bluuebunny/crossref_metadata_2025 huggingface dataset:
Practice nurses and cervical screening: A two‐country review
Authors: Holmes Colin , Mills Jane , Chamberlain‐Salaun Jennifer
Published: June 2013

The aim of this review is to explore the literature relating to the delivery of cervical screening by practice nurses (PNs) in the United Kingdom and Australia. Research relating to PNs began in earnest approximately 15 years ago in the UK context, and more recently, c.2005, in Australia. Although there is scant literature devoted specifically to the role of PNs in cervical screening, literature relating to the role of PNs provides evidence of the extent to which PNs in the United Kingdom and Australia are involved in the provision of cervical screening services. Findings from this review indicate that the role of PNs in the provision of cervical screening differs substantially between the United Kingdom and Australia. PNs in the United Kingdom provide a high percentage of cervical screening services, whereas in Australia general practitioners provide around 80% of all cervical smears, which account for only 0.6% of all procedures undertaken by PNs. Employment and funding models and inadequate multidisciplinary collaboration are contributing to the underutilization of PNs in Australia.
Report of the first Asia‐Pacific influenza summit, Asia‐Pacific Alliance for the Control of Influenza (APACI), Bangkok, 12–13 June 2012
Authors: Jennings Lance C. , Smith David W. , Chan Paul K. S.
Published: June 2013

On June 12‐13, 2012, the Asia‐Pacific Alliance for the Control of Influenza (APACI) convened jointly with the Influenza Foundation of Thailand and the Thailand Department of Disease Control, the First Asia‐Pacific Influenza Summit. The objectives of the meeting were to review the current state of official influenza control policies in Asia‐Pacific countries; identify, summarize and communicate influenza control strategies that have successfully increased vaccine uptake in the region; develop policy and advocacy approaches to improve influenza vaccine uptake in high‐risk groups and healthcare workers in the region; and establish collaborative relationships to promote best practices for the control of influenza. In moving forward, the challenge for the region will be establishing collaborations able to effectively communicate risk and key messages about influenza vaccination.
Digitally enabling social networks: resolving IT–culture conflict
Authors: Koch Hope , Leidner Dorothy E. , Gonzalez Ester S.
Published: June 2013

Digitally enabled social networks, encompassing social media applications such as wikis, blogs and social networking sites, have the potential to dramatically change organizational culture by building communities, promoting information sharing and fostering collaboration. Although organizational social media site (hereinafter SMS) implementations are proliferating, these technologies often do not harmoniously combine with traditional organizational cultures. To shed light on social media's impact on organizational life, this paper draws on an interpretive case study to investigate a global security company's efforts to implement a digitally enabled social network as part of a cultural change effort. Conceptually, based on the theory of IT–culture conflict, this paper underscores the interplay between organizational culture and technology. Our study finds that conflicts can arise between employees' workplace values and the values they ascribe to social media. This can result in an IT–culture system conflict, which organizations can address using policy‐based, socialization‐based and leadership‐based mechanisms aimed at bringing cultural values and social media site values into alignment.
Thermoluminescence and Temperature‐Dependent Afterglow Properties in BaSi2O2N2:Eu2+
Authors: Qin Jinlan , Zhang Haoran , Lei Bingfu , Hu Chaofan , Li Jinfang , Liu Yingliang , Meng Jianxin , Wang Jing , Zheng Mingtao , Xiao Yong
Published: June 2013

BaSi2O2N2:Eu2+ phosphor was successfully synthesized by using a simple solid‐state reaction method. Its properties were systematically investigated utilizing XRD, photoluminescence, excited state decay curve, afterglow emission spectra, and thermoluminescence (TL) glow curve. With increasing temperature, its emission intensity decreases with the broadening full widths at half maximum. Particularly, its temperature‐dependent afterglow emission spectra were investigated for the first time. Based on the information from TL glow curve, temperature‐dependent afterglow decay curves, and afterglow emission spectra, a model was constructed to explain the mechanism of afterglow. This study provides a new perspective to use the temperature‐dependent luminescence properties for studying the afterglow processes of long‐lasting phosphorescence phosphors.
Curve Number Derivation for Watersheds Draining Two Headwater Streams in Lower Coastal Plain South Carolina, USA
Authors: Epps Thomas H. , Hitchcock Daniel R. , Jayakaran Anand D. , Loflin Drake R. , Williams Thomas M. , Amatya Devendra M.
Published: June 2013

The objective of this study was to assess curve number (CN) values derived for two forested headwater catchments in the Lower Coastal Plain (LCP) of South Carolina using a three‐year period of storm event rainfall and runoff data in comparison with results obtained from CN method calculations. Derived CNs from rainfall/runoff pairs ranged from 46 to 90 for the Upper Debidue Creek (UDC) watershed and from 42 to 89 for the Watershed 80 (WS80). However, runoff generation from storm events was strongly related to water table elevation, where seasonally variable evapotranspirative wet and dry moisture conditions persist. Seasonal water table fluctuation is independent of, but can be compounded by, wet conditions that occur as a result of prior storm events, further complicating flow prediction. Runoff predictions for LCP first‐order watersheds do not compare closely to measured flow under the average moisture condition normally associated with the CN method. In this study, however, results show improvement in flow predictions using CNs adjusted for antecedent runoff conditions and based on water table position. These results indicate that adaptations of CN model parameters are required for reliable flow predictions for these LCP catchments with shallow water tables. Low gradient topography and shallow water table characteristics of LCP watersheds allow for unique hydrologic conditions that must be assessed and managed differently than higher gradient watersheds.
Reliability of direct and indirect clinical attachment level measurements
Authors: Corraini Priscila , Baelum Vibeke , Lopez Rodrigo
Published: June 2013

Aims

To investigate the influence of subject‐, tooth‐ and site‐level characteristics on intra‐examiner reproducibility of direct and indirect clinical attachment level (CALDIR and CALIND) recordings, and to quantify the impact of less‐than‐perfect reliability on our ability to assess periodontitis progression.

