bluuebunny/crossref_metadata_2025 huggingface dataset:
Side Holes at the Tip of Chronic Hemodialysis Catheters are Harmful
Authors: Twardowski Zbylut J. , Moore Harold L.
Published: January 2018

Side holes at the inflow tip are necessary for acute hemodialysis catheters without inflow end-hole. Most catheters for chronic dialysis, both single and dual lumen, are also provided with side holes. There are no data in support of the notion that side holes improve blood flow or prolong the life of chronic catheters. The opposite may be true. Firstly, the side holes are created by drilling and have rough edges as can be seen in scanning electron microscopy. Secondly, many times, while removing chronic catheters, either electively or because of obstruction, a clot is found at the tip of the catheter and anchored in the side hole(s). Such a clot is difficult to strip by a snare in situ. Thirdly, a difficult to remove clot is formed on the outer surface of the catheter and extends to the inside lumen. If so, the holes have no role in extending the life of the catheter. Fourthly, the heparin or other anticoagulant, which is instilled to the catheter lumen at the end of dialysis, may not reach the catheter tip and/or be leached out in the period between dialyses, thus, predisposing to clot formation at the tip of the lumen. Finally, if the inflow bore is occluded and the blood flows through the side holes, it is likely that the vein intima is sucked into the holes, becomes damaged and causes formation of the mural thrombus. In such a case these holes would not be beneficial in prolonging catheter life, but may even preclude the possibility of inserting another catheter into the same vein at a later date.
Indication for the use of Central Venous Catheters as Vascular Access for Hemodialysis
Authors: Baracetti S.
Published: January 2018

Adequate treatment for uremic patients on hemodialysis requires valid and lasting access to central vessels.

The Central Venous Catheter (CVC) as a mean of immediate access is indispensable in all acute cases where it has not been possible to prepare an AVF in time and when the peripheral vascularization is highly compromised. We present our investigation on the best access route to central vessels and the selection of the type of catheters to adopt in different conditions.

On the basis of complications arising during the catheter life especially as permanent access, it seems to us that the right internal jugular catheterization with the 2 Tesio catheters Kit is the more useful and less dangerous catheterization.
Ultrasound-Guided Cannulation and Endocavitary Electrocardiography Placement of Internal Jugular Vein Catheters in Uremic Patients: The Importance of Routine Chest X-Ray Evaluation
Authors: Cavatorta F. , Zollo A. , Galli S. , Mij M. , Dolla D.
Published: January 2018

The NKF-DOQI guidelines recommend performing chest-X-ray(CXR) after subclavian and internal jugular vein insertion prior to catheter use. This is to exclude complications such as a pneumothorax before starting hemodialysis.

Indication of a central venous dialysis catheter was based on the historic use of the subclavian vein for placement of these catheters and upon the reported incidence of pneumothorax after this approach of between 1% to 12.4%. In contrast, the incidence of these complications using the internal jugular vein (IJV) is much lower (< 1%).

We report our experience in ultrasound-guided cannulation of the right IJV for dialysis vascular access in 527 uremic patients and central catheter placement by endocavitary electrocardiography (EC-ECG). Fluoroscopy was not utilized. In the first hundred cases, all patients underwent CXR. Subsequently, because of total absence of complications and catheter tip malpositioning, the CXR control was carried out only in selected cases (repeated cannulation of the jugular vein or absence of P wave).

We believe that only in selected cases should a pCXR be performed before starting hemodialysis sessions, and that our method using the right IJV, ultrasound-guided puncture of the vessel, and catheter placement by EC-ECG is a safe and simple technique that avoids the need for CXR control.
Central Venous Catheter Placement in Hemodialysis: Evaluation of Electrocardiography using a Guide-Wire
Authors: Cavatorta F. , Zollo A. , Galli S. , Dionisio P.
Published: January 2018

Internal jugular vein cannulation has become a routine and clinically important aspect of medical care in hemodialysis patients. Mismanagement in the location of a central venous catheter may occur in up to 20% of cases. The aim of the study was to evaluate the utility of endocavitary electrocardiography in right internal jugular vein placement of central venous catheters.

We examined 327 central venous catheterizations performed in two Dialysis Units; all catheters were positioned using intra-atrial ECG monitoring by guide-wire and after, by catheter filled with NaCl solution. EC-ECG via guide-wire was successful on 321 occasions (98.1%). Correct placement of the catheter was confirmed by EC-ECG via catheter in each case, and by plain chest-X-ray only in the first hundred cases. In 314 patients (98.1%), insertion of the catheter was successful at the first attempt. In 6 catheterizations, no atrial trace was obtained due to atrial fibrillation in 4 cases, and in 2 cases technical error and guide-wire looping into a right jugular vein.

