bluuebunny/crossref_metadata_2025 huggingface dataset:
High Prevalence of Vitamin D Deficiency in Patients With Bone Marrow Edema Syndrome of the Foot and Ankle
Authors: Horas Konstantin , Fraissler Lukas , Maier Gerrit , Jakob Franz , Seefried Lothar , Konrads Christian , Rudert Maximilian , Walcher Matthias
Published: March 2017

Background:

Bone marrow edema syndrome (BMOS) is a phenomenon primarily affecting the lower extremity. It is characterized by a sudden onset of pain and an ill-defined osseous hyperintense signal in magnetic resonance imaging. The main cause of BMOS is still largely unknown. Its pathophysiology is presumably multifactorial and it has recently been demonstrated that it usually involves an increase in bone turnover and alterations within the bone microenvironment. Vitamin D plays a pivotal role in maintaining a healthy and well-balanced bone microenvironment. However, to date only limited information has been reported on vitamin D status in patients with BMOS. Moreover, it is still uncertain whether hypovitaminosis D is associated with the etiology and course of the disease. For this reason, the aim of this study was to determine serum vitamin D levels (25(OH)D) of patients diagnosed with BMOS of the foot and ankle.

Methods:

Patients were identified and laboratory results collected by retrospective review of the medical records between year 2011 and 2015. Diagnosis was based on clinical examination, the existence of prolonged foot pain, the presence of abnormal bone marrow signal intensity in T1- and T2-weighted magnetic resonance imaging, and the patient’s medical history. All patients who demonstrated other concomitant diagnoses were excluded from the study.

Results:

Overall, 31 patients were affected by BMOS with a mean age of 44.4 (range, 18-76) years. Notably, 84% of patients (26/31) had low vitamin D levels with a mean 25(OH)D level of 19.03 ng/mL. Specifically, 61% of patients (19/31) were vitamin D deficient, 23% (7/31) vitamin D insufficient, and only 5 patients (16%) had sufficient vitamin D levels. Statistical analysis showed no significant difference comparing vitamin D levels with patient age, sex, and time of diagnosis. Moreover, there was no correlation between vitamin D status and the number of bony foci or location of BMOS.

Conclusion:

We found a widespread rate of vitamin D deficiency in patients presenting with BMOS of the foot and ankle. Comparing these data to the vitamin D status of the general population in Germany and to patients living in comparable latitudes, this raises the possibility that BMOS might be associated with low vitamin D status.

Level of Evidence:

Level IV, retrospective case series.
Animation as a Science Communication Tool in Timor-Leste
Authors: McGillion Chris
Published: March 2017

This article examines the trial of animated video to disseminate new agricultural knowledge among subsistence farmers in Timor-Leste, a small underdeveloped country in Southeast Asia. The aim of the trial was to test the potential for this approach to supply clear, accurate, and engaging information to rural communities where rates of adult illiteracy are high and mass media consumption is low. The findings point to the potential for animation to be used to communicate scientific knowledge in situations where approaches regularly employed in developing countries are unavailable or would be limited in their reach.
Thirty Years of a Science Communication Course in Australia
Authors: McKinnon Merryn , Bryant Chris
Published: March 2017

Since 1985, the Science Circus program has recruited science graduates Australia-wide and provided them with science communication training leading to a university degree. On qualifying these graduates demonstrate highly diverse career paths reflecting the relevance of science communication training to other disciplines. Graduates, by their activities, have contributed to the growth of science communication as an academic discipline and an “industry”—both in Australia and abroad. It suggests that science communication training can have impact far beyond narrowly defined disciplines and skill sets, and this impact is worthy of further exploration.
Catalyzing Public Engagement With Climate Change Through Informal Science Learning Centers
Authors: Geiger Nathaniel , Swim Janet K. , Fraser John , Flinner Kate
Published: March 2017

Using the head, heart, and hands model, we examined a training program designed to catalyze national public engagement with climate change through informal science learning centers (e.g., aquariums, zoos). Survey data were collected from visitors ( N = 7,285) observing 1,101 presentations at 117 U.S. institutions before and after presenters participated in communication training. Visitors who attended posttraining (vs. pretraining) presentations reported greater understanding of climate change (head), hope (heart), and intentions to engage in community action (hands). As hypothesized, results suggested these changes were due to an increase in presenters’ discussion of climate change and use of effective communication techniques.
Engaging the Public at a Science Festival
Authors: Rose Kathleen M. , Korzekwa Kaine , Brossard Dominique , Scheufele Dietram A. , Heisler Laura
Published: March 2017

Theoretically and methodologically sound research on the reach and impact of public engagement practices continues to lag behind. Using the 2015 Wisconsin Science Festival as context, we empirically investigate the impacts of a public engagement activity about a nascent and controversial scientific issue, human gene editing. Overall, we find the panel increased participants’ understanding of the complexities of human gene editing, as demonstrated by increases in knowledge and the moral acceptability of the technology among respondents, as well as the associated risk and benefit perceptions. Practical and theoretical implications for science festivals and public engagement with science activities are discussed.
Full and folded forms: a compact review of the formulation of tensegrity structures
Authors: Hernández-Montes E , Fernández-Ruiz MA , Gil-Martín LM , Merino L , Jara P
Published: March 2017

