bluuebunny/crossref_metadata_2025 huggingface dataset:
Persistence at 1 year of oral antiosteoporotic drugs: a prospective study in a comprehensive health insurance database
Authors: Confavreux Cyrille B , Canoui-Poitrine Florence , Schott Anne-Marie , Ambrosi Véronique , Tainturier Valérie , Chapurlat Roland D
Published: January 2012

Objective

Treatments against osteoporosis have demonstrated fracture risk reduction but persistence to therapy remains a major issue. Intermittent regimens have been developed to improve persistence. The aim of this 1-year prospective study was to compare, in the general population, the persistence of various oral regimens of antiosteoporotic treatment.

Methods

We conducted this prospective study in the French comprehensive public health insurance database of the Rhône-Alpes region. Women aged 45 years or older who had a first reimbursement of an oral antiosteoporotic treatment during February 2007 composed the study cohort. Persistence was defined by the proportion of patients refilling a prescription in the pharmacist delivery register (ERASME). Using statistical analyses like Kaplan–Meier survival curves and log-rank tests, we compared the treatment persistence of strontium ranelate, raloxifene, and daily-, weekly-, and monthly bisphosphonates.

Results

Two thousand four hundred and nineteen patients were included over a period of 1 month and followed up for 12 months. Two hundred and eighty-nine (11.9%) patients were treated with monthly bisphosphonates, 1298 (53.7%) with weekly bisphosphonates, and 832 (34.4%) with daily treatments (526 strontium ranelate (21.7%), 296 raloxifene (12.2%), and 10 bisphosphonates (0.4%)). At 1 year, overall persistence was 34%. Fifty percent of patients on monthly bisphosphonates were still persistent while only 37% of patients on weekly bisphosphonates, 34% on raloxifene, and 16% on strontium ranelate were persistent. Therapy monitoring with biochemical markers or bone mineral density was associated with improved persistence.

Conclusion

Overall persistence at 1 year was low, but intermittent regimens were associated with higher persistence rates, along with women who had therapy monitoring.
Quality assurance and quality improvement in medical practice – Part 2. Evidence-based medicine
Authors: Gődény Sándor
Published: January 2012

For assuring and improving quality of healthcare, everyday medical practice should be based on appropriate scientific evidence and results of health technology assessment. Evidence-based medicine is the integration of clinical expertise, patient values, and the best evidence into the decision making process for patient care, when health technologies are used. On one hand health technologies which proved to be effective should be available for all patients, on the other hand, because of the limited financial resources of the health care system, they should be cost-effective, not to spend on interventions proved to be ineffective or even harmful. For effective implementation of evidence-based practice, development of more clinical guidelines, that contain explicit recommendations, and improvement of quality approach are necessary in Hungary. Orv. Hetil., 2012, 153, 137–143.
Strength variability in lime-cement columns based on cone penetration test data
Authors: Al-Naqshabandy Mohammed Salim , Bergman Niclas , Larsson Stefan
Published: January 2012

Natural and improved soils have relatively high inherent property variability that should be taken into consideration in design. Investigations of the spatial variability in lime-cement columns are important since they provide a rational quantification of the variability parameters needed for a reliability-based design analysis of geotechnical systems. Statistical analyses are used to evaluate the spatial variability parameters, namely the mean, the variance and the scale of fluctuation, which is the distance within which soil properties reveal strong correlation. This paper presents a field test, in which 30 cone penetration test soundings were performed and analysed statistically in order to address the spatial variability in a group of lime-cement columns, with respect to the cone tip resistance. The objective of this paper is to describe the statistical analyses and to make a contribution to the empirical knowledge about strength variability in a volume of lime-cement columns. Stationarity has been assessed, and the scale of fluctuation has been evaluated in the vertical and horizontal directions. Random field theory was used based on the sample autocorrelation function. The scale of fluctuation was found to be within the range of 0·2–0·7 m and 2–3 m in the vertical and horizontal directions, respectively. A simple design consideration shows that the variance reduction factor has a major influence on the determination of the design value.
Clinical Preventive Services for Older Adults: The Interface Between Personal Health Care and Public Health Services
Authors: Ogden Lydia L. , Richards Chesley L. , Shenson Douglas
Published: January 2012

Healthy aging must become a priority objective for both population and personal health services, and will require innovative prevention programming to span those systems. Uptake of essential clinical preventive services is currently suboptimal among adults, owing to a number of system- and office-based care barriers.

To achieve maximum health results, prevention must be integrated across community and clinical settings. Many preventive services are portable, deliverable in either clinical or community settings. Capitalizing on that flexibility can improve uptake and health outcomes.

