bluuebunny/crossref_metadata_2025 huggingface dataset:
CURRENT ADVANCE DIRECTIVE USE IN SOUTH AUSTRALIA: RESULTS FROM THE 2012 SPRING SOUTH AUSTRALIAN HEALTH OMNIBUS SURVEY
Authors: Bradley S L , Woodman R J , Phillips P A , Tieman J
Published: April 2013

Background

Advance directives enable autonomous decision-making for future healthcare and welfare and are an integral part of many advance care planning programmes. Current evidence of use of these instruments in South Australia (SA) is presented.

Aim

To ascertain the prevalence and type of advance directives used in SA.

Methods

Questions exploring the prevalence and type of advance directives experienced by the South Australian public were submitted to the Spring South Australian Health Omnibus Survey (HOS) 2012. The HOS has been conducted regularly since 1991 and is used by government and nongovernment organisations to assess the healthcare needs of the South Australian community. The survey comprised a random sample of 3055 members of the public drawn in a multi-stage, systematic sampling technique*.

Results

Analysis of an unweighted sample of 3055 participants showed that 40% had not completed any advance directive and that 27% have no interest in learning about advance directives. Age and other demographic factors were indicative of differences in participation rates.

Discussion

Using the HOS survey enabled analysis of demographic and sociological characteristics of the SA public with prevalence and type of advance directives experienced and provided evidence-based knowledge of the public's engagement in autonomous decision-making for future healthcare and welfare.

Conclusion

Accurate ascertainment of the South Australian public's current levels of knowledge and engagement with advance directives can assist future advance care planning initiatives in South Australia as well as provide a basis for further research designed to enhance completion rates of these instruments by the general public.
SUCCESSFUL INTERVENTION: RAISING AWARENESS OF ADVANCED CARE PLANNING (ACP) IN THE RURAL COMMUNITY SETTING
Authors: Weaver E , Vaughan T
Published: April 2013

Background

In 2009 in the Barossa Valley, South Australia, a group formed to promote the Respecting Patient Choices Program and ACP in their community. The group represents nurses, (aged and acute sites), doctors, lawyers, Ministers of Religion, Justices of the Peace, Emergency Services and community members.

Location of documentsNumber surveyedAverage age% Male% Female% with ACPLawyers office (%)Doctors surgery (%)Local hospital (%)200925793664162525020101667465418110620118866226827.560321820127566257532442217

Aim

To determine if active promotion of ACP has improved awareness and acceptance in the community

Method

Data collected over a 4 year period to determine public awareness of ACP in our local community. Information collected included age, gender, existing ACP documents and their storage location. At the end of the 4 year period data collected was analysed to determine if the pro-active approach had been effective in the above stated areas.

Results

Over 4 years the table shows a 100% increase of people with Advanced Care Plans. The unexpected positive outcome is the shift in awareness of ACP to younger age groups. Anecdotally people surveyed indicated an awareness of the Respecting Patient Choices branding and literature received through legal services, health services, medical centres and community avenues.

Discussion

Direct contact with individuals has proven to be an effective way to promote community awareness and acceptance of ACP in the rural community.

Conclusion

Data collected proves that active promotion of ACP with the community results in a positive change of attitude towards ACP—no longer a taboo subject.
THE ECONOMICS OF ADVANCE CARE PLANNING: EMPIRICAL DATA AND ETHICAL IMPLICATIONS
Authors: Marckmann G , in der Schmitten J
Published: April 2013

Background

Most health care systems are under increasing financial pressure due to aging populations and medical innovations. Therefore, policy makers pay attention to the economic effects of patient care programmes. While advance care planning (ACP) programmes have shown to improve patient care, the evidence about their financial implications is still sketchy.

Aim

To assess the empirical information about the economic effects of ACP-programmes, discuss the ethical implications of the findings, and to outline an agenda for future research.

Methods

Systematic review of the literature assessing the cost-implications (efficiency) of ACP programmes.

Results

Preliminary findings indicate that the costs for ACP-programmes may be outweighed by their savings; however, robust empirical research to understand the effects of ACP has not yet been undertaken, partly because of methodological challenges, and possibly also for political reasons.

Discussion

The cost-effectiveness of ACP-programmes is a delicate issue, both politically and ethically: If ACP-programmes are cost-saving, they would promote a wise use of scarce health care resources. However, a strong expectation of cost-savings could compromise the open and non-directive character of the facilitation process constitutive for ACP. We will discuss whether ACP programmes should adopt explicit conflict of interests policies. In any case, ACP-programmes must not be misconceived to be primarily an instrument for containing health care costs.

Conclusion

There should be more systematic economic evaluation of ACP-programmes and an open discussion of the corresponding ethical implications. This will be necessary to deal openly with potential conflict of interests and prevent a political backlash against the ‘ACP-movement’.
GUIDELINES: ARE THEY A WASTE OF TIME?
Authors: Saul P
Published: April 2013

Background

A trickle of guidelines about end of life (EOL) care in the 1990s has become a downpour. Governmental, professional, religious and community groups have released documents ranging from a friendly chat through to standards enforced by government agencies. In response to this deluge, clinicians everywhere have put up their umbrellas.

