bluuebunny/crossref_metadata_2025 huggingface dataset:
Strengths-Based Nursing: A Process for Implementing a Philosophy Into Practice
Authors: Gottlieb Laurie N. , Gottlieb Bruce
Published: July 2017

Strengths-Based Nursing (SBN) is both a philosophy and value-driven approach that can guide clinicians, educators, manager/leaders, and researchers. SBN is rooted in principles of person/family centered care, empowerment, relational care, and innate health and healing. SBN is family nursing yet not all family nursing models are strengths-based. The challenge is how to translate a philosophy to change practice. In this article, we describe a process of implementation that has organically evolved of a multi-layered and multi-pronged approach that involves patients and families, clinicians, educators, leaders, managers, and researchers as well as key stakeholders including union leaders, opinion leaders, and policy makers from both nursing and other disciplines. There are two phases to the implementation process, namely, Phase 1: pre-commitment/pre-adoption and Phase 2: adoption. Each phase consists of distinct steps with accompanying strategies. These phases occur both sequentially and concurrently. Facilitating factors that enable the implementation process include values which align, readiness to accept SBN, curiosity–courage–commitment on the part of early adopters, a critical mass of early adopters, and making SBN approach both relevant and context specific.
Hospital Supply Expenses: An Important Ingredient in Health Services Research
Authors: Abdulsalam Yousef , Schneller Eugene
Published: July 2017

The purpose of this article is to shed light on hospital supply expenses, which form the second largest expense category after payroll and hold more promise for improving cost-efficiency compared to payroll. However, limited research has rigorously scrutinized this cost category, and it is rarely given specific consideration across cost-focused studies in health services publications. After reviewing previously cited estimates, we examine and independently validate supply expense data (collected by the American Hospital Association) for over 3,500 U.S. hospitals. We find supply expenses to make up 15% of total hospital expenses, on average, but as high as 30% or 40% in hospitals with a high case-mix index, such as surgery-intensive hospitals. Future research can use supply expense data to better understand hospital strategies that aim to manage costs, such as systemization, physician–hospital arrangements, and value-based purchasing.
Dynamic contact of a thermoelastic Mindlin–Timoshenko beam with a rigid obstacle
Authors: Bock Igor
Published: July 2017

We concentrate on the dynamics of a thermoelastic Mindlin–Timoshenko beam striking a rigid obstacle. We state classical formulations involving complementarity conditions. Weak formulations are in the form of systems consisting of a hyperbolic variational inequality for a deflection, a hyperbolic and a parabolic equation for an angle of rotation and a thermal strain, respectively. The penalization method is applied to solve the unilateral problem. The time derivative of the function representing the deflection of the beam’s middle line is not continuous due to the hitting the obstacle. The acceleration term has the form of a vector measure.
Habit in Personality and Social Psychology
Authors: Wood Wendy
Published: July 2017

Habits are largely absent from modern social and personality psychology. This is due to outdated perspectives that placed habits in conflict with goals. In modern theorizing, habits are represented in memory as implicit context–response associations, and they guide responding in conjunction with goals. Habits thus have important implications for our field. Emerging research shows that habits are an important mechanism by which people self-regulate and achieve long-term goals. Also, habits change through specific interventions, such as changes in context cues. I speculate that understanding of habits also holds promise for reducing intergroup discrimination and for understanding lay theories of the causes for action. In short, by recognizing habit, the field gains understanding of a central mechanism by which actions persist in daily life.
Cytogenetic Profile and FLT3 Gene Mutations of Childhood Acute Lymphoblastic Leukemia
Authors: Alkhayat Nawaf , Elborai Yasser , Al Sharif Omer , Al Shahrani Mohammad , Alsuhaibani Omar , Awad Mohammed , Elghezal Hatem , ben-abdallah Bouhajar Inesse , Alfaraj Mona , Al Mussaed Eman , Alabbas Fahad , Elyamany Ghaleb
Published: July 2017

Background:

Childhood acute lymphoblastic leukemia (ALL) is characterized by recurrent genetic aberrations. The identification of those abnormalities is clinically important because they are considered significant risk-stratifying markers.

Aims:

There are insufficient data of cytogenetic profiles in Saudi Arabian patients with childhood ALL leukemia. We have examined a cohort of 110 cases of ALL to determine the cytogenetic profiles and prevalence of FLT3 mutations and analysis of the more frequently observed abnormalities and its correlations to other biologic factors and patient outcomes and to compare our results with previously published results.

Materials and methods:

Patients—We reviewed all cases from 2007 to 2016 with an established diagnosis of childhood ALL. Of the 110 patients, 98 were B-lineage ALL and 12 T-cell ALL. All the patients were treated by UKALL 2003 protocol and risk stratified according previously published criteria. Cytogenetic analysis—Chromosome banding analysis and fluorescence in situ hybridization were used to detect genetic aberrations. Analysis of FLT3 mutations—Bone marrow or blood samples were screened for FLT3 mutations (internal tandem duplications, and point mutations, D835) using polymerase chain reaction methods.

