bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of active negative pressure peritoneal therapy for reducing the systemic inflammatory response after damage control laparotomy (the Intra-peritoneal Vacuum Trial): study protocol for a randomized controlled trial
Authors: Roberts Derek J , Jenne Craig N , Ball Chad G , Tiruta Corina , Léger Caroline , Xiao Zhengwen , Faris Peter D , McBeth Paul B , Doig Christopher J , Skinner Christine R , Ruddell Stacy G , Kubes Paul , Kirkpatrick Andrew W
Published: May 2013

Background

Damage control laparotomy, or abbreviated initial laparotomy followed by temporary abdominal closure (TAC), intensive care unit resuscitation, and planned re-laparotomy, is frequently used to manage intra-abdominal bleeding and contamination among critically ill or injured adults. Animal data suggest that TAC techniques that employ negative pressure to the peritoneal cavity may reduce the systemic inflammatory response and associated organ injury. The primary objective of this study is to determine if use of a TAC dressing that affords active negative pressure peritoneal therapy, the ABThera Open Abdomen Negative Pressure Therapy System, reduces the extent of the systemic inflammatory response after damage control laparotomy for intra-abdominal sepsis or injury as compared to a commonly used TAC method that provides potentially less efficient peritoneal negative pressure, the Barker’s vacuum pack.

Methods/Design

The Intra-peritoneal Vacuum Trial will be a single-center, randomized controlled trial. Adults will be intraoperatively allocated to TAC with either the ABThera or Barker’s vacuum pack after the decision has been made by the attending surgeon to perform a damage control laparotomy. The study will use variable block size randomization. On study days 1, 2, 3, 7, and 28, blood will be collected. Whenever possible, peritoneal fluid will also be collected at these time points from the patient’s abdomen or TAC device. Luminex technology will be used to quantify the concentrations of 65 mediators relevant to the inflammatory response in peritoneal fluid and plasma. The primary endpoint is the difference in the plasma concentration of the pro-inflammatory cytokine IL-6 at 24 and 48 h after TAC dressing application. Secondary endpoints include the differential effects of these dressings on the systemic concentration of other pro-inflammatory cytokines, collective peritoneal and systemic inflammatory mediator profiles, postoperative fluid balance, intra-abdominal pressure, and several patient-important outcomes, including organ dysfunction measures and mortality.

Discussion

Results from this study will improve understanding of the effect of active negative pressure peritoneal therapy after damage control laparotomy on the inflammatory response. It will also gather necessary pilot information needed to inform design of a multicenter trial comparing clinical outcomes among patients randomized to TAC with the ABTheraversusBarker’s vacuum pack.

Trial registration

ClinicalTrials.gov identifierhttp://www.clicaltrials.gov/ct2/show/NCT01355094
Ultra-early tranexamic acid after subarachnoid hemorrhage (ULTRA): study protocol for a randomized controlled trial
Authors: Germans Menno R , Post René , Coert Bert A , Rinkel Gabriël JE , Vandertop W Peter , Verbaan Dagmar
Published: May 2013

Background

A frequent complication in patients with subarachnoid hemorrhage (SAH) is recurrent bleeding from the aneurysm. The risk is highest within the first 6 hours after the initial hemorrhage. Securing the aneurysm within this timeframe is difficult owing to logistical delays. The rate of recurrent bleeding can also be reduced by ultra-early administration of antifibrinolytics, which probably improves functional outcome. The aim of this study is to investigate whether ultra-early and short-term administration of the antifibrinolytic agent tranexamic acid (TXA), as add-on to standard SAH management, leads to better functional outcome.

Methods/Design

This is a multicenter, prospective, randomized, open-label trial with blinded endpoint (PROBE) assessment. Adult patients with the diagnosis of non-traumatic SAH, as proven by computed tomography (CT) within 24 hours after the onset of headache, will be randomly assigned to the treatment group or the control group. Patients in the treatment group will receive standard treatment with the addition of a bolus of TXA (1 g intravenously) immediately after randomization, followed by continuous infusion of 1 g per 8 hours until the start of aneurysm treatment, or a maximum of 24 hours after the start of medication. Patients in the control group will receive standard treatment without TXA. The primary outcome measure is favorable functional outcome, defined as a score of 0 to 3 on the modified Rankin Scale (mRS), at 6 months after SAH. Primary outcome will be determined by a trial nurse blinded for treatment allocation. We aim to include 950 patients in 3 years.

Discussion

The strengths of this study are: 1. the ultra-early and short-term administration of TXA, resulting in a lower dose as compared to previous studies, which should reduce the risk for delayed cerebral ischemia (DCI), an important risk factor in the long-term treatment with antifibrinolytics; 2. the power calculation is based on functional outcome and calculated with use of recent study results of our own population, supported by data from prominent studies; and 3. the participation of several specialized SAH centers, and their referring hospitals, in the Netherlands with comparative treatment protocols.

