotional states). Cognitive testing found severe impairments in visual attention and visual–spatial construction abilities in four out of 18, and 14 out of 24 patients respectively. No diagnosis was correlated with the transmitting parent’s sex or with cytosine–thymine–guanine (CTG) repeat numbers. Patients with severe visual–spatial construction disabilities had a significantly longer CTG expansion size than those with normal visual–spatial abilities (p=0.04).

Interpretation  Children and adolescents with childhood DM1 have frequent diagnoses on DSM‐IV axis 1, with internalizing disorders being the most common type of disorder. They also have borderline low intelligence and frequent impairments in attention and visual–spatial construction abilities.
Matrix metalloproteinase‐3 in the central nervous system: a look on the bright side
Authors: Van Hove Inge , Lemmens Kim , Van de Velde Sarah , Verslegers Mieke , Moons Lieve
Published: August 2012

Matrix metalloproteinases (MMPs) are a large family of proteases involved in many cell‐matrix and cell‐cell signalling processes through activation, inactivation or release of extracellular matrix (ECM) and non‐ECM molecules, such as growth factors and receptors. Uncontrolled MMP activities underlie the pathophysiology of many disorders. Also matrix metalloproteinase‐3 (MMP‐3) or stromelysin‐1 contributes to several pathologies, such as cancer, asthma and rheumatoid arthritis, and has also been associated with neurodegenerative diseases like Alzheimer's disease, Parkinson's disease and multiple sclerosis. However, based on defined MMP spatiotemporal expression patterns, the identification of novel candidate molecular targets and in vitro and in vivo studies, a beneficial role for MMPs in CNS physiology and recovery is emerging. The main purpose of this review is to shed light on the recently identified roles of MMP‐3 in normal brain development and in plasticity and regeneration after CNS injury and disease. As such, MMP‐3 is correlated with neuronal migration and neurite outgrowth and guidance in the developing CNS and contributes to synaptic plasticity and learning in the adult CNS. Moreover, a strict spatiotemporal MMP‐3 up‐regulation in the injured or diseased CNS might support remyelination and neuroprotection, as well as genesis and migration of stem cells in the damaged brain.
Expression of A1 adenosine receptors in the developing avian retina: in vivo modulation by A2A receptors and endogenous adenosine
Authors: Brito Rafael , Pereira Mariana Rodrigues , Paes‐de‐Carvalho Roberto , Calaza Karin da Costa
Published: August 2012

Little is known about the mechanisms that regulate the expression of adenosine receptors during CNS development. We demonstrate here that retinas from chick embryos injected in ovo with selective adenosine receptor ligands show changes in A1 receptor expression after 48 h. Exposure to A1 agonist N6‐cyclohexyladenosine (CHA) or antagonist 8‐Cyclopentyl‐1, 3‐dipropylxanthine (DPCPX) reduced or increased, respectively, A1 receptor protein and [3H]DPCPX binding, but together, CHA+DPCPX had no effect. Interestingly, treatment with A2A agonist 3‐[4‐[2‐[[6‐amino‐9‐[(2R,3R,4S,5S)‐5‐(ethylcarbamoyl)‐3,4‐dihydroxy‐oxolan‐2‐yl]purin‐2‐yl]amino] ethyl]phenyl] propanoic acid (CGS21680) increased A1 receptor protein and [3H]DPCPX binding, and reduced A2A receptors. The A2A antagonists 7‐(2‐phenylethyl)‐5‐amino‐2‐(2‐furyl)‐pyrazolo‐[4,3‐e]‐1,2,4‐trizolo[1,5‐c] pyrimidine (SCH58261) and 4‐(2‐[7‐amino‐2‐[2‐furyl][1,2,4]triazolo[2,3‐a][1,3,5]triazo‐5‐yl‐amino]ethyl)phenol (ZM241385) had opposite effects on A1 receptor expression. Exposure to CGS21680 + CHA did not change A1 receptor levels, whereas CHA + ZM241385 or CGS21680 + DPCPX had no synergic effect. The blockade of adenosine transporter with S‐(4‐nitrobenzyl)‐6‐thioinosine (NBMPR) also reduced [3H]DPCPX binding, an effect blocked by DPCPX, but not enhanced by ZM241385. [3H]DPCPX binding kinetics showed that treatment with CHA reduced and CGS21680 increased the Bmax, but did not affect Kd values. CHA, DPCPX, CGS21680, and ZM241385 had no effect on A1 receptor mRNA. These data demonstrated an in vivo regulation of A1 receptor expression by endogenous adenosine or long‐term treatment with A1 and A2A receptors modulators.
To boldly go where no volunteer has gone before: predicting volunteer activity to prioritize surveys at the landscape scale
Authors: Tulloch Ayesha I. T. , Mustin Karen , Possingham Hugh P. , Szabo Judit K. , Wilson Kerrie A.
Published: August 2012

Aim

To identify the relationships between volunteer bird survey effort and motivations in order to prioritize investment in future surveying activities.

