bluuebunny/crossref_metadata_2025 huggingface dataset:
The diverging perception among physiotherapists of how to work with the concept of evidence
Authors: Snöljung Åsa , Mattsson Karin , Gustafsson Lena‐Karin
Published: May 2014

Rationale, aims and objectives

Changes in Sweden's municipal care have impacted the situation of physiotherapists by the adoption of practice based on research evidence. Even if physiotherapists appear to be in favour of the idea of evidence‐based practice, barriers still exist that prevent many from keeping up with current research. The aim of this study was to identify and describe the different ways in which physiotherapists in municipal care perceive the concept of evidence in rehabilitation.

Methods

A phenomenographic design with semi‐structured interviews was carried out with physiotherapists working with frail older people in three municipal care units in two neighbouring municipalities in Sweden. The physiotherapists' perceptions of evidence were explored in 12 interviews.

Results

Distinct perceptions of the concept of evidence are identified in three categories: ‘Confidence with the concept of evidence in relation to measurement instruments’; ‘Perception of evidence‐based practice as a duty, condition and demand of the profession’; and ‘Evidence‐based work as a separate rather than directly patient‐oriented activity’.

Conclusions

Physiotherapists take full responsibility to comply with what they perceive to be the demands of their profession. However, what evidence actually meant, and therefore what the practical element of this responsibility consisted of, was not as clear.
Correspondence between neurophysiological and clinical measurements of chemotherapy‐induced peripheral neuropathy: secondary analysis of data from the CI‐PeriNomS study
Authors: Griffith Kathleen A. , Dorsey Susan G. , Renn Cynthia L. , Zhu Shijun , Johantgen Mary E. , Cornblath David R. , Argyriou Andreas A. , Cavaletti Guido , Merkies Ingemar S. J. , Alberti Paola , Postma Tjeerd J. , Rossi Emanuela , Frigeni Barbara , Bruna Jordi , Velasco Roser , Kalofonos Haralabos P. , Psimaras Dimitri , Ricard Damien , Pace Andrea , Galie Edvina , Briani Chiara , Torre Chiara Dalla , Faber Catharina G. , Lalisang Roy I. , Boogerd Willem , Brandsma Dieta , Koeppen Susanne , Hense Joerg , Storey Dawn J. , Kerrigan Simon , Schenone Angelo , Fabbri Sabrina , Valsecchi Maria Grazia ,   the CI‐PeriNomS Group
Published: May 2014

Abstract

Chemotherapy‐induced peripheral neuropathy (CIPN) lacks standardized clinical measurement. The objective of the current secondary analysis was to examine data from the CIPN Outcomes Standardization (CI‐PeriNomS) study for associations between clinical examinations and neurophysiological abnormalities. Logistic regression estimated the strength of associations of vibration, pin, and monofilament examinations with lower limb sensory and motor amplitudes. Examinations were classified as normal (0), moderately abnormal (1), or severely abnormal (2). Among 218 participants, those with class 1 upper extremity (UE) and classes 1 or 2 lower extremity (LE) monofilament abnormality were 2.79 (95% confidence interval [CI]: 1.28–6.07), 3.49 (95%CI: 1.61–7.55), and 4.42 (95%CI: 1.35–14.46) times more likely to have abnormal sural nerve amplitudes, respectively, compared to individuals with normal examinations. Likewise, those with class 2 UE and classes 1 or 2 LE vibration abnormality were 8.65 (95%CI: 1.81–41.42), 2.54 (95%CI: 1.19–5.41), and 7.47 (95%CI: 2.49–22.40) times more likely to have abnormal sural nerve amplitudes, respectively, compared to participants with normal examinations. Abnormalities in vibration and monofilament examinations are associated with abnormal sural nerve amplitudes and are useful in identifying CIPN.
Predicting help‐seeking intention of women with urinary incontinence in Jinan, China: a theory of planned behaviour model
Authors: Wu Chen , Wang Kefang , Sun Tao , Xu Dongjuan , Palmer Mary H
Published: May 2014

Aims and objectives

To develop and test a predictive model of women's help‐seeking intention for urinary incontinence that was developed using the theory of planned behaviour and to identify factors that influenced women's help‐seeking intention.

Background

Urinary incontinence is a chronic progressive condition if left untreated, but few women seek help from healthcare providers. Reasons for not seeking help have been studied in Western countries while relatively little information is available from mainland China.

Design

Questionnaire‐based cross‐sectional survey was performed in this study.

Methods

From May–October 2011, a cross‐sectional survey was conducted with a representative sample of 346 incontinent women from three communities in Jinan using strict inclusion and exclusion criteria. Data were collected via a self‐administered pencil‐and‐paper survey that consisted of a multi‐item questionnaire. Predictive model estimation was performed using structural equation model.

Results

The resultant model demonstrated that incontinent women's help‐seeking intention could be predicted by their perceived self‐efficacy and perceived social impact from urine loss. Perceived self‐efficacy was the negative predictor, while the perceived social impact was the positive one. Overall, the predictive model explained 36% of the variance for incontinent women's help‐seeking intention.