This piece of work presents a simple and compact overview of the design problem of tensegrity structures in two and three dimensions. The main aim of this study is to present the design and calculation of tensegrity structures in their simplest form, avoiding unnecessary simplifications that can rule out solutions, as has happened up until now. As a result of the simplicity of the procedure, two types of tensegrity structures are obtained for the same initial topology: full and folded forms. Several examples are shown.
An examination of LGBTQ-inclusive strategies used by practicing music educators
Authors: Garrett Matthew L. , Spano Fred P.
Published: March 2017

The purpose of this research was to examine LGBTQ-inclusive strategies used by practicing music educators in the United States. Participants ( N = 300) in a nonprobabilistic sample completed a survey inquiring as to their comfort using LGBTQ-inclusive strategies in a school music class, their perceptions of barriers to LGBTQ inclusion, and whether they had received training related to LGBTQ issues. Self-identified heterosexual respondents were requested to complete an additional set of questions to determine their attitudes toward lesbians and gay men. Additional questions were used to capture demographic data including (1) years of teaching experience, (2) school and community types, and (3) racial, ethnic, gender, and sexual identity. Results revealed that respondents self-identifying as heterosexual generally held positive attitudes toward lesbians and gay men. Results suggest that music teacher participants in this study were aware of heterosexist language in their learning environments and likely to discourage this type of classroom behavior. Overall, respondents appeared not to be worried about the various stakeholders (administrators, parents, and colleagues) in their educational environment. The majority of music teachers surveyed indicated that they received no pre-service training (91.3%, n = 274) and no in-service training (87.3%, n = 262) relevant to LGBTQ inclusion. Respondents who had received in-service training, however, were more comfortable discussing LGTBQ issues in their classrooms and promoting LGBTQ awareness in their schools. Findings from this study suggest that in-service professional development related to LGBTQ issues may increase the use of LGBTQ-inclusive strategies used in music classrooms.
Polio monologues: translating ethnographic text into verbatim theatre
Authors: Shah Sonali , Greer Stephen
Published: March 2017

Mass vaccination programmes mean that poliomyelitis is almost a forgotten memory in the Global North. But in reality its effects continue as many people who contracted paralytic polio in childhood may develop functional deterioration (Post-Polio Syndrome or PPS) in later adulthood; mass migration and escape from violence means that it is also re-emerging in contemporary societies. Thus it is crucial for different audiences to have opportunities to engage with, and understand the life histories of polio survivors and their personal experiences of disease and disability across biographical and historical time. This article discusses the process of using recorded delivery verbatim techniques, with disabled and non-disabled actors, to translate ethnographic research about social history of polio into a creative accessible medium for new generation audiences to learn about the hidden, often contested, histories of disability and disease that may collide with professional, medical and public discourse. Our contention is that ethnodrama can give a voice to the voiceless, and enable them to contribute to the production of new knowledge, health interventions and policy instruments that affect their lives.
The discovery of surplus value: Karl Marx and Senior’s ‘last hour’
Authors: Smith Kenneth
Published: March 2017

This essay claims to discover the point at which Marx worked out his theory of surplus value sometime during the 10-year period between 1857 and the publication of Capital Vol. I in 1867. This, it is claimed, was due to his reading of a well-known pamphlet by an English Oxford University professor of political economy, Nassau W. Senior. Senior had claimed that capitalist manufacturers made all of their profit during the last hour of the then normal 12-hour working day. Marx knew that this was incorrect since, if Senior was right, the capitalists might just as well employ their workers for this 1 hour alone and not bother with the other 11 hours of the working day. The workers must then have been doing something else which was of value to the capitalists over and above merely producing their profit. This something else Marx realised was nothing less than the renewal of the worn out fabric of the capitalist enterprise and hence, along with this, the recreation year after year of the capitalists claims to be the legitimate owners of the enterprise. This essay then also claims to have identified two letters by Marx written just 11 months apart which might help to further date the discovery of surplus value, in the first of which, written in 1862, Marx gives Senior’s incorrect view of surplus value as profit and in the second of which, written in 1863, he gives his mature view of surplus value as profit plus the recreation of the capitalist mode of production itself. Having made this theoretical breakthrough by 1863, Marx finally stopped making notebooks and threw himself into the writing of Capital Vol. I in 1864, the year in which by chance Nassau Senior died.
Cost and weight of composite ship structures: A parametric study based on Det Norske Veritas rules
Authors: Håkansson Måns , Johnson Erland , Ringsberg Jonas W
Published: March 2017

