bluuebunny/crossref_metadata_2025 huggingface dataset:
The Italian Register of Biological Prostheses
Authors: Coccolini F. , Poiasina E. , Bertoli P. , Gossetti F. , Agresta F. , Dassatti M.R. , Riccio P. , Cavalli M. , Agrusti S. , Cucchi M. , Negro P. , Campanelli G. , Ansaloni L. , Catena F.
Published: June 2013

Background: A wide variety of meshes are available for surgical treatment of abdominal wall defects. These meshes are constructed with different materials with different biological properties. Methods: A prospective database was instituted (January 2009-December 2010) to register biological prostheses (BPs) implanted in Italy. Results: A total of 193 cases were registered. The mean age of the patients was 53.1 years (SD ±7.4). The ratio of males to females was 1.3 to 1. The mean body mass index was 28.2 (SD ±4.1). The breakdown of American Society of Anesthesiologists (ASA) scores was as follows: ASA I, 35.7%; ASA II, 27.5%; ASA III, 31.6%, and ASA IV, 5.2%. For ventral-incisional hernias, the mean duration of surgery was 101.1 min (SD ±25.3), while for inguinal-femoral hernias it was 49.2 min (SD ±19.1). The rate of urgent procedures was 36.7%. The surgical field was clean in 57.4% of cases, clean-contaminated in 21.3%, contaminated in 12.3% and dirty in 9%. Techniques used for inguinal-femoral hernias were as follows: Lichtenstein in 66.7%, plug and mesh in 3.8%, transabdominal-preperitoneal in 25.7% and intraperitoneal onlay mesh in 3.8%. The following prostheses were used: swine intestinal submucosa in 54.9%, porcine dermal collagen in 39.9% and bovine pericardium in 5.2%. In 45.1% of cases the prostheses were cross-linked. Techniques used for ventral-incisional hernias were as follows: onlay in 3.6%, inlay in 5.5%, sublay in 62.7% and underlay via laparoscopy in 28.2%. The mean overlap was 4.1 cm (SD ±1.2). No intestinal anastomosis was necessary in 65.3% of cases; however, small/large bowel resection and anastomoses were necessary in 22.3 and 12.4% of cases, respectively. Intraoperative blood transfusion was necessary in 10.4% of procedures. The skin was completely closed in 84% of procedures. At the 1-month follow-up, there were no complications in 54.4% of cases. Among the cases with complications, 10 patients (5.8%) experienced recurrence, and the postoperative readmission rate was 12.9%. The average visual analog scale (VAS) score for pain was 2.9 (SD ±1.2) at rest. At the 1-year follow-up, there were no complications in 96.4% of cases. Two patients experienced recurrence, and the postoperative readmission rate was 3.6%. The average VAS score for pain was 1.8 (SD ±0.8) at rest. Conclusions: This register shows that BPs are highly versatile and can be used in either open or laparoscopic surgery in all kinds of patients and in contaminated surgical fields. However, due to the very good outcomes of synthetic meshes and the high costs of BPs, the latter should only be used in selected cases.
Octomeria lilliputana (Orchidaceae), a new species from Brazilian Atlantic Forest, State of Paraná, Brazil
Authors: FORSTER WELLINGTON , SOUZA VINICIUS CASTRO , DE BARROS FÁBIO
Published: June 2013

While conducting a taxonomic revision of Octomeria, a new species from the Atlantic Forest biome, in Paraná State, Brazil was found. The species is here described and illustrated as Octomeria lilliputana. Based on morphological characters, this species belongs to Octomeria section Octomeria subsection Octomeria. The species is provisionally ascribed to the Data Deficient (DD) category of IUCN.
Two new species of Sericosura Fry & Hedgpeth, 1969 (Arthropoda: Pycnogonida: Ammotheidae) from a hydrothermal vent on the East Pacific Rise
Authors: WANG JIANJIA , LIN RONGCHENG , BAMBER ROGER N. , HUANG DINGYONG
Published: June 2013

Between 17th October and 9th November 2009, the third leg of the Chinese DY115-21 cruise on board the R/V Dayangy-ihao, confirmed two new hydrothermal fields near the equatorial East Pacific Rise. Five pycnogonid specimens were ob-tained by deep-sea TV-grab from one of the new hydrothermal vents named 'Precious Stone Mountain' at 1.22°N 101.49°W. These specimens belonged to two new species of the obligately-vent-associated pycnogonid genus Sericosura. Three female specimens represent the new species Sericosura gemmaemonsis with large body size. One male and one fe-male were of the second new species, Sericosura dentatus; the male specimen has a mid-dorsal femoral cement-gland-tube, like that of Sericosura dissita, while the female specimen has more finely-denticulate spines on the oviger strigilis than any other species of the genus.
“I Just Live Here”: Everyday Practices of Disaffiliation of Middle-class Households in Disadvantaged Neighbourhoods
Authors: Pinkster Fenne M.
Published: June 2013

