bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful clearance of cutaneous acyclovir-resistant, foscarnet-refractory herpes virus lesions with topical cidofovir in an allogeneic hematopoietic stem cell transplant patient
Authors: Muluneh B , Dean A , Armistead P , Khan T
Published: May 2012

Cidofovir is a deoxycytidine monophosphate analog with broad spectrum activity against various deoxyribonucleic acid viruses. Cidofovir is marketed as an injectable for intravenous use; however, there is a topical cidofovir formulation utilized for viral dermatologic infections. Here, we present a case of a successful clearance of a perianal acyclovir resistant and foscarnet refractory herpes simplex virus (HSV1) ulcer in a 34 year-old woman who had undergone allogeneic hematopoietic stem cell transplantation. After 1 week of therapy with cidofovir gel, the patient’s ulcer was clinically improved, and the lesion was negative for herpes simplex virus transcripts by real-time polymerase chain reaction testing. The wound remained herpes simplex virus negative by real-time polymerase chain reaction on repeat testing 1 week later. Based on this and other reports in HIV/AIDS patients, we believe that cidofovir gel has utility in the management of cutaneous, acyclovir-resistant HSV infections.
Can Customers Detect Script Usage in Service Encounters?
Authors: Victorino Liana , Verma Rohit , Bonner Bryan L. , Wardell Don G.
Published: May 2012

Service scripts are predetermined guides for employees to follow when delivering service to customers. Some services require employees to strictly follow a script, whereas others use scripts more flexibly, if at all. Extant research regarding service scripts in the domain of service operations has mainly addressed the topic from more of a process view as a control mechanism for the encounter but minimal research has examined customer perceptions of scripted service. The authors examine a pivotal first question, which is if customers can detect different approaches to script use. To answer the question, the authors conducted a video experiment of face-to-face service encounters in the hospitality industry. The results indicate that customers can detect degrees of script use across both standardized and customized encounter types. This work serves as initial empirical evidence that customers are indeed capable of detecting subtleties in scripting approaches in different service situations and supports that script level is an important service design construct for research. Furthermore, the authors highlight the use of a video experiment as an innovative methodology for assessing customer perceptions of intangible aspects to services in a realistic setting. One implication of this study is that managers need to assess the impact that different script levels have on customer perceptions of various service performance measures. Managers should also consider the effect script detection has on customer perceptions of the service experience and service brand to assure their script approach aligns with the organization’s service strategy.
Pressure pulse response of composite sandwich panels with plastic core damping
Authors: Hoo Fatt Michelle S , Chapagain Pradeep
Published: May 2012

An analytical technique is presented for obtaining the large amplitude, damped response of a foam-core composite sandwich panel subjected to uniform pressure pulse loading. The predicted panel response was in agreement with finite element analysis, and it was used to examine the blast resistance of panels with various foam cores. Although blast resistance generally increased with the increasing core density, panels with the densest cores exhibited no energy absorption before panel failure. The panel with the PVC H200 foam also sustained higher failure pressure per unit areal weight density than the denser panels with Klegecell R300 and HCP100 foams.
Evaluation of micromechanical methods to determine stiffness and strength properties of foams
Authors: Subramanian Narendran , Sankar Bhavani V
Published: May 2012

The stiffness and strength properties of foams with tetrakaidecahedral unit cells are evaluated using both finite element-based micromechanics and analytical methods. The finite element analysis models the varying cross section of the struts exactly. The analytical methods assume the struts have constant cross section along the length. Equivalent constant cross section of the strut can be obtained by either matching the densities or by using harmonic averaging of the stiffness properties. A method in which the moment of inertia of the cross section is averaged is also considered. The comparison of properties obtained for the different equivalent constant cross-section foams shows the inability of the various averaging schemes to match the shear modulus and the strength properties, while the Young’s modulus matches to some extent. The failure of the weakest cross section in the varying cross-section strut of the unit cell leads to a lower tensile strength in the actual foam compared to the uniform cross-section foams. The results suggest that although the use of simple analytical models for foam properties are attractive, they often lead to erroneous results, and hence exact modeling of the strut geometry is key to estimating the stiffness and strength properties of foams and other cellular solids.
Corporate social responsibility and individual resistance: Learning as the missing link in implementation
Authors: Blackman Deborah , Kennedy Monica , Quazi Ali
Published: May 2012

This article uses organisational learning literature to explore how employees’ orientations to corporate social responsibility, mental models and assessments of organisations’ espoused and enacted values, impact upon the success of corporate social responsibility programmes and actions. Work by Aguilera et al. (2007) is used to consider the potential dissonance between individual and organisational motives for corporate social responsibility. This theoretical article discusses the role of motives and learning within change. It contemplates both the role of motives held within mental models as a crucial factor in the successful adoption of effective corporate social responsibility practices and the function of learning practices in the support of corporate social responsibility change. Its contribution is in its focus at the level of the individual employee and in its challenge to assumptions about the relationship between individual and organisational motives for corporate social responsibility implementation. It is argued that effective implementation of corporate social responsibility requires organisations to consider both the role of learning and unlearning. Furthermore, organisations need to provide active support for the development of mental models about corporate social responsibility to prevent the development of dissonance between individual and organisational dispositions towards it.
Testimony ceremonies in Asia: Integrating spirituality in testimonial therapy for torture survivors in India, Sri Lanka, Cambodia, and the Philippines
Authors: Agger Inger , Igreja Victor , Kiehle Rachel , Polatin Peter
Published: May 2012