A wider use of composites in larger, commercial vessels has been limited by initial costs and fire regulations, but both of these obstacles are diminishing. Increasing fuel costs and more stringent emission requirements have heightened the value of lightweight structures. Due to the higher acquisition costs and other entry barriers, composite designs must be as cost efficient as possible in order to compete with traditional steel or aluminium designs. The purpose of this article is to investigate which fibre-reinforced polymer materials and types of structures are most suitable for different parts of a ship design in order to minimize weight or cost. This is done by designing and comparing individual composite panels while varying a wide range of input parameters and strictly following the ‘Det Norske Veritas (DNV) Rules for Classification of High Speed, Light Craft and Naval Surface Craft’. The results are presented as weight and cost comparisons between materials and structures and also degree of utilization for the different design criteria; carbon fibre structures are on the average 20%–30% lighter than glass fibre structures but are consistently more expensive. The results also indicate that sandwich panels in most cases are lighter than single-skin panels, and that for sandwich structures, the mechanical properties of the core material are commonly the critical design criterion. The minimum amount of reinforcement stipulated by the rules is also found to be a critical factor.
Absorbable Meshes in Inguinal Hernia Surgery: A Systematic Review and Meta-Analysis
Authors: Öberg Stina , Andresen Kristoffer , Rosenberg Jacob
Published: March 2017

Purpose. Absorbable meshes used in inguinal hernia repair are believed to result in less chronic pain than permanent meshes, but concerns remain whether absorbable meshes result in an increased risk of recurrence. The aim of this study was to present an overview of the advantages and limitations of fully absorbable meshes for the repair of inguinal hernias, focusing mainly on postoperative pain and recurrence. Methods. This systematic review with meta-analyses is based on searches in PubMed, Embase, Cochrane, and Psychinfo. Included study designs were case series, cohort studies, randomized controlled trials (RCTs), and non-RCTs. Studies had to include adult patients undergoing an inguinal hernia repair with a fully absorbable mesh. Results. The meta-analyses showed no difference in recurrence rates (median 18 months follow-up) and chronic pain rates (1 year follow-up) between absorbable- and permanent meshes. Crude chronic pain rates for the RCTs were 2.1% for the absorbable meshes and 7.6% for the permanent meshes. For the absorbable meshes, medial hernias were more susceptible for recurrence compared with lateral hernias ( P < .0005). None of the studies reported allergic reactions or other serious adverse events related to the absorbable mesh. Conclusions. Patients with an absorbable mesh seem to have less chronic pain following inguinal hernia surgery compared with permanent meshes, without increased risk of recurrence.
Open, Arthroscopic, and Percutaneous Surgical Treatment of Lateral Epicondylitis: A Systematic Review
Authors: Burn Matthew B. , Mitchell Ronald J. , Liberman Shari R. , Lintner David M. , Harris Joshua D. , McCulloch Patrick C.
Published: March 2017

Background: Approximately 10% of patients with lateral epicondylitis go on to have surgical treatment; however, multiple surgical treatment options exist. The purpose of this study was to review the literature for the clinical outcomes of open, arthroscopic, and percutaneous treatment of lateral epicondylitis. The authors hypothesized that the clinical outcome of all 3 analyzed surgical treatments would be equivalent. Methods: A systematic review was performed using PubMed, Cochrane Central Register of Controlled Trials, and Google Scholar in July 2016 to compare the functional outcome, pain, grip strength, patient satisfaction, and return to work at 1-year follow-up for open, arthroscopic, and percutaneous treatment of lateral epicondylitis. Results: Six studies (2 Level I and 4 Level II) including 179 elbows (83 treated open, 14 arthroscopic, 82 percutaneous) were analyzed. Three outcome measures (Disabilities of the Arm, Shoulder, and Hand [DASH] score, visual analog scale [VAS], and patient satisfaction) were reported for more than one category of surgical technique. Of these, the authors noted no clinically significant differences between the techniques. Conclusions: This is the first systematic review looking at high-level evidence to compare open, percutaneous, and arthroscopic techniques for treating lateral epicondylitis. There are no clinically significant differences between the 3 surgical techniques (open, arthroscopic, and percutaneous) in terms of functional outcome (DASH), pain intensity (VAS), and patient satisfaction at 1-year follow-up.
Medical Students’ Child Health Experience in Primary Schools
Authors: Muir Fiona , McConville Kevin , Robertson Lois , Campbell Karen , McKnight Shona , McKeown Kenny
Published: March 2017

This study was designed to explore medical students’ and primary school teachers’ experiences of a new community teaching project. Academic staff and students from the School of Medicine Dundee, National Health Service partners, local education department, and primary school teachers engaged in a collaborative project which has embedded community engagement in the curriculum while encouraging interprofessional education through multiagency working. Influenced by evaluative inquiry, this qualitative study used an online questionnaire, designed to give participants the freedom to respond, and give their own opinions, via free text responses. The results show the value of a real primary school–based situation, and the merit of experiential learning gained throughout the program, in which students interacted with children about health promotion in a meaningful way. The interprofessional and collaborative nature of the project enhanced the value of the experience for all participants in relation to the benefits of teamwork, dispelling the doctor authority and recognition of the roles of others. The experience was an interactive, enjoyable, and expressive way to facilitate learning, and has helped prepare the health care students for future practice.
Well, Now What Do We Do? Wait . . .: A Group Process Analysis of Meeting Lateness
Authors: Lehmann-Willenbrock Nale , Allen Joseph A.
Published: March 2017

