bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of a normative framework for evaluating public engagement exercises: reliability, validity and limitations
Authors: Rowe Gene , Horlick-Jones Tom , Walls John , Poortinga Wouter , Pidgeon Nick F.
Published: August 2008

Over recent years, many policy-makers and academics have come to the view that involving the public in policy setting and decision-making (or “public engagement”) is desirable. The theorized benefits of engagement (over traditional approaches) include the attainment of more satisfactory and easier decisions, greater trust in decision-makers, and the enhancement of public and organizational knowledge. Empirical support for these advantages is, however, scant. Engagement processes are rarely evaluated, and when they are, the quality of evidence is generally poor. The absence of standard effectiveness criteria, and instruments to measure performance against these, hinders evaluation, comparison, generalization and the accumulation of knowledge. In this paper one normative framework for evaluating engagement processes is considered. This framework was operationalized and used as part of the evaluation of a recent major UK public engagement initiative: the 2003 GM Nation? debate. The evaluation criteria and processes are described, and their validity and limitations are analyzed. Results suggest the chosen evaluation criteria have some validity, though they do not exhaustively cover all appropriate criteria by which engagement exercises ought to be evaluated. The paper concludes with suggestions on how to improve the framework.
Where has the doctor gone? The mediazation of medicine on Dutch television, 1961—2000
Authors: Verhoeven Piet
Published: August 2008

Health issues and medical science receive a lot of attention on television. Of all the sciences, the European public is most interested in medicine, and the public uses television as their main source of information on science. There has been hardly any empirical research, however, into the historical development of the representation of medical science on television. The development of medical television was explored by carrying out a content analysis of Dutch non-fiction medical television programs spanning a period of 40 years. The speaking time allotted to experts has decreased over the years, while that allotted to laypeople has increased. We are seeing fewer references to sources and science and more expression of emotion and tension. The results suggest three periods of medical television: a scientific, a journalistic and a lay period. Medical television in 2000 shows a personified picture of patients against an instrumentalized and symbolized medical backdrop.
Staging scientific controversies: a gallery test on science museums' interactivity
Authors: Yaneva Albena , Rabesandratana Tania Mara , Greiner Birgit
Published: August 2008

The “transfer” model in science communication has been addressed critically from different perspectives, while the advantages of the interactive model have been continuously praised. Yet, little is done to account for the specific role of the interactive model in communicating “unfinished science.” The traditional interactive methods in museums are not sufficient to keep pace with rapid scientific developments. Interactive exchanges between laypeople and experts are thought mainly through the lens of a dialogue that is facilitated and framed by the traditional “conference room” architecture. Drawing on the results of a small-scale experiment in a gallery space, we argue for the need for a new “architecture of interaction” in museum settings based on art installation and simulation techniques, which will enhance the communication potentials of science museums and will provide conditions for a fruitful even-handed exchange of expert and lay knowledge.
Public perceptions and the nuclear waste repository on Orchid Island, Taiwan
Authors: Fan Mei-Fang
Published: August 2008

This paper examines public perceptions of the nuclear waste repository on Orchid Island, Taiwan and how differing perceived risk and knowledge of nuclear waste might relate to worldviews, culture and social experiences. The majority of the aboriginal Yami groups' perceptions of the impacts of the nuclear waste repository contrast sharply with the Taiwanese migrants' view on technology and environmental problems. Elderly Yami tend to regard nuclear waste as “evil ghosts.” At the same time, ambivalence and expressions of uncertainty about the risk prevail amongst Yami employed by Taipower (Taiwan Power Company), the generator of these evil ghosts. For many of the Taiwanese migrants, theYami's invariable objection to the nuclear waste repository is shaped by an exclusionary attitude toward anything foreign—i.e., a tribal resistance to the dominant Taiwanese society. The disputes over the nuclear waste repository reflect not just the Yami's fear of risk, but also the complexity of political and social relationships.
Designer babies on tap? Medical students' attitudes to pre-implantation genetic screening
Authors: Meisenberg Gerhard
Published: August 2008

This paper describes two studies about the determinants of attitudes to pre-implantation genetic screening in a multicultural sample of medical students from the United States. Sample sizes were 292 in study 1 and 1464 in study 2. Attitudes were of an undifferentiated nature, but respondents did make a major distinction between use for disease prevention and use for enhancement. No strong distinctions were made between embryo selection and germ line gene manipulations, and between somatic gene therapy and germ line gene manipulations. Religiosity was negatively associated with acceptance of “designer baby” technology for Christians and Muslims but not Hindus. However, the strongest and most consistent influence was an apparently moralistic stance against active and aggressive interference with natural processes in general. Trust in individuals and institutions was unrelated to acceptance of the technology, indicating that fear of abuse by irresponsible individuals and corporations is not an important determinant of opposition.
Analysis of an innovative survey platform: comparison of the public’s responses to human health and salmon genomics surveys
Authors: Ahmad Rana , Bailey Jennifer , Danielson Peter
Published: August 2008

