bluuebunny/crossref_metadata_2025 huggingface dataset:
The enigma of ‘harmful’ alcohol consumption: evidence from a mixed methods study involving female drinkers in Scotland
Authors: Gill Jan S , Rush Robert , Black Heather , O’May Fiona P , Chick Jonathan , Rees Cheryl , McPake Barbara
Published: September 2015

Background/aims:

An appreciation of the drinking patterns of population subgroups may usefully inform tailored interventions. For this purpose, research has highlighted a need to better describe the drinking behaviour of UK women. This study aims to characterise the purchasing and consumption behaviour of female heavy, harmed, drinkers in contact with Scottish health services in two cities and to explore the factors that influence the link to harm.

Methods:

Mixed methods study involving cross-sectional survey questionnaires and one-to-one interviews (5). The questionnaires documented (1) demographic data (including derived deprivation score), last week’s (or ‘typical’ weekly) consumption (type, brand, volume, price, place of purchase), self-reported illnesses, and (2) Alcohol-Related Problem Questionnaire score. A total of 181 patients with serious health problems linked to alcohol were recruited within National Health Service (NHS) hospital clinics (in- and outpatient settings), in two Scottish cities during 2012.

Results:

Median consumption was 157.6 UK units for the recorded week, with almost exclusive purchase from ‘off-sale’ retail outlets. Preferred drinks were white cider, vodka and white wine. Increasing problems was positively associated with drinking more in the week, being younger and belonging to Glasgow.

Conclusion:

For Scottish women, the current definition of ‘harmful’ consumption likely captures a fourfold variation in alcohol intake, with gender differences less apparent. While current alcohol-related harm is positively associated with dose and being younger, there is clear evidence of an influence of the less tangible ‘Glasgow effect’. Future harm concerns are warranted by data relating to pattern, alcohol dose and cigarette use.
Ebola Update
Authors: O’Keefe Louise C.
Published: September 2015

The Ebola virus disease first appeared in 1976 in the Sudan and the Democratic Republic of Congo. The most recent outbreak occurred in West Africa in March 2014 and quickly spread in surrounding countries. Ebola spreads through direct contact with the body fluids of an infected individual. The incubation period for Ebola is 2 to 21 days. Individuals are infectious when symptomatic. Identifying individuals at high risk for Ebola in the United States includes early recognition of symptoms and a history of travel to an Ebola-affected area. Multiple diagnostic tests exist and should include a complete blood count and a comprehensive metabolic profile. Standard, contact, and droplet precautions are advised when taking care of patients with Ebola. Appropriate personal protective equipment as recommended by the Centers for Disease Control and Prevention should be worn. No vaccine or antiviral drug has been approved, but vaccine trials are under way. Occupational health nurses play a key role in educating employees about this disease.
Procedural Factors That Affect Psychophysical Measures of Spatial Selectivity in Cochlear Implant Users
Authors: Cosentino Stefano , Deeks John M. , Carlyon Robert P.
Published: September 2015

Behavioral measures of spatial selectivity in cochlear implants are important both for guiding the programing of individual users’ implants and for the evaluation of different stimulation methods. However, the methods used are subject to a number of confounding factors that can contaminate estimates of spatial selectivity. These factors include off-site listening, charge interactions between masker and probe pulses in interleaved masking paradigms, and confusion effects in forward masking. We review the effects of these confounds and discuss methods for minimizing them. We describe one such method in which the level of a 125-pps masker is adjusted so as to mask a 125-pps probe, and where the masker and probe pulses are temporally interleaved. Five experiments describe the method and evaluate the potential roles of the different potential confounding factors. No evidence was obtained for off-site listening of the type observed in acoustic hearing. The choice of the masking paradigm was shown to alter the measured spatial selectivity. For short gaps between masker and probe pulses, both facilitation and refractory mechanisms had an effect on masking; this finding should inform the choice of stimulation rate in interleaved masking experiments. No evidence for confusion effects in forward masking was revealed. It is concluded that the proposed method avoids many potential confounds but that the choice of method should depend on the research question under investigation.
Applying the Bradford Hill criteria in the 21st century: how data integration has changed causal inference in molecular epidemiology
Authors: Fedak Kristen M. , Bernal Autumn , Capshaw Zachary A. , Gross Sherilyn
Published: September 2015

In 1965, Sir Austin Bradford Hill published nine “viewpoints” to help determine if observed epidemiologic associations are causal. Since then, the “Bradford Hill Criteria” have become the most frequently cited framework for causal inference in epidemiologic studies. However, when Hill published his causal guidelines—just 12 years after the double-helix model for DNA was first suggested and 25 years before the Human Genome Project began—disease causation was understood on a more elementary level than it is today. Advancements in genetics, molecular biology, toxicology, exposure science, and statistics have increased our analytical capabilities for exploring potential cause-and-effect relationships, and have resulted in a greater understanding of the complexity behind human disease onset and progression. These additional tools for causal inference necessitate a re-evaluation of how each Bradford Hill criterion should be interpreted when considering a variety of data types beyond classic epidemiology studies. Herein, we explore the implications of data integration on the interpretation and application of the criteria. Using examples of recently discovered exposure–response associations in human disease, we discuss novel ways by which researchers can apply and interpret the Bradford Hill criteria when considering data gathered using modern molecular techniques, such as epigenetics, biomarkers, mechanistic toxicology, and genotoxicology.
Six-month quality-of-life and functional status of acute respiratory distress syndrome survivors compared to patients at risk: a population-based study
Authors: Biehl Michelle , Kashyap Rahul , Ahmed Adil H. , Reriani Martin K. , Ofoma Uchenna R. , Wilson Gregory A. , Li Guangxi , Malinchoc Michael , Sloan Jeff A. , Gajic Ognjen
Published: September 2015

