bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and Radiographic Outcomes of the Mobility Total Ankle Arthroplasty System
Authors: Sproule J. A. , Chin T. , Amin A. , Daniels T. , Younger A. S. , Boyd G. , Glazebrook M. A.
Published: February 2013

Background:

The Mobility Total Ankle System is a third-generation design consisting of a 3-component, cementless, unconstrained, mobile-bearing prosthesis. This study reports the early results of a prospective multicenter study of the Mobility prosthesis.

Methods:

Eighty-eight Mobility total ankle arthroplasties (TAAs) were implanted in 85 patients. The most common underlying diagnosis was posttraumatic arthritis (53%). Ankles were classified according to the Canadian Orthopedic Foot and Ankle Society (COFAS) end-stage ankle arthritis classification system. Coronal plane deformity was quantified preoperatively. Patients were reviewed at regular intervals postoperatively, with clinical and radiographic assessment. The mean follow-up time was 40 months (range, 30-60 months).

Results:

Type 1 ankle arthritis was demonstrated in 44 ankles (50%). No patient had preoperative coronal plane angulation greater than 20 degrees. In 32 ankles (36%) the preoperative coronal alignment was neutral, and in 34 ankles (39%) the deformity was less than 10 degrees. The mean American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score improved from 38.2 (range, 12-59) preoperatively to 74.8 (range, 46-100) postoperatively. Bone-implant interface abnormalities were identified in 33 ankles with a retained prostheses (43%). Thirty (91%) of these involved zones around the tibial plate. In total, 8 TAAs required revision, 6 for aseptic loosening, 1 for talar migration, and 1 for deep infection. There was 1 conversion to arthrodesis for component malpositioning and 1 transtibial amputation for chronic regional pain syndrome. Six patients were being investigated for ongoing pain. The cumulative survival was 89.6% (95% confidence interval, 80.8-94.8) at 3 years and 88.4% (95% confidence interval, 79.3-93.9) at 4 years.

Conclusion:

Early results of the Mobility TAA for independent researchers do not match those reported by other surgeons. Good pain relief and improved function were achieved postoperatively in 72 ankles (82%). High rates of bone-implant interface abnormalities around the tibial plate are concerning but require longer follow-up to determine their clinical significance.

Level of Evidence:

Level IV, case series.
Radiographic Factors and Effect of Fifth Metatarsal Jones and Diaphyseal Stress Fractures on Participation in the NFL
Authors: Carreira Dominic S. , Sandilands Scott M.
Published: February 2013

Introduction:

Jones fracture and proximal diaphyseal stress fracture of the fifth metatarsal have been associated with prolonged healing times and nonunions. We hypothesized that the Jones fracture and proximal diaphyseal stress fracture have a high incidence in elite collegiate football players and that they lead to a decrease in participation in the NFL. Also, we hypothesized that these fractures are associated with a cavovarus foot alignment.

Materials and Methods:

The database collected by a single NFL team during the 2004 to 2009 NFL Combines was reviewed to identify players with Jones and proximal diaphyseal fifth metatarsal fractures. A total of 74 fifth metatarsal fractures were identified in 68 players. Subsequent participation data also were collected through the NFL.com website and included games played and years played. Digital plain radiographs and additional imaging studies also were reviewed to determine the extent of healing, types of fixation utilized, and foot alignment.

Results:

The locations of fractures in the proximal fifth metatarsal were 45 (61%) in the Jones area, 15 (20%) in the proximal diaphyseal area, and 14 (19%) of indeterminate location. The number of patients treated with intramedullary fixation was 55/74 (74%). Of 74 proximal fifth metatarsal fractures, 9 (12.2%) were nonunions at the time of the NFL Combine medical examinations. With the numbers available, the average number of games played in the NFL was not significantly different in the fifth metatarsal fracture group, 16.9, compared to the control group, 24.9 ( P > .05). The average number of games started was 7.4 in the fracture group versus 12.1 in the control group ( P > .05). No significant differences were noted in the number of years played in the NFL. Except for talonavicular angle measurements, all measurements of coronal plane alignment demonstrated significant differences across groups, but no differences were noted in sagittal plane alignment.

Conclusion:

No statistically significant difference was noted in participation in the NFL following Jones fractures and proximal diaphyseal stress fractures of the fifth metatarsal, although a trend toward decreased participation was noted. Radiographic abnormalities were noted in the coronal plane with varus alignment, but not in the sagittal plane.