Trial registration

Nederlands Trial Register (Dutch Trial Registry) number NTR3272
Treatment provider is most predictive of ED dismissal in minimally-injured trauma patients: a retrospective review
Authors: Hunt Diane L S , Berg Gina M , Zackula Rosalee E , Ekengren Francie H , Lippoldt Diana , Ablah Elizabeth , Wetta Ruth
Published: May 2013

Background

Secondary triage protocols have been described in the literature as physiologic (first-tier) criteria and mechanism-related (second-tier) criteria to determine the level of trauma activation. There is debate as to the efficiency of triage decisions based on mechanism of injury which may result in overtriage and overuse of limited trauma resources. Our institution developed and implemented an advanced three-tier trauma alert system in which stable patients presenting with blunt traumatic mechanism of injury would be evaluated by the emergency department (ED) physician rather than the trauma surgeon. The American College of Surgeons Committee on Trauma (ACSCOT) requires that operational changes be monitored and evaluated for patient safety and performance. The primary aim of this study was to evaluate the process, as well as outcomes, of patient care pre and post implementation of the new triage protocol. The secondary aim was to determine predictor variables that were associated with ED dismissal.

Methods

A retrospective blinded pre/post process change implementation explicit chart review was conducted to compare process and outcomes of minimally injured trauma patients who were field triaged by mechanism of injury. Generalized linear modeling was performed to determine which predictor variables were associated with ED dismissal.

Results

There were no significant differences in minutes to physician evaluation, CT scan, OR/ICU disposition, readmission rates, safety or quality. Significant differences only occurred in time to chest x-ray, length of stay in ED, and ED dismissal rates. Trauma surgeon and ED physician patient groups did not differ on ISS, age, or sex. The only significant predictor for ED dismissal was treatment provider, with ED physicians 3.6 times more likely to dismiss the patient from the emergency department.

Conclusions

ED physicians provided compble care as measured by safety, timeliness, and quality in minimally-injured patients triaged to our trauma center based only on mechanism of injury. Moreover, ED physicians were more likely to dismiss patients from the ED. A three-tiered internal triaging protocol can redirect resource usage to reduce the burden on the trauma service. This may be increasingly beneficial in trauma models in which the trauma surgeons also serve as critical care intensivists.
Cytotoxic evaluation of Melia azedarach in comparison with, Azadirachta indica and its phytochemical investigation
Authors: Jafari Samineh , Saeidnia Soodabeh , Hajimehdipoor Homa , Ardekani Mohammad Reza Shams , Faramarzi Mohammad Ali , Hadjiakhoondi Abbas , Khanavi Mahnaz
Published: May 2013

Background

Melia azedarach L. is an important medicinal plant that is used for variety of ailments in Iranian traditional medicine. Azadirachta indica A. Juss is its allied species and possesses similar properties and effects. The present study was undertaken to investigate anticancer activity of these M. azedarach in comparison with A. indica on cancer cell lines and also to evaluate their safety in humans by testing them on normal cell line. The study also aimed to determine the active components that are responsible for medicinal effects of M. azedarach in traditional usages.

Methods

In this study, the cytotoxic activity of crude extracts from M. azedarach and A. indica leaves, pulps and seeds as well as three main fractions of their leaf extracts were assayed against HT-29, A-549, MCF-7 and HepG-2 and MDBK cell lines. MTT assay was used to evaluate their cytotoxic activities. Methanol leaf fraction of M. azedarach as the safest leaf fraction in terms of cytotoxicity was subjected for phytochemical study.

Results

Results of the present study indicated that seed kernel extract of M. azedarach had the highest cytotoxic activity and selectivity to cancer cell lines (IC50 range of 8.18- 60.10 Î¼g mL-1). In contrast to crude seed extract of A. indica, crude pulp and crude leaf extracts of this plant showed remarkably stronger anti-prolifrative activity (IC50 ranges of 83.45 - 212.16 Î¼g mL-1 and 34.11- 95.51 Î¼g mL-1 respectively) than those of M. azedarach (all IC50 values of both plants > 650 Î¼g mL-1). The phytochemical analysis led to the isolation of four flavonol 3-O-glycosides including rutin, kaempferol-3-O-robinobioside, kaempferol-3-O-rutinoside and isoquercetin along with a purin nucleoside, Î²-adenosine.

Conclusions

The anti-prolifrative potentials of extracts from different parts of M. azedarach and A. indica were determined. By comparison, methanol leaf fraction of M. azedarach seems to be safer in terms of cytotoxicity. Our study shows that flavonols are abundant in the leaves of M. azedarach and these compounds seem to be responsible for many of medicinal effects exploited in the traditional uses.
Strategies for obtaining unpublished drug trial data: a qualitative interview study
Authors: Wolfe Nicole , Gøtzsche Peter C , Bero Lisa
Published: May 2013

Background

Authors of systematic reviews have difficulty obtaining unpublished data for their reviews. This project aimed to provide an in-depth description of the experiences of authors in searching for and gaining access to unpublished data for their systematic reviews, and to give guidance on best practices for identifying, obtaining and using unpublished data.

