bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary cervical lymphoma: a rare presentation to a genitourinary medicine clinic
Authors: Bull L , Knowles A , Ogden S , Boag F , Naresh K N , Bower M
Published: July 2013

Summary

Primary non-Hodgkin's lymphoma of uterine cervix is a rare diagnosis. We present the case of a 47-year-old woman who presented to our genitourinary (GU) medicine service complaining of a malodorous discharge. Speculum examination revealed a necrotic mass on the cervix. She was referred urgently to gynaecology and subsequent histology revealed a diffuse large B-cell lymphoma. She received six cycles of RCHOP chemotherapy and is now in clinical remission. This case highlights the need for GU medicine physicians to remain vigilant with regard to possible gynaecological malignancies in all of our patients, the need for medical backup within GU medicine clinics and for clear pathways of referral to other specialists to exist.
Seroprevalence of hepatitis B in a cohort of HIV-infected children and adults in Swaziland
Authors: Dziuban E J , Marton S A , Hughey A B , Mbingo T L , Draper H R , Schutze G E
Published: July 2013

Summary

Hepatitis B virus (HBV) is an important co-morbidity in the HIV epidemic. A retrospective chart review was performed of HIV-infected patients with no previous antiretroviral history enrolled in a Swaziland clinic from January 2009 to May 2011. The seroprevalence of HBV surface antigen (HBsAg) was calculated and the data were analyzed using Mann-Whitney U and Fisher's exact tests. A total of 1282 patients were included in analysis. Five hundred were children aged <15 years. Overall HBsAg seroprevalence was 3.7% (1.4% of children and 5.1% of adults). Prevalence in under-5s was low (0.4%). Among adult women and men, prevalence was 4.2% and 9.8%, respectively ( P = 0.022). Median alanine aminotransferase level was 19 U/L in the HBsAg-negative adults and 25 U/L in the HBsAg-positive adults ( P = 0.005). Given the number of patients found to be HBsAg-positive, especially among adults, it is important for antiretroviral programmes to consider universal screening and strategically utilize medications that have been found effective in treating both HBV and HIV.
Combustion performance of eccentrically rotated flames
Authors: Ismael AM , Abdelkhalek MF , Kamal MM
Published: July 2013

Experimental/computational work highlighted the combustion performance with eccentric blockage rotation in the reactive flow passage to augment the turbulence production rates in the flame for acquiring high power to weight ratios and effective heat transfer in industrial applications. The temporal/spatial velocity gradients stimulated around the reactive stream boundaries enhanced the turbulence development in both premixed and non-premixed flames. The eccentric shapes included circular, elliptical, squared and triangular shafts as well as a triple/straight blade rotor. The design was further developed to incorporate simultaneous rotation of the eccentric blockage around its axis via a planetary gear assembly to duplicate the vortical structure. While the premixed flames responded to such cyclic action by having a mixture velocity of 16.8 m/s, the non-premixed flames acquired an increase of 341% in the largest eddy size and a flame length reduction by 42%. Increasing the Strouhal number to 0.94 and the swirl ratio to 0.78 increased the turbulent kinetic energy to 9.1 m2/s2. By controlling the drag coefficient and wake vorticity for the solid shapes, the triangular rotor enhanced the combustor outward heat flux to exhibit a heater efficiency of 36.8% in the premixed flame mode and reduced the HC and CO emissions, respectively, to 0.1% and 513 ppm for non-premixed flames. Decreasing the reactive stream cross-section favorably increased the flow shearing effects, while the elliptical shape showed the highest sensitivity to axes’ orientation with respect to the direction of rotation. Due to the reduction in peak temperatures via increasing the turbulence intensity and heat transfer rate from the flame, the NO x exhaust concentrations decreased to a minimum value around 10 ppm. The combustion efficiency of diffusion flames was optimized with the fuel port central positioning in the burner, where the planetary gear design provided a turbulence intensity of 13.7% by the triple blade rotor.
The rich dynamics of fractional-order gyros applying a fractional controller
Authors: Aghababa Mohammad P , Aghababa Hasan P
Published: July 2013

The gyro is an interesting and everlasting nonlinear nonautonomous dynamical system that exhibits very rich and complex behavior such as chaos. However, in recent years, modeling and control of fractional-order dynamical systems have become important and useful topics in both research and engineering applications. In this article, the dynamical behavior of a nonautonomous fractional-order gyro system is investigated. We apply the maximal Lyapunov exponent criterion to show that the fractional-order gyro system exhibits chaos. Strange attractors of the system are also plotted to validate the chaotic behavior of the system. Subsequently, in order to suppress the chaotic state of the fractional-order gyro system, a robust finite-time fractional controller is designed. The convergence time of the proposed control scheme is estimated. And the fractional Lyapunov theory is adopted to prove the finite-time stability and robustness of the proposed method. Besides, some computer simulations are given to illustrate the effectiveness and applicability of the proposed fractional controller.
Involvement of mitochondrial pathway in benzo[a]pyrene-induced neuron apoptosis
Authors: Nie J-S , Zhang H-M , Zhao J , Liu H-J , Niu Q
Published: July 2013

