bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical relevance of nalmefene versus placebo in alcohol treatment: Reduction in mortality risk
Authors: Roerecke Michael , Sørensen Per , Laramée Philippe , Rahhali Nora , Rehm Jürgen
Published: September 2015

Reduction of long-term mortality risk, an important clinical outcome for people in alcohol dependence treatment, can rarely be established in randomized controlled trials (RCTs). We calculated the reduction in all-cause mortality risk using data from short-term (6 and 12 months) double-blind RCTs comparing as-needed nalmefene treatment to placebo, and mortality risks from meta-analyses on all-cause-mortality risk by reduction of drinking in people with alcohol dependence. A reduction in drinking in the RCTs was defined by shifts in drinking risk levels established by the European Medicines Agency. Results showed that the reduction of drinking in the nalmefene group was associated with a reduction in mortality risk by 8% (95% CI: 2%, 13%) when compared to the placebo group. Sensitivity analyses confirmed a significant effect. Thus comparing the difference between nalmefene and placebo in reduction in drinking levels with results on all-cause mortality risk from meta-analyses indicated a clinically relevant reduction in mortality risk. Given the high mortality risk of people with alcohol dependence, abstinence or a reduction in drinking have been shown to reduce mortality risk and should be considered treatment goals.
The comparative tableau of mountains and rivers: emulation and reappraisal of a popular 19th-century visualization design
Authors: Hautdidier Baptiste
Published: September 2015

The ‘comparative tableau of mountains and rivers’ is a recently ‘rediscovered’ cartographic layout, aiming to illustrate the size distributions of the world's highest mountains and longest rivers. Its ‘river’ component is basically a barplot of the rivers’ unbent shapes, retaining a ‘thick’ cartographic description of their immediate hinterland. This display was a common feature of French and Anglo-American atlases during most of the 19th century, before it fell totally into disfavour, supplanted by more watershedcentred approaches. The paper is a critical assessment of the design principles of this visualization, via a modern emulation based on generic GIS rubbersheeting algorithms. A recreation of the chart of the world's longest rivers allows for a showcasing of the characteristics of the layout, its intellectual framing, and its political uses. Beyond a discussion of the approach's limitations, its innovative merits are demonstrated with two mapping applications on the evolution of landcover and administrative zonings alongside the Garonne River (southwest France), highlighting complex relationships of human societies along the streams of ‘their’ rivers.
Atmospheres of recovery: Assemblages of health
Authors: Duff Cameron
Published: September 2015

This article investigates recovery from mental health problems with reference to recent geographical analysis of affective atmospheres. In so doing, my research responds to recent calls to clarify the ways social, spatial and political factors may promote or impede recovery. As it is normally deployed, the notion of recovery emphasises the deeply personal character of rehabilitation from mental illness. It describes neither the full restoration of health (as a return to some ‘pre-morbid’ condition), nor the symptomologies characteristic of chronic illness, introducing the need for new ways of conceiving of a kind of health in illness. Throughout my analysis, I will treat recovery as an emergent capacity to manipulate the affects, spaces and events of a body’s “becoming well”. The always-unfinished event of recovery links human and nonhuman spaces, bodies, objects and forces in the joint expression of an enhanced capacity to affect (and be affected by) other bodies and spaces. I ground this discussion in analysis of ethnographic data collected in studies of recovery conducted in Melbourne, Australia. In presenting my findings, I will focus on three discrete atmospheres encountered in the course of this inquiry, and the ways these atmospheres modulated particular recovery events. In each instance, I will explore how atmospheres were encountered and co-constituted in the work of recovery, in the creation of an assemblage of health, and how these atmospheres gave social and material form to the process of becoming well. I will conclude by assessing how an attunement to affects, spaces and bodies may yield novel means of “staging” atmospheres of recovery in the promotion of an assemblage of health.
The impact of cognitive symptoms on migraine attack-related disability
Authors: Gil-Gouveia Raquel , Oliveira António G , Martins Isabel Pavão
Published: September 2015

Background

The socio-economic impact of migraine is mostly related to work loss either by absenteeism or decreased work performance. Migraine-associated cognitive dysfunction during an attack may contribute to these difficulties.

Objective

The objective of this article is to analyze the presence and relevance of cognitive symptoms during migraine attacks and to relate their intensity and symptom-related disability with other migraine-defining symptoms.

Methods

Consecutive migraine patients of a headache clinic completed diaries scoring each migraine symptom (including cognitive symptoms) intensity and symptom-related disability.

Results

Of 100 consecutive patients included in this study, 34 (all females, age average 31.8 ± 8.8 years) returned information on 229 attacks, on average 6.7 per participant. Every symptom’s intensity was always rated slightly higher than the disability it caused. Pain was the symptom scored with the highest intensity and disability, followed by cognitive symptoms (difficulty in thinking and worsening with mental effort) and photo- and phonophobia. Scoring was independent of any of the clinical variables. Attack intensity and disability scores correlated with intensity and disability from pain and from worsening with mental effort.