This paper presents the results of the first two surveys conducted using the innovative NERD (Norms Evolving in Response to Dilemmas) platform. The structure, results, and analysis of the first two NERD surveys on genomics and human health and salmon genomics are compared. This comparison demonstrates that NERD is a cost-effective and efficient public consultation and experimental tool that has provided insight on public acceptance of new technologies such as genomics.
Physicians' and Nurses' Views On Infected Health Care Workers
Authors: Kagan Ilya , Lee Ovadia Karin , Kaneti Tami
Published: August 2008

This study investigated 204 doctors' and nurses' perceived knowledge of bloodborne pathogens and their attitudes towards bloodborne pathogen-infected health care workers. A structured questionnaire examined: (1) their perceived knowledge of bloodborne pathogens; (2) their attitudes towards bloodborne pathogen-infected personnel; and (3) their opinions on limitation of employment of bloodborne pathogen-infected personnel and restrictions on performing clinical procedures. The levels of HIV-related knowledge were significantly higher than for hepatitis C and B viruses. Although the participants demonstrated more positive attitudes towards hepatitis C- and B-infected health care workers, 64% recommended restricting infected personnel from performing invasive procedures. Attitudes were negatively correlated with opinions on restricting infected personnel from health care work or limiting their involvement in clinical activities. This study highlights the need to formulate a policy to cope with the professional and moral dilemmas related to infected health care workers employed in hospitals, especially for those involved in invasive procedures.
Student Nurses' Care of Terrorists and Their Victims
Authors: Margalith Ilana , Tabak Nili , Granot Tal
Published: August 2008

Key words: code of ethics; rejected patients; terrorism; terrorist victims; terrorists; values
Nurses' Professional and Personal Values
Authors: Rassin Michal
Published: August 2008

The purpose of this study was to measure professional and personal values among nurses, and to identify the factors affecting these values. The participants were 323 Israeli nurses, who were asked about 36 personal values and 20 professional values. The three fundamental professional nursing values of human dignity, equality among patients, and prevention of suffering, were rated first. The top 10 rated values all concerned nurses' responsibility towards patients. Altruism and confidentiality were not highly rated, and health promotion and nursing research were rated among the last three professional values. For personal (instrumental) values, honesty, responsibility and intelligence were rated first, while ambition and imagination were rated 14th and 16th respectively out of 18. Significant differences ( P < 0.05) were found among some personal and professional values rated as functions of culture, education, professional seniority, position and field of expertise. The results may assist in understanding the motives of nurses with different characteristics and help to promote their work according to professional ethical values.
The Process of Whistleblowing in a Japanese Psychiatric Hospital
Authors: Ohnishi Kayoko , Hayama Yumiko , Asai Atsushi , Kosugi Shinji
Published: August 2008

This study aims to unveil the process of whistleblowing. Two nursing staff members who worked in a psychiatric hospital convicted of large-scale wrongdoing were interviewed. Data were analyzed using a modified grounded theory approach. Analysis of the interviews demonstrated that they did not decide to whistleblow when they were suspicious or had an awareness of wrongdoing. They continued to work, driven by appreciation, affection, and a sense of duty. Their decision to whistleblow was ultimately motivated by firm conviction. Shortly after whistleblowing, wavering emotions were observed, consisting of a guilty conscience, fear of retribution, and pride, which subsequently transformed to stable emotions containing a sense of relief and regret for delayed action. It is necessary for nurses to recognize that their professional responsibility is primarily to patients, not to organizations. Nurses should also have professional judgment about appropriate allegiance and actions.
Gender and Power: the Irish Hysterectomy Scandal
Authors: McCarthy Joan , Murphy Sharon , Loughrey Mark
Published: August 2008

In April 2004 the Irish Government commissioned Judge Maureen Harding Clark to compile a report to ascertain the rate of caesarean hysterectomies at Our Lady of Lourdes Hospital in Drogheda, Republic of Ireland. The report came about as a result of complaints by midwives into questionable practices that were mainly (but not solely) attributed to one particular obstetrician. In this article we examine the findings of this Report through a feminist lens in order to explore what a feminist reading of the Report and the events that led to the inquiry will bring to light. We consider how sex and gender feature in the Lourdes case, draw attention to the deeply gendered asymmetries of power and privilege that existed between the men and women at the centre of this inquiry, and explore the impact such asymmetries had on this particular situation.
Habits in Perioperative Nursing Culture
Authors: Lindwall Lillemor , von Post Iréne
Published: August 2008

This study focuses on investigating habits in perioperative nursing culture, which are often simply accepted and not normally considered or discussed. A hermeneutical approach was chosen as the means of understanding perioperative nurses' experiences of and reflections on operating theatre culture. Focus group discussions were used to collect data, which was analysed using hermeneutical text analysis. The results revealed three main categories of habits present in perioperative nursing culture: habits that promote ethical values (by temporary friendship with patients, showing respect for each other, and spending time on reflection on ethics and caring); habits that hinder progress (by seeing the patient as a surgical case, not acknowledging colleagues, and not talking about ethics); and habits that set the cultural tone (the hidden power structure and achieving more in less time).
Family Snapshots: A Descriptive Classroom Exercise in Memory and Insight
Authors: Gladding Samuel T. , Cox Elizabeth
Published: August 2008

