bluuebunny/crossref_metadata_2025 huggingface dataset:
The awareness of amblyopia among parents in Saudi Arabia
Authors: Alsaqr Ali M. , Masmali Ali M.
Published: August 2019

Purpose:

Amblyopia is the most common cause of unilateral visual impairment. This study investigated parents’ awareness of amblyopia in different regions of Saudi Arabia.

Methods:

This was a cross-sectional population study. The survey consisted of two main sections; the first section contained 13 general background questions, and the second section (10 questions) focused on awareness of amblyopia, routine vision checks and how to raise awareness of amblyopia in the community. The survey was distributed to respondents using email and social media.

Results:

The responses of 1649 families were received. Respondents’ age range was from 22–62 years (mean ± standard deviation = 33.6 ± 8.7 years). Most respondents had no previous knowledge of amblyopia (1155 participants, 70%), and 313 participants (19%) had no idea if their children had amblyopia. In total, 990 participants (60%) did not visit the eye clinic with their children for a routine eye exam. A total of 495 parents (30%), who were aware of amblyopia, knew of it mainly from eye clinic visits and from Internet websites. A total of 140 respondents reported that their children had amblyopia; 58.3% of those children underwent routine eye examinations once a year, and the rest underwent routine eye examinations twice a year.

Conclusion:

The results clearly showed a lack of amblyopia awareness among the Saudi community. This lack of awareness can lead to visual impairment among children. More efficient efforts are urgently needed from health professionals, education centres, the media and social organizations to promote awareness of amblyopia.
Denoising with weak signal preservation by group-sparsity transform learning
Authors: Wang Xiaojing , Wen Bihan , Ma Jianwei
Published: August 2019

Weak signal preservation is critical in the application of seismic data denoising, especially in deep seismic exploration. It is hard to separate those weak signals in seismic data from random noise because it is less compressible or sparsifiable, although they are usually important for seismic data analysis. Conventional sparse coding models exploit the local sparsity through learning a union of basis, but it does not take into account any prior information about the internal correlation of patches. Motivated by an observation that data patches within a group are expected to share the same sparsity pattern in the transform domain, so-called group sparsity, we have developed a novel transform learning with group sparsity (TLGS) method that jointly exploits local sparsity and internal patch self-similarity. Furthermore, for weak signal preservation, we extended the TLGS method and developed the transform learning with external reference. External clean or denoised patches are applied as the anchored references, which are grouped together with similar corrupted patches. They are jointly modeled under a sparse transform, which is adaptively learned. This is achieved by jointly learning a subset of the transform for each group data. Our method achieves better denoising performance than existing denoising methods, in terms of signal-to-noise ratio values and visual preservation of weak signal. Comparisons of experimental results on one synthetic data and three field data using the [Formula: see text]-[Formula: see text] deconvolution method and the data-driven tight frame method are also provided.
Decreasing Time to Initiation of Chemotherapy for Patients Electively Admitted to a Hematologic Malignancy Service
Authors: Galeas Jose N. , Packer Stuart , Browne Roy , Sakalian Susan , Binder Adam F.
Published: August 2019

PURPOSE:

Delays in initiating elective inpatient chemotherapy can decrease patient satisfaction and increase length of stay. At our institution, we observed that 86% of patients who were admitted for elective chemotherapy experienced a delay—more than 6 hours—with a median time to chemotherapy of 18.9 hours. We developed a process improvement initiative to improve time to chemotherapy for elective chemotherapy admissions.

METHODS:

Our outcome measure was the time from admission to chemotherapy administration in patients who were admitted for elective chemotherapy. Process measures were identified and monitored. We collected baseline data and used performance improvement tools to identify key drivers. We focused on these key drivers to develop multiple plan-do-study-act cycles to improve our outcome measure. Once we started an intervention, we collected data every 2 weeks to assess our intervention.

RESULTS:

At the time of interim analysis, we observed a median decrease in time to chemotherapy administration from 18.9 hours to 8.85 hours ( P = .005). Median time to laboratory results resulted decreased from 3.17 hours to 0.00 hours. There was no change in time from signing chemotherapy to nurse releasing the chemotherapy. We noted that more providers were signing the chemotherapy before patient admission.

CONCLUSION:

By implementing new admission workflows, optimizing our use of the electronic medical record to communicate among providers, and improving preadmission planning we were able to reduce our median time to chemotherapy for elective admissions by 53.2%. Improvement is still needed to meet our goals and to ensure the sustainability of these ongoing efforts.
Early Findings From the Oncology Care Model Evaluation
Authors: Brooks Gabriel A. , Jhatakia Shalini , Tripp Amanda , Landrum Mary Beth , Christian Thomas J. , Newes-Adeyi Gabriella , Cafardi Susannah , Hassol Andrea , Simon Carol , Keating Nancy L.
Published: August 2019

PURPOSE:

The Oncology Care Model (OCM) is an alternative payment model administered by the Centers for Medicare & Medicaid Services (CMS) that is structured around 6-month chemotherapy treatment episodes. This report describes the CMS-sponsored OCM evaluation and summarizes early evaluation findings.

