bluuebunny/crossref_metadata_2025 huggingface dataset:
Cancer patients' hopes and expectations of nursing practice in Stockholm
Authors: Tishelman Carol
Published: March 2013

Although nursing literature on ‘caring’ has proliferated in recent years, relatively little empirical data exists about which aspects of nursing practice are those recognized and valued by patients. The purpose of the qualitative study presented here is to explore the manner in which one group of Swedish patients describe and explain the domain of nursing. The data presented derives from interviews with persons diagnosed with cancer during 1987 at one general hospital in the greater Stockholm area. Forty‐six patients were interviewed in 1988–89, and 20 of these survivors were interviewed again in 1992. The domain of nursing practice ‘expected’ by the patients was seen to be defined positively, both by what nurses ‘are’ and ‘do’, as well as negatively, by what they do not do. It was found that the patient—nurse contact, as described by these patients, was between an individual patient and a nursing collective. Finally, the need for local rather than global criteria for evaluating nursing care is discussed.
The Nurse in Clinical Practice
Authors: RN Ulla Hindsén , RN Bengt Fridlund
Published: March 2013

Swedish colleges and universities are now adapting their syllabuses to the new open European labour market. In this respect the syllabus for training of nurses is to be reorganized. Thinking in terms of health will be very important in the training program and will require practical experience of nursing. The aim of this study was to examine the demands made on competent nurses working in clinical practice. An open question was asked and the results were analysed by the constant comparative method. The 23 nurses interviewed had to answer the question: “What do you require of a competent nurse?” From the empirical data, characteristics of six different ideal types were described. A competent nurse has the ability—to create a good atmosphere; concentrate on the patient and always to have an ethical and humanitarian approach; to teach and instruct; to organize, make priorities, cooperate and make documentations; to use her theoretical knowledge and be able to put it to use; to be keen on development and change. The study showed that a competent nurse has a wide field of knowledge, but also highlighted the complex of the nursing profession. If the nursing student can acquire these skills she will be well prepared for her central role in clinical practice.
From Fun and Excitement to Joy and Trouble
Authors: O. C. Hall Elisabeth
Published: March 2013

The role of the father has undergone considerable change in the West. Fathers of today are expected to take a more active part in birth preparation, birth and childcare than their predecessors were. The purpose of the present study is to describe some Danish fathers' experiences around birth. Three first‐time fathers were interviewed at three different times: in the last month of pregnancy, two weeks after the birth of their child, and again three months later. Data were analyzed in several steps using a hermeneutical approach. The fathers' experiences were identified as fun and excitement at the end of the pregnancy, love at first sight at the birth, at which they all attended and took an active part, awakening when the new family was united at home and when they came to realize how much effort is needed in caring for an infant, and joy and trouble three months later. It is suggested that health personnel might benefit from the study in both a direct and indirect way.
Qualitative Methodology as Caring Science Methodology
Authors: Dahlberg Karin
Published: March 2013

Interest in the use of qualitative methodology is increasing among researchers within the field of caring sciences. Several reasons might account for this growing interest: disappointment from experiences with quantitative methodology in this field; interest in caring issues which do not lend themselves to quantitative analysis; and, simply, an emerging appreciation of qualitative methodology. There is a need for additional clarity about the applications of qualitative methodology in explication of caring. The major questions concern the suitability of qualitative methodology to the study of caring and the scientific status of qualitative methodology. This paper advocates qualitative methodology as a methodology of choice for scientific exploration in the field of caring.
Ritualized Practices among Caregivers at Meals in Geriatric Care
Authors: Sidenvall Birgitta , Fjellström Christina , Ek Anna‐Christina
Published: March 2013

The aim of this study was to examine the procedures of the caregivers in their daily work with meals in geriatric care, emphasizing ritualized practices, praxis and norms. An ethnographic approach was used. Registered nurses, enrolled nurses and nurse's assistants observed in the study responded to a questionnaire and, finally, were interviewed. The findings indicated that the meals mainly took the form of ritualized practices, and praxis depended on the ability and needs of the patients as well as on the working conditions. The guiding norms identified were ‘to provide a homelike situation with fellowship for training purposes’, ‘to ensure each patient gets what he/she needs/wants by means of a fair method of serving’, and ‘to keep things in order and to be responsible’. These norms were transferred from the traditional family in the society, giving the caregivers the role of the parent when training patients. The enrolled nurses, responsible for the meal performance, strove to keep the eating milieu in order, and the meal as a whole was performed as a ritual. Its static form made it difficult to individualize the meal in accordance with the different needs of the patients.
Long‐term Effects of a Comprehensive Rehabilitation Programme after Myocardial Infarction
Authors: Lidell Evy , Fridlund Bengt
Published: March 2013

