bluuebunny/crossref_metadata_2025 huggingface dataset:
Charter schools in the USA
Authors: Halqachmi Arie
Published: April 2013

Purpose

The purpose of this paper is to describe and explain an evolving management strategy in state and local levels of government in the USA that contributes to better productivity through greater responsiveness, governance, increased market‐like competition and leveraging government resources.

Design/methodology/approach

The paper is based on reviews and analysis of published reports about Charter Schools.

Findings

This paper asserts that public private partnership (PPP) charter schools can be very conducive for the development and implementation of a public entrepreneurial strategy (PES) and contribute to local government productivity because: charter schools stretch resources utilization, leverage its ability to license as a mean for mobilizing new resources, improve service quality without expanding cost, reduce future financial obligations (i.e. pensions), diffuse accountability issues that have to do with elementary and secondary education – what the government needs to do in such eventuality is revoke or discontinue the license, induce market dynamics, i.e. consumer choice, effect continuing efforts to improve quality of all schools, become more responsive to demands of some elements of the purpose, describe and explain an evolving management strategy in polity without upsetting others, increase transparency, e.g. who is involved in the process of licensing and the rationale for the decision in each case, accommodate a higher level of community participation in governance, i.e. through opportunities to contribute to the developing of the licensing process, its implementation and the evaluation of its results.

Research limitations/implications

A research limitation is that this approach is still evolving and no long‐term data or evaluations are available. An implication is that this is an evolving management strategy that is geared to address shortage of resources, quality issues in education, governance and the role of government.

Practical implications

This approach might be helpful to other state and local governments outside the USA.

Social implications

The paper describes another way to become more responsive to the educational needs of subgroups.

Originality/value

Knowing more about the context and attributes of Charter Schools in the USA may help others to assess the possible relevancy of this approach for dealing with their own issues of public education.
Cultural dislocation: finding intercultural possibilities in exile
Authors: Kazanjian Christopher J.
Published: April 2013

Purpose

This paper aims to examine the ontology of the exile and its implications for intellectuals, educators, and those seeking greater intercultural understandings. Culture to these scholars of exile becomes problematized as they feel a sense of estrangement to all cultures.

Design/methodology/approach

The paper acts as a review of literature from published scholars who have been lived a great deal of their life in exile.

Findings

Ultimately the paper suggests that educators and intellectuals can learn a great deal from the intellect of the exile, as they live culturally displaced and forge new intercultural understandings.

Originality/value

This paper offers intellectuals and educators a new perception for engaging a transmigrating world.
A comparison of carers needs for service users cared for both in and out of area
Authors: Emery Heidi , Jones Bridget , Chaplin Eddie
Published: April 2013

Purpose

This paper describes an ongoing process of engagement with carers of people with intellectual disabilities currently being monitored by an out of area service for both carers of people placed both in area and out of area within a local Mental Health Learning Disabilities team in South London.

Design/methodology/approach

Using a series of consultation events, carers were asked to participate in a free dialogue which focussed on everyday issues for carers. This included financial implications of caring, knowledge of care pathways/systems in care, carer's needs and expectations and the support they currently receive.

Findings

This paper highlighted a number of issues and concerns that carers face in their daily lives when supporting one or more people. These include lack of recognition, financial difficulties, lack of training and support.

Originality/value

This project offered a valuable insight into current carer perceptions and will help develop further discussion and promote greater engagement by services and mutual understanding with this often neglected group.
Justification and implications of the introduction of an expanded Close Marking System for the Fellowship Examination
Authors: Beasley Spencer W. , Wannan Cassandra , Hardware Narelle
Published: April 2013

Critical review of the close marking system used in the Fellowship Examination revealed that minor modifications to the way in which it was employed could significantly improve the quality (reliability and validity) of the examination. In addition, it could provide better information for the specialty courts to use during their discussion of the borderline candidate at their mini‐court meetings. An expanded close marking system (ECMS) probably has little impact on the overall pass rate, but it does improve the ability to determine the marginal candidate. In addition, it has the capacity to provide feedback on examiner performance and provides the specialty courts with a tool to assess the quality of their questions. Analysis of data collected during several ‘live trials’ of ECMS has shown that the implementation of the ECMS represents a further improvement in the processes around the Fellowship Examination.
Apparent diffusion coefficient values predict outcomes of abusive head trauma
Authors: Tanoue Koji , Aida Noriko , Matsui Kiyoshi
Published: April 2013

Aim

To evaluate the apparent diffusion coefficient (ADC) values for predicting the long‐term neurodevelopmental outcomes of patients with abusive head trauma (AHT).

Methods

Apparent diffusion coefficient maps were retrospectively reviewed for 14 patients who presented with AHT at a mean age of 6.7 months (range 1–18 months), and the clinical outcomes of the survivors were based on the Glasgow Outcome Score.

Results

One of 14 infants died, and two were severely disabled. One had mild impairment and four had moderate disability. In the 4 days after admission, the ADC values in all brain regions were strongly associated with a poor neurodevelopmental outcome (p < 0.05): basal ganglia, thalamus, brain stem, corpus callosum, frontal white matter, central white matter, parietal white matter, frontal grey matter, parietal grey matter, cerebellar vermis, cerebellar cortex and mean total brain.