METHODS:

The OCM evaluation examines health care spending and use, quality of care, and patient experience during chemotherapy treatment episodes. Because OCM participation is voluntary, the evaluation compares participating physician practices with a propensity-matched group of nonparticipating practices by using a difference-in-differences approach. This report examines 6-month episodes initiated during the first OCM performance period (July 1, 2016, through January 1, 2017).

RESULTS:

During the first OCM performance period, there was no statistically significant impact of OCM on total episode payments. There were small declines in intensive care unit (ICU) admissions (7 per 1,000 episodes) and emergency department visits (15 per 1,000 episodes); there was no statistically significant impact on hospitalizations or 30-day readmissions. Analyses of care quality and end-of-life care showed statistically significant impacts of OCM on the proportion of patients with inpatient hospitalizations in the last 30 days of life (1.5% absolute decrease) and ICU admissions in the last 30 days of life (2.1% decrease). There was no significant OCM impact on measures of hospice use.

CONCLUSION:

Early findings from the OCM evaluation demonstrate modest program-related impacts on some acute care services and no change in total episode payments. Early findings may not reflect practice redesign efforts that were phased in after the beginning of OCM.
Lavender Products Associated With Premature Thelarche and Prepubertal Gynecomastia: Case Reports and Endocrine-Disrupting Chemical Activities
Authors: Ramsey J Tyler , Li Yin , Arao Yukitomo , Naidu Ajanta , Coons Laurel A , Diaz Alejandro , Korach Kenneth S
Published: August 2019

Context

Previous case reports associated prepubertal gynecomastia with lavender-containing fragrances, but there appear to be no reports of premature thelarche.

Objective

To add to a case series about lavender-fragranced product use and breast growth in children and to measure endocrine-disrupting chemical activity of essential oil components.

Design, Setting, and Patients

Patients experiencing premature thelarche or prepubertal gynecomastia with continuous exposure to lavender-fragranced products were evaluated in the pediatric endocrinology departments of two institutions. Mechanistic in vitro experiments using eight components of lavender and other essential oils were performed at National Institute of Environmental Health Sciences.

Main Outcome Measures

Case reports and in vitro estrogen and androgen receptor gene expression activities in human cell lines with essential oils.

Results

Three prepubertal girls and one boy with clinical evidence of estrogenic action and a history of continuous exposure to lavender-containing fragrances were studied. Breast growth dissipated in all patients with discontinuation of the fragranced products. Some of the components tested elicited estrogenic and antiandrogenic properties of varying degrees.

Conclusion

We report cases of premature thelarche that resolved upon cessation of lavender-containing fragrance exposure commonly used in Hispanic communities. The precise developmental basis for such conditions could be multifactorial. In vitro demonstration of estrogenic and antiandrogenic properties of essential oil components suggests essential oils in these cases could be considered a possible source and supports a possible link with idiopathic prepubertal breast development. Whether the level of lavender oil estrogenic potency is sufficient to cause these effects is unknown.
Mobile DNA in Endocrinology: LINE-1 Retrotransposon Causing Partial Androgen Insensitivity Syndrome
Authors: Batista Rafael Loch , Yamaguchi Katsumi , Rodrigues Andresa di Santi , Nishi Mirian Yumie , Goodier John L , Carvalho Luciani Renata , Domenice Sorahia , Costa Elaine M F , Kazazian Haig H , Mendonca Berenice Bilharinho
Published: August 2019

Context

Androgen insensitivity syndrome (AIS) is the most common cause of disorders of sex development in 46,XY individuals. It is an X-linked condition usually caused by pathogenic allelic variants in the androgen receptor (AR) gene. The phenotype depends on the AR variant, ranging from severe undervirilization (complete AIS) to several degrees of external genitalia undervirilization. Although 90% of those with complete AIS will have AR mutations, this will only be true for 40% of those with partial AIS (PAIS).

Objective

To identify the genetic etiology of AIS in a large multigenerational family with the PAIS phenotype.

Participants

Nine affected individuals with clinical and laboratory findings consistent with PAIS and a normal exonic AR sequencing

Settings

Endocrine clinic and genetic institute from two academic referral centers

Design

Analysis of whole exons of the AR gene, including splicing regions, was performed, followed by sequencing of the 5′untranslated region (UTR) of the AR gene. Detailed phenotyping was performed at the initial diagnosis and long-term follow-up, and circulating levels of steroid gonadal hormones were measured in all affected individuals. AR expression was measured using RT-PCR and cultured fibroblasts.

Results

All 46,XY family members with PAIS had inherited, in hemizygosity, a complex defect (∼1100 bp) in the 5′UTR region of the AR surrounded by a duplicated 18-bp sequence (target site duplication). This sequence is 99.7% similar to an active, long, interspersed element present on the X chromosome (AC002980; Xq22.2), which was inserted in the 5′UTR of the AR gene, severely reducing AR expression and leading to PAIS.

