bluuebunny/crossref_metadata_2025 huggingface dataset:
Turbine Blade Illusion
Authors: Mather George , Lee Rob
Published: May 2017

In January 2017, a large wind turbine blade was installed temporarily in a city square as a public artwork. At first sight, media photographs of the installation appeared to be fakes – the blade looks like it could not really be part of the scene. Close inspection of the object shows that its paradoxical visual appearance can be attributed to unconscious assumptions about object shape and light source direction.
Prevalence and clinical impact of vitamin D deficiency on abdominal tuberculosis
Authors: Sharma Vishal , Mandavdhare Harshal S. , Kumar Amit , Sharma Ravi , Sachdeva Naresh , Prasad Kaushal K. , Rana Surinder S.
Published: May 2017

Background:

Vitamin D is recognised to have multiple actions, including role in immune modulation. The prevalence and impact of vitamin D deficiency (VDD) in abdominal tuberculosis is unknown.

Methods:

We report the prevalence and clinical impact of VDD in patients with abdominal tuberculosis. The patients were divided into two groups: VDD (<20 ng/ml) or vitamin D sufficient (VDS) (⩾20 ng/ml). Groups were compared for extent (abdominal alone or extra-abdominal also) of disease and pattern of involvement (intestinal, peritoneal or both) and inflammatory response [serum C-reactive protein (CRP)].

Results:

Of 63 patients, 53 had complete data (mean age: 36.3 ± 14.43, 31 males). Fourty-five (84.9%) patients had VDD and mean VD levels were 11.1 ± 10.1 ng/ml. Of 8 patients with VDS, 1 (12.5%) had extra-abdominal involvement while 13 (28.9%) with VDD had extra-abdominal involvement ( p = 0.066). The mean CRP in patients with VDD was 42.9 ± 34.9 mg/dl vis-a-vis 105.38 ± 64.8 in VDS ( p ⩽ 0.05). All seven patients with both intestinal and peritoneal involvement had VDD.

Conclusion:

VDD is common in abdominal tuberculosis and may be associated with more extensive involvement albeit a reduced inflammatory response.
Developing and Applying a Framework for Assessing the Research Quality of Qualitative Project Methods in the EU Project SECUR-ED
Authors: Høyland Sindre A. , Hagen Janne M. , Engelbach Wolf
Published: May 2017

Qualitative research plays a vital role in political development and in the design of statutes and directives. Consequently, ensuring the quality of this research is important. However, the current literature on evaluation of quantitative and qualitative research does not reflect this importance, and we have identified a need to establish guidelines for evaluating qualitative research projects for quality. Therefore, and based on existing research, we have developed a framework for assessing the research quality of large complex projects using qualitative methods. In our study, as presented in this article, we operationalize and apply the framework to evaluate six specific methods in the large European research project, Secured Urban Transportation—A European Demonstration (SECUR-ED); each method is assessed according to the quality criteria of “transferability,” “systematic design/reliability,” and “transactional validity.” Overall, we find that half of the SECUR-ED project methods demonstrate thorough documentation and transferability, and that half of the methods lack consistent usage and therefore score low on both reliability and validity. We also find that one method, the capacity mapping matrix, scores high on all quality parameters. Accordingly, we suggest that future European Union (EU) projects replicate the documentation efforts demonstrated in relation to several of the SECUR-ED methods, and consider the capacity mapping matrix as “best practice” standard. We conclude that the framework represents a novel approach to quality assessments of qualitative project methods across research topics and contexts.
Changing the Subject: Adrienne Rich and the Poetics of Activist Pedagogy
Authors: Savonick Danica
Published: May 2017

This article examines Adrienne Rich’s teaching materials, writings on education, and participation in the Search for Education, Elevation, and Knowledge educational opportunity program in order to argue that poetry and pedagogy were interrelated means through which Rich sought to redistribute institutional power and resources. Although Rich’s poetry and essays have been widely praised for their contributions to feminism, little attention has been paid to the way she changed her life course, moving from Columbia to City College, to participate in one of the most visionary, controversial, and challenging educational experiments in the history of twentieth-century American higher education. Teaching students who were historically excluded from higher education catalyzed a major shift in Rich’s work: a move away from teaching traditional literary history toward the poetics of everyday life, and a related move away from hierarchical models of teaching and learning to a more collective, activist pedagogy, inspired by movements for women’s liberation, anti-imperialism, and black liberation and self-determination. The literary pedagogy that emerges from these classrooms explores how lives are shaped by metaphors, comparisons, erasures, elisions, and gaps, and how the elliptical, unsaid, implied, and occluded might be deployed, instead, to build a better present.
The Talking Book in the Secondary Classroom: Reading as a Promise of Freedom in the Era of Neoliberal Education Reform
Authors: Donnelly Andrew
Published: May 2017

This article contrasts the reading pedagogy inspired by the “talking book” and the reading pedagogy described by Frederick Douglass. The talking book offers literacy as a thing to be acquired that can be traded for freedom. “Literacy as a gift” inculcates in students a view of education as a commodity in the marketplace. This promise, education as a gift of freedom, fails—it fails to speak to students today, fails to remedy racial and gendered disparities, and fails by giving students tests to pass that fail to make them think. Douglass, by contrast, sees literacy and freedom as practices, learning to read not as a gift but as theft, and education not inculcating social values but orienting students to resist social structures that would oppress them.
Critical Educators and Active Citizens: Pedagogy and Critical Praxis
Authors: Brauer Stephen
Published: May 2017

