bluuebunny/crossref_metadata_2025 huggingface dataset:
Weight status of adolescents in secondary schools in port Harcourt using Body Mass Index (BMI)
Authors: Adesina Adesuwa F , Peterside Oliemen , Anochie Ifeoma , Akani Nwadiuto A
Published: July 2012

Background

Adolescent weight status is a cumulative effect of health and nutritional problems. Adolescent weight problems often go unnoticed as weight assessment is not considered a priority in adolescents.

Objectives

To determine the weight status of adolescents using BMI and to identify the contributing factors to adolescent weight problems.

Methods

In April 2010, 960 adolescents aged 10–19 years in secondary schools in Port Harcourt were selected for the study using a stratified multi-staged sampling method. Structured questionnaires were filled by the investigators while weight and height were measured. BMI was calculated using the formula weight/height2(kg/m2).

Results

The prevalence of underweight, overweight, obesity and stunting were 6.4%, 6.3%, 1.8% and 5.4% respectively. Factors which were commoner in overweight adolescents were high socioeconomic class, higher maternal education, spending > 3 hours a day watching television and frequent ingestion of snacks.

Conclusion

There is a need for periodic weight assessment of adolescents and health education to promote healthy eating habits and regular physical exercise as part of the School Health Programme.
Genome-wide analysis of the sox family in the calcareous sponge Sycon ciliatum: multiple genes with unique expression patterns
Authors: Fortunato Sofia , Adamski Marcin , Bergum Brith , Guder Corina , Jordal Signe , Leininger Sven , Zwafink Christin , Rapp Hans Tore , Adamska Maja
Published: July 2012

Background

Sox genes are HMG-domain containing transcription factors with important roles in developmental processes in animals; many of them appear to have conserved functions among eumetazoans. Demosponges have fewer Sox genes than eumetazoans, but their roles remain unclear. The aim of this study is to gain insight into the early evolutionary history of the Sox gene family by identification and expression analysis of Sox genes in the calcareous sponge Sycon ciliatum.

Methods

Calcaronean Sox related sequences were retrieved by searching recently generated genomic and transcriptome sequence resources and analyzed using variety of phylogenetic methods and identification of conserved motifs. Expression was studied by whole mount in situ hybridization.

Results

We have identified seven Sox genes and four Sox-related genes in the complete genome of Sycon ciliatum. Phylogenetic and conserved motif analyses showed that five of Sycon Sox genes represent groups B, C, E, and F present in cnidarians and bilaterians. Two additional genes are classified as Sox genes but cannot be assigned to specific subfamilies, and four genes are more similar to Sox genes than to other HMG-containing genes. Thus, the repertoire of Sox genes is larger in this representative of calcareous sponges than in the demosponge Amphimedon queenslandica. It remains unclear whether this is due to the expansion of the gene family in Sycon or a secondary reduction in the Amphimedon genome. In situ hybridization of Sycon Sox genes revealed a variety of expression patterns during embryogenesis and in specific cell types of adult sponges.

Conclusions

In this study, we describe a large family of Sox genes in Sycon ciliatum with dynamic expression patterns, indicating that Sox genes are regulators in development and cell type determination in sponges, as observed in higher animals. The revealed differences between demosponge and calcisponge Sox genes repertoire highlight the need to utilize models representing different sponge lineages to describe sponge development, a prerequisite for deciphering evolution of metazoan developmental mechanisms.
A comparative 18F-FDG PET/CT imaging of experimental Staphylococcus aureus osteomyelitis and Staphylococcus epidermidis foreign-body-associated infection in the rabbit tibia
Authors: Lankinen Petteri , Lehtimäki Kaisa , Hakanen Antti J , Roivainen Anne , Aro Hannu T
Published: July 2012

Background

18F-FDG-PET imaging has emerged as a promising method in the diagnosis of chronic osteomyelitis commonly due toStaphylococcus aureus. The inaccuracy of18 F-FDG-PET in the detection of periprosthetic joint infections may be related to the predominance of low-virulentS. epidermidisstrains as the causative pathogen. We have compared the18F-FDG-PET characteristics ofS. aureusosteomyelitis and foreign-body-associatedS. epidermidisinfections under standardized laboratory conditions.

Methods

Twenty-two rabbits were randomized into three groups. In group 1, a localized osteomyelitis model induced with a clinical strain ofS. aureuswas applied. In groups 2 and 3, a foreign-body-associated infection model induced with a clinical or laboratory strain ofS. epidermidiswas applied. A small block of bone cement was surgically introduced into the medullary cavity of the proximal tibia followed by peri-implant injection ofS. aureus(1 × 105 CFU/mL) or one of the twoS. epidermidis(1 × 109 CFU/mL) strains with an adjunct injection of aqueous sodium morrhuate. In group 1, the cement block was surgically removed at 2 weeks but left in place in groups 2 and 3 in order to mimic foreign-body-associatedS. epidermidisinfections. At 8 weeks, the animals were imaged using18 F-FDG PET/CT. The presence of bacterial infection was confirmed by cultures, and the severity of bone infections was graded by means of radiography, peripheral quantitative CT, and semi-quantitative histology.

