bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceptions of a Culture of Health
Authors: Jenkins Kristi Rahrig , Fakhoury Nour , Marzec Mary L. , Harlow-Rosentraub Karen S.
Published: November 2014

Purpose. This study aims to illustrate the potential utility of open-ended survey data, regarding faculty and staff perceptions of a culture of health (CoH), for targeting communications and programming. Overall, these types of data show how they may be used to assist in implementing, improving, and sustaining a CoH in an organization. Design/method/approach. An anonymous online questionnaire was sent to 10,000 employees. The analysis of open-ended responses was performed using the grounded theory approach. Emerging themes were organized into two major categories: favorable perceptions and unfavorable perceptions regarding the university’s CoH. Findings. These findings suggest that employees have specific favorable and unfavorable perceptions regarding their university’s CoH. Two main favorable perceptions that both faculty and staff commented on were (1) leaders/supervisors showing interest in health and well-being and (2) colleagues participating in healthful behaviors and setting good examples. Examples of unfavorable perceptions include stress not adequately addressed and healthy food options not readily available. Research limitations. The generalizability of the findings may be somewhat challenging given that the analyses are limited to individuals from a large Midwestern university. Also, given that this survey was voluntary, participants in the survey may possess unique characteristics that may have played a role in their likelihood to participate. Originality/value. There are few studies that address assessing a CoH in a university setting. This study provides examples of (1) topics to consider when evaluating an organization’s CoH and (2) actionable intervention and communication strategies that account for the employee’s perceptions. Others might use such examples when evaluating or preparing to assess their own organization’s CoH.
Student-Centered Transformative Learning in Leadership Education
Authors: Haber-Curran Paige , Tillapaugh Daniel W.
Published: November 2014

Innovative and learner-centered approaches to teaching and learning are vital for the applied field of leadership education, yet little research exists on such pedagogical approaches within the field. Using a phenomenological approach in analyzing 26 students’ reflective narratives, the authors explore students’ experiences of and process of learning within a student-centered and inquiry-focused leadership capstone course. The process of this transformative learning experience is represented in five themes, which include the following: (1) challenging mental models of learning, (2) building trust, (3) finding freedom and empowerment, (4) deepening commitment to learning, and (5) reframing learning and self. Additionally, the students’ approach to learning changed throughout the course, shifting from dependence/independence toward interdependence. Implications for the use of this pedagogy and areas for future research are discussed.
Wielding the spiritual sword again: Some considerations on neo-medievalism in modern international order
Authors: Kalpokas Ignas
Published: November 2014

This article traces the paradoxes within the modern international system, which is guided by liberal norms and values, in particular pertaining to human rights. This system is seen here as being ruled by an empty norm: power is present, but it is disembodied. Therefore, the entire international order is open to uses and abuses by the most powerful actors in the international sphere, especially the power states. Furthermore, when combined with the fact that the modern world has been completely appropriated by humanity as a universal integrated whole, whoever falls outside the dominant normative structure is, in effect, no longer even part of humanity. To analyse the means and effects of such tension between the universal and the particular, this article draws analogies with the medieval struggle between the secular and the religious authorities. It is argued that currently one can observe a return of the Respublica Christiana in the form of a rights-centred ‘international community’. And yet, contrary to earlier scholarly attempts to draw analogies with the Middle Ages, this return is seen here as a dangerous employment of political theology.
Characteristics of bipolar disorder patients treated with immediate- and extended-release quetiapine in a real clinical setting: a longitudinal, cohort study of 1761 patients
Authors: Carlborg Andreas , Thuresson Marcus , Ferntoft Lena , Bodegard Johan
Published: November 2014

Objectives:

The objective of this work was to study characteristics and clinical treatment patterns of bipolar disorder (BD) patients admitted to hospital and treated with quetiapine (immediate-release [IR] or extended-release [XR] formulations).

Methods:

BD patients admitted to hospital and prescribed quetiapine IR were followed by linking two Swedish nationwide registries; the hospitalization and drug dispense registries [ClinicalTrials.gov identifier: NCT01455961]. The study period was from 1 January 2008, to end of 31 December 2011. Data was primarily analysed using descriptive methods.

Results:

Quetiapine IR was used in 1761 patients of whom 1303 subsequently switched to XR (switch XR) and 458 remained on IR (continuous IR). At baseline, Switch XR patients were younger (−3.3 years), more frequently employed (+7.1%), had higher prevalence of single depressive episodes (+6.7%) and anxiety disorders (+5.8%), lower mean daily IR dose (−19.3%) and fewer medications for somatic disorders (−7.5%) than continuous IR patients. During follow up, the number of concomitant psychiatric medications was lower in switch XR patients (−6%) and higher in continuous IR patients (+6%). Mean daily quetiapine dose was 21% higher in switch XR versus continuous IR patients. Prescriptions of lower quetiapine dosages calculated below 50 mg per day in the XR switch and IR continuous groups were seen in 8% versus 10% of the patients, respectively.