Result:

Cytogenetic analysis showed chromosomal anomalies in 68 out of 102 cases with an overall incidence 66.7%. The most frequent chromosomal anomalies in ALL were hyperdiploidy, t(9;22), t(12;21), and MLL gene rearrangements. Our data are in accordance with those published previously and showed that FLT3 mutations are not common in patients with ALL (4.7%) and have no prognostic relevance in pediatric patients with ALL. On the contrary, t(9;22), MLL gene rearrangements and hypodiploidy were signs of a bad prognosis in childhood ALL with high rate of relapse and shorter overall survival compared with the standard-risk group ( P = .031).The event-free survival was also found to be worse ( P = .040).

Conclusions:

Our data are in accordance with those published previously, confirming the overall frequency of cytogenetic abnormalities and their prognostic relevance.
Delay in clearing cervical spine injuries in obtunded trauma patients and its implications
Authors: Parmar Kamaljit K , Ho Kwok M , Bowles Timothy
Published: July 2017

Introduction

Prompt recognition of cervical spine injuries may limit spinal cord damage. This prospective audit assessed the time needed to formally confirm the status of cervical spine using a computed tomography scan, the reasons for any delays, and the subsequent outcomes.

Methodology

Prospective audit analysed the data of 100 consecutive unconscious trauma patients, admitted over a seven-month period, to ascertain whether there was a ‘weekend’ effect in validating the cervical spine status radiologically, and whether the delays were associated with an increased risk of pneumonia and other complications. The sensitivity and specificity of using bony fractures and mal-alignment on the computed tomography scans to diagnose cervical spine injuries were calculated.

Results

Significant radiological evidence of cervical spine injuries occurred in 37 patients (37%). A delay in >48 h to ascertain the cervical spine status occurred in 36 patients, mostly due to logistical (58%) reasons, and this was associated with an increased risk of pneumonia requiring antibiotics (p < 0.001). A ‘weekend’ effect and presence of cervical spine injuries were not significantly related to the time to confirm the cervical spine injury status radiologically. The specificity (98%) of using bony fractures and mal-alignment on the computed tomography to diagnose cervical spine injuries was high, but its sensitivity (83.8%) was only modest.

Conclusions

A delay to confirm the cervical spine injury status was common and associated with an increased risk of pneumonia in unconscious trauma patients, particularly among those who did not sustain any cervical spine injuries. The low sensitivity of computed tomography to exclude non-bony cervical spine injuries suggests that selective early use of magnetic resonance imaging scans for high-risk unconscious trauma patients may improve patient outcomes.
Weight- and meta-analysis of empirical literature on entrepreneurship
Authors: Alferaih Adel
Published: July 2017

While a number of studies have reviewed empirical research on individuals’ entrepreneurial intentions (EIs), very little is known about the cumulative performance of frequently used constructs and their direct and indirect relationships with EI. This research has exposed 123 usable empirical studies of EI to weight- and meta-analyses to determine the cumulative performance of various frequently explored relationships. A generic research model of the antecedents of EI is proposed on that basis. The outcomes of this research and its limitations have practical and theoretical implications for future entrepreneurship research.
Satisfaction with the supervision of undergraduate dissertations
Authors: Del Río M Luisa , Díaz-Vázquez Rosario , Maside Sanfiz José M
Published: July 2017

The undergraduate dissertation is characterized by a conflict between autonomy and support, in which the role of the supervisor is outlined; however, this role is not consistently defined either in the literature or in practice. As a result, a mismatch may arise between the dedication of the supervisor and the dedication expected from the student, which may affect both their satisfaction with the supervisor and the competences developed during the process. A structural equation model was used to test these relationships, concluding that the students who reported having acquired skills from the interaction with their respective supervisors are significantly more satisfied with them, and that the roles attributed to the supervisor by the student influence the skills developed. These findings suggest that it may be important to clarify the role of the supervisor in advance, according to the skills that are intended to be developed.
Sexual Violence Victimization Among College Females: A Systematic Review of Rates, Barriers, and Facilitators of Health Service Utilization on Campus
Authors: Stoner Julie E. , Cramer Robert J.
Published: July 2017

To date, little work specifically addresses empirical studies concerning barriers and facilitators to health service use among college female sexual violence victims. The following objectives were addressed: (1) analyze studies of college-aged women who have been victims of sexual violence to examine the frequency and moderating characteristics of utilization of university-based resources available, (2) identify inconsistencies and gaps in the literature concerning sexual victimization and service utilization, and (3) provide next steps for researchers and clinical care coordinators. Six electronic databases were searched from 1990 to May 2016. Inclusion criteria for the review were (1) university or college setting or sample, (2) empirical design, and (3) inclusion of some discussion or measurement of health service use. Following preferred reporting items for systematic reviews and meta-analyses (PRISMA) procedures, 22 articles were identified for the review. Although prevalence rates of sexual victimization were high (4.7–58%), rates of service utilization were lower (0–42%). There were significant discrepancies between hypothetical use of services and actual rates of service use. Identified barriers included feelings of shame, guilt and embarrassment, not wanting friends and family to find out, and thinking the victimization was not serious enough to report. Identified facilitators included acknowledging the sexual violence victimization as a crime, receiving encouragement from friends and family to utilize health services, and receiving a positive response during the initial informal disclosure. Finally, measurement of victimization was inconsistent across studies. Recommendations are offered for college campus prevention programming and future research.
A Propensity Score–Matched Analysis of Inflammatory Response With Endovascular Aneurysm Sealing vs Endovascular Aneurysm Repair
Authors: Berg Patrick , Stroetges Roland A. , Miller Larry E. , Schoefferle Jochen
Published: July 2017