Workplace meetings start late all the time for a number of reasons. When participants are kept waiting, this can be experienced as a drain of personal resources. In this article, we integrate perspectives from conservation of resources theory, individual goal setting, group problem solving, and temporal dynamics to derive predictions regarding individual attendees’ meeting experiences and behavioral group communication patterns under conditions of meeting lateness. We conducted an experiment using 32 student groups in which 16 groups started their meeting on time, while 16 started their meeting 10 minutes late. We found that late meetings were less satisfying than on time meetings. Using videotaped meeting interactions, we analyzed the group dynamics at the micro-level of conversational utterances. Controlling for meeting duration, groups in the lateness condition showed substantially less solution-focused communication overall, less idea elaboration, less in-depth problem descriptions, and fewer socioemotional support statements than groups who started on time. Furthermore, lag sequential analysis revealed distinctly different temporal communication patterns. We discuss research implications for understanding meeting experiences through a conservation of resources lens as well as practical implications for managing group communication processes in workplace meetings.
West Nile Virus Chorioretinitis With Foveal Involvement
Authors: Yau Gary L. , Chin Eric K. , Parke D. Wilkin , Bennett Steven R. , Almeida David R. P.
Published: March 2017

Purpose:

To describe the clinical course of foveal West Nile virus (WNV) chorioretinitis with longitudinal spectral domain optical coherence tomography (SD-OCT) imaging.

Methods:

Case report.

Results:

A 41-year-old man with diabetes mellitus presented with flashes and floaters of both eyes (OU) and decreased vision of the right eye (OD) 2 weeks after being discharged from a local hospital. He had been treated for WNV meningoencephalitis, and he recovered systemically with supportive therapy. Ophthalmic examination revealed WNV chorioretinitis bilaterally, with predominantly foveal involvement OD. His best-corrected visual acuity (BCVA) was 8/200 OD and 20/20 of the left eye (OS). Spectral domain optical coherence tomography revealed 2 distinct lesion types—the “classic” outer retinal lesion and an intraretinal lesion. Both lesions had associated disruption of the normal outer hyperreflective retinal layers on SD-OCT. Longitudinal SD-OCT over the ensuing 6 weeks revealed a gradual reconstitution of these layers, with BCVA concurrently improving to 20/40 OD.

Conclusion:

We describe the consecutive findings seen on SD-OCT of retinal lesions in WNV chorioretinitis. The tomographic natural history of these lesions involved reconstitution of OCT deficits, with corresponding improvement in functional visual status.
Pilot Educational Intervention and Feasibility Assessment of Breast Ultrasound in Rural South Africa
Authors: Dickerson Lindsay K. , Rositch Anne F. , Lucas Susan , Harvey Susan C.
Published: March 2017

Purpose

Breast cancer is the leading cause of cancer death in women worldwide, with high mortality in low- and middle-income countries because of a lack of detection, diagnosis, and treatment. With mammography unavailable, ultrasound offers an alternative for downstaging. The literature reports successful training in various domains, but a focus on the breast is novel. We assessed the feasibility (knowledge acquisition, perceived usefulness, and self-efficacy) of breast ultrasound training for nonphysician providers.

Methods

Training was implemented for 12 providers at Hlokomela Clinic in Hoedspruit, South Africa, over 3 weeks. Didactic presentations and example cases were followed by a presurvey and test (n = 12). All providers received hands-on training with nurses as models; five providers trained with patients. A post-test (n = 12) assessed knowledge acquisition and a postsurvey (n = 10) assessed perceived program usefulness and provider self-efficacy.

Results

The pre- to post-test averages improved by 68% in total and in four competencies (foundational knowledge, descriptive categories, benign v malignant, and lesion identification). On the postsurvey, providers expressed that ultrasound could significantly influence breast cancer detection (9.1 out of 10), treatment (7.9 out of 10), and survival (8.7 out of 10) in their community and endorsed moderate confidence in their scanning (6.3 out of 10) and interpreting abilities (5.6 out of 10).

Conclusion

Our research supports the feasibility of breast ultrasound training as part of a breast education program in low- and middle-income countries. Pre- and post-test results and observed proficiency indicate that training nonphysician providers is achievable; postsurvey responses indicate program acceptance, community-based ownership, and provider self-efficacy with ultrasound. Future work may show that breast ultrasound is viable for early detection where mammography is unavailable.
Killers: Orcas and Their Followers
Authors: Huggan Graham
Published: March 2017

Orcas are among the world’s most charismatic animals, combining grace and power, violent when they need to be, but rarely toward humans and never in the wild. Attacks on humans have been restricted to captive orcas, opening up widespread discussions on the ethics of marine-mammal captivity and prompting major changes to the North American orca-display industry, as represented by corporate giants such as SeaWorld. Orcas are now more likely to be followed online than watched either in captivity or in the wild, with some individual orcas becoming celebrity targets for activist campaigning. This article assesses some of the different ways that orcas are being “followed” today, showing how the figure of the celebrity orca offers an opportunity to reflect both on the performative nature of celebrity and on the continuing human exploitation of performing animals, which is tied in with the depredations of the modern corporate world.
Muscle-tendon mechanics explain unexpected effects of exoskeleton assistance on metabolic rate during walking
Authors: Jackson Rachel W. , Dembia Christopher L. , Delp Scott L. , Collins Steven H.
Published: March 2017

