bluuebunny/crossref_metadata_2025 huggingface dataset:
Involving individuals with dementia as co-researchers in analysis of findings from a qualitative study
Authors: Stevenson Mabel , Taylor Brian J
Published: January 2017

Patient and public involvement is widely accepted as good practice in dementia research contributing substantial benefits to research quality. Reports detailing involvement of individuals with dementia as co-researchers, more specifically in analysis of findings are lacking. This paper reports an exercise involving individuals with dementia as co-researchers in a qualitative analysis. Data was from anonymised extracts of interviews with people with dementia who had participated in a multistage study on risk communication in dementia care, relating to concepts and communication of risk. Co-researchers were involved in deriving meaning from the data, identifying and connecting themes. The analysis process is described, reflections on the exercise provided and impact discussed. The session improved overall research quality by enhancing validity of the findings through application of multiple perspectives while also generating sub-themes for exploration in subsequent interviews. Development of guidance for involving individuals with dementia in analysis of research findings is needed.
Weight-Related Perceptions and Experiences of Young Adult Women in Southwest Georgia
Authors: Woodruff Rebecca C. , Raskind Ilana G. , Ballard Denise , Battle Glenda , Haardörfer Regine , Kegler Michelle C.
Published: January 2017

Young adulthood is a period of pronounced weight gain, though few weight management interventions exist for this population. This qualitative study explored how young adult women feel about their weight, what kinds of weight-related advice they have received, and concerns about future weight gain to inform the adaptation of a weight gain prevention intervention. Forty women completed semistructured, in-depth interviews, which were digitally recorded, transcribed verbatim, coded, and analyzed using thematic analysis. Participants were women aged 20 to 29 years, primarily overweight (12.5%) or obese (55.0%), and African American (65.0%). Participants expressed dissatisfaction with their current weight and reported receiving advice to lose weight from multiple sources. Direct, health-focused advice from health care professionals tended to be received more positively than indirect, appearance-focused advice from family members and romantic partners. Participants expressed concern about future weight gain, either as a result of a family history of obesity or chronic disease, pregnancy, and child-rearing, or unhealthy lifestyle patterns. Future weight gain was anticipated to impact chronic disease risk, changes in physical appearance, and interference with daily activities. Results suggest that young adult women may be receptive to participating in weight management interventions and that health care systems may be strategic implementation partners.
A Delicate Balance: Party Branding During the 2013 Government Shutdown
Authors: Casas Andreu , Wilkerson John
Published: January 2017

Strong party brands help congressional parties elect candidates, maintain or gain majority control, and advance their policy agendas. Because successful branding efforts depend on consistent messaging, party leaders try to choose issues that most members are willing to promote. But what do leaders do when a party majority pressures them to take up issues that harm the brand for others? We investigate the 2013 government shutdown as a branding event. House Republican leaders instigated the shutdown after learning that a majority of Republicans would not vote for a clean funding bill. However, instead of highlighting the issues that led to the shutdown, they publicized the party’s efforts to resolve it. Party leaders sought to exploit the fact that party brands have both position and valence components to simultaneously address the demands of the party base and the electoral concerns of members representing competitive districts.
Apoptosis and injuries of heavy ion beam and x-ray radiation on malignant melanoma cell
Authors: Qin Jin , Li Sha , Zhang Chao , Gao Dong-Wei , Li Qiang , Zhang Hong , Jin Xiao-Dong , Liu Yang
Published: January 2017

This study aims to investigate the influence of high linear energy transfer (LET) heavy ion (12C6+) and low LET X-ray radiation on apoptosis and related proteins of malignant melanoma on tumor-bearing mice under the same physical dosage. C57BL/6 J mice were burdened by tumors and randomized into three groups. These mice received heavy ion (12C6+) and X-ray radiation under the same physical dosage, respectively; their weight and tumor volumes were measured every three days post-radiation. After 30 days, these mice were sacrificed. Then, median survival time was calculated and tumors on mice were proliferated. In addition, immunohistochemistry was carried out for apoptosis-related proteins to reflect the expression level. After tumor-bearing mice were radiated to heavy ion, median survival time improved and tumor volume significantly decreased in conjunction with the upregulated expression of pro-apoptosis factors, Bax and cytochrome C, and the downregulated expression of apoptosis-profilin (Bcl-2, Survivin) and proliferation-related proteins (proliferating cell nuclear antigen). The results indicated that radiation can promote the apoptosis of malignant melanoma cells and inhibit their proliferation. This case was more suitable for heavy ion (12C6+). High LET heavy ion (12C6+) radiation could significantly improve the killing ability for malignant melanoma cells by inducing apoptosis in tumor cells and inhibiting their proliferation. These results demonstrated that heavy ion (12C6+) presented special advantages in terms of treating malignant melanoma.

