bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of pyogenic liver abscesses caused by hypermucoviscous Klebsiella pneumoniae and non-Klebsiella pneumoniae pathogens in Beijing: A retrospective analysis
Authors: Wang Jing , Yan Yan , Xue Xinying , Wang Kaifei , Shen Dingxia
Published: June 2013

Objective

To perform a retrospective comparison of the clinical and radiological features of Klebsiella pneumoniae (KP)-associated and non-KP-associated pyogenic liver abscesses (PLA) in Chinese patients.

Methods

Patients with confirmed diagnoses of bacterial liver abscess at three Beijing hospitals were enrolled. Clinical isolates from liver abscesses were used to determine serology and expression of hypermucoviscosity genes. Basic clinical, ultrasonographic (US) and computed tomography (CT) data were recorded and compared between patients with KP- and non-KP-associated PLA.

Results

A total of 101 (77.10%) and 30 (22.90%) cases were due to KP and non-KP pathogens, respectively. Compared with the non-KP cohort, the KP cohort demonstrated a significantly higher incidence of underlying diabetes mellitus, and more gas-forming abscesses, as demonstrated by US and CT examinations. Prior abdominal surgery or chemoradiation therapy was significantly associated with non-KP cases. The non-KP group had a higher chance of a clear edge, compared with the KP group, on pre-contrast CT images.

Conclusion

KP and non-KP-associated PLA have distinctive risk factors and unique US and CT features, in Chinese patients.
Philosophy and Art: Changing Landscapes for Aesthetics
Authors: Carter Curtis L.
Published: June 2013

Part I of this essay will examine how the interplay between philosophy and art over the past century is reflected in the aesthetic theories of four leading Twentieth century aestheticians: Walter Benjamin, Merleau-Ponty, Gilles Deleuze, Arthur Danto. The philosophers’ theories are linked to the developments in art most directly related to their respective approaches to problems in aesthetics. Part II will explore selected non-philosophical social and technological developments that are in the process of altering the course of contemporary art today. Among these are globalization, the art market, social/political issues, popular culture, virtual reality, and new manifestations of the avant-garde. Key factors that warrant consideration for future developments in aesthetics are identified in the hope that today’s and future aestheticians will begin to consider what changes are required in aesthetics to address these new developments in art.
10 Years after Baby-Friendly Designation
Authors: Parker Margaret , Burnham Laura , Cook John , Sanchez Emily , Philipp Barbara L. , Merewood Anne
Published: June 2013

Background:

Mothers of preterm and sick infants admitted to the neonatal intensive care unit (NICU) often encounter more difficulties with breastfeeding than mothers of healthy term newborns. The extent to which Baby-Friendly designation is associated with breastfeeding rates for NICU infants over time is unknown.

Objective:

This study aimed to determine the rate of breastfeeding initiation and continuation in a US, inner-city, level 3 NICU 10 years after Baby-Friendly designation.

Methods:

We compared the rate of breastfeeding initiation and continuation among breastfeeding-eligible mothers with infants admitted to the Boston Medical Center NICU in 1999 and 2009, using chi-square tests.

Results:

Breastfeeding initiation increased from 74% in 1999 to 85% in 2009 ( P = .04). Any breast milk at 2 weeks of age increased from 66% to 80% ( P = .05), and exclusive breastfeeding at 2 weeks remained stable between 1999 and 2009. Breastfeeding initiation increased from 68% to 86% among black mothers from 1999 to 2009 ( P = .01).

Conclusion:

Improvement in breastfeeding initiation and any breastfeeding at 2 weeks of age continued 10 years after Baby-Friendly designation among mothers with NICU infants in a US, inner-city, level 3 NICU.
Anthropometric Characteristics and Undernutrition Among Older Persons in a Rural Area of Northern India
Authors: Jamir Limalemla , Kalaivani Mani , Nongkynrih Baridalyne , Misra Puneet , Gupta Sanjeev Kumar
Published: June 2013

This community-based cross-sectional study was conducted to assess anthropometric characteristics and estimate the prevalence of undernutrition among older persons in rural Ballabgarh, Haryana, India. A total of 948 participants aged 60 years and above were examined. Their weight, arm span, mid-upper-arm circumference, triceps skinfold thickness, and calf circumference were measured using standard techniques. The prevalence of undernutrition was estimated to be 53.7% (95% confidence interval [CI] = 50.5-56.9). Logistic regression analysis was done to identify factors independently associated with undernutrition. In the assessment of anthropometric characteristics, the strongest correlation was observed between body mass index and mid-upper-arm circumference ( r = 0.88; P < .0001). Receiver operating characteristic analysis showed that mid-upper-arm circumference has a higher ability (area under curve = 0.93; 95% CI = 0.91-0.96) of detecting undernutrition among older persons than triceps skinfold thickness and calf circumference. The high prevalence of undernutrition among older persons in rural India warrants major public health interventions.
Changes in Intimate Partner Violence Among Women Mandated to Community Services
Authors: Macy Rebecca J. , Rizo Cynthia F. , Guo Shenyang , Ermentrout Dania M.
Published: June 2013

