bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient and Provider Perspectives on Mammographic Breast Density Notification Legislation
Authors: Klinger Elissa V. , Kaplan Celia P. , St. Hubert Stella , Birdwell Robyn L. , Haas Jennifer S.
Published: November 2016

Background: Patient advocacy has fostered the implementation of mammographic breast density (MBD) notification legislation in many states. Little is known about the perspectives of women, primary care physicians (PCPs), and breast radiologists in response to this legislation. The objective of this research was to elicit qualitative information from these multiple stakeholders to understand varied perspectives on the subject of MBD notification and inform best practices around implementation. Methods: Content analysis of narrative data from focus groups with women (2 groups, total of 16 participants) and in-depth interviews with PCPs (n = 7) and breast radiologists (n = 7). Results: Three major themes emerged from the data: 1) knowledge and general attitudes about legislation, 2) concerns about consequences, and 3) actions patients and clinicians should consider based on MBD information. For each of these themes, the views of women, PCPs, and radiologists often demonstrated different perspectives. Conclusion: This work supports the need for clear and concise tools for patients and providers to understand MBD in the context of a woman’s overall breast cancer risk with guidance on next steps.
Endothelial cells produce bone morphogenetic protein 6 required for iron homeostasis in mice
Authors: Canali Susanna , Zumbrennen-Bullough Kimberly B. , Core Amanda B. , Wang Chia-Yu , Nairz Manfred , Bouley Richard , Swirski Filip K. , Babitt Jodie L.
Published: November 2016

Key Points

Endothelial Bmp6 conditional knockout mice exhibit hemochromatosis, whereas hepatocyte and macrophage Bmp6 conditional knockout mice do not. Our data support a model in which EC Bmp6 has paracrine actions on hepatocyte hemojuvelin to regulate hepcidin production.
Development and Validation of the Conceptual Assessment of Natural Selection (CANS)
Authors: Kalinowski Steven T. , Leonard Mary J. , Taper Mark L.
Published: November 2016

We developed and validated the Conceptual Assessment of Natural Selection (CANS), a multiple-choice test designed to assess how well college students understand the central principles of natural selection. The expert panel that reviewed the CANS concluded its questions were relevant to natural selection and generally did a good job sampling the specific concepts they were intended to assess. Student interviews confirmed questions on the CANS provided accurate reflections of how students think about natural selection. And, finally, statistical analysis of student responses using item response theory showed that the CANS did a very good job of estimating how well students understood natural selection. The empirical reliability of the CANS was substantially higher than the Force Concept Inventory, a highly regarded test in physics that has a similar purpose.
Crossing the Threshold: Bringing Biological Variation to the Foreground
Authors: Batzli Janet M. , Knight Jennifer K. , Hartley Laurel M. , Maskiewicz April Cordero , Desy Elizabeth A.
Published: November 2016

Threshold concepts have been referred to as “jewels in the curriculum”: concepts that are key to competency in a discipline but not taught explicitly. In biology, researchers have proposed the idea of threshold concepts that include such topics as variation, randomness, uncertainty, and scale. In this essay, we explore how the notion of threshold concepts can be used alongside other frameworks meant to guide instructional and curricular decisions, and we examine the proposed threshold concept of variation and how it might influence students’ understanding of core concepts in biology focused on genetics and evolution. Using dimensions of scientific inquiry, we outline a schema that may allow students to experience and apply the idea of variation in such a way that it transforms their future understanding and learning of genetics and evolution. We encourage others to consider the idea of threshold concepts alongside the Vision and Change core concepts to provide a lens for targeted instruction and as an integrative bridge between concepts and competencies.
Impact of long-term medical conditions on the outcomes of psychological therapy for depression and anxiety
Authors: Delgadillo Jaime , Dawson Alexander , Gilbody Simon , Böhnke Jan R.
Published: November 2016

Background

Long-term conditions often coexist with depression and anxiety.

Aims

To assess the effectiveness of stepped-care psychological therapies for patients with long-term conditions.

Method

Data from 28 498 patients were analysed using regression to model depression (Patient Health Questionnaire (PHQ-9)) and anxiety (Generalised Anxiety Disorder scale (GAD-7)) outcomes. Post-treatment symptoms and effect sizes (d) were estimated for individuals with and without long-term conditions, controlling for covariates. The likelihood of access and response to intensive psychological interventions was also examined.

Results

Higher post-treatment symptoms were predicted for patients with musculoskeletal problems (d = 0.22–0.27), chronic obstructive pulmonary disease (d = 0.26–0.33), diabetes (d = 0.05–0.13) and psychotic disorders (d = 0.50–0.58). Most long-term conditions were associated with greater odds of accessing high-intensity therapies, yet individuals who accessed these continued to have higher average post-treatment symptoms.