Conclusions

Attack-related cognitive symptoms are intense and disabling. Some attack-related cognitive symptoms correlate to intensity and disability subjectively attributed to the migraine attack. Cognitive performance should be addressed as a valuable secondary endpoint in trials of acute migraine treatment.
Learning and Knowledge Generation in Local Decision Making in the South
Authors: Pineda-Zumaran Jessica
Published: September 2015

Although current planning research acknowledges that learning and knowledge generation are key elements in decision making, the actual extent of their influence is still uncertain. By examining infrastructure-led decision making in Peru, this article presents a Learning-based Approach (LbA) to analyze the extent of their influence in the quality of decisions. The results reveal that learning and (new) knowledge can equally enhance and worsen local decision-making quality to different degrees. Nonetheless, the quality of infrastructure-led decisions can improve largely by empowering municipal officials usually engaged in routine practice through the generation of (spatial) knowledge on the physical and functional aspects of cities.
Neural Correlates of Visuomotor Learning in Autism
Authors: Sharer Elizabeth , Crocetti Deana , Muschelli John , Barber Anita D. , Nebel Mary Beth , Caffo Brian S. , Pekar Jim J. , Mostofsky Stewart H.
Published: September 2015

Motor impairments are prevalent in children with autism spectrum disorder. The Serial Reaction Time Task, a well-established visuomotor sequence learning probe, has produced inconsistent behavioral findings in individuals with autism. Moreover, it remains unclear how underlying neural processes for visuomotor learning in children with autism compare to processes for typically developing children. Neural activity differences were assessed using functional magnetic resonance imaging during a modified version of the Serial Reaction Time Task in children with and without autism. Though there was no group difference in visuomotor sequence learning, underlying patterns of neural activation significantly differed when comparing sequence (ie, learning) to random (ie, nonlearning) blocks. Children with autism demonstrated decreased activity in brain regions implicated in visuomotor sequence learning: superior temporal sulcus and posterior cingulate cortex. The findings implicate differences in brain mechanisms that support initial sequence learning in autism and can help explain behavioral observations of autism-associated impairments in skill development (motor, social, communicative) reliant on visuomotor integration.
Specific Regional and Age-Related Small Noncoding RNA Expression Patterns Within Superior Temporal Gyrus of Typical Human Brains Are Less Distinct in Autism Brains
Authors: Stamova Boryana , Ander Bradley P. , Barger Nicole , Sharp Frank R. , Schumann Cynthia M.
Published: September 2015

Small noncoding RNAs play a critical role in regulating messenger RNA throughout brain development and when altered could have profound effects leading to disorders such as autism spectrum disorders (ASD). We assessed small noncoding RNAs, including microRNA and small nucleolar RNA, in superior temporal sulcus association cortex and primary auditory cortex in typical and ASD brains from early childhood to adulthood. Typical small noncoding RNA expression profiles were less distinct in ASD, both between regions and changes with age. Typical micro-RNA coexpression associations were absent in ASD brains. miR-132, miR-103, and miR-320 micro-RNAs were dysregulated in ASD and have previously been associated with autism spectrum disorders. These diminished region- and age-related micro-RNA expression profiles are in line with previously reported findings of attenuated messenger RNA and long noncoding RNA in ASD brain. This study demonstrates alterations in superior temporal sulcus in ASD, a region implicated in social impairment, and is the first to demonstrate molecular alterations in the primary auditory cortex.
Dispositional Mindfulness as a Moderator of the Relationship Between Perceived Partner Infidelity and Women’s Dating Violence Perpetration
Authors: Brem Meagan J. , Wolford-Clevenger Caitlin , Zapor Heather , Elmquist Joanna , Shorey Ryan C. , Stuart Gregory L.
Published: September 2015

Mindfulness gained increased attention as it relates to aggressive behavior, including dating violence. However, no known studies examined how the combined influences of dispositional mindfulness and perceived partner infidelity, a well-documented correlate of dating violence, relate to women’s dating violence perpetration. Using a sample of college women ( N = 203), we examined the relationship between perceived partner infidelity and physical dating violence perpetration at varying levels of dispositional mindfulness, controlling for the influence of alcohol use. Results indicated perceived partner infidelity and dating violence perpetration were positively related for women with low and mean dispositional mindfulness, but not for women with high dispositional mindfulness. These results further support the applicability of mindfulness theory in the context of dating violence. Implications of the present findings provide preliminary support for mindfulness intervention in relationships characterized by infidelity concerns.
Victims to Saviors
Authors: Roychowdhury Poulami
Published: September 2015

