bluuebunny/crossref_metadata_2025 huggingface dataset:
A priori sensitivity analysis for densification GPS networks and their capacities of crustal deformation monitoring: a real GPS network application
Authors: Küreç P. , Konak H.
Published: May 2014

Abstract. The main purpose of this study is to investigate the possibilities of monitoring crustal movement, during collective evaluation of first- and second-order GPS densification networks. The new criteria, which are independent from the network datum, are widely used for the evaluation and quality processing of geodetic networks. In this study, the values of detectable minimum displacement for a real GPS network are investigated as well as how sensitivity levels are affected by additional datum conditions, which are added to the adjustment model.
Evaluation of MERIS products from Baltic Sea coastal waters rich in CDOM
Authors: Beltrán-Abaunza J. M. , Kratzer S. , Brockmann C.
Published: May 2014

Abstract. In this study, retrievals of the medium resolution imaging spectrometer (MERIS) reflectances and water quality products using four different coastal processing algorithms freely available are assessed by comparison against sea-truthing data. The study is based on a pair-wise comparison using processor-dependent quality flags for the retrieval of valid common macro-pixels. This assessment is required in order to ensure the reliability of monitoring systems based on MERIS data, such as the Swedish coastal and lake monitoring system (http://vattenkvalitet.se). The results show that the pre-processing with the Improved Contrast between Ocean and Land (ICOL) processor, correcting for adjacency effects, improves the retrieval of spectral reflectance for all processors. Therefore, it is recommended that the ICOL processor should be applied when Baltic coastal waters are investigated. Chlorophyll was retrieved best using the FUB (Free University of Berlin) processing algorithm, although overestimations in the range 18–26.5%, dependent on the compared pairs, were obtained. At low chlorophyll concentrations (< 2.5 mg m−3), data dispersion dominated in the retrievals with the MEGS (MERIS ground segment processor) processor. The lowest bias and data dispersion were obtained with MEGS for suspended particulate matter, for which overestimations in the range of 8–16% were found. Only the FUB retrieved CDOM (coloured dissolved organic matter) correlate with in situ values. However, a large systematic underestimation appears in the estimates that nevertheless may be corrected for by using a local correction factor. The MEGS has the potential to be used as an operational processing algorithm for the Himmerfjärden bay and adjacent areas, but it requires further improvement of the atmospheric correction for the blue bands and better definition at relatively low chlorophyll concentrations in the presence of high CDOM attenuation.
Flow dynamics around downwelling submarine canyons
Authors: Spurgin J. M. , Allen S. E.
Published: May 2014

Abstract. Flow dynamics around a downwelling submarine canyon were analysed with the Massachusetts Institute of Technology general circulation model. Blanes Canyon (Northwest Mediterranean) was used for topographic and initial forcing conditions. Fourteen scenarios were modelled with varying forcing conditions. Rossby number and Burger number were used to determine the significance of Coriolis acceleration and stratification (respectively) and their impacts on flow dynamics. A new non-dimensional parameter (χ) was introduced to determine the significance of vertical variations in stratification. Some simulations do see brief periods of upwards displacement of water during the 10 day model period, however, the presence of the submarine canyon is found to enhance downwards advection of density in all model scenarios. High Burger numbers lead to negative vorticity and a trapped anticyclonic eddy within the canyon, as well as an increased density anomaly. Low Burger numbers lead to positive vorticity, cyclonic circulation and weaker density anomalies. Vertical variations in stratification affect zonal jet placement. Under the same forcing conditions, the zonal jet is pushed offshore in more uniformly stratified domains. Offshore jet location generates upwards density advection away from the canyon, while onshore jets generate downwards density advection everywhere within the model domain. Increasing Rossby values across the canyon axis, as well as decreasing Burger values, increase negative vertical flux at shelf break depth (150 m). Increasing Rossby numbers lead to stronger downwards advection of a passive tracer (nitrate) as well as stronger vorticity within the canyon. Results from previous studies were explained within this new dynamic framework.
The Individual Agency and Social Structure Dialectic: Exploring Women's Experiences of Remand Custody through Arts and Community-Based Research
Authors: Rutherford Gayle , Walsh Christine A. , Klemmensen Meredith , Madden Sarah
Published: May 2014

Background: Attention to the interaction between individual agency and the structural causes and solutions to repeated incarceration is important to create sustainable change. In order to create this change, we will need to work in new ways to investigate the issues and to collaboratively identify and implement solutions.Purpose: Arts-and community-based research methods were used to explore the experiences and personal knowledge of women in remand custody.Results: The findings substantiate current knowledge of the underlying causes of women's incarceration, including both structural issues (e.g., poverty, inaccessible education and employment, housing instability) and personal issues (e.g., addictions, history of family violence). Although the women acknowledged individual responsibility, attention to the structural causes and solutions to the cycling in and out of incarceration is fundamentally important, underpinning all of the women's recommendations.Conclusion: The challenge of reducing the cycle of repeated incarceration for women will require a concerted collaborative effort using creative endeavors that bring the knowledge and experience of the women together with key players who can influence change at both the individual and the systemic levels
Les résidences pour personnes âgées de l’île de Montréal appartenant aux parcs social et privé : une exposition inéquitable à la pollution de l’air ?
Authors: Carrier Mathieu , Séguin Anne-Marie , Apparicio Philippe , Crouse Dan
Published: May 2014

