bluuebunny/crossref_metadata_2025 huggingface dataset:
Information and decision support needs in patients with type 2 diabetes
Authors: Weymann Nina , Härter Martin , Dirmaier Jörg
Published: June 2014

Diabetes and its sequelae cause a growing burden of morbidity and mortality. For many patients living with diabetes, the Internet is an important source of health information and support. In the course of the development of an Interactive Health Communication Application, combining evidence-based information with behavior change and decision support, we assessed the characteristics, information, and decision support needs of patients with type 2 diabetes.

The needs assessment was performed in two steps. First, we conducted semi-structured interviews with 10 patients and seven physicians. In the second step, we developed a self-assessment questionnaire based on the results of the interviews and administered it to a new and larger sample of diabetes patients (N = 178). The questionnaire comprised four main sections: (1) Internet use and Internet experience, (2) diabetes knowledge, (3) relevant decisions and decision preferences, and (4) online health information needs. Descriptive data analyses were performed.

In the questionnaire study, the patient sample was heterogeneous in terms of age, time since diagnosis, and glycemic control. (1) Most participants (61.7%) have searched the web for health information at least once. The majority (62%) of those who have used the web use it at least once per month. (2) Diabetes knowledge was scarce: Only a small percentage (1.9%) of the respondents answered all items of the knowledge questionnaire correctly. (3) The most relevant treatment decisions concerned glycemic control, oral medication, and acute complications. The most difficult treatment decision was whether to start insulin treatment. Of the respondents, 69.4 percent thought that medical decisions should be made by them and their doctor together. (4) The most important information needs concerned sequelae of diabetes, blood glucose control, and basic diabetes information.

The Internet seems to be a feasible way to reach people with type 2 diabetes. The heterogeneity of the sample, especially with respect to diabetes knowledge, makes it clear that the projected Interactive Health Communication Application should tailor the content to the individual user, taking account of individual characteristics and preferences. A wide range of topics should be covered. Special attention should be paid to the advantages and disadvantages of insulin treatment and the fears and hopes associated with it. These results were taken into account when developing the Interactive Health Communication Application that is currently being evaluated in a randomized controlled trial (International Clinical Trials Registry DRKS00003322).
eWasted time: Redundant work during hospital admission and discharge
Authors: MacMillan Thomas E , Slessarev Marat , Etchells Edward
Published: June 2014

Potential unintended consequences of health information technology include fragmentation of workflow and redundant work. We could not identify any prior direct observation studies that quantified redundant work related to health information technology in the clinical setting. Our objective was to quantify redundant work during admission and discharge to our general internal medicine service at an academic medical center. We performed a time and motion study at Sunnybrook Health Sciences Centre in Toronto, Canada. We observed 13 clinicians performing an admission or a discharge, and the type and length of each task was recorded using an Apple iPad tablet. We identified redundant tasks related to health information technology and calculated the time spent completing these tasks. We found that 22 percent of clinician time was spent on redundant tasks. Our finding highlights the importance of workflow and software integration when implementing health information technology.
Mixed-Method Nursing Research: “A Public and Its Problems?” A Commentary on French Nursing Research
Authors: Dupin Cécile Marie , Debout Christophe , Rothan-Tondeur Monique
Published: June 2014

Nursing in France is undergoing a transition. In 2009, the preregistration nursing education program was reformed in line with the European Bologna Process, bringing nursing education to the universities. In 2010, the French Programme Hospitalier de Recherche Infirmière, the first national French nursing research funding program, was launched by the French Health Ministry. Of the 149 French research proposals submitted by registered nurses in 2010 and 2011, 13 were mixed-method proposals. The registered nurse principal investigator argued for a complementary use of qualitative and quantitative methods. These trends highlight major issues regarding mixed-method and nursing research. We can reasonably assume that mixed-method research has a broad appeal for nurse scholars, particularly for the exploration of complex phenomena related to nursing. Moreover, the recent movement in the domain of nursing education and research experienced in France highlights the need for dedicated research education in the development of nursing research capacity.
Zinc oxide influences mitogen-activated protein kinase and TGF-β1 signaling pathways, and enhances intestinal barrier integrity in weaned pigs
Authors: Song Ze He , Xiao Kan , Ke Ya Lu , Jiao Le Fei , Hu Cai Hong
Published: June 2014

Weaning is the most significant event in the life of pigs and is always related with intestinal disruption. Although it is well known that zinc oxide (ZnO) exerts beneficial effects on the intestinal barrier, the mechanisms underlying these effects have not yet been fully elucidated. We examined whether ZnO protects the intestinal barrier via mitogen-activated protein kinases and TGF-β1 signaling pathways. Twelve barrows weaned at 21 d of age were randomly assigned to two treatments (0 verus 2200 mg Zn/kg from ZnO) for 1 wk. The results showed that supplementation with ZnO increased daily gain and feed intake, and decreased postweaning scour scores. ZnO improved intestinal morphology, as indicated by increased villus height and villus height:crypt depth ratio, and intestinal barrier function, indicated by increased transepithelial electrical resistance and decreased mucosal-to-serosal permeability to 4-ku FITC dextran. ZnO decreased the ratios of the phosphorylated to total JNK and p38 (p-JNK/JNK and p-p38/p38), while it increased the ratio of ERK (p-ERK/ERK). Supplementation with ZnO increased intestinal TGF-β1 expression. The results indicate that supplementation with ZnO activates ERK ½, and inhibits JNK and p38 signaling pathways, and increases intestinal TGF-β1 expression in weaned pigs.
Chronic cough in adults
Authors: Al-Najjar Haider
Published: June 2014