Introduction

The long-term attributable burden related to acute respiratory distress syndrome (ARDS) is not fully investigated. The aim of this study is to evaluate the quality of life (QOL) and functional status at 6 months after hospitalization in patients at risk for ARDS who did and did not develop the syndrome.

Method

This is a population-based prospective cohort study of adult patients from Olmsted County, Minnesota, with or at risk for ARDS hospitalized from October 2008 to July 2011. The primary outcomes were changes in QOL and functional status, measured through 12-Item Short Form Survey (SF-12) and Barthel Index (BI) respectively, from baseline to 6 months, compared between survivors who did and did not develop ARDS.

Results

Of 410 patients with or at risk for ARDS, 98 had baseline surveys collected and 67 responded to a 6-month survey (26 ARDS, 41 non-ARDS). Both ARDS and non-ARDS groups had lower physical component of SF-12 at baseline compared to general population (P < 0.001 for both). ARDS patients had poorer baseline functional status compared to non-ARDS (mean BI 80 ± 25 vs. 88 ± 22, P = 0.03). No significant differences were observed for the change between 6 months and baseline BI (delta 2.3 for ARDS vs. 2.0 for non-ARDS, P = 0.5), or mental (delta 2.7 vs. 2.4, P = 0.9) or physical (delta –3 vs. –3.3, P = 0.9) component of SF-12 between survivors with and without ARDS.

Conclusion

In this population-based study, decreased QOL and functional status 6 months after hospitalization were largely explained by baseline condition, with similar recovery in survivors who did and did not develop ARDS.
Epigenetic changes during sepsis: on your marks!
Authors: Bataille Aurélien , Galichon Pierre , Ziliotis Marie-Julia , Sadia Iman , Hertig Alexandre
Published: September 2015

Epigenetics is the study of how cells, organs, and even individuals utilize their genes over specific periods of time, and under specific environmental constraints. Very importantly, epigenetics is now expanding into the field of medicine and hence should provide new information for the development of drugs. Bomsztyk and colleagues have detected major epigenetic changes occurring in several organs as early as 6 h after the onset of a mouse model of multiple organ dysfunction syndrome induced by Staphylococcus aureus lung injury. Decrease in mRNA of key genes involved in endothelial function was found to be associated with (and potentially explained by) a decrease in permissive histone marks, while repressive marks were unchanged. We discuss here the limitations of a whole-organ as opposed to a cell-specific approach, the nature of the controls that were chosen, and the pitfalls of histone modifications as a cause of the eventual phenotype. While the use of ‘epidrugs’ is definitely welcome in the clinic, how and when they will be used in sepsis-related multiple organ dysfunction will require further experimental studies.
Dehydroepiandrosterone sulphate: diabolical hormone or epiphenomenon in aneurysmal subarachnoid hemorrhage?
Authors: Murthy Santosh B. , Naval Neeraj S.
Published: September 2015

Inflammation is purported to play an important role in the clinical course of subarachnoid hemorrhage. The current study by Höllig et al. entails using dehydroepiandrosterone sulfate, a hormone that inhibits key inflammatory pathways, as a predictor of functional outcome in these patients.
Effect of end-stage renal disease on long-term survival after a first-ever mechanical ventilation: a population-based study
Authors: Chen Chin-Ming , Lai Chih-Cheng , Cheng Kuo-Chen , Weng Shih-Feng , Liu Wei-Lun , Shen Hsiu-Nien
Published: September 2015

Introduction

Patients with end-stage renal disease (ESRDPos) usually have multiple comorbidities and are predisposed to acute organ failure and in-hospital mortality. We assessed the effect of ESRD on the poorly understood long-term mortality risk after a first-ever mechanical ventilation (1-MV) for acute respiratory failure.

Methods

The data source was Taiwan’s National Health Insurance (NHI) Research Database. All patients given a 1-MV between 1999 and 2008 from one million randomly selected NHI beneficiaries were identified (n = 38,659). Patients with or without ESRD (ESRDNeg) after a 1-MV between 1999 and 2008 were retrospectively compared and followed from the index admission date to death or the end of 2011. ESRDPos patients (n = 1185; mean age: 65.9 years; men: 51.5 %) were individually matched to ESRDNeg patients (ratio: 1:8) using a propensity score method. The primary outcome was death after a 1-MV. The effect of ESRD on the risk of death after MV was assessed. A Cox proportional hazard regression model was used to assess how ESRD affected the mortality risk after a 1-MV.

