bluuebunny/crossref_metadata_2025 huggingface dataset:
Brittany and the Carolingian Empire: A Historical Review
Authors: Brett Caroline
Published: March 2013

Brittany, a region with an obscure early history and an identity in dispute between Britain and France, enters an unusually well‐evidenced period in the ninth century when it was conquered, and then placed under native rulership, by the Frankish Carolingian emperors. Taking advantage of Carolingian weakness to expand territorially, the Breton polity outlasted dynastic violence and Viking attack and would eventually survive until 1532. The historiography of the period has blossomed since the 1980s. English‐ and French‐language historians are in agreement that the creation of Brittany was a direct consequence of the rise and fall of the Carolingian empire, and an illustration of ‘the fundamental political and social changes that often occur on the periphery of dynamic and rapidly evolving societies’ (J.M.H. Smith). They differ, however, in that Francophones are inclined to emphasise the extension of Carolingian institutions to Brittany, while English historiography minimises the institutionalisation of politics, in Brittany and increasingly in the Carolingian empire as a whole. Regardless of these differences, Breton evidence gives a view of the interplay between the local and the supra‐national in social organisation, legal practice, and Christian culture, the significance of which for the whole Carolingian world is increasingly recognised.
Looking down or Looking Up: Status and Subjective Well-Being among Asian and Latino Immigrants in the United States
Authors: Gelatt Julia
Published: March 2013

Foundational theories of international migration rest on the assumption that immigrants maintain reference groups in their country of origin even after settling in a new place, while the transnationalism perspective suggests that immigrants maintain a dual frame of reference. This article uses the nationally representative National Latino and Asian American Survey to test the location of immigrants’ reference groups. I find that the relationship between various measures of subjective social standing and subjective well-being suggests that immigrants maintain simultaneous reference groups in both the United States and the country of origin, supporting transnational theories, and refuting earlier theories.
Manufacturing Plants' Use of Temporary Workers: An Analysis Using Census Microdata
Authors: Ono Yukako , Sullivan Daniel
Published: March 2013

Using plant‐level data from the plant capacity utilization survey, we explore how manufacturing plants' use of temporary workers is associated with the nature of their output fluctuations and other plant characteristics. We find that plants tend to use temporary workers when their output is expected to fall; this may indicate that firms use temporary workers to reduce costs associated with dismissing permanent employees. In addition, we find that plants whose future output levels are subject to greater uncertainty tend to use more temporary workers. We also examine the effects of wage and benefit levels for permanent workers, unionization rates, turnover rates, seasonal factors, and plant size and age on the use of temporary workers; based on our results, we discuss various views of why firms use temporary workers.
Nurses' medication administration practices at two Singaporean acute care hospitals
Authors: Choo Janet , Johnston Linda , Manias Elizabeth
Published: March 2013

This study examined registered nurses' overall compliance with accepted medication administration procedures, and explored the distractions they faced during medication administration at two acute care hospitals in Singapore. A total of 140 registered nurses, 70 from each hospital, participated in the study. At both hospitals, nurses were distracted by personnel, such as physicians, radiographers, patients not under their care, and telephone calls, during medication rounds. Deviations from accepted medication procedures were observed. At one hospital, the use of a vest during medication administration alone was not effective in avoiding distractions during medication administration. Environmental factors and distractions can impact on the safe administration of medications, because they not only impair nurses' level of concentration, but also add to their work pressure. Attention should be placed on eliminating distractions through the use of appropriate strategies. Strategies that could be considered include the conduct of education sessions with health professionals and patients about the importance of not interrupting nurses while they are administering medications, and changes in work design.
NETWORKING FOR AUTONOMY? NATIONAL AGENCIES IN EUROPEAN NETWORKS
Authors: BACH TOBIAS , RUFFING EVA
Published: March 2013

The environment of national agencies has changed considerably in recent years as they increasingly become engaged in European Union networks. This article contributes to a growing body of literature on those networks and their effect on executive politics at the national level by asking whether and how the EU involvement of national agencies affects the agencies' autonomy in policy formulation. We develop an analytical model for explaining the effect of EU involvement on agency autonomy. Analyzing data from a comprehensive survey of federal agencies in Germany, we find that EU involvement has a positive effect on national agencies' policy autonomy. Moreover, we find a somewhat stronger effect of agency involvement in sectoral networks on autonomy than in intergovernmental networks, which is attributed to information asymmetries between ministries and agencies. Yet this effect is weaker than initially expected, which can be explained by a considerable degree of overlap between different types of EU involvement.
Infantile Colic in a Psychodynamic and Nursing Perspective
Authors: Wikander Birgitta , Wahlberg Vivian
Published: March 2013