Conclusions:

Differential use of quetiapine XR and IR in bipolar disorder patients with different and important characteristics was demonstrated. Patients who were switched to quetiapine XR had a higher psychiatric disease burden, were younger and had a higher degree of employment. These differences demonstrate the heterogeneity among bipolar disorder patients and indicate the need in clinical practice for individualized treatment to reduce the risk for both patient and society related losses.
Provider Workforce Assessment in a Rural Hepatitis C Epidemic
Authors: Westergaard Ryan P. , Stockman Lauren J. , Hyland Heather A. , Guilfoyle Sheila M. , Fangman John J. , Vergeront James M.
Published: November 2014

New recommendations for birth cohort screening for hepatitis C virus (HCV) infection and the development of new, highly effective antiviral medications are expected to increase the demand for HCV treatment. In the past, antiviral therapy for HCV was almost exclusively prescribed by specialists in the field of gastroenterology and infectious diseases, meaning that people living in rural areas that are underserved by specialists may have poor access to treatment. We investigated the number and geographic distribution of medical providers who actively prescribed direct acting antiviral drugs for hepatitis C in Wisconsin during 2012. Using public health surveillance data and a state-wide prescription drug database, we found that there was 1 treatment provider for every 340 residents known to be living with HCV. However, 51 of 72 Wisconsin counties had no providers who provided HCV treatment in 2012.Scaling up antiviral treatment to address the epidemic of hepatitis C efficiently and equitably will require strategies to increase the number of treatment providers in rural communities. Providing education, training, and support to the primary care workforce serving rural communities should be considered a potentially effective and efficient approach to preventing future HCV-related illness.
Pakistani Women as Objects of “Fear” and “Othering”
Authors: Rahman Bushra Hameedur
Published: November 2014

The study uses Said’s concept of Orientalism and van Dijks concept of socio-cognitive processes to analyze the framing of Pakistani Muslim women in the newsmagazine Time from 1998-2002. A critical discourse analysis of the selected articles of the magazine follows Fairclough’s and van Dijk’s guidelines. It uncovers how in a particular socio-political context, stereotyped images of Pakistani Muslim women were framed to project “superior American” ideals of “tolerance” and “democracy,” as against the “intolerant,” “undemocratic” values of Muslim as “others.” It also argues how in the process of “othering” Pakistan and particularly its youth are framed as intolerant, and source of fear.
FFC’s Community Empowerment Initiatives towards Sustainability: A Case Study
Authors: Mustaghis-ur-Rahman
Published: November 2014

The case compiles the corporate social responsibility (CSR) activities at Fauji Fertlizer Company Limited (FFC), as a part of United Nations Global Compact (UNGC). It highlights CSR activities as followed in five groups and covers both macro-level and micro-level initiatives within the principles of the UNGC. At the macro level, the company is addressing stakeholders’ concerns for underdevelopment in the country by sponsoring community development projects in its operational areas. At the micro level, FFC is carrying out interventions by spreading education, providing health care, protecting environment, alleviating poverty and responding to the challenges of disasters. The case is sponsored by the UNGC Pakistan Local Network.1
Fighting the Giants: The Case of a New Player
Authors: Rosnan Herwina , Roslin Rosmimah Mohd
Published: November 2014

Today’s business environment is dynamic and current business competition is characterized by some authors as hyper-competition. For a new player, sustainable competitive advantage is a crucial indicator of success. SimplySiti is a new brand in the beauty industry in Malaysia having being established in 2008 and launched in 2010. Amidst the presence of more established global competitors like L’Oreal, Avon and Estee Lauder in the Malaysian market, SimplySiti has done fairly well. Much of its success is attributed to fast acceptance by the market as the main target market for this brand are fans of Dato’ Siti Nurhaliza, the most popular Malaysian singer with vast following not only in Malaysia but across countries such as Indonesia, Singapore, Brunei and the Middle East. The brand itself is associated with Dato’ Siti Nurhaliza as she is the founder and the driver of this brand and she is involved in marketing and promoting this brand directly. This case study highlights how a newly established local business competes with the more established global players. Specifically, the article analyzes how SimplySiti thrives in the midst of very strong and much-established competitors and the direction it takes to steer the company in the next phase of its establishment.
Why Physicians Don’t Ask
Authors: Arya Monisha , Patel Sajani , Kumar Disha , Zheng Micha Yin , Kallen Michael A. , Street Richard L. , Viswanath Kasisomayajula , Giordano Thomas P.
Published: November 2014

In 2006, the US Centers for Disease Control and Prevention recommended HIV testing for all adolescents and adults aged 13 to 64 in health care settings with a HIV prevalence of at least 0.1%. However, 55% of US adults have never been tested and therefore do not know their HIV status. To understand suboptimal HIV testing rates, this study sought to illuminate interpersonal and intrapersonal physician barriers to HIV testing. One hundred and eighty physicians from health centers in Houston completed a survey based on Cabana’s Knowledge, Attitudes and Behaviors model. One-third of the physicians faced at least 1 interpersonal barrier to HIV testing, such as a difference in age or language. Many (41%) physicians faced at least 1 intrapersonal barrier, such as believing their patients would be feeling uncomfortable discussing HIV. Notably, 71% of physicians would prefer their patients ask for the test. A patient-engaging campaign may be an innovative solution to increasing HIV testing and reducing the number of undiagnosed persons.
Thromboembolism Following Shoulder Arthroscopy
Authors: Schick Cameron W. , Westermann Robert W. , Gao Yubo ,   ACESS Group, Wolf Brian R. , Abboud Joseph A. , Athwal George S. , Bicknell Ryan T. , Chebli Caroline , Cheung Emilie V. , Getz Charles L. , Keener Jay D. , Klepps Steven , Lashgari Cyrus J. , Lervick Gregory N. , Levy Jonathan C. , Miller Suzanne L. , Sethi Paul M. , Stein Jason A. , Tashjian Robert Z. , Throckmorton Thomas W.
Published: November 2014

Background:

Thromboembolism following shoulder arthroscopy is considered an uncommon complication, with fewer than 50 cases reported in the literature. Arthroscopy of the shoulder is one of the most commonly performed orthopaedic procedures, with low associated risks.

