bluuebunny/crossref_metadata_2025 huggingface dataset:
Retention of topographical anatomical knowledge following surgeon‐facilitated whole‐body dissection
Authors: Sarkis Leba M. , Treble Alexander , Wing Lindsay W. , Ramsey‐Stewart George
Published: August 2014

Background

Topographical anatomy has been taught to medical students by cadaver‐based dissection for centuries. However, there is a void in the literature assessing the long‐term retention of anatomical knowledge by medical students following teaching by whole‐body dissection. The purpose of this paper was to assess both the acquisition and retention of topographical anatomical knowledge gained by medical students undertaking an elective whole‐body dissection course.

Methods

This is a retrospective review of prospectively gathered data. A total of 24 students completed the elective 8‐week Anatomy by Whole Body Dissection course at the University of Sydney in 2013. Surgeons and surgical trainees acted as demonstrators and anatomical knowledge was assessed on four occasions: pre, mid, end and 8 months post‐course in the form of a 20‐question wet specimen tag test.

Results

There was strong evidence of a significant difference (P < 0.001) in the students’ pre‐course scores (median = 8 out of 20, IQR = 6) compared with their end‐course scores (median = 19 out of 20, IQR = 2). Similarly, there was a highly significant difference (P < 0.001) between students' pre‐course scores and the 8‐month follow‐up post‐course test (median = 18, IQR = 3), with a median difference of 10 points. There was no significant difference (P > 0.2) between the students’ end‐course assessment results and the 8 months post‐course assessment indicating retention of knowledge.

Conclusion

Surgeon‐facilitated anatomical teaching to medical students by whole‐body dissection significantly improves topographical anatomical knowledge which is maintained in the long term.
Attitudes of Physicians and Pharmacists Towards International Non‐Proprietary Name Prescribing in Belgium
Authors: Van Bever Elien , Elseviers Monique , Plovie Marijke , Vandeputte Lieselot , Van Bortel Luc , Vander Stichele Robert
Published: August 2014

International Non‐proprietary Name (INN) prescribing is the use of the name of the active ingredient(s) instead of the brand name for prescribing. In Belgium, INN prescribing began in 2005 and a major policy change occurred in 2012. The aim was to explore the opinions of Dutch‐speaking general practitioners (GPs) and pharmacists. An electronic questionnaire with 39 five‐point Likert scale statements and one open question was administered in 2013. Multivariate analysis was performed with multiple linear regression on a sum score for benefit statements and for drawback statements. Answers to the open question were qualitatively analysed. We received 745 valid responses with a representable sample for both subgroups. Participants perceived the motives to introduce INN prescribing as purely economic (to reduce pharmaceutical expenditures for the government and the patient). Participants accepted the concept of INN prescribing, but 88% stressed the importance of guaranteed treatment continuity, especially in older, chronic patients, to prevent patient confusion, medication non‐adherence and erroneous drug use. In conclusion, the current way in which INN prescribing is applied in Belgium leads to many concerns among primary health professionals about patient confusion and medication adherence. Slightly adapting the current concept of INN prescribing to these concerns can turn INN prescribing into one of the major policies in Belgium to reduce pharmaceutical expenditures and to stimulate rational drug prescribing.
Robust inference in the negative binomial regression model with an application to falls data
Authors: Aeberhard William H. , Cantoni Eva , Heritier Stephane
Published: August 2014

A popular way to model overdispersed count data, such as the number of falls reported during intervention studies, is by means of the negative binomial (NB) distribution. Classical estimating methods are well‐known to be sensitive to model misspecifications, taking the form of patients falling much more than expected in such intervention studies where the NB regression model is used. We extend in this article two approaches for building robust M‐estimators of the regression parameters in the class of generalized linear models to the NB distribution. The first approach achieves robustness in the response by applying a bounded function on the Pearson residuals arising in the maximum likelihood estimating equations, while the second approach achieves robustness by bounding the unscaled deviance components. For both approaches, we explore different choices for the bounding functions. Through a unified notation, we show how close these approaches may actually be as long as the bounding functions are chosen and tuned appropriately, and provide the asymptotic distributions of the resulting estimators. Moreover, we introduce a robust weighted maximum likelihood estimator for the overdispersion parameter, specific to the NB distribution. Simulations under various settings show that redescending bounding functions yield estimates with smaller biases under contamination while keeping high efficiency at the assumed model, and this for both approaches. We present an application to a recent randomized controlled trial measuring the effectiveness of an exercise program at reducing the number of falls among people suffering from Parkinsons disease to illustrate the diagnostic use of such robust procedures and their need for reliable inference.
Modeling longitudinal data with a random change point and no time‐zero: Applications to inference and prediction of the labor curve
Authors: McLain Alexander C. , Albert Paul S.
Published: August 2014

