bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving medical leadership and teamwork: an iterative process
Authors: Smits Stanley J. , Bowden Dawn , Falconer Judith A. , Strasser Dale C.
Published: November 2014

Purpose

– This paper aims to present a two-decade effort to improve team functioning and patient outcomes in inpatient stroke rehabilitation settings.

Design/methodology/approach

– The principal improvement effort was conducted over a nine-year period in 50 Veterans Administration Hospitals in the USA. A comprehensive team-based model was developed and tested in a series of empirical studies. A leadership development intervention was used to improve team functioning, and a follow-up cluster-randomized trial documented patient outcome improvements associated with the leadership training.

Findings

– Iterative team and leadership improvements are presented in summary form, and a set of practice-proven development observations are derived from the results. Details are also provided on the leadership training intervention that improved teamwork processes and resulted in improvements in patient outcomes that could be linked to the intervention itself.

Research limitations/implications

– The practice-proven development observations are connected to leadership development theory and applied in the form of suggestions to improve leadership development and teamwork in a broad array of medical treatment settings.

Practical implications

– This paper includes suggestions for leadership improvement in medical treatment settings using interdisciplinary teams to meet the customized needs of the patient populations they serve.

Originality/value

– The success of the team effectiveness model and the team-functioning domains provides a framework and best practice for other health care organizations seeking to improve teamwork effectiveness.
Bricolage and the Health Promoting School
Authors: Renwick Kerry
Published: October 2014

Purpose

– The propositional knowledge about the Health Promoting School (HPS) and how it privileges the health sector, and research through intervention and behaviour change rather than gaining an understanding of how social bases of health impact and influence individuals and the wider school community. The purpose of this paper is to explore how bricolage offers opportunity for understanding complexity, thick description and inter- and multi-disciplinary work. The experience of health promotion and what it looks like at the school level and provides epistemological considerations for reframing research about HPSs for purposes of social justice and equity through bricolage.

Design/methodology/approach

– An introduction reveals the challenges of health promotion settings, and schools in particular to achieve social justice and equity. Bricolage is discussed with reference to complexity, thick description and inter- and multi-disciplinary work. Considerations are given to bricolage as research to gain understanding and to contribute to social change.

Findings

– As a setting the HPS is a complex site of social interaction and where there is interplay of multiple, casual factors that influence health and well-being. The potential for social justice and equity remains latent and new approaches to investigating and researching are required. Bricolage offers substantial possibilities as it recognises the value of researching social contexts but with a deliberate intent to engage with participants.

Practical implications

– This paper considers how bricolage can re-focus ontological and epistemological positions to engage in health promotion as a social action.

Originality/value

– This paper raises questions about the ability of the HPS model to deliver on social justice under current compliance regimes.
Vulnerable practitioners: fictional narratives affecting masculine teacher identity
Authors: Davis Ian
Published: October 2014

Purpose

– The purpose of this paper is to explore how fictional narratives help us envision ways of constructing the identity as teaching professionals. Furthermore, how encounters with fictional narratives and the absorption of their structures and ideologies can dictate how the author perceive ourselves, and others.

Design/methodology/approach

– The pedagogy of teacher education relies heavily on narratised models of instruction such as Critical Reflective Practice (CRP). The purposefully traumatic aspects of CRP are designed to trouble the sense of self. I suggest here that this creates a period of subjective vulnerability in the pre-service teacher practitioner.

Findings

– This paper examines the response to traumatic learning events focusing on how literary tropes and their encompassing ideologies become a powerful yet regressive force in restabilising the professional identity and galvanising the personal subjectivity.

Research limitations/implications

– Data for this paper has been drawn from the Teaching Men research project that focused on a cohort of male teachers, from Australia and the UK working within TAFE/FE environments all of whom had recently become teachers.

Originality/value

– This paper addresses a parallel concern: at a point of subjective vulnerability, a term coined as part of this analysis, how do fictional representations of male teachers impact on the construction and practice of teachers in the development of their professional identities? And how can the author devise a structure with which to interpret such activity?
Researchers’ reflections of empathy following interviews with migrants
Authors: Laura Vazquez Maggio M. , Westcott Harriet
Published: October 2014

Purpose

– The purpose of this paper is to explore empathy in the research process by drawing on findings from interviews to investigate the experience of empathy when two migrant researchers interviewed other migrants. Empathy is an emotion that can be experienced at both the cognitive and affective levels, and which can reflect feelings of sharing and identification.

Design/methodology/approach

– This paper draws on findings from two separate and distinct but similar research projects, that both used semi-structured interviews to investigate a range of themes about the experience of migration.

Findings

– During interviewing the researchers experienced empathy when respondents drew attention to particular aspects of their migration experience which were: the challenge of language expression when speaking English as an additional language; feelings of loneliness, including for friends or family; and challenges initiating and enacting friendship following migration. The researchers experienced empathy during interviews; however, they felt challenged by how to respond to these feelings.