La qualité des milieux à proximité des résidences pour personnes âgées sur l’île de Montréal, tant celles du parc privé que du parc social, est analysée sous l’angle de la pollution générée par la circulation automobile. Deux types d’indicateurs de polluants sont utilisés pour évaluer la pollution. Les premiers sont basés sur la proximité des axes majeurs de circulation et les seconds estiment, dans un rayon de 200 m, la concentration de NO2. Nos résultats montrent que les résidences privées et celles du parc social se localisent plus souvent à proximité d’axes majeurs de circulation que les résidences de l’ensemble de la population et de la population âgée. Les résidences privées se caractérisent toutefois par des concentrations moindres de NO2 comparativement à ces deux mêmes populations, alors qu’on observe l’inverse pour les résidences du parc social. Ceci s’explique notamment par leur distribution respective au sein du territoire urbanisé.
La lutte contre l’exclusion numérique et la revitalisation des collectivités locales
Authors: Klein Juan-Luis , Huang Ping
Published: May 2014

Ce texte aborde le problème de la lutte contre l’exclusion numérique en lien avec la revitalisation des communautés locales dans le contexte de la nouvelle économie où les réseaux ont une place fondamentale. Nous savons que l’accès à l’information est devenu un facteur d’intensification des inégalités sociales et territoriales, mais sous le leadership des acteurs locaux et communautaires, il peut aussi devenir une base pour le renforcement des communautés et pour la lutte contre la pauvreté et l’exclusion. C’est ce que montre le cas du Carrefour d’éducation populaire de Pointe-Saint-Charles, à l’oeuvre dans l’un des quartiers les plus défavorisés de Montréal. Cet organisme renforce l’empowerment collectif en combinant la solidarité numérique aux autres actions collectives visant l’amélioration des conditions de vie des citoyens et la revitalisation de la communauté.
Logiques territoriales et professionnalisations dans le champ de l’intervention sociale
Authors: Fourdrignier Marc , Molina Yvette
Published: May 2014

Les problématiques de ces dernières années en France ont amené de nouvelles réponses en termes de politiques sociales, qui se caractérisent par une plus grande prise en compte du territoire. Parallèlement, nous assistons à des évolutions dans les pratiques professionnelles où les logiques territoriales et collectives sont attendues par les pouvoirs publics. L’introduction de ces nouvelles exigences pose la question de leur impact sur la professionnalité des intervenants sociaux. Les attentes des organisations, à travers les politiques sociales qu’elles développent, ont-elles un réel impact sur les pratiques de ces derniers?
La territorialisation du social à l’épreuve des associations parapubliques
Authors: Hamzaoui Mejed , Artois Pierre , Mélon Laetitia
Published: May 2014

Le présent article a pour but de s’interroger sur le développement des dispositifs territorialisés d’insertion à partir du concept de partenariat. Ce dernier est mobilisé par l’action publique comme un instrument managérial. En effet, la territorialisation des politiques sociales a produit une forme d’institutionnalisation des acteurs locaux impliqués. À partir d’études diachroniques réalisées en Région de Bruxelles-Capitale, il nous semble que ce processus confisque le débat démocratique pour l’opérer sous un mode consensuel tout en faisant apparaître un système de concurrence entre le monde associatif « privé » de l’intervention sociale et le parapublic.
Réduction des inégalités sociales de santé
Authors: Boisvert Réal
Published: May 2014

Cet article propose de voir comment une certaine forme de production et de diffusion des savoirs contribue à la mobilisation citoyenne et à la transformation des conditions de vie permettant de réduire les inégalités sociales de santé. Pour ce faire, il rappelle l’importance d’adopter et de partager une éthique de la reconnaissance des inégalités, cela à l’échelle des espaces d’expression de la solidarité organique que sont les communautés locales. Il montre comment, notamment, une appropriation collective des savoirs permet de pousser le vecteur du développement dans le sens de l’activation de la capacité d’agir tout en soutenant la montée de contre-pouvoirs capable d’influencer les politiques publiques nationales et en faisant en sorte que les individus et les communautés elles-mêmes aient le quantum de ressources qui leur revient, mais surtout les ressources qui conviennent à leurs besoins et à la possibilité de faire des choix pour leur mieux-être.
Démocratisation des institutions et des pratiques en santé
Authors: Plourde Anne
Published: May 2014

Dans l’optique d’une recherche plus large qui passera par l’analyse du destin des Centres locaux de services communautaires (CLSC), le présent article vise à présenter les résultats d’une recherche documentaire sur la conception de la santé, les pratiques et le modèle de gestion radicalement démocratiques portés par les cliniques populaires qui émergent au Québec à la fin des années 1960 et qui inspireront directement le projet des CLSC. La redécouverte de ce modèle permettra de jeter un éclairage nouveau sur les débats actuels concernant le système public de soins et la Réforme des affaires sociales dans laquelle il s’enracine.
Insolents.es et Insoumis.es. Esquisses sur les droits en santé mentale
Authors: Barbal i Rodoreda Pilar , Blais Denise M.
Published: May 2014