“Family Snapshots” are 100-words-or-less descriptive memories of times in the lives of families that highlight poignant moments. They complement other exercises within a family counseling course, including the use of genograms. Modeled after the Washington Post Magazine 's series “Life Is Short: Autobiography as Haiku,” these snapshots give writers awareness and insight because of their focus on telling a story rather than being didactic. Family snapshots have the potential for use in family counseling and in academic courses for family therapists. Examples of family snapshots are given along with interpretations of, reactions to, and limitations of this technique.
A Research Agenda for Sexual Revictimization
Authors: Macy Rebecca J.
Published: August 2008

Sexual violence against women is a significant problem with serious consequences for women's well-being, including an increased risk of subsequent sexual violence (or revictimization). Although there is substantial and mounting research about sexual revictimization, significant knowledge gaps remain. The factors and processes that drive revictimization are still largely unknown, and thus, little evidence exists to inform revictimization prevention interventions. Given the increased research attention to revictimization, this is an appropriate juncture to take stock of what is known about revictimization and to prioritize next steps for research. This article develops an agenda for further research by identifying three priority areas for investigation, including prospective research, revictimization resilience, and contextualizing revictimization. Next, the article overviews cutting-edge statistical methods that offer innovative ways to investigate these priority areas including growth, multilevel, and person-centered models. Recommendations for revictimization measurement and sampling are also given.
School Is Out
Authors: Mollenkopf John
Published: August 2008

The example of individual cities can certainly provide important lessons for urban theory, but it is unwise for social scientists to think that any one city provides a controlling template for urban development in this (or any other) period. Instead, we need to base our theories on why patterns vary across cities. In this respect, New York offers a fruitful counterpoint to Los Angeles, with Chicago occupying an intermediate position on a number of critical dimensions.
Children's Self-Reports on Perceived Effects on Taking Stimulant Medication for ADHD
Authors: Thorell Lisa B. , Dahlström Kerstin
Published: August 2008

Objective: This study investigates children's views on positive and negative effects of stimulant medication for ADHD and the children's willingness to stop taking medication. Method: Questionnaire data were collected from 79 children with ADHD and one of each child's parents. Results/Conclusion: Swedish children treated with stimulants generally experienced positive treatment effects in many areas, especially in the school setting, and a majority wished to continue taking their medication. There was, however, a small group of children who reported a relatively large number of negative effects. Few differences between parents and children were found for positive effects, although parents reported higher levels of negative effects. Results also indicate that the child's knowledge of why he or she is on stimulant medication and the parent's views of medication are important factors to take into consideration as they influence the child's willingness to continue his or her medication. (J. of Att. Dis. 2009; 12(5) 460-468)
Endovascular therapy for critical limb ischemia
Authors: Arain Salman A , White Christopher J
Published: August 2008

Abstract

Chronic critical limb ischemia (CLI) occurs when arterial perfusion is reduced below a threshold level that results in rest pain and/or tissue breakdown in the lower extremities. Importantly, it is associated with high cardiovascular morbidity and mortality. Without prompt revascularization, CLI may result in loss of a limb (i.e. amputation) and/or life. The goal of endovascular therapy is the re-establishment of pulsatile, straight-line flow to the distal extremity. Percutaneous transluminal angioplasty (PTA) has been shown to be effective and safe in the setting of CLI, with limb salvage rates that compare favorably with surgical procedures. Stents are indicated for failed PTA, while adjunctive therapies such as lasers, thermal angioplasty and atherectomy devices lack data demonstrating improved efficacy compared with conventional lower extremity interventions. In addition to successful revascularization, the institution of lifestyle changes, atherosclerotic risk factor modification, and pharmacologic therapies are indicated to reduce cardiovascular morbidity and mortality.
Measurement characteristics of the ankle–brachial index: results from the Action for Health in Diabetes study
Authors: Espeland Mark A , Regensteiner Judith G , Jaramillo Sarah A , Gregg Edward , Knowler William C , Wagenknecht Lynne E , Bahnson Judy , Haffner Steven , Hill James , Hiatt William R
Published: August 2008

Abstract

Many protocols have been used in clinical and research settings for collecting systolic blood pressure (SBP) measurements to calculate the ankle–brachial index (ABI); however, it is not known how useful it is to replicate measurements and which measures best reflect cardiovascular risk. Standardized measurements of ankle and arm SBP from 5140 overweight or obese individuals with type 2 diabetes were used to estimate sources of variation. Measurement characteristics of leg-specific ABI, as calculated using a standard algorithm based on the highest SBP of the dorsalis pedis or posterior tibial arteries, were projected using simulations. Coefficients of variability ranged from 2% to 3% when single SBP measurements were used and ABI was overestimated by 2–3%. Taking two SBP measurements at each site reduced standard errors and bias each by 30–40%. The sensitivity of detecting low ABI ranges exceeded 90% for ABI within 0.05 of the 0.90 clinical cut-point. The average and the minimum of the two (i.e. right and left) leg-specific ABI values had similar U-shaped relationships with Framingham risk scores; however, the average leg ABI had slightly greater precision. Replicating SBP measurements reduces the error and bias of ABI. Averaging leg-specific values may increase power for characterizing cardiovascular disease risk.
Critical limb ischemia: medical and surgical management
Authors: Slovut David Paul , Sullivan Timothy M
Published: August 2008