Methods

Evidence for the effectiveness of guidelines is generally poor, and end of life guidance, based on expert opinion, broad in nature, and lacking implementation or audit strategies, fair badly. In addition, the term ‘end of life’ has no single definition, and no precise tests exist to define to whom EOL guidelines are meant to apply. As a case history, NSW Health has notched up over two decades' experience in writing EOL guidelines, and has attempted to publicise them. But it remains a reality that end of life guidelines can produce a weak justification for change, but cannot themselves produce that change.

Conclusion

Improving the management of dying in our institutions is crucial to the credibility of our health systems, and to stem the tide of support for euthanasia. And to achieve this we need a coherent approach with a hierarchy of needs: political will, community pressure, legal support, strategic policy, standard setting, audit, feedback and accountability. Failure to be proactive is sure to lead to pressure of all the wrong kinds, as economic imperatives come to drive urgent efficiencies in end of life care. But an important question remains outstanding: what kind of support do acute care clinicians want (or need?) Without a coherent answer to this empirical question, managing and sustaining change is likely to be beyond us.
HOW WELL DOES THE AUSTRALIAN HEALTH CARE SYSTEM SUPPORT QUALITY END-OF-LIFE CARE FOR PEOPLE WITH CHRONIC DISEASE?
Authors: Burgess T , Braunack-Mayer A , Crawford G , Beilby J
Published: April 2013

Background

There is mounting evidence end-of-life care for people with advanced chronic disease is neither adequate nor appropriate. Chronic disease management initiatives have focussed on prevention and systematic care processes, with little or no attention to end-of-life care planning or delivery.

Aim

To determine how the Australian health care system supports end-of-life care for people with advanced chronic disease and their carers and determine the suitability, availability and accessibility of care.

Methods

Using a qualitative case study methodology, nine people with end stage heart, renal and neurological disease identified as likely to be in the last year of life, were interviewed three times over 9 months. Their carers and key service providers were also interviewed.

Results

None of the participants had discussed their prognosis with a clinician and none were supported by specialist palliative care. Participants aged under 65 years of age were more disadvantaged, particularly regarding access to ADL support. Four participants had undertaken advance care planning, at their own instigation. Service providers identified access to services, lack of advance care planning discussions and failure to recognise the terminal nature of many chronic diseases, as key issues.

Discussion

Lack of clarity around responsibility for care planning and co-ordination of end-of-life issues meant participants did not have the opportunity to discuss their care needs and frequently did not access appropriate services.

Conclusion

The Australian health care system is compartmentalised, with a lack of coordinated, practical policy and service delivery responses acting as significant barriers to best practice end-of-life care
ADVANCE CARE PLANNING IN AGED CARE HOMES: ACCREDITATION OR THE PURSUIT OF EXCELLENCE
Authors: Brandon Mark
Published: April 2013

No abstract
EXPANDED FAQS ON ADVANCE CARE PLANNING: DRIVEN BY THE COMMUNITY
Authors: Kelly C , Maloney M A , Smith L , Puls K , Spillane V , Sutton E , Silvester W
Published: April 2013

Background

In March 2011, Respecting Patient Choices at Austin Health established a Volunteers Program to provide education to community groups about Advance Care Planning (ACP). Commencing with 18 Frequently Asked Questions (FAQs), this expanded to 92.

Aim

To review the need for, the benefits and implications of expanded FAQs.

Methods

The FAQs at programme commencement were compared with the FAQs by December 2012. Volunteers were interviewed regarding the FAQ development.

Results

The expansion of the FAQs was driven by consumer demand at Information Sessions; 18 broad questions were not satisfactory. The 92 questions (not all asked at each session) could be grouped into themes. Themes included: Role of the GP; Conflict; Competency; Legal Issues; Organ Donation; ACP in Critical situations; Euthanasia; Dying with Dignity, Religion and ACP. The attendee feedback regarding the sessions and questions was very positive; 94.2% of 309 attendees agreed/strongly agreed that their questions were answered; 96.8% agreed/strongly agreed that the presentation increased their ACP knowledge.

Discussion

The FAQs were expanded to meet community expectations about information provided at the sessions. The benefit of expanding this list was that new Volunteers would be aware of the type of questions that would be asked, and that consistent answers could be provided. The implication is that Volunteers providing information to community groups need to have detailed knowledge of the entire ACP process.

Conclusion

Expanded FAQs required very specific responses, provided greater satisfaction and meant that Volunteers needed high level knowledge of the ACP process.
ADVANCE CARE DIRECTIVES (ACDS): CONSISTENCY AND UNDERSTANDING OF PATIENTS' FUTURE MEDICAL TREATMENT PREFERENCES
Authors: Wallis K , Sellars M , Detering K , Whiteside K , Mawren D , Silvester W
Published: April 2013

Background

ACDs enable individuals to document future treatment preferences. Documented wishes need to be ‘clinically meaningful’ and able to inform medical treatment plans during acute hospitalisation.

Aim

To assess preferences indicated on ACDs for content, consistency within the document and concordance with medical orders on the Resuscitation Plan (RP) (hospital POLST form).

