bluuebunny/crossref_metadata_2025 huggingface dataset:
Theoretical analysis of R1234ze(E), R152a, and R1234ze(E)/R152a mixtures as replacements of R134a in vapor compression system
Authors: Meng Zhaofeng , Zhang Hua , Qiu Jinyou , Lei Mingjing
Published: November 2016

In this article, R1234ze(E), R152a, and three mixtures M1, M2, and M3 composed of R152a and R1234ze(E) (in the ratio of 60:40, 50:50, and 40:60, by mass, respectively) as drop-in replacements of R134a in vapor compression system were theoretically analyzed. The performance of the vapor compression system was compared in terms of compressor discharge temperature, volumetric cooling capacity, cooling capacity, compressor power consumption, and coefficient of performance. The results showed that R152a had better coefficient of performance as well as nearly equal volumetric cooling capacity and cooling capacity compared to R134a; however, flammable R152a running with high compressor discharge temperature was restricted. Cooling capacity of R1234ze(E) was far lower than that of R134a. M2 was selected as the best alternative for R134a. Volumetric cooling capacity of M2 and R134a was similar so that M2 can be used in R134a vapor compressor system without modifying compressor. Coefficient of performance of M2 was higher than that of R134a by about 3% with 7% lower cooling capacity and 10% lower compressor power consumption. Compressor discharge temperature of M2 was higher than that of R134a by about 2°C–5°C. It was concluded that M2 can primely be an energy conservation and environmental protection alternative to R134a in vapor compression system.
Hybrid reliability analysis of structural fatigue life: Based on Taylor expansion method
Authors: Meng Guangwei , Feng Xinyu , Zhou Liming , Li Feng
Published: November 2016

A new method for computing the failure probability of the fatigue life is proposed, dealing with uncertain problems with both random and interval variables. Using a Taylor expansion and the concept of statistical moment, the first four central moments of the structural fatigue life performance function are obtained. Then, using a second Taylor expansion, the first four central moments are expanded at the midpoint of the interval variable, and the intervals of the statistical moments of the performance function are calculated. The obtained moment information is applied into an Edgeworth series expansion expression, giving the cumulative distribution function of the structural fatigue life performance function and getting its interval of the failure probability. Two numerical examples of growing complexity are employed to demonstrate the feasibility of the proposed approach.
Mapping practices of Christian education: Toward a framework of contextual differences around the globe
Authors: de Muynck Bram , Reijnoudt-Klein Willemieke , Spruyt-de Kloe Marike
Published: November 2016

This article reports the development of a framework that structures differences in Christian educational practices worldwide. One of its purposes is to simplify the complexity of the contexts in which global partners cooperate. The framework also offers the theoretical basis for an instrument that nongovernmental organizations can use to determine how to choose the appropriate support for Christian education in a certain region. Based on a literature search and a validation study in Zambia, we find three overarching domains in which 24 dimensions are identified: the teaching and learning processes in classrooms; the educational administration, including stakeholders and their motives, aims and ideals to maintain Christian education; and four kinds of societal factors (historical and cultural, religious, legal and political, and socioeconomic). The framework will be the basis for empirical validation studies in different regions. An operational instrument for determining support needs is currently being developed.
Wagner’s Hypothesis: An Empirical Verification
Authors: Adil Masudul Hasan , Ganaie Aadil Ahmad , Kamaiah B.
Published: November 2016

This study explores the relationship between public expenditure (PE) and gross domestic product (GDP) to verify whether the Wagner’s hypothesis holds good in the Indian context. We cover the period from 1970 to 2013 and use econometric tools like Autoregressive Distributed Lag Model (ARDL) test to check the long-run and causal relationship among the variables. The results of the bounds test suggest that there exists cointegration between PE and GDP, but we found weak evidence for Wagner’s hypothesis as well.
Novel Mutation of Interferon-γ Receptor 1 Gene Presenting as Early Life Mycobacterial Bronchial Disease
Authors: Gutierrez Maria J. , Kalra Neelu , Horwitz Alexandra , Nino Gustavo
Published: November 2016

Mendelian susceptibility to mycobacterial diseases (MSMD) are a spectrum of inherited disorders characterized by localized or disseminated infections caused by atypical mycobacteria. Interferon-γ receptor 1 (IFNGR1) deficiency was the first identified genetic disorder recognized as MSMD. Mutations in the genes encoding IFNGR1 can be recessive or dominant and cause complete or partial receptor deficiency. We present the case of a 2½-year-old boy with a history of recurrent wheezing, diagnosed with endobronchial mycobacterial infection. Immunological workup revealed a homozygous nonsense mutation in the IFNGR1 gene, a novel mutation predicted in silico to cause complete IFNGR1 deficiency. This case demonstrates that ( a) Interferon-γ receptor deficiency can present resembling common disorders of the lung; ( b) mycobacterial infections should be suspected when parenchymal lung disease, hilar lymphadenopathy, and endobronchial disease are present; and ( c) high index of suspicion for immunodeficiency should be maintained in patients with disseminated nontubercular mycobacterial infection.
Knowledge, Attitudes, and Practices of Parents Facing Child and Adolescent Obesity in Brazzaville, Congo
Authors: Mabiala Babela Jean Robert , Nika Evrard Romaric , Nkounkou Milandou Kadidja Grâce Cléona , Missambou Mandilou Steve Vassili , Bouangui Bazolana Succes Brege Albert , Monabeka Henri Germain , Moyen Georges
Published: November 2016

