bluuebunny/crossref_metadata_2025 huggingface dataset:
The Assessment of Athletic Training Students' Knowledge and Behavior to Provide Culturally Competent Care
Authors: Nynas Suzette Marie
Published: June 2015

Context

Culturally competent knowledge and skills are critical for all healthcare professionals to possess in order to provide the most appropriate health care for their patients and clients.

Objective

To investigate athletic training students' knowledge of culture and cultural differences, to assess the practice of culturally competent care, and to determine efficacy of cultural competency instruction.

Design

A mixed methods research design with a case study approach was utilized for this study.

Setting

This study was conducted in an athletic training course over a 2-week time period.

Patients or Other Participants

Ten athletic training students enrolled in a professional athletic training program at the master's level participated in this project. Sampling of participants was purposeful and based on convenience.

Data Collection and Analysis

The Cultural Competence Assessment (CCA) instrument was administered and analyzed to determine athletic training students' cultural awareness, sensitivity, and behavior. An assessment questionnaire and focus group were used to determine the athletic training students' experiences in diversity and cultural competency education, to evaluate the efficacy of classroom activities, and to solicit athletic training students' feedback for recommendation regarding the delivery of cultural competency knowledge and skills in the athletic training curriculum.

Results

The study revealed that athletic training students demonstrated good cultural awareness and sensitivity. However, it was also discovered that athletic training students were less likely to practice culturally competent care.

Conclusion(s)

Both didactic and clinical experiences increased athletic training students' cultural competency; however, athletic training students wanted to spend more time on cultural competency within the curriculum. Athletic training students also believed it was important to use various tools to teach about cultural competency.
Standardized Patient Encounters Improved Athletic Training Students' Confidence in Clinical Evaluations
Authors: Armstrong Kirk J. , Jarriel Amanda J.
Published: June 2015

Context

Researchers have reported that interacting with standardized patients (SPs) is a worthwhile and realistic experience for athletic training (AT) students. These encounters enhance students' interviewing skills, confidence as a clinician, clinical skill development, and interpersonal communication.

Objective

To determine how SP encounters impacted students' confidence in performing clinical evaluations.

Design

Pretest-posttest survey design.

Setting

Athletic training simulation lab.

Patients or Other Participants

Thirty-five students from the junior (n = 20) and senior (n = 15) AT cohorts from a public liberal arts institution in the Southeast.

Intervention(s)

Athletic training students completed 2 SP encounters per semester throughout an academic year in the AT program, totaling 4 SP encounters.

Main Outcome Measure(s)

Each student completed a 17-item Likert scale (1 = strongly disagree, 5 = strongly agree) that rated confidence levels immediately before and after each SP encounter. The confidence rating assessed students' confidence regarding how the SP encounter affected their confidence in completing patient evaluations (eg, identifying history questions, interpreting results of special tests). We computed descriptive statistics for all items Wilcoxon signed rank tests determined differences in pre-encounter and should be postencounter confidence ratings.

Results

Overall, students from both cohorts reported that the SP encounter improved confidence in completing clinical evaluations. Specifically, students reported a significant increase from pre-encounter to postencounter confidence ratings after nutrition-based (Z = −2.991, P = .004), knee (Z = −3.261, P = 0.001), concussion (Z = −3.294, P = .001), psychosocial intervention (Z = −3.062, P = .002), and general medical (Z = −3.524, P > .001) SP encounters.

Conclusions

The authenticity and fidelity of the SP encounter provided the AT students a real-time clinical evaluation in a nonthreatening environment. Students reported that their confidence improved after each encounter. By providing these experiences, AT students can become comfortable interacting with patients in clinical evaluations.
Athletic Trainers' Knowledge Regarding Airway Adjuncts
Authors: Edler Jessica R. , Eberman Lindsey E. , Kahanov Leamor , Roman Christopher , Mata Heather Lynne
Published: June 2015

Context

Research suggests that knowledge gaps regarding the appropriate use of airway adjuncts exist among various health care practitioners, and that knowledge is especially limited within athletic training.

Objective

To determine the relationship between perceived knowledge (PK) and actual knowledge (AK) of airway adjunct use and the difference in PK after AK assessment.

Design

Knowledge assessment.

Patients or Other Participants

Two thousand athletic trainers received the survey via e-mail; 152 (7.6%) responded.

Intervention(s)

The AK assessment included 7 items based on the use and implementation of airway adjuncts based on the National Athletic Trainers' Association educational competencies. Perceived knowledge was measured using a well-established PK questionnaire, which also included 1 item to rate likelihood to pursue continuing education (CE).

Main Outcome Measure(s)

Perceived knowledge was compared pre- and posttest. Our demographic variables assessed how often lifesaving skills were used. We used total scores of the AK assessment to measure AK. We employed dependent t tests to determine the pre- and posttest differences in PK and likelihood to pursue CE. We used a correlation analysis to determine the relationship between PK and AK. We calculated separate analyses of variance to determine differences in AK between the frequencies of lifesaving skill use.

Results

We identified no significant change (t150 = −0.91, P = .37, 95% confidence interval = −0.17 to 0.06) in likelihood to pursue CE. Greater PK was weakly associated with greater AK (r = 0.36, P < .001). We found a significant difference (F1,145 = 4.63, P = .03, effect size = 0.031, 1 − β = 0.57) between the frequency of use of lifesaving skills and AK.