Methods

Retrospective analysis of ACDs completed during facilitated advance care planning in 2011; including assessing consistency between the specific treatment wishes (CPR/Life-Prolonging Treatment (LPT)) and documented outcome preferences, and evaluating concordance of RP orders and ACD requests.

Results

153 patients completed ACDs, 88% also appointed a Substitute-Decision-Maker and 90% documented CPR/LPT preferences. Of these 51% chose ‘No CPR’, 40% chose ‘CPR if medically beneficial’ and 9% accepted medical advice that ‘CPR would be of no benefit’. 48% indicated they didn't want LPT, 50% wanted LPT if doctors anticipated a reasonable outcome and only 2% wanted LPT for as long as possible. 71% identified other undesired treatment(s) (38% ventilation, 37% artificial nutrition, 12% surgery, 10% dialysis). 84% documented their interpretation of unacceptable outcomes (inability to eat—38%, or communicate—43%, impaired cognition 33%, bedbound 33%).CPR and LPT requests were internally consistent in 88% and 85% of cases. A RP was completed during admission in 70 patients; 89% were concordant with ACD requests, 10% limited treatment more and 1% recommended more treatment.

Discussion

Most patients clearly documented preferences and undesired outcomes that were interpretable into actionable medical orders which were followed.

Conclusion

Facilitated ACD completion ensures patients' wishes are known and respected.
TRANSFORMING ATTITUDES: A YOUTH INITIATIVE
Authors: Trimboli J , Anderson L , Rivere M
Published: April 2013

Background

This collaboration enable nine students in Year 11 and two teachers from Our Lady of Sion College to engage with our patients, their families and staff while exploring a number of topics.

Aim

Debunking myths about death, dying and the meaning of Palliative Care.

Methods

Patients and family members were interviewed to explore how they have come to understand how the clinical and non-clinical needs of their family members are met.

Results

Student Victoria reflects on her experiences ‘I could use the clichéd phrase “it changed my life, but in all reality, it did so much more than that. I learnt that hospitals do not have to be places that are starch-white and unfriendly nor do doctors and nurses have to be people to fear. I learnt that courage is an intangible, amazing force that comes from the most unlikely people and places. I learnt that death does not have to be feared; especially not when it could be embraced. I learnt that it is possible for death, the end of someone's life, to be a celebration; a celebration of the life that has occurred rather than the death itself…Finally, I learnt to see past the physical or intellectual disabilities and see the person who is inside. The courageous, friendly, funny, intelligent, remarkable person that they truly are”.

Discussion

The students, their families and the school community have a new understanding of Palliative Care.

Conclusion

This process can be taught to other health care providers—it will create changes in thinking in the community.
PATIENTS' WORDS INTO ACTION: OCCUPATIONAL THERAPY APPROACHES IN RAFIK HARIRI UNIVERSITY HOSPITAL LEBANON
Authors: Souraya Sally
Published: April 2013

Background

The first and unique occupational therapy service in Oncology in Lebanon has started in 2010 at the Rafic Harriri University Hospital. This service was the only psycho-social support provided for cancer patients at this hospital. Thus, many challenges were faced by the team working due to the novelty of this field and the lack of funding. Nevertheless, this service has succeeded in improving the quality of life of those patients and their families.

Aim

The presentation is going to highlight the challenges faced and the approaches used in order to put patients' words into action in individualised therapeutic plans.

Methods

The presentation will be addressing the main features of the service provided and highlighting how patients' words were used to develop therapeutic plans to help in improving the psychological state of cancer patients. Practical examples and case studies will be provided.

Results

The presentation will show qualitative results of the impact of occupational therapy approaches used on the quality of life of cancer patients and their families.

Discussion

The presentation will discuss the importance of individualised therapeutic plan which were based on patients' needs and expectations. Moreover the unique effect of these plans will be highlighted due to the satisfaction attained by the patients regarding the quality of care given.

Conclusion

The presentation will pose the following question: if the care planning is based on the needs voiced by patients' words, how can we effectively listen to cancer patients? And, How can we use this technique to improve the quality of care planning?
ADVANCE CARE PLANNING WHO, WHEN AND WHERE. WHAT IS THE EVIDANCE TO SUPPORT THE CALL TO PLAN EARLY
Authors: Sands M B , Norris C , Varndel W , Caplan G
Published: April 2013

Background

Eighty-six per cent of Australians state a preference to die peacefully at home, in fact only around 20% die at home. What is the evidence that supports our approach to Advance Care Planning? What populations can be effectively targeted? What are the necessary components that comprise and accompany an effective ACP? What are the barriers? What are the important outcomes? How do we provide confidence in the availability of careoutsidethe acute setting to permit the ideal of staff and families/carers following an ACP and avoiding crisis transfers? What is the role of the acute setting in ACP?

Aim

To review the evidence that supports a co-ordianated approach to ACP.

Methods

This presentation is a systematic review of the evidence that informs our approach to ACP in primary and secondary health care settings

Results

The evidence to support a comprehensive, tailored approach to identifying patients who might benefit from ACP, an approach to symptom management and carer support in a primary health care setting with appropriate co-ordination with specialist palliative care will be presented.

Discussion

Only 4% of decedents do not have an the Emergency Department (ED) Presentation in the last year of life. The trajectory of chronic illness and co-morbidity determine that ED presentations provide the opportunity to identify patients who might benefit from ACP how can this inform our approach?