Results

The baseline characteristics of the two cohorts were balanced, but the incidence of mortality was higher in ESRDPos patients than in ESRDNeg patients (342.30 versus 179.67 per 1000 person-years; P <0.001; covariate-adjusted hazard ratio: 1.43; 95 % confidence interval: 1.31–1.51). For patients who survived until discharge, ESRD was not associated with long-term (>4 years) mortality.

Conclusions

ESRD increased the mortality risk after a 1-MV, but long-term survival seemed similar.
Catalytic Effects of Water Clusters on the Hydrolysis of Toluene-2,4-diisocyanate: A DFT Study
Authors: Yuan Yuan , Cao Jiping , Liu Yali , Shi Aijuan , Zhang Qing , Lin Xiaoxiong , Wang Mingliang
Published: September 2015

The reaction mechanism between 2,4-diisocyanatotoluene (2,4-TDI) and water clusters was carried out using density functional theory (DFT) at the B3LYP/6-311++G(d,p) level. The reaction can occur via two pathways. In path a, the 2,4-TDI reacts with water molecules by the attack across the N=C bond to form carbamic acid further decomposed into carbon dioxide and amine. In path b, the hydrolysis proceeds with the attack across C=O bond followed by a 1,3-hydrogen shift to produce carbamic acid. The calculations indicated that the additions across N=C and C=O bonds with water trimer are energetically preferred to the reaction with water dimer and monomer with the free energy barrier of 22.9 and 27.0 kcal mol−1 respectively, which is consistent with the experimental results that the pseudo-first-order rate constants of the reaction are dependent on [H2O]3. In addition, the 1,3-hydrogen shift following an attack across C=O bond is a fast process with water dimer serving as an efficient proton transporter resulting in the free energy barrier of 5.4 kcal mol−1. In the final decomposition of carbamic acid, water trimer or water tetramer shows an important role with the free energy barrier of 16.4 and 15.3 kcal mol−1 respectively. The results show that the 4-position isocyanate group of 2,4-TDI is more active than that of 2-position.
Industrial Policy and Competition
Authors: Aghion Philippe , Cai Jing , Dewatripont Mathias , Du Luosha , Harrison Ann , Legros Patrick
Published: September 2015

Using a comprehensive dataset of all medium and large enterprises in China between 1998 and 2007, we show that industrial policies allocated to competitive sectors or that foster competition in a sector increase productivity growth. We measure competition using the Lerner Index and include as industrial policies subsidies tax holidays, loans, and tariffs. Measures to foster competition include policies that are more dispersed across firms in a sector or measures that encourage younger and more productive enterprises. (JEL L11, L25, L52, O14, O25, O47, P31)
How Much of South Korea’s Growth Miracle Can Be Explained by Trade Policy?
Authors: Connolly Michelle , Yi Kei-Mu
Published: September 2015

This paper assesses the importance of trade policy reforms in South Korea, as well as the General Agreement on Tariffs and Trade (GATT) tariff reductions, in explaining Korea's growth miracle. We develop a model of neoclassical growth and trade in which lower tariffs lead to increased gross domestic product (GDP) per worker via comparative advantage and specialization, and capital accumulation. We calibrate the model and simulate the tariff reductions that occurred between early 1962 and 1989. The model can explain 17 percent of South Korea's catch-up to the G7 countries in value-added per worker in the manufacturing sector. These gains, as well as most of the welfare gains, are driven by two key transmission channels: multistage production and imported investment goods. (JEL F13, F43, L60, O47)
Labor Market Heterogeneity and the Aggregate Matching Function
Authors: Barnichon Regis , Figura Andrew
Published: September 2015

We estimate an aggregate matching function and find that the regression residual, which captures movements in matching efficiency, displays procyclical fluctuations and a dramatic decline after 2007. Using a matching function framework that explicitly takes into account worker heterogeneity as well as market segmentation, we show that matching efficiency movements can be the result of variations in the degree of heterogeneity in the labor market. Matching efficiency declines substantially when, as in the Great Recession, the average characteristics of the unemployed deteriorate substantially, or when dispersion in labor market conditions—the extent to which some labor markets fare worse than others—increases markedly. (JEL E24, E32, J41, J42)
A enfermagem nas estratégias de enfrentamento implementadas a pacientes oncológicos em cuidados paliativos: uma revisão integrativa
 doi: 10.12662/2317-3076jhbs.v3i3.162.p172-179.2015
Authors: Da Silva Silvio Eder Dias , Alves Poliana dos Santos , Araújo Jeferson Santos , Da Cunha Natacha Mariana Farias , Vasconcelos Esleane Vilela , Rodrigues Lais Ferreira
Published: September 2015