Conclusion

The molecular diagnosis of PAIS remains challenging. The genomic effect of retrotransposon mobilization should be considered a possible molecular cause of AIS and other AR diseases.
Carriers of a Classic CYP21A2 Mutation Have Reduced Mortality: A Population-Based National Cohort Study
Authors: Nordenström Anna , Svensson Johan , Lajic Svetlana , Frisén Louise , Nordenskjöld Agneta , Norrby Christina , Almqvist Catarina , Falhammar Henrik
Published: August 2019

Context

Congenital adrenal hyperplasia (CAH) is a common monogenic recessive disorder. It has been suggested that CYP21A2 deficiency is common because carriers may have a survival advantage, 1 in 15,000 in most populations. Carriers of CYP21A2 mutations typically do not have clinical symptoms but have a defined phenotype with a more prompt cortisol response to ACTH.

Objective

We investigated whether the mortality was lower, and determined the cause of death in carriers and population controls.

Design

A total of 1143 obligate carriers of a CYP21A2 mutation (561 men) were identified from the Swedish National CAH Registry, encompassing >700 patients and the Multi-Generation Registry to identify their parents. The mortality and cause of death were identified through the Swedish Cause of Death Registry. The hazard ratios (HRs) and 95% CIs were calculated. The results were compared with controls from the general population, matched for sex and age.

Results

The overall mortality was lower in carriers of a CYP21A2 mutation compared with the controls (HR 0.79; 95% CI, 0.678 to 0.917; P = 0.002). The difference was more marked among carriers of a more severe mutation. Infection as the cause of death was significantly lower (HR 0.65; 95% CI, 0.48 to 0.87; P < 0.01), particularly for death in pneumonia (HR 0.22; 95% CI, 0.06 to 0.88; P = 0.03). The lower overall mortality among women compared with men in the general population was confirmed among both carriers and controls.

Conclusion

Obligate CYP21A2 carriers of a classic mutation had a reduced mortality. Specifically, a possible reduced mortality due to pneumonia was seen.
Preoperative Vancomycin Administration for Surgical Site Prophylaxis: Plasma and Soft-Tissue Concentrations in Pediatric Neurosurgical and Orthopedic Patients
Authors: Brooks Peterson Melissa , Cohen Mindy N. , O’Neill Brent R. , Garg Sumeet , Child Jason , Henthorn Thomas K. , Galinkin Jeffrey G.
Published: August 2019

BACKGROUND:

Vancomycin is used for antibiotic prophylaxis in pediatric surgical patients without a complete understanding of plasma and soft-tissue pharmacokinetics. Guidelines recommend incision within 60 minutes after administration; however, tissue vancomycin concentrations at that early time may not be therapeutic. We conducted a study of plasma and skin concentrations in pediatric neurosurgical and orthopedic patients to characterize intraoperative vancomycin pharmacokinetics.

METHODS:

Patients (0.1–18.8 years of age) undergoing posterior spinal fusion (n = 30) or ventriculoperitoneal shunt placement (n = 30) received intravenous vancomycin 15 mg/kg (maximum 1000 mg) over 1 hour. Skin was biopsied at incision and skin closure. Blood samples were collected at incision, at 2 and 4 hours intraoperatively, and at closure. Population pharmacokinetic analysis was performed to characterize pharmacokinetic parameter estimates and to develop a model of intraoperative plasma and skin vancomycin concentrations versus time.

RESULTS:

Pharmacokinetic analysis included data from 59 subjects, 130 plasma samples, and 107 skin samples. A 2-compartment model, volume of the central (V

c
) and volume of the peripheral compartment (V

2
), proved to have the best fit. Stepwise covariate selection yielded a significant relationship for body surface area on elimination clearance and body weight on V

2
. Skin vancomycin concentrations rose continuously during surgery. Modeling predicted that equilibration of skin and plasma vancomycin concentrations took ≥5 hours.

CONCLUSIONS:

Skin vancomycin concentrations immediately after a preoperative dose are relatively low compared with concentrations at the end of surgery. It may be advisable to extend the time between dose and incision if higher skin concentrations are desired at the start of surgery.
Impact of heating rate on cardiac thermal tolerance in the California mussel, Mytilus californianus
Authors: Moyen Nicole E. , Somero George N. , Denny Mark W.
Published: August 2019

Intertidal communities of wave-swept rocky shores have served as a powerful model system for experiments in ecology, and mussels (the dominant competitor for space in the mid-intertidal zone) play a central role in determining community structure in this physically stressful habitat. Consequently, our ability to account for mussels’ physiological responses to thermal stress affects ecologists’ abilities to predict the impacts of a warming climate on this ecosystem. Here, we examine the effect of heating rate on cardiac thermal tolerance in the ribbed mussel, Mytilus californianus, comparing populations from high and low sites in the intertidal zone where emersion duration leads to different mean daily heating rates. Two temperature-related cardiac variables were examined: 1) the critical temperature (Hcrit) at which heart rate (HR) precipitously declines, and 2) flatline temperature (FLT) where HR reaches zero. Mussels were heated in air at slow, moderate, and fast rates, and heart rate was measured via an infrared sensor affixed to the shell. Faster heating rates significantly increased Hcrit in high-, but not low-zone mussels, and Hcrit was higher in high vs. - mussels, especially at the fastest heating rate. By contrast, FLT did not differ between zones, and was minimally affected by heating rate. Since heating rate significantly impacted high- but not low-zone mussels’ cardiac thermal tolerance, realistic zone-specific heating rates must be used in laboratory tests if those tests are to provide accurate information for ecological models attempting to predict the effects of increasing temperature on intertidal communities.
A structure-based model for the prediction of protein–RNA binding affinity
Authors: Nithin Chandran , Mukherjee Sunandan , Bahadur Ranjit Prasad
Published: August 2019