This paper explores different explanations for the continuing presence of a large share of middle-class households in disadvantaged neighbourhoods in the Netherlands, a seeming anomaly to middle-class residential practices of disaffiliation and elective belonging identified in the research literature. In-depth interviews with middle-class residents in urban restructuring neighbourhoods in Amsterdam and The Hague provide insight into the way in which these residents make sense of and engage with their residential surroundings. The study found that respondents downplay neighbourhood problems and validate living in an urban restructuring area through a value-for-money discourse. At the same time, they display subtle ways of disaffiliating from the neighbourhood through both discursive and socio-spatial practices in everyday life.
Influence of curing systems on dynamically cured epoxidized natural rubber/thermoplastic polyurethane blends
Authors: Pichaiyut Skulrat , Vennemann Norbert , Nakason Charoen
Published: June 2013

Dynamically cured 40/60 epoxidized natural rubber (ENR)/thermoplastic polyurethane (TPU) blends with peroxide and three different types of sulfur curing system were prepared using an internal mixer. It was found that the blends with peroxide exhibited higher modulus, mixing torque, mixing temperature, hardness, and shear viscosity than the blends with the sulfur-cured systems (i.e. conventional (CV), semiefficient (semi-EV), and efficient sulfur vulcanization (EV)). This is attributed to peroxide-caused cross-linking reaction in both ENR and TPU phases. Furthermore, it was found that the dynamically CV-cured blends exhibited higher thermal resistance, relaxation behavior, cross-link density, oil resistance, and mechanical strength than those of the semi-EV and EV-cured blends. The dynamically CV-cured blends also exhibited the smallest vulcanized rubber domains dispersed in the TPU matrix. This is due to higher levels of cross-link density in ENR phase and possibly higher interfacial attraction. On the other hand, it is difficult to identify the spherical rubber particle in the peroxide-cured blend due to cross-linking reaction that occurs in the TPU matrix.
Polylactic acid/polycaprolactone nanocomposite
Authors: Salehiyan Reza , Yussuf A A , Hanani Nurul Fatin , Hassan Azman , Akbari Abozar
Published: June 2013

This article investigates the performance of polylactic acid (PLA)/polycaprolactone (PCL)/montmorillonite (MMT) nanocomposites toughened with metallocene-catalyzed linear low-density polyethylene (mLLDPE), in terms of mechanical, thermal, and morphological properties. All the results were compared and the influence of MMT and mLLDPE on the final properties was observed and reported. mLLDPE decreased the modulus and the strength of PLA/PCL and its nanocomposites due to its inherent lower rigidity compared to PLA/PCL nanocomposites. Moreover, incorporation of clay significantly increased mechanical and thermal stability of the nanocomposites. Scanning electron microscopic images confirmed that MMT acted as a compatibilizer, whereas it reduced the size of the droplets. It has been suggested that improvements in properties are related to good dispersion of clays within the matrix. However, further addition of MMT beyond 2 parts per hundred (phr) level decreases all the properties of PLA/PCL/mLLDPE/MMT nanocomposites. X-Ray diffraction patterns were used to discover the reason of reduction in the properties of PLA/PCL/mLLDPE/MMT at 4 phr. It was revealed that mLLDPE-toughened blends have intercalated structure below 4 phr MMT content as the interlayer spacing decreased at 4 phr MMT.
How can we keep patients with dementia safe in our acute hospitals? A review of challenges and solutions
Authors: George Jim , Long Susannah , Vincent Charles
Published: June 2013

Maintaining patient safety in acute hospitals is a global health challenge. Traditionally, patient safety measures have been concentrated on critical care and surgical patients. In this review the medical literature was reviewed over the last ten years on aspects of patient safety specifically related to patients with dementia. Patients with dementia do badly in hospital with frequent adverse events resulting in the geriatric syndromes of falls, delirium and loss of function with increased length of stay and increased mortality. Contributory factors include inadequate assessment and treatment, inappropriate intervention, discrimination, low staff levels and lack of staff training. Unfortunately there is no one simple solution to this problem, but what is needed is a multifactorial, multilevel approach at the seven levels of care – patient, task, staff, team, environment, organisation and institution.

Improving safety and quality of care for patients with dementia in acute hospitals will benefit all patients and is an urgent priority for the NHS.
Using patient-reported outcome measures to estimate cost-effectiveness of hip replacements in English hospitals
Authors: Appleby John , Poteliakhoff Emmi , Shah Koonal , Devlin Nancy
Published: June 2013

Objective

To estimate the average cost per quality adjusted life year (QALY) gained from hip surgery, and to examine the variation in that between hospitals.

Design

The transformation of patient-reported outcome measures (EQ-5D data) into QALYs, covering 25,463 NHS patient episodes between April 2009 and August 2010 from hospitals in England, using a model of future health change arising from a hip operation compared to a counterfactual of no operation. Hospital-level costs for hip procedures from the National Reference Costs data-set was used to calculate the hospitals' cost per QALY.

Setting

English hospitals treating NHS-funded patients undergoing hip replacement.

Participants

NHS-funded patients undergoing primary hip replacement.

Main outcome measure

Cost per QALY.