Significant reductions in health disparities, mortality, and morbidity, along with decreases in health spending, are achievable through improved collaboration and synergy between population health and personal health systems.
Strategies for Managing the Dual Risk of Sexually Transmitted Infections and Unintended Pregnancy Among Puerto Rican and African American Young Adults
Authors: Carter Marion W. , Hock-Long Linda , Kraft Joan Marie , Henry-Moss Dare , Hatfield-Timajchy Kendra , Singer Merrill
Published: January 2012

Although young adults in the United States are at increased risk for sexually transmitted infections (STIs) and unintended pregnancy, they do not report high rates of dual-method use (condoms plus other contraception) for prevention. We used prospective qualitative data from 69 urban Puerto Rican and African American individuals aged 18 to 25 years to determine how they managed these risks in their heterosexual relationships during a 4- to 8-week period. Hormonal or long-acting contraceptive use, condoms, and withdrawal were the most common unintended pregnancy prevention strategies; condoms, STI testing, and perceived fidelity were dominant among STI prevention strategies. We need to shift the focus from dual-method use toward a broader concept of dual protection to be more responsive to young adults’ concerns, perceptions, and priorities.
Health Behavior Change: Can Genomics Improve Behavioral Adherence?
Authors: McBride Colleen M. , Bryan Angela D. , Bray Molly S. , Swan Gary E. , Green Eric D.
Published: January 2012

The National Human Genome Research Institute recommends pursuing “genomic information to improve behavior change interventions” as part of its strategic vision for genomics. The limited effectiveness of current behavior change strategies may be explained, in part, by their insensitivity to individual variation in adherence responses.

The first step in evaluating whether genomics can inform customization of behavioral recommendations is evidence reviews to identify adherence macrophenotypes common across behaviors and individuals that have genetic underpinnings. Conceptual models of how biological, psychological, and environmental factors influence adherence also are needed.

Researchers could routinely collect biospecimens and standardized adherence measurements of intervention participants to enable understanding of genetic and environmental influences on adherence, to guide intervention customization and prospective comparative effectiveness studies.
Socioeconomic Disparities in Community-Based Treatment of Tobacco Dependence
Authors: Sheffer Christine E. , Stitzer Maxine , Landes Reid , Brackman S. Laney , Munn Tiffany , Moore Page
Published: January 2012

Objectives. We examined socioeconomic disparities in a community-based tobacco dependence treatment program.

Methods. We provided cognitive-behavioral treatment and nicotine patches to 2739 smokers. We examined treatment use, clinical and environmental, and treatment outcome differences by socioeconomic status (SES). We used logistic regressions to model end-of-treatment and 3- and 6-month treatment outcomes.

Results. The probability of abstinence 3 months after treatment was 55% greater for the highest-SES than for the lowest-SES (adjusted odds ratio [AOR] = 1.55; 95% confidence interval [CI] = 1.03, 2.33) smokers and increased to 2.5 times greater for the highest-SES than for the lowest-SES smokers 6 months after treatment (AOR = 2.47; 95% CI = 1.62, 3.77). Lower-SES participants received less treatment content and had fewer resources and environmental supports to manage a greater number of clinical and environmental challenges to abstinence.

Conclusions. Targets for enhancing therapeutic approaches for lower socioeconomic groups should include efforts to ensure that lower-SES groups receive more treatment content, strategies to address specific clinical and environmental challenges associated with treatment outcomes for lower-SES smokers (i.e., higher dependence and stress levels and exposure to other smokers), and strategies to provide longer-term support.
Population Burden of Betel Quid Abuse and Its Relation to Oral Premalignant Disorders in South, Southeast, and East Asia: An Asian Betel-Quid Consortium Study
Authors: Lee Chien-Hung , Min-Shan Ko Albert , Warnakulasuriya Saman , Ling Tian-You , Sunarjo  , Rajapakse Palandage Sunethra , Zain Rosnah Binti , Ibrahim Salah Osman , Zhang Shan-Shan , Wu Han-Jiang , Liu Lin , Kuntoro  , Utomo Budi , Warusavithana Supun Amila , Razak Ishak Abdul , Abdullah Norlida , Shrestha Prashanta , Shieh Tien-Yu , Yen Cheng-Fang , Ko Ying-Chin
Published: January 2012

Objectives. We investigated the population burden of betel quid abuse and its related impact on oral premalignant disorders (OPDs) in South, Southeast, and East Asia.

Methods. The Asian Betel-Quid Consortium conducted a multistage sampling of 8922 representative participants from Taiwan, Mainland China, Malaysia, Indonesia, Nepal, and Sri Lanka. Participants received an interviewer-administered survey and were examined for oral mucosal disorders.

Results. The prevalence of betel quid abuse was 0.8% to 46.3% across 6 Asian populations. The abuse frequency was over 40.5% for current chewers, with the highest proportion in Nepalese and Southeast Asian chewers (76.9%−99.6%). Tobacco-added betel quid conferred higher abuse rates (74.4%−99.6%) among Malaysian, Indonesian, and Sri Lankan men than did tobacco-free betel quid (21.8%−89.1%). Gender, lower education level, younger age at chewing initiation, and clustering of familial betel quid use significantly contributed to higher abuse rates. Indonesian betel quid abusers showed the highest prevalence of OPDs and had a greater risk of OPDs than did nonabusers.