This study explores the therapeutic implications of including culturally adapted spiritual ceremonies in the process of testimonial therapy for torture survivors in India, Sri Lanka, Cambodia, and the Philippines. Data were collected through an action research process with Asian mental health and human rights organizations, during which the testimonial method was reconceptualized and modified to include four sessions. In the first two sessions, community workers assist survivors in the writing of their testimony, which is their narrative about the human rights violations they have suffered. In the third session, survivors participate in an honour ceremony in which they are presented with their testimony documents. In the fourth session, the community workers meet with the survivors for a reevaluation of their well-being. The honour ceremonies developed during the action research process came to employ different kinds of symbolic language at each site: human rights (India), religious/Catholic (Sri Lanka), religious/Buddhist (Cambodia), and religious/Moslem (Philippines). They all used embodied spirituality in various forms, incorporating singing, dancing, and religious purification rituals in a collective gathering. We suggest that these types of ceremonies may facilitate an individual’s capacity to contain and integrate traumatic memories, promote restorative self-awareness, and engage community support. Additional research is needed to determine the method’s applicability in other sociopolitical contexts governed by more Western-oriented medical traditions.
Waste catalyst as raw material in alumina–silica refractories
Authors: Garcia Luis P , da Cruz Richardo T , Bragança Saulo R
Published: May 2012

This work aims for the development of methodology for the utilization of the waste catalyst from hydrocarbons catalytic cracking process in the production of alumina–silica refractories. This residue was used in substitution of part of conventional raw materials, with the consequent ambient and economic profit. Some formulations were selected based on the chemical and mineralogical compositions of refractory bodies. They were fired in similar temperatures to those used for the production of commercial refractories. The analysis of the technological properties of the bodies revealed that the composition containing 15 wt% of catalyst waste had suitable characteristics. The final product showed technical parameters similar to that of a commercial refractory material.
A theoretical formula for predicting the folding wavelength in the rectangular columns
Authors: Niknejad Abbas
Published: May 2012

In this article, a theoretical relation is derived to predict the folding wavelength in the square and rectangular columns under the axial loading. For this purpose, a new deformation model of the columns during the folding progress is introduced. Based on the energy method, final equation is obtained. The derived relation shows the folding wavelength is dependant on the wall thickness and the edge length of the columns cross section and is independent of the column material. Some static folding tests are performed on the square and rectangular columns. Finally, the predictions of the theoretical formula are compared with the experimental results for which good agreement is observed.
Investigation of fracture properties of cement-treated crushed rock
Authors: Zhang Peng , Li Qing Fu , Zhang Yin Peng
Published: May 2012

A series of parametric tests have been conducted to investigate the fracture properties of cement-treated crushed rock with four specimen curing periods (14 d, 28 d, 60 d and 90 d) and four different cement contents (4%, 5%, 6% and 7%). By means of three-point bending method, the fracture toughness, fracture energy and the ultimate deflection in span center of the specimen of cement-treated crushed rock were measured respectively. The test results indicate that the curing period and cement content of the specimen have great influence on the fracture parameters of cement-treated crushed rock. With the increase of curing period, the resistance of cement-treated crushed rock to crack spreading is improved because the fracture toughness and the fracture energy are increasing gradually. With the increase of cement content, the fracture toughness, fracture energy and the ultimate deflection in span center of the specimen are decreasing gradually. It is better to select smaller cement content for the construction of cement-treated crushed rock base layer on condition that the compressive strength of the base layer can meet demand.
Renin–angiotensin system inhibitors can suppress atrial fibrillation recurrence after encircling ipsilateral pulmonary vein isolation in patients with a non-dilated left atrium
Authors: Takigawa Masateru , Yamada Takumi , Yoshida Yukihiko , Ando Monami , Ishikawa Kiyotake , Aoyama Yutaka , Yamamoto Takashi , Inoue Natsuo , Tatematsu Yasushi , Nanasato Mamoru , Kato Kazuo , Tsuboi Naoya , Hirayama Haruo
Published: May 2012

Introduction:

The purpose of this study was to investigate whether the effects of renin–angiotensin system inhibitors (RASIs) after encircling ipsilateral pulmonary veins isolation (EIPVsI) for atrial fibrillation (AF) differed between patients with non-dilated and dilated left atria.

Materials and methods:

We retrospectively studied 292 consecutive patients (mean age=61±11 years, 75% males) who underwent successful EIPVsI for paroxysmal or persistent AF. RASIs’ effects were compared between the patients with a non-dilated left atrium of <40 mm ( n=178) and dilated left atrium of ≥40 mm ( n=114).