Results

Assuming some degradation in patients’ health over the lifetime of the hip prosthesis, average health gain arising from a hip operation was 2.77 QALYs. For procedures paid for by the NHS but carried out in the independent sector the average gain was 2.97 QALYs. Average NHS hospital hip procedure costs were estimated to be £5844. The unweighted average cost per QALY for NHS hospitals was £2128. There were significant variations in cost per QALY between hospitals; most of this variation appears to be driven by variations in cost, not QALYs.

Conclusions

Using the new patient-assessed health-related quality of life data combined with routine hospital-level cost data it is possible to estimate a procedure-based measure of efficiency for hospitals. The fact that variations in cost per QALY are strongly driven by variations in cost suggests that further work is needed to investigate the causes of cost variations per se – especially the quality of routine NHS cost data.
Critical Role of Nutrition in Improving Quality of Care
Authors: Tappenden Kelly A. , Quatrara Beth , Parkhurst Melissa L. , Malone Ainsley M. , Fanjiang Gary , Ziegler Thomas R.
Published: June 2013

The current era of healthcare delivery, with its focus on providing high‐quality, affordable care, presents many challenges to hospital‐based health professionals. The prevention and treatment of hospital malnutrition offer a tremendous opportunity to optimize the overall quality of patient care, improve clinical outcomes, and reduce costs. Unfortunately, malnutrition continues to go unrecognized and untreated in many hospitalized patients. This article represents a call to action from the interdisciplinary Alliance to Advance Patient Nutrition to highlight the critical role of nutrition intervention in clinical care and to suggest practical ways to promptly diagnose and treat malnourished patients and those at risk for malnutrition. We underscore the importance of an interdisciplinary approach to addressing malnutrition both in the hospital and in the acute posthospital phase. It is well recognized that malnutrition is associated with adverse clinical outcomes. Although data vary across studies, available evidence shows that early nutrition intervention can reduce complication rates, length of hospital stay, readmission rates, mortality, and cost of care. The key is to systematically identify patients who are malnourished or at risk and to promptly intervene. We present a novel care model to drive improvement, emphasizing the following 6 principles: (1) create an institutional culture where all stakeholders value nutrition, (2) redefine clinicians’ roles to include nutrition care, (3) recognize and diagnose all malnourished patients and those at risk, (4) rapidly implement comprehensive nutrition interventions and continued monitoring, (5) communicate nutrition care plans, and (6) develop a comprehensive discharge nutrition care and education plan.
Enhancing Patient-Centered Care
Authors: Vanderboom Catherine E. , Holland Diane E. , Lohse Christine M. , Targonski Paul V. , Madigan Elizabeth A.
Published: June 2013

Health care reform focuses on primary care and development of Health Care Homes to improve patient-centered chronic illness care. This pilot study evaluated a community care team intervention that linked chronically ill older patients, support persons, and nurse care coordinators from a Health Care Home with community resources using an adaptation of the Wraparound process. A pragmatic clinical trial design was used. Patient-centered chronic illness care; physical, mental, and social health; service use; and study feasibility were evaluated. Differences between groups were compared using two-sample t, Wilcoxon rank sum, chi-square, or Fisher’s exact tests. At 3 months, the intervention group reported higher patient-centered chronic illness care (mean total Patient Assessment of Chronic Illness Care change scores were 0.39 for the intervention group and −0.11 for the control group, p = .03). Results indicate that the integrated community care team intervention is a promising strategy to support patient-centered chronic illness care.
Classification of High‐Resolution Manometry Data According to Videofluoroscopic Parameters Using Pattern Recognition
Authors: Hoffman Matthew R. , Jones Corinne A. , Geng Zhixian , Abelhalim Suzan M. , Walczak Chelsea C. , Mitchell Alyssa R. , Jiang Jack J. , McCulloch Timothy M.
Published: June 2013

Objective

To determine if pattern recognition techniques applied to high‐resolution manometry (HRM) spatiotemporal plots of the pharyngeal swallow can identify features of disordered swallowing reported on the Modified Barium Swallow Impairment Profile (MBSImP).

Study Design

Case series evaluating new method of data analysis.

Setting

University hospital.

Subjects and Methods

Simultaneous HRM and videofluoroscopy was performed on 30 subjects (335 swallows) with dysphagia. Videofluoroscopic studies were scored according to the MBSImP guidelines while HRM plots were analyzed using a novel program. Pattern recognition using a multilayer perceptron artificial neural network (ANN) was performed to determine if 7 pharyngeal components of the MBSImP as well as penetration/aspiration status could be identified from the HRM plot alone. Receiver operating characteristic (ROC) analysis was also performed.

Results

MBSImP parameters were identified correctly as normal or disordered at an average rate of approximately 91% (area under the ROC curve ranged from 0.902 to 0.981). Classifications incorporating two MBSImP parameters resulted in classification accuracies over 93% (area under the ROC curve ranged from 0.963 to 0.989).