Conclusion

The theory of planned behaviour can be used to predict help‐seeking intention in women who have urinary incontinence. Community nurses should increase patients' help‐seeking intention by addressing perceived social impact and perceived self‐efficacy in managing incontinent symptoms.

Relevance to clinical practice

Our findings suggest that high perceived self‐efficacy in dealing with incontinent symptoms could hinder incontinent women from seeking help from healthcare providers. The strong social impact women perceived, however, facilitates intention to seek help. Nurses should understand and address these factors through education and evidence‐based practices to increase help‐seeking in incontinent women.
Does language ambiguity in clinical practice justify the introduction of standard terminology? An integrative review
Authors: Stallinga Hillegonda A , ten Napel Huib , Jansen Gerard J , Geertzen Jan HB , de Vries Robbé Pieter F , Roodbol Petrie F
Published: May 2014

Aims and objectives

To research the use of ambiguous language in written information concerning patients' functioning and to identify problems resulting from the use of ambiguous language in clinical practice.

Background

Many projects that aimed to introduce standard terminology concerning patients' functioning in clinical practice are unsuccessful because standard terminology is rarely used in clinical practice. These projects mainly aim to improve communication by reducing ambiguous language. Considering their lack of success, the validity of the argument that language ambiguity is used in clinical practice is questioned.

Design

An integrative literature review.

Methods

A systematic search of the MEDLINE (1950–2012) and CINAHL (1982–2012) databases was undertaken, including empirical and theoretical literature. The selected studies were critically appraised using a data assessment and extraction form.

Results

Seventeen of 767 papers were included in the review and synthesis. The use of ambiguous language in written information concerning patients' functioning was demonstrated. Problems resulting from the use of ambiguous language in clinical practice were not identified. However, several potential problems were suggested, including hindered clinical decision‐making and limited research opportunities.

Conclusion

The results of this review demonstrated the use of ambiguous language concerning patients' functioning, but health professionals in clinical practice did not experience this issue as a problem. This finding might explain why many projects aimed at introducing standard terminology concerning functioning in clinical practice to solve problems caused by ambiguous language are often unsuccessful. Language ambiguity alone is not a valid argument to justify the introduction of standard terminology.

Relevance to clinical practice

The introduction of standard terminology concerning patients' functioning will only be successful when clinical practice requires the aggregation and reuse of data from electronic patient records for different purposes, including multidisciplinary decision‐making and research.
Rituals in nursing: intramuscular injections
Authors: Greenway Kathleen
Published: May 2014

Aims and objectives

To consider to what extent intramuscular injection technique can be described to remain entrenched in ritualistic practice and how evidence‐based practice should be considered and applied to the nursing practice of this essential skill.

Background

The notion of rituals within nursing and the value or futile impact they afford to this essential nursing skill will be critically reviewed.

Design

Discursive paper.

Method

Literature review from 2002–2013 to review the current position of intramuscular injection injections.

Results

Within the literature review, it became clear that there are several actions within the administration of an intramuscular injection that could be perceived as ritualistic and require consideration for contemporary nursing practice.

Conclusions

The essential nursing skill of intramuscular injection often appears to fit into the description of a ritualised practice. By providing evidence‐based care, nurses will find themselves empowered to make informed decisions based on clinical need and using their clinical judgement.

Relevance to clinical practice

For key learning, it will outline with rationale how site selection, needle selection, insertion technique and aspiration can be cited as examples of routinised or ritualistic practice and why these should be rejected in favour of an evidence‐based approach. The effect on some student nurses of experiencing differing practices between what is taught at university and what is often seen in clinical practice will also be discussed.
Development of Australian clinical practice outcome standards for graduates of critical care nurse education
Authors: Gill Fenella J , Leslie Gavin D , Grech Carol , Boldy Duncan , Latour Jos M
Published: May 2014

Aims and objectives

To develop critical care nurse education practice standards.

Background

Critical care specialist education for registered nurses in Australia is provided at graduate level. Considerable variation exists across courses with no framework to guide practice outcomes or evidence supporting the level of qualification.

Design

An eDelphi technique involved the iterative process of a national expert panel responding to three survey rounds.

Methods

For the first round, 84 statements, organised within six domains, were developed from earlier phases of the study that included a literature review, analysis of critical care courses and input from health consumers. The panel, which represented the perspectives of four stakeholder groups, responded to two rating scales: level of importance and level of practice.

Results

Of 105 experts who agreed to participate, 92 (88%) completed survey round I; 85 (92%) round II; and 73 (86%) round III. Of the 98 statements, 75 were rated as having a high level of importance – median 7 (IQR 6–7); 14 were rated as having a moderate level of importance – median 6 (IQR 5–7); and nine were rated as having a low level of importance – median 4 (IQR 4–6)–6 (IQR 4–6). The majority of the panel rated graduate level of practice as ‘demonstrates independently’ or ‘teaches or supervises others’ for 80 statements. For 18 statements, there was no category selected by 50% or more of the panel. The process resulted in the development of 98 practice standards, categorised into three levels, indicating a practice outcome level by the practitioner who can independently provide nursing care for a variety of critically ill patients in most contexts, using a patient‐ and family‐focused approach.