Gender scholars have argued that legal reforms against violence position women as victims in need of state help. Using data collected from 22 months of participant observation with survivors of domestic violence in India, I urge academics to re-theorize the relationship between legal reforms and women’s citizenship during an era of neoliberal governance. Burdened with administrative tasks, Indian law enforcement personnel manage new rights claims by displacing regulatory duties onto survivors and caseworkers. Women who have access to women’s organizations are able to take advantage of these changes and “save” themselves and other women from violence. This article shows how neoliberal governmentality, when combined with women’s organizing, has the potential to restructure women’s relationship to the state.
Moisture absorption behavior of hybrid bionanocomposites of polylactic acid and evaluation of physicochemical properties
Authors: Sajna VP , Mohanty Smita , Nayak Sanjay K
Published: September 2015

The current study details on the moisture absorption behavior and its effect on the hybrid bionanocomposites of polylactic acid (PLA). In order to improve the compatibility between PLA and fiber, silanization was performed on fiber as well as C30B nanoclay was used as the secondary reinforcing filler. Silanization was confirmed through Fourier transform infrared study. In addition, thermogravimetric analysis (TGA) of fiber proved that hydrophilicity of fiber could decrease after silane treatment. Bionanocomposites of PLA were prepared using melt blending technique followed by injection molding. Samples were immersed in distilled water for 30 days at room temperature to analyze the moisture absorption behavior and its kinetic parameter. The results from moisture study revealed that PLA/fiber/nanoclay bionanocomposites have higher moisture resistance than PLA/fiber biocomposites. Further, the changes in mechanical as well as thermal properties of PLA and its composites during moisture absorption have been carried out. With increase in percentage of moisture absorption, the mechanical strength and modulus of composites decreased significantly, however, the unnotched impact strength and elongation at break found to improve. TGA of PLA and its composites revealed that thermal stability of composites decreased after moisture absorption. The morphology of the composites was monitored during moisture absorption, and the result revealed that moisture absorption has severely damaged the matrix–fiber interface.
The Connections Between Careers and Organizations in the New Career Era
Authors: McElroy James C. , Weng Qingxiong
Published: September 2015

This article introduces the reader to the articles contained in this special issue. It outlines how these studies contribute to our understanding of career development in light of the protean and boundaryless career era in which we now live. The articles contained in this special issue also raise questions that serve as a road map for future research. As a result of working on this special issue, we urge researchers to better clarify and differentiate among overlapping career-related concepts and to move career development research from a context-free approach to context-dependent one. Career development research that attempts to examine the connections between development in one’s organization, career, and life and the role played by career transitions would go a long way toward answering these questions raised.
The Impact of a Cultural Immersion Study Abroad Experience in Traditional Chinese Medicine
Authors: Conroy Shelley F. , Taggart Helen M.
Published: September 2015

Study abroad programs have increased dramatically. Most programs are short-term and include a cultural immersion as well as classroom and/or service learning. In this article, the authors discuss a study abroad program to China that included cultural immersion and classroom learning specific to traditional Chinese medicine. Participants kept journals with specific writing assignments and reflections about their experiences during the trip. At the conclusion of the trip, a qualitative survey was administered to the participants. Outcomes included the benefits of cultural immersion and a greater appreciation of cultural diversity, complementary and alternative medicine and holistic health care. Participants were able to describe transformational experiences of living in and learning from the Chinese culture and peoples. They intended to incorporate their experiences and enhanced understanding of traditional Chinese medicine and complementary and alternative therapies to provide culturally competent holistic health care in their nursing practice.
Sex Differences in Masculine Depression
Authors: Genuchi Matthew C. , Mitsunaga Lauren K.
Published: September 2015

Gender role socialization significantly affects how many men and women think, feel, and behave, which subsequently affects their depressive symptom presentation. This study involved an examination of symptoms of masculine depression in men and women college students ( n = 548) using the recently developed Masculine Depression Scale (MDS). Analyses of variance (ANOVA) were used to test for significant differences between men’s and women’s scale and subscale scores on the MDS. Overall, the results indicated that men endorsed significantly more externalizing symptoms than women. Additional clinical and research implications, limitations of the study, and suggestions for future research are also addressed.
Long-Term Outcome of Open Plantar Fascia Release
Authors: MacInnes Alasdair , Roberts Sam C. , Kimpton Jessica , Pillai Anand
Published: September 2015

Background:

Plantar fasciitis is thought to be a self-limiting condition best treated by conservative measures, but despite this many patients have a prolonged duration of symptoms and surgery may be indicated. Partial plantar fascial release is reported to have a short-term success rate of up to 80%, but anecdotally this was not thought to represent our local experience.

Methods:

An audit of long-term patient-reported outcomes following open partial plantar fascia release was performed. A total of 30 patients (33 feet) were identified over a 10-year period and case notes were reviewed. Patients were contacted by letter and invited to complete 2 validated patient-reported outcome score questionnaires (Visual Analog Scale–Foot and Ankle [VAS-FA] and Manchester Oxford Foot Questionnaire [MOXFQ]). Responses were received from 24 patients (26 feet). The average ages were 42.4 (range 24-61) for male and 46.2 (range 33-60) for female patients, with a female/male ratio of 2.7:1. The average duration of treatment prior to operative intervention was 3.1 years (range 1-5). Preoperatively, our cohort underwent a range of conservative measures. All patients were reviewed postoperatively, and average time from surgery to completion of questionnaires was 80 months (range 14-130).