Level of Evidence:

Level III, retrospective cohort study.
Delirium
Authors: Field R. Ryan , Wall Michael H.
Published: February 2013

Delirium was described by Hippocrates over 2500 years ago and it remains an important clinical problem today. Work continues to improve definition, prevention, diagnosis, and treatment, but relatively young science remains. Delirium affects 12 500 000 patients and costs $152 000 000 000 every year. Up to 80% of mechanically ventilated patients experience delirium, which exists as a spectrum of acute brain organ dysfunction. Multiple theories exist, including contribution from baseline pathology, medications, surgical inflammation, and environment. Biochemical models point to pathophysiology. Delirium remains largely preventable through planning and subgroup identification. Validated objective assessment models aid diagnosis, whereas protocolized multimodal intervention remains best practice. Pharmacotherapy, as chemical restraint, is reserved for cases of potential harm to self or others. Observation obviates mechanical restraint. The contribution of delirium to cognitive decline remains controversial and concerning. As dollars shrink and cost does not, delirium becomes increasingly important. In an aging population of increasing frailty, delirium will contribute increasingly to long-term morbidity and even mortality.
Anesthetic Considerations in Infants With Hypoplastic Left Heart Syndrome
Authors: Twite Mark D. , Ing Richard J.
Published: February 2013

Hypoplasia of the left ventricle is a congenital cardiac lesion that is almost universally fatal if left untreated. Six decades of improved diagnostic modalities, greater understanding of single ventricle physiology, and earlier surgical and palliative options have given many of these patients an opportunity of surviving well into adulthood. This review will summarize these advances and focus on the anesthetic implications of this challenging disease from diagnosis to beyond the first palliative surgery.
The Impact of Endogenous Motivations on Adoption of IT-Enabled Services
Authors: Wunderlich Philipp , Kranz Johann , Totzek Dirk , Veit Daniel , Picot Arnold
Published: February 2013

Transformative services represent a crucial topic in future service research. Particularly in the energy sector, consumer adoption of transformative—often IT-enabled—services is essential to increased environmental sustainability. As adopting these services increases both individual and collective well-being, research has to delve more deeply into the origins of consumers’ motivations. For this reason, this study aims at augmenting the understanding of how different types of motivation determine consumers’ intention to adopt transformative services. The proposed model integrates the theory of planned behavior and the self-determination theory and is tested with survey data gathered from 462 users and 537 nonusers of home energy management services. Results indicate that consumers’ motivations are major direct determinants of intentions to adopt. While this finding notably holds when consumers perceive the adoption as self-determined and internalize associated values such as environmentalism, motivations based on external rewards and feelings of compulsion matter to a lesser extent. A comparison of users and nonusers reveals important differences in motivation, in particular that extrinsic motivations tend to be more relevant for nonusers than for users.
GIS in Evaluation
Authors: Azzam Tarek , Robinson David
Published: February 2013

This article provides an introduction to geographic information systems (GIS) and how the technology can be used to enhance evaluation practice. As a tool, GIS enables evaluators to incorporate contextual features (such as accessibility of program sites or community health needs) into evaluation designs and highlights the interactions between programs and their environments. Evaluators can formatively utilize GIS to examine implementation issues and their connections to the communities served and summatively to study program impacts and the factors contributing to variations between program sites. Improvements in technology as well as in data storage and access make this a feasible tool for a broader range of users. Through a hypothetical case study, the article discusses the strengths, limitations, and future trends of GIS in the context of the evaluation field.
Evaluator Skill Acquisition
Authors: Dillman Lisa M.
Published: February 2013

This article presents the results of a survey conducted in an attempt to examine evaluators’ perceptions of the contributions that different educational experiences make to the development of their evaluation skill sets. Self-identified new and graduate student evaluators were asked to describe their evaluation training experiences and to indicate how important each experience was to the development of particular evaluation competencies. A paired-comparison analysis was conducted to determine the scaling of the contribution each educational experience made to the development of each competency. Results show that the perceived contribution of different training experiences changes depending on which evaluation competency is being developed. Pedagogical implications of these findings are also discussed.
Siren songs or path to salvation? Interpreting the visions of Web technology at a UK regional newspaper in crisis, 2006–2011
Authors: MacGregor Phil
Published: February 2013

A 5-year case study of an established regional newspaper in Britain investigates journalists about their perceptions of convergence in digital technologies. This research is the first ethnographic longitudinal case study of a UK regional newspaper. Although conforming to some trends observed in the wider field of scholarship, the analysis adds to skepticism about any linear or directional views of innovation and adoption: the Northern Echo newspaper journalists were observed to have revised their opinions of optimum Web practices, and sometimes radically reversed policies. Technology is seen in the period as a fluid, amorphous entity. Central corporate authority appeared to diminish in the period as part of a wider reduction in formalism. Questioning functionalist notions of the market, the study suggests cause and effect models of change are often subverted by contradictory perceptions of particular actions. Meanwhile, during technological evolution, the ‘professional imagination’ can be understood as strongly reflecting the parent print culture and its routines, despite pioneering a new convergence partnership with an independent television company.
Managing multiple goals during fertility treatment: An interpretative phenomenological analysis
Authors: Phillips Elly , Elander James , Montague Jane
Published: February 2013

