bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of self-perceived limitations, stigma and sense of coherence on quality of life in multiple sclerosis patients: results of a cross-sectional study
Authors: Broersma Feddrik , Oeseburg Barth , Dijkstra Jacob , Wynia Klaske
Published: September 2017

Objective:

To examine the impact of perceived limitations, stigma and sense of coherence on quality of life in multiple sclerosis patients.

Design:

Cross-sectional survey.

Setting:

Department of Neurology, University Medical Center Groningen, the Netherlands.

Subjects:

Multiple sclerosis patients.

Main measures:

World Health Organization Quality of Life – abbreviated version, Stigma Scale for Chronic Illness, Sense of Coherence Scale, background and disease-related questions.

Results:

In total, 185 patients (61% response rate) participated in the study with moderate to severe limitations. Stigma was highly prevalent but low in severity. Patients with a higher sense of coherence experienced a lower level of limitations ( B = −0.063, P < 0.01) and less stigma (enacted stigma B = −0.030, P < 0.01; self-stigma B = −0.037, P < 0.01). Patients with a higher level of limitations experienced more stigma (enacted stigma B = 0.044, P < 0.05; self-stigma B = 0.063, P < 0.01). Patients with a higher sense of coherence experienced better quality of life (physical health B = 0.059, P < 0.01; psychological health B = 0.062, P < 0.01; social relationships B = 0.052, P < 0.01; environmental aspects B = 0.030, P < 0.01). Patients with a higher level of limitations experienced poorer quality of life (physical health B = −0.364, P < 0.01; psychological health B = −0.089, P < 0.05) and patients with more stigma also experienced poorer quality of life (self-stigma: physical health B = −0.073, P < 0.01; psychological health B = −0.089, P < 0.01; social relationships B = −0.124, P < 0.01; environmental aspects B = −0.052, P < 0.01, and enacted stigma: physical health B = −0.085, P < 0.10).

Conclusion:

Patients with less perceived limitations and stigma and a higher level of sense of coherence experienced better quality of life. Patients with a higher sense of coherence experienced a lower level of limitations and less stigma.
Use of three-dimensional finite element models of the lateral ankle ligaments to evaluate three surgical techniques
Authors: Wang Cheng-Wei , Muheremu Aikeremujiang , Bai Jing-Ping
Published: September 2017

Objective

To compare three surgical techniques for lateral ankle ligament reconstruction using finite element (FE) models.

Methods

A three-dimensional FE model of the left foot of a healthy volunteer and lateral collateral ligament injury models were developed. Three tendons [one-half of the autologous peroneus longus tendon (PLT), one-half of the peroneus brevis tendon (PBT), and an allogeneic tendon] were used for lateral collateral ligament reconstruction. The ankle varus stress and anterior drawer tests were performed to compare the three surgical techniques.

Results

The ankle varus stress test showed that the equivalent stresses of the anterior talofibular ligament (ATFL) (84.00 MPa) and calcaneofibular ligament (CFL) (27.01 MPa) were lower in allogeneic tendon reconstruction than in the other two techniques but similar to those of normal individuals (138.48 and 25.90 MPa, respectively). The anterior drawer test showed that the equivalent stresses of the ATFL and CFL in autologous PLT reconstruction (31.31 and 28.60 MPa, respectively) and PBT reconstruction (31.47 and 29.07 MPa, respectively) were lower than those in allogeneic tendon reconstruction (57.32 and 52.20 MPa, respectively).

Conclusions

The allogeneic tendon reconstruction outcome was similar to normal individuals. Allogeneic tendon reconstruction may be superior for lateral ankle ligament reconstruction without considering its complications.
Gait Characteristics Associated With a Greater Increase in Medial Knee Cartilage T1ρ and T2 Relaxation Times in Patients Undergoing Anterior Cruciate Ligament Reconstruction
Authors: Teng Hsiang-Ling , Wu Daniel , Su Favian , Pedoia Valentina , Souza Richard B. , Ma C. Benjamin , Li Xiaojuan
Published: September 2017

Background:

Osteoarthritis of the medial tibiofemoral joint (MTFJ) is prevalent among patients undergoing anterior cruciate ligament reconstruction (ACLR). Magnetic resonance T1ρ and T2 relaxation times provide noninvasive methods to quantify early cartilage degeneration. Altered sagittal-plane gait biomechanics have been observed after ACLR, but their associations with longitudinal changes in MTFJ cartilage T1ρ and T2 remain unclear.

Hypothesis/Purpose:

To examine whether the peak knee flexion moment (KFM), knee flexion angle (KFA), and vertical ground-reaction force (vGRF) during gait are associated with prospective changes in medial tibiofemoral cartilage T1ρ and T2 in ACL-reconstructed knees and to compare these gait characteristics between patients undergoing ACLR and healthy control participants. We hypothesized that a higher KFM, KFA, and vGRF would be associated with greater increases in cartilage relaxation times and that patients undergoing ACLR would demonstrate altered gait characteristics compared with healthy controls.

Study Design:

Controlled laboratory study.

