bluuebunny/crossref_metadata_2025 huggingface dataset:
Equipping Aspiring Principals for the Principalship in Hong Kong
Authors: Ng Shun Wing
Published: April 2013

The quality of school principals is of paramount importance for quality education. This article examines the leadership capacities of a group of 228 aspiring principals who participated in a training programme for the principalship in four cohorts. A questionnaire consisting of 24 questions in six core areas of leadership was constructed and distributed to the aspirants one month before the commencement of the training programme. The purpose of the study can contribute to a better understanding of the aspirants’ leadership capacities in general and the refinement of the training programme for aspirants in particular. The findings indicate that the aspirants seemed to feel more competent in the leadership area of ‘teacher professional growth and development’ than they did with regard to ‘quality assurance and accountability’, ‘learning, teaching and curriculum’, ‘strategic direction and policy environment’, ‘external communication and connection to the outside world’, and finally ‘staff and resources management’.
Couples’ experiences of interacting with outside others in chronic fatigue syndrome: a qualitative study
Authors: Brooks Joanna , King Nigel , Wearden Alison
Published: April 2013

Objectives

Social isolation and stigma are frequently reported by patients with chronic fatigue syndrome/myalgic encephalomyelitis and relationships in the home environment with those close to the patients (their ‘significant others’) may thus be particularly important. Rather little attention has yet been paid to the beliefs and experiences of ‘significant others’ themselves in this context. This study sought to explore in-depth the beliefs and experiences of both patients and ‘significant others’ in relation to chronic fatigue syndrome/myalgic encephalomyelitis.

Methods

In-depth interviews using a semi-structured interview schedule designed around the core constructs of the Common-Sense Model of self-regulation were conducted with two patients with chronic fatigue syndrome/myalgic encephalomyelitis and their spouses. Interpretative Phenomenological Analysis was used to analyse interview data.

Results

Experiences of social interactions in relation to chronic fatigue syndrome/myalgic encephalomyelitis with others outside of the relationship dyad emerged as a key issue for all participants when reflecting on their experiences of living with the condition. These concerns are presented under two themes: interactions with healthcare professionals and interactions with the social world.

Conclusions

It is evident that significant others play an important role in the lived experience of chronic fatigue syndrome/myalgic encephalomyelitis. For both patients and significant others, the wider social world and interactions with outside others may be important influences on dyadic coping in chronic fatigue syndrome/myalgic encephalomyelitis. Both future research and treatment interventions could usefully include a ‘significant other’ perspective.
Examining the energy envelope and associated symptom patterns in chronic fatigue syndrome: does coping matter?
Authors: Brown Abigail A , Evans Meredyth A , Jason Leonard A
Published: April 2013

Objective/Hypothesis

The objective of this study was to examine sub-types of individuals with chronic fatigue syndrome based on variables that are associated with the energy envelope theory and to examine the role of coping strategies in explaining the differences found between the subtypes.

Methods

Cluster analysis was used. Grouping variables included physical functioning, post-exertional malaise severity, and the extent to which an individual was outside of the energy envelope. These clusters were evaluated using discriminant function analysis to determine whether they could be differentiated based on coping styles.

Results

Cluster analysis identified three groups. Clusters 1 and 2 were consistent with the energy envelope theory. However, Cluster 3 was characterized by patients with the most impairment, but they were to a lesser extent exceeding their energy envelope. Coping strategies explained a small percentage (10%) of the variance in differentiating the clusters.

Discussion

Energy maintenance may be associated with improved functioning and less severe symptoms for some. However, patients in Cluster 3 were closer to remaining within their energy envelope and also used higher levels of adaptive coping but were more impaired than Cluster 2. This suggests that adaptive coping strategies were not associated with improved health, as members of Cluster 3 were severely limited in functioning.
Assessment of performance properties of wetsuits
Authors: Naebe Maryam , Robins Nicholas , Wang Xungai , Collins Paul
Published: April 2013

Wetsuits are an integral part of surfing especially in the southern regions of Australia. There is currently little information about mechanical, comfort and thermal properties of wetsuits. There is a demand from wetsuit manufacturers to better understand the neoprene properties and wetsuit performance. The performance characteristics of eight top-selling wetsuits, from both high end and low end of the market, were examined. These characteristics include thickness, elasticity, bursting strength, hydrophobicity, thermal conductivity and seal strength. Tensile assessment revealed that neoprene foam was strong and its stretch recovery was well beyond 1.6 times of the original length. Neoprene was found to be hydrophobic with very low surface energy. High-end wetsuits with higher thickness showed slightly higher thermal resistance than low-end wetsuits, indicating that both thickness and bulk density of neoprene influenced thermal properties. High-end wetsuits with fluid seal were stronger than low-end wetsuits with stitched seal.
A Systematic Review on the Reporting of Outcome Data in Studies on Autologous Osteochondral Transplantation for the Treatment of Osteochondral Lesions of the Talus
Authors: Hannon Charles P. , Baksh Nikolas , Newman Hunter , Murawski Christopher D. , Smyth Niall A. , Kennedy John G.
Published: April 2013