Location

South‐west Western Australia, a global biodiversity hotspot.

Methods

We developed nine hypotheses for volunteer motivations to predict the probability of a bird survey being undertaken anywhere in the landscape using data from the New Atlas of Australian Birds. We then established three goals for surveying in the study region: (1) equal representation of surveys across the landscape, (2) surveys stratified by habitat type and (3) representation of surveys in protected areas. We developed a function to estimate the benefit of investing in professional surveys, given the probability of a volunteer survey taking place and the survey goal, and calculated the cost of meeting a surveying goal with and without accounting for the probability of cells not being surveyed by volunteers.

Results

A model combining the location of protected areas, location of previous records of threatened species and habitat diversity was the strongest predictor of the probability of a volunteer bird survey being conducted. Each surveying goal resulted in different areas being prioritized for future surveying, indicating the importance of setting clear objectives before undertaking broad‐scale monitoring or surveying activities. If our primary goal is stratified protected area representation in surveys, there are huge cost savings if only protected areas with a 70% predicted probability of not being surveyed by volunteers are selected for professional surveys.

Main conclusions

Professional sampling in survey gaps is required to reduce bias in volunteer‐collected datasets. Using models of volunteer behaviour, we can identify areas unlikely to be surveyed. If these areas are important for the project objective, then we can either provide incentives for volunteers or carry out professional surveying. These analyses are best carried out before data collection commences.
Effect of artificial gravity with exercise training on lung function during head‐down bed rest in humans
Authors: Guo Yinghua , Guo Na , Liu Changting , Wang Delong , Wang Junfeng , Sun Xiqing , Fan Shangchun , Wang Changyong , Yang Changbin , Zhang Yu , Lu Dongyuan , Yao Yongjie
Published: August 2012

There is evidence to suggest that microgravity/weightlessness can induce changes in lung physiology/function. We hypothesized that microgravity, induced by head‐down bed rest (HDBR), would induce changes in lung function and that exercise training with artificial gravity (AG) would prevent these changes from occurring. Twelve participants were randomly assigned to a control or AG exercise countermeasure (CM) group (n = 6 per group) and 96 h of 6° HDBR. Participants in the CM group were exposed to AG (alternating 2 min intervals of +1·0 and +2·0 G) for 30 min, twice daily, during which time ergometric exercise (40 W intensity) was performed. Pulse rate, oxygen saturation (SO2) and lung function were measured and compared between groups. The CM and control groups were similar in mean age, height and weight. There were no significant within or between group differences over time in pulse rate, SO2, vital capacity, inspiratory capacity, tidal volume, expiratory reserve volume, inspiratory reserve volume, minute ventilation, forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow, maximal expiratory flow in 25%, 50% and 75% vital capacity, forced inspiratory vital capacity, forced inspiratory volume in 1 s and maximal voluntary ventilation. Microgravity induced by 96 h of HDBR does not appear to affect lung function in humans. Further, AG with exercise training does not change lung function during 96 h of HDBR in humans.
The effects of low‐dose epinephrine infusion on spleen size, central and hepatic circulation and circulating platelets
Authors: Bakovic Darija , Pivac Nediljko , Eterovic Davor , Breskovic Toni , Zubin Petra , Obad Ante , Dujic Zeljko
Published: August 2012

In several conditions associated with adrenergic stimulation, an increase in peripheral count of larger platelets has been observed, but the mechanism remained elusive. Larger platelets have greater prothrombotic potential and increase the risk of acute thrombotic events. The human spleen retains one‐third of total body platelets, with mean volume (MPV) about 20% greater than that of circulating platelets. We aimed to answer whether low‐dose epinephrine infusion results in spleen contraction and MPV increase. We undertook the continuous ultrasonic measurements of spleen volume, hepatic and central circulation with concurrent blood sampling in response to intravenous infusion of epinephrine (6 min of 0·06 µg kg−1 per min, followed by 3 min of 0·12 µg kg−1 per min) in nine healthy young subjects. The spleen volume started to decrease immediately after the onset of infusion, in the presence of substantial decreases in peripheral resistance and mean blood pressure and increases in heart rate and cardiac output. The majority of spleen emptying, approximately 25%, (95% CI 71·3–299·7) was observed 1 min after infusion onset, the hepatic vein flow peaked at the end of infusion for 28·4% (95% CI 1074·6–407·9), while increases in platelet count for approximately 31% (95% CI 187·8–314·8) and MPV for 4·4% (95% CI 7·3–10·9) lagged until 1 min after infusion cessation. We suggest that spleen is a dynamic reservoir of large platelets, which are mobilized even by low‐dose epinephrine infusion in conditions of decreased blood pressure.
Elevations of local intravascular pressures release vasoactive substances in humans
Authors: Gustafsson T. , Kölegård R. , Sundblad P. , Norman B. , Eiken O.
Published: August 2012