Benzo[a]pyrene (B[a]P), a well-known carcinogen, is widespread in the environment. Although the neurotoxic effect of B[a]P has not drawn much attention, toxic effects of B[a]P on learning and memory have been reported. Since it is well known that neuronal apoptosis plays a major role in impairment of learning and memory triggered by many stimuli, an effort has been made to examine whether the B[a]P-induced neurotoxicity occurs through mitochondria-mediated apoptosis. Cultured newborn rat cerebral neurons were used to clarify the apoptosis induced by B[a]P in the study. After incubating with different doses of B[a]P in presence of S9 for 40 h, the apoptotic rates of B[a]P-treated neurons increased in a dose-dependent manner. Further analysis showed that B[a]P-induced apoptosis was accompanied by loss of mitochondrial membrane potential, release of cytochrome c from mitochondria to the cytosol, downregulation of antiapoptotic protein B-cell lymphoma-2 (Bcl-2) levels with concurrent upregulation in proapoptotic Bcl-2-associated X protein (Bax) levels, and increase in the levels and activities of caspases-9 and -3. However, there was no difference in the activity of caspase-8 between B[a]P-exposed neurons and controls. Collectively, these results showed that B[a]P upregulates Bax and downregulates Bcl-2 expression in cultured cerebral neurons, which leads to mitochondrial release of cytochrome c, caspase-3 activation and neuronal apoptotic death.
Sir Harry Sinderson Pasha and Iraq’s first medical school
Authors: Al-Fattal Sa’ad
Published: July 2013

During the early twentieth century, the medical status of Mesopotamia, later Iraq, was very bad due to the lack of sanitation and recurrent epidemics and it was rife with endemic diseases including bilharziasis, tuberculosis and malaria. Medical care was poor, with few hospitals and doctors. The condition improved slowly with the return of a few Iraqi doctors who trained outside Iraq, in Turkey, Syria and Lebanon, and with the arrival of British Medical personnel, during and after the First World War, principally Sir Harry Sinderson who was one of the most influential figures in recent Iraqi medical and political history. He had the distinctive role of being one of the founders and the Dean of the first Iraqi medical college. During his service until his retirement in 1946 he achieved, with tireless effort, exceptionally high standards and brought fame and prestige to the new medical college in record time. He attained his goal of training at least 500 local doctors.
The life and work of Jan Jesensky (1566–1621), the physician of a dying time
Authors: Kachlik David , Vichnar David , Kachlikova Dana , Musil Vladimir , Szabo Kristian , Stingl Josef
Published: July 2013

Jan Jesensky (Johannes Jessenius) ranks among the outstanding Renaissance polymaths of Central Europe. Stemming from Horne Jaseno (present-day Slovakia), born in Wrócław (Poland), he studied philosophy and medicine in Wittenberg, Leipzig (Germany) and Padua (Italy), worked in Wrócław, Wittenberg, Prague (Czech Republic) and Vienna (Austria), and was executed in Prague. He was influenced by and himself impacted upon a large area of the pre-30-year-war Europe science, learning and politics. The year 2011 marked the 410th anniversary of the publication of his famous description of the public dissection performed in Prague, as well as the 390th anniversary of his death. His scientific and editorial work covers not only anatomy but also surgery, internal medicine, infectious diseases and even philosophy and poetry. Moreover, he was very active as University Rector (in both Wittenberg and Prague) and also as politician of the Protestant fraction in Bohemia, which unfortunately led to his violent death. He was an excellent promoter of his own person and work and he understood and exerted dexterously the power of publicity.
Treatment of Postherpetic Pain With Scrambler Therapy, a Patient-Specific Neurocutaneous Electrical Stimulation Device
Authors: Smith Thomas J. , Marineo Giuseppe
Published: July 2013

Objectives:

Postherpetic neuropathy (PHN) is common, severe, and often refractory to treatment. We treated 10 patients with refractory PHN using Scrambler therapy, a neurocutaneous stimulation device that delivers “nonpain” information with surface electrodes.

Methods:

Scrambler therapy was given as 30-minute sessions daily for 10 days. Pain was recorded before and after treatment. Two centers.

Result:

The average pain score rapidly diminished from 7.64 ± 1.46 at baseline to 0.42 ± 0.89 at 1 month, a 95% reduction, with continued relief at 2 and 3 months. Patients achieved maximum pain relief with less than 5 treatments.

Discussion:

Scrambler therapy appears to have a promising effect on PHN, with prompt and continued relief and no side effects. Further research is warranted.
Antiretroviral Therapy at the End of Life
Authors: Ruiz Marco , Armstrong Megan , Reske Tom , Cefalu Charles , Anwar Dominique
Published: July 2013

Introduction:

There are no guidelines regarding the discontinuation of antiretroviral therapy at the end of life.

Methods:

We retrospectively reviewed our databases and identified patients with HIV/AIDS who died over the last 12 months in our HIV clinic.

