bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in municipal alcohol control policies in Norway
Authors: Andersen Jan
Published: January 2018

Jan Andersen: Changes in municipal alcohol control policies in Norway

Municipalities have an important role in enacting alcohol policy in Norway. The task of the local authorities is to implement the national goals and develop a locally adapted practice, mainly by controlling the availability of alcohol to the public. The local politicians experience this as an issue where they are exposed to a conflictual pressure between socio-political concerns, on the one hand, and business interests, on the other.

This paper focuses on alcohol policies in municipalities which give priority to business development; especially to tourism. It is based on the case studies of two Norwegian municipalities. The paper first looks at the actual changes in the alcohol policy in the two municipalities, and then at the decision-making process leading up to these changes. Four approaches for studying decision-making processes, inspired by Johan P. Olsens model, are used: rationality, legitimacy, power and necessity.

The study found a liberalisation with regard to the availability of alcoholic beverages in the two municipalities. This can be explained by: changes in external conditions, changes in influential positions between different actors, and changes in public attitudes towards alcohol and the politician's interpretations of the local authorities' ability to control the consumption of alcohol within the population.

At the same time, the local authorities have strengthened efforts to control the license holders. This can be seen as a result of demands from the national authorities, and due to the fact that this activity may be financed by annual fees payed by the license holders. The combination of the liberalisation of the license policy and the strengthening of the control of the license holders may also be seen as a compromise between different political attitudes, but one in which the business interests take more precedence than socio-political concerns.

The local politicians also underlined the importance of information activity aimed at influencing attitudes towards alcohol. This last means is characterised by a legitimating function and almost completely restricted to rhetorics. It would seem that this is more symbolic politics than anything else.

As a whole, the study emphasises those mechanisms which indicate that the consequence of a decentralisation of power to the local authorities will result in a more uniform liberal politics rather than greater locally based differences.
Drinking patterns and alcohol policy: Prospects and limitations of a policy approach
Authors: Simpura Jussi
Published: January 2018

Jussi Simpura: Drinking patterns and alcohol policy. Prospects and limitations of a policy approach

The concept of drinking patterns is a fluid one. Still, it is much used today in the debate around alcohol control policies. Basically, two opposing sides can be found in the debate. The first stresses the view that not all drinking, but only certain drinking patterns are harmful, and that control policies should be targeted at harmful drinking only. This is the harm reduction approach. The other one is the total consumption approach, which stresses the link between consumption level and harm, largely irrespective of the patterns. This article discusses the difficulties in specifying drinking patterns as a target of preventive policies, and analyzes the prospects for developing preventive policies that would, first and foremost, be focused on harmful patterns only. Lacking empirical research on large-scale policy experiments, the conclusions are tentative only. Hypothetically, pattern-specific preventive alcohol policies could better meet some changes in the political atmosphere today, even in the case where the efficacy of the total consumption approach would still be undisputed.
Liver cirrhosis mortality in 15 European countries: Differences and trends during the post-war period
Authors: Ramstedt Mats
Published: January 2018

Mats Ramstedt: Liver cirrhosis mortality in 15 European countries – differences and trends during the post-war period

The aim of this paper was to describe and analyse differences and trends in liver cirrhosis mortality rates during the post-war era in 15 European countries. The study countries include all EU member states (except Luxembourg) and Norway. Liver cirrhosis mortality data and population figures were gathered from the WHO Mortality Database.

The rank order of these countries, with respect to cirrhosis rates, were in general stable during the post-war period and most countries had increasing cirrhosis rates until the 1970s and then declining rates. This general picture was true also when sex-specific rates were studied. A deviant case was Sweden, with an exceptionally sharp increase from 1950 until the 1970s. Other deviant cases were Denmark, Finland and the UK, where cirrhosis mortality has not declined since the 1970s. Age specific analyses revealed that in one group of countries, mortality trends seem to be collective with respect to age, while in another cluster, different age groups exhibited divergent trends. Furthermore, the age-profile of cirrhosis mortality varies considerably between the study countries.

Cross-country analyses were performed to elucidate the influence of some plausible determinants of cirrhosis mortality. According to the outcome, there was a fairly close relationship between cirrhosis mortality, on the one hand, and per capita alcohol consumption, alcohol prices, and the restrictiveness of alcohol policy, on the other. More detailed analyses based on time series data are needed to test how these variables are interrelated.
The idea of alcohol policy
Authors: Room Robin
Published: January 2018