ABSTRACT. The aim of this study was to illuminate the interaction between mother and infant in the condition of infantile colic and compare this with the interaction in a non‐colic group. Infantile colic was defined as daily inconsolable crying. The sample, 21 mother—infant dyads, were recruited from six welfare centres in the north‐west (a middle‐class area) of Stockholm, A non‐colic group, ten mother—infant dyads, were used as control group. The methods used were observing the feeding situation, interviewing the mother about pregnancy, labour and delivery, mother's first contact with the newborn, maternity stay, duration of breastfeeding, the infant's crying and medication, mother's food habits, etc. The mother was then asked to fill in a Sleep/Activity Scale for the seven following days and nights. A questionnaire was sent six months post‐partum to follow up the situation. Labour and delivery was a positive event for most of the mothers and all the fathers had taken part in it. The observations showed a tendency of disturbed mother—infant interaction during feeding. When the infant was crying it was usually the mother who took care and also developed several ways to try to console the infant.
Relatives' Experience of the Terminal Care of Long‐term Geriatric Patients in Open‐plan Rooms
Authors: Sällström Christina , Sandman Per‐Olof , Norberg Astrid
Published: March 2013

ABSTRACT. The advantages and disadvantages of terminal care in open‐plan patient rooms have been discussed in the literature. This article describes the results of a study on relatives' experience of care in open‐plan rooms. It describes how relatives experienced the patient and the ward environment and how they participated in the care. The content of interviews with relatives of long‐term geriatric patients was interpreted according to Erik H. Erikson's theory of “eight stages of man”. The findings indicated that the information to the relatives was insufficient and relatives' participation in planning the care was scarce. The open‐plan room environment was experienced as deterrent and the patient as deserted. A majority of the relatives experienced emotional contact with the patient. Open‐plan patient rooms with a task assignment organisation of care do not provide patients and relatives with the conditions necessary for the experience of integrity, and this could disturb the relationship between the patient and his relatives.
Training of Eating After a Stroke in a Patient with Dysphagia of Pharyngeal Type
Authors: Axelsson Karin , Norberg Astrid , Asplund Kjell , Söderberg Ove , Wenngren Britt‐Inger
Published: March 2013

ABSTRACT. Dysphagia is a common disability after a stroke. This paper presents the diagnosing, training and surgical treatment of a patient with dysphagia of pharyngeal–oesophageal type after a brain stem infarction. Before the training started the patient had not been able to swallow for 18 months. He was nourished through a Witzel fistula. During his first stay in hospital training was concerned with the physical phase of swallowing. A myotomy of the cricopharyngeal muscle was performed during his second stay in hospital, and after this surgery the patient trained to eat normal food. The third and fourth times he stayed in hospital the psychological and social aspects of eating were focused upon. The patient became able to eat normal food together with others and the Witzel fistula was removed.
The Development of the Health Visitor—Client Relationship
Authors: Chalmers Karen I. , Luker Karen A.
Published: March 2013

ABSTRACT. The aim of this paper is to explore the health visitor‐client relationship as it emerged in an indepth qualitative study of health visiting practice. Despite the emphasis in health visiting practice on developing relationships with clients, there is little empirically based knowledge as to how health visitors develop relationships with clients and what effect relationships have on clients' health outcomes. Forty‐five experienced health visitors were interviewed and asked to discuss cases where they felt they had had a positive effect and cases where they thought they had not had any impact. The interviews were tape‐recorded and later transcribed. A detailed analysis of the processes involved in developing relationships is described. The data from this study suggest that health visitors develop relationships with clients in an attempt, not only to provide services to clients, but also to ensure access to clients over time. This study makes a contribution to our understanding of the processes involved in everyday health visiting practice.
Record Keeping and Health Service Mirrored by Data from Swedish Child Health Care Records
Authors: Hagelin Elisabet
Published: March 2013

Abstract. In order to study the completeness and accuracy of the recording of Child Health Care data, 212 randomly sampled records from all of Sweden were collected. The degree of completeness and accuracy was determined by scoring information from the records.

The results showed that the recorded data lacked accuracy to a large extent, and completeness to a somewhat lesser extent. Information on the development of the child, especially speech and language development, but also psychomotor development, were the main areas lacking completeness. Health information, environmental conditions, behaviour, illnesses, accidents and evaluation of the neonatal period were also very poorly recorded.

The results indicate that the records of the Child Health Care service do not constitute, in the respects studied, a complete and secure basis for clinical work, research, planning or evaluation of the quality of the health services.
Nurse Turnover with Special Reference to Factors Relating to Nursing Itself
Authors: Persson Lena , Hallberg Ingalill R. , Athlin Elsy
Published: March 2013

Nurse turnover may decrease the quality of nursing care due to the loss of knowledge. It also resuits in high costs for the employer. Hence, the factors contributing to nurse turnover, if correctly understood, are important in order to know how to reduce it. This study aimed at exploring what contributing factors nurses who had decided to leave referred to concerning their decision to resign. A questionnaire was posted to all nurses who had left within one county council and 142 nurses responded. The most important factors behind the decision to leave turned out to be the following: difficult to implement changes, lack of influence and recognition, to much weekend and evening duty as well as the psychological burden inherent in nursing. The importance of the first three factors became significantly more important when those who remained in the geographical area were compared with those who moved or started to study. The findings support the idea that job satisfaction indirectly influences nurses turnover. However, it also points to the fact that what increases job satisfaction in nursing may need further research. Psychological burden for instance has not been taken into consideration before. In order to increase job satisfaction, thereby reducing nurse turnover, influence and recognition, lessening of the psychological burden and individually planned work schedules seem to be the most important factors.
Mental Wellbeing of Nurse Educators at Work
Authors: Harri Marja
Published: March 2013