The wall stiffness of arteries and arterioles adapts to the long‐term demands imposed by local intravascular pressure. We investigated whether substances capable of inducing acute and long‐term effects on arterial wall stiffness are released locally into the bloodstream in response to an acute marked increase in local intravascular pressure in the blood vessels of the human arm. Experiments were performed on ten subjects positioned in a pressure chamber with one arm extended through a hole in the chamber door and kept at normal atmospheric pressure. Intravascular pressure was increased in the arm, by a stepwise increase in chamber pressure up to +150 mmHg. Diameter and flow were measured in the brachial artery by Doppler ultrasonography. Blood samples were drawn simultaneously from both arms before, during, immediately after and 2 h after the release of the chamber pressure. Plasma levels of endothelin‐1 (ET‐1), vascular endothelial growth factor A (VEGF‐A), fibroblast growth factor 2 (FGF‐2) and angiotensin II (Ang‐II) were measured. Elevation of chamber pressure by 150 mmHg increased local arterial distending pressure to about 220–260 mmHg, resulting in an increase in brachial artery diameter of 9% and flow of 246%. The pressure stimulus increased the plasma levels of ET‐1 and Ang‐II, but not of VEGF‐A or FGF‐2 in the test arm. The local release of the vasoconstrictors ET‐1 and Ang‐II in response to markedly increased distending pressure may reflect one mechanism behind adaptation to acute and long‐term changes in intravascular pressure.
Geography as a shared project: Royal Geographical Society (with IBG) Medals and Awards ceremony 2012
Authors: PALIN MICHAEL , FOTHERGILL ALASTAIR , WITHERS CHARLES , ROSE GILLIAN , LANE STUART , VITA‐FINZI CLAUDIO
Published: August 2012

The Royal Geographical Society (with the Institute of British Geographers) annual Medals and Awards recognise achievements in researching, communicating and teaching a wide range of geographical knowledge. The speeches and citations are a record of the ceremony of 2012. With comments by the BBC's Alastair Fothergill, and Professors Charles Withers, Gillian Rose, Stuart Lane and Claudio Vita‐Finzi, the speeches encompass historical geography, inspiring audiences, domestic visual culture, flood hazards and climate change. President Michael Palin introduces the ceremony, emphasising the breadth and relevance of geographical research.
Early Triassic conodont clusters from South China: revision of the architecture of the 15 element apparatuses of the superfamily Gondolelloidea
Authors: GOUDEMAND NICOLAS , ORCHARD MICHAEL J. , TAFFOREAU PAUL , URDY SEVERINE , BRÜHWILER THOMAS , BRAYARD ARNAUD , GALFETTI THOMAS , BUCHER HUGO
Published: August 2012

Abstract:  Several fused clusters of conodont elements of the genera Neospathodus and Novispathodus were recovered from limestone beds at the Dienerian–Smithian and Smithian–Spathian boundaries, respectively, from several localities in Guangxi province, South China. Conodont clusters are otherwise extremely rare in the Triassic, and these are first described for the Early Triassic. The exceptional specimens partially preserve the relative three‐dimensional position and orientation of ramiform elements and are therefore extremely important for testing hypotheses on the architecture of apparatuses. These specimens partly confirm the previous reconstruction of the Novispathodus apparatus by Orchard. Within apparatuses of members of superfamily Gondolelloidea, elements previously identified as occupying the S1 and S2 positions instead occupy the S2 and S1 positions. Similarly, within apparatuses of members of the subfamily Novispathodinae, elements previously referred to S3 and S4 positions are reinterpreted to have occupied S4 and S3 positions, respectively.
Reporting CAHPS and HEDIS Data by Race/Ethnicity for Medicare Beneficiaries
Authors: Martino Steven C. , Weinick Robin M. , Kanouse David E. , Brown Julie A. , Haviland Amelia M. , Goldstein Elizabeth , Adams John L. , Hambarsoomian Katrin , Klein David J. , Elliott Marc N.
Published: August 2012

Objective

To produce reliable and informative health plan performance data by race/ethnicity for the Medicare beneficiary population and to consider appropriate presentation strategies.

Data Sources

Patient experience data from the 2008–2009 Medicare Advantage (MA) and fee‐for‐service (FFS) CAHPS surveys and 2008–2009 HEDIS data (MA beneficiaries only).

Study Design

Mixed effects linear (and binomial) regression models estimated the reliability and statistical informativeness of CAHPS (HEDIS) measures.