Robin Room: The idea of alcohol policy

The paper first considers the actual situation of diversity and fragmentation of responsibility with respect to alcohol-related problems in governments of modern states. It then examines the conceptual framing of this empirical situation, making the point that the idea of alcohol policy, conceptualizing government responsibilities in the alcohol arena holistically, is historically situated. Only the societies north of the Baltic have a tradition of continuity in such a conceptualization, although the idea has also taken hold in English-speaking and some other societies in the last 20 years. In the wake of this, a substantial literature on the technology of alcohol control has developed. The scope of this literature is described, as well as its limitations in terms of its cultural spread and in terms of its policy influence. Options for sustaining a holistic perspective on alcohol issues within national governments are considered. Convergence on alcohol issues within Europe has so far been in directions which point away from such holistic perspectives, but the tide may be changing.
Correction to: Rp58 and p27kip1 coordinate cell cycle exit and neuronal migration within the embryonic mouse cerebral cortex
Authors: Clément Olivier , Hemming Isabel Anne , Gladwyn-Ng Ivan Enghian , Qu Zhengdong , Li Shan Shan , Piper Michael , Heng Julian Ik-Tsen
Published: January 2018

Correction

After publication of the original article [1] it was realised that there were errors in figures 2a,b,f,g, which arose as a result of preparing figures from data collected and analysed at the same time as the work reported in [2] (Supplementary Figure 1 of [2]).

An updated Fig. 2 is included with this Correction.
Offset vector tile domain wide-azimuth prestack seismic interpretation methods and applications
Authors: Shifan Zhan , Maoshan Chen , Lei Li , Chunfeng Tao , Zhonghong Wan , Xiaohui Zhao
Published: January 2018

The offset vector tile (OVT) is a special prestack seismic gather type, and OVT technology is a seismic processing technology suitable for wide-azimuth seismic (WAZ) exploration. Because current WAZ interpretation is not yet mature and because of the lack of key techniques and tools for OVT-domain seismic interpretation, abundant offset and azimuth information possessed in the OVT gathers has not been fully used. To take full advantage of the OVT gathers to achieve more accurate geologic, reservoir, and fluid information, we have developed an OVT-domain wide-azimuth prestack seismic interpretation technology and a typical workflow. The OVT-domain wide-azimuth prestack seismic interpretation technology is composed of five key prestack analysis and interpretation techniques focused on OVT gathers: (1) sensitive offset and azimuth analysis for choosing their sensitive offset and azimuth ranges, (2) template-based OVT gather optimization for improving their signal-to-noise ratio and quality, (3) multiscale and multiazimuth attribute analysis, (4) OVT domain amplitude versus incidence angle analysis, and (5) azimuthal anisotropy analysis. These technologies are used to extract seismic attributes that vary with offset and/or azimuth from OVT gathers facing on reservoir characterization, fluid detection, and fracture prediction. These technologies can form an OVT-domain prestack seismic interpretation workflow.
Tranexamic Acid Dosing for Cardiac Surgical Patients With Chronic Renal Dysfunction: A New Dosing Regimen
Authors: Jerath Angela , Yang Qi Joy , Pang K. Sandy , Looby Nikita , Reyes-Garces Nathaly , Vasiljevic Tijana , Bojko Barbara , Pawliszyn Janusz , Wijeysundera Duminda , Beattie W. Scott , Yau Terrence M. , Wąsowicz Marcin
Published: January 2018

BACKGROUND:

Tranexamic acid (TXA) is a common antifibrinolytic agent used to minimize bleeding in cardiac surgery. Up to 50% cardiac surgical patients have chronic renal dysfunction (CRD). Optimal dosing of TXA in CRD remains poorly investigated. This is important as TXA is renally eliminated with accumulation in CRD. High TXA doses are associated with postoperative seizures. This study measures plasma TXA concentrations in CRD cardiac surgical patients for pharmacokinetic modeling and dose adjustment recommendations.

METHODS:

This prospective cohort study enrolled 48 patients with stages 1–5 CRD, classified by Kidney Disease Outcome Quality Initiative. Patients were separated into 2 treatment groups. A “low-risk” group underwent simple aortocoronary bypass or single-valve repair/replacement and received a 50 mg/kg TXA bolus. A “high-risk” group underwent redo, aortic, multiple valve or combination surgery and received the Blood Conservation Using Anti-fibrinolytics Trial dosing regimen (loading dose 30 mg/kg, infusion 16 mg/kg/h with 2 mg/kg in pump prime). Primary outcome identified changes in TXA clearance and distribution volume, which provided the rationale for dose adjustment. Descriptive clinical outcomes assessed postoperative seizures, blood loss, ischemic-thrombotic complications, in-hospital mortality, and length of hospital stay.

RESULTS:

TXA concentrations were elevated and sustained above the therapeutic threshold for approximately 12 hours in high-risk stages 3–5 groups, in accordance to CRD severity.

CONCLUSIONS:

Using a pharmacokinetic model, we propose a simple new TXA dosing regimen that optimizes maximal antifibrinolysis and avoids excessive drug dosing.
Academic Anesthesiology Career Development: A Mixed-Methods Evaluation of the Role of Foundation for Anesthesiology Education and Research Funding
Authors: Speck Rebecca M. , Ward Denham S. , Fleisher Lee A.
Published: January 2018

BACKGROUND:

In 1986, the American Society of Anesthesiologists created the Foundation for Anesthesiology Education and Research (FAER) to fund young anesthesiology investigators toward the goal of helping launch their academic careers. Determining the impact of the FAER grant program has been of importance.

