bluuebunny/crossref_metadata_2025 huggingface dataset:
Secondary prevention patterns in persons with pre-existing coronary artery disease: Are we getting it right?
Authors: Abdul Hafidz Muhammad Imran , Zainudin Lily Diana , Lee Zhen-Vin , Hadi Mohd Firdaus , Mahmood Zuhdi Ahmad Syadi
Published: November 2017

Background:

Cardiovascular diseases are the main cause of death globally. Individuals with evidence of coronary artery disease are at increased risk of further cardiovascular events. However, with good secondary prevention, which consists broadly of lifestyle changes, medical therapy and revascularisation, this risk can be reduced. The true extent of secondary prevention in individuals who are re-admitted with a myocardial infarction in such a high-risk cohort has never been explored in Malaysia.

Methods:

We performed a retrospective, observational study in a tertiary hospital in 100 individuals with previously diagnosed coronary artery disease admitted with a myocardial infarction from August 2016 to February 2017.

Results:

Twenty-nine per cent of patients were still smoking; 15% and 47% were not taking antiplatelet or beta-blocker therapy, respectively. A further 45% and 20% of patients were not on any renin–angiotensin–aldosterone inhibition or lipid-lowering therapy, respectively.

Conclusion:

In our high-risk cohort, secondary prevention practices were sub-optimal. Poor physician–patient communication was frequently listed as a major factor. Simple strategies taken at various levels of care should be implemented and audited to improve these practices.
Atherogenic index of plasma and 10-year risk of cardiovascular disease in adult Africans living with HIV infection: A cross-sectional study from Yaoundé, Cameroon
Authors: Noumegni Steve Raoul , Nansseu Jobert Richie , Bigna Jean Joel , Ama Moor Vicky Jocelyne , Kembe Assah Felix , Dehayem Mesmin Y , Kengne Andre Pascal , Sobngwi Eugene
Published: November 2017

Background

The paucity of data regarding the association between atherogenic index of plasma and risk of cardiovascular disease in HIV-infected populations living in sub-Saharan Africa prompted us to conduct this study which aimed to assess the relationship between atherogenic index of plasma and risk of cardiovascular disease among a Cameroonian HIV-infected population.

Methods

This was a cross-sectional study conducted among 452 HIV-infected adults in Yaoundé, Cameroon. Risk of cardiovascular disease was calculated using the Framingham risk score; atherogenic index of plasma was derived as log (triglycerides/high-density lipoproteins cholesterol).

Results

Participants’ mean age (80% females) was 44.4 ± 9.8 years. Atherogenic index of plasma values ranged from –0.63 to 1.36 with a median of 0.11 (25th–75th percentiles: –0.08-0.31). Most participants (88.5%) were on antiretroviral treatment. There was a significant correlation between atherogenic index of plasma and fasting plasma glucose (r = 0.116; p = 0.014), atherogenic index of plasma and total cholesterol (r = –0.164; p < 0.001). Atherogenic index of plasma was significantly associated with the risk of cardiovascular disease either in univariable (β = 5.05, 95% CI: 3.31–6.79; p < 0.001, R2 = 0.067) or in multivariable linear regression model after adjusting for socio-demographic, clinical and biological confounders (adjusted β = 3.79, 95% CI: 1.65 – 4.88; p < 0.001, R2 = 0.187).

Conclusion

Atherogenic index of plasma may be an independent factor impacting the risk of cardiovascular disease among Cameroonian HIV-infected people. More studies are needed to better elucidate the association between atherogenic index of plasma and risk of cardiovascular disease in our setting.
Contemporary trends in cardiogenic shock: Incidence, intra-aortic balloon pump utilisation and outcomes from the London Heart Attack Group
Authors: Rathod Krishnaraj S , Koganti Sudheer , Iqbal M Bilal , Jain Ajay K , Kalra Sundeep S , Astroulakis Zoe , Lim Pitt , Rakhit Roby , Dalby Miles C , Lockie Tim , Malik Iqbal S , Knight Charles J , Whitbread Mark , Mathur Anthony , Redwood Simon , MacCarthy Philip A , Sirker Alexander , O’Mahony Constantinos , Wragg Andrew , Jones Daniel A
Published: November 2017

Background:

Cardiogenic shock remains a major cause of morbidity and mortality in patients with ST-segment elevation myocardial infarction. We aimed to assess the current trends in cardiogenic shock management, looking specifically at the incidence, use of intra-aortic balloon pump therapy and outcomes in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.