Originality/value

– This experience of empathy was novel because both researchers were migrants, hence, their emotions were triggered in relation to their own migration as well as that of their participants. Both researchers concluded that their own migration biographies together with their professional role influenced the extent and intensity of their empathy, and the ways that this emotion was handled. This work contributes to an understanding of the reflexivity of the migrant researcher undertaking migration research which has been a previously neglected area.
Regional Integration Models and Africa's Growth in the 21st Century: A Fitness Evaluation
Authors: Golit Peter D. , Adamu Yusuf
Published: November 2014

The study explores Africa's regional integration models with a view to determining their suitability or otherwise for rapid economic growth. Using annual data spanning 1980–2012, the study employs the Johansen () and the Johansen and Juselius () method of cointegration and Vector Error Correction Mechanism (VECM) to test for the presence of long‐run equilibrium relationships among the variables and estimate their static and dynamic coefficients. The study found a significant positive role for infrastructure financing, and human and physical capital accumulation both of which significantly influenced Africa's economic growth. Intra‐African trade, though positive and significant, was found to be less effective in inspiring growth compared to the above growth fundamentals. Trade openness and government spending were the only variables discovered to significantly influence Africa's economic growth in both the short and long run. The study concludes that the traditional approach to regional integration may not provide the best alternative for Africa's economic growth. It, thus, recommends the adoption of a mixed policy approach to regional economic integration to foster Africa's economic growth in the 21st century. The contribution of the study lies in its ability to subject Africa's models of regional integration to practical examination using modern approaches.
Putting it Right? The Labour Party's Big Shift on Immigration Since 2010
Authors: BALE TIM
Published: October 2014

Under pressure from voters, and from other parties, Europe's centre‐left has had to re‐evaluate its position on migration. The UK Labour party is no exception. Public concern about large‐scale immigration clearly contributed to its heavy defeat at the 2010 general election. Since then it has been slowly but surely hardening its stance on the issue, although this is by no means unprecedented: while the rise of UKIP may have upped the ante in recent months, Labour has a long history of adjusting policy in this area so as to remain competitive with its main rival, the Conservative party. Labour is now asking itself whether it will be possible to do this without challenging one of the fundamental precepts of EU membership—the right of free movement of people. Whatever the result of this internal debate between the party's ‘beer drinkers’ and its ‘wine drinkers’, Labour may still have difficulty in neutralising immigration as an issue since, for the most part, it continues to insist on giving an essentially economic answer to what for many voters is actually a cultural question.
‘How Do You Think I Feel? It's My Country’: Belonging, Entitlement and the Politics of Immigration
Authors: SKEY MICHAEL
Published: October 2014

Current debates around immigration are informed by hierarchies of belonging, with some groups seen to belong more, and therefore deserve more, than others. This link between belonging and entitlement has been predominantly analysed in relation to struggles over access to key material benefits, such as jobs, housing, healthcare and so on. This paper will argue that these struggles also point to the continuing relevance of nationhood to many people's sense of self, community and place and the value that comes from being positioned, and recognised, as part of a group that lies at the heart of national life and culture. In other words, the ‘politics of immigration’ is about the anxieties and concerns of those who no longer feel ‘at home’ in what they consider to be ‘their’ country.
The EU, UKIP and the Politics of Immigration in Britain
Authors: GEDDES ANDREW
Published: October 2014

Immigration politics in Britain have been transformed by high levels of immigration, the effects of EU free movement, strong anti‐immigration sentiment and UKIP's rise. All are compounded by a more general discontent with politics and politicians. In face of claims that something must be done, politicians seek tougher controls on immigration and free movement, but these may be difficult to attain because of entanglement with EU rules, while failure to achieve stated objectives can further compound the disconnect that fuels support for UKIP.
Racism: Less is More
Authors: GOODHART DAVID
Published: October 2014

Racism has been in sharp decline in recent decades yet the word, as accusation, is used more than ever. The word/idea needs to be more restrictively defined and kept for when it is really needed. When almost everyone is a racist, no one is. To this end we need to distinguish more clearly between the greater comfort people often feel among familiar people and places and active hostility towards outsider ethnic groups. We also need a more discriminating language to describe the spectrum of discrimination. Prejudice, clannishness—even in some instances discrimination itself—should be regarded as sentiments and behaviours that are distinct from proper racism.
Neighbourhood Ethnic Diversity and Orientations Toward Muslims in Britain: The Role of Intergroup Contact
Authors: HEWSTONE MILES , SCHMID KATHARINA
Published: October 2014

A persistent theme in the British and international debates about immigration and diversity is the controversial claim that living in diverse areas has negative consequences for intergroup attitudes and community relations. In the present paper we test this claim by investigating the impact of neighbourhood diversity and self‐reported intergroup contact on orientations (outgroup attitudes and social distance) toward one religious outgroup: Muslims. Respondents were both White British majority (N=867) and non‐Muslim ethnic minority (N=567) residents of neighbourhoods in England which varied in their proportion of ethnic minority residents. We tested both direct and indirect (via intergroup contact) effects of diversity on outgroup orientations toward Muslims. Results show that individuals living in more ethnically diverse areas—regardless of whether they are White British members of the majority or non‐Muslim members of ethnic minorities—have more positive contact with Muslims, with positive consequences for intergroup relations with Muslims.
As Good as Policy Gets
Authors: TAYLOR MATTHEW , ROBERTS CARYS
Published: October 2014