Conclusion

We identified a knowledge gap among athletic trainers in the use of airway adjuncts. Although the likelihood to pursue CE score was high, the score did not significantly increase after completing the assessment. Participants who use lifesaving skills more frequently scored higher on the AK assessment, suggesting that the more frequently athletic trainers utilize a skill, the more knowledgeable they are.
Magnetic Resonance Imaging of Non-ischemic Cardiomyopathies: A Pictorial Essay
Authors: Olivas-Chacon Cristina I , Mullins Carola , Stewart Kevan , Akle Nassim , Calleros Jesus E , Ramos-Duran Luis R
Published: June 2015

Non-ischemic cardiomyopathies are defined as either primary or secondary diseases of the myocardium resulting in cardiac dysfunction. While primary cardiomyopathies are confined to the heart and can be genetic or acquired, secondary cardiomyopathies show involvement of the heart as a manifestation of an underlying systemic disease including metabolic, inflammatory, granulomatous, infectious, or autoimmune entities. Non-ischemic cardiomyopathies are currently classified as hypertrophic, dilated, restrictive, or unclassifiable, including left ventricular non-compaction. Cardiovascular Magnetic Resonance Imaging (CMRI) not only has the capability to assess cardiac morphology and function, but also the ability to detect edema, hemorrhage, fibrosis, and intramyocardial deposits, providing a valuable imaging tool in the characterization of non-ischemic cardiomyopathies. This pictorial essay shows some of the most important non-ischemic cardiomyopathies with an emphasis on magnetic resonance imaging features.
The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries
Authors: O’Brien William T , Shen Peter , Lee Paul
Published: June 2015

Accurate interpretation of cervical spine imagining can be challenging, especially in children and the elderly. The biomechanics of the developing pediatric spine and age-related degenerative changes predispose these patient populations to injuries centered at the craniocervical junction. In addition, congenital anomalies are common in this region, especially those associated with the axis/dens, due to its complexity in terms of development compared to other vertebral levels. The most common congenital variations of the dens include the os odontoideum and a persistent ossiculum terminale. At times, it is necessary to distinguish normal development, developmental variants, and developmental anomalies from traumatic injuries in the setting of acute traumatic injury. Key imaging features are useful to differentiate between traumatic fractures and normal or variant anatomy acutely; however, the radiologist must first have a basic understanding of the spectrum of normal developmental anatomy and its anatomic variations in order to make an accurate assessment. This review article attempts to provide the basic framework required for accurate interpretation of cervical spine imaging with a focus on the dens, specifically covering the normal development and ossification of the dens, common congenital variants and their various imaging appearances, fracture classifications, imaging appearances, and treatment options.
Shared Sanitation Versus Individual Household Latrines in Urban Slums: A Cross-Sectional Study in Orissa, India
Authors: Heijnen Marieke , Routray Parimita , Torondel Belen , Clasen Thomas
Published: June 2015

A large and growing proportion of the global population rely on shared sanitation facilities despite evidence of a potential increased risk of adverse health outcomes compared with individual household latrines (IHLs). We sought to explore differences between households relying on shared sanitation versus IHLs in terms of demographics, sanitation facilities, and fecal exposure. We surveyed 570 households from 30 slums in Orissa, India, to obtain data on demographics, water, sanitation, and hygiene. Latrine spot-checks were conducted to collect data on indicators of use, privacy, and cleanliness. We collected samples of drinking water and hand rinses to assess fecal contamination. Households relying on shared sanitation were poorer and less educated than those accessing IHLs. Individuals in sharing households were more likely to practice open defecation. Shared facilities were less likely to be functional, less clean, and more likely to have feces and flies. No differences in fecal contamination of drinking water or hand-rinse samples were found. Important differences exist among households accessing shared facilities versus IHLs that may partly explain the apparent adverse health outcomes associated with shared sanitation. As these factors may capture differences in risk and promote sanitary improvements, they should be considered in future policy.
First Report of a Foodborne Providencia alcalifaciens Outbreak in Kenya
Authors: Shah Mohammad Monir , Odoyo Erick , Larson Peter S. , Apondi Ernest , Kathiiko Cyrus , Miringu Gabriel , Nakashima Masahiro , Ichinose Yoshio
Published: June 2015

Providencia alcalifaciens is an emerging bacterial pathogen known to cause acute gastroenteritis in children and travelers. In July 2013, P. alcalifaciens was isolated from four children appearing for diarrhea at Kiambu District Hospital (KDH) in Kenya. This study describes the outbreak investigation, which aimed to identify the source and mechanisms of infection. We identified seven primary and four secondary cases. Among primary cases were four mothers who had children and experienced mild diarrhea after eating mashed potatoes. The mothers reported feeding children after visiting the toilet and washing their hands without soap. P. alcalifaciens was detected from all secondary cases, and the isolates were found to be clonal by random amplified polymorphic DNA (RAPD) fingerprinting. Our study suggests that the outbreak was caused by P. alcalifaciens, although no fluid accumulation was observed in rabbit ileal loops. The vehicle of the outbreak was believed to be the mashed potato dish, but the source of P. alcalifaciens could not be confirmed. We found that lack of hygiene, inadequate food storage, and improper hand washing before food preparation was the likely cause of the current outbreak. This is the first report of a foodborne infection caused by P. alcalifaciens in Kenya.
Baylisascaris procyonis and Herpes Simplex Virus 2 Coinfection Presenting as Ocular Larva Migrans with Granuloma Formation in a Child
Authors: Liu Grace , Fennelly Glenn , Kazacos Kevin R. , Grose Charles , Dobroszycki Joanna , Saffra Norman , Coyle Christina M. , Weiss Louis M. , Szlechter Moshe M. , Tanowitz Herbert B.
Published: June 2015

