bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical implications of the BRAF mutation in papillary thyroid carcinoma and chronic lymphocytic thyroiditis
Authors: Kim Woon Won , Ha Tae Kwun , Bae Sung Kwon
Published: January 2018

Background

The purpose of this study was to examine the possible prognostics and clinicopathologic characteristics underlying the BRAFV600E mutation and papillary thyroid carcinoma (PTC) coexisting or in absence of chronic lymphocytic thyroiditis (CLT).

Methods

This study was conducted on 172 patients who had undergone total thyroidectomy or unilateral total thyroidectomy for PTC; the patients were then examined for the BRAFV600E mutation using specimens obtained after their surgery from January 2013 to August 2015.

Results

BRAF mutations were found in 130 of 172 patients (75.6%). CLT was present in 27.9% of patients (48/172). The incidence of the BRAFV600E mutation was significantly increased in the group with no CLT ( P = 0.001). The findings of the multivariate analysis pertaining to the coexistence of CLT and PTC showed no significant correlation other than the BRAFV600E mutation. No significant difference was noted in the clinicopathologic factors between the two groups based on the coexistence of CLT in univariate and multivariate analyses.

Conclusions

The BRAFV600E mutation is less frequent in PTC coexisting with CLT presumably because CLT and the BRAFV600E mutation operate independently in the formation and progression of thyroid cancer.
MARSIPAN: management of really sick patients with anorexia nervosa
Authors: Robinson Paul , Rhys Jones William
Published: January 2018

Anorexia nervosa is a potentially fatal illness that affects women and a smaller proportion of men. When a patient becomes so severely ill that admission to a medical unit is required, the risk of a poor outcome is high. Most medical services do not have sufficient expertise, without psychiatric help, to manage the nutritional, medical, behavioural and family problems that often appear. These problems interact and this can adversely affect outcome. This article discusses, with reference to the MARSIPAN report, the procedure that should be followed when such a patient presents to an acute medical service. It considers diagnosis, risk assessment, consent, re-feeding syndrome, underfeeding syndrome and treatment-sabotaging behaviours. It stresses the importance of collaboration between expert medical and psychiatric staff, and involvement of the family. When these issues are adequately addressed, the outcome for the patient is more likely to be positive.

LEARNING OBJECTIVES

•

Be confident in diagnosing individuals with anorexia nervosa and identify when urgent in-patient medical treatment is required

•

Be confident in assessing and managing physical risk in individuals with anorexia nervosa

•

Be aware of the Royal College of Psychiatrists’ MARSIPAN report and its implications for the management of individuals with eating disorders in medical settings

DECLARATION OF INTEREST

None.
Motivational interviewing: living up to its promise?
Authors: Luty Jason , Iwanowicz Maciej
Published: January 2018

Motivational interviewing is a form of psychotherapy in which ambivalence towards an aberrant behaviour is targeted. Rather than challenge the behaviour directly, the clinician encourages the patient to devise a list of problems that are caused by the behaviour and to identify solutions. There are many trials of motivational interviewing, although it has been most studied as treatment for substance misuse. The effect sizes for motivational interviewing are small, they probably diminish over time, the trials often use multiple outcome measures and the outcomes of some very large trials have been disappointing. Large effects are occasionally reported, although these tend to be from small trials conducted by highly motivated research groups and the results tend to diminish when the trials are repeated or enlarged. Nonetheless, motivational interviewing is a well-validated approach supporting and enabling engagement in therapeutic process. It could be argued that even though it might not be as efficacious as a primary/stand-alone means of changing patients’ behaviour, it can still be highly effective when combined with other approaches or used as a conduit to a more intensive therapy.

LEARNING OBJECTIVES

•

Gain a basic understanding of what motivational interviewing involves

•

Develop an awareness of the many therapeutic applications of motivational interviewing

•

Develop an awareness of the modest results of the very large field trials and the tendency for effect to diminish over time

DECLARATION OF INTEREST

None.
Brain-stem serotonin transporter availability in maternal uniparental disomy and deletion Prader–Willi syndrome
Authors: Krishnadas Rajeev , Cooper Sally-Ann , Nicol Alice , Pimlott Sally , Soni Sarita , Holland Anthony J , McArthur Laura , Cavanagh Jonathan
Published: January 2018

Prader–Willi syndrome (PWS) is a rare condition because of the deletion of paternal chromosomal material (del PWS), or a maternal uniparental disomy (mUPD PWS), at 15q11-13. Affective psychosis is more prevalent in mUPD PWS. We investigated the relationship between the two PWS genetic variants and brain-stem serotonin transporter (5-HTT) availability in adult humans. Mean brain-stem 5-HTT availability determined by [123I]-beta-CIT single photon emission tomography was lower in eight adults with mUPD PWS compared with nine adults with del PWS (mean difference −0.93, t = −2.85, P = 0.014). Our findings confirm an association between PWS genotype and brain-stem 5-HTT availability, implicating a maternally expressed/paternally imprinted gene, that is likely to account for the difference in psychiatric phenotypes between the PWS variants.