Complications as a direct result of guide-wire or catheter placement were not observed. In our opinion this method can be used safely and makes radiological control usually unnecessary.
The Placement of Central Venous Catheters in Hemodialysis: Role of the Endocavitary Electrocardiographic Trace. Case Reports and Literature Review
Authors: Dionisio P. , Cavatorta F. , Zollo A. , Valenti M. , Chiappini N. , Bajardi P.
Published: January 2018

At present, the placement of a central venous catheter is becoming more and more a routine procedure nevertheless it involves different operators in fields such as oncology, nutrition, nephrology, and emergency medicine. It is well known that complications in the placement of CVC may occur in up to 20% of cases. One fifth of the catheters may result to be misplaced either in the internal omolateral jugular vein or in the innominate vein or in the controlateral brachiocephalic veins and usually a chest radiogram is necessary to evaluate its location. On the basis of 10 years of experience including more than 1,000 CVC placements, we now believe that endocavitary electrocardiography EC-ECG, initially studied and applied by Dr. Serafini, constitutes the best technique, more secure and more comfortable for the patient, to verify the position of the tip of a CVC. The technique EC-ECG, very simple and secure, utilizes the CVC as an endocavitary electrode. This is connected to a standard electrocardiograph, the same one to which the patient is connected during the placement of the CVC, and provides, in derivation V1 or D3, an electrocardiographic pattern extremely sensitive to the position of the catheter tip.

From December 1991 to December 2000, this technique has been used successfully in our departments of nephrology and applied to 1,139 patients that needed a CVC for hemodialysis. EC-ECG and a standard chest radiogram controlled the first 100 CVC we placed and in the other 1,039 cases, the control was made by EC-ECG alone. Only in 31 patients (2.7% of all cases), due to arrhythmia, the technique EC-ECG was not utilized. According to our experience, the procedure EC-ECG is an extremely reliable technique, sensitive and specific in 100% of cases, easy for the operator to perform, comfortable for patient. It doesn't need additional time to be performed and eliminates the need of taking a chest radiogram that up to now was considered indispensable in order to verify the position of the catheter tip. In this manner serious complications such as pneumothorax, and haemothorax that can complicate the placement of a CVC can also be avoided.

Based on our experience, we now believe that this technique, that today has a large application in nephrology, oncology, clinical nutrition and in various branches of general medicine whenever the placement of a CVC is required, should be considered as a possible new guide line in controlling the placement of a CVC together with a chest X-ray when it is necessary.
Subcutaneous Implantation of the LifeSite® Hemodialysis Access System in the Femoral Vein
Authors: Ross J.
Published: January 2018

Cannulation of the femoral vein is often necessary to provide immediate vascular access for hemodialysis patients in whom a functional permanent access is not available or in patients who have exhausted other access options. Femoral placement of dialysis catheters is typically short term - days, not months - and is associated with high rates of infection, occlusion, recirculation and intervention as well as a high risk of catheter dislodgment.

A new, fully subcutaneous vascular access device - the LifeSite®, Hemodialysis Access System (Vasca, Inc., Tewksbury, MA) - has demonstrated better safety and efficacy profiles than a standard tunneled dialysis catheter in clinical trails that evaluated placement within the thoracic veins. The case reported here extends the use of the LifeSite® System to femoral placement in a patient with multiple failed arteriovenous accesses and dialysis catheters subsequent to central venous stenosis. The LifeSite® System was successfully implanted in the patient's left femoral vein and has served the patient for 4 months with no infections or complications requiring intervention, delivering flow rates >400–450 ml/minute for high-flux, dual-needle hemodialysis. These initial results suggest that the LifeSite® Hemodialysis Access System represents a new, safe and effective vascular access option in patients with limited access choices due to failed access in the upper extremities, central venous stenosis, or other vascular inadequacies.
Factors Influencing Permanent Catheter Performance
Authors: Mandolfo S. , Galli F. , Costa S. , Ravani P. , Gaggia P. , Imbasciati E.
Published: January 2018

Permanent dual lumen catheters (PDLC) provide an alternative vascular access in patients considered unsuitable for arteriovenous fistula, graft or peritoneal dialysis. However, the use of PDLC is often complicated by inadequate blood flow. The aim of this study was to identify catheter dysfunctions. We studied prospectively 57 chronic hemodialyzed patients, 73±11 years of age, with PDLC for 18±14 (1–48) months. Catheters were tunneled in silicone (MedComp Tesio n= 40) or in polyurethane (Permcath Quinton n = 11, GamCath Gambro n = 6) in left or right internal jugular (n = 49), in left or right subclavian (n = 3) and in right femoral vein (n = 5). We studied the blood viscosity indices (hematocrit, total protein, cholesterol and triglycerides), catheter intra-dialytic parameters (pre-pump and venous pressure), localization of the catheter tip (superior vena cava = SVC, right atrium = RA, inferior vena cava = IVC), blood pressure before and after hemodialysis during the 3 last dialyses, use of anticoagulant (ACT) or antiaggregant therapy (AAT) and previous infectious episodes. The mean blood flow was 269±37 ml/min (median 280 ml/min). The patients were divided according to the median value into groups I (Qb < 280, n = 28) and group II (Qb > 280, n =29). Results: Blood viscosity, patients’ mean arterial pressure and venous catheter line pressure did not differ between the two groups. Pre-pump pressure, at the start and at the end of treatment, was higher in group I. ACT, AAT and previous infectious episodes could not explain the low-performance. Blood flows of catheters localized in RA, SVC, and in IVC were respectively 287±20, 268±39, 244±27 ml/min. In the first case the Qb was significantly higher than IVC (p = 0.03) and SVC (p = 0.04).