Purpose: To evaluate the risk of postimplantation syndrome associated with endovascular aneurysm sealing (EVAS) and endovascular aneurysm repair (EVAR) in patients treated for abdominal aortic aneurysm (AAA). Methods: From December 2013 to May 2015, 41 AAA patients treated with EVAS (mean age 72±9 years; 38 men) and 63 with EVAR (mean age 74±10 years; 55 men) at a single center were retrospectively reviewed. To control for treatment selection bias, propensity score matching was used to compare outcomes by treatment mode. Main outcomes were postimplantation syndrome (defined as temperature >38°C and leukocyte count >12,000/µL), inflammatory response markers [platelets and high-sensitivity C-reactive protein (hs-CRP)], and clinical complications through 30 days. Results: In 39 matched patients per group, the incidences of postimplantation syndrome (p=0.07), mean body temperature (p=0.05), mean leukocyte count (p=0.003), and mean hs-CRP (p<0.001) were proportionally lower with EVAS vs EVAR. Serious adverse events (0% vs 12.8%, p=0.05) and endoleaks (0% vs 10.3%, p=0.13) through 30 days were less frequent with EVAS, but the group differences were not significantly different. The choice of endovascular graft material influenced postoperative and 30-day clinical outcomes, with greater overall risk observed with polyester stent-grafts. Conclusion: Endovascular aneurysm sealing is associated with a blunted systematic inflammatory response compared with EVAR. Polyester stent-grafts induce the greatest periprocedural inflammatory response.
Ultrasound probe grip: the afternoon tea technique
Authors: McMenamin Luke , Wolstenhulme Stephen , Hunt Max , Nuttall Stuart , Weerasinghe Asoka
Published: July 2017

Background

Globally, ultrasound is being used to assist in central venous and difficult peripheral intravenous access in a variety of emergency and non-emergency clinical settings.

Context

After reading Flood’s paper on safe central venous access and noting the difficulties clinicians find in probe stabilisation whilst performing dynamic intravenous access, we decided to share our teaching technique.

Innovation

The purpose of this correspondence is to highlight the ‘afternoon tea technique’ as a potential teaching method for probe stabilisation.

Implications

It is hoped that this technique will improve the image quality in dynamic procedures and increase the success rate of ultrasound-guided intravenous access in clinical practice.
Serving the Media Ministers: A Mixed Methods Study on the Personalization of Ministerial Communication
Authors: Figenschou Tine Ustad , Karlsen Rune , Kolltveit Kristoffer , Thorbjørnsrud Kjersti
Published: July 2017

The personalization of politics has received much attention in both the political science and political communication literature, but the focus has almost entirely been on party leaders and prime ministers. This study investigates the personalization of ministerial communication in Norway, a type of decentralized personalization. It combines a survey of communication workers; in-depth interviews with politicians, communication workers, political reporters, and top-level civil servants; and ethnographic observation inside a ministry. The article goes beyond media-centered perspectives and identifies several potential drivers and barriers to personalization processes. Based on our mixed methods approach, we find that ministerial communication in Norway is strongly centered on the minister in both reactive media management and the proactive promotion of the minister and new policies. This decentralized personalization is driven by both demands from the media and the strategic adaptation by political and administrative actors within ministries. Based on the rich empirically grounded insights, the article discusses how the interplay between the logic of the contemporary commercial news media, political ambitions, internal administrative ambitions, and changes in executive government shapes the personalization of ministerial communication, and illuminates how these multiple drivers of personalization are mutually reinforcing.
Isolated revision of the acetabular component using alumina-on-alumina bearings without a metal sleeve: A preliminary study
Authors: Wu Kuan-Ting , Wang Jun-Wen , Lu Yu-Der , Yen Shih-Hsiang , Lee Mel S.
Published: July 2017

Introduction:

There has been a debate on the use of ceramic-on-ceramic coupling with the retained femoral stem in isolated acetabular revision. The purpose of this study was to retrospectively review the results and complications of isolated revision of the acetabular component using alumina-on-alumina bearings.

Methods:

Between August 2010 and December 2013, 22 patients (23 hips) with a mean age of 60.74 years (40–73) underwent isolated revision of the acetabular component from metal-on-polyethylene to alumina-on-alumina bearings without using a metal sleeve on the undamaged trunnion. All patients completed clinical and radiographic evaluation.

Results:

At a mean follow-up of 3 years (2–5.5), all patients had a significant improvement in the clinical outcome, including Harris Hip Score (84.9 vs. 43, p < 0.001), West Ontario McMaster University Osteoarthritis Index Score (14.4 vs. 49.2, p < 0.001), and visual analogue pain score (1.42 vs. 6.63, p < 0.001). Complications included one aseptic loosening of the acetabular component and three noisy hips (click only). No fracture of the ceramic bearings, dislocation, infection, or squeaking noise were observed in any of the patients.

