bluuebunny/crossref_metadata_2025 huggingface dataset:
Patients With a History of Idiopathic Deep Venous Thrombosis Have Long-Term Increased Levels of Inflammatory Markers and Markers of Endothelial Damage
Authors: Jezovnik Mateja Kaja , Fareed Jawed , Poredos Pavel
Published: September 2016

Introduction:

Although the role of inflammation in DVT has been investigated in different studies, there is no definite answer as to whether increased systemic inflammation is the cause or the consequence of DVT.

Aim:

To follow inflammatory parameters in a cohort of patients with idiopathic DVT.

Methods:

Out of 49 patients with an acute idiopathic DVT, which were investigated four months after an acute episode (DEVTA 1), 43 patients were included in the follow-up study investigating inflammatory markers and hemostatic markers of endothelial damage five years after an acute DVT (DEVTA 2). A control group consisted of 43 sex and age matched healthy subjects (CONTROLS).

Results:

The levels of inflammatory markers were significantly higher in DEVTA 2 in comparison to CONTROLS: tumor necrosis factor alpha 2.0 pg/mL (1.1-2.3) vs 1.3 pg/mL (0.8-1.9), p < .001, high sensitivity C-reactive protein 3.2 mg/L (1.5-5.2) vs 1.7 mg/L (0.9-3.0), p = .008, interleukin-6 (IL-6) 2.7 pg/mL (2.0-3.5) vs 2.1 pg/mL (1.5-2.6), p = .025, IL-8 5.0 pg/mL (3.6-7.3) vs 2.4 pg/mL (1.8-2.8), p < .001. IL-10 was significantly decreased (0.9 pg/mL (0.7-1.8) vs 1.8 (1.5-2.2), p < .001. Most of the proinflammatory markers remained elevated in the DEVTA 2 in comparison to DEVTA 1. Markers of endothelial damage were higher in DEVTA 2 in comparison to CONTROLS and higher than in DEVTA 1.

Conclusion:

Patients with idiopathic DVT have long-term increased inflammatory markers and markers of endothelial damage. These findings favor the hypothesis that inflammation is a cause and not merely a consequence of acute DVT.
Associations Between Maltreatment History and Severity of Substance Use Behavior in Youth in Foster Care
Authors: Gabrielli Joy , Jackson Yo , Brown Shaquanna
Published: September 2016

Substance use (SU) in youth remains a significant public health concern and a risk factor for morbidity and mortality in adolescents. The present study offers examination of the association between severity and chronicity of maltreatment history and SU in youth in foster care. Two hundred and ten (48% female) foster youth with a mean age of 12.71 years ( SD = 2.95 years) completed surveys using an audio-computer-assisted self-interview program. Results revealed 31% of participants reported past-year SU, and substance users had a mean CRAFFT score of 3.43 ( SD = 1.90). Reported age of SU onset was 11.08 years ( SD = 2.21 years). The SU measurement model demonstrated excellent fit in this sample. Accounting for both youth age and youth placement type, the structural model with maltreatment predicting SU severity demonstrated strong model fit with a significant path between maltreatment and SU. Youth in residential facilities and older youth had higher rates of use than those residing in traditional foster home environments and younger youth. Findings provide additional support for the link between maltreatment experiences and SU severity in foster youth and suggest the need for screening and intervention services appropriate for this high-risk population.
Adult ADHD and Comorbid Somatic Disease: A Systematic Literature Review
Authors: Instanes Johanne Telnes , Klungsøyr Kari , Halmøy Anne , Fasmer Ole Bernt , Haavik Jan
Published: September 2016

Objective: To systematically review, synthesize, and appraise available evidence, connecting adult ADHD with somatic disease. Method: Embase, Psychinfo, and Medline databases were searched for studies published from 1994 to 2015 addressing adult ADHD and somatic comorbidity. Somatic conditions were classified according to International Classification of Diseases (ICD-10) codes. Levels of evidence were graded as inconclusive, tentative, or well documented. Results: Most of the 126 studies included in the qualitative synthesis were small and of modest quality. Obesity, sleep disorders, and asthma were well-documented comorbidities in adult ADHD. Tentative evidence was found for an association between adult ADHD and migraine and celiac disease. In a large health registry study, cardiovascular disease was not associated with adult ADHD. Conclusion: There are few large systematic studies using standardized diagnostic criteria evaluating adult ADHD and somatic comorbidities. Significant associations are found between adult ADHD and several somatic diseases, and these are important to consider when assessing and treating either adult ADHD or the somatic diseases.
Shared decision-making in multiple sclerosis
Authors: Colligan Erica , Metzler Abby , Tiryaki Ezgi
Published: September 2016

In a healthcare environment that is trying to achieve better clinical outcomes and patient satisfaction, shared decision-making is a well-established concept that is gaining more interest. Multiple sclerosis is a preference-sensitive condition and provides the opportunity to implement decision aids at various decision points in the disease process. Literature about patient education and outcomes of shared decision aids in multiple sclerosis has been growing over the last decade. In this topical review, we present an overview of the current literature on shared decision-making in multiple sclerosis. While limitations to the generalizability and applicability of decision aids exist, there is evidence that decision aids and shared decision-making can be valuable tools in the clinical care of multiple sclerosis patients.
A strategy for the forensic detection of distraction burglary
Authors: Bond John W
Published: September 2016