Increasingly, female victims of intimate partner violence (IPV) are charged with IPV perpetration and mandated by courts or child protective services to receive domestic violence services. A critical need exists for evidence-based interventions targeting the needs of this unique population, but such research is scarce. To address this gap, we evaluate a novel intervention developed by two community-based agencies and delivered to 70 female IPV victims who are primary caregivers for children and mandated to services. Using a quasi-experimental design, IPV perpetration and victimization data are collected at three time points: baseline, program completion, and 3-month follow-up. Analyses use binary logistic regression to control for clustering and to incorporate time-varying covariates. Results show statistically significant reductions in both IPV victimization and perpetration at program completion. This study also provides evidence for the feasibility of recruiting and retaining this vulnerable group of IPV victims in research studies conducted in community-based settings.
Patient–Provider Delays in Superior Vena Caval Obstruction of Lung Cancer and Outcomes
Authors: Ampil Federico L. , Caldito Gloria
Published: June 2013

This retrospective study investigates the types of delay in the initiation of palliative thoracic radiotherapy for superior vena caval obstruction (SVCO) of lung cancer (LCa) and the effect of treatment delay on patient outcomes. Treatment delays were categorized as patient delay (duration of symptoms), in-hospital delay, and professional delay and were determined in 42 people treated by radiation for palliation of the complicated neoplastic condition between 1981 and 2009. The median period of patient delay was 26.2 days, in-hospital delay was 3.5 days, and professional delay was 1.5 days. The majority (80%) of these individuals were uninsured or underinsured, and 69% presented with locally advanced LCa. The overall response rate was 84%, and the 1-year survival rate was 24%. Despite the longest patient-related delay, symptomatic individuals overall derived palliation from conventional treatment. Improved efforts toward early diagnosis and treatment of patients with SVCO-LCa need to be continued.
Correlation of AO and Lauge-Hansen Classification Systems for Ankle Fractures to the Mechanism of Injury
Authors: Rodriguez Edward K. , Kwon John Y. , Herder Lindsay M. , Appleton Paul T.
Published: June 2013

Background:

Our aim was to assess whether the Lauge-Hansen (LH) and the Muller AO classification systems for ankle fractures radiographically correlate with in vivo injuries based on observed mechanism of injury.

Methods:

Videos of potential study candidates were reviewed on YouTube.com . Individuals were recruited for participation if the video could be classified by injury mechanism with a high likelihood of sustaining an ankle fracture. Corresponding injury radiographs were obtained. Injury mechanism was classified using the LH system as supination/external rotation (SER), supination/adduction (SAD), pronation/external rotation (PER), or pronation/abduction (PAB). Corresponding radiographs were classified by the LH system and the AO system.

Results:

Thirty injury videos with their corresponding radiographs were collected. Of the video clips reviewed, 16 had SAD mechanisms and 14 had PER mechanisms. There were 26 ankle fractures, 3 nonfractures, and 1 subtalar dislocation. Twelve fractures with SAD mechanisms had corresponding SAD fracture patterns. Five PER mechanisms had PER fracture patterns. Eight PER mechanisms had SER fracture patterns and 1 had SAD fracture pattern. When the AO classification was used, all 12 SAD type injuries had a 44A type fracture, whereas the 14 PER injuries resulted in nine 44B fractures, two 44C fractures, and three 43A fractures.

Conclusion:

When injury video clips of ankle fractures were matched to their corresponding radiographs, the LH system was 65% (17/26) consistent in predicting fracture patterns from the deforming injury mechanism. When the AO classification system was used, consistency was 81% (21/26). The AO classification, despite its development as a purely radiographic system, correlated with in vivo injuries, as based on observed mechanism of injury, more closely than did the LH system.

Level of Evidence:

Level IV, case series.
Feature extraction of handwritten numeric characters and recognition using an artificial neural network: a new approach
Authors: Latha J , Devarajan N
Published: June 2013

Character recognition has been an active area of research and, due to its diverse applicable environment, it continues to be a challenging research topic. The data entry form is a convenient and successful tool for collection of information by filling the sheets with handwritten characters. For many purposes, such as documenting and archiving, extracting the handwritten characters is important. One of the most important fields in these forms is the data-filled boxes. The extraction process is important in processes of handwritten recognition techniques. Feature extraction plays an important role in different classification-based problems, such as face recognition, signature verification, optical character recognition (OCR), etc. The performance of OCR highly depends on the proper selection and extraction of a feature set. Different feature extraction methods are designed for different representations of the characters. The holistic approach is focused on feature extraction of the entire image and recognition using a neural network. This work proposes a subspace approach that regularizes and extracts Eigen features from handwritten numerals. Extracted Eigen features are recognized using a neural network. The proposed algorithm has been successfully implemented and has the added advantage of obtaining the extraction and recognition result at the same time.
Simultaneous determination of amino acid nitrogen and total acid in soy sauce using near infrared spectroscopy combined with characteristic variables selection
Authors: Zhao Jiewen , Ouyang Qin , Chen Quansheng , Lin Hao
Published: June 2013

