bluuebunny/crossref_metadata_2025 huggingface dataset:
Short‐term patient reported health‐related quality of life (HRQL) outcomes after robot‐assisted radical cystectomy (RARC)
Authors: Poch Michael A. , Stegemann Andrew P. , Rehman Shabnam , Sharif Mohamed A. , Hussain Abid , Consiglio Joseph D. , Wilding Gregory E. , Guru Khurshid A.
Published: June 2013

Objective

To determine short‐term health‐related quality of life (HRQL) outcomes after robot‐assisted radical cystectomy (RARC) using the Bladder Cancer Index (BCI) and European Organisation for Research and Treatment of Cancer (EORTC) Body Image Scale (BIS).

Patients and Methods

All patients undergoing RARC were enrolled in a quality assurance database.

The patients completed two validated questionnaires, BCI and BIS, preoperatively and at standardised postoperative intervals.

The primary outcome measure was difference in interval and baseline BCI and BIS scores.

Complications were identified and classified by Clavien grade.

Results

In all, 43 patients completed pre‐ and postoperative questionnaires

There was a decline in the urinary domain at 0–1 month after RARC (P = 0.006), but this returned to baseline by 1–2 months.

There was a decline in the bowel domain at 0–1 month (P < 0.001) and 1–2 months (P = 0.024) after RARC, but this returned to baseline by 2–4 months.

The decline in BCI scores was greatest for the sexual function domain, but this returned to baseline by 16–24 months after RARC.

Body image perception using BIS showed no significant change after RARC except at the 4–10 months period (P = 0.018).

Conclusions

Based on BCI and BIS scores HRQL outcomes after RARC show recovery of urinary and bowel domains ≤6 months. Longer follow‐up with a larger cohort of patients will help refine HRQL outcomes.
Supported housing for people with Down's syndrome
Authors: Cumella Stuart , Heslam Sheila
Published: June 2013

Accessible summary

This is about people with Down's syndrome who live in supported housing.

Their parents said that they liked the help given by support staff to people with a learning disability.

They thought more help was needed with managing money and finding a job.

People had to wait a long time before they could get a place in supported housing.

Parents carried on giving help to their sons and daughters even after they had gone into supported housing.

Parents helped most with things like managing money and dealing with problems.

This means that people who live in supported housing who do not have parents find life more difficult.

There has been limited research on the attitudes of family carers and the part they play in helping people with a learning disability choose accommodation. A postal questionnaire was sent to family carers of people with Down's Syndrome, to identify their attitudes to supported living, their experience of the application process, and the support they provided to residents. It was found that main family carers of people with Down's Syndrome in supported living were generally satisfied with the housing and support provided, particularly with respect to activities of daily living. There was less satisfaction with the help received with managing finance and employment. There had been a mean of 2 years delay between application and securing accommodation. The large number of people providing care at home who wished their family‐member to move into supported living suggests that there is a large unmet need for this type of accommodation. Almost all family carers continued to provide support after participants moved into supported living, particularly with more complex tasks such as financial management, and with responding to crises and ill‐health. This indicates that people with a learning disability in supported living who do not have active contact with their family may be vulnerable financially and less likely than others to receive help at times of crisis. The proportion of residents in supported living who experience such problems will increase as family carers die or otherwise become too infirm to continue to provide support.
Randomized phase II study of gemcitabine plus S‐1 versus S‐1 in advanced biliary tract cancer: A Japan Clinical Oncology Group trial (JCOG 0805)
Authors: Morizane Chigusa , Okusaka Takuji , Mizusawa Junki , Takashima Atsuo , Ueno Makoto , Ikeda Masafumi , Hamamoto Yasuo , Ishii Hiroshi , Boku Narikazu , Furuse Junji
Published: June 2013

The oral fluoropyrimidine, S‐1, combined with or without gemcitabine is considered to be a promising agent for treating advanced biliary tract cancer; gemcitabine plus cisplatin is the current standard regimen. This randomized phase II trial was designed to evaluate the safety and efficacy of two regimens: gemcitabine plus S‐1 (GS) (gemcitabine: 1000 mg/m2, day 1 and day 8; S‐1: 60 mg/m2, twice daily on days 1–14, repeated every 3 weeks); and S‐1 (80 mg/m2, days 1–28, given orally twice daily for 4 weeks, followed by a 2‐week rest, repeated every 6 weeks). The regimen with a higher 1‐year survival would be selected for a subsequent phase III trial. Between February 2009 and April 2010, 101 patients were randomized. For the GS (n = 51) and S‐1 (n = 50) arms, the 1‐year survival was 52.9% (95% confidence interval, 38.5–65.5) and 40.0% (95% confidence interval, 26.5–53.1), and the median survival times were 12.5 and 9.0 months, respectively. Grade 3/4 hematological toxicities were more frequent in the GS arm (leucocytes 29.4%, neutrophils 60.8%, hemoglobin 11.8%, platelets 11.8%) than in the S‐1 arm (leucocytes 2.0%, neutrophils 4.0%, hemoglobin 4.0%, platelets 4.0%). Although two treatment‐related deaths occurred in the GS arm, all other grade 3/4 non‐hematological toxicities were reversible. In conclusion, GS was considered to be more promising and was selected as the test regimen for a subsequent phase III trial comparing GS with gemcitabine plus cisplatin combination therapy. This study was registered at the UMIN Clinical Trials Registry as UMIN 000001685 (http://www.umin.ac.jp/ctr/index.htm).
Permeability of Roads to Movement of Scrubland Lizards and Small Mammals
Authors: BREHME CHERYL S. , TRACEY JEFF A. , MCCLENAGHAN LEROY R. , FISHER ROBERT N.
Published: June 2013