Conclusion

Advance Care Planning has been associated with improved patient outcomes. The suggested approach supports the aspiration to Plan EARLY, and identifies appropriate target populations and outcome measures.
DEVELOPMENT OF AN END-OF-LIFE CORE MEDICINES LIST FOR COMMUNITY PATIENTS
Authors: Tait P A , Cortis L , Morris B
Published: April 2013

Background

Timely access to medicines within the community is important for palliative patients where their preferred place of care is the home environment. This is particularly relevant in the terminal phase of a palliative illness. Commonly encountered symptoms in the terminal phase include: pain, dyspnoea, restlessness, noisy breathing and nausea. While existing national guidelines influence the management of symptoms for palliative patients, the range of medicines usually needed within the community setting to treat noncomplex terminal phase symptoms is less than required in a tertiary inpatient palliative care unit.

Aim

To (1) Analyse a variety of palliative resources to identify the pharmacological management of common symptoms in the terminal phase; and (2) Create an end-of-life Core Medicines List that guides consistent prescribing for noncomplex community palliative patients in the terminal phase.

Methods

Seven stakeholders representing all consultant-led palliative services in South Australia discussed the management of five common symptoms observed in the terminal phase of a palliative illness. The selection of the core medicines took into consideration cost, availability in the doctor's bag, access to government subsidies (eg, PBS) and drug properties.

Results

The five end-of-life core medicines selected for noncomplex community patients are:

Clonazepam 1 mg injection;

Haloperidol 5 mg/ml injection;

Hyoscine butylbromide 20 mg/ml injection;

Metoclopramide 10 mg/2 ml injection; and

Morphine 10 mg/ml injection

Discussion

There is some overlap in the symptoms which these medicines control, thus allowing some options despite the restricted list.

Conclusion

A concise end-of-life core medicines list of five medicines has been developed to guide prescribing by community clinicians.
NORMALISING ACP IN THE HOSPITAL- THE ROLE OF STANDARDS
Authors: Dunbar N
Published: April 2013

Programmes such as Respecting Choices in the USA and Respecting Patient Choices in Australia have been developed to address the need for improved advance care planning. Numerous guidelines, policies and pieces of legislation exist to provide guidance on requirements for developing and documenting advance care plans. However the problem of sub-optimal advance care planning in hospitals persists.

Problems have been identified in having ‘difficult’ conversations, documenting decisions made, the accessibility of advance care directives and applying advance care directives in practice.

One of the approaches that can support better use of advance care plans in hospitals is the use of standards and accreditation processes. In Australia, new National Safety and Quality Health Service Standards include items regarding the need for systems to receive or prepare advance care plans in partnership with patients and families, and to document these in the clinical record.

These National Safety and Quality Health Service Standards provide explicit statements of the expected level of safety and quality of care to be delivered to patients. The Standards are mandatory and hospitals need to be assessed against them from January 2013.

The Standards provide an opportunity to embed systems that support effective advanced care planning in practice through a system-wide approach to quality improvement. These high-level standards complement the more detailed policy and educational programmes that already exist, and provide a focus for efforts to improve the safety and quality of end of life care for patients in hospitals.
The Streptococcus thermophilus protein Wzh functions as a phosphotyrosine phosphatase
Authors: Cefalo Angela D. , Broadbent Jeffery R. , Welker Dennis L.
Published: April 2013

Amino acid residues that are important for metal binding and catalysis in Gram-positive phosphotyrosine phosphatases were identified in the Wzh protein of Streptococcus thermophilus MR-1C by using sequence comparisons. A His-tagged fusion Wzh protein was purified from Escherichia coli cultures and tested for phosphatase activity against synthetic phosphotyrosine and phosphoserine–threonine peptides. Purified Wzh released 2316.5 ± 138.7 pmol PO4·min−1·μg−1 from phosphotyrosine peptide-1 and 2345.7 ± 135.2 pmol PO4·min−1·μg−1 from phosphotyrosine peptide-2. The presence of the phosphotyrosine phosphatase inhibitor sodium vanadate decreased purified Wzh activity by 45%–50% at 1 mmol·L–1, 74%–84% at 5 mmol·L–1, and by at least 88% at 10 mmol·L–1. Purified Wzh had no detectable activity against the phosphoserine–threonine peptide. These results clearly establish that S. thermophilus MR-1C Wzh functions as a phosphotyrosine phosphatase that could function to remove phosphate groups from proteins involved in exopolysaccharide biosynthesis, including the protein tyrosine kinase Wze and priming glycosyltransferase.
TOWARD A QUALITY FRAMEWORK FOR BUSINESS PROCESS MODELS
Authors: SÁNCHEZ-GONZÁLEZ LAURA , GARCÍA FÉLIX , RUIZ FRANCISCO , PIATTINI MARIO
Published: April 2013