Conclusion

Apparent diffusion coefficient values during the acute phase of AHT were significantly associated with poor long‐term neurodevelopmental outcomes.
Imiquimod 5% cream versus timolol 0.5% ophthalmic solution for treating superficial proliferating infantile haemangiomas: a retrospective study
Authors: Qiu Y. , Ma G. , Yang J. , Hu X. , Chen H. , Jin Y. , Lin X.
Published: April 2013

Background

Infantile haemangiomas (IHs) are the most common vascular tumours of infancy. Topical therapies are a possible treatment for superficial IHs.

Aim

To determine the efficacy and safety of topical therapy in the treatment of superficial proliferating IHs.

Methods

The medical records of all the patients with proliferating superficial IHs were reviewed. All lesions had been treated either with imiquimod 5% cream or timolol 0.5% ophthalmic solution. Lesions were classified into pairs, with one of each treatment in each pair, matched by anatomical location, colour and size. A visual analogue scale (VAS) and the Haemangioma Activity Score (HAS) were used to evaluate the efficacy of the two drugs. The paired Student t-test was used to test for differences in recovery with these two treatments.

Results

In total, 51 patients treated with timolol and 94 treated with imiquimod met the inclusion criteria, and 20 lesions treated with timolol were successfully matched to a lesion treated with imiquimod. The paired t-test indicated that there was no significant difference in either VAS score (P = 0.11) or HAS (P = 0.49). For the imiquimod-treated patients, crusting was the most common reaction (65.0%, 13/20). This did not cause any superficial scarring or skin pigmentation in the matched pairs; however, superficial scars (14.9%, 14/94) and skin pigmentation disorders (28.7%, 27/94) were reported for some of the unmatched cases. There were no adverse events (AEs) during the treatment with timolol.

Conclusions

Both imiquimod 5% cream or timolol 0.5% ophthalmic solution showed equivalent clinical efficacy after 4 months of treatment. Timolol appeared to have fewer AEs than imiquimod in the management of superficial IHs. Larger, prospective controlled trials with long-term treatment are needed to confirm these results.
Lithocholic acid‐induced placental tumor necrosis factor‐α upregulation and syncytiotrophoblast cell apoptosis in intrahepatic cholestasis of pregnancy
Authors: Du Qiaoling , Zhang Youhua , Pan Youdong , Duan Tao
Published: April 2013

Aim

To investigate tumor necrosis factor (TNF)‐α expression and its relationship with serum bile acids in placental trophoblasts from patients with intrahepatic cholestasis of pregnancy (ICP).

Methods

Human placenta, including normal pregnancies (n = 10) and patients with ICP (n = 10), were collected at term and subject to TNF‐α measurements. Bile acid‐induced TNF‐α expression and cell apoptosis were evaluated in cultured syncytiotrophoblasts in vitro.

Results

ICP placental trophoblasts displayed apoptotic histological abnormalities. TNF‐α levels in ICP tissue were significantly greater than those of controls as measured by quantitative polymerase chain reaction and western blot. Levels of placental TNF‐α mRNA were positively correlated with serum bile acid concentration in ICP patients. In vitro, lithocholic acid (LCA) significantly enhanced TNF‐α mRNA at both doses, by 2.07‐fold at 15 μm and by 3.41‐fold at 30 μm, whereas deoxycholic acid mildly increased TNF‐α mRNA by 1.41‐fold at 100 μm only. LCA treatment produced significantly higher percentage of caspase‐3 positive cells than vehicle treatment, rescuable by the addition of a TNF‐α inhibitor, indicative of apoptosis induced by LCA–TNF‐α pathway.

Conclusion

This study shows that the increase of TNF‐α expression in placental trophoblasts is strongly associated with ICP pathology and is inducible by LCA in vitro, suggesting its potential value in the clinical prevention, diagnosis and treatment of ICP.
Effect of Synthesis Route on Electrical and Electrochemical Performance of Nd1.8Ce0.2CuO4+δ Cathode Material for Intermediate‐Temperature Solid Oxide Fuel Cells
Authors: Khandale Anushree P. , Bhoga Shyamsunder S.
Published: April 2013

Nano‐crystalline Nd1.8Ce0.2CuO4+δ synthesized by combusting mixed precursor materials under microwave heating followed by sintering at 1000°C for 4 h exhibits highest dc conductivity (σ = 2.50 S/cm at 700°C) due to lowest crystallite size (50 nm), which compared with preparation by conventional combustion and solid‐state reaction. Symmetric cells configured as electrode/electrolyte/electrode were fabricated by spin coating. The lowest area specific resistance (ASR) value of 0.50 Ω cm2 was obtained at a temperature 700°C. Morphology of cathode material is largely dependent on the preparative route, and that influences ASR. Low frequency complex impedance curve was modeled by Gerischer element. The electrochemical performance suggested absorption of oxygen by the Nd1.8Ce0.2CuO4+δ lattice. Combustion of precursors using microwave heating promises to be a potential route for materials preparation to achieve improved electrochemical performance of cathode in intermediate temperature solid oxide fuel cell applications.
Global patterns and predictors of tropical reef fish species richness
Authors: Parravicini V. , Kulbicki M. , Bellwood D. R. , Friedlander A. M. , Arias‐Gonzalez J. E. , Chabanet P. , Floeter S. R. , Myers R. , Vigliola L. , D’Agata S. , Mouillot D.
Published: April 2013