Purpose:

To identify potential risk factors for the development of venous thromboembolism (VTE) following shoulder arthroscopy and to determine the overall incidence of this complication.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A retrospective case-control review was performed of patients who developed symptomatic deep venous thrombosis (DVT) or pulmonary embolism (PE) following shoulder arthroscopy. Multiple surgeons from across North America were queried. For every case of DVT or PE identified, 2 control cases of shoulder arthroscopy were analyzed. The incidence of DVT/PE following shoulder arthroscopy was determined. A univariate analysis and a multivariate logistic regression model were conducted to identify any potential risk factors for the development of VTE following shoulder arthroscopy.

Results:

A total of 17 surgeons participated in this study and had performed a total of 15,033 cases of shoulder arthroscopy from September 2002 through August 2011. Eleven of the 17 participating surgeons had had a patient with a VTE complication during this time frame. The incidence of VTE in the 15,033 cases was 0.15%; 22 patients of the 15,033 patients had a DVT (n = 15) and/or PE (n = 8). Forty-four control cases were also analyzed. Univariate and multivariate analyses were performed. No significant risk factors were identified other than patient positioning. All cases and controls were positioned in the beach-chair position for surgery.

Conclusion:

The results of this study show that although rare, VTE occurs following shoulder arthroscopy at a rate of 0.15%. The variables analyzed in the cases of VTE compared with the control cases did not show any significant risk factors. All cases were positioned in the beach-chair position. Further analysis of future cases is warranted.
Dynamic Relation Between Working Memory Capacity and Speech Recognition in Noise During the First 6 Months of Hearing Aid Use
Authors: Ng Elaine H. N. , Classon Elisabet , Larsby Birgitta , Arlinger Stig , Lunner Thomas , Rudner Mary , Rönnberg Jerker
Published: November 2014

The present study aimed to investigate the changing relationship between aided speech recognition and cognitive function during the first 6 months of hearing aid use. Twenty-seven first-time hearing aid users with symmetrical mild to moderate sensorineural hearing loss were recruited. Aided speech recognition thresholds in noise were obtained in the hearing aid fitting session as well as at 3 and 6 months postfitting. Cognitive abilities were assessed using a reading span test, which is a measure of working memory capacity, and a cognitive test battery. Results showed a significant correlation between reading span and speech reception threshold during the hearing aid fitting session. This relation was significantly weakened over the first 6 months of hearing aid use. Multiple regression analysis showed that reading span was the main predictor of speech recognition thresholds in noise when hearing aids were first fitted, but that the pure-tone average hearing threshold was the main predictor 6 months later. One way of explaining the results is that working memory capacity plays a more important role in speech recognition in noise initially rather than after 6 months of use. We propose that new hearing aid users engage working memory capacity to recognize unfamiliar processed speech signals because the phonological form of these signals cannot be automatically matched to phonological representations in long-term memory. As familiarization proceeds, the mismatch effect is alleviated, and the engagement of working memory capacity is reduced.
Investigating Interaural Frequency-Place Mismatches via Bimodal Vowel Integration
Authors: Guérit François , Santurette Sébastien , Chalupper Josef , Dau Torsten
Published: November 2014

For patients having residual hearing in one ear and a cochlear implant (CI) in the opposite ear, interaural place-pitch mismatches might be partly responsible for the large variability in individual benefit. Behavioral pitch-matching between the two ears has been suggested as a way to individualize the fitting of the frequency-to-electrode map but is rather tedious and unreliable. Here, an alternative method using two-formant vowels was developed and tested. The interaural spectral shift was inferred by comparing vowel spaces, measured by presenting the first formant (F1) to the nonimplanted ear and the second (F2) on either side. The method was first evaluated with eight normal-hearing listeners and vocoder simulations, before being tested with 11 CI users. Average vowel distributions across subjects showed a similar pattern when presenting F2 on either side, suggesting acclimatization to the frequency map. However, individual vowel spaces with F2 presented to the implant did not allow a reliable estimation of the interaural mismatch. These results suggest that interaural frequency-place mismatches can be derived from such vowel spaces. However, the method remains limited by difficulties in bimodal fusion of the two formants.
Homeopathic Ear Drops as an Adjunct in Reducing Antibiotic Usage in Children With Acute Otitis Media
Authors: Taylor James A. , Jacobs Jennifer
Published: November 2014