The aim of the study was to assess the mental wellbeing of nurse educators at their work by means of self‐assessment. Questionnaires were sent to 100 randomly selected trained nurse educators. Data were collected from 83 respondents. The nurse educators evaluated their mental wellbeing as being rather good. There were, however, some contradictions in the answers to questions covering identical work areas but having somewhat different formulation. The disadvantages of being a nurse educator, as listed by the respondents, included: too much work, and especially too many administrative duties, communication breakdowns with the directors of the nursing college, and underestimation by others of the value of teaching as such.

As characteristics of the job promoting a sense of wellbeing, the nurse educators mentioned their interaction and relationships with the students. In addition, the demands and challenges of the work were found very interesting and rewarding.
Nursing Care as Documented in Patient Records
Authors: Ehnfors Margareta , Smedby Björn
Published: March 2013

A review of 106 nursing records from 12 wards was conducted to categorize and quantify the content of the documentation and to consider the comprehensiveness of the recording for individual nursing problems. Audit instruments, based on a model for nursing documentation were developed and applied. The results show that admission assessment was missing in slightly less than half of all records, two‐thirds had no nursing care plan and about one‐third had no documentation on nursing outcome. About 90% of the records had no nursing diagnosis, no objective or no nursing discharge note. Notes on nursing status and nursing interventions were most common. Only one‐third of the nursing problems identified had recording that gave information about the progress of the patient's problem. The analyses performed give information on the quality of nursing records which may be used to evaluate the quality of nursing care.
Theoretical Discussion of a Model of Caring for Persons with HIV Infection
Authors: Victor Birgit Westphal
Published: March 2013

A model of caring for persons with HIV infection is presented. The model, which identifies the characteristics of care as a holistic phenomenon, consisting of care actions and caring behaviours, was developed through a qualitative approach comparable to the ethnonursing method. The characteristics of care inherent in the model are validated through comparison with knowledge of care from selected historical, linguistic, and caring science sources as well as with care experiences, described in biographies of persons with HIV infection. It is proposed, that the model should be used for further investigation of caring for persons with HIV infection, for investigating caring for persons with other conditions, for teaching caring theory and practice, for planning of caring services and for policy formulation.
Improvement after Surgery in Patients with Osteoarthrosis of the Knee
Authors: Mattsson Eva , Weidenhielm Lars
Published: March 2013

To ascertain both physical and psychosocial effects of knee surgery in patients with moderate gonarthrosis, clinical examination of patients has been supplemented with a questionnaire SIP (Sickness Impact Profile) to describe the functional health status. Sixty patients, 35 women and 25 men, mean age 63 years, with moderate medial osteoarthrosis of the knee were included in the study. Sixteen patients had bilateral symptoms of gonarthrosis. Patients considered that their knee ostheoarthrosis had great influence physically as well as psychosocially. All patients graded pain during walking. Thirty‐five patients were treated with a medial unicompartmental knee endoprosthesis and 25 patients were treated with a valgus osteotomy. After surgery the mean values for all measured variables were improved. Superior results were found among patients with unilateral disease compared to patients with bilateral disease. No differences in results were found between patients given different surgical treatments. The physical and psychosocial influence of osteoarthrosis of the knee were more pronounced in women. It is concluded that the SIP appears to be a measure with sufficient sensitivity to detect physical and psychosocial changes in patients with moderate osteoarthrosis of the knee.
Living with Continuous Muscular Pain—Patient Perspectives
Authors: Henriksson Chris M.
Published: March 2013

The purpose of the present study was to focus on the patient perspectives of living with chronic muscular pain, and to identify factors that can explain and give further understanding of how the condition influences everyday life. Forty women with fibromyalgia, living in two different cultural, health care and social security settings, Sweden and the USA, were interviewed, using a semi‐structured format. Three preliminary typologies are suggested for further studies: Encounters, Consequences, and Strategies. The study is presented in two articles: Part I: Encounters and consequences, Part II: Strategies for daily life. This first article shows that the contradiction between the patients' perception of illness and the lack of objective findings is stressful. The women feel rejected, misunderstood, and disbelieved, which prevents them from dealing with their situation constructively. Long investigation periods provoke anxiety, and confirmation of the diagnosis is a relief. Daily routines are disrupted, conflicts between life roles lead to additional stress and the women experience loss of ability to perform valued activities, lack of physical fitness and loss of future opportunities. Patients need early and adequate information and the consequences of the condition must be acknowledged and taken into consideration if secondary economic and psychosocial consequences are to be minimized.
Nurses' Advice to Parents with a Crying Infant
Authors: Wikander Birgitta
Published: March 2013