Although much reduced in recent years, distraction burglary involving elderly or vulnerable victims continues to make up ∼ 4% of recorded UK domestic burglaries. Detection of these offences by forensic means, such as DNA or fingerprints, can be problematic due to the forensic awareness of the offender and a lack of recall by the victim. In this study, we consider a range of measures designed to improve the forensic detection of distraction burglary using trace DNA or fingerprints. Our findings show that attendance at a distraction burglary by two crime scene investigators, one of whom conducted a cognitive interview of the victim, produced a statistically significant increase in the number of offences detected using trace DNA when the deception involved the offender purporting to be from a utility company. For this deception, a cognitive interview of the victim did not produce increases in the number of offences detected using fingerprints. A cognitive interview of the victim for other deceptions did not produce an increase in trace DNA detections although the frequency of both DNA and fingerprint recovery was reduced, thereby saving time and resources. This success of trace DNA detection is due to the careful targeting of surfaces by the crime scene investigator for DNA recovery, based on information received from the victim. Attendance by crime scene investigators up to 2 h after an offence was reported had no statistically significant effect on the forensic detection of the offence. We include a strategy for the forensic examination of distraction burglary.
Exploring intentions towards human, social and financial capital investments in a turbulent economic environment
Authors: Palamida Eftychia , Xanthopoulou Despoina , Papagiannidis Savvas , Stamati Teta
Published: September 2016

This article applies the theory of planned behaviour in order to understand intentions to create new ventures or participate in existing ones, by investing human, social and financial capital in a turbulent economic environment, such as the one in Greece. We hypothesize that subjective norms relate to investment intentions (IIs) and that individual attitudes and perceived behavioural control over the investment mediate this relationship. We also propose that norms, attitudes and control interact in explaining IIs in such a way that intentions are stronger when positive norms and attitudes coexist with high levels of control. Hypotheses are tested by means of a cross-sectional quantitative study that was conducted in Greece ( N = 203). Bootstrap analyses support our mediation hypotheses by showing that norms relate positively to IIs via their associations with positive attitudes and high control. In addition, regression analyses show that norms, attitudes and control interact in explaining intentions. However, contrary to expectations, results show that positive attitudes towards investment boost IIs, in conditions where norms are positive but control is low.
Topological Navigation of Simulated Robots using Occupancy Grid
Authors: Szabo Richard
Published: September 2016

Formerly I presented a metric navigation method in the Webots mobile robot simulator. The navigating Khepera-like robot builds an occupancy grid of the environment and explores the square-shaped room around with a value iteration algorithm. Now I created a topological navigation procedure based on the occupancy grid process. The extension by a skeletonization algorithm results a graph of important places and the connecting routes among them. I also show the significant time profit gained during the process.
Compliance modeling of planar flexure-based mechanisms and its application to micro-motion stages
Authors: Du Yunsong , Li Tiemin , Ji Wei , Jiang Yao , Li Fuhua
Published: September 2016

This article presents the compliance modeling method of flexure-based mechanisms. The relationship between deformations and loads of the flexure members and the end effector is analyzed according to the zero virtual work principle. Using the matrix method, concise compliance equations for flexure serial and parallel structures are derived in conjunction with consideration of the compliance calculation errors of flexure hinges. Finally, relationships between the output compliances and geometrical parameters of a 3-revolute-revolute-revolute micro-motion stage are discussed. To validate the proposed compliance modeling method, the output compliances calculated by the empirical and theoretical compliance equations are subsequently compared with values derived from finite element analysis (FEA). The comparisons indicate that the results obtained from the empirical compliance equations are in good agreement with those derived from FEA, whereas the errors calculated by the theoretical equations are much larger, which demonstrate the accuracy of the empirical compliance equations and validate the proposed compliance modeling method.
Managing digital identity on Twitter
Authors: Cho Vincent , Jimerson Jo Beth
Published: September 2016

What does it mean to be and to act like a school leader online? Although many school leaders might be comfortable navigating issues of identity in face-to-face environments, online environments may present new and unprecedented challenges. These challenges may range from concerns about privacy and surveillance to questions about how best to leverage social media for professional or school aims. Accordingly, the present study draws upon interview and tweet data to explore administrators’ performance of identity on Twitter. Findings describe how administrators enacted two distinct identities: one relating to instructional leadership and the other relating to school public relations. Administrators were reticent about revealing other, more personal identities. This was seen as a way to maintain and gain followers. Implications for identity research, online professional learning, and public school relations are discussed.
Cyst-like change in the thyroid cartilage: A developmental variant in children
Authors: Chetcuti Karen , Avula Shivaram
Published: September 2016

Neck sonography is frequently encountered on ultrasound lists in the paediatric patient population. Anecdotally, one of the most frequent clinical indications is the investigation of a neck lump. While performing an ultrasound of the neck, structures other than those routinely assessed, such as the thyroid cartilage and mandibular cortex also come into view. Occasionally, pathology in these structures is also encountered, albeit less frequently. The purpose of this case report and review is to illustrate the ultrasound, computed tomography and magnetic resonance imaging appearances of cyst-like changes in the thyroid cartilage that are encountered in children, particularly in early adolescence.
Diabetic foot sepsis
Authors: Forsyth James Michael
Published: September 2016