Methods

This is a qualitative study analyzing in-depth interviews with authors of systematic reviews who have published Cochrane reviews or published systematic reviews outside of The Cochrane Library. We included participants who 1) were the first or senior author of a published systematic review of a drug intervention, 2) had expertise in conducting systematic reviews, searching for data, and assessing methodological biases, and 3) were able to participate in an interview in English. We used non-random sampling techniques to identify potential participants. Eighteen Cochrane authors were contacted and 16 agreed to be interviewed (89% response rate). Twenty-four non-Cochrane authors were contacted and 16 were interviewed (67% response rate).

Results

Respondents had different understandings of what was meant by unpublished data, including specific outcomes and methodological details. Contacting study authors was the most common method used to obtain unpublished data and the value of regulatory agencies as a data source was underappreciated. Using the data obtained was time consuming and labor intensive. Respondents described the collaboration with other colleagues and/or students required to organize, manage and use the data in their reviews, generally developing and using templates, spreadsheets and computer programs for data extraction and analysis. Respondents had a shared belief that data should be accessible but some had concerns about sharing their own data. Respondents believed that obtaining unpublished data for reviews has important public health implications. There was widespread support for government intervention to ensure open access to trial data.

Conclusions

Respondents uniformly agreed that the benefit of identifying unpublished data was worth the effort and was necessary to identify the true harms and benefits of drugs. Recent actions by government, such as increased availability of trial data from the European Medicines Agency, may make it easier to acquire critical drug trial data.
Measuring quality in diabetes care: an expert-based statistical approach
Authors: Bertsimas Dimitris , Czerwinski David , Kane Michael
Published: May 2013

We present a methodology for using health insurance claims data to monitor quality of care. The method uses a statistical model trained on the quality ratings of a medical expert. In a pilot study, the expert rated the quality of care received over the course of two years by 101 diabetes patients. A logistic regression model accurately identified the quality of care for 86% of the patients. Because the model uses data derived from patients’ health insurance claims it can be used to monitor the care being received by a large patient population. One important use of the model is to identify potential candidates for case management, especially patients with complicated medical histories.
Overdiagnosis in breast cancer screening: the importance of length of observation period and lead time
Authors: Duffy Stephen W , Parmar Dharmishta
Published: May 2013

Background

Overdiagnosis in breast cancer screening is a controversial topic. One difficulty in estimation of overdiagnosis is the separation of overdiagnosis from lead time that is the advance in the time of diagnosis of cancers, which confers an artificial increase in incidence when a screening programme is introduced.

Methods

We postulated a female population aged 50-79 with a similar age structure and age-specific breast cancer incidence as in England and Wales before the screening programme. We then imposed a two-yearly screening programme; screening women aged 50-69, to run for twenty years, with exponentially distributed lead time with an average of 40 months in screen-detected cancers. We imposed no effect of the screening on incidence other than lead time.

Results

Comparison of age- and time-specific incidence between the screened and unscreened populations showed a major effect of lead time, which could only be adjusted for by follow-up for more than two decades and including ten years after the last screen. From lead time alone, twenty-year observation at ages 50-69 would confer an observed excess incidence of 37%. The excess would only fall below 10% with 25 years or more follow-up. For the excess to be nullified, we would require 30 year follow-up including observation up to 10 years above the upper age limit for screening.

Conclusion

Studies using shorter observation periods will overestimate overdiagnosis by inclusion of cancers diagnosed early due to lead time among the nominally overdiagnosed tumours.
CRTC2 Is Required for β-Cell Function and Proliferation
Authors: Eberhard Chandra E. , Fu Accalia , Reeks Courtney , Screaton Robert A.
Published: May 2013

Previous work in insulinoma cell lines has established that calcineurin plays a critical role in the activation of cAMP-responsive element binding protein (Creb), a key transcription factor required for β-cell function and survival, by dephosphorylating the Creb coactivator Creb-regulated transcription coactivator (Crtc)2 at 2 regulatory sites, Ser171 and Ser275. Here, we report that Crtc2 is essential both for glucose-stimulated insulin secretion and cell survival in the β-cell. Endogenous Crtc2 activation is achieved via increasing glucose levels to the physiological feeding range, indicating that Crtc2 is a sensor that couples ambient glucose concentrations to Creb activity in the β-cell. Immunosuppressant drugs such as cyclosporin A and tacrolimus that target the protein phosphatase calcineurin are commonly administered after organ transplantation. Chronic use is associated with reduced insulin secretion and new onset diabetes, suggestive of pancreatic β-cell dysfunction. Importantly, we show that overexpression of a Crtc2 mutant rendered constitutively active by introduction of nonphosphorylatable alanine residues at Ser171 and Ser275 permits Creb target gene activation under conditions when calcineurin is inhibited. Taken together, these data suggest that promoting Crtc2-Creb activity is required for β-cell function and proliferation and promoting this pathway could ameliorate symptoms of new onset diabetes after transplantation.
“As False as Cressid”: Virtue Trouble from Chaucer to Shakespeare
Authors: Crocker Holly A.
Published: May 2013