Conclusion:

Isolated revision of the acetabular component to alumina-on-alumina bearings on the undamaged trunnion may be considered if there is no available titanium sleeves. Our study showed a satisfactory early outcome with minimal complications. However, a longer term follow-up study is necessary.
Nonoperative Management of Osteochondritis Dissecans of the Knee: Progression to Osteoarthritis and Arthroplasty at Mean 13-Year Follow-up
Authors: Sanders Thomas L. , Pareek Ayoosh , Johnson Nick R. , Carey James L. , Maak Travis G. , Stuart Michael J. , Krych Aaron J.
Published: July 2017

Background:

Osteochondritis dissecans (OCD) is a disorder of subchondral bone that commonly affects the knee.

Purpose:

To (1) evaluate the rate of arthritis and knee arthroplasty in a population-based cohort of patients with OCD lesions treated nonoperatively and (2) evaluate factors that may predispose patients to knee osteoarthritis and arthroplasty.

Study Design:

Case series; Level of evidence, 4.

Methods:

Eighty-six patients (mean age, 21.4 years) with OCD lesions treated nonoperatively were identified between 1976 and 2014. Information related to the diagnosis, laterality of lesion, details of treatment, and progression to arthritis was obtained from the medical record. Factors predictive of arthritis and arthroplasty (age, sex, body mass index [BMI], and lesion location) were examined.

Results:

At a mean ± SD follow-up of 12.6 ± 9.8 years from diagnosis, 13 patients (15%) were diagnosed with arthritis, corresponding to a cumulative incidence of 5.0% at 5 years, 10.0% at 10 years, 20.0% at 25 years, and 30.0% at 35 years. The cumulative incidence of arthroplasty was 1.0% at 5 years, 3.0% at 10 years, 8.0% at 25 years, and 8.0% at 35 years. BMI at diagnosis greater than 25 kg/m2 (hazard ratio [HR], 15.4; 95% CI, 1.9-124.5), patellar OCD lesions (HR, 15.0; 95% CI, 1.3-345.3), and diagnosis as an adult (HR, 21.7; 95% CI, 2.7-176.3) were factors associated with an increased risk of arthritis.

Conclusion:

Arthritis after nonoperative treatment of OCD lesions is a challenging problem, with an estimated 30% cumulative incidence at 35 years after diagnosis. In contrast, the long-term rate of arthroplasty is low. BMI at diagnosis greater than 25 kg/m2 and patellar OCD lesions are predisposing factors for arthritis. Diagnosis of OCD as an adult was associated with a greater risk of arthritis.
Three-Dimensional Biomechanical Analysis of Rearfoot and Forefoot Running
Authors: Knorz Sebastian , Kluge Felix , Gelse Kolja , Schulz-Drost Stefan , Hotfiel Thilo , Lochmann Matthias , Eskofier Björn , Krinner Sebastian
Published: July 2017

Background:

In the running community, a forefoot strike (FFS) pattern is increasingly preferred compared with a rearfoot strike (RFS) pattern. However, it has not been fully understood which strike pattern may better reduce adverse joint forces within the different joints of the lower extremity.

Purpose:

To analyze the 3-dimensional (3D) stress pattern in the ankle, knee, and hip joint in runners with either a FFS or RFS pattern.

Study Design:

Descriptive laboratory study.

Methods:

In 22 runners (11 habitual rearfoot strikers, 11 habitual forefoot strikers), RFS and FFS patterns were compared at 3.0 m/s (6.7 mph) on a treadmill with integrated force plates and a 3D motion capture analysis system. This combined analysis allowed characterization of the 3D biomechanical forces differentiated for the ankle, knee, and hip joint. The maximum peak force (MPF) and maximum loading rate (LR) were determined in their 3 ordinal components: vertical, anterior-posterior (AP), and medial-lateral (ML).

Results:

For both strike patterns, the vertical components of the MPF and LR were significantly greater than their AP or ML components. In the vertical axis, FFS was generally associated with a greater MPF but significantly lower LR in all 3 joints. The AP components of MPF and LR were significantly lower for FFS in the knee joint but significantly greater in the ankle and hip joints. The ML components of MPF and LR tended to be greater for FFS but mostly did not reach a level of significance.

Conclusion:

FFS and RFS were associated with different 3D stress patterns in the ankle, knee, and hip joint, although there was no global advantage of one strike pattern over the other. The multimodal individual assessment for the different anatomic regions demonstrated that FFS seems favorable for patients with unstable knee joints in the AP axis and RFS may be recommended for runners with unstable ankle joints.