This article focuses on the end-stage of diabetic foot disease: Diabetic foot sepsis. The aetio-pathogenesis and clinical diagnosis of diabetic foot disease is discussed. The article explores the management of limb- and non-limb-threatening diabetic foot infections, and in particular, the importance of utilising the diabetic foot clinic and the specialist multi-disciplinary team to prevent high-risk patients from further foot deterioration. The importance of preventing the development of diabetic foot disease through screening and primary and secondary prevention strategies is also discussed.
Single-Stage Bipedicle Local Tissue Transfer and Skin Graft for Achilles Tendon Surgery Wound Complications
Authors: Dekker Travis J. , Avashia Yash , Mithani Suhail K. , Matson Andrew P. , Lampley Alexander J. , Adams Samuel B.
Published: September 2016

Introduction. Achilles tendon and posterior heel wound complications are difficult to treat. These typically require soft tissue coverage via microvascular free tissue transfer at a tertiary referral center. Here, we describe coverage of a series of posterior heel and Achilles wounds via simple, local tissue transfer, called a bipedicle fasciocutaneous flap. This flap can be performed by an orthopaedic foot and ankle surgeon, without resources of tertiary/specialized care or microvascular support. Methods. Three patients with separate pathologies were treated with a single-stage bipedicle fasciocutaneous local tissue transfer. Case 1 was a patient with insertional wound breakdown after Achilles debridement and repair to the calcaneus. Case 2 was a heel venous stasis ulcer with calcaneal exposure in a diabetic patient with vasculopathy. Case 3 was a patient with wound breakdown following midsubstance Achilles tendon repair. All three cases were treated with a single-stage bipedicle local tissue transfer for posterior ankle and heel wound complications. Results. All 3 patients demonstrated complete healing of the posterior defect, lateral ankle skin graft recipient site, and the skin graft donor site after surgery. Case 3 had a subsequent recurrent ulceration after initial healing. This was superficial and healed with local wound care. All patients regained full preoperative range of motion and were able to ambulate independently without modified footwear. Conclusions. The bipedicled fasciocutaneous flap described here offers a predictable single stage procedure that can be accomplished by an orthopaedic foot and ankle surgeon without resources of a tertiary care center for posterior foot and ankle defects. This flap can be performed with short operative times and can be customized to facilitate defect coverage. The flap is durable to withstand local tissue stresses required for early ambulation. Despite its reliability, patients require careful follow-up to manage underlying comorbid conditions that may complicate wound healing.

Levels of Evidence: Level IV: Case series
Do Easterners and Westerners Differ in Visual Cognition? A Preregistered Examination of Three Visual Cognition Tasks
Authors: Hakim Nicole , Simons Daniel J. , Zhao Hui , Wan Xiaoang
Published: September 2016

When performing cognitive tasks, Easterners often process information more holistically and contextually than Westerners. This is often taken as evidence for fundamental differences in basic cognition, including attention and perception. Yet, evidence for such basic cognitive differences is inconsistent, many studies are based on small samples, and few have been replicated. We report a preregistered replication of three prominent findings of cultural differences in visual cognition, testing a substantially larger sample than the original studies. Our comparisons of American and Asian International students living in the United States provided relatively little evidence for robust and consistent cultural differences in global/local biases, relative and absolute length judgments, or change detection performance. Although we observed some differences in change detection performance when comparing Chinese to American students, those differences were inconsistent across measures. We discuss the need for larger scale replications that adequately control for the testing context and demand characteristics.
Association of glutathione S-transferase GSTM1 and GSTT1 deletion polymorphisms with obesity and their relationship with body mass index, lipoprotein and hypertension among young age Saudis
Authors: Almoshabek Hamoud A , Mustafa Md , Al-Asmari Mohammed M , Alajmi Tahani K , Al-Asmari Abdulrahman K
Published: September 2016

Objectives

Persistent oxidative stress is one of the several risk factors that may be associated with the etiology of obesity. The present study is aimed to investigate association between GSTM1 and GSTT1 polymorphisms with obesity and their relationship with plasma lipoproteins, body mass index (BMI) and hypertension.

Design

The GSTM1 and GSTT1 deletion polymorphisms were analyzed by multiplex polymerase chain reaction. The lipoproteins were measured in plasma using commercially available kit and the weight, height, systolic (SBP) and diastolic (DBP) blood pressures by standard procedure of measurements.

Setting

Prince Sultan Military Medical City, Riyadh Saudi Arabia.

Participants

A total of 420 overweight/obese cases and 234 normal weight controls belong to young age Saudis.

Main outcomes measures

GSTM1/ GSTT1 polymorphisms may be associated with obesity.

Results

Weight, BMI, low-density lipoprotein (LDL) and SBP were significantly higher while high-density lipoprotein (HDL) was significantly lower in cases in comparison to controls. Frequency of GSTM1+/ GSTT1− (OR = 2.70, 95% CI = 1.52–4.81, p = <0.001) and GSTM1−/ GSTT1− (OR = 2.43, 95% CI = 1.15–5.15, p = 0.018) was significantly higher in cases as compared to controls. BMI and weight were significantly higher in GSTM1+/ GSTT1− and GSTM1−/ GSTT1− genotypes, and LDL, DBP and SBP significantly higher in GSTM1−/ GSTT1− null genotype while HDL was significantly lower in GSTM1−/ GSTT1+ and GSTM1−/ GSTT1− genotypes in comparison to GSTM1+/ GSTT1+ genotype.