This article argues that professors of American literature should focus on a pedagogy of “wakefulness” that encourages connections between different writers and texts, between the past and the present, and especially between the classroom and the world beyond. The goal of this pedagogy is to encourage active citizenry in engaging the material conditions of the current moment. This is especially valuable at nonelite institutions, such as mine, where students are not as aware of how knowledge is contingent and contested. Ultimately, this approach privileges metacognition and transferring learning from the course to action as a citizen. This pedagogy ultimately fosters a liberal education that explicitly links private study with public concerns and that encourages students to see themselves as potential agents of change in a neoliberal state that identifies them merely as consumers or tools of production.
New Criticism and Value in Taiwanese College English
Authors: Stewart David M.
Published: May 2017

The first part of this article identifies major problems facing college English in Taiwan, including declining enrollment, reduced funding, and widespread contingent hiring, linking them to similar problems associated with the humanities crisis in the United States. The second examines selected writing on these problems in the United States, including writing on pedagogy associated with the New Criticism, which until the 1990s was the main approach to literary studies in Taiwan. The third reflects on how commentary on English in the United States might apply in the Taiwanese context, with focus on the material value of an English degree and the potential expansion of the degree beyond the isolated major.
High and Mid Back Vowel Fronting in Washington, D.c.
Authors: Lee Sinae
Published: May 2017

While high and mid back vowel (/u/ and /o/) fronting has been examined in many North American regions, no study has systematically explored /u/ and /o/ fronting in Washington, D.C. This study investigates /u/ and /o/ fronting among european American and African American speakers native to D.C. A sociophonetic analysis of the speech of 40 D.C. residents shows that the district is participating in back vowel fronting as a community, with European American speakers exhibiting greater degrees of fronting than African Americans. Although lagging behind, D.C. African American speakers do move toward greater degrees of fronting in apparent time, particularly led by African American men. One factor that affects the speech of African Americans in D.C. is the speaker's neighborhood background, with African American speakers from the Southeast (Se) neighborhoods exhibiting different vocalic characteristics from those who are from elsewhere in the city. The study also provides preliminary evidence of /o/ backing among european American speakers, whose /u/ is fronting in apparent time. A reverse pattern of fronting is observed among African American speakers from Se, whose /u/ is not fronting, but /o/ is. These findings challenge the often-made assumption that /o/ fronting is a parallel process of /u/ fronting.
Remuneração variável aplicada à empresa John & Werner Contadores Associados
Authors: Breitenbach Renato , Gilioli Rosecler Maschio , Bencke Fernando Fantoni , Olea Pelayo Munhoz
Published: May 2017

O caso enfoca o papel da remuneração variável para estratégia de desenvolvimento de uma empresa de contabilidade. Discute o desafio de motivar os colaboradores a gerenciar novas contas com qualidade e interesse, por meio da elevação dos ganhos em termos de remuneração variável, por meio de um programa de participação nos resultados.
A diferença está no jeito de fazer
Authors: Caldas Eduardo de Lima , De Souza Patrícia Laczynski
Published: May 2017

Este caso descreve a visita da Secretária de Educação de uma cidade de porte médio, a duas Escolas Municipais de Ensino Fundamental (EMEFs). O objetivo das visitas é compreender a gestão da alimentação escolar. Cada escola tem uma merendeira: uma delas se queixa de grandes dificuldades de trabalho, enquanto a outra mostra sua rotina, problemas e soluções. O caso é sugerido para cursos de graduação ou especialização, em disciplinas relacionadas a modelos e processos de implementação de políticas públicas, governança das organizações públicas e gestão de recursos humanos.
As reviravoltas da adoção do valor simbólico no Grupo Cultural Olodum
Authors: Davel Eduardo , Neves Joyce Neri dos Reis
Published: May 2017

Este caso de ensino proporciona uma aprendizagem voltada para: (a) a identificação dos significados socioculturais de uma organização, (b) o entendimento de como a adoção de símbolos (com base em construção de parcerias) afeta a identidade organizacional e a gestão de seu valor simbólico e (c) a discussão dos desafios oriundos de uma gestão baseada na adoção de signos. O caso consiste na história de descobertas de Gabriel, estudante de administração que, ao estagiar no Grupo Cultural Olodum, conversa com várias pessoas estratégicas, pois vivenciaram momentos decisivos na história da organização. São momentos significativos que contam com a parceria de algumas celebridades no setor da música nacional e internacional. A cada entrevista, vamos conhecendo mais as virtudes e as reviravoltas inerentes ao processo de gestão do valor simbólico, sobretudo no que tange a adoção de signos.
Personal care plans and glycaemic control: the role of body mass index and physical activity
Authors: Umeh Kanayo
Published: May 2017

Background:

although body mass index (BMI) and physical activity are implicated in diabetes complications, it is unclear how these factors influence personalised care planning linked to glycaemic control. This study assessed the mediating effects of BMI and physical activity on relations between personalised care plans (PCPs) and glycated haemoglobin (HbA1c) levels, using population-based data.