Results

TheS. aureusstrain caused constantly culture-positive osteomyelitis. The clinicalS. epidermidisstrain resulted in foreign-body-associated infections, while the laboratoryS. epidermidisstrain (ATCC 35983) induced only occasionally culture-positive infections. There was a correlation (r = 0.645;P = 0.013) between semi-quantitative score of leukocyte infiltration and the18 F-FDG uptake in animals with positive cultures. Standardized uptake value (SUV) of the infected bones was twofold (P < 0.001) inS. aureusanimals compared withS. epidermidisanimals, but there was only a trend (P = 0.053, ANOVA) in the differences of the corresponding SUV ratios. This was due to the altered18 F-FDG uptake of the contralateral tibias probably reflecting a systemic impact of severe osteomyelitis.

Conclusion

The peri-implant inoculation ofS. epidermidis, reflecting low virulence of the pathogen and limited leukocyte infiltration, was characterized by low18 F-FDG uptake.
Identification of novel human receptor activator of nuclear factor-kB isoforms generated through alternative splicing: implications in breast cancer cell survival and migration
Authors: Papanastasiou Anastasios D , Sirinian Chaido , Kalofonos Haralabos P
Published: July 2012

Introduction

The receptor activator of nuclear factor-kB (NF-kB) (RANK)/receptor activator of NF-kB ligand (RANKL) axis emerges as a key regulator of breast cancer initiation, progression and metastasis. RANK receptor is a tumor necrosis superfamily member, which upon ligand binding transduces a variety of survival, proliferation, differentiation and migration signals. The majority of these intracellular cues merge through the NF-kB transcription machinery.

Methods

TNFRSF11A (RANK) variants were identified and cloned in mammalian expression vectors. Their expression was analyzed using real time PCR on RNA from normal tissue, cell lines and breast cancer specimens. Western blot analysis and immunofluoresence stainings were used to study expression and localization of protein isoforms in a panel of breast cancer cell lines and in transfected 293T cells. Luciferase assays were employed to assess the contribution of each isoform alone or in combinations on NF-kB activation. Isoform effect on cell survival after doxorubicin treatment was analyzed through MTT assay. Wound healing and transwell assays were employed to evaluate the effect of TNFRSF11A isoforms on migration of MDA-MB-231 and 293T cells.

Results

We report the identification of three novel TNFRSF11A (RANK) variants, named TNFRSF11A_Δ9, TNFRSF11A_Δ8,9 and TNFRSF11A_Δ7,8,9 which result from the alternative splicing of exons 7 to 9. Interestingly, variant TNFRSF11A_Δ7,8,9 was found to be upregulated in breast cancer cells lines and its expression inversely correlated with tumor grade and proliferation index. TNFRSF11A_Δ7,8,9 encodes a 40-45 kDa protein, we named RANK-c, which lacks the transmembrane domain and most of the intracellular part of the wild type receptor. Furthermore, we showed that RANK-c could act as a dominant negative regulator of RANK-dependent NF-kB activation, affecting cell survival after apoptosis induction. In addition, RANK-c suppresses cell migration and represses the tumorigenic properties of invasive breast carcinoma cells.

Conclusions

In this study, we provide evidence of a complex regulatory network of RANK receptor splice variants with a role in breast cancer. We identify that the RANK-c isoform is expressed in breast cancer samples and its expression reversely correlates with histological grade. Finally, isoform RANK-c seems to have the capacity to regulate signaling through wild type RANK and moreover to inhibit cell motility and migration of breast cancer cells.
Integration von Vorwissen über Eigenschaften von Funktionen bei der Modellbildung
Authors: Gröll Lutz
Published: July 2012

Modelle können durch Einbeziehen von Vorwissen hinsichtlich Problemadäquatheit und Statistik verbessert werden. Hierzu ist das Vorwissen in eine für die Optimierung geeignete Form zu bringen. Modelle, die durch Funktionen beschrieben werden, stehen dabei im Fokus: statische Kennlinien, Dichtefunktionen, Sprungfunktionen, Kurven und nichtparametrische Darstellungen. Methoden für punkt- und intervallweise Restriktionen, Stetigkeits-, Differenzierbarkeitsrestriktionen, von Nichtnegativität, Monotonie, Konvexität, Unimodalität sowie von Symmetrie- und Sektorrestriktionen werden vorgestellt.
Bandbreitensteigerung von piezoelektrischen Energy Harvesting Systemen durch Magnetkräfte
Authors: Westermann Henrik , Neubauer Marcus , Wallaschek Jörg
Published: July 2012

Piezoelektrische Energy Harvesting Systeme zur Nutzung von Umgebungsenergie haben in den letzten Jahren an Bedeutung gewonnen. Viele vibrationserregte Wandler erzeugen die nötige Energiemenge nur, wenn sie in ihrer Eigenfrequenz angeregt werden. Magnetische Kräfte sind eine Möglichkeit die Energieausbeute zu verbessern. Dieser Beitrag stellt verschiedene Methoden dar durch nichtlineare Magnetkräfte die Bandbreite des Energy Harvestings zu verbessern.
Vorsteuerungs-Entwurf im Frequenzbereich: Offline oder Online
Authors: Zeitz Michael
Published: July 2012