Conclusions

The GSTM1+/ GSTT1− and GSTM1−/ GSTT1− null genotypes were significantly associated with obesity and have shown relationship with obesity risk factors in cases. Hence, these genes may be associative genetic risk factor for obesity among young age Saudis.
Abortion, substance abuse and mental health in early adulthood: Thirteen-year longitudinal evidence from the United States
Authors: Sullins Donald Paul
Published: September 2016

Objective:

To examine the links between pregnancy outcomes (birth, abortion, or involuntary pregnancy loss) and mental health outcomes for US women during the transition into adulthood to determine the extent of increased risk, if any, associated with exposure to induced abortion.

Method:

Panel data on pregnancy history and mental health history for a nationally representative cohort of 8005 women at (average) ages 15, 22, and 28 years from the National Longitudinal Study of Adolescent to Adult Health were examined for risk of depression, anxiety, suicidal ideation, alcohol abuse, drug abuse, cannabis abuse, and nicotine dependence by pregnancy outcome (birth, abortion, and involuntary pregnancy loss). Risk ratios were estimated for time-dynamic outcomes from population-averaged longitudinal logistic and Poisson regression models.

Results:

After extensive adjustment for confounding, other pregnancy outcomes, and sociodemographic differences, abortion was consistently associated with increased risk of mental health disorder. Overall risk was elevated 45% (risk ratio, 1.45; 95% confidence interval, 1.30–1.62; p < 0.0001). Risk of mental health disorder with pregnancy loss was mixed, but also elevated 24% (risk ratio, 1.24; 95% confidence interval, 1.13–1.37; p < 0.0001) overall. Birth was weakly associated with reduced mental disorders. One-eleventh (8.7%; 95% confidence interval, 6.0–11.3) of the prevalence of mental disorders examined over the period were attributable to abortion.

Conclusion:

Evidence from the United States confirms previous findings from Norway and New Zealand that, unlike other pregnancy outcomes, abortion is consistently associated with a moderate increase in risk of mental health disorders during late adolescence and early adulthood.
Opioid use disorder patients’ perceptions of healthcare delivery platforms
Authors: Rakita Uros , Giacobbe Peter , Cavacuiti Chris
Published: September 2016

Objectives:

To assess the acceptability and quality of web-based videoconferencing telemedicine consultation platform in the treatment of opioid use disorder at TrueNorth Medical Centre.

Methods:

We conducted an interview based quality improvement initiative using an investigator-designed questionnaire. The questionnaire consisted of 17 Agree/Disagree questions, measured on a 7-point Likert scale and 2 questions where patients had the ability to elaborate qualitatively on their perceptions and experiences with their telemedicine service. Content-style analysis was performed on qualitative responses.

Results:

The majority of patients (n=14; 47%) preferred face-to-face over telemedicine consultations. The number of patients that preferred telemedicine consultations over face-to-face consultations was lower (n=6; 20%). A notable number of patients (n=10; 33%) indicated no specific preference for either telemedicine or face-to-face consultations. Patients preferring face-to-face consultations rated their clinical outcome and patient-physician relationship following telemedicine consultations similarly as those who preferred telemedicine consultations. Patients preferring telemedicine rated their experience and overall perceptions of the service significantly higher than those preferring face-to-face consultations. Patients who preferred telemedicine consultations identified the efficient and timesaving nature of telemedicine consultations as primary advantages whereas those preferring face-to-face consultations reported lower levels of empathy from their physician during telemedicine consultations as a major disadvantage.

Conclusions:

The majority of patients at TrueNorth Medical Centre viewed telemedicine consultations as an acceptable treatment modality. Patients preferring telemedicine consultations and those preferring face-to-face consultations evaluated the majority of the measured indices of care in a similar fashion.
Long-term acute care hospitals and Georgia Medicaid: Utilization, outcomes, and cost
Authors: Cole Evan S. , Willis Carla , Rencher William C , Zhou Mei
Published: September 2016

Objectives:

Because most research on long-term acute care hospitals has focused on Medicare, the objective of this research is to describe the Georgia Medicaid population who received care at a long-term acute care hospital, the type and volume of services provided by these long-term acute care hospitals, and the costs and outcomes of these services. For those with select respiratory conditions, we descriptively compare costs and outcomes to those of patients who received care for the same services in acute care hospitals.

Methods:

We describe Georgia Medicaid recipients admitted to a long-term acute care hospital between 2011 and 2012. We compare them to a population of Georgia Medicaid recipients admitted to an acute care hospital for one of five respiratory diagnosis-related groups. Measurements used include patient descriptive information, admissions, diagnosis-related groups, length of stay, place of discharge, 90-day episode costs, readmissions, and patient risk scores.

Results:

We found that long-term acute care hospital admissions for Medicaid patients were fairly low (470 90-day episodes) and restricted to complex cases. We also found that the majority of long-term acute care hospital patients were blind or disabled (71.2%). Compared to patients who stayed at an acute care hospital, long-term acute care hospital patients had higher average risk scores (13.1 versus 9.0), lengths of stay (61 versus 38 days), costs (US$143,898 versus US$115,056), but fewer discharges to the community (28.4% versus 51.8%).