Purpose. The purpose of this study was to systematically review studies on autologous osteochondral transplantation (AOT) for osteochondral lesions (OCLs) of the talus and descriptively analyze the outcome data reported to determine whether it is consistent from one study to another and able to be pooled for systematic review. Methods. A systematic electronic search was performed using the MEDLINE and EMBASE databases. Studies that were published between January 1966 and June 2011 were included in the review. Only studies that reported data specifically on AOT for treatment of OCLs of the talus and written in English were included in this review. A predefined data sheet with 36 variables was created, and it was determined whether or not each of those variables were reported or not reported. The 36 variables were then grouped into 6 categories, and the categorical means were reported. Results. A total of 20 studies were included in this systematic review. The categories of general demographics and study design were generally well reported (each more than 80% of studies). Patient-reported outcomes and clinical variables were reported less in 73% and 67% of studies, respectively. The least-reported categories were patient history (45%) and imaging data (49%). Conclusions. Inconsistencies and an underreporting of data were apparent between studies, such that pooling was deemed not possible. An effort must be made by investigators to ensure that there is adequate reporting of data in studies of AOT treatment for OCLs of the talus.

Levels of Evidence: Therapeutic Level IV
Humble Self-Enhancement
Authors: Eriksson Kimmo , Funcke Alexander
Published: April 2013

Prior research has linked religiosity to certain forms of self-enhancement. We extend this literature by three studies linking religiosity to the well-established better-than-average effect (BAE). First, a reanalysis of self-judgments of desirable characteristics in 15 nations showed that the BAE was stronger in more religious countries, even taking into account gross domestic product, interdependence, and economic inequality. Second, in two online surveys totaling 1,000 Americans, the BAE was stronger among more religious individuals. Several observations indicated that this relation was due to individuals self-stereotyping with respect to their religious in-groups. In particular, the relation was restricted to characteristics on the warmth dimension, consistent with the religious stereotype, and the average religious in-group member tended to be judged even more favorably than self. The latter phenomenon, which we term humble self-enhancement, is consistent with other studies linking stronger religiosity to greater favoritism of the religious in-group and greater derogation of religious out-groups.
Collateral Intimate Partner Homicide
Authors: Meyer Emily , Post Lori
Published: April 2013

Collateral intimate partner homicide (CIPH) is an underinvestigated genre of intimate partner violence (IPV) where an individual(s) connected to the IPV victim is murdered. We conducted a content analysis of a statewide database of CIPH newspaper articles (1990-2007). Out of 111 collateral murder victims, there were 84 IPV female focal victims and 84 male perpetrators. The most frequently reported CIPH decedent was the focal victim’s new partner (30%); 45% of focal victims were themselves killed. News reports framed CIPH as the unexpected result of interpersonal conflict, despite evidence of a systematic pattern of coercion and violence that capitulated in murder.
Knowledge Management
Authors: Kiran Ravi , Agarwal Parul D. , Verma Anil K.
Published: April 2013

The present study covers the knowledge management (KM) in institutions of higher technical education (IHTEs) from the perspective of thought leaders and junior academia to identify whether there is a difference of opinion regarding KM strategies, including knowledge technologies, knowledge acquisition, knowledge storage, knowledge dissemination, and KM-based framework for research and curriculum development (CD). Data have been collected through structured questionnaire from 141 respondents covering 30 higher educational institutions in India, including national- and state-level institutions—Designations of the targeted respondents in the IHTEs have been categorized into (a) senior academia, that is, professors, heads, and associate professors occupying senior management positions, considered to be the institute overseers and thought leaders of KM and (b) junior academia consisting of assistant professors and lecturers who are using and also contributing to the KM system. ANOVA has been used to see whether there is a significant difference of opinion among the two groups of knowledge users. The results of the study highlight a significant difference among the two groups regarding knowledge technologies, knowledge acquisition, knowledge storage, and knowledge dissemination. But, there is a consensus regarding KM-based framework for research and CD.
Involvement in Physical Activity
Authors: Gavin James , Mcbrearty Madeleine , Harvey William
Published: April 2013

A total of 1,096 adolescents participated in 123 focus groups regarding the perceived outcomes of their involvement in sports and physical activity (PA). The groups, segmented by grade level, sex, and school types, were conducted in both public and private high schools in Montreal, Quebec. We sought to understand, through the participants’ own words, their perception of the outcome matrix of involvement in sports and PA. Focus group questions emphasized changes that adolescents associated with such engagement. In particular, participants were asked how sports and PA might influence behaviors, emotional states, personal characteristics, and other outcomes. Twelve themes were identified in the responses: Positive Health and Physical Changes (18.5%), Activity-Related Positive Emotions (15.6%), and Personal Learning (11.3%) were most prevalent in the discussions. A cluster of deeper personal changes thematically described as Self-Identity, Autonomy, and Positive Character Development accounted for another 16.5% of the responses. Relatively few commentaries emphasized negative effects (7.1%). Converting the proportions of qualitative data into a quantitative index allowed us to analyze potential differences in emphasis according to sex, age, and school type. Though a few significant findings emerged, the larger pattern was of a uniform perceptual map across the variables for this adolescent sample. Implications drawn from this investigation highlight the need to clearly articulate concrete pathways to positive nonphysical changes (e.g., mood states, autonomy, positive character development) from engagements in sports and PA.
A Ten-Value-Type Framework Associated With Spectator Sports
Authors: Gau Li-Shiue , James Jeffrey D.
Published: April 2013