A primary objective of road ecology is to understand and predict how roads affect connectivity of wildlife populations. Road avoidance behavior can fragment populations, whereas lack of road avoidance can result in high mortality due to wildlife‐vehicle collisions. Many small animal species focus their activities to particular microhabitats within their larger habitat. We sought to assess how different types of roads affect the movement of small vertebrates and to explore whether responses to roads may be predictable on the basis of animal life history or microhabitat preferences preferences. We tracked the movements of fluorescently marked animals at 24 sites distributed among 3 road types: low‐use dirt, low‐use secondary paved, and rural 2‐lane highway. Most data we collected were on the San Diego pocket mouse (Chaetodipus fallax), cactus mouse (Peromyscus eremicus), western fence lizard (Sceloporus occidentalis), orange‐throated whiptail (Aspidoscelis hyperythra), Dulzura kangaroo rat (Dipodomys simulans) (dirt, secondary paved), and deer mouse (Peromyscus maniculatus) (highway only). San Diego pocket mice and cactus mice moved onto dirt roads but not onto a low‐use paved road of similar width or onto the highway, indicating they avoid paved road substrate. Both lizard species moved onto the dirt and secondary paved roads but avoided the rural 2‐lane rural highway, indicating they may avoid noise, vibration, or visual disturbance from a steady flow of traffic. Kangaroo rats did not avoid the dirt or secondary paved roads. Overall, dirt and secondary roads were more permeable to species that prefer to forage or bask in open areas of their habitat, rather than under the cover of rocks or shrubs. However, all study species avoided the rural 2‐lane highway. Our results suggest that microhabitat use preferences and road substrate help predict species responses to low‐use roads, but roads with heavy traffic may deter movement of a much wider range of small animal species.
Costs and Benefits of the Presence of Leopards to the Sport‐Hunting Industry and Local Communities in Niassa National Reserve, Mozambique
Authors: JORGE AGOSTINHO A. , VANAK ABI T. , THAKER MARIA , BEGG COLLEEN , SLOTOW ROB
Published: June 2013

Sport hunting is often proposed as a tool to support the conservation of large carnivores. However, it is challenging to provide tangible economic benefits from this activity as an incentive for local people to conserve carnivores. We assessed economic gains from sport hunting and poaching of leopards (Panthera pardus), costs of leopard depredation of livestock, and attitudes of people toward leopards in Niassa National Reserve, Mozambique. We sent questionnaires to hunting concessionaires (n = 8) to investigate the economic value of and the relative importance of leopards relative to other key trophy‐hunted species. We asked villagers (n = 158) the number of and prices for leopards poached in the reserve and the number of goats depredated by leopard. Leopards were the mainstay of the hunting industry; a single animal was worth approximately U.S.$24,000. Most safari revenues are retained at national and international levels, but poached leopard are illegally traded locally for small amounts ($83). Leopards depredated 11 goats over 2 years in 2 of 4 surveyed villages resulting in losses of $440 to 6 households. People in these households had negative attitudes toward leopards. Although leopard sport hunting generates larger gross revenues than poaching, illegal hunting provides higher economic benefits for households involved in the activity. Sport‐hunting revenues did not compensate for the economic losses of livestock at the household level. On the basis of our results, we propose that poaching be reduced by increasing the costs of apprehension and that the economic benefits from leopard sport hunting be used to improve community livelihoods and provide incentives not to poach.

Costos y Beneficios de la Presencia de Leopardos para la Industria de la Caza Deportiva y las Comunidades Locales en Niassa, Reserva Nacional, Mozambique
Assessing the Potential to Restore Historic Grazing Ecosystems with Tortoise Ecological Replacements
Authors: GRIFFITHS CHRISTINE J. , ZUËL NICOLAS , JONES CARL G. , AHAMUD ZAIRABEE , HARRIS STEPHEN
Published: June 2013