Conclusions. Betel quid abuse is high in regions of Asia where it is customarily practiced, and such abuse correlates highly with OPDs. By recognizing abuse-associated factors, health policies and preventive frameworks can be effectively constructed to combat these oral preneoplasms.
Turbulent mixed convection in asymmetrically heated vertical channel
Authors: Mokni Ameni , Mhiri Hatem , Le Palec , Bournot Philippe
Published: January 2012

In this paper an investigation of mixed convection from vertical heated
channel is undertaken. The aim is to explore the heat transfer obtained by
adding a forced flow, issued from a flat nozzle located in the entry section
of a channel, to the up-going fluid along its walls. Forced and free
convection are combined studied in order to increase the cooling
requirements. The study deals with both symmetrically and asymmetrically
heated channel. The Reynolds number based on the nozzle width and the jet
velocity is assumed to be 3 103 and 2.104; whereas, the Rayleigh number
based on the channel length and the wall temperature difference varies from
2.57 1010 to 5.15 1012. The heating asymmetry effect on the flow development
including the mean velocity and temperature the local Nusselt number, the
mass flow rate and heat transfer are examined.
A combined experimental/numerical approach to study the thermal dispersion in porous media flows
Authors: Languri Ehsan , Pillai Krishna
Published: January 2012

The non-isothermal transport during flow in porous media is studied for
single- and dualscale porous media. A new combined experimental/numerical
approach to estimating the thermal dispersion tensor is introduced and
applied for both isotropic (single-scale) and anisotropic (dualscale) porous
media. The equivalence between the heat and mass transfer is exploited and a
1-D flow experimental setup is employed to study the spreading of a dye.
Later, the mathematical model for such a spreading of concentration
(equivalent to the temperature) around a point input in a constant velocity
field is solved using the finite element based code COMSOL. Thus obtained
numerical spreading pattern is fitted onto the experimentally observed one
using the dispersion matrix (tensor) as a fitting parameter. A few cases of
single- and dual-scale porous media are studied and the dispersion tensors
are reported for each individual case. In one case, the results are validated
with the available experimental data in the literature which shows a good
match.
Homotopy perturbation method for a Stefan problem with variable latent heat
Authors: Rajeev R
Published: January 2012

In this paper, homotopy perturbation method is successfully applied to find
an approximate solution of one phase Stefan problem with variable latent
heat. The results thus obtained are compared graphically with a published
analytical solution and are in good agreement.
Closed vessel combustion modelling by using pressure-time evolution function derived from two-zonal approach
Authors: Tomic Mladen , Perkovic Luka , Zivkovic Predrag , Duic Neven , Stefanovic Gordana
Published: January 2012

In this paper a new method for burned mass fraction - pressure relation, x-p
relation, for two-zone model combustion calculation is developed. The main
application of the two-zone model is obtaining laminar burning velocity, SL,
by using a pressure history from a closed vessel combustion experiment. The
linear x-p relation by Lewis and Von Elbe is still widely used. For linear
x-p relation, the end pressure is necessary as input data for the description
of the combustion process. In this paper a new x-p relation is presented on
the basis of mass and energy conservation during the combustion. In order to
correctly represent pressure evolution, the model proposed in this paper
needs several input parameters. They were obtained from different sources,
like the PREMIX software (with GRIMECH 3.0 mechanism) and GASEQ software, as
well as thermodynamic tables. The error analysis is presented in regard to
the input parameters. The proposed model is validated against the experiment
by Dahoe and Goey, and compared with linear x-p relation from Lewis and Von
Elbe. The proposed two zone model shows sufficient accuracy when describing
the combustion process in a closed vessel without knowing the end pressure in
advance, i.e. both peak pressure and combustion rates can be sufficiently
correctly captured.
Spatial distribution and ethnic homogenization of population in Serbia
Authors: Raduski Nada
Published: January 2012

In the article is going to presented the ethnic picture of the population of
the Serbia and the ethnodemographic changes in period 1991-2002, caused by
migration, natural movement, changed declaration on national affiliation, as
well as some political and socio-economic factors. Ethnocentric migrations
(voluntary and forced) primarily influenced on the change of ethnic structure
of the Serbia, in the sense of creating nationally more homogeneous region,
having in mind the national structure of refugee- population. On the other
side, the emigration of some other nationalities which migrated to their
mother countries due to political and economic reasons influenced on the
ethnic structure, too. Spatial distribution of population according to
nationality is an important aspect of demographic development conditioned
primarily by ethnically differentiated natural growth and migrations, but
also with the impact of numerous other factors. In Serbia is present an
exceptional concentration and homogenization of population of certain
nationalities. Due to specific territorial distribution and ethnic domination
of relevant national minorities in border parts of the country, the question
of their status and territorial-political organization gives special
severity and significance to the minority question in Serbia. Having in mind
that Serbia is a multiethnic and multiconfessional state, the protection of
minorities rights and good inter-ethnic relations are necessary for peace,
stability and democratic development of the Serbia and the Balkans region.
Global trade imbalance and economic crisis
Authors: Pelevic Branislav , Vuckovic Vladimir
Published: January 2012

Global trade imbalance is one of the factors of the ongoing economic crisis.
Dependence of Western countries on capital from Asian countries created a
supply of innovative financial instruments, which drawn the world into
financial and economic crisis. After the crisis, international trade
collapsed, with some specific features: trade declined faster than
production, trade in equipment and durable consumer products plunged,
international supply chains suffered. Future challenges are related to
possible protectionism and wrong approaches for global rebalancing.
Management of markets in the transforming economy
Authors: Jakovlevich Zakharov
Published: January 2012