The study aimed to assess obesity-related knowledge, attitudes, and practices of parents when facing child and adolescent obesity in order to improve the quality of care. A case-control study was conducted from February 1 to July 1, 2013. The study compared parents of obese school children (group 1 or cases; n = 254) and those school children without obesity (group 2 or controls; n = 254). These children were drawn from public and private primary schools of Brazzaville (Congo). Obesity-related knowledge was satisfactory in 83.5% of the cases, attitudes were correct in 29% of the cases, and the practices good in 25.6% of the cases. The parents’ obesity-related knowledge was satisfactory when the socioeconomic level of the family was high ( P < .02), the mothers’ educational level greater than primary ( P < .001), and the fathers’ educational level was greater than primary ( P < 10−4). The same observation was obtained with obesity-related attitudes and practices of the parents when correct. This influence remained after the adaptation of fathers’ educational level. In conclusion, the disease-related knowledge of parents can be considered satisfactory in the majority of the cases; however, obesity-related attitudes and practices remain incorrect in most of the cases.
Histone acetyltransferase activity of MOF is required for adult but not early fetal hematopoiesis in mice
Authors: Valerio Daria G. , Xu Haiming , Eisold Meghan E. , Woolthuis Carolien M. , Pandita Tej K. , Armstrong Scott A.
Published: November 2016

Key Points

MOF acetyltransferase activity is essential for adult but not early and midgestational murine hematopoietic maintenance.
Plasma biomarkers of risk for death in a multicenter phase 3 trial with uniform transplant characteristics post–allogeneic HCT
Authors: Abu Zaid Mohammad , Wu Juan , Wu Cindy , Logan Brent R. , Yu Jeffrey , Cutler Corey , Antin Joseph H. , Paczesny Sophie , Choi Sung Won
Published: November 2016

Key Points

High ST2 and TIM3 at day 28 after allogeneic HCT were associated with nonrelapse mortality and overall survival at 2 years. Low day 28 L-Ficolin was associated with VOD/SOS and high CXCL9 correlated with chronic GVHD.
Characterization of naturally fractured Arbuckle Group in the Wellington Field, Kansas, using S-wave amplitude variation with offset
Authors: Gupta Menal , Spikes Kyle , Hardage Bob
Published: November 2016

S-wave amplitude variation with offset (AVO) analysis is sensitive to the presence of fractures and can provide a high-resolution seismic-based fracture characterization as compared with traditionally used traveltime-based methods. To determine viable attributes for estimation of properties such as spatial density and fluid fill of fractures, S-wave AVO modeling and analysis is carried out in the Wellington Field, Kansas, where 9C-2D seismic data have been acquired. Analysis is performed on the Ordovician fractured-carbonate interval called the Arbuckle Group, which is being considered for [Formula: see text] sequestration. AVO modeling of the Arbuckle interval indicates that differences in AVO intercepts of different S-wave polarizations can estimate S-wave anisotropy parameter [Formula: see text], which gives an estimate of fracture density. In addition, modeling suggests that AVO gradients of [Formula: see text] and [Formula: see text] waves can be used to derive a seismic attribute to discriminate fluid fill in fractures, provided good-quality S-wave gathers are available. The intercept anisotropy (IA) attribute obtained from AVO intercepts of S-waves provides fracture density estimates within the Arbuckle Group. These estimates are consistent with the field-wide, low-frequency observations from seismic velocities and spatially limited, high-frequency estimates obtained from drill cores and sonic and borehole-image logs. The IA attribute highlights possible high-permeability zones in the Upper and Lower Arbuckle suitable for [Formula: see text] injection. The Middle Arbuckle indicates low fracture density, potentially acting as a baffle to vertical flow and providing a seal for the Lower Arbuckle. The gradient anisotropy attribute obtained from the AVO gradient of S-waves suggests that most fractures in the Arbuckle are brine saturated. This attribute has a potential application in monitoring the movement of a [Formula: see text] plume in the Arbuckle Group when time-lapse data become available. These results demonstrate that S-wave AVO attributes can supplement the P-wave derived subsurface properties and significantly reduce uncertainties in subsurface fracture characterization.
Intranasal Medication Administration Using a Squeeze Bottle Atomizer Results in Overdosing if Deployed in Supine Patients
Authors: Goldhammer Jordan E. , Dobish Mark A. , McAnulty Joshua T. , Smaka Todd J. , Epstein Richard H.
Published: November 2016

BACKGROUND:

Vasoconstrictors and local anesthetics are commonly administered using a squeeze bottle atomizer to the nasal mucosa to reduce edema, limit bleeding, and provide analgesia. Despite widespread use, there are few clinical guidelines that address technical details related to safe administration. The purpose of this study was to quantify, via simulation, the amount of liquid delivered to the nasal mucosa when patients are in the supine and upright positions and administration parameters that would reliably provide the desired amount of medication per spray.

METHODS:

A convenience sample of 10 anesthesia residents was studied. Providers were instructed to use a 25-mL dip and tube nasal squeeze bottle to administer the test solution (sterile water) to a mannequin in the upright (90° elevation) and supine (0° elevation) position. After mannequin testing, additional testing was completed with the spray bottles at 0°, 15°, 30°, 45°, and 90° to determine the relationship between the angles of administration and the amount of liquid dispensed.