Impact statement

Malignant melanoma is a malignant skin tumor derived from melanin cells, which has a high malignant degree and high fatality rate. In this study, proliferating cell nuclear antigen (PCNA) can induce the apoptosis of malignant melanoma cells and inhibit its proliferation, and its induction effect on apoptosis is significantly higher than low LET X-ray; hence, it is expected to overcome its lower sensitivity to radiation. This study can provide theoretical basis for clinical trials, in which malignant melanoma is treated by heavy ion (12C6+), in order to accurately determine the clinical efficacy of heavy ion therapy. Clinical applications has revealed that local tumor control rate is high when heavy ion is used to treat malignant melanoma, indicating that heavy ion is an important direction in treating melanoma in the future.
The Impact of Professional Music Diplomas on Women Music Teachers in Early Twentieth-Century New Zealand
Authors: Jane Philip
Published: January 2017

At the end of the nineteenth century, music was an accomplishment that many women were encouraged to pursue. For some, this was merely an additional “ornament” to enhance marriage prospects, but a growing number took the opportunity to turn musical ability into a career option. A small group of musically educated women in New Zealand at the start of the twentieth century is studied. At this time, two British examining bodies, Trinity College, London, and the Associated Board, introduced professional diplomas as the culmination of their graded music exams. In their first five years, forty-five women were successful in these “higher examinations” and gained either an Associate from Trinity College (ATCL), or a Licentiate from the Associated Board (LAB). Armed with a prestigious qualification that granted the right to add “letters” after their name, some then followed a career as a teacher of music. Biographical details of each woman are explored and compared to see if any reasons can be found to explain why some continued with music while others didn’t. Similarities as to family and social background are revealed, while the main reason for not continuing with a musical career appears to be the intervention of marriage and family commitments.
Deconstructing Idealized Motherhood: The Extreme Case of Neonaticidal Women
Authors: Saavedra Luísa , Cameira Miguel
Published: January 2017

In this article, we provide a feminist perspective on neonaticidal women while critically examining the mainstream literature. We analyze 26 cases reported between 2003 and 2013 in a Portuguese online newspaper. We conclude that neonaticide must be framed by two main lines of thought: Motherhood is a social construction that imposes difficult-to-achieve norms, and it is a complex experience, intercepted by age, social class, marital status, and having other children. This approach should encourage a shift from the present focus on palliative and punitive measures to a more preemptive one including new policies on sexual education and pregnancy termination.
A case of filum terminale arterial venous fistula needed a long arterial access for trans-arterial shunt obliteration
Authors: Wajima Daisuke , Nakagawa Ichiro , Park Hun-Soo , Haku Takahide , Wada Takeshi , Kichikawa Kimihiko , Nakase Hiroyuki
Published: January 2017

A 78-year-old man was referred to our institution with a predominantly progressive numbness of both legs, and bladder dysfunction with urinary retention. He was diagnosed as the symptomatic arteriovenous fistula of the filum terminale (AVFFT). A trans-arterial embolization (TAE) of the arteriovenous shunt was planned for his symptomatic AVFFT. The long distance between the origin of the radiculo meningeal artery (Th8) and the site of the fistula (S1) resulted in the first TAE having a feeder occlusion. The length of accessible feeder in the first TAE was the longest (about 40 cm) as the past reports of the endovascular therapy. However, complete shunt occlusion was accomplished at a second session two weeks after the initial TAE because a more accessible feeder was developed by the initial feeder occlusion.
Ruptured intracranial vertebral artery dissecting aneurysms: An evaluation of prognostic factors of treatment outcome
Authors: Urasyanandana K , Withayasuk P , Songsaeng D , Aurboonyawat T , Chankaew E , Churojana A
Published: January 2017

Objective

Intracranial spontaneous vertebral artery dissecting aneurysms commonly occur in the third to fifth decades of life, and are mostly associated with hypertension. Patients present with intracranial haemorrhage or thromboembolic events. Patients who present with intracranial haemorrhage carry about a 70% risk of recurrent bleeding. Patients with a posterior-inferior cerebellar artery (PICA) or ipsilateral dominant vertebral artery involve selecting which parent vessel could not be sacrificed. Recent reconstructive techniques such as stent-assisted coiling embolisation and flow-diverting stents are effective treatments of choice.

Methods

Seventeen patients presented subarachnoid haemorrhage and nine patients with other symptoms. Sacrificing the parent vertebral artery was the first choice for surgical or endovascular methods. Endovascular reconstructive treatment by stent-assisted coiling embolisation was indicated in dissecting vertebral artery aneurysms with ipsilateral dominant vertebral artery or PICA involvement. Clinical outcomes were determined using the modified Rankin Score (mRS) at 90 days, with favourable outcomes defined as 0 to 2.

Results

Of the patients presenting with ruptured aneurysms, 11 (61.1%) had a good clinical outcome, with a mRS of 0–2. Favourable Hunt and Hess grading (65%), mild to moderate GCS (65%) and total occlusion of aneurysms after treatment (65%) were significantly good prognostic factors in patients with ruptured vertebral artery dissecting aneurysms.