In some longitudinal studies the initiation time of the process is not clearly defined, yet it is important to make inference or do predictions about the longitudinal process. The application of interest in this article is to provide a framework for modeling individualized labor curves (longitudinal cervical dilation measurements) where the start of labor is not clearly defined. This is a well‐known problem in obstetrics where the benchmark reference time is often chosen as the end of the process (individuals are fully dilated at 10 cm) and time is run backwards. This approach results in valid and efficient inference unless subjects are censored before the end of the process, or if we are focused on prediction. Providing dynamic individualized predictions of the longitudinal labor curve prospectively (where backwards time is unknown) is of interest to aid obstetricians to determine if a labor is on a suitable trajectory. We propose a model for longitudinal labor dilation that uses a random‐effects model with unknown time‐zero and a random change point. We present a maximum likelihood approach for parameter estimation that uses adaptive Gaussian quadrature for the numerical integration. Further, we propose a Monte Carlo approach for dynamic prediction of the future longitudinal dilation trajectory from past dilation measurements. The methodology is illustrated with longitudinal cervical dilation data from the Consortium of Safe Labor Study.
An Alternative Approach to Confidence Interval Estimation for the Win Ratio Statistic
Authors: Luo Xiaodong , Tian Hong , Mohanty Surya , Tsai Wei Yann
Published: August 2014

Pocock et al. (2012, European Heart Journal  33, 176–182) proposed a win ratio approach to analyzing composite endpoints comprised of outcomes with different clinical priorities. In this article, we establish a statistical framework for this approach. We derive the null hypothesis and propose a closed-form variance estimator for the win ratio statistic in all pairwise matching situation. Our simulation study shows that the proposed variance estimator performs well regardless of the magnitude of treatment effect size and the type of the joint distribution of the outcomes.
Making in‐class skills training more effective: The scope for interactive videos to complement the delivery of practical pedestrian training
Authors: Hammond James , Cherrett Tom , Waterson Ben
Published: August 2014

Skills and awareness of young pedestrians can be improved with on‐street practical pedestrian training, often delivered in schools in the UK by local authorities with the intention of improving road safety. This training is often supplemented by in‐class paper‐based worksheet activities that are seen to be less effective than practical training in that they focus on knowledge acquisition rather than directly improving the correct application of safe pedestrian skills at the roadside. Previous research indicates that interactive video tools have the potential to develop procedural skills while offering an engaging road safety educational experience, which could positively impact on road crossing behaviour.

In this paper, the design and development of a hazard‐identification interactive road safety training video targeting child road crossing skills is presented. The interactive video was shown to be an engaging training resource for 6‐ to 7‐year‐old children. The tool's scope for improving pedestrians' roadside skills is considered along with the wider implications for interactive video to aid safety training in other areas.
Genetic polymorphisms influencing total and γ′ fibrinogen levels and fibrin clot properties in Africans
Authors: Kotzé Retha C. , Nienaber‐Rousseau Cornelie , De Lange Zelda , De Maat Moniek P. , Hoekstra Tiny , Pieters Marlien
Published: August 2014

Inter‐ethnic variation in fibrinogen levels is hypothesized to be the result of differences in genetic background. No information is available regarding the contribution of genetics to fibrinogen γ′ in Africans. Only limited information is available regarding the interaction between genotypes and total and γ′ fibrinogen concentration in determining fibrin clot properties. Our aim was to investigate the effect of polymorphisms in the fibrinogen and Factor XIII genes on total and γ′ fibrinogen and clot properties (turbidimetry) in 2010 black Africans as well as to determine their interactions. Significant associations were observed between rs1049636 (FGG gene), with total fibrinogen levels and between rs2070011 (FGA promoter area) and fibrinogen γ′ levels. Significant associations were observed between single nucleotide polymorphisms (SNPs) in the FGA (rs2070011), FGB (rs1800787) and FGG (rs1049636) genes and fibre size. Significant interactions were found between total and/or γ′ fibrinogen levels and SNPs in the FGA (rs2070011), FGB (rs2227385, rs1800787, rs1800788, rs4220) and F13A1 genes (rs5985) in determining clot properties. The different SNPs influenced the relationships between total and γ′ fibrinogen levels with clot properties in opposing directions. Genetic influences may be ethnic‐specific and should not only focus on fibrinogen concentration, but also on functionality in determining its role in CVD.
The status‐legitimacy hypothesis revisited: Ethnic‐group differences in general and dimension‐specific legitimacy
Authors: Sengupta Nikhil K. , Osborne Danny , Sibley Chris G.
Published: August 2014

The status‐legitimacy hypothesis, which predicts that low‐status groups will legitimize inequality more than high‐status groups, has received inconsistent empirical support. To resolve this inconsistency, we hypothesized that low‐status groups would display enhanced legitimation only when evaluating the fairness of the specific hierarchy responsible for their disadvantage. In a New Zealand‐based probability sample (N = 6,162), we found that low‐status ethnic groups (Asians and Pacific Islanders) perceived ethnic‐group relations to be fairer than the high‐status group (Europeans). However, these groups did not justify the overall political system more than the high‐status group. In fact, Māori showed the least support for the political system. These findings clarify when the controversial status‐legitimacy effects predicted by System Justification Theory will – and will not – emerge.
Targeted next‐generation sequencing in the diagnosis of neurodevelopmental disorders
Authors: Okamoto N. , Miya F. , Tsunoda T. , Kato M. , Saitoh S. , Yamasaki M. , Shimizu A. , Torii C. , Kanemura Y. , Kosaki K.
Published: August 2014