A cough is the single most common presenting complaint in primary care; it is a major burden on the UK economy in terms of both health care costs and lost productivity. The vast majority of these cases are an acute cough, primarily due to self-limiting upper respiratory tract infections. However, a significant proportion of the general population (between 10 and 20%) will experience chronic cough, which can have a debilitating and often overlooked impact on the patient’s quality of life. This article describes the primary care evaluation and management of chronic cough in adults, particularly when there is no obvious underlying cause, based on the recommendations of the British Thoracic Society. There is also a brief discussion regarding which cases of acute cough should be referred early before they become chronic. The article does not discuss the management of a cough in children.
Specialized High Schools and Talent Search Programs
Authors: Almarode John T. , Subotnik Rena F. , Crowe Edward , Tai Robert H. , Lee Geesoo Maie , Nowlin Fiona
Published: June 2014

The purpose of this study is to investigate the association between self-efficacy and maintenance of interest in science, technology, engineering, and mathematics (STEM) resulting in completion of an undergraduate degree in a science related area. To pursue this analysis, the researchers surveyed 3,510 graduates from selective specialized science high schools within the United States as well as 603 same age participants in Talent Search programs who did not graduate from a specialized science high school. Using binary logistic regression analysis, the researchers identified individual-level variables associated with the decision by both groups of high-ability adolescents to earn an undergraduate degree in STEM. These variables include self-efficacy and stability of interest in science, mathematics, and/or technology, and suggest that both specialized science high schools and Talent Search programs both serve equally well as incubators of talent for adolescents with a proclivity for STEM related disciplines.
Perceived Efficacy of Teacher-Made Instructional Materials in Promoting Learning Among Mathematics-Disabled Children
Authors: Igbo Janet N. , Omeje Joachim C.
Published: June 2014

The study explored the perceived efficacy of teacher-made instructional materials in promoting learning among mathematics-disabled children in the primary school. One research question and one hypothesis were used to guide the study. The sample for the study comprised of 155 primary 5 mathematics-disabled pupils, and the study area was central education zone. Questionnaire was the instrument used for data collection. Mean, standard deviation, and t-test statistics were used in the analysis of the data. Results indicated that pupils prefer visual aids, recall better, learn faster, achieve more, and prefer contact with teacher-made instructional materials, among other items.
Acoustic emission study of deformation behaviour of sensitised 304 stainless steel
Authors: Sahoo S. , Jha B. B. , Sahoo T. K.
Published: June 2014

A systematic study has been undertaken to correlate the changes in acoustic emissions during tensile deformation of sensitised AISI type 304 stainless steel. Samples of a typical 304 stainless steel were sensitised at 700°C for 4, 14 and 24 h after being austenised at 1050°C for 30 min. AE signals were recorded during tensile test by using two sensors with 125 kHz resonant frequency. The results showed significant change in generation of AE during tensile deformation of sensitised AISI 304 stainless steel in compare to solution annealed material. This type of behaviour could be attributed to the microstructural changes in the sensitised specimens especially formation of continuous Cr23C6 carbides on grain boundaries which lead to increase in shearing by dislocations.
Synergistic defects of different molecules in the cytotoxic pathway lead to clinical familial hemophagocytic lymphohistiocytosis
Authors: Zhang Kejian , Chandrakasan Shanmuganathan , Chapman Heather , Valencia C. Alexander , Husami Ammar , Kissell Diane , Johnson Judith A. , Filipovich Alexandra H.
Published: June 2014

Key Points

Synergistic effects were observed in the granule mediated lymphocyte cytotoxicity. Digenic pathogenesis contributed to the development of hemophagocytic lymphohistiocytosis.
Impact of daily Chlorella consumption on serum lipid and carotenoid profiles in mildly hypercholesterolemic adults: a double-blinded, randomized, placebo-controlled study
Authors: Ryu Na Hee , Lim Yeni , Park Ji Eeun , Kim Joohee , Kim Ji Yeon , Kwon Sung Won , Kwon Oran
Published: June 2014

Background

High level of serum cholesterol is considered to be a major risk factor for cardiovascular disease (CVD). A double-blinded, randomized, placebo-controlled trial was performed to test the hypothesis that a daily intake of Chlorella may improve serum lipid profile through enhancement of serum carotenoid concentration in mildly hypercholesterolemic subjects.

Methods

Eligible subjects (n = 63) were randomized to either Chlorella (5 g/day) or placebo for a double-blinded trial with a 2-week lead-in period and a 4-week intervention period. Serum triglycerides, total cholesterol, lipoproteins, apolipoproteins and carotenoids were assessed at the beginning and the end of the trial.