The goal of this study was to gain insight into how ankle exoskeletons affect the behavior of the plantarflexor muscles during walking. Using data from previous experiments, we performed electromyography-driven simulations of musculoskeletal dynamics to explore how changes in exoskeleton assistance affected plantarflexor muscle-tendon mechanics, particularly for the soleus. We used a model of muscle energy consumption to estimate individual muscle metabolic rate. As average exoskeleton torque was increased, while no net exoskeleton work was provided, a reduction in tendon recoil led to an increase in positive mechanical work performed by the soleus muscle fibers. As net exoskeleton work was increased, both soleus muscle fiber force and positive mechanical work decreased. Trends in the sum of the metabolic rates of the simulated muscles correlated well with trends in experimentally-observed whole-body metabolic rate (R2 = 0.9), providing confidence in our model estimates. Our simulation results suggest that different exoskeleton behaviors can alter the functioning of the muscles and tendons acting at the assisted joint. Furthermore, our results support the idea that the series tendon helps reduce positive work done by the muscle fibers by storing and returning energy elastically. We expect the results from this study to promote the use of electromyography-driven simulations to gain insight into the operation of muscle-tendon units and to guide the design and control of assistive devices.
Signing Up New Fathers: Do Paternity Establishment Initiatives Increase Marriage, Parental Investment, and Child Well-Being?
Authors: Rossin-Slater Maya
Published: March 2017

With nearly half of US births occurring out of wedlock, understanding how parents navigate their relationship options is important. This paper examines the consequences of a large exogenous change to parental relationship contract options on parental behavior and child well-being. Identification comes from the staggered timing of state reforms that substantially lowered the cost of legal paternity establishment. I show that the resulting increases in paternity establishment are partially driven by reductions in parental marriage. Although unmarried fathers become more involved with their children along some dimensions, the net effects on father involvement and child well-being are negative or zero. (JEL I31, J12, J13, K36)
Structural landscape of base pairs containing post-transcriptional modifications in RNA
Authors: Seelam Preethi P. , Sharma Purshotam , Mitra Abhijit
Published: March 2017

Base pairs involving post-transcriptionally modified nucleobases are believed to play important roles in a wide variety of functional RNAs. Here we present our attempts toward understanding the structural and functional role of naturally occurring modified base pairs using a combination of X-ray crystal structure database analysis, sequence analysis, and advanced quantum chemical methods. Our bioinformatics analysis reveals that despite their presence in all major secondary structural elements, modified base pairs are most prevalent in tRNA crystal structures and most commonly involve guanine or uridine modifications. Further, analysis of tRNA sequences reveals additional examples of modified base pairs at structurally conserved tRNA regions and highlights the conservation patterns of these base pairs in three domains of life. Comparison of structures and binding energies of modified base pairs with their unmodified counterparts, using quantum chemical methods, allowed us to classify the base modifications in terms of the nature of their electronic structure effects on base-pairing. Analysis of specific structural contexts of modified base pairs in RNA crystal structures revealed several interesting scenarios, including those at the tRNA:rRNA interface, antibiotic-binding sites on the ribosome, and the three-way junctions within tRNA. These scenarios, when analyzed in the context of available experimental data, allowed us to correlate the occurrence and strength of modified base pairs with their specific functional roles. Overall, our study highlights the structural importance of modified base pairs in RNA and points toward the need for greater appreciation of the role of modified bases and their interactions, in the context of many biological processes involving RNA.
Barreiras percebidas para a prática de atividade física entre universitários de Educação Física
Authors: Pinto André , Claumann Gaia , Cordeiro Paloma , Felden Erico , Pelegrini Andreia
Published: March 2017

O objetivo deste estudo foi identificar as barreiras percebidas para a prática de atividade física entre universitários de Educação Física de Florianópolis, e testar a associação dessas barreiras percebidas com o nível de atividade física entre os cursos de Bacharelado e Licenciatura em Educação Física. Participaram 301 universitários (173 homens e 128 mulheres) do curso de Educação Física (161 da Licenciatura e 140 do Bacharelado), com média de idade de 23,1(4,9) anos. Foram coletadas informações sociodemográficas, prática de atividade física (Estágios de Mudança de Comportamento relacionados à Atividade Física) e barreiras percebidas. As barreiras foram analisadas individualmente e agrupadas em domínios (ambiental, comportamental, físico e social). Associações entre barreiras percebidas (por domínios) e prática de atividades físicas foram testadas por meio de Regressão de Poisson. As principais barreiras percebidas pelos universitários, de ambos os cursos, foram jornada de trabalho extensa (Bacharelado= 16,5%, Licenciatura= 30,4%), falta de energia (Bacharelado= 11,5%, Licenciatura= 10,6%) e falta de companhia (Bacharelado= 7,2%, Licenciatura= 8,9%). As barreiras do domínio social estiveram associadas à inatividade física no Bacharelado (RP= 3,17; IC95%= 1,52-6,60) e na Licenciatura (RP= 1,89; IC95%= 1,14-3,13). Conclui-se que as barreiras mais prevalentes foram jornada de trabalho extensa, falta de energia e falta de companhia. Quando agrupadas por domínios, as sociais, em ambos os cursos, estiveram associadas à inatividade física. Ações devem ser voltadas a esses aspectos para diminuir seu impacto na tomada de decisão sobre a prática de atividades físicas.
A caseload management tool for community mental health teams
Authors: Spernaes Izabela , Holborn Penny , Whent Amanda , Griffiths Kelly
Published: March 2017