Declaration of interest

None.
Accuracy of the Whooley questions and the Edinburgh Postnatal Depression Scale in identifying depression and other mental disorders in early pregnancy
Authors: Howard Louise Michele , Ryan Elizabeth G. , Trevillion Kylee , Anderson Fraser , Bick Debra , Bye Amanda , Byford Sarah , O'Connor Sheila , Sands Polly , Demilew Jill , Milgrom Jeannette , Pickles Andrew
Published: January 2018

Background

There is limited evidence on the prevalence and identification of antenatal mental disorders.

Aims

To investigate the prevalence of mental disorders in early pregnancy and the diagnostic accuracy of depression-screening (Whooley) questions compared with the Edinburgh Postnatal Depression Scale (EPDS), against the Structured Clinical Interview DSM-IV-TR.

Method

Cross-sectional survey of women responding to Whooley questions asked at their first antenatal appointment. Women responding positively and a random sample of women responding negatively were invited to participate.

Results

Population prevalence was 27% (95% CI 22–32): 11% (95% CI 8–14) depression; 15% (95% CI 11–19) anxiety disorders; 2% (95% CI 1–4) obsessive–compulsive disorder; 0.8% (95% CI 0–1) post-traumatic stress disorder; 2% (95% CI 0.4–3) eating disorders; 0.3% (95% CI 0.1–1) bipolar disorder I, 0.3% (95% CI 0.1–1%) bipolar disorder II; 0.7% (95% CI 0–1) borderline personality disorder. For identification of depression, likelihood ratios were 8.2 (Whooley) and 9.8 (EPDS). Diagnostic accuracy was similar in identifying any disorder (likelihood ratios 5.8 and 6).

Conclusions

Endorsement of Whooley questions in pregnancy indicates the need for a clinical assessment of diagnosis and could be implemented when maternity professionals have been appropriately trained on how to ask the questions sensitively, in settings where a clear referral and care pathway is available.

Declaration of interest

L.M.H. chaired the National Institute for Health and Care Excellence CG192 guidelines development group on antenatal and postnatal mental health in 2012–2014.
Health professionals' views of services for schizophrenia – fragmentation and inequality
Authors: Haddad Peter , Knapp Martin
Published: January 2018

There has been much debate about effective treatments, service configurations and costs within Britain's mental health care system, but it has largely taken place in academic and management circles. We were interested in the views of those providing care. We organised a meeting of community psychiatric nurses, general practitioners and consultant psychiatrists (funded with an educational grant from Zeneca Pharmaceuticals). Participants worked in various parts of Great Britain, including rural and inner city areas. The authors facilitated the discussion, the emphasis of which was on participants' clinical experience.
In the light of Bournewood
Authors: Kearney Norma , Treloar Adrian
Published: January 2018

Aims and Method

A postal audit of practice in the South-East Thames Region of England before and after the Bournewood judgements.

Results

There was a trebling in the rate of admission under section of elderly incapacitated patients occurred prior to the Houseof Lords' ruling. By the time of the ruling many consultants had not changed their practice. There is now, however, no impact of the ruling upon clinical practice. The majority of consultants remain concerned about the lack of safeguards for mentally incapacitated elders at the present time.

Clinical Implications

Although the Bournewood judgement was expected by some to have a permanent impact upon the management of the mentally incapacitated this has not happened. There is a need for effective and resource efficient safeguards for the mentally incapacitated to be developed.
Admission patterns by psychiatric trainees
Authors: Shajahan Polash M. , McLntosh Andrew M. , Cavanagh Jonathan T. O.
Published: January 2018

Aims and Methods

We hypothesised that the increased admission rate for men with major mental illness may bethe result of men being preferentiallyadmitted by psychiatrists. A questionnaire survey was devisedand sent to all psychiatric trainees on the South-East Scotland rotation. The questionnaire contained a series of psychiatric vignettes representing conditions varying in severity of risk.

Results

Seventy-eight per cent responded to the questionnaire. Trainees were more likely to admit patients representing a greater degree of risk irrespective of the gender of the patient.

Clinical Implications

The increasing admission rates for men with major mental illness is unlikely to be due to admission bias by trainees.
Compulsory psychiatric admission
Authors: van Lysebetten T. , Igodt P.
Published: January 2018

Y is a 55-year-old woman who was brought to the accident and emergency department, following an epileptic fit on the street. She had a known history of severe alcohol dependency and epilepsy. She had numerous past admissions, which were always terminated prematurely by her. She has not been adhering to the anti-epileptic treatment. Five days prior to admission her daughter found her in a grossly self-neglected state. There was evidence of recent heavy drinking and she had been incontinent of urine and faeces. Despite this the daughter had not requested help. At interview Y presented as a small unkempt lady, seemingly undernourished and frail. She had recently undergone a hip replacement and was found to have an infected suture wound on physical examination. There were no signs of acute confusion or intoxication. She was neither depressed, nor deluded. There were early signs of cognitive decline (short-term memory impairment). She refused voluntary psychiatric treatment and denied her self-neglect, in spite of her bad personal hygiene and infected wound.
WebGuide
Authors: Briscoe Martin , Hicks Trevor
Published: January 2018

This site summarises systematic reviews of randomised trials by searching Medline and Pubmed. Bandolier Knowledge Bazaar assembles stories from Bandolier under discrete headings, such as ‘healthy living’.
Service innovations
Authors: Bisson Jonathan I. , Roberts Neil , Macho Gavin S.
Published: January 2018

There remains uncertainty on how best to respond to the psychological needs of individuals following traumatic events. Various approaches have been tried, but there is now a growing body of research in this area that allows us to plan appropriate responses in an evidence-based and coordinated manner. This paper describes the development of a local initiative through a partnership between the local traumatic stress service and the emergency planning department.
Service innovations
Authors: Tomar Rahul , Brimblecombe Neil , O'Sullivan Geraldine
Published: January 2018

Aims and Method

Demographic and clinical details were recorded for individuals with first-episode psychosis, potentially requiring hospital admission, who were assessed by two home treatment/crisis resolution teams over an 18-month period. The aims were to identify the proportion of such individuals that can be treated at home, factors associated with successful home treatment and reasons for hospitalisation when this took place.