Prior value studies in sport settings have been focused on participation rather than spectatorship. This study is an initial step in examining the values associated with spectator sports. Interviews and focus groups were utilized in this qualitative study within four progressive phases for triangulation, transferability, and constant comparative assessment. A total of 54 individuals participated in the study. Because values were subjectively perceived at the highest level of abstraction reflecting desirable preference experiences, the interviews were designed to include seven categories of questions: Three categories dealt with observed behaviors and implied metaphors, and four categories including questions comparing spectator sports and sport participation, religion, other leisure activities, and substitutes. Grounded data techniques guided the coding procedure. Using the transcriptions and notes from 26 interviews and three focus groups, five coders were used to provide evidence of interrater reliability. Based on the results of the data analyses, a 10-value-type framework was developed in relation to spectator sports: (a) Enjoyment (pleasure and satisfaction), (b) Sociability (social interaction through sport spectating), (c) Identity (enhancing self-esteem), (d) Status (pursuing social recognition), (e) Moral, (f) Spirituality (inner peace, strength, meaning, and purpose in life), (g) Epistemic, (h) Aesthetics, (i) Ritual (sports spectating becomes a series of formal and serious acts followed regularly and invariably as end-experience), and (j) no or negative values. Different from Kahle’s (1983), Maslow’s (1970a), and Schwartz’ (1992) value theories, the framework was specifically associated with spectator sports and is expected to better predict spectator sport behavior than does a scale measuring motivations of sports fans.
E-Book Readers in Higher Education
Authors: Olsen Arthur N. , Kleivset Birgitte , Langseth Henry
Published: April 2013

This article reports on a research project at the University of Agder that has studied the use of e-readers as a tool for academic study. E-readers (Kindle DX and iPad) were loaded with texts from required reading lists in five courses with 94 participating students. Initially, 87 students responded to the invitation to participate in a survey, but eventually 13 of these submissions had to be removed, as the degree of completion was not sufficient. The final response rate achieved was 79%. Students were in general positive to the use of e-readers but still show a preference for print on paper as the best medium for serious academic study. When reading books, 54% preferred print, 28% a combination of print and e-reader, and finally only 11% were satisfied solely using an e-reader. The iPad scored significantly better than the Kindle DX on tasks that required active interaction with the texts such as highlighting and note taking.
Only severe thrombocytopenia results in bleeding and defective thrombus formation in mice
Authors: Morowski Martina , Vögtle Timo , Kraft Peter , Kleinschnitz Christoph , Stoll Guido , Nieswandt Bernhard
Published: April 2013

Key Points

Hemostasis, thrombosis, and ischemic brain infarction efficiently occur at unexpectedly low platelet counts in mice. The threshold platelet count required for occlusive thrombus formation differs between thrombosis models.
Hypothalamic IGF-I Gene Therapy Prolongs Estrous Cyclicity and Protects Ovarian Structure in Middle-Aged Female Rats
Authors: Rodríguez Silvia S. , Schwerdt José I. , Barbeito Claudio G. , Flamini Mirta A. , Han Ye , Bohn Martha C. , Goya Rodolfo G.
Published: April 2013

There is substantial evidence that age-related ovarian failure in rats is preceded by abnormal responsiveness of the neuroendocrine axis to estrogen positive feedback. Because IGF-I seems to act as a permissive factor for proper GnRH neuronal response to estrogen positive feedback and considering that the hypothalamic content of IGF-I declines in middle-aged (M-A) rats, we assessed the effectiveness of long-term IGF-I gene therapy in the mediobasal hypothalamus (MBH) of M-A female rats to extend regular cyclicity and preserve ovarian structure. We used 3 groups of M-A rats: 1 group of intact animals and 2 groups injected, at 36.2 weeks of age, in the MBH with either a bicistronic recombinant adeno-associated virus (rAAV) harboring the genes for IGF-I and the red fluorescent protein DsRed2, or a control rAAV expressing only DsRed2. Daily vaginal smears were taken throughout the study, which ended at 49.5 weeks of age. We measured serum levels of reproductive hormones and assessed ovarian histology at the end of the study. Although most of the rats injected with the IGF-I rAAV had, on the average, well-preserved estrous cyclicity as well as a generally normal ovarian histology, the intact and control rAAV groups showed a high percentage of acyclic rats at the end of the study and ovaries with numerous enlarged cysts and scarce corpora lutea. Serum LH was higher and hyperprolactinemia lower in the treated animals. These results suggest that overexpression of IGF-I in the MBH prolongs normal ovarian function in M-A female rats.
Cited3 activates Mef2c to control muscle cell differentiation and survival
Authors: Devakanmalai Gnanapackiam Sheela , Zumrut Hasan E. , Özbudak Ertuğrul M.
Published: April 2013