Conclusions

Some long-term conditions are associated with greater intensity of care and poorer outcomes after therapy.
Epitope-Specific Antitumor Immunity Suppresses Tumor Spread in Papillary Thyroid Cancer
Authors: Ehlers Margret , Kuebart Anne , Hautzel Hubertus , Enczmann Juergen , Reis Anna-Carinna , Haase Matthias , Allelein Stephanie , Dringenberg Till , Schmid Christine , Schott Matthias
Published: November 2016

Context:

Papillary thyroid cancer (PTC) is characterized by a lymphocytic infiltration. PTC patients with lymphocytic infiltration may have a better clinical outcome.

Objective:

Characterization of tumor epitope-specific immunity and correlation analyses with the clinical outcome.

Patients:

150 PTC patients; 40 Hashimoto thyroiditis (HT) patients; 21 healthy controls; 27,239 healthy whites (for HLA typing).

Main Outcome Measures:

HLA class I restricted thyroperoxidase (TPO) and thyroglobulin (Tg) epitope-specific T cells (tetramer analyses), correlation analyses between HLA class II phenotypes, T cell immunity, and the clinical course.

Results:

The frequency of TPO- and Tg-specific CD8+ T cells in PTC patients was largely increased compared with healthy controls (TPO and Tg, P < 0.005 and P < 0.005) and was similar to those in HT patients. HLA-DQB1*03–positive PTC patients had a significantly lower risk [risk ratio (RR), 0.170; 95% confidence interval (CI), 0.037 to 0.755; P < 0.05] and HLA-DRB1*03–positive and HLA-DQB1*02–positive PTC patients a significantly higher risk (HLA-DRB1*03: RR, 4.400; 95% CI, 1.378 to 14.05; P < 0.05; HLA-DQB1*02: RR, 3.692; 95% CI, 1.102 to 12.38; P < 0.05) for distant metastases, compared with patients with other haplotypes. HLA-DQB1*03–positive PTC patients revealed an increased responsiveness of tumor epitopes in vitro. These tumor epitope-specific CD8+ T cells were also found in lymph node metastases of HLA-DQB1*03–positive PTC patients.

Conclusion:

We demonstrate a tumor epitope-specific immunity in PTC patients and the protective role of HLA-DQB1*03 against metastatic spread. These results have direct implications for new treatment options with immune checkpoint inhibitors.
Analysis of Physiological Respiratory Variable Alarm Alerts Among Laboring Women Receiving Remifentanil
Authors: Weiniger Carolyn F. , Carvalho Brendan , Stocki Daniel , Einav Sharon
Published: November 2016

BACKGROUND:

Remifentanil may be used by laboring women for analgesia, despite controversy because of potential apneas. We evaluated candidate variables as early warning alerts for apnea, based on prevalence, positive predictive rate, sensitivity for apnea event detection, and early warning alert time intervals (lead time) for apnea.

METHODS:

We performed a secondary analysis of respiratory physiological data that had been collected during a prospective IRB-approved study of laboring women receiving IV patient-controlled boluses of remifentanil 20 to 60 μg every 1 to 2 minutes. Analyzed data included the respiratory rate (RR), end-tidal CO2 (Etco
2), pulse oximetry (Spo
2), heart rate (HR), and the Integrated Pulmonary Index (IPI; Capnostream 20; Medtronic, Boulder, CO) that had been recorded continuously throughout labor. We defined immediate early warning alerts as any drop in a variable value below a prespecified threshold for 15 seconds: RR < 8 breaths per minute (bpm), Etco
2 < 15 mm Hg, and Spo
2 < 92%. We defined alerts as “sustained” when the value remained below the threshold for ≥ 10 further seconds. The IPI value (1 to 10; 10 = healthy patient, ≤4 = immediate attention required, 1 = dire condition) was generated from a proprietary algorithm using RR, Etco
2, Spo
2, and HR parameters. Apnea was defined as maximal CO2 < 5 mm Hg for at least 30 consecutive seconds.

RESULTS:

We counted 62 apneas, among 10 of 19 (52.6%) women who received remifentanil (total dose 1725 ± 1392 μg, administered over 160 ± 132 minutes). We counted 331 immediate early warning alerts for the variables; 271 (82%) alerts were sustained for ≥10 seconds. The positive predictive value of alerts for apnea was 35.8% (99% confidence interval [CI]: 27.1–45.6), 28.9% (99% CI: 20.8–38.7), 4.3% (99% CI: 1.9–9.6), and 24.6% (99% CI: 18.3–32.2) for RR, Etco
2, Spo
2, and IPI, respectively. The sensitivity for apnea event detection was 100% (99% CI: 90.3–100) for RR (<8 bpm) and IPI (≤4); 75.8% (99% CI: 59.8–86.9) for Etco
2 <15 mm Hg; and 14.5% (99% CI: 6.5–29.4) for Spo
2 <92%. We found a statistically significant difference in the timing of RR, Etco
2, Spo
2, and IPI alerts for apnea; Friedman’s Q = 33.53; P < .0001. The Etco
2 had a median (interquartile range) lead time of −0.2 (−12.2 to 0.7) seconds, and Spo
2 had a median (interquartile range) lead time of 40.0 (40.0 to 40.0) seconds.