In conclusion, the most important factor influencing blood flow rates seems to be the position of the catheter tip in the venous system. The best blood flows were found in catheters with the tip localized in the right cardiac cavities, while PLDC placed in inferior vena cava showed lower blood flow.
Central Venous Access in Pediatric Patients
Authors: Fusaro F. , Scarpa M.G. , Piccolo R. Lo , Zanon G.F.
Published: January 2018

Occlusion of traditional sites for central venous cannulation is a challenging problem in patients that require a permanent central venous line for chronic administration of nutrients or drugs.

In rare cases, extensive central venous thrombosis of the superior and inferior vena cava may preclude catheterization, and uncommon routes should be used.

We describe our approach for placement of chronic central venous lines in two pediatric patients with short bowel syndrome and extensive caval occlusion.
Amplatzer Vascular Plug for Arteriovenous Hemodialysis Access Occlusion: Initial Experience
Authors: Bui J.T. , Gaba R.C. , Knuttinen M.G. , West D.L. , Owens C.A.
Published: January 2018

Purpose

The Amplatzer Vascular Plug (AVP; AGA Medical, Golden Valley, MN) is a recently developed self-expanding metallic device indicated for peripheral vascular embolizations. Herein, we describe use of this device in the treatment of vascular complications related to arteriovenous hemodialysis fistulas and grafts.

Materials and methods

This HIPAA compliant retrospective study was approved by the institutional review board with informed consent waived. Six patients with problematic arteriovenous access underwent access occlusion using the AVP. Procedure indications included vascular steal syndrome in five patients, and enlarging vascular aneurysms in one patient. Contraindications for surgical correction were determined by the referring surgeon. AVP embolizations were performed using devices oversized by 50% introduced through vascular sheaths positioned within vein segments just beyond the arteriovenous anastomoses. Noninvasive evaluation of the involved extremity was performed pre- and post-embolization in addition to clinical follow-up examinations. Measured outcomes included success of angiographic occlusion, improvement in distal arterial flow, AVP number, AVP diameter, time to access occlusion, and clinical symptomatic improvement.

Results

Technical success was 100%, with complete arteriovenous access occlusion accomplished in all cases, with an average of 1.5 AVPs used per patient. Mean time to access occlusion was 19.3 minutes. Angiographic improvement in distal arterial flow was immediately evident and resolution of clinical symptoms occurred in all patients, with mean long-term follow-up of 16 months. No procedure-related complications were encountered.

Conclusion

The Amplatzer Vascular Plug provides a minimally invasive and efficacious method for embolization of problematic arteriovenous hemodialysis access.
The Use of a New Kind of Low Profile Retractor for Arteriovenous Fistula Procedure Simplifies and Speeds up the Intervention
Authors: Lo Monte A.I. , Amato G. , Damiano G. , Gioviale M.C. , Lombardo C. , Romano G. , Romano M.
Published: January 2018

Purpose

The aim of this study was to demonstrate the effectiveness of a new kind of disposable surgical retractor in arteriovenous fistula (AVF) procedures in order to achieve an easier, faster and safer surgical intervention.

Methods

Between January and June 2008, 22 AVF procedures were performed using the 3PAWS ReeTrakttrade; (Insightra Inc. - Irvine, Ca., USA) a self-retaining, low profile retractor. An equivalent patient sample, in which an AVF was performed using conventional retraction devices, was considered for comparison of the intra- and post-operative results.

Results

In all of the 22 AVF procedures performed, the ReeTrakt™ system has simplified the performance of the surgical team. The retractors were very easy to place. The view of the operating field was always optimal. The introduction of the surgical instruments was at all times extremely easy and unrestricted. We also noted a reduction in the operating time (from an average of 67 min in controls to 43 min). There were no intraoperative complications. No post-operative complications related to the use of this kind of device occurred. Conversely, the amount of intra- and post-operative complications in the control group managed with conventional retraction devices was marginally higher than in the ReeTrakt™ patient group.

Conclusion

The ReeTrakt™ system is a very simple and useful low profile retractor for AVF procedures. Its ultra low profile allows a much improved view of the operating field, an unhindered insertion of the surgical instruments and a shortening of intervention time, avoiding the problems which arise as a result of standard retractors typically used during this kind of procedure. Due to absolute perpendicular retraction it offers a highly atraumatic performance, avoiding swelling and marks on the insertion sites. Therefore, in our opinion, it has the potential to reduce the risk of wound oedema, hematomas or infection associated with the AVF procedure. This is important as many patients are elderly with fragile tissues.
Heparin Bonded Hemodialysis e-PTFE Grafts Result in 20% Clot Free Survival Benefit
Authors: Davidson Ingemar , Hackerman Clayton , Kapadia Aschmeeta , Minhajuddin Abu
Published: January 2018