METHODS:

This mixed-methods study included quantitative data collection through a Research Electronic Data Capture survey and curriculum vitae (CV) submission and qualitative interviews. CVs were abstracted for education history, faculty appointment(s), first and last author peer-reviewed publications, grant funding, and leadership positions. Survey nonrespondents were sent up to 3 reminders. Interview questions elicited details about the experience of submitting a FAER grant. Quantitative data were summarized descriptively, and qualitative data were analyzed with NVivo.

RESULTS:

Of 830 eligible participants, 38.3% (N = 318) completed surveys, 170 submitted CVs, and 21 participated in interviews. Roughly 85% held an academic appointment. Funded applicants were more likely than unfunded applicants to apply for National Institutes of Health funding (60% vs 35%, respectively; P < .01), but the probability of successfully receiving an National Institutes of Health grant did not differ (83% vs 85%, respectively; P = .82). The peer-reviewed publication rate (publications per year since attending medical school) did not differ between funded and unfunded applicants, with an estimated difference in means (95% confidence interval) of 1.3 (–0.3 to 2.9) publications per year. The primary FAER grant mentor for over one-third of interview participants was a nonanesthesiologist. Interview participants commonly discussed the value of having multiple mentors. Key mentor attributes mentioned were availability, guidance, reputation, and history of success.

CONCLUSIONS:

This cross-sectional data demonstrated career success in publications, grants, and leadership positions for faculty who apply for a FAER grant. A FAER grant application may be a marker for an anesthesiologist who is interested in pursuing a physician-scientist career.
Years Versus Days Between Successive Surgeries, After an Initial Outpatient Procedure, for the Median Patient Versus the Median Surgeon in the State of Iowa
Authors: Dexter Franklin , Jarvie Craig , Epstein Richard H.
Published: January 2018

BACKGROUND:

Previously, we studied the relative importance of different institutional interventions that the largest hospital in Iowa could take to grow the anesthesia department’s outpatient surgical care. Most (>50%) patients having elective surgery had not previously had surgery at the hospital. Patient perioperative experience was unimportant for influencing total anesthesia workload and numbers of patients. More important was the availability of surgical clinic appointments within several days. These results would be generalizable if the median time from surgery to a patient’s next surgical procedure was large (eg, >2 years), among all hospitals in Iowa with outpatient surgery, and without regard to the hospital where the next procedure was performed.

METHODS:

There were 37,172 surgical cases at hospital outpatient departments of any of the 117 hospitals in Iowa from July 1, 2013, to September 30, 2013. Data extracted about each case included its intraoperative work relative value units. The 37,172 cases were matched to all inpatient and outpatient records for the next 2 years statewide using patient linkage identifiers; from these were determined whether the patient had surgery again within 2 years. Furthermore, the cases’ 1820 surgeons were matched to the surgeon’s next outpatient or inpatient case, both including and excluding other cases performed on the date of the original case.

RESULTS:

By patient, the median time to their next surgical case, either outpatient or inpatient, exceeded 2 years, tested with weighting by intraoperative relative value units and repeated when unweighted (both P < .0001). Specifically, with weighting, 65.9% (99% confidence interval [CI], 65.2%–66.5%) of the patients had no other surgery within 2 years, at any hospital in the state. The median time exceeded 2 years for multiple categories of patients and similar measures of time to next surgery (all P < .01). In comparison, by surgeon, the median time to the next outpatient surgical case was 1 calendar day (99% CI, 0–1 day). The median was 3 days to the next date with at least 1 outpatient case (99% CI, 3–3 days).

CONCLUSIONS:

The median time to the next surgery was >2 years for patients versus 1 day for surgeons. Thus, although patients’ experiences are an important attribute of quality of care, surgeons’ experiences are orders of magnitude more important from the vantage point of marketing and growth of an anesthesia practice.
Efficacy of Ultrasound-Guided Serratus Plane Block on Postoperative Quality of Recovery and Analgesia After Video-Assisted Thoracic Surgery: A Randomized, Triple-Blind, Placebo-Controlled Study
Authors: Kim Do-Hyeong , Oh Young Jun , Lee Jin Gu , Ha Donghun , Chang Young Jin , Kwak Hyun Jeong
Published: January 2018

BACKGROUND:

The optimal regional technique for analgesia and improved quality of recovery after video-assisted thoracic surgery (a procedure associated with considerable postoperative pain) has not been established. The main objective in this study was to compare quality of recovery in patients undergoing serratus plane block (SPB) with either ropivacaine or normal saline on the first postoperative day. Secondary outcomes were analgesic outcomes, including postoperative pain intensity and opioid consumption.

METHODS:

Ninety patients undergoing video-assisted thoracic surgery were randomized to receive ultrasound-guided SPB with 0.4 mL/kg of either 0.375% ropivacaine (SPB group) or normal saline (control group) after anesthetic induction. The primary outcome was the 40-item Quality of Recovery (QoR-40) score at 24 hours after surgery. The QoR-40 questionnaire was completed by patients the day before surgery and on postoperative days 1 and 2. Pain scores, opioid consumption, and adverse events were assessed for 2 days postoperatively.