CONCLUSIONS:

The majority of women receiving IV remifentanil for labor analgesia experienced apneas. Alerts for Etco
2 (<15 mm Hg), RR (<8 bpm), and IPI (≤4) detected most apneas, whereas Spo
2 alerts missed the majority of apneas. All variables had a low positive predictive rate, demonstrating the limitations of the respiratory monitors utilized as early warning surveillance for apneas in this setting.
Whole genome sequence, SNP chips and pedigree structure: building demographic profiles in domestic dog breeds to optimize genetic trait mapping
Authors: Dreger Dayna L. , Rimbault Maud , Davis Brian W. , Bhatnagar Adrienne , Parker Heidi G. , Ostrander Elaine A.
Published: November 2016

In the decade following publication of the draft genome sequence of the domestic dog, extraordinary advances with application to several fields have been credited to the canine genetic system. Taking advantage of closed breeding populations and the subsequent selection for aesthetic and behavioral characteristics, researchers have leveraged the dog as an effective natural model for the study of complex traits, such as disease susceptibility, behavior, and morphology, generating unique contributions to human health and biology. When designing genetic studies using purebred dogs, it is essential to consider the unique demography of each population, including estimation of effective population size and timing of population bottlenecks. The analytical design approach for genome-wide association studies (GWAS) and analysis of whole genome sequence (WGS) experiments are inextricable from demographic data.

We have performed a comprehensive study of genomic homozygosity, using high-depth WGS data for 90 individuals, and Illumina HD SNP data from 800 individuals representing 80 breeds. These data were coupled with extensive pedigree data analyses for 11 breeds that, together, allowed us to compute breed structure, demography, and molecular measures of genome diversity. Our comparative analyses characterize the extent, formation, and implication of breed-specific diversity as it relates to population structure. These data demonstrate the relationship between breed-specific genome dynamics and population architecture, and provide essential important considerations influencing the technological and sampling cohort design of association and other genomic studies.
Near Infrared Hyperspectral Imaging in Transmission Mode: Assessing the Weathering of Thin Wood Samples
Authors: Smeland Knut Arne , Liland Kristian Hovde , Sandak Jakub , Sandak Anna , Gobakken Lone Ross , Thiis Thomas Kringlebotn , Burud Ingunn
Published: November 2016

Untreated wooden surfaces degrade when exposed to natural weathering. In this study thin wood samples were studied for weather degradation effects utilising a hyperspectral camera in the near infrared wavelength range in transmission mode. Several sets of samples were exposed outdoors for time intervals from 0 days to 21 days, and one set of samples was exposed to ultraviolet (UV) radiation in a laboratory chamber. Spectra of earlywood and latewood were extracted from the hyperspectral image cubes using a principal component analysis-based masking algorithm. The degradation was modelled as a function of UV solar radiation with four regression techniques, partial least squares, principal component regression, Ridge regression and Tikhonov regression. It was found that all the techniques yielded robust prediction models on this dataset. The result from the study is a first step towards a weather dose model determined by temperature and moisture content on the wooden surface in addition to the solar radiation.
Assessing Trees, Wood and Derived Products with near Infrared Spectroscopy: Hints and Tips
Authors: Sandak Jakub , Sandak Anna , Meder Roger
Published: November 2016

Wood is a renewable and valuable resource for a variety of end-use application areas. However, rapid and reliable assessments are needed to identify the quality of the tree, timber or wood product at all stages of production and processing. The ideal technology for assessing wood and wood products must provide reliable data, be user-friendly, cost-competitive and provide a rapid analysis. The ultimate application of near infrared (NIR) spectroscopy of wood or wood products is to substitute for costly and time-consuming reference measurements in order to aid process optimisation or determine properties and genetic traits on large numbers of individual samples. Increased interest in the application of NIR spectroscopy in various research fields including wood is observed nowadays. A vast number of publications highlight the potential of NIR spectroscopy for the characterisation of wood in a broad area of uses. The Journal of Near Infrared Spectroscopy has published two special issues on the application of NIR to forestry and wood research in 2010 and 2011 and a recent literature search yielded in excess of 556,000 results which can be easily found by using the search terms “NIR” and “wood”. This mass of published data may suggest that the technique of NIR spectroscopy is widely understood and broadly adopted by the timber industry, but even in recent papers it is evident that there is still a need to better understand the fundamental issues regarding sample selection and preparation, instrument choice, correct measurement and spectral interpretation. In this paper we draw on more than 40 years of collective experience and summarise state-of-the-art knowledge regarding instrumentation, spectral acquisition and data mining in regard to wood science and technology. The goal of this tutorial is two-fold: first, to inform early career wood scientists of the critical steps in utilising NIR spectroscopy to assess the quality of wood. Second, to alert managers to the level of operator skill required for the successful adoption of NIR technology. Some basic information is presented here, but due to the limited size of the manuscript, reference to more specific and detailed literature is provided in each section.
Risk management 3/4: risk enablement—the legal framework
Authors: Nazarko Linda
Published: November 2016