Ocular Baylisascaris procyonis infection results from ingestion of infective eggs of B. procyonis, the raccoon ascarid. Herpes simplex virus type 2 (HSV-2) infection of the retina is the result of either primary infection or reactivated disease. Herein, we report a case of a 12-year-old female resident of the Bronx in New York City, who presented with pan-uveitis and vision loss. Initial evaluation for etiologic causes was nondiagnostic. Serology for anti-Baylisascaris procyonis antibodies in serum and vitreous fluid were both positive. Polymerase chain reaction (PCR) of vitreous fluid was positive for HSV-2. Treatment with vitrectomy, albendazole, and acyclovir resulted in mild improvement of visual acuity. The atypical presentation of B. procyonis in this case, as ocular larva migrans with a peripheral granuloma and retinal detachment, underscores the importance of maintaining a high degree of suspicion for this pathogen even in non-diffuse unilateral subacute neuroretinitis (DUSN) patients in urban areas. This case further illustrates that it is possible to have coexisting infections in cases of posterior uveitis.
Constitution Hill: Memory, ideology and utopia
Authors: Ashcroft Bill
Published: June 2015

The opening of the Constitutional Court on the 21st March 2004 in Johannesburg was an eventful national day, because, built on the site of the notorious Number 4 prison, the Court symbolized the intention to build a just future out of the memory of oppression. The incorporation of existing prison buildings and materials in the new court building reinforced the discourse of rebuilding and reconciliation that was to characterise the new nation state. As a text the building yields a broader and paradoxical meaning, for the utopian vision of a just future rests in a building in the service of state ideology. This is a paradox because ideology and utopia are regarded as opposites—ideology legitimates the present while utopia critiques it with a vision of a transformed future. However the building demonstrates a feature of ideology that Marxist philosopher Ernst Bloch first revealed: that all ideology has a utopian element because without it, no “spiritual surplus, no idea of a better world would be possible.” This essay reads the building to show both the function of memory in visions of the future, and the function of utopia in ideology, while using Bloch’s theory to interpret the utopian function of the building.
‘A proper woman, in the African tradition’: The construction of gender and nationalism in Wangari Maathai’s autobiography Unbowed
Authors: Ebila Florence
Published: June 2015

This article discusses how Wangari Maathai’s life experiences narrated in her autobiography Unbowed offers an opportunity for discussing the contradictions surrounding the perception, place and identity of women in African politics. Against the backdrop of gendered nationalism which glorifies the role and place of women in the construction of nations, the article presents a different reality of how some male leaders of postcolonial nation states like the Kenyan example, silences the voices of women politicians by urging them to behave like ‘proper women’. Maathai’s autobiography demonstrates that the social construction of womanhood in African politics is influenced by socio-cultural and patriarchal ideologies that construct the ideal African woman as the docile one, the one who does not question male authority. Maathai’s autobiography becomes a lens that can be used to view and question the social construction of womanhood versus manhood and the influence on gender power relations on women’s participation in the politics of the postcolonial nation states in Africa.
Redefining otherness: Writing fictional (auto)biography and centring female subjectivity in Akachi Adimora-Ezeigbo's Children of the Eagle
Authors: Hunsu Folasade
Published: June 2015

This study seeks to examine how the Nigerian female writer Akachi Adimora-Ezeigbo redefines otherness in Children of the Eagle by exploring the narrative elements of the sub-genre of fictional autobiography in centring female subjects. By foregrounding one of Regenia Gagnier’s descriptions of a subject—one that is “a subject to itself, an ‘I’, however difficult or even impossible it may be for others to understand this ‘I’ from its own viewpoint, within its own experience”—this paper argues that female subjectivity is a strategy that locates female characters as subjects, narrators, insiders and participants who share their experiences in the novel. It shows that the centrality of the female narrative voice(s) in determining the course and thematic focus of the novel enables female characters to demonstrate their otherness as a quality and position that makes them resilient, strong, and uncompromising promoters of women’s cause against debilitating patriarchal beliefs and systems. Being the speaking subjects also helps them to unpack the underlying trajectories in their development and depiction in the novel. This study concludes that Adimora-Ezeigbo’s adoption of this technique in Children of the Eagle strengthens the view that placing women as narrator-subjects enables the redefinition of otherness as a favourable concept capable of showing women as critical members of their societies and also a tool for African women writers’ to transform the literary scene.
André P. Brink se posisie in die Afrikaanse literêre sisteem van die 1960’s
Authors: Senekal Burgert A
Published: June 2015