Child‐Health Centres (CHC) in Sweden have a very good reputation. Despite the non‐obligatory status of the CHC, most families visit these centres. With the purpose of studying nurses' work in general and especially in relation to their dealing with crying infants, an interview study was carried out at eight CHCs in a district in Stockholm. The results were analysed with focus on nurse‐parent relationships, paternalism, and nursing subculture. The findings of this study suggest that nurses at CHC work purposefully to develop a favourable relationship with parents, though sometimes they adopt a paternalistic approach. Their knowledge of research in pediatrics in general and in child health care in particular is good, but a degree of wariness of research findings is evident.
Perceived Importance of Needs Expressed by Parents of Hospitalized Two‐ to Six‐Year‐Olds
Authors: Kristjánsdóttir Gudrún
Published: March 2013

The study describes the needs of 34 parents, 12 fathers and 22 mothers, of hospitalized 2–6 year‐olds in a Pediatric Hospital in Iceland. Subjects responded to 43 statements of possible needs during a child's hospitalization on a Likert‐type scale based on their perception of the importance of items. The reliability coefficient was over 0.91 for all three parts of the instrument. Parents' perception of importance was significantly and positively correlated with their perception of how their needs were being met and with their request for help from the hospital to fulfil them. None of the statements were perceived to be unimportant. Items related to parents' need to trust nurses and doctors were consistently rated as very important. Items related to the need for information and needs related to other family members were consistently rated as lying between important and very important. Needs related to human and physical resources, and the need for support and guidance were in general rated lowest. Items related to the need to be trusted had a mean importance significantly (p < 0.01) lower for fathers. Although not exhaustive, the statements presented were found to be representative of the needs and concerns of parents during the hospitalization of their children.
Activity—From Action to Activity
Authors: Haglund Lena , Henriksson Chris
Published: March 2013

In this article, existing terminology concerning occupational performance is reviewed. The authors conclude that the occupational therapy terminology available is insufficient to describe levels of complexity in the performance of an activity. Concepts are suggested to describe the different aspects of an activity, namely operations, single actions, generated actions, action sequences, and simultaneous actions. The suggested concepts are not intended to replace, but to supplement existing terminology.
Anxiety, Depression and Sleep in Male Patients Undergoing Coronary Artery Bypass Surgery
Authors: Edéll‐Gustafsson Ulla M. , Hetta Jerker E.
Published: March 2013

The aim of this study was to examine the prevalence of depression and anxiety following coronary artery bypass surgery (CABG) and to see how those patients with depression and anxiety differ in sleeping pattern. The individual reaction to sleep loss was tested as a predictor of certain emotional symptoms in the follow‐up period. Thirty‐eight males, between 45 and 68 years, were interviewed prior to, and 1 month after, surgery, and received a questionnaire at the 6‐month follow‐up. Eighty per cent scored moderate anxiety prior to surgery and six patients were depressed. An anxiety‐prone individual reactivity persisted in the same patients in 38.9% (n = 14) following CABG, with significantly more sleep disturbances, tiredness, energy deficits, immobility, and lower degree of quality of life (QoL). Sad/depressed mood or cognitive/behavioural fatigue symptoms as reactions to sleep loss were predictors of sleep problems and daytime sequelae, whereas a higher postoperative NYHA class was predicted by cognitive/behavioural fatigue and dysphoria reactions. Being less refreshed by sleep on final awakening prior to surgery related to 44.5% of the variance in QoL outcome 6 months following surgery. In conclusion, an anxiety‐prone individual reactivity is significantly associated with sleep disturbances. Reactions to sleep loss prior to surgery are associated with emotional distress after surgery.
Coping Strategies and Styles Assessed by the Jalowiec Coping Scale in a Random Sample of the Swedish Population
Authors: Lindqvist Ragny , Carlsson Marianne , Sjödén Per‐Olow
Published: March 2013

A random sample of the Swedish general population (n = 1 200), age range 18–80 years, was studied with regard to coping strategies and styles used for handling stressful situations. The total response rate was 65% (n = 519), and coping was assessed by the Jalowiec Coping Scale (JCS). The three most frequently used coping styles were the confrontative, the optimistic and the self‐reliant. The three least used styles were the emotive, the supportant and the palliative. There were few differences between the age groups for the total material or for each gender separately. Young (18–29 years) and middle‐aged (30–59 years) groups used confrontative and emotive styles significantly more than did the elderly (60–80 years) group. Young and middle‐aged women used significantly more optimistic, evasive, emotive and supportant coping than did elderly women. All subscales except the self‐reliant showed significant gender differences, with women reporting more frequent use than men. Ethnicity is a major determinant of the use of the emotionally‐oriented coping styles. Those of Swedish origin used less of these styles than did those of non‐Swedish origin. The results illustrate the importance of using different norm values for the JCS for groups differering in these demographic variables.
A Comparison of Two Different Team Models for Treatment of Diabetes Mellitus in Primary Care
Authors: Ovhed Ingvar , Johansson Eva , Odeberg Håkan , Råstam Lennart
Published: March 2013