Management of markets in the transforming economy is considered as formation
of strategies of their development and understood as a learning process. A
theoretical basis of management of the markets is the
evolutional-institutional approach. The state promotes achievement of
long-term competitive advantages of the domestic manufacturers, eliminating
a fundamental inequality (?failures of the markets of the
transforming economy?) in a competition with developed countries.
FOXP3+ Regulatory T Cells in Children with Helicobacter Pylori Infection
Authors: Cho Ky Young , Cho Min Sun , Seo Jeong Wan
Published: January 2012

Despite an intensive pro-inflammatory response, the immune system is unable to clear the organism in Helicobacter pylori gastritis. Regulatory T (Treg) cells, which suppress the immune response of antigen-specific T cells, have recently been demonstrated to play a key role in chronic inflammation by immunologic tolerance. The purpose of our study was to investigate the histopathology, FOXP3+CD4+CD25highTreg (FOXP3+ Treg) cell expression, and immune responses in children with H. pylori infection. Twenty-four H. pylori–positive and 24 H. pylori–negative children who underwent esophagogastroduodenoscopy for dyspeptic symptoms were included. Histopathologic grading according to the updated Sydney classification and immunohistochemical stains for FOXP3, transforming growth factor–β1 (TGF-β1), and CD4 were performed. Histopathologic bacterial density score, gastritis activity score, and chronic inflammation score were higher in the H. pylori–positive group than in the negative group ( P < 0.01). The number of FOXP3+Treg cells and CD4+T cells and the grade of TGF-β1 expression were significantly increased in the H. pylori–positive group compared to the negative group ( P < 0.01). The number of FOXP3+Treg cells correlated positively with the grade of TGF-β1 expression regardless of H. pylori status ( P < 0.05). The number of FOXP3+Treg cells and the grade of TGF-β1 expression correlated positively with H. pylori density, gastritis activity score, and chronic inflammation score regardless of H. pylori status ( P < 0.01). These findings indicate that FOXP3+Treg cells could play a role in persistent H. pylori infection.
An Improved, Practical Model of Consumer Choice
Authors: Marchant Len , Prescott Phil , Jackson Nic
Published: January 2012

This paper describes a framework for understanding and researching brand choice. The underlying model starts from the assumption that purchasers faced with alternative brands will select what in their judgement suits them best. It develops the theory and the mathematics as simply as possible, and goes on to describe the marketing implications. It explains how to build a working model of the market using Monte Carlo techniques, and how this can be used to test the validity of the basic assumptions and to explore possible marketing strategies. It demonstrates, using real data from an actual study, how to interpret the market model in terms of purchasers' images of the brands. The paper will be of interest to both qualitative and quantitative researchers.
Using Card-Based Games to Enhance the Value of Semi-Structured Interviews
Authors: Rowley Jennifer , Jones Rosalind , Vassiliou Magda , Hanna Sonya
Published: January 2012

This article reports on the use of the card-based game method in semi-structured interviews in three separate research projects. The essence of the method is simple: cards are created with words or images to represent the concepts or terms that are central to the topics in a semi-structured interview; the cards then act as visual cues to facilitate focus and prompt reflection. Of greater interest is the application of the approach in specific contexts, and the benefits that accrue from its application. This research demonstrates that the card game method can be used to provide qualitative validation of theoretical models, and can be applied variously to elicit and explore definitions, priorities, processes, challenges, issues, difficulties, views on the future and critical success factors. The card game method and other innovative techniques that involve the interviewee in activities have the potential to enhance the value of semi-structured interviews.
Evidence-based health care in Nepal: The importance of systematic reviews
Authors: Van Teijlingen Edwin Roland , Simkhada Bibha , Ireland Jillian C.M. , Simkhada Padam P. , Bruce Julie
Published: January 2012

Systematic reviewing involves a structured, rigorous, and objective approach to provide a critical synthesis of the available evidence in a particular field.   This paper provides a guide to the key steps to undertake a systematic review. It describes the steps to search for relevant literature, provides advice on how to extract data, synthesize and then interpret data during the review process. It also provides the key references and guidelines which are commonly used for systematic review. It is important that researchers conduct and publish systematic reviews to help generate appropriate evidence to interventions and identify gaps in ‘local’ research. The authors argue that there is a place for systematic reviews in health services research in Nepal. Finally, this paper acknowledges that evidence should be considered within the local health situation and context.http://dx.doi.org/10.3126/nje.v1i4.5498 Nepal Journal of Epidemiology 2011;1(4):114-118
Medications for Anxiety: A Drug utilization study in Psychiatry Inpatients from a Tertiary Care Centre of Western Nepal
Authors: Banerjee Indrajit , Roy Bedanta , Sathian Brijesh , Banerjee Indraneel , Kumar Sai Sailesh , Saha Archana
Published: January 2012