Conclusion:

We found that the Medicaid population seeking care at long-term acute care hospitals is markedly different than the Medicare populations described in other long-term acute care hospital studies. In addition, our study revealed that Medicaid patients receiving select respiratory care at a long-term acute care hospital were distinct from Medicaid patients receiving similar care at an acute care hospital. Our findings suggest that state Medicaid programs should carefully consider reimbursement policies for long-term acute care hospitals, including bundled payments that cover both the original hospitalization and long-term acute care hospital admission.
Political Ideology and Immigrant Acceptance
Authors: Brooks Clem , Manza Jeff , Cohen Emma D.
Published: September 2016

How does political ideology influence the ways individuals reason about immigrants? Analyzing data from a 2013 national survey, this study offers new perspective on the relevance of political ideology for understanding individuals’ willingness to accept immigrants. Liberals and conservatives show very different responses to the prospect of specific individuals or groups immigrating to the United States. These differences are large when experimental treatments cue Arabic and Hispanic names or symbolic threats. The authors discuss the benefits of incorporating ideology and extending the scope of established theory and research on immigrant acceptance.
Metformin Synergizes With Conventional and Adjuvant Analgesic Drugs to Reduce Inflammatory Hyperalgesia in Rats
Authors: Pecikoza Uroš B. , Tomić Maja A. , Micov Ana M. , Stepanović-Petrović Radica M.
Published: September 2016

BACKGROUND:

Metformin is a widely used and safe antidiabetic drug that has recently been shown to possess analgesic properties in models of inflammatory pain. Because various arthritic inflammatory disorders are highly prevalent in diabetic patients, we aimed to examine the type of interaction between metformin and several conventional and adjuvant analgesic drugs (ibuprofen, aspirin, tramadol, and pregabalin) in a rat model of somatic inflammatory hyperalgesia.

METHODS:

Inflammation of the rat hind paw was induced by an intraplantar injection of carrageenan (0.1 mL, 1%). The antihyperalgesic effects of metformin (intraperitoneally), analgesics (orally or intraperitoneally), and 2-drug metformin-analgesic combinations were assessed with an electronic Von Frey anesthesiometer, by measuring the change in paw withdrawal thresholds induced by carrageenan (n = 6 rats in drug/drug combination–treated groups). First, we determined the doses of individual drugs needed to produce an antihyperalgesic effect of 50% (ED50 values). In combination experiments, drugs were coadministered in fixed-dose fractions (1/16, 1/8, 1/4, and 1/2) of their individual ED50 values and the type of interaction between components was determined by isobolographic analysis.

RESULTS:

Metformin (50–200 mg/kg) significantly and dose-dependently reduced carrageenan-induced hyperalgesia with a maximal antihyperalgesic effect (mean ± SEM) of 62 ± 6% (all P ≤ .024). Ibuprofen (25–150 mg/kg), aspirin (100–400 mg/kg), tramadol (0.5–5 mg/kg), and pregabalin (2.5–20 mg/kg) also produced significant and dose-dependent antihyperalgesic effects (all P ≤ .042) of similar magnitude to metformin (the maximal antihyperalgesic effects were 73 ± 4% for ibuprofen, 62 ± 4.2% for aspirin, 69 ± 5.9% for tramadol, and 56 ± 3.9% for pregabalin). In combination experiments, administration of 2-drug metformin-analgesic combinations led to a significant and dose-dependent reduction of carrageenan-induced hyperalgesia (all P ≤ .027). The isobolographic analysis revealed that metformin interacted synergistically with the examined analgesics (experimental ED50 values of 2-drug combinations were significantly lower than theoretical additive ED50 values; all P < .05) and that there was a similar, approximately 5-fold, reduction of doses of both drugs in all tested combinations.

CONCLUSIONS:

Our results suggest that in patients who are already receiving metformin therapy, lower doses of ibuprofen/aspirin/tramadol/pregabalin might be sufficient for achieving satisfactory pain relief. Metformin-aspirin combination might be particularly useful because it may achieve multiple therapeutic goals (glucoregulation, pain relief, and cardioprotection).
Acute Normovolemic Hemodilution Reduces Allogeneic Red Blood Cell Transfusion in Cardiac Surgery: A Systematic Review and Meta-analysis of Randomized Trials
Authors: Barile Luigi , Fominskiy Evgeny , Di Tomasso Nora , Alpìzar Castro Ligia Elena , Landoni Giovanni , De Luca Monica , Bignami Elena , Sala Alessandra , Zangrillo Alberto , Monaco Fabrizio
Published: September 2016

BACKGROUND:

To better understand the role of acute normovolemic hemodilution (ANH) in a surgical setting with high risk of bleeding, we analyzed all randomized controlled trials (RCTs) in the setting of cardiac surgery that compared ANH with standard intraoperative care. The aim was to assess the incidence of ANH-related number of allogeneic red blood cell units (RBCu) transfused. Secondary outcomes included the rate of allogeneic blood transfusion and estimated total blood loss.

METHODS:

Twenty-nine RCTs for a total of 2439 patients (1252 patients in the ANH group and 1187 in the control group) were included in our meta-analysis using PubMed/MEDLINE, Cochrane Controlled Trials Register, and EMBASE.