Results

Compared with the control group, the Chlorella group exhibited remarkable changes in total cholesterol (Chlorella −1.6%; placebo 0.03%; P = 0.036), triglycerides (Chlorella −10.3%; placebo 11.9%; P = 0.002), lutein/zeaxanthin (Chlorella 89.6%; placebo −1.7%; P < 0.0001), and α-carotene (Chlorella 163.6%; placebo 15%; P < 0.0001). Improvement of serum lipids was supported by significant reductions of very low-density lipoprotein cholesterol (Chlorella −11%; placebo 11.8%; P = 0.006), apolipoprotein B (Chlorella −1.5%; placebo 1.7%; P = 0.044), non high-density lipoprotein (Chlorella −2.6%; placebo −0.5%; P = 0.032), and high-density lipoprotein/triglycerides (Chlorella 4.0%; placebo −9.5%; P = 0.023), suggesting an inhibitory effect of Chlorella on the intestinal absorption of dietary and endogenous lipids. Further, the changes of serum lipids appeared to be associated with the changes of serum carotenoids.

Conclusion

Daily consumption of Chlorella supplements provided the potential of health benefits reducing serum lipid risk factors, mainly triglycerides and total cholesterol, in mildly hypercholesterolemic subjects. The effect was related to carotenoid consumption.

Trial registration

WHO International Clinical Trials Registry Platform KCT0000259.
Improving scattering layer through mixture of nanoporous spheres and nanoparticles in ZnO-based dye-sensitized solar cells
Authors: Kim Chohui , Choi Hongsik , Kim Jae Ik , Lee Sangheon , Kim Jinhyun , Lee Woojin , Hwang Taehyun , Kang Suji , Moon Taeho , Park Byungwoo
Published: June 2014

A scattering layer is utilized by mixing nanoporous spheres and nanoparticles in ZnO-based dye-sensitized solar cells. Hundred-nanometer-sized ZnO spheres consisting of approximately 35-nm-sized nanoparticles provide not only effective light scattering but also a large surface area. Furthermore, ZnO nanoparticles are added to the scattering layer to facilitate charge transport and increase the surface area as filling up large voids. The mixed scattering layer of nanoparticles and nanoporous spheres on top of the nanoparticle-based electrode (bilayer geometry) improves solar cell efficiency by enhancing both the short-circuit current (J
sc) and fill factor (FF), compared to the layer consisting of only nanoparticles or nanoporous spheres.
Pentachlorophenol removal from aqueous solutions by microwave/persulfate and microwave/H2O2: a comparative kinetic study
Authors: Asgari Ghorban , Seidmohammadi AbdolMotaleb , Chavoshani Afsane
Published: June 2014

Pentachlorophenol (PCP) is one of the most fungicides and pesticides used in wood protection. Poisoning from PCP may be happened in dermal absorption, and respiration or ingestion. With regard to health and environmental effects of PCP, many methods were studied for its removal. Microwave assisted other methods are environmental friendly, safety, and economical method, therefore, in this study; a modified domestic microwave assisted hydrogen peroxide (MW/H2O2) and sodium persulfate (MW/SPS) was used for PCP removal from aqueous solutions. PCP removal rate was measured under different factors such as pH, energy intensity, SPS, H2O2 concentration, Tert- butyl alcohol (TBA) and chemical oxygen demand (COD). The concentration changes of PCP were determined using spectrophotometer and HPLC spectra, respectively. The best removal PCP rate obtained in condition of pH of 11, 0.02 mol L−1 of SPS, 0.2 mol L−1 of H2O2 and energy intensity of 600 W. Moreover, COD removals in MW/H2O2 and MW/SPS process were 83% and 94%, respectively, also TBA test decreased 15% and 3% of PCP removal in MW/SPS and MW/H2O2 processes respectively. Experimental results indicated that sulfate radical was stronger than hydroxyl radical and examinations order reaction was in first order. In this study, was cleared that MW/SPS process was more effective than MW/H2O2 process in PCP removal.
Human kallikrein-2 gene and protein expression predicts prostate cancer at repeat biopsy
Authors: Satkunasivam Raj , Zhang William , Trachtenberg John , Toi Ants , Yu Changhong , Diamandis Eleftherios , Kattan Michael W , Narod Steven A , Nam Robert K
Published: June 2014

Purpose

The human kallikrein-2 (hK2) protein and two single nucleotide polymorphism (SNPs) (rs2664155, rs198977) of the gene are associated with prostate cancer risk. We examined whether hK2 protein and gene SNPs predict prostate cancer at the time of repeat biopsy.

Methods

We prospectively offered a repeat biopsy to men with a negative prostate biopsy performed for a PSA >4.0 ng/mL or abnormal Digital Rectal Exam (DRE) between 2001–2005. We genotyped and measured serum hK2 levels in 941 men who underwent a repeat prostate biopsy. Logistic regression analyses were conducted to determine the significance of KLK2 SNPs and hK2 levels for predicting cancer at repeat biopsy.

Results

Of the 941 patients, 180 (19.1%) were found to have cancer. The rs198977 SNP was positively associated with cancer at repeat biopsy (OR variant T allele = 1.8, 95% CI: 1.04-3.13, p = 0.049). When combined, the odds ratio for prostate cancer for patients with high hK2 levels and the variant T-allele of rs198977 was 3.77 (95% CI: 1.94-7.32, p < 0.0001), compared to patients with low hK2 levels and the C-allele. The addition of hK2 levels and KLK2 rs198977 to the baseline predictive model did not significantly increase the area under the curve from a baseline model of 0.67 to 0.69 (p = 0.6).