The extinction of large herbivores, often keystone species, can dramatically modify plant communities and impose key biotic thresholds that may prevent an ecosystem returning to its previous state and threaten native biodiversity. A potentially innovative, yet controversial, landscape‐based long‐term restoration approach is to replace missing plant‐herbivore interactions with non‐native herbivores. Aldabran giant (Aldabrachelys gigantea) and Madagascan radiated (Astrochelys radiata) tortoises, taxonomically and functionally similar to the extinct Mauritian giant tortoises (Cylindraspis spp.), were introduced to Round Island, Mauritius, in 2007 to control the non‐native plants that were threatening persistence of native species. We monitored the response of the plant community to tortoise grazing for 11 months in enclosures before the tortoises were released and, compared the cost of using tortoises as weeders with the cost of using manual labor. At the end of this period, plant biomass; vegetation height and cover; and adult, seedling, flower, and seed abundance were 3–136 times greater in adjacent control plots than in the tortoise enclosures. After their release, the free‐roaming tortoises grazed on most non‐native plants and significantly reduced vegetation cover, height, and seed production, reflecting findings from the enclosure study. The tortoises generally did not eat native species, although they consumed those native species that increased in abundance following the eradication of mammalian herbivores. Our results suggest that introduced non‐native tortoises are a more cost‐effective approach to control non‐native vegetation than manual weeding. Numerous long‐term outcomes (e.g., change in species composition and soil seed bank) are possible following tortoise releases. Monitoring and adaptive management are needed to ensure that the replacement herbivores promote the recovery of native plants.

Estudiando el Potencial para Restaurar Ecosistemas Históricos de Forrajeo con Reemplazos Ecológicos de Tortugas Terrestres
A model of Chinese central government
Authors: Gilli Mario , Li Yuan
Published: June 2013

Why was the Chinese State able to promote economic growth during the reform era, yet has been unable to do so over the previous 30 years? In this article, we focus on a specific aspect of the question, which will contribute to the development of a more comprehensive explanation: the specific institutional arrangement that may induce the autocratic government to adopt growth‐enhancing policies. We consider a standard political‐agency model (Besley, 2006) where the incumbent leader may or may not be congruent, and where, to maintain power, both leader types need the support of the selectorate, an elite group having a say in selecting the leader, as well as associated access to special privileges. Primarily, we find that in autocracies, without electoral discipline to restrain the opportunistic behaviour of a leader, the size of the selectorate should be intermediate; if it is too small, the selectorate is captured by the leader and has no disciplinary role, but if too big, the leader's incentives are diluted.
Gildas and the ‘grievous divorce from the barbarians’
Authors: Garcia Michael
Published: June 2013

This article examines a specific phrase from Chapter 10 of Gildas's De Excidio Britonum. It suggests that to date, this phrase (lugubre divortium barbarorum) has not been properly understood or translated. In a new interpretation, the article argues that it refers to the breaking of the treaty between the Britons and Saxons mentioned in Chapter 23 of De Excidio Britonum. This new interpretation expands our understanding of Gildas's attitude towards barbarians and the British church.
Reduction of inflammatory slan (6‐sulfo LacNAc) dendritic cells in psoriatic skin of patients treated with etanercept
Authors: Günther Claudia , Blau Kristin , Förster Ulrike , Viehweg Antje , Wozel Gottfried , Schäkel Knut
Published: June 2013

Dermal dendritic cells (DCs) play a central role in the immunopathology of psoriasis. We previously identified slanDCs as pro‐inflammatory TNF‐α, IL‐23‐ and IL‐12‐producing DCs in human blood and as prominent inflammatory dermal TNF‐α secreting and CD11c‐positive DC subset in psoriasis. Here, we ask for the effects of TNF‐α‐inhibition on inflammatory slanDCs in skin and blood of 10 patients with psoriasis during 24 weeks of treatment with etanercept. Treatment with etanercept reduced the frequency of dermal slanDCs but did not induce apoptosis as determined by lack of increased active caspase‐3‐expression. In parallel, we found increased frequencies of slanDCs in blood which expressed lower levels of HLA‐DR. Stimulating slanDCs isolated from the blood of healthy donors in vitro induced a strong production of IL‐1β, IL‐6, IL‐23 and IL‐12p70. This capacity was efficiently reduced in the presence of etanercept, thereby indicating that TNF‐α is an autocrine stimulus for maturation and pro‐inflammatory cytokine production of slanDCs. In vivo, we noticed that treatment with etanercept did reduce the number of dermal slanDCs in parallel to the overall expression of TNF‐α and IL‐23p19. However, successful treatment did not down‐regulated the percentage of dermal slanDCs that stained positive for TNF‐α and IL‐23p19 indicating that remaining slanDCs kept their pro‐inflammatory capacity. This study provides novel insights into the immune regulatory properties of etanercept at the level of inflammatory slanDCs in vivo in skin and blood as well as in vitro.
Muscle phospholipid hydrolysis by Bothrops asper Asp49 and Lys49 phospholipase A2 myotoxins – distinct mechanisms of action
Authors: Fernández Julián , Caccin Paola , Koster Grielof , Lomonte Bruno , Gutiérrez José M. , Montecucco Cesare , Postle Anthony D.
Published: June 2013