Principal Findings

Seven CAHPS and seven HEDIS measures were reliable and informative for four racial/ethnic subgroups—Whites, Blacks, Hispanics, and Asian/Pacific Islanders—at sample sizes of 100 beneficiaries (200 for prescription drug plans). Although many plans lacked adequate sample size for reporting group‐specific data, reportable plans contained a large majority of beneficiaries from each of the four racial/ethnic groups.

Conclusions

Statistically reliable and valid information on health plan performance can be reported by race/ethnicity. Many beneficiaries may have difficulty understanding such reports, however, even with careful guidance. Thus, it is recommended that health plan performance data by subgroups be reported as supplemental data and only for plans meeting sample size requirements.
Fair Value Accounting and Managers' Hedging Decisions
Authors: CHEN WEI , TAN HUN‐TONG , WANG ELAINE YING
Published: August 2012

We conduct two experiments with experienced accountants to investigate how fair value accounting affects managers’ real economic decisions. In experiment 1, we find that participants are more likely to make suboptimal decisions (e.g., forgo economically sound hedging opportunities) when both the economic and fair value accounting impact information is presented than when only the economic impact information is presented, or when both the economic and historical cost accounting impact information is presented. This adverse effect of fair value accounting is more likely when the price volatility of the hedged asset is higher, which is a situation where, paradoxically, hedging is more beneficial. We find that the effect is mediated by participants’ relative considerations of economic factors versus accounting factors (e.g., earnings volatility). Experiment 2 shows that enhancing salience of economic information or separately presenting net income not from fair value remeasurements reduces the adverse effect of fair value accounting. Our findings are informative to standard setters in their debate on the efficacy of fair value accounting.
Novel pyrazole compounds for pharmacological discrimination between receptor‐operated and store‐operated Ca2+ entry pathways
Authors: Schleifer H , Doleschal B , Lichtenegger M , Oppenrieder R , Derler I , Frischauf I , Glasnov TN , Kappe CO , Romanin C , Groschner K
Published: August 2012

Background and purpose

Pyrazole derivatives have recently been suggested as selective blockers of transient receptor potential cation (TRPC) channels but their ability to distinguish between the TRPC and Orai pore complexes is ill‐defined. This study was designed to characterize a series of pyrazole derivatives in terms of TRPC/Orai selectivity and to delineate consequences of selective suppression of these pathways for mast cell activation.

Experimental approach

Pyrazoles were generated by microwave‐assisted synthesis and tested for effects on Ca2+ entry by Fura‐2 imaging and membrane currents by patch‐clamp recording. Experiments were performed in HEK293 cells overexpressing TRPC3 and in RBL‐2H3 mast cells, which express classical store‐operated Ca2+ entry mediated by Orai channels. The consequences of inhibitory effects on Ca2+ signalling in RBL‐2H3 cells were investigated at the level of both degranulation and nuclear factor of activated T‐cells activation.

Key Results

Pyr3, a previously suggested selective inhibitor of TRPC3, inhibited Orai1‐ and TRPC3‐mediated Ca2+ entry and currents as well as mast cell activation with similar potency. By contrast, Pyr6 exhibited a 37‐fold higher potency to inhibit Orai1‐mediated Ca2+ entry as compared with TRPC3‐mediated Ca2+ entry and potently suppressed mast cell activation. The novel pyrazole Pyr10 displayed substantial selectivity for TRPC3‐mediated responses (18‐fold) and the selective block of TRPC3 channels by Pyr10 barely affected mast cell activation.

Conclusions and Implications

The pyrazole derivatives Pyr6 and Pyr10 are able to distinguish between TRPC and Orai‐mediated Ca2+ entry and may serve as useful tools for the analysis of cellular functions of the underlying Ca2+ channels.
α‐lipoic acid prevents non‐alcoholic fatty liver disease in OLETF rats
Authors: Jung Tae Sik , Kim Soo Kyoung , Shin Hyun Joo , Jeon Byeong Tak , Hahm Jong Ryeal , Roh Gu Seob
Published: August 2012

Background

Insulin resistance, oxidative stress, inflammation and innate immune system activation contribute to the development of non‐alcoholic fatty liver disease (NAFLD) through steatosis and inflammation in the liver. The powerful antioxidant α‐lipoic acid (ALA) has been shown to improve insulin sensitivity and suppress inflammatory responses. This study explores how ALA administration protects against NAFLD.

Methods

Otsuka Long‐Evans Tokushima Fatty (OLETF) rats were divided into two groups (treated with 200 mg/kg/day of ALA or untreated) at 12 weeks of age and sacrificed at 28 weeks of age.

