bluuebunny/crossref_metadata_2025 huggingface dataset:
The experience of hospitalisation for physically disabled patients
Authors: Biley Anna M
Published: January 2018

This article aims to illustrate how episodes of acute hospitalisation affect physically disabled patients, particularly wheelchair users. Factors such as poor ward design and lack of equipment may often contribute to a traumatic stay; a lack of awareness of client needs and negative attitudes among health-care professionals have also been noted. Future possibilities include professional recognition of patients’ expertise in managing their own disabilities and the promotion of collaborative, patient-focused care.
Automated care in the community — an engineer’s dream, a health professional’s dilemma?
Authors: Doughty Kevin , Costa Jan
Published: January 2018

The assessment role of occupational therapists places them at the sharp end of the Community Care Act, as hospital managers and social workers battle to survive within their budgets while trying to rehabilitate increasing numbers of patients. ‘Telecare’ has been proposed by engineers as a novel method of providing remote monitoring of such patients. The arguments for and against this initiative are discussed in this article, and examples are given.
Nurses' estimations of patients' prognoses in the last days of life
Authors: Buchan Janet EF
Published: January 2018

This study was based on two medical wards in a teaching hospital. It examined the accuracy with which nurses estimated patients' prognoses in the last days and hours of life and the cues used to make such assessments. An exploratory and descriptive approach was adopted. The study was divided into two parts: a cross-sectional interview study and a prospective patient follow-up study. The cues used by the nurses were identified and categorised and estimates of life expectancy were assessed for accuracy. Results showed that multiple cues were used and that although nurses were able to identify patients who were dying imminently, their accuracy regarding precise prognosis varied considerably. They also revealed that the most accurate assessments were made by nurses carrying out basic patient care, rather than the most experienced staff.
Palliative care services for ethnic groups in Leicester
Authors: Haroon-Iqbal Hifsa , Field David , Parker Hilda , Iqbal Zafar
Published: January 2018

The objectives of this study were to examine current palliative care service provision and its use by the black and minority ethnic (BME) groups in Leicester.* The study comprised two stages, an initial pilot study using semistructured tape recorded interviews, followed by a structured interview schedule. It was set in the voluntary sector, a local hospice and one trust hospital in Leicester. The subjects were 33 palliative care patients and carers from BME groups. The findings identify some deficiencies in access to and provision of palliative care services to BME communities in the city of Leicester. There appears to be a low level of satisfaction among the sample. There are also differences within the group, with 50% indicating that things are unsatisfactory. The main area of need identified was information about illness and available services. The study concluded that providers of palliative care need to examine their policy and practices with regards to whether they are acceptable, accessible and culturally sensitive to the needs of BME groups. A low uptake of services is more likely to suggest inappropriate provision rather than lack of need. An extended version of this article appears in Richardson and Wilson Barnett (1995).

*The term black and minority ethnic (BME) group has been used to refer to people from racial or other minorities who may be disadvantaged because of their racial bakground. There is no single accepted term, nor one that can be seen as politically correct or incorrect. It should, however, be recognised that there may be some people who do not identify themselves as black or a minority but who share a common experience of racism (Anthias, 1992; Cole, 1993).
A comparative study of patients' and nurses' perceptions of pain relief
Authors: Jandelli Karen
Published: January 2018

Visual analogue scales were used to assess pain and pain relief in a sample of 20 cancer patients. Simultaneously, the nurse caring for the patient was asked to assess the status of the patient's pain. The scores were compared to distinguish any differences between the two groups. The two groups were also asked to mark on a schematic body diagram the location of the patient's pain. Six nurses were interviewed to elicit information about their approach to pain relief. The results suggest that there is a discrepancy between the patients' and the nurses' pain ratings. The nurses overestimated the patients' pain in the majority of cases. These results were not anticipated as recent studies have shown that nurses generally underestimate patients' pain. This highlights the nurses' lack of detailed knowledge concerning the patients' pain. In the interviews the nurses demonstrated an awareness of the basis of pain assessment; however, the results of the study suggest that this knowledge is not applied in practice.
Body image: using women who have had breast surgery as a case study
Authors: Refferty Dawn
Published: January 2018

This paper attempts to bring together some of the social and historical influences which impact on body meaning and thereby influence body image formation. Using women with breast cancer as a case study, it is argued that the resultant body image construct has implications for women's attitudes towards their bodies in general and their breasts in particular. These influences are considered in relation to women's response to threats against body image integrity such as those posed by surgical intervention for breast cancer. Knowledge and awareness of the factors which affect body meaning and body image can be used to improve our understanding and care of a wide range of patients with advanced disease.
Book reviews
Authors: Yeo Judith , Bools Keith , Williams Audrey , Partington Lynne , Richardson Karen , Sweeney John J
Published: January 2018

Cancer Care in the Community

Treating AIDs with Chinese Medicine

Aromatherapy for Health Professionals

Palliative Care for People with Cancer (2nd edn)

Cancer Care in the Hospital

Mortally Wounded: Stories of Soul Pain, Death and Healing
Ethical dimensions in palliative nursing
Authors: Webber Jeanette
Published: January 2018