Amino acid nitrogen and total acid are two most important quality indices to assess the quality of soy sauce in China. This work employed near infrared spectroscopy combined with synergy interval partial least square and genetic algorithm to detect amino acid nitrogen and total acid content in soy sauce. First, synergy interval partial least square was used to select efficient spectral regions from the full spectrum region; and then, genetic algorithm was used to selected variables from the efficient spectral regions, to build partial least square model. The optimal genetic algorithm synergy interval partial least square models were obtained as follows: Rc = 0.9988 and Rp = 0.9988 for amino acid nitrogen content model using 64 variables; Rc = 0.9917 and Rp = 0.9902 for total acid content model using 81 variables. Genetic algorithm synergy interval partial least square models showed superiority over the partial least square and synergy interval partial least square models. The results indicated that amino acid nitrogen and total acid content in soy sauce could be rapidly determined by near infrared spectroscopy technique. Also, the results indicated that genetic algorithm synergy interval partial least square can improve the performance in measurement of amino acid nitrogen and total acid content by near infrared spectroscopy.
Combined effect of nisin, carvacrol and a previous thermal treatment on the growth of Salmonella enteritidis and Salmonella senftenberg
Authors: Esteban María-Dolores , Aznar Arantxa , Fernández Pablo S , Palop Alfredo
Published: June 2013

The aim of this study was to evaluate the combined effect of a previous mild heat treatment (15 min at 55 ℃) with the use of antimicrobials, nisin and carvacrol, on the growth of Salmonella enteritidis and Salmonella senftenberg. Natural antimicrobials, alone or combined with a previous mild heat treatment, affected the growth of these two serovars in Tryptone Soy Broth at 37 ℃. Increasing concentrations of carvacrol had a significant effect on both growth rate and lag phase duration of both strains. The time to reach stationary phase was almost doubled in the case of S. enteritidis when a concentration of 0.77 mM in carvacrol was added. For S. senftenberg the effect was smaller. The effect of nisin and of heat, applied individually, was lower for both microorganisms. A combination of 1.2 µM nisin with 0.77 mM carvacrol significantly delayed the growth of heat treated cells, compared to the control without antimicrobials, showing additive effects.
Antioxidant activity and inhibitory effects of lead (Leucaena leucocephala) seed extracts against lipid oxidation in model systems
Authors: Benjakul Soottawat , Kittiphattanabawon Phanat , Shahidi Fereidoon , Maqsood Sajid
Published: June 2013

Antioxidant activity of brown lead ( Leucaena leucocephala) seed extracts with and without prior chlorophyll removal was studied in comparison with mimosine. Both extracts showed similar hydroxyl radical (HO•) scavenging activity, hydrogen peroxide (H2O2) scavenging activity, singlet oxygen inhibition and hypochlorous acid (HOCl) scavenging capacity ( p > 0.05). Nevertheless, the extract without prior chlorophyll removal had higher oxygen radical absorbance capacity than that with prior chlorophyll removal ( p < 0.05). Generally, lead seed extracts with and without prior chlorophyll removal possessed a lower antioxidant activity, compared with mimosine. When lead seed extract without prior chlorophyll removal (100 and 200 ppm) was used in different lipid oxidation model systems, including β-carotene-linoleic acid and lecithin liposome systems, the preventive effect toward lipid oxidation was dose-dependent. At the same level of use, mimosine exhibited a higher efficacy in prevention of lipid oxidation in both systems as indicated by the lower increases in thiobarbituric acid reactive substances. A similar result was obtained in minced mackerel. Therefore, lead seed extract containing mimosine could act as a natural antioxidant to prevent lipid oxidation in foods.
Light gazpachos contain higher phytochemical levels than conventional gazpachos
Authors: Vallverdú-Queralt Anna , Medina-Remón Alexander , Estruch Ramón , Lamuela-Raventós Rosa M
Published: June 2013

Light gazpachos in comparison with conventional alternatives are interesting because of their low percentage of fat and high content of bioactive compounds that are beneficial for human health. An hybrid quadrupole time-of-flight mass spectrometer was used to identify those metabolites that have the greatest impact on the overall metabolic profile in light gazpachos as compared to conventional alternatives. Individual polyphenols were quantified using liquid chromatography-electrospray ionization tandem mass spectrometry. Data obtained revealed that light gazpachos displayed a higher significant phytochemical content than conventionally produced alternatives. The compounds found in significantly higher ( p < 0.05) amounts in light versus conventional gazpachos were: caffeoylquinic and dicaffeoylquinic acids, caffeic and caffeic acid hexosides, kaempferol-3- O-rutinoside, ferulic and ferulic acid hexosides, naringenin-7- O-glucoside, naringenin, rutin and quercetin. Light gazpachos may play a crucial role in terms of health benefits (lower fat and higher bioactive compound intake). Higher consumption levels of phenolic compounds, which are greater in light products, along with caloric restriction and physical activity may be helpful in preventing obesity.
Acta Non Verba? The Role of Customer Participation and Word of Mouth in the Relationship Between Service Firms’ Customer Satisfaction and Sales Performance
Authors: Eisingerich Andreas B. , Auh Seigyoung , Merlo Omar
Published: June 2013