A caseload management tool was developed with the aim of creating a straightforward, unbiased way of assessing a clinician's caseload for the community mental health teams (CMHTs) in Aneurin Bevan University Health Board. For the first time, the tool developed allows for individual clinicians to record caseloads electronically, enabling decision makers and their teams to assess caseloads. The newly developed tool also has the capability to assess a client's individual weighting score over time. This is crucial in ensuring an appropriate clinical response, improving client experience and safety. Developments were made to an existing tool widely used in the literature, resulting in a scoring system which now allows for a more accurate weighting score for clients. Pilot phases of the tool with the adult and older adult CMHTs showed that it is both easy to use and informs the caseload management discussion. Future work involves rolling the tool out to the whole of the health board and teams in the mental health division.
Measuring the organisational recovery climate in a forensic high-secure service
Authors: Ayres Joe , Fegan Terry , Noak James , Puzzo Ignazio
Published: March 2017

The authors seek to build on an ongoing annual service evaluation, to measure commitment to providing recovery–based care. This study used two subscales of the Developing Recovery Enhancing Environments Measure (DREEM). These two measures, recovery markers (patients) and the organisational climate—recovery (staff), generate both qualitative and quantitative data which enable a range of rich data to emerge. Findings for the recovery markers revealed a statistically significant increase in patients' level of perceived recovery between time 1 (2014) and time 2 (2015). There were not statistically significant differences in patients' level of perceived recovery between time point 2 and time point 3 (2016), or between time 1 and time 3. The findings from the organisational climate—recovery, identified a statistically significant increase in staff level of agreement that the organisational climate supports the process of recovery between time 1 (2014) and time 2 (2015). However, between time 2 and time 3 (2016) there was a statistically significant decrease in the level of agreement. When comparing time 1 and time 3 there is a statistically significant increase in the level of agreement from staff that the organisational climate supports the process of recovery.
Foot ulceration in patients with diabetes: a risk analysis
Authors: Rossaneis Mariana Angela , Haddad Maria do Carmo Fernandez Lourenço , Mantovani Maria de Fátima , Marcon Sonia Silva , Pissinati Paloma de Souza Cavalcante
Published: March 2017

The study reported in this article aimed to analyse factors associated with the risk of ulceration in the feet of patients with diabetes using a conceptual hierarchic model. It was a cross-sectional study carried out with 1515 people with diabetes mellitus aged 40 years and older. The risk of foot ulceration was of higher significance in male patients with diabetes (adjusted odds ratio (OR)=1.39 (95% confidence interval (CI) 1.11 to 1.73); p=0.020), who did not practise a regular physical activity (adjusted OR=1.58 (95% CI 1.15 to 2.15); p=0.013), with time since diagnosis over 10 years (adjusted OR=1.42 (95% CI 1.10 to 1.86); p=0.011), who used insulin (adjusted OR=1.40 (95% CI 1.09 to 1.84); p=0.012), with retinopathy (adjusted OR=1.84 (95% CI 1.38 to 2.45); p=0.001) and who had had a previous stroke (adjusted OR=1.47 (95% CI 1.09 to 2.04); p=0.018). Mycosis on the nails and the interdigital spaces of the feet was statistically associated with ulceration risk independent of other variables of the model (adjusted OR=2.48 (95%CI 1.70 to 3.63); p=0.001). Finding the factors associated with ulceration contributes to the provision of quality care by nurses.
Assessment, treatment goals and interventions for oedema/lymphoedema in palliative care
Authors: Cobbe Sinead , Real Shirley , Slattery Sinead
Published: March 2017

Background:

Little is known about the treatment of oedema in palliative care patients.

Aim:

To outline the assessment, goals, and interventions for patients with oedema.

Method:

A 6-month chart review of a specialist physiotherapy-led oedema service was carried out.

Results:

Of the sample group (n=63), 28.6% of patients had lymphoedema, 15.9% had non-lymphatic oedema, 46% had mixed oedema and 9.8% had lymphorrhoea; 58 patients (92%) had cancer. The most common interventions were providing education (100%, n=63), using compression garments (58%, n=37), bandaging (51%, n=32), exercise (38%, n=24), lymphatic massage and kinesio-taping (35%, n=22 each). Treatment regime differed depending on the type of oedema present. Treatment goals were pragmatic: the most common were to maintain skin quality (54%, n=34), reduce limb volume (52%, n=32), and improve quality of life (48%, n=30).