Methods:

Thirty-three patients undergoing ACLR underwent gait analysis before and 6 months and 1 year after ACLR and knee magnetic resonance imaging (MRI) before and 6 months, 1 year, and 2 years after ACLR. Twelve healthy controls underwent knee MRI and gait analysis at baseline and 1 year. Cartilage T1ρ and T2 were calculated for the medial tibia and medial femoral condyle. Linear regressions were used to evaluate associations between gait characteristics and changes in cartilage relaxation times from before ACLR to follow-up time points. Independent t tests were used to compare differences in gait between patients undergoing ACLR and control participants.

Results:

A higher KFM and KFA before ACLR were related to greater increases in medial femoral condyle T1ρ and T2 at 6 months after ACLR. Similarly, a higher KFM, KFA, and vGRF at 6 months were associated with greater increases in medial tibia and medial femoral condyle T1ρ and T2 at 1 and 2 years after ACLR. Gait characteristics at 1 year were not associated with changes in cartilage relaxation times at 2 years after ACLR. Compared with healthy controls, patients undergoing ACLR demonstrated a lower KFM at 6 months after ACLR.

Conclusion/Clinical Relevance:

The findings of this study revealed that a higher KFM, KFA, and vGRF during gait, especially at 6 months after ACLR, were associated with greater deterioration of MTFJ cartilage health at later time points.
Exploration of Children’s Test Behavior During iPad-Administered Intelligence Testing
Authors: Castro Connie J. , Viezel Kathleen , Dumont Ron , Guiney Meaghan
Published: September 2017

This study examined recent technological developments in cognitive assessment and how these developments impact children’s test behavior. The study consisted of two groups: one tested with an iPad and another tested with the standard paper and pencil format of the Wechsler Intelligence Scale for Children (WISC-IV). Independent groups t tests examining the empirically based syndrome and broad scales on the Test Observation Form yielded no significant results. There did not appear to be differences in test behavior between the two groups. Overall, examiners can be more confident that whether they conduct intellectual testing via traditional paper and pencil or via iPad, children’s test behaviors do not appear to be negatively influenced by test format.
General Problem-Solving Styles and Problem-Solving Approaches in Video Games
Authors: Hamlen Karla R.
Published: September 2017

Video game play is a pervasive recreational activity, particularly among college students. While there is a large research base focused on educational video game play and uses of games in the classroom, there is much less research focused on cognitive strategies and entertainment video game play. The purpose of this study was to investigate potential relationships between general problem-solving styles and problem-solving approaches in video games. One hundred and thirty-eight undergraduate college students completed online surveys about their video game play and also an assessment of general problem-solving style. A multivariate linear regression revealed relationships between general problem-solving styles and problem-solving preferences in video games, with a few differences when looking at specific genres of games. This study provides evidence that approaches to video game play can be a reflection of real-life problem-solving styles.
Genotoxic evaluation of different sizes of iron oxide nanoparticles and ionic form by SMART, Allium and comet assay
Authors: Kaygisiz Şöhret Yüksek , Ciğerci İbrahim Hakkı
Published: September 2017

In this study, the genotoxic potential of <50 nm, <100 nm iron oxide (Fe2O3) nanoparticles (IONPs) and ionic form were investigated using the wing somatic mutation and recombination test (SMART) and Allium and comet assays. In the SMART assay, different concentrations (1, 2, 5 and 10 mM) of NPs and ionic forms were fed to transheterozygous larvae of Drosophila melanogaster. No significant genotoxic effect was observed in <100 nm NPs and ionic form, while <50 nm IONPs showed genotoxicity at 1 and 10 mM concentrations. Allium cepa root meristems were exposed to five concentrations (0.001, 0.01, 0.1, 1 and 10 mM) of <50 nm and ionic forms for 4 h and three concentrations (2.5, 5 and 10 mM) for <100 nm of IONPs for 24 and 96 h. There was a statistically significant effect at 96 h at all concentrations of <100 nm IONPs. Similarly, <50 nm of IONPs and ionic forms also showed a statistically significant effect on mitotic index frequencies for all concentrations at 4 h. There was a dose-dependent increase in chromosomal abnormalities for IONPs and ionic form. Comet assay results showed time- and concentration-dependent increases in <100 nm NPs. There was a concentration-dependent increase in <50 nm NPs and ionic form ( p < 0.05). Consequently, the <50 nm of Fe2O3 was found toxic compared to 100 nm Fe2O3 and ionic form.
Worksite Health Promotion for Low-Wage Workers: A Scoping Literature Review
Authors: Stiehl Emily , Shivaprakash Namrata , Thatcher Esther , Ornelas India J. , Kneipp Shawn , Baron Sherry L. , Muramatsu Naoko
Published: September 2017

Objective:

To determine: (1) What research has been done on health promotion interventions for low-wage workers and (2) what factors are associated with effective low-wage workers’ health promotion programs.

Data Source:

This review includes articles from PubMed and PsychINFO published in or before July 2016.

Study Inclusion/Exclusion Criteria:

The search yielded 130 unique articles, 35 met the inclusion criteria: (1) being conducted in the United States, (2) including an intervention or empirical data around health promotion among adult low-wage workers, and (3) measuring changes in low-wage worker health.