Conclusions

The KLK2 SNP rs198977 was positively associated with hK2 levels and predicts prostate cancer at the time of repeat prostate biopsy. Further characterization of the KLK2 gene will be needed to determine its clinical utility.
Monitoring prognosis in severe traumatic brain injury
Authors: Maas Andrew IR , Steyerberg Ewout W
Published: June 2014

The choice of disease-specific versus generic scales is common to many fields of medicine. In the area of traumatic brain injury, evidence is coming forward that disease-specific prognostic models and disease-specific scoring systems are preferable in the intensive care setting. In monitoring prognosis, the use of a calibration belt in validation studies potentially provides accurate and intuitively attractive insight into performance. This approach deserves further empirical evaluation of its added value as well as its limitations.
In silico evaluation of gadofosveset pharmacokinetics in different population groups using the Simcyp® simulator platform
Authors: Spanakis Marios , Marias Kostas
Published: June 2014

Purpose

Gadofosveset is a Gd-based contrast agent used for magnetic resonance imaging (MRI). Gadolinium kinetic distribution models are implemented in T1-weighted dynamic contrast-enhanced perfusion MRI for characterization of lesion sites in the body. Physiology changes in a disease state potentially can influence the pharmacokinetics of drugs and to this respect modify the distribution properties of contrast agents. This work focuses on the in silico modelling of pharmacokinetic properties of gadofosveset in different population groups through the application of physiologically-based pharmacokinetic models (PBPK) embedded in Simcyp® population pharmacokinetics platform.

Methods

Physicochemical and pharmacokinetic properties of gadofosveset were introduced into Simcyp® simulator platform and a min-PBPK model was applied. In silico clinical trials were generated simulating the administration of the recommended dose for the contrast agent (i.v., 30 mg/kg) in population cohorts of healthy volunteers, obese, renal and liver impairment, and in a generated virtual oncology population. Results were evaluated regarding basic pharmacokinetic parameters of Cmax, AUC and systemic CL and differences were assessed through ANOVA and estimation of ratio of geometric mean between healthy volunteers and the other population groups.

Results

Simcyp® predicted a mean Cmax = 551.60 mg/l, a mean AUC = 4079.12 mg/L*h and a mean systemic CL = 0.56 L/h for the virtual population of healthy volunteers. Obese population showed a modulation in Cmax and CL, attributed to increased administered dose. In renal and liver impairment cohorts a significant modulation in Cmax, AUC and CL of gadofosveset is predicted. Oncology population exhibited statistical significant differences regarding AUC when compared with healthy volunteers.

Conclusions

This work employed Simcyp® population pharmacokinetics platform in order to compute gadofosveset’s pharmacokinetic profiles through PBPK models and in silico clinical trials and evaluate possible differences between population groups. The approach showed promising results that could provide new insights regarding administration of contrast agents in special population cohorts. In silico pharmacokinetics could further be used for evaluating of possible toxicity, interpretation of MRI PK image maps and development of novel contrast agents.
Fire ants actively control spacing and orientation within self-assemblages
Authors: Foster Paul C. , Mlot Nathan J. , Lin Angela , Hu David L.
Published: June 2014

To overcome obstacles and survive harsh environments, fire ants link their bodies together to form self-assemblages such as rafts, bridges and bivouacs. Such structures are examples of self-assembling and self-healing materials, as ants can quickly create and break links with one another in response to changes in their environment. Because ants are opaque, the arrangement of the ants within these three-dimensional networks was previously unknown. In this experimental study, we applied micro-scale computed tomography, or micro-CT, to visualize the connectivity, arrangement and orientation of ants within an assemblage. We identified active and geometric mechanisms that ants use to obtain favorable packing properties with respect to well-studied packing of inert objects such as cylinders. Ants use their legs to push against their neighbors, doubling their spacing relative to random packing of cylinders. These legs also permit active control of their orientation, an ability ants use to arrange themselves perpendicularly rather than in parallel. Lastly, we found an important role of ant polymorphism in promoting self-aggregation: a large distribution of ant sizes permits small ants to fit between the legs of larger ants, a phenomenon that increases the number of average connections per ant. These combined mechanisms lead to low packing fraction and high connectivity, which increase raft buoyancy and strength during flash floods.
Generalization and discrimination tasks yield concordant measures of perceived distance between odours and their binary mixtures in larval Drosophila
Authors: Chen Yi-chun , Gerber Bertram
Published: June 2014

Similarity between odours is notoriously difficult to measure. Widely used behavioural approaches in insect olfaction research are cross-adaptation, masking, as well as associative tasks based on olfactory learning and the subsequent testing for how specific the established memory is. A concern with such memory-based approaches is that the learning process required to establish an odour memory may alter the way the odour is processed, such that measures of perception taken at the test are distorted. The present study was therefore designed to see whether behavioural judgements of perceptual distance are different for two different memory-based tasks, namely generalization and discrimination. We used odour–reward learning in larval Drosophila as a study case. In order to challenge the larvae's olfactory system, we chose to work with binary mixtures and their elements (1-octanol, n-amyl acetate, 3-octanol, benzaldehyde and hexyl acetate). We determined the perceptual distance between each mixture and its elements, first in a generalization task, and then in a discrimination task. It turns out that scores of perceptual distance are correlated between both tasks. A re-analysis of published studies looking at element-to-element perceptual distances in larval reward learning and in adult punishment learning confirms this result. We therefore suggest that across a given set of olfactory stimuli, associative training does not grossly alter the pattern of perceptual distances.
Efficient and Versatile Anion Metathesis Reaction for Ionic Liquid Preparation by Using Conjugate Acid and Ortho Ester
Authors: Takao Koichiro , Takao Shinobu
Published: June 2014