Judging by the content and focus of national and international journals and conference programmes, it would appear that the preoccupation of health professionals with ethical aspects of care has increased dramatically in recent years. Nurses in particular are expressing deep concerns about the ethical dimensions of their work and many are opting to undertake advanced educational programmes dealing with this subject. It is interesting to reflect on the reasons for this growing concern. After all, many of the situations which we face today and which give rise to ethical dilemmas have been with us for many years. Life support machines, clinical trials and the desire of some to end their lives, when continued existence seems meaningless or intolerable, are not situations unique to the 1980s or 1990s — indeed, even I can remember them being around when I was a student nurse and that is going back some years!
The organization and delivery of palliative care services in India
Authors: Spencer Debbie , Page Lorraine
Published: January 2018

A study/lecture tour of India was undertaken by the authors during October and November 1995. The purpose of the visit was to provide a programme of education in palliative care and to gain a deeper understanding of the care of dying people in India. Seven centres were visited and the distance covered was approximately 4500 km. This article describes existing palliative care links between India and the UK and discusses the organization and delivery of palliative care services in the areas visited. Problems such as difficulty in accessing services and resources are explored. Psychosocial issues relating to peoples' attitudes towards illness and uptake of services are also investigated. Some strategies are suggested to support the continued development of palliative care in India This journey was an opportunity to gain an empathetic understanding of the spiritual, psychological, emotional and multicultural palliative care needs of the Asian population.
Does aromatherapy provide an holistic approach to palliative care?
Authors: Shenton Diane
Published: January 2018

Palliative care specialist nurses aim to ensure that clients are offered the full range of care modalities. It is important that care is given to the total person. This paper will critically analyse the role of complementary therapy as a contribution to palliative care. Aromatherapy will be specifically highlighted, including examination of the way in which it relates to the four main principles of holism.
Special interest session on C-PET
Authors: Crawford Moira
Published: January 2018

C-PET, a tool designed to aid communication between health care professionals and women with advanced breast cancer, was launched at a special interest session of the International Conference on Cancer Nursing, held in Brighton in August.
Book Reviews
Authors: Hammond Suzanne , Liossi Christina
Published: January 2018

Handbook of Palliative Care in Cancer

Fading Away: The Experience of Transition in Families with Terminal Illness
Quality of life during high dose chemotherapy for breast cancer
Authors: Griffiths Audrey , Beaver Kinta
Published: January 2018

Asmall sample of women (n=9) receiving high dose chemotherapy for advanced breast cancer were asked to complete a quality of life measure (QLQ-C30) at three time points: prior to, during and post treatment.

Despite the onset of severe side effects, no significant deterioration in quality of life was recorded in terms of physical, role, emotional, cognitive or social functioning. The role of the clinical nurse specialist (CNS) in providing continuity of care as well as support and information for these women is discussed. Further work in this area with larger sample sizes is needed to confirm these findings and to further investigate the role of the CNS in this context.
Action research in a palliative care education programme
Authors: Rosser Megan
Published: January 2018

Using an action research approach, the author worked with district nurses to enable them to identify their own palliative care education needs and to plan the appropriate education programme, with reflective practice enabling the identification of further education needs. This approach overcame some of the problems of pre-planned, unresponsive palliative care education programmes. Both the learning and the action research approach are developed through continual reflective practice, which reduces the theory-practice gap as theory is generated from practice. The knowledge gained from reflective practice is as relevant to nursing as the knowledge derived from academic theories. Reflective practice within palliative care education facilitates learning in a relatively new field of practice and generates a greater understanding of the complexities of palliative care and associated education needs.
Patient management and docetaxel
Authors: Aston Val
Published: January 2018

Potent new drugs such as docetaxel (Taxotere®) will alter our perspective on advanced breast cancer, allowing significant disease responses and symptom palliation in many patients. The toxicities associated with docetaxel are generally predictable and manageable and usually reversible. Docetaxel is suitable for use in the outpatient setting. This report describes early experience with the drug in a nurse-assisted day case chemotherapy clinic at the Velindre NHS Trust Hospital and offers practical guidance on the prevention and handling of side-effects.
Providing care for people living with dermatitis and dementia
Authors: Butcher Lesley
Published: January 2018

There is a wide range of skin conditions where healing is made difficult due to the symptoms of dementia. In this article, Lesley Butcher discusses these disorders, and the importance of a holistic, person-centred assessment when looking to treat them
Evidence-based medication review in care homes
Authors: Nazarko Linda
Published: January 2018

Older people living in long-term care are at a higher risk of adverse drug effects than the younger population. In this article, Linda Nazarko explains how reviewing and discontinuing unnecessary medication can improve overall quality of life
Taking a cervical sample: A reflection on good practice
Authors: McMunn Valerie
Published: January 2018

Cervical sample taking is an important role for the practice nurse. Valerie McMunn describes a personal experience and reflects on what constitutes good practice

This article is a reflection of a cervical sample taking experience highlighting the importance of communication, information collection and correct techniques when taking a cervical sample. It explores the negative outcomes of failure to follow the national guidelines, provide good basic nursing care and communicate effectively, and the impact this may have on the woman both in terms of outcomes and her wish to have another sample taken in the future.
Clarity in partnership arrangements
Authors: Pearmain Gemma
Published: January 2018

Are you considering inviting new partners to join your practice or are you about to become a partner yourself? Gemma Pearmain of law firm Cripps explains why it is important to agree clear partnership terms from the start
FDM CLOUD BASED APPLICATION PERFORMANCE MONITORING SYSTEM OF THE CADETS WHILE ON BOARD SHIP TRAINING FOR THE PHILIPPINE MERCHANT MARINE ACADEMY IN SAN NARCISO ZAMBALES
Authors: D. Mobo Froilan
Published: January 2018

The main thrust of the study is to develop a cloud-based application performance monitoring system of the cadets while on board ship training for the Philippine Merchant Marine Academy in San Narciso, Zambales which intended to serve as an alternative system that can be used by the target school in monitoring the performance of the cadets while on ship board and determine its effectiveness.