Evidence has shown that satisfied customers do not necessarily buy more of a company’s products and services, thus spurring researchers to look for a missing link between customer satisfaction and purchase behavior. Word of mouth (WOM) has been advocated as the elusive missing link and as a key indicator of customer-firm relationship strength. Yet, WOM is only one type of customer voluntary performance (CVP). In this study, a second type of CVP, namely customer participation (i.e., customers’ willingness to provide the firm with constructive feedback and suggestions), is argued to be crucial to ensure that a satisfied customer repurchases. The authors develop and test a model that predicts that satisfied customers repurchase when they become productive resources through two spontaneous and cooperative customer behaviors: WOM and participation. The empirical findings support the predictions, thus complementing and extending previous research. This research suggests that while WOM has been heralded as an important factor in firm growth, another factor that is at least equally if not more important to future sales is customer participation.
The Effect of Rank on Police Women Coping With Discrimination and Harassment
Authors: Haarr Robin N. , Morash Merry
Published: June 2013

Qualitative data from 21 in-depth interviews with women in two metropolitan departments reveals how rank and tenure affected responses to negative coworker actions and attitudes. Most women abandoned putting up with harassment and bias after their earliest years in policing, but consistently felt compelled to respond to officers’ tests of their abilities. High-rank women used coping strategies that provided some protections from assaults on their identities and negative treatment from coworkers. Certain coping strategies may enable some women to move up in rank. The power that comes with rank enabled women to take on unique approaches to addressing workplace discrimination and harassment.
Using digital and instant film photography for research documentation: a research note
Authors: Hinthorne Lauren Leigh
Published: June 2013

This research note investigates the potential of digital and instant film photography as distinct approaches to research documentation. It argues that the quality of visual evidence provided by photographs may depend in part on the researcher’s ability to reliably link images with other sources of data. The research note goes on to contextualize instant film photography as a tested documentation technique, though one not commonly used in qualitative research. Benefits and constraints associated with instant film technology are also discussed. It concludes that instant film photography could have advantages over digital photography when used for multimodal documentation of fast-paced research processes.
Off the corner and into the kitchen: entering a male-dominated research setting as a woman
Authors: Soyer Michaela
Published: June 2013

Drawing on ethnographic data about 15 juvenile offenders, collected before and after my own pregnancy, this article shows how becoming a mother enabled me to access a previously closed-off research site while studying young male offenders on Chicago’s South Side. In this study, I introspectively reflect on the obstacles female ethnographers may encounter as they are trying to build rapport in a male-dominated setting. My narrative shows that the apprentice role, often adopted by male ethnographers of the American inner city, may be challenging for women to take on. Sexual advances and limited access to male-only spheres can significantly impede data collection. Yet, as I will demonstrate, women can alternatively rely on nonsexual, gender-specific roles, such that of a mother, not only to build rapport but also to broaden the perspective on field sites that have largely been explored from a male point of view.
Incommensurability and moral value
Authors: Reiff Mark R
Published: June 2013

Some theorists believe that there is a plurality of values, and that in many circumstances these values are incommensurable, or at least incomparable. Others believe that all values are reducible to a single super-value, or that even if there is a plurality of irreducible values these values are commensurable. But I will argue that both sides have got it wrong. Values are neither commensurable nor incommensurable, at least not in the way most people think. We are free to believe in incommensurability or not, depending on what particular conception of morality we want to embrace. Incommensurability is accordingly not a theory about value. It is a presupposition that provides a necessary background condition for a certain kind of value to exist. It is therefore not the kind of view that can be morally true or false. As a presupposition, it can only be accepted or rejected on grounds that do not presuppose that morality already exists. Incommensurability is, like the rejection of hard determinism, one of the presuppositions on which morality as we know it happens to be based.
Participant observation at a youth HIV conference
Authors: Greifinger Rena , St. Louis Gemima , Lunstead Julie , Malik Neha , Vibbert Martha
Published: June 2013

Young people living with HIV in the US have the potential to live long and healthy lives. However, the psychosocial impact of an HIV diagnosis, complicated by poverty, inequality, stigma and marginalization, create structural and behavioral challenges for young people that can overwhelm them and their health care providers. This narrative provides a reflective analysis of insights and discussions captured through participant observation at a five-day conference for young people living with HIV. The manuscript provides practitioners with an additional interpretive lens, highlighting participant observation as a valuable methodology to better understand and design programs for young people living with HIV. The article calls for youth-led, peer-based approaches that focus on support for disclosure of HIV status, self-esteem in relationships and adherence to medication.
Patterns, designs and developments in qualitative research in social work: A research note
Authors: Shaw Ian , Ramatowski Ann , Ruckdeschel Roy
Published: June 2013