The importance of the nurse's role in the management of patients with type 2 diabetes has long since been emphasized. The aim of this study was to test the hypothesis that a structured organization of type 2 diabetes care, with a diabetes nurse working more independently of the general practitioner, has a significant impact on the patient's self‐management and quality of care. The test consisted of 394 registered patients, all with an onset of diabetes mellitus occurring after the age of 34, at two primary health care (PHC) districts in Blekinge county in South Sweden. During one year all consultations for both doctors and nurses were analysed, and a structured telephone survey was carried out involving 364 patients who were 84 years or younger. A comparison between the two PHC centres was made regarding quality of care, frequency of consultation, patients' knowledge of their disease, and patients' self‐management. The results showed that organizing care of type 2 diabetes in a structured way encourages better metabolic control in spite of less use of oral medication, and among the patients a greater knowledge of their disease and a more active self‐management thus favouring implementation of local guidelines. Also, a difference was found in the patients' choice of contact with doctor or nurse regarding their diabetes and even other causes, which shifted the balance from doctor to nurse. This study provides support for organizing type 2 diabetes care in a structured way to increase the quality of care.
Son Preference and the Persistence of Culture: Evidence from South and East Asian Immigrants to Canada
Authors: Almond Douglas , Edlund Lena , Milligan Kevin
Published: March 2013

Preference for sons over daughters, evident in China's and South Asia's male sex ratios, is commonly rationalized by poverty and the need for old‐age support. In this article we study South and East Asian immigrants to Canada, a group for whom the economic imperative to select sons is largely absent. Analyzing the 2001 and 2006 censuses, 20 percent samples, we find clear evidence of extensive sex selection in favor of boys at higher parities among South and East Asian immigrants unless they are Christian or Muslim. The latter finding accords with the explicit prohibition against (female) infanticide—traditionally the main sex‐selection method—in these religions. Our findings point to a strong cultural component to both the preference for sons and the willingness to resort to induced abortion based on sex.
Demographic Origins of the Great Recession: Implications for China
Authors: Gomez Rafael , Lamb Danielle
Published: March 2013

The demographic dividend, that is, the growth of the working age population aged 16 years relative to younger and older age dependents, has often been cited as a crucial component of the accelerated economic growth experienced by disparate countries and regions at different points in time. Generally less emphasized are the ramifications of this process when it occurs in reverse; that is, when the relative size of the working age population begins to shrink. Related to this is the more subtle effect of changes to the age structure of the overall working age population, which can have compounding or offsetting effects in relation to the demographic dividend noted above. This paper explores how these age‐related phenomena were instrumental to both the Great Depression and the Great Recession of 2008. We explore how the generational composition of economic actors and the aging of the baby‐boom worker may have played a role in provoking these remarkable recessionary periods. The reversal of the demographic dividend and the aging of the working age population are factors now contributing to the propagation of the global economic downturn, as witnessed in the example of Japan over the past half‐century. This paper applies the lessons of the Great Depression to offer a forward‐looking analysis of the Chinese economy. China is on the precipice of a significant demographic shift whose implications for economic growth are explored.
A Comparative Study of the Performance of SrCo0.76Fe0.19Al0.1Ox and (SrCo0.8Fe0.2O3−δ)0.95(SrAl2O4)0.05 Mixed‐Conducting Membranes
Authors: Zhu Na , Zhang Guangru , Liu Zhengkun , Dong Xueliang , Jin Wanqin , Liu Shaomin
Published: March 2013

Dense oxygen permeable ceramic membranes are promising materials for separating oxygen from air and for syngas production. The crystal structure, oxygen vacancy, microstructure, thermal expansion behavior, electrical conductivity, and oxygen permeability of two mixed‐conducting ceramics: 5 mol% SrAl2O4‐doped SrCo0.8Fe0.2O3−δ (SCF‐SA) and SrCo0.76Fe0.19Al0.1Ox (SCFA), with the same overall cation composition, were systematically investigated in this work. The main phases of SCFA and SCF‐SA are cubic perovskite and no orthorhombic brownmillerite appears from 700°C to 900°C in air, while SCF‐SA presents minor unidentified phases. SCF‐SA shows lower electrical conductivity than SCFA. SCFA membranes exhibit lower oxygen permeation flux than SCF‐SA. At 850°C, the oxygen permeation fluxes of SCFA and SCF‐SA are 1.23 and 1.46 mL/cm2/min, respectively, under the oxygen partial pressure gradient of 0.21 × 105/1 × 102 Pa.
Synthesis, Characterization, and Microstructure of Hafnium Boride‐Based Composite Ceramics Via Preceramic Method
Authors: Cai Tao , Qiu Wen‐Feng , Liu Dan , Han Wei‐Jian , Ye Li , Zhao Ai‐Jun , Zhao Tong
Published: March 2013