Bothrops snakes are the major cause of ophidian envenomings in Latin America. Their venom contains myotoxins that cause prominent muscle damage, which may lead to permanent disability. These toxins include myotoxins Mt‐I and Mt‐II, which share the phospholipase A2 (PLA2) fold, but Mt‐II lacks enzymatic activity because the essential active site Asp49 is replaced by Lys. Both myotoxins cause sarcolemma alterations, with Ca2+ entry and loss of ATP and K+ from muscle cells, but the molecular lesions at the basis of their cellular action are not known, particularly the role of phospholipid hydrolysis. Here we tested their PLA2 activity in vivo, and evaluated the hypothesis that Ca2+‐activated endogenous PLA2s may be involved in the action of Mt‐II. The time course of phospholipid hydrolysis by Mt‐I and Mt‐II in myotubes in culture and in tibialis anterior mouse muscles was determined. Mt‐I rapidly hydrolyzed phosphatidylcholine and phosphatidylethanolamine but not phosphatidylserine, but no phospho‐lipids were hydrolyzed in the presence of Mt‐II. Whole Bothrops asper venom induced a higher extent of phospholipid hydrolysis than Mt‐I alone. These results demonstrate in vivo PLA2 activity of Mt‐I for the first time, and indicate that it acts only on the external monolayer of the sarcolemma. They also exclude activation of endogenous PLA2s in the action of Mt‐II, implying that plasma membrane disruption by this toxin does not depend on phospholipid hydrolysis. Therefore, both Bothrops myotoxins induce Ca2+ entry and release of ATP and cause myonecrosis, but through different biochemical mechanisms.
Carbon dioxide emissions through oxidative peat decomposition on a burnt tropical peatland
Authors: Hirano Takashi , Kusin Kitso , Limin Suwido , Osaki Mitsuru
Published: June 2013

In Southeast Asia, a huge amount of peat has accumulated under swamp forests over millennia. Fires have been widely used for land clearing after timber extraction, thus land conversion and land management with logging and drainage are strongly associated with fire activity. During recent El Niño years, tropical peatlands have been severely fire‐affected and peatland fires enlarged. To investigate the impact of peat fires on the regional and global carbon balances, it is crucial to assess not only direct carbon emissions through peat combustion but also oxidative peat decomposition after fires. However, there is little information on the carbon dynamics of tropical peat damaged by fires. Therefore, we continuously measured soil CO2 efflux [peat respiration (RP)] through oxidative peat decomposition using six automated chambers on a burnt peat area, from which about 0.7 m of the upper peat had been lost during two fires, in Central Kalimantan, Indonesia. The RP showed a clear seasonal variation with higher values in the dry season. The RP increased logarithmically as groundwater level (GWL) lowered. Temperature sensitivity or Q10 of RP decreased as GWL lowered, mainly because the vertical distribution of RP would shift downward with the expansion of an unsaturated soil zone. Although soil temperature at the burnt open area was higher than that in a near peat swamp forest, model simulation suggests that the effect of temperature rise on RP is small. Annual gap‐filled RP was 382 ± 82 (the mean ± 1 SD of six chambers) and 362 ± 74 gC m−2 yr−1 during 2004–2005 and during 2005–2006 years, respectively. Simulated RP showed a significant negative relationship with GWL on an annual basis, which suggests that every GWL lowering by 0.1 m causes additional RP of 89 gC m−2 yr−1. The RP accounted for 21–24% of ecosystem respiration on an annual basis.
Cluster Headache: Conventional Pharmacological Management
Authors: Becker Werner J.
Published: June 2013

Cluster headache pain is very intense, usually increases in intensity very rapidly from onset, and attacks are often frequent. These clinical features result in significant therapeutic challenges. The most effective pharmacological treatment options for acute cluster attack include subcutaneous sumatriptan, 100% oxygen, and intranasal zolmitriptan. Subcutaneous or intramuscular dihydroergotamine and intranasal sumatriptan are additional options. Transitional therapy is applicable mainly for patients with high‐frequency (>2 attacks per day) episodic cluster headache, and options include short courses of high‐dose oral corticosteroids, dihydroergotamine, and occipital nerve blocks with local anesthetic and steroids. Prophylactic therapy is important both for episodic and chronic cluster headache, and the main options are verapamil and lithium. Verapamil is drug of first choice but may cause cardiac arrhythmias, and periodic electrocardiograms (EKGs) during dose escalation are important. Many other drugs are also in current use, but there is an insufficient evidence base to recommend them.
Ideal Values and Counter‐ideal Values as Two Distinct Forces: Exploring a Gap in Organizational Value Research
Authors: Van Quaquebeke Niels , Graf Matthias M. , Kerschreiter Rudolf , Schuh Sebastian C. , van Dick Rolf
Published: June 2013

Motives and values at work have long been key topics of business and management studies. In a focused review of the literature on the nature of human values, this paper identifies a disconnect with the literature on human motivation, despite the otherwise inherent relatedness of the two fields. Specifically, extant theory and research have conceptualized values generally in terms of ideals, namely desired end‐states that individuals strive to approach. Although values, by this definition, express motivational concerns, theories of human motivation suggest that there are two forces to consider, i.e. approach and avoidance motivation. By applying this ‘two forces’ perspective to value research, this paper identifies a gap in the literature on values: namely, the idea that individuals are also influenced by counter‐ideal values, i.e. end‐states that they deliberately seek to avoid. The identification of this gap opens up new opportunities for value research in general and organizational value research in particular. To pave the way for future research, this paper critically discusses the few studies that have taken first steps in that direction and outlines research questions that may follow for issues such as employer branding and person–organization fit. This paper closes by providing suggestions on how to tackle the issue in organizational practice.
Patients' satisfaction with the quality of nursing care provided: The Saudi experience
Authors: Atallah Mohammad A , Hamdan‐Mansour Ayman M , Al‐Sayed Mohammad M , Aboshaiqah Ahmad E
Published: June 2013