We developed a next‐generation sequencing (NGS) based mutation screening strategy for neurodevelopmental diseases. Using this system, we screened 284 genes in 40 patients. Several novel mutations were discovered. Patient 1 had a novel mutation in ACTB. Her dysmorphic feature was mild for Baraitser‐Winter syndrome. Patient 2 had a truncating mutation of DYRK1A. She lacked microcephaly, which was previously assumed to be a constant feature of DYRK1A loss of function. Patient 3 had a novel mutation in GABRD gene. She showed Rett syndrome like features. Patient 4 was diagnosed with Noonan syndrome with PTPN11 mutation. He showed complete agenesis of corpus callosum. We have discussed these novel findings.
Inferring Learners' Knowledge From Their Actions
Authors: Rafferty Anna N. , LaMar Michelle M. , Griffiths Thomas L.
Published: August 2014

Watching another person take actions to complete a goal and making inferences about that person's knowledge is a relatively natural task for people. This ability can be especially important in educational settings, where the inferences can be used for assessment, diagnosing misconceptions, and providing informative feedback. In this paper, we develop a general framework for automatically making such inferences based on observed actions; this framework is particularly relevant for inferring student knowledge in educational games and other interactive virtual environments. Our approach relies on modeling action planning: We formalize the problem as a Markov decision process in which one must choose what actions to take to complete a goal, where choices will be dependent on one's beliefs about how actions affect the environment. We use a variation of inverse reinforcement learning to infer these beliefs. Through two lab experiments, we show that this model can recover people's beliefs in a simple environment, with accuracy comparable to that of human observers. We then demonstrate that the model can be used to provide real‐time feedback and to model data from an existing educational game.
Socially Responsible Practices: An Exploratory Study on Scale Development using Stakeholder Theory
Authors: Shafiq Asad , Klassen Robert D. , Johnson P. Fraser , Awaysheh Amrou
Published: August 2014

Socially responsible practices of firms have evolved into an important area of research in operations management; however, it remains challenging to identify specific scales that capture multiple dimensions of such social practices. In this exploratory study, we use stakeholder theory to develop new multi‐item measurement scales linked to multiple groups (i.e., internal, supplier, customer, and community stakeholders). Furthermore, we empirically test a higher order multidimensional construct that collectively assesses the socially responsible practices of a firm. Using these stakeholder‐derived constructs as taxons in a cluster analysis, we identify important patterns in the way that multiple groups of stakeholders are engaged. Finally, we demonstrate that the set of social practices are complementary and concentrating on one group can yield spillover effects to other specific stakeholder groups.
Green Purchasing by MNC Subsidiaries: The Role of Local Tailoring in the Presence of Institutional Duality
Authors: Hsu Pei‐Fang , Hu Paul Jen‐Hwa , Wei Chih‐Ping , Huang Jhih‐Wei
Published: August 2014

To examine the essential determinants of green purchasing by multinational corporations’ (MNC) subsidiaries, this study takes institutional theory as a foundation and focuses on the institutional duality associated with localization and globalization. Specifically, we develop a model to explain subsidiaries’ green purchasing and empirically test the model with data from 141 purchasing managers and senior purchasing staff members from subsidiaries in 39 countries. Our results suggest that pressures from headquarters and the local environment do not affect subsidiaries’ green purchasing directly; rather, they exert indirect influences through local tailoring. This study contributes to extant literature by revealing the significance of local tailoring in an MNC context. In addition, our findings offer several implications for practice by providing a roadmap for disseminating green purchasing across the subsidiaries of an MNC, as well as highlighting the importance of both clear communication about the benefits of green purchasing and internal audits.
RISING AUTISM PREVALENCE: REAL OR DISPLACING OTHER MENTAL DISORDERS? EVIDENCE FROM DEMAND FOR AUXILIARY HEALTHCARE WORKERS IN CALIFORNIA
Authors: Dave Dhaval M. , Fernandez Jose M.
Published: August 2014

Autism is a development disorder that has increased in prevalence from 0.5 to 14.7 per 1,000 children over 1970–2010. Using annual wages and provider counts from the American Community Survey and information from 21 regional development centers in California, we estimate the labor demand for auxiliary health providers. We focus on this subset of providers because, unlike physicians and psychologists who can diagnose autism, these workers cannot induce their own demand. If the incidence of autism is increasing independently of other mental disorders, then the demand for auxiliary health providers should increase, leading to higher wages and labor supply. Otherwise, the increase in autism diagnosis is merely displacing other mental disorders. We find that a 100% increase in autism cases increases the wages of auxiliary health workers over non‐autism health occupations by 8–11% and the number of providers by 9–14%. Furthermore, we find that one of every three new autism diagnoses is merely supplanting mental retardation diagnoses, but does not displace other mental disorders. These estimates suggest that at least part of the increase in autism diagnoses, about 50–65%, reflects an increase in the true prevalence of the disorder. (JEL L11, J2, J3)
Highly plastic resource allocation to growth and reproduction in females of an African annual fish
Authors: Vrtílek Milan , Reichard Martin
Published: August 2014