Results

Serum levels of insulin, free fatty acids, total cholesterol, triglyceride, leptin, IL‐6 and blood glucose were decreased in ALA‐treated rats. Serum adiponectin levels were higher in ALA‐treated rats. ALA treatment decreased the expression of sterol regulatory element binding protein‐1 and acetyl CoA carboxylase, and increased glucose transporter‐4 expression in the livers of OLETF rats. Expression of the antioxidant enzymes heme oxygenase‐1 and Cu/Zn‐superoxide dismutase was increased in the livers of ALA‐treated rats. The lipid peroxidation marker 4‐hydroxynonenal was decreased in the liver of ALA‐treated rats. Proteins associated with innate immune activation (Toll‐like receptor‐4 and high‐mobility group protein box‐1) and inflammatory markers (vascular cell adhesion molecule‐1, intercellular adhesion molecule‐1, and cyclooxygenase‐2) were decreased in the livers of ALA‐treated rats.

Conclusions

Chronic ALA supplementation prevents NAFLD through multiple mechanisms by reducing steatosis, oxidative stress, immune activation and inflammation in the liver.
Exploration of Iranian intensive care nurses' experience of end‐of‐life care: a qualitative study*
Authors: Valiee Sina , Negarandeh Reza , Dehghan Nayeri Nahid
Published: August 2012

Background: A challenge for intensive care nurses is providing the best possible care to patients in an end‐of‐life stage. The fact that some patients will die despite the efforts of the health care team can affect the psychological state of the nurses and families. Lack of attention to such an issue can bring about unpleasant consequences for both patients and nurses.

Aim: Using a qualitative design, the aim is this article explores the experiences of intensive care nurses providing care for end‐of‐life patients.

Methods: The data were collected through in‐depth interviews with a purposive sample of 10 nurses working at intensive care units (ICUs). Interviews were transcribed and finally analysed through the conventional content analysis.

Findings: Two themes emerged out of the experience of providing care to the end‐of‐life patients. The findings revealed that for Iranian intensive care nurses providing care to such patients was accompanied by emotional burden and values and beliefs.

Conclusion: The results of the study have increased the current knowledge over the experience of providing care to end‐of‐life patients at ICUs. It also has revealed the need for providing the nurses with psychological support, accommodating the possibility for offering a complete care, attending to and managing the conditions of the patient and their families and engaging nurses in decision making about end‐of‐life patients.

Relevance to practice: Managers ought to provide specialized units for providing care to end‐of‐life patients. Nurses working on these units will require emotional support.
Assessment of a training programme for the prevention of ventilator‐associated pneumonia
Authors: Jam Gatell M Rosa , Santé Roig Montserrat , Hernández Vian Óscar , Carrillo Santín Esther , Turégano Duaso Concepción , Fernández Moreno Inmaculada , Vallés Daunis Jordi
Published: August 2012

Background: Ventilator‐associated pneumonia (VAP) is the most frequent nosocomial infection in intensive care units (ICUs). Most published studies have analysed nurses' theoretical knowledge about a specific procedure; however, the transfer of this knowledge to the practice has received little attention.

Aim: To assess the impact of training session on nurses' knowledge regarding VAP, compliance with VAP preventive measures, VAP incidence and determining whether nursing workload affects compliance.

Method: A prospective, quasiexperimental, pre‐ and post‐study of the nursing team in a 16‐bed medical/surgical ICU. Pre‐intervention phase: a questionnaire to assess nurses' knowledge of VAP prevention measures, direct observation and review of clinical records to assess compliance. Intervention phase: eight training sessions for nurses. The post‐intervention phase mirrored the pre‐intervention phase.

Findings: Nurses answered more questions correctly on the post‐intervention questionnaire than on the pre‐intervention (17·87 ± 2·69 versus 15·91 ± 2·68, p = 0·002). Compliance with the following measures was better during the post‐intervention period (p = 0·001): use of the smallest possible nasogastric tube, controlled aspiration of subglottic secretions and endotracheal tube cuff pressure, use of oral chlorhexidine and recording the endotracheal tube fixation number. VAP incidence remained unchanged throughout the study. However, a trend towards lower incidence of late (>4 days after intubation) VAP was observed (4·6 versus 3·1 episodes/1000 ventilation days, p = 0·37).

Conclusion: The programme improved both knowledge of and compliance with VAP preventive measures, although improved knowledge did not always result in improved compliance.
Trends and recurrence of placenta praevia: A population‐based study
Authors: Roberts Christine L. , Algert Charles S. , Warrendorf Janna , Olive Emily C. , Morris Jonathan M. , Ford Jane B.
Published: August 2012

We determined recent trends and recurrence rates of placenta praevia in 790,366 deliveries in NSW. From 2001 to 2009, the rate of placenta praevia increased by 26%, from 0. 69% to 0. 87% (trend P < 0.001). The placenta praevia recurrence rate in a second birth was 4.8%. Two‐thirds of the increase in placenta praevia was accounted for by trends in known risk factors, and the unexplained portion may reflect changes in unidentified risk factors or in the threshold for placenta praevia diagnosis.
Trade‐Offs between Cattle Production and Bird Conservation in an Agricultural Frontier of the Gran Chaco of Argentina
Authors: Mastrangelo Matias E. , Gavin Michael C.
Published: August 2012

