bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of Health-Promoting Behavior Associated With Cardiovascular Diseases Among Korean Blue-Collar Workers
Authors: Hwang Won Ju , Hong Oi Saeng , Rankin Sally H.
Published: October 2013

The aim of this study was to investigate the contribution of actual cardiovascular disease (CVD) risks, psychosocial and work-related factors as predictors of health behavior. A sample of 234 Korean blue-collar workers, who worked in small companies, was included in this cross-sectional study. Data collection included a survey; anthropometric and blood pressure measures; and blood sampling. Multiple regression analyses showed that the model explained 30% of the variance in health behavior of blue-collar workers. The significant predictors for health behavior included education level, perceived general health, greater family function, higher social support, decision latitude, and non-shift work. Future research should focus on incorporating these significant predictors into effective behavioral interventions designed to promote cardiovascular health in this population.
Factors Causing Delay of Access to Tuberculosis Diagnosis Among New, Active Tuberculosis Patients
Authors: Shu Wen , Chen Wei , Zhu Shiyu , Hou Yongchun , Mei Jian , Bai Liqiong , Xu Weiguo , Zhou Lin , Nie Shaofa , Cheng Shiming , Xu Yihua
Published: October 2013

Few studies have examined, in a prospective cohort study, factors causing delay of access to tuberculosis (TB) diagnosis among new, active TB patients. A prospective cohort study (2009-2011) was carried out among 408 889 Chinese. Data on known/potential influencing factors were obtained from baseline questionnaires. We used stepwise logistic regression models to analyze the association between several known/potential influencing factors and diagnosis delay, assessed the current situation, and explored determinants of diagnosis delay. During follow-up and final visits, 202 new, active TB patients were found. Median patient delay was 5.4 (quartile 2.7-26) weeks, health system delay was 0 (quartile 0-1.6) weeks, and diagnosis delay was 9.9 (quartile 3.1-28.1) weeks. The influencing factors on patient delay were age and duration of symptoms. Smoking and sputum smear status were influencing factors for health system delay, and duration of symptoms was one of the factors for diagnosis delay. These findings provide information on the current situation of diagnosis delay and evidence for specific strategy development for TB control in China.
Effectiveness of Acupuncture for Smoking Cessation in a Chinese Population
Authors: Ma Edmond , Chan Thomas , Zhang Ou , Yang Jin-sheng , Wang Ying-ying , Li Ya-chan , Ho Raymond , Lai Cindy , Lam Ping-yan
Published: October 2013

An observational study was conducted to evaluate the effectiveness of acupuncture for smoking cessation, and determine predictors for successful quitters. Smokers received at least 6 sessions of body acupuncture provided by Chinese medicine practitioners and initiated self-administered auricular acupuncture. We determined self-report 26-week and 52-week quit rates by intention-to-treat analysis and examined predictors for successful quitting by univariate and multivariate analyses. A total of 1002 smokers were recruited; 26-week and 52-week quit rates were 16.8% and 15.8%, respectively. Male sex, older age, lower nicotine dependence level, and number of body acupuncture and counseling sessions received were associated with successful quitting. A multiple logistic regression model showed that sex, nicotine dependence level, and number of body acupuncture sessions received were predictors for successful quitting. Body and auricular acupuncture is effective in smoking cessation and should be considered as an alternative to help smokers in quitting, especially for those whose past attempts using conventional methods were in vain.
Child Marriage and Its Association With Adverse Reproductive Outcomes for Women in Bangladesh
Authors: Kamal S. M. Mostafa , Hassan Che Hashim
Published: October 2013

This study examines the prevalence of child marriage and its effect on reproductive outcomes among women in Bangladesh using the most recent 2011 Bangladesh Demographic and Health Survey data. Both bivariate and multivariate statistical techniques used in the study yielded quantitatively important and reliable estimates of child marriage and its impact on adverse reproductive and health outcomes. Overall, 77% of the marriages among women aged 20 to 49 years old took place before the age of 18 years. Women’s education is the most single significant determinant of child marriage. Findings revealed that after being adjusted for sociodemographic factors, child marriage significantly ( P < .001) increases the likelihood of stillbirth/miscarriage (odds ratio [OR] = 1.80; 95% confidence interval [CI] = 1.45-2.24) and pregnancy termination (OR = 1.24; 95% CI = 1.12-1.38). Programs should aim to retain girls in school for longer periods not only to raise the age at first marriage but also for sound reproductive health and overall social development of Bangladesh.
Gender Identity in Informal Care
Authors: del Río-Lozano María , García-Calvente María del Mar , Marcos-Marcos Jorge , Entrena-Durán Francisco , Maroto-Navarro Gracia
Published: October 2013