This article investigates Andre P. Brink’s role and position in the Afrikaans literary system of the 1960s. It is found that Brink was a very active role player in drama and prose, both as a writer and as a critic, and his activity is compared with every other role player in these subsystems. The paper examines which texts were studied by the largest number of persons in the whole literary system as well as in the subsystems of the drama and prose, and it is indicated that Brink’s texts played an important role in this respect by garnering the attention of a large number of critics and literary historians. Finally, Brink’s texts are positioned in the entire Afrikaans literary system of the decade, and it is found that his works occupy a central position.
Karen Blixen in the African book and literary tourism market
Authors: Marais Johann Lodewyk
Published: June 2015

In 1937, the Danish-born writer Karen Blixen published Out of Africa, an autobiographical account, in English, of the seventeen years she spent in Africa (from 1914 until 1931). During those years, she forged a permanent bond with Kenya, where she managed a coffee plantation. This bond was immortalised in the book, leading to cult status for both the publication and its author. Out of Africa contains a blend of the essay, the sketch and the historical document. A contemporary reading of the book also reveals some offensive and racist passages; footprints, as it were, of the settler society of its day. However, the lyrical, introspective quality of this book has resulted in its becoming one of the great publishing phenomena of the twentieth century, reaching many readers through various reprints, translations and a film version. This article presents the publishing history of Out of Africa and gives an overview of its many translations across the globe. It also indicates the extent to which, and the reasons why, the book did (or did not) achieve success in Africa. A comparison is also made between Out of Africa and a number of texts by other female writers who wrote about their experiences particularly in African landscapes and/or places.
Germinación de semillas de especies de plantas de zonas semiáridas bajo tratamientos de hidratación–deshidratación
Authors: Contreras Quiroz Mariana del Rocío , Pando Moreno Marisela , Jurado Enrique
Published: June 2015

Diversos autores han estudiado la inf luencia de los tratamientos de hidratación-deshidratación (HD) sobre la germinación de algunas especies vegetales. Ciertas semillas conservan una “memoria de hidratación” al retener, durante la deshidratación, los cambios fisiológicos producidos durante la hidratación. La hipótesis es que las semillas de especies del desierto tendrán mayor porcentaje de germinación y menor tiempo medio de germinación después de ser sometidas a tratamientos de hidratación y deshidratación. El objetivo de este estudio fue evaluar cinco especies de plantas: (Frankenia gypsophila (I.M. Johnst.), Muhlenbergia arenicola (Buckl.), Muhlenbergia villif lora (Hitch.), Senna demissa (Rose) y Aristida adscencionis L.), las cuales fueron sometidas a los siguientes tratamientos de HD: T1= 8h·día-1, T2= 8h·día-1 + 8h·día-1 + 8h·día-1, T3= 24h·día-1 y T4= testigo. Los tratamientos de HD aplicados a las cinco especies no promovieron el aumento en el porcentaje de germinación. Los ciclos de hidratación-deshidratación incrementaron la velocidad de germinación y disminuyeron el tiempo medio de germinación (t50) de semillas de F. gypsophila, S. demissa y M. arenicola lo que podría interpretarse como una de las adaptaciones de estas semillas a los intervalos de lluvias y sequías que se presentan en las zonas áridas y semiáridas.
Sistema de producción de forrajes de temporal y pastoreo de cabras. opción para la reconversión productiva
Authors: Echavarría-Cháirez Francisco G. , Serna-Pérez Alfonso , Flores-Nájera Manuel de J. , Medina-García Guillermo , Gutiérrez-Luna Ramón , Salinas-González Homero
Published: June 2015

Amplias áreas de temporal del semi-árido de México con suelos degradados requieren de alternativas de reconversión productiva. Asimismo, los sistemas de producción de caprinos requieren integrarse a áreas agrícolas para la conservación del agostadero en épocas de estiaje. El objetivo fue evaluar la reconversión de suelos degradados por el uso de una combinación de cultivos anuales como maíz y cereales, con matorrales y nopales establecidos en franjas. Los cultivos en franjas al contorno redujeron la erosión hídrica y el escurrimiento (P<0.05) en 50 y 70 % respectivamente, comparados con un suelo bajo laboreo continuo. El almacenamiento de humedad en el suelo fue de 23 a 35 % (con base en el volumen) más alto que con manejo convencional de suelo. Además, se estimó el número de cabras que pueden ser alimentadas con el forraje producido en una superficie de 10 ha en la época de estiaje (diciembre-mayo). Los valores van desde 17.4 cabras·ha-1 en un año, con precipitación mayor a la media, hasta 3 cabras·ha-1 en años secos, con un promedio de 9.6 cabras·ha-1 en cinco años de estudio.
Impacto de la sensibilidad al estrés hídrico en el rendimiento de los cultivos en zonas de temporal deficiente en México
Authors: Sánchez-Cohen Ignacio , Bueno-Hurtado Palmira , Esquivel-Arriaga Gerardo , Velásquez-Valle Miguel A.
Published: June 2015