Background   Anxiety is the most widespread psychiatric disorder and generalized anxiety disorder is the most common disease seen in the primary care setting. Currently there are a number of anxiolytic drugs commercially available in the market for treatment of these disorders such as Benzodiazepines like Diazepam, Chlordiazepoxide, Alprazolam, Betablockers like Propranolol and H1 Antihistaminics like Hydroxyzine. Some of the newer anxiolytics like Buspirone in Azapirone group is marketed as better anxiolytic drug than the traditional drugs.  Buspirone is promoted as a better drug for anxiety, as it does not cause any sedation, tolerance or physical dependence. A need for study further increases as there is no sufficient data on utilization pattern of anxiolytics on Nepalese population. This is the first study done in the utilization pattern of anxiolytic drugs in inpatient in Nepal.  Methods This is an observational study undertaken between 1st October 2009 and 31st March 2010 at the Psychiatric inpatient Department of Manipal Teaching Hospital. The prescribing pattern of Anxiolytic drugs was measured. Out of a total of 240 cases who were admitted to psychiatry inpatient ward, 38 cases have received Anxiolytic drugs. Those who were critically ill with anxiety were included in the study.  Results Out of 240 cases who were admitted to psychiatry inpatient, 130 were male patients (54.2%), 95% CI [47.9,60.5] and the rest were female patients (45.8%), CI [39.5,52.1] . In 38 cases of anxiety, the age of the patient <40 years 89.5% and >40 years 10.5%. Anxiety was more common in females 71.1% than in males 28.9%. 68.4% of the patients were unemployed whereas only 31.6% of the patients were employed. 78.9% of the drugs were prescribed by trade name. Among the anxiolytics, the commonest drug prescribed was Alprazolam (50%), followed by Clonazepam (31.6%), Chlordiazepoxide (15.8%) and Lorazepam (2.6%). Conclusion Utilization patterns of drugs for anxiolytics were according to treatment guidelines and suggested a trend towards the use of shorter acting Benzodiazepines such as Alprazolam. Continuous and prolonged use of longer acting Benzodiazepines has resulted in dependence and may have withdrawal symptoms when the dosage of these drugs is reduced or treatment is stopped.http://dx.doi.org/10.3126/nje.v1i4.5753 Nepal Journal of Epidemiology 2011;1(4):119-125
Blood Group Distribution and Its Relationship with Bleeding Time and Clotting Time: A Medical School Based Observational Study among Nepali, Indian and Sri Lankan Students
Authors: Roy Bedanta , Banerjee Indrajit , Sathian Brijesh , Mondal Monami , Saha Chhanchu Gopal
Published: January 2012

Background Blood group, Bleeding Time and Clotting time are clinically useful tests, extensively used during blood transfusion, platelet disorders and a variety of forms of treatment in hospitals. The objective of our study was to assess the country wise distribution of blood groups and to compare the country wise bleeding time and clotting time with respect to blood group. Material and Methods This Observational Study has been performed at Manipal College of Medical Sciences, during the period of 1st May 2010 to 31st August–2011. The study was carried out on the undergraduate medical students of Basic sciences and included assessment of Bleeding time, Clotting time and Blood grouping by standard procedures. Results 261 medical students participated in the study. Among the Nepalese students, 30.5% had blood group A, 28.9% B, 5.5% AB and remaining 35.2% O. among the Indian students, 22.8% were blood group A, 45.7% B, 7.6% AB and 23.9% O. In Sri Lankan students, 22% had blood group A, 19.5% B, 4.9% AB, and 53.7% blood group O. Among Nepalese students, BT was higher in blood group A (163.85 seconds) as compared to Indians (154.29Sec) and Sri Lankans (133.33 sec). Nepalese students with AB blood group had higher BT (171.43 sec). Indian students with blood group A had comparatively higher clotting time (328.57 sec) followed by Nepali (276.15 sec) and then Sri Lankan students (270 sec). Girls are 4.432 times more prone for bleeding time greater than 4 minutes and 2.453 times for clotting time value above 6 minutes as compared to males. Conclusion Our study suggests that O blood group is predominant in Nepalese students while Blood group B was the most common blood group in the Indian students. We found higher BT and CT in females, which are more prominent in Indians, so this gender disparity is an additional risk factor for them. Health Ministries of respective countries have to improve the proper health care policies required for prevention and management of blood group diseases, bleeding time and clotting time related disorders like Hypoprothrombinemia and Thrombocytopenia.http://dx.doi.org/10.3126/nje.v1i4.5755 Nepal Journal of Epidemiology 2011;1(4):135-140
Reliability of the Jones Patellofemoral Osteoarthritis Score for Radiological Assessment of Patellofemoral Degenerative Changes: Comparing a Physiotherapist to Doctors
Authors: Smith T.O. , Kang S.-N. , De Sprenger Rover W.B. , Walton N.P.
Published: January 2012