Abstract

Chronic critical limb ischemia (CLI), defined as > 2 weeks of rest pain, ulcers, or tissue loss attributed to arterial occlusive disease, is associated with great loss of both limb and life. Therapeutic goals in treating patients with CLI include reducing cardiovascular risk factors, relieving ischemic pain, healing ulcers, preventing major amputation, improving quality of life and increasing survival. These aims may be achieved through medical therapy, revascularization, or amputation. Medical therapy includes administration of analgesics, local wound care and pressure relief, treatment of infection, and aggressive therapy to modify atherosclerotic risk factors. For patients who are not candidates for revascularization, and who are unwilling or unable to undergo amputation, treatments such as intermittent pneumatic compression or spinal cord stimulation may offer symptom relief and promote wound healing. Revascularization offers the best option for limb salvage. The decision to perform surgery, endovascular therapy, or a combination of the two modalities (‘hybrid’ therapy) must be individualized. Patients who are relatively fit and able to withstand the rigors of an open procedure may benefit from the long-term durability of surgical repair. In contrast, frail patients with a limited life expectancy may experience better outcomes with endovascular reconstruction. Hybrid therapy is an attractive option for patients with limited autologous conduit, as it permits complete revascularization with a less extensive procedure, shorter duration of operation, and decreased risk of peri-operative complications. Amputation should be considered for patients who are non-ambulatory, demented, or unfit to undergo revascularization.
The prevalence of occult peripheral arterial disease among patients referred for orthopedic evaluation of leg pain
Authors: Bernstein Joseph , Esterhai John L , Staska Mitchell , Reinhardt Sally , Mitchell Marc E
Published: August 2008

Abstract

Lower extremity peripheral arterial disease (PAD) and musculoskeletal conditions both produce symptoms of leg pain, and may coexist. This study assesses the prevalence of PAD among patients referred to orthopedic surgery for evaluation of lower extremity pain. Fifty consecutive patients aged 50 years or more who had a chief complaint of leg pain, no history of trauma, and no previous history of PAD were studied prospectively. The presence of known risk factors for PAD and classic claudication symptoms was assessed by telephone interview and medical record review. Individuals were then evaluated by measurement of the ankle–brachial index (ABI) using Doppler and pulse volume recordings (PVR). A patient was deemed to have PAD if the ABI was below 0.9 or if the PVR demonstrated significant abnormalities. Occult PAD was detected in 10 of the 50 patients (20%) on the basis of the non-invasive vascular studies. There were no differences between patients with PAD and those without PAD regarding the presence of risk factors for PAD. None of the patients without PAD had claudication, while only one of the 10 patients with PAD had symptoms of classic claudication. In conclusion, 20% of patients referred by primary care providers to the orthopedic surgery clinic for lower extremity pain were discovered to have occult PAD. The majority of these patients did not have claudication. Orthopedic surgeons and primary care providers must maintain an appropriately high index of suspicion for PAD when evaluating patients with non-traumatic lower extremity pain.
Patient with both Wilkie syndrome and nutcracker syndrome
Authors: Barsoum Michel K , Shepherd Roger FJ , Welch Timothy J
Published: August 2008

Abstract

Wilkie syndrome or superior mesenteric artery syndrome is a rare cause of duodenal obstruction in pediatric and adult age groups. Its manifestations are due to compression of the third portion of the duodenum between the aorta and the superior mesenteric artery. We present one case of a 29-year-old female with a recent history of epigastric pain and severe weight loss due to duodenal obstruction from superior mesenteric syndrome. She was treated conservatively with jejunostomy tube feeding to regain loss of weight. Our case is unique in that the patient has also nutcracker syndrome.
An Internet-based weight loss programme — a feasibility study with preliminary results from 4209 completers
Authors: Jonasson J. , Linné Y. , Neovius M. , Rössner S.
Published: August 2008