RESULTS:

The mean volume delivered per spray was substantially greater when administered in the supine position (0.56 ± 0.22 mL) compared with the upright position (0.041 ± 0.02 mL, difference = 0.52 mL, 95% confidence interval [CI], 0.37–0.67 mL, P < .001). Converting the administered volume to the dose of phenylephrine that would be administered using our standard 0.25% solution, an estimated additional 1300 mcg is delivered per spray in the supine position compared with the upright position (95% CI, 925–1675 mcg, P < .001). Administration with a delivery angle of ≤30° resulted in significantly more volume than when the bottle was oriented at a 90° angle. The volume dispensed at 45° was not different from the volume delivered at 90° (0.032 ± 0.006 mL vs 0.030 ± 0.005 mL, P = .34).

CONCLUSIONS:

We found a 14-fold increase in the volume (ie, dose) delivered per spray when a nasal squeeze bottle was used with a mannequin in the supine position compared with the upright position. Given the reported toxicity from the use of intranasal medication and the inadvertent overdosing that occurs when squeeze bottle atomizers are used in clinical practice, our data suggest that all intranasal drugs should be administered with a precise, metered-dose device. If a metered-dose device is unavailable, the medication should be delivered at an angle of ≥45°; however, we recommend administering the drug with the patient in the sitting position and the bottle at 90° because only a small change in angle below 45° will result in a substantial increase in medication delivered.
Effects of Epidural Labor Analgesia With Low Concentrations of Local Anesthetics on Obstetric Outcomes: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Wang Ting-Ting , Sun Shen , Huang Shao-Qiang
Published: November 2016

BACKGROUND:

Low concentrations of local anesthetics (LCLAs) are increasingly popular for epidural labor analgesia. The effects of epidural analgesia with low concentrations of anesthetics on the duration of the second stage of labor and the instrumental birth rate, however, remain controversial. A systematic review was conducted to compare the effects of epidural analgesia with LCLAs with those of nonepidural analgesia on obstetric outcomes.

METHODS:

The databases of PubMed, Embase, and the Cochrane controlled trials register were independently searched by 2 researchers, and randomized controlled trials that compared epidural labor analgesia utilizing LCLAs with nonepidural analgesia were retrieved. The primary outcomes were the duration of the second stage of labor and the instrumental birth rate; secondary outcomes included the cesarean delivery rate, the spontaneous vaginal delivery rate, and the duration of the first stage of labor.

RESULTS:

Ten studies (1809 women) were included. There was no significant difference between groups in the duration of the second stage of labor (mean difference = 5.71 minutes, 95% confidence interval [CI], −6.14 to 17.83; P = .36) or the instrumental birth rate (risk ratio [RR] = 1.52, 95% CI, 0.97–2.4; P = .07). There was no significant difference between groups in the cesarean delivery rate (RR = 0.8, 95% CI, 0.6–1.05; P = .11), the spontaneous vaginal delivery rate (RR = 0.98, 95% CI, 0.91–1.06; P = .62), or the duration of the first stage of labor (mean difference = 17.34 minutes, 95% CI, −5.89 to 40.56; P = .14).

CONCLUSIONS:

Compared with nonepidural analgesia, epidural analgesia with LCLAs is not associated with a prolonged duration of the second stage of labor or an increased instrumental birth rate. The results of this meta-analysis are based on small trials of low quality. These conclusions require confirmation by large-sample and high-quality trials in the future.
Comment on Falade et al. (2016) DNA-barcoding of Clarias gariepinus, Coptedon zillii and Sarotherodon melanotheron from Southwestern Nigeria
Authors: Miller Jeremy A. , van Riemsdijk Isolde , Khalik Mohd Zacaery , Scager David J. , Schilthuizen Menno
Published: November 2016

A publication by Falade et al. was selected for discussion by a Naturalis Biodiversity Center-Leiden University Journal Club. The study focused on the identification of fish from Southwestern Nigeria using a DNA barcoding approach. Questions raised during the discussion led to a reanalysis and reinterpretation of the data presented. The authors characterize the process of deriving a taxonomic identification from their sequence data as straightforward, but we were concerned that their approach made it nearly impossible to fail to obtain a taxonomic name for each sequence. The value of sophisticated DNA taxonomy, as well as the pitfalls of its naïve application, are discussed. We suggest that journal discussion groups may be an untapped resource for expanding rigorous peer review, particularly for journals that have adopted an open review model.
Conciliation chambers as a «semi-judicial institution» in the twenties of the XX century.
Authors: Мачучина Олеся , Machuchina Olesya
Published: November 2016

in this scientific article discusses the reasons for the creation of conciliation chambers in the beginning and at the end of 20-ies of XX century, as the basis of consideration of collective labour disputes, and later as institutions aimed at resolving minor disputes; have the regulatory framework; principles, goals and functions of the conciliation chambers; list of categories of disputes and stages of their consideration in the conciliation chambers; and the creation of conciliation chambers and the eligibility requirements for their members; in addition considers an agreement of conciliation chambers, as well as the act on termination of the dispute or the issuance of an in absentia decision; the advantages and disadvantages of conciliation chambers by village Councils as a «semi-judicial institutions», body «withering away of the court».
Тhe teoretiko-legal aspects of restriction of electoral rights of the citizens who are in imprisonment places
Authors: Жезлов Николай , Zhezlov Nikolay
Published: November 2016