RESULTS:

Eighty-five patients completed the study: 42 in the SPB group and 43 in the control group. The global QoR-40 scores on both postoperative days 1 and 2 were significantly higher in the SPB group than in the control group (estimated mean difference 8.5, 97.5% confidence interval [CI], 2.1–15.0, and P = .003; 8.5, 97.5% CI, 2.0–15.1, and P = .004, respectively). The overall mean difference between the SPB and control groups was 8.5 (95% CI, 3.3–13.8; P = .002). Pain scores at rest and opioid consumption were significantly lower up to 6 hours after surgery in the SPB group than in the control group. Cumulative opioid consumption was significantly lower up to 24 hours postoperatively in the SPB group.

CONCLUSIONS:

Single-injection SPB with ropivacaine enhanced the quality of recovery for 2 days postoperatively and improved postoperative analgesia during the early postoperative period in patients undergoing video-assisted thoracic surgery.
Predicting Heparin Responsiveness in Children Before Cardiopulmonary Bypass: A Retrospective Cohort Study
Authors: Nakamura Sayaka , Honjo Osami , Crawford-Lean Lynn , Foreman Celeste , Sano Minako , O’Leary James D.
Published: January 2018

BACKGROUND:

Inadequate or excess administration of unfractionated heparin for cardiopulmonary bypass (CPB) can cause significant harm. Age-dependent differences in the pharmacodynamics and pharmacokinetics of heparin contribute to increased variability of heparin responsiveness in children. The aims of the current study were to (1) examine the correlation between predicted and observed heparin responsiveness in children before CPB measured using the Hemostasis Management System (HMS) Plus (Medtronic, Minneapolis, MN), (2) describe age-specific reference intervals for heparin sensitivity index (HSI) observed in children, and (3) test predictive models of HSI using preoperative clinical and laboratory data.

METHODS:

In this retrospective cohort study, children (ages ≤17 years) who required therapeutic heparinization for CPB in a 40-month period between September 2010 and December 2013 were investigated. Children weighing ≥45 kg or with a height ≥142 cm were excluded. HSI was defined as the difference between activated clotting time after heparin administration and the baseline activated clotting time divided by the heparin-loading dose (IU) per kilogram. Lin’s concordance correlation coefficient was used for the primary analysis of the relationship between predicted and observed HSI. Reference intervals were calculated for HSI using medians and 2.5% and 97.5% percentiles according to established guidelines for clinical and laboratory standards. Nonparametric regression analyses were used to model the relationship between HSI (dependent variable) and preoperative covariates (independent variables).

RESULTS:

A total of 1281 eligible children were included in the final analysis. Overall, there was a moderate correlation between predicted and observed HSI measured using HMS Plus System (rho_c = 0.46; 95% confidence interval, 0.41–0.50;P< .001). Sixty-five percent (829 of 1281) of predicted HSI values were less than observed. From adjusted regression models, HSI was best predicted by preoperative international normalized ratio, platelet count, and weight, but this model accounted for only 25% of the variance in HSI.

CONCLUSIONS:

In a large cohort of children, heparin responsiveness before CPB was not reliably predicted by either in vitro measurement using the HMS Plus System or commonly available preoperative clinical and laboratory data. We describe age-specific reference intervals for HSI in children, and we anticipate that these data will aid the identification of heparin resistance in this population.
Zurich to Berlin—“Where” Are We Now with the Concussion in Sport Group?
Authors: Pusateri Margaret E. , Hockenberry Brandon J. , McGrew Christopher A.
Published: January 2018

The Concussion in Sport Group recently published its highly anticipated fifth consensus statement on sports-related concussion. The latest iteration features a new organizational format—the “11 Rs” and has input from a wider range of health care professionals, organizations, and experts in the field from both the sport concussion area and from related areas outside of sport. The stated objective of this current document is to “build on the principles outlined in previous statements and develop further conceptual understanding of sports-related concussion.” Its intended audience is “physicians and health care providers who are involved in athlete care, whether at a recreational, elite, or professional level.” We review significant updates including recommendations for sideline evaluation, return to play, and return to learn in athletes with sports-related concussion.
Active and Inactive Leg Hemodynamics during Sequential Single-Leg Interval Cycling
Authors: GORDON NICOLE , ABBISS CHRIS R. , IHSAN MOHAMMED , MAIORANA ANDREW J. , PEIFFER JEREMIAH J.
Published: January 2018

Introduction

Leg order during sequential single-leg cycling (i.e., exercising both legs independently within a single session) may affect local muscular responses potentially influencing adaptations. This study examined the cardiovascular and skeletal muscle hemodynamic responses during double-leg and sequential single-leg cycling.

Methods

Ten young healthy adults (28 ± 6 yr) completed six 1-min double-leg intervals interspersed with 1 min of passive recovery and, on a separate occasion, 12 (six with one leg followed by six with the other leg) 1-min single-leg intervals interspersed with 1 min of passive recovery. Oxygen consumption, heart rate, blood pressure, muscle oxygenation, muscle blood volume, and power output were measured throughout each session.