Managing risk in people with dementia is complex and contentious. We have limited evidence of what is and what is not effective and humane. Professionals and families often have very different perspectives and struggle to understand each other. Much of the research on this subject omits the views of people with dementia. This article discusses risk and the legal framework that aims to protect people who lack capacity.
Primum non nocere—how securement and fixation of indwelling urinary catheters can reduce the risk of harm
Authors: Nazarko Linda
Published: November 2016

Each year, around one million indwelling urinary catheters are inserted in NHS hospitals ( Nazarko, 2010 ). These invasive devices may be clinically necessary, but they have the potential to cause harm. This article examines the importance of reducing risks of harm by ensuring that the need for catheterisation is reviewed, that drainage bags are secured (supported) and fixation devices are used safely when clinically indicated.
Care Certificate Standards 5 and 6: working in a person-centred way; and communication
Authors: Peate Ian
Published: November 2016

These two standards of the Care Certificate are central to the provision of high-quality, safe and effective care. This article discusses the role of the healthcare assistant and assistant practitioner (HCA and AP) when working in a person-centred way.

Putting people at the centre of all that is done can demonstrate that the HCA and AP are working in a person-centred way where the person being cared for is being provided with support.

Communicating effectively allows care and support to be person-centred. Communication is a crucial aspect of a caring relationship and helps to promote trust in relationships with other workers and families as well as those people being cared for. Failing to communicate effectively can jeopardise the care and support the HCA and AP provide.

Person-centred care and effective communication are the hallmarks of high-quality, safe and effective care. This article discusses the importance of communicating effectively in order to provide person-centred care.
Effects of the NHS reforms on financial sustainability
Authors: Mofidi Reza , Marrow Carol
Published: November 2016

The Health and Social Care Act of 2012 (HSCA2012) has transformed the operational and business environment within which NHS trusts in England operate. The Shelford Group is the leading multi-specialty NHS trusts in England. The aim of this study was to assess the impact of HSCA2012 on the financial position of the Shelford Group of NHS trusts. The annual account statements produced by each of the trusts for financial years (FY) 2011–12; 2012–13; 2013–14 and 2014–15 were reviewed and the key financial indicators (KFIs) for each organisation were collected. KFIs for the period just prior to enactment of HSCA2012 (FY2011–12, FY2012–13) were compared with the corresponding values for the period after the enactment of HSCA2012. The clinical services provided by the Shelford Group increased year on year by 10.6%, 7.5% and 4% respectively as did their combined annual income. In FY2014–15, the Shelford Group collectively provided 14 735 000 patient care episodes and reported a combined annual income of £9 672 066 000. There was no significant difference in the median operating surplus returned by the Shelford Group before and after HSCA2012; despite this, 5 of the 10 Shelford Group members delivered an operational deficit in FY 2014–15. The level of financial liabilities and total capital employed remained stable. There were significant improvements in total assets employed in the Shelford Group in the 2 years after the enactment of HSCA2012 compared to before. The financial standing of Shelford Group trusts has not been adversely affected by the enactment of HSCA2012, although there was some evidence that the operational finances of these NHS trusts were less robust in FY 2014–15 than previous years.
Limits to the criminal law in healthcare
Authors: Dimond Bridgit
Published: November 2016

The Secretary of State for Health, Virginia Bottom-ley, made it clear recently at the Conference of the National Association for Health Authorities and Trusts that it was not her intention to bring in a law to make it a criminal offence to pass on the human immunodeficiency virus (HIV). This statement followed the news report that a man in Birmingham was alleged to have infected several women with the virus. He was aware of his condition because, as a haemophiliac, he had received compensation after being infected through the transfusion of contaminated blood.
Implications of the theory/practice gap for Project 2000 students
Authors: Rafferty Dawn
Published: November 2016

Nursing has frequently attempted to address the gap between theory and practice. This article explores their relationship and the implications of any theory/practice gap for emergent Project 2000 students.
First aid: no longer an ephemeral feminine fashion
Authors: Castledine George
Published: November 2016

Like many other non-professional caring initiatives that impinge on the domain of medicine, first aid has received its fair share of criticism. When the St John Ambulance was founded in 1877, the medical profession was not sympathetic to the movement and first aid was scoffed at as an ‘ephemeral feminine fashion’ (Clifford, 1967).
Career development in intensive care: 2
Authors: Sheppard Amanda
Published: November 2016

In part 1 of this article, intensive care nursing and the career opportunities that are available were discussed. Part 2 will examine postregistration intensive care training and career progressions from grade D level to senior/specialist posts.
Consumer satisfaction surveys in mental health
Authors: Ricketts Tom
Published: November 2016

Treating clients of mental health services as consumers is a relatively new concept in Britain. This article seeks to explain the development of consumer satisfaction surveys, reviews the literature, and identifies ways in which the approach can be used to improve services.
The whistle-blower's charter
Authors: Rea Karen
Published: November 2016