La escasa y errática precipitación pluvial en zonas de temporal en México, cataloga a los sistemas productivos de estas zonas como de alto riesgo. Esto conlleva a la necesidad de una mejor planificación agrícola con el objetivo de incrementar la productividad del agua de lluvia. En el presente trabajo se propone un método de cuantificación de sensibilidad al estrés hídrico y su vinculación con el rendimiento de los cultivos. El método utiliza funciones de índice de estrés hídrico (IEH) en los cultivos que se fundamenta en el balance de agua (Pp – Et0) de donde posteriormente se deduce la sensibilidad (λ) y el impacto en el rendimiento relativo (de los cultivos. Se encontró que, para los cultivos analizados, el maíz es el que presenta menos sensibilidad al estrés hídrico en todas sus etapas, contrario al frijol que presenta marcada sensibilidad al déficit. En todos los cultivos evaluados la etapa vegetativa del desarrollo mostró la mayor sensibilidad o impacto al déficit hídrico. También se constató el efecto acumulativo del estrés hídrico en las distintas etapas del crecimiento de los cultivos. Se considera que el método es útil en los procesos de planeación de mecanismos de mitigación de impacto.
Balancing aggregation and smoothing errors in inverse models
Authors: Turner A. J. , Jacob D. J.
Published: June 2015

Abstract. Inverse models use observations of a system (observation vector) to quantify the variables driving that system (state vector) by statistical optimization. When the observation vector is large, such as with satellite data, selecting a suitable dimension for the state vector is a challenge. A state vector that is too large cannot be effectively constrained by the observations, leading to smoothing error. However, reducing the dimension of the state vector leads to aggregation error as prior relationships between state vector elements are imposed rather than optimized. Here we present a method for quantifying aggregation and smoothing errors as a function of state vector dimension, so that a suitable dimension can be selected by minimizing the combined error. Reducing the state vector within the aggregation error constraints can have the added advantage of enabling analytical solution to the inverse problem with full error characterization. We compare three methods for reducing the dimension of the state vector from its native resolution: (1) merging adjacent elements (grid coarsening), (2) clustering with principal component analysis (PCA), and (3) applying a Gaussian mixture model (GMM) with Gaussian pdfs as state vector elements on which the native-resolution state vector elements are projected using radial basis functions (RBFs). The GMM method leads to somewhat lower aggregation error than the other methods, but more importantly it retains resolution of major local features in the state vector while smoothing weak and broad features.
In situ characterization of mixed phase clouds using the Small Ice Detector and the Particle Phase Discriminator
Authors: Vochezer P. , Järvinen E. , Wagner R. , Kupiszewski P. , Leisner T. , Schnaiter M.
Published: June 2015

Abstract. Mixed phase clouds (MPCs) represent a great source of uncertainty for both climate predictions and weather forecasts. In particular, there is still a lack of understanding on how ice forms in these clouds. In this work we present a technique to analyze in situ measurements of MPCs performed with the latest instruments from the Small Ice Detector family. These instruments record high resolution scattering patterns of individual small cloud particles. For the analysis of the scattering patterns we developed an algorithm that can discriminate the phase of the cloud particles. In the case of a droplet, a Mie solution is fitted to the recorded pattern and the size of the corresponding particle is obtained, which allows for a size calibration of the instrument. In the case of an ice particle, its shape and roughness are deduced from the scattering pattern. We apply our data analysis method to measurements from three distinct MPC types. The results from laboratory measurements demonstrate that our technique can discriminate between droplets and ice particles in the same optical size range. This ability was verified by measurements at a mountain top station where we found an alternation of liquid and ice dominated cloud regions. The analysis of results from aircraft based measurements illustrates the ice detection threshold of the technique.
An overview of the use of Twitter in National Weather Services
Authors: Gaztelumendi S. , Martija M. , Principe O. , Palacio V.
Published: June 2015

Abstract. Twitter is a service that enables users to post messages ("tweets") of up to 140 characters supporting a variety of communicative practices. In this paper we analyze different aspects related to the use of Twitter in different National Meteorological Services (NMS) worldwide. Firstly, we will review the general position of NMS worldwide regarding the use of Twitter technology. Secondly, we will focus on different practices of some selected meteorological services. Thirdly, we will deal specifically with the Basque Meteorology Agency (Euskalmet) case. Finally some conclusions are presented.
Decadal variability and trends of the Benguela upwelling system as simulated in a high-resolution ocean simulation
Authors: Tim N. , Zorita E. , Hünicke B.
Published: June 2015

Abstract. Detecting the atmospheric drivers of the Benguela upwelling systems is essential to understand its present variability and its past and future changes. We present a statistical analysis of a high-resolution (0.1°) ocean-only simulation driven by observed atmospheric fields over the last 60 years with the aim of identifying the large-scale atmospheric drivers of upwelling variability and trends. The simulation is found to reproduce well the seasonal cycle of upwelling intensity, with a maximum in the June–August season in North Benguela and in the December–February season in South Benguela. The statistical analysis of the interannual variability of upwelling focuses on its relationship to atmospheric variables (sea level pressure, 10 m wind, wind stress). The relationship between upwelling and the atmospheric variables differ somewhat in the two regions, but generally the correlation patterns reflect the common atmospheric pattern favouring upwelling: southerly wind/wind stress, strong subtropical anticyclone, and an ocean–land sea level pressure gradient. In addition, the statistical link between upwelling and large-scale climate variability modes was analysed. The El Niño–Southern Oscillation and the Antarctic Oscillation exert some influence on austral summer upwelling velocities in South Benguela. The decadal evolution and the long-term trends of simulated upwelling and of ocean-minus-land air pressure gradient do not agree with Bakun's hypothesis that anthropogenic climate change should generally intensify coastal upwelling.
Is Cardiac Rehabilitation Exercise Feasible for People with Mild Cognitive Impairment?
Authors: Intzandt Brittany , Black Sandra E. , Lanctôt Krista L. , Herrmann Nathan , Oh Paul , Middleton Laura E.
Published: June 2015