Conclusion:

Palliative care oedema can be treated using manual methods, including compression and massage. Goals differ from other oedema populations. Research is hampered by lack of suitable measures to record skin changes and quality of life.
The association between nurses' coordination with physicians and clients' place of death
Authors: Naruse Takashi , Yamamoto Natsuki , Sugimoto Takshi , Fujisaki-Sakai Mahiro , Nagata Satoko
Published: March 2017

Aim:

Over 60% of Japanese people hope to die at home; hence, assisting clients in achieving this outcome is an important responsibility of home care providers. This study investigated the effects of nurses' relational coordination with physicians on clients' place of death in home visiting nursing (HVN) agencies.

Method:

Secondary analysis of a public survey conducted in 2015 by local governments in Kurume city, Fukuoka prefecture, Western Japan. Manager nurses from 17 HVN agencies provided data about themselves and their relational coordination with community physicians and 85 deceased clients.

Results:

Among 85 deceased clients, 52 (61.2%) had died at home. Four regression models showed significant positive effects of HVN nurse managers' relational coordination on clients' home death (the odds ratios (95% CI) were 2.488 (1.442–4.293), 2.111 (1.014–4.396), 2.562 (1.409–4.658) and 2.275 (1.079–4.796) in models 1–4, respectively.

Conclusion:

Measuring relational coordination among HVN nursing managers and physicians indicated readiness for home death among HVN clients in an agency or community.
Understanding bladder management on a palliative care unit: a grounded theory study
Authors: Gutmanis Iris , Hay Melissa , Shadd Joshua , Byrne Janette , McCallum Sarah , Bishop Kristen , Whitfield Patricia , Faulds Cathy
Published: March 2017

Background:

Research regarding factors associated with nursing-initiated changes to bladder management at end-of-life is sparse.

Objectives:

To explore the process of Palliative Care Unit (PCU) nurses' approach to bladder management changes.

Methods:

Nursing staff from one PCU in London, Canada were interviewed regarding bladder management care practices. A constructivist grounded theory was generated.

Results:

Four interconnected themes emerged: humanity (compassionate support of patients); journey (making the most of a finite timeline); health condition (illness, functional decline); and context (orders, policies, supplies). These overlapping themes must be considered in light of ongoing changes which prompt recycling through the framework. While bladder management necessitates shared decision-making and individualised care, nurses' phronetic experience may serve to detect the presence of change and the need to consider other alternatives.

Conclusion:

End-of-life bladder management requires nurses to continually reconsider the significance of humanity, journey, health condition and context in light of ongoing changes.
Research roundup
Authors: Costello John
Published: March 2017

Synopses of a selection of recently published research articles of relevance to palliative care.
Applications of Energy Aware Routing Protocols in WSN
Authors: Sumalatha G. , Kumar P
Published: March 2017

In this paper we have reviewed application of energy aware routing protocols like LEACH, LEACH-C, PEGASIS, BCDCP, ENPC-NPSO, ANPC etc In WSN sensors are randomly deployed in the sensor field which brings the coverage problem. Hence energy and coverage problem are very scarce resources for such sensor systems and has to be managed wisely in order to extend the life of the sensors and maximizing coverage for the duration of a particular mission. In past a lot of cluster based algorithm and techniques were used. In this paper we also find out all type of PSO based algorithm, their application and limitation over present techniques to overcome the problems of low energy and coverage of sensor range.
Tricalcium phosphate powder: Preparation, characterization and compaction abilities
Authors: Fatima Abida , Mostafa Elassfouri , Mohamed Ilou , Bahia El ouatli , Mohamed Jamil , Nawal Moncif , Zineb Hatim
Published: March 2017

In this work, we characterize tricalcium phosphate powders Ca9(HPO4)(PO4)5(OH) resulting from a reaction between calcium hydroxide and orthophosphoric acid at room temperature, without pH adjustment and in absence of ionic impurities. The prepared powder has an atomic ratio Ca/P of 1.512 ± 0.005. The real density is 2.68 ± 0.02 g/cm3 and the specific surface area is 80 ± 02 m2 /g. During compression, the microstructure of Cadeficient apatite powder with the presence of HPO4 groups seems to support the cohesion between particles. The transmission ratio is 90%, the transfer ratio is 41.8 and the ratio of the die-wall friction is 0.22. These results show that apatitic tricalcium powder gives a good aptitude to the compaction which leads to a good tensile strength (0.79 MPa). The heat treatment of the prepared powder shows the precise temperature for the formation of pyrophosphate, β-TCP and α-TCPa phases. The purity and aptitude to compaction of the prepared powders are very promising for pharmaceutical and medical applications.
Umdenken in der Naturwissenschaft
Authors: Primas Hans
Published: March 2017