Business process modeling is recognized as a key part of the business process lifecycle. It is during this stage that a conceptual model is produced by collecting business process requirements and representing them with a specific business process notation. While there has been much research into process modeling techniques, little has taken place with regard to the characteristics that should be considered for an effective assessment of the models' quality. This paper presents a synthesis of quality characteristics for business process models, based on a systematic review of the relevant literature. It then goes on to describe a reference model for the quality assessment of business process models, and to relate the aforementioned quality characteristics to existing relevant process model measures. These relations may help organizations to guide the improvement of their business process models according to their chosen quality characteristics.
PERSONALIZED KNOWLEDGE MANAGEMENT IN ENVIRONMENTS OF WEB-BASED EDUCATION
Authors: VALDERRAMA RUBÉN PEREDO , CRUZ ALEJANDRO CANALES , SALAZAR ADRIANA N. RAMÍREZ , RAMÍREZ JUAN CARLOS CARAVANTES
Published: April 2013

This paper is focused on the use of Knowledge Management techniques to develop environments of Web-Based Education to leverage the individual learning process for learners. Evolving use of Knowledge Management plays an important role to enhance problem solving skills. Recently, innovative approaches for integrating Knowledge Management into practical teaching activities have been ignored. The knowledge is defined as combination and organization of data and information in given context, and Knowledge Management provides acquire, storage, sharing, application and creation of knowledge objects. A new Architecture for the development of adaptive and intelligent Web-Based Education systems is presented. This architecture is based on a Learning Model for Personalized Knowledge Management.
CONVERGENCE ANALYSIS OF THE PSEUDOSPECTRAL METHOD FOR LINEAR DAEs OF INDEX-2
Authors: GHANBARI F. , GHOREISHI F.
Published: April 2013

This paper is concerned with the study of pseudospectral discretizations of the differential-algebraic equations (DAEs). Pseudospectral method based on Chebyshev polynomials are used to transcribe a given DAE into a system of algebraic equations. A posteriori error bound between the desired solution to the index 2, DAEs and the pseudospectral approximate solution of the problem is estimated in the weighted L2 norm. Some numerical experiments are considered to demonstrate the efficiency and the applicability of the method.
SUPERCONDUCTIVITY-INDUCED PINNING EFFECT IN SUPERCONDUCTOR/MAGNETIC TUNNEL JUNCTIONS
Authors: YU G. Q. , REN CONG , RIZWAN SYED , YU T. , XU K. , HAN X. F.
Published: April 2013

We have fabricated Nb /magnetic tunnel junction (MTJ) structure to investigate superconductivity-induced impact on magnetization states of the proximal ferromagnet. By sweeping temperature in a parallel or antiparallel magnetization state, a thermal hysteresis in MTJ resistance was observed at temperature below the Nb superconducting critical temperature (Tc). In the parallel configuration, a Barkhausen-like jump in junction resistance arises when the magnetization of free layer is close to switching from parallel to antiparallel configuration. We attribute the hysteresis and Barkhausen-like jump to the pinning effect of Nb on the proximal magnetic domains and estimate the magnitude of the moment change of the free layer responsible for the resistance change resulting from Barkhausen-like jump.
Role of Garlic Usage in Cardiovascular Disease Prevention: An Evidence-Based Approach
Authors: Qidwai Waris , Ashfaq Tabinda
Published: April 2013

Introduction. Rapidly growing prevalence of cardiovascular disease is a major threat for the developed as well as developing world warranting urgent need of intervention. Complementary and alternative medicines are gaining popularity among general population because of their safety profile and easy administration. Garlic, in particular, is considered to be one of the best disease-preventive foods because of its potent and widespread effects. This study was done to find out the role of garlic usage in cardiovascular disease prevention.Methodology. Major databases including Google, PubMed, MEDLINE, and Cochrane library view were used for the literature search. Clinical trials conducted on humans assessing role of garlic usage in cardiovascular disease prevention and the possible mechanisms responsible for such therapeutic actions were assessed.Results. Various clinical trials and meta-analyses conducted have shown positive impact of garlic in cardiovascular-disease prevention especially its effects on lipid levels; however, some contradictory results are also reported. Similarly, its effects on hypertension control, and platelet are also mild with limited data availability. The possible reason for these inconsistent results is the difference in preparations with diverse composition, variations in sulphur content present in different garlic preparations used, and methodological variations in subject recruitment, duration of study, dietary control and so forth.Conclusion. Garlic can be used as an adjuvant with lipid-lowering drugs for control of lipids, however, its role as a main therapeutic agent cannot be recommended and it is suggested that more meta-analyses using standardized preparations with a close watch on methodological shortfalls should be conducted to prove its role.
Mediators of Yoga and Stretching for Chronic Low Back Pain
Authors: Sherman Karen J. , Wellman Robert D. , Cook Andrea J. , Cherkin Daniel C. , Ceballos Rachel M.
Published: April 2013