On 12 June 1992, the Secretary of State for Health, Mrs Virginia Bottomley, announced an amnesty for nurse and doctor whistle-blowers. The proposals included the instigation of an administrative body to which the aggrieved nurse, midwife, health visitor or doctor may have redress, culminating in contact with the Chief Executive of the NHS, Duncan Nicol. We have yet to learn of the details of this body, the constituents of its membership, the extent of its power and other minutiae.
Mental health nursing: now you see it, now you don't
Authors: Farrington Andy
Published: November 2016

As we enter the closing decade of this century, mental health nursing has reached a crisis point and is on the road to invisibility. If the marginalization of mental health nursing continues it will reach the end of that road before the year 2000.
How to respond at interview: 2
Authors: Fish Jane
Published: November 2016

The previous article in this series considered some of the extensive questioning techniques that interviewers use to explore candidates' potential. This article will consider in depth the remaining types of questions used in selection interviews.
Perception of pain and management in a hospital in I hailantl
Authors: Hiscock Michele
Published: November 2016

After winning the American Medical International Nurse Scholarship Award in 1990, the author went to the Chulalongkorn University Hospital in Bangkok to study how the nurses in the surgical intensive care unit manage patients in acute pain.
Community care: are we putting all our eggs in one basket?
Authors: Nolan Mike
Published: November 2016

The forthcoming community care legislation due in April 1993 has been adopted largely without criticism. While supporting the general principles underpinning community care this article sounds a cautionary note, highlighting the need to keep appropriate institutional alternatives to retain an element of choice.
Local research ethics committees and nursing: a critical look
Authors: Hunt Geoffrey
Published: November 2016

The Department of Health guidelines on local research ethics committees are now in operation. But, are they enforceable and what relevance do they have to nursing?
The Health of the Nation: how should nurses respond?
Authors: Morris Mervyn
Published: November 2016

By now all health service nurses should have heard the tightly scripted team briefing about the white paper The Health of the Nation (Department of Health, 1992). There will now be a lull while someone at regional level works out how targets will be achieved. Whether nurses will be expected to read this document, let alone be involved in the processes described therein, is open to conjecture. How should the profession respond?
Long-term effects of cancer on children and their families
Authors: Waterworth Samantha
Published: November 2016

An increasing number of children now survive malignancies, which has implications for nursing practice in caring for long-term survivors and their families. This article will examine the physical, psychological and social consequences of surviving childhood cancer and will suggest how nurses can meet the needs of long-term survivors.
Using a monitored dosage system
Authors: Ashurst Adrian
Published: November 2016

Traditional methods of administering medicines in nursing and residential homes have varied in standard throughout the UK. Monitored dosage systems have the potential to remedy this by making drug administration easier, safer, more hygienic and quicker. This article describes the use of one such system.
A child's right to die: who should decide?
Authors: Ellis Peter
Published: November 2016

When deciding whether to treat children, quality of life is as important as quantity of life. There is some confusion over who has the right to make these treatment decisions. Healthcare professionals are often not the most appropriate decisionmakers.
Nurse information systems: how to gain competitive advantage
Authors: Stonham Gillian
Published: November 2016

This article considers how nurse information systems can make provider units more competitive by supporting a quality-based strategy, and examines the organizational characteristics necessary for success.
Interpersonal skills training in Brunei
Authors: Burnard Philip , Rokiah Binti Haji Zakiah Hajah
Published: November 2016

This article describes an interpersonal skills training workshop set up in Brunei, Darussalam. It identifies important issues in the facilitation of such workshops, which have relevance for interpersonal skills training in a range of cultures.
Government health strategy: adding years to life
Authors: Andrews Sarah
Published: November 2016

The overall aim of the Government's health strategy set out in The Health of The Nation (Department of Health, 1992) is to secure continuing improvement in the general health of the population in England. It seeks to do this by promoting collaboration and integration of health services with other related activities concerned with education, recreation, environmental improvements and social welfare.
The nature of professional child abuse
Authors: Beattie Jean
Published: November 2016

The care study Care of a child with hypospadias: ethical issues in practice in the last issue of British Journal of Nursing (Vol 1(8): 393-8) raises many interesting issues, not least the question of what constitutes child abuse.
Effects of mentorship on learners
Authors: Littlejohn Loraine
Published: November 2016

This small study was carried out in a unit for the care of the elderly to which second-level student nurses are allocated. No mentorship scheme was in operation in this unit and therefore the nursing officer, ward sisters, staff nurses and the nurse teacher in charge of the small school decided to compare the benefits of mentorship with non-mentorship.
The Roper nursing model as an educational and research tool
Authors: McCaugherty David
Published: November 2016

Models are thought to be of value as guides to professional practice; however, nursing models are often criticized. This article examines the concept of a model as a ‘tool’ and describes how the Roper model was used in a research project and proved to be both flexible and educationally sound as a teaching model.
Nurses must learn to take risks
Authors: Castledine George
Published: November 2016

At the recent British Journal of Nursing Wound Care Conference, a leading physician declared that ‘nurses are no longer the handmaidens to doctors’. He is right. Now is a time of great upheaval and change in the British healthcare system; many questions are being asked about quality and the role of the professional nurse.
Career development in intensive care: 1
Authors: Sheppard Amanda
Published: November 2016