In this article the main teoretiko-legal aspects of restriction of electoral rights of the citizens of the Russian Federation condemned are considered to serving of custodial sanction. The problem of discrepancy of the Russian electoral laws to the international regulations and standards concerning this category of persons in the part concerning realization by them of the right to choose is revealed and to be elected. Need of establishment of restriction of the electoral rights condemned as a separate auxiliary view of criminal sanction for the persons condemned is designated and proved for crimes against, the government, the world and safety of mankind, public safety and a public order. Expansion of the political rights of the persons which are in imprisonment places in the part concerning participation in a referendum, possession and use of an active electoral right is offered.
Lagal aspects of water users organizations´ business
Authors: Улугов Умиджон , Ulugov Umidjon
Published: November 2016

Modern Tajikistan experiences considerable difficulties in a solution of the problem of rational management of objects of water infrastructure which don´t belong to maintaining public authorities, and are step by step transferred to hands of water users. In the present article the actual problems of economic (enterprise) activity of associations of water users in the Republic of Tajikistan urged to solve problems of maintaining, operational management of an internal irrigational network of the Republic of Tajikistan are considered. In article the separate data which have become a basis for reforming of sector of agriculture, to reforming of the former collective farms and state farms in modern Dehkan (farmer) farms and also on lack of essential measures on definition of the property right to constructions, the equipment, the earth of internal irrigational networks of Tajikistan are entered. Way out creation of a new civil form – associations of water users is considered – to whom functions on the maintenance of an internal irrigational network due to economic activity are assigned. Arguments concerning equivalence of economic activity commercial and as result – a contradiction to standards of the civil legislation of the Republic of Tajikistan are given in article.
Criminal Responsibility of Fraud under the Legislation of Russia and Germany
Authors: Чиркин Кирилл , Chirkin Kirill
Published: November 2016

This article presents a comparative analysis of anti-fraud legislation and criminal law doctrine of Russia and Germany. The general characteristic of fraud and key positions of criminal law doctrine is given. The author has identified general elements and the main differences of fraud in both countries. In author opinion German experience can be used in future reforms of the Russian Criminal Code.
On the legal nature of representation Prosecutor's office to eliminate violations of legislation and bringing officials to disciplinary liability
Authors: Братановский Сергей , Bratanovsky Sergey , Братановская Милена , Bratanovskaya Milena
Published: November 2016

In the scientific article the legislative features connected with introduction by prosecutor´s office to economic entities of idea of elimination of violations of legality and attraction to a disciplinary responsibility of officials, them allowed are considered. Practical features of this act of public prosecutor´s reaction are considered and advice to employers is given.
FOREIGN CONCEPTS AND DEVELOPMENT MODELS OF RURAL TOURISM
Authors: Трухачев Александр , Trukhachev Aleksandr
Published: November 2016

The phenomenon of rural tourism is known for a long time, now it holds a strong position in the global tourism industry. At national level the phenomenon of rural tourism takes a variety of forms, in which different approaches to the appropriate tourism product development and its integration with additional services are implemented. The study conducted by the author demonstrates that the success of rural tourism development depends on the efforts of national and regional regulatory agencies, as well as local government entities.

The article presents established practices of support and regulation of rural tourism, summarizes scientific approaches to the formalization of the rural tourism state regulation and grouping of its functions. It is proved that the phenomenon of rural tourism appears at the intersection of three management objects: regional policy in terms of development of rural areas, tourism development policies, especially in diversification of the tourism product, as well as agriculture development policies, promotion of technologies and products. Based on the research results the author presents interpretation of the types of the rural tourism development public policies.
RURAL HOSPITALITY DIRECTIONS IN THE RUSSIAN FEDERATION
Authors: Кривцов Иван , Krivtsov Ivan , Косульникова Татьяна , Kosulnikova Tatyana
Published: November 2016

The article discusses the formation of rural hospitality in the Russian Federation. We describe the deep cultural, historical and spiritual roots of the phenomenon of hospitality in different ethnic groups living in our country. Proceeding from the need to find appropriate directions of rural hospitality formation, the article introduces a number of tasks that contribute to the successful solution of given problems. The article discloses the concept of "rural hospitality" in activity and spiritual aspects, characterizes motivation of rural hospitality consumers and reveals those qualities, which the owners of rural estates should have. The legal and socio-economic basics for the formation of hospitality spheres are analyzed. Terminological apparatus of GOST R 56641-2015 "Small funds accommodation services. Rural guest houses. General requirements” is carefully considered. The article highlights the important role of rural tourism in addressing a number of issues of rural areas sustainable development, such as the conservation of small settlements, the development of additional employment, increasing incomes, strengthening of youth in rural areas. The authors present own opinion on the structure and the essential characteristics of the product "rural hospitality" that includes a number of levels, each of which is the object of improving to create optimal tourist product. A systematic interpretation of the substantive descriptions of "rural hospitality service" category is suggested. The strategic directions of state policy in hospitality sphere are outlined, which is associated with the relief of the tax burden for the rural guest houses, development of infrastructure in rural areas, competent information support for the promotion of rural hospitality products in the domestic and international tourist market, the improvement of service quality in rural tourism, on the basis of staff training, development and implementation of service standards.
CURRENT STATE AND FORMATION PROBLEMS OF TOURISM IN RURAL AREAS OF TAMBOV REGION
Authors: Околелов Андрей , Okolelov Andrey
Published: November 2016

Promotion of agritourism in Russian regions is a key condition for the formation and development of this promising trend of tourism industry.