By way of review of the first decade of this journal’s life, we consider, first, how far the journal Qualitative Social Work offers a case study of qualitative research in social work – its patterns, designs and developments. Second, and as a subsidiary intention, we develop the field-testing of a relatively full framework for understanding kinds, purposes and methods of social work research.
Social class and Japanese mothers’ support of young children’s education: A qualitative study
Authors: Yamamoto Yoko
Published: June 2013

The impact of social class backgrounds on young children’s educational experiences has attracted increasing attention in early childhood research. However, few longitudinal studies related to social class and parental involvement in young children’s education are available, especially in East Asian contexts. In this longitudinal qualitative study, I examined middle-class and working-class mothers’ beliefs related to education and processes through which they support their children’s education from preschool to second grade in Japan. Sixteen Japanese mothers were recruited from preschools and four in-depth interviews along with home visits were conducted over 3 years. Findings of this study demonstrated that both middle-class and working-class mothers hoped that their children would do well academically, but their beliefs related to parenting roles and development of the children’s learning interest differed. Such distinctive maternal beliefs affected their ways of supporting their children’s education in everyday contexts.
Incentives and Barriers to Research Participation and Brain Donation Among African Americans
Authors: Schnieders Tyler , Danner Deborah D. , McGuire Caitlin , Reynolds Flores , Abner Erin
Published: June 2013

Successful African American recruitment for aging research requires sensitivity to factors that influence participation. In this work, a structured face-to-face educational interview was used to recruit African Americans for a longitudinal aging study and to collect information about attitudes related to research. The interview was designed to build trust and respect for research and to educate participants about the need for minority participants. Of the 91 African Americans aged 65 and older who completed interviews, 65 (71%) agreed to participate in the longitudinal study and approximately half agreed to brain donation. Those who enrolled and consented to brain donation were more likely to consider benefit to themselves or direct family unit as the main motivator for participation ( P < .01). The study also found a significant increase in agreement to brain donation across enrollment periods ( P = .0005).
Social Studies Progress Monitoring and Intervention for Middle School Students
Authors: Beyers Sarah J. , Lembke Erica S. , Curs Bradley
Published: June 2013

This study examined the technical adequacy of vocabulary-matching curriculum-based measurement (CBM) to identify and monitor the progress of 148 middle school students in social studies. In addition, the effectiveness of a reading comprehension intervention, Collaborative Strategic Reading (Klingner, Vaughn, Dimino, Schumm, & Bryant, 2001), was examined across 8 weeks with 15 low-achieving middle school readers who were monitored with content-area reading passages. Results indicated vocabulary-matching CBMs are valid and reliable indicators of performance in social studies. Significant differences were found for the intervention group on performance on pre to post vocabulary-matching CBM scores. Difference-in-Differences regression models were used to examine differences between groups on pre–post measures. No significant differences were found between groups in weekly change in scores or trend in performance on vocabulary-matching CBM.
The Use of Antioxidants in Radiotherapy-Induced Skin Toxicity
Authors: Amber Kyle T. , Shiman Michael I. , Badiavas Evangelos V.
Published: June 2013

Radiation-induced skin damage is one of the most common complications of radiotherapy. In order to combat these side effects, patients often turn to alternative therapies, which often include antioxidants. Antioxidants such as those in the polyphenol chemical class, xanthine derivatives, tocepherol, sucralfate, and ascorbate have been studied for their use in either preventing or treating radiotherapy-induced skin damage. Apart from their known role as free radical scavengers, some of these antioxidants appear to alter cytokine release affecting cutaneous and systemic changes. We review the role of antioxidants in treating and preventing radiation-induced skin damage as well as the possible complications of using such therapy.
Improving Prenatal Health
Authors: Guadagno Marie , Mackert Michael , Rochlen Aaron
Published: June 2013

The U.S. infant mortality rate is among the highest in the developed world, with recent vital statistics reports estimating 6.14 infant deaths per 1,000 live births. Traditional health education and promotion to improve maternal, infant, and child health in the United States has focused only on women, leaving men out of important health messages that may affect pregnancy outcomes as well as family well-being. Recently, public health scholars have suggested that men be included in prenatal health education in an effort to improve birth outcomes and reduce infant mortality. Incorporating men in prenatal health promotion and education has been found to improve overall birth preparedness, reduce the risk of maternal–infant HIV transmission, and reduce perinatal mortality in less-developed nations. Although these results are positive, research on paternal impact in pregnancy outcomes in the United States to date is lacking. This article proposes a U.S.-specific research agenda to understand the current role of men in pregnancy health, as well as actual involvement, barriers, and the influence men can have in prenatal health. A discussion of culture, individual motivations, health care providers, and social marketing is also considered.
Conflict on the treatment floor: an investigation of interpersonal conflict experienced by nurses
Authors: Wright Robert R. , Mohr Cynthia D. , Sinclair Robert R.
Published: June 2013