The aim of this study was to determine the long‐term effects on myocardial infarction (MI) patients of a six‐month comprehensive rehabilitation programme (CRP) conducted by an interdisciplinary team regarding cardiac events, physical and psychological conditions, life habits, and cardiac health knowledge. The results of a multivariate analysis carried out five years after the MI showed that cardiac events and psychological condition were not significantly influenced by the CRP. However, it was found that the physical condition of the patients benefited from the CRP; self‐reported physical fitness (p < 0.002) and physical exercise test (p < 0.007). CRP participation was linked to significant modifications of life habits (diet change; p < 0.04, sexual activity; p < 0.000). The cardiac health knowledge was significantly improved by participation in the CRP (basic cardiac knowledge; p < 0.005; knowledge about misconceptions; p < 0.04). In conclusion, CRPs have had positive long‐term effects on physical condition, life habits and cardiac health knowledge. No such effects, however, were found regarding either cardiac events or psychological condition.
Assistive Technologies in Stroke Rehabilitation from a User Perspective
Authors: Hass Ursula , Fredén‐Karlsson Ingrid , Persson Jan
Published: March 2013

The purpose of the study was to provide knowledge, from a user perspective, about the selection process for assistive devices. Thirty‐eight persons who had suffered stroke were interviewed about their assistive devices, approximately one year after stroke. It was found that the patients had little influence on the choice of assistive devices and that the maintenance and follow‐up routines varied among patients. In some cases follow‐up was not done at all. Despite these deficits, the patients used their assistive devices as intended.
Home Care—A Realistic Alternative for Bed‐blocking Stroke Victims in Acute Hospital Wards?
Authors: Hermans Eric , Diederiks Joseph P. M. , Philipsen Hans
Published: March 2013

Up to half of the stroke patients admitted to acute hospital wards become bed‐blockers. Investigations have been carried out in an effort to identify factors related to this problem. Very little is known about options which may lead to an alleviation of this problem. We investigated to what extent, in the opinions of professional representatives of six disciplines, home care can contribute to a solution. Sixty‐nine stroke patients who were actually blocking beds in an acute hospital ward were described and examined on paper by a multidisciplinary panel. These patients were all moderately to severely disabled and needed a high degree of help in activities of daily life (ADL) and household activities. Estimations of the number of patients who were judged to be suitable for home care varied, although there was a fair degree of agreement between panel members concerning those patients who could and those who certainly could not return to their homes. Concerning one‐third of the patients, the opinions of the caregivers diverged. Factors relating to the judgement of each panel member are identified. A method for selecting patients to be substituted to lower levels of care is suggested and discussed.
Patients with Chronic Renal Failure and Their Ability to Cope
Authors: Klang Birgitta , Björvell Hjördis , Cronqvist Agneta
Published: March 2013

The subject studied in this paper, describing uremic patients' use of coping strategies and their sense of coherence, was 48 consecutively selected patients with chronic renal failure at a Swedish hospital. The questionnaires used were the Jalowiec Coping Scale (JCS‐40) and the Sense of Coherence Scale (SOC). The results showed that the patients used a variety of coping strategies, such as maintaining control, finding out more about the situation and hoping. In the use of coping styles, the confrontational style was the most favoured one, compared with the palliative and the emotive styles. There was a significant distinction between the predialysis patients and those on dialysis treatment concerning the use of strategies and coping styles. Patients on dialysis treatment showed significantly higher scores in overall strategies and in confrontational and palliative coping styles. The results revealed significant correlations between the JCS and the SOC scores, age and duration of kidney disease. Knowledge of the patients' commonly used coping strategies and sense of coherence is important when nursing care is being planned for the patient.
How Beds are Used at a University Hospital
Authors: Petzäll Kerstin , Berglund Barbro , Lundberg Christer
Published: March 2013

Hospital beds have to fulfil many demands, and the features of the bed will consequently affect the comfort of both paients and staff at the ward. In the present study the use of hospital beds at Sahlgrenska University Hospital in Göteborg was investigated. The study was performed in two somatic wards; one general surgery ward and one internal medicine. The exact time of the observations as well as the categories of usage and activities performed on and at the bedside by the caring staff and the patients were registered. The study shows that there is a substantial difference between the two wards. In the surgery ward, the beds to a great extent play an active part in medical therapy and treatment, whereas beds in the medicine ward are used for vegetative recovery such as sleep, rest and alimentation. The personnel spent only a few hours with the patients, while they were in their beds, most of the caring occurring away from the bed. The results of the present study concerning how beds are utilized in modern hospital care should be considered when purchasing and designing hospital beds.
Caring for the Elderly
Authors: Tornstam Lars
Published: March 2013

In the present article an endeavour is made to present an introduction to a new theoretical framework for caring for the elderly. The theory of gerotranscendence holds that old age is a stage with its own specific quality of life. The venture included two main phases—the introductory phase and the impact evaluation phase. During the introductory phase, ways of understanding and caring for the elderly (the new theory) were presented and discussed among 90 nurses and aids, constituting almost the entire staff working with the elderly in institutional settings in a small Swedish municipality. Six months after the end of the introductory phase, the impact evaluation was carried out using a mail survey. The impact evaluation revealed that almost half of the staff came to a new understanding of specific care recipients and that a third of the staff also changed their attitude towards caring for specific care recipients. The introduction of the new theory also reduced staff members' feelings of guilt about inadequacy at work.
Functional Status and Weil‐Being in a Group of Patients with Abdominal Aortic Aneurysm
Authors: Sandström Veronica , Björvell Hjördis , Olofsson Pär
Published: March 2013