Phenotypic plasticity is an important mechanism to maximise fitness in unpredictable environments by fine‐tuning phenotypes to a specific environmental setting. We used Nothobranchius furzeri, an African annual fish from temporary pools with erratic changes in habitat condition, to study changes in the allocation to growth and reproduction and to test the key trade‐off between egg size and number. In an experimental setting, we quantitatively varied ration at two levels and over two time periods, including temporal switches in ration level. As predicted, female N. furzeri possessed the capacity for compensatory growth, which surprisingly came with no longer‐term cost to fecundity. Females responded strongly to ration manipulation, with a pronounced decrease in fecundity associated with a low ration, even after accounting for body mass. Due to the unpredictability of offspring environment, we expected no adaptive change in oocyte size. However, females responded to the quality of their environment in accordance with an adaptive maternal effect, with females receiving a low ration producing larger eggs. Further, a switch in ration size in either direction was associated with a decrease in egg size. There was a trade‐off between egg size and number in half of the treatments, but high variability in egg size among females made the relationship complex. Overall, N. furzeri females demonstrated high plasticity in both growth rate and fecundity parameters. Females appear able to track and respond adaptively to unpredictable changes in food availability in their environment.
Blood pressure as a risk factor for headache and migraine: a prospective population‐based study
Authors: Fagernæs C. F. , Heuch I. , Zwart J.‐A. , Winsvold B. S. , Linde M. , Hagen K.
Published: August 2014

Background and purpose

During the past decade, several population‐based studies have found an inverse association between blood pressure (BP) and headache. However, most of them have a cross‐sectional design or lack a validated definition of a headache‐free population at baseline. Therefore, additional population‐based studies using a clearly defined headache‐free population and a prospective design are warranted.

Methods

Data from two large epidemiological studies, the Nord‐Trondelag Health Survey 1995–1997 (HUNT 2) and 2006–2008 (HUNT 3), were used to evaluate the association between BP (systolic, diastolic and pulse pressure) at baseline and headache (migraine and tension type headache) at follow‐up.

Results

An inverse relationship was found between all three BP measures at baseline in HUNT 2 and any headache in HUNT 3, more evident for systolic BP [odds ratio (OR) 0.90 per 10 mmHg increase in systolic BP, 95% confidence interval (CI) 0.87–0.93, P < 0.001] and pulse pressure (OR 0.84 per 10 mmHg increase in pulse pressure, 95% CI 0.80–0.89, P < 0.001) than for diastolic BP (OR 0.92 per 10 mmHg increase in diastolic BP, 95% CI 0.87–1.00, P = 0.036). The most robust finding, evident for both sexes, was that increased pulse pressure was linked to decreased prevalence of both migraine and tension type headache.

Conclusion

An inverse relationship between BP and subsequent development of headache was confirmed in this large‐scale population‐based cohort study. Nevertheless, further research is needed to investigate the underlying mechanisms explaining these findings.
Conflicting evidence on the association of white matter hyperintensities with large‐artery disease
Authors: Topakian R.
Published: August 2014

Click here to view the accompanying paper in this issue.
When a Duck Initiates Movement, Do Others Follow? Testing Preference in Groups
Authors: Liste Guiomar , Asher Lucy , Broom Donald M.
Published: August 2014

Choice tests have been widely used to assess animal preferences. In the case of group‐living species, these tests are commonly presented to animals in groups, because isolation can have strong effects on behaviour and motivation. However, assessing preference at the group level could be misleading if strong control of movement, through influential individuals, and group cohesion were present. The needs of majority of the population might not be properly represented by the test results. The current study investigated whether or not groups of ducks (four ducklings per group) have individuals that consistently initiate movement and considered the implications for group cohesion, synchronisation and a measure of preference during a choice test. In all groups included in the analyses, there were ducks that initiated more movements than the rest, and this trend was stronger when leading towards areas providing resources such as pools. Also, more ducks preferentially followed the first initiator (birds initiating most movements within a group) into the bathing area. Group cohesion was higher in groups that frequently had the same individual initiating movement. The number of followers following the ducks that initiated most movements was associated with the measure of preference (time spent at preferred area, as a proportion of total time spent at any area) but the number of movements initiated by these individuals was not. These results highlight the need to consider the effects of initiators and group‐cohesive forces when conducting choice tests in groups of animals.
The Evaluation of Family Functioning by the Family Assessment Device: A Systematic Review of Studies in Adult Clinical Populations
Authors: Staccini Laura , Tomba Elena , Grandi Silvana , Keitner Gabor I.
Published: August 2014