Results:

A total of 41 patients from our HIV clinic died in a period of 12 months. Seventy-three percent of the patients were on antiretroviral therapy during the last clinic visit. During the last 3 months of life, 32% (13 of 41) were off antiretroviral therapy, with 77% (10 of 13) of them having intermittent therapy due to noncompliance. The remaining 23% (3 of 13) decided to stop antiretroviral therapy after discussion among families, patients, and providers.

Conclusion:

Discussions among providers, patients, and families are encouraged to establish goals of care and role of antiretrovirals during the last months of life.
Factors Influencing the Implementation of Health Care Reform
Authors: Lindley Lisa C. , Edwards Sheri , Bruce Donald J.
Published: July 2013

In the wake of the 2013 Presidential reelection, states now face the reality of implementing the healthcare reform, including ACA section 2302 (Concurrent Care for Children). The purpose of our study was to examine the influence of economic, political, and legal factors on state implementation of ACA 2302. Using data from 2010 to 2012, our analysis revealed that for early implementers economic, political or legal factors did not influence implementation of ACA 2302. In 2011, states that were engaged in Medicaid cost containment efforts were more likely to implement ACA 2302 and in 2012, states experiencing a budgetary crisis were less likely to implement ACA 2302. Our findings suggest that state-level implementation of ACA 2302 may be an important bellwether for future healthcare reform implementations.
African American Client Satisfaction With Hospice
Authors: Reese Dona J. , Smith Michelle R. , Butler Charlotte , Shrestha Sabita , Erwin Deborah O.
Published: July 2013

This study, conducted within a larger participatory action research project, explored satisfaction with end-of-life care among African Americans in a rural southeastern community. Researchers collaborated with practitioners and the African American community, conducting qualitative interviews with 1 African American hospice patient, 9 primary caregivers of terminally ill patients within hospice, and 10 family caregivers outside of hospice. Results indicated a more positive experience for hospice patients, and that most nonhospice participants preferred hospice after learning about it through the study. Participants made recommendations for public information efforts, the referral and intake process, and developing a relationship with the African American community. Implications for practice are to include the reasons found for African American preference for hospice in public information sessions with the African American community.
The Role of Analgesic Adjustment Strategies in Achieving Analgesic Efficacy in Opioid-Tolerant Hospice Patients in China
Authors: Deng Di , Wu Xin , Fu Ling , Zhao Yunxiang , Zhang Gong , Liang Chen , Xie Conghua , Zhou Yunfeng
Published: July 2013

Diverse strategies of analgesic adjustment are often, respectively, used to sustain analgesic efficiency for opioid-tolerant patients with different refractory factors of pain. In order to select effective analgesic adjustment strategy for hospice patient without knowing explicit causes of diminishing analgesic efficiency, a retrospective data of 743 patients among 3760 hospice patients were analyzed. The efficacy and adverse effects were not significantly different among analgesic adjustment strategies at each adjustment. Opioid duration was not associated with clinical characteristics. For opioid-tolerant hospice patients, the analgesic adjustment strategy can be selected for individual patient. After repeated analgesic adjustments, opioid tapering may also occur.
Understanding the Complex Role of a Hospice Spiritual Counselor
Authors: Lillis Bonnie S.
Published: July 2013

Hospice’s professional roles in end-of-life care can be widely misunderstood by physicians, patients, and family members as well as others who do not work directly with them. The role of the spiritual counselor may be the most misunderstood due to the nature of this professional title. Hospice care at the end of life is holistic in that it is important to meet physical, emotional, and spiritual needs of the patient and their family. In order to provide the most complete and beneficial end-of-life care, it is important to understand the complexity and the importance of the role of the spiritual counselor.
Investigating Trends in Discharge Destinations and Impact on Allied Health Service Utilization in an Australian Hospice
Authors: Yoong Jaclyn , Boughey Mark , Leung Sarah
Published: July 2013

Australia’s population is aging and increasing. The palliative care needs of the population are also increasing in parallel, with more patients being referred to services for a broad range of reasons including symptom management, psychosocial support, and end-of-life care. Our study looks at how this manifests at on inpatient hospice in Melbourne, Australia, in terms of discharge destinations and allied health service utilization. We noted a trend in more discharges to residential care facilities, which appeared more likely for those patients who were admitted for assessment or had longer length of stay. Patients who were admitted for assessment also appeared in overall to utilize allied health services more than those admitted for end-of-life care. This information will help tailor resource allocation according to the current trends.
Do Public Reports of Provider Performance Make Their Data and Methods Available and Accessible?
Authors: Damberg Cheryl L. , Hyman David , France Julie
Published: July 2013