Intensification of food production in tropical landscapes in the absence of land‐use planning can pose a major threat to biological diversity. Decisions on whether to spatially integrate or segregate lands for production and conservation depend in part on the functional relations between biological diversity and agricultural productivity. We measured diversity, density, and species composition of birds along a gradient of production intensification on an agricultural frontier of the Argentine Chaco, where dry tropical forests are cleared for cattle production. Bird species diversity in intact forests was higher than in any type of cattle‐production system. Bird species richness decreased nonlinearly as cattle yield increased. Intermediate‐intensity silvopastoral systems, those in which forest understory is selectively cleared to grow pastures of non‐native plants beneath the tree canopy, produced 80% of the mean cattle yield obtained in pastures on cleared areas and were occupied by 70–90% of the number of bird species present in the nearest forest fragments. Densities of >50% of bird species were significantly lower in open pastures than in silvopastoral systems. Therefore, intermediate‐intensity silvopastoral systems may have the greatest potential to sustain cattle yield and conserve a large percentage of bird species. However, compared with low‐intensity production systems, in which forest structure and extent were intact, intermediate‐intensity silvopastoral systems supported significantly fewer forest‐restricted bird species and fewer frugivorous birds. These data suggest that the integration of production and conservation through intermediate‐intensity silvopastoral systems combined with the protection of forest fragments may be required to maintain cattle yield, bird diversity, and conservation of forest‐restricted species in this agricultural frontier.

Compromisos entre la Producción de Ganado y la Conservación de Aves en una Frontera Agrícola del Gran Chaco de Argentina
Spontaneous Trigeminal Allodynia in Rats: A Model of Primary Headache
Authors: Oshinsky Michael L. , Sanghvi Menka M. , Maxwell Christina R. , Gonzalez Dorian , Spangenberg Rebecca J. , Cooper Marnie , Silberstein Stephen D.
Published: August 2012

Animal models are essential for studying the pathophysiology of headache disorders and as a screening tool for new therapies. Most animal models modify a normal animal in an attempt to mimic migraine symptoms. They require manipulation to activate the trigeminal nerve or dural nociceptors. At best, they are models of secondary headache. No existing model can address the fundamental question: How is a primary headache spontaneously initiated? In the process of obtaining baseline periorbital von Frey thresholds in a wild‐type Sprague‐Dawley rat, we discovered a rat with spontaneous episodic trigeminal allodynia (manifested by episodically changing periorbital pain threshold). Subsequent mating showed that the trait is inherited. Animals with spontaneous trigeminal allodynia allow us to study the pathophysiology of primary recurrent headache disorders. To validate this as a model for migraine, we tested the effects of clinically proven acute and preventive migraine treatments on spontaneous changes in rat periorbital sensitivity. Sumatriptan, ketorolac, and dihydroergotamine temporarily reversed the low periorbital pain thresholds. Thirty days of chronic valproic acid treatment prevented spontaneous changes in trigeminal allodynia. After discontinuation, the rats returned to their baseline of spontaneous episodic threshold changes. We also tested the effects of known chemical human migraine triggers. On days when the rats did not have allodynia and showed normal periorbital von Frey thresholds, glycerol trinitrate and calcitonin gene related peptide induced significant decreases in the periorbital pain threshold. This model can be used as a predictive model for drug development and for studies of putative biomarkers for headache diagnosis and treatment.
Radical Attitudes and Jihad: A Commentary on the Article by Clark McCauley (2012) Testing Theories of Radicalization in Polls of U.S. Muslims
Authors: Mullins Sam
Published: August 2012

McCauley's research adds to what we know about sympathy for elements of the “global jihad frame” among the wider U.S. Muslim population and establishes the need for a targeted and differentiated approach to persuasive communication aimed at undermining sympathy for terrorism. This commentary aims to supplement McCauley's paper with a brief discussion of the distinction between radical thought and action, and what this means for the “war on ideas.”
Evaluation of Two Fatigability Severity Measures in Elderly Adults
Authors: Schnelle John F. , Buchowski Maciej S. , Ikizler Talat A. , Durkin Daniel W. , Beuscher Linda , Simmons Sandra F.
Published: August 2012

Objectives

To document the stability, concurrent validity, and clinical correlates of two fatigability severity measures as recommended by the American Geriatrics Society.

Design

Descriptive, cross‐sectional.

Setting

Two independent living and one community senior centers.

Participants

Forty‐three participants, with an average age 85 ± 6.