Vertebrate muscle development occurs through sequential differentiation of cells residing in somitic mesoderm – a process that is largely governed by transcriptional regulators. Our recent spatiotemporal microarray study in zebrafish has identified functionally uncharacterized transcriptional regulators that are expressed at the initial stages of myogenesis. cited3 is one such novel gene encoding a transcriptional coactivator, which is expressed in the precursors of oxidative slow-twitch myofibers. Our experiments placed cited3 into a gene regulatory network, where it acts downstream of Hedgehog signaling and myoD/myf5 but upstream of mef2c. Knockdown of expression of cited3 by antisense morpholino oligonucleotides impaired muscle cell differentiation and growth, caused muscle cell death and eventually led to total immotility. Transplantation experiments demonstrated that Cited3 cell-autonomously activates the expression of mef2c in slow myofibers, while it non-cell-autonomously regulates expression of structural genes in fast myofibers. Restoring expression of cited3 or mef2c rescued all the cited3 loss-of-function phenotypes. Protein truncation experiments revealed the functional necessity of C-terminally conserved domain of Cited3, which is known to mediate interactions of Cited-family proteins with histone acetylases. Our findings demonstrate that Cited3 is a critical transcriptional coactivator functioning during muscle differentiation and its absence leads to defects in terminal differentiation and survival of muscle cells.
Fabrication of Photoelectrodes from LaTiO2N Particles for Photoelectrochemical Water Splitting
Authors: Nishimura Naoyuki , Maeda Kazuhiko , Takata Tsuyoshi , Lu Daling , Kubota Jun , Domen Kazunari
Published: April 2013

Methods of fabricating photoelectrodes from LaTiO2N particles on fluorine-doped tin oxide (FTO) glasses for photoelectrochemical (PEC) water splitting were studied. Several sizes of LaTiO2N particles were synthesized by the nitridation of oxide precursors of varying particle size under ammonia flow. TiCl4 treatment, which binds particles both to each other and to substrates, was examined. Without TiCl4 treatment, photoelectrodes made from smaller LaTiO2N particles generated a higher photocurrent. On the other hand, photoelectrodes made from larger LaTiO2N particles generated a higher photocurrent with the treatment. The effect of electronic contact between particles on the PEC properties was examined.
Nanooptical Studies on Physical and Chemical Characteristics of Noble Metal Nanostructures
Authors: Okamoto Hiromi
Published: April 2013

Studies on physical and chemical properties of noble metal nanostructures, mainly by near-field optical microscopy and spectroscopy, are described. Near-field optical microscopy provides optical observation methodology with a spatial resolution in nanometer regime beyond the diffraction limit of light. We developed near-field imaging systems equipped with various light sources including ultrashort pulsed lasers, which enables advanced nonlinear and ultrafast near-field measurements as well as conventional near-field imaging. In particular, near-field two-photon excitation imaging was shown to provide a convenient tool to visualize the enhanced optical fields in the vicinities of metal nanostructures. With these methods we demonstrated that nanoscale optical field structures in metal nanostructures can be directly visualized. For single noble metal nanoparticles, such as gold nanorods as typical examples, plasmon standing wave functions were visualized. Ultrafast imaging revealed that sub-picosecond relaxation was reflected on the plasmon wave function images through thermally induced dielectric function changes of the metal. In some cases optical field distribution features arising from the lightning rod effects were observed, depending on the resonance conditions of the incident wavelengths with the plasmon modes. We also found anomalous near-field transmission phenomenon for nanoapertures blocked by nanodisks near the plasmon resonance wavelengths, which arise from the efficient near-field to propagating-field conversion ability of the nanodisks. In assembled nanoparticles, enhanced optical fields at the gap sites between the particles were visualized, which elucidates experimentally the mechanism of surface-enhanced Raman scattering. The characteristic field distributions in many particle assemblies were also observed and analyzed. Through these studies, we established a valuable methodology to investigate optical and spectroscopic properties of metal nanostructures, and the information obtained is available only by optical measurements with high spatial resolution.
Preconcentration of Trace Metals in Water Using a Newly Designed Thermoresponsive Chelating Polymer for the Sensitive Determination by Graphite Furnace Atomic Absorption Spectrometry
Authors: Saitoh Tohru , Arakawa Akihiro , Hiraide Masataka
Published: April 2013

A thermoresponsive polymer containing highly dense iminodiacetic acid segments was newly designed for the efficient preconcentration of trace metals in water. The polymer was synthesized by the water-soluble carbodiimide-mediated condensation of poly(N-isopropylacrylamide-co-acrylic acid) with polyallylamine and the subsequent conversion of amino groups to iminodiacetic acid. Metal ions in water were collected by adding the thermoresponsive polymer, sodium nitrate, dodecyltrimethylammonium chroride, and buffer components and then heating the resulting solution to form polymer deposits. The use of 0.02% (w/v) thermoresponsive polymer allowed the nearly complete (>99.8%) collection of seven metals (Be, Co, Ni, Cu, Cd, In, and Pb) in the pH range of 6.8–8.3. The polymer deposits were readily collected as a condensed coagulate and dissolved with a small amount of water for the analysis by graphite furnace atomic absorption spectrometry. Because of highly efficient (100-fold) concentration, these metals at pg cm−3–ng cm−3 levels were successfully determined. The precision and accuracy were evaluated by analyzing certified reference water samples.
Study on Electronic Properties of Composite Clusters toward Nanoscale Functional Advanced Materials
Authors: Nakajima Atsushi
Published: April 2013