Nursing is becoming more specialized and leaner in terms of structure and therefore competition for positions is increasing. It is essential for nurses who are considering a career in intensive care to commence the planning process as early as possible. In this, the first of two articles, intensive care nursing and the career opportunities available will be examined.
Patient satisfaction as a measure of quality in the care of the elderly
Authors: O'Leary Anne
Published: November 2016

This article examines the relevance of obtaining patients' views in the measurement of quality in nursing care. The literature on the selection of instruments that measure quality in the care of older people is reviewed.
Nurses and AIDS care
Authors: Hayter Mark
Published: November 2016

The VUIth International Conference on AIDS held in Amsterdam, July 1992, covered many issues pertinent to nurses; however, the lack of nursing participation was evident. This article examines the issues of concern to nurses in AIDS care that were highlighted at the meeting.
Nurse manager who did not take any action over ‘bad’ nurse
Authors: Castledine George
Published: November 2016

Brenda was the nurse in charge of a continuing care ward for elderly people. Most of the residents, all of whom were male, had a dementing illness. The ward itself was a 24-bedded facility consisting of several four-bedded bays and single units, together with a large lounge/dining area. The ward was staffed by Beryl, a junior sister, four E-grade staff nurses three D-grade staff nurses, and several nursing assistants.
Sickle cell disease patients and patient-controlled analgesia
Authors: Johnson Lucy
Published: November 2016

Sickle cell disease (SeD) Is one of the world's commonest hereditary disorders. Painful episodes are the overriding manifestation. SeD pain Is largely oplold-sensltlve and, In severe cases, adult patients warranting hospitalization often need parenteral oplolds. Pain Is essentially subjective and Is often best controlled by patients themselves. This study looks at SeD patients' perceptions of self-administering parenteral oplolds. Using a mainly multiple-choice questionnaire and a focus group Interview, data were gathered from 40 adult SeD patients during hospitalization over a 4-month period. The study was approved by the local research ethics committee and the lead c!lnlclans In both the pain and haematology departments. All patients had past oplold-experlence for acute pain. The majority (65%) had previously used peA dlamorphlne In addition to other oplolds. The findings demonstrate that SeD patients perceive the main benefit of peA to lie In Its potential to restore their control over pain relief while In hospital. Other perceived advantages over nurse-administered analgesia Included better analgesia accessibility, quick pain relief and relative Independence from staff. Patients Identified that realization of peA's full potential Is being limited by Ineffective analgesic regimens, analgesic slde-effects and technical shortcomings. Patients found the main disadvantages of peA to relate to nursing care Issues Including restrictions placed upon patients' ability to exercise choice and much reduced direct nurse contact. The Implications for nursing practice and management Involve addressing these patients' concerns through staff training, Improving patient-staff communication, Inputting resources and further research.
Legal remedies for employees if they are injured in the workplace
Authors: Dimond Bridgit
Published: November 2016

Case Scenario

Angela, a healthcare assistant who worked In the operating theatre, was severely Injured by a scalpel thrown Into the bin that was meant for operating theatre linen. This Is a common problem faced by the theatre employees who have made frequent complaints about the dangers. What Is the law?
School nurse advisers have an important role
Authors: Castledine George
Published: November 2016

School nursing has come a long way since the days of the ‘nit nurse’! In the early 1900s, the duties of the school nurse Were to: Assist the doctor during the ro utine medical inspection of children, ascertain ing their height, weight and preliminary tests of vision and hearing Visit homes and follow up advice given to parents Vi sit the schools periodically and examine, for example, the heads of all the children for pediculosis and ringworm, and to see children suffering from va rious ailments Attend and assist at the school clinic Care for and advise special children suffering at home with such conditions as infectious diseases and epilepsy (Hutt, 1916).
All-Trans-Retinoic Acid Augments the Histopathological Outcome of Neuroinflammation and Neurodegeneration in Lupus-Prone MRL/lpr Mice
Authors: Theus Michelle H. , Sparks Joshua B. , Liao Xiaofeng , Ren Jingjing , Luo Xin M.
Published: November 2016

Recently, we demonstrated that treatment with all- trans-retinoic acid (tRA) induced a paradoxical effect on immune activation during the development of autoimmune lupus. Here, we further describe its negative effects on mediating neuroinflammation and neurodegeneration. Female MRL/lpr mice were orally administered tRA or VARA (retinol mixed with 10% tRA) from 6 to 14 weeks of age. Both treatments had a significant effect on brain weight, which correlated with histopathological evidence of focal astrogliosis, meningitis, and ventriculitis. Infiltration of CD138- and Iba1-positve immune cells was observed in the third ventricle and meninges of treated mice that co-labeled with ICAM-1, indicating their inflammatory nature. Increased numbers of circulating plasma cells, autoantibodies, and total IgG were also apparent. IgG and C3 complement deposition in these brain regions were also prominent as was focal astrogliosis surrounding the ventricular lining and meninges. Using Fluoro-Jade staining, we further demonstrate that neuroinflammation was accompanied by neurodegeneration in the cortex of treated mice compared with vehicle controls. These findings indicate that vitamin A exposure exacerbates the immunogenic environment of the brain during the onset of systemic autoimmune disease. Vitamin A may therefore compromise the immuno-privileged nature of the central nervous system under a predisposed immunogenic environment.
Ideology and Knowledge-How: A Rylean Perspective
Authors: Kremer Michael
Published: November 2016