Conclusion

Endovascular parent vessel sacrifice could be the first choice to treat a ruptured vertebral artery dissecting aneurysm. Stent-assisted coiling to preserve the patency of the parent artery and its branches is a promising treatment for vertebral artery dissections.
“Taking Care” in Intercultural Research
Authors: Richardson Emma Z. L. , Allison Kenneth R. , Teleguario Hermelinda , Chacach Wankar , Tum Silvia , Gesink Dionne , Berry Albert
Published: January 2017

Methodological and ethical aspects of intercultural research are frequently discussed in the literature. However, rarely are detailed examples given or practical suggestions offered, particularly in relation to qualitative enquiry. Drawing on global health qualitative research by an international team with indigenous women in Guatemala about access to family planning, this article highlights consequences of different research designs and implementation strategies and practices. We used the constant comparison method for analysis and developed a code for portions of interviews or content which might have been omitted had the research been conducted differently. These applied examples are used to illustrate the gaps and misinterpretations possible in intercultural research and how critical it is to involve a local team early and throughout the study in such stages as: preparing research instruments, recruitment, and conducting interviews; multilingual interviewing, transcription, and team analysis; and reporting and dissemination. International research has been likened to an extractive industry due to the propensity of scholars to conduct research then publish only in English, essentially extracting knowledge in a way that is inaccessible to those in the country where research was conducted. Practical and ethical implications are highlighted for those conducting, funding, and reviewing intercultural research, to ensure that research does not become the latest extractive industry.
Cerebral haemodynamics in early puerperium: A prospective study
Authors: Anzola GP , Brighenti R , Cobelli M , Giossi A , Mazzucco S , Olivato S , Pari E , Piras MP , Padovani A , Rinaldi F , Turri G
Published: January 2017

Aim

Prospective study on 900 consecutive puerperae to assess normal values and range of the blood flow velocity in the middle cerebral artery in both hemispheres.

Material and method

M1 and M2 segments of both middle cerebral arteries were assessed in all subjects within 96 hours of delivery. Mean flow velocity was recorded after adjusting for insonation angle. Lindegaard index (LI = middle cerebral artery–Internal Carotid Artery mean flow velocity ratio) was calculated whenever the mean flow velocity exceeded 100 cm/second. Asymmetry indexes were calculated inter hemispherically for M1 and M2 segments separately.

Results

Mean flow velocities were 74 ± 17 and 72 ± 17 in right and 73 ± 17 and 72 ± 17 cm/second in the left M1 and M2, respectively. A total of 136 subjects (12.1%) exceeded the threshold of 100 cm/second, but LI was consistently <3 in all of them. Mean flow velocity was inversely and independently correlated to haemoglobin levels and to parity. Mean asymmetry indexes were 0.25 ± 23 in M1 and 0.45 ± 25 in M2.

Conclusion

Mean flow velocity in the middle cerebral artery of healthy subjects in early puerperium is higher than in age-matched non-puerperal women and may exceed the threshold of 100 cm/second with no evidence of intracranial spasm, because of blood loss during delivery. Mean flow velocity is independently correlated with parity. Right-to-left mean flow velocity asymmetry may reach 50% as a consequence of a transient imbalance in vascular tone regulation.
Readiness to participate in advance care planning: A qualitative study of renal failure patients, families and healthcare providers
Authors: Hutchison Lauren A , Raffin-Bouchal Donna S , Syme Charlotte A , Biondo Patricia D , Simon Jessica E
Published: January 2017

Objectives

Advance care planning is the process by which people reflect upon their wishes and values for healthcare, discuss their choices with family and friends and document their wishes. Readiness represents a key predictor of advance care planning participation; however, the evidence for addressing readiness is scarce within the renal failure context. Our objectives were to assess readiness for advance care planning and barriers and facilitators to advance care planning uptake in a renal context.

Methods

Twenty-five participants (nine patients, nine clinicians and seven family members) were recruited from the Southern Alberta Renal Program. Semi-structured interviews were recorded, transcribed and then analyzed using interpretive description.

Results

Readiness for advance care planning was driven by individual values perceived by a collaborative encounter between clinicians and patients/families. If advance care planning is not valued, then patients/families and clinicians are not ready to initiate the process. Patients and clinicians are delaying conversations until “illness burden necessitates,” so there is little “advance” care planning, only care planning in-the-moment closer to the end of life.

Discussion

The value of advance care planning in collaboration with clinicians, patients and their surrogates needs reframing as an ongoing process early in the patient’s illness trajectory, distinguished from end-of-life decision making.
The family impact of caring for a child with juvenile dermatomyositis
Authors: Kountz-Edwards Samantha , Aoki Christa , Gannon Caitlin , Gomez Rowena , Cordova Matthew , Packman Wendy
Published: January 2017

Background

Juvenile dermatomyositis (JDM), a rare autoimmune disease, accounts for more than 80% of idiopathic inflammatory myopathy childhood cases, making it the most common idiopathic inflammatory myopathy among children. The average age of onset is approximately 7 years and commonly leads a chronic course. Symptoms of JDM include cutaneous features (Gottron's rash, heliotrope rash, or nail fold capillary changes), musculoskeletal features, calcinosis and lipodystrophy (a symmetrical deficit of subcutaneous fatty tissue), and acanthosis (thickening of the skin). Despite improvement in treatment regimens and the lowering of mortality rates, some children still lose their lives to JDM. This study assessed the effects of caring for a child diagnosed with JDM on the family system.