Methods and results:

We undertook an observational cohort study of 21,210 ST-segment elevation myocardial infarction patients treated between 2005–2015 at the eight Heart Attack Centres in London, UK. Patients’ details were recorded at the time of the procedure into local databases using the British Cardiac Intervention Society percutaneous coronary intervention dataset. There were 1890 patients who presented with cardiogenic shock. The primary outcome was all-cause mortality at a median follow-up of 4.1 years (interquartile range: 2.2–5.8 years). Increasing rates of cardiogenic shock were seen over the course of the study with consistently high mortality rates of 45–70%. A total of 685 patients underwent intra-aortic balloon pump insertion during primary percutaneous coronary intervention for cardiogenic shock with decreasing rates over time. Those patients undergoing intra-aortic balloon pump therapy were younger, more likely to have poor left ventricular function and less likely to have had previous percutaneous coronary intervention compared to the control group. Procedural success rates were similar (86.0% vs 87.1%, p=0.292) although crude, in-hospital major adverse cardiac event rates were higher (43.8% vs 33.7%, p<0.0001) in patients undergoing intra-aortic balloon pump therapy. Kaplan-Meier analysis demonstrated significantly higher mortality rates in patients receiving intra-aortic balloon pump therapy (50.9% intra-aortic balloon pump vs 39.9% control, p<0.0001) during the follow-up period. After multivariate Cox analysis (hazard ratio 1.04, 95% confidence interval 0.62–1.89) and the use of propensity matching (hazard ratio: 1.29, 95% confidence interval: 0.68–1.45) intra-aortic balloon pump therapy was not associated with mortality.

Conclusion:

Cardiogenic shock treated by percutaneous coronary intervention is increasing in incidence and remains a condition associated with high mortality and limited treatment options. Intra-aortic balloon pump therapy was not associated with a long-term survival benefit in this cohort and may be associated with increased early morbidity.
Malignancy grading of invasive fronts of oral squamous cell carcinomas
Authors: Dissanayake Upul
Published: November 2017

Background:

Clinical stage and pathology grading have consistently failed to predict survival in patients diagnosed with oral squamous cell carcinoma (OSCC). There is a need to develop a grading system that could have a predictive value in assessing the prognosis of patients with OSCC. The aim was to evaluate the prognostic significance of several parameters of the modified Bryne’s malignancy grading system.

Methods:

Malignancy grading of invasive fronts of 60 OSCCs from Sri Lankan subjects was undertaken using Bryne’s criteria.

Results:

Of the five morphological features assessed at the invasive fronts of the tumours, the range of scores derived for keratinization was low, and the host response in the stromal tissue was marked compared with reported series from European countries. There were no tumours scoring a malignancy grading under 9, regarded as tumours with a ‘good prognosis’. In logistic regression analysis among patient factors, age had a positive association on survival, and among tumour factors, the malignancy grading was significantly predictive of overall survival.

Conclusions:

Bryne’s malignancy grading is predictive of overall survival in patients with OSCCs.
Acute and Subchronic Toxicity Studies of Aqueous Extract of Desmodium adscendens (Sw) DC
Authors: Quaye Osbourne , Cramer Precious , Ofosuhene Mark , Okine Laud K. N. , Nyarko Alexander K.
Published: November 2017

Extracts of Desmodium adscendens (Sw) DC are used for the treatment of various diseases but limited toxicological evaluations have been done on the medicinal plant. This study investigates toxicity effects of the leave extract of D adscendens, and the possibility of drug-drug interaction of the plant extract when co-administered with other drugs. Oral administrations of leaf extract of D adscendens to white Wistar rats in an acute toxicity studies allowed the estimation of an LD50 (median lethal dose) value of 1122 mg/kg body weight. In a subchronic toxicity studies, the plant extract caused a decrease in zoxazolamine paralysis time and prevented thiopentone from causing sleep in test animals compared to controls. Overall, the results are consistent with the plant extract being safe at the doses administered in humans. However, the induction of the CYP enzymes is an indication of a possible drug interaction when the plant extract is co-administered with other drugs.
Promoting Social Connections Across Environments for Students With Severe Disabilities
Authors: Schaefer John M. , Cannella-Malone Helen , Brock Matthew E.
Published: November 2017

Building and maintaining positive social relationships is important to every young adult’s quality of life. However, supporting the social inclusion of middle and high school students with severe disabilities can be extremely challenging. Moreover, promoting social inclusion in one classroom may have little impact on social outcomes in other classrooms, in the hallway, in the lunchroom, or out in the community. This article provides a practical framework for how professionals and peers can partner to support the social inclusion of students with severe disabilities across environments. In addition, easily accessible descriptions of research-based assessment and intervention strategies along with references to other tools and practitioners’ guides are included.
Adenosine Treatment Augments Random Flap Survival in Rats
Authors: Saray Aydin , Apan Alpaslan , Tellioglu Ali Teoman
Published: November 2017