BackgroundExercise is a promising strategy to prevent dementia, but no clinically supervised exercise program is widely available to people with mild cognitive impairment (MCI). The objective was to survey health professionals to assess the feasibility of using cardiac rehabilitation exercise programs for MCI populations.MethodsWe distributed surveys to: 1) health professionals working in cardiac rehabilitation exercise programs (36/72 responded); and 2) physicians who treat MCI (22/32 responded). Questions addressed clinician and clinic characteristics and feasibility of referring and accommodating people with MCI.ResultsMost cardiac rehabilitation exercise programs currently treat people with MCI (61.1%). Nearly all were willing and able to accept people with MCI and comorbid vascular risk (91.7%), though only a minority could accept MCI without vascular risk (16.7%). Although most physicians recommend exercise to people with MCI (63.6%), few referred patients with MCI to programs or people to guide exercise (27.3%). However, all physicians (100%) would refer patients with MCI to a cardiac rehabilitation exercise program.ConclusionsOur study supports cardiac rehabilitation exercise programs as a feasible model of exercise for patients with MCI with vascular risk. Patients with and without vascular risk could likely be accommodated if program mandates were expanded.
Routine Clinical Mutation Profiling of Non–Small Cell Lung Cancer Using Next-Generation Sequencing
Authors: Deeb Kristin K. , Hohman Colleen M. , Risch Nicholas F. , Metzger Daniel J. , Starostik Petr
Published: June 2015

Context

The availability of massive, parallel-sequencing technologies makes possible efficient, simultaneous detection of driver and druggable mutations in cancer.

Objective

To develop an amplicon-based, next-generation sequencing, mutation-detection assay for lung cancer using the 454 GS Junior (Roche Applied Science, Indianapolis, Indiana) platform.

Design

Fusion primers incorporating target sequence, 454 adaptors, and multiplex identifiers were designed to generate 35 amplicons (median length 246 base pairs) covering 8.9 kilobases of mutational hotspots in AKT1, BRAF, EGFR, ERBB2, HRAS, KRAS, NRAS, PIK3CA, and MAP2K1 genes and all exons of the PTEN gene.

Results

The assay was validated on 23 formalin-fixed, paraffin-embedded lung cancer specimens. A minimum number of reads was consistently achieved with overall median read depth of 529× per amplicon. In total, 25 point mutations and 4 insertions/deletions (indels) with a frequency of 5.5% to 93.1% mutant alleles were detected. All EGFR, ERBB2, KRAS, PIK3CA, KRAS, and PTEN mutations, as detected by next-generation sequencing, were confirmed by pyrosequencing, with the exception of 3 point mutations in a tumor sample with low mutant-allele burden (below the pyrosequencing limit of detection).

Conclusions

The GS Junior–based, targeted, resequencing assay for a focused set of non–small cell lung cancer driver genes allows for quick and sensitive detection of point mutations and indels for the most relevant therapeutic genes in this type of cancer.
Clinicopathologic Correlates of Primary Aldosteronism
Authors: Duan Kai , Mete Ozgur
Published: June 2015

Primary aldosteronism is the most common cause of secondary hypertension, incurring significant cardiovascular morbidity and mortality. Our understanding of this disease has evolved substantially during the past decade. Recently, the molecular basis of primary aldosteronism has begun to be unraveled, with the discovery of mutations in potassium channel (KCNJ5), ATPases (ATP1A1, ATP2B3), and calcium channel (CACNA1D), and aberrant Wnt/β-catenin signaling. The most recent data suggest that 95% of cases are sporadic, whereas 5% of cases are hereditary. Pathologic correlates of primary aldosteronism include adrenal cortical hyperplasia, adenoma, and carcinoma. Although the most common clinical presentation is bilateral adrenal cortical hyperplasia, this entity is usually treated medically. Therefore, in the setting of primary aldosteronism, surgical pathologists are most commonly exposed to adrenocortical adenomas and the odd occasional carcinoma. This review provides an update on the current knowledge of primary aldosteronism and discusses the clinicopathologic correlations of this important disease.
Drug-Induced Liver Injury
Authors: Fisher Kurt , Vuppalanchi Raj , Saxena Romil
Published: June 2015

Context

Drug-induced liver injury (DILI) represents a diverse set of responses following exposure to any manufactured or naturally occurring chemical compound. Drug-induced liver injury is of major concern owing to the ever increasing number of compounds introduced into the market for treatment of various diseases as well as the increasing popularity of herbals, which lend themselves to self-medication but are not rigorously regulated.

Objective

To provide an overview of the prevalence, classification, and diagnosis of DILI with emphasis on pathogenesis and the role of a liver biopsy. To focus on the most common, emerging, and herbal agents that cause DILI with emphasis on the histologic pattern of injury observed.