Conclusion

Pattern recognition coupled with multiparameter quantitative analysis of HRM spatiotemporal plots can be used to identify swallowing abnormalities, which are currently assessed using videofluoroscopy. The ability to provide quantitative, functional data at the bedside while avoiding radiation exposure makes HRM an appealing tool to supplement and, at times, replace traditional videofluoroscopic studies.
The grip of personalization in adult social care: Between managerial domination and fantasy
Authors: West Karen
Published: June 2013

This paper examines the ‘ideological grip’ of personalization. It does so empirically, tracking the trajectory of personalization through austerity budgeting in one English local authority. In this case, personalization continued to signify hope and liberation even though the most draconian cuts in the Council’s history effectively rendered personalization a practical impossibility. This requires critical theorization. Two bodies of theory are interrogated. First Boltanski’s sociology of critique, and, in particular, his notion of managerial domination illuminate the way in which change imperatives and crises come to cement ideological formations. Here it is argued that the articulation of personalization with transformation lends itself to managerial domination. It is further argued, though, that while institutional actors may be able to manipulate the symbolic to evade, what Boltanski terms, deconstructionist critique, this cannot entirely explain the hold of this particular discourse. Here, the Lacanian concept of enjoyment is deployed to interrogate its extra-symbolic function and fantasmatic form. Finally, the paper explores the political implications of such affective attachment and, in particular, the guarantee that personalization offers in a period of welfare state decline.
Prescription of compression stockings in France in primary care
Authors: Benigni J-P , Ansolabehere X , Saudez X , Toussi M , Branchoux S , Taieb C
Published: June 2013

Objectives

Recent French data describing real-life compression stocking use are lacking. This study aimed to describe the actual situation for patients who were prescribed compression stockings by their general practitioner and to assess annual treatment costs from a societal perspective.

Methods

A retrospective analysis using Disease Analyzer database data from 6349 adults with at least one compression stocking prescription between July 2009 and June 2010.

Results

Mean patient age was 58 years, and 72.3% of patients were women. Seven out of 10 patients received only a single compression stocking prescription over one year. The estimated mean annual per patient cost was 152.2 ± 100.7 Euros.

Conclusion

Most patients received only a single compression stocking prescription during one year. General practitioners prescribing compression stockings more often may have a better understanding of venous disease and may manage their patients differently. Although more expensive, this approach may be one which should be accepted more widely.
An in vitro approach to the evaluation of foot-ankle kinematics: Performance evaluation of a custom-built gait simulator
Authors: Peeters Koen , Natsakis Tassos , Burg Josefien , Spaepen Pieter , Jonkers Ilse , Dereymaeker Greta , Vander Sloten Jos
Published: June 2013

Despite their well-known limitations, in vitro experiments have several benefits over in vivo techniques when exploring foot biomechanics under conditions characteristic of gait. In this study, we present a new setup for dynamic in vitro gait simulation that integrates a numerical model for generating the tibial kinematics control input, and we present an innovative methodology to measure full three-dimensional joint kinematics during gait simulations. The gait simulator applies forces to the tendons. Tibial kinematics in the sagittal plane is controlled using a numerical model that takes into account foot morphology. The methodology is validated by comparing joint rotations measured during gait simulation with those measured in vivo. In addition, reliability and accuracy of the control system as well as simulation input and output repeatability are quantified. The results reflect good control performance and repeatability of the control inputs, vertical ground reaction force, center of pressure displacement, and joint rotations and translations. In addition, there is a good correspondence to in vivo kinematics for most patterns of motion at the ankle, subtalar, and Chopart’s joints. Therefore, these results show the relevance and validity of including specimen-specific information for defining the control inputs.
Optimization of water jet pumps using numerical simulation
Authors: Yapıcı R , Aldaş K
Published: June 2013

A water jet pump is one of the best examples of a device in which liquid-jet mixing phenomena occur. Since such mixing processes are complex, the choice of turbulence model for accurate prediction of performance of the pumps is important. The aim of this numerical simulation study is to investigate effects of parameters such as the jet pump area ratio, nozzle position, and length of the mixing chamber on the pump performance and then to perform an optimization of six different water jet pumps according to these parameters, taking energy efficiency as a criterion. In the optimization procedure, the transition SST model ( γ-Reθ) was used because it provided more accurate results among the four advanced turbulence models. The numerical results obtained with the model were compared with experimental data of the jet pump with the same geometry at the boundary conditions available in the literature and it was seen that maximum deviation in the pump efficiency at the optimum operating conditions was approximately 10%. As a result, the maximum numerical efficiency is found to be 34.6% at the area ratio of 4.61 and a pressure ratio of 0.277.
Stable isotopes in Sphagnum fuscum peat as late-Holocene climate proxies in northeastern European Russia
Authors: Kaislahti Tillman Päivi , Holzkämper Steffen , Andersen Thorbjørn Joest , Hugelius Gustaf , Kuhry Peter , Oksanen Pirita
Published: June 2013