Results:

During a mean follow-up period of 18.9±12.7 months, AF recurred in 38 (21.4%) and 45 (39.5%) patients with non-dilated and dilated left atria, respectively. A multivariate Cox proportional analysis revealed that treatment with RASIs (hazard ratio (HR) 0.30, 95% confidence interval (CI) =0.13–0.66, p=0.003), the duration of AF (HR 1.08/year, 95% CI=1.01–1.16, p=0.03), a history of hypertension (HR 2.86, 95% CI=1.21–6.85, p=0.02) and the left ventricular ejection fraction (HR 0.54/10%↑, 95% CI=0.34–0.87, p=0.01) were associated with AF recurrences in patients with a non-dilated left atrium. On the other hand, only the duration of AF (HR 1.11/year, 95% CI=1.01–1.21, p=0.03) was associated with AF recurrences in those with a dilated LA, and RASIs had no effect on AF recurrences ( p=0.65).

Conclusions:

RASIs suppressed AF recurrences after EIPVsI only in patients with a non-dilated left atrium.
Planning and the ‘stubborn realities’ of global south-east cities: Some emerging ideas
Authors: Watson Vanessa
Published: May 2012

Five years ago Yiftachel (2006) called on planning theorists to focus attention on cities of the global ‘South-East’ where issues differ significantly from northern contexts – which currently inform much planning theory work. This article asks if any such new directions have emerged in this period. It first reviews recent writings on socio-political and material conditions in these cities and suggests a set of assumptions to inform thinking about planning in these regions. It then identifies and assesses new strands of planning thought (some with older roots), and considers the project of taking forward planning theory-building in the global South-East.
Developing visualization-based decision support tools for epidemiology
Authors: Sutcliffe Alistair , de Bruijn Oscar , Thew Sarah , Buchan Iain , Jarvis Paul , McNaught John , Procter Rob
Published: May 2012

The paper describes the application of user-centred design (UCD) methods to a case study of the development of visual decision support tools to support epidemiological research. Understanding the causes of obesity requires analysis of complex medical surveys and geographic information. Translating research on obesity into effective public health measures requires collaboration between medical researchers and public health analysts. The objective of this research is to develop software tools to support medical researchers and public health analysts in collaborative investigation of obesity in children. The UCD approach consisted of scenario-based design, storyboarding and prototyping to explore design options to meet the needs of public health analysts and academic researchers. An evaluation of the prototype was carried out to assess the extent to which the medical researcher model would support public health professionals in their analysis activities. The design and evaluation of the prototype are discussed. A visualization-based research and decision-support system was implemented leading to positive evaluation results from users.
Transnatural ethics: revisiting the nuclear cleanup of Rocky Flats, CO, through the queer ecology of Nuclia Waste
Authors: Krupar Shiloh R.
Published: May 2012

This article explores the cleanup and conversion of former plutonium production facility Rocky Flats, located near Denver, Colorado, into a wildlife refuge. The article addresses the ethical demands of the ‘post-nuclear’ nature refuge and offers transnatural ethics and aesthetics in response, a relational ethics that seeks to take waste as inspiration. The article employs the performative persona of Denver-based drag queen comedienne Nuclia Waste to explore how transnatural ethical practice might figuratively reconstruct subjectivity in waste and develop a queer-ecology approach. The paper asks: what might the irreverent performances of a ‘radioactive’ drag queen open up, particularly for those living as the remains of the nuclear facility? Through detailed empirical analysis of the cleanup of Rocky Flats, the paper outlines the ethical framework historically employed at the site, which has relied upon and reproduced a waste/nature divide; the cleanup and management of the site have further naturalized this binarism. I argue that any effective response to such ongoing containment efforts requires a fundamental reorientation of environmental ethics toward waste. Drawing on ideas about ‘naturecultures’ and Donna Haraway’s work, Michel Foucault’s relational ethics, and the work of Éric Darier and Catriona Mortimer-Sandilands on ‘queer ecology,’ the article seeks to delineate an alternative: a relational ethics that recognizes and politicizes the permutation of waste and human, nature and waste. I utilize the digital performances and mutant drag of Nuclia Waste to revisit Rocky Flats and make broad connections between contamination and militarism, sexuality and the environment. The article speculates that experimental politicizations of subjectivity in waste might potentially foster coalitions between queer, labor, and environmental activisms.
Structure-coupled gravity waves past a vertical porous barrier
Authors: Manam SR , Kaligatla RB
Published: May 2012