The researcher has used the descriptive research method wherein the study is focused on the present situations. It involves the recording, description and the presentation of the present system, composition and phenomena.

The Statement of the problem focused in obtaining the effectiveness of the proposed cloud based application in performance monitoring system of the cadets for the Philippine Merchant Marine Academy, San Narciso, Zambales.

Findings showed that the Department of Shipboard Training needs a real time system that can monitor the cadets while on board ship training. Based on the conclusion of this study, the researcher recommends the development of the cloud based application which will monitor the performance of the cadets while on board ship training and lastly, the developed system was tested during the implementation and met no errors.

Based on the findings, the number of respondents as group per course is in parallel to the ratio of the students currently enrolled at PMMA. Majority of the respondents for both the groups came from the existing Group whose ages range from 19-21 years old.As revealed, the majority of the respondents for both the groups are males from the Proposed Group.

In the proposed system out of one hundred percent respondents, thirty or 93.5% cadets; while the officials are nine or 6.5% of the one hundred, from the total of thirty-nine respondents.
Android Based Student Reminder System
Authors: Bhavani Y. , Sanjay D
Published: January 2018

Now a day’s usage of android applications has become a part of our life. By using these applications our work becomes simple and easier in our day to day activities. This paper suggests an android application which is generally useful for the students and parents. It contains various features like notifying the student about the renewal date of library books, alerting students and their parents about the percentage of attendance and reminds them about number of classes they should present to maintain the specified attendance threshold. This application also alerts the students and parents about various events like examinations, workshops to be held, student activities to be conducted etc. This application is user friendly and can be installed in any android smart phone
Spectrum Handoff in Cognitive Radio Networks: A Survey
Authors: Lala Nisar , Balkhi Altaf , Mir G M
Published: January 2018

Cognitive radio (CR) is a promising solution to improve the spectrum utilization by enabling unlicensed users to exploit the spectrum in an opportunistic manner. Spectrum handoff is a different type of handoff in CR necessitated by the reappearance of primary user (PU) in the licensed band presently occupied by the secondary users (SUs). Spectrum handoff procedures aim to help the SUs to vacate the occupied licensed spectrum and find suitable target channel to resume the unfinished transmission. The purpose of spectrum mobility management in cognitive radio networks is to make sure that the transitions are made smoothly and rapidly such that the applications running on a cognitive user perceive minimum performance degradation during a spectrum handoff. In this paper, we will survey the literature on spectrum handoff in cognitive radio networks.
Quality of Service Provisioning in Cognitive Radio
Authors: Lala Nisar , Balkhi Altaf , Mir G. M. , Simnani R. A.
Published: January 2018

Cognitive radio is a future technology coined for increasing the utilization of otherwise under-utilized spectrum channels. Providing quality of service (QoS) to diverse flows as per their requirements is a very difficult job as there is no dedicated allocation of wireless channels in cognitive radio (CR) network. The paper selects few critical QoS parameters such as signal-strength, bandwidth and user-mobility that assess the influence on quality of communication between users using rule-based fuzzy inference system. The analytical results show the influence of those QoS parameters on the quality of communicating channels and open new issues in designing protocol structure for CR.
A ARQUEOLOGIA COMO OFÍCIO DE MATERIALIZAÇÃO, COMPREENSÃO E ACONTECIMENTO
Authors: Gomes Sérgio
Published: January 2018

Neste texto partimos da natureza epistemológica do registo arqueológico para dar ênfase à arqueologia enquanto prática de materialização da alteridade. Com este propósito, desenvolvemos uma leitura da prática arqueológica a partir de conceitos provenientes do pensamento crítico contemporâneo, designadamente: o Arquivo, a Compreensão e o Acontecimento. Tentamos demonstrar o processo arqueológico como uma prática de arquivo onde seconstituem objetos de estudo que, enquanto objetos de compreensão, podem ser elementos das condições de Acontecimento, isto é, elementos que abalam as finalidades impostas ao conhecimento arqueológico e o abrem enquanto possibilidade de relação com a diferença.
SLAVES IN LUSITANIA: IDENTITY, DEMOGRAPHY AND SOCIAL RELATIONS
Authors: Curchin Leonard A.
Published: January 2018

Se presenta un análisis de las inscripciones lusitanas que mencionan los esclavos, limitado necesariamente a personas identificadas de manera explícita como servi o similares. Una proporción bastante más alta de esclavos masculinos refleja tanto un énfasis en el labor físico como una posible exposición de vernae femeninas. Según las edades atestiguadas, muchos esclavos habrían muerto como jóvenes, pero esta documentación no incluye esclavos manumitidos. Además, las inscripciones proporcionan informes interesantes sobre las relaciones de esclavos con sus padres, sus dueños y sus cónyuges.
Several Functions of Rhizopus sp on Increasing Nutritional Value of Feed Ingredient
Authors: Endrawati Dwi , Kusumaningtyas Eni
Published: January 2018