In the marine realm, the tropics host an extraordinary diversity of taxa but the drivers underlying the global distribution of marine organisms are still under scrutiny and we still lack an accurate global predictive model. Using a spatial database for 6336 tropical reef fishes, we attempted to predict species richness according to geometric, biogeographical and environmental explanatory variables. In particular, we aimed to evaluate and disentangle the predictive performances of temperature, habitat area, connectivity, mid‐domain effect and biogeographical region on reef fish species richness. We used boosted regression trees, a flexible machine‐learning technique, to build our predictive model and structural equation modeling to test for potential ‘mediation effects’ among predictors. Our model proved to be accurate, explaining 80% of the total deviance in fish richness using a cross‐validated procedure. Coral reef area and biogeographical region were the primary predictors of reef fish species richness, followed by coast length, connectivity, mid‐domain effect and sea surface temperature, with interactions between the region and other predictors. Important indirect effects of water temperature on reef fish richness, mediated by coral reef area, were also identified. The relationship between environmental predictors and species richness varied markedly among biogeographical regions. Our analysis revealed that a few easily accessible variables can accurately predict reef fish species richness. They also highlight concerns regarding ongoing environmental declines, with region‐specific responses to variation in environmental conditions predicting a variable response to anthropogenic impacts.
The energy cost of playing active video games in children with obesity and children of a healthy weight
Authors: O'Donovan C. , Roche E. F , Hussey J.
Published: April 2013

What is already known about this subject

Active video games (AVGs) are being marketed as exercise tools.

AVG play can result in light‐to‐moderate intensity physical activity.

What this study adds

A comparison correcting for body size between the energy expended by children with obesity and those of a healthy weight playing AVGs.

An examination of several variables related to the energy cost of AVG play including steps taken and rate of perceived exertion.

There may be some differences in how children with obesity and children of a healthy weight play AVGs.

Background

Increasing physical activity and reducing sedentary behaviour form a large part of the treatment of paediatric obesity. However, many children today spend prolonged periods of time playing sedentary video games. Active video games (AVGs) represent a novel and child friendly form of physical activity.

Objectives

To measure the energy cost of playing two AVGs in children with obesity and healthy age‐ and gender‐matched children.

Methods

The energy cost of gaming and heart rates achieved during gaming conditions were compared between groups.

Results

AVG play can result in light‐to‐moderate intensity physical activity (2.7–5.4 metabolic equivalents). When corrected for fat‐free mass those with obesity expended significantly less energy than healthy weight peers playing Nintendo Wii Fit Free Jogging (P = 0.017). No significant difference was seen between groups in the energy cost of playing Boxing.

Conclusion

Certain AVGs, particularly those that require lower limb movement, could be used to increase total energy expenditure, replace more sedentary activities, or achieve moderate intensity physical activity among children with obesity. There seems to be some differences in how children with obesity and children of a healthy weight play AVGs. This could result in those with obesity expending less energy than their lean peers during AVG play.
Something to chew on: psychosocial factors associated with oral health practices
Authors: Grey Natalie E. , Lobel Marci , Cannella Dolores T.
Published: April 2013

Although they can be prevented or reversed with proper oral hygiene, oral diseases are prevalent because oral self‐care in the population is poor. Using structural equation modeling, we examined associations of theoretically guided psychosocial factors with oral health practices and dissatisfaction in young adults. Conscientiousness predicted lower dissatisfaction (β = −.35, p < .05); oral health self‐efficacy predicted lower dissatisfaction (β = −.52, p < .05) and better oral health practices (β = .89, p < .05). Barriers to receiving dental care and knowledge about oral health did not predict either outcome. Findings suggest that by promoting task‐specific oral health self‐efficacy, healthcare providers may be able to improve patients' oral health satisfaction and increase compliance with recommendations for self‐care.
The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease
Authors: Dietrich Thomas , Sharma Praveen , Walter Clemens , Weston Paul , Beck James
Published: April 2013

Objectives

The objective of this study was to systematically review the epidemiological evidence for an association between periodontitis (PD) and incident atherosclerotic cardiovascular disease (ACVD), including coronary heart disease (CHD), cerebrovascular disease and peripheral arterial disease.

Methods

Systematic review of cohort and case‐control studies on the association of clinically or radiographically diagnosed PD and ACVD.

Results

Overall, 12 studies were included in this study (six studies on CHD, three studies on cerebrovascular disease, two studies on both coronary heart and cerebrovascular disease mortality and one study on peripheral arterial disease). All but one study reported positive associations between various periodontal disease measures and the incidence of ACVD, at least in specific subgroups. The association was stronger in younger adults and there was no evidence for an association between PD and incident CHD in subjects older than 65 years. Only one study evaluated the association between PD and secondary cardiovascular events.