A large body of research, documenting the impact of a family's functioning on health outcomes, highlights the importance of introducing the evaluation of patients' family dynamics into clinical judgment. The Family Assessment Device (FAD) is a self‐report questionnaire designed to assess specific dimensions of family functioning. This qualitative systematic review, which followsPRISMAguidelines, aimed to identify theFAD's clinimetric properties and to report the incremental utility of its inclusion in clinical settings. A thorough literature search was performed, using both computerized and manual searches, yielding a total of 148 studies that were included in this review. TheFADhas been extensively used in a variety of research contexts. In the majority of studies it was able to discriminate between clinical populations and controls and among groups of patients with different illnesses. TheFADalso showed good test–retest and concurrent reliability, and modest sensitivity to change after treatment.FAD‐dysfunctional family functioning was related to several patient clinical outcomes, including lower recovery rates and adherence to treatment, longer recovery time, poorer quality of life, and increased risk of relapse and drop‐out. The present review demonstrates that theFADis a suitable instrument for the evaluation of family functioning both in clinical and research settings.
Recent spring phenology shifts in western Central Europe based on multiscale observations
Authors: Fu Yongshuo H. , Piao Shilong , Op de Beeck Maarten , Cong Nan , Zhao Hongfang , Zhang Yuan , Menzel Annette , Janssens Ivan A.
Published: August 2014

Aim

Although numerous studies have reported advanced Northern Hemisphere spring phenology since the 1980s, recent studies based on remote sensing have reported a reversal or deceleration of this trend. This study aimed (1) to fully understand recent spring phenology shifts using both in situ observations and satellite‐based normalized difference vegetation index (NDVI) datasets, and (2) to test whether the NDVI methods capture the trends observed in situ.

Location

Western Central Europe.

Methods

Temporal spring phenology trends (leaf unfolding dates) were examined using 1,001,678 in situ observations of 31 plant species at 3984 stations, as well as NDVI‐based start‐of‐season dates, obtained using five different methods, across the pixels that included the phenology stations.

Results

In situ and NDVI observations both indicated that spring phenology significantly advanced during the period 1982–2011 at an average rate of −0.45 days yr−1. This trend was not uniform across the period and significantly weakened over the period 2000–2011. Furthermore, opposite trends were found between in situ and NDVI observations over the period 2000–2011. Averaged over all species, the in situ observations indicated a slower but still advancing trend for leaf unfolding, whereas the NDVI series showed a delayed spring phenology.

Main conclusions

The recent trend reversal in the advancement of spring phenology in western Central Europe is likely to be related to the response of early spring species to the cooling trend in late winter. In contrast, late spring species continued to exhibit advanced leaf unfolding, which is consistent with the warming trend during spring months. Because remote sensing does not distinguish between species, the signal of growing‐season onset may only reflect the phenological dynamics of these earliest species in the pixel, even though most species still exhibit advancing trends.
Impact of joint status on contraction steadiness of m. quadriceps femoris in people with severe haemophilia
Authors: Brunner A. , Stäuber F. , Göhler S. , Czepa D. , Wendel M. , Seuser A. , Hilberg T.
Published: August 2014

Impaired contraction steadiness of lower limb muscles affects functional performance and may increase injury risk. We hypothesize that haemophilic arthropathy of the knee and the strength status of quadriceps are relevant factors which compromise a steady contraction. This study addresses the questions if impaired steadiness of the quadriceps is verifiable in people with haemophilia (PWH) and whether a connection between the status of the knee joint and quadriceps strength exists. A total of 157 PWH and 85 controls (C) performed a strength test with a knee extensor device to evaluate their bilateral and unilateral maximal quadriceps strength and steadiness. Isometric steadiness was measured by the coefficient of variation of maximum peak torque (CV‐MVIC in %). For classification of the knee joint status the World Federation of Haemophilia (WFH) score was used. Lower steadiness (higher CV values) was found in PWH compared with C during bilateral [PWH vs. C; 0.63 (0.36/1.13) vs. 0.35 (0.15/0.72), median (Q25/Q75) P < 0.001] and unilateral trials [left leg: 0.70 (0.32/1.64) vs. 0.50 (0.23/1.04), P < 0.05; right leg: 0.68 (0.29/1.51) vs. 0.39 (0.18/0.68), P < 0.001]. PWH with a WFH score difference (≥1) between their extremities showed a less steady contraction in the more affected extremity (P < 0.05). More unsteady contractions have also been found in extremities with lower quadriceps strength compared with the contralateral stronger extremities (P < 0.001), whereby the weaker extremities were associated with a worse joint status (P < 0.001). The results of this study verify an impaired ability to realize a steady contraction of quadriceps in PWH and the influence of joint damage and strength on its manifestation.
Translation and validation of a multidimensional instrument to assess health literacy
Authors: Dwinger Sarah , Kriston Levente , Härter Martin , Dirmaier Jörg
Published: August 2014

Background

The patients' task to find, evaluate and transfer health information to one's individual condition and life requires competences that are summarized by the term ‘health literacy’. Poor health literacy is associated with poorer health outcomes, like a higher rate of rehospitalization, lower receipt of screenings and a higher frequency of doctor visits.