Low melting points and very low volatility are preferable traits of an ionic liquid (IL). However, these characteristics cause difficulty in preparation and purification, and hence, preparation methods for ILs are of great interest even today. Combinatorial use of ortho ester and conjugate acid of constituent anions is proposed to effectively replace the halide ion in IL preparation. The predicted by-product in this reaction is hydrogen halide, which can be evaporated or further converted to volatile alkyl halide through the reaction with an in situ generated or intentionally added alcohol. Therefore, any desired IL can be prepared in principle. Efficiency and versatility of this method were demonstrated by synthesizing several commonly employed ILs in accordance with the protocol taking into account several chemical aspects occurring in the actual experiment. The proposed method is highly accessible and inexpensive despite the high purity of obtained ILs (98.5–99.4 mol %, Br−: 101–102 ppm).
On Flow-Acoustic Resonant Interactions in Transitional Airfoils
Authors: Golubev Vladimir V. , Nguyen Lap , Mankbadi Reda R. , Roger Michel , Visbal Miguel R.
Published: June 2014

We discuss our recent experimental and preliminary numerical efforts examining resonant feedback mechanism of flow-acoustic interactions in airfoil transitional boundary layers. Experimentally recorded unsteady responses of loaded, transitional NACA0012 airfoil with tripped suction or pressure sides confirm the presence of shifted ladder-type tonal structures with dual velocity dependence in the acoustic signal previously reported in the literature. The installation of upstream grid generating low-intensity turbulence appears to eliminate the feedback mechanism leaving just a single velocity dependence for the dominant spectral components. Complementary numerical efforts employ a high-order Navier-Stokes solver implementing low-pass filtering of poorly resolved high-frequency solution content to retain numerical accuracy and stability over the range of transitional flow regimes. Within the scope of 2D analysis, the conducted numerical experiments particularly investigate the behavior of the boundary-layer statistical moments during the transitional flow regimes characterized by the presence of the acoustic feedback, and address sensitivity of the latter to the flow Reynolds number.
Towards Simulation of Far-Field Aerodynamic Sound from a Circular Cylinder Using OpenFoam
Authors: Lysenko Dmitry A. , Ertesvåg Ivar S. , Rian Kjell Erik
Published: June 2014

The low-Mach number flow-induced noise by the flow past a circular cylinder at sub-critical regime was predicted. First, to assess the accuracy of the numerical methodology, the laminar flow over a circular cylinder at the Reynolds number Re = 140 and Mach number M = 0.2 was calculated by direct solution of the unsteady compressible Navier-Stokes equations. Second, the sound generated by a circular cylinder at the Reynolds number Re = 2.2 × 104 and Mach number M = 0.06 was simulated using a technique of large-eddy simulation. For both cases, the calculated acoustic fields showed a dipole directivity, similar to a natural vortex shedding. The impact of the Doppler effect was investigated and discussed as well. In general, the computed aerodynamic and far-field acoustic results were found to be in good agreement with available experimental measurements and analytical relationships.
Statistical Analysis of the Pressure Field in the near Region of a M = 0.5 Circular Jet
Authors: Camussi Roberto , Grizzi Silvano
Published: June 2014

In a recent paper [1] a novel technique providing the separation between hydrodynamic and acoustic components of pressure signals has been presented and applied to near field pressure signals measured in a turbulent jet at M = 0.5. The database is further analyzed herein with the scope of clarifying the physical mechanisms underlying the generation of acoustic pressure fluctuations in the near field. The analysis of cross-correlations between pressure and acceleration and the statistics of the potential core fluctuations, confirm that the region at the end of the potential core plays a fundamental role in this sense. A conditional sampling technique based on the use of wavelet transform identifies ensemble averaged velocity traces of the noise sources. The velocity signatures are interpreted as induced by wavepackets, in the region close to the jet exit, and ring vortices in the far region.
Simulation of Azimuthal Characteristics of Turbulent Jet Noise by Correlation Model of Quadrupole Noise Sources
Authors: Kopiev Victor F. , Chernyshev Sergey A.
Published: June 2014

In the modeling of the noise sources in turbulent jets two open questions are still remain. The first, what is the multipole type of the sources? The second, what kind of stochastic fields can be used for the noise source description. These issues are analyzed in this work. Two-point cross-correlation of the jet noise is used to determine the multipole type of sources. Modeling of the cross-correlation provides clear evidence in favor of the quadrupole type of the jet noise sources. In the context of the second issue the recently developed two-stage correlation model is tested on the basis of measurements of azimuthally decomposed jet noise. The results show a promising agreement in a wide range of parameters.
Evaluation of Upper Limb Sense of Position in Healthy Individuals and Patients after Stroke
Authors: Cusmano I. , Sterpi I. , Mazzone A. , Ramat S. , Delconte C. , Pisano F. , Colombo R.
Published: June 2014