Rhizopus sp is a type of fungi which easily grow in the soil, fruit, vegetables and fermented food. This paper describes some functions of Rhizopus sp on increasing nutritional value of feed ingredient and possibility of its application in Indonesia. Rhizopus mold has been known in Indonesia especially for tempe production for food. Research about Rhizopus sp gives knowledge for utilizing Rhizopus sp for other functions. Rhizopus sp is able to inhibit the growth of toxigenic fungus, Aspergillus flavus and to degrade aflatoxin. Rhizopus sp also produces compounds which are able to inhibit pathogenic bacteria and acts as antioxidant. Rhizopus sp absorbs some minerals and changes them to become organic minerals hence it increases mineral absorption by the body. Utilization of feed fermented by Rhizopus sp in livestock showed better result compared to non fermented feed. Rhizopus sp is also very potential to be applied as feed additive for livestock.
Nekotorye aspekty problemy narusheniyaosanki u podrostkov Primorskogo kraya
Authors: VASIL'EVA T G , KOChETKOVA E A
Published: January 2018

Objective of study was to examine mineral bone density and condition of bone metabolism in adolescent with different types of carriage disorders.
Material and methods: We investigated 122 adolescent with carriage disorders, its dates of dual - energy X - ray absorbtiometry. Condition of bone metabolism was estimated on blood osteocalcini and ßCrossLaps. Condition of calcii-phosphorum exchange was estimated on blood calcium (Ca) and phosphorus concentration and also its level in urinary daily. PTH secretion in the serum blood was estimated. Control group was consisted by 70 health adolescent similar ages and sex.
Results: 48% adolescences with carriage disorders had osteopenic syndrome and dysfunction of calcii-phosphorum exchange and bone metabolism in compare control group.
Conclusion: carriage disorders and long conservation of negative calcium exchange lead to bone metabolism dysfunction and is one's risk factor development of osteopenic syndrome.
VLIYaNIE TERAPEVTIChESKOGO OBUChENIYa BOL'NYKh POSTMENOPAUZAL'NYMOSTEOPOROZOM na modifitsiruemye faktory riska i kachestvo zhizni
Authors: KIRPIKOVA M. N. , KOLOSKOVA N. V. , NAZAROVA O. A.
Published: January 2018

It was studied influence of the therapeutic education the patients with osteoporosis on awareness about disease, dynamic physical activity and quality of life. 42 women with osteoporosis was learned on structuring program. It was noted increase of the percent of the right answers on the questions from 50,7±2,1% to 77,2±20,2% just after education and to 71,5±15,8% after 6 months. It was marked increase of the physical activity after education also. During investigation of quality of life we found improvement on the scale of the pain, mobility, work to be done at home, social activity and general status. We didn'tfined established modification at the scale of psychological function.
Massive osteolysis - gorham-stout syndrome
Authors: Otteva E. N. , Kocherova T. Yu. , Shepichev E. V. , Otteva E. N. , Kocherova T. Yu. , Shepichev E. V.
Published: January 2018

The paper provides a detailed description of the two cases of one of the rarest diseases - Gorham-Stout syndrome. This syndrome is accompanied by the massive osteolysis of various sites of a bone tissue. The literary review is done. The isolated osteolysis of the separate bone parts is a non-malignant process, and it goes without abnormalities of its functions. The combination of osteolysis with chylothorax is an unfavorable process. The treatment of this disease is possible only by calcitonin or bisphosphonates.
AUDIT SOSTOYaNIYa PROBLEMY OSTEOPOROZA V STRANAKh VOSTOChNOY EVROPY I TsENTRAL'NOY AZII 2010
Authors: Lesnyak O. M.
Published: January 2018

This was first time when the epidemiology and burden of osteoporosis and fractures in the Eastern European and Central Asian region were studied. Aim: to study the incidence, prevalence and socio-economic burden of osteoporosis and fractures in Eastern Europe and Central Asia. Methods: the analysis of published data on prevalence, risk factors and consequences of osteoporosis in 21 countries, including Russia, was performed. Results: In countries where epidemiological data is available, fracture rates are high, and vary depending on the age of the population. Osteoporosis and fractures are and will continue to be a major public health burden, escalating as the proportion of people over 50 years of age increases. In the majority of the countries under Audit there is lack of modern standards of care given for patients with osteoporosis: large proportion of hip fractures patients are not hospitalized and not surgically treated, diagnostic facilities and reimbursement policies for antiosteoporotic drugs are poor. The average daily calcium intake in nearly all countries outlined in the report falls far below the FAO/WHO recommendations. In addition the majority of populations in the region suffer from severe vitamin D insufficiency. These findings should serve to focus the attention of governments and health authorities on the devastating and growing problems posed by osteoporotic fractures in the region.
KOSTNAYa MASSA I KOSTNYY METABOLIZM U DETEY S YuVENIL'NYM IDIOPATIChESKIM ARTRITOM
Authors: KOSTIK M. M. , MNUSKINA M. M. , MAKAROVA I N , KUZ'MINA D. A. , ShchEPLYaGINA L. A. , LARIONOVA V. I.
Published: January 2018