Results

Successful home management was achieved in 20 (54%) of cases. No significant difference was found in any demographic variable, diagnostic category and initial Brief Psychiatric Rating Scale (BPRS) ratings between those who were hospitalised and those who were not. The most common reason recorded for admission was that of risk to self.

Clinical Implications

Many patients with first-episode psychosis otherwise requiring hospitalisation can be managed successfully at home by an intensive home-treatment team. These findings have significant implications for both in-patient and community services, in view of the planned increases in home treatment/crisis resolution services proposed in the NHS Plan.
Transcending mental health law
Authors: Sayce Liz
Published: January 2018

We live in an era in which debates on the need for mental health reform are over-focused on single issues (like how to ‘get people who live in the community to keep taking their medication’) or, even worse, single cases (how to prevent another tragedy like the killing by Jason Mitchell). This prevents rational policy-making. Unusual cases make bad law. Narrow proposals for risk reduction ignore many of the most pertinent risks: that service users will be victims of attack, but have no access to justice because they are not seen as ‘credible witnesses’; or that they will be detained for fear of violence when in fact they would not have been violent (Sayce, 1995). The recent statement on prime time British TV by Dr Deahl that he would rather detain nine people unnecessarily than discharge one who went on to harm a member of the public, shows how ‘single issue’ risk analysis can lead straight to breaches of natural justice (‘Panorama’, 13 October 1997, British Broadcasting Corporation).
Survival in a cold climate
Authors: Wells Peter
Published: January 2018

Early in the 1980s I anticipated that sooner or later the Regional Adolescent Service based on the Young People's Unit in Macclesfield would ultimately have to face making a strong and if possible, an unanswerable case for survival.
Images used to sell psychotropic drugs
Authors: Owen John H. , Jelley Matthew
Published: January 2018

Advertisers use powerful images to sell everything from cars to coffee, from banks to baked beans. That this should also apply to pharmaceuticals then is unsurprising. Whatever view we as clinicians might take of drugs, for their manufacturers they are a product like any other, and doctors are the natural targets for their promotion. In 1982 the pharmaceutical industry spent £150,000,000 on drug promotion in the UK (Medawar, 1984). We have attempted to take an objective view of drug advertisements by examining the images used in all the advertisements that have appeared in the British Journal of Psychiatry over the last 30 years.
Is there a case for ‘unidisciplinary working’ in child psychiatry?
Authors: Silveira W. R. , Ballard C. G. , Mohan R. N. C. , McGibben L. , Sheikh A. , Bhadrinath B.
Published: January 2018

In many parts of the country, child psychiatrists currently provide services on their own. This ‘unidisciplinary’ model of practice is out of step with College recommendations for multidisciplinary working in child and adolescent psychiatry (Royal College of Psychiatrists, 1990). The question arises whether one model is in fact superior to the other. In this article we look briefly at the history of the multidisciplinary team, describe our own experience of providing a unidisciplinary service and suggest a working model for the future.
Psychiatric training, Singapore
Authors: Robertson J. R. , Halstead S. , Tan T. , Lawrence J.
Published: January 2018

In 1987 the Charing Cross General Psychiatric Training Scheme incorporated an exchange with the National University Hospital, Singapore (NUH) sponsored by Glaxo Pharmaceuticals. Four selected UK trainees have now spent nine months at NUH as part of their general rotation. A description of psychiatric training based at NUH is outlined here.
The European Federation of Psychoanalytic Psychotherapy (EFPP)
Authors: Martindale Brian
Published: January 2018

The EFPP is a British initiative concerned with public sector psychoanalytic psychotherapy that seems to have touched upon a recognised need in our European neighbours and colleagues. Its origins are inextricably linked with the development of the Association for Psychoanalytic Psychotherapy in the British Health Service (the APP).
Mental health services in Germany
Authors: Tyrie Christine M.
Published: January 2018

On a recent study trip I was able to examine approaches to health care, in particular, mental health services in what was West Germany. I visited a range of facilities and met a wide range of professional workers.
Auditing the administration of ECT
Authors: Pippard John
Published: January 2018

ECT has been valued for over 50 years as an effective treatment for mental illness and especially for depressive illness, and its value has been confirmed by many double-blind comparisons of real and simulated ECT.
Letter of Dr. Foote to the Magistrates of Norfolk
Authors: Foote R. F.
Published: January 2018