Beim Vorsteuerungs-Entwurf muss unterschieden werden, ob die Solltrajektorien wie bei einem Arbeitspunktwechsel vorab geplant oder beispielsweise mit einem Joystick in Realzeit vorgegeben werden. Im ersten Fall werden die Trajektorien für die Vorsteuerung offline entworfen und in einer Look-up-Tabelle gespeichert. Der zweite Fall ist typisch für die Trajektorienfolge in Servosystemen und erfordert, dass die Generierung der Trajektorien für die Vorsteuerung online erfolgt. In dem Übersichtsbeitrag wird der Vorsteuerungs-Entwurf beispielhaft für lineare zeitinvariante SISO-Systeme im Frequenzbereich erläutert, wobei der Offline- und der Online-Fall betrachtet werden.
A Strictly Dissipative State Space Representation of Second Order Systems
Authors: Panzer Heiko , Wolf Thomas , Lohmann Boris
Published: July 2012

This article introduces a novel way of transforming linear second order systems to first order state space models in strictly dissipative realization. This property extends the potential for the analysis of large-scale systems in many ways: it allows for the application of efficient methods for the solution of Lyapunov equations and the guaranteed preservation of asymptotic stability during model order reduction. The transformation is easy to implement and applicable to models of very high order due to its negligible computational effort.
Two photoluminescent silver(I) saccharinate complexes: The formation of a potassium-oxygen cluster, and Ag ··· π and (O—H) ··· Ag interactions
Authors: Yeşilel Okan Zafer , Günay Güneş , Semerci Fatih , Erkmen Duygu
Published: July 2012

Two new Ag(I)-saccharinate complexes, K[Ag(sac)2] · H2O (1) and [Ag(sac)(ina)] · 1.5 H2O (2) (sac = saccharinate and ina = isonicotinamide), have been synthesized and characterized by elemental analyses, IR spectroscopy, thermal analysis and single crystal X-ray diffraction. The silver atoms adopt a linear AgN2 geometry in each case defined by two sac ligands in 1, and one sac and one ina ligand in 2. In 1, the anionic complex units are linked into a two-dimensional array by two potassium atoms, forming an eight-membered bimetallic ring and a K2O10 potassium−oxygen cluster. Complex 2 shows rare (O—H) ··· Ag and (N—H) ··· Ag interactions. The molecules are connected by Ag ··· Csac (η3) interactions involväing the saccharinate-phenyl rings.
Monitoring phase behavior of hydrogen confined in carbon nanopores byin-situSmall Angle Neutron Scattering technique
Authors: Zhang Hongxin , He Lilin , Melnichenko Yuri B. , Contescu Cristian I. , Gallego Nidia C.
Published: July 2012

We report on the use ofin-situsmall angle neutron scattering (SANS) technique to study the phase behavior of hydrogen confined in narrow pores of ultramicroporous carbon (UMC) with a very large surface area (2630 m2/g) and pore volume (1.3 cm3/g). The effect of pore size and pressure on hydrogen adsorbed on UMC at room temperature and pressures up to ∼200 bar were investigated. In a previous experiment, we have measured the density of adsorbed H2gas in the nanopores and mesopores of polyfurfuryl alcohol-derived activated carbon (PFAC) by SANS technique. Here, a comparative SANS study between the UMC and PFAC was conducted in order to further investigate the densification of H2as a function of pore size and pressure. Initial results suggest that the density of confined H2in both UMC and PFAC is considerably higher than that of the bulk hydrogen gas. The density is systematically higher in the narrow pores and decreases with increasing pore size. These results clearly demonstrate the advantage of adsorptive storage over compressed gas storage and emphasize the greater efficiency of micropores over mesopores in the adsorption process, which can be used to guide the development of new carbon adsorbents tailored for maximum H2storage capacities at near-ambient temperatures.
Ritual and conversational discourse in Nahuatl: from ‘There is no drink as sweet and fragrant as this’ to ‘eat your meal!’
Authors: Farfán José Antonio Flores
Published: July 2012

Linked to a series of sociolinguistic differentials (e.g. power, cultural, conversational) materialized in specific linguistic phenomena, this paper analyzes a couple of discourse markers in Nahuatl linguistics; namely, the presence/absence of epenthetic /i/, its metathesis, and the marked use of pronominal prefixes. All these resources indexicalize different discourse genres and types of interaction together with different social positions in ritual and conversational discourse. Epenthetic /i/ has mostly been described as an obligatory segment to maintain the structure of the Nahuatl syllable, which according to existent grammatical descriptions does not allow consonant clusters. Yet as documented by this and other few works this restriction only holds for written discourse. As an overall trend, in actual oral practice the presence or absence of epenthetic /i/ manifests two different types of discourse, ranging from a highly formal (i.e. ritual) to an informal (i.e. extemporaneous) discourse. Metathesis of epenthetic /i/ is also interpreted by speakers as a marked choice towards a Nahuatl de iksaan, “ancient Nahuatl”, especially with the imperative, xi-/ ix-, whereas its deletion is conceived as the unmarked choice indexing more conversational, informal (referential or not) practices. Regarding pronouns, the shift between the first person singular bound morphemes ni- to the second person singular ti-, while addressing a second person singular, mits-, which from an external point of view could be thought as ungrammatical, also indexes different interactional treatments and power differentials, such as those concomitant to generational, gender differences and different types of discourse and interaction. All this is succinctly analyzed in this paper for the first time, theoretically advancing an interpretation that goes beyond quantitative paradigms in sociolinguistics, postulating more than, for example, an audience oriented (Bell 1984) a conversational and power approach to the variable use of language, particularly in the case of Nahuatl.
Entre iguales: notas sobre la socialización lingüística escolar del alumnado inmigrado en Barcelona.
Authors: Unamuno Virginia
Published: July 2012