The ceramic precursor for HfB2/HfC/SiC/C was prepared via solution‐based processing of polyhafnoxanesal, linear phenolic resin, boric acid and poly[(methylsilylene)acetylene)]. The obtained precursor could be cured at 250°C and subsequently heat treated at relative lower temperature (1500°C) to form HfB2/HfC/SiC/C ceramic powders. The ceramic powders were characterized by element analysis, thermal gravimetric analysis, X‐ray diffraction, Raman spectroscopy, and Scanning electron microscopy. The results indicated that the ceramic powders with particle size of 200~500 nm were consisted of pure phase HfB2, HfC, and SiC along with free carbon as fourth phase with low crystallinity.
Ensuring Supply Chain Resilience: Development and Implementation of an Assessment Tool
Authors: Pettit Timothy J. , Croxton Keely L. , Fiksel Joseph
Published: March 2013

In today's tightly connected global economy, traditional management practices that rely on “steady‐state” conditions are challenged by chaotic external pressures and turbulent change. Just in the last few years, the world has experienced a string of catastrophic events, including a global economic meltdown, a volcanic eruption in Iceland, an oil spill in the Gulf of Mexico, a disastrous tsunami and power blackout in Japan, and political upheavals in Africa and the Middle East. Managing the risk of an uncertain future is a challenge that requires resilience—the ability to survive, adapt, and grow in the face of turbulent change. This research develops a measurement tool titled the Supply Chain Resilience Assessment and Management (SCRAM™). Data gathered from seven global manufacturing and service firms are used to validate SCRAM™, using qualitative methodology with 1,369 empirical items from focus groups reviewing 14 recent disruptions. Critical linkages are uncovered between the inherent vulnerability factors and controllable capability factors. Through mixed‐method triangulation, this research identified 311 specific linkages that can be used to guide a resilience improvement process. Pilot testing suggests a correlation between increased resilience and improved supply chain performance.
Vitamins, stress and growth: the availability of antioxidants in early life influences the expression of cryptic genetic variation
Authors: Kim S.‐Y. , Noguera J. C. , Tato A. , Velando A.
Published: March 2013

Environmental inputs during early development can shape the expression of phenotypes, which has long‐lasting consequences in physiology and life history of an organism. Here, we study whether experimentally manipulated availability of dietary antioxidants, vitamins C and E, influences the expression of genetic variance for antioxidant defence, endocrine signal and body mass in yellow‐legged gull chicks using quantitative genetic models based on full siblings. Our experimental study in a natural population reveals that the expression of genetic variance in total antioxidant capacity in plasma increased in chicks supplemented with vitamins C and E despite the negligible effects on the average phenotype. This suggests that individuals differ in their ability to capture and transport dietary antioxidants or to respond to these extra resources, and importantly, this ability has a genetic basis. Corticosterone level in plasma and body mass were negatively correlated at the phenotypic level. Significant genetic variance of corticosterone level appeared only in control chicks nonsupplemented with vitamins, suggesting that the genetic variation of endocrine system, which transmits environmental cues to adaptively control chick development, appeared in stressful conditions (i.e. poor antioxidant availability). Therefore, environmental inputs may shape evolutionary trajectories of antioxidant capacity and endocrine system by affecting the expression of cryptic genetic variation.
The Business Cycle, Investor Sentiment, and Costly External Finance
Authors: MCLEAN R. DAVID , ZHAO MENGXIN
Published: March 2013

The recent financial crisis shows that financial markets can impact the real economy. We investigate whether access to finance typically time‐varies and, if so, what are the real effects. Consistent with time‐varying external finance costs, both investment and employment are less sensitive to Tobin's q and more sensitive to cash flow during recessions and low investor sentiment periods. Share issuance plays a bigger role than debt issuance in causing these effects. Alternative tests that do not rely on q and cash flow sensitivities suggest that recessions and low sentiment increase external finance costs, thereby limiting investment and employment.
Psychotherapy for adult attention deficit/hyperactivity disorder: a comparison with cognitive behaviour therapy
Authors: Chandler M. L.
Published: March 2013

Accessible summary

Attention deficit/hyperactivity disorder (ADHD) is a neurobiological disorder that persists into adulthood for more than half of those diagnosed.

Pharmacotherapy is the first line treatment, but alone may not be sufficient.

When comparing the effectiveness of researched psychotherapies, cognitive behaviour therapy (CBT) is one of the most efficacious treatments.

This literature synthesis offers some intervention guidance for nurses and other clinicians who care for patients with ADHD.