Objective

Three levels of health literacy are distinguished: functional, communicative and critical health literacy. Aim of this study was to translate and adapt the ‘Functional Communicative Critical Health Literacy’ (FCCHL) questionnaire to German, and assess its psychometric properties.

Methods/Design

The FCCHL was sent to 9075 participants enrolled in a RCT on health coaching. 4040 participants responded. Besides descriptive and reliability analysis, confirmatory factor analysis was performed to test the questionnaire's postulated scale structure in a calibration (N = 3000) and a validation sample (N = 1040) for cross‐validation.

Results

The instrument was well accepted (missing values ≤2.1% per item) and showed acceptable or good internal consistency for the entire scale (α = 0.77) and the subscales (α = 0.75–0.80). The proposed three‐factor model did not fit the German data sufficiently. As the scales ‘communicative health literacy’ and ‘critical health literacy’ showed high intercorrelation (0.98), they were combined to a new scale called ‘processing health literacy’. The fit indices for the amended two‐factor model were satisfying in both subgroups.

Conclusions

Reliability and acceptance of the German FCCHL are satisfying. An amended two‐factor structure showed better validity than the original factor structure. Further research regarding the FCCHL and the underlying construct is needed.
Communicating with disabled children when inpatients: barriers and facilitators identified by parents and professionals in a qualitative study
Authors: Sharkey Siobhan , Lloyd Claire , Tomlinson Richard , Thomas Eleanor , Martin Alice , Logan Stuart , Morris Christopher
Published: August 2014

Background

Communication is a fundamental part of health care, but can be more difficult with disabled children. Disabled children are more frequently admitted to hospital than other children.

Aims

To explore experiences of ward staff and families to identify barriers and facilitators to effective communication with disabled children whilst inpatients.

Design

This was an exploratory qualitative study.

Methods

We consulted 25 staff working on paediatric wards and 15 parents of disabled children recently admitted to those wards. We had difficulty in recruiting children and evaluating their experiences. Data were collected through interviews and focus groups. A thematic analysis of the data supported by the Framework Approach was used to explore experiences and views about communication. Emerging themes were subsequently synthesised to identify barriers and facilitators to good communication.

Results

Barriers to communication included time, professionals not prioritising communication in their role and poor information sharing between parents and professionals. Facilitators included professionals building rapport with a child, good relationships between professionals and parents, professionals having a family‐centred approach, and the use of communication aids.

Conclusions

Communication with disabled children on the ward was perceived as less than optimal. Parents are instrumental in the communication between their children and professionals. Although aware of the importance of communication with disabled children, staff perceived time pressures and lack of priority given to communicating directly with the child as major barriers.
The Papal Bull Unigenitus and the Forging of Enlightened Catholicism, 1713–1764
Authors: Burson Jeffrey D.
Published: August 2014

This article discusses the relationship between the papal Bull Unigenitus (1713) and the Catholic Enlightenment. The circumstances under which this controversial bull was received in the 18th century in Europe, and particularly in France, partially occasioned the construction of factions in many dynastic states—factions either pro‐Unigenitus or pro‐Augustinian (including but not limited to Jansenists). These factions, in turn, tailored their particular varieties of Catholic Enlightenment in the process of elaborating their respective positions concerning Unigenitus. This article synthesizes general trends in the present scholarship in order to underscore the importance of Unigenitus to the response of the Catholic Church to the Enlightenment. Because the fractures introduced into Catholic Europe by the bull were most acute during the early 18th century in France and the most formative and contentious factionalism is often presumed to have occurred before the suppression of the bull's most stalwart defenders—the Jesuits—between 1759 and 1773, this article focuses chiefly on the formative years of Catholic Enlightenment factionalism in the middle third of the 18th century before the suppression of the Jesuits.
Cultural Skirmishes in 18th Century England: The Attack on Aristocratic Vice
Authors: Andrew Donna T.
Published: August 2014

This paper seeks to trace the evolution and nature of changing ideas about crime and vice in 18th century England. The new social history of England, which began in the 1960s, inspired perhaps most visibly by the works of E. P. Thompson, had as an early area of interest the history of plebeian criminality: motives, policing, the work of the courts and the nature of punishment. After the first wave of these groundbreaking studies, some historians started considering the crimes and vices of England's upper classes, which, in contrast, were treated quite differently by the courts, whether the offense was killing someone in a duel or killing oneself, both acts which were seen to be murderous, though no aristocrat was so punished. This change in direction created a body of work which complemented the fine earlier studies of plebeian crime and gave rise to studies of four aristocratic vices, i.e. duelling, suicide, adultery and gambling. What made these vices the focus of public attention, however, was the growth of the popular press which highlighted stories of such misdeeds and reported on whatever trials occurred as well as printing letters from their readers on their responses to these stories. This combination of vices unpunished, and a popular media which publicized the fact, enabled the emergence of a critique of aristocratic mores on moral and cultural grounds, and may have led to many of the “middling sort” to think that they were better people than their betters.
Health information, what happens when there isn't any? Information literacy and the challenges for rare and orphan diseases
Authors: Spring Hannah
Published: August 2014

This feature looks at the challenges for information literacy in rare and orphan diseases. In particular, it focuses on the information difficulties faced by those living with a rare condition or awaiting a diagnosis, and also those of the health professionals in charge of their care. The feature also highlights some of the key issues that library and information professionals need to be aware of when providing information support in such circumstances.