Although yoga is an effective treatment for chronic low back pain, little is known about the mechanisms responsible for its benefits. In a trial comparing yoga to intensive stretching and self-care, we explored whether physical (hours of back exercise/week), cognitive (fear avoidance, body awareness, and self-efficacy), affective (psychological distress, perceived stress, positive states of mind, and sleep), and physiological factors (cortisol, DHEA) mediated the effects of yoga or stretching on back-related dysfunction (Roland-Morris Disability Scale (RDQ)). For yoga, 36% of the effect on 12-week RDQ was mediated by increased self-efficacy, 18% by sleep disturbance, 9% by hours of back exercise, and 61% by the best combination of all possible mediators (6 mediators). For stretching, 23% of the effect was mediated by increased self-efficacy, 14% by days of back exercise, and 50% by the best combination of all possible mediators (7 mediators). In open-ended questions, ≥20% of participants noted the following treatment benefits: learning new exercises (both groups), relaxation, increased awareness, and the benefits of breathing (yoga), benefits of regular practice (stretching). Although both self-efficacy and hours of back exercise were the strongest mediators for each intervention, compared to self-care, qualitative data suggest that they may exert their benefits through partially distinct mechanisms.
Changes in Adipokines following Laparoscopic Roux-en-Y Gastric Bypass Surgery in Chinese Individuals with Type 2 Diabetes Mellitus and BMI of 22–30 kg·m−2
Authors: Shrestha Chandrama , He Honghui , Liu Yiqun , Zhu Shaihong , Xiong Jing , Mo Zhaohui
Published: April 2013

Aims.Although altered endocrine changes following bariatric surgery in morbidly obese patients with diabetes have been demonstrated by previous studies, little is known about their effects on low BMI patients of T2DM. We investigated the changes in adipokines and sICAM-1 in Chinese subjects with low BMI and T2DM after LRYGB and explored their relationship with postsurgical insulin sensitivity.Methods.Plasma levels of adiponectin, sICAM-1, fasting glucose, glycated hemoglobin, and fasting insulin and serum levels of visfatin were measured before and at three months after LRYGB in 33 T2DM patients with BMI of 22–30 kg·m−2.Results.Significant reductions in anthropometric measurements and indicators of glucose and lipid metabolism and moderate reductions in insulin resistance and fasting insulin were observed at three months after LRYGB. Postoperative adiponectin level (P<0.001) was increased compared to the preoperative level, whereas visfatin (P<0.001) and sICAM-1 (P<0.001) were lower than that before surgery. Serum adiponectin negatively correlated with HOMA-IR and FIns both preoperatively and at three months after surgery, and visfatin positively correlated with HOMA-IR and FIns both preoperatively and postoperatively.Conclusion.Changes in adipokines were related to an improvement in postsurgical insulin sensitivity, which was predicted by weight loss after LRYGB even in low BMI patients with T2DM.
New Results for Periodic Solution of High-Order BAM Neural Networks with Continuously Distributed Delays and Impulses
Authors: Yang Chang-Bo , Huang Ting-Zhu , Shao Jin-Liang
Published: April 2013

ByM-matrix theory, inequality techniques, and Lyapunov functional method, certain sufficient conditions are obtained to ensure the existence, uniqueness, and global exponential stability of periodic solution for a new type of high-order BAM neural networks with continuously distributed delays and impulses. These novel conditions extend and improve some previously known results in the literature. Finally, an illustrative example and its numerical simulation are given to show the feasibility and correctness of the derived criteria.
On Kadison-Schwarz Type Quantum Quadratic Operators on
Authors: Mukhamedov Farrukh , Abduganiev Abduaziz
Published: April 2013

We study the description of Kadison-Schwarz type quantum quadratic operators (q.q.o.) acting from into . Note that such kind of operators is a generalization of quantum convolution. By means of such a description we provide an example of q.q.o. which is not a Kadison-Schwartz operator. Moreover, we study dynamics of an associated nonlinear (i.e., quadratic) operators acting on the state space of .
Experimental Evidence on the Impact of Food Advertising on Children’s Knowledge about and Preferences for Healthful Food
Authors: Reisch Lucia A. , Gwozdz Wencke , Barba Gianvincenzo , De Henauw Stefaan , Lascorz Natalia , Pigeot Iris
Published: April 2013

To understand the rising prevalence of childhood obesity in affluent societies, it is necessary to take into account the growing obesity infrastructure, which over past decades has developed into an obesogenic environment. This study examines the effects of one of the constituent factors of consumer societies and a potential contributory factor to childhood obesity: commercial food communication targeted to children. Specifically, it investigates the impact of TV advertising on children’s food knowledge and food preferences and correlates these findings with their weight status. Evaluations of traditional information- and education-based interventions suggest that they may not sustainably change food patterns. Based on prior consumer research, we propose five hypotheses, which we then test using a subsample from the IDEFICS study, a large-scale pan-European intervention study on childhood obesity. The results indicate that advertising has divergent effects on children’s food knowledge and preferences and that food knowledge is unrelated to food preferences. This finding has important implications for both future research and public policy.
Horizontal and Vertical Rule Bases Method in Fuzzy Controllers
Authors: Aminifar Sadegh , bin Marzuki Arjuna
Published: April 2013

Concept of horizontal and vertical rule bases is introduced. Using this method enables the designers to look for main behaviors of system and describes them with greater approximations. The rules which describe the system in first stage are called horizontal rule base. In the second stage, the designer modulates the obtained surface by describing needed changes on first surface for handling real behaviors of system. The rules used in the second stage are called vertical rule base. Horizontal and vertical rule bases method has a great roll in easing of extracting the optimum control surface by using too lesser rules than traditional fuzzy systems. This research involves with control of a system with high nonlinearity and in difficulty to model it with classical methods. As a case study for testing proposed method in real condition, the designed controller is applied to steaming room with uncertain data and variable parameters. A comparison between PID and traditional fuzzy counterpart and our proposed system shows that our proposed system outperforms PID and traditional fuzzy systems in point of view of number of valve switching and better surface following. The evaluations have done both with model simulation and DSP implementation.
Exponential Stability of Impulsive Stochastic Functional Differential Systems with Delayed Impulses
Authors: Yao Fengqi , Deng Feiqi , Cheng Pei
Published: April 2013