The aim of the present study was to investigate how abdominal aortic aneurysm (AAA) affects the patient's functional status, health and well‐being. Forty‐two consecutive patients at a university clinic were included. Twenty were operated on and 22 were on regular, conservative check‐ups. The patients answered questionnaires regarding perceived functional status (Sickness Impact Profile, SIP), general health (Health Index, HI) and psychological well‐being. Two reference groups were used. The non‐operated patients scored significantly worse for functional status on the psycho‐social subscale than the operated patients. In comparison with the reference group they had the worst scores for functional status on the overall SIP scale and the physical, eating and home‐management scales. Regarding the HI, there was no difference between the patient groups themselves, but as a whole they had significantly lower scores than the reference group. Thus, the patients perceived their well‐being as worse than a healthy reference group. In their attitudes to well‐being, the non‐operated patients, were significantly less hopeful than the operated patients. It is obvious that asymptomatic AAA has a significant effect on the patient's self‐perceived, functional status and well‐being, irrespective of the surgical or conservative management.
How the Relatives of Elderly Patients in Institutional Care Perceive the Staff
Authors: Hertzberg Annika , Ekman Sirkka‐Liisa
Published: March 2013

The purpose of this paper is to describe how relatives in the next generation to elderly patients in institutional care perceive the staff. The study was carried out using unstructured interviews lasting 60/90 min, followed by a semi‐structured interview lasting about 30 min for each participant. The interviews were analysed by thematic content analysis. The findings gave a picture of how seven relatives perceived the staff. On the whole, they were content with the physical care given, but they had some doubts about the psychological care. Some were worried about what to do during visiting time. Communication between relatives and staff was on a superficial level and concerned mostly practical matters, and it was the relative who had to take the initiative in interactions. The relatives found it very difficult to express criticism. The environment and the possibilities of being out of doors were of importance to the relatives, since they were aware that the nursing home was their parents' last home. The results of this study provide the impetus for further research on topics relating to relative/staff interaction.
Reflective Action—Strategies for Solving Client‐Nurse Partnerships in Primary Care
Authors: Stern Phyllis Noerager , Keffer M. Jan
Published: March 2013

In this grounded theory study, which addressed the research question, ‘What strategies do nurses use to form client‐nurse partnerships,’ a variety of data sources were used. The first data set consisted of participant observation, and reports of focus groups formed as part of the ‘First International Conference on Nursing Theory and Primary Health Care’ at Massey University, New Zealand which was attended by an international group of 80 nurses in 1990. As an adjunct to the formal presentations, members of the focus groups addressed four questions: a) Is a nurse‐client partnership viable in primary care? b) What do you plan to do to promote this partnership? c) What do you think others should do? and d) What is the next step? Reports from these focus groups, pooled with questionnaires (n = 17) and informal interviews completed this data set. The central process that described participants' perceptions of the viability of nurse‐client partnerships was named reflective action. Ethical questions arose and were placed along a continuum of viability. A second data set consisted of interviews with, and selected literature by, Canadian nurses on partnerships in primary care. The perceptions of this international study group are seen as adding to our knowledge of barriers to nurse‐client partnerships in primary care, and strategies for transcending these barriers.
Cancer Patient and Staff Perceptions of Caring vs Clinical Care
Authors: Widmark‐Petersson Viveca , von Essen Louise , Lindman Eva , Sjödén Per‐Olow
Published: March 2013

Two questions were investigated: (1) whether cancer patients (n = 72) and staff (n = 63) have different cognitive representations of the concepts ‘caring’ (in Swedish: omvårdnad) and ‘clinical care’ (in Swedish: vård), and (2) whether two different wordings of the response categories used by patients and staff to rank the perceived importance of 50 specific caring behaviors (‘Old’ response format: ‘of importance’—‘of no importance’ vs ‘New’ format: ‘more or less important’) in relation to these concepts would produce different results. A Swedish questionnaire version of the CARE‐Q instrument was used. Participants were randomized to one of four research conditions: (1) Caring/Old, (2) Caring/New, (3) Clinical care/Old, and (4) Clinical care/New, and asked to rank the importance of the 50 CARE‐Q behaviors for that specific concept/response format combination. Results demonstrated that response formats did not affect patient or staff answers. Neither group did to any great extent value CARE‐Q behaviors differently when regarded as examples of ‘caring’ vs ‘clinical care’. The assumption that different cognitive representations of the concepts or that a specific wording of response categories had affected previous CARE‐Q results was not substantiated.
Pulses of marine subsidies amplify reproductive potential of lizards by increasing individual growth rate
Authors: Wright Amber N. , Piovia‐Scott Jonah , Spiller David A. , Takimoto Gaku , Yang Louie H. , Schoener Thomas W.
Published: March 2013