Method:

Bootstrapping was used to analyse PCP, HbA1c, BMI, and physical activity data from 3894 respondents to the 2014 Health Survey for England, for whom HbA1c data were available, regardless of diabetes status. This group comprised 1812 (46.5%) males and 2082 (53.5%) females, aged 16 to 90 (mean=51.68 years, SD=17.25).

Results:

patients with a PCP had higher HbA1c levels compared with those without a care plan. BMI influenced this relationship among patients aged 40 to 60 years; those with a PCP and higher HbA1c also tended to have higher BMI values. Physical activity did not affect the relationship between PCPs and glycaemic control.

Conclusions:

BMI, but not physical activity, partly explained higher HbA1c levels in patients with a PCP. Given recent population-based evidence implicating exercise in diabetes complications, some debate is needed on the role of physical activity in personalised care planning and glycaemic control.
Interprofessional learning: benefits for healthcare teams and patients
Authors: Stone Ruth
Published: May 2017

Ruth Stone, a final-year student at the University of East Anglia, describes her experiences of attending conferences and workshops on interprofessional learning
Patient safety initiatives from around the world
Authors: Tingle John
Published: May 2017

John Tingle, Reader in Health Law at Nottingham Trent University, and Jen Minford, Junior Doctor Co-ordinator, Nottingham University Hospitals NHS Trust, discuss initiatives presented at a global summit on patient safety
Patient education and mind diversion in supportive care
Authors: Sadruddin Salima , Jan Rafat , Jabbar Adnan A , Nanji Kashmira , Tharani Ambreen
Published: May 2017

Cancer is a growing health problem worldwide. Common treatments include surgery, chemotherapy and radiation therapy. Systemic anti-cancer medications often result in an array of physical and psychological side effects. Supportive care assists patients with cancer in managing multidimensional symptoms that result from treatment or the illness itself. This review discusses supportive care and examines patient counselling and mind-diversion activities, which are safe and cost-effective strategies. Improving cancer patients' health and wellbeing should be encouraged in oncology nursing practice and by teaching students the knowledge and skills needed to provide supportive care.
Using QR codes to enable quick access to information in acute cancer care
Authors: Upton Joanne , Olsson-Brown Anna , Marshall Ernie , Sacco Joseph
Published: May 2017

Quick access to toxicity management information ensures timely access to steroids/immunosuppressive treatment for cancer patients experiencing immune-related adverse events, thus reducing length of hospital stays or avoiding hospital admission entirely. This article discusses a project to add a QR (quick response) code to a patient-held immunotherapy alert card. As QR code generation is free and the immunotherapy clinical management algorithms were already publicly available through the trust's clinical network website, the costs of integrating a QR code into the alert card, after printing, were low, while the potential benefits are numerous. Patient-held alert cards are widely used for patients receiving anti-cancer treatment, and this established standard of care has been modified to enable rapid access of information through the incorporation of a QR code.
Bias correction methods for dynamic panel data models with fixed effects
Authors: Abonazel Mohamed
Published: May 2017

This paper considers the estimation methods for dynamic panel data (DPD) models with fixed effects, which suggested in econometric literature, such as least squares (LS) and generalized method of moments (GMM). These methods obtain biased estimators for DPD models. The LS estimator is inconsistent when the time dimension (T) is short regardless of the cross-sectional dimension (N). Although consistent estimates can be obtained by GMM procedures, the inconsistent LS estimator has a relatively low variance and hence can lead to an estimator with lower root mean square error after the bias is removed. Therefore, we discuss in this paper the different methods to correct the bias of LS and GMM estimations. The analytical expressions for the asymptotic biases of the LS and GMM estimators have been presented for large N and finite T. Finally; we display new estimators that presented by Youssef and Abonazel [40] as more efficient estimators than the conventional estimators.
The Return of Curiosity: What Museums are Good For in the 21st Century (Thomas)
Authors: Kirker Jennifer
Published: May 2017

This work is a book review considering the title The Return of Curiosity: What Museums are Good For in the 21st Century by Nicholas Thomas.
Five-Kilometer Time Trial Reliability of a Nonmotorized Treadmill and Comparison of Physiological and Perceptual Responses vs. a Motorized Treadmill
Authors: Waldman Hunter S. , Heatherly Alex J. , Waddell Ashton F. , Krings Ben M. , O'Neal Eric K.
Published: May 2017