Introdução: O cuidado paliativo apresenta-se como uma abordagem assistencial que tem como objetivo promover uma melhoria na qualidade de vida dos pacientes e de seus familiares, por meio da prevenção e do alívio do sofrimento por meio de identificação precoce e tratamento da dor e outros agravos físicos e psicológicos. Objetivo: identificar como os estudos de enfermagem vem abordando as estratégias de coping ao paciente em cuidados paliativos oncológicos. Método: Trata-se de uma revisão integrativa. O material selecionado para análise foi extraído nas bases de dados National Library of Medicine (PubMed), Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS) e Cumulative Index to Nursing and Alied Health Literature (CINAHL), segundo os seguintes critérios de inclusão: artigos publicados nos idiomas português, inglês ou espanhol, artigos completos que abordem a temática em questão. Ao final do processo de seleção, foram identificados 18 artigos. Resultados: As estratégias de enfrentamento encontradas foram: realizar mudanças no cotidiano; adotar uma nova rotina de acordo com a necessidade de cuidados; manter a esperança; buscar apoio espiritual; preservar uma boa relação do familiar com o profissional de saúde; reconhecer os aspectos positivos do cuidar; valorizar o tempo restante ao lado do ente querido; praticar constantemente a autorreflexão; aceitar as delimitações do cuidado e dividir os cuidados com a equipe. Conclusão: Coping na enfermagem é recente no Brasil; ela constitui uma ferramenta indispensável para a compreensão dos problemas enfrentados pela terminalidade do câncer entre os estudos aqui analisados.
O perfil das gestantes de alto risco acompanhadas no pré-natal da policlínica de Divinópolis-MG, no biênio 2013/14
 doi: 10.12662/2317-3076jhbs.v3i3.177.p137-143.2015
Authors: Luz Bruna Gusman , Soares Luiza Toledo , Grillo Vinicius Tadeu Ramos da Silva , Viola Bárbara Magalhães , Laporte Isabella Carvalho , Bino Danuza Beatriz de Menezes , Mendonça Aline Paiva Alves de Souza , Oliveira Virgínia Junqueira
Published: September 2015

Introdução: A gestação de alto risco ocorre quando a gestante apresenta alguma doença ou condição sociobiológica que possa prejudicar a evolução da gravidez. Objetivos: Objetivou-se traçar o perfil das gestantes de alto risco atendidas em uma cidade de Minas Gerais. Métodos: Foi realizado um estudo descritivo, observacional, de caráter transversal, com abordagem quantitativa, realizado na Unidade de Obstetrícia da Policlínica Municipal de Divinópolis-MG, no período de março de 2013 a fevereiro de 2014. Os dados foram obtidos por meio de um questionário aplicado na consulta puerperal e complementados com a investigação do prontuário e do cartão da gestante. Resultados: Das 218 gestantes acompanhadas no serviço, apenas 52 retornaram à consulta puerperal. A maioria das gestantes eram multigestas (65,5%) e não referiram aborto prévio (73,1%); somente 30,8% foram admitidas precocemente e os diagnósticos mais frequentes foram Diabetes Mellitus Gestacional (23,1%), pré-eclâmpsia (21,2%) e disfunção tireoidiana (13,5%). A maior parte teve o parto a termo (82,7%) e cesariana (59,6%). Destaca-se que 88,5% e 96,2% das mulheres não foram submetidas ao exame de colpocitologia oncótica e das mamas, respectivamente. Conclusões: Deve-se alertar para a necessidade de aprimoramento da atenção à saúde da gestante, com a realização dos exames preventivos rotineiramente, indicação mais precisa da cesariana e educação das gestantes com relação à importância da consulta puerperal.
Influenza em pacientes com doenças cardíacas crônicas: o que há de novo?
 doi: 10.12662/2317-3076jhbs.v3i3.200.p165-171.2015
Authors: Bricks Lucia Ferro , Carvalhanas Telma Regina Marques Pinto , Domingues Carla Magda Allan Santos , Pereira Sirlene Fatima , Bellei Nancy Cristina Junqueira
Published: September 2015

Introdução: A influenza é uma doença infecciosa altamente transmissível, de distribuição global e que tem alto impacto na saúde pública. De acordo com a OMS, anualmente são registrados de três a cinco milhões de casos graves, que resultam em, aproximadamente, 0,25 a 0,5 milhão de mortes em todo o mundo. Indivíduos com doenças crônicas apresentam alto risco e complicações e morte e estão entre os grupos alvo para vacinação anual. Entretanto, as coberturas vacinais estão abaixo das preconizadas pela Assembleia Mundial da Saúde e OMS. Objetivo: Este texto é uma revisão não sistemática da literatura, com o objetivo de apresentar as informações mais recentes sobre os riscos da influenza e benefícios da vacina contra influenza em pacientes portadores de doenças cardíacas crônicas. Métodos: Levantamento dos artigos publicados sobre o tema no PUBMED, SCIELO e sites da OMS, PAHO e CDC, assim como as informações do Ministério da Saúde, no período de janeiro de 2000 a dezembro de 2014. Resultados: De um total de 143 artigos identificados sobre o tema, foram selecionadas 56 referências para esta revisão. Grande parte dos estudos, recentemente publicados, aponta para uma forte associação entre influenza e risco de complicações e morte por doença cardiovascular. Embora a vacina seja recomendada para cardiopatas, as coberturas vacinais são baixas na maioria dos países. Conclusões: É necessário conscientizar os profissionais de saúde e a população sobre os benefícios da vacinação.
Cytotoxic granule secretion by lymphocytes and its link to immune homeostasis
Authors: de Saint Basile Geneviève , Sepulveda Fernando E. , Maschalidi Sophia , Fischer Alain
Published: September 2015