Modern natural science does not deal with nature as a whole but is still based on the Cartesian dualism of mind and body ('res cogitans' and 'res extensa'), as well as on Francis Bacon's motto “dissecare naturam”. Moreover, Bacon restricted science to the investigation of
material and efficient causes and refused to admit the use of final causes. The metaphysics of Baconian science is based on the confidence that nothing can be known about nature except what can be proved by experiments, that is by interventions which require artificially produced,
deliberately controlled, and reproducible conditions. However, empirical science does not intrinsically require the invasive experimental interrogation of nature, called for by Francis Bacon. The Baconian mode of explication seems to be so effective since it sets its own well established normative
standards of judgement we often tacitly adopt for our research, so that we only see what we look for. – There is a growing recognition of the inadequacy of Cartesian and Baconian conceptions as the only basis for our understanding of nature. The Baconian method is specialized in experimental
manipulations and in predictions, but the aim of science is not to manipulate nature but to create insight. Moreover, modern science, specifically quantum mechanics, has rendered obsolete the Cartesian duality, reductionism, and atomism. Furthermore, the Baconian rejection of finality does
not follow from the first principles of quantum theory. There are good reasons for the view that methods of contemporary science are unnecessarily limited by many tacit preconceptions and blind fascinations. In order to secure the continuation of our culture it is important to make our tacit
preconceptions and driving motivation explicit. A full-grown science cannot any longer be one-eyed. We have to admit that nature contains both rational and irrational elements, that it includes physis and psyche as complementary aspects of the same reality. We are at the bare
beginning to understand reality, but we may have reached a turning point, a way of thinking is developing which is very different from that which has been dominant in the past decades, and which recognizes the repression of the irrational as incongruous.
Polychlorierte Biphenyle: 25 Jahre “klassische” Umweltchemikalien
Authors: Giger Walter
Published: March 2017

Polychlorinated biphenyls (PCBs) have been discovered 25 years ago as persistent environmental pollutants. In the meantime the results of many field and laboratory studies have shown that these chemicals must be considered as first-priority pollutants. Several aspects of the environmental
chemistry and toxicology of the PCBs demand a lot of attention. The great variety of the PCBs individual molecular characteristics causes problems for the analytical chemistry on one side and for toxicological and ecotoxicological assessment on the other side. In addition, contaminations contained
in commercial mixtures and products of pyrolytic processes are of major importance. The problem of choosing suitable substitutes is shortly discussed in the light of risk assessment during the use of the chemicals and regarding their environmental acceptability.
Anticipating Conflicts: Public Participation in Managing the Solid Waste Crisis
Authors: Renn Ortwin , Webler Thomas
Published: March 2017

A major problem of environmental policy making is to anticipate potential conflicts among the major participants and to reach a suitable understanding or compromise that meets both competence vis-a-vis the decision problem and fairness vis-a-vis the affected population. This paper
introduces a novel model of public involvement in decisions about solid waste disposal in specific and environmental management in general. Structured in three consecutive steps, the model is based on the philosophy that stakeholders, experts, and citizens should each contribute to the environmental
planning effort their particular concern and experience. In a first step, the research team elicits the values and criteria for assessing and evaluating policy options from all relevant stakeholders; in a second step, experts are asked to provide performance assessments for each option on
each criterion; and in a third step, randomly selected citizens are given the opportunity to evaluate each option on the basis of the concerns and impacts revealed in the previous two steps. This involvement process is illustrated with an example about sewage sludge management.
Die Marktwirtschaft vor der ökologischen Bewährungsprobe
Authors: Seidel Eberhard
Published: March 2017

The unique historic success that the free-market system has enjoyed is, by the same token, an enormous burden for the future of the world. The free-market system's impressive social, economic and political successes attained during both the last century and this one have been had
at the cost of a third party: a quietly suffering nature. The fact that the enormous ecological challenge which we are facing in the next century has been felt by people is reflected in the social problems that are cropping up, and will eventually cast doubt on the historic successes we
have been enjoying. This article analyzes the pre-requisites for ecologizing economic activity; it illustrates the great difficulties involved in bringing about “ecological renewal”. Worldwide collective learning, including learning to deal with paradoxes, the extra effort
that has to be put forth by the most highly developed countries and a lot of “international solidarity” appear to be the only way to embark on a path towards sustainable development. Germany, which still has some arrears to make to the world and to itself, now that it has been
luckily re-united, should resolve to give more of itself to help advance the cause of ecologizing economic activity throughout the world. That is the best and most fundamental way to promote peace.
Artenrückgang in Magerwiesen Wissenschaftlicher Naturschutz am Monte San Giorgio
Authors: Stampfli Andreas , Lörtscher Mathias , Guggisberg Fredi
Published: March 2017

The abandoned meadows of Monte San Giorgio in Switzerland are investigated by botanists and zoologists in order to improve management practices urgently needed to maintain a very special endangered flora and fauna. Suggesled management strategies are now based on empirical knowledge.
The effects of these management practices, however, are not clear. In the future practical nature conservation activities should be combined with long-term scientific experiments to test present-day hypotheses.