RESULTS:

Patients in the ANH group received fewer allogeneic RBCu transfusions (mean difference = −0.79; 95% confidence interval [CI], −1.25 to −0.34; P = .001; I
2 = 95.1%). Patients in the ANH group were overall transfused less with allogeneic blood when compared with controls (356/845 [42.1%] in the ANH group versus 491/876 [56.1%] in controls; risk ratio = 0.74; 95% CI, 0.62 to 0.87; P < .0001; I
2 = 72.5%), and they experienced less postoperative blood loss (388 mL in ANH versus 450 mL in control; mean difference = −0.64; 95% CI, −0.97 to −0.31; P < .0001; I
2 = 91.8%).

CONCLUSIONS:

ANH reduces the number of allogeneic RBCu transfused in the cardiac surgery setting together with a reduction in the rate of patients transfused with allogeneic blood and with a reduction of bleeding.
Pharmacological treatment and BBB-targeted genetic therapy for MCT8-dependent hypomyelination in zebrafish
Authors: Zada David , Tovin Adi , Lerer-Goldshtein Tali , Appelbaum Lior
Published: September 2016

Hypomyelination is a key symptom of Allan-Herndon-Dudley syndrome (AHDS), a psychomotor retardation associated with mutations in the thyroid-hormone (TH) transporter MCT8 (monocarboxylate transporter 8). AHDS is characterized by severe intellectual deficiency, neuromuscular impairment and brain hypothyroidism. In order to understand the mechanism for TH-dependent hypomyelination, we developed an mct8 mutant (mct8−/−) zebrafish model. The quantification of genetic markers for oligodendrocyte progenitor cells (OPCs) and mature oligodendrocytes revealed reduced differentiation of OPCs into oligodendrocytes in mct8−/− larvae and adults. Live imaging of single glial cells showed that the number of oligodendrocytes and the length of their extensions are reduced, and the number of peripheral Schwann cells is increased, in mct8−/− larvae compared with wild type. Pharmacological analysis showed that TH analogs and clemastine partially rescued the hypomyelination in the CNS of mct8−/− larvae. Intriguingly, triiodothyronine (T3) treatment rescued hypomyelination in mct8−/− embryos before the maturation of the blood–brain barrier (BBB), but did not affect hypomyelination in older larvae. Thus, we expressed Mct8-tagRFP in the endothelial cells of the vascular system and showed that even relatively weak mosaic expression completely rescued hypomyelination in mct8−/− larvae. These results suggest potential pharmacological treatments and BBB-targeted gene therapy that can enhance myelination in AHDS and possibly in other TH-dependent brain disorders.
Using health psychology to help patients: common mental health disorders and psychological distress
Authors: Barley Elizabeth , Lawson Victoria
Published: September 2016

This article provides an overview of how health psychology can be used by nurses to help patients experiencing common mental health problems and psychological distress. Mental health problems are common and are associated with poor outcomes, especially for patients with comorbid physical health conditions. Mental health problems are associated with unhealthy behaviours such as smoking, physical inactivity, overeating and excessive alcohol use, which will result in poorer outcomes for patients. Consideration of a patient's psychological health is therefore important for all nurses providing holistic care. Awareness of the symptoms of psychological distress, good communication skills and simple screening instruments can be used by nurses to assess patients' mental health. The cognitive and behavioural risk factors associated with depression and anxiety are also explored, as an understanding of these can help nurses to provide appropriate care.
Childhood obesity plan: the Government declares war on sugar
Authors: Glasper Alan
Published: September 2016

Emeritus Professor Alan Glasper, from the University of Southampton, discusses the latest Government initiative to tackle the rising levels of childhood obesity in the UK
Children's nursing: patient safety and clinical risk in neonatal care
Authors: Tingle John
Published: September 2016

John Tingle, Reader in Health Law at Nottingham Trent University, discusses a recent publication by the Care Quality Commission (CQC) that looks at identifying and managing clinical risks in newborn babies
Deprivation of liberty and covert medicines: practice implications
Authors: Griffith Richard
Published: September 2016

Richard Griffith, Senior Lecturer in Health Law at Swansea Univeristy, considers a recent decision by the Court of Protection
Normalising the abnormal is no good
Authors: Foster Sam
Published: September 2016

Sam Foster, Chief Nurse at Heart of England NHS Foundation Trust, considers the issues around staffing and the importance of being open about challenges
Care and management of a stoma: maintaining peristomal skin health
Authors: Boyles Anna , Hunt Sharon
Published: September 2016

It is estimated that around one in 500 people in the UK are living with a stoma, with approximately 21 000 operations that result in stoma formation being performed each year ( Colostomy Association, 2016 ). These people face a unique set of challenges in maintaining the integrity of their peristomal skin. This article explores the normal structure and function of skin and how the care and management of a stoma presents challenges for maintaining peristomal skin health. Particular focus is paid to the incidence of skin problems for those living with a stoma, whether it is temporary or permanent, and the factors that contribute to skin breakdown in this population. Wider factors such as the central role of the clinical nurse specialist and the impact of product usage on positive outcomes and health economics are also considered.
How stoma care nursing has changed over the course of one nurse's career
Authors: Black Pat
Published: September 2016