Waldman, HS, Heatherly, AJ, Waddell, AF, Krings, BM, and O'Neal, EK. Five-kilometer time trial reliability of a nonmotorized treadmill and comparison of physiological and perceptual responses vs. a motorized treadmill. J Strength Cond Res 32(5): 1455–1461, 2018—This study examined the reliability of running performance across 3 nonmotorized treadmill (NMT) 5-km time trials (TTs) and physiological, gait, and perceptual differences at a 5-km pace for both NMT and motorized treadmills (MTs). Ten male runners experienced in road racing who had never run on an NMT completed 3 TT to establish personal best 5-km pace. In a later session, participants ran at this pace for 5 minutes on the NMT while metabolic, gait, and perceptual measures were recorded and then ran at outdoor 5-km personal best pace on an MT at 1% grade (counter-balanced crossover design). Intraclass correlation (ICC = 0.95) between the TT1 and TT2 was strong but improved between TT2 and TT3 (ICC = 0.99) with considerable reduction in variability. Nonmotorized treadmill resulted in a 24% slower pace (10.6 ± 1.5 vs. 13.9 ± 2.6 km·h−1; p < 0.001), shorter stride length (1.02 ± 0.10 vs. 1.27 ± 0.18 m; p < 0.001), and decreased cadence (175 ± 12 vs. 181 ± 13 steps per·minute; p = 0.01). However, V̇o
2, respiratory exchange ratio (RER), lactate concentration, and heart rate did not differ between modalities (NMT = 3.4 ± 0.4 L·min−1, 0.96 ± 0.04, 6.9 ± 3.7 mmol, 172 ± 10 b·min−1; MT = 3.4 ± 0.5 L·min−1, 0.96 ± 0.04, 5.7 ± 3.4 mmol, 170 ± 10 b·min−1). rate of perceived exertion (RPE) for legs, breathing, and overall did not differ between treadmill types. A familiarization session should be included for TT using NMT. Other than gait and pace characteristics similar responses were elicited by both treadmills when running at 5-km pace. However, with these considerations, NMT TT of 4-km might be more appropriate in matching MT 5-km TT duration without altering physiological responses significantly.
Generator for electrotherapy and stimulation of human nerve centers
Authors: Babelyuk V. E. , Dobrovolskiy Yu. G. , Popovich I. L. , Korsunskiy I. G.
Published: May 2017

A generator for electrotherapy and stimulation of human VEB-1 nerve centers has been developed. The device's robots are based on stimulation of the patient by current pulses. Frequency beat method is used. The accuracy of maintaining the stimulation frequency is not more than 0.001 Hz. The carrier frequency of the working current pulses corresponds to the 32th harmonic of the frequency of the frequency pulse of the operating pulses. The clinical tests of the VEB-1 generator were carried out, showing the ego efficiency in twenty characteristic health indicators
Will intensification of beef production deliver conservation outcomes in the Brazilian Amazon?
Authors: Merry Frank , Soares-Filho Britaldo
Published: May 2017

The intensification of beef production has become a conservation target based on the idea of land sparing and the assumption that in order to contain deforestation and meet increasing beef demand we must increase productivity. There is also increasing attention and conservation credit being given to supply chain management in beef production. Based on a historical comparison between the US, a fully intensive system, and Brazil, one moving in that direction, we suggest that cattle ranching will intensify as a result of conservation investments (reductions in capital and land subsidies) rather than intensifying in order to produce conservation results. If the comparison holds, the new intensive system, however, will continue to require large natural resource inputs, government subsidies, and be plagued by social and conservation problems. It will also be held in thrall by a few large processing companies, which exert undue influence over both producers and consumers. Therefore, we suggest that closer attention be paid to attribution in the claim of conservation outcomes from intensive beef production.
Let's burn whatever you have: mitofusin 2 metabolically re‐wires brown adipose tissue
Authors: Scheideler Marcel , Herzig Stephan
Published: May 2017

Brown adipose tissue (BAT) has received enormous scientific and lay attention in the recent past as its thermogenic, energy‐consuming capacities represent prime candidates for therapeutic interventions toward obesity, glucose intolerance, and diabetes even in humans. The overall positive effects of BAT activation and recruitment on systemic energy homeostasis have been largely attributed to the inherent ability of brown adipocytes to combust fatty acid and glucose energy substrates through mitochondrial uncoupling, driven by the unique expression of uncoupling protein 1 (UCP1). Two recent reports by Boutant et al and Mahdaviani et al now identify the GTPase mitofusin (Mfn) 2 as a key determinant of BAT thermogenic function that is largely independent of its previously described role in mitochondrial fusion [1,2].
Native Books and the “English Book”
Authors: Adejunmobi Moradewun
Published: May 2017

Those of us working in the american academy have so internalized the grammar of postcolonial theory that we now take for grantedinterstices, hybridity, slippage, andliminality, among other terms commonplace in the discourse of postcolonialism. Beyond the terms themselves, we have taken to heart, absorbed, and extended the lessons from Homi K. Bhabha'sThe Location of Culture.Those lessons furnished a stimulative template for analyzing particular power asymmetries. Nevertheless, scholars have not referred as widely as we might expect to Bhabha's work in general andThe Location of Culturein particular, especially in some fields for which postcolonial theory was supposed to be a natural fit, such as African literary studies. The index ofAfrican Literature: An Anthology of Criticism and Theory, a 764-page compendium assembling many of the most important interventions in African literature from the 1970s to the early twenty-first century, is an instructive example: it lists only three entries for Bhabha (Olaniyan and Quayson). Given that postcolonial theory and African literary studies share an interest and a language (the aftermath of British colonialism and English) in their research agendas, we might also ponder the frequency with which postcolonial theory in the vein of Bhabha, Gayatri Chakravorty Spivak, and Edward Said has elicited critique from scholars working with African literary texts and in African studies writ large. Individual persuasion is at work in these critiques but so also undoubtedly are positionality and location. We should read the critiques, then, not for their universal resonance, but for an understanding of debates unfolding in specific locations around the world, as well as in relation to the subject positions of individual scholars and their ideological proclivities.
The World after Empire; or, Whither Postcoloniality?
Authors: Daiya Kavita
Published: May 2017