Luminal surface heparin bonded hemodialysis e-PTFE grafts (N=83) with prolonged bioactivity retention (CBAS® technology) were compared to 67 control e-PTFE grafts using Kaplan-Meier survival curve estimates. Log-rank tests were used for statistical comparisons between groups. Heparin bonded graft recipients were on average 3.5 years older (NS), and had upper arm grafts in 66% vs. 43% (p=0.003) compared to controls. There was no clot-free survival (CFS) difference between groups for upper arm vs. forearm placed grafts (p=0.792). Patient mortality at one year was 15%, with no group difference. The overall combined clot-free survival for all 150 e-PTFE grafts was 69% at 12 months. At 6 and 12 months, CFS for the heparin bonded graft group was 88% and 78%, which is significantly higher than that of 69% and 58% for the control group, respectively, (p=0.007). It is concluded that heparin binding technology to artificial surfaces has evolved to a clinically powerful technique for the hemodialysis patient resulting in a 20% improved primary graft patency of about 80% at one year.
Measurement of the International Normalized Ratio (INR) in Hemodialysis Patients with Heparin-Locked Central venous Catheters: Evaluation of a Novel Blood Sampling Method
Authors: Rioux Jean-Philippe , De Bortoli Bruno , Quérin Serge , Déziel Clément , Troyanov Stéphan , Madore François
Published: January 2018

Background

Accurate measurement of the international normalized ratio (INR) may be difficult in hemodialysis (HD) patients with heparin-locked central catheters. Blood contamination with locking solutions may interfere with INR measurement when samples are collected directly from the catheter.

Methods

The aim of our study was to evaluate a novel sampling method for the measurement of INR in HD patients with heparin-locked central catheters. This novel method consists of measuring the INR directly from the dialysis circuit (arterial bloodline sample port) after 1 hr of treatment regardless of heparin administration during dialysis. We compared this method to the gold standard (peripheral venipuncture prior to dialysis) using the paired t-test. We included 30 patients (23 with warfarin therapy and 7 without).

Results

INRs obtained using the novel sampling method were only minimally overestimated compared to venipuncture values (mean INR overestimation: 0.2 +/- 0.2). This overestimation was not clinically significant and did not lead to changes in warfarin prescription for any of the patients. Correlation tests confirmed the influence of heparin administration on INR overestimation (R=0.4; p=0.05). This influence was present mostly among patients receiving more than 100 Units/kg of heparin during their treatment.

Conclusion

This novel sampling technique provides a convenient and simple method of monitoring INR among HD patients.
Persistent Left Superior Vena Cava: What the Interventional Nephrologist Needs to Know
Authors: Granata Antonio , Andrulli Simeone , Fiorini Fulvio , Logias Francesco , Figuera Michele , Mignani Renzo , Basile Antonio , Fiore Carmelo Erio
Published: January 2018

Variations in the course of the blood vessels are often incidental findings during clinical examination. Persistent left superior vena cava (PLSVC) is an uncommon anomaly, estimated to be present in about 0.3–0.5% of healthy individuals and in about 3–10% of patients with congenital heart disease. It results from the failure of the left anterior cardinal vein to degenerate during embryological development. Serious complications such as shock, angina and cardiac arrest have been described during catheterization in adults with a PLSVC. Since it frequently goes undiagnosed because of lack of symptoms when not accompanied by other anomalies, variations of the superior vena cava should be considered, especially when central venous catheterization via the subclavian or internal jugular vein is difficult. The embryological development, diagnosis, and clinical implications of a PLSVC are therefore reviewed in this article.
Endocavitary Electrocardiography during Central Vein Catheter Positioning in a Newborn with Persistent Left Superior Vena Cava
Authors: Avolio Luigi , Rinaldi Antonio , Serafini Gianpaolo , Martucciello Giuseppe
Published: January 2018

We report an unusual presentation of the P wave and QRS complex during ECG-guided endocavitary assessment of the proper location of the central venous catheter in a pre-term infant operated on for esophageal atresia. The P wave and QRS complex had a normal morphology, but lay specularly to normal above the isoelectric line. The chest X-ray showed that the unusual ECG pattern was due to the left paracardiac position of the catheter, just lateral to the aortic arch within a persistent left superior vena cava.
Māori women leading local sustainable food systems
Authors: Stein Karyn , Mirosa Miranda , Carter Lynette
Published: January 2018

The article explores how Māori women in Aotearoa (New Zealand) are defining their own food system and the values of the women at the heart of their community food initiatives. Using a blend of participatory and kaupapa Māori (Māori principles) research methodologies, the study took place over the course of 3 years, involving four women or case studies who manage community food initiatives, with three located in the North Island and one in the South Island of New Zealand. The article discusses the benefits of community gardens and farms, noting how they are counteracting food poverty through promoting access to local food while bringing more attention to the essential role that Indigenous women play in addressing food security issues. The case studies exemplify how Māori women are leading the way within their own whānau (families) and communities, promoting local solutions to global food issues, solutions based on their own knowledge and Māori cultural values.
A Randomized Controlled Trial Comparing the Depth of Maximal Insertion Between Anterograde Single-Balloon Versus Spiral Enteroscopy
Authors: Moran Robert A , Barola Sindhu , Law Joanna K , Amateau Stuart K , Rolshud Daniil , Corless Erin , Kiswani Vandhana , Singh Vikesh K , Kalloo Anthony N , Khashab Mouen A , Marie Lennon Anne , Okolo Patrick I , Kumbhari Vivek
Published: January 2018

Background:

Three device-assisted deep endoscopic platforms presently exist and are available for clinical use: double-balloon enteroscopy, single-balloon enteroscopy (SBE), and spiral enteroscopy (SE). In a retrospective study, SE was associated with a greater depth of maximal insertion (DMI) with similar diagnostic yields and procedure time as compared with SBE.