Conclusions

There is evidence for an increased risk of ACVD in patients with PD compared to patients without. However, this may not apply to all groups of the population. There is insufficient evidence for an association between PD and the incidence of secondary cardiovascular events.
Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence
Authors: Borgnakke Wenche S. , Ylöstalo Pekka V. , Taylor George W. , Genco Robert J.
Published: April 2013

Background

Periodontal disease and diabetes mellitus are common, chronic diseases worldwide. Epidemiologic and biologic evidence suggest periodontal disease may affect diabetes.

Objective

To systematically review non‐experimental, epidemiologic evidence for effects of periodontal disease on diabetes control, complications and incidence.

Data sources

Electronic bibliographic databases, supplemented by hand searches of recent and future issues of relevant journals.

Study eligibility criteria and participants

Longitudinal and cross‐sectional epidemiologic, non‐interventional studies that permit determination of directionality of observed effects were included.

Study appraisal and synthesis methods

Four reviewers evaluated pair‐wise each study. Review findings regarding study results and quality were summarized in tables by topic, using the PRISMA Statement for reporting and the Newcastle‐Ottawa System for quality assessment, respectively. From 2246 citations identified and available abstracts screened, 114 full‐text reports were assessed and 17 included in the review.

Results

A small body of evidence supports significant, adverse effects of periodontal disease on glycaemic control, diabetes complications, and development of type 2 (and possibly gestational) diabetes.

Limitations

There were only a limited number of eligible studies, several of which included small sample sizes. Exposure and outcome parameters varied, and the generalizability of their results was limited.

Conclusions and implications of key findings

Current evidence suggests that periodontal disease adversely affects diabetes outcomes, and that further longitudinal studies are warranted.
Effects of Vertical Positions of Anterior Teeth on Smile Esthetics in Japanese and Korean Orthodontists and Orthodontic Patients
Authors: Ioi Hideki , Kang Sangwook , Shimomura Takahiro , Kim Seong‐Sik , Park Soo‐Byung , Son Woo‐Sung , Takahashi Ichiro
Published: April 2013

Statement of Problem

The perception of a pleasing smile may differ between the countries in Asia or may be converging on a more internationally pleasing one.

Purpose

The aim of this study was to evaluate the influence of vertical positions of anterior teeth on smile esthetics as assessed by Japanese and Korean orthodontists as well as by orthodontic patients.

Materials and Methods

A standard composite smile was constructed from different females' intraoral and extraoral photographs. Vertical positions of anterior teeth were modified digitally in 1‐mm increments, from 5 mm upper lip coverage of the incisors to 5 mm gingival exposure. Using a visual analog scale, 41 Japanese orthodontists and 96 Japanese orthodontic patients, 25 Korean orthodontists, and 72 Korean orthodontic patients rated the attractiveness of 11 smiles with altered gingival displays.

Results

Overall, the Japanese and Korean raters assigned similar esthetic scores between the corresponding groups. The male orthodontic patients assigned higher scores to the smiles with upper lip coverage of the teeth than the corresponding females did in both countries. The female patients assigned clinically significant higher scores to the smiles from 2 mm upper lip coverage of the teeth to 0 mm gingival exposure in both countries.

Conclusions

In both countries, the orthodontists and the female patients shared the similar preference in the smile evaluation of vertical positions of anterior teeth, whereas the male orthodontic patients were more tolerant of upper lip coverage of the anterior teeth than the orthodontists and the female patients.

Clinical Significance

This study proposes 0 mm to 2 mm of upper lip coverage of the teeth as a threshold of acceptability for esthetic smile evaluations in female orthodontic patients. For male orthodontic patients, the paper proposes negative gingival display as a threshold of acceptability for esthetic smile evaluations.
Marine fish communities in shallow volcanic habitats
Authors: Pinault M. , Loiseau N. , Chabanet P. , Durville P. , Magalon H. , Quod J. P. , Galzin R.
Published: April 2013

This survey of the marine ichthyofauna of the Piton de La Fournaise volcano at Reunion Island is the first explanatory study of fish community structures in this area. It describes and analyses the main qualitative descriptors of the fish communities (i.e. species richness, diet, life history and geographical distribution) and their spatio‐temporal organization. This investigation in 2011 examined lava flows of different ages, including the most recent flows that entered the ocean between 1977 and 2007. In all, 263 species belonging to 45 families were observed. Overall, the fish community was notable for an absence of top predators and a predominance of opportunistic small‐bodied species, with dietary flexibility and high reproductive rates, characteristic of the early stages of ecological succession. Between‐site analysis indicated that the fish assemblages differed essentially according to the intensity of the last volcanic disturbances. Fish communities in the most disturbed sites showed the highest numbers of Serranidae and the highest proportions of omnivores and small‐bodied opportunistic carnivores, including a high proportion of endemic south‐western Indian Ocean species. The spatial pattern of this last category of species could be the result of convergent biological traits, and their adaptation to unstable environments at the expense of their competitiveness in more biodiverse, mature communities. Conversely, fish communities in the less disturbed sites showed the highest number of Holocentridae and the highest proportion of browsers of sessile invertebrates. This last characteristic could be a consequence of higher ecological maturity, illustrated by a more specialized trophic network, for assemblages in areas with less intense disturbances. Otherwise, high structural complexity, either in unconsolidated lava boulders, rocks and rubble or high coral‐covered sites, could favour the increase of the total number of species independent of disturbance intensity. Regarding the broader effects, this study helps better understand how ecosystems can resist or recover from acute disturbances and the process of ecological succession that leads to the establishment of fish communities in newly submerged habitats.
Nutritional status and quality of life in patients with acute leukaemia prior to and after induction chemotherapy in three hospitals in Tehran, Iran: a prospective study
Authors: Malihi Z. , Kandiah M. , Chan Y. M. , Hosseinzadeh M. , Sohanaki Azad M. , Zarif Yeganeh M.
Published: April 2013