Results:

The outcomes were worse in patients who had received preoperative steroid injections and this was found to be statistically significant. The mean MOXFQ score was 33.6 ± 3.9 (0-64). Mean VAS-FA score was 57.8 ± 4.9 (24-100).

Conclusion:

This study found a negative correlation between duration of follow-up and outcome, in both MOXFQ and VAS-FA, showing that patients continued to improve many years postoperatively. The authors also found worse outcomes with preoperative steroid injections, better outcomes in older patients, and a weak gender bias, suggesting results in men were better than those in women. A prolonged recovery period and generally poor outcomes leads the authors to suggest that open plantar fascia release is of questionable clinical value and that patients may improve in the natural course of the disease, in spite of surgery.

Level of Evidence:

Level III, comparative study.
Results of Arthroscopic Subtalar Arthrodesis for Adult-Acquired Flatfoot Deformity vs Posttraumatic Arthritis
Authors: Vilá y Rico Jesús , Jiménez Díaz Verónica , Bravo Giménez Beatriz , Mellado Romero María Ángeles , Ojeda Thies Cristina
Published: September 2015

Background:

The goal of this study was to compare results with arthroscopic posterior subtalar arthrodesis between patients treated for adult-acquired flatfoot deformity (AAFD) due to posterior tibial tendon dysfunction and patients with posttraumatic subtalar arthritis.

Methods:

Retrospective case series of 61 consecutive patients (group 1: posttraumatic arthritis, n = 37; group 2: AAFD, n = 24) averaging 49 years of age (range, 21-72 years) undergoing posterior arthroscopic subtalar arthrodesis via 1 or 2 percutaneous 6.5- to 7.3-mm screws, with a mean follow-up of 57.5 months (range, 24-105 months). Fusion was defined as the appearance of bony trabeculae across the subtalar joint on standard x-rays, along with clinical signs of union.

Results:

Patients with posttraumatic arthritis (group 1) were more predominantly male and younger than patients treated for AAFD (group 2). Overall, we achieved a 95.1% radiologic union rate after an average of 11.7 weeks. Complications appeared in 14.8% of patients. Union rate and complications did not differ significantly between groups. American Orthopaedic Foot & Ankle Society (AOFAS) scores improved significantly for both patient groups, although patients with AAFD showed significantly larger improvement and higher postoperative AOFAS scores, even after adjusting for age and sex (mean improvement in AOFAS scores: 27.0 ± 9.1 points for the posttraumatic arthritis group vs 34.9 ± 7.4 points for the AAFD group; P < .001).

Conclusions:

Arthroscopic subtalar arthrodesis was a safe and reliable technique, with consistent improvement in AOFAS scores throughout different patient subgroups, as well as comparable time to union and complication rates. Improvements were larger for patients treated for AAFD, even after adjusting for age and sex.

Level of Evidence:

Level III, retrospective case series.
A numerical study of the energy-absorption characteristics of metal tube-reinforced polymer foams
Authors: Alia RA , Guan ZW , Haldar AK , Cantwell WJ
Published: September 2015

This article investigates the energy-absorbing behaviour of lightweight foam structures reinforced with aluminium and steel cylindrical tubes. Initial testing focuses on establishing the influence of the inner diameter to thickness ratio ( D/ t) of the metal tubes on their specific energy-absorption characteristics under quasistatic compression and low velocity impact loading. Following this, individual metal tubes are embedded in a range of crosslinked PVC foams, and the specific energy-absorption characteristics of these reinforced systems are determined. The effect of increasing the number of tubes on the energy-absorbing response of the tube-reinforced structures is also studied. The crushing responses of both aluminium and steel structures are then predicted using the finite element analysis package Abaqus/Explicit, and the predictions of the load–displacement responses and the associated failure modes are compared to experimental results. Agreement between the numerical predictions and the experimental data is good across the range of structures investigated, with the model accurately predicting the compression response and failure characteristics observed in the structures. It has been shown that the stiffness of the foam does not significantly alter the energy-absorbing behaviour of the stiffer metal tubes, suggesting that the density of the foam should be as low as possible, whilst maintaining the structural integrity of the part.
‘Meaningful service’: Pedagogy at Israeli pre-military academies and the ethics of militarism
Authors: Eastwood James
Published: September 2015

How can ethics be a militarist practice? This article offers an answer to this question using a study of teaching at Israeli pre-military academies for high-school graduates. It argues that when ethics operates as a practice of subject formation, it is quite possible for it to reinforce the militarist process whereby citizens are turned into soldiers. Based on interviews with teaching staff and participant observation at these academies, this article offers an in-depth analysis of their pedagogy that highlights their increasingly prominent contribution to Israeli militarism. Israeli pre-military academies combine ethics with a programme of military preparation such that military service is presented as an opportunity for individual flourishing and participation in war is imbued with an ideology of ethical soldiering. Given the significance of Israel/Palestine as a theatre of violent conflict, this article argues that this case has wider significance for our understanding of the nature of militarism and of the relationship between ethics and war. It suggests that ethics has become increasingly bound up with militarism, and that there are therefore clear limits to its capacity to constrain the violence of war.
We the peoples? The strange demise of self-determination
Authors: Abulof Uriel
Published: September 2015