Data Sources

A review of the literature was drawn from the PubMed (US National Library of Medicine) repository, textbooks, and online databases. All figures were taken from cases seen at our tertiary referral center, which is 1 of 12 participating sites in the National Institutes of Health–funded Drug-Induced Liver Injury Network.

Conclusions

Drug-induced liver injury due to prescription, over-the-counter, and herbal products is a major cause of liver disease in the United States and around the world. Diagnosis of DILI is challenging because there is no single clinical, laboratory, or histologic feature specific to DILI. Accurate diagnosis requires establishing a causal relationship with the suspected agent and excluding competing causes of liver injury. The liver biopsy is an essential component in the management of DILI by offering clues to the underlying pathogenesis, providing prognostic information, and guiding therapy.
Clinical Laboratory Quality Practices When Hemolysis Occurs
Authors: Howanitz Peter J. , Lehman Christopher M. , Jones Bruce A. , Meier Frederick A. , Horowitz Gary L.
Published: June 2015

Context

Hemolyzed specimens delay clinical laboratory results, proliferate unnecessary testing, complicate physician decisions, injure patients indirectly, and increase health care costs.

Objective

To determine quality improvement practices when hemolysis occurs.

Design

We used the College of American Pathologists (CAP) Survey Program to distribute a Q-Probes–type questionnaire about hemolysis practices to CAP Chemistry Survey participants.

Results

Of 3495 participants sent the questionnaire, 846 (24%) responded. Although 85%, 69%, and 55% of participants had written hemolysis policies for potassium, lactate dehydrogenase, and glucose, respectively, only a few (46%, 40%, and 40%) had standardized hemolysis reports between their primary and secondary chemistry analyzers for these 3 analytes. Most participants (70%) had not attempted to validate the manufacturers' hemolysis data for these 3 analytes; however, essentially all who tried, succeeded. Forty-nine percent of participants had taken corrective action to reduce hemolysis during the past year and used, on average, 2.4 different actions, with collection and distribution of hemolysis data to administrative leadership (57%), troubleshooting outliers (55%), retraining phlebotomist (53%), and establishment of quality improvement teams among the laboratory and at problem locations (37%) being the most common actions. When asked to assess their progress in reducing hemolysis, 70% noted slow to no progress, and 2% gave up on improvement. Upon measuring potassium, lactate dehydrogenase, and glucose, approximately 60% of participants used the same specimen flag for hemolysis as for lipemia and icterus.

Conclusions

Hemolysis decreases the quality and increases the cost of health care. Practices for measuring, reporting, and decreasing hemolysis rates need improvement.
The Impact of Library Resource Utilization on Undergraduate Students’ Academic Performance: A Propensity Score Matching Design
Authors: Kot Felly Chiteng , Jones Jennifer L.
Published: June 2015

This study uses three cohorts of first-time, full-time undergraduate students (N=8,652) at a large, metropolitan, public research university to examine the impact of student use of three library resources (workstations, study rooms, and research clinics) on academic performance. To deal with self-selection bias and estimate this impact more accurately, we used propensity score matching. Using this unique approach allowed us to construct treatment and control groups with similar background characteristics. We found that using a given library resource was associated with a small, but also meaningful, gain in first-term grade point average, net of other factors.
Degrees of Impact: Analyzing the Effects of Progressive Librarian Course Collaborations on Student Performance
Authors: Booth Char , Lowe M. Sara , Tagge Natalie , Stone Sean M.
Published: June 2015

The Claremont Colleges Library conducted direct rubric assessment of Pitzer College First-Year Seminar research papers to analyze the impact of diverse levels of librarian course collaborations on information literacy (IL) performance in student writing. Findings indicate that progressive degrees of librarian engagement in IL-related course instruction and/or syllabus and assignment design had an increasingly positive impact on student performance. A secondary indirect analysis of librarian teaching evaluations and self-perceived learning gains by students and faculty showed no correlation to rubric IL scores, suggesting the importance of “authentic” assessment in determining actual learning outcomes. This mixed-methods study presents findings in each area and examines their implications for effective IL course collaborations.
Relationship Satisfaction in Young Adults: Gender and Love Dimensions
Authors: De Andrade Alexsandro Luiz , Wachelke João Fernando Rech , Howat-Rodrigues Anna Beatriz Carnielli
Published: June 2015

Men and women present differences that go beyond evolutionary mechanisms of reproduction and species maintenance; social and cultural dimensions are indicated as modeling agents of different configurations of romantic relationships. This study presents the results of relationship quality models based on Sternberg’s triangular love theory. There were 335 subjects involved in romantic relationships, of whom 190 (56.7%) were male and 145 (42.3%) were female. Mean age of the participants was 29 years (SD = 9.1 years). The results of the study point out that love components predict relationship satisfaction differently per gender. For women, the intimacy, passion and commitment variables are significant predictors, whereas for men the commitment variable was not significant.
Interpersonal Dynamics in Business Disciplines: Formulating a Hierarchy of Relational Motives
Authors: Rojas Ronald R.
Published: June 2015