Public reports of provider performance are widespread and the methods used to generate the provider ratings differ across the sponsoring entities. We examined 115 hospital and 27 physician public reports to determine whether report sponsors made the methods used to score providers available and accessible. While nearly all websites made transparent some of the methods used to assess provider performance, we found substantial variation in the extent to which they fully adhered to recommended methods elements identified in the Consumer-Purchaser Disclosure Project’s Patient Charter for performance reporting. Most public reports provided descriptions of the data sources, whether measures were endorsed, and the attribution approach. Least often made transparent were methods descriptions related to advanced provider review and reconsideration of results, reliability assessment, and case-mix adjustment. Future research should do more to identify the core elements that would lead consumer end users to have confidence in public reports.
Clinical and magnetic resonance imaging predictors of disease progression in multiple sclerosis: a nine-year follow-up study
Authors: Lavorgna L , Bonavita S , Ippolito D , Lanzillo R , Salemi G , Patti F , Valentino P , Coniglio G , Buccafusca M , Paolicelli D , d’Ambrosio A , Bresciamorra V , Savettieri G , Zappia M , Alfano B , Gallo A , Simone IL , Tedeschi G
Published: July 2013

Objective:

The objective of this paper is to identify clinical or magnetic resonance imaging (MRI) predictors of long-term clinical progression in a large cohort of multiple sclerosis (MS) patients.

Methods:

A total of 241 relapsing–remitting (RR) MS patients were included in a nine-year follow-up (FU) study. The reference MRIs were acquired at baseline (BL) as part of a multicenter, cross-sectional, clinical-MRI study. Volumetric MRI metrics were measured by a fully automated, operator-independent, multi-parametric segmentation method. Clinical progression was evaluated as defined by: conversion from RR to secondary progressive (SP) disease course; progression of Expanded Disability Status Scale (EDSS); achievement and time to reach EDSS 4.

Results:

We concluded that conversion from RR to SP (OR 0.79; CI 0.7–0.9), progression of EDSS (OR 0.85; CI 0.77–0.93), achievement of EDSS 4 (OR 0.8; CI 0.7–0.9), and time to reach EDSS 4 (HR 0.88; CI 0.82–0.94) were all predicted by BL gray matter (GM) volume and, except for progression of EDSS, by BL EDSS (respectively: (OR 2.88; CI 1.9–4.36), (OR 2.7; CI 1.7–4.2), (HR 3.86; CI 1.94–7.70)).

Conclusions:

BL GM volume and EDSS are the best long-term predictors of disease progression in RRMS patients with a relatively long and mild disease.
Tele-ABR using a satellite connection in a mobile van for newborn hearing testing
Authors: Ramkumar Vidya , Hall James W , Nagarajan Roopa , Shankarnarayan Vanaja C , Kumaravelu Selvakumar
Published: July 2013

We assessed the feasibility of conducting Auditory Brainstem Response (ABR) testing in a mobile van with satellite connectivity, with the help of trained health workers. ABR recordings in newborn babies made by telemedicine were compared with recordings made face to face. The auditory evoked response equipment was controlled by an audiologist at a nearby hospital. Videoconferencing was used during the testing process to monitor patient preparation by the village health worker. A total of 24 newborns (13 male and 11 female) aged 8–30 days underwent ABR in face-to-face and tele-mode. There was no significant difference between peak V latency measured at three intensity levels in the two modes. Agreement between the two methods of measurement was examined with a Bland-Altman plot. Almost all points were within the limits of agreement, suggesting no bias in the telemedicine measurements. Real-time tele-ABR testing as a component of newborn hearing screening is feasible in a mobile van using satellite link with the assistance of village health workers.
A telehealth service model for the treatment of hypertension
Authors: Chen Mei-Ju , Chen Kuan-Yu , Chiang Shuo-Ju , Daimon Masao , Lee Jiun-Shiou , Yu Ernest Wr , Ho Chin-Yu
Published: July 2013

We evaluated the effectiveness of a home telehealth service in hypertension control. Patients with hypertension were divided into two groups based on the frequency that they measured blood pressure (BP) at home: the regular group made >3 measurements per week and the irregular group made ≤ 20 measurements per month. Both groups were provided with home monitoring equipment (the Citizen Telemedical Care Service System, CTCS) which contained a computer and video communication device. A total of 160 participants were enrolled and 156 completed the 12-month study. There were 101 participants in the regular BP measurement group and 55 in the irregular group. There was a significant reduction in the average systolic BP from baseline after 6 months in the regular group ( P < 0.001) and after 1 month in the irregular group ( P < 0.001). There was no difference in average diastolic BP between the two groups. For both groups, the systolic BP control was good, especially for irregular group. The results suggest that patients who used CTCS tele-monitoring achieved better BP control than those who self-measured BP at home only.
Cost–effectiveness analysis of telemonitoring versus usual care in patients with heart failure: The TEHAF–study
Authors: Boyne Josiane JJ , Di Van Asselt Antoinette , Gorgels Anton PM , Steuten Lotte MG , De Weerd Gerjan , Kragten Johannes , Vrijhoef Hubertus JM
Published: July 2013