Protein–RNA recognition is highly affinity-driven and regulates a wide array of cellular functions. In this study, we have curated a binding affinity data set of 40 protein–RNA complexes, for which at least one unbound partner is available in the docking benchmark. The data set covers a wide affinity range of eight orders of magnitude as well as four different structural classes. On average, we find the complexes with single-stranded RNA have the highest affinity, whereas the complexes with the duplex RNA have the lowest. Nevertheless, free energy gain upon binding is the highest for the complexes with ribosomal proteins and the lowest for the complexes with tRNA with an average of −5.7 cal/mol/Å2 in the entire data set. We train regression models to predict the binding affinity from the structural and physicochemical parameters of protein–RNA interfaces. The best fit model with the lowest maximum error is provided with three interface parameters: relative hydrophobicity, conformational change upon binding and relative hydration pattern. This model has been used for predicting the binding affinity on a test data set, generated using mutated structures of yeast aspartyl-tRNA synthetase, for which experimentally determined ΔG values of 40 mutations are available. The predicted ΔGempirical values highly correlate with the experimental observations. The data set provided in this study should be useful for further development of the binding affinity prediction methods. Moreover, the model developed in this study enhances our understanding on the structural basis of protein–RNA binding affinity and provides a platform to engineer protein–RNA interfaces with desired affinity.
Identification and phylogenetic analysis of oral Veillonella species isolated from the saliva of Japanese children
Authors: Djais Ariadna A. , Theodorea Citra Fragrantia , Mashima Izumi , Otomo Maiko , Saitoh Masato , Nakazawa Futoshi
Published: August 2019

Background:As the most frequent infectious disease among children worldwide, dental caries have a strong relationship with oral hygiene status, specifically in the development of infection. However, the study regarding the identification and distribution of oralVeillonellaare limited. The oralVeillonellacommunity may affected by the differences in geographical location, age, diet, lifestyle, socio-economic status and oral hygiene status. Here, we studied the oral hygiene status by examining the composition and proportion of oralVeillonellaspecies in saliva of Japanese children.

Methods:Microbial samples collected from 15 Japanese children divided into three oral hygiene groups were cultured under anaerobic conditions after homogenization and dilution, and inoculated onto brain heart infusion and selective mediumVeillonellaagar. Genomic DNA was extracted from each isolate.Veillonellaspecies were detected by one-step PCR usingrpoBspecies-specific primers. To analyse the phylogenetic properties of the unknownVeillonellastrains, PCR amplification and sequence analysis ofrpoBwere conducted for 10 representative strains.

Results:AlthoughV. rogosaewas found as the predominant species among all groups, its prevalence was significantly lower in the children with poor oral hygiene than in those with good oral hygiene.V. parvulawas the prevalent species in the poor oral hygiene group. Approximately 10% of the isolatedVeillonellastrains were not classified to any established species; the phylogenetic analysis showed that they were most closely related toV.infantium

Conclusions:This study demonstrates that the composition and proportion of oralVeillonellaspecies in the saliva of Japanese children is correlated with different oral hygiene status. Changes in detection ratios ofV. parvulaandV. rogosaecan be useful indicators of oral hygiene status. Furthermore, new strains closely related toV. infantiumwere isolated from the saliva of Japanese children.
Biopolitical subjectification
Authors: Puumeister Ott
Published: August 2019

The article proposes a semiotic interpretation of the concept of biopolitics. Instead of a politics that takes “life itself ” as its object and, as a result, separates life as an object from subjects, biopolitics is read as subjectification – a governmental rationality that constructs social ways of being and forms of life, that is, social subjectivities. The article articulates this position on the basis of two concepts: Jakob von Uexküll’s umwelt and Michel Foucault’s dispositive. While the former makes it possible to show that the process of life can be conceptualized as subjectification, the latter enables us to argue against an interpretation of biopolitics as a totalized structure of power intervening directly, without semiotic mediation, into “life itself ”.
Darwin’s antithesis revisited – a zoosemiotic perspective on expressing emotions in animals and animal cartoon characters
Authors: Dydynski Jason Mario , Mäekivi Nelly
Published: August 2019

In the animation and design of cartoon characters, animators have often turned to the study of biological theories and observation of human actors and animals to capture lifelike movements and emotions more successfully. Charles Darwin’s principle of antithesis, as one of the principles he considered to be responsible for the expression of emotions in animals, would seem to be of distinctive importance in the development of animation. By revisiting Darwin’s original idea in the context of the principles of animation formulated by Thomas and Johnston, we are able to assess its application and relevance in the expressions of emotions in cartoon animal characters. The article concentrates on the emotive function of animal social communication as outlined in zoosemiotics, while taking into account that the expressions of animal characters are directed at the viewer. The principle of antithesis, as a descriptive tool, aids us in considering the diversity of modalities used simultaneously in affective communication, and serves to explicate human interpretations of the anthropomorphic and zoomorphic projections onto the behaviour of cartoon animal characters. This paper offers insight into the potential expansion and re-evaluation of unattested principles in animation, which can be utilized by animators in the creation of more dynamic and expressive animated characters.
Vygotsky’s natural history of signs
Authors: Linask Lauri
Published: August 2019