Adenosine and purine nucleosides are intermediates in the pathway of purine nucleotide degradation. Adenosine causes vasodilation in all arterioles, except those in the kidney, and is the major regulator of coronary blood flow. The objective of the present study was to investigate the efficacy and role of 9-beta-D-ribofuranosyl adenosine (RFA), a derivative of adenosine, for the augmentation of random flap survival in rats. Varying doses of adenosine and a nonselective adenosine antagonist, 8-phenyltheophylline, were administered before elevation of 3x10 cm dorsal random flaps in 60 rats. The rats were randomly assigned to five groups and received the following treatment: group I (controls) was treated with placebo (saline, 1 mL/day); group II was treated with RFA 25 μg/kg/day; group III was treated with RFA 50 μg/kg/day; group IV was treated with RFA 100 μg/kg/day; and group V was treated with 8-phenyltheophylline (10 mg/kg/day). All daily injections were given intravenously for seven days. Flap survival was assessed on day 8. Therapeutic and higher doses of adenosine-treated flaps showed a significant increase in viability compared with saline-treated flaps in the control group, while there was no improvement in flap survival with low dose adenosine. Phenyltheophylline reversed the beneficial effect of adenosine and increased flap necrosis, which was comparable with that of the controls. The findings show that adenosine can enhance flap survival, and this beneficial effect is possibly due to vasodilation, inhibition of noradrenalin release, reduction of energy consumption, inhibition of reactive oxygen species and a preconditioning effect; however, this effect seems to be dose-related. Adenosine is an easily available drug for clinical use in ischemic heart diseases and should be considered in potentially ischemic flaps.
Pyoderma gangrenosum: A case report of bilateral dorsal hand lesions and literature review of management
Authors: Mowlds Donald S , Kim Jeff J , Murphy Patrick , Wirth Garrett A
Published: November 2017

Pyoderma gangrenosum is a great masquerader in wound diagnosis and management. Frequently misdiagnosed as a necrotizing infection, the elusive nature of its etiology and pathogenesis has thwarted the establishment of a standardized management algorithm, leaving immunosuppressant therapies as the mainstay of treatment. The present report describes a 61-year-old woman presenting with temporally discrete bilateral dorsal hand lesions successfully managed with distinctive multimodality therapies. The initial lesion was managed under the auspices of a necrotizing process using a combination of hyperbaric oxygen therapy and skin grafting with a negative-pressure dressing, both individually demonstrated to be effective for prompt wound stabilization and coverage. A subsequent contralateral hand lesion was similarly managed as a necrotizing infection before a diagnosis of pyoderma gangrenosum was considered. Stabilization and eventual resolution was achieved using intravenous and topical steroids followed by hyperbaric oxygen therapy, again highlighting the benefits of multimodality therapy in the setting of pyoderma gangrenosum.
The management of incidental findings of reduction mammoplasty specimens
Authors: Goodwin Jessica T , Decroff Chantelle , Dauway Emilia , Sybenga Amelia , Mahabir Raman C
Published: November 2017

Reduction mammoplasty is one of the most commonly performed procedures in plastic surgery. Occasionally, there are findings reported by pathologists that are unfamiliar to the treating surgeon. The aim of the present study was to determine the types of pathologies encountered in reduction mammoplasty specimens. From this list of diagnoses, a best practice guideline for management will be organized to better assist plastic surgeons in the management of patients with incidental findings on pathology reports. A total of 441 pathology reports from patients who underwent bilateral or unilateral reduction mammoplasty in the past three years were identified. A list of 21 different pathologies was generated from the pathology reports, along with supplemental data from recent texts and articles. Occult carcinomas were encountered in two cases (0.45%) and high-risk lesions were found in three cases (0.68%) at the authors' institution. An algorithm was then constructed to organize the pathologies according to risk of malignancy and assign them to a management guideline. There are many different lesions encountered incidentally in reduction mammoplasty specimens that may or may not confer some cancer risk. It is important for plastic surgeons to know which lesions need closer follow-up to provide the best care for their patients.
Evaluation of a Resident Selection Process in Plastic Surgery
Authors: Brown Mitchell H , Backstein David , Regehr Glenn
Published: November 2017

Methods of residency selection continue to be a contentious issue, with little being known about the reliability of the various components of the selection process. By determining the reliability and validity of application reviews and interview judgements, the process of selecting candidates for a residency program can be made more systematic and more efficient. The present study examined the selection process used at the University of Toronto Division of Plastic Surgery for the 1997 selection year. Analysis revealed the initial review of the 51 applications to have high inter-rater reliability, with a panel of three judges producing a reliability of greater than 0.80, and high test-retest reliability (r=0.75). A second review of the 14 applications from candidates selected for interview was somewhat less reliable (probably due to the restriction of range in the scores) and required at least six raters to obtain a reliability of 0.80. Inter-rater reliability of the scores from two independent interviews was quite high, with four raters providing a reliability of at least 0.80 in both interviews. Test-retest reliability between the two interviews was 0.77. Finally, the overall ‘gut’ rankings of the 11-member selection committee were quite reliable and were predicted by a combination of application scores and interview scores (multiple R of 0.96). At least within this program, each component of the selection process appeared to be quite reliable and final ‘gut’ decisions were well founded in a reasonable balance of application scores and interview scores.
Arthroscopic treatment of osteochondral lesions of the talus: Nanofracture versus hyaluronic acid-based cell-free scaffold with concentration of autologous bone marrow aspirate
Authors: Tahta Mesut , Akkaya Mustafa , Gursoy Safa , Isik Cetin , Bozkurt Murat
Published: November 2017

Purpose:

We aimed to evaluate the early clinical and radiological outcomes of arthroscopic one-stage treatment with hyaluronic acid-based cell-free scaffold (HACS) in combination with a concentration of autologous bone marrow aspirate (CBMA) technique compared to nanofracture (NF).