Dans une perspective de défense des droits en santé mentale axée sur l’appropriation du pouvoir, Action Autonomie a mis sur pied un projet d’art conscientisant en collaboration avec le Musée des Beaux-Arts de Montréal. Il s’agit avant tout d’une réponse de l’organisme à ses membres et aux personnes qui ont fait des demandes d’aide et d’accompagnement. Ayant comme toile de fond le témoignage de 15 personnes ayant subi des mesures de contrôle – contention physique, chimique et isolement – dans le milieu psychiatrique montréalais, ce projet se déploie à travers un cycle de sept étapes ayant mené à la création d’une oeuvre collective sur chacun des cinq droits explorés : droit à la dignité, au respect, à la liberté, à la sécurité et au consentement libre et éclairé. Chacune de ces oeuvres est accompagnée de messages et réflexions livrés par les artistes sur chacun des droits. L’objectif de ce projet était de créer cette oeuvre collective itinérante comme outil de sensibilisation et de promotion des droits en santé mentale.
From “Canadians First” to “Workers Unite”: Evolving Union Narratives of Migrant Workers
Authors: Foster Jason
Published: May 2014

Federal government policy changes in the early 2000s led to the rapid expansion of Canada’s Temporary Foreign Worker (TFW) Program by increasing the number of eligible occupations. Before the expansion few trade unions in Canada had interaction with TFWs, but with the new rules, and the high profile political debate that ensued, unions were forced to confront the issue of migrant workers directly for the first time. Using narrative analysis, the paper examines media statements from union officials between 2006 to 2012 to track the narratives constructed by unions regarding TFWs. It finds three temporally sequential narrative arcs: 1-prioritizing of Canadian workers’ interests and portrayal of TFWs as employer pawns; 2-TFWs as vulnerable workers needing union advocacy for their employment and human rights; and 3-post-economic crisis conflicted efforts to integrate Canadian and TFW interests. The changing narratives reflect evolving union reaction to the issue of growing use of TFWs, as well as interaction with external political and economic contexts shaping the issue.

The study examines how unions understand challenging new issues. The results suggest union discourses are shaped by the tension between internal pressures and external contexts. They also suggest that leaders’ responsibility to represent members can sometimes clash with unions’ broader values of social justice. Unions build internal value structures that inform their understanding of an issue, but they must also reflect members’ demands and concerns, even if those concerns may not reflect social justice values. The case study reveals the line between “business union” and “social union” philosophy is fluid, contested and context dependent. The paper also links union narratives of TFWs in this contemporary setting to labour’s historical attitude toward immigration and race, finding elements of both continuity and disruption.
EAARN score, a predictive score for mortality in patients receiving cardiac resynchronization therapy based on pre‐implantation risk factors
Authors: Khatib Malek , Tolosana José M. , Trucco Emilce , Borràs Roger , Castel Ángeles , Berruezo Antonio , Doltra Adelina , Sitges Marta , Arbelo Elena , Matas Maria , Brugada Josep , Mont Lluís
Published: May 2014

Aims

The beneficial effects of CRT in patients with advanced heart failure, wide QRS, and low LVEF have been clearly established. Nevertheless, mortality remains high in some patients. The aims of our study were to identify the predictors of mortality in patients treated with CRT and to design a risk score for mortality.

Methods and results

A cohort of 608 consecutive patients treated with CRT from 2000 to 2011 in our centre was prospectively analysed. Baseline clinical and echocardiography variables were analysed and mortality data were collected. During a mean follow‐up of 36.2 ± 29.2 months, 174 patients died: 123/174 (71%) due to cardiovascular causes, 25/174 (14%) non‐cardiac causes, and 26/174 (15%) unknown aetiology. In a multivariate analysis the predictors of mortality were NYHA class IV [hazard ratio (HR) 2.54, 95% confidence interval (CI) 1.7–3.7, P < 0.001], glomerular filtration rate (GFR) <60 mL/min/1.73 m2 (HR 1.61, 95% CI 1.14–2.30, P = 0.008), AF (HR 1.67, 95% CI 1.19–2.3, P = 0.01), age ≥70 years (HR 1.44, (95% CI 1.04–2.00, P = 0.02), and LVEF <22% (HR 1.83, 95% CI 1.33–2.52, P ≤ 0.001). The EAARN score (EF, Age, AF, Renal dysfunction, NYHA class IV) summarizes the predictors. Each additional predictor increased the mortality: one predictor, HR 3.28 (95% CI 1.37–7.8, P = 0.008); two, HR 5.23 (95% CI 2.24–12.10, P < 0.001); three, HR 9.63 (95% CI 4.1–22.60, P < 0.001); and four or more, HR 14.38 (95% CI 5.8–35.65, P < 0.001).