Objective. To determine if use of a homeopathic ear drop preparation reduces antibiotic use in children diagnosed with acute otitis media (AOM). Methods. Children 6 months to 11 years old, diagnosed with AOM and managed with a delayed antibiotic approach, were randomized to standard therapy alone or standard therapy plus a homeopathic ear drop preparation. The primary outcome was whether or not the antibiotic prescription given at the index visit was filled during a 12- to 15-day follow-up period. Results. Among 210 enrolled children, follow-up antibiotic data were collected on 206. During the 12- to 15-day follow-up period, fewer parents of children randomized to the homeopathic ear drops group filled the antibiotic prescription compared with those of children receiving standard therapy alone (26.9% and 41.2%, respectively, P = .032). Conclusion. Homeopathic ear drops may be effective in reducing the use of antibiotics in children with AOM managed with a delayed antibiotic approach.
Public Expenditure and Scheduled Community Enrolment in Higher Education
Authors: Sumithra S. , Vardhan R. Vishnu , Aruna C.
Published: November 2014

In India, the gross enrolment ratio has increased from 13.1 per cent in 2007–2008 to 15 per cent in 2011–2012 which moves the country from elite to a mass higher education system. This article seeks to examine the enrolment of scheduled caste (SC) students across various states in the country and the expenditure by each state and its effect on SC enrolment. The secondary data is the main source for analysis and data envelopment analysis (DEA) is used to explain the expenditure and enrolment pattern. The data pertain to public expenditure and SC enrolment for the period 2004–2010. The study has revealed that out of 25 states, the smaller state Sikkim is performing relatively better than the larger states which suggests the need for state-specific strategies in addressing the issues of expansion of higher education.
Patient-conducted anodal transcranial direct current stimulation of the motor cortex alleviates pain in trigeminal neuralgia
Authors: Hagenacker Tim , Bude Vera , Naegel Steffen , Holle Dagny , Katsarava Zaza , Diener Hans-Christoph , Obermann Mark
Published: November 2014

Background

Transcranial direct current stimulation (tDCS) of the primary motor cortex has been shown to modulate pain and trigeminal nociceptive processing.

Methods

Ten patients with classical trigeminal neuralgia (TN) were stimulated daily for 20 minutes over two weeks using anodal (1 mA) or sham tDCS over the primary motor cortex (M1) in a randomized double-blind cross-over design. Primary outcome variable was pain intensity on a verbal rating scale (VRS 0–10). VRS and attack frequency were assessed for one month before, during and after tDCS. The impact on trigeminal pain processing was assessed with pain-related evoked potentials (PREP) and the nociceptive blink reflex (nBR) following electrical stimulation on both sides of the forehead before and after tDCS.

Results

Anodal tDCS reduced pain intensity significantly after two weeks of treatment. The attack frequency reduction was not significant. PREP showed an increased N2 latency and decreased peak-to-peak amplitude after anodal tDCS. No severe adverse events were reported.

Conclusion

Anodal tDCS over two weeks ameliorates intensity of pain in TN. It may become a valuable treatment option for patients unresponsive to conventional treatment.
Rare ocular features in a case of Kabuki syndrome (Niikawa-Kuroki syndrome)
Authors: Chen Yi-Hsing , Sun Ming-Hui , Hsia Shao-Hsuan , Lai Chi-Chun , Wu Wei-Chi
Published: November 2014

Background

Kabuki syndrome is a multi-system disorder with peculiar facial features, and ophthalmic abnormalities are frequently involved. This case report of a child with Kabuki syndrome describes two new previously unreported ophthalmic conditions.

Case presentation

A 3-year-old Taiwanese boy with Kabuki syndrome had a short stature, spinal dysraphism, intellectual disability and typical facial features. Ophthalmic findings which have been previously reported in the literature and in this patient, included ptosis, esotropia, coloboma of the iris, retina, choroid and optic disc, and microcornea. The newly identified ophthalmic features in this patient included colobomatous microphthalmos and a dysplastic and elevated disc without central cupping. The genetic analysis identified an MLL2 gene mutation.

Conclusion

The presentations of a dysplastic disc and colobomatous microphthalmia are rarely reported in patients with Kabuki syndrome, but these ophthalmic abnormalities may affect vision. Detailed ophthalmic evaluations in children with Kabuki syndrome are advised.
A composite CdS thin film/TiO2 nanotube structure by ultrafast successive electrochemical deposition toward photovoltaic application
Authors: Fu Han , Liu Hong , Shen Wenzhong
Published: November 2014

Fabricating functional compounds on substrates with complicated morphology has been an important topic in material science and technology, which remains a challenging issue to simultaneously achieve a high growth rate for a complex nanostructure with simple controlling factors. Here, we present a novel simple and successive method based on chemical reactions in an open reaction system manipulated by an electric field. A uniform CdS/TiO2 composite tubular structure has been fabricated in highly ordered TiO2 nanotube arrays in a very short time period (~90 s) under room temperature (RT). The content of CdS in the resultant and its crystalline structure was tuned by the form and magnitude of external voltage. The as-formed structure has shown a quite broad and bulk-like light absorption spectrum with the absorption of photon energy even below that of the bulk CdS. The as-fabricated-sensitized solar cell based on this composite structure has achieved an efficiency of 1.43% without any chemical doping or co-sensitizing, 210% higher than quantum dot-sensitized solar cell (QDSSC) under a similar condition. Hopefully, this method can also easily grow nanostructures based on a wide range of compound materials for energy science and electronic technologies, especially for fast-deploying devices.
An integrated transcriptome and expressed variant analysis of sepsis survival and death
Authors: Tsalik Ephraim L , Langley Raymond J , Dinwiddie Darrell L , Miller Neil A , Yoo Byunggil , van Velkinburgh Jennifer C , Smith Laurie D , Thiffault Isabella , Jaehne Anja K , Valente Ashlee M , Henao Ricardo , Yuan Xin , Glickman Seth W , Rice Brandon J , McClain Micah T , Carin Lawrence , Corey G Ralph , Ginsburg Geoffrey S , Cairns Charles B , Otero Ronny M , Fowler Vance G , Rivers Emanuel P , Woods Christopher W , Kingsmore Stephen F
Published: November 2014