This article argues that Shakespeare’s Troilus and Cressida continues an important late medieval poetic tradition that highlights the troubling consequences of virtue’s performativity for idealized women. If Chaucer is pessimistic about the potential for Criseyde’s ethical agency in an unstable universe, Lydgate locates the source of women’s mutability in the cultural contingency that accompanies masculine violence, especially war. Henryson’s bracing meditation on Cresseid’s physical demise exposes the heroic exploitation of women’s virtue, but it also constructs a tangible form of excellence, an ethics of embodied endurance strong enough to withstand repeated acts of injustice. Like medieval poets, Shakespeare returns to the scene of Cressida’s destruction in order to dramatize the cultural conditions that script her moral evacuation. Taking a long view of Cressida’s downfall reveals the “virtue trouble” inherent to performative gender ideals, as well as the ethical importance of poetic responses to scripted femininities in premodern England.
The Substance of Shadows: Imagination and Credit Culture in Volpone
Authors: Sheerin Brian
Published: May 2013

Discourses of economic exchange and of theatrical participation at the turn of the seventeenth century each began to rely on a rhetoric of “crediting”: both lending and theatergoing, that is, demand a trust in the circularity of expenditure, whereby what is given out may return to the benefit of the giver. Considering that the very word “credit” was only just beginning to acquire a specifically economic usage at this time, how does the crediting of imaginative representation on stage interact with the surge of a rising credit culture? This article posits that credit, as a kind of collective “imagining,” becomes fascinating to Ben Jonson in particular as something utterly fragile and yet vitally necessary for both productive and creative social order. Jonson’s drama Volpone (1606) demonstrates the ability of “credit culture” to sustain itself through theatrical effects of collective belief, even as various rhetorics of obligation become disconcertingly obscured in the process.
Lord Hodgson's Charities Act review
Authors: Dunn Alison
Published: May 2013

The Charities Act 2006, which applies to charities in England and Wales, contained a provision requiring a five-year review. Lord Hodgson of Astley Abbotts, appointed to undertake that review, presented his findings in July 2012. His review considers the impact of the Act in the context of the regulatory framework for charities in England and Wales and sets out over 100 recommendations to take the legal framework forward. Lord Hodgson's recommendations and the principles that underpin them are considered in this article.
Atomic-modeling and Simulation of Copper Sulfide as Micro Solid Lubricant
Authors: Sato Tomohiro , Hirai Yoshimasa , Fukui Takehisa , Ejima Takahiro , Takuma Masanori , Saitoh Ken-ichi
Published: May 2013

Many industries have developed new materials as substitutes for lead in solid lubricants. For example, lead bronze, a Cu-Pb alloy that has been used for slide bearings, has been replaced by a Cu alloy containing sulfide. The development of Pb-free Cu alloys has received considerable attention recently. Pb and sulfide are types of solid lubricants; in particular, MoS2 (molybdenum disulfide) is a popular sulfide lubricant. This study focuses on a material that contains Cu2S. The properties of Cu2S as a solid lubricant are unknown. First principles (FP) and molecular dynamics (MD) are used to clarify the lubrication mechanism of Cu2S. The atomiclevel stable structure of Cu2S is evaluated by FP under specific sliding conditions. The Cu2S lubrication mechanism is clarified by MD using the FP results for the interatomic potential functions. It is clarified that there is a specific slip system and the Cu-S bonds that exists above and below the layers of the slip system are very strong.
Polycaprolactone-Hydroxyapatite Composite Membrane Scaffolds for Bone Tissue Engineering
Authors: Morelli Sabrina , Facciolo Daniele , Messina Antonietta , Piscioneri Antonella , Salerno Simona , Drioli Enrico , De Bartolo Loredana
Published: May 2013

Bone tissue engineering typically involves the use of porous, bioresorbable scaffolds to serve as temporary, three-dimensional scaffolds to guide cell attachment, differentiation, proliferation, and subsequent tissue regeneration. In this study we developed a composite membrane scaffold by phase inversion technique by using biodegradable polyester, Polycaprolactone (PCL), with hydroxyapatite (HA) in order to develop novel controlled nanostructured biomaterials for bone tissue engineering applications.After preparation, membrane scaffolds were characterized in order to evaluate its morphological, physico-chemical and mechanical properties and then used for the cell culture.

Our experimental design consists to apply the knowledge of natural bone tissue remodelling in an in vitro membrane biohybrid system. We used human mesenchymal stem cells for culture in the membrane scaffolds inducing the differentiation in osteoblasts and human monocytes to trigger osteoclastogenesis. Osteoclastic resorption of the scaffold material would lead to subsequent induction of osteoblasts and faster bone formation with mesenchymal stem cells. Our results show that osteoblasts and osteoclasts were successfully differentiated in the developed PCL-HA membrane scaffold. This membrane system will lead to insights in the creation of a controllable osteoinductive microenvironment based on the specific properties (e.g. basic composition, surface chemistry, architecture) and on the function (resorption coupled to proliferation and differentiation) of defined cellular systems.
Methodology for Combined Neutron Diffraction and Bragg Edge Imaging
Authors: Woracek R. , Bunn J.R. , Penumadu D. , Tremsin A. , Siriruk A. , Kardjilov N. , Manke I. , Boin M. , Hilger A. , Hubbard C.R. , Clausen B. , Sisneros T.A.
Published: May 2013

Simultaneous use of neutron diffraction and attenuation based transmission Bragg edge imaging for strain measurements is demonstrated in this paper using the pulse neutron source at Los Alamos National Laboratory. Cylindrical samples made from ferritic steel have been subjected to in-situ elastic loading in tension and torsion. Lattice strains were investigated for both deformation modes by time-of-flight (TOF) neutron diffraction using two detector banks at 2θ of ±90°. At the same time, the transmitted portion of the neutron beam was recorded with the goal to analyze the position and shape of the Bragg edges, using a novel time/energy resolved Microchannel Plate (MCP) detector with pixel size of 55 µm and a 28x28 mm2 field of view. Lattice strains obtained using neutron diffraction indicate that the deformation path (tension versus torsion) has important effect on their evolution and related results are summarized.