Methods:

A retrospective evaluation was made of all the patients with focal osteochondral lesions of the talus that were treated between January 2012 and January 2015. Ninety-eight patients met the criteria and were enrolled in the study. Forty-six patients (group 1) were treated with arthroscopic one-stage treatment with CBMA in combination with an HACS. Fifty-two patients (group 2) were treated with NF. Patient demographics and cartilage defect characteristics, the AOFAS and VAS scoring systems were compared between groups. In the evaluation of cartilage repair tissue, the magnetic resonance observation of cartilage repair tissue (MOCART) scoring system was used.

Results:

No significant differences were determined between the two groups in terms of age ( p = 0.874), body mass index ( p = 0.621), defect size ( p = 0.485), defect depth ( p = 0.674), follow-up time ( p = 0.512). A significant clinical difference was determined between the two groups according to the AOFAS and VAS scores ( p = 0.028, p = 0.046, respectively). The mean MOCART score of group 1 was significantly higher ( p = 0.041).

Conclusions:

Both NF and HACS with CBMA techniques are beneficial in treatment of osteochondral lesions of the talus. Better clinical and radiological results, in addition to higher cartilage quality, could be obtained with HACS with CBMA technique compared to NF.
MRI findings of lumbar spine instability in degenerative spondylolisthesis
Authors: Cho Il Youp , Park Si Young , Park Jong Hoon , Suh Seung Woo , Lee Soon Hyuck
Published: November 2017

Purpose:

To find out the factors suggesting lumbar segmental instability in patients with degenerative spondylolisthesis (DS) on conventional magnetic resonance imaging (MRI).

Methods:

Ninety-four patients with DS who underwent decompression surgery with or without fusion were selected. Patient demographics and findings on simple radiographs and MRI were analyzed. We divided patients into two groups by the presence of lumbar instability on simple standing plain radiographs and measured degeneration status of intervertebral discs and facet joints and distance of facet fluid signal on T2 axial MRI on each groups. The data were analyzed to find out the correlation between facet fluid signal and lumbar instability.

Results:

Sixty-three patients were confirmed to have lumbar instability (unstable group (UG), 67%), while 31 patients (stable group (SG), 33%) did not have instability on simple radiographs. The mean age was slightly older in SG ( p < 0.05) and SG patients’ degeneration status of intervertebral discs and facet joints was advanced than UG patients. Fifty-five of 63 patients had high signal intensity on T2-weighted MR images in the UG, but only 4 of 31 patients had high signal intensity in the SG ( p < 0.001) and UG patients have more larger facet joint distance than SG patients ( p < 0.001).

Conclusion:

High signal in facet joints on T2 MR images can be a useful factor suggestive of lumbar instability. Thus, the identification of fluid signal in the facet joints on MRI should raise the suspicion for lumbar instability and prompt additional evaluations such as with stress radiographs.
Iatrogenic Cushing Syndrome in a 47-Year-Old HIV-Positive Woman on Ritonavir and Inhaled Budesonide
Authors: Colpitts Lily , Murray Thomas B. , Tahhan Sami G. , Boggs Jody P.
Published: November 2017

Iatrogenic Cushing syndrome (CS) is a well-known complication of treating patients with systemic steroids. More rarely, it has been described in HIV-positive patients on ritonavir (RTV) while using the inhaled corticosteroid fluticasone, which is metabolized through the cytochrome P450 3A4 (CYP3A4) enzyme system. In the presence of RTV, a known CYP3A4 enzyme inhibitor, the interaction can result in impaired metabolism and systemic accumulation of inhaled fluticasone resulting in iatrogenic CS. Iatrogenic CS has been less often described with inhaled budesonide compared to inhaled fluticasone. Therefore, inhaled budesonide is often used as an alternative therapy for patients on RTV to avoid iatrogenic CS. We report the fifth case report of budesonide-induced iatrogenic CS in an HIV-positive patient on RTV. We highlight the importance of early recognition of the syndrome and distinguishing it from HIV lipodystrophy. Finally, we review the literature for cases of iatrogenic CS involving RTV and commonly used steroids.
Rethinking the Boundaries: Competitive Threat and the Asymmetric Salience of Race/Ethnicity in Attitudes toward Immigrants
Authors: Schoon Eric W. , Anderson Kathryn Freeman
Published: November 2017

Research on attitudes toward immigrants has come to divergent conclusions regarding the role of race and ethnicity in shaping these attitudes. Using survey data from 18 European countries, the authors analyze how conditions associated with both economic and cultural threat shape respondents’ receptivity to establishing relationships with immigrants of the same race or ethnicity versus immigrants of a different race or ethnicity. The analyses reveal that the salience of racial and ethnic differences in shaping attitudes toward immigrants is asymmetric. Those who are more likely to express negative attitudes toward immigrants are also more likely to differentiate between immigrants on the basis of race and ethnicity, whereas those less likely to express negative attitudes are also less likely to distinguish between immigrants on the basis of racial and ethnic differences. The authors discuss the substantive and theoretical implications of these findings.
More bark than bytes? Reflections on 21+ years of geocomputation
Authors: Harris Richard , O’Sullivan David , Gahegan Mark , Charlton Martin , Comber Lex , Longley Paul , Brunsdon Chris , Malleson Nick , Heppenstall Alison , Singleton Alex , Arribas-Bel Daniel , Evans Andy
Published: November 2017