The paper organizes the topic of signs in Lev Vygotsky’s various writings into a coherent whole in order to study signs’ role in child development. Vygotsky related conventional signs that have their origin in interpersonal communication, and are subject to cultural history taking place over generations during historical time, to psychological functioning of individual human beings. Vygotsky’s “natural history of signs” is the study of how symbolic activity appears and develops. The paper outlines the process of inclusion of symbols within the behaviour of the child and gives an account of various changes in psychological functions and their interrelations that it brings along. In cultural development specifically human forms of behaviour appear, and children’s relationship to social and material environment is changed qualitatively. Vygotsky outlines the formation of sign use and analyses its developmental steps. Vygotsky’s approach explains how the use of various sign systems shapes both the cognitive processes in the person, the child, and the cognitive development as a whole. Vygotsky’s approach to signs is presented within the conceptual framework of its time.
Jakob Linzbach on his life and work
Authors: Moret Sébastien
Published: August 2019

The Estonian scholar Jakob Linzbach is primarily known for having published, in 1916, a Russian-language book with the title The Principles of Philosophical Language: An Attempt at Exact Linguistics. In this book, and in his other published and unpublished works, he aimed at creating a universal written language in which mathematics and images would mix. Linzbach’s ideas have raised awareness among people from different (scholarly) fields – semiotics, interlinguistics, philosophy, cinema theory, informatics, etc. However, not much has been published about Linzbach’s life. In one of his manuscripts kept in Tartu, there is a chapter that can be considered an autobiography and that provided, in the pencil of Linzbach himself, information about his life and work. This text is edited, translated into English and commented here for the first time.
Denying the Denial: Reappraisal of ‘Genocide’ in East Pakistan
Authors: Iqbal Husnain
Published: August 2019

The conflict in erstwhile East Pakistan, especially during 1970-1, was one of the bloodiest and most contested in the post-WWII era. While Bangladesh has always called it genocide, Pakistan has always denied both the intent and the scale of killings. This paper argues that the struggle of East Pakistanis to form their own country was reduced to a civic-political demand and not an ethnic-based claim to distinct nationalism. Revisiting Bangladesh‟s claims of genocide based on primary and archival material, this paper posits that the violence unleashed in former East Pakistan amounted to the systematic wiping out of the ethnic distinctiveness of its people through ideological, economic, political and military means. This paper contends that the recognition of the massacre in former East Pakistan during its Liberation Struggle as genocide is not only ethically demanded, but this recognition also demands a qualitative widening of the existing legal understanding of genocide.
Coffee Cultivation in Kerala: Some Economic Aspects
Authors: Karunakaran N
Published: August 2019

Coffee production in India is mostly done in Karnataka, Kerala and Tamilnadu. It is one of the important commercial crops of Keralaand is the main source of income and employment to the people of three districts in Kerala. Coffee cultivation is not an easy businessandis adversely affected by various factors at present. Small coffee growers fail to acquiretechnological improvement to compensate labour scarcity and climate change and have limited access to technologies promoted by the Coffee Board of India due to high cost and mode of payment of subsidies.This studyreveals that problems like scarcity of labour, pests and diseases, thehigh cost of production, low price for coffee, marketing difficulties and unusual climate changes often hurt coffee cultivators. However,the schemes and programmes ofthe coffee board benefited the growers. Theanalysis of the profitability of the crop shows that coffee cultivation is profitable in Kerala.
‘Little Wolf’ and the Alphabet: Nationality and its Spaces
Authors: Rassendren Etienne
Published: August 2019

This article intends to investigate the conjuncture between the birth of an alphabet, the notion of space, the migration of people, the function of belief and religion and the formation of identities. It employs Ulfilas‘ biblical translation and his missioning attitude to comment on the project of Gothic conversion to Christianity and its attendant controversies, particularly that of Arianism. The article explores how spaces become cultural geographies and imbue geo-histories, specifically in the moment of Biblical translations and the travel of people. It also argues that language and spaces cannot escape the cultural-politics of nationality. At the end, it concludes by commenting of the contemporary relevance of the conjuncture above-mentioned.
Struggles of Norm Construction in the Global Nuclear Order: An Indian Perspective on the Formative Years
Authors: Kumar A Vinod
Published: August 2019

The existence of a global nuclear order as a conglomeration of norms, regimes, and institutions seems to have brought equilibrium to the governance of the Atom. Yet, the „order‟ is dominated by the non-proliferation norm, which has curbed the spread of nuclear weapons though not their existence. The NPT, as the cornerstone treaty, to facilitate this process has faltered due to its incoherent conceptual framing and conflicting interpretations of its process and purpose. The goal of total elimination, however, has remained elusive. This article revisits the early struggles of nuclear norm construction through the perspective of an actor with multiple role identities such as a norm entrepreneur, crusader, and challenger.
Event Motivation Study of Wine Festival Visitors in Maharashtra
Authors: Kotur Kaddi Anupama
Published: August 2019