An explicit solution is provided for the scattering of flexural and membrane-coupled gravity waves in deep water against a complete vertical porous barrier by employing certain mode-coupling relations. The floating structure is considered to be attached with the vertical porous barrier in three different ways, giving rise to edge conditions: (i) free edge, (ii) simply supported edge, (iii) clamped or built-in edge in the case of a floating ice-sheet and to fixed or clamped edge condition in the case of a floating membrane. The effect of the porous barrier on these structure-coupled gravity waves is discussed numerically by plotting reflection coefficient against a wave parameter. Also, important physical quantities such as strain in the ice-sheet, shear force in the ice-sheet and ice-sheet deflections are computed and plotted against relevant parameters. The effect of compressive force on flexural gravity wave scattering is also included in the numerical study.
Learning to manage COPD
Authors: Sohanpal Ratna , Seale Clive , Taylor Stephanie J C
Published: May 2012

The aim of this article is to understand the reasons for attending a chronic obstructive pulmonary disease (COPD)-specific self-management (SM) programme and how attendance at such programmes might be improved. A total of 20 qualitative semistructured interviews were carried out with patients and with lay programme tutors involved in the Better Living with Long term Airways disease (BELLA) pilot trial. Thematic framework data analysis was used. Common reasons for participant attendance arising from patients and tutors include (1) desire to learn about SM, (2) social benefits of meeting others with COPD and (3) altruism. Patients' reasons for poor attendance include (1) being too ill or not feeling ill enough and (2) practical, physical and emotional barriers. Tutor’s explanations for patients’ poor attendance were (1) failure to accept their condition, (2) fear of making a change, (3) lack of adequate support, (4) guilt about smoking and (5) the ‘scripted’ nature of the course. Suggestions for improving programme participation included (1) having choice of several start dates, (2) minimal delay inviting participant onto courses, (3) planning for ‘special needs’. Participation may be better amongst those who have accepted their condition or who are motivated towards improving their condition or to help others. Providing solutions for practical barriers may improve participation. However, alternatives to group-based interventions need to be developed for people with functional and emotional barriers to attendance.
Extending the course of intravenous antibiotics in adult patients with cystic fibrosis with acute pulmonary exacerbations
Authors: Sequeiros Iara Maria , Jarad Nabil A
Published: May 2012

Most severe pulmonary exacerbations (PExs) in adult patients with cystic fibrosis (CF) are treated with 2 week of intravenous (IV) antibiotics. At occasions, the treatment is extended. The morbidity and the cost of extending the treatment are considerable. Risk factors and the outcome of extending the course of treatment have not been formally investigated. This was a prospective study. Decision to extend the course of antibiotics was made in patients who were not deemed to have responded to the initial 14 days of treatment. Risk factors examined for extending the course were site of treatment (home or hospital), CF symptom score, body mass index (BMI), forced expiratory volume in the first second (FEV1) and C-reactive protein (CRP) at days 1 and 14 of the treatment. The following outcome measures were assessed for PExs requiring prolongation of treatment: FEV1, BMI, CF symptom score, CRP and number of days until the following PExs. PExs that were treated with 14 day course were used for comparison. Of all the PExs, 22.9% needed extension of treatment beyond day 14. Compared with PExs needing 14 days of antibiotics, CF symptom score, FEV1 and CRP at day 14 were worse in those who had to have the course extended. Extending the course of IV antibiotics to 21 days improved symptom score, but not any of the other outcome measures, including the number of days until the next PEx. Extending the course beyond 21 days did not result in improvement in any outcome measure. PExs in patients with worse lung disease and greater residual symptoms and lung inflammation at day 14 of antibiotic treatment were associated with the extension of the course of IV antibiotics. Prolonging the treatment to 21 days improved symptoms, but did not result in improvement in any other short-term or lung outcome measures.
The Limits of the Homogeneity Model
Authors: Pearson-Merkowitz Shanna
Published: May 2012

Until recently, Latinos generally were well integrated geographically and did not live in concentrated Latino neighborhoods. That is changing. Latinos now are more likely than ever before to live in isolated Latino areas. If this trend continues, Latinos soon will surpass African Americans as the most segregated minority group in the United States. For decades, political scientists, sociologists, and historians have tracked the perils of residential segregation in the African American community, but the consequences of segregation for Latinos in the United States are far from clear. Using the Social Capital Benchmark 2000 survey, this article investigates the civic consequences of segregation. The data suggest that living in a segregated area decreases the likelihood that Latinos participate in community-building activities. These findings directly challenge previous research that purports to find benefits from living in racially homogeneous areas.
More Bang for the Buck
Authors: Smidt Corwin , Christenson Dino
Published: May 2012

Can candidates spend their way into financial success? We propose that the 2007 presidential money primary offers unprecedented leverage to evaluate spending’s influence since it allows for sharper controls of confounding factors. Our results demonstrate that greater candidate spending on fundraising-related efforts is associated with significant future financial benefits. We estimate that, prior to the primaries, increases in spending have an equal or larger payoff than increases in a candidate’s viability and find different types of spending are beneficial for frontrunner and long-shot candidates. The results consistently indicate greater early spending works to advantage candidates, suggesting a lack of initial resources is a significant obstacle for candidates who seek to financially benefit from their campaign’s performance.
An Extract of Agaricus blazei Murill Administered Orally Promotes Immune Responses in Murine Leukemia BALB/c Mice In Vivo
Authors: Lin Jaung-Geng , Fan Ming-Jen , Tang Nou-Ying , Yang Jai-Sing , Hsia Te-Chun , Lin Jen-Jyh , Lai Kuang-Chi , Sai-Chuen Wu Rick , Ma Chia-Yu , Wood W. Gibson , Chung Jing-Gung
Published: May 2012