At the MLA'S annual convention in 2015, a roundtable i had organized, rememberingThe Location of Culture: circulations, Interventions, and Futurity, gathered scholars from across literary periods and fields to reflect on the legacies of Homi Bhabha's seminal work. As new disciplinary shifts in literary studies witness the reinvention of postcolonial literatures as global anglophone literatures, one of the questions that roundtable asked was, Whither postcoloniality? Returning toThe Location of Culture—one of the most influential texts in the fields of postcolonial studies and critical theory—can perhaps illuminate how postcolonial critique resonates anew for the literature of our world after empire.
“Man in the Anthropocene”: Max Frisch's Environmental History
Authors: Malkmus Bernhard
Published: May 2017

The aesthetic practices in Max Frisch's late storyDer Mensch erscheint im Holozän(Man in the Holocene[1979]) lend themselves to a reflection on the current global environmental crisis and its anthropological and epistemological repercussions. Frisch's visual and narrative artwork anticipates central issues in the current Anthropocene debate, in which the humanities have made incisive interventions. I bring these interventions to bear on close readings of Frisch's intermedia aesthetics, unearthing an environmental reflexivity that revolves around issues of time and history, place and identity, nature and human knowledge, metamorphosis and anthropogenic transformation. I thus invite us to reconsider in the light of the anthropological and sociopolitical imaginaries of the Anthropocene some ways in which the literature of the past half century has negotiated the relation between human beings and their natural environments.
Chloride transport in partially saturated cementitious material: influence of hydric state and binding chloride
Authors: Chalabi Hayet , Bezzar Abdelillah , Khelidj Abdelhafid
Published: May 2017

This study investigated the influence of saturation state on the ingress of chloride ions into a cementitious material. The chloride concentration profiles were determined experimentally for different degrees of saturation, while ensuring optimal contact between the material and saline solution. The experimental profiles were adjusted to a particular solution of Fick's law of diffusion to obtain the corresponding diffusion coefficient. The results showed that the transfer of chlorides depends on the saturation state. It was found that a decrease in moisture content from 97% to 76% led to higher chloride content in the material. Furthermore, for a hydric state with a relative humidity of 76%, the penetration depth of chloride ions was important while their binding to the cementitious matrix was low. This caused the concentration of free chlorides (harmful chlorides for construction) to be larger in the pore solution, meaning that the material was more vulnerable with regard to corrosion.
El nuevo multilateralismo frente al cambio climático: el alcance global y nacional del Acuerdo de París
Authors: Santiago Giannina , Lozano Ricardo
Published: May 2017

Con la adopción y vertiginosa entrada en vigor del Acuerdo de París sobre cambio climático se fortalece un nuevo multilateralismo que rompe con los esquemas tradicionales del derecho internacional ambiental. Este es el primer Tratado con una meta global que mantiene el incremento de la temperatura por debajo de los 2°C, comprometiendo a países desarrollados y en vías de desarrollo, mediante la implementación de un modelo de desarrollo bajo en emisiones y resiliente, que permite la satisfacción de las necesidades básicas, en particular para la población más vulnerable, la conservación de los ecosistemas estratégicos expuestos y el crecimiento sostenido de sectores productivos que cada vez demandan más recursos naturales. Este texto retoma los antecedentes y analiza el mapa al que el nuevo Tratado le apuesta para dar respuesta a la amenaza global del cambio climático.
Die rol van en beperkings op die regbank om sosiale vrede in Suid-Afrika te bevorder
Authors: Bertelsmann Eberhard
Published: May 2017

Judge Eberhard Bertelsmann of the North Gauteng High Court delivered the address published here as he delivered it in Afrikaans in the series of FW de Klerk lectures in Potchefstroom on 20 February 2012.  He dealt with the role of and limitations on the judiciary to promote social peace in South Africa, pointing out the achievements of the courts in the establishment of the constitutional dispensation over the past decades.  He however also showed that the courts are over-burdened and that court administration leaves much to be desired.  Litigants and practitioners do not hesitate to abuse the system and ugly incidents of unethical conduct have marred the professions.  Judges however do not take these trends lying down and measures to rectify the situation are well underway.  Fair, understandable, predictable and speedy adjudication without fear, favour or prejudice continues to be the contribution of judges to the protection of the South African democracy.
The interpretation of the amended RAF Act 56 of 1996 and the regulations thereto by the courts with regard to "serious injury" claims.
Authors: Steynberg Loma , Ahmed Raheel
Published: May 2017