We examined the influence of gender identity on men’s and women’s perceptions of assuming the caregiver role to identify different coping strategies and the effects on caregiver health and quality of life. The study, performed in Andalusia, Spain, was based on a sociological analysis of the narratives produced during semistructured interviews with primary informal caregivers (16 men and 16 women) of different profiles. We observed a cultural assumption that women should assume the caregiver role and found that women shouldered the bulk of caregiving responsibilities and did not usually seek support. This might explain the high prevalence of chronic health disorders, stress, anxiety, depression, neglect of health, and social isolation we observed among women caregivers. Because the caregiver role was not socially imposed on men in our setting, men caregivers adopted a flexible attitude and tended to seek external support before their health and quality of life were seriously affected.
End-of-Life Care Policies and Practices in Pediatric Skilled Nursing Facilities
Authors: Friedman Sandra L. , Helm David T. , Woodman Ashley C.
Published: October 2013

Although most children with intellectual and developmental disabilities reside in the community, a subset of children with severe intellectual disability and complex medical needs reside in pediatric skilled nursing facilities. These children have elevated mortality with end-of-life care (EOLC) routinely provided. The present study explored policies and practice in such settings by surveying administrators, nursing directors, and medical directors in facilities across the United States. In addition to EOLC policies and practices, staff reported on their understanding of definitions of do-not-resuscitate orders, family involvement in EOLC planning, and the availability of in-service training. The presence of an official EOLC policy was associated with higher ratings of perception of effectiveness among staff. Staff felt more prepared and comfortable providing EOLC when in-service training was provided.
Examining the Effect of the Case Management Model on Patient Results in the Palliative Care of Patients With Cancer
Authors: Ozcelik Hanife , Fadiloglu Cicek , Karabulut Bulent , Uyar Meltem
Published: October 2013

Purpose:

We aimed to investigate the improvement in symptoms, quality of life, patient and family satisfaction with care, and direct costs resulting from a palliative care program based case management model.

Methods:

The research was implemented at the Medical Oncology Clinic hospital of a University between September 2009 and September 2011. The research sample consisted of a total of 44 patients (22 control and 22 intervention group). The research tools were the Edmonton Symptom Diagnosis System, the Karnofsky Performance Scale, the EORTCQLQ-C30 Quality of Life Scale, a patient and family satisfaction form, and a patient cost record form.

Results:

The difference between total symptom mean scores and the sub-dimension symptoms of pain, fatigue, nausea, depression, anxiety, lack of appetite, lethargy, well-being, dyspnea, and constipation post-hospitalization and post-discharge of patients in the control and experimental groups were found to be statistically significant (p < 0.05). The level of decrease in symptom severity in the experimental group patients was more than in the control group (p < 0.000). The satisfaction level of patients and family in the palliative care based case management service was higher than that for conventional service in the control group (p < 0.05). No statistical difference was detected between the experimental and control groups regarding health costs and duration of hospitalization (p > 0.05).

Conclusion:

We provided a better symptom control, improved the patient s quality of life (excluding physical and congnitive functions), and patient and family satisfaction levels were higher in the palliative care based case management intervention group, but direct health costs were not affected.
Barriers to End-of-Life Care for African Americans From the Providers’ Perspective
Authors: Rhodes Ramona L. , Batchelor Kim , Lee Simon C. , Halm Ethan A.
Published: October 2013

Research has shown that African Americans (AAs) are less likely to complete advance directives and enroll in hospice. We examined barriers to use of these end-of-life (EOL) care options by conducting semi-structured interviews with hospice and palliative medicine providers and leaders of a national health care organization. Barriers identified included: lack of knowledge about prognosis, desires for aggressive treatment, family members resistance to accepting hospice, and lack of insurance. Providers believed that acceptance of EOL care options among AAs could be improved by increasing cultural sensitivity though education and training initiatives, and increasing staff diversity. Respondents did not have programs currently in place to increase awareness of EOL care options for underrepresented minorities, but felt that there was a need to develop these types of programs. These data can be used in future research endeavors to create interventions designed to increase awareness of EOL care options for AAs and other underrepresented minorities.
Process and Outcomes of School Nurse Case Management for Students With Asthma
Authors: Engelke Martha Keehner , Swanson Melvin , Guttu Martha
Published: October 2013

There have been many studies that have examined the impact of school-based asthma programs on students with asthma. However, most studies do not provide adequate elaboration on the components of the program. Therefore, replication of these programs is difficult. This study examines the process of school nurse case management, which includes the development of individualized goals and the provision of specific interventions. The process is then linked to several outcomes (parent perception, quality of life, and academic success). The study demonstrates the complexity of case management provided by school nurses and how goal attainment is related to the outcomes. The study supports policy recommendations that advocate for the importance of professional school nurses in improving the health and well-being of students with asthma.
Exploring Best Practices in Home Health Care
Authors: Parker Emil , Zimmerman Stephanie , Rodriguez Sally , Lee Teresa
Published: October 2013