Gentlemen,—On Tuesday last, the Committee of Visitors at their meeting, at which four only were present, called upon me to resign my appointment, in consequence of conclusions which they had formed in reference to my conduct; I haying laid before them circumstances in which I considered that my direction^ as to the treatment of patients, had been disobeyed, and myself grossly insulted.
Second Notice of the Eighth Report of the Commissioners in Lunacy
Authors: Conolly John
Published: January 2018

I have been reminded that in my first notice, when I spoke of Dr. Davey, Dr. Nesbitt, and Dr. Hitchman, as having respectively introduced the Non-Restraint System into the asylums of Colney Hatch, Northampton, and Derby, it would appear that I overlooked the fact of that system having been adopted at Northampton by Dr. Nesbitt's predecessor, the late Dr. Thomas Prichard. Although my meaning was merely that the three physicians named had each left Hanwell convinced of the practicability and safety of the non-restraint system, and had steadily maintained it on their removal; I ought, perhaps, to have added, that at Northampton it had already been acted upon, and zealously and ably defended in the successive annual reports of the superintending physician. One or two occasional instances of the abandonment of the principle deprived this early and laudable example of full effect.
Cutaneous Discolorations resembling Bruises occurring to the Insane,
Authors: Bucknill J. C.
Published: January 2018

It has several times happened to me during the earlier years of my asylum experience, to observe the occurrence of what appeared to be extensive bruises in the persons of feeble and helpless patients, who were in the hands of skilful and attentive nurses, and in whom such occurrences perplexed not less than they shocked me; as I am now distinctly convinced that these appearances were not owing to external injuries, as I can find them nowhere alluded to in books, and as their repetition is calculated to lead to unfounded suspicions, I think a few observations respecting them appropriate for the pages of this Journal
The New Pauper Lunatic Asylum for the County of Essex,
Authors: Campbell Donald C.
Published: January 2018

At the Baiter sessions of the year 1846, fifteen justices of this county were appointed a committee, to superintend the erecting or providing of an asylum for the pauper lunatics, in terms of the Act 8th and 9th Victoria, Cap. 126. And at a meeting held on the 80th of August, 1847, the committee directed their clerk to advertise for a site for the asylum, according to the rules of the Commissioners in Lunacy. They finally selected the ground on which the asylum has been erected—eighty-six acres of the Brentwood Hall estate, the same having been purchased for the sum of £8000. After obtaining the sanction of the Court of Quarter Sessions, the committee proceeded to take farther steps in the execution of their commission, and at a meeting held on the 25th October, 1848, they resolved to select a certain number of architects, not exceeding ten, who should be invited to send in plans for the asylum, and that the sum of £100 should be awarded to the second best plan, and £50 to the third best. The committee having availed themselves of the advice and assistance of the county surveyor, and also of a medical gentleman connected with asylums, and having taken their opinion on the comparative merits of the respective plans, resolved on accepting the plan of Mr. H. E. Kendall, Junr., of 83 Brunswick: Square, London, as the best offered to them; which, after having been altered and amended to the satisfaction of the Commissioners, was submitted to the January session, 1850, for the approbation of the Court.
Fourth Notice of the Eighth Report of the Commissioners in Lunacy,
Authors: Conolly John
Published: January 2018

I am sorry to find that my remarks on the use of restraints in the Kent Asylum were displeasing to Dr. Huxley; and can only say that my desire was to confine myself to the actual statements in his own Report I was careful to mention his anxiety to hare it understood with what strict limitation he employed any mechanical restraint at all. Dr. Huxley may be assured, that nothing was farther from my wish than to do him injustice or to give him uneasiness.
Cases by
Authors: Tyermam D. F.
Published: January 2018

A. T., a male patient, æt. 32, ‘unmarried, and by occupation a labourer, deaf and dumb, was admitted into the Colney Hatch Asylum on the 7th of January, 1853; having been subject to epilepsy from childhood, the convulsive paroxysms, of late years, having been succeeded by tendency to dangerous violence. He was of medium stature, of robust make, the osseous and muscular systems, as is generally the case with epileptics, well developed; the neck short and chest broad.
On the Classification and Forms of Insanity
Authors: Monro Henry
Published: January 2018

In my first lecture on the nomenclature of varieties of insanity I dwelt upon those phraseologies which have already been in use. The first of these was the old well known classification, which was grounded on the physical temperament, and conduct of the patient; and which confined itself very much to the question, whether he was violent, low spirited, or silly. Mania, melancholia, and dementia, being applied to these states; monomania and moral insanity, arising in after years as auxiliary to these terms, and being a refinement on the idiosyncracies of various cases. The second phraseology was one which Dr. Noble has developed, if not originated; it dwelt upon the metaphysical position of diseased mind, discarding the consideration of conduct and temperament. It tells us which part or faculty of the mind is diseased; it contains, in short, a geographical sketch of the mind and its diseases, and gives us some ideas of the exact position of each case in the history of diseased mind. Emotional, notional, and intelligential insanity are the chief terms of this vocabulary. I stated my belief that a consideration of both of these histories, the physical and the metaphysical, the state of the conduct and temperament, as well as a history of the part of the mind diseased, were necessary, for a terminology which should represent a fair history of the varieties of diseased mind; and I proposed to compile a nomenclature of the varieties of the disease, constructed from the conjoint consideration of these two histories.
The Pathology of Insanity
Authors: Bucknill John Charles
Published: January 2018