In June 2014, the think tank IPPR published a report, The Condition of Britain, widely seen as important source material for Labour as the party geared up for the 2015 General Election. This is an echo of another report—that of the Commission on Social Justice, published in 1994—which also made an important contribution to the thinking of Labour in opposition. A comparison between the two documents provides insights into the evolution of mainstream progressive thought over the past twenty years.
Fluorescent immunoassay for determination of penicillin and sulphonamide residues in milk using carboxylic magnetic nanoparticles
Authors: Ivanova Svetla , Gabrovska Katya , Godjevargova Tzonka
Published: October 2014

A fluorescent immunoassay for separate and simultaneous determination of penicillin (PEN) and sulphadimethoxine (SDM) in milk was developed. Monoclonal antibodies immobilised on carboxylic magnetic nanoparticles (MNPs) were used. It was proved that the protein A‐oriented immobilisation method (OI) provided a 1.5‐times more sensitive assay than the random immobilisation one (RI). The activation of MNPs with a mixture of N‐(3‐dimethylaminopropyl)‐N‐ethylcarbodiimide (EDC) and N‐hydroxysuccinimide (NHS) ensured a five‐times higher sensitivity of immunoassay than the activation using EDC. The linearity of standard curves in milk was: 3/10 ng/mL PEN (OI and RI), 50/250 ng/mL SDM (OI), and 50/500 ng/mL SDM (RI).
Lessons learnt from sexual and reproductive health and HIV linkages for multipurpose prevention technology service delivery
Authors: Lusti‐Narasimhan M , Collins L , Hopkins J
Published: October 2014

Provision of comprehensive sexual and reproductive health (SRH) services that meet the complex and diverse needs of women, in particular, within resource‐constrained settings, is often exacerbated by separate and uncoordinated reproductive health (RH) and HIV policies and programmes. A Rapid Assessment Tool for Sexual and Reproductive Health and HIV Linkages was developed to assess bi‐directional linkages between SRH and HIV at policy, systems and service delivery levels, as well as to identify gaps and contribute to the development of country‐specific action plans. Findings from the implementation of this Assessment Tool are of particular relevance to the successful delivery and uptake of multipurpose prevention technologies (MPTs), which are products in the development pipeline addressing multiple SRH needs of women, including HIV. The findings highlight the need for better coordination between SRH and HIV programmes in countries; support and training for healthcare providers on SRH, HIV and human rights; supporting SRH and HIV integration at the service delivery level through relevant policies, strategic and operational plans; and strengthening logistics and supplies systems to provide a combination approach to prevention. These lessons learnt could help programme managers and service providers to better understand the strategies for positioning multipurpose prevention products in national policy and service contexts.
An Unusual Case of Death Probably Triggered by the Association of Buprenorphine at Therapeutic Dose with Ethanol and Benzodiazepines and with Very Low Norbuprenorphine Level
Authors: Bardy Guillaume , Cathala Philippe , Eiden Céline , Baccino Eric , Petit Pierre , Mathieu Olivier
Published: October 2014

Buprenorphine is largely prescribed for maintenance treatment in opioid dependence due to its safety profile. Nevertheless, fatalities at therapeutic dose have been described when associated with other central nervous system depressants, such as ethanol or benzodiazepines. Here, we report a case of death due to association of buprenorphine at therapeutic dose with benzodiazepines and ethanol. Although toxicity has been often attributed to its metabolite norbuprenorphine rather than to buprenorphine itself, in our case, norbuprenorphine was not detected in urine and bile and only in traces in blood. Moreover, the presence in blood of free buprenorphine but not of glucuronide metabolites argues for an unusual early death, at the beginning of buprenorphine metabolism. We propose that in the context of prior toxic impregnation, buprenorphine directly (and not via its metabolite norbuprenorphine) acted as a triggering factor by blocking the ventilatory response, rapidly leading to fatal respiratory depression.
Enumeration and functional investigation of endothelial progenitor cells in neovascularization of diabetic foot ulcer rats with a Chinese 2‐herb formula
Authors: Tam Jacqueline Chor Wing , Ko Chun Hay , Lau Kit Man , To Ming Ho , Kwok Hin Fai , Siu Wing Sum , Lau Ching Po , Chan Wai Yee , Leung Ping Chung , Fung Kwok Pui , Lau Clara Bik San
Published: October 2014

Backbround

We investigated the effect of a Chinese 2‐herb formula (NF3) on the enumeration and angiogenic differentiation of endothelial progenitor cells (EPCs) in diabetic foot ulcer rats.

Methods

EPCs and stromal cell‐derived factor‐1α (SDF‐1α) were quantified by flow cytometry and ELISA, respectively. In vitro angiogenesis assays included proliferation, adhesion, migration and tube formation.

Results

Our result demonstrated that NF3 (0.98 g/kg) could significantly enhance the circulating CD34+/VEGFR2+/CD45− EPCs levels in diabetic foot ulcer rats by 60% (P < 0.05) through the partial elevation of SDF‐1α, restoring the mobilization ability of EPCs for wound neovascularization. We successfully isolated the BM‐derived EPCs to study their angiogenic potential after NF3 treatment. BM‐derived EPCs significantly expressed cell surface markers of CD34, CD146 and VEGFR2 (P < 0.05 − 0.01). NF3 could significantly stimulate the proliferation and attachment ability of EPCs dose‐dependently (P < 0.01–0.001). Besides, NF3 could significantly augment EPCs migration (P < 0.001) and tube formation (P < 0.01–0.001).