The RAF Amendment Act 19 of 2005 came into effect on 1 August 2008 and sections 17(1) and 17(1A) introduced the concept of “serious injury”. This entails that a third-party claimant who wishes to claim compensation for non-patrimonial loss suffered after a motor-vehicle accident has to prove that his or her injury is “serious”. If the claimant’s injury is not considered “serious” no compensation will be awarded for the non-patrimonial loss suffered and, furthermore, the claimant will also not be entitled to claim any compensation from the wrongdoer in terms of common law (s 21 of the RAF Act). In a sequence of unreported cases the courts have provided guidelines on the procedure to be followed in serious-injury claims. Firstly, a claimant must submit himself or herself to an assessment by a medical practitioner registered under the Health Professions Act. Secondly, the medical practitioner must assess if the injuries sustained by the claimant fall within the list of “non-serious injuries”, and if so, compensation for non-patrimonial loss will not be awarded. If the injury is not on the list of non-serious injuries, the medical practitioner may assess the injuries and if they result in 30 per cent or more of whole-person impairment (“WPI”) compensation for non-patrimonial loss may be awarded. If the evaluation is that the 30 per cent of WPI cannot be reached, non-patrimonial loss may still be claimed if the injuries fall within the “narrative test”, namely (a) resulting in a serious long-term impairment or loss of a body function; (b) constituting permanent serious disfigurement; (c) resulting in severe long-term mental or severe long-term behavioural disturbance or disorder; or (d) resulting in the loss of a foetus. A plaintiff may use either of the two tests to establish serious injury and in such a manner qualify for compensation for non-patrimonial loss. A medical practitioner must complete and submit a serious-injury assessment report on the RAF 4. If the RAF is not satisfied that the injury has been correctly assessed they must (a) reject the serious-injury assessment report within 60 days and furnish reasons for the rejection; or (b) direct that the third party submit himself or herself, at the cost of the Fund, to a further assessment. Thereafter the RAF must either accept the further assessment or dispute the further assessment within 90 days. An Appeal Tribunal, consisting of three independent medical practitioners, has been created to hear these disputes.
Challenges confronting health care workers in government's ARV rollout: rights and responsibilities
Authors: Vawda Yousuf A , Variawa Farhana
Published: May 2017

South Africa is renowned for having a progressive Constitution with strong protection of human rights, including protection for persons using the public health system. While significant recent discourse and jurisprudence have focused on the rights of patients, the situation and rights of providers of health care services have not been adequately ventilated. This paper attempts to foreground the position of the human resources personnel located at the centre of the roll-out of the government's ambitious programme of anti-retroviral (ARV) therapy.

 

The HIV/AIDS epidemic represents a major public health crisis in our country and, inasmuch as various critical policies and programmes have been devised in response, the key to a successful outcome lies in the hands of the health care professionals tasked with implementing such strategies. Often pilloried by the public, our health care workers (HCWs) face an almost Herculean task of turning the tide on the epidemic. Unless the rights of HCWs are recognised and their needs adequately addressed, the best laid plans of government will be at risk.

 

This contribution attempts to identify and analyse the critical challenges confronting HCWs at the coalface of the HIV/AIDS treatment programme, in particular the extent to which their own rights are under threat, and offers recommendations to remedy the situation in order to ensure the successful realisation of the ARV rollout.
Accessible transportation and mobility issues of elderly — how does Australia compare with Japan?
Authors: Somenahalli Sekhar , Hayashi Yoshitsugu , Taylor Michael , Akiyama Tetsuo , Adair Timothy , Sawada Daisuke
Published: May 2017

Accessible transportation is a key aspect of independent living. As the impact of population ageing on future transport systems is expected to be increasingly felt over the next few decades in a number of countries, including Australia and Japan, it is logical to recognise the importance of formulating appropriate transport policies in ageing societies. However, few studies in Australia have focussed on this issue as most of them have been devoted to the physical dimensions of health. This paper is based on a recent survey of older South Australians and a series of in-depth discussions conducted with key stakeholders both in Australia and Japan, conducted by the principal author. This paper highlights the accessible transportation and mobility issues in Australia’s ageing society by shedding light on some of the important policies and laws prevailing in Japan, which have already reached the proportion of the older population that Australia is projected to be 10 years from now. Our findings would provide answers and new approaches into the challenges from a policy and legislative perspective to help formulate recommendations for the stakeholders.
To study pattern of obstetric cases referred at tertiary care centre in Central India
Authors: Goswami Prakriti , Bindal Jyoti , Chug Niketa
Published: May 2017

Background: Maternal morbidity and mortality remains a major challenge to health systems worldwide. Referral services for identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness of referral are challenge to obstetricians, since delay in referral affects maternal outcome adversely, hence the identification of at risk patients and obstetric emergencies and their timely referral is of immense importance. The aim of this study was to review the pattern of obstetric cases referred to tertiary care centre, to identify their clinical course, mode of delivery and maternal outcomes.Methods: It was prospective observational study carried out from January 2015 to July 2016. Study population was all Obstetrics patients referred to Department of Obstetrics and Gynecology of Kamla Raja Hospital, G.R. Medical College, Gwalior, Madhya Pradesh, a tertiary care centre during the study period.Results: The total number of referred cases in above study period was 4085.The proportion of referred cases in the tertiary care hospital was 20.86%. Mode of transport used by the referred patients were hospital ambulances (38%) and private vehicles (62%). Most common diagnosis at the time of referral was anaemia (27.8%). Out of the total referred cases, 48% had vaginal delivery (either spontaneous or induced), 28% had caesarean section and 24% were managed conservatively. Hypertensive disorders (25.4%) constitutes the leading cause of maternal deaths amongst the referred cases.Conclusions: Peripheral health care system needs to be strengthened and practice of early referral needs to be implemented for better maternal outcome.
A study of maternal near miss cases at tertiary medical college of Jharkhand, India
Authors: Kamal Samarina , Roy Priyankur , Singh Shashibala , Minz Jacinta
Published: May 2017