Background

Sepsis, a leading cause of morbidity and mortality, is not a homogeneous disease but rather a syndrome encompassing many heterogeneous pathophysiologies. Patient factors including genetics predispose to poor outcomes, though current clinical characterizations fail to identify those at greatest risk of progression and mortality.

Methods

The Community Acquired Pneumonia and Sepsis Outcome Diagnostic study enrolled 1,152 subjects with suspected sepsis. We sequenced peripheral blood RNA of 129 representative subjects with systemic inflammatory response syndrome (SIRS) or sepsis (SIRS due to infection), including 78 sepsis survivors and 28 sepsis non-survivors who had previously undergone plasma proteomic and metabolomic profiling. Gene expression differences were identified between sepsis survivors, sepsis non-survivors, and SIRS followed by gene enrichment pathway analysis. Expressed sequence variants were identified followed by testing for association with sepsis outcomes.

Results

The expression of 338 genes differed between subjects with SIRS and those with sepsis, primarily reflecting immune activation in sepsis. Expression of 1,238 genes differed with sepsis outcome: non-survivors had lower expression of many immune function-related genes. Functional genetic variants associated with sepsis mortality were sought based on a common disease-rare variant hypothesis. VPS9D1, whose expression was increased in sepsis survivors, had a higher burden of missense variants in sepsis survivors. The presence of variants was associated with altered expression of 3,799 genes, primarily reflecting Golgi and endosome biology.

Conclusions

The activation of immune response-related genes seen in sepsis survivors was muted in sepsis non-survivors. The association of sepsis survival with a robust immune response and the presence of missense variants in VPS9D1 warrants replication and further functional studies.

Trial registration

ClinicalTrials.gov NCT00258869. Registered on 23 November 2005.
Multiple Biopsies and Detection of Cervical Cancer Precursors at Colposcopy
Authors: Wentzensen Nicolas , Walker Joan L. , Gold Michael A. , Smith Katie M. , Zuna Rosemary E. , Mathews Cara , Dunn S. Terence , Zhang Roy , Moxley Katherine , Bishop Erin , Tenney Meaghan , Nugent Elizabeth , Graubard Barry I. , Wacholder Sholom , Schiffman Mark
Published: November 2014

Purpose

Women with abnormal cervical cancer screening results are referred to colposcopy and biopsy for diagnosis of cervical cancer precursors (high-grade squamous intraepithelial lesions [HSILs]). Colposcopy with a single biopsy can miss identification of HSILs. No systematic study has quantified the improved detection of HSIL by taking multiple lesion-directed biopsies.

Methods

The Biopsy Study was an observational study of 690 women referred to colposcopy after abnormal cervical cancer screening results. Up to four directed biopsies were taken from distinct acetowhite lesions and ranked by colposcopic impression. A nondirected biopsy of a normal-appearing area was added if fewer than four directed biopsies were taken. HSIL identified by any biopsy was the reference standard of disease used to evaluate the incremental yield and sensitivity of multiple biopsies.

Results

In the overall population, sensitivities for detecting HSIL increased from 60.6% (95% CI, 54.8% to 66.6%) from a single biopsy to 85.6% (95% CI, 80.3% to 90.2%) after two biopsies and to 95.6% (95% CI, 91.3% to 99.2%) after three biopsies. A significant increase in sensitivity of multiple biopsies was observed in all subgroups. The highest increase in yield of HSIL was observed for women with a high-grade colposcopic impression, HSIL cytology, and human papillomavirus (HPV) type 16 positivity. Only 2% of all HSILs diagnosed in the participants were detected by biopsies of normal-appearing transformation zone.

Conclusion

Collection of additional lesion-directed biopsies during colposcopy increased detection of histologic HSIL, regardless of patient characteristics. Taking additional biopsies when multiple lesions are present should become the standard practice of colposcopic biopsy.
Hospital Volume, Complications, and Cost of Cancer Surgery in the Elderly
Authors: Nathan Hari , Atoria Coral L. , Bach Peter B. , Elkin Elena B.
Published: November 2014

Purpose

Hospital surgical volume has been shown to correlate with short-term outcomes after cancer surgery, but the relationship between volume and cost of care is unclear. We sought to characterize variation in payments for cancer surgery and assess the relationship between hospital volume and payments.

Methods

Using 2000 to 2007 Surveillance, Epidemiology, and End Results–Medicare data, we assessed risk-adjusted 30-day episode Medicare payments for elderly patients undergoing one of six procedures for resection of cancer. Payments for the index hospitalization, readmissions, physician services, emergency room visits, and postdischarge ancillary care were analyzed, as were data on 30-day mortality and complications.