The environment of the northern taiga to tundra transition is highly sensitive to climate fluctuations. In this study from northeastern European Russia, stable carbon and oxygen isotope ratios (δ13C, δ18O) in α-cellulose of Sphagnum fuscum stems subsampled from hummocks and peat plateau profiles have been used as climate proxies. The entire isotope time series, dated by lead (210Pb), caesium (137Cs) and AMS-radiocarbon (14C) dating, spans the past 2500 years. Plant macrofossil analyses were used as an aid in single species selection, but are also helpful in identifying past surface moisture conditions. The most significant relationships were found between the recent δ13C record and summer (July–August) temperatures ( R2 = 0.58, p < 0.01), and the recent δ18O record and winter (October–May) precipitation anomalies in the tundra region ( R2 = 0.36, p < 0.01). The study demonstrates that stable isotopes preserved in northern peat deposits are useful indicators for summer temperature and winter precipitation at decadal to millennial timescales.
Sensitivity of floodplain geoecology to human impact: A Holocene perspective for the headwaters of the Dijle catchment, central Belgium
Authors: Broothaerts Nils , Verstraeten Gert , Notebaert Bastiaan , Assendelft Rick , Kasse Cornelis , Bohncke Sjoerd , Vandenberghe Jef
Published: June 2013

Floodplain deposition rates have increased markedly under influence of human impact throughout the late Holocene in many western and central European catchments. Consequently the geomorphology and ecology of many floodplains changed. In this study we discuss this human impact and its influence on the floodplain geoecology during the middle and late Holocene for the headwaters of the Dijle catchment, located in the Belgian loess belt. The floodplain geoecology and the regional vegetation was reconstructed from sedimentological and palynological analyses. An age–depth model for the studied sequences was obtained using 17 radiocarbon dates. Statistical analyses of the pollen data (cluster analysis and canonical correspondence analysis) were used to detect changes in the pollen record. Our data show that until c. 2500 cal. BP, human impact was nearly absent or localized with no discernible influence on the floodplain geoecology. The floodplain was in a stable phase and consisted of a marshy environment where organic material could accumulate, which is interpreted as the natural state of the floodplain. From c. 2500 cal. BP onwards, human impact gradually increased. However, only when human impact in the catchment crossed a threshold around 500 cal. BP, the floodplain geoecology changed with clearing of the Alder carr forest, the establishment of a single channel river and the dominance of minerogenic overbank sedimentation. Spatial variability in the coupling between increasing human impact and changes in floodplain geoecology can be attributed to differences in hillslope–floodplain connectivity and local differences in human impact.
Does television reflect the evolution of scientific knowledge? The case of attention deficit hyperactivity disorder coverage on French television
Authors: Bourdaa Mélanie , Konsman Jan Pieter , Sécail Claire , Venturini Tommaso , Veyrat-Masson Isabelle , Gonon Francois
Published: June 2013

Biomedical findings mature from uncertain observations to validated facts. Although subsequent studies often refute initial appealing findings, newspapers privilege the latter and often fail to cover refutations. Thus, biomedical knowledge and media reporting may diverge with time. Here we investigated how French television reported on three scientific questions relative to attention deficit hyperactivity disorder (ADHD) from 1995 to 2010: i) is ADHD mainly genetic in origin, ii) does methylphenidate treatment decrease the risk of academic underachievement, and iii) are brain imaging techniques able to reveal ADHD in individual patients? Although scientific evidence regarding these questions has evolved during these 16 years, we observed that nine out of ten TV programs broadcast between 2007 and 2010 still expressed only opinions against the current scientific consensuses. The failure of TV programs to reflect the evolution of the scientific knowledge might be related to a biased selection of medical experts.
Don’t Worry, Be Sad! On the Cognitive, Motivational, and Interpersonal Benefits of Negative Mood
Authors: Forgas Joseph P.
Published: June 2013

This article reviews recent evidence for the benefits of negative affect for thinking and behavior, consistent with evolutionary theories suggesting an adaptive function for all affective states. Numerous experiments demonstrate that negative affect can improve memory performance, reduce judgmental errors, improve motivation, and result in more effective interpersonal strategies. These findings are interpreted in terms of dual-process theories that predict that positive affect promotes more assimilative, internally focused processing styles, whereas negative affect promotes a more accommodative and externally focused thinking strategy. The theoretical relevance of these findings for recent affect-cognition models is discussed, and the practical implications of recognizing the adaptive benefits of negative affect for social thinking and performance in a number of applied fields are considered.
Effect of hinge friction on the steady-state response of base-excited shallow arches
Authors: van Hoof JAJM , Fey RHB , Shukla A , Nijmeijer H
Published: June 2013

The focus in this paper is on investigating the influence of hinge friction on the steady-state dynamic response of a transversally base-excited shallow arch. Two semi-analytical models are derived by applying an assumed-modes approach based on sinusoidal modes and Craig–Bampton modes respectively. It is shown that both models give qualitatively and also to a great extent quantitatively similar response results. Hinge friction induces the presence of equilibrium sets rather than static equilibria. Furthermore, the influence of friction on the load-path for a quasi-static acceleration loading is illustrated. In the steady-state analysis of the semi-analytical models, amplitude–frequency diagrams are presented. These plots are obtained by solving two-point boundary value problems in combination with a path-following technique. Local stability and bifurcation analysis of periodic solutions is carried out using Floquet theory for systems of Filippov type. Especially for low excitation amplitudes, the responses dramatically change due to hinge friction, since these responses are dominated by hinge stick. Near resonances and in the case of high-amplitude excitation, the frictional hinge will only slip and the influence of hinge friction is significantly reduced. When hinge friction is relevant, the Craig–Bampton model is expected to predict responses more accurately.
What is the point of citizen participation in health care?
Authors: Stewart Ellen
Published: June 2013