Patient's satisfaction has emerged as a central focus of health‐care delivery during the last decades, and nursing care became one significant component of patient's satisfaction. The purpose of this study is to examine patients' satisfaction with quality of nursing care provided in Saudi Arabia. Cross‐sectional descriptive correctional design was used to recruit 100 patients from one regional hospital in Saudi Arabia. Data collected using structured interview from patients related to six dimensions of nursing care. Patients had a high level of satisfaction with nursing care provided (86% agreement rate). Language (56% disagreement rate), discharge information (56% disagreement rate) and availability (20% disagreement rate) have been identified with the lowest rates of patients satisfaction. Nursing leaders and health‐care administrators need to maintain quality nursing care and develop strategies for improving nursing care emphasizing language as barrier and strategies of information dissemination.
Barriers and facilitators to diabetes self‐management: Perspectives of older community dwellers and health professionals in China
Authors: Shen Huixia , Edwards Helen , Courtney Mary , McDowell Jan , Wei Juan
Published: June 2013

Little is known about self‐management among people with Type 2 diabetes living in mainland China. Understanding the experiences of this target population is needed to provide socioculturally relevant education to effectively promote self‐management. The aim of this study was to explore perceived barriers and facilitators to diabetes self‐management for both older community dwellers and health professionals in China. Four focus groups, two for older people with diabetes and two for health professionals, were conducted. All participants were purposively sampled from two communities in Shanghai, China. Six barriers were identified: overdependence on but dislike of western medicine, family role expectations, cuisine culture, lack of trustworthy information sources, deficits in communication between clients and health professionals, and restriction of reimbursement regulations. Facilitators included family and peer support, good relationships with health professionals, simple and practical instruction and a favourable community environment. The findings provide valuable information for diabetes self‐management intervention development in China, and have implications for programmes tailored to populations in similar sociocultural circumstances.
Validation of the Portuguese version of the Stanford Presenteeism Scale in nurses
Authors: Laranjeira Carlos António
Published: June 2013

The SPS‐6 is a tool that is widely used to test the characteristic of presenteeism, which is the ability to concentrate and work despite health problems. This concept refers to the phenomenon of people—despite complaining and being ill—going to work instead of resting and taking sick leave.

The aim of this study was to assess the validity and reliability of the SPS‐6.

Internal consistency was examined by Cronbach's α. The Perceived Stress Scale was selected to determine the external validity of the SPS‐6. Exploratory and confirmatory factor analyses were used to evaluate construct validity.

The reliability analysis of all 126 registered nurses entered in the study showed satisfactory results (Cronbach's α = 0.83). External validity was evidenced by the significant negative correlation between the SPS‐6 and the perceived stress scores. The factor analysis resulted in a two‐component solution that conjointly accounted for 52.4% of the variance. A confirmatory factor analysis showed an adequate model fit.

The Portuguese version of the SPS‐6 displays the appropriate structure to measure the active employee's engagement at work.
Proactive clinical pharmacist interventions in critical care: effect of unit speciality and other factors
Authors: Bourne Richard S , Choo Chui Lynn , Dorward Ben J
Published: June 2013

Background

Clinical pharmacists working in critical-care areas have a beneficial effect on a range of medication-related therapies including improving medication safety, patient outcomes and reducing medicines' expenditure. However, there remains a lack of data on specific factors that affect the reason for and type of interventions made by clinical pharmacists, such as unit speciality.

Objective

To compare the type of proactive medicines-related interventions made by clinical pharmacists on different critical-care units within the same institution.

Methods

A retrospective evaluation of proactive clinical pharmacist recommendations, made in three separate critical-care areas. Intervention data were analysed over 18 months (general units) and 2 weeks for the cardiac and neurological units. Assessment of potential patient harm related to the medication interventions were made in the neurological and cardiac units.

Key findings

 Overall, 5623, 211 and 156 proactive recommendations were made; on average 2.2, 3.8 and 4.6 per patient from the general, neurological and cardiac units respectively. The recommendations acceptance rate by medical staff was approximately 90% for each unit. The median potential severity of patient harm averted by the interventions were 3.6 (3; 4.2) and 4 (3.2; 4.4) for the neurological and cardiac units (P = 0.059). The reasons for, types and drug classification of the medication recommendations demonstrated some significant differences between the units.

Conclusions

Clinical pharmacists with critical-care training make important medication recommendations across general and specialist critical-care units. The patient case mix and admitting speciality have some bearing on the types of medication interventions made. Moreover, severity of patient illness, scope of regular/routine specialist pharmacist service and support systems provided also probably affect the reason for these interventions.
The Formation of Morocco's Policy Towards Irregular Migration (2000–2007): Political Rationale and Policy Processes
Authors: Natter Katharina
Published: June 2013

The factors that influence the formation of transit states' policies towards irregular migration have been insufficiently analysed. The case study in this article therefore investigates why and how Morocco, at the interface of Euro‐African migration flows, created a policy towards irregular migration at the beginning of the twenty‐first century. This article shows that Morocco's policy, rather than being a by‐product of European migration policies, was the authorities' strategic response to the country's complex geopolitical environment that aimed at restoring Morocco's pivotal role in the region via irregular migration control. By retracing the three‐phase inverted agenda‐setting process that occurred between 2000 and 2007, this article shows why and how irregular (transit) migration was set on Morocco's political agenda, transformed into a new area of public intervention and progressively framed as a national public problem.