Results

The analysis included 31,191 colectomies, 2,670 cystectomies, 1,514 pancreatectomies, 2,607 proctectomies, 12,228 prostatectomies, and 10,151 pulmonary lobectomies. There was substantial variation in cost; differences between the first and third terciles of cost varied from 27% for cystectomy to 40% for colectomy. The majority of variation (66% to 82%) was attributable to payments for the index admission rather than readmissions or physician services. There were no meaningful associations between total risk-adjusted payments and hospital volume. Surgical mortality was low, but complication rates ranged from 10% (prostatectomy) to 56% (lobectomy). Complication rates were not correlated with hospital volume, but occurrence of complications was associated with 47% to 70% higher costs.

Conclusion

We found substantial variation in Medicare payments for these six cancer procedures. Cost was strongly associated with postoperative complications and primarily driven by differences in the cost of the index hospitalization. Efforts to prevent and cost-effectively manage complications are more likely to reduce costs than volume-based referral of cancer surgery alone.
Toll-Like Receptor 3 Is Critical for Coxsackievirus B4-Induced Type 1 Diabetes in Female NOD Mice
Authors: McCall Kelly D. , Thuma Jean R. , Courreges Maria C. , Benencia Fabian , James Calvin B.L. , Malgor Ramiro , Kantake Noriko , Mudd William , Denlinger Nathan , Nolan Bret , Wen Li , Schwartz Frank L.
Published: November 2014

Group B coxsackieviruses (CVBs) are involved in triggering some cases of type 1 diabetes mellitus (T1DM). However, the molecular mechanism(s) responsible for this remain elusive. Toll-like receptor 3 (TLR3), a receptor that recognizes viral double-stranded RNA, is hypothesized to play a role in virus-induced T1DM, although this hypothesis is yet to be substantiated. The objective of this study was to directly investigate the role of TLR3 in CVB-triggered T1DM in nonobese diabetic (NOD) mice, a mouse model of human T1DM that is widely used to study both spontaneous autoimmune and viral-induced T1DM. As such, we infected female wild-type (TLR3+/+) and TLR3 knockout (TLR3−/−) NOD mice with CVB4 and compared the incidence of diabetes in CVB4-infected mice with that of uninfected counterparts. We also evaluated the islets of uninfected and CVB4-infected wild-type and TLR3 knockout NOD mice by immunohistochemistry and insulitis scoring. TLR3 knockout mice were markedly protected from CVB4-induced diabetes compared with CVB4-infected wild-type mice. CVB4-induced T-lymphocyte-mediated insulitis was also significantly less severe in TLR3 knockout mice compared with wild-type mice. No differences in insulitis were observed between uninfected animals, either wild-type or TLR3 knockout mice. These data demonstrate for the first time that TLR3 is 1) critical for CVB4-induced T1DM, and 2) modulates CVB4-induced insulitis in genetically prone NOD mice.
The Integrated Hypothalamic Tachykinin-Kisspeptin System as a Central Coordinator for Reproduction
Authors: Navarro Víctor M. , Bosch Martha A. , León Silvia , Simavli Serap , True Cadence , Pinilla Leonor , Carroll Rona S. , Seminara Stephanie B. , Tena-Sempere Manuel , Rønnekleiv Oline K. , Kaiser Ursula B.
Published: November 2014

Tachykinins are comprised of the family of related peptides, substance P (SP), neurokinin A (NKA), and neurokinin B (NKB). NKB has emerged as regulator of kisspeptin release in the arcuate nucleus (ARC), whereas the roles of SP and NKA in reproduction remain unknown. This work explores the roles of SP and NKA in the central regulation of GnRH release. First, central infusion of specific agonists for the receptors of SP (neurokinin receptor 1, NK1R), NKA (NK2R) and NKB (NK3R) each induced gonadotropin release in adult male and ovariectomized, estradiol-replaced female mice, which was absent in Kiss1r−/− mice, indicating a kisspeptin-dependent action. The NK2R agonist, however, decreased LH release in ovariectomized-sham replaced females, as documented for NK3R agonists but in contrast to the NK1R agonist, which further increased LH release. Second, Tac1 (encoding SP and NKA) expression in the ARC and ventromedial nucleus was inhibited by circulating estradiol but did not colocalize with Kiss1 mRNA. Third, about half of isolated ARC Kiss1 neurons expressed Tacr1 (NK1R) and 100% Tacr3 (NK3R); for anteroventral-periventricular Kiss1 neurons and GnRH neurons, approximately one-fourth expressed Tacr1 and one-tenth Tacr3; Tacr2 (NK2R) expression was absent in all cases. Overall, these results identify a potent regulation of gonadotropin release by the SP/NK1R and NKA/NK2R systems in the presence of kisspeptin-Kiss1r signaling, indicating that they may, along with NKB/NK3R, control GnRH release, at least in part through actions on Kiss1 neurons.
An Improved Genetic Algorithm for Optimal Sensor Placement in Space Structures Damage Detection
Authors: Beygzadeh Sahar , Salajegheh Eysa , Torkzadeh Peyman , Salajegheh Javad , Naseralavi Seyed Sadegh
Published: November 2014