Data Extraction:

Central features of the selected studies were extracted, including the theoretical foundation; study design; health promotion intervention content and delivery format; intervention-targeted outcomes; sample characteristics; and work, occupational, and industry characteristics.

Data Analysis:

Consistent with a scoping review, we used a descriptive, content analysis approach to analyze extracted data. All authors agreed upon emergent themes and 2 authors independently coded data extracted from each article.

Results:

The results suggest that the research on low-wage workers’ health promotion is limited, but increasing, and that low-wage workers have limited access to and utilization of worksite health promotion programs.

Conclusion:

Workplace health promotion programs could have a positive effect on low-wage workers, but more work is needed to understand how to expand access, what drives participation, and which delivery mechanisms are most effective.
Developing Trainers for a Changing Business Environment: The Role of Informal Learning in Career Development
Authors: Kwon Kibum , Cho Daeyeon
Published: September 2017

The purpose of this study is to explore the relationship among skill variety, autonomy, and job involvement with the mediating effect of informal learning in the South Korean business context. This study adopts a cross-sectional survey-based research design, drawing on the responses of 226 South Korean trainers to a survey regarding their facilitation experiences. Structural equation modeling is used in order to examine the influential relationship among the research variables. The results suggest that trainers exhibit higher levels of job involvement when they possess significant skill variety and high levels of autonomy and informal learning. Moreover, informal learning is shown to mediate the relationship between the job characteristics and job involvement. Recent changes in the knowledge economy have required professional trainers to expand their capabilities to lead organizations in the execution of business strategies. This study highlights the importance of informal learning to the trainers’ professional and career advancement.
Modelling of condensing steam flows in Laval nozzles with ANSYS CFX
Authors: Grübel Marius , Starzmann Jörg , Schatz Markus , Vogt Damian M
Published: September 2017

The results of the International Wet Steam Modelling Project presented at the Wet Steam Conference in Prague in 2016 again gave rise to a discussion about the suitability of the flow solver ANSYS CFX for the prediction of spontaneous condensation. In this article, the main reason for the discrepancy between results obtained with CFX and measurement data is identified. It could be found that in CFX the temperature of already existing droplets is used for evaluating the fluid properties involved in the nucleation process. This is not in agreement with the isothermal classical nucleation theory, which is based on the assumption that clusters of critical radius are formed at vapour temperature. The most dominant parameter affected by this is the surface tension, the evaluation of which can be altered easily by the user. The influence of the correction is illustrated by means of standard Laval nozzle test cases, and a significant improvement of the results compared to measurement data can be observed.
Ethics and quality care in nursing homes: Relatives’ experiences
Authors: Jakobsen Rita , Sellevold Gerd Sylvi , Egede-Nissen Veslemøy , Sørlie Venke
Published: September 2017

Background:

A total of 71,000 people in Norway suffer from some form of dementia in 2013, of whom approximately 30,000 are in nursing homes. Several studies focus on the experiences of those who have close relatives and who are staying in a nursing home. Results show that a greater focus on cooperation between nursing staff and relatives is a central prerequisite for an increased level of care. Benefits of developing systematic collaboration practices include relief for nursing staff, less stress, and greater mutual understanding. Going through studies focusing on the experiences of nursing home patients’ relatives, negative experiences are in the majority. In this study, relatives are invited to share positive experiences regarding the care of their loved ones; a slightly different perspective, in other words.

Aim:

The aim of the study is to investigate relatives of persons with dementia’s experiences with quality care in nursing homes.

Method:

The study is a part of a larger project called Hospice values in the care for persons with dementia and is based on a qualitative design where data are generated through narrative interviews. The chosen method of analysis is the phenomenological–hermeneutical method for the study of lived experiences.

Participants and research context:

Participants in the project were eight relatives of persons with dementia who were living in nursing homes, long-term residences. The sampling was targeted, enrolment happened through collective invitation. All relatives interested were included.

Ethical considerations:

The Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services approve the study.

Findings:

Findings show that relatives have certain expectations as to how their loved ones ought to be met and looked after at the nursing home. The results show that in those cases where the expectations were met, the relatives’ experiences were associated with engagement, inclusion and a good atmosphere. When the expectations were not met, the relatives experienced powerlessness, distrust and guilt.

Discussion:

The results are discussed considering the concepts of trust, power and asymmetry.

Conclusion:

When asked about experiences with quality care, the relatives spoke both of expectations met and of expectations not met. Results in this study are important knowledge for developing units where performing quality care is the overall aim.
Capturing Stars: Bengali Actresses Through the Camera of Nemai Ghosh
Authors: Gadihoke Sabeena
Published: September 2017