Aims:

This was a prospective, randomized comparison of SE and SBE with respect to DMI, diagnostic yield, procedure time, and rate of adverse events.

Methods:

Patients were prospectively randomized to undergo either anterograde SE or SBE. Patient demographics, indication for procedure, DMI, procedure time, therapeutic procedure time, adverse event, diagnostic findings, and therapeutic interventions were prospectively recorded. The primary outcome was DMI. Secondary outcomes included: procedure time; diagnostic yield; therapeutic yield and adverse event rates.

Results:

During the study period, 30 patients underwent deep enteroscopy (SE 13, SBE 17). The most common indication was gastrointestinal bleeding in both groups. There was no significant difference in the DMI between SE and SBE (330.0 ± 88.2 cm vs 285.3 ± 80.8 cm, P = .16). There was no difference between SE and SBE in procedure time (37.0 ± 10.5 vs 38.3 ± 12.4, P = .76), diagnostic yield (SE = 9 [69%] vs SBE = 7 [41%], P = .16), or therapeutic yield (SE = 6 [46%] vs SBE = 4 [24%], P = .26). There were no major adverse events in either group.

Conclusions:

Spiral enteroscopy and SBE are similar with respect to DMI, diagnostic yield, therapeutic yield, procedure time, and rate of adverse events. Small numbers prevent giving a definitive judgment and future adequately powered prospective study is required to confirm these findings.
Psychological determinants of job retention in multiple sclerosis
Authors: Ford Helen L , Wicks Charlotte R , Stroud Amanda , Tennant Alan
Published: January 2018

Background:

Maintaining paid work is a key issue for people with multiple sclerosis (PwMS). Different factors, including psychological attributes, can influence job retention. Understanding their role should inform potential interventions to help PwMS retain employment.

Objectives:

The aim of this study was to identify the key factors which improve job retention in an employed cohort of PwMS.

Methods:

This three-year longitudinal study used validated self-completed measures of physical and psychological factors at four time points over 28 months.

Results:

Of 208 employed PwMS, just over 1 in 10 was no longer working at the end of the study. Three variables were predictive of continuing employment; low ‘work instability’ at baseline increased the odds of job retention by a factor of 12.76; high levels of self-efficacy by a factor of 4.66 and being less than 50 years of age increased the odds of job retention by a factor of 3.90. Path analysis demonstrated the mediating role of self-efficacy between the physical impact of MS and the level of work instability at exit.

Conclusion:

Screening for work instability and self-efficacy in a clinical setting followed by appropriate interventions to increase self-efficacy and reduce work instability could aid job retention in MS.
Long-term follow-up of pediatric MS patients starting treatment with injectable first-line agents: A multicentre, Italian, retrospective, observational study
Authors: Baroncini Damiano , Zaffaroni Mauro , Moiola Lucia , Lorefice Lorena , Fenu Giuseppe , Iaffaldano Pietro , Simone Marta , Fanelli Fulvia , Patti Francesco , D’Amico Emanuele , Capobianco Marco , Bertolotto Antonio , Gallo Paolo , Margoni Monica , Miante Silvia , Milani Nicoletta , Amato Maria Pia , Righini Isabella , Bellantonio Paolo , Scandellari Cinzia , Costantino Gianfranco , Scarpini Elio , Bergamaschi Roberto , Mallucci Giulia , Comi Giancarlo , Ghezzi Angelo
Published: January 2018

Background:

Few data are available on very long-term follow-up of pediatric multiple sclerosis (MS) patients treated with disease modifying treatments (DMTs).

Objectives:

To present a long-term follow-up of a cohort of Pediatric-MS patients starting injectable first-line agents.

Methods:

Data regarding treatments, annualized relapse rate (ARR), Expanded Disability Status Scale (EDSS) score, and serious adverse event were collected. Baseline characteristics were tested in multivariate analysis to identify predictors of disease evolution.

Results:

In total, 97 patients were followed for 12.5 ± 3.3 years. They started therapy at 13.9 ± 2.1 years, 88 with interferons and 9 with copaxone. During the whole follow-up, 82 patients changed therapy, switching to immunosuppressors/second-line treatment in 58% of cases. Compared to pre-treatment phase, the ARR was significantly reduced during the first treatment (from 3.2 ± 2.6 to 0.7 ± 1.5, p < 0.001), and it remained low during the whole follow-up (0.3 ± 0.2, p < 0.001). At last observation, 40% had disability worsening, but EDSS score remained <4 in 89%. One patient died at age of 23 years due to MS. One case of natalizumab-related progressive multifocal encephalopathy (PML) was recorded. Starting therapy before 12 years of age resulted in a better course of disease in multivariate analysis.