Materials and Methods

Within a 1‐week interval, a single examiner performed duplicate probing depth (PD), CALDIR and gingival recession (GR) recordings in six sites of all teeth present in 148 periodontitis patients. CALIND was calculated on the basis of the PD and GR.

Results

Agreement was observed in 65%, 62%, 69% and 84% of the duplicate CALDIR, CALIND, PD and GR recordings, respectively, and >95% of the differences were within ±1 mm. This study identified multiple predictors for CAL measurement errors ≥1 mm, including tooth and site location, presence of supra‐ and subgingival calculus, bleeding on probing and suppuration. Measurement errors were more likely in patients diagnosed with “extensive” rather than “less extensive” periodontitis. In over half of the patients, measurement error frequencies were too high to allow for detection of possible CAL changes ≥2 mm with a false‐positive rate ≤5%. Detection of CAL changes with low false‐positives was more likely using recordings obtained by the direct method.

Conclusions

From a measurement error point of view, CALDIR recordings are preferable over CALIND.
Candidate gene associations with withdrawn behavior
Authors: Rubin David H. , Althoff Robert R. , Ehli Erik A. , Davies Gareth E. , Rettew David C. , Crehan Eileen T. , Walkup John T. , Hudziak James J.
Published: June 2013

Background

Social withdrawal is a core neuropsychiatric phenomenon in developmental psychopathology. Its presence predicts psychopathology across many domains, including depression, psychosis, autism, anxiety, and suicide. Withdrawn behavior is highly heritable, persistent, and characteristically worsens without intervention. To date, few studies have successfully identified genetic associations with withdrawn behavior, despite the abundance of evidence of its heritability. This may be due to reliance of categorical over dimensional measures of the behaviorally inhibited phenotype. The aim of this study is to identify associations between known psychiatric candidate genes and a dimensionally derived measure of withdrawn behavior.

Methods

Genetic information was collected on 20 single‐nucleotide polymorphisms (SNPs) from a custom‐designed SNP chip and TAQMAN arrays of 4 variable number of tandem repeat (VNTR) genes for 551 individuals from 187 families. Linear mixed modeling was employed to examine the relationship between genotypes of interest and Child Behavior Checklist (CBCL) Withdrawn Behavior Subscale Score (WBS) while controlling for gender and age through multiple linear regressions.

Results

Withdrawn behavior was highly associated with polymorphism rs6314 of the serotonin receptor 2A (HTR2A) [p = .009, estimate = 0.310 (bootstrap 95% CI 0.155–0.448), bootstrap p = .001] and rs1800544 of the alpha 2‐adrenergic (ADRA2A) [p = .001, estimate = −0.310 (bootstrap 95% CI −0.479 to −0.126), bootstrap p = .001] genes after correction for gender and age. The association between withdrawn behavior and ADRA2A was stronger for younger children.

Conclusions

HTR2A and ADRA2A genes are associated with withdrawn behavior. This reinforces the role of catecholaminergic genes in the heritability of withdrawn behavior.
Impaired nerve fiber regeneration in axotomized peripheral nerves in streptozotocin‐diabetic rats
Authors: Nishida Naoki , Yamagishi Shin‐Ichiro , Mizukami Hiroki , Yagihashi Soroku
Published: June 2013

Aim/Introduction

Impaired nerve fiber regeneration is a salient feature of diabetic neuropathy. Its pathogenesis is still unclear. We attempted to characterize the structure of regenerated myelinated fibers after transection in streptozotocin‐diabetic rats.

Materials and Methods

Streptozotocin‐diabetic rats underwent transection of the sciatic nerve. Two and 4 weeks post‐axotomy, regenerated myelinated fibers of the cut end and fibers at its proximal site were morphometrically examined. Non‐diabetic control rats with axotomy were also examined for comparison.

Results

At 4 weeks post‐axotomy, diabetic rats showed an increased myelinated fiber density and total fiber number with a trend toward reduced fiber size at the cut end compared with those in control rats. The average number of myelin lamellae relative to axonal size in regenerated fibers at the cut end was significantly reduced in diabetic rats compared with that in control rats. The proximal site showed a reduced size of fibers and axons in both diabetic and control rats to a similar extent compared with those in a non‐axotomized state. At 2 weeks post‐axotomy, these findings were less apparent.

Conclusions

The nerves of diabetic rats when axotomized undergo impaired regeneration characterized by increased fiber density with hypomyelination.
Entropy and compression: two measures of complexity
Authors: Henriques Teresa , Gonçalves Hernâni , Antunes Luís , Matias Mara , Bernardes João , Costa‐Santos Cristina
Published: June 2013

Rationale, aims and objectives

Traditional complexity measures are used to capture the amount of structured information present in a certain phenomenon. Several approaches developed to facilitate the characterization of complexity have been described in the related literature. Fetal heart rate (FHR) monitoring has been used and improved during the last decades. The importance of these studies lies on an attempt to predict the fetus outcome, but complexity measures are not yet established in clinical practice. In this study, we have focused on two conceptually different measures: Shannon entropy, a probabilistic approach, and Kolmogorov complexity, an algorithmic approach. The main aim of the current investigation was to show that approximation to Kolmogorov complexity through different compressors, although applied to a lesser extent, may be as useful as Shannon entropy calculated by approximation through different entropies, which has been successfully applied to different scientific areas.