This study investigated how men and women made sense of multiple goals during fertility treatment. Both members of three heterosexual couples participated in two or three semi-structured interviews over 6 months, producing 14 accounts, which were analysed using interpretative phenomenological analysis. The goal of biological parenthood dominates assumptions in infertility research, but its importance varied between participants, who balanced that goal with retaining emotional well-being, avoiding financial difficulties and maintaining their relationship. These themes are discussed in the context of the self-regulation model, which allows fertility treatment experiences to be conceptualised more broadly than do other models.
Effect of heating on the properties of nano-crystalline titanium carbide during mechanical alloying process
Authors: Razavi Mansour , Zamani Saiied , Rahimipour Mohammad Reza
Published: February 2013

In this research, the effect of heating on the mechanical alloying process for synthesizing of titanium carbide was investigated. Raw materials containing pure titanium and graphite powders were milled in different times and temperature. In order to detect phases and properties of synthesized materials X-ray diffraction was applied. Physical properties including density and specific surface area along with microstructure were studied. Results showed that heating can accelerate the mechanical alloying process. By increasing the temperature during milling, production mechanism of titanium carbide changed from self-propagating high-temperature synthesis to gradual model. Changes of density confirmed this phenomenon too. Increasing the milling time leads to particle size and crystal of synthesized titanium carbides became finer down to nanometer scale. Because of higher effective time span of produced titanium carbide, increasing the temperature produces finer particle sizes of powders in similar milling time.
Prediction of phase transformation of Ti-6Al-4V titanium alloy during hot-forging processes using a numerical model
Authors: Ducato A , Fratini L , Micari F
Published: February 2013

In this article numerical model for prediction of phase evolution of Ti-6Al-4V titanium alloy was presented. In particular, attention was focused on alpha to beta and beta to alpha+beta phase transformations. The analysis was conducted using a commercial implicit finite element method code, considering the data and the parameters of a real case study to check the quality of the numerical model. The alpha to beta transformation was developed using the simplified form of the Avrami model and the beta to alpha+beta transformation was controlled through the generalized Avrami model. The model so-thought has been used to conduct a 2D simulation of a forging process. A comparison between the numerical and experimental data indicates that the model can be utilized as base for a design tool in complex hot-forging processes of titanium alloys.
Opinions about evidence: A study of social workers’ attitudes towards evidence-based practice
Authors: Gray Mel , Joy Elyssa , Plath Debbie , Webb Stephen A
Published: February 2013

This article reports on a large survey of Australian social workers regarding their attitudes to evidence-based practice and thoughts on the factors affecting its implementation in human service organisations.

Findings

Findings from a national survey of Australian social workers found a degree of support for evidence-based practice with the majority of respondents reporting changes in practice due to the influence of research. A sample size of 364 social workers formed the basis of the final analysis. Both the support for evidence-based practice and the reported changes in practice due to new evidence was highest among social workers in management positions and those with between 10 and 30 years is needed post-qualifying practice experience. The survey also found, however, an unsophisticated understanding of evidence and evidence-based practice and ‘inadequate’ skills in the critical appraisal of research.

Applications

Despite the level of support for evidence-based practice, responses to open-ended questions reflected reservations about the formalisation, relevance, useability, and applicability of the EBP agenda among social workers. Given that the issues relating to the transfer of research to practice appear far more complex than EBP suggests, this study sought to understand the complex dynamics of the research transfer process in social work and the human services.
Reflexive antiracism: A novel approach to diversity training
Authors: Kowal Emma , Franklin Hayley , Paradies Yin
Published: February 2013

This article introduces the concept of reflexive antiracism as a response to two major critiques of antiracism theory and praxis: the dangers of essentialism and the elicitation of counter-productive emotional reactions. The article explores these critiques as they apply to two broad approaches to diversity training: cultural awareness and antiracism. Reflexive antiracism offers an alternative to existing approaches through a focus on racialisation and the formation and maintenance of racialised identities in particular. An emphasis on the paradoxes of racialisation and the contingencies of minority and white antiracist identities can promote a realistic and productive understanding of diversity training that may avoid the pitfalls of existing approaches. To conclude, an outline of factors that contribute to reflexive antiracism praxis are presented, drawing on examples from an existing diversity training course.
Framing Maya culture: Tourism, representation and the case of Quetzaltenango
Authors: Tegelberg Matthew
Published: February 2013