Background

The primary objective of the present study was to assess changes in the nutritional status and quality of life in acute leukaemia patients, aged ≥15 years, who had undergone induction chemotherapy.

Methods

A preliminary and post‐induction chemotherapy assessment of patients' nutritional status, quality of life, sociodemographic status and medical characteristics was conducted using the Patient Generated Subjective Global Assessment (PG‐SGA) and the European Organization for Research and Treatment of Cancer quality of life (QOL‐C30, version 3) questionnaires. The PG‐SGA is a clinical nutrition assessment tool used to evaluate oncology patients. Patients with newly‐diagnosed acute laeukaemia, aged ≥15 years, at three hospitals in Tehran (from May 2009 to March 2010), were recruited for the present study.

Results

Sixty‐three acute leukaemia patients [65% men and 35% women with a mean (SD) age of 33 (15.4) years] participated in the present study. A total of 19.4% were found to be malnourished prior to chemotherapy. After chemotherapy, 76.1% of patients were considered moderately malnourished, whereas 6.3% were severely malnourished. After induction chemotherapy, both the nutritional status and quality of life deteriorated in the majority of patients, as demonstrated by a paired t‐test.

Conclusions

A deteriorated nutritional status and quality of life was the result of the side effects posed by induction chemotherapy in the patients investigated in the present study. These findings highlight the need for an appropriate nutritional support programme to improve the nutritional status and quality of life in patients with leukaemia undergoing chemotherapy.
An investigation into the association between nutritional status and quality of life in older people admitted to hospital
Authors: Rasheed S. , Woods R. T.
Published: April 2013

Background

Malnutrition is prevalent in acute hospitals and malnourished patients have an increased risk of morbidity and mortality. Studies of malnutrition and quality of life (QoL) are generally limited by both the nutritional and QoL assessment methods employed. The present study aimed to evaluate the relationship between malnutrition, as assessed using a range of nutritional assessment methods, and QoL, as measured by EuroQol‐5D‐3L and Short‐Form (SF)‐36 questionnaires.

Methods

The study comprised a prospective cross‐sectional study of malnutrition and QoL in 149 inpatients aged 65–99 years. Exclusion criteria were: terminal illness, active malignancy, lack of capacity to consent and severe communication difficulties. Spearman's rank correlation coefficient was used to test the association between QoL indices and nutritional markers. QoL scores for those scoring above and below thresholds for nutritional risk were compared. Regression models were created to identify nutritional indices contributing to the variability of QoL.

Results

There were significant associations between QoL scores and the Mini Nutritional Assessment (MNA)‐SF. Clear differences were evident between malnourished and well‐nourished patients (on the MNA‐SF), those with low and normal arm muscle circumference and those with good and poor physical function. Regression analysis showed that nutritional scores and functional status made independent contributions to the prediction of QoL. The effect on food intake, mobility and psychological stress/acute disease also had a significant influence.

Conclusions

Malnutrition risk is linked to a poorer QoL in older people on admission to hospital. Functional status and eating‐related factors are major influencers on QoL in this group. These findings reinforce the role of nutrition as a priority with respect to achieving improvements in QoL.
Dietary fat intake, circulating and membrane fatty acid composition of healthy Norwegian men and women
Authors: Min Y. , Blois A. , Geppert J. , Khalil F. , Ghebremeskel K. , Holmsen H.
Published: April 2013

Background

The present study aimed to assess the dietary fat intake and blood fatty acid status of healthy Norwegian men and women living in Bergen whose habitual diet is known to be high in long‐chain omega‐3 fat.

Methods

Healthy men (n = 41) and women (n = 40) aged 20–50 years who were regular blood donors completed 7‐day food diaries and their nutrient intake was analysed by Norwegian food database software, kbs, version 4.9 (kostberegningssystem; University of Oslo, Oslo, Norway). Blood samples were obtained before blood donation and assessed for the fatty acid composition of plasma triglycerides and cholesterol esters, phosphatidylcholine, and red cell phosphatidylcholine and phosphatidylethanolamine.