Conclusion/relevance to clinical practice

The graduate practice outcomes provide a critical care qualification definition for nursing workforce standards and can be used by course providers to achieve consistent practice outcomes.
On the reciprocal relationship between job insecurity and employee well‐being: Mediation by perceived control?
Authors: Vander Elst Tinne , Van den Broeck Anja , De Cuyper Nele , De Witte Hans
Published: May 2014

This study aims to explain the reciprocal relationship between job insecurity and employee well‐being (i.e., emotional exhaustion and vigour) by perceived control. Building on appraisal theory and conservation of resources theory, we suggest that perceived control mediates the cross‐lagged relationships from job insecurity to employee well‐being, and from employee well‐being to job insecurity. These hypotheses were tested using repeated‐measures data (two waves) from 536 Flemish employees from different organizations and sectors. First, cross‐lagged structural equation modelling analyses showed an effect from job insecurity to perceived control, and from perceived control to emotional exhaustion, so that perceived control (partially) mediated the positive cross‐lagged relationship from job insecurity to emotional exhaustion. Second, we established a cross‐lagged effect from emotional exhaustion to perceived control, although not from perceived control to job insecurity. Third, no cross‐lagged paths were found between perceived control and vigour. This study contributes to both appraisal theory and conservation of resources theory by investigating reciprocal relationships that fit the transactional conceptualization of stress within both frameworks. Furthermore, the results of this study highlight perceived control as the process through which the stressor job insecurity impacts on employee well‐being.

Practitioner points

The current study suggests a possible theoretical explanation of the negative consequences of job insecurity for employee well‐being: Perceived control accounted for the effect of job insecurity on emotional exhaustion.

Job insecurity enhances emotional exhaustion by decreasing employees' feelings of control. Therefore, interventions providing employees with a sense of control, such as communication programmes and measures that promote participative decision‐making, may provide a deterrent to this effect.

The current study additionally adds to our knowledge of the impact of employee well‐being on evaluations of the work situation: Emotional exhaustion was found to be related to reduced perceived control over the work situation.

Practitioners may want to invest in measures that stimulate employee well‐being, for example job design. This may increase employees' perceptions of control, which then makes them less vulnerable to stressors. Additionally, by fostering both employee well‐being and perceived control, practitioners may forestall a loss cycle between poor well‐being and lack of control.
Marginal bone resorption around immediate and delayed loaded implants supporting a locator‐retained mandibular overdenture. A 1‐year randomised controlled trial
Authors: Elsyad M. A. , Elsaih E. A. , Khairallah A. S.
Published: May 2014

The aim of this 1‐year study was to evaluate and compare crestal bone loss and clinical outcomes of immediate and delayed loaded implants supporting mandibular overdentures with Locator attachments. In a randomised controlled clinical trial, 36 completely edentulous patients (mean age 59·6 years) who desired to improve the stability of their mandibular dentures were randomly assigned into two groups. Each patient received two implants in the canine area of the mandible after a minimal flap reflection. Implants were loaded by mandibular overdentures either 3 months (delayed loading group, G1) or the same day (immediate loading group, G2) after implant placement. Locator attachments were used to retain all overdentures to the implants. Peri‐implant vertical (VBL) and horizontal (HBLO) bone losses and clinical parameters [plaque scores (PI), gingival scores (GI), probing depths (PD) and implant stability (ISQ)] were assessed at time of overdenture insertion (T0), 6 months (T6) and 12 months (T12) after overdenture insertion. After 12 months of overdenture insertion, two implants (5·5%) failed in G2. Vertical bone loss was significantly higher in G2 compared with G1, while HBLO demonstrated insignificant differences between groups. All clinical parameters (PI, GI, PD and ISQ) did not differ significantly between groups. Vertical bone loss was significantly correlated with PD and HBLO. Immediately loaded two implants supporting a Locator‐retained mandibular overdenture are associated with more vertical bone resorption when compared to delayed loaded implants after 1 year. Clinical outcomes do not differ significantly between loading protocols.
Effect of tannins and saponins in Samanea saman on rumen environment, milk yield and milk composition in lactating dairy cows
Authors: Anantasook N. , Wanapat M. , Cherdthong A. , Gunun P.
Published: May 2014