Clusters consisting of 10–1000 atoms size-dependently exhibit novel electronic and geometric properties. In particular, composite clusters composed of several elements and/or components provide a promising way for a bottom-up approach for designing functional advanced materials, because the functionality of the composite clusters can be optimized not only by the cluster size but also by their compositions. This account surveys recent investigations of composite clusters focusing on the efforts to create a new functional composite cluster by a fine doping or hybridization based on their size-specific electronic properties. Organometallic clusters and caged clusters are demonstrated as a representative example of designing the functionality of magnetism and electronic state structures. In order to create functional nanomaterials, furthermore, a fine controlling methodology of the soft-landing technique has been developed to fix the composite clusters onto a surface decorated with a self-assembled monolayer. The embedded isolation mechanism on the substrate is discussed form the viewpoint of self-assembly phenomena with the molecular ordering of σ–σ interaction, and also the electronic structures characterized by molecular ordering of π–π interaction is intrinsically revealed by molecular clusters of π-conjugate polyacenes as a model for self-assembled aggregates.
The effectiveness of social resource intervention to promote adherence to HIV medication in a multidisciplinary care setting in Kenya
Authors: Kamau T M , Olsen V G , Zipp G P , Clark M
Published: April 2013

Adherence to HIV medication has a dramatic impact on morbidity, mortality and health in people living with HIV. Recent studies have demonstrated good adherence to HIV medication among people in sub-Saharan Africa, but few have investigated factors influencing adherence. The goal of this study was to evaluate the effectiveness of social intervention strategies to enhance adherence to HIV medication. A cross-sectional design study was used to obtain data through self-administered questionnaires from 354 individuals who were prescribed HIV medication at nine satellite centres under the auspice of the Nazareth Hospital in Kenya. Binomial logistics were used to test the relationships between social support and its dimensions with adherence to HIV medication. Composite social support was predictive of adherence to HIV medication ( P < 0.05). Among the four dimensions of support, material and emotional support were the strongest predictors.
Patterns and predictors of cigarette smoking among HIV-infected patients in northern Nigeria
Authors: Iliyasu Z , Gajida A U , Abubakar I S , Shittu O , Babashani M , Aliyu M H
Published: April 2013

The smoking behaviour of persons living with HIV/AIDS in sub-Saharan Africa is poorly documented. We employed a cross-sectional study design to assess the prevalence and predictors of tobacco smoking among HIV-infected patients in northern Nigeria ( n = 296). Approximately one quarter of respondents were either current (7.8%) or ex-smokers (17.9%). Smoking rates among HIV-infected women were extremely low. HIV-infected men were at least three times as likely to smoke as their female counterparts living with HIV: adjusted odds ratio (AOR) 3.16, 95% confidence interval (95% CI) 2.17-7.32. Patients with tertiary education were at least twice as likely to smoke compared with their counterparts without formal education (AOR 2.63, 95% CI 1.08-6.67). The preponderance of cigarette smoking among educated HIV-infected men in northern Nigeria offers a unique opportunity for targeted smoking cessation programmes.
Examining self and partners for syphilis among men who have sex with men: five US cities, 2009-2011
Authors: Surie D , Furness B W , Hernandez-Kline P , Turner A , Perkins R C , Taylor M M , Brewer T , Workowski K , Gamerdinger K , Markowitz L E , Koumans E H
Published: April 2013

To increase self-examination for syphilis among men who have sex with men (MSM), we developed educational materials to increase knowledge of primary and secondary syphilis manifestations. Materials were piloted in five cities’ infectious disease or MSM clinics. Self- and partner-examination behaviour was assessed with an anonymous questionnaire. Of 1459 participants, 914 men had had sex with a man in the previous three months; the 171 MSM who reported having read the materials were significantly more likely to examine themselves (anus, adjusted prevalence ratio [aPR] 1.3, 95% confidence interval [CI] 1.15-1.52), mouth, penis and skin, and their partners’ anus (aPR 1.3, 95% CI 1.03-1.73) and mouth (aPR 1.6, 95% CI 1.1-2.26). Further research is needed to determine whether educational materials affect early detection and treatment of primary and secondary syphilis and reduce transmission.
Impact of timing of antiretroviral therapy initiation on survival of cervical squamous intraepithelial lesions: a cohort analysis from South Africa
Authors: Zeier M D , Nachega J B , Van Der Merwe F H , Eshun-Wilson I , Van Schalkwyk M , La Grange M , Mason D , Louw M , Botha M H
Published: April 2013