This study describes bone metabolism in children withjuvenile idiopathic arthritis (JIA), association between disturbances of bone metabolism with inflammatory activity, juvenile arthritis disease course and therapy in 198 children. Low bone mineral density (BMD) for chronological age was detected by dual-energy X-ray absorptiometry of lumbar spine L1-L4 (densitometer Hologic QDR 4500C, with pediatric reference database) than Z -score < -2 SD in 36 children (18,2%), in 18 girls (15,5%) and in 18 boys (21,9%). Girls with low BMD received glucocorticoids (GCS) in 66,7 % cases, and girls with normal BMD received it in 26,5% cases (р=0,002). Girls with low BMD had lower height, weight, earlier age of disease onset and higher clinical and laboratory parameters of arthritis activity. Girls with low BMD had higher osteocalcin and tendency to decreased parathyroid hormone levels compared to the girls with normal BMD. Children who received GCS had specific stereotypic changes: boys had significantly lower bone mineral density and total Ca and girls had significantly lower bone mineral content and BMD (g/cm2 and Z-score), total Са, non-organic phosphate and total alkaline phosphatase activity. Patients with systemic arthritis had significantly lower mineralization and bone metabolism turnover compared to children with oligoarticular and polyarticular JIA subtypes. Independent predictors of skeletal mineralization were age onset f JIA (р<0,0001), duration of the disease (p<0,0001), hemoglobin level (р=0,004), total calcium level (р=0,024), a2-globulins level (р=0,046). Independent predictors of low BMD were physician’s assessment VAS (р=0,024), C-reactive protein (р=0,04), inorganic phosphate (р=0,05). Systemic glucocorticoids exposure elevated the risk of low BMD for chronological age realization in JIA patients (OR=1,96, 95%CI=0,76-5,05). Enhanced risk of low BMD was in polyarthicular (OR=2,53, 95%CI=0,66-9,65) and systemic JIA (OR=3,16, 95%CI=0,73-13,76). Thus, parameters of inflammation have negative influence on bone metabolism velocity, linear growth and accordingly bone mineralization. Described factors explain heterogeneity of mineralization disorders.
RISK FACTORS OF LOW BONE MINERAL DENSITY IN CHILDREN WITH CELIAC DISEASE
Authors: Mukhina Yu G , Banina T V , Scheplyagina L A
Published: January 2018

The study shows that the long-term non-adherence to glutenfree diet, growth retardation, biological maturation are factors that adversely affect the parameters of BMC and BMD. On gluten-free diet patients with celiac retain physiological principles of accumulation of the mineral and bone remodeling in the skeleton.
THE EDUCATIONAL PROGRAM FOR PATIENTS WITH OSTEOPOROSIS AND ITS IMPACT ON ADHERENCE TO TREATMENT: RESULTS OF A MULTICENTER RANDOMIZED TRIAL
Authors: Evstigneeva L P , Lesnyak O M , Kuznetsova N M , Safonova Yu A , Bulgakova S V , Kirpikova M N , Strunina M V , Telyuschenk M V , Nekrasova M R , Nesmeyanova O B , Vorob’yova A A
Published: January 2018

Introduction: Adherence to treatment in osteoporosis (OP) remains poor. Educating patients is the possible way for improving the situation. Purpose: To evaluate the effect of different forms of educational programs on treatment adherence. Materials and methods: 479 patients (mean age 66.1±7.9 years, 98.1% were women) with osteoporosis from seven centers of Russia were included in the study. The patients were randomly assigned to two groups. Treatment group (241 subjects) was trained at the School of the OP for 4 classes using interactive teaching methods with 7-10 people at a time. Patients of the control group (238 subjects) received information on the OP as a booklet. The number of patients taking calcium and vitamin D, as well as antiosteoporotic medications was not significantly different between groups at baseline. Patients had four centers interim visits at 3 and 6 months. The final visit for all patients was 12 months. Adherence was assessed at 12 months. Results: After the educational program 78.6% of study group and 80.1% of the control group took calcium with vitamin D regularly during 12 months (p>0.05). Antiosteoporotic medications were taken regularly by 55.4% of intervention and 35.1% of the control group, p<0,001. Other factors affecting adherence were: maternal hip fracture (OR=3,09; 1,55-6,16), intermediate visits at 3 and 6 months (OR=2,41; 1,47-3,96), the presence of disability group (OR=2,03; 1,35-3,06). Conclusion: Patient education in the classroom in small groups using interactive methods more effectively influences adherence than getting the information from a booklet.
THE INFLUENCE OF INFLIXIMAB THERAPY ON BONE MINERAL DENSITY IN PATIENTS WITH ANKYLOSING SPONDYLITIS
Authors: Raskina T A , Pirogova O A
Published: January 2018

Introduction. There is evidence that patients with ankylosing spondylitis (AS) in the early stages of the disease have a significantly decreased bone mass. However, the prevalence of osteoporosis, and the mechanism of its development in the AS are poorly understood. The appearance of inhibitors of tumor necrosis factor alpha (TNF-α) significantly improved the prognosis and quality of life of patients with AS. The largest clinical experience has been gained in relation to infliximab (INF). Purpose. To assess the impact of IFN therapy on BMD of the femoral neck in patients with AS. Materials and Methods. We observed 65 male patients with a diagnosis of AS (according to the modified New York criteria 1984). In a deployed or late stage of the disease, with a high degree of activity — BASDAI > 4.0. All patients were divided into 2 groups: group 1 (n=25) — patients receiving combination therapy NSAIDs and IFN, group 2 (n=40) — patients with monotherapy at standard doses of NSAIDs (diclofenac 150 mg/ day, 200 mg of nimesulide/day meloxicam, 15 mg/day). IFN was administered a dose of 5 mg/kg of patient body weight: 1st day after 2 weeks and 6 weeks after the first injection, and after every 8 weeks. Follow-up for BMD was performed at 0 and 24 months. Results. We saw the BMD reduction at femoral neck in all patients with AS. During therapy with IFN BMD parameters showed a trend toward stabilization, which is probably due to a decrease in activity of the disease.
COMPARATIVE EFFICACY OF INTRAARTICULAR THERAPY OF GONARTHROSIS WITH HYALURONIC ACID OF DIFFERENT MOLECULAR WEIGHT (A DOUBLE-BLIND RANDOMI7ED STUDY)
Authors: Vas’kova N V , Lesnyak O M
Published: January 2018