The objective of this study was to investigate the effects of tannins and saponins in Samanea saman on rumen fermentation, milk yield and milk composition in lactating dairy cows. Four multiparous early‐lactating dairy cows (Holstein‐Friesian cross‐bred, 75%) with an initial body weight (BW) of 405 ± 40 kg and 36 ± 8 day in milk were randomly assigned to receive dietary treatments according to a 4 × 4 Latin square design. The four dietary treatments were unsupplemented (control), supplemented with rain tree pod (S. saman) meal (RPM) at 60 g/kg, supplemented with palm oil (PO) at 20 g/kg, and supplemented with RPM at 60 g/kg and PO at 20 g/kg (RPO), of total dry matter (DM) intake. Cows were fed with concentrate diets at a ratio of concentrate to milk yield of 1:2, and chopped 30 g/kg of urea‐treated rice straw was fed ad libitum. The RPM contained condensed tannins and crude saponins at 88 and 141 g/kg of DM respectively. It was found that supplementation with RPM and/or PO to dairy cows diets did not show negative effect on ruminal pH, blood urea nitrogen and milk urea nitrogen concentration (p > 0.05). However, supplementation with RPM resulted in lower ammonia nitrogen (NH3‐N) concentration (p < 0.05). In addition, propionic acid and milk production increased while acetic acid, acetic to propionic ratio, methane production, methanogens and protozoal population decreased with RPM and/or PO supplementation. Furthermore, addition of PO and RPO in the diets increased milk fat while supplementation of RPM resulted in greater milk protein and Fibrobacter succinogenes numbers (p < 0.05). The population of Ruminococcus flavefaciens and Ruminococcus albus were not affected by any treatments. The findings on the present study showed that supplementation with RPM and RPO to diets of cows improved the rumen environment and increased milk yield, content of milk protein and milk fat.
Glycated albumin produced in diabetic hyperglycemia promotes monocyte secretion of inflammatory cytokines and bacterial adherence to epithelial cells
Authors: Shim E. , Babu J. P.
Published: May 2014

Background and Objective

The prevalence and severity of periodontal disease increase in patients with insulin‐deficient or insulin‐resistant forms of diabetes. A common characteristic of diabetes is the presence of hyperglycemia. A critical consequence of hyperglycemia is the nonenzymatic glycation and oxidation of proteins and lipids, resulting in the irreversible formation of advanced glycation end‐products (AGEs). A central means by which AGEs are believed to impart their pathogenic effects is via interacting with specific cellular receptors; the best‐characterized of these is receptor for AGE (RAGE). The major consequences of the AGE–RAGE interaction are the generation of enhanced cellular oxidant stress, hypersecretion of inflammatory mediators and altered subgingival flora. The aim of this study was to elucidate the influence of glycated albumin (G‐alb), with or without lipopolysaccharide (LPS) isolated from periodontal pathogens, on the secretion of inflammatory cytokines by cultured monocytic cells and also to investigate the role of G‐alb in adherence of bacteria to epithelial cells.

Material and Methods

Activated THP‐1 cells (1 × 106 cells) were incubated for 24 h with G‐alb or normal albumin (N‐alb), with or without LPS isolated from two periodontal pathogens. Supernatant fluids were collected and assayed for the cytokines interleukin‐1beta (IL‐1β), tumor necrosis factor‐alpha (TNF‐α) and interleukin‐6 (IL‐6) by ELISA. For bacterial adhesion assays, S‐G epithelial cells were grown on cover slips and incubated with G‐alb (10 μg/mL) or N‐alb (control) for 30 min. The cover slips were rinsed and then incubated with bacteria for 2 h. The number of adherent bacteria was determined by counting 20 epithelial cells chosen randomly under a light microscope.

Results

The secretion of IL‐1β, TNF‐α and IL‐6 by THP‐1 cells was greater in the presence of G‐alb than in the presence of N‐alb. The amounts of cytokines secreted were even greater when THP‐1 cells were incubated with G‐alb and LPS of periodontal pathogens. The effect of G‐alb and LPS was reduced when RAGE was blocked by its antibody. Coating the cultured epithelial cells with G‐alb resulted in increased bacterial adherence.

Conclusion

This study demonstrated the role of G‐alb in stimulating cultured monocytic cells to secrete inflammatory cytokines. The stimulation was found to be greater when cells were incubated with LPS in addition to G‐alb. The over‐expression of inflammatory cytokines as a result of the combined effects of G‐alb and bacterial LPS may contribute to the severity of periodontal disease in diabetic subjects.
Calcium signalling from the type I inositol 1,4,5‐trisphosphate receptor is required at early phase of liver regeneration
Authors: Oliveira André G. , Andrade Viviane A. , Guimarães Erika S. , Florentino Rodrigo M. , Sousa Pedro A. , Marques Pedro E. , Melo Flávia M. , Ortega Miguel J. , Menezes Gustavo B. , Leite M. Fatima
Published: May 2014

Background & Aims

Liver regeneration is a multistage process that unfolds gradually, with different mediators acting at different stages of regeneration. Calcium (Ca2+) signalling is essential for liver regeneration. In hepatocytes, Ca2+ signalling results from the activation of inositol 1,4,5‐trisphosphate receptors (InsP3R) of which two of the three known isoforms are expressed (InsP3R‐I and InsP3R‐II). Here, we investigated the role of the InsP3R‐I‐dependent Ca2+ signals in hepatic proliferation during liver regeneration.

Methods

Partial hepatectomy (HX) in combination with knockdown of InsP3R‐I (AdsiRNA‐I) was used to evaluate the role of InsP3R‐I on liver regeneration and hepatocyte proliferation, as assessed by liver to body mass ratio, PCNA expression, immunoblots and measurements of intracellular Ca2+ signalling.