Results

Oxygen consumption, heart rate, and power output were not different between sets of single-leg intervals, but the average of both sets was lower than the double-leg intervals. Mean arterial pressure was higher during double-leg compared with sequential single-leg intervals (115 ± 9 vs 104 ± 9 mm Hg, P < 0.05) and higher during the initial compared with second set of single-leg intervals (108 ± 10 vs 101 ± 10 mm Hg, P < 0.05). The increase in muscle blood volume from baseline was similar between the active single leg and the double leg (267 ± 150 vs 214 ± 169 μM·cm, P = 0.26). The pattern of change in muscle blood volume from the initial to second set of intervals was significantly different (P < 0.05) when the leg was active in the initial (−52.3% ± 111.6%) compared with second set (65.1% ± 152.9%).

Conclusions

These data indicate that the order in which each leg performs sequential single-leg cycling influences the local hemodynamic responses, with the inactive muscle influencing the stimulus experienced by the contralateral leg.
Global Open Data in Agriculture and Nutrition (GODAN) initiative partner network analysis
Authors: Musker Ruthie , Schaap Ben
Published: January 2018

Background: Ensuring healthy, safe and nutritious food for everyone is a global concern. Accessing the information to make the correct decisions regarding food security can be challenging. Open data has been shown to help solve practical problems related to agriculture and nutrition, enabling effective decision-making. In order to create a global data ecosystem that benefits everyone, a wide range of stakeholders must be included in the conversations. The GODAN initiative involves a network of over 500 partner organizations committed to open data in agriculture and nutrition.

Methods: We analysed data from a survey of the partner organizations, with 225 respondents, to determine open data activities, including challenges, use of open data, stakeholder involvement and future directions. Respondents were asked a variety of free text and multiple choice questions.

Results: 160 partners had at least one open data activity, 65 did not, or did not know. Of the 160, 36 had a second activity. Overall, GODAN partners are developing 200 open data activities. Agriculture is the most common focus for an open data activity. Nutrition-only activities are strongly underrepresented. The most frequently mentioned challenge was cost, which is linked to data governance, management, and human capacity; many do not have the funding to begin or maintain open data activities.

Conclusions: The most common challenges were the ones related to the data itself, including how to access it, manage it, and how to keep the sensitive data secure. GODAN is already focusing on these issues through the Responsible Data and Data Ownership pieces. Capacity building, and empowering partners with the tools they need to act, is one of the most effective actions available for GODAN. Funding for open data, as well as research to create more sustainable business models, should be the focus of the open data agenda.
Down's syndrome: the need for audit
Authors: Newton Carol , Walker Gillian
Published: January 2018

This article describes a study that examined the effects of serum screening for Down's syndrome in women in Nottingham.
Parents who kill their infants
Authors: Marks Maureen , Kumar R
Published: January 2018

Some parents experience considerable difficulties in adapting to and caring for their new infant, and despite current levels of medical and social perinatal support and intervention, things sometimes go badly wrong. This article describes the features of parents who kill an infant under 1 year of age and summarises current research findings about infant homicide.
An evaluation of the use of massage and essential oils on the wellbeing of cancer patients
Authors: Corner Jessica , Cawley Nik , Hildebrand Sheena
Published: January 2018

Massage and aromatherapy are being used increasingly by nurses to enhance the wellbeing of patients in palliative care settings, yet little evaluation of these therapies has been undertaken. This article reports a quasi experimental study comparing the effects of an 8-week course of massage, with or without the addition of a blend of essential oils, on patients undergoing cancer treatment. Findings from the study suggest that massage has a significant effect on anxiety and this was found to be greater where essential oils were used, although the small sample prevented this from being established conclusively. Massage was reported to be universally beneficial by patients, it assisted relaxation and reduced physical and emotional symptoms. The authors call for more research to be conducted in this area with larger cohorts of patients. Copies of the full research report for this study may be obtained from the Macmillan Practice Development Unit, Centre for Cancer and Palliative Care Studies, Institute of Cancer Research/Royal Marsden NHS Trust, Fulham Road, London SW3 6JJ. Price £6.00.
Palliative care nursing in a curative environment: an Australian perspective
Authors: Prior Deborah , Poulton Valda
Published: January 2018

This article describes the experiences of two nurses who developed palliative care specialty practices in acute general hospitals. The principal goal of, their work was to facilitate a smooth curative-palliative transition for patients, their families and the hospital staff. A major challenge was finding techniques to promote the palliative care philosophy in a curative environment. Staff in acute hospitals often work in a paradoxical situation between the ideologies of curative and palliative care. This situation would not occur in a hospice or palliative care unit. Many nurses apparently assume that palliative care is synonymous with terminal care and is therefore only needed when the patient is near to death. Palliative care is often perceived by acute hospital staff to be a separate entity rather than integral to the common goals for good patient care. The first part of this article describes the experiences of a palliative care clinical nurse working with staff and patients in a private hospital. The second part discusses a clinical lecturer post which was established as a joint appointment between a university and a major public hospital in Brisbane, Australia. The goal of the joint appointment was to enhance the blending of theory and practice and to gain deeper understanding about the experience of patients who are dealing with life-threatening disease.
Teenagers and loss
Authors: Evans Margaret
Published: January 2018