Pulsed resource subsidies can have profound effects on recipient communities. The effects of resource pulses are often mediated by increases in the density of consumer populations. Here we investigate several mechanisms linking experimental pulses of seaweed deposition to population‐level responses in the brown anole Anolis sagrei. Subsidized lizards grew approximately 30% faster than lizards in seaweed‐removal plots, but there was no effect of seaweed subsidies on survival or body condition. Breeding is strongly seasonal in A. sagrei, resulting in a limited reproductive window of opportunity. Accelerated growth allows subsidized females to reach sexual maturity earlier and thereby exploit more of this window, which is projected to double fecundity in their first year of life. These results show how changes in an individual trait can translate pulses of resource input into reproductive output. Further, they highlight the importance of seasonal timing in mechanistically linking individual‐, population‐ and community‐level responses to pulsed resource subsidies.
The Need to Reemphasize Behavior Change for HIV Prevention in Uganda: A Qualitative Study
Authors: Green Edward C. , Kajubi Phoebe , Ruark Allison , Kamya Sarah , D'Errico Nicole , Hearst Norman
Published: March 2013

Uganda has long been considered an AIDS success story, although in recent years declines in prevalence and incidence appear to have stalled or even reversed. During the early stages of Uganda's AIDS prevention program, health messages emphasized behavior change, especially fidelity. Ugandans were made to fear AIDS and feel personally at risk of dying from a new, poorly understood disease. In this research, six focus group discussions with 64 participants in peri‐urban and rural areas outside Kampala suggest that HIV prevention messages have shifted in the direction of risk reduction: condoms, testing, and drugs. Ugandans now seem less afraid of becoming infected with HIV, at least in part because antiretroviral therapy is available, and this diminished fear may be having a disinhibiting effect on sexual behavior. Participants believe that HIV rates are on the rise, that more individuals are engaged in multiple and concurrent sexual partnerships, and that sexual behavior is less restrained than a generation ago. These findings suggest that AIDS‐prevention programs in Uganda would benefit from refocusing on the content that yielded success previously—sexual behavior change strategies.
Prevalence of obesity among Arab school children in Nazareth, Israel: comparison with national (Jewish) and international data
Authors: Ram E. , Marcus O. , Joubran S. , Abdo B. , Asal N. R.
Published: March 2013

What is already known about this subject

Lack of published data.

Absence of Ethnic specific data.

Lack of focus on obesity prevention in Arab schools.

What this study adds

First set of data on obesity for Arab children.

Data will be used as reference data.

Alert health/school official for intervention.

Objective

The objective is to produce the first set of obesity prevalence data and use the data as reference values of body mass index (BMI) trends for Arab children in Israel and compare with Jewish and international data.

Methods

A prevalence study was carried out in 2009 in which 4130 children aged 6–12, were selected from eight Arab sector schools representing the Nazareth Municipality. Height, weight and BMI measurements were obtained and presented by age, mean age, size, weight, gender and percentile. Appropriate epidemiological and statistical methods used for comparison.

Results

The obesity and overweight prevalence rates in Arab children by age ranges from 0% to 2.6% and 0% to 11.2%, respectively. Comparison with international and Jewish data revealed differences in almost all age groups but higher rates in Arabs, especially boys.

Discussion

The higher rates/trends in Arab children may be explained by more Arab women entering the workforce, increase in single‐parent families and changes in food and physical activity environments.

Conclusion

Based on our data, we recommend either an ethnic‐specific BMI reference curves and/or inclusion of Arab data in the Israeli data system. Research need to focus on reasons for the increase and interventions to reverse/slow the trend.
Sleep and birthweight predict visceral adiposity in overweight/obese children
Authors: Sokolovic N. , Kuriyan R. , Kurpad A. V. , Thomas T.
Published: March 2013

Background

Visceral adiposity poses significant consequences for long‐term health and it is important to identify methods that can be used to prevent fat deposition in visceral adipose tissue.

Objective

To identify the factors contributing to differential fat distribution in overweight/obese children.

Methods

Demographic, dietary and lifestyle factors potentially associated with increased visceral adipose tissue in overweight and obese South‐Indian children aged 3 to 16 years. The diagnosis of visceral obesity was based on the waist‐to‐height ratio (WHtR) cut‐off value of 0.5.

Results

Exposure variables with statistically different distributions in the two WHtR categories, when examined by Mann–Whitney and chi‐square tests, were used to develop a binary logistic regression model of visceral adiposity. Increased birthweight and higher sleep duration were significant predictors of having a healthy WHtR, with odds ratios of 1.30 and 1.26 respectively.

Conclusions

Early programming effects associated with low birthweight and current sleep deprivation could promote the storage of excess fat as visceral adipose tissue in overweight and obese children.
Caesarean delivery, caesarean delivery on maternal request and childhood overweight: a Chinese birth cohort study of 181 380 children
Authors: Li H. , Ye R. , Pei L. , Ren A. , Zheng X. , Liu J.
Published: March 2013

What is already known about this subject

Both rates of caesarean section and childhood overweight have been steadily increasing over the past decade in many parts of the world.

Caesarean delivery on maternal request contributes remarkably to the rising trend of caesarean births.