Conclusion:

Pediatric-MS patients benefited from interferons/copaxone, but the majority had to switch to more powerful drugs. Starting therapy before 12 years of age could lead to a more favorable outcome.
Cross-linguistic influence in the child third language acquisition of grammar: Sentence comprehension and production among Turkish-German and German learners of English
Authors: Hopp Holger
Published: January 2018

Aims and Objectives/Purpose/Research Questions:

This paper investigates the extent to which current formal models of third language (L3) grammatical acquisition extend to sequential child L3 acquisition. We examine whether heritage speakers learning a foreign language as an early L3 transfer grammatical properties from the heritage language or the dominant second language (L2).

Design/Methodology/Approach:

We used a sentence repetition task and a picture story retelling task. The tasks focussed on grammatical phenomena that were either different between English and German, that is, verb-second and adverb order, or between English and German, on the one hand, and Turkish, on the other, that is, verb-complement order as well as subject and article realization.

Data and Analysis:

We tested matched groups of 31 Turkish-German and 31 monolingual German children learning English in grades 3 and 4, and we compared sentence repetitions as well as oral sentence production across different grammatical phenomena using parametric statistics.

Findings/Conclusions:

In both tasks, the two groups perform indistinguishably from each other, and both groups show selective transfer of grammatical properties from German. These findings suggest L2 transfer from a typologically related language in sequential child L3 acquisition.

Originality:

This paper breaks new ground by testing the applicability of formal models of adult L3 acquisition of grammar to sequential child L3 learners. It uses aural comprehension and oral production tasks with carefully matched groups of L2 and L3 learners of English to isolate the source of grammatical transfer in L3 acquisition.

Significance/Implications:

The research advances our understanding of cross-linguistic influence and unravels the dynamics of grammatical transfer in early child multilingualism. It adjudicates between current models of transfer in L3 acquisition in a multiple-methods design, it shows that these models apply to early L3 acquisition of heritage speakers, and it highlights that these models need to be expanded to include factors such as dominance and proficiency in prior languages.
Interventions minimizing fatigue in children/adolescents with cancer: An integrative review
Authors: Nunes Michelle Darezzo Rodrigues , Bomfim Emiliana , Olson Karin , Lopes-Junior Luis Carlos , Silva-Rodrigues Fernanda Machado , Garcia de Lima Regina Aparecida , Nascimento Lucila Castanheira
Published: January 2018

Fatigue is among the most common, debilitating, and distressing symptoms associated with chronic condition in pediatric population. The purpose of this study was to identify non-pharmacological fatigue interventions in children and adolescents with cancer. For this, we carried out an integrative review of the literature from January 2000 to December 2016. A comprehensive search of four databases was conducted: Cumulative Index to Nursing and Allied Health Literature, Psychology Information, Medline via PubMed, and Web of Science. Randomized controlled trial, quasi-experimental, case-control and cohort studies were included in this review. Thirteen relevant studies were included for analysis. Seven papers reported positive outcomes for exercise, exercise plus leisure activities, healing touch and acupressure. In another six papers using exercise, exercise plus psychological intervention and massage, no effectiveness was found. Effective management of fatigue in children and adolescents is important but research in this area is limited, so the results of this review should be interpreted cautiously. Future researchers are encouraged to test the effective interventions in homogenous cancer populations and in other groups where fatigue is a common concern.
Family management affecting transition readiness and quality of life of Chinese children and young people with chronic diseases
Authors: Sheng Nan , Ma Jiali , Ding Wenwen , Zhang Ying
Published: January 2018

Transition from pediatric to adult health care is a key milestone for children and young people (CYP) with chronic conditions. Family management (FM) and self-management are two important concepts during the process. This study aimed to explore the relationships between FM, self-management and transition readiness, and quality of life (QoL), and identify the potential CYP or family factors influencing the relationships. Data about FM, self-management and transition readiness, QoL, and various contextual factors were collected from 268 caregiver–child pairs. Structural equation modeling was used to examine the relationships between all variables. Results revealed that the easy aspects of FM mediated the relationships between the challenging aspects of FM, self-management and transition readiness, and QoL of CYP. Self-management and transition readiness mediated the relationship between the easy aspects of FM and QoL. Contextual factors indirectly influenced CYP’s transition readiness and QoL through different aspects of FM. The results imply that to ensure the smooth transition from pediatric to adult health care and improve the CYP’s QoL, strengthening CYP’s independence and self-management competencies, combined with the support of the easy aspects of FM, seem to be useful strategies to increase CYP’s readiness for transfer.
Involvement of people with dementia in raising awareness and changing attitudes in a dementia friendly community pilot project
Authors: Phillipson Lyn , Hall Danika , Cridland Elizabeth , Fleming Richard , Brennan-Horley Chris , Guggisberg Nick , Frost Dennis , Hasan Helen
Published: January 2018