Results

AdsiRNA‐I efficiently infected the liver as demonstrated by the expression of β‐galactosidase throughout the liver lobules. Moreover, this construct selectively and efficiently reduced the expression of InsP3R‐I, as evaluated by immunoblots. Expression of AdsiRNA‐I in liver decreased peak Ca2+ amplitude induced by vasopressin in isolated hepatocytes 2 days after HX. Reduced InsP3R‐I expression prior to HX also delayed liver regeneration, as measured by liver to body weight ratio, and reduced hepatocyte proliferation, as evaluated by PCNA staining, at the same time point. At later stages of regeneration, control hepatocytes showed a decreased expression of InsP3R, as well as reduced InsP3R‐mediated Ca2+ signalling, events that did not affect liver growth.

Conclusion

Together, these results show that InsP3R‐I‐dependent Ca2+ signalling is an early triggering pathway required for liver regeneration.
Population structure of the invasive forest pathogenHymenoscyphus pseudoalbidus
Authors: Gross Andrin , Hosoya Tsuyoshi , Queloz Valentin
Published: May 2014

Understanding the genetic diversity and structure of invasive pathogens in source and in introduced areas is crucial to the revelation of hidden biological features of an organism, to the reconstruction of the course of invasions and to the establishment of effective control measures.Hymenoscyphus pseudoalbidus(anamorph:Chalara fraxinea) is an invasive and highly destructive fungal pathogen found on common ashFraxinus excelsiorin Europe and is native toEastAsia. To gain insights into its dispersal mechanisms and history of invasion, we used microsatellite markers and characterized the genetic structure and diversity ofH. pseudoalbiduspopulations at three spatial levels: (i) betweenEurope and Japan, (ii) inEurope and (iii) at the epidemic's front inSwitzerland. Phylogenetic and network analysis demonstrated that individuals from both regions are conspecific. However, populations from Japan harboured a higher genetic diversity and were genetically differentiated from European ones. No evident population structure was found among the 1208 European strains using Bayesian and multivariate clustering analysis. Only the distribution of genetic diversity in space, pairwise population differentiation (GST) and the spatial analysis of principal components revealed a faint geographical pattern around Europe. A significant allele deficiency in most European populations pointed to a recent genetic bottleneck, whereas no pattern of isolation by distance was found. Our data suggest thatH. pseudoalbiduswas introduced just once by at least two individuals. The potential source region ofH. pseudoalbidusis vast, and further investigations are required for a more accurate localization of the source population.
Analysis of the complement sensitivity of oral treponemes and the potential influence of FH binding, FH cleavage and dentilisin activity on the pathogenesis of periodontal disease
Authors: Miller D.P. , McDowell J.V. , Bell J.K. , Goetting‐Minesky M.P. , Fenno J.C. , Marconi R.T.
Published: May 2014

Treponema denticola, a periopathogen, evades complement‐mediated killing by binding the negative complement regulatory protein factor H (FH) to its surface via the FhbB protein. Paradoxically, bound FH is cleaved by T. denticola's dentilisin protease, a process hypothesized to trigger localized dysregulation of complement activation in periodontal pockets. The ability of other oral treponemes to evade complement‐mediated killing and bind and cleave FH has not been assessed. In this report, we demonstrate that representative isolates of Treponema socranskii, Treponema medium, Treponema pectinovorum and Treponema maltophilum are also serum resistant, whereas Treponema vincentii and Treponema amylovorum are serum sensitive. Although T. denticola's ability to evade complement‐mediated killing is strictly dependent on FH binding, other serum‐resistant treponemal species lack FhbB and do not bind FH, indicating an FH‐independent mechanism of complement evasion. To assess the influence of FhbB sequence variation on FH binding and cleavage by T. denticola, fhbB sequences were determined for 30 isolates. Three distinct phyletic types were identified. All T. denticola strains bound FH and were serum resistant, but differences in binding kinetics, dentilisin activity and FH cleavage ability were observed. Based on these analyses, we hypothesize that the composition of the T. denticola population is a determining factor that influences the progression and severity of periodontal disease.
‘It's the little things that count’. Families' experience of roles, relationships and quality of care in rural nursing homes
Authors: Ryan Assumpta Ann , McKenna Hugh
Published: May 2014

Background

Entry to long‐term care is an emotional time for older people and their families. Poor communication and uncertainty about roles and responsibilities in the post‐placement period can cause distress for families and staff, further exacerbating an already difficult situation. However, there are limited studies that specifically address roles and relationships between families and care home staff in the post‐placement period.

Aim

The aim of this study was to explore the experiences of families following the nursing home placement of an older relative.

Design

A qualitative approach using grounded theory methodology was used to conduct the study.

Method

Semi structured interviews were conducted with 29 relatives of nursing home residents in a region of the UK. Consistent with grounded theory methodology, data collection and analysis occurred simultaneously.

Findings

Data analysis revealed five distinct categories that captured the experience of families in the post‐placement period. These were: communication with staff, involvement in relative's care, the importance of ‘the little things’, quality of care and areas for improvement.

Conclusions

Developing caring partnership is crucial if the resources of care home staff and families are to be maximised for the benefit of all concerned.