Nurse conflict has numerous detrimental outcomes for healthcare organisations, patients and nurses themselves. Although past literature has advanced general understanding of conflict and aggression, much of it is limited in its explanation of negative interactions between nurses themselves. To address this, we used a mixed-method approach to identify and describe characteristics of conflict between nurses using content analysis of qualitative descriptions and associated quantitative ratings from practicing registered nurses over 12 weeks of a weekly work experience survey administered online. We found six reliable themes describing the nature of nurse conflict including such characteristics as feeling unfairly treated, others’ irresponsible behaviours and work disagreement. Conflicts containing perceived unfair treatment as well as negative emotion and rude behaviour between nurses were rated very negatively. Results suggest that a comprehensive workplace conflict prevention strategy should include multiple types of policies tailored to address each aspect of nurse conflict. Our findings reinforce the idea that healthcare organisations seeking to reduce nurse conflict should pay attention to promoting fair and courteous treatment among nurses as well as adopt policies to improve features of the work environment such as staffing and training.
Difficulty, despair and hope – an insight into the world of the health professionals treating paediatric pain in sub-Saharan Africa
Authors: Clancy Marie Anne
Published: June 2013

The recognition and treatment of paediatric pain in sub-Saharan Africa brings many challenges and barriers for health professionals to overcome. This paper aims to give a unique insight into the world of the health professional through a dynamic cycle of interpretation via Interpretative Phenomenological Analysis. In-depth interviews with six health professionals were conducted and revealed four main themes: a burden-filled workload, mythology, lack of education and pharmacology. Findings showed how working in this field affects health professionals personally; the task of treating children who suffer unnecessary pain is emotive and potentially damaging. The way in which parents, health professionals and children view pain in terms of their everyday existence and within the context of their culture seems fundamental to gaining a better understanding of the barriers to providing pain relief to children in sub-Saharan Africa.
On risk reduction principles in the context of maintenance optimisation modelling
Authors: Flage Roger
Published: June 2013

This article addresses the relation between maintenance optimisation modelling and safety risk management. Most models for determining optimal maintenance strategies are based on a classical cost-benefit rationale, whereby all effects studied are transformed into monetary value and different concerns are balanced based on expected value calculations. If the failure of a system could have negative safety effects, there is a potential conflict between such an optimisation approach and the risk management principle saying that risk should be reduced to a level that is as low as reasonably practicable (ALARP); at least this is so if an interpretation of ALARP applies where verifying ALARP includes cost-benefit assessments but also extend beyond these. The ALARP principle is also typically implemented in combination with risk acceptance criteria, which could imply a restriction on the set of permissible maintenance policies and hence lead to suboptimal maintenance scheduling from an optimisation modelling point of view. This article considers the implementation of the ALARP principle, in combination with risk acceptance criteria, in the context of maintenance optimisation, addressing two different interpretations of the ALARP principle. A numerical example is included to show how one of these would affect the determination of an optimal policy. Two key points discussed are that risk reduction can be achieved in other ways than by adjusting the decision parameter of a given maintenance optimisation model, and that according to one of the interpretations the philosophy and practice of the ALARP principle extends beyond mechanical cost-benefit optimisation.
Monitoring product safety in the postmarketing environment
Authors: Sharrar Robert G , Dieck Gretchen S
Published: June 2013

The safety profile of a medicinal product may change in the postmarketing environment. Safety issues not identified in clinical development may be seen and need to be evaluated. Methods of evaluating spontaneous adverse experience reports and identifying new safety risks include a review of individual reports, a review of a frequency distribution of a list of the adverse experiences, the development and analysis of a case series, and various ways of examining the database for signals of disproportionality, which may suggest a possible association. Regulatory agencies monitor product safety through a variety of mechanisms including signal detection of the adverse experience safety reports in databases and by requiring and monitoring risk management plans, periodic safety update reports and postauthorization safety studies. The United States Food and Drug Administration is working with public, academic and private entities to develop methods for using large electronic databases to actively monitor product safety. Important identified risks will have to be evaluated through observational studies and registries.
The use of individually wrapped presterilized small orthopaedic implants increase operating time: a prospective experimental study
Authors: Khan Yasmeen , Tokarczyk Szymon , Khan Imran , Eleftheriou Kyriacos , Pearce Christopher
Published: June 2013

Objective

There have been concerns about the potential increases in operating time associated with the use of individually wrapped presterilized small orthopaedic implants compared with our traditional method of screw banks. We set out to quantify this theory.

Design

Prospective experimental study.

Setting

Theatre.

Participants

Orthopaedic Surgical Trainees and Theatre Scrub team.

Main outcome measure

The time taken to complete the operation.

Results

The use of prepacked and sterilized implants added 2 min 56 s to the use of a bank with a full complement of normal screws that required tapping and 3 min 58 s if self-tapping screws were used ( P < 0.001).