Purpose: Radiological measurement scores are used by orthopaedic physiotherapists in triage and surveillance of patients with degenerative changes of the tibiofemoral and patellofemoral joints. The purpose of this study was to estimate the intra- and inter-observer reliability of a radiological measurement score to assess patellofemoral joint osteoarthritis, the Jones Patellofemoral Osteoarthritis Score (JPOS), with an orthopaedic physiotherapist and three grades of junior surgeons/doctors. Methods: A total of 390 skyline X-rays of the patellofemoral joint were reviewed on 2 occasions, 4 weeks apart, by an orthopaedic physiotherapist, 2 orthopaedic surgeons, and an orthopaedic doctor. Intra- and inter-observer reliability of the JPOS was calculated using a weighted kappa analysis. Results: The results indicated that while there was good overall intra-observer agreement for this measurement score for all assessors, inter-observer reliability was generally poor between the orthopaedic physiotherapist and the orthopaedic surgeons/doctor. Conclusion: Our findings call into question the use of the JPOS by orthopaedic physiotherapists working in triage or orthopaedic surveillance programmes with other orthopaedic clinicians.
Wilfred Bion's Letters to John Rickman (1939–1951)Introduction
Authors: Vonofakos Dimitris , Hinshelwood Bob
Published: January 2012

This is a collection of 29 letters, 27 from Wilfred Bion to John Rickman, one addressed to Mrs Rickman and one from Rickman to Bion. These letters have been fully transcribed, annotated and published for the first time and offer a rare glimpse into the blossoming relationship between the two men and the gradual emergence of Bion's intellect through his work in War Office Selection Boards (WOSBs), the Northfield Military hospital and the exploratory groups at the Tavistock Clinic.Through this material it becomes evident that Bion's fascination with the work undertaken at WOSBs had more to do with the social ramifications of the principles and ideology applied there rather than with particular techniques per se, such as ‘leaderless groups’. Furthermore, the reader becomes witness to Rickman's profound influence on Bion's analytic work and in cultivating his interest in therapeutic institutions, ultimately leading to their groundbreaking work at Northfield Military hospital. While Bion's descriptions of his post-war group work at the Tavistock Clinic offer the first signs of his unique theory and technique on the exploration of group dynamics. The continuation of their correspondence until Rickman's untimely death is a testament to their strong collegial and personal relationship which transcended analytical work and other professional engagements.
The LettersThe ‘Spear Head of an Advance’: Bion's Wartime Letters to Rickman
Authors: Roper Michael
Published: January 2012

This article assesses the contributions of Wilfred Bion and John Rickman to military psychiatry in World War II in the light of their lives and careers before the war. While Bion entered World War II with a distinguished record as a tank commander in World War I and an analysis with Rickman that was incomplete, the Quaker and ex-conscientious objector Rickman was surprised to find himself made a Major in the British Army. The creative partnership which Bion's letters to Rickman document, and which resulted in substantial developments in the understanding of groups, stemmed in part from the ways in which each was able to draw on their earlier experiences and reputations, one as a founding figure in the British psychoanalytic community, the other as a decorated veteran.
‘Dear Stokes’: Letters from Melanie Klein about Writing, Painting and Psychoanalysis
Authors: Sayers Janet
Published: January 2012

The article consists of letters from Melanie Klein (1882–1960) to the writer and painter, Adrian Stokes (1902–72). Spanning nearly 20 years (from 1940 to 1959) these letters concern family and psychoanalytic matters together with Klein's repeated request for the destruction of a portrait of her by William Coldstream, commissioned by Stokes in honour of her 70th birthday on 31 March 1952.
Effects of Shade on Nitrogen and Phosphorus Acquisition in Cereal-Legume Intercropping Systems
Authors: Whitehead Meighen , Isaac Marney E.
Published: January 2012

With increasing economic and environmental costs associated with fertilizer use, the need for low-input agroecological systems is on the rise. It is well documented that intercropping legumes can increase the supply of nutrients, through N2-fixation and P mobilization. Concurrently, the integration of trees in the agricultural landscape shows increasing evidence of nutrient inputs through efficient biogeochemical cycles. However, little is known about the effects shade has on legume-crop performance. This research aims to determine whether intercropping of the legumes soybean (Glycine max L. Merr.) and alfalfa (Medicago sativa) with wheat (Triticum turgidum durum) is beneficial for performance, particularly under shady conditions associated with tree-based intercropping. Test species were cultivated in hydroponics with a broad nutrient solution and steady state addition of N for 3 weeks. Individual plants were transferred to rhizoboxes with a 2 mm zone of soil for 16 days under (i) full sun or (ii) shade to mimic light levels at the tree-crop interface. Under monocropping, shading was found to significantly decrease wheat biomass. Intercropping wheat with alfalfa under full sun had no negative effect on growth but did increase wheat P uptake as compared to monocropped wheat. In contrast, intercropping wheat with soybean under full sun decreased wheat biomass, suggesting competition. However, under shade, this competitive effect was mitigated, as wheat exhibited similar biomass and higher N and P shoot concentration when associated with soybean as compared to monocropped wheat under lower light levels. This effect may be attributed to reduced biomass of soybean combined with higher soybean N2-fixation under shade. Legume-based intercrops may increase nutrient supply and growth but these beneficial effects will be dependent on matching species selection to light levels under tree-based intercropping.
Changes in Physical Fitness, Bone Mineral Density and Body Composition During Inpatient Treatment of Underweight and Normal Weight Females with Longstanding Eating Disorders
Authors: Bratland-Sanda Solfrid , Martinsen Egil W. , Sundgot-Borgen Jorunn
Published: January 2012