The teenage years are a difficult phase of life when many physical and emotional changes occur. Although the needs of this age group differ from those of children and adults, professionals in the hospital setting have been slow to recognize and accommodate problems which are specific to teenagers, particularly at times of illness or bereavement. This article offers some thoughts on how to help teenagers cope with loss, whether it be their own death or the death of a loved one.
Review of the correlation between hospice philosophies and logos
Authors: Roch Jean
Published: January 2018

A review was undertaken of the ability of some published hospice philosophies and logos from different countries, known to the author, to convey the spirit of hospice care. Weisman's (1988) essential criteria for a hospice programme – which acknowledge the patient, family and staff – were used when comparing the comprehensive nature of both philosophies and logos. The findings suggest that symbolic logos show a greater potential to succinctly convey the comprehensive spirit of hospice care than written philosophies.
Ethics of resource distribution: implications for palliative care services
Authors: Hunt Susan
Published: January 2018

Over the past few years changes in health care delivery worldwide have prompted health care professionals to become increasingly aware of, and involved in, decisions surrounding resource distribution. This paper aims to examine the ethical issues behind such decisions with particular reference to palliative care services. It is suggested that current outcome measures used to examine the quality and effectiveness of care are unsuitable for use within the palliative care setting, and that health care professionals within the field should be aware of, and promote the use of, more appropriate outcome measures. This is essential in order that the philosophy central to palliative care may be upheld and resources maintained at an appropriate level.
Spirituality, language and depth of reality
Authors: Stanworth Rachel
Published: January 2018

This paper explores the potential for patients to express spiritual concerns other than through a religious vocabulary. The spiritual is presented as an indivisible dimension rather than a compartment of existence and spiritual expressions are regarded as intertwined with autobiography, and attempts to discover ultimate meaning in life's events. It is argued that metaphor and symbol may reveal truths as compelling as those disclosed by the natural sciences and that multiple layers of meaning exist in all human activity and expression. Professionals are invited to reflect upon the authenticity of their communication with patients, for the simplest act of care may be deeply significant when a patient feels that their own sense of reality has been recognised.
An exploration of the concept of spirituality
Authors: Cawley Nik
Published: January 2018

This paper explores the concept of spirituality using the framework developed by Walker and Avant (1995). Consideration of the concept, as used within nursing, suggested two broad categories: one relating to religious connotations and the second relating to non-religious connotations such as belief in the source/principle of life the characteristics or attributes of a person. Use of the concept analysis framework proved to be limited, because of the subjective and often intangible nature of spirituality. It remains a personal and individualistic concept which frustrates the development of a simple, standard definition. It may therefore be more appropriate for future nursing research and practice to explore nursing practices such as interpersonal interaction and communication. This may then facilitate nurses' assessment and exploration of spirituality with their patients.
The nurse's role in assessing and responding to patients' spiritual needs
Authors: Ross Linda Anne
Published: January 2018

The spiritual dimension of health care is becoming increasingly prominent, particularly in terminal care. It is not always clear, however, what spiritual needs are or who has responsibility for spiritual care. The first part of this paper takes the form of a literature review which examines the spiritual dimension and spiritual need. Spiritual needs, which may be particularly acute during terminal illness, are considered broader than religious needs and include the need for meaning, purpose, fulfilment, hope/will to live, and belief and faith in self, others and God.

The role of the nurse in assessing and responding to patients' spiritual needs is addressed in the second part of the paper, with specific reference to the author's doctoral study. There is indication from this study that certain factors related to the patient, nurse, environment and other professionals may hinder the fulfilment of patients' spiritual needs. By addressing these factors it may be possible to improve spiritual care and therefore the quality of dying patients' remaining days.
Whom to help? An exploration of the assessment of grief
Authors: Walshe Catherine
Published: January 2018

Palliative care, and the nursing care associated with it, includes the time around bereavement. Assessment of whether people are at risk of adverse bereavement consequences or suffer such consequences during their time of grief is important. Such assessment, which palliative care nurses are ideally placed to perform, can target those who need more support and intervention.