Conclusion

Using individually wrapped presterilized small orthopaedic implants increases operating time.
Job Perception of Counselors Employed at Integrated Counseling and Testing Centers for HIV in a District of South India
Authors: Papanna Mohan K. , Kumar Pawan , Shetty Avinash , Kulothungan Karthikayan , Poojary Indira B. , Ballala Kirthinath
Published: June 2013

Background:

The counselors’ form the backbone of HIV/AIDS control program, and for voluntary counseling and testing services to be effective counselors’ opinions are crucial.

Purpose:

To assess the perceptions of integrated counseling and testing center (ICTC) counselors with respect to the training received, problems faced in providing services, and job satisfaction.

Methods:

Qualitative methods such as 1 focus group discussion and 7 in-depth interviews were conducted among 14 counselors employed at 13 ICTCs in a costal district of south India.

Results:

The counselors identified the need for improving refresher training; job perception and satisfaction among counselors was found to be poor; issues such as shared confidentiality and targets for counseling were perceived to affect the ICTC services.

Conclusion:

The issues identified by counselors such as problems related to refresher training, targets set for counseling and testing, the pay scale and shared confidentiality should be addressed for better service delivery.
Practical recommendations for exercise training in patients with COPD
Authors: Gloeckl Rainer , Marinov Blagoi , Pitta Fabio
Published: June 2013

The aim of this article was to provide practical recommendations to healthcare professionals interested in offering a pulmonary rehabilitation programme for patients with chronic obstructive pulmonary disease (COPD). The latest research findings were brought together and translated into clinical practice. These recommendations focus on the description of useful assessment tests and of the most common exercise modalities for patients with COPD. We provide specific details on the rationale of why and especially how to implement exercise training in patients with COPD, including the prescription of training mode, intensity and duration, as well as suggestions of guidelines for training progression.
PROFILEing idiopathic pulmonary fibrosis: rethinking biomarker discovery
Authors: Maher Toby M.
Published: June 2013

Despite major advances in the understanding of the pathogenesis of idiopathic pulmonary fibrosis (IPF), diagnosis and management of the condition continue to pose significant challenges. Clinical management of IPF remains unsatisfactory due to limited availability of effective drug therapies, a lack of accurate indicators of disease progression, and an absence of simple short-term measures of therapeutic response. The identification of more accurate predictors of prognosis and survival in IPF would facilitate counseling of patients and their families, aid communication among clinicians, and would guide optimal timing of referral for transplantation. Improvements in molecular techniques have led to the identification of new disease pathways and a more targeted approach to the development of novel anti-fibrotic agents. However, despite an increased interest in biomarkers of IPF disease progression there are a lack of measures that can be used in early phase clinical trials. Careful longitudinal phenotyping of individuals with IPF together with the application of novel omics-based technology should provide important insights into disease pathogenesis and should address some of the major issues holding back drug development in IPF. The PROFILE (Prospective Observation of Fibrosis in the Lung Clinical Endpoints) study is a currently enrolling, prospective cohort study designed to tackle these issues.
Endobronchial ultrasound in the management of nonsmall cell lung cancer
Authors: Dooms Christophe , Muylle Inge , Yserbyt Jonas , Ninane Vincent
Published: June 2013

Flexible bronchoscopy plays a major role in the diagnosis and staging of lung cancer. One of the most important advances in this field is the development of endobronchial ultrasound (EBUS), which has extended the view of the bronchoscopist. These techniques are safe and allow assessment of the depth of tumour invasion in the central airways, detection of peripheral tumours before sampling, localisation of the central tumour in the lung parenchyma close to the central airways for real-time guided sampling, and staging of lymph nodes within the mediastinum. Progress in handling and analyses of the small samples obtained during EBUS procedures also allow modern pathological and molecular studies to be performed. This article reviews the data currently available in the field of convex and radial probe EBUS for the diagnosis and staging of nonsmall cell lung cancer and highlights the strengths but also the weaknesses of these new techniques.
Managing diagnostic procedures in idiopathic pulmonary fibrosis
Authors: Wells Athol U.
Published: June 2013

Idiopathic pulmonary fibrosis (IPF), the most prevalent of the idiopathic interstitial pneumonias, is associated with a poor prognosis. An accurate diagnosis of IPF is essential for its optimal management. The 2011 American Thoracic Society (ATS)/European Respiratory Society (ERS)/Japanese Respiratory Society (JRS)/Latin American Thoracic Association (ALAT) recommendations on the diagnosis and management of IPF were developed from a systematic review of the published literature. High-resolution computed tomography (HRCT) scanning has a central role in the IPF diagnostic pathway, with formal designation of criteria for an HRCT pattern of usual interstitial pneumonia. In the correct clinical context, a usual interstitial pneumonia pattern on HRCT is indicative of a definite diagnosis of IPF and negates the need for a surgical lung biopsy. However, although the 2011 ATS/ERS/JRS/ALAT statement is a major advance, the application of the guideline recommendations by clinicians has identified limitations that should be addressed in future statements. Key problems include: 1) HRCT misdiagnosis, particularly by less experienced radiologists; 2) lack of management recommendations for the highly prevalent clinical scenarios of “probable” or “possible” IPF; 3) ongoing confusion concerning the diagnostic role of bronchoalveolar lavage; and 4) the lack of integration of clinical data in the designation of the diagnostic likelihood of IPF, including the treated course of disease. These issues become evident as the recommendations are applied and highlight the need for continued guideline adjustments.
Small airways diseases, excluding asthma and COPD: an overview
Authors: Burgel Pierre-Régis , Bergeron Anne , de Blic Jacques , Bonniaud Philippe , Bourdin Arnaud , Chanez Pascal , Chinet Thierry , Dalphin Jean-Charles , Devillier Philippe , Deschildre Antoine , Didier Alain , Kambouchner Marianne , Knoop Christiane , Laurent François , Nunes Hilario , Perez Thierry , Roche Nicolas , Tillie-Leblond Isabelle , Dusser Daniel
Published: June 2013