The purpose of this study was to examine changes in aerobic fitness, muscular strength, bone mineral density (BMD) and body composition during inpatient treatment of underweight and normal weight patients with longstanding eating disorders (ED). Twenty-nine underweight (BMI < 18.5, n = 7) and normal weight (BMI ≥ 18.5, n = 22) inpatients (mean (SD) age: 31.0 (9.0) years, ED duration: 14.9 (8.8) years, duration of treatment: 16.6 (5.5) weeks) completed this prospective naturalistic study. The treatment consisted of nutritional counseling, and 2 × 60 min weekly moderate intensive physical activity in addition to psychotherapy and milieu therapy. Underweight patients aimed to increase body weight with 0.5 kg/week until the weight gain goal was reached. Aerobic fitness, muscular strength, BMD and body composition were measured at admission and discharge. Results showed an increase in mean muscular strength, total body mass, fat mass, and body fat percentage, but not aerobic capacity, among both underweight and normal weight patients. Lumbar spine BMD increased among the underweight patients, no changes were observed in BMD among the normal weight patients. Three out of seven underweight patients were still underweight at discharge, and only three out of nine patients with excessive body fat (i.e., >33%) managed to reduce body fat to normal values during treatment. These results calls for a more individualized treatment approach to achieve a more optimal body composition among both underweight and normal to overweight patients with longstanding ED.
Tobacco Use, Exposure to Secondhand Smoke, and Cessation Counseling Among Health Professions Students: Greek Data from the Global Health Professions Student Survey (GHPSS)
Authors: Barbouni Anastasia , Hadjichristodoulou Christos , Merakou Kyriakoula , Antoniadou Eleni , Kourea Kallirrhoe , Miloni Evangelia , Warren Charles W. , Rahiotis George , Kremastinou Jenny
Published: January 2012

We conducted the GHPSS (Global Health Professions Student Survey) to obtain information regarding health profession students’ smoking habits and perceptions, exposure to secondhand smoke (SHS) as well as level of knowledge and training on tobacco use and smoking cessation counseling. GHPSS is a survey for third-year students in the following fields: health visitors, dentistry, medicine, nursing and/or pharmacy. The highest tobacco use prevalence rate and exposure to SHS were recorded among health visitor students with 46.4% and 33.3% respectively. The majority of the respondents believed that their profession serves as a role model for their patients. Formal training on cessation counseling ranged between 10.7% for health visitor students to 22.4% for nursing students. The relatively high percentage of health profession students who currently smoke and the alarmingly high percentage of those exposed to SHS indicate lack of concerted efforts for implementation and effective enforcement of the anti-tobacco policy measures. Despite its significance, formal training on cessation counseling for students is strikingly low. These results indicate the urgent need to train health professional students on tobacco cessation counseling and educate them on the dangers of tobacco use, SHS and the positively influential role they can play to affect their patients’ smoking habits.
Local Mechanical Stimulation of Mardin-Darby Canine Kidney Cell Sheets on Temperature-Responsive Hydrogel
Authors: Harada Ichiro , Yanagisawa Shunpei , Iwasaki Katsuhiko , Cho Chong-Su , Akaike Toshihiro
Published: January 2012

Collective motion of cell sheets plays a role not only in development and repair, but also in devastating diseases such as cancer. However, unlike single-cell motility, collective motion of cell sheets involves complex cell-cell communication during migration; therefore, its mechanism is largely unknown. To elucidate propagation of signaling transduced by cell-cell interaction, we designed a hydrogel substrate that can cause local mechanical stretching of cell sheets. Poly (N-isopropyl acrylamide) (PNIPAAm) hydrogel is a temperature-responsive polymer gel whose volume changes isotropically in response to temperature changes below 37 °C. We designed a combined hydrogel substrate consisting of collagen-immobilized PNIPAAm as the local stimulation side and polyacrylamide (PAAm) as the non-stimulation side to assess propagation of mechanical transduction. Mardin-Darby canine kidney (MDCK) cells adhered to the collagen-immobilized PNIPAAm gel increased it area and were flattened as the gel swelled with temperature decrease. E-cadherin in these cells became undetectable in some domains, and actin stress fibers were more clearly observed at the cell base. In contrast, E-cadherin in cells adhered to the collagen-immobilized PAAm side was equally stained as that in cells adhered to the collagen-immobilized PAAm side even after temperature decrease. ERK1/2 MAPK activation of cells on the non-stimulated substrate occurred after partial stretching of the cell sheet suggesting the propagation of signaling. These results indicate that a change in the balance of mechanical tension induced by partial stretching of cell sheets leads to activation and propagation of the cell signaling.
Effective Heat and Mass Transport Properties of Anisotropic Porous Ceria for Solar Thermochemical Fuel Generation
Authors: Haussener Sophia , Steinfeld Aldo
Published: January 2012