Measurements

Perceived fatigability severity was quantified by directly asking participants to report change in energy after a standardized 10‐minute walk at a self‐selected pace. Performance fatigability severity was defined as a ratio of change in walking speed to total distance walked. The walk test was repeated within 2 weeks to assess stability. Total daily physical activity (PA) was measured over 7 consecutive days using a waist‐worn accelerometer. Frailty was measured using the Vulnerable Elders Survey interview scale, and gait speed was measured using a standardized 25‐feet walk test.

Results

The perceived and performance fatigability severity measures were significantly correlated (correlation coefficient (r) = 0.94, P < .001) and stable over two assessments (r = 0.82 and 0.85, P < .001). Both fatigability severity measures were significantly correlated with PA level (r = −0.42 and r = −0.44, respectively, P = .02), frailty (r = 0.47 and 0.53, respectively, P = .001) and gait speed (r = −0.45, P = .003 and r = −0.54, P = .001, respectively).

Conclusion

The methodology described in this study permits the calculation of two highly correlated fatigability severity scores, which summarize the relationship between a person's change in self‐reported tiredness or change in physical performance and concurrently measured PA. The fatigability severity scores are reproducible and correlated with clinical measures predictive of decline. The methods used to quantify fatigability severity can be implemented during a brief assessment (<15 minutes) and should be useful in the design and evaluation of interventions to increase PA in older adults at risk of functional decline.
Dentition, Dental Health Habits, and Dementia: The Leisure World Cohort Study
Authors: Paganini‐Hill Annlia , White Stuart C. , Atchison Kathryn A.
Published: August 2012

Objectives

To explore the association between dentition and dental health behaviors and incident dementia.

Design

Longitudinal cohort.

Setting

Leisure World, Laguna Hills, CA; a retirement community.

Participants

Five thousand four hundred sixty‐eight older (median age 81) adults followed from 1992 to 2010.

Measurements

Questions regarding dental health focused on number of natural teeth, dentures worn, number of visits to a dentist, and oral health habits. Dementia status was determined from in‐person evaluations, follow‐up questionnaires, hospital data, and death certificates. Estimates of dementia risk were calculated using Cox regression analysis in men and women separately.

Results

Men with inadequate natural masticatory function who did not wear dentures had a 91% greater risk of dementia than those with adequate natural masticatory function (≥10 upper teeth and ≥6 lower teeth). This risk was also greater in women but not significantly so. Dentate individuals who reported not brushing their teeth daily had a 22% to 65% greater risk of dementia than those who brushed three times daily.

Conclusion

In addition to helping maintain natural, healthy, functional teeth, oral health behaviors are associated with lower risk of dementia in older adults.
Persistence and Remission of Musculoskeletal Pain in Community‐Dwelling Older Adults: Results from the Cardiovascular Health Study
Authors: Thielke Stephen M. , Whitson Heather , Diehr Paula , O'Hare Ann , Kearney Patricia M. , Chaudhry Sarwat I. , Zakai Neil A. , Kim Dae , Sekaran Nishant , Sale Joanna E. M. , Arnold Alice M. , Chaves Paulo , Newman Anne
Published: August 2012

Objectives

To characterize longitudinal patterns of musculoskeletal pain in a community sample of older adults over a 6‐year period and to identify factors associated with persistence of pain.

Design

Secondary analysis of the Cardiovascular Health Study.

Setting

Community‐based cohort drawn from four U.S. counties.

Participants

Five thousand ninety‐three men and women aged 65 and older.

Measurements

Over a 6‐year period, pain was assessed each year using a single question about the presence of pain in any bones or joints during the last year. If affirmative, participants were queried about pain in seven locations (hands, shoulders, neck, back, hips, knees, feet). Participants were categorized according to the percentage of time that pain was present and according to the intermittent or chronic pattern of pain. Factors associated with persistent pain during five remaining years of the study were identified.

Results

Over 6 years, 32% of participants reported pain for three or more consecutive years, and 32% reported pain intermittently. Of those who reported pain the first year, 54% were pain free at least once during the follow‐up period. Most of the pain at specific body locations was intermittent. Factors associated with remission of pain over 5 years included older age, male sex, better self‐rated health, not being obese, taking fewer medications, and having fewer depressive symptoms. Approximately half of those with pain reported fewer pain locations the following year.

Conclusion

Musculoskeletal pain in older adults, despite high prevalence, is often intermittent. The findings refute the notion that pain is an inevitable, unremitting, or progressive consequence of aging.
Initial Application of Reduced Port Surgery Using the Single Port Access Technique for Laparoscopic Canine Ovariectomy
Authors: Runge Jeffrey J. , Curcillo Paul G. , King Stephanie A. , Podolsky Erica R. , Holt David E. , Davidson Jeffrey , Agnello Kimberly A.
Published: August 2012

Objective

To describe the Single port access (SPA) laparoscopic entry technique for canine ovariectomy (OVE), report complications, and outcomes.

Study Design

Pilot study.