Conclusion

The predictors of mortality have a significant add‐on predictive effect on mortality. The EAARN score could be useful to stratify the prognosis of CRT patients.
Electrochemical Sensor and Biosensor Strategies for ROS/RNS Detection in Biological Systems
Authors: Calas‐Blanchard Carole , Catanante Gaëlle , Noguer Thierry
Published: May 2014

This review summarises the main electrochemical sensors and biosensors developed for assessing the reactive oxygen (ROS) and nitrogen (RNS) species of interest in clinical and physiological analysis. Among these species, a special attention is focused on sensors for the detection of the highly reactive superoxide radicals O2.−, the very stable hydrogen peroxide H2O2, as well as the well‐known RNS nitric oxide (NO.). The different methods adopted for the detection of each species are commented, considering both sensor and biosensors detection strategies.
Adherence of Helicobacter pylori
Authors: Logan RP
Published: May 2014

Helicobacter pylori infects only gastric type epithelium, to which it adheres closely and forms attaching‐effacing lesions. Similar lesions are also seen in ferrets infected with Helicobacter mustelae, the only other host in which peptic ulcer occurs during the course of infection. These observations imply a specific interaction between bacterial adhesin(s) and host receptor(s). They account for the adherence of H. pylori to the gastric epithelium and suggest that adherence is an important virulence factor. Numerous experimental methods, each with their own advantages or disadvantages, are available to study the interaction and characterize the nature of bacterial adhesins and their receptors. Many studies have shown that H. pylori is able to agglutinate red blood cells. Amongst several bacterial lectins, at least one adhesin has a sialic acid receptor specificity. However, the gene encoding this putative adhesin is larger than originally thought, whilst the function and location of its product is unclear. Adherence of H. pylori to a wide variety of cell lines (gastric and non‐gastric) has also been shown, and is necessary for the induction of pro‐ inflammatory responses. However, there is little evidence to support an association between haemagglutination and extent or pattern of adherence to gastric epithelium or gastric‐derived cell lines.
Germ‐free mice as a model to study effect of gut microbiota on host physiology
Authors: Grover M. , Kashyap P. C.
Published: May 2014

The alterations in resident gut microbiota seen in chronic gastrointestinal disorders have led to an increasing interest in the role of gut bacteria in maintaining intestinal barrier function. While acute alterations in colonic secretomotor function in response to pathogens have been well described, the effect of commensal bacteria on intestinal barrier function and colonic secretomotor function still remains poorly understood. Germ‐free mice represent a model system to study effect of gut microbes on host gastrointestinal physiology. The study by Lomasney et al. represents an important step in this direction by demonstrating that the colonic secretomotor function is largely preserved in germ‐free mice, hence making them a suitable model to study effect of gut microbiota on host function.
Fabrication and Characterization of Photonic Crystals in Photopolymer SZ2080 by Two-Photon Polymerization Using a Femtosecond Laser
Authors: Tian Yinan , Kwon Hyukjoon , Shin Yung C. , King Galen B.
Published: May 2014

Two-photon polymerization (2PP) is a powerful technique in fabricating three-dimensional subdiffraction-limited structures. In this paper, 2PP was applied to generate woodpile structures, one kind of photonic crystal, using SZ2080, which is widely used in 2PP due to its negligible shrinkage. First, the relationship between scanning speed, laser power, and resolution was determined through fabricating free-hanging lines by theoretical and experimental study. Based on this relationship, woodpile structures with different period distances were fabricated with high uniformity as shown by scanning electron microscopy (SEM) images. Then optical properties of woodpile structures were investigated using Fourier transform infrared spectroscopy (FTIR) and a quantitative empirical relationship between period distance and band gaps was established. The empirical relationship can be applied to design woodpile photonic crystals for the optical sensors and filters.
Microbiological investigation of an antibacterial sandwich layer system
Authors: Heidari Zare Hamideh , Sudhop Stefanie , Schamberger Florian , Franz Gerhard
Published: May 2014

To allow medical application of an artificial bladder made of biocompatible polyurethane, a long-term stable antibacterial coating is required. Alone, the artificial bladder exhibits no defense against microorganisms. Silver coating provides long-term antibacterial protection by the continuous release of silver ions into aqueous solutions. To control and to prolong the rate of silver ion release, the deposited silver film has to be protected by an inert film of biocompatible polyparylene by means of chemical vapor deposition. In this study, an antibacterial artificial bladder surface was developed by the formation of a sandwich structure consisting of silver and a biocompatible polymer (polyparylene) as a diffusion barrier. Specifically, this study analyzed the correlation between polyparylene thickness and silver release to determine optimal concentrations to combat common bacteria in vitro. The release of silver from sandwich structures was investigated in vitro by testing different thicknesses of polyparylene (0, 190, 540, and 1000 nm) as a diffusion barrier. The best result was demonstrated with a thickness of 190 nm of polyparylene, which yielded a silver dispense rate of 650 pg/(cm2⋅min), which would yield bacteriozidal concentrations above 30 μg/l in the bladder volume. The authors confirmed the antibacterial effect in vitro against common urinary tract infection pathogens, namely, Escherichia coli and Staphylococcus cohnii. Inhibition of bacterial growth could be detected within 8 h. A diffusion assay with spherical silver spots showed concentric zones free of bacterial growth. Our results suggest the possible utility of silver-polyparylene coatings as antibacterial agents.
In Barrett's esophagus patients and Barrett's cell lines, ursodeoxycholic acid increases antioxidant expression and prevents DNA damage by bile acids
Authors: Peng Sui , Huo Xiaofang , Rezaei Davood , Zhang Qiuyang , Zhang Xi , Yu Chunhua , Asanuma Kiyotaka , Cheng Edaire , Pham Thai H. , Wang David H. , Chen Minhu , Souza Rhonda F. , Spechler Stuart Jon
Published: May 2014