Conclusions

NF3 modulated diabetic wound healing through regulation of systemic EPCs level and increase in local vascular formation.
Effects of Arctium lappa L. (Burdock) root tea on inflammatory status and oxidative stress in patients with knee osteoarthritis
Authors: Maghsoumi‐Norouzabad Leila , Alipoor Beitollah , Abed Reza , Eftekhar Sadat Bina , Mesgari‐Abbasi Mehran , Asghari Jafarabadi Mohammad
Published: October 2014

Aim

This study was designed to examine the effect of Burdock root tea on inflammatory markers and oxidative stress indicators in patients with knee osteoarthritis (OA).

Methods

Thirty‐six patients (10 men and 26 women) aged 50–70 years old with knee osteoarthritis referred to the Physical Medicine and Rehabilitation Department of the Tabriz University of Medical Sciences Hospitals, were selected for the study and randomly divided into two groups. Anthropometric measurements, including height, weight and body mass index (BMI) were measured. For all individuals along the 42 days of study period, the same drug treatments, including two lots of 500 mg acetaminophen twice a day and one glucosamine 500 mg once a day,were considered. The intervention group received daily three cups of Burdock root tea (each cup containing 2 g/150 mL boiled water) half‐hour after the meal. The control group received three cups containing 150 cc boiled water daily. We assessed inflammatory markers such as high sensitivity C‐reactive protein (hs‐CRP) and interleukin‐6 (IL‐6) and oxidative stress indicators such as total antioxidants capacity (TAC), glutathione peroxidase (GPX), superoxide dismutase (SOD) and thiobarbituric acid reactive substances before and after the intervention.

Results

The results showed that burdock root tea significantly decreased the levels of serum IL‐6 (P = 0.002), hs‐CRP (P = 0.003) and malondialdehyde (P < 0.001), while the levels of serum TAC (P < 0.001) and activities of SOD (P = 0.009) were significantly increased. GPX activities increased but not significantly.

Conclusions

The results suggested that Arctium lappa L. root tea improves inflammatory status and oxidative stress in patients with knee osteoarthritis.
Endothelial progenitor cell biology in ankylosing spondylitis
Authors: Verma Inderjeet , Syngle Ashit , Krishan Pawan
Published: October 2014

Aim

Endothelial progenitor cells (EPCs) are unique populations which have reparative potential in overcoming endothelial damage and reducing cardiovascular risk. Patients with ankylosing spondylitis (AS) have increased risk of cardiovascular morbidity and mortality. The aim of this study was to investigate the endothelial progenitor cell population in AS patients and its potential relationships with disease variables.

Methods

Endothelial progenitor cells were measured in peripheral blood samples from 20 AS and 20 healthy controls by flow cytometry on the basis of CD34 and CD133 expression. Disease activity was evaluated by using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional ability was monitored by using Bath Ankylosing Spondylitis Functional Index (BASFI).

Results

EPCs were depleted in AS patients as compared to healthy controls (CD34+/CD133+: 0.027 ± 0.010% vs. 0.044 ± 0.011%, P < 0.001). EPC depletions were significantly associated with disease duration (r = −0.52, P = 0.01), BASDAI (r = −0.45, P = 0.04) and C‐reactive protein (r = −0.5, P = 0.01).

Conclusion

This is the first study to demonstrate endothelial progenitor cell depletion in AS patients. EPC depletions inversely correlate with disease duration, disease activity and inflammation, suggesting the pivotal role of inflammation in depletion of EPCs. EPC would possibly also serve as a therapeutic target for preventing cardiovascular disease in AS.
Demographic and clinical features of Behcet's disease in Azerbaijan
Authors: Khabbazi Alireza , Noshad Hamid , Shayan Farid K. , Kavandi Hadise , Hajialiloo Mehrzad , Kolahi Sousan
Published: October 2014

Aim

Behcet's disease (BD) is a multisystem inflammatory disease characterized by recurrent aphthous ulcers, genital ulcers and uveitis. Demographic and clinical features of BD are different in various countries. Due to these ethnic discrepancies, we decided to consider the clinical picture of BD in the Azeri population of Iran and compare it with other ethnic groups.

Methods

This cross‐sectional cohort study was carried out at the Connective Tissue Diseases Research Center of Tabriz University of Medical Sciences, Tabriz, Iran from 2006 to 2013. We considered the demographic and clinical findings in 166 patients with BD. Disease activity was measured by the Iranian Behcet's Disease Dynamic Activity Measure (IBDDAM) and Total Inflammatory Activity Index (TIAI).

Results

The male‐to‐female ratio was 1.7 : 1.0; the age of disease onset was 25.8 ± 8.9 years. Recurrent oral aphthous ulcers were the initial manifestations of BD in 83.1% of patients. Panophthalmitis and panuveitis were the most common ophthalmic manifestations of disease. Blindness occurred in 7.1% of patients. This study showed no difference between the two genders in mean age of disease onset and clinical manifestations. However, IBDDAM in men was higher than women. Retinal vasculitis in men was more common than women.