The emphasis of this paper is to explain the aspects of the experimental setup and data interpretation associated with neutron Bragg edge transmission technique for obtaining through-thickness averaged strain measurements. Implications of using transmission imaging based strain mapping for samples subjected to deformation under tensile loading (where stress at a given cross-section is constant) versus torsional loading (where stress varies linearly from center to outer radius) are discussed. In the case of samples subjected to tensile loading, analysis of the Bragg edge shifts provides the strain value in the direction of the transmitted beam. Thus, three strain components are measured simultaneously when performing Bragg edge imaging in addition to diffraction using two detector banks. For specimens subjected to pure shear by torsion, the Bragg edge transmission technique cannot readily provide quantitative strain information as the mid-point of the Bragg edge does not shift uniformly due to external loading, but results in a broadening of the Bragg edge. Such information can be used to describe the variation of strain distribution along the transmitted beam direction. Spatially resolved Bragg edge maps will be very helpful to detect d-spacing inhomogeneities within the illuminated volume, which may remain undetected when using diffraction only measurements.
Nucleation and growth of CdS nanoparticles observed by ultrafast SAXS
Authors: Schiener A. , Wlochowitz T. , Gerth S. , Unruh T. , Rempel A. , Amenitsch H. , Magerl A.
Published: May 2013

Aqueous solutions containing Cd2+ and S2- ions have been brought together in a T-mixer, and the formation of CdS nanoparticles has been monitored by ultrafast X-ray small angle scattering down to 0.2 ms. While no particle formation is observed for a laminar flow, their growth can be followed in-situ for conditions of turbulent flow.
Impact of Gate Metal on Surface States Distribution and Effective Surface Barrier Height in AlGaN/GaN Heterostructures
Authors: Goyal Nitin , Fjeldly Tor A.
Published: May 2013

A physics based model is presented to describe the surface donor density distribution for metal/AlGaN/GaN structures. This model partly relies on experimental observations to describe the reduction that takes place in surface donor density when the metal gate is deposited. This new model is based on our previous work on the bare surface barrier height for both unrelaxed and partially relaxed barrier layers. The model predictions are consistent with reported experimental data.
Effects of predator richness on prey suppression: a meta‐analysis
Authors: Griffin John N. , Byrnes Jarrett E. K. , Cardinale Bradley J.
Published: May 2013

It is well established that species richness of primary producers and primary consumers can enhance efficiency of resource uptake and biomass production of respective trophic levels. At the level of secondary consumers (predators), however, conclusions about the functional role of biodiversity have been mixed. We take advantage of a recent surge of published experiments (totaling 46 since 2005) to both evaluate general effects of predator richness on aggregate prey suppression (top‐down control) and explore sources of variability among experiments. Our results show that, across experiments, predator richness enhances prey suppression relative to the average single predator species (mean richness effect), but not the best‐performing species. Mean richness effects in predator experiments were stronger than those for primary producers and detritivores, suggesting that relationships between richness and function may increase with trophic height in food webs. The strength of mean predator richness effects increased with the spatial and temporal scale of experiments, and the taxonomic distinctness (TD, used as a proxy of phylogenetic diversity) of species present. This latter result suggests that TD captures important aspects of functional differentiation among predators and that measures of biodiversity that go beyond species richness may help to better predict the effects of predator species loss.
Breathing Retraining for Individuals Who Fear Respiratory Sensations: Examination of Safety Behavior and Coping Aid Hypotheses
Authors: Lickel James J. , Carruthers Billy R. , Dixon Laura J. , Deacon Brett J.
Published: May 2013

Cognitive behavioral theorists have suggested that breathing retraining may be used as a safety behavior. Safety behaviors are acts aimed at preventing or minimizing feared catastrophe and may maintain pathologic anxiety by hindering resolution of maladaptive cognitive processes. An opposing position is that breathing retraining is an effective coping aid. This study examined the safety behavior and coping aid hypotheses as they apply to breathing retraining. Individuals high in fear of respiratory sensations were randomly assigned to a psychoeducation control condition (EDU; n = 27) or a psychoeducation plus breathing retraining condition (EDU+BR; n = 30). As compared to psychoeducation alone, the addition of breathing retraining neither limited improvement of cognitive processes (e.g., anxiety sensitivity) nor added to the gains observed on measures of coping (e.g., perceived control). The findings are evaluated in light of the available literature regarding breathing retraining and the safety behavior and coping aid hypotheses.
A Preliminary Investigation of Acceptance and Commitment Therapy for Adolescent Obsessive-Compulsive Disorder
Authors: Armstrong Andrew B. , Morrison Kate L. , Twohig Michael P.
Published: May 2013