Methods

To illustrate the applicability of both approaches, two entropy measures, approximate and sample entropy, and two compressors, paq8l and bzip2, were considered. These indices were applied to FHR tracings pertaining to a dataset composed of 48 delivered fetuses with umbilical artery blood (UAB) pH in the normal range (pH ≥ 7.20), 10 delivered mildly acidemic fetuses and 10 moderate‐to‐severe acidemic fetuses. The complexity indices were computed on the initial and final segments of the last hour of labour, considering 5‐ and 10‐minute segments.

Results

In our sample set, both entropies and compressors were successfully utilized to distinguish fetuses at risk of hypoxia from healthy ones. Fetuses with lower UAB pH presented significantly lower entropy and compression indices, more markedly in the final segments.

Conclusions

The combination of these conceptually different measures appeared to present an improved approach in the characterization of different pathophysiological states, reinforcing the theory that entropies and compressors measure different complexity features. In view of these findings, we recommend a combination of the two approaches.
Clinical outcome of sorafenib treatment in patients with advanced hepatocellular carcinoma refractory to hepatic arterial infusion chemotherapy
Authors: Miyaki Daisuke , Aikata Hiroshi , Kan Hiromi , Fujino Hatsue , Urabe Ayako , Masaki Keiichi , Fukuhara Takayuki , Kobayashi Tomoki , Naeshiro Noriaki , Nakahara Takashi , Kawaoka Tomokazu , Hiramatsu Akira , Takahashi Shoichi , Ishikawa Masaki , Kakizawa Hideaki , Awai Kazuo , Chayama Kazuaki
Published: June 2013

Background and Aim

It has been reported about poor prognosis in patients with advanced hepatocellular carcinoma (HCC) refractory to hepatic arterial infusion chemotherapy (HAIC). We assessed the survival benefits of sorafenib therapy for advanced HCC in HAIC refractory patients.

Methods

The study subjects were 191 patients with advanced HCC who had been treated with HAIC. Sorafenib was used in 27 patients who finally failed to respond to HAIC (HAIC/sorafenib group). Clinical outcome was compared between HAIC/sorafenib and HAIC alone groups.

Results

There were no significant differences in clinical characteristics and response rate of HAIC between the two groups (response rate: 25.9%, HAIC/sorafenib group; 30.4%, HAIC alone group). The median survival time (MST) for all patients was 11.0 months. The survival rate was significantly higher in the HAIC/sorafenib group than HAIC alone group (MST 22.2 vs 8.7 months, P = 0.017). From administration sorafenib, the disease control rate was 51.8% with MST of 10.4 months. Among HAIC non‐responders, the survival rate was significantly higher in the HAIC/sorafenib group than HAIC alone group. Multivariate analysis identified additional therapy with sorafenib as significant and independent determinant of overall survival in all patients and HAIC non‐responders.

Conclusion

Additional therapy with sorafenib could probably improve the prognosis of HAIC refractory patients.
Chronic hepatitis C infection is associated with insulin resistance and lipid profiles
Authors: Dai Chia‐Yen , Yeh Ming‐Lun , Huang Chung‐Feng , Hou Chen‐Hsiu , Hsieh Ming‐Yen , Huang Jee‐Fu , Lin I‐Ling , Lin Zu‐Yau , Chen Shinn‐Chern , Wang Liang‐Yen , Chuang Wan‐Long , Yu Ming‐Lung , Tung Hung‐Da
Published: June 2013

Background and Aim

Chronic hepatitis C virus (HCV) infection has been suggested to be associated with non‐insulin‐dependent diabetes mellitus and lipid profiles. This study aimed to investigate the possible relationships of insulin resistance (IR) and lipid profiles with chronic hepatitis C (CHC) patients in Taiwan.

Methods

We enrolled 160 hospital‐based CHC patients with liver biopsy and the 480 controlled individuals without CHC and chronic hepatitis B from communities without known history of non‐insulin‐dependent diabetes mellitus. Fasting plasma glucose, total cholesterol, high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol (LDL‐C), triglycerides (TGs), alanine aminotransferase, and serum insulin levels, and homeostasis model assessment (HOMA‐IR) were tested.

Results

When comparing factors between CHC patients, and sex‐ and age‐matched controls who had no HCV infection, patients with HCV infection had a significantly higher alanine aminotransferase level, fasting plasma glucose level, insulin level, and HOMA‐IR (P < 0.001, P = 0.023, P = 0.017, and P = 0.011, respectively), and significantly lower TG level (P = 0.023), total cholesterol, and HDL‐C and LDL‐C levels (all P < 0.001) than 480 controls. In multivariate logistic regression analyses, a low total cholesterol, a low TGs, and a high HOMA‐IR are independent factors significantly associated with chronic HCV infection. In the 160 CHC patients (41 patients with high HOMA‐IR [> 2.5]), a high body mass index, TGs, and HCV RNA level are independent factors significantly associated with high HOMA‐IR in multivariate logistic analyses.