A few small‐scale studies suggest that caesarean section may be associated with later overweight and obesity, whereas little is known about the impact of caesarean delivery on maternal request.

What this study adds

Caesarean section is associated with an increased risk of childhood overweight.

Children born by caesarean delivery on maternal request are also more likely to be overweight.

The strength of the caesarean‐overweight association is modest.

Objectives

To assess the impact of caesarean delivery including non‐medically indicated maternal request caesarean delivery on childhood overweight.

Methods

We conducted a prospective investigation of a Chinese birth cohort involving 181 380 children, who were born during 1993–1996 to mothers registered in a perinatal care surveillance system and whose weight and height were measured in 2000. Information on delivery mode and covariates was obtained from the surveillance system. Overweight was defined according to the International Obesity Task Force body mass index (BMI) cutoffs. Multivariable logistic regression was used to estimate adjusted odds ratios. Stratified analyses were done to test whether the association between caesarean section and overweight persisted across subgroups.

Results

The adjusted odds ratio of overweight for children born by caesarean compared with vaginal delivery was 1.13 [95% confidence interval {CI}: 1.08, 1.18]. The association persisted in subgroups stratified by gender, maternal education, maternal BMI, weight gain during pregnancy and child birthweight (all P values for interaction test ≥0.30). The adjusted odds ratio of overweight for children born by non‐medically indicated caesarean delivery compared with vaginal delivery was 1.18 (95% CI: 1.00, 1.41).

Conclusion

Caesarean delivery including non‐medically indicated maternal request caesarean delivery compared with vaginal delivery modestly increases childhood overweight risk.
Effect of Polishing Direction on the Marginal Adaptation of Composite Resin Restorations
Authors: St‐Pierre Laurie , Bergeron Cathia , Qian Fang , Hernández Maria Marcela , Kolker Justine L. , Cobb Deborah S. , Vargas Marcos A.
Published: March 2013

Problem

Polishing composite resin restorations may lead to marginal defects and gap formation.

Purpose

To assess the effect of polishing direction on the marginal adaptation of composite resin restorations using two composite resins and two polishing systems.

Materials and Methods

Forty extracted human molars were sectioned along their mesio‐distal axis. Buccal and lingual enamel was flattened and a triangular preparation, 0.87‐mm deep and 3‐mm wide, representing two 60° bevels, was performed. Specimens were randomly assigned to eight groups (N = 20) and restored with two composite resins: a nanofilled (Filtek Supreme Ultra, 3M ESPE, St. Paul, MN, USA) or a microhybrid (Point 4, Kerr, Orange, CA, USA) and finished with two polishing techniques: polishing discs (Sof‐Lex XT, 3M ESPE) or rubber polishers (HiLuster Plus, Kerr, Bioggio, Switzerland). On each specimen, both margins were polished with the same technique, one margin from composite resin to tooth and the other from tooth to composite resin. Replicas were made for field emission scanning electron microscope observation (200×) and quantitative margin analysis was performed based on four criteria. Data were analyzed with a paired‐sample t‐test, a two‐sample t‐test, and one‐way analysis of variance or their nonparametric analog.

Results

Significant differences were found in most groups between polishing directions with better marginal adaptation from composite resin to tooth than from tooth to composite resin. Differences between composite resins and polishing techniques seemed to be dependent on certain combinations of composite resin, polishing technique, and polishing direction.

Conclusion

Polishing from composite resin to tooth leads to better marginal adaptation than polishing from tooth to composite resin.

Clinical Significance

The results obtained from this in vitro study suggest that polishing direction influences the marginal adaptation of composite resins and that polishing from composite resin to tooth structure should be clinically performed whenever possible on accessible margins to preserve marginal integrity and esthetics.
Are cervical and breast cancer screening programmes equitable? The case of women with intellectual and developmental disabilities
Authors: Cobigo V. , Ouellette‐Kuntz H. , Balogh R. , Leung F. , Lin E. , Lunsky Y.
Published: March 2013

Background

Effective cancer screening must be available for all eligible individuals without discrimination. Lower rates of cervical and breast cancer screening have been reported in certain groups compared with women from the general population, such as women with intellectual and developmental disabilities (IDD). Research on the factors explaining those observed differences is crucial to determine whether practices are unfair and could be improved. The aim of this population‐based study was to describe cancer screening utilisation by women with IDD in Ontario, Canada compared with other women in Ontario. The specific objectives were (1) to estimate the rates of cervical and breast cancer screening among eligible women with IDD in Ontario; (2) to compare the rates of cervical and breast cancer screening between eligible women with and without IDD; and (3) to examine if any observed differences between women with and without IDD persist after factors such as age, socio‐economic status, rurality and healthcare utilisation are accounted for.

Method

This study draws women with IDD from an entire population, and draws a randomly selected comparison group from the same population. It controls for important confounders in cancer screening within the limitations of the data sources. The study was conducted using health administrative databases and registries in Ontario, Canada. Two cohorts were created: a cohort of all women identified as having an IDD and a cohort consisting of a random sample of 20% of the women without IDD.