This article summarizes publicly available research related to outcomes and best practices in skilled home health and other kinds of home-based care. As the population ages and the home health care sector grows, the home health community must address current deficiencies in care and expand the use of evidence-based strategies to improve the quality and efficiency of care. Many promising innovations in service delivery currently exist, a wide variety of which have been tested and evaluated in postacute and long-term care settings. Our review found that home health agencies are well positioned to improve patient outcomes through a variety of approaches, including care coordination, telehealth, and data-driven quality of care monitoring. For the most part, evaluations of these interventions show that they can improve patient outcomes and/or cost-effectiveness.
Management of Chronic Lower Back Pain
Authors: Alpert Patricia T.
Published: October 2013

Most individuals suffer from lower back pain at some point in their lives and approximately 2% to 10% of these individuals go on to experience chronicity of their pain. The incidence of lower back pain increases with age, and it is conceivable that one can live with back pain for decades. These individuals more often experience depression and a decrease in quality of life. In this column, we focus on measures that can be taken to prevent lower back pain. Management options, both pharmacological and nonpharmacological, are also explored.
Evaluating Parental Disagreement in ADHD Diagnosis: Can We Rely on a Single Report From Home?
Authors: Caye Arthur , Machado Julia D. , Rohde Luís A.
Published: October 2013

Objective: Few studies assessed factors associated with the agreement/disagreement between fathers and mothers when rating ADHD symptoms of their offspring. Method: Teachers and both parents assessed a referred sample of 98 children and adolescents aged 6 to 16 years ( M age = 9.79, SD = 2.59) using the Swanson, Nolan, and Pelham (SNAP-IV) rating scale. The agreement was assessed for each of the items of the scale and correlated with variables measuring children’s features, socioeconomic adversity, family functioning, and parental psychopathology. Results: Mean agreement between parents was moderate for the inattentive and good for the hyperactive-impulsive construct. Mothers tended to report more symptoms than fathers. The agreement was lower in those families where parents had discrepant educational levels. Conclusion: Our findings suggest a significant cross-informant disagreement between parents on symptoms of ADHD. Discrepant parental education has a relevant role in explaining parental disagreement in reporting ADHD symptoms.
Neurobiology of ADHD From Childhood to Adulthood
Authors: Kasparek Tomas , Theiner Pavel , Filova Alena
Published: October 2013

Objective: To review the pattern of morphological and functional brain changes in both children and adults with ADHD that emerges from the recent literature. In addition, the task of the present review is to explore how to understand the nature of the brain changes. Methods: Literature review. Results: Neuroimaging studies provide a multitude of information that currently allows us to expand the notions of ADHD neurobiology beyond its traditional understanding as a manifestation of frontostriatal dysfunction. They point to disorders of several other areas of the brain, particularly the anterior cingulum, the dorsolateral as well as ventrolateral prefrontal cortex, the orbitofrontal cortex, the superior parietal regions, the caudate nucleus, the thalamus, the amygdala and the cerebellum. Imaging studies point to the persistence of changes in both brain structure and function into adulthood, although there might be a tendency for improvement of caudate nucleus pathology. Changes in neuronal (dendritic) plasticity, which are under the modulatory influence of the dopaminergic system, may be in the background of disorders of brain morphology and anatomical connectivity with subsequent brain dysfunction. Growing evidence suggest that methylphenidate treatment can lead to improvement of brain changes seen in neuroimaging by its positive effect on neuroplasticity. Conclusion: Changes in neuronal plasticity may be behind persisting brain changes in ADHD. Current treatment approaches seem to improve these neuroplastic processes, and, therefore, may have a positive effect on the neuropathology of ADHD.
Informing the Discussion on Evaluator Training
Authors: Christie Christina A. , Quiñones Patricia , Fierro Leslie
Published: October 2013

This classification study examines evaluators’ coursework training as a way of understanding evaluation practice. Data regarding courses that span methods and evaluation topics were collected from evaluation practitioners. Using latent class analysis, we establish four distinct classes of evaluator course-taking patterns: quantitative, evaluation/qualitative, general research/quantitative, and general research. Results highlight the importance of professional development as a mode for learning evaluation-specific information.
What Brain Sciences Reveal About Integrating Theory and Practice
Authors: Patton Michael Quinn
Published: October 2013

Theory and practice are integrated in the human brain. Situation recognition and response are key to this integration. Scholars of decision making and expertise have found that people with great expertise are more adept at situational recognition and intentional about their decision-making processes. Several interdisciplinary fields of inquiry provide insights into how we manage situation recognition in the face of complexity. Classic works on bounded rationality and satisficing, contingency theory, cognitive science, and decision sciences have been identifying how the brain processes information through conceptual screens to facilitate cutting through the messy, confusing, overwhelming chaos of the real world so that we can avoid analysis paralysis. This article presents six conceptual screens that, in combination, constitute a theory to practice situation recognition framework: (1) intended users’ contingencies; (2) nature of the evaluand; (3) evaluation purpose: findings use options; (4) process options; (5) context & situational contingencies; and (6) evaluator characteristics.
Characteristics of suicide notes of children and young adolescents: An examination of the notes from suicide victims 15 years and younger
Authors: Freuchen Anne , Grøholt Berit
Published: October 2013

Objective:

By analysing the suicide notes from suicide victims 15 years and younger, we attempt to gain insight into the process leading to youth suicide and explore the characteristics of the note writers.