Implications for practice

A number of programmes and initiatives already exist to enhance the quality of life of older people in care homes and their families. Serious consideration should be given to more widespread uptake of these initiatives.
Can therapy dogs evoke awareness of one's past and present life in persons with Alzheimer′s disease?
Authors: Swall Anna , Ebbeskog Britt , Lundh Hagelin Carina , Fagerberg Ingegerd
Published: May 2014

Background

Persons with Alzheimer's disease (AD) sometimes express themselves through behaviours that are difficult to manage for themselves and their caregivers, and to minimise these symptoms alternative methods are recommended. For some time now, animals have been introduced in different ways into the environment of persons with dementia. Animal‐Assisted Therapy (AAT) includes prescribed therapy dogs visiting the person with dementia for a specific purpose.

Aim

This study aims to illuminate the meaning of the lived experience of encounters with a therapy dog for persons with Alzheimer's disease.

Method

Video recorded sessions were conducted for each visit of the dog and its handler to a person with AD (10 times/person). The observations have a life‐world approach and were transcribed and analysed using a phenomenological hermeneutical approach.

Results

The result shows a main theme ‘Being aware of one's past and present existence’, meaning to connect with one's senses and memories and to reflect upon these with the dog. The time spent with the dog shows the person recounting memories and feelings, and enables an opportunity to reach the person on a cognitive level.

Conclusions

The present study may contribute to health care research and provide knowledge about the use of trained therapy dogs in the care of older persons with AD in a way that might increase quality of life and well‐being in persons with dementia.

Implications for practice

The study might be useful for caregivers and dog handlers in the care of older persons with dementia.
A Systematic Review of Pharmacoeconomic Studies for Pregabalin
Authors: Parker Lindsay , Huelin Rachel , Khankhel Zarmina , Wasiak Radek , Mould Joaquin
Published: May 2014

Background

With anticonvulsant, anxiolytic, and analgesic properties, pregabalin has been evaluated for neuropathic pain and fibromyalgia (FM). These chronic conditions diminish patients' quality of life and increase healthcare utilization and costs.

Objective

To assess the current understanding of economic outcomes associated with pregabalin in neuropathic pain andFM.

Methods

Using keywords related to economic outcomes and pregabalin, we systematically searchedMEDLINE‐ andEMBASE‐indexed literature and nonindexed “grey” literature on neuropathic pain andFMpublished from March 2001 to October 2012. Included studies reported economic findings associated with pregabalin.

Results

In the past 11 years, 55 publications assessed the direct costs, resource use, or cost‐effectiveness of pregabalin for neuropathic pain andFM. Studies generally lacked comparability due to heterogeneous patient populations, assumptions, time periods, and geographies. In theUS, following treatment initiation, pregabalin resulted in similar or higher levels of healthcare use forFMcompared with duloxetine. In contrast, medical costs for neuropathic pain did not significantly differ after initiation of pregabalin vs. duloxetine or other standard therapies in theUS, but in Spain and Sweden, retrospective database studies suggested that pregabalin was cost‐saving vs. gabapentin. Few economic analyses estimated indirect costs.

Conclusions

Neuropathic pain andFMare associated with high healthcare resource use and costs. Economic studies of pregabalin in neuropathic pain andFMindicate some results favorable to other forms of care, but heterogeneity among study designs and populations hinder comparisons. Future economic analyses should aim to address data gaps regarding effects of pregabalin on productivity and resource use.
The Medicago truncatula hypermycorrhizal B9 mutant displays an altered response to phosphate and is more susceptible to Aphanomyces euteiches
Authors: TRUONG HOAI‐NAM , THALINEAU ELISE , BONNEAU LAURENT , FOURNIER CARINE , POTIN SOPHIE , BALZERGUE SANDRINE , VAN TUINEN DIEDERIK , JEANDROZ SYLVAIN , MORANDI DOMINIQUE
Published: May 2014

Inorganic phosphate (Pi) plays a key role in the development of arbuscular mycorrhizal (AM) symbiosis, which is favoured when Pi is limiting in the environment. We have characterized the Medicago truncatula hypermycorrhizal B9 mutant for its response to limiting (P/10) and replete (P2) Pi. On P2, mycorrhization was significantly higher in B9 plants than in wild‐type (WT). The B9 mutant displayed hallmarks of Pi‐limited plants, including higher levels of anthocyanins and lower concentrations of Pi in shoots than WT plants. Transcriptome analyses of roots of WT and B9 plants cultivated on P2 or on P/10 confirmed the Pi‐limited profile of the mutant on P2 and highlighted its altered response to Pi on P/10. Furthermore, the B9 mutant displayed a higher expression of defence/stress‐related genes and was more susceptible to infection by the root oomycete pathogen Aphanomyces euteiches than WT plants. We propose that the hypermycorrhizal phenotype of the B9 mutant is linked to its Pi‐limited status favouring AM symbiosis in contrast to WT plants in Pi‐replete conditions, and discuss the possible links between the altered response of the B9 mutant to Pi, mycorrhization and infection by A. euteiches.
Efficacy of prophylactic additional cranial irradiation and intrathecal chemotherapy for the prevention of CNS relapse after allogeneic hematopoietic SCT for childhood ALL
Authors: Fukano Reiji , Nishimura Miho , Ito Nobuhiro , Nakashima Kentaro , Kodama Yuichi , Okamura Jun , Inagaki Jiro
Published: May 2014