Aims: 1. To identify characteristics of individuals seeking help for their weight problem via an internet-based programme. 2. To identify indicators of long term success in such a programme. Methods: An internet-based weight club (www.viktklubb.se) was used consisting of standard algorithms for calculating body mass index (BMI), food energy content and exercise energy cost. All members filled in basic data and could volunteer to fill in additional research related questions. Together with data on treatment success, attrition, and use of the various components of the programme, this information was automatically monitored and downloaded to a database. Results: Eighty-six percent of the members were female, and the age range was wide (range 18—101 years; mean 40.3 ±11.5 years). At baseline, BMI of the entire group was 29.3 ±5.1 kg/m2 with 39% obese and 45% overweight. Among the completers, 16% changed from overweight or obese to normal weight. This corresponded to 29% of the members losing 5-9.9% of their initial body weight and 20% losing ≥10% of their. The strongest predictors of weight loss were activity in the weight club as judged by number of logins and diary entries, and sex. Conclusions: A sizeable, but seemingly random, dropout rate was observed, together with significant dose-response effects between activity in the internet-based program and weight-loss among completers. Given its low cost and high accessibility at 24 hours a day, this form of programme delivery is interesting to evaluate and develop further, especially regarding attrition.
Screening tool development for health impact assessment of large administrative structural changes
Authors: Ravn Anne Katrine , Nicolaisen Henriette , Linnrose Karina , Folkersen Mikael W. , Kraemer Stella R.J. , Gulis Gabriel
Published: August 2008

Aims: Screening is the first, extremely important step of health impact assessment (HIA) methodology. It contributes to the decision to conduct or not conduct a full assessment, and predefines the main fields of interest of the assessment. Methods: Although there are examples of screening tools available on the Internet and in the scientific literature, in many cases lack of access to those tools creates a barrier to the use of HIA. Results: Denmark is undergoing a major structural change in state administration, moving many responsibilities from the state to the local level. Newly constructed councils are faced with challenges regarding their responsibilities in health promotion and other fields, and this has opened a window for the introduction of HIA at a local level. Owing to the lack of experience with HIA in Denmark, screening tools are lacking and are frequently requested by councils. Conclusions: This article describes a newly constructed screening tool for use at the local level, and describes how we approached the construction of the tool.
Birthweight and perinatal mortality among singletons and twins in north-eastern Tanzania
Authors: Habib Ndema Abu , Daltveit Anne Kjersti , Mlay Joseph , Oneko Olola , Shao John , Bergsjø Per , Lie-Nielsen Erik , Lie Rolv Terje
Published: August 2008

Background: Low birthweights as well as high perinatal mortality rates are common in most African populations. Little is known, however, about how low birthweight corresponds with higher mortality rates within African populations. Twins are known to have lower birthweights and higher perinatal mortality rates than singletons. If lower birthweights represent higher perinatal risk per se, small twins within a population with generally lower birthweights should have critically increased risks. Methods: In total, 15,255 births in a Tanzanian hospital during 1999—2006 were analysed to determine birthweight distribution and examine perinatal mortality rates (including stillbirths and neonatal deaths within 24 hours) by birthweight in twins and singletons. Referral births from outside the district where the hospital was situated were excluded from analysis. Results: The mean birthweight for births within an estimated normal distribution was 3172 g, with a standard deviation of 462 g. The overall perinatal mortality rate was 43.9 per 1000 births (95% confidence interval: 40.7—47.2). Perinatal mortality rates among twins and singletons were 91.0 and 41.1 per 1000 babies respectively, corresponding to a relative risk of 2.2 (95% confidence interval: 1.7—2.8). The birthweight distribution for twins was shifted to lower birthweights. Twins had a generally lower birthweight and an excess of extremely small births as compared to singletons. The increased mortality rate for twins appeared to be independent of birthweight. Conclusions: The two-fold increased risk of perinatal death for twins was observed across the whole birthweight distribution, and very small twins appeared to have an excess perinatal risk that was almost similar to that of larger twins.
How important are individual counselling, expectancy beliefs and autonomy for the maintenance of exercise after cardiac rehabilitation?
Authors: Mildestvedt Thomas , Meland Eivind , Eide Geir Egil
Published: August 2008

Aims: We examined whether autonomy supportive and self-efficacy enhancing individual lifestyle counselling was associated with improved maintenance of exercise and physical capacity compared with group based counselling. We also tested whether self-efficacy beliefs and autonomous motivation was associated with improved maintenance of exercise over time. Methods: Randomised controlled trial and longitudinal study of predictor variables. One hundred and seventy six (38 female) patients mainly with coronary heart disease were randomized to either have standard group based rehabilitation or to additionally receive the intervention. Patients were recruited from a 4-week cardiac rehabilitation programme with two years follow-up at Krokeide Centre in Bergen, Norway. Results: We found no statistically significant between-group differences. The groups showed an overall improvement of their self-evaluated physical capacity during the two years of the study, corresponding 7% change of score (p<0.001). The composite exercise score improved 6% during follow-up (p<0.001). Intensity of exercise activities improved 17% from inclusion to 24 months' follow-up (p<0.001). Self-efficacy for increased exercise, general expectancy and autonomous motivation were significant predictors of increased exercise and physical capacity. Controlled motivation hampered physical capacity improvement. Conclusions: Among this self-selected and motivated group of rehabilitation patients we found no additional effect of adding individual counselling to group-based interventions. Based on longitudinal documentation this cardiac rehabilitation programme improves long-term maintenance of exercise and physical capacity and this maintenance is related to autonomous motivation, general expectancy and self-efficacy.
Health service interventions targeting relatives of heart patients: A review of the literature
Authors: Nissen Nina Konstantin , Madsen Mette , Olsen Zwisler Ann-Dorthe
Published: August 2008