This essay explores the rich archive of photographer Nemai Ghosh whose production stills on the sets of Satyajit Ray kept his cinema alive in popular memory. While it might appear that Ghosh was overwhelmed by the vision of Satyajit Ray, the essay explores how the documentary impulse in his work created continuity as well as rupture with the cinema of Ray and others in Bengal. Nemai Ghosh’s forte lay in capturing candid moments of actors just before and after filming on the sets. These interstitial moments caught between the vision of the director and the photographer shooting a production still could be used to tease out other deeper meanings about star personas. As we look through Nemai Ghosh’s larger body of work, particularly at images which may not have found public circulation as film stills, we see other kinds of mediations between the photographer, the camera and his subjects. By extricating still frames out of motion, Ghosh’s photographs invite us to contemplate certain tensions between female actors, their roles and their extra cinematic lives. Recollections of these stars are layered by stories, anecdotes and popular myths. In this essay, I explore what it might mean to look back at Nemai Ghosh’s images through the prism of these overlapping memories.
Validation of different score systems in predicting cardiac arrest occurrence of ST‐elevation myocardial infarction
Authors: Han Ko‐Wen , Chen Shou‐Yen , Weng Yi‐Ming , Ng Chip‐Jin , Chiu Te‐Fa , Hsieh I‐Chang , Chen Jih‐Chang
Published: September 2017

Introduction:

Patients with ST‐elevation myocardial infarction are at risk of developing cardiac arrest. A validated tool for predicting cardiac arrest would help physicians recognize these high‐risk patients earlier. This study assessed the usefulness of various score systems in predicting cardiac arrest in patients hospitalized for ST‐elevation myocardial infarction.

Methods:

Patients’ data were retrieved from the hospital's ST‐elevation myocardial infarction registry records. Patients aged 18 years or older seen at the emergency department with a diagnosis of ST‐elevation myocardial infarction between 1 July 2013 and 30 June 2014 were enrolled. The Thrombolysis in Myocardial Infarction score, the 6‐month Global Registry of Acute Coronary Event risk score, CHADS2 score, and HEART score were calculated and compared.

Results:

A total of 249 patients were recruited. The Thrombolysis in Myocardial Infarction score, 6‐month Global Registry of Acute Coronary Event risk score, CHADS2 score, and HEART scores were calculated. In total, 41 (16.5%) patients had cardiac arrest at emergency department or during hospitalization and 12 (29.3%) of them survived. The 6‐month Global Registry of Acute Coronary Event risk score had the biggest area under the receiver‐operating characteristic curve (0.72).

Conclusion:

The 6‐month Global Registry of Acute Coronary Event risk score is more useful in predicting cardiac arrest in patients hospitalized for ST‐elevation myocardial infarction than the other three scores. It is recommended that the 6‐month Global Registry of Acute Coronary Event risk score be calculated for identifying emergency department patients hospitalized for ST‐elevation myocardial infarction who are at risk of cardiac arrest during their hospital stay.
Building Situation Awareness on the Move: Staff Monitoring Behavior in Clinic Corridors
Authors: González-Martínez Esther , Bangerter Adrian , Lê Van Kim
Published: September 2017

We conducted a workplace research project on staff mobility in a Swiss hospital outpatient clinic that involved extensive fieldwork and video recordings. The article describes monitoring practices and routines that staff engage in as they walk through the corridors and in and out of the clinic’s rooms. The staff perform checks on on-going activity, share their observations with colleagues, and take responsive action while engaged in away-oriented walk or in specific roaming, action-seeking, rallying, and patrolling walk. We argue that these behaviors are closely associated with building and sustaining situation awareness (SA) with regard to the status of the clinic’s functioning. They contribute to the coordination of a spatially distributed team that rapidly accomplishes consequential and closely interrelated activities in constantly changing circumstances.
Archaeology of Slavery From Cross-Cultural Perspective
Authors: Hrnčíř Václav , Květina Petr
Published: September 2017

Slavery is difficult to ascertain in the archaeological record, especially because of the lack of material evidence. Using the Standard Cross-Cultural Sample of 186 societies, our aim was to find indirect and easily identifiable indicators of the presence of slavery. The results show links between slavery and the expected and familiar domains (e.g., warfare, polygyny, social and political integration) as well as its relationship to metallurgy, which can be considered an innovative finding. This text attempts to explain and give context to the metallurgy relationship with historical examples related to the exploitation of slaves during various stages of the operational chain of metal production. These include raw material extraction, production of charcoal, and construction or reconstruction of smelting furnaces.
An Evaluation of the Impacts of Changing Firearms Legislation on Australian Female Firearm Homicide Victimization Rates
Authors: McPhedran Samara
Published: September 2017

Reducing lethal violence against women requires comprehensive measures addressing individual, social, economic, cultural, and situational factors. Regarding situational factors, access to weapons—and firearm access in particular—has received notable research attention. However, most study comes from the United States of America, and findings may not apply elsewhere. The current study examines whether changing gun laws in Australia affected female firearm homicide victimization. Female firearm homicide victimization may have been affected; however, no significant impacts were found for male firearm homicide victimization. Findings suggest there may be value in preventing legal access to firearms by persons who have a history of intimate partner violence, although considerable further study is required.
The Role of Partners and Workplaces in British and Swedish Men’s Parental Leave Decisions
Authors: Kaufman Gayle , Almqvist Anna-Lena
Published: September 2017