This year marks the 21st anniversary of the International GeoComputation Conference Series. To celebrate the occasion, Environment and Planning B invited some members of the geocomputational community to reflect on its achievements, some of the unrealised potential, and to identify some of the on-going challenges.
Violence and migration: evidence from Mexico’s drug war
Authors: Basu Sukanya , Pearlman Sarah
Published: November 2017

The effect of violence on people’s residential choice remains a debated topic in the literature on crime and conflict. We examine the case of the drug war in Mexico, which dramatically increased the number of homicides since late 2006. Using data from the Mexican Census and labor force surveys, we estimate the impact of violence on migration at the municipal and state levels. To account for the endogeneity of violence, we use kilometers of federal highways interacted with cocaine supply shocks from Colombia as an instrument for the annual homicide rate. We argue that highways are good measures of pre-existing drug distribution networks, and the interaction with supply shocks arising in Colombia captures the time-variant nature of the value of these routes. After controlling for observed and unobserved area level heterogeneity, we find little evidence that increases in homicides have led to out-migration, at the domestic level. We also find little evidence of international migration at the municipal level, but some evidence of it at the state level. Our results show a muted migration response that is incompatible with a story of wide-scale displacement from the violence.

JEL Classification O12, K42, O54, J11
Follow-up in patients with a burn-related emergency department visit: a feasibility study
Authors: Goei H. , Wijnen B. F. M. , Mans S. , de Jongh M. A. C. , van der Vlies C. H. , Polinder S. , van Loey N. E. E. , van Baar M. E.
Published: November 2017

Background

Data on epidemiology, costs, and outcomes of burn-related injuries presenting at emergency departments (EDs) are scarce. To obtain such information, a questionnaire study with an adequate response rate is imperative. There is evidence that optimized strategies can increase patient participation. However, it is unclear whether this applies to burn patients in an ED setting. The objective of this feasibility study was to optimize and evaluate patient recruitment strategy and follow-up methods in patients with burn injuries presenting at EDs.

Methods

In a prospective cohort study with a 6-month follow-up, patients with burn-related injuries attending two large EDs during a 3-month study period were included. Eligible patients were quasi-randomly allocated to a standard or optimized recruitment strategy by week of the ED visit. The standard recruitment strategy consisted of an invitation letter to participate, an informed consent form, a questionnaire, and a franked return envelope. The optimized recruitment strategy was complemented by a stamped returned envelope, monetary incentive, sending a second copy of the questionnaire, and a reminder by telephone in non-responders. Response rates were calculated, and questionnaires were used to assess treatment, costs, and health-related quality of life.

Results

A total of 87 patients were included of which 85 were eligible for the follow-up study. There was a higher response rate at 2 months in the optimized versus the standard recruitment strategy (43.6% vs. 20.0%; OR = 3.1 (95% CI 1.1–8.8)), although overall response is low. Non-response analyses showed no significant differences in patient, burn injury or treatment characteristics between responders versus non-responders.

Conclusions

This study demonstrated that response rates can be increased with an optimized, but more labor-intensive recruitment strategy, although further optimization of recruitment and follow-up is needed. It is feasible to assess epidemiology, treatment, and costs after burn-related ED contacts.
Alcohol and Cancer: A Statement of the American Society of Clinical Oncology
Authors: LoConte Noelle K. , Brewster Abenaa M. , Kaur Judith S. , Merrill Janette K. , Alberg Anthony J.
Published: November 2017

Alcohol drinking is an established risk factor for several malignancies, and it is a potentially modifiable risk factor for cancer. The Cancer Prevention Committee of the American Society of Clinical Oncology (ASCO) believes that a proactive stance by the Society to minimize excessive exposure to alcohol has important implications for cancer prevention. In addition, the role of alcohol drinking on outcomes in patients with cancer is in its formative stages, and ASCO can play a key role by generating a research agenda. Also, ASCO could provide needed leadership in the cancer community on this issue. In the issuance of this statement, ASCO joins a growing number of international organizations by establishing a platform to support effective public health strategies in this area. The goals of this statement are to:

• Promote public education about the risks between alcohol abuse and certain types of cancer;

• Support policy efforts to reduce the risk of cancer through evidence-based strategies that prevent excessive use of alcohol;

• Provide education to oncology providers about the influence of excessive alcohol use and cancer risks and treatment complications, including clarification of conflicting evidence; and

• Identify areas of needed research regarding the relationship between alcohol use and cancer risk and outcomes.
PPInfer: a Bioconductor package for inferring functionally related proteins using protein interaction networks
Authors: Jung Dongmin , Ge Xijin
Published: November 2017

Interactions between proteins occur in many, if not most, biological processes. This fact has motivated the development of a variety of experimental methods for the identification of protein-protein interaction (PPI) networks. Leveraging PPI data available STRING database, we use network-based statistical learning methods to infer the putative functions of proteins from the known functions of neighboring proteins on a PPI network. This package identifies such proteins often involved in the same or similar biological functions. The package is freely available at the Bioconductor web site (http://bioconductor.org/packages/PPInfer/).
Reflections of Research Getting to the heart of the problem, by Fraser Macrae
Authors: Macrae Fraser
Published: November 2017