Pat Black, Associate Lecturer, Birmingham City University and previously Senior Lecturer, St Mark's Institute for Gastrointestinal Nursing, looks back at the origins of stoma care nursing and ponders what the future might hold
Politics and palliative care: Niger
Authors: Smyth Dion
Published: September 2016

Dion Smyth's review of the internet for palliative nursing
Spooky thrills!
Authors: Hewson Claire
Published: September 2016

It's that time of year again! There is nothing like Halloween to make children excited and get their creative juices flowing. Claire Hewson outlines some easy recipes and fun activities linked to Mr Tickle.
Procesos psicosociales y didácticos en la alfabetización inicial de personas jóvenes y adultas: la urdimbre y la trama
Authors: Kurlat Marcela
Published: September 2016

Este artigo sintetiza as principais conclusões da tese de doutoramento em educação pela Universidade de Buenos Aires: “Processos psicogenéticos, psicossociais e didáticos na alfabetização inicial de jovens e adultos. Estudo de caso”, dentro do Programa de Desenvolvimento Sociocultural e Educação Permanente: a educação de jovens e adultos para além da escola, com sede no Instituto de Investigações em Ciências da Educação da Universidade de Buenos Aires. Apresentam-se as principais categorias que trazem resposta ao problema em investigação: o “Culto às letras” e “Pensar e fazer uso da escrita”. Elas permitem elaborar reflexões sobre a urdidura e a trama nos processos de alfabetização inicial de jovens e adultos, bem como analisar possíveis vinculações com os processos de construção, nessa população, de demandas por mais educação. O que, por sua vez, leva a evidenciar a dívida educacional ainda vigente na alfabetização de jovens e adultos.
Knowledge levels of members of different occupations on child abuse and neglect
Authors: Tural Büyük Esra , Rızalar Selda
Published: September 2016

Due to the fact that there are limited numbers of studies on child abuse and neglect in our country and the fact that insufficient training before and after graduation cause lack of information and experience in occupations that involve children, some cases may not be noticed.Purpose: This study was conducted to find out the knowledge levels of nurses, teachers and police who have an important role in recognizing and preventing child abuse and neglect.Methods: 220 nurses, 128 teachers and 150 police working in a town center in the North of Turkey participated in the study. A questionnaire was used to determine the knowledge levelsof the participants on children's neglect and physical and sexual abuse. The data was analyzed by SPSS package program and percentages and chisquare test was used in analyses.Results: 72.5% of the police, 65.9% of the nurses and 21.1% of the teachers stated that they had encountered child abuse and neglect. In terms of the levels of recognizing evidence of neglect in children, no statistically significant difference was found between occupational groups; however, a statistically significant difference was found between groups in terms of recognizing evidence of physical abuse.Conclusions: The results of this study showed that nurses were more successful than teachers and police in diagnosing the symptoms of physical and sexual abuse in children; however, no difference was found between the members of different occupations in terms of diagnosing signs of neglect in children.
Reliability and Accuracy of a Standardized Shallow Water Running Test to Determine Cardiorespiratory Fitness
Authors: Nagle Elizabeth F. , Sanders Mary E. , Gibbs Bethany B. , Franklin Barry A. , Nagle Jacquelyn A. , Prins Philip J. , Johnson Caleb D. , Robertson Robert J.
Published: September 2016

Nagle, EF, Sanders, ME, Gibbs, BB, Franklin, BA, Nagle, JA, Prins, PJ, Johnson, CD, and Robertson, RJ. Reliability and accuracy of a standardized shallow water running test to determine cardiorespiratory fitness. J Strength Cond Res 31(6): 1669–1677, 2017—A standardized fitness assessment is critical for the development of an individualized exercise prescription. Although the benefits of aquatic exercise have been well established, there remains the need for a standardized nonswimming protocol to accurately assess cardiorespiratory fitness (CRF) in shallow water. The present investigation was designed to assess (a) the reliability of a standardized shallow water run (SWR) test of CRF and (b) the accuracy of a standardized SWR compared with a land-based treadmill (LTM) test. Twenty-three healthy women (20 ± 3 years), with body mass index (23.5 ± 3 kg·m−2), performed 2 shallow water peak oxygen consumption (V̇o
2peak) running tests (SWRa and SWRb), and 1 V̇o
2max LTM. Intraclass correlation coefficients indicated moderately strong reliability for V̇o
2peak (ml·kg−1·min−1) (r = 0.73, p < 0.01), HRpeak (b·min−1) (r = 0.82; p < 0.01), and O2pulse (V̇o
2 [ml·kg−1·min−1]·HR [b·min−1]) (r = 0.77, p < 0.01). Using paired t-tests and Pearson's correlations, SWR V̇o
2peak and HRpeak were significantly lower than during LTM (p ≤ 0.05) and showed moderate correlations of 0.60 and 0.58 (p < 0.001) to LTM. O2pulse was similar (p > 0.05) for the SWR and LTM tests with a moderate correlation of 0.63. A standardized SWR test as a measure of CRF is a reliable, and to some degree, valid alternative to conventional protocols and may be used by strength and conditioning professionals to measure program outcomes and monitor training progress. Furthermore, this protocol provides a water-based option for CRF assessment among healthy women and offers insight toward the development of an effective protocol that can accommodate individuals with limited mobility, or those seeking less musculoskeletal impact from traditional land-based types of training.
The Effects of a Heel Wedge on Hip, Pelvis and Trunk Biomechanics During Squatting in Resistance Trained Individuals
Authors: Charlton Jesse M. , Hammond Connor A. , Cochrane Christopher K. , Hatfield Gillian L. , Hunt Michael A.
Published: September 2016