Conclusions

Chronic HCV infection was associated with metabolic characteristics including IR and lipid profile. IR was also associated with virological characteristics.
Effects of splenectomy on hepatic gene expression profiles after massive hepatectomy in rats
Authors: Arakawa Yusuke , Shimada Mitsuo , Utsunomya Tohru , Imura Satoru , Morine Yuji , Ikemoto Testuya , Takasu Chie
Published: June 2013

Background and Aim

Possible spleno‐hepatic relationships affected by hepatectomy still remained unclear. We have previously reported that splenectomy may ameliorate liver injuries and promote appropriate liver regeneration after massive hepatectomy. Therefore, we investigated the effects of splenectomy on the DNA expression profile in the liver after massive hepatectomy in rats.

Methods

Rats were divided into the following two groups: 90% hepatectomy (Hx group) and 90% hepatectomy with splenectomy (Hx + Sp group). Rats were sacrificed 3 and 6 h after surgery, and mRNA from liver tissue was isolated and hybridized to Affymetrix GeneChip Rat Genome 230 2.0 Array (Affymetrix, Santa Clara, CA, USA) and a pathway analysis was done with Ingenuity Pathway Analysis (Ingenuity Systems, Mountain View, CA, USA).

Results

We determined the Hx + Sp/Hx ratio to assess the influence of splenectomy, and cut‐off values were set at more than 2.0‐fold or less than 1/2 (0.5)‐fold. Immediate early response gene including early growth response‐1 and FBJ murine osteosarcoma‐related pathways were markedly downregulated by splenectomy. In contrast, heme oxygenase‐1 gene‐related pathway was upregulated by splenectomy.

Conclusions

Splenectomy provided the protective effects for liver failure and promoted liver regeneration, possibly owing to the downregulation of immediate early response genes and upregulation of the heat shock protein, heme oxygenase‐1.
Caffeine attenuates liver fibrosis via defective adhesion of hepatic stellate cells in cirrhotic model
Authors: Shim Sung Gon , Jun Dae Won , Kim Eun Kyung , Saeed Waqar Khalid , Lee Kang Nyeong , Lee Hang Lak , Lee Oh Young , Choi Ho Soon , Yoon Byung Chul
Published: June 2013

Background and Aim

Several epidemiological studies have shown that coffee intake attenuates the progression of liver fibrosis; however, the mechanism is unclear.

Aims

We investigated the direct effects of caffeine on hepatic stellate cells (HSCs) and assessed whether caffeine attenuated intrahepatic fibrosis in rat model of liver cirrhosis.

Methods

Human hepatic stellate cell line, an immortalized human HSCs line, was used in in vitro assay system. Cell migration and proliferation were assessed in presence of various caffeine concentrations (0, 1, 5, and 10 mmol), and levels of procollagen type Ic and α‐smooth muscle actin (α‐SMA) were measured by Western blot. Severity of liver inflammation and fibrosis were compared between thioacetamide‐treated rats with and without caffeine supplementation.

Results

Caffeine increased HSCs apoptosis and intracellular F‐actin and cyclic adenosine monophosphate expression. Caffeine also inhibited procollagen type Ic and α‐SMA expression in a dose‐ and time‐dependent manner. In rat model, caffeine decreased periportal inflammation, levels of inflammatory cells (1.4 ± 0.52 vs 2.6 ± 0.46, P < 0.05), and fibrosis (2.1 ± 0.35 vs 2.9 ± 0.84, P < 0.05). Transforming growth factor‐β and α‐SMA expressions were also reduced by caffeine.

Conclusion

Caffeine attenuates the progression of liver fibrosis by inhibiting HSCs adhesion and activation.
Clinical outcomes of endoscopic submucosal dissection for early gastric cancer in patients with chronic kidney disease
Authors: Numata Norifumi , Oka Shiro , Tanaka Shinji , Higashiyama Makoto , Sanomura Yoji , Yoshida Shigeto , Arihiro Koji , Chayama Kazuaki
Published: June 2013

Background and Aim

Endoscopic submucosal dissection (ESD) is a widely accepted treatment for early gastric cancer (EGC), and the number of ESD performed for EGC in patients with chronic kidney disease (CKD) is increasing. Although patients undergoing hemodialysis tend to bleed and are at high risk for cardiovascular disease, the effectiveness and safety of ESD for EGC in patients with CKD in particular have not been established. The aim of this study was to evaluate the effectiveness and potential adverse effects of ESD for EGC in patients with CKD undergoing hemodialysis.

Methods

Sixty‐three consecutive CKD patients in whom 79 EGCs were treated by ESD between October 2004 and January 2012; 15 of the 63 patients were hemodialysis patients. Complete en bloc resection rate and ESD‐related complications in hemodialysis patients versus non‐hemodialysis patients were evaluated.

Results

The complete en bloc resection rate was 100% (15/15) in the hemodialysis patients and 87.5% (56/64) in the non‐hemodialysis patients, respectively. The post‐ESD bleeding rate was 33% (5/15) and 9% (6/64), respectively (P < 0.05). Perforation occurred only in non‐hemodialysis patients; the incidence was 5% (3/64). Two ESD‐related deaths occurred among hemodialysis patients (13%, 2/15); femoral artery infarction triggered post‐ESD bleeding in one of these two patients, and alveolar hemorrhage occurred in the other.