In this study, an improved genetic algorithm is proposed for optimal sensor placement in structures. This algorithm is established by a numerical forward algorithm based on a geometrical viewpoint and genetic algorithm (GVGA). The aim of this strategy is to minimize the effects of noise on the process of optimization algorithm. For this purpose, the fitness function is considered as the standard deviation of the diameters of elliptical noise in the response change space. It is acquired using the geometrical viewpoint. The algorithm is applied to the space structures, then the optimal sensor placement obtained by the GVGA and the GA are compared. The results show that the GVGA improves the algorithm's convergence resulting in a better sensor pattern.
Flipping the script
Authors: Almond Danni
Published: November 2014

The pupil researchers at All Saints School observe and feedback to beginner teachers with their views on teaching and learning. Danni Almond explains how the programme has benefited the school
How can you earn your staff's respect as a new headteacher?
Authors: Bannister Nick
Published: November 2014

A distinct challenge of early headship, especially in schools requiring improvement, is winning the respect and loyalty of your colleagues. Nick Bannister asks a group of headteachers to share their staff management and leadership advice
Statistical consequences of using bone mineral density to pair cadaver femurs in comparative ex vivo hip fracture studies
Authors: Basso T. , Klaksvik J. , Foss O. A.
Published: November 2014

Objective

In ex vivo hip fracture studies femoral pairs are split to create two comparable test groups. When more than two groups are required, or if paired femurs cannot be obtained, group allocation according to bone mineral density (BMD) is sometimes performed. In this statistical experiment we explore how this affects experimental results and sample size considerations.

Methods

In a hip fracture experiment, nine pairs of human cadaver femurs were tested in a paired study design. The femurs were then re-matched according to BMD, creating two new test groups. Intra-pair variance and paired correlations in fixation stability were calculated. A hypothetical power analysis was then performed to explore the required sample size for the two types of group allocation.

Results

The standard deviation (sd) of the mean paired difference in fixation stability increased from 2 mm in donor pairs to 5 mm in BMD-matched pairs. Intra-pair correlation was 0.953 (Pearson’s r) in donor pairs and non-significant at -0.134 (Pearson’s r) in BMD-matched pairs. Required sample size to achieve a statistical power of 0.8 increased from ten pairs using donor pairs to 54 pairs using BMD-matched pairs.

Conclusion

BMD cannot be used to create comparable test groups unless sample size is increased substantially and paired statistics are no longer valid. Cite this article: Bone Joint Res 2014;3:317–20.
Warmed or Burnt by Fire? The Lebanese Maronite Church Navigates French Colonial Policies, 1935
Authors: Malek Abisaab
Published: November 2014

This article sheds light on the development in the relationship between the Lebanese Maronite church and the French colonial authorities during the mid-1930s. It focuses on the confrontational stance of the church toward the French under the leadership of Patriarch Antoine 'Arida (1863–1955). I delineate 'Arida's resistance to the imposition of the tobacco monopoly, the Régie, and his diplomatic and political maneuvers, culminating with the 1935 popular uprising against the French, which cut across Muslim and Christian lines. Through the analysis of French archival documents and reports, I argue that the deterioration in Maronite-French relations was primarily caused by the colonial mapping of Grand Liban and its disruptive consequences for Mount Lebanon's leadership and economy. With the French imposition of the tobacco monopoly, the conflict took the form of a nationalist resistance against the French. Ultimately, the Maronite Church pursued a delicate balance between the interests of its parish and commitments to the French. The crisis sparked a critique of the French colonial logic, pushing the Maronite Church and the nationalist Lebanese elite to struggle for independence from the French.
Gender Variations in Over-the-Counter Sale of Prescription Medicines in Abu Dhabi, UAE
Authors: David Achanfuo Yeboah  , Tracey Maree Yeboah
Published: November 2014

Over-the-counter sale of medicines is endemic in Abu Dhabi, and all sorts of medicines can be purchased without the submission of a prescription (Yeboah, 2013). This study looks at the gender dimensions of the practice and examines the reasons given by pharmacists and their clients for the practice, emphasizing the specific differences between male and female respondents. The methodologies involve survey of pharmacists and their clients together with direct observation of the practice in selected pharmaceutical outlets. The results point to clear differences in the reasons given by male and female purchasers, but little to no differences in the reasons given by male and female pharmacists. The study concludes that both males and females are involved in the practice, albeit more male purchasers were observed buying the medicines.
Be(coming) clean: Confessions as governance in professional cycling
Authors: Sefiha Ophir , Reichman Nancy
Published: November 2014

Drawing from the public confessions of performance-enhancing drug (PED) use by high-profile riders and interviews with current North American-based professional cyclists, we examine the role that confessional accounts play in anti-doping regulation and governance of the sport of cycling. Our research examines the ways in which the confessional accounts make sense of cycling’s PED use and then become the raw material that the current generation of professionals use to both explain the past and inform their own thinking on PED use. We argue that these accounts are key to the emerging narrative of clean cycling, a narrative that legitimates and bolsters the World Anti-Doping Agency’s (WADA) strategies, rationalities and cultures that are distinctive to sport governance.
Constructing the national through sports news in Catalonia (2007–2009)
Authors: Juncà Pujol Albert , Inglés Yuba Eduard
Published: November 2014