We evaluated the efficacy of CRT and IT chemotherapy, in addition to conditioning including TBI, for the prevention of CNS relapse, in allogeneic HSCT for childhood ALL. From January 1999 to December 2009, a total of 48 patients, without previous or presenting CNS involvement, underwent HSCT for ALL. All patients received myeloablative conditioning including TBI of 12 or 13.2 Gy and IT chemotherapy twice between days −10 and −2 prior to HSCT. Twenty‐five patients received CRT prior to TBI (CRT+), and 23 patients did not (CRT−). CRT+ and CRT− patients had a seven‐yr EFS rate of 40.0 ± 9.8% and 41.7 ± 10.6%, respectively (p = 0.8252). The seven‐yr relapse rates for CRT+ and CRT− patients were 45.0 ± 11.2% and 38.4 ± 11.6%, respectively (p = 0.7460). CNS relapses were evident in 1 (4.0%) CRT+ patient and 1 (4.4%) CRT− patient (p = 1.000). There were no significant differences in EFS and the probability of CNS relapse between CRT+ and CRT− patients. These results demonstrate that CRT and IT chemotherapy, in addition to conditioning chemotherapy, may not be necessary in childhood ALL patients without previous or presenting CNS involvement.
Successful living donor liver transplantation for giant extensive venous malformation
Authors: Hatanaka Masahiro , Nakazawa Atsuko , Nakano Natsuko , Matsuoka Kentaro , Ikeda Hitoshi , Hamano Ikumi , Sakamoto Seisuke , Kasahara Mureo
Published: May 2014

We report our success in employing LDLT as a course of treatment for extensive hepatic VM. A 14‐yr‐old pediatric patient presented at our hospital with nosebleed, fatigability, orthopnea, and abdominal distension. He had a history of right hemicolectomy with primary anastomosis due to VM of the transverse colon at age seven. Coagulation abnormalities were apparent, characterized by high international normalized ratio of prothrombin time, decreased fibrinogen level, increased FDPs, and D‐dimer. T2‐weighted magnetic resonance imaging revealed numerous, variable‐sized high signal intensity nodules. Abdominal ultrasonography and CT scan showed hepatomegaly with multiple hypo‐echogenic lesions and arteriovenous shunting in the liver. Doppler ultrasound showed hypokinetic flow in the hypo‐echogenic lesions of liver. Immediate LDLT was performed to avoid spontaneous rupture and DIC. The right lobe of the liver was implanted with temporary portocaval shunt to prevent intestinal congestion and bleeding. Pathologic examination of the explanted liver confirmed the presence of an extensive hepatic VM. The postoperative course was uneventful, and the patient remained symptom‐free with normal liver function throughout the 12‐month follow‐up period.
Indexical Beliefs and Communication: Against Stalnaker on Self‐Location
Authors: Weber Clas
Published: May 2014

Beliefs are commonly analyzed as binary relations between subjects and propositions. Perry and Lewis have shown that the standard account has difficulties in handling self‐locating beliefs. Robert Stalnaker has recently put forward a version of the standard account that is supposed to overcome this problem. Stalnaker's motivation for defending the propositional account of belief is that it comes with a simple and powerful propositional model of communication. In this paper I argue that Stalnaker's proposal fails. The only way of upholding the propositional account of belief is by abandoning the simple account of communication.
Implications of bacterial contaminated seed lots and endophytic colonization by Pseudomonas fuscovaginae on rice establishment
Authors: Adorada D. L. , Stodart B. J. , Pangga I. B. , Ash G. J.
Published: May 2014

The economic impact of seedborne bacterial diseases on rice production provides a major motivation for research on seed health. This paper reports on the endophytic growth of a rifampicin‐marked strain of the seedborne rice pathogen Pseudomonas fuscovaginae. The bacterium was found in most tested seeds indicating that, even without visible discolouration, seed transmission is possible. Crushed discoloured seeds contained more bacterial cells than did non‐crushed discoloured seeds. These bacteria were released during seed soaking, contaminating clean seed and lowering seed germination. Cells of a rifampicin‐resistant strain of P. fuscovaginae, which had been inoculated onto rice seeds, were subsequently recovered from different growth stages and from different rice tissues, thereby indicating endophytic colonization. These results have implications for seedling establishment, as symptomless seeds do not assure disease‐free seeds, and the presence of seedborne bacteria results in poor germination and poor seedling establishment. Elimination of seedborne bacteria by soaking in sodium hypochlorite can increase seed germination. This could be used in developing control strategies, and, if practised regularly, reduce entry of seedborne disease‐causing organisms into crops, resulting in lower disease pressure.
Effect of shoot removal on remobilization of carbon and nitrogen during regrowth of nitrogen‐fixing alfalfa
Authors: Aranjuelo Iker , Molero Gemma , Erice Gorka , Aldasoro Joseba , Arrese‐Igor Cesar , Nogués Salvador
Published: May 2014