Results

There was no difference in dietary fat intake between men and women. Total and saturated fat intakes exceeded the upper limits of the recommendations of the National Nutrition Council of Norway. Although polyunsaturated fat intake was close to the lower limit of the recommended level, the intake varied greatly among individuals, partly as a result of the use of supplementary fish oil. Moreover, the proportional fatty acid composition of plasma and red cell lipids was similar between men and women. Enrichment of docosahexaenoic acid in red cell phosphatidylethanolamine was found in fish oil users.

Conclusions

The results of the present study provide a snapshot of the current nutritional status of healthy Norwegian adults. Moreover, the detailed blood fatty acid composition of men and women whose habitual diet constitutes high long‐chain polyunsaturated omega‐3 fat as well as saturated fat could be used as reference value for population studies.
Taking each day as it comes: staff experiences of supporting people with Down syndrome and Alzheimer's disease in group homes
Authors: Iacono T. , Bigby C. , Carling‐Jenkins R. , Torr J.
Published: April 2013

Background

Disability staff are being increasingly required to support adults with Down syndrome who develop Alzheimer's disease. They have little understanding of the nature of care required, and may lack input from aged care and dementia services, which lack knowledge of intellectual disability. The aim of this study was to report on the experiences of disability staff in group homes supporting residents with Down syndrome and Alzheimer's disease in relation to their under understanding of what was happening to these residents, their responses to them, and how they felt about their support role.

Method

Disability support staff for nine adults with Down syndrome who had a diagnosis of Alzheimer's disease were interviewed twice, over intervals of 6–9 months. Interviews were transcribed and analysed for themes.

Results

Three key themes emerged – (i) struggling to understand change, (ii) taking each day as it comes, and (iii) he's got a disability and that's our job.

Conclusions

Staff had only limited understanding of how Alzheimer's disease impacted the adults with Down syndrome, their responses to changes were ad hoc, and they used strategies on a trial and error basis. They were committed to providing care, but at the risk of rejecting input and support. The need for collaboration across disability, and aged and disability care was evident to facilitate aging‐in‐place and planned care transitions.
Health Literacy and the Readability of Written Information for Hormone Therapies
Authors: Charbonneau Deborah H.
Published: April 2013

Introduction

Health education and counseling are important elements of the care provided by clinicians. Counseling efforts may involve helping women to understand their options for symptom management related to various reproductive life transitions. In light of this, the need for information during the menopausal transition is critical for assisting women with their health care decisions. Yet the Institute of Medicine estimates that approximately half the adult population in the United States has difficulty understanding and using health information. The US Food and Drug Administration (FDA) mandates the distribution of written information for estrogen‐containing products; however, the readability of information for these pharmaceutical products has not been widely studied. To address this gap, this study examined the readability of written information for FDA‐approved prescription menopausal hormone therapies (N = 31).

Methods

Readability of the written information about hormone therapies from 31 hormone therapy products was assessed using the Flesch Reading Ease and Flesch‐Kincaid Grade Level formulas.

Results

The reading level ranged from 6.70 to 12.30, with an average grade level of 9.33 (ninth‐grade reading level). All but one of the hormone therapy products evaluated in this study exceeded the recommended sixth‐grade reading level for written health information. In addition, only 48% of the written information instructions in the study sample (n = 15) included illustrations.

Discussion

Assessment of written information about menopausal hormone therapies showed that the majority of the materials are written at a high reading level. These findings have implications for health literacy and counseling efforts when helping women to understand their options for menopausal symptom management. Midwives, nurses, and other health care providers may need to supplement written information with additional consumer‐friendly written information, utilize illustrations, and use verbal instructions more frequently to help support women in evaluating their treatment options.
Integrating Content and Structure Aspects of the Self: Traits, Values, and Self‐Improvement
Authors: Roccas Sonia , Sagiv Lilach , Oppenheim Shani , Elster Andrey , Gal Avigail
Published: April 2013

Research on the structure of the self has mostly developed separately from research on its content. Taking an integrative approach, we studied two structural aspects of the self associated with self‐improvement—self‐discrepancies and perceived mutability—by focusing on two content areas, traits and values. In Studies 1A–C, 337 students (61% female) reported self‐discrepancies in values and traits, with the finding that self‐discrepancies in values are smaller than in traits. In Study 2 (80 students, 41% female), we experimentally induced either high or low mutability and measured perceived mutability of traits and values. We found that values are perceived as less mutable than traits. In Study 3, 99 high school students (60% female) reported their values, traits, and the extent to which they wish to change them. We found that values predict the wish to change traits, whereas traits do not predict the wish to change values. In Study 4, 172 students (47.7% female) were assigned to one of four experimental conditions in which they received feedback denoting either uniqueness or similarity to others, on either their values or their traits. The results indicated that feedback that one's values (but not traits) are unique affected self‐esteem. Integrating between theories of content and structure of the self can contribute to the development of both.
Curculigoside promotes osteogenic differentiation of bone marrow stromal cells from ovariectomized rats
Authors: Shen Qingping , Zeng Deliang , Zhou Yong , Xia Lunguo , Zhao Yanfan , Qiao Guangyang , Xu Lianyi , Liu Yan , Zhu Ziyuan , Jiang Xinquan
Published: April 2013

Objectives

Curculigoside, a natural compound isolated from the medicinal plant Curculigo orchioides has been reported to prevent bone loss in ovariectomized rats. However, the underlying molecular mechanisms are largely unknown. This study investigated the effects of curculigoside on proliferation and osteogenic differentiation of bone marrow stromal cells (BMSCs).