This review investigates factors which it is important to recognise during nursing assessment of risk and outcome, with particular emphasis on the use of published tools. Three main recommendations are made: for provision of education about grief assessment for nurses; for more careful choosing and use of assessment tools; and for careful consideration of timing of assessment.
Experiential exercises in palliative care training
Authors: Spall Robert , Johnson Matthew
Published: January 2018

Death education research has traditionally focused on the relative effectiveness of experiential versus didactic methods. Although experiential methods have been shown to be more effective at lowering death anxiety, little account has been taken of the distress that many people experience as a result of undertaking this kind of training. This article describes an investigation of the reactions of participants on a palliative care training course which included a day of experiential sessions. It was found that experiential training produced both positive outcomes, in terms of staff attitudes and clinical practice, and negative outcomes, in terms of emotional distress and anxiety experienced by participants. On balance, the positive aspects of this experiential training suggest that the gains do justify the means. Suggestions are therefore made for potential safeguards to minimise any adverse effects.
Palliative nurses' perceptions of the nature and effects of their work
Authors: Taylor Bev , Glass Nel , McFarlane Jennifer , Stirling Catherine
Published: January 2018

This paper presents some of the qualitative findings from a recent research project, which explored the nature and effects of palliative nursing care for nurses, in New South Wales, Australia. By using story telling as the research methodology the participants related their experiences about palliative care nursing practice in which they felt they did or did not make a difference to the people in their care. The results of this project clearly demonstrated that the nature of palliative nursing is expressed by nurses dealing with death, making connections, making contracts, demonstrating advocacy, building interpersonal relationships, requiring family and colleague support and involvement in issues. The effects of palliative nursing were described as whether nurses were able to find solutions; facilitate breakthroughs, acceptance and support; reflect of their values and feelings.
Pathophysiology and management of dyspnoea in palliative care and the evolving role of the nurse
Authors: Birks Carol
Published: January 2018

Dyspnoea is a symptom commonly encountered in palliative care, especially with patients suffering from advanced cancer. An understanding of the pathophysiological mechanisms that are understood to be associated with this symptom will enable health professionals to provide more appropriate management interventions. A review of the literature was undertaken to explore current knowledge on the causes and management of dyspnoea. This paper will describe the results of this review by giving an overview of the pathophysiology of dyspnoea, and discussing controversial treatment issues. Methods of assessment and the role of the nurse in managing this distressing symptom are also explored.
Multidisciplinary case study as an approach to the evaluation of palliative care services: two example
Authors: Ingleton Christine , Field David , Clark David
Published: January 2018

In this paper it is argued that there is a need to adopt a Abroad approach to the evaluation of palliative care services which: takes account of the differing interest groups; reflects the complexities of palliative care provision; and uses varied methods suited to the particular research question. The central tenets of the formative, qualitative model of evaluation are presented and the strengths of such an approach are illustrated by reference to the evaluation of two palliative care services.
An action plan for mental health
Authors: Hancock Dave
Published: January 2018

Dave Hancock looks at ways to implement recommendations in the recently published Stevenson/Farmer review of mental health at work
Realisation of Cognitive Radio:Issues and Challenges
Authors: A Lala Nisar , Mir G M , Balkhi Altaf A
Published: January 2018

For last two decades, the demand for wireless spectrum has been increasing rapidly with tremendous developments in the telecom industry. There also has been huge growth in flow of multimedia traffic over the last decade. Thus, the demand for additional bandwidth is increasing exponentially despite the fact that the electromagnetic spectrum is a finite resource. On the other hand, spectrum occupancy is found to be quiet low in most of the allocated bands. Thus, the under-utilization of the precious spectrum is unaffordable if persistent growth of new and existing wireless services are to be sustained. Cognitive radio (CR) is a future technology initiated by many research organizations and academic institutions to increase the spectrum utilization of underutilized spectrum channels to ameliorate scarcity problem of valuable electromagnetic spectrum. There exists number of issues and challenges in designing and implementation of the cognitive radio. These issues need to be rigorously resolved before a cognitive radio is realised.
Steganography Based on Human Perception
Authors: Chakraborty Suman , Bikash Chowdhury Anil
Published: January 2018

Today internet has become a trusted factotum of everyone. Almost all payments like tax, insurance, bank transaction, healthcare payment, payment in e-commerce are done digitally through debit or credit card or through e-wallet. People share their personal information through social media like Facebook. Twitter, WhatsApp etc. The government of every developing country is going to embrace e-Governance system to interact with people more promptly. The information shares through these applications are the burning target to intruders. This paper utilized the imperceptibility as well as the robustness of steganography techniques which are increased by embedding multiple bits in a particular region selected either based on some image attributes or by Human Visual Perception.
Embodied childbirth
Authors: Ruben Joy
Published: January 2018

Worship of the body and its wisdom was slowly phased out as modern religion and science came to power. The impact of this destruction of reverence for the body is still felt today in our violent and disembodied culture of childbirth. Women’s wisdom is resisted by modern medical practices, and the natural process of birth is largely treated as a medical emergency. This shift away from embodied wisdom has shamed women for embracing their bodies and created unnecessary risk in child-birth. In the United States of America, the maternal mortality rate is on the rise, which is unusual for developed countries. Embodied wisdom is needed to return sanctity to childbirth. It can be resurrected through the use of embodiment practices such as the Feldenkrais Method, Leadership Embodiment and Bones for Life with birthing mothers.
Book Review
Authors: McHugh Jamie
Published: January 2018