Objectives. To study the comparative efficacy and safety of intra-articular treatment of knee osteoarthritis (OA) with hyaluronic acid (HA) of different molecular weights (MW). Material and methods. Randomized double-blind controlled study included 50 patients with osteoarthritis of the knee stage II-III, weight-bearing pain more 40 mm on VAS and Lequesne index score > 4 and < 12. 25 patients received HA with MW 3500 kDa (Rusvisk group) and 25 patients were treated with HA with MW 1200-1400 kDa (Ostenil group) injected at 3-weekly intervals. During the 22-week observation period we assessed dynamics of pain on VAS (weightbearing pain, pain at rest), index WOMAC, and recorded the overall assessment of the effectiveness of therapy by patient and physician, OMERACT-OARSI criteria and the need for NSAIDs. Results. One week after the last injection, a significant decrease in weight-bearing pain (in the group Rusvisk by 69% in the group Ostenil 55%) and the total index WOMAC (group Rusvisk by 63% in the group Ostenil 60%), continuing until the end of observation. A significant decrease in pain at rest observed in the group Rusvisk at all visits and in the group Ostenil only at 6 and 10 weeks of therapy. The overall evaluation of effectiveness of therapy by patient and physician yielded the benefits observed in high molecular HA group. A high percentage of responses to therapy using OMERACT-OARSI criteria and reduced need for NSAIDs were observed in both groups. Tolerability was satisfactory and did not differ significantly between the groups. Most common adverse reactions were mild pain at the injection site. Conclusion. Intra-articular therapy with HA of different molecular weight Rusvisk and Ostenil resulted in pain reduction and improved joint function in patients with knee OA with satisfactory tolerability.
MICROELEMENTS IN THE PREVENTION OF OSTEOPOROSIS: FOCUS ON SILICON
Authors: Skripnikova I A , Gur’ev A V
Published: January 2018

The present review of literature is focusing on the role of the trace element silicon in the process of remodeling of bone tissue and exploring the possibility of using the silicon-containing supplements in the complex prevention of osteoporosis. The experimental studies had proved the involvement of silicon in the development of connective tissue, formation and mineralization of bone tissue. A few clinical trials showed a positive effect of silicon supplements on the bone mass and markers of a bone metabolism. Because the potential biological role of silicon in osteogenesis was not completely studied the growing attention of the scientific medical community to this important nutrient will improve the understanding of its role and place in the formation of healthy bone tissue, and its use to prevent the development of osteoporosis.
THE ROLE OF VITAMIN D IN THE PATHOGENESIS OF CHRONIC NON-COMMUNICABLE DISEASES
Authors: Egshatyan L V , Dudinskaya E N , Tkacheva O N , Kashtanova D A
Published: January 2018

This review shows the role of vitamin D in the regulation of not only the level of calcium, but also in the pathogenesis of chronic systemic inflammation, disruption of insulin sensitivity of tissues. The sufficient levels of vitamin D in the blood can lead to reduced risk of developing type 2 diabetes, obesity, autoimmune destruction of pancreatic β-cells, certain cardiometa-bolic risk factors, and therefore cardiovascular disease. Perhaps preparations of vitamin D in the near future may become additional and necessary nutritional substances for correction of insulin resistance, cardiovascular disease, chronic inflammation and prevention of disorders of glucose metabolism.
THE RUSSIAN COUNCIL OF ExPERTS FOR IMPROVEMENT THE APPROACHES TO THE TREATMENT OF OSTEOPOROSIS
Authors: Volna A A , Ershova O B , Farba L Ya
Published: January 2018

The meeting of the Russian Council of Experts for improvement the approaches to the treatment of osteoporosis (OP) was held in Moscow on December 4, 2014. Leading Russian and Switzerland specialists in orthopedics, traumatology and rheumatology attended the meeting as well as members of Russian unit of clinical department AOTrauma of the international public (non-government) organization AOFoundation and members of the Russian Osteoporosis Association. The participants of the Russian Council of Experts have discussed the system of care for patients with OP in the Russian Federation. They discussed the need for the development of measures to optimize interdisciplinary interaction between orthopedic surgeons and internal medicine specialists in the treatment of patients with OP to reduce the number of postsurgical complications and prevention of further vertebral and nonvertebral fractures. Experts have noted the need to raise the level of knowledge about OP in orthopedic surgeons, clinical characteristics of fractures in patients with OP and measures to control it; to raise awareness of OP among patients by billboards in clinics and outpatient emergency rooms; to develop and implement into clinical practice of orthopedic surgeons standard of care for elderly patients with fragility fractures; to develop algorithm of secondary fractures prevention through the prescription of pathogenic OP therapy at the level of the trauma unit; to form an interdisciplinary system of the medical care for patient with fragility fractures, as well as contribute to the organization of the service Secondary Fractures Prevention (Fracture Liaison Service) in the Russian health care system.
THE LEVEL OF VITAMIN D IN PEOPLE OLDER THAN 50 YEARS RESIDING IN THE REPUBLIC OF BASHKORTOSTAN IN THE PERIOD OF MAXIMUM INSOLATION
Authors: Nurlygayanov R Z , Syrtlanov E R , Minasov T B , Borisov I V
Published: January 2018