Methods

Participants included 36 mothers and 3 fathers of a child diagnosed with JDM. Parents were administered self-report measures, which assessed the overall family functioning (PedsQL-Family Impact Module), and the parents' mood and level of distress (profile of mood states). Additionally, parents were administered a semi-structured interview that included background information, psychosocial information, and sources of support.

Results and conclusion

Families of children with JDM reported difficulties in family functioning, communication problems, and an increased number of conflicts. Parents appeared to be experiencing higher than average levels of worry, worse physical functioning, and family relationships when compared to normative populations. Parents would benefit from psychosocial support due to the many challenges associated with caring for a child with JDM.
Sedition, Law, and the British Empire in India: The Trial of Tilak (1908)
Authors: Mukherjee Mithi
Published: January 2017

This article is a historical inquiry into the sedition trial in 1908 of Bal Gangadhar Tilak, one of the most important anticolonial leaders in twentieth-century India. It argues that Tilak, in the grand spectacle of this political trial, rejected the British discourse of imperial justice that had served as the ground of the British Empire until then, and claimed a new discourse of legislative freedom for the people of India. The trial thus marked a fundamental discursive rupture in the history of empire and paved the way for mass anticolonial movements under the leadership of Gandhi.
Social justice and provision for children with additional support needs in Scotland
Authors: Riddell Sheila , Weedon Elisabet
Published: January 2017

Since the re-establishment of the Scottish Parliament in 1999, successive administrations have reaffirmed their commitment to social justice. However, despite high-level equality policies, social-class inequality is a major feature of Scottish society, affecting all social policy domains, including education. In this article, we provide a brief overview of the development of support for children with learning difficulties and disabilities within the context of Scottish comprehensive schooling. We then consider the way in which ideas of social justice are reflected in education for learners with additional support needs, whose numbers have expanded over recent years and who are particularly likely to live in the most deprived parts of Scotland. Using family case studies, we explore the experiences of families from different social backgrounds, whose children have been identified as having additional support needs. The data suggest that children living in deprived areas experience cumulative disadvantage, attracting stigmatising labels without the benefit of extra resources necessary to improve educational outcomes. By way of contrast, those from more advantaged areas are generally more successful in avoiding stigmatising labels while ensuring that facilitating resources are in place. Findings are discussed within Fraser’s three-dimensional framework of social justice, encompassing distribution, recognition and representation.
Factors that influence clinicians’ decisions to offer intravenous alteplase in acute ischemic stroke patients with uncertain treatment indication: Results of a discrete choice experiment
Authors: De Brún Aoife , Flynn Darren , Ternent Laura , Price Christopher I , Rodgers Helen , Ford Gary A , Rudd Matthew , Lancsar Emily , Simpson Stephen , Teah John , Thomson Richard G
Published: January 2017

Background

Treatment with intravenous alteplase for eligible patients with acute ischemic stroke is underused, with variation in treatment rates across the UK. This study sought to elucidate factors influencing variation in clinicians’ decision-making about this thrombolytic treatment.

Methods

A discrete choice experiment using hypothetical patient vignettes framed around areas of clinical uncertainty was conducted with UK-based clinicians. Mixed logit regression analyses were conducted on the data.

Results

A total of 138 clinicians completed the discrete choice experiment. Seven patient factors were individually predictive of increased likelihood of immediately offering IV alteplase (compared to reference levels in brackets): stroke onset time 2 h 30 min [50 min]; pre-stroke dependency mRS 3 [mRS 4]; systolic blood pressure 185 mm/Hg [140 mm/Hg]; stroke severity scores of NIHSS 5 without aphasia, NIHSS 14 and NIHSS 23 [NIHSS 2 without aphasia]; age 85 [68]; Afro-Caribbean [white]. Factors predictive of withholding treatment with IV alteplase were: age 95 [68]; stroke onset time of 4 h 15 min [50 min]; severe dementia [no memory problems]; SBP 200 mm/Hg [140 mm/Hg]. Three clinician-related factors were predictive of an increased likelihood of offering IV alteplase (perceived robustness of the evidence for IV alteplase; thrombolyzing more patients in the past 12 months; and high discomfort with uncertainty) and one with a decreased likelihood (high clinician comfort with treating patients outside the licensing criteria).

Conclusions

Both patient- and clinician-related factors have a major influence on the use of alteplase to treat patients with acute ischemic stroke. Clinicians’ views of the evidence, comfort with uncertainty and treating patients outside the license criteria are important factors to address in programs that seek to reduce variation in care quality regarding treatment with IV alteplase. Further research is needed to further understand the differences in clinical decision-making about treating patients with acute ischemic stroke with IV alteplase.
Classification of ulnar triangular fibrocartilage complex tears. A treatment algorithm for Palmer type IB tears
Authors: Atzei A. , Luchetti R. , Garagnani L.
Published: January 2017

The classical definition of ‘Palmer Type IB’ triangular fibrocartilage complex tear, includes a spectrum of clinical conditions. This review highlights the clinical and arthroscopic criteria that enable us to categorize five classes on a treatment-oriented classification system of triangular fibrocartilage complex peripheral tears.