Aims: Relatives of heart patients experience anxiety, uncertainty, and low quality of life, and the hospitalization of a heart patient is associated with increased risk of death for the partner. Relatives' physical and mental problems may be rectified by activities established by the health services to support relatives and to enable them to handle the situation. This study systematically reviewed the literature on the latest health service interventions targeting relatives of heart patients. Methods: The literature about interventions targeting relatives of heart patients has been systematically reviewed to clarify what the health services do for relatives of heart patients and to assess the effects of interventions. We searched Medline, EMBASE, PsycINFO, CINAHL database, CSA and the Cochrane Library from January 2000 to March 2006. Results: Only six scientific articles reported on interventions testing health service activities for relatives of heart patients, and one literature review scrutinized earlier studies within the field. All the interventions indicate positive effects on patients' and/or relatives' health and well-being, in accordance with nurses' assessments. Nevertheless, the few studies and their questionable quality means that full evidence on the effects of the interventions is lacking. Conclusions: Future research should clarify the evidence for health service interventions and draw up guidelines for activities for the relatives of heart patients.
Paradoxes of consumer independence: a critical discourse analysis of the independent traveller
Authors: Caruana Robert , Crane Andrew , Fitchett James A.
Published: August 2008

The ideology of independence lies at the very core of the marketing agenda. For the free market to operate as a legitimate means of social organization, the right to be independent and to be free to enact ostensibly independent choices is to all intents and purposes sacred. Independence is an especially critical concept for marketing academics and practitioners to understand given the need to reconcile consumer demand for a sense of individuality, freedom and self, with an organization's need to commodify consumption activities in order to realize market growth. This paper examines the ways in which a sense of independence is successfully offered to consumers within paradoxically mass-market communications. The study investigates what it means to be an independent traveller by implementing a critical discourse analysis of alternative guidebooks. Findings suggest that guidebooks construct independence by reifying inaccessibility, interpreting value, and constructing inauthenticity for consumers. This promulgates a powerful myth of the independent traveller as someone who defies inaccessibility, hunts for bargains, and avoids inauthenticity. Crucially, each of these cultural practices also acts to engender an implicit relation of dependency between the text and the tourist that is found to contradict, but ultimately not threaten, the whole notion of independence that the consumption experience itself is predicated on.
The reflexive consumer
Authors: Beckett Antony , Nayak Ajit
Published: August 2008

Drawing on a detailed reading of the work of Peppers and Rogers (1993, 1997, 2004, 2005), this paper argues that their work offers an emblematic problematization of traditional mass marketing, which articulates a new mentality of marketing — collaborative marketing. Collaborative marketing, implemented through the practices of CRM, reframes the role and identity of the individual consumer within producer—consumer relationships, transforming them from sovereign chooser to active collaborator, or as they are termed here, reflexive consumers. Using Foucault's concept of governmentality the paper articulates the achievement of this transformation and the central role of reflexivity in this transformation of the consumer. We conclude that in redefining the nature of marketing, RM and CRM form new relays of power linking producer and consumer and that these relays re-interpret the antagonism between freedom and subjugation that lie at the heart of producer—consumer relationships.
Confidence in Government and Emotional Responses to Terrorism After September 11, 2001
Authors: Gross Kimberly , Brewer Paul R. , Aday Sean
Published: August 2008

In the aftermath of September 11, 2001, an unusually large percentage of Americans expressed high levels of confidence in the institutions charged with responding to the terrorist attacks. By the following summer, such confidence had declined significantly. This study draws on data from a panel study conducted in fall 2001 and summer 2002 to track Americans' emotional responses to terrorism and their levels of confidence in government institutions as well as to explore how these phenomena were related. It is focused on whether—and if so, how—the positive emotions of pride and hope influenced confidence in institutions and helped sustain that confidence over time. Positive relationships between hope, pride, and confidence during both study periods are found. Analysis of confidence and emotions over time suggests reciprocal relationships between confidence and hope. Taken as a whole, the findings point to the importance of considering the emotional sources and implications of confidence.
Ring Avulsion Injury with Rupture of Both Digital Arteries Despite a Completely Intact Skin Envelope
Authors: STÜTZ N. , FUGE D. , MEIER M. , REICHERT B.
Published: August 2008

A rare case of ring avulsion injury with avulsion of both digital arteries yet without external soft tissue, tendon or skeletal injury in a 29 year-old man is reported.
The Role of Ultrasound in the Management of Flexor Tendon Injuries
Authors: JEYAPALAN K. , BISSON M. A. , DIAS J. J. , GRIFFIN Y. , BHATT R.
Published: August 2008