Clinical Relevance:

Different strike patterns show different 3D stress in joints of the lower extremity. Due to either rehabilitation after injuries or training in running sports, rearfoot or forefoot running should be preferred to prevent further damage or injuries caused by inadequate biomechanical load. Runners with a history of knee joint injuries may benefit from FFS whereas RFS may be favorable for runners with a history of ankle joint injuries.
Fragile State in Iraq and Women Security
Authors: Koolaee Elaheh , Akbari Ziba
Published: July 2017

After the Cold War and the terrorist attacks of September 11, 2001, the term “fragile states” has gained increasing prominence in security debates and the international community turned its attention to how to deal with such countries. These security concerns originate from several factors: emphasis on building peace and security, spread of this idea that development and security are related, and the principle that the stability of state plays an influential role in its development. The term “fragile state” refers to weak states that are vulnerable to internal and external threats and have a poor government that is incapable of managing internal affairs and external policy. In this regard, Iraq was considered as a fragile state after 2003, and its stability has been evaluated poor since ever. The present study employed indices of fragile state and human security in order to investigate the effect of Iraq’s fragile state on development of threats to women security. Violation of human security in Iraq after 2003 was caused by failure in nation state-building process and weakness of Iraqi government in maintaining societal order and unity. Therefore, the main question that the present study aims to address is: “How has women security been threatened by Iraq’s crisis and its fragile state?”
Feasibility and Quality Determinants of 3D Sonography in Children With Hydronephrosis
Authors: Otero Hansel J. , Cerrolaza Juan J. , Loomis Judyta , George Amanda , Biggs Elijah , Jago James , Linguraru Marius G.
Published: July 2017

The objective was to determine the image quality of 3D diagnostic medical sonography (DMS) in children with hydronephrosis. 3D DMS was assessed based on 24 pediatric patients. Image quality was evaluated by two radiologists and a sonographer in terms of rib shadowing, cut-off parenchymal edges, motion artifact, and overall quality. The interreader reliability and relation between image quality and other variables were calculated. The results were based on images of 32 hydronephrotic kidneys. The average quality scoring of the images was quite high. Rib shadowing, cut-off edges, and motion artifact were present in the majority of the cases. The interreader reliability for overall quality, rib shadowing, cut-off, and motion was quite high. There was a correlation between the Society for Fetal and Neonatal Urology’s hydronephrosis grade and higher cut-off edges. Larger kidneys were more likely to show cut-off, motion, and lower quality scores. In this cohort of infants and toddlers with hydronephrotic kidneys, 3D DMS demonstrated good image quality; however, artifacts were attributed to kidney size and severity of hydronephrosis.
Use of Doppler Sonography in Evaluating the Effect of Age in the Central Retinal Artery: A Cohort Study
Authors: Mahmoud Mustafa Z.
Published: July 2017

Intracranial arterial Doppler derived resistive indices (RI), peak systolic velocities (PSV), end diastolic velocities (EDV), and pulsatility indices (PI) have been shown to differ across age groups; therefore, the flow parameters in the central retinal artery (CRA) could also be expected to vary. The aim of this study was to evaluate the effect of age in CRA hemodynamics in a convenience sample of healthy men by using Doppler sonography. A total of 100 healthy adult male participants were recruited prospectively. Hitachi (HI VISION Avius) ultrasound equipment was used to measure the CRA PSV, EDV, RI, and PI within the right eye. Data were analyzed to determine velocity flow differences based on age. The results indicated that the CRA’s PSV and EDV declined with increasing age. The CRA’s RI and PI increased with age. Further research is indicated, specifically employing research designs that are statistically powered and use age matching, to generate clinically useful interpretations.
The genome of the cotton bacterial blight pathogen Xanthomonas citri pv. malvacearum strain MSCT1
Authors: Showmaker Kurt C. , Arick Mark A. , Hsu Chuan-Yu , Martin Brigitte E. , Wang Xiaoqiang , Jia Jiayuan , Wubben Martin J. , Nichols Robert L. , Allen Tom W. , Peterson Daniel G. , Lu Shi-En
Published: July 2017

Xanthomonas citri pv. malvacearum is a major pathogen of cotton, Gossypium hirsutum L.. In this study we report the complete genome of the X. citri pv. malvacearum strain MSCT1 assembled from long read DNA sequencing technology. The MSCT1 genome is the first X. citri pv. malvacearum genome with complete coding regions for X. citri pv. malvacearum transcriptional activator-like effectors. In addition functional and structural annotations are presented in this study that will provide a foundation for future pathogenesis studies with MSCT1.
Chronic wound treatment in elderly and geriatric patients
Authors: Waldhausen P. , Hermanns H.-J.
Published: July 2017

In Germany, there has been a continuous increase in life expectancy for more than 135 years. The number of people aged 80 years and over will triple until 2050. Chronic wounds in different aetiologies will increase in our ageing population, with a parallel growth in numbers of comorbidities and geriatric syndromes. Beside vascular difficulties of wound healing and physiological changes in skin conditions among the elderly, we are challenged by the treatment of comorbidities such as diabetes mellitus, neurological diseases (Polyneuropathy), the decrease of mobility and the increase of joint troubles, as well as cognitive, emotional and motoric deficits and even dementia. On the basis of the expected progress in age, we have selectively analysed our patients from the age of 80 up to the age of 100 years with chronic wounds, leg and foot ulcers, treated in a specialised wound care centre. Further, we performed a statistical evaluation for the geriatric medical department with focus on geriatric patients with additional wound-healing problems.
Diabetic foot syndrome in elderly patients
Authors: Eckert S.
Published: July 2017

In elderly patients with diabetes mellitus and mild deterioration of the lower extremities, peripheral artery disease and diabetic peripheral neuropathy may contribute to the development of a diabetic foot syndrome. Early diagnosis and intervention can help to preserve the foot and thus significantly increase quality of life with diagnostic and therapeutic procedures being the same in elderly and in young patients.