Does citizen participation in health care planning and provision have a clear purpose? Can it reasonably be considered a unified phenomenon? Current conceptual accounts – including a range of typologies descended from Arnstein's ubiquitous but misunderstood ‘ladder of participation’ – are inadequate. The popularity of citizen participation belies fundamental uncertainties about what it entails and its associated benefits. A more pragmatic and less normative usage of the term is vital for the future.
Statutory health assessments for pre-school foster children fail to screen accurately for mental health disorders
Authors: Hillen Thomas , Gafson Leonie
Published: June 2013

The aim of this study was to determine the diagnostic accuracy of statutory health assessments in identifying existing mental health disorders in pre-school foster children. It was examined whether a foster carer completed screening instrument could enhance accuracy. A representative sample of 43 pre-schoolers under the care of one inner-city local authority underwent comprehensive multidimensional mental health assessments as the reference standard. Statutory health assessments gave false negative results for 65% (95% confidence interval (CI) 44–82%) of children diagnosed with at least one mental health disorder according to the reference standard and 18% (95% CI 3–52%) of children with developmental delay. The Ages & Stages Questionnaire completed by the foster carers failed to identify 65% (95% CI 44–82%) of the children with diagnosed mental health disorders. There was no evidence of selective underreporting by foster carers in relation to specific diagnostic categories. In conclusion, statutory health assessments in their current form may fail to identify the majority of pre-school foster children with mental health disorders. Adding a screening instrument to the assessment process may not be adequate to improve diagnostic accuracy.
Predictors of mortality in childhood burns
Authors: Saritas Ayhan , Cakir Zeynep G , Akçay Mufide N , Kandis Hayati , Ersunan Gokhan , Oztürk Gurkan , Aslan Sahin
Published: June 2013

This study aims to analyze the epidemiological characteristics and predictors of mortality from burn injuries in childhood patients admitted to our hospital during an eight-year period. The medical records of acute childhood burn patients were reviewed retrospectively. All variables thought to be associated with mortality were entered in a multiple binary logistic regression model (method = stepwise). The magnitude of risk was measured by the odds ratio, and the 95% confidence interval was estimated. A total of 2269 acute childhood burn patients were admitted during the study period. A total of 86 (3.8%) children died due to burn injuries. Deaths were seen 1.849 times more in males than in females. According to the 1%–10% total body surface area (TBSA) burned group, mortality occurred 121.116 times more in the >41% TBSA burned group. Most burn injuries can be avoided by keeping children away from hazardous and dangerous environments. Also, requiring a multidisciplinary management in these patients, quality of care services given by physicians and nurses certainly will create a positive impact on patients’ outcomes.
Identifying families’ reasons for engaging or not engaging with childhood obesity services
Authors: Banks Jonathan , Cramer Helen , Sharp Deborah J , Shield Julian PH , Turner Katrina M
Published: June 2013

The rise in childhood obesity in recent years has been accompanied by a number of initiatives to treat the condition. However, such interventions have often been characterised by poor levels of adherence to treatment and corresponding high attrition rates. This article presents data drawn from qualitative interviews to examine families’ reasons for engaging or not engaging with child obesity services. Interviews took place with 15 families whose children attended a UK-based childhood obesity service and 17 families whose children withdrew from treatment. Our data suggested that involvement of children in the decision to attend a clinic was important in building engagement. Specialist diet and exercise advice tailored to individual family circumstance encouraged clinic engagement, but failed to engage some families who felt their personal circumstances had not been considered sufficiently. The clinic environment was viewed as not age appropriate for some children and did not match the expectations of some families. Our findings highlight the value of involving children in the decision to attend an obesity service and practitioners should, as much as possible, tailor advice to the circumstances of each family. Providing clinics for particular age groups in terms of environment and timing may enhance engagement with services.
Parenting an infant with a congenital anomaly
Authors: Fonseca Ana , Nazaré Bárbara , Canavarro Maria Cristina
Published: June 2013

The present study examined psychological adjustment in parents of infants with congenital anomalies (CAs), focusing on the interval from the disclosure of the diagnosis to six months after the infant’s birth and considering the effects of the parent’s gender and the timing of diagnosis (pre- vs postnatal). Within-group diversity was also examined by identifying distinct patterns of individual adjustment over time. Parents of 43 infants (43 mothers and 36 fathers) with a pre- or postnatal diagnosis of a CA answered questionnaires assessing psychological distress and quality of life one month after the disclosure of the diagnosis and six months after the infant’s birth. Results showed a significant reduction in psychological distress and a significant increase in physical quality of life over time, for both parents, regardless of the timing of diagnosis. In all, 57% of parents presented a pattern of recovery from diagnosis to six months post birth and 26.6% presented a pattern of resilience. However, 15.2% of parents showed chronic adjustment difficulties. Findings suggest that most parents tend to adjust to their infant’s CA, although some experienced difficulties and should be targeted for specialised counselling. Both members of the couple should be acknowledged, as both experience similar patterns of adjustment.
Intention of pregnant women to exclusively breastfeed their infants
Authors: Ismail Tengku Alina Tengku , Muda Wan Manan Wan , Bakar Mohd Isa
Published: June 2013