Mindful Movement: The Evolution of the Somatic Arts and Conscious Action, Martha Eddy (2016) Bristol: Intellect ISBN: 9781783205837, h/bk, £51.54
Woman, body, earth and spirit: Journeys of descent through myth, embodiment and movement practice
Authors: Hartley Linda
Published: January 2018

In this article I describe some personal journeys, inwards through the deepest layers of the psyche, to discover embodied understanding of what I call the deep feminine, or the feminine ground of being. I explore some myths and ancient stories of the Goddess that reflect the journey of healing and transformation through psychological descent, and can guide us through such ordeals. As C. G. Jung discovered, myths and archetypes are rooted in the instinctual body; as a somatic movement practitioner and transpersonal and body-oriented psychotherapist, my own journeys led me to intuitive appreciations of the somatic sources of mythic journeys that have particular relevance to contemporary women seeking healing/wholeness and spiritual renewal.

The myth of Inanna, the oldest known myth of the Goddess’s descent to the Underworld, affirms the truth that our healing and spiritual journey takes us through a process of ‘endarkenment’, in order to reach wholeness and discover the light of spirit within. The Goddess Lilith also represents the ‘dark’ side of the feminine, which we need to balance and reconcile with our upperworldly nature. La Loba, Wild Woman, shows us a path towards rebirth and revival of our soul and spirit. These ancient and timeless tales offer guidance and reflection for contemporary women, and also men exploring the feminine within their own psyches.
Symbols of the Goddess in Balkan women’s dance
Authors: Shannon Laura
Published: January 2018

Communal dance has been a primary means of worship in Eastern Europe and the Near East for over 9000 years, depicted in rock art and pottery fragments showing circles of dancing women. Existing women’s dance traditions of the Balkans may be direct descendants of these ancient rituals, and may offer living links to matrifocal Goddess cultures of Neolithic Old Europe. Women’s dances and textiles incorporate symbols such as the circle, sun, spiral, zigzag, and Tree of Life, which can be identified with the Goddess. Traditional dance circles, both past and present, also emphasize ancient values of community, connection, cooperation, shared leadership, and peace. Even as these dances change in their places of origin, they are being given new life as an embodied spiritual practice embraced by dancers all over the world. The contemporary movement practice of women’s ritual dances can offer experiences of healing, insight, and transformation to contemporary women from different cultures.
CONDITION OF THE MUSCULOSKELETAL SYSTEM IN PATIENTSWITH ACROMEGALY.
Authors: Fedotova A S , Molitvoslovova N N , Alekseeva L I , Rozhinskaya L Ya , Fedotova A. S. , Molitvoslovova N. N. , Alexeeva L. I. , Rozhinskaya L. Y.
Published: January 2018

Despite the relatively low incidence of acromegaly (60-70 cases per I million inhabitants), this disease has a special place among the heterogeneous group of diseases that lead to the defeat of the locomotor apparatus. The slow growth of the clinical manifestations of acromegaly and as a consequence, late diagnosis, the cause of early disability and premature death of patients. In order to improve the quality of life and social adaptation of patients to date is an obvious need to identify groups of patients with acromegaly, requiring additional therapy for osteoporosis and osteoarthritis. We performed the search in bibliographic bases MEDLINE and Cochrane Collaboration from 2000 on 2009. Key words were the following: acromegaly, acromegaly and arthropathy, osteoporosis and acromegaly, the bone mineral density and acromegaly, fractures and acromegaly. In this article the data about role of risk factors for the defeat ofosteoarticular apparatus, the dynamics of the articular syndrome and the state of bone tissue in acromegaly.
THE NEW PARADIGM IN DIAGNOSIS AND TREATMENT OF OSTEOPOROSIS: PREDICTION OF A 10-YEAR ABSOLUTE RISK OF FRACTURE (CALCULATOR FRAX)
Authors: Lesnyak O. M.
Published: January 2018

New tool to assess fracture probability — the 10-year absolute fracture risk (calculator FRAX), released by WHO in 2008 - is discussed in this review. Dual-energyX-rays absorptiometry (DXA) is considered as a gold standard of diagnosis of osteoporosis. The goal of FRAX was to improve the prognostic performance of densitometry in assessing fracture risk through adding the information on different clinical risk factors independent of bone mineral density. The methodology used in searching for the risk factors included in FRAX is reviewed. Disadvantages and limitations of FRAX as well as ways of it implementation in clinical practice are discussed.
FRACTURE — A RISK FACTOR FOR DEVELOPMENT AND PROGRESSION OF OSTEOPENIA AND OSTEOPOROSIS
Authors: Pobel E A
Published: January 2018

Analyzed literature data demonstrates the influence of fracture in individuals of different age on the risk of post-traumatic osteopenia and osteoporosis, as well as increase in the risk of the recurrent fractures. It is proved that the fracture leads to a decrease in bone mineral density (BMD) not only in the injured limb, but also other parts of the skeleton. In majority of prospective studies and metaanalysis it was shown that there is no full recovery of BMD after sustained fracture. Posttraumatic osteopenia and osteoporosis increase the risk of re-fracture in the future.