This article examines the representation of Maya culture in travel and tourism literature. It compares and contrasts framings in historical, promotional and online tourist media. Two main tropes are identified that have been central to this literature since the mid-nineteenth century, culminating in a current practice described here as Maya cultural tourism. In Guatemala, promotional texts replicate earlier tropes to portray Maya culture as a primary source of attraction. What these dominant commercial framings consistently ignore, however, are Maya contributions to global tourism narratives and exchanges. To address this gap, the second part of the article focuses on the ways in which local actors use online media to present themselves to tourists in the case of Quetzaltenango. This serves to illuminate key differences in how tourism marketers and local actors package Maya culture for global consumption. It is concluded that overcoming a preoccupation with the same tired tropes involves paying closer attention to cultural narratives emerging in cyberspace that acknowledge Maya agency in their relations with tourists and portray these exchanges in a more nuanced and robust manner.
Dementia and its influence on quality of life and what it means to be valued: Family members’ perceptions
Authors: Moyle Wendy , Murfield Jenny , Venturto Lorraine , Griffiths Susan , Grimbeek Peter , McAllister Margaret , Marshall Jenni
Published: February 2013

This pragmatic, exploratory qualitative study, as part of a larger funded research project, sought to explore families’ perspectives on what it means to value a person with dementia and how this value might influence the quality of life of people with dementia. In-depth interviews were conducted with 20 family members who used one long-term care service provider in Australia. Families described the factors influencing a positive quality of life for the person with dementia as being related to the environment and, in particular, to the resident’s room, supportive staff and individualised care that valued the person’s life experience. Family also reported a negative impact on quality of life when staff and the care facility neglected to provide an individualised approach. This study highlights the importance of demonstrating the value of the person with dementia, the family role and partnerships of care.
The ethical and methodological challenges of social work research with participants who fear retribution: To ‘do no harm’
Authors: Drake Gabrielle
Published: February 2013

This article discusses some of the ethical and methodological challenges experienced throughout a doctoral study focusing on boarding house residents in Sydney, Australia, particularly participants’ fear of retribution. Informing the research were forty interviews with a range of participants including current and former licensed boarding house residents, proprietors of boarding houses, and staff of community organizations and government agencies providing support services or monitoring the conditions in boarding houses. The article discusses and analyses the complexity and understandings of anonymity, confidentiality, informed consent and the meanings and implications of de-identification. Some of the strategies to address these complexities are presented and are significant for qualitative researchers, particularly doctoral and early career researchers.
The road to placement breakdown: Foster parents' experiences of the events surrounding the unexpected ending of a child's placement in their care
Authors: Khoo Evelyn , Skoog Viktoria
Published: February 2013

Placement breakdown is a frequently occurring phenomenon in the context of out-of-home care. Although research has pointed to the many problems associated with placement instability and breakdown, less is known about foster parents’ experiences. We carried out deep interviews with foster parents to investigate connections between their caring experiences and experiences of placement breakdown. Results of our study demonstrate that breakdown is a complex process rather than a single event – a process that starts in the discrepancy between the statutory obligations of the social services toward the foster home and the foster parents’ perceptions of the kind if information and support they actually receive from the social services. High demands are placed on foster parents’ ability to provide care and offer a loving home to children who have been raised in difficult environments and who have behaviour problems. The road to breakdown also included a lack of knowledge about the child’s needs, insufficient understanding of the placement process, a difficult relationship with the social worker, and a lack of individualized service with the right supports at the right time. Although the placement may have ended in breakdown, foster parents described a continuing relationship between their families and child which was of lasting significance.
Negotiating with tradition: Curriculum reform and institutional transition in a conservatoire
Authors: Duffy Celia
Published: February 2013

The Royal Conservatoire of Scotland has recently transformed its curriculum through a process of curriculum reform. This has been a major institutional transition and has challenged many of the traditional practices of the conservatoire. Taking the global thinking on curriculum reform as its starting point, the conservatoire’s aspiration has been to open up the traditionally narrow conservatoire curriculum: to provide more flexibility in terms of student choice and, importantly not only for our particular institutional circumstances but also for the direction of travel in the creative professions, to provide opportunities to collaborate with other artistic disciplines. This article reflects on the process of this project, the challenges that we negotiated and the emerging outcomes.
The deliberative democrat’s Idea of Justice
Authors: Dryzek John S.
Published: February 2013

In Amartya Sen’s The Idea of Justice, democracy is necessary for the reconciliation of plural justice claims. Sen’s treatment of democracy is however incomplete and inadequate: democracy is under-specified, there are unrecognized difficulties in any context featuring deep moral disagreement or deep division and a conceptualization of public reason in the singular erodes his pluralism. These faults undermine Sen’s account of justice. Developments in the theory of deliberative democracy can be deployed to remedy these deficiencies. This deployment points to a deliberative system encompassing those affected by collective decisions, with places for non-partisan forums and discursive representatives, conditionally open to multiple forms of communication, and geared to the production of workable agreements under normative and discursive meta-consensus. Democracy does not guarantee justice, but in a plural world it is essential to the pursuit of justice.
A new time-domain reflectometry bridge scour sensor
Authors: Yu Xinbao , Zhang Bin , Tao Junliang , Yu Xiong
Published: February 2013