A class of generalized impulsive stochastic functional differential systems with delayed impulses is considered. By employing piecewise continuous Lyapunov functions and the Razumikhin techniques, several criteria on the exponential stability and uniform stability in terms of two measures for the mentioned systems are obtained, which show that unstable stochastic functional differential systems may be stabilized by appropriate delayed impulses. Based on the stability results, delayed impulsive controllers which mean square exponentially stabilize linear stochastic delay systems are proposed. Finally, numerical examples are given to verify the effectiveness and advantages of our results.
Chemical Composition, Nutritive Value, and Toxicological Evaluation ofBauhinia cheilanthaSeeds: A Legume from Semiarid Regions Widely Used in Folk Medicine
Authors: Teixeira Daniel Câmara , Farias Davi Felipe , Carvalho Ana Fontenele Urano , Arantes Mariana Reis , Oliveira José Tadeu Abreu , Sousa Daniele Oliveira Bezerra , Pereira Mirella Leite , Oliveira Hermogenes David , Andrade-Neto Manoel , Vasconcelos Ilka Maria
Published: April 2013

Among theBauhiniaspecies,B. cheilanthastands out for its seed protein content. However, there is no record of its nutritional value, being used in a nonsustainable way in the folk medicine and for large-scale extraction of timber. The aim of this study was to investigate the food potential ofB. cheilanthaseeds with emphasis on its protein quality to provide support for flora conservation and use as raw material or as prototype for the development of bioproducts with high added socioeconomic value.B. cheilanthaseeds show high protein content (35.9%), reasonable essential amino acids profile, low levels of antinutritional compounds, and nutritional parameters comparable to those of legumes widely used such as soybean and cowpea. The heat treatment of the seeds as well as the protein extraction process (to obtain the protein concentrate) increased the acceptance of diets by about 100% when compared to that of rawBcdiet. These wild legume seeds can be promising alternative source of food to overcome the malnutrition problem faced by low income people adding socioeconomic value to the species.
Efficiency-Aware: Maximizing Energy Utilization for Sensor Nodes Using Photovoltaic-Supercapacitor Energy Systems
Authors: Liu Zheng , Yang Xinyu , Yang Shusen , McCann Julie
Published: April 2013

Recently, photovoltaic-supercapacitor-based energy systems have become more and more popular in the design of energy harvesting wireless sensor networks (EH-WSNs) as an alternative to battery power. Existing research on this area mainly focuses on hardware design and the improvement of the charging efficiency. However, energy is wasted not only by the inefficient charging process, but also the inefficient discharging process and energy leakage. Therefore, to maximize node lifetime and energy utilization, all the previous energy loss should be considered. In this paper, we develop realistic hardware models of the complete photovoltaic-supercapacitor energy systems and propose the efficiency-aware, a systematic duty cycling framework to maximize energy utilization. We formalize the maximization problem as a nonlinear optimization problem and develop two efficient algorithms for its optimal solutions. The performance of our approaches is evaluated via extensive numeric simulations, and the results show that our efficiency-aware framework can, respectively, achieve 60% and 56% more active time (i.e. energy utilization) than the fixed duty cycle scheme and leakage-aware, a state-of-the-art scheme for photovoltaic-supercapacitor energy systems.
Acetylcholinesterase Inhibitory Activities of Flavonoids from the Leaves of Ginkgo biloba against Brown Planthopper
Authors: Ding Xiao , Ouyang Ming-An , Liu Xiang , Wang Rei-Zhen
Published: April 2013

Ginkgo biloba is a traditional Chinese medicinal plant which has potent insecticidal activity against brown planthopper. The MeOH extract was tested in the acetylcholinesterase (AChE) inhibitory assay with IC50 values of 252.1 μg/mL. Two ginkgolides and thirteen flavonoids were isolated from the leaves of Ginkgo biloba. Their structures were established on the basis of spectroscopic data interpretation. It revealed that the 13 isolated flavonoids were found to inhibit AChE with IC50 values ranging from 57.8 to 133.1 μg/mL in the inhibitory assay. AChE was inhibited dose dependently by all tested flavonoids, and compound 6 displayed the highest inhibitory effect against AChE with IC50 values of 57.8 μg/mL.
Multistep Hybrid Extragradient Method for Triple Hierarchical Variational Inequalities
Authors: Kong Zhao-Rong , Ceng Lu-Chuan , Ansari Qamrul Hasan , Pang Chin-Tzong
Published: April 2013