Conclusion

Hemodialysis poses a risk of post‐ESD bleeding. We must understand this risk and provide countermeasures for post‐ESD bleeding in hemodialysis patients.
Assessing communication skills in dietetic consultations: the development of the reliable and valid DIET‐COMMS tool
Authors: Whitehead K. A. , Langley‐Evans S. C. , Tischler V. A. , Swift J. A.
Published: June 2013

Background

There is an increasing emphasis on the development of communication skills for dietitians but few evidence‐based assessment tools available. The present study aimed to develop a dietetic‐specific, short, reliable and valid assessment tool for measuring communication skills in patient consultations: DIET‐COMMS.

Methods

A literature review and feedback from 15 qualified dietitians were used to establish face and content validity during the development of DIET‐COMMS. In total, 113 dietetic students and qualified dietitians were video‐recorded undertaking mock consultations, assessed using DIET‐COMMS by the lead author, and used to establish intra‐rater reliability, as well as construct and predictive validity. Twenty recorded consultations were reassessed by nine qualified dietitians to assess inter‐rater reliability: eight of these assessors were interviewed to determine user evaluation.

Results

Significant improvements in DIET‐COMMS scores were achieved as students and qualified staff progressed through their training and gained experience, demonstrating construct validity, and also by qualified staff attending a training course, indicating predictive validity (P < 0.05). An acceptable level of intra‐rater reliability (rs = 0.90) and a moderate level of inter‐rater reliability (r = 0.49) were demonstrated. Interviews identified many positive features and possible uses for DIET‐COMMS in both pre‐ and post‐registration settings. The need for assessor training was emphasised and how readily qualified dietitians would accept assessment of skills in practice was questioned.

Discussion

DIET‐COMMS is a short, user‐friendly, reliable and valid tool for measuring communication skills in patient consultations with both pre‐ and post‐registration dietitians. Additional work is required to develop a training package for assessors and to identify how DIET‐COMMS assessment can acceptably be incorporated into practice.
Endometrial polyps associated with endometrial hyperplasia in an obese bonnet monkey (Macaca radiata): a case report
Authors: Chaudhari U.K. , Metkari S.M. , Sachdeva G. , Katkam R.R. , Nimbkar‐Joshi S. , Manjaramkar D.D. , Mahajan A. , Thakur M.H. , Kholkute S.D.
Published: June 2013

Background

A 10‐year‐old, female bonnet monkey (Macaca radiata) showed abnormal menstrual cycle length with heavy menstrual bleeding for 6–8 days.

Methods

Uterine ultrasound and histological examinations of endometrium by endometrial biopsy.

Results

An ultrasound examination of the uterine cavity showed presence of an enlarged polypoid mass. Further endometrial histology confirmed the presence of simple endometrial hyperplasia.

Conclusions

We report for the first time that endometrial polyp is associated with endometrial hyperplasia in obese bonnet monkey.
Assessment of relationship between self‐care and fatigue and loneliness in haemodialysis patients
Authors: Akin Semiha , Mendi Basak , Ozturk Bihter , Cinper Cigdem , Durna Zehra
Published: June 2013

Aims and objectives

To assess the level of fatigue, self‐care abilities and level of loneliness in Turkish haemodialysis patients and to determine the relationship between the level of fatigue, self‐care and loneliness.

Background

Dialysis patients experience difficulties such as deterioration in physical performance and self‐care abilities, fatigue and social isolation due to the disease and the treatment.

Design

This is a descriptive study and was conducted at two dialysis treatment centres.

Methods

The sample included 325 haemodialysis patients. Patients were selected via convenience sampling. Criteria for inclusion of patients undergoing haemodialysis treatment were those who volunteered to take part in the study, who were literate and who were over 18 years of age. Data were gathered using Patient Information Form, Visual Analog Fatigue Scale, UCLA Loneliness Scale and Self‐Care Ability Scale.

Results

Haemodialysis patients reported high level of fatigue, low level of self‐care and moderate level of loneliness. The correlation values indicated that as the levels of loneliness and fatigue increased, the self‐care abilities decreased. The self‐care abilities of the female patients were worse. Patients over the age of 60 years, those with low education level or patients on a low income and those with other chronic diseases had higher levels of loneliness and fatigue, and lower level of self‐care.

Conclusions

In this study, the level of fatigue of haemodialysis patients was high, their self‐care ability was very low and their level of perceived loneliness was moderate. Furthermore, fatigue negatively affects patients' self‐care; the higher the patients' level of fatigue was, the lower their level of self‐care.

Relevance to clinical practice

In order for haemodialysis patients to manage their fatigue successfully, to improve their self‐care abilities and to decrease their levels of loneliness and social isolation, nurses should provide physical, social and emotional support.
Older people's views of quality of care: a randomised controlled study of continuum of care
Authors: Berglund Helene , Wilhelmson Katarina , Blomberg Staffan , Dunér Anna , Kjellgren Karin , Hasson Henna
Published: June 2013

Aims and objectives

To analyse frail older people's views of quality of care when receiving a comprehensive continuum of care intervention, compared with those of people receiving the usual care (control group). The intervention included early geriatric assessment, case management, interprofessional collaboration, support for relatives and organising of care‐planning meetings in older people's own homes.

Background

Prior studies indicate that tailored/individualised care planning conducted by a case manager/coordinator often led to greater satisfaction with care planning among older people. However, there is no obvious evidence of any effects of continuum of care interventions on older people's views of quality of care.

Design

Randomised controlled study.