Barcelona, a historically bilingual city, changed its demographic profile in the past few decades due to the arrival of a large number of immigrants. In such a context, it seemed relevant to study the socialisation procedures adopted by young newcomers to take part in sociolinguistic dynamics both in the city and at school. This meant investigating how children, as new members of the host society, learn to participate in monolingual, bilingual or multilingual situations. This paper presents part of the results steaming from a research project carried out at a primary school sited in the old quarter of the city of Barcelona. It focuses on the processes of peer linguistic socialisation; that is, between children of the same age born in the city and abroad. The analysis focuses on language choices and the use of codeswitching as a resource to index contextual changes (change of activity, participant, topic, etc.). Results reveal that language learning by children of immigrant origin is an imbricate process in which language development is related to the process of learning how to progressively appropriate and manage the linguistic patterns other children offer them. This socialisation process seems to be framed in the cultural expectations of both groups of children and in the social relations at the school and in the city.
Is there a role for inherited TR βmutation in human carcinogenesis?
Authors: Weinert Letícia Schwerz , Ceolin Lucieli , Romitti Mírian , Camargo Eduardo Guimarães , Maia Ana Luiza
Published: July 2012

Resistance to thyroid hormone (RTH) is a rare autosomal dominant inherited disorder characterized by end-organ reduced sensitivity to thyroid hormone. This syndrome is caused by mutations of the thyroid hormone receptor (TR) β gene, and its clinical presentation is quite variable. Goiter is reported to be the most common finding. A close association of TRβ mutations with human cancers has become apparent, but the role of TRβ mutants in the carcinogenesis is still undefined. Moreover, higher TSH levels, described in RTH syndrome, are correlated with increased risk of thyroid malignancy, whereas TSH receptor stimulation is likely to be involved in tumor progression. We report here an illustrative case of a 29 year-old patient with RTH caused by a mutation in exon 9 (A317T) of TRβ gene, who presented multicentric papillary thyroid cancer. We review the literature on this uncommon feature, and discuss the potential role of this mutation on human tumorigenesis, as well as the challenges in patient follow-up.
Seasonal patterns in Tree Swallow prey (Diptera) abundance are affected by agricultural intensification
Authors: Paquette Sébastien Rioux , Garant Dany , Pelletier Fanie , Bélisle Marc
Published: July 2012

In many parts of the world, farmland bird species are declining at faster rates than other birds. For aerial insectivores, this decline has been related to a parallel reduction in the abundance of their invertebrate prey in agricultural landscapes. While the effects of agricultural intensification (AI) on arthropod communities at the landscape level have been substantially studied in recent years, seasonal variation in these impacts has not been investigated. To assess the contention that intensive cultures negatively impact food resources for aerial insectivorous birds, we analyzed the spatiotemporal distribution patterns of Diptera, the main food resource for breeding Tree Swallows (Tachycineta bicolor), across a gradient of AI in southeastern Quebec, Canada. Linear mixed models computed from a data set of 5000 samples comprising >150 000 dipterans collected over three years (2006–2008) suggest that both Diptera abundance and biomass varied greatly during swallow breeding season, following a quadratic curve. Globally, AI had a negative effect on Diptera abundance (but not biomass), but year‐by‐year analyses showed that in one of three years (2008), dipterans were more abundant in agro‐intensive landscapes. Analyses also revealed a significant interaction between the moment in the season and AI: In early June, Diptera abundances were similar regardless of the landscape, but differences increased as the season progressed, with highly intensive landscapes harboring fewer prey, possibly creating an “ecological trap” for aerial insectivores. While global trends in our results are in agreement with expectations (negative impact of AI on insect abundance), strong discrepancies in 2008 highlight the difficulty of predicting the abundance of insect communities. Our study indicates that predicting the effects of AI may prove more challenging than generally assumed, even when large data sets are collected, and that temporal variation within a season is important to take into consideration. While further work is required to assess the direct impacts of these seasonal trends in Diptera abundance on bird breeding success and post‐fledging survival, management strategies in agricultural landscapes may need to consider the phenology of breeding birds and their dipteran prey in order to mitigate the potentially negative effects of AI late in the breeding season.
Intraspecific density dependence and a guild of consumers coexisting on one resource
Authors: McPeek Mark A.
Published: July 2012

The importance of negative intraspecific density dependence to promoting species coexistence in a community is well accepted. However, such mechanisms are typically omitted from more explicit models of community dynamics. Here I analyze a variation of the Rosenzweig‐MacArthur consumer–resource model that includes negative intraspecific density dependence for consumers to explore its effect on the coexistence of multiple consumers feeding on a single resource. This analysis demonstrates that a guild of multiple consumers can easily coexist on a single resource if each limits its own abundance to some degree, and stronger intraspecific density dependence permits a wider variety of consumers to coexist. The mechanism permitting multiple consumers to coexist works in a fashion similar to apparent competition or to each consumer having its own specialized predator. These results argue for a more explicit emphasis on how negative intraspecific density dependence is generated and how these mechanisms combine with species interactions to shape overall community structure.
Time for Rebirth
Authors: Budin Wendy C.
Published: July 2012