The granule-dependent cytotoxic activity of T and natural killer lymphocytes has progressively emerged as an important effector pathway not only for host defence but also for immune regulation. The analysis of an early-onset, severe, primary immune dysregulatory syndrome known as hemophagocytic lymphohistiocytosis (HLH) has been decisive in highlighting this latter role and identifying key effectors on the basis of gene mutation analyses and mediators in the maturation and secretion of cytotoxic granules. Studies of cytotoxicity-deficient murine counterparts have helped to define primary HLH as a syndrome in which uncontrolled T-cell activation in response to lymphocytic choriomeningitis virus infection results in excessive macrophage activation and inflammation-associated cytopenia. Recent recognition of late-onset HLH, which occurs in a variety of settings, in association with hypomorphic, monoallelic mutations in genes encoding components of the granule-dependent cytotoxic pathway or even in the absence of such mutations has broadened our view about the mechanisms that underlie the perturbation of immune homeostasis. These findings have led to the development of a model in which disease occurs when a threshold is reached through the accumulation of genetic and environmental risk factors. Nevertheless, validation of this model will require further investigations.
Colonoscopy in patients with inflammatory bowel disease: self-reported experience, understanding, anxieties and tolerance of the procedure
Authors: Morgan Samantha , Alexakis Christopher , Medcalf Lucy , Chhaya Vivek , Neild Penny , Poullis Andrew , Pollok Richard
Published: September 2015

Objective: To address Inflammatory Bowel Disease (IBD) patients’ attitudes, understanding and tolerance of colonoscopy and assess whether there are specific factors that influence these parameters.

Design: structured questionnaire-based survey. Tolerance of various aspects of colonoscopy procedure graded on a scale 1-5, 5 representing most intolerance/burden (worries/concerns about the procedure/risks, bowel preparation, disruption to life, procedural discomfort and travel concerns).

Setting: London teaching hospital - St Georges Hospital

Patients: Consecutive patients with established IBD attending the specialist IBD clinic

Results: 98 patients responded (46% male). Mean age was 43.2 years. 33 had Ulcerative Colitis (UC), 50 had Crohn’s Disease (CD), and 11 were unsure of diagnosis. Mean number of colonoscopies was 3.7. Females were more worried about the procedure than males (3.0 vs 2.1, p<0.05), were less tolerant of bowel preparation (3.5 vs 2.3, p<0.05), experienced more disruption to their lives (2.9 vs 1.9, p<0.05) and were more troubled by travel concerns (2.0 vs 1.4, p<0.05). Patients with the disease for ≥ 5 years experienced significantly more discomfort than patients with the disease for a shorter duration (3.2 vs 2.7 p<0.05). Patients aged ≥55 years are significantly less worried about the procedure (2.7 vs 2.0, p = <0.05) and tolerate the bowel preparation better (3.1 vs 2.4, p = <0.05). The majority of the patients felt colonoscopy was ‘bearable’ (53%) with only 13% describing it as ‘very unpleasant’. 55% would have the procedure ‘as frequently as required’ if their physician felt it appropriate.

Conclusions: Our research highlights a significant difference in the perception of colonoscopy by gender and age. Overall our findings reveal a preparedness to undergo colonoscopy as required despite an increasing requirement for this test. The differences highlighted should prompt endoscopy units to accommodate and make allowances for these different perceived tolerance in routine clinical activity.
Predictors of psychiatric rehospitalization among elderly patients
Authors: Wong Chun Yin Terry
Published: September 2015

The population of Hong Kong and the proportion of elderly people have been increasing rapidly. The aim of this retrospective cohort study is to determine predictive factors for psychiatric rehospitalization within 2 years among elderly patients who were discharged from psychiatric wards, in attempt to reduce their rehospitalization rate and to reintegrate them into the community. Patients aged 65 and over, who were discharged from psychiatric wards of Pamela Youde Nethersole Eastern Hospital from 1 March 2010 to 29 February 2012, were identified. Rehospitalization within 2 years after discharge was the primary outcome measure, and the time to rehospitalization was measured as the secondary outcome. Patients were subgrouped into readmitted and non-readmitted groups. Logistic regression and Cox regression analyses were applied to the potential predictive factors with odds ratios and hazard ratios obtained, respectively, for the significant findings. Kaplan-Meier survival curves were plotted for graphical representation of the study results in survival analysis. 368 individuals satisfying the study criteria were identified. The same four factors were shown to be significantly associated with rehospitalization in both multiple logistic regression and Cox regression survival analysis. Referral to other psychiatric disciplines upon discharge (p< 0.001, OR=0.325, HR=0.405) was associated with a lower rehospitalization risk and correlated to a longer time to rehospitalization. History of suicidal behaviors (p< 0.001, OR=4.906, HR=3.161), history of violent behaviors (p< 0.001, OR=5.443, HR=3.935) and greater number of previous psychiatric admissions (p< 0.001, OR=1.250, HR=1.121)  were associated with a higher rehospitalization risk and predicted earlier rehospitalization. The rehospitalization rate of elderly patients was 5.2% at 1 month, 9.5% at 3 months, 15.0% at 6 months, 17.1% at 1 year, 18.8% at 1.5 year and 20.9% at 2 years.
The triangle of impossibility versus possible modifications of the Polish exchange rate regime during the preparations for the Euro currency’s adoption
Authors: Madrak-Grochowska Małgorzata
Published: September 2015