Class 1 lesions represent isolated tears of the distal triangular fibrocartilage complex without distal radio-ulnar joint instability and are amenable to arthroscopic suture. Class 2 tears include rupture of both the distal triangular fibrocartilage complex and proximal attachments of the triangular fibrocartilage complex to the fovea. Class 3 tears constitute isolated ruptures of the proximal attachment of the triangular fibrocartilage complex to the fovea; they are not visible at radio-carpal arthroscopy. Both Class 2 and Class 3 tears are diagnosed with a positive hook test and are typically associated with distal radio-ulnar joint instability. If required, treatment is through reattachment of the distal radio-ulnar ligament insertions to the fovea. Class 4 lesions are irreparable tears due to the size of the defect or to poor tissue quality and, if required, treatment is through distal radio-ulnar ligament reconstruction with tendon graft. Class 5 tears are associated with distal radio-ulnar joint arthritis and can only be treated with salvage procedures. This subdivision of type IB triangular fibrocartilage complex tear provides more insights in the pathomechanics and treatment strategies.

Level of evidence: II
Strategies to reduce the global burden of direct maternal deaths
Authors: von Dadelszen Peter , Magee Laura A
Published: January 2017

The leading direct causes of the estimated 196 maternal deaths per 100,000 live births globally are postpartum haemorrhage, the hypertensive disorders of pregnancy, obstructed labour, unsafe abortion and obstetric sepsis. Of the Sustainable Development Goals, one (Sustainable Development Goal 3.1) specifically addresses maternal mortality; by 2030, the goal is to reduce the global maternal mortality ratio to less than 70 per 100,000 live births. Eleven other Sustainable Development Goals provide opportunities to intervene. Unapologetically, this review focusses the reader’s attention on health advocacy and its central role in altering the risks that many of the world’s women face from direct obstetric causes of mortality. Hard work to alter social determinants of health and health outcomes remains. That work needs to start today to improve the health and social equality of today’s girls who will be the women delivering their babies in 2030.
Effect of an obesogenic environment and health behaviour-related social support on body mass index and body image of adolescents
Authors: Yayan Emriye H. , Çelebioğlu Ayda
Published: January 2017

Aim:

The purpose of this study was to examine the effect of an obesogenic environment and social support for health behaviours on body mass index and body image in adolescents.

Methods:

This methodological and descriptive study was conducted in a city centre in Turkey. Interviews were made with the Provincial Directorate for National Education, and the schools in the city centre were divided into three regions according to socioeconomic levels; three schools were then determined among the regions by drawing lots. The data collection was performed with 270 students randomly selected from the three schools. A student information form, an obesogenic environment evaluation form, body cathexis scale, body mass index (BMI) and the Child and Adolescent Social Support Scale for Healthy Behaviours were used to collect data. Percentage distributions, correlations, chi-square tests, analyses of variance and independent samples t-tests were used in the data analysis.

Results:

According to the data acquired, 10.7% of adolescents in the study group were overweight and 3.0% were obese. There was a positive relationship between the obesogenic environment and BMI, and as the obesogenic environmental features of adolescents increased, the BMI increased, and the body image scores decreased. As social support for the adolescents’ health behaviours increased from their mothers, fathers, teachers, classmates, and close friends, BMI decreased and they were more likely to be satisfied satisfied with their bodies.

Conclusion:

Our results demonstrate that, while an obesogenic environment contributed to increased BMI in adolescents and decreased their body satisfaction, social support given for health behaviours had a positive effect on BMI and body perception.
Assessment and decision making in the unstable elbow: management of simple dislocations
Authors: van Riet Roger P.
Published: January 2017

Simple elbow dislocations are usually treated conservatively. Radiographs are negative in simple dislocations. Results are generally good, although a small percentage of patients may develop chronic instability. Ligamentous repair can be indicated in high demand patients or if the elbow remains unstable following a closed reduction. Chronic instability is classified per their direction. Surgery is often indicated in the chronically unstable elbow.
Analysis of hydrodilatation as part of a combined service for stiff shoulder
Authors: Sinha Rajendranath , Patel Priyesh , Rose Nicky , Tuckett John , Banerjee Anurag N , Williams John , Aldridge Stephen , Stuart Paul
Published: January 2017

Background

Adhesive capsulitis is a common cause of stiff shoulder and may result in pain and restriction of movement. The study aimed to investigate the role of hydrodilatation of the glenohumeral joint in the management of adhesive capsulitis.

Methods

Patients referred from the shoulder clinic underwent hydrodilatation under ultrasound guidance. Of 209 referred for hydrodilatation, 163 underwent the procedure and attended follow-up physiotherapy. Outcome measures were available for 118 patients (58 men and 60 women). Mean age of the study group was 52.6 years.

Results

There was a statistically significant improvement in both Oxford Shoulder Score (OSS) and Disability Arm Shoulder Hand Scores (Quick DASH) in the first 4 weeks after the procedure, which was maintained but not improved to the end of the study period. Patients presenting with pain, those who had a history of steroid injections and older patients all had worse functional scores at presentation. Diabetes (both Type I and II), previous physiotherapy, length of history and whether pain or stiffness, or both, were the predominant symptom did not have any statistical significance at presentation. These factors were not predictors of any statistically significant improvement in functional scores.