Method:

During a psychological autopsy on 42 youths, we were entrusted with 23 suicide notes in which we explored the themes and compared the note writers to the non-note writers.

Results:

The key messages were as follows: explain the reason for suicide, declare love and give instructions. The note writers had showed suicidal behaviour more frequently than non-note writers.

Conclusion:

In the notes from youth suicide victims they present themselves as fully responsible and without confusion or overwhelming despair. The notes are likely equally informative as the notes of older victims.
Academic abilities in children and adolescents with a history of autism spectrum disorders who have achieved optimal outcomes
Authors: Troyb Eva , Orinstein Alyssa , Tyson Katherine , Helt Molly , Eigsti Inge-Marie , Stevens Michael , Fein Deborah
Published: October 2013

This study examines the academic abilities of children and adolescents who were once diagnosed with an autism spectrum disorder, but who no longer meet diagnostic criteria for this disorder. These individuals have achieved social and language skills within the average range for their ages, receive little or no school support, and are referred to as having achieved “optimal outcomes.” Performance of 32 individuals who achieved optimal outcomes, 41 high-functioning individuals with a current autism spectrum disorder diagnosis (high-functioning autism), and 34 typically developing peers was compared on measures of decoding, reading comprehension, mathematical problem solving, and written expression. Groups were matched on age, sex, and nonverbal IQ; however, the high-functioning autism group scored significantly lower than the optimal outcome and typically developing groups on verbal IQ. All three groups performed in the average range on all subtests measured, and no significant differences were found in performance of the optimal outcome and typically developing groups. The high-functioning autism group scored significantly lower on subtests of reading comprehension and mathematical problem solving than the optimal outcome group. These findings suggest that the academic abilities of individuals who achieved optimal outcomes are similar to those of their typically developing peers, even in areas where individuals who have retained their autism spectrum disorder diagnoses exhibit some ongoing difficulty.
Cigarette smoking and its impact on fracture healing
Authors: Bender Daniel , Jefferson-Keil Tamara , Biglari Bahram , Swing Tyler , Schmidmaier Gerhard , Moghaddam Arash
Published: October 2013

In this review, we discuss current knowledge and studies concerning the pathophysiology of cigarette smoking and its impact on fracture healing. We include studies on the biology of fracture healing and more specifically how smoking affects oxygenation in tissues, serum concentrations of important growth factors, collagen synthesis, and bone mineralization. Also mentioned are clinical studies showing that smoking impacts soft tissue regeneration and the healing of tibial fractures and open fractures, as well as articles discussing the apparent benefits and limitations of presurgical smoking cessation. Our review of the current literature suggests that it is necessary to inform smokers with fractures about their increased risk for impaired fracture healing. They should be closely monitored and additional therapies such as the use of BMP-7, BMP-2, or low-intensity ultrasound should be considered in early stages after trauma.
Ricci-based chaos analysis for roto-translatory motion of a Kelvin-type gyrostat satellite
Authors: Abtahi Seyed Mahdi , Sadati Seyed Hossein , Salarieh Hassan
Published: October 2013

The chaotic dynamics of roto-translatory motion of a triaxial Kelvin-type gyrostat satellite under gravity gradient perturbations is considered. The Hamiltonian approach is used for modelling of the coupled spin-orbit equations of motion. The complex Hamiltonian of the system is reduced via the extended Deprit canonical transformation using the Serret-Andoyer variables. Therefore, this reduction leads to the derivation of the perturbation form of the Hamiltonian that can be used in the Ricci curvature criterion based on the Riemannian manifold geometry for the analysis of chaos phenomenon. The results obtained from Ricci method as well as the values from the Lyapunov exponent demonstrate the presence of a strange attraction and chaotic responses in the perturbed system. The simulation results based on numerical methods such as Poincaré section, trajectories of phase portrait and time series responses quantitatively confirm the heteroclinic bifurcation and chaotic behaviour in the rotational–translational dynamics of the gyrostat satellite system.
Polish immigration in Belgium since 2004: New dynamics of migration and integration?
Authors: Levrau François , Piqueray Edith , Goddeeris Idesbald , Timmerman Christiane
Published: October 2013

Belgium has been a traditional destination for Polish immigrants since the 19th century. In the period after the fall of the Iron Curtain, Polish migration to Belgium was largely characterized by pendulum movements and illegal stays, but following Poland’s accession to the EU in 2004, the Belgian labour market was gradually opened to Polish citizens. To date, this new situation has not been the subject of research, and we therefore present the first analysis of the impact of EU enlargement on Poles in Belgium. By means of semi-structured interviews with both Polish key informants and Polish families, we illustrate the extent to which Polish migration and integration patterns have changed. Our results lead us to conclude that Poles are increasingly opting for longer and more permanent stays, which means that Polish migration no longer follows the pendulum pattern. Although this implies increased orientation toward Belgian society, it does not entirely preclude any attachment to Polish culture and identity. This confirms a widely accepted insight from migration studies: the desire to integrate in structural societal spheres does not reduce the importance that migrants attach to aspects they consider crucial to staying in touch and identifying with their regions of origin.
New approaches in cross-cultural management research
Authors: Dupuis Jean-Pierre
Published: October 2013