There is growing support for the use of acceptance and commitment therapy (ACT) as a treatment for adults with obsessive-compulsive disorder (OCD), but no research has been published on the use of ACT for adolescent OCD. This preliminary study investigated ACT for youth with OCD using a multiple baseline across participants design. Three adolescents, ages 12 or 13 years, were treated with 8–10 sessions of ACT (without in-session exposure exercises). The primary dependent variable was daily self-monitoring of compulsions. Results showed a 40% mean reduction in self-reported compulsions from pretreatment to posttreatment, with results maintained at 3-month follow-up, for a reduction of 43.8%. Pretreatment to posttreament reductions in Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) ratings of OCD severity were 50.0%, 12.5%, and 22.0%; pretreatment to follow-up reductions were 54.0%, 12.5%, and 61.0%. Treatment procedures were rated by participants and parents as highly acceptable. Implications and future directions are discussed.
Rigid Rules of Conduct and Duty: Prediction of Thought–Action Fusion
Authors: Berman Noah C. , Wheaton Michael G. , Abramowitz Jonathan S.
Published: May 2013

Cognitive biases, such as thought–action fusion (TAF), play a crucial role in the cognitive-behavioral model of obsessional symptoms and have been shown to prospectively increase the risk of developing such symptoms. Much less research, however, has examined factors that might lead to the development of the cognitive biases themselves. This study aimed to replicate and extend existing work on correlates of moral (thinking about something is the moral equivalent of the corresponding action) and likelihood (thinking about a particular event increases the probability that this event will occur) TAF. A large sample of unscreened participants (N = 407) completed a measure of TAF, as well as measures of religiosity, motivation for religion, parental psychological control, and parental guilt induction. Results indicated that religion-related variables predicted the moral TAF, whereas parenting strategies were associated with likelihood TAF. Intrinsic motivation for religion also mediated the relationship between religiosity and moral TAF. Findings are discussed in terms of developmental psychopathology and limitations are addressed.
Creativity at the Opening of the 21st Century
Authors: Montuori Alfonso , Donnelly Gabrielle
Published: May 2013

At the beginning of the 21st century, creativity is changing, both in the way we conceptualize and understand it and in the practices of creativity. In this article, we summarize the emerging changes and articulate their outlines, drawing on creativity research, popular culture, the “networked” society, and a variety of other sources.
A Portrait of Holistic Nurse Educators
Authors: Holt-Waldo NaRisa Y.
Published: May 2013

Nurse educators are stewards of the future of the profession of nursing and, ultimately, of the delivery of holistic health care and the welfare of all individuals. Educators have the social responsibility to empower their students and to reenvision the goals of nursing curricula to encompass holistic health and healing.
Stories Are like Water: An Academic Writing Workshop for Nurses
Authors: Walker Madeline , Tschanz Coby
Published: May 2013

Traditionally, there is very little formal instruction in academic writing for nurses in graduate programs. We, the writing scholar and a nurse educator and PhD student at a major Canadian university, describe how we collaborated on developing and delivering a 1-day academic writing workshop for incoming master of nursing students. By sharing this description, we hope to motivate nursing faculty to offer similar workshops to address the dearth of writing instruction for graduate students in nursing and to improve scholarship outcomes.
Transdisciplinarity: An Innovative Approach to Nursing Knowledge
Authors: Potter Teddie
Published: May 2013

A common complaint heard in many quarters is, “Things are moving so fast that it's hard to keep up.” A natural response is to narrow our field of expertise to a smaller and smaller sphere. Even then, the rate of knowledge expansion necessitates regular modification; thus, our spheres continue to shrink. What we gain in a semblance of control, we lose in a grasp of the whole. Transdisciplinarity offers an alternative solution to ever-increasing complexity. This article is an exploration of transdisciplinarity and its potential benefits for the profession of nursing.
Thinking Styles and Creativity Preferences in Nursing
Authors: Almansa Pilar , López-Martínez Olivia , Corbalán Javier , Limiñana-Gras Rosa M.
Published: May 2013

This article describes a study using a descriptive approach of cross-sectional correlation to explore the association between thinking styles and creativity in a group of nursing professionals and students. A thinking style is a characteristic way of thinking. The hypothesis was that the most creative subjects would present thinking styles that enhance and express their creativity. De la Torre and Violant (2006) argue that creativity is not only a personal value, insofar as it recognizes and stimulates the transforming potential of the individual, but is also an educational value because it generates abilities and attitudes toward improvement. The study results show that a legislative thinking style encourages innovation and creativity and should be encouraged both during education and training and in the professional domain.
EMDR With Recurrent “Flash-Forwards”: Reflections on Engelhard et al.’s 2011 Study
Authors: Bellecci-St.Romain Lisa
Published: May 2013