The use of ultrasound scanning to establish tendon pathologies was assessed retrospectively in 17 patients in 18 digits. The ultrasound scan demonstrated four patterns: (1) normal intact tendons in four, (2) ruptured tendons in three, (3) tendons in continuity but attenuated in five and (4) tendons in continuity but thickened with fibrosis and decreased movement representing adhesions in five patients. Surgery was undertaken in only three cases, confirming the ultrasound diagnosis in two. Surgery was offered to all three patients with ruptures but was declined by two. Ultrasound imaging helped to avoid surgery in 14 cases by excluding flexor tendon re-ruptures. This allowed on-going mobilisation, leading to recovery of function.
Digital Blocks With and Without Adrenalin: a Randomised-Controlled Study of Capillary Blood Parameters
Authors: SÖNMEZ AHMET , YAMAN MERAL , ERSOY BURAK , NUMANOĐLU AYHAN
Published: August 2008

This study compared fingertip capillary blood gas parameters before and after digital anaesthesia using lidocaine with and without Adrenalin. Twenty patients who underwent surgery on their fingers under digital ring block anaesthesia were randomly anaesthetised with 2% lidocaine or 2% lidocaine with 1:80,000 Adrenalin. Capillary blood parameters were measured prior to the digital blocks and 15 minutes after the injections. In the plain lidocaine group, PO2 and SaO2 increased significantly after injection ( P = 0.025 and 0.017, respectively). In the lidocaine with Adrenalin group, PO2 and SaO2 decreased after the injections. However, this decrease was not statistically significant. Patients in the plain lidocaine group had return of sensation to the finger tip 4.8 (±0.6) hours after the operation. This period was 8.1 (±0.8) hours for the lidocaine with Adrenalin group.
Volkmann Sign of Non-Ischaemic Origin
Authors: JAIN V. , SEN B. , AGRAWAL M. , MEHTANI A. , DHAL A.
Published: August 2008

This paper presents six cases who had a contracture of the long flexor tendons of the fingers and exhibited Volkmann’s sign due to a chronic abscess or cysticercosis in the belly of the flexor digitorum profundus. All of them were treated conservatively, with full functional recovery in all the cases and with no recurrence.
Early Return to Work Following Open Carpal Tunnel Decompression in Lamb Freezing Workers
Authors: WYATT M. C. , VEALE G. A.
Published: August 2008

Carpal tunnel syndrome is common at the largest lamb processing plant in the world, especially in new lamb boners. The purpose of this study was to establish the incidence and whether expeditious return to work following open carpal tunnel decompression was possible. Two hundred patients with a neurophysiologically confirmed diagnosis underwent surgery between 2002 and 2006. One hundred and eighty-seven patients were assessed retrospectively and 13 prospectively. The incidence in new lamb boners was 10% in their first season. On average, workers commenced rehabilitation at 11 days post-operatively and full duties at 29 days post-operatively with minimal further time off taken. Ninety percent returned to their previous role. By 8 weeks in the prospective group visual analogue pain scores had improved from 8.75 to 2.0 ( P<0.01) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores had improved from 140 points to 68 ( P<0.01). Grip/pinch testing, static two-point discrimination scores and complication rates were comparable with previous studies. This study provides good evidence that coordinated, early rehabilitation and return to work is effective in a high-demand population.
The Relative Incidence of Fractures at the Base of the Proximal Phalanx of the Fingers in Children
Authors: AL-QATTAN M. M. , AL-ZAHRANI K. , AL-BOUKAI A. A.
Published: August 2008

There is debate regarding the most common fracture type at the base of the proximal phalanx of the fingers in children prior to closure of the epiphysis. In total, 100 consecutive children presenting with 103 fractures were included in a prospective study and their X-rays were reviewed by a consultant musculoskeletal radiologist. The study included 61 boys and 39 girls with a mean age of 10 (range 4–14) years. The most common fracture observed was the juxta-epiphyseal type II fracture (53%), followed by the Salter–Harris type II fracture (26%). Other fractures observed included Salter–Harris type I (4%), Salter–Harris type IV (5%), juxta-epiphyseal type I (8%), transverse metaphyseal (2%) and oblique metaphyseal (2%).
Reconstruction of the Distal Finger with Partial Second Toe Transfers by Means of an Exteriorised Pedicle
Authors: BRUNELLI F. , SPALVIERI C. , ROCCHI L. , PIVATO G. , PAJARDI G.
Published: August 2008

This study reports the outcome of a series of ten microsurgical fingertip reconstructions with partial toe transfers in which the vascular pedicle was exteriorised and subsequently excised after the transfer had become established. The aim of this technique was to provide better aesthetic and functional outcomes. The technique was successful and without complication in nine of the ten patients who had excellent functional and aesthetic outcomes. Arterial thrombosis resulted in partial necrosis of the fingertip in the other case.
The Usefulness of Ultrasonography in the Diagnosis of Carpal Tunnel Syndrome
Authors: PINILLA I. , MARTÍN-HERVÁS C. , SORDO G. , SANTIAGO S.
Published: August 2008