The main objective of this paper is to analyze whether and how the Polish exchange rate regime should be modified before Zloty’s adoption to European Rate Mechanism II (ERM II). Possible solutions (it means: currency board, managed floating and adjustable peg) are presented as different nodes of the triangle of impossibility. The conducted research leads to the conclusion that neither currency board nor dirty floating can provide appropriate base for the calculation of the Zloty/Euro central rate. It seems the temporary introduction of adjustable peg, which allows to adjust Polish exchange rate regime to the rules of ERM II in gradual way would be the best solution. Moreover, this option provides The National Bank of Poland with the ability to intervene with the currency market in order to achieve economic stabilization. However, adjustable peg is a good solution for our country as long as both monetary and fiscal authorities cooperate and unify their policy regarding entering the ERM II. Only then can Poland meet all of the convergence criteria.
The strategy of direct inflation targeting – experiences of the countries of Middle-East Europe
Authors: Zbierzchowska Dorota
Published: September 2015

This paper aims at presenting theoretical assumptions of the strategy of direct inflation targeting as well as profits and potential threats stemming from the acceptance of that strategy. Empirical analysis compares the results of implementation of the BCI strategy in the Central and Eastern European countries (Poland, Czech Republic, Romania, Slovakia, Hungary).
The influence of the foreign direct investments on the regional disproportions in Poland
Authors: Ozga Michał
Published: September 2015

The foreign direct investments (FDI) have positive influence on the economy of regions, as such investments cause the inflow of innovative technologies and new management techniques and create new work places. Foreign direct investments contribute to the economic growth of Poland. This article explains the importance of the FDI for the economy of regions, presents the differentiation in the volume of foreign direct investments in different voivodships of Poland and shows the influence of these investments on the disproportions between provinces of Poland. This article also presents the dependence of the macroeconomics indicators on foreign direct investment.
Public expenditure in agriculture in Poland in the years 2001-2008 from regional perspective
Authors: Kołyska Justyna , Baran Joanna
Published: September 2015

The aim of the article is to present the size and dynamics of public funding assigned to agriculture in Poland in the years 2001-2008. The analysis exerted significant regional disparity (diversity) in distribution of public financial funds to individual voivodships. The largest amounts of budgetary funds were assigned to the regions characterized by the largest scale of agricultural activity.
Investments within the areas of special economic zones and creation of long term economical growth
Authors: Pastusiak Radosław
Published: September 2015

In the age of global economy, the possession of unique knowledge and high specialization skills is the key to progress. Under such circumstances, running a business means gaining competitive advantage, especially in terms of intellectual potential. Five sectors: high-tech industry, R&D, education, business services and information technology play the main role in building of the new economy, this is of course due to investments. For developing countries, the main way to attract investors is to a establish special economic zone. The author of the article explores the idea whether investments in SEZ can be a basis for stable long term GDP growth.
The Home Bias in the Process of European Integration
Authors: Kozłowska Anna
Published: September 2015

This article aims to identify the relationship between the phenomenon of home bias and the process of European integration. During the past decades, European integration has evolved from a Common Market and the Customs Union, the Internal Market and Economic, and Monetary Union. Despite the improvements in integration of European markets, their potential is not fully exploited. Countries consumption baskets and inwestment portfolios still contain a predominant share of domestically produced products and domestic assets and national-born workers working in national labour markets. This is commonly known as the phenomenon of home bias.
Problems of Patent Protection in Poland
Authors: Turczak Anna
Published: September 2015

In modern economy the effective intellectual property management has huge influence on the competitiveness and commercial success of the enterprise. Patents granted favour keeping the competitive advantage, improving reputation of the firm and rising its market value. In Poland the awareness of advantages concerning patent protection of inventions is very low. Polish firms make few applications, while small and medium size enterprises make such applications hardly ever. Therefore the large-scale activities aiming at enlarging the entrepreneurs’ knowledge concerning the possibilities to obtain the legal protection for their innovative solutions are necessary. All significant procedural barriers that occur in the process of gaining and claiming protection rights should be also eliminated, with the most irritating one which is too long time for examining the cases by courts and adjudicating possible disputes. The aim of the article is to highlight the most important problems that one has to face if one wants to grant and enforce the patent protection in Poland. Particularly the arguments for and against patenting inventions are presented, requirements that patented invention has to fulfil, problems to claim already existing protection and reasons to patent inventions abroad.
Environmental Management in Germany
Authors: Szymańska-Brałkowska Małgorzata
Published: September 2015