Background: Maternal near miss is said to have occurred when women presented with life threatening complication during pregnancy, child birth and within 42 days after delivery, but survive by chance or good institutional care. For identifying near-miss cases five-factor scoring system was used. In 2009 WHO working group has standardized the criteria for selecting these cases.Methods: The study was conducted in the Department of Obstetrics and Gynecology at RIMS, Ranchi, Jharkhand, India, which is a tertiary care centre. For each case of near miss, data were collected on demographic characteristics including gestational age at the time of sustaining the near-miss morbidity, nature of obstetric complications, presence of organ-system dysfunction/failure, ICU admission and timing of near-miss event with respect to admission.Results: During the twenty-four months of the study period, 20000 deliveries at the institution and 480 women were identified as near-miss obstetrical cases by five factor scoring system. The prevalence of near-miss case in this study was 2.4%. Near-miss per 1000 delivery was 24%. Maternal death to near miss ratio was 1:7.2. The leading causes of maternal near miss were hemorrhage (42.5%) and hypertensive disorder of pregnancy (23.5%) The morbidity was high in unbooked cases.Conclusions: Maternal near miss is good alternative indicator of health care system.
Efficacy and safety of the trans-obturator tape for female stress urinary incontinence
Authors: Roy Priyankur , Biswas Bivas , Hokabaj Shaheen , Garg Ruchika , S. Sujatha M.
Published: May 2017

Background: To assess the safety and efficacy of Trans-obturator tape (TVT-O) for female stress urinary incontinence (SUI).Methods: A cohort of 35 cases of SUI and underwent TVT-O procedure over a period of 4 years. Pre-operative evaluation included pelvic examination, one hour pad test, urodynamic study, urinary diary and baseline haematological tests. Post-operatively all women had post-void residual volume and were followed up for 3 years.Results: The mean age of the patients was 47±9.5 years. TVT-O alone was done in 58.1% of cases. 41.9% of cases had TVT-O done as a concomitant procedure. The median duration of follow-up was 48 months. The overall objective and subjective cure rate was 92.3% with failure rate of 7.7%, 12.9% of women reported post-operative thigh pain and 6.5% patients had immediate post-operative urinary retention. 16.1% of the patients had post-operative voiding dysfunction. No major complications were encountered in these patients.Conclusions: TVT-O is a safe, easy and effective minimally invasive procedure for female SUI with minimal acceptable complications.
A prospective study to evaluate the efficacy of 11-13+6 weeks anatomy scan in detecting fetal structural anomalies compared to traditional 18-22 weeks scan
Authors: Elamaran Elavarasi , Daniel Saley , A. N. Regi George
Published: May 2017

Background: Congenital anomalies are one of the leading causes of infant mortality. Traditional TIFFA scan done at 18-22 weeks leads to delay in diagnosis, referral and management. With high resolution ultrasound and TVS probe, normal and abnormal fetal anatomy could be visualized in early gestation with good accuracy. Objective of present study was to evaluate the efficacy of 11-13+6 weeks anatomy scan in detecting fetal structural anomalies compared to traditional 18 -22weeks scan and in visualizing the complete normal fetal anatomyMethods: An Observational study of 300 antenatal patients at Jubilee Mission Medical College for 1 year (Jan-Dec2014) was done. The scan was performed at 11-13+6 weeks by TAS first, if a full fetal anatomy survey not achieved, TVS added. A mid-trimester fetal anatomy scan was then performed in patients who had not dropped out, miscarried or undergone pregnancy termination at 18-22weeks.Results: The incidence of anomalies in our study was 3.67% -11 cases; 9 detected at 11-13+6 weeks, 2 were newly detected at 18-22 weeks. At 11-13+6 weeks anatomy scan, the detection rate of anomalies was 81.8% and complete fetal anatomy survey was achieved in 92%. Heart and kidneys were not properly visualized in 4% and 12.7%, at 11‐13+6 weeks compared with 0.7% and 0% at 18‐22 weeks.Conclusions: The 11-13+6 weeks anatomy scan is an important diagnostic tool which is underutilized and should be offered to all women as a routine standard of antenatal care. However as fetal anomalies can present at varying gestational age, standard 18-22 weeks anatomy scan cannot be abandoned.
LDH as a prognostic marker in hypertensive pregnancy
Authors: Talwar Prathap , Kondareddy Triveni , C. A. Pranidha Shree
Published: May 2017