Considering the growing interest among Indian travellers in  wine  tourism  within  the  country  and  outside,  it becomes  pertinent to examine  the  wine  enthusiasts‟ consumer  psychology  in  order  to  have  a  deeper understanding of the wine tourism market in India. This study  is  conducted  with  a  three-fold  objective  of (a) Profiling  wine  festival  visitors  based  on  socio  – demographic characteristics; (b) Examining whether any motivational  differences  exist  across  male  and  female visitors of the festival; and (c)Identifying major driving factors  that  attract  visitors  to  the  wine  festival. Seven motivating factors were identified and ranked, of which, unwinding& relaxing, exploring new wines and spending time with family and friends were ranked most important motivators  for  participating  in  the  wine  festival. Friedman‟s Rank Sum Test was performed for confirming significance. In  order  to  analyse  the  motivational differences  across  male  and  female  visitors, Mann- Whitney  Test  was  used  to  test  for  any  significant differences. The socio-demographic profiles of the wine festival visitors were assessed in order to understand the market segment of wine consumers who present a high conversion  possibility  as potential  wine  tourists.  The study is aimed at forming the basis for further research on wine  tourism  management  in  Maharashtra  and  also contributing  to research  literature  in  wine  tourism  in India.
Film Induced Tourism: A Study in Indian Outbound Tourism
Authors: Mitta Nitin , Anjaneyaswamy G
Published: August 2019

It is widely believed that nothing unites India more than Cricket and Bollywood. Indian spending on foreign travel has increased to four fold as compared to that in the year 2000. While entire Europe and USA are still struggling to come out of recession, as per an estimate, Indian travellers are expected to grow to 50 million from 9 million. These statistics have enticed tourism boards across the world to find  multiple  avenues  to  have  maximum  share  of  this ever growing pie. Indian middle class is riding high on its growing  affluence, and  is  exploring  new  locales  and destinations to satisfy its craving for the distinct holiday experience.  Indian outbound market is sending strong growth  signals  to  the  Tourism  Boards  and  National Tourism  Boards  (NTBs) globally,  who  have  been experimenting for novel ways to tap this market within their  restricted resources.  Recent  studies  by  global researchers  have  established  the  positive  influence  of films,  on  people‟s  travel  decisions,  especially  to  the respective  locations and  destinations  featured  on  the silver screen. With its glossy and larger than life portrayal in the films, some of these destinations have successfully captured  the  imagination  of  movie  goers  and  enticed them to visit the places where films are believed to be shot. Unlike  the  promotional  films  made  for  tourism boards, films are considered more authentic as  coming from  a  third  party,  hence  portrayed  with  a  neutral approach. Through this paper, we have tried addressing the concerns in quantifying the impact of  film-induced tourism. We have also covered the factors responsible for hindrance  or  limiting  the  impact  on  destination promotion, which was shown in the particular film.
Perceived Risks; Prominent Dimensions among Tourists from South India
Authors: Antony Jose K
Published: August 2019

Making travel decisions is never an easy task as tourists will have to consider numerous factors revolving around time, finance, transportation, destinations and activities. Travel decisions are normally made with no expectation of any kind of economic or material returns; intangible results such as pleasure and satisfaction are expected. Therefore, the tourist consumption behavior will involve elements of risk taking. Actions of tourists will regularly yield results and consequences that they may not always be able to anticipate with any approximating degree of certainty, and some of these are at least likely to turn unpleasant. Today, tourists are rarely in a state of mind to anticipate the exact probabilities or risks associated with their purchases. Numerous dimensions of perceived risk have already been identified, such as risks associated with Age, Gender, Income, Personality, Satisfaction, Past Experience, Culture, Nationality and Destination Image. Some of these dimensions appeared more prominent than the others, namely Health Risk, Financial Risk, Time Risk, Safety and Security Risk, and Information and Communication Risk. Research on perceived risk related to tourism has most often been neglected, and in-depth studies on the same have not been extensively undertaken, especially on the South Indian tourists. In this context, the study proposes to investigate the risk perception of tourists travelling from South India.
Influence of Unregistered Homestay Establishments on Tourism in Coorg
Authors: Mathachan Silpha
Published: August 2019

This study aims to find out the perception of different stakeholders of unregistered homestays on tourism in South Coorg. The target respondents of the study are entrepreneurs running homestays, local community and tourists visiting Coorg who use homestays for the accommodation purposes. Various statistical tools are used to analyse the data collected.
SWOT Analysis of Marketing Strategies Applied by MTDC for Promotion of Maharashtra Tourism
Authors: Satghare Harshada , Sawant Madhuri
Published: August 2019