H.S.
International trends in health science librarianship part 11: Japan and Korea
Authors: Sakai Yukiko , Sato Kuniko , Suwabe Naoko , Gemba Hiroko , Nozoe Atsutake , Seo Jeong‐Wook , Kim Hye Yang
Published: August 2014

This is the 11th in a series of articles exploring international trends in health science librarianship. The previous article in this series looked at the Far East (Greater China, Hong Kong and Taiwan). The current issue surveys developments in Japan and Korea. The next issue will explore trends in South Asia (India, Pakistan, Bangladesh and Sri Lanka). Next year all four issues will be devoted to trends in four regions in Africa (Southern Africa, East Africa, West Africa and North Africa.

JM
Investigation of a novel mechanically mixed mineral trioxide aggregate (MM‐MTA™)
Authors: Khalil I. , Naaman A. , Camilleri J.
Published: August 2014

Aim

To characterize a novel mechanically mixed mineral trioxide aggregate product (MM‐MTA, MicroMega, Besançon, France) and to investigate the physical and chemical properties in comparison with ProRoot MTA (Dentsply, Tulsa Dental, Johnson City, TN, USA) and MTA Angelus (Angelus, Londrina, Brazil).

Methodology

The three materials were mixed according to manufacturer's instructions. Specimens 10 mm in diameter and 2 mm high were prepared and characterized by scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and X‐ray diffraction (XRD) analysis after 1‐day and 28‐day storage in physiological solution. Calcium ion leaching in solution and pH of the elution were also assessed. Furthermore, the setting time, radiopacity and material porosity were investigated. Statistical analysis was performed by anova and Tukey's post hoc tests.

Results

All the MTAs tested were composed primarily of tricalcium silicate and bismuth oxide. In addition, MM‐MTA exhibited additional peaks for chlorine evident in the EDS analysis; calcium carbonate was present in the set material detected by XRD. Calcium hydroxide was present in the set ProRoot MTA and MTA Angelus. Calcium ion leaching and alkalization of the storage solution were demonstrated in all the materials. Both MM‐MTA and MTA Angelus had a shorter setting time when compared to ProRoot MTA (P < 0.001). ProRoot MTA exhibited larger pores and more porosity than MTA Angelus and MM‐MTA. All the materials exhibited radiopacity greater than the 3 mm aluminium thickness specified in ISO 6876 (2012).

Conclusions

MM‐MTA, ProRoot MTA and MTA Angelus are composed of Portland cement and bismuth oxide. In addition, MM‐MTA contains calcium carbonate and a chloride accelerator. These additives affect the material hydration and the properties of the set material. The properties of MM‐MTA are a result of a combination of factors, namely the particular cement mineralogy, radiopacifier loading, effective water–cement ratio and mechanical mixing.
Shaping ability of ProTaper NEXT and BT‐RaCe nickel–titanium instruments in severely curved root canals
Authors: Bürklein S. , Mathey D. , Schäfer E.
Published: August 2014

Aim

To compare the shaping ability of four different nickel–titanium rotary instruments during the preparation of curved root canals in extracted teeth.

Methodology

A total of 80 root canals with curvatures ranging between 25° and 39° were divided into four groups of 20 canals. Based on radiographs taken prior to instrumentation, the groups were balanced with respect to the angle and the radius of canal curvature. Canals were prepared to a final apical size of 40 using Mtwo, ProTaper Universal, ProTaper NEXT and BT‐RaCe. Using pre‐ and post‐instrumentation radiographs, straightening of the canal curvatures and canal transportation were determined with a computer image analysis programme. Preparation time and instrument failures were also recorded. The data were analysed statistically using anova and Student–Newman–Keuls test.

Results

The use of BT‐RaCe files resulted in significantly more straightening during instrumentation compared to Mtwo (P < 0.05), whilst the differences between all other instruments were not significant (P > 0.05). No significant differences were obtained between all four instruments regarding canal transportation (P = 0.429). Instrumentation with ProTaper NEXT files was significantly faster than with all other instruments (P < 0.05). During the preparation of the curved canals, one BT2 instrument fractured, whilst no fracture occurred when using the other instruments (P > 0.05).