Scour is a major threat to bridge safety. Bridge failures cost millions of dollars each year as the result of not only the direct costs of replacing and restoring these bridges but also the indirect costs related to the disruption of transportation network. Instruments for bridge scour monitoring are necessary to study scour process and support bridge management. Lack of robust and economic scour monitoring devices prevents the implementation of bridge scour monitoring program among bridge owners. This study describes the development of a new time-domain reflectometry scour sensor. The geometry of this sensor was designed to allow for easy installation through common geotechnical boreholes. Coating was applied to the sensor, which provided it with a large range of sensing depths compared to an uncoated metallic rod sensor. The coating also provided corrosion protection. The design of this new sensor was studied by numerical simulations with finite element method. From the results, the effective sampling areas of this sensor were determined. Laboratory evaluations showed that this sensor was sensitive to simulated scour process. An algorithm was developed to determine scour depth from sensor signals. The results indicated that the sensor provided accurate scour depth measurement.
Empowering parents through an action research parenting program
Authors: Loizou Eleni
Published: February 2013

The goal of this article is to consider action research with parents and specifically describe the experience of two parents during a parenting program that employed an action research framework and consider how action research empowered them. Data collection lasted for 24 weeks and included reflection commentaries, home journals, email communication, action plan writing, a conversational group interview, and artefacts. The two case studies exemplify how the methodology of action research as the framework of a parenting program empowered them to develop their own understanding of parenting, to generate theory and develop skills to cope with parenting issues. These cases include: the lone scientist who reflects on her own practice and re-conceptualizes her parenting and the team player who considers the playgroup as a learning community in which she learns from others. This study, especially the in-depth analysis of the two parents, highlights that action research is a promising component of parent education programs because it provides parents with the space and flexibility to be agents of their own learning and development; a framework which others can build on to enrich the action research and early education literature.
Decoupling the bending behavior and the membrane properties of finite shell elements for a correct description of the mechanical behavior of textiles with a laminate formulation
Authors: Döbrich Oliver , Gereke Thomas , Diestel Olaf , Krzywinski Sybille , Cherif Chokri
Published: February 2013

Drape simulation of textiles is a field of research, which is known in the clothing sector for a long time. The ongoing development of high-performance composites made of textile reinforcements and matrix materials focus the interests on a serial production in many industrial sectors, such as aviation and automotive industries. Challenges occur mainly in the serial production technologies and in supplying concepts for the preform architecture and shape. Research aims on the acceleration of preform manufacturing and the reduction of expensive pretests. Numerical simulation models can help to improve the composite development chain with structure and process simulation. A special challenge in drape modeling is the bending behavior of textiles. This study introduces a novel approach for modeling single textile layers as laminates to gain a correct mechanical behavior, where all deformation mechanisms are uncoupled. The implementation in the finite element software LS-DYNA® is described. An algorithm is introduced which provides the membrane stiffness for each layer of a laminate to fit the measured cantilever bending stiffness of textiles in every bending direction and bending side. The calculated parameters for the laminate formulation result in the requested bending stiffness for the textile layer. The cantilever bending stiffness can be used directly for dimensioning the model.
Preparation of photocatalytic cenosphere immobilized with TiO2 nanoparticles by hydrothermal method
Authors: Zhan Jianchao , Zhang Hui , Zhu Guoqing
Published: February 2013

A layer of TiO2 nanoparticles was deposited on the surface of cenosphere by using tetrabutyl titanate or titanium sulfate as the precursor under hydrothermal conditions. The morphology, chemical composition, crystal structure and optical properties of cenosphere before and after treatments were determined by scanning electron microscope, energy dispersive spectroscopy, X-ray diffraction and diffuse reflectance spectrum. The photocatalytic activity of methylene blue degradation was evaluated by using ultraviolet irradiation. The results showed that compared with tetrabutyl titanate, a thicker layer of TiO2 nanoparticles in anatase structure was deposited on the surface of cenosphere treated with titanium sulfate. The crystal size of TiO2 nanoparticle by using titanium sulfate as precursor was larger than that by using tetrabutyl titanate as precursor. The photocatalytic activity of TiO2-coated cenosphere by using titanium sulfate as precursor was slightly enhanced mainly because of the higher crystallinity of anatase TiO2. The formation mechanisms of TiO2 coating on cenosphere surface and photocatalytic degradation of methylene blue with ultraviolet irradiation were also discussed.
Outcomes of Thrombolysis With and Without Predilation of the Inferior Vena Cava (IVC) in Patients With Budd–Chiari Syndrome With Old IVC Thrombosis
Authors: Ren Jian-Zhuang , Huang Guo-Hao , Ding Peng-Xu , Wu Gang , Han Xin-Wei , Wang Yan-Li
Published: February 2013

Purpose:

To compare the efficacy of thrombolysis with and without predilation of the inferior vena cava (IVC) for Budd–Chiari syndrome (BCS) with old IVC thrombosis.