In this column, the editor of The Journal of Perinatal Education (JPE) discusses how nature works exquisitely to accomplish its intended outcomes and compares the rebirth of flowers and trees in the springtime to physiological birth. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote, support, and protect natural, safe, and healthy birth.
Teaching Physiologic Birth in Maternal–Newborn Courses in Undergraduate Nursing Programs: Current Challenges
Authors: Birkhead Ana C. Sanchez , Callister Lynn Clark , Fletcher Nicole , Holt Allison , Curtis Samantha
Published: July 2012

For low-risk childbearing women, fewer technological interventions are associated with better physical and psychosocial outcomes; yet, the number of unmedicated physiologic births is decreasing. As a result, fewer undergraduate nursing students experience caring for women who choose physiologic birth, which presents a challenge for nurse educators and implications for preparing students to provide appropriate care for all childbearing women after the students graduate. This exploratory descriptive qualitative study was conducted among 150 randomly selected undergraduate nursing programs in the United States to explore the challenges of educating nursing students about low-intervention birth. Four themes described current challenges: lack of placement opportunities, education versus clinical practice, evidence-based support of physiologic birth, and the need for more research on pedagogical strategies that effectively educate future nurses to advocate for minimal intervention birth options for all women.
Health Equity, Aboriginal Peoples and Occupational Therapy
Authors: Jull Janet E. G. , Giles Audrey R.
Published: July 2012

Background. In Canada, Aboriginal peoples are affected by colonial relations of power that result in poor health outcomes. Despite occupational therapists' efforts to work in a safe and competent manner with people experiencing challenges to participating in daily life, Western healthcare models reflect values that often undermine Aboriginal peoples' health and well-being. Purpose. Meaningful, effective, and culturally appropriate healthcare practices cannot be fully implemented by occupational therapists without an ongoing and critical examination of occupational therapy's foundational belief systems. Only a critical examination of these foundational belief systems will enable occupational therapists to take action towards addressing these inequities, which is an important step in moving towards culturally safe care. Key Issues. Canadian health professions, including occupational therapy, have the potential to create positive change at a systems level through the critical exploration of underlying professional assumptions. Implications. To advance dialogue about Aboriginal peoples' health, occupational therapists must engage in exploration of their profession's underlying theoretical concepts or risk participating in the perpetuation of health inequities for already at-risk populations.
Religious and/or Spiritual Practices: Extending Spiritual Freedom to People with Schizophrenia
Authors: Smith Sharon , Suto Melinda J.
Published: July 2012

Background. It continues to be a challenge to define and utilize spirituality in client-centred occupational therapy practice. Dialogue about spirituality is especially problematic for occupational therapists working with people with schizophrenia. Purpose. To explore the meaning of religion and/or spirituality for people living with a diagnosis of schizophrenia. Methods. Nine community-based individuals with schizophrenia engaged in interviews about the meaning of religion and/or spirituality and demonstrated self-defined spiritual practices. Phenomenology, hermeneutic theory, and a symbolic interactionism framework provided methodological and analytic guidance. Findings. Participants employed religious and/or spiritual practices to cope with schizophrenia symptoms and make meaning of their lives. Individuals used multiple systems of meaning to explain their experiences. Religious and/or spiritual agency, an individual's sense of freedom to choose among the spiritual options, renewed their sense of empowerment. Implications. Therapists can engage in spiritual negotiation with clients by using well-worded empowering questions toward a common goal of life enhancement.
Evidence-Based Practice Behaviours: A Comparison amongst Occupational Therapy Students and Clinicians
Authors: Thomas Aliki , Saroyan Alenoush , Snider Laurie M.
Published: July 2012

Background. Occupational therapy graduates are expected to demonstrate entry-level competencies in evidence-based practice. To support students during the course of professional education in developing the knowledge, skills, and attitudes for integrating scientific findings into clinical practice, educators must identify the process by which these competencies are developed. Purpose. To identify the differences in evidence-based practice decisions amongst occupational therapy students and experienced clinicians. Methods. Using a vignette depicting an older client with a history of falls, participants' evidence-based practice decisions were compared to a reference model. Results. In the initial steps of the process, knowledge of evidence-based practice concepts appeared to be dependent upon formal instruction, whereas expert-like behaviours in the integration of evidence for decision-making seemed to be a function of clinical experience. Implications. Academic and clinical educators can use identified gaps in knowledge and synthesis of concepts to update the evidence-based practice content in occupational therapy curricula and fieldwork.
Enjeux Entourant la Participation du Personnel Auxiliaire Aux Services d'ergothérapie
Authors: Guay Manon
Published: July 2012