Conclusions

BD in the Azeri population of Iran starts in the third decade and has a male predominance. The activity of the disease and retinal vasculitis in men is more predominant than women in Azerbaijan.
Nabataean or not? The ancient necropolis of Dumat. First stage: a reassessment of al‐Dayel's excavations
Authors: Charloux Guillaume , Cotty Marianne , Thomas Ariane
Published: October 2014

Two reports on excavations carried out in 1985–1986 by archaeologist Khaled Abdulaziz al‐Dayel and published in the journal Atlal (1988, 1986) have revealed the existence of ‘Hellenistic tombs’ in the Dūmat al‐Jandal oasis (ancient Adummatu/Dumat/Dumata) in northern Saudi Arabia. Although attributed more precisely to the Nabataeans by Khalil al‐Muaikel (1994), these tombs nevertheless appear not to have interested specialists of this historical period in the least. Moreover, a re‐examination of the architectural data and of the grave‐goods indicates the difficulty of establishing a link between the unearthed remains and a purely ‘Nabataean’ cultural sphere (i.e. of the Petra type). This study therefore attempts to reassess published archaeological data, formulate questions on the Nabataean presence in the oasis, and also to demonstrate the relations connecting Dumat to the great Levantine and Mesopotamian cultural spheres between the first century BC and the second century AD.
Late pre‐Islamic burials at Mleiha, Emirate of Sharjah (UAE)
Authors: Kutterer Adelina , Overlaet Bruno , Miller Christopher E. , Kutterer Johannes , Jasim Sabah A. , Haerinck Ernie
Published: October 2014

The history of two monumental grave buildings (nos. 4 and 5), excavated in area P of the late pre‐Islamic city of Mleiha, has been studied in detail. Like all other tombs excavated up to the present day in Mleiha, their chambers had been emptied in ancient times. They were found devoid of human remains and grave‐goods. In the upper parts of the grave fills, however, skeletal remains were encountered. One of the skeletons was radiocarbon dated to AD 623–656, the time of the Islamisation of south‐east Arabia. A radiocarbon date of 384–233 BC for a wooden beam from the same tomb showed that it was built during the late pre‐Islamic period (PIR‐A). These dates and stratigraphic observations made clear that the interments were intrusive. The surrounding sediments were deposited by flooding. Directly underneath the skull of the dated skeleton, a layer of sandy loam was encountered, showing mud cracks. To understand the relationship between the burial and these deposits, micromorphological analyses of the surrounding sediments were conducted. The microstructural organisation of the sedimentary components implied that the skull was interred as part of a burial, and not deposited by natural processes.
Effect of nicotine dependence on opioid requirements of patients after thoracic surgery
Authors: YU A. , CAI X. , ZHANG Z. , SHI H. , LIU D. , ZHANG P. , FU Z.
Published: October 2014

Background

This retrospective study investigated the effect of nicotine dependence on required postoperative opioid administration in patients undergoing thoracic surgery.

Methods

The subjects consisted of 215 male patients (112 nonsmokers, 103 smokers) who underwent thoracic surgery and received postoperative patient‐controlled intravenous analgesia. Evaluations of nicotine dependence were based on results of Fagerstrom Test of Nicotine Dependence (FTND) questionnaires. Smokers were categorized as low‐nicotine dependent (LD) (n = 58) or highly‐nicotine dependent (HD, n = 45) with FTND scores < 6 or ≥ 6, respectively. Pain intensity was assessed every 2 h after surgery, using the numerical rating scale (NRS). The cumulative amount of self‐administered sufentanil at 24 and 48 h after surgery was recorded.

Results

There were no significant differences in baseline clinical characteristics among the nonsmoker (NS), LD, and HD groups. The NRS scores and total amount of self‐administered sufentanil were significantly higher in the HD and LD groups compared with the NS group, and were significantly higher in the HD group than in the LD group. The FTND scores positively correlated with the cumulative quantity of sufentanil. Postoperative complications such as nausea and vomiting, sedation, and respiratory depression did not significantly differ among the groups.

Conclusions

Smokers had more severe postoperative pain and required a higher quantity of postoperative opioid than nonsmokers. With increasing nicotine dependence, postoperative pain severity and postoperative opioid requirement increased.
Acute pain service: the journey in a developing country setting
Authors: GOVIND P. , BHAKTA P. , DUREJA G. P. , GUPTA A. , VENKATARAJU A.
Published: October 2014

Background

In India, acute pain service (APS) is in nascent stage because of lesser importance given to pain management. After establishing an APS in our hospital, we conducted a prospective audit (2008–2011) with an aim to regularly assess the efficacy of techniques on pain scores, muscle power, and adverse effects.

Methods

The audit was undertaken in three phases. An assessment of the existing system and recommendation to modify the APS was undertaken in phase I. In phase II, an APS team was constituted and audits were conducted at six monthly intervals for formation of the protocol. Subsequently in phase III, yearly audits were undertaken that led to the development of a final APS.

Results

There was a steady increase in the number of patients availing APS in intravenous patient‐controlled analgesia (IVPCA), epidural analgesia (EA), and continuous peripheral nerve block (CPNB). At the same time, the average visual analogue score (VAS) decreased significantly as the year progressed. While the VAS score did not differ significantly between EA and CPNB, it was less compared with IVPCA. Introduction of regional analgesic techniques played a major role in improving the pain scores.