Conclusions

Hydrodilatation results in a significant improvement of symptoms in patients with adhesive capsulitis.
Smarter Sole Survival: Will Neuropathic Patients at High Risk for Ulceration Use a Smart Insole-Based Foot Protection System?
Authors: Najafi Bijan , Ron Eyal , Enriquez Ana , Marin Ivan , Razjouyan Javad , Armstrong David G.
Published: January 2017

Objective:

This study examined adherence to alert-based cues for plantar pressure offloading in patients with diabetic foot disease.

Method and Design:

Participants (n = 17) with in diabetic foot remission (history of neuropathic ulceration) were instructed to wear a smart insole system (the SurroSense Rx, Orpyx Medical Technologies Inc, Calgary, Canada) over a three-month period. This device is designed to cue offloading to manage unprotected sustained plantar pressures in an effort to prevent foot ulceration. A successful response to an alert was defined as pressure offloading, which occurred within 20 minutes of the alert onset. Patient adherence, defined as daily hours of device wear, was determined using sensor data and patient questionnaires. Changes in these parameters were assessed monthly.

Results:

Patients demonstrating increased adherence over the course of the study received more alerts (0.82 ± 0.31 alerts/hour) than patients whose adherence did not improve (0.36 ± 0.46 alerts/hour, P = .156). By the final stages of the study, participants who had received at least one alert every two hours were more adherent with offloading than participants who received fewer alerts (52.5 ± 4.1% vs 24.7 ± 22.4%, P = .043). Furthermore, duration of time from alert generation to successful offloading was significantly greater in the group receiving fewer alerts. This was measured in the third month with an effect size Cohen’s d = 1.739, P = .043.

Conclusion:

The results suggest a minimum number of alerts (one every two hours) is required for patients with diabetic neuropathy to optimally respond to offloading cues from a smart insole system.
Diagnosis in subdural myeloid sarcoma
Authors: Lackey Alan , Laing Barbara , Perkins Andrew , Bryant Michael
Published: January 2017

Introduction

A 74-year-old man presented to hospital with a headache, thrombocytopaenia and an acute deterioration in cognition on a background of acute monocytic leukaemia in remission.

Method

This is a case report with computed tomography (CT), magnetic resonance (MR) and histopathology imaging.

Results

Preoperative CT and limited MR demonstrated a subdural lesion with marked midline shift. Craniotomy performed for evacuation of the presumed subdural haematoma revealed a solid tumour-like lesion. Histopathology identified the presence of a myeloid sarcoma (chloroma). Postoperative MRI with contrast revealed the solid nature of the mass.

Conclusion

The use of contrast is critical in the assessment of intracranial lesions to distinguish myeloid sarcoma from subdural haematoma in the context of leukaemia and a neurologically deteriorating patient.
Downregulation of mucosal mast cell activation and immune response in diarrhoea‐irritable bowel syndrome by oral disodium cromoglycate: A pilot study
Authors: Lobo Beatriz , Ramos Laura , Martínez Cristina , Guilarte Mar , González‐Castro Ana M , Alonso‐Cotoner Carmen , Pigrau Marc , de Torres Inés , Rodiño‐Janeiro Bruno K , Salvo‐Romero Eloisa , Fortea Marina , Pardo‐Camacho Cristina , Guagnozzi Danila , Azpiroz Fernando , Santos Javier , Vicario María
Published: January 2017

Background and goal

Diarrhoea‐predominant irritable bowel syndrome (IBS‐D) exhibits intestinal innate immune and mucosal mast cell (MC) activation. MC stabilisers have been shown to improve IBS symptoms but the mechanism is unclear. Our primary aim was to investigate the effect of oral disodium cromoglycate (DSCG) on jejunal MC activation and specific innate immune signalling pathways in IBS‐D, and secondarily, its potential clinical benefit.

Study

Mucosal MC activation (by ultrastructural changes, tryptase release and gene expression) and innate immune signalling (by protein and gene expression) were quantified in jejunal biopsies from healthy (HS;n = 16) and IBS‐D subjects after six months of either treatment with DSCG (600 mg/day, IBS‐D‐DSCG group;n = 18) or without treatment (IBS‐D‐NT group;n = 25). All IBS‐D patients recorded abdominal pain and bowel habits at baseline and in the last 10 days prior to jejunal sampling.

Results

IBS‐D‐NT exhibited significant MC activation and over‐expression of immune‐related genes as compared to HS, whereas in IBS‐D‐DSCG MC activity and gene expression were similar to HS. Furthermore, DSCG significantly reduced abdominal pain and improved stool consistency.