Results

The proportion of women with IDD who are not screened for cervical cancer is nearly twice what it is in the women without IDD, and 1.5 times what it is for mammography.

Conclusions

Findings suggest that women with IDD experience inequities in their access to cancer screening. Public health interventions targeting this population should be implemented.
Patterns of sensitisation to common food and inhalant allergens and allergic symptoms in pre‐school children
Authors: Kim Hyeong Yun , Shin Youn Ho , Yum Hye Yung , Jee Hye Mi , Jang Sun Jung , Yoon Jung Won , Han Man Yong
Published: March 2013

Aim

Sensitisation to allergens and allergy symptoms depends on age, but this relationship is poorly understood. We therefore investigated the effect of age on allergen sensitisation and allergy symptoms in pre‐school children.

Methods

A cross‐sectional study was conducted on 629 Korean children (age 3 to 6 years). Current allergic symptoms were assessed by the Korean version of the International Study of Asthma and Allergies in Childhood questionnaire that was adapted for pre‐school children. Sensitisation to five airborne and three food allergens was evaluated by a skin prick test. χ2 test was used to analyse differences in age trend. Multiple logistic regression analysis was performed to obtain the adjusted odds ratios (aOR) for allergic disease.

Results

As age increased, the prevalence of current rhinitis (P < 0.001), the sensitisation to pollen allergens (P < 0.001) and polysensitised children (P = 0.002) increased, but the prevalence of current asthma (P = 0.010) and the sensitisation to food allergens (P = 0.009) decreased. There was no effect of age on the prevalence of current eczema (P = 0.685), monosensitised children (P = 0.282) and atopy (P = 0.160). The agreement between sensitisation to dust mites and atopy increased with age, and was 93% at age 6 years (P = 0.05). The polysensitisation (aOR = 3.0 (95% CI, 1.4–5.0), P < 0.005) and the presence of eczema in the first 2 years of life (aOR = 4.1 (95% CI, 2.2–7.6), P < 0.001) were significant independent risk factors for current rhinoconjunctivitis.

Conclusion

The type and number of allergen sensitisations and allergic symptoms changed from age 3 to 6 years. Careful follow‐up of changes in sensitisation patterns may provide a better understanding of the pathogenesis of the allergic march.
Central neuropeptide W has anorexigenic effect in rats
Authors: Naso T. , Shousha S. , El‐Kirdasy A.
Published: March 2013

Neuropeptide W (NPW) is produced in neurons located in hypothalamus, brain stem and antral G cells and its receptors are present in the hypothalamus, in particular in the paraventricular nucleus (PVN). There are two forms of the peptide, designated as neuropeptide W‐23 (NPW23) and neuropeptide W‐30 (NPW30). Neuropeptide W is an endogenous ligand for G‐protein‐coupled receptor, GPR7 and GPR8 receptors (R), which in humans are expressed in the hypothalamus and probably involved in the control of energy homoeostasis and neuroendocrine axes. We conducted this study to investigate the effects of NPW on feeding intake and energy expenditure in Wistar rats. Systemic (icv) injection of both forms of neuropeptide W (NPW23 and NPW30) to ad libitum feeding Wistar rats decreased dark feeding and fasting‐induced feeding. One week of systemic treatment with NPW23 decreased feeding intake and weight gain during the treatment period. On the other hand, systemic treatment with antineuropeptide W antibody increased feeding intake. Moreover, systemic treatment with neuropeptide W‐23 raised body temperature and consequently thermogenesis. These results strongly suggest that neuropeptide W may play an important central role in the feeding intake and energy balance control in mammals.
Guidelines for Structuring Community Care and Supports for People With Intellectual Disabilities Affected by Dementia
Authors: Jokinen Nancy , Janicki Matthew P. , Keller Seth M. , McCallion Philip , Force Lawrence T. ,   National Task Group on Intellectual Disabilities and Dementia Practices
Published: March 2013

To assist families and organizations in their planning for extended care that accompanies the diagnosis of dementia, the National Task Group on Intellectual Disabilities and Dementia Practices (NTG) in the United States adopted a set of practice guidelines covering the period from when suspicions are aroused to when care ends with eventual death. These guidelines are drawn from the research literature as well as clinical experiences and demonstrated best practices. The guidelines delineate what actions should be undertaken and are presented in a manner that reflects the progressive nature of prevalent dementias. To enable the development of the most appropriate and useful services and care management for adults with intellectual disabilities affected by dementia, the NTG adopted the staging model generally accepted for practice among generic dementia services. The staging model follows the flow from a prediagnosis stage when early recognition of symptoms associated with cognitive decline are recognized through to early, mid, and late stages of dementia, and characterizes the expected changes in behavior and function. In keeping with the National Plan to Address Alzheimer's Disease recommendations for earlier and more widespread efforts to detect possible symptoms, the guidelines cite the application of the NTG‐Early Detection Screen for Dementia as a first step in documenting early signs of cognitive and functional changes among people with intellectual disabilities. The guidelines also provide information on nonpharmacological options for providing community care for persons affected by dementia as well as commentary on abuse, financial, managing choice and liability, medication, and nutritional issues.
Anatomic and Sexual Outcomes After Vaginoplasty Using Tissue-Engineered Biomaterial Graft in Patients with Mayer-Rokitansky-Küster-Hauser Syndrome: A New Minimally Invasive and Effective Surgery
Authors: Zhu Lan , Zhou Huimei , Sun Zhixing , Lou Wenjia , Lang Jinghe
Published: March 2013

Introduction

Recent years have seen continuous reports about the successful reconstruction of numerous organs with the application of tissue-engineering techniques. Thus, we assess the outcomes for vagina reconstruction using tissue-engineered biological material, which we suggested previously as an ideal graft for vaginoplasty.