Non-invasive diagnosis is possible in most bed-ridden patients and should take into account reasonable therapeutic options against the background of overall morbidity, physical performance and quality of life, which should be discussed with the patient and his relatives. Multidisciplinary care structures facilitate treatment and might lead to reduced amputation rates and an improved well-being.
“Blaming, shaming, humiliation”: Stigmatising medical interactions among people with non-epileptic seizures
Authors: Robson Catherine , Lian Olaug S.
Published: July 2017

Background: People with non-epileptic seizures (NES) describe difficult and challenging relationships with health professionals, and explain negative interactions as common and expected. Despite these difficulties, little is known about how people with NES experience healthcare encounters.

Methods: Using a thematic discourse analysis approach, we analysed the free-text survey responses of 135 people with NES and asked: what kind of challenges do people living with this condition encounter when interacting with health professionals, and how do they experience the consequences of difficult interactions? We explore their experiences by interpreting the latent meaning of participants’ texts from a social-constructionist perspective on health and illness.

Results: The overarching narrative depicts a fundamental breakdown in patient-provider relationships. According to our data, the negative experiences of study participants emerge from more than practitioners’ lack of awareness of NES and access to information about the condition - to the extent that it is available. In examining the challenges people with NES encounter when interacting with health professionals, their main experiences centre on blame and humiliation. When exploring their experiences, theories of stigma serve as a useful theoretical framework.

Conclusions: Normative judgements arising from psychogenic understandings of NES are stigmatising and restrict professional displays of respectful (patient-centred) care.Those with the condition depict being negatively stereotyped, illegitimated and held morally culpable by health professionals. Perceived to lack medical, moral and credible status, participants describe practitioners who treat them with disrespect, and they recount conduct that defies ethical and professional obligations and standards. These encounters can have wide-ranging adverse consequences for patients: emotionally, physically, and for their future healthcare. The quality of healthcare interactions for people with NES requires urgent improvements. In addition to increased awareness of the condition, practitioners need to be conscious of making and acting on adverse moral appraisals when interacting with this patient group.
Psychometric properties of the schedule of growing skills II: Portuguese version
Authors: Varajidás Carla Afonso , Machado Magda , Mota Maria Paula , Martins Rui , Lisboa Maria Carmo , Soares Isabel , Sousa Susana , Leitão José Carlos
Published: July 2017

The second version of the Schedule of Growing Skills (SGS-II) was standardized using a sample of 348 UK children, ages 0 to 5 years. It examined ten psychomotor development areas in 14 age ranges. The Portuguese version of SGS-II was published in 2003, re-edited in 2011, and re-published in 2012, but its psychometric properties remained untested. The aim of this study was to evaluate the psychometric properties of the Portuguese version of SGS-II, comparing them with the results of the UK version. A sample of 364 Portuguese children, 193 boys and 172 girls, with an average age of 34.45 months (±18.62) was assessed with the SGS-II. The results have shown suitable psychometric properties of the SGS-II Portuguese version, adequate for the screening of children development. The internal consistency coefficients ranged from adequate to excellent (≥.7) and similar correlation results among the scale’s versions (English and Portuguese) were positive, high, and significant.
Emotional dysregulation as a predictor of peer attachment perceptions of adolescents in residential care
Authors: Lino Alexandra M. , Lima Luiza Nobre
Published: July 2017

Adolescentes em acolhimento residencial tendem a ter um desenvolvimento marcado por experiências de grande insegurança e ambivalência afetiva, exibindo com frequência níveis de desregulação emocional que comprometem a qualidade das suas relações interpessoais. Considerando que neste contexto o grupo de pares assume um papel de grande suporte emocional, este estudo procurou analisar os níveis de desregulação emocional de adolescentes acolhidos e o seu papel preditor na perceção da vinculação aos pares. Foi recolhida uma amostra de 100 adolescentes (71 raparigas; 29 rapazes) em acolhimento residencial, com idades entre os 12 e os 18 anos. Como instrumentos foram utilizados o Inventário de Desregulação Abreviado e o Inventário de Vinculação na Adolescência (versão para pares). Os níveis de desregulação reportados foram baixos, verificando-se uma maior desregulação afetiva do que comportamental. A desregulação cognitiva é a única que explica, negativamente, a variância da comunicação, da confiança e da perceção global de vinculação aos pares. A explicação pode residir no papel regulador que a cognição desempenha na gestão das emoções negativas e no controlo da sua expressão comportamental. Ainda que modestos, os resultados encorajam o investimento na promoção da regulação emocional dos adolescentes em acolhimento residencial, com vista ao estabelecimento de relações interpessoais seguras.
Quinoa (Chenopodium quinoa Willd.) versus soja (Glycine max [L.] Merr.) en la nutrición humana: revisión sobre las características agroecológicas, de composición y tecnológicas
Authors: Chito Trujillo Diana Maria , Ortega Bonilla Rubén Andrés , Ahumada Mamián Andrés Felipe , Rosero López Brandón
Published: July 2017