The aims of this study were to develop and evaluate reliability of a quantitative assessment tool for upper limb sense of position on the horizontal plane. We evaluated 15 healthy individuals (controls) and 9 stroke patients. A robotic device passively moved one arm of the blindfolded participant who had to actively move his/her opposite hand to the mirror location in the workspace. Upper‐limb′s position was evaluated by a digital camera. The position of the passive hand was compared with the active hand′s ‘mirror’ position. Performance metrics were then computed to measure the mean absolute errors, error variability, spatial contraction/expansion, and systematic shifts. No significant differences were observed between dominant and non‐dominant active arms of controls. All performance parameters of the post‐stroke group differed significantly from those of controls. This tool can provide a quantitative measure of upper limb sense of position, therefore allowing detection of changes due to rehabilitation.
Swab and instrument count practice: ways to enhance patient safety
Authors: Smith Yvonne , Burke Linda
Published: June 2014

This article presents the results of an audit of swab and instrument count practices in the operating department of a large hospital NHS Trust in South East England. A literature review of the subject is presented followed by the methodology used including questionnaires and observation of practice. Findings are discussed in terms of compliance with the department's swab and instrument count policy and observed practice mapped against the recommendations for best practice in the literature. The findings show that audit of practice is still treated with suspicion by many and that a number of practices of scrub and circulating personnel in operating theatres need to be improved. Recommendations are made related to improving staff development in the department and introducing clinical supervision as one way to provide support for colleagues to reflect on their practice and change to more evidence-based practices in the operating department.
Improving services for disabled children and their families
Authors: Glasper Alan , Evans Kath
Published: June 2014

Professor Alan Glasper and Kath Evans, Head of Patient Experience, NHS England, discuss two new reports from the charity, Contact a Family, which raises awareness of the experiences of parents of children with disabilities, and how families can engage better with health services
Development of acute kidney injury following a course of non-steroidal anti-inflammatory drugs
Authors: Coleman Adrian , Chai Mee Onn
Published: June 2014

Mr AA, a 42-year-old investment banker, was diagnosed with acute kidney injury after taking non-steroidal anti-inflammatory drugs. Adrian Coleman and Mee Onn Chai discuss the mechanisms of action and adverse effects of this commonly prescribed class of medication.
How do partners living with haemodialysis patients cope?
Authors: Avril-Sephula Beverley , Meekums Bonnie , Jackson Cath
Published: June 2014

Although research has demonstrated a considerable physical and psychosocial impact of dialysis on patients with end-stage renal failure, there is much less literature on the effect of dialysis on the partners of these patients. Beverley Avril-Sephula, Bonnie Meekums and Cath Jackson discuss the findings of this qualitative study on the coping strategies of dialysis patients' partners.
Reflecting on a decade of dialysis
Authors: Millar Christy
Published: June 2014

In 2006, Christy Millar collapsed in agony and was admitted to intensive care for 3 months. After being diagnosed with kidney failure, she was put on the transplant waiting list and has now been a dialysis patient for over 7 years. This article reflects on the role of renal nurses in Christy's journey.
Nutrition and renal diet on the agenda at the ISRNM conference
Authors: Johansson Lina
Published: June 2014

Clinical specialist renal dietitian, Lina Johansson, gives an overview of the topics covered at the 17th International Congress on Nutrition and Metabolism in Renal Disease, organised by the International Society of Renal Nutrition and Metabolism (ISRNM), including restricted protein diets, nutrition for older people with kidney disease, and under- and overnutrition.
Quality of life and self-esteem in patients with paraplegia and pressure ulcers: A controlled cross-sectional study
Authors: Lourenco L. , Blanes L. , Salomé G.M. , Ferreira L.M.
Published: June 2014

Objective:

To evaluate health-related quality of life (HRQoL) and self-esteem in patients with traumatic spinal cord injury (SCI) and pressure ulcers.

Method:

This study was a controlled cross-sectional study. HRQoL was assessed using the generic Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) questionnaire and the Rosenberg Self-Esteem/UNIFESP-EPM Scale. A total of 120 patients with traumatic SCI were included in the sample, of which 60 had pressure ulcers and were assigned to the study group, and 60 had no pressure ulcers and were assigned to the control group. Statistical analysis was performed using the chi-square test, Fisher's exact test, and Student's t-test.

Results:

Of the 60 patients in the study group, 83.3% were men and the mean age was 38.17 years (SD = 9.08 years). When compared with controls, patients in the study group reported significantly lower scores (worse health status) on all SF-36 subscales (p≤0.0013) except for general health (p=0.109). The RSE/UNIFESP-EMP scale total score indicated that patients with pressure ulcers had significantly lower self-esteem than controls (p<0.001).

Conclusion:

Pressure ulcers had an adverse impact on the HRQoL and self-esteem of patients with SCI.

Declaration of interest:

There were no external sources of funding for thist study. The authors have no conflicts of interest to declare.
The Grand Protocol Shakeup
Authors: Jones Mark
Published: June 2014

For years June Crown has been looking into who can prescribe and administer medicines.