“Translating Research Into Practice” is a new regular journal feature in which clinicians share clinical case examples that support, elaborate, or illustrate the results of a specific research study. Each column begins with the abstract of the study, followed by the clinician’s description of their own application of standard eye movement desensitization and reprocessing (EMDR) procedures with the population or problem treated in the study. The column is edited by theEMDR Research Foundationwith the goal of providing a link between research and practice and making research findings relevant in therapists’ day-to-day practices. In this issue’s column, Lisa Bellecci-St. Romain references Engelhard et al.’s (2011) study examining the impact of eye movements on recurrent, intrusive visual images about potential future catastrophes—“flash-forwards.” Illustrating the findings by Engelhard et al., Bellecci-St. Romain describes the successful use of the EMDR standard protocol in two cases—a woman fearful of returning to work even after past memories are cleared and a young man in early sobriety whose reprocessing of the past is interrupted by concerns of an imminent court appearance. The case examples are followed with a discussion of the importance of recognizing and targeting flash-forwards as present triggers in the three-pronged EMDR standard protocol.
Factors Explaining Racial/Ethnic Disparities in Rates of Physician Recommendation for Colorectal Cancer Screening
Authors: Ahmed Nasar U. , Pelletier Valerie , Winter Kelly , Albatineh Ahmed N.
Published: May 2013

Objectives. Physician recommendation plays a crucial role in receiving endoscopic screening for colorectal cancer (CRC). This study explored factors associated with racial/ethnic differences in rates of screening recommendation.

Methods. Data on 5900 adults eligible for endoscopic screening were obtained from the National Health Interview Survey. Odds ratios of receiving an endoscopy recommendation were calculated for selected variables. Planned, sequenced logistic regressions were conducted to examine the extent to which socioeconomic and health care variables account for racial/ethnic disparities in recommendation rates.

Results. Differential rates were observed for CRC screening and screening recommendations among racial/ethnic groups. Compared with Whites, Hispanics were 34% less likely (P < .01) and Blacks were 26% less likely (P < .05) to receive this recommendation. The main predictors that emerged in sequenced analysis were education for Hispanics and Blacks and income for Blacks. After accounting for the effects of usual source of care, insurance coverage, and education, the disparity reduced and became statistically insignificant.

Conclusions. Socioeconomic status and access to health care may explain major racial/ethnic disparities in CRC screening recommendation rates.
Bicycle Guidelines and Crash Rates on Cycle Tracks in the United States
Authors: Lusk Anne C. , Morency Patrick , Miranda-Moreno Luis F. , Willett Walter C. , Dennerlein Jack T.
Published: May 2013

Objectives. We studied state-adopted bicycle guidelines to determine whether cycle tracks (physically separated, bicycle-exclusive paths adjacent to sidewalks) were recommended, whether they were built, and their crash rate.

Methods. We analyzed and compared US bicycle facility guidelines published between 1972 and 1999. We identified 19 cycle tracks in the United States and collected extensive data on cycle track design, usage, and crash history from local communities. We used bicycle counts and crash data to estimate crash rates.

Results. A bicycle facility guideline written in 1972 endorsed cycle tracks but American Association of State Highway and Transportation Officials (AASHTO) guidelines (1974–1999) discouraged or did not include cycle tracks and did not cite research about crash rates on cycle tracks. For the 19 US cycle tracks we examined, the overall crash rate was 2.3 (95% confidence interval = 1.7, 3.0) per 1 million bicycle kilometers.

Conclusions. AASHTO bicycle guidelines are not explicitly based on rigorous or up-to-date research. Our results show that the risk of bicycle–vehicle crashes is lower on US cycle tracks than published crashes rates on roadways. This study and previous investigations support building cycle tracks.
Public Health and Law Collaboration: The Philadelphia Lead Court Study
Authors: Campbell Carla , Gracely Ed , Pan Sarah , Cummings Curtis , Palermo Peter , Gould George
Published: May 2013

Objectives. We determined whether Philadelphia Lead Court is effective in enforcing lead hazard remediation in the homes of children with elevated blood lead levels.

Methods. We created a deidentified data set for properties with an initial failed home inspection (IFHI) for lead hazards from January 1, 1998, through December 31, 2008, and compared compliance rates within the first year and time to compliance for lead hazard remediation between 1998 and 2002 (precourt period) and between 2003 and 2008 (court period). We evaluated predictors of time to compliance.

Results. Within 1 year of the IFHI, 6.6% of the precourt and 76.8% of the court cases achieved compliance (P < .001) for the 3764 homes with data. Four years after the IFHI, 18% had attained compliance in the precourt period compared with 83.1% for the court period (P < .001). A proportional hazard analysis found that compliance was 8 times more likely in the court than the precourt period (P < .001).

Conclusions. Lead court was more effective than precourt enforcement strategies. Most properties were remediated within 1 year of the IFHI, and time to compliance was significantly reduced. This model court could be replicated in other cities with similar enforcement problems.
Increasing Children’s Physical Activity During School Recess Periods
Authors: Chin John J. , Ludwig David
Published: May 2013

Objectives. We examined whether schools’ participation in the Recess Enhancement Program (REP) in the spring of 2011 was associated with higher rates of children’s vigorous physical activity.