El diseño de alimentos funcionales a partir de productos vegetales muy estudiados como la soja (Glycine max [L.] Merr.) y la potencialización de productos ancestrales como la quinoa (Chenopodium quinoa Willd.) son estrategias factibles para contrarrestar la desnutrición mundial. El objetivo de la presente revisión es describir las características agroecológicas, de composición, nutricionales y tecnológicas de estas dos especies vegetales diferentes (leguminosa y pseudocereal), basado en las publicaciones previas. Se realizó una revisión en bases de datos (Scopus, Web of Science, Scielo) y se complementó con una búsqueda manual en Google Scholar y páginas web de instituciones acreditadas. Los estudios incluidos (n=117) en esta revisión muestran que la soja se adapta mejor a altitudes bajas (~1.000 m s. n. m.), mientras que la quinoa lo hace en un rango de mayores altitudes (500-4.000 m s. n. m.) con mayor tolerancia a heladas. Ambas son fuente de una alta calidad proteica por suplir los requerimientos de aminoácidos esenciales sugeridos para niños y adultos sin diferencias significativas (p>0,05), particularmente triptófano y lisina y por los altos porcentajes de digestibilidad (>70%). Sus concentraciones bajas de prolaminas y aceptables de Fe, Zn, Ca, daidzeína y genisteína los convierten en productos de interés para la industria alimentaria.
Análisis de la presencia de dietistas-nutricionistas en hospitales de Andalucía
Authors: García-Puche Alejandro , Cabañas-Alite Luis
Published: July 2017

Introducción: La figura profesional de referencia en el tratamiento dietético en el ámbito hospitalario es el dietista-nutricionista (DN). Su interés público coincide con los datos sobre su actuación y eficiencia clínica. El objetivo es describir su presencia en hospitales públicos y privados de Andalucía y analizar en qué medida se cumplen los criterios de la Declaración de postura de la Asociación Española de Dietistas-Nutricionistas (AEDN) sobre la incorporación del DN en el Sistema Nacional de Salud de 2009.Material y métodos: Se seleccionó como muestra hospitales públicos y privados del Registro de Centros, Establecimientos y Servicios Sanitarios de la Consejería de Salud y Bienestar Social. Se les contactó por vía telefónica y telemática, preguntando: servicios con los que cuenta, número de DN totales, unidades con DN y cantidad y número de camas. Los datos se compararon con la propuesta al Senado de la AEDN de 2009.Resultados: Se incluyeron 105 centros, de los que 57 eran públicos y 48 privados; contestaron 51 (48,6%), 31 públicos (el 54,4%) y 20 privados (el 41,7%). Se registraron 35 DN contratados, 31 en hospitales públicos (88,6%) y 4 en privados (11,4%). Exceptuando hospitales privados en Granada (20%) y Málaga (12,5%), el grado de cumplimiento del criterio estudiado es de 0% en el resto de Andalucía.Conclusiones: La presencia de DN en hospitales públicos y privados de Andalucía no cumple la propuesta presentada al Senado en 2009 por la AEDN. Hacen falta más estudios para observar la situación en distintas comunidades autónomas y describir la situación profesional de DN en hospitales.
Análisis de la tendencia del sobrepeso y obesidad en la población peruana
Authors: Tarqui-Mamani Carolina , Alvarez-Dongo Doris , Espinoza-Oriundo Paula Lita , Sanchez-Abanto Jose Ramon
Published: July 2017

Introducción: Sobrepeso y obesidad constituyen un problema de salud pública a nivel mundial y también en el Perú. El objetivo fue analizar la tendencia del sobrepeso y obesidad según edad, sexo y pobreza.Material y métodos: Estudio de tendencia que analiza el sobrepeso y obesidad en 175.984 peruanos durante 2007 y 2014. Las muestras fueron representativas y probabilísticas de hogares peruanos.Resultados: La tendencia del sobrepeso y obesidad incrementó en todos los grupos etarios (p<0,001), excepto los menores de 5 años. En hombres, la tendencia del sobrepeso incrementó (p<0,001) excepto en los niños. En mujeres, la tendencia incrementó en todos los grupos (p<0,001) excepto en los menores de 5 años y el grupo entre 20-29 años. En personas en situación de pobreza extrema, la tendencia del sobrepeso incrementó en los jóvenes, adultos y adultos mayores (p<0,001). En personas en situación de pobreza, la tendencia del sobrepeso incrementó (p<0,01) excepto en niños de 5-9 años. La tendencia de la obesidad en hombres y mujeres incrementó (p<0,001), excepto en niños menores de 5 años. En las mujeres, la excepción también fue en adultas mayores. Analizando la pobreza se observó que en personas en situación de pobreza extrema la tendencia de la obesidad incrementó en jóvenes y adultos (p<0,01). En personas en situación de pobreza, la tendencia de obesidad incrementó en los adolescentes, jóvenes y adultos (p<0,01).Conclusiones: La tendencia del sobrepeso y obesidad fue en incremento, excepto en niños menores de 5 años, habiendo predominio en varones y personas en situación de pobreza.
Classification of R&D infrastructure models in basic business incubators technology in the state of Paraná
Authors: Nery Vítor Felipe e Silva de Oliveira
Published: July 2017