Mark Jones looks at why and at the first part of the report dealing with group protocols.
Readers respond
Authors: Gupta Karen
Published: June 2014

Disappointed again by nurse prescribing

An excellent time was had by all – but let's not forget the serious messages of the National Conference
Applying Paste Bandages
Authors: Williams Katherine
Published: June 2014

The aim of this article is to give practice nurses a basic guide to applying a paste bandage correctly. Research has shown that nurses do not receive adequate training in bandaging (Thomas, 1993), and this is especially true in the application of paste bandaging.
Polysaccharide Bead Dressings
Authors: Pudner Rosie
Published: June 2014

This fourth article in the series on wound dressing products examines the use of polysaccharide bead dressings in the management of exuding sloughy or infected wounds. The properties of the dressing products will be discussed, followed by the method of application and removal of the dressings. The polysaccharide dressings which will be discussed are Debrisan, Iodosorb and Iodoflex.
Portfolio Opportunities
Authors: Hakesley-Brown Roswyn
Published: June 2014

It is late February in the year 2001. You are a senior practice nurse and member of your local primary care group (PCG) which consists of general practitioners and other community health/social care colleagues. The PCG has been in existence since April 1999 and has recently been earmarked to become a free-standing primary care trust (PCT) in the new financial year.
Patients Need More Than Antihypertensives Alone
Authors: Meredith Peter
Published: June 2014

Since the 1950s, antihypertensives have evolved gradually — not only towards more effective drugs, but also towards better tolerated agents. For example, although the first antihypertensives effectively lowered blood pressure, their side effects were such that only patients suffering from grossly elevated blood pressure and who were in danger of imminent death received them.
Patient Profiling In Hypertension
Authors: Beevers Michèle
Published: June 2014

No two patients are alike, and where blood pressure is concerned management should be tailored to the individual.
Administration of depot neuroleptics: a protocol
Authors: Oldam Diana
Published: June 2014

The administration of depot neuroleptics by practice nurses with no mental health training has been a matter of continuing concern over the last few years. The Department of Health (DoH) in 1995 and The Royal College of Nursing (RCN) in 1996 both circulated leaflets on the subject to primary care, and articles in journals, such as that by Florence Cantle in Practice Nursing in 1997 have raised awareness of the problems for practice nurses who are asked to administer the medication.
Our healthier nation
Authors: McQuarrie Rosemary
Published: June 2014

The broad aim of the green paper is to get the population fit for the 21st Century (Table 1). It will strive to achieve this by establishing what is described as a national contract for better health in which the Government, local communities and individuals will all work together to improve the health of all citizens.
Managing vaginal candida
Authors: Bayliss Jane
Published: June 2014

Mention Thrush to many women and the speckled songbird is not what springs to mind. Thrush is the common name given to the unpleasant condition of vaginal candidiasis. Approximately 50% of women of childbearing age will have experienced this condition at some time and up to one third of them will have the condition more than once (Seal, 1997). Although it tends to occur most often in sexually active women, it can also occur in those who are celibate or have not started sexual activity. Men can also develop candidiasis on their penis, although this tends to be less common.
Chronic obstructive pulmonary disease
Authors: Booker Rachel
Published: June 2014

Many practice nurses involved in asthma management will be familiar with the ‘heart sink’ patient for whom asthma treatment, no matter how vigorous, appears to have little benefit. Such patients are often middle aged or elderly current or ex-smokers. Many will, in fact, have chronic obstructive pulmonary disease (COPD).
Use of practice protocols
Authors: Jones Mark
Published: June 2014

As discussed by Fennessy in the accompanying article, the term protocol is often used to describe a guideline to practice and/or a systematic framework in which a particular aspect of practice takes place. When we speak of protocols in general practice, we are generally referring to a pre-agreed approach to a particular aspect of patient care which assists all of those involved in the care process in doing their work thoroughly, competently and consistently.

In the second of this series, Mark Jones discusses the pros and cons of using protocols.
Anaemia: Treating the cause
Authors: Parker NE
Published: June 2014

Anaemia may be defined as a deficiency of haemoglobin, the oxygen carrying protein. Anaemia is an indicator of a problem and not a final diagnosis, there are many possible causes and it is important to investigate these appropriately. Members of the public may self-prescribe iron when told that they are anaemic, this may treat the anaemia but, as will be shown, this is never good practice and may be harmful. It is important that patients should understand this.

Anaemia is a symptom of many conditions, but the cause needs to be identified to treat it effectively.
Council spreads responsibility
Authors: Richards Sue
Published: June 2014

Reform of the UKCC disciplinary procedures gives practitioners a bigger role. Sue Richards explains the changes that have been made.
Clinical governance within primary care
Authors: Baker Nicola
Published: June 2014

Clinical governance is a term being used in reference to health care quality. Is it yet more NHS jargon?

Emerging from the Government White Paper The New NHS: Modern. Dependable (DOH, 1997), it has the potential to make an impact on health care at all levels. Some guidance has already been incorporated in the more recent White Paper A First Class Service: Quality in the new NHS (DOH, 1998), but health professionals, particularly in primary care groups (PCGs) are awaiting further information.
How To… Venepuncture
Authors: Griffiths Elizabeth
Published: June 2014

Venepuncture is a procedure which is frequently practised by primary care nurses, whether it be in GP surgeries, in clinics or in patients' own homes. Venepuncture is the term applied to the procedure of entering a vein with a needle (Pritchard & Mallett, 1992).