With the increasing role of the Internet in Marketing, Destination Marketing Organisations (DMOs) are focusing on the application of the Internet in destination promotion activities. The present study aims to evaluate the application of Tourism Internet Marketing Strategies by Maharashtra Tourism Development Corporation (MTDC), India. Data Triangulation Method was used for detailed understanding of the phenomenon. Further, the researchers have provided a SWOT Analysis of these strategies, which would be helpful for destination planners and marketers in improving destination competitiveness.
Sustainability Issue in Tourism: A Case Study of Yuksam Village, Sikkim
Authors: Rubita Irengbam
Published: August 2019

North  East  India  is  blessed  with  abundant  tourism resources, which are unique in their own way. The flora and fauna of this region is regarded as one of the seven most bio-diverse regions of the world. Among the States in this region, Sikkim is quite a popular destination with both the domestic and international tourists. It is perhaps the only state, where one can travel 3500 meters above the sea-level in a space of 160 km. Sikkim is thus a trekker‟s paradise,  offering  a  unique  opportunity  to  trek  to  Mt. Kangchen-Dzonga.  The  gateway  to  this  mountain  is  a small  village  called  Yuksam  in  South  Sikkim.  Trends reveal  that  Yuksam  is  in  the  developmental  stage  of increasing  growth  of  tourist  influx,  which  would  also have  implications  on  the  infrastructure,  environment, natural resources, culture and eco-tourism of this village. So  this  paper  aims  to  study  how  tourism  in  Sikkim, Yuksam in particular, can be sustained.
Conceptualizing Destination Performance Evaluation for Internal Destination Benchmarking: A Review
Authors: K Thomas Toney
Published: August 2019

Benchmarking  the  performance  of  tourism  in  a  tourist destination is an extremely complex and challenging task because  of  its  interdisciplinary  nature  and  due  to  the involvement of many sectors, components and elements. Integrating  the  different  sectors  and  synergizing  the tourism system function are major issues as the tourism industry  requires  different  levels  of  involvement  with diverse interests. Since tourism is one of the key areas of economic  transformation  in  developing  countries,  it  is essential to enhance destination image, positioning, and ultimately  to  achieve  market  leadership  which  can contribute significantly to communities and nations. It is important  to  evaluate  the  performance  of  the  tourist destination in order to stabilize the growth of tourism in the most competitive and sustainable manner. This study explains the construction of Index Core Components and performance  evaluation  methods  for  internal  tourist destination benchmarking using  literature reviews.  The findings  revealed  that  a new  conceptual  model  can  be used  by  incorporating  major  sectors,  components  and elements of tourism to measure individual performance of the selected Index Core Components.
ОСОБЕННОСТИ ПОКАЗАТЕЛЕЙ СУТОЧНОГО МОНИТОРИРОВАНИЯ АРТЕРИАЛЬНОГО ДАВЛЕНИЯ У МУЖЧИН С ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНЬЮ ЛЕГКИХ В УСЛОВИЯХ КОМОРБИДНОСТИ
Authors: Kozlov Evgeny Vyacheslavovich , Yaskevich Roman Anatolyevich , Moskalenko Olga Leonidovna , Kochergina Ksenia Nikolaevna
Published: August 2019

Цель. Изучить особенности показателей суточного мониторирования артериального давления (СМАД) у мужчин с хронической обструктивной болезнью легких (ХОБЛ) в условиях коморбидности.Материалы и методы. Обследовано 44 пациента мужского пола с ХОБЛ в сочетании с артериальной гипертонией (АГ) и 21 пациент с ХОБЛ без АГ. В группу сравнения вошло 32 пациента с АГ без ХОБЛ. Протокол исследования включал: клинические, инструментальные и лабораторные методы исследования.Результаты. Сравнительный анализ изучаемых показателей СМАД в исследуемых группах позволил выделить следующие особенности. У пациентов с ХОБЛ в условиях коморбидности выявлены более высокие среднесуточные показатели артериального давления (АД) и повышение вариабельности АД, которое может рассматриваться в качестве фактора риска неблагоприятного прогноза заболевания. Установлены статистически значимые различия по показателям величины утреннего подъема (ВУП) и скорости утреннего подъема (СУП). У пациентов ХОБЛ в условиях коморбидности преобладали патологические типы суточной кривой АД «нон-диппер» и «найт-пикер», характеризующиеся, прежде всего, недостаточной степенью ночного снижения АД.Заключение. Установлено, что у пациентов с ХОБЛ в условиях коморбидности имеются не только нарушения вариабельности АД, но и более выраженные изменения суточного профиля АД в сравнении с другими группами.
Experiences of nurses and other health workers participating in a reflective course on compassion-based care
Authors: Donald Graeme , Wilson Ian , McCarthy Jodie , Hall Ian , Crossley Brenda , Adshead Paula , Shaw Vanessa , Dunne Ross , Dwyer Trish
Published: August 2019

Background:

the risk of compassion fatigue in healthcare staff is real, especially when considering the current financial pressures. A course in compassion-based care (CBC) was delivered to mental health staff at a hospital in north-west England, with the intention of rehabilitating ward culture and, subsequently, improving patient experience.

Aims:

to explore staff experiences of participating in the CBC course.

Methods:

a qualitative study using semi-structured interviews with participants (n=12) was conducted. All staff attending the course were eligible and were invited to participate. Interview transcripts were thematically analysed.