Conclusions

Within the parameters of this study, all instruments maintained root canal curvature well and were safe. However, care should be taken when using the BT2 instrument due to its unique cylindrical design.
Institutionalization of Migration Policy Frameworks in Armenia, Azerbaijan and Georgia
Authors: Makaryan Shushanik , Chobanyan Haykanush
Published: August 2014

This article is a comparative study of the institutionalization of the migration policy frameworks of post‐Soviet states Armenia, Azerbaijan and Georgia since the collapse of the Soviet Union in 1991. All three countries share common historical legacies: a Soviet past, wars and conflicts, unemployment, high emigration, and commitment to integration into European bodies. To what extent do the migration policies of these three countries (driven by contextual forces, i.e. domestic challenges) address country‐specific migration dynamics? Or are they imposed by the European Union? In which dimensions have the national policies on migration of Armenia, Azerbaijan and Georgia evolved, and around which issues have they converged or diverged? Have these trends led to an integration of migration policymaking at the regional level in the South Caucasus?
Statistical Approaches for Non‐parametric Frontier Models: A Guided Tour
Authors: Simar Léopold , Wilson Paul W.
Published: August 2014

A rich theory of production and analysis of productive efficiency has developed since the pioneering work by Tjalling C. Koopmans and Gerard Debreu. Michael J. Farrell published the first empirical study, and it appeared in a statistical journal (Journal of the Royal Statistical Society), even though the article provided no statistical theory. The literature in econometrics, management sciences, operations research and mathematical statistics has since been enriched by hundreds of papers trying to develop or implement new tools for analysing productivity and efficiency of firms. Both parametric and non‐parametric approaches have been proposed. The mathematical challenge is to derive estimators of production, cost, revenue or profit frontiers, which represent, in the case of production frontiers, the optimal loci of combinations of inputs (like labour, energy and capital) and outputs (the products or services produced by the firms). Optimality is defined in terms of various economic considerations. Then the efficiency of a particular unit is measured by its distance to the estimated frontier. The statistical problem can be viewed as the problem of estimating the support of a multivariate random variable, subject to some shape constraints, in multiple dimensions. These techniques are applied in thousands of papers in the economic and business literature. This ‘guided tour’ reviews the development of various non‐parametric approaches since the early work of Farrell. Remaining challenges and open issues in this challenging arena are also described. © 2014 The Authors. International Statistical Review © 2014 International Statistical Institute
An Analysis of Industry Regimes Synchronization in the Eurozone
Authors: Dias José G. , Ramos Sofia B.
Published: August 2014

Geographical versus industrial diversification has been the subject of much debate in equity investment strategies. This article revisits this issue and analyzes the contention that if national factors have lost importance since the launch of the euro, then the regime dynamics of industry indexes in the eurozone countries should be more similar. Results show a core group of country‐industry indexes sharing the same regime dynamics, which comprise the majority of industry indexes of France and Germany. After the euro launch, a group of industry indexes gained more similarities with the core group of the eurozone – notably industries from Italy, Spain and Finland. Nevertheless, dynamics in a small group of industries did not change. Overall, synchronization between country‐industry indexes has increased except for a small group of industries.
Comparison of the prevalence of metabolic syndrome and its association with diabetes and cardiovascular disease in the rural population of Bangladesh using the modified National Cholesterol Education Program Expert Panel Adult Treatment Panel III and International Diabetes Federation definitions
Authors: Bhowmik Bishwajit , Afsana Faria , Siddiquee Tasnima , Munir Sanjida B , Sheikh Fareeha , Wright Erica , Bhuiyan Farjana R , Ashrafuzzaman Sheikh Mohammad , Mahtab Hajera , Azad Khan Abul Kalam , Hussain Akhtar
Published: August 2014

Aims/Introduction

To compare the prevalence of metabolic syndrome (MS) using the modified National Cholesterol Education Program Adult Treatment Plan III (NCEP) and the International Diabetes Federation (IDF) definitions and, using both definitions, determine and compare the association of MS, prediabetes, type 2 diabetes, hypertension (HTN) and cardiovascular disease risk (CVD).

Materials and Methods

A total of 2,293 randomly selected participants (aged ≥20 years) in a rural community in Bangladesh were investigated in a population‐based cross‐sectional study. Sociodemographic and anthropometric characteristics, blood pressure, blood glucose, and lipid profiles were studied. Age‐adjusted data for MS and cardiometabolic risk factors were assessed, and their relationships were examined.

Results

The age‐adjusted prevalence of MS was 30.7% (males 30.5%; females 30.5%) using the NCEP definition, and 24.5% (males 19.2%, females 27.5%) using the IDF definition. The prevalence of MS using the NCEP definition was also higher in study participants with prediabetes, type 2 diabetes, HTN and CVD risk. The agreement rate between both definitions was 92% (k = 0.80). The NCEP definition had a stronger association with type 2 diabetes and HTN (odds ratio 12.4 vs 5.2; odds ratio 7.0 vs 4.7, respectively) than the IDF definition. However, the odds ratios for prediabetes and CVD risk were not significantly different.

Conclusions

The prevalence of MS was higher using the NCEP definition, and was more strongly associated with prediabetes, type 2 diabetes, HTN and CVD in this Bangladeshi population.