Background: Pregnancy induced hypertension (PIH) is a global problem with a 5-15% incidence rate in India and complicating 10-17% of all pregnancies. These are multisystem disorders and lead to a lot of cellular death. LDH is an intracellular enzyme and its level is increased in these women due to cellular death. So, serum LDH levels can be used to assess the extent of cellular death and thereby the severity of disease in this group of women. The objective of the study was to correlate the severity of the disease, maternal and perinatal outcome with Lactic Dehydrogenase (LDH) levels in serum in patients of preeclampsia and eclampsia.Methods: A prospective comparative study was conducted in the department of Obstetrics and Gynecology, JSS Medical Hospital, Mysore.Results: LDH levels were significantly elevated in women with preeclampsia and eclampsia (<0.001). Higher LDH levels had significant correlation with high blood pressure (P <0.10) as well as poor maternal and perinatal outcome.Conclusions: High serum LDH levels correlate well with the severity of the disease and poor outcomes in patients of preeclampsia and eclampsia.
Evaluation of transverse cerebellar diameter to abdominal circumference ratio in prediction of intrauterine growth retardation
Authors: Mourya Saroj , Mourya Harish K. , Makwana Mohan , Gahlot Hanslata , Verma Suresh , Sharma Seema
Published: May 2017

Background: Intrauterine growth restriction accounts for a significant increase in perinatal mortality rate as well as immediate neonatal morbidity and continuing long term disability in some of the survivors. A different clinical problem develops in infants of same weight but different gestational age therefore identification of high risk newborns based on gestational age and weight. Hence without an accurate knowledge of gestational age, the clinician is significant hampered in an attempt to differentiate truly growth restricted fetus from a patient with incorrect gestational parameters. TCD is emerging as a new sonografic parameter and least affected by fetal growth restriction while liver is most affected organ.Methods: The patients were sonographically examined for TCD/AC ratio. The best cut-off value of TCD/AC ratio in predicting IUGR was determined by a receiver operating characteristic (ROC) curve. The fetus with a TCD/AC ratio greater than the cut-off value would be antenatally diagnosed as IUGR for every gestational week. Standard definition of IUGR was a low birth weight, less than the 10th percentile.Results: Eighty pregnancies with suspected IUGR were analyzed. The prevalence of IUGR among the study group was 51.5%. The best cut-off value of the TCD/AC ratio for predicting IUGR was 15.87%, giving the sensitivity, specificity, positive predictive value and negative predictive value of 81.25%, 62.25%, 89.65%, and 45.45%, respectively.Conclusions: The sonographic fetal TCD/AC ratio as a gestational age-independent, useful, feasible and sensitive method for antenatal diagnosis of IUGR, especially in pregnancy with uncertain gestational age. Routine TCD/AC ratio should be performed to diagnose IUGR.
Early sonographic markers and prediction of pregnancy outcome: a prospective study
Authors: Bamniya Jaishree , Panchal Divyesh , Singh Pooja , Shah Ami , Ladola Harshad
Published: May 2017

Background: The objective of the study was to examines the pregnancy outcome in patients with early sonography markers and study design was a prospective study.Methods: This prospective study was conducted at Department of Obstetrics and Gynaecology, GCS Medical College, Ahmedabad, Gujarat, India from Feb 2012 to August 2016. Total of 612 Women with early pregnancy were included in the study that fulfilled the inclusion criterias. After first sonography examination patients were assigned to the control group and study group. Patients were followed up for outcome.14 pateients were lost to follow up.Results: The incidence of pregnancy loss was highest with Large yolk sac i.e 78.57%, followed by loss with Bradycardia (38%), Tachycardia (15.78%) and Smaller than normal G Sac to be 14.28%. As compared to control which had pregnancy loss of only 7.7%. Incidence of other complications like IUGR, PIH were also increased in patients with abnormal early sonography markers up to 33%.Conclusions: T Transvaginal sonography should be used adequately to look for early pregnancy markers like Size of Gestational sac, size and shape of yolk sac, fetal heart rate and in cases of threatened abortion presence of subchorionic haematoma and its size because all these markers are good predictors of pragnacy outcome and can prove helpful in patient counseling.
A study on HPV mRNA test and colposcopy in HIV positive women for early detection of cervical intraepithelial lesions
Authors: Singh Kavita N. , Achale Sheetal , Ghanghoriya Vineeta
Published: May 2017

Background: Sexually transmitted infections (STIs) have a profound impact on sexual and reproductive health worldwide. At any point of time, globally more than 290 million women suffer from HPV infection, one of the most common STIs. There are only few studies from India reported regarding the prevalence of HPV and cervical abnormalities among HIV-positive women. This study was carried out to estimate the prevalence of HPV and other genital tract infection in HIV positive women and correlate HPV mRNA test and colposcopic findings with cyto-histopathology in HIV positive women who are not on antiretroviral therapy (ART). Secondary objective was to benefit HIV positive women by making them aware about the importance of screening, early detection and treatment of various lower genital tract infections, CIN and cancer cervix.Methods: cross sectional observational study was conducted in department of Obstetrics and Gynecology, NSCB medical college Jabalpur (M.P.) from March 2015 to August 2016 on 70 HIV positive women in whom anti-retroviral therapy was not started. This study was approved by institutional ethical committee. The data was recorded in predesign coded case report form and statistical analysis was performed using the STATA 12.1.Results: In the present study, prevalence of lower genital tract infections in HIV positive women not on ART was 30.0% and the prevalence of high risk HPV was 5.9%.Conclusions: The study concludes that diagnostic efficacy of HPV mRNA test has similar diagnostic value as that of histopathology report.