Methods

Items based on a validated questionnaire were used in face‐to‐face interviews to assess older people's views of quality of care at three, six and 12 months after baseline.

Results

Older people receiving a comprehensive continuum of care intervention perceived higher quality of care on items about care planning (p ≤ 0·005), compared with those receiving the usual care. In addition, they had increased knowledge of whom to contact about care/service, after three and 12 months (p < 0·03).

Conclusions

The study gives evidence of the advantages of a combination of components such as organising care‐planning meetings in older people's own homes, case management and interprofessional teamwork.

Relevance to clinical practice

The results have implications for policymakers, managers and professionals in the area of health and social care for older people to meet individual needs of frail older people.
When is the State's Gaze Focused? British Royal Commissions and the Bureaucratization of Conflict
Authors: Keller Matthew R.
Published: June 2013

Scholars have long documented changes in knowledge regimes and power relations characteristic of state‐centric drives to pacify conflicts and govern populations. But the mechanisms through which social conflicts are “made legible” in routine policy processes – as well as the reasons why some ongoing conflicts are pacified and others are persistent – have remained less clear. I explore these issues through an analysis of the shifting analytic terrain of national‐level commissions of inquiry, an historically powerful form of government organization designed to combine publicly‐engaged and “objective” explanation with recommendations for concrete policies of governance. Drawing principally on 19th and early 20th Century British Royal Commissions, I show how investigations into three fields of social conflict – involving prisoners, the working class, and colonial populations – were characterized by cyclical drives to bureaucratize conflict. Yet strikingly, only two of the three substantive fields – prisons and labor – achieved relative bureaucratic closure. Evidence from commission reports is marshaled to explain why some types of conflict have been resistant to incorporation, while others are more readily absorbed into an apparatus of governance.
Expression of Concern: HMGB1 mediates splenomegaly and expansion of splenic CD11b+ Ly‐6Chigh inflammatory monocytes in murine sepsis survivors
Authors: Valdés‐Ferrer S. I. , Rosas‐Ballina M. , Olofsson P. S. , Lu B. , Dancho M. E. , Ochani M. , Li J. H. , Scheinerman J. A. , Katz D. A. , Levine Y. A. , Hudson L. K. , Yang H. , Pavlov V. A. , Roth J. , Blanc L. , Antoine D. J. , Chavan S. S. , Andersson U. , Diamond B. , Tracey K. J.
Published: June 2013

Background

More than 500,000 hospitalized patients survive severe sepsis annually in the USA. Recent epidemiological evidence, however, demonstrated that these survivors have significant morbidity and mortality, with 3‐year fatality rates higher than 70%. To investigate the mechanisms underlying persistent functional impairment in sepsis survivors, here we developed a model to study severe sepsis survivors following cecal ligation and puncture (CLP).

Methods

Sepsis was induced in mice by CLP and survivors were followed for twelve weeks. Spleen and blood were collected and analyzed at different time points post‐sepsis.

Results

We observed that sepsis survivors developed significant splenomegaly. Analysis of the splenic cellular compartments revealed a major expansion of the inflammatory CD11b+ Ly‐6CHigh pool. Serum high‐mobility group box 1 (HMGB1) levels in the sepsis surviving mice were significantly elevated for 4‐6 weeks after post‐sepsis, and administration of an anti‐HMGB1 monoclonal antibody significantly attenuated splenomegaly as well as splenocyte priming. Administration of recombinant HMGB1 to naive mice induced similar splenomegaly, leukocytosis and splenocyte priming as observed in sepsis survivors. Interestingly analysis of circulating HMGB1 from sepsis survivors by mass spectroscopy demonstrated a stepwise increase of reduced form of HMGB1 (with known chemo‐attractant properties) during the first 3 weeks, followed by disulphide form (with known inflammatory properties) 4‐8 weeks after CLP.

Discussion

Our results indicate that prolonged elevation of HMGB1 is a necessary and sufficient mediator of splenomegaly and splenocyte expansion, as well as splenocyte inflammatory priming in murine severe sepsis survivors.
Effect of feeding dried distillers' grains with solubles on milk yield and milk composition of cows in mid‐lactation and digestibility in sheep
Authors: Westreicher‐Kristen E. , Kaiser R. , Steingass H. , Rodehutscord M.
Published: June 2013

We evaluated the effect of three sources of dried distillers' grains with solubles (DDGS) in diets of mid‐lactating dairy cows on milk production and milk composition and on digestibility in sheep. DDGS from wheat, corn and barley (DDGS1), wheat and corn (DDGS2) and wheat (DDGS3) were studied and compared with a rapeseed meal (RSM). RSM and DDGS were characterized through in situ crude protein (CP) degradability. Nutrient digestibility was determined in sheep. Twenty‐four multiparous cows were used in a 4 × 4 Latin square design with 28‐day periods. Treatments included total mixed rations containing as primary protein sources RSM (control), DDGS1 (D1), DDGS2 (D2) or DDGS3 (D3). RSM contained less rapidly degradable CP (fraction a), more potentially degradable CP (fraction b) and more rumen undegradable CP (UDP) than the three DDGS. In vivo digestibility of RSM organic matter was similar to DDGS. Calculated net energy for lactation (NEL) was lower for RSM (7.4 MJ/kg DM) than for DDGS, which averaged 7.7 MJ/kg DM. Cows' dry matter intake did not differ between diets (21.7 kg/day). Cows fed D1 yielded more milk than those fed D3 (31.7 vs. 30.4 kg/day); no differences were found between control and DDGS diets (31.3 vs. 31.1 kg/day). Energy‐corrected milk was similar among diets (31.2 kg/day). Diets affected neither milk fat concentration (4.0%) nor milk fat yield (1.24 kg/day). Milk protein yield of control (1.12 kg/day) was significantly higher than D3 (1.06 kg/day) but not different form D1 and D2 (1.08 kg/day each). Feeding DDGS significantly increased milk lactose concentration (4.91%) in relation to control (4.81%). DDGS can be a suitable feed in relation to RSM and can be fed up to 4 kg dry matter per day in rations of dairy cows in mid‐lactation. However, high variation of protein and energy values of DDGS should be considered when included in diets of dairy cows.
Gene silencing inFucusembryos: developmental consequences ofRNAi‐mediated cytoskeletal disruption
Authors: Farnham Garry , Strittmatter Martina , Coelho Susana , Cock Jeremy Mark , Brownlee Colin
Published: June 2013