The widely differing opinions which have been entertained by the ablest physicians respecting the pathology of insanity, clearly shew that there is some difficulty at the bottom of the question, greater than that which has existed with regard to the nature of other classes of disease. The source of this difficulty is not hard to find. A rational pathology must ever be founded upon the basis of physiology. It is indeed a kind of physiology; it is an account of the abnormalities of organization and of function, which as much depend on the natural laws of our being as do those of health. Fair weather and foul equally depend upon the laws of meteorology; health and disease equally depend upon the laws of animal life. The division of their study into the two departments of pathology and physiology is, therefore, perfectly arbitrary, and useful only for purposes of classification. But the knowledge of the laws of aberration cannot precede, or even be contemporaneous with, the knowledge of the normal laws of action. The high-road of health must be well known before the bye-ways and devious paths which surround it can be investigated.
Development of Deep Shear Wave Velocity Profiles with Estimates of Uncertainty in the Complex Interbedded Geology of Christchurch, New Zealand
Authors: Teague David , Cox Brady , Bradley Brendon , Wotherspoon Liam
Published: January 2018

Deep (+500-m) shear wave velocity ( V S) profiles were developed at 14 sites throughout Christchurch, New Zealand, using a combination of active-and passive-source surface wave testing. The geology of Christchurch is complex and presents several challenges for surface wave testing. Specifically, the complex interlayering of relatively stiff gravels with soft sands, silts, and clays makes (1) the interpretation of experimental dispersion data ambiguous and (2) complicates the determination of appropriate inversion-layering parameterizations. In order to address the first issue, dispersion data uncertainty was quantified and several mode interpretations were considered during inversion. To address the second issue, 155 geotechnical boreholes and 199 geologic well logs in the vicinity of the test sites were used to guide the choice of layering parameterizations such that geologically realistic V S profiles were obtained via surface wave inversion. At each site, a suite of 1,000 V S profiles representing the combined effects of epistemic uncertainty and apparent aleatory variability in V S was obtained. These V S profiles are available on the DesignSafe-CI web site ( https://doi.org/10.17603/DS21D4D ) and are intended to aid in future seismic site response analyses.
Conflictological Preparation for Future Officers of Customs Bodies
Authors: Калмыкова О. , Kalmykova O. , Трубицын К. , Trubicyn K. , Хрящев В. , Hryaschev V.
Published: January 2018

In the article the authors consider the actual problem of formation of the conflictology training strategy for students studying in the specialty "Customs", future leaders and employees of the customs bodies of the Russian Federation. In the article methods of formation of conflictological competence of students are analyzed, developed taking into account the needs of potential employers. The results of various sociological studies conducted among students studying in the specialty "Customs" (Samara State Technical University) and employees of customs bodies are analyzed. Teaching and methodological support of the system of conflictological training is presented. The authors of the article give examples of various conflictological problems used in conducting classes and trainings aimed at the prevention of destructive conflicts, conflicts of interest and the prevention of occupational stress among customs offi cials.
A baixa duração do sono está associada com a inatividade física em adolescentes amazonenses?
Authors: Ferrari Junior Geraldo , Pinto André , Barbosa Rita , Nahas Markus , Pelegrini Andreia , Felden Érico
Published: January 2018

Este estudo teve como objetivo analisar os fatores associados à baixa duração do sono em adolescentes amazonenses. Trata-se de um estudo epidemiológico transversal conduzido em 2.517 adolescentes (1.106 do sexo masculino e 1.411 do sexo feminino) com idades de 14 a 19 anos, matriculados em escolas públicas de ensino médio no estado do Amazonas. Além da baixa duração do sono (< oito horas/dia) foram investigadas informações sobre sexo, faixa etária, ano escolar, turno escolar, renda familiar, situação ocupacional e atividade física. Associações entre a baixa duração de sono com as demais variáveis foram analisadas por meio da regressão de Poisson. A prevalência de baixa duração de sono encontrada nos adolescentes amazonenses foi de (51,2%; IC95%= 49,2-52,9). Os adolescentes mais velhos de 18 a 19 anos (RP= 1,14; IC95%= 1,01-1,29), que estudam no turno matutino (RP= 1,37; IC95%= 1,25-1,48) e noturno (RP= 1,16; IC95%= 1,04-1,28), os que trabalham (RP= 1,34; IC95%= 1,23-1,45) e são inativos fisicamente (RP=1,27; IC95%= 1,06-1,53) apresentaram risco para a baixa duração do sono. Os resultados evidenciam que fatores biológicos, comportamentais e ambientais são fatores importantes para a duração do sono dos adolescentes.
Does a daily consultant ward round affect the outcomes of orthopaedic patients?
Authors: Baryeh Kwaku W , Elliott David , Harb Ziad , Lisk Radcliffe
Published: January 2018

Introduction:

In the UK, more than 60 000 patients present with a fractured neck of femur each year. These patients represent a huge financial cost. This study looks at the 30-day readmissions and total length of hospital stay of patients presenting with a fractured neck of femur, as well as length of stay in non-hip fracture trauma patients, following the change to a daily consultant-led ward round.