In work culminating in Know How (2009), Jason Stanley argues, against Gilbert Ryle, that knowledge-how is a species of knowledge-that. In How Propaganda Works (2015), Stanley portrays this work as undermining a “flawed ideology” supporting elitist valuations of intellectual work and workers. However, the link between Stanley’s two philosophical projects is weak. Ryle’s distinction between knowledge-how and knowledge-that lacks the political consequences foreseen by Stanley. Versions of “intellectualism” have as much potential to align with hierarchical political systems as do versions of “anti-intellectualism.” Consequently, the debate about knowledge-how and knowledge-that comes apart from Stanley’s more recent concerns about flawed ideologies.
Stanley on Ideology
Authors: Protevi John
Published: November 2016

I explore Jason Stanley's notion of ideology. After preliminary remarks on ideology and coercion in social reproduction, I offer a restatement of Stanley's position on ideology, examining his notion of epistemic harm. I then examine the role of emotion in his thinking as that which binds beliefs to agents, and conclude with an argument for a notion I call "affective ideology” that enables us to connect ideology with the use of force in “coercive social reproduction.”
Propaganda and the Authority of Pornography
Authors: McGlynn Aidan Neil
Published: November 2016

Jason Stanley’s How Propaganda Works characterises and explores one democratically problematic kind of propaganda, ‘undermining propaganda’, which involves ‘[a] contribution to public discourse that is presented as an embodiment of certain ideals, yet is of a kind that tends to erode those very ideals’. Stanley’s model for how undermining propaganda functions is Rae Langton and Caroline West’s treatment of moves in pornographic language games. However, Stanley doesn’t consider whether his theory of propaganda might in turn illuminate the harmful nature of pornography, in light of the familiar contention that some pornography acts as a kind of misogynistic propaganda. Drawing on Catharine MacKinnon's writings on pornography, this paper will explore one way of developing the claim thatpornography sometimes functions as undermining propaganda, in something close to Stanley’s sense. Moreover, I will suggest that the discussion points to a new response to the so-called authority problem for Rae Langton’s silencing argument against the protected status of pornography.
Propaganda and Democracy
Authors: Wood Allen
Published: November 2016

We are surrounded by communication of many kinds whose aim is to persuade rather to convince, to manipulate rather than to reason. We are being constantly manipulated into forming beliefs or attitudes, or to have feelings of certain kinds; or beliefs and attitudes we already have, but ought to criticize and perhaps reject, are instead being reinforced rather than questioned. Advertising and much public discourse is like this. How should we react to this fact? Perhaps even more importantly, how should we understand it? What does it mean that this is so?Not all persuasion is regrettable or to be disapproved. Our feelings as well as our rational judgment are part of our humanity; emotions even constitute an essential part of our rational capacities themselves. Not all persuasion is propaganda. And perhaps not even all propaganda is necessarily bad.This last point was the focus of a controversy between W. E. B. Du Bois, who held that propaganda could be used for good, and Alain Locke, who held that all propaganda corrupts our thinking. My own view is that propaganda can be used for good, but Locke was perfectly right to be worried about it. More specifically, Du Bois maintained that artistic propaganda could encourage self-respect among African Americans, while Locke argued that propaganda can never reframe the issues in a debate, but must accept the received perceptions of them, and can contribute to any debate only on those terms.
Editorial: Looking Back, Looking Forward: The UN Trafficking Protocol at fifteen
Authors: Bhabha Jacqueline
Published: November 2016

Anniversaries provide a pretext for reflection—celebration for national independence days, mourning for war-time massacres. For political reforms and legal innovations, anniversaries warrant a different set of reflections: less predictable or uniform, more sober stock taking and weighing of achievements and failures than affirmation of unequivocal success or defeat. This fourth special issue of the Anti-Trafficking Review embraces the occasion of the fifteenth anniversary of the 2000 United Nations (UN) Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children (hereafter Trafficking Protocol), and evaluates the impact of this landmark instrument of international law on the grave social, political and economic problems it targets. Among the many and varied constituencies concerned with issues of trafficking, from government bodies to international advocacy groups to sex worker collectives, the Trafficking Protocol has attracted considerable attention. It has been widely ratified, its definition of trafficking has been extensively invoked, its criminalisation mandates have been aggressively followed, its victim protection measures have been enthusiastically cited.
Purity, Victimhood and Agency: Fifteen years of the UN Trafficking Protocol
Authors: Wijers Marjan
Published: November 2016