To determine factors that influence excision treatment outcome and recurrence of cervical squamous intraepithelial lesions (SIL) in women living with HIV infection, we analysed 1848 women who underwent excision treatment of cervical SIL at Tygerberg Hospital, Cape Town, South Africa. We compared treatment failure defined as presence of cervical intraepithelial neoplasia (CIN) I (presence of CIN I or higher at first follow-up after excision treatment) and post-excision recurrence of lesions (at one year or later) between women of HIV-positive, -negative or unknown status and examined factors associated with excision treatment outcome and recurrence. HIV-infected women experienced higher treatment failure than uninfected women (53.8% versus 26.9%, P< 0.001). At treatment failure, more HIV-infected women had low-grade squamous intraepithelial lesion (LSIL) compared with uninfected women (64.9% versus 37.3%, P < 0.001). Treatment failure did not differ with the type of excision used in HIV-infected women. HIV-infected women were more likely to experience recurrence of lesions after excision treatment than uninfected women (hazard ratio 1.95, 95% confidence interval [CI] 1.59-2.39; P < 0.001). Antiretroviral therapy (ART) initiated before excision biopsy had a strong protective effect against recurrence (hazard ratio 0.70, 95% CI 0.55-0.89; P = 0.006). Our data suggest that women with cervical SIL initiated on ART earlier may be expected to have better long-term excision treatment outcome. Close follow-up should be maintained after cervical excision treatment, especially in a setting of high HIV prevalence.
Differences in implementation of HIV/AIDS clinical research in developed versus developing world: an evidence-based review on protease inhibitor use among women and minorities
Authors: Seminari E , De Silvestri A , Scudeller L , Scotti V , Tinelli C
Published: April 2013

The aim of this revision is to evaluate ethnicity and gender rate of enrolment in registrative clinical trials of the protease inhibitors (Pis) from 1996 to 2009. Company-sponsored, phase II or III registrative clinical trials of PIs were evaluated. Forty-nine clinical trials were included. Clinical trials were conducted in centres in North America ( n = 39), Central-South America ( n = 22), Europe ( n = 22), Africa ( n = 8), Asia ( n = 5), Australia ( n = 10). Overall mean age was 39.6 years; median proportion of women was 16.3%. The most represented ethnic group was Caucasian. A test for trend over time (1996-2009) shows a significant increase in the proportion of women included ( P = 0.012), and a decrease in the proportion of Caucasians included, reaching borderline significance ( P = 0.061). An inverse correlation was observed between the proportion of Caucasians and that of women enrolled in each study ( r = 0.65, P < 0.0001). Women were less likely to be included in double-blind studies (11.2% versus 17%, P = 0.019). Clinical trials for treatment-naive subjects were more likely to enrol ethnicities other than Caucasian compared with Caucasian (44.7% versus 27.1 %, respectively, P = 0.04). Rates of enrolment of minorities in registrative clinical trials for PIs show a positive trend since 1996, mirroring the growing number of people of different ethnic groups accessing ART.
Topical imiquimod 5% as a treatment for localized genital Kaposi's sarcoma in an HIV-negative man: a case report
Authors: Fairley J L , Denham I , Yoganathan S , Read T R H
Published: April 2013

We report a case of Kaposi's sarcoma (KS) in an HIV-negative man who has sex with men (MSM) that was successfully treated by topical application of imiquimod 5% cream (Aldara). Our case highlights a potentially effective and non-invasive method of treatment of Kaposi's sarcoma in the shortest timeframe yet recorded. The location of the lesions on the patient's penis also highlights the need for a non-invasive treatment.
Raltegravir can be used safely in HIV-1-infected patients treated with warfarin
Authors: Honda H , Gatanaga H , Aoki T , Watanabe K , Yazaki H , Tanuma J , Tsukada K , Honda M , Teruya K , Kikuchi Y , Oka S
Published: April 2013

Drug co-administration often affects the patient response to warfarin through various mechanisms. We describe here five HIV-1-infected patients on treatment with warfarin in whom the use of raltegravir was associated with a favourable outcome.
Lancefield group G Streptococcus dysgalactiae subsp. equisimilis: an unusual aetiology of perianal streptococcal dermatitis acquired from heterosexual oral-anal intercourse
Authors: Abdolrasouli A , Hemmati Y , Amin A , Roushan A , Butler I
Published: April 2013

Perianal streptococcal dermatitis (PSD) is an uncommon superficial cutaneous infection of the perianal area, almost exclusively described in children and mainly caused by group A streptococci. We report here a case of PSD caused by Streptococcus dysgalactiae subsp. equisimilis, Lancefield group G, in an adult man due to heterosexual oral-anal sexual contact.
Clinical focus and public accountability in English NHS Trust Board meetings
Authors: Endacott Ruth , Sheaff Rod , Jones Ray , Woodward Valerie
Published: April 2013

Background:

Previous studies have suggested that greater focus on clinical matters in NHS commissioner and provider Trust Board meetings might improve the range, quality or cost of clinical care. This study reports the extent of clinical focus in Board meetings in three types of NHS Trust and considers the implications for public accountability.

Methods:

(1) Content analysis of published minutes of Board meetings from 105 randomly selected NHS Trusts in 2008/09. (2) Structured observation of 24 Board meetings in a qualitative sub-sample of eight of the above Trusts in 2008/09.