The British Heart Foundation (BHF) annual image competition, Reflections of Research, provides a glimpse into the cutting-edge research that the BHF funds
Research Roundup
Authors: Cowan Helen
Published: November 2017

Helen Cowan presents a selection of recently published articles of interest to nurses working in cardiovascular nursing. The aim of this roundup is to provide a brief overview of the research papers selected. A full reference is provided for those who wish to take a look at the research in further detail
Greek patients' beliefs about medicines in hypertension
Authors: Chatziefstratiou Anastasia A. , Giakoumidakis Konstantinos , Fotos Nikolaos V. , Baltopoulos George , Brokalaki Hero
Published: November 2017

Misconceptions about medicines among patients with hypertension are common and the influence of these on their adherence to medication regimens is significant. Despite the importance of this topic, however, few instruments have been developed to assess individuals' beliefs, and none have been translated for use by the Greek population. The aim of this study is to report the validity of the Beliefs about Medicine Questionnaire-12-General (BMQ-12-General) and the Perceived Sensitivity Medicine Scale-5 (PSM-5) among people with hypertension in Greece. This study used a case-control design. The sample consisted of 68 people made up of hypertensives and non-hypertensives, who completed the tools. For those with hypertension, the coefficient alpha was 0.77 for the entire scale; 0.61 for the BMQ-12-General; and 0.91 for the PSM-5. For those without hypertension, the coefficient alpha was 0.84 for the entire scale; 0.62 for the BMQ-12-General; and 0.96 for the PSM-5. Findings provide support for the validity of the Greek version of the BMQ-12-General and PSM-5.
Are you up to standard?
Authors: Bridges Glenys
Published: November 2017

‘You must protect patients and colleagues from risks posed by your health, conduct or performance’ – Glenys Bridges suggests the pressure is on for dental nurses…
End of an era...
Authors: Ireland Robert
Published: November 2017

Professor Robert Ireland delivers a final lecture and encourages dental nurses to ‘take up research and challenge the traditional’
Time for change
Authors: Sharma Priya
Published: November 2017

Priya Sharma considers next year's enhanced continuing professional development
Philanthropy and dentistry
Authors: Thomas Megan
Published: November 2017

A look at BrushUpUK's mission to improve the oral health education provided to substance and alcohol misuse rehabilitation projects in South West England
Drink and drugs – what's really going on?
Authors: Thomas Howard
Published: November 2017

Howard Thomas on why dental teams must take extra time to screen patients for possible symptoms of substance abuse during examinations
The surgical epidemic
Authors: Henry Maeve , Poyser Thomas , Bampoe Sohail
Published: November 2017

This article outlines the growing demand for surgical services globally, both in developing and developed countries. The implications of this increasing demand are explored, with particular attention focused on the enduring burden of perioperative complications. The role of critical care in ensuring the safe delivery of surgical services is also examined. Solutions to the ‘surgical epidemic’ are proposed including the role of perioperative medicine in reconfiguring services to provide safe surgical care.
Perioperative medicine: a new model of care?
Authors: Al-Shammari Lena , Douglas Deborah , Gunaratnam Geetha , Jones Chris
Published: November 2017

The discipline of perioperative medicine provides a foundation for the consistent delivery of safe and good quality care to surgical patients. Its goals include the identification and optimal care of the high-risk surgical patient, fostering patient-centred decision making throughout the surgical perioperative pathway, and reducing unwarranted variation in practice. In turn, this should reduce preventable complications and improve patient satisfaction, long-term morbidity and survival.

This review concludes a series of articles which have described the epidemiology of surgical disease, the growth in the objective means of risk assessment, and novel outcome measures. It describes shortcomings in current practice, and how perioperative care pathways may overcome these. It discusses the growth of enhanced recovery programmes, which exemplify many of the sub-specialty's principles of patient-centred and coordinated care. Reported initiatives to modify local health-care systems, such as the Perioperative Surgical Home, are presented. Consideration is given to how clinicians can use the philosophy and tools of quality improvement methodology, with important current examples. The article concludes by looking at obstacles to change when introducing new frameworks and the future horizons for the discipline.
Treatment of limb length discrepancy following total hip arthroplasty
Authors: Kayani Babar , Pietrzak Jurek , Donaldson Matthew J , Konan Sujith , Haddad Fares S
Published: November 2017

Limb length discrepancy is the leading cause of patient dissatisfaction following total hip arthroplasty and the most common reason for litigation in the field of orthopaedics. This article provides a systematic, stepwise approach for identifying the aetiology of limb length discrepancy following total hip arthroplasty and provides guidance on the treatment of this complication to optimize postoperative clinical and functional outcomes. This review discusses postoperative history taking, clinical examination, radiographic assessment, conservative treatment, and surgical intervention for the management of patients with established limb length discrepancy following total hip arthroplasty. A comprehensive understanding of the multifactorial nature and methods of managing postoperative limb length discrepancy is essential for optimizing patient satisfaction, clinical outcomes and long-term function following total hip arthroplasty.
Consultation skills: a personal reflection on history-taking and assessment in aesthetics
Authors: Demosthenous Nestor
Published: November 2017