This study was aimed at identifying behavioural, normative and control belief influencing intention to practise exclusive breastfeeding among pregnant women in Malaysia. An interviewer-guided questionnaire assessing behavioural, normative and control belief was developed based on the findings elicited from focus group discussions. Intention referred to the respondent’s intended duration of exclusive breastfeeding, which was measured in weeks. Bivariate correlational analysis, linear regression analysis and independent t test comparing intenders and non-intenders were conducted to identify the composite belief measures and individual beliefs significantly influencing intention. Composite measures of all the beliefs were significantly correlated with intention, but injunctive normative belief and behavioural belief were the only significant factors identified from linear regression analysis. The respondents agreed to comply with four referents of their mother, husband, nurses and mother-in-law. Non-intenders believed that those referents would oppose them practising exclusive breastfeeding for six months. The behavioural belief concerning difficulty to leave the infant significantly differentiated intenders from non-intenders. Exclusive breastfeeding promotion should include the woman’s mother, husband and mother-in-law. Nurses should provide accurate and complete information related to breastfeeding practise. Providing support for women to continue the practise even though separated from their infants may improve their intention and practise of exclusive breastfeeding.
Tastes of Talk: Qualia and the moral flavor of signs
Authors: Gal Susan
Published: June 2013

This essay explores the semiotic processes by which speakers attribute sensuous qualities – e.g. lightness, dryness, straightness and others – to speech registers. Language ideologies create indexical relations linking linguistic forms to typical personae, activities and values in social life; they also construct other semiotic relations that enable speakers to attribute taste, texture, smell, sound, or shape to speech. Such extended, cross-modal, sensuous metaphors are taken up as lived experience, as part of larger frameworks of cultural value. By extending several Peircean concepts, the essay shows how speakers become persuaded that such sensuous properties of speech are existentially real. Two pedagogical genres from 19th and 20th century Hungary illustrate how properties of speech are reproduced, either via explicit instruction or as displayed in the parallelism of narrative. Both genres construct speech qualia as constitutive moves in moral and political projects that become more persuasive through the display of valued qualia.
Worora kinship and ‘parenteral’ relationships
Authors: Silverstein Michael
Published: June 2013

Among the Worora-speaking Aboriginal Australian people, in addition to the usual verbal expressions by which classificatory kinship is denoted, and the various contextual behaviors that index such categorial relations, kinship is experienced not only on the body, through a system of gestures, but as well as in the body, that is, through feelings in the musculature: hence kinship – one’s parents, etc. – is as well experienced parenterally. Cross-culturally, the adult human body constitutes what we might term both a diagrammatic model of other, generally macro-social aspects of the experienceable universe of phenomena, and as well a ‘natural’ origō or indexical centerpoint from which, in practices and in imaginative representations, a cultural actor can project a connection between the here-and-now and some encompassing social order. The Worora case is interesting precisely as it unites the two in both a topographical and parenteral experience of a system of classificatory kinship, reflexively experienced on and in the body.
Homo duplex revisited: A defence of Émile Durkheim’s theory of the moral self
Authors: Fish Jonathan S.
Published: June 2013

Over the years arguments focusing on process have gained ascendancy over traditional dualist arguments in various areas of sociological inquiry, including that of the moral self. This paper challenges current convention by offering a defence of Émile Durkheim’s now largely discredited dualism-based homo duplex theory of the moral self by engaging it in a dialogue with one key exponent of the rival process view on this theme, namely the American pragmatist thinker George Herbert Mead. A seminal essay published in 1909 by one of Durkheim’s former students, the anthropologist Robert Hertz, will be drawn upon when arguing for the continued relevance of binary or dualistic thought, contra Mead, and, by extension, Durkheim’s classical homo duplex theory. The idea of a ‘dynamic dualism’ will be introduced in the face of Mead’s critical claims as a way forward for binary thought in future sociological debate.
Paradoxes of sovereignty: Toward a Durkheimian analysis of monarchy
Authors: Ramp William
Published: June 2013

In sociological or political-theoretical discussions of monarchy, the voice of Émile Durkheim is mostly absent. Although Durkheim himself had little to say on the topic, his theory of religion, and elements of his political sociology, provide resources for an engagement with monarchy both as a social institution and as a political possibility. The twentieth-century crisis of religion which Durkheim addressed in a particularly trenchant fashion has an analogue in the twentieth-century crisis of monarchical sovereignty: its supposed collapse into irrelevance, its survival, and its return in other forms. In the work of Schmitt and Agamben, this is represented as a theologico-political dilemma. This article explores what Durkheimian sociology might still contribute to a discussion of sacral and juridical aspects of sovereignty. By this is meant not only examination of its sociopolitical location and functions, but also a study of the ‘fictions’ and paradoxes of monarchical sovereignty as exemplary instances of the paradoxicality of the social. What are the features and consequences of a king-shaped hole or an empty throne in modern political imaginaries?
Rasayana Drugs From the Ayurvedic System of Medicine as Possible Radioprotective Agents in Cancer Treatment
Authors: Baliga Manjeshwar Shrinath , Meera Sharake , Vaishnav Lalit Kumar , Rao Suresh , Palatty Princy Louis
Published: June 2013