Aim

To evaluate the anatomic and sexual outcomes in patients undergoing vaginoplasty using tissue-engineered biomaterial mesh.

Methods

This prospective study included 53 patients with Mayer-Rokitansky-Küster-Hauser syndrome admitted to our hospital. Patients underwent vaginoplasty with tissue-engineered biological material (acellular dermal matrix). Postoperatively, a silicone vaginal dilator (length: 10 cm, diameter: 3.5 cm) was advised to be used for the first 3–6 months to prevent contraction of the neovagina. Follow-up was performed at 4 weeks, 12 weeks, 12 months, and then annually. Twenty-four age-matched women who underwent health examinations during the same time period were selected as a health control group and answered Female Sexual Function Index (FSFI) questionnaires for the purpose of comparing sexuality.

Main Outcome Measures

Anatomic success was defined by a vaginal length ≥8 cm and a width allowing the easy introduction of two fingers. Sexual outcomes were assessed at the 12-month follow-up according to body image perception and FSFI questionnaires validated for the Chinese-speaking population.

Results

No severe intra-operative complications occurred. No graft-related infection, rejection, or detachment was recorded. The cost for tissue-engineered biomaterial graft was $1,900 (¥12,000) per person. Postoperatively, granulomatous polyps occurred in 6/53 patients (11.3%) at the vaginal vault and were removed in an outpatient clinic. During a mean follow-up of 21.1 months, the anatomic success rate was 100%, and all of the patients were satisfied with their body image. Postoperatively, 42 patients were followed up for more than 1 year, and 32 of them were sexually active. Among the 24/32 patients (75%) who answered the FSFI questionnaire, the mean total FSFI score was 26.7 ± 3.5, which was similar to that of the control group (25.6 ± 7.4, P = 0.46). The similarity was also observed in six separate domains of the functional aspect of female sexuality.

Conclusions

Vaginoplasty with tissue-engineered biomaterial graft is a safe, effective, minimally invasive cosmetic procedure that provides near normal sexual function for patients with vaginal aplasia.
The Transformations of Charles Dickens in Early Socialist Poland
Authors: Kujawska‐Lis Ewa
Published: March 2013

Charles Dickens was the most widely read and published foreign novelist in nineteenth‐century Poland, primarily viewed as a humorist and social critic. In the modernist and inter‐war periods he remained extremely popular, though Polish critics assigned him to the position of a classic writer who was no longer regarded as a great artist, because his novels did not comply with modernist aesthetics. After the Second World War there came a fresh wave in his reception. With a new social order and political system, Dickens started to be evaluated according to the new ideological premises. The re‐evaluation of this writer’s oeuvre was accompanied by a change of critical discourse and concentrated on the historical background in which the novels were conceived, especially concerning the situation of the working class in a capitalist society. Polish propaganda critics admired his depictions of the destruction caused by capitalism, yet criticised him for not being radical enough to support social revolution. This paper examines press articles and introductions to Dickens’s novels published in Poland in the 1950s in order to highlight the most significant changes to his circulation, focusing on the different attitudes toward, and the interpretations of, his works.
A Restoration? 25 years of Jacobite Studies
Authors: Monod Paul Kleber
Published: March 2013

The past quarter‐century has seen an efflorescence of studies of Jacobitism, within both political and cultural history. The scope and impact of these studies are considered in the present article, which ranges across the major fields of research that are now associated with Jacobite Studies. They include plots and conspiracies; rebellions and uprisings; Irish Jacobitism, particularly as it was embodied in poetic works; the Jacobite diaspora to the European continent; the Stuart courts in exile; and Jacobite culture, including literature. The significance of Jacobitism for English literary history is examined, and major controversies, including the debate over Samuel Johnson, are discussed.
Shakespeare and World Cinema: A Critical Overview
Authors: Murray Kevin
Published: March 2013