The field of cross-cultural management is expanding rapidly. Traditional approaches are being critiqued and new approaches put forward. The latter mainly adopts an interactionist perspective, pay more attention to context and different levels of analysis (local, regional, national etc.) and propose more qualitative methods as well as a more dynamic definition of culture. Our research is in keeping with this new shift and contributes to this renewal in two ways. First, it shows the variability of the perceptions of individuals from a given culture regarding the management practices existing in another culture when they find themselves working in that other culture. This variability is based on contextual elements that we have identified: duration of work experience in the country of origin, occupation of the respondent, quality of the relations with locals and so on. Then, the research reveals the link that exists between the quality of the respondents’ integration into this culture and their interpretation of the others’ management practices. These findings were obtained by combining a qualitative approach (some 40 semi-directed interviews) and a quantitative approach (a questionnaire administered to a population of more than 1000 respondents) among a population of French nationals working in Quebec and Quebecers working in France.
Supervisor–subordinate kankei, job satisfaction and work outcomes in Japanese firms
Authors: Cheung Millissa FY , Wu Wei-Ping , Wong Mei-Ling
Published: October 2013

In this study, we revisit a research model in which the relationships between Japanese supervisor–subordinate kankei (S-S kankei) and organisational commitment, job promotions and turnover intentions are mediated through job satisfaction. Based on the data randomly collected from a sample of 201 Japanese subordinates in three manufacturing firms in Tokyo, Japan, the results of structural equation modelling tests indicated that job satisfaction does partially mediate the relationships between Japanese S-S kankei and organisational commitment, job promotions and turnover intentions. The theoretical implication is that S-S relationship–job satisfaction–work outcomes model, supported in the Chinese context is equally valid in the Japanese context, suggesting the robustness of this mediation model. The practical implication is that Japanese firms are advised to encourage the development of S-S relationship and make sure that employees are satisfied with their jobs in order to enhance an employee’s commitment to the organisation, facilitate job promotions and reduce his/her intentions to leave.
Work–family conflict in four national contexts
Authors: Billing Tejinder K , Bhagat Rabi , Babakus Emin , Srivastava BN , Shin Mansoo , Brew Fran
Published: October 2013

In this study, we examine the role of cultural variations conceptualized in terms of vertical and horizontal individualism and collectivism in the prediction of work–family conflict in four distinct national contexts of the United States, Australia, South Korea, and Japan. The results of our study suggest that vertical individualism is a strong predictor of work–family conflict across cultural and national boundaries. The findings indicate the importance of cultural dimensions as correlates or predictors of work–family conflict—especially, it highlights the role of the two components of the polythetic construct of individualism–collectivism: horizontal and vertical. Implications are discussed for future research in the area of international and cross-cultural studies of work–family conflict-related issues.
From madres to mujeristas: Latinas making change with Photovoice
Authors: Mejia Angie Pamela , Quiroz Olivia , Morales Yolanda , Ponce Ruth , Chavez Graciela Limon , Torre Elizabeth Olivera y
Published: October 2013

Photovoice projects operate within multiple and often contradictory social, political, and cultural contexts. This article describes how Latina madres (mothers) participating in a community health initiative introduced concepts of mujerismo (Latina womanism) to fully incorporate their often marginalized voices into a conversation of minority health inequalities. We argue that a mujerista-led Photovoice challenges dominant assumptions about US Latinas’ roles as research collaborators. This model was shown to nurture politicized identities that seek to question issues of power embedded in health promotion initiatives.
The importance of the second loop in educational technology: An action science study of introducing blogging in a course curriculum
Authors: Glassman Michael , Bartholomew Mitchell , Hur Eun Hye
Published: October 2013

This paper uses an action science approach in analyzing attempts to introduce readable/writable web technology, specifically blogging, into a course curriculum. It is suggested that action science is an important and to this point underused approach for understanding the potential and ramifications of introducing this new technology as a central part of the teaching and learning process. We concentrate especially on Argyris and Schon’s construct “double loop” learning where study of the target phenomenon focuses on the impact of underlying “governing variables” on the ways members of an organization – in the case of this paper the classroom community – act in everyday situations. The intervention studied in this paper was the introduction of blogs as not only a key, but the primary component of a large, undergraduate, general education course. The intervention is analyzed two sequential classrooms. In the initial classroom the teaching team attempted to implement blogs by making adjustments to a traditional curriculum and was largely unsuccessful in terms of what teachers claimed they wanted to accomplish through introduction of the new technology. In the second classroom the teaching team opened the class up to changes in governing variables and through double loop learning developed more successful strategies for using blogs.
Network meta-analysis of randomized clinical trials: Reporting the proper summaries
Authors: Zhang Jing , Carlin Bradley P , Neaton James D , Soon Guoxing G , Nie Lei , Kane Robert , Virnig Beth A , Chu Haitao
Published: October 2013

Background

In the absence of sufficient data directly comparing multiple treatments, indirect comparisons using network meta-analyses (NMAs) can provide useful information. Under current contrast-based (CB) methods for binary outcomes, the patient-centered measures including the treatment-specific event rates and risk differences (RDs) are not provided, which may create some unnecessary obstacles for patients to comprehensively trade-off efficacy and safety measures.