Methods:

A total of 200 records of patients with fractured neck of femur were reviewed with data collected retrospectively and prospectively following the introduction of the daily consultant-led ward round. Readmissions were classed as patients who spent a period of time admitted to hospital. Those who only attended an emergency unit were not included. Reasons for readmission and length of readmission were reviewed as were the initial and total length of stay. The authors also evaluated the length of stay in trauma patients (non-hip fracture emergency admissions) for a period of 6 months before and 4 months after the new working model was introduced.

Results:

With the new working pattern, there was a reduction in the length of stay in those readmitted (13 vs 8 days), and the total length of stay of readmitted patients was also considerably lower (23 vs 13 days). In non-hip fracture trauma patients, there was a reduction in length of stay (8 vs 6 days).

Conclusions:

This study demonstrates that by adopting a daily orthopaedic consultant-led ward round, it is possible to reduce the length of stay for patients with a fractured neck of femur, both on initial and subsequent hospital admissions, as well reducing the length of stay for non-hip fracture trauma patients.
De las marcas y otros signos distintivos en Cuba: Historia y Derecho
Authors: Yeney Acea Valdés
Published: January 2018

La necesidad de identificar objetos, personas, fenómenos naturales y sociales ha estado ligada al desarrollo del hombre, en este sentido los signos distintivos, desde el punto de vista jurídico, se han erigido como una herramienta fundamental para el desarrollo de la actividad empresarial. En Cuba, país con una fuerte tradición desde el punto de vista del uso de los signos distintivos en la industria tabacalera, el Derecho no ha estado al margen de las diversas tendencias y exigencias internacionales. El presente estudio constituye una síntesis apretada de los principales momentos, desde el ámbito del Derecho, por los cuales han transitado las marcas y otros signos distintivos en Cuba.
Assertive training and family psychological education therapy on adolescents self-esteem in prevention of drug use in boarding school
Authors: Ramadhan Indah , Keliat Budi , Wardani Ice
Published: January 2018

Adolescents are prone to use drugs when they have low self-esteem. Assertiveness training and family psychological education therapies are mental health nursing specialist interventions that are expected to increase adolescent self esteem so that adolescent has ability to prevent drug use. This study aims to determine the effect of assertiveness training and family psychological education therapy on adolescent self-esteem in the prevention of drug use in boarding schools. The research design was a quasi-experimental pre-post test with a control group. Sixty four adolescent students at the boarding school were selected using purposive sampling technique and cluster random sampling. The intervention group 1 only received general nursing intervention and the intervention group 2 received general nursing intervention, assertiveness training, and family psychological education therapy. The results showed that the self-esteem of adolescent students increased significantly after receiving nursing intervention and in the high self-esteem category (p = 0.017), after assertiveness training and family psychological education therapy, adolescent self-esteem in the intervention group 2 increased greater than only general nursing intervention ( P = 0, 000) with the high self-esteem category. There is the influence of assertiveness training and family psychological education therapy on adolescent self-esteem in prevention of drugs uses in a boarding school. Community health center is recommended to do nursing care in school through school health unit program either by primary care nurse or nurse specialist of mental health nursing.
Optimasi Multi Objektif Pada Pemilihan Portofolio Saham Syariah Menggunakan Compromise Programming (CP) dan Nadir Compromise Programming (NCP)
Authors: Saputro Tri Anton , Qudratullah Mohammad Farhan
Published: January 2018

Portofolio saham merupakan sekumpulan aset invetasi berupa saham yang dibentuk oleh para investor. Tujuan investor membentuk portofolio antara lain untuk mendapatkan pengembalian atau return yang tinggi dengan risiko yang rendah. Untuk mendapatkan portofolio yang optimal maka dilakukan optimasi pada beberapa faktor investasi yaitu mengoptimalkan risiko, memaksimalkan expected return dan meminimalkan modal investasi. Dalam penelitian ini dilakukan pembentukan portofolio menggunakan metode Compromise Programming (CP) dan Nadir Compromise Programming (NCP).Model CP dibentuk berdasarkan dari kemungkinan solusi terbaik, sedangkan model NCP dibentuk berdasarkan dari kemungkinan solusi terburuk.Hasil dari penelitian ini menunjukkan bahwa metode NCP lebih baik dibandingkan dengan metode CP karena risiko yang optimal dapat diperoleh pada metode NCP.
Densities of nitrate hydrates used as phase change materials
Authors: Danielik Vladimír , Szendreiová Dominika
Published: January 2018

Temperature dependency of densities of the liquid system magnesium nitrate hexahydrate - zinc nitrate hexahydrate was measured. Densities of liquid mixtures were experimentally measured at different temperatures by a method using submersible corpuscle. Based on the obtained data, temperature dependence on the density was obtained. A model describing the density in the whole concentration range very well was created.
Influence of pre-treatment on zirconium based conversion coating on AA2024
Authors: Zemanová Matilda , Lokaj Ján , Karľová Mária , Madejová Jana
Published: January 2018