Results:

The percentage of clinical items among the items discussed by NHS Trust Boards ranged from 0% to 51%, but did not differ by Trust type. Primary Care Trusts (PCTs) recorded more items than NHS Trusts and NHS Foundation Trusts because of PCTs’ dual role as service providers and commissioners. There were significant differences between Trusts’ board meetings in the numbers of clinical items concerning service design, clinical outcomes and activity levels. The availability and accessibility of supposedly publicly-available minutes from NHS Foundation Trust Board meetings was sometimes problematic. Observation of meetings revealed a number of dynamics not evident in the minutes. Board meetings were generally chair-led (conducted according to the chair's discretion); collegial; had similar levels and extent of discussion from the non-executive directors, with a focus on current policy initiatives. Boards differed in the extent of public questioning, how they exercised internal governance over the provision and quality of patient care, and the extent of pre-planning before the Board meeting. Published minutes were not always an accurate record of meetings.

Conclusions:

Findings illuminate important transparency issues which should be given careful consideration in the English NHS.
Twelve myths about systematic reviews for health system policymaking rebutted
Authors: Moat Kaelan A , Lavis John N , Wilson Mike G , Røttingen John-Arne , Bärnighausen Till
Published: April 2013

Systematic reviews are increasingly being viewed as important sources of information for policymakers who need to make decisions on different aspects of the health system, often under tight time constraints and with many factors competing for their attention. Unfortunately, a number of misconceptions, or ‘myths’, stand in the way of promoting their use. The belief that systematic review topics are not relevant to health systems policymaking, that they cannot be found quickly, and that they are not available in formats that are useful for policymakers are but three examples of such myths. This paper uses evidence drawn mainly from Health Systems Evidence, a continuously updated repository of syntheses of health systems research, to counter these and nine other common myths, with the aim of changing the constraining beliefs associated with them, while improving the prospects for the use of systematic reviews in health system policymaking.
Fragmentation: A wicked problem with an integrated solution?
Authors: Shaw Sara E , Rosen Rebecca
Published: April 2013

Integrated care is central to current health care reforms as policy makers and practitioners struggle to address fragmentation of care planning and delivery. However, those pursuing integration have failed to appreciate the complex nature of fragmentation. We seek to bring some much-needed clarity to current debate by considering fragmentation as a ‘wicked problem’ requiring a locally driven and multifaceted approach to integration.
Entangled complexity: Why complex interventions are just not complicated enough
Authors: Cohn Simon , Clinch Megan , Bunn Chris , Stronge Paul
Published: April 2013

The shift of health care burden from acute to chronic conditions is strongly linked to lifestyle and behaviour. As a consequence, health services are attempting to develop strategies and interventions that can attend to the complex interactions of social and biological factors that shape both. In this paper we trace one of the most influential incarnations of this ‘turn to the complex’: the Medical Research Council (MRC) guidance on developing and evaluating complex interventions. Through an analysis of the key publications, and drawing on social scientific approaches to what might constitute complexity in this context, we suggest that such initiatives need to adjust their conceptualisation of ‘the complex’. We argue that complexity needs to be understood as a dynamic, ecological system rather than a stable, albeit complicated, arrangement of individual elements. Crucially, in contrast to the experimental logic embedded in the MRC guidance, we question whether the Randomised Controlled Trial (RCT) is the most appropriate method through which to engage with complexity and establish reliable evidence of the effectiveness of complex interventions.
Reducing ineffective practice: Challenges in identifying low-value health care using Cochrane systematic reviews
Authors: Garner Sarah , Docherty Mary , Somner John , Sharma Tarang , Choudhury Moni , Clarke Mike , Littlejohns Peter
Published: April 2013

Objectives:

Despite international agreement that stopping low value practices will increase efficiency, identifying them is difficult and controversial. Opponents of centralized lists of low value practices stress that the actual problem is inappropriate low value use, and better targeting and implementation of treatment thresholds is needed. Our objective was to use Cochrane Reviews to identify low value practices to support local disinvestment decisions.

Methods:

New or updated reviews were included if the authors concluded that the uncertain effectiveness of an intervention meant it should only be used in research, or that it was ineffective or harmful and should not be used. The reviews go through a production and quality assurance process, and are published as ‘Cochrane Quality and Productivity topics’ through the NHS Evidence website ( http://www.library.nhs.uk/qipp/ ).

Results:

Over a six-month period, 65 Cochrane reviews were processed by the National Institute for Health and Clinical Excellence (NICE). Of these, 28 identified potentially low value practices in the UK context. This was primarily due to a lack of randomized evidence of effectiveness, rather than robust evidence of a lack of effectiveness, or evidence of harm.

Conclusions:

Identifying low-value health care practices for local disinvestment (total or partial) is both practically and politically challenging, yet it is necessary to manage health budgets. This project identified that Cochrane Reviews can potentially identify low value health care practices. However, each review has to be reinterpreted for the UK context and additional analysis has to be undertaken to facilitate local implementation. Recommendations to improve the usability of systematic reviews are made.
Risk Estimation Versus Screening Performance: A Comparison of Six Risk Algorithms for Cardiovascular Disease
Authors: Simmonds Mark C , Wald Nicholas J
Published: April 2013

Background

Risk of future cardiovascular disease (CVD) events is typically estimated from risk factors such as age, sex, blood pressure and cholesterol. Many ‘risk algorithms’ exist to estimate CVD risk. All should have similar screening performances because of the dominant effect of age in predicting who will and will not have a CVD event, regardless of the accuracy of CVD risk estimation. Six CVD risk algorithms were compared (Framingham 1991, Framingham 2008, Reynolds risk, ASSIGN, SCORE and QRISK2), each differing in the risk factors used and in CVD outcomes.