Sweden has been long known for its early introduction of parental leave in the 1970s and the introduction of the first nontransferable “daddy month” in 1995 while the United Kingdom (UK) lagged behind with policies that reflected a strong male breadwinner model until the recent introduction of Additional Paternity Leave, which extended paternity leave up to twenty-six weeks. Our study examines parental leave decisions following the changes in policy, paying particular attention to the role of partners and workplaces. We draw on data from thirty-two interviews with Swedish parents conducted in 2008 and twenty-two interviews with British parents conducted in 2012. We find that mothers in both countries have great influence over parental leave decisions. However, this often perpetuates a much greater gendered division of parental leave in the UK than in Sweden. Furthermore, the British workplace continues to hold very different expectations for male and female employees regarding parental leave, while Swedish employers are generally accepting of men’s use of long parental leave.
Method-comparison studies in telehealth: Study design and analysis considerations
Authors: Russell Trevor G , Martin-Khan Melinda , Khan Asaduzzaman , Wade Victoria
Published: September 2017

When establishing telehealth services, clinicians need to be confident that the examinations, assessments and clinical decisions that they make while using technology are equivalent to conventional best practice. Method-comparison studies are ideally suited to answering these questions, however there is a lack of consistency in the telehealth literature in the study methodologies and data analysis techniques used. Methodologies should closely match clinical practice to maximise external validity and data analysis techniques should match the data types generated in order to be clinically meaningful. In this article we discuss the design, analysis and interpretation of method-comparison studies in the context of telehealth research.
Poverty risk among older immigrants in a scandinavian welfare state
Authors: Jakobsen Vibeke , Pedersen Peder J.
Published: September 2017

The focus of this paper is on poverty among immigrants and refugees aged 60 years and older coming to Denmark from countries outside of the OECD, with an emphasis on immigrants who came as guest workers before 1974, as refugees and as family members and marriage partners (tied movers) of the individuals coming as guest workers and as refugees. A large proportion of people in this group were fairly young at the time of their arrival in Denmark. Guest workers who came before 1974 and refugees and tied movers who arrived in the 1970s and 1980s are now either close to or above the age of 60, with conditional eligibility to a labour market-related early retirement programme or to the State pension. Poverty rates by national background are described using alternative household concepts. A number of background factors with relevance for poverty are summarised. We focus on age, gender, marital status, occupational status at age 55, and duration of residence, and find major differences between migrant groups and between immigrants and natives regarding how income is dependent at different ages on market income, pensions and benefits. We also present a number of regressions aiming at explaining differences in the risk of poverty risk in terms of these background factors.
Multiplatform news consumption and its connections to civic engagement
Authors: Molyneux Logan
Published: September 2017

Studies of informational media use have focused on individual platforms or pitted platforms against each other when investigating their connections to civic engagement. This study offers evidence, collected in a 2016 survey of US adults, of how civically engaged individuals consume various types of news content across multiple platforms. Results suggest that the best condition is the most varied one, wherein consumers get news on all six platforms studied. A breakdown of content categories finds that television viewers and those who pay attention to breaking news and crime are less civically engaged.
Reflexivity and visual technology in research: young children’s perspectives of paternal engagement in the home environment
Authors: Chawla-Duggan Rita , Milner Susan , Porter Jill
Published: September 2017

Although existing notions of reflexivity address the positionality of researchers, they rarely consider the processes through which methods and methodologies can come about. This study builds children’s reflexivity into the research design. Drawing on footage from a pilot visual ethnography of paternal engagement in home environments, we show first, that at one level, building children’s reflexivity into data collection and analysis, allows us to look at the relationship between the child, technology and the subject of their images; thereby establishing a position from which their perspective is produced. We found that their age and the particular visual technology used, shaped how the children positioned themselves and in turn, the kind of representations we gathered. As this was a collaborative study with a film maker and also involving discussions of film findings with teachers; a more general level reflexive analysis allowed us generate different viewpoints from which their perspectives were produced.
Emotional Connection of Military Couples after 16 Years of War: Integrating Pastoral Counseling and Evidence-Based Theory
Authors: Cheney Gregory J.
Published: September 2017

Sixteen years of war created significant challenges for military couples and seems to contribute to their relational distress. Military couples seek out pastoral counselors for assistance with their relational distress. Many of these pastoral counselors are military chaplains or pastors serving close to military bases. The integration of pastoral counseling with evidence-based theory is presented as an option to serve military couples in their relational distress. Emotionally Focused Couple Therapy is presented as an example.
Endotracheal tube-induced sore throat pain and inflammation is coupled to the release of mitochondrial DNA
Authors: Puyo Carlos A , Peruzzi Daniela , Earhart Alexander , Roller Evan , Karanikolas Menelaos , Kollef Marin H , Krupnick Alexander S , Kreisel Daniel , Ibrahim Mohsen , Gelman Andrew E
Published: September 2017