The self-determination of peoples is a fundamental legitimating principle of the international system; it justifies the system’s very existence. Through a vast diachronic corpus and pertinent data sets, this article nevertheless reveals a puzzling decline in the public discourse on, and practice of, self-determination over the last 50 years. I identify and assess four structural explanations for this decline: “lexical change” (replacing self-determination with alternative terms); “silent hegemony” (taking the norm for granted); “reactive rhetoric” (echoing conflicts and new state formation post hoc); and “mission accomplished” (rectifying the incongruence between national boundaries and state borders). Complementing these structural causes with agential reasons, I further suggest that powerful state actors and persuasive academics have sought to “tame” self-determination as both principle and practice, retaining the term but altering its meaning from a source of threat into a resource for containing it. Self-determination, however, has not been eliminated, and taming it may yet prove a pyrrhic victory.
The perils of realist advocacy and the promise of securitization theory: Revisiting the tragedy of the Iraq War debate
Authors: Van Rythoven Eric
Published: September 2015

Why does realist political advocacy for a more limited national security agenda fail? For nearly two decades, realists in general and Stephen Walt and John Mearsheimer in particular have publicly lamented an endemic problem of threat inflation in America, culminating in the unnecessary 2003 Iraq War. This article argues that understanding the failure of realist advocacy requires appreciating its roots in the model of the marketplace of ideas, an ironically liberal model of discourse that downplays questions of power. As a corrective, I argue that securitization theory and its framing of security debates as discursive, competitive and ultimately power-laden processes offers substantive insights into understanding realism’s anaemic interventions. Focusing specifically on the advocacy of Stephen Walt and John Mearsheimer in their opposition to the 2003 Iraq War, I examine how powerful processes involving social identity and collective emotion came to be turned against realists by their neoconservative interlocutors. In the final section, I suggest that a common research agenda among realism and securitization scholarship is needed to explore their joint interest in the statecraft of threat construction in order to produce practical, politically relevant knowledge.
Alexithymia in food-allergic versus healthy children and young adults
Authors: Polloni Laura , Gregori Dario , Ferruzza Emilia , Oricoli Cristina , Lazzarotto Francesca , Bonaguro Roberta , Toniolo Alice , Celegato Nicolò , Muraro Antonella
Published: September 2015

Alexithymia is a multifaceted personality construct associated with several medical illnesses. However, no studies have focused on food allergy. We investigated alexithymia among food-allergic youths, compared to a matched healthy sample. A total of 220 participants aged 9–25 years were assessed using the Toronto Alexithymia Scale and the Alexithymia Questionnaire for Children. Food-allergic patients reported higher levels of alexithymia compared to a matched healthy sample. Furthermore, an association between alexithymia and a clinical history of anaphylaxis was found among patients. Some possible hypotheses have been discussed considering physiological, psychological, developmental, and cognitive/behavioral factors.
‘You can’t walk with cramp!’ A qualitative exploration of individuals’ beliefs and experiences of walking as treatment for intermittent claudication
Authors: Galea Holmes Melissa N , Weinman John A , Bearne Lindsay M
Published: September 2015

Walking is an effective but underused treatment for intermittent claudication. This qualitative study explored people’s experiences of and beliefs about their illness and walking with intermittent claudication. Using the Framework method, semi-structured in-depth interviews included 19 individuals with intermittent claudication, and were informed by the Theory of Planned Behaviour and Common Sense Model of Illness Representations. Walking was overlooked as a self-management opportunity, regardless of perceptions of intermittent claudication as severe or benign. Participants desired tailored advice, including purposeful and vigorous exercise, and the potential outcome of walking. Uncertainties about their illness and treatment may explain low walking participation among people with intermittent claudication.
Waiting for scheduled surgery: A complex patient experience
Authors: Carr Tracey , Teucher Ulrich , Casson Alan G
Published: September 2015

The aim of this study was to understand experiences of wait time among patients awaiting scheduled orthopaedic or cardiac surgery. Using a qualitative approach, 32 patients completed two interviews each regarding their wait time experiences, including effects of waiting. Patient experiences of wait time varied regardless of actual wait time and included reports of restriction, uncertainty, resignation, coping and opportunity. Participants’ waiting experiences indicate a complex relationship between greater symptom severity and less tolerance for wait time. We suggest healthcare resources focus on alleviating the deleterious effects of waiting for certain patients rather than reducing absolute wait times.
Modernity and capitalist progress in the periphery
Authors: Paulani Leda Maria
Published: September 2015