Policy Implications

Morocco's irregular migration policy, unlike that of receiving states, is less guided by national‐electoral than by geopolitical considerations. Migratory flows considerably impact Morocco's regional negotiation capital; but while strengthening relations with Europe remains a top priority, Morocco's cooperation with African states is increasingly important.

Framing irregular migration as an exterior threat by stigmatizing sub‐Saharan transit migration and concealing irregular national emigration is crucial for Moroccan authorities to assure popular adherence to restrictive policies.

Civil society activism on migration is an important democratization vector in Morocco. However, selective state responses create a labour division between a state‐run border‐control and civil society‐run integration measures.
Time‐Varying Credit Risk Discovery in the Stock and CDS Markets: Evidence from Quiet and Crisis Times
Authors: Forte Santiago , Lovreta Lidija
Published: June 2013

We analyse the dynamic relationship between the stock and the CDS market during the period 2002–2008. We document that the stock market's informational dominance reported in previous studies holds only in times of financial crisis. During tranquil times, the CDS market's contribution to price discovery is equal or higher than that of the stock market. Moreover, the credit risk level of the company has a positive effect on the information share of its stocks beyond the effect of the overall state of the economy. We show that these conclusions do not contradict the argument of insider trading in credit derivatives.
Dissociation of Basal Dislocations in 4H–SiC Single Crystals Deformed Around the Transition Temperature
Authors: Castillo‐Rodríguez Miguel , Lara Ana , Muñoz Antonio , Domínguez‐Rodríguez Arturo
Published: June 2013

The dislocation microstructure was studied in 4H–SiC samples plastically deformed by basal slip activation around the transition temperature (1000°C–1100°C). Dissociation of basal dislocations takes place over a wide temperature range (800°C–1300°C), but its influence on dislocation motion is different in the high‐ and low‐temperature regimes due to the difference in mobility of partials. Consequently, this material exhibits a completely different mechanical behavior below and above its transition temperature, indicating a change in the deformation mechanism. In this work, the dislocation microstructure was studied around the transition temperature at which both mechanisms are still operative, thus providing a richer number of different configurations generated by dissociation of basal dislocations. They were observed and analyzed by means of the complementary use of weak‐beam dark‐field imaging and high‐resolution transmission electron microscopy. Firstly, 3C band nucleation in the 4H–SiC matrix was identified and its appearance discussed from an energy standpoint. Secondly, the attractive interaction between partials in dipoles and the difference in mobility between the leading and the trailing partial have remarkable effects on the dissociation width, and explain the absence of work hardening above the transition temperature.
Factors influencing self‐management in patients with type 2 diabetes: a quantitative systematic review protocol
Authors: Bagnasco Annamaria , Di Giacomo Patrizia , Da Rin Della Mora Roberta , Catania Gianluca , Turci Carlo , Rocco Gennaro , Sasso Loredana
Published: June 2013

Aim

To describe a protocol for a quantitative systematic review, to identify critique and summarize factors that influence self‐management education.

Background

Self‐management education enables patients to manage their condition successfully and it is associated with better self‐care, good control over lifestyle and leading the best possible quality of life, notwithstanding the presence of a chronic disease. Type II Diabetes is a chronic disease that requires lifestyle adjustments and disease management to keep glycaemia and long‐term complications under control. Education has to be customized and based on an assessment that includes factors influencing self‐management, such as personal characteristics that can optimize the educational intervention.

Design

The protocol for the systematic review was conducted according to the guidelines of the Centre for Reviews and Dissemination, York (UK).

Method

The review question was defined in terms of population, interventions, comparators, outcomes and study designs. The protocol included decisions about the review question, inclusion criteria, search strategy, study selection, data extraction, quality assessment, data synthesis and plans for dissemination. Funding for the review was confirmed on January 2011 by the Centre of Excellence for Nursing Scholarship in Rome.

Discussion

An initial summary will be made by tabulating the data; the review will be reported in a narrative style and be developed according to the PRISMA guidelines. The protocol for the systematic review will allow us to identify, among the factors influencing self‐management in people with Type II diabetes, the personal characteristics most relevant to the factors of motivation and empowerment. In addition, the systematic review will also identify an appropriate self‐management model.
Generic reflective feedback: An effective approach to developing clinical reasoning skills
Authors: Wojcikowski K. , Brownie S.
Published: June 2013