Comprehensive elaboration of regulatory and legal framework, as well as the consolidation and the multifaceted support of the municipal and regional authorities are in need for its implementation. The article is devoted to assessing the current state and development problems of agritourism in Tambov region. Agritourism in Tambov region is at the initial stage. In the region there is a complex of natural, cultural, historical and socio-economic condi- tions for its development. However, there are a number of difficulties (legal, infrastructure and others). The state and regional programs for the domestic tourism development and support for small businesses in rural areas are the most important element for the successful development of rural tourism. The article provides an analysis of tourist potential of Tambov region and identifies the problems and prospects of domestic tourism development. The author describes possibilities of agritourism for promotion and innovative development of domestic tourism, as well as justifies the necessity of the various forms of supporting tourism destinations. Tambov is currently one of the most promising regions of Russia for investments in tourism development, especially agritourism. However, successful development of this kind of business needs not only support at the municipal level. The solution of problem of agritourism development lies at the regional level. In addition, systematic work is needed in the field of professional training in rural tourism activities. For this purpose, in the region a system of continuous education in agribusiness has been developed It includes the implementation of the project activities with school children in the field of rural tourism, professional training of bachelors of technology and organization of excursion services (Agritourism) and advanced training courses for workers of RF Ministry of Agriculture
DEMOGRAPHIC ASPECTS OF RURAL TOURISM: PROBLEMS AND SOLUTIONS
Authors: Сидельникова Ксения , Sidelnikova Kseniya , Иволга Анна , Ivolga Anna , Карнаухова Яна , Karnaukhova Yana
Published: November 2016

The contemporary relevance of ensuring sustainable rural development stems from the growing economic and social backwardness of rural territories on the one hand, and their ultimate importance for the state in the context of food security, preservation of soil and environmental resources, and the use of agricultural, production and labour potentials on the other hand. One of the key conditions for sustainable rural development is population strength- ening in rural areas and its sufficient employment. The article analyzes the current demographic problems of rural development, based on the example of Stavropol region. The authors describe threats to sustainable rural development such as unemployment and depopulation, as well as substantiate the practicality of diversification of traditional rural sources of income by means of tourism and other alternative activities.

The research is performed on the base of actual materials and the results of studies related to the rural tourism development, and also using the authors´ observations. The authors have used monographic, sociological, economicstatistical methods of research, the systematic approach and comprehensive analysis.

Rural tourism today should be seen as an important development direction of entrepreneurship and diversification in rural areas, as one of the important areas of sustainable development, and as a form and the chance of economic, social and cultural revitalization of rural areas as a whole. This makes the study of essence and prospects of this business direction development of high priority.
Leadership in learning organizations: a strategy for improvement
Authors: Till Alex , Amin Maslah , McKimm Judy
Published: November 2016

The learning organization is a potential framework for managing transformational culture change and delivering high quality health care. It helps to shift the focus from the development of individuals as leaders to one which takes a ‘whole organization’ approach.
Evaluating your professionalism
Authors: Burr Steven , Neve Hilary , Leung Yee
Published: November 2016

What does being professional look like? Does it mean that you do the ‘right’ thing, even when no-one is looking? How do you evaluate your professionalism knowledge, values and behaviour? How do you identify and address underperformance in professionalism? How can you transfer your professionalism to different circumstances?
Exploration of the economic and quality of life impact on carers of individuals undergoing community rehabilitation
Authors: Comans Tracy A , Sealey Cindy J , Mervin Merehau C , Barker Ruth N
Published: November 2016

Background/Aims:

For people with neurological conditions, informal carers form an important part of the rehabilitation journey. The aim of the current study was to assess the economic and quality of life outcomes for someone caring for a person undertaking a community rehabilitation programme.

Methods:

A prospective study was conducted of a community rehabilitation service with baseline and 3-month follow-up data. Participants in this study were carers of people undergoing rehabilitation. Data was collected on time spent caring and on employment status using a questionnaire. Quality of life was measured using the carer experience scale.

Results:

Carers spend an average of 28 hours per week in caring activities and this was similar after rehabilitation was complete. Replacement by a paid worker would cost over A$650 a week. Quality of life of the carer did not significantly change after rehabilitation was completed. Thirty-seven percent of carers have ceased work because of their caring duties.

Conclusions:

Three months may be too short to measure the impact of rehabilitation on carers. Carers represent a substantial economic resource and carers are at increased risk of poverty because of their caring duties. Integrating carers into the rehabilitation process may help improve outcomes for carers as well as for clients of community rehabilitation services.
Can eyes cause neck pain?
Authors: Hood Wendy , Hood Martin
Published: November 2016

Background/Aims: Cackground/Aims:

This article is a narrative analysis of literature relating to ocular-motor imbalance and the potential postural consequences. It aims to highlight the importance of sensory integration between the visual and vestibular systems and proprioception. The consequences of extra-ocular muscle imbalance are discussed in terms of the disruption to this sensory integration. The symptoms that this may give rise to include spinal pain, postural instability and potential increased risk of falls. This paper therefore encourages a wider multidisciplinary awareness in managing patients with such symptoms.
Pulsed electromagnetic field versus microcurrent electrical nerve stimulation in patients with lateral epicondylopathy
Authors: Ammar Tarek Abdel Rahman
Published: November 2016

Background:

Lateral epicondylopathy is a frequent overload injury of the common wrist extensor tendons. This study was designed to compare between the effects of the pulsed electromagnetic field (PEMF) and microcurrent electrical nerve stimulation (MENS) on improving pain intensity, threshold, and grip strength in patients with lateral epicondylopathy.