We examined the incremental cost–effectiveness of telemonitoring (TM) versus usual care (UC) in patients with congestive heart failure (CHF). In one university and two general hospitals, 382 patients were randomised to usual care or telemonitoring and followed for 1 year. Hospital-related and home costs were estimated, based on resource use multiplied by the appropriate unit prices. Effectiveness was expressed as QALYs gained. Information was gathered, using 3 monthly costs diaries and questionnaires. The mean age of the patients was 71 years (range 32–93), 59% were male and 64% lived with a partner. Health related quality of life improved by 0.07 points for the usual care and 0.1 points for the telemonitoring group, but the difference between groups was not significant. There were no significant differences in annual costs per patient between groups. At a threshold of €50,000 the probability of telemonitoring being cost-effective was 48%. The cost effectiveness analysis showed a high level of decision uncertainty, probably caused by the divergence between the participating institutions. It is therefore premature to draw an unambiguous conclusion regarding cost-effectiveness for the whole group.
Cost-effectiveness of a helpline for suicide prevention
Authors: Pil Lore , Pauwels Kirsten , Muijzers Ekke , Portzky Gwendolyn , Annemans Lieven
Published: July 2013

We evaluated the cost-effectiveness and budget impact of a suicide helpline in Belgium, consisting of a telephone- and a chat service. An age- and gender-dependent Markov model with a ten-year time horizon and a one-year cycle length was developed, assuming a societal perspective, to predict cumulative costs and quality-adjusted life-years (QALYs) in the helpline users. The model included six transition states: the initial state (at risk), first attempt, re-attempt, follow-up, suicide and death from other causes. Data on the effect of the helpline and costs associated with model states were obtained from the literature. One-way and probabilistic sensitivity analyses were performed to capture uncertainty. In addition, the budget impact of the helpline was analysed. Over ten years, the telephone- as well as the chat service could avoid about 36% of suicides and attempts in this high-risk population. In males, 0.063 QALYs (95% confidence interval, CI 0.030–0.097) and 0.035 QALYs (95%CI -0.026–0.096) were gained by users of the telephone- and chat service respectively. The corresponding values for females were 0.019 QALYs (95%CI -0.015–0.052) and a QALY-neutral result of -0.005 (95%CI -0.071–0.062). There were net societal savings of respectively €2382 (95%CI 1953–2859) and €2282 (95%CI 1855–2758) in male users; €21 71 (95%CI 1735–2664) and €2458 (95%CI 1945–3025) in female users. At the population level, an investment of €218,899 saved €1,452,022 for the public health service (national health insurance), mainly due to the telephone service. The analysis predicted that both means of telemedicine for suicide prevention in Flanders are cost-saving, and have a modest effect on QALYs.
Families changing families: The protective function of multi-family therapy for children in education
Authors: Morris Emma , Le Huray Corin , Skagerberg Elin , Gomes Rosemary , Ninteman Aafke
Published: July 2013

The Marlborough Family Education Centre (MFEC) uses a specific multi-family group approach with families where children exhibit (primarily) conduct problems and function poorly in school. Research indicates that failure to intervene with these children carries great potential cost to both the family and society. Outcomes for 50 families receiving intervention from the MFEC were compared with a control group of 28 who had access to a range of interventions, but not the multi-family group approach pioneered by the MFEC. Data on child and family social, emotional and behavioural functioning were collected at the point of referral, and at 6 and 12 months. Parents of children receiving support from the MFEC reported statistically and clinically significant improvements in their children that were maintained at 12 months whereas there was no change in the control group. In addition, measures of family functioning were fairly stable for the MFEC group, while the control group showed significant deterioration over the same time period. Other results were not significant. These findings are interpreted within the context of early intervention. The methodological limitations of the study are considered and suggestions for future research are outlined.
School meaning systems: The symbiotic nature of culture and ‘language-in-use’
Authors: Abawi Lindy
Published: July 2013

Recent research has produced evidence to suggest a strong reciprocal link between school context-specific language constructions that reflect a school’s vision and schoolwide pedagogy, and the way that meaning making occurs, and a school’s culture is characterized. This research was conducted within three diverse settings: one school in the Sydney Catholic Education system and two Education Queensland State schools, in Australia. Emergent from the school data is the understanding that a contextually created meaning system can be a powerful force, having a beneficial effect on, and symbiotic relationship with, school culture. Such a meaning system is not dependent on words alone. Metaphors, images, structures and processes unique to each context appear integral to the creation of meaning within each school, and how staff and students make sense of their ‘life-world’. Each meaning system works at the level of establishing and reinforcing basic norms, assumptions and ways of working. The creation of such a meaning system does not happen by accident but requires nurturing. This research suggests that over time, shared understandings appear to become intuitive to some extent, and accepted ways of thinking and working become firmly embedded as school culture.
Activating ‘language for learning’ through schoolwide pedagogy: The case of MacKillop School
Authors: O’Neill Shirley
Published: July 2013

This article presents a case study of a primary school that engaged with the Innovative Designs for Enhancing Achievement in Schools (IDEAS) Project, and moved to the sustaining phase over a period of three years. It reports how the students, who were 98 percent English as a second language, improved their reading and numeracy during this time and investigates staff perceptions of the reasons why. It also considers how the school’s practices particularly exemplify two of the six IDEAS Project criteria for the development of a schoolwide pedagogy (SWP). These are the need to honour the distinctive features and needs of the school’s student community and the requirement for it to be informed by authoritative educational theories and research. The school’s SWP, termed ‘active pedagogy’ and its principles are explored, along with its implementation and perceived impact on teaching and learning. The case study raises the issue and importance of teachers’ and students’ mutual use of a common language for learning. A preliminary definition of this is offered and the school’s improvement experience is further explored through the development of a concept map.
Metaphor: Powerful imagery bringing learning and teaching to life
Authors: Abawi Lindy
Published: July 2013