In the absence of infection, the pathophysiology of endotracheal tube-induced sore throat pain is unclear. Activated neutrophils release elastase, reactive oxygen species, and inflammatory cytokines known to contribute to neuropathic pain. Sterile tissue injury can cause the release of damage-associated molecular patterns such as mitochondrial DNA that promote neutrophil activation. We hypothesized that endotracheal tube-induced sore throat pain is linked to mitochondrial DNA-mediated neutrophil inflammation. A nonrandomized prospective survey for sore throat pain was conducted in 31 patients who required short-term intubation and had no evidence of upper airway infection. Patterns of neutrophil abundance, activation, and mitochondrial DNA levels were analyzed in tracheal lavage fluid following intubation and prior to extubation. Thirteen of 31 patients reported sore throat pain. Sore throat patients had high neutrophilia with elevated adhesion molecule and TLR9 expression and constitutive reactive oxygen species generation. Tracheal lavage fluid from sore throat patients accumulated mitochondrial DNA and stimulated neutrophils to release mediators associated with pain in a TLR9- and DNAse-dependent fashion. Endotracheal tube-induced sore throat is linked to the release of mitochondrial DNA and can drive TLR9-mediated inflammatory responses by neutrophils reported to cause pain. Mitigating the effects of cell-free mitochondrial DNA may prove beneficial for the prevention of endotracheal tube-mediated sore throat pain.
Shared decision making after severe stroke—How can we improve patient and family involvement in treatment decisions?
Authors: Visvanathan Akila , Dennis Martin , Mead Gillian , Whiteley William N , Lawton Julia , Doubal Fergus Neil
Published: September 2017

People who are well may regard survival with disability as being worse than death. However, this is often not the case when those surviving with disability (e.g. stroke survivors) are asked the same question. Many routine treatments provided after an acute stroke (e.g. feeding via a tube) increase survival, but with disability. Therefore, clinicians need to support patients and families in making informed decisions about the use of these treatments, in a process termed shared decision making. This is challenging after acute stroke: there is prognostic uncertainty, patients are often too unwell to participate in decision making, and proxies may not know the patients’ expressed wishes (i.e. values). Patients’ values also change over time and in different situations. There is limited evidence on successful methods to facilitate this process. Changes targeted at components of shared decision making (e.g. decision aids to provide information and discussing patient values) increase patient satisfaction. How this influences decision making is unclear. Presumably, a “shared decision-making tool” that introduces effective changes at various stages in this process might be helpful after acute stroke. For example, by complementing professional judgement with predictions from prognostic models, clinicians could provide information that is more accurate. Decision aids that are personalized may be helpful. Further qualitative research can provide clinicians with a better understanding of patient values and factors influencing this at different time points after a stroke. The evaluation of this tool in its success to achieve outcomes consistent with patients’ values may require more than one clinical trial.
The Polish version of the Michigan Hand Outcomes Questionnaire: Cross-cultural adaptation, reliability, construct validity, and measurement error
Authors: Koziej Mateusz , Trybus Marek , Mydłowska Anna , Sałapa Kinga , Gniadek Maksymilian , Banach Marta , Brudnicki Jarosław
Published: September 2017

The aims of this study were to translate the Michigan Hand Outcomes Questionnaire into the Polish language and to test the measurement properties of its quality criteria. A total of 120 patients with hand complaints completed the Polish Michigan Hand Outcomes Questionnaire and the Disabilities of the Arm, Shoulder, and Hand questionnaire on the first assessment, along with the grip test, pinch test, and pain sore assessed using a visual analogue scale during activity. After 7 days, 76 patients completed the Michigan Hand Outcomes Questionnaire the second time. The Cronbach alpha of the Michigan Hand Outcomes Questionnaire subscales ranged from 0.79 to 0.96. The intraclass correlation coefficient varied from 0.82–0.97, and the Bland–Altman method indicated the Michigan Hand Outcomes Questionnaire total score limit of agreement was −13.2–12.3 and −9.18–9.62 for the right and left hand, respectively. The construct validity revealed a moderate to strong correlation between every subscale of the Polish Michigan Hand Outcomes Questionnaire and Disabilities of the Arm, Shoulder, and Hand, but they only correlated with the grip test and the visual analogue scale, and neither correlated with the pinch test. The study demonstrated properties similar to the original version, validating the belief that the use of this questionnaire in medical practice in Poland is justified.
Release with or without reconstruction of the transverse carpal ligament for severe carpal tunnel syndrome: a randomized clinical trial
Authors: Gutiérrez-Monclus Rodrigo G. , Gutiérrez-Espinoza Hector J. , Flores-Astudillo Alvaro R. , Lluch-Homedes Alberto L. , Aguirre-Jerez Marcela
Published: September 2017

The objective of this study is to compare the clinical effectiveness of two surgical techniques in patients with severe unilateral idiopathic carpal tunnel syndrome. A total of 117 patients were randomized in two groups. In the experimental group ( n = 59) reconstruction of the transverse carpal ligament was performed after open retinaculum release (TCL reconstruction group). In the control group ( n = 58) only retinaculum release was performed (TCL release group). The primary outcome measure was grip strength; secondary outcome measures were pain and response to the Boston questionnaire. Significance was analysed using the t-test or Mann–Whitney test. At 6 months, the experimental group showed clinical and statistically significant improvement in grip strength and decrease in symptom severity. Retinaculum release with reconstruction of the transverse carpal ligament results in improvement of grip strength in the medium term when compared with open retinaculotomy in patients with severe unilateral idiopathic carpal tunnel syndrome.