Problem‐based learning can be an effective tool to develop clinical reasoning skills. However, it traditionally takes place in tutorial groups, giving students little flexibility in how and when they learn. This pilot study compared the effectiveness of generic reflective feedback (GRF) with tutorial‐based reflective feedback on the development of students' clinical reasoning skills. Case studies were placed in an interactive software package, with GRF for the nine patient cases (36 GRF forms in total). The GRF contained information about common mistakes and omissions made by students in previous years. By design, the GRF left some clinical questions unanswered in order to prompt student reflection, enhance the development of their clinical reasoning skills and give the 2010 students (n = 53) greater control over the way in which they engaged with the unit. Clinical reasoning skills development, assessed by responses to the 36 parts across the 9 cases and in the relevant section of the final exam, was compared with the 2009 tutorial cohort (n = 47 students). GRF enabled student progression through each of the nine online cases with minimal tutor intervention. The cohort receiving GRF performed as well as those students engaging in tutorials with individualized feedback. GRF was associated with a significant increase in student satisfaction and flexibility in how and when they learned. We conclude that GRF enabled online enhancement of a case‐based clinical reasoning unit. Further research on how GRF can optimize learning in different online settings is warranted.
Interdisciplinary Treatment of a Class III Patient with Congenitally Absent Maxillary Lateral Incisors
Authors: Oliveira Dauro Douglas , de Oliveira Bruno Franco , da Mata Cid Pinto Larissa Salgado , Figueiredo Daniel Santos Fonseca , Pithon Matheus Melo , Seraidarian Paulo Isaías
Published: June 2013

The purpose of this paper is to present a case report of an adult Class III patient presenting bilateral congenitally missing maxillary lateral incisors that compromised occlusal function as well as smile and facial esthetics. After the interdisciplinary diagnosis, spaces for prosthetic substitution were opened with the help of miniscrews. The orthodontic therapy achieved a better dental relationship, and the final interdisciplinary treatment results represented a significant improvement in function and both dental and facial esthetics.

Clinical Significance

The interdisciplinary treatment of orthodontics and restorative dentistry is very important because the two complement each other in search of the best for the patient. This case demonstrates very well that where orthodontics provided the best tooth position prior to implant placement and restorations.
The effect of posture on body circumferences in older adults
Authors: Sousa A. S. , de Sousa O. L. , Amaral T. F.
Published: June 2013

Background

Standards for anthropometrical assessment define that measurements must be carried out with the subject in the standing position, although this is not always possible. The effect of body position on girth measurement has not been evaluated, even though this issue is clinically relevant because it may bias nutritional assessment results. The present study aimed to evaluate the effect of body position and symmetry on girth measurement.

Methods

A cross‐sectional study was conducted on 102 older adults aged ≥65 years from care homes and tertiary hospitals. Right and left arm, waist, hip mid‐thigh and calf girths were obtained with the subject standing or in the supine position. Mini‐Nutritional Assessment Short‐Form (MNA‐SF) score and reference data percentiles (NHANES IV) misclassification according to girths assessed in the supine position was evaluated.

Results

A high intraclass correlation coefficient (ICC > 0.97) and quartiles agreement (k > 0.89) were found between girth measurements conducted on participants in the standing and supine positions. According to MNA‐SF, 23.5% of the participants were undernourished and 51% were at risk of undernutrition. A high agreement between MNA‐SF score using calf circumference measured on standing or supine position was found (k = 0.96). A relevant agreement for NHANES IV girth percentiles by sex and age was also found (ICC > 0.89).

Conclusions

Agreement between girth measurements on standing and supine positions among older adults is high and differences do not have any clinically relevant impact on MNA–SF classification and reference data percentiles.
Frequency of odontogenic cysts and tumors: a systematic review
Authors: Johnson Nigel R. , Gannon Orla M. , Savage Neil W. , Batstone Martin D.
Published: June 2013

A systematic review of the literature from 1993 to 2011 was undertaken examining frequency data of the most common odontogenic cysts and tumors. Seven inclusion criteria were met for the paper to be incorporated. In the preliminary search 5231 papers were identified, of these 26 papers met the inclusion criteria. There were 18 297 odontogenic cysts reported. Of these there were 9982 (54.6%) radicular cysts, 3772 (20.6%) dentigerous cysts and 2145 (11.7%) keratocystic odontogenic tumors. With the reclassification of keratocystic odontogenic tumor in 2005 as an odontogenic tumor, there were 8129 odontogenic tumors reported with 3001 (36.9%) ameloblastomas, 1163 (14.3%) keratocystic odontogenic tumors, 533 (6.5%) odontogenic myxomas, 337 (4.1%) adenomatoid odontogenic tumors and 127 (1.6%) ameloblastic fibromas. This systematic review found that odontogenic cysts are 2.25 times more frequent than odontogenic tumors. The most frequent odontogenic cyst and tumor were the radicular cyst and ameloblastoma respectively.
Prenatal Corticosteroids Modify Glutamatergic andGABAergic Synapse Genomic Fabric: Insights from a Novel Animal Model of Infantile Spasms
Authors: Iacobas D. A. , Iacobas S. , Chachua T. , Goletiani C. , Sidyelyeva G. , Velíšková J. , Velíšek L.
Published: June 2013