Using metaphor to clarify pedagogical understanding and to anchor teacher beliefs and knowledge to meaningful contextualized mental maps can have powerful consequences in schools. Frequent changes in school staff and clientele present schools with the challenge of how to share culturally specific messages quickly and effectively to those new to the school, whether staff, students or parents. Conscious collective use of metaphor within a school’s meaning-making system has been found to be one of the possible answers. This article explores the use of metaphorical visions within schools that have undertaken the Innovative Designs for Enhancing Achievement in Schools (IDEAS) Project and how the linking of metaphor to understandings of schoolwide practices creates cognitive connections capable of facilitating collective understandings. The duality of meaning through metaphor facilitates a cognitive ‘Place’ where new and old understandings can be shared, explored and enriched. A skilfully chosen and well investigated rich metaphor can capture the essence of what a school community believes to be important for student success. This essence can be shared, refined, reflected upon and used to guide and align understandings of practice. The findings show that the strong reinforcement of cognitive links through the use of metaphor may also sustain cultural understandings of pedagogical practice over the long term.
Raising the pedagogical bar: Teachers’ co-construction of explicit teaching
Authors: O’Neill Shirley , Geoghegan Deborah , Petersen Shauna
Published: July 2013

Recent shifts in the conceptualization of effective literacy teaching have focused on the need for teachers to make teaching explicit (Edwards-Groves, 2010; Purcell-Gates, Duke, & Martineau, 2007; Rosenshine, 1986) or in Hattie’s (2005) terms, learning ‘visible’. Research has shown that the analysis of classroom interactive dialogue can provide a sound basis to examine the quality of teaching and learning. For instance, it has been established that the more teachers use the metalanguage relevant to their lesson in their pedagogical talk the more effective students’ learning (Louden et al., 2005). This research examines selected approaches to the evaluation of teacher–student/s classroom dialogue and their ability to identify how teachers support and facilitate students’ learning and engagement. It reports on 63 teachers’ group co-constructions (concept maps) of their understandings of explicit teaching that take into account the role of classroom interactive talk. A mind map is developed to synthesize the resultant concept maps (11) and explore their conceptualization of students’ learning and construction of knowledge.
Creating enduring strength through commitment to schoolwide pedagogy
Authors: Conway Joan M , Abawi Lindy
Published: July 2013

The term schoolwide pedagogy was once rarely heard and yet has now become a part of most discussions around school improvement. But what does it really mean and why is the presence of a schoolwide pedagogical framework important? Some would say that in their school the adoption of an authoritative approach such as Habits of Mind, Bloom’s Taxonomies or the Productive Pedagogies is a schoolwide pedagogical framework. To some extent they are, but what is often lacking is the intellectual and social capacity that is built through collective professional sharing and articulation of strongly held beliefs about contextually relevant teaching and learning practices. Without this sense of ownership, teacher adoption ends up being sporadic at best with some teachers paying only lip service to imposed quality frameworks. In schools that have engaged with the processes of the Innovative Designs for Enhancing Achievements in Schools ( IDEAS) project, personal pedagogical principles and authoritative pedagogical principles are contextualized by the school community as a whole. The story from one school is used to demonstrate the enduring strength of commitment when a school creates its own SWP.
Performing Authority: Communicating Judicial Decisions in Lower Criminal Courts
Authors: Roach Anleu Sharyn , Mack Kathy
Published: July 2013

In the courtroom legal authority must be performed by the presiding judicial officer. It is also a social situation where information and emotions must be managed in face-to-face interactions. This paper investigates how magistrates perform their authority in the delivery of decisions in open court. An observational study of criminal cases in Australian lower courts shows that magistrates communicate sentencing decisions in a distinct manner. Magistrates frequently look and speak directly to the person being sentenced (the defendant), in line with everyday conversational conventions, and preface their decision with explanations, which allow for some engagement with the defendant. When delivering other kinds of decisions (in criminal cases), such as adjournments, magistrates display less engagement with the defendant. These findings underscore the important ways in which the embodied presence of the defendant and the interactional dimensions of the courtroom can impact on the legal process and the legitimacy of judicial authority.
Local people, local places, local voices and local spaces: How talkback radio in Australia provides hyper-local news through mini-narrative sharing
Authors: Ewart Jacqui
Published: July 2013

Talkback radio in Australia has primarily been conceptualized as a space where populist meta narratives are constructed and, through repetition, entrenched. However, little attention has been paid to talkback that occurs beyond populist programs. This article focuses on the contributions non-populist talkback programs make to local news and community. It examines commercial and non-commercial talkback programs’ facilitation of the sharing of audiences’ mini-narratives and their provision of hyper-local news. Drawing on data from a study of 12 Australian talkback radio programs, the article identifies that these programs provide one of the few available sources of hyper-local news in an increasingly globalized media market. The article examines the type of hyper-local news the study participants gain from talkback and how they use that information.
The comparison of quality of life among people with mild dementia in nursing home and home care—a preliminary report
Authors: Nikmat Azlina W , Hawthorne Graeme , Al-Mashoor Syed H
Published: July 2013

Background

Living arrangements play an important role in determining the quality of life (QoL) of people with dementia. Although informal care (home-based) is favored, the transition to formal (institutional) care often becomes necessary, especially in the later stages of dementia. Nevertheless, there is currently no definitive evidence showing that informal or formal care provides a higher QoL for those with dementia.