Attention deficit/hyperactivity disorder (ADHD), a disorder generally associated with children, has become a valid disorder for adults in the last decade. The first line treatment of adult ADHD is medications, but historically there have been limitations to medication as the only treatment. Psychotherapy has become a feasible modality in the treatment of ADHD for those who have residual symptoms. The aim of this review of literature is to compare cognitive behaviour therapy with other psychotherapeutic treatment for effectiveness in improving symptoms of ADHD in adults and adolescences. The evidence‐based practice approach by Stillwell et al. is adopted to guide the systematic review. The use of this small evidence utilization project that led to a synthesis of available research will provide direction for future research and expand knowledge in treatment for adult ADHD.
Leucine markedly regulates pancreatic exocrine secretion in goats
Authors: Yu Z. P. , Xu M. , Liu K. , Yao J. H. , Yu H. X. , Wang F.
Published: March 2013

Four goats (30.1 ± 1.3 kg) with common bile duct re‐entrant catheter and duodenal catheter were used to evaluate the effects of duodenal leucine infusion on pancreatic exocrine secretion and plasma parameters with two 4 × 4 Latin square design experiments. In the long‐term infusion experiment, goats were fed twice daily [700 g/day, dry matter (DM) basis] at 8:00 and 18:00 hours and were duodenally infused with 0, 3, 6, 9 g/day leucine for 14 days. Pancreatic juice and jugular blood samples were collected over 1‐h intervals for 6 h daily from d 11 to 14 days to encompass a 24‐h day. In the short‐term experiment, goats were infused leucine for 10 h continuously at the same infusion rate with Experiment 1 after feed deprivation for 24 h repeated every 10 days. Pancreatic juice and blood samples were collected at 0, 1, 2, 4, 6, 8 and 10 h of infusion. The results showed that the long‐term leucine infusion did not affect pancreatic juice secretion, protein output, trypsin and lipase secretion and plasma insulin concentration, but linearly increased α‐amylase secretion. No changes in pancreatic protein and lipase secretion were observed in the short‐term infusion. Pancreatic juice and α‐amylase secretion responded quadratically, with the greatest values observed in the 3 and 6 g/day leucine respectively. Trypsin secretion linearly decreased, while plasma insulin concentration increased linearly with increased leucine infusion. The results demonstrated that duodenal leucine infusion dose and time dependently regulated pancreatic enzyme secretion not associated with the change in plasma insulin concentration.
Acute exposure to evening blue‐enriched light impacts on human sleep
Authors: Chellappa Sarah L. , Steiner Roland , Oelhafen Peter , Lang Dieter , Götz Thomas , Krebs Julia , Cajochen Christian
Published: March 2013

Light in the short wavelength range (blue light: 446–483 nm) elicits direct effects on human melatonin secretion, alertness and cognitive performance via non‐image‐forming photoreceptors. However, the impact of blue‐enriched polychromatic light on human sleep architecture and sleep electroencephalographic activity remains fairly unknown. In this study we investigated sleep structure and sleep electroencephalographic characteristics of 30 healthy young participants (16 men, 14 women; age range 20–31 years) following 2 h of evening light exposure to polychromatic light at 6500 K, 2500 K and 3000 K. Sleep structure across the first three non‐rapid eye movement non‐rapid eye movement – rapid eye movement sleep cycles did not differ significantly with respect to the light conditions. All‐night non‐rapid eye movement sleep electroencephalographic power density indicated that exposure to light at 6500 K resulted in a tendency for less frontal non‐rapid eye movement electroencephalographic power density, compared to light at 2500 K and 3000 K. The dynamics of non‐rapid eye movement electroencephalographic slow wave activity (2.0–4.0 Hz), a functional index of homeostatic sleep pressure, were such that slow wave activity was reduced significantly during the first sleep cycle after light at 6500 K compared to light at 2500 K and 3000 K, particularly in the frontal derivation. Our data suggest that exposure to blue‐enriched polychromatic light at relatively low room light levels impacts upon homeostatic sleep regulation, as indexed by reduction in frontal slow wave activity during the first non‐rapid eye movement episode.
Interpretation of Odds and Risk Ratios
Authors: O'Connor A.M.
Published: March 2013

Background

Odds ratio and risk ratio are measures of association used to describe the efficacy of interventions and disease determinates; however, they are not interchangeable measures of association.

Objectives

To illustrate that interpretation of the odds ratio as a risk‐based measure of efficacy can be misleading.

Animals

None.

Methods

A meta‐analysis reported, the odds ratio and the risk ratio as measures of vaccine effect. Example data were obtained from a meta‐analysis of the risk of infection with Tritrichomonas fetus (T. fetus), in trials that assessed whole‐cell killed T. fetus vaccination in beef heifers.

Results

When risk was used as the measure of disease frequency, the summary risk ratio was 0.82 (95% CI = 0.7–1.01), a 18% decrease in risk of infection. When odds were used as the measure of disease frequency and the summary odds ratio was 0.41 (95% CI = 0.2–0.84), a 59% decrease in odds of infection.

Conclusions and Clinical Importance

Problems arise for clinicians or authors when they interpret the odds ratio as a risk ratio. In the example provided, the efficacy of protective interventions was overestimated. In the case of disease determinates that increase the occurrence of disease, the interpretation of the odds ratio as a risk ratio would also lead to overestimation of the effect. It is important not to use the terms risk or probability of disease when the odds are the measure of disease frequency.
Pneumocystis jirovecii colonization among renal transplant recipients
Authors: Fritzsche Carlos , Riebold Diana , Fuehrer Andreas , Mitzner Andrea , Klammt Sebastian , Mueller‐Hilke Brigitte , Reisinger Emil C
Published: March 2013

Aim

Renal transplant recipients are at risk of developing Pneumocystis pneumonia (PcP), especially in the first 2 years after transplantation, with a mortality rate of up to 50%. No data are available on pulmonary colonization with Pneumocystis jirovecii in renal transplant recipients. The aim of this study was to determine the prevalence of pulmonary colonization with Pneumocystis jirovecii in renal transplant recipients and to find related risk factors.