Methods

The six algorithms were applied to a simulated sample of 500,000 people aged 40-74, based on the population of England. CVD risk was calculated for each individual using all risk algorithms, and who did and did not have a CVD event in 10 years was simulated according to those estimated risks. Screening performance was assessed by estimating the detection rate (sensitivity) and false-positive rate (1 – specificity) at a range of cut-off values of CVD risk for each algorithm. The accuracy (calibration) of risk estimation was compared across the six algorithms.

Results

At a 20% false-positive rate the detection rates of the six algorithms ranged from 72% to 79%. The estimated risk cut-offs to achieve the same false-positive rate varied five-fold, from 4% to 21% because of the different risk factors and outcomes considered.

Conclusions

All six risk algorithms had similar screening performances. The accuracy (calibration) of CVD risk estimation does not materially affect screening performance. In distinguishing who will and will not develop CVD it is screening performance that matters rather than the accuracy of the risk estimation.
Feasibility of Using Plasma Rather Than Serum in First and Second Trimester Multiple Marker Down's Syndrome Screening
Authors: Lambert-Messerlian Geralyn M , Palomaki Glenn E , Eklund Elizabeth E , Kloza Edward M , Neveux Louis M , Phipps Maureen G , Canick Jacob A
Published: April 2013

Objective

To compare maternal plasma with serum for measuring markers currently used in first and second trimester screening for Down's syndrome.

Setting

A laboratory-based investigation of two sample types in assays used in prenatal screening for Down's syndrome.

Methods

A paired data-set included both plasma and serum from 101 pregnant women. A nested case/control data-set included only plasma samples from 34 first and 23 second trimester Down's syndrome pregnancies, each matched with six euploid controls. Analyte levels were measured and converted to multiples of the median (MoM).

Results

In the paired data-set, each of the five analytes (alphafetoprotein, unconjugated estriol, human chorionic gonadotropin, inhibin-A and pregnancy-associated plasma protein A) in serum and plasma was highly correlated (r > 0.970) and after conversion to MoM, the resulting distributions were equivalent ( P > 0.7). In the matched data-set, plasma-based median MoM levels in cases were consistent with the published serum counterparts for all markers.

Conclusions

This study provides strong evidence that current serum-based prenatal screening can be performed equally well using plasma samples. This may prove useful, especially if secondary screening using a DNA-based test requires maternal plasma.
All Are Not Equal: An Examination of the Economic Returns to Different Forms of Participation in Open Source Software Communities
Authors: Hann Il-Horn , Roberts Jeffrey A. , Slaughter Sandra A.
Published: April 2013

Open source software (OSS) communities live and die with the continuous contributions of programmers who often participate without direct remuneration. An intriguing question is whether such sustained participation in OSS projects yields economic benefits to the participants. Moreover, as participants engage in OSS projects, they take on different roles and activities in the community. This raises additional questions of whether different forms of participation in OSS communities are associated with different economic rewards and, if so, in which contexts. In this paper, we draw upon theories of signaling and job matching to hypothesize that participants who possess “proof” of their skills in OSS projects are financially rewarded for their activities in the labor market. More specifically, we distinguish between participation in OSS communities that is associated with a signaling value for unobserved productivity characteristics and an additional value that accrues to participants whose OSS roles and activities match those in their paid employment. Following a cohort of OSS programmers over a six-year period, we empirically examine the wages and OSS performance of participants in three of the foremost OSS projects operating within the Apache Software Foundation. Controlling for individual characteristics and other wage-related factors, our findings reveal that credentials earned through a merit-based ranking system are associated with as much as an 18% increase in wages. Moreover, we find that participants who have OSS project management responsibilities receive additional financial rewards if their professional job is in IT management. These findings suggest that rank within an OSS meritocracy is a credible and precise signal of participants' productive capacity and that participants' roles and activities in an OSS community have additional financial value when aligned with their paid employment.
Research Commentary—Too Big to Fail: Large Samples and the p-Value Problem
Authors: Lin Mingfeng , Lucas Henry C. , Shmueli Galit
Published: April 2013

The Internet has provided IS researchers with the opportunity to conduct studies with extremely large samples, frequently well over 10,000 observations. There are many advantages to large samples, but researchers using statistical inference must be aware of the p-value problem associated with them. In very large samples, p-values go quickly to zero, and solely relying on p-values can lead the researcher to claim support for results of no practical significance. In a survey of large sample IS research, we found that a significant number of papers rely on a low p-value and the sign of a regression coefficient alone to support their hypotheses. This research commentary recommends a series of actions the researcher can take to mitigate the p-value problem in large samples and illustrates them with an example of over 300,000 camera sales on eBay. We believe that addressing the p-value problem will increase the credibility of large sample IS research as well as provide more insights for readers.