Objective

To compare the QoL of people with dementia in the nursing home and home care, and identify factors that differentiate their QoL.

Design and methods

This was a cross-sectional survey. A total of 49 people with dementia ≥60 years old were recruited from government nursing homes and hospitals (home care). Consenting participants were assessed on cognitive severity, QoL, activities of daily living (ADLs), depression, and social isolation/connectedness by the Short Mini Mental State Examination (SMMSE), the WHO-8 (the EUROHIS-QOL), Short Assessment of Quality of Life (AQoL-8), Barthel Index (BI), Cornell Scale for Depression (CSDD), and Friendship Scale (FS).

Results

There were significant differences in QoL, HRQoLs, ADLs, and social connectedness among people with dementia in home care ( n = 19) and those in nursing homes ( n = 30) ( p < 0.01). No significant differences were found by socio-demographic factors, cognitive severity, or depression between the study cohorts.

Conclusions

Older adults with dementia who were living at home experienced higher QoL, ADLs, and social connectedness compared with those living in institutional care. Support should be provided enabling home care and empowering caregivers to provide better care for people with dementia.
The experiences of staff in a specialist mental health service in relation to development of skills for the provision of person centred care for people with dementia
Authors: Smythe Analisa , Bentham Pete , Jenkins Catharine , Oyebode Jan R
Published: July 2013

It is estimated that 820,000 people in the UK have dementia. Dementia costs the UK 17 billion a year and in the next 30 years this will treble to over £50 billion a year. There is a need to raise competence of staff delivering care to people living with dementia across health, social and voluntary sector provision. Effective education and training will build capacity and improve staff knowledge. However, at present not enough is known about the experiences of staff involved in gaining the skills, knowledge and attitudes required to support provision of high quality care for people with dementia.

This study was conducted within a large National Health Service Trust in the UK serving an urban, ethnically mixed population, in collaboration with a local university. The trust responded to government policy by seeking to identify staff training needs.

The aim was to explore the experiences of staff working within a specialist mental health service in relation to development of skills for the provision of person-centred care for people with dementia. To achieve this, staff roles, experiences of dementia training and the ways in which staff feel they learn were explored through focus group interviews. Relatives’ views of staff competencies necessary for effective care provision were also explored to supplement the data from staff. A total of 70 staff and 16 family carers participated and data were subjected to inductive thematic analysis.

Five themes emerged: competency-based skills, beliefs, enablers and barriers and ways of learning. Findings suggested participants felt that skills for person-centred care were innate and could not be taught, while effective ways of learning were identified as learning by doing, learning from each other and learning from experience.
How to coordinate care for people with dementia? A case study of a region in the Netherlands
Authors: Vollenberg Marion , Schalk René , Merks-Van Brunschot Ineke
Published: July 2013

The greying of the population and trends that will change the future institutional context have implications for the social care for people with dementia and their caregivers. Based on the data of services provided by 50 organisations in a region in the South of the Netherlands, an organisational analysis revealed that better coordinated care is needed to fit the changing needs of clients in different phases of the disease process.
Aristotle and the ERA: Measuring the immeasurable
Authors: Bennett Dawn , Franzmann Majella
Published: July 2013

The research assessment framework is an unstable reality in many countries. While few would disagree that there is a need to measure and reward research excellence, there has been little investigation of how assessment mechanisms relate to knowledge itself. With a focus on the arts and humanities and writing from an Australian perspective, this paper draws together discussions of research assessment frameworks and forms of knowledge to consider what can and cannot be measured, and what we might gain from (or lose from not) measuring these things. We argue that the focus on measurable outputs risks a culture that favours effective packages of knowledge at the same time as ignoring the immeasurable, or hidden elements of research and scholarship – elements that Aristotle considered to underpin scholarship itself.
Occupational Differences Between Alzheimer’s and Aphasic Dementias
Authors: Josephs Keith A. , Papenfuss Sarah M. , Duffy Joseph R. , Strand Edythe A. , Machulda Mary M. , Whitwell Jennifer L. , Petersen Ronald C.
Published: July 2013