Conclusion

Implementation of APS resulted in reduced pain scores in our surgical patients. Proper planning, role allocation, formation, and adherence to protocols as well as undertaking regular audit resulted in improving the quality of APS.
Efficacy of transarterial embolisation in the management of post‐partum haemorrhage and its impact on subsequent pregnancies
Authors: Inoue Seiji , Masuyama Hisashi , Hiramatsu Yuji ,   Multi‐Institutional Study Group of Transarterial Embolization for Massive Obstetric Haemorrhage in Chugoku & Shikoku Area Society of Obstetrics and Gynecology
Published: October 2014

Background

Transarterial embolisation (TAE) has been attracting attention as a treatment option for post‐partum haemorrhage (PPH).

Aims

We investigated cases in which TAE was performed for PPH to determine the efficacy of TAE for the treatment of PPH and its impact on subsequent pregnancies and childbirth in a multi‐institutional case‐series study.

Materials and Methods

A total of 211 women who underwent emergency (n=161) or prophylactic (n=50) TAE for the management of PPH from 2002 to 2011 in the Chugoku and Shikoku regions of Japan were evaluated. Data on maternal background, treatment efficacy, adverse events in 113 cases followed up after TAE and subsequent pregnancies in 76 women were obtained.

Results

The overall success rate of emergency and prophylactic TAE was 91.9 and 96.0%, respectively. The rate of complications such as infection, uterine necrosis and amenorrhoea was 13.3% among women followed up after TAE. Forty women became pregnant after TAE, and the pregnancy rate among those who desired fertility was 52.6%. Twenty‐eight gave birth, including four preterm deliveries. Five (16.7%) were associated with a hysterectomy due to placenta accreta.

Conclusions

To reduce haemorrhage and avoid hysterectomy, TAE may be considered as a treatment option for PPH, however short and long terms complications are not uncommon.
Prenatal and preconception population carrier screening for cystic fibrosis in Australia: Where are we up to?
Authors: Massie John , Ioannou Liane , Delatycki Martin
Published: October 2014

Aims

To describe prenatal and preconception population carrier screening for cystic fibrosis (CF) in Australia and consider progress towards establishing a universal program.

Method

Medline and Embase databases (1989–2013) were searched for all publications with Australian data. Existing programs for CF carrier screening in Australia were reviewed and professional peak body websites accessed to determine recommendations.

Results

Twenty‐two studies met the inclusion criteria. Key stakeholder groups believe that prenatal and preconception carrier screening for CF should be available. Health‐economic analyses support that CF carrier screening can be cost‐effective. There are small programs for CF carrier screening, in Victoria, New South Wales and Queensland. The Human Genetics Society of Australasia (HGSA) specifically recommend that screening be offered to women and couples planning a pregnancy and in the early stages of pregnancy. Other peak bodies indirectly endorse the availability of CF carrier screening. Barriers to screening include not being offered screening, the cost of testing, inequity of access and an incorrect perception that not having a family history of CF lowers risk.

Conclusions

There is support for prenatal and preconception CF carrier screening by the community, health professionals and peak professional bodies in Australia. The barriers to development of a national screening program could be overcome with greater physician engagement and government support.

Implications

In the interest of equity, government funded testing should be routinely offered to all pregnant women and couples planning a pregnancy.
Idiopathic inflammatory demyelinating disease of the central nervous system in patients with inflammatory bowel disease: retrospective analysis of 9095 patients
Authors: De Felice K. M. , Novotna M. , Enders F. T. , Faubion W. A. , Tremaine W. J. , Kantarci O. H. , Raffals L. E.
Published: October 2014

Background

Anti‐TNFα biologics induce and maintain remission in inflammatory bowel disease (IBD). Also, they have been reported to induce or unmask idiopathic inflammatory demyelinating disease of the central nervous system (IIDD).

Aim

To determine if anti‐TNFα biologics increased the risk of IIDD in a large cohort of patients with IBD.

Methods

We retrospectively identified adult patients referred to the Mayo Clinic, Rochester, MN for management of IBD from a five state capture area (Minnesota, Wisconsin, North Dakota, South Dakota and Iowa) between 1996 and 2010. IIDDs were identified in both Crohn's disease (CD) and ulcerative colitis (UC) patients with and without anti‐TNFα exposure using the 2010 McDonald MRI criteria. The risk of IIDDs in patients with and without anti‐TNFα exposure was estimated for IBD; CD and UC groups separately.

Results

A total of 9095 patients with IBD were identified (4342 CD and 4753 UC). Four patients with CD with exposure to anti‐TNFα agents (4/2054) and five patients with CD without anti‐TNFα exposure (5/2288) developed a confirmed IIDD. One patient with UC with exposure to anti‐TNFα agents (1/1371) and five patients with UC without anti‐TNFα agents developed a confirmed IIDD (5/3382). The per cent of IIDDs in patients with and without anti‐TNFα exposure was; IBD: 0.15% and 0.18% (RR = 0.83, 95% CI: 0.28–2.42; P = 0.729); CD: 0.19% and 0.22% (RR = 0.89, 95% CI: 0.24–3.31; P = 0.863); UC: 0.07% and 0.15% (RR = 0.49, 95% CI: 0.06–4.22; P = 0.510).