A comparison of the influence of two alloy pre-treatments and temperature treatments on the formation and composition of zirconium based conversion coating on the AA2024 alloy has been performed. The investigation employed mass changes, atomic force microscopy (AFM), XRD dispersive spectroscopy (EDX), infrared spectroscopy (IR) and electrochemical tests by open circuit potential (OCP) measurements. Pre-treatment using only alkaline etching is called alkaline pre-treatment. When alkaline etching is followed by de-oxidization in a phosphoric acid solution the process is called acidic pre-treatment. Conversion coatings were formed in Pragokor BL. IR analysis revealed the formation of a phosphate on the alloy surface. EDX analysis showed Mg dissolution. The Zr content increased with the temperature of the conversion coating formation. Both pre-treatment methods provided a phosphate layer on the alloy surface.
Modelling of syngas production from municipal solid waste (MSW) for methanol synthesis
Authors: Šuhaj Patrik , Husár Jakub , Haydary Juma
Published: January 2018

Approximately 1 300 Gt of municipal solid waste (MSW) are produced worldwide every year. Most of it is disposed of in landfills, which is very hazardous for the environment. Up to 10 % of produced MSW are incinerated. However, incineration is not very effective and requires specific conditions for preventing emissions. Gasification and pyrolysis are more effective processes which can be used not only for heat and electricity generation but also for fuel and valuable chemicals production. MSW can be transformed into refuse-derived fuel (RDF) which has higher heat of combustion. Synthesis gas produced by RDF gasification can be utilised in methanol production. Methanol is a very lucrative chemical which can be used as renewable liquid fuel or as a reagent in organic syntheses. Gasifier design and process optimisation can be done using a reliable mathematical model. A good model can significantly decrease the number of experiments necessary for the gasification process design. In this work, equilibrium model for RDF gasification was designed in Aspen Plus environment and the flow of oxygen and steam as gasification agents were optimised to achieve the highest theoretical methanol yield. Impact of the recycle of unreacted steam and produced tar on the methanol yield was evaluated. The highest theoretical methanol yield (0.629 kgMEOH/kgRDF) was achieved when the steam and tar recycle were switched on, the ratio between oxygen and RDF feed was 0.423 kg/kg and that between the steam and RDF feed was 0.606 kg/kg. In this case, fresh steam represented only 12 % of the total steam fed to the reactor, the rest consisted of recycled steam. Optimal gasifier temperature was 900 °C.
Thermal rate constants of beryllium clusters in gas phase
Authors: Matúška Ján , Sukuba Ivan
Published: January 2018

Formation and fragmentation of beryllium clusters up to 100 atoms were studied using molecular dynamics trajectory simulations. Association rate constants of a single Be atom attachment to Ben clusters, n = 2-20, 30, 40, 50, 60, 70, 80, 90 and 100, and dissociation rate constants of these clusters were calculated directly. Dependence of the dissociation rate constants on temperature is strong and follows the Arrhenius equation. An analysis of the dissociation reactions has shown that beryllium clusters dissociate mainly into single Be atoms. The monomer association reaction depends weakly on temperature but strongly on the size of the cluster.
Hydrogen bonded homodimetallic compounds of the formula [M(H2O)5M(dipic)2]·2H2O, M = CoII or NiII and dipic = dipicolinate anion
Authors: Masárová Petra , Moncol Jan
Published: January 2018

Two homodimetallic dipicolinate compounds of the formulae [Co(H2O)5Co(dipic)2]·2H2O (1) and [Ni(H2O)5Ni(dipic)2]·2H2O (2) have been synthesized and their crystal structures have been determined by single-crystal X-ray diffraction analysis. The prepared isostructural compounds consist of cationic {MO5O’}2+ and anionic {MN2O4}2- moieties, where CoII/CoII or NiII/NiII metal centers are connected together by bridging μ-carboxylate oxygen atoms from dipicolinate anions. H-bond interactions involving aqua ligands, dipicolinate oxygens and lattice solvent molecules stabilize the dimeric units by linking them into 3-D polymeric networks.
Axial profiles of heat transfer coefficients in a liquid film evaporator
Authors: Pavel Timár , Ján Stopka , Vladimír Báleš
Published: January 2018

Regeneration is the most efficient way of managing used oil. It saves money by preventing costly clean-ups and liabilities associated with mismanagement of used oil and it also helps to protect the environment. A numerical study of the flow, heat and mass transfer characteristics of the vertical evaporating tube with the films flowing down on both the inside and the outside tube surfaces has been carried out. Condensation occurs along the outside wall surface and evaporation at the free surface of the inside film. The calculation domain of two film flow regions and tube wall is solved simultaneously. The longitudinal variation of temperature, mass flow rate, and hence the thickness of the films downward the tube can be obtained by applying conservation of the energy requirement to the differential element.
Crystallographic characterization of a novel spiro-[chroman-chromene]-carboxylate
Authors: Vrábel Viktor , Sivý Július , Švorc Ľubomír , Světlík Jan , Marchalín Štefan
Published: January 2018

We report here the crystal and electronic structure of a new spiro-derivative, namely methyl (2R,4S)- 4-(benzothiazol-2-ylamino)-8,8´-dimethoxyspiro[chroman-2,2´-chromene]-3´-carboxylate (I), C28H24N2O6S, which crystallizes as racemate in the space group C2/c. In this compound, the chromanone moiety consists of a benzene ring fused with a six-membered heterocyclic ring which adopts a distorted half-chair conformation. The molecules are linked by a combination of N-H∙∙∙N hydrogen bonds and weak C-H∙∙∙O, C-H∙∙∙S, C-H∙∙∙ π, inter- and intra-molecular interactions resulting in a two-dimensional network in the crystal structure.
Examining the Possibility of Detecting Brucella Canis from Tissue Samples Using Bruce-Ladder Multiplex PCR Assay
Authors: Stević Nataša , Mišić Dušan , Bogunović Danica , Matović Kazimir , Valčić Miroslav , Milovanović Milovan , Radojičić Sonja
Published: January 2018