We aimed to determine whether there is an association between teaching and the development of progressive speech and language disorders (SLDs). Occupation was compared between 100 patients with a progressive SLD, 404 patients with Alzheimer’s dementia, and the 2008 US census. In SLDs, the most common occupation was teacher (22%) versus 8% in Alzheimer’s dementia. The odds ratio (OR) of being a teacher in SLDs compared to Alzheimer’s dementia was 3.4 (95% confidence interval [CI] = 1.87-6.17). No differences were observed in the frequency of other occupations. The frequency of teachers was higher in SLDs compared to the US census, OR of 6.9 (95% CI = 4.3-11.1). Farming, forestry, and fishing occupations were more frequent in SLDs compared to the US census. We identified an association between progressive SLDs and the occupation of teaching. Since teaching is a communication demanding occupation, teachers may be more sensitive to the development of speech and language impairments.
Challenges to Traditional Clinical Definitions of Depression in Young Black Men
Authors: Perkins Danielle EK
Published: July 2013

Despite high rates of unemployment, incarceration, violence, and suicide experienced by young Black men in America, research conducted in inner-city environments consistently report nonsignificant levels of depression among Black men. The unique history of social exclusion, stereotyping, and discrimination experienced by Black men has significant implications for the accurate assessment of depression. A review of significant historical and current sociological, educational, and legal-justice circumstances that affect the mental health of young Black men is presented. Barriers and limitations to traditional depression assessment and measurement is discussed and followed by recommendations for advancing knowledge of depression in young Black men. Research and practice that seeks to explore and explain sociocultural variances in traditional definitions of depression among young Black men will improve mental health, mental health outreach, and social function in this population.
The components of action planning and their associations with behavior and health outcomes
Authors: Lorig Kate , Laurent Diana D , Plant Kathryn , Krishnan Eswar , Ritter Philip L
Published: July 2013

Background

Based on the works of Kiesler and Bandura, action plans have become important tools in patient self-management programs. One such program, shown effective in randomized trials, is the Internet Chronic Disease Self-Management Program. An implementation of this program, Healthy Living Canada, included detailed information on action plans and health-related outcome measures.

Methods

Action plans were coded by type, and associations between action plans, confidence in completion and completion were examined. Numbers of Action Plans attempted and competed and completion rates were calculated for participants and compared to six-month changes in outcomes using regression models.

Results

Five of seven outcome measures significantly improved at six-months. A total of 1136 action plans were posted by 254 participants in 12 workshops (mean 3.9 out of 5 possible); 59% of action plans involved exercise, 16% food, and 14% role management. Confidence of completion was associated with completion. Action plan completion measures were associated with improvements in activity limitation, aerobic exercise, and self-efficacy. Baseline self-efficacy was associated with at least partial completion of action plans.

Discussion

Action planning appears to be an important component of self-management interventions, with successful completion associated with improved health and self-efficacy outcomes.
Public attitudes to the sentencing of drug offences
Authors: Kirby Amy , Jacobson Jessica
Published: July 2013

This article presents the findings of focus group research into public attitudes to the sentencing of drug offences. The study was commissioned by the Sentencing Council for England and Wales to inform the development of their new guideline on drug offences. There were two main findings: first, participants’ responses were generally no more punitive than current sentencing practice for less serious offences; second, participants’ overriding concerns were about the harms associated with drug offences rather than the culpability of drug offenders. Thus the findings of the study indicate that lighter sentences for drug ‘mules’ (as were subsequently introduced by the Sentencing Council’s new guideline) would be tolerated by the public. However, if the Council wishes to engage more fully with public opinion it will need to take a closer look at public concerns with harm.
Induction of inflammatory responses from THP-1 cells by cell-free filtrates from clinical isolates of Alloiococcus otitidis
Authors: Ashhurst-Smith Christopher , Hall Sharron T , Burns Christine J , Stuart John , Blackwell C Caroline
Published: July 2013

In our model system using the THP-1 monocytic cell line, whole heat-killed cells of Alloiococcus otitidis elicited several pro-inflammatory cytokines identified in ear effusions of children with otitis media (OM). Levels of these cytokines were equivalent to or greater than those elicited by a standard Gram-positive otopathogen, Streptococcus pneumoniae. The current study examined the hypothesis that extracellular material produced by A. otitidis might also contribute to the inflammatory responses in OM. Cell-free culture filtrates of recent A. otitidis isolates ( n = 39) were tested for induction of pro-inflammatory cytokines from THP-1 cells primed with IFN-γ. The highest responses were from IL-8 followed by IL-1β, and the lowest from IL-6. Filtrates from nine isolates were treated with lysozyme or proteinase K to assess the nature of the extracellular stimulants. Peptidoglycan was not a major component eliciting the responses. There was no correlation between colony type or β-haemolysin production. Proteinase K treatment indicated extracellular proteins might induce the inflammatory responses, particularly the 70–75 ku band. Further studies on the role of the extracellular proteins of A. otitidis and cytokine responses in pathogenesis of ear infections are needed.
Mandated Preparation Program Redesign
Authors: Browne-Ferrigno Tricia
Published: July 2013

This case study presents a chronicle of events spanning a decade in Kentucky that led to state policy changes for principal preparation and details the response to those mandated changes by professors at the University of Kentucky. Professors’ collaborative efforts resulted in a new teacher leadership program and redesigned principal certification program that reflect characteristics of effective preparation programs described in literature. The article closes with lessons learned including a reflection by the author who was an active participant throughout the statewide and university redesign efforts.