Conclusion

Oral DSCG modulates mucosal immune activity and improves gut symptoms in IBS‐D patients. Future placebo‐controlled clinical trials are needed for confirmation of clinical benefit of DSCG for IBS‐D.
Boy With Toy or Black Male With Gun: An Analysis of Online News Articles Covering the Shooting of Tamir Rice
Authors: Stone Rebecca , Socia Kelly M.
Published: January 2017

The current study explores how online media framed the police shooting of 12-year-old Tamir Rice in Cleveland, OH. We conducted a qualitative content analysis of a large sample of online news articles published in the first 48 hours following the event. In doing so, we consider how online media outlets used headlines, narrative, quotes, and images to frame this emerging story. We find that the online news media framed the shooting of Rice in ways that largely supported the official police narrative of the event. Rice was projected as a noncompliant and threatening subject and the police as reacting out of concerns for public safety. Unlike international sources, relatively few domestic news sources linked this incident to the larger issues of race and police use of force in the United States. The dominant frame promotes a moral evaluation of the event that downplays police responsibility and promotes localized, nonsystemic solutions as opposed to wide-spread policing reform.
Integrating the Linkages between Learning Systems and Knowledge Process: An Exploration of Learning Outcomes
Authors: Kushwaha Pooja , Rao M. K.
Published: January 2017

This study intends to explore the influence of learning systems (formal and informal) and knowledge process integration on individual level learning outcomes. This article reviews the extensive literature on the role of learning systems to acquire, disseminate, interpret, and store knowledge within the organizational purview, which subsequently leads toward learning outcomes in the workplace. A methodical review of the literature has been conducted to explore the connection among learning systems, knowledge process, and learning outcomes. Based on the theoretical underpinnings, a conceptual framework has been proposed. Furthermore, this study incorporates a discussion on Huber’s (1991) learning components for achieving better learning outcomes. Findings of the study outline that the role of informal learning is preferential than formal learning system, which harmonizes with knowledge processes and subsequently affects organizational learning outcomes. Authors point out the potentiality of contextual factors to affect the aforesaid relationship. Later part of the study discusses implication, limitations, and future suggestions for the researchers.
Analysis of Social Cognitive Model in the Context of Green Marketing: A Study of the Ghanaian Environment
Authors: Preko Alexander Kofi
Published: January 2017

Environmental degradation is the concern of governments, organizations, and consumers all over the world as each party has a role to play. The aim of this article was to test and explain the triadic interactions of the consumer behavior, personal factor, and environmental factors which constitute the Social Cognitive Theory (SCT) model. The study also identified the variables that mostly influence green behavior of consumers of sachet drinking water. In total, a quantitative approach and multistage research designs were utilized to gather 1,589 valid questionnaires from consumers at Labadi Pleasure Beach, Ghana. Findings revealed that personal factors positively relate to green behavior that influences environmental degradation conforming to the SCT model. The study recommended the provision of litterbins, enactment of beach sanitation rules and regulations, introduction of sanitation beach guards and collaboration of the beach authourities, producers of sachet water, and regulating bodies in carrying out regular sanitation exercises.
Azad Products (Pvt.) Ltd: The Challenges Ahead
Authors: Ahmed Jashim Uddin , Shimul Anwar Sadat , Hossain Shahid
Published: January 2017

This case study investigates key competitive advantages, opportunities, and challenges faced by Azad Products (Pvt.) Ltd (hereinafter referred to as APPL)—a pioneer in printing service company of Bangladesh. Over the last three decades, the company has gone through the dynamics of ever-changing consumer tastes and preferences embraced with technological shifts. The company develops diverse products consisting of greeting cards, calendars, view cards, posters and so on. APPL is the first ever company in Bangladesh to bring forth a complete printing solution encompassing such a broad product categories. Its impressive list of products entails a myriad of strategic issues regarding supply chain activities, future expansion plan, and current challenges faced. After 35 years of its successful operation, now, APPL is considering a strategic plan for sustainable growth and market leadership in the coming years. This case is an effort to probe further into this promising company’s strategic elements and future potential.
Outcomes after orthopedic trauma
Authors: Suk Michael , Daigl Monica , Buckley Richard E , Lorich Dean G , Helfet David L , Hanson Beate
Published: January 2017

Background:

Clinical orthopedic research needs better ability to assess patient expectations with regard to orthopedic trauma surgery outcomes. The aim of this study was to investigate to which extent patient expectations prior to surgery could be met after surgery.

Methods:

Patients (≥18 years) with surgical ankle fractures were prospectively recruited at 5 orthopedic trauma clinics in the United States (USA), Canada, and Brazil and followed up for 12 months. Patients were asked to complete a previously validated trauma expectation factor (TEF) questionnaire prior to surgery and a trauma outcome measure (TOM) 1 year after surgery.

Results:

At 1 year, 155 patients had provided complete records. Almost half (49%; 76/155) had a 1-year TOM score equaling or exceeding their preoperative TEF score (95% CI: 41–57%). The remaining scores failed to meet patient expectations. TOM scores matched or exceeded patient expectations for 33% of patients in the USA and 47% in Canada, but for 69% in Brazil ( p = 0.001 (USA); p = 0.024 (Canada)). This geographical effect was attributable to higher patient expectations in North America as compared to Brazil (average TEF scores: 36 (North America) versus 31 (Brazil); p < 0.001). Patients with lower household income or smokers were more likely to be satisfied with their treatment ( p = 0.02 and p = 0.05, respectively). Furthermore, patients with severe type C fractures had better rates of satisfaction (62%) than patients with simpler B (50%) or type A fractures (33%) ( p = 0.01 [C type versus A type]).