Aim. To study the vitamin D levels in the period of maximal sun exposure in individuals older than 50 years residing in the Republic of Bashkortostan, to compare them with the levels during the period of the minimum insolation. Materials and methods. In the period of high insolation in 175 people aged over 50 years residing in the city (Ufa) and rural areas of the Republic of Bashkortostan, we investigated the levels of 25 (OH) D and parathyroid hormone (PTH) by the indirect ELISA. Results. We show that the senior age groups of the population of the Republic of Bashkortostan even in the period of the maximum insolation are characterized by the high frequency of hypovitaminosis and deficiency of vitamin D. The level of vitamin D is higher in the period of the maximum insolation, and in rural areas, this increase is more prominent. Levels of vitamin D and PTH in the period of the maximum insolation do not depend on male or female sex, and do not differ in rural and urban population. Conclusions. In general, our results show that the problem of deficiency of vitamin D for senior citizens remains of high relevance even in the period of the maximum insolation.
SUMMARY OF CLINICAL GUIDELINES OF THE RUSSIAN ASSOCIATION OF ENDOCRINOLOGISTS VITAMIN D DEFICIENCY IN ADULTS: DIAGNOSIS, TREATMENT AND PREVENTION
Authors: Pigarova E A
Published: January 2018

Vitamin D belongs to the group of fat-soluble vitamins. It is naturally present in only a very limited amount of food, and the synthesis in the human body is possible only under certain conditions - when the UV rays of sunlight fall on the skin. National and foreign studies show that the insufficiency of vitamin D, defined as levels of 25(OH)D less than 30 ng/ml or less than 20 ng/ml, is widespread throughout the world. This publication is a shortened version of the guideline «Vitamin D deficiency in adults: diagnosis, treatment and prevention» which was approved on February 27th, 2015 at the session «National clinical guidelines for the diagnosis and treatment of endocrinopathies» at the VIIth All-Russian Congress of Diabetes.
THE ROLE OF THE PHYSICIAN IN THE DETECTION AND TREATMENT OF OSTEOPOROSIS IN PATIENTS WITH FRACTURES OF THE RADIUS
Authors: Yevstigneyeva L P , Kuznetsova E V , Nizamutdinova R M
Published: January 2018

Introduction: fracture of distal part of forearm at a low level of a trauma with women in the age of 50 and elder is the index to osteoporosis and serves as reason to get tested for the diagnosis of OP. However, osteoporosis isn’t often diagnosed and treated with patients with such localization of fracture. The purpose: to estimate of detection and treatment of osteoporosis at the patients of senior age group with fracture of distal part of forearm and influence of traumatologist’s information on their changes. Materials and methods: The study was conducted in two stages. At the first stage a retrospective analysis of a sample of 104 patients aged 50 years and older who underwent fracture of distal part of forearm with a low level of injury was conducted. At the second stage a controlled trial with the inclusion of 121 women aged 50 years and older with fracture of distal part of forearm obtained with a low level of injury was carried out. The patients of intervention group (56 patients, the median age was 61.3 ± 8.6) received information about osteoporosis, assignment to densitometry and recommendation of treatment from traumatologist. The patients of control group (65 patients, the median age was 63.5 ± 8,1) were conducted as it was established in practice of the department of traumatology. There was a questioning of all patients who had been included in investigation after 6 months since fracture. Osteoporosis investigation and treatment were estimated at both stages. Results: osteoporosis was identified in 18 (17.3%) patients, densitometry was performed in 6 (5.8%) patients, calcium and D3 were taken 13 (12.5%) patients, medications of pathogenic action - 2 (1.9%) patients in a retrospective study. By the results of the second phase of the study densitometry was performed in 26 (46.4%) patients of intervention group and 2 (3.1%) patients of control group, р<0.0001. 31 (55.4%) patients of intervention group and 23 (35.4%) patients of control group began to take calcium and D3, p=0,0276. 7 (12.5%) patients of intervention group and 2 (3.1%) patients of control group began the treatment with pathogenetic medications, p=0.051, in 6 months pathogenetic medications took 12.5 % persons of intervention group and 1.5 % patients of control group, p=0.018. Conclusion: the patients with fracture of distal part of forearm at a low level of a trauma concern to group of the high risk of osteoporosis, but most of them remain without corresponding examination and treatment. Information about osteoporosis, assignment to densitometry and recommendation by treatment from traumatologist is an effective way to motivate patients to perform densitometry and start treatment.
CREATION OF SERVICES FOR PREVENTION OF RECURRENT BONE FRACTURES IN PATIENTS WITH OSTEOPOROSIS
Authors: Kochish A Yu , Lesnyak O M , Zotkin E G , Ivanov S N , SafonovaYuA Yu A
Published: January 2018