We consider a triple hierarchical variational inequality problem (THVIP), that is, a variational inequality problem defined over the set of solutions of another variational inequality problem which is defined over the intersection of the fixed point set of a strict pseudocontractive mapping and the solution set of the classical variational inequality problem. Moreover, we propose a multistep hybrid extragradient method to compute the approximate solutions of the THVIP and present the convergence analysis of the sequence generated by the proposed method. We also derive a solution method for solving a system of hierarchical variational inequalities (SHVI), that is, a system of variational inequalities defined over the intersection of the fixed point set of a strict pseudocontractive mapping and the solution set of the classical variational inequality problem. Under very mild conditions, it is proven that the sequence generated by the proposed method converges strongly to a unique solution of the SHVI.
A Self-Adjusting Spectral Conjugate Gradient Method for Large-Scale Unconstrained Optimization
Authors: Qiu Yuanying , Cui Dandan , Xue Wei , Yu Gaohang
Published: April 2013

This paper presents a hybrid spectral conjugate gradient method for large-scale unconstrained optimization, which possesses a self-adjusting property. Under the standard Wolfe conditions, its global convergence result is established. Preliminary numerical results are reported on a set of large-scale problems in CUTEr to show the convergence and efficiency of the proposed method.
Safety Evaluation of Engineered Nanomaterials for Health Risk Assessment: An Experimental Tiered Testing Approach Using Pristine and Functionalized Carbon Nanotubes
Authors: Coccini Teresa , Manzo Luigi , Roda Elisa
Published: April 2013

Increasing application of engineered nanomaterials within occupational, environmental, and consumer settings has raised the levels of public concern regarding possible adverse effects on human health. We applied a tiered testing strategy including (i) a first in vitro stage to investigate general toxicity endpoints, followed by (ii) a focused in vivo experiment. Cytotoxicity of laboratory-made functionalized multiwalled carbon nanotubes (CNTs) (i.e., MW-COOH and MW-NH2), compared to pristine MWCNTs, carbon black, and silica, has been assessed in human A549 pneumocytes by MTT assay and calcein/propidium iodide (PI) staining. Purity and physicochemical properties of the test nanomaterials were also determined. Subsequently, pulmonary toxic effects were assessed in rats, 16 days after MWCNTs i.t. administration (1 mg/kg b.w.), investigating lung histopathology and monitoring several markers of lung toxicity, inflammation, and fibrosis. In vitro data: calcein/PI test indicated no cell viability loss after all CNTs treatment; MTT assay showed false positive cytotoxic response, occurring not dose dependently at exceedingly low CNT concentrations (1 μg/mL). In vivo results demonstrated a general pulmonary toxicity coupled with inflammatory response, without overt signs of fibrosis and granuloma formation, irrespective of nanotube functionalization. This multitiered approach contributed to clarifying the CNT toxicity mechanisms improving the overall understanding of the possible adverse outcomes resulting from CNT exposure.
New Insights on Human Polyomavirus JC and Pathogenesis of Progressive Multifocal Leukoencephalopathy
Authors: Bellizzi Anna , Anzivino Elena , Rodio Donatella Maria , Palamara Anna Teresa , Nencioni Lucia , Pietropaolo Valeria
Published: April 2013

John Cunningham virus (JCV) is a member of thePolyomaviridaefamily. It was first isolated from the brain of a patient with Hodgkin disease in 1971, and since then the etiological agent of the progressive multifocal leukoencephalopathy (PML) was considered. Until the human immunodeficiency virus (HIV) pandemic, PML was rare: in fact HIV-induced immunodeficiency is the most common predisposing factor accounting for 85% of all instances of PML. This data led to intense research on JCV infection and resulted in better understanding of epidemiology and clinic-pathologic spectrum. Recently, cases of PML have been observed after the introduction of monoclonal antibodies, such as natalizumab, rituximab, efalizumab, and infliximab, in the treatment of autoimmune disease, underlining the important role of host immunity in PML pathogenesis. In this review current understanding of the JCV infection and the new findings relating to the pathogenesis of PML has been comprehensively revised, focusing our attention on the interaction between the cellular and viral molecular pathways implicated in the JCV infection and the modulating role of host immune surveillance in the viral reactivation from a latent state.
A New Characteristic Nonconforming Mixed Finite Element Scheme for Convection-Dominated Diffusion Problem
Authors: Shi Dongyang , Tang Qili , Zhang Yadong
Published: April 2013

A characteristic nonconforming mixed finite element method (MFEM) is proposed for the convection-dominated diffusion problem based on a new mixed variational formulation. The optimal order error estimates for both the original variableuand the auxiliary variableσwith respect to the space are obtained by employing some typical characters of the interpolation operator instead of the mixed (or expanded mixed) elliptic projection which is an indispensable tool in the traditional MFEM analysis. At last, we give some numerical results to confirm the theoretical analysis.
Transient Headache and Neurological Deficits with Cerebrospinal Fluid Lymphocytosis Associated with IgM Antibodies to the Epstein-Barr Virus Viral Capsid Antigen
Authors: Apetse Kossivi , Breynaert Ludovic , Butaud Chloe , Beschet Albert , Blanc-Lasserre Karine , Ribouillard Loic , Chan Victor
Published: April 2013

Some authors have suggested that the syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL) results from an immunological response directed against a viral agent. Here we report a case of HaNDL in an immunocompetent 19-year-old male that could support this hypothesis.