Methods:

Eighty-four subjects were randomly assigned into three equal groups. Group 1 received PEMF and exercises, group 2 received MENS and exercises, and group 3 received exercises. All subjects received three visits a week for 4 weeks. The visual analogue scale, the disabilities of the arm, shoulder and hand questionnaire and the hand dynamometer were used to measure pain intensity, disability and grip strength.

Results:

There were improvements in all dependent variables. Also, subjects who received PEMF and exercises had the most significant effects. PEMF may be more effective than MENS in treating lateral epicondylopathy by reducing pain intensity, disability and increasing grip strength.

Conclusions:

PEMF may be more effective than MENS in treating lateral epicondylopathy by reducing pain intensity, disability and increasing grip strength.
Cognitive change following stroke and its impact on long-term care
Authors: Orme Fiona , Gurr Birgit
Published: November 2016

Aims/Background:

The outcomes of cognitive assessments after stroke provide important information for the implementation of immediate specialist interventions. This study investigated the trajectory of cognitive changes in an acute stroke sample. This was done by examining the relationship between cognitive changes following stroke as determined by the Montreal Cognitive Assessment (MoCA) and patients' discharge locations (own home, home with social care package, and placement).

Method:

The data of 124 hospitalised patients with acute stroke was retrospectively analysed. Patients' age ranged from 51 to 96 years, 77 patients were women and 47 were men. Data of post-stroke cognitive outcomes as represented by the MoCA results and discharge location were collected.

Results:

Patients' MoCA Mean outcome was 12.12 and Standard Deviation 7.77. Significant differences were found between patients with low post-stroke cognitive functioning, requiring more intensive care after discharge (i.e. placement), and those with better cognition, who subsequently were discharged home. The MoCA subdomain ‘Concentration and Calculation’ was associated most with discharge location. The study outcomes can potentially improve the efficiency of very early interventions and hospital discharge plans for acute stroke patients.
Extracorporeal shockwave therapy in the treatment of chronic diabetic foot ulcers: a prospective randomised trial
Authors: Jeppesen S.M. , Yderstraede K.B. , Rasmussen B.S.B. , Hanna M. , Lund L.
Published: November 2016

Objective:

To investigate the efficacy of extracorporeal shockwave therapy (ESWT) on healing chronic diabetic foot ulcers (DFU).

Method:

Patients with chronic DFUs were randomised (1:1) to receive a series of six ESWT treatments over 3 weeks in combination with standard care or standard care alone. ESWT was performed on DFUs using 250 shocks/cm2 and 500 shocks on arterial beds supplying the ulcer location.

Results:

We recruited 23 patients, 11 in the intervention group and 12 in the control. Transcutaneous oxygen tension was significantly increased in patients treated with ESWT compared with those receiving standard care alone at 3 weeks (p=0.044). Ulcer area reduction was 34.5% in the intervention group versus 5.6% in the control group at 7 weeks (p=0.387). Within-group analysis revealed a significant reduction of ulcer area in the intervention group (p<0.01), while healing was not demonstrated in the control group (p>0.05) (data tested for trend).

Conclusion:

This randomised study indicates a potential beneficial effect of ESWT on ulcer healing as well as tissue oxygenation. Owing to weaknesses of the study and the fact that ulcer healing was not significantly improved in the intervention group compared with the control group, a larger randomised trial with blinded design is suggested.
Calibration power of the Braden scale in predicting pressure ulcer development
Authors: Chen Hong-Lin , Cao Ying-Juan , Wang Jing , Huai Bao-Sha
Published: November 2016

Objective:

Calibration is the degree of correspondence between the estimated probability produced by a model and the actual observed probability. The aim of this study was to investigate the calibration power of the Braden scale in predicting pressure ulcer development (PU).

Method:

A retrospective analysis was performed among consecutive patients in 2013. The patients were separated into training a group and a validation group. The predicted incidence was calculated using a logistic regression model in the training group and the Hosmer-Lemeshow test was used for assessing the goodness of fit. In the validation cohort, the observed and the predicted incidence were compared by the Chi-square (χ2) goodness of fit test for calibration power.

Results:

We included 2585 patients in the study, of these 78 patients (3.0%) developed a PU. Between the training and validation groups the patient characteristics were non-significant (p>0.05). In the training group, the logistic regression model for predicting pressure ulcer was Logit(P) = –0.433*Braden score+2.616. The Hosmer-Lemeshow test showed no goodness fit (χ2=13.472; p=0.019). In the validation group, the predicted pressure ulcer incidence also did not fit well with the observed incidence (χ2=42.154, p=0.000 by Braden scores; and χ2=17.223, p=0.001 by Braden scale risk classification).