The omnipresence of sport in the media and some of the characteristics associated with its presentation (constant presence, banality, emotional attachments … ) make it a prominent tool for the construction and reproduction of nationalism. In Catalonia, a territory in which two national identities coexist (Catalan and Spanish), sport plays a dominant role in the transmission of nationalizing messages. The present article analyses how the general press in Catalonia reproduce the nation through its treatment of sports information. We analyse the press coverage of sporting events in the period before the emergence of the recent pro-independence movement (2007–2009). The results reveal the presence of messages informed by the two nationalist persuasions (Catalan and Spanish), although with a clear prevalence of the latter in four of the six newspapers analysed.
Book Reports
Authors: Crane Diana
Published: November 2014

Fashion and Orientalism: Dress, Textiles and Culture from the 17th Century to the 21st Century, Adam Geczy (2013) London: Bloomsbury, (255 pp.) 978 1 84788 599 9 PB, $34.95

The Chinese Fashion Industry: An Ethnographic Approach, Jianhua Jhao (2013) London: Bloomsbury, (197 pp.) 9781 84788 935 5 (PB), $34.99
‘It’s kind of where the shoe gets you to I suppose’: Materializing identity with footwear
Authors: Sherlock Alexandra
Published: November 2014

Through their narrative incorporation in fairytales, song lyrics, in movies and on television shoes have become a ‘loaded device’ (Pine, 2006: 353) recycled as metonymy for the wearer or as metaphor for experience. Due to such extensive representation this article argues that they have become, in a sense, invisible. In existing academic literature we have tended to see the message rather than the shoe and we become blind to what Miller describes as the ‘humility’ of the shoe as a ‘thing’ (Miller 2005: 5). This neglect of the materiality of the shoe itself obscures the highly nuanced and subjective experiences of the wearer. As consumers/wearers, we might fully understand – even aspire to – the cultural connotations of a particular pair of shoes, yet this does not mean we will feel socially comfortable wearing them. Using empirical data gathered from wearers of the culturally significant Clarks Originals brand, this article reveals the co-constitutive relationship between the social identity of the wearer and that of the shoe. By focusing on the materiality of objects, bodies and environments we can overcome subject-object dualisms and really ‘see’ shoes in terms of the role they and their meanings play in a process of identification, transformation and cultural embodiment.
Materializing fashion: Designers, materials, ideas and the creation of designer shoes
Authors: Braithwaite Naomi
Published: November 2014

The article discusses the findings from an extensive ethnographic study of contemporary British women’s shoe designers that explored what creativity in shoe design entails. This study profiled 23 shoe designers who create shoes for the high fashion industry. The objective of the study was to tease out how these designers go about creating shoes while at the same time revealing how they perceive and experience their creativity in relation to the commercial world of fashion in which they are engaged. The designers presented in the article are celebrated by the fashion press and buyers internationally as creators of fashion. While the fashion industry enables these designers to create new collections each season, an acceptance that they were creating, or influenced by, fashion was absent from their narratives. Instead, for them, design was defined by creative freedom, expression and personal taste and through the materiality of their creations they were able to present their self-identities. This article presents shoe design as a creative process where materials are significant inspirational stimuli for each designer. Their selection of materials was often triggered by personal emotive reasons, as their sensory, tactile engagements with them would bring forth ideas for particular designs. They narrated creativity as a personal and emotional experience, distinct from fashion, yet each season their designs were commercialized as fashion and were proclaimed by fashion buyers, and other media agents, to be ‘on trend’ in terms of colours, materials and silhouettes. The article explores this paradox between the shoe designers’ desire to be creatively free and their necessary relationship to the commerciality of the fashion industry, examining how fashion works by drawing out the relationship between fashion’s different layers of design, materiality, creativity and commerciality.
Mongo: Refuse or resource? Residual narrations, an opportunity for the development of critical thinking and creative capacity
Authors: Zubiaga Augusto , Cilleruelo Lourdes
Published: November 2014

In ‘mongo, refuse or resource?’ we investigate the opportunities offered by the utilization of waste/retrieved products as a teaching resource for the development of critical thinking and creative capacity. Focussing on this uncertain and fluctuating transactional sphere allows us to access new dimensions when we undertake an intellectual dynamic of our sociocultural surroundings and when we accept and understand our values and how they can fluctuate. Entering the mongo dimension entails a shift of perspective when we attempt to tell ourselves stories in a creative way, because it allows us to speculate directly about the value of our objects, which leads us ineluctably to a constant rereading of our own identity, starting from that which we strive to conserve, as well as what we would like to dispose of – at least until others show that they would like to possess it.

En ‘mongo, ¿residuos o recursos?’ investigamos acerca de las oportunidades que ofrece la utilización de lo desechado/recuperado como recurso didáctico para el desarrollo del pensamiento crítico y la capacidad creativa. Poner el foco en ese ámbito transaccional incierto y cambiante,  permite acceder a nuevas dimensiones  a la hora de abordar una intelección dinámica de nuestro entorno sociocultural, asumir y entender nuestros valores y su fluctuación. Entrar en la dimensión mongo implica un cambio de perspectiva a la hora de abordar el intento de narrarnos a nosotros mismos de forma creativa, porque nos permite especular  directamente acerca de lo que valen nuestros objetos, y nos aboca irremisiblemente a una  relectura constante de nuestra propia identidad, a partir de aquello que nos empeñamos en atesorar, y de aquello que nos gustaría hacer desaparecer..., por lo menos hasta que ciertos otros demuestren querer poseerlo.