Purpose. The edible mushroom (fungus) Agaricus blazei Murill (ABM) is a health food in many countries. Importantly, it has been shown to have antitumor and immune effects. There is no available information on ABM-affected immune responses in leukemia mice in vivo. Experimental Design. In this study, the authors investigated the immunopotentiating activities of boiled water–soluble extracts from desiccated ABM in WEHI-3 leukemia mice. The major characteristic of WEHI-3 leukemia mice are enlarged spleens and livers after intraperitoneal injection with murine leukemia WEHI-3 cells. Isolated T cells from spleens of ABM-treated mice resulted in increased T-cell proliferation compared with the untreated control with concanavalin A stimulation. Results. ABM decreased the spleen and liver weights when compared with WEHI-3 leukemia mice and this effect was a dose-dependent response. ABM promoted natural killer cell activity and phagocytosis by macrophage/monocytes in leukemia mice in a dose-dependent manner. ABM also enhanced cytokines such as interleukin (IL)-1β, IL-6, and interferon-γ levels but reduced the level of IL-4 in WEHI-3 leukemia mice. Moreover, ABM increased the levels of CD3 and CD19 but decreased the levels of Mac-3 and CD11b in leukemia mice. Conclusions. The ABM extract is likely to stimulate immunocytes and regulate immune response in leukemia mice in vivo.
Challenges in recruiting participants in a multi-centre study on symptom experiences and self care strategies of bowel symptoms following colo-rectal surgery
Authors: Landers Margaret , McCarthy Geraldine , Savage Eileen
Published: May 2012

Aim: the purpose of this paper is to present some of the challenges found to be problematic in recruiting individuals following sphincter-saving surgery for rectal cancer for a multi-centre study. While the focus of the study is on symptom experience and self-care strategies of bowel symptoms following colo-rectal surgery, the paper will concentrate solely on the challenges experienced in recruiting a sample for the study.

Background: recruitment of an adequate number of participants is a challenge for researchers in any area of research involving patients. Enrolment of patients treated for rectal cancer poses particular challenges, because the total population of this group in a given country can be small. The use of multiple centres was required to obtain the required number of participants for the current study.

Findings: in multi-centre studies, researchers can encounter substantial challenges in obtaining ethical approval, accessing clinical sites and gaining direct access to patients. These challenges are embedded in a convoluted process involving many systems of communication, which can vary from one centre to another.

Conclusions: the process of obtaining ethical approval is prolonged in the absence of a central ethical review committee. A central review process based on a standard application for researchers seeking ethical approval for multi-centred studies is necessary. Establishing and maintaining access to clinical sites requires co-operation from many individuals during the development of the proposal and continuing throughout the data collection process.
Using an emic and etic ethnographic technique in a grounded theory study of information use by practice nurses in New Zealand
Authors: Hoare Karen J. , Buetow Stephen , Mills Jane , Francis Karen
Published: May 2012

This paper draws lessons from the use of an emic–etic ethnographical technique in a grounded theory study of how New Zealand practice nurses use information. The technique was used to heighten theoretical sensitivity in this study. As a nurse practitioner, I (the lead author) could not step out of my emic perspective to provide an etic perspective of my own general practice. From my emic embodied subjectivity I constructed my work environment to fit with best practice. Conversely, in four other general practices, my lack of personal connection protected an etic sense of disembodiment. New insights into mental models guiding the emic and etic roles of ethnography are suggested. Emic and etic perspectives, along with embodied and disembodied feelings, are not binary opposites but rather sit along a philosophical continuum. Their position on this continuum depends on the role and relationships of the researcher(s) in the social and cultural context of the area of inquiry.
Young (3–5 year-old) children’s ways of engagement in care procedures involving venepuncture
Authors: Söderbäck Maja
Published: May 2012

A fear of medical examination and of pain in care procedures is common among children. Young children are particularly sensitive to the way a procedure is carried out. The children will engage and act in the way they understand the situation and what is meaningful for them, which will depend on their experiences, interests and motivation. This study describes the qualitative differences in the complexity of how young children, aged 3–5 years, demonstrated the way they engaged in care procedures involving venepuncture. Video observation captured the young children as social actors in the procedure, and interpretive descriptive analysis was used to seek an understanding of the children’s demonstrated expressions and actions. The identified ways of engagement among the children were as follows: watchful engagement, curious engagement and adaptive engagement, as well as avoidance, forced engagement and resigned engagement. The children could fluctuate between the different ways of engagement during the course of the procedure. The results call attention to the sensitivity and responsiveness shown by the adults, nurses and parents in guiding the young children’s engagement and their ability to become integrated and act through active participation in a sometimes frightening care procedure.
Birth memories of Jordanian women: findings from qualitative data
Authors: Hatamleh Reem , Sinclair Marlene , Kernohan George , Bunting Brendan
Published: May 2012

Background:

Birth memories about their childbirth experience are powerful factors influencing women’s future fertility and exploring birth memories is important. Birth memories of women in Jordan have never been reported previously.