Hydrophobic bile acids like deoxycholic acid (DCA), which cause oxidative DNA damage and activate NF-κB in Barrett's metaplasia, might contribute to carcinogenesis in Barrett's esophagus. We have explored mechanisms whereby ursodeoxycholic acid (UDCA, a hydrophilic bile acid) protects against DCA-induced injury in vivo in patients and in vitro using nonneoplastic, telomerase-immortalized Barrett's cell lines. We took biopsies of Barrett's esophagus from 21 patients before and after esophageal perfusion with DCA (250 μM) at baseline and after 8 wk of oral UDCA treatment. DNA damage was assessed by phospho-H2AX expression, neutral CometAssay, and phospho-H2AX nuclear foci formation. Quantitative PCR was performed for antioxidants including catalase and GPX1. Nrf2, catalase, and GPX1 were knocked down with siRNAs. Reporter assays were performed using a plasmid construct containing antioxidant responsive element. In patients, baseline esophageal perfusion with DCA significantly increased phospho-H2AX and phospho-p65 in Barrett's metaplasia. Oral UDCA increased GPX1 and catalase levels in Barrett's metaplasia and prevented DCA perfusion from inducing DNA damage and NF-κB activation. In cells, DCA-induced DNA damage and NF-κB activation was prevented by 24-h pretreatment with UDCA, but not by mixing UDCA with DCA. UDCA activated Nrf2 signaling to increase GPX1 and catalase expression, and protective effects of UDCA pretreatment were blocked by siRNA knockdown of these antioxidants. UDCA increases expression of antioxidants that prevent toxic bile acids from causing DNA damage and NF-κB activation in Barrett's metaplasia. Elucidation of this molecular pathway for UDCA protection provides rationale for clinical trials on UDCA for chemoprevention in Barrett's esophagus.
Effects of 12-wk eccentric calf muscle training on muscle-tendon glucose uptake and SEMG in patients with chronic Achilles tendon pain
Authors: Masood Tahir , Kalliokoski Kari , Magnusson S. Peter , Bojsen-Møller Jens , Finni Taija
Published: May 2014

High-load eccentric exercises have been a key component in the conservative management of chronic Achilles tendinopathy. This study investigated the effects of a 12-wk progressive, home-based eccentric rehabilitation program on ankle plantar flexors' glucose uptake (GU) and myoelectric activity and Achilles tendon GU. A longitudinal study design with control ( n = 10) and patient ( n = 10) groups was used. Surface electromyography (SEMG) from four ankle plantar flexors and GU from the same muscles and the Achilles tendon were measured during submaximal intermittent isometric plantar flexion task. The results indicated that the symptomatic leg was weaker ( P < 0.05) than the asymptomatic leg at baseline, but improved ( P < 0.001) with eccentric rehabilitation. Additionally, the rehabilitation resulted in greater GU in both soleus ( P < 0.01) and lateral gastrocnemius ( P < 0.001) in the symptomatic leg, while the asymptomatic leg displayed higher uptake for medial gastrocnemius and flexor hallucis longus ( P < 0.05). While both patient legs had higher tendon GU than the controls ( P < 0.05), there was no rehabilitation effect on the tendon GU. Concerning SEMG, at baseline, soleus showed more relative activity in the symptomatic leg compared with both the asymptomatic and control legs ( P < 0.05), probably reflecting an effort to compensate for the decreased force potential. The rehabilitation resulted in greater SEMG activity in the lateral gastrocnemius ( P < 0.01) of the symptomatic leg with no other within- or between-group differences. Eccentric rehabilitation was effective in decreasing subjective severity of Achilles tendinopathy. It also resulted in redistribution of relative electrical activity, but not metabolic activity, within the triceps surae muscle.
Sequence Variation in Vitamin K Epoxide Reductase Gene Is Associated With Survival and Progressive Coronary Calcification in Chronic Kidney Disease
Authors: Holden Rachel M. , Booth Sarah L. , Tuttle Angie , James Paula D. , Morton Alexander R. , Hopman Wilma M. , Nolan Robert Louis , Garland Jocelyn S.
Published: May 2014

Objective—

Sequence variations in the gene(s) encoding vitamin K epoxide reductase complex subunit 1 (VKORC1), the enzyme target of warfarin, have been associated with increased cardiovascular disease in the general population. Coronary artery calcification (CAC) is a prevalent form of cardiovascular disease in chronic kidney disease. We tested the hypothesis that the VKORC1 rs8050894 CC genotype would be associated with mortality and progression of CAC ≤4 years.

Approach and Results—

This study is an observational, prospective study of 167 individuals with stages 3 to 5 chronic kidney disease. Survival ≤4 years was assessed in all participants, and CAC progression was measured in a subset of 86 patients. Participants with the CG/GG genotype of VKORC1 had higher baseline CAC scores (median score, 112 versus 299;
P
=0.036). Of those 86 patients who had a 4-year CAC score, those with the CG/GG genotype had an increased risk of progressive CAC (adjusted for age, diabetes mellitus, estimated glomerular filtration rate, and hypertension) compared with those with the CC genotype. Four-year mortality risk was 4 times higher for individuals with the CG/GG genotypes compared with individuals with the CC genotype (odds ratio, 3.8; 95% confidence interval, 1.2–12.5;
P
=0.02), adjusted for age, sex, diabetes mellitus, estimated glomerular filtration rate, baseline CAC, and hypertension.