Purpose

We aim to develop NMA to accurately estimate the treatment-specific event rates.

Methods

A Bayesian hierarchical model is developed to illustrate how treatment-specific event rates, RDs, and risk ratios (RRs) can be estimated. We first compare our approach to alternative methods using two hypothetical NMAs assuming a fixed RR or RD, and then use two published NMAs to illustrate the improved reporting.

Results

In the hypothetical NMAs, our approach outperforms current CB NMA methods in terms of bias. In the two published NMAs, noticeable differences are observed in the magnitude of relative treatment effects and several pairwise statistical significance tests from previous report.

Limitations

First, to facilitate the estimation, each study is assumed to hypothetically compare all treatments, with unstudied arms being missing at random. It is plausible that investigators may have selected treatment arms on purpose based on the results of previous trials, which may lead to ‘nonignorable missingness’ and potentially bias our estimates. Second, we have not considered methods to identify and account for potential inconsistency between direct and indirect comparisons.

Conclusions

The proposed NMA method can accurately estimate treatment-specific event rates, RDs, and RRs and is recommended.
Beyond intention to treat: What is the right question?
Authors: Shrier Ian , Steele Russell J , Verhagen Evert , Herbert Rob , Riddell Corinne A , Kaufman Jay S
Published: October 2013

Background

Most methodologists recommend intention-to-treat (ITT) analysis in order to minimize bias. Although ITT analysis provides an unbiased estimate for the effect of treatment assignment on the outcome, the estimate is biased for the actual effect of receiving treatment (active treatment) compared to some comparison group (control). Other common analyses include measuring effects in (1) participants who follow their assigned treatment (Per Protocol), (2) participants according to treatment received (As Treated), and (3) those who would comply with recommended treatment (Complier Average Causal Effect (CACE) as estimated by Principal Stratification or Instrumental Variable Analyses). As each of these analyses compares different study subpopulations, they address different research questions.

Purpose

For each type of analysis, we review and explain (1) the terminology being used, (2) the main underlying concepts, (3) the questions that are answered and whether the method provides valid causal estimates, and (4) the situations when the analysis should be conducted.

Methods

We first review the major concepts in relation to four nuances of the clinical question, ‘Does treatment improve health?’ After reviewing these concepts, we compare the results of the different analyses using data from two published randomized controlled trials (RCTs). Each analysis has particular underlying assumptions and all require dichotomizing adherence into Yes or No. We apply sensitivity analyses so that intermediate adherence is considered (1) as adherence and (2) as non-adherence.

Results

The ITT approach provides an unbiased estimate for how active treatment will improve (1) health in the population if a policy or program is enacted or (2) health of patients if a clinician changes treatment practice. The CACE approach generally provides an unbiased estimate of the effect of active treatment on health of patients who would follow the clinician’s advice to take active treatment. Unfortunately, there is no current analysis for clinicians and patients who want to know whether active treatment will improve the patient’s health if taken, which is different from the effect in patients who would follow the clinician’s advice to take active treatment. Sensitivity analysis for the CACE using two published data sets suggests that the underlying assumptions appeared to be violated.

Limitations

There are several methods within each analytical approach we describe. Our analyses are based on a subset of these approaches.

Conclusions

Although adherence-based analyses may provide meaningful information, the analytical method should match the clinical question, and investigators should clearly outline why they believe assumptions hold and should provide empirical tests of the assumptions where possible.
Echocardiographic changes and treatment goal rates after a 6-month combined treatment with amlodipine and losartan: a validation study in Andean countries (METAL study)
Authors: Pérez Carreño Juan Guillermo , Romero Juan Diego , Villar Centeno Juan Carlos ,   for the METAL Study Investigators
Published: October 2013

Background:

The extent to which treatment with amlodipine/losartan may help patients and their doctors from Andean countries to reach their treatment goals remains unknown.

Methods:

We conducted a quasi-experimental, validation study in which patients with primary, uncomplicated hypertension received open-label, fixed combination therapy with amlodipine/losartan 5/50 mg or 5/100 mg according to their baseline blood pressure (BP). The primary outcome was echocardiographic reduction of left ventricular mass (LMV) after 6 months of treatment. Secondary outcomes were changes in BP, uricemia and albuminuria from baseline. We defined patients with adequately controlled hypertension as those with decreases in at least three out of these four variables.