The goal of this study was to compare the results of serological and conventional bacteriological methods with the results obtained using multiplex PCR Bruce-ladder assay. Based on the obtained results, the usability of the assay was assessed in regard to rapid diagnosis of canine brucellosis directly from the samples of reproductive organs of infected dogs. Out of 225 blood samples, 33 (14.67%) had a positive agglutination reaction. In this study, out of the 225 assayed reproductive organs of dogs, B. canis was isolated from 3 samples (1.33%), while the PCR Bruce-ladder assay detected two positive samples (0.88%). Two dogs from which B. canis was isolated, an antibody titer of 1/200 was established in blood serums, and third dog from which B. canis was isolated was negative using the tube agglutination test. From a total of 225 assayed organ samples, a positive PCR reaction was obtained from two samples. The obtained results show that the tube agglutination method remains the first choice for the detection of dogs infected with B. canis. In addition, whenever possible, it is necessary to try isolation. It is desirable to attempt the detection of B. canis in tissues using PCR, but the results may not be treated as definitive and reliable.
Entwurf robuster optischer Systeme am Beispiel des Künstlichen Akkommodationssystems
Authors: Sieber Ingo
Published: January 2018

Der modulare Aufbau optischer Systeme bedingt eine isolierte Herstellung der einzelnen Komponenten und ihres
nachgeordneten Zusammenbaus zu einem Gesamtsystem. Sowohl die Herstellung als auch das Zusammenfügen der einzelnen
Komponenten unterliegen Toleranzen. Materialverzüge, verursacht durch umgebungs- und betriebsbedingte
Effekte, führen zu Fehlpositionierungen und damit zu eingeschränkter Funktionstüchtigkeit. Um die
Fertigbarkeit bereits in der Modellbildung sicherzustellen, müssen Entwurfsregeln eingebunden werden. In diesem Artikel
wird eine Vorgehensweise vorgestellt, welche unter Berücksichtigung von Fertigungsregeln und -toleranzen und
Umgebungseinflüssen die Entwurfsauslegung eines robusten und fertigungsgerechten optischen Systems sicherstellt. Die
Vorgehensweise findet Anwendung auf das aktiv-optische System des Künstlichen Akkommodationssystems.
Dämpfung von Leistungspendelungen in Energienetzen – Stand der Technik
Authors: Wohlfarth Herbert
Published: January 2018

Power System Stabilizer (PSS) und netzseitig regelbare Betriebsmittel spielen weltweit eine zentrale Rolle für die
dynamische Stabilität von Energieversorgungsnetzen. Der Beitrag beschreibt die Entwicklung gängiger Verfahren zur Dämpfung
von Leistungspendelungen, die wesentlichen Erkenntnisse zum Reglerdesign, zu Wechselwirkungen zwischen den
beteiligten Komponenten und zu Optimierungsansätzen sowie den Stand der
Implementierungspraxis. Darüber hinaus werden besondere Anforderungen an Wide Area Measurement Systems
vorgestellt. Auch wird die aktuelle Methodenvielfalt und daraus resultierend die Notwendigkeit einer standardisierten
Vergleichbarkeit innovativer Konzepte verdeutlicht.
Fault-tolerant tracking control of petri nets
Authors: Fritz Raphael , Zhang Ping
Published: January 2018

In this paper, the fault-tolerant tracking control of petri nets is considered. The control aim is to steer a petri net
in case of faults from an initial marking into a destination marking by an appropriate firing sequence. Sensor, actuator
and process faults in the plant are modeled based on four types of faulty transitions. Depending on the characteristics of
the faults, two approaches are proposed to handle the faults. The tracking control problem is realized by solving two
integer linear programming problems. This two-step approach reduces the computational effort significantly. Faults are
taken into account as constraints and by adapting the firing sequence. Finally, an example is given to illustrate the
proposed fault-tolerant tracking control approach.
Instability detection of the tire-road contact and torque control for wheel-individual driven vehicles
Authors: Speth Peter , Hummler Andreas , Buchholz Michael , Dietmayer Klaus
Published: January 2018

Traction control for vehicles with wheel individual drives is a challenging task, since the wheel slips are unknown when
each wheel transfers a torque. This contribution presents an approach which deals with this problem especially for
electrical vehicles, where the drive torques can be changed very fast in comparison to vehicles with combustion
engines. The algorithm is based on two filters. The first filter is an adaptive Kalman filter which is used to detect fast
changes in the stability conditions of the wheels. The filter also delivers a valuation for the torque to which the drive
torque has to be reduced to get the wheel stable again. The second filter estimates the wheel slip. It is based on
a simplified expression of the slip dynamics in combination with a special reset strategy for low slip situations. This
filter allows detection of slow changes in the stability conditions. All filters are wheel individual and use only
standard sensor information. No tire model is needed for the filters to work. A simple reflexive traction controller,
which is based on a state machine, computes the drive torques in dependence on the stability criteria based on the filter
outputs.