Conclusions—

Patients with the CG/GG genotype of VKORC1 had a higher risk of CAC progression and a poorer survival. These data provide new perspectives on the potential extrahepatic role of VKORC1 in individuals with chronic kidney disease.
Ten steps to developing an abstract for conferences
Authors: Hardicre Jayne , Devitt Patric , Coad Jane
Published: May 2014

There is an increasing importance being placed on the dissemination of research and other high quality evidence. This article will assist you in ensuring that your work is presented in the best light at the conference of your choice. In this first article we guide you through the ten steps you need to take to ensure that you submit the best possible abstract to the scientific committee. We also will guide you through the process of selection.
An investigation into the perceptions and preferences of birth positions in a Kenyan referral hospital
Authors: Mwanzia Lydia
Published: May 2014

Moi teaching and referral hospital has the largest mother and baby hospital (Riley Mother and Baby hospital (RMBH) in the western region of Kenya. It has convenient labour-and-delivery rooms which are suitable for different labour and birth techniques and positions. Many women delivering in hospitals are not aware of their right to informed choice of birth position and often accept what is offered to them by midwives ( Lugina et al, 2004 ). According to the International Confederation of Midwives (ICM) (2004) , the role of the midwife Includes ensuring that the labouring woman is adequately informed of options that may facilitate a more informed choice and a less stressful birth experience. de Jonge et al (2008) assert that the ability of midwives to provide health information related to birth positioning and to support women in their preferred positions will depend largely on their knowledge and experience of various positions, attitudes towards evidence on birth positions, women's preferences and hospital protocols on midwifery care. This study researched midwives' practices and women's perceptions and preferences of birth positions and how these may influence a woman's view of the hospital birth experience or choice of birth place.
Using a collaborative approach to address task shifting during the HIV epidemic: The Tanzania experience
Authors: Kohi Thecla W , Mselle Lilian T , Mashauri Paul M , Mpandana Clavery , Vermond Ndementria , Mfalila Lena
Published: May 2014

The shortage of trained health workers is particularly severe in Tanzania. Due to the health worker shortage, many nurses and midwives in Tanzania provide critical HIV services that were formerly provided by physicians. This service delivery strategy, called task sharing, is recommended by the World Health Organization, but it has not yet been formally endorsed by the Tanzanian government. Using a collaborative approach developed by the African Health Profession Regulatory Collaborative (ARC) for nurses and midwives, Tanzanian nursing leaders from four professional sectors, the ‘Quad’, along with in-country partners have successfully advocated for nursing on a number of issues important to the profession. With continued support from ARC and other partners, the Quad is working to advance task sharing in a collaborative, sustainable way, which could be an important example for the rest of the region.
The management of atrial fibrillation after coronary artery bypass graft surgery
Authors: Prime KellyAnn
Published: May 2014

Atrial fibrillation is a common arrhythmia that often develops post-operatively in coronary artery bypass graft surgery (CABG) patients. Patients can become haemodynamically compromised very quickly as a result of the rapid heart rate and loss of cardiac output, while others may complain of the onset of ‘palpitations’ with no other physical signs of discomfort. In the routine assessment of post–operative CABG patients, atrial fibrillation can be easily detected and treated, especially when cardiac monitoring is in use. It can also be diagnosed by palpating an irregular pulse. In this case study the focus will be on the assessment, diagnosis and treatment of atrial fibrillation of an 80 year-old woman.
Using nitrate therapy to treat stable angina
Authors: Walthall Helen
Published: May 2014

Advances in the research and enquiries into the development of coronary heart disease (CHD) have led to changes in the pharmacological management of CHD and the role nitrates play within this. The following paper will review the pharmacology of nitrates and the role nitrates play in the management of stable angina. Nitrates are seen as an effective drug in the management of stable angina. The benefits of nitrate therapy is the ability to cause vasodilatation, coronary artery dilatation and reduce myocardial workload, enabling myocardial oxygen supply and demand needs to be met. The most important need for patients with stable angina is the education required to ensure the full potential of drug therapy is gained.
Removal of femoral arterial sheaths: A practical guide
Authors: Gibson Tracey
Published: May 2014

The number of percutaneous coronary interventions (PCIs) is increasing in the UK with over 53 000 carried out annually in the UK (British Heart Foundation (BHF), 2005). Cardiac arrhythmias are also an area of concern for cardiac nurses because they affect more than one million people in the UK and are consistently one of the top ten reasons for hospital admission (Arrhythmia Alliance, 2006). Nurses working in the area of cardiac care often encounter patients who require investigation and treatment of these conditions.
Deactivating implantable cardioverter defibrillators in the terminally ill
Authors: Meldrum Nicola
Published: May 2014

Implantable cardioverter defibrillators (ICDs) reduce mortality rates in patients who are at high risk of developing ventricular arrhythmias. As survival from arrhythmic deaths is improved, patients are more likely to die from chronic conditions such as heart failure, cancer and respiratory disease. The increasing number of patients implanted with ICDs has highlighted an issue of concern that patients are receiving ICD shocks in the last few days or hours before death is expected due to a terminal illness. Many health professionals are unaware that ICD shock therapy can be deactivated easily if this is in accordance with the patient’s wishes. Unfortunately, however, many patients do not realize that this option is available to them as the issue is not routinely discussed. This limits the patient’s ability to make fully informed decisions about the end of their lives. This paper aims to highlight this issue and encourage health professionals to promote this discussion at the earliest opportunity.
The pathophysiology and management of atrial fibrillation
Authors: Banner Davina
Published: May 2014