The article raises the problem of environmental management in Germany. Its main research field is focused on environmental management systems (EMS) certified according to ISO 14001 and on Ecology Management and Audit Scheme – EMAS. The main target of this paper is to analyse how EMS operate in German economy and to evaluate the role of ecological initiatives among companies dealing with various aspects of global economic and environmental issues. The article underline German strong economic performance that leads to generating approximately 20% of EU’s GDP. That makes German economy one of the strongest among the EU Member States. The research shows that the environmental management plays an important role for German companies and organisations. The high rate of ISO 14001 implementations (4 877 in the end of 2007) gives Germany fourth rank in Europe and eight place globally. Whereas the evaluation of companies that took part in EMAS shows Germany as a leading country in this research field (1417 companies and organisations in 2009). The analysis carried through this research underlines the high importance of environmental management in German economy and among the companies. Moreover it shows the increasing significance of environmental CSR as a way of competing on global market, improving company’s image and fitting to global economic and environmental demand. Improving company’s environmental performance by implementation of environmental management conduct to cost reduction and rationalisation of its organisation. Therefore it is appropriate way of dealing with the global economic crisis and environmental questions.
The Utility of Zero-Inflated Models in the Estimation of the Number of Accidents in the Automobile Insurance Industry
Authors: Melgar Marija Del Carmen , Ordaz Jose Antonio
Published: September 2015

The main purpose of the present paper is to provide an econometric model which estimates the number of automobile accidents that policyholders declare to their insurance companies, pointing out those variables that are significant in this process. Our empirical analysis is based on the data supplied by a private insurance company that operates in Spain, and on the zero-inflated count data models as methodology. We find a positive association between the levels of coverage and the accident rates, suggesting the existence of problems related to adverse selection and moral hazard. This result is one of the most important conclusions of our work and confirms the theoretical aspects pointed up by other empirical studies in the literature. Additionally, estimating the number of policyholders that suffered any accident but not declared, and how many these non-declared accidents are, could be very useful information for insurers to evaluate their risk planning. Our model attempts to reach this target as well.
The efficiency of monetary policy instruments of the European Central Bank in liquidity regulating in euro area
Authors: Pietryka Ilona
Published: September 2015

Mechanism of forming of liquidity level of national central banks participating in ESCB is clear. It is based on centralized and decentralized operations. The ECB decides on the direction of monetary policy, and the national central banks implement monetary policy taking into account those guidelines as well as the conditions of their country. The aim of the paper is to estimate the efficiency of the EBC monetary policy in regulating the liquidity of the banking system in euro area. The aim was achieved by characterizing the organizational and balance relationship banks of the Eurosystem because of this regulation. Special accent was placed on monetary policy instruments, which are created by national central banks and they form liquidity of the euro area.
Comparison of public, non-profit and private hospitals
Authors: Held Barbel
Published: September 2015

The health care system in Germany is undergoing a phase of transformation. The resulting challenges and fields of action for the hospitals were described as one outcome of a scenario analysis conducted by the author. These include, for example, setting up new organisation structures, professionalising management competence or also developing a comprehensive quality management system. In the following analysis, the hospitals are to be described and compared to one another in terms of their initial conditions regarding these fields of action. The question at the focus is which different prerequisites and options the clinics have subject to their organisational structure.
The application of epic3 guidelines: the complexity of practice
Authors: Cole Mark
Published: September 2015

Healthcare-associated infection (HCAI) is a major patient safety concern and is associated with morbidity, mortality and increased healthcare costs. Prevention and control requires a multi-modal approach, but the individual's accountability and rigorous application of standard infection prevention and control behaviours is at its core. The third instalment of the epic3 guidance ( Loveday et al, 2014a ) provided the evidence and advanced the importance of hand-hygiene behaviour, the use of non-sterile gloves and environmental cleanliness. This discussion considers some of the recommendations made in these areas of practice and some of the underlying complexities. Producing guidelines based on the best available evidence and transforming them into policies can be a useful adjunct to communicating the necessary standards. However, policies often erase the complexity of implementation. To strive for the best possible standard is an understandable and laudable objective, but organisations need to be mindful of the difficulties and obstacles that stand in their way, particularly in an era where the philosophy of ‘zero tolerance’ is gaining popularity.
Letter to the Editor
Authors: Smith Jackie
Published: September 2015

The editorial in BJN 24(15) written by BJN Editor in Chief, Ian Peate, challenged the Nursing and Midwifery Council's (NMC) Chief Executive and Registrar's assertion that the progress her organisation has achieved over the past 12 months is something to be ‘delighted’ about. The NMC responded and their letter is below.

If you would like to comment on the issue email us: bjn@markallengroup.com
The impact of nurse prescribing on the clinical setting
Authors: Creedon Rena , Byrne Stephen , Kennedy Julia , McCarthy Suzanne
Published: September 2015

Aim:

To investigate the impact nurse prescribing has on the organisation, patient and health professional, and to identify factors associated with the growth of nurse prescribing.

Methods:

Systematic search and narrative review. Data obtained through CINAHL, PubMed, Science direct, Online Computer Library Centre (OCLC), databases/websites, and hand searching. English peer-reviewed quantitative, qualitative and mixed-method articles published from September 2009 through to August 2014 exploring nurse prescribing from the perspective of the organisation, health professional and patient were included. Following a systematic selection process, studies identified were also assessed for quality by applying Cardwell's framework.

Results:

From the initial 443 citations 37 studies were included in the review. Most studies were descriptive in nature. Commonalities addressed were stakeholders' views, prescribing in practice, jurisdiction, education and benefits/barriers.