Methods:

We divided 40 patients with BCS with old IVC thrombosis into 2 groups, group A (n = 21), thrombolysis after dilation of the obstructed IVC and group B (n = 19), thrombolysis without predilation of the obstructed IVC. Thrombolysis was performed via urokinase administration through the dorsal vein of the foot.

Results:

Color Doppler ultrasonography at 30 days showed complete resolution of the thrombus in 21 (100%) group A patients and 6 group B patients (31.6%; P < .001). Thrombolysis was achieved using a lower dose of urokinase and within a shorter time frame in group A than in group B ( P < .001).

Conclusions:

Thrombolysis after dilation was superior to thrombolysis alone and was safe and efficacious in patients with BCS with old IVC thrombosis.
Pretreatment Loss-to-Follow-Up after HIV Diagnosis from 27 Counseling and Testing Centers across India
Authors: Sarna Avina , Sebastian Mary , Bachani Damodar , Sogarwal Ruchi , Battala Madhusudana
Published: February 2013

Individuals testing HIV positive were interviewed at testing centers, followed prospectively and interviewed again when they registered at referral antiretroviral therapy (ART) centers (ARTCs). Those who did not register at ARTCs were traced and interviewed in the community. A total of 1057 newly diagnosed people living with HIV (PLHIV; 52% women; mean age, 34.7 years) were recruited. A total of 73.5% of PLHIV registered at referral ARTCs within 60 days, 17.9% did not register and were interviewed in the community, and 8.6% were not interviewed. The 2 main reasons cited for not registering were a perception of good health (30%) and work/family engagements (22%). Single clients (adjusted relative risk [ARR]: 1.54; 95% confidence interval [CI]: 1.02-2.34), participants who had not disclosed their HIV status (ARR: 2.32; 95%CI: 1.77-3.05), participants who knew a PLHIV (ARR: 1.89; 95% CI: 1.41-2.53), and participants from laborer households (ARR: 2.66; 95%CI:1.15-6.15) were more likely to not register. In conclusion, the majority of newly diagnosed PLHIV do reach ARTCs. Disclosure concerns and a perception of good health prevent PLHIV from accessing services.
Histological Findings Following Use of CoSeal in a Patient With a Left Ventricular Assist Device
Authors: Cannata Aldo , Petrella Duccio , Gambacorta Marcello , Russo Claudio F. , Bruschi Giuseppe , Martinelli Luigi
Published: February 2013

Adhesions are a formidable challenge in patients undergoing reoperative cardiac surgery, particularly in those supported by an intracorporeal left ventricular assist device (LVAD) and undergoing heart transplantation. This report describes the pathological findings following the clinical use of a surgical sealant (CoSeal, Baxter Healthcare, Fremont, CA), in a patient who underwent LVAD implantation. On the treated surfaces, a minimal amount of adhesions were observed, whereas in untreated surfaces adhesions were present.
Integrated dynamic modeling for energy optimization in the building: Part 1:The development of the model
Authors: Heibati S Mohammadreza , Atabi Farideh , Khalajiassadi Morteza , Emamzadeh Abolghasem
Published: February 2013

Considering the magnitude of energy loss in Iran’s buildings, development of energy saving and energy optimization methods appears to be essential. To date, many energy saving methods, such as energy auditing, have been developed in this area, though none of them enjoyed high accuracy and efficiency. Optimization methods aided by energy modeling are the most useful tools for energy saving as well as energy loss reduction. In this study, a new model has been developed based on mathematical equations of mass and energy balance between different parts of a building and its surrounding area. Generally, this model integrates two methods of load and heating, ventilation and air conditioning modeling. Furthermore, the presented model allows for simulation of energy-efficient scenarios and their optimization based on life cycle cost analysis method. In this part, capabilities of the model have been closely analyzed based on historical records of existing models. The relations covering boundary conditions at external–internal surfaces; energy equations for building systems; interzone airflow and infiltration; heating, ventilation, and air conditioning models and economic models; and their optimization method and possible solutions have been explained in detail. Complete details about the application of this model for the XYZ case study building will be given in the second part of this article.
Youth activists, youth councils, and constrained democracy
Authors: Taft Jessica K. , Gordon Hava R.
Published: February 2013