Findings:

five themes characterising participant experience emerged from the data: meeting a need; creating the space; reorientation; prioritising self-care; and influencing team dynamics. Data overwhelmingly indicated the success of the CBC course.

Conclusion:

the CBC course appeared to have a profound effect on participants; it should be considered for further rollout and evaluation.
The inherent jurisdiction of the High Court
Authors: Griffith Richard
Published: August 2019

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the recent use of the High Court's inherent jurisdiction to protect capable but vulnerable adults at risk of exploitation, coercion or harm
Implementing the NHS Patient Safety Strategy
Authors: Glasper Alan
Published: August 2019

Emeritus Professor Alan Glasper, University of Southampton, discusses a new NHS Improvement strategy that aims to enable the health service to continuously improve patient safety
A process for developing a professional practice model with branding support from communication design students
Authors: Robbins Helen
Published: August 2019

This article discusses the development of a professional practice model (PPM) within NHS Grampian. A shared governance approach was used to develop the model, supported by the findings from a Florence Nightingale Travel Scholarship, which included visiting hospitals in Australia to explore the principles adopted by Magnet-designated organisations. The process of developing the PPM is described: this involved senior nurses and staff across various nursing, midwifery and allied health professional teams and collaborating with graphic design colleagues and communication design students. The article then describes how the model was disseminated and used across the health board in presentations, and at conferences and workshops.
Hypotension at emergency department admission and hospital-acquired pressure ulcers in older patients: prospective study
Authors: Gong Xiang , Chen Hong-Lin , Shen Jun-Hua , Zhu Bao-Feng
Published: August 2019

Objective:

To investigate the relationship between admission hypotension and hospital acquired pressure ulcers (PU) among older patients in an emergency department.

Methods:

The study was a prospective cohort conducted between March and May 2017 in the emergency department of a tertiary care hospital in Eastern China. Data on PUs and possible PU risk factors were collected using a pre-designed form. Multivariate logistic regression was used to calculate the adjusted odds ratio (OR).

Results:

A total of 157 older patients were included in the study. PU incidence was 8.3%, with 95% confidence interval (CI) of 4.5 to 13.7%. The majority (76.9%) of PUs developed in the first three days of admission. On admission, 28 patients were found to be hypotensive, and 129 non-hypotensive. In the hypotensive group, PU incidence was 21.4% (6/28), and 5.4% (7/129) in the non-hypotensive group, respectively. The crude OR was 4.753 (95%CI: 1.183 to 18.086). After adjustment by patients' age, admission to emergency intensive care unit and if requiring assistance to move, the adjusted OR of hypotension on admission for PU risk was 1.755 (95%CI: 1.356 to 3.224).

Conclusion:

Our study showed that admission hypotension was an independent risk factor of PU among elderly patients in emergency department. However, this conclusion should be confirmed by further studies with large sample size.
Implementation of NICE technology guidance on venous leg ulcers and diabetic foot ulcers: a conference report
Authors: Cowan Tracy , Milne Jeanette , Atkin Leanne , McCardle Jo , Shorney Richard
Published: August 2019

Implementation of evidence-based care is central to achieving good results. In the UK, this involves implementing guidance from the National Institute for Health and Care Excellence (NICE). Here, Tracy Cowan, JWC consultant editor, reports on a conference that outlined recently published NICE guidance on UrgoStart for treating leg ulcers and diabetic foot ulcers, and described how to incorporate this into everyday practice to drive significant cost savings and improve patient outcomes.
Detection of bacteria in burn wounds with a novel handheld autofluorescence wound imaging device: a pilot study
Authors: Pijpe Anouk , Ozdemir Yildiz , Sinnige Jan C. , Kwa Kelly A.A. , Middelkoop Esther , Meij-de Vries Annebeth
Published: August 2019

Objective:

To compare the detection of bacteria in burn wounds between an bacterial fluorescence imaging device MolecuLight i:X, (Canada), and standard microbiological swabs.

Methods:

Wounds were swabbed three times on one occasion; once with a standard swab, once with a high-fluorescent area swab, indicating a bacterial load >104 colony-forming units (CFU)/gram and a finally with a non-fluorescent (nF) area swab. Proportion agreement of the microbiological results was calculated and the accuracy of the device to detect relevant bacteria was assessed.

Results:

A total of 14 patients with 20 wounds participated in the study. Median post-burn day at sampling time was 21 days. Of the 20 wounds, nine had a positive swab result in either of the three swabs, and 11 showed a highfluorescent area. Overall, positive and negative proportion agreement between standard swab and high-fluorescent swab sample results were 100%. Sensitivity, specificity, positive and negative predictive values of presence of high-fluorescence were 78%, 64%, 64%, and 78%, respectively. For Pseudomonas aeruginosa detection, these results were 100%, 70%, 44% and 100%, respectively.

Conclusion:

The diagnostic accuracy of the bacterial fluorescence imaging device to detect relevant bacteria in burn wounds was moderate and the reliability was equal to standard swabbing. Further research in larger sample sizes and on the relevance of minimal bacterial load and its potential to help with Pseudomonas aeruginosa management is needed.