Low levels of public understanding can contribute to the fear, stigma and social exclusion associated with living with dementia. Dementia friendly communities aim to address this by empowering people with dementia and increasing their social inclusion. As a part of a Community Based Participatory Action Research (CBPAR) process, a multicomponent dementia friendly community intervention supported: research; the establishment of a Dementia Advisory Group and Alliance; an awareness campaign and education in community organisations. Educational events were co-designed and co-facilitated by people with dementia and their care partners. To assess project reach and changes in attitudes of community members, two cross sectional surveys were conducted with adults (aged over 18 years) using validated scales. Independent samples t-tests compared responses to the surveys prior to the commencement of the project (2014) and two years later (2016). In 2016, respondents showed increased agreement with the statements: ‘People with dementia participate in a wide variety of activities and interests,’ and, ‘It is easy to find out about dementia friendly services or organisations in Kiama’. Respondents who attended an educational event reported less negative views about how they themselves would feel if they were diagnosed with dementia compared with respondents who did not attend an event. CBPAR appears useful to support the involvement of people with dementia and the engagement of the community to improve awareness of dementia services. The direct involvement of people living with dementia as spokespeople and educators was an effective way to improve positive attitudes and reduce the negative stereotypes associated with living with dementia. Further research is needed to compare different approaches to the creation of dementia friendly communities in different locations, and to establish the extent to which local interventions are useful to complement efforts to raise awareness of dementia at a national level.
Why Children Obey the Law: Rethinking Juvenile Justice and Children’s Rights in Europe through Procedural Justice
Authors: Bernuz Beneitez Maria José , Dumortier Els
Published: January 2018

This article explores how the idea of procedural justice can help us to rethink juvenile justice and research children’s rights in Europe differently. To frame the following argument, we will question four implications of the procedural justice perspective: 1) the need to implement rights and not just proclaim them, 2) the need to investigate a ‘double perspective’ on children’s rights implying both juvenile justice professionals and children in conflict with the law, 3) the child’s right to effectively participate and be involved in the process and 4) the idea that age matters in the judicial reaction to crime. The resulting conclusions and discussions revolve around the scientific consequences and challenges we must face when we take procedural justice perspective seriously.
Gaussian mixture model–based path-synthesis accumulation imaging of guided wave for damage monitoring of aircraft composite structures under temperature variation
Authors: Ren Yuanqiang , Qiu Lei , Yuan Shenfang , Fang Fang
Published: January 2018

With the capabilities of achieving large-scale monitoring, improving signal-to-noise ratio, and obtaining a high localization accuracy and strong fault tolerance, guided wave and piezoelectric sensor network–based damage imaging technique seems to be the key technique to realize damage localization of complex aircraft composite structures. However, aircraft structures usually work under random and complicated time-varying conditions, which may introduce nonnegligible uncertainties in the acquired guided wave signals and mask the subtle changes caused by damage. The current damage imaging methods barely consider this time-varying issue and are unable to reliably locate damage. To increase reliability, a Gaussian mixture model–based guided wave path-synthesis accumulation imaging method is proposed for damage imaging of complex aircraft composite structures under time-varying conditions. The Gaussian mixture model is used to suppress time-varying influence and achieve time-varying-independent damage characterization, based on which the guided wave path-synthesis imaging is conducted to perform the fusion of sensor network information and generate an image. During the monitoring process, a series of images will be generated with damage information accumulated, and the damage will gradually emerge in these images and can be located eventually. The typical time-varying condition, temperature variation, is chosen to verify the feasibility and effectiveness of the proposed method on a stiffened carbon fiber composite plate; the results show good performance of reliable damage imaging and localization within a temperature range from 0°C to 60°C.
Community–Clinical Linkages With Community Health Workers in the United States: A Scoping Review
Authors: Lohr Abby M. , Ingram Maia , Nuñez Annabelle V. , Reinschmidt Kerstin M. , Carvajal Scott C.
Published: January 2018

Despite the proliferation of community–clinical linkage (CCL) interventions with community health workers (CHWs), little is known about the components of these programs or how linkages are realized. In this scoping review, we synthesize evidence concerning the role of CHWs in creating and sustaining CCLs aimed at improving individual health outcomes. Our inclusion criteria included peer-reviewed articles that described a CHW intervention in the United States that used a CCL model. A total of 2,776 titles and/or abstracts were screened and 47 articles underwent full text review. Two independent reviewers rated the screened articles based on additional criteria including the CHW connection to community and evidence of linkage follow up rather than simple referral. For the 11 peer-reviewed articles included in the final review, we describe the CHW’s relationship to the community, training, and role within the intervention, linkage, and outcomes. We used a standardized framework to determine commonalities in CHW roles across the interventions. CCLs with CHWs positively affect the delivery of both clinical care and community resources across a range of disease areas in a variety of contexts. To identify effective CCL models, additional information on CHW training, CCL follow-up methods, and the CHW role in CCLs is recommended.
Effects of Interactive Book Reading for Increasing Children’s Knowledge of Instructional Verbs
Authors: Lowman Joneen , Stone Laura T. , Guo Jing
Published: January 2018

Interactive book reading (IBR) has proven effective for increasing children’s lexicons with most of the results based on students’ learning of nouns. Little is known about the application of IBR to instructional verbs (i.e., words used during the instruction of academic content). To address this gap, 122 prekindergarten children were recruited from seven elementary schools. Each school was randomly assigned to the intervention group or the control group. Children in the intervention group were taught 12 instructional verbs across a 3-week period using interactive book-reading strategies. Children assigned to the control group only received implicit exposure to instructional verbs during teacher talk. Children in the book-reading group knew significantly more words on a receptive picture identification task than children in the control group both at posttesting and at follow-up testing in the fall. No significant group differences were noted at spring testing.
Survival capability of healthcare-associated, multidrug-resistant bacteria on untreated and on antimicrobial textiles
Authors: Hanczvikkel Adrienn , Víg András , Tóth Ákos
Published: January 2018