Contexte. Dans un contexte de pénurie d'ergothérapeutes, le recours au personnel auxiliaire en ergothérapie est une idée qui ne fait pas consensus. En fait, les ergothérapeutes se retrouvent face à des options de prestation de services pour lesquelles ils sont peu informés. Objectifs. Présenter une synthèse narrative des perspectives canadiennes et québécoises du recours à «l'éventail des qualifications», c'est-à-dire la participation du personnel auxiliaire aux services d'ergothérapie, et discuter de certaines modalités de leur participation. Principaux enjeux. L'éventail des qualifications permettrait à l'ergothérapeute de transférer certaines activités cliniques au personnel auxiliaire afin de faire valoir le plein potentiel de l'ergothérapie. L'Association canadienne des ergothérapeutes et l'Ordre des ergothérapeutes du Québec reconnaissent l'apport du personnel auxiliaire et offrent des repères pour la mise en oeuvre des pratiques utilisant leur service. Conséquences. Cet article propose une réflexion critique sur ce sujet qui doit être davantage étudié.
Administration of the Canadian Occupational Performance Measure: Effect on practice
Authors: Colquhoun Heather L. , Letts Lori J. , Law Mary C. , MacDermid Joy C. , Missiuna Cheryl A.
Published: July 2012

Background. The Canadian Occupational Performance Measure (COPM) is recommended as a systematic approach to identify issues and determine client progress in occupational therapy, yet little empirical evidence is available that supports this practice. Purpose. To determine if COPM administration was associated with changes in eight dimensions of occupational therapy practice. Methods. Twenty-four occupational therapists on eight geriatric rehabilitation sites completed a before-and-after study with a repeated baseline. The eight practice dimensions were assessed after three months of usual care (no COPM use) and after three months of intervention (COPM use) using chart stimulated recall (CSR) interviews and chart audit. Findings. Mean practice scores for CSR interviews indicated a statistically significant practice improvement (p < .0001) across the eight dimensions, including knowledge of client perspective, clinical decision making, clinician ability to articulate outcomes, and documentation. Chart audit indicated that COPM use resulted in identifying more occupation-focused issues. Implications. COPM administration could improve occupational therapy practice.
Extraction of Sm(III)and Nd(III) with N,N,N’,N’-tetrabutyl-3-oxy-diglycolamidefrom hydrochloric acid
Authors: Yang J.H. , Cui Y. , Sun G.X. , Nie Y. , Xia G.M. , Zheng G.X.
Published: July 2012

The extraction behavior of Sm(III) and Nd(III) with
N,N,N?,N?-tetrabutyl-3-oxa-diglycolamide (TBDGA) in 70% kerosene-30%
n-octanol from hydrochloride acid wasstudied. The effect of hydrochloric acid
concentration, extractant concentration,and temperature on the distribution
of rare earth elementswas investigated. The extraction mechanism was
established and the stoichiometry of the main extracted species was confirm
to be SmCl3?2TBDGA and NdCl3?2TBDGA for Sm(III) and Nd(III), respectively.
The extraction distribution ratio decreases with an increase in temperature,
which demonstrates that the extraction reaction is exothermic. The IR spectra
of the loaded organic phase and free extractant were recorded and discussed.
Comparative analysis of accuracy of diagnosis of chronic periapical lesions made by clinical and histopatological examination
Authors: Mirkovic Sinisa , Tadic Ana , Djurdjevic-Mirkovic Tatjana , Levakov Aleksandra
Published: July 2012

Introduction. The preliminary diagnosis of chronic periapical lesions is made
on the basis of clinical symptoms and radiographs, which is a reliable
diagnostic tool, but it has only a subsidiary role since histopathological
verification is essential for the definitive diagnosis. This study was aimed
at diagnosing removed chronic periapical lesions and classifying them by size
as well as at comparing the clinical diagnoses with histipathological
results. Material and Methods. The study included 34 patients diagnosed with
chronic periapical process by applying clinical examination and radiography.
The removed chronic periapical lesions were processed according to classical
histological technique and analyzed by hematoxylin and eosin staining
protocol. Results. According to histopathological analysis 53% of chronic
periapical lesions were periapical granulomas and 47% were radicular cysts.
The size of the lesions ranged from < 9 mm (70% of lesions), 9 to 20 mm (18%
of lesions) and > 20 mm (12% of lesions).The histopathological examination
revealed that clinical diagnosis was wrong in 26% of cases. Conclusion. A
statistically significant difference between clinical and histopathological
diagnosis has been found. The histopathological findings strongly suggest the
necessity of complete curettage of lesions sizing > 20 mm in order to prevent
recurrences.
Pilot programme - detection of colon tumour in subjects living in the district of northern Banat
Authors: Naumov Ivana , Fenjvesi Atila
Published: July 2012

Introduction. Tumours of the colon are among the leading neoplasms in the
world as well as in Europe and our country both in the male and female
population. The study was aimed at showing the incidence of colon tumour in a
group of 300 subjects who had undergone total colonoscopy as well. Material
and Methods. The endoscopic examinations were performed by the Fujinon video
endoscopes. The faecal occult blood test was done by the original test ?ULTI
Med Products Deutschland GmbH?. The biopsy specimens were delivered to the
Pathomorphological Service to be processed and stained by the method of
Hematoksilin-eosin. Results. A group of 300 subjects, consisting of 144 men
(48%) and 156 women (52%) were examined. The indication for the lower
endoscopy in 52 patients (17.33%) was manifest bleeding. The faecal occult
blood test was positive in 79 patients (26.33). The endoscopic examination
verified 25 colon polyps (8.33%) and 14 malignant colon tumours (4.60%) in
the examined group. The endoscopy was also performed in 48 patients who had
been already operated for colon carcinoma (16%) and in 5 patients who had
undergone endoscopic polypectomy (1.66%). Specificity, sensitivity and
predictivity were calculated to be 55.8%, 63% and for positive finding 9.4%
and for negative finding 95.8%, respectively, for the Haemoccult test as
compared to the histological finding as a ?gold standard?. Discussion. The
obtained results were compared with the findings of other authors.
Conclusion. Our opinion, formed according to the obtained results and
findings of other authors, is that it is necessary to perform systematic
examination of people over 45 years of age for early detection of colon
tumour.
Effects of epidural analgesia using different concentrations of bupivacaine during combined general and epidural anesthesia
Authors: Unic-Stojanovic Dragana , Neskovic Vojislava , Ilic Ivan
Published: July 2012