Support for the development of new technology-based business is a major challenge in Brazil. One reason is the change of the paradigm of an economy based on supply of commodities to an economy of developing and offering technology. In this environment, business incubators are presented as a key player in this process. However, incubators lack of infrastructure available for the technological development of products, as entrepreneurs begin to demand something beyond basic infrastructure. This article aims to classify research and development infrastructure models, based on the degree of importance earned by entrepreneurs belonging to incubators of technology-based companies in the state of Parana. An extensive literature review identified seven research infrastructure development models and discrete manufacturing products. These models were then classified by their features and practices. Following, a hierarchy was built, using the Analytic Hierarchy Process (AHP). Based on this hierarchy, an electronic questionnaire was designed and it was applied to 115 entrepreneurs belonging to 15 incubators of technology-based company, all located in the state of Parana. The responses were used for the construction of the weights of criteria based on the characteristics and analyzed practices. Finally, seven models were classified according to the AHP, providing incubator managers with the best options of laboratory models, according to the characteristics and needs.
The organizational culture and values alignment management importance for successful business
Authors: Ludolf Nicholas Van-Eerven , Silva Marcela do Carmo , Gomes Carlos Francisco Simões , Oliveira Valmir Martins
Published: July 2017

The main objective of this study was to carry out an organizational culture diagnosis in a shipyard, verifying the alignment degree between personal and organizational values. For data collection, a structured questionnaire was adopted and it was answered by 104 employees. In this questionnaire, the employees pointed out the main values cultivated by the company and by themselves. The results showed that there is a significant misalignment between organizational and personal values and an organizational culture based on values that aim at the self-interest of the organization and not the common good. The background of this article is to demonstrate the importance of the diagnosis and management of the organizational culture. To provoke a reflection on the importance of a culture that aims at the common good and not only the financial interest for a select group; not as an altruistic thinking, but as a strategy for organizational sustainability.
Effectiveness of EFQM Model Implementation: a survey on Iranian automotive after sale services companies
Authors: Sharifi Moghaddam Behrouz , Rashidzadeh Davan Abrisham , Musakhani Morteza , Gholamzadeh Daryush
Published: July 2017

It is nearly a decade that Iranian companies attempt to obtain European foundation for quality management (EFQM) organizational excellence award with guidance of public sector, spending enormous financial cost and utilization of human resources. Authors experiences an expert or consultant in implementing this pattern in several companies is motivated them to perform a research about effectiveness of EFQM pattern in Iranian companies.In this regard, automotive after-sales services companies that engaged in achieving EFQM award have been chosen as the study population. To evaluate effectiveness of this pattern, several dimensions of organization based on research literature, patterns and theories translated to operational and measurable indicators. Questionnaires were completed by a sample of employees and managers, were used for data collection. Research hypotheses were tested by comparison of coupled mean before and after implementation of EFQM model.  Results suggest that the effectiveness of EFQM model implementation in Iranian companies, is very low and only in some dimensions.
The Legal Efforts on Marine Culture Development in Pacitan, 1999-2015
Authors: Pianto Heru Arif
Published: July 2017

Beach is one of the most famous tourism areas in Pacitan. Beaches in Pacitan have special features compared to other beaches. The beautiful nature is able to attract tourists to come, visit and enjoy it. Therefore, the beaches in Pacitan have a lot of possibilities to be a tourism area of marine culture.This article is a historical research. The method used in this study was a historical research method, consisting of four steps, heuristics, criticism, interpretation and historiography. The results of this study indicate that the beaches in the Pacitan region have special attraction for tourists to visit.Thus, to be a tourism area of marine culture, Pacitan requires a better management. Based on research conducted so far, the beaches in Pacitan have not been managed optimally, due to a lack of facilities, and low human resources as managers. In short, it is the responsibility of communities, private parties and local governments to maximize the quality of management of coastal tourism around Pacitan, and their cooperation is need. Therefore, the beaches can be a tourist area of marine culture that can grow rapidly in Pacitan region.
Pět klíčových indikátorů udržitelného rozvoje: nástroj pro vzdělávání a osvětu veřejnosti
Authors: Janoušková Svatava , Moldan Bedřich , Hák Tomáš
Published: July 2017

Sustainable Development strategy is going to celebrate its 30th anniversary this year (1987). Despite its long existence it is a concept very little understood globally and causing public sentiment just at a small part of population. The article thinks about the causes and ways to improve it. It is indicators that have an underused potential for presentation sustainability principles and ideas. The sustainability indicators may serve as informative, educational and public enlightenment tools and assist in understanding of the whole concept – an instrumental condition for its embracing. The article defines general qualities of the indicators, as inter alia thematic relevance and indicator relevance, and proposes a set of five key indicators representing all dimensions of sustainable development: People, Planet, Prosperity, Peace and Partnership.
Divíme se
Authors: Nečas Jiří
Published: July 2017

The author, in his address to the faithful recalls the text of chapter 17 of the Acts of the Apostles, in Paul's preaching in Athens. Paul is an experienced preacher and wants his listeners to convert to Christianity – based on their existing worldviews and original religious thinking. His method is ingenious, and is even in line with today's didactic techniques; the number of those who converted to Christ on this occasion, however, was relatively low. Some in fact may even consider this to be a preaching fiasco, but a religious way of thinking excludes consideration of the effectiveness of the prostelatization.