Conclusions:

Prescriptive authority for nurses continues to be a positive addition to clinical practice. However, concerns have emerged regarding appropriate support, relationships and jurisdictional issues. A more comprehensive understanding of nurse and midwife prescribing workloads is required to capture the true impact and cost-effectiveness of the initiative.
Technology and the issues facing nursing assessment
Authors: Ansell Helen , Meyer Alannah , Thompson Shona
Published: September 2015

This article describes an investigation into the use of technology and the issues nurses face undertaking nursing assessment. It reports qualitative, descriptive research involving interviews with ten ward nurses from three hospitals in New Zealand. Thematic analysis of the data revealed three key issues: the impact of technology, the influence of early warning systems and nurse autonomy. Results show how clinical decision making around nursing assessment is influenced by technology and the Early Warning Score. These clinical decisions may not always be informed by critical thinking in complex healthcare environments. The article concludes that nurse autonomy, while supported and endorsed in theory, is frequently in conflict with hospital risk-management policies and the use of prescriptive algorithms.
Patient information: confidentiality and the electronic record
Authors: Griffith Richard
Published: September 2015

The rise of the electronic record now allows nurses to access a large archive of patient information that was more difficult to obtain when records consisted of manually held paper files. There have been several instances where curiosity and, occasionally, more malicious motivations have led nurses to access these records and read the notes of a celebrity or a person they know. In this article, Richard Griffith considers whether nurses' accessing and reading of the record of someone who is not in their care is in breach of their duty of confidentiality.
Examining the role of personal traumas in a nurse's work life
Authors: Mendes Aysha
Published: September 2015

In this monthly column, Aysha Mendes discusses the impact a nurse's personal traumas can have on his or her nursing practice, professional and personal experience of caring, and on patients and their families
Psychosocial impact of intestinal failure: a familial perspective
Authors: Cadogan Jane
Published: September 2015

Intestinal failure is a complicated long-term condition that can have profound physical and psychosocial consequences for a patient's life. Hospitalisation can be long, with many distressing and unpleasant medical procedures being endured. Patients often have to deal with large volumes of unmanageable faecal fluid from stomas or fistulae and usually require home parenteral nutrition (HPN) for the remainder of their life. The literature focuses on how patients often have to tolerate long periods of suffering, which can be the basis for significant emotional anguish. It also addresses how the condition can contribute to myriad psychosocial difficulties, which can have devastating effects on their body image and quality of life. However, there is a lack of information regarding the effects of this condition on the family, who not only have to provide ongoing support for the patient, but also have to attempt to function normally while coping with their own fears and emotions. This article reviews the experiences of two patients, father and daughter, living with intestinal failure; it discusses their experiences and reveals how they cope with the physical aspects. It also addresses how the condition can effect psychosocial disturbances, not only for them but for those living closely with them. The article addresses ways that nurses could develop their relationship with the patient, enabling them to recognise and act early on signs of emotional malady.
Medication adherence in chronic obstructive pulmonary disease
Authors: Duncan Deborah
Published: September 2015

Non-adherence to prescribed medications in chronic obstructive pulmonary disease is a common problem. Deborah Duncan explores the reasons behind this and how practice nurses can help
Clinical decision making in minor illness
Authors: Odell Jennifer
Published: September 2015

Advanced clinical decision making is required to manage minor illness in primary care. Jennifer Odell explores the skills needed
The mediatisation of university governance: a theoretical and empirical exploration of some side-effects
Authors: Friedrichsmeier Andres , Marcinkowski Frank
Published: September 2015

This paper is concerned with analysing potential negative effects of mediatisation of university governance in Germany. Among others, mediatisation reflects a change in expectations on how higher education institutions (HEI) should relate to the public. We start with an exploration of two sets of developments that spawned this change of expectations. On the one hand, the policy idea of a trend to a knowledge society affected what public contributions are expected of HEI. On the other hand, reforms to decentralise HEI-governance compelled universities to orient themselves more directly towards the demands of external stakeholder. Both developments reinforce each other, both are associated with extended needs for actor intermediation, and for consolidating means of orientation. Since performance figures and competition solely allow for a partial mapping of society’s demands and needs, HEI and state administrators alike can be expected to make additional use of the public discourse to evaluate comparatively a multitude of demands and expectations. This results in what we call a model of mediatised university governance. Since the media discourse on higher education is strongly biased towards news values, this type of governance bears a potential for unintended side effects. In the second part of the paper, two empirical illustrations of side effects are discussed. First, the role of media attention in accidentally reinforcing a reputational mismatch of teaching and research is investigated. For a second case, we focus on an overstretching of the information value of media-effective rankings for decision making. The cases draw upon survey data, semi-standardised expert-interviews and content analysis of news media coverage.
The limitations of quantitative social science for informing public policy
Authors: Jerrim John , de Vries Robert
Published: September 2015

Quantitative social science (QSS) has the potential to make an important contribution to public policy. However it also has a number of limitations. The aim of this paper is to explain these limitations to a non-specialist audience and to identify a number of ways in which QSS research could be improved to better inform public policy.