Aesthetic medicine is a rapidly developing specialty that many have a growing passion for and dedication to. Although not strictly defined by the Nursing and Midwifery Council (NMC) or General Medical Council (GMC) as a specialty, it should, in the author's opinion, be treated as such. This would suggest that every facet of aesthetic medicine stand on the four pillars of medical ethics: autonomy, beneficence, non-maleficence and justice. These have been described in the GMC's Good Medical Practice (2013) in four domains. Domain one describes knowledge, skills and performance, making the care of the patient a doctor's first concern. Domain two looks at safety and quality, urging doctors to ‘take prompt action’ if they think that patient safety, dignity or comfort is being compromised. Domain three describes how to work with patients and colleagues to reach decisions together about their treatments. Domain four is about maintaining trust by being open and honest with patients. The consultation is arguably the cornerstone of any practitioner–patient interaction. Consultations include taking a history, undertaking an examination, arriving at a diagnosis and formulating a treatment plan, while also taking into consideration a patient's ideas, concerns and expectations. Executed correctly, this will ensure the four domains of good medical practice are adhered to. The success of any consultation depends on how well the patient and practitioner communicate with each other. This article looks to focus on the consultation process in aesthetic medicine.
Body dysmorphic disorder and addiction to medical aesthetic procedures
Authors: Gorbis Eda , Kim Carolyn
Published: November 2017

According to the Diagnostic and Statistical Manual of Mental Disorders, body dysmorphic disorder (BDD), or dysmorphophobia, is the preoccupation with an imagined defect in appearance that leads to significant distress and impairments to daily functioning. Due to their lack of insight, individuals with BDD believe that cosmetic procedures will be the solution to their insecurities, even though they rarely get satisfaction from them. Cosmetic procedures can then become an addiction, as patients never reach full satisfaction. In response to this issue, aesthetic practitioners need to identify those presenting with BDD by administering a questionnaire that asks how many cosmetic surgeries the individual has had previously, before continuing with any aesthetic procedure. Those who show signs of BDD can then be referred to mental health professionals for specialised treatments, such as medications, cognitive behavioural therapy, exposure and response prevention, and family support.
Tutorial 5: Information & Society
Authors: Magnoni Dee
Published: November 2017

Where are we going will all this? Why is it important in the first place? The following items focus mostly on the science side of these questions. There is some missing information here about big data and the quantities of information being generated in today’s society, but these questions—while very interesting—are also a bit beside the more central questions (at least for our immediate purposes) of why and how we gather, publish and teach.
Promotion & Tenure Reform Workgroup Report
Authors: Ball Cheryl , Barrett Kim , Berkery Peter , Clemons Jessica , Crosby Sheree , Falk-Krzesinski Holly J. , Konkiel Stacy
Published: November 2017

The remit of the Open Scholarship Initiative  2017 Promotion & Tenure Reform workgroup clearly connected researchers’ personal publishing choices to the oft-traditionalist system of promotion and tenure in the United States, wherein researchers feel compelled to publish in toll access journals or monographs if they wish to achieve tenure, win grants, receive awards, or otherwise advance professionally. Other professional advancement systems worldwide, such as university hiring, contract renewals and government and foundation grantmaking processes similarly reinforce the primacy of toll access research formats. Hiring practices were of concern for our workgroup, given the increasing “adjunctification” and precarious state of tenured university posts in the United States. Due to these parallels, the Reform working group expanded our charge to consider hiring, grants, and other professional advancement scenarios common to researchers’ concerns worldwide.In this report, we unpack how professional advancement practices—including and beyond promotion and tenure review standards—can be realigned to encourage researchers’ adoption of open access (OA), open research, and open educational practices.Here, we set the scope of the current problem, discuss the reasons why professional advancement scenarios should be realigned to reward open research practices, identify challenges to reforming professional advancement scenarios wholesale and worldwide, recommend concrete actions for beginning the reformation process, and share resources related to professional advancement and open access.
Análise de redes sociais no arranjo produtivo local dos ramos têxtil e de confecções da região da grande São Paulo a partir de uma visão de governança
Authors: Farina Milton Carlos , Bitante Alessandra Preto , Britto Lidiane Campos , Pinheiro Luciane Ribeiro Dias
Published: November 2017

Este artigo caracteriza-se pelo estudo das relações entre os atores participantes do APL Têxtil e de Confecções do Grande ABC a partir de uma visão de governança. Para compreender os fatores facilitadores e dificultadores das relações no APL, foi feito um levantamento bibliográfico sobre os temas. Foram entrevistados representantes do sindicato do setor têxtil, da Prefeitura de São Bernardo do Campo e de uma universidade colaboradora do APL. Além disso, 26 empresas pertencentes ao APL responderam a um questionário estruturado. Por fim, assistiu-se uma reunião do APL em junho de 2015. A principal conclusão deste artigo é que ainda há mais fatores dificultadores que facilitadores para o sucesso do APL estudado. Entre eles, a pouca adesão/participação das empresas do setor no arranjo produtivo local e a escassez de mão de obra especializada no setor.
Sobre incentivos fiscais municipais e o desenvolvimento local de Montes Claros (MG): dilemas e percepções sobre “cidades atrativas”
Authors: Couto Felipe Fróes , Ckagnazaroff Ivan Beck
Published: November 2017