This article provides a critical examination of a common form of adult attempts to promote civic engagement among young people, namely, youth advisory councils. While youth councils have been widely celebrated as an effective way to integrate young people into political processes, little research has explored why some politically active youth choose to leave, or refuse to join, youth councils. Based on two qualitative studies of politically active teens throughout North and Latin America, the authors argue that teenage activists possess valuable dissident knowledge of, and critical perspectives on, the potential for youth advisory councils to promote youth political power. We argue that young activists understand democracy in ways that are fundamentally different from that offered to them by youth councils. Youth activists put forth a theory of democracy that emphasizes authority and impact, not just voice; they understand democracy as representing collective concerns and perceive youth councils as elitist and nonrepresentative; and they emphasize the value of controversy and contentious politics while expressing anxiety that youth councils can function as modes of social control that tame and channel youth dissent, rather than opportunities to foster youth political power.
ICTs in political engagement among youth in the Philippines
Authors: David Clarissa C
Published: February 2013

Political engagement among young activists in the Philippines has changed since new media technologies have gained critical mass. This article reports on how engagement has been redefined by the young and how information and communication technologies (ICTs) have contributed to the amplification of their voices in political life. Activists and ordinary youth were interviewed through unstructured individual and group conversations, and they were asked about their definitions of political, civic, and social engagement. The expression of opinions online is highly valued as a political activity and is believed to be a politically consequential action. Young activists strategically use ICTs and social networks to gather support for their causes and to gain the attention of the traditional media and politicians.
Nutritional management of Crohn’s disease
Authors: Donnellan Clare F. , Yann Lee H. , Lal Simon
Published: February 2013

Nutritional care and therapy forms an integral part of the management of patients with Crohn’s disease (CD). Nutritional deficiencies result from reduced oral intake, malabsorption, medication side effects and systemic inflammation due to active disease. Enteral nutrition has a role in support for the malnourished patient, as well as in primary therapy to induce and maintain remission. The use of parenteral nutrition in CD is mainly limited to the preoperative setting or for patients with intestinal failure, but does not offer any additional advantage over EN in disease control. Dietary modifications, including elimination–reintroduction diets and a low fermentable, oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet may improve symptoms but there are currently no data to suggest that these approaches have any role in the induction or maintenance of remission.
Intravascular Catheter-Related Bloodstream Infection
Authors: Shah Harshal , Bosch Wendelyn , Thompson Kristine M. , Hellinger Walter C.
Published: February 2013

Intravascular catheters required for the care of many hospitalized patients can give rise to bloodstream infection, a complication of care that has occurred most frequently in intensive care unit (ICU) settings. Elucidation of the pathogenesis of catheter-related bloodstream infections (CRBSIs) has guided development of effective diagnostic, management, and prevention strategies. When CRBSIs occur in the ICU, physicians must be prepared to recognize and treat them. Prevention of these infections requires careful attention to optimal catheter selection, insertion and maintenance, and to removal of catheters when they are no longer needed. This review provides a succinct summary of the epidemiology, pathogenesis, and microbiology of CRBSIs and a review of current guidance for the diagnosis, management, and prevention of these infections.
Platelet Function Analysis Using PFA-100 Tests in Patients With Acute Gastrointestinal Bleeding
Authors: Jones Catherine , Alalawi Raed , Doctolero Susan , Nugent Kenneth
Published: February 2013

Aim. To investigate platelet function in patients with acute gastrointestinal bleeding. Methods. We prospectively studied platelet function using the PFA-100 test in a convenience sample of patients with gastrointestinal bleeding admitted to the medical ICU from July 2010 to August 2011. Patients on warfarin or heparin were excluded. Results. In all, 41 patients (30 men) participated in the study. The mean age was 55 years (range 25-74 years). Most patients (31/41) presented with blood in their stools as at least one of their presenting symptoms. Fourteen of the 41 patients were on aspirin, 4 on nonsteroidal anti- inflammatory drugs, and 5 on clopidogrel or other antiplatelet drugs. The average hemoglobin was 9.2 g/dL (range 5.1-16.1 g/dL). The average platelet count was 170 kU/L (range 41-496 kU/L). The average international normalized ratio was 1.37(range 1.01-2.08). Analysis of platelet function was performed in 9 patients (22%). These patients had closure times which ranged from 98 to >300 seconds with an average time of 107.3 seconds (normal range 92-193 seconds). Esophagogastroduodenoscopy revealed gastritis in 14 patients, gastric ulcer in 10, esophageal varices in 11, duodenal ulcer in 6, esophagitis in 3, gastric varices in 8, and an esophageal tear in 2. Patients on antiplatelet drugs did not require more blood transfusions than patients not on these drugs. All patients survived the ICU admission; one required surgery. Conclusions. Platelet function analysis was not possible in most patients using a commercially available assay because our laboratory requires a hematocrit >35% and a platelet count >150 000 kU/L for accuracy.
Workplace bullying and employee performance
Authors: Samnani Al-Karim , Singh Parbudyal , Ezzedeen Souha
Published: February 2013