Healthcare-associated infections are of global concern, and textiles can contribute to the transmission of pathogens. In this study, we examined quantitatively the survival capability of 60 multidrug-resistant bacterial strains from four species ( Klebsiella pneumoniae, Acinetobacter baumannii, Staphylococcus aureus and Enterococcus faecium) on untreated cotton textile in clinically relevant incubation periods. We determined the antibacterial efficiency of textiles treated either with quaternary ammonium compound (QAC)-containing Sanitized T99-19 liquid (50 m/m% Dimethyltetradecyl (3-(trimethoxysilyl)propyl) ammonium-chloride) or with silver salt-containing Sanitized T27-22 Silver liquid (2 m/m% AgCl and 8 m/m% TiO2) as well. Finally, we compared the results of the healthcare-associated, multidrug-resistant strains and antibiotic-sensitive, quality control standard strains (ATCC 25922, ATCC 11105 Escherichia coli, and ATCC 25923, ATCC 6538 Staphylococcus aureus) often used in antimicrobial efficiency tests. The results revealed that all investigated multidrug-resistant bacteria are able to survive on untreated cotton textile and pose health risk in hospitals. During one day the T27-22-Silver-treated textile was able to eliminate most of the Gram-positive pathogens, reducing the risk of cross-contamination, but none of the examined agents destroyed the multidrug-resistant, Gram-negative isolates. The antibiotic-susceptible and the multidrug-resistant Staphylococcus aureus strains had similar survival capability and biocide-tolerance, while the risk of infections caused by multidrug-resistant, Gram-negative pathogens could be extremely underestimated using only ATCC Escherichia coli standard strains. Our results also draw attention to the careful evaluation of antimicrobial efficiency tests and indicate that a significant reduction of bacterial count does not necessarily mean significant antibacterial efficiency that would be suitable to avoid infections.
Case Study of Acceptance and Commitment Therapy and Functional Analysis for Emetophobia
Authors: Bogusch Leah M. , Moeller Mary T. , O’Brien William H.
Published: January 2018

Acceptance and Commitment Therapy (ACT) is a third-wave behavioral therapy that is an empirically supported treatment for various mental health concerns. ACT has been found to be efficacious for treating different types of anxiety disorders. This case study presents the conceptualization (functional analysis), treatment (ACT), and treatment outcomes of a client who presented with emetophobia, a phobia of vomiting, complicated by a metabolic disorder. Measures of emetophobia symptoms, mindfulness, cognitive fusion, thought control strategies, and believability of anxious thoughts and feelings, were collected at pretreatment, posttreatment, 6-month follow-up, and 12-month follow-up. The Reliable Change Index was used to evaluate changes across time. Large and clinically significant decreases on all measures were observed at posttreatment. At 12-month follow-up, improvements were maintained on all measures except the Reappraisal subscale of the Thought Control scale. The implications of this study are discussed, and recommendations are made for clinicians using ACT for the treatment of emetophobia.
When Good Deeds Hurt: The Potential Costs of Interpersonal Helping and the Moderating Roles of Impression Management and Prosocial Values Motives
Authors: Eissa Gabi , Lester Scott W.
Published: January 2018

Drawing on the conservation of resource theory, the current study builds and tests a moderated-mediation model that explores the potential costs of engaging in interpersonal helping—a common type of organizational citizenship behavior. Specifically, this research argues that interpersonal helping induces emotional exhaustion, which adversely affects task performance. The study also examines impression management and prosocial values motives as conditional moderators among these relationships. Using multisource field data across two time periods, results suggest that an impression management motive is likely to strengthen the proposed relationships, whereas a prosocial values motive is likely to weaken them. Theoretical and practical implications as well as future research avenues are also discussed.
“They Can’t Search Her”: How Gender Imbalances in the Police Force Contribute to Perceptions of Procedural Unfairness
Authors: Novich Madeleine , Kringen Anne Li , Hunt Geoffrey
Published: January 2018

Research suggests that gender imbalances in police forces can significantly affect individuals’ experiences when interacting with police. Of importance, yet rarely examined, is the extent to which predominantly male police forces, in conjunction with adherence to gendered departmental policies, can simultaneously send signals of procedural justice and procedural injustice. Drawing on data from 253 in-depth interviews of San Francisco–based male and female drug-dealing gang members, we investigated how interactions with a male-dominated police force, who were required to search only suspects of the same gender, affected perceptions of fair policing. Our findings revealed that the study participants raised concerns that the police unfairly enforced the law to the detriment of the men in the study. The gang members were aware that male officers could only search same-sex suspects and this exacerbated the gendered experiences of the gang members. Specifically, it contributed to the perception that male officers targeted male gang members to the omission of women and, if women were stopped, they were frequently released. These findings suggest that the gender composition of the police force is important in shaping attitudes toward equitable enforcement of the law and procedural fairness. Of theoretical importance, these findings highlight a contradiction that compliance with rules can contribute, counter intuitively, to perceptions of procedural injustice. Procedurally unfair police behavior may be a systemic problem where the gender composition of the police force itself creates an inherently unfair system.