Results:

From 109 eligible patients with hypertension, 99 started the protocol (70 under the low-dose combination). Echocardiography indices had mutual correlation and contributed independently to the primary outcome (Cronbach’s α index = 0.66). Intention-to-treat analysis showed that 60 patients [60.6%, 95% confidence interval (CI) 50.3–70.3] had reduced LVM. Echocardiographic changes were not associated with dose levels. Favorable changes in BP, uricemia and microabuminuria were seen in 77, 64 and 76 patients respectively. After 6 months there were 64 (95% CI 54–74%) patients with adequately controlled hypertension.

Conclusion:

Every two of three patients of this sample of Andean countries reached adequate control after 6 months of combined antihypertensive treatment with amlodipine/losartan.
Prevention of recurrent urinary tract infections by intravesical administration of heparin: a pilot study
Authors: Ablove Tova , Patankar Manish , Seo Songwon
Published: October 2013

Objective:

To assess the effect of bladder instillations using heparin on the rate of urinary tract infections in women resistant to standard therapy.

Patients and methods:

The medical records of all women who received bladder instillations between May 2009 and January of 2010 at the University of Wisconsin urogynecology clinic were reviewed. Eighteen women (mean age 67 years) with a history of recurrent urinary tract infections received intravesical instillations (heparin 40,000 U, 2% lidocaine 8 ml, sodium bicarbonate 4 ml) once weekly for 6 weeks. Patients were considered resistant to standard therapy if their condition failed to respond to chronic suppression antibiotic therapy; they had chronic infections and for this reason could not be placed on chronic suppression; or they were not candidates for chronic suppression due to drug allergies. The number of urinary tract infections was monitored during treatment and for 6 months after therapy. The urinary tract infection rates were compared with the rates of urinary tract infection in the 6 months before treatment.

Results:

Seventy-eight percent of patients responded to therapy. Subjects were thought to have responded to therapy if there was a greater than 50% reduction in the rate of urinary tract infection. Other variables reviewed included evidence of chronic infection, hormonal status, glomerular filtration rate, age, body mass index, antibiotic allergies, diabetes, hypertension, and chronic antibiotic therapy during bladder instillations. None of these variables were found to be statistically significant.

Conclusion:

Bladder instillations decreased the rate of urinary tract infection in this pilot study; this effect persisted into the post-treatment period. More research is needed to confirm these preliminary findings.
The Relationship Between Implementation of School-Wide Positive Behavior Intervention and Supports and Performance on State Accountability Measures
Authors: Marin Adriana M. , Filce Hollie Gabler
Published: October 2013

This study examined data from 96 schools in a Southeastern U.S. state participating in training and/or coaching on School-Wide Positive Behavioral Interventions and Supports (SWPBIS) provided by the State Personnel Development Grant (SPDG) in their state. Schools studied either received training only (“non-intensive” sites) or training and on-site coaching (“intensive” sites). Fidelity of implementation was self-evaluated by both types of schools using the Benchmarks of Quality (BOQ). Some schools were also externally evaluated using the School-Wide Evaluation Tool (SET), with those scoring 80% or higher determined “model sites.” Using an independent sample t-test, analyses revealed statistically significant differences between intensive and nonintensive schools’ Quality of Distribution Index (QDI) scores and between model sites and nonmodel sites on QDI scores. Correlations were performed to determine whether the fidelity of implementation of SWPBIS as measured by the BOQ was related to any of the state’s accountability measures: performance classification, QDI, or growth.
From Yellow to Blue
Authors: Hambrick Marion E. , Frederick Evan L. , Sanderson Jimmy
Published: October 2013

This research explored how Lance Armstrong utilized image repair strategies during 2012 and early 2013. This time frame represented a turbulent period in his career, as he faced a doping investigation by the U.S. government and later admitted to using performance-enhancing drugs during a nationally televised interview with Oprah Winfrey. Armstrong’s 859 tweets during this time period and his comments during the Oprah Winfrey interview were collected and subjected to a thematic analysis using Benoit’s image repair typology. Results indicated that via Twitter, Armstrong used attacking the accuser, bolstering, and stonewalling strategies but during the interview demonstrated contrition by employing mortification, shifting blame, simple denial, provocation, and victimization along with two newly identified strategies: conforming and retrospective regret. The results suggest that athletes who display multifaceted image repair strategies can embolden identification and attachment with followers and introduce competing media narratives surrounding their identity. However, these strategies may backfire when divergent messages are delivered in different media forums. Theoretical and practical implications will be discussed.
On the mechanism of exfoliation of ‘Vermiculite’
Authors: Hillier S. , Marwa E. M. M. , Rice C. M.
Published: October 2013