Introduction. Thoracic epidural analgesia, combined with general anesthesia,
is an established anesthetic choice for abdominal aortic surgery. However,
there are controversies about the level of anesthesia as well as the dose and
concentration of the local anesthetic used. The aim of the study was to
compare the effects of two different concentrations of epidural bupivacaine
on sevoflurane requirements and hemodynamic parameters during aortic surgery
under combined epidural/general anesthesia. Methods and Material. Sixty
patients scheduled for abdominal aortic surgery were randomly divided into
two groups according to the concentration of local anesthetic used for
epidural anesthesia: - Group 1- low concentration - where 0.125% bupivacaine
was used, and - Group 2 - high concentration - where 0.5% bupivacaine was
used at the beginning and then the concentration was reduced to 0.25%.
Anesthesia was maintained with sevoflurane, the dose was adjusted to achieve
the target entropy of 40-60. The measurements included the inspired
sevoflurane concentrations, blood pressure, and heart rate at the beginning
and every 5 min during the surgery. Results. Both groups had similar heart
rate and blood pressure, but the inspired sevoflurane concentration was
significantly higher and more variable in patients where bupivacaine 0.125%
was used. Vasopressors were used more often and in higher doses in the 0.5%
bupivacaine group, and in the same group the blood loss and fluid
requirements were reduced. Conclusion. When 0.5% bupivacaine is used in
combined thoracic epidural/ general anesthesia for aortic surgery, the
sevoflurane concentrations are lower and less variable. In addition, the
blood loss and fluid requirements are reduced.
Treatment of pediatric patient with ruptured intracranial aneurysm: Case report
Authors: Meljnikov Igor , Vulekovic Petar , Cigic Tomislav , Borisev Vladimir , Milojevic Aleksandar , Idjuski Stevan
Published: July 2012

Introduction. Despite the contemporary diagnostics of intracranial aneurysms
their treatment is still a great challenge. The decision when and if to
apply a surgical or endovascular treatment of intracranial aneurysms should
be made by a team of medical specialists which consists of a cerebrovascular
neurosurgeon, neuro-radiologist and neuro-anesthesiologist. Case Report. We
report a case of a patient aged 16 who was admitted because of a sudden
intensive headache followed by sickness, vomiting, and loss of
consciousness. On admission the patient was conscious but sleepy. Glasgow
Coma Scale score was 14 and the World Federation of Neurological Surgeons
Scale grade was I. The computed tomography scan showed a massive
subarachnoid haemorrhage. The computed tomography angiography and digital
subtraction angiography revealed a ruptured saccular aneurysm in the left
vertebral artery. An early treatment with the coiling of the lumen of the
aneurysm was performed under general anaesthesia. On the tenth day the boy
was discharged in good condition and without any neurological deficits. Six
months after the intervention the patient was without symptoms and the
control digital subtraction angiography showed the complete occlusion of the
aneurysm. Conclusion. Intracranial aneurysms in children are more common in
males and are predominantly localized in the posterior circulation. In
addition, they are frequently of greater size and more complex architecture
and they are associated with a lower incidence of clinically manifest
vasospasm. According to previous experience, endovascular treatment of
intracranial aneurysms in paediatric patients has proven to be a safe and
efficient method with a small number of complications.
Posttranslational Modifications of Proteins in Type 1 Diabetes: The Next Step in Finding the Cure?
Authors: Dunne Jessica L. , Overbergh Lut , Purcell Anthony W. , Mathieu Chantal
Published: July 2012

The overall role of modification of β-cell antigens in type 1 diabetes has not been elucidated and was the focus of a recent workshop on posttranslational modification of proteins in type 1 diabetes. The prevailing opinion of the workshop attendees was that novel insights into the mechanism of loss of immune tolerance might be gained and that novel diagnostic and therapeutic approaches could be developed for type 1 diabetes if protein modifications were shown to play a critical role in the disease.
What Do Magnetic Resonance–Based Measurements of Pi→ATP Flux Tell Us About Skeletal Muscle Metabolism?
Authors: Kemp Graham J. , Brindle Kevin M.
Published: July 2012