Conclusions:

Orthopedic surgeons have difficulty in meeting or exceeding presurgical patient expectations of long-term outcomes for ankle fracture surgery. This study provides evidence that culture, geography, and surgeon—patient communication have considerable influence on patient expectations.
Surgical treatment for Pipkin type IV femoral head fracture
Authors: Yu Yi-Hsun , Hsu Yung-Heng , Chou Ying-Chao , Tseng I-Chuan , Su Chun-Yi , Wu Chi-Chung
Published: January 2017

Purpose:

Pipkin type IV femoral head (FH) fracture was thought as poor prognosis. There were several surgical approaches and treatments for this difficult fracture. However, there was no one treatment superior to another. We reviewed a serious of patients with Pipkin type IV FH fracture underwent surgery via a modified Gibson approach.

Methods:

We reviewed a consecutive series of nine patients with Pipkin type IV FH fracture under surgery via a modified Gibson approach between 2012 and 2013. The surgical procedure was completely described, and the radiological outcome and the functional outcome were also reviewed.

Results:

The mean follow-up duration was 17 (12–30) months. The mean Merle d’Aubigne score was 16 (8–19). Seven patients had anatomical reductions, and two had imperfect reductions by Matta’s grading. There was no early posttraumatic osteoarthritis during the follow-up period. One patient with early post-traumatic osteonecrosis 3 months after index surgery underwent total hip arthroplasty.

Conclusions:

Through this surgery approach to fix the FH and the acetabulum, the radiological and the functional results were satisfactory. We still need more patients with prospective study to find an optimal surgical approach for Pipkin type IV FH fracture.
Effectiveness of leucocyte esterase as a diagnostic test for acute septic arthritis
Authors: Gautam VK , Saini Rishabh , Sharma Siddharth
Published: January 2017

Background:

We hypothesized that leucocyte esterase strip test can aid in diagnosing septic arthritis in native synovial fluid because leucocyte esterase concentrations would be elevated at the infection site because of secretion by recruited neutrophils.

Method:

The cohort included 27 patients (suspected septic arthritis and normal subjects). A standard chemical test strip (graded as negative, trace, +, ++ or +++) was used to detect the presence of leucocyte esterase. Fluid leucocyte count, Gram staining, culture, erythrocyte sedimentation rate and C-reactive protein were also assessed.

Results:

The leucocyte esterase test with a threshold of ++/+++ had a sensitivity of 79.2% (95% CI [confidence interval], 65.9% to 89.2%), specificity of 80.8% (95% CI, 73.3% to 87.1%), positive predictive value (PPV) of 61.8% (95% CI, 49.2% to 73.3%) and negative predictive value (NPV) of 90.1% (95% CI, 84.3% to 95.4%).

Conclusion:

The leucocyte esterase strip test yielded a high specificity, PPV, NPV, high sensitivity and high diagnostic accuracy. Leucocyte esterase is an accurate, quick and bedside test for septic arthritis and can be used effectively for diagnosing periprosthetic joint infections along with other battery of tests according to the Musculoskeletal Infection Society criteria.
Ertapenem-Induced Encephalopathy in a Patient With Normal Renal Function
Authors: Sutton S. Scott , Jumper Mark , Cook Sean , Edun Babatunde , Wyatt Michael D.
Published: January 2017

Drug-induced neurotoxicity is a rare adverse reaction associated with ertapenem. Encephalopathy is a type of neurotoxicity that is defined as a diffuse disease of the brain that alters brain function or structure. We report a patient with normal renal function who developed ertapenem-induced encephalopathy manifesting as altered mental status, hallucinations, and dystonic symptoms. The patient’s symptoms improved dramatically following ertapenem discontinuation, consistent with case reports describing ertapenem neurotoxicity in renal dysfunction. Since clinical evidence strongly suggested ertapenem causality, we utilized the Naranjo Scale to estimate the probability of an adverse drug reaction to ertapenem. Our patient received a Naranjo Scale score of 7, suggesting a probable adverse drug reaction, with a reasonable temporal sequence to support our conclusion.
Establishing an Interview Anxiety Baseline: Assessing Applicants’ Readiness
Authors: Boyer Lori , Carden Lila , Johnson Lars , Boyd Raphael
Published: January 2017

This research includes survey data about the types of anxiety levels that college students experience while preparing for job interviews. Survey findings included female students reporting higher levels of anxiety than their male counterparts on four of the five scales. Results suggest that additional training for female applicants could reduce anxiety levels and help them excel in job interviews. Implications for job applicants, academic communities, and recruiters are discussed. The article concludes with study limitations and suggestions for future research.
Sexual Exploitation of Cult Women: The Challenges of Problematizing Harmful Traditional Practices in Africa from a Doctrinalist Approach
Authors: Omeje Kenneth
Published: January 2017

Harmful traditional practices are probably the most severe menace to women's rights and the optimum realization of their development potential in contemporary African history. Over time, and in recent years in particular, community activists, women's rights campaigners, church missionaries and the state have tended increasingly to confront the problem of harmful traditional practices from a doctrinalist paradigm, which mainly emphasizes the prohibition and/or obliteration of the practices. This article highlights some of the critical problems and challenges triggered by the doctrinalist approach using an ethnographic analysis of the tradition of sexual exploitation of cult women among the Bangu. It concludes by making a case for a multitrack sociological approach and solution to the problem.