Objective:

To explore the childbirth memories of women in Jordan.

Design:

An exploratory descriptive study was conducted to collect quantitative and qualitative data on 160 first-time mothers giving birth in Northern Jordan’s Bade' a Hospital. Data were collected using three open-ended questions up to six weeks after the birth. Major themes emerging from the analysis were subject to manifest and latent content analysis to quantify qualitative data where appropriate.

Results:

All women were married and their age ranged from 17 to 37 years. About two-thirds (64.5%) had school education and 35.5% had graduate education. The majority (72.5%) were housewives. The major themes to emerge from the data were negative childbirth memories, women being processed, dehumanised birth, vivid recall, halo effect, the joy of becoming a mother and praise for the support of Allah.

Conclusion:

Findings provide evidence of the poor care that women receive during labour and birth. Women seem to be processed as objects to give birth in a technological manner. They are treated more like machines devoid of feeling than independent women requiring information, childbirth education or supportive ‘one to one’ care. Childbirth care was based on a medical model where the birth process is institutionalised, managed and controlled by the use of birth technology. There was no evidence of holistic care provided for women, and little consideration of their psychological, environmental or family relationships.
The LPS2 mutation in TRIF is atheroprotective in hyperlipidemic low density lipoprotein receptor knockout mice
Authors: Richards M Rachel , Black Audrey S , Bonnet David J , Barish Grant D , Woo Connie W , Tabas Ira , Curtiss Linda K , Tobias Peter S
Published: May 2012

Signaling through MyD88, an adaptor utilized by all TLRs except TLR3, is pro-atherogenic; however, it is unknown whether signaling through TIR-domain-containing adaptor-inducing interferon-β (TRIF), an adaptor used only by TLRs 3 and 4, is relevant to atherosclerosis. We determined that the TRIFLps2 lack-of-function mutation was atheroprotective in hyperlipidemic low density lipoprotein (LDL) receptor knockout (LDLr−/−) mice. LDLr−/− mice were crossed with either TRIFLps2 or TLR3 knockout mice. After feeding an atherogenic diet for 10–15 wks, atherosclerotic lesions in the heart sinus and aorta were quantitated. LDLr−/− mice with TRIFLps2 were significantly protected from atherosclerosis. TRIFLps2 led to a reduction in cytokines secreted from peritoneal macrophages (Mϕ) in response to hyperlipidemia. Moreover, heart sinus valves from hyperlipidemic LDLr−/− TRIFLps2 mice had significantly fewer lesional Mϕ. However, LDLr−/− mice deficient in TLR3 showed some enhancement of disease. Collectively, these data suggest that hyperlipidemia resulting in endogenous activation of the TRIF signaling pathway from TLR4 leads to pro-atherogenic events.
The prevalence of nasal carriage of meticillin resistant Staphylococcus aureus among healthcare workers in a non-acute healthcare facility
Authors: Kelly R , Dillon AL , Carroll AM , McNamara EB
Published: May 2012

There is a lack of data available concerning the baseline prevalence of meticillin resistant Staphylococcus aureus (MRSA) carriage among healthcare workers (HCWs) in the Republic of Ireland. This anonymous prevalence study screened HCWs for nasal carriage of MRSA in a non-acute healthcare facility (HCF) in Dublin and the prevalence rate among these HCWs was calculated. Three hundred and four HCWs were invited to participate, with 112 (37%) consenting to take part in the study. Nasal swabs were analysed by culture method for MRSA with reference to Health Protection Agency guidelines. Meticillin resistant isolates were examined for presence of MecA gene by real-time polymerase chain reaction. The overall rate of nasal carriage MRSA was found to be 8.9% (10/112), of whom eight were nurses, one was medical staff and one was household/catering staff. High-level mupirocin resistance was detected in two of the isolates. This study confirms a significant prevalence of MRSA carriage among the cohort studied, particularly among frontline HCWs. This emphasises the need for strict adherence to infection control protocols to minimise healthcare associated MRSA infections among patients in non-acute healthcare facilities. The detection of high level mupirocin resistant MRSA has implications for MRSA decontamination protocols.
Portable Head Computed Tomography in the Diagnosis of Cerebral Fat Embolism Secondary to Cardiac Surgery
Authors: Malik Amer M.
Published: May 2012