Elizabeth Griffiths offers a step by step guide for nurses in how to take blood.
Emotional problems 3: management
Authors: Watkins Jean
Published: June 2014

This is the third in a series of three articles that looks at the practice nurse's role in dealing with patient's emotional problems. The two previous articles (Watkins, 1999a, 1999b) provided an overview of the subject, and looked at how these problems can manifest themselves in the surgery. This article looks at how emotional problems should be managed.
How to…Take a cervical smear
Authors: Paniagua Hilary
Published: June 2014

Cervical smears can serve to reduce the incidence and mortality of cervical cancer by identifying the disease in an asymptomatic precancerous stage, facilitating early intervention and potential curability. Central to this is the ability to take smears accurately, as poor sampling can result in missing 20% or more of precancerous abnormalities (Paniagua, 1997). The effectiveness of the cervical screening programme and the saving of lives, therefore, lies in the quality of smears taken.

Hilary Paniagua provides a step-by-step explanation of the process of taking a cervical smear
Walk-in Clinic: Gastro-oesophageal reflux disease
Authors: Johnson Wendy , Johnson Stephen
Published: June 2014

Gastro-oesophageal reflex disease affects 7% of the population, a figure which is increasing.

Gastro-oesophageal reflux disease (GORD) is the abnormal reflux of gastroduodenal contents into oesophagus, through an incompetent gastro-oesophageal junction (Galmiche et al, 1998), which may lead to oesophageal inflammation. Typical symptoms are heartburn, a burning retrosternal pain, which may radiate to the throat, and regurgitation. It is a common problem, affecting 7% of the adult population at any one time (Jones et al, 1990), and its incidence is increasing. The average GP sees at least one new case per week.

Wendy and Stephen Johnson describe its causes, symptoms and management
Primary care in the real world
Authors: Watkins Jean
Published: June 2014

In a recent defence of his decision to push ahead with the expansion of walk-in centres and NHS Direct, Tony Blair has maintained that GPs will then ‘gain more time for serious cases’. As such one must assume that he is talking about the undoubted problems of acute physical and mental illness, cardiovascular disease, cancer and other long-term problems of such as rheumatoid or osteoarthritis.

Jean Watkins warns of the dangers of the rush to embrace walk-in centres and NHS Direct in favour of traditional general practice
Telemedicine within primary care
Authors: Sibson Lynda
Published: June 2014

Lynda Sibson gives the nursing perspective on the new technology that can bring consultants ‘virtually’ into the practice
Prescribing and practice nursing
Authors: Baird Anne
Published: June 2014

The recommendation that certain groups of nurses should be granted limited prescribing rights was first proposed in the Neighbourhood Nursing Review, (DHSS, 1986).The review team noted that district nurses in particular wasted much time requesting prescriptions from GPs, and proposed that a limited list of items which could be prescribed by nurses should be devised. This suggestion was taken forward in the Report of the Advisory Group on Nurse Prescribing (DoH, 1989), which examined the circumstances in which nurses should be able to prescribe.

Anne Baird gives an overview of the nurse prescribing situation to date
What is hypertension?
Authors: Cowley Nigel
Published: June 2014

Hypertension is a common condition affecting about 18% of the population. With the rare exception of malignant hypertension (diastolic >140mmHg), there are no symptoms, hence it is known as the silent killer. It is a major risk factor for heart disease, the commonest form of death in the developed world.

Dr Nigel Cowley provides an overview of this common problem
Treatment of hypertension
Authors: Chapman John , Bent Marie
Published: June 2014

Nurses are increasingly taking on responsibilities previously undertaken by doctors. Hypertension is an example of a therapy where nurse intervention could be of benefit. Over 25% of elderly people become hypertensive, as do more than 50% of type 2 diabetics, and recent evidence suggests that these groups of people benefit from being managed more aggressively than was previously recognized.

Dr John Chapman and Mary Bent look at the treatments available
Taking an accurate blood pressure
Authors: Ilves Peter
Published: June 2014

Over the past few years there have been many minor and major changes in the management of hypertension. At times it is difficult for us to keep up with these and translate this into appropriate patient care. We are all now aware that tight control across all age groups shows positive outcomes in morbidity and mortality. We are also aware that managing other risk factors such as smoking, obesity, hyperchloesterolemia, salt intake and diabetes, to name a few, is vital.

Dr Peter Ilves provides an overview of the current guidelines
Walk-in Clinic Amenorrhoea
Authors: Johnson Wendy , Johnson Stephen
Published: June 2014

Amenorrhoea is defined as the absence of menstrual periods and is classified as primary — the failure of occurrence of the first menstrual period by age 16 — and secondary — when a woman with previously regular menses misses six or more periods (Gupta and Fergusson, 1997). It is very common — a Swedish study showed 1.8% of women experienced 6months or more of amenorrhoea, occurring most often in those aged under 24 (Guillebaud, 1993).

Wendy and Stephen Johnson examine the causes and treatment of this alarming condition
Ensure Safety By Careful Warfarin Monitoring
Authors: Baird Anne
Published: June 2014

Previous articles in this series have looked at the clotting process and the pharmacology of warfarin.

In this article, the various indications for anticoagulation and the monitoring necessary to achieve a safe and effective regime will be discussed.