The contribution of carbon and nitrogen reserves to regrowth following shoot removal has been studied in the past. However, important gaps remain in understanding the effect of shoot cutting on nodule performance and its relevance during regrowth. In this study, isotopic labelling was conducted at root and canopy levels with both 15N2 and 13C‐depleted CO2 on exclusively nitrogen‐fixing alfalfa plants. As expected, our results indicate that the roots were the main sink organs before shoots were removed. Seven days after regrowth the carbon and nitrogen stored in the roots was invested in shoot biomass formation and partitioned to the nodules. The large depletion in nodule carbohydrate availability suggests that root‐derived carbon compounds were delivered towards nodules in order to sustain respiratory activity. In addition to the limited carbohydrate availability, the upregulation of nodule peroxidases showed that oxidative stress was also involved during poor nodule performance. Fourteen days after cutting, and as a consequence of the stimulated photosynthetic and N2‐fixing machinery, availability of Cnew and Nnew strongly diminished in the plants due to their replacement by C and N assimilated during the post‐labelling period. In summary, our study indicated that during the first week of regrowth, root‐derived C and N remobilization did not overcome C‐ and N‐limitation in nodules and leaves. However, 14 days after cutting, leaf and nodule performance were re‐established.
What Students Say About Their Mathematical Thinking When They Listen
Authors: Kosko Karl W.
Published: May 2014

Mathematical listening is an important aspect of mathematical communication. Yet there are relatively few examinations of this phenomenon. Further, existing studies of students' mathematical listening come from observational data, lacking the student perspective. This study examined student replies to an open‐response question regarding what happens to their thinking about mathematics when they listen to their peers' mathematical talk. Results suggest varying ways of listening that range from more passive to more active forms. While relationships were observed between ways of listening and perceived forms of engaging in mathematical discussion, no relationship was observed with the frequency with which students reported participating in discussions.
Metaphor Clusters: Characterizing Instructor Metaphorical Reasoning on Limit Concepts in College Calculus
Authors: Patel Rita Manubhai , McCombs Paul , Zollman Alan
Published: May 2014

Novice students have difficulty with the topic of limits in calculus. We believe this is in part because of the multiple perspectives and shifting metaphors available to solve items correctly. We investigated college calculus instructors' personal concepts of limits. Based upon previous research investigating introductory calculus student metaphorical reasoning, we examined 11 college instructors' metaphorical reasoning on limit concepts. This paper focused on previous research of metaphor clusters observed among students to answer the following: (a) Do college instructors use metaphorical reasoning to conceptualize the meaning of a limit? (b) Can we characterize instructor metaphorical reasoning similar to those observed among students? (c) Will an instructor's self‐identification of metaphor clusters be consistent with our metaphor coding? We found that college instructors' perspectives vary, either graphical or algebraic, in their explanations of limit items. All the instructors used metaphors, and instructor metaphorical reasoning aligned with student metaphor clusters. Instructors tended to change their metaphors with respect to the limit item. Instructors were not aware of their use of metaphors, nor were they aware of their inconsistency in their choice of metaphor. We believe that instructor awareness of their own distinct perspectives and metaphors would assist students' understanding of limit concepts.
Taking the Awful Out of the German Language: A Study of a New Way to Teach German Gender and Plural Assignment
Authors: Kraiss Andrew
Published: May 2014

This paper is a study of a method for teaching German gender and plural assignment developed by the late Donald Steinmetz. My primary source for classroom material was the unpublished handbook for students that Steinmetz co‐authored with Donald Nelson, The Joy of Gender: A Student Handbook made available to me by his son, Erik Steinmetz. In the spring semester of 2012, I taught two sections of First Semester German back‐to‐back in the early afternoon at Central Michigan University which offered me a unique opportunity to test the system on one class while using the other as a control group under identical learning conditions. In this article, I present the teaching methodology of the system and the findings of the study. The first section of the article explains the rule system for German gender and plural assignment. The second section outlines how the study was conducted and discusses the handouts used and the quizzes given. The third section discusses the results of the study and the final section lays out some ideas for further research and teaching practice.
The Kulturpass: Strategies for Enhancing Cultural Engagement outside the German‐Language Classroom
Authors: Prager Debra N. , Kramer Daniel J.
Published: May 2014

Extracurricular events in foreign language programs are often treated either as extra credit or an afterthought. And yet if organized creatively and systematically, activities that promote cultural engagement outside the classroom can enhance and extend the curriculum, deepen exposure to the target culture, create a sense of community among students, and raise the department's profile on campus. This article argues that extracurricular activities can and should be an important corollary to the foreign language curriculum, and offers a specific strategy for creating a successful activities program – the Kulturevent series and the Kulturpass. The paper outlines the impetus behind the Kulturpass, howit works, what results we have seen since implementing it in fall 2010, and why we believe it has been so successful.
Iterative breakthrough invasive aspergillosis due to TR(34)/L98H azole‐resistant Aspergillus fumigatus and Emericella sublata in a single hematopoietic stem cell transplant patient
Authors: de Fontbrune F.S. , Denis B. , Meunier M. , Garcia‐Hermoso D. , Bretagne S. , Alanio A.
Published: May 2014

We report 3 consecutive episodes of invasive aspergillosis in a single hematopoietic stem cell transplant patient successively attributed to TR(34)/L98H azole‐resistant Aspergillus fumigatus and to a first occurrence of invasive Emericella sublata infection. This case illustrates potential selection of resistant molds during antifungal therapy in hematological patient.