This study assessed the use of ultrasound in the diagnosis of carpal tunnel syndrome and to determine the best ultrasound criterion for diagnosis. Forty wrists of 27 patients with surgically proven moderate and severe carpal tunnel syndrome and 30 wrists of 15 controls were examined. Measurements of the cross-sectional area and the anteroposterior diameter of the median nerve at the inlet and outlet of the carpal tunnel were obtained. Patients also underwent electrophysiological evaluation. Median nerve ultrasonographic measurements were significantly higher in patients. The cross-sectional area of the median nerve at the tunnel inlet was found to be the most useful diagnostic criterion. The optimal cut-off value was 6.5 mm2 (sensitivity 89.5%, specificity 93%). Ultrasound parameters failed to correlate with the electrophysiological findings. The usefulness of ultrasonography in the diagnosis of carpal tunnel syndrome is discussed.
Can Local Supply of Bone Marrow Mononuclear Cells Improve the Outcome from Late Tubular Repair of Human Median and Ulnar Nerves?
Authors: BRAGA-SILVA J. , GEHLEN D. , PADOIN A. V. , MACHADO D. C. , GARICOCHEA B. , COSTA DA COSTA J.
Published: August 2008

The purpose of this non-randomised retrospective study was to compare nerve regeneration after reconnection with silicone tubes with two different strategies. A total of 44 patients with injured median or ulnar nerves in the forearm were surgically treated. In one group of patients, a silicone tube alone was placed in the nerve gap. In a second group, the silicone tube was filled with autologous bone marrow mononuclear cells obtained by aspiration from the iliac crest. Motor function, sensation and the effect of pain on function were assessed 1 year after surgery. The tubes filled with bone marrow cells showed better recovery than the empty tubes. The use of bone marrow mononuclear cells in addition to tube re-connection may promote better nerve regeneration than conventional tubular repair.
Comparison of Zones 1 to 4 Flexor Tendon Repairs Using Absorbable and Unabsorbable Four-strand Core Sutures
Authors: CAULFIELD R. H. , MALEKI-TABRIZI A. , PATEL H. , COLDHAM F. , MEE S. , NANCHAHAL J.
Published: August 2008

Absorbable sutures behave favourably in vitro and in an animal model. We report the outcome of flexor tendon injuries in a series of 272 consecutive patients treated over 45 months with a mean follow-up of 4 (range 3–12) months. Five hundred and seventy-six tendons were repaired in 416 digits. The patients were not randomised and all repairs were performed using a Strickland four-strand core technique. In 191 (73%) patients an absorbable core suture was used (Group 1) and in 81 (27%) a non-absorbable material was used (Group 2). There were six ruptures (2%) in Group 1 and two (2%) in Group 2. Using the original Strickland criteria, there were 72% excellent/good and 28% fair/poor results in the absorbable core suture group, and 73% and 27%, respectively, in the non-absorbable core suture group. This study suggests that appropriate absorbable core sutures can be used safely for flexor tendon repair.
Subscapularis Muscle Mechanics in Children with Obstetric Brachial Plexus Palsy
Authors: EINARSSON F. , HULTGREN T. , LJUNG B. -O. , RUNESSON E. , FRIDÉN J.
Published: August 2008

This study investigates the passive mechanical properties of the subscapularis muscle in children with a contracture as a result of obstetrical brachial plexus palsy. Muscle biopsies were harvested from nine children undergoing open surgery for shoulder contracture. Passive mechanical testing of single cells and muscle bundles was performed. Corresponding comparisons were made using muscle biopsies from seven healthy controls. Single muscle fibres from patients with obstetric brachial plexus palsy displayed a shorter slack sarcomere length, linear deformation of the fibre within a wider zone of sarcomere length and a greater relative increase in stiffness compared with muscle bundles.

We conclude that secondary changes in muscle fibre properties will occur as a result of a longstanding lack of sufficient passive stretch, leading to compensatory changes in the extracellular matrix. These results suggest the presence of a dynamic feedback system constituting a muscle-to-extracellular matrix communication interface.
An Assessment of Skin Preparation in Upper Limb Surgery
Authors: SULLIVAN P. J. , HEALY C. E. , HIRPARA K. M. , HUSSEY A. J. , POTTER S. M. , KELLY J. L.
Published: August 2008

Postoperative wound infections remain a major source of upper limb morbidity. The effectiveness of peri-operative human upper limb preparation was determined using a clear fluid antiseptic and an iodine-based solution over 60 and 90 seconds. Less area was missed using iodine over both times and increasing clear solution preparation time from 60 to 90 seconds improved coverage. Surgical experience had little outcome relevance and a 90-second preparation time with either solution was insufficient, with fingers being the sites most commonly missed.
Claw-finger Correction in Leprosy Using Half of the Flexor Digitorum Superficialis
Authors: NARAYANAKUMAR T. S.
Published: August 2008

The commonest paralytic deformity in leprosy is the claw deformity of the fingers. Many surgical procedures have been described and are practiced to correct this deformity, but none is free from complications. A modification of the Zancolli lasso operation in which only half of the flexor digitorum superficialis tendon of the middle finger was used as the motor is described and a comparative study of this and the conventional procedure was carried out in 70 hands in 70 patients. The results suggest that the modification is technically simpler, with comparable results to those of the conventional procedure and fewer complications.