Six samples of ‘Vermiculite’ have been studied to investigate the mechanism of its well known but poorly understood property to exfoliate. The samples were analysed quantitatively by XRD to determine their precise mineralogical composition. Electron microprobe methods, including elemental mapping of native potassium and of caesium (introduced by cation exchange) were used to examine variation in the chemical composition of the particles. Most of the samples examined show heterogeneous mineralogical compositions which occur as distinct zones within the volume of individual particles, presenting a mosaic texture. Exfoliation is related to this mosaic distribution of the different mineral phases within the particles. Lateral phase boundaries between vermiculite and mica layers, or vermiculite and chlorite layers are postulated to prevent or impede the escape of gas from a particle, resulting in exfoliation when the pressure exceeds the interlayer bonding forces that hold the layers together. This mechanism provides a common explanation for the exfoliation of ‘Vermiculite’ by thermal methods or by treatment with H2O2. Paradoxically, one sample which consists of pure vermiculite, in the mineralogical sense of the term, demonstrates that pure vermiculite does not and should not exhibit the property of exfoliation. Our explanation of the mechanism of exfoliation explains the commonly observed particle size dependence of exfoliation and the tendency for obviously poly-phase ‘Vermiculite’ samples to show the largest coefficients of expansion.
Adsorption of enrofloxacin from aqueous solution by bentonite
Authors: Zhang J. X. , Zhou Q. X. , Li W.
Published: October 2013

The removal of enrofloxacin, a fluoroquinolone antibiotic, from aqueous solution by adsorption onto bentonite was investigated in this study. The effects of initial concentrations, contact time and temperature on the adsorption of enrofloxacin were studied via batch experiments. The adsorption equilibrium was achieved within 60 min for all studied concentrations. The adsorption capacity increased with the increase of initial concentration within a concentration range. Higher temperatures were favourable for the adsorption. The change of Gibbs free energy (ΔG°), change of enthalpy (ΔH°) and change of entropy (ΔS°) were evaluated and the results indicate that the adsorption should be an endothermic and spontaneous process. The Langmuir isotherm model fitted to the experimental data better than the Freundlich model. The adsorption follows the pseudo-second order kinetic model.
Montmorillonite mitigates the toxic effect of heavy oil on hydrocarbon-degrading bacterial growth: implications for marine oil spill bioremediation
Authors: Chaerun S. K. , Tazaki K. , Okuno M.
Published: October 2013

The ability of montmorillonite to mitigate the toxic effect of heavy oil from theNakhodkaoil spill, by growth of hydrocarbon-degrading bacteria and enable bioremediation was studied. Montmorillonite enhanced the bacterial growth significantly (P< 0.05) in the main treatment containing heavy oil+bacteria+montmorillonite (OBM), because the specific growth rate (μ) was greater than that in the biotic control treatment containing heavy oil+bacteria (OB). Significant amounts of Si and Al (major constituents of montmorillonite) were not released in the aqueous phase over the ∽24-day experiment (P> 0.05). Transmission electron microscopic observation showed that the hydrocarbon-degrading bacterial cells were covered and encrusted with montmorillonite particles. Scanning transmission electron microscopy coupled with energy dispersive X-ray spectroscopy (STEM-EDS) also showed that the surrounding of the bacterial cells was frequently rich in Si but not in Al. Fourier transform infrared (FTIR) spectroscopy indicated that the heavy oil-bacterial cell-montmorillonite particle complex retained the composition of both water and heavy oil. X-ray powder diffractrometery (XRD) analysis revealed that heavy oil and heavy oil-bacteria did not change the basal spacing of montmorillonite over a period of 24 days. The enhancement of hydrocarbon-degrading bacterial growth is attributed to montmorillonite likely serving as both bacterial growth-supporting carrier and protective outer layer against high concentrations of heavy oil that inhibit growth. These results shed light on the interactions in oil-bacteria-clay complexes and could potentially be used in marine oil spill bioremediation.
Characterization of clay deposits of Nanga-Eboko (central Cameroon): suitability for the production of building materials
Authors: Nzeukou Nzeugang A. , Medjo Eko R. , Fagel N. , Kamgang Kabeyene V. , Njoya A. , Balo Madi A. , Mache J. R. , Melo Chinje U.
Published: October 2013

Clayey deposits of Nanga-Eboko (central Cameroon) were studied to assess their potential as building materials. Characterization was performed using XRD, FTIR, XRF, DTA/DTG and firing testing. Clays appear as discontinuous pockets with the same textural characteristics in three villages located on both sides of the Sanaga River. The average thickness of the exploitable layer is about 3m. The estimated tonnage ∼7–17×105m3can supply a brick industry of great importance. SiO2(∼70%), Al2O3(∼15%) and Fe2O3(∼4%) are the predominant oxides of the natural clays. Quartz (∼55%), kaolinite (∼33%), illite (∼5%) and K-feldspar (∼4%) are major minerals. Clays are not suitable for building construction due to their fine-grained size and high plasticity properties. Firing properties of bricks (950 and 1050°C) are good despite the high shrinkage values. Therefore the addition of “degreasers” is recommended to control shaping and drying.