The aim of this article is to show the peculiarities of modernity in a peripheral capitalist country like Brazil. To do this, our understanding of modernity and its relationship with capitalist progress will be explained. Subsequently, the particular character of capitalism in peripheral regions, with an emphasis on the Brazilian experience, will be analysed. More specifically, we shall explore the meaning of capitalist progress in Brazil in the last two decades, underlining Brazil’s role as an international platform for financial valorization and the retrocession of the country’s industrial production in a context of monetary stability. These observations on a peripheral economy and its historical trajectory will allow us, in a third step, to analyse the particularity of Brazilian modernity today. Finally, we shall discuss the role of compensatory income programs and the rise of the so-called ‘new middle class’ in this scenario.
Private/public – common
Authors: Pichierri Angelo
Published: September 2015

This article endeavors to describe and explain the constitution of modernity, its different trajectories, and its ongoing crisis using the Weberian concept of ‘legitimate order’, and by considering the changing relations between orders. One possible basis for the interpretation of the changing constitution of modernity – which involves, most significantly, a move beyond the great public/private dichotomy – is drawn from economic theory, or rather theories, of goods. The ability of certain orders to produce certain types of goods and to allocate them defines different types of society; in different societies, the same good will differ in nature and occupy a place within different property regimes. Changing relations can also be analyzed on the basis of the capacity of an order to impose upon others its negative externalities, and to manage effectively the production and allocation of its characteristic goods at different territorial scales.
Transforming patient care by introducing an electronic medical records initiative in a developing country
Authors: Shuaib Waqas , Suarez Julia Marielly , Romero Juan David , Pamello Carlos Dillon , Alweis Richard , Khan Aizaaz Ali , Shah Syed Raza , Shahid Hassan , PierreCharles Serge B. , Sanchez Laura Rosemary
Published: September 2015

The incorporation of an electronic medical record into patient care is a priority in developed countries, but faces significant obstacles for adoption in developing countries. The goal of our study was to define and assess the efficiency of a personalized intervention on village physicians’ use of electronic medical records in rural community health services of underprivileged areas. Six towns were selected with two bordering local health stations from each town. One was randomly given to the intervention group and the other to the control group. A structured on-site intervention was provided to village physicians in the intervention group, for 7 months. The results showed that in the intervention group, the percentage of households with complete records increased. The percentage of clinic medical records and complete child vaccination in the intervention group also increased from 2 to 14 percent (p = <0.05) and from 10 to 23 percent (p = 0.05), respectively. Our investigation demonstrated that on-site education, supervision, and technical support directly correlate with improved use of electronic medical record. Our results report the challenges in implementing such a system and the steps being taken to enhance likelihood of sustainability.
Does State Legislation Improve Nursing Workforce Diversity?
Authors: Travers Jasmine , Smaldone Arlene , Gross Cohn Elizabeth
Published: September 2015

A health-care workforce representative of our nation’s diversity is a health and research priority. Although racial and ethnic minorities represent 37% of Americans, they comprise only 16% of the nursing workforce. The purpose of this study was to examine the effect of state legislation on minority recruitment to nursing. Using data from the National Conference of State Legislatures, American Association of Colleges of Nursing, and U.S. census, we compared minority enrollment in baccalaureate nursing programs of states (Texas, Virginia, Michigan, California, Florida, Connecticut, and Arkansas) before and 3 years after enacting legislation with geographically adjacent states without legislation. Data were analyzed using descriptive and chi-square statistics. Following legislation, Arkansas (13.8%–24.5%), California (3.3%–5.4%), and Michigan (8.0%–10.0%) significantly increased enrollment of Blacks, and Florida (11.8%–15.4%) and Texas (11.2%–13.9%) significantly increased enrollment of Hispanic baccalaureate nursing students. States that tied legislation to funding, encouragement, and reimbursement had larger enrollment gains and greater minority representation.
Trends in Practice Patterns and Perspectives of Colorado Certified Nurse-Midwives
Authors: Hastings-Tolsma Marie , Tanner Tanya , Hensley Jennifer G. , Anderson Jessica , Patterson Elisa , Dunemn Kathleen N. , Purcell Susan K.
Published: September 2015

Healthcare resources are stretched perilously thin and the demand for primary healthcare services has never been greater. Despite this demand for service, relatively little is known about the practice environment of primary healthcare providers, particularly certified nurse-midwives (CNMs), where workforce surveys frequently include these specialists within the broader nurse practitioner category. A distinct professional discipline, nurse-midwives are one type of primary care provider recommended to enhance access to services. The objective of this study was to understand the nature of the nurse-midwifery practice environment in the state of Colorado. Online survey of Colorado CNMs ( N = 328) found little ethnic/racial diversity and an aging workforce, with most providing care in an urban, hospital/medical center environment. Several key legislative issues were identified though respondents felt ill prepared to engage in legislative change. Overall, CNMs were optimistic about the future of midwifery and were largely satisfied with their practice.
Computed Tomography Evaluation of Density Following Stereotactic Body Radiation Therapy of Nonspine Bone Metastases
Authors: McDonald Rachel , Probyn Linda , Poon Ian , Erler Darby , Brotherston Drew , Soliman Hany , Cheung Patrick , Chung Hans , Chu William , Loblaw Andrew , Thavarajah Nemica , Lang Catherine , Chin Lee , Chow Edward , Sahgal Arjun
Published: September 2015

Introduction:

Stereotactic body radiation therapy allows for the precise delivery of high-dose radiation to disease sites and is becoming increasingly used to treat nonspine bone metastases. Previous studies have shown that remineralization of lytic bone metastases follows after conventional radiotherapy. The objective of this study was to investigate changes in bone density in nonspine bone metastases following stereotactic body radiation therapy.