Animals

Intact female dogs (n = 6).

Methods

With owner consent, 6 intact female dogs had SPA laparoscopic OVE. Data, including signalment, surgical time (from incision to completion of closure), size and location of port placement, need for conversion (both to standard multiport laparoscopy and laparotomy), as well as any intraoperative complications including blood loss or tissue injury were recorded.

Results

Mean surgical time was 52.5 minutes (range, 45–60 minutes) and mean incision length, 1.8 cm (range, 1.5–2.0 cm). In an 18‐kg mix breed dog (dog 3), a “single port rescue” was required and located on midline 2‐cm caudal to the umbilicus. Close positioning of the trocars caused instrument interference, limited viewing, and prevented safe ligation of the ovarian vessels vein with a vessel‐sealing device. OVE was successfully completed laparoscopically in all dogs.

Conclusion

The SPA laparoscopic entry technique can be used in dogs, although instrument and camera interference can occur if trocar placement is too consolidated within the initial skin incision.
Prevalence of Piriformis Syndrome in Chronic Low Back Pain Patients. A Clinical Diagnosis with Modified FAIR Test
Authors: Kean Chen Chee , Nizar Abd J.
Published: August 2012

Purpose:  Piriformis syndrome is a collection of symptoms and signs of pain from piriformis muscle and is characterized by pain in buttock with variable involvement of sciatic nerve. This syndrome is often overlooked in clinical practice because its presentation has similarities with other spine pathologies. A major problem with the clinical diagnosis of piriformis syndrome is the lack of consistent objective findings and an absence of single test that is specific for piriformis syndrome. Therefore, a precise and reliable clinical method of diagnosing piriformis syndrome should be developed by clinicians.

Methods:  This is a prospective observational study involving 93 consecutive patients who attended the Pain Management Unit for chronic low back pain. The diagnosis of piriformis syndrome was made using the modified Flexion Adduction Internal Rotation (FAIR) test, which is a combination of Lasègue sign and FAIR test. Prevalence of piriformis syndrome based on this technique was compared with the previous data using other techniques. Chi square (χ2) analysis was performed to detect the relationship between piriformis syndrome and the potential risk factors.

Results:  On the basics of our diagnostic criteria, the prevalence of piriformis syndrome was 17.2% among low back pain patients. All the patients diagnosed with piriformis syndrome responded well with piriformis muscle injections. No significant associations were detected between piriformis syndrome and spine disorders.

Conclusions:  Piriformis syndrome is a painful condition that is often overlooked in the differential diagnosis of chronic buttock or low back pain. The modified FAIR test together with piriformis muscle injection is potentially a reliable method for the clinical diagnosis of piriformis syndrome.
Treatment Outcomes for Workers Compensation Patients in a US‐Based Interdisciplinary Pain Management Program
Authors: Gagnon Christine M. , Stanos Steven P. , van der Ende Geke , Rader Lynn R. , Harden R. Norman
Published: August 2012

Objectives:  Assess the efficacy of an outpatient‐based interdisciplinary pain rehabilitation program for patients with active workers compensation claims.

Patients:  Data were available for 101 patients, primarily with chronic low back pain (75%), who participated in the program.

Methods:  Treatment included a 4‐week (Monday to Friday), 8‐hours/day graded progressive program that included individual and group therapies (pain psychology, physical therapy, occupational therapy, relaxation training/biofeedback, aerobic conditioning, pool therapy, vocational counseling, patient education and medical management). Outcome measures included program completion status, release‐to‐work status, return‐to‐work status, total scores on the Beck Depression Inventory, State‐Trait Anxiety Inventory, Pain Catastrophizing Scale, and the McGill Pain Questionnaire Visual Analogue Scale (MPQ VAS). The majority of the patients (65%) graduated from the program. Pre‐postoutcome data were available for those who graduated from the program. For noncompleters, last obtained MPQ VAS was compared with their initial MPQ VAS scores.

Results:  Of those completing the program, most patients (91%)were released to return to work; with 80% released to full‐time status and 11% released to gradual return. Approximately half (49%) of the program completers returned to work. Paired‐samples t‐tests showed that program completers had significant reductions in depression (P = 0.000), pain‐related catastrophizing (P = 0.033), and pain intensity (P = 0.000), but not in anxiety (P = 0.098). Interestingly, the last obtained (at early discharge/withdrawal) pain intensity scores (M = 70.33) were higher than at baseline (M = 61.20) in the noncompleters. This difference was not statistically significant (P = 0.127) but may be clinically meaningful.

Discussion:  Our results support the efficacy of an outpatient‐based 4‐week interdisciplinary pain rehabilitation program in decreasing emotional distress, reducing pain intensity, and improving return‐to‐work status in the majority of completers in this challenging population. Patients reporting increased pain at discharge or those discharged early may have been due to operant factors.