Conclusion

Anti‐TNFα biologics do not appear to impact the risk of developing clinical idiopathic inflammatory demyelinating disease in patients with inflammatory bowel disease.
The Patron–Client System and Its Effect on Resources Management in Cambodia: A Case in the Tonle Sap Lake
Authors: Sithirith Mak
Published: October 2014

This article discusses the sociopolitical context of resource management in Cambodia, focusing on the contemporary ecological conditions in Tonle Sap Lake, the largest freshwater lake in mainland Southeast Asia. It describes the resource governance system in the area that has developed through the local community's ecological knowledge, and how intervention by the state through a patron–client system has led to a conflict with it, fostering over‐exploitation of natural resources. The article argues that conflict harms the management of the lake and ultimately, the sustainability of resources in the area.

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A Fall From Grace? “Beef‐gate” and the Case of Indonesia's Prosperous Justice Party
Authors: Kramer Elisabeth
Published: October 2014

This article explores the impact of a widely publicized corruption scandal upon Indonesia's most prominent Islamic Party, the Prosperous Justice Party (PKS) in 2013, involving the exchange of money in return for beef‐import licenses (“Beef‐gate”). In the 2004 and 2009 elections PKS ran a populist campaign, drawing heavily upon anti‐corruption rather than Islamic issues, and became renowned for its hard‐line stance against graft. However, while PKS's reputation certainly deteriorated due to Beef‐gate, it still performed better than anticipated in the nation's legislative election held in April 2014. This article proposes two possible reasons for this: the party's grassroots membership structure provided a solid basis from which to rebuild, and the senior leadership adeptly managed its image while the scandal was in the public eye. With this effective image management, the party was able to retain the support of many of its voters, while minimizing damage to its image more broadly.

Makalah ini membahas dari satu kasus yang hangat diberitakan tahun 2013 yaitu skandal korupsi yang dihadapi Partai Keadilan Sejahtera (PKS) mengenai lisensi impor daging sapi (dikenal sebagai “Beef‐gate”). Pada pemilihan umum tahun 2004 dan 2009, PKS mengambil langkah kampanye populis, dengan mengedepankan isu‐isu anti‐korupsi daripada isu‐isu Islami lainnya, dan dikenal mempunyai sikap yang sangat keras menolak korupsi. Meski reputasi PKS menurun akibat skandal impor daging sapi ini, dalam pemilihan umum bulan April 2014 PKS masih mampu meraih lebih banyak suara daripada yang diperkirakan. Makalah ini mengajukan dua alasan atas hal tersebut: struktur keanggotaan di akar rumput menyediakan dasar yang cukup kuat untuk bangkit kembali, dan pimpinan senior partai mahir menjalin citra partai di saat skandal tersebut menjadi sorotan publik. Dengan kemahiran menjalin citra partai secara efektif ini, PKS tetap mampu menahan suara dan pada saat yang sama, secara umum memperkecil dampak dari citra yang rusak itu.
Communication challenges learners face online: Why addressing CMC and language proficiency will not solve learners' problems
Authors: Jung‐Ivannikova Liubov
Published: October 2014

Computer‐mediated communication (CMC) has been argued to cause (mis)communication issues. Research and practice suggest a range of tactics and strategies for educators focused on how to encourage and foster communication in a virtual learning environment (VLE) (eg, Salmon). However, while frameworks such as Salmon's support the effective development of online communication and collaboration between students, they are not sufficient to address intercultural issues. In this paper, research data are used to develop an argument that both native and non‐native English‐speaking students can use CMC successfully but that both groups experience challenges expressing themselves through written communication. Data collected from in‐depth interviews and discourse analysis of textual datasets reveal that students felt obliged to write in an unfamiliar way because of the asynchronous mode of communication, the presence of the tutor and the design of the VLE. Ironically, these are elements that previous studies have proposed as benefits of CMC. Additionally, while national culture was important in intercultural communication, so too were students' educational and professional cultures, which are more commonly overlooked in studies of online communication.
Newly Designed and Synthesized Curcumin Analogs with in vitro Cytotoxicity and Tubulin Polymerization Activity
Authors: Fawzy Iten M. , Youssef Khairia M. , Ismail Nasser S. M. , Gullbo Joachim , Abouzid Khaled A. M.
Published: October 2014

Novel curcumin analogs with 4‐piperidone ring were designed, synthesized, and evaluated for their cytotoxic activities against five different cancer cell lines. 3,5‐bis(4‐Hydroxy‐3‐methoxybenzylidene)‐4‐oxo‐N‐phenylpiperidine‐1‐carbothioamide (XIIe) exhibited considerable cytotoxic activity with IC50 values in 1–2.5 μm range. In silico and in vitro, studies were also performed to predict the binding affinity of the target compounds to the β‐chain of tubulin receptor (PDB code 1SA1) and their abilities to affect microtubules polymerization cycle. 3,5‐bis(3‐Iodo‐5‐methoxy‐4‐propoxybenzylidene)‐N‐acetylpiperidin‐4‐one (VIIa) was found to exert 93.3% inhibition of tubulin and destabilization of microtubules in vitro compared to vincristine while, 3,5‐bis(3,4,5‐trimethoxybenzylidene)‐N‐benzoylpiperidin‐4‐one (XIIc) showed high potency in a different way where it exerted 94.8% stabilization of microtubules in vitro compared to positive control paclitaxel.
Environment‐Adaptive Contact Poses for Virtual Characters
Authors: Kang Changgu , Lee Sung‐Hee
Published: October 2014