Methods

The toxicity, proliferation and osteogenic differentiation of BMSCs cultured with various concentrations (0 as control, 10, 100 and 500 µm) of curculigoside were measured by viability assay, MTT analysis, alkaline phosphatase (ALP) activity assay, alizarin red staining and mineralization assay, real-time PCR analysis on osteogenic genes including ALP, type I collagen (Col I), osteocalcin (OCN) and osteoprotegerin (OPG), runt-related transcription factor 2 (Runx2), as well as OPG enzyme-linked immunosorbent assay.

Key findings

No significant cytotoxicity was observed for BMSCs after supplementation with curculigoside. The proliferation of BMSCs was enhanced after administration of curculigoside, especially 100 µm curculigoside. Moreover, the osteogenic gene expression was significantly enhanced with 100 µm curculigoside treatment. Importantly, curculigoside significantly increased OPG secretion.

Conclusions

The data indicate that curculigoside could promote BMSC proliferation and induce osteogenic differentiation of BMSCs. The most profound response was observed with 100 µm curculigoside. These findings may be valuable for understanding the mechanism of the effect of curculigoside on bone, especially in relation to osteoporosis.
A physiologically based pharmacokinetic model for the prediction of the depletion of methyl‐3‐quinoxaline‐2‐carboxylic acid, the marker residue of olaquindox, in the edible tissues of pigs
Authors: Yang B. , Huang L. L. , Fang K. , Wang Y. L. , Peng D. P. , Liu Z. L. , Yuang Z. H.
Published: April 2013

To estimate the consumer exposure to olaquindox (OLA) residues in porcine edible tissues, a physiologically based pharmacokinetic (PBPK) model for methyl‐3‐quinoxaline‐2‐carboxylic acid (MQCA), the marker residue of OLA, was developed in pigs based on the assumptions of the flow‐limited distribution, hepatic metabolism, and renal excretion. The model included separate compartments corresponding to blood, muscle, liver, kidney, adipose, and an extra compartment representing the remaining carcass. Physiological parameters were determined from literatures. Plasma protein binding, partition coefficients, and renal clearance for MQCA were determined in in vitro and in vivo studies. The metabolic conversion of OLA to MQCA was assumed as a simple, one‐step process, and an apparent first‐order rate constant (k) was employed to describe this metabolic process. The PBPK model was optimized and validated with plasma and tissue data from literatures and our study. Sensitivity analysis and Monte Carlo simulation were also implemented to estimate the influence of model parameters on the goodness of fit. When compared with the observed data, the PBPK model underestimated the MQCA level in all compartments at the early time points, whereas gave excellent predictions of MQCA concentration in porcine edible tissues at later time points. The correlation coefficients between the predicted and observed values were over 0.88. The consistency between the model predictions and the real residues of OLA in pigs proved the good applicability of our model in food safety risk assessment.
Efficacy and Quality of Life Outcomes of Oxybutynin for Treating Palmar Hyperhidrosis in Children Younger than 14 Years Old
Authors: Wolosker Nelson , Schvartsman Claudio , Krutman Mariana , Campbell Taiz Pereira Dozono Almeida , Kauffman Paulo , de Campos Jose Ribas M. , Puech‐Leão Pedro
Published: April 2013

The effects of oxybutynin for treating hyperhidrosis in children are still unknown. Therefore the aim of this study was to investigate the effects of oxybutynin on improving symptoms of hyperhidrosis and quality of life (QOL) in children with palmar hyperhidrosis (PH). Forty‐five children ages 7–14 years with PH were evaluated 6 weeks after protocol treatment with oxybutynin. QOL was evaluated before and after treatment using a validated clinical questionnaire. More than 85% of the children with PH treated with oxybutynin experienced moderate or greater improvement in the level of sweating and 80% experienced improvement in QOL. Children who initially presented with very poor QOL were those who benefited most from oxybutynin therapy. Side effects occurred in 25 children (55.5%) and were mainly dry mouth. Only one patient had neurologic symptoms, which was reported as drowsiness. Oxybutynin is an effective treatment option for children with PH because it improves clinical symptoms and QOL. Further studies are required to determine the long‐term outcomes of treatment with oxybutynin.
Lichen Nitidus with Involvement of the Palms
Authors: Çakmak Seray Külcü , Ünal Emine , Gönül Müzeyyen , Yayla Derya , Özhamam Esra
Published: April 2013

A 14‐year‐old girl presented with hyperkeratotic, pitted, skin‐colored papules on a slightly erythematous surface on her palms and erythematous and squamous papules around her ankles. She was clinically and histopathologically diagnosed with lichen nitidus, which is observed rarely on the palms.
Baboon‐Like Syndrome in Children
Authors: Neri Iria , Dondi Arianna , Ricci Lorenza , Patrizi Annalisa
Published: April 2013