This article is dedicated to the problem of creating off fracture liaison services (FLS) for patients with osteoporosis including overview of the problem and some recommendations on it. The article presents there levance of the problem discussed, gives recommendations of the IOF working group,shows an international and Russian experience of FLS creation, its medical-economic effectiveness and discus the key moments that provide effectiveness of fracture liaison services for patients with osteoporosis. The recommendations part includes goals, main working directions and principles of FLS creation in the Russian Federation. They are based on the "Prometheus" program that was introduced by the Russian Osteoporosis Association and became the first national experience of organizing fracture liaison service. According to author’s point of view the information from this article can be help full in organizing FLS invarious medical institutionsin our country and can be used to reduce the negative effects of repeated osteoporosis fractures.
SchauSpielPlatz Venedig
Authors: Volz Dorothea
Published: January 2018

Wie wird durch eine Dynamisierung der Bewegung auch die Imagination in Bewegung versetzt? Wie lässt eine zunehmende Bewegtheit der Bilder vom Panorama über die Drehbühne bis hin zum frühen Film neue, teils immersive Vorstellungswelten entstehen? Ausgehend von den pulsierenden Metropolen des 19. Jahrhunderts widmet sich Dorothea Volz aus kulturwissenschaftlicher Perspektive der Rezeptionsgeschichte Venedigs. Ihre Studie verbindet Ansätze der historischen Konsum-, Reise- und Tourismusforschung mit Beispielen einer spielerischen Stadtaneignung und -hervorbringung im Spiel.
»nicht, weil wir es für schön halten«
Authors: Herold Stephanie
Published: January 2018

Das Schöne wird seit den Anfängen denkmaltheoretischer Überlegungen als wertstiftende Kategorie explizit ausgeklammert. Gleichzeitig wird es implizit ständig verhandelt, sei es im theoretischen Kontext oder in der Auseinandersetzung um das »schöne« Denkmal in der Praxis. Ausgehend von dieser Diskrepanz untersucht Stephanie Herold die Rolle des Schönen in der Denkmalpflege von deren Anfängen im 19. Jahrhundert bis in die heutige Zeit. Dabei geht sie nicht nur möglichen historischen Gründen für das ambivalente Verhältnis der Denkmalpflege zum Schönen nach, sondern fragt zudem, ob ein anderer Umgang mit dem Thema möglich ist, um neue Potenziale zu erschließen.
Unheimliche Geschichte
Authors: Knittel Susanne C.
Published: January 2018

Warum gehen manche Geschehnisse in die Geschichte einer Nation ein? Warum werden andere vergessen oder gar unterdrückt? Und wie und warum kommen diese wieder zum Vorschein? Susanne C. Knittel analysiert verdrängte Aspekte des Zweiten Weltkrieges und des Holocausts in den Erinnerungskulturen Deutschlands und Italiens nach 1945. Diese tauchen beharrlich auf und stören den dominanten Erinnerungsdiskurs, dessen Gedenkrituale und etablierte Vorstellungen: die NS-»Euthanasie« einerseits und die Verbrechen des italienischen Faschismus sowie die Kollaboration mit den deutschen Besatzern andererseits. Durch eine vergleichende Betrachtung von Gedenkstätten sowie künstlerischen und literarischen Darstellungen, die diesen Verbrechen und ihren Opfern gewidmet sind, entsteht ein zwiespältiges Porträt der Holocausterinnerung in Europa. Aus dem Amerikanischen von Eva Engels, Elisabeth Heeke und Susanne C. Knittel.
Die Neue Berliner Schule und die chinesische Sechste Generation
Authors: Tang Yuanyuan
Published: January 2018

Ist es möglich, durch den Vergleich zweier zeitgenössischer Filmströmungen unterschiedlicher kultureller Provenienz neue Aspekte im Wesen der Ästhetik sowie in soziokulturellen Phänomenen des Zeitgeistes zu erkennen? Wie treten die Effekte der Verfremdung und der realistischen Ästhetik, die in der Forschung bisher als zwei gegensätzliche Konzepte behandelt werden, in den Werken der Neuen Berliner Schule und der chinesischen Sechsten Generation zueinander in Verbindung? In ihrem inter- und transkulturellen Vergleich widmet sich Yuanyuan Tang nicht nur der kulturellen Ebene, sondern nimmt auch Bezug auf weitere Aspekte, etwa sozialpolitische Phänomene oder ästhetische Konzeptionen.
Korrespondenten des Wandels
Authors: Heidelberger Martin
Published: January 2018

Wie entstehen unsere Bilder der Welt? Der Auslandsjournalismus des 21. Jahrhunderts stützt sich zunehmend auf lokale Akteure der globalen Nachrichtenindustrie, die häufig als lokale »Stringer« oder »Fixer« bezeichnet werden. Auf Basis von Feldforschungen in Indien und Europa untersucht Martin Heidelberger diese lokale Teilhabe an der globalen Nachrichtenindustrie aus einer ethnologischen Perspektive. Er zeichnet nach, wie lokale Akteure in der Praxis Zugänge für reisende Journalisten herstellen, wie sie vor Ort übersetzen, Interviews übernehmen oder Medienprodukte für Auslandsredaktionen autonom produzieren. Die Studie zeigt, wie bei der journalistischen Kooperation lokale Standpunkte wirksam werden, die den Auslandsjournalismus verändern.