Atrial fi brillation (AF) is the most common sustainable arrhythmia encountered in acute care. Previously, AF was considered a benign rhythm disorder. However, risks and personal burden have reinforced effective management as vital in improving mortality, morbidity and quality of life. This article will detail the clinical manifestation, pathophysiology and management of AF. AF management strategies include the use of medication for cardioversion and maintenance of ventricular rate, electrophysiological procedures and the minimisation of thromboembolic risks. Since AF is encountered in a variety of care environments, nurses are in an important position to effectively assess, educate and support patients with AF and their families. Consequently, nurses must have a good understanding of AF to effectively contribute to the care of such patients.
The British Heart Foundation education pathway
Authors: Curtis Cynthia
Published: May 2014

Cynthia Curtis discusses the launch of a framework for heart nurses and other health professionals whose professional development is funded by the foundation
Research Roundup
Authors: Linden Belinda
Published: May 2014

Although the introduction of automated external defi brillators (AEDs) in community- based resuscitation programmes has helped to increase survival aft er witnessed cardiac arrest, evidence of the eff ect of such programmes is limited, especially as outof-hospital cardiac arrest most commonly occur within the home.
Achieving haemostasis after femoral access: alternatives to manual (digital) compression
Authors: Bowden Tracey
Published: May 2014

Cardiac nurses often encounter patients following invasive diagnostic and interventional procedures. After these procedures the sheath(s) must be removed and this has become a routine practice for nurses working in the field of interventional cardiology. The best method for achieving haemostasis remains controversial and this controversy has increased the availability of new devices for closing femoral punctures. The purpose of this paper is to provide an overview of the most common alternatives to digital compression and discuss the nursing considerations associated with these. The evidence base in relation to patient outcomes and nursing practice will also be explored
ECG of the month
Authors: Regan Claire
Published: May 2014

Claire Regan presents an ECG for you to analyse. The answer and management plan are given on page 35.
The skills, knowledge and educational needs of BHF arrhythmia care coordinators
Authors: May Susie , Pattenden Jill
Published: May 2014

The British Heart Foundation (BHF) funded 32 arrhythmia care coordinators (ACCs) in 19 trusts and approached two universities to develop and run a master’s degree-level module in arrhythmia management.

Aim: The purpose of this study was to explore the skills, knowledge and educational needs of a cohort of ACCs under taking the module in their first year of setting up a service.

Methods: A qualitative approach was used from data gathered from the population’s quarterly reports, CVs, job descriptions and two focus groups.

Findings: ACCs worked across the primary, secondary and tertiary care inter face with varying roles and ser vice priorities. The ACCs reported that the arrhythmia module fulfilled the clinical component of their role. They identified a need for: more focus on primary/ secondary care (rather than tertiary); more clinical support to assess competency; more knowledge on the operational aspects of setting up a specialist nurse ser vice and more education in bereavement counselling.

Conclusions: The role of the BHF ACC requires an extensive range of skills, to meet the complex needs of patients with arrhythmias and sudden cardiac death. Further training is required on the operational aspects of the role, bereavement counselling and knowledge of primary care. The provision of adequate cardiology support is essential to assess clinical competency to ensure patient safety.
Providing a perspective on patients’ needs
Authors: Geldard David
Published: May 2014

David Geldard, president of Hear t Care Partnership UK from 2004 to 2008, was recently honoured for his voluntary ser vice to people with cardiovascular disease. He talked to Lucy Jolin about his experiences of patient representation
Pre-participation cardiac screening: Considerations for young athletes
Authors: Ingle Lee
Published: May 2014

This article is the first of two focusing on the utility and evidence base for pre-participation cardiac screening in competitive athletic populations. The second article will focus on the diagnostic value of different screening modalities used in the large-scale screening of athletic populations. The current article, however, focuses on the incidence of sudden cardiac death (SCD) in young athletic populations and goes on to consider the effectiveness of cardiac screening programmes for reducing the risk of SCD.

Cardiac screening in athletic populations is problematic as it may be difficult to distinguish between physiological adaptations resulting from a specific exercise training stimulus and pathological conditions. Different types of chronic exercise training can induce eccentric or concentric myocardial hypertrophy, which may mimic pathological conditions. The final section discusses some of the practical issues that a clinician may face when needing to advise a young athlete to either stop or modify his/her habitual patterns of physical activity including future exercise considerations.
Pre-participation cardiac screening in young athletes: Models and criteria
Authors: Ingle Lee
Published: May 2014

This is the second of two review articles focusing on the value of preparticipation cardiac screening in young athletes. The article focuses on the efficacy of the resting 12-lead electrocardiogram (ECG), physical examination, and medical history questionnaire, which commonly make up the first stage of a cardiac screening protocol. The review then focuses on specific structural and electrical abnormalities which are responsible for sudden cardiac death (SCD) in young athletes – the most common of which is hypertrophic cardiomyopathy. The identification of appropriate ‘red flag’ signs and symptoms is essential for teasing out potential pathological conditions and allowing differentiation from often benign physiological adaptations. The final section provides guidance on how the resting 12-lead ECG can be used to separate pathological from physiological adaptations in young athletes
Heart failure self-care behaviour in the West of Scotland: A descriptive study
Authors: Barber David , Currie Kay , Gardiner Bill
Published: May 2014