High-resolution X-ray computed tomography is employed to obtain the exact 3D geometrical configuration of porous anisotropic ceria applied in solar-driven thermochemical cycles for splitting H2O and CO2. The tomography data are, in turn, used in direct pore-level numerical simulations for determining the morphological and effective heat/mass transport properties of porous ceria, namely: porosity, specific surface area, pore size distribution, extinction coefficient, thermal conductivity, convective heat transfer coefficient, permeability, Dupuit-Forchheimer coefficient, and tortuosity and residence time distributions. Tailored foam designs for enhanced transport properties are examined by means of adjusting morphologies of artificial ceria samples composed of bimodal distributed overlapping transparent spheres in an opaque medium.
Computational evidence for intramolecular hydrogen bonding and nonbonding X···O interactions in 2'-haloflavonols
Authors: Fonseca Tânia A O , Freitas Matheus P , Cormanich Rodrigo A , Ramalho Teodorico C , Tormena Cláudio F , Rittner Roberto
Published: January 2012

The conformational isomerism and stereoelectronic interactions present in 2'-haloflavonols were computationally analyzed. On the basis of the quantum theory of atoms in molecules (QTAIM) and natural bond orbital (NBO) analysis, the conformer stabilities of 2'-haloflavonols were found to be dictated mainly by a C=O···H–O intramolecular hydrogen bond, but an unusual C–F···H–O hydrogen-bond and intramolecular C–X···O nonbonding interactions are also present in such compounds.
E-Leadership and Information Literacy
Authors: Farmer Lesley
Published: January 2012

In the information society, learners need to locate and evaluate resources carefully as well as determine how to use relevant information to solve problems and make wise decisions. As more students learn in online environments, resources and support must be available to optimize their success. Information literacy offers a series of processes as a means to deal successfully with information. By melding information literacy and content matter in e-learning environments, instructional designers can create authentic experiences for students to hone their skills. E-leadership is a core factor for successful experiences. E-leaders orchestrate people, processes, and systems to optimize education’s operations and impact. Within that charge, technology plays a central role.
Community College Leadership and Technology
Authors: Robinson Petra A. , Metoyer Tyra , Byrd David , Louis Dave , Bonner Fred A.
Published: January 2012

Community colleges serve an important role in local communities across the United States. These institutions, based on their mission, seek to fulfill a social contract as partner in community development in the 21st century. Their function in local and the wider US community is undeniably important; more than half of the college students enrolled in the United States attend community, technical, and junior colleges (Pew Research Center, 2009). Community college leaders face especially challenging times given the economic, social, political, and technological contexts within which these institutions operate. This chapter brings focus to the various nuances of community college educational leadership with specific focus on technology in this new virtual age.
Leadership for Learning
Authors: Kevany Kathleen M.
Published: January 2012

To address current pressures in higher education of viability and sustainability, while also being ambitious and relevant require well placed leadership, technology, and information. The prudent use of technology by competitors can threaten the uptake of high quality education at a non-innovative institute. This is the era of the transforming university through the innovative application of leadership and technology. Expanding avenues for distance education and online learning may help to activate knowledge and skills needed in an epoch of globalization. Impediments facing administrators, educators, and peer-to-peer relations along with opportunities and strategies for employing leadership and ICTs are examined for their impact on learning and culture. Recommendations to enhance accessibility, connectivity, and ingenuity are included.
Sustaining Organizational Innovation
Authors: Allen Jeff , Gojer Ashwini Joshua , Gavrilova-Aguilar Mariya , Philpot Denise
Published: January 2012

Organizational change is a situation, while innovation is an attitude of change. Organizations cannot, in a global economy, remain static and rooted in current practices. Organizational innovation is the necessary ingredient for successful change. More difficult than both change and innovation is the subject of sustainability. Change is often a temporary “fix” that quickly reverts to status-quo. This chapter recommends practices for change management and organizational innovation by reviewing change theories, describing innovation models, referencing sustainability leadership, and providing examples of technology integration. Educators, trainers, performance specialists, change agents, managers, and organizational development professionals will benefit by understanding the principles and future trends of innovation. Both educational institutions and industrial organizations will utilize the guiding questions to determine their readiness to embrace organizational innovation. The goal is to instill the need for an attitude of change in all stakeholders of the organization in order to be well equipped to direct the nation’s workforce.
Frequency Synchronization for OFDM/OFDMA Systems
Authors: Bayón Javier González , Vaquer Carlos Carreras , Herrero Angel Fernández
Published: January 2012

Orthogonal frequency division multiplexing (OFDM) has been the focus of many studies in wireless communications because of its high transmission capability and its robustness to the effects of frequency-selective multipath channels. However, it is well known that OFDM systems are much more sensitive to a carrier frequency offset (CFO) than single carrier schemes with the same bit rate. Therefore, a frequency synchronization process is necessary to overcome this sensitivity to frequency offset. Synchronization is performed in two stages: acquisition and tracking. After a first estimation and correction of the CFO performed in the acquisition stage, there still remains a residual frequency offset (RFO) due to real system conditions. Therefore, the RFO tracking has to be performed for all the receiving data. Frequency synchronization is even more complicated for uplink communications in OFDMA (orthogonal frequency division multiple access) systems because the base station (BS) has to deal with signals from different users in the same bandwidth. Each user’s data is affected by a different CFO. Because of this, estimation and correction of the CFOs cannot be accomplished by the same methods as in OFDM systems.