Methods. In REP, a coach guides children through age-appropriate games aimed at increasing their physical activity. During recess at 25 New York City public elementary schools (15 REP, 10 non-REP), researchers visually scanned predetermined areas (n = 1339 scans), recording the number of sedentary, walking, and very active children.

Results. Multivariate statistical analysis found that participation in REP was a significant predictor (P = .027) of the rate of vigorous physical activity (percentage very active in scan area) whose least-squares means were 41% in REP schools and 27% in non-REP schools. A significantly higher rate in REP schools persisted when the coach was not in the scan area, suggesting a change in the recess culture of REP schools.

Conclusions. The rate of vigorous physical activity in REP schools was 14 percentage points, or 52%, higher than the rate in non-REP schools. This low-cost intervention might be a valuable addition to the tools for combating childhood obesity and worth replicating elsewhere.
Pathways to Early Violent Death: The Voices of Serious Violent Youth Offenders
Authors: Richardson Joseph B. , Brown Jerry , Van Brakle Michelle
Published: May 2013

Quantitative studies have uncovered factors associated with early violent death among youth offenders detained in the juvenile justice system, but little is known about the contextual factors associated with pathways to early violent death among youths detained in adult jails.

We interviewed young Black male serious violent youth offenders detained in an adult jail to understand their experience of violence. Their narratives reveal how the code of the street, informal rules that govern interpersonal violence among poor inner-city Black male youths, increases the likelihood of violent victimization.

Youth offenders detained in adult jails have the lowest rate of service provision among all jail populations. We have addressed how services for youth offenders can be improved to reduce the pathways to early violent death.
Creating Smoke-Free Places Through the UN Convention on the Rights of Persons With Disabilities
Authors: Rutkow Lainie , Vernick Jon S. , Tung Gregory J. , Cohen Joanna E.
Published: May 2013

In some high-, middle-, and low-income countries, law has been employed to limit individuals’ secondhand smoke exposure. Innovative legal tools are still needed, especially in low- and middle-income countries where smoking prevalence continues to rise.

For some persons with severe respiratory conditions, the presence of secondhand smoke is intolerable and prevents their entrance into restaurants and other venues. With its adoption of the Convention on the Rights of Persons with Disabilities (CRPD) in 2006, the United Nations gave countries a new way to promote the rights of disabled individuals and simultaneously address secondhand smoke exposure.

We analyze the CRPD’s potential to advance tobacco control goals and offer recommendations for advocates, policymakers, and others seeking to apply this approach.
Impact of Connecticut Legislation Incentivizing Elimination of Unhealthy Competitive Foods on National School Lunch Program Participation
Authors: Long Michael W. , Luedicke Joerg , Dorsey Marice , Fiore Susan S. , Henderson Kathryn E.
Published: May 2013

Objectives. We analyzed the impact of Connecticut legislation incentivizing voluntary school district–level elimination of unhealthy competitive foods on National School Lunch Program (NSLP) participation.

Methods. We analyzed data on free, reduced, and paid participation in the NSLP from 904 schools within 154 Connecticut school districts from the 2004–2005 to the 2009–2010 school year, resulting in 5064 observations of annual school-level meal participation. We used multilevel regression modeling techniques to estimate the impact of the state competitive food legislation on the count of NSLP lunches served per student in each school.

Results. Overall, the state statute was associated with an increase in school lunch participation. We observed increases between 7% and 23% for middle- and high-school meal programs, and a slight decrease of 2.5% for the elementary school free meal eligibility category, leading to an estimated revenue increase of roughly $30 000 for an average school district per school year.

Conclusions. This study provides support for national implementation of proposed rigorous competitive food standards that can improve the health of students while supporting local school district finances.
Reversible, Crosslinkable Polymer for Fluid-Loss Control
Authors: Himes R. E. , Ali S. A. , Hardy M. A. , Holtmyer M. D. , Weaver J. D.
Published: May 2013

A new, environmentally friendly polymer has been developed for use in well completion and stimulation treatments where a premium is placed on maximizing effectiveness while minimizing formation damage. This new polymer is finding uses in many operational areas such as high-permeability fracturing, gravel packing, zonal isolation pills, spacer pills, pipe line pigs, kill pills and the like. This presentation will center on its use as a low-damage, fluid loss control agent for completion operations, particularly well control during and after perforation of high-pressure, high-permeability wells.

The use of expensive, clean completion fluids is common on high-productivity, high-pressure wells to prevent the loss of productivity. High fluid loss can result in high completion cost, deep formation damage and, potentially, loss of well control; therefore, completion fluids must be effective in controlling fluid loss. A number of materials have been used for controlling fluid loss: sized particulates, viscous fluids and gelled fluids. Guar-based fluids and sized salts are commonly used due to their low cost; however, both types of systems can leave significant well damage.

Hydroxyethylcellulose (HEC) is accepted as a fluid affording minimal permeability damage during completion operations. Normally, HEC polymer solutions do not form rigid gels, but control fluid loss by a viscosity-regulated mechanism. Permeability damage has been shown to increase with increasing penetration of the viscous fluid.