Baboon syndrome is a combination of diffuse symmetrical erythema on the major flexural areas and V‐shaped erythema on both upper anteromedial thighs. Infectious agents have been described as possible triggers. We describe for the first time baboon syndrome in a child induced by a coinfection with Epstein‐Barr virus and cytomegalovirus.
Epidemiology of Plasmodium falciparum gametocytemia in India: prevalence, age structure, risk factors and the role of a predictive score for detection
Authors: Shah Naman K. , Poole Charles , MacDonald Pia D. M. , Srivastava Bina , Schapira Allan , Juliano Jonathan J. , Anvikar Anup , Meshnick Steven R. , Valecha Neena , Mishra Neelima
Published: April 2013

Objective

To characterise the epidemiology of Plasmodium falciparum gametocytemia and determine the prevalence, age structure and the viability of a predictive model for detection.

Methods

We collected data from 21 therapeutic efficacy trials conducted in India during 2009–2010 and estimated the contribution of each age group to the reservoir of transmission. We built a predictive model for gametocytemia and calculated the diagnostic utility of different score cut‐offs from our risk score.

Results

Gametocytemia was present in 18% (248/1 335) of patients and decreased with age. Adults constituted 43%, school‐age children 45% and under fives 12% of the reservoir for potential transmission. Our model retained age, sex, region and previous antimalarial drug intake as predictors of gametocytemia. The area under the receiver operator characteristic curve was 0.76 (95%CI:0.73,0.78), and a cut‐off of 14 or more on a risk score ranging from 0 to 46 provided 91% (95%CI:88,95) sensitivity and 33% (95%CI:31,36) specificity for detecting gametocytemia.

Conclusions

Gametocytemia was common in India and varied by region. Notably, adults contributed substantially to the reservoir for potential transmission. Predictive modelling to generate a clinical algorithm for detecting gametocytemia did not provide sufficient discrimination for targeting interventions.
Effectiveness of a real‐time clinical decision support system for computerized physician order entry of plasma orders
Authors: Yazer Mark H. , Triulzi Darrell J. , Reddy Vivek , Waters Jonathan H.
Published: April 2013

Background

We investigated the effect of implementing adaptive plasma ordering criteria in the computerized physician order entry (CPOE) system, with alerts that were automatically generated if the recipient's antecedent international normalized ratio (INR) did not meet the institutional criteria.

Study Design and Methods

In a regional health care system consisting of 11 hospitals using a common CPOE, data on the number of plasma orders and alerts that were generated were collected over a 4‐month period before prescribers were required to select an indication for plasma. When adaptive ordering was implemented prescribers had to choose from prepopulated indications for plasma: INR of 1.6 or greater with bleeding, INR of 1.6 or greater before an invasive procedure, therapeutic exchange, massive transfusion, and other. Regardless of the antecedent INR the alert did not trigger if massive transfusion or plasmapheresis was selected. Information on prescribers and recipients was collected during this 5‐month period.

Results

In the 4‐month period before the adaptive alerts were implemented, 42.9% of the plasma orders generated an alert; in the 5‐month period thereafter the alert rate was significantly lower at 27.9% (p < 0.0001). The percentage of heeded alerts increased during the adaptive alert period (24.3% vs. 17.1%, respectively, p = 0.004). A significant percentage (45%) of other plasma orders were for periprocedure or bleeding patients whose antecedent INR was less than 1.6. There were significant differences in prescriber specialties among those who ordered plasma using the other indication compared to all plasma orders.

Conclusion

Electronic interventions improve compliance with plasma guidelines but as implemented are not sufficient to completely curtail non–evidence‐based ordering.
Design Enhancements for High Performance Dye-Sensitized Solar Cells
Authors: Parmar K. , Kianimanesh A. , Freiheit T. , Park S. S.
Published: April 2013

Due to the abundance of solar energy, solar cells are considered as a renewable source of energy to replace conventional fossil fuels. Compared to the silicon-based photovoltaic (PV) cell, the next generation dye-sensitized solar cell (DSSC) offers the advantages of increased absorption of visible light, high efficiency potential, less energy intensive and lower-cost manufacturing process, colorable design, and lightweight material options. DSSC is a photo-electrochemical system that is based on a photosensitive dye-sensitized semiconductor (mostly titanium dioxide, TiO2) anode and an iodide-based electrolyte. In order to improve the performance of current DSSC systems, we proposed various design improvement schemes through the use of TiO2 nanotube (TONT) arrays and a multistack design of single cells. Through design modifications, approximately 38% improvement in the performance compared to conventional DSSC is reported. Moreover, optical enhancements to increase the amount of incident light on the cell were applied to DSSCs to further improve its performance by application of Fresnel lenses on top of the DSSC and the use of light reflecting material such as Aluminum on the rear side of the cell. The polarization curves for different designs were measured using a potentiostat and the performance of each cell was compared. Optical enhancements improved the power output by 27% compared to normal cells. A semi-empirical DSSC model was also developed based on the experimental results and the change in the performance of different designs was examined. Based on the model, the necessary conditions for maximum performance could be determined.