Methods:

A retrospective review was conducted for all patients treated with stereotactic body radiation therapy to nonspine bone metastases between May 2011 and April 2014. A minimum of 1 pretreatment and 1 posttreatment computed tomography scan was required. An independent musculoskeletal radiologist contoured the lesions on the most representative computed tomography slices. Density was measured in Hounsfield units and analyzed using pretreatment and posttreatment ratios.

Results:

Forty sites were treated (55% lytic, 30% sclerotic, and 15% mixed). The median follow-up duration was 7 months. Lytic osseous metastases from renal cell carcinoma progressed during initial follow-up imaging and then returned to baseline. Of 9 lytic lesions not from renal cell carcinoma, 6 showed an immediate increase in density and 2 remained stable. Six of 7 sclerotic lesions from prostate cancer showed decreased density throughout all follow-ups.

Conclusion:

Stereotactic body radiation therapy is efficacious in the remineralization of lytic and demineralization of sclerotic nonspine bone metastases.
TNF-α mutation affects the gene expression profiles of patients with multiple trauma
Authors: Chen GT , Han N , Li GF , Li X , Li G , Liu YZ , Wu W , Wang Y , Chen YX , Sun GX , Li ZC , Li QC
Published: September 2015

Multiple trauma can induce sepsis and organ failure, even threaten people’s lives. To further study the mechanisms of multiple trauma, we analyzed microarray of GSE5760. GSE5760 was downloaded from the Gene Expression Omnibus including a total of 58 peripheral blood transcriptome from patients without (WT, n = 30) and carrying (MUT, n = 28) the tumor necrosis factor (TNF) rs1800629 A variant. The differentially expressed genes (DEGs) were screened using the limma package in R and the Benjamin and Hochberg method in a multi-test package. Then, functional enrichment analysis of DEGs was performed. Also, transcription factors significantly related to DEGs were searched using WebGestalt and interaction network of transcription factors and DEGs were constructed using STRING online software. Furthermore, pathway enrichment analysis for the DEGs in the interaction network was conducted using KO-Based Annotation System (KOBAS). We screened 39 DEGs including 27 upregulated and 12 downregulated genes. The enriched functions were associated with biological process (BP) (such as response to hypoxia, P value = 0.039803), cell components (CC) (such as mitochondrial part, P value = 0.043857), and molecular function (MF) (such as structural constituent of ribosome, P value = 0.008735). Besides, RPS7 and RPL17 were associated with ribosome and participated in ribosome pathway. PPP2R2B was related to mitochondrion. KCNMA1, ALAS2 and SOCS3 were associated with hypoxia. Moreover, transcription factors of LEF1, CHX10, ELK1, SP1, and MAZ were significantly related to DEGs. RPS7, RPL17, PPP2R2B, KCNMA1, ALAS2, and SOCS3 might relate to multiple trauma. And TNF-α mutation could cause sepsis in patients with multiple trauma by changing the expression of these genes.
Role of endogenous TNF-α in cardiomyocyte apoptosis induced by bacteria lipoprotein and the protective effect of IL-10
Authors: Li Zhicai , Zhou Jing , Zhu Dongmei , Zhang Qian , Huang Min , Han Yi , Zhou Suming
Published: September 2015

Cardiomyocyte apoptosis is thought to play an important role in sepsis-induced cardiodepression. Previous studies mainly focused on the role of exogenous TNF-α in sepsis-induced cardiac damage, however, the role of endogenous TNF-α is rarely known. Therefore, we hypothesized that endogenous TNF-α also contributed to sepsis-induced cardiomyocyte apoptosis. Primary neonatal rat cardiomyocytes were time- and dose-dependently stimulated with BLP and TNF-α. In separate experiments, cells were treated with TNF-α antagonist and IL-10, respectively, to determine effects of endogenous TNF-α and exogenous IL-10 on BLP-induced cardiomyocyte apoptosis. After treatment, apoptosis was evaluated by nuclear condensation, membrane permeability change, caspase-3 activation, and pro- to anti-apoptotic protein (bax to bcl-2) expression. Treatment of cardiomyocytes with BLP and TNF-α both significantly induced caspase-3 activation in a time- and dose-dependent manner and caused apparent nuclear condensation and increased membrane permeability. TNF-α antagonist pretreatment attenuated BLP-induced caspase-3 activation, and downregulated bax/bcl-2 ratio. In addition, administration of IL-10 inhibited TNF-α production and suppressed cardiomyocyte apoptosis induced by BLP. Our data suggest that endogenous TNF-α play an important role in BLP-induced cardiomyocyte apoptosis and IL-10 protect cardiomyocytes from BLP-induced apoptosis, an effect partially through inhibition of endogenous TNF-α production.
Depressive symptoms and fatigue as mediators of relationship between poor sleep factors and medication adherence in HIV-positive women
Authors: George Dalmida Safiya , McDonnell Holstad Marcia , Fox Rodney , Mara Delaney Augustina
Published: September 2015