Brown algae (Phaeophyceae) are an important algal class that play a range of key ecological roles. They are often important components of rocky shore communities. A number of members of the Fucales and Ectocarpales have provided models for the study of multicellular evolution, reproductive biology and polarized development. Indeed the fucoid algae exhibit the unusual feature of inducible embryo polarization, allowing many classical studies of polarity induction. The potential of further studies of brown algae in these important areas has been increasingly hindered by the absence of tools for manipulation of gene expression that would facilitate further mechanistic analysis and gene function studies at a molecular level. The aim of this study was to establish a method that would allow the analysis of gene function throughRNAi‐mediated gene knockdown. We show that injection of double‐strandedRNA(dsRNA) corresponding to an α‐tubulin gene intoFucus serratusLinnaeus zygotes induces the loss of a large proportion of the microtubule cytoskeleton, leading to growth arrest and disruption of cell division. Injection of dsRNAtargeting β‐actin led to reduced rhizoid growth, enlarged cells and the failure to develop apical hair cells. The silencing effect on actin expression was maintained for 3 months. These results indicate that theFucusembryo possesses a functionalRNAinterference system that can be exploited to investigate gene function during embryogenesis.
The Relationship Between Perceived Burden of Chronic Conditions and Colorectal Cancer Screening Among Appalachian Residents
Authors: Tarasenko Yelena N. , Fleming Steven T. , Schoenberg Nancy E.
Published: June 2013

Purpose

As the population living with several concurrent chronic conditions or multiple morbidity (MM) increases, understanding how to effectively fit prevention efforts into disease management becomes more important, particularly among rural, underserved populations. Compared to their urban counterparts, rural residents suffer higher rates of disease, receive fewer preventive services, and often live in environments limiting access to optimal medical care. This study describes rural residents’ perceived burdens of disease management and explores the relationship between these burdens, as proxies of individuals’ competing demands, and colorectal cancer screening (CRCS).

Methods

We conducted a cross‐sectional study, based on telephone survey data from 1,012 Appalachian residents, ages 50‐75, with 1 or more chronic conditions. Measures of perceived MM burdens were developed based on 85 pilot interviews previously undertaken with providers and patients with MM residing in Appalachian Kentucky.

Results

Many participants (81%) agreed with 1 or more statements indicating perceived burdens of disease management effects on receiving CRCS. A higher percentage of rural (vs nonrural) Appalachians perceived burdens related to physician's recommendation, preparation to colonoscopy, and time management and affordability of both current diseases and screening. These differences did not modify the overall association between perceiving MM as burdensome and forgoing CRCS. The negative effect on CRCS of perceived burdens related to interaction with physician and time management was lower for participants with multiple rather than single morbidity.

Conclusion

Future research designed to address perceived burdens of MM and improved interaction with health care providers may enhance critical prevention efforts among vulnerable populations.
Astragaloside IV Protects Heart from Ischemia and Reperfusion Injury via Energy Regulation Mechanisms
Authors: Tu Lei , Pan Chun‐Shui , Wei Xiao‐Hong , Yan Li , Liu Yu‐Ying , Fan Jing‐Yu , Mu Hong‐Na , Li Quan , Li Lin , Zhang Yu , He Ke , Mao Xiao‐Wei , Sun Kai , Wang Chuan‐She , Yin Chang‐Cheng , Han Jing‐Yan
Published: June 2013

Objective

This study was designed to investigate the protective potential of AS‐IV against ischemia and I/R‐induced myocardial damage, with focusing on possible involvement of energy metabolism modulation in its action and the time phase in which it takes effect.

Methods

SD rats were subjected to 30 minutes LADCA occlusion, followed by reperfusion. MBF, myocardial infarct size, and cardiac function were evaluated. Myocardial structure and myocardial apoptosis were assessed by double immunofluorescence staining of F‐actin and TUNEL. Content of ATP, ADP, and AMP in myocardium, cTnI level, expression of ATP5D, P‐MLC2, and apoptosis‐related molecules were determined.

Results

Pretreatment with AS‐IV suppressed MBF decrease, myocardial cell apoptosis, and myocardial infarction induced by I/R. Moreover, ischemia and I/R both caused cardiac malfunction, decrease in the ratio of ATP/ADP and ATP/AMP, accompanying with reduction of ATP 5D protein and mRNA, and increase in P‐MLC2 and serum cTnI, all of which were significantly alleviated by pretreatment with AS‐IV, even early in ischemia phase for the insults that were implicated in energy metabolism.