Charlton, JM, Hammond, CA, Cochrane, CK, Hatfield, GL, and Hunt, MA. The effects of a heel wedge on hip, pelvis, and trunk biomechanics during squatting in resistance trained individuals. J Strength Cond Res 31(6): 1678–1687, 2017—Barbell back squats are a popular exercise for developing lower extremity strength and power. However, this exercise has potential injury risks, particularly to the lumbar spine, pelvis, and hip joint. Previous literature suggests heel wedges as a means of favorably adjusting trunk and pelvis kinematics with the intention of reducing such injury risks. Yet no direct biomechanical research exists to support these recommendations. Therefore, the purpose of this study was to examine the effects of heel wedges compared with barefoot on minimally loaded barbell back squats. Fourteen trained male participants performed a barbell back squat in bare feet or with their feet raised bilaterally with a 2.5-cm wooden block while 3-dimensional kinematics, kinetics, and electromyograms were collected. The heel wedge condition elicited significantly less forward trunk flexion angles at peak knee flexion, and peak external hip joint moments (p ≤ 0.05) compared with barefoot conditions. However, no significant differences were observed between conditions for trunk and pelvis angle differences at peak knee flexion (p > 0.05). Lastly, no peak or root mean square differences in muscle activity were elicited between conditions (p > 0.05). Our results lend support for the suggestions provided in literature aimed at using heel wedges as a means of reducing excessive forward trunk flexion. However, the maintenance of a neutral spine, another important safety factor, is not affected by the use of heel wedges. Therefore, heel wedges may be a viable modification for reduction of excessive forward trunk flexion but not for reduction in relative trunk-pelvis flexion during barbell back squats.
John C. Calhoun And The Constitutional Amending Process: Article V And The Theory Of Concurrent Majorities
Authors: Vile John R.
Published: September 2016

Among Americans, John C. Calhoun is generally regarded by scholars not only as a prominent nineteenth century statesman but also as one of the most original and logical political thinkers. (For discussion of prominent interpretations, see Current 1963 and Harris 1984.) Initially a strong nationalist who professed little concern “ for refined arguments on the constitution,” (Calhoun 1959, I, 403) Calhoun increasingly became the acknowledged spokesman for those southerners who turned to the Constitution (Carpenter 1963, 127-170) in the hope of protecting their peculiar institution.
Committee Policy Making In The House: Comparing The Agriculture And Judiciary Committees
Authors: Dewhirst Robert E.
Published: September 2016

This paper explores whether committees or their subcommittees dominate policy making in the standing committees of the House of Representatives. Such a research question falls within a tradition of inquiry initiated more than a century ago when Woodrow Wilson argued that Congressional government was ultimately committee government. However, more recent scholars have begun speculating that committees have declined in influence in favor of subcommittees. The most extreme dimension of this viewpoint has even maintained that congressional government has become subcommittee government.
Further Explorations Of Regionalism And Political Opinion In Arkansas
Authors: Blaire Diane D. , Mangold William D. , Savage Robert L.
Published: September 2016

While some persist in arguing that Arkansas politics is inexplicable in any systematic way, others continue to attempt to find some reliable, predictable patterns in regional political preferences and voting behavior. In 1984, Savage and Blair reviewed the intrastate distinctions that had been traditionally offered in explanation of Arkansas politics, and then tested some of those generalizations against contemporary public opinion data.
Measuring Legislative Effectiveness In The Missouri General Assembly: A Longitudinal Study
Authors: Ellickson Mark C. , Whistler Donald E.
Published: September 2016

The responsibilities and duties of a state legislator are numerous. In addition to their policymaking efforts, legislators are expected to provide constituent service, preside over the bureaucracy, resolve conflict, educate the public, promote good government, and campaign for re-election to name a few (Rosenthal, 1974: 11-12; Jewell and Patterson, 1986: 9-13). However, if there is one activity that dominates a legislator’s time and energy when they are in session, it is the sponsoring of legislation and promoting its enactment into law (Rosenthal, 1981: 255-256; Patterson, 1983: 165).
County Government Reform Efforts In Mississippi
Authors: Wiseman Martin
Published: September 2016

County government reform has become the subject of great interest today in Mississippi. Recent incidents of illegalities and irregularities in the conduct of county government have brought forth calls for reform from various sectors and these reform demands have been met by equally enthusiastic opposition to any action which might alter the current relationship that rural citizens have with county officials who represent them. Opposition by county officials and a large segment of the rural electorate quickly evaporates any notion that reform will be easy. Reform efforts generally create controversy because the affected constituents believe their fundamental rights to be governed as they choose will be abridged.
Opinion Agreement Analysis Of Supreme Court Justices: A Methodological Note (Research Note)
Authors: LeVar C. Jeddy
Published: September 2016

The purpose of this paper is to explain the uses of opinion agreement analysis in studying appellate courts and provide examples of those uses with U.S. Supreme Court justices. This method is a relatively new approach, whose potential for expanding our knowledge about judicial behavior is just beginning to be tapped.