We present a novel method to generate a virtual character's multi‐contact poses adaptive to the various shapes of the environment. Given the user‐specified center of mass (CoM) position and direction as inputs, our method finds the potential contacts for the character in the surrounding geometry of the environment and generates a set of stable poses that are contact‐rich. Major contributions of the work are in efficiently finding admissible support points for the target environment by precomputing candidate support points from a human pose database, and in automatically generating interactive poses that can maintain stable equilibrium. We develop the concept of support complexity to scale the set of precomputed support points by the geometric complexity of the environment. We demonstrate the effectiveness of our method by creating contact poses for various test cases of environments.
Editing and Synthesizing Two‐Character Motions using a Coupled Inverted Pendulum Model
Authors: Hwang J. , Suh I.H. , Kwon T.
Published: October 2014

This study aims to develop a controller for use in the online simulation of two interacting characters. This controller is capable of generalizing two sets of interaction motions of the two characters based on the relationships between the characters. The controller can exhibit similar motions to a captured human motion while reacting in a natural way to the opponent character in real time. To achieve this, we propose a new type of physical model called a coupled inverted pendulum on carts that comprises two inverted pendulum on a cart models, one for each individual, which are coupled by a relationship model. The proposed framework is divided into two steps: motion analysis and motion synthesis. Motion analysis is an offline preprocessing step, which optimizes the control parameters to move the proposed model along a motion capture trajectory of two interacting humans. The optimization procedure generates a coupled pendulum trajectory which represents the relationship between two characters for each frame, and is used as a reference in the synthesis step. In the motion synthesis step, a new coupled pendulum trajectory is planned reflecting the effects of the physical interaction, and the captured reference motions are edited based on the planned trajectory produced by the coupled pendulum trajectory generator. To validate the proposed framework, we used a motion capture data set showing two people performing kickboxing. The proposed controller is able to generalize the behaviors of two humans to different situations such as different speeds and turning speeds in a realistic way in real time.
Using physically Based Rendering to Benchmark Structured Light Scanners
Authors: Medeiros Esdras , Doraiswamy Harish , Berger Matthew , Silva Claudio T.
Published: October 2014

Structured light scanning is ubiquituous in 3D acquisition. It is capable of capturing high geometric detail at a low cost under a variety of challenging scene conditions. Recent methods have demonstrated robustness in the presence of artifacts due to global illumination, such as inter‐reflections and sub‐surface scattering, as well as imperfections caused by projector defocus. For comparing approaches, however, the quantitative evaluation of structured lighting schemes is hindered by the challenges in obtaining ground truth data, resulting in a poor understanding for these methods across a wide range of shapes, materials, and lighting configurations. In this paper, we present a benchmark to study the performance of structured lighting algorithms in the presence of errors caused due to the above properties of the scene. In order to do this, we construct a synthetic structured lighting scanner that uses advanced physically based rendering techniques to simulate the point cloud acquisition process. We show that, under conditions similar to that of a real scanner, our synthetic scanner replicates the same artifacts found in the output of a real scanner. Using this synthetic scanner, we perform a quantitative evaluation of four different structured lighting techniques – gray‐code patterns, micro‐phase shifting, ensemble codes, and unstructured light scanning. The evaluation, performed on a variety of scenes, demonstrate that no one method is capable of adequately handling all sources of error – each method is appropriate for addressing distinct sources of error.
Interactive Image‐Guided Modeling of Extruded Shapes
Authors: Cao Yan‐Pei , Ju Tao , Fu Zhao , Hu Shi‐Min
Published: October 2014

A recent trend in interactive modeling of 3D shapes from a single image is designing minimal interfaces, and accompanying algorithms, for modeling a specific class of objects. Expanding upon the range of shapes that existing minimal interfaces can model, we present an interactive image‐guided tool for modeling shapes made up of extruded parts. An extruded part is represented by extruding a closed planar curve, called base, in the direction orthogonal to the base. To model each extruded part, the user only needs to sketch the projected base shape in the image. The main technical contribution is a novel optimization‐based approach for recovering the 3D normal of the base of an extruded object by exploring both geometric regularity of the sketched curve and image contents. We developed a convenient interface for modeling multi‐part shapes and a method for optimizing the relative placement of the parts. Our tool is validated using synthetic data and tested on real‐world images.
Anisotropic geodesics for live‐wire mesh segmentation
Authors: Zhuang Yixin , Zou Ming , Carr Nathan , Ju Tao
Published: October 2014

We present an interactive method for mesh segmentation that is inspired by the classical live‐wire interaction for image segmentation. The core contribution of the work is the definition and computation of wires on surfaces that are likely to lie at segment boundaries. We define wires as geodesics in a new tensor‐based anisotropic metric, which improves upon previous metrics in stability and feature‐awareness. We further introduce a simple but effective mesh embedding approach that allows geodesic paths in an anisotropic path to be computed efficiently using existing algorithms designed for Euclidean geodesics. Our tool is particularly suited for delineating segmentation boundaries that are aligned with features or curvature directions, and we demonstrate its use in creating artist‐guided segmentations.