The use of ionizing radiation, which is the cornerstone of cancer treatment, is compromised by the radiosensitivity of normal tissues. A chemical that can give selective benefit to the normal cells against the deleterious effects of ionizing radiation has been a long-sought goal. However, most of the compounds studied have shown inadequate clinical application owing to their inherent toxicity, undesirable side effects, and high cost. Studies carried out in the past 2 decades have shown that some of the classical Indian Ayurvedic drugs (Amritaprasham, Ashwagandha Rasayana, Brahma Rasayana, Chyavanprasha, Narasimha Rasayana, and Triphala Churna) possess radioprotective effects. In the current review, an attempt is made to summarize the radioprotective observations of these Ayurvedic drugs and the mechanisms responsible for the radioprotective effects.
Variability in local pressures under digital tourniquets
Authors: Middleton S. D. , Jenkins P. J. , Muir A. Y. , Anakwe R. E. , McEachan J. E.
Published: June 2013

The UK National Patient Safety Agency issued a rapid response report in 2009 following reports of complications related to digital tourniquet use and inadvertent retention. In their guidance, they recommend the use of CE marked digital tourniquets and advise against the use of surgical gloves. There are a number of different commercially available non-pneumatic digital tourniquets, but little clear data relating to their comparable physical properties, clinical efficacy or safety. The aim of this study was to investigate the variability of pressures exerted by non-pneumatic digital tourniquets. A Tekscan FlexiForce® force sensor was used to measure applied force and to calculate the surface pressures under: the Toe-niquet™; T-Ring™ and surgical glove ‘roll down’ tourniquets in finger models. The lowest mean pressures were produced by the larger glove sizes (size 8) (25 mmHg), while the highest pressures were produced by the Toe-niquet (1560 mmHg). There was a significant overall difference in pressures exerted under tourniquets when comparing tourniquet type ( p<0.001) and finger size ( p<0.001) with these techniques. It is difficult to anticipate and regulate pressures generated by non-pneumatic tourniquets. Safe limits for application time and surface pressures are difficult to define. Further work is required to model the pressure effects of commercially available digital tourniquets and to identify which are most effective but safe.
Acute asthma in adults
Authors: Rajakulasingam Ramyah , Wilkinson Alex , Wilkinson Emily
Published: June 2013

Consultations related to asthma account for approximately 2–3% of GP encounters and 85% of asthma patients are managed solely in general practice. Uncontrolled asthma continues to be highly prevalent; in 2010 there were 1071 deaths from asthma in the UK. Exacerbations incur substantial costs to both the patient and the healthcare system. It is thus very important that all GPs and AiTs know how to manage acute asthma, are able to identify the ‘at risk’ patient and can arrange appropriate follow-up after acute exacerbations. This article aims to review current knowledge of acute asthma in adults, with an emphasis on management in a primary care setting according to the latest national guidelines.
Urethritis in men
Authors: Smith Thomas Joseph
Published: June 2013

Urethritis is a clinical syndrome characterised by inflammation of the urethra. It is the most common condition diagnosed and treated in men attending genitourinary medicine (GUM) clinics in the UK, with 80 000 new cases diagnosed each year. Urethritis can be the result of an infectious or non-infectious cause with the majority of cases following sexually transmitted infections.
Primary care management of vulnerable adults
Authors: Maddams Jessica
Published: June 2013

As doctors, patient safety should be our primary concern; this and other duties of a doctor are clearly set out in the General Medical Council's (GMC) Good Medical Practice. However, several high-profile inquiries into patient safety have raised concerns about how our most vulnerable patients are protected from harm. The Department of Health (DH) has recently issued new guidance to doctors and healthcare commissioners in the hope of improving safeguarding practice in England and Wales. The aim of this article is to summarise the key messages contained in the guidance, as well as providing practical advice on how GPs can meet their safeguarding responsibilities.
Accuracy and Bias in Perceptions of Relationship Interest for Intergroup and Intragroup Roommates
Authors: West Tessa V. , Dovidio John F. , Pearson Adam R.
Published: June 2013

Previous research suggests that the perception of anxiety in intergroup interactions can be detrimental to relationship formation. However, the underlying processes through which this occurs remain unclear. The present longitudinal study, which studied same- and different-race/ethnicity roommates over 6 weeks, investigated whether perceived partner anxiety moderates two types of processes previously shown to facilitate relationship development: (a) tracking accuracy, the relationship between perceivers’ assessments of their partner’s interest in remaining roommates and the partner’s stated interest and (b) positive directional bias, representing overestimation of partners’ relationship interest. Under high levels of perceived anxiety, both accuracy and directional bias were generally low, independent of the dyad type. In contrast, when perceived anxiety was relatively low, Whites and minorities in cross-race dyads and Whites in same-race dyads showed a positive directional bias in their evaluations; Whites in cross-race relationships also achieved tracking accuracy. Implications of perceived anxiety for perceptual dynamics in cross-group friendships are discussed.