Patients living with HIV commonly experience sleep disturbances, depression, excessive daytime sleepiness and fatigue, which negatively affect antiretroviral medication adherence. Few studies have examined relationships between these symptoms and medication adherence in women living with HIV or examine the mechanisms through which these symptoms affect adherence. The purpose of this study was to examine the associations between sleep quality, excessive daytime sleepiness and medication adherence, and energy/fatigue and depression as mediators of these relationships among 206 women living with HIV. Correlations, t-tests and hierarchical regression analysis were utilised. The majority of participants (93.2%) were African American or Black. The average age of participants was 43.3 years and average years infected was 9.6. More than half of the women reported poor sleep quality and, on average, participants reported moderate daytime sleepiness, high depressive symptoms and moderate levels of fatigue. Additionally, both depression and low energy/fatigue were identified as significant mediators of the relationship between sleep quality and medication adherence. Depression also significantly mediated the relationship between excessive daytime sleepiness and medication adherence. The findings from this study highlight the impact of sleep on medication adherence and associated mechanisms and emphasise the need for healthcare providers to assess and address sleep factors when providing care for patients living with HIV.
Ebola viral disease and pregnancy
Authors: Black Benjamin O , Caluwaerts Séverine , Achar Jay
Published: September 2015

Ebola viral disease’s interaction with pregnancy is poorly understood and remains a particular challenge for medical and para-medical personnel responding to an outbreak. This review article is written with the benefit of hindsight and experience from the largest recorded Ebola outbreak in history. We have provided a broad overview of the issues that arise for pregnant women and for the professionals treating them during an Ebola outbreak. The discussion focuses on the specifics of Ebola infection in pregnancy and possible management strategies, including the delivery of an infected woman. We have also discussed the wider challenges posed to pregnant women and their carers during an epidemic, including the identification of suspected Ebola-infected pregnant women and the impact of the disease on pre-existing health services. This paper outlines current practices in the field, as well as highlighting the gaps in our knowledge and the paramount need to protect the health-care workers directly involved in the management of pregnant women.
Pregnancy in acromegaly
Authors: Laway Bashir A.
Published: September 2015

With advances in surgical and medical treatment and the availability of assisted reproductive techniques, pregnancy in women with acromegaly is more frequently encountered. Diagnosis of acromegaly during pregnancy is difficult because of changes in growth hormone and insulin like growth factor-1 (IGF-1) axis secondary to placental production of growth hormone. The difficulty is compounded by the inability of routine hormone assays to detect placental growth hormone. In the majority of patients with acromegaly, pregnancy does not have an adverse effect on mother or fetus and pituitary mass does not increase in size. The level of IGF-1 usually remains stable because of the effect of estrogen causing a growth hormone resistant state. In patients with pituitary macroadenoma, the possibility of an increase in size of the pituitary mass needs to be kept in mind and more frequent monitoring is required. In case of tumor enlargement, pituitary surgery can be considered in the mid trimester. Experience with the use of medical treatment for acromegaly during pregnancy is increasing. Dopamine agonists, somatostatin analogs or growth hormone receptor antagonists have been used without any adverse consequences on mother or fetus. At present, it is advisable to stop any medical treatment after confirmation of pregnancy till more data are available on the safety of these drugs.
Microstructure and brazeability of SiC nanoparticles reinforced Al–9Si–20Cu produced by induction melting
Authors: Sharma A. , Lim D.-U. , Jung J.-P.
Published: September 2015

The effect of 0.5 wt-% SiC nanoparticle addition on microstructure and brazeability of Al–9Si–20Cu alloys has been investigated. The brazing is performed using the filler at 550°C for 30 min. Microstructural observations reveal the refinement of Si and CuAl2 in Al–9Si–20Cu–0.5SiC composite. The average size of Si particles decreases from ∼9 to ∼4 μm. It has been shown that SiC nanoparticles improve the filler brazeability; the spreading ratio increases up to 88.4% as compared to 76.67% over Al–9Si–20Cu alloy. The tensile strength and ductility of Al–9Si–20Cu–0.5SiC are also enhanced by 47 and 53% respectively. The melting point shows a depression ∼4°C in Al–9Si–20Cu–0.5SiC and thus can be a potential filler candidate for brazing industries.