Research has found that the most prevalent forms of bullying in the workplace are ambiguous and difficult to detect. As a result, bullying often results in subjective interpretations of the behavior thereby inducing various possible attributions by targets. Based on findings about the misattribution of bullying behavior, we extend current conceptualizations of workplace bullying and investigate the role of targets’ attributions in explaining the relationship between workplace bullying and key dimensions of targets’ performance. We propose that different attributions can have differential effects on targets’ work performance. This contributes to the current debate and conflicting views about the effects of workplace bullying on work performance. We develop a theoretical model of bullying attributions that integrates key contextual factors across multiple levels. We propose that bullying can paradoxically result in positive effects on target performance under certain conditions. This theoretical model serves as a roadmap for future research in this area.
Synopsis of recent guidelines on pancreatic exocrine insufficiency
Authors: Löhr J‐Matthias , Oliver Mark R , Frulloni Luca
Published: February 2013

Background

In recent years, three national gastroenterology societies established guidelines for the diagnosis and therapy of pancreatic exocrine insufficiency (PEI). In addition, the Cochrane Collaboration issued a review.

Objective

The purpose of this paper is to present an overview of the recommendations and concordance between the four recent published guidelines and stimulate further discussion.

Methods

A review of the Australian, German and Italian guidelines and the Cochrane review was conducted, and a synthesis was made of common statements.

Results

There is a high degree of agreement on almost all items within these guidelines, both in the diagnosis of PEI and in terms of therapy and approach to management of PEI. In addition, novel emerging developments are highlighted, such as the fecal elastase‐1 test, which is widely used but is not suitable for measuring mild‐to‐moderate PEI despite its ability to positively establish the diagnosis of severe PEI. One of the few novel tests proving to be useful is the 13 C mixed‐chain triglycerides (MCT) breath test. This test, albeit an excellent quantitative test, is not widely used and is rarely available. The use of this test is making it apparent that there is a difference between treating the symptoms of PEI and treating malnutrition, the broader underlying defect. This may have direct consequences for the dosing of pancreatic enzymes (pancreatin), in that the consensus starting dose of all guidelines may be too low for some patients. Although chronic pancreatitis in adults and cystic fibrosis in children account for the main evidence base used for PEI, other indications are also discussed.

Conclusions

There is good concordance between recommendations provided by international groups. More prospective studies are required in many areas, including the use of pancreatic enzymes in other gastrointestinal disorders, such as celiac disease and irritable bowel syndrome (IBS). We also need to assess the feasibility of the 13 C MCT breath test. At the same time, it needs to be confirmed that higher doses of pancreatic enzymes are really necessary to not only relieve the symptoms of PEI but also treat malnutrition appropriately.
Comparison of a standard fully covered stent with a super‐thick silicone‐covered stent for the treatment of refractory esophageal benign strictures: A prospective multicenter study
Authors: Chaput Ulriikka , Heresbach Denis , Audureau Etienne , Vanbiervliet Geoffroy , Gaudric Marianne , Bichard Philippe , Bauret Paul , Coumaros Dimitri , Ponchon Thierry , Fumex Fabien , Bensoussan Emmanuel , Lamouliatte Hervé , Chryssostalis Ariane , Robin Françoise , Prat Frédéric
Published: February 2013

Background

Some esophageal strictures resist endoscopic treatments. There is a need for new treatments, such as specifically designed stents.

Objective

Our study sought to compare the results achieved with a standard, fully covered metallic stent (FCMS) and those achieved using a stent designed specifically for benign strictures (BS‐FCMS).

Patients and methods

The study used a prospective, multicenter, controlled design, with patients recruited from tertiary referral centers. Patients with refractory esophageal strictures were included. Standard FCMS were used in group 1 (N  = 24), and BS‐FCMS were used in group 2 (N  = 17). Patients were followed for 24 months after stent removal. The main outcomes measured were stricture resolution rate, 24 months’ recurrence rate and stent‐related morbidity.

Results

Early stent migrations occurred in one (4.1%) patient from group 1 and five (29.4%) from group 2 (p  < 0.05). During esophageal stenting, complications occurred in six patients (25%) in group 1 and six patients (35.3%) in group 2 (p  = 0.47), respectively. Fifty percent of complications were attributed to migration. There was no procedure‐related morbidity associated with the extraction of the stent. The stricture resolution rate was, respectively, 95.2% in group 1 and 87.5% in group 2 (the difference between the two groups is not significant). During follow‐up, stricture recurrence occurred in 15/19 patients (group 1, 79%) and 7/8 patients (group 2, 87.5%; p  = 1.0). The median time to recurrence of esophageal stricture was 1.7 months (group 1, 0.6–12 months) and 1 month (group 2, 0.1–6 months). Study limitations include its nonrandomized design.

Conclusion

The stricture resolution rate was high at the end of the stenting period for both types of stents without any statistical difference between the two groups, but the long‐term results were disappointing, with stricture recurring frequently and rapidly in both groups.