This review is the summary of a workshop on small airways disease, which took place in Porquerolles, France in November 2011. The purpose of this workshop was to review the evidence on small airways (bronchiolar) involvement under various pathophysiological circumstances, excluding asthma and chronic obstructive pulmonary disease. Histopathological patterns associated with small airways disease were reviewed, including cellular and obliterative bronchiolitis. Many pathophysiological conditions have been associated with small airways disease including airway infections, connective tissue diseases and inflammatory bowel diseases, bone marrow and lung transplantation, common variable immunodeficiency disorders, diffuse panbronchiolitis, and diseases related to environmental exposures to pollutants, allergens and drugs. Pathogenesis, clinical presentation, a computed tomography scan and pulmonary function test findings are reviewed, and therapeutic options are described with the objective of providing an integrative approach to these disorders.
Desquamative interstitial pneumonia: an analytic review with an emphasis on aetiology
Authors: Godbert Benoît , Wissler Marie-Pierre , Vignaud Jean-Michel
Published: June 2013

Desquamative interstitial pneumonia (DIP) is characterised by the accumulation of numerous pigmented macrophages within most of the distal airspace of the lung and, sometimes, the presence of giant cells. Diagnosis of DIP is not easy and requires surgical lung biopsy. DIP is usually associated with tobacco smoke. However, the association between smoking and DIP is less robust than that with respiratory bronchiolitis with interstitial lung disease or pulmonary Langerhans’ cell histiocytosis; approximately 10–42% of patients with DIP are nonsmokers. DIP can also occur in patients following exposure to certain inhaled toxins (occupational exposure) and drugs, and may occur in the context of certain viral illnesses and autoimmune diseases. In the context of DIP, occupational exposure should be systematically investigated.
Sedation for flexible bronchoscopy: current and emerging evidence
Authors: José Ricardo J. , Shaefi Shahzad , Navani Neal
Published: June 2013

Flexible bronchoscopy is commonly performed by respiratory physicians and is the gold standard for directly visualising the airways, allowing for numerous diagnostic and therapeutic interventions. With the widespread use of flexible bronchoscopy and the evolution of interventional bronchoscopy with more complex and longer procedures, physicians are placing increasing importance on the use of sedation as a necessary adjunct to topical anaesthesia. There is no standardised practice for the use of sedation in bronchoscopy with a good deal of variation among physicians regarding the use of pre-procedure medication and pharmacological sedatives. In addition, there is ongoing debate and controversy about proceduralist-administeredversusanaesthetist-administered sedation whilst at the same time there is a growing body of evidence that nonanaesthetist administered sedation is safe and cost-effective. In this review we summarise the evidence for the use of sedation as an adjunct to topical anaesthesia in bronchoscopy and provide the clinician with up-to-date concise guidance for the use of pharmacological sedatives in bronchoscopy and future directions for sedation in the bronchoscopy suite.
Sensitive and specific detection of mosaic chromosomal abnormalities using the Parent-of-Origin-based Detection (POD) method
Authors: Baugher Joseph D , Baugher Benjamin D , Shirley Matthew D , Pevsner Jonathan
Published: June 2013

Background

Mosaic somatic alterations are present in all multi-cellular organisms, but the physiological effects of low-level mosaicism are largely unknown. Most mosaic alterations remain undetectable with current analytical approaches, although the presence of such alterations is increasingly implicated as causative for disease.

Results

Here, we present the Parent-of-Origin-based Detection (POD) method for chromosomal abnormality detection in trio-based SNP microarray data. Our software implementation, triPOD, was benchmarked using a simulated dataset, outperformed comparable software for sensitivity of abnormality detection, and displayed substantial improvement in the detection of low-level mosaicism while maintaining comparable specificity. Examples of low-level mosaic abnormalities from a large autism dataset demonstrate the benefits of the increased sensitivity provided by triPOD. The triPOD analyses showed robustness across multiple types of Illumina microarray chips. Two large, clinically-relevant datasets were characterized and compared.

Conclusions

Our method and software provide a significant advancement in the ability to detect low-level mosaic abnormalities, thereby opening new avenues for research into the implications of mosaicism in pathogenic and non-pathogenic processes.