Level of evidence: II
Non-vascularized iliac bone grafting for scaphoid nonunion with avascular necrosis
Authors: Kim Jihyeung , Park Jin Woo , Chung Jeehyeok , Jeong Bae Kee , Gong Hyun Sik , Baek Goo Hyun
Published: September 2017

We present the surgical outcomes of non-vascularized bone grafting taken from the iliac crest in 24 patients with scaphoid nonunion and avascular necrosis. The Fisk-Fernandez technique was used in 11 patients, and cancellous bone grafting was used in 13 patients. Bony union was achieved in 22 of the 24 patients. Non-vascularized iliac bone grafting can be used for the surgical management of scaphoid nonunion with avascular necrosis. Although revascularization of the proximal fragment after surgery was not evaluated, bony union was confirmed in nearly all patients.

Level of evidence: IV
Human factors in suicide prevention
Authors: Mahajan Sangeeta , Johnstone Craig
Published: September 2017

This article uses a case study to discuss the importance of human factors in maintaining patient safety in the community. Although the case relates to a patient suffering from mental illness, the principles discussed here are transferrable to physical illnesses. This article aims to describe some of these human factors and how they relate to the healthcare setting.
Revenue Management Outsourcing: A Hybrid Model of Transaction Cost Economics and Organizational Capability
Authors: Altin Mehmet , Uysal Muzaffer , Schwartz Zvi
Published: September 2017

Hotel revenue management is an activity domain that is uniquely technical, complex, and dynamic, and as such, it is often outsourced. This study explores the motivation of hotels to outsource their revenue management function to an outside entity. The major theoretical contribution is in being first to suggest, and empirically test, the notion that in complex environments, such as revenue management, the firm’s capabilities are moderating the impact of assets specificity on managers’ inclination to outsource. From a practical perspective, this study is the first to empirically explore the contextual determinants of the decision to outsource in the hotel-specific domain of revenue management.
Extracranial internal carotid artery vasospasm during thrombectomy
Authors: Miura Isamu , Kawashima Akitsugu , Hayashi Masataka , Tanda Akane , Ishikawa Tomomi , Kawamata Takakazu
Published: September 2017

The use of a stent retriever increases the risk of intracranial vasospasm. Here, we report the case of a man who developed severe vasospasm in a long segment of the extracranial internal carotid artery after mechanical irritation by a stent retriever inserted for the treatment of acute cerebral ischemia. A 47-year-old right-handed man presented with sudden-onset right-sided weakness and difficulty speaking. The patient’s National Institutes of Health Stroke Scale score was 6 and he had an Alberta Stroke Program Early Computed Tomography Score of 9. The patient was started on intravenous alteplase therapy, and an acute thrombectomy was performed. Left internal carotid digital subtraction angiography showed narrowing of the left common and internal carotid arteries and occlusion of the proximal left M1 segment of the middle cerebral artery. A stent retriever was retracted into a guiding catheter placed at the left carotid bulb under continuous suction. Recanalization of the middle cerebral artery was not achieved and there was significant narrowing in a long segment of the extracranial internal carotid artery associated with exacerbation of the patient’s aphasia. The cervical vasospasm improved after nicardipine infusion via the catheter. We encountered vasospasm in a long segment of the extracranial internal carotid artery after mechanical irritation by a stent retriever. If a stent retriever is used in a patient with a narrow extracranial internal carotid artery, consideration should be given to using a Penumbra or smaller guiding catheter located in the distal internal carotid artery to prevent irritation to the cervical vessel wall.
Boundary Extension in Face Processing
Authors: Blazhenkova Olesya
Published: September 2017

Boundary extension is a common false memory error, in which people confidently remember seeing a wider angle view of the scene than was viewed. Previous research found that boundary extension is scene-specific and did not examine this phenomenon in nonscenes. The present research explored boundary extension in cropped face images. Participants completed either a short-term or a long-term condition of the task. During the encoding, they observed photographs of faces, cropped either in a forehead or in a chin area, and subsequently performed face recognition through a forced-choice selection. The recognition options represented different degrees of boundary extension and boundary restriction errors. Eye-tracking and performance data were collected. The results demonstrated boundary extension in both memory conditions. Furthermore, previous literature reported the asymmetry in amounts of expansion at different sides of an image. The present work provides the evidence of asymmetry in boundary extension. In the short-term condition, boundary extension errors were more pronounced for forehead, than for chin face areas. Finally, this research examined the relationships between the measures of boundary extension, imagery, and emotion. The results suggest that individual differences in emotional ability and object, but not spatial, imagery could be associated with boundary extension in face processing.
Substantial improvement of primary cardiovascular prevention by a systematic score-based multimodal approach: A randomized trial: The PreFord-Study
Authors: Gysan Detlef Bernd , Millentrup Stefanie , Albus Christian , Bjarnason-Wehrens Birna , Latsch Joachim , Gohlke Helmut , Herold Gerd , Wegscheider Karl , Heming Christian , Seyfarth Melchior , Predel Hans-Georg
Published: September 2017

Trial design

Prospective randomized multicentre interventional study.