Background and Purpose: Cerebral fat embolism (CFE) has been diagnosed previously by both brain magnetic resonance imaging (MRI) and dedicated head computed tomography (HCT) studies. The most commonly reported feature on CT is the presence of the “hypodense artery sign,” although the number of reported cases has been minimal to date. Methods: Report of a single case involving a 88-year-old patient who underwent cardiac surgery. Postoperatively, the patient developed right hemiparesis. Contraindications existed for performing brain MRI and dedicated head CT. Portable head CT (pHCT) was obtained. Hounsfield unit measurement was used. Results: A hypodense artery sign was visualized, and Hounsfield unit measurement indicated fat density. Diagnosis was determined to be CFE. Conclusion: This case report emphasizes that pHCT quality may be sufficient to diagnose CFE and offers a viable alternative when MRI or HCT is contraindicated.
Linagliptin for type 2 diabetes mellitus: a review of the pivotal clinical trials
Authors: McGill Janet B.
Published: May 2012

Patients with type 2 diabetes mellitus (T2DM) frequently require multiple therapies to effectively control hyperglycemia, and many new agents for glucose control have been developed over the past few decades. Linagliptin is a recently approved oral antidiabetic drug that acts by inhibiting the enzyme dipeptidyl peptidase-4 (DPP-4). Unlike other DPP-4 inhibitors, linagliptin is excreted chiefly via the enterohepatic system, and can be used without dose adjustment in patients with renal or hepatic impairment. Linagliptin was approved by the US Food and Drug Administration based on a large development program, including four pivotal trials in patients with T2DM, assessing the efficacy and safety of linagliptin when used as monotherapy or in combination with other oral antidiabetes drugs. Linagliptin was associated with significant improvements in glycosylated hemoglobin, fasting plasma glucose and postprandial glucose, and more patients receiving linagliptin showed meaningful improvements and achieved targets for glycosylated hemoglobin. Linagliptin was well tolerated, with an adverse event profile similar to that of placebo, and low rates of hypoglycemic events. Taken together, the pivotal trials confirm linagliptin is effective and safe in patients with T2DM: the convenience of oral dosing with no requirement for dose adjustment in patients with renal or hepatic impairment make linagliptin a valuable option when considering therapies for patients with T2DM.
Spiritual Well-Being May Buffer Psychological Distress in Patients With Implantable Cardioverter Defibrillators
Authors: Salmoirago-Blotcher Elena , Crawford Sybil , Tran Chau , Goldberg Robert , Rosenthal Lawrence , Ockene Ira
Published: May 2012

Psychological distress is common in patients with implantable cardioverter defibrillators and has been associated with a worse prognosis. The authors examined whether spiritual well-being is associated with reduced psychological distress in patients with ICDs. The Functional Assessment of Chronic Illness Therapy–Spiritual Wellbeing (FACIT-SWB) questionnare and the Hospital Anxiety and Depression Scale (HADS) were used to measure spiritual well-being and overall psychological distress. Multivariate linear regression was used to explore the relationship between these variables. The study sample included 46 implantable cardioverter defibrillator outpatients (32 males, 14 females; age range = 43-83 years). An inverse association between HADS and FACIT-SWB scores was found, persisting after adjustment for demographics, anxiety/depression, medications, therapist support, and functional status ( F = .001; β = −0.31, confidence interval = −0.44, −0.19). In conclusion, spiritual well-being was independently associated with lower psychological distress in ICD outpatients. Spiritual well-being could act as a protective factor against psychological distress in these high-risk patients.
Climate Change as a Wicked Problem
Authors: FitzGibbon John , Mensah Kenneth O.
Published: May 2012

Understanding complexity suggests that some problems are more complex than others and defy conventional solutions. These wicked problems will not be solved by the same tools and processes that are complicit in creating them. Neither will they be resolved by approaches short on explicating the complex interconnections of the multiple causes, consequences, and cross-scale actors of the problem. Climate change is one such wicked problem confronting water management in Ghana with a dilemma. The physical consequences of climate change on Ghana’s water resources are progressively worsening. At the same time, existing institutional arrangements demonstrate weak capacities to tackle climate change–related complexities in water management. Therefore, it warrants a dynamic approach imbued with complex and adaptive systems thinking, which also capitalizes on instrumental gains from prior existing institutions. Adaptive Co-Management offers such an opportunity for Ghana to adapt its water management system to climate change.
Comovement Between Self-Employment and Macroeconomic Variables
Authors: Carmona Mónica , Congregado Emilio , Golpe Antonio A.
Published: May 2012

The relationship between self-employment and certain macroeconomic variables is often at the heart of the debate about the contributions of self-employment to employment and economic growth; examining this relationship is the aim of this article. This article is devoted to the empirical exploration of the comovement and causality between entrepreneurship and economic performance in both directions. This study searches for basic relationships between self-employment and certain macroeconomic variables in Spain using quarterly data from 1980:1 to 2009:4. From this analysis, four key findings emerge: (a) the relation between self-employment and the business cycle differs across two components of self-employment, that is, employers and own-account workers; (b) the existence of a strong bidirectional causality between self-employment and unemployment and GDP; (c) business cycles contain information valuable for predicting today’s employers; and (d) entrepreneurship promotion policies oriented to encourage the emergence of new job creators may be a cornerstone of a new strategy to combat unemployment. These results should be kept in mind when designing entrepreneurship policies.
Addressing Gender Inequities in Collegiate Sport
Authors: Yiamouyiannis Athena , Osborne Barbara
Published: May 2012