Conclusion:

The Braden scale has low calibration power in predicting PU formation.
Cattle Review
Authors: Barrett David C
Published: November 2016

Introduction:

This edition of Cattle Review considers a paper on farmers' attitude toward selective dry cow treatment and a paper on the use of NSAIDs in the treatment of acute metritis.
Treatment of periocular tumours — what are the options?
Authors: Mackenzie Catriona
Published: November 2016

Periocular neoplasia is a frequently encountered problem in horses, but remains one of the most challenging to treat. Multiple treatment modalities are available, however, to date, there is no single efficacious treatment option. Subsequently, selecting the most appropriate treatment option when faced with a periocular tumour can be complicated. This article explores the various options for the management of periocular tumours and aims to highlight some of the advantages and disadvantages of each. The role of each modality in the treatment of the three most commonly diagnosed periocular tumours: sarcoids, squamous cell carcinomas and melanomas, is discussed.
Equine Review
Authors: Parker Russell
Published: November 2016

Introduction:

This edition of Equine Review looks at sarcoids, orthodontic correction of overbite, laryngotomy incisions, and antimicrobial susceptibility.
Is calcaneal broadband ultrasound attenuation a valid index of dual-energy x-ray absorptiometry-derived bone mass in children?
Authors: Weeks B. K. , Hirsch R. , Nogueira R. C. , Beck B. R.
Published: November 2016

Objectives

The aim of the current study was to assess whether calcaneal broadband ultrasound attenuation (BUA) can predict whole body and regional dual-energy x-ray absorptiometry (DXA)-derived bone mass in healthy, Australian children and adolescents at different stages of maturity.

Methods

A total of 389 boys and girls across a wide age range (four to 18 years) volunteered to participate. The estimated age of peak height velocity (APHV) was used to classify children into pre-, peri-, and post-APHV groups. BUA was measured at the non-dominant heel with quantitative ultrasonometry (QUS) (Lunar Achilles Insight, GE), while bone mineral density (BMD) and bone mineral content (BMC) were examined at the femoral neck, lumbar spine and whole body (DXA, XR-800, Norland). Associations between BUA and DXA-derived measures were examined with Pearson correlations and linear regression. Participants were additionally ranked in quartiles for QUS and DXA measures in order to determine agreement in rankings.

Results

For the whole sample, BUA predicted 29% of the study population variance in whole body BMC and BMD, 23% to 24% of the study population variance in lumbar spine BMC and BMD, and 21% to 24% of the variance in femoral neck BMC and BMD (p < 0.001). BUA predictions were strongest for the most mature participants (pre-APHV R2 = 0.03 to 0.19; peri-APHV R2 = 0.05 to 0.17; post-APHV R2 = 0.18 to 0.28) and marginally stronger for girls (R2 = 0.25-0.32, p < 0.001) than for boys (R2 = 0.21-0.27, p < 0.001). Agreement in quartile rankings between QUS and DXA measures of bone mass was generally poor (27.3% to 38.2%).

Conclusion

Calcaneal BUA has a weak to moderate relationship with DXA measurements of bone mass in children, and has a tendency to misclassify children on the basis of quartile rankings. Cite this article: B. K. Weeks, R. Hirsch, R. C. Nogueira, B. R. Beck. Is calcaneal broadband ultrasound attenuation a valid index of dual-energy x-ray absorptiometry-derived bone mass in children? Bone Joint Res 2016;5:538–543. DOI: 10.1302/2046-3758.511.BJR-2016-0116.R1.
Com fer lectors de poesia en secundària
Authors: Ballester Marco Anna
Published: November 2016

En aquest article es presenten una sèrie d’activitats pràctiques i de reflexions amb el propòsit de fer lectors de poesia a Secundària, tot un repte per al professorat. S’hi insisteix en la necessitat de treballar a l’aula textos poètics per descobrir una altra forma d'utilitzar el llenguatge, vinculada al joc del ritme i la rima de les paraules, i perquè la poesia és indispensable per al desenvolupament intel·lectual i afectiu. Es pretén així facilitar experiències gratificants per ajudar el nostre alumnat a descobrir el gust per la lectura, l'escriptura i la dramatització de textos poètics.
Ensenyar i aprendre literatura en contextos digitals: reptes i necessitats didàctiques
Authors: Hernández i Ortega Josep
Published: November 2016

En aquest article es presenta una perspectiva del desenvolupament de la tecnologia al servei de l'ensenyament. El docent del segle XXI ha d'acomplir amb objectius cognitius, metodològics i tecnològics per a abastir el seu alumnat dins dels paràmetres de competència curricular, com també els instrumentals. La generació que està a les nostres aules són usuaris i gestors d'una societat en què estan consolidant habilitats i coneixements transversals que han de formar-se a l'escola tant com ho fan a l'àmbit domèstic.
Faktor yang Berhubungan dengan Terjadinya Infeksi Clostridium Difficile pada Penderita Diare akibat Antibiotik
Authors: Delfican Delfican , Jurnalis Yusri Dianne , Bachtiar Hafni , Putra Andani Eka
Published: November 2016