Methods

Individual cardiovascular risk assessment in Ford Company, Germany employees (n = 4.196), using the European Society of Cardiology-Systematic Coronary Risk Evaluation (ESC-SCORE) for classification into three risk groups. Subjects assigned to ESC high-risk group (ESC-SCORE ≥ 5%), without a history of cardiovascular disease were eligible for randomization to a multimodal 15-week intervention programme (INT) or to usual care and followed up for 36 months.

Objectives

Evaluation of the long-term effects of a risk-adjusted multimodal intervention in high-risk subjects. Primary endpoint: reduction of ESC-SCORE in INT versus usual care. Secondary endpoints: composite of fatal and non-fatal cardiovascular events and time to first cardiovascular event. Statistical analysis: intention-to-treat and per-protocol analysis.

Results

Four hundred and forty-seven subjects were randomized to INT (n = 224) or to usual care (n = 223). After 36 months ESC-SCORE development favouring INT was observed (INT: 8.70% to 10.03% vs. usual care: 8.49% to 12.09%; p = 0.005; net difference: 18.50%). Moreover, a significant reduction in the composite cardiovascular events was observed: (INT: n = 11 vs. usual care: n = 27). Hazard ratio of intervention versus control was 0.51 (95% confidence interval 0.25–1.03; p = 0.062) in the intention-to-treat analysis and 0.41 (95% confidence interval 0.18–0.90; p = 0.026) in the per-protocol analysis, respectively. No intervention-related adverse events or side-effects were observed.

Conclusions

Our results demonstrate the efficiency of identifying cardiovascular high-risk subjects by the ESC-SCORE in order to enrol them to a risk adjusted primary prevention programme. This strategy resulted in a significant improvement of ESC-SCORE, as well as a reduction in predefined cardiovascular endpoints in the INT within 36 months. (ISRCTN 23536103.)
Predictors of subsequent myocardial infarction, stroke, and death in stable post-myocardial infarction patients: A nationwide cohort study
Authors: Chen Dong-Yi , Li Chen-Yu , Hsieh Ming-Jer , Chen Chun-Chi , Hsieh I-Chang , Chen Tien-Hsing , Chen Shao-Wei , Wang Chao-Yung , Chang Shang-Hung , Lee Cheng-Hung , Tsai Ming-Lung , Ho Ming-Yun , Yeh Jih-Kai , Chang Chee-Jen , Wen Ming-Shien
Published: September 2017

Background:

This study investigated the predictors of subsequent cardiovascular events in stable post-myocardial infarction patients in Taiwan.

Methods:

A total of 11,183 patients were recruited who had survived one year post-myocardial infarction without subsequent events of recurrent myocardial infarction or stroke from the Taiwan National Health Insurance Research Database. Their composite cardiovascular event rates were identified.

Results:

The composite cardiovascular events rate in three year follow-up in the post-myocardial infarction population was 13.8%. Corresponding event rates were 5.8% recurrent myocardial infarction, 5.0% stroke, and 5.2% death. Independent factors associated with a higher risk of ischemic events or death included heart failure (hazard ratio (HR)=1.19), hypertension (HR=1.16), age (65–75 vs <65 years: HR=1.29; 75–85 vs <65 years: HR=1.50; >85 vs <65 years: HR=1.70), diabetes (HR=1.33), prior stroke (HR=1.24), chronic kidney disease (HR=1.4), atrial fibrillation (HR=1.27), and underutilization of guideline-based medication (HR=1.73). Composite risk for myocardial infarction, stroke and death increased progressively from 4.9% in patients with zero risk factor to 100.0% in patients with eight risk factors.

Conclusions:

For acute myocardial infarction patients surviving one year without subsequent events of recurrent myocardial infarction or stroke, the risk of cardiovascular events remained high. Eight predictors identified patients at increased risk for subsequent cardiovascular events within the next three years. These results suggest an unmet need, particularly in patients with additional risk factors.
Chronic pain, loss and the future – Development and evaluation of an innovative, interactive pain education tool
Authors: Curtis Sally Anne , Pirie Katrina Ishbel
Published: September 2017

Background:

The development of chronic pain can result in multiple losses to an individual, which can negatively impact their quality of life. Presentation of the concepts of loss and grief as an interactive educational tool may help those who live with chronic pain gain a deeper understanding of their condition. This in turn may enable more effective management of their pain. This study aims to explore the effectiveness of such a tool through the perceptions and experiences of people living with chronic pain.

Methods:

An interactive pain education tool was developed and distributed with an evaluation questionnaire. Participants were invited to re-evaluate the tool three months later. Responses to the questionnaire were provided using a Likert scale and free text comments. Descriptive statistics were used to present quantitative results and inductive thematic analysis was applied to the free text comments.

Results:

The pain education tool was well received by participants, the majority of whom found the process of using the tool a positive experience. Responses showed the tool helped participants express themselves and promoted self-reflection. The tool provided access to the reflections of others, which helped validate and legitimise their feelings and gain the understanding that their response to pain was normal. This in turn helped promote self-compassion and a sense of belonging, reducing feelings of isolation associated with chronic pain.

Conclusion:

The outcomes of this study show the pain education tool can help individuals gain a new and more positive perspective on themselves and their pain experience, therefore helping them live with and manage their chronic pain.