Methods

We investigated the induced sputa of 70 renal transplant recipients for the presence of Pneumocystis jirovecii using nested polymerase chain reaction.

Results

Thirteen of 70 patients (18.6%) were colonized with Pneumocystis jirovecii. There was no significant correlation between colonization and immunosuppressive medication or regimens. However, colonized subjects had undergone transplantation longer ago than non‐colonized subjects. 30.8% of those whose transplantation had taken place more than 8 years previously were colonized, in contrast to 11.4% of those whose transplantation had taken place less than 8 years ago (P = 0.059; odds ratio = 3.467, 95% confidence interval = 0.99–12.09).

Conclusion

Most cases of Pneumocystis colonization were detected in those patients where renal transplantion had taken place more than 2 years previously. As most PcP cases occur within the first 2 years of transplantation, colonization does not seem to play a role in the development of acute PcP in this period. Though Pneumocystis pneumonia is likely to be a newly acquired infection in the first 2 years after transplantation, colonized patients remain a potential source of transmission of Pneumocystis jirovecii.
Motivational journey of Iranian bachelor of nursing students during clinical education: a grounded theory study
Authors: Hanifi Nasrin , Parvizy Soroor , Joolaee Soodabeh
Published: March 2013

This study explored how nursing students can be kept motivated throughout their clinical education. Motivation is a key issue in nursing clinical education for student retention. The study was conducted using grounded theory methods, which are appropriate when studying process in a social context. Sixteen students and four instructors, who were purposefully selected, participated in semistructured interviews. Data were analyzed using the constant comparative method. Students' motivational journey occurred in three steps: (i) social condition; (ii) encountering the clinical education challenges; and (iii) looking for an escape from nursing, or simply tolerating nursing. Struggling with professional identity emerged as the core variable. Iran's social context and many other conditions in the clinical education setting affect students' motivation. Identifying motivational process might assist educational authorities in offering solutions to promote motivation among students.
Influence of nitric oxide synthase inhibition on the motility and sensitivity of distal colon in man
Authors: Corsetti M. , Vos R. , Gevers A. , Demedts I. , Janssens J. , Tack J.
Published: March 2013

Background

Alterations of nitrergic innervation have been implicated in the pathophysiology of motor‐sensory abnormalities of post infectious functional dyspepsia and could be involved in the pathophysiology of post infectious irritable bowel syndrome. The role of nitrergic neurons in the control of distal colonic sensorimotor function in man is not known. The aim of this study is to evaluate the motility and sensitivity of distal colon in healthy subjects before and after a nitric oxide synthase inhibitor (l‐NMMA).

Methods

A 700‐mL balloon connected with a barostat‐manometry assembly was placed in the descending colon of 10 healthy subjects and distension (4 mmHg/2 min) was performed. Intra‐balloon pressure was then set at minimal distending pressure + 2 mmHg for 30 min, placebo or l‐NMMA (8 mg kg−1 h−1) was administered i.v. in double‐blind, randomized, cross‐over design and distensions were repeated.

Key Results

Placebo and l‐NMMA did not influence colonic compliance, motility index, and tone. Placebo did not affect thresholds for first perception and discomfort and the areas under the pressure‐perception curve. l‐NMMA did not alter thresholds for first perception, but significantly decreased the pressure thresholds for discomfort (P = 0.008) and increased the areas under the pressure‐perception score (P = 0.01).

Conclusions & Inferences

In man, inhibition of nitric oxide synthase sensitizes the distal colon to distension. Impaired nitrergic innervation is a mechanism that may be involved in the pathogenesis of hypersensitivity to colonic distension.
Pseudoatrial Fibrillation during Pacemaker Interrogation: What is the Mechanism?
Authors: ALCALDE ÓSCAR , VILLUENDAS ROGER , PEREFERRER DAMIÀ , SARRIAS AXEL , BAYES‐GENIS ANTONI
Published: March 2013

Background

Normal pacemaker response to magnet and programmer is almost universal and helps to interpret basal rhythm.

Methods and results

In this report, we report an undescribed atypical magnet response due to an internal cross‐talk with atrial oversensing during a specific part of interrogation, simulating atrial fibrillation.
Spatial Spline Regression Models
Authors: Sangalli Laura M. , Ramsay James O. , Ramsay Timothy O.
Published: March 2013

We describe a model for the analysis of data distributed over irregularly shaped spatial domains with complex boundaries, strong concavities and interior holes. Adopting an approach that is typical of functional data analysis, we propose a spatial spline regression model that is computationally efficient, allows for spatially distributed covariate information and can impose various conditions over the boundaries of the domain. Accurate surface estimation is achieved by the use of piecewise linear and quadratic finite elements.