Conclusions

AS‐IV prevents I/R‐induced cardiac malfunction, maintains the integrity of myocardial structure through regulating energy metabolism. The beneficial effect of AS‐IV on energy metabolism initiates during the phase of ischemia.
EVALUATING ALTERNATIVE MANAGEMENT STRATEGIES FOR ABALONE
Authors: BEDFORD R. A. , HEARNE J. W. , WANG Y. , GORFINE H. K. , TAYLOR B.
Published: June 2013

Industry participation in co‐management has become a cornerstone of assessing the blacklip abalone, Halitois rubra, fisheries of South‐Eastern Australia. Engaging industry in developing and implementing management strategies is aimed at stemming recent trends of stock depletion and reduced harvest. An alternative to the current strategy for determining harvests is under consideration. A central question is: which management strategy is most likely to maintain sufficient biomass to produce consistent harvest rates into the future? This question is addressed using a Systems Dynamics modeling approach. We evaluated the two strategies of harvest management planning under (i) unchanging environmental conditions and (ii) following a high‐mortality event. To assess the performance of each strategy, an existing abalone model was used to estimate yield and mature biomass over three decades (>5 generations). A strategy using mean length of commercial catch as a novel performance measure generally provided a better path to recovery from the high‐mortality event than the current harvest threshold strategy.
Advanced building energy management system demonstration for Department of Defense buildings
Authors: O'Neill Zheng , Bailey Trevor , Dong Bing , Shashanka Madhusudana , Luo Dong
Published: June 2013

This paper presents an advanced building energy management system (aBEMS) that employs advanced methods of whole‐building performance monitoring combined with statistical methods of learning and data analysis to enable identification of both gradual and discrete performance erosion and faults. This system assimilated data collected from multiple sources, including blueprints, reduced‐order models (ROM) and measurements, and employed advanced statistical learning algorithms to identify patterns of anomalies. The results were presented graphically in a manner understandable to facilities managers. A demonstration of aBEMS was conducted in buildings at Naval Station Great Lakes. The facility building management systems were extended to incorporate the energy diagnostics and analysis algorithms, producing systematic identification of more efficient operation strategies. At Naval Station Great Lakes, greater than 20% savings were demonstrated for building energy consumption by improving facility manager decision support to diagnose energy faults and prioritize alternative, energy‐efficient operation strategies. The paper concludes with recommendations for widespread aBEMS success.
Barley metallothioneins differ in ontogenetic pattern and response to metals
Authors: SCHILLER MICHAELA , HEGELUND JOSEFINE N. , PEDAS PAI , KICHEY THOMAS , LAURSEN KRISTIAN H. , HUSTED SØREN , SCHJOERRING JAN K.
Published: June 2013

The barley genome encodes a family of 10 metallothioneins (MTs) that have not previously been subject to extensive gene expression profiling. We show here that expression of MT1a, MT2b1, MT2b2 and MT3 in barley leaves increased more than 50‐fold during the first 10 d after germination. Concurrently, the root‐specific gene MT1b1 was 1000‐fold up‐regulated. Immunolocalizations provided the first evidence for accumulation of MT1a and MT2a proteins in planta, with correlation to transcript levels. In developing grains, MT2a and MT4 expression increased 4‐ and 300‐fold over a 28‐day‐period after pollination. However, among the MT grain transcripts MT2c was the most abundant, whereas MT4 was the least abundant. Excess Cu up‐regulated three out of the six MTs expressed in leaves of young barley plants. In contrast, most MTs were down‐regulated by excess Zn or Cd. Zn starvation led to up‐regulation of MT1a, whereas Cu starvation up‐regulated MT2a, which has two copper‐responsive elements in the promoter. Arabidopsis lines constitutively overexpressing barley MT2a showed increased sensitivity to excess Cd and Zn but no Cu‐induced response. We suggest that barley MTs are differentially involved in intracellular homeostasis of essential metal ions and that a subset of barley MTs is specifically involved in Cu detoxification.
A Syndemic Model of Women Incarcerated in Community Jails
Authors: Kelly Patricia J. , Cheng An‐Lin , Spencer‐Carver Elaine , Ramaswamy Megha
Published: June 2013

Objective

The purpose of this study was to test whether variations in substance abuse, mental health diagnoses, individual experiences of violence, community experiences of violence, and incarceration history may be reduced to a single underlying syndemic factor for a sample of women incarcerated in three Midwestern U.S. jails.

Design and Sample

Secondary data analysis of a cross‐sectional study of a medical utilization survey; initial confirmatory factor analysis tested fit of model; modification indexes provided confirmatory fit. 290 women incarcerated in three urban Midwestern U.S. jails.

Measures

Demographics and variables associated with women's criminal justice experience and sexual health risk were assessed. The analysis included women's mental health, drug dependence, childhood sexual and physical abuse, and partner violence.

Results

The final model had four variables with significant pathways: childhood sexual abuse, childhood physical abuse, domestic violence, and mental health diagnoses. The fit of this model was very good (χ2 (1) = 0.6; CFI = 1.00; standardized RMR = 0.0147), strongly suggesting the intertwined nature of the variables.

Conclusion

Clarification of the specific components in a syndemic model for this population will allow for the implementation of interventions with the appropriate inclusion of content. In interventions and clinical practice, public health nurses should consider these interrelationships.