Magnetic resonance spectroscopy (MRS) methods offer a potentially valuable window into cellular metabolism. Measurement of flux between inorganic phosphate (Pi) and ATP using 31P MRS magnetization transfer has been used in resting muscle to assess what is claimed to be mitochondrial ATP synthesis and has been particularly popular in the study of insulin effects and insulin resistance. However, the measured Pi→ATP flux in resting skeletal muscle is far higher than the true rate of oxidative ATP synthesis, being dominated by a glycolytically mediated Pi↔ATP exchange reaction that is unrelated to mitochondrial function. Furthermore, even if measured accurately, the ATP production rate in resting muscle has no simple relationship to mitochondrial capacity as measured either ex vivo or in vivo. We summarize the published measurements of Pi→ATP flux, concentrating on work relevant to diabetes and insulin, relate it to current understanding of the physiology of mitochondrial ATP synthesis and glycolytic Pi↔ATP exchange, and discuss some possible implications of recently reported correlations between Pi→ATP flux and other physiological measures.
ATLANTIC DIP: Closing the Loop
Authors: Owens Lisa A. , Avalos Gloria , Kirwan Breda , Carmody Louise , Dunne Fidelma
Published: July 2012

OBJECTIVE

Prospective evaluation of pregnancy outcomes in women with pregestational diabetes over 6 years.

RESEARCH DESIGN AND METHODS

The ATLANTIC Diabetes in Pregnancy group provides care for women with diabetes throughout pregnancy. In 2007, the group identified that women were poorly prepared for pregnancy and outcomes were suboptimal. A change in practice occurred, offering women specialist-led, hub-and-spoke evidence-based care. We now compare outcomes from 2005 to 2007 with those from 2008 to 2010.

RESULTS

There was an increase in the numbers attending preconception care (28–52%, P = 0.01). Glycemic control before and throughout pregnancy improved. There was an overall increase in live births (74–92%, P < 0.001) and decrease in perinatal mortality rate (6.2–0.65%, P < 0.001). There was a decrease in large-for-gestational-age babies in mothers with type 1 diabetes mellitus (30–26%, P = 0.02). Elective caesarean section rates increased, while emergency section rates decreased.

CONCLUSIONS

Changing the process of clinical care delivery can improve outcomes in women with pregestational diabetes.
Local Anesthetics: Review of Pharmacological Considerations
Authors: Becker Daniel E , Reed Kenneth L
Published: July 2012

Local anesthetics have an impressive history of efficacy and safety in medical and dental practice. Their use is so routine, and adverse effects are so infrequent, that providers may understandably overlook many of their pharmacotherapeutic principles. The purpose of this continuing education article is to provide a review and update of essential pharmacology for the various local anesthetic formulations in current use. Technical considerations will be addressed in a subsequent article.
Complicated Airway Due to Unexpected Lingual Tonsil Hypertrophy
Authors: Patel Aarti Bhavesh , Davidian Edward , Reebye Uday
Published: July 2012

We report an unexpected failed laryngeal mask airway in a patient with unrecognized lingual tonsil hypertrophy (LTH). A 19-year-old obese woman presented for extraction of multiple teeth via intravenous general anesthesia. Surgery was interrupted due to a laryngospasm midway through the procedure. The laryngospasm required the existing laryngeal mask airway to be removed so the patient could be suctioned. Although it is unclear the extent of obstruction caused by LTH, the surgery had to be postponed due to the discovery of enlarged lingual tonsils, which prevented endotracheal intubation. One reason for unexpected difficult airways is attributed to LTH. It is recognized that LTH is more common in patients with obstructive sleep apnea; however, LTH also has an increased prevalence in obese children with prior palatine tonsillectomies or adenoidectomies. Unexpected LTH can complicate general anesthesia by making placement of a laryngeal mask airway difficult. Thus, further research needs to be conducted to gain a deeper understanding on how to reduce the risks presented by LTH during sedation surgeries.
Dual Bougie Technique for Nasotracheal Intubation
Authors: Mahajan Rasjesh , Ahmed Parvaiz , Shafi Firdose , Bassi Rishab
Published: July 2012

We read with great interest the anesthetic technique of using a gum elastic bougie (GEB) for nasal intubation in a recent issue of Anesthesia Progress. The authors recommend the use of GEB for the first attempt of nasotracheal intubation in patients with a difficult airway. We agree that this is an excellent alternative. We also have found an excellent variation of this method that utilizes a double bougie technique for insertion of a nasotracheal tube if the difficult airway can be secured initially with an orotracheal tube.
The Effect of Anesthetic Technique on Recovery After Orthognathic Surgery: A Retrospective Audit
Authors: Chegini Soudeh , Johnston Kevin D , Kalantzis Athanasios , Dhariwal Daljit K
Published: July 2012

We audited the recovery characteristics of 51 patients who had undergone orthognathic maxillofacial surgery at a single center. Patients whose anesthesia had been maintained with intravenous propofol and remifentanil (n  =  21) had significantly higher pain scores during the first 4 hours after surgery than those whose anesthesia was maintained with volatile inhalational agents and longer-acting opioids (n  =  30) (P  =  .016). There was a nonsignificant trend towards shorter recovery times in the former group, while there were no differences in early postoperative opioid usage, hemodynamic parameters, or postoperative nausea and vomiting . Given that our data were collected retrospectively and without the ability to control for potential confounders, we interpret the results with caution. Notwithstanding these limitations, we believe this is the first report comparing the effects of different opioid-based anesthetic regimens on early recovery from orthognathic surgery, and we believe this report may be used as the starting point for a controlled study.