O objetivo deste artigo é compreender a percepção dos gestores públicos e privados locais sobre o papel da política de incentivos fiscais municipais no desenvolvimento local de Montes Claros (MG). Esta é experiência qualitativa, realizada por meio de entrevistas em profundidade com 60 entrevistados de diferentes instituições do município sobre a temática de incentivos fiscais municipais, dado o seguinte problema de pesquisa: na sua percepção, de que forma a política de incentivos fiscais municipais contribui para o desenvolvimento local do município? Obteve-se que os incentivos fiscais municipais no caso analisado são menos importantes do que as condições de vida e estética do município. Foi possível observar fragilidades provocativas em ganhos sistêmicos para a economia local quando consideradas as externalidades, uma vez que as empresas não fazem parte de um projeto político de desenvolvimento local hábil a potencializar as vantagens da proximidade física entre indústrias.
RISCO SISTÊMICO E EFEITO CONTÁGIO À LUZ DO MÉTODO COVAR: UMA ANÁLISE COM AS AÇÕES MAIS LÍQUIDAS LISTADAS NA BM&FBOVESPA
Authors: Fernandes Ana Paola , Machado Márcio André Veras , Cavalcante Paulo Roberto Nóbrega
Published: November 2017

O objetivo deste artigo é avaliar as ações mais líquidas inseridas na BM&FBovespa, mostrando como variações nas séries de retornos das ações e de mercado geram e sofrem externalidades negativas entre si a partir do método CoVaR. Para isso, utilizou-se tanto o retorno mensal das ações quanto o índice Bovespa, analisando o período de 1994 a 2015. Foram calculados o VaR e ?CoVaRsist|i para efeito de comparação de métodos. Para o VaR, observou-se que a empresa Vale, representada pelas ações R_VALE3 e a R_VALE5 apresentaram maior VaR, com -1,35 e -1,33, respectivamente. Já em relação ao ?CoVaRsist|i, as duas ações que mais contribuíram para o risco sistêmico foi a R_VALE3 e a R_ABEV3, com -1,38 e -1,35, respectivamente. De modo geral, uma possível crise sistêmica pode não necessariamente se originar no setor financeiro, o que instiga um estudo setorial mais abrangente e possíveis modificações regulatórias não só ao setor financeiro.
Relationships and boundaries between provider and recipient families following embryo adoption
Authors: Blyth Eric , Lui Steve , Frith Lucy
Published: November 2017

This article reports on a study of individuals and couples who provided or received embryos under the Snowflakes® embryo adoption programme in the US and had established contact with each other. This mixed-methods study comprised two phases: an online survey, followed by email interviews. It explores participants’ initial experiences of establishing contact after embryo adoption and the birth of a child; how they developed and negotiated boundaries in their relationships with their respective provider or recipient families; and the fluid meaning and role of genetics in forming the basis for relationships. To our knowledge, this is the first study to explore how relationships are negotiated in these emerging family forms. This article extends knowledge and understanding of embryo adoption and contributes to the growing body of sociological research on information exchange and contact between parents who have children who share the same embryo or gamete donor.
Mothering and othering in the city: Polish migrants in the UK
Authors: Lisiak Agata
Published: November 2017

This article addresses the many complexities of migrant mothering by examining the unique ways in which it is performed, negotiated and made sense of by migrant mothers themselves. Drawing on interviews conducted with recent Polish migrant women who mother small children in British cities, I study how mothering is inscribed with value and how kinwork is done locally, among ‘people like us’ (Stack, 1974). I discuss how migrant mothers position themselves vis-à-vis the other mothers they encounter in their neighbourhoods, and how these positionings are gendered, classed and ethnicised. I propose that practising and displaying intensive mothering may serve as a form of cultural capital for migrant mothers, a means of positioning themselves favourably in a new neighbourhood or school. For recent migrants, intensive mothering may thus work to ‘elevate’ them beyond the migrant experience.
Inserção das tecnologias digitais na educação
Authors: Maia Janicleide Vidal , Matias Avanúzia Ferreira
Published: November 2017

Neste artigo, por meio de um estudo de caso a partir de relatos proferidos por uma professora do Ensino Básico, objetivamos, à luz da perspectiva da Teoria Sistêmico Funcional (HALLIDAY; MATTHIESSEN, 2004), perscrutar nuanças da nova identidade docente no contexto de inserção das tecnologias digitais na sala de aula, considerando o posicionamento da professora acerca da sua própria identificação e sua atitude reflexiva em relação a sua prática pedagógica. O resultado da pesquisa permite vislumbrar o processo de incompletude da identificação na modernidade tardia e indica a constituição de uma identidade docente em formação.