The purpose of this study was to examine issues related to female representation within the governance structure of the National Collegiate Athletic Association (NCAA). A descriptive statistics approach through the lens of feminism was taken in collecting and analyzing data related to the gender representation of staff leadership positions within the NCAA national office and gender representation within the NCAA Division I, II, and III governance structure. This was coupled with a review of NCAA programming initiatives related to leadership opportunities. Although a number of strategies are being implemented by the NCAA to provide greater access and leadership opportunities for women (e.g., diversity initiatives, Senior Woman Administrator legislation, and guaranteed representation on committees), women continue to be underrepresented within NCAA governance substructures and upper leadership levels within the NCAA national office. In addition, nongender neutral sport governance policies still exist that impede the progress of achieving gender equality.
Ultrasonographic Findings in Anterior Chest Wall Abscess
Authors: Wong On Manuel , Quirós Gustavo Castillo
Published: May 2012

Empyema necessitatis is a rare complication of empyema, in which the pleural infection spreads outside of the pleural space to involve the soft tissues of the chest wall, and is difficult to diagnose with sonography alone. In the case presented, sonography to evaluate a focal anterior chest wall pain in a patient resulted in findings consistent with an abscess and prompted additional workup. Further testing included sonography-guided aspiration and computed tomography scan to establish the diagnosis followed by surgical debridement.
Using Automated Breast Sonography as Part of a Multimodality Approach to Dense Breast Screening
Authors: Giuliano Vincenzo , Giuliano Concetta
Published: May 2012

Three-dimensional automated breast sonography is currently an investigational modality for breast cancer screening not yet accepted clinically in the United States. In this pilot study, a prospective study of 24 asymptomatic female patients with more than 50% breast density by digital screening mammography was performed using automated breast sonography and compared with 3D contrast breast magnetic resonance imaging (MRI) correlation (the gold standard). This study was performed as part of a multimodality approach to histologically proven breast lesions classified as categories 4 and 5 according to the American College of Radiology Breast Imaging, Reporting, and Data System (BI-RADS). Comparable diagnostic reliability (kappa values between 0.95 and 0.98) was observed between automated breast sonography and MRI in differentiating benign from malignant breast lesions based on similar morphologic criteria. This preliminary study offers automated breast sonography as a promising cost-effective adjunct diagnostic modality to MRI in the evaluation women with increased breast density by digital mammography.
Continuing Medical Education for Sonographers
Authors: Baker Anthony L. , Whitney Ella C.
Published: May 2012

The requirement for continuing medical education in health care originated in the early 1900s when several investigators in the United States determined that the training physicians were receiving was woefully inadequate. The Flexner Report, which was based on an extensive analysis of how the early medical schools were educating physicians, proposed several radical changes in physician instruction, including a recommendation for postgraduate training. Now known as continuing medical education (CME), this obligation is practically universal in the medical and allied health fields including sonography. Although there are many options for the diagnostic medical sonographer to earn CME credits, the Society of Diagnostic Medical Sonography (SDMS) instituted a unique program for sonographers to earn credits by providing clinical instruction to sonography students. By using electronic data collection and management systems, it is now easy for sonography program directors to submit their clinical instructors for CME credits through the SDMS.
Monocyte-derived dendritic cells from breast cancer patients are biased to induce CD4+CD25+Foxp3+ regulatory T cells
Authors: Ramos Rodrigo Nalio , Chin Lilian Sally , dos Santos Ana Paula S A , Bergami-Santos Patrícia Cruz , Laginha Fábio , Barbuto José Alexandre M
Published: May 2012

Immune deviation induced by breast cancer may have a role in current failures of dendritic cell-based immunotherapy.

DCs orchestrate immune responses contributing to the pattern of response developed. In cancer, DCs may play a dysfunctional role in the induction of CD4+CD25+Foxp3+ Tregs, contributing to immune evasion. We show here that Mo-DCs from breast cancer patients show an altered phenotype and induce preferentially Tregs, a phenomenon that occurred regardless of DC maturation stimulus (sCD40L, cytokine cocktail, TNF-α, and LPS). The Mo-DCs of patients induced low proliferation of allogeneic CD3+CD25negFoxp3neg cells, which after becoming CD25+, suppressed mitogen-stimulated T cells. Contrastingly, Mo-DCs from healthy donors induced a stronger proliferative response, a low frequency of CD4+CD25+Foxp3+ with no suppressive activity. Furthermore, healthy Mo-DCs induced higher levels of IFN-γ, whereas the Mo-DCs of patients induced higher levels of bioactive TGF-β1 and IL-10 in cocultures with allogeneic T cells. Interestingly, TGF-β1 blocking with mAb in cocultures was not enough to completely revert the Mo-DCs of patientsˈ bias toward Treg induction. Altogether, these findings should be considered in immunotherapeutic approaches for cancer based on Mo-DCs.