When the women’s movement reverted back to the nineteenth-century Victorian concept of ‘trafficking in women’ to address abuses of migrant women in the sex industry, it unwittingly adopted not only a highly morally biased concept—dividing women into innocent victims in need of rescue and guilty ones who can be abused with impunity—but also one with racist and nationalistic overtones. Despite efforts to counter these flaws, this inheritance continues to define the debate on trafficking today, exemplified by the distinction made by the United Nations Trafficking Protocol between so-called ‘sexual exploitation’ and ‘labour exploitation’ and its focus on the aspects of recruitment and movement. As a result, its implementation in the last fifteen years has led to a range of oppressive measures against sex workers and migrants in the name of combating trafficking. The focus on the purity and victimhood of women, coupled with the protection of national borders, not only impedes any serious effort to address the exploitation of human beings under forced labour and slavery-like conditions, but actually causes harm. The call of the anti-trafficking movement for a human rights-based approach does not necessarily solve these fundamental problems, as it tends to restrict itself to protecting the rights of trafficked persons, while neglecting or even denying the human rights of sex workers and migrants.
Deploying Disclosure Laws to Eliminate Forced Labour: Supply chain transparency efforts of Brazil and the United States of America
Authors: Feasley Ashley
Published: November 2016

States are increasingly addressing forced labour in supply chains by implementing transparency or disclosure measures that aim to make companies disclose the existence of forced labour in their supply chains. Examining the recent approaches of Brazil and the United States of America shows some promising practices to best inform governmental policy going forward.
Asylum, Immigration Restrictions and Exploitation: Hyper-precarity as a lens for understanding and tackling forced labour
Authors: Lewis Hannah , Waite Louise
Published: November 2016

The topic of forced labour is receiving a growing amount of political and policy attention across the globe. This paper makes two clear contributions to emerging debates. First, we focus on a group who are seldom explicitly considered in forced labour debates: forced migrants who interact with the asylum system. We build an argument of the production of susceptibility to forced labour through the United Kingdom’s (UK) asylum system, discussing the roles of compromised socio-legal status resulting from restrictive immigration policy, neoliberal labour market characteristics and migrants’ own trajectories. Second, we argue that forced labour needs to be understood as part of, and an outcome of, widespread normalised precarious work. Precarity is a concept used to describe the rise of insecure, casualised and sub-contracted work and is useful in explaining labour market processes that are conducive to the production of forced labour. Using precarity as a lens to examine forced labour encourages the recognition of extreme forms of exploitation as part of a wider picture of systematic exploitation of migrants in the labour market. To understand the reasons why forced migrants might be drawn into severe labour exploitation in the UK, we introduce the concept of hyper-precarity to explain how multidimensional insecurities contribute to forced labour experiences, particularly among forced migrants in the global north. Viewing forced labour as connected to precarity also suggests that avenues and tools for tackling severe labour exploitation need to form part of the wider struggle for migrant labour rights.
Vulnerability to Forced Labour and Trafficking: The case of Romanian women in the agricultural sector in Sicily
Authors: Palumbo Letizia , Sciurba Alessandra
Published: November 2016

This paper focuses on labour and sexual exploitation faced by Romanian female workers employed in the agricultural sector in Ragusa, Sicily, Italy. Drawing on fieldwork conducted in 2013 and 2014 with Romanian female farm workers in Ragusa, the paper identifies factors that contribute towards their vulnerability to exploitation. By paying specific attention to the experiences of women who are mothers with dependent children, we look at structural factors that increase their vulnerability and consider how this vulnerability ‘forces’ women into situations whereby they effectively accept and/or submit to abuse. We also highlight how European Union (EU) citizenship does not automatically protect migrants from such abuse. This is important because, as we argue, the mistreatment experienced by participants in this study can be regarded as cases of forced labour and trafficking, based on International Labour Organization (ILO) indicators[1] and the definition of trafficking provided by the Directive 2011/36/EU. For a long time, these cases have mostly been neglected by incompetent authorities or addressed using only repressive and assistentialist approaches. Thus, this paper also investigates the limits and potentialities of the Italian legal framework on trafficking, and the ways local institutions and organisations confront the rights violations occurring in the agricultural sector. We contend that in order to effectively counter these phenomena, labour rights measures and anti-trafficking interventions have to be combined based on a comprehensive approach aimed not only at assisting victims, but also at tackling the structural factors that create their vulnerability.[1] ILO, ‘ILO Indicators of Forced Labour’, International Labour Office, 2012, retrieved 11 August 2015, http://www.ilo.org/wcmsp5/groups/public/---ed_norm/---declaration/documents/publication/wcms_203832.pdf
Not All Prosecutions are Created Equal: Less counting prosecutions, more making prosecutions count
Authors: McAdam Marika
Published: November 2016

Response to ATR Debate Proposition: ‘Prosecuting trafficking deflects attention from much more important responses and is anyway a waste of time and money’
Villains and Victims, but No Workers: Why a prosecution-focussed approach to human trafficking fails trafficked persons
Authors: Thiemann Inga
Published: November 2016

Response to ATR Debate Proposition: ‘Prosecuting trafficking deflects attention from much more important responses and is anyway a waste of time and money’