Latar belakang. Pemakaian antibiotik yang tidak rasional dapat menyebabkan Clostridium Difficile Associated Diarrhea (CDAD).Tujuan. Mengetahui proporsi CDAD, faktor yang berhubungan, dan antibiotik yang paling banyak menimbulkan CDAD.Metode. Penelitian potong lintang terhadap anak yang mendapat antibiotik pada bulan Maret-September 2013. Clostridium Difficile Associated Diarrhea adalah ditemukannya gen tcdB C. difficile dari pemeriksaan PCR. Faktor risiko adalah umur, status gizi, jumlah, dosis, cara dan lama mendapat antibiotik. Analisis dilakukan secara bivariat dan multivariat.Hasil. Terdapat 82 orang anak dengan proporsi CDAD 39%. Persentasenya lebih tinggi pada usia 1 bulan-5 tahun, mendapat lebih dari 1 jenis antibiotik, dosis biasa, pemberian oral dan mendapat antibiotik kurang dari 7 hari dengan nilai p >0,05. Persentase CDAD hampir sama pada anak gizi baik dan gizi kurang. Persentase CDAD tertinggi didapatkan pada anak yang mendapat amoksisilin oral.Kesimpulan. Proporsi CDAD cukup tinggi. Usia muda, jumlah antibiotik, pemberian dosis biasa secara oral dan waktu pemberian yang singkat menunjukkan kecenderungan menderita CDAD lebih besar, walaupun secara statistik tidak bermakna.Usia merupakan faktor paling dominan. Persentase CDAD tertinggi pada anak yang mendapat amoksisilin oral.
Penggunaan Skor Pediatric Logistic Organ Dysfunction Harian sebagai Prediktor Mortalitas Anak yang Dirawat di Unit Perawatan Intensif Anak
Authors: Salim Hendra , B Suparyatha I , Nym Budi-Hartawan I
Published: November 2016

Latar belakang. Penggunaan sistem skoring Pediatric Logistic Organ Dysfunction (PELOD) sebagai prediktor mortalitas anak yang dirawat di Unit Perawatan Intensif Anak (UPIA) di Indonesia masih belum banyak diteliti.Tujuan. Mengetahui hubungan skor PELOD harian dalam memprediksi mortalitas anak yang dirawat di UPIA.Metode. Penelitian observasional analitik terhadap 49 anak yang dirawat di UPIA bulan Maret-Juli 2012. Skor PELOD harian dinilai selama satu minggu pertama perawatan dan dibandingkan antara subyek hidup dan meninggal. Analisis statistik dikerjakan dengan menggunakan program komputer.Hasil. Terdapat perbedaan nilai skor PELOD harian rendah, sedang, dan tinggi terhadap mortalitas anak yang dirawat di UPIA pada perawatan hari ketiga dengan p=0,001. Nilai skor sedang dan tinggi masing-masing berhubungan dengan peningkatan risiko mortalitas dengan RR 2,3 (1,09-5,02) dan RR 3,3 (1,01-10,6). Rerata terjadinya mortalitas menurut analisis kurva Kapplan Meier pada skor rendah, sedang, dan tinggi masing-masing 23, 12 dan 7 hari dengan p=0,002.Kesimpulan. Skor PELOD harian dapat memprediksi mortalitas anak yang dirawat di UPIA dengan prediksi terbaik pada hari ketiga.
Karakteristik dan Kesintasan Penyakit Ginjal Kronik Stadium 3 dan 4 pada Anak di Departemen Ilmu Kesehatan Anak FKUI-RSCM
Authors: Chunnaedy Swanty , Pardede Sudung O , Djer Mulyadi M.
Published: November 2016

Latar belakang. Penyakit ginjal kronik merupakan terminologi baru untuk pasien yang mengalami kerusakan ginjal paling sedikit selama tiga bulan dengan atau tanpa penurunan LFG. Terminologi ini belum banyak digunakan di Indonesia sehingga karakteristik dan kesintasan PGK stadium 3 dan 4 pada anak belum banyak diteliti.Tujuan. Mendapatkan karakteristik dan kesintasan PGK stadium 3 dan 4 pada anak yang berobat di Departemen Ilmu Kesehatan Anak FKUI-RSCMMetode. Penelitian kohort prospektif historikal ini diambil dari rekam medis pasien dengan PGK stadium 3 dan 4 menurut kiriteria NKF KDOQI di Departemen Ilmu Kesehatan Anak FKUI-RSCM sejak Januari 2004 hingga 30 November 2012. Kesintasan dianalisis dengan menggunakan Kaplan Meier dengan event yang dinilai adalah PGK stadium 5 atau kematian.Hasil. Terdapat 50 rekam medis yang masuk dalam analisis, terdiri atas 36 subjek PGK stadium 3 dan 14 subjek PGK stadium 4. Median usia adalah 7,9 (2-15) tahun dengan jenis kelamin perempuan (58%) sedikit lebih banyak dari pada laki-laki (42%). Etiologi terbanyak adalah glomerulonefritis (56%) dengan sindrom nefrotik memiliki proporsi terbesar. Gambaran klinis yang ditemukan adalah hipertensi (42%), gizi kurang (40%), anemia (70%), gangguan elektrolit (78%), asidosis (34%), proteinuria (72%), perawakan pendek (56%), osteodistrofi renal (2%), dan kardiomiopati dilatasi (14 %). Median kesintasan keseluruhan adalah 57,13 bulan (IK 95% 11,18 sampai 103,09).Kesimpulan. Penyakit ginjal kronik stadium 3 dan 4 sedikit lebih banyak terjadi pada perempuan dengan etiologi terbanyak adalah glomerulonefritis. Komplikasi yang paling sering adalah gangguan elektrolit, anemia, perawakan pendek, gizi kurang, dan hipertensi. Median kesintasan keseluruhan adalah 57,13 bulan (IK 95 % 11,18 sampai 103,09).