Prenatal exposure to corticosteroids has long‐term postnatal somatic and neurodevelopmental consequences. Animal studies indicate that corticosteroid exposure‐associated alterations in the nervous system include hypothalamic function. Infants with infantile spasms, a devastating epileptic syndrome of infancy with characteristic spastic seizures, chaotic irregular waves on interictal electroencephalogram (hypsarhythmia) and mental deterioration, have decreased concentrations of adrenocorticotrophic hormone (ACTH) and cortisol in cerebrospinal fluid, strongly suggesting hypothalamic dysfunction. We have exploited this feature to develop a model of human infantile spasms by using repeated prenatal exposure to betamethasone and a postnatal trigger of developmentally relevant spasms withNMDA. The spasms triggered in prenatally primed rats are more severe compared to prenatally saline‐injected ones and respond toACTH, a treatment of choice for infantile spasms in humans. Using autoradiography and immunohistochemistry, we have identified a link between the spasms in our model and the hypothalamus, especially the arcuate nucleus. Transcriptomic analysis of the arcuate nucleus after prenatal priming with betamethasone but before trigger of spasms indicates that prenatal betamethasone exposure down‐regulates genes encoding several important proteins participating in glutamatergic andGABAergic transmission. Interestingly, there were significant sex‐specific alterations after prenatal betamethasone in synapse‐related gene expression but no such sex differences were found in prenatally saline‐injected controls. A pairwise relevance analysis revealed that, although the synapse gene expression in controls was independent of sex, these genes form topologically distinct gene fabrics in males and females and these fabrics are altered by betamethasone in a sex‐specific manner. These findings may explain the sex differences with respect to both normal behaviour and the occurrence and severity of infantile spasms. Changes in transcript expression and their coordination may contribute to a molecular substrate of permanent neurodevelopmental changes (including infantile spasms) found after prenatal exposure to corticosteroids.
Anatomical knowledge among medieval folk artists: osteological interpretation of two Dance of Death motifs
Authors: Petaros Anja , Čulina Tatjana , Šuran Andrea , Škrobonja Ante
Published: June 2013

Anatomy has a long history that started with dissection of animals and then expanded and flourished thanks to dissections performed on human bodies. Artists had a crucial role in uncovering the secrets of human anatomy. While most studies have focused on the influence of famous Renaissance artists on human anatomy studies, the anatomical drawings by pre‐Renaissance artists and local craftsmen have remained in their shadow. One of the most popular artistic genres in which complete or parts of human skeletons appear is the Dance of Death (Danse Macabre). This article is an anthropological study of two medieval Dance of Death frescoes that are unusual in being relatively early as well as accurately datable. A comparative morphological analysis of the two late 15th century works present in Istria has been conducted. The two works were painted by two local masters and show how the artists filled the gaps in their knowledge of human anatomy mostly with insights into animal bones and imagination. Their artworks, even though only 16 years apart, demonstrate substantial differences in the representation of the skeletons. The article argues that the history of medicine and of art could make good use of osteology and physical anthropology in attempts to define and understand how anatomical knowledge developed among pre‐Renaissance and post‐Renaissance artists and local people.
Biodiversity and evolutionary history: useful extensions of the PD phylogenetic diversity assessment framework
Authors: Faith Daniel P.
Published: June 2013

Evolutionary biology is a core discipline in biodiversity science. Evolutionary history or phylogeny provides one natural measure of biodiversity through the popular phylogenetic diversity (PD) measure. The evolutionary model underlying PD means that it can be interpreted as quantifying the relative feature diversity of sets of species. Quantifying feature diversity measures possible future uses and benefits or option values. Interpretation of PD as counting‐up features is the basis for an emerging broad family of PD calculations, of use to both biodiversity researchers and decision makers. Many of these calculations extend conventional species‐level indices to the features level. Useful PD calculations include PD complementarity and endemism, Hill and Valley numbers incorporating abundance, and PD dissimilarities. A flexible analysis framework is provided by expected PD calculations, applied to either probabilities of extinction or presence–absence. Practical extensions include phylogenetic risk analysis and measures of distinctiveness and endemism. These support the integration of phylogenetic diversity into biodiversity conservation and monitoring programs.
The effect of rocuronium and sugammadex on neuromuscular blockade in a child with congenital myotonic dystrophy type 1
Authors: Pickard Amelia , Lobo Clinton , Stoddart Peter A.
Published: June 2013

Myotonic dystrophy type 1 (MD1) is the commonest muscular dystrophy found in adults; however, it may present in the neonatal period with hypotonia, talipes, poor feeding, and respiratory failure. Inheritance is autosomal dominant with a defect in the DMPK gene found on the long arm of chromosome 19 with variable expansion of the cytosine–thymine–guanine (CTG) triplet repeat. A 14‐month‐old boy with congenital MD type 1 was scheduled for percutaneous endoscopic gastrostomy (PEG) insertion, orchidopexy, and division of tongue‐tie. Following induction of anesthesia, acceleromyography was used to monitor neuromuscular function. This revealed a very rapid onset of profound neuromuscular block which lasted significantly longer than would be expected in a child without MD1. Sugammadex reversed the block rapidly. The anesthetic management of children with MD1 has been well described but not the acceleromyographic monitored use of rocuronium and its subsequent reversal with the new cyclodextrin sugammadex.