Self-care, encompassing self-monitoring and self-management, has been widely promoted within heart failure management programmes to improve patient outcomes and reduce hospital admissions. Limited quantitative evidence describing heart failure self-care in the Scottish context led to the descriptive study reported here. The European Heart Failure Self-care Behaviour Scale was used to measure levels of self-reported self-care in a convenience sample of 39 chronic heart failure patients receiving care from a nurse-led service in the West of Scotland. The total self-care score ranged from 12 to 44 with a mean score of 25.59 from a possible range of 12 to 60; comparing favourably with similar international studies. The items ‘I exercise regularly’; ‘I weigh myself every day’ and ‘I eat a low salt diet’ had the lowest levels of agreement. While further research is warranted, we recommend that practitioners direct attention towards these self-care deficits within the identified heart failure population.
Self-monitoring improves anticoagulation control
Authors: Linden Belinda
Published: May 2014

This section presents a synopsis of a selection of recently published articles of interest to those nurses working in the field of cardiovascular nursing. The aim of this round-up is to provide a brief overview, rather than a detailed critique, of the research papers selected. A full reference is provided for those who wish to look at the research in further detail.
Isolated noncompacted left ventricular cardiomyopathy
Authors: Wittmann-Price Ruth A , Altman-Shaw Amy
Published: May 2014

Isolated noncompacted left-ventricular cardiomyopathy or left-ventricular noncompaction (LVNC) is a specific myopathy that was first recognized 25 years ago. It is congenital in origin and there are important characteristics of the syndrome that distinguish it from other types of cardiomyopathy. The exact genetic transmission is still being investigated. LVNC affects mainly young adults and the diagnosis is often made when the patient presents with symptoms of severe congestive heart failure. The condition can lead to death from heart failure, a thromboembolism, or a fatal arrhythmia. Treatment of this cardiomyopathy is most effective when started early, and consists of preventing heart failure and emboli, and decreasing the incidence of arrhythmias. Identification of affected families is needed as well as research about appropriate treatment modalities. This review aims to increase nurses' awareness of the condition, its diagnosis, and treatments
Healthy eating habits in cardiovascular disease
Authors: Merriman Sheila
Published: May 2014

A healthy balanced diet can help protect patients from cardiovascular disease by helping maintain a healthy weight and reduce risk of diabetes, high blood pressure and high cholesterol. This articles provides an outline of what a health diet should consist of.
Cardiac nurse support in enabling smoking cessation
Authors: Percival Jennifer
Published: May 2014

Cardiac nurses are ideally placed to help patients who smoke to consider the adverse health implications of their smoking habit. This article describes the effect of smoking on the cardiovascular system and details various different nicotine-replacement therapy (NRT) products and smoking-cessation support services available to smokers who are committed to smoking cessation. Nurses are provided with template, guideline conversations designed to assist them in approaching the subject of smoking cessation and embarking on a non-argumentative, ongoing, supportive conversation with patients, which has been shown to motivate and guide smokers towards the process and practicalities of successful smoking cessation.
Takotsubo cardiomyopathy: a cause of chest pain
Authors: Chen Alexander WY
Published: May 2014

Takotsubo cardiomyopathy is an uncommon but well-recognised cause of chest pain. This can produce dramatic electrocardiogram changes with subsequent release of cardiac enzymes. It is often initially mistaken for acute coronary syndrome and treated as such. I present such a case, and would like to remind readers of the importance of taking a thorough history and performing relevant investigations.
Hypoplastic left heart syndrome: an overview
Authors: Hardiman Toni
Published: May 2014

Hypoplastic left heart syndrome (HLHS) is a rare type of congenital heart disease involving a spectrum of cardiac abnormalities characterised as hypoplasia of the left ventricle and ascending aorta. If left untreated it inevitably results in death. Since the 1980s, advances in surgical techniques have improved long-term survival, and only in recent years have the longer term complications of surgical palliation become apparent. This article describes the pathophysiology of HLHS, original and current advances in surgical palliation and the ensuing long-term complications. The psychosocial impact on the individual with HLHS is also discussed.
The management of arrhythmias after AF ablation
Authors: Griffiths Angela , Meredith Tara , Sturgess Michael , Betts Timothy R , Bashir Yaver , Wong Kelvin C , Ginks Matthew R , Rajappan Kim
Published: May 2014

Catheter ablation for atrial fibrillation is being increasingly performed worldwide and, with the development of new technologies, the procedure has become safer and more effective after a single attempt. Post-ablation arrhythmia remains common, however, and can be challenging to manage. This review describes the types of arrhythmias seen, when they occur, and how they may be managed. It is particularly important that all health-care professionals are aware of this problem, its identification, and its management as patients will often present to a different hospital from the one at which the ablation was performed. Although many patients will not need further ablation, it is likely that they will need treatment with pharmacological therapy, cardioversion, or a combination of the two.