This article analyzes the topic of relational motives within the business disciplines and represents one attempt in responding to criticisms of a lacking framework capable of providing wider and more coherent understandings of relational typologies. By means of a review of the management and leadership literature and using a utility-by-motives clustering, six relational motives are identified and ordered hierarchically using a paired comparison methodology. The value of this approach for scholars and practitioners is explored and specific areas of further research are suggested.
Insulinotropic Activity of Methanolic Extract of Mesua ferrea Linn.
Authors: Umamahesh Balekari  , Ciddi Veeresham
Published: June 2015

Mesua ferrea flowers have been used in the Indian traditional medicine for treating various diseases. In present study, the Mesua ferrea flowers methanolic extract (MFME, 200 mg/kg bw) was studied for anti diabetic activity and underlying mechanisms for its activity. In Streptozotocin induced diabetes rats model, MFME treatment enhanced plasma insulin levels by 69.53% (P
Personalized Medicines: Reforming Diagnostics and Therapeutics
Authors: Poonam Yadav  , Sheefali Mahant
Published: June 2015

Since the first use of the term ‘Personalized Medicine’ (PM) in 1990, many research and review articles have coined this term. Nevertheless, this topic has not been widely researched about till now. The PMs are the application of genomic and molecular data for developing therapies with unprecedentedly higher efficiencies, better safety, lower ADR’s, and reduced costs of therapies. PMs are developed through molecular level knowledge of the drug targets and diseases, which leads to the promise of the right treatment for right patient at the right time. This paper gives a comprehensive view of PMs. For this purpose, this paper is divided into following sections: defining personalized medicines; the history and evolution of personalized medicines; the human genome project; drug discovery & development process; merits of personalized medicines; applications of personalized medicines; challenges on the road of personalized medicines; regulatory evolution in the generation of personalized medicines; role of US FDA in the era of personalized medicines and, conclusion.
Clinical management of carbamazepine intoxication during anti-tubercular treatment: a case report
Authors: Calderazzo Massimo , Rende Pierandrea , Gambardella Paolo , Colosimo Manuela , De Sarro Giovambattista , Gallelli Luca
Published: June 2015

We describe a 67-year-old man with medical history of focal post-stroke seizure and type 2 diabetes mellitus treated with carbamazepine, clobazam, gliclazide, insulin glargine, and omeprazole we visited for the onset in the last 7 days of asthenia, cough with mucus, breathing difficulty, chest pain, and weight loss. After clinical and laboratory tests, pulmonary tuberculosis was diagnosed, and a treatment with isoniazid, ethambutol, pyrazinamide rifampicin, and pyridoxine was started. Therapeutic drug monitoring of tuberculosis treatment documented that all drugs were in normal therapeutic range. Four days after the beginning of the treatment, we documented the improvement of fever, and three days later the patient showed sleepiness, visual disorder and asthenia. Clinical and pharmacological evaluation suggested a carbamazepine toxicity probably related to a drug interaction (Drug Interaction Probability Scale score = 6). The impossibility to switch carbamazepine for another antiepileptic drug, due to a resistant form of seizure, induced the discontinuation of tuberculosis treatment, resulting in the normalization of serum carbamazepine levels in one day (10 µg/ml) and in the worsening of fever, requiring a new clinical and pharmacological evaluation. The titration dosage of carbamazepine and its therapeutic drug monitoring allowed to continue the treatment with both antitubercular drugs and carbamazepine, without the development of adverse drug reactions. To date, tuberculosis treatment was stopped and clinical evaluation, radiology and microbiology assays documented the absence of tubercular infection and no seizures appeared (carbamazepine dosage 800 mg/bid; serum levels 9.5 µg/ml).
Analogs in the treatment of chronic hepatitis B: real life experience with tenofovir and entecavir
Authors: Villani Rosanna , Forlano Roberta , Vendemiale Gianluigi , Serviddio Gaetano
Published: June 2015

INTRODUCTION: Tenofovir and entecavir are potent antiviral agents. By suppressing viral replication, they induce histological improvement and finally delay the progression of chronic hepatitis B and the development of complications. They are rarely associated with serious side effects. Our data from a real life experience support data from the literature and suggest some minimal difference that may be useful in tailoring therapy.PATIENTS AND METHODS: We retrospectively analyzed 54 patients affected by chronic hepatitis B (31 and 23 treated by entecavir and tenofovir, respectively). Eight patients were cirrhotic. At baseline and 4-12 and 24 weeks after starting therapy, biochemical and virological analysis were performed in all patients. Renal function tests (serum creatinine, creatinine clearance and blood urea), serum (calcium and phosphate blood level) and urine electrolyte were also studied.RESULTS: All the patients reached virological control within 24 weeks. Only in the group treated by tenofovir we observed a complete viral suppression within 12 weeks. Some patients treated with tenofovir showed increased creatinine clearance without serum creatinine alteration. No significant side effects were reported with the exception of one case of persistent headache in the entecavir group for which the drug was suspended.CONCLUSIONS: Entecavir and tenofovir are effective in suppressing viral replication in patients with chronic hepatitis B. Tenofovir is more potent than entecavir and viral replication is blocked within 12 weeks of therapy. Tenofovir administration is associated with slight increase of creatinine clearance without alteration of serum creatinine levels. The choice of one or the other should be made according to target and specific patients characteristics. In patients with high serum viral load where the complete and quick control of viral replication is the main target, tenofovir may represent the best choice.