This essay traces the history of the idea of world cinema, cataloguing its key meanings within film studies before going on to provide an overview of its uses within the critical discipline of Shakespeare on film. The innocuousness of the term ‘world cinema’ belies the plethora of potential meanings which it has accrued; such is the term’s fluidity, in fact, that it has courted allegations of being, at best, indistinct or simplistic, and, at worst, specious and neo‐colonial. Arguing against assumptions that the term is too indistinct to be of value, or that it is, in a post‐national age, obsolete, various critics have shown that world cinema is a concept whose very malleability renders it indispensable in contemplating how the films of various international directors can be seen, to lesser or greater degrees, to relate to Shakespeare, to the industrial, political and cultural specificities of nation or region (and the cinematic traditions therein) and to global networks of demographic exchange, cinematic intertextuality and monetary and/or aesthetic collaboration. Surveying the key ideas currently provoking debate within film studies and Shakespeare on screen criticism, this article endeavours to reveal how theoretical templates of world cinema have been deployed to consider how a globally circulating Shakespeareanism interacts with the representational practices of diverse localities. The article’s conclusion tentatively suggests some new paths yet to be explored within the field.
Role of Triggering Pulmonary Veins in the Maintenance of Sustained Paroxysmal Atrial Fibrillation
Authors: TRAYKOV VASSIL B. , PAP RÓBERT , GINGL ZOLTÁN , CHADAIDE SZAMI , HAQQANI HARIS M. , KLAUSZ GERGELY , GALLARDO RODRIGO , FORSTER TAMÁS , CALLANS DAVID J. , SÁGHY LÁSZLÓ
Published: March 2013

Background

Triggers from thoracic veins have been implicated not only in the initiation, but also in the perpetuation of paroxysmal atrial fibrillation (PAF). To investigate their role we studied the distribution and stability of dominant frequencies (DFs) during PAF and the response to isolation of the triggering pulmonary vein (PV).

Methods and Results

Triggering structures inducing PAF were identified during isoproterenol challenge in 26 patients (15 males, 55 ± 8.5 years). During sustained PAF, sequential recordings were made with a decapolar circular mapping catheter from each PV and the left atrial posterior wall (LAPW), together with coronary sinus (CS) and right atrium (RA) recordings. DF was determined using fast Fourier transformation. Recordings were repeated after ≥15 minutes of PAF. Radiofrequency ablation was directed first at the triggering PVs. PAF initiated from the PVs in 24 patients and from RA in two. There was a significant frequency gradient from the triggering structure to the PVs, CS, LAPW, and RA (P < 0.0001). During the second recording, DF decreased at all sites (P < 0.02), but the frequency gradient remained unchanged. Despite isolation of the triggering PV, PAF continued in 53% of patients, although DF measured in the CS was lower. AF termination occurred with contralateral PV isolation in half of the remaining patients and further AF slowing was noted in the rest.

Conclusions

Triggering structures harbor the fastest activity during sustained PAF pointing to their leading role in arrhythmia perpetuation. However, nontriggering PVs also seem to contribute to PAF maintenance.
Skin Burns Associated with Radiofrequency Catheter Ablation of Cardiac Arrhythmias
Authors: DHILLON PARAMDEEP S. , GONNA HANNEY , LI ANTHONY , WONG TOM , WARD DAVID E.
Published: March 2013

Skin burns are a rare complication associated with radiofrequency catheter ablation of cardiac arrhythmias. Burns related to the indifferent electrode patch may be severe and result in significant comorbidity. We describe our experience of skin burns and discuss potential predisposing and possible causative factors.
Exponential Asymptotics for Line Solitons in Two‐Dimensional Periodic Potentials
Authors: Nixon Sean D. , Akylas T. R. , Yang Jianke
Published: March 2013

As a first step toward a fully two‐dimensional asymptotic theory for the bifurcation of solitons from infinitesimal continuous waves, an analytical theory is presented for line solitons, whose envelope varies only along one direction, in general two‐dimensional periodic potentials. For this two‐dimensional problem, it is no longer viable to rely on a certain recurrence relation for going beyond all orders of the usual multiscale perturbation expansion, a key step of the exponential asymptotics procedure previously used for solitons in one‐dimensional problems. Instead, we propose a more direct treatment which not only overcomes the recurrence‐relation limitation, but also simplifies the exponential asymptotics process. Using this modified technique, we show that line solitons with any rational line slopes bifurcate out from every Bloch‐band edge; and for each rational slope, two line‐soliton families exist. Furthermore, line solitons can bifurcate from interior points of Bloch bands as well, but such line solitons exist only for a couple of special line angles due to resonance with the Bloch bands. In addition, we show that a countable set of multiline‐soliton bound states can be constructed analytically. The analytical predictions are compared with numerical results for both symmetric and asymmetric potentials, and good agreement is obtained.
Mathematical Wit and Mathematical Cognition
Authors: Aberdein Andrew
Published: March 2013

The published works of scientists often conceal the cognitive processes that led to their results. Scholars of mathematical practice must therefore seek out less obvious sources. This article analyzes a widely circulated mathematical joke, comprising a list of spurious proof types. An account is proposed in terms of argumentation schemes: stereotypical patterns of reasoning, which may be accompanied by critical questions itemizing possible lines of defeat. It is argued that humor is associated with risky forms of inference, which are essential to creative mathematics. The components of the joke are explicated by argumentation schemes devised for application to topic‐neutral reasoning. These in turn are classified under seven headings: retroduction, citation, intuition, meta‐argument, closure, generalization, and definition. Finally, the wider significance of this account for the cognitive science of mathematics is discussed.